Hypoglycemia i nā keiki hou

He hypoglycemia i loko o kahi keiki hou he ʻano mea i ʻike ai ka pae o ka glucose i ko lākou koko ma lalo o 2 mmol / L i nā hola 2-3 ma hope o ka hānau ʻana. Hōʻike nā hōʻike i ke ʻano o kēia kūlana i 3% o nā keiki āpau. ʻO ka haʻahaʻa, hoʻemi ʻia ke kaumaha, asphyxia perinatal e hoʻonāukiuki i ka hypoglycemia i nā keiki.

I mea e hana ai i ke kauka i kahi maʻi maʻi, hoʻokeleʻo ia i kahi hōʻike glucose no ka pēpē hou. Hoʻokuʻu wale ʻia kēia kūlana - ke mālama ʻia ka mālama ʻana ma ka hoʻokele intravenous o ka glucose. ʻO ka hypoglycemia kekahi o nā kumu maʻamau o ka make i waena o nā keiki hou.

Kahi helu

ʻO ka hypoglycemia i loko o kahi keiki hou he ʻelua mau ʻano: mau a mau ka transient. Hōʻike ke ʻano transient e pili ana i ka hope o ka immaturity pancreatic, ʻaʻole hiki ke hana pono i ka nui o nā huina, a me kahi haʻahaʻa haʻahaʻa haʻahaʻa. ʻAʻole naʻe kēia ʻae i ke kino e hōʻiliʻili i ka nui o ka glycogen i koi ʻia. I nā pilikia pinepine, hāpai ʻia ka hypoglycemia i nā keiki hou. Hōʻike ʻia kēia ʻano lesion e ka hilinaʻi i ka insulin, he mea ia ma muli o ka hōʻino o ka hana o nā hormones contrainsular. I nā pilikia lohi, ʻo ia ka leʻaleʻa no ka maʻi metabolic.

Hiki ke mālama ʻia i ka hala ʻana o ka hypoglycemia transient e ka wā ma mua o nā keiki me ka nui o ke kaumaha o ke kino a i ʻole ka paʻa placental. Hiki iā Intranatal asphyxia ke alakaʻi i kēlā hopena. ʻO ka hemahema o ka oxygen e hoʻopau i nā hale kūʻai glycogen i ke kino, no laila hiki i ke hypoglycemia ke ulu i loko o nā keiki like i loko o kekahi mau lā o ke ola. Hiki i ke kikowaena nui ma waena o nā mea hānai ke alakaʻi i kēia hopena.

Loaʻa pinepine ʻia ka hypoglycemia transient i nā keiki hou i hānau ʻia kona makuahine me ka maʻi maʻi. Eia kekahi, ulu kēia hanana i kahi kūlana o ke kaumaha o ka physiological. Ma nā hihia maʻamau, nā maʻi like ʻole e hōʻeha ʻia e ka maʻi autoimmune e koi ai ke kino i ka nui o ka insulin. ʻO ka Hyperplasia o nā pūpuna ma ka pancreas, Beckwith-Wiedemann syndrome, hiki ke hoʻonāukiuki i ka hoʻomohala ʻana o ia ʻano maʻi.

Hiki i nā hypoglycemia i nā keiki hou ke hoʻomohala koke ma hope o ka hānau ʻana a hiki i 5 mau lā o kona hoʻolālā. ʻO ka hapa nui o nā hihia, he mau hana kolohe ka mea i lawa ʻole ka hanana intrauterine a i ʻole ka lohi i ka hoʻoili ʻana o nā kino o loko.

Eia kekahi, ʻo ka haunaele o ka mea hiki ke alakaʻi i ka hypoglycemia. ʻO ka pōʻino nui loa ka puka mau ʻana o ke kaawale ʻana. ʻLelo kēlā, aia ka hypoglycemia i nā pathen congenital. Pono kēia ʻano i ka mālama mau ʻana a me ka mālama mau ʻana i nā lāʻau lapaʻau.

Me ka transog hypoglycemia, kahi emi o ke kōpaʻa i hōʻemi ʻia i hoʻokahi manawa, ma hope o ka hoʻomaha wikiwiki, ʻaʻole pono ka hoʻouka kaua i ka lāʻau lōʻihi. Eia nō naʻe, ʻelua ʻano ʻano o hoʻokahi hoʻohiki e koi wikiwiki i ka kauka. ʻOiai hiki i kahi lohi iki ke hiki i nā hana koʻikoʻi i ka hana o ka pīkī, ʻo ka mea i ka wā e hiki mai ana ke alakaʻi i nā kuʻuna i ka hana o nā papa kūloko.

ʻO nā kumu maʻamau o hypoglycemia i loko o nā keiki hou.

• Hoʻohana lōʻihi ka lōʻihi o ka maʻi insulin
• Maʻi hānai maʻiʻai
• ʻO ka lawe nui ʻana i ka glucose kiʻekiʻe e ka makuahine ma mua o ka hānau ʻana,
• Hypotrophy o ka wahine ma loko o ka ʻōpū,
• ʻO ka asphyxia mekanika i ka wā hānau,
• ʻAʻohe kūpono o ke ʻano o ke keiki,
• ʻO nā hopena o nā kaʻina maʻi.

Nā hōʻailona mua

Hoʻokomo koke ka hypoglycemia i nā keiki hou. Ua kū ʻia ia ma muli o ka hoʻopōʻino ʻana i ka pancreas, ka mea hiki ʻole ke hana pono i ka nui o ka insulin a me nā hāmeʻa keu. Ma muli o kēia, ʻaʻole hiki ke loli ke kino me ka nui o ka glycogen.

Hiki ke hoʻomaopopo ʻia ka hypoglycemia i nā keiki hou i kēia mau ʻōhua:

• ʻUlaʻulaʻula o nā lehelehe,
• Palani
• Hoʻoikaika nā pahu
• Noho nāwaliwali
• Hoʻopilikia
• Uwē ʻia ʻo nā kū ʻana
• Heachikux,
• Kaho loa
• Kuhi kaumaha.

Nā huapau

Maʻalahi ka hypoglycemia i nā keiki hou i maʻalahi. No kēia, lawa ia no ke kauka ke hoʻokolohua i nā hōʻike koko kiʻekiʻe. Kōkua lākou i ka loea e hoʻoholo i nā hōʻike mua o ka hypoglycemia akene a i ʻole ka protracted i loko o nā keiki. ʻO ka maʻamau, ʻo kēia mau haʻawina e hana nei e hōʻoia i ka maʻi maʻi:

• Holo ʻaia glucose,
• ʻO ka hōʻike koko ākea e hoʻoholo ai i ke kiʻekiʻe o ka momona momona,
• ʻO ka hōʻike koko ākea no ka hoʻoholo ʻana i ke kiʻekiʻe o nā kino ketone,
• ʻO ka hōʻike koko ākea e hoʻoholo ai i ke kaʻe o ka insulin i loko o ke koko,
• ʻO ka hoʻokolohua koko koko no ka pae o cortisol, nona ke kuleana a me ka hoʻomohala ʻana i ke kino.

He mea nui ia e hoʻomaʻamaʻa koke i ka mālama ʻana o ka hypoglycemia i nā keiki hou. No ka hoʻoholo ʻana i kēia kūlana ma kahi keiki, hoʻohana ke kauka i nā ʻoka hōʻike maʻalahi koke e hoʻoholo i ka neʻe o ka glucose i ke koko. Inā ʻaʻole e hoʻopili ka hōʻailona i ke pae o 2 mmol / l, a laila lawe ʻia ke keiki i ke koko no ke hoʻopaʻa lōʻihi. Ma hope o ka hōʻoia ʻana i ka hoʻomohala ʻana, maʻi hou ka ʻepekema i kekahi nui o nā glucose i loko o ka intravenously.

Hoʻoikaika ia ma muli o ka pono kīkino pono ʻole. Ma hope o ka pau ʻana i ka hoʻouka ʻana, hiki ke loaʻa nā hōʻailona o ka hypoglycemia me ka loaʻa ʻole o ka loaʻa ʻana o kahi hopena a me nā hopena no ke kino.

He mea nui ia e pili ana i nā lula e pili ana i ka mālamaʻana i kēia ʻano:

• ʻAʻole hiki iā ʻoe ke hōʻala i ka hoʻokūkū o ka glucose - hiki i kēia ke alakaʻi i ka hōʻemi o ka hypoglycemia. E hele lohi ana ka hoʻopau ʻana, ke hoʻemi iki nei ke kauka i ka nui o nā mea ikaika.
• Pono ka hoʻomaka ʻana o ka glucose i ka 6-8 mg / kg, e hoʻonui mālie i 80.
• Hōʻole loa ia i ke kauʻana i nā glucose iʻoi aku ma mua o 12,5% i loko o nā veins peripheral o ke keiki.
• ʻAʻole ia e noʻonoʻo i ke kīleʻa i ka ʻai i ka wā o ka hoʻokele glucose.
• Inā mālama ʻia ka glucose i ka wahine hāpai e pale aku i ka hypoglycemia i kāna keiki hou, pono e mālama pono i ka piʻi ʻana o ke kōʻai koko koko ma luna o 11 mmol / L. a i ʻole, hiki iā ia ke alakaʻi i kahi comog hypoglycemic i kahi wahine hāpai.

Me ka ala kūpono e pili ai i ka maʻi maʻi, e hiki koke i ke kauka ke ho'ōki i ka hoʻouka ʻana o ka hypoglycemia i ke keiki.

Eia nō hoʻi, inā hahai ka wahine hāpai i nā ʻōlelo a pau o ke kauka hele mai, hiki nō iā ia ke hōʻemi i ka hopena o ka hoʻoulu ʻana ʻaʻole wale ka hōʻemi ʻana o ke kō i loko o ka honi i loko o ka pēpē, akā pale pū nō hoʻi i ka hopena o ka hyperbilirubinemia, erythrocytosis a me nā ʻano hanu like ʻole.

Nā hopena

He hewa nui ka hypoglycemia i ka hana o ke kino, ka mea e hiki ai i nā hopena koʻikoʻi. E loiloi i kā lākou hōʻeha, ua nui nā haʻawina i hana. Hoʻomaopopo lākou i ka pehea e hoʻomohala ai nā kino a me nā ʻōnaehana o ke keiki ma muli o ka hypoglycemia ma mua. Ua hōʻike ʻia nā haʻawina lehulehu, ma muli o ka emi ʻana o ke kūpaʻa glucose, hoʻomohala hou i nā pilikia hou i ka hana o ka lolo. Ke alakaʻi nei kēia i ka holo ʻana o nā maʻi o ka ʻōnaehana, hoʻonui i ka ʻalike o ka loaʻa ʻana o ka epilepsy, ulu ka ulu.

Kāohi

Hōʻalo ka hypoglycemia i nā keiki hou i ka wā kūpono a me ka hoʻopihaʻai piha. Inā hoʻomaka ʻoe i nā meaʻai hoʻohui wale nō i nā lā 2-3 ma hope o ka hānau ʻana, nui loa ka hopena o ka ulu ʻana o kēia ʻano. Ma hope o ka hānau ʻana ke pēpē, pili lākou me ka catheter, ma o ka mea i hoʻomohala ʻia ai ka hui mua ʻana o ka huaʻai ma hope o 6 mau hola. I ka lā mua, hāʻawi ʻia iā ia ma kahi o 200 ml o ka umauma umauma.

Inā ʻaʻohe wai ka makuahine i ka waiu, a laila hāʻawi ʻia ke keiki i nā lā lāʻau intravenous kūikawā, ʻo ke kahe ma kahi o 100 ml / kg. Inā loaʻa kekahi pilikia o ka hypoglycemia, e nānā pono ʻia ka nui o ke kōpaʻa koko i kēlā me kēia mau hola.

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 pinepine nā hale kūʻai glycogen i ka wā hānau i nā pēpē mua a me ke kaumaha koʻikoʻi loa, nā pēpē a ka poʻe liʻuliʻu e ka gestation ma muli o ka nele o ka placental, a me nā pēpē i loaʻa kahi intranatal 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.

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.

Nui! ʻO ka hānai ʻana i ke pēpē e hoʻomaka me ka wikiwiki. Loaʻa koke kēia i ka hypoglycemia i hala i ka wā a ma hope o ka hānau ʻana.

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.

E makaʻala! ʻO ka ulaula a me ka inu ʻana i ka wā hāpai e alakaʻi ai i kahi emi o ke kahe o ke koko! Eia kekahi, ʻaʻole wale ka mea ikaika, akā ua hōʻeha hoʻi nā mea huna passive!

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 i hiki ʻole. Hiki ke hoʻokō ʻia ka hopena e nā hoʻokele.

Nā Hypoglycemia a me nā hōʻailona

1. Hanu wikiwiki.
2. Ka manaʻo hopohopo.
3. Hoʻohui maikaʻi loa.
4. Kaʻaea o nā wāwae.
5. Ke hoʻohālikelike nei ka manaʻo o ka pōloli.
6. ʻ .lelo hoʻohālikelike.
7. Hoʻopilikiaʻia ka hana hanu a hiki i kona pau ʻole.
8. ʻOmaʻomaʻo.
9. Nāwaliwali o ka ʻōpū.
10. ʻEhaʻeha.

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

Nui! ʻAʻohe ʻike kiʻekiʻe glucose i kēlā mau mana i ʻike ʻia ai nā hōʻailona o ka hypoglycemia! ʻO kēia hiʻohiʻona o nā keiki hou a me nā pēpē! ʻOiai me ka glycogen lawa i kēia mau keiki, hiki ke hypoglycemia i ulu!

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

1. gestational hele hewa
2. makua
3. me nā hōʻailona o ka hypoxia,
4. 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.

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.

Nā kumu kumu o ka maʻi

Hōʻike ʻo Hypoglycemia iā ia iho i kahi keiki hou ma hope o ka hānau ʻana a i ʻole a hiki i ke kiʻekiʻe ʻelima mau lā ma hope o ke ʻano. I ka maʻamau pinepine, hiki i ke kumu ke ahonui a i ʻole ka ulu ʻole ʻana o ka ulu ʻana o ka hōʻohi, nā mea hoʻoneʻe (carbonat).

I kēia hihia, ua māhele ʻia ka maʻi i ʻelua mau pūʻulu nui:

• ʻO ke transient - kahi ʻano pōkole pōkole, maʻa mau ia ma hope o nā lā mua o ke ola a ʻaʻohe koi i ka mālama lōʻihi.
• Iau. Aia ia e pili ana i nā abnormalities kongenital, ka mea i hui pū ʻia e nā pilikia o nā kino o nā kalapona a me nā metabolism ʻē aʻe ma ke kino. Pono lākou i ka mālama mālama ʻana.

Ka hoʻokaʻawale ʻana nā kauka i nā kumu o ka hypoglycemia transient i ʻekolu mau pūʻulu:

• ma ka maʻi makua a i ʻole ka hoʻokomo o ka glucose hou ma mua o ka hānau ʻana.
• ʻO ka fetoma hypotrophy o ka mea hoʻoulu, ʻo ka asphyxiation i ka wā o ka hana, luhi a me ka lawa ʻole o ka hoʻololi ʻana o ke keiki,
• hoʻohana lōʻihi o ka insulin.

ʻO ka hana nui o ka manaʻo o ka hypoglycemia i nā keiki hou

ʻO ka Glucose ke kumu nui o ka ikehu o ke ola o ke kanaka, ʻo ka lolo hoʻi. I ka wā o ka hoʻomohala ʻana o ke ola a loaʻa i ka wahine me ke koko o ka makuahine.

I ka manawa like, ua ʻike pono ke kūlohelohe o ka nui o ke kō e lawa ai no ka hana maʻamau ʻana i nā pono āpau a me nā ʻōnaehana. Ma hope koke o ka hoʻomakeʻa ʻana o ka hua i loko o ke kino wahine, ua loli ka loli o ka hormonal, e hoʻonui iki i ke kaʻe o ka nui o ke koko i ka wahine hāpai, "e hōʻoiaʻiʻo ana i kona lawa" no ʻelua.

Ma hope o ka hoʻopili ʻana i ke kaula umbilical, hoʻomaka ke kino o ke keiki a ka hana kūʻokoʻa, a laila hoʻokaʻawale ke kō o ke koko i nā mea āpau a pau, a hiki i ka 30 minu o ke ola ka palena. A laila e piʻi mālie kona nānā ʻana i nā hana maʻamau ma ka 72 mau hola mai ka wā o ka hānau ʻana.

ʻO kēia kaʻina hana ke hoʻololi i nā kūlana ola ma waho o ka ʻōpū a me kahi hoʻololi koi o ka metabolism mai ka ʻai ʻana o ka glucose maternal i kāna kūʻokoʻa kūʻokoʻa e nā ʻāpana o nā ate.

Manaʻo ʻo WHO e waiho i ka pēpē ma ka umauma ma hope o ka hānau ʻana

I kahi moʻolelo. I nā kolostrum wahine, aia ka glucose a me nā mea pōmaikaʻi e kōkua pono i holo wikiwiki i nā ʻōpū a me nā a me nā hāwili. The ate, nona i kuleana no ka hoʻopili ʻana o ka glucose mai kā nā hale glycogen, i hōʻiliʻili nui ʻia i nā pule o hope o ka hoʻomōloʻi ʻana i ka ʻōpiopio.

ʻO ka glucose hāpai a me ka hypoglycemia

I kēia lā, e pili ana kahi neonatologist hale i kahi protocol e hoʻokumu ana i kahi mea hōʻike i ke kaʻe o ke kō o ke koko ma ke ʻano he criterion no ka hypoglycemia i loko o kahi keiki hou - Kahiakau ʻana o ka hypoglycemia neonatal a me nā hui hopena (kumu)

ʻO nā ʻāpana like ʻole o nā ʻōpala āpau i ʻōlelo ʻia ma luna nei, ʻo ka mea hope loa, ʻo ia nō ka mea i loaʻa i nā ala aʻoaʻo, pono ia i ke kiaʻi mau a me ke kākoʻo olakino.

Eia kekahi, ua hōʻike ʻia nā noiʻi hou ʻana i ka emi ʻana o ke kō koko koko i nā keiki, i nā lā mua ma hope o ka hānau ʻana, hiki ke hōʻeha ʻia e:

• ka hānau ʻana o ke keiki ua hala mua me ke kaumaha nui o ke kino,
• hypertension ma ka wahine i ka wā hāpai, lawe i nā blockers beta a i ʻole nā ​​lāʻau lapaʻau ʻē aʻe no ka hoʻoluhi ʻana,
• i ka wā hāpai, terbutaline, ritodrin, propranolol,
• ka heleʻana i ka wā o ka hāpai ʻana o ka makuahine e hiki mai ana i kahi kūlana prediabetic - ka hoʻomanawanui i ka hoʻokaʻawale glucose.
• ke kū nei i ka wahine hāpai i nā manawa pōkole epileptic me ka valproic acid a i ka phenytoin,
• ka lawe ʻana i nā lāʻau lapaʻau
• ka koho ana i ka indomethacin hou, heparin, quinine, fluoroquinolones, pentamidine a i ʻole beta-blockers,
• ka heleʻana o ka naʻau congenital i ka pēpē.

He mea nui ia. ʻOi aku ma mua o ka hapalua o nā keiki a nā makuahine i hoʻopili ʻia me ka hopena o ka glucose i ko lākou hānau ʻana (5%) i loaʻa i ka nui o ke kō me ka wai gula. Manaʻo ʻo WHO e pani i kēia hana infusion me ka ʻaina o ka meaʻai i ka wā hānau. Hoʻemi kēia i ka hopena o ka hoʻokumuʻana i kahi kūlana hypoglycemic pathological i kahi keiki ma mua o 2 mau manawa.

Ke nānā nei i ka hoʻomaka ʻana o kahi kūlana hypoglycemic i loko o kahi keiki i nā lā mua o ke ola ʻana, mālama pono nā kauka i nā hōʻike hou aʻe o ia, akā, ʻaʻole pono naʻe, e hōʻike ana i kahi kahe o ke kō koko.

I ka hapanui pinepine, ʻike ʻia nā hōʻailona like ʻole:

• Hiki: paha i ka nystagmus ka hūnā - e hoʻomaka ka neʻe ʻana o ka maka i loko o kahi pōʻai, a i ʻole ka neʻe ʻana o ka "kui maka" - ke neʻe nei ke poʻo, ʻaʻole neʻe ka pale a me ka ʻaoʻao.
• Hōʻalo ke keiki a hoʻomaka nui e hoʻōho. Eia nō naʻe, ma ka manawa like ke kani nei i nā kani, ʻoiai ke piʻi nei, akā ʻaʻole nui loa a ʻaʻole leo o ka naʻau.
• ʻ sp pinepine ke pēpē i ke pēpē. ʻAʻole ia e kau i ke kaumaha, akā e kāpae iā ia.
• ʻO nā mea palupalu a nāwaliwali hoʻi. Aia haʻalulu nā lima a me / a mau wāwae paha, e like me ka wikiō. Hoʻomaʻamaʻa mau ʻia nā hiʻona jitteriness-paroxysm o ke kāʻei hema (ma ka 20-28 lua o ka wiki).

ʻO ka maʻamau maʻamau, akā hiki ke hele pū ʻia nā kūlana hypoglycemic e like me nā hōʻike like ʻana:

• ʻO ka ʻiliʻili a huli ʻana paha i uliuli nā ʻili. ʻO ka cyanosis paha:
  1. maʻamau
  2. ma nā lehelehe, ma ka ʻūhā o nā manamana lima, nā pepeiao a me ka ihu.
  3. a puni ka triangle nasolabial.
• Hoʻonui ke koko, piʻi ka naʻau a me ka hanu. Loaʻa paha ka hoʻomohala ʻana o ka apnea (hopu i ka hanu me nā helu repetition like ʻole a me ka lōʻihi o nā manawa hoʻomaha) i ka manawa).
• "Hūpeke" i ke ʻano kino o ke kino. Hoʻonui ka māla.

Hoʻomanaʻo E ka makuahine, ma hope o ka hānau ʻana, mai hopohopo nui. Inā aia kāu keiki i kahi hui koikoi hypoglycemic, a laila e kūpaʻa maoli nā kauka i ka glucose koko, e nānā pono i nā hōʻailona o kēia ʻano pathological, a hana koke i nā hanana inā e hōʻike a haʻalele paha lākou mai ke ʻano maʻamau.

Pono ʻoe e ʻike he pinepine ka neonatal hypoglycemia me nā hōʻailona ʻole. No laila, i ko mākou'āina, no nā pēpē i hōʻeha i ka hoʻomohala ʻana i kēia ʻano kiʻina, ua hāʻawi ʻia nā ʻōlelo aʻo e pili ana i ka hoʻomaʻamaʻa ʻana i nā hoʻokolohua pili.

• ka hoʻāʻo mua kaila koko no ka honi 30 mau minuke ma hope o ka hānau ʻana.
• i ka wā 24 mau hola ma hope o ka hānau ʻana, e nānā ʻia ke koko no ka hilo i kēlā me kēia 3 hola,
• mai ka 2 a i 4 mau lā (ka palena) i mālama ʻia ka glucose i kēlā me kēia 6 hola,
• hou - 2 mau manawa i ka lā.

Inā pau ka glucose koko i loko o ka pēpē ma lalo o 2.6 mmol / l, a laila e hoʻomohala i kona pae, ua hoʻohana nā neonatologists i nā ʻōhua o ka WHO i ʻāpono ʻia i ka makahiki 1997:

• i ka wā o ka mālama ʻana, inā ʻaʻole hiki ke hōʻeha ʻia ka pēpē, hoʻomau ʻia ka pēpē e hānai ʻia i ka wai i hōʻike ʻia e ka wai a hoʻohuihui ʻia, e ʻike pono ana i ka papa hana ʻai, me ka kīʻaha, ke kīʻaha, a me ke kō, a inā pono, ma ke kō.
• inā ʻaʻole i hiki i ka mea ʻai ke hoʻoulu i ka pae o ka glucose i ka liʻiliʻi o ka waiwai maʻamau, a laila pono e hana i kahi kōkole o intravenous glucose (dextrose), a i ʻole koho i ka wikiwiki a me ka hopena o ka glucose glucose, hoʻomaka i ka maʻi infusion.
• inā ʻaʻole i lawe ka infusion glucose i ka piʻi o ka makemake o ke kō i ke koko, ua hāʻawi ʻia ka pēpē i kahi kaila o ka glucagon a me hydrocortisone (prednisone).

A i ka hopena, makemake mākou e hōʻoia hou i nā mākua o nā keiki i loaʻa i ka hypoglycemia neonatal. ʻAʻole i ʻike i nā kauka i ka manaʻo hoʻokahi a me nā hōʻike kūpono e pili ana i kona hopena i ka loaʻa ʻana o nā pilikia neuropsychiatric mamao, ʻoiai ka wā e hiki mai ana i nā pēpē o kāna maʻi pathology asymptomatic.

Akā naʻe, ʻaʻole ʻo ia ʻo "kupanaha maikaʻi" kēia manawa e hana i kekahi manawa i ka wā hāpai, ʻaʻole hoʻokele pono i nā pae glucose, a inu pū i nā lāʻau lapaʻau nāu.

ʻĀmaʻomaʻo

Hypoglycemia i loko o nā keiki hou i loaʻa i kāna mau hōʻailona, ​​akā, kahi hoʻokaʻawale ʻia kahi ʻano asymptomatic. I ka lua o kēia, hiki ke ʻike wale ʻia ma o ka nānā ʻana i ke koko no ka pae o ke kō.

Hōʻike ʻia ka hōʻike ʻana o nā hōʻailona he neʻe ʻole e hele ʻole ʻole me ka hoʻopuka o ka glucose a ʻai mau paha. Ua hoʻokaʻawale ʻia lākou i kahi somatic, nāna e lawe i ke ʻano o ka pōkole o ka hanu, a me ka neurological. Eia nō kekahi, hiki i nā hōʻailona o ke ʻōnaehana nerve ma waena ke kūlike ʻole: ka nui o ka excitability a me ka haʻalulu a pupū paha a lūlū paha, luhi.

Hypoglycemia ma mua o nā pēpē

ʻAʻole ʻokoʻa nā hypoglycemia i loko o nā pēpē i mua i nā hōʻailona mai nā keiki maʻamau. E nānā paha ʻoe:

• ahonui
• ulu kino kino
• ʻaina meaʻai haʻahaʻa
• lethargy
• hakulua
• hopu
• cyanosis.

Kēia kiʻi e like me ka hoʻomohala ʻana o kāu keiki e hōʻike ai i ka emi ʻana o ke kō koko. Eia nō naʻe, ʻoi aku ka nui o nā pēpē i mua o ka manawa e ʻike ai i ka maʻi i ka manawa, ʻoiai he nui nā hōʻike e hāʻawi ʻia ana a ʻoi aku ka mālama o nā kauka ma mua o kahi pēpē i hānau i ka manawa.

I nā makahiki he nui, ua aʻo wau i ka pilikia o DIABETES. He makaʻu ke ʻike i ka nui o nā kānaka e make ana, a ʻoi aku ka ulu ma muli o ka maʻi maʻi.

Ua wikiwiki wau e haʻi i ka nūhou - ua hana ka Endocrinological Research Center o ka Russian Academy of Medical Sciences i ka hoʻomohala ʻana i kahi lāʻau lapaʻau e hoʻōla pono i ka maʻi maʻi. I kēia manawa, ke hoʻokokoke nei ka hopena o kēia lāʻau lapaʻau i ka 100%.

ʻO kekahi nūhou maikaʻi: ua mālama ka Ministry of Health i ka hoʻopaʻa ʻana i kahi papahana kūikawā e uku ana i ka uku holoʻokoʻa o ka lāʻau lapaʻau. Ma Lūkia a me nā ʻāina CIS maʻi ma kahi maʻi maʻi mamua 6 Iulai paha e loaʻa ana kahi hopena - HE MAU KOA!

Inā ʻike ka maʻi i ka manawa, a laila maʻalahi loa ka mālama ʻana - hāʻawi i ke wai i ke keiki me ka glucose, hiki nō ke hoʻomāhuʻi iā ia i loko o loko. I kekahi manawa, hoʻohui pū ʻia ka insulin no ka maikaʻi o ke kō ʻana o ke kō ma ke kino.

Hoʻopilikia i ka hypoglycemia i nā keiki hou

ʻO ka hypoglycemia kahi maʻi maʻamau maʻamau e loaʻa ana i ka 1.5 i nā hihia 3 mai 1000 mau keiki hou. Ke hele nei ka Transit (hele) i ʻelua mau hanana ʻekolu i waena o nā pēpē mua. Aia ka nui o ka loaʻa ʻana o kēia maʻi ma nā keiki i maʻi nā makuahine i ka maʻi maʻi.

Ma ka manawa like, ʻo ka pale ʻana o ka maʻa ma nā keiki piha ʻole i ʻike ʻole ʻia i ka hoʻomaʻamaʻa kūlohelohe, kahi e uku ai i nā mea pono o ke keiki ponoʻī. ʻAʻole koi ka male i ka hoʻouka ʻana i nā lāʻau lapaʻau hou, a hiki ke ʻike ʻia nā hōʻailona o ka maʻi wale nō ma ka maʻi hōʻino. Eia kekahi, inā ulu ke kiʻi o ka maʻi maʻi, pono e hoʻomaopopo i ke kumu, hiki, ʻaʻole i lawa ke kiʻekiʻe o ka wela.

Inā makemake ʻia ka lāʻau lapaʻau, a laila ua kuhikuhi ʻia ka glucose i ke ʻano o kahi hopena a i ʻole nā ​​infusion intravenous. I kekahi mau hihia, hoʻohui paha ka insulin. I ka manawa like, pono e nānā pono nā keiki i nā kauka e pale i ka kahe ʻana o ke kō koko koko ma lalo o kahi pae koʻikoʻi.

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 hānō e hoʻomā ʻole mau iā lākou e hoʻomaopopo ʻo ka pae o ka glucose i hāʻule mau.

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 ʻole e ʻai i kahi mea ʻole, ke loaʻa nei ka paona a hōʻole i ka ʻaoʻao o ka ʻona e hoʻoneʻe iā ia iho, ma ia mea e hoʻonāukiuki ai i 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.

Manaʻo mākou iā ʻoe e ʻike: Pehea e pili ai nā node isoechogen i ka gland thyroid?

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.

Hānau wale - 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 lawa ʻole o 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,
• nā kinipōpō alo,
• 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.

Manaʻo mākou iāʻoe e ʻike: He aha ka lactic acidosis a me ka hyperlactacidemic coma?

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:

1. 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.
2. 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.
3. ʻO nā pilikia hānau (asphyxia, nā hōʻeha o ka naʻau, nā hemorrhages). Hiki i ka hypoglycemia ke ulu i kēlā me kēia manawa.
4. ʻO nā pilikia me ka background o ka hormonal o ke keiki (ka adrenal dysfunction, hyperinsulinism, tumors, impaired protein a me ka synthet synthesis). Kola maʻa mau haʻahaʻa holi i hoʻokahi hebedoma 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 ʻano koʻikoʻi, ua hoʻohana ka intramuscular a i ʻole intravenous i nā lāʻau i mea e hoʻonui ai i ke kō.

Manaʻo mākou iā ʻoe e ʻike: Pupini hormone Duphaston - nā kikoʻī e pili ana i ka noi

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 hāpai ʻo ia ka 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 aku iā ia mai ka weliweli.

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 i nā keiki hou: he aha ia a no ke aha e kū ai?

Hōʻike ʻo Hypoglycemia i nā keiki hou i ka haʻahaʻa o ka hoʻokaʻa o ke koko, a no ia kumu ke hiki ʻole i kahi keiki ke hele wale i nā maʻi koʻikoʻi o ka pūnaehana poʻomanaʻo, akā, ʻaʻole maʻamau ka make. Ua maopopo ke ʻano me kēia ʻano, pono i ka manawa kūpono a me nā lāʻau kūpono e pono ai, a laila hiki pono ke pale i nā hopena maikaʻi ʻole.

Hoʻomaopopo o ka maʻi

Aia kēlā mau ʻano i ke ʻano o kāna mau hōʻailona, ​​eia naʻe, i kekahi mau hihia, e like paha me ka asymptomatic. A eia loa kēia ʻo nā hihia hope loa ka maikaʻi loa, ʻo ka mea ʻike ʻole ʻia ua maʻi mua ke keiki a ʻaʻole ʻike ʻia ka maʻi ʻike ma hope wale nō o nā hopena o ke ʻano maʻi, i ka wā e nānā ai ke kiʻekiʻe o ke kō.

Inā mākou e kamaʻilio e pili ana i nā hōʻailona, ​​a laila hiki mai nā lawaiʻa ma ʻaneʻi, a hoʻomanee ia a hiki i ka hoʻopuka ʻana o ka glucose i ke keiki, hiki pū ka ʻai hou.

Aia kekahi mau hōʻailona somatic, loaʻa iā lākou ke ʻano o ka pōkole o ka hanu a me nā hōʻailona o kahi ʻano neurological.

Inā ʻike ʻia nā hōʻailona ma ka ʻaoʻao o ka pūnaehana nūnakela, a laila ʻike ka mea āpau i kēlā me kēia, ʻo ia, lilo ka pēpē nui loa i laila, hiki paha i kahi haʻalulu, a me ke ʻano hopohopo, a laila hele mai ka manaʻo o ka lethargy a me ka hoʻoluhi.

ʻO ka maʻamau pinepine kekahi ʻike i nā mana āpau a ʻike ʻole ʻia, akā hiki iā lākou ke hoʻomohala i ke ʻano kūlohelohe i ka hopena he kaua kūʻē, a he ʻano hopohopo ʻole. Akā ʻo ka hopena o ia ʻano ʻano he puna wai kōpono a he mea nui loa ia e komo i ka paona ʻaila e pono ai, a eia a ʻaʻole ʻoe e pili ana i kekona kekona, akā e pili ana i nā paukū o ka lua, inā ʻaʻole ʻoe ka manawa, a laila hiki i nā mea āpau ke hoʻopau i loko ʻino loa.

Pehea e hōʻike ʻia nei ka maʻi i nā pēpē i hala

Inā mākou e kamaʻilio e pili ana i nā hōʻailona, ​​a laila ʻaʻole ʻokoʻa loa i nā pēpē i hala. Hoʻomaopopo ʻia nā ʻōuliʻu penei:

• ʻeha ʻole ke ʻano o ke keiki,
• ʻaʻole ke kino ka ʻala
• ʻai liʻiliʻi ka pēpē,
• ʻike pinepine ʻia ka pīpī
• kaumaha i ka ʻeha
• maluhia paha
• ka hoʻomohala ʻana o ka cyanosis.

Inā liʻiliʻi ka liʻiliʻi o ka pēpē i kēia mau lua, ʻo ia ka mea i loaʻa ka kiʻekiʻe i kāna koko koko haʻahaʻa.

A eia nō hoʻi, e like me ka hōʻike ʻana o nā hana, i nā keiki like ke ʻike wikiwiki ʻia a ʻoi aku ia ma mua o nā mea maʻamau a he kumu maʻalahi loa kēia kumu - ʻoi aku ka nui o ka helu mau ʻana.

A ma ke kānāwai, mālama pono nā kauka i kēia mau keiki ma mua o nā keiki maʻamau.

He aha paha nā hopena

Inā ʻaʻole i mālama ʻia kēlā maʻi ma ka manawa, ua hala ia i loko o kahi alualu i mua, a laila pili paha i ke kikowaena sentela.

Eia nō naʻe, ʻo ka pōmaikaʻi, i ka nui o nā hihia, ʻike ʻia ka maʻi ma kahi la e hiki mai ana i mua, ka mea e mālama pono ai i ka mālama ʻana.

No ka hana i kēia, pono e mālama pono i ka olakino o ke pēpē a, inā aia kekahi mau loli, pono e ʻimi koke i ke kōkua olakino.

Pehea ka hana ʻana o ka maʻi

Ma mua o ka hoʻomaka ʻana e mālama i kēia ʻano kuʻuna, pono e hoʻomaopopo ʻia he mea maʻamau loa, lawa ia e ʻōlelo ai ma ka 2 mau hapalua o nā tausani pēpē ua hōʻike ʻia iā ia.

I nā pēpē mua, ʻelua mau hānau hānau ʻekolu, eia nō naʻe, ʻo kēlā mau ʻano o ka maʻi i ka manawa pinepine ke ʻano o kahi transit, ʻo ia hoʻi, ke hele koke koke nei nō ma ona pono.

Akā i nā keiki i hiki i ka mau māmā ke maʻi i ka maʻi maʻi, a lailaʻike lākou i kahi maʻi like.

Pono ʻoe e hoʻomaopopo koke inā inā pilikia koke ke pēpē ma hope o ka hānau ʻana, pono nō, me ke kali ʻole o ka nānā ʻana i nā hōʻailona maikaʻi ʻole, e hana i nā loiloi o kahi ʻano ʻē aʻe. ʻO ia, i ka hapalua hola o ke ola o ke pēpē, pono koke ʻoe e hana i nā hōʻike no ka pae o ke kō, a laila pono e hana ʻia ʻo ia ʻo kēlā me kēia hola 3 i nā lā 2 mau lā o ke ola o ke keiki.

Inā e hoʻomaʻamaʻa ʻia kēlā mau meaʻai, a laila ʻaʻohe pono e hoʻohana i nā lāʻau lapaʻau hou, a e like me nā hōʻailona o ka maʻi, e ʻike wale ʻia inā he pōpilikia. Me ka hoʻomohala ikaika o ke kiʻi o kahi maʻi o ke ʻano lapaʻau, ʻo ka mea mua e hana ai, ʻo ke kiʻi ʻana i ke kumu, ʻaʻole maʻamau ke ʻano o ke ʻano holoʻokoʻa.

Hana ia i kekahi mau lāʻau lapaʻau e hoʻohana ʻia no ka hoʻomaʻamaʻa ʻana, e like me ka hoʻokō ʻana o ka rula ma ke ʻano he mea hiki ke hoʻohana ʻia a i ʻole ʻia i loko o kahi uaua. ʻAʻole lawa nā hihia o ka hoʻohuiʻana i ka insulin no ka hoʻopili ʻana ʻoi aku ka maikaʻi.

Ka hānai a kaʻu keikikāne .Mapela hoʻokalakiko hoʻokele EasyTouch (glucometer 3v1 diabetes mellitus o nā keiki hou

ʻO ka hypoglycemia transient i loko o nā keiki hou

He hypoglycemia transient keiki hou o nā keiki hou i hōʻike mai iā ia ma loko o 12-48 mau hola ma hope o ka hānau ʻana, ua ʻike ʻia ma kekahi ʻano palena ʻē aʻe, a hana ʻia ma ʻelua o nā keiki hānau poʻokela me ke kaumaha haʻahaʻa, a i ʻole nā ​​mea i hānau ʻia me nā makuahine me ka maʻi maʻi. Ma ka ʻatikala e pili ana i kēia.

No nā makahiki he nui, ua lawe ʻia nā noiʻi e ʻike i nā haʻahaʻa haʻahaʻa haʻahaʻa ma o nā keiki hou a me nā kumu o nā maʻi neonatal hypoglycemia.

ʻO nā wehewehe like ʻole o kēia pilikia e kū mai e pili ana i nā ʻano like ʻole i kēia ala pili. A hiki i nā 80s o ka makahiki i hala, ua ʻike ke ʻano o ka glucose i 1,67 mmol / L i nā hola 72 mua o ke ola o kahi pēpē a me kahi hoʻonui me 2.2 mmol / L i manaʻo ʻia he mea pono.

No nā pēpē kahiko, ʻaʻole e hoʻemi ʻia kēia helu ma mua o 1.1 mmol / L. I kēia manawa, manaʻo ʻia ka hypoglycemia ma ke kō he wai haʻahaʻa ma lalo o ka 2.2 mmol / l, a me ka manawa i ʻōlelo ʻia no ka nānā ʻana i ke ʻano o nā pēpē ua hoʻonui ʻia ʻo 18 mau mahina mai ka lā o ka hānau ʻana.

Ma nā hopena o nā noiʻi, ua hoʻopau nā poʻe loea ʻo WHO i nā helu ma luna o 2.6 mmol / L hiki ke manaʻo ʻia he pae palekana. Inā hāʻule ka glucose i lalo o ka waiwai paepae, pono e hoʻomaka koke ka mālama ʻana, no ka mea, ʻo ka like o ke kō o ke kō i loko o ke koko e pili ana me ka pilikia ʻole o ka neurological.

ʻAʻole maopopo maopopo i ka pathogenesis o ka hypoglycemia i nā keiki, hoʻokahi mea maopopo: ke kumu ke waiho nei o ka glycogen ma loko o ka pēpē o ka pēpē, no ka mea, ʻaʻole i hoʻoulu ka fetus i ka glucose, akā ola ia i ka makuahine. A ʻike ʻia aia ua kūkulu ʻia nā hale kūʻai glycogen i nā pule o hope o ke ʻano o ka hapahapa, ʻo ia ke kumu a ka pēpē mua o ka pēpē me ka maʻi kino o ka intrauterine.

Ka papa hoʻonohonoho ʻana o ka hypoglycemia transient

Aia nā koho ʻē aʻe no ka hypoglycemia:

• ka mua - ulu i loko o nā hola 6-12 o ke ola mua loa, a ʻo ka hui pilikia ʻo nā keiki a nā makuahine me ka maʻi maʻi,
• ke keiki neʻe - 12-48 mau hola o ke ola, no nā pēpē mua a me nā māhoe;
• Ua hili ʻia ka hypoglycemia kūlehu me ka sepsis, kahi kuʻuwale o ke keena wela, hemorrhage ma nā kelepa adrenal, kahi maʻi o ka pīhoihoi, a nona nā makuahine i lawe i nā lāʻau lapaʻau e hōʻemi i ka kōpī.
• hele mau ka hypoglycemia maʻamau i hoʻokahi pule ma hope o ka hānau ʻana me ka hemahema o ka hormone, hyperinsulinism, ʻehā aila amino synthesis,

ʻO nā hōʻike lapaʻau o kēia kūlana ke hōʻoia pinepine pinepine i nā pēpē, haʻalulu, twitching, hyper-irritability syndrome, ka mea i hōʻike ʻia e kahi ʻūʻā a me ke kūmū ʻana. ʻO ka hiʻona ka nāwaliwali, regurgitation, apnea, anorexia, cyanosis, tachycardia, ke ʻano kino o ke kino, hypotension arterial.

Hoʻokomo ʻia nā pēpē i hānau ma ka pilikia:

• nā keiki me ka pōʻino loa,
• pēpē kaumaha hānau pēpē pēpē
• hānau ʻia i nā makuahine me ka maʻi diabetes
• mau keiki i hōʻeha ʻia i ka ʻopa
• nā pēpē me ke koko i ka wā hānau.

No nā keiki e pili ana i kēlā mau hui pilikia, e pono e hana ʻia ka loiloi mua o 30 mau minuke ma hope o ka hānau ʻana a laila kēlā me kēia 3 mau hola no ka mau hola 24-48 mua, a laila kēlā me kēia hola 6, a mai ka lā 5 o ke ola he ʻelua i ka la.

Pono e ʻike pono i nā neonatologists a me nā mea lapaʻau e hāʻawi i ka diagnostics wehe me ka sepsis hiki, asphyxia, hemorrhage i loko o ka lolo, a me nā hopena o ke ʻano.

Hoʻokomo ʻia nā pēpē i hānau ma ka pilikia:

• na keiki me ka palalau kaumaha,
• pēpē kaumaha hānau pēpē pēpē
• hānau ʻia i nā makuahine me ka maʻi diabetes
• mau keiki i hōʻeha ʻia i ka ʻopa
• nā pēpē me ke koko i ka wā hānau.

No nā keiki e pili ana i kēlā mau hui pilikia, e pono e hana ʻia ka loiloi mua o 30 mau minuke ma hope o ka hānau ʻana a laila kēlā me kēia 3 mau hola no ka mau hola 24-48 mua, a laila kēlā me kēia hola 6, a mai ka lā 5 o ke ola he ʻelua i ka la.

Hoʻomaʻamaʻa kokoke i nā poʻe loea i nā neonatologists a me nā mea lapaʻau e pono ke hāʻawi i ka maʻi me ka ʻāpana sepsis, asphyxia, hemorrhage i ka lolo o ka lolo, a me nā hopena o ka lāʻau lapaʻau ʻenehana.

ʻO ka manawa pinepine loa no ka hiki ʻana o ka hypoglycemia i nā keiki he 24 mau hola o ke ola o ke pēpē, ʻo ia paha ma muli o ka maʻi kumu, kahi mea hoʻonāukiuki i ka maʻi hypoglycemia transient. Inā hōʻike kahi keiki i nā maʻi lapaʻau koʻikoʻi o ka hypoglycemia e like me ka hopu ʻana i nā mea hanu, nā māpala, a me nā mea he nui.

Inā haʻahaʻa nā helu kaomi ma lalo o 2.6 mmol / L, e kuhikuhi pono ʻia ka hoʻokele glucose intravenous wikiwiki a me ka nānā pinepine ʻana i ka pae kōlaʻa, ukali ʻia e nā hoʻoponopono ʻana ma nā helu ma lalo o ka 2.2 mmol / L a me ka alakaʻi o nā lāʻau lapaʻau: Glucagon, Somatostatin, Hydrocortisone, Diazoxide, etc.

ʻO kahi rula nui o ka mālama ʻana no ka hypoglycemia i loko o nā keiki hou e hoʻomau mau ana i ka hana aloha ʻana.

Hoʻokomo ka prognosis o ka mālamaʻana i ka manawa o ka maʻi a me ka nui o ke kūlana o ke pēpē. Inā ʻaʻole hui ʻia nā haʻahaʻa haʻahaʻa haʻahaʻa e nā hōʻike olakino maʻamau, ʻaʻole i hiki mai nā leʻaleʻa hiki ke hoʻololi ʻia. Ua manaʻo ʻo neonatologists Pelekānia ʻo ka piʻi o ka rima o ka lolo mai ka hypoglycemia transient e pili ana i ka ulu ʻana o ka maʻi o Down.

Nīnau Medkrug.ru

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 me 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 lōʻihi ʻana i 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 indomethacin ma luna o ka ductus arteriosus wehe, a me ka hoʻohana ʻana i ka hana hoʻomau i ka insulin i ka mālama ʻana o 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 (ka naʻau hypotension, ka hoʻokaʻawale ʻana o ka papa hana, ka lethargy āpau, hōʻeha a me nā hanana 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 kāʻei ʻana i ka maʻi 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 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.

Nā kumu o 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
• hypothermia
• 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.

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 nā dextrose i loko o ka intravenously, hoʻoholo ʻia kekahi mea e hoʻoponopono ai i ka pono o ke kīpoki, aia nā hihia i ka lawelawe ʻia o kaagonagon 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. Ke hele 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 kiaʻi pono i kāu pēpē e pale aku i nā pilikia koʻikoʻi.

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

Papa kiʻina o nā mea:

• Hypoglycemia: nā kumu, nā hōʻailona, ​​ka mālama ʻana
• He aha ka hypoglycemia?
• Nā Hypoglycemia: nā kumu
• ʻO ka hoʻolālāʻana o ka hypoglycemia (wikiō)
• Nā hōʻailona a me nā hōʻailona o ka hypoglycemia
• He koko koko haʻahaʻa, he aha ka hana? (wikiō)
• ʻO ka hopena a me ka hopena o ka maʻi hypoglycemia, hypoglycemic syndrome
• ʻO ka hypoglycemia i nā keiki
• Ka hopena o ka lāʻau hypoglycemia, nā lāʻau lapaʻau hypoglycemic
• Diet no ka hypoglycemia
• Kāohi
• Nā ʻano o ka hypoglycemia: transient, react, alkohol, nocturnal, maʻi
• Palapala Hoʻoikaika a i ʻole Neonatal Hypoglycemia
• Hōʻoiaʻiʻo i ka hypoglycemia
• He kahakaha hypoglycemia
• Hypoglycemia Nocturnal
• He maʻi hypoglycemia ʻeha
• Hāpai hypoglycemia
• Hypoglycemia akue
• He hypoglycemia alimentary
• Nā manaʻo a me nā ʻōlelo
• Waiho i kahi loiloi a manaʻo paha
• ʻAʻole nā ​​mea e pono ai i ke kumuhana:
• Nā lāʻau lapaʻau maʻi
• NA MALAMI DIA
• Makemake wau e ʻike i nā mea āpau!
• E pili ana i ka maʻi maʻi
• ʻO nā ʻano a me nā ʻano
• Mea ʻai
• Hoʻomaʻamaʻa
• Kāohi
• Nā maʻi
• Nā kumu, nā hōʻailona a me ka mālama ʻana i ka hypoglycemia i nā keiki hou
• ʻO nā kumu hanana
• ʻO nā hōʻailona o ka maʻi
• ʻO ka hypoglycemia transient o ka pēpē
• Hoʻomaʻamaʻa
• Nā wikiō pili
• He aha ka mea hypoglycemia transient
• ʻO kahi hui
• Hōʻailona
• Kahi helu
• ʻĀmaʻomaʻo
• Nā huapau
• Hoʻohana ʻia ka hypoglycemia transient
• Wānana
• Kāohi
• Ka helu ʻana, pathogenesis a me nā hōʻailona o ka hypoglycemia
• ʻO kaʻoiaʻiʻo kūpono a me ka hypoglycemia
• Nā ʻano o Hypoglycemia
• ʻO ke ʻano kumu o ke kūlana patological
• Hypoglycemia Nocturnal
• Kelepona
• Kūpono
• Hōʻike hou
• Alimentary hypoglycemia postgastroectomy
• Hāpai hypoglycemia
• ʻO ka haʻaola hemoglycemia
• ʻO ka Posthypoglycemic
• Nā Hoʻomaka
• ʻO ka pēpē hypoglycemia
• Neonatal
• Nā papa hana o ka maʻi
• ʻO ke ʻano maʻalahi
• Ke kekona kahaona
• ʻO ke kolu ʻokoʻa, kaumaha
• ʻO ke poʻo puka ʻo coma
• Kōkua ma mua o ka hiki ʻana mai o kahi kauka
• Hōʻea Hypoglycemia

Ua hoʻonui hou ʻia ka mea i loaʻa ai ka hypoglycemia ma muli o nā kai like ʻole a me nā hōʻino.

Nā Hypoglycemia: nā kumu

ʻO kēia ʻano, ma ke ʻano he kānāwai, ulu i ka nui o ka hana o ka nui o ka insulin. A ʻo kahi hopena ia, hoʻokaʻawale ʻia ke kaʻina maʻamau o ka hoʻohuli ʻana i nā kalapona i ka glucose. ʻO ke kumu maʻamau maʻamau, ʻo ia ka maʻi diabetes. Akā he mau kumu ʻē aʻe kekahi wahi i loko o ka hoʻomaʻamaʻa olakino. E nānā i nā kikoʻī hou aku, he aha nā kūlana e hiki ke alakaʻi i ka hypoglycemia.

• ʻO ka heleʻana o nā neoplasms i ka lōkihi gastrointestinal.

Nā hōʻailona a me nā hōʻailona o ka hypoglycemia

ʻO kahi hiʻohiʻona o nā hōʻailona lapaʻau o ka hypoglycemia i ʻokoʻa i nā maʻi maʻi ʻē aʻe. Eia nō naʻe, aia kekahi mau hiʻohiʻona maʻamau e hiki ke hele mai ma kahi o ke kāne a me nā makahiki o nā maʻi. Pono lākou e mālama pono, ʻoiai lākou e hoʻomaʻamaʻa maikaʻi loa i ka maʻi o ka maʻi.

ʻO ka hopena a me ka hopena o ka maʻi hypoglycemia, hypoglycemic syndrome

ʻO ka pono, he pilikia nui ka moku'āina o ka hypoglycemia a hiki ke alakaʻi i nā hoʻopiʻi koʻikoʻi, me ka make. ʻOiai ka hoʻoliʻiliʻi ʻana i ke kō koko koko hoʻoweliweli i kahi kanaka me nā pilikia olakino.

ʻO ka pōʻino nui loa i ka lolo o ke kanaka he transog hypoglycemia. ʻAʻole hiki i kā mākou lolo keʻano me ka nui o ke kō e pono ai i kahi manawa lōʻihi. Pono ʻo ia i ka ikehu ma ka nui. No laila, me kahi hapa o ka glucose, e hoʻomaka koke ʻo ia e hāʻawi i nā hōʻailona a noi aku i ka meaʻai.

ʻO ka hypoglycemia i nā keiki

• ʻO ka hemahema o kaʻaiʻai.

ʻO nā hōʻailona o ka hypoglycemia i nā keiki: ka mea o ka hakahaka o ka acetone mai ka waha, ʻili papala, ka nele o ka momona, a me ka luaʻi.

Hiki i ka luaʻi ʻōleʻa hiki ke alakaʻi i ka dehydration, nalowale o ka noʻonoʻo, hoʻonui ke kino o ke kino.

I kekahi mau hihia, e kuhikuhi ʻia e hoʻohana i nā ʻōpū i ka glucose a me ka mālama i loko o ka hale mālama ma lalo o ka mālama ʻana o nā kauka.

Ma hope o ka hoʻohaʻahaʻaʻana o ke kō, pono ia e hoʻokumu i ka ʻai kūpono me ka nui o nā lau, nā hua, nā kai. ʻOi aku ka maikaʻi o ka ʻai ʻana i ka mea liʻiliʻi ma ka liʻiliʻi me i ʻole ka lawe ʻana aʻe i nā mea o loko.

He kūlana maikaʻi loa ka kūlana o ka hypoglycemia i ka hiki ʻana o ke keiki. Eia kekahi, hoʻoweliweli ia i ke ola ma muli o nā hana hoʻokūkū koʻikoʻi.

Ka hopena o ka lāʻau hypoglycemia, nā lāʻau lapaʻau hypoglycemic

ʻO ka Therapy o kēia patula ma ka hoʻomaka mua e komo i kahi ʻaina o ka ʻai o ka mea i lawe ʻia e ka mea maʻi.

• Nā hua hua o ka sulfonylureas (Glibenclamide, Glikvidon). ʻO kēia ka hui kaulana loa o nā mea hana i hoʻohana ʻia.

Ke koho nei i kahi lāʻau lapaʻau no ka mea maʻi kūikawā, pono ia e noʻonoʻo i nā hiʻohiʻona pilikino o ka mea maʻi a me nā hopena hopena pae lāʻau. Eia kekahi, pono e hoʻoponopono pololei i ka dosage i makemake ʻia.

I mea e pale ai i ka edema cerebral, hiki ke mālama ʻia i ka intravenously maʻa magnesium sulfate.

ʻO ka hypoglycemia ma loko o kahi hōʻailona 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 ka neonatal hypoglycemia ke kumu lua e koi ana i ka noho lōʻihi o ka pēpē ma hope o ka hānau ʻana.