Koj puas tau kuaj ntshav thiab pom ntau lo lus thiab ntau tus nqi sib txawv ntawm daim ntawv qhia uas nyuaj nkag siab? Tej zaum koj tus kws kho mob yuav piav qhia rau koj, tab sis qee zaum peb tus kheej kuj tsis meej pem me ntsis txog lub ntsiab lus ntawm cov no. Piv txwv li, ib lo lus uas koj yuav pom ntawm qee daim ntawv qhia ntshav yog "Anion Gap". Hnub no peb yuav tham, yooj yim heev, txog qhov Anion Gap no yog dab tsi thiab vim li cas nws thiaj tseem ceeb rau peb.
Hauv lus yooj yim, qhov Anion Gap no yog dab tsi?
Yuav kom nkag siab qhov no, peb yuav tsum xub paub me ntsis txog peb cov ntshav. Muaj cov tshuaj sib txawv hauv peb cov ntshav. Ib txhia ntawm cov no muaj hluav taws xob zoo (+), thaum lwm tus muaj hluav taws xob tsis zoo (-). Peb hu cov khoom no ua electrolytes . Sodium, potassium, chloride, thiab bicarbonate yog cov electrolytes tseem ceeb.
Yog li, qhov Anion Gap yog ib qho kev xam yooj yim heev. Nws yog qhov sib txawv ntawm cov nqi tseem ceeb (+) (xws li sodium) thiab cov nqi tseem ceeb (-) (xws li chloride thiab bicarbonate) hauv koj cov ntshav. Yog xav kom meej, nws yog "qhov sib txawv" ntawm cov nqi zoo thiab tsis zoo uas ntsuas tau.
Qhov tseem ceeb yog tias qhov no tsis yog kev kuaj ntshav sib cais. Tus nqi Anion Gap no yog xam hauv chav kuaj siv cov nqi sodium, chloride, thiab bicarbonate uas pom muaj nyob rau hauv kev kuaj ntshav ib txwm muaj (zoo li lub vaj huam sib luag electrolyte, BMP, CMP).
Vim li cas cov kws kho mob thiaj txhawj xeeb txog qhov Anion Gap tus nqi no?
Tus nqi no qhia peb txog qee yam tseem ceeb heev hauv peb lub cev. Qhov ntawd yog qhov sib npaug ntawm cov kua qaub thiab cov hauv paus hauv peb cov ntshav . Ib yam li lub cav tsheb yuav tsum muaj cov roj thiab dej kom raug kom nws khiav tau zoo, qhov kua qaub ntawm peb cov ntshav yuav tsum nyob hauv qee qhov ntau thiab tsawg kom cov hlwb hauv peb lub cev ua haujlwm tau zoo.
- Yog tias cov kua qaub ntawm cov ntshav nce ntau dhau, nws hu ua acidosis .
- Yog tias cov kua qaub ntawm cov ntshav qis dhau thiab qhov alkalinity nce ntxiv, nws hu ua alkalosis .
Ob qho mob no tuaj yeem ua rau muaj kev phom sij vim tias lawv qhia tias muaj qee yam hauv lub cev tsis ua haujlwm zoo. Yog li, yog tias tus nqi Anion Gap hloov pauv, nws yog ib qho tseem ceeb rau tus kws kho mob kom kuaj mob xws li acidosis.
Thaum twg tus kws kho mob thiaj xav tias qhov kev kuaj no tsim nyog?
Feem ntau, koj yuav pom qhov no thaum koj muaj cov tsos mob tsis xis nyob. Piv txwv li:
- Ua pa nyuaj
- Ntuav thiab xeev siab
- Lub plawv dhia ceev
- Kev tsis meej pem
- Xav tias nkees heev
Tab sis qee zaum, tsis muaj tsos mob dab tsi, tus nqi Anion Gap no yuav nyob rau ntawm koj daim ntawv qhia ua ib feem ntawm kev kuaj ntshav niaj hnub ua thaum lub sijhawm kuaj mob txhua xyoo.
Kuv yuav npaj li cas rau kev kuaj ntshav? Yuav muaj dab tsi tshwm sim thaum rho ntshav tawm?
Qhov no yog kev kuaj ntshav ib txwm muaj, yog li ntawd tsis tas yuav npaj tshwj xeeb. Txawm li cas los xij, qee zaum koj tus kws kho mob yuav hais kom koj yoo mov ob peb teev ua ntej pub ntshav. Qhov no txhais tau tias koj yuav tsum tsis txhob noj lossis haus dab tsi. Nws tseem ceeb heev uas yuav tsum qhia rau koj tus kws kho mob txog cov tshuaj uas koj noj, vim tias qee cov tshuaj tuaj yeem cuam tshuam rau cov txiaj ntsig ntawm kev kuaj no.
Koj paub zoo heev li cas kos ntshav.
1. Thaum koj zaum hauv lub rooj zaum, tus kws saib mob lossis tus kws kho mob ntshav yuav nrhiav tau ib txoj hlab ntshav hauv koj txhais caj npab.
2. Tom qab ntawd, muab ib txoj hlua roj hmab (tourniquet) tso rau ntawm sab caj npab kom ua rau cov leeg ntshav zoo dua.
3. Thaum pom cov leeg ntshav lawm, ces ntxuav thaj chaw ntawd kom huv si, muab ib rab koob me me ntxig rau hauv, thiab muab ib qho ntshav me me rau hauv ib lub raj kuaj. Thaum no, tej zaum yuav zoo li ib tug ntsaum me me tom koj.
4. Tom qab tau txais cov ntshav raws li qhov xav tau lawm, ces muab rab koob tshem tawm thiab muab ib daim paj rwb tso rau hauv thaj chaw ntawd thiab nias.
5. Thaum cov ntshav tsis ntws lawm, muab ib daim plaster me me rau ntawm thaj chaw ntawd thiab txoj haujlwm tiav lawm.
Tag nrho cov txheej txheem no siv sijhawm tsawg dua tsib feeb.
Cov txiaj ntsig qhia li cas?
Thaum koj daim ntawv qhia txog kev kuaj ntshav tuaj txog, muaj lwm yam uas los nrog tus nqi Anion Gap. Qhov ntawd yog "qhov ntau thiab tsawg ib txwm muaj". Qhov no tuaj yeem txawv me ntsis ntawm chav kuaj mus rau chav kuaj. Yog li ntawd, koj yuav tsum piv koj tus nqi rau qhov ntau thiab tsawg ib txwm muaj uas tau muab rau hauv daim ntawv qhia nws tus kheej kom pom tias nws puas yog qhov ib txwm muaj lossis tsis yog.
Tam sim no cia peb saib seb qhov nqi no yuav muab dab tsi rau peb yog tias nws nce lossis txo qis.
| Tus nqi sib txawv ntawm Anion | Nws txhais li cas (piv txwv) |
|---|---|
| Qhov sib txawv ntawm Anion siab | Qhov no txhais tau tias koj cov ntshav muaj kua qaub ntau dhau. Qhov no hu ua acidosis . Qhov no tuaj yeem tshwm sim los ntawm:
|
| Qhov sib txawv Anion qis | Qhov no tsis tshua muaj . Yog li ntawd, koj tus kws kho mob yuav rov ua qhov kev kuaj dua kom paub tseeb tias qhov tshwm sim yog qhov tseeb. Yog tias muaj tus nqi qis heev, cov laj thawj tseem ceeb rau nws tuaj yeem yog:
|
Kuv puas yuav tsum txhawj xeeb yog tias kuv tus nqi Anion Gap tsis zoo li qub?
Yeej tsis yog li ntawd. Tsuas yog vim koj tus nqi Anion Gap nyob sab nraum qhov ntau thiab tsawg ib txwm tsis tau txhais hais tias koj muaj mob hnyav. Nco ntsoov, qhov no tsuas yog ib qho cim qhia xwb.
- Nws yuav yog vim muaj qhov yuam kev me me uas tshwm sim thaum lub sijhawm sau, thauj, lossis kuaj cov ntshav.
- Tej zaum yuav yog vim cov tshuaj uas koj noj.
- Tej zaum nws yog vim muaj kev hloov pauv ib ntus hauv koj lub cev.
Thaum koj tus kws kho mob saib qhov tshwm sim no, nws yuav xav txog ntau yam, xws li koj cov tsos mob, koj keeb kwm kev kho mob, thiab cov tshuaj uas koj noj. Yog tias tus nqi Anion Gap tsis zoo thiab muaj kev tsis ntseeg txog nws, nws yuav pom zoo kom kuaj ntxiv kom pom qhov ua rau tseeb.
Qhov tseem ceeb tshaj plaws yog tsis txhob txhawj txog cov nqi hauv koj daim ntawv qhia thiab tham nrog koj tus kws kho mob txog nws. Nws yog tus uas tuaj yeem muab cov lus piav qhia zoo tshaj plaws rau koj.
Peb paub tias kev pom cov txiaj ntsig kuaj mob txawv txawv tuaj yeem ua rau ntshai heev. Tab sis nco ntsoov, tag nrho cov kev kuaj mob no yog ua kom nkag siab zoo dua txog peb txoj kev noj qab haus huv thiab kom paub sai sai thiab kho txhua yam teeb meem.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Anion Gap tsis yog ib qho kev xeem sib cais. Nws yog xam los ntawm cov nqi pom hauv kev kuaj ntshav ib txwm muaj.
- Qhov no feem ntau saib qhov sib npaug ntawm cov kua qaub-puag ntawm koj cov ntshav .
- Feem ntau qhov Anion Gap siab qhia txog kev nce ntxiv ntawm cov kua qaub ntawm cov ntshav (acidosis). Qhov no tuaj yeem tshwm sim los ntawm ntau yam, los ntawm ntshav qab zib mus rau kab mob raum.
- Qhov sib txawv ntawm Anion qis yog qhov tsawg heev. Nws feem ntau cuam tshuam nrog kev txo qis ntawm cov protein albumin hauv cov ntshav.
- Txawm tias koj cov txiaj ntsig tsis zoo li qub los xij, tsis txhob maj nrawm txiav txim siab. Nco ntsoov nrog koj tus kws kho mob tham kom paub meej ntxiv.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus