Lactic acidosis matsala ce mai haɗari, kodayake yana da wuya. Wannan ciwo yana faruwa lokacin da abun ciki na lactic acid a cikin jini ya tara, ya wuce al'ada.
Wani suna don cutar shine lactic acidosis (motsi a cikin matakin acidity). A cikin ciwon sukari na mellitus, wannan rikitarwa yana da haɗari sosai, saboda yana haifar da cutar sikari.
Mene ne lactic acidosis a cikin ciwon sukari?
Magungunan na nuna rashin lafiyar “lactic acidosis” idan maida hankali na lactic acid (MK) a cikin jiki ya wuce 4 mmol / l.
Ganin cewa matakin acid din na yau da kullun (wanda aka auna a cikin mEq / l) don jinin venous yana daga 1.5 zuwa 2.2 kuma jini na jijiya yana daga 0,5 zuwa 1.6. Jiki mai kyau yana haifar da MK a cikin adadi kaɗan, kuma ana amfani dashi nan da nan, yana samar da lactate.
Lactic acid ya tara a cikin hanta kuma ya karye cikin ruwa, carbon monoxide da glucose. Tare da tara adadin lactate mai yawa, fitowar sa ta rikice - lactic acidosis ko matsanancin motsi a cikin yanayin acidic yana faruwa.
Wannan bi da bi yana kara haɗarin ciwon sukari, saboda insulin ya zama baya aiki. Bayan haka, juriyawar insulin yana inganta samar da kwayoyin halittun na musamman wanda ke rushe metabolism mai. Jikin yana fitar da ruwa, maye ne da acidosis. A sakamakon haka, an ƙirƙiri coma na hyperglycemic. Babban maye yana da rikitarwa ta rashin aiki na gina jiki mara kyau.
Yawan kayayyakin samfurori na jiki suna tarawa a cikin jini kuma mara lafiya na yin gunaguni na:
- janar gaba daya;
- gazawar numfashi;
- ƙarancin jijiyoyin jiki;
- rashin jin daɗi da ƙwayar jijiya mafi girma.
Wadannan alamu na iya haifar da mutuwa.
Babban dalilai
Lactic acidosis a cikin nau'in ciwon sukari na 2 ana gano shi ta abubuwa da yawa:
- cuta cuta na rayuwa sakamakon rashin kyautar gado;
- babban adadin fructose a jikin mai haƙuri;
- giya barasa;
- haɓaka aikin samar da lactate a sakamakon shan allunan-sukari;
- rashin bitamin B1;
- ketoacidosis mai ciwon sukari (gazawar metabolism metabolism);
- wuce haddi lactic acid a sakamakon lalacewar hanta;
- hypoxia (sel ba sa shan iskar oxygen) don cututtukan zuciya ko tsarin numfashi;
- lalata lalacewar jiki;
- zub da jini (yawan zubar jini);
- daban-daban siffofin anemia.
Symptomatology
Cutar na bayyana kanta ba zato ba tsammani, tana tasowa da sauri sosai (awanni da yawa) kuma ba tare da magani cikin lokaci ba yakan haifar da sakamako mai wahala Iyakar abin da ke nuna alama na lactic acidosis shine ciwon tsoka, kodayake mai haƙuri bai da ƙarfin motsa jiki. Sauran alamun da ke haɗuwa da lactic acidosis a cikin ciwon sukari na mellitus na iya kasancewa cikin wasu cututtuka.
Yawanci, lactic acidosis a cikin ciwon sukari yana haɗuwa da waɗannan alamun:
- tsananin farin ciki (yiwuwar asarar hankali);
- tashin zuciya da amai;
- tsananin ciwon kai;
- ciwon ciki
- rashin daidaituwa;
- karancin numfashi
- mai rauni sosai;
- dabarun motsa jiki;
- saurin urination, har sai ya daina gaba daya.
Cakuda yawan lactate yana ƙaruwa cikin hanzari kuma yana kaiwa zuwa:
- wani sautin numfashi, wani lokacin yakan zama nishi;
- keta ayyukan zuciya, wanda hanyoyin al'ada ba za a iya kawar da su ba;
- saukarwa (kaifi) hawan jini, gazawar zuciya;
- rashin tsotsewar tsoka (bugun zuciya);
- zubar jini. Cutar mai haɗari sosai. Ko bayan bayyanar cututtukan lactic acidosis, ƙwayoyin jini suna ci gaba da motsawa ta cikin tasoshin kuma yana iya haifar da ƙarar jini. Wannan na iya haifar da cutar ƙoshin yatsa ko tsoratar da gangrene;
- oxygen abinci na kwakwalwa Kwayoyin cewa tasowa hyperkinesis (excitability). Hankalin mai haƙuri ya warwatse.
Sannan yazo da wakafi. Wannan shine matakin karshe a ci gaban cutar. Hankalin mai haƙuri ya ragu, zafin jiki yana sauka zuwa digiri 35.3. Fuskokin fushin mai haƙuri suna da kaifi, urination ya daina aiki, kuma yana asuba.
Binciko
Lactic acidosis yana da matukar wahalar ganewa. Dole ne a tabbatar da yanayin ta hanyar gwaje gwaje. Jiki a cikin wannan yanayin ya ƙunshi babban adadin lactic acid da raunin plasma antionic.
Manunfofi kamar:
- babban matakin lactate - fiye da 2 mmol / l;
- ƙananan kudaden bicarbonates;
- babban matakan nitrogen;
- lactic acid maida hankali - 6.0 mmol / l;
- matakin mai sosai;
- acidity na jini ya ragu (kasa da 7.3)
An gano shi tare da lactic acidosis a cikin ciwon sukari na mellitus na musamman a cikin cibiyar likita. Yana da kyau a aiwatar da mara lafiyar kafin sake farfadowa, tunda kusan mutane ne kawai zasu taimaka wa likita don tattara tarihin likita.
Jiyya
Ba za a iya gano acid acid a gida ba, duk yunƙurin warkewa akan ƙarshen rayuwar su ta mutu. Ya kamata a gudanar da jiyya kawai a asibiti.
Tunda cutar tana tsokani musamman ta rashin isashshen oxygen, maganirta ya samo asali ne daga hanyar girke jikin kwayoyin halittar oxygen. Ana yin wannan ta amfani da iska mai tilastawa.
Samun iska
Don haka, da farko, likita ya ware hypoxia, a matsayin babban dalilin lactic acidosis. Kafin wannan, yana da mahimmanci a gudanar da duk gwaje-gwajen likita da wuri-wuri, saboda mai haƙuri yana cikin mummunan yanayin.
A cikin yanayi mawuyacin hali, likita ya ba da izinin sodium bicarbonate, amma ya ba da cewa asarar jinin ta ƙasa da 7.0. A lokaci guda, ana kula da matakin pH na jinin venous a koyaushe (kowane 2 hours) kuma an allurar da bicarbonate har sai an sami darajar acid fiye da 7.0. Idan mai haƙuri ya sha wahala daga cututtukan koda, ana yin hemodialysis (tsarkake jini).
Ana bai wa masu ciwon sukari lokaci guda tilas da ilimin insulin. Ana bai wa mara haƙuri digon ciki (glucose tare da insulin) don gyara raunin ƙwayar cuta. An tsara magunguna don kiyaye aikin zuciya da jijiyoyin jini. Don rage acidity na jini, ana amfani da maganin soda sosai. An allura ne a ciki (kwayar ta yau ce lita 2) sannan a sanya idanu a kan matakin kwayayen da ke cikin jini da kuzarin acidity.
Detoxification far ne kamar haka:
- jini yana allurar jini cikin jijiya;
- carboxylase bayani kuma a cikin ta ciki;
- ana gudanar da heparin;
- reopoliglukin bayani (karamin kaso don kawar da coagulation na jini).
Lokacin da aka rage yawan acidity, ana ba da thrombolytics (hanya don daidaita zubar jini) don maganin masu ciwon sukari na 2 na ciwon sukari.
Yin rigakafin
Ba shi yiwuwa cewa zai yuwu a faɗi hango ci gaban lactic acidosis a cikin nau'in ciwon sukari na 2.A lokacin harin, rayuwar mai haƙuri gaba daya ya dogara da ƙwarewar ma'aikatan kiwon lafiya, da kuma akan mutanen da suke kusa da mai haƙuri a wannan mawuyacin lokaci. Cikakken bincike na yiwuwa ne kawai tare da gwajin jini don nazarin halittu.
Ya kamata a tuna cewa wannan yana ɗaukar ɗan lokaci, wanda matukan jirgin motar asibiti yawanci ba su da shi. Saboda haka, dole ne a kai haƙuri cikin gaggawa zuwa asibiti mafi kusa kuma a can ne ake yin gwajin lafiya.
Yana da matuƙar mahimmanci ga masu ciwon sukari su iya sarrafa “cutar sukari” koyaushe. Don yin wannan, dole ne:
- saka idanu akai-akai ta endocrinologist;
- Guji shan magani. Ana ɗaukar magunguna kawai tare da izinin likita, in ba haka ba abin hana daukar ciki da acidosis mai yiwuwa ne;
- yi hankali da kamuwa da cuta.
- saka idanu kan jin daɗin rayuwa yayin shan magunguna masu rage sukari - biguanides;
- bi abinci, lura da tsarin yau da kullun;
- idan bayyanar cututtuka masu haɗari, kira nan da nan don kulawa ta gaggawa.
Yawancin lokaci mai ciwon sukari yakan san game da rashin lafiyarsa ne kawai bayan kamuwa da cutar lactic acidosis. An ba da shawarar marasa lafiya don ba da gudummawar jini don sukari a shekara.
Bidiyo masu alaƙa
Kuna iya gano menene rikicewar cutar ciwon sukari na iya haifar daga wannan bidiyo:
Neman taimakon likita akan lokaci, zaka iya ceton ranka. Lactic acidosis cuta ce mai wahala wanda ba za'a iya jurewa akan kafafu ba. Abun da aka samu da gogewa mai cike da lactic acidosis coma babbar nasara ce ga mara haƙuri. Dole ne a yi dukkan qoqarin don dakile faruwar hakan. Ana magance wannan matsalar ta hanyar endocrinologist. Yakamata a nemi likita nan da nan bayan gano babban matakin acidity a cikin kyallen.
