Ke loaʻa iā ʻoe kahi hoʻāʻo koko, ke haʻi aku nei ke kauka iā ʻoe "ua kiʻekiʻe iki kou pae calcium koko"? He mea maʻamau ke manaʻo iki i ka makaʻu ke lohe ʻoe i kēlā. Akā, mai hopohopo. ʻO kēia kūlana ka mea a mākou e kapa nei he hypercalcemia . I ka ʻōlelo maʻalahi, ʻo ia hoʻi, he nui aku ka calcium i loko o kou koko ma mua o ka mea e pono ai. E kamaʻilio kākou e pili ana i kēia me ka maʻalahi a me ke aloha i kēia lā.
He aha maoli ka hypercalcemia?
He mea nui ka kalipuna no ko kākou kino, ʻoiai no ka ikaika o ko kākou mau iwi a me nā niho. Pono nō hoʻi ia no ka hana pono ʻana o ko kākou ʻōnaehana nerve a me nā ʻiʻo . Eia naʻe, e like me nā mea ʻē aʻe, ʻaʻole maikaʻi ka nui o ka kalipuna i loko o ke kino.
Inā kiʻekiʻe iki ka pae calcium o kou koko, ʻaʻole paha ʻoe e ʻike i kekahi mau hōʻailona. Akā i ka piʻi ʻana o ka pae, hoʻāʻo ko mākou kino e hoʻopau i kēia calcium keu i loko o ka mimi. No laila e ʻike paha ʻoe i nā mea e like me:
- ʻO ka pono e mimi pinepine.
- Ke make wai nei ma mua o ka maʻamau.
Inā piʻi nui ka nui o ka calcium, hiki iā ia ke hoʻopilikia i kā mākou ʻōnaehana nerve, e hoʻoulu ai i ka huikau, ka nalowale o ka hoʻomanaʻo, a i kekahi manawa hiki ke nalowale i ka naʻau .
ʻO ka mea nui loa, inā ʻaʻole mālama ʻia kēia ʻano, hiki iā ia ke alakaʻi i nā ʻano koʻikoʻi e like me ka nalowale o ka iwi, nā pōhaku puʻupaʻa, ka hāʻule ʻana o ka puʻupaʻa, a me nā maʻi puʻuwai . No laila, he mea nui loa ia e makaʻala i kēia, e kamaʻilio me kāu kauka, a e hana i nā hana e pono ai.
He aha nā kumu nui no kēia?
ʻOiai aia ma mua o 25 mau kumu o ke kiʻekiʻe o ka calcium koko, 90% o lākou e kū mai ana ma muli o ʻelua mau kumu nui.
1. Nā ʻāpana Parathyroid Overactive
ʻO kēia ke kumu maʻamau o ka hypercalcemia. ʻO nā kelepa parathyroid he ʻehā mau kelepa liʻiliʻi i loaʻa i ko mākou ʻāʻī, ma hope o ke kelepa thyroid . Hana lākou e like me ka thermostat e kaohi ana i ka calcium.
Ke emi ka nui o ka calcium i loko o ke koko, hoʻokuʻu kēia mau kelepa i ka hormone parathyroid (PTH).Hoʻopuka ʻia ka PTH . Hōʻailona kēia hormone i ko mākou mau iwi e "hoʻokuʻu i ka calcium hou aʻe i loko o ke koko," ko mākou mau puʻupaʻa e "hōʻemi i ka calcium excretion i loko o ka mimi," a ko mākou mau ʻōpū e "omo i ka calcium hou aʻe mai ka meaʻai."
Eia nō naʻe, inā lilo kekahi a ʻoi aku paha o kēia mau kelepa i hana nui ʻia, hana lākou i ka PTH ma mua o ka mea e pono ai. Hiki i kēia ke hoʻonui i ka pae calcium i loko o ke koko me ke kumu ʻole. Hiki ke kumu kēia ma muli o ka hoʻonui ʻia ʻana o nā kelepa a i ʻole ka hoʻokumu ʻia ʻana o kahi puʻupuʻu ʻaʻole cancerous.
Inā loaʻa iā ʻoe ka Hypercalcemia no kēia kumu, hiki iā ʻoe ke ʻike i nā hōʻailona e like me:
- Kaumaha
- Poho hoʻomanaʻo
- ʻĀʻī puʻuwai
- Nā pilikia hiamoe
- ʻEha i nā iwi a me nā ʻiʻo
- Luhi mau
Ma ke ʻano he lāʻau lapaʻau, e ʻōlelo pinepine kāu kauka i ka wehe ʻoki ʻana i ka gland a i ʻole nā glands i hoʻopilikia ʻia. Inā ʻaʻole koʻikoʻi loa ke ʻano, hiki iā ʻoe ke nānā i kou ʻano ma ka nānā pinepine ʻana i kāu mau pae calcium, ke koko, a me ke olakino o nā puʻupaʻa.
2. Ka maʻi ʻaʻai
Hiki ke loaʻa ka hypercalcemia i 10%-30% o nā maʻi kanesa. ʻO kēia no ka mea ʻo kekahi mau maʻi kanesa:
- Hiki ke wāwahi ʻia nā iwi, e hoʻokuʻu ana i ka calcium i loko o ke koko.
- Hiki iā ia ke hana i kahi mea e hana like me ka hormone PTH a hōʻailona i ka hoʻokuʻu ʻia ʻana o ka calcium mai nā iwi.
- Hiki iā ia ke hoʻopilikia i ka hana o nā puʻupaʻa a hoʻemi i ka nui o ka calcium i hoʻokuʻu ʻia i loko o ka mimi.
ʻO nā ʻano maʻi kanesa e pili pinepine ʻia me ka hypercalcemia:
- Ka maʻi ʻaʻai māmā
- Ka maʻi ʻaʻai puʻupaʻa
- Ka maʻi ʻaʻai umauma
- ʻO ka myeloma maha - He ʻano maʻi koko e hoʻomaka ana ma ka iwi iwi.
Hiki ke paʻakikī ke mālama i ka hypercalcemia i hoʻokumu ʻia e ka maʻi kanesa. ʻO ka mea nui ka mālama ʻana i ke kanesa. Eia nō naʻe, hiki i kāu kauka ke hāʻawi iā ʻoe i nā lāʻau lapaʻau e like me "Bisphosphonates" a i ʻole "Denosumab" ma ke ʻano he intravenous (IV) a i ʻole injection e kāohi i ka hoʻokuʻu ʻia ʻana o ka calcium mai nā iwi.
Pehea ka hopena o nā huaora a me nā mea hoʻohui
I kekahi manawa ʻo nā wikamina a me nā mea hoʻopihapiha a mākou e hoʻohana ai kekahi kumu o kēia.
| Mea Hoʻohui / Wikamina | Pehea e pili ai |
|---|---|
| Nā mea hoʻohui Kalipuna a me nā Antacids | ʻO ka hoʻohana nui ʻana a me ka hoʻohana lōʻihi ʻana i kekahi mau antacids a me nā papa calcium i hoʻohana ʻia no ka gastritis hiki ke hoʻonui i ka calcium i loko o ke koko. Ua kapa ʻia kēia ʻano (Milk-alkali syndrome) . Hiki i kēia ke hōʻino i nā puʻupaʻa. |
| Wikamina D | Kōkua ka wikamina D i ko mākou kino e omo i ka calcium. Eia nō naʻe, inā ʻoe e lawe i nā nui kiʻekiʻe loa o ka wikamina D no kekahi mau mahina (no ka laʻana, 60,000 IU i kēlā me kēia lā), hiki i kou pae calcium ke lilo i mea kiʻekiʻe loa. ʻAʻole ʻoe e loaʻa i kēia nui o ka wikamina D mai ka meaʻai maʻamau a i ʻole ka lā. |
| Wikamina A | ʻO ka lawe ʻana i ka nui o ka wikamina A hiki ke hoʻokuʻu ʻia ka calcium keu mai nā iwi a hōʻiliʻili i loko o ke koko. |
E hoʻomanaʻo, inā ʻoe e lawe ana i kekahi mau huaora a i ʻole nā mea hoʻohui, e hōʻoia e haʻi i kāu kauka e pili ana iā lākou. Mai hoʻomaka a hoʻōki paha i ka lawe ʻana i kekahi mea me ka ʻole o ke kamaʻilio mua ʻana me lākou.
Nā kumu ʻē aʻe a me nā pilikia
Nā mea ʻē aʻe e hiki ke hoʻopilikia
- Nā lāʻau lapaʻau ʻē aʻe: ʻO kekahi mau lāʻau lapaʻau no ke koko kiʻekiʻe (e.g., thiazide diuretics) a me nā lāʻau lapaʻau no ka maʻi noʻonoʻo, e like me ka lithium, hiki ke hoʻonui i nā pae calcium.
- ʻIke Hoʻoilina: He mea kākaʻikahi loa, hiki ke hana ʻia kēia e kahi kūlana hoʻoilina i kapa ʻia ʻo Familial Hypocalciuric Hypercalcemia (FHH).
- Nā kūlana olakino: Nā maʻi māmā e like me ka maʻi puʻupuʻu, nā kūlana e like me ka thyroid overactive.
- Ka hana ʻole kino: Hiki ke loaʻa kēia ʻano i nā poʻe e moe ana ma kahi moe no ka manawa lōʻihi ma muli o kahi ʻano e like me ka maʻi lolo a i ʻole kekahi maʻi ʻē aʻe. ʻO ke kumu o kēia, ʻoiai ke ʻike ʻole nā iwi i ke kaumaha o ke kino, hoʻokuʻu ʻia ka calcium mai nā iwi.
- Ka maloʻo nui: Ke lawa ʻole ka wai i loko o ke kino, ʻaʻole hiki i nā puʻupaʻa ke hoʻokuʻu i ka calcium keu.
Āhea kēia he pilikia?
ʻO ka pae calcium maʻamau o ke koko no kahi pākeke ma waena o 8.5 - 10.3 mg/dL. Inā piʻi aʻe kēia pae i ke kiʻekiʻe loa, he kūlana ia e pono ai ke kōkua lapaʻau koke.
Inā loaʻa koke iā ʻoe ka huikau nui, ka poʻo māmā, ka luaʻi ʻana, a i ʻole ka ʻeha nui o ka ʻōpū , he hōʻailona paha ia o kahi maʻi koʻikoʻi i kapa ʻia ʻo hypercalcemia. Inā hana kēia, pono ʻoe e hele koke i ka lumi pilikia o ka haukapila (ETU) . Ma laila, hiki ke hāʻawi ʻia iā ʻoe nā wai IV a me nā lāʻau lapaʻau e kāohi koke i kāu mau pae calcium.
Leka Lawe-Home
- ʻO ka Hypercalcemia kahi pae kiʻekiʻe o ka calcium i loko o ke koko. ʻIke pinepine ʻia ia i ka wā o kahi hoʻāʻo koko i hana ʻia no kekahi kumu ʻē aʻe.
- ʻO ke kumu maʻamau o kēia he pilikia me nā kelepa parathyroid a i ʻole ke kanesa, no laila he mea nui loa e ʻimi i ke kumu pololei.
- Mai hopohopo inā ʻike ʻoe ua kiʻekiʻe ke kalipuna o kou koko. E kamaʻilio me kāu kauka, e ʻike i ke kumu, a hoʻomaka i ka lāʻau kūpono no ia.
- Mai hoʻohana i nā huaora, nā pila calcium, a i ʻole nā mea hoʻohui ʻē aʻe me ka ʻole o ka nīnau ʻana i kāu kauka.
- Inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi e like me ka huikau a i ʻole ka nalowale ʻana o ka ʻike, he pilikia ia. E hele koke i ka ʻOihana Pilikia o ka haukapila (ETU).
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