Isifo sikashukela i-insipidus (isifo sikashukela i-insipidus) yisifo esingajwayelekile se-endocrine esenzeka ngenxa yokulimala pituitary, hypothalamus, noma umsebenzi wezinso. Lesi sifo sibonisa nge-polydipsia (umuzwa wokoma njalo) ne-polyuria (ukukhiqizwa komchamo okwandisiwe - kusuka kumalitha ayi-6 kuye kwangama-50 ngosuku).
Lesi sifo singalapheki, singakhula kubantu besifazane nakwabesilisa ngasiphi isikhathi, kepha imvamisa isifo sikashukela sivela kubantu abaneminyaka engu-18 kuya kwengama-28 ubudala.
I-pituitary gland ne-hypothalamus yizinduna ze-endocrine ezixhumene. Zibonisa iphaneli yokulawula ethile elawula izindlala zomzimba we-endocrine.
Nakani! Ama-Sector neurons we-hypothalamus akhiqiza ama-hormone - i-oxytocin ne-vasopressin.
I-hormone ye-antidiuretic - i-vasopressin iqoqwa emgodini ongasemva kwendawo. I-hormone iyadedelwa uma kunesidingo futhi ilawula ukufakwa okubuyiselwa emuva kwamanzi kumathumbu ezinso.
Esimweni sokuxineka okuphansi kwe-antidiuretic hormone egazini ezinsweni izinqubo zokubuyiselwa kwamanzi kabusha - uyakhungatheka, yingakho kwakheka i-polyuria.
Izimpawu nezimbangela zesifo sikashukela i-insipidus
Isifo sikashukela i-mellitus syndrome sivele uma izinguquko ze-pathological zenzeka emzimbeni, izimbangela zazo:
- ukuwohloka okwenziwe ngcono kwe-vasopressin;
- ukwenzeka kwamafomu ku-pituitary kanye ne-hypothalamus;
- kumaseli okuhlosiwe ezinsweni, kuba khona ukuphazamiseka kwemizwa kwe-hormone ye-antidiuretic;
- ukungasebenzi kahle kwe-hypothalamus noma i-pituitary gland;
- ifa lokuphamba (isethulo sohlobo lwamandla amakhulu we-autosomal);
- ukulimala kwekhanda noma ukuhlinzwa kwe-neurosuction okungaphumeleli, okubangela ukulimala kwama-vasopressin neurons;
- ama-metcases we-oncological anomthelela ongemuhle emsebenzini wezinhlungu zombili;
- izifo ze-autoimmune nezifo ezithathelwanayo ezibhubhisa ama-neurons e-antidiuretic hormone.
Izimpawu eziphambili zesifo sikashukela i-mellitus yi-polydipsia ne-polyuria, ngamazinga ahlukahlukene obulukhuni.
Izimpawu ezivela nenkambo ende yesifo
Kuyisifundo eside lesi sifo, izimpawu ezinjengokwanda kwe-bladder, prolapse kanye nokuqothuka kwesisu kuyimpawu. Izimpawu zesifo sikashukela i-insipidus syndrome futhi zifaka i-anorexia (ukwehlisa isisindo ngokweqile), ukugabha, kanye nenausea.
Izimpawu ezilandelayo ezinobuntu umfutho wegazi ophansi, i-lethargy ne-asthenia. Isifo sikashukela i-mellitus sibuye sihambisane nezimpawu ezifana ne-migraine kanye ne-sedation yensimu ebonakalayo.
Izimpawu ezengeziwe zesifo sikashukela i-insipidus zilele ekuqothulweni komzimba:
- isikhumba esomile nesama-atonic;
- iminyakazo engenzeka;
- sunben cheekbones.
Futhi, ngesinye isikhathi ngokushintshwa okubukhali kwesikhundla somzimba, isiguli siba nezimpawu ezifana nokuwohloka kwamathambo.
Ukuxilonga
Lapho kunqunywa ukutholakala kwesifo, kubalulekile ukusungula ngokunembile indlela yesifo ukuze ukwelashwa kube kahle. Ekutholakalweni kwalesi sifo, ama-anamnesis nezimpawu ezibonisa i-polydipsia ne-polyuria (ngaphezu kwamalitha amabili ngosuku) kubalulekile.
Uma umlando wemtholampilo nowezokwelapha ukhombisa ukuthi isifo sikashukela i-insipidus syndrome, udokotela ubeka izivivinyo ezithile. Kulokhu, umuntu udinga ukushiya amanzi okwesikhashana.
Isiguli sinikeza nokuhlolwa komchamo negazi ukuthola:
- ukungasebenzi komchamo;
- i-osmolarity;
- ukuqoqwa kwe-nitrogen, i-potassium, ushukela, i-sodium, i-calcium egazini;
- glucosuria.
Okunye ukuhlaziya okwenziwa ngokudla okomile, lapho isiguli singaphuzi amanzi kusuka emahoreni ayi-8 kuye kwangama-24. Ngenqubo yokuhlola, isisindo, nobukhulu kanye nomthamo womchamo kuyaqoshwa njalo ngehora futhi okuqukethwe kwe-sodium kumchamo kuyalinganiswa.
Uma isisindo sesiguli sehla ngo-5%, futhi inani le-sodium lingaphezu kwama-3 mmol / l, khona-ke isifundo sesiphelile. Ngakho-ke, kungenzeka ukuphika noma ukuqinisekisa ubukhona be-insipidus yesifo sikashukela, lapho kungekho khona i-antidiuretic hormone, eyenza sikwazi ukufeza i-disdiagnosis nge-polydipsia yezinzwa neyengqondo.
Ukuxilongwa okuhlukile kwe-nephrogenic kanye ne-hypothalamicabetes insipidus syndrome kufaka phakathi isifundo esisebenzisa iMinirin: ukuhlolwa kwenziwa ngokwe-Zimnitsky ngaphambi kokuthatha uMinirin nangemva kokusebenzisa lesi sidakamizwa. Uma, ngemuva kokuthatha umuthi, umthamo womchamo wehla futhi nobukhulu bawo bukhuphuka, lokhu kufakazela ukutholakala kwe-hypothalamicabetes insipidus.
Ekuhlolweni okungafani kohlobo lwe-nephrogenic ne-hypothalamic, okuqukethwe kwe-vasopressin esegazini kubaluleke kakhulu: ngesifo sikashukela se-nephrogenic, inani laleli hormone likhuphuka, esimweni sesibili alibukelwa phansi.
Ukuze kutholakale uhlobo lwe-mellitus yesifo sikashukela sohlobo oluphambili, kwenziwa i-MRI, enquma ubukhona be-pathologies, amabala akhanyayo kanye nokwakheka kwe-pituitary gland.
Ukwelashwa
Isifo sikashukela esimaphakathi
Ukwelashwa kwalolu hlobo lwe-insipidus yesifo sikashukela kubandakanya ukusetshenziswa kokuqhubeka kokunye ukwelashwa. Umuthi oyinhloko okwenziwa ngawo ukwelashwa okuphumelelayo yi-Desmopressin nezinhlobonhlobo zawo:
- I-Minirin (amaphilisi) - i-analogue yokufakelwa ye-hormone ye-antidiuretic;
- I-Adiuretin (ampoules) - ukusetshenziswa kwe-intranasal.
IMinirin (vasopressin yokwenziwa)
Ngemuva kokuphathwa, umuthi ungatholakala egazini ngemuva kwemizuzu engu-15-30, bese kugxilwa kuwo ngemuva kwemizuzu engu-120.
Udokotela ukhetha umthamo ngamunye, aqaphe imiphumela yesidakamizwa lapho ukwelashwa kusesigabeni sokuqala. Umthamo usethelwe, kuya ngesibalo soketshezi esidakiwe futhi nenani lokuchama. Njengomthetho, yithebula le-1-2 ngosuku.
Umuthi uthathwa uhhafu wehora ngaphambi kokudla noma ngemuva kwamahora ama-2 ngemuva kokudla. Isikhathi iMinirin sisuka emahoreni ayi-8 kuye kwayi-12, ngakho-ke kufanele sithathwe kathathu ngosuku.
Uma kwenzeka kusetshenziswa i-overdose, kungavela:
- ukudumba;
- ikhanda
- kunciphile ukuphuma komchamo.
Izimbangela ze-overdose zivame ukuhlotshaniswa nomthamo ongalungile, ukuguquguquka kwesimo sezulu, umkhuhlane kanye nokushintsha kwendlela yokuphila.
Ukwelashwa kwesifo sikashukela i-insipidus nephrogenic
Ukwelashwa kwalolu hlobo lwesifo kubandakanya ukusetshenziswa kwezindlela zokwelapha ezihlanganiswa, ezinezinhlobo ezahlukahlukene zokugaya ukudla ngokwanele ngosawoti. Lokhu kuyadingeka ukuthuthukisa umphumela we-thiazide diuretics.
Njengokwelashwa kwe-adjunct, ama-inhibitors e-prostaglandin asetshenziswa: ibuprofen, aspirin, indomethacin.
Nakani! Ngohlobo lwe-nephrogenic lwesifo sikashukela, i-Desmopressin ayisebenzi.
Ukwelashwa kohlobo lwesifo se-dipsogenic akudingi umuthi. Umgomo wayo oyinhloko ukunciphisa inani lamanzi asetshenzisiwe.
Nge -abetes insipidus syndrome, isiguli kufanele sikhawule inani likasawoti, utshwala nokudla kwamaprotheni okudliwayo. Ingxenye eyinhloko yokudla kwakhe kufanele ibe yimikhiqizo yobisi, izithelo nemifino.
Futhi ukunciphisa ukoma, kufanele uphuze iziphuzo ezipholile nge-apula nelamula.
