Isifo sikashukela yisifo esingelapheki lapho iziguli eziningi zifaka i-insulin emizimbeni yazo impilo yonke. Ungasithola lesi sifo usebenzisa izimpawu eziningi zesimo. Ngaphezu kwalokho, ezinye zezimpawu ezihlaba umxhwele kakhulu ze-carbohydrate metabolism yimizimba ye-ketone.
I-urine acetone kushukela iyatholakala uma ingalashwa. Kulokhu, iphunga elingajabulisi lingaqhamuka emlonyeni ngisho nasezikhunjeni zesiguli. Isibonakaliso esinjalo singakhombisa ukuthuthukiswa kwezinkinga zesifo esiholayo, ngakho-ke, ukwelashwa okufanele kufanele kwenziwe ngokushesha okukhulu.
I-glucose ingumthombo oyinhloko wamandla kubantu. Ukuze ibonwe ngamaseli omzimba, kudingeka i-insulin, ekhiqizwa ngamanyikwe. Kepha ngesifo sikashukela sohlobo 1, lesi sitho siyayeka ukufeza imisebenzi yaso, yingakho isiguli sithuthukisa i-hyperglycemia engapheli.
Ngenxa yalokhu, amangqamuzana abona indlala kanye nenani elidingakalayo lezakhi zomsoco akungeni ebuchosheni, futhi isiguli sanda ngokwanda koshukela begazi. Kepha kungani i-acetone itholakala umchamo kushukela?
Yini ebangela i-ketonuria?
Ukuqonda ukwakheka kokubonakala kwe-acetone kumchamo kushukela, kufanele wazi ukuthi imizimba ye-ketone ingumqondo ojwayelekile oqukethe izinto ezintathu:
- propanone (acetone);
- i-acetoacetate (acetoacetic acid);
- I-B-hydroxybutyrate (beta-hydroxybutyric acid).
Futhi, lezi zingxenye ziyimikhiqizo yokuqhekeka kwamaprotheni namafutha endo native. Izimbangela zokuvela kwazo egazini nomchamo zihlukahlukene. Lezi kungaba yizinkinga zokudla okunempilo, njengokudla okune-carb ephansi noma indlala. Ngaphezu kwalokho, i-acetone yesifo sikashukela iyatholakala esimweni sokubola lesi sifo.
Ezinye izimbangela ze-ketonuria:
- ukushisa ngokweqile;
- isifo sohudo nokuhlanza, okuphikelelayo isikhathi eside;
- ukomisa;
- ubuthi bamakhemikhali;
- inkambo yezifo ezinzima ezithathelanayo ngokuphelelwa amandla emzimbeni.
Uma sikhuluma ngokwehluleka kwe-carbohydrate metabolism, khona-ke i-acetone yomchamo kwisifo sikashukela ivela phambi kwezimo ezimbili ezihlukile. Owokuqala yi-hyperglycemia, eyenzeka ngokuntuleka kwe-insulin, lapho ushukela omningi ungangenwa amaseli obuchopho. Kulokhu, ukuqhekeka kwamaprotheni namafutha kwenzeka, okuholela ekwakhekeni kwezidumbu ze-ketone, isibindi ezingakwazi ukubhekana nazo, futhi zingena ngomchamo, zinqobele izinso.
Esimweni sesibili, i-ketonuria yenzeka ngokumelene nesizinda se-hypoglycemia, esivele lapho kunokushoda kwe-glucose uma kwenzeka ukungondleki kahle kwe-insulin noma ngokweqile.
Izizathu zile futhi ekushoda kwe-hormone eguqula ushukela ube amandla, ngakho-ke umzimba uqala ukusebenzisa ezinye izinto.
ISymbomatology
Njengomthetho, ukubonakaliswa kwe-ketoacidosis kuthuthukisa izinsuku ezimbalwa. Kulokhu, isimo sesiguli siya ngokuya siba sibi, futhi isithombe somtholampilo siba sobala ngokwengeziwe:
- ukukhathala;
- ikhanda
- umoya we-acetone;
- ukomiswa kwesikhumba;
- ukoma
- ukungasebenzi kahle kwenhliziyo (i-arrhythmia, palpitations);
- ukuncipha;
- ukulahleka kwengqondo;
- ukukhubazeka kwenkumbulo;
- ukugxilisa ingqondo.
Ngaphezu kwalokho, ukuphazamiseka kwe-dyspeptic kuyaphawulwa. Futhi, esigabeni sokuqala sokukhula kwe-ketoacidosis, inani eliningi lomchamo liyagcinwa, futhi kuthi lapho sekufika isikhathi eside, ukuchama, kunalokho, kungabikho.
Kuyaphawuleka ukuthi i-ketonuria ivame ukutholwa ngesikhathi sokukhulelwa. Isibonelo, lokhu kwenzeka ngesifo sikashukela sokukhulelwa, lapho umzimba we-carbohydrate metabolism uphazamiseka. Imvamisa lesi simo siyisandulelo ekuthuthukisweni kwesifo sikashukela ngemuva kokubeletha.
Izimpawu zokuba khona kwe-acetone emzimbeni we-fluid kuhlobo loku-1 nohlobo 2 lwesifo sikashukela kuya ngokuqina kwe-metabolic acidosis. Ngefomu elithambile, isifiso sokudla sesiguli siyanyamalala, izinhlungu zivela ekhanda nasiswini. Uhlushwa ukoma, isicanucanu nesiyezi. Kulesi simo, kuzwakala iphunga eliphela amandla le-acetone ephuma emlonyeni, futhi isiguli sivame ukuya endlini yangasese siyochama.
Izinga eliphakathi kwe-ketoacidosis libonakaliswa yi-hypotension, Ubuhlungu besisu, isisu kanye nokushaya kwenhliziyo okuqinile. Ngenxa yokuphazamiseka ekusebenzeni kwe-NS, ukusabela kwezimoto kuhamba kancane, abafundi empeleni abasabeli ngokukhanya, nokwakheka komchamo kuyancipha.
Isigaba esinzima sihambisana nokuphefumula okuqinile kwe-acetone, ukufoka, nokujulile, kepha ukuphefumula okuqabile. Kulokhu, abafundi bayayeka ukuphendula ukukhanya, futhi imisipha ikhombisa ukuhamba kancane. Ukuchama kuyancishiswa noma akekho ngokuphelele.
I-degree yesithathu ye-ketoacidosis iholela eqinisweni lokuthi izinkomba ze-glucose ziphezulu ngaphezu kwama-20 mmol / l, isibindi sesiguli sikhuphuka ngosayizi. Kodwa-ke, ulwelwesi lwalo nolwelwesi lwesikhumba loma ngaphandle.
Uma ungasebenzisi ukwelashwa okusheshayo kohlobo lwesifo sikashukela sohlobo 2 kanye nesifo esincike ku-insulin, kungavela i-ketoacidotic coma enezindlela ezihlukile zokuthuthuka:
- Inhliziyo - kuboniswa ngobuhlungu enhliziyweni kanye nomfutho wegazi ophansi.
- Isisu - kwenzeka ngezimpawu ezinzima ezihambisana nomgudu wokugaya ukudla.
- I-Encephalopathic - ithinta ukujikeleza kwe-cerebral, ehambisana nesiyezi, isicanucanu, ikhanda kanye nokukhubazeka okubukwayo.
- I-Renal - ekuqaleni kunokuchithwa okuchichimayo komchamo, kepha kamuva inani layo liyancipha.
Ngakho-ke, i-acetone kushukela ayinangozi enkulu emzimbeni wesiguli, kodwa ibonisa ukuntuleka kwe-insulin noma i-hyperglycemia. Ngakho-ke, lesi simo asithathwa njengesijwayelekile, kepha akusona ukuphambuka okubalulekile. Ukuvimbela ukuthuthukiswa kwe-ketoacidosis, kuyadingeka ukuthi ngaso sonke isikhathi kuqashwe i-glycemia futhi ihlolwe udokotela oyi-endocrinologist.
Ngaphandle kwalokho, ukuntuleka kwamandla kuzoholela ekufeni kwe-neurocytes ebuchosheni nasemiphumeleni engenakuphikwa.
Futhi lesi simo sizodinga ukulaliswa esibhedlela ngokushesha, lapho odokotela bezolungisa khona izinga le-pH.
Yiziphi izivivinyo okufanele zithathwe nge-acetone?
Kunezinhlobo eziningi zezifundo ezithola ama-ketones angenziwa ekhaya noma elebhu. Umtholampilo wenza ukuhlaziywa kwegazi nomchamo ngokujwayelekile nangokuphathelene nezinto eziphilayo. Futhi ekhaya, imichilo yokuhlola iyasetshenziswa, eyehliselwa umchamo, emva kwalokho ishintsha umbala ngaphansi kwethonya le-acetone.
Ukuqoqwa kwezinto ze-ketone kunqunywa inani le-pluses. Uma kunophawu olulodwa kuphela, khona-ke okuqukethwe kwe-propanone akukho ngaphezu kwe-1.5 mmol / l, okuthathwa njengefomu elinamandla le-ketonuria. Lapho kufakwa i-plus yesibili, i-acetone efinyelela ku-4 mmol / L, ehambisana nokuphefumula okubi. Kulokhu, ukubonisana nge-endocrinologist sekudingekayo.
Uma ama-pluses amathathu avele ngemuva kokuhlolwa, khona-ke izinga le-acetone liyi-10 mmol / L. Lesi simo sidinga ukulashwa okuphuthumayo kwesiguli.
Ubuhle bemichilo yokuvivinya intengo yabo ephansi nokufinyeleleka.
Kodwa-ke, abanesifo sikashukela kufanele bazi ukuthi ukuzithiba kwamazinga we-urone we-urone akubhekwa njengento ehlukile ekuhlolweni kwelebhu.
Ungakuguqula kanjani ngokwejwayelekile ukuhlangana kwezinto ze-ketone emchameni?
Ukuba khona kwezidumbu ze-ketone emanzini omzimba kungakhombisa uhlobo lokuqala lwesifo sikashukela. Kulokhu, ukwelashwa kwe-insulin efanelekile kuzosiza ukususa i-acetone. Ngemuva kwakho konke, imijovo ejwayelekile ye-hormone ku-dosage efanele igcwalisa amaseli nge-carbohydrate, ekuvumela ukuthi ukhiphe kancane kancane i-acetone.
Ngeshwa, i-mellitus encike kwisifo sikashukela idinga ukuphathwa kwe-insulin impilo yonke. Kepha ukukhula kwayo kungavinjelwa uma umuntu engenabo ubuhlakani bokusungula ifa. Ngakho-ke, ukwelashwa kwe-ketononuria kuqukethe ukuvimbela kwayo, okusho ukuhambisana nemithetho eminingana:
- umsebenzi ojwayelekile kodwa olinganiselayo;
- ukwenqaba ukulutha;
- umsoco olinganiselayo;
- isigaba esifike ngesikhathi sokuhlolwa okuphelele kwezokwelapha.
Kepha ungasusa kanjani i-acetone ngosizo lwemithi nezinye izindlela zokwelapha? Ngale njongo, izidakamizwa ezinjengeMethionine, Cocarboxylase, Splenin, Essentiale zingabekwa.
Ngoshukela ongaxekile ku-insulin, ukuvuselela emzimbeni, ukuvuselela ibhalansi ye-acid, ukulawulwa kwe-glycemic kanye nokwelashwa kwe-antibacterial kusiza ukususa i-acetone. Lezi zinyathelo zifaka isandla ekubuyiselweni kwe-carbohydrate metabolism, futhi zinciphisa nokuxineka, bese zisusa ama-ketones egazini.
Uma i-ketoacidosis yesifo sikashukela ithuthukile, khona-ke ukwelashwa kuhloselwe ukuxazulula izinkinga ezimbili. Owokuqala ukuqala kabusha kwe-plasma osmolality, electrolyte kanye ne-intravascular metabolism. Umgomo wesibili wokwelashwa ukulungisa umthamo we-insulin ngokuvimbela kokukhiqizwa kwamahomoni ajwayelekile, ukwandisa ukusetshenziswa nokukhiqizwa kweglucose ne-ketogeneis.
Ngenxa yokushoda okunamandla okuvela kwe-extracellular and intracellular fluid, kunesidingo sokwelashwa kwe-infusion. Okokuqala, isiguli sifakwa nge-1-2 l yesisombululo sikasawoti se-isotonic kungakapheli ihora. Ilitha lesibili lezimali liyadingeka uma kune-hypovolemia enzima.
Ukube lezi zindlela bezingasebenzi, isiguli sifakwa ngesisombululo se-saline esejwayelekile. Lokhu kukuvumela ukuthi ulungise i-hypovolemia futhi wenze ngokwejwayelekile i-hyperosmolarity. Le nqubo iyaqhubeka kuze kube yilapho ivolumu ye-intravascular ibuyiselwe ngokuphelele noma ukufundwa kwe-glucose kwehle ku-250 mg.
Ngemuva kwalokho kwethulwa isixazululo se-glucose (5%), esinciphisa ubungozi bokuthola i-edema yamakhemikhali kanye ne-insulin hypoglycemia. Kanye nalokhu, imijovo ye-insulin ebamba amafushane iyaqala, bese idluliselwa ekufakweni kwayo okuqhubekayo. Uma kungenzeka ukuthi kungabikho ukuphathwa kwe-intravenous kwe-hormone, lesi sidakamizwa sikhishwa ngendlela efanelekile.
Isifo sikashukela kufanele sikhumbule ukuthi le misebenzi kumele. Ngemuva kwakho konke, ukungasuswa kwe-acetone kungaholela ekwakhiweni kwesifo sikashukela, esivame ukuphela ngo-edema we-cerebral nokufa okulandelayo.
Ungayisusa kanjani i-acetone emzimbeni ngokudla? Okokuqala, isiguli kufanele silahle imikhiqizo ethile ekhulisa okuqukethwe kwama-ketones:
- inhlanzi, amakhowe, amasobho amathambo;
- ukubhema inyama;
- i-crayfish kanye nezinhlanzi zasemfuleni (ngaphandle kwe-pike ne-pike perch);
- izithelo ezimuncu namajikijolo;
- marinade kanye ukhukhamba;
- amasoseji;
- icala;
- noma yikuphi ukudla okunamafutha, kufaka phakathi ushizi;
- ezinye izinhlobo zemifino (i-rhubarb, utamatisi, isipinashi, i-pepper, i-sorrel, isitshalo seqanda);
- ama-buns kanye nobuthakathaka obuhlukahlukene;
- iziphuzo ezinekhofi nekhofi, ikakhulukazi okumnandi.
Kufanele futhi ubeke umkhawulo ekusetshenzisweni kokudla kwasolwandle, imidumba, inyama ekheniwe, pasta, ukhilimu omuncu nobhanana. Okubaluleke kakhulu yizinhlobo ezinamafutha amancane enyama nezinhlanzi, ezingabanjiswa noma ziboshwe kuhhavini.
Ngokuphathelene nesobho, ukukhetha kufanele kunikezwe kuma-broths zemifino. Futhi kuvunyelwe ukusetshenziswa kwamabele, imifino, izingcweti zezithelo namajusi.
Okufanele ukwenze lapho uthola i-acetone kumchamo kuzotshela uchwepheshe kuvidiyo ekulesi sihloko.
