pH Kusalongosoka: Momwe Thupi Lanu Limasungilira Kusamalitsa Kwama Acid-Base

Zamkati

• Momwe mapapu ndi impso zimakhalira ndi pH bwino
• pH kusamala
• Mitundu ya acidosis
• Kupuma acidosis
• Matenda a acidosis
• Mitundu ya alkalosis
• Kupuma kwa alkalosis
• Kagayidwe kachakudya alkalosis
• Kodi amawapeza bwanji?
• Kuthetsa kusamvana kwa pH
• Chiwonetsero

Kodi pH balance ndi chiyani?

Kulemera kwa pH kwa thupi lanu, komwe kumatchedwanso kuti acid-base balance, ndiye mulingo wa zidulo ndi mabesi m'magazi anu momwe thupi lanu limagwira ntchito bwino.

Thupi lamunthu limamangidwa mwachilengedwe kuti lizikhala ndi acidity komanso alkalinity wathanzi. Mapapu ndi impso zimathandiza kwambiri pantchitoyi. Mulingo wabwinobwino wa pH wamagazi ndi 7.40 pamlingo wa 0 mpaka 14, pomwe 0 ndiye acidic kwambiri ndipo 14 ndiyofunikira kwambiri. Mtengo uwu umatha kusiyanasiyana pang'ono mbali iliyonse.

Ngati mapapo kapena impso zikulephera kugwira ntchito, pH ya magazi anu imatha kukhala yoperewera. Kusokonezeka muyezo wa acid-base kungayambitse matenda monga acidosis ndi alkalosis. Zonsezi zimafunikira chithandizo kuchokera kwa akatswiri azachipatala, osati kusintha kwa zakudya zokha.

Momwe mapapu ndi impso zimakhalira ndi pH bwino

Mapapu amalamulira pH thupi lanu potulutsa carbon dioxide.

Mpweya woipa ndi gawo lowonjezera pang'ono. Ndizotayanso zopangidwa ndimaselo mthupi momwe amagwiritsira ntchito mpweya. Maselo amatulutsa magazi anu, ndipo amapita nawo m'mapapu anu.

Mukatulutsa mpweya, mukutulutsa kaboni dayokisaidi, njira yomwe imathandizanso kuwongolera kuchuluka kwa pH mthupi lanu pochepetsa acidity.

Kuchuluka kwa kaboni dayokisaidi amene mumatulutsa ndi ntchito ya momwe mumapumira kapena kutulutsa mpweya wanu. Ubongo wanu umayang'anitsitsa izi nthawi zonse kuti mukhale ndi pH yoyenera mthupi lanu.

Impso zimathandiza mapapu kukhalabe ndi asidi-poyambira pochotsa zidulo kapena zidazi m'magazi. Impso zimakhudza acidity zimagwira ntchito pang'onopang'ono kuposa momwe zimakhalira m'mapapu.

pH kusamala

Kusagwirizana kwa pH yamagazi kumatha kubweretsa zinthu ziwiri: acidosis ndi alkalosis.

Acidosis imatanthawuza kukhala ndi magazi omwe ndi acidic kwambiri, kapena pH yamagazi ochepera 7.35. Alkalosis amatanthauza kukhala ndi magazi omwe ndi ofunika kwambiri, kapena pH yamagazi yoposa 7.45.

Pali mitundu yosiyanasiyana ya acidosis ndi alkalosis kutengera zomwe zimayambitsa.

Pamene acidosis kapena alkalosis imayambitsidwa ndi vuto lamapapu kapena vuto la kutulutsa mpweya, amatchedwa "kupuma." Pamene acidosis kapena alkalosis imayamba chifukwa cha vuto la impso, amatchedwa "kagayidwe kachakudya."

Mitundu ya acidosis

Kupuma acidosis

Kupuma kwa acidosis kumayambitsidwa ndi mapapu anu osakhoza kuchotsa mpweya woipa wokwanira mukamatulutsa mpweya. Izi zitha kuchitika mapapu anu akakhudzidwa ndi matenda kapena matenda ena.

Zina zomwe zingayambitse kupuma kwa acidosis ndi monga:

• mphumu
• emphysema
• chibayo (chachikulu)

Kupuma kwa acidosis kungayambitsenso kumwa mankhwala ozunguza bongo kapena kugona tulo. Ubongo ndi zovuta zamanjenje zomwe zimayambitsa kupuma zingayambitsenso kupuma kwa acidosis.

Zizindikiro zoyambirira za kupuma kwa acidosis ndi izi:

• kugona kwambiri
• kutopa
• chisokonezo
• mutu

Ngati sanalandire chithandizo, kupuma kwa acidosis kumatha kukhala koopsa ndipo kumatha kukomoka kapena kufa.

Matenda a acidosis

Metabolic acidosis ndikumanga kwa asidi m'thupi komwe kumayambira impso. Zimachitika pamene thupi lanu silingathe kuchotsa asidi owonjezera kapena kutaya kwambiri. Zomwe zimayambitsa ndi monga:

• kukhala ndi sodium bicarbonate yocheperako m'magazi anu, vuto lomwe lingakhale kusanza koopsa kapena kutsegula m'mimba
• kuchuluka kwa ma ketoni chifukwa chosowa insulin, matenda omwe amadziwika kuti ketoacidosis omwe anthu odwala matenda ashuga amakumana nawo
• kuchuluka kwa lactic acid, vuto lomwe lingachitike chifukwa chomwa mowa mwauchidakwa, khansa, ndi khunyu
• Kulephera kwa impso kutulutsa asidi m'magazi, omwe amadziwika kuti renal tubular acidosis

Metabolic acidosis amathanso kuyambitsidwa ndi kumeza zinthu zina, monga:

• methanol
• zoletsa kuzizira
• aspirin (muyezo waukulu)

Zizindikiro za kagayidwe kachakudya acidosis zitha kuphatikizira nseru, kusanza, ndi kutopa kwambiri.

Mofanana ndi kupuma kwa acidosis, kagayidwe kachakudya kwa acidosis kumatha kubweretsa chikomokere kapena kufa ngati sikusamalidwe.

Mitundu ya alkalosis

Kupuma kwa alkalosis

Respiratory alkalosis ndipamene mulibe kaboni dayokisaidi wochuluka m'magazi anu. Zomwe zimayambitsa kupuma kwa alkalosis zimaphatikizira kupuma mpweya chifukwa cha nkhawa, aspirin bongo, kutentha thupi kwambiri, komanso mwina kupweteka.

Zizindikiro za kupuma kwa alkalosis ndikuphwanya kwa minofu ndi kugwedezeka. Mwinanso mungaone kumenyedwa kwa zala zanu, zala zakumapazi, ndi milomo, komanso kukwiya.

Kagayidwe kachakudya alkalosis

Metabolic alkalosis imachitika ma bicarbonate m'magazi anu akakhala okwera kwambiri kapena thupi lanu limataya asidi wambiri. Itha kubweretsedwa ndi nthawi yayitali ya kusanza, kumwa mopitilira muyeso kwa okodzetsa, kapena gland wambiri wa adrenal.

Zina zomwe zingayambitse kagayidwe kachakudya ndi kuwonongeka kwa impso komwe kumadza chifukwa cha kutayika kwamadzimadzi kapena kumeza soda yambiri.

Zizindikiro za kagayidwe kachakudya alkalosis ndizofanana ndi zomwe tafotokozazi pamwambapa za kupuma kwa alkalosis.

Kodi amawapeza bwanji?

Ngati mukuganiza kuti muli ndi vuto la pH, ndikofunikira kupita kuchipatala mwachangu. Kuphatikiza pa kutenga mbiri yanu yazachipatala, adokotala adzagwiritsa ntchito mayeso osiyanasiyana amwazi ndi mkodzo kuti adziwe chomwe chikuyambitsa vuto lanu la pH.

Mayeso omwe angakhalepo ndi awa:

• magazi ochepa kuti ayang'ane mpweya wa oxygen ndi carbon dioxide komanso pH yamagazi
• Gawo loyambira lamagetsi kuti muwone momwe impso imagwirira ntchito komanso michere yambiri
• urinalysis kuti muwone ngati kuthetseratu ma acid ndi maziko
• mkodzo mayeso a pH kuyesa kuyeza kwake ndi acidity ya mkodzo

Komabe, kutengera matenda anu komanso zina zomwe adokotala akutenga, mayeso ena atha kuchitidwa. Ngati muli ndi matenda ashuga, kuchuluka kwanu kwa glucose ndi ketone kumatha kuyesedwa. Ngati mwadya ethylene glycol kapena methylene, mutha kuyesedwa osmolality.

Kuthetsa kusamvana kwa pH

Kuchiza kwa kusamvana kwa pH kudzasiyana kwambiri kutengera ngati mukukumana ndi acidosis kapena alkalosis, komanso chomwe chimayambitsa. Cholinga chachikulu ndikubwezera asidi-base mulingo woyenera.

Chithandizo cha Acidosis chingaphatikizepo:

• pakamwa kapena kudzera mu intravenous sodium bicarbonate kukweza magazi pH
• mankhwala ochepetsa mayendedwe anu
• chida chopitilira mpweya wabwino (CPAP) chothandizira kupuma
• sodium citrate pofuna kuchiza impso kulephera
• insulini komanso madzi am'mitsempha yochizira ketoacidosis

Chithandizo cha alkalosis chingaphatikizepo:

• kupuma pang'ono ngati chomwe chimayambitsa matendawa ndi kupuma mpweya
• mankhwala a oxygen
• mankhwala obwezeretsa michere, monga chloride kapena potaziyamu
• madzi kapena zakumwa za electrolyte kuti zibwezeretse mphamvu zamagetsi

Chiwonetsero

PH yanu ndiyofunika kuti mukhale ndi thanzi labwino, ndipo mutha kukhulupirira kuti thupi lanu lili ndi zida zokwanira kuti lizitha kusungabe ndekha. Komabe, ngati dokotala atapeza kuti mulingo wanu wadzere chifukwa chakuyesa magazi ndi mkodzo, adzayesanso zina kuti adziwe chifukwa chake.

Choyambitsacho chitha kupezeka, mudzapatsidwa dongosolo la chithandizo kuti mukonze ndikubwezeretsa pH ya thupi lanu pamzere.