Isifo sikashukela se-hyperglycemic hyperosmolar syndrome

Isifo sikashukela se-hyperglycemic hyperosmolar syndrome (HHS) siyinkinga yesifo sikashukela sohlobo 2. Kuhilela izinga likashukela egazini eliphakeme kakhulu (glucose) ngaphandle kwama-ketone.

I-HHS yisimo se:

• Izinga leshukela egazini eliphakeme kakhulu (glucose)
• Ukuntuleka kwamanzi ngokweqile (ukoma)
• Ukwehla kokuqwashisa noma ukwazi (ezimweni eziningi)

Ukwakhiwa kwamaketoni emzimbeni (ketoacidosis) nawo kungenzeka. Kepha akujwayelekile futhi kuvame ukuba mnene uma kuqhathaniswa ne-ketoacidosis yesifo sikashukela.

I-HHS ivame ukubonakala kubantu abane-type 2 yesifo sikashukela abangenaso isifo sikashukela sabo. Kungenzeka futhi kulabo abangatholakali benesifo sikashukela. Isimo singalethwa ngu:

• Ukutheleleka
• Okunye ukugula, njengokuhlaselwa yinhliziyo noma isifo sohlangothi
• Imithi eyehlisa ukusebenza kwe-insulin emzimbeni
• Imithi noma izimo ezandisa ukulahleka koketshezi
• Ukuphelelwa, noma ukungathathi imithi enqunyiwe yesifo sikashukela

Imvamisa, izinso zizama ukwakha izinga eliphezulu le-glucose egazini ngokuvumela i-glucose eyengeziwe ukuthi ishiye umzimba emchameni. Kepha lokhu kubangela nokuthi umzimba ulahlekelwe ngamanzi. Uma ungaphuzi amanzi anele, noma uphuza uketshezi oluqukethe ushukela bese uqhubeka nokudla ukudla okunama-carbohydrate, uba nomzimba omubi kakhulu. Lapho lokhu kwenzeka, izinso azisakwazi ukususa i-glucose eyengeziwe. Ngenxa yalokhu, izinga le-glucose egazini lakho lingaphakama kakhulu, kwesinye isikhathi liphindwe kashumi kunenani elijwayelekile.

Ukulahleka kwamanzi nakho kwenza igazi ligxile kakhulu kunokujwayelekile. Lokhu kubizwa nge-hyperosmolarity. Kuyisimo lapho igazi linenqwaba kasawoti (i-sodium), i-glucose, nezinye izinto. Lokhu kudonsa amanzi aphume kwezinye izitho zomzimba, kufaka phakathi ubuchopho.

Izici zobungozi zifaka:

• Umcimbi ocindezelayo njengokutheleleka, isifo senhliziyo, isifo sohlangothi, noma ukuhlinzwa kwakamuva
• Ukwehluleka kwenhliziyo
• Ukoma okungakhubazekile
• Ukufinyelela okulinganiselwe kwamanzi (ikakhulukazi kubantu abane-dementia noma ababoshwe embhedeni)
• Ukuguga
• Umsebenzi ombi wezinso
• Ukuphathwa kabi kwesifo sikashukela, kungalandelwa uhlelo lokwelashwa njengoba kuqondisiwe
• Ukumisa noma ukuphela kwe-insulin noma eminye imithi eyehlisa izinga le-glucose

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ukoma ukwanda nokuchama (ekuqaleni kwesifo)
• Ukuzizwa ubuthakathaka
• Isicanucanu
• Ukwehla kwesisindo
• Umlomo owomile, ulimi olomile
• Imfiva
• Ukuquleka
• Ukudideka
• I-Coma

Izimpawu zingase zibe zimbi kakhulu ngezinsuku noma amasonto.

Ezinye izimpawu ezingase zivele ngalesi sifo:

• Ukulahlekelwa umuzwa noma ukusebenza kwemisipha
• Izinkinga ngokuhamba
• Ukukhubazeka kwenkulumo

Umhlinzeki wezokunakekelwa kwempilo uzokuhlola abuze ngezimpawu zakho nomlando wezokwelapha. Ukuhlolwa kungakhombisa ukuthi une:

• Ukwehla kwamanzi emzimbeni ngokweqile
• Umkhuhlane uphakeme kune-100.4 ° F (38 ° C)
• Ukunyuka kwenhliziyo
• Umfutho wegazi ophansi we-systolic

Ukuhlolwa okungenziwa kufaka:

• I-osmolarity yegazi (ukuhlushwa)
• BUN namazinga e-creatinine
• Izinga le-sodium yegazi (lidinga ukuhlenga izinga le-glucose yegazi)
• Ukuhlolwa kweKetone
• Iglucose yegazi

Ukuhlolwa kwezimbangela okungenzeka kungafaka:

• Amasiko egazi
• I-x-ray yesifuba
• I-Electrocardiogram (ECG)
• Ukuhlolwa komchamo
• I-CT yekhanda

Ekuqaleni kokwelashwa, inhloso ukulungisa ukulahleka kwamanzi. Lokhu kuzothuthukisa umfutho wegazi, ukuphuma komchamo nokusakazwa kwegazi. Ushukela wegazi nawo uzokwehla.

Uketshezi ne-potassium kuzonikezwa ngomthambo (ngemithambo). Lokhu kufanele kwenziwe ngokucophelela. Izinga eliphezulu le-glucose liphathwa nge-insulin enikezwa ngomthambo.

Abantu ababa ne-HHS imvamisa sebevele sebegula. Uma kungalashwa ngaso leso sikhathi, kungavela ukuquleka, ikhoma noma ukufa.

Ukungalashwa, i-HHS ingaholela kunoma yikuphi okulandelayo:

• Ukushaqeka
• Ukwakheka kwegazi
• Ukuvuvukala kobuchopho (i-cerebral edema)
• Ukukhuphuka kwezinga le-asidi yegazi (i-lactic acidosis)

Lesi simo yisimo esiphuthumayo sezokwelapha. Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma uba nezimpawu ze-HHS.

Ukulawula uhlobo lwesifo sikashukela sohlobo 2 nokubona izimpawu zokuqala zokuphelelwa amandla kwamanzi nokutheleleka kungasiza ekuvimbeleni i-HHS.

HHS; Ikhoma le-hyperglycemic hyperosmolar; I-comonotic hyperglycemic hyperosmolar coma (NKHHC); Ikhoma le-Hyperosmolar nonketotic (HONK); Isimo se-Hyperglycemic hyperosmolar non-ketotic; Isifo sikashukela - i-hyperosmolar

• Thayipha i-2 yesifo sikashukela - okufanele ubuze udokotela wakho

• Ukukhishwa kokudla kanye ne-insulin

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Lebovitz HE. I-Hyperglycemia yesibili kuya kwezimo ze-nondiabetic kanye nokwelashwa. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, abahleli. I-Endocrinology: Eyabantu Abadala Neyengane. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 42.

USinha A. Izimo eziphuthumayo zikashukela. Ku: Bersten AD, Handy JM, eds. Ibhukwana Lokunakekela Abagula Ngokujulile. Umhlaka 8. IPhiladelphia, PA: Elsevier; 2019: isahluko 59.