Hypoglycemic chikomole mu akulu ndi ana: thandizo, chithandizo

Hypoglycemic coma ndi chikhalidwe chovuta kwambiri m'thupi la munthu chomwe chimachitika chifukwa chakugwa kwakukulu kwa kuchuluka kwa shuga m'magazi. Imafunikira chisamaliro chachipatala mwachangu, ngati kuti yachedwa, imatha kupha munthu mosavuta.

Popereka njira zoyamba zobwezeretsera, ndikofunikira kufotokoza momwe zinthu zilili ndikusiyanitsa hypoglycemia ku hyperglycemia. Nthawi zambiri, kuchitidwa molakwika chithandizo chamankhwala kumakhala chifukwa chodzetsa matenda oopsa a mitsempha kapena mtima.

Zifukwa

Hypoglycemia ndi chinthu chodabwitsa chomwe kuchuluka kwa glucose m'magazi kumatsika ndi 3.5 mmol / lita. Vutoli lingayambike chifukwa chotsatira:

1. Kutalikirana kwa nthawi yayitali kwa hypoglycemia;
2. Kumwa mowa wambiri;
3. Kukhazikitsidwa kwa Mlingo waukulu wa insulin;
4. Kumwa mankhwala ena;
5. Kuchita zolimbitsa thupi kwambiri;
6. Chakudya chopanda malire.

Nthawi zambiri, chikomokere cha hypoglycemic chimayambitsidwa ndi jakisoni wa insulin. Zotsatira izi zikuwonetsa ndondomeko yolakwika.

Madotolo adazindikira zolakwitsa zingapo zotsatirazi pomwe, chifukwa cha kusasamala kwawo, wodwala akukumana ndi izi:

• Kuphwanya Mlingo: m'malo mwa 40 PESCES / ml, wodwalayo amadzidziwitsa yekha 100 PESCES / ml. Izi ndizokwera ma 2,5 kuposa zomwe zikuchitika ndipo zimatsimikiziridwa kuti zidzatsogolera ku izi.
• Insulin nthawi zonse imayendetsedwa kokha. Ena akabayidwa amalowa m'matumbo, ndichifukwa chake zochita za zigawo zomwe zimagwira ntchito zimathandizira kwambiri.
• Pambuyo pa jakisoni, wodwalayo amaiwala kudya zakudya zamafuta ambiri.
• Dokotala samalingalira za matenda omwe wodwala amakhala nawo: kuchepa kwamafuta, kuchepa kwa magazi ndi matenda aimpso kumachepetsa njira yochotsera insulini m'thupi.
• Wodwala amatenga katundu wolemera kwambiri kapena samayang'anira kukula kwake kwakuthupi konse.

Zizindikiro

Hypoglycemic coma imadziwika ndi kukula msanga. Komabe, njira yake ikhoza kugawidwa m'magawo awiri.

Madokotala amatsatira izi:

1. Gawo loyamba - panthawiyi thupi la munthu limakumana ndi vuto la oxygen, lomwe ndi loopsa ku ubongo. Hypoxia yam'maselo am'maselo am'madzi am'mimba, nchifukwa chake mawonekedwe a munthu amasintha kwambiri. Amakhala wokhumudwa kapena wokhumudwa. Komanso, odwala amadandaula ndi mutu, kumva kuda nkhawa, kufooka kwa minofu. Anthu ena, poyerekeza ndi kuchepa kwamisempha, amamva njala, kukakamizidwa kumawonjezeka, kugunda kwamitsempha kumachepa, ndipo khungu limakhala lonyowa.
2. Gawo lachiwiri, shuga wochepa amachititsa kuwonongeka kwa gawo laubongo. Itha kuzindikiridwa ndi kukondoweza kwagalimoto, mawonekedwe amaso, mawonekedwe osayenera ndi diplopia.
3. Gawo lachitatu limadziwika ndi kuwonongeka kwa ntchito ya maubwino. Chifukwa cha izi, kuyendetsa kwa magnesium kumasokonekera, zomwe zimapangitsa kuti pakhale kukhumudwitsidwa komwe kumayambira kumbuyo kwa kamvekedwe ka minofu. Kugwedezeka kwakanthaŵi kumafanana ndi khunyu, popeza ana mwa munthu amakula kwambiri. Thukuta ndi tachycardia zimachulukirachulukira.
4. Pa gawo lachinayi, pali kuphwanya kwakukulu pakugwira ntchito kwa zigawo zapamwamba za medulla oblongata. Munthu amasiya kuzindikira, amakhala ndi nkhawa komanso kutentha kwa thupi. Kutupa thukuta lozizira kumawonekeranso pankhope pake, kugunda kwake ndi kuthamanga kwa magazi kumachulukirachulukira, kupuma kwakeko kumachitika. Ndi magawo anayi pomwe munthu amagwa mu vuto la hypoglycemic.
5. Gawo lachisanu, lomaliza, limakhudza mbali zam'munsi za medulla oblongata. Amayang'anira malamulo mthupi. Chifukwa cha izi, munthu amayamba kuperewera. Chifukwa cha izi, adotolo akumaliza kuti njira zamtundu wa pathogenic zimayambitsa kutsika kwa kamvekedwe ka minofu, kutsirizika kwa thukuta kwambiri, kuchepa kwa zovuta, ndi chisokonezo m'miyambo ya mtima.

Mukabweretsa gawo la munthu pachigawo chachisanu, pamakhala chiopsezo chachikulu cha kufa. Kutsika kowopsa m'magazi a glucose kumatha kuyambitsa edema yam'mimba, momwe cortex imawonongedwa. M'tsogolo, izi zidzakhudza njira zonse mthupi.

Zizindikiro zoyambirira za edema ya ubongo imatha kuzindikirika ndi kupuma, kutentha thupi, kusintha kwa mtima, mseru komanso kusanza.

Komanso, munthu amatha kukhala ndi zotsatirapo zakale. Nthawi zambiri amatha kuzindikiridwa pokhapokha miyezi yochepa. Nthawi zambiri anthu omwe adakumana ndi vuto la chikomokere (hypoglycemic coma) amakhala ndi khunyu, encephalopathy, kapena parkinsonism.

Hypoglycemic chikomacho mwa ana

Mfundo za kakulidwe ka hypoglycemic coma mu ana ndendende monga zimakhalira kwa akulu. Amatha kupangitsa kuti izi zizichitika mwa kudya kwanthawi yayitali kapena kudya zakudya zochepa zama calorie, komanso kupewa insulin kapena zotsatira za matenda osachiritsika.

Komanso, zomwe zimayambitsa kukhala osowa zakudya m'thupi kapena kusowa kwa michere. Kompyuta ya hypoglycemic mu ana ndi chiopsezo chachikulu, chifukwa sizotheka nthawi zonse kuzindikira kuti ili m'magawo oyambira. Mwana sangathe kufotokoza molondola komanso momveka bwino zomwe zikumuvutitsa.

Nthawi zambiri, makolo amayamba kuwomba mawu pamene ana awo ayamba kukhala ndi nkhawa kapena kulira kwambiri. Chifukwa cha kukula kwakumva kupweteka m'mimba, chidwi chawo chimachepa kapena kulibe. Ndi njala yomwe ndiye chizindikiro chokhazikika cha hypoglycemia. Popita nthawi, ana amakhala owopsa, osalumikizana, osayang'ana chilichonse chomwe chimachitika. Kusintha konseku kuyenera kuonetsetsa kuchenjeza kholo lililonse.

Kampani ya hypoglycemic mu ana, monga akuluakulu, imayambitsidwa ndi khungu lotupa kwambiri, kunjenjemera kwa malekezero, kumachulukitsa thukuta. Mwadzidzidzi akayamba kuyenda, mwana amakomoka.

Tiyenera kukumbukira kuti chiwonetsero cha mkhalidwewu mwa ana chimakula kwambiri kuposa akulu. Zizindikiro za mkhalidwewu sizimasiyana konse. Mukayamba kuyimba ambulansi, pamakhala ngozi yoti mungafunike kuchita zinthu zolimbitsa thupi.

Zizindikiro

M'magawo oyamba, ndikovuta kudziwa kupusa kwa hypoglycemic. Zizindikiro za izi zimatha kusokonezeka mosavuta ndi matenda ena, chifukwa chomwe munthu salandira chithandizo chofunikira. Choyamba, ndikofunikira kuyang'ana munthu m'maso, kuyeza kukakamiza kwake, kukoka kwake, kuwunika momwe zinthu zilili. Komabe, kunena molondola ngati ichi ndi chifuwa cha hypoglycemic kapena ayi, kungoyesa magazi wamba kungatheke.

Nthawi zambiri zimawonetsa zotsatirazi:

• Zizindikiro zoyambirira zimawonekera ngakhale kuchuluka kwa shuga m'magazi kumatsika ndi 3.5 mmol / L.
• Shuga akamatsikira ku 1.66-2.77 mmol / L, zizindikiro zonse za hypoglycemia zimawonekera mwa munthu.
• Pazakudya za shuga za 1.38-1.65 mmol / l, munthu amasiya kuzindikira.

Mukazindikira mtundu wa hypoglycemic, kudziwa kuchuluka kwa kuchepa kwa glycemia ndikofunikira kwambiri. Ngati wodwalayo sanakulipire shuga yemwe amadalira insulin, amayamba ndi glycemia wowonjezera kapena wabwinobwino - 11.1 mmol / lita. Izi zimachitika ngati kutsika kumachitika kuchokera kwambiri.

Maphunziro ena ozindikira a hypoglycemic coma si ofunika kwenikweni. Palibe shuga mumkodzo, kupenda kwamankhwala am'mwazi kumawonetsa kuchepa kwa kuchuluka kwa michere ya chiwindi. Kuzindikira kumachitika pokhapokha ngati glycemia yotsimikizika itatsimikiziridwa.

Thandizo loyamba

Nthawi zambiri pamkhalidwe uwu, kukonza thanzi la wodwala, zosinthira zotsatirazi zimachitika:

1. Amapatsidwa china chake chokoma ndi shuga wambiri: tiyi, khofi, maswiti, ayisikilimu, msuzi wokoma.
2. Wodwalayo amakhala kuti wagona kapena atakhala pansi kuti apereke magazi osasokoneza. Wodwala akataya chikumbumtima, amayikidwa pambali pake. Izi zimachitika kuti kusanza sikupunthwa. Komanso ikani chidutswa cha shuga patsaya.
3. Pambuyo pa izi, muyenera kuyimbira ambulansi nthawi yomweyo.

Chothandiza kwambiri poletsa kuukira kwa hypoglycemic chikomaso ndi yankho la shuga. Itha kugwiritsidwa ntchito pokhapokha ngati munthu akudziwa. Kukonzekera mankhwalawa, ndikofunikira kupukuta supuni zingapo za shuga mu kapu ya madzi owiritsa.

Ngati mukudziwa matenda a munthu komanso mukudziwa zachipatala, mutha kum'patsa adrenaline cube ndi njira yolowerera shuga. Komabe, kumbukirani kuti zotsatirazi zonse zidzakhala pa inu.

Chithandizo

Ngati mukukayikira kuti nthawi yakubwera mwachangu, mutha kudziletsa. Kuti muchite izi, ingodya mkate pang'ono ndikumwa zakumwa zotsekemera: tiyi kapena njira yokhazikika ya shuga.

Mungathenso kudya zakudya zina zamafuta othamanga: uchi, maswiti, ufa, kuwira. Tengani zakudya pang'onopang'ono kwa mphindi 10-15 mpaka kukomoka kutha. Ngati palibe zotulukapo, itanani dokotala.

Ngati wina walephera kuzindikira matenda a hypoglycemic munthawi yake, madokotala oyenerera amathandiza. Woopsa akamataya chikumbumtima, wodwalayo amapaka jekeseni wa shuga m'mitsempha. Nthawi zambiri izi zimakhala zokwanira kubwezeretsa zolimbitsa thupi. Ngati pakapita mphindi 15 palibe kusintha komwe kwatsatiridwa, katswiriyo akubwereza njirayi, koma ndi kukoka.

Makonzedwe a 1 ml a glucagon amawonetsedwanso kudzera m'mitsempha, intramuscularly komanso subcutaneally. Njira zoterezi zimathandizira kubwezeretsa munthu m'mphindi 10-20. Ngati ndi kotheka, kuyendetsa shuga kumatha kubwerezedwa.

Ndi woopsa kwambiri hypoglycemic chikomokere, wodwalayo amamuika mu mnofu kapena mtsempha wa makonzedwe a 150-200 ml ya hydrocortisone. Zimathandizira kubwezeretsa kapamba. Wodwalayo akapanda kukhalanso ndi chikumbumtima, amapitilirabe ndi vuto la shuga m'mitsempha.

Pofuna kupewa kutupa kwa amuna omwe ali ndi kutupa, katswiri amayambitsa njira yothetsera matenda a mannitol. Zimathandizira kuteteza kagayidwe kachakudya njira, komanso kupewa. Ngati ndi kotheka, mankhwala a mtima amaperekedwa. Atayima, munthuyo amakhazikika moyang'aniridwa ndi adokotala masiku angapo.

Kupewa

Kupewa kukomoka kwa magazi ndi kutsatira malangizo onse a dokotala. Anthu omwe ali ndi matenda ashuga ayenera kugwiritsa ntchito mankhwalawa mosiyanasiyana komanso muyezo.

Zofunikanso kutsatira zakudya zapadera komanso kuwunika kukula kwa zochitika zolimbitsa thupi zilizonse.

Yesetsani kuthana ndi kupsinjika ndi kutaya mtima pang'ono momwe mungathere. Zimathanso kukhumudwitsa magwiridwe anthawi zonse.

Musanatuluke m'nyumba, onetsetsani kuti muli ndi maswiti, shuga kapena kagawo ka mkate wamba pafupi. Ngati mumakumana ndi vuto la chikomokere pafupipafupi, onetsetsani kuti mukukumana nanu za matendawa. Chifukwa chake kudzakhala kosavuta kwa madokotala omwe abwera kudzapulumutsa, adzayamba kukuthandizani mwachangu.

Yesetsani kukhala ndi moyo wathanzi, kusiya kusala komanso kumwa pafupipafupi mavitamini. Komanso, musaiwale kuti nthawi zonse mumayesedwa magazi a glucose, komanso kutsatira malangizo onse a dokotala.