Ntshav qab zib ketoacidosis

Ntshav qab zib ketoacidosis (DKA) yog ib qho teeb meem phom sij txaus ntshai uas cuam tshuam rau cov neeg muaj ntshav qab zib. Nws tshwm sim thaum lub cev pib tsoo lub cev rog ntawm tus nqi uas nrawm dhau heev. Lub siab ua cov rog ua kom zoo li cov roj hu ua ketones, uas ua rau cov ntshav ua acidic.

DKA tshwm sim thaum lub teeb liab los ntawm cov tshuaj insulin hauv lub cev qis heev tias:

1. Cov piam thaj hauv ntshav (cov piam thaj hauv ntshav) tsis tuaj yeem nkag mus rau hauv lub hlwb kom siv los ua cov khoom siv roj.
2. Daim siab ua ib qhov ntau ntawm cov ntshav qab zib.
3. Rog ua kom tawg sai rau lub cev ua tiav.

Cov rog yog tawg los ntawm lub siab mus rau hauv cov roj hu ua ketones. Ketones ib txwm yog tsim los ntawm daim siab thaum lub cev zom cov rog tom qab nws tau ntev ntev txij li koj lub pluas mov kawg. Cov ketones no ib txwm siv los ntawm cov leeg thiab lub siab. Thaum cov ketones tsim tawm sai dhau thiab tsim kom muaj cov ntshav, lawv tuaj yeem ua kom lom tau los ntawm kev ua cov ntshav acid. Tus mob no yog hu ua ketoacidosis.

Qee zaum DKA yog thawj cov cim qhia txog ntshav qab zib hom 1 hauv cov neeg uas tseem tsis tau kuaj mob ntshav qab zib. Nws kuj tseem tuaj yeem tshwm sim hauv ib tus neeg uas twb tau kuaj pom tias muaj ntshav qab zib hom 1. Kev kis mob, raug mob, mob hnyav, ploj ntawm cov tshuaj insulin, lossis kev ntxhov siab ntawm kev phais mob tuaj yeem ua rau DKA rau cov neeg muaj ntshav qab zib hom 1.

Cov neeg muaj ntshav qab zib hom 2 tuaj yeem tsim muaj DKA, tab sis nws tsis tshua muaj thiab tsawg dua. Feem ntau nws yog los ntawm kev noj qab haus huv cov ntshav qab zib ncua ntev, noj cov tshuaj uas ploj lawm, lossis muaj mob hnyav lossis kis tau tus mob.

Cov tsos mob tshwm sim ntawm DKA tuaj yeem suav nrog:

• Tsawg dua kev ceev faj
• Sib sib zog nqus pa sai heev
• Lub cev qhuav dej
• Qhuav ntawm daim tawv nqaij thiab qhov ncauj
• Ua ntsej muag yaug
• Nquag tso zis lossis nqhis dej ntev ib hnub lossis ntev dua
• Fruity-ua pa tsw phem
• Mob taub hau
• Mob ua txhav los yog mob ib ce
• Xeev siab thiab ntuav
• Plab mob

Kev kuaj ntshav Ketone yuav raug siv nyob hauv hom 1 ntshav qab zib los kuaj rau ketoacidosis thaum ntxov. Qhov ketone kev ntsuam xyuas feem ntau yog ua tiav siv cov zis lossis kuaj ntshav.

Ketone kev ntsuas feem ntau yog ua tiav thaum DKA xav tias:

• Feem ntau, kuaj cov zis yog sim ua ntej.
• Yog tias qhov zis tso tawm zoo rau ketones, feem ntau ketone hu ua beta-hydroxybutyrate yog ntsuas hauv cov ntshav. Qhov no yog ketone ntsuas tshaj plaws. Lwm qhov ketone tseem ceeb yog acetoacetate.

Lwm yam kev ntsuam xyuas rau ketoacidosis suav nrog:

• Arterial ntshav roj
• Cov vaj huam sib luag metabolic yooj yim, (ib pawg kev kuaj ntshav uas ntsuas koj qib ntsev thiab potassium, lub raum ua haujlwm, thiab lwm yam tshuaj lom neeg thiab cov haujlwm, suav nrog qhov tsis sib haum)
• Ntshav qab zib mus kuaj
• Ntsuas ntsuas ntshav
• Osmolality kuaj ntshav

Lub hom phiaj ntawm kev kho mob yog los kho cov ntshav qab zib kom siab ntxiv nrog insulin. Lwm lub hom phiaj yog hloov cov kua dej uas poob los ntawm kev tso zis, poob qab los, thiab ntuav yog tias koj muaj cov tsos mob no.

Yog tias koj muaj ntshav qab zib, tej zaum koj tus kws kho mob qhia koj yuav ua li cas pom cov cim ceeb toom ntawm DKA. Yog tias koj xav tias koj muaj DKA, sim rau ketones siv ib txoj hlab zis. Qee qhov ntsuas dej qabzib tseem tseem tuaj yeem ntsuas cov ntshav ketones. Yog tias muaj cov ketones tam sim no, hu rau koj tus kws kho mob tam sim ntawd. TSIS TXHOB Ruam. Ua raws li cov lus qhia uas koj tau muab rau.

Nws zoo li koj yuav tsum tau mus tom tsev kho mob. Nyob rau ntawd, koj yuav tau txais insulin, kua, thiab lwm yam kev kho rau DKA. Tom qab ntawd cov chaw muab kev pabcuam tseem yuav tshawb thiab kho cov hauv paus hauv DKA, xws li tus kabmob.

Feem ntau cov neeg siv los kho mob hauv 24 teev. Qee zaum, nws siv sijhawm ntev dua los ua kom rov zoo dua.

Yog tias DKA tsis raug kho, nws tuaj yeem ua rau mob hnyav lossis tuag taus.

Cov teeb meem kev noj qab haus huv uas yuav tshwm sim los ntawm DKA suav muaj ib qho hauv qab no:

• Kev haus dej hauv lub hlwb (cerebral edema)
• Lub plawv nres tsis ua haujlwm (raug ntes)
• Raum tsis ua haujlwm

DKA feem ntau yog xwm ceev mob. Hu rau koj qhov chaw muab kev pab yog koj pom cov tsos mob ntawm DKA.

Mus rau chav kho mob ceev lossis hu rau tus npawb xov tooj xwm ceev (xws li 911) yog tias koj lossis koj tsev neeg muaj ntshav qab zib muaj qee yam hauv qab no:

• Tsis nco qab qis
• Fruity ua pa
• Xeev siab thiab ntuav
• Teeb meem ua pa

Yog tias koj muaj ntshav qab zib, kawm kom paub txog cov cim thiab cov tsos mob ntawm DKA. Paub thaum twg sim rau ketones, xws li thaum koj mob.

Yog tias koj siv cov tshuaj insulin, xyuas ntau zaus kom pom tias cov insulin ntws los ntawm lub raj xa dej. Nco ntsoov tias lub raj tsis txhaws, kinked lossis kaw tawm los ntawm cov twj tso kua mis.

DKA; Ketoacidosis; Ntshav qab zib - ketoacidosis

• Khoom noj khoom haus thiab insulin tso
• Kev ntsuam xyuas cov ntshav qabzib nyob hauv qhov ncauj
• Insulin twj tso kua mis

Koom Haum Asmeskas Mob Ntshav Qab Zib. 2. Kev faib tawm thiab kuaj mob ntshav qab zib: cov txheej txheem kho mob hauv ntshav qab zib - 2020. Ntshav Qab Zib Kho Mob. 2020; 43 (Cov Khoom Siv 1): S14-S31. PMID: 31862745 pubmed.ncbi.nlm.nih.gov/31862745/.

Atkinson MA, Mcgill DE, Dassau E, Laffel L. Hom Ntshav Qab Zib 1 Hauv: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Phau Ntawv ntawm Endocrinology. Xab 14th. Philadelphia, PA: Elsevier; 2020: cha 36.

Maloney GE, Glauser JM. Mob ntshav qab zib mellitus thiab mob ntawm cov ntshav qabzib homeostasis. Hauv: Phab Ntsa RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Cov Tshuaj Siv Thaum Muaj Xwm Ceev: Cov Ntsiab Lus thiab Kev Siv Tshuaj. 9le ed. Philadelphia, PA: Elsevier; 2018: chap 118.