Acetonemic syndrome mwa ana ndi akulu

Ndikusowa kwa shuga wamagazi, thupi limapangidwanso kuti lipange mphamvu kuchokera kwina, pomwe acetonemic syndrome imayamba. Vutoli limatengedwa kuti ndi la pathological, chifukwa limayendera limodzi ndi kutulutsidwa kwa matupi a ketone - acetone ndi ma keto acids, omwe mwa kuchuluka kwakukulu amachititsa kuledzera kwa thupi. Nthawi zambiri, matendawa amapezeka mwa ana, achikulire otopa komanso kunenepa kwambiri, odwala matenda a shuga komanso matenda ena amtundu wa endocrine. Kuwonjezeka kwa ndende ya acetone kumayendera limodzi ndi kufooka, kusanza, ndi madzi. Matendawa ndi oopsa kwambiri kwa ana aang'ono ndi anthu omwe ali ndi vuto la insulin.

Pathogenesis

Njira yosavuta yothandizira kuti thupi likwaniritse zofunika zake zamagetsi ndikuphwanya shuga. Pochepa, nthawi zonse timakhala m'magazi athu; gwero lake lalikulu ndi chakudya chonse. Mukatha kudya, kuchuluka kwa shuga m'magazi kumakwera mwachangu, kenako kumafalikira mwachangu ndi magazi ake kumaselo onse amthupi.

Ngati munthu sakudya nthawi, kusowa kwa glucose kumakutidwa ndi glycogen. Ndi polysaccharide yomwe imasungidwa mu chiwindi ndi minofu. Minofu minofu imatha kusunga mpaka 400 g wa glycogen. Mkuluyu amadyedwa pokhapokha, pamalo, osaloledwa kulowa m'magazi. Pali glycogen ochepera m'chiwindi - pafupifupi 100 g mwa achikulire ndi 50 g mwa ana a zaka zoyambira kusukulu. Imaponyedwa m'magazi ndikufalikira mthupi lonse. Nthawi yovomerezeka, glycogen imeneyi imakwanira pafupifupi tsiku limodzi, ndikuchita masewera olimbitsa thupi amatha osakwana ola limodzi. Mwa ana, glycogen imadyedwa mwachangu, popeza moyo wawo umakhala wolimbikira kuposa akuluakulu, ndipo nkhokwe za polysaccharide ndizochepa.

Matenda a shuga ndi kupsinjika kudzakhala chinthu chakale

• Matenda a shuga -95%
• Kuthetsa kwa mitsempha thrombosis - 70%
• Kuthetsa kwa kugunda kwamtima kwamphamvu -90%
• Kuthana ndi kuthamanga kwa magazi - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku -97%

Ngati nkhokwe ya glycogen yatha, ndipo shuga sanalandire m'magazi, thupi limaphatikizanso makina ena - lipolysis. Umu ndi momwe amagawa mafuta kukhala ma acid acid kenako nkukhala mu coenzyme A. Potsatira zomwe zimachitika, mphamvu zomwe zimafunikira m'thupi zimamasulidwa, matupi a cholesterol ndi ketone amapangidwa. Pazinthu zochepa, ma ketoni amakhala otetezeka, amatha kupezeka mu mkodzo ndi magazi, popanda kuvulaza. Mafuta akayamba kuthothoka, pamakhala mavuto am'madzi kapena impso, ma acetone alibe nthawi yoti atulutsidwe ndikuyamba kudziunjikira. Poterepa, amalankhula za acetonemic syndrome. Zizindikiro zake ndi kukula kwa ma ketoni m'magazi - acetonemia ndi kutulutsa kwawo mkodzo - acetonuria.

Zofunika: Kodi tikuyenera kuwopa acetone mu mkodzo ndi zifukwa zowonjezera zake, takambirana izi apa - werengani zambiri

Zoyambitsa Syndrome

Kuchepa kwa glucose ndi acetonemic syndrome yosiyanasiyana yamatenda kumatha kubweretsa:

1. Kudya chakudya chamagulu ochepa monga chakudya, mwachitsanzo, zakudya zamafuta ochepa kapena kuwonda. Kusowa kwa carbohydrate kwa nthawi yayitali kumachepetsa mphamvu ya chiwindi kusunga glycogen, chifukwa chake acetonemic syndrome imakula mwachangu pakati pa anthu omwe amadya izi kuposa anthu omwe amadya saccharides yokwanira. Mwa mwana, kuthekera kophatikiza glycogen kumapangidwa ngakhale asanabadwe. Chifukwa cha kuchuluka kwake, makanda amafunika kudya pafupipafupi ndi zakudya zopatsa mphamvu.
2. Zakudya zamafuta, zomanga thupi kwambiri zopanda mbale.
3. Zinthu zomwe zimatsagana ndi kuchuluka kwa mphamvu yamagetsi. Acetonemic syndrome pachifukwa ichi ndi khalidwe la ana osakwana zaka 8. Amakhala ndi nkhawa, matenda, poyizoni komanso amatha kudumphira chakudya chamadzulo kumatha kubweretsa ma ketoni. Ana ena amakhala ndi vuto loti acetonuria, nthawi zambiri amakhala owonda, mafoni, osavuta, alibe chidwi chokwanira komanso amakhala ndi glycogen yochepa. Akuluakulu, acetone wambiri amamasulidwa pambuyo povulala kwambiri, kugwira ntchito, ndikutuluka chikomokere, chifukwa chake, panthawiyi, wodwalayo amapaka jekeseni wa shuga m'mitsempha.
4. Ndi toxosis kapena gestosis, yomwe imayendetsedwa ndi kusanza komanso kusowa kwa chakudya, mayi wapakati samapeza chakudya chokwanira, kotero mafuta amayamba kuthyoka mthupi, ndipo ma acetone amasulidwa. Monga mwa ana, zomwe zimayambitsa matenda mu azimayi oyembekezera zimatha kukhala matenda aliwonse komanso malingaliro akukumana nawo.
5. Kutulutsa kwa minofu yayitali kwambiri kumawotcha shuga ndi masitolo a glycogen, ndipo kutulutsa shuga kumapitirirabe kwakanthawi pambuyo pophunzitsidwa kapena kulimbitsa thupi. Kuti mupewe matenda a acetonemic, tikulimbikitsidwa kugwiritsa ntchito chakudya pambuyo pama katundu - "tsekani zenera la chakudya." Ndipo mosinthanitsa, ngati cholinga cha phunziroli chikucheperachepera, pambuyo pake pakakhala zosafunika kwa maola angapo, chifukwa ndi panthawiyi pomwe mafuta amawonongeka.
6. Kutha kwa kupanga kwa insulin mu mtundu 1 wa shuga. Palibe mahomoni ake omwe, shuga imalephera kwathunthu kulowa m'maselo, kotero mafuta amawonongeka makamaka mwachangu. Acetonemic syndrome imayamba ndi matenda a shuga kapena matenda osakwanira a insulin kukonzekera ndipo imatha kuyamba kukhala ketoacidotic coma.
7. Kutsika kwakukulu kwa kaphatikizidwe ka insulin kwambiri mtundu 2 wa matenda ashuga. Monga lamulo, panthawiyi wodwalayo amasamutsidwa ku insulin mankhwala kuti ateteze matenda a hyperglycemia ndi minofu. Ngati izi sizingachitike, limodzi ndi kukula kwa shuga m'magazi, matenda a acetonemic amayamba.
8. Kukana kwamphamvu kwa insulin kwa odwala omwe ali ndi matenda a shuga a 2. Pankhaniyi, shuga ndi insulin zonse ndizokwanira m'magazi, koma ma membala am'mimba sawalola kulowa. Chomwe chimayambitsa kukana ndi kunenepa kwambiri komanso kusowa kwa kuyenda.
9. Kugwiritsa ntchito mowa pafupipafupi kumathandizira kuchepetsa kuchuluka kwa glycogen, komwe kumathandizira kukula kwa matendawa.

Zizindikiro za Acetonemia

Zizindikiro zoyambirira zimakhudzana ndi kuledzera kwa ketone. Khansa, kutopa, nseru, mutu, kuwawa, kapena kusamva bwino m'mimba kungamveke.

Pamene kuchuluka kwa ma ketoni kumawonjezeka, zotsatirazi zimawonedwa:

• kusanza kosalekeza. Kuukira kumatha kukhala maola angapo, munthawi yomwe wodwalayo amataya madzi onse akumwa nthawi imeneyi. Vomit amatulutsa fungo la acetone. Kutha kusanza kwa bile ndipo ngakhale magazi;
• Fungo lomweli limamveka kudzera pakupuma kwa wodwalayo, ndipo nthawi zina kuchokera pakhungu lake;
• kupweteka kwa peritoneum, yomwe nthawi zambiri imafanana ndi zizindikiro zam'mimba zam'mimba: lakuthwa, kukulitsidwa pambuyo kukakamiza. Kutsegula m'mimba ndikotheka;
• kufooka kwakula msanga. Mwana wagona pansi ndipo amakhudzidwa ndi zinthu zomwe kale zinali zosangalatsa kwa iye;
• Photophobia - wodwalayo amafunsa kuti ayatse nyali, ajambule makatani, akudandaula za kupweteka m'maso;
• kutentha kumatha;
• kuchepa thupi chifukwa chosanza komanso kutsuka pafupipafupi, wodwala amakhala ndi milomo yowuma, malovu pang'ono, mkodzo umachotsedwa pang'onopang'ono, wamtundu wakuda.

Ngati mwana amakonda kwambiri acetonemic syndrome, amakhalanso ndi zofananira nthawi ndi nthawi. Pambuyo pamagawo angapo a acetonemia, makolo amaphunzira kuzindikira mwachangu ndi kusiya izi. Kuchiza kunyumba ndikotheka ndikuwonetsa matendawa. Ngati mwana amamwa pang'ono ndikuyamba kuchepa, chifukwa madzi onse amatuluka ndi kusanza, muyenera kuyimbira dokotala. Mwana akamacheperachepera, thupi limachepa msanga.

Zowopsa komanso zotheka

Nthawi zambiri, matupi a ketone amapangidwa pang'ono, amatulutsa impso ndi mapapu ndipo samayenderana ndi thanzi. Acetonemic syndrome ndiyowopsa kwa ana, odwala operewera ndi odwala matenda ashuga.

Mwa ana, chifukwa cha kuchepa mphamvu, kuchuluka kwa ma ketoni kumadzuka mwachangu, kusanza kumayambira ndipo kufooka kwamadzi kwamphamvu kumayamba. Munthawi imeneyi, ndizosatheka kuti azipereka chakudya chamagulu, motero kuchipatala ndi kulowetsedwa kwa shuga kumafunika.

Mu matenda ashuga, acetone imakhala yotetezeka ngati yayambitsidwa ndi zakudya zama carb ochepa kapena zolimbitsa thupi. Koma ngati acetonemic syndrome imayendetsedwa ndi shuga wambiri, chiwopsezocho chimakula kwambiri. Mu chikhalidwe ichi, polyuria imawonedwa - kuchulukitsa kwa mkodzo, komwe kumayambitsa madzi am'mimba. Thupi limayankha chifukwa chosowa madzi posunga mkodzo, motero ma ketoni. Kuchuluka kwa acetone kungayambitse ndi matenda ashuga nephropathy, limodzi ndi aimpso kulephera. Kuwonjezeka kwa kuchuluka kwa ma ketones kumawonjezera kuchuluka kwa magazi ndi acidity yake. Mavuto omwe ali pamwambapa amatchedwa diabetesic ketoacidosis. Ngati simuletsa pakapita nthawi, ketoacidosis imabweretsa kukomoka kwa hyperglycemic.

Zizindikiro

Nthawi zambiri zimakhala zovuta kudziwa zomwe zimayambitsa odwala kukhala ndi matenda ashuga ngati amagwiritsa ntchito glucometer nthawi zonse ndikuyang'anira thanzi lake. Zimakhala zovuta kudziwa komwe kumachitika mwana akamadwala matenda acetonemic, ndipo nthawi zambiri ana okhala ndi matendawa amagonekedwa kuchipatala, ndipo atazindikira koyenera, amapititsidwa kuchipatala kuti akalandire chithandizo. Mtsogolomo, makolo amatha kugula zida zodziwonera acetone kunyumba, ndikuzindikira ndikuyimitsa vutoli panthawi popanda thandizo la madokotala.

Njira zasayansi

Ku chipatala, magazi ndi mkodzo amatengedwa kuti adziwe ma ketones. Mu mkodzo, acetone imatsimikiziridwa ndi njira yochulukitsa, zotsatira za kusanthula uku zikuchokera 1 mpaka 4 pluses. Mokulirapo ndende, zochulukirapo.

Kupotoza kusanthula:

Ma ketoni am'madzi amatsimikiziridwa mu mmol / l, chizolowezi ndicho at kuchokera pa 0.4 mpaka 1.7, kutengera njira yomwe imagwiritsidwa ntchito pofufuza. Kuwonjezeka kwa 100-170 mmol / l kumawonedwa ketoacidotic chikomokere.

Njira zofotokozera

Kunyumba, acetone mumkodzo amadziwika mosavuta ndi timitengo ta mayeso apadera omwe amagwiritsa ntchito pepala la litmus. Zodziwika kwambiri ndi a Ketogluk (ma 50 ma PC kwa ma ruble 240), Uriket (ma ruble 150), Ketofan (ma ruble 200). Kuphatikizika kwa ma ketones kumatsimikiziridwa ndi kukula kwa kuyesa kwa Mzere wozungulira pambuyo pomiza mkodzo.

Migwirizano:

1. Sungani mkodzo mumtsuko. Pa kusanthula, mkodzo uyenera kukhala watsopano, sungasungidwe kwa maola opitilira 2.
2. Pezani mzere woyesa. Tsekani chidebecho nthawi yomweyo, pomwe zingwe zotsalazo zimayipa kuti asalumikizane ndi mpweya.
3. Gawo lotsika ndi mzere ndi chizindikiritso cha mkodzo kwa masekondi 5.
4. Vula zovala. Gwirani m'mphepete mwake kutipukuta kuti mkodzo wowonjezera ugwidwe.
5. Pambuyo pa mphindi ziwiri, yerekezerani mtundu wa chizindikirocho ndi sikelo pamaphukusi ndikuwona mulingo wa ma ketoni. Mtundu ukakulirakulira, umalimbikiranso acetone.

Odwala omwe ali ndi matenda ashuga amatha kugwiritsa ntchito mitundu ya glucometer yomwe imatha kudziwa ma shuga ndi ma magazi a magazi. Kuti mupeze acetone, muyenera kugula zingwe zingapo.

Mpumulo wa acetonemic syndrome

Lamulo lothandizira mankhwalawa acetonemic syndrome ndikuchotsa madzi m'thupi. Wodwala amafunikira kuperekedwa nthawi zambiri, koma pang'onopang'ono, madzimadzi. Ngati kusanza mobwerezabwereza kuchitika, muyenera kumwa supuni yeniyeni mphindi zisanu zilizonse kufikira zizindikiro za kusowa magazi ndipo mkodzo utayamba kutuluka pang'ono. Nthawi yomweyo, chifukwa cha acetonemia ziyenera kuthetsedwa.

Odwala odwala matenda ashuga

Ngati acetone amawoneka m'magazi a shuga, chinthu choyamba chomwe muyenera kuchita ndikuyeza magazi. Ngati ichulukitsidwa kwambiri (> 13 mmol / L), chiopsezo cha ketoacidosis ndi chambiri. Kuti muchepetse shuga, muyenera kumwa Metformin, osapatula chakudya m'zakudya, kapena jekeseni wolondola wa insulin.

Acetone imayamba kutsika pokhapokha kukodza kwachilungamo kubwezeretsedwa. Kuti muchite izi, mumafunika chakumwa chochulukirapo, chopanda bwino kuposa madzi wamba wamba otentha. Ndikusanza kwanthaŵi yayitali, njira zapadera zothetsera madzi m'mimba zimagwiritsidwa ntchito - Regidron, Trisol, Hydrovit. Zakudya ndi zakumwa ndi chakudya zimaloledwa pokhapokha ngati glycemia ikhale yachilendo.

Ku chipatala, wodwalayo amatsitsidwa magazi mothandizidwa ndi insulin, akumwa amabwezeretsa kuchuluka kwa madzi mthupi. Kupezeka kwa madokotala panthawi yake, matenda acetonemic sayambitsa kuvulaza thupi.

Mu ana

Acetonemic syndrome ndimakonda kupezeka mwa ana, nthawi zambiri amatha kuimitsidwa msanga. Ana ena "amapatsa" acetone pamavuto aliwonse, monga kuzizira kapena kusanza kamodzi, komanso chifukwa cha zinthu zatsopano kwa iwo kapena masewera omwe amakhala otakataka. Izi sizoyenera kuopa, pofika unyamata, masitolo a glycogen azikula, ndipo matendawa sadzapwetekanso.

Mwana akangokhala ndi vuto lachilendo - kung'amba, kufoka, kuwodzera, muyenera kuyesa acetone mkodzo mwachangu. Kuti muchite izi, nthawi zonse muzikhala ndi mayeso kunyumba. Ngati pali kuwonjezeka pang'ono, ndiye kuti pali kuchepa kwa zakudya zamafuta. Njira yothamanga ndikupangira izo mothandizidwa ndi chakumwa chokoma: compote, juisi, tiyi. Pambuyo pa chithandizo chotere, mapangidwe a ma ketoni amasiya, sipadzakhala kusanza.

Nthawi zambiri, matenda a acetonemic sangathe kupewedwa kumayambiriro kwenikweni. Zimachitika kuti kusanza kumwana kumayamba m'mawa kwambiri, kugona tulo. Pankhaniyi, maukadaulo ndi ofanana - timagwira mwana. Ndikwabwino kugwiritsa ntchito chipukuta chowuma, kuphatikiza shuga kapena mandimu ndi uchi. Kumwa kuyenera kutentha. Zakumwa za Carbonated sizabwino, chifukwa zimatha kuwonjezera ululu wam'mimba. Ngati kusanza kubwerezedwa, perekani madziwo kawirikawiri, ndi supuni. Ngati mwana ali ndi matenda a shuga, koma palibe hyperglycemia, chakumwa chokoma chiyenera kutsagana ndi kuyambitsa insulin.

Pa chithandizo, muyenera kuyang'anira kupezeka pokodza. Ndi mafuta okwanira okwanira, mwana ayenera kupita kuchimbudzi osachepera maola atatu aliwonse, mkodzo wake uzikhala wopepuka.

Imbani ambulansi ya acetonemic syndrome mwa ana mu zochitika zotsatirazi:

• mwana wosakwana miyezi 4;
• kusanza, ngakhale chithandizo, chimakhala cholemera, madzi onse oledzera amatayika;
• palibe mkodzo kwa maola opitilira 6;
• masanzi amakhala ndi tinthu tating'onoting'ono tofiirira;
• kusokonezeka kwa chikumbumtima kapena kusachita bwino kumawonedwa;
• kupuma kosazolowereka kulipo;
• kupweteka kwam'mimba sikumatha pambuyo poti asanza.

Pambuyo kuwonekera koyamba kwa matendawa, muyenera kulumikizana ndi Dokotala wazachipatala kuti mudziwe zomwe zimayambitsa. Kuti athane ndi mavuto a mayamwidwe azakudya, azikupatsani mayeso a magazi ndi mkodzo, kuyezetsa shuga.

Momwe mungapewere kuyambiranso kwa acetone

Ndi matenda ashuga, acetonemic syndrome imatha kupewedwa pokhapokha kubwezeretsa bwino matendawa. Ndi shuga wabwinobwino wamagazi, kumasulidwa kwa acetone sikofunikira, simungathe kumvetsera. Panthawi yodwala kapena kupsinjika, shuga amafunika kuwayeza pafupipafupi kuti muwone kukula kwake pakapita nthawi. Panthawi imeneyi, mungafunike kuwonjezera kuchuluka kwa mapiritsi ochepetsa shuga ndi insulin.

Zizindikiro za kubwereza acetonemic kusanza kwa ana kumafuna bungwe logwirira chakudya mkati mwa chakudya.Onetsetsani kuti chakudya chamadzulo ndi chofunikira, chifukwa nthawi zambiri matendawa amayambira usiku. Tsiku loyamba pambuyo pa kuukira kumafuna chakudya chamagulu - cracker kapena masikono ndi tiyi, mpunga ndi madzi. Tsiku lotsatira mutha kupatsa chakudya chokhacho. Chakudya chokhwima sichofunikira. Malamulo awiri okha akuyenera kuwonetsetsa: perekani mafuta pamodzi ndi chakudya chamagulu ndikuthana ndi zakudya zamafuta kwambiri.

Simungathe kuteteza ana awa ku masewera olimbitsa thupi, chifukwa kukula bwino kwa minofu ndikuchulukitsa kuchuluka kwa glycogen amalimbikitsa ngakhale magawo m'magawo. Pambuyo pakuphunzitsidwa, mwana amapatsidwa madzi kapena chidutswa cha chokoleti. Kuti muchepetse chiopsezo cha matenda opatsirana oyambitsidwa, katemera amafunikira.

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