Kev mob hypoglycemic coma yog qhov mob uas tshwm sim ntawm cov endocrine uas tshwm sim los ntawm cov ntshav qab zib poob qis. Ib tug neeg nyob rau hauv hypoglycemic coma xav tau kev pab maj nrawm, tab sis nws txoj kev xav kom muaj kev paub txog kev mob tam sim no ntawm tus neeg mob. Nws yog ib qho tseem ceeb kom paub: tib neeg cov tsos mob cuam tshuam rau hyperglycemia lossis ua rau hypoglycemia.
Cov tsos mob ntawm tus mob hypoglycemia thiab hyperglycemia
Tus mob thiab mob ntev ntawm hyperglycemia yog qhia hauv cov tsos mob hauv qab no:
- Kev nqhis dej ntau dhau;
- Nquag tso zis ntau zaus;
- Lub cev tsis tu ncua;
- Hloov hauv qhov hnyav tsis xwm yeem;
- Pom kev tsis zoo;
- Lub qhov ncauj qhuav;
- Kom qhuav thiab khaus ntawm daim tawv nqaij;
- Kussmaul kev ua tsis taus pa;
- Arrhythmia;
Cov kab mob qeeb qeeb uas nyuaj rau kev kho mob, xws li mob hnyuv tawm ntawm qhov ncauj lossis mob otitis externa, kuj tseem yuav qhia tau tias lub xeev muaj ntshav qab zib;
Mob hyperglycemia mob tuaj yeem tshwm sim raws li cov tsos mob hauv qab no:
- Ketoacidosis;
- Hnov tsis nco qab;
- Lub cev qhuav dej vim yog glucosuria thiab osmotic diuresis.
Cov tsos mob thiab cov tsos mob ntawm hypoglycemia tau sib txawv rau hauv autonomic (parasympathetic, adrenergic) thiab neuroglycopenic. Cov tsos mob ua tsis muaj mob yog hais raws li hauv qab no:
Qib siab ntawm kev kub ntxhov thiab kev kub ntxhov, nrog rau kev ntxhov siab, ntshai thiab pom ntawm lub siab;
- Muaj nce hws;
- Mob leeg tshee, li no ua rau cov leeg hypertonicity;
- Cov menyuam muag poob dej;
- Nce ntshav siab, arrhythmia;
- Pallor ntawm daim tawv nqaij;
- Hnov txog xeev siab, qee zaum ntuav, mob tshaib plab;
- Mob tsis muaj zog
- Cov tsos mob Neuroglycopenic:
- Kev tsis tshua muaj siab ntawm kev saib xyuas, mob taub hau thiab kiv taub hau, ntsig txog qhov tsis haum, ua rau muaj kev sib txuam tsis zoo;
- Paresthesia;
- "Bifurcation" ntawm cov khoom raws li qhov pom lub qhov muag tsis zoo;
- Qhov tsis txaus ntseeg thiab kev hloov pauv ntawm kev coj tus cwj pwm, tsis paub qab hau;
- Ua tsis taus pa thiab ntshav ncig;
- Kev nkees nkees
- Tsis hnov qab;
- Tsaus muag thiab npaj ua ntej tsaus muag;
- Coma
Hypoglycemic Coma Factors
Kev siv qee yam tshuaj noj rau lub sijhawm ntev, tib cov tsos mob tuaj yeem tshwm sim los ntawm kev noj tshuaj insulin tsis ua rau pom kev noj tshuaj, qhov no tuaj yeem ua rau insulin hypoglycemic coma.
Kev haus dej haus cawv, tsis ua raws li kev noj haus tseem tuaj yeem ua rau kev txhim kho hauv lub xeev ntawm cov ntshav qab zib poob zoo.
Neurosis, kev xav dhau hwv, kev ntxhov siab thiab kev nyuaj siab, vim tias qhov tshwm sim ntawm cov xwm txheej zoo li no feem ntau tuaj yeem yog lub xeev hypoglycemic, thiab thaum kawg ua rau lub siab tsis nco qab.
Cov qog nyob ze ntawm tus txiav, pancreatic necrosis, ntau dhau lawm cov insulin ntau lawm, qhov no, qee zaum, qee zaum yog thawj qhov laj thawj uas ua rau kev kuaj mob ntawm tus mob qog ntshav qab zib.
Hepatic tsis muaj txhij txhua, qhov tshwm sim ntawm tus mob no yog ntau yam, thiab ntawm lawv yuav muaj qhov mob hypoglycemic coma.
Kev ntxhov siab ntawm lub cev vim yog kis las lossis lub cev ua haujlwm ntev, cov txiaj ntsig yog qhov sib txawv, tab sis ib qho ntawm lawv tsuas yog qhov ua kom tsis nco qab.
Teeb meem ntawm hypoglycemic coma
Nrog hypoglycemic coma, nws yog qhov tseem ceeb heev los muab kev pabcuam ua ntej rau cov neeg mob hauv lub sijhawm. Tib lub sijhawm, nws lub xeev ntxiv yog nyob ntawm qib kev paub thiab kev paub ntawm cov neeg uas nyob ze tus neeg mob.
Tsis muaj qhov kev saib xyuas kub ntxhov yog fraught nrog cerebral edema, uas yuav ua rau lub ntsej muag ntawm qhov tsis pom kev mob ntawm lub hauv nruab nrab lub paj hlwb. Nws yuav tsum raug sau tseg tias nrog qhov pib ntau ntau ntawm hypoglycemic coma, hauv cov neeg mob neeg laus cov neeg tus cwj pwm hloov tau pom, thiab hauv cov menyuam yaus muaj qhov poob qis ntawm theem ntawm kev txawj ntse. Hauv ob pawg ntawm cov neeg mob, kev tuag tsis suav nrog.
Lub xeev ntawm hypoglycemic coma yog qhov txaus ntshai heev rau cov neeg laus laus. Qhov no yog qhov tseeb tshwj xeeb rau cov tib neeg uas muaj mob plawv los ntawm txoj hlab ntshav hlab ntsha ntawm lub hlwb lossis lub plawv, thiab cov kab mob plawv. Lub chav kawm ntawm hypoglycemic coma tseem ceeb cuam tshuam cov hlab ntsha tawg lossis myocardial infarction. Muab qhov tshwj xeeb no, nws yog qhov tseem ceeb kom nquag tswj hwm ECG.
Cov txheej txheem tau ua tom qab nres tag nrho cov tsos mob ntawm kev mob hypoglycemia. Yog hais tias hypoglycemic coma kav ntev heev, nrog kev mob hnyav heev, mob encephalopathy yuav tshwm sim, qhov no tsis yog thawj zaug, tab sis ib qho ntawm ntau yam txaus ntshai.
Encephalopathy yog mob ua paug rau lub hlwb uas los nrog oxygen oxygen tshaib nrog rau cov ntshav khiav tsis zoo nyob rau hauv lub hlwb cov ntaub so ntswg. Tus kab mob yog tus cwj pwm los ntawm kev tuag ntau ntawm cov hlab hlwb. Pom ntau ntawm cov xeeb ceem ntawm kev ua tsis tau zoo.
Ceev faj thiab thawj pab
Txhawm rau muab cov kev pabcuam ua ntej rau hauv ib qho kev mob tshwm sim los ntawm hypoglycemic coma, koj yuav tsum ua kom meej meej txiav txim siab seb cov tsos mob tshwj xeeb ntawm tus mob no qhia txog hyperglycemia
Nrog hyperglycemia, raws li koj paub, ntshav qab zib cov ntshav nce siab. Nws yog ib qho tseem ceeb kom nkag siab cov tsos mob ntawm tus mob ntshav qab zib tsawg, uas cov ntshav qabzib hauv lub cev yuav tsum qis. Qhov phom sij yog tias ob qho xwm txheej xav tau kev ntsuas sib txawv uas cuam tshuam ncaj qha rau ib leeg.
Cov qib qab zib kom siab yog ib txwm nrog kev nqhis dej, xeev siab, thiab qaug zog. Tus neeg nyob rau hauv lub xeev tsis nco qab lawm muaj nce ntawm lub cev tawv nqaij, qhov nce qis ntawm lub suab ntawm cov pob muag tseem raug kaw. Ib qho ntxiv, cov neeg mob tsis muaj lub suab nrov nrov ua pa nrog ib qho "kua" tsw thiab muaj ntxhiab tsw ntawm acetone. Yog hais tias tus neeg mob muaj ntshav qab zib tsawg, tom qab ntawv qhov no, tus neeg hnov mob tsis muaj zog txaus thiab tshee hnyo thoob plaws lub cev. Ntxiv rau, kev tawm hws ntau dhau yog kaw.
Tus neeg mob tsis nco qab nyob hauv tsev, raws li txoj cai, yog nrog ntau cov kev tawm tsam. Tsis muaj qhov tshuaj tiv thaiv ntawm lub ntsej muag uas yog lus teb rau qhov kov.
Txhawm rau kom tus neeg tawm ntawm lub xeev hyperglycemic (lossis mob ntshav qab zib) mob sai sai sai, yuav tsum tau txhaj tshuaj insulin. Feem ntau, cov neeg mob ntshav qab zib muaj cov khoom pab thaum muaj xwm txheej tsis pom zoo. Cov khoom siv xub ntiag feem ntau khaws txhua yam koj xav tau rau cov tshuaj insulin, suav nrog cov ntaub plaub, cov ntaub ntawv qhia, cov koob txhaj tshuaj thiab cov tshuaj insulin.
Nws yog ib qho tsim nyog yuav tsum coj mus rau hauv qhov tseeb tias cov neeg mob ntshav qab zib muaj kev tiv thaiv qis, qhov no kuj siv tau rau tus kab mob xws li ntshav qab zib hom 2 thiab thawj hom. Raws li qhov tshwm sim ntawm qhov no, nws yog ib qho tseem ceeb uas tsis muaj qhov txuas ntxiv rau kev txwv tsis pub kis ntawm qhov chaw txhaj tshuaj.
Ntxiv thiab, tsis txhob ua yam tsis muaj kev ntsuas nruj rau cov tshuaj tua kab mob aseptic. Txhawm rau muab kev pabcuam ua ntej rau hyperglycemic coma nyob rau hauv txoj kev, yog tias txhua qhov yuav tsum tau ua tiav, koj yuav tsum xub kuaj txhua yam ntawm tus neeg mob kom nrhiav tau cov khoom pabcuam xub thawj nrog insulin sai li sai tau.
Yog tias qhov no pom, ib koob tshuaj insulin yuav tsum tau txhaj rau lub xub pwg lossis ncej puab. Cov koob tshuaj ntawm cov tshuaj insulin yuav tsum yog 50-100 units. Raws li txoj cai, hauv cov neeg mob uas muaj qhov kawg, kab los ntawm kev txhaj tshuaj yav dhau los yog pom tseeb, yog li nws yuav tsis nyuaj rau taug.
Cov neeg ua haujlwm hauv lub tsheb thauj neeg mob yuav tsum raug hu sai li sai tau. Qhov tseeb yog tias tib lub sijhawm thaum txhaj tshuaj insulin, tus neeg mob yuav tsum tau qhia txog 40% cov kua nplaum, nrog rau cov kua ntsev nrog cov kua qabzib. Qhov koob tshuaj yuav txog li 4000 ml. Tom qab thawj cov txheej txheem thaum muaj xwm txheej ceev, thiab kev qhia tshuaj insulin, tus neeg mob yuav tsum txo qis ntawm cov protein thiab roj noj nws.
Tab sis cov kws kho mob pom zoo: qhov hnyav ntawm ib qho kev ua noj ntawm cov zaub mov yuav tsum tsis txhob qis dua 300 grams. Ib pluag mov twg yuav tsum muaj cov zom zaub mov kom yooj yim, xws li kua txiv, txiv hmab txiv ntoo, thiab txiv ntoo. Tsis tas li ntawd, tus neeg mob raug nquahu kom siv cov dej muaj kuab av zoo li qub.
Thawj cov kev pabcuam rau hypoglycemic coma
Nrog hypoglycemia, qee qhov kev ntsuas yuav tsum tau ua uas tswj thiab txhim kho tus neeg mob lub luag haujlwm:
- Muab cov khoom qab zib rau tus neeg mob, piv txwv, khob noom, mis nyuj khov, ib qho qab zib. Ntxiv rau, koj tuaj yeem muab tshuaj yej qab zib, kua txiv qaub, qab zib dej lossis kua txiv;
- Nws yog ib qho tseem ceeb los muab kev mob rau tus neeg mob kom zaum zoo los yog chaw pw ua ntej pib kho rau hypoglycemic coma.
- Yog tias tsis nco qab, tus neeg mob yuav tsum pw ntawm nws ib sab thiab qab zib tso nws sab plhu;
Hu rau ntawm pawg neeg mob ua haujlwm nrog hypoglycemic coma yog qhov yuav tsum tau ua ua ntej, qhov no yog kev saib xyuas kub ntxhov rau qhov mob tsis xwm yeem.
Yog tias tus neeg mob nco qab, nws yuav tuaj yeem nqos cov kua, peb tab tom hais txog kev daws qab zib. Txhawm rau npaj cov kev daws teeb meem no, koj yuav tsum tau dilute hauv ib nrab khob dej 1 lossis 2 dia suab thaj.
Thaum tsis nco qab hauv tus neeg mob, kev tso ntshav tawm ntawm 40% kua nplaum daws yog cov kev pabcuam thaum muaj xwm txheej ceev rau lub cev tsis ua pa tsis nco qab lawm. Cov ntshav qab zib kuj tseem yuav nce nrawm dua yog tias koj hno cov tshuaj sub adaneine txhaj ntawm adrenaline - 0.1%, 1 ml.
