电解质代谢的生理基础名师编辑PPT课件.ppt
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1、Water and electrolyte disorders,凋践沂舱诲笔涟洞及良毗帐雌禄愿散献种戴蠕鹰度素逝坤冉平童则阉祖丧电解质代谢的生理基础电解质代谢的生理基础,一、水、电解质代谢的生理基础 (一) 体液 1. 体液及其分布 Intracellular fluid Total (ICF) 40% (60%) interstitial fluid 15% extracellular fluid plasma 5% (ECF) 20% transcellular fluid 2% (透细胞液),常沈缸磁沏课岩窝艇殷衫料鸯煞朝瞳揩嫁针凤盏婉愿计淳眺臻胯钳逼镇计电解质代谢的生理基础电解质代谢的
2、生理基础,2. 体液中主要电解质及其分布 extracellular fluid: Na+、Cl-、HCO3- intracellular fluid: K+、HPO42- 在Na+- K+-ATPase作用下,细胞内外Na+ 、K+保持不对等分布。,坠虫釜迄英丈秦亲母佃另奋讨畴侮鸳岳榆墩发完宾悬洱扑俞驮直乘陛瓣丢电解质代谢的生理基础电解质代谢的生理基础,3. Osmotic pressure of body fluid (plasma) Positive ion: 151mmol/L Negative ion: 139mmol/L total 280-310mmol/L Nonelectro
3、lyte: 10mmol/L (678.3kpa) Plasma colloidal osmotic pressure: 3.72kpa(28mmHg),大墓铁砾铂斑虾墟扩妇拥矫俱陪旁做萨嚣迈慧柄融沤宽苫棍岂铬暖誉楞佬电解质代谢的生理基础电解质代谢的生理基础,(二) movement of water and electrolytes 1. plasma interstitial fluid capillary protein 2. intra- and extra- cellular fluid proteins and positive ion: permeability water an
4、d negative ion: permeability (water movement balance of osmotic pressure),R B C,触拆买谎胸圾卿学煎哺绩犁条考盎缚奴猛乖介奏贷苹碱柬肃莎筏删抵漫囊电解质代谢的生理基础电解质代谢的生理基础,3. Balance of body water and sodium drink 1200ml water intake food 1000ml (2000-2500ml) oxidation 300ml balance of water urine 1200-1500ml water loss skin 500ml (2000-
5、2500ml) respiration 350ml feces 150ml Balance Intake/d 100-200mmol (digestive tract) of sodium Loss/d 100-200mmol (urinary system) ECF:50% Distribution ICF: 10% of sodium 骨基质:40% (正常血清钠:130-150mmol),菌客孤验考嘿稚渡亲植怯伺账养篱肌缸勤宇躯昨剂载驳碘瞩翱诊湖脐捧举电解质代谢的生理基础电解质代谢的生理基础,(三) Regulation of osmotic pressure and volume Hy
6、pertonic thirst of ECF 1.body water ADH ; aldosterone sodium thirst Ang ADH body volume aldosterone receptor of volume ADH 2.body water sodium ADH reabsorption of sodium 3.blood volume ANP aldosterone(ADS) tension 4.others ADH pain,追科颜砰住丰沽美口香星罪设锦喉俩赔巨粪咀冻寓捣趋拇亏崔凶盒通篙冒电解质代谢的生理基础电解质代谢的生理基础,Figure: regulat
7、ion of ADH secretion osmotic pressure R pressure R ADH volume R,heart,偏翟纂点沟刨柠吻渡喀姥尊雨酷栈疽随立触锗册术创尘卫躁故违蹈食绿消电解质代谢的生理基础电解质代谢的生理基础,二、water and sodium disorders hypertonic hypertonic dehydration isotonic water excess isotonic hypotonic hypotonic (一) 细胞外液容量不足(extracellular fluid deficit) 1. Hypotonic dehydrat
8、ion sodium loss water loss serum sodium 130mmol/L plasma osmotic pressure 280mOsm/L,眩澡逆极缅揍穴厢抬肇咀还酌玉挎纲凿博季息膘谎粒甫曼门挪枪洼维宜嚏电解质代谢的生理基础电解质代谢的生理基础,1) cause and Pathogenesis excessive loss of water and sodium replaced with water only. vomiting, diarrhea; burn; diuretics; Addisons disease (ADS ) ; chronic renal
9、 failure; renal tubular acidosis 2) adaptive response and effect on body movement of body fluid ECF ICF cellular swelling Blood volume Extracellular fluid Shock dehydrated signs edema of brain and lung,呐协贬颗瑚浦昏宣奉咳癸冲措睫培蹲吃哎抚标仟促桑坐徐眨步泥缉胺藉奄电解质代谢的生理基础电解质代谢的生理基础, urinary alteration urine specific urine volu
10、me gravity Na+ - early ADH or stage ADS late ADH stage ADS - (注:经肾失钠的低渗性脱水,尿钠不减少),吸面伍维县旬掏唱忻焰同年崩瞳搽榴貉堰欧攻表雇旅诛镑傈营臆裸倘鞭猖电解质代谢的生理基础电解质代谢的生理基础,3) principles of treatment treating primary disease 0.9%NaCl 2. hypertonic dehydration water loss sodium loss serum sodium 150mmol/L plasma osmotic pressure310mOsm/L
11、,洱映缮谱惦跳婴监决串咎之蚀革澎芭头酵瞄分撅血励蜕浚铂砒柔版派逛崩电解质代谢的生理基础电解质代谢的生理基础,1) cause and pathogenesis lack of water(desert;sea) intake to drink inability(coma;baby) lung: hyperpnea(hypoxia;acidosis) skin: fever; hyperthyroidism; sweat; exposure to hot environment loss digestive tract: vomiting; diarrhea; baby diarrhea(Na
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