Sanadin, iri da kuma hanyoyin magance cututtukan insipidus

Insipidus na ciwon suga yana haifar da ƙaranci ko ɓarna a cikin jikin hormone wanda ake kira antidiuretic (ADH), ko vasopressin. Ayyukan vasopressin sune ka'idojin adadin ruwa a jikin mutum, cire sodium daga jini da takaita matakan jijiyoyin jini.

Take hakkin aiki ko aikin hodar ya haifar da rikicewar kwayar halittar gaba daya. Ciwon sukari insipidus (ND) na bukatar kulawar likita cikin gaggawa don wajabta magani.

Ana gano babban adadin cututtukan a cikin marasa lafiya masu shekaru 20-30, amma kuma yana faruwa a cikin yara daga jarirai. Yawan cutar ya kasance ƙananan - 3 cikin 100,000, amma kwanan nan akwai yiwuwar karuwa saboda karuwar yawan ayyukan a kwakwalwa. Menene haɗarin wannan nau'in ciwon sukari?

Iri na Pathology

Cutar sankara (insipidus) na rarrabuwa cikin nau'ikan da yawa waɗanda ke nuna tushen dalilin cutar da wurin matsalar.

Rashin Hormone a cikin jiki na iya zama cikakke ko dangi.

1. Idan hypothalamus yana haifar da isasshen adadin ADH, muna magana ne game da ƙimar ƙarancin darajar. Tsarin hypothalamic-pituitary ko neurogenic shine cutar ta haɓaka a cikin jikin mutum.
2. Nau'in nau'in na ND yana da alaƙa da rashin ƙarfin kodan don fahimtar ADH. Kwayar halittar da aka samar da isasshen adadin ba zai iya cika nufin ta ba, kuma fitsari mara amfani da ya fita daga jiki. Ilimin halittar wannan nau'in ana kiransa renal ko nephrogenic.

Wannan nau'in rarrabuwa yana nuna matsayin matsalar - ƙodan ko kwakwalwa.

An tsara nau'ikan neurogenic gwargwadon yadda ya bayyana a nau'ikan guda biyu:

1. Symptomatic - wanda ya haifar da matsalolin kwakwalwa - hanyoyin kumburi, lalacewar aikin tiyata, neoplasms.
2. Idiopathic - sanadi ne sanadin ƙwayar jini ga ƙirar halitta ta vasopressin.

Nau'in ƙwayar cutar ƙwayar cuta ta ƙwaƙwalwa shine asalin halitta a cikin yanayi ko kuma sakamakon matsalolin koda ne. Bayyanar wannan nau'in ND na iya haifar da tsawaita amfani da magunguna da cututtukan cututtukan gabobin tsoka.

Matan da ke da juna biyu na iya haifar da wani nau'in cutar, wanda wasu lokuta ke wucewa bayan haihuwa.

Ga jarirai, saboda ajizancin tsarin garkuwar jiki, tsarin aikin ND shine halayyar.

Wani nau'in cuta shine psychogenic a cikin yanayi - polydipsia na farko, wanda ƙishirwa ba tare da kulawa ba yana haɓaka saboda raguwa a cikin samarwar ADH. Koyaya, idan ruwa bai shiga cikin jiki ba, ƙwayar ƙwayar ma'anar ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta ta al'ada da kuma sake dawo da haɗin vasopressin.

Dangane da ICD 10, rarrabuwar cutar tana faruwa a cikin azuzuwan biyu - nau'in koda shine lambar N25.1 - ana kiran wannan cutar zuwa tsarin ƙwayar cuta. Tsarin neurogenic na ND an ɓoye shi a cikin aji na cututtukan endocrine, lambar ICD 10 - E23.2.

Dalilai da tsarin haɓaka

Dangane da ICD 10, nau'ikan ND guda biyu ana rarrabe su a babi daban-daban.

ADH an samar dashi ta hanyar hypothalamus kuma yana aiki don tsara juyawa a cikin ƙwayoyin koda.

A take hakkin reabsorption, wanda ba a cika fitar da fitsari daga jiki a cikin adadi mai yawa, ƙishirwa yana bayyana saboda babban asarar danshi.

Pathophysiology ya bambanta hanyoyi guda biyu don haɓakar ciwon insipidus na sukari daidai da wurin da yankin matsalar ke cikin jiki:

1. Ana nuna nau'ikan neurogenic ta ƙarancin wadatar ADH.
2. Rashin ND yana faruwa ne saboda rashin ƙwaƙwalwar ƙwayoyin koda don tsinkaye da amfani da vasopressin da aka karɓa don tace ruwa.

Pathogenesis na manyan nau'ikan ND guda biyu sun sha bamban, duk da haka, sanadin abubuwan da ke faruwa suna faruwa iri ɗaya. Ci gaban ilimin halittar cuta yana haifar da tsinkayar halittar jini, kazalika da cututtuka da raunin da ya faru a kai ko gabobin urinary.

Cutar sankara ta Nephrogenic na iya haifar da:

• cutar koda
• guban tare da kwayoyi da abubuwa masu guba;
• Pathology na tubules na kodan.

Sanadin nau'ikan neurogenic:

• kwakwalwar tiyata;
• m neoplasms da metastases;
• cututtuka, mai kumburi da cututtuka na jijiyoyin jini.

Alamomin cutar

Matsayin bayyanar cutar, watau tsananin tsananin bayyanar cututtuka, ya dogara da dalilai biyu:

1. Nawa ne vasopressin yake a cikin jiki, ko ba haka bane.
2. Yaya yawan ƙwayoyin koda ke da damar fahimtar hormone.

Alamu na farko da kuma bayyanannun alamun ND sune ƙishirwa mai raɗaɗi (polydipsia) da kuma dagewa akai-akai don urinate (polyuria).

Polydipsia suna tilasta mutum ya sha fiye da lita 3 na ruwa a rana. Yawan fitsari ya tashi daga lita 5 zuwa 15 a kowace rana. Yunwa da ƙishirwa suna kama da dare.

Wadannan abubuwan sannu a hankali sun zama sanadin wasu canje-canje a cikin jiki, wanda ke zama ƙarin alamun cutar:

• yawan shan ruwa mai yawaita shimfidar ciki, tsawon lokaci, ya fadi;
• akwai tsawa daga mafitsara;
• gumi yana raguwa, wanda wasu lokuta yakan haifar da karuwa cikin zafin jiki;
• bushewar mucous membranes da fata, gashi ya zama kamar toshiya;
• lalacewar narkewar hanji, matsewar rikice-rikice - maƙarƙashiya, a sakamakon haka, haɓaka hanyoyin kumburi a cikin waɗannan gabobin;
• rikicewar kwakwalwa ta fito daga damuwa na yau da kullun, ci gaban neuroses, asarar sha'awar rayuwa, ciwon kai, raunin ƙwaƙwalwa;
• raunin gani;
• rashin ruwa yana haifar da raguwar hauhawar jini da hauhawar zuciya.

Wadannan bayyanar cututtuka a wasu halayen ana kara su ta hanyar enuresis ko tashin zuciya da amai ba tare da wani dalili a fili ba.

Siffar halayyar cututtukan hormonal ita ce lalatawar jima'i.

Tare da ciwon sukari insipidus lura:

• a cikin maza, yawan raguwa a cikin sha'awar jima'i da lalata erectile, wanda ke faruwa ta hanyar tururuwar kumburi da kumburi a cikin gabobin ƙwayoyin cuta;
• a cikin mata, matsalar haila wacce zata iya haifar da ashara yayin daukar ciki ko rashin haihuwa.

A yayin gudanar da aikin jiyya, an rarraba marasa lafiya zuwa rukunoni uku gwargwadon matsayin diyya:

• ƙishirwa ta daina azabtar da mai haƙuri, urination al'ada ce - wannan diyya ce;
• tare da subcompensation - karuwar sha'awar sha da urinate yana faruwa lokaci-lokaci;
• rarrabuwar halaye shine halin cewa magani baya taimakawa shawo kan ƙishirwa, mai haƙuri yana wahala kamar baya.

A cikin yara, cutar tana haifar da asarar ci, rashin isasshen nauyi, ƙarancin ci gaba da haɓaka. Cin abinci yakan haifar da amai, yara suna maƙarƙashiya, gado. Iyaye suna buƙatar kulawa da hankali game da yanayin yaran.

Bayyanar cutar ND a cikin jarirai:

• asarar nauyi maimakon rarar nauyi;
• kuka ba tare da hawaye ba;
• urination akai-akai, sassan fitsari suna da yawa sosai;
• yawanci amai da bugun jini.

Sharuɗɗa don ganewar asali

Alamomin farko na ND a bayyane - ƙishirwa mai yawa da urination akai-akai har da dare.

Cikakken binciken cutar ya hada da:

• Gwajin Zimnitsky;
• ƙuduri na yawan fitsari yau da kullun;
• gwaji don osmolarity na jini da fitsari;
• ƙuduri na yawan fitsari;
• ƙuduri na glucose, sodium, urea, potassium a cikin jini;
• CT, aikin rediyo, echoencephalography;
• daukar hoto, duban dan tayi na kodan.

Tebur na alamun ND bisa ga sakamakon binciken:

Don ware ciwon sukari, ana yin gwajin jini don glucose akan komai a ciki.

Idan osmolarity na jini da fitsari sune al'ada, gudanar da gwaji ban da na ruwa.

An bambanta nau'ikan Renal da neurogenic na ciwon sukari ta hanyar canje-canje a cikin nauyin jiki, sodium serum da osmolarity. Wannan ya zama dole saboda magani zai sha bamban.

ND magani

A yayin taron cewa ya yuwu a gano musabbabin cutar sankara, suna kokawa da cutar ND. Ana yin ƙarin magani dangane da nau'in cutar.

Nau'in Neurogenic

Ana gudanar da aikin magani tare da fitsari fiye da lita 4 a rana. Idan ƙarancin ya ragu, an wajabta wa marasa lafiya abincin da ya haɗa da saka idanu na yawan shigar ruwa.

Shawarwarin asibiti sun tsara Minirin, wanda shine madadin ADH. An zaɓi kashi na miyagun ƙwayoyi daban-daban kuma baya dogaro da shekaru da nauyi. Bayanin shine ingantaccen yanayi, raguwa a cikin urination da ƙishirwa. Theauki magani sau 3 a rana.

Shirye-shirye na carbamazepine, chlorpropamide yana inganta aikin vasopressin. Adiurekrin aka shigar cikin hanci don rage bushewar mucous membranes, rage fitowar fitsari.

Nau'in nau'in fansa

Don lura da nau'in cutar nephrogenic, ana amfani da diuretics - Hypothiazide, Indapamide, Triampur. Don rama asarar potassium, an wajabta Asparkam ko Panangin.

Wani lokacin magani yana haɗu da magungunan anti-mai kumburi. Zabi na kudade ya dogara da tsananin yanayin da kuma matsayin lalacewar urinary tubules.

A cikin lura da nau'ikan cututtukan biyu, ana amfani da magani don taimakawa rage yanayin gaba ɗaya, inganta bacci, kwantar da tsarin juyayi.

Abincin

Abincin yana da nufin rage ƙishirwa da kuma gyara don asarar abubuwan gina jiki da aka rasa tare da fitsari. An shawarci marassa lafiya don rage gishiri da sukari.

Ana bada shawarar cin abinci sau 5-6 a rana.

Abubuwan amfani:

• 'ya'yan itatuwa da suka bushe - suka yi asarar potassium;
• abincin teku - babban sinadarin phosphorus;
• sabo kayan lambu da 'ya'yan itatuwa;
• nama mara nama.

Abubuwa masu mahimmanci da kuma carbohydrates - iri biyu na man shanu, dankali, taliya.

Wannan yayi daidai da abun da ake ci No. 7 da 10.

Hasashen

Ta hanyar magungunan zamani, ba za a iya warke cutar ba. Magungunan da aka tsara suna taimakawa wajen daidaita ma'aunin ruwa da rage yanayin. Game da diyya, mai haƙuri zai iya yin aiki.

Yin rigakafin insipidus na ciwon sukari ya danganta ne da kula da cututtuka na lokaci da raunin da zai iya haifar da ci gaban ciwon sukari. Wannan ya shafi duka matsalolin kwakwalwa da cututtukan koda.

Abubuwan bidiyo game da insipidus na ciwon sukari, abubuwan da ke haifar da faruwarsa da magani:

Marasa lafiya tare da masu buƙatar ND suna buƙatar yin cikakken kulawa da shan kwayoyi kuma ku bi tsarin rage cin abinci da abin sha. Wannan zai taimaka inganta rayuwa da kuma hana ƙarin matsaloli daga cututtukan zuciya da jijiyoyi.