Lactate: yintoni kwaye kutheni inokuba phezulu

Umxholo

• Nini ukuthatha uvavanyo lwe-lactate
• Ithetha ntoni i-lactate ephezulu

I-Lactate yimveliso ye-glucose metabolism, oko kukuthi, sisiphumo senkqubo yokuguqula i-glucose ibe ngamandla kwiiseli xa kungekho oksijini yaneleyo, inkqubo ebizwa ngokuba yi-anaerobic glycolysis. Nangona kunjalo, nakwiimeko ze-aerobic, apho kukho ioksijini, ilactate iveliswa, kodwa kumanani amancinci.

I-Lactate yinto ebalulekileyo, njengoko ithathwa njengophawu lwenkqubo e-Central Nervous System, i-biomarker yokutshintsha kwemithambo-luvo kunye ne-hypoperfusion yethishu, apho kukho inani elincinci le-oksijini efikelela kwizicwili, kunye nokuqina kokusebenza komzimba kunye nokudinwa kwemisipha, ukusukela ukuba mkhulu kangakanani umsebenzi, inkulu isidingo seoksijini namandla, esikhokelela kwimveliso enkulu yeelactate.

Nini ukuthatha uvavanyo lwe-lactate

Uvavanyo lwe-lactate lusetyenziswa ngokubanzi kunyango kwizigulana ezibhedlele nanjengesalathisi sokuqina kokusebenza komzimba kunye nokudinwa kwezihlunu. Kwizibhedlele, idosi ye-lactate ibalulekile ukuvavanya imeko yomguli ngokubanzi kunye nokuqinisekisa impendulo kunyango. Ngokwesiqhelo idosi yenziwa kwizigulana ezibhedlele ezikrokrelwayo okanye ezifunyenwe zine-sepsis okanye i-septic shock, ezo ziimeko ezibonakaliswa yi-lactate ngaphezulu kwe-2 mmol / L ukongeza uxinzelelo lwegazi, ukuphefumla ngokukhawuleza, ukwehla kwemveliso yomchamo kunye nokudideka kwengqondo.

Ke, xa usenza i-lactate dosing, kunokwenzeka ukuba ujonge ukuba ngaba isigulana siyaluphendula na unyango okanye ukuba kunyanzelekile na ukutshintsha isicwangciso sonyango kunye nokunyusa ukhathalelo ngokwehla okanye ukonyuka kwamazinga e-lactate.

Kwezemidlalo, idosi ye-lactate ivumela ukumisela inqanaba lokusebenza kwembaleki kunye namandla omthambo. Kwimisebenzi enzima kakhulu okanye yexesha elide yomzimba, isixa seoksijini esikhoyo asisoloko sanele, sifuna ukuveliswa kwe-lactate ukugcina ukusebenza kweeseli. Ke, ukulinganisa inani le-lactate emva kokusebenza komzimba kuvumela utitshala ukuba abonise isicwangciso soqeqesho esifanelekileyo kumbaleki.

Ixabiso le-lactate lithathwa njengesiqhelo xa lingaphantsi okanye lilingana no-2 mmol / L. Ukuphakama koxinzelelo lwe-lactate, kokukhona esi sifo siba qatha. Kwimeko ye-sepsis, umzekelo, ubuninzi be-4.0 mmol / L okanye ngaphezulu bunokufumaneka, nto leyo ebonisa ukuba unyango kufuneka luqalwe ngokukhawuleza ukunqanda iingxaki.

Ukwenza uvavanyo lwe-lactate, akukho mfuneko yokuzila ukutya, nangona kunjalo kuyacetyiswa ukuba umntu aphumle, kuba imisebenzi yomzimba inokutshintsha amanqanaba e-lactate kwaye, ngenxa yoko, ifuthe kwiziphumo zovavanyo.

Ithetha ntoni i-lactate ephezulu

Ukwanda kokuxinana kwe-lactate ejikelezayo, ebizwa ngokuba yi-hyperlactemia, kunokwenzeka ngenxa yokwanda kwemveliso ye-lactate, utshintsho ekunikezelweni kweoksijini kwizicubu okanye ukusilela ekupheliseni le nto emzimbeni, nto leyo ikhokelela ekufumaneni kwayo egazini. Ke, i-lactate ephezulu inokwenzeka ngenxa:

• I-Sepsis kunye nokutshutshiswa kwe-septic, apho, ngenxa yokuveliswa kwetyhefu ngamagciwane, kukho ukuhla kwenani leoksijini efikelela kwizicwili, kunye nokwanda kwemveliso yelactate;
• Umsebenzi onzima womzimba, kuba kwezinye iimeko isixa seoksijini sokwenza umthambo asonelanga, ngokunyuka kwemveliso ye-lactate;
• Ukudinwa kwezihlunu, ngenxa yemali enkulu ye-lactate eqokelelwe kwimisipha;
• Inkqubo yesifo sokuphendula esidumbisayo (SIRS), njengoko kukho utshintsho ekuhambeni kwegazi nakwiiseli zomzimba, ezibangela ukwanda kwemveliso yeelactate kwimizamo yokugcina imisebenzi yeselula kunye nokunceda kwisisombululo sokudumba. Umthamo we-lactate kule meko usetyenziswa ngokubanzi ukubeka esweni impendulo yesigulana kunye nokulinganisa umngcipheko wokungaphumeleli komzimba, ukuba sisalathiso sokuxela kwangaphambili;
• Umothuko weCardiogenic, apho kukho utshintsho ekunikezelweni kwegazi entliziyweni kwaye, ngenxa yoko, ioksijini;
• Ukutshatyalaliswa kwe-Hypovolemic, apho kukho ukulahleka okukhulu kwamanzi kunye negazi, ukuguqula ukuhanjiswa kwegazi kwizicubu;

Ukongeza, olunye uphononongo lubonakalisile ukuba ukonyuka kwe-lactate kunokwenzeka kwimeko yesibindi kunye nezintso, isifo seswekile, ityhefu ngamachiza kunye neetyhefu kunye ne-metabolic acidosis, umzekelo. Ke, ngokusekwe kuvavanyo lwe-lactate concentration, kunokwenzeka ukuba kwenziwe isifo, ukujonga ukuvela kwesigulana kunye nokuphendula kunyango kunye nokuqikelela isiphumo seklinikhi.