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Department OverIntroduction of different causes sustained increases in blood lactic acid and PH decreased (7.35 for a treatment. Should be prevention, timely detection and treatment, if necessary oxygen. II. Fluid expansion can improve tissue perfusion, correct shock, diuretic row acid. With saline, to avoid the use of preparations containing lactic acid. III. Make base: 5% sodium bicarbonate 100-200mlIV, when 7.25 when the stop input base, in order to avoid alkalosis. IV. Insulin: Insulin adding glucose infusion to reduce the sugar in the anaerobic glycolysis, which will help the elimination of lactic acid. Five. Hemodialysis: Shuinazhuliu commonly used in patients can not tolerate.
The pathophysiology of diabetes and treatment of comaYou can in the "My Services" in the you add a reference to the notification list, and configure access to notices.Diabetic coma, it is necessary with diabetic ketoacidosis, diabetic hyperosmolar coma, lactic acidosis, low blood sugar coma, diabetic coma caused by other diseases such as phase identification. Hypoglycemic coma, the most common of which should be as the most important differential, but after onset, such as hypoglycemia and blood glucose levels make it easy to identify. unconscious principle of treatment of patients with early detection, early treatment, patient's condition has changed at any time, should be constantly checked to carry out the necessary proper disposal. In this paper, diabetic ketoacidosis, hyperosmolar diab


etic coma, lactic acidosis in the pathophysiology and treatment reed. of: Eiichi Araki Title: Japanese Medicine in English Title: PROGRESS IN JAPANESE MEDICINE, the volume (of): 2003 24 (9) DOI: R587 Keywords: Machine Standard Classification: R58 R44 machine standard Key words: diabetic ketoacidosis, hypoglycemic coma, the pathophysiology of lactic acid acidosis, the principle of differential treatment of diabetic hyperosmolar coma coma coma early treatment of early detection of disease by blood glucose levels in patients with symptoms of sickness funds checked items: DOI: similar to the literature cited relevant literature Bowen (1) High Shu-Fang. Sun Chunlin. beginner light semi-permeability glucose solution hyperosmolar nonketotic diabetic coma efficacy [Papers] - Chinese doctors in 2008 (25)
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The names of diseases (English) lactic acidosis Pinyin RUSUANXINGSUANZHONGDU Classification of Diseases code alias Western diseases, metabolic and nutritional disease name Western medicine defines disease classification codes for the glucose metabolism in lactic acid intermediates. When the grape stage of glycolysis to pyruvate oxidation is not easy when lacking O2 into lactic acid can lead to lactic acidosis (lactic acidosis). Normal blood lactate was 0.5-1.2mmol / L, about 10 times that of pyruvate. When the blood concentration increased up to 5mmol / L or more can occur when the lactic acidosis. Sometimes up to 30mmol / L or more, the diagnostic criteria for the 7mmol / L. Release Name Western medicine there are two causes of clinical: found in a variety of state of shock associated with lack of O2, such as dehydration, hemorrhagic (hypovolemic) shock, septic shock (severe sepsis), anaphylactic shock, status asthmaticus with congestion and lack of O2, the surrounding tissue. found in a variety of non-shock, including acute heart failure, uremia, respiratory failure, liver failure (especially in acute viral hepatitis, acetaminophen or acetaminophen toxic hepatitis). Diabetic ketoacidosis, leukemia, severe sepsis, dying stages of metastatic cancer, acute myocardial infarction, pulmonary infarction and intestinal infarction, also found in a variety of drug and chemical poisoning, such as phenyl double muscle (phenformin) and metformin (lower sugar pill), methanol and ethanol classes (including ethylene glycol), salicylic acid, fructose, sorbitol and xylulose sugar overdose. Infant with lactic acidosis do not have a large shock are considered congenital metabolic disorders, such as glucose -6- phosphatase deficiency, fructose 1,6 - bisphosphatase deficiency, subacute necrotizing cerebral spinal disease, lactic acidosis with muscle disease, methylmalonic acid (malonic) urine. Cause of seasonal strength of Chinese population with the incidence of the pathogenesis and dissemination of TCM diagnostic criteria for pathological pathophysiology Traditional Chinese Medicine diagnostic criteria for diagnosis of Western history of Western medicine diagnosis is based on incidence of major clinical manifestations of symptoms and signs of metabolic acidosis caused by a large breath, severe consciousness fuzzy trance, stupor, drowsiness is induced coma. Sometimes vomiting, abdominal pain. Can be misdiagnosed as acute abdomen. The other for the primary disease symptoms and shock. Patient in this group often severe acidosis, blood pH values as low as 7.0 or less. Anion gap often more than 18mmol / L, suggest the accumulation of lactic acid-based, up to 25-45mmol / L. The urine is strongly acidic, mostly white blood cells increased up to 60 109 / L. Elevated blood lactate may be 10-30 times the normal value. Except as may be ketosis, uremia, and drug-induced acidosis is suspected of the disease and, after blood test and diagnosis. Medical diagnostic imaging diagnostic laboratory diagnostic power of urine feces blood cerebrospinal fluid immunological histology other diagnostic test certificate in Traditional Chinese Medicine Western differential diagnosis evaluation standard prognosis of this disease is mostly a very serious and often occurs without the rescue who died of shock, the mortality benzene muscle caused by low double-B. According to Cohen and woods in 1976, 91 cases reported in 48.5% mortality, there were particularly high shock was 64.9%. Non-biguanide may cause up to 85%. Often in shock several hours after death. Prevention and treatment of complications should be noted that Western medicine has liver and kidney dysfunction should not use double-muscle type to treat diabetes, try to avoid the use of fructose and sorbitol. First of all disabled rescue the drug or chemical. A large number of intravenous isotonic NaHCO3, pH, pCO2 estimates by dose, which normally takes more than supply 1000mmol, old central venous pressure should be measured to help observe and prevent heart failure. Hypertonic NaHCO3 inhibit O2 separation, increase the lack of O2, particularly those of early circulatory failure should not be used. Diabetic ketoacidosis NaHCO3 to pH values only a small amount back to around 7.0-7.1 degrees. General case it would only have to correct the pH value to 7.2 or so. In addition to rehydration supplement base outside. Any time to add potassium to prevent hypokalemia or potassium deficiency. If a serious condition who can not accept large amounts of sodium solution can be used such as artificial kidney dialysis therapy, biguanide and lactic acid may be discharged by dialysis. There into the use of dichloroacetate treatment may reduce the activation of pyruvate dehydrogenase and lactic acid, animal experiments have confirmed that in recent years, foreign countries have been tested in humans and good effect, but the Chinese toxic in animal studies found that great, so far the clinical without trial. Previous treatment with methylene blue, has been seldom used. Chinese Acupuncture and Chinese Medicine Integrative Medicine Massage preventive care and rehabilitation of historical research


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