Mene ne lactic acidosis kuma menene alamun wannan rikitarwa a cikin ciwon sukari mellitus - tambayoyin da yawancin lokuta za a iya ji daga marasa lafiya na endocrinologist. Mafi yawan lokuta ana tambayar wannan tambayar ta marasa lafiya da ke fama da nau'in ciwon sukari na biyu.
Lactic acidosis a cikin ciwon sukari cuta ce mai wahala sosai. Haɓaka lactic acidosis a cikin ciwon sukari yana faruwa ne sakamakon tara ƙwayoyin lactic acid a cikin ƙwayoyin gabobin da kyallen takarda a ƙarƙashin rinjayar matsanancin ƙoƙari na jiki ko ƙarƙashin aikin abubuwan da suka dace da mummunan sakamako akan mutumin da ke haifar da ci gaba da rikitarwa.
Gano lactic acidosis a cikin ciwon sukari ana yin shi ta hanyar binciken dakin gwajin lactic acid a cikin jinin mutum. Lactic acidosis yana da babban fasalin - taro na lactic acid a cikin jini ya fi 4 mmol / l kuma kewayon ion 10 ne.
A cikin mutum mai lafiya, ana samar da lactic acid a cikin adadi kaɗan yau da kullun sakamakon hanyoyin rayuwa na jiki. Wannan kwayar tana aiki da sauri cikin jiki zuwa cikin lactate, wanda, shigar da hanta, yana cigaba da aiki. Ta hanyar matakai da yawa na aiki, ana canza lactate zuwa carbon dioxide da ruwa ko cikin glucose tare da sake farfadowa na lokaci guda na bicarbonate anion.
Idan jiki ya tara lactic acid, to lactate ya daina zama mai cire hanta da kuma sarrafa hanta. Wannan halin yana haifar da gaskiyar cewa mutum ya fara haɓaka lactic acidosis.
Ga lafiyayyen mutum, adadin lactic acid a cikin jini bai wuce mai nuna alamar 1.5-2 mmol / L ba.
Sanadin lactic acidosis
Mafi sau da yawa, lactic acidosis yana haɓaka a cikin nau'in ciwon sukari na 2 na mellitus a cikin marasa lafiya waɗanda, a kan asalin cutar da ke fama da cutar, sun sha wahala infarction na zuciya ko bugun jini.
Babban dalilan da ke ba da gudummawa ga ci gaban lactic acidosis a cikin jiki sune kamar haka:
- yunwar oxygen na kyallen takarda da gabobin jikin mutum;
- ci gaban anemia;
- zub da jini da ke haifar da asarar jini mai yawa.
- mummunan lalacewar hanta;
- kasancewar gazawar koda, haɓaka yayin ɗaukar metformin, idan akwai wata alama ta farko daga jerin da aka ƙayyade;
- tsananin motsa jiki da wuce kima a jiki;
- abin da ya faru na girgiza yanayin yanayin ko kuma sepsis;
- bugun zuciya;
- kasancewar a cikin jikin cututtukan cututtukan cututtukan zuciya wanda ba a sarrafa shi ba kuma a cikin abin da ya faru cewa an dauki ƙwayar cututtukan cututtukan ciwon sukari
- kasancewar wasu rikice-rikice a cikin jiki.
Ana iya gano faruwar cutar a cikin mutane masu lafiya saboda tasirin jikin ɗan adam na wasu yanayi kuma a cikin marasa lafiya da masu ciwon sukari mellitus.
Mafi sau da yawa, madara acidosis yana haɓaka cikin masu ciwon sukari a kan tushen hanyar da ke fama da cutar sukari.
Ga masu ciwon sukari, wannan yanayin jikin mutum ba shi da kyan gani kuma yana da haɗari, tunda a wannan yanayin ana iya samun lactacidic coma.
Lactic acid coma na iya haifar da mutuwa.
Bayyanar cututtuka da alamun rikitarwa
A cikin cututtukan lactic acidosis na ciwon sukari, alamu da alamu na iya zama kamar haka:
- mai rauni sosai;
- bayyanar rashin farin ciki;
- asarar hankali;
- bayyanar ji na tashin zuciya;
- bayyanar uriri zuwa amai da amai da kanta;
- akai-akai da zurfin numfashi;
- bayyanar jin zafi a ciki;
- bayyanar raunin rauni ko'ina cikin jiki;
- rage ayyukan motsa jiki;
- ci gaba na lactic coma mai zurfi.
Idan mutum yana da nau'in na biyu na mellitus na ciwon sukari, to, ana lura da kwarara zuwa cikin lactic acid coma bayan wasu alamun farko na rikitarwa.
Lokacin da mara lafiya ya fadi cikin rashin lafiya, yana da:
- hyperventilation;
- karuwar cutar glycemia;
- raguwa a cikin adadin bicarbonates a cikin jini na jini da raguwa a cikin pH jini;
- an gano ƙaramin adadin ketones a cikin fitsari;
- matakin lactic acid a jikin mai haƙuri ya tashi zuwa matakin 6.0 mmol / l.
Rikicin ya bunkasa sosai kuma yanayin mutumin da ke fama da kamuwa da ciwon sukari na 2 wanda yake wahala a hankali akan awoyi da yawa.
Kwayar cutar cututtukan dake hade da ci gaban wannan rikice-rikice sun yi kama da na sauran rikice-rikice, kuma mai haƙuri da ciwon sukari na iya fadawa cikin rashin lafiya tare da ƙananan matakan sukari a cikin jiki.
Dukkanin cututtukan cututtukan lactic acidosis sun dogara ne akan gwaje-gwajen jinin jini.
Jiyya da rigakafin lactic acidosis a gaban ciwon sukari mellitus
Saboda gaskiyar cewa wannan rikicewar ya samo asali ne daga rashin isashshen sunadarin oxygen a cikin jiki, hanyoyin magance warkewa don cire mutum daga wannan yanayin sun samo asali ne daga tsarin oxygenation na ƙwayoyin jikin mutum da gabobin jikinsa. Don wannan dalili, ana amfani da na'urar huhu ta huhu ta wucin gadi.
Lokacin cire mutum daga yanayin lactic acidosis, aikin farko na likita shine kawar da hypoxia wanda ya tashi a cikin jikin mutum, tunda shine ainihin wannan shine ainihin farkon ci gaban lactic acidosis.
A yayin aiwatar da matakan warkewa, matsa lamba da duk alamun mahimmancin jikin suna kulawa. Ana aiwatar da iko na musamman lokacin da aka cire tsofaffi daga jihar lactic acidosis, waɗanda ke fama da hauhawar jini kuma suna da rikitarwa da rikice-rikice a cikin hanta.
Kafin a gano mai haƙuri da lactic acidosis, dole ne a dauki jini don bincike. A yayin aiwatar da nazarin dakin gwaje-gwaje, pH na jini da taro na ion potassium da ke ciki an ƙaddara su.
Dukkan hanyoyin ana aiwatar da su da sauri, tunda mace-mace daga haɓakar irin wannan rikitarwa a jikin mai haƙuri yana da girma sosai, kuma tsawon lokacin miƙa mulki daga yanayin al'ada zuwa cuta na yau da kullun ne.
Idan an gano maganganu masu tsanani, ana gudanar da bicarbonate potassium, wannan magani yakamata a iya amfani da shi idan jinin acid ɗin ya kasa da 7. Gudanar da miyagun ƙwayoyi ba tare da sakamakon binciken da ya dace ba haramtacce.
Ana bincika acidity na jini a cikin haƙuri a cikin awa biyu. Dole ne a aiwatar da gabatarwar potassium bicarbonate har zuwa lokacin da matsakaici zai sami acidity fiye da 7.0.
Idan haƙuri yana da gazawar koda, hemodialysis na kodan an yi. Bugu da ƙari, ana iya yin diyya na peritoneal dialysis don dawo da matakin al'ada na potassium bicarbonate a jiki.
Yayin aiwatar da cire jikin mai haƙuri daga acidosis, ana kuma amfani da isasshen ilimin insulin da gudanarwar insulin, manufar wacce shine a gyara metabolism.
Ba tare da gwajin jini na kwayoyin halitta ba, ba shi yiwuwa a tsayar da ingantaccen ganewar asali ga mara lafiya. Don hana haɓakar yanayin cututtukan cuta, ana buƙatar mai haƙuri ya sadar da buƙatun karatu zuwa cibiyar likitancin lokacin da alamun farko na alamun cutar ta bayyana.
Don hana haɓakar ci gaban lactic acidosis a cikin jiki, ya kamata a kula da yanayin metabolism na jikin mai haƙuri tare da ciwon sukari a fili. Bidiyo a cikin wannan labarin yayi magana game da alamun farko na ciwon sukari.
