Kuyini Ukuphefumula Kussmaul, Futhi Yini Okukubangelayo?

-Delile

• Yini ebangela ukuphefumula kukaKussmaul?
• I-ketoacidosis yesifo sikashukela
• Ezinye izimbangela
• Ziyini izimpawu?
• Kuphathwa kanjani ukuphefumula kukaKussmaul?
• Ungakuvimbela kanjani ukuphefumula kweKussmaul
• Ukuphefumula kukaKussmaul kwehluke kanjani ekuphefumuleni kweCheyne-Stokes?
• Okubalulekile

Ukuphefumula kweKussmaul kubonakala ngokuphefumula okujulile, okusheshayo, nokusebenza kanzima. Le ndlela ehlukile yokuphefumula engajwayelekile ingavela ezimweni ezithile zezokwelapha, ezinjenge-ketoacidosis yesifo sikashukela, okuyinkinga enkulu yesifo sikashukela.

Ukuphefumula kukaKussmaul kubizwa ngoDkt. Adolf Kussmaul, ophefumula ngo-1874.

Qhubeka ufunde ukuze uthole okuningi mayelana nokuphefumula kukaKussmaul, kufaka phakathi ukuthi kubangelwa yini nokuthi ungayibona kanjani le ndlela yokuphefumula.

Yini ebangela ukuphefumula kukaKussmaul?

Uma kukhulunywa ngokuphefumula kukaKussmaul, kuyasiza ukukhumbula ukuthi umzimba wakho uhlala uzama ukuthola ibhalansi.

Umzimba wakho ugcina i-pH ezinzile engu-7.35 kuye ku-7.45. Lapho leli zinga le-pH likhuphuka noma liphansi, umzimba wakho kufanele uthole izindlela zokuzama ukwenza ushintsho lwe-pH. Yilapho kungena khona ukuphefumula kukaKussmaul.

Ake sibheke ezinye zezimbangela ezingaba khona zezinguquko ze-pH ezingaholela ekuphefumuleni kweKussmaul.

I-ketoacidosis yesifo sikashukela

Esinye sezimbangela ezivame kakhulu zokuphefumula kukaKussmaul yisifo sikashukela ketoacidosis, okuyinkinga exakile evame ukuhlotshaniswa nohlobo 1 lwesifo sikashukela. Kodwa-ke, ngohlobo lwesifo sikashukela sohlobo 2.

I-ketoacidosis yesifo sikashukela ingabangelwa uma umzimba wakho ungakhiqizi i-insulin eyanele futhi ungakwazi ukucubungula kahle i-glucose. Lokhu kungaholela ekuphelelweni ngamanzi emzimbeni, nakho okungadala ukuthi umzimba wakho uqale ukwephula amafutha ukuze uthole amandla ngokushesha okukhulu.

Imikhiqizo yalokhu ngamaketoni, ane-asidi kakhulu futhi angadala i-asidi emzimbeni wakho.

Nayi incazelo yokuthi i-ketoacidosis yesifo sikashukela ingaholela kanjani ekuphefumuleni kukaKussmaul:

• Amaketoni angeziwe emzimbeni wakho abangela i-asidi ukuba yakhe egazini lakho.
• Ngenxa yalokhu, uhlelo lwakho lokuphefumula lubangelwa ukuqala ukuphefumula ngokushesha.
• Ukuphefumula ngokushesha kusiza ukukhipha isikhutha esiningi, esiyinhlanganisela ene-asidi egazini lakho.
• Uma amazinga e-asidi eqhubeka enyuka futhi ungakutholi ukwelashwa, umzimba wakho uzokhombisa ukuthi udinga ukuphefumula okujulile.
• Lokhu kubangela ukuphefumula kukaKussmaul, okubonakala ngokuphefumula okujulile, okusheshayo, ukuzama ukukhipha isikhutha esiningi ngangokunokwenzeka.

Ezinye izimbangela

Ezinye izimbangela zokuphefumula kukaKussmaul zifaka:

• ukwehluleka komzimba, njengenhliziyo, izinso, noma ukwehluleka kwesibindi
• ezinye izinhlobo zomdlavuza
• ukuphuza ngokweqile isikhathi eside
• ukungeniswa kobuthi, njenge-salicylates (i-aspirin), i-methanol, i-ethanol, noma i-antifreeze
• isithuthwane
• sepsis
• i-overexertion, evame ukuxazulula ngokushesha ngokuphumula

Ngayinye yalezi zimo ibangela ukwakheka kwe-asidi egazini. Ngaphandle kwe-overexertion, iningi lalezi zimo kungenxa yezici ze-metabolic.

Lokhu kusho ukuthi izitho ezivame ukubhekela ukuhlunga imfucumfucu azikwazi ukuhambisana njengoba kudingeka. Le mikhiqizo yemfucuza, evame ukuba ne-acid, yakhela egazini, futhi umzimba wakho uzama ukuguqula lokhu kungalingani.

Ziyini izimpawu?

Ezinye zezimpawu zokuphefumula kukaKussmaul zifaka:

• ukuphefumula okujulile
• izinga lokuphefumula ngokushesha
• isilinganiso sokuphefumula esilinganayo nesingaguquguquki ngesilinganiso nangesigqi

Abanye abantu bachaza ukuphefumula kukaKussmaul ngokuthi "indlala yomoya." Lokhu kusho ukuthi uma uhlangabezana nakho, ungahle ubonakale sengathi uphefumulela phezulu, noma sengathi ukuphefumula kwakho kubukeka njengokuthukile.

Abantu abanokuphefumula kukaKussmaul abanakulawula indlela abaphefumula ngayo. Kuyimpendulo yomzimba esimeni esingaphansi.

Ngoba ukuphefumula kukaKussmaul kuvame ukubangelwa i-ketoacidosis yesifo sikashukela, kubalulekile ukubona izimpawu eziyisixwayiso zalesi simo, ezingafika ngokushesha okukhulu.

Ezinye izimpawu ezivamile ze-ketoacidosis yesifo sikashukela zifaka:

• amazinga aphezulu kashukela egazini
• ukoma ngokweqile
• isicanucanu noma ukuhlanza
• ukwanda kokuchama
• ukudideka
• umoya onuka kamnandi noma onethelo
• amazinga aphezulu e-ketone emchameni
• ukukhathala

Ngaphandle kokuthi izimpawu zibangelwe wukusebenza ngokweqile, kubalulekile ukuthi noma ngubani onezimpawu zokuphefumula kukaKussmaul athole usizo lwezokwelapha ngokushesha.

Kuphathwa kanjani ukuphefumula kukaKussmaul?

Ukwelapha ukuphefumula kukaKussmaul kubandakanya ukubhekana nesimo esidale lokho. Imvamisa, ukwelashwa kudinga ukuhlala esibhedlela.

Ukwelashwa kwe-ketoacidosis yesifo sikashukela ngokuvamile kudinga ukufakwa kwe-intravenous fluid ne-electrolyte. I-insulini nayo izofakwa ngendlela efanayo, kuze kube yilapho amazinga kashukela egazi engaphansi kwamamiligremu angama-240 kwidesilitha ngayinye.

Endabeni ye-uremia, ungahle udinge i-dialysis ukunciphisa ukwakheka kobuthi obedlulele izinso zakho ezingakwazi ukukuhlunga.

Ungakuvimbela kanjani ukuphefumula kweKussmaul

Ukuvimbela ukuphefumula kukaKussmaul kuvame ukufaka ukuphathwa ngokucophelela kwezimo zezokwelapha ezingamahlalakhona.

Uma unesifo sikashukela, lokhu kufaka:

• uthatha imithi yesifo sikashukela njengoba uyalelwe
• ukulandela uhlelo lokudla njengokuyalelwa ngumhlinzeki wezokunakekelwa kwempilo
• ukuhlala kahle kahle
• ukuhlola amazinga kashukela egazini njalo
• ukuhlola umchamo wamaketoni

Uma unesimo esihlobene nezinso, lokhu kufaka:

• ukwamukela ukudla okunobungane nezinso
• ukugwema utshwala
• ukuhlala kahle kahle
• ukugcina amazinga kashukela egazini elawulwa

Ukuphefumula kukaKussmaul kwehluke kanjani ekuphefumuleni kweCheyne-Stokes?

Olunye uhlobo lwephethini yokuphefumula engajwayelekile ukuphefumula kukaCheyne-Stokes. Yize lokhu kungenzeka uma uphapheme, kuvame kakhulu ngesikhathi sokulala.

Ukuphefumula kwe-Cheyne-Stokes kujwayele ukubonakaliswa ngu:

• ukwanda kancane kancane kokuphefumula, kulandelwe ukwehla
• isigaba se-apneic, noma esingaphefumuli, esenzeka ngemuva kokuphefumula komuntu sithole ukujula okungaphezulu
• isikhathi se-apneic esivame ukuhlala imizuzwana engu-15 kuye kwengu-60

Ukuphefumula kwe-Cheyne-Stokes kuvame ukuhlobene nokuhluleka kwenhliziyo noma isifo sohlangothi. Kungabangelwa futhi yizimo ezihlobene nobuchopho, njenge:

• izicubu zobuchopho
• ukulimala okubuhlungu ebuchosheni
• i-encephalitis
• ukwanda kwengcindezi ye-intercranial

Nakhu ukuqhathanisa phakathi kukaCheyne-Stokes nokuphefumula kukaKussmaul:

• Izimbangela: Ukuphefumula kweKussmaul kuvame ukubangelwa amazinga aphezulu e-asidi egazini. Ukuphefumula kwe-Cheyne-Stokes kuvame ukuhlobene nokwehluleka kwenhliziyo, ukushaywa unhlangothi, ukulimala ekhanda, noma izimo zobuchopho.
• Iphethini: Ukuphefumula kweKussmaul akushintshi phakathi kwezikhathi zokuphefumula okusheshayo nokuhamba kancane. Akubangeli nokuthi ukuphefumula kume okwesikhashana njengoba kwenza uCheyne-Stokes ukuphefumula.
• Linganisa: Ukuphefumula kweKussmaul imvamisa kuyalingana futhi kuyashesha. Yize ukuphefumula kweCheyne-Stokes kungashesha ngezikhathi ezithile, iphethini ayihambisani. Kunganciphisa futhi kume ngaphambi kokuba umuntu aqale ukuphefumula futhi.

Okubalulekile

Ukuphefumula kweKussmaul kubonakala ngephethini ejulile, esheshayo yokuphefumula. Ngokuvamile kuyinkomba yokuthi umzimba noma izitho seziphenduke zaba ne-asidi kakhulu. Emzameni wokukhipha i-carbon dioxide, eyinhlanganisela ene-asidi egazini, umzimba uqala ukuphefumula ngokushesha nangaphezulu.

Le ndlela yokuphefumula engajwayelekile ivame ukubangelwa yi-ketoacidosis yesifo sikashukela, okuyinkinga eyinkimbinkimbi yohlobo 1 futhi, kaningi, uhlobo lwesifo sikashukela sohlobo 2. Kungabangelwa futhi ukwehluleka kwezinso noma kwesibindi, eminye imidlavuza, noma ukungeniswa kobuthi.

Uma usola ukuthi wena noma othandekayo unezimpawu zokuphefumula kukaKussmaul noma i-ketoacidosis yesifo sikashukela, kubalulekile ukuthi ufune usizo lwezokwelapha ngokushesha.