Umhlahlandlela Wokwelapha weMetabolic Acidosis

-Delile

• Kuyini i-metabolic acidosis?
• Ukwelashwa kuya ngesizathu
• Ukwelashwa okuvamile kwe-metabolic acidosis
• Isinxephezelo sokuphefumula
• Isinxephezelo se-Metabolic
• Ukwelashwa kwesifo sikashukela
• IV sodium bicarbonate
• Ukuhlolwa kweHemodialysis
• Ezinye izindlela zokwelapha i-metabolic acidosis
• Ukuthatha

Kuyini i-metabolic acidosis?

I-Metabolic acidosis yenzeka lapho umzimba wakho une-asidi eningi kuneyisisekelo. Lesi simo sibizwa nangokuthi i-acute metabolic acidosis. Kungumthelela ojwayelekile wezinkinga ezithile ezingapheli neziphuthumayo. I-Acidosis ingenzeka nganoma yisiphi isikhathi; kungathinta izinsana, izingane, nabantu abadala.

Ngokuvamile, umzimba wakho une-acid-base balance. Kukalwa ngezinga le-pH. Izinga lamakhemikhali lomzimba lingaba yi-acidic ngezizathu eziningi. I-metabolic acidosis ingenzeka uma:

• ukwenza i-asidi eningi kakhulu
• ukwenza isisekelo esincane kakhulu
• ukungasusi ama-asidi ngokushesha noma kahle ngokwanele

I-Metabolic acidosis ingaba mnene futhi ibe yesikhashana ibe yimbi futhi isongele impilo. Ungadinga ukwelashwa. Lesi simo singathinta ukusebenza komzimba wakho. Ama-acid amaningi emzimbeni angaholela nakwezinye izinkinga zempilo.

Ukwelashwa kuya ngesizathu

Ukwelashwa kwe-metabolic acidosis kuya ngesizathu. Ezinye izimbangela zingezesikhashana kanti i-acidosis izophela ngaphandle kokwelashwa.

Lesi simo singaba inkinga yezinye izinkinga zempilo ezingamahlalakhona. Ukwelapha isimo esingaphansi kungasiza ekuvikeleni noma ekwelapheni i-metabolic acidosis.

I-Metabolic acidosis i-acidosis ngenxa yezinguquko ezithinta ukujikeleza kwegazi, izinso, noma ukugaya ukudla. Lokhu kungabangelwa:

• I-ketoacidosis yesifo sikashukela. Umzimba ushisa amanoni esikhundleni sikashukela, ubangele ukuba kwakheke ama-ketone noma ama-acid.
• Uhudo. Uhudo olunzima noma ukuhlanza kungaholela ku-hyperchloremic acidosis. Lokhu kubangela amazinga aphansi esisekelo okuthiwa i-bicarbonate, esiza ukulinganisa ama-acid egazini.
• Umsebenzi ombi wezinso. Isifo sezinso nokuhluleka kwezinso kungaholela ku-renal tubular acidosis. Lokhu kwenzeka lapho izinso zakho zingakwazi ukukhipha izihlungi ngaphandle komchamo kahle.
• I-Lactic acidosis. Lokhu kwenzeka lapho umzimba ukhiqiza ngokweqile noma ungasebenzisi i-lactic acid ngokweqile. Izimbangela zifaka ukwehluleka kwenhliziyo, ukuboshwa kwenhliziyo, kanye ne-sepsis enamandla.
• Ukudla. Ukudla imikhiqizo yezilwane eyeqile kungadala ama-acid amaningi emzimbeni.
• Ukuzivocavoca umzimba. Umzimba wenza i-lactic acid eningi uma ungatholi i-oxygen eyanele isikhathi eside ngesikhathi sokuzivocavoca okukhulu.

Ezinye izimbangela ze-acidosis zifaka:

• ukusetshenziswa kabi kotshwala noma izidakamizwa
• imishanguzo ephefumula kancane njenge-benzodiazepines, imithi yokulala, imithi yezinhlungu, kanye nezidakamizwa ezithile

Izimo ezinjengesifuba somoya, izifo ezingapheli zokuphefumula kwamaphaphu (COPD), i-pneumonia, ne-apnea yokulala kungadala olunye uhlobo lwe-acidosis ebizwa ngokuthi i-respiratory acidosis. Lokhu kwenzeka uma amaphaphu engakwazi ukuphefumula kahle isikhutha. Isikhutha esiningi sinyusa amazinga e-acid egazi.

Ukwelashwa okuvamile kwe-metabolic acidosis

Ukwelashwa kwe-metabolic acidosis kusebenza ngezindlela ezintathu eziyinhloko:

• ukukhipha noma ukususa ama-acid amaningi
• ukugcina ama-acid ngesisekelo sokulinganisa i-acidity yegazi
• ukuvimbela umzimba ekwenzeni ama-acid amaningi kakhulu

Ezinye izinhlobo zokwelashwa kwe-metabolic acidosis zifaka:

Isinxephezelo sokuphefumula

Uma une-acidosis yokuphefumula, ukuhlolwa kwegesi yegazi kuzobonisa amazinga aphezulu e-carbon dioxide. Olunye uvivinyo lokuthola lolu hlobo lwe-metabolic acidosis lubandakanya ukuhlolwa kokuphefumula ukukhombisa ukuthi amaphaphu asebenza kanjani, kanye ne-X-ray yesifuba noma i-CT scan ukuhlola ukutheleleka kwamaphaphu noma ukuvinjelwa.

Izindlela zokuphefumula ze-metabolic acidosis zifaka:

• imithi ye-bronchodilator (i-Ventolin inhaler)
• izidakamizwa ze-steroid
• umoya-mpilo
• umshini wokungenisa umoya (CPAP noma i-BiPaP)
• umshini wokuphefumula (wamacala abucayi)
• ukwelashwa ukuyeka ukubhema

Isinxephezelo se-Metabolic

Ukwelashwa kwesifo sikashukela

Ukuxazulula i-metabolic acidosis ebangelwa yisifo sikashukela esingalashwa noma esingalawulwa kubandakanya ukwelashwa kwesifo sikashukela. Uma une-ketoacidosis yesifo sikashukela, ukuhlolwa kwegazi lakho kuzobonisa amazinga aphezulu kashukela egazini (i-hyperglycemia). Ukwelashwa kufaka ukulinganisa amazinga kashukela egazini ukusiza umzimba ukuthi ususe futhi uyeke ukwenza ama-acid:

• insulini
• imithi yesifo sikashukela
• uketshezi
• ama-electrolyte (i-sodium, i-chloride, i-potassium)

Ukwelashwa kwe-insulin kuzosebenza kuphela uma isifo sikashukela sidala i-metabolic acidosis.

IV sodium bicarbonate

Ukungeza isisekelo sokulwa namazinga aphezulu e-acid aphatha ezinye izinhlobo ze-metabolic acidosis. Ukwelashwa ngomjovo (IV) ngesisekelo esibizwa nge-sodium bicarbonate kungenye yezindlela zokulinganisa ama-acid egazini. Isetshenziselwa ukwelapha izimo ezibanga i-acidosis ngokulahleka kwe-bicarbonate (base). Lokhu kungenzeka ngenxa yezimo ezithile zezinso, isifo sohudo nokuhlanza.

Ukuhlolwa kweHemodialysis

I-Dialysis iyindlela yokwelapha izifo ezinzima zezinso noma ukwehluleka kwezinso. Ukuhlolwa kwegazi ngezinkinga zezinso ezingamahlalakhona kuzokhombisa amazinga aphezulu e-urea nezinye izinhlobo ze-asidi. Ukuhlolwa komchamo kungakhombisa nokuthi izinso zisebenza kahle kangakanani.

I-Dialysis isiza ukususa ama-acid amaningi nokunye ukungcola egazini. Ku-hemodialysis, umshini uhlunga igazi ususe imfucuza noketshezi olungeziwe. I-Peritoneal dialysis iyindlela yokwelapha esebenzisa isisombululo ngaphakathi komzimba wakho ukumunca imfucuza.

Ezinye izindlela zokwelapha i-metabolic acidosis

• Ama-Inotropes neminye imishanguzo isiza ukuthuthukisa ukusebenza kwenhliziyo ezimeni ezinjenge-low blood pressure kanye nokuhluleka kwenhliziyo. Lokhu kuthuthukisa ukugeleza komoya-mpilo emzimbeni futhi kwehlise amazinga e-asidi egazi.Ukufundwa kwengcindezi yegazi, ukuhlolwa kwegazi, kanye ne-ECG (electrocardiogram) kuzobonisa ukuthi ngabe inkinga yenhliziyo ibangela i-metabolic acidosis.
• I-Metabolic acidosis ngenxa yotshwala noma ubuthi bezidakamizwa iphathwa ngokukhishwa kobuthi emzimbeni. Abanye abantu bangadinga futhi i-hemodialysis ukukhipha ubuthi. Ukuhlolwa kwegazi kufaka phakathi ukuhlolwa kwesibindi kuzobonisa ukungalingani kwe-acid-base. Ukuhlolwa komchamo nokuhlolwa kwegesi kungakhombisa nokuthi ubuthi bungakanani.

Ukuthatha

I-Metabolic acidosis wuhlobo lwe-acidosis oluvame ukubangelwa izimo zezempilo ezithinta izinso, inhliziyo, ukugaya, noma imetabolism. I-acid iyakheka egazini futhi ingaholela ezinkingeni ezinkulu zempilo uma iyekwa ingalashwa.

Ukwelashwa kwe-acidosis ye-metabolic kuya ngesimo esingaphansi. Ezinye izinhlobo zimnene noma zesikhashana futhi azidingi ukwelashwa. I-metabolic acidosis ingaba uphawu lokuthi kukhona okungahambi kahle emzimbeni wakho. Ungadinga ukwelashwa kwesinye isimo sempilo ukulinganisela ama-acid nezisekelo ezisegazini lakho.

Uma une-metabolic acidosis noma unesimo esingelapheki esingadala i-acidosis, bheka udokotela wakho njalo. Thatha yonke imithi njengoba kunqunyiwe bese ulandela izincomo zokudla. Ukuhlolwa kwegazi njalo nokunye ukuhlola kungasiza ukugcina amazinga akho e-acid-base alinganisela.