ʻO ka mālamaʻana i ka insulin he ʻano hoʻololi, no ka mea, ʻo ka hana nui o ka lapaʻau ka hoʻopiʻi ʻana i nā malfunctions i ka ʻaila metabolism e ke kiʻi ʻana i kahi lāʻau lapaʻau kūikawā ma lalo o ka ʻili. ʻO kēlā lāʻau lapaʻau e hoʻopilikia i ke kino a me ka insulin kūlohelohe i hana ʻia e ka pancreas. I kēia hihia, ʻo ke kāohi paha he piha a ʻokoʻa paha.
I waena o nā lāʻau lapaʻau i hoʻohana ʻia no ka maʻi diabetes, ʻo kekahi o ka maikaʻi loa ʻo ka Isofan insulin. ʻO ka lāʻau lapaʻau ka mea i hoʻopili ai i nā kānaka genetically i hana ʻia ma ka lōʻihi o ka lōʻihi.
Loaʻa ka hāmeʻa i nā ʻano like ʻole. Hoʻohana ʻia ia ma ʻekolu mau ala - subcutaneously, intramuscularly and intravenously. ʻAe kēia i ka mea maʻi e koho i ke koho maikaʻi loa no ka pale ʻana i ke kiʻekiʻe o ka glycemia.
Nā hōʻailona no ka hoʻohana a me nā inoa kālepa o ka lāʻau lapaʻau
Hōʻike ʻia ka hoʻohana ʻana o ka lāʻau lapaʻau no kahi ʻano like ole o ka maʻi diabetes. Eia kekahi, pono e ola ka lāʻau maʻi.
ʻO Insulin e like me Isofan he ʻano mea i hana ʻia e ka huaʻāina i hōʻike ʻia i loko o ia mau hihia:
- ʻano type diabetes 2 (hilinaʻi-insulin);
- hana;
- ke kūʻē nei i nā lawaiʻa hypoglycemic i lawe waha ʻole ma ke ʻano o ka mālama paʻakikī;
- maʻi gestational maʻi (i ka ʻole o ka hopena o ka hoʻoulu ʻia ʻana o ka ʻai);
- kūlia pili.
ʻO nā hui lāʻau lapaʻau e hana i nā kānaka genetically engineered insulin ma lalo o nā inoa like ʻole. ʻO ka mea i kaulana loa ʻo Vozulim-N, Biosulin-N, Protafan-NM, Insuran-NPH, Gensulin-N.
ʻO nā ʻano ʻē ʻē aʻe o ka Isofan insulin e hoʻohana ʻia me nā inoa kālepa kālepa aʻe:
- Insumal;
- Humulin (NPH);
- Penikala;
- Isofan insulin NM (Protafan);
- Actrafan
- Insulidd H;
- Biogulin N;
- Protafan-NM Penifill.
He mea kūpono ia e pono ke ʻae ʻia ka hoʻohana ʻana o kekahi ʻano ʻano like no Insulin Isofan me ke kauka.
Ka hana lāʻau lapaʻau
Loaʻa i ka insulin o ke kanaka he hopena hypoglycemic. Pili ka lāʻau lapaʻau me nā ʻenehana o nā membrane cytoplasmic cell, e hana ana i kahi mea ulu o ka insulin-receptor. Hoʻopili ia i nā kaʻina hana i loko o nā pūpū a synthes i nā enzyme nui (glycogen synthetase, pyruvate kinase, hexokinase, etc.).
Ke lawe ʻia nei ka hoʻoliʻiliʻi o ke kō me ka hoʻonui ʻana i kāna kaomi intracellular, hoʻohaʻahaʻa ʻana i ka nui o ka hana glucose ma o ka ʻāʻī, hoʻoulu ʻia ʻana i nā mea hou aʻe a me ke komo hou ʻana o ka glucose i nā kiko. Eia kekahi, hoʻonāwī i ka insulin o ke kanaka i ka synt synt protein, glycogenogenesis, lipogenesis.
ʻO ka lōʻihi o ka hana o ka lāʻau lapaʻau e hilinaʻi ana i ka wikiwiki o ka komo ʻana, a e kau ia ma muli o nā ʻano like ʻole (area o ka hoʻokele hoʻomalu, ke ʻano a me ka ʻano lāʻau). No laila, ʻo ka hopena o ka insulin Isofan hiki ke pohō i ka mea maʻi a me nā mea maʻi ʻē aʻe.
Hoʻomaʻamaʻa pinepine ma hope o ka hoʻonā ʻana, ʻike ʻia ka hopena o nā lāʻau lapaʻau ma hope o 1,5 mau hola. ʻO ka kiʻekiʻe kiʻekiʻe loa e hoʻokō ʻia i loko o 4-12 mau hola ma hope o ka hoʻokele ʻana. Ka lōʻihi o ka hana - hoʻokahi lā.
No laila, ʻo ka hoʻopiha piha ʻana o ka hakahaka a me ka hoʻomaka ʻana o ka hana a ka luna e hilinaʻi ʻia i nā mea e like me:
- wahi kīnā (pōkā, ʻūhā, ʻōpū);
- ikaika mea hoʻoikaika kino;
- pākē
Hoʻonohonoho ʻia ka hoʻomākaukau ʻana o ka inika manuahi a ke kanaka ma nā kiko. ʻAʻole lākou e komo i ka plasenta a ʻaʻole i hoʻokomo ʻia i loko o ka waiū umauma.
Ua luku ʻia lākou e ka insulinase ma nā ʻōpū a me nā ate, ua hoʻopā ʻia me nā pōpoki ma kahi hapa 30-80%.
ʻLoe a me ke kākele
ʻO nā ʻōlelo e ʻimi ai me ka insulin Izofan, e mālama pinepine ʻia ka subcutaneously a hiki i ka 2 mau manawa i ka lā ma mua o ka ʻaina kakahiaka (30-45 mau minuke). I kēia hihia, pono ʻoe e hoʻololi i ka ʻōlelo ʻoi aku ka lā a mālama i ka syringe i hoʻohana ʻia i ke ana o ka lumi, a he mea hou aʻe i loko o ka friji.
I kekahi manawa ke lawelawe ʻia nei ka lāʻau intramuscularly. A ua hoʻohana ʻole ʻia ka ʻano hana intravenous e hoʻohana ai i ka hana medium-acting.
Hoʻolaha ʻia ka nui o ka dosage no kēlā me kēia maʻi, e pili ana i ka pae o ke kōpaʻa o ke kō i loko o nā wai o nā mea wili a me ke ʻano o ka maʻi. E like me ke kānāwai, ka awelika o kēlā me kēia lā maʻamau mai 8-24 IU.
Inā loaʻa ka poʻe maʻi i ka hypersensitivity i ka insulin, a laila ʻo ka helu kiʻekiʻe o kēlā me kēia lā o ka lāola ʻo 8 IU. Me ka hikiʻole o ka hormone, hoʻonui ka nui o ka nui - mai 24 IU i kēlā me kēia lā.
Keʻoi aku ka nui o ka helu o kēlā me kēia lā i ka 0.6 IU i ka 1 kg o ka lahilahi, a laila hana ʻia nā inikini 2 ma nā wahi like o ke kino. ʻO nā maʻi me ka maʻi pākahi o kēlā me kēia lā o 100 IU a i ʻole he nui ke halihali inā paʻa ke insulin.
Eia kekahi, ke hoʻokuʻi nei mai hoʻokahi ʻano huahana i kahi ʻē aʻe, pono e nānā i nā ʻike o ke kō.
ʻO nā hōʻike hewahewa a me ke keu
Hiki i ka hoʻohanaʻana i ka insulin kanaka ke hōʻemi i nā hōʻike hoʻohālikelike. ʻO ka hapa pinepine, ʻo ia ka angioedema (hypotension, pōkole o ka hanu, ke kuni) a me ka urticaria.
Eia kekahi, ʻoi aku ka nui o ka dosage ke alakaʻi i ka hypoglycemia, i hōʻike ʻia e kēia mau hōʻailona:
- ʻōpala
- ʻaʻano o ka ʻili;
- Hōʻikeʻike
- hyperhidrosis;
- makaʻu
- kūlana ʻoliʻoli;
- palpitations puʻuwai;
- lie kanikela
- pupule o ka ike;
- nā maʻi vestibular;
- pololi
- mea hoʻoweliweli a me nā mea.
ʻO nā hopena ʻaoʻao ka hopena o ka acidosis maʻi maʻi a me ka hyperglycemia, ka mea i hōʻike ʻia e ka ʻula ʻana o ka maka, ka hiamoe, ka momona maikaʻi a me ka makewai. ʻO ka manawa pinepine, ulu nā ʻano like i ke kuana ʻana o nā maʻi maʻi a me ka kūlohelohe, inā hiki ʻole ke nānā ʻia, he hala ʻole ke ala, a inā ʻaʻole i hahai ʻia nā meaʻai.
I kekahi manawa luhi i ka hoʻomaopopoʻole. I nā pilikia paʻakikī, ulu kahi kūlana precomatous a me ka coma.
I ka hoʻomaka ʻana o ka hoʻomaʻamaʻa, hiki i nā mea lawehala ke hala hele i ka hana ʻike ʻia. ʻO ka hoʻonui ʻana i nā ʻāpana o nā kino anti-insulin e ʻike ʻia me ka hoʻomohala mua o ka glycemia a me ka hopena immunological o kahi ʻano kea me ka insulin kanaka.
Nui nā ʻōkuhi o ka injection a me nā kuʻekuʻe. I kēia hihia, subcutaneous fatty fat hypertrophies or atrophies. A ma ka hoʻomaka mua o ke kuʻina, hiki ke kū mai kekahi mau wā hōʻemi o ka hoʻokaʻawale ʻana a me ka pupuhi.
I kahi hihia o kahi lāʻau hoʻomehana nui o hormonal, e hāʻule nui ka nui o ke kō koko koko. Hoʻopilikia kēia i ka hypoglycemia, a i kekahi manawa ua hāʻule ka mea maʻi i kahi coma.
Inā liʻiliʻi iki ka nui o ka lāʻau, pono ʻoe e ʻai i nā meaʻai-ka ʻai kiʻekiʻe (ʻoka, ʻai ʻaina keʻokeʻo, kahi ʻāpana, kīʻaha) a inu i kahi kīʻaha ʻono loa. Ma kahi o nā nāwaliwali, kahi hopena o ka dextrose (40%) a i ka glucagon (s / c, v / m) e lawelawe ʻia i ka mea maʻi i ka /.
Ke hāpai ka mea maʻi i ka ʻike, pono ia e hānai iā ia i ka meaʻai i mea momona i ke kīleʻao.
Pale kēia i ka hoʻēmi hypoglycemic a me ka comly glycemic.
Hoʻohui a me nā ʻōlelo koʻikoʻi
Hoʻohana ʻole ka hana no ka hoʻokele sc me nā hoʻonā o nā lāʻau lapaʻau ʻē aʻe. A ke kākoʻo '-hooponopono me sulfonamides, ACE / Mao / carbonic anhydrase, NSAIDs, ethanol nā mea kūpale, anabolic steroid, chloroquine, androgens, quinine, bromocriptine, pirodoksin, tetracyclines, likiuma hoomakaukau, clofibrate, fenfluramine, Ketonozolom, Tsiklofosvamidom, theophylline, mebendazole Hoʻonui i ke hypoglycemic hopena.
Ke hoʻonāwī nei i ka hana hypoglycemic e kōkua i:
- H1-histamine ʻenemi blocker blocker;
- Glucagon;
- Somatropin;
- Epinephrine;
- GCS;
- Phenytoin;
- nā hana hoʻohālikelike waha ʻole;
- Epinephrine;
- ʻElekene;
- nā antagonis kalona.
Eia kekahi, ʻo ka hoʻohaʻahaʻa o ka hilo i kumu no ka hoʻohana pono ʻana o ka insulin Isofan me ka diuretics a me ka thiazide diuretics, Klondin, BMKK, Diazoxide, Danazol, nā hormones thyroid, tricyclic antidepressants, sympathomimetics, Heparin a sulfinpyrazone. Hoʻonui ka nikotine, ka hana a me ka morphine i ka hypoglycemia.
ʻO Pentamidine, nā beta-blockers, Octreotide a me Reserpine hiki ke hoʻonui a hoʻonāwaliwali i ka glycemia.
ʻO ka mālama nui no ka hoʻohana ʻana ʻana o ka isofan insulin i kahi kanaka me ka maʻi maʻi e hoʻololi mau i nā wahi i kahi e hāʻawi ʻia ai kahi inikini insulin. Ma hope o nā mea āpau, ʻo ke ala wale e pale ai i ke ʻano o lipodystrophy.
E kue i kahi o ka lāʻau o ka insulin, pono ʻoe e kiaʻohi pinepine i ka neʻe o ka glucose. Ma hope o nā mea a pau, i ka hoʻopili pū ʻana me nā lāʻau lapaʻau ʻē aʻe, hiki i nā mea ʻē aʻe ke hoʻoulu i ka hypoglycemia:
- huehue a hoʻomehana;
- laau hoʻokolo;
- hoʻonui hoʻonui kino kino;
- nā maʻi e hōʻemi ai i ka pono o kahi hormone (ʻoi a i ʻole a me nā leʻaleʻa e nānā ai, hypofunction o ka momona thyroid, gland pituitary, etc.);
- kaʻai ʻole kai;
- loli ka wahi ʻae.
ʻO ka hewa nui a i ʻole nā pau lōʻihi ma waena o nā inikini insulin e hiki ke kōkua i ka hoʻomohala ʻana o ka hyperglycemia, me ka maʻi maʻamau o ka maʻi type 1. Inā hoʻoponopono ʻole ʻia ka lāʻau i ka manawa, a laila hoʻomohala ka mea maʻi i kahi como ketoacidotic.
Eia kekahi, pono ke hoʻololi ʻia he dosis inā he ʻoi aku ka nui o ka mea maʻi ma mua o 65, ua loaʻa iā ia ke hana i ka ʻōmaiko thyroid, nā ʻōpū a me nā pēpē. He pono naʻe i ka maʻi o ka hypopituitarism a me Addison.
Eia kekahi, pono e ʻike nā poʻe maʻi e hoʻomākaukau i ka hoʻomākaukau ʻana o ka insulin i ka hoʻolaʻa ʻana i ka wai ʻona. I ka hoʻomaka ʻana o nā lāʻau lapaʻau, inā hiki i kahi mea e hoʻololi ai i nā mea hoʻoponopono, ke ʻano kaumaha, nā hoʻoikaika kino ikaika, ʻaʻole pono ke alakaʻi i kahi kaʻa a me nā mea ʻenehana a paʻakikī paha e komo i nā hana pōʻino e pono ai e hoʻonui i ke kūpaʻa a me ka wikiwiki o nā hopena.
Pono ka poʻe maʻi maʻi maʻi e noʻonoʻo ma ka trimester mua ka pono o ka insulin i hōʻemi, a ma ka 2 a me 3 ka hoʻonui. Eia kekahi, liʻiliʻi kekahi hapa o ka hormone i ka wā o ka hana.
E kūkākūkā nā lāʻau lapaʻau o Isofan i ke wikiō i kēia kolamu.
