Acid ea phefumoloho

Respiratory acidosis ke boemo bo etsahalang ha matšoafo a sa khone ho tlosa khabone eohle e tsoang 'meleng. Sena se etsa hore maro a 'mele, haholo mali, a be asiti haholo.

Lisosa tsa ho hema acidosis li kenyelletsa:

• Maloetse a lifofane, joalo ka asma le COPD
• Maloetse a lisele tsa matšoafo, joalo ka pulmonary fibrosis, e bakang letšoele le botenya ba matšoafo
• Maloetse a ka amang sefuba, joalo ka scoliosis
• Mafu a amang methapo le mesifa e supang matšoafo hore a fehloe kapa a fokotsehe
• Meriana e hatellang ho hema, ho kenyeletsoa meriana e matla ea bohloko, joalo ka li-narcotic (opioids), le "downers," joalo ka benzodiazepines, hangata ha e kopantsoe le joala
• Botenya bo matla, bo thibelang hore na matšoafo a ka atoloha hakae
• Ho thibela ho koaleha moea ka nakoana borokong

Lefu la ho hema le sa foleng le hlaha nako e telele. Sena se lebisa boemong bo tsitsitseng, hobane liphio li eketsa lik'hemik'hale tsa 'mele, tse kang bicarbonate, tse thusang ho khutlisa botsitso ba' mele-acid.

Acute ea ho hema ke boemo boo carbon dioxide e hahang ka potlako, pele liphio li ka khutlisetsa 'mele boemong bo leka-lekaneng.

Batho ba bang ba nang le asiti e sa foleng ea ho hema ba fumana acidosis e matla ea ho hema hobane bokuli bo hlobaetsang bo mpefatsa boemo ba bona mme bo senya botsitso ba 'mele ea bona ea acid.

Matšoao a ka kenyelletsa:

• Pherekano
• Ho tšoenyeha
• Mokhathala o bonolo
• Lethargy
• Phefumoloho e khutšoanyane
• Ho robala
• Ho thothomela (ho thothomela)
• Letlalo le futhumetseng le le bosootho
• Ho fufuleloa

Mofani oa tlhokomelo ea bophelo o tla etsa tlhahlobo ea 'mele mme a botse ka matšoao.

Liteko tse ka etsoang li kenyelletsa:

• Khase ea mali, e lekanyang maemo a oksijene le carbon dioxide maling
• Setsi sa metabolic sa mantlha
• X-ray sefubeng
• Tlhatlhobo ea sefuba ea CT
• Teko ea tšebetso ea pulmonary ho lekanya phefumoloho le hore na matšoafo a sebetsa hantle hakae

Kalafo e etselitsoe lefu lena, mme e ka kenyelletsa:

• Meriana ea Bronchodilator le corticosteroids ho khutlisa mefuta e meng ea tšitiso ea sefofane
• Moea o kenang ntle le khatello ea moea (oo ka linako tse ling o bitsoang CPAP kapa BiPAP) kapa mochini o hemang, ha ho hlokahala
• Oxyjene haeba boemo ba oksijene ea mali bo le tlase
• Kalafo ea ho emisa ho tsuba
• Bakeng sa linyeoe tse matla, ho ka hlokahala mochini o phefumolohang (ventilator)
• Ho fetola meriana ha ho loketse

Hore na o sebetsa hantle hakae ho latela lefu le bakang asiti ea ho hema.

Mathata a ka hlahang a kenyelletsa:

• Ts'ebetso e mpe ea setho
• Ho hloleha ho phefumoloha
• Ho tshoha

Asitiosis e matla ea ho hema ke tšohanyetso ea bongaka. Batla thuso ea bongaka hang-hang haeba u e-na le matšoao a boemo bona.

Bitsa mofani oa hau haeba u e-na le matšoao a lefu la matšoafo le mpefalang ka tšohanyetso.

U SE KE UA tsuba. Ho tsuba ho lebisa ho nts'etsopele ea maloetse a mangata a matla a matšoafo a ka bakang phefumoloho ea acidosis.

Ho theola boima ba 'mele ho ka thusa ho thibela ho hema acidosis ka lebaka la botenya (obesity-hypoventilation syndrome)

Hlokomela ho noa moriana, 'me le ka mohla u se ke ua kopanya meriana ena le joala.

Sebelisa sesebelisoa sa hau sa CPAP khafetsa haeba u se u fuoe.

Ho hloleha ha moea; Ho hloleha ho phefumoloha; Acidosis - ho hema

• Tsamaiso ea phefumoloho

Effros RM, Swenson ER. Tekanyo ea acid-base. Ka: Broaddus VC, Mason RJ, Ernst JD, et al, li-eds. Buka ea Bongaka ea Phefumoloho ea Murray le Nadel. La 6th. Philadelphia, PA: Elsevier Saunders; 2016: khaolo ea 7.

Seifter JL. Mathata a acid-base. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 110.

Moqapi RJ. Mathata a acid-base. Ka: Marako RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Likhopolo le Tloaelo ea Kliniki. La 9th. Philadelphia, PA: Elsevier; 2018: khaolo ea 116.