E ʻike kākou e pili ana i kāu mau pae ammonia. Hiki i kēia ke lilo i mea weliweli?

Nui nā mea e hana nei i loko o ko kākou kino, ʻeā? Hoʻoheheʻe ʻia nā mea a kākou e ʻai ai a inu ai, hana ʻia ka ikehu, a hana ʻia hoʻi nā ʻōpala. No laila, ʻo kēia ammonia kekahi o ia mau ʻōpala i hana ʻia i loko o ko kākou kino. Akā inā ʻaʻole i hoʻokuʻu pono ʻia kēia, hiki iā ia ke hana i kekahi mau pilikia. I kēia lā, e kamaʻilio kākou e pili ana i kēia ammonia, no ke aha e hiki ai ke hoʻoweliweli, a pehea e kāohi ai.

He aha ka ammonia? I ka ʻōlelo maʻalahi...

I ka ʻōlelo maʻalahi, ʻo ka ammonia, a i ʻole (NH3), he huahana ʻōpala ia a nā bacteria i loko o ko kākou ʻōpū e hana ai i ka wā e ʻeli ai kākou i nā protein a kākou e ʻai ai. E noʻonoʻo e like me kahi mea i koe mai ka ʻeli ʻana i ka meaʻai. No laila, ʻike anei ʻoe i ka mea e hana pinepine ai? Hele kēia ammonia i ko kākou akepaʻa . Ua like ke akepaʻa me kahi hale hana kupanaha i loko o ko kākou kino. Ma laila, hana ʻia kēia ammonia a hoʻololi ʻia i loko o kahi huahana ʻōpala ʻē aʻe i kapa ʻia ʻo urea . A laila, hele kēia urea i ko kākou mau puʻupaʻa , kahi e hoʻokuʻu ʻia ai i loko o ka mimi. Ua kapa ʻia kēia kaʻina holoʻokoʻa ʻo ke kaʻina hana urea .

Akā, e noʻonoʻo inā he pilikia ma kekahi ʻāpana o kēia pōʻaiapuni urea, inā paha he akepaʻa, nā puʻupaʻa, a i ʻole kekahi mea ʻē aʻe e kōkua ana i kēia kaʻina hana, a laila ʻaʻole i hana pono ʻia a hoʻokuʻu ʻia ka ammonia. Ke hana ʻia kēlā, hoʻomaka ka ammonia e hōʻiliʻili i loko o ke koko. Ke hōʻiliʻili ʻia, hiki nō hoʻi ke hele mai ke koko a i ka lolo. He haʻahaʻa loa ka nui o ka ammonia e pono ai i loko o ko kākou koko. Inā piʻi iki ia, ʻo ia hoʻi, inā loaʻa kahi kūlana i kapa ʻia ʻo hyperammonemia , he mea ʻawahia loa ia i ko kākou ʻōnaehana nerve waena (CNS). ʻO ia hoʻi, he mea weliweli ia.

ʻEhia ka nui o ka ammonia e pono ai i loko o ke kino?

I kēia manawa, ʻokoʻa ka nui o ka ammonia e pono ai i loko o ke koko o ke kanaka olakino me ka makahiki. Loaʻa i nā pēpē hānau hou he ʻoi aku ka nui ma mua o nā pākeke. Eia kekahi, ʻo ka hānau ʻana o ka pēpē i ka manawa kūpono a i ʻole ka wā mua e pili pū ana iā ia.

• Nā pēpē hānau keiki olakino : Ma kahi o 45±9 micromoles no ka lita / micromol/L. ʻO ka maʻamau, ʻo ka palena kiʻekiʻe ma waena o 80 a me 90 micromol/L.
• Nā pēpē hānau mua : Ma kahi o 71±26 micromol/L. E emi ana kēia i nā pae maʻamau ma hope o ʻehiku mau lā.
• Nā keiki ma mua o hoʻokahi mahina : Ma lalo o 50 micromol/L.
• Nā pākeke : Ma lalo o 30 micromol/L.

Akā hoʻokahi mea e hoʻomanaʻo ai. Hiki ke ʻokoʻa iki kēia mau waiwai mai kēlā me kēia keʻena hoʻokolohua a i kēia keʻena hoʻokolohua. No laila, ʻoi aku ka maikaʻi o ka hoʻohālikelike ʻana iā lākou me nā waiwai i loko o kāu hōʻike keʻena hoʻokolohua. Inā he pilikia,E nīnau pono i kāu kauka a kahu maʻi paha.

Pehea ka nui o ka pilikia o ka ammonia?

He mea ʻawahia loa ka ʻAmonia. ʻO ka maʻamau, ʻo ka nui o ka ʻamonia i loko o ke koko o kahi pākeke olakino he emi ma mua o 50 micromoles i ka lita (micromol/L). Eia nō naʻe, inā piʻi kēia i 100 micromoles i ka lita (100 micromol/L), hiki ke hoʻomaka nā loli i ka ʻike. ʻO ke ʻano kēia e lilo ia i mea paʻakikī ke noʻonoʻo pono, a hiki iā ʻoe ke huikau iki. Inā piʻi ka nui o ka ʻamonia i loko o ke koko a hiki i ka 200 micromol/L, hiki iā ʻoe ke komo i loko o kahi coma a loaʻa nā ʻōhū. He mea weliweli loa kēia a hiki ke hoʻoweliweli i ke ola.

Pehea e hoʻoholo ai i ka nui o ka ammonia i loko o ke kino?

Hiki i kāu kauka ke ana i kou pae ammonia me kahi hoʻāʻo koko . No nā pākeke, hana pinepine ʻia kēia ma ka lawe ʻana i kahi koko liʻiliʻi mai kahi aʻa koko ma kou lima. No nā pēpē hānau hou, e hoʻomaʻemaʻe ke kauka i ke kuʻekuʻe wāwae o ka pēpē, e hou iā ia me kahi nila liʻiliʻi, a lawe i kekahi mau kulu koko. A laila, kau ʻia kahi kāʻei liʻiliʻi ma luna o ka wahi. Ua like kēia me kahi hoʻāʻo koko maʻamau.

He aha nā hōʻailona o ke kiʻekiʻe o ka ammonia?

Inā piʻi aʻe kou mau pae ammonia koko, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Ka huikau a me ka nalowale ʻana o ke kuhikuhi
• Ka hiamoe nui, ka paʻakikī ke ala aʻe
• Nā loli i ka ʻike, i kekahi manawa nalowale ka ʻike
• Nā loli o ke ʻano, ka huhū, a me nā loli o ke ʻano
• Nā haʻalulu lima, ʻoiai i ka wā e hoʻolōʻihi ai i ka lima i mua
• Coma - ke kūlana o ka ʻike ʻole a me ka pane ʻole

He mea nui loa kēia: inā loaʻa iā ʻoe a i ʻole kekahi mea kokoke iā ʻoe kēia mau hōʻailona, ​​​​mai hoʻonele i ka manawa a kāhea aku i ka lawelawe ambulance 1990, a i ʻole e hele i ka ʻoihana pilikia o ka haukapila kokoke loa i ka hikiwawe loa. Hiki i ka hoʻonui ʻia o nā pae ammonia ke hoʻoweliweli i ke ola, no laila pono koke ka mālama lapaʻau.

Nā hōʻailona o kahi pēpē hānau hou

Inā hōʻike kahi pēpē hānau hou i kekahi o kēia mau hōʻailona i nā lā mua ma hope o ka hānau ʻana, hiki i ke kauka ke hoʻāʻo no nā pae ammonia:

• Ka hoʻomaha mau, ka uē pinepine, a me ka makemake ʻole e inu waiū (Irritability)
• Ka luaʻi ʻana
• Ka hiamoe, ka luhi, ka paʻakikī e ala aʻe
• Nā hopu ʻana

Inā loaʻa i kahi pēpē kēia mau hōʻailona, ​​mai hoʻowahāwahā iā lākou. E ʻike koke i ke kauka.

No ke aha e piʻi nui ai ka nui o ka ammonia i loko o ke kino?

Aia kekahi mau kumu e piʻi ai ka nui o ka ammonia i loko o ke koko. E nānā kākou i ko lākou ʻano:

• Maʻi akepaʻa:ʻO kēia ke kumu nui . Inā ua hōʻino ʻia kou ake, e like me ka cirrhosis, ʻaʻole hiki i ke ake ke hoʻomaʻemaʻe pono i ka ammonia. ʻO kēia ka hihia pinepine me nā maʻi ake koʻikoʻi. Eia nō naʻe, i kekahi manawa, ʻoiai inā paʻa ka maʻi ake, inā loaʻa kekahi mea i loko o ka ʻōpū a i ʻole nā ​​​​​​naʻau, e like me ke kahe ʻana o ke koko ma ka ʻōpū, a i ʻole kahi kaulike ʻole o ka electrolyte, hiki ke piʻi koke nā pae ammonia.

• Hoʻemi ʻia ke kahe koko i ke akepaʻa: Inā ʻaʻole lawa ke koko i ke akepaʻa, ʻaʻohe ala o ka ammonia e hiki ai i ke akepaʻa a hoʻomaʻemaʻe ʻia. A laila, hōʻiliʻili ka ammonia i loko o ke koko.

• ʻO ka encephalopathy hepatic: He ʻoi aku ka paʻakikī o kēia. I ka ʻōlelo maʻalahi, ke maʻi a hōʻino ʻia paha ke akepaʻa a ʻaʻole hiki ke hoʻomaʻemaʻe pono i ka ammonia, hōʻiliʻili ka ammonia i loko o ke koko a hele i ka lolo. Hiki i kēia ke hana i ka disorientation, ka huikau, a me ka coma. I kekahi manawa hiki ke make.

• ʻO ka maʻi Reye: He maʻi kakaikahi kēia akā he koʻikoʻi loa e hoʻopilikia ana i ke koko, ka lolo, a me ke ake. Hoʻoulu pinepine ia i nā pae ammonia koko kiʻekiʻe a me nā pae glucose koko haʻahaʻa. Loaʻa pinepine ia i nā keiki a me nā pākeke ʻōpio i lawe i ka aspirin no nā hōʻailona i ka wā e hoʻōla ana mai kahi maʻi viral e like me ka chickenpox a i ʻole ka influenza (flu). ʻAʻole ʻike ʻia ke kumu kikoʻī o ka maʻi Reye. Eia naʻe, ma muli o kēia pilikia, ʻaʻole pono nā keiki a me nā pākeke ʻōpio e lawe i ka aspirin ke ʻole i ʻōlelo kikoʻī ʻia e ke kauka.

• Ka hāʻule ʻana o nā puʻupaʻa / puʻupaʻa: Inā ʻaʻole hana pono kou mau puʻupaʻa, ʻo ia hoʻi ke hāʻule nei lākou, ʻaʻole hiki iā lākou ke hoʻoneʻe pono i ka urea. ʻO kēia ke kumu o ka hōʻiliʻili ʻana o ka ammonia i loko o ke koko.

• Nā maʻi hoʻoilina o ke kaʻina hana urea: He mau maʻi hoʻoilina kakaikahi loa. Hoʻokumu ʻia kēia e ka hemahema hānau ʻole o kekahi o nā enzymes e pono ai no ke kaʻina hana urea. ʻIke pinepine ʻia kēia i ka wā hānau.

• ʻO ka maʻi hemolytic o ka pēpē hānau hou: Hana ʻia kēia ke hana ka makuahine hāpai i nā antibodies e kūʻē i nā hunaola koko o kāna pēpē. Hiki ke pale ʻia kēia ʻano. Inā he Rh-negative ʻoe a ʻaʻole i hoʻomaopopo mua ʻia, hiki iā ʻoe ke lawe i kahi lāʻau lapaʻau e pale ai i kāu mau antibodies mai ka pane ʻana me nā hunaola Rh-positive o kāu pēpē.

He aha nā lāʻau lapaʻau no ka hoʻonui ʻia o ka ammonia?

ʻO ke ʻano o ka mālama ʻana no nā pae ammonia kiʻekiʻe e pili ana i ke kumu. No ka laʻana, i loko o kahi pākeke, hiki ke kumu o ka maʻi akepaʻa a i ʻole ka encephalopathy hepatic, ʻoiai i loko o kahi keiki hānau hou, hiki ke kumu o kahi kūlana hānau e hoʻopilikia ai i ka pōʻaiapuni urea.

I ka mālama ʻana i ka hyperammonemia koʻikoʻi, ʻo ka mea nui ka hoʻemi ʻana i nā pae ammonia a me ka kaohi ʻana i nā pilikia e like me ka edema cerebral a me ka hypertension intracranial.

Inā piʻi ka pae ammonia o kahi pēpē hānau hou, hoʻōki nā kauka i ka hāʻawi ʻana iā lākou i ka protein (no ka mea, hana ʻia ka ammonia i ka wā e ʻeli ʻia ai ka protein). Akā, hāʻawi lākou iā lākou i nā hopena glucose e hāʻawi i ka ikehu. Hoʻohana pū lākou i kahi lāʻau i kapa ʻia ʻo hemodialysis e wehe i ka ammonia mai ke koko o ka pēpē. Pili kēia i ka hoʻomaʻemaʻe ʻana i ke koko me ka hoʻohana ʻana i kahi mīkini kūikawā i kapa ʻia he mīkini dialysis a me kahi kānana, e like me kahi puʻupaʻa hana.

I ka mālama ʻana i ka encephalopathy hepatic, ʻo ka pahuhopu ka hōʻemi ʻana i ka hana ʻana o ka ammonia i loko o nā ʻōpū. ʻO ka laina mua o ka lāʻau lapaʻau he mau lāʻau lapaʻau waha i kapa ʻia ʻo lactulose a me lactitol . Hoʻemi kēia mau kō i ka hana ʻana a me ka omo ʻana o ka ammonia i loko o nā ʻōpū.

Āhea wau e ʻike ai i ke kauka e pili ana i koʻu mau pae ammonia?

Ua maopopo loa kēia. Inā ʻoe a i ʻole kekahi mea kokoke iā ʻoe e ʻike nei i nā hōʻailona o ke kiʻekiʻe o ka ammonia koko, e like me ka disorientation a mākou i kamaʻilio ai ma mua, ka hiamoe mau, a me nā loli o ka ʻike, e kāhea koke i ka 911, a i ʻole e hele i ka lumi pilikia haukapila kokoke loa i ka hikiwawe loa. ʻAʻole kēia he mea e hoʻopaneʻe ai.

Inā loaʻa iā ʻoe ka maʻi akepaʻa, pono ʻoe e ʻike pinepine i kāu kauka e hōʻoia i ka hoʻomaʻemaʻe pono ʻana o kou akepaʻa i ka ammonia. E kōkua kēia iā ʻoe e ʻike i nā pilikia i ka wā mua.

No laila, he aha nā mea nui e pono ai kākou e hoʻomanaʻo mai kēia moʻolelo?

ʻOiai he mea maʻamau i ko mākou kino ke hana i ka ammonia ma ke ʻano he huahana ʻōpala, hiki ke lilo i mea weliweli loa inā hōʻiliʻili nui ʻia i loko o ke koko.

Inā loaʻa iā ʻoe a i ʻole kekahi mea kokoke iā ʻoe nā hōʻailona o nā pae ammonia kiʻekiʻe (no ka laʻana, ka huikau, ka hiamoe nui, nā loli o ke ʻano), e hele koke i ka haukapila kokoke loa me ka hoʻokaʻulua ʻole. Hiki i kēia ke lilo i kūlana ola a make paha.

He mea nui loa ia e ʻike i kēia mau hōʻailona inā loaʻa iā ʻoe ka maʻi akepaʻa, no ka mea, hiki i kēia ke hoʻonui i ka pilikia o nā pae ammonia kiʻekiʻe.

Inā he mau nīnau kāu e pili ana i ka pilikia o nā pae ammonia kiʻekiʻe, a i ʻole kekahi mea āu e makemake ai e ʻike, mai kānalua e kamaʻilio me kāu kauka. Aia lākou ma laila e kōkua iā ʻoe a pane i kāu mau nīnau. ʻO ka noho olakino ka mea nui loa!

ʻAmonia , Nā Pae ʻAmonia, ʻAkepaʻa, Pūpū, Pōʻaiapuni Urea, Hepatic Encephalopathy, Reye's Syndrome, Hoʻāʻo Koko, Hyperammonemia