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Teach you how to treat water poisoning
Water poisoning means that too much water enters the cell, too much water in the cell, and too much water means that the water accumulates more than the normal amount of body fluid in the body. It belongs to the category of dilutive hyponatremia. How to treat water poisoning?
Clinical manifestations of water poisoning:
The extracellular fluid is too much water and sodium is reduced, showing a low osmotic state, water enters the cell, and the cells with excessive intracellular water (especially brain cells) are swollen and hypotonic, and the cell metabolism is disordered. The clinical manifestation is related to the speed and degree of excessive water.
1. Acute excessive water and water poisoning
The disease is acute, mainly caused by brain edema. Headaches, mental disorders, disorientation, ataxia, seizures penis pump , lethargy, restlessness, coma and other mental symptoms. Intracranial hypertension such as headache, vomiting, increased blood pressure, respiratory depression and slow heart rate may also occur, and cerebral hernia may occur in severe cases.
Chronic water overload and water poisoning
The disease develops slowly and is often covered by the symptoms of the primary disease. Mild excessive water will only lead to weight gain. When the plasma osmotic pressure is lower than 260mmol/L (serum natrium 25mmol/L), the plasma osmotic pressure of fatigue dildo hero , apathy, nausea, anorexia and subcutaneous tissue swelling falls to 240~250mmol/L (serum natriuretic 115~120mmol/L), and the plasma osmotic pressure of headache, lethargy, mental disorder, arrogance and other neurological symptoms falls to 230mmol/L (serum natriuretic 110mmol/L), it may cause spasm or coma. Plasma sodium drops rapidly to less than 108 mm / L within 48 hours, which may lead to permanent damage or death of the nervous system.
Diagnosis of water poisoning:
According to the causes of excessive water and water poisoning gay masturbation , such as the history of fluid infusion, such as excessive secretion of diuretic hormone and acute renal failure, combined with clinical manifestations and necessary laboratory examinations, such as plasma osmotic pressure, serum sodium reduction, plasma albumin, hemoglobin, hematocrit average diagnosis The effective circulating blood volume of ① (body weight change, 24-hour inflow and inflow of water, serum sodium concentration, etc.) should be judged. The plasma osmotic pressure of ③ should be calculated or the cause of heart, lung and renal function state of slow ⑤ caused by ④ should be determined.
Treatment of water poisoning:
Preventing the occurrence of excessive water and controlling the aggravation of its degree mainly depends on the active treatment of the primary disease. at the same time, it is necessary to control the intake of water to avoid excessive rehydration.
1. Limit the intake of water with mild illness
Record the amount of water in and out in 24 hours, so that the amount of water in and out is less than the amount of urine. Or appropriate addition of diuretics, with Enionic acid (diuric acid) and furosemide and other loop diuretics as the first choice.
2. Excessive water and water poisoning in acute and severe cases
Treatment should aim at protecting heart and brain function, dehydration and / or correcting hypotonic.
The main cause of hypervolemic syndrome is dehydration, which reduces the cardiac load. Loop urine drugs such as furosemide and nilic acid are preferred, such as furosemide 20~60mg, taken orally 3 or 4 times a day. For severe cases, 20~80mg can be injected intravenously every 6 hours; etanilic acid 25~50mg, diluted with 25% glucose solution 40~50ml, can be injected slowly, and can be repeated after 2 to 4 hours if necessary. For patients with insufficient effective circulatory blood volume, attention should be paid to the supplement of effective blood volume. Emergency cases can be treated by hemofiltration. For people who secrete too much antidiuretic hormone, they can choose dimecycline or carbonic acid. Protect the heart, reduce the heart load panty vibrator , use sodium nitroprusside, nitroglycerin and other vasodilators.
Patients with hypoosmosis (especially the occurrence of mental and neurological symptoms) should quickly correct the hypotonic state in the cell. in addition to limiting water and diuresis, 3% 5% sodium chloride solution should be used, the general dose is 5~10ml/kg, strictly observe the changes of cardiopulmonary function, adjust the dose and speed, and generally supplement in stages. Diuretics can be used at the same time to reduce blood volume. Pay attention to correct abnormal potassium metabolism and acidosis.
Clinical manifestations of water poisoning:
The extracellular fluid is too much water and sodium is reduced, showing a low osmotic state, water enters the cell, and the cells with excessive intracellular water (especially brain cells) are swollen and hypotonic, and the cell metabolism is disordered. The clinical manifestation is related to the speed and degree of excessive water.
1. Acute excessive water and water poisoning
The disease is acute, mainly caused by brain edema. Headaches, mental disorders, disorientation, ataxia, seizures penis pump , lethargy, restlessness, coma and other mental symptoms. Intracranial hypertension such as headache, vomiting, increased blood pressure, respiratory depression and slow heart rate may also occur, and cerebral hernia may occur in severe cases.
Chronic water overload and water poisoning
The disease develops slowly and is often covered by the symptoms of the primary disease. Mild excessive water will only lead to weight gain. When the plasma osmotic pressure is lower than 260mmol/L (serum natrium 25mmol/L), the plasma osmotic pressure of fatigue dildo hero , apathy, nausea, anorexia and subcutaneous tissue swelling falls to 240~250mmol/L (serum natriuretic 115~120mmol/L), and the plasma osmotic pressure of headache, lethargy, mental disorder, arrogance and other neurological symptoms falls to 230mmol/L (serum natriuretic 110mmol/L), it may cause spasm or coma. Plasma sodium drops rapidly to less than 108 mm / L within 48 hours, which may lead to permanent damage or death of the nervous system.
Diagnosis of water poisoning:
According to the causes of excessive water and water poisoning gay masturbation , such as the history of fluid infusion, such as excessive secretion of diuretic hormone and acute renal failure, combined with clinical manifestations and necessary laboratory examinations, such as plasma osmotic pressure, serum sodium reduction, plasma albumin, hemoglobin, hematocrit average diagnosis The effective circulating blood volume of ① (body weight change, 24-hour inflow and inflow of water, serum sodium concentration, etc.) should be judged. The plasma osmotic pressure of ③ should be calculated or the cause of heart, lung and renal function state of slow ⑤ caused by ④ should be determined.
Treatment of water poisoning:
Preventing the occurrence of excessive water and controlling the aggravation of its degree mainly depends on the active treatment of the primary disease. at the same time, it is necessary to control the intake of water to avoid excessive rehydration.
1. Limit the intake of water with mild illness
Record the amount of water in and out in 24 hours, so that the amount of water in and out is less than the amount of urine. Or appropriate addition of diuretics, with Enionic acid (diuric acid) and furosemide and other loop diuretics as the first choice.
2. Excessive water and water poisoning in acute and severe cases
Treatment should aim at protecting heart and brain function, dehydration and / or correcting hypotonic.
The main cause of hypervolemic syndrome is dehydration, which reduces the cardiac load. Loop urine drugs such as furosemide and nilic acid are preferred, such as furosemide 20~60mg, taken orally 3 or 4 times a day. For severe cases, 20~80mg can be injected intravenously every 6 hours; etanilic acid 25~50mg, diluted with 25% glucose solution 40~50ml, can be injected slowly, and can be repeated after 2 to 4 hours if necessary. For patients with insufficient effective circulatory blood volume, attention should be paid to the supplement of effective blood volume. Emergency cases can be treated by hemofiltration. For people who secrete too much antidiuretic hormone, they can choose dimecycline or carbonic acid. Protect the heart, reduce the heart load panty vibrator , use sodium nitroprusside, nitroglycerin and other vasodilators.
Patients with hypoosmosis (especially the occurrence of mental and neurological symptoms) should quickly correct the hypotonic state in the cell. in addition to limiting water and diuresis, 3% 5% sodium chloride solution should be used, the general dose is 5~10ml/kg, strictly observe the changes of cardiopulmonary function, adjust the dose and speed, and generally supplement in stages. Diuretics can be used at the same time to reduce blood volume. Pay attention to correct abnormal potassium metabolism and acidosis.
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