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Title:

Disorders of Water and Electrolyte Metabolism

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Title: Author: chen Last modified by: office-bs Created Date: 9/2/1997 12:17:00 PM Document presentation format: – PowerPoint PPT presentation

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Title: Disorders of Water and Electrolyte Metabolism


1
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2
?????????
Disorders of Water and Electrolyte Metabolism
  • ??
  • ??????
  • ?????
  • ?????
  • ??????

3
?????????????????????
4
??????????, ?????????
????(?????)
???????????????
5
???????
???
???
Cl- HCO3-
Na K Ca Mg
ECF
SO42- HPO42- ???
K
HPO42- ??
ICF
Mg Na Ca
SO42- HCO3- Cl-
ECF?ICF????????????
6
Na
Na
Cl-
Cl-
HPO42- SO42- ???
HPO42- SO42- ??? ???
K Ca2 Mg2
K Ca2 Mg2
HCO3-
HCO3-
??
????
7
?? 7 ????
0.05-0.35 ????????????? ??,??????????????????
????
????
8
  • ??????

???
  • ???? 1500-2000ml

9
???
????
10
??????1.??????
2.???? 3.????
4.??????(???)?
????????1.???????????????
2.????????????????
?,???????????
3.??????????????
11
???????
???? ADH ??? ???
12
???????????
????????
????????????
??????
ADH???
???????
??
???????????
???????
???????
13
  • ?????????

??????????
14
??????????????
15
???????? hypovolemic hyponatremia
????? hypotonic dehydration
  • ?? ???gt ??
  • ?????
  • ??????

lt130mmol/L lt280mmol/L
16
  • (1)??

??? ??
????? ??????
?????????? ??????
??????? ? ???? ?????????????
??????
??????????? ??????????????
17
  • (2)??????

?????????,?????????????
????
?? ????
ADH?
?????
???
??????????
18
(3)??
??????????????
19
(???)
  • ????????

?? ????,?????lt130mmol/L,
?????lt280mmol/L, ??????????,????
(1)?????
????? ????????????? ????? ???????
ADH??????????
????????
20
(2)??
?????????????????????
????
???? ???
ECF?
ECF??
????
21
?? ????? ?? ????????? ???????
?????????????????,???????????????????????
22
???????? hypovolemic hypernatremia ?????hypertoni
c dehydration
?? ???gt?? ?????
gt150mmol/L ?????? gt310mmol/L
??????????????
23
(1)??
???????????????
???
?? ?????? ADH??? ????????
????
????
???
???????? ??????
??????????? ??(?????)
??????????????
24
(2)??????
ECF??? ?????
ECF
??????
25
  • ?????

?
26
(3)????
???? ???? ???? ????
27
??
??(?????) ??????? ???????????? ???????
28
??
??
29
?????????
??
????? ????
??????
????
?????
30
????
?????
??????
?????
?????
???????
????????????????????
31
????1
????
1. ???????
2. ????????
3. ????????
4. ??????
32
1. ???????
??
??
??
33
?????
1. ???????
2. ????????
3. ????????
4. ??????
34
2. ????????
??
??
?? ??? ?
35
1. ???????
2. ????????
3. ????????
4. ??????
36
3. ????????
??
??
37
1. ???????
2. ????????
3. ????????
4. ??????
38
4. ??????
??
??
????????
39
???????2
????
????
?????
1. ???????
2. ??????????
3. ??????????????
40
1. ???????
  • ???GFR???????????
  • ???GFR? ??????(ECBV)?
  • ?????????

41
(2) ????
???
????????? ??ADH????
  • ??? (ANP)
  • ????????(filtration fraction, FF)

?
?
42
20
43
???????
GFR(125)
20
FF
?????(600)
44
???????
?????
???,??
?????
???,??
(300)
45
???????
GFR
(100)
33
FF
?????(300)
46
(No Transcript)
47
?
48
3. ??????????????
???
??????? ADH????
???
???
????????????????
49
????????????
1.??????---???????
?? ??? ???????
?? ?? ?? ?? ?25g/L ?25g/L
?? ?1.015 ?1.018
??? ? ?
50
1.????
????(frank edema)
????(recessive edema) ?????????????, ???????,
??????10
51
frank edema
52
2.??????????
?????????,????????
????
????
??????????,??????????
????
????,???????????
53
???????? ??????
???? ????????
????????
54
(No Transcript)
55
?????????
Disorders of Water and Electrolyte Metabolism
  • ??
  • ??????
  • ?????
  • ?????
  • ??????

56
?? ??????
??
???? ???? ????
57
???????
1.????????
2.??????
58
1.???????(?-???) --??????????
???? ????? ???? ??? ???? ??
???? ????? ??? ???? ???
ECF
ECF
K
ICF
K
K
??
Na
Na
59
2.?????
???????? ?????--????????
???????? ???????????
?????? ??????
60
???????
???
??
??
?K????
???
K
K
Na
??
K
K
Na
61
??
??
???
H
H
???
K
K
K
K
62
???? ????? ???
????????? ????
63
??????
1.??????
K
K
???
???
?
2.??????
3.?????????????
64
Hypokalemia(1)
  • ??

Plasma K lt 3.5mmol/L
?
65
  • ?????

66
  • ?????

???
67
  • ?????

???
68
  • ?????

ECF
ICF
K
??
?? lt3.5 mmol/L
69
  • ?????

1.????
2.????
??? ?????. ????K??????
70
2.????
???? ???
???????
????
???(??????-??)
71
3.????????????
???
??ß-????????
????????
?????????
72
??????
1.???????????
1)??????
(1)???????????
??
73
(1)???????????
???
1
2
0
3
4
74
(1)???????????
30
1
2
0
0
-30
3
-60
4
-90
75
(1)???????????
????
30
1
2
0
0
-30
3
-60
4
-90
76
(1)???????????
77
???????
4??????? ???????????
78
???????
4??????? ???????????
79
????
???????
4
???? ??????
80
(1)???????????
81
(2)????????????
?????????
30
0
-30
-60
P? ?? QRS???,?? ST? ??,?? T?
??,?? U? ?????
-90
82
(3)???????????
  • ????
  • ?????????
  • ????????

83
2)????????
???
???
?????
84
??
85
2.????????????
???????????????? ????????????
????????
86
3.????????--???
K?
??????
87
  • ????

?? ???????
??????? (lt 40-120mmol/D )
?? (lt 10-20mmol/h )
?? (lt 40 mmol/L )
?? (???? )
88
Hyperkalemia(1)
  • ??

Plasma K gt 5.5mmol/L
  • ?????

?????
89
????????????????
90
????????????????
ECF
ICF
??
???
91
  • ??????

1.????
????
???
K
?????
92
  • ??????

1.????
????
93
  • ??????

1.????
????
???
Et
Em
94
  • ??????

1.????
????
???
Et
Em
?????
95
  • ??????

1.????
2.????,??????
?????? 0 ?????? 2 ???? 3 ????
96
  • ??????

1.????
2.????,??????
????? ??? ???
?
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