Polankhula za zovuta zowopsa zomwe zimayambitsa matenda ashuga, munthu sangathe kulephera kutchula lactic acidosis. Matendawa amapezeka kawirikawiri kwambiri, mwayi wokumana nawo pazaka 20 zokhala ndi matenda a shuga ndi 0,06% yokha.
Kuti theka la odwala omwe "ali ndi mwayi" agwere m'zigawo izi, peresenti ya lactic acidosis imapha. Kufa kwakukulu kotereku kukufotokozedwa ndikukula kwakatchulidwe ka matendawa komanso kusapezeka kwa zodziwikiratu zodziwika bwino m'magawo oyamba. Kudziwa zomwe zingayambitse lactic acidosis mu matenda ashuga, momwe zimadziwonekera, komanso zomwe mungachite ngati mukukayikira za matenda amtunduwu, tsiku lina lingakupulumutseni kapena okondedwa anu.
Lactic acidosis - ndi chiyani
Lactic acidosis ndikuphwanya kagayidwe kakang'ono ka shuga, kamene kamayambitsa kuchuluka kwa magazi, ndipo chifukwa chake, chiwonongeko cha mitsempha yamagazi, matenda amanjenje, komanso kukula kwa hyperlactacidemic chikomokere.
Nthawi zambiri, shuga wolowa m'magazi amalowa m'maselo ndi kulowa m'madzi ndi kaboni diokosijeni. Potere, mphamvu imamasulidwa, yomwe imapereka ntchito zonse za thupi. Pakusintha kwa ma carbohydrate, zimachitika kuphatikiza ndimankhwala angapo, iliyonse imafunikira. Ma enzyme ofunikira omwe amapereka njirayi amayambitsa insulin. Ngati, chifukwa cha matenda ashuga, sikokwanira, kusweka kwa glucose kumalephereka pamapangidwe a pyruvate, amasinthidwa kukhala lactate pamiyeso yambiri.
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%
Mwa anthu athanzi, chizolowezi cha lactate m'magazi ndizosakwana 1 mmol / l, kuphatikiza kwake kumagwiritsidwa ntchito ndi chiwindi ndi impso. Ngati kudya kwa lactic acid m'magazi kukupitilira ziwalo kuti zichotse, kusintha kosaloza m'magazi kwa acid kumachitika, zomwe zimabweretsa kukula kwa lactic acidosis.
Pamene lactate m'magazi amadzaza oposa 4 mmol / l, kuwonjezeka pang'onopang'ono kwa acidity kumakhala spasmodic. Vutoli limakulirakulira chifukwa cha kuchuluka kwa insulini m'malo okhala acidic. Kusokonezeka kwa mapuloteni ndi mafuta metabolism kumawonjezeredwa pamavuto amagetsi a kagayidwe kazinthu, kuchuluka kwa mafuta achilengedwe m'magazi kukwera, zinthu za metabolic zimadziunjikira, kuledzera kumachitika. Thupi silingathenso kuchoka pagululi palokha.
Ngakhale madotolo sangakhale okhazikika pamkhalidwewu, ndipo popanda thandizo la kuchipatala, lactic acidosis yayikulu imangomwalira.
Zifukwa za maonekedwe
Matenda a shuga a mellitus amakhala kutali ndi chifukwa chokhacho cha lactic acidosis, mu theka la milandu imachitika chifukwa cha matenda ena akuluakulu.
| Zowopsa | Zotsatira pa Glucose Metabolism |
| matenda a chiwindi | Kuphwanya kwamphamvu kuyeretsa magazi kuchokera ku lactic acid |
| uchidakwa | |
| matenda aimpso | kulephera kwakanthawi mu limagwirira wa excretion wa lactate |
| intravenous makonzedwe a othandizira osiyanasiyana a x-ray diagnostics | |
| kulephera kwa mtima | mpweya njala ya zimakhala ndipo kuchuluka mapangidwe lactic acid |
| matenda kupuma | |
| kuvulala kwamitsempha | |
| kuchepa kwa hemoglobin | |
| kuphatikiza kwa matenda angapo omwe amathetsa thupi | kuchuluka kwa lactate chifukwa cha zifukwa zosiyanasiyana - onse kuchuluka kaphatikizidwe ndi kufooka chilolezo cha lactic acid |
| ziwalo zolowa chifukwa cha ukalamba | |
| zovuta zingapo za matenda ashuga | |
| kuvulala kwambiri | |
| matenda opatsirana oyamba | |
| kusowa kwambiri kwa vitamini B1 | kutsekera pang'ono kagayidwe kachakudya |
Chiwopsezo chachikulu cha lactic acidosis mu matenda ashuga imayamba ngati matendawa aphatikizidwa ndi zinthu zomwe zili pamwambazi.
Metformin, imodzi mwa mankhwala omwe nthawi zambiri amalembera mtundu wachiwiri wa matenda ashuga, amathanso kuyambitsa matenda a glucose metabolism. Nthawi zambiri, lactic acidosis imayamba ndi mankhwala osokoneza bongo, munthu amachita kapena chifukwa chodzikundikira m'thupi chifukwa cha vuto la chiwindi kapena impso.
Zizindikiro za lactic acidosis mumitundu 1 ndi 2 shuga
Lactic acidosis nthawi zambiri imakhala yovuta. Nthawi kuyambira zizindikiritso zoyambirira mpaka kusintha kosasintha m'thupi sizitenga tsiku limodzi. Mwa ziwonetsero zoyambirira za lactic acidosis, imodzi yokha ndi yokhazikika - myalgia. Uku ndikumva kupweteka kwamisempha chifukwa chokhala ndi lactate wambiri. Aliyense wa ife adamva mphamvu ya lactic acid pamene tinayambiranso masewera olimbitsa thupi patatha nthawi yopuma. Zomverera izi ndizabwinobwino, zathupi. Kusiyana pakati ululu ndi lactic acidosis ndikuti sikulumikizana ndi katundu wanyumba.
Onetsetsani kuti mwaphunzira: >> Metabolic acidosis - chifukwa chiyani muyenera kuwopa?
Zizindikiro zotsalira za lactic acidosis zitha kupezeka mosavuta chifukwa cha matenda ena.
Zingaoneke:
- kupweteka pachifuwa
- kupuma movutikira
- kupuma pafupipafupi
- milomo yabuluu, zala, kapena manja;
- kumverera kwodzaza m'mimba;
- kusokonezeka m'matumbo;
- kusanza
- mphwayi
- zosokoneza tulo.
Momwe lactate ikukula, zizindikilo zimadziwika zomwe zimapangitsa vuto la acidity:
- Kuyesera kwa thupi kukonza minyewa ya okosijeni kumabweretsa phokoso, kupuma kwakukuru.
- Chifukwa cha kulephera kwa mtima, kupanikizika kumatsika ndikuwonekera.
- Kuchuluka kwa lactate kumakwiyitsa minofu kukokana.
- Kusakwanira muubongo kumapangitsa kusinthika kwa chisangalalo ndi kupunduka, ndipo kupusitsika ndi kupuwala pang'ono pang'ono kwamisempha kumatha kuchitika.
- Kupanga kwa magazi kuwunjika, nthawi zambiri m'miyendo.
Ngati lactic acidosis singathe kuyimitsidwa pakadali pano, wodwala yemwe ali ndi matenda ashuga amapsa.
Mfundo zakuchiritsa matenda
Atalandira odwala matenda ashuga okayikiridwa ndi lactic acidosis kuchipatala, amayesedwa kangapo:
- Madzi a m'magazi. Kuzindikira kumapangidwa ngati mulingo wake uli pamwamba pa 2.2 mol / L.
- Magazi a magazi. Mtengo womwe uli pansi pa 22 mmol / L umatsimikizira lactic acidosis.
- Acetone mu mkodzo watsimikiza kusiyanitsa acidity chifukwa cha lactic acid ku ketoacidosis.
- Magazi a creatinine amakulolani kusiyanitsa uremic acidosis.
Zolinga zikuluzikulu zamankhwala ndizomwe zimapangitsa kuti magazi achulukane komanso kuthetseratu vuto la okosijeni.
| Mayendedwe azithandizo | Njira | Mawonekedwe |
| Kuchepetsa chinyezi | Dontho la sodium bicarbonate | Mlingo amawerengedwa molondola kwambiri, njira yowongolera imayang'aniridwa nthawi zonse. Cardiogram ndi muyeso wamagazi amachitidwa pafupipafupi, ndipo ma electrolyte amwazi amayesedwa. |
| Trisamine kudzera m'mitsempha | Amagwiritsidwa ntchito m'malo mwa bicarbonate ndikuwonjezereka kwa acidity komanso chiwopsezo cha mtima kulephera, amakhala ndi zotsatira zamphamvu. | |
| Kulimbana kwa kusintha kwa pyruvate kuti lactate | Methylene buluu | Thupi limakhala ndi katundu wa redox ndipo limatha kukhathamiritsa michere yomwe imagwira shuga. |
| Hypoxia Kuthetsa | Mankhwala othandizira okosijeni | Gwiritsani ntchito zoyezera mpweya wabwino kapena mpweya wokuthandizira wa patracorporeal. |
| Mapeto a kuchuluka kwa metformin | Kutumphuka kwa m'mimba, kugwiritsa ntchito ma sorbents | Imachitika choyamba. |
| Kuyimitsa mkhalidwe wowopsa | Hemodialysis | Lalose-free dialysate imagwiritsidwa ntchito. |
Kupewa
Kuti mupewe lactic acidosis, muyenera kuyang'anira thanzi lanu nthawi zonse:
- Pambuyo pazaka 40, zaka zitatu zilizonse, chopereka chamagazi ndizofunikira kudziwa kuchuluka kwa shuga. Lactic acidosis imachitika nthawi zambiri mtundu wa shuga wachiwiri usanapezeke, zomwe zikutanthauza kuti palibe chithandizo.
- Pokhala ndi matenda a shuga, muyenera kutsatira malingaliro onse a dotolo, kukayezetsa kuchipatala kuti mupeze zinthu zomwe zingayambitse vuto lactic acidosis.
- Ngati mukutenga metformin, werengani mndandanda wazotsutsana ndi malangizo. Ngati matenda amodzi atchulidwa mmatchulawa, funsani kwa endocrinologist kuti muthane ndi kusintha kwa mankhwalawo.
- Musapitirire kuchuluka kwa mankhwala a Metformin popanda chilolezo cha dokotala, ngakhale kubwezeretsedwa kwa matenda a shuga sikokwanira.
Ngati mukukumana ndi zofanana ndi mawonekedwe a lactic acidosis, muyenera kuyimbira ambulansi. Ulendo wodziyimira wokha kupita kwa asing'anga kapena kukayesa kuthana ndi matendawo panokha ungathe momvetsa chisoni.
