Ke kō kō haʻahaʻa - nā keiki hānau hou

ʻO ke kiʻekiʻe o ke kō kō i loko o nā pēpē hou i kapa ʻia hoʻi ʻo hypoglycemia neonatal. Pili ia i ke kō kō (glucose) haʻahaʻa i nā lā mua ma hope o ka hānau ʻana.

Pono nā pēpē i ke kō kō (glucose) no ka ikehu. Hoʻohana ʻia ka hapa nui o kēlā glucose e ka lolo.

Loaʻa i ka pēpē ka glucose mai ka makuahine ma o ka placenta ma mua o ka hānau ʻana. Ma hope o ka hānau ʻana, loaʻa ka pēpē i ka glucose mai ka makuahine ma o kāna waiū, a mai ka haʻilula. Hiki i ka pēpē ke hana i kekahi glucose i ke ake.

Hiki ke hāʻule ka pae Glucose inā:

• Nui loa ka insulin i loko o ke koko. ʻO ka insulin ka hone e huki i ke kō mai ke koko.
• ʻAʻole hiki i ka pēpē ke hana i ka nui o ka glucose.
• Ke hoʻohana nei ke kino o ka pēpē i ka glucose ma mua o ka hana.
• ʻAʻole hiki i ka pēpē ke lawe i lawa ka glucose ma ka hānai ʻana.

Hana ʻia ka neonatal hypoglycemia ke kū nei ka pae glucose o kahi keiki hānau hou i nā ʻōuli a i ʻole ma lalo o ka pae i manaʻo ʻia he palekana no ka makahiki o ka pēpē. Hana ʻia ma kahi o 1 a 3 mai kēlā me kēia 1000 hānau.

ʻOi aku ka nui o ka pae kō kō i lalo i nā pēpē me hoʻokahi a ʻoi paha o kēia mau kumu pilikia.

• Hānau hānau ʻia, loaʻa ka maʻi ʻino, a i ʻole pono ka oxygen ma hope pono o ka hānau ʻana
• He maʻi diabetes koʻu makuahine (ʻoi aku ka nui o kēia mau pēpē ma mua o ka maʻamau)
• ʻO ka lohi o ka ulu ʻana o ka ʻōpū i ka wā hāpai
• Liʻiliʻi a ʻoi aku paha ka nui ma mua o ka mea i manaʻo ʻia no ko lākou wā hānau

ʻAʻole loaʻa nā ʻōuli i nā pēpē me ke kō kō kō. Inā loaʻa i kāu pēpē kekahi o nā mea pilikia no ke kō kō, e nānā pono nā kahu maʻi i ka haukapila i ke kiʻekiʻe o ke kō o kāu pēpē, ʻoiai inā ʻaʻohe ʻōuli.

Eia kekahi, nānā pinepine ʻia ka pae kō kō no nā pēpē me kēia mau ʻōuli.

• ʻIli ʻulaʻula a ʻulaʻula paha
• Nā pilikia hanu, e like me ka hoʻomaha ʻana i ka hanu ʻana (apnea), ka hanu wikiwiki ʻana, a i ʻole ke kani ʻana o ke kaniʻuhū
• Huhū a papa inoa ʻole paha
• Loose a palupalu nā mākala
• Hānai hānai a luaʻi paha
• Nā pilikia e mahana ai ke kino
• Nā haʻalulu, ka haʻalulu, ka hou, a me ka hopu ʻana

ʻO nā keiki hānau hou i ka makaʻu no ka hypoglycemia pono e hōʻoia i ke koko e ana i ke kiʻekiʻe o ke kō i ke kō ma hope o ka hānau ʻana. E hana ʻia kēia me ka lāʻau kuʻekuʻe wāwae. Pono ka mea mālama ola e hoʻomau i ka lawe ʻana i nā hoʻokolohua koko a hiki i ka pae o ka glucose glucose o ka pēpē e noho maʻamau ma kahi o 12 a 24 mau hola.

ʻO nā hoʻokolohua kūpono ʻē aʻe e pili ana i ka loiloi hou o nā keiki no nā maʻi metabolic, e like me nā hoʻokolohua koko a me ka mimi.

ʻO nā pēpē me kahi pae kō kō e hoʻohaʻahaʻa e pono ke loaʻa i nā meaʻai keu me ka waiū o ka makuahine a i ʻole nā ​​kumuhana. Pono paha nā pēpē e hānai ʻia i ka umauma e loaʻa i nā kaho keu inā ʻaʻole hiki i ka makuahine ke hana i ka waiū lawa. (Hiki i ka haʻi lima a me ka lomilomi ke kōkua i nā makuahine e hōʻike hou aku i ka waiū.) I kekahi manawa hāʻawi ʻia kahi kō kō e ka waha no ka manawa ke lawa ʻole ka waiū.

Pono paha i ka pēpē kahi hopena kō i hāʻawi ʻia ma o ka aa (intravenously) inā ʻaʻole hiki ke ʻai ma ka waha, a inā haʻahaʻa haʻahaʻa ke kō kō.

E hoʻomau ʻia ka mālama ʻana a hiki i ka pēpē ke mālama i ka pae kō kō. He mau hola a mau lā paha kēia. ʻO nā pēpē i hānau mua ʻia, loaʻa ka maʻi, a i hānau ʻia paha i kahi haʻahaʻa haʻahaʻa e pono ke mālama ʻia no kahi manawa lōʻihi.

Inā hoʻomau ke kō kō haʻahaʻa, i nā hanana kakaikahi, loaʻa paha i ka pēpē ka lāʻau e hoʻonui ai i ke kiʻekiʻe o ke kō. I nā hihia kakaʻikahi loa, ʻo nā keiki hānau hou me ka hypoglycemia koʻikoʻi loa i hoʻomaikaʻi ʻole me ka lapaʻau e pono ai i kahi ʻoki e wehe i kahi hapa o ka pancreas (e hoʻemi i ka hana o ka insulin).

Maikaʻi ka kuanaʻike no nā keiki hānau hou i loaʻa ʻole nā ​​ʻōuli, a i ʻole e pane maikaʻi i ka lāʻau. Eia nō naʻe, hiki i ka pae kō kō haʻahaʻa e hoʻi i kahi helu liʻiliʻi o nā pēpē ma hope o ka mālama ʻana.

E hoʻi paha ke ʻano ke lawe ʻia nā pēpē i nā wai i hāʻawi ʻia ma o ke aa ma mua o ka mākaukau loa e ʻai ma ka waha.

ʻO nā pēpē me nā ʻōuli ʻoi aku ka nui e hoʻomohala i nā pilikia aʻo. ʻOi aku ka ʻoiaʻiʻo o kēia no nā pēpē i emi ke kaumaha ma mua o ka awelika a i ʻole he maʻi diabetes ko ka makuahine.

ʻO ke kiʻekiʻe o ke kō a me ke kūmau o ke kō e hoʻoliʻiliʻi paha i ka hana noʻonoʻo o ka pēpē. I nā hihia maʻamau, hiki i ka ʻole o ka puʻuwai a i ʻole ka hopu ʻana. Eia nō naʻe, pili kēia mau pilikia i ke kumu kumu o ke kō kō kō, ma mua o ka hopena o ke kō kō kō haʻahaʻa.

Inā loaʻa ʻoe i ka maʻi kō i ka wā hāpai, e hana pū me kāu mea lawelawe e kaohi i kāu pae kō kō. E nānā pono i ka nānā ʻana i ke kiʻekiʻe o ke kō o kāu keiki hānau hou ma hope o ka hānau ʻana.

ʻO hypoglycemia neonatal

ʻO Davis SN, Lamos EM, Younk LM. Hypoglycemia a me hypoglycemic syndrome. I: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Makua a Pediatric. ʻEpekema 7 Piladelapia, PA: Elsevier Saunders; 2016: chap 47.

ʻO Garg M, Devaskar SU. Nā maʻi o ka pūnao carbohydrate i ka neonate. I: Martin RM, Fanaroff AA, Walsh MC, hua. ʻO Fanaroff lāua ʻo Martin's Neonatal-Perinatal Medicine. 11th hua. Piladelapia, PA: Elsevier Saunders; 2020: chap 86.

ʻO Sperling MA. Hypoglycemia. I: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. ʻO Puka Textbook of Pediatrics ʻo Nelson. 21st ed. Piladelapia, PA: Elsevier; 2020: chap 111.