Isifo sikashukela i-mellitus sibizwa ngokuthi i-endocrine pathology, eyenzeka ngemuva kwesizinda sokwehla okukhulu ekwenziweni kwe-vasopressin noma ukwephulwa kwesenzo sayo. Esimweni sokuqala, uhlobo oluphambili lwalesi sifo luba khona, okwesibili, uhlobo lwe-renal (nephrogenic) lwe-pathology, lapho inani le-hormone lanele, kodwa ngenxa yokushintsha okuthile emzimbeni, ama-receptors alahlekelwa umuzwa wawo ngalo.
Lesi sifo singathinta umuntu omdala nengane. Isifo sikashukela ezinganeni sikashukela sinokufana nokuhlukahluka okuhlukahlukene okuvela ekubonisweni kwe-pathology yabantu abadala. Okuningi ngalokhu esihlokweni.
Mayelana ne-vasopressin
I-hormone ye-antidiuretic ikhiqizwa kuyi-nuclei ethile ye-hypothalamus, lapho ihlangana khona nezinto ezithile zeprotheni zokuhamba bese ingena kwi-neurohypophysis. Lapha i-vasopressin itholakala kuze kube yilapho umzimba udinga isenzo sayo.
Ukukhishwa kwe-hormone egazini kulawulwa yizinkomba ezilandelayo:
- umfutho we-osmotic wegazi nomchamo (okunciphisa izinkomba, ukukhuphuka kwezinga le-hormone egazini);
- umthamo wegazi elijikelezayo;
- izinkomba zokucindezela kwegazi;
- ukuvuka nokulala (ebusuku, izinga lezinto ezisebenza ngama-hormone liyanda, futhi inani lomchamo okhiqizwayo liyancipha);
- isenzo sohlelo lwe-renin-angiotensin-aldosterone;
- ubuhlungu, ukuhlukunyezwa kwemizwelo, umsebenzi womzimba - bandisa ukukhiqizwa kwe-vasopressin;
- isicanucanu kanye nokwehla okuthe xaxa koshukela wegazi - kubangela ukukhishwa kwenani elikhulu le-hormone egazini.
I-Pathology ye-hypothalamus kanye ne-pituitary gland ingenye yezimbangela zokuqalwa kwalesi sifo
Umzimba udinga i-vasopressin ukuze ulondoloze inani elanele lamanzi ngokufakwa kwawo kabusha ngesikhathi sokuchama komchamo. Isenzo sento esetshenziswa ngama-hormone senziwa ngenxa yama-receptors akhethekile azwelayo atholakala endaweni engaphezulu kwamaseli wamashubhu wokuqoqa kanye nokuvuvukala kukaHenle.
Izinga lamanzi emzimbeni alisekelwa kuphela ngesenzo se-vasopressin, kepha futhi "nesikhungo sokoma", esenziwe endaweni ye-hypothalamus. Ngokukhishwa kwenani elikhulu loketshezi emzimbeni kanye nokwanda kokuxineka kwegazi kwe-osmotic, lesi sikhungo esizwelayo siyajabula. Umuntu uchama kakhulu, ngokulandelana, unesifiso sokuphuza.
Izimbangela ezinkulu zalesi sifo
Izimo eziningi zesifo sikashukela ezingena ezinganeni zi-idiopathic. Ukuthuthukiswa kwezimpawu kungenzeka kunoma yimuphi unyaka, kepha kaningi lokhu kwenzeka esikhathini sezingane zasenkulisa. Uhlobo lwe-idiopathic lwesifo lubonakala ngokungasebenzi komzimba kwesifunda se-hypothalamic-pituitary, lapho kutholakala khona amangqamuzana abhekene nokukhiqizwa kwe-antidiuretic hormone vasopressin.
Kukholakala ukuthi le ndawo ingaba nezimpawu zokuzalwa ezenza ukuthi kuqale lesi sifo ngaphansi kwethonya lezinto ezimbi zangaphandle nezangaphakathi.
Isifo sikashukela ezinganeni zingakhula zingafani nesizinda se-post-traumatic syndrome. Kwenzeka njengokulimala kwesisekelo sikakhanda, ukuthuthukiswa kwe-edema yamakhemikhali ngenxa yomonakalo womshini. Esinye isizathu okungenzeka ukuthi kube yimisebenzi ye-neurosuction kanye nokukhwabanisa.
Kunamacala aziwayo wokuthuthuka kwalesi sifo ngemuva kwezinsuku ezingama-30-45 kusuka esikhathini sokulimala kobuchopho kobuhlungu. I-polyuria enjalo (umchamo obedlulele, okuwuphawu oluhamba phambili lwesifo sikashukela) ibizwa ngokuthi ihlala njalo.
Lesi sifo ezinganeni singenzeka ngenxa yezifo eziningi:
- umkhuhlane
- inkukhu yenkukhu;
- ama-mumps;
- ukukhwehlela;
- i-meningitis
Ukuthuthuka kwenqubo yokutheleleka kuyinto evusa umdlavuza yalesi sifo
Kubalulekile! Izifo ezingalapheki eziba yingozi ekuqaleni kokuqala, njengokuvuvukala kwamathumbu, kanye nezifo ze-nasopharynx, nazo zingabamba iqhaza kulenqubo.
Isifo sikashukela senzeka ngokwasemuva kwe-neuroinfections ngenxa yokuhlinzekwa kwegazi okuningana kwi-hypothalamus kanye ne-pituitary gland ezinganeni, ukuqina okukhulu kwemithambo yegazi, kanye nezici zokuvunyelwa kwesithiyo segazi-ingqondo.
Ezinye izimo lapho ukuthuthukiswa kohlobo lwesifo kungenzeka khona:
- ukutheleleka kwe-intrauterine;
- ukucindezelwa okungokomzwelo;
- ushintsho lwamahomoni;
- isimila se-hypothalamus kanye ne-pituitary gland;
- isikhathi sokwelashwa kwenqubo yamathumbu;
- i-leukemia;
- ifa.
Izimbangela zefomu leRenal
Uhlobo lwe-Nephrogenic lwe-pathology ezinganeni lwenzeka ngenxa yokuthi izinso azikwazi ukuphendula ngokwanele esenzweni se-hormone ye-antidiuretic. Isimo esinjalo singazalwa futhi sitholakale. Kubonakala ngokuchama okuncane kune-lesion central.
Ingakhula ngenxa yokuvela kokuvela komzimba wezinso nezakhiwo zazo, ngokubhekene nesizinda se-hydronephrosis, i-polycystosis, ukuvela okungapheli kwama-ducts womchamo, i-pyelonephritis engapheli.
Ukubonakaliswa kwalesi sifo
Izimpawu zesifo sikashukela i-insipidus ezinganeni zingavela kakhulu noma kancane kancane. Uma ama-syndromes asemva kokuhlukumezeka ahambisana nokuthuthuka kwalesi sifo aziveza ngemuva kwezinyanga ezimbalwa, khona-ke kuphuma i-neuroinfection - ngemuva kweminyaka embalwa.
I-Polyuria iwuphawu oluphambili lwesifo sikashukela
Izimpawu zokuqala zokucabanga nge-pathology yi-polyuria ne-polydipsia. Ingane ingaphuza amalitha ayi-12 amanzi abandayo ngosuku. Uketshezi olufudumele namasiphu amnandi awukwazi ukuqeda umuzwa wokoma njalo. Ukuchama kwenzeka kaningi. Ngesinye isikhathi, ingane egulayo ingagxilisa umchamo ongacacile futhi ongenawo umbala ongama-700 ml. Ukubonakaliswa okuvame kakhulu ukungamanzi kombhede, yingakho izingane zobudala besikole ziyinkimbinkimbi kakhulu.
Ngokuphikisana nesizinda sokuphuma komchamo njalo, ukuphuma komzimba kukhula ngokushesha. Lokhu kuyiqiniso ikakhulukazi ezinganeni, ngoba azikwazi ukuchaza isifiso sazo sokuphuza. Ingane iqala ukunciphisa isisindo, kuqhamuke isikhumba esomile nolwelwesi lwama-mucous, izinyembezi, izinyembezi azibonakali, kudedelwa isigaxa esincane.
Izingane zikhononda njalo ngenxa yokucanuzelelwa inhliziyo, Ubuhlungu besisu, ubuhlungu bendawonye kanye nemisipha. Inhliziyo nemithambo yegazi, njengomthetho, ayithinteki. Ezinye izingane zingaba nokushaya kwenhliziyo okusheshayo kanye nokwehla komfutho wegazi.
Ukuphelelwa ngamandla emzimbeni kwesifo sikashukela i-insipidus kubonakala ngezimpawu ezilandelayo:
- ikhanda elinzima;
- ukuphefumula kwenhliziyo kanye nokuhlanza;
- ukukhathazeka okukhulu;
- ukwehla okubukhali kombono, umuzwa weveli phambi kwamehlo;
- ukwehla kwezinga lokushisa lomzimba;
- ukushaya kwenhliziyo
- umsebenzi wokukhubazeka ongaboni kahle;
- ingane izichamele.
Kanye nezimpawu zesifo sikashukela i-insipidus, kungenzeka ushintsho ekusebenzeni kwamanye ama-endocrine gland. Ingane ingahlushwa i-cachexia, i-dwarfism noma i-gigantism (i-pathology evela ekukhuleni kwama-hormone), ukubambezeleka kokukhula, ukungahambi kahle kokuya esikhathini ezinganeni.
Uhlobo lweNephrogenic
I-mestitus yesifo sikashukela sokukhulelwa ngesikhathi sokukhulelwaIfomu lesifo se-regenital yesi sifo lingahambisana nesithombe somtholampilo ezinyangeni eziyisithupha zokuqala zokuphila kwengane. Ukuchama okuningana akuphenduli ekusetshenzisweni kwe-vasopressin analogues. Abazali bakhala ngokuthuthuka kokuqunjelwa ezinganeni, ukwenzeka kokuhlanza, umkhuhlane.
Inani lomchamo okhishwe ngosuku lifinyelela ku-2000 ml. Ukuqina, ukungaboni kahle, ukwehla okungathí sina kwengcindezi yegazi kungakhula.
Ukuxilonga
Isifo sikashukela i-mellitus ezinganeni nasebusheni siqinisekiswa ngesisekelo sedatha emtholampilo neyaselebhu. Uchwepheshe okwelapha ucacisa lapho kuvela izibonakaliso zokuqala zalesi sifo, sibonisa ukuxhumana kwabo okungenzeka kungalimala ngomshini, ama-neuroinestions. Inani lansuku zonke lomchamo kanye nezinga lokwehla komzimba, izinga lokuqhubeka kwezimpawu, ukuba khona kwezihlobo ezigulayo kunqunywa.
Izindlela ezilandelayo zokuxilonga ziyenziwa:
- ukukalwa kwansuku zonke kwenani lomchamo okhishwe (diuresis yansuku zonke);
- ukuhlaziywa komchamo ojwayelekile;
- ukuhlaziywa komchamo ngokusho kweZimnitsky;
- ukucaciswa kokuba khona koshukela namaprotheni ekuhlaziyeni;
- i-biochemistry yegazi ngokubalwa kwezinkomba zamanani we-electrolyte, urea, i-creatinine, ushukela, i-cholesterol;
- ibhalansi ye-acid-base.
I-Urinalysis iyindlela eyinhloko yokuxilongwa kwelabhoratri yokuthuthukiswa okusolwa kwe-endocrine pathology
Ukuhlolwa kwe-dehydration (okuhlushwa)
Ukuxilonga kuqala, imvamisa ngo-6 ekuseni. Ingane ehlolwayo ivunyelwe ukudla ukudla okuqinile kuphela. Amanzi nanoma yikuphi okunye uketshezi kufanele kulahlwe isikhathi esishiwo udokotela oholayo (kusuka emahoreni amane kuya kwayi-6, kubantu abadala - kuze kufinyelele emahoreni angama-24).
Le ndlela ivunyelwe kuphela esibhedlela ngaphansi kweso labachwepheshe abaqeqeshiwe. Ukuqinisekiswa kwalesi sifo kuncike ekwehlekeni kwesisindo sengane kanye namandla adonsela phansi omchamo ofanayo.
Hlola nge-vasopressin analog
I-Desmopressin yayisetshenziswa ukusetshenziswa, manje iMinirin isetshenziswa kaningi. Umuthi umuthi uhambisana nokwanda kwamandla adonsile omchamo kanye nokwehla kokukhipha kwawo kulezo zingane ezinendlela esezingeni eliphakeme yesifo sikashukela. Uhlobo lwe-renal lwalesi sifo aluhambisani nokubonakaliswa okunjalo.
Ezinye izifundo
Lezi zindlela zokuxilonga ziyadingeka ukuze kukhonjwe imbangela eyinhloko yokuqanjwa kwesimo esiyisisekelo salesi sifo. Izintandokazi zinikezwa izindlela ezilandelayo zokucwaninga:
- Ngefomu eliphakathi: i-x-ray yeswazi; I-MRI yobuchopho; I-scan scan yesifuba nesisu.
- Ngohlobo lwe-nephrogenic: i-ultrasound yezinso; isivivinyo i-Addis-Kakovsky; i-excretory urography.
Kubalulekile! Udokotela wezifo zamathambo, isazi sezinzwa
Umehluko wokuxilongwa
Ukuze wenze ukuxilongwa okuyiqiniso, kuyadingeka ukuhlukanisa i-insipidus yesifo sikashukela kanye nalezo zimpawu ezibonakala ngezimpawu ezifanayo. Izici kanye nokwehluka kuboniswa etafuleni.
| Uyini umehluko owenziwe? | Isifo esinjani | Umehluko omkhulu |
| I-Psychogenic polydipsia | Ukuphuma komchamo ngokweqile ngenxa yokuphazamiseka kwengqondo | Imininingwane yaselebhu iyafana. Kumehluko, kusetshenziswa ukuhlolwa kokuphelelwa ngamanzi emzimbeni: inani lomchamo othululiwe liyancipha, amandla athile adonsela phansi anda, isimo sempilo esishintshashintshi |
| Ukwehluleka kwezinso | I-Pathology yezinso, ebonakala ngokuphulwa kwayo yonke imisebenzi eholela ekuphazamisweni kwe-electrolyte yamanzi, i-nitrogen nezinye izinqubo ze-metabolic | I-polyuria encane, amandla adonsela ngokuqondile uhla lwe-1010-1012, izinto zamaprotheni namasilinda kunqunywa ekuhlaziyweni komchamo, umfutho wegazi uphakeme kunokwejwayelekile |
| Isifo sikashukela mellitus | Ukuntuleka kokukhiqizwa kwe-pancreatic insulin noma ukulahleka kokuzwela kweseli nezicubu kuyo | Ekuhlaziyweni kwegazi nomchamo, kutholakala ushukela, amandla athile omchamo aphezulu. Akuvamile, kepha ukuhlanganiswa kwesifo sikashukela nesifo sikashukela esigulini esisodwa kuyenzeka |
| Hyperparathyroidism | Ukukhiqizwa ngokweqile kwe-hormone yizindlala ze-parathyroid | Ukudonswa okuqondile komchamo kuncishiswa kancane, inani le-calcium emisebeni yomzimba liyakhuphuka |
| I-Albright Syndrome | Ukuguqulwa kwamathambo kufakwe esikhundleni sawo izinto ezi-cartilage | Inani elikhulu le-calcium ne-phosphorus likhishwa emchameni, okuholela ku-pathologies yesistimu ye-musculoskeletal |
| I-Hyperaldosteronism | Ukukhiqizwa ngokweqile kwe-aldosterone ye-hormone yizindlala ze-adrenal | Ngaphezu kwe-polyuria, imvuthuluka, imizwa yokulimala, kanye nomfutho wegazi okhuphukile kuyimpawu. Egazini kune-potassium encane, i-chloride, isodium eningi |
| Nephronoftis Fanconi | I-Psoriology yenzelwa ukuthi ikhule eminyakeni yobudala yasenkulisa. Kuboniswa ukwakheka kwama-cysts kwizicubu zezinso ezisezingeni lokuqunjelwa | Ngokuqhubeka kwesifo, kuqhamuka amazinga aphezulu e-urea, i-acidity ligijika iye kwi-acidosis, amazinga aphansi we-potassium wegazi |
Izici zokwelapha izingane
Okokuqala, kunconywa ukudla. Izingane azikukhiphi ukudla ngesikhathi sokupheka. Ukudla kufanele kube njalo, kepha ngezingxenye ezincane. Bandisa inani lezithelo nemifino ekudleni, imikhiqizo yobisi nezinhlanzi. Izingane kufanele ziphuze ngokweqile njengoba zifisa. Lokhu kuyadingeka ukuvimbela ukomisa. Izingane zinikezwa amanzi ejwayelekile, itiye elibuthakathaka, iziphuzo ezihlanjululwe neziphuzo zezithelo.
Ukwelashwa kwalesi sifo kuncike ekutheni hlobo luni lwesifo sikashukela esikhona kuleli cala lomtholampilo. Ngefomu eliphakathi lalesi sifo, kusetshenziswa ukwelashwa okufakwa esikhundleni sokufakwa kwezidakamizwa ezisekelwe kuma-antidiuretic.
Izingane zinconywa ukuthi zisebenzise ifomu lethebhulethi le-Desmopressin noma i-Adiurekrin ngendlela yokugcoba. Umuthi osele uyatholakala njengempuphu yokuphefumula ngekhala. Ziyindathane yezingane ukuyisebenzisa, ngoba ukuphefumula kungadala ukuthi umuthi ungene emehlweni.
Izingane zinganikezwa umuthi i-Chlorpropamide. Isetjentiswa ekwelapheni i-mellitus yesifo sikashukela engatheni i-insulin, kepha-ke, nangefomu le-non-ushukela lalesi sifo, iyakwazi ukunciphisa i-diuresis yansuku zonke ngesigamu. Kumele kukhunjulwe ukuthi umuthi unganciphisa ushukela wegazi, ngakho-ke kubalulekile ukulawula i-glycemia ngezindlela zaselebhu.
UMinirin - omunye wabamele ama-analogues we-antidiuretic hormone
Isidingo sokwelashwa kwesifo sikashukela esimaphakathi ukususa imbangela yokuthuthuka kwayo. Uma kungenzeka, kusetshenzelwa izinqubo zamathumbu; ama-antibiotic, ama-NSAIDs, ama-antihistamines kanye nama-ejenti omzimba abekelwe izifo.
Uma into ye-autoimmune ikhona emkhakheni wokuqalwa kwesifo, kubalulekile ukusebenzisa izidakamizwa ze-hormonal. Ukusebenza kokulashwa okunjalo kuyabonakala uma i-pathology itholwa ezigabeni zokuqala.
Ukwelashwa kwezifo ezithinta inhliziyo
Kulokhu, ukwelashwa okuqondile akukho. I-Thiazide diuretics ikhombisa ukusebenza kahle. Umphumela ukwanda kokuhlungwa komchamo we-osmotic kanye nokwehla okulingene kwevolumu yayo. Isenzo esifanayo sikuvumela ukuba uzuze ama-NSAIDs. Ukwengeza ukusebenza ngempumelelo, la maqembu amabili wezidakamizwa ahlanganiswa.
Ukucatshangelwa komphumela wesifo kuncike kumbangela yokuvela kwawo. Izingane kufanele zigadwe yi-endocrinologist futhi zivivinywe elebhu kanye ngekota. Ukuhlolwa kwe-Ophthalmologist kanye ne-neurologist njalo ezinyangeni eziyisithupha, i-CT ne-X-ray yekhanda kanye ngonyaka.
