Karolo ea insulin 'meleng ha e utloahale ho feta tekano. Tekanyo efe kapa efe ea khaello ea insulin e tletse le lefu le tebileng la endocrine - lefu la tsoekere. Lilemong tse 40 tse fetileng, batho ba nang le lefu la tsoekere ha ba sa phela lilemo tse fetang 10-15.
Phekolo ea sejoale-joale e sebelisa insulin e sebetsang hantle ka ho fetesisa ea liphatsa tsa lefutso ho etsa hore maemo a tsoekere ea mali a fokotsehe. Ka lebaka la lithethefatsi tsena, lefu la tsoekere le khaotse ho ba polelo, ho fa bakuli monyetla oa bophelo bo felletseng le bo bolelele.
Hobaneng insulin e bitsoa "genetically engineer"
Bakuli ba bang ba tšohile ha ba re "ba entsoe ka liphatsa tsa lefutso, 'ba ba hopotsa ka" li-GMO tse mpe. "
Ebile, e ne e le qibollo ea sethethefatsi sena se pholositseng bophelo ba batho ba limilione.
Qalong, lingaka li ne li sebelisa insulin e arohaneng le liphoofolo (boholo ba likolobe le likhomo). Leha ho le joalo, lihormone tsena e ne e se tsa batho feela, empa hape li ile tsa kena hang-hang maling, tsa baka tsitsipano ea tsoekere mme ea baka mathata a mangata.
Ho ile ha qaptjoa insulin ea insulin molemong oa ho nahanisisa ka litlhoko tsohle tsa mokuli ea nang le lefu la tsoekere, a etsa hore ho be le lintho tse fapaneng tseo a sa li utloeng. Kamora ho qeta ts'ebetso ea eona, e ikhula ho li-amino acid tse tloaelehileng mme e tsoa 'meleng.
Melemo ea mantlha ea meriana
Soluble human insulin e bua ka lithethefatsi tse nkang nakoana insulin.
Hammoho le cell wall receptor, sethethefatsi se etsa mofuta oa "insulin" receptor o tsosetsang ts'ebetso ea methating:
- Ho itšehla thajana ka botlalo bakeng sa ts'ebetso e felletseng le ntlafatso ea tsoekere ke linama;
- Keketseho ea lipallo tsa intracellular le tsoekere ea tsoekere;
- Tekanyetso e theohileng ea sebopeho sa glycogen sebeteng;
- Ho susumetsa tlhahiso ea liprotheine le mafura.
Ka tsamaiso ea subcutaneous, moriana o qala ho sebetsa kamora metsotso e 20-30, o fihla o fihla ka nako ea lihora tse 1-3, o nka lihora tse ka bang 5-8.
Setlhare sena se ajoa ka tsela e fapaneng lithong: mohlala, ha se kenelle ka sehikeng sa placental ebile ha se fetele ka lebese la matsoele. Kamora ho qeta ts'ebetso ea eona, insulin ea motho e epuoa ho tsoa lipelong (hoo e ka bang 80%) kamora ho felisoa ha eona ke insulinase.
Matšoao a ho sebelisoa
Hangata, lingaka li fana ka insulin e qhibilihang maemong a:
- Phekolo ea ho iphekola kapa ea ho kopanya ea mofuta oa 1 le mofuta oa 2 lefu la tsoekere;
- Ho hanyetsa ka botlalo kapa ho se lekane (ho hanyetsa) ha 'mele ho lithethefatsi tse tsoang ka molomo (tse nkiloeng ke molomo);
- Lefu la tsoekere ka nako ea boimana (haeba lijo li sa sebetse);
- Mathata a lefu la tsoekere mellitus (ketoacidosis, hypersmolar kapa ketoacidotic coma);
- Tsela ea kalafo ea lefu la tsoekere khahlanong le semelo sa ts'oaetso e fapaneng;
- Maemo a tšosang ho batho ba nang le lefu la tsoekere ba taolong ea molomo ea lithethefatsi tse fokotsang tsoekere (nako ea ts'ebetso, maloetse a tebileng, likotsi kapa serame pele a hlaha.
- Lefu la tsoekere kapa ho fokola ha hepatic;
- Liso tsa letlalo la Dystrophic (furunculosis, carbuncle, ulcers);
- Ho fetohela insulin ka phello ea nako e telele (ea nako e telele).
Contraindication
E netefalitsoe bakeng sa ts'ebeliso ea insulin ho:
- Ho theola tsoekere ea mali (hypoglycemia);
- Ho eketsa matla a kutlo a mmele ho insulin.
Lintho tse fapaneng tse tla etsahala
Leha e na le mamello e ntle, insulin e ka ba le litlamorao ha e sebelisoa joalo ka:
- Nts'etsopele ea hypoglycemia ka lebaka la ho lahloa ha sethethefatsi ke 'mele kapa karabelo ea immunological ka insulin ea eona;
- Litla-morao tse o utloisang bohloko (urticaria, ho hlohlona kapa ho teba ho hoholo ha Quincke edema ka ho ruruha ho tebileng ha sefahleho le membrane ea mucous, pallor le ho hema ka thata);
- Hypoglycemic coma;
- Ho sithabetsoa ke letsoalo (ka linako tse ling ho fihlela ho akheha);
- Hyperglycemia kapa diabetesic acidosis (khahlano le semelo sa feberu kapa tšoaetso, lijo tse se nang phepo e ntle, kamora ho enta e sa sebetseng kapa lethal la phoso);
- Ho theoha ha bophelo bo botle ka sebopeho sa lenyora, ho otsela, takatso e fokotsehileng, bofubelu ba sefahleho;
- Boitšoaro ba lehae selelekeleng hammoho (ho chesa, ho hlohlona, redness, proliferation or atrophy of adipose tiske).
Ho kopanya le lithethefatsi tse ling
Ha u sebelisa insulin ea motho ka lithethefatsi tse ling, phello ea eona ea hypoglycemic ea matlafala kapa ea fokola.
Phello ea ho fokotsa tsoekere e ka eketseha ha o nka insulin le:
- Li-Sulfonamides (li-sulfonamide kapa li-agents tsa hypoglycemic);
- MAO inhibitors (furazolidone, jj);
- Li-inhibitors tsa ACE (Captopril, enalapril, jj.);
- Li-inhibitors tsa NSAIDs (aspirin, diclofenac, jj);
- Androgens le anabolic steroids (Anavar, Androxon, jj.);
- Lithethefatsi tsa Antimalarial (quinoline, quinidine, jj);
- Tetracyclines (tetracycline, doxycycline);
- Lithethefatsi tse ling (theophylline, pyridoxine, morphine, jj)
Ho fokotsa phello ea hypoglycemic ea lithethefatsi, tšebelisano ea eona le:
- Glucocorticoids;
- Amphetamines;
- Estrogens (ho kenyelletsa le mofuta oa lithibela-pelehi tsa molomo);
- Diuretics;
- Sympathomimetics;
- Lihomone tsa qoqotho;
- Lithethefatsi tse ikhethileng (triamterone, phenytoin, glucagon).
Hape, hammoho le insulin, lithethefatsi li ka fokotsa kapa tsa ntlafatsa sephetho sa hypoglycemic:
- Beta-blockers;
- Reserpine;
- Morphine;
- Octreotide.
Khetho le ts'ebeliso ea litekanyetso
Tekanyetso le mokhoa oa ts'ebetso ea insulin ea motho o lula o khethoa ka bomong ke endocrinologist, ho nahanela matšoao a hlokahalang a tsoekere ea mali le moroto oa mokuli.
Setlhare sena se fanoa ka lefu la tsoekere ka mekhoa e mengata: subcutaneously (s / c), intramuscularly (i / m) kapa intravenously (i / v). Hangata, insulin e tsamaisoa ntle ho tšenyo ea nako. Ho etsa sena, sebelisa sebaka:
- Mpa;
- Mahetla;
- Letlalo le koaheloa ke leoto.
Hangata lithethefatsi li fanoa ka methapo e matla maemong a hlobaetsang le a bakoang ke lefu la tsoekere: ketoacidosis, lefu la tsoekere.
E eletsoa ho tsamaisa insulin metsotso e 15-30 pele ho lijo, makhetlo a 3 ka letsatsi. Ka linako tse ling ho laoloa lithethefatsi ho la 5-6.
Tekanyetso ea insulin hangata e baloa ka tekanyo ea likarolo tsa 0.5-1 ka boima ba kilo e le ngoe. Haeba insulin e fanoa ka makhetlo a fetang 0,6 mg ka boima ba 'mele ka nako eo, moriana o lokela ho fuoa bonyane makhetlo a 2 ka letsatsi. Ka karolelano, litekanyetso tsa letsatsi le letsatsi li ka ba li unit tse 3040 (ho bana, likarolo tse 8).
Bakhachane ba tloaetse ho fuoa tekanyo ea likarolo tsa 0,6 ka kilo e le ngoe. Lijana hangata li hlahisa makhetlo a 3-5 ka letsatsi, ho latela palo ea lijo.
Hangata, insulin e sebetsang ka potlako e kopantsoe le insulin e nkang nako e telele.
Melao ea tsamaiso ea insulin
Le bo-ramahlale ba nang le boiphihlelo ba etsa liphoso ha ba tsamaisa insulin.
Melao ea bohlokoahali ea kalafo ea insulin ke:
- Ho hlahloba bophelo ba sehatsetsing le maemo a polokelo ea lithethefatsi: ha ea lokela ho pepesetsoa ho chesa haholo kapa hypothermia.
- Fokotsa likhahla tsa insulin tse tsoang ka sehatsetsing. Ho lekane ho boloka botlolo e qalileng sebakeng se lefifi ka mocheso oa kamore.
- Pholoso ea litekanyetso tsa moriana ka litaelo le litlhahiso tsa ngaka.
- Lokolla moea ho tsoa syringe pele ho ente. Ha ho hlokahale ho hlakola letlalo ka joala. Tšoaetso ka kalafo ea insulin ha e na seoelo, 'me joala bo fokotsa litlamorao tsa sethethefatsi.
- Ho khetha sebaka se nepahetseng seo o ka se hlahisang. Bakeng sa insulin e nkang nakoana, ena ke mpa. Ha e kenngoa lehetleng kapa lemenong la gluteal, moriana o sebetsa butle butle.
- Thibelo ea mathata a setsing sa ente ea popelo ka mokhoa oa ho sebelisa sebaka sohle se kahare. Bakeng sa kenyelletso ea "insulin" e sebetsang ka nakoana, ho sebelisoa mpa eohle: ho tloha holimo mabarong a theko e boima ho isa polokelong ea inguinal, ka bokaholimo ba teranka. Ho bohlokoa ho khutlisetsa lisenthimithara tse peli ho tloha libakeng tsa khale tsa ente, ho hlahisa syringe ka li-degrees tsa 45-60, e le hore mori o se ke oa lutla.
- Pele u fana ka moriana, ho molemo ho nka letlalo ka mokhoa o tšesaane le monoana le phatla. Haeba e kena mesifa, moriana o tla fokotsa ts'ebetso ea ona. Kamora ho kenya nale, ts'oara syringe hoo e ka bang metsotso e 5-10.
- Ka mpeng, insulin e nkang nakoana e tsamaisoa hofihlella metsotso e 20 pele ho lijo. Libakeng tse ling, moriana o fuoa halofo ea hora pele ho lijo.
Khoebo lebitso la lithethefatsi
Insulin e etsoa ka tsela ea tharollo ea ente 'me e rekisoa meriana.
Li-insulin tsa motho tse hlahisitsoeng ka liphatsa tsa lefutso li ka hlahisoa tlasa mabitso a mabitso:
- Biosulin;
- Actrapid;
- Actrapid NM;
- Gensulin;
- Re tla e etella pele;
- Polao.
Ka lebaka la mahlale a morao-rao a liphatsa tsa lefutso, ho ile ha etsoa insulin ea batho ea maiketsetso (recombinant). Ke eena mohloli oa tšebetso: Humodar, Humulin, Insuman, Gansulin, Humalog, Apidra SoloStar, Mikstard. Lithethefatsi tsena li fapana le tsa pele ka tatellano e fapaneng ea li-amino acid, e eketsang thepa e ncha ho tsona (mohlala, phello e telele ea mekha e 'meli), e bohlokoa haholo ho bakuli ba lefu la tsoekere.
Lintho tse fapaneng tse tla etsahala
Leha e na le mamello e ntle, moriana ona o ka ba le litlamorao ka mokhoa oa:
- Boitšoaro ba 'mele bo amanang le insulin le mokuli ka boeena;
- Bohloko bo hlalosang (urticaria, ho hlohlona) kapa edema ea Quincke (ka ho ruruha ho tebileng ha sefahleho le membrane oa mucous, pallor,
- Ho hema ka thata, letlalo le leputsoa, kapa ho lahleheloa ke kelello);
- Hypoglycemic coma;
- Ho ferekana kelellong (ka linako tse ling ho fihlela ho akheha);
- Hyperglycemia kapa diabetesic acidosis (khahlano le semelo sa feberu kapa tšoaetso, lijo tse se nang phepo e ntle, kamora ho enta e sa sebetseng kapa lethal la phoso);
- Ho hlora, ho otsela, takatso e fokotsehileng, bofubelu ba sefahleho;
- Liponahatso tsa lefutso ho kenyelletso mmoho (ho chesa, ho hlohlona, ho atoloha kapa atrophy ea adipose tiske).
Ka nako e 'ngoe qalong ea ho sebelisa moriana ho na le lipontšo ka mokhoa oa ho sitisoa hoa pono tse fapaneng (pono e habeli, ho fifala, jj.) Kapa ponahalo ea edema. Empa ke liphetoho tse etsahalang 'meleng' me li feta kamora libeke tse 'maloa tsa kalafo.
Bongata
Hoa etsahala hore tsamaiso ea insulin maemong a mang e lebisa ho hyperglycemia.
Matšoao a mantlha a hyperglycemia ke lipontšo ka mokhoa oa:
- Mefokolo;
- Pallor;
- Mofufutso o batang;
- Lipallo
- Bohloko ba hlooho;
- Maikutlo a tlala;
- Ho thothomela 'meleng;
- Bofuma ba leleme, molomo, maoto.
Ha matšoao a tšoanang a qala, mokuli o lokela ho nka lijo tsa lik'habohaedreite habonolo (hangata pompong, sengoathoana sa tsoekere kapa tee e tsoekere).
Mathata
Ho phekoloa ka nako e telele ka insulin ho ka lebisa mathateng a fapaneng. Tse ka sehloohong ke:
- Ketsahalo ea hypoglycemia. Sena se ka tsamaisoa ke mathata a ho ja, ho sebelisa lithethefatsi hampe, ho ikoetlisa ka ho feteletseng, mafu a liphio le sebete.
- Postinjection lipodystrophy. Thibelo ea ts'oaetso ea methapo ea mafu ke ho fetola sebaka sa ente, ho eketsa tharollo ea "novocaine" (0.5-1,5 ml) ho "insulin", le ho kenella syringe ho Ѕ ea botenya ba lithane tsa adipose.
- Khanyetso ea lithethefatsi. Lithethefatsi tse ling tse atisang ho theoleloa tsoekere lia khethoa.
- Litla-morao. Motsoako o sebelisitsoeng o rarahaneng (li-antihistamines, glucocorticoids) le phetisetso e nepahetseng ea lithethefatsi.
Insulin ea insulin ea motho ke eona e bolokang bakuli ba bangata ba lefu la tsoekere. Leha ho le joalo, ho bohlokoa ho sebelisa lithethefatsi tsena ka bohlale, o ela hloko melao eohle bakeng sa tsamaiso ea eona. Hoa hlokahala hore ngaka e laele moriana ona, ho bala tekanyo ea eona le ho lekola boemo ba mokuli nakong eohle ea kalafo.
