Isimo esiphuthumayo esiyingozi kakhulu kushukela: Uyazi nge-HHS? (Isimo se-Hyperosmolar Hyperglycemic)

Ingabe unesifo sikashukela? Noma ingabe umama wakho, ubaba wakho, noma omunye umuntu emndenini wakho unesifo sikashukela? Khona-ke lesi sihloko esikhuluma ngaso namuhla sizoba sibaluleke kakhulu kuwe. Isifo sikashukela yisimo esingaphathwa kahle, futhi ungaphila impilo evamile. Kodwa-ke, uma singalawulwa kahle, singaholela ezimweni eziphuthumayo ezinkulu ezingaba yingozi ngisho nokuphila. Leso yisimo esiphuthumayo esiyingozi kakhulu esikhuluma ngaso namuhla. Lokhu kubizwa ngokuthi i-Hyperosmolar Hyperglycemic State , esiyibiza ngokuthi i-HHS ngamafuphi.

Kalula nje, iyini i-HHS?

Kulungile, ake sikubeke kalula lokhu. Cabanga ukuthi izinga likashukela egazini lakho (i-glucose egazini) liphezulu kakhulu kangangokuthi akunakwenzeka ukulilawula. Uma izinga likashukela egazini lakho lidlula u-180 mg/dL, izinso zethu kufanele zikhiphe lowo shukela omningi emchameni. Kodwa lo shukela awuziphumi nje wodwa, kodwa uthatha namanzi ayigugu omzimba.

Manje, kwenzekani uma izinga likashukela egazini lakho liya ezingeni eliphezulu kakhulu, njengo-600 mg/dL, futhi lihlala linjalo izinsuku, mhlawumbe amasonto? Uqala ukuchama ngokweqile, futhi umzimba wakho uphelelwa amanzi emzimbeni kakhulu. Njengoba inani lamanzi emzimbeni wakho lehla, igazi lakho liyaqina kancane kancane. Njengoba nje senza uju, amanzi ayaqina. Ngokwezokwelapha, lokhu sikubiza ngokuthi ukuqina kwegazi okubizwa ngokuthi i -hyperosmolarity .

Ngakho-ke, i-HHS iyisimo esiphuthumayo esisongela ukuphila esenzeka lapho lezi zici ezintathu zihlangana: amazinga aphezulu kashukela egazini (i-hyperglycemia) , ukuphelelwa amanzi emzimbeni okukhulu , kanye ne -hyperosmolarity. Lesi simo sibonakala kakhulu kubantu abanesifo sikashukela sohlobo 2. Lesi yisimo esidinga ukulaliswa esibhedlela ngokushesha nokwelashwa. Uma singelashwa, singaholela ngisho nasekufeni.

I-HHS ne-DKA: Uyini umehluko phakathi kwalokhu okubili?

Esinye isimo esiphuthumayo esiyingozi esingase senzeke kubantu abanesifo sikashukela yi-DKA (Diabetic Ketoacidosis). Nakuba kokubili i-HHS ne-DKA kuyizifo ezisongela ukuphila ezibangelwa ushukela ophezulu egazini, kunomehluko ocacile phakathi kwazo zombili. Kubalulekile ukwazi lo mehluko.

• I-DKA (i-Diabetic Ketoacidosis): Lokhu kwenzeka kakhulu kubantu abanesifo sikashukela sohlobo 1. Okwenzeka lapha ukuthi umzimba cishe awunayo i-hormone ye-insulin. Ngenxa yokuntuleka kwe-insulin, amangqamuzana omzimba awakwazi ukusebenzisa ushukela ukwenza amandla. Bese umzimba uya kwenye indlela yokuthola amandla. Okungukuthi, ngokushisa amafutha emzimbeni. Uma amafutha eshiswa ngale ndlela, into yamakhemikhali ebizwa ngokuthi ama-ketone ingezwa egazini njengomkhiqizo ongeziwe. Lawa ma-ketone ayi-asidi. Uma ama-ketone anda egazini, igazi liba ne-asidi. Lena yinto eyingozi kakhulu nge-DKA.

• I-HHS (Isimo se-Hyperosmolar Hyperglycemic):Lokhu kwenzeka kakhulu kubantu abanesifo sikashukela sohlobo 2. Lapha, kune-insulini eningi emzimbeni. Ngenxa yalelo nani elincane le-insulini, umzimba ushisa amafutha futhi uvimbele ukwakheka kwama-ketones. Ngakho-ke, igazi alibi yi-asidi ku-HHS. Kodwa inkinga enkulu lapha ukwenyuka okungalawuleki kwamazinga kashukela kanye nokuphelelwa amanzi emzimbeni okukhulu kanye nokuqina kwegazi okubangelwa yilokhu.

Ake sibheke leli thebula ukuze sicacise kabanzi lo mehluko.

Ziyini izimpawu ze-HHS? Qaphela lezi!

Into eyingozi kakhulu nge-HHS ukuthi izimpawu azibonakali zonke ngesikhathi esisodwa . Zikhula kancane kancane, ezinsukwini noma emavikini. Ngakho umuntu angase angakuboni kuze kube yilapho sekuyimbi kakhulu. Yingakho kubalulekile ukuqaphela lezi zimpawu.

• Izinga likashukela egazini eliphakeme kakhulu: Ukuhlolwa kwe-glucometer yasekhaya ephakeme kakhulu kune-600 mg/dL (noma i-33 mmol/L).
• Ukudideka kwengqondo: Ukulahlekelwa ukwazi, ukungakwazi ukugxilisa ingqondo, ukudideka ekukhulumeni, ukulahlekelwa isikhathi, indawo, kanye nabantu abajwayelene nabo.
• Ukubona noma ukuzwa izinto ezingekho (Imibono Engaqondakali): Kungashiwo ukuthi ubona noma uzwa izinto ezingekho ngempela.
• Ukulahlekelwa ukwazi: Ezimweni ezimbi kakhulu, i-coma ingase ivele.
• Umlomo owomile, ulimi, kanye nokoma ngokweqile: Umuzwa wokoma ongapheli kungakhathaliseki ukuthi uphuza amanzi angakanani.
• Ukuchama kaningi: Nakuba ungase uchame kakhulu ekuqaleni, ungase uchame kancane njengoba ukuphelelwa amanzi emzimbeni kuba kubi kakhulu.
• Ukubona okufiphele noma ukulahlekelwa umbono: Ukubona kungase kufiphele kancane kancane.
• Ubuthakathaka bomzimba: Umuzwa wobuthakathaka emzimbeni. Ngezinye izikhathi uhlangothi olulodwa lomzimba lungakhubazeka, njengokungathi unesifo sohlangothi.

Kungani lesi simo se-HHS senzeka? Yiziphi izimbangela eziyinhloko?

Umuntu onesifo sikashukela esilawulwa kahle amathuba amancane okuthola i-HHS. Kodwa-ke, kumuntu isifo sikashukela esingalawulwa kahle, lesi simo singabangelwa "yimbangela." Okusho ukuthi, isenzakalo singabangela amazinga kashukela egazini ukuba aphakame kakhulu ukuba angawalawula, okuholela ku-HHS.

Izimbangela eziyinhloko ze-HHS yilezi:

• Ukutheleleka: Abantu abangu-50% kuya ku-60% abathola i-HHS banesifo sohlobo oluthile. Ikakhulukazi, i-pneumonia , ukutheleleka komgudu womchamo (UTI ), kanye ne-sepsis .) ukutheleleka yikona okuyinhloko. Cabanga nje, umama osekhulile unesifo sikashukela, uthola ukutheleleka esifubeni okunamafinyila amaningi. Ukucindezeleka okubangelwa yilokhu kutheleleka kungabangela amazinga kashukela egazini ukuba akhuphukele ezingeni elingalawuleki.
• Ukungayithathi imithi yakho yesifo sikashukela njengoba uyalelwe: Lesi futhi yisizathu esivame kakhulu. Abanye abantu bayadinwa bese beyeka ukuthatha imithi yabo, noma abayithathi ngesikhathi. Uma uthatha i-insulin, uma ungayithathi kahle, amazinga kashukela egazini lakho angakhuphuka kakhulu.
• Eminye imithi: Eminye imithi, njenge -corticosteroids (esetshenziselwa ukwelapha i-asthma kanye ne-arthritis), i-thiazide diuretics (esetshenziselwa ukwelapha umfutho wegazi ophakeme), kanye neminye imithi yesifo sengqondo, ingabangela amazinga aphezulu kashukela egazini futhi ibangele i-HHS.
• Izimo eziphuthumayo zenhliziyo nemithambo yegazi: Esimweni esibucayi njengesifo sohlangothi , ukuhlaselwa yinhliziyo , noma i-pulmonary embolism , umzimba uba ngaphansi kokucindezeleka okukhulu. Ama-hormone okucindezeleka akhishwa umzimba ngalesi sikhathi angabangela amazinga kashukela egazini ukuba akhuphuke ngokuzumayo.

Ubani osengozini enkulu yokuthola i-HHS?

Njengoba kushiwo ngaphambili, le ngozi iphansi uma isifo sikashukela silawulwa kahle. Kodwa-ke, abantu abalandelayo basengozini enkulu yokuthola i-HHS:

• Abantu abangalawuli kahle isifo sikashukela.
• Abantu abadala abangaphezu kweminyaka engama-65: Njengoba bekhula, ikhono labo lokuzwa ukoma lingase linciphe, ngakho-ke bangase bangaqapheli ukuthi baphelelwe amanzi emzimbeni.
• Labo abanezinye izifo (ukutheleleka, ukugula) noma izinkinga zenhliziyo.

Yiziphi izinkinga ezingaba khona ngenxa ye-HHS?

Uma i-HHS ingelashwa ngesikhathi, kungaholela ezinkingeni ezinkulu kakhulu.

• Ukuquleka
• I-Coma
• Ukwehluleka kwezitho zomzimba
• Ukufa

Abantu abaphakathi kuka-10% no-20% abathola i-HHS bayafa. Lokho kusho ukuthi oyedwa noma ababili kwabayishumi bazofa. Yileso simo esibucayi kakhulu.

I-HHS ihlolwa futhi yelashwa kanjani esibhedlela?

Uma ungeniswa eMnyangweni Wezimo Eziphuthumayo (i-ETU), udokotela uzokuxilonga futhi akubuze ngezimpawu zakho. Ngemuva kwalokho, bazokuyala ukuhlolwa kwegazi okuningana. Lokhu kuzohlola izinga likashukela egazini lakho, i-osmolality yegazi, ukusebenza kwezinso, kanye nokuthi ngabe kukhona yini ama-ketone egazini lakho.

Uma izinga likashukela egazini liphakeme kakhulu kuno-600 mg/dL futhi izinga le-ketone egazini liphansi, kutholakala ukuthi yi-HHS.

Ukwelashwa kuhilela ukukugcina ewadini noma egunjini lokunakekelwa okujulile (ICU) kanye nokukunikeza uketshezi olungena emzimbeni.

Kunezinhloso ezintathu eziyinhloko zokwelashwa:

1. Ukubuyiselwa kwamanzi emzimbeni: Usawoti unikezwa ngemithambo ukuze kuqedwe ukuphelelwa amanzi emzimbeni.

2. Ukulinganisela Ama-Electrolyte: Uma umzimba uphelelwa amanzi emzimbeni, amaminerali amaningi abalulekile njenge-potassium ayalahleka emzimbeni. Athathelwa indawo ngosawoti.

3. Ukulawula amazinga kashukela egazini: I-insulin inikezwa ngemithambo yegazi ukuze kwehliswe amazinga kashukela egazini kancane kancane nangokulawulwayo.

Ngaphezu kwalezi zindlela zokwelapha, uma kukhona ukutheleleka okuyisisekelo okubangele isimo se-HHS, nakho kuyalashwa.

Ingabe izinkinga zingaba khona ngesikhathi sokwelashwa?

Yebo, nakuba kungavamile kakhulu, izinkinga zingavela ngenxa yokwelashwa. Okusho ukuthi, uma amazinga kashukela egazini ehla ngokuzumayo nangokushesha, amangqamuzana obuchopho angagcwala amanzi ngokuzumayo bese ubuchopho buvuvukala (i-cerebral edema). Kodwa lokhu akuvamile kakhulu. Odokotela bayazi ukuthi bangawehlisa kanjani amazinga kashukela egazini ngokuphepha nangokuhamba kancane. Ngakho-ke asikho isidingo sokukhathazeka ngakho.

Ungazivikela kanjani ku-HHS?

Indlela engcono kakhulu newukuphela kwayo yokugwema lesi simo esiyingozi ukuphatha isifo sikashukela sakho kahle kakhulu. Ukuze wenze lokhu, qiniseka ukuthi uyazenza lezi zinto.

• Hlola amazinga kashukela egazini lakho njalo bese uzama ukuwagcina ngaphakathi kwebanga eliqondiwe udokotela wakho akunike lona.
• Phuza umuthi (amaphilisi noma i-insulin) owunikezwe udokotela wakho ngesikhathi esifanele nangesilinganiso esifanele, ngaphandle kokulahlekelwa usuku olulodwa.
• Uma unenkinga yokulawula isifo sikashukela sakho, khuluma nodokotela wakho ngakho bese uthola iseluleko esidingekayo.
• Landela ukudla okunempilo okukufanele.
• Uma unesifo esifana nomkhuhlane noma umkhuhlane, qaphela kakhulu. Phuza amanzi amaningi, phumula ngokwanele, futhi uhlole ushukela wakho wegazi kaningi kunokujwayelekile. Lokhu kungenxa yokuthi ukucindezeleka emzimbeni wakho uma ugula kungabangela ushukela wakho wegazi ukwenyuka.
• Qaphela izimpawu ze-HHS. Uma ubona noma yiziphi zalezi zimpawu, thatha isinyathelo ngokushesha.