Matenda ashuga insipidus: chomwe chiri, chimayambitsa, zizindikiro ndi chithandizo

Zamkati

• Zizindikiro zazikulu
• Momwe mungatsimikizire matendawa
• Zomwe zingayambitse
• 1. Central shuga insipidus
• 2. Nephrogenic shuga insipidus
• 3. Gestational shuga insipidus
• 4. Dipsogenic shuga insipidus
• Momwe mankhwalawa amachitikira
• 1. Kulamulira kumwa madzi
• 2. Hormone
• 3. Zodzikongoletsera
• 4. Mankhwala oletsa kutupa
• Zovuta zotheka
• Kodi pali kusiyana kotani pakati pa matenda a shuga insipidus ndi mellitus?

Matenda a shuga insipidus ndimatenda omwe amabwera chifukwa chakusasiyana kwamadzimadzi mthupi, zomwe zimabweretsa zizindikilo monga kukhala waludzu kwambiri, ngakhale mutamwa madzi, ndikupanga mkodzo mopitirira muyeso, zomwe zingayambitse kuchepa kwa madzi m'thupi.

Vutoli limachitika chifukwa cha kusintha kwa zigawo muubongo zomwe zimayambitsa kupanga, kusunga ndi kutulutsa mahomoni antidiuretic (ADH), omwe amatchedwanso vasopressin, omwe amayang'anira kuthamanga kwa mkodzo, koma amathanso kuchitika chifukwa cha kusintha kwa impso zomwe zimalephera kuyankha mahomoni amenewo.

Matenda a shuga alibe mankhwala, komabe, mankhwala, omwe akuyenera kuwonetsedwa ndi adotolo, amatha kuchepetsa ludzu komanso kuchepetsa mkodzo.

Zizindikiro zazikulu

Zizindikiro za matenda a shuga insipidus ndi ludzu losalamulirika, kupanga mkodzo wambiri, nthawi zambiri amafunika kudzuka usiku ndikukonda kumwa madzi ozizira. Kuphatikiza apo, pakapita nthawi, kumwa kwambiri madzi kumapangitsa chidwi cha mahomoni a ADH kapena kupangika pang'ono kwa hormone iyi, yomwe imatha kukulitsa zizindikilo.

Matendawa amathanso kupezeka mwa ana ndi ana ndipo chifukwa cha mkodzo wochuluka ndikofunika kudziwa zizindikilo za matenda a shuga monga nthawi zonse matewera onyowa kapena mwana amatha kukodza pabedi, kuvutika kugona, malungo, kusanza, kudzimbidwa , kukula ndi chitukuko kumachedwa kapena kuchepa thupi.

Momwe mungatsimikizire matendawa

Kuzindikira matenda ashuga insipidus kuyenera kupangidwa ndi endocrinologist kapena, kwa ana ndi ana, dokotala wa ana, yemwe ayenera kupempha kuyesa kwa mkodzo kwa maola 24 ndikuyesa magazi kuti awone kuchuluka kwa sodium ndi potaziyamu, zomwe zingasinthidwe. Kuphatikiza apo, adotolo atha kupempha kuyesa kwa madzi, momwe munthuyo agonekedwa m'chipatala, osamwa zakumwa ndipo amayang'aniridwa ngati ali ndi vuto la kuchepa kwa madzi m'thupi, kuchuluka kwa mkodzo wopangidwa ndi kuchuluka kwa mahomoni. Chiyeso china chomwe dotolo angayitanitse ndi MRI yaubongo kuti iwunikire kusintha kwaubongo komwe kungayambitse matendawa.

Zomwe zingayambitse

Zomwe zimayambitsa matenda a shuga insipidus zimadalira mtundu wa matendawa ndipo amatha kuwerengedwa kuti ndi:

1. Central shuga insipidus

Central shuga insipidus imayambitsidwa ndi kusintha kwa dera lotchedwa hypothalamus, lomwe limalephera kutulutsa hormone ya ADH, kapena gland ya pituitary yomwe imayambitsa kusungunula ndi kumasula ADH mthupi ndipo imatha kuyambitsidwa ndi:

• Kuchita maubongo;
• Kusokonezeka mutu;
• Chotupa chaubongo kapena aneurysm;
• Matenda osokoneza bongo;
• Matenda amtundu;
• Matenda mu ubongo;
• Kulepheretsa mitsempha yamagazi yomwe imapereka ubongo.

Mlingo wa mahomoni ADH akatsika, impso sizingathe kuwongolera mkodzo, womwe umayamba kupangika kwambiri, motero munthuyo amakodza kwambiri, womwe umatha kufikira malita opitilira 3 mpaka 30 patsiku.

2. Nephrogenic shuga insipidus

Nephrogenic shuga insipidus imachitika pamene kuchuluka kwa mahomoni a ADH m'magazi kumakhala kwachilendo, koma impso sizimayankha bwino. Zomwe zimayambitsa ndi izi:

• Kugwiritsa ntchito mankhwala, monga lithiamu, rifampicin, gentamicin kapena kusiyanitsa mayeso, mwachitsanzo;
• Matenda a impso a Polycystic;
• Matenda aakulu a impso;
• Kusintha kwa potaziyamu wamagazi;
• Matenda monga sickle cell anemia, multipleeloma, amyloidosis, sarcoidosis, mwachitsanzo;
• Kuika pambuyo paimpso;
• Khansa ya impso;
• Zimayambitsa sizinafotokozeredwe kapena kusamvana.

Kuphatikiza apo, pali zomwe zimayambitsa nephrogenic shuga insipidus, zomwe ndizosowa kwambiri komanso zowopsa, ndipo zawonetsedwa kuyambira ali mwana.

3. Gestational shuga insipidus

Gestational diabetes insipidus ndichinthu chosowa kwambiri, koma zimatha kuchitika patatha miyezi itatu itatha mimba chifukwa chopanga enzyme ya placenta, yomwe imawononga timadzi ta ADH, zomwe zimayambitsa kuyambitsa kwa zizindikilo.

Komabe, ndi matenda omwe amapezeka pokhapokha mukakhala ndi pakati, ndikumazungulira masabata 4 mpaka 6 mutabereka.

4. Dipsogenic shuga insipidus

Dipsogenic diabetes insipidus, yotchedwanso primary polydipsia, imatha kuchitika chifukwa cha kuwonongeka kwa njira yothetsera ludzu mu hypothalamus, zomwe zimapangitsa kuti zizindikilo za matenda ashuga insipidus. Mtundu wa matenda ashuga amathanso kukhala okhudzana ndi matenda amisala, monga schizophrenia, mwachitsanzo.

Momwe mankhwalawa amachitikira

Mankhwala a shuga insipidus cholinga chake ndikuchepetsa mkodzo womwe thupi limatulutsa ndipo akuyenera kuwonetsedwa ndi adotolo malinga ndi zomwe zimayambitsa matendawa.

Nthawi zina matenda a shuga insipidus amayamba chifukwa chogwiritsa ntchito mankhwala ena, adokotala amalimbikitsa kuti asiye kugwiritsa ntchito mankhwala osinthira. Pankhani yamatenda amisala, mankhwalawa amayenera kuchitidwa ndi sing'anga ndi mankhwala amtundu uliwonse, kapena ngati matenda a shuga amayambitsidwa ndi matenda, mwachitsanzo, matendawa ayenera kuthandizidwa asanayambe mankhwala enaake.

Mwambiri, mitundu yamankhwala imadalira kuopsa kwa matendawa ndi mtundu wa insipidus ya shuga, ndipo amatha kuichita ndi:

1. Kulamulira kumwa madzi

Pazovuta zochepa za matenda a shuga insipidus, adotolo amalimbikitsa kuti azingowongolera kuchuluka kwa madzi omwe amamwa, ndipo tikulimbikitsidwa kumwa osachepera 2.5 malita amadzimadzi patsiku kuti tipewe kutaya madzi.

Central shuga insipidus amaonedwa ngati wofatsa ngati munthuyo atulutsa 3 mpaka 4 malita a mkodzo m'maola 24.

2. Hormone

Pazovuta kwambiri za matenda a shuga insipidus kapena gestational diabetes insipidus, adotolo amalimbikitsa kuti m'malo mwa ADH hormone, kudzera mu mankhwala a desmopressin kapena DDAVP, omwe amatha kuperekedwa kudzera mumitsempha, pakamwa kapena mwa kupuma.

Desmopressin ndi mahomoni amphamvu kwambiri ndipo amalephera kuwononga kuposa ADH mwachilengedwe omwe amapangidwa ndi thupi ndipo imagwira ntchito ngati ADH yachilengedwe, kuteteza impso kutulutsa mkodzo pomwe madzi m'thupi amakhala otsika.

3. Zodzikongoletsera

Mankhwala okodzetsa amatha kugwiritsidwa ntchito, makamaka pamavuto akulu a nephrogenic diabetes insipidus, ndipo diuretic yolimbikitsidwa kwambiri ndi dokotala ndi hydrochlorothiazide yomwe imagwira ntchito pochepetsa kuchuluka kwa kusefera kwamagazi kudzera mu impso, zomwe zimachepetsa kuchuluka kwa mkodzo womwe thupi limatulutsa.

Kuphatikiza apo, adotolo akuyenera kulangiza zakudya zamchere wambiri kuti muchepetse kuchuluka kwa mkodzo impso zanu zimatulutsa ndikumwa madzi osachepera 2.5 malita patsiku popewa kutaya madzi m'thupi.

4. Mankhwala oletsa kutupa

Mankhwala odana ndi zotupa, monga ibuprofen, atha kusonyezedwa ndi dokotala ngati ali ndi nephrogenic diabetes insipidus, chifukwa amathandizira kuchepetsa mkodzo ndipo amayenera kugwiritsidwa ntchito limodzi ndi okodzetsa.

Komabe, kugwiritsa ntchito mankhwala odana ndi zotupa kwa nthawi yayitali, kumatha kuyambitsa m'mimba kapena zilonda zam'mimba. Poterepa, adotolo amalimbikitsa njira yoteteza m'mimba monga omeprazole kapena esomeprazole, mwachitsanzo.

Zovuta zotheka

Zovuta zomwe matenda a shuga insipidus angayambitse ndi kusowa kwa madzi m'thupi kapena kusalinganizika kwama electrolyte m'thupi monga sodium, potaziyamu, calcium ndi magnesium, chifukwa chakuchepa kwamadzi ndi ma electrolyte amthupi mwa mkodzo, zomwe zimatha kuyambitsa zizindikilo monga:

• Pakamwa youma;
• Mutu;
• Chizungulire;
• Kusokonezeka kapena kukwiya;
• kutopa kwambiri;
• kupweteka kwa minofu kapena kukokana;
• Nseru kapena kusanza;
• Kutaya njala.

Ngati mukukumana ndi izi, muyenera kupita kuchipatala mwachangu kapena kuchipatala chapafupi.

Kodi pali kusiyana kotani pakati pa matenda a shuga insipidus ndi mellitus?

Shuga insipidus ndiyosiyana ndi matenda a shuga, chifukwa mahomoni omwe amasintha mitundu iwiri ya matenda ashuga ndi osiyana.

Mu matenda a shuga insipidus pamakhala kusintha kwa mahomoni ADH omwe amayang'anira kuchuluka kwa mkodzo womwe munthuyo amatulutsa. Mu matenda a shuga, komano, pali kuwonjezeka kwa magazi m'magazi chifukwa cha kuchepa kwa insulin ndi thupi kapena chifukwa chokana thupi kuyankha insulini. Onani mitundu ina ya matenda ashuga.