Une chirwere cheshuga here? Kana kuti amai vako, baba vako, kana mumwe munhu mumhuri mako ane chirwere cheshuga here? Saka nyaya iyi yatiri kutaura nezvayo nhasi ichave yakakosha zvikuru kwauri. Chirwere cheshuga chirwere chinogona kutarisirwa zvakanaka, uye unogona kurarama hupenyu hwakajairika. Zvisinei, kana chikasadzorwa zvakanaka, chinogona kutungamira kune emergency dzakakomba dzinogona kutoisa hupenyu panjodzi. Ndiyo emergency ine njodzi zvikuru yatiri kutaura nezvayo nhasi. Izvi zvinonzi Hyperosmolar Hyperglycemic State , yatinoti HHS muchidimbu.
Zvichitaurwa zviri nyore, chii chinonzi HHS?
Zvakanaka, ngatizvitaure zviri nyore. Fungidzira kuti huwandu hweshuga muropa rako (glucose muropa) hwakwira zvakanyanya zvekuti hazvigoneke kudzora. Kana huwandu hweshuga muropa rako hwakwira kupfuura 180 mg/dL, itsvo dzedu dzinofanira kuburitsa shuga yakawandisa muweti. Asi shuga iyi haingobudi yoga, inotorawo mvura inokosha yemuviri.
Zvino, chii chinoitika kana huwandu hweshuga muropa rako hukakwira zvakanyanya, senge 600 mg/dL, uye hukaramba hwakadaro kwemazuva, pamwe mavhiki? Unotanga kuita weti zvakanyanya, uye muviri wako unopera mvura mumuviri wako zvakanyanya. Sezvo huwandu hwemvura mumuviri wako huchiderera, ropa rako rinokura zvishoma nezvishoma. Sezvatinoita huchi, mvura inokura. Mukurapa, tinodana uku kukora kweropa hyperosmolarity .
Saka, HHS idambudziko rinotyisidzira hupenyu rinowanzoitika kana zvinhu izvi zvitatu zvasangana: huwandu hweshuga yeropa hwakakwira zvakanyanya (hyperglycemia) , kushaya mvura mumuviri zvakanyanya , uye hyperosmolarity. Dambudziko iri rinonyanya kuonekwa muvanhu vane chirwere cheshuga cheType 2. Iri idambudziko rinoda kuendeswa kuchipatara nekukurumidza uye kurapwa. Kana rikasarapwa, rinogona kutokonzera rufu.
HHS neDKA: Musiyano uripo pakati pezviviri izvi ndeupi?
Imwe njodzi ine njodzi inogona kuitika kuvanhu vane chirwere cheshuga iDKA (Diabetic Ketoacidosis). Kunyange zvazvo HHS neDKA zviri zvirwere zvinotyisidzira hupenyu zvinokonzerwa neshuga yakakwira muropa, pane musiyano wakajeka pakati pezviviri izvi. Zvakakosha kuziva musiyano uyu.
- DKA (Diabetic Ketoacidosis): Izvi zvinonyanya kuitika kuvanhu vane chirwere cheshuga cheType 1. Chinoitika pano ndechekuti muviri hauna insulin hormone. Nekuda kwekushaikwa kwe insulin, masero emuviri haakwanise kushandisa shuga kugadzira simba. Ipapo muviri unoenda kune imwe nzira yekutsvaga simba. Kureva, nekupisa mafuta mumuviri. Kana mafuta apiswa nenzira iyi, kemikari inonzi ketones inowedzerwa muropa sechinhu chimwe chete. Maketone aya iasidhi. Kana maketone akawedzera muropa, ropa rinova acidic. Ichi ndicho chinhu chine njodzi zvikuru nezveDKA.
- HHS (Hyperosmolar Hyperglycemic State):Izvi zvinonyanya kuitika kuvanhu vane chirwere cheshuga cherudzi rwechipiri. Pano, muviri une insulin yakawanda. Nekuda kwehuwandu hushoma hwe insulin, muviri unopisa mafuta uye unodzivirira kuumbwa kwemaketones. Nokudaro, ropa harina acid muHHS. Asi dambudziko guru pano kukwira kusingadzoreki kwehuwandu hweshuga uye kupera mvura mumuviri zvakanyanya uye kukora kweropa kunoguma kwaitika.
Ngatitarisei tafura iyi kuti tinyatsojekesa musiyano uyu.
| Chinhu | HHS (Hyperosmolar Hyperglycemic State) | Chirwere cheshuga chinonzi DKA (Diabetic Ketoacidosis) |
|---|---|---|
| Zvinonyanya kuonekwa | Pakati pevanhu vane chirwere cheshuga cherudzi rwechipiri, kunyanya avo vane makore anopfuura makumi matanhatu nemashanu. | Pakati peavo vane chirwere cheshuga cherudzi rwekutanga. |
| Huwandu hweshuga muropa | Yakakwira zvakanyanya (kazhinji >600 mg/dL). | Yakakwira (kazhinji >250 mg/dL), asi inogona kunge isiri yakakwira seHHS. |
| Kuvapo kwemaketone | Kwete, kana kuti pane mari shoma kwazvo. | Inowanikwa muropa nemuweti zvakanyanya. |
| Asidi muropa | Ropa harina acid. | Ropa rinova neacid yakawanda zvine njodzi. |
| Dambudziko guru | Kupera mvura mumuviri zvakanyanya uye kukora kweropa (hyperosmolarity). | Kuwanda kweacid muropa nekuda kwemaketones (ketoacidosis). |
Ndezvipi zviratidzo zveHHS? Chenjerera izvi!
Chinhu chine njodzi zvikuru nezveHHS ndechekuti zviratidzo hazvionekwi zvese panguva imwe chete . Zvinokura zvishoma nezvishoma, kwemazuva kana mavhiki. Saka munhu anogona kusazviziva kusvika zvanyanya kuipa. Ndosaka zvichikosha kuziva zviratidzo izvi.
- Huwandu hweshuga yeropa hwakakwira zvakanyanya: Chiyero chemushonga weglucose wepamba chakakwira kupfuura 600 mg/dL (kana 33 mmol/L).
- Kuvhiringidzika kwepfungwa: Kurasikirwa nepfungwa, kutadza kunyatsoteerera, kuvhiringidzika pakutaura, kurasikirwa nenguva, nzvimbo, uye vanhu vaunoziva.
- Kuona kana kunzwa zvinhu zvisipo (Kufungidzira): Zvinogona kutaurwa kuti unoona kana kunzwa zvinhu zvisipo zvechokwadi.
- Kurasikirwa nepfungwa: Muzviitiko zvakakomba, coma inogona kuitika.
- Muromo wakaoma, rurimi, uye nyota yakawandisa: Kunzwa nyota isingapere zvisinei nekuti unonwa mvura yakawanda sei.
- Kuita weti kakawanda: Kunyangwe ungangoda weti yakawanda pakutanga, ungangoda weti shoma sezvo mvura ichiwedzera kuoma.
- Kuona kusina kujeka kana kurasikirwa nekuona: Kuona kunogona kusviba zvishoma nezvishoma.
- Kushaya simba kwemuviri: Kunzwa kushaya simba mumuviri. Dzimwe nguva rimwe divi remuviri rinogona kuoma, sekunge uri kurwara nesitiroko.
Kana iwe kana mumwe munhu wemumhuri mako aine chimwe chezviratidzo izvi, ndapota musamirira kwenguva refu. Musafunga kuti zvakajairika. Endai naye kuchipatara chiri pedyo neEmergency Department (ETU) nekukurumidza sezvinobvira. Izvi zvinogona kuva mamiriro ezvinhu anogumbura kana kufa.
Sei chirwere ichi cheHHS chichiitika? Ndezvipi zvikonzero zvikuru?
Munhu ane chirwere cheshuga chinodzorwa zvakanaka haana mukana wekuwana HHS. Zvisinei, kune munhu ane chirwere cheshuga chisina kudzorwa zvakanaka, chirwere ichi chinogona kuitika nekuda kwe "chinokonzera." Kureva kuti, chiitiko chinogona kukonzera kuti huwandu hweshuga muropa hukwire zvakanyanya zvekuti havakwanise kudzora, zvichikonzera HHS.
Zvinhu zvikuru zvinokonzera HHS ndeizvi:
- Utachiona: 50% kusvika 60% yevanhu vanorwara neHHS vane hutachiona hwerudzi rwakati. Kunyanya pneumonia , urinary tract infections (UTI ), uye sepsis .) hutachiona ndihwo hukuru. Fungidzira, amai vakwegura vane chirwere cheshuga, vanobatwa nehutachiona hwepachipfuva hune manyoka akawanda. Kushushikana kunokonzerwa nehutachiona uhwu kunogona kukonzera kuti huwandu hweshuga muropa hukwire kusvika padanho risingadzoreki.
- Kusatora mushonga wako wechirwere cheshuga sezvawakarairwa: Ichi chikonzero chinowanzoitikawo. Vamwe vanhu vanofinhwa vorega kutora mushonga wavo, kana kuti havautore nenguva. Kana ukatora insulin, kana ukasatora zvakanaka, huwandu hweshuga muropa rako hunogona kukwira zvine njodzi.
- Mimwe mishonga: Mimwe mishonga, yakaita se corticosteroids (inoshandiswa kurapa asthma ne arthritis), thiazide diuretics (inoshandiswa kurapa BP yakakwira), uye mimwe mishonga yezvirwere zvepfungwa, inogonawo kukonzera huwandu hweshuga muropa uye kukonzera HHS.
- Dambudziko remwoyo: Kana paine dambudziko guru rakadai sestroke , chirwere chemwoyo , kana pulmonary embolism , muviri unenge wava nedambudziko guru. Mahormone ekushushikana anoburitswa nemuviri panguva ino anogona kukonzera kuti huwandu hweshuga muropa hukwire kamwe kamwe.
Ndiani ari panjodzi huru yekubatwa neHHS?
Sezvambotaurwa, njodzi iyi ishoma kana chirwere cheshuga chikadzorwa zvakanaka. Zvisinei, vanhu vanotevera vari panjodzi huru yekubatwa neHHS:
- Vanhu vasingadzore chirwere cheshuga zvakanaka.
- Vakuru vane makore anopfuura 65: Pavanenge vachikura, kugona kwavo kunzwa nyota kunogona kudzikira, saka vangasaziva kuti vapera mvura mumuviri.
- Avo vane zvimwe zvirwere (hutachiona, chirwere) kana zvirwere zvemwoyo.
Ndezvipi zvinetso zvinogona kuitika nekuda kweHHS?
Kana HHS ikasarapwa nenguva, zvinogona kukonzera matambudziko akakomba.
- Kubatwa nepfari
- Kushaya simba
- Kukundikana kwenhengo
- Rufu
Pakati pe10% ne20% yevanhu vanorwara neHHS vanofa. Izvi zvinoreva kuti munhu mumwe chete kana vaviri pavanhu gumi vanofa. Ndiyo nyaya yakakomba iyi.
HHS inoongororwa sei uye inorapwa sei muchipatara?
Kana wapinda muEmergency Department (ETU), chiremba achakuongorora uye obvunza nezvezviratidzo zvako. Zvadaro, vachakuraira kuongororwa kweropa kakawanda. Izvi zvichaongorora huwandu hweshuga muropa rako, osmolality yeropa rako, mashandiro eitsvo, uye kana paine ma ketone muropa rako.
Kana huwandu hweshuga muropa hwakakwira zvakanyanya kupfuura 600 mg/dL uye huwandu hweketone muropa hwakaderera, zvinoonekwa seHHS.
Kurapwa kunosanganisira kukuchengeta muwadhi kana mukamuri rekutarisirwa zvakanyanya (ICU) uye kukupa mvura inobuda mutsinga.
Kune zvinangwa zvikuru zvitatu zvekurapa:
1. Kudzorerwa kwemvura mumuviri: Munyu unopinzwa netsinga kuti ubvise kupera mvura mumuviri.
2. Kuenzanisa Maelectrolyte: Kana muviri ukarasikirwa nemvura, maminerari akawanda anokosha akadai sepotassium anorasika mumuviri. Anotsiviwa nemunyu.
3. Kudzora huwandu hweshuga muropa: Insulin inopihwa netsinga kuti ideredze huwandu hweshuga muropa zvishoma nezvishoma uye nenzira inodzorwa.
Pamusoro pemishonga iyi, kana paine hutachiona hwakakonzera chirwere cheHHS, hunorapwawo.
Matambudziko anogona kuitika panguva yekurapwa here?
Ehe, kunyangwe zvisingawanzoitiki, matambudziko anogona kuitika kubva mukurapwa. Kureva kuti, kana huwandu hweshuga muropa hukadzikira kamwe kamwe uye nekukurumidza, masero europi anogona kungoerekana azara nemvura uye uropi hunozvimba (cerebral edema). Asi izvi hazviwanzoitiki. Vanachiremba vanoziva nzira yekudzikisa huwandu hweshuga muropa zvakachengeteka uye zvishoma nezvishoma. Saka hapana chikonzero chekunetseka nezvazvo.
Ungazvidzivirira sei kubva kuHHS?
Nzira yakanakisisa uye yega yekudzivirira mamiriro ezvinhu ane njodzi aya ndeyekutarisira chirwere chako cheshuga zvakanaka. Kuti uite izvi, iva nechokwadi chekuita zvinhu izvi.
- Tarisa huwandu hweshuga muropa rako nguva nenguva uye edza kuhuchengeta huri mukati mehuwandu hwawakapihwa nachiremba.
- Inwa mushonga (mapiritsi kana insulin) wakanyorerwa nachiremba wako panguva yakakodzera uye nemuyero wakakodzera, usingapotse kana zuva rimwe chete.
- Kana uchinetseka kudzora chirwere chako cheshuga, taura nachiremba wako nezvazvo wowana mazano anodiwa.
- Tevedzera kudya kwakanaka kunokukodzera.
- Kana uine chirwere chakadai sedzihwa kana furuu, nyatso ngwarira. Inwa mvura yakawanda, zorora zvakakwana, uye tarisa shuga yako yeropa kakawanda kupfuura zvawagara uchiita. Izvi zvinodaro nekuti kushushikana mumuviri wako paunenge uchirwara kunogona kukonzera kuti shuga yako yeropa ikwire.
- Ziva zviratidzo zveHHS. Kana ukaona chimwe chezviratidzo izvi, tora matanho nekukasika.
Mharidzo Yekuenda Nayo Kumba
- HHS chirwere chakakomba, chinotyisidzira hupenyu chinogona kuitika kuvanhu vane chirwere cheshuga.
- Chikonzero chikuru cheizvi ishuga yakakwira muropa isingadzoreki uye kupera mvura mumuviri zvakanyanya.
- Kuvhiringidzika kwepfungwa, nyota yakawandisa, uye huwandu hweshuga hwakanyanya (hunopfuura 600 mg/dL) ndizvo zviratidzo zvikuru .
- HHS inowanzo kukonzerwa nehutachiona kana kumisa mishonga yechirwere cheshuga.
- Nzira yakanakisisa yekudzivirira izvi ndeyekuchengetedza chirwere chako cheshuga chiri pasi pekutarisirwa kwakanaka.
- Kana uchifungidzira kuti iwe kana mumwe munhu waunoziva ane zviratidzo zveHHS, enda kuchipatara kuEmergency Department (ETU) nekukasika. Nguva ndiyo inokosha.
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