I-Hypercalcemia 

I-Hypercalcemia yisimo sezokwelapha esivamile kodwa esivame ukuphuthelwa esenzeka lapho amazinga e-calcium egazini eba phezulu kakhulu. Amazinga e-calcium egazini kufanele ahlale phakathi kuka-8 no-10 mg/dL. Iziguli ezine-calcium ephakeme egazini lazo zibonisa izimpawu eziningana, kuhlanganise ezinso, ubuhlungu bethambo, ukungakhululeki kwesisu, ukucindezeleka, ubuthakathaka, nokudideka. Le bhulogi ichaza lokho iziguli okufanele zazi mayelana nokuxilongwa kanye nezinketho zokwelashwa kwe-hypercalcemia. 

Iyini i-Hypercalcemia? 

Amazinga e-calcium egazini angaphezu kuka-8.5-10.5 milligrams ngedesilitha ngayinye (mg/dL) abonisa isifo se-hypercalcemia. Lesi simo silahla umzimba wakho ibhalansi ye-calcium, izindlala ze-parathyroid, izinso, kanye nomgudu wokugaya ukudla ngokuvamile okwaziyo ukuwulawula. Odokotela bahlukanisa i-hypercalcemia ngokusekelwe ebukhulwini: okumaphakathi (10.5-11.9 mg/dL), okumaphakathi (12.0-13.9 mg/dL), noma okunzima (ngaphezu kuka-14.0 mg/dL). Imisebenzi evamile yomzimba wakho iqala ukuwohloka lapho amazinga e-calcium ehlala ephakeme; amacala angalashwa angalimaza izitho zomzimba. 

I-Hypercalcemia Izimpawu Nezimpawu 

Ungase ungaboni noma yiziphi izimpawu nge-hypercalcemia ethambile. Njengoba amazinga e-calcium enyuka, izimpawu zingathinta izinhlelo eziningi zomzimba: 

• Okuhlobene nezinso: Ukoma ngokweqile, ukuvuthwa njalo, amatshe ezinso 
• Isistimu yokugaya ukudla: I-nausea, ukuhlanza, ukungakuthandi ukudla, ukuqunjelwa, ubuhlungu besisu Amathambo nemisipha: Ubuhlungu bethambo, ubuthakathaka bemisipha, ukukhathala 
• Ubuchopho: Ukudideka, izinkinga zenkumbulo, ukucindezeleka, ubunzima bokugxila Inhliziyo: Ukushaya kwenhliziyo okungajwayelekile, palpitations, umfutho wegazi ophakeme 

Izinkinga ze-Hypercalcemia 

Izindlala ze-parathyroid ezisebenza ngokweqile zibangela cishe amaphesenti angama-90 amacala e-hypercalcemia. Lezi zindlala zikhipha i-hormone ye-parathyroid eningi kakhulu ohlelweni lwakho. Umdlavuza ubalwa njengembangela yesibili evame kakhulu, ikakhulukazi umdlavuza wamaphaphu, webele, wezinso, nomdlavuza wegazi njenge-multiple myeloma. 

Ezinye izimbangela ze-hypercalcemia zihlanganisa: 

• Amavithamini D amaningi kakhulu noma izithasiselo ze-calcium 
• Imithi (thiazide diuretics, lithium) 
• Izifo ze-Granulomatous (sofubai-sarcoidosis) 
• Ukunganyakazi isikhathi eside 
• ezinzima kwamanzi emzimbeni 
• Izimo zofuzo ezifana ne-familia hypocalciuric hypercalcemia

Izingozi ze-Hypercalcemia 

Izici eziningana zingaphakamisa ingozi yakho yokuthuthukisa i-hypercalcemia. Lokhu kubandakanya: 

• Abesifazane abangaphezu kweminyaka engama-50 babhekana nezingozi eziphakeme ngenxa yezinguquko zangemva kokuya esikhathini. 
• Iziguli ezinomdlavuza, ikakhulukazi lezo ezinama-metastases amathambo, zisengozini kakhulu. 
• Abantu abane isifo sezinso, ukuphazamiseka kwe-parathyroid, noma labo abasebenzisa imithi ethile bangase babe nalesi simo. 
• Izinketho zakho zendlela yokuphila nazo zinendaba - ukuntula umsebenzi womzimba nokusinda utshwala ukusetshenziswa kungandisa ingozi yakho. 

Imiphumela Emibi Yamazinga E-Calcium Aphakeme 

I-hypercalcemia engalashwa ingaholela ezinkingeni ezinkulu zezempilo. Izinso zakho zingase zehluleke, zibe namatshe, noma ziqongelele i-calcium deposits. Izinkinga zamathambo zivame ukulandela, kuhlanganise kwamathambo, ukuphuka, nama-bone cysts. Izimo ezinzima zingathinta isigqi senhliziyo yakho nokusebenza kobuchopho, okungaholela ekudidekeni, ukuwohloka komqondo, noma ikhoma. Isistimu yakho yokugaya ingase futhi ibe nezinkinga ezifana ne-pancreatitis kanye ne-peptic ulcer. 

Sifo 

Odokotela basebenzisa izivivinyo eziningana ukuze bahlole i-calcium ephakeme egazini futhi bathole ukuthi yini ebangela lokho. 

Ukuhlolwa kwegazi kuyisinyathelo sokuqala sokuhlola amazinga e-calcium ne-parathyroid hormone. Lezi zivivinyo zisiza odokotela ukuthi bafunde ukuthi izinhlelo zomzimba ezahlukene zisebenza kanjani. 

Ukuhlolwa komchamo kuza ngokulandelayo ukukala ukuphuma kwe-calcium nokubona izinkinga zezinso. 

Uma imbangela ingacacile, odokotela bangase badinge:  

• I-Electrocardiogram (EKG) ukurekhoda umsebenzi kagesi wenhliziyo 
• I-X-ray yesifuba ukuhlola umdlavuza wamaphaphu noma izifo 
• I-Mammogram okufanele uyihlole umdlavuza webele 
• I-CT noma i-MRI ihlola ukuze ibheke izitho zangaphakathi 
• Iskena se-DEXA ukukala ukuminyana kwamathambo 

Ukwelashwa kwe-Hypercalcemia 

Uhlelo lokwelapha luncike ekutheni isimo sibi kangakanani nokuthi sibangelwa yini. Odokotela baqapha izimo ezithambile (i-calcium <11.5 mg/dL) kuyilapho belapha imbangela. Izimo ezimaphakathi zinezinketho zokwelashwa ezimbalwa: 

Imithi: 

• I-Calcitonin - Ihomoni elehlisa ngokushesha amazinga e-calcium 
• Ama-Bisphosphonates - Lawa asebenza kangcono ku-hypercalcemia ehlobene nomdlavuza 
• I-Calcimimetics - Isiza ukulawula izindlala ze-parathyroid ezingasebenzi ngokweqile 
• I-Prednisone - Isebenza kahle ku-vitamin D ehlobene ne-hypercalcemia
• I-Denosumab - Iwusizo lapho ama-bisphosphonates engasebenzi 

I-hypercalcemia enzima idinga ukunakekelwa esibhedlela ngoketshezi lwe-IV kanye nama-diuretics. 

Uzoyibona Nini Udokotela 

Kufanele uthole usizo lwezokwelapha ngokushesha uma ubona ukoma okukhulu, ukuchama njalo, ubuhlungu besisu, ukudideka, noma ukushaya kwenhliziyo okungajwayelekile. I-hypercalcemia emaphakathi ingase ingabangeli izimpawu, kodwa ngaphandle kokwelashwa, ingaholela ezinkingeni ezinkulu ezifana ezinso, i-osteoporosis, ngisho ne-coma. 

Prevention 

Ungathatha izinyathelo ezimbalwa zokuvimbela i-hypercalcemia. 

• Ukuphuza amanzi amaningi kwenza izinso zakho zikhiphe i-calcium eyengeziwe. 
• Ungathathi izithako ze-calcium ngaphandle uma udokotela wakho ekuyalela. 
• Ukuzivocavoca umzimba okuthwala isisindo njalo kuthuthukisa impilo yamathambo futhi kugcina i-calcium emathanjeni akho esikhundleni segazi lakho. 
• Abantu abanezimo ezingaphansi kufanele bahlole amazinga e-calcium njalo futhi bakhulume nodokotela babo ngamasu okuphatha. 

Isiphetho 

I-Hypercalcemia yinkinga yezempilo ebucayi ethinta kufika ku-2% wabantu. Izimo ezithambile zingase zingabonisi zimpawu, kodwa lesi simo sidinga nje ukunakwa ngenxa yezingozi ezingaba khona. I-hyperparathyroidism eyinhloko kanye nomdlavuza yizizathu ezivame kakhulu ngemuva kwamazinga aphezulu e-calcium, nezinye izici eziningi zingabangela lesi simo, futhi. Ukuhlolwa kwegazi okuvamile kusiza ukulibona kusenesikhathi futhi kunikeze ithuba elingcono kakhulu lokulilawula ngaphambi kokuba kwenzeke umonakalo unomphela. Ukunakekelwa okufanele kwezokwelapha kusiza ukuphatha i-hypercalcemia ngokuphumelelayo naphezu kwemvelo yayo engathi sína. Odokotela bakhetha ukwelashwa ngokusekelwe ekutheni isimo sinzima kangakanani nokuthi kungani kwenzeka. Izinketho zisukela ekuhlolweni okulula kuye emithini, ukuhlinzwa, noma ukulaliswa esibhedlela ezimeni ezinzima. Ngokungangabazeki, iziguli ezisiqondayo isimo sazo zenza ukukhetha okungcono kwezempilo futhi zisebenze kangcono nodokotela bazo 

Imibuzo Evame Ukubuzwa 

1. Uyini umehluko phakathi kwe-hypocalcemia ne-hypercalcemia? 

Lezi zimo zibonisa ukungalingani kwe-calcium egazini. I-Hypocalcemia yenzeka lapho amazinga e-calcium ehla ngaphansi kwebanga elijwayelekile. I-Hypercalcemia yenzeka lapho amazinga e-calcium eba ngaphezu kuka-10.5 mg/dL. Zombili lezi zimo zithinta izinhlelo eziningi zomzimba kodwa zakha izimpawu ezihlukene. I-Hypocalcemia imvamisa idala ukuqina kwemisipha, ama-spasms, ukudideka, nezinkinga zenkumbulo. I-Hypercalcemia ingabangela amatshe ezinso, ubuhlungu bamathambo, & izinkinga zokugaya ukudla. 

2. I-hypercalcemia ivame kangakanani? 

I-Hypercalcemia ithinta cishe i-1-2% yabantu emhlabeni jikelele. 

3. I-hypercalcemia ithinta bani? 

Abantu bayo yonke iminyaka yobudala bangathola lesi simo, kodwa abesifazane abangaphezu kweminyaka engama-50 babhekene nengozi enkulu kakhulu, ikakhulukazi ngemva kwalokho menopause. Iziguli ezinomdlavuza zisengozini enkulu, cishe 2% yazo zonke izinhlobo zomdlavuza ezixhunywe ku-hypercalcemia. 

4. Wehlisa kanjani amazinga e-calcium egazini lakho? 

Unganciphisa amazinga e-calcium egazini ngezindlela eziningi: 

• Phuza amanzi amaningi (3-4 amalitha nsuku zonke) ukuze izinso zakho zikwazi ukukhipha i-calcium eningi 
• Thatha imithi yokwelashwa enqunyiwe efana noketshezi lwe-IV, imithi efana nayo 
• Ama-bisphosphonates, i-calcitonin, noma i-corticosteroids 
• Hlala usebenza uma kungenzeka, ngoba ukuntuleka kokunyakaza kungenza i-hypercalcemia ibe yimbi kakhulu 
• Yeqa izithasiselo ze-calcium ngaphandle uma udokotela wakho ezincoma 

5. Yikuphi ukuntula okubangela i-calcium ephezulu? 

I-calcium ephezulu ayivamisile ukuvela ngenxa yokushoda—imvamisa ibangelwa ukweqisa. I-vitamin D eningi kakhulu evela ezithasiselweni ingakhuphula amazinga e-calcium ngokwandisa ukumuncwa emgudwini wokugaya ukudla. Eminye imithi, njenge-lithium ne-thiazide diuretics, ingase ikhulise amazinga e-calcium ngokuphazamisa ukusebenza kwe-parathyroid. 

6. Yikuphi ukudla okwehlisa i-calcium egazini? 

Ukudla okunosawoti kanye notshwala kungasiza ukwehlisa amazinga e-calcium egazini. Ukudla okunothe nge-fiber enama-phytates (okutholakala kokusanhlamvu, okusanhlamvu, namantongomane) kungase kuvimbele ukumuncwa kwe-calcium uma kudliwa nokudla okunothe nge-calcium. Ukudla okugcwele i-oxalic acid (isipinashi, imifino yebhitrudi, i-rhubarb, nobhatata) nakho kubopha i-calcium futhi kunciphise ukumuncwa kwayo. 

7. Yini ongayidli uma une-calcium ephezulu? 

Abantu abane-hypercalcemia kufanele banciphise: 

• Imikhiqizo yobisi (ubisi, ushizi, iyogathi, u-ayisikhilimu)
• Ukudla okune-calcium (ijusi yewolintshi, okusanhlamvu)
• Izinhlanzi ezisemathinini ezinamathambo athambile (i-salmon, sardines)
• Ama-antacid aqukethe i-calcium 
• Ukudla okunosawoti omningi
• Utshwala obuningi 

8. Sehlisa kanjani i-hypercalcemia ngokwemvelo? 

I-hydration enhle isebenza kahle kakhulu ukuphatha i-hypercalcemia ngokwemvelo ngokusiza umzimba wakho ukuthi ukhiphe i-calcium eningi ngomchamo. Isikhathi sokudla esihlakaniphile siyasiza - yidla ukudla okubopha i-calcium okungenani amahora amabili ngaphambi noma ngemva kokudla okune-calcium. Ukusebenza okuvamile kusiza umzimba wakho ukuthi usebenzise i-calcium ngendlela efanele, kodwa ukuhlala unganyakazi isikhathi eside kungenza izinto zibe zimbi nakakhulu. Ukunciphisa utshwala kuvimbela i-calcium ukuthi ingashiyi amathambo akho.

UDkt Kamal P. Bhutada

MD, DNB (General Medicine), MNAMS, IDCCM, EDIC
I-Ganga CARE Hospital Limited, eNagpur

Ukuze Ubhukhe Isikhathi, shayela:

+ 91 40-68106529