Matenda a shuga ndi njira ya endocrine yomwe imakhala ndi zovuta zingapo zovuta. Kuphwanya kagayidwe kachakudya komwe kumachitika motsutsana ndi maziko a insulin kukana kumayambitsa vuto mu ntchito ya ziwalo zonse zofunika komanso machitidwe.
Chimodzi mwamavuto owopsa ndikupanga kulephera kwa impso. Zotsatirazi ndikuphwanya kwa ntchito yowonekera, kuzimiririka kwa zinthu zovulaza m'thupi. Poyerekeza ndi maziko a hyperglycemia, kuyamba kwa mphamvu zowonjezera mphamvu mu mawonekedwe a kudzipha kwa glucose ndi kudzikundikira m'magazi ambiri a lactic acid, omwe alibe nthawi yoti atulutsidwe chifukwa cha vuto la impso. Matendawa amatchedwa lactic acidosis. Zimafunika kukonzanso mwachangu ndipo zimatha kupangitsa kuti lactic acidosis chikomokere.
Zambiri
Lactic acidosis yamtundu wa 2 shuga sichinthu wamba, komabe, ndiyowopsa. Zotsatira zabwino zimawoneka pokhapokha mu 10-50% ya milandu. Lactate (lactic acid) amawonekera m'thupi chifukwa cha kuwonongeka kwa glucose, koma impso sizingathe kuzimasulira zochuluka motero.
Zotsatira za Laborator - chifukwa chotsimikizira kuti matendawa ndi ozindikira
Kuchulukana kwa magazi ochepa ndi lactate kumabweretsa kusintha kwa acidity yake. Kuzindikira kumatsimikiziridwa mwa kudziwa mulingo wa lactic acid pamwamba pa 4 mmol / L. Dzina lachiwiri la kuphatikizika kwa shuga ndi lactic acidosis.
Zifukwa zazikulu
Lactic acidosis mu mtundu 2 wa shuga samapezeka mwa odwala onse, koma mothandizidwa ndi zina zoyambitsa:
Zizindikiro za Hyperglycemic Coma- matenda a kagayidwe kachakudya njira chibadidwe;
- kukhazikitsidwa kwa kuchuluka kwa fructose mthupi, kudutsa m'mimba;
- poyizoni wa mowa;
- kuwonongeka kwamakina;
- magazi
- zotupa, matenda opatsirana;
- poyizoni wa cyanide, kugwiritsa ntchito salicylates nthawi yayitali;
- matenda a shuga a mellitus, mankhwala osagwirizana, komanso zovuta zina;
- hypovitaminosis B1;
- kwambiri mawonekedwe a kuchepa magazi.
Pathology imatha kukhala osati kokha motsutsana ndi maziko a "matenda okoma", komanso pambuyo pa vuto la mtima.
Njira yopititsira patsogolo
Mafuta akamalowa m'thupi la munthu kudzera m'mimba, matupi awo amayamba kuwonongeka. Ngati palibe insulin yokwanira yopangidwa (izi zimachitika m'magawo apambuyo a matenda a 2) ndi kuchepa kwa maselo a pancreatic), kuwonongeka kwa mafuta ndi madzi ndi mphamvu kumachedwa pang'ono kuposa momwe kumafunikira ndipo kumayendetsedwa ndi kuphatikizika kwa pyruvate.
Chifukwa chakuti zochulukitsa zowonetsa za pyruvate zimakhala zokwera, lactic acid imasonkhanitsidwa m'magazi. Amakonda kugwira ntchito kwa ziwalo zamkati moopsa.
Lactic acid molekyulu - chinthu chomwe kudzikundikira kwake kumabweretsa chitukuko cha lactic acidosis
Zotsatira zake ndi kukula kwa hypoxia, ndiye kuti, maselo ndi minyewa yathupi sizilandira mpweya wokwanira, womwe umakulitsa boma la acidosis. Mlingo wamwaziyu pH umabweretsa kuti insulini imataya ntchito yake kwambiri, ndipo lactic acid imakwera ndikukwera pamwamba.
Ndi kukula kwa matenda, kudwala matenda a shuga amapangidwa, limodzi ndi kuledzera kwa thupi, kuchepa mphamvu kwa thupi ndi acidosis. Mawonekedwe oterewa akhoza kupha.
Mawonekedwe
Zizindikiro za lactic acidosis zimawonjezeka maola angapo. Nthawi zambiri, wodwalayo amadandaula za chithunzi chotsatira chachipatala:
- mutu
- Chizungulire
- kupumirana mseru ndi kusanza;
- chikumbumtima;
- kupweteka pamimba;
- kusokonekera kwa magalimoto;
- kupweteka kwa minofu
- kugona, kapena, kusowa tulo;
- kupuma pafupipafupi.
Zizindikiro zotere sizili zachindunji, chifukwa zimawonedwa osati kokha ndi kudzikundikira kwa lactic acid, komanso motsutsana ndi maziko azovuta zina zingapo.
Coma ndi chizindikiro cha gawo lotsiriza pakupanga lactic acidosis. Zimayambitsidwa ndikuwonjezereka kwa vuto la wodwalayo, kufooka kwambiri, khungu lowuma komanso mucous membrane, kupuma kwa Kussmaul (kupumula kwaphokoso ndi phokoso losungika). Kamvekedwe ka mawonekedwe a wodwalayo amachepa, kutentha kwa thupi kumatsikira mpaka madigiri 35.2-35,5. Nkhope zakuthwa zadukiza, maso akung'ung'uza, mkodzo kulibe. Kupitilira apo, pamakhala kutayika.
Kukula kwa chikumbumtima ndi gawo lomaliza la zovuta za matenda ashuga
Njirayi itha kukulitsidwa ndi kukula kwa DIC. Awa ndi mkhalidwe womwe magazi amapangira magazi, amapanga magazi kwambiri.
Zizindikiro
Kuzindikira matenda ndizovuta mokwanira. Monga lamulo, mkhalidwe umatsimikiziridwa ndi mayeso a labotale. M'magazi mumakhala lactate wambiri komanso nthawi ya anionic ya plasma. Mfundo zotsatirazi zikuwonetsa kukula kwa matenda:
- Zizindikiro za lactate pamwamba pa 2 mmol / l;
- kuchuluka kwa ma bicarbonates ochepera 10 mmol / l, omwe amakhala otsika kwambiri kuposa abwinobwino;
- mulingo wa nayitrogeni ndi zomwe zimachokera m'magazi zimakwera;
- lactic acid ndi yokwera nthawi 10 kuposa pyruvic acid;
- mafuta chizindikiro chikuwonjezeka;
- acidity m'munsimu 7.3.
Njira zothandizira ndi kuwongolera
Kuthandizidwa kuchipatala kuyenera kukhala ndi cholinga chothana ndi kusintha kwa magazi acidity, mantha, kukondera kwa elekitirodi. Mofananamo, endocrinologists akuwongolera chithandizo cha mtundu wa 2 matenda a shuga.
Popeza kuchuluka kwa mpweya wa monoxide kumapangidwa motsutsana ndi maziko a magazi acid, vutoli liyenera kuthana. Wodwalayo amapsinjika kwambiri m'mapapo (ngati wodwalayo sakudziwa, ndiye kuti makulitsidwe amafunikira).
Glucose yemwe amangokhala ndi insulin amalowetsedwa m'mitsempha (pofuna kukonza zovuta za metabolic) kumbuyo kwa njira ya matenda ashuga), yankho la sodium bicarbonate. Vasotonics ndi mtima zimayikidwa (mankhwala othandizira ntchito ya mtima ndi mitsempha yamagazi), heparin ndi reopoliglukin amatumizidwa paz Mlingo wochepa. Kugwiritsa ntchito ma diagnostics a labotale, kuchuluka kwa magazi ndi kuchuluka kwa potaziyamu kuyang'aniridwa.
Mass kulowetsedwa ndi gawo lofunika mankhwalawa a matenda ashuga lactic acidosis
Ndikosatheka kuchitira wodwala kunyumba, chifukwa ngakhale akatswiri odziwa bwino ntchito sangakhale ndi nthawi yothandizira wodwalayo. Pambuyo pokhazikika, ndikofunikira kuti mupumule pakama, chakudya chamagulu, komanso kuyang'anira kuthamanga kwa magazi, acidity, ndi shuga m'magazi.
Kupewa
Monga lamulo, sizingatheke kuneneratu kukula kwa lactic acidosis mu mtundu 2 wa matenda ashuga. Moyo wa wodwalayo umatengera anthu omwe amamuzungulira panthawi yopanga zovuta, komanso ziyeneretso za ogwira ntchito kuchipatala omwe adafika pakufunikira.
Popewa kukula kwa matenda a m'matumbo, upangiri wa chithandizo cha endocrinologist uyenera kuyang'aniridwa mosamala, ndipo mankhwala omwe amachepetsa shuga ayenera kumwedwa panthawi yake komanso molondola. Ngati mwaphonya kumwa mapiritsi, simuyenera kumwa mopitilira kuchuluka nthawi yotsatira. Muyenera kumwa kuchuluka kwa mankhwalawa omwe adapangidwa nthawi imodzi.
Panthawi ya matenda opatsirana kapena kachilombo, wodwala matenda ashuga amatha kulandira mwadzidzidzi mankhwala omwe atengedwa. Zizindikiro zoyambirira za matendawa zitawoneka, muyenera kulumikizana ndi katswiri wothandizira kuti mupeze kusintha kwamankhwala komanso mankhwalawa.
Ndikofunika kukumbukira kuti lactic acidosis si matenda omwe "amachoka". Kufunafuna thandizo pa nthawi yake ndiye njira yabwino.
