Matenda a shuga ndi matenda osachiritsika omwe odwala ambiri amafunika kubaya insulin m'matupi awo amoyo. Mutha kudziwa matendawa pogwiritsa ntchito zizindikiro zingapo. Komanso, chimodzi mwazizindikiro chodabwitsa kwambiri cha kuchepa mphamvu kwa kagayidwe kazinthu kakang'ono ndi matupi a ketone.
Mimbayo acetone mu shuga imapezeka ngati simunalandire. Pankhaniyi, fungo losasangalatsa limatha kuchokera mkamwa komanso ngakhale pakhungu la wodwalayo. Chizindikiro chotere chikhoza kuwonetsa kukula kwa zovuta za matenda omwe akutsogolera, chifukwa chake, chithandizo choyenera chikuyenera kuchitika mwachangu.
Glucose ndiye gwero lalikulu lamphamvu kwa anthu. Kuti azindikire ndi maselo amthupi, insulin ndiyofunikira, zomwe zimapangidwa ndi kapamba. Koma ndi matenda amtundu woyamba 1, gawo limaleka kukwaniritsa ntchito zake, ndichifukwa chake wodwala amakula hyperglycemia.
Zotsatira zake, maselo amakhala ndi njala ndipo kuchuluka kofunikira kwa michere sikulowa muubongo, ndipo wodwalayo amawonjezera kuchuluka kwa shuga m'magazi. Koma chifukwa chiyani acetone imapezeka mkodzo m'matenda a shuga?
Chimayambitsa ketonuria ndi chiyani?
Kuti mumvetse momwe mawonekedwe a acetone amkodzo mu shuga, muyenera kudziwa kuti matupi a ketone ndi lingaliro lalikulu lokhala ndi zinthu zitatu:
- propanone (acetone);
- acetoacetate (acetoacetic acid);
- B-hydroxybutyrate (beta-hydroxybutyric acid).
Komanso, izi ndi zinthu zomwe zimapangitsa kuti mapuloteni asokonekere ndi mafuta amkati. Zomwe zimayambitsa kupezeka kwawo m'magazi ndi mkodzo ndizosiyanasiyana. Awa amatha kukhala mavuto azakudya zopatsa thanzi, monga chakudya chamafuta ochepa kapena kufa ndi njala. Kuphatikiza apo, acetone mu matenda a shuga amapezeka kuti ali ndi vuto la matenda.
Zomwe zimayambitsa ketonuria:
- kutenthetsa;
- kusanza ndi kusanza, kulimbikira kwa nthawi yayitali;
- kusowa kwamadzi;
- poyizoni wa mankhwala;
- nthawi ya matenda opatsirana oyambitsidwa ndi kusowa kwamadzi.
Ngati tikulankhula za zolephera mu chakudya cha carbohydrate, ndiye kuti ma acetone mu mkodzo mu diabetes amawonekera pamaso pamikhalidwe iwiri. Yoyamba ndi hyperglycemia, yomwe imayamba ndi kuchepa kwa insulin, pomwe shuga wambiri sangatengeredwe ndi maselo aubongo. Zitachitika izi, kuwonongeka kwa mapuloteni ndi mafuta kumachitika, zomwe zimapangitsa kuti pakhale matupi a ketone, omwe chiwindi sichitha kuthana nawo, ndipo amalowa mkodzo, kuthana ndi impso.
Mlandu wachiwiri, ketonuria imachitika motsutsana ndi maziko a hypoglycemia, omwe amawoneka ngati pali kusowa kwa glucose pakhungu kapena vuto la insulin.
Zifukwazi zimagonekanso mu kuperewera kwa mahomoni omwe amasintha shuga kukhala mphamvu, motero thupi limayamba kugwiritsa ntchito zinthu zina.
Zizindikiro
Monga lamulo, mawonetseredwe a ketoacidosis amakula masiku angapo. Potere, mkhalidwe wodwalayo umakulirakulira, ndipo chithunzi chachipatala chimayamba kutchulidwa:
- kutopa;
- mutu
- mpweya wa acetone;
- kuyanika khungu;
- ludzu
- zolakwika za mtima (arrhythmia, palpitations);
- kuchepa thupi;
- kulephera kudziwa;
- kusokonezeka kwa kukumbukira;
- kusokonezeka ndende.
Kuphatikiza apo, zovuta za dyspeptic zimadziwika. Komanso, poyambira chitukuko cha ketoacidosis, mkodzo wambiri umabisidwa, ndipo kumapeto kwake, kukodza, m'malo mwake, kulibe.
Ndizachilendo kuti ketonuria imadziwika nthawi yayitali. Mwachitsanzo, izi zimachitika ndi matenda osokoneza bongo a gestational shuga, pomwe chakudya chamafuta cha mayi chimachepa. Nthawi zambiri mkhalidwewu umakhala patsogolo pa chitukuko cha matenda ashuga pambuyo pobereka.
Zizindikiro za kukhalapo kwa acetone mu madzi amthupi amtundu 1 komanso matenda amtundu wa 2 zimadalira kuuma kwa metabolic acidosis. Ndi mawonekedwe ofatsa, chidwi cha wodwalayo chimazimiririka, kupweteka kumawonekera m'mutu ndi m'mimba. Amazunzidwanso ndi ludzu, nseru komanso chizungulire. Mwanjira imeneyi, fungo lokomoka la acetone kuchokera mkamwa limamveka, ndipo wodwalayo amapita kuchimbudzi kukakodza.
Akuluakulu digiri ya ketoacidosis amawonetsedwa ndi hypotension, m'mimba kupweteka, m'mimba komanso kugunda kwamtima kolimba. Chifukwa chododometsa pakugwira ntchito kwa NS, kayendedwe ka magalimoto amayenda pang'onopang'ono, ophunzirawo sachitapo kanthu pakuwala, ndipo mapangidwe a mkodzo amachepa.
Gawo lowopsalo limatsatiridwa ndi kupuma kwamphamvu kwa acetone, kukomoka, komanso kupumira pansi koma osapumira. Zikatero, ophunzirawo amasiya kuyankha mopepuka, ndipo minyewa imayamba kuchepa. Kutupa kumachepetsedwa kapena kulibe kwathunthu.
Digiri yachitatu ya ketoacidosis imatsogolera ku chakuti zidziwitso za glucose zimakwezeka kuposa 20 mmol / l, ndipo chiwindi cha wodwalayo chimakulanso kukula. Komabe, zimagwira ntchito pakhungu ndi khungu limapukuta ndi kupindika.
Ngati simupereka chithandizo mwachangu cha mtundu wachiwiri wa matenda a shuga ndi mtundu wa matenda omwe amadalira insulin, matendawa amatha kuoneka kuti ali ndi njira zingapo:
- Mtima - ukuwonetsedwa ndi kupweteka mumtima ndi kuthamanga kwa magazi.
- Mimba - imakhala ndi zizindikiro zoopsa zogwirizana ndi kugaya kwam'mimba.
- Encephalopathic - imakhudza kufalikira kwa ubongo, komwe kumayendetsedwa ndi chizungulire, mseru, kupweteka kwa mutu komanso kuwonongeka kwa mawonekedwe.
- Chophimba - kumayambiriro kwake kumachitika mkodzo wambiri, koma pambuyo pake kuchuluka kwake kumachepa.
Chifukwa chake, acetone mu shuga sichowopsa thupi la wodwalayo, koma chikuwonetsa kuchepa kwa insulin kapena hyperglycemia. Chifukwa chake, mkhalidwewu suwonedwa ngati wamba, koma sikuti ndikupatuka kwakukulu. Popewa kukula kwa ketoacidosis, ndikofunikira kuyang'anitsitsa glycemia ndikuwunikidwa ndi endocrinologist.
Kupanda kutero, kuchepa mphamvu kumabweretsa kufa kwa mitsempha muubongo ndi zotsatira zosasintha.
Ndipo vutoli lidzafunika kuchipatala mwachangu, komwe madokotala amasintha kuchuluka kwa pH.
Ndi mayeso ati oti atengere acetone?
Pali mitundu ingapo ya maphunziro yomwe imazindikira ma ketoni omwe angachitike kunyumba kapena labu. Chipatalachi chimawunika magazi ndi mkodzo kwathunthu. Ndipo kunyumba, zingwe zoyesera zimagwiritsidwa ntchito, zomwe zimatsitsidwa mkodzo, pambuyo pake zimasintha mtundu mothandizidwa ndi acetone.
Kuphatikizika kwa zinthu za ketone kumatsimikiziridwa ndi kuchuluka kwa ma pluses. Ngati pali chizindikiro chimodzi chokha, ndiye kuti zomwe zili za propanone sizoposa 1.5 mmol / l, zomwe zimawoneka ngati mawonekedwe ofewa a ketonuria. Kuphatikiza kwachiwiri kumawonjezeredwa, kuchuluka kwa acetone kumafika ku 4 mmol / L, komwe kumakhala ndi mpweya wabwino. Pankhaniyi, kufunsira kwa endocrinologist kuli kofunikira kale.
Ngati ma pluses atatu adawonekera pambuyo poyesa, ndiye kuti mulingo wa acetone ndi 10 mmol / L. Izi zimafunikira kuchipatala wodwala mwachangu.
Ubwino wa mikwingwirima yoyeserera ndi mtengo wawo wotsika komanso wokwera mtengo.
Komabe, odwala matenda ashuga ayenera kudziwa kuti kudzipereka kwamawonekedwe amkodzo a ketone sikuwonedwe ngati njira ina yoyeserera yoyeserera.
Momwe mungasinthire kuchuluka kwa zinthu zam'm ketoni mu mkodzo?
Kupezeka kwa matupi a ketone m'madzi amthupi kungasonyeze mtundu woyamba wa matenda ashuga. Potere, chithandizo chokwanira cha insulin chithandiza kuchotsa acetone. Kupatula apo, jakisoni wokhazikika wa mahomoni mulingo woyenera amadzaza maselo ndi chakudya, chomwe chimakupatsani mwayi kuti muchepetse acetone pang'onopang'ono.
Tsoka ilo, matenda a shuga omwe amadalira insulin amafunikira insulin. Koma kukula kwake kumatha kupewa ngati munthu alibe chibadwa chobadwa nacho. Chifukwa chake, mankhwalawa a ketononuria amateteza kupewa, kutanthauza kutsatira malamulo angapo:
- kuchita zolimbitsa thupi mokhazikika koma zolimbitsa thupi;
- kukana zosokoneza bongo;
- zakudya zoyenera;
- Nthawi yodutsa mayeso athunthu a kuchipatala.
Koma momwe mungachotsere acetone mothandizidwa ndimankhwala ndi njira zina zochizira? Chifukwa chaichi, mankhwala monga Methionine, Cocarboxylase, Splenin, Essentiale amatha kukhazikitsidwa.
Ndi matenda a shuga omwe amadalira insulin, kuperekanso madzi m'thupi, kukonzanso ulesi wa asidi, kuwongolera glycemic komanso antibacterial chithandizo kumathandizira kuchotsa acetone. Njira izi zimathandizira kubwezeretsa kagayidwe kazakudya, amachepetsa ndende, ndikuchotsa ma ketones m'magazi.
Ngati matenda ashuga a ketoacidosis atakula, ndiye kuti chithandizo chamankhwala chimalimbikitsa mavuto awiri. Choyamba ndi kuyambiranso kwa plasma osmolality, electrolyte ndi intravascular metabolism. Mfundo yachiwiri ya chithandizo ndikusintha muyezo wa insulin ndi choletsa chinsinsi cha mahomoni okhazikika, kuonjezera kugwiritsidwa ntchito ndikupanga shuga ndi ketogene.
Chifukwa cha kuchepa kwakukulu kwa madzi amkati komanso ma intracellular, pamafunika kulowetsedwa. Choyamba, wodwalayo amapaka jekeseni ndi 1-2 l ya isotonic mchere solution mkati mwa ola limodzi. Lita yachiwiri ya ndalama ndiyofunikira ngati pali Hypovolemia.
Ngati njirazi sizinali kugwira ntchito, ndiye kuti wodwalayo amapaka jekeseni ndi njira yocheperako yamchere. Izi zimakuthandizani kukonza Hypovolemia ndi kusintha hyperosmolarity. Njirayi imapitilira mpaka voliyumu ya intravascular itabwezeretseka kwathunthu kapena kuwerenga kwa glucose kutsikira 250 mg.
Kenako njira yothetsera shuga (5%) imayambitsidwa, yomwe imachepetsa chiopsezo chokhala ndi vuto la ubongo komanso insulin hypoglycemia. Pamodzi ndi izi, jakisoni wochepa wa insulin amayambitsidwa, kenaka amasamutsidwa ku kulowetsedwa kwake kosalekeza. Ngati palibe kuthekera kwa intravenous makonzedwe a mahomoni, ndiye kuti mankhwalawa amaperekedwa kudzera mu intramuscularly.
Anthu odwala matenda ashuga ayenera kukumbukira kuti izi ndizofunikira. Kupatula apo, osachotsedwa acetone kumatha kubweretsa kukulira kwa matenda ashuga, omwe nthawi zambiri amatha ndi edema yam'mimba ndikumwalira pambuyo pake.
Momwe mungachotsere acetone kuchokera mthupi ndi chakudya? Choyamba, wodwalayo ayenera kusiya zinthu zingapo zomwe zimapangitsa kuti ma ketoni apangidwe:
- nsomba, bowa, sopo msuzi;
- kusuta nyama;
- nsomba zazinkhanira ndi nsomba za mumtsinje (kupatula pike ndi pike perch);
- zipatso wowawasa ndi zipatso;
- marinade ndi ma pickles;
- misuzi;
- offal;
- zakudya zilizonse zamafuta, kuphatikiza tchizi;
- mitundu ina ya masamba (rhubarb, tomato, sipinachi, tsabola, sorelo, biringanya);
- buns ndi zofowoka zosiyanasiyana;
- zakumwa zoziziritsa kukhofi ndi koloko, makamaka zotsekemera.
Muyeneranso kuchepetsa kumwa kwa nsomba zam'madzi, nyemba, nyama zamzitini, pasitala, kirimu wowawasa ndi nthochi. Choyambirira ndicho mitundu ya nyama ndi nsomba zochepa, zomwe zimatha kuwotchera kapena kuwotcha.
Ponena za msuzi, zokonda ziyenera kuperekedwa kwa broths zamasamba. Ndimalolanso kugwiritsidwa ntchito monga chimanga, ndiwo zamasamba, ma compotes zipatso ndi timadziti.
Zoyenera kuchita mukazindikira acetone mu mkodzo uuza katswiri muvidiyoyi.
