Kuyini i-lactic acidosis futhi yini izimpawu zalokhu kuhlanganiswa kwesifo sikashukela - imibuzo evame ukuzwakala kakhulu ezigulini ze-endocrinologist. Imvamisa lo mbuzo ubuzwa yiziguli ezihlushwa uhlobo lwesibili sikashukela.
I-Lactic acidosis kusifo sikashukela iyinkimbinkimbi yesifo. Ukuthuthukiswa kwe-lactic acidosis kushukela kungenxa yokuqongelela kwe-lactic acid kumaseli wezitho nezicubu ngaphansi kwethonya lokuqina komzimba emzimbeni noma ngaphansi kwesenzo sezinto ezifanele kumuntu okuvusa ukukhula kwezinkinga.
Ukutholwa kwe-lactic acidosis kushukela kuyenziwa ngokubona kwe-lactic acid egazini lomuntu. I-Lactic acidosis inesici esiyinhloko - ukuqoqwa kwe-lactic acid esegazini kungaphezu kwe-4 mmol / l futhi ububanzi be-ion buyi-10.
Kumuntu ophile kahle, i-lactic acid ikhiqizwa ngamanani amancane nsuku zonke ngenxa yezinqubo ze-metabolic emzimbeni. Le khompiyutha icutshungulwa ngokushesha umzimba yi-lactate, okuthi, ngokungena esibindini, iqhubeke nokuqhutshwa ngokuqhubekayo. Ngezigaba eziningana zokucutshungulwa, i-lactate iguqulwa ibe yi-carbon dioxide namanzi noma ibe ushukela ngokuvuselelwa kanyekanye kwe-anic ye-bicarbonate.
Uma umzimba uqongelela i-lactic acid, i-lactate iyayeka ukukhishwa bese kusetshenzwa yisibindi. Lesi simo siholela eqinisweni lokuthi umuntu uqala ukukhulisa i-lactic acidosis.
Kumuntu ophilile, inani le-lactic acid esegazini akufanele lidlule inkomba engu-1.5-2 mmol / L.
Izimbangela ze-lactic acidosis
Imvamisa, i-lactic acidosis iba nohlobo 2 lwesifo sikashukela ezigulini, ezihlaselwe yisizinda sesifo esiyisisekelo, ngemuva kokuthola lesi sifo.
Izizathu ezinkulu ezibangela ukuthuthukiswa kwe-lactic acidosis emzimbeni yilezi ezilandelayo:
- ukulamba kwe-oxygen yezicubu nezitho zomzimba;
- ukuthuthukiswa kwe-anemia;
- ukopha okuholela ekulahlekelweni kwegazi okukhulu;
- ukulimala kwesibindi okunzima;
- ukuba khona kokwehluleka kwezinso, ukuthuthukisa ngenkathi uthatha i-metformin, uma kunophawu lokuqala kusuka kuludwe olubekiwe;
- ukuzikhandla okukhulu ngokomzimba emzimbeni;
- ukuvela kwesimo sokushaqeka noma i-sepsis;
- ukuboshwa kwenhliziyo;
- ukuba khona komzimba wesifo sikashukela esingalawulwa futhi uma kwenzeka kuthathwa isidakamizwa sikashukela;
- ukuba khona kwezinkinga ezithile zikashukela emzimbeni.
Ukuvela kwe-pathology kungatholakala kubantu abaphilile ngenxa yomthelela emzimbeni womuntu wezimo ezithile nasezigulini ezinesifo sikashukela i-mellitus.
Imvamisa, ubisi lwe-acidosis luba kushukela lapho kuphambana nenkambo yesifo sikashukela esingalawulwa.
Kumuntu onesifo sikashukela, lesi simo somzimba siyinto engathandeki kakhulu futhi siyingozi, ngoba kulesi simo kungaqalwa ikoma lactacidic.
I-lactic acid coma ingaholela ekufeni.
Izimpawu nezimpawu zezinkinga
Ku-diabetes lactic acidosis, izimpawu nezimpawu zingaba ngale ndlela elandelayo:
- ukungazi kahle;
- ukubonakala kwesiyezi;
- ukulahleka kwengqondo;
- ukubonakala komzwa wokucanuzelelwa kwenhliziyo;
- ukubonakala kwezifiso zokuhlanza nokuzihlanza;
- ukuphefumula kaningi nokujulile;
- ukubonakala kobuhlungu esiswini;
- ukubonakala kobuthakathaka obukhulu emzimbeni wonke;
- ukwehla kwezimoto;
- ukuthuthukiswa kwe-lactic coma ejulile.
Uma umuntu enohlobo lwesibili lwe-mellitus yesifo sikashukela, khona-ke ukugeleza ku-lactic acid coma kubonwa isikhathi esithile ngemuva kokuvela kwezimpawu zokuqala zokuxakaniseka.
Lapho isiguli siwohloka,:
- hyperventilation;
- ukukhuphuka kwe-glycemia;
- ukwehla kwenani lama-bicarbonate ku-plasma yegazi kanye nokwehla kwe-pH yegazi;
- kutholakala inani elincanyana lama-ketones emchameni;
- Izinga le-lactic acid emzimbeni wesiguli linyukela ezingeni le-6.0 mmol / l.
Ukudideka kukhula kakhulu futhi isimo somuntu onenkinga yesifo sikashukela sohlobo 2 sikhula kancane kancane amahora amaningi alandelanayo.
Izimpawu ezihambisana nokwakhiwa kwale nkinga ziyafana nalezo ezinye izingqinamba, futhi isiguli esinesifo sikashukela singawela ekhefini elinezishukela eziphansi neziphezulu emzimbeni.
Konke ukuxilongwa kwe-lactic acidosis kususelwa ekuhlolweni kwegazi elebhu.
Ukwelashwa nokuvimbela i-lactic acidosis lapho kukhona isifo sikashukela
Ngenxa yokuthi le nkinga ngokuyinhloko ibangelwa ukuntuleka komoya-mpilo emzimbeni, izindlela zokwelapha zokususa umuntu kulesi simo ngokuyinhloko zisekelwe ohlelweni lokuphefumula kwamangqamuzana nezicubu zomuntu. Ngale njongo, kusetshenziswa imishini yokufaka umoya wamaphaphu yokufakelwa.
Lapho ususa umuntu esimweni se-lactic acidosis, umsebenzi oyinhloko kadokotela ukukhipha i-hypoxia evele emzimbeni, ngoba yikho ngqo lokhu okuyimbangela eyinhloko yokwakhiwa kwe-lactic acidosis.
Ehlelweni lokusebenzisa izindlela zokwelapha, ingcindezi nazo zonke izimpawu ezibalulekile zomzimba zigadwe. Ukulawulwa okukhethekile kwenziwa lapho abantu asebekhulile besuswa kuhulumeni we-lactic acidosis, abahlushwa umfutho wegazi ophakeme futhi babe nezinkinga nokuphazamiseka kwesibindi.
Ngaphambi kokuba isiguli sitholakale sine-lactic acidosis, igazi kufanele lithathwe ukuze lihlaziywe. Ngenqubo yokwenza ucwaningo lwelabhoratri, i-pH yegazi nokuxineka kwama-ion e-potassium kuyo kunqunywa.
Zonke izinqubo zenziwa ngokushesha okukhulu, ngoba ukubulawa kwabantu kusukela ekukhuleni kwengxaki enjalo emzimbeni wesiguli kuphezulu kakhulu, futhi isikhathi soguquko kusuka esimweni esivamile sisiya kwesinye se-pathological sifushane.
Uma kutholakala amacala abucayi, i-potassium bicarbonate iyalawulwa, lo muthi kufanele uphathwe kuphela uma i-acidity engaphansi kwe-7.
I-acid acidity ihlolwa isiguli njalo emahoreni amabili. Ukwethulwa kwe-potassium bicarbonate kufanele kwenziwe kuze kufike isikhathi lapho i-medium izoba ne-acidity engaphezu kwe-7.0.
Uma isiguli sinehluleki sezinso, kwenziwa i-hemodialysis yezinso. Ngokwengeziwe, i-peritoneal dialysis ingenziwa ukubuyisela izinga elijwayelekile le-potassium bicarbonate emzimbeni.
Ehlelweni lokususa umzimba wesiguli ku-acidosis, kusetshenziswa i-insulin yokwelashwa okwanele kanye nokuphathwa kwe-insulin, inhloso yayo ukulungisa umzimba we-carbohydrate metabolism.
Ngaphandle kokuhlolwa kwegazi okune-biochemical, akunakwenzeka ukuthola ukutholwa kwesiguli okuthembekile. Ukuvimbela ukukhula kwesimo se-pathological, isiguli siyadingeka ukuletha izifundo ezidingekayo esikhungweni sezokwelapha lapho kuvela izimpawu zokuqala ze-pathology.
Ukuze uvimbele ukukhula kwe-lactic acidosis emzimbeni, isimo se-carbohydrate metabolism emzimbeni wesiguli esinesifo sikashukela kufanele silawulwe ngokucacile. Ividiyo ekulesi sihloko ikhuluma ngezimpawu zokuqala zesifo sikashukela.
