Masifumanise ngamanqanaba akho e-ammonia. Ngaba oku kungaba yingozi?

Zininzi izinto ezenzekayo emizimbeni yethu, akunjalo? Izinto esizityayo nesiziselayo ziyagaywa, amandla aveli, kwaye nenkunkuma iveli. Ngoko ke, le ammonia yenye yenkunkuma eveliswa emizimbeni yethu. Kodwa ukuba ayikhutshwa kakuhle, inokubangela iingxaki. Namhlanje, masithethe ngale ammonia, isizathu sokuba inokuba yingozi, kunye nendlela yokuyilawula.

Yintoni i-ammonia? Ngamafutshane...

Ngamafutshane, i-ammonia, okanye (NH3), yinkunkuma eveliswa ziibhaktheriya emathunjini ethu xa sigaya iiproteni esizityayo. Cinga ngayo njengento eseleyo ekugayeni ukutya. Ngoko ke, uyazi ukuba kwenzeka ntoni rhoqo? Le ammonia iya esibindini sethu. Isibindi sifana nomzi-mveliso omhle emzimbeni wethu. Apho, le ammonia iyacutshungulwa ize iguqulwe ibe yimveliso yenkunkuma ebizwa ngokuba yi-urea . Emva koko, le urea iya kwizintso zethu, apho ikhutshwa khona kumchamo. Le nkqubo iphela ibizwa ngokuba yi-urea cycle .

Kodwa, khawucinge ukuba kukho ingxaki nakweyiphi na inxalenye yalo mjikelo we-urea, nokuba sisibindi, izintso, okanye enye into enceda le nkqubo, i-ammonia ayicutshungulwa kwaye ayikhutshwa ngokufanelekileyo. Xa oko kusenzeka, i-ammonia iqala ukuqokelelana egazini. Nje ukuba iqokelelene, inokuhamba isuka egazini iye engqondweni. Ubungakanani be-ammonia ekufuneka bube segazini lethu buphantsi kakhulu . Ukuba iyanda nokuba kancinci, oko kukuthi, ukuba kukho imeko ebizwa ngokuba yi -hyperammonemia , iyingozi kakhulu kwinkqubo yethu yemithambo-luvo (CNS). Oko kukuthi, iyingozi.

Ingakanani i-ammonia ekufuneka ibe emzimbeni?

Ngoku, ubungakanani be-ammonia obufanele ukuba segazini lomntu ophilileyo buyahluka ngokweminyaka. Iintsana ezisandul’ ukuzalwa zinenani elingaphezulu kancinci kunelabantu abadala. Kwakhona, nokuba umntwana wazalwa ngexesha lokukhulelwa okanye ngaphambi kwexesha nako kuyayichaphazela loo nto.

• Iintsana ezisempilweni ezisele zikhulile : Malunga ne-45±9 micromoles ngelitha nganye / micromol/L. Ngokwesiqhelo, umda ophezulu uphakathi kwe-80 kunye ne-90 micromol/L.
• Iintsana ezingekafiki ixesha : Malunga ne-71±26 micromol/L. Oku kwehla kuye kumanqanaba aqhelekileyo emva kweentsuku ezisixhenxe.
• Abantwana abangaphezu kwenyanga enye : Ngaphantsi kwe-50 micromol/L.
• Abantu abadala : Ngaphantsi kwe-30 micromol/L.

Kodwa kukho into enye ekufuneka uyikhumbule. La maxabiso anokwahluka kancinci kwilabhoratri nganye. Ke ngoko, kungcono ukuwathelekisa namaxabiso akwingxelo yakho yelabhoratri. Ukuba kukho nayiphi na ingxaki,Qiniseka ukuba ubuza ugqirha wakho okanye umongikazi.

Ingakanani ingozi ye-ammonia ekwinqanaba eliphezulu?

I-Ammonia yinto enobuthi kakhulu . Ngokwesiqhelo, inqanaba le-ammonia egazini lomntu omdala ophilileyo lingaphantsi kwama-micromoles angama-50 ngelitha (i-micromol/L). Nangona kunjalo, nokuba oku kuyanda ukuya kwi-100 micromoles ngelitha (100 micromol/L), utshintsho engqondweni lunokuqala ukwenzeka. Oku kuthetha ukuba kuba nzima ukugxila, kwaye unokudideka kancinci. Ukuba inqanaba le-ammonia egazini lifikelela kwi-200 micromol/L, usenokuba kwi-coma kwaye ube nokuxhuzula. Oku kuyingozi kakhulu kwaye kunokuba yingozi ebomini.

Indlela yokujonga amanqanaba e-ammonia emzimbeni?

Ugqirha wakho unokulinganisa amanqanaba akho e-ammonia ngovavanyo lwegazi . Kubantu abadala, oku kudla ngokwenziwa ngokuthatha igazi elincinci elivela kumthambo osesandleni sakho. Kubantwana abasandul’ ukuzalwa, ugqirha uza kucoca isithende somntwana, asihlabe ngenaliti encinci, aze athathe amathontsi ambalwa egazi. Emva koko, kufakwa ibhandishi encinci phezu kwendawo leyo. Oku kufana novavanyo lwegazi oluqhelekileyo.

Zithini iimpawu zokuba ne-ammonia ephezulu?

Ukuba amanqanaba e-ammonia egazini lakho ayanda, unokubona iimpawu ezifana nezi:

• Ukudideka kunye nokudideka
• Ukulala kakhulu, ubunzima bokuvuka
• Utshintsho engqondweni, ngamanye amaxesha kwanokulahlekelwa yingqondo
• Ukutshintshatshintsha kweemvakalelo, ukucaphuka, kunye nokutshintshatshintsha kweemvakalelo
• Ukungcangcazela kwezandla, ingakumbi xa ulula ingalo phambili
• I-Coma - Imeko yokungazi nto nokungaphenduli

Oku kubaluleke kakhulu: ukuba wena okanye umntu osondeleyo kuwe unezi mpawu, musa ukuchitha ixesha kwaye utsalele umnxeba kwi-ambulensi 1990, okanye uye kwicandelo likaxakeka lesibhedlele esikufutshane ngokukhawuleza. Ukwanda kwamanqanaba e-ammonia kunokuba yingozi ebomini, ngoko ke kufuneka unyango olukhawulezileyo.

Iimpawu zomntwana osandul' ukuzalwa

Ukuba usana olusandul’ ukuzalwa lubonisa naziphi na ezi mpawu kwiintsuku zokuqala emva kokuzalwa, ugqirha unokuvavanya amanqanaba e-ammonia:

• Ukungazoli rhoqo, ukukhala rhoqo, nokungafuni ukusela ubisi (Ukucaphuka)
• Ukuhlanza
• Ukozela, ukudinwa, ubunzima bokuvuka
• Ukuxhuzula

Ukuba umntwana unezi mpawu, musa ukuzityeshela. Bonana nogqirha ngokukhawuleza.

Kutheni amanqanaba e-ammonia emzimbeni enyuka kangaka?

Kukho izizathu ezahlukeneyo zokuba amanqanaba e-ammonia egazini anokunyuka. Makhe sijonge ukuba zeziphi:

• Isifo sesibindi:Esi sesona sizathu siphambili . Ukuba isibindi sakho sonakele, njengakwi-cirrhosis, isibindi asikwazi ukuyisusa kakuhle i-ammonia. Oku kudla ngokuba njalo kwisifo sesibindi esinzima. Nangona kunjalo, ngamanye amaxesha, nokuba isifo sesibindi sizinzile, ukuba kukho into eyenzekayo esiswini okanye emathunjini, njengokuphuma kwegazi esiswini, okanye ukungalingani kwe-electrolyte, amanqanaba e-ammonia anokunyuka ngequbuliso.

• Ukuncipha kokuhamba kwegazi esibindini: Ukuba isibindi asifumani gazi laneleyo, i-ammonia ayinandlela yokufikelela esibindini ize icocwe. Emva koko, i-ammonia iqokelelana egazini.

• I-Hepatic encephalopathy: Oku kunzima ngakumbi. Ngamafutshane, xa isibindi sinesifo okanye sonakele kwaye singayisusi kakuhle i-ammonia, i-ammonia iqokelelana egazini ize iye engqondweni. Oku kunokubangela ukudideka, ukudideka, kunye ne-coma. Ngamanye amaxesha inokubulala.

• Isifo sikaReye: Esi sisifo esingaqhelekanga kodwa esibi kakhulu esichaphazela igazi, ingqondo, nesibindi. Sidla ngokubangela amanqanaba aphezulu e-ammonia egazini kunye namanqanaba aphantsi e-glucose egazini. Sidla ngokuvela kubantwana nakubantu abadala abancinci abaye bathatha i-aspirin ngenxa yeempawu ngelixa besaphila kwisifo sentsholongwane esifana ne-chickenpox okanye i-influenza (flu). Isizathu esichanekileyo sesifo sikaReye asaziwa. Nangona kunjalo, ngenxa yale ngozi, abantwana kunye nabantu abadala abancinci akufuneki bathathe i-aspirin ngaphandle kokuba kucetyiswe ngugqirha ngokukodwa.

• Ukungasebenzi kakuhle kwezintso/kwezintso: Ukuba izintso zakho azisebenzi kakuhle, oko kuthetha ukuba azikwazi ukususa i-urea ngokufanelekileyo. Oku kubangela ukuba i-ammonia iqokeleleke egazini.

• Izifo zemfuza zomjikelo we-urea: Kukho izifo zemfuza ezingaqhelekanga. Ezi zibangelwa kukunqongophala kwenye yee-enzymes ezifunekayo kumjikelo we-urea. Oku kudla ngokubonwa xa umntwana ezalwa.

• Isifo se-Hemolytic somntwana osandul’ ukuzalwa: Oku kwenzeka xa umama okhulelweyo esenza ii-antibodies ezichasene neeseli zegazi zomntwana wakhe. Le meko inokuthintelwa. Ukuba awunayo i-Rh kwaye awuzange ube ne-sensitization ngaphambili, ungathatha iyeza elithintela ii-antibodies zakho ukuba zingasabelani neeseli ze-Rh-positive zomntwana wakho.

Ziziphi iindlela zonyango zamanqanaba aphezulu e-ammonia?

Unyango lwamanqanaba aphezulu e-ammonia luxhomekeke kwisizathu. Umzekelo, kumntu omdala, isenokuba ngenxa yesifo sesibindi okanye i-hepatic encephalopathy, ngelixa kusana olusandul’ ukuzalwa, inokuba ngenxa yemeko yokuzalwa ephazamisa umjikelo we-urea.

Xa kunyangwa i-hyperammonemia ebukhali, eyona nto iphambili kukunciphisa amanqanaba e-ammonia nokulawula iingxaki ezifana nokudumba kobuchopho kunye noxinzelelo lwegazi olungaphakathi kwentloko.

Ukuba inqanaba le-ammonia losana olusandul’ ukuzalwa liyanyuka, oogqirha bayayeka ukulinika iproteni (kuba i-ammonia iveliswa xa iproteni ityiwa). Endaweni yoko, balinika izisombululo zeglucose ukuze linike amandla. Basebenzisa nonyango olubizwa ngokuba yi-hemodialysis ukususa i-ammonia egazini lomntwana. Oku kuquka ukucoca igazi kusetyenziswa umatshini okhethekileyo obizwa ngokuba ngumatshini we-dialysis kunye nesihluzo, njengesintso sokwenziwa.

Xa kunyangwa isifo sesibindi, injongo kukunciphisa ukuveliswa kwe-ammonia emathunjini. Unyango lokuqala ngamayeza athathwa ngomlomo abizwa ngokuba yi-lactulose kunye ne-lactitol . Ezi swekile zinciphisa ukuveliswa kunye nokufunxwa kwe-ammonia emathunjini.

Ndifanele ndimbone nini ugqirha malunga namanqanaba am e-ammonia?

Oku kucacile kakhulu. Ukuba wena okanye umntu osondeleyo kuwe ufumana iimpawu zamanqanaba aphezulu e-ammonia egazini, njengokuphazamiseka kwengqondo esithethe ngako ngaphambili, ukozela rhoqo, kunye notshintsho engqondweni, fowunela u-911 ngoko nangoko, okanye uye kwigumbi likaxakeka lesibhedlele esikufutshane ngokukhawuleza. Asikuko ukulibazisa oku.

Ukuba unesifo sesibindi, kufuneka ubonane nogqirha wakho rhoqo ukuqinisekisa ukuba isibindi sakho sisusa i-ammonia ngokufanelekileyo. Oku kuya kukunceda ufumanise naziphi na iingxaki kwangethuba.

Ngoko ke, zeziphi izinto ezibalulekileyo ekufuneka sizikhumbule kweli bali?

Nangona kuqhelekile ukuba imizimba yethu ivelise i-ammonia njengenkunkuma, kunokuba yingozi kakhulu ukuba iqokelelana egazini ngokugqithisileyo.

Ukuba wena okanye umntu osondeleyo kuwe uneempawu ze-ammonia ephezulu (umzekelo, ukudideka, ukozela kakhulu, utshintsho kwindlela yokuziphatha), yiya esibhedlele esikufutshane ngokukhawuleza. Oku kunokuba yimeko yobomi okanye ukufa.

Kubaluleke kakhulu ukuba uqaphele ezi mpawu ukuba unesifo sesibindi, kuba oku kunokunyusa umngcipheko wokunyuka kwamanqanaba e-ammonia.

Ukuba unemibuzo malunga nomngcipheko wokunyuka kwamanqanaba e-ammonia, okanye nantoni na ongathanda ukuyazi, ungathandabuzi ukuthetha nogqirha wakho. Bakhona ukukunceda nokuphendula imibuzo yakho. Ukuhlala usempilweni yeyona nto ibalulekileyo!

I- Ammonia, Amanqanaba e-Ammonia, Isibindi, Izintso, Umjikelo we-Urea, I-Hepatic Encephalopathy, I-Reye's Syndrome, Uvavanyo lweGazi, i-Hyperammonemia