Kahi Lapaʻau no Metabolic Acidosis

Anter

• He aha ka metabolic acidosis?
• Kaukaʻi pili ʻana i ke kumu
• Nā mālama maʻamau no ka acidosis metabolic
• Uku hanu
• Uku metabolic
• Hoʻomaʻo diabetes
• IV paʻakai bicarbonate
• Hemodialisis
• Nā mālama ʻē aʻe no ka acidosis metabolic
• ʻO ka lawe lawe ʻana

He aha ka metabolic acidosis?

Hana ʻia ka acidosis metabolic ke ʻoi aku ka acidic o kou kino ma mua o ke kumu. Kāhea ʻia kēia ʻano he acidosis metabolic huʻi. He hopena ʻaoʻao maʻamau ia o kekahi mau pilikia olakino olakino a me ka wikiwiki. Hiki ke Acidosis i kēlā me kēia makahiki; hiki ke hoʻopili i nā pēpē, nā keiki, a me nā mākua.

ʻO ka maʻamau, loaʻa i kou kino kahi kaulike acid-base. Ua ana ʻia e ka pae pH. Hiki i ka pae kemika o ke kino ke lilo i acidic no nā kumu he nui. Hiki ke hana i ka acidosis metabolab inā ʻoe:

• e hana ana i ka waikawa he nui loa
• hana kumu liʻiliʻi loa
• ka holoi ʻole ʻana i nā waikawa a lawa paha

Metabolic acidosis hiki ke akahai a me ka manawa pōkole i ke koʻikoʻi a me ka hoʻoweliweli ola. Pono ʻoe i ka lāʻau lapaʻau. Hiki i kēia ʻano ke hoʻololi i ka hana o kou kino. Hiki i nā acid he nui i ke kino ke alakaʻi i nā pilikia olakino ʻē aʻe.

Kaukaʻi pili ʻana i ke kumu

ʻO ka mālama ʻana i ka acidosis metabolic ma muli o ke kumu. Kūleʻa kekahi mau kumu a hele aku ka acidosis me ka ʻole o ka lapaʻau.

Hiki i kēia ʻano ke lilo i mea paʻakikī i nā pilikia olakino olakino ʻē aʻe. ʻO ka mālama ʻana i ke kūlana kumu e kōkua ai i ka pale ʻana a mālama ʻana i ka acidosis metabolic.

ʻO ka acidosis Metabolic ka acidosis ma muli o nā loli e hoʻopili i ke kahe o ke koko, nā puʻupaʻa, a me ka digestion. ʻO kēia paha ke kumu o:

• Ketoacidosis diabetes. Puhi ke kino i nā momona ma kahi o nā kō, e hoʻoulu ana i nā ketone a i ʻole nā ​​waikawa.
• Pohā. Hiki i ka diarrhea nui a i ʻole ka luaʻi ke alakaʻi i ka hyperchloremic acidosis. ʻO kēia ke kumu o nā pae haʻahaʻa i kapa ʻia ʻo bicarbonate, ka mea e kōkua i ke kaulike i nā waikawa i ke koko.
• Hana maikaʻi ʻole ka hakuʻala. Hiki i ka maʻi kīwī a me ke kō ʻole o ke kōpaʻa ke alakaʻi i ka acidosis tubular renal. Hana ʻia kēia inā ʻaʻole hiki i kou puʻupaʻa ke kiʻi i nā kānana ma o ka mimi pono.
• Losis acidosis. Hana ʻia kēia ke hana ke kino i ka hana nui a i ʻole ka hoʻohana ʻana i ka waikawa lactic. ʻO nā kumu e loaʻa ʻole ka puʻuwai puʻuwai, hopu ʻia ka naʻau, a me nā sepsis koʻikoʻi.
• Meaʻai ʻO ka ʻai ʻana i nā huahana holoholona keu e hana i nā waikawa i loko o ke kino.
• Hoʻoikaika kino. Hana ke kino i ka waikawa lactic hou inā ʻaʻole lawa kāu oxygen no kahi manawa lōʻihi i ka hoʻoikaika ikaika.

ʻO nā kumu ʻē aʻe o ka acidosis:

• ʻalekohola a lāʻau hoʻomāinoino paha
• nā lāʻau e hoʻolohi i ka hanu ʻana e like me benzodiazepines, nā lāʻau hiamoe, nā lāʻau ʻeha, a me kekahi mau narcotics

ʻO nā kūlana e like me ka hānō, ka maʻi pulmonary obstructive maʻi mau (COPD), ka niumonia, a me ka apnea hiamoe hiki ke hana i kekahi ʻano acidosis i kapa ʻia ka acidosis respiratory. Hana ʻia kēia inā ʻaʻole hiki i nā māmā ke hanu kūpono i ke kalapona kalapona. Hoʻonui aʻe ka nui o ke kalapona kalapona i nā kiʻekiʻe o ka waikawa.

Nā mālama maʻamau no ka acidosis metabolic

Hana ka mālama ʻana no ka acidosis metabolic i ʻekolu ala nui:

• excreting a hoʻopau ʻana paha i nā waikawa keu
• buffering acid me kahi kumu e kaulike i ke kawa koko
• ka pale ʻana i ke kino mai ka hana ʻana i nā waikawa he nui loa

Nā ʻano lapaʻau ʻē aʻe no ka acidosis metabolic:

Uku hanu

Inā loaʻa iā ʻoe ka acidosis hanu, e hōʻike nā hoʻokolohua kinoea koko i nā kiʻekiʻe o ke kalapona kalapona. ʻO nā hoʻokolohua ʻē aʻe e kuhi i kēia ʻano metabolic acidosis e komo pū ana me nā hōʻike hanu e hōʻike i ke ʻano o ka hana o nā akehā, a me ka X-ray a i ʻole CT scan e nānā ai no ka maʻi o ka maʻi a i ʻole blockage.

Nā hana hanu no ka metabolic acidosis e komo pū me:

• nā lāʻau bronchodilator (Ventolin inhaler)
• lāʻau lāʻau steroid
• oxygen
• mīkini ea (CPAP a BiPaP paha)
• mīkini hanu (no nā hihia koʻikoʻi)
• lapaʻau e hoʻōki i ka puhipaka ʻana

Uku metabolic

Hoʻomaʻo diabetes

Hoʻoholo i ka metabolic acidosis i hoʻokumu ʻia e ka maʻi diabetic untreated a i ʻole kaohi ʻole ʻia me ka lapaʻau ʻana no ka maʻi kō. Inā loaʻa ʻoe i ka ketoacidosis diabetic, e hōʻike ana kāu mau hōʻoia koko i ke kiʻekiʻe o ke kō i ke kō (hyperglycemia). Hoʻopili ka mālama ʻana i ke kaulike ʻana i nā pae kō kō e kōkua ai i ke kino e hemo a kū i ka hana ʻana i nā waikawa.

• insulina
• lāʻau lapaʻau diabetes
• wai
• electrolytes (sodium, koleka, potassium)

E holo wale ka mālama ʻana o ka insulina inā ke kumu ka maʻi diabetic i ka metabolic acidosis.

IV paʻakai bicarbonate

Hoʻohui i ka waihona e kūʻē i nā pae waikawa kiʻekiʻe e mālama i kekahi ʻano o ka metabolic acidosis. ʻO ka mālama Intravenous (IV) me kahi kumu i kapa ʻia ʻo sodium bicarbonate kekahi ala e kaulike ai i nā waikawa i ke koko. Hoʻohana ia e mālama i nā kūlana i kumu i ka acidosis ma o ka bicarbonate (kumu) poho. Hiki i kēia ke hana ma muli o kekahi mau ʻano puʻupaʻa, diarrhea, a me ka luaʻi.

Hemodialisis

He lāʻau lapaʻau ʻo Dialysis no ka maʻi maʻi kōkō a i ʻole kūleʻa ʻole ka hakuʻala. ʻO nā hoʻokolohua koko no nā pilikia o ka puʻuwai mau e hōʻike i nā pae kiʻekiʻe o ka urea a me nā ʻano waikawa ʻē aʻe. Hiki i kahi hōʻike mimi ke hōʻike i ka maikaʻi o ka hana o nā puʻupaʻa.

Kōkua ka Dialysis e hemo i nā keu keu a me nā ʻōpala ʻē aʻe mai ke koko. I ka hemodialysis, kānana kahi mīkini i ke koko a hemo i nā ʻōpala a me nā wai keu. ʻO ka dialysis Peritoneal kahi lapaʻau e hoʻohana i kahi hopena i loko o kou kino e loaʻa ai nā ʻōpala.

Nā mālama ʻē aʻe no ka acidosis metabolic

• ʻO nā Inotropes a me nā lāʻau ʻē aʻe e kōkua i ka hoʻomaikaʻi ʻana i ka hana o ka puʻuwai i nā ʻano e like me ke kahe o ke koko a me nā puʻuwai ʻole. Hoʻomaikaʻi kēia i ke kahe o ka oxygen i ke kino a hoʻohaʻahaʻa i nā kiʻekiʻe o ka acid acid. ʻO nā heluhelu kaomi koko, nā hoʻokolohua koko, a me kahi ECG (electrocardiogram) e hōʻike inā he pilikia puʻuwai ke kumu o ka metabolic acidosis.
• Mālama ʻia ka metabolic acidosis ma muli o ka ʻalekohola a lāʻau lāʻau lāʻau paha me ka detoxification. Pono paha kekahi poʻe hemodialysis e hoʻomaʻemaʻe i nā toxins. ʻO nā hoʻokolohua koko me nā hoʻokolohua o ka hana ate e hōʻike i kahi kaulike acid-base. Hiki i kahi hōʻike mimi a me nā hoʻokolohua kinoea koko ke hōʻike i ke koʻikoʻi o ka lāʻau make.

ʻO ka lawe lawe ʻana

ʻO ka Metabolic acidosis kahi ʻano acidosis i hana mau ʻia e nā kūlana olakino e hoʻopili i nā puʻupaʻa, ka puʻuwai, ka ʻai, a me ka metabolism. Kūkulu nā ʻakika i ke koko a hiki ke alakaʻi i nā pilikia olakino koʻikoʻi inā haʻalele ʻole ʻia.

ʻO ka mālama ʻana no ka acidosis metabolic kaukaʻi ʻia i ke ʻano o ke kumu. Akahai a kūlohelohe paha kekahi ʻano a ʻaʻole pono ka lapaʻau ʻana. He hōʻailona paha ka metabolic acidosis i hewa kekahi mea i kou kino. Pono ʻoe e mālama i kahi kūlana olakino ʻē aʻe e kaulike i nā waikawa a me nā kumu i kou koko.

Inā loaʻa iā ʻoe ka acidosis metabolic a i ʻole kahi maʻi maʻi lōʻihi e hiki ai ke kumu i ka acidosis, e ʻike pinepine i kāu kauka. Lawe i nā lāʻau āpau e like me ke kauoha a me ka ukali i nā kuhikuhi papaʻai. Hiki i nā hoʻokolohua koko maʻamau a me nā hōʻoia ʻē aʻe ke kōkua i ka mālama ʻana i kāu pae acid.