I-Hyperkalemia

I-Hyperkalemia, eyaziwa nangokuthi amazinga aphezulu e-potassium egazini, yisifo esibucayi esingakwehlela ngaphandle kwesixwayiso. Lokhu kungalingani kumakhemikhali omzimba wakho kuthinta indlela izinzwa zakho nemisipha esebenza ngayo, kuhlanganise nenhliziyo yakho. Ukuqonda i-hyperkalemia kubalulekile ngoba kungaholela ezinkingeni ezisongela ukuphila uma kungelashwa. Kulesi sihloko, sizohlaziya ukuthi iyini i-hyperkalemia, izimpawu zayo, nezizathu ze-hyperkalemia. 

Iyini i-hyperkalemia (i-Potassium ephezulu)? 

I-Hyperkalemia yisifo sezokwelapha lapho amazinga e-potassium egazini lakho eba phezulu kakhulu. Ngokuvamile, amazinga e-potassium awela phakathi kuka-3.5 no-5.0 millimoles ilitha ngalinye (mmol/L). Uma la mazinga edlula ku-5.5 mmol/L, kubhekwa njenge-hyperkalemia. Lesi simo singaba sibi, ikakhulukazi uma amazinga e-potassium enyuka ngaphezu kuka-6.5 mmol/L, okungase kubangele izinkinga zenhliziyo ezidinga usizo lwezokwelapha ngokushesha. 

potassium idlala indima ebalulekile emzimbeni wakho. I-electrolyte eshajwa kahle esiza ukuthwala amasignali kagesi emzimbeni wakho, okuvumela imisipha yakho nemizwa ukuthi isebenze kahle. Lokhu kuhlanganisa imisipha yenhliziyo yakho, ethembele ebhalansi efanele ye-potassium ukuze ugcine isigqi esiqinile. 

Izimpawu nezimpawu ze-Hyperkalemia 

I-Hyperkalemia ngokuvamile ayibangeli izimpawu ze-potassium ephezulu, ikakhulukazi ezigabeni zayo ezithambile, okwenza kube yisimo esikhohlisayo ukubona ngaphandle kokuhlolwa okufanele kwezokwelapha. Kodwa-ke, njengoba amazinga e-potassium enyuka, izimpawu ezihlukahlukene ze-hyperkalemia zingase ziqale ukuvela. 

Izimpawu ezivamile ze-potassium ephezulu zihlanganisa: 

• Ukuzizwa ukhathele noma ubuthakathaka 
• Uzwa izinhlungu zemisipha, amajaqamba, noma ubuthakathaka 
• Ukuba ndikindiki ezandleni nasemilenzeni 
• Ukuzizwa ugula esiswini (nausea) 
• Ubuhlungu besisu 
• Ukuphefumula kanzima 
• Ukushaya kwenhliziyo okungajwayelekile 

Izimbangela Nezingozi Ze-Hyperkalemia 

I-Hyperkalemia inezimbangela eziningana nezici eziyingozi. Lokhu kungase kuhlanganise: 

• Isifo sezinso: Isizathu esivame kakhulu isifo sezinso. Uma izinso zakho zingasebenzi kahle, azikwazi ukususa ngempumelelo i-potassium eyengeziwe egazini lakho. Lokhu kuholela ekwakhekeni kwe-potassium egazini lakho. I-Hyperkalemia ngokuvamile ayenzeki kuze kube yilapho ukusebenza kwezinso kwehla ngaphansi kuka-30% kokujwayelekile. 
• Ukudla Okuphezulu Nge-Potassium: Ukudla okunjengezithelo ezomisiwe, amantongomane, ukwatapheya, amazambane, isipinashi, nenyama ebomvu kucebile nge-potassium. 
• Imithi: Lokhu kufaka phakathi eminye imithi yomfutho wegazi efana ne-angiotensin receptor blockers, ACE inhibitors, kanye ne-potassium-sparing diuretics. Amanye ama-antibiotics kanye nezinto ezinciphisa igazi zinganyusa amazinga e-potassium egazini, ikakhulukazi kubantu abanezinkinga zezinso. 

Ezinye izici eziyingozi ze-hyperkalemia zihlanganisa: 

• Isifo sika-Addison, esithinta ukukhiqizwa kwamahomoni 
• Ukusha okukhulu noma ukulimala 
• Akulawulwa kahle sikashukela 
• Ukuphelelwa amanzi emzimbeni noma ukopha kakhulu 
• Ukuhluleka kwenhliziyo ukulahla 
• Utshwala usebenzisa ukuphazamiseka 

Izinkinga ze-Hyperkalemia 

I-Hyperkalemia ingaholela ezinkingeni ezinkulu uma ishiywe inganakiwe: 

• Ukuboshwa Kwenhliziyo: Uma amazinga e-potassium egazini eba phezulu kakhulu, aphazamisa izimpawu zikagesi zenhliziyo. Lokhu kungabangela izigqi zenhliziyo ezingavamile, ezaziwa ngokuthi ama-arrhythmias, okungase kubeke ukuphila engozini. 
• Ukukhubazeka: Ezimweni ezinzima, i-hyperkalemia ingathinta indlela izinzwa nemisipha esebenza ngayo ndawonye, ​​​​kubangele ubuthakathaka ngisho nokukhubazeka. 
• Ubuhlungu besifuba kanye Nobunzima Bokuphefumula: Abantu bangase babe nenkinga yokuphefumula noma izinhlungu esifubeni, izimpawu zokuthi inhliziyo idonsa kanzima. 

Sifo 

Ukuxilongwa kwe-hyperkalemia kuqala ngophenyo lwegazi le-potassium, elikala inani le-potassium ku-serum yegazi lakho. Olunye uphenyo yilezi: 

• I-ECG: Izinguquko ze-ECG zingabandakanya amagagasi e-T aphakeme, isikhawu se-PR eside, ukunwetshwa kwenkimbinkimbi ye-QRS, futhi, ezimweni ezinzima, iphethini ye-sine wave. 
• Izilinganiso ze-potassium, i-sodium, ne-osmolality yomchamo 
• Gcwalisa inani legazi 

Ukwelashwa kwe-Hyperkalemia 

Ukwelashwa kwe-hyperkalemia kuncike ebucayi besimo kanye nempilo yonke yesiguli. 

• Izimo Ezincane: Odokotela bangase batusa ukulandela ukudla okune-potassium ephansi futhi ugweme ezinye izithako zikasawoti. 
• Izimo ezinzima: Ukwelashwa kungafaka: 
  • I-Calcium Gluconate: Lokhu kusiza ukuvikela inhliziyo emiphumeleni ye-potassium ephezulu. 
  • I-insulin eneGlucose: Le nhlanganisela isiza ukususa i-potassium egazini iye kumaseli. 
  • I-Beta-agonists: Le mithi ingashintsha i-potassium ibe amaseli. 
  • I-Diuretics: Lezi zikhuphula ukuphuma kwe-potassium ngomchamo. 
  • I-Potassium Binders: Le mithi isebenza emgudwini wokugaya ukuze isuse i-potassium eyengeziwe ngaphambi kokuba ingene egazini. 
  • I-Dialysis: Ezimeni lapho ezinye izindlela zokwelapha zingasebenzi noma uma isiguli sinokuhluleka kwezinso, i-dialysis ingase idingeke. Le nqubo ihlunga igazi ukuze isuse i-potassium eyeqile. 

Uzoyibona Nini Udokotela 

I-Hyperkalemia ingaba usongo oluthule, ngokuvamile olungabonisi zimpawu ezicacile kuze kube yilapho iba nzima. 

Kufanele uxhumane nodokotela wakho uma uhlangabezana nezimpawu ezithambile ezifana nesisu esibuhlungu, isifo sohudo, isicanucanu, ukuhlanza, noma ukukhathala. Lezi kungaba izimpawu zokuqala ze-hyperkalemia. 

Ezimweni ezimbi kakhulu, ukunakekelwa kwezokwelapha okusheshayo kuyadingeka. Uma unenkinga yokuphefumula, ubuthakathaka obukhulu bemisipha, ubuhlungu obukhulu besisu, nanoma yiziphi izimpawu zokuhlaselwa yinhliziyo, njengobuhlungu besifuba noma ukushaya kwenhliziyo okubuthakathaka, ungalindi - shayela usizo oluphuthumayo ngokushesha. Lezi zimpawu zingabonisa i-hyperkalemia enzima, engasongela ukuphila. 

Prevention 

Ukuvimbela i-hyperkalemia kuhilela ukulawula ukudla kwakho nokulandela iseluleko sikadokotela wakho. 

• Uma usengozini, ikakhulukazi ngenxa yezinkinga zezinso, kubalulekile ukuqapha ngokucophelela ukudla kwakho kwe-potassium. 
• Ukudla okune-potassium ephansi, ngokuvamile okungu-2-3 amagremu ngosuku, kungasiza ukugcina amazinga esheke. Qaphela ukudla okune-potassium ephezulu njengobhanana, izithelo ezomisiwe, amantongomane, nemifino ethile. 
• Ukubilisa imifino kunganciphisa okuqukethwe kwayo kwe-potassium, njengoba eminye ingena emanzini okupheka. 
• Qaphela ngokufaka esikhundleni sikasawoti, njengoba eziningi zine-potassium chloride. 
• Uma unesifo sikashukela, ukugcina izinga likashukela egazini liphansi kubalulekile, ngoba ushukela ophezulu uhlobene namazinga aphezulu e-potassium. 
• Ukukhipha isisu njalo kungasiza ekuvimbeleni ukunqwabelana kwe-potassium egazini. Uma uqunjelwa, khuluma nodokotela wakho mayelana nezindlela eziphephile zokwandisa ukudla kwakho i-fiber. 
• Eminye imithi, njengemithi ethile yomfutho wegazi, ingathinta amazinga e-potassium, ngakho ukulandela isiqondiso sikadokotela wakho kubalulekile. 

Isiphetho 

I-Hyperkalemia yisimo esibucayi esidinga ukunakwa nokuphathwa ngokucophelela. Ukuqonda izimbangela ze-hyperkalemia, izimpawu, kanye nezinkinga ezingaba khona kubalulekile kulabo abasengozini, ikakhulukazi abantu abanezinkinga zezinso noma labo abaphuza imithi ethile. Ukuhlolwa njalo nokuhlolwa kwegazi kudlala indima ebalulekile ekutholakaleni kusenesikhathi nasekuvimbeleni lesi simo esingase sibe yingozi. 

Ukwelashwa okufanele kanye nokushintsha kwendlela yokuphila kungasiza ukugcina amazinga e-potassium ehlola futhi kuvimbele izinkinga. Abantu bangakwazi ukuphatha ngempumelelo i-hyperkalemia ngokusebenzisana eduze nodokotela, ngokulandela ukudla okune-potassium ephansi uma kudingeka, nokuhlala benolwazi ngalesi simo. Khumbula, ungangabazi ukufuna iseluleko sezokwelapha ngokushesha uma unezimpawu noma usengozini. Impilo yenhliziyo yakho ingancika kukho. 

Imibuzo Evame Ukubuzwa 

1. Kwenzekani uma i-potassium iphezulu? 

Lapho amazinga e-potassium egazini eba phezulu kakhulu, kungaholela ezinkingeni ezinkulu zempilo. Ngokuvamile, izinso zisusa i-potassium ngokweqile ngomchamo. Nokho, uma izinso zingasebenzi kahle noma ezinye izici zidlala, i-potassium inganqwabelana egazini. Le potassium eqoqiwe ingalimaza inhliziyo, ibangele ukushaya kwenhliziyo, futhi ibangele ngisho nesifo senhliziyo. Abantu abaningi abane-potassium ephezulu abaziboni izimpawu eziphawulekayo, okwenza ukuhlolwa kwegazi njalo kube kubalulekile kubantu abasengozini. 

2. Liyini izinga le-potassium egazini eliphephile noma elivamile? 

Izinga le-potassium elijwayelekile kubantu abadala lisukela phakathi kuka-3.5 & 5.0 millimoles ilitha (mmol/L). I-Hyperkalemia yenzeka lapho izinga le-potassium egazini lingaphezu kuka-5.5 mmol/L. Amazinga angaphezu kuka-6.5 mmol/L angabangela izinkinga zenhliziyo ezidinga ukunakekelwa ngokushesha. Kubalulekile ukuqaphela ukuthi izinga loshintsho kumazinga e-potassium lingabaluleka kakhulu kunenani langempela lenombolo. 

3. I-hyperkalemia ivame kangakanani? 

I-Hyperkalemia ayivamile kubantu abaningi, ithinta cishe u-2% kuya ku-3% wabantu. Nokho, kuvame kakhulu emaqenjini athile. Abantu abane isifo sezinso esingamahlalakhona (CKD) amathuba okuba ne-hyperkalemia aphindwe kathathu. Eqinisweni, ngaphezu kwesigamu salabo abane-CKD abangayidingi i-dialysis ekugcineni baba namazinga aphezulu e-potassium. 

4. I-hyperkalemia ithinta bani? 

Noma ubani angaba ne-hyperkalemia, kodwa izici ezithile zandisa ingozi. Lokhu kuhlanganisa ukuba nezimo ezifana nesifo sika-Addison, ukuphazamiseka kokusebenzisa utshwala, isifo sikashukela, noma isifo sezinso esingamahlalakhona. Abantu abanenkinga yokumelwa yinhliziyo, ukusha kakhulu, noma ukwakheka kwezinso okungavamile nabo basengozini enkulu. Imithi ethile, ikakhulukazi imithi yomfutho wegazi, ingakhuphula namazinga e-potassium. 

5. Ngiwehlisa kanjani amazinga e-potassium? 

Odokotela bangase batuse izinguquko zokudla, ukulungiswa kwemithi, noma imithi ethile yokwehlisa amazinga e-potassium. Izinguquko zokudla zihlanganisa ukunciphisa ukudla okune-potassium ephezulu kanye nokugwema esikhundleni sikasawoti esiqukethe i-potassium chloride. Imithi efana ne-diuretics ingasiza ekususeni i-potassium eyengeziwe ngomchamo. Odokotela ngezinye izikhathi bangase banikeze izibophezelo ze-potassium ukuze zisuse i-potassium eyengeziwe emzimbeni. Ezimweni ezinzima, ukwelashwa kwe-hyperkalemia nge-intravenous noma i-dialysis kungase kudingeke. 

6. Ungawahlola kanjani amazinga e-potassium ekhaya? 

Njengamanje, ayikho indlela ethembekile yokuthi iziguli zihlole amazinga azo e-potassium ekhaya. Indlela enembe kakhulu iwukuhlolwa kwegazi esikhungweni sezempilo. Kodwa-ke, ucwaningo lusaqhubeka lokuthuthukisa ama-monitor aphethwe ngesandla anganikeza ukufundwa okuvamile, okufana nendlela abantu abanesifo sikashukela abahlola ngayo amazinga kashukela egazini. 

UDkt. Rita Bhargava

I-PGDID, M.Sc, DE, PhD (Nutrition)
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529

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