Isifo sikashukela: siyini lesi sifo futhi kungani sivela

Isifo sikashukela yisifo sohlelo lwe-endocrine oluhambisana nokuchama okuningi nokoma. Amanye amagama alo "ushukela", "isifo sikashukela sezinso." Ngokuvamile, lesi sifo sitholakala kubantu besifazane abaneminyaka engu-40 ubudala. Naphezu kweqiniso lokuthi izimpawu eziphambili ziyafana nezimpawu zesifo sikashukela, ziyizifo ezihlukile.

Izizathu

Ukuthuthukiswa kwesifo sikashukela i-insipidus akuhlotshaniswa noshintsho kushukela wegazi; kulesi sifo, umthetho wokuchama nokuchama uphazamiseka. At ukoma okungagculiseki kuyavela ezigulini, inani lomchamo ovuthiwe landa. Ukunciphisa ukusetshenziswa kwamanzi kubangela ukomisa, umuntu angalahlekelwa ingqondo, awele ekhefini.

Kunezindlela eziningana zalesi sifo:

1. Ephakathi. Ikhula ngenxa yokukhiqizwa okunganele kwe-vasidiuretic hormone vasopressin yi-hypothalamus.
2. I-Renal. Isizathu sinokwehla kokuzwela kwezicubu zezinso ukuya ku-vasopressin. Ukwephula kungaba ufuzo noma kubangelwe ngumonakalo wezinsana.
3. I-dipsogenic. Ukusetshenziswa okungapheli koketshezi kubangelwa ukuhlulwa kwendlela yokulawula ukoma ku-hypothalamus. Le ndlela yesifo sikashukela kwesinye isikhathi iba ngenxa yokugula kwengqondo.

I-insipidus yesifo sikashukela esezingeni eliphakathi ihlukaniswe i-idiopathic kanye neimpawu. I-Idiopathic idalwa ama-pathologies amafa, ahambisana nokuncipha kokukhiqizwa kwe-antidiuretic hormone (ADH).

ISymbomatic (etholakele) ibonwa ngokungafani nesizinda sezinye izifo:

• Izinsimbi zobuchopho;
• Ama-Metastases
• Ukulimala kobuchopho obuhlungu;
• Encephalitis
• Isifo sezinso (esizalwe kabusha noma esitholiwe);
• ISarcoidosis;
• I-Syphilis;
• Izilonda zamaseli ebuchosheni.

Lesi sifo kwesinye isikhathi sitholakala ngemuva kokungenelela kwe-neurosuction.

Izimbangela zefomu le-renal (nephrogenic):

1. I-Polycystic;
2. Shintsha emazingeni e-potassium;
3. I-Sickle cell anemia;
4. I-Renal amyloidosis;
5. Ubudala obuthuthukisiwe;
6. Ukwehluleka kwezinso okungamahlalakhona;
7. Ukuphuza imithi ethinta kabi izinso.

Kwabanye besifazane, i-insipidus yesifo sikashukela ivela ngesikhathi sokukhulelwa, ibizwa nge- "gestational".

Izimpawu zesifo sikashukela insipidus

Lesi sifo sibonakaliswa ngentuthuko esheshayo, kepha kwesinye isikhathi iyaqina kancane kancane. Izimpawu zokuqala zesifo sikashukela kubantu besilisa nabesifazane azifani - lokhu ukomelela okuqinile, ukuchama njalo. Emini, isiguli siphuza amalitha amanzi ayi-5-20 (ngesilinganiso sama-1.5-2 amalitha).

Ukwephulwa kwemali esele ye-electrolyte kunikeza umfutho wokunye ukonakala.

Isifo sikashukela i-insipidus singabonakala ngezimpawu zayo:

• Ubuthakathaka
• Ukulahlekelwa isisindo;
• Ubuhlungu ekhanda;
• Kwehliswe imfihlo yamathe
• Ukomiswa kwe-epidermis;
• Ukunwebeka kwesinye isisu, isisu;
• Ukwephulwa kokukhululwa kwama-enzymes wokugaya ukudla;
• Umfutho wegazi ophansi;
• Ukushaya kwenhliziyo okuhlala njalo.

Ukusebenza kwesiguli kuncishiswa kakhulu, ukuphazamiseka kwengqondo ngokwengqondo (ukuqwasha, ukungajabuli) kuyabhekwa. Enye yezimpawu zesifo sikashukela i-insipidus kwabesifazane kungaba ukwephula komjikelezo wokuya esikhathini.

Ezinganeni ezisuka eminyakeni engu-3 ubudala, i-pathology iziveza ngendlela efanayo neyabantu abadala, kepha ngokuvamile izimpawu zayo azishiwongo. Ukuvezwa okuyinhloko kufaka phakathi:

• Isifiso sokudla;
• Ukuthola isisindo esinganele noma ukunciphisa umzimba;
• Ukuqhekeka nokudla;
• Ukuqunjelwa
• Enursis.

Ezinganeni ezisanda kuzalwa nezinsana ezingaphansi konyaka ubudala, izimpawu zesifo sikashukela yilezi:

• Ukuphuma komchamo ovela kaningi;
• Ukwehla kwesisindo esisheshayo;
• Ukukhathazeka
• Ukwanda kwenhliziyo;
• Ukuqhafaza
• Ugxuma ngokungazelelwe emazingeni okushisa.

Esikhundleni sobisi lukamama, ingane ithanda ukuphuza amanzi. Uma kungekho ukunakekelwa kwezokwelapha, isimo sengane siba sibi ngokushesha. Izingqinamba ziqala ukubulala.

Ukuxilonga

Uma usola i-insipidus yesifo sikashukela, kufanele uthintane nodokotela wakho we-endocrinologist. Iziguli zengeza zivakashela i-neurosurgeon, neurologist, optometrist. Abesifazane kufanele babonane nodokotela we-gynecologist.

Olunye ucwaningo luzodingeka. Ukuthola i-insipidus yesifo sikashukela:

1. Hlola umchamo negazi;
2. Yenza ukuhlolwa kweZimnitsky;
3. Yenza i-ultrasound yezinso;
4. Yenza i-CT noma i-MRI yobuchopho, i-echoencephalography.

Ukuhlolwa kwelabhorathri kuzohlola ukushoda kwegazi, ukungalingani kwabantu nokuqina komchamo. Ukuhlolwa kwegazi okune-biochemical kwenza ukuthi kube lula ukuthola idatha esezingeni le-glucose, i-nitrogen, i-potassium, i-sodium nezinye izinto.

Izinkomba zesifo

• I-osmolarity yomchamo ophansi (ngaphansi kuka-100-200 mosm / kg);
• Isodium ephezulu yegazi (kusuka ku-155 meq / l);
• Ukuncipha kwezihlobo zomchamo oncishisiwe (ngaphansi kuka-1010);
• Ukwanda kwe-osmolarity ye-plasma yegazi (kusuka kuma-290 mosm / kg).

Isifo sikashukela i-insipidus nesifo sikashukela kulula ukusihlukanisa. Esimweni sokuqala, ushukela awutholakali kumchamo wesiguli, izinga le-glucose esegazini alidluli okujwayelekile. Ikhodi yesifo ye-ICD-10 ngu-E23.2.

Ukwelashwa

Ukwelashwa kwe-insipidus yesifo sezimpawu kuqala kuqala ngokukhonjwa kanye nokuqedwa kwembangela ye-pathology. Ukulungisa ibhalansi kasawoti wamanzi, isiguli sinikezwa ukumfaka okuxubha kwezixazululo kasawoti. Lokhu kuzovikela ukukhula komzimba.

Kunezindlela eziningana zemithi enjalo:

• UMinirin - amaphilisi (okuphathwa ngomlomo nawokutholwa kabusha);
• I-Apo-desmopressin - isifutho samakhala;
• I-Adiuretin - amaconsi emakhaleni;
• I-Desmopressin - amaconsi emakhaleni kanye nesifutho.

Inani lansuku zonke likhethiwe ngokuya ngesimo somzimba, uhlobo lomuthi, ngokwesilinganiso yile:

1. Amacwecwe okuphatha ngomlomo - 0,1-1.6 mg;
2. Amathebhulethi angaphansi komhlaba - 60-360 mcg;
3. Fafaza ukusetshenziswa kwe-intranasal - 10-40 mcg.

Lapho unquma i-Adiuretin, okokuqala kuyadingeka ukuthola impendulo yomzimba kulo muthi, ngenxa yalesi sizathu, amaconsi angu-1-2 afakwa ekhaleni kusihlwa noma ebusuku. kusho. Kamuva, umthamo uyandiswa ukuze wenze inqubo yokuchama ibe yejwayelekile.

Ezinye izidakamizwa zokwelashwa okufakwa esikhundleni:

• I-Adiurekrin (i-lyophilisate ye-pituitary gland of izinkomo). Umuthi kumele udakwe ngaphakathi komthamo we-0,03-0.05 g 3 r. / Usuku. Kukhona isisombululo esithengiswayo. Ithuluzi lidonswe ekhaleni lika-2-3 r. / Usuku lwamaconsi ama-2-3.
• Isifo sikashukela se-Adiuretin (i-analog yamakhemikhali ye-vasopressin). Isixazululo sifakwa emonweni we-1-4 cap. 2-3 kk / Usuku.
• I-Demopressin acetate (i-analog ye-vasopressin, inomphumela wesikhathi eside). Isixazululo sidonswa ekhaleni ngo-5-10 mcg 1-2 r. / Usuku.

Kusetshenziswe izidakamizwa ezithuthukisa ukukhiqizwa kwe-vasopressin kanye nokungena kwayo egazini. Lokhu kufaka phakathi:

1. I-Chlorpropamide (umenzeli we-hypoglycemic). Kuthathwa ku-0.125-0.25 g 1-2 p / Day.
2. I-Miskleron (i-anti-atherogenic agent). Nikeza amaphilisi amabili ama-2-Z r / ngosuku.

Iziguli ezinjalo zinqunyelwe i-diuretics, enomphumela wokuxaka: zenza buthaka ukungcola, inani lomchamo osusiwe liwohloka ngo-50-60%. I-Hypothiazide ingahle ibekelwe isiguli; inani lansuku zonke lingama-25-100 mg.

Ama-diuretics asebenzayo futhi ahlanganisiwe (i-Amiloretic, Isobar). Ngesikhathi sokulashwa, kuyadingeka ukwehlisa inani likasawoti elichithwayo (kufika ku-2 g / ngosuku.). Ngaphezu kwalokho, kunqunyelwe ama-prostaglandin synthesis inhibitors (Ibuprofen, Indomethacin).

Ezinganeni, ukwelashwa kwesifo sikashukela i-insipidus kubuye kube nokuqokwa kwezimali eziqukethe i-desmopressin. Umthamo kufanele ukhethwe ngudokotela ohambelayo. Lapho uthatha umuthi, kufanele kwenziwe i-urinalysis ukuqapha inkomba yokuxinana okuhlobene.

Uma kutholakala ifomu le-diasogenic, ama-diuretics noma amalungiselelo aqukethe i-desmopressin afakwa isiguli. Izidakamizwa ezinjalo zivusa ukudakwa kwamanzi kakhulu. Izindlela zokwelapha ukunciphisa ukudonsa kwamanzi.

Kwabesifazane, umjikelezo wokuya esikhathini uyalungiswa. Indlela yokuthambisa eye yavela ngesikhathi sokukhulelwa iphathwa njenge-central central, okungukuthi, i-drug desmopressin inqunywe. Ukuvikela ukomisa, kufanele uphathe amanzi njalo nawe, kepha ukuphuza okuncane kunconyelwa phakathi nosuku.

Izinga lokuphuza uketshezi kufanele linqunywe ngudokotela ohambelayo.

Ukudla kwesifo sikashukela insipidus

Ukudla kwesifo sikashukela i-insipidus kufanele kukhethe uchwepheshe. Ukondliwa kwemitholampilo kuyingxenye ebalulekile yokwelashwa. Umgomo wayo ukunciphisa inani lokuphuma kwe-fluid, ukubuyiselwa kwezakhi zomzimba.

Yidla kakhulu (kuze kufike ku-5-6 p. / Day), ezingxenyeni ezincane. Khawula inani likasawoti (kuya ku-5-6 g / ngosuku.). Yengeza ekudleni okulungiselelwe, futhi ungakufaki usawoti ekudleni. Kubalulekile ukwandisa ukudla kwakho kwe-carbohydrate. Faka imifino, amakhambi, izithelo kwimenyu. Ungapheka i-pasta, izitsha zamazambane. Amafutha nawo ayadingeka (imifino, isilwane).

Ukugcina ukusebenza kobuchopho, udinga ukudla ukudla okuqukethe i-phosphorus eningi (inhlanzi enamafutha aphansi, ukudla kwasolwandle). Yidla izithelo ezomisiwe, zinothile nge-potassium, ethuthukisa ukwakheka kwe-AGD. Kuhle ukuphuza iziphuzo zezithelo, amasipuni asanda kufakwa, ama-compotes (mhlawumbe okuzenzela).

Faka nenyama engenamafutha, ubisi, imikhiqizo yobisi olunoshukela kumenyu, noma kunjalo, okuqukethwe kwamaprotheni ekudleni kusadinga ukuncishiswa, ngoba lokho kudla kulayisha izinso. Khipha amaswidi, banegalelo ekomelekeni okomileyo.

Izeluleko Zemithi Yendabuko

Izindlela zokupheka zemithi yendabuko zizosiza ukuqeda izimpawu zesifo sikashukela i-insipidus. Lungiselela ukumfakwa kwezimpande ze-burdock, okuzonciphisa ukoma kakhulu.

Uzodinga izithako ezilandelayo:

• Impande yeBurdock - 60 g;
• Amanzi - 1 l.

Gaya impande ye-burdock, beka ku-thermos. Faka amanzi abilayo, shiya amahora ayi-10-12. Ungalungisa ukumnika kusihlwa bese uwuphuza ekuseni. Umthamo onconyiwe yi-150 ml (3 r. / Day).

Isusa kahle isiphuzo esomile esivela emaqabungeni e-walnuts. Izithako

• Amacembe ahlanganisiwe (mhlawumbe asemancane) - 1 itiye. l;
• Amanzi (amanzi abilayo) - 1 tbsp.

Gcwalisa impahla eluhlaza ngamanzi, ngemuva kwemizuzu eyi-15. ubunzima. Phuza esikhundleni setiye. Ungeqi umthamo omkhulu wezinsuku zonke, okuyi-1 litre.

Ukulungisa ukwakheka kwamahormone e-AD, sebenzisa ukumfaka kwe-elderberry. Ukuyilungiselela uzodinga:

• I-inflorescence eyomile ye-elderberry - 20 g;
• Amanzi abilayo - 1 tbsp.

Kungcono ukupheka umkhiqizo ku-thermos, ushiye ihora eli-1. Cindezela isiphuzo, chaza itafula eli-1. l uju. Thatha ukumnika 3 r. / Usuku ngemithamo elinganayo. Inkambo yokwelashwa izoba yinyanga eyi-1. Ezinsukwini eziyi-10 kamuva ukwamukelwa kwezimali kungaphindwa.

Izithako ezilandelayo zizodingeka (ngamanani alinganayo):

1. Hops (izigaxa);
2. IValerian (impande);
3. Umamawort (utshani);
4. I-rosehip (amajikijolo achotshoziwe);
5. Iminti (utshani).

Hlanganisa zonke izithako, beka itafula eli-1 ku-thermos. l izinto zokusetshenziswa, yenza inkomishi e-1 yamanzi afudumele (85 ° C). Ngemuva kwehora, isiphuzo singadakwa. Thatha in 80 ml isigamu sehora ngaphambi kokulala. Inkambo yokwamukelwa ingafika ezinyangeni ezi-3.

Abanye odokotela banquma izithasiselo zemithi njengekhambi elingeziwe lemithi, kepha amakhambi esintu awakwazi ukusetshenziswa njengekhambi eliyinhloko. Ngaphambi kokusebenzisa noma imiphi imiyalo, kunconywa ukuthi uthinte uchwepheshe.

Isimo sezulu

I-insipidus yesifo sikashukela kwabesifazane, okuvela ngesikhathi sokukhulelwa, inyamalala ngemuva kokubeletha.

Ngezinye izindlela, ngokwesibonelo, i-idiopathic, ukululama akuvamile, kepha ukwelashwa okubuyisela okunye kuzovumela iziguli ukuthi zikwazi ukusebenza. Uma imbangela eyinhloko yalesi sifo ikhonjwa futhi iqedwa, ukwelashwa kuyophumelela.

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