Ko te āhuatanga ohorere tino morearea o te mate huka: Kei te mōhio koe ki te HHS? (Hyperosmolar Hyperglycemic State)

He mate huka tōu? He mate huka rānei tōu whaea, tōu pāpā, tōu whānau rānei? He mea nui tēnei kaupapa e kōrerohia nei e tātou i tēnei rā ki a koe. He mate ka taea te whakahaere tika i te mate huka, ā, ka taea e koe te noho noa i te ao. Heoi, ki te kore e whakahaeretia tika, ka taea e ia te arahi ki ngā āhuatanga ohorere nui ka taea te whakararu i te ora. Koinei te āhuatanga ohorere tino morearea e kōrerohia nei e tātou i tēnei rā. Ka kiia tēnei ko te Hyperosmolar Hyperglycemic State , e kiia nei e tātou ko te HHS .

He aha te HHS?

Āe, me whakamāmā noa iho tēnei. Whakaarohia te nui rawa o te huka i roto i tō toto (te huka toto) kāore e taea te whakahaere. Ina neke ake te taumata huka i te 180 mg/dL, me whakaputa e ō tātou whatukuhu taua huka nui ki roto i te mimi. Engari kāore tēnei huka e puta noa mai, engari ka tangohia hoki te wai utu nui o te tinana.

Nā, he aha te mea ka tupu mēnā ka eke te taumata huka toto ki te taumata tino tiketike, pērā i te 600 mg/dL, ā, ka noho pērā tonu mō ngā rā, mō ngā wiki pea? Ka tīmata koe ki te mimi nui rawa, ā, ka tino maroke tō tinana. I te hekenga o te nui o te wai i roto i tō tinana, ka mātotoru haere tō toto. Pērā i te wā e hanga ana tātou i te honi, ka mātotoru te wai. I roto i ngā kupu hauora, ka kiia tēnei ko te mātotorutanga o te toto hyperosmolarity .

Nō reira, he āhuatanga ohorere morearea te HHS e puta ana ina honoa ēnei āhuatanga e toru: te taumata huka toto tino teitei (hyperglycemia) , te matewai nui , me te hyperosmolarity. Ko te nuinga o tēnei āhuatanga ka kitea i roto i te hunga e pangia ana e te Mate Huka Momo 2. He āhuatanga tēnei e hiahia ana kia haria ki te hōhipera me te rongoā tonu. Ki te kore e rongoatia, ka mate pea.

HHS me DKA: He aha te rerekētanga i waenganui i ngā mea e rua?

Ko tētahi atu āhuatanga ohorere mōrearea ka pā ki te hunga mate huka ko te DKA (Diabetic Ketoacidosis). Ahakoa he mate morearea te HHS me te DKA nā te huka toto tiketike, he mārama ngā rerekētanga i waenganui i ngā mea e rua. He mea nui kia mōhio ki tēnei rerekētanga.

• DKA (Ketoacidosis Mate Huka): Ko te nuinga o tēnei ka pā ki te hunga mate huka momo 1. Ko te mea e tupu ana i konei, tata kore he homoni insulin i roto i te tinana. Nā te kore o te insulin, kāore e taea e ngā pūtau o te tinana te whakamahi i te huka hei hanga pūngao. Kātahi ka haere te tinana ki tētahi atu huarahi ki te kimi pūngao. Arā, mā te tahu i te ngako i roto i te tinana. Ina tahuna te ngako i tēnei ara, ka tāpirihia he matū e kiia nei ko ngā ketone ki te toto hei hua taha. He waikawa ēnei ketone. Ina piki ake ngā ketone i roto i te toto, ka waikawa te toto. Koinei te mea tino morearea mō te DKA.

• HHS (Āhua Hyperosmolar Hyperglycemic):Ko te nuinga o tēnei ka pā ki te hunga mate huka momo 2. I konei, he nui te insulin i roto i te tinana. Nā te iti o te insulin, ka tahuna e te tinana te ngako, ā, ka ārai i te hanganga o ngā ketone. Nō reira, kāore te toto e waikawa i roto i te HHS. Engari ko te raruraru matua i konei ko te pikinga kore e taea te whakahaere o ngā taumata huka me te matewai nui me te matotoru o te toto e puta mai ana.

Me titiro tātou ki tēnei ripanga hei whakamārama ake i tēnei rerekētanga.

He aha ngā tohu o te HHS? Kia tūpato ki ēnei!

Ko te mea tino mōrearea mō te HHS ko te kore e puta katoa ngā tohu i te wā kotahi . Ka āta puta haere, i roto i ngā rā, i ngā wiki rānei. Nō reira, kāore pea te tangata e mōhio kia tino kino rawa atu. Koia te mea nui kia mōhio ki ēnei tohu.

• Te taumata huka toto tino tiketike: He mita huka toto kāinga he nui ake i te 600 mg/dL (33 mmol/L rānei).
• Pōhēhē hinengaro: Ngaronga o te māramatanga, te kore e taea te arotahi, te pōhēhē kōrero, te ngaronga o te wā, te wāhi, me ngā tāngata e mōhiotia ana.
• Te kitenga, te rongo rānei i ngā mea kāore i reira (Whakaaroaro Hāunga): Ka taea te kī kei te kite, kei te rongo rānei koe i ngā mea kāore i reira.
• Te ngaronga o te māramatanga: I ngā wā tino kino, ka pā mai pea te koma.
• Waha maroke, arero maroke, me te matewai nui: He āhua matewai e kore e memeha ahakoa te nui o te wai e inuhia ana.
• Te mimi pinepine: Ahakoa ka nui rawa tō mimi i te tīmatanga, ka iti ake pea tō mimi ina nui haere te matewai.
• Te tirohanga pōuri, te ngaro rānei o te tirohanga: Ka pōuri haere pea te tirohanga.
• Ngoikore o te tinana: He ngoikore te tinana. I ētahi wā ka pararutiki tetahi taha o te tinana, me te mea kua pāngia e te whiu.

He aha i puta ai tēnei āhuatanga HHS? He aha ngā tino take?

He iti ake te tūponotanga ka pāngia te tangata e te mate huka e whakahaeretia pai ana e te HHS. Heoi, mō te tangata kāore i te whakahaeretia pai tana mate huka, ka puta pea tēnei āhuatanga nā te "mea whakaoho". Arā, ka taea e tētahi huihuinga te whakanui rawa i ngā taumata huka toto kāore e taea e rātou te whakahaere, ka arahi ki te HHS.

Ko ngā mea matua e whakaoho ana i te HHS ko:

• Ngā Mate Pukupuku: 50% ki te 60% o te hunga e pāngia ana e te HHS he mate pukupuku kei a rātou. Tērā pea ko te niumōnia , ngā mate pukupuku o te ara mimi (UTI ), me te sepsis .) ko ngā mate urutā ngā mea matua. Whakaarohia, he whaea kaumātua e mate huka ana, ka pāngia ia e te mate uma me te nui o te hūpē. Ko te ahotea i puta mai i tēnei mate urutā ka piki ake te taumata huka toto ki tētahi taumata e kore e taea te whakahaere.
• Te kore e tango i tō rongoā mate huka e ai ki te whakahaunga: He take tino noa hoki tēnei. Ka hoha ētahi tāngata, ka mutu te tango i ā rātou rongoā, kāore rānei e tango i te wā tika. Ki te tango koe i te insulin, ki te kore e tangohia tika, ka tino teitei rawa ngā taumata huka toto.
• Ētahi atu rongoā: Ko ētahi rongoā, pērā i te corticosteroids (e whakamahia ana hei rongoā i te mate huango me te mate rumatiki), ngā diuretics thiazide (e whakamahia ana hei rongoā i te toto toto tiketike), me ētahi rongoā mō te mate hinengaro, ka piki ake te huka toto me te HHS.
• Ngā āhuatanga ohorere o te ngākau: I roto i tētahi āhuatanga nui pērā i te whiu , te mate ngākau , te mate pūkahukahu rānei, kei raro te tinana i te ahotea nui. Ka taea e ngā homoni ahotea e tukuna ana e te tinana i tēnei wā te piki ohorere o ngā taumata huka toto.

Ko wai kei te mōrearea nui ake ki te whakawhanake i te HHS?

E ai ki te kōrero i mua ake nei, he iti tēnei mōrearea mēnā he pai te whakahaere i te mate huka. Heoi, ko ēnei tāngata e whai ake nei he nui ake te mōrearea ki te whakawhanake i te HHS:

• Ngā tāngata kāore e taea te whakahaere pai i te mate huka.
• Ngā pakeke neke atu i te 65 tau te pakeke: I a rātou e pakeke haere ana, ka heke pea tō rātou kaha ki te rongo i te matewai, nō reira kāore pea rātou e mōhio kua maroke rātou.
• Te hunga whai mate kē atu (mate pāwera, mate puku), mate manawa rānei.

He aha ngā raruraru ka puta mai i te HHS?

Ki te kore e rongoatia te HHS i te wā tika, ka ara ake pea he raruraru tino kino.

• Ngā mate hopuhopu
• Koma
• Te ngoikore o te okana
• Mate

E 10% ki te 20% o te hunga e pāngia ana e te HHS ka mate. Ko te tikanga, kotahi, e rua rānei i roto i te 10 tāngata ka mate. Koinei te kino o tēnei mate.

Me pēhea te tātaritanga me te rongoā i te HHS i te hōhipera?

Ina whakaurua koe ki te Tari Whawhati Tata (ETU), ka tirohia koe e te tākuta, ka pātai atu mō ō tohumate. Kātahi ka whakaritea e rātou ētahi whakamātautau toto. Mā ēnei ka tirohia tō taumata huka toto , te osmolality toto, te mahi a te whatukuhu, me te mea kei roto i ō toto ngā ketone.

Mena he nui ake te taumata huka toto i te 600 mg/dL, ā, he iti hoki te taumata ketone i roto i te toto, ka whakatauhia he HHS.

Ko te maimoatanga ko te pupuri i a koe i roto i te wāhanga tiaki nui (ICU) me te hoatu wai ki a koe.

E toru ngā whāinga matua o te maimoatanga:

1. Whakaora wai: Ka hoatu te tote mā roto i te uaua hei whakakore i te matewai.

2. Te Whakataurite i ngā Irahiko: I te matewai, ka ngaro te nuinga o ngā kohuke whai hua pēnei i te pāhare pāporo i te tinana. Ka whakakapia ēnei mā te tote.

3. Te whakahaere i ngā taumata huka toto: Ka tukuna te insulin mā roto i te uaua hei whakaheke mārire, hei whakahaere hoki i ngā taumata huka toto.

Haunga ēnei maimoatanga, mēnā he mate kei raro i te pūtake o te mate HHS, ka rongoatia anō hoki tēnā.

Ka taea te puta he raruraru i te wā e rongoatia ana?

Āe, ahakoa he tino onge, ka puta pea ngā raruraru mai i te maimoatanga. Arā, ki te whakahekehia ohoreretia ngā taumata huka toto, ka taea e ngā pūtau roro te kī tonu i te wai, ā, ka pupuhi te roro (edema roro). Engari he tino onge tēnei. E mōhio ana ngā tākuta me pēhea te whakaheke i ngā taumata huka toto me te haumaru, me te āta haere. Nō reira, kāore he take e manukanuka ai.

Me pēhea te tiaki i a koe mai i te HHS?

Ko te huarahi pai rawa atu, ko te huarahi anake hoki hei karo i tēnei āhuatanga morearea, ko te whakahaere pai i tō mate huka. Hei whakatutuki i tēnei, kia tino mahia ēnei mea.

• Tirohia tonutia ō taumata huka toto, me te ngana kia mau tonu i roto i te awhe ūnga kua tohua e tō tākuta.
• Tangohia te rongoā (pire, insulin rānei) i tohua e tō tākuta i te wā tika me te horopeta tika, kaua e mahue tetahi rā.
• Mena kei te uaua koe ki te whakahaere i tō mate huka, kōrero ki tō tākuta mō tēnei mea, kia whiwhi ai koe i ngā tohutohu e tika ana.
• Whāia he kai hauora e pai ana ki a koe.
• Kia tino tupato mēnā kei te pāngia koe e te mate pēnei i te makariri, te rewharewha rānei. Inuhia he nui te wai, kia nui te okiokinga, ā, tirohia tō huka toto i ngā wā katoa. Nā te mea ka piki ake te huka toto i te taumahatanga o tō tinana i a koe e mate ana.
• Kia tūpato ki ngā tohu o te HHS. Ki te kite koe i tētahi o ēnei tohu, me mahi tonu.