He maha ngā wā ka ngoikore koe, ka mamae ō wheua? I tirohia rānei e tō tākuta he pūrongo toto, ā, ka mea, "He paku teitei tō taumata konupūmā"? Ko te take pea o tēnei he āhuatanga kāore e tino kōrerohia ana, engari he mea tino nui. I tēnei rā, me kōrero tātou mō tēnei āhuatanga e kiia nei ko te hyperparathyroidism i roto i tētahi huarahi māmā e mārama ai koe.
He aha te hyperparathyroidism?
Ki te whakarapopototanga, ko te hyperparathyroidism te wā ka nui rawa te mahi a tētahi, neke atu rānei o ō repe parathyroid, ā, ka nui rawa te homoni parathyroid (PTH) e whakaputa ana. Ka piki ake te taumata konupūmā i roto i tō toto. E kiia ana tēnei e te rongoā he hypercalcemia .
Whakaarohia, i muri i te repe tairoiti i roto i tō tātou kaki, e whā ngā repe iti e rite ana te rahi ki te kakano raihi. Ko ēnei e kiia ana ko ngā repe parathyroid. Pērā i te pōro e whakahaere ana i te taumata wai i roto i tō tātou tāke wai i te kāinga, ko te mahi matua o ēnei repe he whakahaere i ngā taumata konupūmā me te phosphate i roto i ō tātou toto ki ngā taumata tika.
Koinei te āhua o tana mahi:
- Ina heke te taumata o te konupūmā i roto i te toto, ka whakaputahia e ēnei repe te homoni PTH.
- Ka tukuna e tēnei homoni PTH he tohu ki ō tātou wheua kia "tukuna ētahi konupūmā ki roto i te toto".
- Ka kī atu hoki ki ngā whatukuhu kia "whakaitihia te nui o te konupūmā e tukuna ana i roto i te mimi, kia mau tonu hoki ki roto i te tinana."
- Kātahi ka whakahohehia e ngā whatukuhu te huaora D ka tukuna ki ō tātou whekau . Kātahi ka mimitihia e ngā whekau te konupūmā i roto i ngā kai e kainga pai ana e tātou.
He pūnaha tino taurite tēnei. Heoi, i roto i te hyperparathyroidism, ka nui rawa te whakaputanga o te homoni PTH, ka tukuna tonutia e ngā wheua te konupūmā, ka angiangi, ka pakarukaru hoki. Hei tāpiri, ko te konupūmā tāpiri e kohia ana i roto i te toto ka taea te whakatakoto ki roto i ngā whatukuhu (ka taea te hanga kohatu), ngā uaua toto, te ngākau, me ētahi atu okana, ka puta ai ngā raruraru hauora.
He aha ngā momo matua o tēnei āhuatanga?
E toru ngā momo matua o te hyperparathyroidism, e whakarōpūtia ana i runga i te āhua o tōna putanga mai.
| Momo | Hei whakarāpopototanga... |
|---|---|
| Te hyperparathyroidism tuatahi | Ko te raruraru i tēnei take kei te repe parathyroid tonu. Mā te pukupuku (ehara i te matepukupuku te nuinga) i roto i te repe, mā te whakanui rānei i te repe ka puta te homoni PTH i te tinana ahakoa kāore e hiahiatia ana. |
| Te hyperparathyroidism tuarua | Ehara i te he o ngā repe i konei. Ko tētahi atu mate hauora (he maha ngā wā ko te Mate Tākihi Mau tonu) ka heke ai ngā taumata konupūmā o te tinana. Hei whakautu, ka tīmata ngā repe parathyroid ki te mahi i te wā roa hei whakakapi i te ngoikore. |
| Te hyperparathyroidism tuatoru | Ka puta tēnei ina roa te wā kāore i rongoatia te mate tuarua. Ka kaha tonu te mahi a ngā repe, ka nui haere, ka whakaputa i te homoni PTH me te kore e taea te whakahaere. |
He aha ngā tohu?
Ko te nuinga o te hunga e pāngia ana e tēnei mate kāore he tohu . He maha ngā wā ka kitea ngā taumata konupūmā toto tiketike i roto i te whakamātautau toto mō tētahi atu take. Heoi, ko ētahi tāngata, inā koa he tino tiketike ō rātou taumata konupūmā, ka pāngia pea e ēnei tohu e whai ake nei:
- Mamae wheua me ngā hononga
- ngoikore o te uaua
- Te ngenge tonu me te ngenge
- Te pouri
- He uaua ki te arotahi ki tētahi mea
- Hiahia kai
- Whakapairuaki me te ruaki
- Te pōhēhē, te wareware i ngā mea
- Te tino matewai me te hiahia ki te mimi pinepine
- Te kōroke
Kia maumahara, he tino noa ēnei tohu. Ehara i te mea ko te hunga katoa e pāngia ana e ēnei tohu he hyperparathyroidism. Engari ki te mau tonu ēnei tohu, he pai ake te toro atu ki te tākuta.
He aha te take o tēnei?
Me titiro tātou ki ngā take mō ngā momo e toru i kōrerotia e tātou i mua ake nei.
Ngā Take o te Hyperparathyroidism Tuatahi
- Adenoma: He pukupuku kore-matepukupuku tēnei e puta mai ana i roto i te repe parathyroid. Koinei te tino take o te hyperparathyroidism tuatahi.
- Hyperplasia: Koinei te wā ka nui haere tetahi o ngā repe parathyroid.
- Matepukupuku:He tino onge te take o te mate pukupuku o ngā repe parathyroid.
Ngā Take o te Hyperparathyroidism Tuarua
Ko te tino take o tēnei ko te Mate Tākihi Mau tonu (CKD) . Ina kore e mahi tika ngā tākihi, ka piki ake ngā taumata phosphate i roto i te tinana, ka heke hoki ngā taumata huaora D. Ka heke iho ngā taumata konupūmā i roto i te toto. Nō reira, hei utu mō tēnei korenga o te konupūmā, ka nui rawa te homoni PTH e whakaputaina ana e ngā repe parathyroid.
Hei tāpiri, ka taea hoki tēnei e te korenga nui o te huaora D (nā te kore e whiti ki te rā, nā te kore rānei o ngā kai e tika ana).
Me pēhea te mohio ki tēnei āhuatanga?
Ka whakarongo tō tākuta ki ō tohumate, ka tirotiro i a koe, ā, ka tuku i a koe mō ētahi whakamātautau mēnā e whakapae ana rātou kei a koe tēnei mate.
| Whakamātautau | He aha tāu e titiro atu nei? |
|---|---|
| Ngā Whakamātautau Toto | Ka tirohia ngā taumata o te konupūmā, te homoni PTH, te huaora D, te phosphate, me te mahi a te whatukuhu (Creatinine) i roto i te toto. |
| Whakamātautau Mimi 24-hāora | Ka inehia te nui o te konupūmā i roto i te mimi i kohia i roto i ngā haora 24. |
| Matawai Parathyroid | Mā tēnei ka āwhina i te tautuhi ko tēhea repe e kaha rawa ana te mahi. He mea tino nui tēnei i mua i te pokanga. |
| Matawai Ultrasound | Ka whakamahia hei tirotiro i te āhua o ngā repe me ngā whatukuhu i te kaki. |
| Matawai Kīanga Wheua | Ka mahia tēnei whakamātautau hei tirotiro mēnā kua ngaro te konupūmā o ngā wheua, ā, kua angiangi (Osteoporosis). |
Me pēhea te rongoā?
Ko ngā tikanga maimoatanga e whakawhirinaki ana ki te momo tuatahi, tuarua rānei, me te kaha o te mate.
Te maimoatanga mō te hyperparathyroidism tuatahi
Ko te otinga pai rawa atu, ā, ko te otinga pumau rawa atu mō tēnei ko te mahi pokanga (parathyroidectomy) hei tango i te repe, i ngā repe rānei e kaha rawa ana te mahi. Whai muri i tēnei pokanga, neke atu i te 90% o te tangata ka hoki ki ngā taumata konupūmā toto noa.
Mena kei raro iho koe i te 50 tau te pakeke, he tohu tōu, he tino nui ō taumata konupūmā, he kōhatu tākihi tōu, he kikokore rānei ō wheua, ka tino taunaki tō tākuta kia pokanga koe.
Mēnā kāore i te kino rawa, ā, kāore e hiahiatia he pokanga, ka aroturukihia tō āhua e tō tākuta i ia wā, i ia wā. Tērā pea ka:
- Ngā Bisphosphonates: Ka ārai ēnei rongoā i te tukunga o te konupūmā mai i ngā wheua, ā, ka whakapakari i a rātou.
- Ngā Calcimimetics: Ka "tinihanga" ēnei rongoā i ngā repe parathyroid kia whakaitihia ai te hanga o te homoni PTH.
- Ngā huringa āhua noho: Ka tohutohuhia pea koe kia mutu te tango i ētahi rongoā (hei tauira, ngā rongoā diuretic thiazide, lithium) me te mahi i ngā huringa kai.
Te maimoatanga mō te hyperparathyroidism tuarua
Ko te mea nui i konei ko te rongoā i te pūtake o te mate , pērā i te whakahaere i te mate tākihi me te rongoā i te ngoikore o te huaora D.
- Tērā pea me dialysis, me whakawhitinga whatukuhu rānei te tangata e mate ana i te tākihi.
- Ka hoatu ngā rongoā pēnei i ngā here phosphate hei whakaiti i ngā taumata phosphate i roto i te toto.
- Ka whakamahia hoki te huaora D me ngā rongoā calcimimetic mō tēnei kaupapa.
Mena kāore e taea e ēnei maimoatanga te whakahaere i te āhua, me mahi pea te pokanga.
Ko te mea nui, kaua e tango noa i ngā pire huaora D, i te konupūmā rānei. Me kōrero tonu ki tō tākuta, ā, me whakamahi noa i ngā mea kua tohua. I ētahi wā ka kino ake te āhua.
Karere Tangohia ki te Kāinga
- Ko te Hyperparathyroidism he āhuatanga e piki ai ngā taumata konupūmā i roto i te toto nā te nui rawa o te hanga o te homoni PTH e ngā repe parathyroid.
- I te nuinga o te wā, kāore he tohu motuhake. Tērā pea ka pāngia koe e ngā tohu whānui pērā i te ngenge me te mamae o te wheua.
- Ko te momo tuatahi ka puta mai i tētahi raruraru i roto i te repe tonu, ko te take matua ia o te momo tuarua ko te mate tākihi mau tonu.
- Ka kitea te mate mā te toto, ngā whakamātautau mimi, me ngā karapa.
- Ko te maimoatanga pai rawa atu mō te momo tuatahi ko te tango pokanga i te repe e pāngia ana.
- Me kōrero tonu ki tō tākuta i mua i te whakamahi i tētahi rongoā, huaora rānei.
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