Ka Hanu ʻana o Kussmaul: Ke Hoʻomaopopo ʻana i nā Kumu, nā Hōʻailona, ​​a me ka Lāʻau

ʻO ka hanu ʻana ʻo Kussmaul kahi ʻano ʻokoʻa o ka hanu hohonu a luhi e pili pinepine ana me nā kūlana olakino koʻikoʻi. ʻIke pinepine ʻia kēia ʻano hanu ʻana i nā poʻe me ka metabolic acidosis, ʻoiai ke ketoacidosis diabetic (DKA), a hiki ke lilo i hōʻailona o kahi kūlana hoʻoweliweli ola e pono ai ke kōkua koke ʻana o ke kauka. Ma kēia ʻatikala, e ʻimi mākou i nā kumu o ka hanu ʻana o Kussmaul, nā hōʻailona pili, ka wā e ʻimi ai i ke kōkua lapaʻau, ka hōʻailona, ​​​​a me nā koho lapaʻau i loaʻa.

He aha ka hanu ʻana o Kussmaul?

ʻIke ʻia ka hanu ʻana o Kussmaul e nā hanu hohonu a wikiwiki e paʻakikī pinepine ana a paʻakikī ke kāohi. ʻIke pinepine ʻia kēia ʻano hanu ʻano ʻē i nā poʻe me ka metabolic acidosis, kahi kūlana kahi e hōʻiliʻili ai ke kino i ka waikawa keu a nalowale paha ka bicarbonate nui. Hoʻoponopono ke kino no ke kaulike ʻole ma ka hanu hohonu ʻana e hoʻokuke aku i ka carbon dioxide hou aku, he waikawa. ʻO ka hopena, ʻo ka hanu ʻana o Kussmaul he hōʻailona maʻamau ia e hoʻāʻo nei ke kino e hoʻoponopono i kahi haunaele metabolic koʻikoʻi.

Nā kumu o ka hanu ʻana o Kussmaul

ʻOiai ʻo ka hanu ʻana o Kussmaul e pili pinepine ʻia me ka metabolic acidosis, hiki ke hoʻoulu ʻia e nā ʻano maʻi like ʻole. ʻO kekahi o nā kumu maʻamau:

• ʻO ke Ketoacidosis Diabetic (DKA): ʻO DKA kekahi kumu maʻamau o ka hanu ʻana o Kussmaul, ʻoi aku hoʻi i nā poʻe me ka maʻi diabetes Type 1. Ma kēia kūlana, wāwahi ke kino i ka momona no ka ikehu, e hana ana i nā ketones, ka mea e hoʻolilo i ke koko i waikawa. Hoʻoponopono ke kino ma ka hanu hohonu ʻana e hoʻokuke i ke kalapona dioxide keu.
• Ka hāʻule ʻana o ka puʻupaʻa: ʻO ka maʻi puʻupaʻa mau loa a i ʻole ka hāʻule ʻana o ka puʻupaʻa koke hiki ke alakaʻi i ka metabolic acidosis, no ka mea, ʻaʻole hiki i nā puʻupaʻa ke hoʻoneʻe pono i nā waikawa mai ke kino. Hiki paha i kēia ke hopena i ka hanu ʻana o Kussmaul.
• ʻAkika Lactic: Hiki mai ka lactic acidosis ke hana nui ke kino i ka lactic acid, pinepine ma muli o ka hoʻoikaika kino nui, sepsis, a i ʻole kekahi mau lāʻau lapaʻau. Hiki i kēia ke alakaʻi i ka hanu ʻana o Kussmaul i ka wā e hoʻāʻo ai ke kino e hoʻoponopono i nā pae pH.
• Ketoacidosis ʻona: Loaʻa kēia ʻano maʻi i nā poʻe i inu nui i ka waiʻona, e alakaʻi ana i ka hōʻiliʻili ʻana o nā ketones i loko o ke kino. E like me DKA, hoʻoponopono ke kino me ka hanu hohonu a wikiwiki.
• Ka pōloli: I nā hihia o ka pōloli lōʻihi a i ʻole ka hoʻokē ʻai ʻana, hiki i ke kino ke komo i kahi kūlana ketosis, hiki ke alakaʻi i ka hanu ʻana o Kussmaul i ka wā e hoʻāʻo ai ke kino e hoʻokuke i nā waikawa keu.
• Dehydration nui: Hiki i ka dehydration ke hoʻoulu i nā electrolyte imbalances a alakaʻi i ka metabolic acidosis, e hopena ai i ka hanu ʻana o Kussmaul.

Nā hōʻailona pili o ka hanu ʻana o Kussmaul

Ma waho aʻe o ke ʻano hanu ʻokoʻa, hele pinepine ka hanu ʻana o Kussmaul me nā hōʻailona ʻē aʻe e pili ana i ke kumu kumu. ʻO kekahi mau hōʻailona pili maʻamau:

• Hanu ʻala hua: I ka ketoacidosis maʻi diabetes, he ʻala hua i loko o ka hanu kahi hōʻailona nui ma muli o ke alo o ka acetone, kahi ʻano ketone.
• Ka luhi a me ka nawaliwali: ʻO ka metabolic acidosis a me ka hopena o ka hanu ʻana o Kussmaul hiki ke hana i kahi manaʻo luhi a me ka nāwaliwali.
• Abdominal eha: ʻO ka ʻeha ʻōpū, ka nausea, a me ka luaʻi ʻana he mea maʻamau ia i nā kūlana e like me DKA a me ka lactic acidosis.
• Huikau a i ʻole ka haunaele: Hiki i ka acidosis koʻikoʻi ke hoʻopilikia i ka hana o ka lolo, e alakaʻi ana i ka huikau, ka hiamoe, a i ʻole ka nalowale o ka ʻike i nā hihia koʻikoʻi.
• Ka Paʻi Puʻuwai wikiwiki: ʻO ka Tachycardia, a i ʻole ka wikiwiki o ka puʻuwai, he pane maʻamau ia i nā haunaele metabolic a hiki ke ʻike ʻia me ka hanu ʻana o Kussmaul.
• Hoomalu: ʻO nā hōʻailona o ka make wai, e like me ka waha maloʻo, ka emi ʻana o ka mimi, a me ka ʻūlū ʻana o ka ʻili, hiki ke hele pū me ka hanu ʻana o Kussmaul i kekahi mau hihia.

I ka wa e imi ai i na lapaau

He pilikia olakino ka hanu ʻana o Kussmaul, a inā ʻoe a i ʻole kekahi e ʻike nei i kēia ʻano hanu ʻana, he mea nui e ʻimi koke i ke kōkua lapaʻau. He mea nui loa ia e ʻimi i ke kōkua inā loaʻa nā hōʻailona penei:

• Paʻakikī ka hanu ʻana: Inā koʻikoʻi ka hanu ʻana o Kussmaul a i ʻole hele pū me ka paʻakikī o ka hanu ʻana a i ʻole ka ʻeha o ka umauma, hiki iā ia ke hōʻailona i kahi maʻi koʻikoʻi e pono ai ke kōkua koke ʻana.
• Ka huikau a i ʻole ka nalowale o ka ʻike: Inā huikau, pio ke ala, a nalowale paha ka ʻike o ka mea e loaʻa ana i ka hanu ʻana ʻo Kussmaul, pono ka mālama olakino ulia pōpilikia.
• Nā hōʻailona o ka Diabetic Ketoacidosis: Inā hele pū ka hanu ʻana o Kussmaul me ka hanu ʻala hua, ka ʻeha o ka ʻōpū, a i ʻole ka luaʻi ʻana, he hōʻailona paha ia o ka ketoacidosis maʻi diabetes, kahi e pono ai ka mālama koke ʻia.
• Nā Hōʻailona o ka Holo ʻole ʻana o ka Pūnaʻi: Inā hele pū ka hanu ʻana o Kussmaul me ka pehu ʻana, ka luhi, a i ʻole ka emi ʻana o ka mimi i hoʻopuka ʻia, hiki iā ia ke hōʻailona i ka hāʻule ʻana o ka puʻupaʻa, kahi e pono ai ke kōkua koke ʻia e ke kauka.

Ka ʻike ʻana i ka hanu ʻana o Kussmaul

Ke ʻike ʻia ka hanu ʻana o Kussmaul, e hana nā mea lawelawe olakino i kahi loiloi piha e hoʻoholo ai i ke kumu. ʻO ke kaʻina hana diagnostic maʻamau e pili ana i:

• Nānā Moʻolelo Lapaʻau: E nīnau ke kauka e pili ana i nā kūlana o kēia manawa, nā maʻi i hala koke aku nei, a i ʻole nā ​​​​lāʻau lapaʻau e hiki ke kōkua i nā hōʻailona.
• Nānā kino: E kōkua ka hoʻokolohua kino i ka loiloi ʻana i ke koʻikoʻi o ke ʻano hanu a ʻike i nā hōʻailona pili, e like me ka dehydration a i ʻole ka ʻeha o ka ʻōpū.
• Nā ho'āʻo koko: Hiki i nā hoʻāʻo koko, me ka nānā ʻana i ke kinoea koko, ke kōkua i ka hoʻoholo ʻana i ka pae pH a me ka ʻike ʻana i ka metabolic acidosis. Hiki i nā pae ketone kiʻekiʻe ke hōʻike i ka ketoacidosis diabetic, ʻoiai ʻo nā pae lactate kiʻekiʻe e hōʻike paha i ka lactic acidosis.
• Nā hōʻike mimi: Hiki ke hana ʻia nā hoʻāʻo mimi e nānā i ke alo o nā ketones, hiki ke hōʻoia i ka ketoacidosis diabetic a i ʻole ka ketoacidosis alcoholic.
• Hoʻāʻo ʻana i ka Electrolyte: Hiki i kahi papa electrolyte piha ke kōkua i ka loiloi ʻana i nā kaulike ʻole e hiki ke kōkua i nā hōʻailona.
• Nā hoʻāʻo kiʻi: I kekahi mau hihia, hiki ke hoʻohana ʻia nā hoʻokolohua kiʻi e like me ka ultrasound a i ʻole CT scan e kāpae i nā kumu kumu ʻē aʻe, e like me ka hāʻule ʻana o ka puʻupaʻa a i ʻole ke kahe koko i loko.

Nā Koho Lapaʻau no ka Hanu ʻana o Kussmaul

ʻO ke ʻano o ka mālama ʻana no ka hanu ʻana o Kussmaul e hoʻoponopono i ke kūlana kumu e hoʻoulu ai i ka metabolic acidosis. ʻO kekahi mau koho lapaʻau maʻamau:

• Ka Insulin Therapy: No nā poʻe me ka ketoacidosis maʻi diabetes, lawelawe ʻia ka lāʻau lapaʻau insulin e hoʻemi i nā pae kō koko a hoʻemi i ka hana ʻana o nā ketones.
• Hoʻololi Wai: Hāʻawi pinepine ʻia nā wai intravenous e hoʻoponopono i ka dehydration a hoʻihoʻi i ke kaulike electrolyte i loko o ke kino.
• Hoʻololi i ka Electrolyte: Hiki ke hoʻopiha hou ʻia ka potassium, sodium, a me nā electrolytes ʻē aʻe e hoʻoponopono i kekahi mau kaulike ʻole e kōkua ana i ka acidosis.
• Lapaʻau Oxygen: I nā hihia kahi i pilikia ai ka hanu ʻana, hiki ke hāʻawi ʻia ka oxygen e hoʻomaikaʻi i ka pae saturation oxygen i loko o ke koko.
• Dialysis: I nā hihia koʻikoʻi o ka hāʻule ʻana o nā puʻupaʻa, pono paha ka dialysis e wehe i nā waikawa keu a me nā mea ʻawaʻawa mai ke kino.
• Nā lāʻau lapaʻau no ka Lactic Acidosis: I nā hihia o ka lactic acidosis, hiki ke lawelawe ʻia nā lāʻau lapaʻau e hoʻoponopono i ke kumu kumu, e like me ka sepsis a i ʻole ka inu ʻona nui.
• Nā lāʻau lapaʻau anti-nausea: Hiki ke kuhikuhi ʻia nā lāʻau lapaʻau e kōkua i ka hōʻoluʻolu ʻana i ka nausea a me ka luaʻi e pili ana i nā kūlana e like me DKA a i ʻole lactic acidosis.

Nā Moʻolelo a me nā ʻoiaʻiʻo e pili ana i ka hanu ʻana o Kussmaul

Aia kekahi mau moʻolelo hoʻopunipuni e pili ana i ka hanu ʻana o Kussmaul e pono e wehewehe ʻia:

• Kaʻi: ʻO ka hanu ʻana o Kussmaul e hana wale ʻia i ka poʻe me ka maʻi diabetes.
• ʻOiaʻiʻo: ʻOiai ʻo ka hanu ʻana o Kussmaul e pili pinepine ʻia me ka ketoacidosis maʻi diabetes, hiki ke hana ʻia e nā kūlana ʻē aʻe e like me ka hāʻule ʻana o ka puʻupaʻa a i ʻole ka lactic acidosis.
• Kaʻi: He mea make mau ka hanu ʻana o Kussmaul.
• ʻOiaʻiʻo: ʻO ka hanu ʻana o Kussmaul he hōʻailona ia o kahi maʻi koʻikoʻi, akā me ka mālama koke ʻana, hoʻōla piha nā poʻe he nui.

Nā pilikia o ka hanu ʻana o Kussmaul

Inā waiho ʻole ʻia ka hanu ʻana o Kussmaul a i ʻole ʻaʻole i mālama pono ʻia, hiki iā ia ke alakaʻi i kekahi mau pilikia, e like me:

• Hāʻule ka hanu: Inā ʻaʻole hiki i ke kino ke hoʻoponopono no ka metabolic acidosis, hiki ke hana i ka hāʻule ʻana o ka hanu, e pono ai ka ea mechanical.
• Poino Organ: Hiki i ka acidosis metabolic koʻikoʻi ke hōʻino i nā ʻōpū e like me nā puʻupaʻa, ka puʻuwai, a me ke akepaʻa.
• Dehydration nui: Inā ʻaʻole hoʻololi ʻia nā wai a me nā electrolytes, hiki i ka dehydration ke lilo i mea koʻikoʻi, e alakaʻi ana i nā pilikia hou aʻe e like me ka hāʻule ʻana o ka puʻupaʻa.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka hanu ʻana o Kussmaul

1. He aha ke kumu o ka hanu ʻana o Kussmaul?

ʻO ka hanu ʻana o Kussmaul ka mea maʻamau i hoʻokumu ʻia e ka metabolic acidosis, hiki ke hoʻoulu ʻia e nā kūlana e like me ka diabetic ketoacidosis, ka hāʻule ʻana o ka renal, ka lactic acidosis, a me ka alcoholic ketoacidosis.

2. Hiki ke mālama ʻia ka hanu ʻana o Kussmaul ma ka home?

He pilikia olakino ka hanu ʻana o Kussmaul a pono e mālama koke ʻia e ke kauka. Hoʻokomo pinepine ʻia ka lāʻau lapaʻau i nā wai intravenous, ka lāʻau lapaʻau insulin, a me nā lāʻau lapaʻau e hoʻoponopono ai i ke kumu.

3. He hōʻailona anei ka hanu ʻana o Kussmaul no ka diabetic ketoacidosis?

ʻAe, pili pinepine ka hanu ʻana o Kussmaul me ka diabetic ketoacidosis (DKA), kahi pilikia koʻikoʻi o ka maʻi diabetes. Hana ia i ka wā e hana ai ke kino i nā ketones keu, e alakaʻi ana i ka metabolic acidosis.

4. Pehea e ʻike ai nā kauka i ka hanu ʻana o Kussmaul?

Hoʻomaopopo nā kauka i ka hanu ʻana o Kussmaul ma o ka hoʻokolokolo kino, nā hoʻāʻo koko e nānā no ka metabolic acidosis, a me nā hoʻāʻo mimi e ʻike i nā ketones. Hiki ke hoʻohana ʻia nā hoʻokolohua kiʻi e kāpae i nā kumu ʻē aʻe.

5. Hiki ke pale ʻia ka hanu ʻana o Kussmaul?

ʻOiai ʻo ka hanu ʻana o Kussmaul e pili pinepine ana i nā kūlana olakino maʻamau, ʻo ka mālama pono ʻana i ka maʻi diabetes, nā maʻi puʻupaʻa, a me nā mea ʻē aʻe e hiki ke hōʻemi i ka pilikia o ka hoʻomohala ʻana i kēia hōʻailona.

Panina

He maʻi koʻikoʻi ka hanu ʻana o Kussmaul e pono ai ka nānā koke ʻana a me ka mālama ʻana. ʻOiai e pili pinepine ʻia me ka ketoacidosis diabetic, hiki ke hana ʻia e nā pilikia metabolic ʻē aʻe. He mea nui ka ʻike mua ʻana a me ka mālama kūpono e pale aku i nā pilikia a hoʻomaikaʻi i nā hopena. Inā ʻoe a i ʻole kekahi āu i ʻike ai e ʻike nei i ka hanu ʻana o Kussmaul, e ʻimi koke i ke kōkua lapaʻau.