Kuskuren Cibiyar Cikin gida

Sabar ta sadu da wani kuskuren ciki ko kuskuren ciki kuma bai iya kammala buƙatarka ba.

Da fatan za a tuntuɓi mai kula da uwar garke a imel da aka kiyaye don sanar da su lokacin da wannan kuskuren ya faru, da kuma ayyukan da kuka yi kafin wannan kuskuren.

Informationarin bayani game da wannan kuskuren na iya kasancewa a cikin kuskuren uwar garken.

Bugu da ƙari, an sami kuskuren Sabis na 503 na sabis yayin ƙoƙarin amfani da KuskurenDocument don gudanar da buƙatun.

Yadda lactic acidosis ke tasowa

Babban matsala wanda lactate ke saurin shiga hanjin jini shine madara acidosis. Lactic acidosis a cikin nau'in sukari na 2 na ciwon sukari na iya faruwa bayan amfani da magunguna masu rage sukari. Wannan tasirin gefen yana da mahimmanci a cikin shirye-shiryen nau'in biguanide (Metformin, Bagomet, Siofor, Glyukofazh, Avandamet). Halin ya kasu kashi biyu:

Type A lactic acidosis - hypoxia na nama. Jiki ba ya rasa iskar oxygen a cikin cututtuka masu mahimmanci: sepsis, septic shock, matsanancin matakai na cutar hanta ko bayan tsananin aiki na jiki.
Rashin nau'in B lactic acidosis ba shi da alaƙa da hypoxia na kyallen kayan jikin mutum. Yana faruwa yayin lura da wasu magunguna game da ciwon sukari da kamuwa da kwayar cutar HIV. Acos acid na wannan nau'in sukan bayyana kanta a kan asalin giya ko a cikin cututtukan hanta na hanta.

Lactic acidosis an kafa shi ne saboda lalacewa a cikin hanyoyin rayuwa na jiki. Yanayin cututtukan cuta yana faruwa lokacin da:

Type 2 ciwon sukari.
Yawan abin sha da yawa na Metformin (akwai tarin magunguna a jikin mutum saboda lalacewar aikin na kayyayaki).
Oxygen yunwar (hypoxia) na tsokoki bayan gajiyawar aiki na jiki. Wannan yanayin jikin ɗan ɗan lokaci ne kuma yana ƙetara da kansa bayan hutawa.
Kasancewar ciwace-ciwacen ƙwayar cuta a cikin jiki (mai ƙima ko rashin damuwa).
Cardiogenic ko girgiza hypovolemic.
Rashin ƙwayar Thiamine (Vit B1).
Cutar sankarar jini (leukemia).
Mai rauni concomitant rauni.
Sepsis.
Cututtuka masu kumburi da kumburi na etiologies daban-daban.
A gaban giya,
Jin jini mai yawa.
Festering raunuka a jikin mai ciwon sukari.
Babban myocardial infarction.
Kasawar numfashi.
Rashin wahala.
Ciwon hanta na kullum.
Magungunan rigakafi don kamuwa da kwayar cutar HIV. Wannan rukunin magungunan yana ba da nauyi a jiki, don haka yana da matukar wahala a kula da matakin lactic acid na jini.

Alamomin lactic acidosis

Milk acidosis yana gudana a saurin walƙiya, a zahiri a cikin 'yan awanni. Alamomin farko na lactic acidosis sun hada da:

jihar rashin tausayi
jin zafi a baya daga cikin tsananin da kuma a cikin kasusuwa,
disorientation a sarari,
bushe mucous membranes da fata,
yellowing na idanu ko fata,
bayyanar da saurin numfashi,
bayyanar nutsuwa da rashin bacci.

Wani mummunan nau'in lactic acidosis a cikin haƙuri yana bayyana ta rashin nasarar zuciya. Irin wannan cin zarafin yana haifar da canje-canje a cikin kwanciyar hankali na myocardium (yawan ƙuƙwalwar zuciya yana ƙaruwa). Bugu da kari, yanayin janar na jikin dan Adam ya kara tabarbarewa, jin zafi a ciki, tashin zuciya, amai, zawo, da kuma rashin ci. Sannan alamu na jijiyoyin lactic acidosis an kara su:

areflexia (daya ko fiye da reflexes ba ya nan),
hyperkinesis (motsawar motsa jiki na mutum ko gungun tsokoki),
paresis (ƙarancin rashin lafiya).

Kafin farawar cutar hyperlactacPs, alamun bayyanar acidosis na metabolism yana bayyana: mai haƙuri yana haɓaka zurfi da hayaniya mai amo (hayaniya a bayyane a nesa), tare da taimakon wanda jiki yayi ƙoƙarin cire lactic acid mai yawa daga jiki, kuma DIC - ciwo (coralation coralation) yana bayyana. Sannan akwai alamun rushewa: na farko, oliguria yana haɓaka (raguwa a yawan fitsari), sannan cutar ƙanƙara (babu urination). Sau da yawa akwai alamun cutar cututtukan jini na yatsun yatsun.

Binciko

Hyperlactacidemia yana da wuya a gano cutar kawai a gaban alamun bayyanar cututtuka waɗanda ba a tabbatar da sakamakon gwajin ba. Ana amfani da cututtukan cututtukan lactic acidosis a matsayin bayani mai taimako. .Ari abin dogara ne bayanan dakin gwaje-gwaje, wanda ya dogara da ma'aunin lactic acid. Bugu da kari, sun yanke shawara:

yawan bicarbonates (tare da lactic acidosis, suna raguwa da sauri),
digiri na hauhawar jini,
rashin acetone a cikin fitsari (acetonuria).

Mene ne lactic acidosis?

Lactaciosis a cikin nau'in 2 na ciwon sukari mellitus da wuya ya inganta, amma yana haifar da mummunan sakamako. A cikin 50% na lokuta, lactic acidosis (hyperlactacidemia) yana da m.

Idan muka yi la’akari da abin da lactic acidosis yake daga mahangar biochemical, to wannan shine bayyanar lactate (lactic acid) a cikin tsarin dan adam. Yana faruwa ne sakamakon fashewar glucose a adadi mai yawa, wanda kodan basa iyawa

Jikin mutumin da ke da ƙoshin lafiya yana samar da lactic acid a cikin ƙarancin allurai sakamakon hanyoyin aiki. A cikin matakai da yawa, ana sarrafa lactate cikin ruwa da carbon dioxide ko glucose. Tare da haɓakar lactic acidosis, hyperlactatemia yana faruwa - yanayin inda acidity na jijiyoyin jini ke gudana, ƙwayoyin suna ƙoshin wadataccen iskar oxygen, sakamakon insulin ya ragu, kuma ƙididdigar lactic acid yana ƙaruwa akasin haka.

Idan ba a ba da haƙuri tare da kulawar likita a kan lokaci ba, ƙwayar hyperglycemic hyperlactacidic coma (lactic acidosis) yana faruwa. Don haka menene lactic acidosis kuma menene haɗarin wannan ilimin?

Dalilai na ci gaba

Lactic acidosis yana haɓaka a cikin nau'in ciwon sukari na 2 na mellitus a cikin marasa lafiya tare da tarihin bugun jini ko infarction myocardial.

Dalilan ci gaban lactate acidosis na iya zama:

barasa mai guba
magani na miyagun ƙwayoyi na fructose a cikin jiki,
zub da jini
cututtuka da kumburi
ilimin halittar gado na jikin ta tafiyar matakai,
raunuka
guba cyanide,
hypovitaminosis B1,
mai tsananin rauni,
kasancewar cutar ciwan ƙoshin cuta.

Symptomatology

Idan mai haƙuri ya haɗu da lactic acidosis a cikin nau'in ciwon sukari na 2, alamu sune mafi kyawun bayyanar cututtuka a farkon matakan, tunda wannan ilimin a cikin ciwon sukari yana haɓaka cikin hanzari kuma yana da mummunan sakamako ga mai haƙuri.

Ganin sunan cutar - lactic acidosis, alamunta suna da alaƙa da haɓaka matakin jini na mai lactic acid.

Innovation a cikin ciwon sukari - kawai sha kowace rana.

Alamomin lactic acidosis suna da hoto mai zuwa:

tsananin farin ciki da ciwon kai
tashin zuciya da amai
rikice,
aiki mai rauni,
ciwon ciki
ciwon tsoka
matsalar rashin bacci ta wani yanayi dabam (rashin bacci, rashin bacci),
da yawaitar numfashi.

Lokacin da ake bincika lactic acidosis, alamomin ya kamata a haɗa su da sauran rikice-rikice masu yiwuwa, tunda ana lura da alamun irin wannan ba kawai tare da tara ƙwayar lactic acid ba. Kuma kamar yadda aka riga aka ambata a cikin labarin, lactic acidosis, alamun farko waɗanda aka jera su a sama, a matakin ƙarshe na ci gaba ana nunawa ta hanyar asarar haƙuri da ƙwaƙwalwa.

Marasa lafiya yakamata su iya tantance cutar da kansu, su san mene ne kuma alamunta a cikin cutar sankara, sannan damar samun nasara mai saurin kamuwa da ita. Yayinda cutar ta haɓaka, yanayin haƙuri yana hanzarta lalacewa - amaiji, zafin ciki ya bayyana.

Wataƙila haɗarin thrombosis da cututtukan ƙwayar cuta na zuciya da na ƙananan jijiyoyin na iya kasancewa. Musamman kulawa dole ne a biya don cin zarafin canji da kuma faruwar haɗarin toshiyar tsoka. Mai haƙuri zai iya gano duk waɗannan alamun lactic acidosis kansa kuma nan da nan tuntuɓi likita.

Siffofin lura da ciwon sukari

A farkon jiyya, ya kamata a haifa da hankali cewa lactate acidosis cuta ce da ke tasowa tare da rashin isashshen oxygen a cikin jini. Abin da ya sa ya kamata duk manipulation likita ya dogara da gaskiyar cewa wannan ilimin ilimin halittu shine yunwar oxygen na jiki. Yakamata a fitar da mutum daga wannan halin ta hanyar cike sel kwayoyin halitta da kyallen takarda na jiki tare da oxygen.

Likitoci sun san cewa lactic acidosis a cikin ciwon sukari mellitus an keɓe shi da taimakon mai ba da iska. Don fitar da mara lafiya daga wannan yanayin, ya kamata a ɗauka a hankali cewa wannan cutar hypoxia ce, wanda shine farkon dalilin farawa da haɓaka cutar.

Cire hypoxia aiki ne mai mahimmanci ga likita. A lokacin manipulations na likita, kwararru suna ci gaba da sa ido kan hauhawar jini a cikin tasoshin mai haƙuri, haka kuma suna lura da matsayin duk mahimman alamomin jikin.

Idan an gano lactic acidosis a cikin mai haƙuri na shekaru masu tasowa, kulawa ta musamman game da sigogin jiki ya kamata a aiwatar, tunda wannan nau'in yawanci yana fama da hauhawar jini, kuma cututtukan hanta suma zasu yiwu.

Dukkanin shirin magudi ana aiwatar da shi ne cikin hanzari, tunda barazanar mummunan sakamako tana da girma sosai, kuma sauyawa daga yanayin al'ada zuwa yanayin cuta yana ɗaukar lokaci mafi ƙarancin lokaci. Yana yiwuwa a narkar da lactic acidosis a cikin cibiyar likita. Dangane da gwajin jini, likitoci sun tantance tsananin cutar, a lokuta mafi tsauri yayin da asarar jini ba ta wuce 7 ba, ana sarrafa bicarbonate na mai haƙuri.

A yayin taron cewa lactic acidosis yana tare da lalacewa na koda, ana yin hemodialysis. Kamar yadda ƙarin hanyoyin, ana iya aiwatar da dial na peritoneal, wanda zai mayar da matakin potassium bicarbonate a jiki. Ya kamata a la'akari lokacin da ake magance lactic acidosis cewa wannan cuta ce da ke buƙatar ƙwarewar insulin don mayar da metabolism metabolism a jikin mai haƙuri. Wajibi ne a la'akari da kawar da lactic acidosis cewa irin wannan cuta tana buƙatar tsayayyen saka idanu na metabolism a cikin jikin mai haƙuri da ke fama da ciwon sukari mellitus.

Yin rigakafi da shawarwari

Kafin aiwatar da matakan kariya, yakamata ku fahimci menene lactic acidosis kuma ku sami damar sanin alamun ta. Cutar tana da matukar wahalar ganewa da kuma hango ko hasashen. Don hana shi, dole ne a ɗauka a hankali cewa wannan cuta tana buƙatar daidaito don ɗaukar magunguna da bin shawarar likitocin halartar. Ya kamata ku bi hanyoyin maganin. Idan ba a dauki kwamfutar hannu akan lokaci ba, ba a bada shawara ba don haɓaka kashi na gaba a gaba in ka sha maganin, saboda wannan na iya haifar da yawan shaye-shaye ko haifar da sakamako masu illa.

Yakamata ka sani cewa lactic acidosis na iya faruwa akan asalin kamuwa da cuta ko kwayar cuta.

A wannan gaba, jikin mai haƙuri tare da ciwon sukari na iya amsawa game da sakamakon magunguna. A alamomin farko, ya zama dole a bincika cutar sannan a ci gaba da maganin ta. Kai magani ba zai dace ba a nan, don haka yakamata a tsara shi ta ƙwararren likita bayan ya tattara anamnesis. Kulawa na lokaci zai taimaka wajen kawar da cutar da wuri-wuri, kuma zai kasance cikin ƙwaƙwalwar mai haƙuri.

Ciwon sukari koda yaushe yana haifar da rikitarwa mai wahala. Wuce kima sugar yana da matukar hadari.

Aronova S.M. ya ba da bayani game da lura da ciwon sukari. Karanta cikakken

Etiology (Sanadin) na lactic acidosis

Waɗannan yanayi masu zuwa suna tsoratar da haɓakar lactic acidosis:

Nau'in cututtuka da na cuta
Babban nau'in zub da jini,
Alcoholism a cikin na kullum mataki,
Sharp
Raunin raunin jiki
Cutar hanta (na kullum).

A cikin adadin abubuwan da ke haifar da lactic acidosis da alamu na nau'in da ya dace, an sanya wuri na musamman don ɗaukar biguanides. A wannan yanayin, alamun lactic acidosis suna faruwa a cikin marasa lafiya suna shan magungunan antidiabetic tare da kasancewar wannan abun a cikin abun da ke ciki. Ko da ƙananan ƙwayar ta don ƙwayoyin kodan da aka shafa ko hanta na iya tsokani lactic acidosis, wanda aka sauƙaƙe musamman ta hanyar tara waɗannan kwayoyi a cikin jiki.

Haɓaka lactic acidosis yana faruwa tare da hypoxia wanda ke faruwa a cikin ƙwayar tsoka, wanda, alal misali, na iya haɗuwa da tsawan yanayin jiki. Sanadin lactic acidosis ba tare da bayyanar kasancewar hypoxia na iya yin hidima ba, kazalika da adadin wasu nau'o'in ayyukan ciwace-ciwacen daji. Hakanan ya hada da gazawar numfashi, matsananciyar ciwon zuciya na daya daga cikin huhu, hanjin ciki, da kuma rashi a jikin garkuwar thiamine.

Lactic acidosis: bayyanar cututtuka

Mafi yawan ci gaban lactic acidosis yana faruwa a cikin mummunan yanayin a cikin zahiri da yawa a cikin sa'o'i, yayin da ba za a iya samun madaidaici game da hakan. Sa’annan marasa lafiya na iya jin zafin jijiya da raunin da ke faruwa a bayan sternum. Alamar halayyar alama ce ta nau'ikan alamomin dyspeptik, rashin tausayi, saurin numfashi, rashin bacci, ko kuma, magana, rashin barci.

Bayyanar cututtukan da suka ci gaba, a halin yanzu, alamu ne da ke haifar da rashin ciwan zuciya, wanda sakamakon cututtukan acid da ke ƙaruwa da ƙaruwa. A game da tushen sa, canje-canje daga baya, suna nunawa a cikin ƙa'idar aiki, halayyar myocardium.

Hakanan, an lura da ci gaba mai lalacewa a cikin kuzarin yanayin yanayin mai haƙuri, wanda a ciki ana iya haɗuwa da amai da zafi na ciki da haɓakar acidosis. Idan yanayin ya tsananta tare da lactic acidosis, ana kuma rarrabe alamun ta hanyar bayyanar cututtuka daban-daban, daga areflexia zuwa paresis da hyperkinesis.

Nan da nan gabanin farawa na ci gaban kwaro, tare da asarar hankali, akwai wani motsin numfashi, wanda ake ji da shi lokacin da aka jiyo shi da numfashi, yayin da warin acetone halayyar wannan sabon abu ba ya cikin iska mai shuɗewa. Wannan nau'in numfashi yawanci yana haɗuwa da acidosis metabolic.

Sannan lactic acidosis yana alamta bayyanar cututtuka ta hanyar rushewa: da farko tare da oligoanuria, sannan kuma tare da anuria, a kan asalin abin da haɓaka ƙwayar coagulation na ciki (ko DIC) ya faru. Sau da yawa, alamun lactic acidosis ana lura da abin da ya faru na ƙwayoyin jijiyoyin jini na jijiyoyin jini tare da cututtukan ƙwaƙwalwar ƙwayar cuta wanda ke shafar yatsun hannu da hannu. Ya kamata a lura cewa saurin ci gaban lactic acidosis, wanda ke faruwa a cikin 'yan awanni kaɗan, baya bayar da tasirin gudummawa ga alamun alamun halayyar kamuwa da cutar sankara. Waɗannan alamun musamman sun haɗa da bushewar ƙwayoyin mucous na harshe da membranes, harma da bushewar fata baki ɗaya. Abin lura ne cewa a wannan yanayin, har zuwa 30% na marasa lafiya tare da hyperosmolar da ciwon sukari suna da abubuwan da suka dace da bayyanar cututtuka na lactate acidosis.

Yin rigakafin Coma

Yin rigakafin, wanda ke taimakawa hana farawa na lactacPs coma a kan asalin lactic acidosis, alamun da muka bincika a sama, ya ƙunshi bi da bi, a cikin hana hypoxia, da kuma cikin ma'anar iko akan biyan diyyar cutar sankara. Hakanan, lactic acidosis, alamun cututtukan waɗanda zasu iya faruwa tare da yin amfani da biguanides, suna buƙatar tsauraran matakan mutum akan sakinsu tare da sokewa nan da nan idan akwai wani nau'in cuta mai kama da cuta (ko dai sauransu). Lactic acidosis bayyanar cututtuka ma ya dace dangane da ayyukan hana daukar ciki, sabili da haka, marasa lafiya masu ciwon sukari lokacin da suke shan biguanides yakamata suyi la'akari da wannan yanayin.

Don kowane irin tuhuma game da lactic acidosis, kazalika da nuances na mahawara da muka tattauna a cikin labarin, yakamata a tuntuɓi endocrinologist nan da nan.

Shin duk abin da yake daidai cikin labarin daga ra'ayi na likita?

Amsa kawai idan ka tabbatar da ilimin likita.

Cututtukan da ke kama da alamu:

Ba asirin ba ne cewa a jikin kowane mutum yayin matakai daban-daban, gami da narke abinci, ƙwayoyin cuta ke shiga. Dysbacteriosis cuta ce da a take cin mutuncin ƙwayoyin cuta da ke tattare da ƙananan ƙwayoyin cuta da ke zaune a cikin hanji. Wannan na iya haifar da rikicewar ciki da hanji.

Rashin wuce gona da iri wani yanayi ne wanda a yau yawanci ke fuskantar ba kawai ga manya ba, har ma da yara. An kwatanta shi da rage yawan aiki, nutsuwa, rashin kulawa da damuwa. Haka kuma, mutane da yawa sun yi imanin cewa yawan aiki ba matsala ba ce mai kyau, kuma yana da kyau isasshen bacci domin ya tafi. A zahiri, ba shi yiwuwa a kawar da irin wannan cin zarafin don dogon bacci. Akasin haka, sha'awar yin bacci da kuma rashin ƙarfi don sake samun ƙarfi bayan bacci sune manyan alamun rashin aiki.

Lactic acidosis (lactic acidosis, lactacidemia, hyperlactatacidemia, lactic acidosis) wani yanayi ne wanda lactic acid ke shiga jini da sauri fiye da yadda aka ƙetareshi, wanda zai haifar da ci gaban rikice-rikicen rayuwa. A cikin fiye da 50% na lokuta, lactic acidosis yana rajista a cikin marasa lafiya da ciwon sukari mellitus.

A game da tushen lactic acidosis, cerebral edema da kuma aikinta na yau da kullun, kullun coma, da mutuwa na iya haɓaka.

Lactic acid shine samfurin ƙarshe na anaerobic glycogenolysis da glycolysis, wani gluconeogenesis, ana amfani dashi azaman kayan makamashi ta hanyar ƙarfin zuciya. Increaseara yawan abubuwan da ke cikin lactic acid a cikin jini yana da alaƙa da haɓaka samuwar sa a cikin tsokoki da raguwar iyawar hanta don canza lactic acid zuwa glucose da glycogen. Dangane da cutar sikari na mellitus decompensation, matakin lactic acid a cikin jini shima yana iya karuwa sakamakon toshe katanga na pyruvic acid da karuwa a cikin NAD-N / NAD. Mai da hankali cikin jinin lactic acid na iya aiki azaman ƙarin gwajin bincike.

Sanadin da Matsalar Hadarin

Hypoxia wanda ke faruwa a cikin tsokoki na kasusuwa saboda tsawan yanayin jiki na iya haifar da ci gaban lactic acidosis. Hakanan, tsarin pathology na iya haɓaka tare da mellitus na ciwon sukari, cututtukan cututtukan ƙwayoyin cuta, cututtukan cututtuka da na kumburi, gazawar numfashi, ƙarancin ƙwaƙwalwar hanji, ƙonewar ƙananan hanji ko huhu, gazawar renal, cututtukan hanta na yau da kullun, zubar jini mai yawa, raunin raunin cuta, rashin shan wahala mai guba.

Abubuwan haɗari sun haɗa da:

cuta na rayuwa,
shan wasu magunguna (alal misali, biguanides, musamman a gaban cututtukan hanta da hanta),
rashi na bitamin a jiki (musamman bitamin B 1),
amfani da methanol ko ethylene glycol,
tsarin gudanarwa na fructose a babban allurai.

Tare da lactic acidosis, ana buƙatar asibiti mai gaggawa don haƙuri don daidaita acidosis da hypoxia.

Bayyanar cututtuka na Acact Acidosis

Lactic acidosis, a matsayin mai mulkin, yana haɓaka ainihin, a cikin 'yan sa'o'i kaɗan, ba tare da alamun alamun riga-kafi ba. Marasa lafiya suna koka game da raɗaɗin tsoka, jin zafi a bayan sternum, dyspepsia, apathy, nutsuwa ko rashin bacci, saurin numfashi. Halin gaba ɗaya na mai haƙuri daɗaɗɗa da sauri, karuwa a cikin acidosis yana haɗuwa da ciwon ciki da amai, raunin jijiyoyin jiki (areflexia, hyperkinesis, paresis).

A cikin mawuyacin yanayi, alamun bayyanar cututtukan lactic acidosis alamu ne na rashin lafiyar zuciya, wanda ke haifar da mummunan acidosis yayin da tsarin ci gaba ke gudana. Ssarfin hankali da haɓakar ƙwayar cuta suna gab da lalacewa, bayyanar mai haƙuri da saurin yin numfashi (sautunan numfashi da aka ji a nesa), kuma babu ƙamshin acetone a cikin iska mai nutsuwa. Mai haƙuri ya ɓaci ɓarna, na farko tare da oligoanuria, sannan kuma tare da anuria, daga baya aka watsa coagulation intravascular coagulation (DIC). A cikin wasu marasa lafiya, ana lura da cutar ƙoshin jini na yatsunsu na manya da ƙananan a tsakanin alamun cutar lactic acidosis.

Fasali na hanya na lactic acidosis a cikin yara

Hanyar gado na lactic acidosis an nuna shi a cikin yara ƙanana da ke fama da mummunan acidosis, tare da raunin ƙwayar cuta mai rauni. Marasa lafiya suna da ƙwayar tsoka, jinkirtawa a cikin ci gaban psychomotor. Yawancin lokaci, yanayin mai haƙuri yana inganta tare da tsufa, amma a wasu halaye hanyoyin aiwatar da cuta yana haifar da mutuwa.

Kimanin kashi 50% na duk lamuran lactic acidosis an ba da rahotonsu a cikin marasa lafiya da ke fama da ciwon sukari.

Matsaloli da ka iya yiwuwa da kuma sakamako

A game da tushen lactic acidosis, cerebral edema da kuma aikinta na yau da kullun, kullun coma, da mutuwa na iya haɓaka.

Tsinkayar don samun nau'in lactic acidosis ya dogara da cutar da ta tashi daga kanshi, kan matakin lactic acid a cikin jinin mara lafiya, da kuma kan dacewar lokacin jiyya. Tare da haɓaka rikitarwa, kazalika da yanayin haɓaka na lactic acidosis, tsinkayen yana ƙaruwa.

Bayyanar cutar

Masu ciwon sukari ya kamata su lura da alamun lactic acidosis. Wannan yanayin yana tasowa cikin sauri, a cikin 'yan awanni kaɗan mutum ya kamu da rashin lafiya. Babu alamun wata cuta kuma wannan ana ɗaukarsa ɗayan manyan haɗarin.

Mai zuwa yana nuna cigaban wannan yanayin:

tsokoki na rauni wanda ke bayyana
rashin kulawa
rauni
jin gajiya
matsa lamba
rikicewa, har zuwa asarar sa,
karancin urination ko raguwar yawan fitsari,
ci gaban alamun cututtukan huhu (wanda ake kira Kussmaul respiration),
rashin jin daɗi a cikin yankin a bayan sternum,
lokacin da mara lafiyar ya yi muni, amai yana buɗewa, zafin ciki ya bayyana.

Waɗannan sune manyan alamun bayyanar lactic acidosis a cikin ciwon sukari. Lokacin da suka bayyana, dole ne kai tsaye ka garzaya asibiti. A cikin wuraren kiwon lafiya, suna iya ɗaukar jini don bincike don tantance taro na lactic acid: ya tashi sosai. Matsayin ya wuce 6 mmol / L.

Sauran sigogi na dakin gwaje-gwajen halayyar hyperlactatemia kuma ana duba su:

hyperphosphatemia (gwajin rashin lafiyar azotemia),
raguwa a cikin jini pH
digo cikin matakin CO 2 a cikin jini,
raguwa a cikin jini bicarbonates.

Ana buƙatar gwajin jini da tabbatar da alamun. Bayan haka, alamun cutar suna halayyar wasu yanayi. Marasa lafiya tare da ciwon sukari na iya fadawa cikin rashin lafiya a karamin taro na sukari a cikin jini kuma sama da kima.

Tare da lactic acidosis, mummunan sakamako mai yiwuwa ne: mai haƙuri yana haɓaka rauni na zuciya, rauni na wasu sassan jiki, gami da gabobin numfashi, mai yiwuwa ne.

Sakamakon haɓakawa, ƙwayar lactaclera ta taso. Kafin haɓakawarsa, sanyin numfashi ya zama sananne. Marasa lafiya tare da DIC sun bayyana. Wannan wani yanayi ne wanda ake amfani da jijiyar ciki na ciki.

Alamomin lactic acidosis kuma sun hada da bayyanar cutar basur ne yatsun hancin yatsu, da jini cikin jini na ciki. A lokaci guda, bushewar mucous membranes da fata.

Hanyar warkewa

Hyperlactacidemia a cikin marasa lafiya masu ciwon sukari ya haɗu da asalin rashi oxygen. Sabili da haka, da farko, a asibiti, yana da buqatar saturate jiki tare da oxygen kamar yadda zai yiwu. Ana yin wannan ta amfani da injin motsa iska. Yakamata likitocin su cire haɓakar haɓakar hailax da wuri-wuri.

A lokaci guda, ana kula da duk mahimman alamomi. Ana kulawa da kulawa ta musamman ga tsofaffi waɗanda ke fama da hauhawar jini, matsaloli tare da hanta, koda.

Idan an tabbatar da hyperlactatemia ta hanyar bincike, matakin pH bai wuce 7.0 ba, to mara lafiya ya fara allurar sodium bicarbonate cikin jijiya. Maganin an shirya shi daga ruwa mai bakararre, sodium bicarbonate, kwatancen potassium chloride. Shigar dashi tare da dropper na tsawon awanni 2. Yawan maganin zai iya bambanta dangane da pH. Ana kimantawa a cikin kowane sa'o'i 2: maganin jiko yana ci gaba har zuwa lokacin da pH ya wuce fiye da 7.0.

Idan mai ciwon sukari tare da hyperlactacidemia yana da gazawar koda, to, ana yin hemodialysis na kodan lokaci guda.

Zai yuwu a hana ci gaban ci gaban zuciya ta hanyar tsara takamammen magunguna. A cikin kananan allurai, Reopoliglukin, Heparin za'a iya tsara shi. Zaɓin isasshen ilimin insulin yana da mahimmanci. Wannan zai daidaita metabolism na metabolism.

Tare da haɓaka ƙwayar lactic acidosis coma, magungunan maganin antiseptik suna narkewa ga mai haƙuri. A lokaci guda aiwatar da maganin antichock. Ana amfani da Trisamine don rage bayyanar lactic acidosis.

Yiwuwar samun daidaituwa game da yanayin tare da kulawa na lokaci zuwa ma'aikatar likita shine 50%. Idan kun dauki lokaci kuma ba ku kula da alamun ci gaba da sauri na cutar ba, to mace-mace na iya kaiwa 90%. A cikin yanayin sakaci, har ma likitocin ba za su iya ceton mai haƙuri ba.

Bayyanar cututtuka na lactic acidosis

Wannan rikitarwa tana tasowa a cikin 'yan awanni. Babban bayyanar cututtuka sune:

sauke cikin karfin jini
rauni
ciwan zuciya
bayyanar cututtukan huhu,
nauyi a cikin wata gabar jiki
tashin zuciya da amai
zuciya tashin hankali,
saurin numfashi
jin zafi a ciki da bayan sternum.

Wadannan bayyanar cututtuka suna kama da haɓakar haɓakar sukari na jini. Yanayin ketoacidosis shima ya fadi a karkashin irin wannan alamun.

Babban bambanci tsakanin su shine kasancewar jin zafi a cikin tsokoki, kamar bayan horo na jiki. Tare da ketoacidosis, babu ciwo.

Idan mai haƙuri da ciwon sukari ya koka da ciwon tsoka, to ya cancanci auna matsayin sukari a cikin jini da lura da yanayin mutumin. Sharparkewar yanayin lalacewa cikin walwala, kasancewar waɗannan alamun suna nuna lactic acidosis. Kuna buƙatar kiran motar asibiti. Ba shi yiwuwa a samar da taimakon farko da kanka.

Sanadin lactacidemia

Lactic acidosis na iya haɓaka yayin shan wasu magunguna masu rage sukari. Abun da ke tattare da irin waɗannan magunguna yawanci ya ƙunshi biguanide na abu. Wannan sinadarin yana hana hanta lalata lalata lactate mai yawa. Tare da wuce haddi na lactate a cikin jikin mutum, haɓaka ƙwayar madara yana yiwuwa.

Rarraba lactic acid a cikin kyallen na jikin yana faruwa ne sakamakon matsanancin iskar oxygen wanda kyallen takarda, wanda, hakan ke haifar da raguwa a cikin matakin pH a cikin jini.

Cututtukan da ake nunawa da hypoxia na iya haifar da lactacidemia. Waɗannan cututtukan tsarin zuciya ne. A haɗuwa tare da ciwon sukari, haɗarin lactic acidosis yana ƙaruwa.

Ofayan abin da ke haifar da haɓakar ƙwayar madara na iya zama lalacewa ta rayuwa. Lactacidic coma a zahiri ba ya haɓaka a cikin yara masu fama da ciwon sukari.

Hanyoyin jiyya

Kulawa na lactic acidosis a cikin ciwon sukari mellitus ana aiwatar dashi a cikin kulawa mai mahimmanci kuma ya haɗa da irin waɗannan matakan:

na ciki na sodium bicarbonate,
gabatarwar methylene blue don sauƙaƙa farin ciki,
yin amfani da maganin trisamine na miyagun ƙwayoyi - yana kawar da hyperlactatacidemia,
hemodialysis tare da raguwa a cikin pH a cikin jini

Haɓaka lactic acidosis yana yiwuwa ba kawai a cikin ciwon sukari na mellitus ba, har ma a cikin wasu cututtukan da ke haɗuwa tare da raguwa a cikin samar da oxygen zuwa nama, yayin da gushewar glucose da metabolism na makamashi yana faruwa bisa ga nau'in anaerobic. An nuna shi ta hanyar haɓakar kyakkyawan lactic acid, wanda aka saki cikin jini.

Hakanan, yanayin cuta yana faruwa ne a gaban cututtukan gabobin da ke amfani da cire lactic acid. Wannan yana faruwa tare da cututtuka na kodan da hanta, wanda ke tattare da lalacewa sakamakon rashin aiki.

Akwai wasu dalilai daban da ke ba da gudummawa ga karuwar samar da lactic acid a cikin kyallen jiki, wanda ke haifar da lactic acidosis, wanda aka danganta su.

A lokaci guda, akwai raguwar haɓakar oxygen oxygen, huhun ba ya aiki yadda yakamata, kuma dukkanin gabobin sun fara fama da raunin iskar oxygen. Don rama yanayin, sel sun fara rushe glucose a cikin nau'in anaerobic, tare da sakin lactate.

Rashin zuciya

Yana kaiwa zuwa bayyanar lactic acidosis iri ɗaya kamar gazawar huhun ciki. Amma tare da cin zarafin zuciya, akwai raguwa sosai a yawan zubar jini daga hanjinsa, wanda hakan ke haifar da hauhawar yawan zubar da jini. Wannan yana haifar da ƙaruwa a cikin matsa lamba a cikin karamin da'irar jini kuma ya shiga cikin babban huhun hanji, da kuma huhun haɗe da gajiyawar zuciya.

Rashin wahala

Babban fasalin kodan shine sakin dukkan abubuwan da basu da amfani da guba daga jiki. Kodan kuma suna tsara tattarawar wasu abubuwa a cikin jiki, idan akwai da yawa daga cikinsu, kodan sun fara fidda su sosai, wanda ke faruwa da yanayin ilimin halittar jiki, tare da lactic acid. Rashin nasarar fitsari baya haifar da sakamako da ake so, kuma lactic acid ya tara a jiki.

Tare da babban tsari mai saurin kamuwa da cuta, mummunar lalacewar jini daga wakilai na kwayan cuta na faruwa, wannan rikitarwa yana haifar da karuwar zubar jini.

A wannan yanayin, zagayawa cikin jini a cikin karamin capillaries yana tsayawa kuma kyallen takan fara fama da hypoxia.

Wanda ke ba da gudummawa ga haɓaka matakan lactate na jini.

Yanayin shakatawa

A wannan yanayin, karuwar samar da lactic acid yana faruwa tare da matsanancin oxygen na kyallen takarda saboda vasospasm. Wannan na faruwa ne azaman kariya daga tsokar jiki zuwa ga abubuwanda ke haifar da illa, wanda ke haifar da raguwar yaduwar jini a cikin farji, da kuma haɓaka samar da jini zuwa gabobin ciki.

Suna taimakawa wajen kara adadin gubobi a cikin jini, suna kuma lalata hanta da kodan, gabobin da ke lalata da cire duk wasu gubobi a jiki. Hakanan, yayin rushewar barasa na ethyl a cikin aiwatar da metabolism, samfuran abubuwan da ke lalata shi ya faru, ɗayansu shine lactic acid.

Tumor tafiyar matakai

A wannan yanayin, akwai canji a cikin yanayin metabolism a cikin kwatancen tsokoki na daji, yawancin anaerobic irin metabolism tare da sakin lactate ana lura da su. Kuma saboda haɓakar ƙwayoyin neoplasm, tasoshin da ke ba da tasoshin jini suna matsewa, wanda ke haifar da yunwar oxygen na haɓakar kansa da ƙwararrun maƙwabta.

A cikin mutane masu ciwon sukari, tare da raunin insulin, an kunna enzyme, pyruvate dehydrogenase.

A lokacin metabolism na makamashi, a ƙarƙashin rinjayar wannan abu mai aiki na biologically, pyruvic acid ya bazu cikin samfuran karshe, tare da haɓaka samar da lactic acid. Wannan tsari yana haifar da karuwa a cikin yawan lactic acid a cikin jini. Amma lokacin shan magungunan hypoglycemic, biguanides, akwai karuwa mai yawa a cikin taro na lactate. Wannan saboda gaskiyar magana ne cewa magungunan wannan rukunin suna haɗuwa a cikin hanta da ƙodan, wanda ke toshe kewa da amfani da lactate ta waɗannan gabobin.