Mathata a maholo a adrenal

Tlokotsi e matla ea adrenal ke boemo bo sokelang bophelo bo etsahalang ha cortisol e sa lekane. Ena ke hormone e hlahisoang ke litšoelesa tsa adrenal.

Litšoelesa tsa adrenal li kaholimo ho liphio. Tšoelesa ea adrenal e na le likarolo tse peli. Karolo e kantle, e bitsoang cortex, e hlahisa cortisol. Ena ke hormone ea bohlokoa bakeng sa ho laola khatello ea mali. Karolo e ka hare, e bitsoang medulla, e hlahisa hormone adrenaline (eo hape e bitsoang epinephrine). Ka bobeli cortisol le adrenaline li lokolloa ka lebaka la khatello ea maikutlo.

Tlhahiso ea Cortisol e laoloa ke pituitary. Ena ke tšoelesa e nyane e ka tlase ho boko. Pituitary e ntša hormone ea adrenocorticotropic (ACTH). Ena ke hormone e etsang hore litšoelesa tsa adrenal li lokolle cortisol.

Tlhahiso ea adrenaline e laoloa ke methapo e tsoang bokong le mokokotlong le ka ho potoloha ha lihormone.

Mathata a adrenal a ka hlaha ho efe kapa efe ho tse latelang:

• Tšoelesa ea adrenal e senyehile ka lebaka la, mohlala, lefu la Addison kapa lefu le leng la adrenal gland, kapa ho buuoa
• Pituitary e lemetse ebile e ke ke ea lokolla ACTH (hypopituitarism)
• Ho haella ha adrenal ha ho alafuoe hantle
• U nkile meriana ea glucocorticoid nako e telele, 'me ka tšohanyetso u emise
• U se u felloa ke metsi haholo
• Tšoaetso kapa khatello e 'ngoe ea' mele

Matšoao le matšoao a koluoa ​​ea adrenal a kenyeletsa tse latelang:

• Bohloko ba mpeng kapa bohloko ba lehlakore
• Pherekano, ho lahleheloa ke kelello, kapa ho akheha
• Ho felloa ke metsi 'meleng
• Botsoa kapa hlooho e bobebe
• Mokhathala, bofokoli bo matla
• Ho opeloa ke hlooho
• Feberu e phahameng
• Ho felloa ke takatso ea lijo
• Khatello ea mali e tlase
• Tsoekere e tlase maling
• Ho nyekeloa ke pelo, ho hlatsa
• Ho otla ha pelo ka potlako
• Sekhahla sa ho hema ka potlako
• Ho tsamaea butle, ho ba botsoa
• Mofufutso o sa tloaelehang le o feteletseng sefahlehong kapa liatleng

Liteko tse ka laeloang ho thusa ho fumana bothata bo matla ba adrenal li kenyelletsa:

• Teko ea ho hlasimolla ea ACTH (cosyntropin)
• Boemo ba Cortisol
• Tsoekere ea mali
• Boemo ba potasiamo
• Boemo ba sodium
• boemo ba pH

Mathateng a adrenal, o hloka ho fuoa lithethefatsi tsa hydrocortisone hang-hang ka methapo (intravenous) kapa mesifa (intramuscular). U ka fumana maro a kenang ka har'a methapo haeba u na le khatello e tlase ea mali.

U tla hloka ho ea sepetlele bakeng sa kalafo le tlhokomelo. Haeba tšoaetso kapa bothata bo bong ba bongaka bo bakile koluoa, o kanna oa hloka kalafo e eketsehileng.

Ho tsosoa ho ka etsahala haeba kalafo e sa fuoe kapele, 'me e ka beha bophelo kotsing.

E-ea kamoreng ea maemo a tšohanyetso kapa u letsetse nomoro ea ts'ohanyetso ea lehae (joalo ka 911) haeba u ba le matšoao a tlokotsi e matla ea adrenal.

Bitsa mofani oa tlhokomelo ea bophelo haeba u na le lefu la Addison kapa hypopituitarism mme u sa khone ho noa moriana oa hau oa glucocorticoid ka lebaka lefe kapa lefe.

Haeba u na le lefu la Addison, hangata u tla bolelloa hore u eketse litekanyetso tsa meriana ea hau ea glucocorticoid ka nakoana haeba u imetsoe kelellong kapa u kula, kapa pele u etsoa opereishene.

Haeba u na le lefu la Addison, ithute ho tseba matšoao a khatello ea maikutlo a ka bakang mathata a maholo a adrenal. Haeba u laetsoe ke ngaka ea hau, itokisetse ho ipeha thunya ea tšohanyetso ea glucocorticoid kapa ho eketsa litekanyetso tsa hau tsa meriana ea glucocorticoid ea molomo nakong ea khatello ea maikutlo. Batsoali ba lokela ho ithuta ho etsa sena bakeng sa bana ba bona ba nang le ho se lekane ha adrenal.

Kamehla jara ID ea bongaka (karete, sefaha sa letsoho, kapa sefaha sa sefaha) se reng ha u na matla a adrenal. ID e boetse e lokela ho bolela mofuta oa moriana le litekanyetso tseo u li hlokang haeba ho le kotsi.

Haeba u nka meriana ea glucocorticoid bakeng sa khaello ea pituitary ACTH, etsa bonnete ba hore u tseba nako ea ho noa lethal dose la moriana oa hau. Buisanang ka sena le mofani oa thepa ea hau.

Le ka mohla u se ke ua hloloheloa ho noa meriana ea hau.

Mathata a Adrenal; Mathata a Addisonia; Ho hloleha ho matla ha adrenal

• Litšoelesa tsa endocrine
• Sephiri sa adrenal gland

Bornstein SR, Alloliu B, Arlt W, le al. Ho lemoha le kalafo ea khaello ea mantlha ea adrenal: Tataiso ea boits'oaro ea Mokhatlo oa Endocrine. J Kliniki ea Endocrinol Metab. 2016; 101 (2): 364-389. PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116.

Stewart PM, Newell-Price JDC. Karolo ea adrenal cortex. Ka: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, bahlophisi. Buka ea Williams ea Endocrinology. 13th ed. Philadelphia, PA: Elsevier; 2016: khaolo ea 15.

Thiessen MEW. Mathata a qoqotho le a adrenal. Ka: Marako RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Likhopolo le Tloaelo ea Kliniki. La 9th. Philadelphia, PA: Elsevier; 2018: khaolo ea 120.