Acetonemic syndrome mu ana > Matenda a shuga

Acetonemic syndrome mu ana
Gulu la Keto

Acetonemic syndrome mu ana (ketotic hypoglycemia yaubwana, osadwala matenda a ketoacidosis, matenda a cyclic acetonemic kusanza, kusanza kwa acetonemic- - zizindikiro zingapo zoyambitsidwa ndi kuwonjezereka kwa matupi a ketone m'madzi am'magazi - njira yamakhalidwe yomwe imachitika kwambiri mwana, yowonetsedwa ndi magawo obwereza akusintha, kusinthana kwa nthawi yonse yokhala ndi thanzi lathunthu. Pali matenda oyamba (idiopathic) - amakula chifukwa cha zolakwika zakudya (kupuma pang'ono ndi njala) komanso sekondale (motsutsana ndi matenda amtundu, matenda, endocrine, zotupa ndi zotupa za chapakati mantha dongosolo) acetonemic syndrome.

Gulu

Dongosolo la acetonemic syndrome limapezeka mu 4 ... 6% ya ana azaka 1 mpaka 12 ... zaka 13. Zimakhala zambiri pakati pa atsikana (kuchuluka kwa atsikana / anyamata ndi 11/9). Avereji ya zaka zambiri yowonetsera matenda a cyclic acetonemic kusanza ndi zaka 5.2. Nthawi zambiri (pafupifupi 90% ya milandu), zovuta zimakulirakulira chifukwa cha kusanza kosaneneka, komwe kumatchedwa acetonemic. Pafupifupi 50% ya odwala amafuna mpumulo wa vuto la acetone kudzera m'madzi amkati.

Zambiri zakukula kwa sekondale acetonemic syndrome sizipezeka kwina ndi kwachilendo. mabuku.

Sinthani ya masanjidwe |Zambiri

Acetonemic syndrome (cyclic acetonemic kusanza syndrome, ketoacidosis) yokhala ndi diabetes ndi vuto la kuchuluka kwa magazi m'matumbo a ketone (acetone, b-hydroxybutyric acid, acetoacetic acid), omwe amapangidwa chifukwa cha kusokonekera kwa metabolic amino acid ndi mafuta. Matenda a acetonemic mu ana akuti amabwera chifukwa cha zovuta za acetone.

Mu ana, pali pulayimale (idiopathic) acetonemic syndrome, yomwe ndi njira yodziyimira payokha, komanso yachiwiri ya acetonemic syndrome, yomwe imayendera limodzi ndi matenda angapo. Pafupifupi 5% ya ana azaka zapakati pa 1 mpaka 12-13 amakhala otukuka kwambiri, ndipo atsikana ndi anyamata amakhala 11: 9.

Hyperketonemia yachiwiri imatha kupezeka ndi matenda osokoneza bongo a ana, insulin hypoglycemia, hyperinsulinism, thyrotooticosis, matenda a Itsenko-Cushing, matenda a glycogen, kuvulala pamutu, zotupa zaubongo ku chisokonezo cha chiwindi, kuwonongeka kwa chiwindi, matenda opatsirana a hemolytic, leukemia, leukemia, leukemia, leukemia, leukemia mikhalidwe. Popeza maphunzirowa adzatsatiridwa ndi matenda a sekondale komanso matenda am'mimba, zomwe zimatsatirazi tiona za ketoacidosis yoyamba.

Kukula kwa acetonemic syndrome kumakhazikitsidwa chifukwa cha kuperewera kwathunthu kwa zakudya m'thupi zomwe mwana amadya kapena kuchuluka kwa mafuta acids ndi ketogenic amino acid. Kukula kwa acetonemic syndrome kumathandizira kuchepa kwa michere ya chiwindi yomwe imakhudzana ndi njira za oxidative. Kuphatikiza apo, mawonekedwe a kagayidwe mu ana ndiwakuti pali kuchepa kwa ketolysis, njira yogwiritsira ntchito matupi a ketone.

Ndikusowa kwathunthu kapena kuperewera kwa chakudya m'thupi, zosowa zama thupi zimatha chifukwa cholimbikitsidwa ndi lipolysis popanga kuchuluka kwamafuta amafuta aulere. Pansi pa zochitika zapamwamba zamatenda m'chiwindi, mafuta acids aulere amasinthidwa kukhala metabolite acetyl coenzyme A, omwe pambuyo pake amakhudzidwa ndi kuyambiranso kwa mafuta acids ndikupanga cholesterol. Gawo laling'ono la acetyl coenzyme A limagwiritsidwa ntchito popanga matupi a ketone.

Ndi lipolysis yolimbikitsidwa, kuchuluka kwa acetyl coenzyme A ndikuchulukirapo, ndipo ntchito za ma enzymes omwe amachititsa kuti mapangidwe a mafuta ndi cholesterol asakwanira. Chifukwa chake, kugwiritsidwa ntchito kwa acetyl coenzyme A kumachitika makamaka ndi ketolysis.

Chiwerengero chachikulu cha matupi a ketone (acetone, b-hydroxybutyric acid, acetoacetic acid) imayambitsa kuphwanya kwa acid-base ndi madzi-electrolyte bwino, imakhala ndi zotsatira zoyipa zamagetsi am'mimba komanso m'mimba, yomwe imawonetsedwa kuchipatala cha acetone syndrome.

Kupsinjika kwa Psychoemotional, kuledzera, kupweteka, kufalitsa, matenda opatsirana a kupweteka kwa mavairasi, gastroenteritis, chibayo, neuroinfection) zingakhale zinthu zomwe zimayambitsa matenda acetonemic. Ntchito yofunikira pakukula kwa acetonemic syndrome imaseweredwa ndi zinthu zopatsa thanzi - njala, kudya kwambiri, kumwa kwambiri mapuloteni komanso zakudya zamafuta ndikusowa kwa chakudya. Acetonemic syndrome mu akhanda nthawi zambiri amagwirizanitsidwa ndi mochedwa toxicosis - nephropathy, yomwe idachitika mwa mayi wapakati.

Zizindikiro za Acetonemic Syndrome

Acetonemic syndrome nthawi zambiri imapezeka mwa ana omwe ali ndi vuto la Constitution (neuro-arthritic diathesis). Ana oterewa amawasiyanitsa ndi kuchuluka kwakuchulukirachulukira komanso kutopa kwakanthawi kwamanjenje, amakhala ndi thupi loonda, nthawi zambiri amakhala amanyazi kwambiri, amakhala ndi vuto la kugona ndi kugona. Nthawi yomweyo, mwana yemwe ali ndi neuro-arthritic anomaly wamalamulo amakulitsa zolankhula, kukumbukira komanso njira zina zazidziwitso mwachangu kuposa anzawo. Ana omwe ali ndi neuro-arthritic diathesis amakonda kuperewera metabolism wa purines ndi uric acid, chifukwa chake, atakula amakula urolithiasis, gout, nyamakazi, glomerulonephritis, kunenepa kwambiri, mtundu 2 shuga.

Mawonetsero amtundu wa acetone syndrome ndi mavuto a acetone. Zovuta zofananira ndi acetonemic syndrome zimatha kudwala mwadzidzidzi kapenanso pambuyo pa otsogola (omwe amatchedwa aura): ulesi kapena kukwiya, kusowa chilimbikitso, nseru, mutu waching'alang'ala, etc.

Chipatala wamba cha vuto la acetonemic chimadziwika ndi kusanza mobwerezabwereza kapena kosagwirizana, komwe kumachitika poyesa kudyetsa kapena kumwa mwana. Poyerekeza ndi kusanza ndi acetonemic syndrome, zizindikiro za kuledzera ndi kusowa kwamadzi zimakhazikika msanga (minofu hypotension, adynamia, khungu la khungu ndi blush).

Kusangalala kwamagalimoto ndi nkhawa za mwana zimaloledwa ndi kugona ndi kufooka, ndi zovuta zamatenda a acetonemic syndrome, zizindikiro za matenda amisempha komanso kukomoka zimatheka. Thupi (37,5-38.5 ° C), kupweteka kwam'mimba, kutsekula m'mimba, kapena kusungunulira kwa stool ndi chikhalidwe. Kuchokera mkamwa mwa mwana, kuchokera pakhungu, mkodzo ndi masanzi, fungo la acetone limatuluka.

Kuukira koyamba kwa matenda a acetonemic syndrome nthawi zambiri kumakhala ndi zaka 2-3, kumakhala pafupipafupi ndi zaka 7 ndikuzimiririka ndi zaka 12 mpaka 13.

Kuzindikira kwa acetonemic syndrome

Kuzindikira kwa acetonemic syndrome kumathandizidwa ndi kuphunzira kwa anamnesis ndi zodandaula, zizindikiro zamankhwala, ndi zotsatira zasayansi. Onetsetsani kuti mwasiyanitsa pakati pa pulayimale ndi sekondale ya acetonemic syndrome.

Kuunika kwa mwana yemwe ali ndi vuto la acetonemic panthawi yamavuto kumawonetsa kufooka kwa mkokomo wamtima, tachycardia, arrhythmia, khungu lowuma komanso mucous membrane, kuchepa kwa khungu turgor, kuchepa kwa misozi, tachypnea, hepatomegaly, ndi kuchepa kwa diresis.

Kuyesedwa kwa magazi kwachipatala kwa acetonemic syndrome kumadziwika ndi leukocytosis, neutrophilia, kuthamanga kwa ESR, kuyesa kwamkodzo - ketonuria yama degree osiyanasiyana (kuchokera + mpaka ++++). Pakuwunika kwamwazi wamagazi, hyponatremia (ndi kutayika kwa madzi akunja) kapena hypernatremia (kutayika kwa madzi amkati), hyper- kapena hypokalemia, kuchuluka kwa urea ndi uric acid, hypoglycemia yabwinobwino kapena yapakati.

Kusiyanitsa kosiyanasiyana kwa matenda acetonemic oyambira kumachitika ndi sekondididosis yachiwiri, chifuwa cham'mimba (ana a peritonitis), matenda amitsempha ya m'mimba (meningitis, encephalitis, matenda am'mimba), poyizoni ndi matenda am'matumbo. Pankhani imeneyi, mwana ayenera kuphatikizidwa ndi dokotala wa endocrinologist, dokotala wokhudzana ndi matenda opatsirana a ana, gastroenterologist wa ana.

Acetonemic Syndrome Chithandizo

Madera akuluakulu othandizira acetonemic syndrome ndi mpumulo wa mavuto komanso kukonza kwakanthawi kokhazikika, pofuna kuchepetsa kuchuluka kwa kuchuluka.

Ndi mavuto a acetonemic, kugonekedwa kwa mwana kumasonyezedwa. Zakudya zam'mimba zimapangidwa: mafuta ndi ochepa, zakudya zamagulu am'mimba ndi zakumwa zambiri zowonjezera zimalimbikitsidwa. Ndikofunika kukhazikitsa enema yotsuka ndi yankho la sodium bicarbonate yomwe imalepheretsa gawo lina la matupi a ketone omwe amalowa m'matumbo. Kukonzanso kwamlomo ndi acetonemic syndrome kumachitika ndi madzi amchere amchere ndi njira zina zophatikizidwira. Ndi kuchepa mphamvu kwa madzi m'thupi, kulowetsedwa kwamankhwala kumachitika - kukoka kwa mtsempha wa 5% shuga, njira zamchere. Chithandizo cha Syndrome chimaphatikizanso kukhazikitsidwa kwa mankhwala a antiemetic, antispasmodics, sedative. Ndi chithandizo choyenera, zizindikiro za vuto la acetonemic zimatha pakatha masiku 2-5.

Munthawi zopatsirana, mwana yemwe ali ndi vuto la acetonemic amayang'aniridwa ndi dokotala wa ana. Ndikofunikira kukonza zakudya zopatsa thanzi (zakudya zamkaka zamkaka, kupewa zakudya zokhala ndi mafuta ambiri), kupewa matenda opatsirana ndimaganizo okhathamira, madzi ndi ma templo (madzi osamba, maphwando osiyanitsa, ma douche, rubdown), kugona mokwanira ndikukhala mu mpweya wabwino.

Mwana yemwe ali ndi acetonemic syndrome akuwonetseredwa njira zophunzitsira za multivitamini, hepatoprotectors, michere, mankhwala othandizira, kutikita minofu, kuwongolera pulogalamu. Kuwongolera mkodzo acetone, tikulimbikitsidwa kudziyimira pawokha kuti muwone zamkati za matupi a ketone pogwiritsa ntchito mizera yoyesera.

Ana omwe ali ndi acetonemic syndrome amayenera kulembetsa ndi dokotala wa endocrinologist, chaka chilichonse amaphunzira shuga wamagazi, ma impso ndi ultrasound yam'mimba.

Ichi ndi chiyani

Acetonemic syndrome ndi vuto lomwe limachitika pamene zochita za metabolic mthupi la mwana zasokonekera, mtundu wa kusayenda bwino kwa zochita za metabolic. Pankhaniyi, palibe zolakwika zamatumbo, zosokoneza zomwe zimapangidwa sizikupezeka, zimangogwira ntchito, mwachitsanzo, kapamba ndi chiwindi sizimayendetsedwa.

Matendawa pawokha ndi amodzi mwa kuwonetsa kwa neuro-arthritic anomaly wa lamulo (neuro-arthritic diathesis ndi dzina lakale lofanananso). Izi ndi zina mwazomwe zimakhazikika pakaphatikizidwe ndi ntchito inayake yamkati ndi ziwalo zamanjenje za mwana.

Zomwe zimachitika

Nthawi zambiri, matenda a acetonemic amapezeka mwa ana, komanso amapezeka mwa akuluakulu. Zifukwa zake ndi izi:

matenda a impso - makamaka kulephera kwaimpso,
kuperewera kwa enzyme - cholowa kapena cholandira,
zovuta zobadwa nazo kapena zotumphukira za endocrine system,
diathesis - neurogenic ndi arthritic,
biliary duct dyskinesia.

Mu makanda, izi zitha kukhala chifukwa cha mochedwa gestosis ya mayi woyembekezera kapena nephropathy.

Zinthu zakunja zomwe zimayambitsa acetone syndrome:

kusala kudya, makamaka motalika,
matenda
zoyipa - kuphatikizapo kuledzera pakudwala,
matenda ammimba omwe amayamba chifukwa cha kuperewera kwa chakudya,
nephropathy.

Akuluakulu, kudziwika kochuluka kwa matupi a ketone kumachitika chifukwa cha matenda ashuga. Kuperewera kwa insulin kumalepheretsa kulowa kwa glucose m'maselo a organic system, omwe amasonkhana m'thupi.

Nthawi yomweyo, mwana yemwe ali ndi neuro-arthritic anomaly wamalamulo amakulitsa zolankhula, kukumbukira komanso njira zina zazidziwitso mwachangu kuposa anzawo. Ana omwe ali ndi neuro-arthritic diathesis amakonda kuperewera metabolism wa purines ndi uric acid, chifukwa chake, atakula amakula urolithiasis, gout, nyamakazi, glomerulonephritis, kunenepa kwambiri, ndi mtundu 2 shuga.

Zizindikiro za acetonemic syndrome:

Mwana amanunkhira acetone kuchokera mkamwa mwake. Fungo lomweli limachokera pakhungu la mwana ndi mkodzo wake.
Kuchepa kwa thupi ndi kuledzera, kukhuthala kwa khungu, mawonekedwe a khungu losasangalatsa.
Kukhalapo kwa kusanza, komwe kumachitika nthawi zopitilira 3-4, makamaka poyesa kumwa kapena kudya kena kake. Kusintha kumatha kuchitika m'masiku 1-5.
Kuwonongeka kwa mawu a mtima, arrhythmia ndi tachycardia.
Kupanda chilimbikitso.
Kuchuluka kwa kutentha kwa thupi (nthawi zambiri mpaka 37.50С-38.50С).
Mavuto akayambika, mwana amakhala ndi nkhawa komanso kukhumudwa, kenako amayamba kufooka, kugona, komanso kufooka. Osowa kwambiri, koma kukokana kumatha kuchitika.
Ululu wopweteketsa, chopondapo chopondapo, nseru (spastal tumbo) umawonedwa pamimba.

Nthawi zambiri, zizindikiro za acetonemic syndrome zimachitika ndi vuto la kuperewera kwa zakudya m'thupi - michere yaying'ono yazakudya muzakudya ndi kuchuluka kwa ketogenic ndi mafuta amino acid mkati mwake. Ana ali ndi kagayidwe kofulumira, ndipo dongosolo logaya chakudya silinasinthidwe mokwanira, chifukwa chomwe kuchepa kwa ketolysis - njira yogwiritsira ntchito matupi a ketone imachepera.

Kuzindikira matendawa

Nawonso makolo amatha kuchita zinthu zodziwikitsa mwachangu kuti adziwe zamkodzo mu mkodzo - timizere tapadera tomwe timagulitsidwa ku pharmacy titha kuthandiza. Afunika kutsitsidwa mu gawo la mkodzo ndipo, kugwiritsa ntchito mwapadera, kudziwa mtundu wa acetone.

Mu labotore, pakusanthula kwamkodzo matenda, kupezeka kwa ma ketoni kumatsimikizika kuchokera "kuphatikiza" (+) mpaka "ma ploses anayi" (++++). Kuukira kosavuta - mulingo wa ma ketones ku + kapena ++, ndiye kuti mwana amatha kuthandizidwa kunyumba. "Ma pluses atatu" amafanana ndi kuchuluka kwa matupi a ketone m'mwazi nthawi 400, ndipo kanayi - 600. Muzochitika izi, kugonekedwa kuchipatala kumafunika - kuchuluka kwa acetone kumakhala koopsa pakupanga chikumbumtima ndi ubongo. Dokotala amayenera kudziwa mtundu wa matenda acetone: kaya ndi pulayimale kapena yachiwiri - yopangidwa mwachitsanzo, monga zovuta za matenda ashuga.

Pa mgwirizano wapadziko lonse wa ana mu 1994, madokotala adatsimikiza njira zapadera zothandizira kudziwa matendawa, amagawidwa pang'onopang'ono komanso owonjezera.

kusanza kumachitika mobwerezabwereza, m'njira zosiyanasiyana,
pakati povulaza pamakhala magwiridwe abwinobwino a mwana,
kutalika kwa zovuta kumayambira maola angapo mpaka masiku 2-5,
zotsatira zoyipa zasayansi, radiology ndi endoscopic zotsatira zotsimikizira chomwe chimayambitsa kusanza, monga chiwonetsero cha matenda am'mimba.

Njira zina zikuphatikiza:

magawo a kusanza ali ndi chikhalidwe komanso kusokonekera, ma episode amtsogolo ndi ofanana ndi am'mbuyomu munthawi, kulimba komanso kutalika, ndipo kuukira kwawo kumatha kutha zokha.
kusanza kumayendetsedwa ndi nseru, kupweteka m'mimba, kupweteka mutu, kufooka komanso kufoka kwa mwana.

Matendawa amapangidwanso kuphatikizidwa ndi matenda ashuga a ketoacidosis (zovuta za matenda ashuga), matenda am'mimba am'mimba - peritonitis, appendicitis. Neurosological pathology (meningitis, encephalitis, matenda am'mimba), matenda opatsirana ndi poizoni nawonso samayikidwa.

Momwe mungagwiritsire acetonemic syndrome

Ndi chitukuko cha vuto la acetone, mwana ayenera kuchipatala. Chitani kukonza zakudya: tikulimbikitsidwa kudya zakudya zopatsa mphamvu, muchepetse zakudya zamafuta, perekani zakumwa zambiri. Kugwiritsa ntchito bwino kwa njira yoyeretsera ndi sodium bicarbonate, yankho lake lomwe limatha kupatutsa mbali ina yamatumbo a ketone omwe amalowa m'matumbo. Kutulutsa madzi mkamwa pogwiritsa ntchito njira zophatikizira (orsol, rehydron, etc.), komanso madzi amchere a mchere, adawonetsedwa.

Malangizo omwe angathandizidwe ndi matenda osokoneza bongo a ketoacidosis ana:

1) Zakudya zonse (zophatikiza ndimadzi ndi mafuta ochulukirapo omwe amapezeka ndi mafuta ochepa) zimaperekedwa kwa odwala onse.

2) Kukhazikitsidwa kwa prokinetics (motilium, metoclopramide), ma enzymes ndi ma cofactors a carbohydrate metabolism (thiamine, cocarboxylase, pyridoxine) kumathandizira kubwezeretsa koyambirira kwa kuvomerezera chakudya komanso kuphatikiza mafuta ndi metabolism ya carbohydrate.

3) kulowetsedwa:

amathetsa kuchepa kwa madzi m'thupi (kusowa kwa madzi m'thupi)
muli alkalizing othandizira, imathandizira kuchira kwa plasma bicarbonates (normalizes acid-base balance),
ili ndi chakudya chokwanira chopezeka mosavuta chomwe chimapukusidwa m'njira zosiyanasiyana, kuphatikiza osakhudzidwa ndi insulin,

4) Etiotropic therapy (mankhwala opha maantibayotiki ndi mankhwala opatsirana) imayikidwa molingana ndi mawonekedwe.

Mu milandu ya ketosis yofatsa (acetonuria mpaka ++), yomwe siyimayenda ndi kuchepa kwamadzi, kusokonezeka kwa madzi m'magetsi ndi kusanza kosalephera, mankhwala othandizira pakudya ndi kutulutsa madzi mkamwa motsatana ndi kukhazikitsidwa kwa prokinetics pamankhwala okhudzana ndi zaka komanso etiotropic chithandizo cha matenda oyambitsidwa.

Pochiza matenda acetonemic syndrome, njira zazikulu ndi zomwe zimalimbana ndi mavuto. Chithandizo chothandizira chomwe chimathandizira kuchepetsa kutulutsa ndikofunikira kwambiri.

Kulowetsedwa mankhwala

Zisonyezo poika kulowetsedwa mankhwala:

Kusanza kosalekeza komwe kumatha kuyambika pambuyo pa kugwiritsa ntchito prokinetics,
Kukhalapo kwa vuto la hemodynamic ndi microcirculation,
Zizindikiro za chikumbumtima chosavomerezeka (chikomokere, chikomokere),
Kupezeka kwa zolimbitsa thupi (mpaka 10% ya kulemera kwa thupi) komanso koopsa (mpaka 15% ya kulemera kwa thupi) kuchepa thupi,
Kukhalapo kwa decompensated metabolic ketoacidosis ndi kuchuluka kwa anionic imeneyi,
Kukhalapo kwa zovuta za anatomical ndi magwiridwe antchito amkamwa kutulutsa mkamwa (anomalies mu chitukuko cha mafupa amaso ndi pakamwa patsekeke), zovuta zamitsempha (bulbar ndi pseudobulbar).

Musanayambe chithandizo cha kulowetsedwa, ndikofunikira kuonetsetsa kuti venous ifika (makamaka zotumphukira), kudziwa hemodynamics, acid-base ndi usawa-electrolyte.

Malangizo azabwino

Zogulitsa zomwe sizimayikidwa m'gulu la zakudya za ana omwe ali ndi vuto la acetonemic syndrome:

kiwi
caviar
wowawasa zonona - aliyense
sorelo ndi sipinachi,
nyama yamwana wamwamuna
mafuta - impso, ubongo, mapapo, chiwindi,
nyama - bakha, nkhumba, mwanawankhosa,
msuzi wonenepa - nyama ndi bowa,
masamba - nyemba zobiriwira, nandolo zobiriwira, broccoli, kolifulawa, nyemba zouma,
ndasuta mbale ndi soseji
mudzayenera kusiya cocoa, chokoleti - m'mipiringidzo ndi zakumwa.

Zakudya zanu zimaphatikizaponso: phala kuchokera ku mpunga, soups zamasamba, mbatata zosenda. Ngati Zizindikiro sizikubwerera mkati mwa sabata, mutha kuwonjezera pang'onopang'ono nyama (yosakhwima), obalaza, zitsamba ndi masamba.

Zakudyazi zimatha kusinthidwa nthawi zonse ngati zizindikiro za matendawa zibwereranso. Ngati mumapuma bwino, muyenera kuwonjezera madzi ambiri, omwe muyenera kumwa m'magawo ang'onoang'ono

Patsiku loyamba la chakudyacho, mwana sayenera kupatsidwa chilichonse kupatula mkate wa mkate wa rye.
Pa tsiku lachiwiri, mutha kuwonjezera msuzi wa mpunga kapena maapulo ophika.
Ngati zonse zachitika molondola, ndiye kuti tsiku lachitatu, nseru ndi matenda am'mimba zidzatha.

Palibe vuto kuti musamalize zakudya ngati zizindikirozo zapita. Madokotala amalimbikitsa kutsatira malamulo ake onse mosamalitsa. Pa tsiku lachisanu ndi chiwiri, mutha kuwonjezera ma biscuit cookies, phala la mpunga (wopanda batala), msuzi wamasamba muzakudya. Ngati kutentha kwa thupi sikukwera, ndipo kununkhira kwa acetone kumatha, ndiye kuti zakudya za mwana zimatha kusiyanasiyana. Mutha kuwonjezera nsomba zamafuta ochepa, masamba osenda, buckwheat, zinthu mkaka.

Njira zopewera

Makolo omwe mwana wawo amakonda kuwonekera chifukwa cha matendawa ayenera kukhala ndi glucose ndi fructose kukonzekera mu zida zawo zothandizira. Komanso ziyenera kukhala zouma nthawi zonse, zouma zouma, zouma zouma. Zakudya za mwana ziyenera kukhala zazing'ono (kangapo patsiku) komanso zofunikira. Malingana ngati pali chizindikiro chilichonse cha kuchuluka kwa acetone, muyenera kum'patsa kenakake kokoma.

Ana sayenera kuloledwa kudzipereka mopitilira muyeso, mwamalingaliro kapena mwakuthupi. Kuwonetsa kuyenda kwa tsiku ndi tsiku, chilengedwe, madzi, kugona kwa maola asanu ndi atatu, kapangidwe kake.

Pakati pa kukomoka, ndibwino kuchitira njira zothandizira kupewa mavuto. Izi zimachitika bwino-nthawi kawiri pachaka.

Zimayambitsa Acetonemic Syndrome

Nthawi zambiri, acetonemic syndrome imayamba kukhazikika mwa ana mpaka zaka 12 mpaka 13. Izi ndichifukwa choti kuchuluka kwa acetone ndi acetoacetic acid m'magazi kumachuluka. Njirayi imabweretsa chitukuko cha vuto lotchedwa acetone. Mavuto ngati amenewa amapezeka pafupipafupi, ndiye kuti titha kukambirana za matendawa.

Monga lamulo, acetonemic syndrome imapezeka mwa ana omwe ali ndi matenda ena a endocrine (matenda ashuga, chithokomiro), leukemia, kuchepa kwa magazi, komanso matenda am'mimba. Nthawi zambiri izi zimachitika pambuyo pokangana, kukomoka kwa chiwindi, chotupa mu ubongo, kufa ndi njala.

Pathogenesis

Njira za catabolism zamapuloteni, chakudya chamafuta ndi mafuta omwe amakhala m'malo azolimbitsa thupi zimadutsana pamagulu ena azinthu zomwe zimatchedwa Krebs. Ili ndiye gwero lamphamvu ponseponse lolola kuti thupi lizikula bwino.

Ndi njala kapena kudya kwambiri mapuloteni ndi zakudya zamafuta, kupsinjika kosalekeza kumakula ketosis. Ngati thupi nthawi yomweyo limakumana ndi wachibale kapena kuperewera kwathunthu kwa chakudya, kumalimbitsa lipolysis, lomwe liyenera kukhutiritsa kufunikira kwa mphamvu.

Matupi a Ketone amayamba kuphatikiza ndimatimu kuti akhale madzi ndi kaboni, kapena atachotsedwa ndi impso, thirakiti la m'mimba ndi mapapu. Ndiye kuti, acetonemic syndrome imayamba kukulitsa ngati kuchuluka kwa matupi a ketone kumakhala kotsika poyerekeza momwe amapangira.

Zizindikiro zazikulu za kusanza kwa acetonemic ndi:

Kuchulukitsa kwamanjenje.
Ketoacidosis.
Pafupipafupi lipid kagayidwe kachakudya.
Mawonekedwe a shuga.

Pano, kubadwa kwa makolo kumatenga gawo lofunikira kwambiri. Ngati achibale a mwanayo adapezeka ndi matenda a metabolic (gout, gallstone matenda ndi urolithiasis, atherosulinosis, migraine), ndiye kuti mwana akhoza kulandira matendawa. Zakudya zoyenera ndizofunikanso.

Acetonemic syndrome mwa akulu

Akuluakulu, acetonemic syndrome imatha kukhala purine kapena protein yokhala ndi vuto. Poterepa, kuchuluka kwa matupi a ketone kumawonjezeka m'thupi. Tiyenera kumvetsetsa kuti ma ketoni amaonedwa ngati zinthu zabwinobwino m'thupi lathu. Ndiwo gwero lalikulu lamphamvu. Ngati thupi lipeza chakudya chokwanira, izi zimalepheretsa kupanga acetone kwambiri.

Akuluakulu nthawi zambiri amaiwala za zakudya zoyenera, zomwe zimapangitsa kuti ma ketone ophatikizana ayambe kudziunjikira. Izi ndiye chifukwa choledzera, chomwe chimawonetsedwa ndi kusanza.

Kuphatikiza apo, zomwe zimayambitsa matenda a acetone mu akulu zingakhale:

Mphamvu zamagetsi.
Zoopsa komanso zopatsa thanzi.
Kulephera kwina.
Zakudya zoyipa zopanda chakudya chokwanira.
Kusokonezeka mu endocrine system.
Kusala komanso kudya.
Matenda obadwa nawo.

Kwambiri zimakhudza chitukuko cha matenda ashuga amtundu wa 2.

Zizindikiro zakuyamba kwa acetone syndrome mwa akulu:

Kufika pamtima kukuchepa.
Kuchuluka kwa magazi mthupi kumachepetsedwa kwambiri.
Khungu limakhala lotumbululuka, kuwala kumayaka m'masaya.
M'chigawo cha epigastric, kupweteka kwa spasmodic kumachitika.
Kuthetsa madzi m'thupi.
Kuchuluka kwa shuga m'magazi kumachepetsedwa.
Kusanza ndi kusanza.

Mavuto ndi zotsatirapo zake

Chiwerengero chachikulu cha ma ketones, omwe amatsogolera ku acetonemic syndrome, chimayambitsa zovuta zoyipa. Choyipa chachikulu ndi metabolic acidosispomwe chilengedwe chamkati cha thupi chimaphatikizidwa. Izi zimatha kuwononga ziwalo zonse.

Mwana amapuma mofulumira, magazi amayenda kumapapu kumawonjezeka, kutsika ziwalo zina. Kuphatikiza apo, ma ketoni amakhudza mwachindunji minofu yaubongo. Mwana yemwe ali ndi acetone syndrome amakhala woopsa komanso wokhumudwa.

Kodi ndi njira ziti zomwe amagwiritsa ntchito pozindikira?

Ndime zopumira zimabwerezedwa pafupipafupi komanso mwamphamvu kwambiri.
Pakati pa zigawo, pakhoza kukhala nthawi yocheza ndi nthawi zosiyana.
Kusintha kumatha masiku angapo.
N`zosatheka kuyanjana ndi kusanza ndi michere m'mimba.
Mavuto a kusanza ndi stereotypical.
Nthawi zina kusanza kumatha mwadzidzidzi, popanda chithandizo.
Pali zizindikiro zofananira: nseru, mutu, kupweteka kwam'mimba, Photophobia, zoletsa, adynamia.
Wodwala amakhala wotumbululuka, amatha kukhala ndi malungo, kutsegula m'mimba.
M'masanzi mumatha kuwona bile, magazi, ntchofu.

Zoyeserera zasayansi

Palibe kusintha pa kuyezetsa magazi kwamankhwala. Nthawi zambiri chithunzicho chimangowonetsa matenda omwe amachititsa kuti matendawa akhazikike.

Palinso kuyesa kwamkodzo komwe mumatha kuwona ketonuria (kuphatikiza chimodzi kapena zinayi kuphatikiza). Komabe, kupezeka kwa shuga mumkodzo si chizindikiro chapadera.

Chofunika kwambiri pakuzindikira matendawa - zambiri zomwe zatsatidwa kuyesa kwamwazi wamagazi. Poterepa, nthawi yayitali yakusanza, kumatha madzi ambiri. Plasma ali ndi chiwonetsero chachikulu cha hematocrit ndi mapuloteni. Urea imachulukanso m'magazi chifukwa chakufooka.

Chida chozindikira

Njira yofunikira kwambiri yodziwitsira matenda ndi echocardioscopy. Ndi iyo, mutha kuwona zofunikira za hemodynamics yapakati:

diastolic voliyumu yamanzere yamitsempha yamagazi imachepetsedwa,
kupanikizika kwamphamvu kumatsika
kachigawo kakang'ono kamachepetsedwa
motsutsana ndi kumbuyo kwa zonsezi, cholembera chamtima chimawonjezeka chifukwa cha tachycardia.

Ngati vuto la acetone layamba kale

Chitani zomwe amati ndizodyetsa zakudya mwachangu. Zimakhazikitsidwa ndikugwiritsa ntchito zakudya zamagetsi zomwe zimapangika mosavuta, kuchepetsa zakudya zamafuta, kupereka zakudya ndi zakumwa zozizwitsa. Nthawi zina amaika enema yapadera yoyeretsera ndi sodium bicarbonate. Izi zimathandizira kuthetsa ena mwa matupi a ketone omwe adalowa kale m'matumbo.

Kukhudzanso kwamlomo ndi njira zothetsera monga rehydron kapena orsol.

Ngati madzi am'madzi akula, ndikofunikira kuchita kulowetsedwa kwa 5% shuga ndi njira zamchere. Nthawi zambiri kutumikiridwa antispasmodics, sedative ndi antiemetics. Ndi chithandizo choyenera, zizindikiro za matendawa zimatha patatha masiku 2-5.

Mankhwala

Yoyambitsa kaboni. Sorbent, yomwe ndi yotchuka kwambiri. Izi ndi zochokera kumera kapena nyama. Amakonzedwa makamaka kuti azitha kugwira ntchito yake. Monga lamulo, kumayambiriro kwa vuto la acetone, limayikidwa kuti lizichotsa poizoni m'thupi. Zina mwazotsatira zoyipa: kudzimbidwa kapena kutsekula m'mimba, mapuloteni osakhazikika, mavitamini ndi mafuta.
Makala ophatikizidwa amachotsedwa pakakhala kutaya kwa m'mimba, zilonda zam'mimba.

Motilium. Ndi antiemetic yomwe imalepheretsa ma dopamine receptors. Chithandizo chogwira ntchito ndi domperidone. Kwa ana, mlingo wake ndi piritsi limodzi 3-4 pa tsiku, kwa akulu ndi ana osaposa zaka 12 - mapiritsi 1-2 katatu patsiku.

Nthawi zina Motilium imatha kuyambitsa mavuto: matumbo kukokana, matumbo, extrapyramidal syndrome, kupweteka mutu, kugona, mantha, kuchuluka kwa plasma prolactin.

Mankhwala osavomerezeka kuti azigwiritsidwa ntchito ndi magazi am'mimba, kutsekeka kwa m'mimba thirakiti, kulemera kwa thupi mpaka 35 makilogalamu, kulekerera kwa munthu pazigawo zina.

Metoclopramide. Mankhwala odziwika bwino a antiemetic omwe amathandizira kupewetsa mseru amathandizira matumbo kuyenda. Akuluakulu amalimbikitsidwa kutenga 10 mg 3-4 pa tsiku. Ana opitirira zaka 6 zitha kutumikiridwa mpaka 5 mg katatu patsiku.

Zotsatira zoyipa za kumwa mankhwalawa ndi: kutsekula m'mimba, kudzimbidwa, kukamwa kowuma, mutu, kugona, kukhumudwa, chizungulire, agranulocytosis, sayanjana.

Sizingatenge kutulutsa magazi m'mimba, mafuta am'mimba, kutsekeka kwamakina, khunyu, pheochromocytoma, glaucoma, kutenga pakati, kuyamwa.

Thiamine. Mankhwalawa amatengedwa chifukwa cha kuchepa kwa vitamini ndi hypovitaminosis B1. Osatenga ngati hypersensitivity ku zigawo zikuluzikulu za mankhwala. Zotsatira zoyipa ndi izi: edema ya Quincke, kuyabwa, zotupa, urticaria.

Atoxil. Mankhwalawa amathandiza kuyamwa poizoni m'mimba ndipo amachotsa m'thupi. Kuphatikiza apo, amachotsa zinthu zovulaza m'magazi, khungu ndi zimakhala. Zotsatira zake, kutentha kwa thupi kumachepa, kusanza kumayima.

Kukonzekera kuli ngati mawonekedwe a ufa womwe kuyimitsidwa kumakonzedwa. Ana azaka zisanu ndi ziwiri akhoza kumwa 12 g ya mankhwala patsiku. Mlingo wa ana osakwana zaka zisanu ndi ziwiri ayenera kutumizidwa ndi dokotala.

Njira zina

Acetonemic syndrome imatha kuthandizidwa kunyumba. Koma apa muyenera kulabadira kuti mutha kungogwiritsa ntchito zida zomwe zingachepetse acetone.

Ngati simukuwona kusintha kwa mwana, muyenera kufunsa dokotala nthawi yomweyo.

Njira ina yothandizira pankhaniyi ndi yoyenera chabe kuti muchepetse fungo losasangalatsa la acetone, kuchepetsa kutentha kapena kuchotsa kusanza. Mwachitsanzo, kuchotsa fungo ndilabwino kwa decoction ya sorelo kapena tiyi wapadera wokhazikitsidwa ndi rose ya galu.

Chithandizo cha zitsamba

Nthawi zambiri zitsamba zimagwiritsidwa ntchito, kusiya kusanza. Kuti muchite izi, konzekerani izi:

Tengani supuni 1 ya mankhwala a mandimu ndi kutsanulira 1 chikho cha madzi otentha. Kuumirira pafupifupi ola limodzi, wokutidwa ndi nsalu yotentha. Vutani ndi kumwa supuni 1 mpaka katatu patsiku.

Tengani supuni 1 ya peppermint, kutsanulira kapu ya madzi otentha. Kuumirira maola awiri. Tengani kangapo 4 pa tsiku, supuni imodzi.

Zakudya zopatsa thanzi komanso zakudya za acetone syndrome

Chimodzi mwazinthu zazikulu zomwe zimawoneka ngati acetonemic syndrome ndi kuperewera kwa zakudya m'thupi. Pofuna kupewa kubwereranso mtsogolo, ndikofunikira kuwongolera kwambiri zomwe mwana wanu amadya tsiku lililonse.

Osaphatikiza zakudya zomwe zimakhala ndizotetezedwa, zakumwa zozizilitsa kukhosi, kapena tchipisi. Musapatse mwana wanu zakudya zonenepa kwambiri kapena zokazinga.

Pofuna kuchiza matenda a acetone, muyenera kutsatira zakudya kwa milungu iwiri kapena itatu. Zakudya zanu zimaphatikizaponso: phala la mpunga, soups zamasamba, mbatata zosenda.

Zakudya zimatha kusinthidwa nthawi zonse ngati zizindikiro za matendawa zibwereranso. Ngati kupuma kosasangalatsa kumabwera, muyenera kuwonjezera madzi ambiri, omwe muyenera kumwa m'magawo ang'onoang'ono. Palibe vuto kuti musamalize kudya ngati zizindikirozo zikusowa. Madokotala amalimbikitsa kutsatira malamulo awo onse. Patsiku la chisanu ndi chiwiri, mutha kuwonjezera ma biscuit cookies, mpunga wa mpunga (wopanda batala), masamba msuzi.

Ngati kutentha kwa thupi sikukwera, ndipo kununkhira kwa acetone kumachoka, ndiye kuti zakudya za mwana zimatha kusiyanasiyana. Mutha kuwonjezera nsomba zamafuta ochepa, mbatata zosenda, buluwheat, zinthu zamkaka.

Zolemba zaukadaulo wazachipatala

Acetonemic syndrome kapena AS ndi zovuta kuzinthu zomwe zimapangitsa kuti matupi a ketone (makamaka, β-hydroxybutyric ndi acetoacetic acid, komanso acetone, achuluke m'magazi).

Izi ndi zinthu zopanda mafuta okwanira zama asidi, ndipo ngati zomwe zake zitheka, kusintha kwa kagayidwe kazinthu kumachitika.

Kupewa

Mwana wanu akachira, muyenera kupewa matendawa. Ngati izi sizichitika, ndiye kuti matenda a acetone amatha kudwala. M'masiku oyambirawa, onetsetsani kuti mwatsata zakudya zapadera, kukana mafuta ndi zakudya zonunkhira. Chakudya chikatha, muyenera kulowetsa pang'onopang'ono komanso mosamala kwambiri zakudya zamagulu ena zilizonse.

Ndikofunikira kwambiri kudya chakudya chopatsa thanzi. Ngati muphatikiza zakudya zonse zofunikira m'zakudya za mwana wanu, ndiye kuti palibe chomwe chingawononge thanzi lake. Yesetsani kumamupatsanso moyo wogwira ntchito, pewani kupsinjika, kulimbitsa chitetezo chokwanira komanso kusamalira microflora.

Zotsatira za matendawa nthawi zambiri zimakhala zabwino. Nthawi zambiri, pamsika wazaka 11 mpaka 12, matenda acetonemic amazimiririka palokha, komanso zisonyezo zake zonse.

Ngati mungapemphe thandizo kwa akatswiri, izi zikuthandizani kupewa zovuta zambiri komanso zotsatirapo zake.

Kanema pa acetonemic syndrome. Wolemba: NIANKOVSKY Sergey Leonidovich
Pulofesa, Mutu wa Dipatimenti Yothandiza ndi Zipatala

Acetonemic kusanza syndrome

Acetonemic kusanza syndrome ndi concomitant syndrome mu neuro-arthritic diathesis. Matendawa amatengedwa ngati gawo la chipangizo cha thupi la mwana. Zimadziwika ndi chakuti mineral ndi purine metabolism amasintha. Mkhalidwe wofananawo ukupezeka mwa ana 3-5%. Komanso, m'zaka zaposachedwa chiwerengero cha odwala chikuchulukirachulukira.

Zizindikiro zazikulu za kusanza kwa acetonemic ndi:

Mchitidwe wamkamwa umawonjezeka.
Ketoacidosis.
Pafupipafupi lipid kagayidwe kachakudya.
Mawonekedwe a shuga.

Pano, kubadwa kwa makolo kumatenga gawo lofunikira kwambiri. Ngati abale ake a mwanayo adapezeka ndi matenda a metabolic (gout, cholelithiasis ndi urolithiasis, atherosulinosis, migraines), ndiye kuti mwana atha kudwala matendawa. Komanso sikuti gawo locheperako limasewera ndi zakudya zoyenera.

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Njira zina

Acetonemic syndrome imatha kuthandizidwa kunyumba. Koma apa ndikofunikira kuyang'anira chidwi chakuti mutha kugwiritsa ntchito zinthu zomwe zimatha kutsitsa acetone. Ngati simukuwona kusintha kwa mwana, muyenera kufunsa dokotala nthawi yomweyo. Njira zochiritsira zosagwiritsidwa ntchito mwanjira imeneyi ndizoyenera kuti muchepetse fungo losasangalatsa la acetone, kuchepetsa kutentha kapena kuchepetsa kusanza. Mwachitsanzo, kuti muchepetse fungo, msuzi wa sorelo kapena tiyi wapadera wokhala ndi m'chiuno cha rose ndi wangwiro.

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Zakudya zabwino komanso zakudya za acetonemic syndrome

Chimodzi mwazifukwa zazikulu zowonekera kwa acetonemic syndrome ndikusowa kwa chakudya. Pofuna kupewa kutenganso matendawo mtsogolo, ndikofunikira kuwongolera zakudya zomwe mwana wanu amadya tsiku lililonse. Sikoyenera kuphatikiza zogulitsa zomwe zili ndizapamwamba kwambiri, zakumwa zoziziritsa kukhosi, tchipisi. Musapatse mwana wanu zakudya zonenepa kwambiri kapena zokazinga.

Kuti mankhwalawa acetonemic syndrome akhale opambana, muyenera kutsatira zakudya kwa masabata awiri kapena atatu. Zakudya zanu zimaphatikizaponso: phala kuchokera ku mpunga, soups zamasamba, mbatata zosenda. Ngati Zizindikiro sizikubwerera mkati mwa sabata, mutha kuwonjezera pang'onopang'ono nyama (yosakhwima), obalaza, zitsamba ndi masamba.

Zakudyazi zimatha kusinthidwa nthawi zonse ngati zizindikiro za matendawa zibwereranso. Ngati mumapuma bwino, muyenera kuwonjezera madzi ambiri, omwe muyenera kumwa m'magawo ang'onoang'ono.

Patsiku loyamba la chakudyacho, mwana sayenera kupatsidwa chilichonse kupatula mkate wa mkate wa rye.

Pa tsiku lachiwiri, mutha kuwonjezera msuzi wa mpunga kapena maapulo ophika.

Ngati zonse zachitika molondola, ndiye kuti tsiku lachitatu, nseru ndi matenda am'mimba zidzatha.

Ngati kutentha kwa thupi sikukwera, ndipo kununkhira kwa acetone kumatha, ndiye kuti zakudya za mwana zimatha kusiyanasiyana. Mutha kuwonjezera nsomba zamafuta ochepa, masamba osenda, buckwheat, zinthu mkaka.