Unoitei kana munhu ane chirwere cheshuga akangoerekana arasikirwa nepfungwa uye asingakwanise kumutswa zvisinei nekuti unotaura naye zvakadini? Izvi zvinotyisa chaizvo. Uku kurara, chimwe chezvinetso zvine njodzi zvechirwere cheshuga. Kutaura chokwadi, imamiriro ekushaya pfungwa anoita kuti munhu arara hope dzakadzika. Izvi zvinotoisa hupenyu panjodzi. Asi kana ukanyatsoziviswa, unogona kudzivirira mamiriro ezvinhu aya uye kutoponesa hupenyu hwemumwe munhu. Saka ngatitaurei nezvazvo nhasi.
Chii chinonzi diabetic coma iyi?
Zvichitaurwa zviri nyore, kana munhu ane chirwere cheshuga aine huwandu hweshuga muropa husingadzoreki (hyperglycemia) kana huwandu hweshuga muropa hushoma (hypoglycemia) , zvinogona kukanganisa mashandiro europi zvoita kuti munhu arasikirwe nepfungwa. Izvi zvinonzi diabetic coma. Ichi chirwere chakakomba chinoda kurapwa nekukurumidza.
Rudzi urwu rwekoma runogona kukonzerwa nezvirwere zvikuru zvitatu zvine chekuita nechirwere cheshuga.
1. Diabetic Ketoacidosis (DKA): Izvi zvinoitika kana ma ketone, rudzi rweasidhi, achiwedzera muropa, zvichiita kuti ropa rive neasidhi.
2. Hyperosmolar Hyperglycemic State (HHS): Ichi chirwere apo huwandu hweshuga muropa hunokwira zvakanyanya uye muviri unoshaya mvura mumuviri zvakanyanya.
3. Kushaya simba rakakwana mumuviri: Apa ndipo apo huwandu hweglucose inopa simba kuuropi hunoderera zvikuru, zvichiita kuti mashandiro europi amire.
Chinhu chakakosha ndechekuti kana ukaona munhu akadai, unofanira kufonera amburenzi ye1990 nekukasika woenda naye kuEmergency Treatment Unit (ETU) yechipatara .
Ngatitarisei zvikonzero zvitatu zvikuru zvinokonzera coma zvakadzama.
Zvakakosha kuziva zvishoma nezvezvirwere zvitatu izvi, nekuti kuziva zviratidzo zvechirwere chimwe nechimwe nekukurumidza kunogona kudzivirira kuti vasapfuurire pakoma.
1. Chirwere cheshuga chinonzi ketoacidosis (DKA)
Dambudziko iri rinowanzoitika kuvanhu vane chirwere cheshuga cherudzi rwekutanga , asi dzimwe nguva rinogona kuitika kune vanhu vane chirwere cheshuga cherudzi rwechipiri.
Zviri nyore: Homoni inonzi insulin inokosha kuti masero emuviri wedu awane glucose (shuga) kuti awane simba. MuDKA, muviri hauna insulin yakakwana. Zvadaro, nekuti masero haakwanise kuwana glucose, muviri unotanga kupisa mafuta awo kuti uwane simba. Kana mafuta aya apiswa , ma ketone anogadzirwa semugumisiro.Kemikari inonzi ma ketone inoungana muropa. Ma ketone aya rudzi rweasidhi. Kana aungana muropa, ropa rinova acidic. Izvi zvinonzi DKA. Kana chirwere ichi chikasarapwa nekukurumidza, unogona kupinda mukoma.
Kazhinji, DKA chirwere apo huwandu hweshuga muropa huri pamusoro pe250 mg/dL . Asi yeuka, chikonzero chikuru cheDKA hachisi shuga yakawandisa chete, asiwo kushaikwa kweinsulin uye kuwedzera kwemaketones.
2. Hyperosmolar hyperglycemic state (HHS)
Izvi zvinonyanya kuitika kuvanhu vane chirwere cheshuga cherudzi rwechipiri . Apa ndipo apo huwandu hweshuga muropa hunokwira zvisingadzoreki (kazhinji hunopfuura 600 mg/dL ). Kana izvi zvikaitika, muviri unoedza kubvisa shuga yakawandisa muweti. Panguva imwe chete, mvura yakawanda inorasika mumuviri, zvichikonzera kupera mvura mumuviri zvakanyanya . Izvi zvinogona kukanganisa uropi, zvichikonzera kurasikirwa nepfungwa, uye kana zvikasarapwa, zvinogona kukonzera coma.
3. Kuwanda kweshuga yeropa (hypoglycemia)
Apa ndipo apo huwandu hweshuga muropa hunodzikira kusvika padanho rakaderera, kazhinji pasi pe40 mg/dL . Izvi zvine njodziwo zvikuru muhupenyu.
Glucose ndiyo inonyanya kupa simba kumiviri yedu, kunyanya uropi. Kana pasina glucose muropa, uropi hunorasikirwa nekugona kwahwo kushanda. Sezvinoita injini yemotokari painomira kana yapera mafuta, uropi hunogona "kudzima" hwobva hwaita coma. Dambudziko iri rinowanzoitika kuvanhu vanotora majekiseni e insulin kana mamwe marudzi emishonga yeshuga (semuenzaniso, sulfonylureas).
Zviratidzo zvekunyevera usati wapinda mukoma
Munhu haangoerekana apinda mukoma. Muviri wake usati watanga, unoratidza zviratidzo zvakawanda zvekunyevera. Chinhu chakakosha ndechekuziva zviratidzo izvi nekukurumidza. Ngatitarisei zviratidzo zvine chekuita nemamiriro ezvinhu aya matatu zvakasiyana.
| Chirwere cheshuga (DKA) | HHS (Hyperglycemia uye kupera mvura mumuviri) | Hypoglycemia yakanyanya |
|---|---|---|
| Kusvotwa nekurutsa | Kupera mvura mumuviri zvakanyanya (muromo wakaoma, rurimi) | Kuona kusina kujeka |
| Marwadzo emudumbu | Nyota yakawandisa (polydipsia) | Kuoma kutaura (kukambaira) |
| Kuwedzera kwekufema (kufema kweKussmaul) | Kuita weti kakawanda | Kurasikirwa nekuenzana, kurasikirwa nekubatana |
| Kunhuhwirira kwemichero pakufema | Kurasikirwa nepfungwa, kuona zvinhu zvisipo | Kudedera uye pfari |
| Kuneta kwakanyanya uye kushaya simba | Kurasikirwa nepfungwa kune rumwe rutivi rwemuviri | Hunhu hwakaora mwoyo |
Mushure mezviratidzo izvi, kana munhu akapinda mukoma, acharatidza zviratidzo zvikuru zvitatu:
- Kurasikirwa zvachose nepfungwa: Sekunge uri muhope huru. Haugone kumutswa nechero nzira.
- Maziso asingapinduri: Maziso anoramba akavharwa. Hapana mhinduro kana maziso akavhurwa.
- Kusafamba kwemuviri: Hapana kufamba kwemaoko kana makumbo uchiziva. Zvisinei, pane zvimwe zviratidzo zvinogona kuitika.
Zvinhu zvatinofanira kuita nekukasika kana munhu apererwa nepfungwa (rubatsiro rwekutanga)
Fungidzira kana mumwe munhu ane chirwere cheshuga munharaunda yako akafenda seizvi. Pane zvinhu zvishoma zvaunogona kuita. Izvi zvinogona kutoponesa hupenyu.
1. Fonera 1990 nekukasika: Chinhu chekutanga chekuita kufonera amburenzi. Paunofona, iti, "Munhu ane chirwere cheshuga haazive."
2. Usape chero chinhu chekudya kana chekunwa: Kana ukapa munhu asina chaanoziva chikafu kana chekunwa, chinogona kudzika mumhepo yoita sechinokuvadza zvakanyanya.
3. Tendeudza munhu wacho parutivi: Pane kuti arare nerutivi, tendeudza munhu wacho parutivi (nerutivi rwake) kudzivirira kurutsa kana kudzipwa.
4. Mirira kuti amburenzi isvike: Tevedzera mirairo yakapihwa nemushandi wepa1990.
Sei izvi zvichiitika? Ndezvipi zvinhu zvinokonzera njodzi?
Sezvambotaurwa, kupera mvura mumuviri zvakanyanya, kunoitika muDKA neHHS, kunokanganisa uropi uye kunotungamira kukoma. Saizvozvowo, panguva yehypoglycemia, uropi hahugamuchire simba (glucose) rahunoda, zvichiita kuti mashandiro europi amire uye zvichikonzera koma.
Munhu wese ane chirwere cheshuga ari panjodzi, asi zvimwe zvinhu zvinogona kuwedzera njodzi iyi.
- Rudzi rwechirwere cheshuga: Vanhu vane chirwere cheshuga cherudzi rwekutanga vane mukana wakakura wekusvika pakoma nekuda kweDKA uye hypoglycemia yakanyanya. Vanhu vane chirwere cheshuga cherudzi rwechipiri vane mukana wakakura wekusvika pakoma nekuda kweHHS.
- Zvimwe zvirwere: Munguva yezvirwere zvakaita sefivha nehutachiona, zvinonetsa kudzora huwandu hweshuga mumuviri.
- Kuvhiyiwa kana tsaona: Kushushikana kwezvinhu izvi kunogona kukonzera kuti huwandu hweshuga muropa hukwire.
- Matambudziko pakushandisa insulin: Dambudziko iri rinogona kukonzerwa nekusashandisa insulin jekiseni, kutora dose isiriyo, kana kusashanda zvakanaka kwepombi ye insulin.
- Kusagadzirisa chirwere cheshuga nemazvo: kusatora mishonga nemazvo, kusaongorora huwandu hweshuga muropa nguva dzose.
- Kunwa doro: Doro rinogona kukonzera kudzikira kweshuga muropa zvine njodzi.
- Kusaziva nezveHypoglycemia: Vamwe vanhu havaoni zviratidzo zvekutanga zveshuga shoma muropa, zvakaita sekubvunda nekudikitira. Vanogona kungoerekana varasikirwa nepfungwa.
Vanoitei kuchipatara? (Kuongororwa uye kurapwa)
Nekuti iyi inyaya yekurapa, kurapwa kwese kunoitirwa muchipatara. Vanachiremba vanogona kukurumidza kuona chirwere ichi nekutarisa ruzivo rwemurwere uye huwandu hweshuga muropa. Vanotarisawo ropa kuti harina ketones.
Ndosaka zvichikosha kuti vanhu vane chirwere cheshuga vapfeke bhandi remuhuro kana chishongo chemuhuro . Izvi zvinogona kubatsira zvikuru kune vanovarapa panguva yenjodzi.
Kurapwa kunoenderana nechikonzero chekoma.
- Kana zvichikonzerwa neDKA kana HHS:
- Mvura yemumutsinga (mushonga wemunyu): Munyu unopihwa nemutsinga kudzivirira kupera mvura mumuviri uye kuenzanisa munyu wemuviri.
- Insulin: Insulin inopinzwa mutsinga kana kuti jekiseni kudzora huwandu hweshuga muropa.
- Mamwe marapirwo: Kana paine hutachiona huri kukonzera chirwere ichi, hucharapwawo.
- Hypoglycemia yakanyanya (shuga shoma muropa) inokonzerwa ne:
- Jekiseni reGlucagon: Glucagon ihormone inobatsira chiropa chedu kuburitsa glucose nekukurumidza muropa. Inogona kupihwa sejekiseni kana semushonga wekupfapfaidza mhino (hupfu hwemhino). Kunyangwe ukapa izvi kune mumwe munhu kumba,Zvechokwadi unofanira kuendeswa kuchipatara.
Zvinokwanisika here kupora zvachose kubva mudambudziko iri?
Ehe. Kana ikarapwa nekukasika uye nemazvo, chirwere cheshuga chinogona kurapwa zvachose. Zvisinei, dzimwe nguva, kana kurapwa kukanonoka, kunogona kukonzera kukuvara kwehuropi zvachose uye, mune dzimwe nguva, kutouraya.
Kuti munhu anogara kwenguva yakareba sei ari mukoma zvinoenderana nekuti anokurumidza sei kurapwa. Kana asina kurapwa, munhu haazomuki kubva mumamiriro ezvinhu aya ega. Saka, zvakakosha kuti aendeswe kuchipatara nekukurumidza.
Mamiriro ezvinhu ane njodzi akadai angadziviswa sei?
Iyi coma inowanzo dzivirirwa . Chinhu chakakosha kuita kuziva zviratidzo zveDKA, HHS, uye Hypoglycemia uye kutora matanho nekukurumidza pazvinenge zvaonekwa.
Taura nachiremba wako nezvehurongwa hwako hwekurapa chirwere cheshuga. Tsvaga rubatsiro rwechiremba nekukasika kana ukasangana nechimwe chezvinotevera:
- Kana huwandu hweshuga muropa rako hwakakwira kupfuura 300 mg/dL kaviri kakatevedzana pasina chikonzero.
- Kana huwandu hweshuga muropa rako huri pasi pe70 mg/dL uye wakamboedza kudya chimwe chinhu chinotapira katatu asi chisina kuwedzera.
Zvakajairika kuti unzwe kutya kana ukanzwa nezvematambudziko echirwere cheshuga. Asi kuva neruzivo rwakakwana uye kugadzirira ndiyo nzira yakanakisisa yekudzivirira. Usambozeza kubvunza chiremba wako chero mibvunzo yaunayo nezvekurapa chirwere chako cheshuga.
Mharidzo Yekuenda Nayo Kumba
- Chirwere cheshuga chinonzi diabetic coma idambudziko rehutano rinotyisidzira hupenyu rinokonzerwa nehuwandu hweshuga yeropa hwakakwira zvakanyanya (DKA, HHS) kana huwandu hweshuga yeropa hwakaderera zvakanyanya (hypoglycemia yakanyanya).
- Gara uchiziva zviratidzo zvekunyevera pakutanga zvakaita sekusvotwa, kurwadziwa mudumbu, kunhuwa kwemweya (kweDKA), nyota yakawandisa, kuvhiringidzika (kweHHS), uye kudedera, kukakama (kwehypoglycemia).
- Kana munhu ane chirwere cheshuga akashaya remuromo, fonera 911 nekukasika womuendesa kuchipatara. Usambomupa chekudya kana chekunwa.
- Dambudziko iri rine njodzi rinogona kudzivirirwa zvakanyanya nekutarisira chirwere cheshuga nemazvo, kutarisa huwandu hweshuga muropa nguva nenguva, uye kutsvaga mazano kubva kuna chiremba wako nezvezvaunofanira kuita kana warwara.
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