N'ikwu okwu banyere nsogbu dị ize ndụ nke ọrịa shuga nwere ike ibute, mmadụ enweghị ike ịkwụsị ịkọ laos acidosis. Ọrịa a na - adịkarị obere, enwere ike ibute ya afọ iri abụọ na - arịa ọrịa shuga bụ 0.06%.
Ihe dị ka ọkara nke ndị ọrịa “nwere ihu ọma” ịdaba na irighiri ihe ndị a pasent, lactic acidosis na-egbu egbu. A na-akọwapụta oke ọnwu dị elu site na mmepe ngwa ngwa nke ọrịa na enweghị ihe mgbaàmà doro anya na mbido mbụ. Mara ihe nwere ike ibute lactic acidosis n'ọrịa shuga, otu esi egosipụta onwe ya, yana ihe ị ga - eme ma ọ bụrụ na ị na-enyo enyo ụdị ọrịa a, nwere ike otu ụbọchị ịzọpụta gị ma ọ bụ ndị ị hụrụ n'anya.
Lactic acidosis - gịnị ka ọ bụ
Lactic acidosis bụ imebi metabolism nke glucose, nke na-eduga n'ịba ụba nke acidity ọbara, yana n'ihi nke a, mbibi nke arịa ọbara, pathology nke ọrụ ụjọ, mmepe nke hyperlactacPs coma.
Dị ka ọ na-adịkarị, glucose na-abanye n’ọbara na-abanye n’ime sel ya ma gbaba n’ime mmiri na carbon dioxide. N'okwu a, a na-ewepụta ike, nke na-enye ọrụ niile nke ahụ mmadụ. Na ntụgharị na carbohydrates, ihe karịrị ọgwụ iri na-emetụta ọgwụ na-eme, nke ọ bụla chọrọ ọnọdụ ụfọdụ. Isi enzymes nke na-eme ka usoro a rụọ ọrụ insulin. Ọ bụrụ na, n'ihi ọrịa shuga, ọ ezughị, a na-egbochi iwelata glucose n'oge a na-etolite pyruvate, a gbanwere ya na lactate n'ọtụtụ.
Ọrịa shuga na oke nrụgide ga-abụ ihe mgbe ochie
- Normalization shuga -95%
- Mwepu nke akwara mbufụt - 70%
- Mwepu nke obi ike -90%
- Bibie ọbara mgbali elu - 92%
- Mmụba na ume n'ụbọchị, na-eme ka ụra na-ehi ụra n'abalị -97%
N'ime ndị ahụ siri ike, usoro lactate n'ime ọbara erughị 1 mmol / l, akwara na akụrụ na-arụ ọrụ ya. Ọ bụrụ na oriri nke lactic acid dị n'ọbara karịrị akwara ndị nwere ike iwepu ya, ngbanwe dị na acid acid basement nke ọbara n'akụkụ akụkụ acidicis, na-eduga na mmepe nke lactic acidosis.
Mgbe lactate n'ime ọbara na-agbakọta karịa 4 mmol / l, mmụba nwayọọ nwayọọ na acidity na-aghọ spasmodic. Ọnọdụ insulin na-eme ka ọnọdụ ahụ ka njọ. Ihe ọghọm nke protein na abụba metabolism na-esonye na nsogbu ndị a na-eme n’arụ carbohydrate, ọ̀tụ̀tụ̀ abụba abụba dị n’ọbara na-ebili, ọgwụ ndị mejupụtara ọgwụ ndị ahụ, na-egbu egbu. Ahụ adịghịzi ike nkewapụ nke a okirikiri onwe ya.
Ọbụna ndị dọkịta enweghị ike ime ka ọnọdụ a kwụsị mgbe niile, na-enweghị enyemaka ahụike, ọrịa lactic acidosis siri ike na-anwụ mgbe niile.
Ihe kpatara ọdịdị ahụ
Ọrịa shuga mellitus dị anya site na naanị ihe kpatara mmepe nke lactic acidosis, n'ọkara nke ikpe ọ na - apụta n'ihi ọrịa ndị ọzọ siri ike.
| Ihe ihe egwu | Mmetụta Ọ Na-enwe Onwe Mmiri glucose |
| ọrịa imeju | adịghị ala ala nke ịsacha ọbara site na lactic acid |
| a .ụrụma | |
| arụ ọrụ ezumike | nwa oge nwaputara na sistemu nke lactate |
| nchịkwa intravenous nke ndị ihe dị iche maka nyocha raa-ray | |
| obi obara | ụrọ oxygen na anụ ahụ yana ịba ụba nke lactic acid |
| akụkụ okuku ume na | |
| Ọrịa vaskụla | |
| ụkọ haemoglobin | |
| nchikota ọtutu oria nke na aru aru | mmụba nke lactate n'ihi ọtụtụ ebumnuche - ma nwekwuo njikọta na mkpochapu nke lactic acid. |
| arụ ọrụ na-arụ ọrụ n'ihi agadi | |
| otutu nsogbu ọrịa shuga | |
| nnukwu mmerụ ahụ | |
| ajọ ọrịa na-efe efe | |
| enweghi vitamin C1 na-adighi ala ala | igbochi nke carbohydrate metabolism |
Ihe kachasị dị ize ndụ nke lactic acidosis na ọrịa shuga na-ebilite ma ọ bụrụ na ejikọtara ọrịa a na ihe ndị a dị n'elu.
Metformin, otu n'ime ọgwụ a na-enyekarị maka ọrịa shuga 2, nwekwara ike ibute ọrịa glucose metabolism. Ọtụtụ mgbe, lactic acidosis na-amalite site na ịdoụbiga ọgwụ ókè, na-emeghachi omume n'otu oge ma ọ bụ na-etinye ya n'ahụ n'ihi ọrụ imeju ma ọ bụ akụrụ.
Ihe ịrịba ama nke lactic acidosis na oria 1 na 2 nke ọrịa shuga
Lactic acidosis na-amalitekarị n'ụdị nnukwu. Oge site na nrịbama nke mbụ rue mgbanwe a na - agbanwe agbanwe na ahụ anaghị ewe otu ụbọchị. N'ime ngosipụta mbụ nke lactic acidosis, naanị otu akọwapụtara - myalgia. Nke a bụ mgbu akwara nke a na - eme maka lactate. Onye ọ bụla n'ime anyị nwere mmetụta nke lactic acid mgbe anyị maliteghachi mmega ahụ mgbe ogologo oge gachara. Ihe mmetụta ndị a bụ ihe nkịtị, physiological. Ọdịiche dị na ihe mgbu na lactic acidosis bụ na ọ nweghị njikọ na ibu.
Jide n'aka na ị ga-amụ: >> Metabolic acidosis - gịnị kpatara ị ga-eji tụọ ya ụjọ?
Enwere ike ịpụta ihe mgbaàmà ndị ọzọ nke lactic acidosis na ngosipụta nke ọrịa ndị ọzọ.
Nwere ike hụrụ:
- obi mgbu
- mkpụkpu ume
- iku ume ugboro ugboro
- egbugbere ọnụ na-acha anụnụ anụnụ, mkpịsị ụkwụ, ma ọ bụ aka;
- mmetụta nke afọ ju n’ime afọ;
- nsogbu nke eriri afọ;
- vomiting
- enweghị mmasị
- nsogbu ịrahụ ụra.
Ka ọkwa lactate na-abawanye, ihe ịrịba ama na-ebili nke e ji mara nanị maka nsogbu acidity:
- Mgbalị anụ ahụ iji meziwanye akwara oxygen anụ ahụ na-eduga mkpọtụ, iku ume miri emi.
- N'ihi nkụchi obi, ọsịsọ nsogbu na arrhythmia na-apụta.
- Nnukwu ụkọ nke lactate na-akpalite ọnya akwara.
- Ezigbo nri ụbụrụ ezughi oke na-eme ka ntụgharị nke ike dị n'ụdị na -eme ka ọnụnọ mmadụ pụta ụwa, ihe mgbawa na ahụ ike mmadụ nwere ike ime.
- Mepụta mkpụkọ ọbara, ọtụtụ mgbe na aka na ụkwụ.
Ọ bụrụ na enweghi ike ịkwụsị laos acidosis n'oge a, onye ọrịa nwere ọrịa shuga na-amalite iyịpu.
Cipleskpụrụ nke ịgwọ ọrịa
Mgbe enwetara onye ọrịa mamịrị na enyo enyo na lactic acidosis n'ụlọ ọgwụ, ọ na-ele ọtụtụ usoro:
- Late n'ime ọbara. A na-eme nchọpụta ọrịa ma ọ bụrụ na ọkwa ya dị elu karịa 2.2 mol / L.
- Bicarbonates ọbara. Uru dị n'okpuru 22 mmol / L na-akwado lactic acidosis.
- Acetone na mmamịrị kpebisiri ike ịmata ọdịiche dị n’etiti acidity n’ihi lactic acid na ketoacidosis.
- Ọbara creatinine na-enye gị ohere ịdị iche uremic acidosis.
Ebumnuche bụ isi nke ọgwụgwọ bụ ịhazi acidity ọbara na iwepụ agụụ oxygen.
| Ntuziaka ọgwụgwọ | .Zọ | Njirimara |
| Mbelata acant | Ickwanye sodium bicarbonate | A na-agbakọta usoro onunu ogwu ahụ site na iji eziokwu dị elu, a na-enyocha usoro nchịkwa mgbe niile. A na-eme cardiogram na ọ̀tụ̀tụ̀ ọbara ọ̀tụ̀tụ̀ ọbara ugboro ugboro, a na-anwalekwa electrolytes ọbara. |
| Trisamine intravenia | A na-eji ya kama bicarbonate nwere mmụba siri ike na acidity na ihe ize ndụ nke nkụda obi, nwere mmetụta alkalizing ngwa ngwa. | |
| Nkwụsị nke ntụgharị nke pyruvate na lactate | Methylene acha anụnụ anụnụ | Ihe nwere redox Njirimara ma nwere ike oxidize enzymes abuana ke glucose metabolism. |
| Ọgwụ Hypoxia | Oxygen ọgwụ | A na-ejikwa ikuku ikuku anakwere ikuku ma ọ bụ oxygen extracorporeal. |
| Mmechi nke oke ọgwụ metformin | Gọkọfọ na-a ,ụ, ojiji nke anwansi | A ga-ebu ụzọ rụọ ya. |
| Nkwụsị ọnọdụ siri ike | Ahụ ike | A na-eji dinalysate Lactose na-anaghị akwụ ụgwọ. |
Mgbochi
Iji gbochie lactic acidosis, ịchọrọ nlekọta ahụike gị mgbe niile:
- Mgbe afọ 40 gasịrị, afọ atọ ọ bụla, inye onyinye ọbara dị mkpa iji chọpụta ọkwa nke glucose. Lactic acidosis na-aputa ihe mgbe anaghi acho oria abuo nke abuo, nke putara na odighi ọgwụgwọ.
- Ọrịa shuga na-arịa ya, ịkwesịrị ịgbaso ndụmọdụ dọkịta ahụ, gaa nyocha ahụike iji chọpụta ihe ndị dị ize ndụ maka lactic acidosis.
- Ọ bụrụ na ị na-ewere metformin, gụọ ndepụta nke contraindications dị na ntuziaka ahụ. Ọ bụrụ na otu n'ime ọrịa ndị edepụtara na ya pụta, kpọtụrụ onye na-arịa endocrinologist ozugbo iji kagbuo ma ọ bụ dozie ọgwụ ahụ.
- Agaferela oke usoro ọgwụgwọ Metformin nke edepụtara n’ekwenyeghị dọkịta, ọ bụrụgodị na ego ịkwụ ụgwọ maka ọrịa shuga ezughi oke.
Ọ bụrụ na ị na-enweta mgbaàmà ndị yiri ya na ngosipụta nke lactic acidosis, ịkwesịrị ịkpọ ụgbọ ihe mberede. Njem nnwere onwe nke dọkịta na-aga ma ọ bụ ịnwe ịnagide ọrịa ahụ n'onwe gị nwere ike ịkwụsị n'ụzọ dị mwute.
