Kodi munapitapo kuchipatala? Kapena munapitapo kukawona munthu wina? Muyenera kuti munawonapo botolo la saline litalumikizidwa ku dzanja lanu panthawiyo, sichoncho? Ambiri aife timaganiza kuti mabotolo onse a saline omwe amaperekedwa m'thupi mwanjira imeneyi ali ndi chinthu chomwecho. Koma kwenikweni, sizili choncho. Pali mitundu yosiyanasiyana ya madzi a IV omwe amagwiritsidwa ntchito pa matenda osiyanasiyana komanso m'mikhalidwe yosiyanasiyana. Chifukwa chake lero, tiyeni tikambirane za madzi awiri a IV omwe amagwiritsidwa ntchito kwambiri mdziko lathu, omwe ndi Lactated Ringers ndi Normal
saline .
N’chifukwa chiyani madzi ndi ofunikira kwambiri m’thupi lathu?
Choyamba, tiyeni tiwone chifukwa chake matupi athu ndi ofunikira kwambiri kuti thupi likhale ndi madzi. Tangoganizani,
60% ya matupi athu amapangidwa ndi madzi. Madzi awa ndi ofunikira kuti chiwalo chilichonse m'thupi lathu chigwire ntchito bwino, kuphatikizapo ubongo wathu,
mtima , mapapo, ndi impso. Mwachidule, madzi amachita zinthu zambiri zofunika m'thupi lathu, kuphatikizapo:
- Zimathandiza maselo kuchita ntchito yawo moyenera.
- Amapaka mafuta m'malo olumikizirana mafupa athu.
- Amalamulira kutentha kwa thupi.
- Zakudya zimayendetsedwa m'thupi lonse.
- Zinyalala zimatuluka kudzera mu mkodzo ndi ndowe.
- Zimateteza ubongo ndi msana kuti zisawonongeke.
Tsopano mwamvetsa kufunika kwa madzi? Pazifukwa zina, mwachitsanzo,
tikamasanza kwambiri,
tikataya magazi ambiri pangozi yaikulu, kapena tikamavutika ndi kutentha, madzi ambiri amachotsedwa m'thupi lathu. Izi timazitcha kuti
kutaya madzi m'thupi. Izi zikachitika, kuchuluka kwa ma electrolyte m'thupi kumakhala kosakhazikika, magazi amakhuthala, ndipo mtima umayenera kugwira ntchito molimbika. Apa ndi pamene madzi amaperekedwa kudzera m'mitsempha (IV) kuti abwezeretse ntchito za thupi.
Kodi Lactated Ringers ndi Normal Saline ndi chiyani?
Izi ndi madzi awiri a IV omwe amagwiritsidwa ntchito kwambiri m'zipatala. Timatcha onse awiriwa
kuti crystalloid solutions . Izi zikutanthauza kuti tinthu tating'onoting'ono ta madzi awa ndi tating'ono kwambiri. Chifukwa chake amatha kudutsa mosavuta m'maselo athu ndikulowa m'thupi. Komanso, madzi onsewa
ndi isotonic . Izi zikutanthauza kuti kuchuluka kwa madzi awa kumafanana kwambiri ndi kuchuluka kwa madzi a m'magazi athu. Chifukwa chake akaperekedwa m'thupi, savulaza maselo. Koma pali kusiyana kwakukulu pakati pa awiriwa. Chifukwa cha kusiyana kumeneku, madokotala amasankha mtundu wa madzi omwe ndi oyenera wodwala aliyense.
| Mtundu wa Madzimadzi | Zosakaniza | Zapadera |
|---|
| Mchere Wabwinobwino (0.9% sodium chloride) | Ingogwiritsani ntchito sodium chloride (mchere) ndi madzi. | Madzi oyambira a IV omwe amagwiritsidwa ntchito kwambiri. |
| Ma Ringers Omwe Amamwa Lactated (LR) | Madzi ndi monga sodium chloride, sodium lactate, potaziyamu chloride, calcium chloride ndi madzi. | Yankho loyenera, lofanana kwambiri ndi plasma m'magazi athu. |
Monga mukuonera, Normal Saline ndi madzi amchere chabe. Koma Lactated Ringers ili ndi mchere wina (electrolytes) womwe matupi athu amafunikira. Chifukwa chake, yankho la Lactated Ringers lili pafupi kwambiri ndi kapangidwe ka magazi athu.
Kodi madokotala amasankha bwanji izi?
Chabwino, tsopano chinthu chofunika kwambiri. Kodi Normal Saline iyenera kuperekedwa liti? Kodi Lactated Ringers iyenera kuperekedwa liti? Chisankho ichi chimapangidwa ndi dokotala yekha amene akukuchizani. Pali zinthu zambiri zomwe zimakhudza.
Chofunika kwambiri n’chakuti si udindo wa wodwala kusankha mtundu wa madzi a m’mitsempha omwe akufunikira. Ichi ndi chisankho chomwe dokotala adzapanga kutengera momwe wodwalayo alili, zotsatira za mayeso a magazi , ndi matenda ena.
Tiyeni tifotokoze izi mozama mu tebulo ili m'munsimu.
| Mtundu wa madzi m'mitsempha | Nthawi zabwino kwambiri zogwiritsira ntchito | Zinthu zomwe muyenera kupewa/kusamala nazo pogwiritsa ntchito |
|---|
| Mchere Wamba | - Pa matenda ambiri osowa madzi m'thupi (kusanza/kutsegula m'mimba).
- Ngati magazi atuluka.
- Mu mkhalidwe wodabwitsa .
- Ngati sodium ili yochepa m'magazi.
- Uwu ndi madzi okhawo omwe angaperekedwe poika magazi.
| - Odwala matenda a mtima .
- Odwala matenda a impso.
- Anthu omwe ali pachiwopsezo cha kuchuluka kwa madzi m'thupi.
- Chiwopsezo cha kuchuluka kwa chloride m'magazi (Hyperchloremia).
|
| Ma Ring Omwe Amayamwa | - Ngati mwapsa ndi ngozi zoopsa (zoopsa).
- Ngati mwatuluka magazi mwadzidzidzi.
- Pa nthawi ya opaleshoni komanso pambuyo pake.
- Pamene thupi litaya ma electrolyte .
- Mu matenda monga metabolic acidosis.
| - Odwala matenda a chiwindi.
- Kulephera kwakukulu kwa impso.
- Pankhani ya lactic acidosis (kuchuluka kwa lactic acid m'magazi).
- Ngati pH ya magazi ili pamwamba pa 7.5.
|
Kodi pali zoopsa zilizonse ndi madzi a IV?
Mankhwala a IV nthawi zambiri amakhala otetezeka kupereka motsogozedwa ndi dokotala. Komabe, monga momwe zimakhalira ndi chithandizo chilichonse, pali zoopsa. Zoopsa zazikulu ndi kupereka
madzi olakwika, kupereka ochuluka kapena ochepa, kapena kupereka ochepa kwambiri .
Ngati mupeza madzi ochulukirapo kuposa momwe mukufunira:
- Kutupa kwa miyendo ndi manja.
- Kuthamanga kwa magazi kwambiri.
- Kuvuta kupuma.
- Kuchira kwa bala mochedwa.
Ngati simukupeza madzi okwanira (ngati kutaya madzi m'thupi kukupitirira):
- Kuwonjezeka kwa kugunda kwa mtima.
- Kuthamanga kwa magazi pang'ono.
- Kulephera kwa impso.
- Kugwedezeka ndi kulephera kwa ziwalo.
Ichi ndichifukwa chake mukapatsidwa madzi a m'mitsempha kuchipatala, anamwino nthawi zonse amabwera kudzayang'ana kuchuluka kwa madzi m'thupi komanso momwe mulili.
Uthenga Wopita Nawo Kunyumba
- Ngakhale timati "saline," pali mitundu ingapo ya madzi a IV omwe amagwiritsidwa ntchito m'zipatala. Mankhwala a Normal Saline ndi Lactated Ringers ndi awiri mwa mitundu ikuluikulu.
- Madzi aliwonsewa ali ndi kapangidwe kosiyana, motero, momwe amagwirira ntchito m'thupi ndi osiyana.
- Dokotala wanu adzasankha mtundu woyenera kwambiri wa madzi a m'mitsempha kuti akupatseni, poganizira za matenda anu, zaka zanu, matenda ena, ndi zotsatira za mayeso a magazi.
- Madzi a m'mitsempha ya m'magazi ndi otetezeka kwambiri akaperekedwa moyenera motsatira upangiri wa dokotala, choncho musawaope mosayenera.
- Ngati muli ndi mafunso kapena nkhawa zokhudzana ndi izi, musazengereze kufunsa dokotala kapena namwino omwe akukuthandizani.
Madzi a m'mitsempha yamagazi, mchere, Mchere Wamba, Ma Ringers Omwe Amayamwa, Kutaya Madzi m'thupi, Madzi a m'mitsempha yamagazi, Sinhala, mitundu ya mchere
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