Iswekile yesifo sehyperglycemic hyperosmolar syndrome

Isifo seswekile i-hyperglycemic hyperosmolar syndrome (HHS) sisimo seswekile sesi-2. Kubandakanya inqanaba leswekile ephezulu yegazi (iswekile) ngaphandle kokubakho kweeetoni.

I-HHS yimeko yoku:

• Iswekile yegazi ephezulu kakhulu (iswekile)
• Ukunqongophala kwamanzi (ukungabikho komzimba)
• Ukuhla kokuncipha okanye ukuqonda (kwiimeko ezininzi)

Ukwakhiwa kweeetoni emzimbeni (ketoacidosis) nako kunokwenzeka. Kodwa ayiqhelekanga kwaye ihlala ithambile xa ithelekiswa nesifo seswekile ketoacidosis.

I-HHS ibonakala rhoqo kubantu abanesifo seswekile sesi-2 abangenaso isifo seswekile. Inokwenzeka nakwabo bangakhange bafunyaniswe benesifo seswekile. Le meko inokuziswa ngu:

• Usulelo
• Esinye isifo, njengokuhlaselwa yintliziyo okanye ukubetha
• Amayeza ukunciphisa isiphumo insulin emzimbeni
• Amayeza okanye iimeko ezonyusa ukulahleka kolwelo
• Ukuphelelwa, okanye ukungathathi amayeza amiselweyo eswekile

Ngokwesiqhelo, izintso zizama ukwenza inqanaba eliphezulu le-glucose egazini ngokuvumela iswekile eyongezelelweyo ukuba ishiye umzimba kumchamo. Kodwa oku kukwabangela ukuba umzimba ulahlekelwe ngamanzi. Ukuba awuseli manzi aneleyo, okanye usela ulwelo oluneswekile kwaye uqhubeka nokutya ukutya okuneecarbohydrate, uye uphelelwe ngamanzi emzimbeni. Xa oku kusenzeka, izintso azisakwazi ukususa iswekile engaphezulu. Ngenxa yoko, inqanaba leswekile egazini lakho linokuphakama kakhulu, ngamanye amaxesha liphindaphindwe kali-10 kunesiqhelo.

Ukuphulukana namanzi kwenza ukuba igazi ligxile ngakumbi kunesiqhelo. Oku kubizwa ngokuba yi-hyperosmolarity. Yimeko apho igazi linokuxinana okukhulu kwetyuwa (isodiyam), iswekile, kunye nezinye izinto. Oku kukhupha amanzi kwamanye amalungu omzimba, kubandakanya nengqondo.

Izinto zomngcipheko zibandakanya:

• Isiganeko soxinzelelo esifana nosulelo, isifo sentliziyo, ukubetha, okanye utyando lwamva nje
• Ukumelwa yintliziyo
• Ukunxanwa okungakhuselekanga
• Ukufikelela okulinganiselweyo emanzini (ngakumbi kubantu abanesifo sengqondo esixhalabisayo okanye abo balalwa ngumandlalo)
• Ukwaluphala
• Umsebenzi ombi wezintso
• Ukulawulwa kakubi kwesifo seswekile, kungalandelwa isicwangciso sonyango njengoko kuyalelwe
• Ukuyeka okanye ukuphuma kwe-insulin okanye amanye amayeza aphantsi kwinqanaba le-glucose

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Ukwanda kokoma kunye nokuchama (ekuqaleni kwesifo)
• Ndiziva ndibuthathaka
• Isicaphucaphu
• Ukuhla ukusinda
• Umlomo owomileyo, ulwimi olomileyo
• Ifiva
• Ukuxhuzula
• Ukudideka
• Coma

Iimpawu zinokuba zibi ngakumbi kwiintsuku okanye iiveki.

Ezinye iimpawu ezinokuthi zenzeke kwesi sifo:

• Ukuphulukana nokuziva okanye ukusebenza kwezihlunu
• Iingxaki ngokuhamba
• Ukonakala kwentetho

Umboneleli wezempilo uya kukuvavanya kwaye akubuze malunga neempawu zakho kunye nembali yezonyango. Uviwo lunokubonisa ukuba une:

• Ukuphelelwa ngamanzi emzimbeni
• Umkhuhlane ungaphezulu kwe-100.4 ° F (38 ° C)
• Ukunyuka kwentliziyo
• Uxinzelelo lwegazi oluphantsi

Uvavanyo olunokwenziwa lunokubandakanya:

• I-osmolarity yegazi (uxinzelelo)
• BUN kunye namanqanaba okudala
• Inqanaba lesodiyam yegazi (kufuneka ihlengahlengiswe kwinqanaba leswekile yegazi)
• Uvavanyo lweKetone
• Iswekile yegazi

Uvavanyo lwezizathu ezinokubakho lunokubandakanya:

• Iinkcubeko zegazi
• I-x-ray yesifuba
• I-Electrocardiogram (ECG)
• Uhlalutyo lomchamo
• I-CT yentloko

Ekuqaleni konyango, injongo kukulungisa ukulahleka kwamanzi. Oku kuyakuphucula uxinzelelo lwegazi, ukuphuma komchamo kunye nokuhamba. Iswekile yegazi nayo iya kuncipha.

Ulwelo kunye ne potassium ziya kunikwa ngomthambo (efakwa ngaphakathi). Oku kufuneka kwenziwe ngononophelo. Inqanaba leswekile ephezulu liphathwa nge-insulin enikezwe ngomthambo.

Abantu abaphuhlisa i-HHS bahlala begula. Ukuba awunyangwa kwangoko, ukuxhuzula, isiqaqa, okanye ukufa kunokubangela.

Ukunganyangwa, i-HHS inokukhokelela kuyo nayiphi na kwezi zinto zilandelayo:

• Umothuko
• Ukubumba kwegazi
• Ukudumba kobuchopho (i-edema yobuchopho)
• Ukunyusa inqanaba leasidi yegazi (lactic acidosis)

Le meko ingxamisekileyo kwezonyango. Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba uvelisa iimpawu ze-HHS.

Ukulawula udidi lwesibini lwesifo seswekile kunye nokuqonda iimpawu zokuqala zokuphelelwa ngamanzi emzimbeni kunye nosulelo kunokunceda ukuthintela i-HHS.

HHS; Ikhoma le-Hyperglycemic hyperosmolar; I-Nonketotic hyperglycemic hyperosmolar coma (NKHHC); I-Hyperosmolar nonketotic coma (HONK); I-Hyperglycemic hyperosmolar non-ketotic imeko; Seswekile - hyperosmolar

• Uhlobo lwe-2 yeswekile- ukubuza ugqirha

• Ukutya kunye nokukhutshwa kwe-insulin

ICrandall JP, uShamon H. Isifo seswekile. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 216.

ULebovitz HE. I-Hyperglycemia yesibini ukuya kwiimeko ze-nondiabetic kunye nonyango. Ku: Jameson JL, De Groot LJ, de Kretser DM, et al, ii-eds. Endocrinology: Abantu abadala kunye nabantwana. Umhla wesi-7. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 42.

USinha A. Ingxamiseko yeswekile. Ku: Bersten AD, Handy JM, ii-eds. Incwadana yoKhathalelo oluKhulu. Ngomhla we-8. IPhiladelphia, PA: Elsevier; I-2019: isahluko 59.