Potassium belongs rau qeb ntawm macronutrients, tsis muaj tib neeg lub neej ua tsis tau. Cov kab mob plawv, cov leeg nqaij thiab endocrine hnov mob heev rau qhov tsis txaus ntawm cov ntxhia, cov poov tshuaj hauv lub hlwb ua lub luag haujlwm tseem ceeb hauv cov txheej txheem ntawm kev nco thiab kev kawm. Raws li kev txheeb cais, txhua tus neeg thib tsib ntawm lub ntiaj teb tsawg kawg ib zaug ntsib cov tsos mob ntawm hypokalemia. Lub luag haujlwm tseem ceeb ntawm kev kho etiotropic yog txhawm rau txiav txim siab qhov ua rau muaj kev cuam tshuam sai li sai tau thiab pib ua kom cov dej thiab cov hluav taws xob sib npaug hauv lub cev.
daim ntawv pov thawj kho mob
Kev txo qis ntawm cov poov tshuaj hauv cov ntshav ntshav qis dua 3.5 mmol / l, nrog cov qauv tsim los ntawm 3.5 txog 5.5 mmol / l, qhia tias hypokalemia. Qhov taw qhia nyob ntawm lub hnub nyoog, poj niam txiv neej ntawm tus neeg mob, kev nyab xeeb. Qib ntawm cov ntxhia hauv cov niam expectant fluctuates raws li lub sij hawm ntawm cev xeeb tub. Ib tug poj niam poob ntshav ntau thaum yug menyuamYog li ntawd, qhov nruab nrab hypokalemia nyob rau hauv lub sij hawm puerperal yog suav hais tias yog ib qho txawv ntawm cov qauv.
Tus tsov ntxhuav feem ntawm cov poov tshuaj (txog 90%) yog nyob rau hauv qhov chaw intracellular, cov ntshav thiab pob txha cov ntaub so ntswg muaj 10%. Lub macroelement yog lub luag haujlwm rau normalization ntawm cov ntshav siab, tswj lub plawv atherosclerosis, tsub kom lub cev endurance thiab kev nyuaj siab, thiab pab tshem tawm toxins thiab allergens ntawm lub cev. Hauv qab no peb yuav tham txog cov kev kuaj mob, cov tsos mob, ua rau thiab kev kho mob ntawm hypokalemia.
ntsuas ntsuas
Qib ntawm cov ntshav poov tshuaj yog txiav txim siab los ntawm kev kuaj ntshav biochemical. Txhawm rau kom paub meej qhov etiology ntawm hypokalemia, qhov concentration ntawm sodium, magnesium thiab nitrogenous tebchaw (creatinine thiab urea) hauv cov ntshav ntshav yog xam. Cov ntaub ntawv ntxiv tuaj yeem tau txais los ntawm kev tshawb fawb ntawm acid-base balance (ABR) thiab qhov ntim ntawm cov kua dej ntxiv. Qee qhov kev hloov pauv hauv ECG, xws li kev nyuaj siab ntawm ntu ST, flattening ntawm T nthwv dej, qhov pom ntawm U nthwv dej, qhia txog qhov tsis txaus ntawm macronutrient.
Lub luag haujlwm tseem ceeb hauv kev kuaj mob yog ua los ntawm kev nug thiab kuaj lub cev ntawm tus neeg mob. Cov tsos mob ntawm hypokalemia hauv cov menyuam yaus yog qhov nyuaj dua rau kev paub, vim lawv tseem tsis tau paub meej txog lawv tus mob. Kev kuaj zis chloride yuav lees paub lossis txiav txim tawm Bartter syndrome.
Hypokalemia: Cov tsos mob ntawm tus kab mob
Thaum ntxov ntawm hypokalemia, pathological tsis muaj zog thiab kiv taub hau tau hnov. Macronutrient deficiency cuam tshuamclarity ntawm lub siab, manifested los ntawm apathy, ntxhov siab vim-phobic teeb meem. Txij li thaum lub hom phiaj ntawm hypokalemia yog cov hlwb ntawm cov leeg nqaij thiab paj hlwb, cov neeg mob ua rau muaj kev cuam tshuam, chim siab, teeb meem nrog kev nco thiab kev xav tau tshwm sim, thiab kev ua haujlwm tau qis dua.
Cov tsos mob ntawm hypokalemia suav nrog:
- Muscle tsis muaj zog.
- Hypotension.
- tsis qab los noj mov, dyspepsia (xeev siab, ntuav, raws plab).
- Nyob tsis tsaug zog, mob taub hau.
- tawv nqaij qhuav thiab plaub hau nkig.
- Tes tshee, tshee tshee.
- Ntsws thiab tuag tes tuag taw.
Raws li txoj cai, hauv cov menyuam yaus thiab cov neeg laus tau kuaj pom tias muaj "hypokalemia" cov zis tso tawm ib hnub nce. Nrog nocturia, cov qauv kev pw tsaug zog raug cuam tshuam, uas ua rau muaj zog ntxiv thaum nruab hnub. Qhov tsis txaus macronutrient cuam tshuam rau kev ua haujlwm ntawm lub plab zom mov: cov leeg nqaij du ntawm txoj hnyuv plam lawv lub suab, so, teeb meem tshwm sim nrog kev zom zaub mov, thiab lub chaw cia khoom thiab kev khiav tawm ntawm lub plab cuam tshuam. Cov tsos mob ntawm hypokalemia tuaj yeem ua rau tsis meej pem nrog kev ua haujlwm ntau dhau, noj tshuaj lom lossis beriberi, yog li cov kws kho mob pom zoo kom pub ntshav rau biochemistry tsawg kawg ib xyoos ib zaug.
Etiological yam
Potassium deficiency hauv lub cev yog cuam tshuam nrog kev noj cov zaub mov tsis txaus los ntawm cov zaub mov lossis nws qhov kev faib tawm ntawm cov hlwb thiab cov kua dej ntxiv nrog rau / hauv kev qhia ntawm epinephrine, insulin,siv folic acid thiab vitamin B 12. Feem ntau, hypokalemia yog tshwm sim los ntawm kev poob ntawm cov poov tshuaj ntau dhau los ntawm txoj hnyuv lossis ob lub raum (ntuav, plab zom mov, noj cov tshuaj diuretics).
Ntxiv rau, kev txhim kho cov tsos mob ntawm hypokalemia yog vim:
- YMetabolic alkalosis.
- Primary lossis secondary hyperaldosteronism.
- mob plawv tsis ua hauj lwm.
- Cirrhosis ntawm daim siab.
- YThyrotoxicosis.
- Hypomagnesemia.
- Nyob rau hauv plab plab.
- Ntau dhau ntawm cov tshuaj hormones ntawm adrenal cortex hauv Itsenko-Cushing's syndrome.
Kev nyuaj siab ntev thiab kev puas siab puas ntsws ntau dhau ua rau hypokalemia. Cov kab mob tsis tshua muaj tshwm sim hu ua paroxysmal myoplegia yog tus cwj pwm los ntawm kev txo qis hauv cov ntshav cov poov tshuaj thaum muaj kev tawm tsam. Cov pab pawg muaj kev pheej hmoo siab suav nrog cov neeg mob ntshav siab, ntshav qab zib mellitus, anorexia nervosa, malabsorption syndrome. Cov neeg muaj hnub nyoog tshaj 65 xyoo, nrog rau cov poj niam cev xeeb tub thiab lactating cov poj niam, yuav tsum paub dab tsi yog cov tsos mob ntawm hypokalemia hauv tib neeg, nws yog dab tsi thiab yuav ua li cas tiv thaiv kev loj hlob ntawm tus kab mob.
False hypokalemia
kev ua haujlwm ntev hauv lub gym, kev noj zaub mov tsis zoo, suav nrog txoj kev poob phaus, txo qis lossis tsis qab los noj mov, lub cev qhuav dej thiab kev ntxhov siab tas li cuam tshuam rau cov ntsiab lus ntawm cov poov tshuaj hauv cov ntshav plasma. Cov poj niam tshaj 50 xyoo muaj cov tsos mob ntawm hypokalemia vim kev hloov hormonal hauv lub cev. Asthma, exacerbation ntawm COPD (chronicobstructive pulmonary kab mob), lub plawv tsis ua hauj lwm thiab lwm yam pathologies ntawm cov hlab plawv system yog nrog los ntawm ib tug loj heev tso catecholamines rau hauv cov ntshav, ntau tshaj uas ua rau pseudohypokalemia. Cov dej qab zib, cov khoom qab zib ntau, cov tshuaj yej muaj zog thiab kas fes cuam tshuam nrog lub ntuj nqus ntawm macronutrient.
Kev sib koom ua ke ntawm cov tsos mob ntawm hypokalemia thiab kev kho mob ntshav qab zib ketoacidosis tau piav qhia los ntawm kev txhaj tshuaj ntawm exogenous insulin, uas txo qis cov poov tshuaj hauv cov ntshav ib ntus. Cov neeg mob uas muaj leukocytosis hnyav yuav tsum tau npaj kom tau txais txiaj ntsig tsis zoo. Thaum lub sij hawm ntev cia cov hlab ntshav nyob rau hauv vitro mob, cais cov qe ntshav dawb ceev ceev K⁺ los ntawm qhov nruab nrab incubation. Tsawg zaus, hypokalemia yog txuam nrog kev noj cov av nplaum (lithophagy). Yav dhau los, qhov tshwm sim tau ntsib nyob rau lub sijhawm "tshaib plab", tam sim no kev noj zaub mov tsis zoo yog pom tshwj xeeb rau cov menyuam yaus thiab cov poj niam cev xeeb tub.
Potassium deficiency hauv tsiaj
Cov leeg tsis muaj zog yog cov tsos mob tseem ceeb ntawm hypokalemia hauv dev thiab miv. Tsiaj txhu tsis kam txav, stoop, lawv gait ua tsis meej, lawv qab los yog ploj tag nrho. Potassium deficiency kuj tshwm sim los ntawm ventroflexion ntawm lub caj dab (txoj hauj lwm ntawm lub taub hau tsis siab tshaj theem ntawm withers). Txog li 30% ntawm cov miv uas mob raum tsis ua haujlwm yog hypokalaemic.
Cov concentration ntawm electrolyte hauv cov ntshav yog tswj hwm los ntawm aldosterone, nrog rau kev sib txuas ntawm cov tshuaj hormones.lub raum tsis tuaj yeem khaws cov poov tshuaj. Vim li cas thiaj muaj ntau cov tsos mob ntawm hypokalemia hauv Burmese miv tsis paub. Nws tsuas yog tsim tau tias qhov tsis xws luag tau txais los ntawm autosomal recessive yam. Raws li nyob rau hauv tib neeg, cov ntxhia tau tawm ntawm lub cev ntawm cov tsiaj los ntawm ob lub raum, yog li cov poov tshuaj hauv cov zaub mov noj txhua hnub yuav tsum txaus los hloov nws qhov poob hauv cov zis.
Kev kho mob
Kev kho mob ntawm hypokalemia yog lub hom phiaj tseem ceeb ntawm kev ntxiv cov macronutrient deficiency thiab tshem tawm cov hauv paus hauv paus ntawm qhov teeb meem. Kev ntuav tau ua tiav nrog cov tshuaj "Motilac", "Cerukal" lossis "Metoclopramide", yog tias plab zom mov, cov tshuaj tiv thaiv kab mob tau muab tshuaj ("Loperamide", "Imodium", "Diara" thiab lwm yam). Endocrine lossis autoimmune pathologies raug kho nrog cov tshuaj hormones, tshwj xeeb yog corticosteroids. Cov tshuaj diuretic zoo li Triamterene los yog Spironolactone tsis cuam tshuam rau cov tshuaj potassium excretion, yog li lawv tuaj yeem muab tshuaj zoo rau cov neeg mob uas xav tau cov tshuaj diuretics.
Nrog rau qhov tsis txaus ntawm cov ntxhia hauv lub cev, kev kho cov tshuaj potassium hloov muab cov txiaj ntsig zoo:
- "Asparkam". Ib qho tshuaj pheej yig tshaj plaws los ntawm pawg metabolic. "Asparkam" them nyiaj rau qhov tsis muaj magnesium thiab poov tshuaj nyob rau hauv lub hlwb, restores pH tshuav nyiaj li cas. Yog tias koj haus cov tshuaj 30 feeb tom qab noj mov, ces qhov acidic ib puag ncig ntawm lub plab yuav tsis cuam tshuam rau nws cov txiaj ntsig.
- "Potassium orotate". Tsis yog-steroidal tus neeg sawv cev koom nrognyob rau hauv lipid, protein thiab carbohydrate metabolism, ntxiv dag zog rau lub plawv cov leeg. Txhawm rau tshem tawm cov tsos mob ntawm hypokalemia, cov ntsiav tshuaj tau noj ntawm lub plab khoob ntawm tus nqi ntawm 10-20 mg rau 1 kg ntawm lub cev hnyav ib hnub.
- "Pab". Lub plawv tsis tuaj yeem zam qhov tsis muaj poov tshuaj. "Panangin" normalizes lub plawv dhia, txhawb cov ntshav coronary, tiv thaiv kev loj hlob ntawm atherosclerosis, myocardial infarction.
- "Kalinor". Potassium hauv Kalinor effervescent ntsiav tshuaj muaj nyob rau hauv daim ntawv ntawm citrate monohydrate thiab bicarbonate. Cov tshuaj ua ke yog muab rau cov tshuaj hypokalemia (tsawg dua 3.2 mmol / l), kev ua haujlwm tsis zoo ntawm cov khoom siv neuromuscular, mob plawv arrhythmia.
Cov kua dej ntawm cov ntsev ntsev yog qhov phem rau cov neeg mob dua li cov ntsiav tshuaj lossis tshuaj ntsiav. Kev tswj hwm ntawm cov tshuaj tuaj yeem ua rau rov qab hypokalemia, lossis ua rau muaj kev nce ntxiv ntawm cov ntxhia hauv cov ntshav. Feem ntau, kev daws teeb meem ntawm potassium chloride, potassium citrate los yog potassium bicarbonate yog siv rau kev txhaj tshuaj rau hauv cov hlab ntsha. Cov koob tshuaj raug xaiv nruj me ntsis raws li tus kheej. Kev tswj tsis tau ntawm cov tshuaj yuav ua rau mob plab los ntshav, convulsions, blockade ntawm lub plawv conduction system. Nrog rau kev txhim kho cov tsos mob ntawm kev ua phem rau lub neej ntawm hypokalemia, kev kho mob yog nqa tawm hauv tsev kho mob.
Qhia los ntawm cov kws kho mob ib txwm
Cov ntaub ntawv ua kua dej yog nrov heev ntawm homeopaths: extracts, infusions, decoctions, thiab lwm yam Tincture ntawm belladonna, sage, centaury, eleutherococcus extract, St.qab los. Parsley, lemongrass txiv hmab txiv ntoo, raspberry, mint thiab nettle nplooj yog nplua nuj nyob rau hauv vitamin A thiab tocopherol, uas txhim kho cov mob ntawm cov plaub hau, rau tes, thiab nthuav tawm qhov txhab kho mob. Nyob rau hauv cov ntaub ntawv ntawm hypokalemia, muaj xws li zaub xam lav los ntawm sauerkraut, dos los yog pre-soaked dandelion nplooj nyob rau hauv cov zaub mov txhua hnub, tab sis licorice paus, ntawm qhov tsis tooj, pab tshem tawm cov ntxhia hauv lub cev, rhuav tshem cov leeg nqaij.
Muaj ntau yam zaub mov noj tshuaj zoo:
- Infusion raws hawthorn. Brew 1 tbsp. ib diav ntawm qhuav thiab crushed hawthorn txiv hmab txiv ntoo 200 ml ntawm boiling dej. Infuse cov khoom nyob rau hauv ib lub thermos li 2-3 teev. Tom qab lub sijhawm teev tseg, lim cov kua los ntawm 3-txheej gauze lossis lim. Nrog hypokalemia, nws raug nquahu kom haus dej haus ntawm 2 tbsp. diav 3-4 zaug ib hnub.
- Decoction ntawm Rose hips. Ncuav cinnarodium (1 tablespoon) nrog ib liter ntawm boiled dej. Protomite cov khoom siv raw rau 5 feeb hauv da dej. Tshem lub saucepan los ntawm lub qhov cub thiab tawm hauv qhov tsaus ntuj, txias qhov chaw rau 24 teev. Cov dej haus tau noj hauv 0.25 khob ua ntej noj mov. Rosehip decoction maj mam txo cov tsos mob ntawm hypokalemia hauv cov menyuam yaus thiab cov neeg laus, txhawb nqa hematopoiesis, thiab ua kom cov metabolism sai.
- Beet tops. Txhawm rau npaj cov tshuaj rau hypokalemia, ncuav 1 tbsp. l. finely tws beet nplooj nrog ib khob ntawm boiling dej. Ib teev tom qab, cov dej haus tau npaj haus. Txhawm rau kom cov poov tshuaj ntau ntxiv hauv cov ntshav, noj 50 ml ntawm infusion ib hnub.
Khoom noj khoom haus
Potassium, txhais los ntawm Arabic,txhais tau hais tias "cov ntoo tshauv", txij li lub hauv paus tseem ceeb ntawm macronutrient yog cov khoom cog. Potassium tebchaw nkag mus rau hauv lub cev feem ntau nrog zaub mov, los yog nyob rau hauv daim ntawv ntawm kev noj haus. Qhov pom zoo pub nyiaj txhua hnub rau cov neeg laus yog 1,800 - 5,000 mg. Potassium yog qhov tsim nyog rau kev loj hlob ib txwm, lub cev thiab kev loj hlob ntawm tus menyuam. Qhov kev xav tau niaj hnub ntawm cov menyuam yaus rau cov ntxhia tseem ceeb yog 600 - 1,700 mg, hauv lwm lo lus, los ntawm 16 txog 30 mg rau 1 kg ntawm lub cev hnyav.
Rau hypokalemia, suav nrog hauv kev noj haus:
- Cov txiv hmab txiv ntoo tshiab thiab zaub (avocados, kiwi, bananas, apricots, txiv duaj, spinach, parsley).
- Muaj.
- taum.
- Tomato khoom.
- Hiav txwv ntses (pollock, salmon, nees mackerel, sprat, tuna).
- Cauliflower and white cabbage, broccoli.
- Bran ci khoom.
Rau lub plawv, koj tuaj yeem npaj cov khoom noj khoom haus sib xyaw ntawm prunes, raisins, walnuts thiab qhuav apricots. Ua li no, sib tov tws txiv ntoo thiab txiv hmab txiv ntoo qhuav nyob rau hauv sib npaug proportions, ntxiv zib mu rau saj. Chocolate muaj tej yam ntuj tso stimulants ntawm lub paj hlwb - poov tshuaj thiab magnesium, nrog rau cov hlau, calcium, vitamins ntawm pab pawg B. Compotes, freshly squeezed kua txiv, tshwj xeeb tshaj yog txiv hmab txiv ntoo, txiv kab ntxwv, txiv qaub thiab carrot kua txiv, yuav coj invaluable txiaj ntsim kev noj qab haus huv.
Cov tsos mob ntawm hypokalemia thiab hypomagnesemia hauv tib neeg yog qhov zoo sib xws. Ironically, ob qho tib si macronutrients muaj ntau nyob rau hauv marinezaub qhwv, cereals, avocados, lentils, cocoa hmoov, tsev cheese thiab qaub cream, yog li cov khoom lag luam uas tau teev tseg tuaj yeem siv nyab xeeb kom txog thaum kuaj pom tseeb. Nws yog ib qho tseem ceeb uas cov poov tshuaj yog khaws cia rau hauv cov tais diav ua tiav. Muab qhov nyiam rau cov txiv hmab txiv ntoo tshiab thiab ci, chav cutlets los ntawm ntses lossis nqaij. Jacket qos yaj ywm tuav cov ntaub ntawv rau cov ntxhia hauv cov zaub. Nco ntsoov tias thaum kho cua sov, feem ntau ntawm cov poov tshuaj yaj hauv dej, yog li ntawd, cov khoom yuav tsum tau boiled nyob rau hauv ib tug tsawg kawg nkaus tus nqi ntawm cov kua.
Yuav ua li cas tiv thaiv kev ua txhaum
Cov txheej txheem tiv thaiv muaj xws li lub koom haum ntawm kev noj zaub mov kom raug, ua kom lub cev tsis zoo. Tsis txhob noj cov zaub mov uas muaj calorie tsawg (tsawg dua 800 kcal ib hnub), thaum ua noj legumes, txiv hmab txiv ntoo thiab zaub, tsis txhob ua txhaum txoj cai ntawm kev kho cua sov. Saib xyuas qhov zoo ntawm kev pw tsaug zog thiab wakefulness, tso tseg cov cwj pwm phem. Yog tias ua tau, hloov cov tshuaj diuretics uas txhawb kev tshem tawm cov micro- thiab macroelements ntawm lub cev nrog cov tshuaj potassium-sparing diuretics. Raws li qhov tshwm sim ntawm kev tawg ntawm cov nqaij fibers, ntau cov poov tshuaj raug tso tawm los ntawm myocytes, yog li ntawd, lub zog thiab kev ua kis las raug txwv nruj heev thaum muaj hypokalemia.
Yog li, peb tau paub txog cov yam ntxwv ntawm kev kho mob hypokalemia, ua rau, cov tsos mob thiab cov tsos mob ntawm electrolyte tsis txaus. Nws tsis pom zoo kom tsis quav ntsej txog qhov teeb meem - qhov tsis muaj peev xwm thiab kev kho mob raws sij hawm hem nrog glycoside intoxication, acid-base imbalance, depletion ntawm insular apparatus, thiab lwm yam teeb meem. Thaum xub thawjceeb toom, rov xav txog koj tus cwj pwm rau txoj kev ua neej, kev noj qab haus huv feem ntau, tsis muaj kev kho tus kheej. Ua neeg ntse thiab saib xyuas koj tus kheej!
