Kaalshiyam xad-dhaaf ah (Hypercalcemia): Sababaha, Calaamadaha iyo Daaweynta

Qanacsan

• Calaamadaha suuragalka ah
• Sababaha ugu waaweyn ee hypercalcemia
• Sida loo xaqiijiyo cudurka
• Sida daaweynta loo sameeyo

Hypercalcemia waxay u dhigantaa xad-dhaafka kaalshiyamka dhiigga ku jira, taas oo cadadka macdantan oo ka weyn 10.5 mg / dL lagu xaqiijiyo baaritaanka dhiigga, taasoo laga yaabo inay muujiso isbeddellada ku dhaca qanjirada 'parathyroid', burooyinka, cudurrada endocrine ama dhinaca saameynta daawooyinka qaarkood.

Isbeddelkan badiyaa ma keeno astaamo, ama wuxuu keenaa oo keliya calaamado khafiif ah, sida cunto la'aan iyo lallabbo. Si kastaba ha noqotee, marka heerarka kaalshiyamku kor u kacaan, kana sarreeyaan 12 mg / dl, waxay sababi kartaa astaamo sida calool istaag, xaddiga kaadida oo kordha, lulmo, daal, madax xanuun, arrhythmias iyo xitaa kooma.

Daaweynta hypercalcemia way ku kala duwan tahay hadba sababta keentay, iyada oo loo tixgeliyo xaalad deg deg ah haddii ay keento calaamado ama gaadho qiimaha 13 mg / dl. Si loo yareeyo heerarka kaalshiyamka, dhakhtarku wuxuu tilmaami karaa isticmaalka serum ee xididka iyo daawooyinka sida diuretics, calcitonin ama bisphosphonates, tusaale ahaan.

Calaamadaha suuragalka ah

In kasta oo kalsiyumku yahay macdan aad muhiim ugu ah caafimaadka lafaha iyo hababka muhiimka u ah jidhka, haddana markay badato waxay saamayn taban ku yeelan kartaa shaqada jidhka, taasoo keenta calaamado ay ka mid yihiin:

• Madax xanuun iyo daal fara badan;
• Dareemo harraad joogto ah;
• Doonista joogtada ah ee kaadida;
• Lalabbo iyo matag;
• Cunto yaraanta;
• Isbedelada shaqada kelyaha iyo halista samaysashada dhagaxa;
• Xanuun joogto ah ama murqo xanuun;
• Xanuunka wadnaha.

Intaas waxaa sii dheer, dadka qaba hypercalcemia sidoo kale waxay yeelan karaan astaamo la xiriira isbeddelada neerfaha sida xusuus beel, niyad jab, xanaaq fudud ama jahwareer, tusaale ahaan.

Sababaha ugu waaweyn ee hypercalcemia

Sababta ugu weyn ee keenta kaalshiyamka xad-dhaafka ah ee jidhka ku jira waa hyperparathyroidism, taas oo qanjidhada yar yar ee parathyroid, oo ku yaalliin tayroodhka gadaashiisa, ay soo saaraan hormoon xad-dhaaf ah oo nidaamiya xaddiga kaalshiyamka dhiigga ku jira. Si kastaba ha noqotee, hypercalcemia sidoo kale waxay u dhici kartaa natiijada xaaladaha kale, sida:

• Kelyaha oo xumaada;
• Xaddiga fitamiin D, badanaa sababa cudurada sida sarcoidosis, qaaxada, coccidioidomycosis ama cunid xad dhaaf ah;
• Dhibaatada dhinaca isticmaalka daawooyinka qaarkood sida lithium, tusaale ahaan;
• Buro ku taal lafaha, kilyaha ama xiidmaha oo ku jira marxalad heer sare ah;
• Buro ku taal jasiiradaha ganaca;
• Myeloma badan;
• Cilladda 'Milk-alkali Syndrome', oo ay keento kaalshiyam xad-dhaaf ah iyo adeegsiga dawooyinka ka hortagga jirka;
• Cudurka Paget;
• Hyperthyroidism;
• Myeloma badan;
• Cudurada Endocrinological sida thyrotoxicosis, pheochromocytoma iyo cudurka Addison.

Cudurka 'hypercalcemia malignant' wuxuu ku yimaadaa soo saarista hormoon la mid ah hormoonka parathyroid ee unugyada buro, taas oo keenta daran oo ay adag tahay daaweynta hypercalcemia. Nooc kale oo ah 'hypercalcemia' kiisaska kansarka wuxuu ku dhacaa nabarro lafaha ah oo ay sababaan lafaha lafaha.

Sida loo xaqiijiyo cudurka

Baadhista cudurka 'hypercalcemia' waxaa lagu xaqiijin karaa baaritaanka dhiigga, kaas oo lagu ogaanayo wadarta qiimaha kalsiyum ee ka sarreeya 10.5mg / dl ama ionic calcium ka sarreeya 5.3mg / dl, iyadoo ku xiran shaybaarka la sameeyay.

Kadib markuu xaqiijiyo isbadalkan, dhakhtarku waa inuu amraa baaritaano si loo cadeeyo waxa sababay, taas oo ay kujirto cabirka hoormoonka PTH ee ay soo saarto qanjidhada parathyroid, baaritaanada sawirada sida tomography ama MRI si loo baaro jiritaanka kansarka, marka lagu daro qiimeynta heerarka fitamiin D-ga. , shaqada kelyaha ama jiritaanka cudurada kale ee endocrinological.

Sida daaweynta loo sameeyo

Daaweynta cudurka 'hypercalcemia' waxaa badanaa muujiya dhakhtarka endocrinologist, oo inta badan loo sameeyo sababtiisa, taas oo ay ka mid tahay isticmaalka daroogada si loo xakameeyo heerarka hoormoonka, isweydaarsiga daroogada kuwa kale ee aan lahayn hypercalcemia waxyeelo ama qalliin si looga saaro burooyinka laga yaabo inay keenaya kalsiyum xad-dhaaf ah, haddii tani ay tahay sababta.

Daaweynta si dhakhso leh looma sameeyo, marka laga reebo xaaladaha ay calaamadaha keenaan ama marka heerarka kaalshiyamka dhiiggu gaaro 13.5 mg / dl, taas oo ka dhigan khatar caafimaad oo weyn.

Sidaa awgeed, dhakhtarku wuxuu kuu qori karaa fuuq-baxa xididka, loop-yada loop-ka, sida Furosemide, calcitonin ama bisphosphonates, si loo isku dayo yareynta heerarka kaalshiyamka oo looga fogaado isbeddellada ku dhaca garaaca wadnaha ama dhaawaca nidaamka neerfaha.

Qalliinka lagu daaweynayo cudurka 'hypercalcemia' waxaa la isticmaalaa oo keliya marka sababta dhibaatada ay tahay cillad ka timaadda mid ka mid ah qanjidhada 'parathyroid', waxaana lagu talinayaa in laga saaro.