Tonsefe takhala tikumva mwambi kuyambira tili ana: "Musadye mchere wambiri, si wabwino kwa thupi lanu." Ndipotu, tikudziwa kuti mchere wambiri, kapena sodium, ungawonjezere kuthamanga kwa magazi ndikuyambitsa matenda a mtima. Koma kodi munayamba mwaganizapo kuti mchere wochepa m'thupi ungakhale woopsa mofanana, ndipo nthawi zina woopsa kwambiri? Ndicho chimene timachitcha hyponatremia mu zamankhwala. Ngakhale kuti izi zingawoneke ngati nkhani yovuta, lero tikambirana za izo m'njira yosavuta yomwe mungamvetse.
Mwachidule, kodi Hyponatremia ndi chiyani?
Hyponatremia ndi pamene mulingo wa sodium m'magazi mwanu (gawo lalikulu la mchere womwe timadya) uli wochepa kuposa wabwinobwino. Kawirikawiri, mulingo wa sodium m'magazi mwa munthu wathanzi uyenera kukhala woposa 135 milliequivalents pa lita imodzi (135 mEq/L). Ngati mtengo uwu uli pansi pa 135, timatcha vutoli Hyponatremia.
Tsopano mwina mukuganiza kuti, "O... chimachitika ndi chiyani ngati titaya mchere pang'ono?" Koma sizophweka choncho. Kuti chilichonse m'thupi lathu chigwire ntchito bwino, chilichonse chiyenera kukhala chofanana. Kugwirizana pakati pa madzi ndi sodium ndikofunikira kwambiri. Ngati kuyanjana kumeneku kwatayika, kutanthauza kuti, ngati kuchuluka kwa madzi m'thupi kukuwonjezeka ndipo sodium ikachepa, madzi ochulukirapo amayamba kulowa m'maselo a thupi lathu. Kenako maselo amenewo amatupa. Ngakhale izi zitha kuchitika kulikonse m'thupi, kutupa kwa maselo a ubongo ndi koopsa kwambiri.
Tangoganizani mukupanga tiyi. Chimachitika ndi chiyani ngati muwonjezera shuga pang'ono ndi madzi ambiri? Kukoma kwa tiyi kumatayika, sichoncho? Umu ndi momwe zimakhalira. Madzi ambiri m'thupi akachuluka kuposa sodium m'thupi, kuchuluka kwa sodium m'magazi kumachepa. Ngati impso zathu zikugwira ntchito bwino, vutoli nthawi zambiri silimachitika ngakhale titamwa madzi ochulukirapo. Komabe, chifukwa cha matenda ena, mankhwala, kapena ngati tituluka thukuta kwambiri, monga kuthamanga marathon, ndikumwa madzi okha panthawiyo, tilibe ma electrolyte omwe thupi lathu limafunikira.
Kodi pali mitundu ikuluikulu ya Hyponatremia?
Inde, madokotala amagawa Hyponatremia m'magulu atatu akuluakulu kuti zikhale zosavuta kupeza chomwe chimayambitsa vutoli. Zimatsimikiziridwa ndi kuchuluka kwa madzi ndi sodium m'thupi. Tiyeni timvetse motere.
| Mtundu wa Hyponatremia | Mwachidule, chimachitika n’chiyani? |
|---|---|
| Euvolemic Hyponatremia (kuchepetsa) | Chomwe chimachitika pamenepa n’chakuti ngakhale kuchuluka kwa sodium m’thupi kuli pamlingo wabwinobwino, kuchuluka kwa madzi kokha ndiko kumawonjezeka. Kunena zoona, mcherewo umachepetsedwa. |
| Kuchuluka kwa mpweya m'thupi (Hyponatremia) | Pamenepa, madzi ndi sodium m'thupi zimawonjezeka. Koma kuchuluka kwa madzi kumawonjezeka kwambiri kuposa kuchuluka kwa sodium. Izi zimathandizanso kuchepetsa sodium m'thupi. Mutha kuona kutupa m'thupi. |
| Hypovolemic Hyponatremia | Pankhaniyi, madzi ndi sodium zimatayika m'thupi. Komabe, kuchuluka kwa sodium komwe kumatayika kumakhala kwakukulu kuposa kuchuluka kwa madzi komwe kumatayika. Izi nthawi zambiri zimachitika munthu akamasanza kwambiri kapena kutsegula m'mimba. |
Dokotala wanu akangodziwa mtundu wa matenda omwe muli nawo, zidzakhala zosavuta kudziwa chomwe chikuyambitsa komanso chithandizo chabwino kwambiri.
Kodi zizindikiro za vutoli ndi ziti?
Zizindikiro za hyponatremia zimatha kusiyana malinga ndi momwe sodium ilili yotsika komanso momwe imatsikira mofulumira. Nthawi zina, pamene sodium imatsika pang'onopang'ono (Chronic Hyponatremia), sipangakhale zizindikiro zazikulu. Koma ngati kuchepako kukuchitika mwadzidzidzi (Acute Hyponatremia), zizindikirozo zimatha kukhala zazikulu.
Zizindikiro zomwe zingawonekere nthawi zambiri ndi izi:
- Kugwedezeka kwa minofu kapena kufooka.
- Kusanza ndi kusanza .
- Kutopa kwambiri komanso kutopa. Kumva ngati simungathe kuchita chilichonse.
- Mutu .
- Kusokonezeka: Kuiwala komwe uli, zomwe ukuchita, ndikusokonezeka ndi zomwe ukunena.
- Kugwidwa ndi khunyu ndi matenda omwe amafanana ndi khunyu.
Nchifukwa chiyani izi zimachitika? Zifukwa za Hyponatremia
Nthawi zambiri, chifukwa chachikulu cha Hyponatremia ndi matenda omwe amachititsa kuti thupi lisunge madzi ambiri, zomwe zimapangitsa kuti sodium isungunuke. Kupatula apo, imathanso kuchitika chifukwa cha kutayika kwa sodium m'thupi (komwe kumakhala kochepa pang'ono).
Nazi zina mwa zifukwa zazikulu zomwe zimakhudza vutoli:
- SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion): Ichi ndi vuto la mahomoni. Pankhaniyi, mahomoni (ADH) omwe amalamulira kutulutsa madzi m'thupi lathu amatulutsidwa mopitirira muyeso. Izi zimachepetsa kutulutsa madzi m'impso, zomwe zimapangitsa kuti madzi azisonkhana m'thupi ndikuchepetsa sodium.
- Kulephera kwa Mtima: Mtima ukakhala wofooka, kuyenda kwa magazi m'thupi sikwabwino. Izi zingayambitse madzimadzi kusonkhana m'thupi.
- Kulephera kwa Impso: Ntchito imodzi yayikulu ya impso ndikusefa madzi ochulukirapo ndi zinyalala m'thupi. Impso zikafooka, njirayi sigwira ntchito bwino, ndipo madzi amasonkhana m'thupi.
- Matenda a Cirrhosis a Chiwindi: Matendawa amatha kuchitika pamene ntchito ya chiwindi yasokonekera kwambiri.
- Mankhwala ena: Matendawa angayambitsidwe ndi "mapiritsi amadzi" (mankhwala ochepetsa mphamvu ya magazi) makamaka omwe amagwiritsidwa ntchito pochiza kuthamanga kwa magazi ndi mankhwala ena omwe amagwiritsidwa ntchito pochiza matenda amisala (SSRIs).
- Kutsegula m'mimba kwambiri kapena kusanza: Panthawiyi, madzi ndi sodium wambiri zimatayika m'thupi.
- Kumwa mowa mopitirira muyeso (Polydipsia): Kungayambitsidwenso ndi chilakolako chomwa madzi ambiri popanda chifukwa, zomwe zingabwere chifukwa cha matenda ena amisala.
- Kumwa mowa kapena mowa wambiri.
- Kugwiritsa ntchito mankhwala monga MDMA (Ecstasy).
Kodi uwu ndi matenda oopsa komanso oopsa?
Inde, ndithudi. Makamaka ngati kuchuluka kwa sodium m'thupi kutsika mwadzidzidzi komanso pang'onopang'ono kwambiri, kungakhale koopsa.
Monga ndanenera kale, pamene sodium m'magazi achepa, madzi ambiri amalowa m'maselo. Ngati izi zichitika ku maselo a muubongo, ubongo umatupa (cerebral edema). Ubongo wathu umatsekeredwa m'bokosi lopangidwa ndi mafupa lotchedwa chigaza. Choncho ubongo umakhala wopanda malo okwanira otupa. Ubongo ukatupa chonchi, umakankhira chigaza. Izi zingayambitse kuwonongeka kwa ubongo kosatha, chikomokere, kapena imfa.
Chifukwa chake, Hyponatremia si vuto loyenera kuonedwa mopepuka.
Kodi dokotala amapeza bwanji izi?
Mukapita kukaonana ndi dokotala, choyamba adzakufunsani za zizindikiro zanu. Kenako adzakuyesani ndikuyitanitsa mayeso angapo kuti atsimikizire vutoli ndikupeza chomwe chikuyambitsa.
- Kuyezetsa magazi: Iyi ndi njira yofunika kwambiri yoyezetsa magazi. Ikhoza kuwona kuchuluka kwa mchere m'magazi mwanu, monga sodium ndi potaziyamu, komanso momwe impso zanu zikugwira ntchito.
- Kuyesa mkodzo: Mukayang'ana kuchuluka kwa sodium mkodzo ndi kuchuluka kwake, mutha kudziwa chomwe chimayambitsa.
- Mayeso ena: Ngati kuli kofunikira, kutengera chifukwa chake, zinthu monga X-ray pachifuwa kapena CT scan ya ubongo zitha kuchitidwa.
Dokotala angakufunseninso za zinthu monga:
- Kodi mumamwa mankhwala ati?
- Ndi matenda ena ati omwe muli nawo?
- Kodi mumamwa mowa?
- Kodi nthawi zambiri mumamwa madzi angati patsiku?
Kodi Hyponatremia imachiritsidwa bwanji?
Chithandizo chimadalira momwe sodium yanu ilili yochepa, momwe zizindikiro zanu zilili zazikulu, komanso chomwe chinayambitsa.
- Kuchiza chomwe chimayambitsa vutoli: Gawo loyamba ndikuwongolera vuto lachipatala lomwe limayambitsa vutoli. Mwachitsanzo, ngati layamba chifukwa cha mankhwala, mankhwalawo akhoza kuyimitsidwa kapena kusinthidwa.
- Kuchepetsa kumwa madzi: Kawirikawiri, makamaka ngati muli ndi sodium yochepa kwambiri, dokotala wanu amakulangizani kuti muchepetse kuchuluka kwa madzi omwe mumamwa patsiku.
- Saline ya m'magazi: Ngati muli ndi sodium yochepa kwambiri kapena zizindikiro zanu zili zoopsa, mungafunike kugonekedwa m'chipatala ndikupatsidwa sodium kudzera mu mtsempha (saline).
- Mankhwala apadera: Nthawi zina, mankhwala apadera, monga tolvaptan, amaperekedwa kuti athandize kuchotsa madzi ochulukirapo m'thupi.
Mfundo yapadera yoti musamale nayo mukalandira chithandizo!
Izi ndizofunikira kwambiri. Madokotala akamachiza hyponatremia, amasamala kwambiri.
Chofunika kwambiri: N'koopsa kwambiri kubwezeretsa kuchuluka kwa sodium m'thupi mofulumira kwambiri, chifukwa kwatsika kwambiri. Kuchita izi kungayambitse matenda otchedwa ``Central Pontine Myelinolysis'' kapena ``Osmotic Demyelination Syndrome'', omwe angawononge ubongo kwamuyaya. Chifukwa chake, izi ziyenera kuchiritsidwa kuchipatala chokha, moyang'aniridwa ndi dokotala. Musayese kukonza vutoli nokha kunyumba mwa kumwa madzi amchere kapena kudya makapisozi amchere.
Kodi ndiyenera kupita liti kwa dokotala? Kodi ndiyenera kupita liti ku ETU?
Ichi ndi chinthu chomwe muyenera kudziwa bwino, chifukwa kuchitapo kanthu pa nthawi yake kungapulumutse moyo.
| Ngati muli ndi zizindikiro izi, pitani kwa dokotala nthawi yomweyo: | |
|---|---|
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| Ngati zizindikirozi zikupezeka, pitani naye wodwalayo nthawi yomweyo ku ETU (Emergency Treatment Unit): | |
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Uthenga Wopita Nawo Kunyumba
- Hyponatremia ndi vuto lomwe mchere (sodium) m'thupi umakhala wochepa. Ichi si chinthu chongopeka kapena kuseweretsa nacho.
- Nthawi zambiri, izi zimachitika chifukwa cha madzi ambiri m'thupi, m'malo modya mchere wochepa.
- Zizindikiro zake zimatha kuyambira kugwedezeka kwa minofu, kutopa, ndi mutu mpaka matenda oopsa monga chisokonezo ndi khunyu.
- Ngati muwona zizindikiro zilizonse zoopsa, monga chisokonezo kapena kusokonezeka maganizo, musachite china chilichonse ndipo nthawi yomweyo mutengereni wodwalayo ku chipatala cha Emergency Treatment Unit (ETU).
- Izi ziyenera kuchiritsidwa pokhapokha ngati dokotala akuyang'anira. Musayese kuchiza izi kunyumba, chifukwa kukweza kuchuluka kwa sodium mwachangu kungayambitse kuwonongeka kwa ubongo.
- Ngati muli ndi vuto lina la matenda lomwe limakuikani pachiwopsezo chotenga vutoli, lankhulani ndi dokotala wanu za vutoli ndikutsatira malangizo ofunikira.
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