Hypercalcemia

Hypercalcemia e bolela hore o na le calcium e ngata haholo maling a hao.

Hormone ea Parathyroid (PTH) le Vithamine D li thusa ho laola botsitso ba calcium 'meleng.

• PTH e entsoe ke litšoelesa tsa parathyroid. Tsena ke litšoelesa tse 'ne tse nyane tse teng molaleng kamora' qoqotho.
• Vithamine D e fumanoa ha letlalo le pepesetsoa khanya ea letsatsi, le ho tsoa mehloling ea lijo kapa li-supplement.

Lebaka le tloaelehileng haholo la boemo bo phahameng ba mali a calcium ke PTH e fetelletseng e hlahisoang ke litšoelesa tsa parathyroid. Ho feteletseng ho etsahala ka lebaka la:

• Ho atolosoa ha litšoelesa tse le 'ngoe kapa ho feta.
• Khōlo ho e 'ngoe ea litšoelesa. Boholo ba nako, likhola tsena li kotsi (eseng mofets'e).

Tekanyo ea mali ea calcium le eona e ka ba holimo haeba 'mele oa hau o le tlase ho maro kapa metsi.

Maemo a mang a ka baka le hypercalcemia:

• Mefuta e meng ea mofetše, joalo ka mofets'e le mofetše oa matsoele, kapa mofetše o nametseng lithong tsa hau.
• Vithamine D e ngata haholo maling a hau (hypervitaminosis D).
• Ho lula u sa robala betheng matsatsi kapa libeke tse ngata (haholo ho bana).
• K'halsiamo e ngata lijong tsa hau. Sena se bitsoa lefu la lebese-alkali. Hangata ho etsahala ha motho a noa li-milligram tse fetang 2000 tsa calcium bicarbonate ka letsatsi le litekanyetso tse ngata tsa Vitamin D.
• Tšoelesa ea qoqotho e feteletseng.
• Lefu le sa foleng la liphio kapa ho hloleha ha liphio.
• Meriana e kang lithium le thiazide diuretics (lipilisi tsa metsi).
• Mafu a mang kapa mathata a bophelo bo botle a kang, Lefu la Paget, lefuba le sarcoidosis.
• Boemo ba lefutso bo amang bokhoni ba mmele ba ho laola calcium.

Banna le basali ba lilemo tsohle ba ka ba le khalsiamo e phahameng ea mali. Leha ho le joalo, e atile haholo ho basali ba fetang lilemo tse 50 (kamora ho khaotsa ho ilela khoeli). Maemong a mangata, sena se bakoa ke tšoelesa e feteletseng ea parathyroid.

Boemo bona hangata bo fumanoa bo sa le qalong ho sebelisoa liteko tsa mali tse tloaelehileng. Batho ba bangata ha ba na matšoao.

Matšoao ka lebaka la khalsiamo e phahameng a ka fapana, ho latela sesosa le hore na bothata bo bile teng nako e kae. Li ka kenyelletsa:

• Matšoao a silang lijo, a kang ho nyekeloa ke pelo kapa ho hlatsa, takatso ea lijo e fokolang, kapa ho sokela
• Ho nyoroa ho eketsehileng kapa ho ntša metsi khafetsa, ka lebaka la liphetoho liphio
• Bofokoli kapa mesifa ea mesifa
• Liphetoho tseleng eo boko ba hau bo sebetsang ka eona, joalo ka ho ikutloa u khathetse kapa u khathetse kapa u ferekane
• Bohloko ba masapo le masapo a senyehang habonolo a robehang habonolo

Tlhahlobo e nepahetseng e hlokahala ho hypercalcemia. Batho ba nang le majoe a liphio ba lokela ho etsa liteko ho lekola hypercalcemia.

• Khalase ea serum
• Serum PTH
• Serum PTHrP (protheine e amanang le PTH)
• Tekanyo ea vithamine D ea Serum
• K'halsiamo ea moroto

Kalafo e etselitsoe sesosa sa hypercalcemia ha ho khonahala. Batho ba nang le hyperparathyroidism ea mantlha (PHPT) ba ka hloka ho buuoa ho tlosa tšoelesa e sa tloaelehang ea parathyroid. Sena se tla folisa hypercalcemia.

Batho ba nang le hypercalcemia e bonolo ba ka khona ho lekola boemo bona haufi le nako ntle le kalafo.

Basali ba leng nakong ea ho khaotsa ho ilela khoeli, kalafo ka estrogen ka linako tse ling e ka khutlisa hypercalcemia e bonolo.

Hypercalcemia e matla e bakang matšoao mme e hloka hore motho a lule sepetlele a ka alafshoa ka tse latelang:

• Maro a tsoang mothapong - Ena ke kalafo ea bohlokoahali.
• Calcitonin.
• Dialysis, haeba ho ameha tšenyo ea liphio.
• Meriana ea diuretic, e kang furosemide.
• Lithethefatsi tse emisang ho senyeha ha masapo le ho monya ke 'mele (bisphosphonates).
• Li-glucocorticoids (li-steroid).

Hore na o sebetsa hantle hakae ho latela sesosa sa boemo ba hau ba calcium e phahameng. Pono e ntle ho batho ba nang le hyperparathyroidism e bonolo kapa hypercalcemia ba nang le sesosa se ka phekolehang. Boholo ba nako, ha ho na mathata.

Batho ba nang le hypercalcemia ka lebaka la maemo a kang mofetše kapa sarcoidosis ba kanna ba se sebetse hantle. Hangata hona ho bakoa ke lefu lena ka bolona, ​​ho fapana le boemo bo phahameng ba calcium.

LIEKETSENG MASELE

• Pancreatitis
• Lefu la peptic ulcer

KHOELE

• Calcium e kenya liphio (nephrocalcinosis) e bakang ts'ebetso e mpe ea liphio
• Ho felloa ke metsi 'meleng
• Khatello ea mali e phahameng
• Ho hloleha ha liphio
• Majoe a liphio

KHAOLO TS'OLO

• Ho tepella maikutlo
• Ho thata ho tsepamisa mohopolo kapa ho nahana

SEKELE

• Li-cysts tsa masapo
• Ho robeha hoa dikarolo
• Lefu la ho fokola ha masapo

Mathata ana a hypercalcemia ea nako e telele ha a tloaeleha kajeno linaheng tse ngata.

Ikopanye le mofani oa tlhokomelo ea bophelo haeba u na le:

• Nalane ea lelapa ea hypercalcemia
• Nalane ea lelapa ea hyperparathyroidism
• Matšoao a hypercalcemia

Lisosa tse ngata tsa hypercalcemia li ke ke tsa thibeloa. Basali ba ka holimo ho lilemo tse 50 ba lokela ho bona mofani oa bona khafetsa mme ba hlahlojoe boemo ba calcium ea bona haeba ba na le matšoao a hypercalcemia.

Bua le mofani oa hau ka lethal dose haeba u nka li-supplement tsa calcium le vithamine D.

Calcium - e phahameng; Boemo bo phahameng ba calcium; Hyperparathyroidism - hypercalcemia

• Hypercalcemia - ho tsoa

• Litšoelesa tsa endocrine

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Darr EA, Sritharan N, Pellitteri PK, Sofferman RA, Randolph GW. Tsamaiso ea mathata a parathyroid. Ka: Flint PW, Haughey BH, Lund V, et al, eds. Cummings Otolaryngology: Ho Buuoa Hlooho le Nko. La 6th. Philadelphia, PA: Elsevier Saunders; 2015: khaolo ea 124.

Thakker RV. Litšoelesa tsa parathyroid, hypercalcemia le hypocalcemia. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 232.