I-Hypoglycemia izinga le-serum glucose elingaphansi kwama-40 mg / dl (ngaphansi kuka-2.2 mmol / l) ezinganeni ezinempilo nezinesikhathi esigcwele noma ezingaphansi kwama-30 mg / dl (ngaphansi kuka-1.7 mmol / l) ezinganeni ezisencane.
Izici zobungozi zibandakanya ukuvikela imvelo kanye nokubizwa ngokuthi yi-intrapartum asphyxiation.
Izimbangela eziphambili zesimo esiyingozi njenge-hypoglycemia enganeni kuze kube unyaka, ziyimbangela - izitolo ezincane ze-glycogen ne-hyperinsulinemia. Izimpawu zalokhu kugula yilezi tachycardia, cyanosis, cramps kanye nokuboshwa ngokuzumayo kwephupho ephusheni.
Lokhu kutholwa kuqinisekiswa ngokuthola ukunqwabelana kwe-glucose egazini. I-prognosis incike kumbangela, kepha ukwelashwa kungukudla okufanele kanye nemijovo yeglucose ye-intravenous. Ngakho-ke yini i-hypoglycemia ezinganeni ezisanda kuzalwa?
Izimbangela zokwenzeka
Njengoba wazi, kunezinhlobo ezimbili eziphambili zalesi simo se-pathological: zesikhashana futhi ezihlala njalo.
Izizathu zalokhu kufaka phakathi ukuntuleka kwe-substrate noma ukuqina kokusebenza kwe-enzyme, okungavusa ukungabikho kwesamba esanele se-glycogen emzimbeni.
Kepha izici ezingathinta ukubonakala kohlobo lwesibili lokugula yi-hyperinsulinism, ukwephulwa kwama-hormone aphikisayo nezifo ze-metabolic, ezitholakala njengefa.
Amasheya amancane we-glycogen ngesikhathi sokuzalwa avame kakhulu ezinganeni ezizalwe ngaphambi kwesikhathi. Imvamisa inesisindo esincane somzimba lapho zizalwa. Futhi, lokhu kugula kutholakala ezinganeni ezincane ngokuya maqondana nobudala bokukhulelwa ngenxa yalokhu okubizwa ngokuthi yi-placental insuffence.
Imvamisa, i-hypoglycemia iyaphawuleka ezinsaneni ezithole i-intrapartum asphyxia.
Le okuthiwa yi-anaerobic glycolysis inyakazisa izitolo ze-glycogen ezikhona emzimbeni walezi zingane ezisanda kuzalwa.
Njengomthetho, lesi simo esiyingozi singavela ezinsukwini ezimbalwa zokuqala, ikakhulukazi uma isikhathi eside impela sagcinwa phakathi kokuphakelayo. Ukuze uvimbele ukwehla kushukela wegazi, kubaluleke kakhulu ukugcina ukuhamba kweglucose engaphandle.
Bambalwa abantu abakwaziyo, kepha i-hyperinsulinism yesikhashana itholakala kakhulu ezinganeni kusuka kumama onenkinga ekhona yohlelo lwe-endocrine. Uyakwazi futhi ukuvela phambi kwengcindezi yomzimba ezinganeni.
Izimbangela ezingaphansi ezijwayelekile zifaka i-hyperinsulinism, i-erythroblastosis enzima, ne-Beckwith-Wiedemann syndrome.I-Hyperinsulinemia iboniswa ukwehla okusheshayo kokuhlushwa kwe-glucose ku-serum emahoreni ambalwa okuqala ngemuva kokuzalwa kwengane, lapho ukudla okujwayelekile kwe-glucose ngokusebenzisa i-placenta kumisa kakhulu.
Ukwehla ushukela wegazi kungenzeka uma ungayeka ngokuzumayo ukufaka umjovo solution yeglucose.
Izimpawu zesifo
Kubalulekile ukunaka zonke izinguquko ezenzeka emzimbeni wengane, ngoba i-hypoglycemia inemiphumela emibi ezinganeni ezisanda kuzalwa, uma isiqalile.
Njengomthetho, okokuqala udinga ukubheka izimpawu zesifo. Iningi lezingane alinakho ukubonakaliswa kwalesi sifo. Uhlobo lwesifo eside noma olubucayi lwesifo lubangela zombili izimpawu ezizimele nezemizwa yomvelaphi ophakathi nendawo.
Isigaba sokuqala sezimpawu sifaka ukukhuphuka kokujuluka, ukushaya kwenhliziyo, ubuthakathaka obujwayelekile bomzimba, ukubanda, kanye nokuthuthumela. Kepha kwesibili - ukweqiwa, ukukhohlisa, izikhathi ze-cyanosis, ukuboshwa kokuphefumula ephusheni, i-bradycardia, ukucindezelwa kokuphefumula kanye ne-hypothermia.
Kungahle kube nokubulawa ngamandla, ukulahleka kwesifiso sokudla, ukwehlisa umfutho wegazi kanye ne-tachypnea. Zonke lezi zinto ezibonakalayo zitholakala ezinganeni ezisanda kuzalwa futhi zithole ulwazi ngo-asphyxiation. Kungakho zonke izingane ezinezimpawu ezingenhla zidinga ukulawulwa kweglucose okuphoqelekile. Izinga elehliswe kakhulu liqinisekiswa ngokuzimisela kwe-glucose egazini le-venous.
I-hypoglycemia yesikhashana yosanda kuzalwa
Njengoba wazi, ngalesi sifo kunokwehla okusheshayo koshukela wegazi. Lokhu kungenzeka ngenxa yezizathu ezahlukahlukene.
Ukugula kubantu abadala kungakhula ngokuzila isikhathi eside, kulandela ukudla okuqinile futhi udle nemithi ethile.
Cishe amaphesenti ayisishiyagalombili awo wonke amacala, lokhu kutholwa kwenziwa ezinganeni omama bazo abahlushwa i-carbohydrate metabolism. Kepha ngamaphesenti amabili wamacala ezinganeni ezisengozini, kutholakala uhlobo oluyingozi lwalesi sifo.
Izigaba ezilandelayo zezinsana ezisanda kuzalwa zisengozini ye-hypoglycemia:
- izingane ezinokungondleki kahle kwe-intrauterine;
- izinsana ngaphambi kwesikhathi ezinesisindo somzimba ophansi;
- izingane ezinomama abalimele i-carbohydrate metabolism;
- izingane ezizalwe zine-asphyxia;
- izingane eziye zampompela igazi.
Izizathu zokunciphisa ushukela wegazi azisungulwa ngokuphelele. Okubaluleke kakhulu ukuncishiswa kwenani le-glycogen, elenziwa endaweni esibindini. Bambalwa abantu abazi ukuthi ukwakheka kwalezi zitoko kwenzeka cishe emavikini edlule okukhulelwa. Ngalesi sizathu, izingane ezizalwe ngaphambi kosuku olubekiwe ziwela eqenjini elibizwa ngengozi.
Nge-hypoglycemia yezinsana ezisanda kuzalwa, kunokungalingani okuthile phakathi kwesisindo somzimba wengane, umsebenzi wesibindi okhiqiza i-glycogen, kanye nokusebenza kwengqondo, okudingeka kakhulu i-glucose. Ngokukhula kwe-hypoxia yezinsana nengane, lesi simo sanda ngokwengeziwe.
Njengoba wazi, ngesikhathi sokukhula kwe-intrauterine, i-glucose ayakhi, ngenxa yalokho, lo mbungu uwuthola emzimbeni kamama.
Odokotela abaningi bathi i-glucose ihanjiswa ku-fetus ngesilinganiso esingama-5-6 mg / kg ngomzuzu. Ngenxa yalokho, kufinyelela cishe ku-80% wazo zonke izidingo zamandla emboziwe, futhi uthola okunye kusuka kwamanye amakhompiyutha awusizo.
Bambalwa abantu abazi ukuthi i-insulin, i-glucagon, ne-hormone yokukhula ayidluleli kwi-placenta yomama. Ochwepheshe baqinisekisile ukuthi ukwehlisa ukugcwala koshukela kowesifazane osesikhundleni kumandisa kuphela esibelethweni, okuvuselela ukukhiqizwa kwe-pancreatic hormone. Ngaphezu kwalokho, lo mkhuba awunawo nomthelela omubi kusebenze kwe-glucagon nokukhiqizwa kwama-hormone okukhula.
I-Trogent hypoglycemia yisimo esikhula ngenxa yokuba khona kwezitolo ezincane ze-glucose emzimbeni. Njengomthetho, lokhu akuhlali isikhathi eside, ngoba ngenxa yezinqubo zokuzithiba kokuqoqwa kwe-glucose kwiplasma yegazi, ezempilo zisheshe zizinze.
Ungakhohlwa ukuthi kunezici ezimbalwa ezingathinta ukuhlolwa kwegazi kwezintsha:
- indlela yokuzimisela esetshenzisiwe;
- indawo lapho igazi lithathwa khona ukuze kwenziwe ucwaningo;
- ukuba khona kokunye ukugula kwe-pathological okwenzeka njengamanje emzimbeni.
I-Trogent hypoglycemia, evela ngezimpawu eziphinyisiwe, ifaka ukwethulwa kwekhambi le-glucose leshumi.
Ukuhlolwa okwengeziwe koshukela wegazi kufanele kwenziwe njalo. Kwesinye isikhathi kwenzeka ukuthi kunzima kakhulu ukunqika ngokuthembekile izinga le-glucose esegazini. Ezimweni ezinjalo, kuyadingeka ukusebenzisa ukuphatha kwayo okuphathelene nokuqothula ngokuphelele izimpawu eziphambili zokwephulwa komthetho.
Ukwelashwa
Kubalulekile ukuqaphela ukuthi ngaphambi kokuqala ukwelashwa, ukuxilongwa okugcwele kwalesi sifo kufanele kwenziwe.
Ezinganeni ezingakafiki unyaka owodwa, thatha lezi zivivinyo ezilandelayo ukusiza ukuqinisekisa ukutholakala kwale nkinga:
- okuqukethwe ushukela we-plasma;
- inkomba yamafutha acid yamahhala;
- ukutholwa kwamazinga e-insulin;
- ukuzimisela kokuhlushwa kwe-hormone yokukhula;
- inani lemizimba ye-ketone.
Ngokuqondene nokwelashwa, indawo esemqoka lapha kufanele inikezwe ukugcinwa kwemigomo yokuthuthukiswa kwengqondo.
Kufanele uqale ukuncelisa ibele ngokushesha, ukuvimbela ngokuphelele ukukhula kwe-hypoxia, futhi uvikele i-hypothermia.
Nge-neonatal hypoglycemia, kubaluleke kakhulu ukuphatha isisombululo sikashukela esingamaphesenti amahlanu ngaphakathi. Uma ingane ingaphezu kosuku, ungasebenzisa isisombululo samaphesenti ayishumi. Kungemva kwalokhu kuphela lapho kufanele kwenziwe zonke izivivinyo ezidingekayo nezivivinyo ukuze kulawulwe ushukela. Ngokuqondene nokuhlolwa kwegazi, kufanele kuthathwe esithendeni sengane.
Ividiyo ehambisanayo
Kule khathuni, uzothola impendulo yombuzo wokuthi iyini i-hypoglycemia nokuthi yini okufanele uyenze uma kwenzeka:
Izinsana, ngemuva kokuzalwa, azikwazi ukuzivikela futhi zisengozini enkulu yezici ezingezinhle zemvelo. Ngakho-ke, kudingeka avikeleke kuzo zonke izinkinga futhi aqaphe isimo sezempilo ezinyangeni zokuqala zempilo.
Ukuhlola njalo, izivivinyo ezifanele kanye nokuvakashela ku-dokotela isiqinisekiso sokulawula umzimba noshukela wegazi. Uma kutholakala izimpawu ze-hypoglycemia ezinganeni ezisanda kuzalwa, kufanele kuthathwe izinyathelo ezifanele ukwandisa amazinga kashukela egazini.
