Lactic acidosis mea i kapa ʻia hoʻi o ka acidact lactic. ʻO kēia kūlana, kahi e hoʻonāukiuki i ka coml hyperlactacidemic, he hoʻopiʻi pōpilikia kahi i kūpono no ka maʻi maʻi.
Lactic acidosis e puka ana ma o ka lactic acid hōʻiliʻili i loko o ke kino o ke kanaka. Hoʻopilikia ʻia e:
- He huʻeke ʻili
- ʻIli
- ʻO ka ʻuhane.
Ma hope o ka hōʻiliʻili ʻana i kekahi nui o ka waikona, ua hoʻololi ʻia ka acidact lactic i loko o ka metabolic acidosis.
He mea koʻikoʻi loa ia no ka poʻe āpau me ka maʻi maʻi i ʻike i nā hōʻailona nui o ka lactic acidosis.
Nā kumu o ka Lactic Acidosis
Lactic acidosis ʻike ʻia ma ke ʻano o:
- Nā maʻi pākuʻi a me nā luhi,
- ʻO ka huhū huhū,
- Lāukiuki keʻaihue,
- Acokocaena myocardial infarction,
- Nā hōʻeha kino kino,
- ʻO Renal hiki ʻole
- ʻO nā maʻi lohi mau maʻi.
ʻO ka mea nui e kumu ai i ka acidact lactic e lawe ana i ka biguanides, no ka laʻana, ua lawe pinepine ʻia ʻo Metformin. Ma kēia hihia, ʻike ʻia nā hōʻailona o ka lactic acidosis i nā mea maʻi me ka maʻi mellitus, lawe i nā lāʻau lapaʻau o ka hui ʻana i ke kō.
Inā pili i ka aʻa ole a me nā aʻa paha, ʻoiaiʻo kahi liʻiliʻi o ka biguanides e hiki ai i ka lactic acidosis. Ma kēia ʻano ke ʻano o ka hōʻiliʻili ʻana i nā lāʻau lapaʻau i loko o ke kino.
ʻO ka acidosis Lactic e hana me nā hypoxia uaua skeletal. Hiki i ka hypoxia ke hanana, no ka laʻana, me ka hoʻoikaika kino lōʻihi. E pono nō i ka lāʻau lapaʻau.
Inā ʻaʻohe ʻike kūlike o ka hypoxia, a laila ke kumu nui o ka maʻi leukemia a me nā ʻano lāʻau ʻē aʻe. ʻO nā kumu ʻē aʻe paha e kau ʻia:
- Hōʻalo kahi
- ʻO ka puʻuwai puʻuwai ākea o kekahi o nā māmā,
- Intestinal infarction
- ʻO ka hemahema o Thiamine i ke kino.
Nā hōʻailona nui o ka Lactic Acidosis
ʻO ka maʻi maʻi lactic acid, ʻo ka mea pinepine, e komo i loko o kahi ʻano hoʻohālikelike, ma kahi kokoke i kekahi mau hola. ʻO ka maʻamau, ʻokoʻa ke nānā ʻole, akā pono ka hana lapaʻau.
Hoʻomaopopo ka poʻe maʻi i ka hōʻeha ʻana o nā ʻiʻo a me nā manaʻo maikaʻi ʻole e ʻike ʻia ma hope o ka sternum. Loaʻa i ka acidosis lactic nā hōʻailona aʻe:
- ʻoluʻolu
- wikiwiki hanu
- ʻōpala
- hiamoe
ʻO nā hōʻike ʻana o ka hana cardiovascular ka mea maʻamau i nā hōʻailona maʻamau o ka waikawa koʻikoʻi. Ua hoʻonāukiuki kēia hoʻohālikelike i ka aelike, ʻano o ka myocardium, ʻoiai e ulu ana ka lactic acidosis.
Ma hope o kēia, e hoʻonāukiuki ka acidact lactic i kahi hōʻino holomua i ka maʻi maʻamau, kahi, ma muli o ka hoʻonui i ka acidosis, hoʻomaka ka ʻeha i ka hōʻeha, a ʻike ʻia ka luaʻi.
Inā loli nui ka kūlana o ka lactic acidosis maʻi, a laila hiki i nā hōʻailona ke ʻokoʻa loa: mai ka isflexia a paresis a me ka hyperkinesis.
Ma mua o ka hoʻomaka ʻana o ke kohu, ka mea i hui pū ʻia e ka nalowale o ka hoʻomaopopo ʻana, hoʻomaka ka mea maʻi i ke kani ʻana me ke kani ʻana o nā hanu. ʻO ka manaʻo ʻano o ka acetone ʻaʻole e hoʻonā i ka acidact lactic. ʻO ka maʻamau, ʻo kēia ʻano hanu e loaʻa me ka metabolic acidosis.
ʻO ka lōʻihi o ka wā, hoʻomaka ka lactic acidosis e hōʻike iā ia iho me nā hōʻailona o ka hina. ʻO ka mua, hele mai nā oligoanuria, a ma hope o anuria. Ma muli o kēia, hoʻomaka ka hoʻomohala ʻana o ka DIC - coravulation intravascular. Inā loaʻa kēia mau kūlana, pono koke ke kauka i ka mālama lapaʻau.
ʻO nā hōʻailona lactic acidosis ka hiʻohiʻona o ka trombosis intravascular me ka necrosis hemorrhagic, nā manamana lima a me nā lima.
E nānā i ka wikiwiki o nā lactic acidosis form, hana ia i ka hoʻokumu i loko o kekahi mau hola wale nō.
Nā hōʻailona o ke ʻano:
- elelo e leʻaleʻa
- ʻili maloʻo
- maloʻo maloʻo.
ʻO ka hoʻomaʻamaʻa ʻana a me nā keʻokeʻo diagnostic o ka lactic acidosis
ʻO ka hōʻikeʻana i ka acidosis lactic me nā hōʻailona āpau ma luna e paʻakikī ke paʻakikī. ʻIke ʻia nā hōʻailona me ke ʻano kōkua.
Loaʻa ka ʻikepili hana i ka hōʻoia kūpono e pili ana i ka hoʻoholo o ka waikawa lactic i loko o ke koko. Eia kekahi, e hoʻoholo ʻia nā mea hōʻike huaʻōlelo:
- ke hoʻoemi nei i nā huahe koko,
- nā palena o ka hyperglycemia,
- nele o acetonuria.
Ke noʻonoʻo nei i nā hōʻailona o ka lactic acidosis a me ke ʻano ponoʻī nona iho, pono ia, ka mea mua loa, no ka hoʻoholo ʻana i nā hōʻailona no ka hoʻopau wikiwiki o ka hypoxia.
Me nā hōʻailona o ke kūlana a me ka lactic acidosis ʻo ia iho, aia ka mālama mālama i loko o ka hoʻokele intravenous i kahi hopena o ka sodium bicarbonate (4% a i ʻole 2,5%) a hiki i ka 2 lita i kēlā me kēia lā.
Lawe ʻia ka Metformin no ka maʻi maʻi, hoʻohaʻahaʻa ia i ka hyperglycemia, akā ʻaʻole ia e hoʻomohala i ka hypoglycemia. ʻAʻole i like me derivatives sulfonylurea, kahi i loaʻa ai nā lāʻau sulfa, Metformin ʻaʻole i hoʻoikaika i ka hana o ka insulin.
I ka hihia o ka overdose me Metformin i ka maʻi diabetes, e hoʻomohala ka lactic acidosis me ka hoʻoweliweli o kahi hopena momona. ʻO ke kumu ʻo ka hoʻopiʻi ʻana o ka lāʻau lapaʻau ma muli o ka hana renal impaired.
Inā puka pū nā hōʻailona o ka lactic acidosis, a laila ʻoi aku ka maikaʻi o ka hōʻea ʻana me ka hoʻohana ʻana i ka Metformin. Pono ka mea maʻi e hoʻokipa ma ka haukapila. Hoʻopau maikaʻi loa ʻo Metformin i nā hemodialysis i nā kūlana olakino. Hoʻohui, hana ʻia ka hana hōʻailona maʻi.
Hiki i ka hypoglycemia ke ulu inā lawe ʻia ʻo Metformin me ka sulfonylureas.
He mea nui ia e nānā i nā waiwai o ka pH a me nā pae kalapona i ke koko.
Eia kekahi, me ka acidact lactic acid a me nā hōʻailona, insulin therapy o ka hana genetically engineered ʻano o ka hana a i ʻole ka monocomponent therapy me ka hoʻokaʻawale ʻana i ka insulin e hoʻohana ʻia ma ke ʻano he mālama.
I ka mālama ʻana i nā hōʻailona a me ka acidosis lactic, hiki ke mālama ʻia i nā pahu kalaka me ka hana kīnā me ka hoʻopuka ʻana i ka 200 mg i kēlā me kēia lā.
Hoʻokomo ʻia ka hoʻomaʻamaʻa ʻana i ka hoʻokō intravenous o ka plasma koko a me kahi liʻiliʻi heparin, kahi i hāʻawi ʻia i ka hoʻoponopono ʻana o ka hemostasis.
Kālepaʻa Coma
I mea e pale ai i ka coma lactacidemic ma muli o ka lactic acidosis, pono e pale i ka hypoxia a me ka hoʻolālā maikaʻi ʻana i ka hoʻomohala ma luna o ka papa o ka maʻi maʻi.
Lactic acidosis, ʻike ʻia ka hopena o ka wā e hoʻohana ai i ka biguanides, pono i ka hoʻoholo i kā lākou mau inika me ka wehe wikiwiki i ka hihia o nā maʻi o waena, no ka laʻana, me ka maʻi pneumonia.
Ka hopena maʻi laʻi lactic me nā hiʻohiʻona o nā kaʻina suppuration, no laila, pono ka maʻi diabetes me ka hoʻohana ʻana i nā biguanides i ka wā e hana ai ka mālama ʻana.
Inā aia kekahi kānalua e kuhi ana i ka lactic acidosis, pono koke ʻoe e hoʻopili i kahi endocrinologist.
