Ngwọta Ọkpụkpụ 200mg glucose 200mg

Ihe ngosiputa maka mmejuputa iwu:gbakọọ dose insulin na ntinye nke usoro glucose.

Ihe mgbaru ọsọ ọzụzụ

- gbakọọ dose nke insulin site na ịba ụba nke glucose na ngwọta.

Ihe akụrụngwa:

- mpempe akwụkwọ maka nlebara anya nke onye ọrịa,

- kalama nwere uzo glukos nke 20% - 400 ml,

Nlekọta ihe mberede maka mmiri hyperglycemic

Ihe ngosiputa maka mmejuputa iwu: nlekọta mberede.

Ihe akụrụngwa:

1. Antishock set.

2. Sterile syringes maka injections, sistemu eji otu maka nchịkwa mgbochi mmiri, bi-x tinyere ihe na ngwa.

3. insulin na-adị mkpụmkpụ.

4. Isotonic ngwọta.

5. Metazone ma ọ bụ norepinephrine.

6. Osisi, akwa nhicha akwa, akwa ọkpọ, akwa akwa, akwa mmanụ.

Nlekọta ihe mberede maka uremic coma

Ihe ngosiputa maka mmejuputa iwu: nlekọta mberede.

Ihe akụrụngwa:

1. Antishock set.

2. Sterile syringes maka injections, sistemu eji otu maka nchịkwa mgbochi mmiri, bi-x tinyere ihe na ngwa.

3. Tree, mmanu, kpochapu, uwe eji akuko, akwa roba, ohiri isi.

4. ọgwụ: glucose 40%, 5%, vitamin C, prednisone, soda soda, isotonic sodium chloride solution, atropine, droperidol.

5. Ngwa maka imeju afọ, na-esetịpụ enema.

Carotid Obi ọnụego

Ihe ngosiputa maka mmejuputa iwu: chọpụta ihe ịrịba ama nke ọnwụ ọgwụ

Ihe mgbaru ọsọ ọzụzụ

Nwee ike

- chọpụta ọnụnọ nke pulse na akwara carotid

№	Etapi	Zmist	Ziri ezi
1.	Mbido Mbido maka Ihe	1. Onye e metọrọ ya dinara n’elu ụlọ siri ike. 2. Zere ịkpọtụrụ ọbara na ihe nzuzo ndị ọzọ	Lekọta nchekwa nke onwe gị.
2.	Isi	3. Debe mkpịsị aka anọ n'akụkụ etiti nke olu emetụ, na uzo dị n'etiti akwara azụ na akwara sternocleidomastoid wee chọpụta usoro ahụ.	Chọta ntule nke akwara carotid
3.	Emechaa	4. Leruo anya na enweghi ogwe ure

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Glucose, 200 mg / ml na 400 mg / ml infusion solution

Aha kemịkal. D - (+) - glucopyranose

General njirimara. Ogwu a bu ezigbo uzo adighi acha ma obu nke edo edo edo

Ngwakọta ọgwụ ahụ.

200 mg / ml

400 mg / ml

Ngwọta hydrochloric 0.1 M

Mmiri maka ịgba ntụtụ

Mpempe mwepụta. Ngwunye infusion

Ndị na-ere ọgwụ. Ngwọta maka nchịkwa intraven. Ngwọta maka nri parenteral.

Koodu PBX. B05BA03

Ngwongwo ogwu

Mlọ ọgwụ Plasma dochie, rehydrating, metabolic na detoxification waki. Usoro nke usoro bụ n'ihi ihe mejupụtara glucose na usoro nke ike (glycolysis) na rọba (transamination, lipogenesis, nucleotide synthesis) metabolism.

Na-ekere òkè na usoro metabolic dị iche iche na ahụ, na-eme ka usoro redox dị na ahụ dịkwuo mma, na-eme ka ọrụ antitoxic nke imeju dịkwuo mma. Ọrịa glucose, na-abanye n’akwara ahụ, phosphorylates, na-agbanwe ghọọ glucose-6-phosphate, nke na-arụsi ọrụ ike n’ọtụtụ akụkụ nke metabolism nke anụ ahụ. Na metabolism nke e-glucose na anụ ahụ

eweputara ike di nkpa maka ndu ahu.

Ngwọta glucose 400 mg / ml bụ hypertonic n'ihe metụtara plasma ọbara, na-enwewanye ọrụ osmotic. Mgbe ejiri ya rụọ ọrụ intraven, ọ ga - eme ka ọpụpụ nke mmiri anụ ahụ dị n’elu akwa akwara ma jide ya n’ime ya. Na-abawanye diuresis, na-eme ka ntụpọ nke bekee dị na mmamịrị na-ebulite ọrụ antitoxic nke imeju.

Mgbe etinyere na steeti isotonic (50-100 mg / ml) ọ na-enwughachi olu nke mmiri furu efu, na-ejigide olu nke ikesa plasma.

maka ngwọta nke 200 mg / ml - 1278 mOsmol / n'arọ,

maka ihe ngwọta nke 400 mg / ml - 2989 mOsmol / n'arọ.

Mlọ ọgwụ Mgbe a na-ahazi ya n'ime ọgwụ, glucose na-ahapụ ngwa ngwa gbasara akwa akwara. Ahụ a na - eme biotransformation

n'okporo ụzọ hexose phosphate - ụzọ bụ isi nke ike metabolism na ịkpụpụta oke macroergic ogige (ATP) na pentose phosphate way - ụzọ bụ isi nke metabolism plastic na ịkpụpụta nucleotides, amino acid, glycerol.

A na-eji ụmụ irighiri glucose n’usoro n’enye ike nke ahụ.

Ọkpụkpụ glucose na-abanye na mkpụrụ ndụ phosphorylates, na-agbanwe ghọọ glucose-6-phosphate, nke a na-etinyezi na metabolism (ngwaahịa njedebe nke metabolism bụ carbon dioxide na mmiri). Ọ na-abanye n'ụzọ dị mfe site na mgbochi akụkọ ihe ochie na akụkụ ahụ niile na

Anụ ahụ na-etinye ya kpamkpam, akụrụghị ya (ọdịdị dị na mmamịrị bụ ihe nnọchianya).

Ihe ngosi maka ojiji

Usoro onunu ogwu na nhazi

Tupu okwu mmeghe, dọkịta nwere ụgwọ iji nyocha ọgwụ ọgwụ polymer na ọgwụ ahụ. Ngwọta ahụ kwesịrị ịpụta ìhè, enweghị ihe mgbochi ma ọ bụ ntụ ọka. A na-ahụ ọgwụ a dị mma maka iji ya mee ihe na akara ma na-ejigide ike nke ngwugwu ahụ.

A na-agwọta azịza hypertonic n'usoro.

Usoro onunu ogwu dabere n’afọ, ike na ọnọdụ onye ọrịa.

A na-edozi 200 mg / ml nke a na-agbanye n'amaghị ama na ntanetị ọnụego ruru 30-40 tụlee / min (1.5-

2 ml / min), nke kwekọrọ na ihe dịka 120 ml / awa. Oke kachasị maka ndị okenye kwa ụbọchị bụ 500 ml.

A na-etinye 400 mg / ml ngwọta intravenly na ọnụego ruru ihe ruru 30 tụlee / min

(1.5 ml / min), nke kwekọrọ na ihe dịka 48 ml / awa. Oke kachasị maka ndị okenye kwa ụbọchị bụ 250 ml.

Mgbe dilts na 100 mg / ml nke ihe ngwọta, ọnụọgụ infusion kachasị ruru 60 tụlee / min,

olu - 500 ml / ụbọchị. Mgbe dilution 50 mg / ml nke ihe ngwọta, ọnụego infusion kachasị elu bụ 150 cap / min, olu nchịkwa dị ruo 2 l / ụbọchị.

Maka nyocha nke glucose zuru ezu, nke a na-ahụ n'ọtụtụ, a na-enye insulin n'otu oge iji ya na ọnụego 1 unit nke insulin kwa 4-5 g nke glucose. Maka ndị ọrịa na-arịa ọrịa shuga, a na-eji glucose na-elekọta ya anya n'okpuru nchịkwa shuga na mmamịrị ọbara.

Mmeghachi omume ọjọọ

Mmeghachi omume na-adịghị mma nke nwere ike ime n'ihi iwebata glucose nke 200 na 400 mg / ml,

Mmeghachi omume ọjọọ na saịtị ịgba ahụ: ihe mgbu na saịtị ịgba ahụ, mgbatị akwara, phlebitis, thrombosis venous,

Nsogbu sitere na usoro endocrine na metabolism: hyperglycemia, hypokalemia, hypophosphatemia, hypomagnesemia, acidosis,

Ọrịa digestive: polydipsia, ọgbụgbọ,

Mmeghachi omume niile nke anụ ahụ: hypervolemia, mmeghachi ahụ nfụkasị (ahụ ọkụ, ọnya anụ ahụ, angioedema, ujo).

N'ọnọdụ mmeghachi omume na-adịghị mma, a ga-akwụsị nchịkwa nke ihe ngwọta, ọnọdụ onye ọrịa nyochara ma enyemaka ga-enyerịrị ya. A ga-edozigharị usoro ga-adịgide maka nyocha na-esote.

Ihe ngbanwe

A na - enye ndị na - arịa ọrịa glucose ọgwụ nke 200 na 400 mg / ml na:

- ọbara ọgbụgba n'ime ọbara na intraspinal, ewezuga ọnọdụ metụtara hypoglycemia,

- Okpo akpịrịkpa, tinyere mmanya na-egbu egbu,

- Hypersensitivity na dextrose na akụkụ ndị ọzọ nke ọgwụ,

- Ọrịa shuga mellitus na ọnọdụ ndị ọzọ sonyere hyperglycemia.

Ejila ọgwụ n’otu oge n’otu iji ọgwụ ọbara.

Ime na lactation

Iji ọgwụ ọjọọ eme ihe maka ụmụ nwanyị dị ime na-arịa ọrịa Normoglycemia nwere ike ibute hyperglycemia nwa ebu n'afọ, metabolic acidosis. Nke ikpeazụ a dị mkpa ịtụle, ọkachasị mgbe nsogbu nwa ebu n'afọ ma ọ bụ hypoxia adịla n'ihi ihe ndị ọzọ na-akpata agụụ.

Mmetụta ike ịkwọ ụgbọala na igwe nwere ike ịdị ize ndụ.

Dodoụbiga ya ókè

Site na ịdoụbiga ọgwụ ókè, hyperglycemia, glucosuria, mmụba ọbara osmotic (ruo n'ọbara hyperroslylar hyperosmolar coma), ịba ọcha n'anya, elektrolyte enweghị nsogbu. N'okwu a, a ga-akagbu ọgwụ ahụ wee kọọ insulin na-arụ ọrụ ọsọ ọsọ na ọnụego nke 1 maka nke ọ bụla 0.45 - 0.9 mmol nke glucose ọbara ruo mgbe ọkwa glucose ọbara dị 9 mmol / l.

Ekwesịrị iji nwayọọ nwayọọ belata ọkwa glucose. N'otu oge, nhọpụta insulin, infusion nke edozi saline agbanwe.

Ọ bụrụ na ọ dị mkpa, a na-enye usoro ọgwụgwọ Symptomatic.

Ntụziaka pụrụ iche

Mgbe ị na-a theụ ọgwụ ahụ, ọ dị mkpa iji nyochaa nguzo mmiri-electrolyte na ọkwa nke glucose dị n'ọbara ọbara.

Site n'ị useụ ọgwụ ahụ ogologo oge, ọ dị mkpa ijikwa ọkwa shuga ọbara.

A naghị atụ aro ịkọ ọgwụ glucose na oge nnukwu mmerụ ahụ ụbụrụ na-akpata nnukwu nsogbu, ọ bụrụ na ọghọm nke ọrịa ụbụrụ cerebrovascular, ebe ọgwụ ahụ nwere ike ịbawanye mmebi nke akụkụ ụbụrụ wee mee ka ọrịa ahụ ka njọ (ma ewezuga okwu banyere mgbazi nke hypoglycemia).

Site na hypokalemia, a ghaghị ijikọ ntinye nke glucose na mgbazi nke ụkọ potassium (maka ihe ize ndụ nke ịba ụba hypokalemia).

Maka iwulite glucose ka mma na ọnọdụ normoglycemic, ọ dị mma ijikọta nchịkwa ọgwụ na nchịkwa nke (subcutaneous) na-eme ngwa ngwa insulin na ọnụego 1 unit kwa 4-5 g nke glucose (okwu akọrọ).

Ejila ihe ngwọta ahụ subcutaneously na intramuscularly.

Ekwesighi iji edozi glucose ngwa ngwa ma ọ bụ ogologo oge. Ọ bụrụ na mgbazere na-eme n’oge nchịkwa ahụ, aga-akwụsị nchịkwa ozugbo. Iji gbochie thrombophlebitis, ị kwesịrị ịbanye nwayọ site na nnukwu veins.

Na ọdịda akụrụ, ọgbụgba akwara obi, hyponatremia, a chọrọ nlekọta pụrụ iche mgbe ị na-ede akwụkwọ glucose, na-eleba anya na etiti akụrụngwa hemodynamics.

Enwere ike iji ihe dị n'ime akpa ahụ mee naanị maka otu onye ọrịa, mgbe ọ mebiri mkpesa nke akpa ahụ, a ga-atụfu akụkụ ahụ adịghị eji ọdịnaya ahụ.

Mmekọrịta na ọgwụ ndị ọzọ

Enweghi ike inye glucose 200 na 400 mg / ml na otu sirinji ya na hexamethylenetetramine, ebe ọ bụ na glucose bụ ihe na - eme ka ọ dị nro. A naghị atụ aro ka ị gwakọta ngwọta alkaline n'otu sirinji: yana ọgwụ ị generalụ ọgwụ na ọgwụ hypnotics, ka ọrụ ha na-ebelata, ngwọta alkaloids, na-egbochi streptomycin, na-ebelata ịdị irè nke nystatin.

N'okpuru mmetụta nke thiazide diuretics na furosemide, nnabata glucose na-ebelata. Insulin na - akwalite mmeri nke glucose na anụ ahụ na - emegharị ahụ, na - akpali nguzobe nke glycogen, njikọ nke protein na ọdụdụ ọdụdụ. Ngwọta glucose na-ebelata nsonaazụ nsị nke pyrazinamide na imeju. Mmeghe nke nnukwu glucose ngwọta na-enye aka na mmepe nke hypokalemia, nke na-abawanye nsị nke ọgwụ ọgwụ digitalis na-ejikarị.

Usoro na ọnọdụ nchekwa. Na-echekwa na okpomọkụ site na 5 ºС ruo 30 ºС. Mee ka ụmụaka ghara iru.

Exbọchị mmebi. Afọ 2 Ejila oge ngafe ya.

Okwu ezumike. Site na ndenye ọgwụ.

Mbukota. 100 ml, 250 ml na 500 ml na ngwongwo polymer maka ngwọta infusion.

A na-etinye arịa polima ọ bụla, yana ntuziaka maka ojiji ahụike, na akpa plastic.

Maka ụlọ ọgwụ: a na-etinye igbe polymer ọ bụla na paịlị transperent ma tinye ya na ntuziaka ahụike ọgwụ na ego nke kwekọrọ na ọnụọgụ polymer, na igbe kaadi akpịrịkpa nke 100 ml na ngwugwu 80 ma ọ bụ 100, 250 ml n'ime ngwugwu 40 ma ọ bụ 55, 500 ml 25 ma ọ bụ 30 ngwugwu.

Guzosie ike - onye nrụpụta, mba

Belarusian-Dutch na-emekọ ihe ọnụ na ụlọ ọrụ Farmland Limited Liability Company, Republic of Belarus
222603, Minsk mpaghara, Nesvizh, st. Leninsky, 124-3
Tel./fax. 8 (017) 2624994, tel. 8 (01770) 63939

Osisi na ọgwụgwọ ọrịa shuga

A na-ejikarị ngwakọta mee ihe iji gwọọ ọkwa glucose dị ala nke ukwuu - hypoglycemia. Ọnọdụ a na - ebulikarị ndị ọrịa nwere ọrịa diabetesdị 1 nke na - eji ọgwụ insulin iji gwọọ ọrịa ahụ.

Mbelata shuga dị n'ọbara shuga nwere ike ịbụ nsonaazụ insulin buru oke ibu, na-abanye ya na akwara ma ọ bụ na akwara anụ ahụ (ọ bụghịkwa na anụ ahụ dị n'okpuru ala), yana nnukwu nkwụsị na nri nri ma ọ bụ nnukwu mmega ahụ.

Ọ kachasị dị mma iji ihe mejupụtara hypoglycemia, mgbe onye ọrịa amaghị ihe ọ bụla. N'okwu a, a na-ewebata ngwakọta glucose-insulin-potassium n’ime ọbara onye ọrịa site na iji ihe eji eme ihe. Ogwe na-enye gị ohere iwelie shuga ọbara ngwa ngwa n'ọkwa nkịtị ma gbochie ọnwụ nke ụbụrụ.

N'agbanyeghị ọdịnaya glucose, ihe a sokwa na ọgwụ ndị a na-eji na ọgwụgwọ nke hyperglycemic ọrịa mamịrị coma na ketoacidosis. Ngwakọta glucose na-enye aka egbochi mmepe nke ọtụtụ nsogbu ndị mmadụ nwere oke ọbara nwere oke.

Nke a bụ n'ihi n'eziokwu na mmụba nke mkpokọta glucose na ọbara nwere njikọ insulin na-ezughị ezu, nke na-arụ ọrụ dị oke mkpa na nnabata nke glucose. Na steeti a, mọzụlụ na-akwụsị ịhapụ ahụ, mkpụrụ ndụ nke ahụ amalitekwa inwe ume ike.

Iji kwụọ maka nke a, a na-ebido usoro nke glyconeogenesis, njikọ nke glucose site na protein na abụba n'ime ahụ onye ọrịa nwere ọrịa shuga. Ma na protein na lipid metabolism, nnukwu ketone ahụ na-abanye n'ọbara onye ọrịa, nke nwere mmetụta na-egbu egbu n'ahụ ahụ.

Ngwaahịa kachasị dị ize ndụ nke glyconeogenesis bụ acetone, ụba ọdịnaya nke ọbara na mmamịrị na-eme ka mmepe nke ketoacidosis. Iji kwụsị nguzobe nsogbu a nke ọrịa shuga, ọ dị mkpa iji hụ na a na-enyefe sel nke mkpụrụ ndụ, maka nke a ga-eji mee ọgwụ na ọgwụ nke nwere glucose na insulin.

Mellitus na-arịa ọrịa shuga bakwara uru nke ukwuu n'ihi ihe ndị ọzọ ngwakọta, ya bụ potassium na magnesium. Potassium dị mkpa maka ịrụ ọrụ akụrụngwa nkịtị na mgbochi nke ọrịa strok. Ọ na - eme ka mgbasawanye nke akwara ọbara, yabụ enweghị potassium na - akpata obara mgbali elu.

Otu n'ime isi ihe na-egosi ọrịa shuga bụ ịmịpụta akwara karịrị akarị, n'ihi nke ahụ ndị ọrịa mamịrị na-efunahụ akụkụ ụfọdụ nke potassium. Ya mere, iji ọgwụgwọ gluu-insulin-potassium agwakọta na-enyere aka mejupụta ụkọ nke ihe a dị mkpa ma si otú ahụ belata ọbara mgbali elu.

Magnesium na-arụkwa ọrụ dị mkpa n'ịnagide ọbara mgbali nkịtị. Na mgbakwunye na potassium, ọ nwere mmetụta kachasị baa uru na obi na arịa ọbara, nke na-arịa hyperglycemia mgbe mgbe.

Na mgbakwunye, magnesium na-arụ ọrụ nke sistem ahụ ma na - enyere aka igbochi mmepe nke neuropathy.

Uru nke parenteral way of management

Nchịkwa nke ọgwụ ọgwụ ọbara nwere ọtụtụ uru doro anya karịa nchịkwa ọnụ nke ọgwụ ndị yiri ya.Ndị a gụnyere ihe ndị a:

Ederede metụtaraParenteral Nutrition Lactic Acidosis Cholinolytics ọgwụ

1. Ọ ga - ekwe omume ịgwọ ndị ọrịa n'ọnọdụ amaghị ihe.
2. Ike inyere ndị ọrịa nwere nnukwu vomiting na nsogbu ndị ọzọ nke usoro nri nri ọgụ, mgbe enwere ihe ize ndụ nke ị reụ ọgwụ a ralụrụ.
3. Mmelite bioavailability nke ndị nọ n'ọrụ ọgwụ (na-amụba ha digestibility).
4. Ọnụego mmalite nke ọgwụgwọ ọgwụgwọ na njikwa parenteral na-abawanye, nke kachasị mkpa na ọnọdụ dị oke mkpa.
5. Ikike nke ị nweta ọgwụ ịgwọ ọrịa na ọbara mgbe niile.
6. Ọ ga - ekwe omume iji ọgwụ na - eme ihe na - adịghị mma mgbe ị na - agafe eriri afọ ma ọ bụ nwee mmetụta iwe na - emetụta ya, ihe na - emebi acid na enzymes nke ihe ọ juiceụricụ gastric (dịka ọmụmaatụ, adrenaline ma ọ bụ insulin).
7. N'ihi nnukwu pores dị na akpụkpọ ahụ nke mkpụrụ ndụ endothelial, ngbanwe nke ụdị ụfọdụ nke nchịkwa parenteral adịghị adabere na solubility nke ọgwụ ahụ na abụba.
8. Ihe omimi nke ihe ndi di n’ime ogwu anaghi adabere n’usoro nri, ihe omuma nke ihe omimi nke uto, bile, enzymes.
9. Parenteral nri bụ akụkụ dị mkpa maka ọgwụgwọ maka ọrịa imeju na akụrụ siri ike.

Prozerin - ntuziaka maka ojiji, ihe mejupụtara, ụdị ntọhapụ, ngosipụta, nsonaazụ n'akụkụ, analogs na ọnụ ahịa Diuretics - kedu ihe ọ bụ, nhazi nke ọgwụ, iji maka ọbara mgbali elu, edema na ọrịa obi Cereton - ntuziaka maka ojiji, ihe ngosi, ihe mejupụtara, ụdị ntọhapụ, akụkụ mmetụta, analogs na ọnụahịa

Etu esi ewere pola

Dika odi, a na-enye onye oria ahu site na ntapu intravenous, mana mgbe ufodu, a na-ebunye onye ogwu ahu nsogbu site na iji ogwu igba ya. A kwenyere na ịdaba n'ọbara onye ọrịa, ogwe osisi nwere mmetụta ọgwụgwọ kachasị na ya.

N'ọnọdụ ndị a na-adịghị ahụkebe, a na-ahapụ onye ọrịa ka ọ ralụọ glucose na potassium salts n'ọnụ (site na ọnụ), a na-agbanyekwa insulin n'ime ọbara na onye na-eji ụrọ. A na-ele usoro a anya dị ka nke a na-apụghị ịtụkwasị obi, n'ihi na ogo nke nnabata glucose na potassium n'ime eriri afọ mmadụ na-adabere n'ọtụtụ ihe ma nwee ike ịdị iche iche na ndị dị iche iche.

Ọka dibia bekee kpebiri na ọ dabere na ogo ọrịa ya na njiri mara ọrịa ya. Ya mere, a na-atụ aro ka usoro a rụọ naanị n'ụlọ ọgwụ na n'okpuru nlekọta nke ndị ọkachamara. Ngụkọta usoro ịgwọ ọrịa ezighi ezi nwere ike imerụ onye ọrịa ahụ ma bute nsonaazụ dị egwu.

Ihe ndi ozo enwere ike iji gwọ oria oria a ka ndi okacha mara n’igwe vidiyo n’isiokwu a.

Insdị insulin

N’inye ụdị ọrịa shuga 1, ngụkọta insulin na-ebelata. Site n'ọrịa nke abụọ, uche anụ ahụ na homonụ na-ebelata. N'okwu nke mbụ, ọgwụgwọ ntụtụ bụ naanị ụzọ iji nyere aka. Na nke abụọ, a na-enye ọgwụ insulin maka mgbasa ọrịa.

Onye ọ bụla ọrịa nwere ụdị nke ego ha họọrọ.

Site na usoro inweta insulin na ekewa n'ime ụdị 4:

• mmadu - nke enwetara n’aka aru mmadu site na iji Escherichia coli,
• ezi - enwetara site na pancreas nke ezi,
• sitere na ehi - bụ nke sitere na nnukwu anụmanụ, mejupụtara.
• whale - enwetara site na pancreas nke whales,
• ọrụ mkpụrụ ndụ ihe nketa - esite n’aka anụ ezi, dochie amino acid nke na - adabara adabara onye nwere ya.

Insulin a rụpụtara ọhụrụ na mmadụ bụ otu. Ọtụtụ mgbe, a na-eji ya agwọ ọrịa shuga. Ọbara site na ehi nwere amino acid atọ dị iche iche, edepụtara ya n'ọnọdụ ndị anaghị adịkarị n'ihi mmeghachi ahụ nfụkasị ahụ na ọgwụ ahụ. Whale homonụ dịtụdị iche na nke mmadụ, a na-edekwa ya oke ọfụma.

Uzo ojoo

Isi nsogbu ahụike usoro mgbe usoro ndị ahụ bụ necrosis, ọnya afọ, mmeghachi omume nfụkasị onye ọ bụla. Ndị na-ahụ maka ọgwụ na-eme ụzọ parenteral nke nlekọta ọgwụ. Ọdịmma na nchekwa nke injections na-esite na nrube isi nke ọgwụ igba ogwu yana nhicha aka, ntozu oke ọkachamara, nnabata iwu na usoro eji achịkwa ọgwụ. Ọ bụrụ n’ị mebie ihe ndị a n’ime otu ụbọchị ka usoro nchịkwa ahụ gachara, enwere ike ịchọpụta ihie ọnya na-efe efe.

Mụta otu esi abụ onye na-ahụ maka nri na-edozi ahụ n'ime ụbọchị 30 ma nweta mgbakwunye 50,000 rubles. kwa ọnwa!

Nsogbu ọzọ na-adabakarị nke na-emegide ụzọ ntụtụ bụ ikuku ma ọ bụ ikuku mmanụ - obere ikuku ma ọ bụ mmanụ na-abanye n'ime arịa ọbara. Ọnọdụ a nwere ike ibute necrosis, kpalite vein thrombosis. Jegachi insulin na shuga shuga na-eme ka insulin lipodystrophy oge nile - atrophy ma ọ bụ ọbara mgbali elu nke anụ ahụ na saịtị nke nchịkwa ọgwụ na-aga n'ihu.

Ngwá ọrụ na-abụghị sterilaiz ma ọ bụ nke na-adịghị mma nke ejiri n'oge usoro ahụ nwere ike ime ka onye ọrịa butere ọrịa nje virus siri ike (ịba ọcha n'anya, nje HIV (immunodeficiency virus) nke mmadụ, wdg). Nsonaazụ nke infrenteral infusion bụ endoflebitis, ụdị mbufụt nke mgbidi venous nke na - amalite n'ihi mbibi akwara dị n'ime akwara ma ọ bụ mmerụ ahụ na - esote catheterization ma ọ bụ ekpughe ogologo oge nke agịga na oghere.

Dabere na ọnụ ọgụgụ, mmeghachi omume nfụkasị dị ukwuu na ọgwụ, dịka ọmụmaatụ, ujo anaphylactic, na-etolitekarị oge na parenteral injections karịa mgbe nchịkwa ọnụ gasịrị. Yabụ, inye ọgwụ mgbochi siri ike na usoro a na - eji ọgwụ eme ihe bụ nnagide onye ọ bụla mejupụtara ya.

Uzo ogwu eji agwo ogwu di iche-iche dika ebe ogwu a si abanye na nmekorita ya. A na-eme irugharị n'ime anụ ahụ intracutaneously (nyocha), subcutaneously (ihe nbanye ahụ na-abanye na arịa ọbara ọbara subcutaneous), intramuscularly (ọgwụ ahụ na-abanye lymphatic na arịa ọbara n'ime akwara), yana intraosseous (a na-eme ya ma ọ bụrụ na ntinye ma ọ bụ ntinye intramuscular agaghị ekwe omume).

Anotherzọ ọzọ nke nchịkwa parenteral bụ n’ime arịa (intravenally, intraarterially yana n’ime arịa lymphatic). A na-egosi ụdị ịgba ntụtụ ikpeazụ n'ọnọdụ ebe ọ dị mkpa iji zere nnyefe ọgwụ ahụ site na umeji na akụrụ. N'ọnọdụ ụfọdụ, ọ dị mkpa ka a na-eduzi ọgwụ a ka ọ banye n'ime oghere (eriri afọ, ihe na-emetụta akwara, articular). Typesfọdụ ụdị pụrụ iche nke ọchịchị nchịkwa bụ:

Rumalon - ntuziaka maka ojiji na ụdị mwepụta, ngosipụta, ihe mejupụtara na ọnụahịa Platifillin - ntuziaka maka ojiji, ụdị ntọhapụ, ngosipụta, ihe mejupụtara, mmetụta ndị ọzọ, analogues na ọnụ ahịa ọnụahịa - ntuziaka maka ụmụaka na ndị okenye.

• Ratzọ intrathecal (subarachnoid ma ọ bụ epidural): gafere mmiri mmiri cerebrospinal.
• Subzọ Subconjunctival: na ọgwụgwọ mpaghara nke ọrịa anya, site na njikọ nke anya.
• Intzọ intranasal: site na oghere imi.
• Intraracheal (inhalation): site na inhalation nke vapors jupụta na ọgwụ ọgwụ site na inhaler.
• Transdermal: nnabata nke mmiri ọgwụ a na-aputa n’ahụ.

Kedu mgbe m kwesịrị ịgbanwere ọgwụ insulin?

Mkpebi ịmegharị na pọmpụ ahụ bụ ndị nne na nna, nwa ahụ na dibịa na-aga. Enweghị mgbochi afọ ọ bụla mgbe ị na-ebufe na mgbapụta ahụ, gụnyere ụmụ aka.

N'ọtụtụ oge, mbufe na mgbapụta a na-eme tupu ọnwa 3-6 site na mmalite nke ọrịa ahụ, mgbe ndị mmadụ nwere ọrịa shuga na ndị mụrụ ha ọ bụghị nanị na ha mụtara usoro ihe ọmụma banyere ọrịa shuga, kamakwa ha enweta ahụmịhe bara uru zuru ezu. N’ezie, ndị na-arịa ọrịa shuga nwere ike gbanwee na pọmpụ, n’agbanyeghi afọ ole ọ na-arịa ọrịa shuga, yana ọbụlagodi ozugbo a chọpụtara ha.

Agbanyeghị, ịgbanwee ọgwụ insulin ozugbo ịmalite ọrịa shuga nwere ike jikọta ya na ọtụtụ ihe isi ike. Ọ bụghị naanị ezigbo ihe ọmụma banyere ụkpụrụ nke usoro ọgwụgwọ insulin, kamakwa ezigbo ihe ọmụma banyere ọrịa shuga mellitus n'ozuzu. Dịka amamịghe ọ bụla, ịghọta ọtụtụ atụmatụ nke ọrịa shuga na-abịa na ahụmịhe.

Na mgbakwunye, oge mbụ ọrịa ahụ gasịrị, enwere ike belata ntụtụ nke insulin, nke ga-achọ imeghari insulin ugboro ugboro. N'afọ mbụ nke ọrịa, ụmụaka na-eto eto na-eji ọgwụ insulin eme ka ọgwụ ụfọdụ nwee ụfọdụ njirimara nke sọọsọ basal, nke bụ naanị 10-30% nke dose kwa ụbọchị, ihe fọrọ nke nta ka ọ bụrụ ọkara ụmụaka nwere ike ịchọ ọgwụ insal.

N'ọnọdụ ụfọdụ, na nnukwu agụụ siri ike nke ndị na-eto eto na ndị nne na nna na ngwa ngwa njikwa njide onwe onye, ​​ị nwere ike ibugara ya na mmiri mgbapụta n'oge, na-eji obere ọrịa shuga. Ya mere, Dọkịta kpebiri n’oge nnyefe na ọgwụ insulin, dabere na njirimara nke onye ọ bụla nwere ọrịa shuga.

Nchịkwa nchịkwa ọgwụ Parenteral

A na-eme parenteral injections nke ụdị dị iche iche dịka ụfọdụ algorithms si hụ na nchekwa na arụmọrụ nke usoro. Iwu ndị a gụnyere ịkwadebe onye ọrịa, dọkịta na ngwaọrụ ndị dị mkpa, usoro ntụtụ ahụ, ọtụtụ usoro ikpeazụ mgbe ọ gbasịrị njedebe. Maka ọgwụ dị iche iche, ọsọ na usoro nchịkwa ha dị iche.

Ọnọdụ ntụgharị

Ọ bụ ezie na ọgwụ mgbochi mmiri na-abawanye ụba n'etiti ụmụaka nwere ọrịa shuga, a naghị atụ aro ya maka mmadụ niile. Iji gwọọ ọgwụ nke ọma, nwa ahụ na ndị mụrụ ya ga-achọrịrị nke a. Ọtụtụ ndị ọkachamara n'ọrịa shuga kwenyere na nyocha onwe onye (ọnụ ọgụgụ chọrọ glycemic nha kwa ụbọchị, idebe akwụkwọ nyocha nke onwe, insulin therapy treatment, wdg) bụ ọnọdụ kachasị mkpa maka ịgbanye na mgbapụta. Ọtụtụ ndị ọrịa ụmụaka chọrọ nlezianya nke njide onwe onye site n'aka ndị nwere ọrịa shuga ịmalite ọgwụgwọ mgbapụta, n'ihi na nke a abụghị naanị ntọala maka ibute nsonaazụ ahụ, kamakwa ọ dị mkpa iji gbochie nsogbu ndị nwere ike ịdị.

Installwụnye ọkpọ insulin na-azọpụtaghị gị njide onwe onye! Iji mee ka ọkwa glucose ọbara dị na mgbapụta ahụ ka ọ dị mma ma ketoacidosis adịghị eme, ị ga-achọ nyocha onwe gị mgbe niile: ịlele glucose, nchịkwa insulin, idebe akwụkwọ ọgụgụ, carbohydrate na-agụta.

Ebumnuche maka ịgbanwere ọgwụ insulin:

• HbA1c dị elu anaghị ejikọ ya na njide onwe onye na-adịghị mma
• Childrenmụaka na ndị nọ n’afọ iri na ụma nwere ihe ịtụnanya ‘ututu ụtụtụ’
• Qualityzọ ndụ dị ala (echiche na-adịghị mma maka mkpa insulin insulin na ndị bịara abịa, mkpa ịchekwa nri siri ike, ọchịchọ ịgbakwunye nri dị ka o kwere mee)
• Ugboro ugboro ma ọ bụ nnukwu hypoglycemia
• Childrenmụaka nwere insulin chọrọ obere
• Withmụaka na-atụ egwu inje
• Mmega ahụ mgbe niile
• Ọchịchọ imeziwanye ndụ

Uzo ojoo nsogbu ogwu a puru ime ka onye ozo jiri ya. Agbanyeghị, ndị na-arịa ọrịa shuga na ndị otu ọrịa shuga anaghị ajụkarị ịga n'ihu na usoro mgbapụta mmiri. Nnyocha nke ndị mmadụ nwere ọrịa shuga na usoro mmiri pọmpụ na Germany na Austria gosipụtara na naanị ihe dịka 4% ndị mmadụ jụrụ ịgba mgbapụta.

Isi ihe maka ịjụ ọgwụ mgbapụta bụ: enweghi ọnọdụ ịgwọ ọrịa maka ịgwọ ọrịa, mbelata nke mgbanwe ngbanwe nke ndụ na mbelata glucose ọbara. Ya mere, ọ dị mkpa iburu n'uche ihe ndị a mgbe ị na-ekpebi ntụgharị maka ọgwụgwọ mgbapụta.

Gbakọọ insulin mgbe ọ na-agbanye na mgbapụta

Mgbe ị na-agbanye na pọmpụ, kwa ụbọchị insulin (obere insulin + ogologo insulin kwa ụbọchị) na-agbadakarị 10-25%. Cingbelata dose nke insulin na-adabere n’ụzọ dị ukwuu maka nkwụghachi ụgwọ nke carbohydrate, ya bụ, n’ihe ndị na-egosi glucose ọbara, yana n’otu oge oge ịba ụba hypoglycemia si ewere ọnọdụ. N'ihe banyere glucose dị ukwuu n'ọbara, ọ̀tụ̀tụ̀ insulin pụrụ ịgbanwe ma ọ bụ ọbụna mụbaa.

Tebụl 1. Mgbanwe na ubochi insulin kwa ụbọchị (SDI) n'oge ntụgharị aka na mmiri mgbapụta

Mgbe ha gụsịrị ọgwụ insulin kwa ụbọchị na ọgwụ mgbapụta, ha gara n'ihu ịgbakọ ọnụọgụ basal na bolus.

Ngụkọta oge nke Basal

Imirikiti ndị na-eji mgbapụta nwere obere insulin insulin karịa ọgwụ bolus. N'okwu a, ogo n'etiti basal na usoro bolus na mgbapụta ahụ buru ibu dabere na afọ nwata ahụ. Mgbe ị na-agbakọ dose basal, ị nwere ike iji iwu na - esote - nwata dị obere, pere mpe karịa insulin insal na ọkwa pasent. N’aka umuaka, onodu insulin nwere ike ibu 30% nke ubochi kwa ubochi, ebe n’ulo ndi umu agbogho na ndi okenye, o na abukari ihe ruru 50%. Agbanyeghị, na ndị okenye, mmado basal nwere ike ịmara na-erughị bolus.

Ọkwa nke usoro basal:

• 0mụaka 0-6 dị afọ - ihe dịka 30-35% nke dose insulin kwa ụbọchị
• 6mụaka 6-12 gbara - ihe dị ka 35-40% nke insulin kwa ụbọchị
• Ndị na-eto eto na ndị okenye - ihe dị ka 40-50% nke insulin kwa ụbọchị

Mgbe ị gụsịrị otu usoro basal kwa ụbọchị, ọ dị mkpa iji aka ole insulin insulin ga-enye kwa elekere. A na-akpọ ego nke insulin na-elekọta kwa awa ka akpọrọ basal, ebe ọ bụ na ọ tụrụ ya na nkeji kwa elekere - nkeji / elekere (UI / h). Enwere nhọrọ abụọ maka ịgbakọ ọnụego elekere elekere kwa ọnwa.

N'okwu nke mbụ, ị nwere ike kesaa ọgwụ kwa ụbọchị otu ụbọchị ka ụbọchị dum. Iji mee nke a, naanị ịchọrọ ịkekọrịta ọgwụ ị na-enweta kwa ụbọchị site awa 24.

Nhọrọ nke abuo bu gbakọọ uzo ego, na-eburu n'uche njirimara nke mmadu. Ọtụtụ mgbe n'oge ehihie enwere mkpa insulin nke basal, nke na-adaberekarị afọ nwatakịrị ahụ. Youngmụaka na-enwekarị mkpa dị elu na oge mgbede na ọkara nke mbụ nke abalị yana obere mkpa maka ụbọchị.

Ogo nke insal basal na bolus dabere na afọ nwata.

Dika nwatakiri toro, o bidoro imeri. ututu ututu ututu - elu insulin chọrọ n'isi ụtụtụ. Ihe ndị a na - agbanwe agbanwe na mkpa insulin insal metụtara na afọ dị iche na ọdịiche dị na nzuzo nke mmiri ọgwụ mgbochi yana dịka homonụ nke uto, cortisol na homonụ mmekọahụ. Dịka ọmụmaatụ, na ụmụaka, mkpa dị elu maka insulin insulin na mgbede nwere ike jikọtara ya na mmụba nke ọkwa hormone na-eto ngwa ngwa ozugbo ụra.

Tebụl 3. Atụmatụ afọ nke profaịlụ basal

Tebụl 4. Ihe atụ nke ịgbakọ ọnụọgụ galọn mgbe ị na-agbanye na mgbapụta

Ngụkọta ọnụọgụ Bolus

Mgbe ị na-eji mgbapụta mmiri, enwere ike ịgbakọọ bolus maka nri ma ọ bụ maka glucose ọbara dị elu site n'aka onye nwere ọrịa shuga ma ọ bụ ndị nne na nna n'onwe ha, ma ọ bụ jiri onye na-ahụ maka bolus (ma ọ bụ onye inyeaka bolus). Ihe mgbako bolus bu ihe eji ewunye n’ime igwe mgbapu na-agbako otinye insulin dika odika usoro eji eme ya. Onye na - enye aka bolus anaghị enye insulin, kama ọ na - atụ aro ka ọ .ụọ ọgwụ. Mkpebi iwebata dose a bụ nke gị sitere na ahụmịhe nke gị.

Onye na-enye aka bolus anaghị ewepụta insulin, kama ọ na-atụ aro ka ị insụọ insulin!

Mkpa insulin, yabụ na oke insulin na-elekọta, na-agbanwe ka oge na-aga. Nke a bụ n'ihi uto nwata, mgbanwe ndụ, wdg.Yabụ, ọbụlagodi iji dọkịta dọkịta bolus ahazi ya, ọ dị mkpa ịgụta ọgwụ ahụ n'onwe gị, n'ihi na ọ bụrụ na ọria glucose n'ọbara, ị nwere ike idozigharị ntọala nke nnyemaka bolus.

Enyere insulin Bolus maka nri (bolus maka nri) ma ọ bụ iji dozie glucose ọbara (bolus na-agbazi).

Iji gbakọọ bolus maka nri, jiri ya carbohydrate ruru (UK).

Carbohydrate ọnụọgụ - UK

CC bụ ego mkpuchi insulin 1 achicha achịcha - XE (maka ndị na-agụta carbohydrates na XE), ma ọ bụ ọnụ ọgụgụ gram nke carbohydrates nke 1 U insulin na-ekpuchi (maka ndị na-agụta carbohydrates na grams).

Carbohydrate ọnụọgụ, insulin uche ihe na mgbaru ọsọ glycemic larịị na-adịkarị iche na ụmụaka nke afọ dị iche iche na n'oge dị iche iche nke ụbọchị.

Inwekwu oru - insulin karia kwa nri.

Mgbe ị na-agbakọ bolus na-agbazi Ihe nnabata insulin (PSI) na mgbaru ọsọ glycemic etoju.

Ihe nyocha insulin Senseiti - PSI

PSI bụ ókè ọkwa glucose dị n'ọbara si adalata ma ewebata otu ngalaba insulin.

Nnukwu ọnụọgụ - insulin na-ebelata kwa afọ.

Tebụl 5. Nlekọta ihe atụ nke carbohydrate coefficient na insulin sensitivity factor

Ọ bụrụ na CC na PSI nwetara n'ụzọ dị iche iche anaghị adakọ ọnụ, anyị nwere ike were uru dị n'etiti ha.

Ebumnuche glucose ọbara - ebumnuche nke glucose ọbara dị n'okpuru ala nke mgbapụta ahụ ga - achọ maka enyemaka nke bolus ịgbazi. A na-ekpebi ọkwa nke glycemia iche iche maka mmadụ ọ bụla yana onye dibịa bekee ma dabere afọ ole, ọchịchọ nke hypoglycemia, wdg.

N'iji ọnụọgụ carbohydrate, ị nwere ike ikpebi bolus maka insulin nri iji banye carbohydrates anabata.

Bolus nri (BE) = Number XE x UK

N'iji nnabata uche nke insulin na mgbanye glycemia, ị nwere ike ikpebi bolus na - agbazi - insulin, dị mkpa iji mezuo ọkwa ahụ. ọbara glucose (HA).

Bolus na - agbazi (KB) = (GK ugbu a - GK target) / PSI

Bolus na-agbazi nwere ike ịdị mma (na-ebelata) - ma ọ bụrụ na ọkwa glucose ọbara dị elu karịa ihe achọrọ, ma ọ bụ na-adịghị mma (ịbawanye) - ma ọ bụrụ na ọkwa glucose ọbara dị ala karịa ihe a chọrọ. Iji gbakọọ mkpokọta bolus, ịkwesịrị ịgbakwunye bolus na-edozi ahụ na nri. Ọ bụrụ na bolus na-agbazi adịghị mma, mgbe ahụ, a ga-ebelata ogo insulin iji belata glucose ọbara iji zụlite ụkpụrụ.

Na mkpokọta Bolus (OB) = Bolus nri

Tebụl 6. Ihe atụ nke ngụgụ bolus

A na-agbakọ profaịlụ basal, ọnụọgụ carbohydrate, na mmetụta uche insulin mgbe ị tụgharịrị na pọmpụ adịghị mma mgbe niile. N'ọdịnihu, yikarịrị, a ga-achọzi nzizi nke onwe ya dabere na ihe ngosipụta nke glycemic.

Ntọala nke profaịlụ basal na onye inyeaka bolus gbakọọ mgbe ọ tụgharịrị na mgbapụta adịghị ezigbo mma mgbe niile. N’ọ n’ihu, a ga-achọ mgbazi nke aka ha.

I.I. Dedov, V.A. Peterkova, T.L. Kuraeva D.N. Laptev

Nlekọta intraven

Preparationkwadebe maka ọgwụ irighiri akwara gụnyere ime ihe iji gbasoo iwu idebe ọcha - ịsacha ma hichaa aka nke dọkịta, ịsa ahụ aka (ọ bụrụ na ọ dị mkpa), nyochaa ampoule ọgwụ, ịnakọta sirinji, itinye ọgwụ ọgwụ n'ime ya ma tinye ngwa a kwadebere na trakasị na-enweghị atụ. Mgbe ahụ, a na-eme nkwadebe maka ntụtụ onye ọrịa, na-esonye n'omume ndị a:

1. Etinye aka onye ọrịa n’elu ala siri ike, dokwara.
2. Site na nyocha, dọkịta ahụ na-ahọrọ vein maka ọgwụ.
3. A na-etinye ya emegharị n'etiti atọ nke ubu, emesịa onye ọrịa ahụ kwesịrị ịdochie ma mechikwa mbọ aka ya ugboro atọ ma ọ bụ anọ ka akwara ahụ wee nwee ike ịpụta nke ọma wee dị mfe site na mkpịsị aka ya.

A na-eme ogwu ogbugba dị ka algorithm doro anya, naanị ọnụego nchịkwa nke mgbanwe ọgwụ. Usoro nke usoro ogwu ihe parenteral di otu a:

1. A na-eji akwa owu a alcoholụ mmanya mee ka ọ dị ọcha na-agwọ ebe a na-ahụ maka ntụtụ ahụ na akụkụ anụ ahụ dị n'akụkụ ya.
2. Wepu okpu ahụ na agịga syringe, a na-ewere sirinji n'aka nri, a na-eji mkpịsị mkpịsị mkpịsị aka dozie cannula. Ejiri aka ekpe ya jide aka onye ọrịa, akpụkpọ ahụ na-agbatị aka ya na mkpịsị aka ya wee dabaa na akwara. Tupu iwebata agịga, onye ọrịa ahụ kwesịrị ịkpụchi aka ya.
3. Akpukpo aru na arịa ahụ n’akụkụ 15 Celsius, mgbe ahụ agịga na-aga n’ihu 15 mm gaa n’ihu. N'ihe aka ekpe, a na-adọta piston ntakịrị, ebe ọbara kwesịrị ịpụta na sirinji (nke a pụtara na agịga dị n'ime akwara).
4. Mgbe ahụ, ana-ewepu njegharị ahụ na aka ekpe, onye ọrịa ahụ na-emeghe ọbụ aka ya, mgbe nyocha ọzọ nke agịga na akwara, dọkịta na-eji nwayọ na-agbagide ọkpọ ahụ ruo mgbe a na-enye ya ọgwụ mgbochi kpamkpam.

N'oge ịgba ọgwụ ahụ, onye ọrụ ahụike ga-akpachara anya nyochaa mgbanwe n'ọnọdụ ọnọdụ onye ọrịa (pallor of the skin, dizziness, wdg). Mgbe ịgba ntụtụ ahụ, a na-ewepụ agịga ahụ ngwa ngwa na akwara, a na-eji bọl owu ahoụrụma na-agbanye ebe akara aka. Ọrịa ahụ kwesịrị ịnọdụ ala ruo nkeji 7-10 ka ogwe aka ya gbupụrụ aka n’ikpere. Mgbe nke a gasị, ọbara agaghị apụta na ntụtụ.

Ihe algorithm maka ịkwadebe maka nchịkwa subcutaneous nke nchịkwa parenteral adịghị iche na ntinye akwara. A na-etinye aka na akụrụngwa (ọ bụrụ na ọ dị mkpa), a na-enyocha ampoule ahụ, a na-adọrọ ọgwụ ogwu n'ime sirinji. A na-eji mmanya na-agwọ ebe a na-agba ya na akpụkpọ ahụ. A na-eme ntụtụ ahụ dị ka ndị a:

1. N'aka aka ekpe ya, agbajiri akpụkpọ ahụ.
2. A na-etinye agịga n'otu akụkụ nke 45 Celsius, na ntọala nke ogige, n'okpuru anụ ahụ, ruo omimi nke 15 mm.
3. Mkpịsị aka aka nke mebere anụahụ ahụ nwayọ jiri nwayọ pịa onye na-agagharị ahụ sirinji.
4. Mgbe emechara ọgwụ ọgwụ, a na-ewepụ agịga ahụ, a na-etinye bọl na-egbu egbu a na-egbu egbu na saịtị ahụ.

Nkewa oso

Ọ dabere n'ọrịa ahụ, a na-amata ụdị ọgwụ 5 dịgasị iche iche site na ọsọ na oge ikpughe:

• Ultrashort edinam. Oru aka na-aputa nkeji iri ma atesịa ogwu gi. A na-edozi ya tupu nri ma ọ bụ ozugbo nri gachara. Enwekwara ike karịa awa 3.
• Omume dị mkpirikpi. Kemgbe afọ iri atọ. A na-ebu ya tupu nri. Nkpughepụ na-ewe awa 6.
• Ọkara. A na-enye ọgwụ ahụ ugboro abụọ n'ụbọchị n'otu oge. Mmetụta ahụ na-amalite mgbe awa 1.5 gachara anaghị anọ karịa awa iri abụọ.
• Ogologo oge na-eme ihe. Mmetụta ahụ na-apụta awa 3 mgbe nchịkwa gasịrị. Ogologo ihe a rụpụtara bụ awa iri abụọ na anọ. A na-ahụ ya ugboro atọ n'ụbọchị.
• Ọgwụ ị gwakọtara. Jikọta ọsọ ọsọ na oge nke mmetụta ahụ.

Ọgwụ Ultra-dị mkpụmkpụ ma dị mkpụmkpụ na-e mimomi pancreas mgbe erichara nri.

Mgbe ha risịrị nri, anụ ahụ na - emepụta anabolic nke nwere ike ịmegharị shuga na - esite na ume. Ọgwụ na ogologo oge ogologo oge na-eyi ọrụ nke akwara nri na-abụghị nri oriri. N’etiti nri, anụ ahụ na - eme glucose n’onwe ya, nhazi nke ọ ga - achọ ka ọ nwee ike ị amountụ insulin. Site na mmebi ahụ nke zuru oke, iji otu oge na nke ogologo oge mee ihe ga-akwụ ụgwọ ọrụ nke ahụ.

Etu ị ga-esi gbakọọ ọgwụ insulin

Igha insulin na-ezighi ezi na-akpata ọnwụ. Mgbe ngafe nke homonụ gafere, ọkwa shuga dị n’ahụ na-ada nke ukwuu, nke na-akpata akpịrị glycemic. A na-ahụta ọnụọgụ ọgwụ anabolic site na dọkịta n’otu n’otu, mana onye na-arịa ọrịa mamịrị nwere ike inye aka n’ikpebisi ike nke usoro a:

Innovation na ọrịa shuga - na-a everyụ kwa ụbọchị.

• Needkwesiri ịzụta glucometer, ọ na-ekpebi ego shuga n'ebe ọ bụla, n'agbanyeghị oge. Ekwesịrị tụọ shuga n'izu: n'ụtụtụ na afọ efu, tupu nri, mgbe nri gasịrị, na nri ehihie, na mgbede. Ná nkezi, a na-eme opekempe 10 kwa ụbọchị. Edere data niile na akwụkwọ ndetu.
• Akpịrịkpa pụrụ iche ga-ejikwa nri nri riri, ọ ga - enyere aka ịgbakọ protein, abụba na carbohydrates riri. Na ọrịa shuga, nri bụ otu n’ime ihe dị mkpa maka ọgwụgwọ. Ogo nri kwesiri ịdị n'otu ego kwa ụbọchị.

Uru kachasị dị na insulin mgbe ị na-agbakọ usoro onunu ogwu bụ otu 1 n’ime kilogram 1 n’arọ. Bawanye uru kasịnụ anaghị enye aka na nkwalite ma na-ebute hypoglycemia. Odika onunu ogwu n’usoro di iche-iche oria a:

• Mgbe ị na-achọpụta ụdị ọrịa shuga dị mgbagwoju anya, a na-eji nkeji 0.3 / 1 n'arọ.
• Ọ bụrụ na achọpụtara insulin dabere na ọrịa ahụ, a na-enye kọlọ 0,5 / 1 n'arọ ibu.
• N'afọ, na ezigbo ike, usoro onunu ogwu na abawanye rue 0.6 nkeji / 1kg.
• N'ọnọdụ ikpe siri ike na enweghị akwụghachi, usoro ọgwụgwọ ahụ bụ 0.7-0.8 nkeji / 1kg.
• Mgbe nsogbu mere, 0.9 nkeji / 1 n'arọ ka edere.
• N'oge afọ ime, usoro onunu ogwu rute 1 unit / 1kg nke aro.

Otu uzo ogwu a - adighi karia 40% nke ubochi. Ọzọkwa, olu nke ntụtụ na-adabere n'ịdị njọ nke ọrịa ahụ na ihe ndị dị na mpụga (nrụgide, mmega ahụ, ị ​​drugsụ ọgwụ ọjọọ ndị ọzọ, nsogbu ma ọ bụ ọrịa concomitant).

1. Maka onye ọrịa na-atụ kilogram 90, nke nwere ọrịa shuga nke 1, na-agbanwe agbanwe, ihe insulin bụ nkeji 0.6. kwa ụbọchị (90 * 0.6 = 54 nkeji - usoro insulin kwa ụbọchị).
2. A na-ahụ homonụ ogologo oge ogologo oge 2 kwa ụbọchị ma na-eme ọkara nke ụbọchị ọ bụla (54/2 = 27 - insulin kwa ụbọchị nke insulin na-arụ ọrụ ogologo oge). Uzo mbu nke ogwu a bu 2/3 nke olu zuru ezu ((27 * 2) / 3 = 18 - onodu ubochi nke ogwu nwere ogologo ekpughe). Thebọchị mgbede bụ 1/3 nke olu mkpokọta (27/3 = 9 - insulin mgbede nke insulin na-arụ ọrụ ogologo oge).
3. Insulin na-eme ihe dị mkpụmkpụ na-abụkwa ọkara nke ngụkọta homonụ (54/2 = 27 - nke ọgwụ kwa ụbọchị). A na-a medicineụ ọgwụ ahụ tupu nri ugboro atọ n'ụbọchị. Nri ututu bu 40% nke insulin, nri ehihie na nke mgbede nke 30% (27 * 40% = 10.8 - dose ụtụtụ, 27 * 30% = 8.1 nkeji - mgbede na usoro nri ehihie).

N’inwe afọ ojuju dị elu tupu i rie nri, ngụkọta oge nke ịbanye insulin ngwa ngwa.

A na-eme ihe nrịgo n’ime achịcha. 1XE = gram 12 nke carbohydrates. A họrọ ọ̀gwụ nke ọgwụ adịghị eme ihe dabere na uru XE na oge nke ụbọchị:

• ututu 1XE = 2 nkeji,
• na nri ehihie 1XE = 1,5ed,
• na mgbede 1XE = 1 unit.

Dabere ogo nke ọrịa ahụ, ọnụọgụgụ na usoro onunu ogwu dịgasị:

• N'ime ụdị shuga 1, ahụ mmadụ anaghị emepụta insulin. N'ime ọgwụgwọ nke homonụ na-eji, ngwa ngwa ma na-arụ ọrụ ogologo oge. Iji gbakọọ, ego ole insulin na-anabata ga-ekewa na ọkara. A na-a drugụ ọgwụ nke ogologo oge utịp ugboro abụọ n'ụbọchị. A na-ahụ insulin mkpụmkpụ ugboro 3-5 n'ụbọchị.
• N'ime ọrịa shuga siri ike nke ụdị nke abụọ, a na-a medicineụ ọgwụ ogologo oge. A na-agba ya mgbochi ugboro abụọ n'ụbọchị, ọ bụghị ihe karịrị nkeji iri abụọ na ụma.

Otu 1 nke insulin na-ebelata shuga ọbara site na nkezi 2 mmol / L. Maka ọnụ ahịa zuru oke, a na-atụ aro ịhapụ shuga na-aga n'ihu.

Usoro insulin na ụdị ya

Ọrụ insulin na-arụ bụ mmalite nke ọnụọgụ ọgwụ na-agbaso usoro ọmụmụ nke ndị ọrịa. N'ehihie, a na-enye ihe dịka 80% nke homonụ ahụ, a na-edozi ike ndị ọzọ n'abalị. Modezọ nlekọta ọgwụ a dị nso n’ichepụta ihe ọmụmụ nke homonụ na ahụ ike.

Onye ọ bụla metara glucose n'ụzọ nke ya. Nhazi nke iberibe achịcha 1 chọrọ insulin site na nkeji 0,5 ruo 4. Iji chọpụta ụzọ dị mma esi gwọọ mmiri, ịkwesịrị ịlele ọkwa shuga mgbe ị risịrị.

Therapydị ọgwụgwọ

Maka ọgwụgwọ nke ọrịa shuga, a na-eji ụzọ 2 ọgwụ insulin mee ihe:

• Ọgwụ ọdịnala. N'oge ọgwụgwọ, a na - eji insulins dị mkpụmkpụ ma dị ogologo. Ihe ruru 60% bụ n'ihi iji homonụ ogologo oge, 40% na insulin ngwa ngwa. Oge a na-ahụ nri na oge ịgba ntụtụ. Nri pụrụ iche, nri iri nri, egwuregwu n’agaghị usoro, nchekasị.
• Nlekọta kpụ ọkụ n'ọnụ N'ime ọgwụgwọ insulin, a na-eji mkpịsị mkpịsị mkpụmkpụ ma dị ogologo. A na-agbakọta oriri homonụ dị mkpụmkpụ dabere na nri riri. Enweghị nri siri ike achọrọ, a na-anabata egwuregwu na nri nri.

Nchịkwa Ọgwụ

Maka ịdị mma nke nchịkwa insulin, e mepụtala ngwaọrụ pụrụ iche nke eji eme ihe ngwa ngwa. E nwere ụzọ atọ nke nchịkwa ọgwụ:

• Sirinji insulin.
• Mkpịsị sirinji bụ kọmpat kompeni nke na-enye ọgwụ ọfụma. A na-eji ya na Russia.
• Dispenser-pump - ngwaọrụ na-ewebata ọgwụ n’onwe ya. Ọ bụ dọkịta na-agbazi ya ma ọ bụ onye ọrịa ahụ, dabere n'ụdị nchịkwa nke homonụ ahụ. A na-eji ya na Europe na USA.

Dodoụbiga ọgwụ ike ókè ga-eduga Somogy syndrome, hypoglycemia, ma ọ bụ ọrịa mamịrị. Ọ bụrụ na ị na-enwe ọgbụgbọ, ọgbụgbọ, ọgbụgbọ, ọgbụgbọ, ọ dị mkpa iji tụọ shuga ọbara. Site na mmụba dị ukwuu, ịkwesịrị ịkpọ ụgbọ ihe mberede. Iji zere ịwa ahụ na glucose na mberede, ịkwesịrị ịgbaso ntuziaka dọkịta, na-elekọta insulin n'oge ma rube isi na nri.

Ọrịa shuga na-edugakarị ọrịa na-egbu egbu. Oké ọbara shuga dị oke ize ndụ.

Aronova S.M. nyere nkọwa banyere ọgwụgwọ ọrịa shuga. Na-agụ zuru ezu

Intramuscular

A na-eme nkwadebe maka nchịkwa intramuscular dịka usoro algorithm yiri ya. Onye ọrịa ahụ dina n’elu ihe ndina ya ihu, maka ịgba ya, a na-ahọrọ oghere n’elu akụkụ nke akwara gluteal. A alcoholụrụ ya na-aba n'anya. A na-eme ọgwụ mgbochi dị ka iwu ndị a:

1. A na-ejide sirinji site n'aka nri, ya na mkpịsị aka aka ekpe nke nta wee gbatịa anụ ahụ na ebe a ga - eme ka ụgwụ gị ga - eme n'ọdịnihu.
2. Site na mkpagharị dị nkọ, a na-etinye agịga n'ime akwara gluteus ihe dị ka 2/3 nke ogologo ya, na mpaghara 90 Celsius.
3. N'iji aka ekpe gị, ha na-elele otu ọkpọ na akwara - ha na-adọta ọkpọ ahụ obere n'ahụ gị, ọbara ekwesịghị ịnwe.
4. Ogwu ogwu ogwu olom, ebebe ogwu usọ ikwaan̄ me uwu ya.

Intraarterial

Iji rụpụta ọgwụ mgbochi irighiri akwara, a na-ahọrọ akwara ndị dị nso n'akụkụ akpụkpọ ahụ - cervical, el el, axillary, radial, ma ọ bụ femoral. A na-eme nkwadebe maka ọgwụ mgbochi dịka iwu ndị si dị. Ọ bụ dọkịta ga-ekpebi ntụgharị ntụtụ ahụ site na mpaghara nnwale kachasị. A na-apịa anụ ahụ na akwara dị ka otu iwu si dị ka iji ọgwụ ịgba agba agba agba, n’akụkụ mmegharị nke oghere olu. Mgbe usoro ahụ gachara, a na-etinye mmachi nrụgide na saịtị ahụ ụkwara ahụ ruo ọtụtụ minit.

Intrathecal

Nchịkwa nke Parenteral nke ọgwụ n'ime mmiri apịtị apịtị bụ usoro dị mgbagwoju anya ma na-egbu mgbu nke onye ọrịa dina n'akụkụ ya n'ụkwụ ya na-etinye ya n'afọ na isi ya n'obi. A na-ahọrọ oghere ịgba ọgwụ ahụ n'etiti lumbar vertebrae, ọ bụghị naanị ọgwụ antiseptik ka ejiri ya, kama ọ bụ ọgwụ ọgwụ subcutaneous ka ejiri ọgwụ. A na-etinye agịga ahụ na ọwa mmiri n'ọkpụkpụ azụ; mgbe usoro a gasịrị, onye ọrịa ahụ ga-anọrịrị na-enweghị ngagharị maka oge 20-30.

Ngwongwo glucose

Onye Britain ahụike W. Praouth bụ onye mbụ kewapụrụ ma kọwaa ya na mmalite narị afọ nke 19. Ọ bụ kọlịflawa (ụtọ), ihe dị n'ime ya bụ carbon carbon 6.

A kpụrụ ya na osisi site na photosynthesis, n'ụdị ya dị ọcha bụ naanị mkpụrụ vaịn. Dị ka ọ na-adị, ọ na-abata ahụ mmadụ na nri nri ndị nwere stachi na emeju, ọ na-ahapụkwa ya mgbe mgbaze.

Akụkụ ahụ na-etolite “usoro nchekwa” nke ihe a n'ụdị glycogen, na-eji ya dị ka isi iyi ọzọ nke ike iji kwado ndụ na mmetụ obi, anụ ahụ ma ọ bụ nke uche, ọrịa ma ọ bụ ọnọdụ ndị ọzọ jọgburu onwe ya.

Maka ịrụ ọrụ mmadụ nkịtị, ọkwa nke glucose dị n'ọbara kwesịrị ịbụ ihe dịka 3.5-5 mmol kwa lita. Ọtụtụ homonụ na-arụ ọrụ dị ka ndị na-achịkwa ókè nke ihe ahụ, ihe ndị kasị mkpa bụ insulin na glucagon.

A na-eri glucose oge niile dị ka isi iyi nke ike maka neurons, akwara na mkpụrụ ndụ ọbara.

Ọ dị mkpa maka:

• na-enye metabolism n’ime sel,
• Usoro mmegharị nke usoro redox,
• normalization nke imeju,
• tụgharịa ume nke ikike,
• na-eme ka mmiri mmiri ghara itisa,
• na - eme ka mkpocha nsị ghara ịdị.

Ojiji nke glucose na-efe efe maka ebumnuche ọgwụ na-enyere aka weghachite anụ ahụ mgbe nsí na ọrịa gasịrị, ịwa ahụ.

Mmetụta n'ahụ

Ofkpụrụ nke dextrose bụ nke onwe ya ma ejiri atụmatụ ya na ụdị ọrụ mmadụ rụzie ya.

Ihe kachasi ike nke ubochi obula bu ndi mmadu ndi n’eme oru ike ma obu ndi aru ike (nihi na ha choro ka ha nweta ume ozo).

Ahụ mmadụ na-ata ahụhụ n'otu aka ụkọ na oke shuga ọbara:

• imebiga ihe ókè na-akpalite oke akwara iji mepụta insulin na iweta glucose na nkịtị, nke na-eme ka akwara ngwa ngwa na-eyi, ọnya afọ, akwara nke imeju akwara n'ime abụba, na-emebi obi,
• ụkọ na - akpata ụbụrụ mkpụrụ ndụ ụnwụ nri, nkụda mmụọ na nke na - adịghị ike, na - akpata adịghị ike izugbe, nchekasị, ọgba aghara, ịda mba, ọnwụ nke neurons.

Isi ihe kpatara enweghị glucose na ọbara bụ:

• nri na-ezighi ezi, nri zuru ezu nke na-abanye na nri diges,
• nri na egbu egbu egbu,
• ọgba aghara n'ahụ ahụ (ọrịa thyroid, neoplasms na-eme ihe ike, nsogbu eriri afọ, ọrịa dị iche iche).

Ekwesịrị idobe ọkwa dị mkpa nke ihe a na ọbara iji hụ na ọrụ dị mkpa - arụ ọrụ nke obi, usoro akwara dị n’ahụ, akwara, ahụ dị mma.

Dịka ọ dị, nri dịkarịsịrị ejupụta na ihe ahụ dị mkpa iji jupụta ọnọdụ ahụ (trauma, ọrịa, nsị), glucose ka edozie ọnọdụ ahụ.

Ọnọdụ maka Dextrose

Maka ebumnuche ahụike, a na-eji dropper nwere dextrose maka:

• iwetulata shuga dị ala
• ike ọgwụgwụ nke anụ ahụ na ọgụgụ isi,
• Ọtụtụ ọrịa (ọrịa ịba ọcha n'anya, eriri afọ na-efe efe, ọnya ọgbụgba na usoro mmerụ ahụ) dị ka isi iyi nke ume arụ ọrụ maka ahụ.
• ọ ga-enyekwa nsogbu n'obi,
• ọnọdụ ujo
• mbelata nke ọbara mgbali elu, gụnyere ọbara ọgbụgba,
• nnukwu akpịrị ịkpọ nkụ n'ihi ịxụbiga mmanya ókè ma ọ bụ ọrịa, gụnyere ọgwụ, mmanya na ọgwụ ọjọọ (ya na afọ ọsịsa na ọgbụgbọ na-asọ oyi),
• afọ ime iji nọgide na-enwe mmepe nwa ebu n'afọ.

Maindị usoro ọgwụgwọ bụ isi eji eme ọgwụ bụ ngwọta na mbadamba.

Sdị Usoro Ọgwụ

Ngwọta kachasị mma, ojiji ha na-enyere aka idozi ma dozie ahụ onye ọrịa ngwa ngwa o kwere mee.

N'ime ọgwụ, a na-eji ụdị edozi abụọ nke Dextrose, nke dị iche na atụmatụ ngwa:

• isotonic 5%, nke eji eme ihe iji melite arụ ọrụ nke akụkụ ahụ, nri ha parenteral, na-ejigide mmiri, na-enye gị ohere inyekwu ume ndụ,
• hypertonic, mmezi metabolism na ọrụ imeju, ọbara ọgbụgba osmotic, na-eme ka nsacha dị ọcha site na toxins, nwere ntinye dị iche (ihe ruru 40%).

Ọtụtụ mgbe, a na-achịkwa glucose na intraven, dị ka ihe ntụtụ nke nnukwu ịba uru hypertonic. A na-eji nchịkwa Drip mee ihe ma ọ bụrụ na ị constantụ ọgwụ mgbe niile n'ime arịa ndị ahụ chọrọ oge ụfọdụ.

Mgbe abatịrị nke dextrose na-abanye n'ime ala, ọ na-agbari n'ime carbon dioxide na mmiri n'okpuru acid, na-ewepụta ike mkpụrụ ndụ chọrọ.

Glucose na ntụpọ isotonic

A na-etinye ntụpọ Dextrose 5% nye ahụ onye ọrịa n'ụzọ niile enwere ike, ebe ọ dabara na ọnụọgụ ọbara osmotic.

Ọtụtụ mgbe, a na-ewepụta ntapu mmiri site na iji sistemụ 500 ml ma ọ bụ karịa. ruo 2000 ml. kwa ụbọchị. Maka mfe iji, a na-etinye glucose (ihe eji eme ka mmiri doo) na akpa polyethylene 400 ml ma ọ bụ karama iko nke otu ike.

A na-eji usoro isotonic mee ihe dị ka ihe ndabere maka ọgwụ nke ọgwụ ndị ọzọ dị mkpa maka ọgwụgwọ, nsonaazụ nke dropper dị otú ahụ na ahụ ga-abụ n'ihi ihe mgbakwunye nke glucose na otu ọgwụ ọgwụ akọwapụtara na ngwakọta ya (cardiac glycosides ma ọ bụ ọgwụ ndị ọzọ nwere oke mmiri, ascorbic acid).

N'ọnọdụ ụfọdụ, nsonaazụ yana njikwa drip omume ga - ekwe omume:

• mebiri metabolism nke nnu-mmiri,
• Ibu ibu n'ihi oke mmiri,
• oké agụụ
• ahu ọkụ
• mkpụkọ ọbara na hematomas na saịtị ịgba ahụ,
• mmụba nke ọbara,
• ngafe ọbara (n’okwu siri ike, coma).

Enwere ike ime nke a site na mkpebi na-ezighi ezi banyere ọnụọgụ mmiri nke ahụ na-efunahụ ya na olu ụmụ irighiri mmiri dị mkpa iji mejupụta ya. Usoro nchịkwa nke mmiri mmiri ajectedụbiga ọ byụ na-abụ site n'aka ndị diuretics.

Ngwọta Hypertonic Dextrose

Routezọ bụ isi maka nchịkwa nke azịza a na-etinye ọbara. Maka ndi nwere oria, a na-a drugụ ọgwụ ahụ na ịta ahụ nke dọkịta nyere (10-40%) dabere na-erughi 300 ml kwa ụbọchị yana oke mbelata ọbara, nnukwu ọbara ọgbụgba mgbe mmerụ ahụ na ọbara ọgbụgba.

Iwepu glucose lekwasịrị anya na-enye gị ohere:

• kwalite ọrụ imeju,
• ndozi obi obi
• mee ka aru aru ike zuru oke,
• na - eme ka ikpochapụ mmiri si n’ahụ dị,
• na-eme ka metabolism anụ ahụ
• dilates arịa ọbara.

Ọ bụ afọ ole onye ọrịa ga-ekpebi ka ọ̀tụ̀tụ̀ infusion nke ihe a na-arụ ọrụ kwa elekere, olu a ga na-achịkwa ya ruo ụbọchị otu ụbọchị.

• ndị okenye - enweghị ihe karịrị 400 ml.,
• ụmụaka - ruru 170 ml. kwa 1000 grams nke ibu, ụmụ ọhụrụ - 60 ml.

Site na coma hypoglycemic, a na-etinye dropper nwere glucose dị ka ụzọ isi mee ka mmadụ dịghachi ndụ, bụ nke, dị ka ntụziaka dọkịta si dị, a na-enyocha ọkwa shuga n'ọbara onye ọrịa mgbe niile (dị ka nzaghachi nke akụkụ ahụ maka ọgwụgwọ).

Njirimara nke ogwu

Ihe na - eme ka mmiri ọgwụ juputara na homonụ bụ ọgwụ protein-peptide eji maka ọgwụgwọ a kapịrị ọnụ nke ọrịa shuga mellitus. Ọ bụ ike na-emetụta ike metabolic Filiks na ahụ, na ọkachasị na carbohydrate.

N'ihi insulin, glucose dị n'ọbara na ogo nke mkpanaka ya nwere ike belata nke ukwuu. Na mgbakwunye, homonụ ahụ na-akwalite mmepụta nke glycogen ma na-akwụsị ntụgharị nke lipids na amino acids ka carbohydrates.

A na - ewere insulin na - arụ ọrụ na - arụ ọrụ belata shuga dị 0.045 mg nke insulin.

Mmetụta ọgwụgwọ na ahụ onye na-arịa ọrịa shuga bụ ihe metụtara ya na mkpochapu ihe nkwụsị na metabolism nke lipids na carbohydrates kwa ụbọchị. Insulin kwalitere onodu ahuike nke ndi oria nihi na:

1. ọbara ọgbụgba na-ebelata
2. A na-ewepụ glucoseuria (glucose na mmamịrị) na acetonuria (mkpokọta acetone n'ime ọbara),
3. ngosiputa nke ọtụtụ nsogbu nke ọrịa shuga (polyarthritis, furunhma, polyneuritis) belatara.

Onye ka egosiputara maka insulin?

Ihe kachasị egosi maka iji ọgwụ ahụ bụ ọrịa nke ụdị ọrịa shuga mellitus 1 (insulin-dependance). Y’oburu n’inweta homonu n’ime obere onodu ogwu (site na nkeji ise rue iri), mgbe ahu o gha enyere aka iwepu:

• ụfọdụ ọrịa imeju
• acidosis
• ọnwụ nke ike
• ike ọgwụgwụ
• furunlera,
• thyrotoxicosis.

N'akụkụ dị ukwuu, enwere ike iji ọgwụ ahụ mee ọgwụ fata. Insulin nwere ike ịlụ ọgụ megide ọrịa mamịrị toxidemia, akpịrị, eczema, psoriasis, urticaria, pyoderma na-adịghị ala ala na mmebi ahụ.

Mgbe ụfọdụ enwere ike iji insulin mee ihe gbasara omume na akparamaagwa. Na mgbakwunye, a na-eji homonụ ahụ agwọ ọrịa ịdabere na mmanya na nsogbu usoro ụjọ.

Taa, ụfọdụ ụdị schizophrenia bụ ndị a na-agwọ nke ọma maka ọgwụgwọ insulinocomatosis. Ọ na-ewebata mmeghe nke ọgwụ ọgwụ n'ụdị ọnya ndị a nwere ike ibute ujo hypoglycemic.

Iwu ntinye

N'ọtụtụ ọnọdụ, insulin na-etinye ọgwụ irighiri mmiri na intramuscular na sirinji pụrụ iche. N'ọnọdụ ndị pụrụ iche, dịka ọmụmaatụ na Comama, enwere ike ịchịkwa ya n'efere. A na - enye insulin kwụsịlata naanị n'okpuru anụahụ.

O kwesịrị ị shouldụ ụbọchị ọ bụla kwesịrị ịtụtụ ọnụ ugboro abụọ na mgbe ọ bụla tupu nri (nkeji iri atọ). Nsonaazụ nke ịgba mbụ na-amalite mgbe nkeji 30-60 na-adigide site na awa 4 ruo 8.

Mgbe enyere ya ọgwụ intravenly, ọgwụ ahụ rute elu mgbe nkeji 20-30 gachara, ma mgbe nkeji 60 gasị, ntinye nke hormone ahụ n'ọbara onye ọrịa rute ọkwa mbụ ya.

Gchịkọta nkwusioru nke ikpịpụta oge ruo na sirinji, ihe dị na vial ahụ ga-eme mkpatụ ruo mgbe etolite nkwusioru otu.

Mgbe ị na-ewepụ ọrịa shuga na inulin, ọ dị mkpa ịgbaso nri pụrụ iche. Usoro nke iji ọgwụ ọjọọ eme ihe n'ọnọdụ a ga-ahọrọ oke n’otu n’otu. Ọ dabere kpam kpam:

1. ogo ọrịa ahụ
2. ole glucose dị na mmamịrị
3. ọnọdụ onye ọrịa.

Ọkọlọtọ olu di iche na nkeji iri rue iri anọ. Na usoro ọgwụgwọ shuga na-arịa ọrịa shuga, a ga-amụba ka usoro homonụ ga-amụba:

• ya na ụdị nchịkwa ibe ya ruru 100 PIECES,
• intravenously ruo 50 nkeji.

Ọrịa toxidermy na-arịa ọrịa shuga na-enye insulin, nke ga-adị iche dabere na ogo ọrịa ahụ na-akpata. N'ọnọdụ ndị ọzọ a na-adakarị achọghị oke olu nke ihe nchịkwa.

Kedu onye na-ekwesịghị ịgbanye insulin?

E nwere contraindications doro anya maka ojiji nke insulin. Ọnọdụ ndị a gụnyere ọrịa:

1. ịba ọcha n'anya
2. eriri afọ na ọnya afọ.
3. jed
4. pancreatitis
5. ọrịa akụrụ
6. ọrịa butere ọrịa obi.

Nsonaazụ n'ahụ

Dịka iwu, mmeghachi omume ojoo na-etolite naanị n'ihi ịseụ ọgwụ insulin. N’ihi nsị nke ọbara ma ọ bụ nke subcutaneous, itinye uche ya na ọbara na-abawanye nke ukwuu. Ọzọkwa, ọ bụrụ na glucose abanyeghị n'ahụ mmadụ, mgbe ahụ enwere ike ịmalite ịma jijiji hypoglycemic dị elu (mgbe glucose daa ọkwa na-anabataghị).

A, insulin dị elu na-akpata:

• oké obi obi
• ike adighi ike
• mkpụkpu ume
• ọsụsọ
• nnu.

N'ime ọnọdụ siri ike, mmụba nke insulin na-akwụghị ụgwọ carbohydrate (ma ọ bụrụ na enweghi ike ịmịcha glucose) na-emetụta ọnwụ nke mmụọ, nkwarụ na ọbara ọgbụgba.

Iji kpochapụ ọnọdụ a ngwa ngwa, ọ dị mkpa iji nye onye ọrịa ahụ 100 g achịcha ọka achịcha ọcha, tii ojii dị ụtọ ma ọ bụ tablespoons abụọ nke shuga granulated na ngosipụta mbụ nke hypoglycemia.

Mgbe enwere nnukwu ihe mgbaàmà nke ịda ọrịa shuga, glucose na akwara nke ntapu. Ọ bụrụ na ọ dị mkpa, enwere ike ịlekọta glucose na subcutaneously ma ọ bụ ejiri epinephrine mee ihe.

Etu esi abanye ntụtụ?

Edere irighiri irighiri akwara n’aru juru na ọnya ụkwara: n’apata ụkwụ, n’afọ ulnar fossa na aka. Ihe ntụtụ algorithm gụnyere omume ndị a:

• nchọpụta zuru oke
• ntinye agịga site na iji ụdọ ke akwara,
• na - agbagọ aka na nkwonkwo aka mmadụ iji mee ka ọbara si n'ogwe ahụ dị ọcha.

• Kwadebe onye ọrịa maka ọgwụ mgbochi - ịnọdụ ala n'oche ma ọ bụ n'ihe ndina.
• Debe oghere aka ekpe n'ihu nkedo ahụ akwara n'ịnyịnya.
• Na-anakọta ọgwụ n'ime sirinji.
• Idozi ebe a na-emegharị emegharị n’elu ikikere iji mee ka ọbara na-erute na veins.
• Gwa onye ọrịa ka o jiri aka ya rụọ ọrụ n'oge oge ịchọrọ ka akwara jupụtara n'ọbara.
• A ga-enye ọgwụ ọgwụ n’ebe a chọrọ.
• Twice withụbiga mmanya ókè ugboro abụọ.
• A na-etinye agịga (na mbe), a na-edozigharị mkpịsị ugodi, ọkpọ ahụ anaghị agbakọ.
• A na-eji ọgwụ ahụ nwayọ nwayọ, otu ụzọ n'ụzọ iri nke ml na-anọgide na sirinji.
• Wepu agịga ahụ na akwara, a na-etinye swab owuiti n’ebe a na-agba ya, ogwe aka agbadawo.
• N’ebe a na -emechi ya, a na-atụ aro ka ị jide aka gị maka nkeji ise (ọnya anaghị etolite).

Dị Mkpa! Ọ ga - ekwe omume ichebe onye ọrịa n'ọrịa ma ọ bụrụ na a na - ahụ ọcha ịdị ọcha: mkpụfu mkpụfu nke nọọsụ na - enye, na - enye ọnọdụ ọnọdụ nkwakọ ngwaahịa, ọgwụ nke agịga na ọgwụ ọgwụ. Na njedebe nke usoro ahụ, a na-eji swab owu nwere mmanya na-emechi ebe injection ahụ.

Nleta ọbara sitere na akwara na ntụtụ ọgwụ ọ bụla n’akwara

Nghachị, iwu na nkọwapụta nke irighiri irighiri akwara site na mmalite ruo na njedebe na-egosi vidiyo

Usoro eji eme ihe nke irighiri irighiri akwara

Ogologo oge nke iwebata ọgwụ n'ime akwara na-ewe nkeji iri. Usoro injection na-enye onye nọọsụ nwere ahụ nsogbu ohere ka ọ banye na akwara na-enweghị mgbu na ngwa ngwa nke na ị nweghị oge ịtụ ụjọ. N’ezie, otu ogwu ka abanye n’uzo na ikpere aka. Ọ bụrụ na ọ gaghị ekwe omume ịchọta veins jupụtara n'ọbara na mpaghara a, a ga-ewere veins ndị ọzọ dị n'azụ aka iji gbaa ntụtụ. A gaghi etinye ogwu ahu n’ime akwara n’ukwu n’ihi na ihe iyi egwu nke ibuso ọbara agha na-abawanye. Igwe ntụtụ ahụ ziri ezi nwere usoro ndị a:

• Ejiri aka nri wee jiri sirinji ahụ, mkpịsị aka agịga nwere ya site na mkpịsị aka ntanetị.
• A na-eji mkpịsị aka ndị ọzọ na-agbanye mmiri sirinji.
• A na-eteji akwara ahụ ọzọ, a na-eji swab ọhụrụ agwọ saịtị, nke na-eme ka ọgwụ ọdịnihu ga-adị mma.
• Onye ọrịa na-ehicha aka ya.
• Aka jide aka syringe fọrọ nke nta ka ya na ya (n’otu akụkụ nke ogo 15) n’ebe ntụtụ ahụ, agịga - bepu ya.
• Emere ọkpọ, agịga gafere otu ụzọ n'ụzọ atọ n'etiti akpụkpọ ahụ na akwara, wee dụpu mgbidi nke akwara, a na - enwe mmetụta nke "ọdịda".
• Jiri nwayọ gbatịa ngwa ngwa syringe, ọbara ga-apụta na cylinder, nke na-egosi ọnụnọ agịga na akwara.
• Wepu ememme ahụ, aka ahụ na-ezu ike
• Inyochagharị agịga na akwara.
• Nchịkwa ọgwụ na-eji nwayọ, akụkụ nke ọgwụ ahụ ka na-anọ na silinda - azọghị ya.
• Wepu sirinji, a na-etinye akwa swab na mmanya na-egbu egbu, na-akụ aka.
• N’ebe ị na -emechi aka, jide aka gị maka minit 5, ọgaghị enwe mmerụ ahụ.