Momma yensua pii mfa Anion Gap sɔhwɛ a ɛkyerɛ sɛnea wo mogya mu acid ne base kari pɛ no ho.

Ebia woate mogya mu nhwehwɛmu ho asɛm bere a wokɔ oduruyɛfo nkyɛn no. Mogya mu nhwehwɛmu betumi ama woahu nneɛma ahorow a ɛwɔ yɛn nipadua mu ho nsɛm pii. Afei nso, wɔfrɛ ade titiriw bi a ɛkyerɛ sɛnea acid ne base kari pɛ wɔ yɛn mogya mu, kyerɛ sɛ, acid ne base a ɛkari pɛ no Anion Gap . Biribiara nni hɔ a ɛsɛ sɛ wusuro bere a wote eyi, ɛma clues fa akwahosan tebea horow bi a ɛwɔ yɛn nipadua mu ho. Momma yɛnka eyi ho asɛm tiawa, na afei ɛbɛda adi pefee ama wo nso.

Dɛn ne Anion Gap yi, Oduruyɛfo?

Sɛ yɛbɛka no tiawa a, Anion Gap yɛ nsonsonoe a ɛda nneɛma nketenkete a anyinam ahoɔden wom (electrolytes) a ɛwɔ wo mogya mu no ntam. Ebia wobɛkae sɛ wusuaa ions a ɛwɔ ahoɔden a ɛyɛ papa (+) ne ion a ɛwɔ ahoɔden bɔne (-) ho ade wɔ sukuu mu. Saa na ɛte. Electrolytes a ɛyɛ papa ne nea enye yi nso wɔ yɛn mogya mu.

Enti, nea Anion Gap yi yɛ ne sɛ ɛbɛsusuw nsonsonoe, anaa "nsonsonoe," a ɛda electrolytes atitiriw a ɛwɔ ahoɔden pa (te sɛ potassium ne sodium) ne electrolytes atitiriw a ɛwɔ ahoɔden bɔne (te sɛ chloride ne bicarbonate) a ɛwɔ mogya no mu no ntam. Eyi nyɛ biribi a wɔde afiri susuw tẽẽ. Wɔde mogya mu nhwehwɛmu afoforo a wo duruyɛfo ahyɛ sɛ wɔmfa mma wo no mu aba na ebu Anion Gap no ho akontaa. Mpɛn pii no, wɔde nhwehwɛmu ahorow yi ka mogya mu nhwehwɛmu nneɛma a yenya bere a yɛkɔ oduruyɛfo nkyɛn kɔhwɛ yare bi no ho. Nhwɛsoɔ:

• Nneɛma a Wɔde Yɛ Nneɛma a Ɛyɛ Fɛ (CMP) .
• Mfitiaseɛ Nkwammoaa mu Nneɛma Ho Panel (BMP) .
• Electrolyte Panel a Wɔde Yɛ Nneɛma

Sɔhwɛ ahorow te sɛ eyi ma wonya data a ehia na ama wɔahu anion gap no.

Dɛn nti na wɔyɛ anion gap sɔhwɛ yi? Dɛn na ɛhwehwɛ mu?

Saa Anion Gap yi hwɛ titiriw sɛ ebia electrolyte a ɛnkari pɛ wɔ wo mogya mu, anaasɛ wo mogya no yɛ acidic dodo (`(Acidosis)`) anaasɛ basic dodo (`(Alkalosis)`) .

Susuw ho saa kwan yi so: yɛn nipadua te sɛ afiri a wɔayɛ no yiye. Ɛsɛ sɛ biribiara a ɛwɔ afiri yi mu kari pɛ. Acid ne base a ɛkari pɛ wɔ mogya no mu no yɛ pɛ. Sɛ ɛnkari pɛ wɔ eyi mu a, ɛkyerɛ sɛ biribi a ɛwɔ nipadua no mu ntumi nyɛ adwuma yiye. Acidosis anaa alkalosis, a ne nyinaa betumi ayɛ asiane. Enti, nnuruyɛfo de saa anion gap result yi di dwuma de bɔ mmɔden sɛ wobehu nea ɛde saa kari a ɛnkari pɛ yi ba.

Bere bɛn na mihia Anion Gap sɔhwɛ?

Ebia wo duruyɛfo bɛhyɛ sɛ wɔnyɛ mogya mu nhwehwɛmu a anion gap no ka ho, titiriw sɛ woreda sɛnkyerɛnne ahorow adi a ɛkyerɛ sɛ acid dodow a ɛwɔ wo mogya mu no nkari pɛ a. Ɛne sɛ, sɛnkyerɛnne ahorow a acidosis (acid a ɛkɔ soro) anaa alkalosis (alkalin a ɛkɔ soro) de ba. Ebia eyinom bi ne:

• Ɔhome a ɛyɛ den
• Ɔfe ne akisikuru
• Kesereneeyɛ
• Koma a ɛbɔ denneennen
• Ɔbrɛ kɛse a wɔte nka

Ɛtɔ mmere bi a, sɛ woyɛ mogya mu adwuma daa esiane biribi foforo nti a, ebia wɔde Anion Gap no bɛka nhwehwɛmu no ho. Wɔ tebea horow a ɛtete saa mu no, ebia worennya yare no ho sɛnkyerɛnne pɔtee biara, nanso wɔbɛka saa bo yi ho asɛm wɔ amanneɛbɔ no mu. Sɛ nhwɛso no, wɔ sɔhwɛ ahorow a ɛtete saa mu no, wobetumi ahu nea efi Anion Gap mu ba no sɛ:

• Mfitiaseɛ Nkwammoaa mu Nneɛma Ho Panel (BMP) .
• Nneɛma a Wɔde Yɛ Nneɛma a Ɛyɛ Fɛ (CMP) .
• Electrolyte Panel a Wɔde Yɛ Nneɛma
• Adwene mu Dwumadi Ho Dwumadibea (RFP) .

Ɔkwan bɛn so na wɔyɛ sɔhwɛ yi? So ɛsɛ sɛ misuro sɛ wɔbɛtwe mogya?

Nokwarem no, Anion Gap no yɛ sɔhwɛ tẽẽ sen nhwehwɛmu a wɔyɛ wɔ aduruyɛdan mu, a nyansahufo susuw nneɛma te sɛ sodium, chloride, ne CO2 (carbon dioxide) a ɛwɔ wo mogya mu na wɔde saa gyinapɛn ahorow no bu bo bi ho akontaa. Saa nsunsuansoɔ yi bɛtumi aboa ama woahunu sɛ ebia wo nsɛnkyerɛnneɛ no firi acid a ɛkɔ soro anaasɛ alkalinity a ɛso tew (i.e., alkalinity a ɛkɔ soro). Ebetumi aboa nso ma woahu sɛ ebia wowɔ aduruyɛ mu tebea bi a ɛhyɛ wo ase anaa.

So biribi titiriw bi wɔ hɔ a ɛsɛ sɛ meyɛ ansa na mede mogya ama?

Wo duruyɛfo bɛkyerɛ wo sɛ ɛsɛ sɛ woyɛ biribi titiriw bi ansa na woayɛ mogya mu nhwehwɛmu a. Ebia wɔbɛka akyerɛ wo sɛ mmuada nnɔnhwerew kakraa bi ansa na wɔayɛ mogya mu nhwehwɛmu. Ɛsɛ sɛ woka kyerɛ wo duruyɛfo nso sɛ worenom nnuru bi a, efisɛ nnuru bi betumi aka nea efi nhwehwɛmu no mu ba no.

Sɛ wode mogya ma a, dɛn na ɛba?

Mogya a wɔde ma no nyɛ hu ankasa sɛnea ebia wususuw no. Nea ɛtaa ba ni:

• Wɔbɛtena akongua bi so. Afei phlebotomist no bɛpaw ntini bi a ɛnyɛ den wɔ wo basa mu a wobɛtwe mogya afi mu. Ebia wɔde rɔba bɛtwa abasa no atifi ho ahyia na ama ntini no ada adi. Mpɛn pii no, wɔtwe mogya no fi nsateaa no mu.
• Sɛ wohu ntini no wie a, wɔhohoro baabi a ɛwɔ no yiye na wɔde nnuru a ekum mmoawa gu mu.
• Afei, wɔde ade ketewaa bi hyɛ ntini no mu na wogye mogya. Saa bere yi de, ebia wobɛte nka sɛ woabɔ wo kakra, te sɛ nea ntɛtea aka wo . Eyi nso kyɛ sikani kakraa bi.
• Bere a wɔde ade no hyɛ mu wie no, wɔboaboa mogya kakraa bi ano wɔ afiri bi a wɔde sɔ hwɛ mu.
• Sɛ wɔgye mogya a ɛdɔɔso ma nhwehwɛmu no wie a, woyi ade no na wɔde kotoku anaa gauze asinasin bi gu beae no na wɔde mia so na ama mogya no agyae.
• Afei wɔde plaster kakra gu beae no. Ɛno ara ne no, adwuma no awie!

Saa adeyɛ yi nyinaa taa gye nea ennu simma anum .

Dɛn na ɛba wɔ sɔhwɛ no akyi? Bere tenten ahe na egye ansa na wɔanya amanneɛbɔ no?

Wɔde wo mogya kɔ aduruyɛdan mu kɔhwɛ. Ɛhɔ no, aduruyɛdan mu nyansahufo bi siesie nhwɛsode no na ɔde mfiri titiriw (mogya mu nhwehwɛmu) yɛ nhwehwɛmu no.

Sɛ sɔhwɛ no aba wie a, wo duruyɛfo bɛka nea efii mu bae no akyerɛ wo, anaasɛ ebia wɔbɛkyerɛw wɔ wo kɔmputa so aduruyɛ ho kyerɛwtohɔ mu. Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ ahome a ɛyɛ tiaa anaa ɔfe, na woyɛ anion gap nhwehwɛmu a, ebia wubenya nea efi mu ba wɔ nnɔnhwerew kakraa bi mu . Nanso, sɛ wɔyɛ nhwehwɛmu yi sɛ mogya mu nhwehwɛmu a wɔyɛ daa no fã (te sɛ nipadua mu nneɛma a ɛsakra no titiriw) a, ebetumi agye adwuma nna biako kosi abien ansa na nea efi mu ba no asan aba.

So asiane bi wɔ mogya mu nhwehwɛmu yi mu?

Mogya mu nhwehwɛmu yɛ adeyɛ a abu so yiye na ɛho hia wɔ nnuruyɛ mu. Asiane akɛse biara nni mogya a wɔde ma mu ankasa . Ebia wubenya apirakuru anaa ɔfe bi a ɛnyɛ den wɔ baabi a wɔtwee mogya no. Nanso eyi bɛbrɛ ase wɔ da koro anaa nnanu ntam. Enti mma ɛnhaw wo wɔ ho.

Okay, afei dɛn na Anion Gap amanneɛbɔ yi ka?

Mogya mu nhwehwɛmu amanneɛbɔ a Anion Gap mogya mu nhwehwɛmu aba ka ho no taa kura nsɛm a edidi so yi:

• Mogya mu nhwehwɛmu no din, anaa nea wɔsusuu wɔ wo mogya mu.
• Wo mogya mu nhwehwɛmu aba no dodow anaa susuw.
• Lab no susuw a wɔtaa susuw ma saa sɔhwɛ no.
• So nea efi mu ba no yɛ nea ɛfata, ɛnyɛ nea ɛfata, ɛkɔ soro anaasɛ ɛba fam?

Dɛn ne anion gap a ɛyɛ daa?

Nokwarem no, botae biako biara nni hɔ ma Anion Gap a ɛka sɛ "eyi ne bo a ɛfata ma obiara." Sɛ wonya wo mogya mu nhwehwɛmu aba a, amanneɛbɔ no nso bɛka nea Anion Gap dodow a ɛfata yɛ ma saa lab no.

Afei nso, saa "normal" Anion Gap range yi betumi ayɛ soronko a egyina nneɛma ahorow so. Sɛ nhwɛso no, nnipa a wɔnom aduru a wɔfrɛ no Lithium Carbonate ma adwenemhaw no betumi anya Anion Gap a ɛba fam kakra esiane aduru no nti.

Sɛ anion gap no kɔ soro a, dɛn na ɛkyerɛ? So ɛyɛ hu?

Sɛ wo mogya mu nhwehwɛmu kyerɛ sɛ Anion Gap dɔɔso a, ebia wubenya acidosis . Wei kyerɛ sɛ wo mogya mu acid yɛ kɛse sen sɛnea ɛte daa (wo mogya no pH sua sen sɛnea ɛte daa).

Nneɛma pii betumi ama acidosis aba:

• Nsu a ɛho ntew: Nsu a ɛdɔɔso a wonnya mma nipadua no.
• Akisikuru : Atiridiinini ma nsu ne anyinam ahoɔden pii yera fi nipadua no mu.
• Apɔw-mu-teɛteɛ a ɛboro so : Apɔw-mu-teɛteɛ boro so betumi ama nneɛma te sɛ lactic acid ayɛ kɛse wɔ nipadua no mu.

Eyinom akyi no, acidosis nso betumi ayɛ aduruyɛ mu tebea afoforo pii a emu yɛ den ho sɛnkyerɛnne :

• Asaabo Yare : Asaabo a ɛte apɔw no nam nsu so yi acid a ɛboro so fi nipadua no mu. Nanso, wɔ nnipa a wɔwɔ asaabo mu yare mu no, asaabo no ntumi nyɛ adwuma yi yiye. Acid boaboa ano wɔ nipadua no mu, na ɛde tebea bi a wɔfrɛ no metabolic acidosis ba.
• Asikreyare : Acidosis betumi aba, titiriw sɛ wowɔ asikreyare a ɛto so 1 a wonhuu bi. Sɛ dwensɔtwaa no ntumi nyɛ insulin a ɛdɔɔso a, nkwammoaa no ntumi nnye asikre (glucose), na mogya no betumi ayɛ acidic.
• Asikreyare Ketoacidosis (DKA) : Eyi yɛ ɔhaw a emu yɛ den a ɛde nkwa to asiane mu a insulin a enni asikreyare a wonhuu bi mu de ba.
• Salicylate Poisoning (`(Salicylate Poisoning / Salicylate Toxicity)`) : Salicylate yɛ nnuru a ɛwɔ nnuru pii a wɔtɔn a wɔmfa nnuru nhyɛ mu ne nea wɔkyerɛw ma obi mu. Aspirin yɛ aduru a wɔtaa de di dwuma a saa salicylate yi wom. Sɛ obi nom eyinom pii anaasɛ ɔnom boro so a, ebetumi ama wanya salicylate awuduru, na ɛno nso de ne nkwa to asiane mu.

Nea ɛho hia: Ɛnyɛ bere nyinaa na anion gap a ɛkɔ soro no kyerɛ yare a emu yɛ den. Nanso, oduruyɛfo no bɛhwehwɛ nea ɛde ba.

Na sɛ anion ntam kwan no so tew nso ɛ? Ɛno ntaa nsi, ɛnte saa?

Yiw, ɛntaa nsi koraa sɛ Anion Gap no bɛda bo a ɛba fam adi . Enti, ɛda adi sɛ wo duruyɛfo no bɛsan ayɛ nhwehwɛmu no bio de ahwɛ ahu sɛ nea ebefi mu aba no yɛ nokware.

Sɛ wo mogya mu nhwehwɛmu mu aba kyerɛ sɛ anion ntam kwan sua a, ebetumi akyerɛ sɛ protein bi a wɔfrɛ no albumin dodow a ɛba fam sen sɛnea ɛte daa wɔ wo mogya mu (hypoalbuminemia). Albumin yɛ protein a ɛho hia wɔ yɛn mogya mu. Albumin dodow a ɛba fam no betumi afi tebea horow te sɛ:

• Asaabo ho nsɛm
• Koma mu yare
• Mmɛn mu yare
• Kokoram ahorow bi

Bio nso, nea efi anion gap a ɛba fam ba no ho yɛ na. Hwɛ hu sɛ wo ne wo duruyɛfo bɛkasa sɛ wopɛ sɛ wuhu nea efii wo nhwehwɛmu no mu bae no ho nsɛm pii a.

Enti, so ɛsɛ sɛ yɛhaw yɛn ho bere a saa anion nsonsonoe yi kɔ soro anaasɛ ɛso tew no?

Sɛ́ ebia wo mogya mu nhwehwɛmu no kyerɛ sɛ Anion Gap dɔɔso anaasɛ ɛba fam no, ɛnkyerɛ ankasa sɛ wowɔ yare a emu yɛ den . Nneɛma pii wɔ hɔ a ɛka wo electrolyte dodow, na ɛno nso betumi aka Anion Gap susuw no. Ebetumi aba sɛ biribi ankɔ yiye bere a wɔregye mogya no, de akɔ lab, anaasɛ wɔreyɛ nhwehwɛmu no.

Sɛ wo duruyɛfo hwehwɛ wo mogya mu nhwehwɛmu mu aba a, obesusuw nneɛma pii ho, te sɛ w’ayaresa ho abakɔsɛm nyinaa ne nnuru a worenom . Sɛ wo Anion Gap aba no nyɛ nea ɛfata a, ebia wɔbɛhyɛ sɛ wɔnyɛ nhwehwɛmu foforo na ama wɔahu sɛ wowɔ wo yare no. Obiara mpɛ sɛ wɔbɛyɛ mogya mu nhwehwɛmu, titiriw sɛ ɛsɛ sɛ wɔyɛ no mpɛn pii nnidiso nnidiso a. Nanso, ɛyɛ ɔkwan a eye sen biara a wobɛfa so ahwɛ ahu sɛ wo electrolyte dodow no yɛ pɛpɛɛpɛ.

Sɛ wowɔ nsɛmmisa bi fa nea ebefi mu aba ho a, nsuro sɛ wubebisa wo duruyɛfo. Wɔwɔ hɔ sɛ wɔbɛboa wo.

Nea etwa to no, nneɛma a ɛho hia sen biara a ɛsɛ sɛ yɛkae (Take-Home Message) .

Okay, enti yɛaka Anion Gap sɔhwɛ no ho asɛm pii. Nneɛma a ɛho hia paa a ɛsɛ sɛ wokae ni:

• Anion Gap yɛ akontaabu a ɛho hia: ɛma wonya nsɛm a ɛsom bo fa wo mogya mu acid ne base a ɛkari pɛ ho.
• Ɛnyɛ bere nyinaa na bo a ɛsom anaa nea ɛba fam no yɛ nea asiane wom: Mma nsakrae a ɛba mpofirim wɔ bo a ɛsom wɔ w’amanneɛbɔ no so no nnyɛ wo hu. Ebia ntease afoforo nso wɔ hɔ a enti ɛte saa.
• Wo duruyɛfo ne ɔtemmufo a oye sen biara: Wo duruyɛfo nkutoo na obetumi asusuw w’akwahosan tebea a edi mũ ho, ayɛ nhwehwɛmu foforo sɛ ɛho hia a, na wakyerɛkyerɛ nea ebefi mu aba no mu.
• Bisa nsɛm: Sɛ biribi wɔ hɔ a wonte ase a, mfa nsie wo ho, na mmom bisa wo duruyɛfo.

Kae: Worentumi nhu yare bi denam nɔma bi a wobɛhwɛ wɔ amanneɛbɔ bi so kɛkɛ so. Enti, nya wo duruyɛfo no mu ahotoso na di n’afotu akyi. Afei wubetumi akɔ so anya apɔwmuden!

` Anion Gap, Mogya mu Nhwehwɛmu, Acidosis, Alkalosis, Electrolytes, Mogya mu Acidity