Cov tsos mob thiab ua rau cov ntshav qog ntshav qab zib hauv ntshav qab zib

Hlwb hlwb xav tau kev pab ntawm cov piam thaj tas li yog khoom noj haus. Nrog nws tsis muaj peev xwm, ib tus neeg tuaj yeem plam nco qab thiab poob rau hauv lub cev ntog ntshav qab zib, yog tias koj tsis muab kev pabcuam thawj zaug.

Kev hypoglycemia yog dab tsi?

Hypoglycemia yog ib qho mob uas qhov txo qis ntshav hauv ntshav tshwm sim, tus lej rau ICD-10 yog 16.0. Tus mob no cuam tshuam rau cov neeg muaj ntshav qab zib. Hauv cov neeg noj qab nyob zoo, tus mob yuav tshwm sim yog los ntawm kev yoo mov thaum muaj xwm ceev.

Kev mob hypoglycemia yog ib qho mob uas cov ntshav qabzib tsawg tshwm sim.

Cov neeg mob ntshav qab zib siv cov tshuaj uas txo cov ntshav qab zib. Hauv qhov no, kev pheej hmoo ntawm hypoglycemia nce. Cov kev mob tshwm sim tas li ua rau lub cev ua rau tus neeg tsis mloog tus mob, pib siv tus mob no, thaum cov tshuaj insulin txo qis.

Nocturnal hypoglycemia hauv npau suav

Lub cev muaj peev xwm tiv thaiv nrog mob qog nocturnal hypocglycemia ntawm nws tus kheej, tab sis rau tus neeg muaj ntshav qab zib, tus mob no txaus ntshai. Nws yuav tsum muaj kev tiv thaiv los ntawm kev hloov kho cov tshuaj uas txo cov suab thaj.

Cov tsos mob ntawm nocturnal hypoglycemia:

• nce tawm hws, uas yog vim cov pajamas lossis cov ntawv ua ntub;
• npau suav phem, zoo nkaus li qaug zog thiab mob taub hau thaum sawv ntxov;
• muaj cov ketone lub cev thaum sawv ntxov tso zis muaj cov ntshav qabzib tsawg;
• Lub ntsej muag dhia hauv qabzib thaum sawv ntxov.

Qhov tseem ceeb ua rau muaj ntshav nce siab hauv ntshav qab zib

Kev tsim cov ntshav qog ntshav qab zib yuav cuam tshuam nrog kev kho mob kom txo qab zib. Qhov laj thawj yuav yog:

1. Kev nce ntxiv ntawm cov koob tshuaj tiv thaiv kab mob ua rau muaj qhov yuam kev lossis ua tsis zoo ntawm daim duab syringe los yog xaum xaum.
2. Kev siv ntau tshaj ntawm cov tshuaj tiv thaiv hypoglycemic siv nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, lossis ib qho kev ntsuas tsis tau nce ntxiv ntawm cov tshuaj ntawm cov tshuaj.
3. Yog hais tias txhaj tshuaj tsis raug cai (hloov qhov tob ntawm cov tshuaj insulin, kev hloov chaw tsis raug ntawm qhov chaw txhaj tshuaj, zaws ntawm qhov chaw txhaj lossis qhov cua sov ntawm thaj chaw uas tau txhaj tshuaj).
4. Nce insulin rhiab heev los ntawm kev qoj ib ce.

Ua rau tawm hws ntau yog lub cim ntawm nocturnal hypoglycemia.

Nrog hmo hypoglycemia, npau suav phem txhawj xeeb tus neeg mob.

Kev tsim cov qog ntshav qab zib tuaj yeem tshwm sim nrog kev txhaj tshuaj insulin tsis raug.

Qab zib tuaj yeem txo qis vim kev haus dej haus cawv.

Nrog cov pluas noj zaub mov uas tsis muaj cov carbohydrates, qhov kev poob rau hauv cov ntshav qab zib tuaj yeem tshwm sim.

Kev noj tshuaj ntau dhau ntawm kev txiav ntshav qab zib hauv daim ntawv ntawm cov ntsiav tshuaj tuaj yeem ua rau ntshav qab zib tsawg.

Kev txo qis hauv qab zib tuaj yeem tshwm sim vim kev ua haujlwm tsis tau npaj lub cev.

Qab zib tuaj yeem mus poob vim kev noj zaub mov zoo:

1. Cov ntsiab lus carbohydrate tsawg nyob hauv cov zaub mov lossis hla zaub mov noj.
2. Nrog rau qhov nce hauv lub sijhawm sib nrug ntawm cov zaub mov thiab insulin.
3. Nrog khaus luv luv-sijhawm tsis siv lub cev tsis ua lub cev yam tsis tau noj carbohydrates.
4. Kev haus dej caw.
5. Nrog rau cov pluas noj zaub mov kom tsawg hauv carbohydrates rau qhov poob phaus lossis tshaib plab, tab sis tswj cov tshuaj ntau rau txo cov ntshav qab zib, xws li Metformin.

Qib ntawm tus kab mob

Kev muaj ntshav qab zib tsawg muaj mob sib khuav, theem nrab thiab hnyav:

1. Cov ntshav qog ntshav qis yuav tshwm sim thaum qhov Performance index qis dua 2.8 mmol / L. Ib tus neeg tuaj yeem pab nws tus kheej los ntawm kev siv lub cuab yeej zoo.
2. Cov theem hauv nruab nrab tuaj yeem tsis meej pem nrog cov dej cawv sib xyaw. Ib tus neeg xav tau kev pab: nws yuav tsum muab cov piam thaj hauv nws lub qhov ncauj.
3. Ib qho kev kawm hnyav yog qhov txawv txav hauv qhov chaw thiab lub sijhawm, ua kom qaug dab peg. Ib tus neeg tuaj yeem poob mus rau hauv txoj kev tsis nco qab.

Cov tsos mob ntawm tus mob hypoglycemia

Yog mob me me, cov tsos mob hauv qab no yog cai:

1. Kev tshaib kev nqhis, nce ntau dua qhov qab los noj mov - thawj lub cim ntawm hypoglycemia.
2. Lub plawv palpitations.
3. Ntsej muag ntawm tus ntsis ntawm tus nplaig thiab daim di ncauj.
4. Tsis tshua muaj siab ncua.
5. Tsis muaj zog hauv cov ceg.
6. Kev npau taws, ua kom pom kev tsim txom lossis tsis ntxhov siab.

Nrog rau qhov ntsuas ntshav me me ntawm lub ntsejmuag ntshav siab, qhov tsis hnov ​​ntawm loog ntawm lub ntsis tus nplaig thiab daim di ncauj yog pom.

Kev tshaib kev nqhis, nce ntau dua qhov qab los noj mov - thawj lub cim ntawm hypoglycemia.

Lub plawv palpitations yog cov tsos mob ntawm cov hypoglycemia.

Kev ua kom qeeb ntawm kev ua haujlwm ntawm lub hlwb yog qhov tshwm sim ntawm kev mob ntshav qab zib tsawg.

Nrog hypoglycemia, kev tsis txaus siab thiab tsis muaj kev sib cav tshwm sim.

Nrog cov ntshav qog ntshav nruab nrab, tshee tshee tshee tshwm sim.

Kev mob ntshav khov ntau heev tshwm sim los ntawm qhov tsis nco qab.

Cov tsos mob uas tau ntxiv nrog mob hnyav:

1. Lub cev lub teeb tshee, tes tshee, ua kom mob leeg.
2. Pom me ntsis tsis meej ("goosebumps" ua ntej lub qhov muag).
3. Slowing ntawm kev puas hlwb.
4. Qhov tsis nco qab ntawm kev coj ua uas zoo txawv txawv rau lwm tus.
5. Poob ntawm kev qhia hauv lub sijhawm thiab chaw.

Muaj qhov tsis txaus ntseeg yog ua los ntawm kev tsis nco qab, qee qhov mob hnyav tshwm sim.

Nrog rau cov ntshav qis thiab ntawm qib qis ntawm lub qog ntshav qab zib, lub paj hlwb tsis puas, thiab ib daim ntawv foos nrog rau kev nthuav qhia ntau zaus tuaj yeem ua rau tsis nco qab thiab tuag tes tuag taw. Yog tias degree 3 nthuav dav tsis tshua pom, ces qhov tshwm sim rau lub cev tsis tshwm sim.

Hauv poj niam

Kev mob ntshav qab zib hauv cov poj niam muaj feem ntau mob ntshav qab zib. Thaum tsis muaj tus kab mob no, tus mob yuav pib loj tuaj nyob rau peb lub hlis kawg ntawm kev xeeb tub.

Cov ntshav qab zib cov ntshav muaj peev xwm poob qis vim tias qhov tshaib plab lossis siv cov khoom noj kom yuag.

Hauv menyuam yaus

Hnub nyoog qis dua 1 xyoos, nws tsis yooj yim los kuaj ntshav qog ntshav, vim hais tias cov tsos mob zoo li tsis meej thiab atypical rau tus mob no:

• cyanosis;
• daj ntseg tawv nqaij;
• cov leeg tsis tshua muaj zog;
• apnea (ua pa ntes);
• kev co ntawm nqua, cramps;
• nystagmus (dov lub qhov muag daj).

Nystagmus yog ib cov tsos mob ntawm cov ntshav qog ntshav qab zib hauv cov menyuam yaus hnub nyoog qis dua 1 xyoos.

Nrog rau cov ntshav qab zib kom tsis muaj ntshav hauv cov menyuam yaus, cov kab mob pathological uas ua rau cov khoom qab zib tshwm tuaj.

Lub hom phiaj tsis meej ntawm insulinoma hauv cov menyuam yaus ua rau pw tsaug zog.

Qhov kev mob loj ntawm lub cev yog qhov loj me hauv lub cev (qhov hnyav ntawm lub cev ntawm cov menyuam mos yog siab dua li ib txwm muaj), o.

Hauv cov kawm preschool thiab hnub nyoog kawm ntawv, raug kuaj pom muaj lub siab tsis tus ntsws ntawm insulinoma. Hauv cov menyuam yaus li no, kev pw tsaug zog tab tom muaj kev ntxhov siab, tsis muaj qhov ua tau zoo thaum sawv ntxov, thiab tsaug zog heev. Cov concentration ntawm cov xim paub tau txo qis. Cov kab ntsig ntsig ua rau qab zib. Qhov feem ntau rau cov ntshav qab zib cov ntshav qis yog pom nrog qhov nce ntawm cov sijhawm ntawm cov pluas noj.

Hauv cov laus

Hauv cov laus uas muaj hnub nyoog, hypoglycemia hauv ntshav qab zib yog qhov txaus ntshai tshwj xeeb, vim nws ua rau kev ua tsis zoo ntawm cov hlwb hlwb. Qhov kev hem thawj no ua rau mob stroke thiab ischemic, myocardial infarction thiab lwm yam pathologies uas ua rau tib neeg lub neej ploj.

Kev kho mob hypoglycemia hauv ntshav qab zib

Ua ntej mus pw hauv tsev kho mob, tus neeg mob tau txhaj nrog glucagon tov (10%) lossis piam thaj (40%).

Hauv tsev kho mob, cov piam thaj yog tswj xyuas cov leeg ntshav. Nrog lub hypoglycemic coma, kev tswj xyuas kev kho mob tau siv ntau, tus neeg mob tau muab tso rau hauv chav kuaj mob hnyav rau kev kho mob nyuaj. Tom qab thim rov qab los ntawm coma, qhov tseem ceeb uas ua rau muaj tus mob no tau kho.

Yuav ua li cas thaum muaj qhov mob ntawm cov ntshav qab zib

Yog tias cov piam thaj hauv cov ntshav qis dua 3.9 mmol / L, ces txoj cai 15x15 siv:

• noj 15 g ntawm carbohydrates ceev (3-4 tsp lossis 1 tbsp suab thaj yaj hauv dej, 1 khob kua txiv, 4-5 lozenges) lossis qabzib hauv cov ntsiav tshuaj (15 g ntawm cov tshuaj nquag siv);
• tom qab 15 feeb, ntsuas cov piam thaj.

Nrog lub hypoglycemic coma, tus neeg mob tau muab tso rau hauv chav kuaj mob hnyav rau kev kho mob nyuaj.

Hauv tsev kho mob, tus neeg mob cov kua qabzib daws nrog lub cev.

Yog tias cov piam thaj hauv ntshav qis dua 3.9 mmol / L, tom qab ntawd cov piam thaj yuav tsum muab tshuaj rau hauv cov ntsiav tshuaj.

Yog tias qhov ntsuas tsis nce ntxiv, ces siv piam thaj (15 g) thiab tos 15 feeb.

Nws yog ib qho tsim nyog los soj ntsuam qhov xwm txheej, pom qhov ua rau ua rau poob rau hauv cov ntshav qab zib. Txhawm rau kom tsis txhob ua rau rov qab ua dua nyob rau hauv qabzib, koj tuaj yeem hla tsis dhau cov pluas mov tom ntej. Yog tias cov tsos mob mob siab, nrhiav kev kho mob tam sim ntawd.

Thawj pab

Yog tias tus neeg mob nco qab, ces cov yeeb yam hauv qab no tau ua:

• ib tug neeg yuav tsum coj txoj haujlwm xis nyob thaum dag lossis zaum;
• muab cov neeg mob qab zib tshuaj yej, qab zib, qab zib los yog chocolate, ncuav qab zib (cov khoom qab zib tsis siv vim tias nws tsis pab);
• muab kev thaj yeeb nyab xeeb kom txog thaum tus neeg tus mob zoo.

Yog tias tsis nco qab, nws yuav tsum tso tus neeg mob pw, saib xyuas tus mob ua ntej lub tsheb thauj neeg mob tuaj txog. Npaj kom rov qab zoo.

Teeb meem ntawm cov ntshav qog

Ntawm hom 1 thiab ntshav qab zib hom 2, ntshav qab zib ntshav qab zib tsawg tsawg thiab cov teeb meem yuav tsum tsis ntshai. Tab sis nrog kev tawm tsam ntau zaus, kev ua haujlwm ntawm cov hlab plawv thiab cov hlab ntsha hlwb, hlwb paj hlwb tau cuam tshuam, lwm yam kabmob muaj kev txom nyem.

Kev mob ntshav qab zib ntshav qab zib tsis tuaj yeem ua rau myocardial infarction.

Mob stroke yog ib qho kev cuam tshuam ntawm hypoglycemic coma.

Qhov teeb meem loj tshaj plaws ntawm kev mob ntshav qab zib yog cerebral edema.

Mob tsis txaus siab

Kev mob ntshav qab zib ntshav qab zib ua rau tsis nco qab tuaj yeem ua rau mob hlwb, uas ua rau myocardial infarction, retinal hemorrhages, thiab mob hlab ntsha tawg.

Qhov mob loj tshaj plaws yog mob hlwb.

Kev Tiv Thaiv Hypoglycemia

Kev tiv thaiv ntawm hypoglycemia muaj raws li cov lus qhia hauv qab no:

1. Noj tsawg kawg 6 zaug hauv ib hnub. Yog tias cov tshuaj insulin nyob rau hmo ntuj, tom qab ntawd tus neeg mob xav tau ib qho khoom noj txom ncauj me me nrog cov khoom noj nrog cov khoom noj qeeb (ua mov ci, khoom noj siv mis, buckwheat thiab oatmeal, qhaub cij nrog butter, cheese, hnyuv ntxwm) ntawm tus nqi ntawm 1-2 lub khob cij.
2. Tas li saib xyuas cov qib ntawm cov piam thaj hauv cov ntshav uas siv lub ntsej muag. Qhov ntsuas tau 5.7 mmol / l yog qhov tseem ceeb. Cov lus qhia ntawm insulin ncua kev ua tau muab ncua rau 22 teev lossis tom qab. Koj tuaj yeem txo qhov koob tshuaj thiab noj ua ntej mus pw.
3. Ib txwm nqa cov piam thaj hauv cov ntsiav tshuaj, ob peb lumps ntawm qab zib, haus dej qab zib, thiab ntawm kev mus ncig ntev, nws tsim nyog khaws Glucagon ampoule thiab koob txhaj tshuaj intramuscular.
4. Tsis kam haus dej haus cawv, haus luam yeeb thiab lwm yam tsis zoo.
5. Zam kev ua txhaum ntawm kev noj zaub mov, kom tsis txhob ua rau cov ntshav qab zib nce siab sai.

Cov txheeb ze thiab cov phooj ywg ntawm tus neeg mob yuav tsum muaj peev xwm los muab kev pabcuam tau txhua lub sijhawm txhawm rau txhawm rau tiv thaiv qhov pib ntawm kev tsis nco qab.