Central shuga insipidus

Central diabetes insipidus ndichinthu chosowa chomwe chimakhudza ludzu kwambiri komanso kukodza kwambiri.

Matenda a shuga insipidus (DI) ndichinthu chachilendo pomwe impso zimalephera kutulutsa madzi. DI ndi matenda osiyana ndi matenda ashuga, ngakhale onse amakhala ndi zizindikilo zofala za kukodza kwambiri ndi ludzu.

Central diabetes insipidus ndi mtundu wa DI womwe umachitika thupi likakhala ndi mahomoni ochepetsa antidiuretic (ADH). ADH imatchedwanso vasopressin. ADH imapangidwa mu gawo lina la ubongo lotchedwa hypothalamus. Kenako ADH imasungidwa ndikumasulidwa ku gland gland. Ichi ndi kansalu kakang'ono kumapeto kwa ubongo.

ADH imayang'anira kuchuluka kwa madzi omwe amachokera mumkodzo. Popanda ADH, impso sizigwira bwino ntchito kusunga madzi okwanira mthupi. Zotsatira zake ndikutaya mwachangu madzi m'thupi ngati mkodzo wosungunuka. Izi zimapangitsa kufunikira kwakumwa madzi ochulukirapo chifukwa cha ludzu lokwanira komanso kulipirira madzi ambiri mumkodzo (malita 10 mpaka 15 patsiku).

Kuchepetsa kwa ADH kumatha kubwera chifukwa cha kuwonongeka kwa hypothalamus kapena pituitary gland. Kuwonongeka kumeneku kumatha kukhala chifukwa cha opaleshoni, matenda, kutupa, chotupa, kapena kuvulala kwaubongo.

Nthawi zambiri, chapakati matenda ashuga insipidus amayamba ndimavuto amtundu.

Zizindikiro za matenda a shuga insipidus ndi monga:

• Kuchulukitsa kwamikodzo
• Ludzu lokwanira
• Kusokonezeka ndikusintha pakuchenjeza chifukwa cha kuchepa kwa madzi m'thupi komanso kupitirira kuposa msinkhu wa sodium m'thupi, ngati munthuyo sangathe kumwa

Wothandizira zaumoyo adzafunsa za mbiri yanu yazachipatala komanso zizindikilo zake.

Mayeso omwe atha kulamulidwa ndi awa:

• Magazi a sodium ndi osmolarity
• Vuto la Desmopressin (DDAVP)
• MRI ya mutu
• Kupenda kwamadzi
• Mkodzo ndende
• Kutulutsa mkodzo

Zomwe zimayambitsa vutoli zichiritsidwa.

Vasopressin (desmopressin, DDAVP) imaperekedwa ngati mankhwala amphuno, mapiritsi, kapena jakisoni. Izi zimayang'anira kutulutsa mkodzo komanso madzi amadzimadzi ndikuletsa kutaya madzi m'thupi.

Nthawi zochepa, kumwa madzi ambiri kungakhale zonse zofunika. Ngati ludzu la thupi silikugwira ntchito (mwachitsanzo, ngati hypothalamus yawonongeka), chiphaso chokwanira pamlingo winawake wamadzi chingafunikenso kuti muwonetsetse kuti madzi ali bwino.

Zotsatira zimadalira choyambitsa. Ngati akuchiritsidwa, matenda a shuga insipidus nthawi zambiri samayambitsa mavuto akulu kapena kubweretsa kufa msanga.

Kusamwa madzi okwanira kumatha kubweretsa kuchepa kwa madzi m'thupi komanso kusalinganizana kwama electrolyte.

Mukamamwa vasopressin ndikumva ludzu la thupi lanu si zachilendo, kumwa madzi ambiri kuposa momwe thupi lanu lingafunire kumatha kuyambitsa kusamvana kowopsa kwa ma electrolyte.

Itanani omwe akukuthandizani ngati mukukula ndi matenda a shuga insipidus.

Ngati muli ndi matenda a shuga insipidus, kambiranani ndi omwe amakupatsani ngati mukukodza pafupipafupi kapena mukamva ludzu kwambiri.

Milandu yambiri imatha kukhala yotetezedwa. Kuchiza mwachangu matenda, zotupa, ndi kuvulala kumachepetsa chiopsezo.

Matenda a shuga - pakati; Matenda a shuga a insipidus

• Kupanga kwa mahomoni a Hypothalamus

Brimioulle S. Matenda a shuga insipidus. Mu: Vincent JL, Abraham E, Moore FA, Prime Minister wa Kochanek, MP wa Fink, eds. Buku Lopereka Chithandizo Chachikulu. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2017: chap 150.

Giustina A, Frara S, Spina A, Mortini P. Hypothalamus. Mu: Melmed S, mkonzi. Pituitary. Wolemba 4. Philadelphia, PA: Elsevier; 2017: mutu 9.

Moritz ML, Ayus JC. Matenda a shuga ndi matenda a mahomoni osavomerezeka a antidiuretic. Mu: Singh AK, Williams GH, olemba., Eds. Buku la Nephro-Endocrinology. Wachiwiri ed.Philadelphia, PA: Elsevier; 2018: mutu 8.