Metabolism acidosis - nau'ikan, alamu da yadda za a bi

Ana kiyaye ma'aunin Acid a cikin lafiyayyen jikin mutum a kodayaushe, jinin yana da rauni na maganin alkaline. Lokacin da ya karkata zuwa ga acidification, metabolic acidosis yana haɓaka, alkalin - alkalosis. Rashin daidaituwa a cikin gefen acidic shine mafi yawan gama gari, likitocin duk ƙwarewa suna fuskantar ta.

Acidosis da kanta ba ta faruwa; koyaushe tana haɓaka ta kowane cuta ko cuta. Akwai dalilai da yawa da ke haifar da acidosis: daga ciwon sukari zuwa hauhawar ascorbic acid. A dukkan halayen, matakai a cikin jikin sun ci gaba kamar haka: halayen sunadarai suna rage aiki, sunadarai suna canza tsarin su. Wannan yanayin yana da haɗari, har zuwa gaɓarɓar jikin mutum da mutuwa.

Metabolic acidosis - menene?

Sunadarai suna nan a cikin kowace ƙwayoyin jikin mu. An samo su a cikin kwayoyin, da enzymes, da kuma cikin tsarin rigakafi. Sunadarai suna da amphoteric, wato, suna da abubuwan mallakar acid da tushe. Suna yin aikinsu a cikin wani kunkuntar kewayon pH: 7,37 - 7,43. Tare da kowane karkacewa daga gareshi, sunadaran basa canza tsarin su ba tare da bata lokaci ba. Sakamakon haka, enzymes ya rasa aiki, ana lalata tashoshin ion, tashan ƙwayoyin sel sun daina cika ayyukansu, masu karɓa sun kasa, kuma watsa rikicewar jijiyoyi ya tarwatse.

Ciwon sukari da hauhawar jini zai zama abin da ya wuce

• Normalization na sukari -95%
• Cirewa kan jijiyoyin mara wuya - 70%
• Cire zuciyar mai karfin zuciya -90%
• Rabu da cutar hawan jini - 92%
• Increasearuwar kuzarin rana, inganta bacci da dare -97%

Daga irin wannan mummunan sakamako, jiki yana kare kansa daban-daban tare da taimakon tsarin samar da abubuwa da dama. Babban shine bicarbonate. Gishiri na carbonic acid, bicarbonates suna kasancewa koyaushe a cikin jini, wanda, tare da haɓaka abun cikin acid ɗin jini, nan da nan sai a soke shi. Sakamakon amsawar, an kirkiro carbonic acid, wanda ke bazu zuwa cikin carbon dioxide da ruwa.

Cutar kwarjinin bicarbonates tana kiyayewa ta hanjin kodan, akasin haka yana faruwa: ion iskar hydrogen an cire shi a cikin fitsari, kuma an mayar da bicarbonate cikin jini.

Idan acid a cikin adadin mai yawa ya fito daga waje ko kuma yana kasancewa cikin jiki, acidosis yana haɓaka. An kwatanta shi da faɗuwa a cikin PH zuwa 7.35 da ƙasa. Dalilin canzawa a cikin ma'aunin acid-tushe na iya ƙara yawan ƙwayar carbon dioxide, lalacewar koda tare da dakatar da aikin su don dawo da ajiyar bicarbonate, karɓar sansanonin tushen ta hanyar hanji. Zai iya haifar da acidification da gurbata tafiyar matakai, wanda a cikin hakan ne ake haifar da metabolic acidosis.

Dalilai da dalilai na ci gaba

Don bi da acidosis, bai isa ba gabatar da bicarbonates da suka ɓace a cikin jini. Haka kuma, a wasu halaye, gabatarwarsu na iya zama haɗari. Don kawar da acidosis, ya zama dole a fahimta ƙarƙashin rinjayar abin da abubuwan suka fara bunkasa.

Matsaloli da ka iya haddasa acidosis na rayuwa:

1. Rashin insulin ko tsananin juriya. Saboda wannan, kyallen takarda ba su samun abinci mai gina jiki kuma ana tilasta su amfani da kitsen da ke rushewa don samar da acid.
2. Inganta samuwar lactic acid a cikin cututtukan hanta, karancin insulin a cikin ciwon sukari, rashin isashshen sunadarin oxygen a cikin kyallen takarda saboda cututtukan tasoshin jini, huhu, zuciya.
3. Yawan shan barasa, tare da amai da kuma lokacin azumi.
4. Azumin nafila ko mai yawan wuce haddi a abinci.
5. Haramcin jikin mutum lokacin cinye shi: ethylene glycol - barasa, wani ɓangaren maganin daskarewa; acid na salicylic wanda ya fi 1.75 g a kilogiram na nauyi; methanol.
6. Guba tare da vapors na toluene, wanda aka ƙunshi a cikin paints, varnishes, manne, sauran ƙarfi.
7. Rage aikin renal glomerular saboda nephropathy, pyelonephritis, nephrosclerosis, magani tare da wasu kwayoyi: magungunan anti-kumburi; amphotericin - wani maganin antifungal; tetracycline maganin rigakafi ne; shirye-shiryen lithium - psychotropics; acetazolamide (diacarb); spironolactone (Veroshpiron) - diuretics.
8. Asarar hydrocarbons daga narkewa a ciki saboda zawo, fistulas na waje.
9. Doarin yawaitar metformin, magani ne wanda aka tsara don cututtukan cututtukan da ba na insulin ba. Amincewa da Metformin a cikin marasa lafiya da ke fama da cutar hanta ko koda.
10. Ba a isasshen samar da ma'adinan cortex na aldosterone ko deoxycorticosterone.
11. Wuce hadadden potassium da take hakkin ta excretion da kodan.
12. Gabatar da acid a cikin abinci na parenteral ko ammonium chloride don rage kumburi.
13. Cutar ƙarancin nama mai narkewa saboda tsawan lokaci, ƙonewa, myopathy, rauni na trophic da canje-canje na gangrenous a cikin ciwon sukari na mellitus.

Iri cuta

Dangane da abin da ya haifar da tara acid a cikin jini, acidosis ya kasu kashi biyu:

Hanya mai hade da acidosis shima yana faruwa, musamman a cikin marasa lafiya da cuta na rayuwa. Misali, hadarin acidosis saboda yawan sukari a cikin sukari yana karuwa sosai ta hanyar amfani da giya da kuma cutar sankarar jini.

Dangane da matsayin diyya, acidosis ya kasu kashi uku:

• rama acidosis: Kwayar cuta ba kasafai ba ne, acidity yana kusa da ƙarshen ƙimar al'ada, yanayin kwanciyar hankali. Ba a buƙatar magani na musamman, ya zama dole don gano da kuma kawar da dalilin abin da ya faru;
• acidosis mai rikitarwa: yanayin kan iyaka, da ake buƙatar sa ido;
• decompensated nau'i na metabolic acidosis - pH na jini an rage shi a dabi'un barazanar rayuwa ko ci gaba da raguwa. Ana buƙatar asibiti mai gaggawa, gyaran acid tare da mafita na musamman, a wasu matakan matakan sake dawowa. Ba tare da magani ba, acidosis mai ɓoyewa na iya haifar da ƙwayar cuta da haifar da mutuwar mai haƙuri.

Sharuɗɗa don ƙayyade matakin metabolic acidosis:

Bayyanar cututtuka da alamu

Daga ra'ayi na batun ilimin halittar jini, acidosis wani tsari ne na al'ada tare da alamu gaba ɗaya. Za'a iya gane acidosis da aka biya kawai ta hanyar canji a cikin tsarin jini da fitsari. Bayyanar cututtuka a cikin mara lafiya a wannan lokacin sun dogara ne akan cutar da ta haifar da rashin lafiyar canzawa.

Yayin da yanayin ke tsananta, alama ta farko ta kowa ga kowane nau'in acidosis ya bayyana - karuwa, numfashi akai-akai. An yi bayanin shi ta hanyar haɓaka abubuwan da ke tattare da carbon dioxide a cikin jini yayin aiki da tsarin abubuwan ɓoye jiki. Lokacin da oxygen abinci na kyallen takarda fara, shortness na numfashi faruwa, numfashi zama pathological - shi zama m, hutu tsakanin numfashi taqaitaccen, sa'an nan gaba daya bace.

Tare da acidosis metabolic, akwai kwantar da hankulan adrenaline da magabata, saboda haka, aikin zuciya yana kara haɓaka, saboda abin da bugun jini yayi saurin ƙaruwa, zubar jini yana ƙaruwa a lokaci ɗaya, kuma matsin lamba ya hau. A hankali, sunadarai na membranes tantanin halitta sun rasa wasu ayyukan su, ion hydrogen yana shiga sel, kuma potassium ya barsu. Calcium yana barin kasusuwa; hauhawar jini yakan faru a cikin jini. Sakamakon wuce haddi na electrolytes na jini, alamu sun canza zuwa akasi: matsin lamba yana raguwa, arrhythmia na faruwa. Irin waɗannan alamun suna nuna cewa acidosis ya wuce zuwa mawuyacin mataki.

Daga cikin cututtukan da ke faruwa akai-akai, amai da gudawa kuma ana iya bambance su. Ana haifar dasu da maye tare da ketones, abubuwan da aka karɓa daga waje ko haɓaka sautin jijiya, wanda ke haifar da ƙara narkewa da narkewa.

Hakanan ana lura da cututtukan daga gefen tsarin juyayi na tsakiya: mai haƙuri yana nutsuwa a cikin fashewa, yanayin bacci, yana jin bacci. Tashin hankali na iya canzawa tare da fushi da fushi. Tare da karuwa a cikin acidosis, mai haƙuri ya rasa hankali.

Alamomin halayyar wasu nau'ikan acid metabolis:

• don ketoacidosis, ƙanshi na acetone daga fata da bakin mai haƙuri alama ce, zafin ciki mai zafi, tashin hankali na bangon ciki. Tare da ciwon sukari, ketoacidosis yana farawa ne kawai da babban sukari, wanda ke haɗuwa da ƙishirwa, polyuria da bushewar mucous membranes;
• alamun farko na acidosis da ke haifar da shan magunguna sun haɗa da raguwa a cikin tasirin su;
• lokacin da acidosis na metabolism ke haɗuwa da maye mai tsanani, mai haƙuri na iya fuskantar numfashin uncharacteristic - na sama, na al'ada;
• idan acidosis ya haifar da cutar koda, musamman gazawar koda, ana yawan ganin alamun munafunci: ƙwaƙwalwar ajiyar zuciya, ƙwaƙwalwar tsoka. Numfashin mai haƙuri na iya samun warin ammonia;
• increasedarin haɓakar lactic acid yayin lactic acidosis yana bayyana ta hanyar tsoka, yana ɗaukar nauyi a kansu. Idan sanadin lactic acidosis shine matsalolin huhu, fatar mai haƙuri ya fara jujjuya launin toka, a hankali ya juya ya zama mai ruwan ɗumi.

Bayyanar cututtuka na acidosis

Bayyanar cututtukan acidosis ana yin su ne a matakai biyu. Na farko yana tantance ko akwai motsi a cikin acidity na jini da nau'inta. Na biyu ya bayyana dalilin metabolos acidosis.

Za'a iya tantance yanayin acid-base, ko pH na jini, abubuwan da ke cikin oxygen da carbon dioxide a ciki a dakin gwaje-gwaje ta amfani da injin gas. Ana ɗaukar jini daga jijiya radial, wani lokacin daga capillaries akan yatsa. Binciken ba ya ɗaukar minti 15.

Don sanin nau'in acidosis a mafi yawan lokuta, nazarin kan matakin glucose da lactate a cikin jini, jikin ketone a cikin fitsari ya isa:

A mataki na jiyya, wajibi ne don kawar da cin zarafin da ya haifar da acidosis. Don gano shi, ana iya gudanar da bincike da yawa, dangane da cututtukan da aka gano a cikin mai haƙuri da hoton asibiti.

Babban sune janar da gwaje-gwaje na jini na halittun jini, urinalysis na gaba ɗaya.

Matsaloli masu yiwuwa:

1. Protein, ƙwayoyin koda, abubuwan silinda a cikin fitsari, da haɓaka jini nainininine yana nuna matsalolin koda.
2. Sugar a cikin fitsari yana nuna babban matsayi a cikin jini, mafi yawan lokuta saboda ciwon sukari ko matsanancin mataki na pancreatitis.
3. Haɓaka jini na leukocytes yana nuna cewa acidosis ya faru ne saboda kumburi da rashin aiki na ɗayan gabobin ciki. Neutrophils an haɓaka tare da cututtukan ƙwayar cuta, tsoffin ƙwayoyin cuta tare da cututtukan hoto.
4. An lura da haɓakawa da tarawar bilirubin ko raguwa a cikin ƙwayoyin jini tare da gazawar hanta, cirrhosis.

Dangane da sakamakon binciken, ana iya yin amfani da duban dan tayi, lissafin ko hoton maganadisu. Isarar da binciken ya ƙaddara ta likita, la'akari da abin da ake zargi da haɗarin acidosis metabolic.

Hanyoyin jiyya

Abu na farko da yakamata ayi idan bayyanar cututtuka ta sama shine a kira motar asibiti, tunda kula da acidosis a gida bashi da tasiri kuma yana da mutuƙar mutuwa. Sau da yawa shawarar da aka ba da shawarar tare da soda ba ta da amfani. Carbonate sodium lokacin da ya shiga cikin ciki zai zama mai ruwan 'ya'yan itace na ciki, ba zai iya shiga cikin jini ba, saboda haka, pH din zai kasance ba canzawa.

A asibiti don kula da acidosis, da farko suna ƙoƙarin kawar da dalilin da ya haifar da shi. A cikin ciwon sukari, ana rage sukarin jini ta hanyar gudanarwar insulin. Don ketoacidosis marasa ciwon sukari, ana iya buƙatar abinci mai ƙoshin abinci ko guban glucose. Ana cire bushewar ruwa ta hanyar zartar da aikin saline. Idan rashin jini ya faru lokacin da aka dawo da potassium zuwa sel, to ana gabatar da sinadarin chloride potassium. Tare da gazawar renal da guba tare da abubuwa masu kisa, an tsabtace jinin tare da cutar sankara.

Ana amfani da kulawar cikin ruwa na mafita don maganin alkaline azaman makoma ta ƙarshe, tunda zasu iya hana numfashi, rage matsin lamba, daɗa tasirin insulin, da yawan shan ruwa na iya haifar da alkalosis. Mafi yawancin lokuta, ana amfani da sodium bicarbonate da trometamol.

Ana amfani da sodium bicarbonate don acidosis metabolic mai zafi, lokacin da pH ya faɗi zuwa 7.1, kuma mai haƙuri yana da ƙarancin jini. Hakanan za'a iya amfani dashi don asarar carbonates ta hanyar narkewa da kuma magungunan ƙwayoyi. Adadin da ake buƙata ana lissafta shi ta hanyar dabara. Ana magance maganin a hankali, a ƙarƙashin kulawa da kullun abubuwan da ke cikin jini.

Trometamol yana iya ɗaukar ƙarin ions hydrogen, ba kawai a cikin jini ba, har ma a cikin sel. Ana amfani da wannan magani a lokuta inda acidosis na tsawan lokaci na iya zama haɗari ga zuciyar mai haƙuri. Da ake bukata a gabatar da trometamol shine aikin koda.

Idan an gudanar da aikin a cikin tsararren lokaci kuma an hana rikice-rikice, ana cire acidosis a ranar farko, kuma bayan mako guda za a fitar da mara lafiyar.