Kodi thupi lanu lili ndi asidi wambiri? Tiyeni tiphunzire za metabolic acidosis!

Kodi mudamvapo kutopa, njala, kapena chizungulire? Kapena mwina kupuma kwanu kwawonjezeka pang'ono, kapena chifuwa chanu chikugunda? Izi nthawi zina zimatha kuchitika chifukwa cha kusintha pang'ono kwa thupi lanu. Lero tikambirana za vuto lomwe limafuna chisamaliro pang'ono, koma ngati mukudziwa, lingathandize kulithetsa. Limenelo limatchedwa metabolic acidosis . Dzinalo lingamveke ngati loopsa pang'ono, koma tiyeni tikambirane mwachidule.

Kodi Metabolic Acidosis ndi chiyani? Mwachidule...

Mwachidule, metabolic acidosis ndi pamene madzi m'thupi lanu, makamaka m'magazi mwanu, amakhala acidic kwambiri kapena acidic kwambiri . Ganizirani matupi athu ngati makina ofewa. Chilichonse chomwe chili mkati mwake, makamaka mankhwala, chiyenera kukhala bwino. Zikapanda kuchitika, mavuto amayamba.

Matupi athu ali ndi mankhwala otchedwa bicarbonate . Ichi ndiye maziko akuluakulu omwe amalamulira, kapena kuletsa, acidity m'thupi. Chifukwa chake, pali njira ziwiri zazikulu zomwe metabolic acidosis ingachitikire.

1. Kuchuluka kwa asidi m'thupi kumawonjezeka kuposa momwe kungafunikire ndipo kumaposa kuchuluka kwa bicarbonate (izi zimatchedwa 'High Anion Gap Metabolic Acidosis' ).

2. Kupanda kutero, bicarbonate yochuluka imatulutsidwa m'thupi kudzera mu impso kapena m'njira zina (izi zimatchedwa 'Normal Anion Gap Metabolic Acidosis') .

Komabe, zotsatira zake n'zakuti thupi limakhala ndi asidi wambiri. Mwina munamvapo madokotala akulankhula za chinthu chotchedwa 'Anion Gap' . Uku ndi kusiyana pakati pa tinthu tating'onoting'ono tomwe tili ndi mphamvu zabwino komanso zoipa (electrolytes) m'magazi mwathu. Izi zimathandiza madokotala kudziwa bwino momwe asidi alili.

Kodi ndani amene angakhudzidwe kwambiri ndi vutoli? Kodi tonsefe tiyenera kusamala?

Kwenikweni, aliyense akhoza kudwala matenda otchedwa metabolic acidosis. Komabe, chiopsezochi chimakhala chachikulu makamaka kwa iwo omwe impso zawo sizikugwira ntchito bwino (Kulephera kwa Impso / Kulephera kwa Impso) kapena omwe ali ndi matenda osatha a impso . Izi zili choncho chifukwa impso zathu zimagwira ntchito yayikulu pakusunga thupi bwino pochotsa asidi wochulukirapo womwe umapangidwa m'thupi lathu kudzera mu mkodzo. Chifukwa chake impso zikafooka, ntchito imeneyi sigwira ntchito bwino.

Kodi chimachitika n'chiyani m'thupi pamene asidiyu akuwonjezeka? Nkhani yokhudza pH yathu

Kuti ziwalo zonse za thupi lathu zigwire ntchito bwino, magazi athu ayenera kukhala pamlingo winawake wotchedwa pH balance . pH iyi ndi muyeso wa kuchuluka kwa asidi ndi alkali m'magazi athu. Ndi sikelo kuyambira 0 mpaka 14. 0 ndi acidic kwambiri, ndipo 14 ndi alkali kwambiri. pH ya magazi a munthu wathanzi nthawi zambiri imakhala pakati pa 7.35 ndi 7.45.Ndicho chimene chiyenera kukhala. Ichi ndi chilinganizo chosavuta kwambiri.

Impso ndi mapapo athu ndi ziwalo zazikulu zomwe zimathandiza kuti pakhale bata. Impso zimatulutsa ma asidi ochulukirapo ndi maziko mu mkodzo. Mapapo amalamulira kuchuluka kwa carbon dioxide m'magazi tikamapuma. Carbon dioxide imakhudzanso kuchuluka kwa asidi m'thupi.

Choncho, mu metabolic acidosis, njira za kagayidwe kachakudya m'thupi zimapanga asidi wochuluka, kapena impso sizingathe kutulutsa asidiyu moyenera. Kenako pH yomwe tatchulayi imatsika pansi pa 7.35, zomwe zikutanthauza kuti magazi amakhala ndi asidi wambiri.

Kodi zizindikiro za izi ndi ziti? Ndikofunikira kwambiri kudziwa izi!

Chodabwitsa n'chakuti nthawi zina anthu omwe ali ndi metabolic acidosis sangasonyeze zizindikiro zilizonse poyamba . Komabe, pali zizindikiro zina zomwe zimaonekera pamene vutoli likupita patsogolo. Ndikofunikira kuti inu ndi banja lanu mudziwe izi:

• Kugunda kwa mtima mwachangu mwadzidzidzi (tachycardia). Kungamveke ngati chifuwa chanu chikugunda, kapena ngati mukuopa.
• Kumva chizungulire kapena mutu wopepuka. Nthawi zina zimatha kuchitika ngakhale mutayimirira.
• Kumva kutopa kwambiri, kumva ngati wopanda moyo komanso wotopa nthawi zonse. Kaya mugone tulo totani, mumakhalabe otopa.
• Kusowa chilakolako cha chakudya, kunyansidwa ngakhale akaona chakudya.
• Mutu wopweteka nthawi zonse.
• Kupuma kumakhala kofulumira, kapena kumatenga nthawi yayitali, komanso kozama. Uku kwenikweni ndi thupi lomwe likuyesera kuchepetsa asidi potulutsa mpweya wambiri wa carbon dioxide (mtundu wa asidi).
• Kusanza ndi kusanza.
• Kumva kufooka ndi kufooka kwa thupi lonse.
• Mpweya umakhala wokoma komanso wofanana ndi zipatso. Ichi ndi chizindikiro cha matenda a shuga otchedwa ketoacidosis.

Chofunika kwambiri: Ngati vutoli lakula kwambiri, kutanthauza kuti, ngati asidi m'thupi akuwonjezeka kwambiri, mavuto aakulu monga kulephera kwa impso, kuwonongeka kwa ziwalo zina, kutayika kwa chidziwitso, komanso imfa zingachitike . Chifukwa chake, ngati muli ndi chimodzi mwa zizindikiro izi, ndi bwino kufunafuna upangiri wa dokotala nthawi yomweyo.

Kodi izi zimachitika chifukwa chiyani? Kodi zifukwa zazikulu zomwe zimayambitsa metabolic acidosis ndi ziti?

Pali magulu anayi akuluakulu a zifukwa zomwe zingayambitse metabolic acidosis. Tiyeni tiwone zomwe zimayambitsa:

1. Matenda a shuga okhudzana ndi acidosis / Diabetic Ketoacidosis (DKA):Anthu ambiri amvapo za izi. Zingachitike mwa anthu omwe ali ndi matenda a shuga osalamulirika bwino, makamaka omwe ali ndi matenda a shuga a mtundu woyamba. Maselo a thupi akasowa insulin yomwe amafunikira kuti apange mphamvu, kapena insulin yomwe ali nayo ikapanda kugwira ntchito bwino, maselowo sangalandire shuga kuchokera m'magazi. Kenako thupi limayamba kuyatsa mafuta kuti lipeze mphamvu. Monga zotsatira za njirayi, mtundu wa asidi wotchedwa 'matupi a ketone' umasonkhana m'thupi. Uwu ndi vuto loopsa kwambiri lomwe limafuna chithandizo mwachangu.

2. Hyperchloremic acidosis: Izi zimachitika chifukwa chakuti thupi limataya mchere wochuluka wa sodium bicarbonate. Tangoganizirani, mumakhala ndi kutsegula m'mimba kwambiri kwa masiku angapo , mpaka kufika poti mumataya madzi. Panthawiyo, bicarbonate yambiri imatha kutulutsidwa m'matumbo. Izi zitha kuchitikanso ngati mugwiritsa ntchito mankhwala ena otseketsa ( mankhwala otseketsa ) mopitirira muyeso, popanda kufunsa dokotala.

3. Lactic acidosis: Matendawa amapezeka pamene thupi lathu lili ndi asidi wambiri wotchedwa lactic acid. Taganizirani izi, pamene tikuchita masewera olimbitsa thupi molimbika, kapena pamene maselo a thupi lathu salandira mpweya wokwanira (monga matenda a mtima, matenda oopsa), lactic acid imapangidwa ngati chinthu chochokera ku kupanga mphamvu. Nthawi zambiri, thupi limalamulira izi. Koma nthawi zina, mwachitsanzo, mwa munthu amene ali ndi vuto la chiwindi , kapena pamene shuga m'magazi atsika mwadzidzidzi (Hypoglycemia kapena Low blood glucose) , kapena ngati anthu ena amamwa mowa mopitirira muyeso (Kugwiritsa ntchito mowa mopitirira muyeso) , m'matenda ena a khansa , kapena ngati tikuchita masewera olimbitsa thupi molimbika kwambiri (Kuchita masewera olimbitsa thupi kwambiri) , kuchuluka kwa lactic acid kumatha kuwonjezeka ndipo thupi silingathe kupirira.

4. Renal Tubular Acidosis (RTA): Izi zimachitika pamene machubu ang'onoang'ono (machubu) m'impso sangathe kutulutsa asidi wokwanira ndi mkodzo. Kapena, bicarbonate simayamwanso bwino. Zotsatira zake, acidity m'magazi imawonjezeka pang'onopang'ono.

Zifukwa ziwiri zomwe zimafala kwambiri ndi kutsegula m'mimba kosatha komanso kulephera kwa impso.

Kodi iyi ndi matenda opatsirana? Kodi ena angawatengere kwa ine?

Ayi, ayi konse. Matenda a metabolic acidosis si matenda opatsirana . Simungathe kuwafalitsa kwa wina chifukwa choti muli nawo. Ndi vuto la momwe thupi limagwirira ntchito.

Kodi madokotala amazindikira bwanji izi?

Mukapita kukaonana ndi dokotala, iye adzakufunsani kaye za zizindikiro zanu, adzakufunsani za matenda anu akale, kenako adzakuyesani. Kenako adzakulamulani kuti muyesedwe kangapo kuti atsimikizire vutoli ndikupeza chomwe chikuyambitsa.

Nthawi zina mungatumizidwe kwa dokotala wa matenda a impso , makamaka ngati mukukayikira kuti muli ndi vuto la impso.

Mumachita chiyani ndi mayeso awa?

Mayeso amatha kusiyana malinga ndi zizindikiro zanu komanso zomwe dokotala wanu akuganiza kuti ndi zomwe zimayambitsa. Mayeso ofala kwambiri ndi awa:

• Kuyezetsa magazi: Izi ndizofunikira kwambiri.
• Kuyesa Kugawanika kwa Anion: Chitsanzo chaching'ono cha magazi chimatengedwa kuchokera mumtsempha womwe uli m'dzanja lanu ndipo kusiyana pakati pa mankhwala abwino ndi oipa otchedwa electrolytes kumayesedwa. Ngati kusiyana kumeneku kuli kwakukulu kuposa kwachibadwa, kungakhale chizindikiro champhamvu chakuti muli ndi metabolic acidosis.
• Kuyesa kwa Mtsempha wa Magazi (ABG): Uku ndi kuyesa kosiyana pang'ono. Izi zimaphatikizapo kutenga magazi ochepa kuchokera mumtsempha wamagazi womwe uli m'dzanja lanu, m'chigongono, kapena m'mimba (nthawi zambiri umakhala wocheperako kuposa mtsempha). Izi zimayesa kuchuluka kwa mpweya, kuchuluka kwa mpweya wa carbon dioxide, ndipo chofunika kwambiri, pH ya magazi anu. pH yochepera 7.35 imatanthauza kuti magazi anu ndi acidic kwambiri kapena ndi ochepa kwambiri.
• Mayeso ena a magazi: Kuchuluka kwa shuga m'magazi, mayeso a ntchito ya impso (monga Serum Creatinine, BUN), ndi kuchuluka kwa ma electrolyte (Electrolytes monga Sodium, Potassium, Chloride) kungayang'anitsidwenso.

• Mayeso a mkodzo:

Mukakodza m'botolo lapadera, pH imayesedwa. Izi zingakuuzeni zinthu monga ngati mkodzo wanu uli ndi asidi wambiri, wosavuta, kapena uli ndi ma ketone.

Kodi izi zimachiritsidwa bwanji? (Chithandizo)

Dokotala wanu akangodziwa chomwe chimayambitsa metabolic acidosis yanu, adzakupatsani dongosolo la chithandizo lomwe lingakuthandizeni. Chithandizocho chimadalira chomwe chimayambitsa.

• Chofunika kwambiri ndi kuchiza chomwe chimayambitsa matendawa . Mwachitsanzo, mu matenda a shuga otchedwa diabetesic ketoacidosis, shuga m'magazi amayendetsedwa popereka insulin ndi madzi a m'magazi.
• Anthu omwe ali ndi matenda a impso amatha kupatsidwa sodium bicarbonate mu mawonekedwe a mapiritsi kapena sodium citrate mu mawonekedwe a yankho kuti achepetse acidity m'thupi.
• Ngati madzi ambiri atayika m'thupi (monga chifukwa cha kutsegula m'mimba), ndikofunikira kupereka saline (madzi a m'mitsempha) kudzera m'mitsempha.
• Nthawi zina zoopsa kwambiri, sodium bicarbonate imaperekedwa kudzera mu mtsempha (IV Sodium Bicarbonate) kuti asidi m'magazi azitha kukhazikika mwachangu.
• Ngati mankhwala oopsa alowa m'thupi (monga kumwa aspirin wochuluka kapena kumwa mankhwala monga methanol), chithandizo chapadera (monga dialysis) chingafunike kuti muchotse mankhwala oopsa m'magazi.

Kodi chakudya ndi zakumwa zimakhudza izi? Kodi ndidye chiyani ndipo ndidye chiyani chochepa?

Inde, ndithudi. Zakudya ndi zakumwa zina zomwe timadya zimawonjezera asidi m'thupi, pomwe zina zimawonjezera alkalinity ndikuthandizira kuchepetsa acidity. Komabe, izi ndizofunikira kwambiri: Musanasinthe kwambiri zakudya zanu, muyenera kulankhula ndi dokotala wanu kapena katswiri wa zakudya. Malangizo awa ndi ofunikira kwambiri ngati muli ndi matenda a impso.

Zakudya zopangira asidi:

• Nyama (makamaka nyama yofiira, nkhuku, nsomba).
• Mazira.
• Tchizi ndi zinthu zina za mkaka (zina).
• Mbewu zokonzedwa.
• Mowa.

Zakudya zopangira alkaline zomwe zimawonjezera alkalinity m'thupi, kutanthauza kuti, zimathandiza kuchepetsa acidity:

• Mitundu yambiri ya zipatso (makamaka zipatso za citrus).
• Mtedza ndi mafuta a mtedza.
• Nyemba (monga lentils, nsawawa, nyemba zobiriwira, soya).
• Ndiwo zamasamba zambiri (makamaka ndiwo zamasamba zobiriwira).
• Anthu ena amalankhula za madzi amchere , koma pali maganizo osiyanasiyana pankhani ya maziko asayansi a izi, choncho ndi bwino kufunsa dokotala.

Ndi mankhwala ena ati omwe amagwiritsidwa ntchito pa izi?

Nthawi zina mankhwala ogulitsidwa kunja kwa chipatala (OTC) monga Sodium Citrate kapena Sodium Bicarbonate angathandize kuchepetsa acidity m'thupi. Komabe, musagwiritse ntchito mankhwala aliwonsewa popanda kufunsa dokotala wanu, chifukwa angayambitse mavuto ena.

Nthawi zina zoopsa, pamene mtima sukugwira ntchito bwino ndipo thupi silikupeza mpweya wokwanira, madokotala amatha kupereka mankhwala otchedwa inotropes . Mankhwalawa amapangitsa mtima kugunda mwamphamvu. Izi zimathandiza thupi kupeza mpweya wochuluka komanso zimathandiza kuchepetsa asidi m'magazi. Mankhwalawa nthawi zambiri amaperekedwa kudzera mu mtsempha (IV) kuchipatala.

Kodi pali chilichonse chomwe tingachite kuti tichepetse kukula kwa metabolic acidosis?

Ngakhale kuti n'zosatheka kupewa vutoli kotheratu, pali zinthu zingapo zomwe tingachite kuti tichepetse chiopsezochi:

• Kumwa madzi okwanira ndi madzi ena abwino tsiku lonse.
• Ngati muli ndi matenda a shuga, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi mwanu monga momwe dokotala wanu wanenera. Izi zikuphatikizapo mankhwala, zakudya, ndi masewera olimbitsa thupi.
• Ngati mumwa mowa, chepetsani kuchuluka kwa mowa womwe mumamwa kapena siyani kumwa konse. Mlingo woyenera umaonedwa kuti ndi wocheperapo zakumwa ziwiri patsiku kwa amuna komanso wocheperapo chimodzi patsiku kwa akazi.
• Kudya zakudya zopatsa thanzi.

Kodi chidzachitike ndi chiyani mtsogolo ndi vutoli? Kodi ndi chinthu choopa? (Outlook)

Ngati muli ndi metabolic acidosis, tsogolo lanu limadalira kuopsa kwa vutoli, chomwe chinayambitsa, komanso momwe mumalandira chithandizo mwachangu komanso moyenera.

• Nthawi zambiri, vutoli limatha kuthetsedwa ngati matendawo apezeka bwino komanso ngati munthuyo walandira chithandizo choyenera.
• Muzochitika zochepa , zizindikiro zimatha kukhala zakanthawi kochepa ndipo sizingafunike chithandizo chapadera ngati chifukwacho chatha chokha.
• Koma, monga ndanenera kale, pazochitika zoopsa kwambiri, ngati sizikuthandizidwa, zimatha kupangitsa kuti impso kapena ziwalo zina zisagwire bwino ntchito, ngakhale imfa. Ndicho chifukwa chake izi sizinthu zopepuka.

Kodi ndingadzisamalire bwanji? Ndi zinthu ziti zomwe ndingachite ndekha? (Kudzisamalira)

Dokotala wanu adzapanga dongosolo la chithandizo lomwe likugwirizana ndi inu. Lidzaphatikizapo mankhwala ndi kusintha moyo wanu. Kutsatira njira izi kudzakuthandizani kuchira msanga ndikuletsa kuti vutoli lisabwererenso:

• Yang'anani shuga m'magazi mwanu nthawi zonse (ngati muli ndi matenda a shuga). Yesani kuyang'anira shuga m'magazi kunyumba monga momwe dokotala wanu wanenera.
• Imwani mankhwala omwe dokotala wanu wakupatsani molondola, panthawi yoyenera, komanso mu mlingo woyenera. Musaphonye mlingo umodzi.
• Ngati dokotala wanu kapena katswiri wa zakudya akulangizani, yesani kudya zakudya zomwe zili ndi asidi wochepa komanso zamchere kwambiri.
• Chepetsani kumwa mowa kapena siyani kumwa mowa kotheratu.
• Sungani nthawi yokumana ndi dokotala. Mwanjira imeneyi, mutha kuwona momwe mukuchitira ndikusintha chilichonse chofunikira.

Kodi ndiyenera kupita kwa dokotala liti? Kodi ndi nthawi yadzidzidzi?

Ngati muli ndi zizindikiro za metabolic acidosis (monga kutopa komwe takambirana kale, kusintha kwa kupuma, nseru), kapena ngati muli ndi zizindikiro zoopsa za matenda ena omwe angayambitse vutoli (monga matenda a shuga osalamulirika, kutsegula m'mimba kwambiri, zizindikiro za matenda a impso), pitani kuchipatala nthawi yomweyo. Musazengereze.

Kodi pali kusiyana kotani pakati pa Metabolic Acidosis ndi Respiratory Acidosis?

Ngakhale zonsezi ndi zinthu zomwe zimapangitsa kuti asidi m'thupi aziwonjezeka, momwe zimachitikira komanso ziwalo zomwe zimakhudzidwa kwambiri zimasiyana.

Matenda a metabolism acidosis ndi matenda omwe amakhudza kwambiri kagayidwe ka thupi ndi njira ya mkodzo, makamaka impso . Amayamba pamene asidi wochuluka amapangidwa m'thupi, kapena impso sizingathe kusefa bwino asidi kuchokera m'magazi, kapena thupi limataya bicarbonate.

Matenda a kupuma otchedwa Respiratory acidosis ndi matenda omwe amakhudza kwambiri njira yopumira, kapena mapapo . Izi zimachitika pamene mapapo sangathe kuchotsa mpweya woipa (CO2) m'magazi mwachangu mokwanira. CO2 imasakanikirana ndi madzi kuti ipange asidi. Matenda monga mphumu akakula kwambiri, matenda a m'mapapo (monga COPD), kuwonongeka kwa ubongo komwe kumayambitsa kupuma movutikira, kapena kugwiritsa ntchito mankhwala enaake mopitirira muyeso kapena mapiritsi ogonetsa kungakhudze momwe mapapo amagwirira ntchito, zomwe zimapangitsa kuti CO2 idziunjikane ndikuwonjezera asidi.

Mwachidule, kagayidwe kachakudya ndi vuto la njira zamagetsi zomwe zimachitika m'thupi ndi impso. Kupuma ndi vuto la njira yopumira ndi mapapo.

Pomaliza, zinthu zofunika kwambiri zomwe muyenera kukumbukira (Uthenga Wopita Nawo Kunyumba)

Matenda a metabolism acidosis ndi vuto lomwe muyenera kuda nkhawa nalo, chifukwa limakhudza bwino thupi. Nthawi zina mungayese kunyalanyaza zizindikirozo ndi kunamizira kuti, "Zikhala bwino." Koma kumbukirani, ndi thupi lanu lomwe likulankhula nanu ndikunena kuti, "Pali vuto lalikulu mkati, ndithandizeni."

Muyenera kusamala kwambiri ndi zizindikiro izi, makamaka ngati muli ndi matenda omwe akhalapo kwa nthawi yayitali monga mavuto a impso kapena matenda a shuga.

Koma musadandaule. Simuli nokha. Pali madokotala, anamwino, ndi akatswiri ena azaumoyo omwe angakuthandizeni ndikukutulutsani mu vutoli. Ndi matenda olondola komanso chithandizo choyenera, vutoli lingathe kuthetsedwa kwambiri ndikusinthidwa. Chifukwa chake, ngati muli ndi kukayikira kulikonse pa izi, musachite manyazi kapena kuchedwa kupita kwa dokotala, funsani mafunso anu, ndikupeza upangiri ndi chithandizo chofunikira. Chifukwa, thanzi lanu ndiye chinthu chamtengo wapatali kwambiri padziko lapansi!

` Kagayidwe ka asidi m'thupi, acid-base balance, pH value, matenda a impso, matenda a shuga, ketoacidosis, lactic acidosis, zizindikiro, chithandizo