Chithandizo Chothandizira Metabolic Acidosis

Zamkati

• Kodi metabolic acidosis ndi chiyani?
• Chithandizo chimadalira chifukwa
• Mankhwala ochiritsira a metabolic acidosis
• Kubwezera kupuma
• Malipiro amadzimadzi
• Chithandizo cha matenda ashuga
• Bicarbonate ya sodium
• Kutulutsa magazi
• Mankhwala ena a kagayidwe kachakudya acidosis
• Kutenga

Kodi metabolic acidosis ndi chiyani?

Metabolic acidosis imachitika thupi lanu likakhala la acidic kuposa zoyambira. Matendawa amatchedwanso pachimake kagayidwe kachakudya acidosis. Ndizovuta zomwe zimachitika chifukwa cha zovuta zina zamatenda azachangu komanso zachangu. Acidosis imatha kuchitika msinkhu uliwonse; imatha kukhudza makanda, ana, komanso akulu.

Nthawi zambiri, thupi lanu limakhala ndi acid-base balance. Imayezedwa ndi mulingo wa pH. Mulingo wamankhwala amthupi ukhoza kukhala wowonjezera pazifukwa zambiri. Metabolic acidosis itha kuchitika ngati muli:

• kupanga asidi wambiri
• kupanga maziko ochepa kwambiri
• osachotsa zidulo mwachangu kapena zokwanira

Metabolic acidosis imatha kukhala yofatsa komanso yosakhalitsa mpaka yayikulu ndikuwopseza moyo. Mungafunike chithandizo chamankhwala. Izi zimatha kukhudza momwe thupi lanu limagwirira ntchito. Ma acid ambiri mthupi amathanso kubweretsa mavuto ena azaumoyo.

Chithandizo chimadalira chifukwa

Chithandizo cha metabolic acidosis chimadalira chifukwa. Zina mwazifukwa ndizakanthawi ndipo acidosis imatha popanda chithandizo.

Vutoli litha kukhalanso vuto lamavuto ena azaumoyo. Kuthana ndi vutoli kungathandize kupewa kapena kuchiza matenda amadzimadzi.

Metabolic acidosis ndi acidosis chifukwa cha kusintha komwe kumakhudza kayendedwe ka magazi, impso, kapena chimbudzi. Izi zitha kuyambitsidwa ndi:

• Matenda a shuga ketoacidosis. Thupi limawotcha mafuta m'malo mwa shuga, ndikupangitsa ma ketoni kapena zidulo kukula.
• Kutsekula m'mimba. Kutsekula m'mimba kapena kusanza kumatha kubweretsa hyperchloremic acidosis. Izi zimayambitsa m'munsi otsika omwe amatchedwa bicarbonate, omwe amathandizira kuchepetsa acid m'magazi.
• Ntchito yosauka ya impso. Matenda a impso ndi impso kulephera kumatha kuyambitsa matenda a impso a acidosis. Izi zimachitika pamene impso zanu sizingathe kutulutsa zidulo kudzera mumkodzo moyenera.
• Lactic acidosis. Izi zimachitika thupi likagundika kapena kugwiritsira ntchito lactic acid. Zoyambitsa zimaphatikizapo kulephera kwa mtima, kumangidwa kwamtima, komanso sepsis yayikulu.
• Zakudya. Kudya zopangira nyama kungapangitse zidulo zambiri m'thupi.
• Chitani masewera olimbitsa thupi. Thupi limapanga asidi wambiri wa lactic ngati simukupeza mpweya wokwanira kwa nthawi yayitali pakuchita masewera olimbitsa thupi.

Zina mwa zifukwa za acidosis ndizo:

• kumwa mowa kapena kugwiritsa ntchito mankhwala osokoneza bongo
• mankhwala omwe amapuma pang'onopang'ono ngati benzodiazepines, mankhwala ogona, mankhwala opweteka, ndi mankhwala ena osokoneza bongo

Zinthu monga mphumu, matenda osokoneza bongo (COPD), chibayo, ndi kugona tulo kumatha kuyambitsa mtundu wina wa acidosis wotchedwa kupuma acidosis. Izi zimachitika ngati mapapu sangathe kupuma bwino mpweya woipa. Carbon dioxide yochuluka imakweza magazi m'magazi.

Mankhwala ochiritsira a metabolic acidosis

Chithandizo cha metabolic acidosis chimagwira m'njira zitatu zazikulu:

• kuchotsa kapena kuchotsa asidi owonjezera
• buffering zidulo ndizoyambira magazi
• kuteteza thupi kuti lisapangitse zidulo zambiri

Mitundu ina yothandizidwa ndi metabolic acidosis ndi iyi:

Kubwezera kupuma

Ngati muli ndi kupuma kwa acidosis, mayeso amwazi wamagazi amawonetsa kuchuluka kwa kaboni dayokisaidi. Mayesero ena oti mupeze mtundu uwu wa kagayidwe kachakudya acidosis akuphatikizapo kuyesa kupuma kuti muwonetse momwe mapapo akugwirira ntchito, ndi X-ray pachifuwa kapena CT scan kuti ayang'anire matenda am'mapapo kapena kutsekeka.

Mankhwala opatsirana a metabolic acidosis ndi awa:

• mankhwala a bronchodilator (Ventolin inhaler)
• mankhwala a steroid
• mpweya
• makina othandizira mpweya (CPAP kapena BiPaP)
• makina opumira (pamavuto akulu)
• chithandizo chosiya kusuta

Malipiro amadzimadzi

Chithandizo cha matenda ashuga

Kuthetsa kagayidwe kachakudya komwe kamayambitsa matenda ashuga osalandiridwa kapena osalamulirika kumaphatikizapo chithandizo cha matenda ashuga. Ngati muli ndi matenda ashuga ketoacidosis, kuyezetsa magazi kwanu kukuwonetsa kuchuluka kwa shuga wamagazi (hyperglycemia). Chithandizochi chimaphatikizapo kuwerengetsa misinkhu ya shuga m'magazi kuthandiza thupi kuchotsa ndikusiya kupanga zidulo:

• insulini
• mankhwala a shuga
• madzi
• ma electrolyte (sodium, chloride, potaziyamu)

Mankhwala a insulin amangogwira ntchito ngati matenda ashuga akuyambitsa metabolic acidosis.

Bicarbonate ya sodium

Powonjezera maziko olimbana ndi milingo yayikulu yama asidi amathandizira mitundu ina ya metabolic acidosis. Mankhwala a intravenous (IV) omwe amatchedwa sodium bicarbonate ndi njira imodzi yothetsera mavitamini m'magazi. Amagwiritsidwa ntchito pochiza zinthu zomwe zimayambitsa acidosis kudzera mu kutaya kwa bicarbonate (m'munsi). Izi zitha kuchitika chifukwa cha impso zina, kutsegula m'mimba, ndi kusanza.

Kutulutsa magazi

Dialysis ndi chithandizo cha matenda akulu a impso kapena kulephera kwa impso. Kuyesedwa kwa magazi pamavuto osagwirizana ndi impso kumawonetsa kuchuluka kwa urea ndi mitundu ina ya asidi. Kuyezetsa mkodzo kungasonyezenso momwe impso zikugwirira ntchito bwino.

Dialysis imathandiza kuchotsa zidulo zowonjezera ndi zonyansa zina m'magazi. Mu hemodialysis, makina amasefa magazi ndikuchotsa zonyansa ndi madzi ena owonjezera. Peritoneal dialysis ndi mankhwala omwe amagwiritsa ntchito yankho mkati mwa thupi lanu kuyamwa zinyalala.

Mankhwala ena a kagayidwe kachakudya acidosis

• Inotropes ndi mankhwala ena amathandizira kukonza magwiridwe antchito amtima pamikhalidwe monga kuthamanga kwa magazi komanso kulephera kwa mtima. Izi zimapangitsa mpweya wabwino kuyenda m'thupi ndikuchepetsa magawo a asidi m'magazi. Kuwerengera kwa magazi, kuyesa magazi, ndi ECG (electrocardiogram) ziwonetsa ngati vuto la mtima likuyambitsa metabolic acidosis.
• Metabolic acidosis chifukwa chakumwa mowa kapena poizoni wamankhwala amathandizidwa ndi detoxification. Anthu ena amafunikanso hemodialysis kuti athetse poizoni. Kuyezetsa magazi kuphatikiza kuyeserera kwa chiwindi kudzawonetsa kuchepa kwa asidi-base. Kuyezetsa mkodzo ndi kuyesa magazi kwamagazi kumatha kuwonetsanso kuti poyizoni ndi woopsa bwanji.

Kutenga

Metabolic acidosis ndi mtundu wa acidosis womwe nthawi zambiri umayambitsidwa ndimatenda omwe amakhudza impso, mtima, chimbudzi, kapena metabolism. Zidulo zimakhazikika m'magazi ndipo zimatha kubweretsa zovuta zovuta ngati sizichiritsidwa.

Chithandizo cha kagayidwe kachakudya acidosis chimadalira mkhalidwewo. Mitundu ina ndi yofatsa kapena yakanthawi ndipo safuna chithandizo. Metabolic acidosis ikhoza kukhala chizindikiro kuti china chake chalakwika mthupi lanu. Mungafunike chithandizo chamankhwala ena kuti muchepetse zidulo ndi maziko m'magazi anu.

Ngati muli ndi metabolic acidosis kapena muli ndi matenda omwe angayambitse acidosis, pitani kuchipatala nthawi zonse. Tengani mankhwala onse monga mwalembedwera ndikutsatira malangizo azakudya. Kuyezetsa magazi pafupipafupi ndi zina zowunika kumatha kuthandiza kuti magawo anu a asidi akhale olingana.