Ashuga hyperglycemic hyperosmolar syndrome

Matenda ashuga hyperglycemic hyperosmolar syndrome (HHS) ndi vuto la mtundu wachiwiri wa shuga. Zimaphatikizapo kuchuluka kwa shuga wambiri m'magazi popanda ma ketoni.

HHS ndichikhalidwe cha:

• Mulingo wambiri wa shuga (shuga)
• Kusowa madzi kwambiri (kusowa madzi m'thupi)
• Kuchepetsa kuchepa kapena kuzindikira (nthawi zambiri)

Kuphatikiza kwa ma ketoni mthupi (ketoacidosis) amathanso kuchitika. Koma si zachilendo ndipo nthawi zambiri zimakhala zofewa poyerekeza ndi matenda ashuga ketoacidosis.

HHS imawonekera kwambiri mwa anthu omwe ali ndi matenda amtundu wa 2 omwe alibe matendawa. Zitha kukhalanso kwa iwo omwe sanapezeke ndi matenda ashuga. Vutoli litha kubweretsedwa ndi:

• Matenda
• Matenda ena, monga matenda a mtima kapena sitiroko
• Mankhwala omwe amachepetsa mphamvu ya insulin m'thupi
• Mankhwala kapena mikhalidwe yomwe imakulitsa kutayika kwamadzimadzi
• Kutha, kapena kusamwa mankhwala oyenera a shuga

Kawirikawiri, impso zimayesetsa kupanga shuga wochuluka m'magazi mwa kulola shuga wochuluka kuti atuluke m'thupi mwa mkodzo. Koma izi zimapangitsanso thupi kutaya madzi. Ngati simumamwa madzi okwanira, kapena mumamwa madzi omwe ali ndi shuga ndikupitiliza kudya zakudya zokhala ndi chakudya, mumakhala wopanda madzi ambiri. Izi zikachitika, impso sizingathenso kutulutsa shuga wowonjezerawo. Zotsatira zake, kuchuluka kwa shuga m'magazi mwanu kumatha kukwera kwambiri, nthawi zina kuposa kuwirikiza kawiri kuchuluka kochuluka.

Kutayika kwa madzi kumapangitsanso magazi kukhala ochulukirapo kuposa zachilendo. Izi zimatchedwa hyperosmolarity. Ndi momwe magazi amakhala ndi mchere wambiri (sodium), shuga, ndi zinthu zina. Izi zimatulutsa madzi kuchokera m'ziwalo zina za thupi, kuphatikiza ubongo.

Zowopsa ndi izi:

• Chochitika chopsinjika monga matenda, matenda amtima, sitiroko, kapena opaleshoni yaposachedwa
• Mtima kulephera
• Ludzu losowa
• Kuchepa kwamadzi (makamaka kwa anthu omwe ali ndi matenda amisala kapena omwe ali pafupi kugona)
• Ukalamba
• Ntchito yosauka ya impso
• Kusasamala bwino kwa matenda ashuga, osatsata dongosolo la chithandizo monga adanenera
• Kuyimitsa kapena kutha kwa insulin kapena mankhwala ena omwe amachepetsa shuga

Zizindikiro zimatha kuphatikizira izi:

• Kuchuluka kwa ludzu ndi kukodza (koyambirira kwa matenda)
• Kumva kufooka
• Nseru
• Kuchepetsa thupi
• Pakamwa pouma, lilime louma
• Malungo
• Kugwidwa
• Kusokonezeka
• Coma

Zizindikiro zimatha kukulirakulira pakatha masiku kapena milungu.

Zizindikiro zina zomwe zingachitike ndi matendawa:

• Kutaya kumverera kapena kugwira ntchito kwa minofu
• Mavuto ndi kuyenda
• Kuwonongeka kwamalankhulidwe

Wothandizira zaumoyo adzakufunsani ndikufunsani za zomwe mukudziwa komanso mbiri yazachipatala. Mayesowa atha kuwonetsa kuti muli ndi:

• Kutaya madzi m'thupi kwambiri
• Kutentha kwakukulu kuposa 100.4 ° F (38 ° C)
• Kuchuluka kwa kugunda kwa mtima
• Kutaya magazi pang'ono

Mayeso omwe angachitike ndi awa:

• Magazi osmolarity (ndende)
• BUN ndi milingo ya creatinine
• Mulingo wa sodium wamagazi (uyenera kusinthidwa kuti ukhale ndi shuga wamagazi)
• Mayeso a ketone
• Magazi a shuga

Kuwunika pazomwe zingayambitse kungaphatikizepo:

• Zikhalidwe zamagazi
• X-ray pachifuwa
• Electrocardiogram (ECG)
• Kupenda kwamadzi
• CT wamutu

Kumayambiriro kwa chithandizo, cholinga chake ndi kukonza kutayika kwa madzi. Izi zithandizira kuthamanga kwa magazi, kutulutsa mkodzo, komanso kufalikira. Shuga wamagazi amathanso kuchepa.

Zamadzimadzi ndi potaziyamu zimaperekedwa kudzera mumitsempha (kudzera m'mitsempha). Izi ziyenera kuchitidwa mosamala. Mulingo wambiri wama glucose amathandizidwa ndi insulin yoperekedwa kudzera mumitsempha.

Anthu omwe amakhala ndi HHS nthawi zambiri amakhala akudwala kale. Ngati sanalandire chithandizo nthawi yomweyo, amatha kugwidwa, kukomoka, kapena kufa.

Popanda kuchitapo kanthu, HHS imatha kubweretsa izi:

• Chodabwitsa
• Mapangidwe a magazi
• Kutupa kwa ubongo (edema yaubongo)
• Kuchuluka kwa asidi m'magazi (lactic acidosis)

Matendawa ndi achipatala mwadzidzidzi. Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) mukakhala ndi zizindikiro za HHS.

Kulimbana ndi matenda a shuga amtundu wachiwiri komanso kuzindikira zizindikilo zoyambirira zakuchepa kwa madzi m'thupi ndi matenda kungathandize kupewa HHS.

HHS; Kukomoka kwa hyperglycemic hyperosmolar; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Kukoma kwa Hyperosmolar nonketotic (HONK); Hyperglycemic hyperosmolar non-ketotic boma; Matenda a shuga - hyperosmolar

• Lembani 2 matenda ashuga - zomwe mungafunse dokotala wanu

• Chakudya ndi insulin kumasulidwa

Crandall JP, Shamoon H. Matenda a shuga. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 216.

Lebovitz HE. Hyperglycemia yachiwiri mpaka yazovuta komanso zochiritsira. Mu: Jameson JL, De Groot LJ, de Kretser DM, et al, olemba. Endocrinology: Akuluakulu ndi Ana. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier Saunders; 2016: chap 42.

Sinha A. Zadzidzidzi mwadzidzidzi. Mu: Bersten AD, Handy JM, eds. Buku Lopatsa Chidwi la Oh. 8th ed. Philadelphia, PA: Elsevier; 2019: mutu 59.