إضطرابات الكهارل والتوازن الحمضي القاعدي

الحماض Acidosis

حميد صالح الحراسي

الحماض هو زيادة حموضة الدم بحيث يكون الأس الهيدروجيني (درجة الحموضة) أقل من 7.35.

الحماض التنفسي

الحماض

يقوم الجسم بالمحافظة على الأس الهيدروجيني للدم بحيث يكون ما بين 7.35 و 7.45 وذلك عن طريق التحكم بتركيز البيكربونات والضغط الجزئي لثاني أكسيد الكربون في الدم، ويتم ذلك عن طريق كل من الكلية والرئة.

أنواع الحماض

ينقسم الحماض الى ما يلي : -

الحماض التنفسي .
الحماض الاستقلابي (الأيضي) .

الحماض التنفسي

يحدث الحماض التنفسي نتيجة زيادة تركيز الضغط الجزئي لثاني أكسيد الكربون في الدم والذي يزيد من حموضة الدم نتيجة لتحولة إلى حمض كربونيك . وعادة ما يصاحبه نقص في الأكسجين نتيجة لتدهور وضائف الرئة .

الحماض الاستقلابي

يحدث الحماض الاستقلابي (الأيضي) نتيجة تراكم الأحماض في الدم أو نقصان في تركيز البيكربونات .

ويمكن تقسيم مسببات الحماض الأيضي إلى قسمسن رئيسيين تبعاً لفرق أنيونات الجسم فيما يعرف بالفرق الأنيوني كما يلي : -

حماض عدم وجود فرق أنيوني : وهنا تتعدد الأسباب وأهمها حماض أنبوبي كلوي ومرض أديسون والإسهال .
حماض مع وجود فرق أنيوني : وينتج من أرتفاع تركيز الأحماض غير المحسوبة كالكيتون وسمية الأسبيرين والميثانول .

أعراض وعلامات الحماض

تشمل أعراض وعلامات الحماض بشكل عام على ما يلي : -

صداع .
تشويش وغيبوبة .
ضعف عام في العضلات .
زيادة سرعة التنفس .
لانظميات .
الغثيان والتقيؤ .

تعديل المقال

الأقسام إضطرابات الكهارل والتوازن الحمضي القاعدي أمراض الإستقلاب الأيضي أمراض الدم أمراض الغدد الصماء

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