Ingabe isifo sikashukela singadala i-coma? (I-Coma Ehlobene Nesifo Sikashukela) Ake sixoxe ngalesi simo esiyingozi

Wenzenjani uma umuntu onesifo sikashukela elahlekelwa ingqondo ngokuzumayo futhi engakwazi ukuvuswa kungakhathaliseki ukuthi ukhuluma kangakanani naye? Lokhu kuyesabeka ngempela. Lokhu kuyi-coma, okungenye yezinkinga eziyingozi kakhulu zesifo sikashukela. Uma sikhuluma iqiniso, yisimo sokungazi lutho esenza umuntu alale ubuthongo obujulile. Lokhu kusongela ngisho nokuphila. Kodwa uma unolwazi olufanele, ungavimbela lesi simo futhi usindise nokuphila komuntu. Ngakho-ke ake sixoxe ngalokhu namuhla.

Iyini le coma yesifo sikashukela?

Kalula nje, uma umuntu onesifo sikashukela enamazinga aphezulu kashukela egazini angalawuleki (i-hyperglycemia) noma amazinga aphansi kashukela egazini (i-hypoglycemia) , kungathinta ngqo ukusebenza kobuchopho futhi kubangele umuntu alahlekelwe ingqondo. Lokhu kubizwa ngokuthi i-diabetesic coma. Lesi yisimo esibucayi esidinga ukwelashwa okuphuthumayo.

Lolu hlobo lwe-coma lungabangelwa yizimo ezintathu eziyinhloko ezihlobene nesifo sikashukela.

1. I-Diabetic Ketoacidosis (DKA): Lokhu kwenzeka lapho ama-ketone, uhlobo lwe-asidi, enyuka egazini, okwenza igazi libe ne-asidi.

2. Isimo Se-Hyperosmolar Hyperglycemic (HHS): Lesi yisimo lapho amazinga kashukela egazini eba phezulu kakhulu futhi umzimba uphelelwa amanzi emzimbeni kakhulu.

3. I-hypoglycemia enzima: Lokhu kwenzeka lapho inani le-glucose elinikeza amandla ebuchosheni liba liphansi kakhulu, okubangela ukuthi ukusebenza kobuchopho kume.

Ake sibheke izimbangela ezintathu eziyinhloko ze-coma ngemininingwane ethe xaxa.

Kubaluleke kakhulu ukwazi okuncane ngalezi zimo ezintathu, ngoba ukuqaphela izimpawu zesimo ngasinye kusenesikhathi kungazivimbela ukuthi zingathuthukeli ekubeni yi-coma.

1. I-ketoacidosis yesifo sikashukela (i-DKA)

Lesi simo sivame kakhulu kubantu abanesifo sikashukela sohlobo 1 , kodwa ngezinye izikhathi singakhula kubantu abanesifo sikashukela sohlobo 2.

Kulula: I-hormone i-insulin ibalulekile kumaseli omzimba wethu ukuze athole i-glucose (ushukela) ukuze athole amandla. Ku-DKA, umzimba awunayo i-insulin eyanele. Ngemuva kwalokho, ngenxa yokuthi amaseli awakwazi ukuthola i-glucose, umzimba uqala ukushisa amafutha awo ukuze athole amandla. Lapho la mafutha eshiswa , ama-ketone akhiqizwa njengomkhiqizo olandelanayo.Ikhemikhali ebizwa ngokuthi ama-ketone iyanda egazini. Lawa ma-ketone awuhlobo lwe-asidi. Uma eyanda egazini, igazi liba ne-asidi. Lokhu kubizwa ngokuthi i-DKA. Uma lesi simo singelashwa ngokushesha, ungangena kwi-coma.

Ngokuvamile, i-DKA yisimo lapho izinga likashukela egazini liphakeme kuno- 250 mg/dL . Kodwa khumbula, imbangela eyinhloko ye-DKA akuyona nje ushukela ophezulu, kodwa futhi nokuntuleka kwe-insulin kanye nokwanda kwama-ketone.

2. Isimo se-hyperosmolar hyperglycemic (HHS)

Lokhu kuvame kakhulu kubantu abanesifo sikashukela sohlobo 2. Lokhu kwenzeka lapho amazinga kashukela egazini eba phezulu ngendlela engalawuleki (ngokuvamile ngaphezu kuka -600 mg/dL ). Uma lokhu kwenzeka, umzimba uzama ukukhipha ushukela omningi emchameni. Ngesikhathi esifanayo, kulahleka amanzi amaningi emzimbeni, okubangela ukuphelelwa amanzi emzimbeni okukhulu . Lokhu kungathinta ubuchopho, kubangele ukulahlekelwa ukwazi, futhi uma kungelashwa, kungaholela ekuqulekeni.

3. I-hypoglycemia enkulu

Lokhu kwenzeka lapho amazinga kashukela egazini ehla emazingeni aphansi kakhulu, ngokuvamile ngaphansi kuka -40 mg/dL . Lokhu futhi kuyingozi kakhulu empilweni.

I-glucose ingumthombo oyinhloko wamandla emizimbeni yethu, ikakhulukazi ubuchopho. Uma kungekho glucose egazini, ubuchopho bulahlekelwa amandla abo okusebenza. Njengoba nje injini yemoto ima lapho iphelelwa uphethiloli, ubuchopho bungacima bese buba yi-coma. Lesi simo sivame kakhulu kubantu abathatha imijovo ye-insulin noma izinhlobo ezithile zemithi yesifo sikashukela (isib., ama-sulfonylurea).

Izimpawu eziyisixwayiso ngaphambi kokuya e-coma

Umuntu akavele angene kwi-coma. Ngaphambi kwalokho, umzimba ubonisa izimpawu eziningana eziyisixwayiso. Into ebaluleke kakhulu ukuqaphela lezi zimpawu kusenesikhathi. Ake sibheke izimpawu ezihlobene nalezi zimo ezintathu ngokwehlukana.

Ngemva kwalezi zimpawu, uma umuntu eba se-coma, uzobonisa izimpawu ezintathu eziyinhloko:

• Ukulahlekelwa ngokuphelele ingqondo: Njengokulala ubuthongo obujulile. Awukwazi ukuvuswa nganoma iyiphi indlela.
• Amehlo angaphenduli: Amehlo ahlala evaliwe. Akukho mpendulo uma amehlo evuliwe.
• Ukungasebenzi komzimba: Akukho ukunyakaza kwezingalo noma imilenze okubonakalayo. Kodwa-ke, kungase kube khona okunye ukusabela komzimba.

Izinto okufanele sizenze ngokushesha uma umuntu equleka (usizo lokuqala)

Cabanga nje uma umuntu onesifo sikashukela endaweni yakini equleka kanje. Kunezinto ezimbalwa ongazenza. Lokhu kungasindisa ngisho nokuphila.

1. Shayela u-1990 ngokushesha: Into yokuqala okufanele uyenze ukushayela i-ambulensi. Uma ushaya ucingo, yithi, "Umuntu onesifo sikashukela akaqondi lutho."

2. Unganiki lutho ukudla noma ukuphuza: Uma unikeza umuntu oqulekile ukudla noma isiphuzo, kungangena endaweni yokuphefumula futhi kube yingozi nakakhulu.

3. Phendula umuntu eceleni: Esikhundleni sokumlalisa ngohlangothi, mphendulele eceleni (ngohlangothi) ukuze uvimbele ukuhlanza noma ukuminza.

4. Linda i-ambulensi ifike: Landela imiyalelo enikezwe umqhubi we-1990.

Kungani lokhu kwenzeka? Yiziphi izinto ezibangela ingozi?

Njengoba kushiwo ngaphambili, ukuphelelwa amanzi emzimbeni okukhulu, okwenzeka kokubili ku-DKA kanye ne-HHS, kuthinta ubuchopho futhi kuholele ekumeni. Ngokufanayo, ngesikhathi se-hypoglycemia, ubuchopho abutholi amandla (ushukela) obuwadingayo, okubangela ukuthi ukusebenza kobuchopho kume futhi kuholele ekumeni.

Noma ubani onesifo sikashukela usengozini, kodwa izici ezithile zingandisa le ngozi.

• Uhlobo lwesifo sikashukela: Abantu abanesifo sikashukela sohlobo 1 banamathuba amaningi okuba ne-coma ngenxa ye-DKA kanye ne-hypoglycemia enzima. Abantu abanesifo sikashukela sohlobo 2 banamathuba amaningi okuba ne-coma ngenxa ye-HHS.
• Ezinye izifo: Ngesikhathi sezifo ezifana nomkhuhlane kanye nokutheleleka, kunzima ukulawula amazinga kashukela emzimbeni.
• Ukuhlinzwa noma izingozi: Ukucindezeleka lezi zinto ezikufaka emzimbeni kungabangela ukwenyuka kwamazinga kashukela egazini.
• Izinkinga ngokusetshenziswa kwe-insulin: Lesi simo singabangelwa ukungafakwa kahle kwemijovo ye-insulin, ukuthatha umthamo ongalungile, noma ukungasebenzi kahle kwephampu ye-insulin.
• Ukungalaphi kahle isifo sikashukela: ukungaphuzi imithi ngendlela efanele, ukungahloli amazinga kashukela egazini njalo.
• Ukuphuza utshwala: Utshwala bungabangela ukuthi amazinga kashukela egazini ehle ngendlela eyingozi.
• Ukungazi Nge-Hypoglycemia: Abanye abantu abaziboni izimpawu zokuqala zoshukela ophansi egazini, njengokuqhaqhazela nokujuluka. Bangase balahlekelwe ingqondo ngokuzumayo.

Benzani esibhedlela? (Ukuxilongwa nokwelashwa)

Ngenxa yokuthi lesi yisimo esiphuthumayo sezokwelapha, konke ukwelashwa kwenzeka esibhedlela. Odokotela bangasithola ngokushesha lesi simo ngokuhlola imininingwane yesiguli kanye namazinga kashukela egazini. Baphinde bahlole igazi ukuze babone ukuthi liqukethe ama-ketone.

Ukwelashwa kuncike embangela ye-coma.

• Uma kungenxa ye-DKA noma i-HHS:
• Uketshezi lwe-IV (usawoti): Usawoti unikezwa ngemithambo ukuze kuvinjelwe ukuphelelwa amanzi emzimbeni futhi kulinganiswe usawoti womzimba.
• I-insulin: I-insulin inikezwa ngemithambo yegazi noma njengomjovo ukulawula amazinga kashukela egazini.
• Ezinye izindlela zokwelapha: Uma kukhona ukutheleleka okuyisisekelo okubangela lesi simo, nakho kuzokwelashwa.

• I-Hypoglycemia Enkulu (ushukela ophansi egazini) ibangelwa yi:
• Umjovo we-Glucagon: I-Glucagon iyi-hormone esiza isibindi sethu ukuthi sikhiphe i-glucose ngokushesha egazini. Inganikezwa njengomjovo noma njengesifutho samakhala (impuphu yamakhala). Ngisho noma unikeza lokhu kumuntu ekhaya,Udinga ngempela ukuyiswa esibhedlela.

Kungenzeka yini ukululama ngokuphelele kulesi simo?

Yebo. Uma welashwa ngokushesha nangendlela efanele, i-diabetic coma ingalapheka ngokuphelele. Kodwa-ke, ngezinye izikhathi, uma ukwelashwa kwephuza, kungabangela ukulimala kwengqondo okungapheli, futhi kwezinye izimo, ngisho nokufa.

Ukuthi umuntu uhlala isikhathi esingakanani ekwi-coma kuncike ekutheni uthola ukwelashwa ngokushesha kangakanani. Ngaphandle kokwelashwa, umuntu ngeke avuke kulesi simo eyedwa. Ngakho-ke, kubalulekile ukumyisa esibhedlela ngokushesha okukhulu.

Lesi simo esiyingozi singagwenywa kanjani?

Lokhu ku-coma kuvame ukuvinjelwa . Into ebaluleke kakhulu okufanele uyenze ukuqaphela izimpawu zokuqala ze-DKA, HHS, kanye ne-Hypoglycemia bese uthatha isinyathelo ngokushesha nje lapho zivela.

Khuluma nodokotela wakho mayelana nohlelo lwakho lokuphatha isifo sikashukela. Funa usizo lwezokwelapha ngokushesha uma uhlangabezana nanoma yikuphi kwalokhu okulandelayo:

Kuvamile ukuzizwa wesaba uma uzwa ngezinkinga zesifo sikashukela. Kodwa ukuba nolwazi oluhle nokulungiselela kuyindlela engcono kakhulu yokuzivimbela. Ungalokothi unqikaze ukubuza udokotela wakho noma yimiphi imibuzo onayo mayelana nokuphatha isifo sikashukela sakho.