Cov kws tshwj xeeb tis npe ib qho ntawm cov kev mob tshwm sim ua kom tuag nyob hauv cov menyuam tshiab. Kev mob ntshav qab zib hauv cov menyuam yaus tsim nyob rau hauv peb feem pua ntawm tag nrho cov neeg mob neeg tuag. Qhov tshwm sim ntawm cov ntshav qab zib hauv cov menyuam yaus muaj ntau yam nrog rau kev mob uas zoo sib xws hauv cov neeg laus. Qhov phom sij yog qhov cov kev ceeb toom ceeb toom loj hlob sai thiab tuaj yeem hla tau. Dab tsi yog qhov tshwm sim ntxiv rau cov menyuam yaus uas muaj qhov teebmeem endocrinological hauv thawj teev, hnub ntawm lub neej? Tus poj niam cev xeeb tub thiab tus me nyuam hauv plab yuav tsum mloog zoo li cas?
Vim li cas
Cov kws tshaj lij ntawm cov chaw kho mob neonatal paub txog cov menyuam yaus muaj kev pheej hmoo, hypoglycemic syndrome, thiab cov hau kev ntawm kev kho. Thawj thawj teev thiab hnub ntawm lub neej ntawm cov menyuam yaus yug yog qhov tseem ceeb rau lawv txoj kev loj hlob thiab kev txhim kho yav tom ntej. Txhua lub cev yuav tsum hloov mus rau qhov kev ua haujlwm ywj pheej tshiab - sab nraum leej niam lub tsev menyuam.
Muaj kev hem thawj tiag tiag rau kev noj qab haus huv ntawm tus menyuam 2-3 teev tom qab yug. Hauv kev tsim tshiab cov menyuam mos uas muaj qhov hnyav tsawg, tsawg dua 2.7-2.5 kg, cov ntshav qab zib cov ntshav muaj peev xwm poob qis dua 2.0 mmol / L.
Cov kws tshaj lij tshwj xeeb cais cov asphyxia ntawm cov qib sib txawv. Nrog cov mob hnyav hnyav, kev ua haujlwm ntawm kev ua haujlwm hauv nruab nrog, suav nrog cov txiav tsis ua haujlwm yog cuam tshuam. Qhov qis qis ntawm cov pa oxygen hauv cov ntshav txav cov me me ntawm glycogen.
Ib qho mob me me ntawm cov pa oxygen tsis xav tau, raws li txoj cai, kev kho loj. Yog tias tsim nyog, lawv rov qab los ua pa hauv tus menyuam. Lawv tau daig, sov nws. Nrog rau qhov ua kom tsis txhob mob hnyav, ua rau tus menyuam txuas nrog lub tshuab ua pa.
Kuj tseem yuav muaj qee qhov poob qis hauv cov piam thaj hauv tus menyuam cov ntshav cov keeb kwm ntawm:
Ntshav qab zib hauv cov menyuam yaus- physiological kev nyuaj siab;
- cov kab mob autoimmune (necrosis-necrosis ntawm cov ntaub so ntswg, mob siab daim siab);
- pancreatic hyperplasia (degeneration ntawm cov hlwb rau cov rog).
Hauv cov xwm txheej zoo li no, cov ntaub so ntswg yuav tsum muaj ntau cov insulin ua haujlwm. Kev loj hlob ntawm cov tshuaj hormones ua rau txo qis glycemia.
Cov tub ntxhais hluas lub cev xav tau cov khoom noj kom tsis tu ncua, uas yog, qhov pheej ntawm cov piam thaj hauv cov ntshav hauv cov ntshav. Kev tiv thaiv ntawm ntau yam mob yog thaum ntxov thov cov menyuam mus rau leej niam lub mis rau pub mis. Hauv tus menyuam muaj kev noj qab haus huv, tom qab yug, tom ntej ntawm leej niam, lub siab plawv thiab ua pa rov qab los. Nws nyob nyab xeeb thiab calms lawm.
Qhov loj nruab nrab ntawm kev pub mis yog txaus ntshai, ntau tshaj 10 teev yuav ua rau muaj neeg tuag taus. Cov kws kho mob paub tau pom zoo kom cov poj niam ua tib zoo saib xyuas qhov teeb meem kev noj zaub mov zoo txij thawj lub neej ntawm menyuam yaus - kom pub nws noj raws li qhov xav tau. Nws yog ib qho tseem ceeb kom tsis txhob hnov qab muab rau menyuam cov dej hau. Nws yuav tsum nyob ntawm tib yam li lub cev. Nyob rau thawj hnub, tus menyuam tau txais thaj tsam li 200 mg ntawm niam mis.
Kev kuaj mob thiab tsos mob
Feem ntau cov cim ntawm cov ntshav qab zib hauv tus menyuam thiab tus neeg laus yuav zoo sib xws. Cov tsos mob pom tseeb ntawm asphyxia yog daim di ncauj xiav. Tus me nyuam tuaj yeem ua cov qw nrov nrov. Txhawm rau ua siab tsis zoo (tsis muaj zog) lossis, hloov pauv, lub xeev nyob tsis tswm ntxiv:
- pallor ntawm daim tawv nqaij;
- tachycardia (mob plawv palpitations);
- tu leeg;
- tawm hws ntau dhau.
Kev mob ntshav qab zib hauv cov menyuam yug tshiab tau muab faib ua hom: haujlwm ruaj khov thiab hla mus. Thawj qhov kev xaiv qhia tau hais tias muaj ib qho kab mob ua ntej yug. Tej zaum, ib lossis ob leeg niam txiv ntawm tus menyuam muaj mob ntshav qab zib. Qhov tshwm sim ntawm kev muaj keeb ntawm kev mob endocrinological yog 25% thiab 50%, feem, nyob hauv thawj kis thiab thib ob.
Txoj kev hloov chaw tshwm sim yog vim lub cev tsis muaj zog ntawm tus kabmob me. Lub cev tsis tuaj yeem cia qhov muaj qhov glycogen txaus. Cov tsos mob maj mam ploj zuj zus mus raws li tus neeg mob raum txiav.
Hauv thawj ob peb teev ntawm tus menyuam mos lub neej, lawv tau saib xyuas lub luag haujlwm ntawm lub plawv thiab txoj hlab ua pa ntawm lub cev
Txhawm rau kom paub tam sim ntawd, koj yuav tsum tau noj cov hlab ntsha capillary rau kev txheeb xyuas. Txhawm rau kom tau txais txiaj ntsig sai, kev sib tw siv cov khoom siv. Txoj kev tshawb fawb txuas ntxiv suav nrog kev tshuaj xyuas dav dav tsis yog rau cov piam thaj xwb, tab sis kuj rau cov ntsiab lus ntawm cov roj ntsha, lub cev ketone, thiab insulin. Nws kuj tseem yuav tsum tau txais cov ntaub ntawv ntawm cov keeb cortisol, uas yog lub luag haujlwm rau kev loj hlob thiab kev loj hlob ntawm tus menyuam lub cev.
Kho thiab txim
Kev mob ntshav qab zib ntshav ntau hauv cov menyuam yug tshiab raug tshem tawm los ntawm kev siv cov tshuaj ua kua qab zib. Muaj ntau cov cai ntawm kev coj ua kom zoo:
- pib nkag nrog kev suav muab xam (6-8 mg rau ib phaus ntawm tus menyuam qhov hnyav), nce mus rau 80 mg / kg;
- koj tsis tuaj yeem tsis sai sai tsis noj tshuaj, nws yog qhov tsim nyog los txo nws kom tus nqi pib;
- nws yog txwv tsis pub siv txoj kev daws teeb meem ntau dua 12.5% hauv cov leeg ntu (piv txwv, ntawm nqaj) ntawm tus menyuam yug tshiab;
- tsis txhob tsum tseg tus menyuam hauv plab thaum kho cov kua nplaum.
Tus poj niam cev xeeb tub yuav tsum tau soj ntsuam cov ntshav qab zib kom tsis tu ncua, kom tsis txhob muaj glycemic nce siab tshaj 11 mmol / L.
Tus nqi ntawm 10-11 mmol / L raug suav tias yog "lub raum pib" thaum ua rau lub cev muaj peev xwm tseem tuaj yeem tiv thaiv cov piam thaj ntau dhau. Feem ntau, hypoglycemia ntawm tus neeg me lossis tus neeg laus tsis xav tau kev kho mob ntev ntev, tab sis tsuas yog pab kho mob ib zaug xwb. Tab sis txhua qhov xwm txheej, kev tawm tsam sai ntawm cov neeg kho mob nyob ib puag ncig lawv yog qhov tsim nyog.
Mob ntshav qab zib Gestational lossis theem siab tuaj yeem tshwm sim hauv tus poj niam noj qab haus huv kiag li. Thaum cev xeeb tub, muaj qhov nce ntawm physiological load rau tag nrho cov kev ua haujlwm sab hauv ntawm nws lub cev. Lub txiav ua qoob, vim tias qhov ua haujlwm ntawm lub cev lossis cov yam ntxwv ua haujlwm, tsis tuaj yeem ua tiav nrog "tus qauv tshiab" ntawm kev ua haujlwm. Raws li qhov tshwm sim, kev kub ntxhov ib ntus hauv cov ntshav qab zib muaj tshwm sim.
Kev txiav txim los ntawm cov ntaub ntawv kho mob, feem ntau feem ntau hypoglycemia hauv cov menyuam yug tshiab tshwm sim hauv cov niam uas muaj mob ntshav qab zib mellitus thaum thawj lossis cev xeeb tub
Kev kho mob ntawm tus poj niam cev xeeb tub nrog hyperglycemia thiab insulin deficiency zoo li kev kho mob ntshav qab zib hom 1:
- kev txhaj tshuaj hormonal;
- tsis muaj carbohydrate thiab cov rog rog tsawg;
- kev tawm dag zog lub cev.
Thaum yug menyuam los yog tom qab tus poj niam thiab tus menyuam mos, qib glycemic poob los ntawm kev ua haujlwm dhau thiab ntxhov siab. Txoj haujlwm ntawm cov neeg ua haujlwm kho mob yog kom nws nce rau qhov tsim nyog hauv lub sijhawm (6.5 mmol / L - ntawm lub plab khoob; txog 7-8 mmol / L - tom qab noj mov).
Tom qab, nws yog qhov tseem ceeb rau tus poj niam thiab nws cov menyuam los tshuaj xyuas lub cev qhov hnyav, tsis txhob cia siab rau qhov ntau tshaj ntawm cov kev coj ua. Rau cov menyuam yaus thiab cov poj niam cev xeeb tub, muaj cov ntxhuav tsim los ntawm cov kws tshwj xeeb. Hauv cov menyuam mos (txog 1 xyoos) - rau ntau hlis, tom qab - rau ib nrab xyoo. Rau cov neeg laus, kwv yees daim duab (kg) yog qhov qub, tau los ntawm cov qauv: qhov siab (cm) rho tawm qhov sib npaug ntawm 100.
Koj yuav tsum tau ua kom ib ce muaj zog noj kom zoo rau cov protein, rog thiab carbohydrates. Txhawm rau ua cov txheej txheem ib puag ncig (1-2 zaug hauv ib xyoos) tswj ntshav qab zib kom tiv thaiv kev txhim kho ntawm cov kab mob endocrinological thiab cov teeb meem nyuaj.
Kuj tseem muaj kev pheej hmoo rau qaug dab peg ntawm tus menyuam. Kev mob hnyav ntawm kev tiv thaiv posthypoglycemic muaj xws li mob hlwb (hlwb txha caj qaum), kev txwv tsis pub muaj kev txhim kho ntawm kev txawj ntse thiab lub cev muaj zog. Kev tiv thaiv ib tus tsos mob txaus ntshai yog kev tswj kom zoo ntawm cev xeeb tub, yug tus me nyuam puv ib hnub. Hypoglycemia tsis yog kab mob, tab sis qhov tsos mob - cov cim qhia uas yuav tsum tau txais kev kho mob sai.
