Matenda osavomerezeka a antidiuretic hormone secretion

Matenda osavomerezeka a antidiyuretic secretion (SIADH) ndimomwe thupi limapangira mahomoni oletsa antidiuretic (ADH). Hormone iyi imathandizira impso kuyang'anira kuchuluka kwa madzi omwe thupi lanu limataya kudzera mkodzo. SIADH imapangitsa kuti thupi lisunge madzi ochulukirapo.

ADH ndi chinthu chopangidwa mwachilengedwe m'dera laubongo lotchedwa hypothalamus. Kenako imatulutsidwa ndimatumbo am'munsi m'munsi mwaubongo.

Pali zifukwa zambiri zomwe thupi limafunikira kupanga ADH yambiri. Nthawi zomwe ADH imatulutsidwa m'magazi pomwe siyiyenera kupangidwa (zosayenera) ndi monga:

• Mankhwala, monga mtundu wina wachiwiri wa mankhwala ashuga, mankhwala olanda, mankhwala opatsirana, mtima ndi magazi, mankhwala a khansa, anesthesia
• Kuchita opaleshoni pansi pa anesthesia wamba
• Kusokonezeka kwaubongo, monga kuvulala, matenda, sitiroko
• Kuchita opaleshoni yaubongo m'dera la hypothalamus
• Matenda am'mapapo, monga chibayo, chifuwa chachikulu, khansa, matenda opatsirana

Zomwe zimayambitsa zimaphatikizapo:

• Matenda achilendo a hypothalamus kapena pituitary
• Khansa ya m'mapapo, m'matumbo ang'ono, kapamba, ubongo, khansa ya m'magazi
• Matenda amisala

Ndi SIADH, mkodzo umakhala wolimba kwambiri. Palibe madzi okwanira omwe amathiridwa ndipo mumakhala madzi ochuluka kwambiri m'magazi. Izi zimasungunula zinthu zambiri m'magazi monga sodium. Mulingo wochepa wa sodium ndi womwe umayambitsa kufala kwa ADH.

Nthawi zambiri, palibe zisonyezo zomwe zimachokera ku sodium low.

Zizindikiro zikachitika, zimatha kukhala izi:

• Nseru ndi kusanza
• Mutu
• Mavuto osamala omwe angayambitse kugwa
• Kusintha kwamaganizidwe, monga kusokonezeka, zovuta zokumbukira, machitidwe achilendo
• Kugwidwa kapena kukomoka, pamavuto akulu

Wothandizira zaumoyo adzayesa kwathunthu kuti akuthandizeni kudziwa zomwe zimayambitsa matenda anu.

Mayeso a labu omwe angatsimikizire ndikuthandizira kupeza sodium yocheperako ndi awa:

• Zowonjezera zamagetsi (kuphatikiza magazi a sodium)
• Kuyesa magazi kwa Osmolality
• Mkodzo osmolality
• Mkodzo wa sodium
• Toxicology imawunikira mankhwala ena
• Mungafunike maphunziro ojambulira omwe amachitikira m'mapapu achichepere ndi m'mapapo a ubongo ndi kuyesa kwa ubongo kwa ana omwe akuganiza kuti ali ndi SIADH

Chithandizo chimadalira chifukwa cha vutoli. Mwachitsanzo, opareshoni yachitika kuti muchotse chotupa chotulutsa ADH. Kapenanso, ngati mankhwala ndi omwe amachititsa, mlingo wake ungasinthidwe kapena mankhwala ena akhoza kuyesedwa.

Nthawi zonse, gawo loyamba ndikuchepetsa kuchepa kwamadzimadzi. Izi zimathandiza kupewa madzi owonjezera kuti asamangidwe mthupi. Wopereka wanu angakuuzeni zomwe muyenera kudya tsiku lililonse madzimadzi.

Mankhwala angafunike kutsekereza zotsatira za ADH pa impso kuti madzi owonjezera amasakanizidwa ndi impso. Mankhwalawa amatha kuperekedwa ngati mapiritsi kapena jakisoni woperekedwa m'mitsempha (kudzera m'mitsempha).

Zotsatira zimatengera zomwe zikuyambitsa vutoli. Sodium otsika omwe amapezeka mwachangu, osakwana maola 48 (pachimake hyponatremia), ndi owopsa kuposa sodium yocheperako yomwe imayamba pang'onopang'ono pakapita nthawi. Mlingo wa sodium ukagwa pang'onopang'ono pamasiku kapena milungu (matenda a hyponatremia), ma cell aubongo amakhala ndi nthawi yosintha ndipo zizindikilo zowopsa monga kutupa kwa ubongo sizimachitika. Hyponatremia yanthawi yayitali imalumikizidwa ndimavuto amachitidwe amanjenje monga kusachita bwino komanso kukumbukira kukumbukira. Zambiri zomwe zimayambitsa SIADH zimasinthidwa.

Nthawi zovuta, sodium yocheperako imatha kubweretsa ku:

• Kuchepetsa chikumbumtima, kuyerekezera zinthu m'maganizo kapena kukomoka
• Kutulutsa ubongo
• Imfa

Mlingo wa sodium wa thupi lanu utatsika kwambiri, ukhoza kukhala pangozi yoopsa. Itanani omwe akukuthandizani nthawi yomweyo ngati muli ndi zizindikilo za vutoli.

SIADH; Katemera wosayenera wa antidiuretic hormone; Matenda osatulutsidwa a ADH osayenera; Matenda a antidiuresis osayenera

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Zamatsenga JG. Kusokonezeka kwamadzi. Mu: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, olemba. Brenner ndi Rector a Impso. 10th ed. Philadelphia, PA: Elsevier; 2016: chap 16.