Lefu la tsoekere le hlaha khahlano le semelo sa tšenyo ea marako a methapo ke tsoekere e phahameng ea tsoekere le nts'etsopele ea phepelo e lekaneng ea mali, bolulo ba litho tsohle le litsamaiso tsohle.
Ho haella ha phepo e nepahetseng ea tishu ka lebaka la bothata ba ho monya tsoekere le ho fokotseha hoa boits'ireletso, ho lebisa kholong ea khafetsa ea mathata nakong ea ts'ebetso ea bongaka. Ntle le moo, ts'ebetso ea ho hlaphoheloa kamora ho buuoa e sitisoa ke ho fola butle ha maqeba a postoperative.
Ntlheng ena, bakuli ba nang le lefu la tsoekere ba hloka maqheka a khethehileng a ho itukisetsa opereishene le ho ikoetlisa nakong ea ts'ebetso ea bongaka.
Litokisetso tsa ho buuoa lefu la tsoekere
Mosebetsi oa mantlha oa ho thibela mathata ka mor'a ho buuoa ke ho lokisa tsoekere e phahameng ea mali ho bakuli ba nang le lefu la tsoekere. Bakeng sa sena, lijo li laoloa haholo. Melao ea mantlha ea kalafo ea ho ja pele u buuoa:
- Ho kenyelletsoa ha lijo tse nang le khalori e phahameng.
- Lijo tse tšeletseng ka letsatsi ka likarolo tse nyane.
- Ho kenyelletsoa ha tsoekere, liswiti, phofo le confectionery, litholoana tse monate.
- Fokotsa mafura a liphoofolo 'me u li kenye ka thoko lijo tse nang le k'holeseterole e ngata: nama e mafura, mafura a liphoofolo tse halikiloeng, lijo, mafura, chisi, mafura a bolila a chisi, chisi ea chisi le tranelate.
- Thibelo ea lino tse tahang.
- Ntlafatso ea lijo le li-fiber tsa phepo e tsoang ho meroho, litholoana tse sa fuoeng, korong.
Ka mofuta o bonolo oa lefu la tsoekere kapa mamello ea tsoekere e kulang, phepo e tiileng e kanna ea lekana ho theola tsoekere ea mali, maemong ohle a mang, ho etsoa litekanyetso tsa litekanyetso tsa lithethefatsi tse fokotsang tsoekere. Matlapa a nkileng nako e telele le insulin a hlakotsoe ho bakuli ka letsatsi. Tšebeliso ea insulin e khutšoane e bontšoa.
Haeba glycemia ea mali e le kholo ho feta 13.8 mmol / L, joale 1 - 2 IU ea insulin e tsamaisoa kahare ka hora, empa e tlase ho 8,2 mmol / L ha e khothalletsoe ho theola letšoao. Ka mofuta o mongata oa lefu la tsoekere, ba tataisoa ke boemo bo haufi le 9 mmol / l le ho ba sieo ha acetone ka har'a moroto. Tlhahiso ea tsoekere ho moroto ha ea lokela ho feta 5% ea litaba tsa k'habohaedreite lijong.
Ntle le ho boloka tsoekere ea mali ho bakuli ba nang le lefu la tsoekere, ba etsa:
- Phekolo ea mafu a pelong le khatello ea mali.
- Tlhokomelo ea liphio.
- Phekolo ea lefu la tsoekere la lefu la tsoekere.
- Thibelo ea mathata a tšoaetsanoang.
Ho lefu la tsoekere, ho na le kotsi e kholo ea ho ba le tlhaselo ea pelo, khatello ea mali ea methapo. Liso tsa pelo li ka ba ka sebopeho sa lefu la ischemic, myocardial dystrophy, pelo le mesifa ea pelo. Karolo ea maloetse a pelo ke mefuta e sa utloiseng bohloko ea ho hlaseloa ke pelo, e bonahatsoang ke tlhaselo ea ho akheha, ho lahleheloa ke kelello, kapa ho roba morethetho oa pelo.
Ho lefu la pelo, ho hlobaela ho matla ha coronary ho tsoela pele ka sekhahla, ho lebisa lefung la tšohanyetso. Bakuli ba lefu la tsoekere ha baa bontšoa kalafo ea moetlo ka baetsi ba beta-blockers le bahanyetsi ba calcium ka lebaka la phello e mpe ea bona metabolism ea carbohydrate.
Ho itokisetsa ho buoa bakuli ba nang le lefu la tsoekere le lefu la pelo, ho sebelisoa litokisetso tsa dipyridamole - Curantil, Persantine. E ntlafatsa phallo ea mali e potoloha, e matlafatsa methapo ea pelo 'me ka nako e ts'oanang e potlakisa ho sisinyeha ha insulin ho ea linama.
Ho fokotsa khatello ea mali ho bakuli ba nang le lefu la tsoekere ho thatafatsoa ke phello ea insulin mabapi le ho boloka sodium. Hammoho le sodium, mokelikeli o bolokoa 'meleng, edema ea lebota la sekepe e etsa hore e ele hloko ketso ea lihormone tsa vasoconstrictive. Ntle le moo, ho senyeha ha meno ho lefu la tsoekere, liphetoho tsa atherosselotic methapong ea mali le botenya li eketsa khatello ea mali.
Ho fokotsa khatello, ho molemo ho phekola le lithethefatsi tse tsoang lihlopheng tse thibelang li-adrenergic: beta 1 (Betalok), alpha 1 (Ebrantil), hammoho le angiotensin-converting enzyme inhibitors (Enap, Kapoten). Ho batho ba baholo, kalafo e qala ka li-diuretics, li kopana le lithethefatsi tse tsoang lihlopheng tse ling. Thepa ea khatello e tlase e ile ea tsebahala ho Glyurenorm.
Ha matšoao a nephropathy a hlaha, letsoai le lekantsoe ho 1-2 g, liprotheine tsa liphoofolo ho fihlela ho 40 g ka letsatsi. Haeba lipontšo tsa metabolism ea mafura a sa sebetseng li sa tlosoe ke sejo, joale lithethefatsi li laetsoe ho theola cholesterol. Ho lefu la tsoekere la polyneuropathy, tšebeliso ea Thiogamm kapa Belithion e bonts'itsoe.
Khalemelo ea immunological e boetse e etsoa, ka matšoao - kalafo ea lithibela-mafu.
Lefu la tsoekere la lefu la tsoekere
Nakong ea ts'ebetso, ba leka ho boloka boemo ba glucose maling, bo thibela ho fokotseha ha eona, kaha sena se ka lebisa ho mathata kelellong. Ho ke ke ha khoneha ho tsepamisa mohopolo matšoao a hypoglycemia tlasa maemo a ho opa. General anesthesia ha e ba lumelle ho fumanoa, ka hona tlhahlobo ea mali bakeng sa tsoekere e sebelisoa. E nka lihora tse ling le tse ling tse peli.
Methapo e meholo ea li-anesthetics, hammoho le tsamaiso ea bona ea nako e telele e fokotsa tsoekere ea mali. Ka hona, nakong ea anesthesia nakong ea ts'ebetso, motsoako oa tsoekere le insulin lia tsamaisoa. Ketso ea insulin nakong ea anesthesia e telele ho feta tlasa maemo a tloaelehileng, ka hona boemo ba tsoekere bo tloaelehileng bo nkeloa sebaka ke hypoglycemia kapele.
Ha o sebelisa lithethefatsi bakeng sa anesthesia, o hloka ho nahana ka phello ea tsona ho metabolism ea carbohydrate:
- Ho inhalation anesthesia e nang le Ether le Fluorotan ho eketsa boemo ba glucose.
- Li-Barbiturates li khothalletsa ho kenella ha insulin liseleng.
- Ketamine e ntlafatsa mosebetsi oa pancreatic.
- Kameho e fokolang ho metabolism e hlahisoa ke: droperidol, sodium oxybutyrate, nalbuphine.
Ts'ebetso ea nako e khuts'oane e etsoa tlasa li-anesthesia tsa lehae, ho bakuli ba sa tsitsang maikutlong e ka matlafatsoa ka li-antipsychotic. Bakeng sa ts'ebetso e lipheletsong tse tlase le karolo ea cesarean, ho sebelisoa lesapo la mokokotlo kapa lefu la sethoathoa.
Anesthesia ea lefu la tsoekere mellitus ka mokhoa oa liente kapa ho kenngoa ha catheter e lokela ho etsoa tlasa maemo a letsoalo le felletseng ka lebaka la ts'oaetso ea bakuli kholisong ea phepelo ea phetisetso.
Khatello ea mali le eona e ke ke ea fokotsoa haholo, hobane batho ba nang le lefu la tsoekere ha ba lumelle khatello ea maikutlo. Ka tloaelo, khatello e eketsoa ke maro a kenang le li-elektrone. Lithethefatsi tsa Vasoconstrictor ha li khothalletsoe.
Ho pheta tahlehelo ea mali, u se ke oa sebelisa dextrans - Polyglyukin, Reopoliglyukin, hobane li theotsoe ke tsoekere. Tsamaiso ea bona e ka baka hyperglycemia e mpe le komello ea glycemic.
Tharollo ea Hartman kapa Ringer ha e sebelisoe, kaha lactate e tsoang ho bona ka har'a sebete e ka fetoha glucose.
Mathata
Mathata a ka morao ho bakuli ba nang le lefu la tsoekere a amahanngoa le taba ea hore tahlehelo ea mali, tšebeliso ea meriana le bohloko ka mor'a ho buuoa ho kenya ts'ebetso ea glucose bokong, sebopeho sa 'mele oa ketone, le ho phatloha hoa mafura le liprotheine.
Ka opereishene e ngata kapa nakong ea ts'ebetso ho phekola mathata a lefu la tsoekere, hyperglycemia e ka ba holimo haholo. Ka hona, bakuli ba behiloe litsing tse hlokang tlhokomelo e matla le tsoekere ea mali, ts'ebetso ea pelo le mapheo li hlahlojoa lihora tse ling le tse ling tse peli.
Insulin e nkang nakoana e sebelisoa ho thibela ketoacidosis le komisi. Kenya kahare kahare ka tharollo ea glucose ea 5%. Glycemia e bolokiloe ka bophara ba 5 ho isa ho 11 mmol / L.
Ho tloha ka letsatsi la bosupa ka mor'a ts'ebetso, o ka khutlisetsa mokuli ho insulin ea nako e telele kapa matlapeng ho fokotsa tsoekere. Ho fetolela litafoleng, tekanyetso ea mantsiboea e hlakoloa qalong, ebe ka letsatsi le leng le le leng ebe, qetellong, tekanyetso ea hoseng.
Ho boloka sekhahla se tsitsitseng sa tsoekere maling, ho hlokahala phomolo e lekaneng ka mor'a ho buuoa. Hangata, li-analgesics li sebelisoa bakeng sa sena - Ketanov, Nalbufin, Tramadol.
Bakuli ba lefu la tsoekere ka mor'a ts'ebetso ba fuoa litlhare tse thibelang likokoana-hloko tse fapaneng le tse ngata ho kopantsoe mefuta e 'meli ho isa ho e meraro. Ho sebelisoa li-penicillin tsa semisynthetic, cephalosporins le aminoglycosides. Ntle le meriana e thibelang likokoana-hloko, ho khethiloe metronidazole kapa clindamycin.
Motsoako oa liprotheine o sebelisoa bakeng sa phepo e ntle ea botsoali, kaha tšebeliso ea nako e telele ea litharollo tsa tsoekere e lebisa ho hyperglycemia, 'me tšebeliso ea metsoako ea lipid e lebisa ho lefu la tsoekere la tsoekere. Ho tlatselletsa khaello ea protheine, e ka eketsang tsoekere ea mali, motsoako o ikhethang bakeng sa bakuli ba lefu la tsoekere - Nutricomp Diabetes le Diazon - ba se ba thehiloe.
Tlhahisoleseling ka mefuta ea anesthesia e fanoa ka har'a video ena.
