I-Hypoglycemia ezinganeni ezisanda kuzalwa yinto eyenzeka lapho izinga likashukela egazini lazo liwela ngaphansi kwe-2 mmol / L ngaphakathi kwamahora angama-2-3 ngemuva kokuzalwa. Izibalo zikhombisa ukuthi lesi simo sikhula ku-3% yazo zonke izingane. Ukusungulwa okwandisiwe, isisindo esiphansi, i-asphyxia ye-perinatal kungavusa i-hypoglycemia ezinganeni.
Ukuze udokotela akwazi ukuthola lolu hlobo lokuxilonga, wenza ukuhlolwa koshukela kosana olusanda kuzalwa. Lesi simo simiswa nje - ukwelashwa kuqukethe ukuphathwa kwe-glucose kwe-intravenous. I-Hypoglycemia ingenye yezimbangela ezivame kakhulu zokufa phakathi kwezingane ezisanda kuzalwa.
Ukuhlukaniswa
I-Hypoglycemia ezinganeni ezisanda kuzalwa zezinhlobo ezimbili: ezingapheli nezesikhashana. Uhlobo lwesikhashana kwenzeka ngokungafani nesizinda sokuvuthwa kwe-pancreatic, okungeke kukhiqize ama-enzyme anele, noma ukunikezwa okuphansi komhlaba. Konke lokhu akuvumeli umzimba ukuthi uqongelele inani elidingekayo le-glycogen. Ezimweni ezingavamile, i-hypoglycemia eqhubekayo itholakala ezinganeni ezisanda kuzalwa. Lolu hlobo lesion lubonakala ngokuncika kwe-insulin, kwenzeka ngenxa yokwephulwa komkhiqizo wama-hormone aphikisayo. Ezimweni ezingavamile, i-lesion enjalo ibangelwa ukuphazamiseka kwe-metabolic.
Ukuthuthuka kwangaphambi kwesikhathi kwe-hypoglycemia kungabangelwa ukukhula kuqala ezinganeni ezinesisindo esibuthakathaka noma ngokuntuleka kwe-placental. I-asphyxia ye-Intranatal nayo ingaholela emiphumeleni enjalo. Ukuntuleka komoya-mpilo kubhubhisa izitolo ze-glycogen emzimbeni, ngakho-ke i-hypoglycemia ingakhula kulezi zingane ezinsukwini ezimbalwa zokuphila. Ukuphumula okukhulu phakathi kokuphakelayo nakho kungaholela kulokhu.
I-hypoglycemia yesikhashana ivame ukwenzeka ezinganeni ezisanda kuzalwa ezinomama onesifo sikashukela. Futhi, le nto iba ngokuqhathanisa nesizinda sokuxineka ngokomzimba. Ezimweni ezingavamile, lokhu kudalwa kwesifo kubangelwa yisifo se-autoimmune lapho umzimba udinga khona insulin enkulu. I-Hyperplasia yamaseli kumanyikwe, i-Beckwith-Wiedemann syndrome ingavusa ukuthuthukiswa kwe-pathology enjalo.
Izizathu
I-Hypoglycemia ezinganeni ezisanda kuzalwa zingakhula ngokushesha ngemuva kokuzalwa kuze kufike ezinsukwini ezingama-5 zokukhula kwayo. Esikhathini esiningi samacala, ukwephulwa okunjalo kubangelwa ukukhula okunganele kwe-intrauterine noma ukubambezeleka ekwakhekeni kwezitho zangaphakathi.
Futhi, ukuphazamiseka kwe-metabolic kungaholela ku-hypoglycemia. Ingozi enkulu kakhulu indlela ephikelelayo yokuphambuka okunjalo. Uthi i-hypoglycemia idalwa yi-patgenital pathologies. Lesi simo sidinga ukuqashwa njalo nokulungiswa njalo kwezokwelapha.
Nge-hypoglycemia yesikhashana, ukwehla kokuhlushwa ushukela kuyancipha ngesikhathi esisodwa, ngemuva kokukhululeka okusheshayo, ukuhlasela akudingi ukwelashwa okuhlala isikhathi eside. Kodwa-ke, izinhlobo ezimbili zokuphambuka okukodwa zidinga ukuphendula okusuka kudokotela. Noma ukubambezeleka okuncane kungadala ukuphambuka okukhulu ekusebenzeni kohlelo lwezinzwa, okuthi esikhathini esizayo kungaholele ekuphambukeni emsebenzini wezitho zangaphakathi.
Ezinye zezimbangela ezivame kakhulu ze-hypoglycemia ezinganeni ezisanda kuzalwa yilezi:
- Ukwelashwa kwe-insulin ekhulelwe ngokuthatha isikhathi eside;
- Isifo sikashukela soMama
- Ukudla okukhulu kwe-glucose ephezulu ngaphambi nje kokuzalwa;
- I-Hypotrophy ye-fetus ngaphakathi kwesibeletho;
- I-asphyxia yemishini ngesikhathi sokuzalwa kwengane;
- Ukungashintshi okwanele kwengane;
- Imiphumela yezinqubo ezithathelwanayo.
Izimpawu zokuqala
I-Hypoglycemia ezinganeni ezisanda kuzalwa iba ngokushesha okukhulu. Kwenzeka ngenxa yomonakalo kumanyikwe, angakwazi ukukhiqiza i-insulin eyanele namanye ama-enzyme. Ngenxa yalokhu, umzimba awukwazi ukuqoqa inani elifanele le-glycogen.
I-Hypoglycemia ezinganeni ezisanda kuzalwa ingabonakala kulezi zimpawu ezilandelayo:
- Isikhumba esiluhlaza okwesibhakabhaka sezindebe;
- Pallor;
- Ukuqina kwemisipha;
- Isimo esibuthakathaka;
- Uzwela;
- Ukukhala okungazelelwe kokumemeza;
- I-Tachycardia;
- Ukujuluka ngokweqile;
- Ukukhathazeka.
Ukuxilonga
Ukuxilonga i-hypoglycemia ezinganeni ezisanda kuzalwa kulula kakhulu. Kulokhu, kwanele ukuthi udokotela enze ukuhlolwa kwegazi okuthuthukile. Basiza uchwepheshe ekuboneni ukubonakaliswa kokuqala kwe-hypoglycemia ebukhali noma evulekile ezinganeni. Imvamisa, lezi zifundo ezilandelayo zenziwa ukuqinisekisa ukutholakala kwale sifo:
- Ukuhlolwa kwegazi okujwayelekile kwe-glucose;
- Ukuhlolwa kwegazi okujwayelekile ukuthola inani lama-acid amaningi;
- Ukuhlolwa kwegazi okujwayelekile kokuthola izinga lemizimba ye-ketone;
- Ukuhlolwa kwegazi okujwayelekile ukuthola ukunqampuna kwe-insulin egazini;
- Ukubala kwegazi le-Hormonal ezingeni le-cortisol, elibhekele ukukhula nokukhula komzimba.
Ukwelashwa
Kubaluleke kakhulu ukuthi ukwelashwa kwe-hypoglycemia ezinganeni ezisanda kuzalwa kusheshe. Ukuthola lesi simo enganeni, udokotela usebenzisa imichilo yokuhlola eshesha enquma ukuhlangana kweglucose egazini. Uma inkomba ingafiki ezingeni le-2 mmol / l, khona-ke ingane ithatha igazi ukuze ifundwe isikhathi eside. Ngemuva kokuqinisekisa ukutholakala kwesifo, uchwepheshe ulimaza inani elithile le-glucose ngaphakathi.
Ukhula ngenxa yokudla okungenamsoco. Ngemuva kokumisa ukuhlaselwa, izimpawu ze-hypoglycemia zinganyamalala ngaphandle komkhondo nemiphumela yomzimba.
Kubaluleke kakhulu ukunamathela kule mithetho elandelayo ekwelashweni kwalesi simo:
- Awungeke ukuphazamise ngokushesha ukuphathwa kwe-glucose - lokhu kungaholela ekwandeni kwe-hypoglycemia. Ukuqedwa kwenzeka kancane, udokotela wehlisa kancane kancane umthamo wento esebenzayo.
- Ukwethulwa kwe-glucose kufanele kuqale ngo-6-8 mg / kg, kancane kancane kukhule kube ngu-80.
- Kuyenqatshelwe ngokuqinile ukufaka i-glucose engaphezu kwe-12,5% emithanjeni yengane.
- Akunconywa ukuphazamisa ukondla ngesikhathi sokuphathwa kwe-glucose.
- Uma i-glucose ihanjiswa kowesifazane okhulelwe ukuvikela i-hypoglycemia enganeni yakhe esanda kuzalwa, ukunakekelwa kufanele kuthathwe ukuze kuqinisekiswe ukuthi ukuqina koshukela egazini akukhuphuki ngaphezu kuka-11 mmol / L. ngaphandle kwalokho, kungaholela ekhefeni le-hypoglycemic kowesifazane okhulelwe.
Ngendlela efanele yokwelashwa, udokotela uzokwazi ukuyeka ngokushesha ukuhlaselwa kwe-hypoglycemia enganeni.
Futhi, uma owesifazane okhulelwe ebuka zonke izincomo zikadokotela ozobakhona, uzokwazi nokunciphisa ingozi yokuthola hhayi kuphela ukwehla kokubandakanywa koshukela osanda kuzalwa, kodwa futhi avikele ukuvela kwe-hyperbilirubinemia, erythrocytosis kanye nokuphazamiseka okuhlukahlukene kokuphefumula.
Imiphumela
I-Hypoglycemia ukuphambuka okukhulu ekusebenzeni komzimba, okungaholela emiphumeleni emibi. Ukuhlola ubulukhuni bazo, kwenziwa izifundo eziningi. Benza ukuthi baqonde ukuthi izitho nezinhlelo zezingane zizokhula kanjani ngenxa ye-hypoglycemia yangaphambilini. Ucwaningo oluningi selukhombisile ukuthi, ngenxa yokwehla kwamazinga kashukela, izingane ezisanda kuzalwa ziba nezinkinga ezinkulu ekusebenzeni kwengqondo. Lokhu kuholela ekuthuthukisweni kwezifo zohlelo lwezinzwa, kwandisa ingozi yokuthola isithuthwane, ukukhula kwesimila.
Ukuvimbela
Ukuvimbela i-hypoglycemia ezinganeni ezisanda kuzalwa kuqukethe ukudla okufika ngesikhathi futhi okuphelele. Uma uqala ukudla okuhambisana kuphela ezinsukwini ezingama-2-3 kuphela ngemuva kokuzalwa, ubungozi bokukhula ngalesi simo buzoba phezulu kakhulu. Ngemuva kokuba ingane izelwe, zixhunywe kwi-catheter, okuyilapho izithako zokuhlanganiswa zokuqala zethulwa ngemuva kwamahora ayi-6. Ngosuku lokuqala, unikezwa cishe ama-200 ml wobisi lwebele.
Uma umama engenalo ubisi, ingane inikezwa imishanguzo ekhethekile yokungena emzimbeni, umthamo wayo ungaba yi-100 ml / kg. Uma kunengozi eyandayo ye-hypoglycemia, ukugxilwa koshukela egazini kuhlolwa njalo emahoreni ambalwa.
