Lefu la tsoekere > Lefu la tsoekere

Lefu la tsoekere- lefu le bakoang ke ho haella ka ho felletseng kapa ho se lekane ha hypopalamic hormone vasopressin (AdH-antidiuretic hormone).

Khafetsa ea lefu lena ha e tsejoe, e etsahala ho 0.5-0,7% ea bakuli ba endocrine.

Taolo ea ho lokolloa ha vasopressin le litlamorao tsa eona

Vasopressin'me oxytocin e entsoe ka bokaholimo ba "hypothalamus" le "patothopular", e pakiloe ka masenke ka li-neurophysin tse tsamaellanang,' me li tsamaisoa hammoho le li-axon ho ea ka morao ho pituitary gland (neurohypophysis), moo li bolokiloeng ho fihlela li lokolloa. Mehloli ea vasopressin ho neurohypophysis e nang le ts'usumetso e sa tsitsitseng ea secretion ea eona, mohlala, ka ho tlohela nako e telele ho e-noa, e fokotsehile haholo.

Secretion ea vasopressin e bakoa ke lintlha tse ngata. Bohlokoa ka ho fetisisa ho tsena ke khatello ea mali ea osmotic, i.e. osmolality (kapa ka tsela e ngoe osmolarity) ea plasma. Ho anterior hypothalamus, haufi, empa ka thoko ho supraoptical le paraventicular nuclei, e fumanehaosmoreceptor. Ha osmolality ea plasma e le bonyane ka tsela e itseng e tloaelehileng, kapa boleng ba monyako, khatello ea vasopressin ho eona e nyane haholo. Haeba osmolality ea plasma e feta monyako ona oa tlhophiso, osmocenter o lemoha sena, mme khatello ea vasopressin e nyoloha ka matla. Sistimi ea osmoregulation e arabela ka botebo le ka nepo haholo. Keketseho e nyane ea kutloisiso ea osmoreceptor e amahanngoa leka lilemo.

Osmoreceptor ha e amehe ka ho lekana linthong tse fapaneng tsa plasma. Sodium(Na +) le anions tsa eona ke tsona tse matlafatsang ka ho fetisisa tsa secretion ea osmoreceptor le vasopressin.Le Na le anions ea eona hangata e khetholla 95% ea plasma osmolality.

Hlohlelletsa secretion ea vasopressin haholo ka osmoreceptor sucrose le mannitol. Glucose ha e hlile ha e tsose osmoreceptor, joalo ka ha urea.

Ntho e tšepahalang ka ho fetisisa ea tlhahlobo ea ho hlasimolla secretion ea vasopressin ke ho tsebaNa+le plasma osmolality.

Sechetion ea Vasopressin ea ameha molumo oa mali le khatello ea mali. Litlamorao tsena li bonoa ka li-baroreceptors tse fumanehang ho atria le arctic arch. Baroreceptor stimuli ka li-fibre tse amanang le eona e ea bokong ba bokong e le karolo ea methapo ea botšehali le glossopharyngeal. Ho tloha kutu ea boko, lipontšo li fetisetsoa ho neurohypophysis. Ho fokotseha ha khatello ea mali kapa ho fokotseha ha palo ea mali (mohlala, tahlehelo ea mali) ho matlafatsa secretion ea vasopressin haholo. Empa sistimi ena e na le botebo bo tlase ho feta ts'usumetso ea osmotic ho osmoreceptor.

E 'ngoe ea lintlha tse sebetsang tse khothalletsang tokollo ea vasopressin ke ho nyekeloahang-hang, kapa ho bakoa ke lits'ebetso (gagging, joala, nicotine, apomorphine). Le haeba le nausea, ntle le ho hlatsa, boemo ba vasopressin ka plasma bo nyoloha ka makhetlo a 100-1000!

Ha e sebetse hantle ho feta ho nyekeloa, empa e boetse eu susumetsa khafetsa ka mokhoa o tšoanang oa secretion ea vasopressin hypoglycemia,haholo bohale. Ho fokotseha ha boemo ba tsoekere ka 50% ea boemo ba pele maling ho eketsa litaba tsa vasopressin ka makhetlo a 2-4 ho batho, le likotong ka makhetlo a 10!

E eketsa secretion ea vasopressin renin-angiotensin tsamaiso. Boemo ba renin le / kapa angiotensin e hlokahalang ho susumetsa vasopressin ha e e-so tsejoe.

Ho boetse ho lumeloa hore khatello ea kelello e sa hlakange bakoang ke lintlha tse kang bohloko, maikutlo, ts'ebetso ea 'mele, e ntlafatsa secretion ea vasopressin. Leha ho le joalo, e ntse e sa tsejoe hore na khatello ea maikutlo e phahamisa secretion ea vasopressin joang - ka tsela e ikhethang, kapa ka ho theola khatello ea mali le ho nyekeloa.

Thibela secretion ea vasopressinLintho tse sebetsang tsa vascular, joalo ka norepinephrine, haloperidol, glucocorticoids, opiates, morphine. Empa ha e e-so hlake hore na lintho tsena tsohle li sebetsa bohareng, kapa ka ho eketsa khatello ea mali le molumo.

Ha e se e le tsamaisong ea potoloho ea mali, vasopressin e tsamaisoa ka potlako ho tsoa mokelikeling o mong le o mong o tsoang ka ntle. Tekano pakeng tsa sebaka sa Intra- le extravascular e fihlelleha nakong ea metsotso e 10-15. Ho se sebetse hantle ha vasopressin ho hlaha haholo-holo ka har'a sebete le liphio. Karolo e nyane ha e senyehe ebile e pepesitsoe ka har'a moroto ka mokhoa o hlakileng.

Liphello.Phello ea bohlokoahali ea vasopressin kepaballo ea metsi 'melengka ho fokotsa tlhahiso ea moroto. Ntlha ea ts'ebetso ea ketso ea eona ke epithelium ea distal le / kapa li-tubules tse kopaneng tsa liphio. Ha vasopressin e le sieo, li-membrane tsa lisele li kenella karolong ena ea nephron li etsa tšitiso e ke keng ea lekanngoa ea tšilafalo ea metsi le lintho tse qhibilihang. Tlas'a maemo a joalo, filtrate ea hypotonic e thehiloeng likarolong tse haufi haholo tsa nephron e feta ka har'a tubule ea distal le ho bokella li-ducts ntle le phetoho. Bophahamo bo itseng ba moroto o joalo bo tlase.

Vasopressin e eketsa boteng ba distal le ho bokella marang-rang bakeng sa metsi. Kaha metsi a kopantsoe hape ntle le lintho tsa osmotic, ho kenella ha lintho tse ngata ho lona hoa eketseha, le bophahamo ba lona, i.e. bongata boa fokotseha.

Ho na le bopaki ba hore lihormone tsa "tis" tsa sebakeng seo, li thibela ts'ebetso ea vasopressin lipelong. Ka lehlakoreng le leng, lithethefatsi tse seng khahlanong le ts'oaetso tsa "cell" (mohlala, Indomethacin), tse thibelang ho hlophisoa ha li-prostaglandins lipelong, li eketsa phello ea vasopressin.

Vasopressin e sebetsa le lits'ebetsong tse fapa-fapaneng tse eketsehileng, tse kang methapo ea mali, pampitšana ea mala, tsamaiso ea methapo e bohareng.

Nyoriloee sebetsa e le tlatsetso e bohlokoa bakeng sa ts'ebetso ea antidiuretic ea vasopressin. Lenyora ke letsoalo la tlhoko ea tlhoko ea metsi.Motsoako o susumetsoa ke lintho tse ngata tse bakang sechetion ea vasopressin. E sebetsang ka ho fetisisa ho tsena ketikoloho ea hypertonic.Boemo bo felletseng ba plasma osmolality, moo ho nang le maikutlo a lenyora, ke 295 mosmol / kg. Ka osmolality ena ea mali, moroto o nang le khatello e phahameng hangata o ntšoa. Motsoako ke mofuta oa brake, mosebetsi oa mantlha oa eona ke ho thibela tekanyo ea ho fokolloa ke metsi, e fetang bokhoni ba phello ea tsamaiso ea antidiuretic.

Motsoako o eketseha ka sekhahla ka kotloloho ea osmolality ea plasma mme o sitoa ho mamella ha osmolality e le feela mosmol / kg ka holimolimo ho tekanyo ea monyako. Tšebeliso ea metsi e lekana le lenyora. Ho theoha ha molumo oa mali kapa khatello ea mali le hona ho baka lenyora.

Nts'etsopele ea mefuta ea mantlha ea lefu la tsoekere e thehiloe ho ho hloloa hoa likarolo tse fapaneng tsa hypothalamus kapa pituitary ea morao-rao, i.e. neurohypophysis. Mabaka a ka kenyelletsa lintlha tse latelang:

tšoaetsoa hlobaetsang kapa a sa foleng: ntaramane, meningoencephalitis, feberu e khubelu, pertussis, typhus, sepsis, tonsillitis, lefuba, syphilis, rheumatism, brucellosis, mala,

likotsi tse mpe tsa kelello: ka kotsi kapa ts'ebetso ea motlakase, tšabo ea motlakase, likotsi tsa pelehi nakong ea tlhaho ea ngoana,

hypothalamic kapa tumello ea pituitary:metastatic, kapa mantlha. Kankere ea litšoelesa tse anyesang le tsa qoqotho, metonase ea bronchi e ea gland hangata. Ho kenella ka metsoako ea tumor ho lymphogranulomatosis, lymphosarcoma, leukemia, kakaretso ea xanthomatosis (lefu la Hend-Schuller-Crispen). Makhopho a mantlha: adenoma, glioma, teratoma, craniopharyngioma (haholo hangata), sarcoidosis,

mafu a endocrine:Simmonds, Skien, Lawnd-Moon-Beadl syndromes, sebaka se fokolang sa maemo a peto, tlhako ea mahalane, gigantism, adinogenital dystrophy,

idiopathic:ho bakuli ba 60-70%, sesosa sa lefu lena se lula se sa tsebahale. Har'a mefuta ea idiopathic, boemeli bo hlahelletseng bo na le lefu la tsoekere la lefu la tsoekere, le fumanehang meloko e mengata. Mofuta oa lefa ke o busang hape o renang hape.

autoimmunetimetso ea mookotaba oa hypothalamus ka lebaka la ts'ebetso ea autoimmune. Sebopeho sena se nahanoa hore se etsahala ho "lefu la tsoekere" la idiopathic, leo ho lona ho hlahang li-autoantibodies ho lisele tsa secopressin.

Ka peripheraltlhahiso ea "insipidus vasopressin" ea tsoekere e bolokiloe, empa kutloisiso ea methapo ea methapo ea kutlo ea mokokotlong e ea fokotsoa kapa ha e eo, kapa hormone e senngoe haholo ka har'a sebete, liphio le placenta.

Nephrojene lefu la tsoekerehangata e bonoa baneng, mme e bakoa ke ho fokola hoa sebopeho sa renal tubules (malgenations ea tlhaho, lits'ebetso tsa cystic degenerative), kapa tšenyo ea nephron (amyloidosis, sarcoidosis, chefo ea lithium, methoxyfluramine). kapa ho fokotseha hoa kutloisiso ea li-receptor tsa renal tubule epithelium ho vasopressin.

Kliniki ea lefu la tsoekere

bakeng sa lenyoraho tloha ho hlalosoa ka tsela e itekanetseng ho isa ho bohloko, ho se tlohelle bakuli mots'ehare kapa bosiu. Ka linako tse ling bakuli ba nwa lilithara tse 20-25 tsa metsi ka letsatsi. Tabeng ena, ho na le takatso ea ho nka metsi a leqhoa,

polyuriale ho ntša metsi kapele. Motsoako o khanya, ntle le urochromes,

'meleng le kelellongbofokoli,

takatso e fokotsehilengho theola boima ba 'melemohlomong nts'etsopelebotenyahaeba lefu la tsoekere le fetoha le leng la matšoao a mafu a mantlha a hypothalamic.

mathata a dyspepticho tloha ka mpeng - maikutlo a ho tlala, ho lofa, ho opeloa ke epigastrium, mala - ho senyeha, lesapo la nyooko - boima, bohloko bo kahara hypochondrium,

mathata a kelello le a maikutlo: ho opeloa ke hlooho, ho se leka-lekane maikutlong, ho hloka boroko, ho fokotseha hoa kelello, ho se khonehe, ho lla, ho hlaseloa ke kelello ka linako tse ling.

menstrual irregularities, ho banna - potency.

Ho qala ha lefu lena ho ka ba boima haholo, ka tšohanyetso, butle-butle hanyane ka hanyane, 'me matšoao a eketseha ha lefu le ntse le mpefala. Lisosa e ka ba likotsi tse bohloko tsa kelellong kapa kelellong, ts'oaetso, ts'ebetso ea ts'ebetso ea ts'ebetso bokong. Hangata, sesosa ha se khetholloe. Ka linako tse ling lefutso le boima bakeng sa lefu la tsoekere le thehiloe.

Letlalo le omile, sesoplese se fokotsehile le mofufutso,

boima ba 'mele bo ka fokotsoa, bo tloaelehileng kapa bo eketseha,

leleme le lula le omme ka lebaka la lenyora, meeli ea mpa e ea theoha ka lebaka la ho tšeloa ke metsi khafetsa. Ka nts'etsopele ea gastritis kapa bysary dyskinesia, ho eketseha ha maikutlo le bohloko ka palpation ea epigastrium le hypochondrium e nepahetseng lia khoneha,

methapo ea pelo le matšoafo, hangata sebete ha se utloe bohloko,

Sisteme sa urination: ho ntša khafetsa, polyuria, nocturia,

lipontšoho omellammele, haeba mokelikeli o lahliloeng ke moroto, ka lebaka le itseng, ha o phethoe - ho haella ha metsi, ho etsa liteko ka "ho ja ho omileng", kapa maikutlo a setsi sa lenyora a fokotseha:

ho fokola ka kakaretso, ho opeloa ke hlooho, ho nyekeloa, ho hlatsa khafetsa, ho felloa ke metsi 'meleng,

hyperthermia, tšusumetso e matla, khatello ea kelello psychototor,

Boloetse ba CCC: tachycardia, hypotension ho fihlela ho oa le ho akheha,

thickening ea mali: keketseho ea palo ea Hb, lisele tse khubelu tsa mali, Na + (N136-145 mmol / L, kapa meq / L) creatinine (N60-132 mmol / L, kapa 0.7-1.5 mg%),

matla a khoheli a itseng a moroto a tlase - 1000-1010, polyuria ea phehella.

Tsena tsa ho fokola hoa mmele oa hyperosmolar ke tšobotsi e ikhethang ea lefu la tsoekere le tsoekere la bana le bana.

E Khethiloee ipapisitse le matšoao a khale a lefu la tsoekere le lefu la sethoathoa:

botebo bo tlase ba moroto - 1000-1005

plasma hyperosmolarity,> 290 mosm / kg (N280-296 mosm / kg metsi, kapa metsi a mmol / kg),

urine hypoosmolarity, 155 meq / l (N136-145 meq / l, mmol / l).

Haeba ho hlokahala disampole:

Teko ka ho ja-omileng.Teko ena e etsoa sepetlele, nako ea eona hangata ke lihora tse 6-8, ka mamello e ntle - lihora tse 14. Ha ho na mokelikeli o fanoang. Lijo li lokela ho ba liprotheine. Morara o bokelloa hora e 'ngoe le e' ngoe, boholo le bophahamo bo itseng ba karolo e 'ngoe le e' ngoe ea hora lia lekanyetsoa. Boima ba 'mele bo lekanngoa kamora' litara e le 'ngoe ea moroto o tsoang.

Tekanyetso: ho ba sieo ha matla a maholo a khoheli e ikhethang ea moroto likarolo tse peli tse latelang ka tahlehelo ea 2% ea boima ba 'mele ho bontša ho ba sieo ha ts'usumetso ea vasopressin ea endo native.

Mohlala ka iv tsamaiso ea 50 ml ea 2,5% tharolloNaClnakong ea metsotso e 45 Ka lefu la tsoekere la tsoekere, molumo le letsoalo la moroto oa hau ha li fetohe haholo. Le psychogenic polydipsia, keketseho ea mahlaseli a plasma a osmotic a potlakisa ho lokolla ho lokolloa ha vasopressin ea endo native mme bongata ba urine e pepesitsoeng boa fokotseha, mme matla a eona a ikhethang a eketseha.

Teko ka kenyelletso ea litokisetso tsa vasopressin - 5 I / O kapa / m.Ka insipidus ea 'nete ea lefu la tsoekere, boemo ba bophelo bo botle boa ntlafala, polydipsia le polyuria lia fokotseha, osmolarity ea plasma e ea fokotseha, moroto oa osmolarity oa eketseha.

Tlhahlobo e fapaneng ea lefu la tsoekere le lefu la tsoekere

Ho ea ka matšoao a mantlha a lefu la tsoekere - polydipsia le polyuria, lefu lena le aroloa ho tsoa ho mafu a mangata a etsahalang ka matšoao ana: psychogenic polydipsia, lefu la tsoekere la lefu la tsoekere, polyuria e tlatselletsang ho se atleheng ha renal (ho sa sebetse hantle ha renal).

Nephrogenic vasopressin e thibelang lefu la tsoekere insipidus (e tsoetseng pele kapa e fumanoeng) e khetholloa ke polyuria ka aldosteronism ea mantlha, hyperparathyroidism e nang le nephrocalcinosis, le malabsorption syndrome e sa foleng ea enterocolitis.

Sena ke eng

Lefu la tsoekere ke lefu le sa tloaelehang (hoo e ka bang 3 ho 100,000) le amanang le ho se sebetse ha hypothalamus kapa pituitary gland, e khetholloang ke polyuria (excretion ea lilithara tse 6-15 tsa moroto ka letsatsi) le polydipsia (lenyora).

E etsahala bathong ba bong ka bobeli, ho batho ba baholo le ho bana. Hangata, bacha ba kula - ho tloha ho lilemo tse 18 ho isa ho 25. Litaba tsa bokuli ba bana ba selemo sa pele sa bophelo lia tsebahala (A.D. Arbuzov, 1959, Sharapov V.S. 1992).

Lisosa tsa lefu la tsoekere

Lefu la tsoekere ke lefu le hlahisoang ke khaello ea vasopressin, ho haella ha eona ka botlalo kapa ho fokola. Vasopressin (hormone ea antidiuretic) e bolokiloe ho hypothalamus mme, har'a mesebetsi e meng, e ikarabella bakeng sa ho rarahana ha ho ruruha. Ka hona, ke moetlo ho khetholla mefuta e meraro ea lefu lena le lisosa tsa tšimoloho: liphatsa tsa lefutso, tse fumanoeng, idiopathic.

Ho bakuli ba bangata ba nang le lefu lena le sa tloaelehang, sesosa se ntse se sa tsejoe. Lefu la tsoekere le joalo le bitsoa ideopathic, ho fihlela liperesente tse 70 tsa bakuli ba nang le lona. Lefutso ke ntho e futsitsoeng. Maemong ana, lefu la tsoekere ka linako tse ling le iponahatsa ka har'a litho tse 'maloa tsa lelapa le bakeng sa meloko e' maloa ka tatellano.

Bongaka bo hlalosa sena ka liphetoho tse kholo mofuteng oa genotype, li kenya letsoho ho hlaha hoa pherekano mosebetsing oa lihormone tsa antidiuretic. Sebaka seo lefu lena le futsitsoeng ho lona se bakoa ke bofokoli bo tsoaloang sebopeho sa diencephalon le midbrain.

Ha re nahana ka lisosa tsa lefu la tsoekere la lefu la tsoekere, re lokela ho nahana ka methati ea ntlafatso ea lona.

1) Insipidus ea lefu la tsoekere bohareng - e hlaha ka ho sa lekana ha vasopressin ho hypothalamus kapa ka tlolo ea sephiri sa eona maling a tsoang gland ea pituitary, mohlomong mabaka a eona ke:

Psychology ea hypothalamus, kaha e na le boikarabello ba ho laola tšilafalo ea moroto le ho kopana ha li-hormone tsa antidiuretic, ts'ebetso e sa sebetseng e lebisa ho lefu lena. Maloetse a tšoaetsanoang a sa foleng kapa a sa foleng: tonsillitis, feberu, mafu a tšoaetsanoang ka tsa thobalano, lefuba e ka ba lisosa le lisosa tsa ho hlaha ha litheko tsa hypothalamic.
Ho kenella ha ts'ebetso bokong le maikutlong a boko.
Ho tšoenyeha, kotsi e bohloko ea bokong.
Maloetse a Autoimmune.
Li-cystic, matla a mpefatsang, a ruruhileng a liphio a fokolisang pono ea vasopressin.
Mekhoa ea tumor ea hypothalamus le gland ea pituitary.
Hape, boteng ba khatello ea mali ke e 'ngoe ea lisosa tsa lefu la tsoekere.
Ho ruruha ha methapo ea tsamaiso ea hypothalamic-pituitary, ho lebisang ho mathata a ho potoloha ha lisele ka har'a lijana tse fepelang hypothalamus le gland ea pituitary.

2) Insulin ea lefu la tsoekere la Renal - ha vasopressin e hlahisoa ka bongata, leha ho le joalo, lisele tsa renal ha li e arabe hantle. Mabaka a ka ba ka tsela e latelang:

Tšenyo ea ho hlatsoa moroto oa nephron kapa medulla ea a liphio.
lefutso - lefutso,
sickle cell anemia,
potasiamo e ngata kapa lerotholi la calcium calcium
ho se sebetse hantle hantle ha renal
amyloidosis (setšoantsho sa amyloid ho li-tishu) kapa polycystosis (sebopeho sa li-cysts tse ngata) tsa liphio,
ho sebelisa meriana e ka ba chefo liseleng tsa bana ("Demeclocilin", "Amphotericin B", "Lithium"),
ka linako tse ling pathology e etsahala botsofaling kapa khahlano le semelo sa ho fokola ha Psychology e 'ngoe.

Ka linako tse ling, khahlano le semelo sa khatello ea maikutlo, lenyora le eketsehang (psychogenic polydipsia) le ka hlaha. Kapa lefu la tsoekere le lefu la tsoekere nakong ea kemolo, le emang ka mokokotlong oa 3 ka lebaka la tšenyo ea vasopressin ka li-enzyme tse hlahisoang ke placenta. Mefuta ka bobeli ea tlolo e felisoa ka bo eona kamora ho tlosa sesosa sa metso.

Tlhomamiso

Ke moetlo ho khetholla mefuta e 'meli ea kliniki ea lefu lena:

Nephrogenic lefu la tsoekere "insipidus" (peripheral). Mofuta ona oa lefu lena ke phello ea ho fokotseha kapa ho hloka matla ho felletseng ha li-distal renal tubules ho litlamorao tsa tlhaho tsa vasopressin. Ha e le molao, sena se bonoa maemong a kalafo ea liphio a sa foleng (ka pyelonephritis kapa khahlano le semelo sa liphio tsa polycystic), ho fokotseha ha nako e telele moleng oa potasiamo maling le keketseho ea tekanyo ea calcium, ka ho se lekane ha protheine ea lijo - protein tlala, Sjogren's syndrome, le bofokoli bo bong ba tlhaho. Maemong a mang, lefu lena le hlaha ka tlhaho.
Neurogenic lefu la tsoekere "insipidus" (bohareng). E ba teng ka lebaka la liphetoho tsa methapo tsamaisong ea methapo, haholo, ho hypothalamus kapa gland ea morao. Ha e le molao, sesosa sa lefu lena ke ts'ebetso ea ho tlosa tšoelesa ea pituitary ka mokhoa o phethahetseng, lefu le tšoaetsanoang la sebaka sena (hemochromatosis, sarcoidosis), ho sithabela kapa ho fetoha hoa tlhaho ea ts'oaetso. Maemong a mang, lefu la lefu la tsoekere la neurogenic ke idiopathic, le ikemiselitsoeng ka nako e ts'oanang ho litho tse 'maloa tsa lelapa le le leng.

Matšoao a lefu la tsoekere

Matšoao a pele a lefu la tsoekere ke ho nyoriloe ho hoholo (polydipsia) le ho ruruha khafetsa (polyuria), tse tšoenyang bakuli esita le bosiu. Ho tloha ho lithara tse tharo ho isa ho tse 15 tsa moroto li ka ntšoa ka letsatsi, 'me ka linako tse ling palo ea tsona e fihla ho lilithara tse 20 ka letsatsi. Ka hona, mokuli o hlokofatsoa ke lenyora le tebileng.

Matšoao a lefu la tsoekere ho lefu la tsoekere ho banna ke ho fokotseha hoa ho tsamaisoa ha thobalano le potency.
Matšoao a lefu la tsoekere le lefu la tsoekere ho basali: ho se sebetse ka nako ea khoeli ho fihlela ho amenorrhea, ho hloka thoko ho amanang le lefutso, mme haeba ho ima ho hlaha, ho na le menyetla ea ho ntša mpa ka boomo.
Matšoao a lefu la tsoekere ho bana a bitsoa. Ho bana ba sa tsoa hlaha le ho bana ba banyenyane, boemo ba lefu lena hangata bo tebile. Ho eketseha ha mocheso oa 'mele hoa hlokomeleha, ho hlatsa ho sa hlalosoang ho etsahala, ho senyeha hoa tsamaiso ea methapo. Ho bana ba seng ba le baholo ho fihlela lilemong tsa bocha, letšoao la lefu la tsoekere le hloka boroko, kapa ho thatafatsa.

Nakong e tlang, ka tsoelo-pele, matšoao a latelang a ikopanya:

Ka lebaka la tšebeliso ea mokelikeli o mongata, mpa ea otloloha, 'me ka linako tse ling e bile ea oa
Ho na le matšoao a ho felloa ke metsi 'meleng (ho se be le metsi' meleng): letlalo le omileng le li-membrane tsa mucous (molomo o omileng), boima ba 'mele boa fokotseha,
Ka lebaka la ho tsoa ha moroto ka bongata bo boholo, bladder e otlolohile,
Ka lebaka la khaello ea metsi 'meleng, tlhahiso ea li-enzyme tse ka mpeng ka mpeng le mala ea senyeha. Ka hona, takatso ea mokuli ea fokotseha, gastritis kapa colitis e ea hlaha, ho na le mokhoa oa ho sokela,
Hangata khatello e tlase ea mali le sekhahla sa pelo,
Kaha ha ho na metsi a lekaneng 'meleng, mofufutso oa fokotseha.
Mokuli o khathala kapele
Ka linako tse ling ho nyekeloa le pelo le ho hlatsa ho sa hlalosoeng,
Mocheso oa 'mele o ka nyoloha.
Nako le nako ho hlaha bedwetting (enuresis).

Kaha lenyora le ho ruruha ho feteletseng li tsoela pele bosiu, mokuli o na le mathata a kelello le a maikutlo:

khatello ea maikutlo (ka linako tse ling esita le psychoses ea hlaha) le ho se khonehe,
ho hloka boroko le hlooho e bohloko
ho fokotseha hoa kelello.

Hona ke matšoao a lefu la tsoekere maemong a tloaelehileng. Leha ho le joalo, lipontšo tsa lefu lena li ka fapana hanyane ho banna le basali, hammoho le bana.

Ts'oaetso

Maemong a tloaelehileng, ho fumanoa ha lefu la tsoekere ha ho bonolo ebile ho ipapisitse le:

lenyora le matla
bophahamo ba moriti oa letsatsi le letsatsi o feta lilithara tse 3 ka letsatsi
plasma hyperosmolality (ho feta 290 mosm / kg, ho latela ts'ebetso ea mokelikeli)
sodium e phahameng
hypoosmolality of urine (100-200 mosm / kg)
letsoalo le tlase la moroto (

Melao ea phepo e nepahetseng

Motho e mong le e mong oa tseba hore bakuli ba nang le lefu la tsoekere ba na le kamano e "ikhethang" le tsoekere. Empa ho ka thoe'ng ka phepo e nepahetseng haeba bokuli e se tsoekere? Tabeng ena, thibelo e tla ama sehlahisoa se seng - letsoai. Haeba mokuli a sa utloe bohloko ke ho se sebetse hantle ke phepo, joale ho ka khoneha ho khutlisetsa letsoai ka tlatsetso ea lijo, mohlala, Sanasol.

Lijo tse nang le lefu lena li kenyelletsa ho fokotsa phepelo ea lijo tsa protheine (e seng ho feta 70 g ka letsatsi). Mokuli o khothalletsoa ho ja tafole ea 7.

Lijo le lino tse latelang li kenyelelitsoe lijong:

Monokotšoai le litholoana tse nang le tatso e bolila le e bolila.
Meroho e ncha.
Li-jusi tse sa tsoa pepesoa, kvass, tee - limela le tse tala.
Metsi a nang le lero la lemone.
Lihlahisoa tsa lebese le tsoekere.
Mefuta e bonolo ea nama.
Litlhapi tse nang le mafura a fokolang, lijo tsa leoatleng.

Idiopathic lefu la tsoekere, le fanoang ka phekolo e loketseng, ha le behe bophelo ba mokuli bohloko, empa ho hlaphoheloa ka sebopeho sena ha ho khonehe.

Lefu la tsoekere, le ileng la hlaha khahlano le semelo sa mafu a mang, maemong a mangata le feta ka mor'a hore a felise sesosa se a bakileng.