Isisu - kuyini? Ukwahlukanisa futhi umsebenzi isisu

Abantu abaningi baye bezwa eside ezifana "isisu." Ukuthi kuyini, sizozama ukuhlunga ngezansi. Leli qembu izidakamizwa has ngezigaba zawo, izakhiwo kanye nezici

Isisu - kuyini?

Isisu futhi ngokuthi isisu imithi. Ziyakwazi nemithi zokwenziwa noma imvelaphi sithombo esingatshalwanga labo abazokwazi okwandisa excretion of umchamo by nezinso. Ngalesi, kanye sithuthukiswe umchamo excretion nosawoti namanzi, futhi sehlise izinga ketshezi izimbotshana nezicubu. Ngenxa yalokhu encishisiwe noma zinyamalale edema. Isisu - izidakamizwa ukuthi kabanzi yokwelapha nomfutho wegazi ophezulu (aphakeme blood pressure). Avame asetshenziselwa ukwelapha omnene congestive inhliziyo ukwehluleka, uhlobo kanye nenani nezifo zesibindi futhi yizifo ezihlobene nokungabikho kwegazi kahle ukuthi kumkhathaze yokujama tsi emzimbeni. Imithi evame ukusetshenziswa isisu ukunciphisa noma kuqede izimpawu of ukubuyisa, okuyinto ngezinye izikhathi zihambisana PMS noma kakade wabonakaliswa esesikhathini. Ngo bawuhloniphe ukwelashwa lwemithi futhi umthamo isisu musa abangele ezinzima engemihle. Balondekile ngempela ukuyisebenzisa.

Isisu ngesikhathi sokukhulelwa

gynecologists Abaningi kungukuthi belulekwa ukuba baphuze ngesikhathi sokukhulelwa isisu. Izidakamizwa kungahle kungaphephi ukuze fetus impilo kamama. Umphumela ongemuhle kwatholakala akunjalo kudala. Ngaphambili, izidakamizwa isisu eyayisetshenziselwa ukunciphisa edema ekukhulelweni, UKUPHEBEZA preeclampsia et al.

Isisu: ngezigaba

Kunezinhlobo ezahlukene imithi isisu. Isigaba ngasinye has zayo siqu emandla nebutsakatsaka lobukhona kumfundzi. Kuze kube manje, kukhona iqembu izidakamizwa:

• Jika Imithi.
• potassium-engashiyi isisu.
• izidakamizwa Thiazide.
• thiazide ejenti.

Mayelana nalezi amaqembu Kuchazwa kabanzi lapha ngezansi ngokugcwele.

iluphu isisu

Lesi sigaba izidakamizwa yikho okuvame kakhulu. Lokhu kuhlanganisa izidakamizwa ezifana "ethacrynic acid," "Torasemide" "Furosemide" "piretanide" "bumetanide". Naphezu kweqiniso lokuthi isakhiwo chemical ingahluka kakhulu, lezi isisu ube indlela efanayo senzo. Lezi amalungiselelo yezokwelapha zivimbela reabsorption izinto ezifana sodium, chloride kanye potassium. Isiqu esithi "loop isisu" ngenxa indlela izenzo zabo. Resorption kwenzeka kumjikelezo ekuntweleni Henle share. It Kwenziwa ivimbela sodium, chlorine, potassium ulwelwesi apical lamaseli ijabulise EPITHELIAL. Ngenxa yalesi msebenzi ukuyiveza jika-counterflow uhlelo e nezinso. Ngaphezu kwalokho, isisu labo abazokwazi lolu hlobo Nweba izitsha cortex.

imiphumela emibi iluphu isisu

Amandla umphumela lezi imithi inkulu ngokungavamile: bangakwazi ukwandisa umchamo okuphumayo by 25%. Ngokungafani nezinye izidakamizwa ukuthi ulahlekelwe nomphumela nge ukuzinza of BCC, le isisu iluphu-uhlobo izimo ezinjalo zaqhubeka zikhona. Kuyinto ngenxa isenzo oqinile isisu bangakwazi kuvuse engemihle. I ezingavamile kakhulu futhi kunzima - iconsi wegazi, hypovolemia, encishisiwe glomerular filtration isilinganiso kanye kwezinso ukugeleza kwegazi. Ngenxa ukususwa lelitfutfukile hydrogen, chlorine ne potassium ayikwazi ayifakiwe alkalosis umzimba. Ngezinye izikhathi iluphu isisu kuphakamisa hyponatremia futhi hypokalemia. Ezimweni ezingavamile - Hyperglycemia, hyperuricemia. Eminye imiphumela emibi ibandakanya: isiyezi, isicanucanu ebuthakathakeni. Medicine "ethacrynic acid" ngokuvamile kuphakamisa ubuthulu unomphela noma okwesikhashana, futhi neutropenia. Imithi Konke lokhu uhlobo akade ngenhla, asuswe umzimba usebenzisa izinso, metabolizing esibindini.

Izinkomba iluphu isisu

Lezi Imithi enqunyiwe zonke izinhlobo senhliziyo. Futhi ayadingeka ikakhulukazi izifo ezifana senhliziyo uhlobo refractory futhi edema yamaphaphu. Imithi futhi aphumelele hyponatremia, hypoalbuminemia, hypokalemia, hypochloremia, futhi ukwehluleka kwezinso. Isisu iluphu uhlobo bayaqhubeka basebenze lapho nezinye isisu iqembu, futhi inhlanganisela yawo ayizwakali. Lena ukubaluleka kwabo okukhulu. Ngakho-ke, lolu hlobo esivamile - isisu iluphu. Kuyini, siye kakade asebenzelana ngayo.

isisu thiazide

Lezi amalungiselelo wezokwelapha kanye nemikhiqizo yabo ( "Indapamide" "chlorthalidone" futhi "Metolazone") asetshenziswa impela njalo. Ngokuyinhloko, lokhu kungenxa isilinganiso sabo eliphezulu ukumuncwa e pheshana emathunjini, kanye ezingeni ezinhle tolerability nesineke. isisu Thiazide mancane enamandla ukwedlula loop, kodwa sibonga isikhathi eside yesenzo aboniswa abantu abanezifo ezimbi kakhulu ezingalapheki njenge lwemithambo nomfutho wegazi ophezulu we kubalulekile uhlobo non-ezinzima congestive ukumelwa inhliziyo, uhlobo. isisu Thiazide kuyabekwa ekuphathweni ngomlomo. Diuresis ngokuvamile uqala ngemva 1-2 amahora, kodwa nomphumela oqabulayo antihypertensive kwezinye izimo, kungase waphawula kuphela emva 3 nezinyanga zokwelashwa okuqhubekayo. Ngukhokho leli qembu chlorothiazide. It libhekene ongaphakeme lipid solubility, futhi bioavailability ngenxa yalokho ongaphakeme. Ngenxa yalokhu, ngenxa nomphumela oqabulayo kudinga ephakeme umthamo imithi. Umuthi 'chlorthalidone "ngempela kancane amuncwa umzimba, ngakho-ke kuba kancane isenzo isikhathi. Kusho "Metolazone" kuvame ukuba nemiphumela emihle kakhulu in iziguli kahle umsebenzi kwezinso, njengoba kuqhathaniswa neminye imithi kulesi sigaba.

isisu potassium-engashiyi

Kukhona potassium ekulondolozeni isisu. Kuyini lokhu? Le mithi asetshenziselwa ukwelapha umfutho ophakeme wegazi lihambisana namanye izinhlobo izidakamizwa. Bona ukuvimbela excretion ngokweqile potassium emzimbeni, okuyinto evamile side effect izidakamizwa isisu kwezinye izigaba. Hypokalemia - ukwehla izinga potassium-plasma. Kuyinto ihlupha isisu thiazide, okuyinto evame ukunikezwa ukulapha nomfutho wegazi ophezulu. Lapho izinga potassium ancipha kakhulu, isiguli uqala uzizwa ubuthaka, ukhathele ngokushesha, yena unalo arrhythmia inhliziyo. Ukuze uvimbele lokhu, kanye ngokuvamile izidakamizwa thiazide kuyabekwa isisu potassium-ungahawukelanga. Baqhubeka umzimba kanye potassium ngaphezulu namanye amaminerali abalulekile - magnesium calcium. Kanjalo kakhulu ungalibali ukuhoxiswa uketshezi ngokweqile kanye sodium. Ukungabi kwemithi potassium-engashiyi kanje. Potassium amazinga e-plasma kungase kwandise ngokweqile (ngaphezu kuka-5 mmol / l.). Lesi simo njengoba hyperkalemia ezaziwayo. Kungabangela kwemisipha nokukhubazeka kanye arrhythmias inhliziyo, lize lithi khimilili. Ukuthuthukiswa zezifo eziningi kungenzeka in iziguli esingamahlalakhona kwezinso.

Ukusetshenziswa ukwelapha umfutho ophakeme wegazi

Isisu ophakeme wegazi kuthiwa kungase kutholakale. Isiza ukususwa uketshezi emzimbeni, ngaleyo ndlela kuncishiswe blood pressure. Eqinisweni Eliqinisekisiwe wukuthi imithi isisu aphumelela kakhudlwana ekwelapheni iziguli esezikhulile njengoba kuqhathaniswa ne-beta-blocker. Isisu Imithi kufakwe ohlwini lokuqala umugqa imithi, asetshenziselwa kujwayeleke blood pressure. Ngokusho izincomo odokotela United States, kulesi sigaba kumele sisetshenziswe ukwelashwa kokuqala nomfutho wegazi ophezulu (ayinzima). Ngenxa ukubaluleka okukhulu wegazi ukulawula kanye ukwehlisa ubungozi zenhliziyo ekwelapheni, ukunakekelwa okukhethekile ikhokhelwa kuze imiphumela umzimba, yiziphi eziyizici imithi antihypertensive. Lokunye lokubaluleke kakhulu umthelela Yiqiniso nokuphulukiswa ezifweni zabo futhi izici isitho-okuhlobene.

Imithi Thiazide futhi thiazide ophakeme wegazi

Ngaphambili, umfutho ophakeme wegazi uvamise ukwelashwa nge iluphu isisu. Kodwa manje base ngokwethukela kusetshenziswa kakhulu ekwelapheni izinso, ukuhluleka kwenhliziyo futhi edema. Imiphumela yabonisa ezinhle ngempumelelo thiazide-uhlobo izidakamizwa. Babe ngcono onalesi sifo nomfutho wegazi ophezulu. Nokho, ukunciphisa ubungozi bokwenza izenzakalo yenhliziyo uma usebenzisa lezi zimali sasingeyona evelele njengoba kuqhathaniswa imiphumela elindelekile. Ukusetshenziswa kwezidakamizwa thiazide kwandisa amathuba arrhythmias. Ezinye iziguli can ngisho okungazelelwe ukufa arrhythmic. Njengoba ngokuvamile kwenzeka iziyaluyalu carbohydrate lipid umzimba, kanye hyperuricemia. Ingaba yimbi kakhulu i-atherosclerosis kanye nesifo sikashukela. Medpreparty leli qembu ngokuvamile kuhlanganiswe isisu potassium-ungahawukelanga.

Izinga esilandelayo kwemvelo isisu ukwelapha umfutho ophakeme wegazi thiazide amathuluzi ensimbi. Ikakhulu, i-kahle kungase kutholakale kuhlelwe 1974 ukhokho wawo - Imithi "Indapamide". Inzuzo ukuthi tiazidopodobnye kusho ukusebenza ingasaphathwa ku-sodium reabsorption, okusho ukuthi okukhiphayo ingasaphathwa potassium emzimbeni. Ngakho-ke, imiphumela emibi umzimba kanye diabetogenic cishe lingekho. Manje kungase kutholakale ukuthi isetshenziswa ngemithamo emincane zomuthi "Indapamide" ngaphandle isinyathelo isisu ongenza indima a omelene calcium womsebenzi vasodilator futhi kukhuthaza ukukhiqizwa kwe prostaglandin E2.

Ezimweni zanamuhla of Imithi thiazide futhi thiazide kabanzi hhayi kuphela ukwehlisa blood pressure, kodwa futhi njengoba isilinganiso izifo, kanye ukwelapha ekupheleni-isitho izilonda. Le mithi ngokuvamile kakhulu ebekiwe a izifundo ukwelashwa. Basuke kungase kutholakale kahle ngakhoke kabanzi emhlabeni wonke.