Ngaba umzimba wakho une-asidi eninzi? Masifunde nge-metabolic acidosis!

Ngaba wakha waziva udiniwe, ulambile, okanye unesiyezi? Okanye mhlawumbi ukuphefumla kwakho kuye kwanda kancinci, okanye isifuba sakho siyabetha? Oku ngamanye amaxesha kunokubangelwa lutshintsho oluncinci kwibhalansi emzimbeni wakho. Namhlanje siza kuthetha ngemeko efuna ingqalelo encinci, kodwa ukuba uyazi, inokukunceda uyilawule. Oko kubizwa ngokuba yi -metabolic acidosis . Eli gama lisenokuvakala lisoyikisa kancinci, kodwa masithethe ngalo ngokulula.

Yintoni iMetabolic Acidosis? Ngamafutshane...

Ngamafutshane, i-metabolic acidosis iyenzeka xa ulwelo emzimbeni wakho, ingakumbi igazi lakho, luba ne-asidi kakhulu okanye lube ne-asidi kakhulu . Cinga ngemizimba yethu njengoomatshini ababuthathaka. Yonke into ekuyo, ingakumbi iikhemikhali, kufuneka ilingane ngokugqibeleleyo. Xa oko kungenzeki, iingxaki ziqala ukuvela.

Imizimba yethu inekhemikhali ebizwa ngokuba yi-bicarbonate . Le yeyona siseko iphambili elawula, okanye ethintela i-asidi yomzimba. Ngoko ke, kukho iindlela ezimbini eziphambili ezinokwenzeka ngazo i-metabolic acidosis.

1. Nokuba ubungakanani be-asidi emzimbeni buyanda ngaphezu kokuba kuyimfuneko kwaye budlule ubungakanani be-bicarbonate (oku kubizwa ngokuba yi -'High Anion Gap Metabolic Acidosis' ).

2. Ngaphandle koko, i-bicarbonate eninzi kakhulu ikhutshwa emzimbeni ngezintso okanye ngezinye iindlela (oku kubizwa ngokuba yi -'Normal Anion Gap Metabolic Acidosis') .

Nangona kunjalo, isiphumo kukuba umzimba uba ne-asidi engakumbi. Usenokuba ukhe weva oogqirha bethetha ngento ebizwa ngokuba yi-'Anion Gap' . Lo ngumahluko nje phakathi kwamasuntswana atshajiswe kakuhle nalawo atshajiswe kakubi egazini lethu. Oku kuvumela oogqirha ukuba bafumane umbono webhalansi ye-asidi-base.

Ngubani onokuthi achaphazeleke kakhulu yile meko? Ngaba sonke kufuneka silumke?

Enyanisweni, nabani na unokufumana imeko ebizwa ngokuba yi-metabolic acidosis. Nangona kunjalo, lo mngcipheko uphezulu kakhulu kwabo bangasebenzi kakuhle kwizintso zabo (Ukusilela Kwezintso / Ukusilela Kwezintso) okanye abo banesifo sezintso esingapheliyo . Oku kungenxa yokuba izintso zethu zidlala indima enkulu ekugcineni umzimba ulungelelene ngokususa i-asidi egqithisileyo eveliswa emizimbeni yethu ngomchamo. Ngoko ke xa izintso zibuthathaka, lo msebenzi awusebenzi kakuhle.

Kwenzeka ntoni ngaphakathi emzimbeni xa le asidi isanda? Ibali malunga nexabiso lethu le-pH

Ukuze zonke iinkqubo zomzimba wethu zisebenze kakuhle, igazi lethu kufuneka libe kwinqanaba elithile elibizwa ngokuba yi-pH balance . Le pH yindlela yokulinganisa ukuba ingakanani i-asidi kunye ne-alkali egazini lethu. Sisikali esiqala ku-0 ukuya kwi-14. U-0 une-asidi eninzi, kwaye u-14 une-alkali eninzi. I-pH yegazi lomntu ophilileyo idla ngokuba phakathi kwe-7.35 kunye ne-7.45.Yiloo nto ifanele ukuba yiyo. Olu lulungelelwano olunobunono kakhulu.

Izintso nemiphunga yethu zezona zitho ziphambili ezinceda ukugcina olu lungelelwano. Izintso zikhupha ii-asidi ezigqithisileyo kunye neziseko kumchamo. Imiphunga ilawula ubungakanani be-carbon dioxide egazini xa siphefumla. I-carbon dioxide ikwachaphazela nenqanaba le-asidi emzimbeni.

Ngoko ke, kwi-metabolic acidosis, nokuba iinkqubo ze-metabolic emzimbeni zivelisa i-asidi eninzi kakhulu, okanye izintso azikwazi ukuyikhupha ngokufanelekileyo le asidi. Emva koko i-pH esiyikhankanyileyo yehla ngaphantsi kwe-7.35, oko kuthetha ukuba igazi liba ne-asidi engaphezulu.

Zithini iimpawu zoku? Kubaluleke kakhulu ukuba uzazi ezi zinto!

Okumangalisayo kukuba, ngamanye amaxesha abantu abane-metabolic acidosis basenokungabonakalisi zimpawu zithile ekuqaleni . Nangona kunjalo, kukho iimpawu eziqhelekileyo ezinokubonakala njengoko imeko iqhubeka. Kubalulekile ukuba wena nosapho lwakho nizazi ezi zinto:

• Ukubetha kwentliziyo ngokukhawuleza ngequbuliso (i-tachycardia). Kungavakala ngathi isifuba sakho siyabetha, okanye ngathi uyaxhalaba.
• Ukuziva unesizungu okanye unesizungu. Ngamanye amaxesha oku kunokwenzeka nokuba umi ngeenyawo.
• Ukuziva udiniwe kakhulu, uzive udiniwe rhoqo, kwaye udiniwe nokuba ulala kangakanani na.
• I-Anorexia, ukuziva ucaphukile nokuba ubona ukutya.
• Intloko ebuhlungu engapheliyo.
• Ukuphefumla kuyakhawuleza, okanye kuthatha ixesha elide, ukuphefumla nzulu. Oku kukwenza umzimba uzama ukukhupha i-carbon dioxide egqithisileyo (uhlobo lwe-asidi) nokunciphisa i-asidi.
• Isicaphucaphu nokuhlanza.
• Ukuziva ubuthathaka kunye nobuthathaka ngokubanzi.
• Ivumba elimnandi nelifana neziqhamo emlonyeni. Olu luphawu olukhethekileyo lwe-ketoacidosis yeswekile.

Kubaluleke kakhulu: Ukuba le meko iba mandundu kakhulu, oko kukuthi, ukuba inqanaba le-asidi emzimbeni liyanda kakhulu, iingxaki ezinkulu ezifana nokungasebenzi kakuhle kwezintso, ukonakala kwamanye amalungu omzimba, ukulahlekelwa yingqondo, kwanokufa kunokwenzeka . Ke ngoko, ukuba unenye okanye ngaphezulu kwezi mpawu, kububulumko ukufuna ingcebiso kugqirha ngaphandle kokulibazisa.

Kutheni oku kusenzeka? Zithini izizathu eziphambili ze-metabolic acidosis?

Kukho iindidi ezine eziphambili zezizathu ezinokukhokelela kwi-metabolic acidosis. Makhe sijonge ukuba zeziphi:

1. I-acidosis enxulumene nesifo seswekile / i-Diabetic Ketoacidosis (DKA):Abantu abaninzi baye beva ngale nto. Ingakhula kubantu abanesifo seswekile esingalawulekiyo, ingakumbi abo banesifo seswekile sohlobo loku-1. Xa iiseli zomzimba zingenayo i-insulin eziyidingayo ukuvelisa amandla, okanye xa i-insulin enayo ingasebenzi kakuhle, iiseli azikwazi ukuthatha i-glucose egazini. Umzimba emva koko uqala ukutshisa amafutha ukuze ufumane amandla. Njengomphumo wale nkqubo, uhlobo lwe-asidi olubizwa ngokuba yi -'ketone bodies' luyaqokelelana emzimbeni. Le yimeko eyingozi kakhulu efuna unyango olukhawulezileyo.

2. I-Hyperchloremic acidosis: Oku kubangelwa kukulahlekelwa ngumzimba yiminerali eninzi ye-sodium bicarbonate. Khawuthelekelele, unesifo sorhudo esinzima kangangeentsuku ezininzi , ude ulahlekelwe ngamanzi. Ngelo xesha, inani elikhulu le-bicarbonate linokukhululwa emathunjini. Oku kunokwenzeka nokuba usebenzisa amayeza athile okulahla inkunkuma ( i-laxatives ) ngokugqithisileyo, ngaphandle kokubonisana nogqirha.

3. I-Lactic acidosis: Le meko yenzeka xa imizimba yethu ine-asidi eninzi kakhulu ebizwa ngokuba yi-lactic acid. Cinga ngayo, xa sizilolonga kakhulu, okanye xa iiseli zethu zomzimba zingafumani ioksijini eyaneleyo (umz., uhlaselo lwentliziyo, usulelo olunzima), i-lactic acid iveliswa njengemveliso yokwenza amandla. Ngokwesiqhelo, umzimba uyayilawula le nto. Kodwa ngamanye amaxesha, umzekelo, kumntu onesifo sesibindi , okanye xa iswekile yegazi yehla ngequbuliso (iHypoglycemia okanye iswekile yegazi ephantsi) , okanye ukuba abanye abantu basebenzisa utywala ngokugqithisileyo (ingxaki yokusebenzisa utywala) , kwezinye iimeko zomhlaza , okanye ukuba bazilolonga kakhulu (ukuzilolonga kakhulu) , ubungakanani be-lactic acid bunokwanda kwaye umzimba awukwazi ukumelana nayo.

4. I-Renal Tubular Acidosis (RTA): Oku kwenzeka xa iityhubhu ezincinci (iityhubhu) kwizintso zingakwazi ukukhupha i-asidi eyaneleyo ngomchamo. Okanye, i-bicarbonate ayifunxwa kakuhle. Ngenxa yoko, i-asidi yegazi iyanda kancinci kancinci.

Ezona zinto zimbini zixhaphakileyo kurhudo olungalawulekiyo kunye nokungasebenzi kakuhle kwezintso.

Ingaba esi sisifo esosulelayo? Ngaba ndiza kusisasaza na kwabanye?

Hayi, akunjalo konke konke. I-metabolic acidosis ayisosifo esosulelayo . Awunakuyisasaza komnye umntu kuba nje unayo. Yingxaki yokulinganisela kwamakhemikhali emzimbeni.

Oogqirha bayixilonga njani le nto?

Xa usiya kugqirha, uza kuqala akubuze ngeempawu zakho, akubuze ngeemeko zakho zempilo zangaphambili, aze akuhlole. Emva koko uza kuyalela iimvavanyo ezininzi ukuqinisekisa imeko kunye nokufumanisa unobangela.

Ngamanye amaxesha ungathunyelwa kwi-nephrologist , ingakumbi ukuba kukho ingxaki yezintso ekrokrelwayo.

Wenza ntoni ngezi mvavanyo?

Uvavanyo lunokwahluka ngokuxhomekeke kwiimpawu zakho kunye nento ugqirha wakho acinga ukuba yimbangela. Uvavanyo oluqhelekileyo zezi:

• Uvavanyo lwegazi: Olu vavanyo lubaluleke kakhulu.
• Uvavanyo lwe-Anion Gap: Isampuli encinci yegazi ithathwa kumthambo osengalweni yakho kwaye umahluko phakathi kweekhemikhali ezitshajiweyo ezilungileyo nezingalunganga ezibizwa ngokuba zii-electrolytes uyalinganiswa. Ukuba lo msantsa mkhulu kunesiqhelo, kunokuba luphawu oluqinileyo lokuba une-metabolic acidosis.
• Uvavanyo lweArterial Blood Gas (ABG): Olu vavanyo lwahluke kancinci. Oku kuquka ukuthatha igazi elincinci elivela kumthambo osesihlahleni sakho, engqinibeni, okanye emqolo (ngesiqhelo lincinci kunomthambo). Oku kulinganisa inqanaba leoksijini, inqanaba lekhabhoni dayokhsayidi, kwaye okona kubaluleke kakhulu, i-pH yegazi lakho. I-pH engaphantsi kwe-7.35 ithetha ukuba igazi lakho line-asidi eninzi okanye lilula kakhulu.
• Ezinye iimvavanyo zegazi: Amanqanaba eswekile egazini, uvavanyo lokusebenza kwezintso (umz. iSerum Creatinine, iBUN), kunye namanqanaba e-electrolyte (ii-Electrolytes ezifana neSodium, iPotassium, iChloride) nazo zinokujongwa.

• Uvavanyo lomchamo:

Xa uchama kwibhotile ekhethekileyo, i-pH iyajongwa. Oku kunokukuxelela izinto ezifana nokuba umchamo wakho une-asidi eninzi, ulula kakhulu, okanye unee-ketones.

Iphathwa njani le nto? (Unyango)

Nje ukuba ugqirha wakho afumanise unobangela ochanekileyo we-metabolic acidosis yakho, uza kukunika isicwangciso sonyango esikusebenzelayo. Unyango luxhomekeke kwisizathu.

• Eyona nto ibalulekileyo kukunyangela unobangela . Umzekelo, kwi-diabetesic ketoacidosis, iswekile yegazi ilawulwa ngokunika i-insulin kunye nolwelo lwe-IV.
• Abantu abanesifo sezintso banokunikwa i-sodium bicarbonate ngendlela yeetablethi okanye i-sodium citrate ngendlela yesisombululo sokunciphisa i-asidi emzimbeni.
• Ukuba kukho ulwelo oluninzi olulahlekileyo emzimbeni (umz. ngenxa yorhudo), kubalulekile ukunika i-saline (IV fluids) ngomthambo.
• Kwezinye iimeko ezinzima, i-sodium bicarbonate inikwa ngemithambo yegazi (IV Sodium Bicarbonate) ukuze ilungelelanise ngokukhawuleza i-asidi egazini.
• Ukuba into enobungozi ingene emzimbeni (umz., ngenxa yokuthatha i-aspirin eninzi okanye ukusela ikhemikhali efana ne-methanol), unyango olukhethekileyo (umz., i-dialysis) lunokufuneka ukuze kususwe into enobungozi egazini.

Ngaba ukutya neziselo zinefuthe koku? Ndifanele nditye ntoni kwaye nditye ntoni kancinci?

Ewe, ngokuqinisekileyo. Ezinye zokutya neziselo esizityayo zonyusa i-asidi emzimbeni, ngelixa ezinye zonyusa i-alkalinity kwaye zinceda ekunciphiseni i-asidi. Nangona kunjalo, oku kubaluleke kakhulu: Ngaphambi kokuba wenze naluphi na utshintsho olukhulu kwindlela otya ngayo, ngokuqinisekileyo kufuneka uthethe nogqirha wakho okanye ingcali yokutya. Eli cebiso libaluleke kakhulu ukuba unesifo sezintso.

Ukutya okwakha i-asidi:

• Inyama (ingakumbi inyama ebomvu, inkukhu, intlanzi).
• Amaqanda.
• Itshizi kunye nezinye iimveliso zobisi (ezinye).
• Iinkozo ezicutshungulweyo.
• Utywala.

Ukutya okwakha i-alkaline okwandisa i-alkaline emzimbeni, oko kukuthi, kunceda ekunciphiseni i-acidity:

• Iintlobo ezininzi zeziqhamo (ingakumbi iziqhamo ze-citrus).
• Amantongomane kunye nebhotolo yamantongomane.
• Iimbotyi (umz. iilentile, iitshizi, iimbotyi eziluhlaza, i-soya).
• Imifuno emininzi (ingakumbi imifuno eluhlaza).
• Abanye abantu bathetha ngamanzi ane-alkaline , kodwa kukho izimvo ezahlukeneyo malunga nesiseko sesayensi sale nto, ngoko ke kungcono ubuze ugqirha.

Ngawaphi amanye amayeza asetyenziswa koku?

Ngamanye amaxesha amayeza athengiswa ngaphandle kwemvume kagqirha (OTC) anje ngeSodium Citrate okanye iSodium Bicarbonate anokunceda ukulinganisela iasidi emzimbeni. Nangona kunjalo, musa ukusebenzisa naliphi na kula mayeza ngaphandle kokubonisana nogqirha wakho, kuba anokubangela ezinye iingxaki.

Kwezinye iimeko ezinzima, xa intliziyo ingasebenzi kakuhle kwaye umzimba ungafumani ioksijini eyaneleyo, oogqirha banokunika amayeza abizwa ngokuba yi-inotropes . La mayeza enza intliziyo ibethe ngamandla. Oku kunceda umzimba ufumane ioksijini engakumbi kwaye kunceda nokunciphisa iasidi egazini. La mayeza adla ngokunikezelwa ngemithambo yegazi (IV) esibhedlele.

Ngaba kukho into esinokuyenza ukunciphisa uphuhliso lwe-metabolic acidosis?

Nangona kungenakwenzeka ukuyithintela ngokupheleleyo le meko, kukho izinto ezimbalwa esinokuzenza ukunciphisa umngcipheko:

• Ukusela amanzi aneleyo kunye nezinye izinto eziluncedo imini yonke.
• Ukuba unesifo seswekile, kubalulekile ukulawula amanqanaba eswekile egazini lakho njengoko ugqirha wakho ekuyalele. Oku kuquka amayeza, ukutya okunempilo, kunye nokuzilolonga.
• Ukuba usela utywala, nciphisa umlinganiselo owuselayo okanye uyeke ngokupheleleyo. Umda ofanelekileyo uthathwa njengongadluli kwiziselo ezimbini eziqhelekileyo ngosuku kumadoda kwaye ungadluli kwisiselo esinye esiqhelekileyo ngosuku kubafazi.
• Ukutya ukutya okunesondlo.

Kuza kwenzeka ntoni kwixesha elizayo ngale meko? Ngaba yinto ekufuneka uyoyike? (Imbono)

Ukuba une-metabolic acidosis, ikamva lixhomekeke kubukhali bemeko, yintoni ebangele oko, kunye nokuba ufumana unyango ngokukhawuleza nangokufanelekileyo kangakanani.

• Kwiimeko ezininzi, le meko inokupheliswa ngokuxilongwa nonyango olufanelekileyo.
• Kwiimeko ezingephi , iimpawu zinokuba zezexeshana kwaye zisenokungafuni unyango olukhethekileyo ukuba imbangela iyaphela ngokwayo.
• Kodwa, njengoko benditshilo ngaphambili, kwiimeko ezinzima, ukuba azinyangwa, zinokukhokelela ekungasebenzini kwezintso okanye kwezinye izitho zomzimba, kwanokufa. Yiyo loo nto oku kungeyonto yokuyithatha lula.

Ndingazinyamekela njani? Zeziphi ezinye zezinto endinokuzenza ndedwa? (Ukuzinyamekela)

Ugqirha wakho uza kudala isicwangciso sonyango esifanelekileyo kuwe. Siza kuquka amayeza kunye notshintsho kwindlela ophila ngayo. Ukulandela la manyathelo kuya kukunceda ukhawulezise ukuchacha kwaye kuthintele ukuba imeko ingaphindi ivele:

• Jonga amanqanaba eswekile egazini lakho rhoqo (ukuba unesifo seswekile). Yenza uhlolo lweswekile egazini lakho ekhaya njengoko uyalelwe ngugqirha wakho.
• Sela amayeza owanikwe ngugqirha wakho kanye, ngexesha elifanelekileyo, nangedosi efanelekileyo. Ungaphoswa yidosi enye.
• Ukuba ugqirha wakho okanye ingcali yesondlo ikucebisa, zama ukutya ukutya okune-asidi encinci kunye ne-alkaline eninzi.
• Nciphisa okanye uyeke ngokupheleleyo ukusela utywala.
• Gcina amadinga akho kagqirha ngexesha. Ngale ndlela, unokubona ukuba uqhuba njani kwaye wenze naluphi na utshintsho olufunekayo.

Ndifanele ndimbone nini ugqirha? Ngaba yingxamiseko?

Ukuba uneempawu ze-metabolic acidosis (ezifana nokudinwa esikuthethe ngako ngaphambili, utshintsho ekuphefumleni, isicaphucaphu), okanye ukuba uneempawu eziqatha zesinye isifo esinokubangela le meko (umz. isifo seswekile esingalawulekiyo, urhudo oluqatha, iimpawu zesifo sezintso), funa uncedo lonyango ngoko nangoko. Musa ukulibazisa.

Yintoni umahluko phakathi kweMetabolic Acidosis kunye neRespiratory Acidosis?

Nangona zombini ezi ziimeko apho i-asidi yomzimba inyuka khona, indlela ezenzeka ngayo kunye neenkqubo zamalungu ezichaphazeleka kakhulu zahlukile.

I-Metabolic acidosis yimeko echaphazela kakhulu imetabolism yomzimba kunye nenkqubo yomchamo, ingakumbi izintso . Yenzeka xa kuveliswa i-asidi eninzi emzimbeni, okanye izintso zingakwazi ukucoca i-asidi egazini ngokufanelekileyo, okanye umzimba ulahlekelwa yi-bicarbonate.

I-acidosis yokuphefumla yimeko echaphazela kakhulu inkqubo yokuphefumla, okanye imiphunga . Oku kuxa imiphunga ingakwazi ukususa i-carbon dioxide (CO2) egazini ngokukhawuleza ngokwaneleyo. I-CO2 idibana namanzi ukwenza i-asidi. Xa iimeko ezifana ne-asthma ziba nzima, isifo semiphunga (njenge-COPD), umonakalo wobuchopho obangela ubunzima bokuphefumla, okanye ukusetyenziswa kakhulu kweziyobisi ezithile okanye iipilisi zokulala kunokuchaphazela ukusebenza kwemiphunga, okubangela ukuba i-CO2 iqokeleleke kwaye yonyuse i-asidi.

Ngamafutshane, i-metabolism yingxaki yeenkqubo zeekhemikhali emzimbeni nasezintsoni. Ukuphefumla yingxaki yenkqubo yokuphefumla kunye nemiphunga.

Okokugqibela, ezona zinto zibalulekileyo ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-Metabolic acidosis yimeko ekufuneka uyixhalabele ngokwenene, kuba ichaphazela ibhalansi yomzimba. Ngamanye amaxesha ungazama ukungawunaki lo mqondiso uze wenze ngathi, "Kuza kulunga." Kodwa khumbula, ngumzimba wakho othetha nawe uthi, "Kukho into engalunganga ngaphakathi, ndincede."

Kufuneka ulumke kakhulu ngezi mpawu, ingakumbi ukuba unezifo ezihlala ixesha elide ezifana neengxaki zezintso okanye isifo seswekile.

Kodwa ungakhathazeki. Awuwedwa. Kukho oogqirha abanobuchule, abahlengikazi, kunye nabanye oochwephesha bezempilo abanokukunceda bakukhuphe kule meko. Ngokuchongwa ngokuchanekileyo kunye nonyango olukhawulezileyo nolufanelekileyo, le meko inokulawulwa kakhulu kwaye iguqulwe. Ke ngoko, ukuba unamathandabuzo malunga noku, ungabi nantloni okanye ulibazise ukubona ugqirha, buza imibuzo yakho, kwaye ufumane ingcebiso kunye nonyango olufunekayo. Kuba, impilo yakho yeyona nto ixabisekileyo kweli hlabathi!

I- Metabolic acidosis, ibhalansi ye-acid-base, ixabiso le-pH, isifo sezintso, isifo seswekile, i-ketoacidosis, i-lactic acidosis, iimpawu, unyango