I-Ketoacidosis Ephuzile

-Delile

• Yini ebangela i-ketoacidosis yotshwala?
• Ziyini izimpawu ze-ketoacidosis yotshwala?
• Ketoacidosis yotshwala itholakala kanjani?
• Iphathwa kanjani i-ketoacidosis yotshwala?
• Yiziphi izinkinga ze-ketoacidosis yotshwala?
• Uyini umbono wesikhathi eside we-ketoacidosis yotshwala?
• Ngingabuvimbela kanjani i-ketoacidosis yotshwala?

Kuyini i-ketoacidosis yotshwala?

Amaseli adinga i-glucose (ushukela) ne-insulin ukuze asebenze kahle. Ishukela lisuka ekudleni okudlayo, kanti i-insulin ikhiqizwa amanyikwe. Uma uphuza utshwala, amanyikwe akho angayeka ukukhiqiza i-insulin isikhashana. Ngaphandle kwe-insulin, amaseli akho ngeke akwazi ukusebenzisa i-glucose oyisebenzisela amandla. Ukuthola amandla owadingayo, umzimba wakho uzoqala ukushisa amanoni.

Lapho umzimba wakho ushisa amanoni ukuthola amandla, kwenziwa imikhiqizo eyaziwa ngokuthi yimizimba ye-ketone. Uma umzimba wakho ungakhiqizi i-insulin, imizimba ye-ketone izoqala ukwakha egazini lakho. Lokhu kwakhiwa kwamaketoni kungaveza isimo esisongela impilo esaziwa nge-ketoacidosis.

I-Ketoacidosis, noma i-metabolic acidosis, yenzeka lapho ufaka okuthile okwenziwe ngomzimba noma okuphendulwe kwaba yi-asidi. Lesi simo sinezimbangela eziningi, kufaka phakathi:

• imithamo emikhulu ye-aspirin
• ukushaqeka
• isifo sezinso
• umzimba ongavamile

Ngaphezu kwe-ketoacidosis ejwayelekile, kunezinhlobo ezithile ezithile. Lezi zinhlobo zifaka:

• ketoacidosis yotshwala, edalwa ukuphuza ngokweqile utshwala
• ketoacidosis yesifo sikashukela (DKA), ekhula kakhulu kubantu abanesifo sikashukela sohlobo 1
• indlala ketoacidosis, eyenzeka kakhulu kwabesifazane abakhulelwe, ku-trimester yabo yesithathu, futhi behlanza ngokweqile

Ngasinye salezi zimo sandisa inani le-asidi ohlelweni. Futhi zinganciphisa inani le-insulin ekhiqizwa ngumzimba wakho, okuholele ekuwohlokeni kwamaseli amafutha kanye nokukhiqizwa kwamaketoni.

Yini ebangela i-ketoacidosis yotshwala?

I-ketoacidosis yotshwala ingakhula lapho uphuza kakhulu utshwala isikhathi eside. Ukuphuza ngokweqile kuvame ukudala ukungondleki (izakhi zomzimba ezinganele ukuze umzimba usebenze kahle).

Abantu abaphuza utshwala obuningi kungenzeka bangadli njalo. Bangaphalaza futhi ngenxa yokuphuza ngokweqile. Ukungadli ngokwanele noma ukuhlanza kungaholela ezikhathini zendlala. Lokhu kuqhubeka kunciphisa ukukhiqizwa kwe-insulin yomzimba.

Uma umuntu esevele engondlekile ngenxa yokuphuza ngokweqile, angaba ne-ketoacidosis yotshwala. Lokhu kungenzeka ngemuva kosuku olulodwa ngemuva kokuphuza ngokweqile, kuya ngesimo somsoco, isimo sempilo jikelele, kanye nenani lotshwala obudliwayo.

Ziyini izimpawu ze-ketoacidosis yotshwala?

Izimpawu ze-ketoacidosis yotshwala zizohluka ngokuya ngokuthi ungakanani utshwala obudlile. Izimpawu zizoncika futhi enanini lamaketoni egazini lakho. Izimpawu ezivamile ze-ketoacidosis yotshwala zifaka:

• ubuhlungu besisu
• ukuyaluza nokudideka
• ukuncipha kokuqwashisa noma ikhoma
• ukukhathala
• ukuhamba kancane
• ukuphefumula okungajwayelekile, okujulile nokushesha (uphawu lukaKussmaul)
• ukulahlekelwa isifiso sokudla
• isicanucanu nokuhlanza
• izimpawu zokwehla emzimbeni, njengesizungu (i-vertigo), ikhanda elikhanyayo nokoma

Uma uthuthukisa noma iyiphi yalezi zimpawu, funa usizo oluphuthumayo lwezokwelapha. I-ketoacidosis yotshwala isifo esisongela impilo.

Umuntu one-ketoacidosis yotshwala angaba nezinye izimo ezihlotshaniswa nokusebenzisa kabi utshwala. Lokhu kungafaka:

• isifo sokuqaqamba kwamalunga
• isifo sesibindi
• isifo sezinso
• izilonda
• ubuthi be-ethylene glycol

Lezi zimo kufanele zikhishwe ngaphambi kokuthi udokotela akwazi ukukuxilonga nge-ketoacidosis yotshwala.

Ketoacidosis yotshwala itholakala kanjani?

Uma unezimpawu ze-ketoacidosis yotshwala, udokotela wakho uzokwenza ukuhlolwa komzimba. Bazobuza futhi ngomlando wakho wezempilo nokusetshenziswa kotshwala. Uma udokotela wakho esola ukuthi usuhlakulele lesi simo, bangahle ba-oda ukuhlolwa okwengeziwe ukukhipha ezinye izimo ezingenzeka. Ngemuva kokuthi le miphumela yokuhlolwa ingenile, bangaqinisekisa ukuxilongwa.

Ukuhlolwa kungafaka okulandelayo:

• ukuhlolwa kwe-amylase ne-lipase, ukuqapha ukusebenza kwamanyikwe kanye nokuhlola isifo samaphaphu
• ukuhlolwa kwegazi lomthambo wegazi, ukukala amazinga e-oxygen egazini lakho kanye ne-acid / base balance
• anion gap, okulinganisa amazinga e-sodium ne-potassium
• ukuhlolwa kotshwala egazini
• iphaneli lekhemistri yegazi (i-CHEM-20), ukuze uthole ukubuka okuningiliziwe kwe-metabolism yakho nokuthi isebenza kahle kangakanani
• ukuhlolwa kweglucose yegazi
• igazi urea nitrogen (BUN) nokuhlolwa kwe-creatinine, ukuthola ukuthi izinso zakho zisebenza kahle kangakanani
• ukuhlolwa kwe-serum lactate, ukuthola amazinga e-lactate egazini (amazinga aphezulu e-lactate angaba wuphawu lwe-lactic acidosis, isimo esivame ukukhombisa ukuthi amaseli nezicubu zomzimba azitholi i-oxygen eyanele)
• ukuhlolwa komchamo ngamaketoni

Uma izinga lakho le-glucose likhuphukile, udokotela wakho angenza nokuhlolwa kwe-hemoglobin A1C (HgA1C). Lokhu kuhlolwa kuzohlinzeka ngolwazi ngamazinga kashukela wakho ukusiza ukunquma ukuthi unesifo sikashukela yini. Uma unesifo sikashukela, ungadinga ukwelashwa okwengeziwe.

Iphathwa kanjani i-ketoacidosis yotshwala?

Ukwelashwa kwe-ketoacidosis yotshwala kuvame ukuphathwa egumbini lezimo eziphuthumayo. Udokotela wakho uzoqapha izimpawu zakho ezibalulekile, kufaka phakathi ukushaya kwenhliziyo yakho, umfutho wegazi nokuphefumula kwakho. Zizokunikeza futhi uketshezi ngaphakathi. Ungathola amavithamini nezakhi zomzimba ukusiza ukuphatha ukungondleki, kufaka phakathi:

• thiamine
• i-potassium
• i-phosphorus
• i-magnesium

Udokotela wakho futhi angakwamukela egumbini labagula kakhulu (i-ICU) uma udinga ukunakekelwa okuqhubekayo. Ubude bokuhlala kwakho esibhedlela buxhomeke ebucayi be-ketoacidosis yotshwala. Kuya futhi ngokuthi kuthatha isikhathi esingakanani ukuthi umzimba wakho ulawulwe futhi uphume engozini. Uma unezinye izinkinga ezengeziwe ngesikhathi sokwelashwa, lokhu kuzothinta nobude bokuhlala kwakho esibhedlela.

Yiziphi izinkinga ze-ketoacidosis yotshwala?

Enye inkinga ye-ketoacidosis yotshwala ukuhoxiswa kotshwala. Udokotela wakho nabanye ochwepheshe bezokwelapha bazokubheka ukuze uthole izimpawu zokuhoxa. Uma unezimpawu ezinzima, bangakunika umuthi. I-ketoacidosis yotshwala ingaholela ekuphumeni kwegazi emathunjini.

Ezinye izinkinga zingafaka:

• i-psychosis
• ikhoma
• isifo sokuqaqamba kwamalunga
• inyumoniya
• i-encephalopathy (isifo sobuchopho esingadala ukulahleka kwememori, ukushintsha kobuntu, nokuxhuma kwemisipha, yize lokhu kungavamile)

Uyini umbono wesikhathi eside we-ketoacidosis yotshwala?

Uma kutholakala ukuthi une-ketoacidosis enotshwala, ukululama kwakho kuzoya ngezici eziningi. Ukufuna usizo ngokushesha lapho kuvela izimpawu kunciphisa amathuba okuba nezinkinga ezinkulu. Ukwelashwa kokulutha utshwala nakho kuyadingeka ukuvimbela ukubuyela emuva kwe-ketoacidosis yotshwala.

Isibikezelo sakho sizothinteka ubunzima bokusetshenziswa kwakho kotshwala nokuthi unesifo sesibindi noma cha. Ukusetshenziswa kotshwala isikhathi eside kungaholela ekuqineni kwesibindi, noma ekulimaleni unomphela kwesibindi. I-cirrhosis yesibindi ingadala ukukhathala, ukuvuvukala kwemilenze, nesicanucanu. Kuzoba nomthelela omubi ekubikezelweni kwakho konke.

Ngingabuvimbela kanjani i-ketoacidosis yotshwala?

Ungavimbela i-ketoacidosis yotshwala ngokunciphisa ukuphuza kwakho utshwala. Uma ungumlutha wotshwala, funa usizo lochwepheshe. Ungafunda ukuthi unganciphisa kanjani ukuphuza kwakho utshwala noma ukubuqeda ngokuphelele. Ukujoyina isahluko sendawo se-Alcoholics Anonymous kungakunika ukuxhaswa okudingayo ukuze ubhekane nakho. Kufanele futhi ulandele zonke izincomo zikadokotela wakho ukuze uqinisekise ukondleka okufanele nokululama.