Pilikia adrenal koʻikoʻi

ʻO ke kūpilikiʻi adrenal koʻikoʻi kahi kūlana hoʻoweliweli i ke ola inā ʻaʻole lawa ka nui o ka cortisol. ʻO kēia kahi hormone i hana ʻia e nā adrenal glands.

Aia nā aka adrenal ma luna pono o nā puʻupaʻa. ʻO ka adrenal gland ʻelua mau ʻāpana. ʻO ka ʻāpana o waho, i kapa ʻia ʻo Cortex, e hua mai i ka cortisol. ʻO kēia kahi hōmona koʻikoʻi no ka kaohi ʻana i ke koko. ʻO ka ʻāpana o loko, i kapa ʻia ka medulla, hana i ka adrenaline hormone (i kapa ʻia hoʻi ʻo epinephrine). Hoʻokuʻu ʻia ʻo cortisol a me adrenaline i ka pane o ke koʻikoʻi.

Hoʻoponopono ʻia ka hana Cortisol e ka pituitary. He gland liʻiliʻi kēia ma lalo o ka lolo. Hoʻokuʻu ka pituitary i ka adrenocorticotropic hormone (ACTH). ʻO kēia kahi hōmona e hoʻonā i nā adrenal glands e hoʻokuʻu i ka cortisol.

Hoʻoponopono ʻia ka hana adrenaline e nā aʻalolo e hele mai ana mai ka lolo a me ka iwi kuamoo a ma nā kaheoneoneone.

Hiki i kahi pilikia adrenal ke hana mai kekahi o kēia mau mea:

• Ua pōʻino ke kino adrenal ma muli o, no ka laʻana, Addison maʻi a i ʻole nā ​​maʻi adrenal gland, a i ʻole ke ʻoki kino
• Ua ʻeha ka pituitary a ʻaʻole hiki ke hoʻokuʻu iā ACTH (hypopituitarism)
• ʻAʻole mālama maikaʻi ʻia ka lawa ʻole o ka adrenal
• Ke lawe nei ʻoe i nā lāʻau a glucocorticoid no kekahi manawa lōʻihi, a kū koke
• Ua make wai loa ʻoe
• ʻO ka maʻi a i ʻole ke koʻikoʻi koʻikoʻi kino

Hiki i nā ʻōuli a me nā hōʻailona o ka pilikia adrenal ke hoʻopili i kekahi o kēia mau mea:

• ʻEha o ka ʻōpū a i ʻole ka ʻeha flank
• Huikau, nalowale o ka ʻike, a i ʻole koma
• Make wai
• ʻO ka puʻupuʻu a i ʻole ka uila
• Ka luhi, nāwaliwali loa
• ʻEha poʻo
• Wela wela
• Loaʻa ka ʻai ʻole
• Kaomi haʻahaʻa
• Koko kōpaʻa haʻahaʻa
• Nualea, luaʻi
• Helu puʻuwai wikiwiki
• Ka helu hanu wikiwiki
• Hele lohi, lohi
• ʻO ka hou pinepine ʻole a nui ʻole i ka helehelena a me nā poho lima

Nā hoʻokolohua i kauoha ʻia paha e kōkua i ke kuhi hewa ʻana me ka pilikia adrenal koʻikoʻi:

• Hōʻike hoʻonāukiuki ACTH (cosyntropin)
• Pae Cortisol
• Koko kō
• Papa potasiuma
• Pae paʻakai
• pae PH

I ka pilikia adrenal, pono ʻoe e hāʻawi koke ʻia i ka lāʻau hydrocortisone ma o ke aa (intravenous) a i ʻole nāʻiʻo (intramuscular). Hiki paha iā ʻoe ke loaʻa i nā wai a loaʻa ke koko kiʻekiʻe.

Pono ʻoe e hele i ka haukapila no ka mālama ʻana a me ka nānā ʻana. Inā loaʻa i ka maʻi maʻi a i ʻole kekahi pilikia olakino ka pilikia, pono paha ʻoe i kahi lāʻau hou aʻe.

Kūleʻa paha ka haʻalulu inā ʻaʻole hoʻolako ʻia ka lapaʻau i ka wanaʻao, a hiki ke hoʻoweliweli i ke ola.

E hele i ka lumi pilikia a kāhea paha i ka helu kūloko kūloko (e like me 911) inā hoʻomohala ʻoe i nā ʻōuli o ka pilikia adrenal koʻikoʻi.

Kāhea i kāu mea mālama ola inā loaʻa ʻoe i ka maʻi ʻo Addison a i ʻole hypopituitarism a ʻaʻole hiki iā ʻoe ke lawe i kāu lāʻau lapaʻau glucocorticoid no kekahi kumu.

Inā loaʻa ʻoe i ka maʻi ʻo Addison, e haʻi pinepine ʻia ʻoe e hoʻonui iki i nā lāʻau o kāu lāʻau glucocorticoid inā pilikia ʻoe a maʻi paha, a ma mua o ka hana ʻoki ʻana.

Inā loaʻa ʻoe i ka maʻi ʻo Addison, e aʻo e ʻike i nā hōʻailona o ke koʻikoʻi koʻikoʻi e hiki ai i kahi ulia adrenal crisis. Inā ua aʻo ʻia ʻoe e kāu kauka, e mākaukau e hāʻawi iā ʻoe iho i kahi kī pōkino o ka glucocorticoid a i ʻole e hoʻonui i kāu mea o ka lāʻau lāʻau lāʻau oral i nā manawa pilikia. Pono nā mākua e aʻo e hana i kēia no kā lākou keiki i loaʻa ʻole ka adrenal insufficiency.

Lawe mau i ka ID olakino (kāleka, kūpeʻe lima, a i ʻole ka lei) i ʻōlelo e loaʻa ka lawa ʻole o ka adrenal. Pono e ʻōlelo ka ID i ke ʻano o ka lāʻau a me nā mea pono āu e pono ai i ka wā pilikia.

Inā ʻoe e lawe i nā lāʻau a glucocorticoid no ka hemahema pituitary ACTH, e ʻike pono ʻoe ʻike i ka wā e lawe ai i kahi hopena koʻikoʻi o kāu lāʻau. Kūkākūkā i kēia me kāu mea hāʻawi.

Mai haʻalele iki i ka lawe ʻana i kāu lāʻau.

Pilikia Adrenal; Pilikia Addisonian; Huʻi adrenal pono ʻole

• Nānā Endocrine
• Huna ka adrenal gland hormone

Bornstein SR, Alloliu B, Arlt W, et al. ʻIke a me ka mālama ʻana i ka pono adrenal kumu mua: kahi papa hana hoʻomaʻamaʻa ʻo Endocrine Society. ʻO J Clin Endocrinol Metab. 2016; 101 (2): 364-389. PMID: PMC4880116 www.ncbi.nlm.nih.gov/pmc/articles/PMC4880116.

ʻO Stewart PM, Newell-Kumukūʻai JDC. ʻO ka Cortex adrenal. I: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. ʻO Williams Textbook of Endocrinology. 13th ed. Piladelapia, PA: Elsevier; 2016: chap 15.

ʻO Thiessen MEW. Nā maʻi thyroid a me adrenal. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 120.