Cov tsos mob ntawm hyperkalemia - ib tug kos npe rau ntawm ib tug kab mob nyob rau hauv uas ntau zog rau qhov tseem ceeb ntau tshaj li 5 mmol / l poov tshuaj theem nyob rau hauv cov ntshav ntshiab. Nyob rau hauv tib neeg, poov tshuaj mas concentrated nyob rau hauv lub hlwb los ntawm kev muab DNA thiab cov protein synthesis, cell loj hlob, ib txwm hauj lwm ntawm enzymes thiab t. D. Tsuas 2% ntawm poov tshuaj yog nyob rau hauv lub extracellular kua. Raum thiab extrarenal mechanisms poov tshuaj homeostasis yog khaws cia, cov thawj saib xyuas ntawm poov tshuaj tas, thiab lub thib ob zaj yog muab los ntawm poov tshuaj mus rau lub hlwb los ntawm cov extracellular kua. Action poov tshuaj yog muab ib qho kev siv hluav taws xob tej zaum ntawm cell week. Cov tsos mob ntawm hyperkalemia nyob rau hauv lub loj tsawv theem - yuav txo tau ntawm daim nyias nyias so tej zaum ntawm paj thiab mob hlwb, uas muaj feem xyuam rau qhov kev nce rau hauv lub excitability ntawm lub hlwb. Yog hais tias lub poov tshuaj concentration hauv cov ntshav nce mus rau 7.5 mmol / L, lub hlwb tsis tau lawv lub excitability kiag li.
Hyperkalemia: cov tsos mob
Hyperkalemia yog nrog depolarization ntawm lub hlwb thiab yuav txo tau ntawm lawv excitability uas ua rau cov leeg tsis muaj zog, ua pa tsis ua hauj lwm thiab paresis. Cardiotonic txiav txim manifests siab poov tshuaj sharpened T tsis nyob rau hauv lub electrocardiogram. Nyob rau hauv tej rooj plaub, tus kab mob no muaj feem xyuam rau lub elongation ntawm lub PQ-luv, thiab cov expansion ntawm lub QRS-complex thiab tseg AV thiab tsis P yoj Tag nrho cov tsos mob no ua rau ventricular fibrillation thiab asystole.
Cov tsos mob ntawm hyperkalemia: ua
Nyob rau hauv noj qab nyob zoo rau cov tib neeg qhov tsawg ntawm cov poov tshuaj nyob rau hauv high koob tshuaj tsis tshua muaj ua rau tus kab mob. Lub hom ua ntawm tus kab mob nyob rau hauv ib txwm raum muaj nuj nqi - adrenal insufficiency. Rau hauv sib piv, oliguric mob raum tsis ua hauj lwm nce rau hauv cov ntshav potassium ntau nyob rau hauv lub sij hawm luv luv tsis muaj zog poov tshuaj load. Ib tug xov tooj ntawm cov neeg mob uas mob raum insufficiency rau cov neeg kawm ntawv ntawm hyperkalemia nyhuv ntawm aldosterone tsis muaj peev xwm, uas yog lub luag hauj lwm rau lub tso pa tawm ntawm poov tshuaj. Qhov no mob yog feem ntau cai nyob rau hauv ntshav qab zib nephropathy, tubulointerstitial raum tus kab mob thiab kev puas tsuaj juxtaglomerular apparatus.
mob
Hyperkalemia yog kuaj tau los ntawm laboratory kev ntsuam xyuas ntawm ntshiab rau poov tshuaj thiab electrocardiographic xeem.
kev kho mob ntawm hyperkalemia
Cov thawj cov cim qhia ntawm hyperkalemia yuav tsum tsis txhob quav ntsej. Mob pib, uas hawv ua phem rau hauv lub neej ntawm tus neeg mob yog kho nrog tso dej thawj coj ntawm calcium gluconate tshuaj txhua txhua 2-3 teev. Ua calcium cov ntsiab lus nyob rau hauv cov ntshav decreases thiab tsub kom tus Harbor tej zaum qhov sib txawv ntawm qhov kev txiav txim tej zaum thiab so, kom txhob muaj cov excitability ntawm lub hlwb. Tso dej thawj coj ntawm sodium hydrogencarbonate txhawb txoj kev hloov ntawm poov tshuaj los ntawm cov extracellular kua rau hauv lub hlwb ncaj qha. Thiab tiv thaiv kev hypokalemia intravenously muab insulin-mus pab tau txoj kev ua ntawm sodium-poov tshuaj twj tso kua mis thiab yog li - nyob rau hauv lub khiav ntawm poov tshuaj hlwb. Yuav kom txo tau cov concentration ntawm poov tshuaj nyob rau hauv cov ntshiab sodium xaiv ion pauv cob fosfattsellyuloznuyu, feem ntau combining nws nrog sorbitol. Sij hawm ntawm resins haum rau kev tiv thaiv ntawm tus kab mob nyob rau hauv mob raum tsis ua hauj lwm. Cov tsos mob ntawm hyperkalemia uas tsim nyob rau hauv kauj ruam tshem tawm nrog hemodialysis los yog peritoneal lim ntshav nrog bezkalievym tshuaj.