[ppt模板]低血糖-在線瀏覽
2025-05-09 00:19本頁(yè)面
【正文】 surgery, or in the presence of metastatic or residual disease. Diazoxide has been used for over 30 years and counteracts hypoglycemia by effects on potassium channels of b cells, with resultant inhibition of calcium influx ? It also inhibits peripheral glucose uptake and increases glucose production . ? A national UK survey found that treatment was effective with no debilitating side effects despite continuous treatment for over 10 years. The most mon side effects include fluid retention, which can be bated by the conitant use of thiazide, and hirsutism. 2022521 27 藥物治療 2 ? A newer candidate is octreotide, a somatostatin analogue, which suppresses the release of neuroendocrine peptides when given subcutaneously one to three times daily 。1 低血糖癥 蔡曉頻 2022521 2 Whipple三聯(lián)癥 ? 1938年提出 ? 低的血糖數(shù)值 ? 低血糖癥狀 自主神經(jīng)興奮（饑餓，心悸，出汗，惡心，震顫，焦慮） 中樞神經(jīng)系統(tǒng)功能受損（乏力，抽搐，昏迷） ? 糾正血糖后癥狀緩解 2022521 3 最常見原因 ? 糖尿病相關(guān) DCCT： 1型糖尿病患者 10~30%經(jīng)歷 1次嚴(yán)重低血糖 UKPDS：胰島素治療的 2型糖尿病患者% 發(fā)生嚴(yán)重低血糖 1型與 2型相似 2022521 4 糖穩(wěn)態(tài)的調(diào)節(jié) ? 胰島素 ? 胰高糖素 ? 腎上腺素 ? 生長(zhǎng)激素 ? 皮質(zhì)醇 ? 調(diào)節(jié)受損（藥物，糖尿病，肝衰竭，腎衰竭） 2022521 5 低血糖分類 ? 空腹低血糖 ? 反應(yīng)性低血糖（餐后低血糖） 2022521 6 空腹低血糖病因 ? 藥源性 高劑量水楊酸， β 阻滯劑，磺胺藥，奎寧，奎尼丁，喹諾酮類 ? 器官衰竭（肝，腎，內(nèi)分泌?。? ? 腫瘤（非胰島細(xì)胞腫瘤，胰島細(xì)胞瘤，胰島細(xì)胞增生） ? 自身免疫（ IAA,IRA） 2022521 7 反應(yīng)性低血糖 ? 傾倒綜合癥（核素胃排空試驗(yàn)） ? 糖尿病前期 ? 胰島細(xì)胞增生 2022521 8 胰島細(xì)胞瘤 ? Approximately 90% of insulinomas are single and benign。 ? 10 to 15%, usually multiple adenomas, are associated with multiple endocrine neoplasia 2022521 9 胰島細(xì)胞瘤 ? When the clinical suspicion is present, diagnosis depends on the demonstration of hyperinsulinemic hypoglycemia. 2022521 10 胰島細(xì)胞瘤定性診斷 ? If spontaneous hypoglycemia is not encountered, supervised prolonged fasting may be required . ? In the presence of an insulinoma, the semiautonomous basal insulin secretion inhibits hepatic glucose efflux, leading to fasting hypoglycemia. ? The finding of hypoglycemi
教學(xué)課件相關(guān)推薦
鄂ICP備17016276號(hào)-1