Isifo sikashukela insipidus: siyini, izimbangela, izimpawu nokwelashwa

-Delile

• Izimpawu eziyinhloko
• Ungakuqinisekisa kanjani ukuxilongwa
• Izimbangela ezingaba khona
• 1. Isifo sikashukela esiphakathi insipidus
• 2. I-Nephrogenic diabetes insipidus
• 3. Isifo sikashukela sokukhulelwa insipidus
• 4. I-Dipsogenic diabetes insipidus
• Yelashwa kanjani
• 1. Ukulawulwa kokuphuza uketshezi
• 2. IHormone
• 3. Izidakamizwa
• 4. Ama-anti-inflammatories
• Izinkinga ezingenzeka
• Uyini umehluko phakathi kwesifo sikashukela i-insipidus ne-mellitus?

Isifo sikashukela i-insipidus ukuphazamiseka okwenzeka ngenxa yokungalingani kuketshezi emzimbeni, okuholela ezimpawu ezifana nokoma kakhulu, noma ngabe uphuze amanzi, nokukhiqiza ngokweqile komchamo, okungadala ukoma.

Lesi simo senzeka ngenxa yezinguquko ezifundeni zobuchopho ezibhekele ukukhiqizwa, ukugcinwa kanye nokukhishwa kwe-hormone elwa namagciwane (ADH), ebizwa nangokuthi i-vasopressin, elawula ijubane lapho umchamo ukhiqizwa khona, kodwa futhi kungenzeka ngenxa yezinguquko izinso ezihluleka ukuphendula kuleyo hormone.

Isifo sikashukela i-insipidus asinalo ikhambi, noma kunjalo, izindlela zokwelashwa, okumele zikhonjiswe ngudokotela, zinganciphisa ukoma ngokweqile futhi zinciphise ukukhiqizwa komchamo.

Izimpawu eziyinhloko

Izimpawu zesifo sikashukela i-insipidus ukoma okungalawuleki, ukukhiqizwa komchamo omningi, isidingo esivamile sokuvuka ukuze uchame ebusuku nokukhetha ukuphuza uketshezi olubandayo. Ngaphezu kwalokho, ngokuhamba kwesikhathi, ukusetshenziswa oketshezi ngokweqile kubangela ukuzwela okweqile ku-hormone ye-ADH noma ukukhiqizwa okuncane nokuncane kwale hormone, okungadala izimpawu zibe zimbi kakhulu.

Lesi sifo singenzeka nasezinsaneni nasezinganeni futhi ngenxa yokukhiqizwa ngokweqile komchamo kubalulekile ukuthi wazi izimpawu zesifo sikashukela i-insipidus njengamanabukeni ahlala emanzi noma ingane ingakwazi ukuchama embhedeni, ubunzima bokulala, umkhuhlane, ukuhlanza, ukuqunjelwa , ukubambezeleka kokukhula nentuthuko noma ukwehla kwesisindo.

Ungakuqinisekisa kanjani ukuxilongwa

Ukuxilongwa kwesifo sikashukela insipidus kufanele kwenziwe ngudokotela we-endocrinologist noma, esimweni sezinsana nezingane, udokotela wezingane, okufanele acele ukuhlolwa komthamo womchamo wamahora angama-24 nokuhlolwa kwegazi ukuhlola amazinga e-sodium ne-potassium, angashintshwa. Ngaphezu kwalokho, udokotela angacela ukuhlolwa kokuvinjelwa uketshezi, lapho umuntu elaliswe esibhedlela, ngaphandle kokuphuza uketshezi futhi abhekelwe izimpawu zokoma, inani lomchamo okhiqizwayo namazinga ama-hormone. Olunye uvivinyo udokotela anga-oda ngalo yi-MRI yobuchopho ukuhlola ushintsho ebuchosheni okungenzeka ukuthi ludala lesi sifo.

Izimbangela ezingaba khona

Izimbangela zesifo sikashukela insipidus zixhomeke ohlotsheni lwesifo futhi zingahlukaniswa njenge:

1. Isifo sikashukela esiphakathi insipidus

I-insipidus yesifo sikashukela emaphakathi ibangelwa izinguquko esifundeni sobuchopho esibizwa nge-hypothalamus, elahlekelwa amandla ayo okukhiqiza i-hormone ADH, noma indlala yesibopho ebhekene nokugcina nokukhulula i-ADH emzimbeni futhi ingadalwa yi:

• Ukuhlinzwa kobuchopho;
• Ukuhlukumezeka ekhanda;
• Isigaxa sobuchopho noma i-aneurysm;
• Izifo ezizimele;
• Izifo zofuzo;
• Ukutheleleka ebuchosheni;
• Ukuvinjelwa kwemithambo yegazi enikezela ubuchopho.

Lapho amazinga e-hormone ADH ehliswa, izinso azikwazi ukulawula ukukhiqizwa komchamo, oqala ukwakhiwa ngobuningi, ngakho-ke umuntu uchama kakhulu, ongafinyelela ngaphezu kwamalitha ama-3 kuye kwangama-30 ngosuku.

2. I-Nephrogenic diabetes insipidus

I-Nephrogenic diabetes insipidus yenzeka lapho ukuhlushwa kwe-hormone ye-ADH egazini kuyinto ejwayelekile, kepha izinso aziphenduli ngokujwayelekile kuyo. Izimbangela eziyinhloko yilezi:

• Ukusetshenziswa kwemithi, njenge-lithium, i-rifampicin, i-gentamicin noma ukuqhathanisa kokuhlolwa, isibonelo;
• Isifo sezinso sePolycystic;
• Izifo ezinamandla zezinso;
• Izinguquko emazingeni e-potassium egazi;
• Izifo ezinjenge-sickle cell anemia, i-myeloma eminingi, i-amyloidosis, i-sarcoidosis, isibonelo;
• Ukufakelwa kabusha ngemuva kwezinso;
• Umdlavuza wezinso;
• Izimbangela ezingacacisiwe noma ze-idiopathic.

Ngaphezu kwalokho, kunezimbangela zofuzo ze-nephrogenic diabetes insipidus, eziyivelakancane nezimbi kakhulu, futhi eziye zabonakaliswa kusukela ebuntwaneni.

3. Isifo sikashukela sokukhulelwa insipidus

I-Gestational diabetes insipidus yisimo esingajwayelekile, kepha singenzeka cishe ngethathu lesithathu lokukhulelwa ngenxa yokukhiqizwa kwe-enzyme yi-placenta, ecekela phansi i-hormone ye-ADH yowesifazane, okuholela ekuqaleni kwezimpawu.

Kodwa-ke, yisifo esenzeka kuphela ngesikhathi sokukhulelwa, esijwayelekile emasontweni amane kuya kwayisithupha ngemuva kokubeletha.

4. I-Dipsogenic diabetes insipidus

I-Dipsogenic diabetes insipidus, ebizwa nangokuthi i-polydipsia eyinhloko, ingenzeka ngenxa yokulimala kwendlela yokulawula ukoma ku-hypothalamus, okuholele ekuveleni kwezimpawu ezivamile zesifo sikashukela insipidus. Lolu hlobo lwesifo sikashukela lungabuye luhlobene nezifo zengqondo, njenge-schizophrenia, isibonelo.

Yelashwa kanjani

Ukwelashwa kwesifo sikashukela i-insipidus kuhlose ukunciphisa inani lomchamo okhiqizwa ngumzimba futhi okufanele ukhonjiswe udokotela ngokusho kwembangela yalesi sifo.

Ezimweni lapho i-insipidus yesifo sikashukela ibangelwe ukusetshenziswa kwemithi ethile, udokotela angancoma ukuthi ayeke ukusebenzisa futhi ashintshele kolunye uhlobo lokwelashwa. Endabeni yokugula kwengqondo, ukwelashwa kufanele kwenziwe ngudokotela wezifo zengqondo ngemithi ethile ecaleni ngalinye, noma uma isifo sikashukela i-insipidus sidalwe yisifo, isibonelo, ukutheleleka kufanele kulashwe ngaphambi kokuqala ukwelashwa okuthile.

Ngokuvamile, izinhlobo zokwelashwa zincike ebucayi besifo nohlobo lwesifo sikashukela i-insipidus, futhi kungenziwa nge:

1. Ukulawulwa kokuphuza uketshezi

Ezimweni ezincane zesifo sikashukela esiphakathi, insipidus, udokotela angancoma kuphela ukulawula inani loketshezi oludliwayo, futhi kunconywa ukuthi uphuze okungenani amalitha angu-2,5 oketshezi ngosuku ukugwema ukuphelelwa amandla.

I-insipidus yesifo sikashukela emaphakathi ibhekwa njengomnene uma umuntu ekhiqiza amalitha amathathu kuya kwayi-4 kuphela omchamo emahoreni angama-24.

2. IHormone

Ezimweni ezimbi kakhulu zesifo sikashukela esiphakathi noma insipidus sikashukela wokukhulelwa, udokotela angancoma ukushintshwa kwehomoni ye-ADH, ngokusebenzisa umuthi we-desmopressin noma i-DDAVP, ongalawulwa ngomthambo, ngomlomo noma nge-inhalation.

I-Desmopressin iyi-hormone enamandla kakhulu futhi iyamelana nokwehliswa ngokweqile kune-ADH ekhiqizwa ngokwemvelo ngumzimba futhi isebenza njenge-ADH yemvelo, evimbela izinso ekukhiqizeni umchamo lapho izinga lamanzi emzimbeni liphansi.

3. Izidakamizwa

Ama-diuretics angasetshenziswa, ikakhulukazi ezimweni ezinzima ze-nephrogenic diabetes insipidus, futhi isisu esinconywe kakhulu udokotela yi-hydrochlorothiazide esebenza ngokunciphisa izinga lokuhluza igazi ngezinso, elehlisa inani lomchamo okhishwe ngumzimba.

Ngaphezu kwalokho, udokotela wakho kufanele ancoma ukudla okunosawoti omncane ukusiza ukunciphisa inani lomchamo okhiqizwa izinso zakho futhi uphuze okungenani amalitha angu-2.5 wamanzi ngosuku ukuvimbela ukuphelelwa amandla kwamanzi.

4. Ama-anti-inflammatories

Izidakamizwa ezilwa nokuvuvukala, njenge-ibuprofen, zingakhonjiswa ngudokotela ezimweni ze-nephrogenic diabetes insipidus, njengoba zisiza ukunciphisa ivolumu yomchamo futhi kufanele zisetshenziswe zihlangene nezidakamizwa.

Kodwa-ke, ukusetshenziswa kwemithi elwa nokuvuvukala isikhathi eside, kungadala ukucasuka kwesisu noma isilonda esiswini. Kulokhu, udokotela angancoma ikhambi lokuvikela isisu njenge-omeprazole noma i-esomeprazole, isibonelo.

Izinkinga ezingenzeka

Izinkinga ezingabangelwa yisifo sikashukela i-insipidus kungukuphelelwa ngamanzi emzimbeni noma ukungalingani kwama-electrolyte emzimbeni njenge-sodium, i-potassium, i-calcium ne-magnesium, ngenxa yokulahleka okukhulu koketshezi nama-electrolyte ngumzimba ngomchamo, okungadala izimpawu ezifana nokuthi:

• Umlomo owomile;
• Ikhanda;
• Isiyezi;
• Ukudideka noma ukucasuka;
• ukukhathala ngokweqile;
• ubuhlungu bemisipha noma amajaqamba;
• Isicanucanu noma ukuhlanza;
• Ukuphelelwa isifiso sokudla.

Uma uhlangabezana nanoma yiziphi zalezi zimpawu, kufanele ufune usizo lwezokwelapha ngokushesha noma igumbi lokuphuthumayo eliseduzane.

Uyini umehluko phakathi kwesifo sikashukela i-insipidus ne-mellitus?

Isifo sikashukela i-insipidus sehlukile kunesifo sikashukela, ngoba amahomoni ashintsha lezi zinhlobo ezimbili zesifo sikashukela ahlukile.

Ku-insipidus yesifo sikashukela kunoshintsho ku-hormone ADH elawula inani lomchamo okhiqizwa ngumuntu. Ngokwesifo sikashukela, ngakolunye uhlangothi, kukhona ukwanda kwamazinga eglucose egazini ngenxa yokukhiqizwa kwe-insulin okuncane ngumzimba noma ngenxa yokumelana komzimba nokuphendula i-insulin. Bheka ezinye izinhlobo zesifo sikashukela.