He aha ka maʻi maʻi: ka papahele a me nā helu e like me ka ICD-10

ʻO ka maʻi Dieles mellitus he pūʻulu o nā maʻi metabolic kahi he kiʻekiʻe ke kiʻekiʻe o ka glycemia no ka manawa lōʻihi.

I waena o nā hōʻike maʻamau maʻamau e hele pinepine ai i ka urination, hoʻonui nui ʻana i ka momona, ka ʻehaʻeha, make wai, ka hoʻi ʻana o nā kaʻina purulent-inflammatory.

ʻO ka maʻi maʻi ke kumu o nā hoʻopiʻi he nui e alakaʻi ana i ke kīnā. Ma waena o nā kūlana koʻikoʻi, kahiʻokoʻa ka ketoacidosis, hyperosmolar a me ka hypoglycemic coma. Hoʻomaʻamaʻa ka maʻi i kahi pālahalaha o nā maʻi cardiovascular, nā hemahema o ka mea i ʻike pono ʻia, nā ʻōpū, nā kahe o ke koko a me nā nires o nā hopena o lalo.

Ma muli o ka pālahalaha a me ka nui o nā ʻano lāʻau lapaʻau, pono ia e hāʻawi i ka code ICD i ka maʻi maʻi maʻi. I ka 10 makahiki o ka loiloi he mau code E10 - E14.

ʻO ka papa helu 1 a me 2 ke ʻano o nā maʻi

Hiki i ke maʻi maʻi ke kumu o ka lawa ʻole piha o ka hana endocrine o ka pancreas (type 1) a i ʻole ka hoʻemi ʻana i ka hoʻonaninani kino i nā insulin (type 2). Hoʻokaʻawale ka ʻeli a me nā ʻano ʻē aʻe o nā maʻi, nā kumu i ʻike ʻia i ka nui o nā hihia.

ʻO nā ʻano maʻi maʻi ʻekolu.

• maʻi diabetes type 1. ^ E Ha yM. ʻAʻole paʻi mai ka pancreas i ka nui o ka insulin. Hoʻomaopopo pinepine ʻia i ka wai a i ʻole ʻĀina i hilinaʻi ʻia, e like me ka mea i ʻike mua ʻia i ka wā kamaliʻi a e koi pono i ka hoʻokō hoʻokō piha pono hormon. ʻO ka maʻi maʻi ma ke kumu o kekahi o ia mau ʻano kaomi: ʻo ka wikiwiki o ke koko hoʻoneʻe ma mua o 7.0 mmol / l (126 mg / dl), glycemia 2 mau hola ma hope o ka ukana o ka haʻaleka he 11,1 mmol / l (200 mg / dl), ʻoi aku ka nui o ka hemoglobin glycated (A1C) a i like me 48 mmol / mol (≥ 6.5 DCCT%). Ua aponoia ka laikini hope ma 2010. ʻO ka ICD-10 he helu helu E10, ka waihona i nā maʻiʻehā o nā ʻano genetic OMIM e wehewehe i nā pathology ma lalo o ke code 222100;
• diabetes type 2. ^ E Ha yM. Hoʻomaka ia me nā hōʻike o ka pale ʻana i ka wili o ka insulin, kahi kūlana e nalowale ai nā pūleʻa i ko lākou hiki ke pane pono i nā hōʻailona humoral a hoʻopau i ka glucose. Ke hele nei ka maʻi, hiki ke lilo i ka hoʻopau ʻana i ka insulin. Hōʻike nui ʻia ia i ka wā ʻelemakule a ʻelemakule paha. Ua hōʻoia ia i kahi pilina me ka momona nui, ka hypertension a me ka hoʻoilina. Hoʻemi i ka hoʻolōʻihi o ke ola ma kahi o 10 mau makahiki, he kiʻekiʻe nui ka maʻi. Hoʻopili ʻia ka ICD-10 ma lalo o ke code E11, ka waihona OMIM i kuhikuhi i ka helu 125853;
• maʻi maʻi maʻi gestational. ^ E Ha yM. Hoʻokumu ke kolu o ke ʻano o ka maʻi i nā wahine hāpai. He papa nui a maleign nona, pau loa ma hope o ka hānau ʻana. Wahi a ICD-10, ua kau ʻia ma lalo o ka code O24.

Ma muli o ka maʻi maʻi ʻole i ʻike ʻia e like me ICD 10 (me ke ʻano o ka maʻi hou)

Hōʻike pinepine ia i kahi kanaka i komo i kahi keʻena me ke kiʻekiʻe o ka glucose koko a i ʻole i ke kūlana koʻikoʻi (ketoacidosis, hypoglycemia, hyperosmolar coma, acute coronary syndrome).

I kēia hihia, hiki pinepine ke kiʻi pono i ka hōʻiliʻili ʻana i kahi anamnesis a ʻike i ke ʻano o ka maʻi.

ʻIke anei kēia i kahi ʻano 1 a i ʻole type 2 i komo i ka hoʻomakaʻana o ka insulin (kūlohelohe nui hormon)? Ua pane pinepine ʻole kēia nīnau.

I kēia hihia, hiki i kēia mau hopena ke hoʻoneʻe ʻia:

• diabetes mellitus, unspecified E14;
• ka mellitus maʻi maʻi ʻole i haʻi ʻia me ka coma E14.0;
• ka maʻi mellitus maʻamau ʻole i hoʻopuka ʻia me ka pōpilikia peripheral lēwa E14.5.

Kūpaʻa ʻia ke Insulin

ʻO nā papa maʻi maʻi 1 ka nui no ka 5 i ka 10% o nā hihia a pau o ka metabolism. Kuhi ka poʻe ʻepekema ʻo 80,000 mau keiki a puni ka honua i kēlā me kēia makahiki.

ʻO ke kumu e pau ai ka pancreas i ka hana ʻana i ka insulin:

• hoʻoilina. ^ E Ha yM. Eia ka pilikia o ka hoʻomohala ʻana i ka maʻi diabetes i kahi keiki i loaʻa i nā mākua i kēia maʻi mai ka 5 a 8%. ʻOi aku ma kahi o 50 mau genena i pili me kēia ʻano. Hoʻokumu i ka locus, hiki iā lākou ke alakaʻi, recessive, or intermediate;
• kaiāulu. ^ E Ha yM. ʻO kēia ʻāpana ka noho ʻana, nā mea koʻikoʻi, nā mea hoʻonaninani. Ua hōʻike ʻia ua noho ʻo nā poʻe o ka megalopolises, e hoʻohana nui ana i nā hola i loko o nā keʻena, e loaʻa i ke kaumaha o ka psycho-emotional, maʻi pinepine ʻia i ka maʻi diabetes i nā manawa pinepine ma mua o nā poʻe noho o ka ʻāina;
• a me nā lāʻau lapaʻau. ^ E Ha yM. Hiki i kekahi mau lāʻau lapaʻau ke hoʻopau i nā mokupuni o Langerhans (aia kekahi mau cell e hana i ka insulin). ʻO kēia mau lāʻau lapaʻau nui no ka mālamaʻana i ka maʻi maʻi.

Ke kūʻokoʻa nei ka Insulin

A laila ua manaʻoʻiʻo ʻia ʻo ke kumu o kēia maʻi ka hoʻemi ʻana i ka hoʻohaʻahaʻa glucose i ka mau hema, ʻoiai ua loaʻa ka insulin endogenous i ka nui.

I ka wā mua, ʻoiaʻiʻo kēia, pane maikaʻi ka glycemia me nā mea maʻi hypoglycemic waha.

Akā ma hope o kekahi mau manawa (mau mahina a i ʻole mau makahiki), ulu ka pancreatic endocrine insulency, no laila ke hoʻomau ʻia nei ka maʻi diabetes (e koi ʻia nā kānaka e hoʻololi i "jabs", i ka hoʻohui ʻia i nā pōpoki).

Aia i ke ʻano o ka maʻi maʻamau ka maʻi o ka maʻi me kēia ʻano (maʻamau), ʻoi loa ka poʻe o ka momona.

ʻO ka hōʻino a me ke ola maikaʻi

I ka makahiki 1985, ua hoʻokomo ʻo WHO i kekahi ʻano ʻē aʻe o ka pono o kaʻai i loko o ka papa o ka maʻi diabetes.

Hoʻonui nui ʻia kēia maʻi ma nā ʻāina kaiapuni; ʻeha nā keiki a me nā ʻōpio ʻōpio. Kūkulu ʻia ia i ka hemahema o ka palaka, pono ia no ke kāpili ʻana o ka mololi insulin.

I kekahi mau wahi, ua ulu ʻia ka mea i kapa ʻia ka pancreatogen - ua pā ka pancreas i ka nui o ka hao, e komo ana i ke kino me ka wai inu ʻona. Wahi a ICD-10, ua hoʻopili ʻia kēia ʻano maʻi maʻi e like me ka E12.

ʻO nā ʻano maʻi ʻē aʻe a i hui ʻia paha

Nui nā subtypes o nā hana hoʻonaninani o ka maʻi iki, he paʻakikī loa kekahi.

• ʻOi nā maʻi maʻi MODY. ^ E Ha yM. E loaʻa ana kēia ʻāpana i kekahi mau ʻano like o nā maʻi e pili ana i ka poʻe ʻōpio, he papa maʻalahi a ʻoluʻolu hoʻi. Ua ʻike nā ʻepekema ʻepekema ke kumu no ka hoʻopōʻino i ka mea hoʻopiha genetic o nā beta beta o ka pancreas, ka mea e hoʻomaka ai ka hana i ka insulin i nā liʻiliʻi liʻiliʻi (ʻoiai ʻaʻole i nele ka nui o ka hormone ulu);
• maʻi maʻi maʻi gestational. ^ E Ha yM. Hoʻoulu ia i ka wā o ka hapai ʻana, e hoʻopau loa ʻia ma hope o ka hānau keiki;
• lāʻau lapaʻau-keʻaila ʻana ka maʻi āpau. ^ E Ha yM. Hana ʻia kēia maʻi ma kahi ʻano he ʻokoʻa i ka hiki ʻole ke hoʻokū ʻia kahi kumu hilinaʻi. ʻO nā mea maʻamau maʻamau he diuretics, cytostatics, kekahi o nā antibiotics;
• maʻi pākuhi-paʻa maʻi. ^ E Ha yM. Ua hōʻoia ʻia ka hopena ʻōʻinoʻino o ka maʻi, ka mea e hoʻonā ai i nā ʻōlaʻi o nā kelepona parotid, gonads a me nā pancreas (mumps).

Nā ʻano maʻi kuhihewa ʻole

E hoʻokaʻawale i nā hiʻohiʻona maʻamau me kahi puka ʻole i hoʻomaopopo ʻia, e hana ʻia ka maʻi ma hope o ka nānā ʻana i ke ʻano piha o ke kino a me ka ʻano paʻi. ʻAʻole hiki i ke kauka ke hoʻomaopopo pono i ke ʻano, no ka mea, he papa uncharacteristic a maʻi ʻole e hoʻohui pū i nā hōʻailona o kekahi mau ʻano maʻi maʻi maʻi.

ʻO nā ʻokoʻa i nā pākeke a me nā keiki

E hōʻeha nui nā keiki i ka maʻi type type 1 a i ʻole kekahi o nā ʻano hoʻoilina hoʻoilina maʻamau.

Hoʻomaka pinepine ʻia ka maʻi ma ka wā kula a hōʻike i ka ketoacidosis.

Hōʻalo ʻole ka hele ʻana o ke kaʻina hana a me ke kū ʻole i ke koho i ka insulin dosis dosing regimen.

ʻO kēia ma muli o ka ulu wikiwiki o ke keiki a me ka nui o nā kaʻala palapa (synthes protein). ʻIke nui loa o ka ulu ulu ʻana a me nā corticosteroids (contra-hormonal hormone) i hāʻawi pinepine i ka hoʻokaʻina o ka maʻi maʻi.

Palapala Endocrine

Hiki i nā hōʻeha i kekahi o nā mea endocrine ke hoʻopilikia i ka metabolism o nā glucose a me ka insulin.

Hoʻopilikia ka hanana o ka adrenal i nā ʻōnaehana o gluconeogenesis, ʻike pinepine ʻia nā kūlana hypoglycemic.

Mālama ka thyroid gland i ke kiʻekiʻe o ka insulin, no ka mea e hoʻopilikia i nā kaʻina o ka ulu a me ka metabolism.

ʻO ka hāʻule ʻole i ka ʻōnaehana hypothalamic-pituitary e alakaʻi pinepine i nā hopena pōʻino ma muli o ka nalowale o ka kaohi o nā kino āpau o ka pūnaehana endocrine.

ʻO ka papa no Endocrine kahi papa inoa o nā pilikia paʻakikī e koi i kahi mau loea ola mai nā kauka. No ka hoʻohālikelike, ua hoʻohilahila pinepine ʻia ka maʻi diabetes type 2 me ka LADA maʻi maʻamau.

Loaʻa kahi papa hana kūpono loa, me ka mālama ʻana ma ka maikaʻi (ʻoi ʻia nā wai lāʻau hoʻoliʻi waha), hele koke i ke ʻano o ka decompensation.

ʻO ka maʻi diabetes Phropate kahi maʻi ma mua o ka wā kamaliʻi e pili iki i ka metabolism glucose. I kēia hihia, huehue ka paʻakai o ka phosphorus-calcium.

Nā wikiō pili

E pili ana i ka maʻi diabetes ma ka hōʻike TV "Ola ola maikaʻi!" me Elena Malysheva: