Cerebral Salt Wasting Syndrome ndi SIADH monga Zomwe Zimayambitsa Mavuto a Sodium
Mavitamini otsika kwambiri (hyponatremia) m'maganizo a odwala matenda am'thupi angapangitse kugwidwa kapena kugunda. Odwala omwe ali ndi vuto la ubongo, kuchepa kwa sodium m'magazi kungachititse kuti madzi azidumpha pamphepete mwa mitsempha ya mitsempha komanso kutupa koopsa mu ubongo. Komano, mlingo wa sodium wokwera kwambiri (hypernatremia) kawirikawiri ndi chizindikiro cha kutaya madzi m'thupi.
Nthawi zambiri, izi zingachititsenso kugwidwa ndi kugwidwa.
Chifukwa chiyani kufufuza za Sodium kapena High High Sodium Level Matters
Kufufuza electrolytes monga sodium, potaziyamu, calcium ndi bicarbonate ndizofala m'zipatala. Kwenikweni, gulu la electrolyte limaphatikizidwapo pamagazi a tsiku ndi tsiku kuwongolera kuti atsimikizire kuti maseĊµera a mankhwalawa ndi ofunika kwambiri. Ngakhale ena anganene kuti kufufuza tsiku ndi tsiku kumakhala odwala ambiri, pali zifukwa zabwino kwambiri zoyenera kuziganizira ngati magulu a electrolyte sali oyenera, ndipo ayenera kuyang'anitsitsa tsiku ndi tsiku mu chipatala chodziletsa kwambiri.
Chifukwa kutupa kwa ubongo kungayambitse kupweteka kwa ubongo, kuwonongeka kwa ubongo, komanso imfa, madokotala mu ICU yokhudzana ndi ubongo nthawi zambiri amasamala kwambiri kuti asatetezeke kwambiri m'magazi a sodium. Mwamwayi, mavuto monga kuperewera kwa magazi , ubongo , ubongo ndi meningitis zingayambitse hyponatremia, ndipo motero zimapweteka kwambiri kutupa kwa ubongo.
Njira yomwe amachitira zimenezi ndi kusintha maonekedwe a madzi otchedwa hormonal ndi madzi ndi ma sodium m'thupi.
Zowona za Masewu a Sodium
Zimakhala zachilendo ngakhale kwa ophunzira a chaka choyamba azachipatala kuti asokonezeke chifukwa cha vuto la sodium. Ndikofunika kukumbukira kuti zomwe ubwino wa lab la magazi umayimira ndizovuta.
Ndiko, mtengo umayimira kuchuluka kwa sodium pa kuchuluka kwa madzi. Pali njira ziwiri, ndiye, kuti msinkhu uwu ukhoza kukhala wotsika:
- Sodium ikhoza kukhala nambala yochepa, kapena
- Pakhoza kukhala kuchuluka kwa kuchuluka kwa madzi.
Zoona zake ndizofala kwambiri ndipo zingakuthandizeni kufotokoza mipira isanu ya ping-pong ikuyandama mumtsuko wa madzi. Bwalo lirilonse limaimira molekyu wa sodium. Ngati mtsuko wa madzi ndi wawung'ono, mipira idzaphatikizidwa pamodzi-izi ndi zofanana ndi kunena kuti ndondomeko ndi yapamwamba.
Ngati mtsuko uli waukulu (ie, madzi ambiri), mipira idzakhala kutali kwambiri-izi ndizofanana ndi kunena kuti ndondomeko ili yochepa. Zoonadi, nambala ya mipira ya ping-pong imakhala yofanana. Kawirikawiri, hyponatremia kwenikweni imayimira kuchulukira kwa madzi, monga choncho ndi mtsuko waukulu wa madzi.
Matenda Amene Amayambitsa Hyponatremia
Zinthu zambiri zomwe zingatheke komanso zamoyo zomwe zimayambitsa moyo zingayambitse hyponatremia, koma makamaka pa matenda a neurology, 2 syndromes angayambe kuchepetsa mphamvu ya sodium:
Syndrome of Inappropriate Antidiuretic Hypersecretion (SIADH). Matendawa ndi njira imodzi imene ma sodium angakhale otsika. Hormone ya antidiuretic (ADH) kawirikawiri imabisika ndi thupi kusunga madzi.
Izi zingakhale zothandiza, mwachitsanzo, pa tsiku lotentha la chilimwe. Mahomoni nthawi zambiri amachitikira pamene makwerero amadzimadzi amafika pamtunda winawake. Mu SIADH, mabwato omwe nthawi zambiri amatha kutsegula ADH samagwira ntchito, ndipo thupi limapitirizabe kuyamwa madzi.
Mwamwayi, mavuto ambiri a ubongo amachititsa SIADH, yomwe imadula sodium yamtundu wambiri m'magazi ndipo imatha kupweteka kwambiri m'mimba. Izi zingachititse kuti vuto likhale ngati vuto la meningitis limene limayambitsa SIADH, zomwe zimachititsa ubongo kutupa, zomwe zimaipitsa SIADH, ndi zina zotero.
SIADH ikhozanso kuyambitsidwa ndi mavuto ena kupatula kuwonongeka kwa ubongo. Mwachitsanzo, mavuto a mapapu monga khansara kapena chibayo angayambitsenso SIADH, monga mankhwala ambiri monga carbamazepine ndi amitriptyline.
Kusokonezeka kwa mankhwala osokoneza bongo kungayambitsenso SIADH.
Monga tafotokozera, ngakhale SIADH imayambitsa zowonongeka kwambiri za sodium, zimatero chifukwa cha kutaya madzi. Choncho, mankhwalawa ndi kuchepetsa kuchuluka kwa madzi omwe wodwala amalandira, ndikutsimikizira kuti chifukwa chake chimayambitsidwa.
Cerebral Salt Wasting Syndrome (CSWS). Matendawa amachitanso chifukwa cha kuwonongeka kwa ubongo, komanso zimayambitsa kutaya kwa sodium, ndipo zimakhala zovuta kusiyanitsa ndi SIADH. Komabe, njirayi ndi yosiyana kwambiri.
Kuchuluka kwa mchere wa cerebral ndizosiyana ndi lamulo lakuti hyponatremia kwenikweni imayimira maulendo apamwamba a madzi osungirako. Monga momwe dzina limasonyezera, ubongo wa ubongo umayambitsa kwenikweni thupi limatulutsa mchere. Kubwereranso ku chitsanzo chathu choyamba, zimakhala ngati mipira ya ping-pong imachotsedwa mu mtsuko, zomwe zimapangitsa kuti asiye kuchepa.
Kuchotsa mchere wamchere kumapezeka kawirikawiri patatha mlungu umodzi kuvulala kwa ubongo ndikukhazikitsa pambuyo pa masabata awiri kapena anayi. Komabe, nthawi zina ikhoza kukhala nthawi yaitali, yokhalitsa zaka.
Ngakhale kuti SIADH ikhoza kuchititsa kuti thupi lonse likhale lofanana kapena kuti likhale lofanana, mchere umasokoneza kutaya thupi. Imeneyi ndi njira imodzi yokha yosiyanitsira pakati pa mavuto awiriwa, makamaka wodwala amene sadziwa kanthu kapena amayerekeza .
Njira Zothandizira
Ndikofunika kuyesa kusiyanitsa pakati pa CSWS ndi SIADH chifukwa mavuto awiriwa amachiritsidwa mosiyana. Mu CSWS, wodwalayo amafunikira madzi kapena adzatenthedwa. Mu SIADH, thupi lonse la sodium limakhala lofanana, koma kuchuluka kwa sodium payeso ya madzi kugwa chifukwa thupi limasunga madzi ambiri. Kupereka madzi kumangowonjezera vutoli, motero odwala omwe ali ndi SIADH amapezedwa kuchepetsa kuchulukira kwa madzi omwe amatha kulandira tsiku ndi tsiku. Kufotokozera kusiyana kungakhale kovuta, ndipo ndi chimodzi mwa zifukwa zambiri zomwe odwala amapindula ndi magulu apadera omwe amasamalidwa kwambiri atagwidwa ndi vuto lalikulu la ubongo.
Zotsatira:
Allan H. Ropper, Daryl R. Gress, Michael. Diringer, Deborah M. Green, Stephan A. Mayer, Thomas P. Bleck, Neurological and Neurosurgical Care, Revised Four, Lippicott Williams & Wilkins, 2004
Ropper AH, Samuels MA. Adams ndi Victor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009. McCabe MP, O'Connor EJ.
Braunwald E, Fauci ES, ndi al. Mfundo za Harrison za Mankhwala a M'kati. 16th ed. 2005.