He nui rawa te waikawa o tō tinana? Me ako tātou mō te waikawa pūmua!

Kua pāngia koe e te ngenge, te hiakai, te pōuri rānei? Kua piki ake pea tō manawa, kua pāngia rānei tō uma e te tukinga? I ētahi wā, ka puta ēnei i ngā panoni iti o te taurite i roto i tō tinana. I tēnei rā ka kōrero tātou mō tētahi āhuatanga e hiahia ana kia arohia, engari ki te mōhio koe ki tēnā, ka taea e ia te āwhina i a koe ki te whakahaere. Ko te ingoa tēnā ko te metabolic acidosis . Tērā pea he ahua whakamataku te ingoa, engari me kōrero noa iho.

He aha te Metabolic Acidosis? He māmā noa iho...

Ki te whakarapopototanga, ko te waikawa pūmua te wā e tino waikawa rawa ai, e waikawa rawa ai rānei ngā wai o tō tinana, inā koa ō toto . Whakaarohia ō tātou tinana he mīhini ngoikore. Me tino taurite ngā mea katoa o roto, inā koa ngā matū. Ki te kore tēnā e tupu, ka tīmata te puta o ngā raruraru.

Kei roto i ō tātou tinana tētahi matū e kiia nei ko te paikāponate . Koinei te pūtake matua e whakahaere ana, e whakakore ana rānei i te waikawa o te tinana. Nō reira, e rua ngā huarahi matua e puta ai te waikawa pūmua.

1. Ka nui ake te nui o te waikawa i roto i te tinana i te mea e tika ana, ā, ka nui atu i te nui o te paikāpōnate (e kiia ana tēnei ko te 'High Anion Gap Metabolic Acidosis' ).

2. Ki te kore, ka nui rawa te paikāpōnate ka puta mai i te tinana mā roto i ngā whatukuhu, i ētahi atu huarahi rānei (e kiia ana tēnei ko te 'Normal Anion Gap Metabolic Acidosis') .

Heoi, ko te mutunga iho, ka nui ake te waikawa o te tinana. Tērā pea kua rongo koe i ngā tākuta e kōrero ana mō tētahi mea e kiia nei ko te 'Anion Gap' . Koinei noa te rerekētanga i waenga i ngā matūriki utu pai me ngā matūriki utu kino (ngā electrolyte) i roto i ō tātou toto. Mā tēnei ka taea e ngā tākuta te whai whakaaro mō te taurite waikawa-pūtake.

Ko wai te mea ka tino pāngia e tēnei āhuatanga? Me tūpato tātou katoa?

Ina hoki, ka taea e te tangata te pāngia e te mate e kiia nei ko te metabolic acidosis. Heoi, he tino teitei tēnei mōrearea mō te hunga kāore ā rātou whatukuhu e mahi tika ana (Te Raru o te Whatukuhu / Te Raru o te Whatukuhu) me te hunga rānei he mate whatukuhu mau tonu . Nā te mea he mahi nui tā ō tātou whatukuhu ki te pupuri i te taurite o te tinana mā te tango i te waikawa nui i hangaia i roto i ō tātou tinana mā te mimi. Nō reira, ina ngoikore ngā whatukuhu, kāore tēnei mahi e mahi tika.

He aha te mea ka tupu i roto i te tinana ina piki ake tēnei waikawa? Te kōrero mō tō tātou uara pH

Kia tika ai te mahi a ngā pūnaha katoa o te tinana, me noho ō tātou toto i roto i tētahi awhe e kiia nei ko te taurite pH . Ko tēnei pH he ine i te nui o te waikawa me te kawakore kei roto i ō tātou toto. He tauine mai i te 0 ki te 14. He tino waikawa te 0, ā, he tino kawakore te 14. Ko te pH o te toto o te tangata hauora kei waenganui i te 7.35 me te 7.45.Koinā te tikanga. He taurite tino ātaahua tēnei.

Ko ō tātou whatukuhu me ō tātou pukahukahu ngā whekau matua e āwhina ana ki te pupuri i tēnei taurite. Ka tukuna e ngā whatukuhu ngā waikawa me ngā kawakore nui rawa atu ki roto i te mimi. Ka whakahaerehia e ngā pukahukahu te nui o te hauhā waro i roto i te toto ina manawa tātou. Ka pā hoki te hauhā waro ki te taumata waikawa i roto i te tinana.

Nō reira, i roto i te waikawa pūmua, ka nui rawa te waikawa ka puta mai i ngā tukanga pūmua i roto i te tinana, kāore rānei e taea e ngā whatukuhu te tuku tika i tēnei waikawa. Kātahi ka heke te pH i kōrerotia e mātou ki raro i te 7.35, ko te tikanga ka nui ake te waikawa o te toto.

He aha ngā tohu o tēnei? He mea nui kia mōhio koe ki ēnei!

He mea whakamiharo, i ētahi wā, kāore pea te hunga e pāngia ana e te mate waikawa metabolic e whakaatu i tētahi tohu motuhake i te tīmatanga . Heoi, kei reira ētahi tohu noa ka kitea i te whanaketanga haere o te mate. He mea nui kia mōhio koe me tō whānau ki ēnei:

• He tere ohorere o te manawa (tachycardia). Ka rite ki te mea kei te patupatu tō uma, kei te mataku rānei koe.
• Te pōuriuri, te māhunga rānei. I ētahi wā ka pā mai tēnei ahakoa kei te tū koe.
• Te tino ngenge, te tino pōuri tonu, me te ngenge tonu ahakoa te roa o te moe.
• Anorexia, te ahua whakarihariha ahakoa te kitenga i te kai.
• Te mamae o te upoko e mau tonu ana.
• Ka tere ake te manawa, ka roa ake rānei, ka hohonu ake rānei te manawa. Koinei te tinana e ngana ana ki te whakaiti i te waikawa mā te whakaputa i te hauhā waro (he momo waikawa).
• Whakapairuaki me te ruaki.
• Te ngoikore me te ngoikore whānui.
• He kakara reka, he kakara hua ki te manawa. He tohu tēnei nō te ketoacidosis mate huka.

He mea tino nui: Ki te tino kino rawa atu tēnei āhuatanga, arā, ki te piki haere te taumata waikawa i roto i te tinana, ka pā mai pea ngā raruraru nui pērā i te ngoikore o te whatukuhu, te kino o ētahi atu okana, te ngaronga o te māramatanga, tae noa ki te mate . Nō reira, ki te pā mai tētahi, neke atu rānei o ēnei tohu, he mea whakaaro nui kia rapu tohutohu hauora tonu.

He aha tēnei ka puta? He aha ngā tino take o te waikawa pūmua?

E whā ngā momo take matua ka arahi pea ki te waikawa pūmua. Me titiro tātou ki ēnei:

1. Te waikawa waikawa e pā ana ki te mate huka / Te Ketoacidosis Diabetic (DKA):He tokomaha kua rongo mō tēnei. Ka pā mai pea tēnei ki te hunga mate huka kāore i te tino whakahaeretia, inā koa ko te hunga mate huka momo 1. Ina kore te insulin e hiahiatia ana e ngā pūtau o te tinana hei whakaputa pūngao, ina rānei kāore te insulin e mahi tika ana, kāore e taea e ngā pūtau te tango i te hukahuka mai i te toto. Kātahi ka tīmata te tinana ki te tahu ngako hei pūngao. Hei hua o tēnei tukanga, ka puta he momo waikawa e kiia nei ko ngā 'tinana ketone' i roto i te tinana. He tino morearea tēnei āhuatanga e hiahia ana kia rongoatia tonutia.

2. Te waikawa toto nui rawa atu: Nā te nui rawa o te konutai paikāpōnate e ngaro ana i te tinana. Whakaarohia, he nui te mate korere e pāngia ana e koe mō ētahi rā , tae noa ki te ngaronga o te wai. I taua wā, ka tukuna he nui o te paikāpōnate mai i ngā whekau. Ka taea hoki tēnei te tupu mēnā ka nui rawa te whakamahi i ētahi rongoā whakawai ( rongoā whakawai ), me te kore e kōrero ki te tākuta.

3. Te waikawa waikawa lactic: Ka puta tēnei āhuatanga ina nui rawa te momo waikawa o te tinana e kiia nei ko te waikawa lactic. Whakaarohia, ina kaha rawa tā tātou whakakori tinana, ina kore rānei e nui te hāora e whiwhi i roto i ngā pūtau o te tinana (hei tauira, he mate manawa, he mate kino), ka puta te waikawa lactic hei hua o te hanga pūngao. I te nuinga o te wā, ko te tinana te kaiwhakahaere i tēnei. Engari i ētahi wā, hei tauira, i roto i te tangata he ngoikore te ate , i te heke ohorere rānei o te huka toto (Hypoglycemia, te iti rānei o te huka toto) , i te nui rawa rānei o te waipiro e whakamahia ana e ētahi tāngata (te mate whakamahi waipiro) , i roto i ētahi āhuatanga mate pukupuku , i te kaha rawa rānei o tā rātou whakakori tinana (te whakakori tinana nui) , ka piki ake te nui o te waikawa lactic, ā, kāore e taea e te tinana te whakahaere.

4. Te Waikawa o ngā Ngongo Tākihi (RTA): Ka puta tēnei ina kore e taea e ngā ngongo iti (ngā ngongo) i roto i ngā whatukuhu te whakaputa i te waikawa nui me te mimi. Kāore rānei e mimiti tika te paikāponate. Nō reira, ka piki haere te waikawa o te toto.

Ko ngā tino take e rua ko te mate korere kāore e taea te whakahaere me te ngoikore o te whatukuhu.

He mate hopuhopu tēnei? Ka horahia rānei e au ki ētahi atu?

Kāo, kāore rawa. Ehara te mate pāwera i te mate hopuhopu. Kāore e taea te hora atu ki tētahi atu nā te mea kei a koe. He raruraru tēnei ki te taurite matū o roto o te tinana.

Me pēhea te tautuhi a ngā tākuta i tēnei?

Ina haere koe ki te tākuta, ka pātai tuatahi ia ki a koe mō ō tohumate, ka pātai anō hoki mō ō mate hauora o mua, kātahi ka tirotirohia koe. Kātahi ka whakahau ia i ētahi whakamātautau hei whakaū i te mate me te kimi i te pūtake.

I ētahi wā ka tukuna pea koe ki tētahi tohunga whatukuhu , inā koa mēnā e whakapaetia ana he raruraru tākihi.

He aha tāu e mahi ai ki ēnei whakamātautau?

Ka rerekē pea ngā whakamātautau i runga i ō tohu me te whakaaro o tō tākuta mō te take. Ko ngā whakamātautau e tino kitea ana ko:

• Ngā whakamātautau toto: He mea tino nui ēnei.
• Whakamātautau Āputa Anion: Ka tangohia he tauira toto iti mai i tētahi uaua i roto i tō ringa, ā, ka inehia te rerekētanga i waenga i ngā matū utu pai me te kino e kiia nei ko ngā electrolytes. Mena he nui ake tēnei āputa i te mea noa, he tohu kaha pea tēnei kei te pāngia koe e te metabolic acidosis.
• Whakamātautau Hau Toto Arteri (ABG): He whakamātautau rerekē tēnei. Ko te tikanga he tango toto iti mai i te uaua i roto i tō ringaringa, i tō tuke, i tō hope rānei (he iti ake i te uaua i te nuinga o te wā). Mā tēnei ka ine i te taumata hāora, te taumata hauhā waro, me te mea nui, te pH o tō toto. Ko te pH iti iho i te 7.35 te tikanga he waikawa rawa, he kawakore rawa rānei tō toto.
• Ētahi atu whakamātautau toto: Tērā pea ka tirohia ngā taumata huka toto, ngā whakamātautau mahi whatukuhu (hei tauira, te Creatinine toto, te BUN), me ngā taumata electrolyte (ngā electrolyte pēnei i te Sodium, te Potassium, te Chloride).

• Ngā whakamātautau mimi:

Ina mimi koe ki roto i tētahi pounamu motuhake, ka tirohia te pH. Mā tēnei ka taea e koe te mōhio mēnā he waikawa rawa tō mimi, he kawa rawa rawa, he ketone rānei kei roto.

Me pēhea te rongoā i tēnei? (Te rongoā)

Kia mōhio tō tākuta ki te tino take o tō mate waikawa metabolic, ka hoatu e ia he mahere maimoatanga e tika ana māu. Ko te maimoatanga e whakawhirinaki ana ki te take.

• Ko te mea nui ko te rongoā i te pūtake . Hei tauira, i roto i te ketoacidosis mate huka, ka whakahaeretia te huka toto mā te hoatu i te insulin me ngā wai IV.
• Ka taea te hoatu i te konutai paikāpōnate i roto i te ahua o ngā papa, i te konutai citrate rānei i roto i te ahua o tētahi otinga hei whakaiti i te waikawa o te tinana ki te hunga whai mate tākihi.
• Mena he nui te wai kua ngaro i te tinana (hei tauira, nā te mate korere), he mea nui kia hoatu he wai tote (wai IV) mā roto i te uaua.
• I ētahi wā tino kino, ka hoatuhia te paikāponate konutai mā roto i tētahi uaua (IV Sodium Bicarbonate) hei taurite wawe i te waikawa o te toto.
• Mena kua uru mai tētahi matū paitini ki te tinana (hei tauira, nā te nui rawa o te aspirin i tangohia, nā te horomitanga rānei i tētahi matū pēnei i te methanol), me whai maimoatanga motuhake pea (hei tauira, te dialysis) hei tango i te matū paitini mai i te toto.

He pānga tō te kai me te inu ki tēnei? He aha ngā mea me kai e au, ā, he aha ngā mea me whakaiti e au te kai?

Āe, tino tika. Ko ētahi o ngā kai me ngā inu e kainga ana e tātou ka whakanui ake i te waikawa o te tinana, ko ētahi ka whakanui ake i te kawakore me te āwhina ki te whakaiti i te waikawa. Heoi, he mea tino nui tēnei: ​​I mua i te hanga i tētahi huringa nui ki tō kai, me kōrero koe ki tō tākuta, ki te tohunga kai rānei. He mea nui rawa tēnei tohutohu mēnā he mate tākihi tōu.

Ngā kai hanga waikawa:

• Ngā mīti (ina koa ko te mīti whero, heihei, ika).
• Ngā hua manu.
• Tīhi me ētahi atu hua miraka (ētahi).
• Ngā witi tukatuka.
• Waipiro.

Ngā kai hanga-kawakore e whakanui ana i te kawakore o te tinana, arā, e āwhina ana ki te whakaiti i te waikawa:

• He maha ngā momo hua (ina koa ko ngā hua citrus).
• Ngā nati me ngā pata nati.
• Ngā pīni (hei tauira, te rēneti, te pīni kākāriki, te pīni soya).
• He maha ngā huawhenua (ina koa ngā huawhenua matomato).
• E kōrero ana ētahi mō te wai kawakore , engari he rerekē ngā whakaaro mō te pūtake pūtaiao mō tēnei, nō reira he pai ake te pātai atu ki te tākuta.

He aha atu ngā rongoā e whakamahia ana mō tēnei?

I ētahi wā, ka taea e ngā rongoā kore utu (OTC) pērā i te Sodium Citrate , te Sodium Bicarbonate rānei te āwhina i te whakataurite i te waikawa o te tinana. Heoi, kaua e whakamahi i tētahi o ēnei rongoā me te kore kōrero ki tō tākuta, nā te mea ka pā mai ētahi atu raruraru.

I ētahi wā tino kino, ina kore te ngākau e mahi tika, ā, kāore te tinana e whiwhi i te nui o te hāora, ka tohua pea e ngā tākuta ngā rongoā e kiia nei ko ngā inotropes . Mā ēnei ka kaha ake te pao o te ngākau. Ka āwhina tēnei i te tinana kia nui ake te hāora, ā, ka āwhina hoki ki te whakaiti i te waikawa o te toto. Ko te tikanga ka hoatu ēnei rongoā mā te uaua (IV) i te hōhipera.

He aha ngā mea ka taea e tātou te mahi hei whakaiti i te whanaketanga o te waikawa pūmua?

Ahakoa e kore e taea te ārai katoa i tēnei āhuatanga, he iti noa ngā mea ka taea e tātou te mahi hei whakaiti i te mōrearea:

• Te inu i te wai me ētahi atu wai hauora i te roanga o te rā.
• Mena he mate huka tōu, he mea nui kia whakahaeretia ō taumata huka toto e ai ki ngā tohutohu a tō tākuta. Kei roto i tēnei ko te rongoā, te kai, me te whakakori tinana.
• Ki te inu waipiro koe, whakawhāitihia te nui o te waipiro e inuhia ana e koe, kati rānei te inu. Ko te rohe hauora e kiia ana ko te kore e neke atu i te rua inu paerewa ia rā mō ngā tāne, ā, kaua e neke atu i te kotahi inu paerewa ia rā mō ngā wāhine.
• Te kai i tētahi kai taurite.

He aha ngā mea ka puta i te heke mai me tēnei āhuatanga? He mea hei wehi mā tātou? (Tirohanga)

Mena kei a koe te waikawa metabolic, ko te āmua kei runga i te kaha o te mate, te take, me te tere me te tika o te whiwhinga maimoatanga.

• I te nuinga o te wā, ka taea te whakakore i tēnei āhuatanga mā te tautuhi tika me te maimoatanga tika.
• I ngā kēhi ngawari , he rangitahi pea ngā tohu, ā, kāore pea e hiahiatia he maimoatanga motuhake mēnā ka ea te take i a ia anō.
• Engari, e ai ki taku kōrero i mua, i roto i ngā take kino, ki te kore e rongoatia, ka arahi pea ki te ngoikore o te whatukuhu, o ētahi atu okana rānei, tae atu ki te mate. Koia te take ehara tēnei i te mea hei whakaaro māmā noa iho.

Me pēhea taku tiaki i ahau anō? He aha ētahi mea ka taea e au te mahi ko au anake? (Te tiaki i ahau anō)

Mā tō tākuta e waihanga he mahere maimoatanga e tika ana māu. Kei roto ko ngā rongoā me ngā huringa āhua noho. Mā te whai i ēnei mahi ka tere ake tō whakaoranga me te ārai i te hokinga mai o te mate:

• Tirohia tonutia ō taumata huka toto (mēnā he mate huka koe). Me aroturuki i te huka toto i te kāinga kia rite ki ngā tohutohu a tō tākuta.
• Tangohia te rongoā i tohua e tō tākuta kia tika, i te wā tika, me te horopeta tika. Kaua e mahue tetahi horopeta.
• Ki te mea kei te tohutohu tō tākuta, tō kai rānei, ngana ki te kai i ngā kai he iti ake te waikawa, he nui ake te kawakore.
• Whakaitihia, kati rawatia rānei te inu waipiro.
• Kia tae ki te wā tika mō ōu wā tirotiro tākuta. Pērā ai, ka taea e koe te kite i tō āhua me te mahi i ngā huringa e tika ana.

Āhea ahau me toro atu ki te tākuta? He āhuatanga ohorere tēnei?

Mena kei a koe ngā tohu o te waikawa pūmua (pērā i te ngenge i kōrerotia i mua ake nei, ngā huringa o te manawa, te whakapairuaki), mēnā rānei kei a koe ngā tohu kino o tētahi atu mate e puta ai tēnei mate (hei tauira, te mate huka kāore i te whakahaeretia, te mate korere kino, ngā tohu o te mate tākihi), rapua tonutia te awhina hauora. Kaua e whakaroa.

He aha te rerekētanga i waenga i te Metabolic Acidosis me te Respiratory Acidosis?

Ahakoa he āhuatanga ēnei e rua e piki ake ai te waikawa o te tinana, he rerekē te āhua o te puta me ngā pūnaha okana e pāngia nuitia ana.

Ko te waikawa pūmua he āhuatanga e pā nui ana ki te pākia o te tinana me te pūnaha mimi, inā koa ko ngā whatukuhu . Ka puta tēnei ina nui rawa te waikawa e puta ana i roto i te tinana, kāore rānei e taea e ngā whatukuhu te tātari tika i te waikawa mai i te toto, ka ngaro rānei te paikāponate i te tinana.

Ko te waikawa manawa he āhuatanga e pā nui ana ki te pūnaha manawa, arā, ki ngā pukahukahu . Koinei te wā kāore e taea e ngā pukahukahu te tango wawe i te hauhā waro (CO2) mai i te toto. Ka honoa te CO2 ki te wai hei hanga waikawa. Ina kino haere ngā āhuatanga pēnei i te mate huango, ka pāngia te mahi a ngā pukahukahu e ngā mate pukahukahu (pēnei i te COPD), te kino o te roro e uaua ai te manawa, te whakamahi nui rānei i ētahi rongoā, i ētahi pire moe rānei, ka puta te kohi o te CO2, ka piki ake te waikawa.

Ki te kī māmā noa, ko te pākia o te tinana te raruraru o ngā tukanga matū i roto i te tinana me ngā whatukuhu. Ko te manawa te raruraru o te tukanga manawa me ngā pukahukahu.

Hei whakamutunga, ko ngā mea tino nui hei maumahara māu (Karere hei tango ki te kāinga)

He āhuatanga te mate pāwera matūkai e tika ana kia āwangawanga koe, nā te mea ka pā ki te taurite taketake o te tinana. I ētahi wā ka taea e koe te ngana ki te wareware i ngā tohu me te kī, "Ka pai katoa." Engari kia mahara, ko tō tinana te kōrero ki a koe, me te kī, "Kei roto i a koe tetahi mea he nui te hē, āwhina mai."

Me tino tupato koe ki ēnei tohu, ina koa mēnā he roa tō mate pēnei i ngā mate tākihi, i te mate huka rānei.

Kaua e manukanuka. Kāore koe i te mokemoke. Kei reira ngā tākuta, ngā nēhi, me ētahi atu tohunga hauora hei āwhina i a koe, hei whakaora i a koe i tēnei āhuatanga. Mā te tātaritanga tika me te maimoatanga tere, tika, ka taea te whakahaere i tēnei āhuatanga ki te whānuitanga nui, ā, ka taea te whakakore. Nō reira, ki te mea he ruarua āu mō tēnei, kaua e whakamā, kaua hoki e whakaroa ki te toro atu ki te tākuta, pātai atu, ā, tikina ngā tohutohu me ngā maimoatanga e tika ana. Nā te mea, ko tō hauora te mea tino nui o tēnei ao!

` Te waikawa pūmua, te taurite waikawa-pūtake, te uara pH, te mate tākihi, te mate huka, te ketoacidosis, te waikawa lactic, ngā tohu, te maimoatanga