Lactate: ndi chiyani ndipo chifukwa chiyani itha kukhala yayitali

Zamkati

• Nthawi yotenga mayeso a lactate
• Kodi mkulu lactate amatanthauza chiyani

Lactate imapangidwa ndi kagayidwe kabwino ka shuga, ndiye kuti, ndi zotsatira za kusintha kwa glucose kukhala mphamvu yama cell pomwe mpweya mulibe okwanira, njira yotchedwa anaerobic glycolysis. Komabe, ngakhale m'malo othamangitsika, momwe muli mpweya, lactate imapangidwa, koma pang'ono pang'ono.

Lactate ndichinthu chofunikira, chifukwa chimawerengedwa kuti ndi chizindikiro ku Central Nervous System, yomwe imayambitsa kusintha kwamitsempha ndi hypoperfusion ya minofu, momwe mpweya wake umapitilira pang'ono, komanso kulimbitsa thupi komanso kutopa kwa minofu, kuyambira momwe ntchitoyo imakhudzira kwambiri, kufunika kwa mpweya ndi mphamvu, komwe kumabweretsa kupanga kwa lactate.

Nthawi yotenga mayeso a lactate

Mayeso a lactate amagwiritsidwa ntchito kwambiri pakuchipatala kwa odwala omwe ali mchipatala komanso ngati chisonyezo chakulimbitsa thupi komanso kutopa kwa minofu. M'zipatala, mlingo wa lactate ndikofunikira kuti muwone momwe wodwalayo alili ndikuwunika momwe amathandizira. Nthawi zambiri mlingowu umachitika odwala omwe ali mchipatala omwe akuwakayikira kapena omwe amapezeka kuti ali ndi sepsis kapena septic mantha, zomwe zimadziwika ndi lactate pamwamba pa 2 mmol / L kuphatikiza kutsika kwa magazi, kupuma mwachangu, kuchepa kwa mkodzo komanso kusokonezeka kwamaganizidwe.

Chifukwa chake, popanga lactate dosing, ndizotheka kuwunika ngati wodwalayo akumvera chithandizo kapena ngati kuli kofunikira kusintha njira yothandizira ndikuwonjezera chisamaliro kutengera kuchepa kapena kuchuluka kwa milingo ya lactate.

M'maseŵera, mlingo wa lactate umalola kudziwa momwe othamanga amagwirira ntchito komanso kulimbitsa thupi. Pazinthu zolimbitsa thupi kapena zazitali, kuchuluka kwa mpweya wambiri sikokwanira nthawi zonse, komwe kumafuna kupanga lactate kuti ntchito yamaselo igwire ntchito. Chifukwa chake, kuyeza kuchuluka kwa lactate mutatha kuchita masewera olimbitsa thupi kumalola wophunzitsayo kuwonetsa dongosolo la maphunziro loyenera kwambiri kwa othamanga.

Mtengo wa lactate amawerengedwa kuti ndi wabwinobwino mukakhala wochepera kapena wofanana ndi 2 mmol / L. Kukwera kwa ndulu ya lactate, kumakulirakulira kwa matendawa. Pankhani ya sepsis, mwachitsanzo, kuchuluka kwa 4.0 mmol / L kapena kupitilira apo kumatha kupezeka, zomwe zikuwonetsa kuti chithandizo chiyenera kuyambitsidwa mwachangu kuti tipewe zovuta.

Kuti muchite mayeso a lactate, sikoyenera kusala, komabe tikulimbikitsidwa kuti munthuyo apumule, chifukwa zolimbitsa thupi zimatha kusintha milingo ya lactate motero, zimakhudza zotsatira zake.

Kodi mkulu lactate amatanthauza chiyani

Kuwonjezeka kwa kuchuluka kwa lactate, komwe kumatchedwa hyperlactemia, kumatha kuchitika chifukwa cha kuchuluka kwa lactate, kusintha kwa kupezeka kwa mpweya kumatumba kapena kuchepa kwa kuchotsedwa kwa chinthuchi mthupi, zomwe zimapangitsa kuti magazi azikundana. Chifukwa chake, lactate yayikulu imatha kuchitika chifukwa cha:

• Sepsis ndi septic mantha, momwe, chifukwa chakupanga poizoni ndi tizilombo tating'onoting'ono, pamakhala kuchepa kwa mpweya womwe umafikira minofu, ndikuwonjezeka pakupanga kwa lactate;
• Kuchita masewera olimbitsa thupi kwambiri, chifukwa nthawi zina kuchuluka kwa mpweya wochita zolimbitsa thupi sikokwanira, ndikuwonjezera kupanga kwa lactate;
• Kutopa kwa minofu, chifukwa cha lactate yambiri yomwe imasonkhanitsidwa mu minofu;
• Matenda othana ndi zotupa (SIRS), popeza pali kusintha kwa magazi ndi chitetezo cha mthupi, zomwe zimapangitsa kuchuluka kwa ma lactate poyesa kukhalabe ndi magwiridwe antchito am'manja ndikuthandizira kuthana ndi kutupa. Mlingo wa lactate panthawiyi umagwiritsidwa ntchito kwambiri kuwunika momwe wodwalayo akuyankhira komanso kuyeza chiwopsezo cha kulephera kwa ziwalo, kukhala chisonyezero cha kulosera;
• Kusokonezeka kwamtima, momwe magazi amasinthira kusintha kwa mtima, motero, mpweya;
• Kusokoneza maganizo, momwe mumatayika kwambiri madzi ndi magazi, kusintha magawikidwe amwazi kumatumbawo;

Kuphatikiza apo, kafukufuku wina wasonyeza kuti kuwonjezeka kwa lactate kumatha kuchitika chifukwa cha mavuto a chiwindi ndi impso, matenda a shuga, poyizoni ndi mankhwala osokoneza bongo komanso poizoni wa acid, mwachitsanzo. Chifukwa chake, kutengera kuwunika kwa ndulu ya lactate, ndizotheka kupangitsa kuti azindikire matenda, kuwunika momwe wodwalayo amasinthira komanso kuyankha kwa chithandizo ndikulosera zamankhwala.