Izimbangela kanye nendlela yokukhula kwe-ketonuria

Lokhu kudalulwa kunikezwe isifo esingumphumela wento ethile - ukuvela kwesimo se-ketonemia (aka acetonemia) - ukuvela kwegazi le-acetone (ketone) compounds.

Ngenxa yokuhlunga kwegazi izinso, i-acetone ngokungenakunqotshwa ingena kumchamo, otholakala kalula elabhorethri kunasegazini.

Lokhu kunikeza isizathu sokucabanga kokuba khona kwesifo sikashukela nezinye izimo lapho leli khompiyutha elilula lingena esigangeni lapho ukuba khona kwalo kungafanele ngokuphelele.

Kuyini ketonuria?

I-Acetone iyinto esebenza futhi enolaka kakhulu, ngenxa yezakhi ze-molecule yayo, ivele ikwazi ukungaphazamisi ngesikhathi sokutholwa ngamakhemikhali.

Nemiphumela efanayo ebangela ukwaneliseka lapho wenza imisebenzi yasendlini (i-dilizing paintened thick), ibangela ukukhathazeka okusemthethweni uma kukhulunywa ngezinqubo zamakhemikhali ngaphakathi emzimbeni. Ngokukhululeka okufanayo lapho i-acetone isusa khona ibala elinamafutha ezingutsheni, ichitha ama-lipid kumakhompiyutha e-organic womzimba, ayinandaba nhlobo nombono wakhe ngale ndaba, futhi ikwazi ukwenza nezinkinga eziningi ezahlukahlukene.

Emzimbeni ojwayelekile, onempilo, ukuba khona kwe-acetone esegazini kungavezwa yigama: ubukhona bomsuka wento, kuba igazi yi-1-2 mg / 100 ml, komchamo - ungadluli ku-0,01-0.03 g ngevolumu yansuku zonke. Kafushane nje, lo mbala awuhlali isikhathi eside kungaba ekwakhekeni kwegazi noma komchamo, uhamba nalo, noma ngesithukuthuku, noma nomoya osuswe ngamaphaphu.

Kodwa-ke, kwezinye izimo, asisakhulumeli ngomkhondo wento emzimbeni, kepha mayelana nomphumela onobuthi kuyo, ngoba womabili amazinga ayo egazini nokuqukethwe kuwo umchamo akhuphuka kakhulu (okuholela kokuvela kwesigameko se-ketonemia ne-ketonuria).

Izimbangela nezimpawu ze-pathology

I-Ketonuria, engabalulekile futhi engenangozi emzimbeni, ingaba ngumphumela wezimbangela zemvelo:

• umlutha ngokweqile emikhiqizweni yobisi ebilisiwe, ukudla okunobunzima obuningi bokwehla amaprotheni namafutha, kepha ngokuntuleka kwama-carbohydrate;
• ukuphuza utshwala.

Njengoba imizimba ye-ketone esegazini (ebusweni be-acetone, acetoacetic ne-ꞵ-hydroxybutyric acid) ivela ngenxa yezinqubo ezenzeka esibindini (ukuwohloka kwe-glycogen), ukunqwabelana kwawo egazini nokuningi emchameni kungenzeka kube umphumela wokungasebenzi kwawo.

Ezinye izizathu (ngesimo sokunyuka kwesidingo se-glycogen) zifaka zonke izinketho zokuzila noma izimo ezihlobene:

• indlala ngenxa yokuntuleka kokudla okungatheni (noma okubabazekayo) okunempilo, noma indlala yokuzithandela, noma ingxenye ebalulekile yohlelo lokudla komzimba (phakathi kwabasubathi, abakhi bomzimba, ababambelela kunoma iyiphi inkambo yokomoya);
• ukulamba ngenxa yenqubo ye-oncological (umdlavuza wesisu), inkambo yesifo esithathelwanayo;
• ukukhathala ngenxa yokusebenza kanzima komzimba, i-hypothermia engapheli;
• ukulahleka kwezakhi zomzimba uma kungukwephula inqubo yokumuncwa emathunjini, kanye nokukhubazeka kwesisu esishubile nge-stenosis ye-pylorus yakhe noma i-esophagus;
• ngenxa yokuhlanza okuphindaphindiwe noma okujwayelekile (ukuhlanza okungalungile kowesifazane okhulelwe onesifo sokuqina kwesikhumba ngesikhathi sokuqina kwesithambo sofuba), isifo sokuqaqamba kwamakhala.

Amacala we-anemia nesifo sikashukela i-mellitus awela esigabeni esifanayo. Esimweni sokuqala, awekho amaseli ezithwala ngokwanele kwezicubu zezakhamzimba, kwesesibili - izinga lokungaphepheki kweglucose lidinga ukuhanjiswa kwalo kusuka kudepho ye-glycogen esibindini.

Isiqephu se-ketonuria singaba wuphawu:

• ubuthi obunzima (ukuhola, i-phosphoric, ukudakwa kwe-atropine);
• umkhuhlane isikhathi eside;
• isikhathi sokuphila ngemuva kokuhlinzwa (ikakhulukazi ngemuva kwe-chloroform anesthesia).

Isimo se-ketonuria ngenxa yesidingo ngokweqile sama-carbohydrate kanye nesilinganiso esiphakeme sokusebenzisa kwabo sivela nge-thyrotooticosis kanye nezimo ngokugcwala okukhulu kanye nokungahambi kahle kohlelo lwezinzwa oluphakathi:

• hemorrhages of subarachnoid localization;
• ukulimala ekhanda;
• isimo esihle.

Ukuvela kwezifo eziqhamuka ezinjengomkhuhlane obomvu, umkhuhlane noma ukuba khona kwabaningi kakhulu (isifo sofuba, i-meningitis) nakho kuholela ku-acetonuria, kepha akuyona inkomba yokuxilonga kulezi zimo.

I-Ketonuria ku-mellitus yesifo sikashukela ifanelwe ukunakwa ngokukhethekile - ukuba khona kwayo kukhombisa ukwanda kwalesi sifo noma indlela yezimo ezinkulu kakhulu (inkinga ye-acetone noma i-hyperglycemic coma).

Ngakho konke lokhu, ukuba khona kwe-acetonuria eyedwa (ngaphandle kwe-glucosuria ehlanganisiwe - ukulahleka kwe-glucose kumchamo) kukuvumela ukuthi ungafaki ngokuphepha ushukela ohlwini lwezimbangela ezilubangele.

Enye yezizathu ze-ketonuria ubukhona be-hyperinsulinism (noma i-hypoglycemic yesifo) etholakalayo futhi yesibili - isimo lapho ukugcwala ngokweqile kwe-insulin egazini ngokwehla kweglucose kungabangelwa isifo sikashukela mellitus.

Izimpawu ze-ketonuria zifaka nephunga elibukhali le-acetone emabusweni abantu.

Kungaba:

• umoya ophelile;
• umchamo
• ukuhlanza.

Izimpawu ezihambisanayo kubantu abadala ziyadinisa, ukudangala kwengqondo, ukunganaki.

Ezinganeni, lokhu:

• ukwenqaba hhayi kuphela ekudleni, kodwa nasemanzini (ngenxa yesicanucanu njalo);
• Izimpawu zokuphelelwa amandla emzimbeni (ikhanda, ukondleka, ubuthakathaka esikhunjeni esomile nolimi);
• ukuthokozela kwe-psyche, kwathathelwa indawo ukucindezelwa kwayo;
• ukubonakaliswa kwe-spastic esiswini (imvamisa esifundeni se-umbilical);
• isicanucanu
• ukuhlanza okuhambisana nakho konke isiphuzo nokudla;
• ukukhuphuka kokushisa komzimba ngokumelene nesizinda se-pallor yesikhumba esine-blush engathandeki ebusweni;
• ukuphefumula okuphoqelekile kwe-acetone, umchamo nokuqhuma kokuhlanza.

Kwabesifazane abakhulelwe, ukubonakala nokukhula kwalesi sibonakaliso (ngokudla okwanele kanye nokuzivocavoca okwanele komzimba) kukhombisa:

• ukuthuthukiswa kwe-toxicosis;
• ukutheleleka komzimba;
• ubunzima bokugaya;
• ushukela okhulelwe.

Ividiyo yesifo sikashukela sokukhulelwa:

Ngenxa yemiphumela enobuthi ku-fetus, i-ketonemia ne-ketonuria zidinga ukucatshangelwa ngokucophelela nezinyathelo ezifanele zokulawulwa nokuphathwa kwesiguli (okokuqala, ukubuyiselwa kwemali esele).

Ngenxa yobuncane bezindawo zokulondolozwa kwe-glycogen esibindini sengane, ukuncipha kwabo kwenzeka ngokushesha, okuholela ezingxenyeni zokubulawa yindlala ngesidingo sokudicilela phansi amanye amafutha omzimba.

Ukuntuleka noma ukungakwazi kwe-oxidation yabo kubangela i-acetonemia ngokuvela kokuhlanza kwe-acetonemic enephunga elithile lezinto ezinikezwe kusuka ekuhlanzeni.

Ngaphezu kokuphazamiseka kokufakwa kwamaprotheni namafutha (lapho kunokudla ngokweqile), ukubukeka kwawo kungaba ngumphumela we-hyper-excitability yengane, engaphenduka ngokushesha ibe yisimo senkinga ye-acetone.

Izimpawu ezandulele yilezi:

• ukozela
• ubuqili;
• ukushisa (ukukhuphuka kwezinga lokushisa);
• colic esiswini.

Ukuvama kokuhlanza i-acetonemic kuhlanganiswa ne-acetonuria kudinga okuhlukile:

• isifo sikashukela mellitus;
• ukutheleleka kwamathumbu;
• isimila sobuchopho;
• i-pathology yesibindi.

Ezinye izimbangela ze-acetonuria yobuntwana yilezi:

• ukuthuthukiswa okungaphelele kwe-pancreatic;
• ukuba khona kokudla kwenani elikhulu lezinto ezilondoloziwe, udayi, ukunambitheka kwemvelaphi yamakhemikhali, kanye nemithi elwa namagciwane athathwe ngaphandle noma ngaphandle;
• ukucindezelwa okuphezulu kwengqondo nangokomzimba;
• i-helminthic infestations, i-diathesis (yehlisa izinga lokungazethezeki kwemvelo);
• izimo zokuphila ezicindezelayo, i-hyperthermia, i-hypothermia.

Isisekelo se-ketonuria yezingane ezisanda kuzalwa singaphansi kokutholwa noma ukuba khona kokushintshwa kwaso okunamandla, okulungiselelwe izakhi zofuzo - i-leucinosis, eyenzeka ezinganeni eziyizinkulungwane ezingama-30 futhi (ngenxa yokuphazamiseka kakhulu kwesistimu yezinzwa ephakathi nendawo) imvamisa iphelela ekufeni.

Ukuxilongwa kwe-ketonuria kungenziwa lula ngokusebenzisa indlela yokuxilonga esisheshayo - i-violet stain lapho usebenzisa imichilo yokuhlola (njalo kathathu ngokulandelana) kanye nesampula enesixazululo se-ammonia - lapho ingezwa umchamo oqukethe imizimba ye-ketone, umbala wayo uzojika ubomvu ngokugqamile.

Ividiyo evela kuDkt Komarovsky:

Izindlela zokwelapha

Ngenxa yezinhlobonhlobo zezimpawu eziyinkimbinkimbi ngenxa ye-acetonuria, isiguli kufanele siqondiswe ukuthi yisiphi isazi esingathinta kuso.

Lapho kukhona ukoma kanye nendlala engapheli, ukuchama okusheshayo nokuningi ngokweqile, ukucindezelwa kwengqondo, kanye nezimpawu zokuphelelwa ngamandla, kubalulekile ukubonana nodokotela wobugqila, ukuba khona komkhuhlane kanye nezimpawu zokutheleleka kudinga ukunakwa kochwepheshe wezifo ezithathelanayo.

Isiphuzo esidakayo esilandelwa i-acetonuria siyisizathu sokuxhumana nodokotela wezifo zesibeletho, kuyilapho ukuhlinzwa kwangaphambilini ne-anesthesia kuyisibopho somvuseleli. Izimpawu ze-hyperinsulinism noma ze-thyrotooticosis zisebenza njengesisekelo sokuhlolwa kukadokotela we-endocrinologist.

Abesifazane abakhulelwe bayadingeka ukuthi bavakashele udokotela obelethayo (i-gynecologist), omama abanezingane ezigulayo - udokotela wezingane. Ukulimala ekhanda okuphathelene nokuphazamiseka kwengqondo noma izimpawu ezinobuthi kuyindlela eya ehhovisi likadokotela oyi-neurologist noma i-tothologist, uma usola ukuthi unoplasm okulimazayo, kufanele uthintane nodokotela oncologist, futhi uma umtholampilo ungacacile, thintana nodokotela ohlinzayo.

Ngokuya ngezimpawu ezikhonjwe, udokotela owenza ukuhlolwa uzonikeza izivivinyo ezidingekayo nokuhlolwa okwenziwa ngeso lokhozi. Ingqikithi yemininingwane etholakele izosebenza njengesisekelo sokuqokwa kwesimo sokwelashwa esanele.

Uhla lwezindlela zokwelashwa zingafaka ukulungiswa kokulala, ukuphumula kanye nokudla okunempilo, kanye nokusebenza okuyinkimbinkimbi kwe-cavity kumbangela ye-oncological yesimo. Ku-genesis yesifo sikashukela ye-acetonuria, ukwelashwa kunqunywa yi-endocrinologist kucatshangelwa ukuthi kukhona i-concomitant pathology (isibindi, ukuphakama kwamathumbu, njll). Isiguli kufanele sivele njalo esifundweni sokulawula ukuze sihlole ukusebenza kahle kokwelashwa.

Ukwenezela uketshezi, kusiza ukusebenzisa izixazululo ze-Orsol noma iRegidron, noma i-decoction yamagilebhisi, ezinye izithelo ezomisiwe, amanzi e-alkali ngaphandle kwegesi.

Uma kungenakwenzeka ukuphuza ngenxa yokuhlanza, uketshezi lukhishwa ngabazali (ngaphakathi ngokudonsa), umjovo weCerucal uvumela ukususa ukuhlanza.

Umgomo wokususa ubuthi ungafinyelelwa ngokusebenzisa ama-sorbents (ama-Sorbeks, ama-carbon ocushiwe), ukusetha i-enema yokuhlanza (nge-hyperthermia ehlanganayo, engeza u-1 tbsp. Usawoti kwilitha ngalinye lamanzi).

Ukudla kukhiqizwa uchwepheshe wezokudla okunempilo.

Inyama (i-turkey, unogwaja, inyama yenkomo) idliwa i-stewed noma ibilisiwe. Njengokuqala, sincoma i-borsch, isobho semifino, iphalishi nenhlanzi enamafutha amancane.

Njengendlela yokuphindisela emzimbeni futhi wenze kabusha izinto ezilandelwayo namavithamini, amajusi wezithelo nemifino, kunikelwa ama-compotes (mhlawumbe i-compote compote).

Kuyenqatshelwe ngokuphelele ukusebenzisa:

• amaswidi;
• okunamafutha (ngisho nangendlela yomhluzi);
• izinongo;
• izithelo ezisawolintshi;
• ubhanana.

Kumele kukhunjulwe ukuthi umehluko ocacile kufanele wenziwe phakathi kwezimbangela ze-acetonuria - ekubambeni indlala okuwukuphela komthombo wamandla ebuchosheni nakuzo zonke izigaba zezicubu zemisipha.