Ua haʻahaʻa anei ka phosphate i kou koko? E kamaʻilio kākou e pili ana i kēia maʻi (Hypophosphatemia) !

Ua ʻike paha ʻoe i kahi mea i kapa ʻia ʻo "Phosphate" ke nānā ʻoe i kahi hōʻike koko, ʻeā? A i ʻole ua haʻi aku kekahi kauka iā ʻoe e pili ana i ia mea. He mea nui loa kēia phosphate no ko mākou kino. No laila, he aha ka mea e hana ai inā emi kēia pae phosphate i loko o ke koko? ʻO ia ka mea a mākou e kapa nei he (Hypophosphatemia). E kamaʻilio kākou e pili ana i kēia me nā kikoʻī, me ka maʻalahi loa, i kēia lā.

He aha ke ʻano o ka phosphate haʻahaʻa? ʻO ia anei ka (Hypophosphatemia)?

ʻO ka ʻōlelo maʻalahi, ʻae. ʻO ka Hypophosphatemia kahi kūlana kahi i haʻahaʻa ai ka pae o kahi mineral i kapa ʻia ʻo phosphate i loko o kou koko. ʻO ka Phosphate kahi electrolyte e pono ai no nā hana he nui i loko o ko mākou kino. Hana ia e like me ka pila i loko o ko mākou kino. Hiki i kēia kūlana ke akahai a koʻikoʻi paha. Hiki nō hoʻi ke hiki koke mai (ʻoi) a i ʻole i ka hala ʻana o ka manawa (mau).

No laila, pehea ke koʻikoʻi o kēia phosphate i ke kino?

E noʻonoʻo i ka nui o ka hana a kēia phosphate i loko o ko mākou kino!

• Ke kūkulu ʻana i ko kākou mau iwi a me nā niho a me ka mālama ʻana iā lākou i ikaika: 85% o ka phosphorus i loko o ko kākou kino aia i loko o ko kākou mau iwi. No laila, he mea nui kēia no nā iwi ikaika.
• E mālama pono i ka ʻōnaehana nerve: Pono ko mākou mau aʻalolo i ka phosphate e hana pono.
• Kōkua i ka ʻūmiʻi ʻana o nā ʻiʻo: Ke neʻe mākou i ko mākou mau lima a me nā wāwae, a i ka wā e paʻi ai ko mākou puʻuwai, ʻūmiʻi ko mākou mau ʻiʻo, no laila kōkua pū kēia me kēlā.

Loaʻa iā mākou kēia phosphorus/phosphate mai ka meaʻai a mākou e ʻai ai.

ʻO ka mea nui, pili pono ka pae phosphate i loko o ko kākou koko i ka pae calcium. Hana nā mea ʻelua ma ke kua. ʻO ia hoʻi, i ka piʻi ʻana o ka pae calcium i loko o ke koko, emi iho ka pae phosphate. Ke hana nei kēia i kēlā me kēia kekona. ʻO ka hormone parathyroid (PTH), ka mea i hana ʻia e nā kelepa parathyroid i loko o ko kākou ʻāʻī, ke kāohi nei i kēia mau pae calcium a me phosphate.

Pehea ka maʻamau o kēia ʻano (Hypophosphatemia)?

ʻO ka hypophosphatemia iki kahi maʻi maʻamau i loaʻa i nā hoʻokolohua koko. Manaʻo kekahi mau hōʻike e hoʻopilikia ia a hiki i ka 5% o ka heluna kanaka ma ʻAmelika Hui Pū ʻIa. ʻO ka hapa nui o ka manawa, ʻaʻole ia he maʻi koʻikoʻi a ʻaʻole ia e hōʻike i kekahi mau hōʻailona. ʻIke pinepine ʻia ia ma kahi hanana.

Eia nō naʻe, ʻoi aku ka maʻamau o ka hypophosphatemia koke a koʻikoʻi (hypophosphatemia koʻikoʻi, koʻikoʻi) i nā poʻe me kekahi mau kūlana olakino. Eia kekahi laʻana:

• No ka poʻe i hoʻopilikia ʻia e ka waiʻona (Alcohol use disorder)
• I ke ʻano o ka ketoacidosis e pili ana i ka maʻi diabetes (DKA)
• I ka maʻi nui, ka sepsis
• No ka poʻe me nā kuni nui

Hiki ke ʻike ʻia kēia ʻano ma kahi o 80% o ka poʻe e makemake nei i kēia.

No laila, he aha nā hōʻailona o ka (Hypophosphatemia)?

Hoʻopili ʻia nā hōʻailona i ka haʻahaʻa o ka pae phosphate.

Hypophosphatemia ʻoluʻolu

ʻAʻohe hōʻailona o ka poʻe me ka hypophosphatemia ʻoluʻolu, akā hiki i kekahi ke loaʻa i ka nāwaliwali o nā ʻiʻo a me ka luhi iki.

Inā he koʻikoʻi (Hypophosphatemia koʻikoʻi)

Eia nō naʻe, inā haʻahaʻa loa nā pae phosphate (hypophosphatemia koʻikoʻi), hiki ke ʻike ʻia nā hōʻailona aʻe, a ʻaʻole pono e lawe māmā ʻia kēia mau mea:

• ʻEha i nā ʻiʻo a me nā iwi
• Nāwaliwali koʻikoʻi o nā ʻiʻo
• Nā loli i ke ʻano - no ka laʻana, hiki ʻole ke noʻonoʻo, e huhū maʻalahi
• Ka hāʻule ʻana o ka hanu a i ʻole ka puʻuwai
• Manaʻo o ka nāwaliwali, emi iho ka pane ʻana
• Loaʻa i kahi hoʻopā (seizure)

He mea nui loa kēia: Inā ʻaʻole mālama koke ʻia ka hypophosphatemia koʻikoʻi , hiki iā ia ke alakaʻi i ka coma a me ka make . No laila, inā loaʻa iā ʻoe a i ʻole kekahi āu i ʻike ai kēia mau hōʻailona koʻikoʻi, pono ʻoe e hele koke i ka haukapila kokoke loa.

Inā ua lōʻihi ka manawa (Chronic Hypophosphatemia)

ʻO ka poʻe i loaʻa ka haʻahaʻa o ka phosphate no ka manawa lōʻihi (hypophosphatemia mau) e ʻike paha i nā hōʻailona e like me:

• ʻEha i nā iwi
• Nā haki iwi
• Nāwaliwali
• Makemake nui

Hiki i nā keiki ʻōpio me nā pae phosphate haʻahaʻa i ka manawa lōʻihi ke hoʻomohala i nā hōʻailona o kahi maʻi i kapa ʻia ʻo rickets , ʻo ia hoʻi:

• ʻO ka nalowale o ke kiʻekiʻe no ka makahiki
• Ke kūlou ʻana o nā wāwae e like me ke kakaka
• Ka hoʻonui ʻia ʻana o nā wahi pulima a me nā kuʻekuʻe wāwae ma muli o nā loli o nā iwi

Inā loaʻa iā ʻoe a i kāu keiki paha kekahi o kēia mau hōʻailona, ​​​​he mea nui loa e ʻimi i ke kōkua lapaʻau.

He aha nā kumu o ka (Hypophosphatemia)?

Aia kekahi mau kumu e hiki ai ke loaʻa kēia ʻano. ʻOkoʻa nā kumu ma muli o ka mea he akahai a koʻikoʻi paha, koke, a lōʻihi paha.

Nā kumu o ka hypophosphatemia waena a koʻikoʻi

Hiki ke loaʻa ka hemahema phosphate ma ke ʻano waena a koʻikoʻi paha i nā kūlana aʻe:

• I ka wā e ho'ōla ai mai ka diabetic ketoacidosis (DKA)
• Ka hoʻohana ʻana i ka waiʻona a me ka haʻalele ʻana i ka waiʻona
• Nā kuni nui
• ʻO ka maʻi hānai hou : He ʻoi aku ka paʻakikī o kēia. I ka ʻōlelo maʻalahi, ʻo ia ka hoʻi koke ʻana i ka meaʻai ma hope o kahi manawa hoʻokē ʻai, kahi e hoʻoulu ai i nā loli weliweli, i kekahi manawa hoʻoweliweli i ke ola, i nā pae wai a me nā electrolyte i loko o ke kino.
• ʻO ka alkalosis hanu koʻikoʻi: ʻO kēia ka manawa ʻaʻole lawa ka carbon dioxide i loko o ke koko.

Nā kumu o ka hypophosphatemia lōʻihi

• Ka hoʻonui ʻia o ka nui o ka hormone parathyroid, no ka laʻana ma ke ʻano "Hyperparathyroidism".
• ʻO nā hemahema hormonal ʻē aʻe, e like me ka Cushing's syndrome.
• Ka nele o ka wikamina D.
• ʻO ka Malabsorption kahi kūlana i komo pono ʻole ai ka meaʻai ma muli o ka ʻai ʻole a me nā pilikia o ka ʻōpū.
• ʻO nā hemahema electrolyte ʻē aʻe, e like me ka magnesium haʻahaʻa (hypomagnesemia) a me ka potassium haʻahaʻa (hypokalemia).
• ʻO ka lāʻau lapaʻau no ka nele o ka hao, ʻo ia ka hoʻokomo ʻana i ka hao IV, ʻoiai ke ʻano i kapa ʻia ʻo ferric carboxymaltose (FCM). Hana pinepine ʻia kēia ke lawe mau ʻia ka hao ma kēia ʻano.
• Hoʻohana ʻia ka diuretics no ka manawa lōʻihi.
• Ka hoʻohana pinepine ʻana a nui ʻole paha i nā antacids phosphate-binding, i kūʻai ʻia mai kahi hale kūʻai lāʻau me ka ʻole o ke aʻo lapaʻau. Hoʻokomo pū kēia i nā antacids i loaʻa ka alumini, calcium, a me ka magnesium.
• Ka lāʻau make ʻana e ka lāʻau lapaʻau i kapa ʻia ʻo theophylline, i hāʻawi ʻia i nā wahine hāpai.

ʻO ka poʻe me ka maʻi puʻupaʻa holomua (ʻoi aku ka poʻe ma ka dialysis) lawe i nā lāʻau lapaʻau i kapa ʻia ʻo "phosphate binders" me nā meaʻai, i kuhikuhi ʻia e kā lākou loea puʻupaʻa, e kaupalena i ka omo ʻana o ka phosphate mai ka meaʻai. Hiki i kēia mau mea ke hana i nā pae phosphate haʻahaʻa inā hoʻohana lōʻihi.

Pehea e ʻike ʻia ai kēia maʻi (Hypophosphatemia)?

He mea maʻalahi loa kēia e ʻike ai. E hana ke kauka i kahi hoʻāʻo koko e nānā i ka pae o ka phosphate i loko o kou koko . Inā emi ka nui o ka phosphate o kou koko ma mua o 2.5 milligrams i kēlā me kēia deciliter (mg/dL), ua ʻōlelo ʻia ʻoe he "Hypophosphatemia".

ʻO ka pae phosphate koko maʻamau no nā pākeke ma waena o 2.5 a me 4.5 mg/dL, a no nā keiki, ma waena ia o 4.5 a me 6.5 mg/dL. Eia nō naʻe, hiki ke ʻokoʻa iki kēia mau waiwai mai kēlā me kēia keʻena hoʻokolohua.

I nā hihia he nui, ʻoiai ma nā hihia o ka hypophosphatemia koʻikoʻi, hiki ke ʻike maopopo ʻia ke kumu ma muli o kāu mōʻaukala olakino a me nā hōʻailona.

No ka mea, ʻo ka hypophosphatemia ka hopena pinepine o kekahi maʻi ʻē aʻe, hiki i kāu kauka ke kauoha i nā hoʻokolohua hou aʻe e hoʻoholo i ke kumu a loiloi i kou olakino holoʻokoʻa. Hiki i kēia mau mea ke komo pū me:

• Nā hoʻokolohua koko ʻē aʻe: Nā hoʻokolohua hana puʻupaʻa, nā hoʻokolohua koko calcium, nā hoʻokolohua koko vitamin D.
• Ka nānā ʻana i ka mimi.
• Malia paha he mau scan kiʻi.

He aha nā lāʻau lapaʻau no ka (Hypophosphatemia)?

ʻO ka lāʻau nui e mālama i ke kumu nui o kēia ʻano, me ka hoʻihoʻi ʻana i nā pae phosphate i loko o ke koko.

Hāʻawi pinepine ʻia nā poʻe me ka hypophosphatemia ʻoluʻolu a me ka haʻahaʻa i nā pila pani phosphate waha. Hiki i kāu kauka ke ʻōlelo aku i ka ʻai ʻana i nā meaʻai kiʻekiʻe i ka phosphorus.

Eia nō naʻe, inā koʻikoʻi ke kūlana, hāʻawi ʻia ka phosphate ma ke ʻano intravenous (ma o ka IV) .

Aia kekahi mea hiki iā mākou ke hana e pale aku ai i kēia kūlana?

ʻOiaʻiʻo, ʻaʻole hiki ke pale ʻia nā hihia āpau o ka hypophosphatemia, ʻoiai nā mea koʻikoʻi a koke. Eia nō naʻe, ʻo ka ʻai ʻana i kahi meaʻai olakino a kaulike hiki ke pale i nā pae phosphate liʻiliʻi.

He aha nā meaʻai i loaʻa ka phosphorus kiʻekiʻe?

• ʻIʻo, iʻa a me nā protein ʻē aʻe: Nā ʻāpana e like me nā hua manu, moa, pelehū, puaʻa, meaʻai kai, a me ke ake.
• Nā huahana waiū: waiū, tīhi, tīhi hale liʻiliʻi, yogurt.
• Nā nati a me nā hua: nā ʻalemona, nā cashews, nā nati Brazil, nā hua paukena, nā hua sesame.

Mea nui: Ma mua o ka hana ʻana i kekahi mau hoʻololi nui i kāu meaʻai, e kamaʻilio me ke kauka a meaʻai meaʻai paha.

Inā loaʻa iā ʻoe kahi maʻi e hoʻonui ai i ka pilikia no ka hypophosphatemia, e like me ka hyperparathyroidism, nā pilikia malabsorption, a i ʻole ka nele o ka vitamin D, he mea nui e ʻike pinepine i kāu kauka a hahai i kāu hoʻolālā lapaʻau. Hiki i kēia ke kōkua i ka pale ʻana i ka hypophosphatemia.

He aha ka mea e hiki mai ana? (Wānana)

ʻO ka wānana o kēia maʻi e pili ana i ka mea he akahai a koʻikoʻi paha, hoʻomaka koke, a i ʻole ka lōʻihi. ʻO ka maʻamau, pane maikaʻi nā hihia akahai i ka lāʻau lapaʻau, ʻo ia hoʻi hiki ke ho'ōla ʻia. Eia nō naʻe, hiki i nā hihia koʻikoʻi a hoʻomaka koke ke alakaʻi i nā pilikia koʻikoʻi inā ʻaʻole mālama koke ʻia.

Hiki ke loaʻa nā pilikia ma muli o ka (Hypophosphatemia)?

ʻAe, inā ʻaʻole mālama ʻia, ʻoiai inā he emi lōʻihi ka phosphate (hypophosphatemia mau), hiki ke ulu kahi kūlana i kapa ʻia ʻo osteomalacia . I ka ʻōlelo maʻalahi, ʻo ia ka manawa e palupalu ai nā iwi a haki maʻalahi .

E like me ka mea i ʻōlelo ʻia ma mua, inā loaʻa iā ʻoe nā hōʻailona koʻikoʻi o ka hypophosphatemia, e like me ka ʻeha ʻiʻo i wehewehe ʻole ʻia a me nā loli i ke kūlana noʻonoʻo, he mea nui loa ia e hele i ka haukapila kokoke loa i ka hikiwawe loa.

ʻO ka mea hope loa, e hoʻomanaʻo i kēia.

No laila, ʻo kēia phosphate a mākou i kamaʻilio ai i kēia lā he "electrolyte" koʻikoʻi loa ia i loko o ko kākou koko. Hiki ke ʻike ʻia kahi emi iki o ka phosphate (ʻo ia hoʻi ka "mild hypophosphatemia") ma kahi hoʻāʻo koko a ʻaʻole ia he mea e hopohopo ai. Inā hana ʻia kēlā, e haʻi aku kāu kauka iā ʻoe e ʻai hou aku i nā meaʻai i kiʻekiʻe i ka phosphorus.

Eia nō naʻe, inā he maʻi kou a i ʻole kahi ʻano maʻamau e hoʻoweliweli iā ʻoe no ka nele nui o ka phosphate, e like me ka inu nui ʻana i ka waiʻona a i ʻole ka malabsorption ʻōpū, ʻoi aku ka maikaʻi o ke kamaʻilio ʻana me kāu kauka e pili ana i ia mea. E nīnau iā lākou pehea e pale aku ai i ka hypophosphatemia a me nā hōʻailona e makaʻala ai. E hoʻomanaʻo, ʻo kāu kauka kou hoaaloha maikaʻi loa ma kāu huakaʻi olakino. Hiki iā lākou ke kōkua iā ʻoe.

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