水和电解质紊乱（PPT讲稿）Water and electrolyte disorders

Water and electrolyte disorders

Water and electrolyte disorders

水、电解质代谢的生理基础 ()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%o (透细胞液)

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)

2.体液中主要电解质及其分布 extracellular fluid: Na+、CI、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

2. 体液中主要电解质及其分布 extracellular fluid: Na+ 、Cl-、HCO3 - intracellular fluid： K+ 、HPO4 2- 在Na+- K+-ATPase作用下，细胞内外Na+ 、 K+保持不对等分布

3. Osmotic pressure of body fluid (plasma) Positive ion: 151mmolL Negative ion: 139 mmol/L total 280-310mmol/L Nonelectrolyte: 10mmol/L (678.3kpa) Plasma colloidal osmotic pressure 3.72 kpa(28 mmHg)

3. Osmotic pressure of body fluid (plasma) Positive ion: 151mmol/L Negative ion: 139mmol/L total 280-310mmol/L Nonelectrolyte: 10mmol/L (678.3kpa) Plasma colloidal osmotic pressure: 3.72kpa(28mmHg)

(= movement of water and electrolytes 1. plasma interstitial fluid capillary protei In RBC 2. intra- and extra- cellular fluid proteins and positive ion: permeability water and negative ion permea bilit ity (water movement- balance of osmotic pressure)

（二） movement of water and electrolytes 1. plasma interstitial fluid capillary protein 2. intra- and extra- cellular fluid proteins and positive ion: permeability water and negative ion: permeability (water movement balance of osmotic pressure) R B C

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 (2000-2500ml) respiration 350ml eces 150ml Balance r 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:130-150mmo

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 (2000-2500ml) 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)

C Regulation of osmotic pressure and volume Hypertonic thirst of ECF l. body water↓ ADHt; aldosterone↓ sodium↑ thirst AngⅡtADH body volume↓ aldosterone↑ receptor of volume e ADH 2. body water f sodium↓」ADH reabsorption of sodium I 3 blood volume f→+ANP1 aldosterone(ADS)↓ tension 4. others ADH↑ pa an

(三) Regulation of osmotic pressure and volume Hypertonic thirst of ECF 1.body water ADH ; aldosterone sodium thirst Ang Ⅱ 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

Figure: regulation ofadh secretion osmotic pressure R pressure R ADH volume r heart

Figure: regulation of ADH secretion osmotic pressure R pressure R ADH volume R heart

二、 water and sodium disorders hypertonic ypertonIc dehydration isotonic water excess 3 isotonic hypotonic hypotonic ()细胞外液容量不足( extracellular fluid deficit) 1. Hypotonic dehydration sodium loss water loss serum sodium 130mmoVL plasma osmotic pressure 280m0sm/L

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 dehydration sodium loss ＞ water loss serum sodium ＜ 130mmol/L plasma osmotic pressure ＜ 280mOsm/L

1) cause and Pathogenesis excessive loss of water and sodium replaced with water only. vomiting, diarrhea; burn; diuretics; Addison's disease (ADs+); chronic renal failure; renal tubular acidosis 2)adaptive response and effect on body ① movement of body fluid ECF- icf cellular swelling Blood volume↓ Extracellular fluid↓ Shock dehydrated signs edema of brain and lung

1) cause and Pathogenesis excessive loss of water and sodium replaced with water only. vomiting, diarrhea; burn; diuretics; Addison’s disease (ADS ) ; chronic renal failure; renal tubular acidosis 2) adaptive response and effect on body ① movement of body fluid ECF ICF cellular swelling Blood volume Extracellular fluid Shock dehydrated signs edema of brain and lung