Chirwere cheshuga hyperglycemic hyperosmolar syndrome

Chirwere cheshuga hyperglycemic hyperosmolar syndrome (HHS) chinetso cherudzi rwechipiri chirwere cheshuga. Inosanganisira yakanyanya shuga yeropa (glucose) danho pasina kuvapo kwemaketone.

HHS mamiriro e:

• Yakanyanya shuga yeropa (glucose) mwero
• Kushaya mvura zvakanyanya (kupera mvura mumuviri)
• Kupera kwekusvinura kana kuziva (mune dzakawanda zviitiko)

Kuvakwa kwemaketoni mumuviri (ketoacidosis) kunogona kuitika. Asi hazvishamise uye zvinowanzo nyoro kana zvichienzaniswa neshuga ketoacidosis.

HHS inowanzoonekwa kune vanhu vane chirwere cheshuga chechipiri vasina chirwere cheshuga. Izvo zvinogona zvakare kuitika kune avo vasina kuongororwa kuti vane chirwere cheshuga. Mamiriro acho anogona kuunzwa ne:

• Utachiona
• Zvimwe zvirwere, zvakadai sekurwadziwa kwemoyo kana sitiroko
• Mishonga inoderedza kushanda kwe insulin mumuviri
• Mishonga kana mamiriro anowedzera kurasikirwa kwemvura
• Kupera, kana kusatora mishonga yakatemerwa chirwere cheshuga

Kazhinji, itsvo dzinoedza kugadzira iro glucose yakakwira muropa nekubvumira iro glucose kuti riwedzere kubuda mumuviri weti. Asi izvi zvinoitawo kuti muviri urasikirwe nemvura. Kana ukasanwa mvura yakakwana, kana ukanwa zvinwiwa zvine shuga uye uchiramba uchidya chikafu chine makabhohaidhiretsi, unopera mvura. Kana izvi zvikaitika, itsvo hadzichakwanise kubvisa iyo yakawedzera glucose. Nekuda kweizvozvo, huwandu hweglucose muropa rako hunogona kuve hwakanyanya, dzimwe nguva kanodarika kagumi huwandu hwakajairwa.

Kurasikirwa kwemvura kunoitawo kuti ropa riwedzere kuwanda kupfuura zvakajairwa. Izvi zvinonzi hyperosmolarity. Iyo mamiriro mune iro ropa rine huwandu hwakanyanya hwemunyu (sodium), glucose, uye zvimwe zvinhu. Izvi zvinokwevera mvura kubva mune dzimwe nhengo dzemuviri, kusanganisira huropi.

Njodzi zvinhu zvinosanganisira:

• Chiitiko chinonetsa senge utachiona, chirwere chemwoyo, sitiroko, kana kuvhiyiwa kuchangobva kuitika
• Kutadza kwemoyo
• Nyota isina kukwana
• Kuwana kushomeka kwemvura (kunyanya kune vanhu vane dementia kana vari pamubhedha)
• Kukwegura
• Dambudziko reitsvo
• Kusarongeka manejimendi cheshuga, kwete kutevera chirongwa chekurapa sezvakarairwa
• Kumisa kana kupera insulini kana mimwe mishonga inoderedza glucose level

Zviratidzo zvinogona kusanganisira chero zvinotevera:

• Kuwedzera nyota uye kuita weti (pakutanga kwechirwere)
• Kunzwa kupera simba
• Nausea
• Kuonda
• Muromo wakaoma, rurimi rwakaoma
• Kupindwa nechando
• Kufenda
• Kuvhiringidzika
• Coma

Zviratidzo zvinogona kuwedzera kupfuura mazuva kana vhiki.

Zvimwe zviratidzo zvinogona kuitika nechirwere ichi:

• Kurasikirwa kwekunzwa kana kushanda kwemhasuru
• Matambudziko nekufamba
• Kukanganisa kutaura

Anokuchengetedza hutano achakuongorora obvunza nezvezviratidzo zvako uye nhoroondo yezvokurapa. Bvunzo dzinogona kuratidza kuti une:

• Kunyanyisa kupera mvura mumuviri
• Fivha yakakwira kupfuura 100.4 ° F (38 ° C)
• Yakawedzera kurova kwemoyo
• Yakadzika systolic yeropa

Muedzo unogona kuitwa unosanganisira:

• Ropa osmolarity (kusangana)
• BUN uye creatinine mazinga
• Ropa sodium muyero (inoda kugadziridzwa kune iro glucose level)
• Ketone bvunzo
• Ropa glucose

Kuongorora kwezvikonzero zvinoita kunogona kusanganisira:

• Tsika dzeropa
• Chest x-ray
• Electrocardiogram (ECG)
• Kuongorora urinal
• CT yemusoro

Pakutanga kwekurapa, chinangwa ndechekugadzirisa kurasikirwa kwemvura. Izvi zvichavandudza kuwedzerwa kweropa, kubuda kweweti, uye kutenderera. Ropa shuga richadererawo.

Mvura uye potasium zvinopihwa kuburikidza nemutsinga (intravenously). Izvi zvinofanirwa kuitwa nemazvo. Yepamusoro glucose level inorapwa ne insulin inopihwa kuburikidza nevevheni.

Vanhu vanokudziridza HHS vanowanzove vachirwara. Kana ikasarapwa ipapo ipapo, pfari, chikoma, kana kufa zvinogona kubuda.

Isina kurapwa, HHS inogona kutungamira kune chero eanotevera:

• Shock
• Ropa kugadzirwa
• Kuzvimba kwehuropi (cerebral edema)
• Kuwedzera kweropa acid level (lactic acidosis)

Aya mamiriro ndeyekurapwa kwekukurumidzira. Enda kuimba yekukurumidzira kana kufonera iyo yemuno emergency emergency (senge 911) kana iwe ukaita zviratidzo zveHHS.

Kudzora rudzi rwechipiri chirwere cheshuga uye kuziva zviratidzo zvekutanga zvekushaiwa mvura uye hutachiona zvinogona kubatsira kudzivirira HHS.

HHS; Hyperglycemic hyperosmolar coma; Nonketotic hyperglycemic hyperosmolar coma (NKHHC); Hyperosmolar nonketotic coma (HONK); Hyperglycemic hyperosmolar isiri-ketotic nyika; Chirwere cheshuga - hyperosmolar

• Nyora 2 chirwere cheshuga - chii chekubvunza chiremba wako

• Kudya uye insulin kusunungurwa

Crandall JP, Shamoon H. Chirwere cheshuga mellitus. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 216.

Lebovitz HE. Hyperglycemia yechipiri kune nondiabetic mamiriro uye marapirwo. Muna: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Vakuru uye Chiremba. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016: chitsuwa 42.

Sinha A. Diabetic emergency. Mune: Bersten AD, Handy JM, eds. Chinyorwa Chekuchengetedza Kwakanyanya. 8th ed. Philadelphia, PA: Elsevier; 2019: chitsiko 59.