英文班水电解质授课.pptVIP

病 例 分 析 男性 29岁，王XX,因急性上腹部疼痛 12小时，急诊收住入院。诊断为重症急性胰腺炎。 入院后病人主诉上腹部胀痛和极度口渴。HR 150次/分，R 38次/分，BP 170/98mmHg，无尿。腹部体征示，压痛、反跳痛、严重的腹胀，后背部有凹陷性水肿。诊断性穿刺游离腹腔内有棕褐色腹腔渗液， CT发现肠腔内有大量的液体积聚。 How to differentiate function and non-function interstitial fluids Function:Taking part in modulating the balance of body fluids. Third Space Definition: Pathophysiologicly,relatively nonfunctional extracellular fluid.Mainly for the change of quantity of nonfunctional ECF. The Concept of Osmotic Pressure Definition the number of osmotically active particles or ions per unit volume. Unit : milliosmoles per liter （mOsm / L） Plasma Osmotic Pressure The Regulation of Body Fluid Balance Maintaining normal osmotic pressure Maintaining normal concentration Integral dose of natrium Maintaining normal Volume (Blood-volume) Classification of body fluid change(Four Types) Volume Changes(ECF) Volume Deficit Volume Excess Concentration Changes Hyponatremia Hypernatremia Mixed volume and Concentration Abnormalities ECF Deficit and Excess with Hyponatremia ECF Deficit and Excess with Hypernatremia Volume Changes Isotonic ECF deficit  Clinical manifestations Seeing Table below Moderate Severe CNS Sleepiness Decreased tendon reflexes Apathy Anesthesia of distal extremities Slow responses Stupor Anorexia Coma Cessation of usual activity GI Progressive decrease in Nausea, Vomiting food consumption Refusal to eat Silent ileus and distention Isotonic ECF deficitDiagnosis Etiology Clinical manifestation:Seeing Table mentioned above. Isotonic ECF deficit Fluid electrolyte therapy To eliminate etiologies Quality of Solution - Iso