水盐教学讲义.pptVIP

第七章 水电解质代谢紊乱Disorders of Water and Electrolyte Metabolism §1 Homeostasis §2 Water and Sodium Metabolism Disorders §3 Potassium Metabolism Disorders §1 水电解质稳态 Water and Electrolyte Homeostasis 内环境 internal environment water ——total body water (TBW)function 体液 Body fluid—— 电解质功能 electrolyte function 1. 体液的容量和分布 Volume and distribution of body fluid extracellula fluid(ECF) 2. 电解质的分布 electrolyte distribution   体液的交换  exchange of body fluid 体内外的交换 exchange between intra-extra body 血管内外交换 exchange between intra-extra capillary 细胞内外交换 exchange between intra-extracellular 体内外的交换 血管内外交换 细胞内外交换 exchange between intra-extra body 体内外的交换 血管内外交换 细胞内外交换 体液的交换exchange of body fluid 体内外的交换 exchange between intra-extra body 血管内外交换 exchange between intra-extra capillary 细胞内外交换 exchange between intra-extracellular exchange between intra-extracellular  Ion exchange —— ion pump Water exchange —— osmotic pressure 1mol=6.02×1023 micro particle=17004mmHg 渗量单位 Osm或mOsm/L 不同分子量物质（如H+ 和Na+ )mol相同,Osm相同 Na+ 1mmol = 1mOsm = 1mEq NaCl 1mmol = 2mOsm = 2mEq Na2SO4 1mmol = 3mOsm = 4mEq Iso-osmolality law §2 水钠代谢紊乱 Water and Sodium Metabolism Disorders Sodium in ECF is major cation ion Function : keep crystalloid osmolality Normal 280——310 mOsm Na+ 130~150mmol/L ECF Na+ 、H2O loss 1. ECF Volume imbalance Na+ normal Volume↓Hypovolemia (isotonic dehydration) cause: loss isotonic fluid from GI loss kidney loss other loss Effect on organismECF↓→ CO↓→ BP↓　symp. N(+++) → compensation → circ failure ECF↓↓→ blood volume↓↓→ thirst urine volume ↓ (ADH↑ ADS↑) skin elasticity ↓(interstitial fluid↓) Treat : intake 5% glucose 2 :1 sodium 3:2:1 NS NaHCO3 1. ECF Volume im