Water-mchere kugawana munthu ntchito, ndi lamulo kuphwanya

Normal ntchito za thupi la munthu ndi zovuta ya munthu kuchuluka kwa njira, mmodzi amene ndi madzi amchere kuwombola. Pamene iye ali mu chikhalidwe wabwinobwino, munthu mofulumira palibe kusintha umoyo wawo, koma mwamsanga pamene pali kwenikweni kwambiri zolakwika, ambiri yomweyo amayesetsa kutsatira miyezo yosiyanasiyana. Kuti izi sizinachitike, ndi bwino kupeza kodi kagayidwe madzi amchere, ndi chifukwa chake ndi chofunika kusunga bwino. Komanso, m'nkhani ino tikambirana njira zoyambirira za kuphwanya ake ndi kuchira.

Ndi chiyani icho?

Madzi ndi mchere kuwombola - ali pamodzi ndi chimodzi electrolytes wina Zofika ndi madzi m'thupi, ndi mbali yaikulu ya kuloŵerera awo ndi kugawa zina za ziwalo, ziwalo, mapangidwe, ndi njira zosiyanasiyana awo excretion ku thupi.

chakuti anthu awo oposa theka ndi madzi, aliyense amadziwa kuti kuyambira ali mwana, ndi m'malo chidwi n'chakuti chiwerengero cha madzimadzi thupi zimasiyanasiyana ndipo watsimikiza ndi chiwerengero mokwanira lalikulu zinthu, kuphatikizapo zaka, okwana mafuta misa, komanso pakati pa anthu electrolytes kwambiri. Ngati wakhanda ndi munthu mmadzi ndi pafupifupi 77%, munthu wamkulu kumafuna% 61 okha, ndi akazi - onse 54%. Choncho otsika madzi okhutira mu thupi la akazi ndi chifukwa iwo ali wosiyana pang'ono madzi mchere kagayidwe, komanso panopa nambala mokwanira waukulu wa maselo mafuta.

mbali Ofunika

Kuchuluka okwana madzi mu thupi la munthu anapereka pafupifupi motere:

• Pafupifupi 65% zapatsidwa kwa madzi okhudza maselo ambiri ndi kugwirizana ndi phosphate ndi potassium amene ali anion ndi cation, motero.
• 35% ndi extracellular madzimadzi, zomwe zambiri mu m'magazi ndi minofu ndi madzimadzi interstitial.

Komanso, Dziwani chakuti madzi mu thupi mu mkhalidwe free, zonse unachitikira colloids, kapena amagwira ntchito mapangidwe ndi kuwonongeka kwa mapuloteni, mafuta ndi zimam'patsa mamolekyulu. Pa zimakhala pano zosiyanasiyana osiyana chiŵerengero cha madzi omangidwa, free ndipo adzamangidwa kwa amene mwachindunji yozungulira lamulo la madzi ndi mchere kuwombola.

Poyerekeza ndi madzi a m'magazi, komanso achindunji intercellular madzimadzi, minofu yodziwika ndi kukhalapo kwa ndalama mokwanira lalikulu magnesium, potaziyamu ndi mankwala, ndipo si woipa lalikulu la calcium, sodium, chlorine ndi wa hydrogen ayoni mmodzi. Kusiyana kumeneku amayamba ndi chakuti capillary khoma mapulotini ali otsika permeability.

lamulo moyenera kagayidwe madzi amchere anthu athanzi osati zipangitsa ntchito yokonza ndodo okhazikika, komanso kuchuluka chofunika cha mthupi, chingakuthandizeni asidi-m'munsi, komanso zayamba zofanana kuti maganizo ofunikira zinthu osmotically yogwira.

lamulo

Muyenera kumvetsa bwinobwino mmene ntchito kagayidwe madzi amchere. lamulo ntchito akutsatiridwa ndi machitidwe zingapo zokhudza thupi. Choyamba maselo apadera kuwathandiza osiyanasiyana mu ndende ya wothandizila osmotically yogwira, ayoni, electrolytes, ndi buku la pano madzimadzi. Kenako zizindikiro zimatumizidwa chapakati mantha dongosolo, ndi pamenepo pokha thupi limayamba kusintha mowa madzi, komanso kudzipatula ake ndi mchere wofunikira, ndipo, chotero, dongosolo kuwombola madzi amchere ukulamulidwa.

Excretion wa ayoni, madzi, ndi electrolytes impso ali m'manja mwachindunji ya ubongo ndipo zosiyanasiyana mahomoni. Pa malamulo a madzi ndi mchere kuwombola naonsO angapezekeko physiologically yogwira opangidwa mu impso ndi. Onse zili ndi sodium mu thupi mosalekeza kusintha mu impso womvera CNS ankalamulira kudzera natrioretseptory apadera mosalekeza kumva pakutchulidwa kusintha kulikonse zili ndi sodium mwa madzi m'thupi komanso osmoreceptors ndi volyumoretseptory mosalekeza kupenda kuthamanga osmotic wa extracellular ndi buku la kufalitsidwa madzi.

Pakuti lamulo la kuwombola potaziyamu mkati thupi Yankho dongosolo chapakati mantha, amene amagwiritsa zosiyanasiyana kuwombola timadzi madzi amchere, ndi corticosteroids osiyanasiyana kuphatikizapo insulin ndi aldosterone.

Lamulo chlorine kuwombola mwachindunji zimatengera mtundu wa impso, ndi excreted ayoni amapezeka nthawi zambiri zaphindu ndi mkodzo. Kuchuluka okwana excreted sodium kolorayidi mwachindunji zimadalira zakudya anthu, ntchito reabsorption sodium, muyezo asidi-m'munsi, aimpso tubular boma makina, ndi gulu la zinthu zina. Kusinthana kwa mankhwala enaake a mwachindunji ndi nzeru madzi, kotero lamulo la madzi ndi mchere kuzizira thupi amakhudza chiwerengero cha zinthu zina za uziyenda yachibadwa kachitidwe zosiyanasiyana.

Kodi ponseponse?

Yaikulu chiwerengero cha njira zosiyanasiyana zokhudza thupi mu thupi lathu, mwachindunji amadalira kuchuluka okwana salt ndi zakumwa. Panopa amadziwika kuti pofuna kupewa kuphwanya kagayidwe madzi amchere, munthu tsiku muyenera kumwa za 30 ml ya madzi pa kilogalamu wa bodyweight. ndalamazo ndi zokwanira kupereka thupi lathu kuchuluka kwa mchere. madzi amatayika pa maselo osiyanasiyana a mtima minofu ndi mafupa, komanso kupasuka ndiponso kusamba kunja muli zosiyanasiyana. Mu namtindi wa milandu Kuchuluka kwa madzi ankadya masana munthu pafupifupi Kodi musalumphe awiri ndi theka malita, ndi buku ili aumbike zambiri motere:

• kuti okwanira 1 timapeza chakudya;
• mpaka malita 1.5 - likuvutika kumwa madzi opanda;
• 0.3-0.4 malita - mapangidwe wa makutidwe ndi okosijeni wa madzi.

The lamulo la madzi ndi kuwombola mchere mu chamoyo mwachindunji zimadalira bwino pakati kuchuluka chiphaso ake ndi kumasulidwa kwa nyengo zina za nthawi. Ngati masana thupi akufunitsitsa kumapita za 2.5 malita, mu nkhani iyi, za yofanana adzakhala excreted thupi.

Madzi ndi kuwombola mchere m'thupi la munthu ndi Lamulo kuipidwa osiyanasiyana neuroendocrine mayankho omwe makamaka umalimbana kukhala bata zonse buku, komanso kuthamanga osmotic ya nchito extracellular, ndipo kuti ndi kofunika kwambiri - ndi madzi a m'magazi. Ngakhale kuti zosiyanasiyana njira chizindikiro deta kudzudzulidwa ndi yoyenda yokha, iwo onse ndi yofunika kwambiri mkulu.

Chifukwa chotero lamulo zimatheka ndi kuchirikiza khola kwambiri ndende kaperekedwe ka ayoni ndi electrolytes ndi lopangidwa ndi madzimadzi extracellular ndi okhudza maselo ambiri. Mwa thupi chachikulu ndi kupereka cations potaziyamu, sodium, calcium ndi magnesium, pamene anions - hayidirojeni, chlorine, sulphate ndi mankwala.

siudzalandilidwa ngathi lamulo

Sikutheka kuti mbali ya chitsulo kagayidwe madzi amchere, monga mwa ndondomeko izi nawo nambala yaikulu matupi osiyana. Ndi chifukwa chake mu ndondomeko ya thupi angasonyeze zosiyanasiyana kuyan'anila, kusonyeza phunziro, mwa womwenso kunja zotsatirazi:

• zosayembekezereka wa edema;
• kudzikundikira yambiri madzi mwa thupi, kapena, Tikawonetsetsa akusowa ake;
• kuphwanya bwino electrolyte;
• kuwonjezera kapena kuchepa mu kuthamanga osmotic magazi;
• kusintha mu muyezo asidi-m'munsi;
• kuwonjezera kapena kuchepa mu ndende ya ena ayoni yeniyeni.

zitsanzo

M'pofunika kudziwa molondola, kuti matupi ambiri nawo lamulo la kagayidwe madzi mchere, namtindi wa milandu sakhala pomwepo zotheka kukhazikitsa chifukwa yeniyeni ya vuto. Mwachidule madzi bwino mwachindunji anatsimikiza ndi kuchuluka kwa madzi anadzetsa ndi m'thupi lathu, ndi kuphwanya aliyense kuwombola izi zokhudza bwino electrolyte ndi kuyamba kuoneka mu mawonekedwe a hydration ndi ludzu. Mawu akuti lenileni la muyeso - izi kutupa, kuti ndi madzi kwambiri zimakhala zosiyanasiyana za thupi, malo intercellular ndipo cavities serous, amene anatsagana ndi electrolyte vutoli.

Pamene madzi m'thupi uyu, nayenso, lagawidwa mitundu ikuluikulu iwiri:

• popanda ndalama yokwana cations limene pali ludzu mosalekeza, ndi madzi ali maselo, umaperekedwa kwa danga interstitial;
• imfa ndi sodium amenewa amapezeka mwachindunji ku madzi extracellular ndi zambiri osati limodzi ndi ludzu.

matenda osiyanasiyana bwino madzi anatisonyeza kumene kuchepetsedwa kapena kuchuluka okwana madzi kufalitsidwa. Nthawi zambiri amapezeka kwambiri kuwonjezeka chifukwa polyplasmia kuti, kuonjezera chiwerengero cha magazi mu madzi.

Kusinthana kwa sodium wochuluka

Kudziŵa zinthu zosiyanasiyana pathological limene pali kusintha zikuchokera amaayoni wa madzi a m'magazi kapena ndende ya ayoni ena mmenemo ndi yofunika kwambiri kwa masiyanidwe matenda angapo a matenda. matenda osiyanasiyana mu kuwombola ndi sodium mu chamoyo ndi owonjezera kapena kusowa kusintha zosiyanasiyana kugawa ake thupi lonse. Yotsirizira amapezeka mu kukhalapo kwa ndalama labwinobwino kapena adasandulika wa sodium wochuluka.

Akusowa angathe kukhala:

• N'zoona. Ndi chifukwa imfa ya madzi, ndi sodium, omwe kawirikawiri akuwonetseredwa mu thupi wambiri osakwanira mchere komanso thukuta amphamvu kwambiri, polyuria, amayaka yaikulu, matumbo kutsekeka, ndi njira zina komabe ambiri.
• Wachibale. Akhoza kukhala ndi makonzedwe kwambiri njira amadzimadzi pa mtengo choposa madzi excretion ndi impsozo.

Muyeso komanso zimasiyanasiyana n'zimenenso:

• N'zoona. Chikuyendetsedwera kuti wodwala chifukwa njira iliyonse mchere, kumwa kwambiri a mchere wamba, kuchedwa zosiyanasiyana excretion wa sodium wochuluka ndi impso, komanso kupanga kwambiri kapena kwambiri makonzedwe yaitali glucocorticoids.
• Wachibale. Nthawi zambiri anati pamaso pa madzi m'thupi ndipo ndi chifukwa mwachindunji zimamuchulukira madzimadzi ndi chitukuko zina za mitundu yonse kutupa.

mavuto ena

kuyan'anila Major kuwombola potaziyamu zomwe pafupifupi kwathunthu (98%) akupezeka mu madzimadzi okhudza maselo ambiri ukufanizidwa hyperkalemia ndi hypokalemia.

Hypokalemia amapezeka mu kukhalapo kwa yambiri mankhwala, kapena nkhani ya kuyambitsa kuchokera kunja kwa glucocorticoids kapena aldosterone amene amayambitsa amphamvu kwambiri katulutsidwe potaziyamu mu impso ndi. Komanso angayambe nkhani ya utsogoleli mtsempha, mitundu yosiyanasiyana ya mankhwala kapena osakwanira potaziyamu kulowa mu Thupi ndi chakudya.

Hyperkalemia ndi zotsatira pafupipafupi kuvulazidwa, kusala yafupika magazi voliyumu ndi makonzedwe kwambiri njira zosiyanasiyana potaziyamu.

kuchira

Matenda madzi ndi mchere kuwombola mungathe impso ntchito yokonzekera apadera mankhwala amene apangidwa makamaka kuti kusintha okhutira okwana electrolyte ndi, ayoni hydrogen ndi madzi. Support ndi kusintha zinthu zazikulu za homeostasis likuvutika ntchito coherent wa excretory, endocrine ndi machitidwe kupuma. Aliyense, ngakhale kusintha kwambiri zazing'ono zili madzi kapena electrolytes kungayambitse mavuto aakulu kwambiri, zomwe zina kusokoneza moyo wa munthu.

Kodi Kwalamulidwa?

Kuti matenda kugawana madzi mchere munthu, mungathe kugwiritsa ntchito zotsatirazi:

• Asparangiat magnesium ndi potaziyamu. Nthawi zambiri zaphindu anatumizidwa yekha monga zowonjezerazo ndi mankhwala chititsimikizira kuti mtima kulephera zikachitika, matenda osiyanasiyana mungoli mtima kumachitika kapena m'mnyewa wamtima infarction. Ndithu mosavuta odzipereka pamene anatengedwa pakamwa, kenako excreted ndi impsozo.
• Sodium bicarbonate. Kwenikweni anatumizidwa pamaso pa mmatumbo matenda chilonda ndi m'mimba, kagayidwe kachakudya acidosis, komanso gastritis ndi asidi wambiri umene umachitika choledzeretsa, matenda, kapena matenda a shuga, ndi pa nthawi postoperative. Mokwanira mofulumira neutralizes chapamimba asidi mchere, komanso amatipatsa mofulumira kwambiri mankhwala ochotsa asidi zotsatira ndipo timapitiriza ayambe wonse wa gastrin ndi kutsegula yachiwiri ya katulutsidwe.
• Sodium kolorayidi. Amaganiza pamaso zomvetsa yaikulu ya madzimadzi extracellular kapena pamaso pa kudya ake sangakwanitse. Komanso, madokotala amalangiza zambiri zokwanira ntchito mu hyponatremia, chloropenia, kutsekeka m'matumbo ndipo intoxications zosiyanasiyana. chida ichi ali ndi zakumwa zobwezeretsa ndi detoxication tingati ndi amatipatsanso ayambe kusowa kwa sodium wochuluka pamaso pa zikhalidwe zosiyanasiyana pathological.
• Sodium citrate. Izo ntchito kuonetsetsa olimba a magawo magazi. Ndi binder kwa calcium, komanso ngati woletsa wa coagulation magazi. Kenako kumawonjezera zili okwana ndi sodium mu thupi ndi kumawonjezera magazi soda nkhokwe, amene amathandiza zotsatira zabwino.
• Hydroxyethyl starch. Ntchito ntchito ndondomeko, komanso amayaka, zoopsa, kukha magazi pachimake ndi matenda osiyanasiyana opatsirana.

Choncho, mudzatha kuti matenda kagayidwe madzi mchere ndi thupi kubwerera ku ntchito bwinobwino. Sankhani njira makamaka mankhwala ayenera kwambiri oyenerera dokotala, monga anu, mukhoza kwambiri kuvutika chikhalidwe.