Hyponatremia yana faruwa lokacin da jiki ya ƙunshi ƙarancin sodium don adadin ruwan da ke ciki. Abubuwan da ke haifar da su sun haɗa da amfani da diuretics, gudawa, gazawar zuciya, da SIADH. Bayyanar asibiti na da mahimmanci na jijiyoyin jiki, biyo bayan canja wurin ruwa zuwa cikin ƙwayoyin kwakwalwa, musamman a cikin m hyponatremia, kuma sun haɗa da ciwon kai, rikicewa, da rashin hankali. Ciwon kai da coma na iya faruwa. Gudanarwa ya dogara da alamun cututtuka da alamun asibiti, musamman kimanta ƙimar extracellular, da abubuwan da ke haifar da cutar. Jiyya ta dogara ne akan rage yawan shan ruwa, ƙara fitar da ruwa, ƙara raunin sodium, da magance matsalar rashin lafiya.

Hyponatremia cuta ce ta electrolyte wacce ke nuna yawan ruwan jikin mutum dangane da jimlar sodium na jiki. Muna magana ne game da hyponatremia lokacin matakin sodium yana ƙasa da 136 mmol / l. Yawancin hyponatremias sun fi 125 mmol / L kuma suna asymptomatic. Kawai hyponatremia mai tsanani, wato a ce ƙasa da 125 mmol / l, ko alama, ya zama na gaggawa da magani.

Matsalar hyponatremia shine:

• game da cutar 1,5 ga marasa lafiya 100 kowace rana a asibiti;
• 10 zuwa 25% a cikin sabis na geriatric;
• 4 zuwa 5% a cikin marasa lafiya da aka shigar da su cikin sassan gaggawa, amma wannan mita na iya tashi zuwa 30% a cikin marasa lafiya da cirrhosis;
• kusan 4% a cikin marasa lafiya da cutar tumo ko hypothyroidism;
• Sau 6 ya fi girma a cikin tsofaffi marasa lafiya kan maganin rage yawan damuwa, kamar masu zaɓin maganin serotonin reuptake inhibitors (SSRIs);
• fiye da 50% a cikin marasa lafiya da ke asibiti da cutar kanjamau.
  

Hyponatremia na iya haifar da:

• asarar sodium mafi girma fiye da asarar ruwa, tare da raguwar ƙimar ruwan jiki (ko ƙarar extracellular);
• riƙewar ruwa tare da asarar sodium, tare da ƙarar extracellular mai kiyayewa;
• riƙewar ruwa mafi girma fiye da riƙewar sodium, wanda ke haifar da ƙaruwa a cikin ƙimar sel.

A kowane hali, ana narkar da sodium. Tsawon amai ko gudawa mai tsanani na iya haifar da asarar sodium. Lokacin da aka rama asarar ruwa kawai da ruwa, ana narkar da sodium.

Asarar ruwa da sodium galibi asalin asalin renon ne, lokacin da aka rage ƙarfin reabsorption na tubule na koda, bayan gudanar da diuretics na thiazide. Waɗannan magunguna suna haɓaka haɓakar sodium, wanda ke haɓaka haɓakar ruwa. Waɗannan galibi ana yin haƙuri da su amma suna iya haifar da hyponatremia a cikin mutanen da ke da ƙarancin sodium, musamman tsofaffi. Rashin hasara na narkewa ko cutanous yana da yawa.

Tsayar da ruwa shine sakamakon karuwar da bai dace ba a cikin ɓoyayyen hormone antidiuretic (ADH), wanda kuma ake kira vasopressin. A wannan yanayin, muna magana game da SIADH ko ciwo na ɓoyayyen ɓoyayyiyar ADH. Vasopressin yana taimakawa daidaita adadin ruwan da ke cikin jiki ta hanyar sarrafa adadin ruwan da kodar ta fitar. Yawan sakin vasopressin yana haifar da raguwar fitar da ruwa ta kodan, wanda ke haifar da riƙe ruwa a cikin jiki kuma yana narkar da sodium. Rufin vasopressin ta glandon pituitary zai iya motsawa ta:

• zafi;
• danniya;
• motsa jiki;
• hypoglycemia;
• wasu cututtukan zuciya, thyroid, kodan ko adrenals. 

SIADH na iya kasancewa saboda shan kwayoyi ko abubuwan da ke motsa ɓarna na vasopressin ko ta motsa aikinta a cikin kodan kamar:

• chlorpropamide: maganin da ke rage sukarin jini;
• carbamazepine: anticonvulsant;
• vincristine: miyagun ƙwayoyi da ake amfani da su a jiyyar cutar sankara;
• clofibrate: maganin da ke rage matakan cholesterol;
• antipsychotics da antidepressants;
• aspirin, ibuprofen;
• ecstasy (3,4-methylenedioxy-methamphetamine [MDMA]);
• vasopressin (hormone antidiuretic roba) da oxytocin da ake amfani da su wajen haifar da aiki yayin haihuwa.

Hakanan SIADH na iya haifar da yawan amfani da ruwa fiye da ƙarfin tsarin koda ko a lokuta:

• potomanie;
• polydipsie;
• Cutar Addison;
• hypothyroidism. 

A ƙarshe, yana iya zama sakamakon raguwar ƙarar kewaya saboda:

• gazawar zuciya;
• gazawar koda;
• cirrhosis;
• nephrotic ciwo.

Riƙe sodium shine sakamakon karuwar ɓarkewar aldosterone, bayan raguwar ƙarar kewaya.

Yawancin marasa lafiya tare da natremia, watau yawan sodium da ya fi 125 mmol / l, suna asymptomatic. Tsakanin 125 zuwa 130 mmol / l, alamun sune galibi na ciki: tashin zuciya da amai.

Kwakwalwa tana da hankali musamman ga canje -canje a matakin sodium a cikin jini. Hakanan, don ƙimar da ke ƙasa da 120 mmol / l, alamun neuropsychiatric sun bayyana kamar:

• ciwon kai;
• kasala;
• yanayin rikicewa;
• rashin hankali;
• ƙwanƙwasa tsoka da girgiza;
• ciwon farfaɗiya;
• da coma.

Sakamakon illar kumburin kwakwalwa, yana haifar da rashin aiki, kuma farkon sa ya dogara da tsananin da saurin farawar hyponatremia.

Wataƙila alamun cutar sun fi tsanani a cikin tsofaffi waɗanda ke da yanayin rashin lafiya.

Hyponatremia na iya zama barazanar rayuwa. Ana amfani da matakin, tsawon lokaci da alamomin hyponatremia don sanin yadda sauri zai zama dole don gyara jinin jini. Hyponatremia na Symptomatic yana buƙatar asibiti a duk lokuta.

Idan babu alamun, hyponatremia galibi na yau da kullun ne kuma gyara kai tsaye baya da mahimmanci. Koyaya, ana ba da shawarar yin asibiti idan matakin sodium na jini bai wuce 125 mmol / l ba. Don asymptomatic hyponatremia ko fiye da 125 mmol / l, gudanarwa na iya kasancewa na asibiti. Daga nan likitan ya tantance ko ya zama dole a gyara hyponatremia ko a'a kuma ya tabbatar da cewa bai yi muni ba. Gyara dalilin hyponatremia yawanci ya isa ya daidaita shi. Lallai, daina shan miyagun ƙwayoyi, inganta jiyya na gazawar zuciya ko cirrhosis, ko ma maganin hypothyroidism galibi ya isa.

Lokacin da aka nuna gyara na hyponatremia, ya dogara da ƙarar extracellular. Idan ya kasance:

• al'ada: ƙuntata shan ruwa, ƙasa da lita ɗaya a kowace rana, ana ba da shawarar, musamman a cikin yanayin SIADH, kuma ana ba da magani kan abin da ya haifar (hypothyroidism, ƙarancin adrenal, shan diuretics);
• ya karu: diuretics ko vasopressin antagonist, kamar desmopressin, wanda ke da alaƙa da ƙuntatawar shan ruwa, sannan ya zama babban magani, musamman a lokutan bugun zuciya ko cirrhosis;
• raguwa, bayan asarar narkewa ko na koda: an nuna karuwar yawan sodium da ke hade da rehydration. 

Wasu mutane, musamman waɗanda ke da SIADH, suna buƙatar magani na dogon lokaci don hyponatremia. Ƙuntataccen ruwa kawai bai isa ba don hana sake dawowa hyponatremia. Za'a iya amfani da allunan sodium chloride a cikin mutanen da ke da hyponatremia mai rauni zuwa matsakaici. 

Hyponatremia mai tsanani gaggawa ne. Jiyya shine a hankali ƙara matakin sodium a cikin jini ta amfani da ruwa mai ruɓi kuma wani lokacin diuretic. Zaɓuɓɓukan masu hana mai karɓar vasopressin, kamar conivaptan ko tolvaptan, wani lokacin ana buƙata.