Hypoglycemic coma: cov tsos mob. Kev khomob kub ntxhov rau kev mob hypoglycemic coma

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Kev mob ntshav qab zib tsis ua rau lub cev tsis nco qab - tsis nco qab vim qhov pib ntawm cov theem uas mob ntshav qab zib ntau tshaj plaws hauv ntshav qab zib. Tus neeg mob uas poob rau hauv lub ntsej muag tsis tsaug zog feem ntau muaj tawv nqaij daj ntseg, noo noo. Tachycardia feem ntau sau tseg - kev nce siab hauv lub siab mus txog 90 neeg ntaus ib feeb lossis ntau dua.

Raws li tus mob loj dua, ua tsis taus pa ua pa, ntshav nce siab, bradycardia, thiab tawv nqaij txias tau sau tseg. Cov tub ntxhais kawm tsis teb rau lub teeb.

Ua rau hypoglycemic coma

Cov neeg tsis paub qab zib nyob lub siab tsis zoo yog ib qho ntawm peb qhov laj thawj:

  • tus neeg mob ntshav qab zib tsis tau kawm ua kom tsis txhob mob ntshav qab zib tsawg lub sijhawm;
  • tom qab haus dej ntau dhau (qhov kev xaiv txaus ntshai tshaj plaws);
  • qhia qhov tsis zoo (loj dhau) ntawm cov tshuaj insulin, tsis tau koom tes nrog nws los ntawm kev zom cov zaub mov carbohydrates lossis kev siv dag zog.

Nyeem tsab xov xwm "Kev mob ntshav qab zib tsawg ntshav qab zib mellitus: cov tsos mob thiab kev kho" - yuav ua li cas cov neeg mob ntshav qab zib tuaj yeem tso ntshav qab zib tsawg sijhawm nyob ntawm lawv tus kheej thaum lawv hnov ​​zoo li thawj cov tsos mob.

Hauv cov xwm txheej dab tsi qhov kev pheej hmoo uas siv cov tshuaj insulin yog ntau dhau thiab ua rau cov ntshav qab zib tsis tsaug zog nce:

  • lawv tsis tau ceeb toom tias qhov tshuaj insulin yog 100 PIECES / ml hloov 40 PIECES / ml thiab lawv tau qhia cov koob tshuaj 2.5 zaug ntau dua qhov tsim nyog;
  • yuam kev txhaj tshuaj insulin tsis subcutaneously, tab sis intramuscularly - yog li ntawd, nws qhov kev txiav txim siab tau nrawm nrawm;
  • tom qab txhaj koob tshuaj "luv" lossis "ultrashort" insulin yog muab rau noj, tus neeg mob tsis nco qab muaj kev yoov kom noj, i.e. noj carbohydrates;
  • kev siv dag zog tsis tau tawm dag zog - football, caij tsheb kauj vab, caij skiing, pas dej da dej, thiab lwm yam - tsis tas yuav muaj kev ntsuas ntau ntxiv ntawm cov piam thaj hauv cov ntshav thiab noj zaub mov carbohydrates;
  • yog tias tus mob ntshav qab zib muaj rog cov roj ntsha ntawm lub siab;
  • mob raum tsis ua haujlwm (mob ntshav qab zib hauv lub raum) qeeb "kev siv" ntawm cov tshuaj insulin, thiab hauv qhov xwm txheej no, nws cov tshuaj yuav tsum raug txo hauv lub sijhawm;

Cov neeg mob ntshav qab zib tsis tsaug zog feem ntau tshwm sim yog tias mob ntshav qab zib txhob txwm tshaj qhov noj ntawm cov tshuaj insulin. Qhov no yog ua los ua kev tua tus kheej lossis ua txuj ua.

Cov roj ntsha hypoglycemic nyob rau tom qab ntawm cawv

Ntawm cov ntshav qab zib hom 1, feem ntau tsis haus cawv, tab sis nws yuav tsum haus lub sijhawm tsawg. Nyeem ntxiv hauv kab lus “Noj cov ntshav qab zib hom 1.” Yog tias koj haus dej ntau dhau, ces qhov ntxim nyiam tias yuav muaj qhov tsis nco qab txog lub cev kub siab yog qhov ntau. Vim hais tias ethanol (cawv) txwv cov synthesis ntawm qabzib hauv lub siab.

Kev mob ntshav qab zib tsis tsaug zog tom qab noj haus muaj zog heev yog qhov txaus ntshai heev. Vim tias nws zoo li intoxication zoo tib yam. Yuav kom nkag siab tias qhov teeb meem no yog qhov nyuaj heev, tsis haus dej haus cawv nws tus kheej thiab cov neeg nyob ib puag ncig nws muaj sijhawm. Thiab kuj vim tias nws feem ntau los tsis tom qab booze, tab sis tom qab ob peb teev.

Kev kuaj mob

Txhawm rau paub qhov txawv hypoglycemic coma los ntawm hyperacea coma (i.e. vim tias muaj ntshav qab zib heev), koj yuav tsum ntsuas ntshav qab zib nrog ib qho glucometer. Tab sis tsis yooj yim li. Muaj qee cov xwm txheej tshwj xeeb uas tus neeg mob tau mob ntshav qab zib ntev dhau los, tab sis tsis tau kho, thiab nyuam qhuav pib noj tshuaj insulin thiab / lossis txo cov tshuaj qab zib.

Hauv cov neeg mob zoo li no, hypoglycemic coma tuaj yeem tshwm sim nrog qhov ib txwm los yog nce cov ntshav cov piam thaj - piv txwv li ntawm 11.1 mmol / L. Qhov no ua tau yog tias cov ntshav qab zib cov ntshav poob sai heev ntawm qhov uas muaj ntau. Piv txwv, los ntawm 22.2 mmol / L txog 11.1 mmol / L.

Lwm cov ntaub ntawv kuaj tsis tso cai rau kuaj pom tseeb tias tus mob tsis meej pem hauv tus neeg mob yog qhov tseeb hypoglycemic. Raws li txoj cai, tus neeg mob tsis muaj suab thaj hauv lub tso zis, tshwj tsis yog thaum muaj cov piam thaj hauv nws cov zis ua ntej txoj kev rov qab tuaj tsis xeev.

Kev khomob kub ntxhov rau kev mob hypoglycemic coma

Yog tias tus mob ntshav qab zib tsis txaus siab vim tias nws lub cev tsis tsaug zog, ces lwm tus yuav tsum:

  • muab nws tso rau ntawm nws ib sab;
  • tsis pub dawb ntawm lub qhov ncauj los ntawm cov zaub mov khib nyiab;
  • yog tias nws tseem tuaj yeem nqos - haus nrog dej qab zib sov;
  • yog tias nws chim nws yuav tsis tuaj yeem nqos nws ntxiv, - tsis txhob nchuav kua rau hauv nws lub qhov ncauj kom nws tsis daig kom tuag;
  • yog tias tus mob ntshav qab zib muaj cov koob txhaj tshuaj nrog glucagon nrog nws, hno 1 ml subcutaneously lossis intramuscularly;
  • hu rau lub tsheb tos neeg mob.

Tus kws kho mob yuav ua li cas:

  • ua ntej, 60 ml ntawm 40% cov kua nplaum ntawm cov tshuaj pleev yuav muab tshuaj rau tom qab, thiab tom qab ntawd nws yuav cais tawm seb tus neeg mob puas nco qab - hypoglycemic lossis hyperglycemic
  • yog tias tus mob ntshav qab zib tsis rov qab zoo li qub, ces 5-10% cov kua nplaum tau txhaj tshuaj ua ke thiab raug thauj mus tom tsev kho mob.

Rov qab mus kho hauv tsev kho mob

Hauv tsev kho mob, tus neeg mob tau kuaj xyuas seb puas muaj kev raug mob puas hlwb lossis mob plawv lossis mob hlab ntsha nrog (nrog rau kev mob hlab ntsws). Tshawb xyuas seb puas muaj kev noj tshuaj hleb ntau dhau ntawm cov piam thaj lossis cov tshuaj insulin.

Yog tias muaj kev noj ntau dhau ntawm cov ntsiav tshuaj, ces lub plab zom zaub mov tiav thiab ua kom hluav ncaig hluav taws xob yog tswj hwm. Yog hais tias muaj ntau dhau ntawm cov tshuaj insulin (tshwj xeeb tshaj yog lub sijhawm ua ntev), kev phais mob ntawm thaj chaw txhaj tshuaj yog ua tiav yog tias tsis pub dhau 3 teev tau dhau mus tom qab nws.

Kev tswj hwm kev ua haujlwm ntawm 10% cov kua nplaum ua kom txuas ntxiv mus kom txog rau thaum cov ntshav qab zib kom rov qab zoo li qub. Txhawm rau kom tsis txhob muaj kua ntau dhau, hloov 10% piam thaj nrog 40%. Yog tias tus neeg mob tsis tuaj yeem tsim ua ntej 4 teev lossis ntev dua, kev mob hlwb thiab qhov tshwm sim tsis zoo (kev tuag lossis xiam oob khab) yog qhov muaj peev xwm heev.

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