Vuto lalikulu la adrenal

Vuto lalikulu la adrenal ndi vuto lowopsa lomwe limachitika pakakhala kuti pali cortisol yokwanira. Iyi ndi hormone yopangidwa ndi adrenal glands.

Zilonda za adrenal zili pamwamba pa impso zokha. Adrenal gland ili ndi magawo awiri. Gawo lakunja, lotchedwa kotekisi, limapanga cortisol. Iyi ndi mahomoni ofunikira owongolera kuthamanga kwa magazi. Gawo lamkati, lotchedwa medulla, limapanga mahomoni adrenaline (amatchedwanso epinephrine). Onse cortisol ndi adrenaline amamasulidwa poyankha kupsinjika.

Kupanga kwa Cortisol kumayendetsedwa ndi pituitary. Ichi ndi kansalu kakang'ono kamene kali pansi pa ubongo. Pituitary imatulutsa adrenocorticotropic hormone (ACTH). Iyi ndi hormone yomwe imapangitsa kuti adrenal glands atulutse cortisol.

Kupanga kwa adrenaline kumayendetsedwa ndi mitsempha yochokera kuubongo ndi msana komanso potulutsa mahomoni.

Mavuto a adrenal amatha kuchitika mwazinthu izi:

• Matenda a adrenal awonongeka chifukwa cha, mwachitsanzo, matenda a Addison kapena matenda ena a adrenal gland, kapena opaleshoni
• Pituitary wavulala ndipo sangathe kumasula ACTH (hypopituitarism)
• Kulephera kwa adrenal sikuchiritsidwa moyenera
• Mwakhala mukumwa mankhwala a glucocorticoid kwa nthawi yayitali, ndipo mwadzidzidzi lekani
• Mwasowa madzi kwambiri
• Kutenga kapena kupsinjika kwina kwakuthupi

Zizindikiro ndi zovuta za adrenal zitha kukhala izi:

• Kupweteka m'mimba kapena kupweteka m'mbali
• Kusokonezeka, kutaya chidziwitso, kapena kukomoka
• Kutaya madzi m'thupi
• Chizungulire kapena kupepuka
• Kutopa, kufooka kwakukulu
• Mutu
• Kutentha kwakukulu
• Kutaya njala
• Kuthamanga kwa magazi
• Shuga wamagazi ochepa
• Nseru, kusanza
• Kuthamanga kwa mtima mwachangu
• Kuthamanga mwachangu
• Pang'onopang'ono, ulesi
• Thukuta losazolowereka pankhope kapena kanjedza

Mayeso omwe atha kulamulidwa kuti athandizire kupeza mavuto azovuta za adrenal ndi awa:

• Mayeso okondoweza a ACTH (cosyntropin)
• Mulingo wa Cortisol
• Shuga wamagazi
• Mulingo wa potaziyamu
• Mulingo wa sodium
• mulingo wa pH

Pazovuta za adrenal, muyenera kupatsidwa mankhwala a hydrocortisone nthawi yomweyo kudzera mumitsempha (intravenous) kapena minofu (intramuscular). Mutha kulandira madzi am'mitsempha yolimbitsa thupi ngati muli ndi kuthamanga kwa magazi.

Muyenera kupita kuchipatala kukalandira chithandizo ndikuwunika. Ngati matenda kapena vuto lina lachipatala lidayambitsa vutoli, mungafunike chithandizo china.

Kudandaula kumatha kuchitika ngati mankhwala sanaperekedwe mwachangu, ndipo zitha kupha moyo.

Pitani kuchipinda chodzidzimutsa kapena itanani nambala yadzidzidzi yakomweko (monga 911) mukayamba kukhala ndi vuto la vuto lalikulu la adrenal.

Itanani omwe akukuthandizani ngati muli ndi matenda a Addison kapena hypopituitarism ndipo mukulephera kumwa mankhwala anu a glucocorticoid pazifukwa zilizonse.

Ngati muli ndi matenda a Addison, nthawi zambiri mungauzidwe kuti mukulitseko pang'ono mankhwala anu a glucocorticoid ngati mwapanikizika kapena mukudwala, kapena musanachite opareshoni.

Ngati muli ndi matenda a Addison, phunzirani kuzindikira zizindikiritso zomwe zingayambitse vuto lalikulu la adrenal. Ngati mwalangizidwa ndi dokotala wanu, khalani okonzeka kudzipatsa glucocorticoid mwadzidzidzi kapena kuonjezera mlingo wanu wa mankhwala a glucocorticoid munthawi yamavuto. Makolo ayenera kuphunzira kuchita izi kwa ana awo omwe alibe kuperewera kwa adrenal.

Nthawi zonse nyamulani chiphaso chachipatala (khadi, chibangili, kapena mkanda) chomwe chimati mulibe mphamvu ya adrenal. Chizindikirocho chiyeneranso kunena mtundu wa mankhwala ndi mlingo womwe mungafune pakagwa vuto ladzidzidzi.

Ngati mumamwa mankhwala a glucocorticoid pituitary ACTH, onetsetsani kuti mukudziwa nthawi yoyenera kumwa mankhwala anu. Kambiranani izi ndi omwe akukuthandizani.

Musaphonye konse kumwa mankhwala anu.

Mavuto a adrenal; Mavuto a Addisonian; Pachimake adrenal insufficiency

• Matenda a Endocrine
• Kutulutsa kwa hormone ya adrenal

Bornstein SR, Alloliu B, Arlt W, ndi al. Kuzindikira ndikuchiza kusowa koyambira kwa adrenal: malangizo othandizira a Endocrine Society. J Clin Endocrinol Metab. 2016; 101 (2): 364-389. (Adasankhidwa) PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116. (Adasankhidwa)

Stewart PM, Newell-Price JDC. Kachilombo kotchedwa adrenal cortex. Mu: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, olemba. Buku la Williams la Endocrinology. Wolemba 13. Philadelphia, PA: Elsevier; 2016: chap 15.

Thiessen MEW. Matenda a chithokomiro ndi adrenal. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 120.