Hoʻomaʻamaʻa aku ka maʻi maʻi ma ke ʻano o ka pōʻino i nā paia vascular e nā kiʻekiʻe glucose i ka kiʻekiʻe a me ke kūkulu ʻana i ka nui o ka lawa o ke koko, ka hohonu o nā ʻokoʻa āpau a me nā ʻoihana.
ʻO ka nele o nā kīʻaha i ka iwi ma muli o ka paʻakikī i ka hoʻopili ʻana o ka glucose a me ka hoʻohaʻahaʻa i ka pale ole, e alakaʻi i ka ulu pinepine ʻana o nā ʻōpiopio i ka wā o ka hōʻemi o ka hōʻemi. Eia kekahi, ʻo ke kaʻina hana e hoʻihoʻi mai ma hope o ka hōʻemi ʻia e ka hoʻolōʻihi ʻana o nā hōʻeha o ka wā postoperative.
Ma kēia mea, pono nā mea maʻi me ka maʻi maʻi maʻi pili i ka hoʻomākaukau pre preativeative a me ka anesthesia i ka wā o ka hoʻomaʻamaʻa ʻana.
ʻO ka hoʻomākaukau no ka maʻi maʻi no ka maʻi maʻi
ʻO ka hana nui e pale i nā hoʻopiʻi ma hope o ka hoʻomaʻamaʻa ʻana e hoʻoponopono i ke kō o ke koko kiʻekiʻe i nā mea maʻi me ka maʻi diabetes. No kēia mea, ʻo ka mea nui ka mālama ʻana o ka meaʻai. ʻO nā lula nui o ka mālama ʻana i ka papa ʻaina ma mua o ka hoʻomaʻemaʻe ʻana:
- ʻO ka komo ʻana o nā meaʻai kiʻekiʻe.
- Eono ʻai i ka lā ma nā wahi liʻiliʻi.
- Hoʻohui ʻia ka kō, nā mea hoʻoluʻu, ka palaoa a me ka confectionery, nā hua momona.
- Ke kaupalena ana i nā momona holoholona a me ka wehe ʻana o nā meaʻai i ke kiʻekiʻe i ka kolamu: ka momona momona, nā momona holoholona iʻa, nā meaʻai, ka lard, offal, fatty cream cream, cheese cheese and cream, butter.
- ʻO ka pāpā i nā mea inu wai.
- ʻO ka hoʻonaniʻana i ka meaʻai me ka fiber meaʻai mai nā lau i nā mea kanu, nā huaʻai ʻole i hoʻopiha ʻia, bran.
Me kahi ʻano maʻi o ka maʻi maʻi a i ʻole ke kala ʻole o ka hoʻoliʻiliʻi ʻole, hiki ke lawa kahiʻai e hoʻohaʻahaʻa i ke kōpaʻa koko, ma nā mea āpau āpau, ʻo ka hoʻoponopono ʻia ʻana o ka wai i ka lāʻau hoʻokaʻa gula. Hoʻopauʻia nā papa hana lōʻihi a me nā insulin no nā mea maʻi i kēlā me kēia lā. Hoʻomaopopo ʻia ka hoʻohana ʻana o nā ʻaina pōkole pōkole.
Inā heʻoi aku ka nui o ka glycemia koko ma mua o 13.8 mmol / L, a laila mālama ka 1 - 2 IU o ka insulin i ka intravenously i kēlā me kēia hola, akā hoʻohaʻahaʻa ʻia ma lalo o 8.2 mmol / L ʻaʻole i'ōlelo ʻia e hoʻohaʻahaʻa i ka hōʻailona. Me kahi papa lōʻihi o ka maʻi maʻi, ua alakaʻi ʻia lākou e kahi pae kokoke i 9 mmol / l a me kaʻole o ka acetone i ka urine. ʻAʻole hiki i ka mea o ke kūmole i ka glucose i loko o ka lāʻai ka nui o ka 5% o ka waihona o ka hāleʻe i ka meaʻai.
Ma kahi o ka mālamaʻana i ke koko glucose i loko o nā poʻe maʻi me ka maʻi maʻi, hoʻokō lākou:
- Hoʻopilikia i nā pilikia o ka puʻuwai a me ke koko.
- ʻO ka mālama ʻana i nā pōpoki.
- Hoʻopilikia i nā maʻi neuropathy maʻi.
- ʻO ka pale ʻana i nā hoʻopiʻi maʻi ʻole.
Ma ka maʻi maʻi, he nui ka hopena o ka hoʻomohala ʻana i ka hōʻeha ʻana o ka naʻau, ka mea hypertension arterial. Hiki i nā ʻōlima puʻuwai ke ʻano i ka maʻi ischemic, myocardial dystrophy, cardiac muscle neuropathy. ʻO kahi ʻano o nā maʻi puʻuwai, nā ʻano like ʻole o ka hōʻeha ʻana o ka puʻuwai, i hōʻike ʻia e nā hōʻeha o ka hōʻeha ʻana, nā nalowale o ka ʻike ʻole, a i ʻole ke hōʻeuʻeu ʻole o ka puʻuwai puʻuwai.
I ka maʻi puʻuwai, paʻa ka nui o ka coronary e alakaʻi ana i ka make koke. ʻAʻole i hōʻike ʻia nā mea maʻi maʻi maʻi maʻi kūlohelohe me nā beta-blockers a me nā antagonist calcium ma muli o ko lākou hopena maikaʻi ʻole i ka ʻaila metabolism.
No ka hoʻomākaukau no ka hana ʻana no nā maʻi me ka maʻi maʻi me ka maʻi naʻau, ua hoʻomākaukau ʻia nā mākaukau dipyridamole - Curantil, Persantine. Hoʻomaʻo ia i ka kaila koko peripheral, hoʻoikaika i ka ʻoihana naʻau, a ma ka manawa like i ka neʻe ʻana i ka neʻe o ka insulin i nā io.
ʻO ka hōʻemi ʻana i ke koko o ka poʻe maʻi me ka maʻi maʻi e paʻakikī i ka hopena o ka insulin i ka hoʻokele sodium. Me ka sodium, e paʻa ʻia ka wai i loko o ke kino, ka edema o ka pā moku e hoʻokaʻawale i ka hana o nā hormone vasoconstrictive. Eia kekahi, ʻo kaʻeha kino i ka maʻi diabetes, nā hoʻololi o ka atherosclerotic i ke kīʻaha koko a me ka momona e hoʻonui i ka hypertension.
No ka hōʻemi ʻana i ke kaomi, ʻoi aku ka maikaʻi o ka mālama ʻana i nā lāʻau lapaʻau mai nā pūʻulu poloka adrenergic: beta 1 (Betalok), alpha 1 (Ebrantil), a me ka angiotensin-hoʻohuli i ka enzyme inhibitors (Enap, Kapoten). I nā poʻe kahiko, hoʻomaka ka lāʻau me nā diuretics, e hui pū me nā lāʻau mai nā hui ʻē aʻe. ʻO ka waiwai o ke hoʻohaʻahaʻa i kau ʻia ma Glyurenorm.
Ke kūpaʻa nei nā hōʻailona o ka nephropathy, ua palena ka paʻakai ma ka 1-2 g, nā kīpū holoholona a hiki i 40 g i ka lā. Inā ʻaʻole i hoʻokuʻu ʻia nā hōʻike o ka hoʻolaʻa momona o ka momona ma o kaʻai, a laila ua kuhikuhi ʻia nā lāʻau lapaʻau e hoʻohaʻahaʻa i ka cholesterol. I ka polyneuropathy diabetic, hōʻike ʻia ka hoʻohana ʻana o Thiogamma a i Belithion.
Ke lawe ʻia nei kahi hana hoʻoponopono immunological a me ke ʻano, me ka hōʻike ʻana - i ka maʻi antibiotic.
Hoʻomaʻomaʻi maʻi
I ka wā o ka hana, hoʻāʻo lākou e mālama i ke koena o ka glucose i loko o ke koko, ke pale nei i kona hōʻemi ʻana, ʻoiai hiki kēia ke alakaʻi i nā hōʻeha i loko o ka lolo. ʻAʻole hiki ke kau koʻikoʻi i nā hōʻailona o ka hypoglycemia ma lalo o nā kūlana o ka anesthesia. ʻAʻole ʻae ʻia ka nunui anesthesia e ʻike ʻia, no laila ua hoʻohana ʻia kahi hōʻike koko no ka kō. Lawe ʻia kēlā me kēia 2 hola.
ʻO nā dosis nui o ka anesthetics, me kā lākou mālama wā lōʻihi hoʻi e hōʻemi i ka glucose koko. No laila, i ka wā o ka anesthesia i ka wā o ka hana, ke lawelawe ʻia kahi ʻano o ka glucose a me ka insulin. ʻOi aku ka hana o ka insulin i ka wā ma ka anesthesia ma mua o nā kūlana maʻamau, no laila ke loli koke ka pae glucose maʻamau ma ka hypoglycemia.
Ke hoʻohana nei i nā lāʻau lapaʻau no ka anesthesia, pono ʻoe e noʻonoʻo i ko lākou hopena ma ka puhaka o ka puhaka:
- Hoʻopuka nā inestation anesthesia me Ether a me Fluorotan i ka piʻi o ka glucose.
- Hoʻokomo ʻia nā Barbiturates i ka komo ʻana o ka insulin i loko o nā pūpū.
- Hoʻokomo ʻo Ketamine i ka hana pancreatic.
- Hoʻohana ʻia ka hopena liʻiliʻi o ka metabolism e: droperidol, sodium oxybutyrate, nalbuphine.
Hana ʻia nā hana pōkole ma lalo o ka anesthesia kūloko, ma nā mea maʻi i hōʻemi ʻole ʻia i hiki ke hoʻonui ʻia me nā antipsychotics. No nā hana ma nā pae haʻahaʻa haʻahaʻa a me ka mahele o ka cesarean, hoʻohana ʻia ka nui o ka spinal a i ʻole nā hanana anesthesia.
ʻO ka pīhoihoi no ka maʻi mellitus ma ke ʻano o nā inikina a i ʻole ka hoʻomaka ʻana o kahi catheter e pono e hana ma lalo o nā kūlana o ka sterility piha ma muli o ka hiki o nā mea maʻi i ka hoʻomohala ʻana o ka suppuration.
ʻAʻole hiki ke hoʻemi ʻia ke kahe koko, no ka mea, ʻaʻole i ʻae ʻia ka maʻi maʻi maʻi hypotension. ʻO ka maʻamau, hoʻonui ʻia ke kaomi e nā kaila intravenous a me nā electrolytes. ʻAʻole kōkua ʻia nā lāʻau Vasoconstrictor.
E hoʻoulu hou i kaʻeha koko, mai hoʻohana iā dextrans - Polyglyukin, Reopoliglyukin, ʻoiai ua ʻohi ʻia lākou i ka glucose. Hiki i kā lākou hoʻokō ke hōʻeha koʻikoʻi hyperglycemia a me ka comly glycemic.
ʻAʻole ia e hoʻohana i ka hopena ʻo Hartman a Ringer, ʻoiai ke lactate mai o lākou aku i ka puʻu e lilo i glucose.
Nā hopena
ʻO ka hoʻopiʻi postoperative i nā mea maʻi me ka maʻi maʻi e pili ana i ka nalowale o ke koko, ka hoʻohana ʻana o ka anesthetics a me ka hōʻeha ma hope o ka hōʻoki ʻana e hoʻōla ai i ka synthesis glucose i loko o ka ate, ka hana ʻana o nā kino ketone, ka wāwahi o nā loina a me nā protein.
Me nā hana nui a i ka wā e hana ai e mālama ai i nā hoʻopiʻi maʻi diabetes, hiki loa i ka maʻi hyperglycemia. No laila, hoʻokomo ʻia nā mea maʻi i nā hui mālama mālama a me ka hoʻokahe koko, ke nānā ʻana a me ka naʻau o ka ʻōpū ma kēlā me kēia 2 mau hola.
Hoʻohana ʻia ka insulin hana pōkole e pale i ka ketoacidosis a me ka coma. E hoʻokomo i loko ona me kahi hoʻonā o 5% glucose. Mālama ʻia ka glycemia i ka waena o 5 a 11 mmol / L.
Mai ka hiku o ka lā ma hope o ka hana, hiki iā ʻoe ke hoʻihoʻi i ka mea maʻi i kahi insulin a lōʻihi paha e hōʻemi i ke kō. Ke hoʻololi i nā papa, oki ke kāpae i ke ahiahi ma mua, a laila i kekahi me kēlā me kēia lā a, ʻoi aku ka hopena o ke kakahiaka.
E mālama i kahi pae o ka glucose i loko o ke koko, pono ka hōʻoluʻolu ʻana ma hope o ka hoʻomaʻamaʻa ʻana. Hoʻohana pinepine ʻia, analgesics no kēia - Ketanov, Nalbufin, Tramadol.
ʻO nā maʻi maʻi maʻi maʻi i ka wā postoperative e kuhikuhi ʻia ana i nā antibiotika o kahi ākea ākea o kahi ākea ākea a me nā hui pū o 2 a 3 mau ʻano. Ke hoʻohana nei nā penicillins Semisynthetic, cephalosporins a me aminoglycosides Hoʻopili i nā antibiotics, metronidazole a clindamycin i kuhikuhi ʻia.
Hoʻohana ʻia ka hoʻoneʻe ʻana o ka protein no ka meaʻai o ka makua, ʻoiai ka lōʻihi o ka hoʻohana ʻana i nā hoʻonā glucose e alakaʻi i ka hyperglycemia, a me ka hoʻohana ʻana o nā lula lipid e alakaʻi i ka ketoacidosis maʻi. No ka hoʻohui i ka hapa o ka protein, hiki ke hoʻonui ʻia i ka glucose o ke koko, nā hui kūikawā no nā maʻi maʻi maʻi maʻi - ua hoʻomohala ʻia iā Nutricomp Diabetes a me Diazon.
Hāʻawi ʻia ka ʻike ma nā ʻano anesthesia i loko o ke wikiō ma kēia ʻatikala.
