ʻO ka hypoglycemia i loko o nā keiki hou: nā kumu, nā hōʻailona, ka mālama ʻana, nā hōʻailona

ʻAʻole nō i wehewehe iki ka hypoglycemia e pili ana i nā haʻawina ʻōnaehana.

Hoʻokomo ʻia nā mea pilikia i ka wā mua, ka nui o ka nui / ka nui no ka makahiki gestational, a me ka asinine perinatal. Kuhi ʻia ka maʻi maʻi neʻe a hōʻoia ʻia e ka hōʻike glucose. Hoʻokomo ka prognosis i nā maʻi lalo. ʻO ka hoʻomaʻemaʻe ke komo ʻana i ka meaʻai kūpono ʻole a i ʻole ke intravenous glucose.

Wahi a kahi noiʻi o nā neonatologists ma ʻEnelani i ka hopena o 80s, ka palena haʻahaʻa o ka glucose plasma maʻamau, e hoʻoholo ai i ka neʻe ʻana i kahi kūlana o ka hypoglycemia, mai ka 18 ka 42 mg / dL!

ʻO nā kumu mua o nā "glucose" mua o ke kaila o ke koko (GC) i loko o nā pēpē, ʻaʻole ia e hōʻike maoli i kahi hōʻike o ke kaola hemahema o ka glucose, akā he hopena ia o ka hoʻomaka ʻana e hānai i nā keiki hou i ka makahiki 60s. E like me nā pēpē mua a me nā pēpē liʻiliʻi e ka wā gestational, ʻoi aku ka nui o ka nui o ka hypoglycemia ma mua o nā pēpē piha piha maʻi ʻokoʻa ma muli o kā lākou mālama liʻiliʻi o ka glycogen a me ka loaʻa ʻole o nā enzyme glycogenolysis. I ka hoʻomaka mua o ka hānai, ka pae o HA i ka manawa o ka pule mua o ke ola ma waena o 70 mg / dl.

ʻO kēia ka mana o ka helu hoʻohālikelike o ka hypoglycemia e pili ana i nā helu serial o HA i ka pēpē piha piha ʻana i ka pēpē piha. ʻAʻole i pau ʻia ka nīnau "he aha ka hypoglycemia", akā "he aha ka pae o HA e pono ai no ka hana maʻamau o nā keiki a ke keiki a ka maʻi āpau"?

ʻElua mau hana kūʻokoʻa i hoʻopaʻa ʻia e loiloi i ka hopena o nā haʻahaʻa haʻahaʻa o HA ma ka hana o ka lolo i hana like me nā hopena like:

Ua hoʻokō ʻo Lucas (1988) i ka loiloi neurological i loko o nā keiki aloha ma mua (n = 661) a hōʻike ia i ka hui o nā keiki i hōʻoki ʻia ke kiʻekiʻe GK ma lalo o 2.6 mmol / L no ka liʻiliʻi o 3 mau lā, akā naʻe nā mau hōʻailona ua hala, ma ka makahiki o 18 mau mahina, ua hōʻike ko ka neʻe ʻana o ka neurological i nā manawa he 3.5 i ka manawa pinepine ma mua o ka hui o ka ʻoihana. Ma hope mai o kēia mau hopena i ka ʻike o ka noi ʻana o ka Duvanel (1999) i ka loiloi ʻana i ka hana neurological i loko o nā keiki i hānau mua maoli ma ka makahiki 5 mau makahiki, a ua ʻike ʻia i nā hopena pinepine o hypoglycemia ka hopena maikaʻi loa i ka hoʻomohala ʻana o ka psychomotor o ke keiki.
ʻO Koh (1988) i kāna aʻo ʻana me ka hoʻohana ʻana i nā hana neurophysiological e loiloi i ka pilina ma waena o ke kiʻekiʻe o ka HA a me ka hiki ʻana mai o nā māka acoustic pathological i loko o nā keiki hou. Eia nō naʻe, i nā keiki i hōʻemi ʻole i ka pae GK ma lalo o 2.6 mmol / l, ʻaʻole i ʻike ʻia nā mea kūpono o ka pathological i kekahi mea, like ʻole me ka pūʻulu o nā keiki me nā haʻahaʻa haʻahaʻa haʻahaʻa (n = 5).

Wahi a nā hualoaʻa i kēia mau noiʻi, hiki ke loaʻa nā hopena hope aʻe:

ʻO ka mea mua, mālama ka glycemia> 2.6 mmol / L pale i ka hoʻomohala ʻana o ka hana hōʻeha a me ka hoʻomau.
ʻO ka lua, ʻike pinepine a lōʻihi ka lōʻihi o ka hypoglycemia ke nānā aku i ke koʻikoʻi no kahi keiki hou ma mua o ka manawa pōkole a hoʻokahi wale nō hoʻi. ʻO ka nele o nā maʻi lapaʻau maʻamau i ka manawa neonatal he kūlana maʻamau, ʻaʻole ia e hōʻike i kahi papa haʻahaʻa haʻahaʻa o ka hypoglycemia. No laila, pono e noʻonoʻo ʻia ka hypoglycemia e like me ka paʻakikī a koi i ka mālama hou a me ka kaohi.

Wehewehe

Nā pēpē piha a me nā keiki mua (ma mua o SGA): 4300 g.

ʻO ka asphyxia, heʻano paʻakikī ka perinatal.

Hoʻonui hoʻonui ʻia / Hyperinsulinism:

ʻO ka lāʻau lapaʻau Maternal (thiazides, sulfonamides, β-mimetics, tocolytics, diazoxide, antidiabetic drug, propranolol, valproate).
ʻO kahi keiki mai kahi makuahine me ka maʻi maʻi (a hiki i 30%).
Polyglobulia.
Wiedemann-Beckwith Syndrome (1: 15000).
ʻO ka hyperinsulinism kongenital (ʻo ka ʻōlelo o mua: nezidioblastosis), insulinoma (loaʻa pinepine loa).
Leucine-maʻi hyperinsulinism.

Hoʻemi ka hōʻaila glucose:

Nā manaʻo o nā enzymes gluconeogenesis:

fructose-1,6-bisphosphatase
phosphoenolpyruvate kinases carboxy
kalekomo pyruvate

Nā manaʻo o nā enzyme glycogenolysis (glycogenoses me kahi luhi i ka hypoglycemia):

glucose-6-phosphatase (type I)
ʻEiwa no ka ʻaila o ka lālā (kūlohelohe enzyme) (type III)
nā pūpū paʻilima (type VI)
Nā kinases ka phosphorylase (type IX)
glycogen synthetase (ʻano 0).

Nā maʻi i loko o ka pauku huela amino amino: e.g. maple syrup disease, tyrosinemia.

Organemiaemia: e.g. propionic acidemia, methylmalonic acidemia.

ʻO Galactosemia, ka intolerance fructose.

Nā huina i ka heleʻana o nā momona momona.

ʻO kahi kīnā ʻole o ka glucose mai ka meaʻai.

ʻO nā maʻi o ka maʻi: ka nui o ka ulu ana o ka hormone, ka hemahema ACTH, hemahema glucagon, hypothyroidism, hemahema cortisol, hoʻokaʻawale a hui pū ʻia nā pilikia o ka pituitary.

Nā kumu ʻē aʻe: kahi hewa i ka lawe ʻana i ka maʻi infusion, kahi hōʻeha i ke ʻano o ka infusion therapy e pili ana i kahi kūlana o ka hāʻawi kiʻekiʻe o ka glucose, maʻi ʻeha loa, ke hoʻololi ʻana i ke koko, ka pakanā peritoneal, indomethacin therapy, hoʻōla glucose ma loko o kahi catheter kiʻekiʻe i ka ʻōpū o ka umbilical.

Nā hōʻailona a me nā hōʻailona o ka hypoglycemia i nā keiki hou

I ka nui o nā manawa, ʻaʻole hele mai nā hōʻailona. ʻO nā hōʻailona neuroglycopenic ka hoʻohewa ʻia, coma, nā cyanotic episodes, apnea, bradycardia, a i ʻole e hoʻopiʻi a me ka hypothermia.

Polokalamu: hiki i nā hōʻailona lapaʻau ke noho i ka hyperglycemia koʻikoʻi, no laila, ma nā hihia kānalua, hoʻoholo mau i ka GC!

ʻAnoopihi, nāwaliwali palupalu (nā maʻi atypical o ka hypoglycemia i nā keiki kahiko).
E hopohopo, hoʻopauʻana.
Mākia kekahi kerebral.
ʻO Tachycardia, hoʻōki i ke koko.
Hoʻokomo ʻo Tachypnea, apnea a me cyanosis.
Ke kū nei kekahi hoʻōho me ke ʻano.

ʻO ka maʻi kuʻuna o ka hypoglycemia i loko o nā keiki hou

Nā pōkoki huapalapala i ka pō.

Nā hōʻailona āpau he nonspecific a ua ʻike ʻia i loko o ka poʻe keiki hou me ka asphyxia, sepsis, hypocalcemia, a me ka maʻi hōʻemi opioid. No laila, ʻo nā pēpē hou i pilikia me ka ʻole a ʻole kēia mau ʻōuli e koi koke i nā hoʻāʻo ʻana ma ka moe. Hoʻomaopopo ʻia nā haʻahaʻa haʻahaʻa haʻahaʻa ma o ka nānā ʻana i kahi tauira koko venous.

Polokalamu: hypoglycemia = hoʻohana ma ke ʻano maʻi!

Pehea?: Nā kiʻina hoʻohana pālua no ka hoʻohana ʻana i ka glycemic control ma ka haʻahaʻa haʻahaʻa o ke ana mai ka ʻālaina i loaʻa mai e ka metana hexokinase i hoʻohana ʻia i loko o ka ʻoihana, i.e., nā waiwai kīwī liʻiliʻi pathologically mai nā hualoaʻa o nā ana ʻana e hoʻohana ai i nā ʻāpana hoʻāʻo. ua nānā ʻia e ke ʻano hana ʻoihana. Na rula o ka hoʻomaʻamaʻa: HA 4300 g i ka wā hānau, nā pēpē mai ka makuahine me ka maʻi maʻamau, nā pēpē preterm.
Anahea? Ka huki ʻana o ka mākaʻikaʻi GC, 1/2, 1, 3, a me 6 mau hola ma hope o ka lawe ʻana, a laila e like me nā hōʻike.

ʻO ka maʻi haʻahaʻa: mua, e haʻalele i nā maʻi me ka metaboleta, e like me sepsis, malformations.

Kekahi / hopena-pale hypoglycemia:

hoʻoholo i ke kua o ka hypoglycemia o kahi metabolite kīʻaha o P-hydroxybutyrate, ka wai momona momona, lactate a me nā kahe koko.
hou algorithm diagnostic algorithm.
Hōʻike ʻia i ka maʻi maʻi - alakaʻi ʻia e nā ʻāpana kūhelu ʻehā.

Hoʻopilikia i ka hypoglycemia i nā keiki hou

Dextrose intravenously (no ka pale a me ka mālama ʻana).
Mau meaʻai ʻai.
I kekahi manawa glagonagon intramuscular.

Hana ʻia nā pēpē kiʻekiʻe kiʻekiʻe e mālama ʻia. ʻO nā pēpē mai nā wāhine me ka maʻi maʻi e hoʻohana nei i ka insulin e hāʻawi mau ʻia i kahi hopena momona no 10% mai ka hānau ʻana. ʻO nā pēpē hou i hiki ʻole i nā mea maʻi ʻole e hoʻomaka i nā mea e hānai pinepine ai me nā mea hui e hāʻawi i nā calcium.

Inā hāʻule ka pae glucose i 120 ml / kg / lā no nā mea ʻai 6-8.

Inā ʻaʻole hiki, hoʻonāukiuki glucose 10% 4-5 ml / kg / hola.

E hoʻokaʻawale koke i glucose glucose 3 ml / kg 10% glucose, ʻōlelo hou inā pono.
Ma hope o kahi bolus, kahi mālama i ka infusion mālama i ka glucose o 5 ml / kg / hr o ka hopena o ka glucose i ka 10%.
Mai poina e pili ana i ka hāʻawi kālā nui o ka glucose. Hoʻohui i ka maltodextrin i ka waiū waiū (ua hoʻoulu ʻia ʻo ia i ka mea huna o ka insulin i ka liʻiliʻi ma mua o ka iv glucose).
I ka hala ʻole o ka hopena: e hoʻonui nui ana i ka waihona o ka glucose glucose ma 2 mg / kg / min a i ka nui o 12 mg / kg / min.
Inā ʻaʻole kūleʻa ka pōmaikaʻi ma hope o ka lawe ʻia ʻana o nā hana i luna: ke alakaʻi ʻana i kahi gluon rut: ka pākaukau no ka pēpē piha piha (eutrophic) 0.1 mg / kg iv, s / c a i ʻole iv. Mai hoʻohana me HH a i ʻole SGA paha!

Polokalamu: ʻO ka pale ʻana, no ka mea ua pōkole ka hopena!

Polokalamu: kahi polū glucose nui → ka hoʻoulu ikaika o ka hana ʻenehana insulin i kahi hāʻule hou aʻe i ka glycemia!

Inā ʻaʻole i loaʻa ka hopena.

ʻO Octreotide (kahi hui o somatostatin) 2-20 mcg / kg / lā s / c no nā 3-4 inikua, hiki nō hoʻi i ka iv i ka wā preoperative me ka hyperinsulinism congenital.
E like me kahi hopena hope loa: diazoxide, chlorothiazide.

Polokalamu: ka hopena nui i ka GC.

Nifedipine.
No kekahi mau lā, hydrocortisone. Nā hana: hoʻoulu ʻia o gluconeogenesis. Hoʻemi ka huehue olakino peripheral. Ma mua, ua ana ʻia nā cortisol a me nā pae o ka insulin no ka hypoglycemia.

Hōʻuluʻuluʻike: ʻoihana lawelawe kālā e like me ka mea e hiki ai, i loko / a i kahi e pono ai.

Kāohi i ka hypoglycemia i nā keiki hou

I nā wahine hāpai i ka maʻi maʻi, e mālama ana i ka kiʻekiʻe o ka glycemia kiʻekiʻe, ʻoi aku ka ma hope o ka wā hāpai

ʻO ka hānai a me ka hana maʻamau mai ka hola 3 o ke ola, ʻoiai nui ʻo HH a me SGA.

E makaʻala pono hou i ka hana ʻai mau, me ka waiho ʻana ma hope o ka hoʻokuʻu ʻana (ma ka liʻiliʻi o nā hola 4). I ka NN e hoʻomākaukau nei no ka hoʻokuʻu ʻana, ma nā 18% o nā hihia he mau manawa o ka hypoglycemia hope me ka hoʻolohi ʻana i ka hānai.

ʻAtikala lāʻau lapaʻau

ʻO ka hypoglycemia he serum glucose ka nui o nā haʻahaʻa ma lalo o 40 mg / dl (a emi mai ka 2.2 mmol / l) i ka piha holoʻokoʻa a i ʻole ma mua o 30 mg / dl (ma mua o 1.7 mmol / l) i nā pēpē hānau mua. Pākuʻi ʻia nā mea pilikia ma mua o ke kau a me ka asphyxiation intrapartum. ʻO nā kumu maʻamau e lawa ai nā hale kūʻai glycogen a me ka hyperinsulinemia. Nā hōʻailona o ka hypoglycemia e pili ana i ka tachycardia, cyanosis, cramps a me apnea.

Hōʻike ʻia ka ʻike maʻi hypoglycemia e hoʻopaʻa ʻia e ka hoʻoholo ʻana i ka pae o ka glucose. Hoʻokomo ka prognosis i ke kumu, ke ʻano mea e mālama ai i ka ʻai kai komo ʻana i ka glucose intravenous.

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He aha ke kumu o ka hypoglycemia i nā keiki hou?

ʻO ka hypoglycemia i loko o nā keiki hou e loli a mau a mau paha paha. ʻO nā kumu o ka palaka hypoglycemia ka lawa ʻole o ka substrate a i ʻole ka pau ʻole o ka hana enzyme, e alakaʻi ana i nā kikowaena kūmole glycogen. ʻO nā kumu o ka hoʻomau i ka hypoglycemia he hyperinsulinism, he kaʻe hewa ʻana o nā hormones contrainsular a me nā maʻi metabola o nā hua ona e like me ka glycogenosis, ka hopenaoneoneoneoneonea impaired, ka hopena o ka hoʻoneʻe ʻana i nā momona momona.

Loaʻa i nā hale glycogen kakela i ka wā hānau a loaʻa i nā pēpē mua me ke kaumaha koʻikoʻi loa, nā pēpē a ka poʻe ma kahi o ka gestation ma muli o ka maʻi plentally, a me nā pēpē i loaʻa kahi intrapartum asphyxiation. Anaerobic glycolysis depletes hale kūʻai glycogen i loko o ia mau keiki, a hypoglycemia hiki ke ulu i kēlā me kēia manawa i nā lā mua, akā inā he lōʻihi ka lōʻihi ma waena o ka hoʻomohala a i ʻole ka ʻai ʻana o nā huaʻai e haʻahaʻa. No laila, he mea nui ka mālama ʻana i ka waiwai o ka exogenous e pale i ka hypoglycemia.

He maʻamau ka maʻi hyperinsulinism i nā keiki mai nā makuahine me ka maʻi maʻi. Hōʻike pinepine ʻia ʻo ia me ke kaumaha o ke kino ma nā keiki liʻiliʻi e ka ulu ʻana. ʻO nā kumu maʻamau ka liʻiliʻi o ka hyperinsulinism (hoʻopili ʻia e ka autosomal dominanum a me ka hoʻoilina hoʻoilina autosomal), erythroblastosis aʻōkole, Beckwith-Wiedemann syndrome (i hui pū ʻia me ka hyperplasia islet me nā hōʻailona o macroglossia a me ka hernia umbilical). Hōʻike ka Hyperinsulinemia i kahi wikiwiki wikiwiki i ka glucose sima i ka 1-2 mau hola mua ma hope o ka hānau ʻana, ke pau ka hoʻomau mau ʻana o ka glucose ma o ka placenta.

Hiki nō hoʻi i ka hypoglycemia ke hoʻomaka inā he kikowaena intravenous o kahi hopena ʻai i ka wikiwiki.

Nā hōʻailona o ka hypoglycemia i nā keiki hou

ʻAʻohe keiki nui ʻaʻohe hōʻailona o ka hypoglycemia. ʻO ka lōʻihi a i ʻole ka hypoglycemia e hoʻolōʻihi i nā hōʻailona lāʻau a me ka neurological o ke kumu kumu. ʻO nā hōʻailona o nā lauila me ka palau, tachycardia, nāwaliwali, a me nā mea hoʻowalewale a i ʻole nā mea nunui. ʻO nā hōʻailona neilima waena o ka hypoglycemia me ka hōʻino, ka coma, nā manawa cyanosis, apnea, bradycardia a i ʻole ka hanu kaumaha, hypothermia. ʻO ka lethargy, kaʻai ʻole maikaʻi, ka hypotension, a me ka tachypnea e ʻike ʻia. ʻO nā hōʻike a pau he nonspecific a ua ʻike ʻia i nā wā pēpē hou e ʻike ana i ka asphyxia, me sepsis a hypocalcemia, a me ka maʻi maʻi opioid paha. No laila, ʻo nā mea maʻi e pilikia ana a i ʻole a ʻole kēia mau ʻōuli e koi koke i ka mālama pono ʻana i ka glucose o ke koko capillary. Kuhi ʻia kahi papa haʻahaʻa kūpono loa e ka hoʻoholo ʻana o ka glucose i ke koko venous.

Hoʻopilikia i ka hypoglycemia i nā keiki hou

Hōʻeha ʻia nā pēpē liʻiliʻi kiʻekiʻe e mālama ʻia. ʻOkoʻa, ke loaʻa pinepine nei nā keiki mai nā wahine me ka diabetes mellitus e pili ana i ka maʻi mellitus e loaʻa ai ka infusion intravenous o ka hopena o ka glucose 10% ma hope koke o ka hānau ʻana a i hāʻawi ʻia i nā mea hoʻonaninani a ʻōlelo ʻia, a i nā mea maʻi e maʻi mua ʻole a i nā keiki paha me ka maʻi hanu. Aia nā pēpē i nā pēpē e pono e loaʻa ka hānai pinepine ʻana i ka pānaʻi e hoʻolako iā lākou me nā mea lolo.

I kahi pēpē e hoʻēmi ana ka pae o ka glucose i ka emi a i ʻole ka like me ke 50 mg / dl, pono e hoʻomaka ʻia ka mālama kūpono me ka hoʻoulu ʻana i kahi ʻai a i ʻole hoʻokele ʻana i ka hopena ʻana o ka glucose me ka hoʻokaʻina ʻana a hiki i 12,5%, ma ka nui o ka 2 ml / kg no ka mau manawa he 10 mau hola aku, kiʻekiʻe hiki ke lawelawe ʻia nā ʻike, inā pono, ma o ka catheter kikowaena. A laila hoʻomau ka infusion i ka manawa e hōʻoia ai ka lawe ʻana i ka 4-8 mg / (kg min) o ka glucose, i.e., kahi hopena o ka glucose i 10% ma ka nui o ka aneane 2.5-5 ml / (kg h). Pono ka nānā ʻia o ka serum glucose e pale ʻia i ka helu o ka infusion. Me ka holomua o ke kūlana o ka pēpē, hiki i ka mea hoʻokomo ke hoʻoliu kūleʻa i nā infusion intravenous, ʻoiai e hoʻomalu mau ʻia ka ʻike ka glucose. Hoʻopau pinepine nā infusion glucose infusion e lohi, e like me ka hoʻokaʻawale koke ʻana iho e hiki ai i ka hypoglycemia.

Inā paʻakikī ka hoʻomaka ʻana i kahi infusion intravenous i loko o kahi pēpē me ka hypoglycemia, glucagon ma kahi o 100-300 μg / kg intramuscularly (ka nui (1 mg) nui pinepine e hoʻonui i ka pae o ka glucose, e mau loa kēia hopena i nā hola 2-3, koe wale nō nā pēpē me ka hala o nā hale kūʻai glycogen. ʻO ka hypoglycemia, ka mea hou i ka hoʻoliʻi ka glucose ma kahi kiʻekiʻe loa, hiki ke mālamaʻia me ka hydrocortisone ma kahi pākana o 2.5 mg / kg intramuscularly 2 mau manawa i ka lā. Inā pale ʻole ka hypoglycemia i ka mālama ʻana, e hoʻokaʻawale ʻia nā kumu ʻē aʻe (no ka laʻana, ka sepsis) a, inā paha, he palapala endocrinological e kuhikuhi ʻia e hoʻomaopopo i ka hyperinsulinism hoʻomau a me ka gluconeogenesis hoʻomālamalama a i ʻole glycogenolysis.

ʻO ka hypoglycemia transient: hoʻolilo i nā keiki hou

ʻO ka oxygen a me ka glucose ka kumu kumu o ke ola no ke kino.Ma hope o ka hyperbilirubinemia, ua manaʻo ʻia ʻo ka hypoglycemia neonatal kahi kumu lua e koi ai i ka lōʻihi o ka pēpē i ka haukapila ma hope o ka hānau ʻana. Pono ke keiki me kahi maʻi maʻi e nānā i kahi kikoʻī, no ka mea he nui nā maʻi e hiki pū me ka hypoglycemia.

A ʻo ke koina koko haʻahaʻa o ka mea hou a me ke keiki o ka makahiki mua o ke ola e manaʻo ʻia nei he wahi pōpilikia loa no ke olakino. Hoʻopilikia nui ia i nā mea kūpono o ka lolo a me nā kiko āpau.

Ke ala (transient) hyponlycemia neonatal

Ke hānau kahi pēpē, loaʻa nā pilikia i ke kaumaha. I ka wā o ka hana a ma ka wā o ke kau ʻana o ke keiki ma o ke kahawai hānau o ka makuahine, hoʻokuʻu ʻia ka glucose mai ka glycogen i loko o ka ate, a me ke ʻano o ke kō koko koko i nā keiki.

Pono kēia e pale i nā pōʻino o ka lolo o ke pēpē. Inā he haʻahaʻa haʻahaʻa haʻahaʻa a ke keiki, hoʻoulu ʻia ka hypoglycemia transient i loko o kona kino.

ʻAʻole mau kēia kūlana, no ka mea, ke hoʻomaikaʻi nei i nā hana o ka hoʻoponopono ponoʻī o ke kahe o ka nui o ke koko, ke hoʻi hou nei kona ʻano me ka maʻamau.

Hiki i ke ʻano o kēia kūlana ma muli o ke ʻano luhi o nā limahana olakino (hypothermia), akā he mea kūpono kēia no nā pēpē mua a i ʻole nā keiki me ke kaumaha. Me ka hypothermia, hiki i ka hypoglycemia ke hanana i kahi pēpē ikaika.

Naihue

ʻO nā keiki olakino piha kahi nui o nā glycogen ma loko o ka nui. E maʻalahi maʻalahi ka paleʻana i ka pēpē i ka paʻakikī o ka hānau ʻana. Akā inā hoʻomau ʻia ka ulu ʻana o loko o ka pūpū me kekahi mau abnormalities, hypoglycemia ma ke keiki like lōʻihi a koi aku i ka hoʻoponopono hou aku me ka hoʻohana ʻana i nā lāʻau lapaʻau (hoʻokele glucose).

Hoʻokomo ka lōʻihi i ka hypoglycemia ma mua o nā keiki mua, nā pēpē haʻahaʻa a i nā pēpē lōʻihi.

Ma ke kānāwai, ʻo kēia pūʻulu o nā pēpē hou me ka mālama haʻahaʻa nā protein, adipose tissue a me ka glycogen hepatic.

Eia kekahi, ma muli o ka nele o nā enzyme i kēlā mau keiki, ua hoʻemi ʻia ka ʻano o ka glycogenolysis (hōʻea i ka glycogen). ʻO kēlā mau kālā i loaʻa i ka makuahine, ua hoʻopau koke ʻia lākou.

Nui! Uku ka nānā pono ʻana i kēlā mau keiki i hānau ʻia i nā wahine me ka maʻi maʻi. Maʻa pinepine kēia mau pēpē, a nui ka ʻike o ka glucose i ko lākou koko. Hoʻopiʻi kēia ma ka hyperinsulinemia.

ʻO nā pēpē i hānau ʻia ma ke alo o kahi hakakā Rhesus e loaʻa i nā pilikia like. Ka mea, me ke ano o ka paʻakikī o nā hana serological, hiki i ka hyperplasia o nā pankreatic papa ke hoʻomohala, ka mea e hana ai i ka insulin hormone. A ʻo ke hopena, e wikiwiki ʻoi aku nā palu i ka glucose.

Perinatal

Ua loiloi ke kūlana o ka pēpē i ka pākēnē Apgar. ʻO kēia ke kumu o ka hoʻoholoʻana o ka hypoxia keiki. ʻO ka mea mua, ʻeha nā keiki i ka hypoglycemia, nona ka hānau pono ʻana a ua hele pū ʻia me ke koko nui.

Hoʻokumu ka kūlana hypoglycemic i nā keiki me ka arrhythmias cardiac. Hāʻawi pū kekahi ʻo ia i ka hoʻohana ʻia ʻana e ka makuahine i ka wā o kahi hapai o kekahi mau lāʻau lapaʻau.

ʻO nā kumu ʻē aʻe o ka transog hypoglycemia

Lawe pinepine ʻia ka hypoglycemia transient e nā maʻi like ʻole. ʻO kekahi o kāna ʻano (ʻaʻole kūpono ke pathogen) i ka hypoglycemia. ʻO kēia no ka nui o ka ikehu ka nui o ka ikehu ka hakakā ʻana i ka maʻi maʻi. A, e like me kāu e ʻike ai, he glucose ka kumu o ka ikehu. ʻO ka hōʻeha o nā hōʻailona neonatal hypoglycemic pili i ka nui o ka maʻi ma lalo o ka maʻi kumu.

ʻO nā hui nui hou i nā pēpē hou e loaʻa nei nā puʻuwai naʻau congenital a me ka puni koko. I kēlā kūlana, hoʻonāukiuki ka hypoglycemia i ke kahe koko ma loko o ke akea a me ka hypoxia. Ua nalowale nā makemake no ka inikini insulin i loko o kekahi o kēia mau hihia, ka hoʻolako ʻia i ka manawa kūpono o nā maʻi pae lua:

kaʻe lele ʻana
anemia
hypoxia.

ʻO ka hypoglycemia hoʻomau

I ka wā o nā maʻi he nui i loko o ke kino aia kekahi hewaʻole o nā kaʻina metabola. Aia nā kūlana i kū aʻe ai nā hemahema e pale i ka hoʻomohala maʻamau o ka pēpē a hoʻopau i kona ola.

ʻO kēlā mau keiki, ma hope o ka hoʻopaʻa ʻana, e koho maikaʻi i kaʻai kūpono a me ka lāʻau lapaʻau. ʻO nā pēpē e hōʻeha nei i ka galactosemia congenital, ʻike ʻia kona mau hōʻailona mai nā lā mua o ke ola.

Ma hope iki, ua hoʻomohala nā keiki i ka fructosemia. ʻO kēia no ka hopena i loaʻa i ka fructose i nā huaʻai he nui, ka meli, nā wai wai wai, a ua hoʻopuka ʻia kēia mau huahana i ka papa ʻaina o ke keiki i ka nui ma hope aku. ʻO ka hele ʻana o nā maʻi ʻelua e pono ai i kahi meaʻai ikaika no ke ola.

ʻO ka hoʻomohalaʻana o ka hypoglycemia hiki ke hoʻokaʻawale i kekahi mau maʻi hormonal. ʻO ka mea mua i kēia hana, ʻo ia ka lawa o ka kelima pituitary a me nā kelepa adrenal. I ke kūlana like, hoʻokau pinepine ʻia ke keiki ma lalo o ka mālama ʻana o kahi endocrinologist.

Hiki i nā ʻōmaʻomaʻo o kēia mau ala ke hele i nā pēpē a i kekahi makahiki ma hope aku. Me ka ulu o nā sela pancreatic, hoʻonui ka nui o ka insulin a, ma muli, ua emi ka nui o ka glucose i ke koko.

Hoʻoholo pololei i kēia kūlana ma nā ʻano kuʻuna hiki ʻole. Hiki ke hoʻokō ʻia ka hopena e nā hoʻokele.

ʻO ka Hogoglycemia a me nā hōʻailona

Hanu wikiwiki.
Ka manaʻo hopohopo.
Hoʻohui maikaʻi loa.
Kaʻaea o nā wāwae.
Ke hoʻohālikelike nei ka manaʻo o ka pōloli.
ʻ .lelo hoʻohālikelike.
Hoʻopilikiaʻia ka hana hanu a hiki i kona pau ʻole.
ʻOmaʻomaʻo.
Nāwaliwali o ka ʻōpū.
ʻEhaʻeha.

No ke keiki, ʻo nā kīwaha a me nā pilikia hanu ka mea weliweli loa.

ʻO ka manawa pinepine, ua hoʻopaʻa ʻia ka hypoglycemia i ka lā mua o ke ola o ka pēpē.

Ka hoʻomāhuā ʻana o ka maʻi

I nā keiki o ka makahiki mua o ke ola a me nā pēpē, lawe ʻia nā hoʻokolohua e hōʻike i ka maʻi a i ʻole ka lōʻihi o ka hypoglycemia:

kōhumu koko,
hōʻailona o nā momona momona,
ka hoʻoholo ʻana i nā pae insulin,
ka hoʻoholo o ka pae o ka ulu ʻana o ka hormone (cortisol),
ka nui o nā kino ketone.

Inā he pilikia ke keiki, e hana ʻia ana ka noiʻi i nā hola 2 o kona ola. Mākaukau i kēia mau kuhikuhi, ua hoʻoholo ka ʻano a me ka pae o ka neonatal hypoglycemia, kahi e hiki ai ke kākau i kahi kūpono kūpono no ka pēpē.

ʻO wai ka hopena hopohopo

Hiki i ka hypoglycemia ke ola i kekahi keiki, akā aia kekahi hewahewa e pili ana i nā keiki:

gestational hele hewa
makua
me nā hōʻailona o ka hypoxia,
hānau ʻia i nā makuahine me ka maʻi diabetes.

I kēia mau pēpē, e hoʻoholo ʻia nā pae kōʻai koko ma hope o ka hānau ʻana (ma loko o 1 hola o ke ola).

He mea koʻikoʻi loa ia e hōʻike koke i ka hypoglycemia i kahi keiki hou, no ka mea, ʻo ka mālama kūpono a me ka pale ʻana e pale aku i ke pēpē i ka ulu ʻana o nā hopena koʻikoʻi o kēia ʻano.

ʻO ke kikowaena o ka nānā ʻana i nā loina o ka hoʻomohala perinatal. Pono e hoʻomaka mua o ka hōʻuluʻulu i ka wā hiki ke pale, e pale i ka ulu ʻana o ka hypoxia, a pale i ka hypothermia.

ʻO ka mea mua, me neonatal hypoglycemia, loaʻa ka poʻe pediatricians i ka hopena o ka glucose 5% intravenously. Inā heʻoi aku ka pēpē o ka pēpē i ka lā, hoʻohana ka 10% o ka momona glucose. Ma hope o kēlā, e hoʻomaʻamaʻa ʻia nā hoʻokolohua o ke koko i lawe ʻia mai ka kuekuʻe o ka pēpē hou a hiki i ka pepa hōʻike.

Eia kekahi, ke hāʻawi nei ke keiki i kahi wai i loko o ke ʻano o ka hopena o ka hopena glucose a i hoʻohui ʻia i ka waiu hui. ʻAʻole lawe kēia mau kaʻina i ka hopena i makemake ʻia, e hoʻohana ʻia ka lāʻau hormonal me ka glucocorticoids. He mea kūpono ia e hoʻomaopopo i ke kumu o ka hypoglycemia, hiki iā ia ke loaʻa nā ala kūpono no kona ʻānai ʻana.

Hypoglycemia i nā pēpē

Aia nā hewa ma ka ʻike o ka glucose i nā keiki ma ke koko i ka wā hānau. ʻO ka hui nui nui loa i waena o nā pēpē pēpē pēpē. ʻO ka hapa liʻiliʻi o nā hebedoma, ʻoi aku ka mākaukau ʻole no ke ola kūʻokoʻa. Hōʻike ka haʻahaʻa haʻahaʻa haʻahaʻa akā ʻaʻole wale ka neʻe o ka hypoglycemia, akā, nā mea i hoʻopiʻi hou aku ai. Inā kūpaʻa ka glucose i loko o kahi pēpē ma lalo o 2.2 mmol / l, he hōʻailona kēia no nā kauka a me nā mākua.

Hoʻohana ʻia nā wai momi ʻole e like me ke kīʻaha i loko o ka puʻuwai, ka puʻuwai, a me nā mea nā māhina, a lilo lākou i nā ate i ka lipoproteins low haʻahaʻa. Ua hōʻike kekahi mau hōʻike i ka emi ʻana o ka hoʻomaloka ʻana i nā emidion lipid intravenous i nā keiki liʻiliʻi no ka wā ulu a me nā keiki hou ma lalo o nā hebedoma 32 o ka ulu ʻana. Loaʻa pinepine kēia ma o ka hāʻawi ʻana i nā lipids i loko o 24 mau hola. ʻAʻohe “window” ʻole me nā lipid ka mea, ʻaʻole i lawelawe ʻia kēia mau mea hoʻomaʻemaʻe e hoʻomaʻemaʻe i nā lipid koko.

Aia nā mea ʻelua i ka nui o ka hua a me ka wai me ka glycerol. Eia nō naʻe, loaʻa i kēlā me kēia mahele ka nui o nā phospholipid ma mua o ka mea e pono ai ke emulsify triglycerides, ʻo ka nui o nā mea i lilo i mea ʻino i loko o ka triglycerides me nā phospholipid bilayers a ua ʻike ʻia ʻo ia he liposomes. No kēlā me kēia waiʻona i hāʻawi ʻia o ka triglycerides, pono ia e hoʻokomo i ka emulsion volume i ʻelua mau manawa ma ka 10% e hoʻohālikelike ʻia me 20%, no laila, no ka nui o nā triglycerides, ka emulion ma kahi o 10% e hoʻonui a hiki i nā manawa hou aʻe i nā liposomō ma mua o ka emulsion ma 20%.

ʻO nā keiki i hānau ʻia me ka hypoglycemia i ʻike ʻole ʻia a i ʻole haʻi ʻia ʻole e ola i ka wā hānau. ʻO kēia kekahi o nā kumu maʻamau o ka hapanui o ke keiki. Me ka maʻi kūpono, pono e hoʻokaʻawale koke ke keiki i ka mālama ʻana. Akā inā hāʻawi ʻia ka kōkua ke keiki i ka manawa a ola ʻo ia, a ʻawaʻawa paha nā hopena. ʻO ka hapa o kēia mau pēpē he palebral palsy. Me kēia maʻi, ua hele pū ka manawa me ka ʻohi lohi a me ka underdevelopment, hiki ke noʻonoʻo ʻia i hope nui. He maʻi paʻakikī kēia, no ke keiki a no kona ʻohana āpau. E lilo ia i kahi lōʻihi lōʻihi, me ka hoʻohana ʻana i nā ʻōnaehana hou loa.

Ua hōʻike ʻia kahi emulsion 10% e pili pū me ka kiʻekiʻe triglycerides plasma a me ka hōʻiliʻili o ka kolamu a me ka phospholipid i ke koko o nā pēpē mua, e like paha ma kahi o nā haʻahaʻa phospholipid kiʻekiʻe. ʻO nā liposomoli phospholipid nui i kahi emulsion 10% i manaʻoʻiʻo ia e koi i nā pahuhopu triglyceride e hoʻopili i nā pūnaewele lipase, ka hopena o ka hydrolysis wikiwiki o nā triglycerides. ʻO kēia manawa koke, loaʻa ka 10% o nā emulion lipid me ka hapalua o nā emulator phospholipid i hoʻohana mua ʻia.

I kahi noi ʻana i nā pēpē i hala mua ʻia, ka maikaʻi loa lākou i ʻole, me ka piʻi ʻole o ka pathological i ka ʻike o ka triglycerides a i ʻole kolamu i serum. Aia nā hopena o nā hopena hopena o ka emulsions lipid intravenous, ka mea e pili ana i ka hoʻololi ʻana o ka bilirubin indirect mai nā wahi paʻa i nā albimins, e hoʻonui ana i ka ulu ʻana o ka pūlohelohe, ʻo ka hoʻokuʻi ʻana i ka ʻōnaehana pale, ʻeha me ka coagulase-hewa staphylococci a me mycosis, thrombocytopenia a me ka hōʻuluʻulu ʻana o nā lipids ma macrophages, keolila palukoli.

I ka wā e ulu ai lākou, pono nā kō o ke koko i nā pēpē e hoʻokō me nā ʻano maʻamau i ʻāpono ʻia no nā pākeke. Ma kahi e kūlohelohe mai nā palena i koho ʻia mai ka 3.1 a i ka 5, 5 mmol l, ke wikiwiki loa e hana i kahi maʻi maʻi a me ka nānā ʻana i ke pēpē e hoʻomaopopo ai i nā kumu o ka poino o nā hōʻike. Hoʻolāwili koke ʻia ke koko no ka pau ʻana o ka honi o ka pēpē a inā pono, ʻoi aku ka hoʻomaʻamaʻa ʻana, a me ka hoʻomaka ʻana o ka infusion glucose infravenous, ʻoi ka manaʻo e ola ka pēpē.

Me ka hoʻopuka o nā lipids, ua hāʻawi ʻia nā mea hou o ka pēpē me ka hyperbilirubinemia me ka nānā ʻana i ka plasma triglycerides. Hiki i nā lipid ke hopena maikaʻi. He mālama maikaʻi ka hoʻokele ʻana o ka emidion lipid i ka endothelium vascular o nā vena peripheral, e alakaʻi ana i kahi manawa lōʻihi o ka permeability. No laila, hiki i nā lipid venosis ke hoʻonui i ka hopena o ka phototherapy a lilo i mea kōkua pono iā ia. ʻO ke kaohi ʻana o ke ʻano hana pale a me ka hoʻonui ʻia o ka sepsis e pili pinepine ʻia me ka hoʻohana ʻana i nā mea hana i loko o ko lākou mau waha.

ʻO ka hypoglycemia o ka hānau hānau hou

Ma hope o ka hānau ʻana o ke keiki, ua uhi ʻia nā pono o kona ikehu e ka maternal glucose, kahi i mālama ʻia ai i loko o ka umbilical vein, a i hoʻokumu ʻia ka glucose i ka hopena o ka glycogenolysis. Eia naʻe, kiʻi koke ka hale kūʻai glycogen, a ma nā mea hou a pau, he helu paka i ka neʻe ʻana o ka hoʻokaʻa ʻai koko i ka hola mua a i ʻole ʻelua.

Hōʻalo nā haʻawina liʻiliʻi loa ma nā minuke 30-90 mua. I nā pēpē piha mau ola e loaʻa ana i ka ʻai olakino i loko o ka mau hola 4 o ke ola mua, he piʻi nui ka piʻi o ka hoʻokahe o ke koko mai ka hora 2 a hiki i ka hola 4 i ka awelika o luna he 2.2 mmol / L, a ma ka hopena o ka lā mua - ma mua o 2. 5 mmol / l.

Pono e hoʻomanaʻo ʻia he hiki i ka pēpē o ka pēpē, me ka pēpē hānau mua, hiki ke hoʻoikaika a hoʻohana i ka kūlohelohe, a hiki hoʻomake ʻia kāna kūkulu.

Eia nō naʻe, i ka laulā, ʻaʻole i paʻa ka hoʻoponopono o ka glucose koko i ka wiki mua o ke ola, ka mea i hōʻike ʻia i kona mau ʻokoʻa mai ka hypoglycemia i ka hyperglycemia transient.

Hiki i ka hypoglycemia o nā pēpē hou i ka lolo (mai ke kuhi a hoʻokaʻawale i nā loli), no laila, he mea koʻikoʻi nui nā kuleana no kona hoʻoholo.

I kēia manawa, ʻo ka hapanui o nā neonatologists no ka manaʻo o ka ʻōlelo ʻana no ka hypoglycemia o nā keiki hou e pono ai e manaʻo ʻia he kahe o ka nui o ke koko ma lalo o 2 mmol / l i nā mau minuke 2-3 mua o ke ola a ma lalo o 2.22 mmol / l ma hope mai. Hoʻopili kēia hōʻailona i nā pēpē piha a me nā keiki mua.

Wahi a ka hōʻailona pathogenetic o ka hypoglycemia, ua hoʻokaʻawale ka poʻe keiki hou i ka transient a me ka hoʻomau. ʻO ka maʻa maʻamau ke pōkole o ka wā ma mua, ʻoi aku ka palena o nā lā mua o ke ola, a ma hope o ka hoʻoponopono ʻana, ʻaʻole pono e hoʻopaʻa i ka mālama pale ʻana i nā lā lōʻihi, ʻaʻole i pili ka lākou mau kumu i nā hana kūlohelohe o ka metabolism.

Hoʻokumu ʻia ka hypoglycemia kūmole o nā pēpē hou e pili ana i nā abnormalities congenital i hele pū ʻia e nā pilikia o nā pakanā o nā pakanā a i ʻole nā ʻano like ʻole o ka metabolism a me ka makemake o ka mālama mālama lōʻihi me ka glucose. ʻO kēia ʻano o ka hypoglycemia kekahi o nā hōʻailona o kekahi maʻi i lalo, ʻaʻole pono ia e ʻike ʻia me ka hypoglycemia o nā pēpē hou ʻole inā he lā kahi ola i ʻike ʻia.

ʻO ke kumue kumu ana i ka hypoglycemia transient o nā keiki hou i hoʻokaʻawale ʻia ma ke ʻano ʻekolu.

Hoʻokomo mua ka mea mua i nā mea e pili i ka hiki ke hoʻoweliweli i ka hoʻokahe nui o nā minamina o ka wahine hāpai: ʻo ka maʻi kūmole insulin e hilinaʻi nei a lawe aku paha i kahi wahine hāpai i ka manawa ma mua o ka hānau ʻana i ka nui o ka glucose.

Hōʻike ka lua o nā pūʻulu i nā pilikia neonatal maoli: hiki i ka intrauterine malnutritation o ka pūpū, asphyxiation i ka wā hānau, hoʻomaha, maʻi a me ka lawa ʻole o ka hoʻololi ʻana i ke ola extrauterine.

ʻO ke kolu o ka hui nā kumu iatrogen: ʻo ka pau ʻana o ka infusion lōʻihi e pili ana i ka nui o ka hopena o ka glucose, ke kuleana intravenous o ka indomethacin ma luna o ka ductus arteriosus wehe, a me ka hoʻohana ʻana i ka hana hoʻomau i ka insulin i ka hoʻomohala ʻana i ka mellitus maʻi kongenital.

ʻO Intrauterine hypotrophy ka kumu maʻamau loa o ka hypoglycemia transient. ʻO kāna genesis ma muli o ka emi wikiwiki o ka glycogen. Hōʻike ʻia kēlā mau maʻi i ka infusion therapy hou.

Ma waena o ka hypoglycemia transient o ka pēpē a me ka hypoglycemia hoʻomau e pili ana i nā anomalies kongenital, aia nā ʻano kikowaena i ʻike ʻia a lōʻihi ka hoʻokau ʻana i ka hypoglycemia, me kahi (noho ʻole e pili ana i ka anomalies congenital a ʻaʻole i kumu ʻole e ka hyperinsulinism transient, a ma kahi ʻē aʻe; ke koko i ka wā e noi ai i ka infusion therapy o ka pānō o ka glucose kiʻekiʻe loa, ma mua o 12-15%. Solu Cortef.

Nā hōʻailona o ka hypoglycemia i nā keiki hou

I nā keiki hou, ʻelua mau ʻano o ka hypoglycemia: ʻelua hōʻailona a me ka asymptomatic. Kuhi ʻia ka hope loa e ka hoʻemi ʻana o ka glucose koko.

ʻO ke ʻano o nā maʻi lapaʻau o ka hypoglycemia hōʻailona like ʻole e manaʻo ʻia he hoʻouka, ʻo ia kekahi mau hōʻailona i loko o lākou iho me ka holo ʻole ʻana, hoʻopuka waha a me ka pili ʻana o ka hānai e hele ʻole.

ʻAʻole ʻike i nā hōʻailona i nānā ʻia me ka hypoglycemia, hiki iā lākou ke hoʻokaʻawale i kahi somatic (pōkole o ka hanu, tachycardia) a me ka neurological. ʻO ka hope kekahi i nā hui heterogeneous.

Hoʻopili ka mea mua i nā hōʻailona o ka leʻaleʻa o ka pīhoihoi o ka nūhou (irritability, twitching, tremors, cramps, nystagmus), ka lua - nā hōʻailona o ke kaumaha (na hypotension musikal, ka hana kūlohelohe, ka lethargy āpau, nā hōʻeuʻeu o ka apnea a me nā manawa i nā cyanosis, ka nalowale o ka ʻike).

ʻO ka hōʻike kiʻekiʻe loa i ka hoʻouka kaua o hypoglycemia i ka hui mua o nā hōʻailona i ka hōʻino, ma ka lua - coma.

Hiki i ke Sygtomatic hypoglycemia o nā keiki hou ke hoʻomohala a hoʻopau ʻia, me ka ʻole o nā hōʻailona ʻike ʻole, a i ʻole e hele ʻana me ka hoʻouka kaua a me ka wikiwiki. Hōʻike ka hōʻike o ke kauka o ka hypoglycemia i ka helu o ka hoʻohaʻahaʻa i ka glucose a me ka hoʻokaʻawale ʻana i kona pae, ʻoi aku ka nui o ka loli i kēia mau loli, ʻo ke kukui loa ke kiʻi.

Ma kēia e pili ana i ka hoʻomohala ʻana o ka hoʻoulu ʻana o ka hypoglycemic i kahi keiki hou i ke ʻano o ka hoʻomehana ʻana o ka insulin i ka mālama ʻana i ka maʻi maʻi congenital he mea hoʻohālike nui: hoʻomohala koke, hypotension umauma ākea, adynamia, nalowale o ka ʻike, coma.

E helu ka helu i nā kekona mau minuke, a ʻo ka pane like ʻole o ka hoʻonā glucose uila intravenous.

ʻOiaʻiʻo, ʻikea ʻia nā hōʻike olakino o ka hypoglycemia o nā pēpē i ke kua ʻana o ka hoʻomehana ʻana o ka insulin, akā ua nānā mākou i kahi kiʻi like like i loko o kahi mana hoʻonaninani a hiki i kona hoʻohana.

ʻO ka maʻamau, maʻamau ka maʻi hypoglycemia transient o nā pēpē me kahi kiʻi haukapila i hoʻomohala ʻia ma ke ʻano o ka hoʻouka ʻia ʻana ma ka wā e mālama ai me ka hopena o glucose e 10 neʻe koke a ʻaʻole i hoʻi hou, a hiki i kekahi mau maʻi nā maʻi a i ʻole lehulehu paha.

ʻO ka palapala asymptomatic, e like me nā mea kākau haole, loaʻa ma mua o ka hapalua o nā hihia o ka hypoglycemia transient o nā keiki hou.

ʻO kahi pākēneka nui o nā ʻano asymptomatic o ka hypoglycemia transient i loko o nā pēpē hou a me ka hoʻomaikaʻi ʻana i ke ākea maikaʻi i kēia mau keiki i ka ʻike ʻana i ka waiho ʻole ʻana o ka correlation kūlohelohe ma waena o ke ʻano o ke kō o ke koko serum i lawe ʻia mai ka kuʻekuʻe a me kona paʻa ʻana i nā hā o ka lolo a me CSF.

Hoʻoholo ka hope i ka saturation maoli o ka lolo me ka glucose. ʻO ka hoʻonui nui o ka glucose i loko o ka lolo o nā keiki hou a me kāna lawe maikaʻi ʻana i loko o ia mea e hōʻano hou i ka kaila o ke kō ma waena o ka lolo a me ka periphery.

ʻO ka hoʻowalewale o ka hypoglycemia hōʻailona o nā keiki hou me kāna mau ʻōuli i hiki ke hōʻike i kekahi mau pilikia, no ka mea, ʻaʻole i kikoʻī ʻia kona mau ʻōuli a hiki ke loaʻa i nā ala āpau, ʻo ia hoʻi nā mea like. ʻElua mea e pono ai no kāna ʻōlelo: ʻoi aku ka haʻahaʻa o ka glucose ma lalo o ka 2.2-2.5 mmol / l a me ka nalo ʻana o nā hōʻailona, i manaʻo ʻia ʻo "hypoglycemic," ma hope o ke alakaʻi ʻana o ka glucose.

Kahi Waho

Hiki ke alakaʻi i ka hypoglycemia Symptomatic o nā pēpē hou. I kēia hihia, ke ʻano o ke kaua (hōʻeha, ke kaumaha ʻana), ʻo kona lōʻihi a ʻoi aku ka mea nui. ʻO ka hui pū ʻana o kēia mau ʻano mea i ʻoi aku ka koʻikoʻi o ka ʻike.

Hoʻomaopopo nā keiki i ka hoʻomohala ʻana o ka hypoglycemia transient i loko o nā mea hou o ka pēpē prophylactic intravenous glucose infusion mai nā hola mua o ke ola, inā ʻaʻole lākou i loaʻa ka hoʻāʻo koko koko a i ʻole.

ʻO ka hui pilikia he mau:

nā pēpē hou me nā ʻino
nā pēpē mai nā makuahine me ka maʻi ʻano type 1,
mau keiki nui e ka ulu kino ʻana a i ʻole ka hānau ʻana i ka momona 4 ma mua o 4 kg,
nā keiki e ko lākou kūlana, ʻaʻole hiki ke loaʻa i nā meaʻai kai komo.

Me ka hoʻonohonoho makapō o kahi infusion, ʻaʻole iʻoi aku ka ʻike o ka glucose i loko o ka 4-5 mg / (kg-min), kahi no ka hoʻonāʻana i ka glucose% 2.5% ʻo 2.5-3 ml / kg / h. Hoʻokumu nā hana hou aʻe i ka glucose.

Me ka asymptomatic hypoglycemia, pono nā ʻōpiopio mua loa e loaʻa i ka therapy infusion me kahi hopena o ka glucose o 10% o 4-6 ml / kg / h.

I ka hypoglycemia hōʻailona, e mālama ʻia kahi hopena o glucose kūleʻa ma kahi he 2 ml / kg i 1 mau minuke, a laila ma ka pae o 6-8 mg / kg / min.

Pono e mālama ʻia nā maʻi o ka asymptomatic a me ka hypoglycemia hōʻailonaaticatic o nā keiki hou i lalo o ka kaohi o ke kō o ka honu i ka liʻiliʻi o nā manawa 3 i ka lā. Ma hope o ka hōʻea ʻana i kahi papa kōpili ma ka pā o 3.5-4 mmol / L, e emi iki ka nui o ka infusion, a i ka wā e kūpaʻa ʻia i kēia mau waiwai, ua pau ka hoʻokō.

ʻO ka nele o ka hopena o ka hopena maʻi e kānalua nei i ka hele ʻana o ka hypoglycemia transient maʻamau i nā keiki hou. Pono kēlā mau keiki iā lākou iho hoʻokolohua e hoʻokaʻawale i nā malenations congenital me ka hypoglycemia lua.

ʻO nā kumu, nā hopena a me nā mālama ʻana o ka hypo- a me ka hyperglycemia i nā keiki hou

ʻO ka hypoglycemia i loko o nā keiki hou he kūlana lihilihi, inā ʻaʻole mākou e kamaʻilio e pili ana i ka ulana o ke ʻano o kēia pathology.

ʻAʻole noʻonoʻo ka hapanui o nā wāhine hāpai i ka hoʻohaʻahaʻa a hōʻume nui i ka glucose i mea e nui ai ka pōpilikia i ka hoʻomohala ʻana o ka pēpē.

Eia nō naʻe, hiki ke pale ʻia nā pilikia inā ʻike ʻoe i nā hōʻailona a hypoglycemia, ma ka pākeke a me kahi kanaka hou i hānau ʻia. He mea nui e ʻike i nā hana i hoʻohana ʻia e hoʻoponopono i ke ʻano.

ʻO ka hopena o ka hāpai ʻana i ka glucose

ʻO kēlā me kēia makuahine i ka wā hāpai e noʻonoʻo mau i ke olakino o ke pēpē. Eia naʻe, ʻaʻoleʻo ia e mālama mau i ka hilinaʻi o ka pēpē ma kona kūlana iho.

Ma muli o ka nui o ka kaupaona ʻana, hiki i ka wahine ke paʻakikī a hōʻole i ka ʻai ʻana a i ʻole ka hele ʻana i ka meaʻai me ka ʻole ke kūkākūkā ʻana i kahi loea. I kēia hihia, hiki ke loli nui ka pale o ke kalaiwa.

ʻO ke ʻano o ka hormonal wahine i ka wā hāpai a loaʻa i nā loli nui, no ka laʻana, hoʻomaka ka pancreas e hana i ka nui o ka insulin ma lalo o ka mana o ka estrogen a me ka prolactin, ʻoiai ka poʻe e mamao loa i nā maʻi e like me ka maʻi hilahila ʻaʻole e hoʻomau mau i ka hoʻomaopopo e kūleʻa ka pae o ka glucose.

I nā pilikia koʻikoʻi, inā he pōpilikia ka hoʻomohala ʻana i kahi kūlana e like me ka hypoglycemia i nā wahine hāpai, e hōʻeha nā kino kino a pau, aia kahi kiʻekiʻe o ka hoʻoweliweli ʻana i ka kūlana kino a me ka noʻonoʻo o nā maʻi wale nō, akā ʻo ka makuahine hoʻi.

A i ʻole ʻokoʻa, ka makuahine, no ka makemake mau loa e ʻai i kahi mea ʻole, ke loaʻa nei ke kaumaha a hōʻole i ka ʻaoʻao o ka ʻona e ka ona pono, a laila e hoʻowalewale ʻia ai ka hoʻomohala ʻana i ka maʻi maʻi. A ʻo ka mea nō hoʻi, ma ka hihia mua loa, ʻaʻole hiki ke ʻike mau i ka piʻi ʻana o ke kō - kōpō - hyperglycemia i ka wā hapai he pilikia nō.

Akā ka ulu ʻana o ke keiki a loaʻa i nā mea pono a pau mai ka makuahine, ʻo ka nui a ʻokoʻa paha o ka glucose ka mea e hoʻopilikia kino i kona olakino. ʻOiai ʻaʻole hiki iā ia ke mālama i ka hormone pancreatic ma kāna iho.

Hiki i ka Hyperglycemia i nā wahine hāpai ke alakaʻi i ka hyperglycemia o nā keiki hou a me ka hoʻomohala ʻana o ka maʻi diabetes i nā pēpē mai ka hānau ʻana.

ʻO ia ke kumu he mea nui loa ka kāohi ʻana i ka papaʻaina o ka makuahine ʻāpono, nānā aku i ka pae o ke kō, ināʻoi aku inā loaʻa iā ia ka maʻi maʻi mellitus a i ʻole he hopena ʻē aʻe paha i nā hana kaʻina metabolic.

Pono hoʻi ʻoe e hoʻolohe i ke ʻano o kou kino ponoi, me ka ʻike ʻole i ka momona nui, ka makewai mau ʻole, pono ʻoe e nīnau i ke kauka e mālama ana i kahi hāpai.

Ua hānau hoʻokahi - ua pilikia

ʻO nā pilikia me ka hoʻokaʻa o ke koko i nā keiki hou keiki olakino ke ʻano maʻamau. Ma muli o ka hyperglycemia o nā pēpē a i ʻole hypoglycemia e hopohopo mua i nā pēpē mua ma mua o ke kaumaha kino kino.

He mea pono no ka mālama i ka neʻe ʻana aia he hypoglycemia transient o nā keiki hou (ʻo ia ka palu) - he kūlana maʻamau i nā hola mua o ke ola o kahi keiki.

ʻOiai ʻaʻole ia i hana i ke kino i kona iho i kaʻai, i nā minuke mua o ke ola ka hoʻohana ʻana i ka papa i hōʻuluʻulu ʻia i ka ate. Ke holo ka lako, a lohi ka ʻai, pōkole ka loaʻa ʻana o ke kō. ʻO ka maʻamau ma nā mau hola a i ʻole mau lā ua hoʻi ka mea i ka maʻamau.

Hoʻololi koke i ka wā ʻaʻole lawa ka glucose

ʻO kahi pēpē mua e hele ai i mua o nā mea e hoʻomohala i ka hypoglycemia, ʻoiai aia kekahi mau hōʻailona o kēia ʻano.

Nā ʻano hōʻailona ma ke ʻano e hiki ai ke hāpai ʻia ka hypoglycemia:

nāwaliwali nawaliwali i ka wā hānau
nāwaliwali palupalu,
kiʻu i luna
cyanosis
nahoa
ʻneapiha
ua hoemi ka tonus o nā ʻōpū o ka maka,
kinaki
lethargy aoao.

Hoʻopili pū kekahi mau maʻi Hypoglycemic mālamuhua me ka ʻili maloʻo, ke kahe koko nui, nā huhū naʻau.

No ka mea ʻaʻole hiki i nā hōʻailona āpau o ka hypoglycemia hiki ke hele mai, pono ka hoʻoliʻoli ʻia o ke koko maʻamau no ka maʻi maʻi, no ka mea, hiki i kēlā mau hōʻailona ke ʻōlelo pū kekahi i nā pathology koʻikoʻi.

He aha nā kumu o nā patology?

Manaʻo mau nā pilikia no nā maʻi i ka mālama ʻana i kahi wā hāpai a i ka wā hānau.

Inā aia nā hōʻailona o ka hypoglycemia, nā loea, ʻo ka mea mua, hoʻomaka i nā kumu kumu o ka hoʻomohala ʻana i ka palaka pōpilikia, no laila e pili ana i ka ʻike, koho i ka hana kūpono.

Hoʻokumu pinepine ka hypoglycemia i nā kumu penei:

ʻO ka loaʻa ʻana o ka maʻi diabetes i ka wahine ma ka hana, me ka hoʻohana ʻana i nā lāʻau ʻolua e ia. Aia kekahi hypoglycemia transient mua, e hoʻomaka ana mai nā hola 6-12 o ke ola o ka pēpē.
Preterm a i ʻole ka nui o ka hāpai ʻana me ka lehulehu o nā keiki ma lalo o 1500 g. Hiki i ka wā i loko o nā hola 12-48. ʻO ka mea pōʻino loa ka hānau ʻana o kahi pēpē ma ka 32th pule o ka hāpai ʻana.
ʻO nā pilikia hānau (asphyxia, nā hōʻeha o ka naʻau, nā hemorrhages). Hiki i ka hypoglycemia ke ulu i kēlā me kēia manawa.
ʻO nā pilikia me ka background o ka hormonal o ke keiki (ka adrenal dysfunction, hyperinsulinism, tumors, impaired protein a me ka synthet synthesis). ʻO ka maʻamau o ka holi koko i hāʻule i hoʻokahi pule ma hope o ka hānau ʻana.

I nā keiki i ka pilikia, lawe ʻia ke koko no ka nānā ʻana i kēlā me kēia 3 mau hola no ka 2 mau lā mua o ke ola, a laila e hōʻemi ʻia ka nui o nā hōʻiliʻili koko, akā e nānā ʻia nā pae gula ma kahi o ka 7 mau lā.

Ka hopena

ʻO ka maʻamau, ʻaʻole pono nā mana o nā therapeutic, akā i nā kūlana koʻikoʻi, i ka wā o ka hapa o ka glucose e hiki ke alakaʻi i nā pilikia o ka ʻōnaehana o ka nūnū, a me ka mālama ʻana i ka mālama olakino.

Inā hoʻi ʻole ke ʻano i ka maʻamau ma hope o kekahi mau lā, ʻaʻole mākou e kamaʻilio e pili ana i ka hele, akā e pili ana i ka hypoglycemia maʻi, ʻo ia paha he mea hoʻoilina a i ʻole congenital i ke ʻano, ʻo ia ka hopena o ka hānau paʻakikī me ka trauma.

Inā hele ʻole ka hypoglycemia o nā keiki hou a ʻaʻole maopopo nā hōʻailona e pili ana i ke ola, e like me nā ʻōlelo a AAP (American Academy of Pediatrics), ʻo ka hana i hoʻohana ʻia e hāʻawi i ka hopena like me ka nele o ka lāʻau.

Wahi a nā kaʻina mālama ʻo WHO i hoʻopaʻa ʻia, pono e loaʻa i ka mea hou ke kumukūʻai i ka nui o ka ʻai, inā e pili ana i ka lāʻau e pili ana i ka glucose.

Eia kekahi, inā hāwele mau ke keiki a i ʻole ka hē ʻana i ka mea hoʻonāukiuki, hānai ma waena o ka uapo e hoʻohana ʻia.

I kēia hihia, hiki i ka pēpē ke hānai i nā umauma umauma a me ka hoʻopili.

Ke kū pono ka nui o ke kō ma lalo o kahi mākaʻikaʻi koʻikoʻi, hoʻohana ka intramuscular a i ʻole intravenous i nā lāʻau i mea e hoʻonui ai i ke kō.

I kēia hihia, e hoʻohana ʻia ka nui o ka glucose i ka nui ma mua o ka liʻiliʻi infusion rate, inā i ka manawa like ʻaʻohe o ka hopena, hoʻonui ʻia ka wikiwiki.

No kēlā me kēia keiki, koho ʻia nā lāʻau lapaʻau pilikino ponoʻī a me kā lākou hewa ma ke ʻano. Inā hāʻawi ka palena intravenous i ka glucose i hāʻawi i ka hopena i makemake ʻia, e lawe ʻia ana ka lāʻau corticosteroid.

Eia kekahi, inā paʻa ka normoglycemia no ka manawa lōʻihi, ʻaʻole i hoʻokuʻu ʻia ke keiki mai ka keʻena neonatal, ʻike ʻia nā hana hou a koho ʻia ke ʻano pono.

Ua hoʻokumu ʻia ʻo Normoglycemia inā ʻaʻole e loli ka pae glucose i nā hola 72 me ka ʻole o ka hoʻohana ʻana i nā lāʻau lapaʻau.

Hoʻolohe Hoʻoweliweli!

ʻO ka hypoglycemia transient i loko o nā pēpē maʻamau, ʻaʻohe hopena koʻikoʻi no ke kino a holo koke.

A laila, e like me ka hoʻokūkū mau loa o ka hypoglycemia i ka wā hāpai a ma hope o ka hānau ʻana, hiki ke hoʻopilikia i ka pono kino, noʻonoʻo a me ka noʻonoʻo ʻana o nā keiki.

ʻO ka hoʻokaʻawale haʻahaʻa lolo koko hiki ke alakaʻi i kēia hopena:

māhuahua noʻonoʻo
nā lolo ʻōpū
ka hoʻomohala ʻana o ka hopu epileptic,
ka ulu ʻana o ka maʻi o Parkinson.

Eia nō hoʻi, ʻo ka mea pōpilikia ka mea hiki ke hoʻohaʻahaʻa i ka hilo he make.

ʻO ka wā Pregnancy kahi manawa maikaʻi o ke ola a me ka manawa e hāʻawi ai i ke keiki i nā mea pono āpau e pono ai, ʻoiai e pale ana iā ia i ka pōʻino.

Ua pili like i kēia mea i ka pale ʻana o ka hypoglycemia a i ʻole ka mālama ʻana i ka kūlana e pono ai o ka makuahine a me ka ʻoi hoʻi i ka wā hāpai a i nā keiki hou.

E nīnau i ka mea kākau i kahi nīnau ma nā kūmole

ʻO ka hypoglycemia o ka hānau hānau hou

ʻO ka hypoglycemia o ke keiki hou i ke ʻano weliweli loa. ʻO ia ka mea i manaʻo ʻia he kumu maʻamau o ka hoʻomohala ʻana o nā hōʻeha kino o ka ʻōnaehana ma o ke kikowaena, a me ka make o ka pēpē. ʻO ka mea pōmaikaʻi, ua hōʻea pinepine ia - hoʻopaʻa nā lāʻau lapaʻau i nā hihia 1-3 i hoʻokahi tausani keiki hou.

Pono ʻoe e ʻike ke pale ʻia ka pilikia a ʻike ʻia i ka manawa ma ka hoʻomaka ʻana - laila ʻo ke kaʻina o ka mālama ʻana i ka hypoglycemia e ʻoi aku ka wikiwiki o ka hana hou aku.

He aha ka hypoglycemia neonatal?

Ke kamaʻilio nei e pili ana i ka hypoglycemia i nā keiki hou, ke kamaʻilio nei mākou e pili ana i ka nui o ka pae o glucose i ka serum a me ka plasma. Ma ka ʻōlelo a nā helu, ua hōʻike ʻia kēia kūlana e nā kuhikuhi ma hope: 2.2 mmol / L a me 2,5 mmol / L, kēlā me kēia.

ʻO ka hypoglycemia he pōkole a mau loa. Hōʻike ʻia ka hypoglycemia pēkē i ka haukapila, ʻoiai e ulu ana i ka mau hola 6-10 mua ma hope o ka hānau ʻana o ke pēpē. I kēia hihia, makemake nui ka wānana i ka hiki - holo koke ka pilikia. Ke haʻalele nei i kahi maʻa i ke ʻano o nā pilikia neʻe.

I ka hapanui pinepine, e pili ana kēia maʻi i nā pēpē i hala, ma waena o nā mea ʻē aʻe e pili ana i ka manaʻo e hāpai i nā pilikia aʻe.

Hoʻopiʻi ka hana o ka papa kalawana i ka makuahine,
Na wahine maʻi mellitus
ʻO nā pilikia ʻē aʻe o ka lawe ʻana i ka ʻōpū,
ʻO ka hoʻoili pilikia
Hāpopu Hyperinsulinism
Hōʻino ʻia nā kelena adrenal i kahi keiki liʻiliʻi,
Loaʻa nā ala i loaʻa e ka pēpē i ka hoʻoilina.

Hana ʻia ka maʻi maʻi hypoglycemia e kekahi kauka i hoʻokumu ʻia ma kahi hōʻike hoʻokolohua. ʻO nā hōʻike mua o kahi pēpē hou e pili ana i ka hoʻowalewale e pili ana i ka panana koko no kēia hōʻike. Lawe ʻia lākou i ka hola mua ma hope o ka hānau ʻana, a laila ʻelua mau lā i kēlā me kēia 3 hola.E hoʻopau i nā kanalua, ke noho nei ka mea maʻi ma lalo o ka nānā ʻana no kekahi lā ʻelua, i ka manawa e loaʻa ai ke ʻano ʻoi ʻia i kēlā me kēia 6 hola.

Nā hōʻailona a me ka mālama ʻana i ka hypoglycemia i nā keiki hou

Hoʻomaka ma mua o nā maʻi no ka hypoglycemia i nā keiki hou. Hoʻomaopopo ka hōʻailona o nā maʻi i ka hōʻike ma hope.

Ma kahi keiki, ua emi ka nui o nā ʻuhane o ka maka, ua pau ka ʻula o ka oococephalic o ke keiki hou, ua neʻe nā maka i loko o ka pōʻai i loko o kahi lula e holo nei.
Ua palupalu ka pēpē, no laila e hōʻole i ka ʻai. Eʻai palupalu, ʻai, ʻai. E lilo ke keiki i ka huhū, hoʻoweliweli, lethargic a, i ʻole, i ka hauʻoli. Aia kekahi leo hea leo kiʻekiʻe ma mua o ka uha a me ka haʻalulu.
Hoʻololi wale ke ʻano o ke ʻano o ke kino o ke keiki, a lilo ke keiki a palulu ʻia a no kahi kumu ʻole. Kuhi ʻia kahi hypotension a me ke ʻano o ka hypothermia.

Inā ʻaʻole hoʻomaka ʻia ka mālama ʻana a ʻaʻole hoʻi e hāʻawi i ka hopena i makemake ʻia, pilikia nā ʻōuli. Hiki i ke keiki ke hāʻule i kahi stupor, hōʻeha kaumaha o ka naʻau, ʻike ʻia nā hōʻailona o ka tachycardia, cyanosis, apnea, a me nā mea hou aku.

ʻO ka hopena no ka hypoglycemia i loko o nā keiki hou ka hana ʻana i ka infra glucose infravenous. Pono kēlā me kēia hihia i kahi hoʻokokoke kūʻokoʻa a hana ʻia ka ʻaoʻao injection e ka loea e pili kokoke i kahi mea maʻi liʻiliʻi.

Inā hele maikaʻi ke kaʻina, ʻaʻole nui ka loaʻa o ka hoʻihoʻi - ma hope o nā lā 2-3, e hoʻēmi ʻia ana ka infusion glucose. Inā mālama ʻole ke kino o ke keiki i ia mau ʻano, hoʻohana ʻia ka hydrocartisone.

Hoʻohana pinepine ʻia nā mea hoʻoulu ai me kahi ʻano hoʻopalike e hoʻonui ana i ke kiʻekiʻe o ka saturation o nā kalapona.

Hoʻomaʻi ʻia ka mālama ʻana o nā keiki hou i ka ʻāina kiʻekiʻe.

ʻO ka hypoglycemia i nā keiki a me nā keiki hou i nā kumu a me nā hōʻailona o ka maʻi a i ʻole hōʻā ʻia

ʻO ka hypoglycemia i nā keiki He ʻano hiʻohiʻona ia e ke kahe koko haʻahaʻa, a i ʻole he awelika o ke koko haʻahaʻa haʻahaʻa. ʻO ka hypoglycemia i loko o nā keiki hou kekahi o nā ʻano o ke ʻano o ka hopena o ke kino o ke kino i kahi hoʻololi kaumaha i ke kūlana kūlohelohe.

ʻO ka hypoglycemia i loko o ka hopena lapaʻau, ʻike ʻia ʻo ia i ka mea hoʻonaninani i ka insulin, he ʻano o ke kino i kumu ʻia e ka nui o ka glucose i ke koko (emi iho ma mua o 4 mmol / l). Hōʻike ka maʻi hypoglycemia i nā keiki me ka maʻi type like 1, akā hiki i kekahi mau hanana i nā keiki a me nā ʻōpio me nā maʻi maʻi 2.

Hoʻomaʻamaʻa pinepine ʻia i nā poʻe maʻi e lawe ana i nā mākaukau sulfonylurea. ʻO ka ʻai kūpono ʻole, kahi wai nui ʻole o ka insulin, nā maʻi like ʻole a me ka hana koʻikoʻi a me ke ʻano kino me ka uku ʻole no nā kumukūʻai ikaika hiki ke kūpono i ka hoʻouka ʻana o ka hypoglycemia. Inā ʻaʻole e pau, hiki iā ia ke alakaʻi i ka nalowale o ka ʻike naʻau.

Ma nā hanana nui aʻe, hiki i kahi coma ke ulu.

Hiki i kahi keiki me ka hypoglycemia ke hoʻomohala koke i ka huhū, ʻoi aku, haʻalulu, haʻalulu, hoʻopiʻi loa i kona pōloli. I ka nui o nā hihia, ʻo ka ʻai ʻana i ka calcium ka wikiwiki (e like me ka wai a i ʻole ke kukui) hoʻoponopono i ke kūlana.

Hiki i ke hoʻohana ʻola ma ke ʻano o nā papa a i ʻole ka hopena. ʻO kahi keiki e pōʻino ma muli o kahi hoʻouka ʻana o hypoglycemia e hoʻi koke i ka maʻamau ma hope o kahi maʻi intravenous glucose.

E kōkua kēia i ka hoʻihoʻi hou i nā pae koko koko i ka maʻamau.

Hōʻoiaʻiʻo i ke ʻano hypoglycemia i loko o nā keiki

ʻO kahi ʻano maʻamau o kēia maʻi, ka mea i kapa ʻia ʻo ka hypoglycemia reactive i nā keiki, hiki ke hiki i nā poʻe me ka maʻi ʻole. Me ka hypoglycemia reactive, e hāʻule ana ka hoʻokahe o ke koko i ka 3.5 mmol / L ma kahi oʻehā mau hola ma hope o kaʻai hope loa, e hōʻeha ana i nā hōʻailona like o ka nui o ke kōʻai koko i hiki ke hiki i nā poʻe me ka maʻi maʻi.

ʻO ka pāʻina hoʻi ka hypoglycemia maʻamau. ʻO kēia kahi kahi e hoʻohele ai ka nui o ke kō koko koko 3.5-4.0 mmol / L ma ke kakahiaka ma hope o ke ala ʻana a i ʻole ma waena o nā pāʻina. ʻO kekahi mau lāʻau lapaʻau a me nā hoʻāʻo ʻana e hiki ai i nā maʻi hypoglycemia i nā keiki me ka maʻi ʻole.

Ma waena o nā keiki me ka maʻi maʻi, hypoglycemia ka mea maʻamau loa i nā mea maʻi me ka maʻi type 1 (ʻike ʻia ʻo ka maʻi kūlohelohe a insulin a i ʻole ka maʻi ʻaʻa ʻana o ka maʻi maʻi) ma mua o nā mea maʻi me ka maʻi maʻamau type 2 (ma mua i helu ʻia me ka maʻi maʻamau).

ʻO ka hypoglycemia a me nā kumu

Hūnā ʻia nā kumu o ka hypoglycemia ma ka mīkini nā hana o ka hoʻoponopono ʻana o ka pākūkū a me ka metabolism ikaika ma ke kino kanaka. Me ka hoʻokuʻu nui loa o ka insulin i loko o ke koko o kahi keiki, hiki ke hōʻake ʻia kahi hōʻeha o ka hypoglycemia, me ka manaʻo ʻole o kona wī ʻana i ka hoʻomohala ʻana i ka maʻi diabetes.

Hiki i nā hypoglycemia i nā keiki a me nā wā'ōpiopio me ka maʻi diabetes inā he nui loa ka huehue o ka insulin.

Ma ke ʻano o ke kino a me ka noʻonoʻo me ka ʻole o ka hoʻopai ʻana i ka meaʻai kūpono, kekahi mau lāʻau, ka hōʻoki ʻana i ka ʻai, a me ka inu ʻona hiki ke hoʻopuka i kahi hoʻouka.

ʻO ka hypoglycemia ma ke kaila mellitus he mea maʻamau ka mea maʻi i hiki ai i ka mea maʻi ke hoʻoku i kāna iho ma ka manawa kūpono.

Hiki i ka hypoglycemia React ke hoʻoulu ʻia e kahi maʻi enzymatic ma hope o ka hōʻeha ʻana i ka gastpass bypass.

Hiki i nā hypoglycemia i nā keiki me ka ʻole o ka maʻi maʻi e nā maʻi tumi ʻana i ka insulin, kekahi mau maʻi hormonal, nā lāʻau lapaʻau (e komo ana i nā lāʻau sulfa a me nā kiʻekiʻe o ka aspirin), a me nā maʻi āpau koʻikoʻi. ʻO ka neʻe ʻana mai ka maʻi hypoglycemia ākea, ʻoi aku ka maʻamau o nā keiki i nā makahiki 10.

ʻO ka Hogoglycemia a me nā hōʻailona

E hoʻomanaʻo nā mākua ʻaʻole ʻaʻole ʻo nā maʻi āpau o ka hypoglycemia e hoʻomaopopo ʻia me ka ʻike ʻole ʻia o ka ʻike koko. E makaʻala ʻoe i nā loli i ke ʻano a me nā hana ʻai o kāu keiki. Kūlana inā he kānalua iā ia. Hiki ke kau ʻia nā hōʻailona o ka hypoglycemia:

he aloha, he
huhū a me ka huhū
luhi a me ka hauoli,
hoʻonui hoʻonui ʻia
ka hilahila ʻana o ka ʻōlelo, ka hiki ʻole ke haʻi i nā ʻōlelo a me nā leka.
ka ʻāʻuhi o ka luhi a me ka ʻāʻei
pololi
hopohopo o ke kaumaha.

ʻO ka Hogoglycemia ma ke kōpeka: ke ʻike nei i ke kauka

Hoʻopilikia ʻia ka hypoglycemia i ka maʻi diabetes ma ka nui o ka insulin a me ka nele o ka glucose i ke koko o ke pēpē. Pono nā keiki e ʻike i nā popo pinepine o ka hypoglycemia i kā lākou mālama olakino olakino. ʻElua paha ia e hoʻoponopono i ka insulin, dosis, a i ʻole nā loli hou i ka regimen mālama o kēia manawa.

Inā hoʻomaka kahi keiki a ʻōpiopio paha me ka maʻa maʻi e hōʻike i ke koko koko liʻiliʻi me ka ʻole o kekahi mau ʻaoʻao, hiki i kēia ke holo ʻole. Eia nō naʻe, pono e ʻike ke kauka i nā loli a pau o ke kūlana o kahi keiki maʻi. ʻO ka nele o nā mālama olakino kūpono i ka manawa hypoglycemia syndrome hiki i ka nalowale o ka ʻike.

ʻO nā kumu o ka hypoglycemia

Hiki i ka hypoglycemia i nā keiki hou ke hele mau i nā manawa a i kekahi manawa.

Nā kumu o ka hypoglycemia, ka mea e hōʻike pū ana iā ia iho ma kēlā me kēia manawa.

lawa palapala
functionature enzyme function, mea hiki ke alakaʻi i ka nele o ka hōʻiliʻili glycogen.

Hiki i ke hypoglycemia kūmau no nā kumu aʻe:

hyperinsulinism i loko o kahi keiki,
kue i ka hana ana i nā hormone,
nā maʻi kumu hoʻoili.

Hiki i ka hypoglycemia i loko o nā keiki hou no ka hoʻopiʻi ʻana o kahi infravenous infusion solution i nā hopena wai. Hiki paha iā ia ke hopena i kahi kūlana maikaʻi ʻole o ka catheter a i ka sepb umbilical sepsis.

Hiki i ka hypoglycemia i loko o nā keiki hou ke ʻano hōʻailona i kahi maʻi maʻi a i ʻole ke alualu maʻi:

sepsis
hipotermia,
polyglobulia,
pepeke hepatitis,
maʻi maʻi cyanotic,
hoʻōla ʻalea.

Kū pinepine ʻo Hyperinsulinism no nā kumu aʻe:

makuahine ua makemake i ka lāʻau lapaʻau lāʻau
ua hānau ʻia ka pēpē mai ka wahine i loaʻa i ka maʻi maʻi maʻi,
ua loaʻa ka polyglobulia i ke keiki,
maʻi maʻi.

Eia kekahi, nā pilikia o nā hana hormonal i loko o ke kino o nā keiki hou i hiki ke hoʻomau i nā hypoglycemia.

Nā hōʻailona o ka maʻi i nā keiki ʻōpio

ʻO ka mea pōʻino, ʻaʻohe hopena hōʻailona kēia. ʻO kekahi o nā hōʻailona ke alapine, apnea, a me ka bradycardia hoʻi.

Inā loaʻa ke ʻano o ka pēpē a me ka hypoglycemia, ʻaʻole ia e loaʻa i kahi mau hōʻailona, no laila e pono ke ana i ke kiʻekiʻe o ka glucose, a e mālama pono hoʻi i kēlā mau hōʻailona:

palupalu ka pēpē i ka hānai ʻana i ka umauma a i ʻole he hue.
hoʻomaha mau ke keiki a ʻoluʻolu loa,
kahaka cerebral
lele ka pēpē i pēpē koko a aia nō ka tachycardia,
hoʻomaka hoʻomaka ke keiki a uʻi wale.

Nā manaʻo a me nā ʻōlelo

ʻAe iaʻu i ka maʻi diabetes 2 - ke hilinaʻi ʻole-insulin. Ua ʻōlelo kekahi hoa e hoʻohaʻahaʻa i ke kō koko me DiabeNot. Kau kauoha au ma ka Pūnaewele. Hoʻomaka ka hoʻokipa. Ke hahai nei au i ka meaʻai ʻole koʻikoʻi, i kēlā me kēia kakahiaka ua hoʻomaka wau e hele i 2-3 mau kilomita ma ka wāwae. I nā mau hebedoma i hala aku nei, ua ʻike wau i ka hoʻemi ʻana o ka hoʻōki ma ka mika ma ka mika i kakahiaka ma mua o ka ʻaina kakahiaka mai 9.3 a 7.1, a me nehinei a hiki i 6.1! Hoʻomau wau i ka papa pale. E kākau hou wau e pili ana i ka holomua.

Pono ka loiloi ʻana i nā koi o ka triglyceride i ka wā i hoʻomohala ʻia ai ka make o ka lipid emulsion, a laila hebedoma. Pono e hānai ʻia nā keiki wai maʻi mai ka maka o ka metabolic o ka nānā ʻana ma muli o ka haunaele i ka hopena o ke koena o ka waiʻala a me nā electrolytes, nā home glucose, nā hana ʻona a me ke kūpaʻa acid-base. Hiki ke nānā maʻalahi i ka momona intolerance ma ke lā aʻe o ka hoʻokele intralipid, me ka hana o kahi microhematocyte i loko o kahi capillary tube e ʻike ana i ka supernatant serum ma hope o ka centrifuging o ka pākana.

No ka hana kino a me ke olakino pono e loaʻa i nā pehu nā kikoʻī i kekahi mau lako o ke kō a me ka glucose. Inā loaʻa nā pākeke i nā minamina i nā meaʻai, a laila ʻo nā pēpē hou mai ka waiū umauma, no laila e pono ʻoe e kiaʻi pono i ka papa o ke pēpē, ʻoi aku ka maʻi o ka makuahine me ka maʻi maʻi. I kēia hihia, e hoʻoulu ke kino i ka nui o ka insulin, e kōkua ana i ka hoʻohaʻahaʻa haʻahaʻa.

Inā loaʻa ka ʻano waiʻai i ka supernatant, ʻaʻole hiki ke lawelawe ʻia kekahi ʻano ʻē aʻe o ka intralipid i kēia lā, inā he ʻano ʻoniʻoni ʻoniʻoni ʻole, hiki ke komo ʻia ke ʻano i ʻōlelo ʻia no kēia lā. He kūpono ia o nā hana ke kūpono i nā pae momona momona, nā triglycerides a me ka cholesterol i loko o ke koko.

Mai haʻalele koke i ka mea hou. Mai hoʻomaka i ka hoʻokele waha. E hoʻohana i ka ngongo nasogastric i loko o nā pēpē a pau ma lalo o 32 mau makahiki o ka makahiki gestational. Mai hoʻonui i ka nui. ʻAʻole hiki ke hāʻawi ʻia i kahi pānana ke keiki kahe ʻana o ka manawa hanu ma mua o 60 mau minuke a i ʻole he hypothermia.

ʻO nā kumu hoʻohaʻahaʻa haʻahaʻa i loko o kahi pēpē:

Puka hanau.
Hoʻopilikia kino intrauterine.
Papa kekahi maʻi maʻi.
Hānau, hānau pū ʻia e ka asphyxia o ke keiki.
Ka puka koko.
ʻO ka Hypothermia aiʻole kahi maʻi i ke kino o ke pēpē.
ʻO ka nele o kaʻaiʻai, ka pololi, nā kī nui ma waena o nā umauma.
ʻO ka hoʻonui hoʻonui ʻia o nā kino ketone.

Pau ka hōʻailona ʻana o kēia maʻi i nā keiki hou, akā i kekahi manawa ke hōʻike ʻia nei ʻo ia iho me nā hōʻailona aʻe:

Mai hāʻawi i ka meaʻai waha i ka pēpē i hānau ʻia me ka mōʻaukala o nā hydramnios ma mua a i ʻole ka nui o ke kuihue a hiki i ka hāʻawi ʻana mai i ka ʻōpū i loko o kahi ʻōpū a hoʻomaʻamaʻa ʻia ka hoʻokolokolo ʻana. E mālama i kahi pākuhi o kāu hoʻokomo o nā kala a me nā kaloria.

I nā pēpē i hōʻeha ʻia i ka enterrotitis necrotizing, e hana i kahi hoʻemi hoʻoliʻu gula hōʻemi ma mua o hoʻokahi manawa, ʻoiai inā hoʻomaka ka mea maʻi. E hoʻāʻo e mālama i ka pēpē i loko o ka ventral a lateral incision i ka wā e hānai ai, ʻoiai e wikiwiki nei i ka hana ʻana o ka ʻōpū a hōʻemi i ka hopena o ka regurgitation a me ka moʻoʻoleʻe.

Hoʻololiʻole ke koko.
Nā ala neurological o ke kikowaena genesis (i ʻike ʻia i ka wā mālama loea).
Ka hūlū komo ʻana i nā wāwae a i ʻole nā manamana lima.
Iʻa o ke anuanu, haʻalulu.
Ka huluhulu iawe loa.
ʻO ka noho ʻana o ka ʻili a me nā memo mucous i ka uliuli.
Kuhi e hoʻokaʻawale i nā mea hanu no ka manawa lōʻihi - mai 10 a 30 mau kekona.
ʻO ka haʻahaʻa o ka naʻau hōʻemi haʻahaʻa ma mua o 100 beats i hoʻokahi minuke.
ʻEha hopohopo. Hōʻike maikaʻi i nā hemahema ma waena o kahi hū a me ka hoihoi.
ʻO ke ʻano kino o ke kino, ma muli o ke kino o ka pēpē i hiki ke kākoʻo i ka hana hoʻokalakupua olakino.

ʻAʻole kēlā me kēia ʻano like ʻole i ke ʻano a ʻike ʻia me ka poʻe ʻē aʻe, no laila inā ʻike ʻoe i kekahi ʻōmole, pono ʻoe e ʻimi i ke kōkua mai ke kauka. Eia kekahi, ʻo kekahi o nā hōʻailona o ke kō o ke koko haʻahaʻa i loko o kahi pēpē i manaʻo ʻia he wikiwiki wikiwiki loa. Ke kaohi nei i ka glycemia ma ka home, ua makemake ʻia e hoʻohana i nā glucometer kūikawā e ana i ke kō o ke koko a hāʻawi i kahi hopena i loko o kahi mau minuke.

E ʻōlelo mau i kahi kahu hānai ma mua o ka hoʻonui ʻana i ka nui a hoʻololi paha i ke ala hoʻokele. E aʻo i kou makuahine e hānai a hānai i kāna pēpē. Mai noi iā ia e hana i kahi mea like me ia ʻaʻole hiki ke hana. Hoʻohana ʻia ka momona hānau i ke kālā ma mua o ka loaʻa ʻana o ka momona hānau.

Pono ke hōʻalo i ka neʻe ʻana o 10% lipid ma muli o ka ʻae ʻole. Pono e loiloi i ka pae o ka triglycerides i loko o kahi serum koko ma mua o ka hoʻomaka ʻana o ka infid lipid mua, ʻoiai ke mālama ʻia ka hopena, a ma kēlā me kēia pule. ʻO ke kumu kumu o ka hydration a me ka ʻōleloʻai makua makua i hāpai ʻia.

I loko o nā keiki i hānau ʻia mai nā makuahine me ka maʻi diabetes, nā hōʻailona mua a me nā hōʻailona o ka maʻi i loko o nā hola mua, a ma kēlā mau hānau mai nā makuahine hānai i loko o nā lā ʻekolu.

ʻAʻole hiki i ka maʻi maʻamau ke ʻike i ke kahe koko haʻahaʻa i loko o kahi keiki i ka manawa kūpono, ʻoiai nā mea hōʻailona o ka hypoglycemia i like nā mea like me ka ʻeha ʻana o ka hanu, ke hele ʻole ka pulmonary ma muli o ka haʻahaʻa o ka hui enveve alveolar i hui pū ʻia me ka pōkole o ka hanu, ka ʻili a me nā wheezing i ka wā hanu. Hoʻololi ʻia nā hōʻailona like me ka hemorrhage intracranial.

No nā kumu kumu, me nā pilikia, a me nā mea koʻikoʻi

Hoʻomaopopo i kona ʻano. Ma hope o ka hoʻomaikaʻi ʻana i ka ʻatikala, e wehe i kēia ʻano. Maikaʻi ka prognosis no nā pēpē hou ʻaʻohe ʻano i ʻike ʻia a i ʻole i hoʻomaikaʻi i ka hypoglycemia me ka mālama ʻana. Eia naʻe, hoʻi ka hypoglycemia e hoʻi i ka hapa liʻiliʻi o nā pēpē ma hope o ka mālama ʻana. E hoʻi hou ana ke ʻano inā lawe ʻia nā pēpē ma mua o ka mākaukau ʻē aʻe e lawe i ka meaʻai waha. Nā kumu o ka hypoglycemia hoʻomau.

I loko o kēia mau keiki, ua hoʻopau ka anaerobic glycolysis i ka hoʻohemo ʻana o ka glycogen a me ka hypoglycemia i kēlā me kēia manawa i nā lā mua, akā inā he lōʻihi ka lōʻihi o ka wā ma waena o ka ʻai. No laila, he mea hoʻomau mau o ka glucose exogenous i mea nui e pale ai i ka hypoglycemia. Hoʻokomo ka hyperinsulinism transient, i ka nui o nā hihia, nā keiki o nā makuahine maʻi a ʻōpiopio kūlike i ka pae o ka kaohi o ka maʻi maʻi.He maʻamau nō hoʻi i nā pēpē hou e loaʻa ana i ka kaumaha o ka physiological a i ʻole like ʻole no nā makahiki gestational.

He aha ka palu inā he haʻahaʻa haʻahaʻa haʻahaʻa ʻo ka mea hou

I ka wā e haʻahaʻa ai ka haʻahaʻa o ka pēpē hou, he aha ka pōʻino? He aha nā hopena he aha? He aha ka mea e hoʻoweliweli ai i ka maʻi? Hiki i nā hopena o ka hoʻohaʻahaʻa i ke kō i loko o ke kino o ka wahine hānau hou kekahi o nā maʻi like, me ka make, no ka laʻana, me ka hōʻeha ʻana i nā kahe koko o nā wāwae a me nā lima, mahele a ʻoki paha a nānā i ka ʻike, maʻi cardiovascular, a me ka make ma muli o ka make o nā mau lolo o ka saturated me ka glucose. ʻOiai he mea paʻakikī ka hilo haʻahaʻa i kahi pēpē hou, hiki i ka hoʻomohala hou ʻia ʻana o ka maʻi ke alakaʻi i kēia mau ʻōuli.

ʻO nā kumu maʻamau he congenital hyperinsulinism, kahi erythroblastosis o ka maʻi fetal, a me nā maʻi Beckwith-Wiedemann. ʻO ka maʻamau, ʻo ka hyperinsulinemia e hoʻoulu i kahi emi wikiwiki i ka glucose serum i nā hola mua o 1-2 ma hope o ka hānau ʻana, ke wāwahi ʻia ka lawe ʻia ʻana o ka glucose ma o ka plasenta.

I ka hopena hope loa, pili paha ka hypoglycemia me ka umbilical catheter posisyon a sepsis paha. Noho nui nā pēpē hou asymptomatic. ʻO nā hōʻailona adenergic e pili ana i ka sweating, tachycardia, lethargy, aiʻole nāwaliwali a me nā haʻalulu. Aia paha ka apathy, kaʻai maikaʻi, ka hypotension, a me ka tachypnea. Ka nānāʻana i nā glucose i kahi moe o ka mea maʻi. . ^ E Ha yM. ʻO nā hōʻailona āpau he nonspecific, a ʻike pū ʻia i nā pēpē hou me ka asphyxia, sepsis a hypocalcemia, a me ka wehe ʻana o nā opiates. No laila, i nā pēpē me ka piʻi nui o ka nui a i ʻole mau i kēia mau hōʻailona, nānā koke ka ʻike o ka level serum glucose i loko o kahi moe o ka mea maʻi mai kahi ʻōpiopio e pono ai.

ʻO ke ʻano o ke koko koko ma nā moku koko.
Ke hoʻomohala ʻana o nā pua thrombophilia a me varicose.
ʻO ka hoʻonāukiuki o ke kaila o ke koko, e hopena paha i ka metabolism maikaʻi ʻole a me ka lawa ʻole o ka saturation o ke kino me nā mea pono e pono ai a me nā huaora.
ʻO ka hana ʻole o nā wahī roto ma muli o ka loaʻa ʻole o ka loaʻa o ke koko.
Tissue mokulele
Ka hopena ma ke akamai, kaʻina noʻonoʻo a me ka hoʻomanaʻo. ʻO kekahi manawa hiki i ka hopena o kēia mau ʻano hoʻokele manuahi. Hōʻike ka hana o ka cognitive me ka uku manawa i ka kō o ke kō.
Hōʻino i ka ʻōnaehana musculoskeletal, kahi i hiki ai ke alakaʻi i ka maʻi kīnā.

Akā e hoʻomaʻamaʻa ka manawa kūpono a me nā hana pale e pale i nā hopena o ka hypoglycemia a i ka wā mua i kona hoʻomohala ʻana, no ka mea he wai koko liʻiliʻi ka nui, pono e hoʻomaka ʻia ka mālama ʻana i ka manawa.

ʻO nā mea hoʻohaʻahaʻa haʻahaʻa kūpono loa i hōʻoia i ka tauira venous. Hōʻike ʻia ka hoʻomaikaʻi prophylactic o nā neonates nui loa. ʻO nā pēpē liʻiliʻi i loaʻa ʻole i nā maʻi, e pono e hānai wikiwiki ʻia a pinepine me nā ʻōlelo pēpē e hāʻawi ai i nā calcium.

Pono ka nānā ʻana o nā pae glucose Serum i mea e hoʻoholo ai i nā helu infusion rate. Inā kūpaʻa ka hypoglycemia i ka mālama ʻana, e noʻonoʻo i nā kumu ʻē aʻe a, inā paha, e loiloi i ka endocrine, e noiʻi i ka hyperinsulinism hoʻomau a me ka hopena o ka gluconeogenesis a i ʻole glycogenolysis.

Kākoʻo a me ka mālama ʻana

ʻO ke kāohi ʻana o nā maʻi ke kī i ka hana pono o ke kino a me ka loaʻa ʻole o nā maʻi. I mea e pale ai i ka hypoglycemia, pono ʻoe e mālama i kēia mau lula:

Nā umauma nui. I nā hihia kahi i hala mua ai ka pēpē, ʻae ʻia ia e kīʻai me ka cereals, akā ma hope o ka ʻae ʻia o ke kauka.
ʻAno o ka meaʻai pēpē hou. ʻAʻole hiki i kahi pēpē hou ke ʻai ʻana i kekahi mea ʻē aʻe ma ka waiū o ka makuahine.
ʻO ka thermoregulation kūpono o nā ʻāpana, nā diapers, nā lole moe ma ka moʻo. ʻO ka mālama ʻana i ke ea kino o ke kino ke ʻano he nui ma ka mālama ʻana i ke kō kaʻa haʻahaʻa.
Pono ke maleʻe i loko o hoʻokahi hola ma hope o ka hānau ʻana.
ʻOi aku ka maikaʻi o ka hoʻolālā ʻana i ka papa ʻaina o ka pēpē ma ka papa hoʻonohonoho no ka loaʻa ʻole ʻana a ʻona ʻole hoʻi, ma kahi hopena e ulu ai kēia maʻi. Inā ʻaʻole e hōʻike ʻo ke keiki i nā hōʻailona o ka pōloli (noi ke keiki olakino e ʻai ma kahi o 4-5 mau manawa i ka lā), a laila he hōʻailona kēia no ke kipa ʻana i ke kauka.
ʻOiai paha ka liʻiliʻi o ka makahiki o ka wahine hou ma mua o 32 hebedoma, a ʻo ke kumu hoʻi o ke kaumaha ma mua o 1.5 kg.
Inā emi loa ka pae o ka glucose ma ka 2,6 mol, a laila e hoʻomaka koke ka infusion intravenous glucose.

Me ka maʻi paha o ka pēpē a i ʻole a i ʻole, i nā hola mua o kona ola e loaʻa ai iā ia ka glucose intravenous i loko o ke kino.

Ua hānau ʻia nā ʻōlio hou me kahi ʻōnaehana pale ola ʻole, pono ia e kūkulu ʻia i ka wā lōʻihi, e hoʻomaka ana me ka waiū o ko lākou makuahine. Ma muli o nā mea kikoʻī a me nā ʻōnaehana maʻamau, pākī ka pēpē i nā ʻano hoʻomāukiuki like ʻole, me ke ʻano o ka maʻi a me ke kaiapuni, nā mea momona a me ka metabolic. Eia kekahi, ʻaʻole noho piha nā holoholona ʻōpiopio i ka mālama ʻana i ka mahana o ke kino, a hiki ke loli ka nui o ke kino i ka hopena o nā loli a me ke ʻano haʻahaʻa. Mahalo paha ka mana o ka Glucose, a hāʻule paha ke kiʻekiʻe o ka glucose koko ma lalo o ke ʻano maʻamau no ka ʻai ʻana i ka pilikia, ke alakaʻi nei i kahi kūlana o ka hypoglycemia.

Hōʻuluʻulu ka pūʻulu kuleana i nā keiki nāna:

Hoʻōla ʻia ʻo Digestion.
ʻO ke koʻikoʻi o ke kino ma mua o ʻehā kilamu.
Papa maʻi 1 ka maʻi diabetes.
ʻAʻohe ala kūpono ʻole o ka loko komo.

ʻO nā kumu a me nā ʻōlelo hoʻopōmaikaʻi

I kēia lā, he nui ka hoʻomohala ʻana o ka hypoglycemia i nā pākeke a me nā kamaliʻi, me nā keiki hou. ʻO kēia no nā kumu he nui i hana i ka makahiki 21. ʻAʻohe mea i kapa ʻia kēia maʻi i ka maʻi o ko mākou manawa. Hoʻopilikia i ka ʻōnaehana nīnū, hoʻololi pono ka maʻi i nā hana psychomotor o ke kino a lilo i kumu o ka hoʻomohala ʻana i nā maʻi concomitant, ka mea i hui pū ʻia e ka pōkole a me ka hana puʻuwai puʻuwai.

No laila, ʻo ka hypoglycemia me nā hōʻailona ʻole e hoʻonāukiuki i ka thrombosis a i ʻole hōʻeha ka puʻuwai, ʻoiai ʻaʻole e ʻike ʻia ka hōʻailona a i ʻole ka hale. No laila, ma nā hōʻailona mua o ka hoʻohaʻahaʻa haʻahaʻa, pono ʻoe e hoʻopili i ka haukapila a hoʻokō i nā hōʻike koko kūpono e kōkua ai i ka pale ʻana i ke pēpē i kahi maʻi a ma laila e hoʻopakele i kona ola. ʻAe ʻae nā mea he kumu nui e hopohopo ai.

Pehea e kāohi ai i ka hypoglycemia

I mea e pale ai i ka glycemia, aia nā ʻoka hōʻike kūikawā. ʻAʻole lākou e hāʻawi i kahi hopena kūpono. Inā hōʻike i ka hōʻike haʻahaʻa nā haʻahaʻa haʻahaʻa loa, pono e hoʻokaʻawale koke i ke kikowaena no nā diagnostics. He mea nui ia e ʻike pono e hoʻomaka koke ka mālama ʻana, me ke kali ʻole o nā hoʻokolohua lāʻau. ʻAʻole hiki i ka hoʻokolohua 100% haʻalele i ka maʻi.

Pono mākou e hoʻomanaʻo he pili pū paha ka hui o nā mea hou i ka pēpē hou ma mua o 2800 a ʻoi aku hoʻi ma mua o 4300 mau grama, nā pēpē mua a me nā poʻe i hānau ʻia e ka wahine me ka maʻi maʻi.

Nui nā mea makemake i ka nīnau: ke hana a hana i nā hōʻike no nā hōʻailona glycemia? Hoʻomaka lākou e mālama i ka glycemia hapalua hola ma hope o ka hānau ʻana, a laila hoʻokahi hola, ʻekolu, ʻeono mau hola ma hope iho, ma ka ʻōpū ʻole. Inā loaʻa nā hōʻike, e hoʻomau ka hoʻomalu. A pau ka hana mua ʻana, ʻaʻole haʻalele ka congenital malectionations a sepsis.

Hypoglycemia i nā keiki hou: mālama

Hoʻohana ʻia ka mālama ʻana o ka hypoglycemia ma nā ʻano like ʻole: ke mālama ʻia nei ka dextrose ma ke ʻano, e hoʻoholo ʻia no ke kuhikuhi ʻana i ka mea komo kīnā, aia nā hihia i ka lawelawe ʻia o ka glucagon ma intramuscularly.

No nā pēpē i hānau ʻia i kahi makuahine me ka maʻi diabetes nona e lawe i ka insulin, i ka hapa nui, nā lawelawe glucose aqueous e lawelawe ʻia ma hope o ka hānau ʻana. Ke aʻo aku nei nā kauka i nā keiki ʻē aʻe e ola mua ana e hoʻomaka i ka hānai i nā mea e like me ka mea hiki a me ka pinepine pinepine i ka nui o nā mea hou i loko o ke kino.

I ka manawa e loaʻa ai ka pae o ka glucose i loko o ke koko o ka pēpē hou, pono ia e hoʻomaka i ka mālama ʻana i ka pēpē. No ka hana ʻana i kēia, koho i ke kīpona komo a me ka hopena kūnaehana o ka maʻi glucose, i hoʻokomo ʻia i loko o kahi vein.

Ma hope o kēia, pono ia e kiaʻi pinepine i ka pae o ka glucose a e wikiwiki wikiwiki i nā hana kūpono.

Inā maʻamau ke ʻano o ke pēpē, hiki iā ʻoe ke hoʻololi i ka mālama olakino, akā hiki ʻole iā ʻoe ke keʻae i ka nānā ʻana.

He mea koʻikoʻi loa ia e hoʻomaopopo i kēlā me kēia ʻano hypoglycemia, ʻo ia ke hala me kahi ʻole o nā hōʻailona, pono ke mālama ʻia. Ke hoʻomau mau nei ka mālama ʻana i ka uaki a hiki i ka moʻo keiki. ʻOiai inā ʻaʻole koʻikoʻi nā mākaʻi, pono nō hoʻi ka mālama ʻana.

Hiki i ka hypoglycemia ke ʻano ʻelua: ʻano nui a paʻakikī. Inā ʻo ka mea hou i ke ʻano o ka maʻi mua, a laila ua hāʻawi ʻia iā 15% maltodextrin a me ka waiū makuahine. Inā hiki ʻole kēia, inject glucose.

Ma kahi hoʻohālike koʻikoʻi, hana ʻia kahi bolus, a laila hoʻohui ʻia ka glucose, ua hoʻohui ʻia hoʻi me ke ʻano. Inā ʻaʻole kōkua kēia, e lawelawe ʻia ʻo glucagon. I kēia hihia, pono ia e mākaʻikaʻi pono i nā hōʻailona, ʻoiai hiki iā ia keʻike maikaʻi wale nō.

ʻAʻole ia e hāʻawi i kahi hopena o nā mea āpau o luna, a laila huli lākou i nā hopena koʻikoʻi a hāʻawi iā iazoxide a chlorothiazide paha.

Nā kaʻina hana no nā pēpē hou

He mea koʻikoʻi loa ia no nā makuahine hāpai i loaʻa ka mōʻaukala o nā maʻi maʻi i nā malama o nā malama i hala iho nei e hōʻoia i ka pae o ko lākou glucose.

Pono mākou e hoʻāʻo e hoʻomaka i ka hānai o ka pēpē i ka hiki a hiki i ka hōʻoia i nā mea ʻai maʻamau. I ka wā e loaʻa ai ka pēpē i ka home, pono e hoʻomau ka hānai maʻamau.

ʻAʻole hoʻi iʻoi aʻe ma mua o ʻehā mau hola. Loaʻa nā manawa pinepine i hoʻokuʻu ʻia ka pēpē i ka home i ka maʻi maikaʻi, a ma laila, ma muli o ka hoʻomaha lōʻihi ma waena o nā mea hānai, ua ulu ʻo ia i ka hypoglycemia i ka hopena.

ʻO ka hypoglycemia i loko o kahi pēpē he maʻi maʻi nui ka pono e koi pono ai ka nānā ʻana a me ka mālama koke. Pono ʻoe e nānā pono i kāu pēpē e pale aku i nā pilikia koʻikoʻi.

Makemake mākou iā ʻoe a me kāu keiki i ke olakino olakino maikaʻi!