Eyona ngxaki iyingozi kwisifo seswekile: Ngaba uyazi nge-HHS? (Imeko yeHyperosmolar Hyperglycemic)

Ngaba unesifo seswekile? Okanye ngaba umama wakho, utata wakho, okanye omnye umntu kusapho lwakho unesifo seswekile? Ke le ngongoma sithetha ngayo namhlanje iya kuba ibaluleke kakhulu kuwe. Isifo seswekile sisifo esinokulawulwa ngokufanelekileyo, kwaye ungaphila ubomi obuqhelekileyo. Nangona kunjalo, ukuba asilawulwa ngokufanelekileyo, sinokukhokelela kwiingxakeko ezinkulu ezinokuba yingozi nakubomi. Leyo yeyona ngxakeko iyingozi kakhulu esithetha ngayo namhlanje. Oku kubizwa ngokuba yiHyperosmolar Hyperglycemic State , esiyibiza ngokuba yiHHS ngamafutshane.

Kalula nje, yintoni i-HHS?

Kulungile, masiyibeke ngokulula le nto. Khawucinge ukuba inqanaba leswekile egazini lakho (iswekile egazini) liphezulu kakhulu kangangokuba akunakwenzeka ukuyilawula. Xa inqanaba leswekile egazini lakho lidlula i-180 mg/dL, izintso zethu kufuneka zikhuphe loo swekile igqithisileyo kumchamo. Kodwa le swekile ayiziphumi yodwa, ikwathatha namanzi axabisekileyo omzimba.

Ngoku, kwenzeka ntoni ukuba inqanaba leswekile egazini lakho liye kwinqanaba eliphezulu kakhulu, njenge-600 mg/dL, kwaye lihlala linjalo kangangeentsuku, mhlawumbi iiveki? Uqala ukuchama kakhulu, kwaye umzimba wakho uphelelwa ngamanzi emzimbeni. Njengoko inani lamanzi emzimbeni wakho lincipha, igazi lakho liyaqina kancinci kancinci. Kanye njengokuba sisenza ubusi, amanzi ayaqina. Ngokwezonyango, sibiza oku ngokuba kukuqina kwegazi nge-hyperosmolarity .

Ngoko ke, i-HHS yimeko engxamisekileyo esongela ubomi eyenzeka xa ezi zinto zintathu zidibana: amanqanaba aphezulu kakhulu eswekile egazini (i-hyperglycemia) , ukuphelelwa ngamanzi emzimbeni kakhulu , kunye ne -hyperosmolarity. Le meko ibonwa kakhulu kubantu abanesifo seswekile sohlobo lwesibini. Le yimeko efuna ukulaliswa esibhedlele ngokukhawuleza kunye nonyango. Ukuba ayinyangwa, inokukhokelela ekufeni.

I-HHS kunye ne-DKA: Yintoni umahluko phakathi kwezi zimbini?

Enye imeko engxamisekileyo enobungozi enokwenzeka kubantu abanesifo seswekile yi-DKA (Diabetic Ketoacidosis). Nangona zombini i-HHS kunye ne-DKA zizifo ezisongela ubomi ezibangelwa yiswekile ephezulu yegazi, kukho umahluko ocacileyo phakathi kwezi zimbini. Kubalulekile ukwazi lo mahluko.

• I-DKA (i-Diabetic Ketoacidosis): Oku kwenzeka kakhulu kubantu abanesifo seswekile sohlobo loku-1. Okwenzekayo apha kukuba umzimba awunayo phantse i-hormone ye-insulin. Ngenxa yokunqongophala kwe-insulin, iiseli zomzimba azikwazi ukusebenzisa iswekile ukwenza amandla. Emva koko umzimba uye kwenye indlela yokufumana amandla. Oko kukuthi, ngokutshisa amafutha emzimbeni. Xa amafutha etshiswa ngale ndlela, into yekhemikhali ebizwa ngokuba yi-ketones yongezwa egazini njengemveliso ephumayo. Ezi ketones ziyi-asidi. Xa ii-ketones zisanda egazini, igazi liba ne-asidi. Le yeyona nto iyingozi nge-DKA.

• I-HHS (Imeko yeHyperosmolar Hyperglycemic):Oku kwenzeka kakhulu kubantu abanesifo seswekile sohlobo lwesibini. Apha, kukho i-insulin eninzi emzimbeni. Ngenxa yaloo mthamo mncinci we-insulin, umzimba utshisa amafutha kwaye uthintele ukwenziwa kwee-ketones. Ke ngoko, igazi alibi ne-asidi kwi-HHS. Kodwa ingxaki ephambili apha kukunyuka okungalawulekiyo kwamanqanaba eswekile kunye nokuphelelwa ngamanzi emzimbeni okubangelwa kukwanda kwegazi.

Makhe sijonge le theyibhile ukuze sicacise ngakumbi lo mahluko.

Zithini iimpawu ze-HHS? Zilumkele ezi!

Eyona nto iyingozi nge-HHS kukuba iimpawu azibonakali ngaxeshanye . Zikhula kancinci, emva kweentsuku okanye iiveki. Ngoko ke umntu usenokungaziqondi de kube nzima kakhulu. Yiyo loo nto kubalulekile ukuba uzazi ezi mpawu.

• Inqanaba eliphezulu kakhulu leswekile egazini: Uvavanyo lwe-glucometer yasekhaya ephezulu kakhulu kune-600 mg/dL (okanye i-33 mmol/L).
• Ukudideka kwengqondo: Ukulahlekelwa zingqondo, ukungakwazi ukugxila, ukudideka ekuthetheni, ukulahleka kwexesha, indawo, kunye nabantu abaqhelene nabo.
• Ukubona okanye ukuva izinto ezingekhoyo (Iingcamango): Kungathiwa ubona okanye uva izinto ezingekhoyo ngokwenene.
• Ukulahlekelwa yingqondo: Kwiimeko ezinzima kakhulu, i-coma inokwenzeka.
• Umlomo owomileyo, ulwimi, kunye nonxano olugqithisileyo: Ukuziva unxaniwe kodwa okungapheliyo nokuba usela amanzi angakanani na.
• Ukuchama rhoqo: Nangona usenokuchama kakhulu ekuqaleni, usenokuchama kancinci njengoko ukuphelelwa ngamanzi emzimbeni kuba nzima.
• Umbono ofipheleyo okanye ukulahleka kombono: Umbono usenokuba lufiphele kancinci kancinci.
• Ubuthathaka bomzimba: Ukuziva ubuthathaka emzimbeni. Ngamanye amaxesha elinye icala lomzimba linokukhubazeka, ngokungathi unesifo sohlangothi.

Kutheni le meko ye-HHS isenzeka? Zithini izizathu eziphambili?

Umntu onesifo seswekile esilawulwa kakuhle akanawo amathuba amaninzi okufumana isifo seswekile i-HHS. Nangona kunjalo, kumntu onesifo seswekile esingalawulwa kakuhle, esi sifo sinokwenzeka ngenxa "yento ebangela ukuba angakwazi ukulawula." Oko kukuthi, isiganeko sinokubangela ukuba amanqanaba eswekile egazini abe phezulu kakhulu ukuba angakwazi ukulawula, nto leyo ekhokelela kwisifo seswekile i-HHS.

Izinto eziphambili ezibangela i-HHS zezi:

• Izifo: Ama-50% ukuya kuma-60% abantu abafumana i-HHS banosulelo oluthile. Ngokukodwa, i-pneumonia , izifo zomchamo (UTI ), kunye ne -sepsis .) usulelo zezona ziphambili. Khawuthelekelele, umama osele ekhulile unesifo seswekile, ufumana usulelo esifubeni olune-mucus eninzi. Uxinzelelo olubangelwa lolu sulelo lunokubangela ukuba amanqanaba eswekile egazini anyuke aye kwinqanaba elingalawulekiyo.
• Ukungawathathi amayeza akho eswekile njengoko kuyalelwe: Esi sisizathu esiqhelekileyo. Abanye abantu bayadinwa baze bayeke ukuwathatha amayeza abo, okanye abawathathi ngexesha. Ukuba uthatha i-insulin, ukuba awuyithathi kakuhle, amanqanaba eswekile egazini lakho anokunyuka kakhulu.
• Amanye amayeza: Amanye amayeza, anjenge -corticosteroids (asetyenziselwa ukunyanga i-asthma kunye ne-arthritis), i-thiazide diuretics (asetyenziselwa ukunyanga uxinzelelo lwegazi oluphezulu), kunye namanye amayeza esifo sengqondo, anokubangela amanqanaba aphezulu eswekile egazini kwaye abangele i-HHS.
• Iingxaki zentliziyo: Kwimeko enzima efana nestroke , ukuhlaselwa yintliziyo , okanye i-pulmonary embolism , umzimba uphantsi koxinzelelo olukhulu. Iihormone zoxinzelelo ezikhutshwa ngumzimba ngeli xesha zinokubangela ukuba amanqanaba eswekile egazini anyuke ngequbuliso.

Ngubani osengozini enkulu yokuphuhlisa i-HHS?

Njengoko bekutshiwo ngaphambili, lo mngcipheko uphantsi ukuba isifo seswekile silawulwa kakuhle. Nangona kunjalo, abantu abalandelayo basengozini enkulu yokuhlaselwa yi-HHS:

• Abantu abangalawuleki kakuhle isifo seswekile.
• Abantu abadala abangaphezu kweminyaka engama-65 ubudala: Njengoko bekhula, amandla abo okuva unxano anokwehla, ngoko ke banokungazi ukuba baphelelwe ngamanzi emzimbeni.
• Abo banezinye izifo (usulelo, ukugula) okanye iingxaki zentliziyo.

Ziziphi iingxaki ezinokwenzeka ngenxa ye-HHS?

Ukuba i-HHS ayinyangwa ngexesha, inokukhokelela kwiingxaki ezinkulu kakhulu.

• Ukuxhuzula
• I-Coma
• Ukungasebenzi kakuhle kwamalungu omzimba
• Ukufa

Phakathi kwe-10% kunye ne-20% yabantu abafumana i-HHS bayafa. Oko kuthetha ukuba umntu omnye okanye ababini kwabalishumi baya kufa. Yiyo loo nto le meko imbi kangaka.

I-HHS ifunyaniswa kwaye inyangwa njani esibhedlele?

Xa ungeniswe kwiSebe leNgxamiseko (i-ETU), ugqirha uza kukuxilonga aze akubuze ngeempawu zakho. Emva koko, baya kuyalela uvavanyo lwegazi oluninzi. Olu vavanyo luza kujonga inqanaba leswekile egazini lakho, i-osmolality yegazi, ukusebenza kwezintso, kunye nokuba kukho ii-ketones egazini lakho.

Ukuba inqanaba leswekile egazini liphezulu kakhulu kune-600 mg/dL kwaye inqanaba le-ketone egazini liphantsi, kuxilongwa njenge-HHS.

Unyango lubandakanya ukukugcina kwigumbi okanye kwigumbi lonyango olunzima (ICU) kunye nokukunika ulwelo lwe-IV.

Kukho iinjongo ezintathu eziphambili zonyango:

1. Ukubuyisela amanzi emzimbeni: Ityuwa ifakwa ngemithambo ukuze kupheliswe ukuphelelwa ngamanzi emzimbeni.

2. Ukulinganisela ii-Electrolytes: Xa umzimba uphelelwa ngamanzi emzimbeni, iiminerali ezininzi ezixabisekileyo ezifana ne-potassium ziyalahleka emzimbeni. Zithathelwa indawo yi-saline.

3. Ukulawula amanqanaba eswekile egazini: I-insulin inikwa ngemithambo yegazi ukuze inciphise kancinci nangokulawulayo amanqanaba eswekile egazini.

Ukongeza kwezi ndlela zonyango, ukuba kukho usulelo olufihlakeleyo olubangele imeko ye-HHS, nalo luyanyangwa.

Ngaba iingxaki zinokwenzeka ngexesha lonyango?

Ewe, nangona kunqabile kakhulu, iingxaki zinokwenzeka ngenxa yonyango. Oko kukuthi, ukuba amanqanaba eswekile egazini ehla ngequbuliso nangokukhawuleza, iiseli zengqondo zinokuzaliswa ngamanzi ngequbuliso kwaye ingqondo idumbe (i-cerebral edema). Kodwa oku kunqabile kakhulu. Oogqirha bayazi indlela yokunciphisa amanqanaba eswekile egazini ngokukhuselekileyo nangokucothayo. Ngoko ke akukho mfuneko yokukhathazeka ngayo.

Ungazikhusela njani kwi-HHS?

Eyona ndlela ilungileyo nekuphela kwayo yokuphepha le meko iyingozi kukulawula isifo sakho seswekile kakuhle. Ukuze wenze oku, qiniseka ukuba uyazenza ezi zinto.

• Jonga amanqanaba eswekile egazini lakho rhoqo uze uzame ukuwagcina ngaphakathi koluhlu olujoliswe kulo ugqirha wakho.
• Sela amayeza (iipilisi okanye i-insulin) owalelwe ngugqirha wakho ngexesha elifanelekileyo nangedosi efanelekileyo, ungaphoswa lusuku olunye.
• Ukuba unengxaki yokulawula isifo sakho seswekile, thetha nogqirha wakho ngaloo nto uze ufumane icebiso elifanelekileyo.
• Landela ukutya okunempilo okukufaneleyo.
• Xa unesifo esifana nomkhuhlane okanye umkhuhlane, lumka kakhulu. Sela amanzi amaninzi, phumla ngokwaneleyo, kwaye ujonge iswekile yakho yegazi rhoqo kunesiqhelo. Oku kungenxa yokuba uxinzelelo emzimbeni wakho xa ugula lunokubangela ukuba iswekile yakho yegazi inyuke.
• Qaphela iimpawu ze-HHS. Ukuba ubona naziphi na kwezi mpawu, thatha inyathelo ngokukhawuleza.