Cov kua nplaum tsim nyog hauv lub cev rau ntau yam kev zom zaub mov.

Vim nws txoj kev ua tiav los ntawm lub cev thiab nws txoj kev hloov mus rau hauv cov piam thaj-6-phosphate, cov kua nplaum ntawm cov kua nplaum txhawm rau qee qhov them nyiaj rau cov dej tsis txaus. Hauv qhov no, txoj kev daws teeb meem 5% dextrose yog isotonic rau cov ntshav ntshav, thiab 10%, 20% thiab 40% (hypertonic) cov kev daws teeb meem ua rau muaj qhov nce siab ntawm cov ntshav osmotic thiab ntshav nce ntxiv.

Glucose Analogs

Glucose analogues rau cov nquag ua haujlwm yog cov tshuaj Glucosteril thiab Dextrose nyob rau hauv daim ntawv ntawm kev daws rau infusion.

Raws li cov txheej txheem ntawm kev nqis tes ua thiab zwm rau ib pawg pharmacological, Glucose analogues suav nrog Aminokrovin, Aminotrof, Aminoven, Aminodez, Aminosol-Neo, Hydramin, Dipeptiven, Infuzamine, Infuzolipol, Intralipid, Nefrotekt, Nutriflex, Oliklinomel thiab Haimiks.

Kev taw qhia rau kev siv piam thaj

Cov kua nplaum tov, raws li cov lus qhia, yog tshuaj:

• Tawm tsam keeb kwm yav dhau los ntawm cov khoom noj khoom haus tsis muaj txiaj ntsig carbohydrate,
• Tawm tsam tus keeb kwm yav dhau los ua rau qaug cawv,
• Hauv kev kho mob ntawm hypoglycemia,
• Tawm tsam keeb kwm yav dhau los ntawm intoxication nrog kab mob siab - kab mob siab, mob ua paug thiab mob ntshav hauv lub siab, nrog rau daim siab ua haujlwm,
• Nrog kev siv tshuaj lom,
• Nrog rau lub cev qhuav dej ntawm ntau cov etiologies - zawv plab thiab ntuav, raws li nyob rau hauv lub sijhawm postoperative,
• Nrog hemorrhagic diathesis,
• Nrog cev qhuav dej thiab poob siab.

Cov cim no tseem yog lub hauv paus rau kev siv cov kua nplaum thaum cev xeeb tub.

Ib qho ntxiv, Cov kua nplaum ua kua yog siv los ua ib qho kev tiv thaiv rau ntau yam kev tiv thaiv kom tsis txhob poob siab thiab hloov ntshav hauv lub cev, thiab ntxiv rau kev npaj cov tshuaj daws teeb meem rau kev tswj hwm.

Cov Yuav Tsum Muaj

Cov kua nplaum nyob hauv txhua daim ntawv teev tshuaj yog sib kis hauv:

• Qog Ntshav,
• Qog hyperosmolar,
• Kev ua haujlwm tsis zoo
• Dej siab,
• Hyperlactacidemia,
• Cov mob puas tsuaj uas tsim teeb meem ntsig txog kev mob ntsws qhuav,
• Tom Qab Siv Cov Ntawv Tsis Muaj Qab Zib,
• Mob laug ventricular tsis ua hauj lwm,
• O o rau lub hlwb thiab lub ntsws.

Hauv kev kho mob ntshav ntshav, kua dej qabzib ua kua ntau dhau 20-25% tsis siv.

Nrog ceeb toom, nyob rau hauv kev tswj hwm ntawm qib qabzib, cov tshuaj yog tawm ntawm lub keeb kwm ntawm decompensated mob plawv tsis ua hauj lwm, hyponatremia thiab ntshav qab zib mellitus.

Cov kua nplaum kua tshuaj thaum cev xeeb tub yog siv nyob rau hauv kev saib xyuas ntawm tus kws kho mob hauv tsev kho mob.

Dosing Glucose thiab ntau npaum li cas

Cov kua nplaum rau cov neeg laus yog tswj xyuas qhov quav:

• Cov kua dej qab zib 5% - txog 2 litres ib hnub ntawm qhov nqi ntawm 7 ml ib feeb,
• 10% - txog 1 litre nrog ceev ntawm 3 ml ib feeb twg,
• 20% - 500 ml ntawm tus nqi ntawm 2 ml ib feeb twg,
• 40% - 250 ml ntawm tus nqi ntawm 1.5 ml ib feeb.

Raws li cov lus qhia, cov kua dej qab zib 5% thiab 10% tuaj yeem muab tshuaj kom tsawg.

Txhawm rau kom qhov siab tshaj qhov nqus ntawm qhov txhaj tshuaj loj ntawm cov tshuaj tiv thaiv (dextrose), nws raug nquahu kom siv cov tshuaj insulin nrog nws. Tawm tsam keeb kwm ntawm cov ntshav qab zib mellitus, txoj kev daws teeb meem yuav tsum tau tswj hwm los ntawm saib xyuas theem ntawm cov piam thaj hauv cov zis thiab ntshav.

Rau cov khoom noj khoom haus niam txiv, cov menyuam, nrog rau cov amino acids thiab cov rog yog muab cov kua nplaum ntawm 5% thiab 10% rau thawj hnub ntawm tus nqi ntawm 6 g ntawm dextrose rau 1 kg ntawm lub cev hnyav ib hnub. Hauv qhov no, qhov tso cai txhua hnub ntawm cov kua dej txhaj tshuaj yuav tsum raug tswj:

• Rau cov menyuam yaus hnyav li 2-10 kg - 100-160 ml ib 1 kg,
• Nrog rau qhov hnyav ntawm 10-40 kg - 50-100 ml ib 1 kg.

Thaum kho, nws yog qhov yuav tsum tau saib xyuas tas li ntawm cov piam thaj.

Sab Cawv Los Ntawm Cov Khaub Nplaws

Raws li txoj cai, kua nplaum ua kua tsis feem ntau ua phiv. Txawm li cas los xij, tiv thaiv keeb kwm ntawm qee yam kab mob, kev siv tshuaj kho mob tuaj yeem ua rau mob laug ntawm lub cev tsis ua hauj lwm thiab hypervolemia.

Muaj qee kis, thaum thov kev daws, kev cuam tshuam ntawm thaj chaw yuav tshwm sim ntawm qhov chaw txhaj tshuaj rau hauv daim ntawv ntawm thrombophlebitis thiab kev txhim kho kev kis mob.

Nrog kev noj tshuaj ntau dhau ntawm Cov Qab Zib, cov tsos mob hauv qab no yuav tshwm sim:

• Ua txhaum ntawm cov dej-electrolyte tshuav,
• Glucosuria
• Qog Ntshav,
• Tshaj dhau
• Qaug zog hyperosmolar coma,
• Txhim kho liponeogenesis nrog ntau dua CO2 ntau lawm.

Nrog rau kev txhim kho ntawm cov tsos mob zoo li no, tej zaum yuav muaj qhov nce siab hauv cov feeb ua pa thiab lub siab rog, uas xav kom thim tawm ntawm cov tshuaj noj thiab kev qhia ntawm cov tshuaj insulin.

Dosage daim ntawv

Txhaj tshuaj 40%, 10 ml thiab 20 ml

1 ml ntawm kev daws

yam tshuaj: qabzib monohydrate 0.4 g thaum hais txog anhydrous qab zib

tus zam: 0.1 M hydrochloric acid, sodium chloride, dej rau kev txhaj tshuaj

Pob tshab, tsis muaj kob los sis kua daj

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Tom qab kev tswj hwm ntshav qab zib, cov piam thaj nrog ntshav ntws nkag mus rau cov kabmob thiab cov ntaub so ntswg, qhov twg nws tau suav nrog hauv cov txheej txheem hauv metabolic. Glucose khw muag khoom nyob rau hauv lub hlwb ntawm ntau cov ntaub so ntswg hauv daim ntawv ntawm glycogen. Nkag mus rau txheej txheem ntawm glycolysis, qabzib yog metabolized rau pyruvate lossis lactate, nyob rau hauv aerobic tej yam kev mob, pyruvate kiag li metabolized rau carbon dioxide thiab dej nrog kev tsim lub zog hauv daim ntawv ntawm ATP. Cov khoom kawg ntawm kev ua tiav oxidation ntawm cov piam thaj yog zais cov ntsws thiab lub raum.

Cov Tshuaj Hauv Tshuaj

Cov kua nplaum muab lub zog ntxiv rov ua kom zoo rau lub zog siv. Nrog kev qhia txog hypertonic cov kev daws teeb meem rau hauv cov hlab ntsha, intravascular osmotic siab nce, kua dej nkag los ntawm cov ntaub so ntswg mus rau cov ntshav nce ntxiv, cov txheej txheem metabolic nrawm dua, daim siab antitoxic muaj nuj nqi txhim kho, mob nqaij daim ntawv cog lus cog lus nce, diuresis nce. Nrog kev qhia txog hypertonic glucose tov, redox kev ua kom zoo dua qub, thiab glycogen deposition nyob rau hauv daim siab ua haujlwm.

Cov tshuaj sib cuam tshuam

Cov kua nplaum 40% yuav tsum tsis txhob siv nyob rau hauv tib lub koob tshuaj nrog hexamethylenetetramine, vim tias cov piam thaj yog ib qho muaj zog oxidizing tus neeg sawv cev. Nws tsis pom zoo kom sib xyaw daws teeb meem alkaline hauv tib lub koob txhaj: nrog kev ua kom loog thiab hypnotics, vim tias lawv cov kev ua ub no tsawg zuj zus, cov kev daws teeb meem alkaloids, inactivates streptomycin, txo cov txiaj ntsig ntawm nystatin.

Raws li kev cuam tshuam ntawm thiazide diuretics thiab furosemide, kev ua kom lub ntsej muag txo qis. Cov tshuaj Insulin txhawb nqa cov khoom noj ntawm cov piam thaj mus rau hauv cov ntaub so ntswg peripheral, txhawb kev tsim cov glycogen, kev sib txuas ntawm cov nqaijrog thiab fatty acids. Cov kua nplaum ua kom txo cov tshuaj lom los ntawm pyrazinamide ntawm daim siab. Kev qhia ntawm lub ntim loj ntawm cov kua nplaum ua rau muaj kev txhim kho hypokalemia, uas ua rau kom lub cev tsis muaj zog ntau ntawm kev siv digitalis npaj txhij.

Cov lus qhia tshwj xeeb

Cov tshuaj yuav tsum tau siv nyob rau hauv kev tswj hwm ntawm cov ntshav qab zib thiab qib electrolyte.

Cov tshuaj yuav tsum tsis txhob siv ib txhij nrog cov ntshav cov khoom lag luam.

Nws tsis pom zoo kom sau cov piam thaj hauv kev daws teeb meem thaum lub sij hawm mob hnyav ntawm lub hlwb raug mob, yog tias muaj kev mob hlwb, vim tias qhov tshuaj muaj peev xwm nce ntxiv kev puas tsuaj rau cov qauv hauv lub hlwb thiab ua rau muaj kev puas tsuaj rau tus kab mob (tshwj tsis yog nyob rau hauv kev kho ntawm hypoglycemia).

Nrog hypokalemia, cov lus qhia ntawm cov dej qab zib yuav tsum tau ua ke nrog kev kho ntawm cov poov tshuaj tsis muaj zog (vim tias qhov txaus ntshai ntawm nce hypokalemia).

Rau cov ntshav qabzib zoo dua nyob hauv normoglycemic tej yam kev mob, nws raug nquahu kom muab kev tswj hwm tshuaj ntawm cov tshuaj nrog kev tswj hwm ntawm (subcutaneous) luv luv ua yeeb yam insulin ntawm tus nqi ntawm 1 pawg rau 4-5 g ntawm qabzib (teeb meem qhuav).

Tsis txhob siv cov tshuaj subcutaneously thiab intramuscularly.

Cov ntsiab lus ntawm ampoule tuaj yeem siv rau ib tus neeg mob nkaus xwb, tom qab ua txhaum ntawm lub ceev ntawm ampoule, txoj kev daws teeb meem tsis siv yuav tsum tau muab pov tseg.

Nrog lub raum tsis ua haujlwm, decompensated lub plawv tsis ua haujlwm, hyponatremia tshwj xeeb kev zov me nyuam yog xav tau, saib xyuas ntawm central hemodynamics.

Siv thaum cev xeeb tub lossis lactation

Cov kua nplaum pleev rau cov poj niam cev xeeb tub uas muaj kab mob normoglycemia tuaj yeem ua rau me nyuam hauv plab hyperglycemia thiab ua rau cov kab mob metabolic acidosis. Qhov tom kawg yog qhov tseem ceeb rau kev txiav txim siab, tshwj xeeb tshaj yog thaum menyuam mob ntxhov siab lossis hypoxia twb yog vim muaj lwm yam cuam tshuam.

Kev Siv Khomob

Cov tshuaj no yog siv rau cov menyuam yaus tsuas yog kho thiab tswj hwm los ntawm tus kws kho mob.

Cov yam ntxwv ntawm cov nyhuv ntawm cov tshuaj rau ntawm lub peev xwm tsav tsheb lossis cov phom sij phom sij

Noj ntau dhau

Cov tsos mob: hyperglycemia, glucosuria, nce ntshav osmotic (nce mus rau kev loj hlob ntawm hyperglycemic coma), hyperhydration thiab electrolyte tsis txaus.

Kev Kho Mob: cov tshuaj raug tshem tawm thiab cov tshuaj insulin nyob ntawm tus nqi ntawm 1 chav rau txhua txhua 0.45-0.9 mmol ntawm cov ntshav qabzib kom txog thaum muaj ntshav ntau ntawm cov ntshav 9 mmol / l. Cov piam thaj hauv ntshav yuav tsum tau qis qis dua. Ib txhij nrog kev teem sij hawm ntawm insulin, Txoj kev lis ntshav ntawm txoj kev daws teeb meem ntsev yog nqa tawm.

Yog tias tsim nyog, kev kho mob cov tsos mob raug kho.

Daim ntawv tso tawm thiab ntim khoom

10 ml lossis 20 ml hauv khob ampoules nrog lub nplhaib tawg lossis lub taw tes tawg. 5 lossis 10 ampoules ua ke nrog cov lus qhia rau kev siv kho mob hauv lub xeev thiab Lavxias lus yog muab tso rau hauv pob ntawv nrog cov ntawv kho mob corrugated cardboard.

Los yog 5 ampoules tau muab tso rau hauv cov hlwv qhwv cov hlua ntim los ntawm cov ntaub ntawv polymer. Rau 1 lossis 2 blister sawb ntim nrog ampoules, ua ke nrog cov lus qhia rau kev siv kho mob hauv lub xeev thiab Lavxias lus, muab tso rau hauv pob ntawv los qhia.

Daim Ntawv Tso Npe Sau Npe

Pej Xeem Koom Nrog Kev Lag Luam Lub Tuam Txhab Farmak, Ukraine

Lub koom haum chaw nyobtswv hauvKoom pheej ntawm Kazakhstanthov nyiaj los ntawm cov neeg siv khoom ntawm cov khoom lag luam zoo (cov khoom lag luam)

Koom pheej ntawm Kazakhstan, 050009 Almaty, ul. Abay 157, chaw ua haujlwm 5

Kev Sib Sau thiab daim ntawv ntawm kev tso tawm

Ib puas millilitres ntawm 40% kev daws rau kev txhaj tshuaj muaj plaub caug grams qabzib. Ib puas milliliters ntawm 5% daws muaj tsib milligrams ntawm cov tshuaj nquag. Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm 40% kev daws teeb meem rau Txoj kev lis ntshav hauv cov iav fwj uas muaj peev xwm ntawm 100, 200, 250, 400 thiab 500 ml. Lawv tau ntim rau hauv thawv ntawv thawv, qhov twg muaj kev qhia rau kev siv tshuaj. Tsis tas li, cov khoom muaj nyob hauv hnab yas.

40% ntawm cov tshuaj muaj nyob hauv ampoules ntawm kaum thiab nees nkaum milliliters, uas tau ntim rau hauv lub thawv ntawv thawv. Ib lub thawv twg muaj kaum lub ampoules rau kev tswj hwm txoj leeg. Muaj kuj yog kev qhia rau kev siv tshuaj.

Cov lus qhia rau kev siv cov kua nplaum nyob hauv ampoules

Cov kua dej qabzib yog qhov ua kom yooj yim zom tau cov carbohydrates. Cov tshuaj muaj peev xwm them rau ib feem ntawm cov nqi zog thiab txhim kho cov txheej txheem redox hauv lub cev. Cov tshuaj nquag ua haujlwm ntawm cov tshuaj tsis raug tshem tawm los ntawm lub raum thiab yog nqus los ntawm lub cev. Ua ntej siv cov tshuaj, nws raug nquahu kom koj nyeem cov lus piav qhia nyob rau ntawd thiab sab laj nrog tus kws tshaj lij.

Kev taw qhia thiab contraindications

Tus lej piav txog lub ntsiab tseem ceeb thiab kev txwv rau kev noj tshuaj. Qhov taw qhia tseem ceeb rau kev siv tshuaj tiv thaiv yog hypoglycemia. Contraindications suav nrog cov xwm txheej hauv qab no:

• hypersensitivity rau lub active khoom sib ua zaub mov,
• cawv delirium thiab lub cev qhuav dej kom txaus,
• Kev Mob Nkeeg
• lub ntsws thiab lub hlwb edema,
• mob laug laug ventricular tsis ua hauj lwm,
• subarachnoid thiab intracranial hemorrhage nyob rau hauv txha caj qaum,
• mob ntshav qab zib mellitus
• hyperosmolar coma,
• hyperlactacidemia,
• piam thaj-galactose malabsorption.

Nrog hyponatremia, decompensated lub plawv tsis ua haujlwm, thiab lub raum tsis ua haujlwm, cov tshuaj yuav tsum siv nrog ceev faj.

Analogs ntawm kev txhais tau tias

Cov tshuaj muaj hloov pauv. Nws cov neeg nyiam tshaj plaws yog Glucosteril. Cov tshuaj no tau sau tseg rau cov khoom noj tsis haum lub cev thiab rau lub cev qhuav dej.

Cov tshuaj nquag ntawm Glucosteril ua rau txhim kho cov tshuaj tiv thaiv kab mob siab thiab ua kom lub siab ua kom rov zoo li qub thiab oxidation. Txoj kev kho mob pab txhawb qhov ua kom dej tsis txaus. Kev nkag mus rau hauv cov ntaub so ntswg, qhov kev hloov pauv yog phosphorylated thiab hloov pauv mus rau cov piam thaj-6-phosphate. Hauv cov txheej txheem ntawm cov metabolism, lub zog txaus tsim, uas xav tau los xyuas kom meej qhov kev ua haujlwm ntawm lub cev. Hypertonic tov dilates cov hlab ntsha, nce diuresis thiab myocardial contractility, nce osmotic siab ntawm cov ntshav.

Txhawm rau nqus thiab ua kom tiav ntawm cov tshuaj nquag, 1 UNIT ntawm cov tshuaj insulin rau ib 4 ml ntawm cov tshuaj tau muab tshuaj. Thaum ua ke nrog lwm cov tshuaj, Nws raug nquahu kom kuaj xyuas lub ntsej muag kom haum. Rau cov niam txiv kev noj haus hauv lub hnub nyoog menyuam yaus, hauv thawj hnub ntawm kev kho, 6 ml ntawm cov tshuaj rau 1 kg ntawm lub cev hnyav yuav tsum tau muab tshuaj. Raws li kev saib xyuas ntawm tus kws tshaj lij, cov tshuaj siv rau anuria thiab oliguria.

Kev hloov tus kheej ntawm cov kua nplaum tov nrog lwm yam tshuaj yog txwv. Kev sab laj ntawm cov kws kho mob xav tau.

Kev Ntsuam Xyuas Rau Neeg Mob

Cov cuab yeej tseem ceeb rau kuv yog qabzib hauv ampoules. Cov lus qhia rau kev siv muaj tag nrho cov ntaub ntawv tsim nyog txog cov nyhuv ntawm cov tshuaj. Koj tuaj yeem yuav nws hauv ampoules thiab iav fwj rau cov tee dej. Nws zoo heev pab tswj lub xeev ntawm lub cev hauv lub sijhawm postoperative. Cov tshuaj yog qhov tseem ceeb heev, nws tau raug tshaj tawm rau ua rau muaj kev poob siab, qhov txo qis hauv cov ntshav siab thiab cov kab mob sib kis.

Hauv cov tshuaj acetone syndrome, tus tub tau muab tshuaj rau isotonic piam thaj ntawm 5%. Cov lus qhia tau qhia lub ntsiab contraindications thiab cim kev siv ntawm cov tshuaj, nrog rau kev phiv uas yuav tshwm sim. Txog hnub thib 2 ntawm kev kho mob, qhov pom tshwm sim zoo pom tau. Txhawm rau kom zam kev txhim kho kev phiv tshuaj, kuv qhia koj kom tswj cov tshuaj tsuas yog nyob hauv kev saib xyuas ntawm tus kws tshaj lij. Txoj kev daws teeb meem tau mus yuav hauv lub tsev muag tshuaj yam tsis tau tshuaj.

Kev daws teeb meem ntshav qab zib 5% yog qhov pheej ywg thiab qhov tseeb. Nws raug txhaj nrog dej txhaws. Cov tshuaj muaj peev xwm yuav tau ntawm tus nqi txaus nyiam ntawm txhua lub tsev muag tshuaj. Lub thawv muaj cov ntawv qhia ntxaws ntxaws. Nws muaj cov lus piav qhia ntawm cov tshuaj nquag thiab yuav ua li cas nws yuav tsum siv kom raug. Kuv xav kom koj ua tib zoo kawm cov lus qhia rau cov piam thaj. Muaj ntau cov txiaj ntsig los ntawm kev txhaj tshuaj, tab sis qhov tseeb tsis muaj qhov tshwm sim tsis zoo tshwm sim.

Sab sij huam

Cov koob tshuaj txhaj suab thaj ua rau cov ntshav khov ua rau lub cev tsis haum ntawm lub ion balance lossis hyperglycemia. Kuj tseem muaj teeb meem tshwm sim los ntawm cov hlab plawv system, uas tau pom los ntawm hypervolemia, mob laug ntawm ventricular tsis ua haujlwm. Muaj qee zaus, kub ib ce yuav pib mob. Ntawm qhov chaw txhaj tshuaj, voos, kev txhim kho ntawm kev sib kis mob hnyav thiab mob thrombophlebitis yog ua tau.

Kev cuam tshuam nrog lwm yam tshuaj

Nrog rau kev siv ua ke ntawm cov kua nplaum nrog furasemide thiab thiazide diuretics, nws yuav tsum tau nyob rau hauv lub siab tias lawv muaj peev xwm cuam tshuam rau theem ntawm no carbohydrate hauv cov ntshav cov ntshav.

Cov tshuaj insulin pab cov piam thaj sai sai rau hauv cov ntaub so ntswg. Nws kuj txhawb qhov ua tiav ntawm glycogen, kev sib txuas ntawm cov rog thiab cov nqaijrog. Cov kua qabzib ua rau txo cov tshuaj phiv hauv pyrazinamide ua rau lub siab. Nrog kev qhia ntawm ntau cov tshuaj, hypokalemia tuaj yeem txhim kho (txo qis hauv theem ntawm cov poov tshuaj hauv ntshav cov ntshav), thiab qhov no nce rau kev muaj tshuaj lom ntawm digitalis npaj yog tias lawv siv ua ke nrog cov piam thaj.

Muaj pov thawj ntawm kev tsis sib haum ntawm cov tshuaj no nrog cov tshuaj xws li aminophylline, soluble barbiturates, erythromycin, hydrocortisone, kanamycin, soluble sulfanilamide tshuaj thiab cyanocobalamin.

Yog tias muaj kev noj ntau dhau, kev kho mob ntawm tus neeg mob yuav tsum tau nqa tawm, qib ntawm cov piam thaj hauv cov ntshav yuav tsum txiav txim siab thiab cov tshuaj insulin yuav tsum raug siv rau hauv cov tshuaj uas tsim nyog.

Piam thaj rau yog dab tsi?

Glucose hauv lub cev yog qhov kev ua kom muaj zog. Feem ntau, cov kws kho mob siv cov piam thaj hauv kev kho qee yam kab mob siab. Tsis tas li, cov kws kho mob feem ntau hno cov piam thaj rau hauv tib neeg lub cev thaum lom. Nkag nws los ntawm cov dav hlau los yog nrog lub dauv.

Cov kua nplaum kuj tseem siv rau kev pub menyuam yaus, yog tias vim qee yam lawv tsis haus khoom noj. Cov kua nplaum tuaj yeem ntxuav lub siab ntawm co toxins thiab co toxins. Nws rov qab ua kom lub siab ua haujlwm poob thiab ua kom cov metabolism hauv lub cev ceev ceev.

Nrog kev pab ntawm cov piam thaj, cov neeg ua haujlwm kho mob tshem tawm ib yam kev qaug dab tsi. Thaum lub zog ntxiv nkag mus rau hauv lub cev, cov ntaub so ntswg thiab cov nruab nrog cev pib ua haujlwm ntau dua. Cov kua nplaum muab cov roj ua kom rog hauv lub cev.

Nws yog qhov tsim nyog tiag tiag los tswj tus nqi ntawm cov piam thaj hauv tib neeg lub cev. Qhov tsis muaj lossis ntau dhau ntawm cov tshuaj no qhia tias muaj qee yam kabmob hauv ib tus neeg. Cov piam thaj hauv lub siab yog tswj hwm los ntawm cov kab mob endocrine, thiab cov tshuaj hormone insulin tswj hwm.

Cov piam thaj nyob qhov twg?

Koj tuaj yeem ntsib cov ntshav qabzib nyob rau hauv cov txiv hmab thiab lwm hom txiv hmab txiv ntoo thiab txiv hmab txiv ntoo. Piam thaj yog ib hom suab thaj. Xyoo 1802, W. Praut nrhiav pom cov piam thaj. Kev lag luam koom nrog hauv kev tsim cov kua nplaum. Lawv tau txais nws nrog kev pab los ntawm cov hmoov txhuv nplej siab ua.

Hauv cov txheej txheem ntuj, qabzib tshwm thaum lub sijhawm photosynthesis. Tsis muaj ib qho kev tawm tsam hauv lub cev tshwm sim yam tsis muaj kev koom tes hauv qabzib. Rau lub hlwb hlwb, qabzib yog ib qho ntawm cov as-ham tseem ceeb.

Cov kws kho mob tuaj yeem sau ntawv tawm suab thaj nyob rau ntau yam. Ntau zaus, cov piam thaj pib noj nrog hypoglycemia - tsis muaj cov piam thaj hauv lub cev. Noj tsis zoo tej zaum yuav cuam tshuam rau qib qabzib hauv lub cev. Piv txwv li, thaum ib tug neeg nyiam noj zaub mov muaj protein ntau - thiab lub cev tsis muaj khoom noj khoom noj (carbohydrates) (txiv hmab txiv ntoo, cereals).

Thaum lub sij hawm lom, nws yog ib qho tsim nyog yuav rov ua kom lub siab ua haujlwm ntawm daim siab. Kev siv cov kua nplaum nyob hauv tsev kuj pab tau rau ntawm no. Nrog rau cov kab mob siab, qabzib tuaj yeem rov qab ua haujlwm ntawm nws lub hlwb.

Nrog raws plab, ntuav, los ntshav, ib tus neeg tuaj yeem ua kua ntau. Siv cov piam thaj, nws qib yog rov qab.

Nrog poob siab los yog tsaus muag - qhov txo qis hauv cov ntshav siab - tus kws kho mob kuj tseem tuaj yeem sau ntawv ntxiv rau cov piam thaj ntxiv.

Cov kua nplaum kuj tseem siv rau kev noj zaub mov rau menyuam yaus, yog tias vim qee tus neeg tsis tuaj yeem noj cov zaub mov zoo li qub. Qee zaum cov piam thaj tov ntxiv rau tshuaj.

Nrog kev tswj hwm subcutaneous, phiv yuav tshwm sim hauv daim ntawv ntawm cov nqaij mos necrosis. Thiab los ntawm kev qhia sai sai ntawm cov dej qabzib tov rau hauv cov hlab ntsha, phlebitis tuaj yeem pib. Yog li, tsis txhob noj tshuaj rau tus kheej, tshwj xeeb yog tias koj tsis nkag siab dab tsi txog qhov no. Tso koj cov kev noj qab haus huv rau cov kws kho mob.

Cov kua nplaum nyob rau hauv cov ntshav qab zib, tab sis qee kis nws raug muab nrog tshuaj insulin tshwj xeeb hauv tsev kho mob.

Muab thiab kev coj:

Cov kua nplaum daws 40% yog muab rau cov leeg ntshav (qeeb heev), rau cov neeg laus - 20-40-50 ml ib zaug tswj hwm. Yog tias tsim nyog, txia yog muab rau ntawm tus nqi ntawm li 30 tee / min (1.5 ml / kg / h). Qhov muab tshuaj rau cov neeg laus nrog cov kua dej nrog yog nrog txog 300 ml ib hnub. Qhov siab tshaj plaws txhua hnub rau cov neeg laus yog 15 ml / kg, tab sis tsis ntau tshaj 1000 ml ib hnub.

Daim Ntawv Thov Nta:

Siv thaum cev xeeb tub lossis lactation

Cov kua nplaum (infusions) rau cov poj niam cev xeeb tub uas muaj tus mob normoglycemia tuaj yeem ua rau tus me nyuam hauv plab tau ua rau nws. Qhov tom kawg yog qhov tseem ceeb uas yuav tau txiav txim siab, tshwj xeeb tshaj yog thaum menyuam muaj kev ntxhov siab lossis twb yog vim muaj lwm yam cuam tshuam.

Cov tshuaj no yog siv rau cov menyuam yaus tsuas yog kho thiab tswj hwm los ntawm tus kws kho mob.

Cov tshuaj yuav tsum tau siv nyob rau hauv kev tswj hwm ntawm cov ntshav qab zib thiab qib electrolyte.

Nws tsis pom zoo kom sau ntawv tsis muaj qabzib rau hauv lub sijhawm mob hnyav, nrog rau kev cuam tshuam tsis zoo ntawm cov hlab hlwb, vim tias qhov tshuaj muaj peev xwm nce kev puas tsuaj rau lub hlwb cov qauv thiab cuam tshuam cov chav kawm ntawm tus kabmob (tshwj tsis yog kis ntawm kev kho).

Rau qhov zoo dua ntawm cov piam thaj hauv kev kho mob hauv normoglycemic, nws raug nquahu kom sib txuas kev qhia ntawm cov tshuaj nrog kev tswj hwm ntawm (subcutaneous) luv luv ua yeeb yam insulin ntawm tus nqi ntawm 1 pawg rau 4-5 g ntawm qabzib (teeb meem qhuav). Polyuria, glucosuria,

lub plab zom mov tsis zoo:,,

cov kev tawm tsam ntawm lub cev: hypervolemia, kev tsis haum tshuaj (ua npaws, tawm pob ntawm daim tawv nqaij, mob caj dab, poob siab).

Thaum muaj qhov tshwm sim tsis zoo, kev tswj hwm ntawm txoj kev daws teeb meem yuav tsum tau tsum txiav, kev ntsuam xyuas tus neeg mob, thiab kev pabcuam.

Kev cuam tshuam nrog lwm cov tshuaj:

Cov kua nplaum 40% yuav tsum tsis txhob siv nyob rau hauv tib lub koob txhaj nrog hexamethylenetetramine, vim tias cov piam thaj yog ib qho muaj zog oxidizing tus neeg sawv cev. Nws tsis pom zoo kom sib xyaw daws teeb meem alkaline hauv tib lub koob txhaj: nrog kev ua kom loog thiab hypnotics, vim tias lawv cov kev ua ub no tsawg zuj zus, cov kev daws teeb meem alkaloids, inactivates streptomycin, txo cov txiaj ntsig ntawm nystatin.

Raws li kev cuam tshuam ntawm thiazide diuretics thiab furosemide, kev ua kom lub ntsej muag txo qis. Cov tshuaj Insulin txhawb nqa cov khoom noj ntawm cov piam thaj mus rau hauv cov ntaub so ntswg peripheral, txhawb kev tsim cov glycogen, kev sib txuas ntawm cov nqaijrog thiab fatty acids. Cov kua nplaum ua kom txo cov tshuaj lom los ntawm pyrazinamide ntawm daim siab. Kev qhia ntawm lub ntim loj ntawm cov kua nplaum ua rau muaj kev txhim kho hypokalemia, uas ua rau kom lub cev tsis muaj zog ntau ntawm kev siv digitalis npaj txhij.

Cov Tshuaj Tiv Thaiv:

Cov kua dej qab zib ntawm 40% yog sib kis rau cov neeg mob nrog: mob ntshav txha ntshav thiab mob ntshav nrog, tsuas yog muaj cov kev mob uas cuam tshuam nrog hypoglycemia, lub cev tsis muaj dej tsis txaus, suav nrog cawv, mob ntshav qab zib rau cov feem ntawm cov tshuaj, anuria, mob ntshav qab zib mellitus thiab lwm yam mob uas muaj los ntawm hyperglycemia, ntshav qabzib galacto malabsorption mob. Cov tshuaj yuav tsum tsis txhob siv ib txhij nrog cov ntshav cov khoom lag luam.

Cov sijhawm so:

10 ml lossis 20 ml ib ampoule. 5 lossis 10 ampoules hauv ib pob. 5 ampoules hauv lub hlwv, 1 lossis 2 hlwv hauv ib pob.

Peb teb cov lus nug: tab sis tseem, vim li cas peb thiaj li yuav tsum muaj kua nplaum? Nws koom nrog cov txheej txheem dab tsi? Nws tau txais txiaj ntsig zoo li cas, muaj kev kub ntxhov, thiab muaj xwm txheej dab tsi tshwm sim? Thaum twg Kuv tuaj yeem noj cov tshuaj noj, hmoov, dej qab zib nrog kua nplaum?

Cov yam ntxwv ntawm cov khoom ua ke, muaj txiaj ntsig zoo thiab muaj teeb meem

Glucose tsis yog cov tshuaj tawm hauv lub cev rau qee lub sijhawm ntawm cov khoom siv tshuaj lom neeg (Mendeleev lub rooj), txawm li cas los xij, ib tus tub ntxhais kawm yuav tsum muaj tsawg kawg lub tswv yim hais txog qhov no, vim hais tias tib neeg lub cev xav tau tiag tiag. Los ntawm chav kawm ntawm kev qhia txog tshuaj lom neeg organic nws tau paub tias ib qho tshuaj muaj 6 pob atoms, sib cuam tshuam nrog kev koom tes ntawm covalent bonds. Ntxiv rau cov pa roj carbon, nws muaj hydrogen thiab oxygen atoms. Tus qauv ntawm cov compound yog C 6 H 12 O 6.

Glucose hauv lub cev yog nyob rau hauv tag nrho cov ntaub so ntswg, kabmob nrog cov kev zam tsis tshua muaj. Vim li cas thiaj yuav tsum muaj cov kua nplaum ntev yog tias nws nyob hauv cov xov xwm lom neeg? Firstly, 6-atom cawv no yog lub zog tshaj plaws nyob rau hauv txheej hauv neeg lub cev. Thaum zom tau, cov piam thaj nrog kev koom tes ntawm cov txheej txheem enzymatic tso tawm ib qho nyiaj ntau ntawm lub zog - 10 lwg me me ntawm adenosine triphosphate (lub hauv paus tseem ceeb ntawm lub zog cia) los ntawm 1 carbohydrate molecule. Ntawd yog, qhov kev sib txuas no ua rau lub zog tseem ceeb hauv peb lub cev. Tab sis hais tias tsis yog txhua yam piam thaj yog qhov zoo rau.

Nrog 6 H 12 Txog 6 mus rau kev tsim kho ntawm ntau lub tsev txawb. Yog li, cov piam thaj hauv lub cev ua rau cov cuab yeej siv tshuaj (glycoproteins). Tsis tas li ntawd, cov piam thaj hauv nws cov ntau dhau zuj zus hauv daim ntawv ntawm glycogen hauv lub siab thiab noj tau raws li qhov tsim nyog. Cov compound no zoo siv thaum muaj tshuaj lom. Nws khi cov tshuaj lom, dilutes lawv cov concentration hauv cov ntshav thiab lwm yam kua, ua rau lawv txoj kev tshem tawm (tshem tawm) los ntawm lub cev kom sai li sai tau, yog qhov tseem ceeb uas ua rau detoxifier.

Tab sis cov carbohydrate no tsis tsuas yog muaj txiaj ntsig, tab sis kuj muaj kev phom sij, uas ua kom muaj kev ceev faj ntawm nws cov ntsiab lus hauv cov xov xwm lom - hauv cov ntshav, zis. Tom qab tag nrho, nyob hauv lub cev nyob hauv lub cev, yog tias nws cov concentration ntau dhau, ua rau cov piam thaj piam thaj. Cov theem tom ntej yog ntshav qab zib. Glucose toxicity tshwm sim hauv qhov tseeb tias cov protein hauv peb cov tib neeg cov ntaub so ntswg nkag mus rau hauv cov tshuaj lom neeg cov tshuaj tiv thaiv nrog kev sib txuas. Txawm li cas los xij, lawv txoj haujlwm ploj. Ib qho piv txwv zoo nkauj ntawm qhov no yog hemoglobin. Hauv cov ntshav qab zib mellitus, qee qhov nws dhau los ua glycated, ntsig txog, qhov no ib feem ntawm hemoglobin tsis ua nws txoj haujlwm tseem ceeb. Tib yam rau lub qhov muag - glycosylation ntawm protein qauv ntawm lub qhov muag ua rau cataracts thiab retinal dystrophy. Thaum kawg, cov txheej txheem no tuaj yeem ua rau dig muag.

Cov zaub mov hauv cov ntau uas muaj cov khoom siv dag zog no

Khoom noj muaj ntau yam. Nws tsis pub leejtwg paub tias cov hws cov khoom noj qab zib, cov piam thaj ntau ntxiv muaj. Yog li ntawd, khoom qab zib (ib qho), qab zib (tshwj xeeb yog dawb), zib ntab txhua yam, nplej zom ua los ntawm cov hom nplej muag, feem ntau cov khoom tsis sib haum nrog ntau cov qab zib thiab qab zib yog cov zaub mov qabzib, uas cov piam thaj nyob hauv ntau qhov ntau.

Raws li rau txiv hmab txiv ntoo, berries, muaj qhov tsis to taub tias cov khoom no yog cov nplua nuj nyob hauv kev sib tov piav qhia los ntawm peb. Nws yog kev nkag siab, yuav luag txhua cov txiv ntoo yog qhov qab zib hauv qab saj. Yog li ntawd, nws zoo nkaus li cov ntsiab lus qabzib kuj tseem muaj. Tab sis cov khoom qab zib ntawm cov txiv hmab txiv ntoo ua rau lwm cov carbohydrate - fructose, uas txo qhov feem pua ​​ntawm cov piam thaj. Yog li, kev siv ntau ntawm cov txiv hmab txiv ntoo tsis txaus ntshai rau cov neeg mob ntshav qab zib.

Cov khoom muaj cov piam thaj rau cov ntshav qab zib yuav tsum tau tshwj xeeb. Koj yuav tsum tsis txhob ntshai thiab zam rau lawv siv. Tom qab txhua tus, txawm tias tus neeg mob ntshav qab zib yuav tsum tau haus ib qho txiaj ntsig ntawm cov khoom noj no (cov piam thaj txhua hnub yog tus kheej rau txhua tus thiab nyob ntawm lub cev qhov hnyav, ntawm nruab nrab - 182 g ib hnub). Nws yog txaus los them sai sai rau glycemic Performance index thiab glycemic load.

Cov nplej nplej (tshwj xeeb yog cov txhuv nplej dawb-lis), pob kws, hlaws barley, cov khoom lag luam ua rau cov hmoov txhuv nplej (los ntawm cov nplej hom mos) yog cov khoom muaj cov kua nplaum nyob hauv nruab nrab. Lawv muaj glycemic Performance index ntawm nruab nrab thiab theem siab (ntawm 55 txog 100). Lawv siv hauv cov khoom noj rau cov mob txhab ntshav qab zib yuav tsum tau txwv.

Noj tshuaj rau ntshav qab zib: nws puas tuaj yeem ua tau lossis tsis yog?

Mob ntshav qab zib mellitus yog ib qho kev mob ntsws ntev uas tshwm sim nrog kev cuam tshuam ntawm txhua hom metabolism, tab sis rau feem ntau cuam tshuam cov metabolism hauv carbohydrates, uas nrog cov ntsiab lus ntxiv ntawm cov piam thaj hauv cov ntshav, zis (hyperglycemia, glucosuria). Yog li ntawd, muaj ntshav qab zib, twb muaj ntau ntawm cov tshuaj no lawm, thiab nws cov ntau dhau los ua rau cov piam thaj hauv tshuaj lom, raws li tau hais los saum no. Ntawm cov ntshav qab zib, dhau li ntawm cov piam thaj hloov kho cov lipids, cov roj cholesterol, nce nws feem "tsis zoo" feem ntau (muaj cov roj "phem" ntau, qhov no yog qhov txaus ntshai rau kev loj hlob ntawm atherosclerosis). Nws yog txaus ntshai thiab qhov kev tsis txaus siab rau lub qhov muag.

Taw! Nws yog ib qho tseem ceeb kom paub tias cov piam thaj siv hauv cov ntsiav tshuaj, hmoov lossis hauv cov qauv ntawm cov ntshav mob ntshav qab zib tsuas yog hauv cov xwm txheej tshwj xeeb (muaj qee yam qhia tau). Nws yog nruj me ntsis contraindicated coj lawv koj tus kheej!

Kev siv cov piam thaj hauv ntshav qab zib tsuas yog tsim nyog nrog txoj kev loj hlob ntawm lub qog ntshav qab zib - qhov xwm txheej thaum nws qib poob hauv cov ntshav qis dua 2.0 mmol / L. Tus mob no yog qhov txaus ntshai rau kev loj hlob ntawm qhov tsis nco qab. Nws muaj nws cov tsos mob soj ntsuam:

• Ua fws hws
• Kev ntxhov siab thoob kuv lub cev
• Lub qhov ncauj qhuav
• Lub siab xav noj,
• Lub plawv dhia, txoj xov zoo li mem tes,
• Cov ntshav siab qis

Kev siv cov kua nplaum nyob hauv cov xwm txheej no tuaj yeem siv nrog cov khoom lag luam qhov muaj ntau ntawm nws (qab zib qab zib, qhob cij, zib ntab). Yog tias qhov xwm txheej mus dhau deb thiab qhov mob ntshav qab zib tsis zoo tshwm sim, thiab tom qab ntawd nws tsis xeev, ces cov tshuaj yuav tsum tau txhaj tshuaj (hauv ampoules nrog 40% tshuaj ntsiab lus). Nrog lub siab xav, koj tuaj yeem siv cov piam thaj hauv cov ntsiav tshuaj (hauv qab tus nplaig nws yog qhov zoo dua).

Kev siv cov kua nplaum hauv cov ntsiav tshuaj thiab hmoov

Cov piam thaj hauv cov ntsiav tshuaj feem ntau pom nyob rau hauv txhua qhov chaw kho mob ntshav qab zib, tshwj xeeb tshaj yog tias nws tau noj tshuaj isulin ntev ntev thiab muaj kev txhawj xeeb txog ntshav qab zib tsawg. Txog yuav ua li cas cov piam thaj ntsiav tshuaj tau siv rau hauv qhov kev txhim kho ntawm cov xwm txheej no tau piav qhia ntxov.

Cov tshuaj "Glucose" ntsiav tshuaj yuav pab kho cov kab mob hauv qab no:

1. Malnutrition (cachexia), tshwj xeeb tshaj yog nrog kev tsis txaus ntawm cov carbohydrate feem ntawm cov zaub mov,
2. Khoom noj khoom haus tshuaj lom neeg mob thiab lwm yam mob uas tshwm sim nrog ntuav, ua kom lub cev qhuav dej, kom dhau mus ua exicosis hauv menyuam yaus,
3. Kev siv tshuaj yeeb los yog lwm yam tshuaj muaj peev xwm ua rau lub siab puas.

Cov kua nplaum rau kev kho mob ntawm kev lom thiab lwm yam mob nrog rau poob dej ntau ntawm cov kua yog siv raws qhov hnyav ntawm ib tus neeg (qhov no yog qhov tshwj xeeb tshaj yog rau menyuam yaus). Ib qho ntxiv, hauv lub neej txhua hnub koj feem ntau yuav tsum cuam tshuam nrog kev lom. Cov kua nplaum nrog nws lub zog detoxifying yog siv tau zoo heev hauv cov xwm txheej no.

Cov ntsiav tshuaj qab zib muaj 0.5 g ntawm cov tshuaj nquag, thaum 1 pob hmoov muaj 1 g. Kev npaj hmoov yuav siv tau yooj yim thaum tseem yau, vim tias cov piam thaj hauv cov ntsiav tshuaj nws nyuaj rau nqos.

Cov kua nplaum ntau kawg ntawm cov tshuaj yog 0.5 g rau qhov ua rau lub qog ntshav (ntau kawg koob - txog 2.0 g), rau kev lom - 2 ntsiav tshuaj ib 1 liter ntawm kev daws. Thaum raug mob nrog tshuaj lom neeg mob hepatotropic, 2 ntsiav tshuaj yuav tsum noj txhua 3-4 teev.

Puas yog siv ncos?

Dab tsi ntxiv uas kuv tuaj yeem siv cov tshuaj no. Yog tias tsis muaj cov lus sib kis, ces siv rau hauv cov kua xa ntshav kom yog. Cov lus piav qhia txog cov tshuaj tso cai rau koj kom nkag siab txog qhov xwm txheej twg uas tau tso kua dej nrog kua qabzib.

1. Isotonic lub cev qhuav dej ntawm lub cev (lub cev qhuav dej),
2. Me nyuam nyiam hemorrhages thaum menyuam yaus (hemorrhagic diathesis),
3. Kev kho cov dej-electrolyte cuam tshuam nyob rau hauv kev tsis nco qab (hypoglycemic) raws li ib feem ntawm cov kev kho mob nyuaj lossis ua cov txheej txheem kev kho mob tseem ceeb ntawm prehospital theem ntawm kev saib xyuas,
4. Kev raug lom ntawm ib qho keeb kwm.

Txhawm rau kom nkag siab yuav ua li cas kom muaj kua nplaum nyob hauv qee kis, koj yuav tsum paub koj tus kheej nrog nws muaj pes tsawg leeg, kev qhia thiab contraindications. Cov lus qhia rau kev siv yuav muab cov lus teb rau cov lus nug no. Cov kua dej qab zib feem ntau siv rau cov neeg uas muaj cawv quav cawv lossis lwm yam ua rau lub siab ua rau lub siab puas. Vim li cas thiaj tsis muaj piam thaj hauv qhov no? Cov lus teb tau yooj yim. Nws txhawb zog lub zog cia, txij li lub siab nrog cov kab mob no tsis cuam tshuam cov haujlwm no.

Cov kua nplaum ampoules muaj 5 lossis 10 ml ntawm cov khoom sib xyaw. Lub cev kaw lus yuav tsum siv cov vials nrog cov khoom no.

Taw! Nws yog ib qho tseem ceeb kom nco ntsoov tias qhov cia ntawm ampoules thiab vials ntawm cov piam thaj yuav tsum tau nqa tawm hauv qhov chaw txias, zoo dua yog tsis muaj kev nkag mus rau cov menyuam yaus.

Thaum twg yog cov tshuaj contraindicated?

Kev siv yeeb tshuaj yam tsis tau sab laj nrog kws kho mob tuaj yeem ua rau muaj kev phom sij loj, vim tias cov piam thaj twg tsis yog cov tshuaj tsis haum. Cov kab mob sib kis yog dab tsi?

• Decompensated hom kawm ntawm hyperglycemia hauv hom 1 thiab hom 2 mob ntshav qab zib,
• Mob raum tsis ua hauj lwm
• Lub plawv tsis ua haujlwm (hawb pob, ntsws tawm),
• Mob stroke

Cov kab mob no yuav tsum tau txiav txim siab thaum kho mob tshuaj.

Tsev »Tshuaj» Tshuaj Txhaj hauv qab zib. Cov kua nplaum: cov lus qhia, tshuaj xyuas, cov khoom sib piv thiab cov nqi