Wake wambona umuntu ephefumula ngokushesha nangokujulile, njengokungathi usanda kuqeda ukugijima isikhathi eside, ngaphandle kokulawula? Kodwa wayengagijimi. Lokhu yilokho esikubiza ngokuthi 'ukuphefumula kukaKussmaul', esikubona njengophawu lwesimo esiyingozi. Lokhu akuyona nje into engathandeki, kodwa yisixwayiso esingathi sína esivela ngaphakathi emzimbeni. Ngakho-ke, ake sikuqonde lokhu ngqo namuhla.
Kuyini ukuphefumula kwe-Kussmaul?
Kalula nje, ukuphefumula kukaKussmohl kuwukuphefumula okusheshayo, okujulile, nokunesigqi ngendlela engavamile. Kuwuhlobo lwesimo esibizwa ngokuthi i-hyperventilation.
Cabanga nje, kunenkinga enkulu emzimbeni wethu. Okusho ukuthi, okuqukethwe yi-asidi egazini kuyanda kuze kube sezingeni eliyingozi. Ngokwezokwelapha, lokhu sikubiza ngokuthi i-metabolic acidosis . Uma lokhu kwenzeka, umzimba uzama ukususa le-asidi eningi. Enye yezindlela ezinhle zokwenza lokhu ukukhipha i-carbon dioxide. Ngoba i-carbon dioxide nayo iyi-asidi enkulu egazini. Ngakho-ke, umzimba uphefumula ngokushesha nangokujulile ukuze ukhiphe le-asidi ngokushesha.
Lokhu kufana nomzamo womzimba wokuzisindisa. Yingakho umuntu okubonayo lokhu ebonakala sengathi uhlushwa "yindlala yomoya."
Into ebalulekile ukuthi umuntu ophefumula ngale ndlela akakwazi ukuyilawula. Kuyimpendulo yomzimba ngokwakhe esimweni sezokwelapha esingaphansi. Ngakho-ke, ukuphefumula kukaKussmohl kuyisimo esiphuthumayo sezokwelapha. Uma wena noma othile omaziyo ephefumula ngale ndlela, kufanele umyise ngokushesha emnyangweni wezimo eziphuthumayo wesibhedlela (ETU) .
Lokhu kuhluke kanjani ekuphefumuleni okuvamile kanye nezinye izindlela zokuphefumula?
Ngezinye izikhathi lezi zindlela zokuphefumula zingadidaniswa. Kodwa kukhona umehluko omkhulu. Ake sibheke umehluko omkhulu.
| Iphethini yokuphefumula | Umehluko omkhulu | Isizathu esivame kakhulu |
|---|---|---|
| Ukuphefumula kwe-Kussmaul | Ukuphefumula okusheshayo, okujulile, nokunesigqi. Umzamo wokunciphisa i-asidi emzimbeni. | I-ketoacidosis yesifo sikashukela (i-DKA). |
| Ukuphefumula kweCheyne-Stokes | Ukuphefumula kuyashesha, kuyajula, kuyehla futhi, bese kuyeka okwesikhashana. Isigqi siyaqhubeka nokushintsha. | Ukwehluleka kwenhliziyo, isifo sohlangothi. |
| Ukuphefumula ngokweqile | Ukuphefumula okusheshayo noma okujulile, okuvame ukubangelwa ukucindezeleka, ukukhathazeka, noma ukwesaba. | Ukukhathazeka, ukuphazamiseka kovalo. |
Yiziphi izimbangela eziyinhloko zokuphefumula kukaKussmohl?
Njengoba sixoxile ngaphambili, imbangela eyinhloko yisimo esibizwa ngokuthi i-metabolic acidosis. Lokhu kusho ukuthi i-asidi egazini iyanda. Imbangela eyinhloko nevame kakhulu yalokhu yizimo ezihlobene nesifo sikashukela.
Imbangela eyinhloko: I-Diabetic Ketoacidosis (DKA)
Lena yimbangela evame kakhulu yokuphefumula kweKussmohl. I-DKA iyinkinga esongela impilo, kodwa engelapheka, engenzeka kumuntu onesifo sikashukela.
- Kwenzekani ku-DKA?: Uma umzimba untula i-insulin eyanele, i-hormone ebalulekile emzimbeni ukuze usebenzise i-glucose ukuze uthole amandla, umzimba uqala ukushisa amafutha ukuze uthole amandla.
- Inkinga iqala lapha: Uma ushisa amafutha, amakhemikhali abizwa ngokuthi ama-ketone aqoqana egazini njengomkhiqizo ophumayo. Lawa ma-ketone awuhlobo lwe-asidi.
- Umphumela: Lapho la ma-ketone eqongelela egazini lomuntu onesifo sikashukela, i-asidi (pH) yegazi yehla ngendlela eyingozi.
- Isigaba sokugcina: Ukuphefumula kukaKussmohl kuyisibonakaliso sesigaba sokugcina se-DKA esinzima. Kungaholela ngisho nasekufeni uma kungelashwa ngokushesha.
Yiziphi ezinye izizathu?
Ngaphezu kwe-DKA, kunezinye izimbangela ezingathinta ukuphefumula kwe-Kussmohl.
- Ukwehluleka Kwezinso: Uma izinso zingakwazi ukususa ama-asidi ngomchamo, ama-asidi aqoqana egazini. Lokhu kungaholela ezimweni ezifana ne-"Renal tubular acidosis".
- I-Sepsis:Ukutheleleka okungene emzimbeni kuba kubi kakhulu.
- Ukungenisa ubuthi obuthile: Isibonelo, uma ugwinya ubuthi obufana ne-methanol, esimweni esinjalo, ungashayela iNational Poison Information Center eColombo National Hospital ukuze uthole iseluleko.
- Inkinga yokusebenzisa utshwala.
- Ukwehluleka kwezitho ezibalulekile njengenhliziyo nesibindi.
- Izifo ezithile ezifana nomdlavuza .
Indlela yokwelapha nokuvimbela lesi simo?
Ngenxa yokuthi ukuphefumula kukaKussmohl kuyimpawu, ukwelashwa kuqondiswa esimweni esiyisisekelo esibangele lokhu. Ukwelashwa kuvame ukwenziwa esibhedlela.
Odokotela bavame ukunikeza uketshezi olufakwa ngemithambo yegazi (IV) kanye nama-electrolyte ukuze kubuyiselwe ibhalansi ye-acid-base yegazi. Ku-DKA, i-insulin efakwa ngemithambo yegazi (IV) ibalulekile.
Into ebaluleke kakhulu ukuvimbela lesi simo, ikakhulukazi i-DKA.
- Uma unesifo sikashukela: Hlola amazinga kashukela egazini lakho njalo. Thatha i-insulin yakho kanye neminye imithi njengoba udokotela wakho ekuyalele ngesikhathi. Uma ugula (njengomkhuhlane noma umkhuhlane), usengozini enkulu ye-DKA, ngakho khuluma nodokotela wakho mayelana nendlela yokuphatha isifo sikashukela sakho phakathi nalesi sikhathi.
- Isifo sikashukela esingatholakali: Kunzima ukuvimbela i-DKA. Ngakho-ke, ukwazi izimpawu zayo eziyisixwayiso kungasindisa impilo.
| Izimpawu eziyisixwayiso ze-diabetesic ketoacidosis (DKA) | |
|---|---|
| Izimpawu Zokuqala | |
| |
| Izimpawu Ezinzima | |
|
Uma wena noma ingane yakho ninalezi zimpawu, hambani niye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela esiseduze ngokushesha, ngaphandle kokulibala.
Umlayezo Wokuya Nawe Ekhaya
- Ukuphefumula kukaKussmohl akuvamile. Kuwuphawu lwenkinga enkulu yezokwelapha, njenge-metabolic acidosis.
- Imbangela evame kakhulu yalokhu yi-diabetesic ketoacidosis (DKA), okuyinkinga enkulu yesifo sikashukela.
- Lesi yisimo esiphuthumayo sezokwelapha. Uma ubona umuntu ephefumula kanje, myise eMnyangweni Wezimo Eziphuthumayo wesibhedlela (ETU) ngokushesha.
- Uma unesifo sikashukela, ukusiphatha kahle kuyindlela engcono kakhulu yokuvimbela i-DKA. Landela imiyalelo kadokotela wakho.
- Qaphela izimpawu zokuqala ze-DKA, njengokoma ngokweqile, ukuchama njalo, kanye nephunga elimnandi lokuphefumula. Thatha isinyathelo ngokushesha, kunokulinda ushintsho endleleni yokuphefumula.
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