Tiyeni tidziwe kuchuluka kwa ammonia m'thupi lanu. Kodi izi zingakhale zoopsa?

Pali zinthu zambiri zomwe zimachitika m'thupi lathu, sichoncho? Zinthu zomwe timadya ndi kumwa zimagayidwa, mphamvu zimapangidwa, ndipo zinyalala zimapangidwanso. Chifukwa chake, ammonia iyi ndi imodzi mwa zinyalala zomwe zimapangidwa m'thupi lathu. Koma ngati sizitulutsidwa bwino, zingayambitse mavuto ena. Lero, tiyeni tikambirane za ammonia iyi, chifukwa chake ingakhale yoopsa, komanso momwe tingailamulire.

Kodi ammonia ndi chiyani? Mwachidule...

Mwachidule, ammonia, kapena (NH3), ndi zinyalala zomwe mabakiteriya m'matumbo mwathu amapanga tikamagaya mapuloteni omwe timadya. Taganizirani ngati chinthu chotsala pogaya chakudya. Ndiye, kodi mukudziwa zomwe zimachitika nthawi zambiri? Ammonia iyi imapita ku chiwindi chathu. Chiwindi chili ngati fakitale yabwino kwambiri m'thupi lathu. Pamenepo, ammonia iyi imakonzedwa ndikusinthidwa kukhala zinyalala zina zotchedwa urea . Kenako, urea iyi imapita ku impso zathu, komwe imatulutsidwa mu mkodzo. Njira yonseyi imatchedwa urea cycle .

Koma, taganizirani ngati pali vuto lililonse mu gawo lililonse la urea cycle iyi, kaya ndi chiwindi, impso, kapena china chilichonse chomwe chimathandiza njirayi, ndiye kuti ammonia siikonzedwa bwino ndikutulutsidwa. Izi zikachitika, ammonia imayamba kusonkhana m'magazi. Ikangosonkhana, imathanso kuchoka m'magazi kupita ku ubongo. Kuchuluka kwa ammonia komwe kuyenera kukhala m'magazi athu kumakhala kochepa kwambiri . Ngati ikuwonjezeka ngakhale pang'ono, ndiko kuti, ngati vuto lotchedwa hyperammonemia litachitika, ndi poizoni kwambiri ku dongosolo lathu la mitsempha (CNS). Ndiye kuti, ndi loopsa.

Kodi ammonia iyenera kukhala yochuluka bwanji m'thupi?

Tsopano, kuchuluka kwa ammonia komwe kuyenera kukhala m'magazi a munthu wathanzi kumasiyana malinga ndi zaka. Makanda obadwa kumene amakhala ndi ochulukirapo pang'ono kuposa akuluakulu. Komanso, kaya mwana anabadwa nthawi yobereka kapena yoyambirira zimakhudzanso.

• Makanda athanzi omwe ali ndi nthawi yobereka : Pafupifupi 45±9 micromoles pa lita imodzi / micromol/L. Kawirikawiri, malire apamwamba amakhala pakati pa 80 ndi 90 micromol/L.
• Makanda osakwana nthawi : Pafupifupi 71±26 micromol/L. Izi zimachepa kufika pamlingo wabwinobwino patatha masiku pafupifupi asanu ndi awiri.
• Ana opitirira mwezi umodzi : Osakwana 50 micromol/L.
• Akuluakulu : Osakwana 30 micromol/L.

Koma chinthu chimodzi choyenera kukumbukira. Makhalidwe amenewa amatha kusiyana pang'ono kuchokera ku labu kupita ku labu. Chifukwa chake, ndibwino kuwayerekeza ndi ma mtengo omwe ali mu lipoti lanu la labu. Ngati pali vuto lililonse,Onetsetsani kuti mwafunsa dokotala kapena namwino wanu.

Kodi kuchuluka kwa ammonia ndi koopsa bwanji?

Ammonia ndi mankhwala oopsa kwambiri . Kawirikawiri, kuchuluka kwa ammonia m'magazi a munthu wathanzi kumakhala kochepera ma micromoles 50 pa lita (micromol/L). Komabe, ngakhale izi zitawonjezeka kufika pa ma micromoles 100 pa lita (100 micromol/L), kusintha kwa chidziwitso kungayambe kuchitika. Izi zikutanthauza kuti zimakhala zovuta kukhazikika, ndipo mungasokonezeke pang'ono. Ngati kuchuluka kwa ammonia m'magazi kukwera kufika pa 200 micromol/L, mutha kukhala ndi chikomokere ndikukhala ndi khunyu. Izi ndizoopsa kwambiri ndipo zitha kukhala zoopsa pamoyo.

Kodi mungayang'ane bwanji kuchuluka kwa ammonia m'thupi?

Dokotala wanu akhoza kuyeza kuchuluka kwa ammonia m'magazi mwa kuyeza magazi . Kwa akuluakulu, nthawi zambiri izi zimachitika potenga magazi ochepa kuchokera mumtsempha womwe uli m'manja mwanu. Kwa makanda obadwa kumene, dokotala amatsuka chidendene cha mwana, kumubaya ndi singano yaying'ono, ndikumupatsa madontho ochepa a magazi. Kenako, bandeji yaying'ono imayikidwa pamalopo. Izi zili ngati kuyeza magazi nthawi zonse.

Kodi zizindikiro za kuchuluka kwa ammonia m'thupi ndi ziti?

Ngati kuchuluka kwa ammonia m'magazi anu kukukwera, zizindikiro monga:

• Kusokonezeka ndi kusokonezeka maganizo
• Kugona tulo tofa nato, kuvutika kudzuka
• Kusintha kwa chidziwitso, nthawi zina ngakhale kutaya chidziwitso
• Kusintha kwa maganizo, kukwiya, ndi kusintha kwa maganizo
• Kugwedezeka kwa manja, makamaka pamene mkono ukutsogozedwa patsogolo
• Chikomokere - Mkhalidwe wa kusazindikira komanso kusayankha

Izi ndizofunikira kwambiri: ngati inu kapena munthu amene ali pafupi nanu ali ndi zizindikirozi, musataye nthawi ndipo imbani ambulansi 1990, kapena pitani ku dipatimenti yothandiza anthu mwadzidzidzi kuchipatala chapafupi mwamsanga. Kuchuluka kwa ammonia m'thupi kungakhale koopsa, choncho chithandizo chamankhwala mwachangu n'chofunika.

Zizindikiro za mwana wakhanda

Ngati mwana wakhanda akuwonetsa zizindikiro izi m'masiku oyamba atabadwa, dokotala angamuyese kuti awone kuchuluka kwa ammonia m'thupi:

• Kusakhazikika maganizo, kulira pafupipafupi, komanso kusafuna kumwa mkaka (Kukwiya)
• Kusanza
• Kugona, kutopa, kuvutika kudzuka
• Kugwidwa ndi khunyu

Ngati mwana ali ndi zizindikiro izi, musamazinyalanyaze. Pitani kwa dokotala nthawi yomweyo.

Nchifukwa chiyani kuchuluka kwa ammonia m'thupi kumawonjezeka kwambiri?

Pali zifukwa zingapo zomwe kuchuluka kwa ammonia m'magazi kungakwere. Tiyeni tiwone zomwe zili:

• Matenda a chiwindi:Ichi ndiye chifukwa chachikulu . Ngati chiwindi chanu chawonongeka, monga matenda a chiwindi, chiwindi sichingathe kuchotsa bwino ammonia. Izi nthawi zambiri zimakhala choncho ndi matenda aakulu a chiwindi. Komabe, nthawi zina, ngakhale matenda a chiwindi atakhala osakhazikika, ngati china chake chachitika m'mimba kapena m'matumbo, monga kutuluka magazi m'mimba, kapena kusalinganika kwa ma electrolyte, kuchuluka kwa ammonia kumatha kukwera mwadzidzidzi.

• Kuchepa kwa magazi kupita ku chiwindi: Ngati chiwindi sichilandira magazi okwanira, ammonia singathe kufika ku chiwindi ndikutsukidwa. Kenako, ammonia imadzaza m'magazi.

• Matenda a chiwindi: Izi n'zovuta kwambiri. Mwachidule, chiwindi chikakhala ndi matenda kapena kuwonongeka ndipo sichingathe kuchotsa bwino ammonia, ammonia imasonkhana m'magazi ndipo imapita ku ubongo. Izi zingayambitse kusokonezeka, kusokonezeka, komanso kukomoka. Nthawi zina zimatha kupha.

• Matenda a Reye: Uwu ndi matenda osowa koma oopsa kwambiri omwe amakhudza magazi, ubongo, ndi chiwindi. Nthawi zambiri amayambitsa kuchuluka kwa ammonia m'magazi komanso kuchepa kwa shuga m'magazi. Nthawi zambiri amapezeka mwa ana ndi achinyamata omwe adamwa aspirin chifukwa cha zizindikiro zawo pamene akuchira matenda opatsirana monga nkhuku kapena chimfine. Chifukwa chenicheni cha matenda a Reye sichikudziwika. Komabe, chifukwa cha chiopsezochi, ana ndi achinyamata sayenera kumwa aspirin pokhapokha ngati dokotala wawalangiza mwapadera.

• Kulephera kwa impso/impso: Ngati impso zanu sizikugwira ntchito bwino, zomwe zikutanthauza kuti zikulephera, sizingathe kuchotsa urea bwino. Izi zimapangitsa kuti ammonia ichuluke m'magazi.

• Matenda a majini a urea cycle: Pali matenda osowa kwambiri a majini. Izi zimachitika chifukwa cha kusowa kwa ma enzyme ofunikira mu urea cycle. Izi nthawi zambiri zimapezeka munthu akangobadwa.

• Matenda a hemolytic a mwana wakhanda: Izi zimachitika mayi wapakati akapanga ma antibodies motsutsana ndi maselo a magazi a mwana wake. Matendawa akhoza kupewedwa. Ngati muli ndi Rh-negative ndipo simunakhalepo ndi vuto la Rh, mutha kumwa mankhwala omwe amaletsa ma antibodies anu kuti asagwirizane ndi maselo a Rh-positive a mwana wanu.

Kodi mankhwala otani a ammonia wochuluka?

Chithandizo cha kuchuluka kwa ammonia m'magazi chimadalira chomwe chimayambitsa. Mwachitsanzo, mwa munthu wamkulu, izi zitha kukhala chifukwa cha matenda a chiwindi kapena matenda a chiwindi, pomwe mwa mwana wakhanda, zitha kukhala chifukwa cha vuto lobadwa nalo lomwe limasokoneza kayendedwe ka urea.

Pochiza matenda a hyperammonemia, cholinga chachikulu chimakhala kuchepetsa kuchuluka kwa ammonia ndikuwongolera mavuto monga kutupa kwa ubongo ndi kuthamanga kwa magazi mkati mwa mutu.

Ngati kuchuluka kwa ammonia m'thupi la mwana wakhanda kukwera, madokotala amasiya kuwapatsa mapuloteni (chifukwa ammonia imapangidwa mapuloteni akagayidwa). M'malo mwake, amawapatsa njira zothetsera shuga kuti apereke mphamvu. Amagwiritsanso ntchito mankhwala otchedwa hemodialysis kuti achotse ammonia m'magazi a mwana. Izi zimaphatikizapo kuyeretsa magazi pogwiritsa ntchito makina apadera otchedwa dialysis machine ndi fyuluta, monga impso yopangira.

Pochiza matenda a chiwindi, cholinga chake ndi kuchepetsa kupanga kwa ammonia m'matumbo. Chithandizo choyamba ndi mankhwala omwa otchedwa lactulose ndi lactitol . Shuga awa amachepetsa kupanga ndi kuyamwa kwa ammonia m'matumbo.

Kodi ndiyenera kupita liti kwa dokotala za kuchuluka kwa ammonia m'thupi langa?

Izi n'zomveka bwino. Ngati inu kapena munthu wina wapafupi nanu akukumana ndi zizindikiro za kuchuluka kwa ammonia m'magazi, monga kusokonezeka maganizo komwe tidakambirana kale, kugona tulo tosalekeza, komanso kusintha kwa chikumbumtima, imbani 911 nthawi yomweyo, kapena pitani kuchipatala chapafupi mwamsanga. Ichi si chinthu chochedwetsa.

Ngati muli ndi matenda a chiwindi, muyenera kupita kwa dokotala nthawi zonse kuti muwonetsetse kuti chiwindi chanu chikuchotsa ammonia moyenera. Izi zikuthandizani kuzindikira mavuto aliwonse msanga.

Ndiye, ndi zinthu ziti zofunika kwambiri zomwe tiyenera kukumbukira kuchokera munkhaniyi?

Ngakhale kuti ndi zachilendo kuti matupi athu atulutse ammonia ngati zinyalala, zingakhale zoopsa kwambiri ngati itasonkhana m'magazi mopitirira muyeso.

Ngati inu kapena munthu amene muli naye pafupi ali ndi zizindikiro za kuchuluka kwa ammonia m'thupi (monga kusokonezeka maganizo, kugona tulo topitirira muyeso, kusintha kwa khalidwe), pitani kuchipatala chapafupi mwamsanga mwamsanga. Izi zitha kukhala vuto lalikulu.

Ndikofunikira kwambiri kudziwa zizindikiro izi ngati muli ndi matenda a chiwindi, chifukwa izi zitha kuwonjezera chiopsezo cha kuchuluka kwa ammonia.

Ngati muli ndi mafunso okhudza chiopsezo cha kuchuluka kwa ammonia m'thupi, kapena china chilichonse chomwe mukufuna kudziwa, musazengereze kulankhula ndi dokotala wanu. Alipo kuti akuthandizeni ndikuyankha mafunso anu. Kukhala ndi thanzi labwino ndiye chinthu chofunikira kwambiri!

` Ammonia, Kuchuluka kwa Ammonia, Chiwindi, Impso, Kuzungulira kwa Urea, Hepatic Encephalopathy, Reye's Syndrome, Kuyesa Magazi, Hyperammonemia