Hana ʻia ka hyponatremia ke loaʻa ka sodium i ke kino no ka nui o nā wai i loaʻa iā ia. ʻO nā kumu maʻamau ka hoʻohana ʻana o diuretics, diarrhea, puʻuwai puʻuwai, a me SIADH. ʻO nā mea hōʻike Clinical he neurological, ma hope o ka osmotic transfer o ka wai i nā lolo lolo, ʻo ia hoʻi i ka hyponatremia huehue, a me ka ʻeha poʻo, huikau, a me ka stupor. Hiki ke loaʻa ka hopu ʻana a me ke koma. Aia ka hoʻokele i nā ʻōuli a me nā hōʻailona maʻi, i ka loiloi i ka nui o nā extracellular, a me nā pathology o lalo. Hoʻokumu ʻia ka mālama ʻana ma ka hōʻemi ʻana i ka lawe ʻana o ka wai, hoʻonui i ka kahe o ke kahe, ka hoʻokō ʻana i ka hemahema sodium, a me ka mālama ʻana i ka maʻi maʻi.

ʻO ka hyponatremia kahi maʻi electrolyte i hōʻike ʻia e ka nui o ke kino o ke kino e pili ana i ka sodium āpau o ke kino. 'Speaklelo mākou no ka hyponatremia ke emi ka pae sodium ma lalo o 136 mmol / l. ʻOi aku ka nui o nā hyponatremias ma mua o 125 mmol / L a he asymptomatic. ʻO ka hyponatremia koʻikoʻi wale nō, ʻo ia ka mea i ʻoi aku ma mua o 125 mmol / l, a i ʻole nā ​​mea hōʻailona, ​​ʻo ia ka diagnostic a me ka emergency therapeutic emergency.

ʻO ka hanana o hyponatremia:

• ma kahi o 1,5 mau hihia no 100 mau maʻi i kēlā me kēia lā i ka haukapila;
• 10 i ka 25% i ka lawelawe geriatric;
• 4 a 5% i nā mea maʻi i ʻae ʻia i nā keʻena pilikia, akā hiki ke piʻi aʻe kēia pinepine i 30% i nā maʻi me ka cirrhosis;
• aneane 4% i nā maʻi me ka maʻi tumo a hypothyroidism paha;
• 6 mau manawa i ʻoi aku i nā mea maʻi ʻelemakule ma ka mālama antidepressant, e like me nā mea hōʻemi e lawe i nā serotonin reuptake (SSRIs);
• ʻoi aku ma mua o 50% i nā poʻe maʻi maʻi me ka maʻi maʻi.
  

Hiki ke hopena i ka hyponatremia mai:

• ʻoi aku ka nui o ka make sodium ma mua o ka nalowale o ka wai, me ka nui o ka nui o ka wai o ke kino (a i ʻole ka nui o nā extracellular);
• ka paʻa ʻana o ka wai me ka nalo ʻana o ka sodium, me ka nui o ka extracellular i mālama ʻia;
• ka paʻa ʻana o ka wai ma mua o ka paʻa ʻana o ka sodium, e hopena ana i ka hoʻonui ʻana i ka nui extracellular.

I nā hihia āpau, hoʻoliʻiliʻi ka sodium. ʻO ka luaʻi hoʻolōʻihi a i ʻole diarrhea nui hiki ke alakaʻi i ka nalo ʻana o ka sodium. Ke uku ʻia nā nalo wai me ka wai wale nō, hoʻoliʻiliʻi ka sodium.

ʻO ka nalo ʻana o ka wai a me ka sodium he kumu pinepine ia o ke kumu, ke hoʻemi ʻia nā mana reabsorption o ka tubule renal, ma hope o ka lawelawe ʻana o diuretics thiazide. Hoʻonui kēia mau lāʻau i ka excretion o ka sodium, kahi e hoʻonui ai i ka excretion o ka wai. ʻAe maikaʻi ʻia kēia mau mea akā hiki ke kumu i ka hyponatremia i ka poʻe hiki i ka sodium haʻahaʻa, ʻo ka mea ʻelemakule hoʻi. Kākaʻikahi nā pohō Digestive a i ʻole cutaneus.

ʻO ka paʻa ʻana o ka wai ka hopena o ka hoʻonui kūpono ʻole ʻana i ka huna o antoneuretic hormone (ADH), i kapa ʻia hoʻi ʻo vasopressin. I kēia hihia, ʻōlelo mākou e pili ana iā SIADH a i ʻole syndrome o ka huna ADH kūpono ʻole. Kōkua ʻo Vasopressin i ka hoʻoponopono ʻana i ka nui o ka wai i loaʻa i loko o ke kino e ka kaohi ʻana i ka nui o ka wai i hoʻopau ʻia e nā puʻupaʻa. ʻO ka hoʻokuʻu nui ʻana o nā vasopressin i ka hopena o ka hoʻemi ʻia ʻana o ka wai e nā puʻupaʻa, kahi e alakaʻi ai i ka nui o ka paʻa ʻana o ka wai i ke kino a hoʻokahe i ka sodium. ʻO ka huna o vasopressin e ka pituitary gland hiki ke hoʻoulu ʻia e:

• ʻeha;
• ke koʻikoʻi;
• hoʻoikaika kino;
• hypoglycemia;
• kekahi mau maʻi o ka puʻuwai, thyroid, nā konāhua a i ʻole nā ​​adrenals. 

ʻO SIADH paha ma muli o ka lawe ʻana i nā lāʻau a i ʻole nā ​​mea e hoʻonāukiuki i ka huna ʻana o vasopressin a i ʻole hoʻonāukiuki i kāna hana i nā puʻupaʻa e like me:

• chlorpropamide: lāʻau e hoʻohaʻahaʻa i ke kō kō;
• carbamazepine: anticonvulsant;
• vincristine: lāʻau i hoʻohana ʻia i ka chemotherapy;
• clofibrate: kahi lāʻau e hoʻohaʻahaʻa i nā kiʻekiʻe kolesterol;
• antipsychotics a me nā antidepressants;
• aspirin, ibuprofen;
• ecstasy (3,4-methylenedioxy-methamphetamine [MDMA]);
• vasopressin (synthetic antidiuretic hormone) a me ka oxytocin i hoʻohana ʻia e hoʻoulu i ka hana i ka wā hānau.

Hiki i ka SIADH ke hopena ma muli o ka hoʻohana nui ʻana i nā wai ma mua o ka hiki o ka renal rula a i ʻole nā ​​hihia o:

• potomanie;
• polydipsie;
• Maʻi ʻo Addison;
• hypothyroidism. 

ʻO ka hope, ʻo ia paha ka hopena o ka hōʻemi o ka nui o ka holo ʻana ma muli o:

• puʻuwai puʻuwai;
• hakuʻala ʻole;
• cirrhosis;
• maʻi nephrotic.

ʻO ka paʻa paʻakai ka hopena o ka hoʻonui ʻana o ka huna aldosteron, ma hope o ka emi ʻana o ka nui o ka holo.

ʻO ka hapa nui o nā mea maʻi me ka natremia, ʻo ia hoʻi ka paʻakai sodium ma mua o 125 mmol / l, he asymptomatic. Ma waena o 125 a me 130 mmol / l, ʻo nā ʻōuli ka nui o ka gastrointestinal: nausea a me ka luaʻi.

ʻIke nui ka lolo i nā loli i ke kiʻekiʻe o ka sodium i loko o ke koko. Eia kekahi, no nā waiwai ma lalo o 120 mmol / l, ʻike ʻia nā ʻōuli neuropsychiatric e like me:

• ʻeha poʻo poʻo;
• lethargy;
• he mokuʻāina huikau;
• haʻalulu;
• nā kuʻikuʻi Muscle a me nā haunaele;
• ka hopu ʻana i ka maʻi epileptic;
• koma

ʻO lākou ka hopena o ka edema cerebral, e hana ana i ka hana ʻole, a ʻo ka hoʻomaka ʻana e pili i ka paʻakikī a me ka wikiwiki o ka hoʻomaka o hyponatremia.

E ʻoi aku paha ke koʻikoʻi o nā ʻōuli ma nā poʻe kūpuna me nā kūlana mau.

Hiki i ka hyponatremia ke hoʻoweliweli i ke ola. Hoʻohana ʻia ke kekelē, ka lōʻihi a me nā ʻōuli o ka hyponatremia e hoʻoholo ai i ka wikiwiki e pono ai e hoʻoponopono i ke kīʻaha koko. Pono ka hyponatremia hōʻailona i ka haukapila ma nā hihia āpau.

I ka loaʻa ʻole o nā ʻōuli, maʻamau ka hyponatremia a hoʻomau ʻole ka hoʻoponopono koke ʻana i nā manawa āpau. Eia nō naʻe, koi ʻia ka haukapila inā ʻoi aku ka liʻiliʻi o ka pae sodium ma mua o 125 mmol / l. No ka hyponatremia asymptomat a ʻoi aku paha ma mua o 125 mmol / l, hoʻomau ka noho hoʻokele. Loiloi ke kauka inā pono a pololei ʻole e hoʻoponopono i ka hyponatremia a hōʻoia ʻaʻole ia e pōʻino. ʻO ka hoʻoponopono ʻana i ke kumu o ka hyponatremia e lawa ai ka maʻamau. ʻOiaʻiʻo, ke kāpae ʻana i ka lāʻau hōʻino, hoʻomaikaʻi ʻana i ka mālama ʻana i ka hōʻeha puʻuwai a i ʻole cirrhosis, a i ʻole ʻo ka mālama ʻana i ka hypothyroidism e lawa pinepine ai.

Ke kuhikuhi ʻia ka hoʻoponopono ʻana o ka hyponatremia, pili ia i ka nui extracellular. Inā ʻo ia:

• maʻamau: kaohi ʻana o ka lawe ʻana o ka wai, ma lalo o hoʻokahi lita o ka lā, ua paipai ʻia, keu hoʻi i ka hihia o SIADH, a me ke kuhikuhi ʻana e kūʻē i ke kumu (hypothyroidism, adrenal insufficiency, taking diuretics) hoʻokō ʻia;
• māhuahua: diuretics a i ʻole vasopressin antagonist, e like me desmopressin, e pili pū me ka palena o ka lawe ʻana i ka wai, a laila lilo i ka lapaʻau nui, keu hoʻi i nā hihia o ka puʻuwai puʻuwai a i ʻole cirrhosis;
• hoʻemi, ma hope o ka digestive a i ʻole nā ​​hōʻino puʻupaʻa: hoʻonui ʻia ka lawe ʻana i ka sodium e pili pū ana me ka rehydration. 

ʻO kekahi poʻe, ʻo ia hoʻi ka poʻe me SIADH, koi i ka mālama lōʻihi no ka hyponatremia. ʻAʻole lawa ka kaohi kapu wale ʻana e pale ai i ka hoʻi hou o hyponatremia. Hiki ke hoʻohana ʻia ʻo Sodium chloride papa i loko o ka poʻe me ka hyponatremia maʻi mau. 

ʻO ka hyponatremia koʻikoʻi kahi pilikia. ʻO ka mālama ʻana e hoʻonui mālie i ka pae sodium i loko o ke koko e hoʻohana ana i nā wai a me nā wai i kekahi manawa he diuretic. ʻO nā mea kāohi vasopressin receptor receptor, e like me conivaptan a i ʻole tolvaptan, i kekahi manawa e pono ai.