Ingabe umzimba wakho une-asidi eningi kakhulu? Ake sifunde nge-metabolic acidosis!

Wake wazizwa ukhathele, ulambile, noma unesiyezi? Noma mhlawumbe ukuphefumula kwakho kuye kwanda kancane, noma isifuba sakho siyashaya? Lokhu ngezinye izikhathi kungabangelwa izinguquko ezincane ekulinganiseni emzimbeni wakho. Namuhla sizokhuluma ngesimo esidinga ukunakwa okuncane, kodwa uma usazi, singakusiza ukuthi usilawule. Lokho kubizwa ngokuthi i-metabolic acidosis . Igama lingase lizwakale liyesabeka kancane, kodwa ake sixoxe ngakho kalula.

Kuyini i-Metabolic Acidosis? Kalula nje...

Kalula nje, i-metabolic acidosis yilapho uketshezi emzimbeni wakho, ikakhulukazi igazi lakho, luba ne-acid noma i-acid kakhulu . Cabanga ngemizimba yethu njengemishini ebucayi. Konke okukuyo, ikakhulukazi amakhemikhali, kudingeka kube nokulinganisela okuphelele. Uma lokho kungenzeki, izinkinga ziqala ukuvela.

Imizimba yethu inekhemikhali ebizwa ngokuthi i-bicarbonate . Lesi yisisekelo esiyinhloko esilawula, noma esiqeda ubumuncu bomzimba. Ngakho-ke, kunezindlela ezimbili eziyinhloko i-metabolic acidosis engenzeka ngazo.

1. Noma ngabe inani le-asidi emzimbeni liyanda ngaphezu kokudingekile futhi lidlula inani le-bicarbonate (lokhu kubizwa ngokuthi 'i-High Anion Gap Metabolic Acidosis' ).

2. Ngaphandle kwalokho, i-bicarbonate eningi ikhishwa emzimbeni ngezinso noma ngezinye izindlela (lokhu kubizwa ngokuthi 'i-Normal Anion Gap Metabolic Acidosis' ).

Kodwa-ke, umphumela wokugcina uba ukuthi umzimba uba ne-asidi eyengeziwe. Kungenzeka ukuthi uke wezwa odokotela bekhuluma ngento ebizwa ngokuthi 'i-Anion Gap' . Lona umehluko nje phakathi kwezinhlayiya ezishajelwe kahle nezine-negative (ama-electrolyte) egazini lethu. Lokhu kuvumela odokotela ukuthi bathole umbono webhalansi ye-asidi-base.

Ubani okungenzeka kakhulu ukuthi athinteke yilesi simo? Ingabe sonke kufanele siqaphele?

Empeleni, noma ubani angaba nesimo esibizwa ngokuthi i-metabolic acidosis. Kodwa-ke, le ngozi iphezulu kakhulu kulabo izinso zabo ezingasebenzi kahle (Ukwehluleka Kwezinso / Ukwehluleka Kwezinso) noma labo abanesifo sezinso esingamahlalakhona . Lokhu kungenxa yokuthi izinso zethu zidlala indima enkulu ekugcineni umzimba ulinganisela ngokususa i-asidi eningi ekhiqizwa emizimbeni yethu ngomchamo. Ngakho-ke uma izinso zibuthakathaka, lo msebenzi awusebenzi kahle.

Kwenzekani ngaphakathi emzimbeni uma lobu asidi bukhuphuka? Indaba ngenani lethu le-pH

Ukuze zonke izinhlelo zomzimba wethu zisebenze kahle, igazi lethu kudingeka libe sebangeni elithile elibizwa ngokuthi ibhalansi ye-pH . Le pH iyisilinganiso sokuthi ingakanani i-asidi ne-alkali egazini lethu. Kuyisikali esisuka ku-0 kuya ku-14. U-0 une-asidi kakhulu, kanti u-14 une-alkali kakhulu. I-pH yegazi lomuntu ophilile ivame ukuba phakathi kuka-7.35 no-7.45.Yilokho okufanele kube yikho. Lokhu kuyibhalansi ebucayi kakhulu.

Izinso namaphaphu ethu yizitho eziyinhloko ezisiza ukugcina lokhu kulinganisela. Izinso zikhipha ama-asidi amaningi kanye nezisekelo emchameni. Amaphaphu alawula inani le-carbon dioxide egazini lapho siphefumula. I-carbon dioxide nayo ithinta izinga le-asidi emzimbeni.

Ngakho-ke, ku-metabolic acidosis, izinqubo ze-metabolic emzimbeni zikhiqiza i-asidi eningi kakhulu, noma izinso azikwazi ukukhipha le-asidi ngendlela efanele. Bese i-pH esikhulume ngayo yehla ngaphansi kuka-7.35, okusho ukuthi igazi liba ne-asidi eningi.

Ziyini izimpawu zalokhu? Kubaluleke kakhulu ukuzazi lezi!

Ngokumangazayo, ngezinye izikhathi abantu abane-metabolic acidosis bangase bangakhombisi zimpawu ezithile ekuqaleni . Kodwa-ke, kunezimpawu ezithile ezivamile ezingabonakala njengoba isimo siqhubeka. Kubalulekile ukuthi wena nomndeni wakho niqaphele lezi:

• Ukushaya kwenhliziyo okusheshayo okungazelelwe (i-tachycardia). Kungase kuzwakale sengathi isifuba sakho siyashaya, noma sengathi uyesaba.
• Ukuzizwa unesizungu noma unekhanda elibuhlungu. Ngezinye izikhathi kungenzeka ngisho noma umi ngezinyawo.
• Ukuzizwa ukhathele kakhulu, uzizwa ungenampilo futhi ukhathele ngaso sonke isikhathi. Kungakhathaliseki ukuthi ulala kangakanani, usazizwa ukhathele.
• I-Anorexia, ukuzizwa unengwa ngisho noma ubona ukudla.
• Ikhanda elibuhlungu eliqhubekayo.
• Ukuphefumula kuyashesha, noma kuthatha ukuphefumula okujulile isikhathi eside. Empeleni lokhu kungumzimba ozama ukunciphisa i-asidi ngokukhipha i-carbon dioxide eningi (uhlobo lwe-asidi).
• Isicanucanu nokuhlanza.
• Ukuzizwa ubuthakathaka kanye nobuthakathaka obujwayelekile.
• Iphunga elimnandi nelinjengezithelo emlonyeni. Lokhu ikakhulukazi uphawu lwe-ketoacidosis yesifo sikashukela.

Kubaluleke kakhulu: Uma lesi simo siba sibi kakhulu, okungukuthi, uma izinga le-asidi emzimbeni landa kakhulu, izinkinga ezinkulu njengokwehluleka kwezinso, ukulimala kwezinye izitho zomzimba, ukulahlekelwa ukwazi, ngisho nokufa kungenzeka . Ngakho-ke, uma unesinye noma ngaphezulu salezi zimpawu, kuwukuhlakanipha ukufuna iseluleko sezokwelapha ngokushesha.

Kungani lokhu kwenzeka? Yiziphi izimbangela eziyinhloko ze-metabolic acidosis?

Kunezinhlobo ezine eziyinhloko zezimbangela ezingaholela ku-metabolic acidosis. Ake sibheke ukuthi ziyini:

1. I-acidosis ehlobene nesifo sikashukela / I-Diabetic Ketoacidosis (DKA):Abantu abaningi bake bezwa ngalokhu. Kungakhula kubantu abanesifo sikashukela esingalawulwa kahle, ikakhulukazi labo abanesifo sikashukela sohlobo 1. Lapho amangqamuzana omzimba engenawo i-insulini ayidingayo ukuze akhiqize amandla, noma lapho i-insulini anayo ingasebenzi kahle, amangqamuzana awakwazi ukungenisa ushukela egazini. Umzimba ube usuqala ukushisa amafutha ukuze uthole amandla. Njengomphumela wale nqubo, uhlobo lwe-asidi olubizwa ngokuthi 'imizimba ye-ketone' luyakheka emzimbeni. Lesi yisimo esiyingozi kakhulu esidinga ukwelashwa ngokushesha.

2. I-Hyperchloremic acidosis: Lokhu kubangelwa ukuthi umzimba ulahlekelwa kakhulu yi-sodium bicarbonate eyigugu. Cabanga nje, unesifo sohudo esinzima izinsuku eziningana , kuze kube yilapho ulahlekelwa amanzi. Ngaleso sikhathi, inani elikhulu le-bicarbonate lingakhishwa emathunjini. Lokhu kungenzeka futhi uma usebenzisa imithi ethile yokudambisa ( imithi yokudambisa ) ngokweqile, ngaphandle kokubonisana nodokotela.

3. I-Lactic acidosis: Lesi simo senzeka lapho imizimba yethu inohlobo oluningi lwe-asidi olubizwa ngokuthi i-lactic acid. Cabanga ngakho, lapho sizivocavoca kakhulu, noma lapho amangqamuzana omzimba wethu engatholi umoya-mpilo owanele (isib., ukuhlaselwa yinhliziyo, ukutheleleka okukhulu), i-lactic acid ikhiqizwa njengomkhiqizo wokwenza amandla. Ngokuvamile, umzimba uyakulawula lokhu. Kodwa ngezinye izikhathi, isibonelo, kumuntu onenkinga yesibindi , noma lapho ushukela wegazi wehla ngokuzumayo (i-Hypoglycemia noma ushukela wegazi ophansi) , noma uma abanye abantu besebenzisa utshwala ngokweqile (i-Alcohol use disorder) , kwezinye izimo zomdlavuza , noma uma bezivocavoca kakhulu (Ukuzivocavoca okukhulu) , inani le-lactic acid linganda futhi umzimba awukwazi ukuliphatha.

4. I-Renal Tubular Acidosis (RTA): Lokhu kwenzeka lapho amapayipi amancane (amapayipi) ezinso engakwazi ukukhipha i-asidi eyanele ngomchamo. Noma, i-bicarbonate ayimuncwa kahle. Ngenxa yalokho, i-asidi yegazi iyanda kancane kancane.

Izimbangela ezimbili ezivame kakhulu uhudo olungenakulawuleka kanye nokwehluleka kwezinso.

Ingabe lesi yisifo esithelelanayo? Ingabe abanye bazosithola kimi?

Cha, akunjalo nhlobo. I-metabolic acidosis ayisona isifo esithathelwanayo . Awukwazi ukuyidlulisela komunye umuntu ngoba nje unayo. Kuyinkinga ngokulinganisela kwamakhemikhali emzimbeni.

Odokotela bakuthola kanjani lokhu?

Uma uya kudokotela, uzoqala ngokukubuza ngezimpawu zakho, abuze ngezimo zakho zezokwelapha zangaphambilini, bese ekuxilonga. Uzobe eseyala ukuhlolwa okuningana ukuqinisekisa isimo nokuthola imbangela.

Ngezinye izikhathi ungathunyelwa kudokotela wezinso , ikakhulukazi uma kusolwa ukuthi unenkinga yezinso.

Wenzani ngalezi zivivinyo?

Ukuhlolwa kungahluka kuye ngezimpawu zakho nokuthi udokotela wakho ucabanga ukuthi kuyimbangela. Ukuhlolwa okuvame kakhulu yile:

• Ukuhlolwa kwegazi: Lokhu kubaluleke kakhulu.
• Ukuhlolwa Kwesikhala Se-Anion: Kuthathwa isampula encane yegazi emthanjeni osengalweni yakho bese kulinganiswa umehluko phakathi kwamakhemikhali ashajekile amahle nangalungile abizwa ngokuthi ama-electrolyte. Uma lesi sikhala sikhulu kunokuvamile, kungaba uphawu oluqinile lokuthi une-metabolic acidosis.
• Ukuhlolwa kwe-Arterial Blood Gas (ABG): Lokhu ukuhlolwa okuhlukile kancane. Lokhu kuhilela ukuthatha inani elincane legazi elivela emthanjeni osesihlakaleni sakho, endololwaneni, noma embotsheni (ngokuvamile elincane kunemithambo). Lokhu kulinganisa izinga lomoya-mpilo, izinga le-carbon dioxide, futhi okubaluleke kakhulu, i-pH yegazi lakho. I-pH engaphansi kuka-7.35 isho ukuthi igazi lakho line-asidi kakhulu noma lilula kakhulu.
• Okunye ukuhlolwa kwegazi: Amazinga kashukela egazini, ukuhlolwa kokusebenza kwezinso (isib. i-Serum Creatinine, i-BUN), kanye namazinga e-electrolyte (ama-Electrolyte afana ne-Sodium, i-Potassium, i-Chloride) nawo angahlolwa.

• Ukuhlolwa komchamo:

Uma uchamela ebhodleleni elikhethekile, i-pH iyahlolwa. Lokhu kungakutshela izinto ezifana nokuthi umchamo wakho une-asidi kakhulu, ulula kakhulu, noma uqukethe ama-ketone.

Kuphathwa kanjani lokhu? (Ukwelashwa)

Uma udokotela wakho esethole imbangela eqondile ye-metabolic acidosis yakho, uzokunikeza uhlelo lokwelashwa olukusebenzelayo. Ukwelashwa kuncike embangela.

• Into ebaluleke kakhulu ukwelapha imbangela . Isibonelo, ku-ketoacidosis yesifo sikashukela, ushukela egazini ulawulwa ngokunikeza i-insulin kanye noketshezi lwe-IV.
• Abantu abanesifo sezinso banganikwa i-sodium bicarbonate ngendlela yamaphilisi noma i-sodium citrate ngendlela yesisombululo sokunciphisa i-asidi emzimbeni.
• Uma kulahleke uketshezi oluningi emzimbeni (isib. ngenxa yohudo), kubalulekile ukunikeza usawoti (uketshezi lwe-IV) ngomthambo.
• Kwezinye izimo ezinzima, i-sodium bicarbonate inikezwa ngemithambo yegazi (IV Sodium Bicarbonate) ukuze kusheshe kulinganiswe i-asidi egazini.
• Uma into enobuthi ingene emzimbeni (isib., ngokuthatha i-aspirin eningi noma ngokudla ikhemikhali efana ne-methanol), ukwelashwa okukhethekile (isib., i-dialysis) kungadingeka ukuze kususwe into enobuthi egazini.

Ingabe ukudla neziphuzo kuyayithinta le nto? Yini okufanele ngiyidle futhi yini okufanele ngiyidle kancane?

Yebo, impela. Okunye kokudla neziphuzo esikudlayo kwandisa i-asidi emzimbeni, kanti okunye kwandisa i-alkalinity futhi kusiza ekunciphiseni i-asidi. Kodwa-ke, lokhu kubaluleke kakhulu: Ngaphambi kokwenza noma yiziphi izinguquko ezinkulu ekudleni kwakho, kufanele nakanjani ukhulume nodokotela wakho noma isazi sokudla. Lesi seluleko sibaluleke kakhulu uma unesifo sezinso.

Ukudla okwakha i-asidi:

• Inyama (ikakhulukazi inyama ebomvu, inkukhu, inhlanzi).
• Amaqanda.
• Ushizi neminye imikhiqizo yobisi (eminye).
• Okusanhlamvu okucutshunguliwe.
• Utshwala.

Ukudla okwakha i-alkaline okwandisa i-alkaline emzimbeni, okungukuthi, kusiza ekunciphiseni i-acidity:

• Izinhlobo eziningi zezithelo (ikakhulukazi izithelo ze-citrus).
• Amantongomane namabhotela amantongomane.
• Imifino (isib. amalentili, ubhontshisi oluhlaza, ubhontshisi).
• Imifino eminingi (ikakhulukazi imifino eluhlaza).
• Abanye abantu bakhuluma ngamanzi ane-alkaline , kodwa kunemibono ehlukene mayelana nesisekelo sesayensi salokhu, ngakho-ke kungcono ukubuza udokotela.

Yimiphi eminye imithi esetshenziswa kulokhu?

Ngezinye izikhathi imithi ethengiswa ngaphandle kwemithi kadokotela (i-OTC) efana ne -Sodium Citrate noma i-Sodium Bicarbonate ingasiza ekulinganiseni i-asidi emzimbeni. Kodwa-ke, ungasebenzisi noma yimuphi wale mithi ngaphandle kokubonisana nodokotela wakho, ngoba ingabangela ezinye izinkinga.

Kwezinye izimo ezinzima, lapho inhliziyo ingasebenzi kahle futhi umzimba ungatholi umoya-mpilo owanele, odokotela bangase banikeze imithi ebizwa ngokuthi i-inotropes . Le mithi yenza inhliziyo ishaye ngamandla. Lokhu kusiza umzimba ukuthi uthole umoya-mpilo owengeziwe futhi kusiza nokunciphisa i-asidi egazini. Le mithi ivame ukunikezwa ngemithambo yegazi (IV) esibhedlela.

Ingabe kukhona esingakwenza ukunciphisa ukuthuthukiswa kwe-metabolic acidosis?

Nakuba kungenakwenzeka ukuvimbela lesi simo ngokuphelele, kunezinto ezimbalwa esingazenza ukuze sinciphise ingozi:

• Ukuphuza amanzi anele kanye nezinye izinto eziwusizo ezinempilo usuku lonke.
• Uma unesifo sikashukela, kubalulekile ukulawula amazinga kashukela egazini lakho njengoba kunqunywe udokotela wakho. Lokhu kuhlanganisa imithi, ukudla okudlayo kanye nokuzivocavoca.
• Uma uphuza utshwala, nciphisa inani oliphuzayo noma uyeke ngokuphelele ukuphuza. Umkhawulo onempilo ubhekwa njengongadluli iziphuzo ezimbili ezijwayelekile ngosuku kwabesilisa kanye nongadluli isiphuzo esisodwa esijwayelekile ngosuku kwabesifazane.
• Ukudla ukudla okunempilo.

Kuzokwenzekani esikhathini esizayo ngalesi simo? Ingabe kuyinto okufanele uyesabe? (I-Outlook)

Uma une-metabolic acidosis, ikusasa lincike ebunzimeni besimo, ukuthi yini ebangele lokho, nokuthi uthola ukwelashwa ngokushesha nangokufanele kangakanani.

• Ezimweni eziningi, lesi simo singalungiswa ngokuxilongwa nokwelashwa okufanele.
• Ezimweni ezincane , izimpawu zingase zibe zesikhashana futhi zingase zingadingi ukwelashwa okukhethekile uma imbangela ixazululeka yodwa.
• Kodwa, njengoba ngishilo ngaphambili, ezimweni ezimbi kakhulu, uma kungelashwa, kungaholela ekuhlulekeni kwezinso noma kwezinye izitho zomzimba, ngisho nokufa. Yingakho lokhu kungeyona into okufanele ithathwe kalula.

Ngingazinakekela kanjani? Yini engingayenza ngedwa? (Ukuzinakekela)

Udokotela wakho uzokwakha uhlelo lokwelashwa olukufanele. Luzohlanganisa imithi kanye nezinguquko zendlela yokuphila. Ukulandela lezi zinyathelo kuzokusiza ukusheshisa ukululama kwakho futhi kuvimbele lesi simo ukuthi singaphinde sivele:

• Hlola amazinga kashukela egazini lakho njalo (uma unesifo sikashukela). Hlola ushukela egazini lakho ekhaya njengoba uqondiswe udokotela wakho.
• Thatha umuthi owunikezwe udokotela wakho njengoba nje uyalelwe, ngesikhathi esifanele, nangesilinganiso esifanele. Ungaphuthelwa umthamo owodwa.
• Uma udokotela wakho noma isazi sokudla okunempilo sikululeka, zama ukudla ukudla okune-asidi encane futhi okune-alkaline eningi.
• Nciphisa noma uyeke ngokuphelele ukuphuza utshwala.
• Gcina ama-aphoyintimenti akho kadokotela ngesikhathi. Ngaleyo ndlela, ungabona ukuthi unjani futhi wenze noma yiziphi izinguquko ezidingekayo.

Kufanele ngimbone nini udokotela? Ingabe kuyisimo esiphuthumayo?

Uma unezimpawu ze-metabolic acidosis (njengokukhathala esixoxe ngakho ekuqaleni, izinguquko ekuphefumuleni, isicanucanu), noma uma unezimpawu ezimbi zesinye isimo esingase sibangele lesi simo (isb. isifo sikashukela esingalawuleki, isifo sohudo esibi, izimpawu zesifo sezinso), funa usizo lwezokwelapha ngokushesha. Ungalibali.

Uyini umehluko phakathi kwe-Metabolic Acidosis kanye ne-Respiratory Acidosis?

Nakuba zombili lezi zimo zikhula lapho i-asidi yomzimba ikhuphuka khona, indlela ezenzeka ngayo kanye nezinhlelo zezitho ezithinteka kakhulu zihlukile.

I-Metabolic acidosis yisimo esithinta kakhulu i -metabolism yomzimba kanye nesistimu yomchamo, ikakhulukazi izinso . Kwenzeka lapho kukhiqizwa i-asidi eningi kakhulu emzimbeni, noma izinso zingakwazi ukuhlunga i-asidi egazini, noma umzimba ulahlekelwa yi-bicarbonate.

I-acidosis yokuphefumula yisimo esithinta kakhulu uhlelo lokuphefumula, noma amaphaphu . Lokhu kwenzeka lapho amaphaphu engakwazi ukususa i-carbon dioxide (CO2) egazini ngokushesha ngokwanele. I-CO2 ihlangana namanzi ukuze yakhe i-asidi. Lapho izimo ezifana ne-asthma ziba zimbi kakhulu, isifo samaphaphu (njenge-COPD), ukulimala kobuchopho okubangela ubunzima bokuphefumula, noma ukusebenzisa ngokweqile imithi ethile noma amaphilisi okulala kungathinta ukusebenza kwamaphaphu, okubangela ukuba i-CO2 iqoqeke futhi inyuse i-asidi.

Kalula nje, i-metabolism yinkinga ngezinqubo zamakhemikhali emzimbeni nasezinso. Ukuphefumula yinkinga ngenqubo yokuphefumula kanye namaphaphu.

Okokugcina, izinto ezibaluleke kakhulu okudingeka uzikhumbule (Umyalezo Wokuya Ekhaya)

I-metabolic acidosis yisimo okufanele ukhathazeke ngaso ngempela, ngoba sithinta ibhalansi eyisisekelo yomzimba. Ngezinye izikhathi ungazama ukungazinaki izimpawu bese wenza sengathi, "Kuzolunga." Kodwa khumbula, umzimba wakho ukhuluma nawe uthi, "Kukhona okungahambi kahle ngaphakathi, ngisize."

Kufanele uqaphele kakhulu ngalezi zimpawu, ikakhulukazi uma unezifo ezihlala isikhathi eside njengezinkinga zezinso noma isifo sikashukela.

Kodwa ungakhathazeki. Awuwedwa. Kukhona odokotela abanekhono, abahlengikazi, nabanye ochwepheshe bezempilo abangakusiza futhi bakukhiphe kulesi simo. Ngokuthola isifo esinembile kanye nokwelashwa okusheshayo nokufanelekile, lesi simo singalawulwa ngezinga elikhulu futhi siguqulwe. Ngakho-ke, uma unokungabaza ngalokhu, ungabi namahloni noma ulibale ukubona udokotela, buza imibuzo yakho, bese uthola iseluleko nokwelashwa okudingekayo. Ngoba, impilo yakho iyinto ebaluleke kakhulu kuleli zwe!

I- Metabolic acidosis, ibhalansi ye-acid-base, inani le-pH, isifo sezinso, isifo sikashukela, i-ketoacidosis, i-lactic acidosis, izimpawu, ukwelashwa