Isikhokelo sonyango lweMetabolic Acidosis

Umxholo

• Yintoni i-metabolic acidosis?
• Unyango luxhomekeke kwisizathu
• Unyango oluqhelekileyo lwe-metosis acidosis
• Imbuyekezo yokuphefumula
• Imbuyekezo yeMetabolic
• Unyango lweswekile
• IV sodium bicarbonate
• Uhlalutyo lweHemodialysis
• Olunye unyango lwe-metabolic acidosis
• Ukuthatha

Yintoni i-metabolic acidosis?

I-Metabolic acidosis yenzeka xa umzimba wakho uneasidi eninzi kunesiseko. Le meko ikwabizwa ngokuba yi-acetabolic acidosis ebukhali. Sisiphumo secala esiqhelekileyo sezinye iingxaki ezingapheliyo nezingxamisekileyo zempilo. I-Acidosis inokwenzeka nakweyiphi na iminyaka; inokuchaphazela iintsana, abantwana kunye nabantu abadala.

Ngokwesiqhelo, umzimba wakho une-acid-base balance. Ilinganiswa ngenqanaba le-pH. Inqanaba lekhemikhali lomzimba linokuba neasidi ngakumbi ngenxa yezizathu ezininzi. I-metabolic acidosis inokwenzeka ukuba:

• ukwenza iasidi eninzi
• ukwenza isiseko esincinci kakhulu
• ukungazicimi ii-asidi ngokukhawuleza okanye ngokwaneleyo

I-Metabolic acidosis inokuba nobulali kwaye yexeshana ukuya kubuzaza nokusongela ubomi. Unokufuna unyango. Le meko inokuchaphazela ukusebenza komzimba wakho. Iiasidi ezininzi emzimbeni zinokukhokelela nakwezinye iingxaki zempilo.

Unyango luxhomekeke kwisizathu

Unyango lwe-metabolic acidosis luxhomekeke kwisizathu. Abanye oonobangela yeyokwexeshana kwaye iasidi iyaphela ngaphandle konyango.

Le meko inokuba yingxaki yezinye iingxaki zempilo ezingapheliyo. Ukunyanga imeko engaphantsi kunokunceda ukunqanda okanye ukunyanga i-metabolic acidosis.

I-Metabolic acidosis yi-acidosis ngenxa yeenguqu ezichaphazela ukujikeleza kwegazi, izintso, okanye ukwetyisa. Oku kunokubangelwa:

• I-ketoacidosis yeswekile. Umzimba utshisa amafutha endaweni yeswekile, ubangele ukuba ietoni okanye iiacidi zakhiwe.
• Urhudo. Urhudo olomeleleyo okanye ukugabha kunokukhokelela kwi-hyperchloremic acidosis. Oku kubangela amanqanaba asezantsi esiseko abizwa ngokuba yi-bicarbonate, enceda ukulinganisa iiasidi egazini.
• Umsebenzi ombi wezintso. Isifo sezintso kunye nokusilela kwezintso kungakhokelela kwizifo ze-tubular acidosis. Oku kwenzeka xa izintso zakho zingenako ukucoca iiasidi ngomchamo ngokufanelekileyo.
• Lactic acidosis. Oku kwenzeka xa umzimba uvelisa ngaphezulu okanye ungasebenzisi kakuhle i-lactic acid. Oonobangela kubandakanya ukusilela kwentliziyo, ukubanjwa kwentliziyo, kunye nokudakumba okuqatha.
• Ukutya. Ukutya iimveliso zezilwanyana ezigqithileyo kunokwenza iiasidi ezininzi emzimbeni.
• Zilolonge. Umzimba wenza i-lactic acid ngakumbi ukuba awufumani oksijini yaneleyo ixesha elide ngexesha lokuzilolonga kakhulu.

Ezinye izizathu ze-acidosis zibandakanya:

• utywala okanye iziyobisi
• iziyobisi ezenza kancinci ukuphefumla njenge-benzodiazepines, amayeza okulala, amayeza eentlungu, kunye nezinye iziyobisi

Iimeko ezinjenge-asthma, isifo esingapheliyo sokuphazamiseka kwemiphunga (COPD), inyumoniya, kunye ne-apnea yokulala kunokubangela olunye uhlobo lwe-acidosis ebizwa ngokuba yi-respiratory acidosis. Oku kuyenzeka ukuba imiphunga ayikwazi ukuphefumla ngokufanelekileyo ikhabhon diokside. I-carbon dioxide eninzi inyusa amanqanaba e-asidi yegazi.

Unyango oluqhelekileyo lwe-metosis acidosis

Unyango lwe-metabolic acidosis lusebenza ngeendlela ezintathu eziphambili:

• ukukhupha okanye ukulahla iiasidi ezingaphezulu
• Ukuhlaziya iiasidi ngesiseko sokulinganisa iasidi yegazi
• ukuthintela umzimba ekwenzeni iiasidi ezininzi

Ezinye iintlobo zonyango lwe-metabolic acidosis zibandakanya:

Imbuyekezo yokuphefumula

Ukuba une-acidosis yokuphefumla, iimvavanyo zerhasi yegazi ziya kubonisa amanqanaba aphezulu e-carbon dioxide. Olunye uvavanyo lokuchonga olu hlobo lwe-metabolic acidosis lubandakanya uvavanyo lokuphefumla ukubonisa indlela esebenza kakuhle ngayo imiphunga, kunye ne-X-ray yesifuba okanye iskena se-CT ukukhangela usulelo lwemiphunga okanye ukuvaleka.

Unyango lokuphefumla lwe-metabolic acidosis lubandakanya:

• amayeza e-bronchodilator (Ventolin inhaler)
• iziyobisi ze-steroid
• ioksijini
• umatshini wokungenisa umoya (CPAP okanye iBiPaP)
• umatshini wokuphefumla (weemeko ezinzima)
• unyango lokuyeka ukutshaya

Imbuyekezo yeMetabolic

Unyango lweswekile

Ukusombulula isifo se-metabolic acidosis esibangelwa sisifo seswekile esinganyangekiyo okanye esingalawulwayo kubandakanya unyango lwesifo seswekile. Ukuba unesifo seswekile ketoacidosis, iimvavanyo zakho zegazi ziya kubonisa amanqanaba eswekile yegazi ephezulu (hyperglycemia). Unyango lubandakanya ukulinganisa amanqanaba eswekile yegazi ukunceda umzimba ususe kwaye uyeke ukwenza iiasidi:

• insulin
• amayeza seswekile
• ulwelo
• i-electrolyte (i-sodium, i-chloride, i-potassium)

Unyango lwe-insulin luya kusebenza kuphela ukuba isifo seswekile sibangela i-metabolic acidosis.

IV sodium bicarbonate

Ukongeza isiseko sokulwa namanqanaba aphezulu e-asidi anyanga ezinye iintlobo ze-metabolic acidosis. Unyango olufakwa ngaphakathi (IV) ngesiseko esibizwa ngokuba yi-sodium bicarbonate yenye yeendlela zokulinganisa iiasidi egazini. Isetyenziselwa ukunyanga iimeko ezibangela i-acidosis ngokusebenzisa ilahleko ye-bicarbonate (base). Oku kunokwenzeka ngenxa yeemeko zezintso, isifo sohudo kunye nokuhlanza.

Uhlalutyo lweHemodialysis

I-Dialysis yonyango lwesifo sezintso okanye ukungaphumeleli kwezintso. Uvavanyo lwegazi kwiingxaki zezintso ezingapheliyo luya kubonisa amanqanaba aphezulu e-urea kunye nezinye iintlobo zeasidi. Uvavanyo lomchamo lunokubonisa indlela ezisebenza kakuhle ngayo izintso.

I-Dialysis iyanceda ukususa iiasidi ezongezelelweyo kunye nezinye inkunkuma egazini. Kwi-hemodialysis, umatshini ucoca igazi asuse inkunkuma nolwelo olongezelelekileyo. I-Peritoneal dialysis lunyango olusebenzisa isisombululo ngaphakathi komzimba wakho ukufunxa inkunkuma.

Olunye unyango lwe-metabolic acidosis

• Inotropes kunye namanye amayeza anceda ukuphucula ukusebenza kwentliziyo kwiimeko ezinje ngoxinzelelo lwegazi kunye nokusilela kwentliziyo. Oku kuphucula ukuhamba kweoksijini emzimbeni kwaye kwehlise amanqanaba e-asidi yegazi. Ukufundwa koxinzelelo lwegazi, uvavanyo lwegazi, kunye ne-ECG (electrocardiogram) iya kubonisa ukuba ingxaki yentliziyo ibangela i-metabolic acidosis.
• I-Metabolic acidosis ngenxa yotywala okanye iziyobisi ityhefu iphathwa ngokutsalwa emzimbeni. Abanye abantu banokufuna i-hemodialysis ukucoca i-toxins. Uvavanyo lwegazi kubandakanya uvavanyo lwesibindi luza kubonisa ukungalingani kwesiseko seasidi. Uvavanyo lomchamo kunye nokuvavanywa kwerhasi yegazi nako kungabonisa ubuzaza betyhefu.

Ukuthatha

I-Metabolic acidosis luhlobo lwe-acidosis edla ngokubangelwa ziimeko zempilo ezichaphazela izintso, intliziyo, ukwetyisa, okanye imetabolism. Iasidi ziyakhiwa egazini kwaye zingakhokelela kwiingxaki ezinkulu zempilo ukuba ziyekwe zinganyangwa.

Unyango lwe-metabolic acidosis luxhomekeke kwimeko esezantsi. Ezinye iintlobo zithambile okanye zethutyana kwaye azidingi nyango. I-Metabolic acidosis inokuba luphawu lokuba kukho into engalunganga emzimbeni wakho. Unokufuna unyango lwenye imeko yezempilo yokulinganisa iiasidi kunye neziseko ezisegazini lakho.

Ukuba une-metabolic acidosis okanye unesifo esinganyangekiyo esinokubangela i-acidosis, jonga ugqirha wakho rhoqo. Thatha onke amayeza njengoko kumiselwe kwaye ulandele iingcebiso ngokutya. Uvavanyo lwegazi rhoqo kunye nolunye uhlolo kunokunceda ukugcina amanqanaba esiseko se-asidi elungeleleneyo.