Izinketho Zokwelashwa Kokungakwazi Ukwanela Kwe-Adrenal
I-Pengantar
Ukungakwazi ukusebenza kahle kwezindlala ze-adrenal kuyisimo esingavamile esenzeka lapho izindlala ze-adrenal zingakhiqizi ama-hormone abalulekile anele, ikakhulukazi i-cortisol, futhi kwezinye izimo, i-aldosterone. Lesi simo singaba yingozi empilweni uma singelashwa kahle. Izimbangela zokungakwazi ukusebenza kahle kwezindlala ze-adrenal zingahluka, kusukela enkingeni yokuzivikela komzimba ebhubhisa izindlala ze-adrenal (isifo sika-Addison) kuya ekukhuthazweni okunganele kwendlala ye-pituitary ukukhiqiza ama-hormone e-adrenal (ukungakwazi ukusebenza kahle kwezindlala ze-adrenal kwesibili). Lesi sihloko sizochaza izindlela ezahlukene zokwelapha ezitholakalayo zokungakwazi ukusebenza kahle kwezindlala ze-adrenal nokuthi zingasiza kanjani iziguli ukuba ziphile impilo evamile.
Ukuxilongwa Kokuntuleka Kwe-Adrenal
Ngaphambi kokuzama ukwelashwa, kubalulekile ukuqonda ukuthi ukuxilongwa okufanele kubalulekile ekuphatheni ukungasebenzi kahle kwe-adrenal. Ukuxilongwa kuvame ukufaka uchungechunge lokuhlolwa kwegazi ukukala amazinga e-cortisol, i-ACTH, kanye ne-electrolyte, kanye nokuthwebula izithombe zezindlala ze-adrenal noma ze-pituitary. Ukuhlolwa kokukhuthaza kwe-ACTH nakho kusetshenziselwa ukuhlola impendulo yendlala ye-adrenal kuma-hormone akhuthazayo.
Ukwelashwa Kwemithi
Ukwelashwa ngemithi kuyindlela eyinhloko esetshenziswa ukwelapha ukungasebenzi kahle kwe-adrenal. Nazi ezinye zezinketho eziyinhloko kulesi sigaba:
1. Ukwelashwa nge-Corticosteroid
Ukufakwa esikhundleni se-cortisol kuyisisekelo sokwelashwa kokuntuleka kwe-adrenal. I-Hydrocortisone (Cortef), i-prednisone, noma i-dexamethasone zivame ukunikezwa ukuze kufakwe esikhundleni se-cortisol. Umthamo uvame ukuhlukaniswa kabili noma kathathu ngosuku ukuze ulingise ukukhiqizwa kwe-cortisol yemvelo yomzimba.
2. I-Fludrocortisone
Iziguli ezinesifo esiyinhloko sokungasebenzi kahle kwe-adrenal noma isifo sika-Addison zivame ukuba namazinga aphansi e-aldosterone. I-Fludrocortisone, i-mineralocorticoid steroid, inikezwa ukuze ithathe indawo ye-aldosterone. Lokhu kusiza ukugcina ibhalansi ye-electrolyte kanye nomfutho wegazi.
3. Ukuguqulwa Komthamo Ezimweni Ezikhethekile
Ngesikhathi sokucindezeleka okukhulu ngokomzimba noma ngokomzwelo (njengokuhlinzwa noma ukutheleleka okukhulu), umzimba uvame ukwandisa ukukhiqizwa kwe-cortisol. Ngakho-ke, iziguli ezinesifo se-adrenal insufficiency zingadinga ukulungisa umthamo wazo we-corticosteroid. Lokhu kuvame ukubizwa ngokuthi "ukwelashwa kokucindezeleka komthamo," futhi kungafaka phakathi ukwandisa umthamo we-corticosteroids yomlomo noma ngisho nokunikeza imijovo ye-corticosteroid ezimweni ezimbi kakhulu.
Indlela Engeyona Eyemithi
Nakuba ukwelashwa ngemithi kuyisici esibalulekile ekuphathweni kokungasebenzi kahle kwe-adrenal, izindlela ezingezona ezemithi nazo zibalulekile.
1. Imfundo Yesiguli Nomndeni
Kubalulekile ukuthi iziguli nemindeni yazo ziqonde isimo sazo kanye nokwelashwa kwazo. Lokhu kuhlanganisa indlela yokubona izimpawu zokuntuleka kwe-adrenal (inkinga ye-adrenal) kanye nokuthi kufanele ufune nini usizo lwezokwelapha oluphuthumayo. Le mfundo ivame ukufaka indlela futhi nini yokusebenzisa imijovo ye-hydrocortisone ephuthumayo.
2. Indlela Yokuphila Enempilo
Ukwamukela indlela yokuphila enempilo kungasiza ekulawuleni ukungasebenzi kahle kwe-adrenal. Lokhu kuhlanganisa ukudla okulinganiselayo, ukuvivinya umzimba njalo, kanye nokulawula ukucindezeleka. Ukudla okucebile nge-sodium kungadingeka kubantu abathatha i-fludrocortisone, njengoba lo muthi ungabangela ukulahlekelwa yi-sodium.
3. Amathuluzi Okukhumbuza Nokuqapha
Ukusebenzisa izikhumbuzo, njenge-alamu noma izinhlelo zokusebenza zeselula, ukukhumbuza iziguli ngezinhlelo zazo zemithi kungasiza iziguli zinamathele ohlelweni lwazo lwemithi. Ngaphezu kwalokho, ukuqapha njalo uchwepheshe wezempilo ukuze kuhlolwe ukusebenza kahle kokwelashwa nokulungisa imithamo njengoba kudingeka kuyisici esibalulekile sokuphathwa kwesikhathi eside.
Ukuphathwa Kwezinkinga Zezinso
Inkinga ye-adrenal iyisimo esiphuthumayo sezokwelapha esidinga ukwelashwa okusheshayo. Kwenzeka lapho umzimba uhlangabezana nokuntuleka kwe-cortisol ngokuzumayo futhi kungabangelwa ukugula, ukulimala, noma ukucindezeleka okukhulu.
1. Umjovo we-Hydrocortisone
Ezimweni zenkinga ye-adrenal, imijovo ye-hydrocortisone efakwa ngemithambo ivame ukusetshenziselwa ukwandisa amazinga e-cortisol ngokushesha emzimbeni. Iziguli ezitholakale zinokuntuleka kwe-adrenal zivame ukunikezwa ama-kit okujova okuphuthumayo aqukethe i-hydrocortisone.
2. Ukusekelwa kwe-Electrolyte kanye noketshezi
Inkinga yezinso ivame ukuhambisana nokuphelelwa amanzi emzimbeni kanye nokungalingani kwama-electrolyte, okudinga ukuphathwa koketshezi ngemithambo yegazi kanye nokulungiswa kwama-electrolyte afana ne-sodium ne-potassium.
3. Ukuqapha Isibhedlela
Ngesikhathi senkinga ye-adrenal, ukulaliswa esibhedlela kuvame ukudingeka ukuze kuqashwe ngokucophelela futhi kutholakale ukwelashwa okusheshayo. Uma sezizinzile, iziguli zingabuyela emthanjeni wazo womlomo ngaphansi kokuqashwa ngudokotela.
Ukuphathwa Kwezifo Ezibangelwa Yizifo Nezinkinga
Ukuntuleka kwe-adrenal ngokuvamile kwenzeka ngezinkinga ezahlukahlukene, njengezinkinga ze-thyroid noma isifo sikashukela. Ukulawula lezi zinkinga kubalulekile ekuphathweni kwesimo sesiguli.
1. Ukuhlolwa Okuvamile
Ukuqapha njalo ukusebenza kwe-adrenal, ukusebenza kwe-thyroid, kanye namazinga kashukela egazini ngokuhlolwa kwegazi kubalulekile. Lokhu kusiza ekutholeni nasekuphatheni izinkinga ezingaba khona kusenesikhathi.
2. Ukwelashwa Okukhethekile
Ezinye iziguli zingadinga ukwelashwa okwengeziwe ngezinkinga ezikhona kakade. Lokhu kungafaka phakathi imithi ye-thyroid, ukuphathwa kwesifo sikashukela, noma ezinye izindlela zokwelapha ezikhethekile ezenzelwe isimo somuntu ngamunye.
Ubuchwepheshe Nokusungula Izinto Ezintsha Kwezokwelapha
Eminyakeni yamuva nje, ukusungulwa kobuchwepheshe sekuqalile ukuguqula indlela okuphathwa ngayo ukungasebenzi kahle kwe-adrenal. Lokhu kufaka phakathi intuthuko kwezokwelapha ngezakhi zofuzo kanye namadivayisi okuqapha.
1. Ukwelashwa Ngezakhi Zofuzo
Ucwaningo luyaqhubeka ukuthola izindlela zokwelapha ukuntuleka kwama-hormone e-adrenal ngokusebenzisa ukwelashwa ngezakhi zofuzo. Nakuba kusesesigabeni sayo sokuqala, le ndlela inesithembiso esikhulu sokuthuthukiswa kokwelashwa kwesikhathi eside.
2. Ukuqapha Idivayisi
Amadivayisi okuqapha, njengeziqaphi ze-cortisol zesikhathi sangempela, ayathuthukiswa ukuze ahlinzeke ngedatha enembile kakhulu futhi enze kube lula ukulungiswa kwemithamo ngesikhathi. Lokhu kungasiza ukuphathwa komuntu siqu futhi kuphendule izidingo zomuntu ngamunye.
Isiphetho
Ukungakwazi ukusebenza kahle kwe-adrenal kuyisimo esiyinkimbinkimbi futhi sidinga indlela yokwelapha ephelele. Inhlanganisela yokwelashwa nge-corticosteroid, ukwesekwa kwezemfundo, kanye nendlela yokuphila enempilo kungasiza ekuphatheni lesi simo ngempumelelo. Ukuphathwa kwezinkinga ze-adrenal kanye nezinye izifo nakho kuyingxenye ebalulekile yokwelashwa kwesikhathi eside. Ngokuthuthuka kobuchwepheshe kanye nokusungula izinto ezintsha emkhakheni wezokwelapha, ikusasa lokwelashwa kokungakwazi ukusebenza kahle kwe-adrenal liya ngokuya likhanya, linikeza ithemba elisha ngeziguli lokuphila impilo enempilo nengcono.
