鉀代謝障礙酸堿平衡紊亂(參考版)
2025-05-17 12:02本頁面
【正文】 s duration. On examination, he had a blood pressure of 90/60 mmHg and a pulse of 116/minute. See the laboratory results. Arterial blood : pH PaCO2 46 mmHg HCO3 39 mmol/L Na+ 143 mmol/L K+ mmol/L Cl 72 mmol/L Urine pH (3) A 52yearold man with chronic obstructive lung disease is admitted to the hospital with worsening dyspnea. He appears cyanosis and in respiratory distress. The laboratory data follow. Arterial blood pH PaCO2 60 mmHg PaO2 50 mm Hg HCO3 35 mmol/L Na+ 136mmol/L K+ mmol/L Cl 96 mmol/L (4) A 48yearold female presented with severe vomiting. On examination, T 38℃ , HR 89/min, R 26/min, Bp 150/100 mmHg. She appears general edema. The laboratory results Arterial blood pH PaCO2 43 mmHg PaO2 95 mm Hg HCO3 26 mmol/L Na+ 142mmol/L K+ mmol/L Cl 98 mmol/L 。 ABSB, hyperventilation ③ Buffer base BB ④ Base excess BE ⑤ CO2 bine power（ CO2CP） 4) AG (anion gap): AG describes the difference between unmeasured anion (UA) and unmeasured cation (UC). AG= Na+ (Cl + HCO3). The normal range is 10 ~ 14 mmol /L (12 mmol /L). II. Acidbase imbalances 1. Metabolic acidosis 1) Concept: Metabolic acidosis refers to a primary deficit in base bicarbonate, the pH falls. 2) Causes: (1) Increase in metabolic acids ① Excess production of metabolic acids . fasting and starvation, diabetic ketoacidosis, lactic acidosis ( shock, hypoxia, heart failure, anemia). ② Decreased loss of metabolic acids . renal failure, renal tubular acidosisI ③ Over dose of acidic medicine (aspirin). AG is increased. (2) Increase in bicarbonate loss . ① Severe diarrhea, intestinal fistulas ② Renal tubular acidosisII. ③ Over dose of NH4+ ,releases HCl AG is normal. 3) Compensation: (1) Buffer system and cell (2) Signs of pensation ① Kussmaul breathing ② Acid urine 4) Manifestations (1) Heart failure: ① Hyperkalemia __cardiac arrhythmia ② Impair myocardial contraction (2) Decreased response of capillary to catecholamines __Shock (3) Depression of neural function Lethargy, disorder of consciousness, a. (4) Changes of osseous system Renal rickets腎性佝僂病 , osteomalacia骨軟化癥 4) Laboratory findings ↓pH, ↓HCO3, ↓ PaCO2 if there is pensation of respiratory system. Case study: Arterial blood: pH PaCO2 26 mmHg PaO2 108 mmHg HCO3 12 mmol/L Na+ 135 mmol/L K+ mmol/L Cl 110 mmol/L Urine: pH (1) A 36yearold man was hospitalized with a 3day history of fever and watery diarrhea. The blood pressure is 90/60 mmHg, the pulse is 112/minute, the respiratory rate is 24/minute, and the temperature is . The laboratory results were obtained. 2. Respiratory acidosis 1) Concept: Respiratory acidosis is defined as a decrease of pH induced by primary increase in plasma [H2CO3]. 2) Causes Respiratory acidosis can occur as an acute or a chronic disorder. (1) Acute respiratory acidosis . acute respiratory in
畢業(yè)設(shè)計(jì)相關(guān)推薦
鄂ICP備17016276號(hào)-1