Kuyini isifo sikashukela? Okokuqala, lesi yisifo se-endocrinological, izibonakaliso eziphambili zazo ezingoma njalo nokuchama ngokweqile.
Ibonakala ikakhulukazi kubantu abasha abaneminyaka engama-25-30 ubudala, kepha kungenzeka kunoma yimuphi ubudala, kubandakanya nokuzalwa.
Izinhlobo zesifo sikashukela i-insipidus nezimbangela
Imbangela eyinhloko yesifo sikashukela ukuntuleka kwe-antidiuretic hormone (i-ADH noma i-vasopressin), umsebenzi ophambili wayo ukubopha i-renal tubule cell receptors kanye nokuqinisekisa ukubuyiselwa okungamamanzi okuvela kumchamo oyinhloko. IVasopressin yakhiwa kuma-hypothalamus ebuchosheni, lapho ingena khona egazini ngokusebenzisa uhlelo lwe-hypothalamic-pituitary.
Ngakho-ke, ukwephulwa kwesenzo se-ADH kungenzeka ngezinga lobuchopho (ukukhiqizwa kwalo okunganele noma isithiyo sokungena mahhala kwi-plasma yegazi), noma ezingeni lezinso (ukuzivikela okuphelele noma okuyingxenye kwezicubu ze-renal).
Kulokhu, izindlela ezilandelayo zesifo sikashukela zihlukaniswa:
1. Isifo sikashukela esimaphakathi
Kungenzeka kumacala alandelayo:
- Izakhiwo ze-volumetric ze-hypothalamus noma i-pituitary gland;
- I-metastatic lesion yalezi zinhlaka;
- I-encephalitis ye-viral kanye ne-bacterial, i-meningitis, kufaka phakathi isifo sofuba, imvelo yes syphilitic nabanye;
- Ukulimala kobuchopho obuhlungu: ukuhlangana kwezimpawu, ukuphazamiseka kwengqondo;
- Ukuphazamiseka kokuhlinzekwa kwegazi: imivimbo, i-hematomas ye-intracerebral;
- Imiphumela yokungenelela kwe-neurosuction;
- Ukungasebenzi kahle kwe-diencephalon ne-midbrain.
I-insipidus yesifo sikashukela esijwayelekile kayiphindeki kaningi kune-mellitus ejwayelekile yesifo sikashukela, kodwa eRussia inani labantu abahlangabezana nalesi sifo linabantu abacishe babe yizinkulungwane ezingama-21.
2. Isifo sikashukela se-renal
Izizathu:
- Isici sofuzo sama-receptors e-ADH;
- Isifo sezinso esivuthayo (pyelonephritis, glomerulonephritis);
- Umfutho wegazi ophakeme
- I-Renal amyloidosis;
- Ama-cysts amaningi;
- Ukwehluleka kwezinso okungamahlalakhona;
- I-Sickle cell anemia;
- Ukusetshenziswa isikhathi eside kwemithi ethile.
3. Ifomu le-Psychogenic
Ngokuvamile kwenzeka ezimweni ezicindezelayo.
4. Ukukhulelwa sikashukela insipidus
I-pathology engavamile, ivela kaningi ekukhulelweni sekwedlule isikhathi, ihlotshaniswa nokubhujiswa kwe-placenta yama-molecule e-ADH Ngemuva kokubeletha, izimpawu ziyanyamalala.
Cishe ingxenye eyodwa kwezintathu yamacala, i-etiology ihlala ingacacile.
Ukubonakaliswa kwezempilo kwesifo sikashukela
Lesi sifo sivame ukuqala kakhulu, inkambo ekhula kahle ayinasici.
- Isibonakaliso esibonisa kakhulu ukwanda kokuvama kokuchama, iziguli zichama kaningana ebusuku (kwenzeka i-nocturia), i-enuresis ingakhula. Inani lomchamo okhishwa ngosuku ngokuvamile awudluli amalitha angama-3-4, kepha ezimweni ezinzima, ikakhulukazi ngesimo sofuzo salesi sifo, singafinyelela amalitha angama-25-30.
- Kwesinye isikhathi kuba nokwenyuka kwezinga lokushisa. Ngenxa yokulahlekelwa ngokweqile kwe-fluid kumchamo, i-turgor yesikhumba iyancipha, iba mncane, kube lula ukusonga, okungaqondile isikhathi eside.
- Kuvela isikhumba esomile kanye nezikhumba ezingama-mucous, okuholela ekucindezelweni nasekukhuleni okukhulu. I-Stomatitis, i-gastritis, i-colitis ikhula.
- Iziguli zihlushwa ukoma okungapheli. Ngenxa yokuphuza kakhulu nokuchama ngokweqile, ukuhlukaniswa kwesisu nesinye kuyabonakala.
Ngenxa yokulahleka okukhulu kukamanzi, kuvela isikhumba esomile esinzima. - Ukuntuleka kokulala, ukulahlekelwa uketshezi njalo kuholela ekubonakala kokuphazamiseka kwe-neurotic, ubuthakathaka beziguli, ukunciphisa umzimba. Isici ukuqwasha, ukungaphatheki kahle, ukuguquka kwemizwelo okuvame ukwenziwa.
- Ngenqubo ye-oncological yobuchopho, ezinye izifo ezihlobene ne-neurological ne-endocrine zivame ukuvela. Lokhu kuvame kakhulu ukuba yimoto, imizwa, ukuphazamiseka okubukwayo, ukuphazamiseka kokuxhumana nokulinganisela.
- Izinqubo zokutheleleka zihambisana ne-hyperthermia, ukwanda kwamangqamuzana amhlophe egazi kanye ne-ESR egazini. Ubuhlungu noma ukudonsa kwemizwa esifundeni se-lumbar kungavela.
- Ngaphezu kwezimpawu ezingenhla zesifo sikashukela i-insipidus, amadoda avame ukuba nezinkinga nge-libido ne-potency.
- Izimpawu ezilandelayo zimpawu zesithombe somtholampilo kwabesifazane: ukungahambi kahle kokuya esikhathini, izinkinga nge-ovulation nokukhulelwa. Ukuphuphuma kwesisu kungenzeka ngezigaba ezahlukahlukene zokukhulelwa.
Ezinganeni ngemuva kweminyaka emithathu, ukubonakaliswa kwalesi sifo kuyafana nakubantu abadala. Amabele ngokuvamile achama, anciphise isisindo, akhale, ancamela ukuphuza amanzi asobala esikhundleni sobisi, ahlushwa ukuqunjelwa. Imvamisa, isimo ezinganeni ezincane kakhulu sihlala singaziwa ngesikhathi futhi kungaholela ekufeni.
Ungayibona kanjani i-insipidus yesifo sikashukela
- Ukuxilongwa okukhulu kwesifo sikashukela i-insipidus iyi-urinalysis ejwayelekile, kanye ne-urinalysis ngokusho kweZimnitsky. Isimilo ukwanda kwenani lomchamo wansuku zonke, ubukhulu bendawo yasebusuku, kanye nokwehla kobukhulu bayo obuhlobene. Emchamweni, kungatholakala amaseli egazi namaprotheni. Ukuba khona kwe-glucose, i-acetone, ngokungafani nesifo sikashukela, akuvamile kakhulu, kuvame ukwenzeka lapho la ma-pathologies amabili ehlanganiswa.
- Ekuhlolweni kwegazi, inani le-sodium lenyuka, i-creatinine, i-urea, ne-nitrogen esele.
- Indlela ebiza kakhulu, kepha efundisayo kakhulu yokuthola isilinganiselo sehomoni ye-antidiuretic ku-plasma. Imvamisa, le nombolo ingaphezulu kuka-6 mmol ngelitha ngalinye.
- Ukuhlolwa okwomile. Isiguli simenyelwa ukuba sinciphise umthamo wanoma yiluphi uketshezi kuze kube yilapho isimo salo jikelele siqala ukuwohloka ngokuphelele. Le ndlela iyasebenza futhi lapho kudingekile ukwahlukanisa phakathi kwamafomu aphakathi nawokuphinda abe yi-insipidus yesifo sikashukela. Ukuhlolwa kwezinguquko enhlalakahleni, ukucwaninga ngomchamo kudalulwe.
- Ukukhuphela ngaphandle i-pathology yezinso, ukuhlolwa kwe-ultrasound kwesitho somzimba kanye nombhede we-vascular, kusetshenziswa i-urret ye-excretory;
- Ezimweni ezingavamile, kuyadingeka ukuthatha izinto ezibonakalayo zomlando nge-biopsy;
- I-X-ray yoswazi iyasiza ukubona ngeso lengqondo ukwakheka kwezakhiwo zamathambo esihlalweni se- "Turkish", ukuba khona kweziqhekeza zesisekelo noma i-arch;
- Ukuqagela okucatshangwayo nokuhlaziywa kukazibuthe kuyadingeka ukuthola i-benign noma i-malignant, kanye nokwakheka kokulimala ebuchosheni;
- Phambi komlando womndeni, kusetshenziswa ukuhlaziya kofuzo;
Kunoma yikuphi, i-insipidus yokusolwa yesifo sikashukela iboniswa ngokubonisana nodokotela we-nephrologist, udokotela oyi-neurologist, i-endocrinologist ne-neurosurgeon.
Ukwelashwa
Ubukhulu bokubonakaliswa kwalesi sifo ngokuvame ngokuqondile kuncike kumthamo wamanzi abuyele kabusha.
Ukwelashwa kwesifo sikashukela i-insipidus kuqala ngokuqokwa kokudla ngokunwa kwenani lamanzi asobala, amajusi, amakhompiyutha, amasobho. Khawula inani likasawoti wethebula kumagremu amabili ngosuku, iziphuzo ezinoshukela nezidakwa. Kunconywa ukungafaki ukudla okunamaprotheni aphezulu, inyama ebhemayo, nokudla okuthosiwe ukunciphisa umthwalo ezinso. Ukudla okuwusizo okucebile ku-potassium: imifino, izithelo. Imvamisa, ukudla kwesifo sikashukela kufana nethebula lesikhombisa noma leshumi.
Njengokwelashwa okubuyiselwa, kusetshenziswa ama-analogues okwenziwa kwe-antidiuretic hormone. Zitholakala ngesimo samathebhulethi noma ngamakhala.
Kwezinye izimo, ama-diuretics anjenge-spironolactone akhonjelwa ukulawula amazinga e-sodium.
Endabeni yenqubo ye-oncological ye-hypothalamus noma i-pituitary gland, kunqunywa umbuzo wokungenelela kokuhlinzwa, i-chemotherapy noma ukwelashwa kwe-radiological.
Kwezifo ezithathelwanayo, kunikezwa i-antibacterial noma i-antiviral therapy. Izidakamizwa ezilwa nokuvuvukala, kusetshenziswa imithi ekhulisa ukungatheleleki.
Yize isifo sikashukela siyisifo esingajwayelekile futhi sivela kakhulu kunoshukela, sisengaba wuphawu lwezifo ezibulalayo futhi siholele emiphumeleni emibi. Ngakho-ke, kubaluleke kakhulu ukunaka ngesikhathi izimpawu zezimpawu zesifo sikashukela, yenza ukuxilongwa bese uqala ukwelashwa.
