ʻO ke maʻi mellitus he maʻi maʻamau ka maʻi maʻamau e hoʻoili pinepine i nā hoʻopiʻi pilikia. Inā ʻaʻole ʻoe e hoʻokau kūpono i ka mālama kūpono a ʻaʻole i pili i ka ʻaina meaʻai, he alakaʻi koʻi maʻi i ka hōʻeha ʻana o ka hihiʻo, nā ʻōpū, nā atea a me nā ʻaoʻao ʻē aʻe.
ʻO ka hoʻopiʻi o ka maʻi diabetes ua hoʻokaʻawale ʻia i loko o ke kumu a me ka maʻi. ʻO nā hopena hoʻonā o ka maʻi maʻi e hele ana ma hope o kahi manawa pōkole e pane i kahi piʻi wikiwiki a hōʻemi paha i ke kōhi koko. Ma hope mai o nā hoʻopiʻi ʻana e like me ka hopena o ka hopena o ka hopena o ka hyperglycemia ma luna o ke ake palola a me nā kīʻaha koko.
Hōʻike nā hopena o ka maʻi maʻi me ka mālama kūpono ʻole a lohi paha i ka maʻi.
Nā hopena hoʻonāukiuki
ʻO ka Angiopathy, ʻo ia hoʻi, nā ʻōnaehana vascular i ka maʻi maʻi o ka maʻi maʻi, e like me ka nui o nā moku i hoʻopau ʻia, ʻokoʻa ʻia ka macroangiopathy a me microangiopathy.
ʻO nā hoʻopiʻi Microvascular i ka maʻi diabetes e hoʻonāukiuki i nā maka a me nā keiki. Inā loaʻa ka macroangiopathy, loaʻa nā pilikia me ka lolo, ka puʻuwai a me nā ʻiʻo peripheral.
Hoʻokumu ka Coma i ka maʻi hānai e like me ke ʻano he hopena i nā loli nui i ka glucose o ke koko. Hoʻopilikia pinepine kēia ʻano hoʻopiʻi maʻi ʻana i ka maʻi maʻamau i ke kua o ka hypoglycemia.
ʻO nā hoʻopiʻi hopena e hopena i ka make.
ʻO ka piko hāpū pīhoihoi
Ke hāʻule ka nui o ka glucose i ka nui o nā ʻōpū o ka lolo i ka nele o ka ikehu, ʻike ʻia nā hōʻailona o ka hōʻeuʻeu o ka coma. Hāʻawi ka hypoglycemia i ka waiwai glucose i emi mai ma ke 3.3 mmol / L.
ʻO ka pōʻino o ka coma hiki ke pā i ka pōpoki lolo. Hiki i ke kūlana pōʻino ke ulu pū, no ka laʻana, inā pihi kekahi kanaka i ka hoʻomaopopo. Hiki i kēia ke keʻa aku i ka kaʻa a i nā kūlana ʻē aʻe kahi e koi ʻia ai ka manaʻo kiʻekiʻe.
Hoʻokumu ʻia ka hypoglycemia no nā kumu penei:
- pono ole i ka inika insulin ole a me ka hoʻohana 'ole' ana i nā lāʻau 'kala-kala kūpono.
- nā kīnā meaʻai,
- ka hana pilikino ʻole me ka nui o ka ʻai kūpono o nā ʻōpala,
- hookeai
- inu waiʻona
- ka lawe ʻana i nā lāʻau lapaʻau, ma waena o lākou: e hoʻomākaukau ai ka lithium, sulfonamides, beta-blockers.
Nā ʻano hōʻailona o ka hypoglycemia:
- kaohuu
- nā haʻalulu haʻalulu o ke kino
- tachycardia
- he kūlana ikaika o ka pōloli
- ʻōpū ma ke lehelehe
- hopohopo a makaʻu
- ninini
ʻO kēia mau maʻi āpau i mua o nā ʻōkumu o ka lolo, no laila, pono e hana ʻia nā mea hoʻohālike e pale ai i ka piko. Inā ʻaʻole hoʻōla ʻia ka mālama.
- hiamoe
- nānā nānā
- hilahila
- poʻomanaʻo.
Inā loaʻa kekahi mau hōʻailona, e nīnau koke i kahi kauka.
ʻO ka coma Hyperglycemic
ʻO Coma, kahi i hoʻonui nui ai i ke kōhi koko, hiki ke ketoacidotic (ketoacidosis), me hypersmolar a me lacticidal.
Hoʻopilikia ʻia ʻo Ketoacidosis ma muli o ka hoʻonui o ke kō a me nā huahana metabolic, ʻo ia hoʻi, nā ketones, ka hoʻopilikia kino i ke kino. ʻO ke kumu paha ka maʻi, ka nele o ka mālama ʻana, a me nā hewa paha i loko, a me nā hōʻeha, nā hana a me nā mea ʻē aʻe.
Hoʻokumu ʻia kahi coma hyperosmolar (dehydrating) i ke koko me ka osmolarity kiʻekiʻe "huki" mai ka wai mai nā puna, a hoʻokaʻawale iā lākou. Loaʻa kēia kūlana ma muli o ka nele o nā insulin.
ʻO nā mea i alakaʻi i kēia coma e like me ke kumu o ke ketoacidosis, kekahi mau ala no hoʻi e alakaʻi i ka nalowale i ka wai hiki ke hōʻike ʻia i kēia.
Nā hōʻailona maʻamau e neʻe nei i kahi coma:
- ka piʻi ʻana o ka nui i ka urine (a hiki i 8 lita),
- makewai nui
- luhi, nāwaliwali, migraines,
- me ka loli o ke kō koko koko, kahi hōʻailona ke ʻoi aku ma mua o 16.5 mmol / l,
- nā ʻōpala maloʻo a me ka ʻili,
- kekahi mau lā ma hope mai, he hiʻohiʻona ʻike maka ʻole ʻole.
ʻO kēlā mau hōʻailona kēia ka hiʻohiʻona o kahi moku a hyperosmolar a me ka ketoacidosis. Eia naʻe, ʻokoʻa nā ketoacidosis:
- Hoʻopuka ka hanu o Kussmaul (leo nui, ʻaʻole anuanu a hohonu),
- ka hāʻā o nā "ʻala ʻona" ʻike ʻia
- nā hopena pinepine o ka ʻeha o ka ʻōpū.
Me ka hyperosmolarity, paresis, pālule, ʻōlelo ʻino a me nā hallucinations e hele pinepine ana. Hōʻike ka Hyperosmolar coma i ka piʻi nui o ke kauwela.
Hōʻike nā hōʻike i ka uluʻana o ka comact lactic acida i kāna iho pono ʻole. Hōʻike ʻia ma muli o ka emi ʻana o ka nui o ka oxygen e komo ana i nā uaua i ka wā o ke ala maʻi cardiac, ka hapa ʻana o ka ʻeha o ka ea, nā anemia, nā hōʻeha, ka make koko a me nā maʻi.
Hiki i ka coma acid lactic ke hiki mai ma muli o ke koʻikoʻi o ke kino, maʻi kūlohelohe a i ʻole ma hope o 65 mau makahiki.
Hoʻololi ka hōʻailona i nā comas ʻē aʻe, akā ʻaʻohe ona ketones i loko o ka urine a me ka hyperglycemia kiʻekiʻe.
ʻO nā hopena hoʻonā
ʻO nā maʻi hāhaiʻi o nā maʻi mellitus a i ʻole nā līlapa o nā maʻi maʻi i nā maʻi pili koko, i.e. angiopathies diabetes.
ʻO ka angathyathy Diabetic kahi lesi o nā moku liʻiliʻi, waena a me nā nui. Inā pili nā moku liʻiliʻi (arterioles, capillaries a me venules), kūkulu ʻia ka microangiopathy.
ʻO ka nalowale o nā moku o ka nui a me nā ʻāpana nui i kapa ʻia ʻo macroangiopathy. Ke alakaʻi nei kēia mau maʻi i ka hōʻeha o ka maka a me kaʻeha. ʻO nā moku hoʻi e kau pū ʻia:
- mau naʻau
- lolo
- nā lālā haʻahaʻa.
Na ka papa ʻaina ʻOkopi
ʻO ka nephropathy Diabetic he mea hōʻeha o ka pōpoki i ka maʻi diabetes, ka mea e alakaʻi ai i ka hiki ʻole o ke kaulike.
Hōʻike ʻia ka hōʻike mua o ka nephropathy 5-10 mau makahiki ma hope o ka hoʻomaka ʻana o ka maʻi diabetes. ʻO Nepropathy kēia ʻano o ka hoʻopiʻi pinepine e hōʻeha pinepine ai i ka make o kahi mea maʻi me ka maʻi maʻi type 1.
ʻO kēia ʻano kuʻuna o nā pūpū he nui nā pae:
- microalbuminuria,
- proteinuria
- uhaola hooulu pila.
Ke neʻe nei ka lolo me ka Neprotic i ka emi ʻana o ka nui o ka protein i kēlā me kēia māhele o ke koko. Mai ka hoʻokumu ʻana o ka proteinuria mau loa, ʻo nā hōʻailona āpau e hōʻike nei i ka hiki ʻole o ke kaulike o ka aʻalolo pale ke komo pū aku. Loaʻa kahi pae holomua i kahi pae i kahi ʻokoʻa.
ʻO ka mea koho i ka hoʻomohala ʻana o ka hiki ʻole o ka hana renal i manaʻo ʻia i ka hypertension arterial, ʻo ia hoʻi, he piʻi o ke kahe koko. E like me ke kānāwai, i kēia manawa, ʻike ʻia nā ʻano like ʻole e hele i ka urinary system.
Pono e hoʻokō i kekahi pae i ke kahe o ke koko, ʻaʻole pono ia eʻoi aku ma mua o 130/85 mm RT. ʻAniā. Inā ua ʻike ʻia ka lāʻau lapaʻau ʻo Enalapril a me nā lāʻau like ʻole e like me ka pono ʻole, e pono ke kuhikuhi hou i nā lāʻau hou me Verapamil a i ʻole Diltiazem.
Eia kekahi, hiki iā ʻoe ke hoʻohana i ka diuretics, no ka laʻana, Furosemide, a me Atenolol. ʻO ka lāʻau lapaʻau i ka hoʻokumu ʻana o kahi hana ʻole i hoʻoholo ʻia e ka mahele o ke ala iā pathology.
Hiki i ka male ʻole ke hōʻino a me ka hoʻokele.
Retinopathy Diabetic
Ke hōʻike nei kēia hoʻopiʻi i ka hōʻino o nā veins o ka retina, ka arteri a me nā capillaries. Ma ka maʻi maʻi, ua hoʻomaopopo ʻia kahi kaʻina o ka paʻa o nā moku. I kēia hihia, hoʻomaka nā moku e hōʻeha ma kahi o ke koko. Hōʻike nā pathologiesative, puka nā puka saccular ma luna o nā moku, lilo nā pā i lalo.
Ke hele ka hemahema o ka oxygen no ka manawa lōʻihi, hoʻomaka nā lipids a me nā paʻakai pākīpī i ka retina. Ke alakaʻi nei kēlā mau kaʻina i ke ʻano o nā wahi ākea. Ma muli o ka piha nui o nā loli pathological, nā hōʻeha a me nā infiltrates e kau ana ma luna o nā moku o ka retina.
Inā ʻaʻole i loaʻa ka homaʻi a ke hoʻokuʻu ʻia ke kaʻina hana, hiki ke hoʻokele ʻia ka retinalment a ma muli o ke ʻano, he makapō. Hoʻopuka i ka puʻuwai a me nā hakahaka o nā moku kīnā ʻia i ka hemorrhages koʻikoʻi ma ka kino vitreous o ka maka. Eia nō hoʻi, ʻaʻole i hoʻokaʻawale ʻia ka pilikia o ka hoʻolālā ʻana i ka glaucoma.
I mea e ʻike ai i ka retinopathy maʻi maʻi, pono e hana kekahi mau hōʻike. Nā noiʻi noiʻi:
- hōʻike maka
- ka hoʻoholo ʻana i ka pae a me nā mākeke o ka ʻike,
- ka loiloi o ka iris, cornea, a me ka kihi o ka keʻena anterior o ka maka e hoʻohana ana i kahi kukui hana.
Inā mālama ʻia ka ʻiole vitreous a me nā manea, a laila pono e hana ʻia kahi pā ultrasound o ka maka.
ʻO ka neuropathy maʻi maʻi
ʻO ka neuropathy Diabetic ka palaka o ka paila peripheral a me nā kikowaena waena i ka maʻi diabetes. ʻO ke kumu nui o kēia hoʻopiʻi ʻana he hoʻonui i ka glucose o ke koko.
Nui nā mau ʻoihana o ka neuropathy diabetes. E like me nā mea i kaulana nui, ma muli o ke kiʻekiʻe o ka nui o ka glucose i ke koko, kahi nui o ka nui o ka nui o ka kūlohelohe e kū pono ana i ka neʻe. No ka mea, ʻaʻole i pili ka glucose i ka nui o ka metabolism no ka hoʻopiha piha i ka metabolism, ua hāʻawi kēia i ka hana o ka sorbitol.
Ma muli o ka neuropathy sensory, ka paʻakikī o ka vibrational. Hoʻomaopopo ka hoʻomaopopo ʻana i kēia lawehala me ka hoʻohana ʻia ʻana o ka puʻu mākole i puka mua ʻia, ua kau ʻia ma luna o ke poʻo o ka iwi mua o ka tarsus.
ʻO ka hōʻailona maʻamau o kēia hoʻopiʻi ʻana i ka maʻi hika, ʻo ke hiʻohiʻona o ka ʻāʻī ʻia a me nā "goose bumps" i nā wāwae. I loko o ka maʻi mellitus, kahi hopena o ka hōʻino i ka nūnaehana ka manaʻo i mālama pinepine ʻia i nā palaho i lalo, i hōʻalo ʻia.
Ke hele nei ka maʻi, loaʻa ka pilikia ma ka ʻōpū, ka umauma a me nā lima. Me kahi papa lōʻihi o ka maʻi maʻi, hoʻomaka nā mea hōʻehaʻeha ʻeha e make, ka mea e hōʻike ana iā ia iho me ka hoʻōho o ka hōʻeha ʻana i nā ʻeha.
ʻO ka neuropathy Sensomotor pinepine me ka hoʻohaʻahaʻa ʻana i ka ʻike. I ka kikoʻī, hoʻēmi i ka uluʻana i nā wāwae a me nā lima i ka hapalua.
Eia kekahi, hiki ke hele aku nā pilikia paʻakikī. ʻOiai he pale hewaʻole ka maʻi o ka maʻi o ka maʻi, ʻike pinepine kahi kanaka i ka pōʻino i nā wāwae, kahi mea e hiki mai ana.
ʻO ka cardiovascular he ʻano cardiovascular o ka neuropathy, ka mea i hōʻike ʻia e ka piʻi nui ʻana o ka puʻuwai ma ka hoʻomaha, ʻo ia hoʻi, me ka hana kino ʻole.
ʻO ka ʻano gastrointestinal a i ʻole gastrointestinal i hoʻokumu ʻia i ka neuropathy diabetic i hoʻokumu ʻia ma muli o ka hoʻoponopono hoʻonā o ka gastrointestinal tract. Hoʻopilikia ʻia ka hele ʻana o ka meaʻai ma ka esophagus, hana ʻia ka huhū o ka pā o ka esophagus.
Ma muli o ke kīpē ʻana o ka hanana a me ka maʻi maʻi, constipation a me ka maʻi ʻana. Eia kekahi, ʻo ka hana hoʻopiʻi o ka hana o ka wai ʻona e ka pancreas i hoʻopaʻa ʻia. Hoʻopuka pinepine ʻia nā kuhi waiwai a me ka biliary dyskinesia, i alakaʻi i ka hoʻokumu ʻana o nā pōhaku i nā papa lepo.
Loaʻa i nā kāne i ka emi ʻana o nā hana moekolohe, i loko o nā wahine i laila ke pale hewa o ka hoʻoulu ʻana o nā genitals.
Hoʻopili ʻia ka neuropathy Diabetic me ka hoʻokaʻawale ʻana i ka hana a nā haumāna, kahi kūpono o ka ʻike o ka ʻike i ka pōʻeleʻele.
ʻO ka wāwae Diabetic
Hoʻomaopopo ka maʻi maʻi wāwae maʻi maʻi wāwae i ka maʻi diabetes, ka mea i hana ʻia ma muli o ka hōʻino ʻana i nā nipili peripheral, nā palupalu palaleka, nā ʻili, nā aʻa a me nā iwi. Hōʻike ʻia ka pathology i nā ulia a me nā maʻi lahilahi, nā pāpale-articular mau maʻi a me nā hana purulent-necrotic.
ʻO ke ʻano o ke ʻano neuropathic o ka wāwae maʻi maʻi me ka loli ʻana o ke kīʻaha o nā manamana. Ma muli o ka hoʻonuiʻana o nā moku o ka wāwae, ka edema a me kahi hoʻonui i ka mahana. Ma muli o ke kahe koko hele ʻole, hoʻomaka ka moku koko me ka ʻole o ka oxygen e komo ai i nā ʻāpana o ka wāwae.
Hoʻomaka ka wāwae ma ʻōmaʻomaʻo. ʻO ka hoʻonāukiuki i nā kaʻina hana i ka iwi-ligamentous hiki ke lōʻihi i kahi lōʻihi.
No ka mālamaʻana i ka wāwae maʻi, pono e hana ʻia nā hana e hoʻomaʻamaʻa i nā kaʻina metabola, a:
- antibiotika
- ʻeha hōʻeha
- ka wehe a me ke koena o ka wāwae,
- ka hemo ana o ka wahi o ka ulaula o ka ili,
- ʻaina kāmaʻa kāmaʻa kūikawā.
ʻO ka ʻili ma ka wāwae he mau ʻoliʻoli a cyanotic paha. I kekahi manawa ma muli o ka hoʻonuiʻia o nā capillaries, lilo ka ʻulaʻulaʻula-ʻulaʻula.
No nā noi diagnostic e pili ana:
- Doppler kaʻina
- nā angiography o nā moku o nā wāwae,
- ka hoʻohuihui a me ka magneton resonance imaging,
- ʻO ka nānā ʻana i ka pōkole.
Kāohi
ʻO ka Therapy no nā hoʻopiʻi o ka ʻano type type 1 a me ke ʻano type 2, ʻo ka mea mua, he mau pale. He mea nui ia e hoʻokō pono i nā ʻōlelo lapaʻau āpau e pale aku ai i ka hoʻopulapula ʻana o nā maʻi maʻi i ka maʻi kōpili a mālama i nā hakahaka o nā glucose koko.
I ka hana ʻana o nā hoʻopiʻi, pono e hoʻihoʻi i nā hana e hoʻomaʻamaʻa i nā pae kōnī o ka wai plasma, no ka mea i ka maʻi o ka maʻi diabetes, a me nā hopena e kū aʻe ai, hilinaʻi i kēia.
E loaʻa i nā hana kūpono:
- ka nānā ʻana o nā ʻōnaehana olakino a me nā palapala hoʻopaʻa palapala ʻana.
- kahe koko koko,
- ka hoʻokō ʻana i nā rula kai,
- hoʻomaʻamaʻa i nā hana maʻamau i kēlā me kēia lā
- kekahi mau hana kino pilikino a hoʻomaha.
- ka maemae pilikino a me ka maemae o ka hale,
- Kākoʻo o ka ʻoihana a me ka mālama ʻana i ka manawa kūpono o ka maʻi maʻi a me ke anu.
ʻO ka hoʻokō ʻana me kēia mau ʻōlelo kō aʻe e hiki ai i ka mālama pono ʻana i ka kū ʻana o ka maʻi a hōʻemi i ke ʻano o ka hopena o nā ʻōpiopio.
He aha nā hōʻeha e hiki ke hoʻomohala me ka maʻi maʻi maʻi e wehewehe ʻia e kekahi loea mai ka wikiō ma kēia ʻatikala.
