Matenda a shuga (inshuwarid): matenda ndi chiyani ndipo amawoneka bwanji

Matenda a shuga insipidus ndimatenda a endocrine dongosolo lomwe limayendera limodzi ndi kukodza kwakukulu ndi ludzu. Mayina ake ena ndi "shuga", "matenda a shuga a impso." Nthawi zambiri, matendawa amapezeka mwa akazi kuyambira zaka 40. Ngakhale kuti zizindikiro zazikulu ndizofanana ndi matenda a shuga, ndizovuta zosiyanasiyana.

Zifukwa

Kukula kwa matenda a shuga insipidus sikugwirizana ndi kusintha kwa magazi m'magazi; mu matendawa, kayendedwe ka kukodza ndi kusokonekera kumasokonezeka. At ludzu losasunthika limawonekera odwala, kuchuluka kwa mkodzo wowonjezera kumawonjezeka. Kuchepetsa kugwiritsa ntchito madzi kumayambitsa kusowa kwamadzi, munthu amatha kulephera, kugwa.

Pali mitundu ingapo ya matendawa:

1. Chapakati. Amayamba chifukwa chosakwanira kupanga antidiuretic timadzi vasopressin ndi hypothalamus.
2. Renal. Cholinga chake ndikuchepa kwa chidwi cha minofu ya impso kupita ku vasopressin. Kuphwanya malamulo kumatha kukhala kwachilengedwe kapena kuwonongeka chifukwa cha kuwonongeka kwa ma nephrons.
3. Dipsogenic. Kugwiritsa ntchito kwamadzi kosalekeza kumachitika chifukwa chakugonjetsedwa kwa kayendedwe ka ludzu mu hypothalamus. Matenda amtunduwu nthawi zina amakula chifukwa cha matenda amisala.

Insipidus yapakati pa shuga imagawidwa kukhala idiopathic komanso chisonyezo. Idiopathic imayambitsidwa ndi matenda obadwa nawo, limodzi ndi kuchepa pakupanga kwa antidiuretic mahomoni (ADH).

Zizindikiro (zopezedwa) zimawonedwa motsutsana ndi zomwe matenda ena amakumana nazo:

• Zotupa zamaubongo;
• Ma metastases
• Kuvulala kwamtundu wamatumbo;
• Encephalitis
• Matenda a impso (wobadwa kumene kapena wotengedwa);
• Sarcoidosis;
• Syphilis;
• Zotupa zam'mimba za bongo.

Matendawa nthawi zina amapezeka pambuyo pa kulowererapo kwa mitsempha.

Zimayambitsa mawonekedwe a impso (nephrogenic):

1. Polycystic;
2. Kusintha kwa milingo ya potaziyamu;
3. Odwala cell anemia;
4. Renal amyloidosis;
5. Zaka zotsogola;
6. Kulephera kwa impso;
7. Kumwa mankhwala omwe amakhudza impso.

Mwa amayi ena, matenda a shuga amayamba pamene ali ndi pakati, amatchedwa "gestational".

Zizindikiro za matenda a shuga

Matendawa amadziwika ndi kukula msanga, koma nthawi zina amakula pang'onopang'ono. Zizindikiro zoyambirira zodwala matenda ashuga mwa abambo ndi amayi sizosiyana - uku ndi ludzu lamphamvu, kukodza pafupipafupi. Masana, wodwalayo amamwa malita 5-20 a madzi (amodzi ndi 1.5-2 malita).

Kuphwanya mphamvu yamagetsi yamagetsi kumapereka chilimbikitso chowonjezereka.

Matenda a shuga atha kuzindikirika chifukwa cha zomwe ali nazo:

• Zofooka
• Kuchepetsa thupi;
• Ululu m'mutu;
• Katemera wamasamba akucheperachepera
• Kuuma kwa khungu;
• Kutambasula kwa chikhodzodzo, m'mimba;
• Kuphwanya chimbudzi cha michere;
• Kuthamanga kwa magazi;
• Kugunda kwamtima pafupipafupi.

Kuchita kwa wodwalayo kumachepetsedwa kwambiri, kusokonezeka kwa psychoemotional (kusowa tulo, kusokonekera) kumawonedwa. Chizindikiro chimodzi cha matenda ashuga omwe azimayi amakhala nacho ndikuphwanya kwa msambo.

Mwa ana kuyambira zaka zitatu, matenda amtunduwu amadziwonetsera chimodzimodzi monga akulu, koma nthawi zambiri zizindikiro zake sizitchulidwa. Mawonetsero akulu akuphatikizira:

• Kulakalaka;
• Kuchepetsa thupi kapena kuchepa thupi;
• Kusinthana ndi chakudya;
• Kudzimbidwa
• Envesis.

Mwa makanda ndi makanda osakwana chaka chimodzi, Zizindikiro za matenda a shuga.

• Kutuluka kawirikawiri komanso kwamphamvu kwamikodzo;
• Kuchepetsa thupi kwambiri;
• Kuda nkhawa
• Kuchuluka kwa mtima;
• Kubweza
• Amalumphira mwadzidzidzi kutentha.

M'malo mwa mkaka wa amayi, mwana amakonda kumwa madzi. Popanda chithandizo chamankhwala, khanda limakulirakulira. Kutembenuka kumayamba.

Zizindikiro

Ngati mukukayikira matenda a shuga, muyenera kulumikizana ndi endocrinologist. Odwala kuwonjezera amayendera neurosurgeon, neurologist, optometrist. Amayi ayenera kufunsa dokotala wazamankhwala.

Kafukufuku ena adzafunika. Kuti mupeze matenda a shuga:

1. Onaninso mkodzo ndi magazi a wodwala;
2. Chitani kafukufuku wa Zimnitsky;
3. Chitani kafukufuku wa impso;
4. Chitani CT kapena MRI ya ubongo, echoencephalography.

Laboratory mayeso kuwunika osmolarity magazi, kuchuluka kachulukidwe ndi osmolarity kwamikodzo. Kuyesedwa kwa magazi kwamomwe kumapangitsa kuti zitheke kupeza data pamlingo wa glucose, nayitrogeni, potaziyamu, sodium ndi zinthu zina.

Zizindikiro za matenda:

• Osmolarity wochepa mkodzo (osakwana 100-200 mosm / kg);
• Sodium yayikulu (kuyambira 155 meq / l);
• Kuchepa kwamkodzo kwamkodzo (osakwana 1010);
• Kuchulukitsa kwa osmolarity kwamadzi am'magazi (kuchokera 290 mosm / kg).

Matenda a shuga komanso matenda ashuga ndizosavuta kusiyanitsa. Poyambirira, shuga sapezeka mkodzo wa wodwalayo; kuchuluka kwa shuga m'magazi sikupitirira zomwe zimachitika. Khodi ya matenda a ICD-10 ndi E23.2.

Chithandizo

Chithandizo cha matenda a shuga insipidus chimayamba ndi chizindikiritso ndikuchotsa chomwe chimayambitsa matenda. Kuti achepetse kuchuluka kwamchere wamchere, wodwalayo amapatsidwa kulowetsedwa kwa kulowetsedwa kwa njira zamchere. Izi zithandiza kupewa kuchepa kwa madzi m'thupi.

Pali mitundu ingapo ya mankhwalawa:

• Minirin - mapiritsi (a pakamwa ndi a resorption);
• Apo-desmopressin - kupopera kwammphuno;
• Adiuretin - madontho amphuno;
• Desmopressin - madontho amphuno ndi utsi.

Kuchuluka kwa tsiku ndi tsiku kumasankhidwa kutengera mtundu wa thupi, mtundu wa mankhwalawa, pafupifupi:

1. Mapiritsi okhudzana ndi pakamwa - 0,1-1.6 mg;
2. Mapiritsi ang'onoang'ono - 60-360 mcg;
3. Pukuta mankhwalawa pa intranasal ntchito - 10-40 mcg.

Popereka mankhwala a Adiuretin, ndikofunikira kudziwa momwe thupi limayankhira mankhwalawa, chifukwa chaichi, madontho 1-2 amakhazikitsidwa pamphuno madzulo kapena usiku. amatanthauza. Pambuyo pake, mlingo umachulukitsidwa kuti umasinthidwe kwamikodzo.

Mankhwala ena oletsa

• Adiurekrin (lyophilisate wa pituitary gland of ng'ombe). Mankhwala ayenera kukhala osavomerezeka mu mlingo wa 0,03-0.05 g 3 r. / Tsiku. Pali yankho pamalonda. Chidacho chimabwanyidwira mu mphuno 2-3 r. / Tsiku la 2-3 madontho.
• Matenda a shuga a Adiuretin (analog ya vasopressin) ya mankhwala. Njira yothetsera vutoli imayikidwa mu sinuses ya 1-4 cap. 2-3 tsa / Tsiku.
• Demopressin acetate (analog ya vasopressin, imakhala ndi mphamvu yayitali). Yankho limalowetsedwa mu mphuno pa 5-10 mcg 1-2 r. / Tsiku.

Mankhwala omwe amagwiritsidwa ntchito omwe amasintha kupanga vasopressin ndi kulowa kwake m'magazi. Izi zikuphatikiza:

1. Chlorpropamide (wothandizira wa hypoglycemic). Amatengedwa pa 0.125-0.25 g 1-2 p. / Tsiku.
2. Miskleron (anti-atherogenic agent). Perekani 2 makapisozi 2-Z r / tsiku.

Odwala amatchulidwa okodzetsa, omwe ali ndi paradoxical: amachepetsa kusefera, kuchuluka kwa mkodzo wochotsedwa kumagwera ndi 50-60%. Hypothiazide itha kutumizidwa kwa wodwala; kuchuluka kwake tsiku lililonse ndi 25-100 mg.

Othandizira komanso ophatikizira okodzetsa (Amiloretic, Isobar). Pa chithandizo, ndikofunikira kuchepetsa kuchuluka kwa mchere womwe umamwetsa (mpaka 2 g / tsiku.). Kuphatikiza apo, ma prostaglandin synthesis inhibitors (Ibuprofen, Indomethacin) ndi omwe amapatsidwa.

Mu ana, chithandizo cha matenda a shuga a insipidus chimakhalanso ndi kuperekedwa kwa ndalama zokhala ndi desmopressin. Mlingo uyenera kusankhidwa ndi adokotala. Mukamamwa mankhwala, urinalysis uyenera kuchitidwa kuti ayang'anire kuchuluka kwa kachulukidwe.

Ngati wapezeka ndi diasogenic mawonekedwe, okodzetsa kapena makonzedwe okhala ndi desmopressin amalembedwa kwa wodwalayo. Mankhwalawa amasokoneza kuledzera kwamadzi. Njira zochizira ndikuchepetsa kuchuluka kwa madzimadzi.

Mwa akazi, msambo umasintha. Momwe mawonekedwe a gestational omwe amawonekera panthawi yapakati amathandizidwa, monga pakati, ndiye kuti, desmopressin ndi mankhwala. Popewa kusowa kwamadzi, muyenera kumatenga madzi nthawi zonse, koma kumwa pang'ono kumalimbikitsidwa masana.

Kuchuluka kwa madzi akumwa ayenera kutsimikiziridwa ndi adokotala.

Zakudya za matenda a shuga insipidus

Zakudya za matenda a shuga insipidus ayenera kusankha katswiri. Zakudya zamankhwala ndizofunikira kwambiri pothandizira. Cholinga chake ndikuchepetsa kuchuluka kwa madzi am'madzi, kubwezeretsanso michere.

Idyani nthawi zambiri (mpaka 5-6 p. / Tsiku), m'magawo ang'onoang'ono. Chepetsa kuchuluka kwa mchere (mpaka 5-6 g / tsiku.). Onjezerani muzakudya zomwe zakonzedwa, ndipo osathira mchere pakuphika. Ndikofunikira kuwonjezera chakudya chanu cha carbohydrate. Phatikizani masamba, zitsamba, zipatso mumenyu. Mutha kuphika pasitala, mbale za mbatata. Mafuta ndizofunikira (masamba, nyama).

Kuti ubongo ugwire ntchito, muyenera kudya zakudya zomwe zimakhala ndi phosphorous (nsomba zamafuta ochepa, nsomba zam'madzi). Idyani zipatso zouma, zimakhala ndi potaziyamu, zomwe zimasintha kapangidwe ka AGD. Ndikwabwino kumwa zakumwa zakumwa zaphikidwe, timadziti tangofika kumene, ma compotes (makamaka ongochita tokha).

Phatikizaponso nyama yokonda, mkaka, mkaka wowawasa mu menyu, komabe, mapuloteni omwe amapezeka muzakudya amayenerabe kuchepetsedwa, popeza chakudya chotere chimadzaza impso. Pewani maswiti, amathandizira ludzu lochulukirapo.

Malangizo a Chikhalidwe Chachikhalidwe

Maphikidwe a mankhwala azikhalidwe amathandizira kuthetsa zizindikilo za matenda a shuga. Konzani kulowetsedwa kwa mizu ya burdock, yomwe imachepetsa ludzu kwambiri.

Mufunika izi:

• Muzu wa Burdock - 60 g;
• Madzi - 1 l.

Pogaya mizu ya burdock, ikani mu thermos. Onjezani madzi otentha, chokani kwa maola 10-12. Mutha kukonzekera kulowetsedwa madzulo ndikumwa m'mawa. Mlingo woyenera ndi 150 ml (3 r. / Day).

Amachotsa zakumwa zakumwa kuchokera masamba a walnuts. Zosakaniza

• Masamba okhala ndi masamba (makamaka achichepere) - 1 tiyi. l;
• Madzi (madzi otentha) - 1 tbsp.

Dzazani ndiiwisiyo ndi madzi, pakatha mphindi 15. kupsyinjika. Imwani m'malo mwa tiyi. Musapitirire muyeso waukulu tsiku lililonse, womwe ndi 1 lita.

Kuti musinthe kaphatikizidwe ka mahomoni a AD, gwiritsani ntchito kulowetsedwa kwa elderberry. Kuti mukonzekere muyenera:

• Zouma elderberry inflorescence - 20 g;
• Madzi owiritsa - 1 tbsp.

Ndi bwino kuphika mankhwala mu thermos, kusiya kwa ola limodzi. Senzani zakumwa, sungunulani tebulo limodzi. l wokondedwa. Tengani kulowetsedwa 3 r. / Tsiku limodzi Mlingo wofanana. Njira ya mankhwala akhale mwezi umodzi. Patatha masiku 10 Kulandila ndalama kungathe kubwerezedwa.

Zofunikira zotsatirazi zidzafunika (zofanana):

1. Maops (ma cones);
2. Valerian (muzu);
3. Mayiwort (udzu);
4. Rosehip (zipatso zophwanyika);
5. Mbewa (udzu).

Sakanizani zosakaniza zonse, ikani tebulo limodzi mu thermos. l Zinthu zopangira, brew 1 chikho cha madzi ofunda (85 ° C). Pambuyo pa ola limodzi, chakumwa chimatha kuledzera. Imwani pofika 80 ml ya theka la ola musanakagone. Njira yovomerezeka ndi miyezi itatu.

Madokotala ena amati mankhwala azitsamba monga njira yowonjezerapo mankhwala, komabe, wowerengeka azitsamba sangathe kugwiritsidwa ntchito ngati chithandizo chachikulu. Musanagwiritse ntchito infusions iliyonse, decoctions, ndikulimbikitsidwa kuti mukafunse katswiri.

Ziwonetsero

Gestational matenda a shuga a insipidus mwa azimayi, omwe amakula nthawi yapakati, amasowa pambuyo pobala.

Mwanjira zina, mwachitsanzo, idiopathic, kuchira sikofunikira, koma chithandizo chothandizira m'malo mwake chimalola odwala kupitiliza kugwira ntchito. Ngati chachikulu chomwe chimayambitsa matendawa chizindikirika ndikuchotsedwa, mankhwalawo amatheka.

Kanema wofananira: