• Kutopa
• Mutu
• Chizungulire
• Kununkhira kwa acetone kuchokera mkamwa
• Kubweza
• Kusokonezeka kwa mtima
• Chikumbumtima
• Kutsegula m'mimba
• Kusakwiya
• Akuyenda
• Ludzu lalikulu
• Kuchepetsa thupi
• Kugona
• Pakamwa pakamwa
• Khungu lowuma
• Kuchepetsa mseru
• Kutsika kwamkodzo
• Kupumira mwachangu
• Zosangalatsa pamtima
• Kukodza pafupipafupi

Ketoacidosis ndimavuto owopsa a matenda ashuga, omwe, popanda chithandizo chokwanira komanso chakanthawi, angayambitse kudwala matenda ashuga kapena ngakhale kufa. Vutoli limayamba kupita patsogolo ngati thupi la munthu silingagwiritse ntchito bwino glucose monga gwero lamphamvu, popeza limasowa insulin. Poterepa, makina olumikizira adakonzedwa, ndipo thupi limayamba kugwiritsa ntchito mafuta obwera ngati mphamvu yamagetsi.

Zotsatira zakusokonekera kwa mafuta, ma ketoni amapangidwa. Zinthu izi ndi zinthu zonyansa zomwe zimadziunjikira pang'onopang'ono m'thupi la munthu ndikuzipweteka. Kuledzera kwambiri kungayambitse kudwala matenda ashuga. Ngati simupatsa wodwala thandizo la panthawi yake, zotsatira zake zimakhala zoopsa.

Asayansi adafotokozera kaye za matenda a ketoacidosis mwa ana ndi akulu kuyambira 1886. Mpaka insulin itapangidwa, matenda a shuga a ketoacidosis pafupifupi nthawi zonse amayambitsa kufa. Tsopano zinthu zasintha kwambiri. Chiwerengero cha anthu omwalira chimakhala chotsika kwambiri. Chachikulu ndikuyamba chithandizo chokwanira komanso chokwanira.

Matenda a matenda ashuga ketoacidosis amakhudza akulu ndi ana omwe ali ndi mbiri ya matenda ashuga a mtundu woyamba. Ndizofunikira kudziwa kuti mkhalidwe wowopsa uwu ndi wosowa kwambiri mu mtundu 2 wa shuga. Chithandizo cha matenda a matenda a m'magazi ziyenera kuchitika pokhapokha ngati madokotala ali ndi mwayi wofufuza momwe wodwalayo alili, ndipo ngati ndi kotheka, azitsatira njira zodutsira.

Matenda a diabetesic ketoacidosis mwa akulu ndi ana amadziwika ndi kuchepa kwa insulin ya mahomoni, kuwonjezeka kwa kuchuluka kwa matupi a glucose ndi thupi la munthu, mawonekedwe a acetone mu mkodzo, komanso vuto la metabolic. Vutoli limakhala lalikulu kwambiri mwa ana ndi achinyamata omwe salipiridwa bwino matenda a shuga 1.

Chifukwa chachikulu chakukula kwa matenda ashuga a ketoacidosis a mtundu 1 a shuga ndi kuchepa kwa insulin. Zomwe zimayambitsa chidwi cha ketoacidosis ndi izi:

• chiwonetsero choyambirira cha matenda amtundu 1,
• chithandizo chokwanira cha matenda a shuga 1: osawerengeka a insulin komanso kuwerengetsa magazi molakwika.
• osagwirizana ndi kudya zakudya - kudya zakudya zambiri zomwe zimakhala ndi zopatsa mphamvu m'mimba,
• Matenda akukulitsa matenda a shuga 1 amtundu wa ana ndi akulu: matenda opatsirana kwamikodzo, kupuma kwamatenda, myocardial infarction, ischemic stroke.
• othandizira opaleshoni ndikuvulala kosiyanasiyana,
• mavuto
• kugwiritsa ntchito mankhwala ena omwe angakulitse kuchuluka kwa shuga m'magazi. Mwachitsanzo, izi zimaphatikizapo glucocorticoids,
• matenda a endocrine dongosolo,
• kubala mwana.

Akatswiri azachipatala amasiyanitsa madigiri akuluakulu a matenda ashuga a ana ndi akulu:

• zosavuta. Zizindikiro zoyambirira za matenda amtunduwu zimawonekera: kukodza kumachitika pafupipafupi, wodwalayo amayamba kumva kupweteka ndipo zizindikiro za kuledzera zimawonekera. Ndikofunika kudziwa kuti panthawiyi chizindikiro cha ketoacidosis chikuwonekera - fungo la acetone mu mpweya wotuluka.
• pafupifupi. Matenda a wodwalayo amakula pang'onopang'ono - amakhala soporotic. Zizindikiro za kusayenda bwino kwamtima kumawonekera: tachycardia, kuchepa kwa magazi. Kusungunuka, kupweteka kwam'mimba kumawonekeranso (wodwalayo sangadziwe kutulutsa kwake momveka bwino),
• zolemetsa. Zoopsa kwambiri. Kuphonya kwa chikumbumtima kumawonedwa, ana ndi opapatiza ndipo samayankha kutulutsa kotsika. Fungo la acetone ndilamphamvu kwambiri kotero kuti limatha kumva mosavuta m'chipinda momwe wodwalayo alili. Pali zizindikiro zazikulu zakutha kwamadzi.

Zizindikiro

Ndikofunika kudziwa kuti zizindikiro za ketoacidosis mwa ana ndi akulu zimawonekera pang'onopang'ono - kuyambira tsiku mpaka sabata 1. Koma ndi njira yochepetsetsa yomweyi yomwe imapangitsa kuti munthu athe kukayikira kuti matenda oopsawa akuchitika ndipo nthawi yomweyo amapempha thandizo kuchipatala.

Zizindikiro za ketoacidosis:

• Kuchepetsa thupi pakudya wamba
• kufooka
• munthu amatopa msanga ndi ntchito yake,
• ludzu lalikulu
• mutu
• chizungulire nchotheka
• kusakhazikika
• khungu lowuma
• tachycardia
• kusokonezeka kwa mtima
• nseru ndi kugwedezeka
• kutsegula m'mimba
• pa gawo loyambirira la kufalikira kwa matendawa, kukodza pafupipafupi kumawonedwa, koma ndikusintha kwa gawo la chikomokere, kuchuluka kwa mkodzo kumachotsedwa kwambiri (ngakhale anuria ndikotheka),
• fungo lokhazikika la acetone kuchokera pamlomo wamkamwa,
• chikumbumtima. Zoletsa kapena kugona. Ngati chithandizo sichichitika pa nthawi yake, ndiye kuti mumakhomomoka.

Ngati mulabadira izi ndipo simumalandira chithandizo chokwanira, ndiye kuti ketoacidotic chikomokere. Ili ndi njira zingapo:

• mtima. Mwa munthu, zizindikiro za kukomoka kwa mtima ndi mtima zimatchulidwa kwambiri - kupweteka pamalo a kuchuluka kwa mtima, tachycardia, kutsika kwa magazi,
• m'mimba. Zizindikiro za pseudoperitonitis zimawonekera - kupweteka kwam'mimba, nseru ndi kusanza,
• aimpso. Kukodza pafupipafupi, komwe pambuyo pake kumasinthidwa ndi anuria,
• encephalopathic. Kutsogolo kuli zizindikiro za kufooka kwa magazi muubongo - kuchepa kwa mawonekedwe a ntchito, nseru, chizungulire, ndi zina zambiri.

Zizindikiro

Zizindikiro zoyambirira zikawoneka mwa ana ndi akulu, zomwe zikuonetsa kupita patsogolo kwa ketoacidosis, muyenera kupita kuchipatala kuti mumve ndikutsimikizira kapena kutsutsa kuti matendawo ndi. Dongosolo labwino lodziwika ngati matenda amapezeka ndi:

• kusanthula kwa chizindikiro
• kuwunika kwa mbiri ya matendawa - kupezeka kwa matenda ashuga amtundu 1, komanso matenda ena othandizira,
• kupenda wodwalayo,
• kuyezetsa magazi kudziwa kuchuluka kwa shuga m'magazi,
• urinalysis kuti mupeze matupi a ketone ndi acetone,
• kusanthula kwa magazi ndi mkodzo,
• magazi zamankhwala.

Mavuto

• matenda edema
• kukanika kwa mtima,
• kuchuluka kwa matenda osiyanasiyana opatsirana,
• chiopsezo chachikulu cha imfa.

Kuchiza kwa matenda amisempha kuyenera kuyamba pokhapokha atazindikira bwinobwino. Dongosolo la chithandizo liyenera kuchitidwa kokha ndi katswiri woyenereradi, poganizira zovuta za momwe wodwalayo alili, komanso kuopsa kwa ketoacidosis yake. Ndizofunikira kudziwa kuti chithandizo cha odwala omwe ali ndi vutoli nthawi zambiri chimachitika mu chipinda chothandizira kwambiri.

Mankhwalawa akuphatikizapo:

• mankhwala a insulin. Insulin ya insulin imasonyezedwa kuti muchepetse magazi. Munthawi yamankhwala awa, ndikofunikira kuyang'anira kuchuluka kwa shuga m'magazi,
• chithandizo cha madzi m'thupi. Ndikofunikira kubwezeretsa madzi omwe atayika. Pachifukwa ichi, mchere umayendetsedwa iv
• kuteteza kupitirira kwa hypoglycemia, njira ya shuga ikuwonetsedwa,
• kukonza kwa zosokoneza zamagetsi,
• mankhwala a antiotic. Gululi ndilofunikira popewa kupitilira kwa zovuta zamatenda,
• anticoagulants.

Kupewa

Ketoacidosis ndi owopsa, chifukwa chake, ndikofunikira kupewa chifukwa cha anthu omwe ali ndi matenda ashuga 1. Njira zopewera:

• Kukhazikitsidwa kwa Mlingo wa insulin yolondola ndi yake
• kutsatira mosamalitsa zakudya
• kuphunzitsa odwala omwe ali ndi matenda ashuga oyambilira ndi mtundu wachiwiri kuti azindikire za kuwonongedwa.

Mitundu ya matenda

• Diabetesic ketosis, momwe mulingo wa matupi a ketone m'mwazi umakwera, koma palibe chowopsa m'mthupi la munthu.
• Matenda a shuga a ketoacidosis omwe ali ndi mtundu woyamba wa 1 kapena mtundu wa 2 wodwala matenda a shuga amakhala ndi zizindikiro zowopsa, popanda kulandira chithandizo chanthawi yake kumabweretsa kukula kwa chikomokere.

Kusiyana pakati pa mitundu iyi ya matenda ndi kuopsa kwa kusokonezeka kwa kagayidwe kachakudya m'thupi ndi kuwonetsedwa kwamankhwala.

Zoyambitsa ketoacidosis

Ketoacidosis imayamba motsutsana ndi maziko a:

• mankhwala molondola wodwala,
• matenda osokoneza bongo a shuga osadziwika, nthawi zambiri amakhala a mtundu 1,
• anasamutsa matenda oyambitsidwa ndi tizilombo, matenda opatsirana, nthawi zambiri am'mapazi apamwamba,
• kuphwanya malamulo a jakisoni wa insulin, kudumphira jakisoni, kumwa mankhwala osokoneza bongo,
• kusokonekera kwa endocrine dongosolo, momwe kupangika kwa mahomoni otsutsana kumachuluka,
• matenda opatsirana otupa,
• kuphwanya zakudya ndi zakudya zotchulidwa, kugwiritsa ntchito kuchuluka kwa chakudya chamafuta ambiri, mafuta,
• kuvulala kwamakina, kuchitapo kanthu opaleshoni,
• mimba odwala matenda ashuga
• mavuto, makamaka ana ndi achinyamata,
• mankhwala a mahomoni, glucocorticoids, okodzetsa,
• kumwa mankhwala osokoneza bongo
• mikwingwirima yapitayo kapena vuto la mtima.

Pankhani ya zoterezi zimachitika, kuchuluka kwa insulin kumafunika. Izi ndizofunikira, chifukwa kutulutsa kwamphamvu kwa adrenaline kumachitika m'thupi, ndipo chiwopsezo cha minyewa yokhudzana ndi insulin chimachepa. Ndi kuchepa kwa timadzi ta pancreatic, ketoacidosis imayamba. Mwa odwala ena, zoyambitsa kuwonongeka sizikuyenda bwino.

Kodi ketoacidosis amawonetsedwa bwanji?

Zizindikiro za matenda a shuga a ketoacidosis mwa akulu ndi ana:

• kusowa kwa chakudya
• kununkhira kwa acetone kuchokera mkamwa,
• kufooka wamba, kugona,
• kusanza, kusanza mobwerezabwereza,
• khungu louma ndi nembanemba
• kukomoka kwa mtima, kuthamanga kwa magazi,
• kupuma kwamkati
• Kukutira khungu pakhungu ndi pachifuwa (rubeosis),
• kupweteka m'mimba ndi kutukuka kwakanthawi,
• kuchuluka kwamkodzo
• mwina kukulitsa chiwindi
• ludzu lalikulu.

Zomwe zimapangitsa kupweteka kwam'mimba komanso kusanza ndizotupa pang'ono mu peritoneum, kuchepa kwake kwa madzi, komanso kuwopsa kwa matupi a ketone pamatumbo. Matumbo a abdominal amawonedwa mwa ana ambiri odwala ndi achinyamata omwe ali ndi matchulidwe owopsa.

Kuponderezedwa kwamkati wamanjenje kumayambitsa kufooka, kusilira, chizungulire, kukomoka. Kamvekedwe ka minofu kochepa kamacheperachepera, minyewa yodziyimira payokha imawoneka. Mwina makulidwe a khungu (kuchepa kwa khungu), komwe kumayambitsa kuwonongeka kwa ma ketoni paminyewa ya epithelial.

Ndi chithandizo chanthawi yake kwa wodwala, matendawa ndi abwino, apo ayi zikomoka zimachitika. Asanayambike kupuma, kuthamanga kwa magazi kumatsika kwambiri, kusungika kwamikodzo kumachitika, ndipo kulephera kwa impso kumayamba. Minyewa ya magazi imachulukana, imathandizira kuti magazi azisamba, zomwe zimayambitsa magazi, zimayambitsa matenda a mtima, stroke, hemorrhagic necrosis ya zala ndi zala. Matenda okhudzana ndi matenda ashuga ali ndi chiwopsezo chachikulu cha kufa kwa ana.

Mankhwala othandizira

Dziwani matenda ashuga a ketoacidosis mwa odwala omwe ali ndi mtundu woyamba wa 2 ndi matenda a shuga 2 pamaziko a matenda azachipatala, omwe ali ndi kuchuluka kwa shuga m'magazi. Chitani mayeso a labotale. Odwala, kupezeka kwa matupi a ketone mu mkodzo ndi seramu ya magazi, kuphwanya kwa mulingo wa acid-base balance, ndi bicarbonates kuwululidwa.

Zizindikiro za ketoacidosis zikawoneka, wodwala amafunikira chisamaliro chodzidzimutsa. Chithandizo chimachitika kuchipatala. Choyamba, chotsani zomwe zidayambitsa izi. Kenako, mapiritsi a insulin amasinthidwa, jakisoni wocheperako amaperekedwa mpaka 4-6 pa tsiku. Kuti athetse zizindikiro zakanjenjemera ndikusintha momwe madziwo amakhalira, njira ya isotonic sodium kolorayidi imayendetsedwa kudzera mkati.

Pezani shuga wambiri ndi glucose infusions. Kupanga kutaya kwa potaziyamu, odwala amapatsidwa madzi akumwa a zipatso popanda shuga pambuyo poti wodwalayo ayambiranso kuzindikira. Pa chithandizo, ndikofunikira kukhazikika pa mtima ndi mtima komanso impso, ndikuchotsa kuledzera kwa thupi.

Zochizira ketosis, zakumwa zamchere zimayikidwa, awa ndi madzi amchere kapena yankho la soda. Kubwezeretsa pH, alkaline enemas imathandiza. Kuchokera pazakudya za wodwala, ndikofunikira kupatula zakudya zamafuta. Intramuscularly Ikani cocarboxylase, maphunziro a Splenin mpaka masiku 10. Fotokozeraninso kudya kwa ma amino acid ofunikira, ma phospholipids ndi enterosorbents. Mankhwalawa amathandizira kubwezeretsa njira za metabolic, kulimbitsa chiwindi, ndikuchotsa poizoni m'thupi.

Popewa matenda a thrombosis, magazi amawonda kwambiri. Izi zimachepetsa chiopsezo cha matenda a mtima, stroko, necrosis yamankhwala ndi ziwalo zamkati.

Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, fungo la acetone limawonekeranso pafupipafupi, izi zimachitika motsutsana ndi chiyambi cha kuchuluka kwamphamvu kwa magazi. Cholinga chake ndi kumwa mafuta ambiri. Odwala amatchulidwa okhwima zakudya, zakumwa zamkati, antiemetic mankhwala.

Momwe mungapewere kukula kwa ketoacidosis

Kuti muchepetse chiopsezo chokhala ndi matenda, muyenera kuyang'anira thanzi lanu, kutsatira mosamalitsa zomwe dokotala wanu akukuuzani.

Njira yofunikira kwambiri yoletsera ndikukhazikitsa milingo yoyenera ya insulin komanso kupita kwa dokotala nthawi yoyamba zizindikiro za zovuta. M'pofunikanso kuyeserera pafupipafupi ndi endocrinologist.

Ndi chitukuko cha matenda opatsirana kapena chimfine, chithandizo chikuyenera kuchitika moyang'aniridwa ndi dokotala. Ana odwala amafunika kuwunika kwambiri zakudya, kuwongolera zakudya zomwe zimamwa, kutsatira zakudya.

Ketoacidosis ndi matenda owopsa omwe amafunika chithandizo chamankhwala kwa ana ndi akulu. Kufunafuna chithandizo chochepa kumayambitsa kudwala matenda ashuga, kulemala kwa wodwala kapena kufa. Vutoli ndi loopsa makamaka kwa ana ndi achinyamata.

- mtundu wopangidwa ndi matenda ashuga, womwe umachitika ndi kuchuluka kwa shuga ndi matupi a ketone m'magazi. Amadziwika ndi ludzu, kukodza kwambiri, khungu lowuma, kupuma kwa acetone, kupweteka kwam'mimba. Kuchokera kumbali yamanjenje yapakati, maonekedwe a mutu, ulesi, kusokonekera, kugona, kufoka. Ketoacidosis imapezeka mwamagazi am'mwazi ndi mayeso amkodzo (shuga, ma electrolyte, matupi a ketone, CBS). Maziko a mankhwalawa ndi mankhwala a insulin, njira zokuthandanso madzi m'thupi komanso kukonza kwa kusintha kwa ma metabolism mu metabolrolyte metabolism.

Matenda a shuga a ketoacidosis

Chithandizo cha ketoacidotic mkhalidwe chimachitika kokha mu chipatala, ndi chitukuko cha chikomokere - kuchipatala kwambiri. Adalimbikitsa mpumulo. Therapy imakhala ndi zigawo izi:

• Mankhwala a insulin. Kusintha kwa mlingo wa mahomoni kapena kusankha kwa mulingo woyenera wa matenda oyambitsidwa ndi matenda a shuga. Kuchiza kuyenera kutsagana ndi kuyang'anira kuchuluka kwa glycemia ndi ketonemia.
• Kulowetsedwa mankhwala. Imachitika m'malo atatu akuluakulu: kukonzanso madzi, kukonza kwa WWTP komanso kusokonezeka kwa ma elekitirodi. Intravenous makonzedwe a sodium mankhwala ena, potaziyamu kukonzekera, sodium bicarbonate ntchito. Kuyamba koyambirira kumalimbikitsidwa. Kuchuluka kwa njira yovulazidwa kumawerengedwa ndikuganizira zaka ndi zovuta za wodwala.
• Chithandizo cha concomitant pathologies. Kugunda kwamtima koyerekeza, matenda opha ziwalo, matenda opatsirana amatha kukulitsa zomwe wodwala ali ndi DKA. Mankhwalawa matenda opatsirana, mankhwala othandizira akuwonetseredwa, mwangozi ya mtima - ya thrombolytic.
• Kuyang'anira zofunikira. Ma electrocardiography a pafupipafupi, mapangidwe oculet, glucose ndi matupi a ketone amayesedwa. Poyamba, kuwunikira kumachitika mphindi 30-60 zilizonse, ndipo pambuyo poti wodwalayo azikhala ndi thanzi lililonse patatha maola atatu tsiku lotsatira.

Masiku ano, zomwe zikuchitika zikuchepetsa kuchepa kwa matenda a DKA kwa odwala omwe ali ndi matenda osokoneza bongo (kukonzekera kwa insulin kukupangidwanso m'njira zamtundu wa piritsi, njira zoperekera mankhwala m'thupi zikukonzedwa, ndipo njira zikufunidwa kuti abwezeretse kupanga kwawo kwa mahomoni).

Zotsogola ndi kupewa

Ndi chithandizo chanthawi yake komanso chothandiza kuchipatala, ketoacidosis imatha kuyimitsidwa, kudalirika kwake ndikabwino. Kuchedwa kukapereka chithandizo chamankhwala, matendawa amatembenukira msana. Imfa ndi 5%, ndipo mwa odwala opitirira zaka 60 - mpaka 20%.

Chomwe chimapangitsa kupewa ketoacidosis ndi maphunziro a odwala omwe ali ndi matenda ashuga. Odwala ayenera kudziwa bwino za kusokonezeka, kudziwitsidwa za kufunika kogwiritsa ntchito mankhwala a insulin ndi zida zake pakukonzekera, ophunzitsidwa bwino pazoyang'anira kuchuluka kwa shuga m'magazi. Munthu ayenera kudziwa za matenda ake momwe angathere. Kukhala ndi moyo wathanzi ndikutsatira zakudya zosankhidwa ndi endocrinologist ndikulimbikitsidwa. Ngati zizindikiro za matenda a matenda ashuga ketoacidosis zikukula, ndikofunikira kufunsa dokotala kuti mupewe mavuto.

Zizindikiro za matenda a shuga a ketoacidosis komanso chifukwa chake ndi oopsa

Ketoacidosis ndi vuto lalikulu la matenda ashuga. Amayamba kukhala odwala omwe sanaphunzitsidwe kuthana ndi matenda awo. Mukatha kuwerenga nkhaniyi, muphunzira zonse zomwe mukufuna pazomwe mungagwiritse ntchito pochiza matenda ashuga a ketoacidosis mwa ana ndi akulu. Tsambali limalimbikitsa malowa - njira yothandiza yolamulira matenda a shuga 1 ndi mtundu 2. Mwa odwala matenda ashuga omwe amatsatira chakudyachi, mizere yoyesera imawonetsa kukhalapo kwa ma ketones (acetone) mkodzo ndi magazi. Palibe vuto, ndipo palibe chomwe chimayenera kuchitidwa pomwe shuga ndimagazi wamba. Acetone mu mkodzo si ketoacidosis pano! Palibenso chifukwa chochitira mantha. Werengani zambiri pansipa.

Matenda a shuga a ketoacidosis: Zizindikiro ndi kulandira chithandizo kwa ana ndi akulu

Pakakhala vuto la insulin, maselo sangathe kugwiritsa ntchito glucose ngati mphamvu. Poterepa, thupi limasinthana ndi chakudya ndi mafuta omwe amakhala nawo. Mafuta akaphwanyidwa, matupi a ketone (ma ketones) amapangidwa mwachangu. Ma ketoni ochuluka kwambiri akamazungulira m'magazi, impso sizikhala ndi nthawi yowachotsa m'thupi ndipo acidity imayamba. Izi zimayambitsa zizindikiro - kufooka, nseru, kusanza, ludzu, komanso kununkhira kwa acetone kuchokera mkamwa. Ngati achitapo kanthu mwachangu, wodwala matenda ashuga akhoza kugwa ndipo akhoza kufa. Odwala odziwa bwino amadziwa momwe sayenera kubweretsera vutoli ku ketoacidosis. Kuti muchite izi, muyenera kubwezeretsanso madzi osungidwa m'thupi ndikupanga jakisoni wa insulin. Pansipa amafotokozedwa mwatsatanetsatane momwe angachitire matenda a shuga a ketoacidosis kunyumba komanso kuchipatala. Choyamba, muyenera kudziwa komwe acetone mu mkodzo amachokera ndi chithandizo chomwe chikufunikira.

Kodi pali kusiyana kotani pakati pa matenda ashuga a ketoacidosis ndi acetone mu mkodzo

M'mayiko olankhula Chirasha, anthu amakonda kuganiza kuti acetone mu mkodzo ndiowopsa, makamaka kwa ana. Inde, acetone ndi fungo lonunkhira lomwe limagwiritsidwa ntchito kupukuta zinyalala muzouma zouma. Palibe aliyense m'malingaliro awo oyenera omwe angafune kuyitenga mkati. Komabe, acetone ndi amodzi mwa mitundu ya matupi a ketone omwe amapezeka m'thupi la munthu. Kulimbikira kwawo m'magazi ndi mkodzo kumawonjezereka ngati malo ogulitsa ma carbohydrate (glycogen) atatha ndipo thupi limasinthira chakudya ndi mafuta ake. Izi zimachitika kawirikawiri kwa ana a matupi oonda omwe amakhala olimbitsa thupi, komanso odwala matenda ashuga omwe amatsata zakudya zamagulu ochepa.

Acetone mu mkodzo si owopsa mpaka sipadzakhala madzi. Ngati zingwe zoyeserera za ma ketones zikuwonetsa kukhalapo kwa acetone mu mkodzo, ichi sichizindikiro pakuletsa chakudya chamafuta ochepa odwala omwe ali ndi matenda ashuga. Mwana wamkulu kapena wodwala matenda ashuga ayenera kupitiliza kutsatira zakudya ndikusamala kuti amwe madzi okwanira. Musabisire insulin ndi ma syringe kutali. Kusinthana ndi chakudya chamafuta ochepa kumapangitsa odwala matenda ashuga ambiri kuwongolera matenda awo popanda jakisoni wa insulin konse. Khumi, komabe, palibe chitsimikizo chomwe chingaperekedwe pa izi. Mwinanso, pakupita nthawi, mumafunikabe kubaya insulini yaying'ono. Acetone mu mkodzo sizivulaza impso kapena ziwalo zina zamkati, bola ngati magazi a shuga ali abwinobwino ndipo wodwala matenda ashuga alibe vuto la madzimadzi. Koma ngati muphonya kuchuluka kwa shuga osakuchulukitsa ndi jakisoni wa insulin, izi zitha kubweretsa ketoacidosis, yomwe ndiyowopsa. Awa ndi mafunso ndi mayankho okhudza acetone mkodzo.

Zakudya zamafuta ochepa zimabwezeretsa shuga yanga yamagazi kukhala yabwinobwino. Koma mayeso nthawi zonse amawonetsa kukhalapo kwa acetone mkodzo. Zimandivuta. Kodi izi ndizowopsa bwanji?

Acetone mu mkodzo ndimomwe zimachitika ndi chakudya chochepa chamafuta. Izi sizoyipa malinga ngati shuga m'magazi ndi abwinobwino. Anthu makumi angapo odwala matenda ashuga padziko lonse lapansi amayendetsa matenda awo ndi zakudya zamagulu ochepa. Chithandizo chamankhwala chimayiyika pagudumu, osafuna kutaya kasitomala ndi ndalama. Sipanakhalepo mbiri yoti acetone mu mkodzo amatha kuvulaza wina aliyense. Izi zikadachitika mwadzidzidzi, pomwepo adani athu amayamba kufuula za chilichonse.

Kodi mkodzo acetone ndi matenda ashuga a ketoacidosis? Izi ndi zakupha!

Matenda a diabetesic ketoacidosis amayenera kupezeka ndi kuthandizidwa pokhapokha ngati wodwala ali ndi shuga ya 13 mmol / L kapena kuposa. Ngakhale kuti shuga ndi abwinobwino komanso athanzi, simuyenera kuchita chilichonse chapadera. Pitilizani kudya zakudya zamafuta ochepa ngati mukufuna kupewa zovuta za matenda ashuga.

Ndi kangati komwe muyenera kuyang'ana mkodzo ndi magazi pogwiritsa ntchito zingwe zamtundu wa ma ketones (acetone)?

Musayese magazi kapena mkodzo konse ndi mizere yoyeserera ma ketones (acetone). Osasunga izi kuyesa kunyumba - mudzakhala bata. M'malo mwake, yikani shuga m'magazi pafupipafupi ndi mita yamagazi a m'magazi - m'mawa pamimba yopanda kanthu, komanso maola 1-2 mutatha kudya. Chitani zinthu mwachangu ngati shuga watuluka. Shuga 6.5-7 mukatha kudya ndi zoipa kale. Zosintha pazakudya kapena ma insulin Mlingo wofunikira, ngakhale ngati endocrinologist wanu akuwonetsa izi. Komanso, muyenera kuchitapo kanthu ngati shuga yemwe ali ndi matenda ashuga pambuyo chakudya atakwera pamwamba 7.

Endocrinologist amawopseza makolo a mwana yemwe ali ndi matenda ashuga omwe ali ndi ketoacidosis komanso kuti atha kufa chifukwa cha poyizoni wa acetone. Zimafunikira kusintha kuchokera ku chakudya chamafuta ochepa kupita kwa choyenera. Zoyenera kuchita

Chithandizo chokwanira cha matenda ashuga mwa ana chimayambitsa kukhathamira kwa shuga m'magazi, kuchepetsedwa kwa chitukuko, ndi milandu ya hypoglycemia ndizotheka. Matenda osakhazikika a mtima amapezeka pambuyo pake - ali ndi zaka 15-30. Wodwala yekha ndi makolo ake adzakumana ndi mavuto awa, osati endocrinologist yemwe amaletsa zakudya zoyipa zodzaza ndi chakudya. Ndikotheka kuti mtundu wina ugwirizane ndi adotolo, kupitilizabe kudyetsa mwana zakudya zamafuta ochepa. Musalole wodwala matenda ashuga kupita kuchipatala, komwe zakudya sizingamuyendere. Ngati ndi kotheka, muyenera kuthandizidwa ndi endocrinologist yemwe amavomereza zakudya zamagulu ochepa.

Momwe mungathane ndi nkhawa za acetone mu mkodzo?

Ndibwino kuti odwala matenda ashuga, monga wina aliyense, akhale ndi chizolowezi chomwa madzi ambiri. Imwani madzi ndi tiyi ya zitsamba pa 30 ml pa 1 makilogalamu a thupi patsiku. Mutha kugona pokhapokha mukamwa zomwe zimachitika tsiku lililonse. Nthawi zambiri muyenera kupita kuchimbudzi, mwina usiku. Koma impso zidzakhala mu moyo wawo wonse. Amayi amawona kuti kuwonjezeka kwamadzimadzi mkati mwa mwezi umodzi kumasintha mawonekedwe a khungu. Werengani,. Matenda opatsirana ndi osagwirizana ndi omwe amafunikira zochita zapadera kuti apewe ketoacidosis mwa odwala matenda ashuga.

Kuopsa kwa matenda ashuga ketoacidosis

Ngati acidity yamagazi ikukwera pang'ono, ndiye kuti munthuyo amayamba kufooka ndipo amatha kugwa. Izi ndizomwe zimachitika ndi matenda ashuga ketoacidosis. Izi zimafuna chithandizo chamankhwala mwachangu, chifukwa nthawi zambiri zimabweretsa imfa.

Ngati munthu wapezeka ndi matenda ashuga a ketoacidosis, ndiye kuti izi zikutanthauza kuti:

• shuga wamagazi amawonjezeka kwambiri (> 13.9 mmol / l),
• kuchuluka kwa matupi a ketone m'magazi kumakulitsidwa (> 5 mmol / l),
• Mzere woyeserera umaonetsa ma ketoni mkodzo,
• acidosis idachitika mthupi, i.e. Miyezo yokhala ndi asidi yakhala ikukula kuti acidity (ochepa pH) ngati wodwala matenda ashuga aphunzitsidwa bwino, ndiye kuti alibe mwayi wa ketoacidosis. Kwa zaka makumi angapo, kukhala ndi matenda ashuga komanso osagwa ndi matenda ashuga ndi vuto lenileni.
  

Zoyambitsa Ketoacidosis

Ketoacidosis mu odwala matenda ashuga amakhala ndi insulin kuchepa kwa thupi. Vutoli likhoza kukhala "mtheradi" mu mtundu 1 wa matenda ashuga kapena "wachibale" wokhala ndi matenda a shuga a 2.

Zinthu zomwe zimawonjezera mwayi wokhala ndi matenda ashuga a ketoacidosis:

• matenda okhudzana ndi matenda a shuga, makamaka njira zotupa ndi matenda,
• Opaleshoni
• kuvulala
• kugwiritsa ntchito mankhwala osokoneza bongo a insulin (glucocorticoids, diuretics, mahomoni ogonana),
• kugwiritsidwa ntchito kwa mankhwala omwe amachepetsa chidwi cha minyewa ya insulin (atypical antipsychotic ndi magulu ena a mankhwala),
• pakati (),
• kutsika kwa insulin katemera patapita nthawi yachiwiri ya matenda ashuga,
• pancreatectomy (opaleshoni yamapapo) mwa anthu omwe sanakhalepo ndi matenda ashuga.

Zomwe zimayambitsa ketoacidosis ndichikhalidwe chosayenera cha wodwala matenda ashuga ::

• kudumpha jakisoni wa insulin kapena kuchotsedwa kwawo kosavomerezeka (wodwalayo "amatengedwa" ndi njira zina zochizira matenda a shuga),
• chosowa kwambiri ndi glucometer,
• wodwalayo sakudziwa kapena sakudziwa, koma samachita, kutengera ndalamazo zamagazi m'magazi ake,
• pakufunika insulin yambiri chifukwa cha matenda opatsirana kapena kumwa mankhwala ochulukirapo, koma sanalipidwe
• jekeseni insulin yomwe idatha kapena idasungidwa molakwika,
• njira yolakwika ya insulin,
• cholembera cha insulin ndi chopanda pake, koma wodwala samachilamulira.
• Pampu ya insulin ndi yopanda tanthauzo.

Gulu lapadera la odwala omwe ali ndi vuto la matenda ashuga a ketoacidosis ndi omwe amaphonya jakisoni wa insulin chifukwa akufuna kudzipha. Nthawi zambiri awa ndi amayi achichepere omwe ali ndi matenda a shuga 1. Amakhala ndimavuto akulu amisala kapena matenda amisala.

Chomwe chimayambitsa matenda ashuga ketoacidosis nthawi zambiri zimakhala zolakwika zachipatala. Mwachitsanzo, mtundu wongobwera kumene wa matenda ashuga 1 sanadziwike panthawi yake. Kapenanso insulini idachedwa nthawi yayitali ndi matenda a shuga a 2, ngakhale panali zofunikira pakuwonetsa insulin.

Zizindikiro za ketoacidosis mu shuga

Matenda a matenda ashuga ketoacidosis amakula, nthawi zambiri pakangotha ​​masiku ochepa. Nthawi zina - osakwana 1 tsiku. Choyamba, zizindikiro za shuga m'magazi zimakwera chifukwa chosowa insulin:

• ludzu lalikulu
• kukodza pafupipafupi,
• khungu louma komanso ma mucous membrane,
• Kuchepetsa thupi
• kufooka.

Kenako amaphatikizidwa ndi zizindikiro za ketosis (kupanga kupanga kwa matupi a ketone) ndi acidosis:

• nseru
• kusanza
• Kununkhira kwa acetone kuchokera mkamwa,
• phokoso losazolowereka - limakhala laphokoso komanso lakuya (lotchedwa Kussmaul kupuma).

Zizindikiro za kupsinjika kwa mtima wamanjenje:

• mutu
• kusakhazikika
• kubweza
• ulesi
• kugona
• precoma ndi ketoacidotic chikomokere.

Matupi owonjezera a ketone amakhumudwitsa m'mimba. Komanso, maselo ake amakhala opanda madzi, ndipo chifukwa cha matenda ashuga kwambiri, kuchuluka kwa potaziyamu m'thupi kumachepa. Zonsezi zimayambitsa matenda owonjezera a diabetesic ketoacidosis, omwe amafanana ndi mavuto a opaleshoni ndi thirakiti la m'mimba. Nayi mindandanda wawo:

• kupweteka m'mimba
• khoma lam'mimba limakhala losasangalatsa komanso lopweteka kwambiri.
• peristalsis yafupika.

Mwachidziwikire, zizindikilo zomwe tatchulazi ndizizindikiro zakugonekedwa kuchipatala mwadzidzidzi. Koma ngati mumayiwala ndikuyang'ana mkodzo wa matupi a ketone ogwiritsa ntchito chingwe choyesera, ndiye kuti atha kugonekedwa molakwika kuchipatala chopatsirana kapena opaleshoni. Izi zimachitika nthawi zambiri.

Matenda a shuga a ketoacidosis insulin

Ketoacidosis m'malo insulin Therapy ndiye chithandizo chokhacho chomwe chitha kusokoneza machitidwe a thupi opangitsa kuti matenda a shuga asinthe. Cholinga cha mankhwala a insulini ndikukweza misamu ya serum mpaka 50-100 mcU / ml.

Mwa izi, mosalekeza kasamalidwe ka "kafupi" insulin 4-10 pa ola limodzi, pafupifupi magawo 6 pa ola limodzi. Mlingo wotere wa mankhwala a insulin amatchedwa regimen "otsika." Amapondereza kuthyoka kwamafuta ndikupanga matupi a ketone, akuletsa kutulutsa shuga m'magazi ndi chiwindi, ndikuthandizira pakupanga kwa glycogen.

Chifukwa chake, zolumikizira zazikulu za limagwirira ntchito za matenda a matenda ashuga ketoacidosis zimathetsedwa. Nthawi yomweyo, mankhwala a insulin omwe amapezeka mu "mankhwala ochepetsa" amakhala ndi chiopsezo chochepa cha zovuta ndipo amalola shuga kuwongolera kuposa magazi omwe amapezeka kwambiri.

Ku chipatala, wodwala wodwala matenda a ketoacidosis amalandira insulin mwa kulowetsedwa kosalekeza. Choyamba, insulini yokhala ndi kanthawi kochepa imayendetsedwa kudzera m'mitsempha yolimbitsa thupi pang'onopang'ono ya 0,15 PIECES / kg, pafupifupi imapezanso 10-12 PIECES. Pambuyo pa izi, wodwalayo amalumikizidwa ndi infusomat kotero kuti amalandira insulini ndi kulowetsedwa kosalekeza pamiyeso ya magawo 5-8 paola, kapena mayunitsi 0,1 / ola / kg.

Pulasitiki, adsorption ya insulin ndiyotheka. Kuti mupewe izi, tikulimbikitsidwa kuti tiwonjezere anthu seramu albumin pa yankho. Malangizo okonzera kulowetsedwa: onjezani 50 ml ya 20% albumin kapena 1 ml ya magazi a wodwalayo m'magawo 50 a insulin "yifupi", ndiye kuti mubweretse kuchuluka kwa 50 ml pogwiritsa ntchito 0,9% NaCl saline.

Mtsempha wa intravenous wa insulin kuchipatala pakalibe infusomat

Tsopano timalongosola njira ina yongowerengera insulin mankhwala, ngati palibe infusomat. Insulin yogwira ntchito yayifupi imatha kutumikiridwa kamodzi pa ola kudzera m'mitsempha, pang'onopang'ono, ndi syringe, mu chingamu cha kulowetsedwa.

Mlingo umodzi wabwino wa insulin (mwachitsanzo, mayunitsi 6) uyenera kudzazidwa ndi syringe ya 2 ml, kenako ndikuwonjezera mpaka 2 ml ndi 0,9% NaCl mchere solution. Chifukwa cha izi, kuchuluka kwa zosakaniza mu syringe kumawonjezeka, ndipo zimatha kubayirira insulin pang'onopang'ono, mkati mwa mphindi 2-3. Kuchita kwa "ifupi "insulin kutsitsa magazi kumatenga ola limodzi. Chifukwa chake, kusinthasintha kwa kayendetsedwe ka nthawi 1 pa ola limodzi kungaganizidwe kuti ndi kothandiza.

Olemba ena amalimbikitsa m'malo mwanjira yotira jakisoni wa “kufupika” m'magulu 6 pa ola limodzi. Koma palibe umboni kuti njira yogwira mtima ngati imeneyi siyikhala yoipa kuposa kuwongolera kwaubongo.Matenda a shuga a ketoacidosis nthawi zambiri amayenda ndi matenda opatsirana, omwe amachititsa kuti magazi azigwira insulin, kutumikiridwa kudzera m'mitsempha, komanso ngakhale osagonja.

Singano yotalika pang'ono imaphatikizidwa ndi syringe ya insulin. Nthawi zambiri zimakhala zosatheka kuti amupatse jakisoni wa mu mnofu. Osanena kuti pali zovuta zina zomwe zimapangitsa odwala komanso othandizira. Chifukwa chake, pa matenda a shuga a ketoacidosis, kulowetsedwa kwa insulin kumalimbikitsidwa.

Insulin iyenera kuthandizidwa pang'onopang'ono kapena m'mitsempha yodwala matenda ashuga ketoacidosis, ngati wodwalayo sakadwala kwambiri ndipo safunikira kukhala m'chipinda chothandizira kwambiri.

Kusintha kwa insulin

Mlingo wa insulin "yayifupi" umasinthidwa malinga ndi momwe shuga ilili masiku ano, omwe amayenera kuwerengedwa ola lililonse. Ngati mu maora atatu ndi atatu mulingo wa glucose m'mwazi suchepa ndipo kuchuluka kwa kuchuluka kwa thupi ndi madzi ndikokwanira, ndiye kuti mlingo wotsatira wa insulini ungakhale wowirikiza.

Nthawi yomweyo, kuchuluka kwa shuga m'magazi sikungathe kuchepetsedwa mwachangu kuposa 5.5 mmol / l pa ola limodzi. Kupanda kutero, wodwalayo amatha kudwala matenda owopsa a ubongo. Pazifukwa izi, ngati kuchepa kwa shuga m'magazi kwayambira pansi mpaka 5 mmol / l pa ola limodzi, ndiye kuti mlingo wotsatira wa insulin utha. Ndipo ngati zidapitilira 5 mmol / l pa ola limodzi, ndiye kuti jakisoni wotsatira wa insulin nthawi zambiri amadumphira, pomwe akupitiliza kuwongolera shuga.

Ngati, mchikakamizo cha insulin, shuga m'magazi amachepetsa kwambiri kuposa ndi 3-4 mmol / l pa ola limodzi, izi zitha kuwonetsa kuti wodwalayo alibe madzi kapena minyewa ya m'mimba imafooka. Pankhaniyi, muyenera kuwunikiranso kuchuluka kwa magazi ndikuwunikira kuchuluka kwa creatinine m'magazi.

Patsiku loyamba m'chipatala, ndibwino kuti muchepetse shuga m'magazi osapitirira 13 mmol / L. Mlingo uwu ukafikika, glucose 5-10% imalowetsedwa. Pa 20 g iliyonse ya glucose, magawo atatu a insulin yochepa amadzipaka kudzera m'matumbo. 200 ml ya 10% kapena 400 ml ya 5% yankho lili ndi magalamu 20 a shuga.

Glucose amathandizira pokhapokha ngati wodwalayo akulephera kudya yekha, ndipo vuto la insulin limatha. Matenda a glucose si ochizira matenda ashuga a ketoacidosis pa se. Imapangidwira kupewa, komanso kusungabe osmolarity (kachulukidwe kakang'ono ka madzi m'thupi).

Momwe mungasinthire ku subcutaneous makonzedwe a insulin

Intravenous insulin mankhwala sayenera kuchedwa. Thupi la wodwalayo litasintha, kuthamanga kwa magazi kumakhazikika, shuga wamagazi amasungidwa osaposa 11-12 mmol / L ndi pH> 7.3 - mutha kusintha kuti mupeze insulin. Yambani ndi kuchuluka kwa magawo 10 mpaka 14 maola 4 aliwonse. Amasinthidwa malinga ndi zotsatira za kuwongolera shuga.

Mothandizidwa kulowetsedwa kwa insulin "yayifupi" imapitilizidwanso kwa maola ena awiri pambuyo pobayira jekeseni woyamba, kotero kuti palibe kusokonezeka kwa insulin. Patsiku loyamba la jakisoni wokhazikika, insulin yoonjezereka ingagwiritsidwe ntchito imodzi. Mlingo wake woyambirira ndi mayunitsi 10-12 kawiri pa tsiku. Momwe makonzedwe ake akufotokozedwera mu nkhani ya “”.

Chifukwa chiyani ketoacidosis ndiowopsa?

Ngati acidity ya m'magazi a anthu ikukwera pang'ono, ndiye kuti wodwalayo amayamba kufooka nthawi zonse ndipo amatha kugwa.

Izi ndizomwe zimatha kuchitika ndi matenda ashuga a ketoacidosis. Mkhalidwewu umapereka chisamaliro chachipatala mwachangu, apo ayi imfa imachitika.

Matenda ashuga ketoacidosis akuwonetsa zotsatirazi:

• shuga wamagazi amakwera (amakhala pamwamba kuposa 13.9 mmol / l),
• kuchuluka kwa matupi a ketone kumawonjezeka (pamwamba pa 5 mmol / l),
• mothandizidwa ndi chingwe chapadera choyesa, kupezeka kwa ma ketoni mumkodzo kumakhazikitsidwa,
• acidosis imapezeka m'thupi la wodwala yemwe ali ndi matenda ashuga (kusintha kosangalatsa kwa asidi-poyambira kuwonjezeka).

M'dziko lathu, pafupipafupi zakafukufuku wodwala ketoacidosis zaka 15 zapitazo anali:

1. Milandu ya 0.2 pachaka (odwala omwe ali ndi mtundu woyamba wa matenda ashuga),
2. Milandu ya 0.07 (yokhala ndi matenda a shuga 2).

Ngati tilingalira zaimfa za matendawa, ndiye kuti zidafika pa 7-19 peresenti.

Kuti muchepetse kuthekera kwa ketoacidosis, munthu aliyense wodwala matenda amtundu uliwonse amafunika kudziwa njira ya insulin yopanda ululu, monga kuyerekezera kwake ndi gluueter wa Acu Chek, mwachitsanzo, komanso kuphunziranso momwe angawerengere moyenera kuchuluka kwa timadzi timene timatulutsa.

Ngati malangizowa akwaniritsidwa bwino, ndiye kuti matenda ashuga a ketoacidosis azikhala opanda matenda a shuga 2.

Zomwe zimayambitsa matendawa

Anthu odwala matenda ashuga ketoacidosis amapezeka mwa odwala omwe ali ndi matenda amtundu wa 2 ndipo amakhala ndi matenda amtundu wa 2 omwe akumva kuperewera kwa insulin m'magazi. Kuchepa kotereku kumatha kukhala kotheratu (kumatanthauza matenda amtundu wa 1 shuga) kapena wachibale (wofanana ndi matenda a shuga 2).

Pali zinthu zingapo zomwe zingakulitse kwambiri chiopsezo cha kupezeka kwa matenda a ketoacidosis mu shuga:

• kuvulala
• opaleshoni kuchitapo kanthu
• Matenda omwe amayenda ndi matenda ashuga (njira zotupa kapena zotupa),
• kugwiritsa ntchito mankhwala a insulin antagonist (mahomoni ogonana, glucocorticosteroids, diuretics),
• kugwiritsa ntchito mankhwala omwe amachepetsa chidwi cha zimakhala kuti insulin (atypical antipsychotic),
• matenda ashuga
• pancreatectomy (opaleshoni yamapapo) mwa omwe sanadwalidwepo kale ndi matenda ashuga,
• kutsika kwa insulin popanga nthawi ya 2 matenda a shuga.

Titha kusiyanitsa zifukwa zikuluzikulu zomwe zimapangitsa chidwi cha matenda ashuga a ketoacidosis - izi ndi zolakwika za munthu wodwala matenda ashuga. Uwu ukhoza kukhala kupitiliza kwa jakisoni kapena ngakhale kuchotsedwa kwawo kosavomerezeka.

Izi zimachitika munyengo pomwe wodwalayo amasinthira njira zomwe siziri zachikhalidwe zochizira matendawa. Zifukwa zina zomwe ndizofunikira ndizophatikiza:

• kusakwanitsa kapena kudziyang'anira wekha wamagazi m'magazi pogwiritsa ntchito chipangizo chapadera (glucometer),
• umbuli kapena kulephera kutsatira malamulo osintha insulin malinga ndi kuchuluka kwa shuga m'magazi,
• pakufunika insulin yowonjezereka chifukwa cha matenda opatsirana kapena kugwiritsa ntchito kuchuluka kwamafuta ambiri omwe sanalipidwe,
• kukhazikitsidwa kwa insulin yomwe itatha kapena chomwe chinasungidwa osasunga malamulo okhazikitsidwa,
• njira yolakwika yolowa ndi mahomoni,
• kulakwitsa kwa pampu ya insulin,
• kusachita bwino kapena kusakwanira kwa cholembera.

Pali ziwerengero zakuchipatala zomwe zimanena kuti pali gulu lina la anthu omwe akhala akudwala matenda ashuga a ketoacidosis. Amadumphira dala kasamalidwe ka insulin, akuyesera mwanjira iyi kuti aphedwe.

Monga lamulo, amayi achichepere omwe akhala akuvutika ndi matenda amtundu wa 1 akuchita izi. Izi zimachitika chifukwa chazovuta zazikulu m'maganizo komanso zamaganizidwe omwe amadziwika ndi matenda ashuga a ketoacidosis.

Nthawi zina, chifukwa cha matenda ashuga ketoacidosis imatha kukhala zolakwika zachipatala. Izi zimaphatikizira kuzindikira mtundu wa matenda ashuga a mtundu woyamba kapena kuchedwa kwakanthawi kothandizidwa ndi mtundu wachiwiri wa matenda omwe ali ndi zisonyezo zazikuluzikulu zakuyamba kwa mankhwala a insulin.

Zizindikiro za matendawa

Matenda a shuga a ketoacidosis amatha kukula msanga. Itha kukhala nthawi kuyambira tsiku limodzi mpaka masiku angapo. Poyamba, Zizindikiro za shuga wambiri zimakwera chifukwa cha kuchepa kwa insulin:

• ludzu kwambiri
• kukodza kosalekeza
• khungu louma ndi nembanemba
• kuwonda kwambiri
• kufooka wamba.

Pa gawo lotsatira, pali kale zizindikiro za ketosis ndi acidosis, mwachitsanzo, kusanza, kununkhira kwa acetone kuchokera kumkamwa wamkamwa, komanso phokoso lachilendo pakupuma mwa anthu (mwakuya komanso kwamkati kwambiri).

Kuletsa kwapakati pa mantha a wodwalayo kumachitika, zizindikiro zimakhala motere:

• mutu
• kugona
• ulesi
• kuchuluka kwa mkwiyo
• zoletsa zochita.

Chifukwa cha kuchuluka kwa matupi a ketone, ziwalo zam'mimba zimakwiya, ndipo maselo ake amayamba kutaya madzi. Matenda akuluakulu a shuga amatsogolera pakuchotsa kwa potaziyamu m'thupi.

Kuchita kwa unyolo kotereku kumabweretsa kuti zizindikirozi ndizofanana ndi zovuta za opaleshoni yam'mimba: kupweteka kwam'mimba, kusokonezeka kwa khoma lamkati lam'mimba, kupweteka kwake, komanso kuchepa kwamatumbo am'mimba.

Ngati madokotala sayeza shuga la wodwalayo, ndiye kuti kuchipatala cholakwika kapena kuchipatala kungapangidwe.

Kodi matenda a ketoacidosis ali ndi matenda ashuga bwanji?

Asanayambe kuchipatala, ndikofunikira kuchita mayeso a glucose ndi matupi a ketone m'mwazi, komanso mkodzo. Ngati mkodzo wa wodwalayo walephera kulowa chikhodzodzo, ndiye kuti ketosis imatha kupezeka pogwiritsa ntchito magazi a seramu. Kuti muchite izi, ikani dontho lake pamiyeso yapadera ya mkodzo.

Kupitilira apo, ndikofunikira kukhazikitsa digiri ya ketoacidosis mu matenda ashuga komanso kudziwa mtundu wa zovuta za matendawa, chifukwa sangakhale kokha ketoacidosis, komanso hyperosmolar syndrome. Kuti muchite izi, mutha kugwiritsa ntchito tebulo lotsatirali pakuwunika: