I-acidosis ichazwa ngokuba khona kwe-asidi ngokweqile egazini, umphumela wezinkinga ezihlukahlukene ze-metabolic kanye nezifo lapho i-acidity eyengeziwe ikhiqizwa khona. Ngezinye izikhathi kuba isimo esiphuthumayo esibalulekile. Ukuphatha kwayo kusekelwe ekwelapheni imbangela. 

Ukuba khona kwe-metabolic acidosis emzimbeni kuxhunyaniswa nokwanda kokukhiqizwa noma ukungeniswa kwama-acids kanye / noma ukwehla kokukhishwa kwama-asidi. Futhi ngezinye izikhathi kuwumphumela wokulahlekelwa umgudu wokugaya ukudla noma izinso zama-bicarbonates (HCO3-) ezivame ukuvimbela ukuba khona ngokweqile kwama-asidi egazini futhi zibambe iqhaza ekuseleni kwesisekelo se-asidi.

Imvamisa, i-plasma (ingxenye yegazi engenawo amangqamuzana abomvu egazi, amangqamuzana amhlophe egazi nama-platelet) iwuketshezi olungenantambo ngogesi, okungukuthi, luqukethe amanani amaningi ama-ionic angalungile njengephozithivu (HCOE-, H +, Na +, K +), CL-…). Kulapho amashaji amahle emakhulu ngenani lapho kwenzeka khona i-metabolic acidosis.

Kunezimbangela eziningi ze-metabolic acidosis. I-Metabolic acidosis akusona isifo ngokwaso, kodwa ukubonakaliswa kwebhayoloji yokungalingani kwegazi phakathi kwe-acidity nama-bicarbonates. Lokhu kungalingani kuwumphumela wezifo eziningana ezingase zibe khona.

Ukuba khona kwe-lactic acid eningi ngokunqwabelana egazini

Le organic metabolic acidosis ibangelwa: 

• isimo sokushaqeka komzimba; 
• ukwehluleka kwesibindi (isibindi asisayenzi imisebenzi yaso yokuhlanza igazi);
• isifo segazi njenge-acute leukemia noma i-lymphoma (umdlavuza wama-lymph nodes);
• isifo sezinso esingamahlalakhona (izinso azisayisusi i-asidi eningi egazini); 
• ubuthi bokudla (i-methanol, i-salicylates, i-ethylene glycol, njll.);
• i-ketoacidosis (isifo sikashukela lapho i-insulin iphela).

Ukuba khona kwe-lactic acid eningi egazini ngokunciphisa ukuqedwa kwayo

Le mineral metabolic acidosis ivela ku:

• ukwehluleka kwezinso okukhulu;
• ukweqisa kwe-NaCl chloride infusion (usawoti);
• ukulahlekelwa kwe-bicarbonate ezinso;
• ukulahlekelwa kwe-bicarbonate emgudwini wokugaya (uhudo);
• ukungasebenzi kahle kwezindlala ze-adrenal.

I-Metabolic acidosis ingenzeka futhi ekuhlulekeni kokuphefumula okukhulu lapho umzimba ungasakwazi ukukhipha isikhutha ngamaphaphu, okubangela ukugcwala kwe-acid ku-plasma yegazi. I-acidosis ibizwa ngokuthi "ukuphefumula".

Lapho ibhalansi ye-acid-base yomzimba iphazamisekile kungakhathaliseki ukuthi iyini imbangela, izimpawu ezihlukahlukene zingavezwa. Uma lokhu kungalingani kulinganiselwe, ngeke kube khona izimpawu ngaphandle kwalezo zembangela eyinhloko (uhudo, ukungakhululeki okuhlobene nesifo sikashukela esingalingani, njll.). Kodwa ukungalingani kugcizelelwe (pH <7,10), izimpawu ezilandelayo zingase zenzeke:

• isicasuli;
• ukuhlanza;
• ukuzizwa ungaphilile;
• ukwanda kwezinga lokuphefumula (i-polypnea emzamweni wokuqeda i-asidi ye-metabolic ngokweqile);
• umfutho wegazi ophansi (hypotension) noma ngisho nokushaqeka kwenhliziyo nemithambo yenhliziyo ene-arrhythmias yenhliziyo kanye ne-coma.

Uma le acidosis ikhona ngendlela engapheli (ukwehluleka ukuphefumula okungapheli…), ingabangela ukulahlekelwa kwe-calcium emathanjeni (i-osteoporosis, rickets).

Ngaphandle kokusesha imbangela eyisisekelo ngokuhlolwa okuhambisanayo, ukuhlolwa kwegazi ezingeni lemithambo ekala amagesi egazi kanye nama-electrolyte e-serum kuzokwenza kube nokwenzeka ukugqamisa imiphumela yebhayoloji ye-metabolic acidosis.

Izimbangela eziyisisekelo ze-metabolic acidosis zizosolwa umlando wezokwelapha (isifo sikashukela, ukuphefumula, ukwehluleka kwezinso noma isibindi ...) kodwa futhi ngokuhlolwa kwezinto eziphilayo ezihlola amazinga kashukela egazini, ukusebenza kwesibindi nezinso, i-sodium ne-chlorine yegazi, noma umkhiqizo onobuthi igazi (methanol, salicylate, ethylene glycol).

Ukwelashwa kwe-metabolic acidosis okokuqala kukho konke okuyimbangela (isifo sikashukela esingalingani, isifo sohudo, isibindi, ukwehluleka kwezinso noma ukuphefumula, njll.). Kepha ezimeni eziphuthumayo lapho i-metabolic acidosis isinzima, kwesinye isikhathi kuyadingeka ukuthi kufakwe i-sodium bicarbonate ukuze kwehliswe i-asidi ye-plasma yegazi.

Uma kwenzeka ukwehluleka okukhulu kwezinso noma ubuthi, i-hemodialysis (ukuhlunga ubuthi obuvela egazini) izohlanza igazi futhi ithathe indawo yomsebenzi wezinso.

Ekugcineni, lapho kubhekene ne-acidosis engapheli, ukudla kunconywa ukubuyisela ibhalansi ye-acid-base yegazi ngamathiphu ambalwa:

• khetha ukudla okune-alkali kakhulu (ikhambi likalamula, itiye le-ginger, imbewu yethanga, njll.);
• thola umoya-mpilo ngokuzijwayeza umsebenzi wezemidlalo ojwayelekile endaweni evulekile;
• thatha izithako zokudla ezikhuthaza i-alkalization yegazi.