Kuyesa Magazi a CO2

Zamkati

• Kodi kuyezetsa magazi kwa CO2 ndi chiyani?
• Chifukwa chomwe kuyezetsa magazi kwa CO2 kulamulidwa
• Momwe magazi amatengera
• Kupereka magazi magazi
• Mwazi wamagazi wamagazi
• Momwe mungakonzekerere magazi anu
• Kuopsa kwa mayeso a magazi a CO2
• Zotsatira zakuyesa
• Bicarbonate yotsika (HCO3)
• Bicarbonate wapamwamba (HCO3)
• Kuwona kwakanthawi

Kodi kuyezetsa magazi kwa CO2 ndi chiyani?

Mayeso a magazi a CO2 amayesa kuchuluka kwa kaboni dayokisaidi (CO2) mu seramu wamagazi, womwe ndi gawo lamadzi m'magazi. Mayeso a CO2 amathanso kutchedwa:

• kuyesa kwa carbon dioxide
• mayeso a TCO2
• kuyesa kwathunthu kwa CO2
• mayeso a bicarbonate
• mayeso a HCO3
• seramu yoyesera ya CO2

Mutha kulandira mayeso a CO2 ngati gawo la kagayidwe kachakudya. Gulu lamagetsi ndi gulu la mayeso omwe amayesa ma electrolyte ndi mpweya wamagazi.

Thupi liri ndi mitundu iwiri yayikulu ya CO2:

• HCO3 (bicarbonate, mawonekedwe akulu a CO2 mthupi)
• PCO2 (mpweya woipa)

Dokotala wanu amatha kugwiritsa ntchito mayeso awa kuti awone ngati pali kusamvana pakati pa oxygen ndi kaboni dayokisaidi m'magazi anu kapena kusamvana kwa pH m'magazi anu. Kusiyanaku kumatha kukhala zizindikilo za impso, kupuma, kapena vuto la kagayidwe kake.

Chifukwa chomwe kuyezetsa magazi kwa CO2 kulamulidwa

Dokotala wanu adzaitanitsa kuyezetsa magazi kwa CO2 kutengera zomwe muli nazo. Zizindikiro zakusalinganika kwa oxygen ndi kaboni dayokisaidi kapena kusalingana kwa pH zimaphatikizapo:

• kupuma movutikira
• mavuto ena opuma
• nseru
• kusanza

Zizindikirozi zitha kuloza kusokonekera kwamapapu komwe kumakhudzana ndikusinthana pakati pa oxygen ndi kaboni dayokisaidi.

Muyenera kuyeza magazi anu okosijeni ndi kaboni dayokisaidi omwe amayesedwa pafupipafupi ngati muli ndi mankhwala a oxygen kapena mukuchita maopareshoni ena.

Momwe magazi amatengera

Zitsanzo zamagazi pakuyesedwa kwa magazi a CO2 atha kutengedwa kuchokera kumtsempha kapena mtsempha.

Kupereka magazi magazi

Venipuncture ndi mawu omwe amagwiritsidwa ntchito pofotokoza za magazi oyambira omwe amachokera mumtsempha. Dokotala wanu angakulamulireni magazi osavuta ngati akufuna kungoyesa HCO3.

Kuti mupeze magazi obwezeretsanso magazi, wothandizira zaumoyo:

• amatsuka malowa (nthawi zambiri mkati mwa chigongono) ndi mankhwala opha majeremusi
• kukulunga lamba wokulirapo kuzungulira mkono wanu wakumwamba kuti mitsempha itupuke ndi magazi
• mokoma amalowetsa singano mumtsempha ndikusonkhanitsa magazi mu chubu cholumikizidwa mpaka chadzaza
• amachotsa zotanuka ndi singano
• Amaphimba bala lopanda ndi gauze wosabala kuti athetse magazi

Mwazi wamagazi wamagazi

Kusanthula mpweya wamagazi nthawi zambiri kumakhala gawo la mayeso a CO2. Kusanthula mpweya wamagazi kumafunikira magazi ochepa chifukwa mpweya ndi milingo ya pH m'mitsempha yosiyana ndi magazi am'magazi (magazi ochokera mumitsempha).

Mitsempha imanyamula mpweya mthupi lonse. Mitsempha imanyamula zonyansa zamagetsi ndi magazi opopa mphamvu m'mapapu kuti akatulutsidwe ngati kaboni dayokisaidi ndi impso kuti zikaperekedwe mkodzo.

Njira yovutayi imachitika ndi dokotala wophunzitsidwa kuti athe kupeza mitsempha. Mitsempha yamagazi nthawi zambiri imachotsedwa pamitsempha m'manja yotchedwa radial artery. Uwu ndiye mtsempha wamagazi waukulu molingana ndi chala chamanthu, pomwe mutha kumva kugunda kwanu.

Kapenanso, magazi amatha kusonkhanitsidwa kuchokera pamitsempha yama brachial m'zigongono kapena mtsempha wachikazi m'mimba. Kuti atenge magazi ochepa, adokotala:

• amatsuka malowa ndi mankhwala opha tizilombo toyambitsa matenda
• mokoma amalowetsa singano mumtsempha ndikutulutsa magazi mumachubu yolumikizidwa mpaka itadzaza
• amachotsa singano
• amapaka mphamvu pachilondacho kwa mphindi zosachepera zisanu kuti magazi asiye kutuluka. (Mitsempha imanyamula magazi kuthamanga kwambiri kuposa mitsempha, motero zimatenga nthawi yochulukirapo kuti magazi apange magazi.)
• imayika kukulunga mozungulira malo obowoleza omwe adzafunika kukhalabe m'malo kwa ola limodzi

Momwe mungakonzekerere magazi anu

Dokotala wanu akhoza kukupemphani kuti musale kudya, kapena musiye kudya ndi kumwa, musanayezetse magazi. Dokotala wanu amathanso kukupemphani kuti musiye kumwa mankhwala musanayesedwe monga corticosteroids kapena ma antacids. Mankhwalawa amachulukitsa kuchuluka kwa bicarbonate mthupi.

Kuopsa kwa mayeso a magazi a CO2

Pali zoopsa zochepa zomwe zimadza chifukwa chobwezeretsa magazi komanso magazi ochepa. Izi zikuphatikiza:

• kutaya magazi kwambiri
• kukomoka
• mutu wopepuka
• hematoma, lomwe ndi mtanda wamagazi pansi pa khungu
• matenda pamalo opumira

Mukakoka magazi, dokotala wanu adzaonetsetsa kuti mukumva bwino ndipo adzakuuzani momwe mungasamalire malo obowolako kuti muchepetse mwayi wotenga matenda.

Zotsatira zakuyesa

Mtundu wabwinobwino wa CO2 ndi 23 mpaka 29 mEq / L (milliequivalent unit pa lita imodzi yamagazi).

Kuyezetsa magazi nthawi zambiri kumayeza pH yamagazi limodzi ndi milingo ya CO2 kuti mudziwe zomwe zimayambitsa matenda anu. Magazi pH ndiyeso ya acidity kapena alkalinity. Alkalosis ndipamene madzi amthupi lanu amakhala amchere kwambiri. Acidosis, mbali inayo, ndi pamene madzi amthupi lanu amakhala ndi acidic.

Nthawi zambiri, magazi amakhala ofunikira pang'ono ndi muyeso wa pH pafupifupi 7.4 osungidwa ndi thupi. Mitundu yabwinobwino kuyambira 7.35 mpaka 7.45 imawoneka ngati yopanda ndale. Kuchuluka kwa magazi pH ochepera 7.35 kumawerengedwa kuti ndi acidic. Chinthu chimakhala chamchere kwambiri pamene magazi ake a pH amaposa 7.45.

Bicarbonate yotsika (HCO3)

Zotsatira zoyesera za bicarbonate yotsika ndi pH yochepera (yochepera 7.35) ndi vuto lotchedwa metabolic acidosis. Zomwe zimayambitsa ndi izi:

• impso kulephera
• kutsegula m'mimba kwambiri
• lactic acidosis
• kugwidwa
• khansa
• kusowa kwa mpweya kwanthawi yayitali kuchokera ku kuchepa kwa magazi m'thupi, kulephera kwa mtima, kapena kusokonezeka
• matenda ashuga ketoacidosis (matenda ashuga acidosis)

Zotsatira zoyesera za bicarbonate yotsika ndi pH yayikulu (yoposa 7.45) ndimavuto otchedwa kupuma alkalosis. Zomwe zimayambitsa ndi izi:

• kutulutsa mpweya
• malungo
• ululu
• nkhawa

Bicarbonate wapamwamba (HCO3)

Chotsatira cha bicarbonate ndi pH yochepa (yochepera 7.35) ndi vuto lotchedwa kupuma acidosis. Zomwe zimayambitsa ndi izi:

• chibayo
• Matenda osokoneza bongo (COPD)
• mphumu
• m'mapapo mwanga fibrosis
• kukhudzana ndi mankhwala owopsa
• mankhwala omwe amaletsa kupuma, makamaka akaphatikizidwa ndi mowa
• chifuwa chachikulu
• khansa ya m'mapapo
• Matenda oopsa
• kunenepa kwambiri

Chotsatira cha bicarbonate ndi pH yapamwamba (yoposa 7.45) ndi vuto lotchedwa metabolic alkalosis. Zomwe zimayambitsa ndi izi:

• kusanza kosatha
• potaziyamu otsika
• hypoventilation, yomwe imakhudza kupuma pang'onopang'ono ndikuchepetsa kuchotsedwa kwa CO2

Kuwona kwakanthawi

Ngati dokotala atapeza kusayenerera kwa CO2 komwe kumanena za acidosis kapena alkalosis, ayang'ana zomwe zayambitsa kusamvana ndikuzichitira moyenera. Chifukwa zimayambitsa zosiyanasiyana, chithandizo chitha kuphatikizira kusintha kwa moyo, mankhwala, ndi opaleshoni.