I-ketoacidosis yeswekile

Isifo seswekile ketoacidosis (DKA) yingxaki esongela ubomi echaphazela abantu abanesifo seswekile. Kwenzeka xa umzimba uqala ukophula amanqatha kwinqanaba elikhawuleze kakhulu. Isibindi sisebenzisa amanqatha kwi-fuel ebizwa ngokuba yi-ketone, ebangela ukuba igazi libe ne-asidi.

I-DKA yenzeka xa uphawu oluvela kwi-insulin emzimbeni lusezantsi kangangokuba:

1. Iswekile yegazi (iswekile yegazi) ayinako ukungena kwiiseli ukuba zisetyenziswe njengomthombo wamafutha.
2. Isibindi senza isixa esikhulu seswekile egazini.
3. Amafutha aqhekezwa ngokukhawuleza ukuze umzimba usebenze.

Amafutha aphulwe sisibindi esibizwa ngokuba yi-ketone. Iiketoni zihlala ziveliswa sisibindi xa umzimba wophula amanqatha emva kwexesha elide ukusukela kwisidlo sakho sokugqibela. Ezi ketoni zihlala zisetyenziswa yimisipha kunye nentliziyo. Xa iiketoni ziveliswa ngokukhawuleza kwaye zakha egazini, zinokuba yityhefu ngokwenza igazi libe neasidi. Le meko yaziwa ngokuba yi ketoacidosis.

I-DKA ngamanye amaxesha luphawu lokuqala lohlobo 1 lweswekile kubantu abangakafumaneki. Inokuthi yenzeke nakomntu osele efumene ukuba unesifo seswekile sokuqala. Usulelo, ukonzakala, isifo esibi, ukungabikho kwe-insulin shots, okanye uxinzelelo lotyando kungakhokelela kwi-DKA kubantu abane-1 yeswekile.

Abantu abanesifo seswekile sesi-2 banokuphuhlisa i-DKA, kodwa ayiqhelekanga kwaye ayinabunzima. Ihlala ibangelwa siswekile yegazi engalawulekiyo ixesha elide, iidosi ezingekhoyo zamayeza, okanye isifo esibi okanye isifo.

Iimpawu eziqhelekileyo ze-DKA zinokubandakanya:

• Ukuhla kwesilumkiso
• Ukuphefumla okunzulu, okukhawulezayo
• Ukuphelelwa ngamanzi emzimbeni
• Ulusu olomileyo nomlomo
• Ubuso obugungxulileyo
• Ukuchama rhoqo okanye ukunxanwa okuhlala usuku okanye nangaphezulu
• Umphunga onuka iziqhamo
• Intloko ebuhlungu
• Ukuqina kwemisipha okanye iintlungu
• Isicaphucaphu nokugabha
• Intlungu yesisu

Ukuvavanywa kwe-ketone kunokusetyenziselwa uhlobo lweswekile 1 kwiscreen se ketoacidosis yokuqala. Uvavanyo lwe-ketone luhlala lusenziwa kusetyenziswa isampulu yomchamo okanye isampulu yegazi.

Uvavanyo lweKetone luhlala lusenziwa xa kurhanelwa i-DKA:

• Rhoqo, uvavanyo lomchamo lwenziwa kuqala.
• Ukuba umchamo ulungile kwiietoni, amaxesha amaninzi i-ketone ebizwa ngokuba yi-beta-hydroxybutyrate ilinganiswa egazini. Le yeyona ketone ixhaphakileyo ilinganiswa. Enye i-ketone ephambili yi-acetoacetate.

Olunye uvavanyo lwe-ketoacidosis lubandakanya:

• Irhasi yegazi ejikelezayo
• Iphaneli yokuSisiseko ye-metabolic, (iqela leemvavanyo zegazi ezilinganisa amanqanaba akho esodium kunye nepotassium, ukusebenza kwezintso, kunye nezinye iikhemikhali kunye nemisebenzi, kubandakanya umsantsa we-anion
• Uvavanyo lweglucose yegazi
• Umlinganiselo woxinzelelo lwegazi
• Uvavanyo lwegazi lwe-Osmolality

Injongo yonyango kukulungisa inqanaba leswekile yegazi ephezulu ene-insulin. Enye injongo kukutshintsha ulwelo olulahlekileyo ngokuchama, ukungabinamdla wokutya, kunye nokugabha ukuba unale mpawu.

Ukuba unesifo seswekile, kunokwenzeka ukuba umboneleli wakho wokhathalelo lwempilo ukuxelele ukuba ungazibona njani iimpawu zezilumkiso ze-DKA. Ukuba ucinga unayo i-DKA, vavanya iitoni usebenzisa imichamo yomchamo. Ezinye iimitha zeswekile zinokulinganisa ietoni zegazi. Ukuba ietoni zikhona, tsalela umnikezeli wakho kwangoko. SUKULIBazisa. Landela nayiphi na imiyalelo oyinikiweyo.

Kusenokwenzeka ukuba kuya kufuneka uye esibhedlele. Kulapho, uya kufumana i-insulin, ulwelo kunye nolunye unyango lwe-DKA. Emva koko ababoneleli baya kukhangela kwaye baphathe unobangela we-DKA, njengosulelo.

Uninzi lwabantu luphendula kunyango kwisithuba seeyure ezingama-24. Ngamanye amaxesha, kuthatha ixesha elide ukubuyela kwimeko yesiqhelo.

Ukuba i-DKA ayinyangwa, inokubangela ukugula kakhulu okanye ukufa.

Iingxaki zempilo ezinokubangelwa yi-DKA zibandakanya nayiphi na kwezi zinto zilandelayo:

• Ulwakhiwo lwamanzi kwingqondo (i-edema yobuchopho)
• Intliziyo iyeke ukusebenza (ukubanjwa kwentliziyo)
• Ukungaphumeleli kwezintso

I-DKA ihlala ingxamisekileyo kwezonyango. Tsalela umnikezeli wakho ukuba ubona iimpawu ze-DKA.

Yiya kwigumbi likaxakeka okanye fowunela inombolo yongxamiseko yendawo (enje nge-911) ukuba wena okanye ilungu losapho elinesifo seswekile ninakho oku kulandelayo:

• Ukuhla kwengqondo
• Ukuphefumla ngesiqhamo
• Isicaphucaphu nokugabha
• Ingxaki yokuphefumla

Ukuba unesifo seswekile, funda ukuqonda iimpawu kunye neempawu ze-DKA. Yazi ukuba zivavanywa nini iitoni, njengaxa ugula.

Ukuba usebenzisa impompo ye-insulin, jonga rhoqo ukuze ubone ukuba i-insulin ihamba ngetubhu. Qiniseka ukuba ityhubhu ayivalwanga, ikinki okanye ayiqhawukwanga kwimpompo.

I-DKA; Ketoacidosis; Seswekile - ketoacidosis

• Ukutya kunye nokukhutshwa kwe-insulin
• Uvavanyo lokunyamezelana ngeswekile yomlomo
• Impompo ye-insulin

Umbutho weSwekile yaseMelika. 2. Ukwahlulahlula kunye nokuchonga isifo seswekile: imigangatho yokhathalelo lonyango kwisifo seswekile-2020. Unonophelo lweSwekile. 2020; 43 (iSuppl 1): S14-S31. IINKCUKACHA: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

Atkinson MA, Mcgill DE, Dassau E, Laffel L. Uhlobo lwe-1 yeswekile. Ku: UMelmed S, uAuchus, RJ, uGoldfine AB, uKoenig RJ, uRosen CJ, ii-eds. Incwadi kaWilliam ye-Endocrinology. Umhla we-14. IPhiladelphia, PA: Elsevier; 2020: isahluko 36.

IMaloney GE, iGlauser JM. Isifo seswekile kunye nokuphazamiseka kweglucose homeostasis. Ku: Iindonga RM, iHockberger RS, iGausche-Hill M, ii-eds. Unyango lukaRosen oluNgxamisekileyo: Iikhonsepthi kunye nokuziqhelanisa neKlinikhi. Umhla we-9. IPhiladelphia, PA: Elsevier; 2018: isahl. 118.