YINI I-LACTIC ACIDOSIS FUTHI IHLANGANA KANJANI NESIFO SIKASHUKELA?

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Ukukhiqizwa okwandisiwe noma ukusetshenziswa okwehlisiwe kwe-lactic acid kuholela ekwehliseni okukhulu kokulingana kwe-acid emzimbeni. Le "acidization" icasula isimo esibucayi se-pathological - lactic acidosis.

Ngabe kuqhamukaphi i-lactate ngokweqile?

I-Glucose metabolism inqubo eyinkimbinkimbi, umsebenzi wayo okungewona kuphela ukugcwala komzimba "ngamandla", kodwa futhi nokuhlanganyela "kwinqubo yokuphefumula yamaseli."

Ngaphansi kwethonya lama-biochemical catalysts, i-molecule ye-glucose iyabola futhi yakhe ama-molecule amabili e-pyruvic acid (pyruvate). Ngomoya-mpilo owanele, i-pyruvate iba yinto yokuqala yezinqubo ezibaluleke kakhulu ze-metabolic esitokisini. Uma kwenzeka indlala i-oxygen iphenduka i-lactate. Inani elincane laso liyadingeka emzimbeni, i-lactate ibuyiselwa esibindini iguqulwe ibuyele kushukela. Lokhu kwakha isitoko secebo le-glycogen.

Imvamisa, isilinganiso se-pyruvate ne-lactate singu-10: 1, ngaphansi kwethonya lezinto zangaphandle, ibhalansi ingashintsha. Kunesimo esisongela impilo - lactic acidosis.

Izici ezikhuthaza ukwanda kokuhlungwa kwe-lactic acid zifaka:

i-izicubu hypoxia (ukushaqeka ubuthi, ubuthi bekhabhoni dayokthokho, i-anemia enamandla, isithuthwane);
indlala ye-oxygen engeyona izicubu (enobuthi nge-methanol, i-cyanides, i-Biguanides, ukwehluleka kwe-renal / kwesibindi, i-oncology, izifo ezinzima, isifo sikashukela).

Ukwanda okubucayi kwezinga le-lactic acid emzimbeni isimo esidinga ukulashwa ngokushesha, esibhedlela. Kuze kube yi-50% yamacala akhonjwayo ayabulala!

Izimbangela ze-Diabetesic Lactic Acidosis

I-Lactic acidosis yinto eyivelakancane, kanti ngaphezu kwesigamu samacala abikiwe enzeka kubantu abanesifo sikashukela.

I-Hyperglycemia iholela eqinisweni lokuthi ushukela omningi egazini uguqulwa ngokuqinile yi-lactic acid. Ukushoda kwe-insulin kuthinta ukuguqulwa kwe-pyruvate - ukungabi bikho komsuka wemvelo kuholela ekwandeni kokuhlanganiswa kwe-lactate. Ukuwohloka okuqhubekayo kunomthelela kuma-hypoxia okungama-cell, kubandakanya izinkinga eziningi (izinso, isibindi, uhlelo lwenhliziyo) okwandisa indlala ye-oksijini.

Ingxenye enkulu yokubonakaliswa kwe-lactic acidosis yenzeka kubantu abathatha izidakamizwa ze-hypoglycemic. Ama-biguanides wesimanje (metformin) awabangeli ukugcwala okuqhubekayo kwe-lactic acid emzimbeni, noma kunjalo, uma kwenzeka izinto eziningana ezisikhathazayo (izifo ezithathelwanayo, usizi, ubuthi, ukuphuza utshwala, ukuzikhandla ngokweqile komzimba), zingaba nomthelela esimweni sokugula.

Izimpawu ze-lactic acidosis kushukela

Izithombe ezijwayelekile zokuboniswa ziyefana nangoshukela wegazi ophakeme

Ukomela, ubuthakathaka, ukukhathala, ukusindeka emilenzeni kuyabhekwa, isicanucanu, ukuhlanza okuvame ukwenzeka. I-Lactic acidosis iyingozi ngoba ikhula ngokushesha emahoreni ambalwa nje. Ngemuva kwezimpawu ezijwayelekile zesifo sikashukela, isifo sohudo, ukugabha, nokudideka kuvela ngokushesha. Ngaso leso sikhathi, azikho izidumbu ze-ketone emchameni, akukho phunga le-acetone.

I-Lactic acid coma ingenye eyingozi kakhulu, ukuvezwa kwendlela yokuphuma kwayo akulungile!

Uma imivimbo yokuhlolwa kokuzimisela okubonakalayo kwe-ketoacidosis nezinga le-glucose ibonisa kuphela ushukela ophakeme, kuyilapho kunobuhlungu bemisipha, kufanele ushayele i-ambulensi ngokushesha! Uma ungathathi noma yisiphi isinyathelo futhi uzama ukumisa lesi simo ngokwakho, khona-ke ukwehla okukhulu komfutho wegazi, ukuphefumula okungajwayelekile futhi okunomsindo, ukwephula isigqi senhliziyo, kuzolandelwa yi-coma.

Umehluko omkhulu phakathi kwe-lactic acidosis ne-ketoacidosis noma i-hyperglycemia ebukhali ukuba khona kobuhlungu emisipha, okuvame ukuqhathaniswa nemisipha evalekile yabasubathi.

I-Hyperlactatacidemia Ukwelashwa

Ukuxilongwa kwe-lactic acidosis kungenziwa kuphela ngokuhlolwa kwelebhu. Okokuqala, bazama ukuhlukanisa i-acidosis. Amazinga we-Serum lactate kusuka ku-5.0 mmol / L no-ph ngaphansi kuka-7.25 akuvumela ukuthi ngokusobala uthole ubuthi be-lactic acid emzimbeni. Izinga le-acid-base ngaphansi kwe-6.8 libucayi.

Ukwelashwa kuqukethe ukubuyisela ibhalansi ye-acid-base, kuqedwe izimbangela ze-hyperglycemia

Uma i-ph ingaphansi kuka-7.0, okuwukuphela kwendlela yokusindisa isiguli yi-hemodialysis - ukuhlanzwa kwegazi.
Ukuqeda i-CO2 eyeqile, i-hyperventilation yamaphaphu eyodingeka.
Ezimweni ezinobuncane, ngokufinyelela okufika ngesikhathi kochwepheshe, i-dropper ene-solution ye-alkaline (sodium bicarbonate, trisamine) kwanele. Izinga lokuphatha lincike ekucindezelweni okuphakathi kwe-venous. Lapho imetabolism yakho isithuthukisiwe, ungaqala ukwehlisa izinga le-lactate yegazi lakho. Kulokhu, kusetshenziswa izikimu ezahlukahlukene zokuphatha isisombululo se-glucose nge-insulin. Njengomthetho, lokhu kuyunithi 2-8. ngejubane le-100-250 ml / h.
Uma isiguli sinezinye izinto ezihlotshaniswa ne-lactic acidosis (ubuthi, i-anemia), ukwelashwa kwabo kwenziwa ngokwemigomo ye-classical.

Cishe akunakwenzeka ukunikeza usizo lokuqala lwezimpawu ze-lactic acidosis. Ukwehlisa i-acidity yegazi ngaphandle kwesibhedlela ngeke kusebenze. Izisombululo zamaminerali ze-alkaline nezishukela azizoholela kumphumela oyifunayo. Ngomfutho wegazi ophansi noma ukushaqeka, ukusetshenziswa kwe-dopamine kunobulungiswa. Kuyadingeka ukuqinisekisa ukugeleza komoya okuphezulu, lapho kungekho khona umgodi we-oksijini noma i-inhaler, ungavula umswakama futhi uvule wonke amawindi.

I-prognosis yokutakula kusuka ku-lactic acidosis imbi. Ngisho nokwelashwa okwanele nokufinyelela okufika ngesikhathi kodokotela akuqinisekisi ukonga impilo. Ngakho-ke, abanesifo sikashukela, ikakhulukazi labo abathatha i-metformin, kufanele balalele ngokucophelela imizimba yabo futhi bagcine amazinga abo kashukela ebangeni eliqondisiwe.

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