Ọrịa mamịrị insipidus: gịnị bụ ọrịa a na gịnị kpatara o ji apụta

Ọrịa shuga insipidus bụ ọrịa nke usoro endocrine nke na-eso urination na akpịrị ịkpọ nkụ. Aha ya ndị ọzọ bụ "ọrịa shuga", "ọrịa mamịrị." Ọtụtụ mgbe, a na-achọpụta ọrịa a n'ime ụmụ nwanyị dị afọ 40. N'agbanyeghị eziokwu ahụ bụ na isi ihe mgbaàmà ndị ahụ yiri ihe ịrịba ama nke ọrịa shuga, ha bụ ọrịa dị iche iche.

Ihe kpatara

Mmepụta nke ọrịa shuga insipidus adịghị emetụta mgbanwe nke glucose ọbara; n'ọrịa a, a na-akụghasị usoro iku ume na urination. Na akpịrị ịkpọ nkụ na-apụta na ndị ọrịa, ọnụọgụ mmamịrị ahụ na-abawanye. Lim igbochi ojiji mmiri na-eme ka akpịrị kpọọ nkụ, mmadụ nwere ike itufu uche, daba na mmiri.

E nwere ọtụtụ ụdị ọrịa ahụ:

1. Etiti. Ọ na - etolite n'ihi ezughi oke nke vasopressin antidiuretic hormone na hypothalamus.
2. Ubọbọ. Ihe kpatara ya bu mbelata ihe banyere akuko nke akwara we rue vasopressin. Ime ihe ike nwere ike ịbụ mkpụrụ ndụ ihe nketa ma ọ bụ site na mmebi nke nephrons.
3. Dipsogenic. Fluid na-ejikarị mmiri mmiri eme ihe site na mmeri nke usoro nhazi nke akpịrị ịkpọ nkụ na hypothalamus. Ofdị ọrịa shuga a na-ebilite mgbe ụfọdụ n’ihi ọrịa ụbụrụ.

A na - ekewa Central insipidus n'ime ọrịa idiopathic na Symptomatic. Idiopathic bụ ihe kpatara ọrịa metụtara ọrịa, na-esote mbelata nke mmepụta homonụ antidiuretic (ADH).

A na-ahụ Symptomatic (enwetara) megide nzụlite ọrịa ụfọdụ:

• Ọkpụkpụ ụbụrụ;
• Metastases
• Nsogbu ụbụrụ na-akpata;
• Encephalitis
• Ọrịa akụrụ (ma ọ bụ nke enwetara);
• Sarcoidosis;
• Syphilis;
• Vaskụla ụbụrụ ụbụrụ.

A na - achọpụta ọrịa ahụ mgbe ụfọdụ nbanye neurosurgical.

Ihe na-akpata ụdị akụrụ (nephrogenic):

1. Polycystic;
2. Mgbanwe na ọkwa potassium;
3. Ọrịa Sickle cell anaemia;
4. Renal amyloidosis;
5. Ọka nká;
6. Ọkụ akwara na-adigide;
7. Medicationsnweta ọgwụ nke na-emetụta oke akụrụ.

Somefọdụ ụmụ nwanyị, insipidus ọrịa shuga na-apụta n’oge ime, a na-akpọ ya "mmega ahụ."

Ihe mgbaàmà nke ọrịa shuga insipidus

A na-amata ọrịa ahụ site na mmepe ngwa ngwa, mana mgbe ụfọdụ ọ na-akawanye nwayọ nwayọ. Ihe ịrịba ama nke mmalite nke ọrịa shuga insipidus na ụmụ nwoke na ụmụ nwanyị adịghị iche - nke a bụ akpịrị ịkpọ nkụ siri ike, ịre ugboro ugboro. N'ehihie, onye ọrịa na-a 5ụ mmiri 5-20 lita mmiri (na usoro nke 1.5-2 lita).

Mmebi nke mmiri-electrolyte nguzozi na-enyere anyị aka inwekwu njọ.

Enwere ike ịchọpụta ọrịa shuga insipidus site na njiri mara ya:

• Adịghị Ike
• Ibelata ibu;
• Mgbu n’isi;
• Mbelata ntuze
• Ajọ nkụ nke epidermis;
• Ogbu nke eriri afọ, afọ;
• Imebi nke zoro ezo nke enzymes digestive;
• Ọbara mgbali elu;
• Ọkụkụ obi ugboro ugboro.

A na-ebelata ihe onye ọrịa na-eme nke ukwuu, a na-ahụta nsogbu uche (ehighị ụra, iwe). Otu n'ime ihe ngosipụta nke ọrịa shuga dị n’ime ụmụ nwanyị nwere ike ịbụ mmerụ nwoke.

N’aka umuaka site na afo ato, oria n’azu gosiputara onwe ya n’otu aka ahu dika n’ime ndi okenye, ma adighi egosiputa ihe iriba ama ya. Ihe ngosi putara bu:

• Agụụ nri;
• Iri ibu na-ezughị ezu ma ọ bụ iwetulata ya;
• Voming na nri;
• Ntachi
• Enuresis.

N'ime ụmụ amụrụ ọhụrụ na ụmụ ọhụrụ gbara afọ 1, ihe mgbaàmà nke ọrịa shuga bụ insipidus:

• Mmepụta mmamịrị ugboro ugboro;
• Igbu oke ibu;
• Nchekasị
• Ratebara mgbali elu;
• Vomiting
• Na mberede jumps na okpomọkụ.

Kama ị mother'sụ mmiri ara nne, nwa ahụ na-ahọrọ ị waterụ mmiri. Ọnọdụ nlekọta ahụike, ọnọdụ nwa ahụ kawanyere njọ ngwa ngwa. Ọnwụ na-akpata nke pụrụ igbu mmadụ.

Diagnostics

Ọ bụrụ na ị na-enyo enyo insipidus ọrịa shuga, ị kwesịrị ịkpọtụrụ endocrinologist. Ọzọkwa, ndị ọrịa na-eleta neurosurgeon, neurologist, optometrist. Mụ nwanyị kwesịrị ịga hụ dọkịta na-ahụ maka ụmụ nwanyị.

A ga-achọ nyocha ụfọdụ. Iji chọpụta shuga ọrịa insipidus:

1. Nyochaa mmamịrị na ọbara onye ọrịa;
2. Mee ule nke Zimnitsky;
3. Mee nguan nke nwatakiri;
4. Mee CT ma ọ bụ MRI nke ụbụrụ, nkuzi echoencephalography.

Nyocha ụlọ nyocha ga-enyocha osmolarity ọbara, nha anya na mmụba mmamịrị. Nnyocha ọbara sitere na mmiri na-eme ka o kwe omume ịnweta data n'ọkwa glucose, nitrogen, potassium, sodium na ihe ndị ọzọ.

Diagnostic egosi oria:

• Osmolarity mmamịrị dị ala (ihe na-erughị 100-200 mosm / kg);
• Sodium ọbara dị elu (site na 155 meq / l);
• Mbelata nke mmamịrị na-ebelata (ihe na-erughị 1010);
• Mmụba osmolarity nke plasma ọbara (site na 290 mosm / kg).

Ọrịa shuga dị insipidus na ọrịa shuga dị mfe ịmata. N'okwu nke mbụ, a chọpụtaghị shuga na mmamịrị nke onye ọrịa, ọkwa nke glucose dị n'ọbara anaghị agafe oke. Koodu oria ICD-10 bu E23.2.

Ọgwụgwọ

Ọgwụ nke nrịbama ọrịa Symptomatic na-amalite site na njirimara na mkpochapu ihe kpatara ọrịa ahụ. Eme ka mmiri nnu gharazie ịba uru, a na-enye onye ọrịa ahụ mkpo nta mmịrị nke mmiri nnu. Nke a ga - egbochi mmepe nke akpịrị.

Enwere ụdị ọgwụ dị iche iche:

• Minirin - mbadamba (maka nchịkwa ọnụ na maka resorption);
• Apo-desmopressin - ịgba mmiri n'imi;
• Adiuretin - ọduọ nasal;
• Desmopressin - ọduọ nke imu ya na ịgba.

A na-ahọrọ ego ahụ kwa ụbọchị dabere na steeti ahụ, ụdị ọgwụ, ná nkezi, ọ bụ:

1. Mbadamba maka nchịkwa ọnụ - 0.1-1.6 mg;
2. Mbadamba ụrọ Sublingual - 60-360 mcg;
3. Fesa maka intranasal iji - 10-40 mcg.

Mgbe ị na-ede akwụkwọ Adiuretin, ọ dị mkpa iji chọpụta azịza anụ ahụ na ọgwụ, maka ebumnuche a, a na-etinye 1-2 tụlee n'ime imi na mgbede ma ọ bụ n'abalị. pụtara. Mgbe nke a gasịrị, a na-amụba dose ahụ ka ọzie ịhazi usoro urinary.

Ọgwụ ndị ọzọ maka ọgwụgwọ mkpụrụ ọgwụ:

• Adiurekrin (lyophilisate nke pituitary gland nke ehi). Ekwesịrị ị inụ ọgwụ ọgwụ na 0.03-0.05 g 3 r / ụbọchị. E nwere otu ụzọ e si ere ya ere. Ngwá ọrụ ahụ na-abanye na imi 2-3 r. / Forbọchị maka 2-3 tụlee.
• Adiuretin na-arịa ọrịa shuga (analog kemịkal nke vasopressin). A na-etinye ihe ngwọta ahụ n'ime sinuses nke 1-4 okpu. 2-3 p / ụbọchị.
• Demopressin acetate (analog nke vasopressin, nwere mmetụta na-adịte aka). A na-agbanye mmiri na imi na 5-10 mcg 1-2 r / ụbọchị.

Ogwu ndi n’eme ka emeputa vasopressin na ntinye ya n’ime obara. Ndị a gụnyere:

1. Chlorpropamide (onye na-ahụ maka hypoglycemic). A na - ewere ya na 0.125-0.25 g 1-2 p. / Day.
2. Miskleron (onye na-emegide antihe atherogenic). Nenye capsules 2-Z r / ụbọchị.

Ndị ọrịa dị otú a ka etinyere ọgwụ diuretics, nke nwere mmetụta na-efe efe: ha na-ebelata filtita ahụ, ọnụọgụ mmamịrị wepụrụ na-ebelata 50-60%. Enwere ike inye onye ọrịa hypothiazide ọgwụ ego ya kwa ụbọchị bụ 25-100 mg.

Urenweta mmakọ na mgbakwunye (Amiloretic, Isobar). N'oge ọgwụgwọ, ọ dị mkpa iji belata oke nnu riri (ihe ruru 2 g / ụbọchị.). Na mgbakwunye, a na-enye ọgwụ mgbochi prostaglandin inhibitors (Ibuprofen, Indomethacin).

N'ime ụmụaka, ọgwụgwọ nke ọrịa shuga ọrịa insipidus sokwa na nhọpụta ego nwere desmopressin. Ekwesịrị ịhọrọ ọgwụ ahụ maka ọghọm ga-abịa. Mgbe ị na-a medicationụ ọgwụ, a ga-enyocha urinal nyocha iji nyochaa nbipụta ịdị obosara.

Ọ bụrụ na achọpụtara n'ụdị diasogenic, a na - enye onye ọrịa ahụ ihe ndị na - eme ka a na - eme ya ihe dị iche iche. Ọgwụ ndị dị otú ahụ na-akpasu mmachi mmiri. Usoro ọgwụgwọ bụ iji belata oriri mmiri.

N’ime ụmụ nwanyị, a na-agbazi usoro nsọ nwoke. A na-ahụ maka ụdị mmegharị ahụ nke gosipụtara n'oge afọ ime, dịka nke etiti, ya bụ, ọgwụ ọgwụ desmopressin ka edepụtara. Iji gbochie akpịrị ịkpọ nkụ, ị ga na-ebu mmiri mgbe niile, mana ị na-atụkarị ị drinkingụ mmanya na-apụ ụbọchị.

Ọ bụ dibia bekee ga-ekpebi etu mmiri si ewe ya.

Nri maka oria insipidus

Nri maka insipidus ọrịa shuga kwesịrị ịhọrọ ọkachamara. Clinical oriri na-edozi bụ akụkụ dị mkpa nke ọgwụgwọ. Ebumnuche ya bụ ibelata oke mmiri ga - eme ka mmiri jupụta, imeju nri.

Nri karia (rue 5-6 p. / Day), na obere akụkụ. Belata oke nnu (ka 5-6 g / ụbọchị.). Tinye ya na nri ejikere, emekwala nri nnu mgbe ị na-esi nri. Ọ dị mkpa ka iwelie oriri na ọ carbohydụ carbohydụ carbohydrate gị. Tinye akwukwo nri, ogwu, nkpuru nkpuru n’ime menu. Nwere ike esi nri pasili, ofe nduku. Abụba dịkwa mkpa (akwukwo nri, anụmanụ).

Iji nọgide na-arụ ọrụ ụbụrụ, ịkwesịrị iri nri nwere ọtụtụ phosphorus (azụ nwere obere nri, azụ). Nri nkpuru osisi akpọnwụwo akpọnwụ, ha bara ụba na potassium, nke na-eme ka njikọ nke AGD dị mma. Ọ dị mma ị drinkụ ihe ọ fruitụ fruitụ mkpụrụ osisi, ihe ọ juụlyụ ndị a mịrị amị ọhụrụ, compotes (ọkacha mma ụlọ.

Gụnye anụ na-eme nri, mmiri ara ehi, ngwaahịa mmiri ara ehi n'ime achịcha, ka ọ dị, nri protin dị na nri ka ga-ebelata, ebe nri dị otú ahụ na-ebu akụrụ. Ewepu ihe uto, ha na - atụnye ụtụ na akpịrị ịkpọ nkụ.

Ndụmọdụ Ọgwụ

Usoro ọgwụgwọ nke ọdịnala ga - enyere aka iwepụ ihe mgbaàmà nke ọrịa shuga insipidus. Kwadebe infusion nke burdock mgbọrọgwụ, nke a ga - ebelata oke akpiri.

Ingredients ga-achọ ihe ndị a:

• Mgbọrọgwụ Burdock - 60 g;
• Mmiri - 1 l.

Kpuchie burdock mgbọrọgwụ, tinye ya na thermos. Tinye mmiri ọ boilingụ leaveụ, hapụ maka awa 10-12. can nwere ike ịkwadebe infusion na mgbede wee itụọ ya n'ụtụtụ. Usoro akwadoro bụ 150 ml (3 r / ụbọchị).

Ọfụma na - ewepụ ihe ọ thirstụ thirstụ na-egbu mmiri site na akwụkwọ nke walnuts. Efrata

• Shredded epupụta (ọkacha mma na-eto eto) - 1 tii. l;
• Mmiri (esi mmiri) - 1 tbsp.

Jupụta mmiri ahụ n'ime mmiri, mgbe minit 15 gasịrị. nje. Na-a insteadụ kama tii. E karila ubochi nke kariri, nke bu 1 lita.

Iji hazie njikọta nke homonụ AD, jiri ọgwụ infili. Iji kwadebe ya ị ga-achọ:

• Inflorescences dikwa elderry - 20 g;
• Esi mmiri esi mmiri - 1 tbsp.

Ọ ka mma iji esi nri na thermos, na-ahapụ awa 1. Igbu ihe ọ drinkụ drinkụ, igbari 1 okpokoro. l mmanụ a .ụ. Were infusion 3 r / inbọchị na doses. Usoro ọgwụgwọ ya ga-abụ ọnwa 1. 10bọchị 10 mgbe e mesịrị nnabata ego nwere ike imeghari.

A ga-achọ ihe ndị na-esonụ ihe (nha anya otu):

1. Hops (cones);
2. Valerian (mgbọrọgwụ);
3. Motherwort (ahihia);
4. Rosehip (tomato azọpịa);
5. Mint (ahịhịa).

Gwakọta ihe niile na-edozi, tinye tebụl 1 na thermos. l ngwaọrụ, ime biya 1 iko mmiri ọkụ (85 Celsius C). Mgbe otu awa gachara, mmanya nwere ike ị drunkụ mmanya. Were ya na 80 ml ọkara otu awa tupu ị lakpuo ụra. Usoro nnabata ahụ bụ ọnwa 3.

Doctorsfọdụ ndị dọkịta na-ede ọgwụ ọgwụ ka ọ bụrụ ọgwụ ọzọ maka ọgwụ, mana enweghị ike iji ọgwụgwọ ndị mmadụ dịka ọgwụgwọ kachasị. Tupu itinye ihe ọ bụla infusus, decoctions, a na-atụ aro ka ị kpọtụrụ ọkachamara.

Amụma

Mmekpa ahụ na-eme n’ime ime afọ nwanyị, nke na-amalite n’oge afọ ime, na-apụ n’anya mgbe amuchara nwa.

N’ụdị ndị ọzọ, dịka ọmụmaatụ, idiopathic, mgbake adịkarịghị, mana ọgwụgwọ ọzọ ga-eme ka ndị ọrịa nwee ike ịna-arụ ọrụ. Ọ bụrụ na amata ihe kpatara ọrịa ahụ ma kpochapụ ya, ọgwụgwọ ahụ ga-aga nke ọma.

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