Litsela tse ka sehloohong tsa kalafo ea lefu la tsoekere ke:

- tšebeliso ea lithethefatsi,

- tloaelo ea ho ikoetlisa

- thuto ea mamello le boitšoaro (sekolo sa lefu la tsoekere),

- Thibelo le kalafo ea mathata a kapele a lefu la tsoekere.

Morero oa kalafo ea lefu la tsoekere ke ho fumana mats'oafo a lefu lena.

Bakuli ba lefu la tsoekere ba tlameha ho qhelela ka thōko tšebeliso ea tsoekere, sirapo, polokeho, lero, lijo-thollo, libisikiti, libanana, morara, matsatsi, joala le lihlahisoa tse ling.

Phekolo ka lithethefatsi tsa molomo tsa hypoglycemic.

Lithethefatsi tse tloaelehileng tse fokotsang tsoekere li arotsoe ka lihlopha tse peli tse kholo: tse tsoang ho tsona sulfonylureas le biguanides.

Mochine oa ts'ebetso ea lithethefatsi sulfonylureas e rarahaneng ebile e le ka lebaka la ketso ea bona e bohareng le e poteletseng. Tšusumetso ea bona e kholo lihlekehlekeng tsa "pancreatic" e hlalosoa ke ho hlohlelletsoa ha insulin secretion, ntlafatso kutloisisong ea lisele tsa клеток ho glycemia, eo qetellong e lebisang ntlafatsong ea insulin.

Phello e eketsehileng-pancreatic e lebisa hoketsong ha tšebeliso ea tsoekere maling le mesifa ka keketseho ea sebopeho sa glycogen ho bona, i.e. tlhahiso ea tsoekere e tsoang ho sebete e fokotseha le katleho ea ketso ea insulin ea tsoelo-pele e eketseha.

Biguanides eketsa tšebeliso ea phello ea glucose boteng ba insulin, fokotsa tsoekere, ho monya ha tsoekere maling ka mpeng, hape e fokotsa litaba tsa insulin tse maling le bakuli ba nang le botenya le mofuta oa 2 lefu la tsoekere. Ntle le moo biguanides ba le phello e itseng ea anorectic. Ts'ebeliso ea nako e telele ea tsona e ama hantle metabolism ea lipid (ho fokotsa cholesterol, triglycerides).

Ha phello e sa khotsofatseng ea kalafo ka lithethefatsi tsa hypoglycemic e fanoa kalafo ea insulin.

Matšoao a akaretsang bakuli ba lefu la tsoekere ba fuoe insulin: 1) mofuta oa 1 lefu la tsoekere, 2) ketoacidosis, lefu la tsoekere, 3) ho fokotsa boima ba 'mele, 4) ho hlaha ha mafu a kopanang, 5) ts'ebetso ea botona, 6) ho ima le ho nyekeloa. kalafo.

Sehlopha sa insulin

Ka nako ea nako insulin ke:

khato e khuts'oanyane - ho qala ha ts'ebetso kamora metsotso e 15-30, nako e tloaelehileng ea lihora tse 5-8,

nako e mahareng - ho qala ha ts'ebetso kamora lihora tse 1.5 -3, bolelele - lihora tse 12-22,

nako e telele - ho qala ha ts'ebetso kamora lihora tse 4-6, nako - ho tloha lihora tse 25 ho isa ho tse 30 (36).

bovine (insulrap, ultralong, ultlente, jj),

nama ea kolobe - e haufi haholo le motho, e fapana ka amino acid e le ngoe (monoinsulin, actrapid, insulrap SPP, jj.),

pig ea bovine (iletin-kamehla, insulin-B),

ea motho - e fumanoe ke boenjiniere ba liphatsa tsa lefutso ho tsoa ho E. coli le tomoso ea baker's (humulin, monotard, protofan NM).

Ka tekanyo ea tlhoekiso ea insulin (ho tloha somatostatin, pancreatic polypeptide, glucagon, jj.):

tloaelehileng (moetlo) - boholo ba litšila bo ka ba ho fihla ho 1%, e khethollang bohloeki ba bona bo phahameng,

monopic (semi-hloekisitsoeng) - litšila li na le 0,1%,

monocomponent (e hloekisitsoe) - lisosa tsohle tsa batho.

Li-insulin tsa monopic le monocomponent li sebetsa haholo ho feta tse tloaelehileng, ha li atise ho theha lithibela-mafu, lipodystrophy, le allergic reaction.

Mekhoa ea phekolo ea insulin

Ho baloa ha tekanyetso ea insulin e le 'ngoe le ea letsatsi le letsatsi ho etsoa ho nahaneloa boemo ba glycemia le glucosuria. Lintho tse ling li lekane, tlhokomelo e khethehileng e lokela ho nkuoa ha ho khethoa litekanyetso tsa insulin maemong a ho senyeha ha meno, hobane lipalo tse tlase tsa glucosuria ha se kamehla li supang boemo ba 'nete ba glycemia. Ntle le moo, liphio ke sebaka sa ho senya (tšenyo) ea insulin mme ha ts'ebetso ea bona e sa sebetse, tlhoko ea insulin e ea fokotseha, e leng tlasa khalemelo e tlamang. Ho seng joalo, mokuli, ho ka bonahala e le litekanyetso tse tloaelehileng tsa insulin bakeng sa hae, a ka ba le hypoglycemia e matla le e behang bophelo kotsing.

Qalong, mokuli o fuoa tekanyetso ea letsatsi le letsatsi - ena ke boleng bo bontšang tlhoko ea insulin ea letsatsi le letsatsi ho latela boima ba 'mele ba mokuli le hore na lefu le tla nako e kae.

Likarolo tsa lefu la tsoekere la mofuta oa 1

Karolelano ea letsatsi le letsatsi insulin, UNITS / kg

Kamora ho lefa tefo ea metabolism ea mofuta oa 1 oa lefu la tsoekere o fumanoeng

Haeba ho na le matšeliso a sa khotsofatseng

Selemo sa bobeli le nako e telele ea lefu lena

Ketoacidosis, ho ba teng ha mafu a tšoaetsanoang le a tšoaetsanoang

Hajoale, ba sebelisa mokhoa oa insal-bolus oa tsamaiso ea li-insulin (i.e., motsoako oa li-insulin tse khutšoane le tse telele), ba etsisa ts'ireletso ea insulin. Tabeng ena, insulin ea nako e telele e fanoa pele ho lijo tsa hoseng ka tekanyo e lekanang le 1/3 ea lethal dose ea letsatsi le letsatsi, tekanyetso e setseng ea 2/3 ea letsatsi le letsatsi e tsamaisoa ka mokhoa oa insulin ea nakoana (e ajoa pele ho lijo tsa hoseng, tsa mots'eare le tsa lijo tsa mantsiboea ka tekanyo ea 3: 2: 1).

Tlhokomelo ea maemo a tšohanyetsoka hyperglycemic coma:

Mokhoa o akaretsang oa kalafo ea lefu la tsoekere o kenyeletsa:

1) ho felisoa ha khaello ea insulin le ho tloaeleha ha metabolism ea carbohydrate,

2) ho hlasimolla 'mele ka potlako,

3) tsosoloso ea motsoako o tloaelehileng oa mak'homphieutha le maiketsetso,

4) Ho khutlisetsoa mehloli ea "glucose" glycogen) 'meleng,

5) khutlisetso ea tekanyetso e tloaelehileng ea acid-base (COR),

6) ts'oaetso le kalafo ea mafu kapa maloetse a a bakileng letšollo,

7) lethathamo la mehato ea kalafo e reretsoeng ho khutlisa le ho boloka ts'ebetso ea litho tsa ka hare (pelo, liphio, matšoafo, jj.).

Ho loants'a ho putlama ho lefu la tsoekere, "Catecholamine" le lithethefatsi tse ling tsa kutlo ha li lokela ho sebelisoa. Contraindication ha e amahanngoe feela le taba ea hore li-catecholamine ke lihormone tsa li-contra-hormone, empa le taba ea hore ho bakuli ba lefu la tsoekere phello ea bona e matlafatsang ho secretion ea glucagon e matla haholo ho feta ho batho ba phetseng hantle.

Hang ha mokuli a isoa setsing sa bongaka, pele ba qala kalafo, ba lekola boemo ba tsoekere ea mali (haeba ho ka khoneha 'mele ea ketone, hammoho le pH, sebaka sa polokelo ea alkaline, li-electrolyte le naetrojene e setseng), ba etsa tlhahiso ka ho theha microcatheter ea venous. Ka mor'a moo, catheterization ea lesapo la mokokotlo le boikemisetso bo potlakileng ka moroto oa boemo ba tsoekere le 'mele oa ketone (haeba ho khoneha hape le liprotheine le lisele tse khubelu tsa mali), sefutho se qobelloang sa gastric ka tharollo ea bicarbonate.

Ketoacidotic coma insulin kalafo e qala ka nako e tšoanang ka ho omella hape, hangata sethaleng sa pele ho bophelo. Hajoale, linaheng tsohle tsa lefats'e, ho kenyeletsoa le naheng ea rona, litekanyetso tsa "insulin" tse nyane kapa "tsa mmele" li sebelisetsoa merero ena. Lebaka la ts'ebeliso ea litekanyetso "tse nyane" tsa insulin ho ketoacidosis e ne e le lithuto tse bonts'ang hore karolo ea "insulin" ea mali ea 10-20 mU / ml e thibela lipolysis, gluconeogeneis le glycogenolysis, le bongata ba li-insulin tsa 120-180 mU / ml. Ho hlahisoa ha insulin ka tekanyo ea 5-10 U / h ho baka khatello ea mali maling, ho hlokahala hore ho hatelle feela lipolysis, glycogenolysis le glucogenesis, empa hape le ketogenesis.

Mokhoa o nepahetseng ka ho fetesisa oa ho kenella ka har'a tekanyetso e nyane ea insulin. Insulin e bonolo e kenngoa ka tharollo ea 0,9% ea sodium chloride mme e tšeloa ka tekanyo ea 5-10 (ka tlase khafetsa 10-15) U / h. Pele ho qala ts'oaetso, ho khothalletsoa hore likarolo tsa 10 tsa insulin li tsamaisoe kahare ka matla. Tekanyetso e hlokahalang ea insulin bakeng sa infusion e tsoelang pele ka nako e fetang hora ke 0.05-0.1 U / kg.

Tekanyo ea infusion 'me, ka hona, tekanyetso ea insulin e itšetleha ka matla a litaba tsa glucose tse serumeng ea mali ea mokuli, e hlahlojoang hora e' ngoe le e 'ngoe. Sekhahla se nepahetseng sa ho fokotseha ha tsoekere maling ke 3,89-5.55 mmol / h. Kamora hore tsoekere ea mali e fokotsehe ho 11.1-13.9 mmol / L, sekhahla sa infusion se theotsoe ka 2-4 U / h e le hore letšoao lena le lule le le maemong a 8.33-11.1 mmol / l ho etsa hore pH e be le mali, ebe insulin e tsamaisoa ka mokhoa o ikhethileng ka li-unit tse 12 ka mor'a lihora tse 'ne kapa tse ling le tse ling tse 4 ho isa ho tse peli.

Glycemia, likhase le li-elektrone tsa mali, hammoho le glucosuria le ketonuria li hlahlojoa hora e 'ngoe le e' ngoe. Haeba bofelong ba hora ea pele ea infusion boemo bo sa fokotsehe ka 10% ho tloha ho ea pele, ho hlokahala hore ho pheta tsamaiso e le 'ngoe ea 10 PIECES ea insulin' me u tsoele pele ho kenella ka sekhahla ka tekanyo e tšoanang kapa ho eketsa tekanyetso ea insulin ho 12-16 PIECES / h.

Ho khutlisetsa tsoekere 'meleng ke mohato oa ho qetela phekolong ea lefu la tsoekere. Joalokaha ho bontšitsoe kaholimo, ka ho fokotseha ha glycemia ho 11.1-13.9 mmol / l, tekanyetso ea insulin e fokotsehile haholo, ha ts'ebetso e kenelletseng ea tharollo ea glucose ea 5% e qala. Nakong e tlang, kalafo ea insulin e etsoa feela ka kopanelo le tsoekere, e le hore maemong a glycemia a phahameng ho feta 10-11 mmol / l, bakeng sa tharollo e 'ngoe le e' ngoe ea 100 ml ea glucose, likarolo tsa 2-3 tsa insulin li fanoa, 'me ka glycemia ka tlase ho 10 mmol / l - ha ho sa le tse ling Setsi se le seng ka 100 ml ea tharollo ea 5%. Tharollo ea glucose ea isotonic e kenngoa ka tekanyo ea 500 ml ka lihora tse 4-6, ha tekanyo ea tsoekere e fanoang ka letsatsi e lokela ho ba 100-150 g. Ka tlhahlobo e nepahetseng ea laboratori, regimen ena ea "glucose insulin" e thata e lumella ho boloka tsitsipano ea mali e tsitsitseng ea 9 -10 mmol / l nako e telele.

Tlhokomelo ea tšohanyetso bakeng sa komello ea hypoglycemic:

Ha ho netefatsa ho fumanoa ha lefu la hypoglycemic coma, kalafo e kenyelletsa kenyelletso ea 50 ml ea tharollo ea glucose ea 50% kahare (haeba ho sa khonehe phepelo ea phepo e nepahetseng ea mokuli) bakeng sa metsotso e 3-5, e lateloe ke ho ts'oaroa ha tharollo ea glucose ea 5 kapa 10%. Ho bakuli ba bang, ho hlaphoheloa hoa kelello ho etsahala hang kamora ho tsamaisoa ha tsoekere, ho ba bang ho nka nako e itseng. Tsamaiso ea methapo ea tsoekere e lokela ho tsoela pele nakong eohle ea ts'ebetso ea insulin kapa sethethefatsi sa hypoglycemic se ileng sa baka komello ena (mohlala, haeba komello e bakoa ke ho nka chlorpropamide, tsoekere e lokela ho tsamaisoa ka matsatsi a 'maloa). Ho feta moo, ho khothalletsoa tlhahiso ea 1 mg ea glucagon intramuscularly. Kamora ho emisa komello, ho lokisoa kalafo e fokotsang tsoekere, lijo le mofuta oa mokuli li lokela ho etsoa.

Komisi ea lefu la tsoekere ke eng

E 'ngoe ea mathata a tloaelehileng a lefu la tsoekere ke lefu la tsoekere le amanang le phetoho ea khatello ea glucose ea plasma le nts'etsopele ea liphetoho tsa metabolic. Haeba motho a sa bonoe ka nako, ka nako eo liphetoho li ka se fetohe 'me tsa lebisa lefung.

Hyperglycemic

Hyperglycemic (hyperosmolar) coma ka lefu la tsoekere e tšoauoa ke tsoekere e phahameng ea mali (ho feta 30 mmol / l), sodium e phahameng (ho feta 140 mmol / l), osmolarity e phahameng (palo ea li-cations tse qhibilihileng, li-anions le lintho tse sa nke lehlakore li fetang 335 mosm / l) .

Se ka u tsosang:

1. Ho ja ka mokhoa o sa lekanyetsoang oa lithethefatsi tse fokotsang maemo a tsoekere.
2. Ho tlosa kapa ho sebelisa litlhare tsa hypoglycemic ntle le tumello ntle le tumellano le ngaka ea hau.
3. Mokhoa o fosahetseng oa ho tsamaisa lithethefatsi tse nang le insulin.
4. Psychitant pathology - khatello ea maikutlo, pancreatitis, boimana, ho buoa.
5. Bohlokoa ba lik'habohaedreite ka har'a lijo - maemo a tsoekere a eketseha.
6. Ts'ebeliso ea lithethefatsi tse itseng (diuretics li baka ho omella hoa metsi, ka hona ho eketsa osmolarity, glucocorticoids e eketsa tsoekere ea mali).
7. Nyoriloe, ka sekhahla se nyane sa metsi. E lebisa ho qoelleng 'mele.
8. Metsi a metsi, ho hlatsa ho sa khaotseng - ho omella hoa hoa.

E har'a tse kotsi bophelong le bophelong. Ka keketseho e potlakileng ea tsoekere ea mali, o lokela ho batla thuso ea bongaka ka potlako.

Hypoglycemic coma

Mokhoa oa thuso ea pele bakeng sa lefu la tsoekere.

Ona ke mofuta o atileng haholo oa lefu la tsoekere. E tšoauoa ka ho theoha ka tšohanyetso tsoekere ea mali ka tlase ho 3 mmol / L.

• tekanyetso e phahameng ea insulin
• ho hloleha hoa matla
• ho ikoetlisa ka matla
• ho nooa haholo,
• lithethefatsi tse ling (B-blockers, lithium carbonate, clofibrate, anabolics, calcium).

Hangata ho etsahala, empa ho emisoa habonolo ke ts'ebeliso ea lik'habohaedreite tse potlakileng (metsi a nang le tsoekere, lipompong).

Lefu la tsoekere la ketoacidotic

Ena ke komello e kotsi ka ho fetisisa ho lefu la tsoekere mellitus, moo pH e theohelang ka tlase ho 7.35, litekanyetso tsa tsoekere e nyolohang ho 13 kapa ho feta, mme palo e eketsehileng ea 'mele ea ketone e teng maling. Batho ba nang le lefu la tsoekere la tlhaho ea tlhaho le bona ba kotsing e kholo ea ho utloa bohloko. Lebaka ke khetho e sa utloahaleng ea litekanyetso tsa insulin kapa keketseho ea tlhokahalo ea eona.

1. Tekanyetso e sa lekaneng ea lithethefatsi tsa hypoglycemic kapa ho tlōla tekanyetso ea insulin.
2. Ho hana kalafo ea hypoglycemic.
3. Tsamaiso e fosahetseng ea litokisetso tsa insulin.
4. Li-pathologies tse khahlisang - ts'ebetso ea ts'ebetso ea ho buoa, ho otloa, joalo-joalo.
5. Lijo tse phahameng tsa carb, ho nona ho feta tekano.
6. Ho ikoetlisa ka thata ka 'mele o nang le tsoekere e ngata ea mali.
7. Bokhoba ba tahi
8. Mekhoa e meng ea meriana (lithibela-pelehi tsa lihormone, diuretics, morphine, litokisetso tsa lithium, li-dobutamine, li-adrenal le lihomone tsa qoqotho).

Ketoacidotic coma e hloka ho kena lipakeng tsa bongaka ka ho tsosa takatso, ho seng joalo motho o shoa.

Phapang lipontšo

Lethathamo: Litla-morao tsa sebopeho sa matšoao.

Ketoacidotic le hyperglycemic coma ea lefu la tsoekere e eketseha butle butle, motho a ka ela hloko ponahalo ea monko o bohale o tsoang molomong kapa ho fokotseha ha matla a mesifa. Hypoglycemic e hlaha ka matla, kahoo mokuli o lokela ho lula a e-na le liswiti le eena, tse lokelang ho jeoa ha ho thothomela ho hlaha.

Thuso ea pele bakeng sa coma ea hyperglycemic

Maano pele ho ho fihla ha lingaka:

1. Beha lehlakore la eona, lokisa leleme.
2. Fumana hore na ho na le "mellitus" ea lefu la tsoekere kapa boemo bo ntlafalitsoeng ka lekhetlo la pele.
3. Haeba ho khonahala, lekanya tsoekere ea mali pele u fana ka litokisetso tsa insulin le metsotso e 20 kamora moo. Kenya likarolo tsa 5-10 tsa insulin ka mokhoa o ikhethileng.
4. Ha ho phefumoloha ho emisa ho phefumoloha ka molomo.
5. Ka ho sisinyeha, matlafatsa maoto le matsoho.

Ketso ea ho ferekanya kelello

Mekhahlelo ea phepelo ea thuso ea pele:

1. Beha lehlakore la eona, lokisa leleme.
2. Leka ho fana ka tharollo e tsoekere ea tsoekere ho nooa (3 tbsp. Per 100 ml ea metsi) kapa ente tharollo ea glucose (litlhare tsa litlhare) kahare.
3. Ha ho phefumoloha ho emisa, nka mehato ea ho tsosa - ho phefumoloha ka molomo.
4. Leka ho fumana hore na motho o na le lefu la tsoekere kapa o na le boemo bo itlhahetse feela.

Seo u lokelang ho se etsa ka ketoacidotic coma

1. Beha mokuli lehlakoreng la hae, lokisa leleme.
2. Kenya insulin ea 5-10.
3. Ha ho phefumoloha ho emisa, phefumoloha ka molomo ka molomo.
4. Lekola sekhahla sa pelo, khatello ea mali, tsoekere ea mali.

Tlhokomelo ea tšohanyetso e nang le komello ea ketoacidotic e theohela ho phekolo ea infusion (tsamaiso ea methapo ea methapo), ka hona e ile ea ba lingaka.

Haeba mofuta oa komisi o sa hlalosoe

1. Fumana hore na mokuli o na le lefu la tsoekere.
2. Lekola boemo ba tsoekere.
3. Lekola motho bakeng sa matšoao a mofuta o le mong oa komisi.

Coma ke boemo bo kotsi, ho ke ke ha khoneha ho etsa mekhoa e meng ea kalafo lapeng. Ho diabetesology, seo u ka se etsang maemong a joalo se tlalehiloe ho li-algorithms tsa tlhokomelo ea tšohanyetso, hobane mofuta o mong le o mong oa li-coma li fapane, empa li ka etsoa feela ka thuto ea bongaka.

Thuso ea Pele bakeng sa lefu la tsoekere

E 'ngoe ea maloetse a kajeno a thellang ke lefu la tsoekere. Batho ba bangata ha ba tsebe, ka lebaka la khaello ea tlhahiso ea matšoao, hore ba na le lefu la tsoekere. Bala: Matšoao a mantlha a lefu la tsoekere - o lokela ho a hlokomela? Ka lebaka leo, khaello ea insulin e ka baka mathata a maholo 'me ha ho sa tšoaroe kalafo e nepahetseng, e beha bophelo kotsing. Mathata a tebileng a lefu la tsoekere ke ho ferekana. Ke mefuta efe ea lefu la tsoekere e tsebahalang, hona u ka fana ka thuso ea pele ho mokuli ea boemong bofe?

Letsoalo la lefu la tsoekere - lisosa tse ka sehloohong, mefuta ea lefu la tsoekere

Har'a mathata 'ohle a lefu la tsoekere, maemo a hlobaetsang a joaloka lefu la tsoekere, maemong a mangata, a ka fetoha. Ho ea ka tumelo e tloaelehileng, komello ea lefu la tsoekere ke boemo ba hyperglycemia. Ka mantsoe a mang, ke tsoekere e feteletseng ea mali. Ebile, lefu la tsoekere le ka ba mefuta e fapaneng:

1. Hypoglycemic
2. Hyperosmolar kapa hyperglycemic coma
3. Ketoacidotic

Sesosa sa komello ea lefu la tsoekere e ka ba keketseho e matla tekanyong ea tsoekere maling, kalafo e sa lokelang ea lefu la tsoekere esita le tšebeliso e ngata ea insulin, eo boemo ba tsoekere bo theohelang ka tlase ho tloaelehileng.

Matšoao a komello ea hypoglycemic, thuso ea pele bakeng sa ho lemala ha hypoglycemic

Maemo a Hypoglycemic ke sebopeho, boholo, bakeng sa lefu la tsoekere la mofuta oa 1, leha li etsahala ho bakuli ba sebelisang lithethefatsi matlapeng. Ha e le molao, nts'etsopele ea mmuso e etelloa pele ke keketseho e tšabehang ea palo ea insulin maling. Kotsi ea ho ba le komello ea hypoglycemic e ho tlhaselo (e sa fetoheng) ea tsamaiso ea methapo ea kelello le bokong.

Thuso ea pele bakeng sa ho lemala ha hypoglycemic

Ka lipontšo tse bonolo mokuli o lokela ho fana ka likotoana tse seng kae tsa tsoekere kapele, hoo e ka bang 100 g ea likuku kapa likhaba tse 2 tsa jeme (mahe a linotsi). Ho bohlokoa ho hopola hore ka lefu la tsoekere le itšetlehileng ka insulin o lokela ho lula o e-na le liswiti "sefubeng".
Ka lipontšo tse matla:

• Tšela tee e futhumetseng ka hanong la mokuli (khalase / likhaba tse tharo tsa tsoekere) ha a khona ho koenya.
• Pele o kenngoa tee, ho hlokahala hore o kenye se bolokang lipakeng tsa meno - hona ho tla thusa ho qoba khatello e matla ea mehlahare.
• Ka hona, tekanyo ea ntlafatso, fepa mokuli lijo tse nang le lik'habohaedreite tse ngata (litholoana, lijana tsa phofo le lijo-thollo).
• Ho qoba tlhaselo ea bobeli, fokotsa tekanyetso ea insulin ka likarolo tse 4,8 hoseng ho latelang.
• Kamora ho felisa karabelo ea hypoglycemic, etela ngaka.

Haeba ho akheha ho fetoha ka ho lahleheloa ke tseboebe e latela:

• Kenya tlhahiso ea 40-80 ml ea tsoekere kahare.
• Ka potlako bitsa ambulense.

Thuso ea pele bakeng sa hyperosmolar coma

• Beha mokuli hantle.
• Kenyelletsa mokhoa oa ho tsamaisa le ho qhelela ka thoko puo ea puo.
• Etsa liphetoho tsa khatello.
• Kenyelletsa kahare 10-25 ml ea tsoekere (40% tharollo).
• Ho tahoa e matla - hang-hang letsetsa ambulense.

Tlhokomelo ea tšohanyetso ea komello ea ketoacidotic, matšoao le lisosa tsa komello ea ketoacidotic ho lefu la tsoekere

Lintlhatse eketsang tlhokahalo ea insulin hape li kenya letsoho kholisong ea komello ea ketoacidotic hangata:

• Tlhahlobo ea nakoana ea lefu la tsoekere.
• Kalafo e sa tsebeng ho bala (litekanyetso tsa moriana, phetisetso, joalo-joalo).
• Ho hlokomoloha melao ea boitaolo (tšebeliso ea joala, mathata a lijo le litloaelo tsa boikoetliso ba 'mele, jj.).
• Mafu a tšoaetsanoang ka tšoaetso.
• Ho lemala 'meleng / kelellong.
• Lefu la vascular ka foromo e matla.
• Ts'ebetso.
• Ho beleha / ho ima.
• Khatello ea maikutlo.

Ketoacidotic coma - matšoao

Lipontšo tsa pele eba:

• Khafetsa ho ntša.
• Ho tlala lenyora.
• Ho otsela, bofokoli bo akaretsang.

Ka ho senyeha ho hlakileng:

• Monko oa acetone e tsoang molomong.
• Bohloko bo boholo ba ka mpeng.
• Ho hlatsa ho matla.
• Ho lerata, ho phefumoloha ho tebileng.
• Ebe ho latela ho itšireletsa, ho akheha ka letsoalo le ho oela.

Ketoacidotic coma - thuso ea pele

Pele ho tsohle e lokela ho letsetsa ambulense 'me e hlahlobe mesebetsi eohle ea bohlokoa ea mokuli - Ho phefumoloha, khatello, ho phahamisa maikutlo, letsoalo. Mosebetsi oa mantlha ke ho tšehetsa ho otla ha pelo le ho hema ho fihlela ambulense e fihla.
Ho lekola hore na motho oa tseba, ka tsela e bonolo: u mo botse potso efe kapa efe, otla hanyane marameng 'me u hlatsoe litsebe tsa litsebe tsa hae. Haeba ho se na karabelo, motho o kotsing e kholo. Ka hona, ho lieha ho bitsa ambulense ha ho khonehe.

Melao e akaretsang ea thuso ea pele bakeng sa lefu la tsoekere, haeba mofuta oa lona o sa hlalosoe

Ntho ea pele eo ba leloko la mokuli ba lokelang ho e etsa ka pele mme, haholoholo, lipontšo tse tebileng tsa ho akheha ke letsetsa ambulense hang-hang . Bakuli ba nang le lefu la tsoekere le ba malapa a bona ba tloaetse matšoao ana. Haeba ho na le monyetla oa ho ea ngakeng, joale matšoao a pele u lokela ho:

• Intramuscularly kenya insulin - 6-16 yuniti. (boikhethelo).
• Eketsa tekanyetso hoseng ho latelang - li-unit tsa 4-12 / ka nako, liente tse 2-3 mots'eare.
• Ts'ebeliso ea lik'habohaedreite e lokela ho ntlafatsoa., mafura - ntle le ona.
• Eketsa palo ea litholoana / meroho.
• Sebelisa metsi a nang le liminerale tse nang le alkaline. Ho ba sieo ha bona - metsi ka khaba e qhibilihang ea seno se nooang.
• Enema ka tharollo ea soda - ka letsoalo le ferekaneng.

Beng ka mokuli ba lokela ho ithuta ka hloko litšobotsi tsa lefu lena, kalafo ea sejoale-joale ea lefu la tsoekere, lefu la tsoekere le thuso ea pele ea nako - ke moo thuso ea pele ea tšohanyetso e tla sebetsa.