A na-akpọkwa laos acidosis lactic acidosis. Ọnọdụ a, nke na-akpalite hyperlactaclera coma, bụ ihe mgbagwoju anya dị njọ nke dị mkpa maka ọrịa shuga.
Lactic acidosis na - egosi dị ka lactic acid na - agbakọ n'ime ahụ mmadụ. Emetụta ya:
- Akwara akwara
- Akpụkpọ anụ
- Ụbụrụ.
Mgbe mkpokọ acid bara uru, aghọrọ acid lais nke metabolic acidosis.
Ọ dị ezigbo mkpa maka ndị niile nwere ọrịa shuga ịmara isi ihe mgbaàmà nke lactic acidosis.
Ihe na-akpata Lactic Acidosis
Lactic acidosis putara n'ihi:
- Ọrịa na-efe efe na-efe efe,
- Oke ọbara ọgbụgba,
- Mmanya na-egbu egbu,
- Nnukwu myocardial infarction,
- Nnukwu mmerụ ahụ,
- Odida ntaramahụhụ
- Ọrịa imeju na-adịghị ala ala.
Isi ihe na-akpata lactic acidosis na-ewere biguanides, dịka ọmụmaatụ, a na-ewerekarị Metformin. N'okwu a, akara nke lactic acidosis na-apụta na ndị ọrịa nwere ọrịa mellitus, na-a medicationsụ ọgwụ nke ndị na-ebelata shuga na ihe a na ihe mejupụtara.
Ọ bụrụ na emetụta akụrụ ma ọ bụ imeju, obere obere biguanides nwere ike ibute lactic acidosis. Ọnọdụ a bụ nchikota ọgwụ na ahụ.
Lactic acidosis na-eme na hypoxia ọkpụkpụ akwara. Hypoxia nwere ike ime, dịka ọmụmaatụ, na mgbatị anụ ahụ ogologo oge. Ọ ga-achọkwa ọgwụgwọ ọgwụ.
Ọ bụrụ na ọnweghị ọnụnọ hypoxia doro anya, mgbe ahụ, ihe kpatara ọnọdụ ahụ nwere ike ịbụ ọrịa leukemia na ọtụtụ usoro tumo ndị ọzọ. Ihe ndị ọzọ nwere ike ịgụnye:
- Okuku iku ume
- Nnukwu nkụchi obi nke otu n'ime akpa ume,
- Nnukwu infarction
- Eriri ụkpa n'ime ahụ.
Ihe ịrịba ama dị mkpa nke Acactosis Lactic
Lactic acidosis, ọtụtụ mgbe, na-abanye n'ụdị nnukwu, ihe fọrọ nke nta ka ọ bụrụ awa ole na ole. Dị ka ọ na-adị, mgbaàmà nwere ike ịnọ kpamkpam, mana ọgwụgwọ dị mkpa.
Ndị ọrịa na-ahụ ihe mgbu akwara na mmetụta na-adịghị mma nke na-apụta n'azụ sternum. Lactic acidosis nwere akara ndị a:
- enweghị mmasị
- iku ume ngwa ngwa
- ehighi ura
- iro ụra
Ihe ngosiputa nke odida akwara bu ihe ngosi akwara nke anakpo acidosis. Violationdị ihe ahụ na-akpalite nkwekọrịta, njirimara nke myocardium, ebe lactic acidosis na-amalite.
Mgbe nke a gasịrị, lactic acidosis na-akpalite mmebi nke na-aga n'ihu na ọnọdụ izugbe, nke, n'ihi mmụba nke acidosis, afọ na-amalite imerụ ahụ, a na-ahụ vomiting.
Ọ bụrụ na ọnọdụ onye ọrịa ahụ lactic acidosis na-akawanye njọ, mgbe ahụ, mgbaàmà ahụ nwere ike ịdị iche iche: site na beflexia na paresis na hyperkinesis.
Ozugbo tupu mmalite nke coma, nke ejikọ mmụọ, onye ọrịa na-amalite na -eme mkpọtụ na-eme mkpọtụ na -ekwusi ike na-eku ume. Omume mara mma nke acetone anaghị akpata lactic acidosis. N’ezie, ụdị iku ume a na-eme na metabolic acidosis.
Ka oge na-aga, lactic acidosis na-amalite igosipụta onwe ya na ihe mgbaàmà nke ọdịda. Nke mbu, oligoanuria putara, ma ogba anuria. N'ihi nke a, mmepe nke DIC bidoro - coagulation intravascular. Ọ bụrụ na achọtara ọnọdụ ndị a, dọkịta kwesịrị ịmalite ọgwụgwọ ozugbo.
Ihe nrịba ama nke acidosis bụ ngosipụta nke mkpụrụobi intravascular thrombosis nke nwere necrosis hemorrhagic, mkpịsị aka na aka.
Lezienụ anya na ngwa ngwa lactic acidosis na-etolite, e guzobere ya n'ime naanị awa ole na ole.
Ihe ịrịba ama nke ọnọdụ gụnyere:
- ire asat
- shells akọrọ
- akpukpo aru.
Ọgwụgwọ na usoro nyocha nke lactic acidosis
Nchọpụta nke lactic acidosis na mgbaama ndị a niile siri ike ịchọpụta. A na-ahụta ọrịa dị ka ihe inyeaka.
Ihe omumu ulo nyocha nwere ntukwasiri nke rijuru afọ dabere na mkpebi nke lactic acid n'ime ọbara. Na mgbakwunye, a na-ekpebi ihe ndị na-egosi:
- mbelata nke ọbara bicarbonates,
- ogo nke hyperglycemia agafeghị oke,
- enweghi acetonuria.
Mgbe ị na-atụle ihe mgbaàmà nke lactic acidosis na ọnọdụ ahụ n'onwe ya, ọ dị mkpa, nke mbụ, iji chọpụta ihe ngosipụta maka iwepụ hypoxia ngwa ngwa.
Site na ihe mgbaàmà nke ọnọdụ ahụ na lactic acidosis n'onwe ya, nlekọta mberede na-esonye na nhazi nchịkwa nke ihe ngwọta nke sodium bicarbonate (4% ma ọ bụ 2.5%) ruo 2 lita kwa ụbọchị.
A na-ewere Metformin maka ọrịa shuga, ọ na-ebelata hyperglycemia, mana ọ naghị etolite hypoglycemia. N'adịghị ka usoro sulfonylurea, nke gụnyere ọgwụ sulfa, Metformin anaghị akpali mmepụta insulin.
N'ihe banyere oke shuga na Metformin na ọrịa shuga, lactic acidosis nwere ike ịmalite site n'ihe egwu nke nsonaazụ na-egbu egbu. Ihe kpatara ya bu cumulation nke ogwu n'ihi oru ezughi oke.
Ọ bụrụ na ihe ịrịba ama nke lactic acidosis pụtara, mgbe ahụ ọ ka mma ịkwụsị iji Metformin. Ekwesịrị ka e nye ya onye ọrịa ahụ n'ụlọ ọgwụ ngwa ngwa. Metformin kachasị kpochapụrụ hemodialysis na ọnọdụ ahụike. Na mgbakwunye, a na-eme ọgwụgwọ symptomatic.
Hypoglycemia nwere ike itolite ma ọ bụrụ na a na-ewere Metformin na sulfonylureas.
Ọ dị mkpa inyocha ụkpụrụ pH na ọkwa potassium dị n'ọbara.
Na mgbakwunye, na lactic acidosis na akara, insulin insulin nke arụ ọrụ sitere na mkpụrụ ndụ ihe eji eme ihe ma ọ bụ usoro ọgwụgwọ monocomponent na insulin dị mkpụmkpụ dị ka ọgwụgwọ.
Na ọgwụgwọ nke mgbaàmà na lactic acidosis, a pụkwara iji ọgwụ ọxyụ carboụ na-eme ka a na-ejikarị ụgbọ ala nje intravenly site na ntinye nke ihe dị ka 200 mg kwa ụbọchị.
Ọgwụgwọ mejupụtara na nchịkwa ọbara ọbara nke plasma ọbara yana obere heparin, nke na-enye aka na mgbazi nke hemostasis.
Mgbochi Coma
Iji gbochie Cakecakia coma n'ihi lactic acidosis, ọ dị mkpa iji gbochie hypoxia ma nwee ikike ịchịkwa usoro shuga.
Lactic acidosis, ihe mgbaàmà nke nwere ike ịpụta mgbe a na-eji biguanides, chọrọ mkpebi nke ọgwụ ha na nkwụsị ngwa ngwa ma ọ bụrụ na ọ bụ oria, dịka ọmụmaatụ, ka oyi baa.
Lactic acidosis nwere akara na ọdịdị nke usoro mgbochi, yabụ, ndị ọrịa mamịrị n'iji biguanides ga-eburu nke a n'uche mgbe ha na-eme ọgwụgwọ.
Ọ bụrụ na enwere enyo ọ bụla na-egosi na lactic acidosis, ị kwesịrị ịkpọtụrụ endocrinologist ozugbo.
