Hōʻike koko Osmolality

ʻO Osmolality kahi hoʻāʻo e ana ana i ka hoʻouluulu ʻana o nā hunaola kemika āpau i loaʻa i ka ʻāpana wai o ke koko.

Hiki ke ana ʻia ka Osmolality me kahi hōʻike mimi.

Pono kahi laʻana koko.

E hāhai i nā ʻōkuhi mai kāu lawelawe mālama ola e pili ana i ka ʻai ʻole ma mua o ka hoʻāʻo. E haʻi paha kāu mea lawelawe iā ʻoe e haʻalele iki i ka lawe ʻana i nā lāʻau e hoʻopilikia paha i nā hopena hōʻike. Hiki i kēlā mau lāʻau ke hoʻopili i nā hua wai (diuretics).

Ke hoʻokomo ʻia ke kui kele e huki i ke koko, manaʻo kekahi poʻe i ka ʻeha kaulike. ʻO ka manaʻo ʻē aʻe he prick a wīwī wale paha ka manaʻo. Ma hope, loaʻa paha i kahi kūpikipiki a i ʻole ka ʻūlū iki. Hele koke kēia.

Kōkua kēia hōʻoia e nānā i ke kaulike wai o kou kino. Hiki i kāu kauka ke kauoha i kēia hōʻike inā loaʻa iā ʻoe nā hōʻailona o kekahi o kēia mau mea:

• Low sodium (hyponatremia) a i ʻole ka pohō wai
• Poisoning mai nā mea hoʻopilikia e like me ka ethanol, methanol, a i ʻole ethylene glycol
• Nā pilikia e hana ana i ka mimi

I ka poʻe olakino, ke kiʻekiʻe ka osmolality i ke koko, hoʻokuʻu ke kino i ka hormone antidiuretic (ADH).

Hoʻokumu kēia hormone i nā puʻupaʻa e hou hou i ka wai. ʻO kēia ka hopena i ka mimi paʻa hou aʻe. Hoʻopili ka wai i hoʻopili hou ʻia i ke koko. ʻAe kēia i ka osmolality o ke koko e hoʻi i ka maʻamau.

ʻO ke osmolality koko haʻahaʻa e kāpae iā ADH. Hoʻoemi kēia i ka nui o ka wai e makemake ai nā puʻupaʻa. Hoʻoholo ʻia ka mimi dilute e hemo i ka nui o ka wai, kahi e hoʻonui ai i ka osmolality o ke koko i ka mea maʻamau.

Loaʻa nā kumukūʻai maʻamau mai 275 a 295 mOsm / kg (275 a 295 mmol / kg).

Hiki ke loli iki nā pae waiwai maʻamau i waena o nā hale hana ʻokoʻa. Hoʻohana kekahi mau labs i nā ana like ʻole a i ʻole nā ​​hoʻāʻo i nā laʻana like ʻole. E kamaʻilio i kāu mea hāʻawi e pili ana i ke ʻano o kāu mau hopena hōʻike.

ʻO kahi kiʻekiʻe ma mua o ka pae maʻamau ma muli o:

• Insipidus diabetes
• Kiʻekiʻe pae kō kō (hyperglycemia)
• ʻO ke kiʻekiʻe kiʻekiʻe o nā huahana neoneo nitrogen i ke koko (uremia)
• Kiʻekiʻe pae sodium (hypernatremia)
• ʻO ka hahau a poʻo poʻo poʻo paha e hopena ai i ka hoʻoliʻiliʻi ADH
• Ka pohō wai (make wai)

Ma muli o nā pae maʻamau ma muli o:

• ADH kahuna nui
• Adrenal gland ʻaʻole e hana maʻamau
• Pili nā kūlana i ka maʻi ʻaʻai māmā (ke kumu o ka hana ʻana o ADH kūpono ʻole, a i ʻole SIADH)
• Ke inu nui nei i ka wai a wai paha
• Low pae sodium (hyponatremia)
• SIADH, kahi e hoʻonui ai ke kino iā ADH
• Pahu thyroid underactive (hypothyroidism)

ʻAʻohe pilikia iki i ka lawe ʻia ʻana o kou koko. ʻOkoʻa nā aʻa a me nā aʻa i ka nui mai kekahi mea hoʻomanawanui a i kekahi ʻē aʻe a mai kekahi ʻaoʻao o ke kino i kekahi. ʻOi aku ka paʻakikī o ka lawe ʻana i ke koko mai kekahi poʻe ma mua o nā poʻe ʻē aʻe.

ʻO nā pilikia ʻē aʻe e pili ana i ke kau ʻana o ke koko he liʻiliʻi akā hiki ke hoʻopili ʻia:

• Kahe nui ke koko
• Pāleʻale a ʻoluʻolu paha
• Nā punctures he nui e ʻimi i nā uaua
• Hematoma (hōʻiliʻili koko ma lalo o ka ʻili)
• Maʻiʻaʻai (i iki kamepiula i kēlā me kēia manawa ka ʻili i haki)

• Hōʻaʻo koko

ʻO MS, Briefel G. Ka loiloi ʻana i ka hana o ke kōpaʻa, ka wai, nā electrolytes, a me ke kaulike acid-base. I: McPherson RA, Pincus MR, hua. ʻO kā Henry's Clinical Diagnosis a me Management e nā Laboratory Methods. 23rd Ed. St Louis, MO: Elsevier; 2017: chap 14.

ʻO Verbalis JG. Nā maʻi o ke kaulike wai. I: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. ʻO Brenner a me Rector's The Kidney. 11th hua. Piladelapia, PA: Elsevier; 2020: chap 15.