I-Cerebral I-Syrium Yokudambisa Isilonda kunye ne-SIADH njengezizathu zeNqanaba leSodium
Amanqanaba e-sodium ephantsi (hyponatremia) kwizigulane ze-neurology zingakhokelela ekuthinjeni okanye kwi-coma. Kwizigulane ezinomonakalo wengqondo, iqondo lezinga lezantsi le-sodium egazini lingabangela ukuba amanzi aphephe kwiindonga zeemithwalo zegazi kunye nokukhukhumaza kakhulu kwiingqondo. Ngakolunye uhlangothi, inqanaba le-sodium eliphezulu kakhulu (hypernatremia) lidla ngokuba ngumqondiso wokungcola.
Kwiimeko ezigqithiseleyo, oku kunokukhokelela ekuthinjeni nakwi-coma.
Kutheni uhlolisisa i-Sodium Levels okanye iNqanaba eliPhantsi leSodium level Matters
Ukuhlola i-electrolytes njenge-sodium, i-potassium, i-calcium kunye ne-bicarbonate isebenza ngokuqhelekileyo esibhedlele. Enyanisweni, iphaneli ye-electrolyte ihlala iqukwa kwigazi lemihla ngemihla ukulungiselela ukuqinisekisa ukuba amanqanaba ala ma khemikhali abalulekileyo asemida. Nangona abanye bebanokuthi ukutshekisha le mihla yonke kuninzi kwizigulane ezininzi, kukho izizathu ezintle zokukhathazeka ukuba amazinga e-electrolyte aqhelekanga, kwaye ngokuqinisekileyo kufuneka ahlolwe ubuncinci imihla ngemihla kwiyunithi yonyango enamandla.
Ngenxa yokuba ukukhukhuza kwengqondo kunokukhokelela ekutheni umonakalo, umonakalo ophezulu wengqondo, nokufa, oogqirha kwi-ICU ye-neurological bahlala bekhathalele ngokukhethekileyo ukuphepha amanqanaba e-sodium ephantsi. Ngelishwa, iziphazamiso ezinjenge- sarachnoid , i- tumor , i- stroke kunye ne- meningitis zingabangela i-hyponatremia, kwaye yonakalisa ukuvuvukala kwengqondo.
Indlela abenza ngayo ngoku kukuguqula ulawulo oluqhelekileyo lwe-hormone yamanzi kunye namanqanaba e-sodium emzimbeni.
Ubume bemiSebenzi yeSodium
Kuqhelekile kubafundi bezobugqirha beminyaka yokuqala badideke kwiimeko zeengxaki ze-sodium. Kubalulekile ukukhumbula ukuba oko ixabiso lebhu legazi ngokwenene lilinganisa ingqwalaselo.
Oko kukuthi, ixabiso limela inani le-sodium ngomlinganiselo wamanzi. Kukho iindlela ezimbini, ngoko, ukuba le nqanaba ingaba phantsi:
- I-sodium ingaba yinani eliphantsi, okanye
- Kukho ukwanda kwindleko yamanzi.
Enyanisweni, imeko yokugqibela ixhaphakile kwaye inokunceda ukujonga iibhola ezi-5 ze-ping-pong zihamba ngebhodi lwamanzi. Ibhola ngalinye limele i-molecule ye-sodium. Ukuba ibhobho yamanzi ibancinci, iibhola ziya kuhlanganiswa ngokuqinileyo-oku kufana nokuthi ukugxininisa kuphezulu.
Ukuba ibhokhwe inkulu (oko kukuthi, amaninzi amanzi), iibhola ziya kuba kude kakhulu-oku kufana nokuthi ukuxinwa kuphantsi. Enyanisweni, inani leebhola ze-ping-pong lihlala lifanayo. Ngokuqhelekileyo, i-hyponatremia ngokuqinisekileyo ibonisa inani elininzi lomkhuhlane, njengolu hlobo ngebhotile enkulu yamanzi.
Ama-syndromes angabangela i-Hyponatremia
Iimeko ezininzi ezinokuthi zikwazi ukukhokelela kwi-hyponatremia, kodwa ngokukodwa kwi-neurology, i-syndromes 2 ingabangela i-sodium concentrations ephantsi:
I-Syndrome ye-Hormone Hypersection (iSHAD). Le syndrome yindlela enye i-concentrations ye-sodium ingaba yinto ephantsi. I-hormone ye-antidiuretic (ADH) iqhelekileyo ibanjwe ngumzimba ukugcina amanzi.
Oku kunokuba luncedo kakhulu, umzekelo, ngosuku lokushisa kwehlobo. I-hormone ivame ukugcinwa ngetekisi xa amazinga amanzi afikelela kwisixa esithile. Kwi-SIADH, iibhuleki eziqhelekileyo kwi-ADH yokufihla ayisebenzi, kwaye umzimba uyazigcina amanzi.
Ngelishwa, iingxaki ezininzi zeengxaki ze-neurological zibangelwa i-SIADH, ehlahlela isixa esinxulumene nesodium kwi-blood circulation kwaye ingabangela ngakumbi ukuqhuma kwengqondo. Oku kungakhokelela ekuhlaleni apho ingxaki efana ne-meningitis ibangela i-SIADH, ebangela ukuvuvukala kwengqondo, eyonakalisa iSADH, njalonjalo.
I-SIADH inokubangelwa ezinye iingxaki ngaphandle kokulimala kwegazi. Ngokomzekelo, iingxaki zomphunga ezifana nomhlaza okanye umpneumonia ungabangela i-SIADH, njengokuba uninzi lwamachiza afana ne-carbamazepine kunye ne-amitriptyline.
Isiyobisi esingekho mthethweni singabangela i-SIADH.
Njengoko sixoxile, nangona i-SIADH ibangela iqondo le-sodium ephantsi, lenza njalo ngenxa yokungena kwamanzi. Ngoko ke unyango ke ukunciphisa ubuninzi bamanzi isigulane, kwaye uqinisekise ukuba isizathu esicwangcisiweyo sibhekiswe.
I-Cerebral Salt Symphony (CSWS). Le syndrome ibangelwa ngumonakalo wengqondo, ibangela ukulahlekelwa kwe-sodium, kwaye ngoko, kunokuba nzima ukuhlula kwi-SIADH. Nangona kunjalo, le ndlela ihluke kakhulu.
I-cerebral ityuwa yokutshabalalisa yinto ehlukile kwimigaqo yokuba i-hyponatremia imele imilinganiselo ephezulu ngokungapheliyo yokugcina amanzi. Njengoko igama lisikisela, ukutshabalala kwetyuwa yecerebral kubangelwa ngumzimba oqhekeza ityuwa. Ukubuyela kumzekelo wethu wangaphambili, kunjengokuba iibhola ze-ping-pong zisuswe ngokusemthethweni kwinqanaba, kubangela ukuba ukugxininiswa kwehle.
Ukutshatyalaliswa kwetyuwa ye-cerebral ngokuqhelekileyo kubonakala malunga neveki emva kokulimala kwengqondo kwaye isombulula emva kweveki ezimbini ukuya kwezine. Nangona kunjalo, ngezinye iinkqubo kunokuhlala ixesha elide, lihlala iminyaka.
Ngelixa i-SIADH inokubangela ukuba umgangatho womzi womhlaba wonke unyuke okanye ubuncinci uhlale ufana, utywala lwe-cerebral ukuchitha ukhokelela ekudambiseni amanzi. Le ngenye yezindlela ezikuphela zokwahlula phakathi kwezi ngxaki ezimbini, ngokukodwa kwisigulane esingazi kakuhle okanye esithandanayo .
Izinyango Zonyango
Kubalulekile ukuzama ukuxelela umahluko phakathi kwe-CSWS ne-SIADH kuba iingxaki ezimbini ziphathwa ngokuhlukileyo. Kwi-CSWS, isigulane sidinga amanzi okanye iya kuba yilapha. Kwi-SIADH, iqela lomzimba wonke we-sodium empeleni lihlala lifanayo, kodwa inani le-sodium ngomlinganiselo wamanzi liwela ngenxa yokuba umzimba ugcina amanzi amaninzi. Ukunikezela ngamanzi kuza kwenza ukuba ingxaki ibe yimbi ngakumbi, kwaye ngoko izigulane ze-SIADH ziphathwa ngokunciphisa inani lemveliso yamanzi yonke imihla. Ukutshintsha umahluko kunokuba nzima, kwaye sinye yezizathu ezininzi zokuba izigulane zizuze kwiiyunithi ezizodwa zonyango xa zixinzeleleke kakhulu.
Imithombo:
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I-Ropper AH, i-Samuels MA. I-Adams kunye neMigaqo yeVictor ye-Neurology, 9-ed: I-McGraw-Hill Companies, Inc., 2009. Ilungu leMcCabe, u-O'Connor EJ.
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