Kupuma acidosis

Kupuma kwa acidosis ndi vuto lomwe limachitika pomwe mapapo sangathe kuchotsa mpweya wonse womwe thupi limatulutsa. Izi zimapangitsa kuti madzi amthupi, makamaka magazi, akhale acidic.

Zomwe zimayambitsa kupuma acidosis ndizo:

• Matenda apanjira, monga mphumu ndi COPD
• Matenda am'mapapo, monga pulmonary fibrosis, omwe amayambitsa zipsera ndi kunenepa kwamapapu
• Matenda omwe angakhudze chifuwa, monga scoliosis
• Matenda omwe amakhudza mitsempha ndi minofu yomwe imafotokoza kuti mapapu amakula kapena kutuluka
• Mankhwala omwe amapondereza kupuma, kuphatikizapo mankhwala opweteka kwambiri, monga ma narcotic (opioids), ndi "downers," monga benzodiazepines, nthawi zambiri akaphatikizidwa ndi mowa
• Kunenepa kwambiri, komwe kumalepheretsa kuchuluka kwa mapapu
• Kulepheretsa kugona tulo

Matenda opuma acidosis amapezeka nthawi yayitali. Izi zimabweretsa mkhalidwe wokhazikika, chifukwa impso zimawonjezera mankhwala amthupi, monga bicarbonate, omwe amathandizira kubwezeretsa mphamvu ya asidi-thupi.

Acute kupuma acidosis ndi momwe mpweya woipa umakhalira mwachangu kwambiri, impso zisanabwezeretse thupi kuti likhale lolimba.

Anthu ena omwe ali ndi vuto la kupuma kwa acidosis amatenga chifuwa chachikulu cha acidosis chifukwa matenda oyambitsa matendawa amapangitsa kuti thupi lawo likule kwambiri ndikusokoneza kuchuluka kwa asidi m'thupi mwawo.

Zizindikiro zimaphatikizapo:

• Kusokonezeka
• Nkhawa
• Kutopa kosavuta
• Kukonda
• Kupuma pang'ono
• Kugona
• Kugwedezeka (kugwedezeka)
• Khungu lotentha komanso loyera
• Kutuluka thukuta

Wothandizira zaumoyo adzayesa thupi ndikufunsa za zizindikiro.

Mayeso omwe angachitike ndi awa:

• Mpweya wamagazi wamagazi, womwe umayeza mpweya wa oxygen ndi kaboni dayokisaidi m'magazi
• Gulu loyambira lama metabolic
• X-ray pachifuwa
• Kujambula kwa CT pachifuwa
• Ntchito yama pulmonary kuyesa kupuma komanso momwe mapapo amagwirira ntchito

Chithandizochi chimalimbana ndi matendawa, ndipo atha kuphatikizanso:

• Mankhwala a Bronchodilator ndi corticosteroids kuti athetse mitundu ina yolepheretsa kuyenda kwa ndege
• Mpweya wabwino (womwe nthawi zina umatchedwa CPAP kapena BiPAP) kapena makina opumira, ngati kuli kofunikira
• Mpweya ngati mpweya wa magazi ndi wochepa
• Chithandizo chosiya kusuta
• Pazovuta zazikulu, makina opumira (othandizira mpweya) angafunike
• Kusintha mankhwala pakafunika kutero

Momwe mumakhalira bwino zimatengera matenda omwe amayambitsa kupuma kwa acidosis.

Zovuta zomwe zingakhalepo ndi izi:

• Ntchito yosagwira bwino ziwalo
• Kulephera kupuma
• Chodabwitsa

Matenda opumira acidosis ndi vuto lazachipatala. Funsani thandizo lachipatala nthawi yomweyo ngati muli ndi zizindikiro za matendawa.

Itanani omwe akukuthandizani ngati muli ndi zizindikilo za matenda am'mapapo omwe amakula mwadzidzidzi.

Osasuta. Kusuta kumabweretsa kukula kwa matenda ambiri am'mapapo omwe angayambitse kupuma kwa acidosis.

Kuchepetsa thupi kungathandize kupewa kupuma kwa acidosis chifukwa cha kunenepa kwambiri (kunenepa-hypoventilation syndrome).

Samalani ndikumwa mankhwala ogonetsa pansi, ndipo osaphatikiza mankhwalawa ndi mowa.

Gwiritsani ntchito chida chanu cha CPAP pafupipafupi ngati mwapatsidwa.

Mpweya kulephera; Kulephera kupuma; Acidosis - kupuma

• Dongosolo kupuma

Effros RM, Swenson ER. Kulimbitsa pakati pa acid. Mu: Broaddus VC, Mason RJ, Ernst JD, et al, olemba. Murray ndi Nadel's Bookbook of Respiratory Medicine. Lachisanu ndi chimodzi. Philadelphia, PA: Elsevier Saunders; 2016: mutu 7.

Seifter JL. Mavuto amadzimadzi. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 110.

Wopopera RJ. Mavuto amadzimadzi. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: chap 116.