Kev mob ntshav qab zib nyob hauv hom 2 mob ntshav qab zib mellitus - cov tsos mob thiab kev tiv thaiv ntawm cov teeb meem

Kev mob ntshav qab zib ntshav qab zib nyob hauv hom ntshav qab zib hom 2 yog qhov mob hnyav, nrog kev poob qis hauv cov ntshav qab zib. Pathology kev tsim kho sai sai, cia li ntawm ib nrab ntawm ib teev. Thaum tsis muaj qhov tsim nyog ntsuas, hypoglycemia yuav ua rau lub hlwb tsis ua haujlwm thiab tuag.

Cov yam ntxwv ntawm kev loj hlob ntawm pathology

Lub tshuab kev txhim kho ntawm cov ntshav qog nqaij hlav yog ua rau yog tias qhov concentration ntawm cov piam thaj hauv cov ntshav yog 3.3-4 mmol / L thiab qis dua (3.5-5.5 mmol / L yog qhov qub). Qhov laj thawj tseem ceeb yog xav paub ntau dhau ntawm cov tshuaj insulin, yog li cov piam thaj yuav nqus tau. Lub cev tab tom sim los rov ua kom cov piam thaj li qub, cov peev txheej tseg rau hauv lub siab nyob rau hauv daim ntawv ntawm glycogen.

Txhawm rau tig cov khoom no rau hauv qabzib, cov tshuaj hormones contrainsular (adrenaline, glucagon, cortisol) nkag mus rau hauv cov ntshav.

Yog tias nws tsis tuaj yeem sau qhov tsis muaj piam thaj, muaj kev rau txim loj ntxiv. Kev mob hypoglycemic muaj kev cuam tshuam tsis zoo rau lub hlwb, lub zog ntawm lub zog ntawm lub neurons ua rau lub cev tsis hnov ​​qab, nriaj, tsis nco qab.

Muaj 4 theem ntawm hypoglycemia:

1. Hypoxia ntawm cov hlwb ntawm cov hlab ntshav ntawm cov hlab ntshav hlab ntshav, qee thaj chaw ntawm lub paj hlwb, txhim kho. Tus neeg mob mloog nws lub cev tsis muaj zog, mob taub hau, ntxhov siab, tshaib plab heev. Lub plawv dhia thiab tawm hws.
2. Lub qhov txhab ntawm cov subcortical-diencephalic thaj av ua kom muaj zog. Ib tug neeg lub ntsej muag tig xim liab, txav mus los zoo nkauj, thiab tus cwj pwm ua tsis txaus.
3. Ib qho xwm txheej zoo sib xws ntawm kev tawm tsam mob rov huam tuaj. Qhov tshwm sim tshwm sim, ntshav nce siab, tachycardia thiab tawm hws sib zog.
4. Lub luag haujlwm ntawm qaum ntu ntawm nruab nrab ntawm medulla oblongata yog qhov tsis sib haum, tsis hnov ​​qab zuj zus.

Cov Hom Tshuaj Hypoglycemia

Muaj ob hom pathology:

1. Kev yoo mov hypoglycemia. Qab zib ntog tom qab pw tsaug zog.
2. Kev mob hypoglycemia tom qab noj mov. Nws pom tshwm tom qab 2-3 teev tom qab noj mov.

Tsis muaj ntshav qab zib los ntshav yog ib leeg ntshav txha ntau. Nws txaus ntshai vim tias nws tus yam ntxwv tsis paub txog. Tus neeg mob tawm hws, npau suav phem pib ua npau suav rau nws.

Kev mob ntshav qab zib nyob hauv hom 1 mob ntshav qab zib mellitus tsis txawv tshwj xeeb hauv kev txhim kho, tab sis nws tshwm sim sai dua. Kev tawm tsam tshwm sim ntau zaus (yuav luag 10 zaus), lawv muaj ntau dua li ntawm cov neeg mob ntshav qab zib hom 2. Cov cim ntawm kev poob qis hauv qab zib qee zaum yuav luag tsis tuaj, tus neeg tuaj yeem tam sim ntawd yuav tsis nco qab.

Vim li cas

Feem ntau, hypoglycemia tshwm sim thaum kho mob ntshav qab zib hom 2 nrog sulfonylurea tshuaj los yog thaum noj tshuaj ntau dhau. Cov piam thaj poob qis dua qhov qub, qee zaum hauv 3 hnub tom qab pib noj cov tshuaj no. Kev siv cov tshuaj txo cov ntshav qab zib nyob rau theem ntawm cov ntshav qab zib them nyiaj yuav ua rau cov piam thaj tsawg dua yog tias ib tug neeg noj cov tshuaj nyob hauv tib qho.

Lwm yam laj thawj:

1. Koob tshuaj tsis yog xam ntawm cov tshuaj insulin los yog noj ntau dhau.
2. Kev tswj tsis raug cai ntawm cov tshuaj (intramuscular txhaj hloov subcutaneous).
3. Hloov chaw txhaj tshuaj lossis kis rau nws. Piv txwv li, zaws ua rau kom nqus sai dua ntawm cov tshuaj, uas ua rau dhia hauv insulin.
4. Qhia cov tshuaj tshiab, uas tus neeg mob tsis muaj sijhawm rau yoog.
5. Kev cuam tshuam nrog qee yam tshuaj. Kev nkag siab ntawm cov tshuaj insulin ntau ntxiv: tshuaj tiv thaiv kev puas tsuaj, barbiturates, antihistamines, tshuaj aspirin.
6. Cev xeeb tub, pub niam mis.
7. Kev siv zog ntau dhau ntawm lub cev, ua dhau dhau.
8. Ua tsis tiav kev noj haus zoo, hla zaub mov noj.
9. Khoom noj tsis zoo, tsis muaj calorie tsawg.
10. Txoj kev ua kom qeeb ntawm cov txheej txheem ntawm assimilation ntawm cov zaub mov, nchuav ntawm lub plab.
11. Kev ua tsis zoo ntawm ob lub raum, mob siab.
12. Haus dej cawv, tshwj xeeb ntawm kev npliag plab.

Cov tsos mob ntawm tus mob hypoglycemia

Tus neeg mob ntshav qab zib yuav tsum muaj peev xwm paub txog cov tsos mob ntawm tus mob ntshav qab zib lub sijhawm. Yog tias koj tsis nres qhov kev tawm dag zog, kev hloov pauv tsis tau hauv lub cev, ib tus neeg tuaj yeem tuag lossis neeg xiam oob qhab. Muaj cov mob hnyav thiab hnyav heev. Hauv thawj kis, qhov mob tshwm sim yog pom los ntawm cov yam ntxwv tshwm sim, uas suav nrog:

• Kev tawm hws hnyav;
• Lub Nruab Siab;
• Blanching ntawm daim tawv nqaij;
• Nce lub plawv dhia;
• Kev poob siab sai;
• Kev tsis paub qab hau;
• Ntxhov siab vim
• Nkees
• Mob leeg tsis muaj zog;
• Kiv taub hau
• Mob taub hau;
• Cov tsos ntawm "goosebumps" ntawm daim tawv nqaij;
• Pom kev tsis zoo;
• Tsa ntawm cov ntiv tes;
• Xeev siab, raws plab,
• Nquag tso zis ntau zaus.

Yog tias tus neeg mob tsis tuaj yeem rov qab ua kom cov ntshav qabzib rov qab, nrog nws lub caij nplooj zeeg ntxiv (txog qib 1.7 mmol / L thiab qis dua) qhov kev mob ntshav qab zib tsawg nce. Ib tug neeg tuaj yeem poob rau hauv kev tsis nco qab, uas yog nrog los ntawm kev tsis tsim kev ntxhov siab. Cov tsos mob ntawm tus mob hypoglycemia loj heev suav nrog:

• Ua txhaum ntawm kev saib xyuas, pom kev, kev koom tes;
• Kev hloov pauv muaj zog ntawm kev coj tus kheej (piv txwv li, kev tshwm sim ntawm kev ua phem);
• Kev ua si;
• Tsis nco qab;
• Cramps
• Mob tuag tes tuag taw;
• Mob stroke

Nrog rau kev txhim kho daim ntawv foos hnyav, ib tus neeg pab tsis tau nws tus kheej.

Cov kws kho mob nco ntsoov tias kev muaj ntshav ntau nyob rau hauv txhua tus neeg mob qhia lawv tus kheej sib txawv, yog li cov tsos mob ntawm tus kab mob pathological tuaj yeem yog tus neeg ntshiab.

Tsis yog txhua tus neeg mob ntshav qab zib yuav muaj ntshav qab zib nyob ze; qhov pheej hmoo yog cov neeg mob ntshav qab zib tau ntev, cov neeg laus thiab cov uas muaj kev tawm tsam ntau dhau. Qee zaum tus neeg mob tsuas hnov ​​mob me ntsis.

Cov cim ntawm hypoglycemia yog dulled rau lwm yam. Cov no suav nrog:

• Fibrosis, mob qog adrenal ua haujlwm necrosis;
• Daim foos hnyav ntawm neuropathy, uas tawm tsam keeb kwm ntawm qhov ua tsis taus ntawm kev ua haujlwm ntawm cov hlab ntaws;
• Cov piam thaj hauv qab no qis dua ib txwm nyob ntev;
• Kev noj cov beta-blockers, cov tshuaj no feem ntau yog tshuaj tom qab lub plawv nres;
• Cov khoom noj tsis yog muaj ntau cov carbohydrates.

Hauv cov xwm txheej no, nws pom zoo kom ntsuas cov piam thaj nrog lub ntsej muag zoo. Nrog rau cov txiaj ntsig hauv qis dua 3.5 mmol / l, kev ntsuas yuav tsum tau coj los nce nws.

Teeb meem ntawm cov ntshav qog

Kev poob hauv qab zib ua rau cov teeb meem hauv qab no:

• Kev ua rau lub hlwb tsis zoo;
• Nce ntshav viscosity;
• Kev txhim kho ntawm lub plawv nres, mob hlab ntsha tawg;
• Tsawg tus neeg mob tsis txaus yuav ua rau lub qog ntshav qab zib;
• Hauv cov menyuam yaus - mob hlwb qeeb qeeb, mob hlab ntsha hlwb.

Kev mob ntshav qab zib ntshav siab thaum cev xeeb tub nce ntxiv qhov kev pheej hmoo ntawm qhov tsis taus ntawm tus menyuam hauv plab.

Qhov ntxim nyiam ntawm cov teeb meem nce ntxiv hauv cov neeg laus, tshwj xeeb tshaj yog thaum thawj rog. Cov teeb meem hnyav yog hypoglycemic coma, uas ua rau xiam oob qhab lossis tuag.

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

Yuav tsum tau maj nrawm nrawm nrawm nrog cov tsos ntawm cov tsos mob ntawm kev mob ntshav qab zib tsawg. Qhov nres raug tso tseg yog tias koj ua kom ntseeg tau cov khoom noj ntawm carbohydrates sai sai. Ua li no, haum:

• Qab zib tshuaj yej;
• Khaub noom
• Zib ntab (2-3 rooj. L.);
• Cov kua txiv kab ntxwv
• Khoom qab zib (nws yog qhov zoo dua los muab kev nyiam rau caramel);
• Qab zib

Cov kua nplaum hauv lub ntsej muag muaj cov txiaj ntsig zoo dua. Ntawm hom 2 mob ntshav qab zib, muaj qhov sib cuam tshuam ncaj qha los ntawm qhov ntau ntawm cov khoom noj carbohydrates thiab qhov nce hauv qab zib: nws nce los ntawm 2 pawg. tom qab noj 2 g ntawm piam thaj. Cov ntsiav tshuaj zoo li no yuav tshem tawm qhov xav tau noj cov zaub mov tsis raug cai thiab tiv thaiv kev tsis nco qab. Tom qab ntawd, ua kom koj tshaib plab los ntawm kev noj cov zaub mov uas tsis muaj cov carb qis.

Tom qab noj cov carbohydrates, tos 15 feeb. Yog tias tsis muaj kev txhim kho, noj lub qab zib dua. Deterioration ntawm kev zoo yog qhov laj thawj rau kev kho mob sai sai.

Yog tias ib tug neeg nyob tsis nco qab, nws yuav tsis muaj peev xwm zom zom qab zib lossis tshuaj kom zoo. Muab nws cov kua nplaum (nws muag hauv khw muag tshuaj). Hloov chaw, koj tuaj yeem ua cov kua qab zib koj tus kheej. Nco ntsoov tias tus neeg mob tau nqos tau txoj kev daws teeb meem. Cov khoom yuav muaj qhov cuam tshuam li 5 feeb. Tom qab ntawd, koj yuav tsum ntsuas ntsuas qib qab zib.

Ib tug neeg uas tau poob siab yuav tsum muab tso rau saum txaj (ntawm nws sab lossis lossis nws lub plab). Siv daim ntawv so ntswg los tso nws qhov ncauj ntawm qhov ntswg, cov zaub mov khib nyiab. Nkag tau cua ntshiab los ntawm qhib qhov rais. Tom qab ntawd hu rau lub tsheb tos neeg mob.

Nrog rau kev tsis nco qab, qhov qhia txog glucagon thiab kev daws teeb meem ntawm cov ntshav qabzib yuav tau ua, qhov no yog ua los ntawm cov kws kho mob ceev. Koj tuaj yeem yuav cov khoom siv tshwj xeeb hu ua Glucagon rau kev kho mob xwm txheej ceev. Nws raug tso tawm rau hauv lub hwj tshuaj. Qhov kev txhaj tshuaj yog ua tiav intramuscularly, tom qab 20 feeb. tus neeg yuav rov qab nco qab.

Kev Tiv Thaiv

Nws yog ib qho tseem ceeb uas yuav tsum tau them sai sai rau kev tiv thaiv kev txhim kho rau kev txhim kho hypoglycemia, txij li kev qaug dab peg lossis ntau zaus dhau los ua rau muaj kev cuam tshuam uas tsis tuaj yeem hloov pauv.

1. Saib xyuas koj cov ntshav qab zib txhua hnub nrog lub ntsuas ntshav qabzib.
2. Yog tias xav tias tsam lub qog ntshav qab zib ntau ntau, ntsuas qab zib sai li sai tau. Yog tias qhov ntsuas tau poob qis 0.6 mmol / L (piv nrog piv txwv li ib txwm muaj), siv cov kev ntsuas tau teev tseg saum toj no.
3. Tham nrog tus neeg noj zaub mov zoo rau kev noj zaub mov kom yog.
4. Noj thoob plaws ib hnub nrog kev so kom luv. Kev pabcuam yuav tsum yog me me. Nws raug nquahu kom noj txhua 3 teev.
5. Xaiv qib ntawm kev qoj ib ce nyob ntawm lub xeev ntawm kev noj qab haus huv, tus yam ntxwv ntawm lub cev.
6. Nrog lub cev qoj ib ce ntev, haus cov khoom noj protein thiab cov zaub mov uas muaj cov carbohydrates txhua teev (noj nqaij yog ib qho yooj yim).
7. Haus dej cawv.
8. Nqa cov piam thaj hauv qab zib (lossis khoom qab zib, qab zib).
9. Txheeb xyuas qhov ntev ntawm so ntawm kev noj mov thiab insulin.
10. Tham nrog koj tus kws kho mob rau kev txiav tsis tau ntawm sulfonylurea npaj. Qhov ntxim nyiam ntawm lub qog ntshav qog tau txo qis thaum siv cov tshuaj insulin los ntawm txoj kev noj tshuaj tsawg.
11. Qhia rau cov txheeb ze, cov phooj ywg thiab cov npoj yaig txog cov tsos mob ntawm tus mob ntshav qab zib, yuav ua li cas kom nws, yog li lawv tuaj yeem pab koj yog tias tsim nyog.
12. Nqa daim ntawv nrog koj rau qhov twg txoj kev kuaj mob yuav qhia meej. Koj tuaj yeem yuav ib txoj hlua tes tshwj xeeb. Qhov no yuav ua rau lwm tus muab kev pabcuam txaus yog tias koj tsis nco qab kiag li.