Isifo seswekile i-insipidus: yintoni, unobangela, iimpawu kunye nonyango

Umxholo

• Iimpawu eziphambili
• Indlela yokuqinisekisa ukuxilongwa
• Izizathu ezinokubangela
• 1. Isifo seswekile esiphakathi
• 2. I-Nephrogenic isifo seswekile insipidus
• 3. Isifo seswekile sesifo seswekile
• 4. I-Dipsogenic diabetes insipidus
• Unyango lwenziwa njani
• 1. Ukulawulwa kokutya okungamanzi
• 2. IHormone
• 3. womchamo
• 4. Amachiza okuthomalalisa ukudumba
• Iingxaki ezinokwenzeka
• Nguwuphi umahluko phakathi kwesifo seswekile i-insipidus kunye ne-mellitus?

Isifo seswekile i-insipidus sisifo esenzeka ngenxa yokungalingani kulwelo emzimbeni, olukhokelela kwiimpawu ezinjengokunxanwa kakhulu, nokuba usele amanzi, kunye nemveliso egqithisileyo yomchamo, enokubangela ukomisa.

Le meko yenzeka ngenxa yotshintsho kwimimandla kwingqondo ejongene nemveliso, ukugcinwa kunye nokukhululwa kwehomoni ye-antidiuretic (ADH), ekwabizwa ngokuba yi-vasopressin, elawula isantya apho umchamo uveliswa khona, kodwa inokwenzeka ngenxa yotshintsho izintso ezingaphenduliyo kuloo hormone.

Isifo seswekile i-insipidus ayinanyango, nangona kunjalo, unyango, ekufuneka luboniswe ngugqirha, lunokuphelisa ukunxanwa okungaphezulu kunye nokunciphisa imveliso yomchamo.

Iimpawu eziphambili

Iimpawu zesifo seswekile i-insipidus kukunganxanwa okungalawulekiyo, ukuveliswa komchamo omkhulu, ukufuna rhoqo ukuphakama ukuze uchame ebusuku kunye nokukhetha ukusela iziselo ezibandayo. Ukongeza, ekuhambeni kwexesha, ukusetyenziswa gwenxa kwe-fluid kubangela ukonyuka kokuziva kwehomoni ye-ADH okanye imveliso engaphantsi nangaphantsi kule hormone, enokuthi ibe mandundu ngakumbi iimpawu.

Esi sifo sinokubakho nakwiintsana nasebantwaneni kwaye ngenxa yemveliso egqithisileyo yomchamo kubalulekile ukuba wazi iimpawu zesifo seswekile ezifana neepapu ezimanzi rhoqo okanye umntwana angakwazi ukuchama ebhedini, ubunzima bokulala, umkhuhlane, ukugabha, ukuqhina , ukukhula kunye nokulibaziseka kophuhliso okanye ukunciphisa umzimba.

Indlela yokuqinisekisa ukuxilongwa

Ukuchongwa kwesifo seswekile i-insipidus kufuneka kwenziwe ngugqirha ongu-endocrinologist okanye, kwimeko yeentsana nabantwana, ugqirha wabantwana, ekufuneka acele uvavanyo lwevolumu yomchamo weeyure ezingama-24 kunye novavanyo lwegazi ukuvavanya amanqanaba esodiyam neepotassium. Ukongeza, ugqirha unokucela uvavanyo lokuthintelwa kolwelo, apho umntu alaliswe esibhedlele, ngaphandle kokusela iziselo kwaye ujongwa ngeempawu zokuphelelwa ngamanzi emzimbeni, isixa somchamo esivelisiweyo kunye namanqanaba ehomoni. Olunye uvavanyo ugqirha anokulu-odola yi-MRI yengqondo ukuvavanya utshintsho kwingqondo olunokubangela isifo.

Izizathu ezinokubangela

Izizathu zesifo seswekile i-insipidus zixhomekeka kuhlobo lwesifo kwaye zinokuhlelwa njenge:

1. Isifo seswekile esiphakathi

Isifo seswekile esembindini sibangelwa lutshintsho kwingingqi yengqondo ebizwa ngokuba yihypothalamus, ephulukana namandla ayo okuvelisa i-hormone ye-ADH, okanye idlala lengqula elinoxanduva lokugcina nokukhupha i-ADH emzimbeni kwaye kunokubangelwa:

• Utyando lobuchopho;
• Ukwenzakala entloko;
• Ithumba lobuchopho okanye i-aneurysm;
• Izifo ezizimeleyo;
• Izifo zemfuza;
• Usulelo kwingqondo;
• Ukuthintelwa kwemithambo yegazi ebonelela ngengqondo.

Xa amanqanaba e-hormone ye-ADH ehlisiwe, izintso azikwazi ukulawula imveliso yokuchama, eqala ukwenziwa ngobuninzi, ke loo mntu uchama kakhulu, onokufikelela ngaphezulu kweelitha ezi-3 ukuya kwezingama-30 ngosuku.

2. I-Nephrogenic isifo seswekile insipidus

I-Nephrogenic diabetes insipidus yenzeka xa uxinzelelo lwehomoni ye-ADH egazini kuyinto eqhelekileyo, kodwa izintso aziphenduli ngokwesiqhelo kuyo. Oonobangela abaphambili zezi:

• Ukusetyenziswa kwamayeza, afana ne-lithium, i-rifampicin, i-gentamicin okanye umahluko wovavanyo, umzekelo;
• Polycystic isifo sezintso;
• Usulelo olunzima lwezintso;
• Utshintsho kumanqanaba egazi potassium;
• Izifo ezinjenge-sickle cell anemia, i-myeloma ezininzi, i-amyloidosis, i-sarcoidosis, umzekelo;
• Ukufakelwa emva kwezintso;
• Umhlaza wezintso;
• Oonobangela abangacaciswanga okanye idiopathic.

Ukongeza, kukho oonobangela bemfuza yesifo seswekile i-nephrogenic sesifo se-insipidus, esinqabileyo nesomelele ngakumbi, kwaye sabonakaliswa ukusukela ebuntwaneni.

3. Isifo seswekile sesifo seswekile

Isifo seswekile i-insipidus yinto enqabileyo, kodwa inokwenzeka kwithuba lesithathu lesithathu lokukhulelwa ngenxa yokuveliswa kwe-enzyme yi-placenta, etshabalalisa i-hormone ye-ADH yomfazi, ekhokelela ekuqalekeni kweempawu.

Nangona kunjalo, sisifo esenzeka kuphela ngexesha lokukhulelwa, esiqhelekileyo kwiiveki ezi-4 ukuya kwezi-6 emva kokubeleka.

4. I-Dipsogenic diabetes insipidus

I-Dipsogenic diabetes insipidus, ekwabizwa ngokuba yi-polydipsia ephambili, inokwenzeka ngenxa yomonakalo kwindlela yokulawula ukunxanwa kwi-hypothalamus, ekhokelela ekubonakaleni kweempawu zesifo seswekile i-insipidus. Olu hlobo lwesifo seswekile lunokunxulunyaniswa nezifo zengqondo, ezinje nge-schizophrenia, umzekelo.

Unyango lwenziwa njani

Unyango lwe-insipidus yeswekile lujolise ekunciphiseni umchamo oveliswa ngumzimba kwaye kufuneka uboniswe ngugqirha ngokwesizathu sesifo.

Kwiimeko apho isifo seswekile i-insipidus ibangelwe kukusetyenziswa kwamayeza athile, ugqirha unokucebisa ukuba ayeke ukusetyenziswa kwaye atshintshele kolunye uhlobo lonyango. Kwimeko yokugula ngengqondo, unyango kufuneka lwenziwe ngugqirha wezifo zengqondo onamayeza athile kwityala ngalinye, okanye ukuba isifo seswekile sibangelwa sisifo, umzekelo, usulelo kufuneka lunyangwe ngaphambi kokuqala unyango oluthile.

Ngokubanzi, iintlobo zonyango zixhomekeke kubukhali besifo kunye nohlobo lwesifo seswekile, kwaye lunokwenziwa:

1. Ukulawulwa kokutya okungamanzi

Kwiimeko ezinobuzaza zesifo seswekile esiphakathi, ugqirha unokuncoma kuphela ukulawula isixa sokungenisa ulwelo, kwaye kuyacetyiswa ukuba usele ubuncinci i-2.5 yeelitha zamanzi ngosuku ukunqanda ukomisa.

Isifo seswekile esiphakathi sithathwa ngokuba sinobulali ukuba umntu uvelisa kuphela iilitha ezi-3 ukuya kwezi-4 zomchamo kwiiyure ezingama-24.

2. IHormone

Kwiimeko ezinzima kakhulu zesifo seswekile okanye i-insipidus yesifo seswekile, ugqirha unokucebisa ukutshintshwa kwehomoni ye-ADH, ngokusebenzisa iyeza le-desmopressin okanye i-DDAVP, elinokuqhutywa ngomthambo, ngomlomo okanye nge-inhalation.

I-Desmopressin yihomoni enamandla ngakumbi kwaye iyamelana nokuthotywa komzimba kune-ADH ngokwendalo eveliswa ngumzimba kwaye isebenza njenge-ADH yendalo, ethintela izintso ekuveliseni umchamo xa inqanaba lamanzi emzimbeni liphantsi.

3. womchamo

I-diuretics inokusetyenziswa, ngakumbi kwiimeko ezinzima ze-nephrogenic diabetes insipidus, kunye ne-diuretic ekucetyiswa kakhulu ngugqirha yi-hydrochlorothiazide esebenza ngokunciphisa izinga lokuhluzwa kwegazi ngezintso, elinciphisa inani lomchamo ophuma emzimbeni.

Ukongeza, ugqirha wakho kufuneka acebise ukutya okunetyuwa encinci ukunceda ukunciphisa umchamo xa uvelisa izintso kunye nokusela ubuncinci i-2.5 yeelitha zamanzi ngosuku ukunqanda ukomisa.

4. Amachiza okuthomalalisa ukudumba

Amachiza alwa nokudumba, afana ne-ibuprofen, anokuboniswa ngugqirha kwimeko ye-nephrogenic diabetes sesifo se-insipidus, njengoko zinceda ukunciphisa umthamo womchamo kwaye kufuneka zisetyenziswe ngokudibanisa ne-diuretics.

Nangona kunjalo, ukusetyenziswa kweziyobisi ezichasayo ixesha elide, kunokubangela ukucaphuka kwesisu okanye isilonda esiswini. Kule meko, ugqirha unokucebisa iyeza lokukhusela isisu njenge-omeprazole okanye i-esomeprazole, umzekelo.

Iingxaki ezinokwenzeka

Iingxaki ezinokubangelwa sisifo seswekile i-insipidus inokubangela ukuphelelwa ngamanzi emzimbeni okanye ukungalingani kwe-electrolyte emzimbeni njenge-sodium, i-potassium, i-calcium kunye ne-magnesium, ngenxa yokulahleka okukhulu kwamanzi kunye ne-electrolyte ngumzimba ngomchamo, onokubangela iimpawu ezinje:

• Umlomo owomileyo;
• Intloko ebuhlungu;
• Isiyezi;
• Ukudideka okanye ukucaphuka;
• ukudinwa okugqithisileyo;
• iintlungu zezihlunu okanye iicramps;
• Isicaphucaphu okanye ukugabha;
• Ukuphelelwa ngumdla wokutya.

Ukuba ufumana enye yezi mpawu, kuya kufuneka ufune uncedo lwezonyango kwangoko okanye kwigumbi lezongxamiseko elikufutshane.

Nguwuphi umahluko phakathi kwesifo seswekile i-insipidus kunye ne-mellitus?

Isifo seswekile i-insipidus sahlukile kwisifo seswekile, kuba iihomoni ezitshintsha ezi ntlobo zimbini zeswekile zahlukile.

Kwi-insipidus yeswekile kukho utshintsho kwihomoni ye-ADH elawula umchamo oveliswa ngumntu. Kwi-diabetes mellitus, kwelinye icala, kukho ukonyuka kwamanqanaba eglucose egazini ngenxa yemveliso ephantsi ye-insulin ngumzimba okanye ngenxa yokuxhathisa komzimba ukuphendula kwi-insulin. Jonga ezinye iintlobo zeswekile.