Koj puas muaj ib tug neeg hauv tsev neeg lossis ib tug phooj ywg uas muaj tus kab mob ntshav qab zib? Koj puas tau hnov txog qhov xwm txheej ceev uas ib tug neeg cov ntshav qab zib poob qis dhau lossis siab dhau? Lawv yuav tsis muaj peev xwm saib xyuas lawv tus kheej lub sijhawm no. Koj tuaj yeem pab cawm lawv txoj sia. Yog li, yog tias ib tug neeg koj paub muaj tus kab mob ntshav qab zib, nws yog ib qho tseem ceeb uas yuav tsum tham nrog lawv txog yam yuav ua thaum muaj xwm txheej ceev.
Kev kub ntxhov ntawm tus kab mob ntshav qab zib yog dab tsi?
Hais yooj yim xwb, qhov xwm txheej ceev ntawm tus kab mob ntshav qab zib yog thaum ib tus neeg uas muaj tus kab mob ntshav qab zib muaj cov ntshav qab zib qis lossis siab heev uas txaus ntshai. Qhov no tuaj yeem ua rau muaj cov tsos mob hnyav thiab txawm tias ua rau tuag taus. Muaj ob hom mob no tseem ceeb.
| Hom xwm txheej ceev | Kev piav qhia |
|---|---|
| Kev txo qis ntshav qab zib | Cov ntshav qab zib qis heev. Ib txhia neeg kuj hu qhov no ua "insulin shock." |
| Kev mob ntshav qab zib ntau dhau | Cov ntshav qab zib tuaj yeem nce siab heev. Qhov no tuaj yeem ua rau muaj mob hnyav xws li DKA lossis HHS. |
Kev hloov pauv loj ntawm cov piam thaj hauv cov ntshav tuaj yeem muaj kev cuam tshuam loj rau peb lub cev ua haujlwm li cas, thiab yog li ntawd yuav tsum tau kho mob tam sim ntawd.
Xwm txheej ceev tshwm sim los ntawm cov ntshav qab zib qis - "Insulin shock"
Qhov no yog ib qho mob hu ua hypoglycemia hnyav heev. Qhov no yog thaum cov ntshav qab zib poob qis heev, feem ntau qis dua 60 mg / dL. Txawm hais tias nws hu ua "insulin shock," qhov no tsis yog tsuas yog tshwm sim rau cov neeg noj insulin xwb, tab sis kuj tshwm sim rau cov neeg noj qee yam tshuaj rau ntshav qab zib (piv txwv li, sulfonylureas).
Vim li cas qhov no thiaj yog xwm txheej ceev?
Xav txog nws, peb lub hlwb xav tau glucose (qabzib) kom ua haujlwm tau. Thaum cov piam thaj poob qis dhau, peb tsis tuaj yeem xav tau meej thiab peb tuaj yeem tsaug zog. Qhov ntawd txhais tau tias peb tsis tuaj yeem kho qhov mob no ntawm peb tus kheej. Yog tias peb tsis muaj leej twg los pab, nws tuaj yeem ua rau tuag tau.
Muaj ib txhia neeg tsis paub tias lawv cov piam thaj qis. Peb hu qhov no ua "Kev Tsis Paub Txog Qhov Ntshav Qab Zib Hauv Cov Neeg Mob." Tej zaum lawv yuav tsis pom cov tsos mob thaum ntxov, thiab qhov mob no tuaj yeem loj hlob sai sai.
Vim li cas thiaj ua rau qab zib tsawg
- Tsis noj mov.
- Ua si ntau dua li niaj zaus.
- Haus cawv tsis muaj zaub mov.
- Noj tshuaj insulin ntau dhau, siv hom tshuaj tsis raug, lossis txhaj tshuaj tsis raug.
- Noj tshuaj kho mob ntshav qab zib tsis raug.
Cov tsos mob ntawm cov piam thaj qis
Cov tsos mob thaum xub thawj yuav muaj xws li tshee hnyo thiab xav tias tshaib plab. Txawm li cas los xij, yog tias tsis kho, qhov mob yuav hnyav zuj zus thiab ua rau muaj cov tsos mob hauv qab no:
- Kev tsis meej pem.
- Pom kev tsis meej.
- Tsis muaj zog heev.
- Qaug dab peg.
- Dhau mus.
- Coma.
Koj yuav pab ib tus neeg uas muaj ntshav qab zib tsawg li cas?
Yog tias ib tug neeg muaj cov tsos mob no, qhia rau lawv kom lawv kuaj xyuas lawv cov ntshav qab zib. Tom ntej no, pab lawv ua raws li "txoj cai 15/15."
1. Muab 15 grams ntawm cov carbohydrates uas zom tau sai:
- 3-4 lub tshuaj glucose.
- 120 milliliters (kwv yees li ib nrab khob) ntawm cov kua txiv hmab txiv ntoo los yog ib qho dej qab zib (dej qab zib ib txwm).
- Ib diav ntawm zib ntab los yog qab zib.
2. Tos 15 feeb: Tom qab ntawd rov xyuas koj cov ntshav qab zib dua. Yog tias nws tseem qis, muab lwm 15-gram carbohydrate ib feem.
Ceeb Toom: Yog tias ib tug neeg tsis nco qab lawm, qhov no yog xwm txheej ceev hauv kev kho mob. Tsis txhob muab zaub mov lossis dej haus rau hauv qhov ncauj - nws tuaj yeem ua rau txhaws. Yog tias ib tug neeg tau kawm tiav, muab tshuaj glucagon rau lawv. Nws ua rau cov ntshav qab zib nce siab. Nws tsis yog insulin! Tom qab ntawd hu rau 1990 tam sim ntawd thiab coj lawv mus rau Chav Kho Mob Ceev (ETU) ntawm tsev kho mob.
Cov xwm txheej ceev uas tshwm sim los ntawm cov ntshav qab zib siab
Kev nce ntxiv ntawm cov ntshav qab zib uas tsis tswj tau tuaj yeem ua rau muaj ob qho xwm txheej ceev heev.
1. Kab mob ntshav qab zib ketoacidosis (DKA)
Thaum tsis muaj insulin txaus los siv glucose (qab zib) ua lub zog, peb lub cev pib hlawv rog ua lub zog. Cov txheej txheem no tsim cov tshuaj hu ua ketones . Thaum cov ketones no sib sau ua ke hauv cov ntshav, cov ntshav yuav ua acidic thiab tuaj yeem ua rau lub cev lom. Qhov no hu ua DKA. Qhov no yog ib qho teeb meem uas feem ntau tshwm sim rau cov neeg uas muaj ntshav qab zib hom 1, tab sis nws kuj tuaj yeem tshwm sim rau cov neeg uas muaj ntshav qab zib hom 2 thiab ntshav qab zib thaum cev xeeb tub.
Vim li cas DKA thiaj yog xwm txheej ceev?
Qhov no yog ib qho mob uas txaus ntshai rau lub neej. DKA yog ib qho ua rau neeg tuag coob tshaj plaws, tshwj xeeb tshaj yog cov menyuam yaus uas muaj ntshav qab zib.
Ua rau muaj DKA:
- Teeb meem ntawm cov tshuaj insulin: tsis tau noj cov tshuaj insulin, siv cov tshuaj insulin tas sij hawm, lub twj tso kua mis insulin tsis ua haujlwm.
- Kev Mob: Qee cov kab mob thiab tej yam mob nkeeg tuaj yeem ua rau muaj DKA.
- Kev Nyuaj Siab: Kev ntxhov siab hnyav rau lub hlwb, tej yam mob xws li mob plawv nres.
- Qee cov tshuaj.
| Cov tsos mob ntawm DKA | |
|---|---|
| Cov tsos mob thaum ntxov | |
| |
| Cov tsos mob hnyav dua | |
|
Yuav pab li cas thaum muaj DKA?
Yog tias ib tug neeg muaj cov tsos mob thaum ntxov, hais kom lawv kuaj xyuas lawv cov ketone hauv cov zis nrog "cov khoom siv kuaj ketone." Yog tias cov ketone siab, lawv yuav tsum hu rau lawv tus kws kho mob tam sim ntawd. Txawm li cas los xij, yog tias lawv muaj cov tsos mob hnyav, lawv yuav tsum raug coj mus rau chav kho mob ceev (ETU) hauv tsev kho mob tam sim ntawd.
2. Mob ntshav qab zib ntau dhau hauv cov ntshav (HHS)
Qhov no tshwm sim thaum cov ntshav qab zib nce siab tshaj 600 mg/dL thiab tseem nyob rau theem ntawd rau ntau hnub lossis ntau lub lis piam. Qhov no tuaj yeem ua rau lub cev qhuav dej heev thiab muaj kev phom sij rau lub neej.
- HHS feem ntau tshwm sim rau cov neeg uas muaj ntshav qab zib hom 2.
- Nws tsis loj hlob sai zoo li DKA, nws maj mam loj hlob mus rau ob peb hnub.
- Hauv HHS, cov ketones tsis sib sau ua ke hauv cov ntshav zoo li hauv DKA.
Ua rau HHS:
- Kab mob ntshav qab zib hom 2 uas tswj tsis tau zoo.
- Cov kab mob xws li mob ntsws thiab mob txeeb zis.
- Cov mob xws li mob plawv nres thiab mob hlwb.
- Qee cov tshuaj.
Cov tsos mob ntawm HHS:
Cov tsos mob yuav muaj xws li qhov ncauj qhuav, nqhis dej ntau dhau, tso zis ntau zaus, kub taub hau, lub plawv dhia ceev ceev, tsis meej pem, hais lus tsis tau zoo, ib sab ntawm lub cev tsis muaj zog, thiab tsis nco qab.
HHS yuav pab tau li cas rau qhov xwm txheej no?
Hu rau lawv tus kws kho mob tam sim ntawd. Tom qab ntawd coj lawv mus rau chav kho mob ceev (ETU) ntawm tsev kho mob sai sai.
Mob ntshav qab zib tsis nco qab
Qhov no yog hom mob ntshav qab zib hnyav tshaj plaws. Ib qho mob uas tsis nco qab ntev ntev uas tshwm sim los ntawm cov ntshav qab zib uas siab dhau (vim yog DKA lossis HHS) lossis qis dhau (vim yog hypoglycemia hnyav) thiab tsis kho. Ib tug neeg uas tsis nco qab yuav tsis teb lus lossis kov.
Vim li cas tus mob ntshav qab zib tsis nco qab yog qhov xwm txheej ceev?
Qhov no muaj kev phom sij rau lub neej vim tias cov mob uas ua rau nws tuaj yeem ua rau muaj kev lom ntshav, ua tsis taus haujlwm ntawm lub cev, puas hlwb mus tas li, thiab txawm tias tuag taus.
Koj yuav pab ib tug neeg li cas thaum mob ntshav qab zib tsis nco qab lawm?
Yog tias ib tug neeg uas muaj tus kab mob ntshav qab zib tsis nco qab thiab tsis teb dab tsi, nws yuav yog tus mob ntshav qab zib tsis nco qab lawm.
- Hu rau 1990 lossis tus xov tooj pabcuam thaum muaj xwm txheej ceev tam sim ntawd.
- Ua raws li cov lus qhia uas tus neeg teb xov tooj muab.
- Tsis txhob muab dab tsi rau hauv koj lub qhov ncauj (kua txiv hmab txiv ntoo, dej qab zib) xav tias koj cov qab zib yuav qis. Qhov no tuaj yeem ua rau txhaws.
- Yog tus neeg ntuav, tig lawv rau ib sab kom tsis txhob txhaws.
Cov Khoom Siv Thaum Muaj Xwm Ceev Rau Cov Neeg Mob Ntshav Qab Zib
Kev npaj rau qhov xwm txheej ceev yuav cawm tau koj txoj sia lossis lub neej ntawm ib tus neeg koj hlub. Khaws cov khoom no ze ntawm tes, thiab xyuas kom txhua tus neeg hauv koj lub tsev paub lawv nyob qhov twg.
- Insulin: Yog tias koj siv insulin, nco ntsoov khaws cov khoom tshiab uas tseem tsis tau tas sij hawm.
- Tej yam yuav tsum muab thaum qab zib tsawg: kua txiv hmab txiv ntoo, dej qab zib, lossis cov ntsiav glucose.
- Cov khoom siv Glucagon: Yuav kom nce cov ntshav qab zib yog tias koj tsis nco qab. Yog tias koj tab tom saib xyuas tus neeg mob ntshav qab zib, paub siv qhov no.
- Cov khoom siv kuaj ketone: Yuav kuaj yog tias xav tias muaj DKA.
- Ib txoj hlua tes ceeb toom kev kho mob: Qhov no pab txheeb xyuas koj tias yog tus neeg mob ntshav qab zib yog tias muaj xwm txheej ceev.
- Cov ntaub ntawv tiav txog cov tshuaj uas koj noj: Muaj txawm tias cov xov tooj 'apps' rau qhov no tam sim no.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Ib tug neeg uas muaj tus kab mob ntshav qab zib muaj peev xwm muaj cov ntshav qab zib siab lossis qis uas txaus ntshai heev. Cov no hu ua cov xwm txheej ceev ntawm tus kab mob ntshav qab zib.
- Paub txog cov tsos mob ntawm cov ntshav qab zib qis (tshee, tshee hnyo) thiab ntshav qab zib siab (nqhis dej ntau dhau, ua pa tsw qab).
- Yog tias ib tug neeg tsis nco qab lawm, hu rau lub tsheb thauj neeg mob tam sim ntawd (1990). Tsis txhob muab dab tsi rau hauv lawv lub qhov ncauj.
- Yog koj muaj ntshav qab zib, nrog koj tus kws kho mob tham txog koj txoj kev npaj rau yam yuav ua thaum muaj xwm txheej ceev.
- Yog koj muaj ib tug phooj ywg lossis ib tug neeg hauv tsev neeg uas muaj tus kab mob ntshav qab zib, kev paub pab lawv yuav pab tau ib tug neeg txoj sia.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus