Hyponatremia inoitika kana muviri uine sodium shoma yakawandisa pahuwandu hwemvura yauinayo. Zvikonzero zvinowanzoitika zvinosanganisira kushandiswa kwemadiuretics, manyoka, kutadza kwemoyo, uye SIADH. Kuratidzwa kwekiriniki kunonyanya kuenderana neurological, zvichitevera kutamiswa kweosmotic yemvura mumasero ehuropi, kunyanya muacute hyponatremia, uye inosanganisira musoro, kuvhiringidzika, uye stupor. Kugwinya uye coma zvinogona kuitika. Kutungamira kunoenderana nezviratidzo uye zviratidzo zvekiriniki, kunyanya kuongororwa kweiyo extracellular vhoriyamu, uye ari pasi pathologies. Kurapa kunoenderana nekuderedza kudyiwa kwemvura, kuwedzera kubuda kwemvura, kuwedzera kushomeka kwesodium, uye kurapa dambudziko riripo.

Hyponatremia chirwere che electrolyte chinoratidzwa nekuwanda kwemvura yemuviri maererano nemuviri wese sodium. Isu tinotaura nezve hyponatremia kana iyo sodium level iri pasi pe136 mmol / l. Yakawanda hyponatremias yakakura kupfuura 125 mmol / L uye haina asymptomatic. Chete yakanyanya hyponatremia, kureva isingasviki 125 mmol / l, kana symptomatic, inoumba dambudziko rekuongorora uye kurapa.

Chiitiko che hyponatremia ndeche:

• nezve 1,5 zviitiko pavarwere ve100 pazuva muchipatara;
• 10 kusvika 25% mubasa regeriatric;
• 4 kusvika ku5% muvarwere vanobvumirwa kune madhipatimendi ekukurumidzira, asi iyi nguva inogona kukwira kusvika ku30% kune varwere vane cirrhosis;
• inenge 4% muvarwere vane bundu chirwere kana hypothyroidism;
• 6 nguva yakakura muvarwere vakwegura pamishonga inodzvinyirira, yakadai sekusarudza serotonin reuptake inhibitors (SSRIs);
• vanopfuura 50% muvarwere vari muchipatara vane AIDS.
  

Hyponatremia inogona kukonzerwa ne:

• kurasikirwa kwesodium yakakura kudarika kurasikirwa kwemvura, nekuderera kwehuwandu hwemvura yemuviri (kana extracellular volume);
• kuchengetwa kwemvura nekurasikirwa kwesodium, inoperekedzwa neyakachengetwa extracellular volume;
• kuchengetwa kwemvura kwakakura kupfuura kuchengetwa kwesodium, zvichikonzera kuwedzera kwehuwandu hweextracellular.

Muzviitiko zvose, sodium inoderedzwa. Kurutsa kwenguva refu kana manyoka akanyanya kunogona kukonzera kurasikirwa nesodium. Kana kurasikirwa kwemvura kuchibhadharwa chete nemvura, iyo sodium inonatswa.

Kurasika kwemvura uye sodium kazhinji kunobva paitsvo, apo simba rekudzorera renal tubule rinoderedzwa, zvichitevera kupihwa kwethiazide diuretics. Iyi mishonga inowedzera kubuda kwe sodium, iyo inowedzera kubuda kwemvura. Izvi zvinowanzotenderwa zvakanaka asi zvinogona kukonzera hyponatremia muvanhu vane sodium shoma, kunyanya vakura. Kurasika kwekugaya kana kucheka hakuwanzoitiki.

Kuchengetwa kwemvura ndiko mhedzisiro yekuwedzera kusingakodzeri mukuburitswa kweantidiuretic hormone (ADH), inonziwo vasopressin. Muchiitiko ichi, tinotaura nezveSIADH kana syndrome yeasina kukodzera ADH secretion. Vasopressin inobatsira kudzora huwandu hwemvura huripo mumuviri nekudzora huwandu hwemvura inoburitswa neitsvo. Kuburitswa kwakanyanya kwevasopressin kunokonzeresa kuderera kwekubuda kwemvura neitsvo, izvo zvinotungamira mukuchengetwa kwemvura kwakanyanya mumuviri uye inoderedza sodium. Kuburitswa kwevasopressin nepituitary gland kunogona kukurudzirwa ne:

• kurwadziwa;
• kunetseka;
• kuita muviri ;
• hypoglycemia;
• kumwe kusagadzikana kwemoyo, thyroid, itsvo kana adrenals. 

SIADH inogona kunge iri nekuda kwekutora zvinodhaka kana zvinhu zvinokurudzira kuvanzika kwevasopressin kana kukurudzira kuita kwayo muitsvo senge:

• chlorpropamide: mushonga unoderedza shuga yeropa;
• carbamazepine: anticonvulsant;
• vincristine: mushonga unoshandiswa muchemotherapy;
• clofibrate: mushonga unoderedza cholesterol mazinga;
• antipsychotics uye antidepressants;
• aspirin, ibuprofen;
• ecstasy (3,4-methylenedioxy-methamphetamine [MDMA]);
• vasopressin (synthetic antidiuretic hormone) uye oxytocin inoshandiswa kukonzera kurwadziwa panguva yekusununguka.

SIADH inogonawo kuguma nekunyanya kunwa zvinwiwa zvinopfuura simba renal regulation kana muzviitiko zve:

• potomanie;
• polydipsie;
• Chirwere cheAddison;
• hypothyroidism. 

Pakupedzisira, inogona kunge iri mhedzisiro yekudzikira kwekutenderera kwevhoriyamu nekuda kwe:

• kutadza kwemoyo;
• itsvo kutadza;
• cirrhosis;
• nephrotic syndrome.

Sodium retention ndiyo mhedzisiro yekuwedzera kwe aldosterone secretion, zvichitevera kuderera kwehuwandu hwekutenderera.

Varwere vazhinji vane natremia, kureva sodium concentration inodarika 125 mmol/l, havana symptomatic. Pakati pe125 uye 130 mmol / l, zviratidzo zvinonyanya kuitika mudumbu: kusvotwa uye kurutsa.

Uropi hunonyanya kukoshesa kuchinja kwehuwandu hwe sodium muropa. Zvakare, kune zvakakosha pazasi 120 mmol / l, neuropsychiatric zviratidzo zvinoita senge:

• musoro;
• kuneta;
• a confused state;
• stupor;
• kukanganisika kwetsandanyama uye kugwinha;
• pfari pfari;
• kuti pakoma.

Ndivo mhedzisiro yecerebral edema, inokonzera kusagadzikana, uye kutanga kwayo kunoenderana nekuoma uye nekukurumidza kwekutanga kwe hyponatremia.

Zviratidzo zvinowanzonyanya kuoma kune vanhu vakwegura vane zvirwere zvisingaperi.

Hyponatremia inogona kutyisidzira upenyu. Dhigirii, nguva uye zviratidzo zve hyponatremia zvinoshandiswa kuona kuti zvichakurumidza sei kugadzirisa serum yeropa. Symptomatic hyponatremia inoda kuchipatara mune zvese zviitiko.

Mukusavapo kwezviratidzo, hyponatremia inowanzogara isingaperi uye kururamisa kwekukurumidza hakusi nguva dzose kwakakosha. Nekudaro, kuchipatara kunokurudzirwa kana serum sodium level iri pasi pe125 mmol / l. Kune asymptomatic hyponatremia kana kupfuura 125 mmol / l, manejimendi anogona kuramba ari ambulatory. Chiremba anozoongorora kana zvakakosha kugadzirisa hyponatremia uye kuona kuti haina kuwedzera. Kugadzirisa chinokonzeresa hyponatremia kazhinji zvakakwana kuti chiite kuti chijaire. Zvechokwadi, kumisa mushonga unogumbura, kuvandudza marapirwo ekushaya simba kwemoyo kana cirrhosis, kana kunyange kurapwa kwe hypothyroidism kunowanzoitika.

Kana kururamiswa kwe hyponatremia kunoratidzwa, zvinoenderana neiyo extracellular volume. Kana ari:

• zvakajairika: kudziviswa kwekudya kwemvura, pasi perita pazuva, kunokurudzirwa, kunyanya munyaya yeSIADH, uye kurapwa kunotarisana nechikonzero (hypothyroidism, adrenal insufficiency, kutora diuretics) inoshandiswa;
• yakawedzera: diuretics kana vasopressin anopikisa, akadai se desmopressin, yakabatana nekudziviswa kwekudya kwemvura, zvino inoumba kurapa kukuru, kunyanya mumamiriro ekushaya mwoyo kana cirrhosis;
• yakaderera, kutevera kugaya kana kurasikirwa kwerenal: kuwedzera kwekudya kwesodium kunobatanidza nekudzorera mvura kunoratidzwa. 

Vamwe vanhu, kunyanya avo vane SIADH, vanoda kurapwa kwenguva refu kwe hyponatremia. Fluid restriction chete kazhinji haina kukwana kudzivirira kudzoka kwe hyponatremia. Sodium chloride mapiritsi anogona kushandiswa muvanhu vane hunyoro kusvika pakati nepakati chisingaperi hyponatremia. 

Yakanyanya hyponatremia ndeye emergency. Kurapa ndekwekuwedzera zvishoma nezvishoma sodium muropa uchishandisa intravenous fluid uye dzimwe nguva diuretic. Kusarudza vasopressin receptor inhibitors, senge coniaptan kana tolvaptan, dzimwe nguva inodiwa.