Isifo seGuillain-Barré

I-Guillain-Barré syndrome (i-GBS) yingxaki enkulu yezempilo eyenzeka xa inkqubo yomzimba yokuzikhusela (amajoni omzimba) ihlasela ngempazamo inxalenye yenkqubo yemithambo-luvo. Oku kukhokelela kukudumba kwemithambo-luvo okubangela ubuthathaka bemisipha okanye ukukhubazeka kunye nezinye iimpawu.

Isizathu ngqo se-GBS asaziwa. Kucingelwa ukuba i-GBS sisifo esingumzimba. Ngokuphazamiseka komzimba, amajoni omzimba azihlasela ngempazamo. I-GBS inokwenzeka nakweyiphi na iminyaka. Ixhaphake kakhulu kubantu abaphakathi kweminyaka engama-30 ukuya kwengama-50.

I-GBS inokwenzeka ngokusuleleka kwiintsholongwane okanye kwiibhaktheriya, njenge:

• Umkhuhlane
• Ezinye izifo zesisu
• I-Mycoplasma inyumoniya
• Intsholongwane kaGawulayo, intsholongwane ebangela i-HIV / AIDS (kunqabile kakhulu)
• I-Herpes simplex
• Mononucleosis

I-GBS inokwenzeka nezinye iimeko zonyango, ezinje:

• Inkqubo ye lupus erythematosus
• Isifo seHodgkin
• Emva kotyando

I-GBS yonakalisa iinxalenye zemithambo-luvo. Umonakalo wemithambo-luvo ubangela ukurhawuzelela, ubuthathaka bemisipha, ukuphulukana nokulingana, kunye nokukhubazeka. I-GBS ihlala ichaphazela ukugquma kwemithambo-luvo (myelin sheath). Lo monakalo ubizwa ngokuba kukudanjiswa. Yenza ukuba imithambo-luvo ihambe kancinci. Ukonakala kwezinye iinxalenye zentsholongwane kunokubangela ukuba i-nerve iyeke ukusebenza.

Iimpawu ze-GBS zinokuba mandundu ngokukhawuleza. Kungathabatha iiyure ezimbalwa kuphela ukuba ezona mpawu ziqatha zibonakale. Kodwa ubuthathaka obonyuka ngaphezulu kweentsuku ezininzi kuqhelekile.

Ubuthathaka bemisipha okanye ukuphulukana nomsebenzi wemisipha (ukukhubazeka) kuchaphazela omabini amacala omzimba. Kwiimeko ezininzi, ubuthathaka bemisipha buqala emilenzeni kwaye bunwenwele kwiingalo. Oku kubizwa ngokuba kukunyuka komzimba.

Ukuba ukudumba kuchaphazela imithambo-luvo yesifuba kunye nediaphragm (umsipha omkhulu ophantsi kwemiphunga okunceda ukuba uphefumle) kwaye ezo zihlunu zibuthathaka, unokufuna uncedo lokuphefumla.

Ezinye iimpawu kunye neempawu ze-GBS zibandakanya:

• Ukuphulukana nokuthamba kwethenda ezingalweni nasemilenzeni
• Ukulinganisa okanye ukuphazamiseka (ukulahleka kancinci kwemvakalelo)
• Ukuthamba kwemisipha okanye iintlungu (inokuba yingqaqambo efana necramp)
• Intshukumo engahambelaniyo (ayinakuhamba ngaphandle koncedo)
• Uxinzelelo lwegazi olusezantsi okanye ulawulo lwegazi olubi
• Inqanaba lentliziyo elingaqhelekanga

Ezinye iimpawu zingabandakanya:

• Umbono ophazamisayo kunye nombono ophindwe kabini
• Ukuqaqadeka nokuwa
• Kunzima ukuhambisa izihlunu zobuso
• Izihlunu zemisipha
• Ukuziva ukubetha kwentliziyo (ukubetha)

Iimpawu ezingxamisekileyo (funa uncedo lwezonyango kwangoko):

• Ukuphefumla kuyayeka okwethutyana
• Ayinakuthatha umphefumlo
• Kunzima ukuphefumla
• Kunzima ukugwinya
• Ukutsala amathe
• Ukufa isiqaqa
• Ukuva ukukhanya kukhokelela xa umile

Imbali yokwanda kobuthathaka bemisipha kunye nokukhubazeka kunokuba luphawu lwe-GBS, ngakumbi ukuba bekukho ukugula okwangoku.

Uvavanyo lonyango lunokubonisa ubuthathaka bemisipha. Kusenokubakho iingxaki ngoxinzelelo lwegazi kunye nokubetha kwentliziyo. Le yimisebenzi elawulwa ngokuzenzekelayo yinkqubo yemithambo-luvo. Uviwo lunokubonisa ukuba i-reflexes efana ne-ankle okanye idolo jerk iyancipha okanye ilahlekile.

Kunokubakho iimpawu zokwehla kokuphefumla okubangelwa kukhubazeka kwezihlunu zokuphefumla.

Olu vavanyo lulandelayo lunokwenziwa:

• Isampulu yeCerebrospinal fluid (impompo yomqolo)
• ECG ukujonga umsebenzi wombane entliziyweni
• I-Electromyography (EMG) yokuvavanya umsebenzi wombane kwimisipha
• Uvavanyo lwe-velocity velocity test ukuvavanya ukuba isantya sombane sihamba njani kwi-nerve
• Uvavanyo lomsebenzi wePulmonary ukulinganisa ukuphefumla kunye nendlela esebenza kakuhle ngayo imiphunga

Akukho lunyango lwe-GBS. Unyango lujolise ekunciphiseni iimpawu, ekunyangeni iingxaki, nasekukhawuleziseni ukubuyela kwimeko yesiqhelo.

Kumanqanaba okuqala okugula, unyango olubizwa ngokuba yi-apheresis okanye iplasmapheresis lunokunikwa. Kubandakanya ukususa okanye ukuvimba iiproteni, ezibizwa ngokuba ngamachiza omzimba, ahlasela iiseli zemithambo-luvo. Olunye unyango yi-immunoglobulin (IVIg) efakwa emithanjeni. Zombini unyango zikhokelela ekuphuculeni ngokukhawuleza, kwaye zombini zisebenza ngokulinganayo. Kodwa akukho ngenelo ekusebenziseni zombini unyango ngaxeshanye. Olunye unyango luyanceda ukunciphisa ukudumba.

Xa iimpawu zinzima, unyango esibhedlele luya kufuneka. Inkxaso yokuphefumla iya kuthi inikwe.

Olunye unyango esibhedlele lujolise ekuthinteleni iingxaki. Oku kunokubandakanya:

• Abacoci begazi ukunqanda amahlwili egazi
• Ukuphefumla inkxaso okanye ityhubhu yokuphefumla kunye ne-ventilator, ukuba uvalo lubuthathaka
• Amayeza obuhlungu okanye amanye amayeza ukunyanga iintlungu
• Ukuma komzimba okufanelekileyo okanye ityhubhu yokondla ukukhusela ukukrwitshwa ngexesha lokondla, ukuba izihlunu ezisetyenziselwa ukugwinya zibuthathaka
• Unyango lomzimba ukunceda ukugcina amalungu kunye nezihlunu zisempilweni

Ezi zixhobo zinokubonelela ngolwazi oluthe kratya malunga ne-GBS:

• IGuillain-Barré Syndrome Foundation International - www.gbs-cidp.org
• Umbutho weSizwe weengxaki zoRare- rarediseases.org/rare-diseases/guillain-barre-syndrome

Ukuchacha kungathatha iiveki, iinyanga, okanye iminyaka. Uninzi lwabantu luyasinda kwaye luyachacha ngokupheleleyo. Kwabanye abantu, ubuthathaka obuncinci bunokuqhubeka. Isiphumo sinokulunga xa iimpawu ziphela kwiiveki ezi-3 emva kokuba ziqale.

Iingxaki ezinokubakho ze-GBS zibandakanya:

• Ukuphefumla ubunzima (ukusilela ukuphefumla)
• Ukunciphisa izicubu kumalungu (iikhontrakthi) okanye ezinye iziphene
• Amahlwili egazi (i-vein thrombosis enzulu) eyenzeka xa umntu one-GBS engasebenzi okanye kufuneka elele ebhedini
• Ukwanda komngcipheko wosulelo
• Uxinzelelo lwegazi oluphantsi okanye olungazinzanga
• Ukukhubazeka okusisigxina
• Ukukrala kwemiphunga
• Ukonakala kolusu (izilonda)
• Ukuphefumla ukutya okanye ulwelo emiphungeni

Funa uncedo lwezonyango kwangoko ukuba unayo nayiphi na le mpawu:

• Ingxaki yokuphefumla nzulu
• Ukuncipha kwemvakalelo (imvakalelo)
• Kunzima ukuphefumla
• Kunzima ukugwinya
• Ukufa isiqaqa
• Ukuphulukana namandla emilenzeni okuba kubi ngokuhamba kwexesha

I-GBS; Isifo seLandry-Guillain-Barre; Polyneuritis ebukhali; Polyneuritis eyosulelayo; I-polyneuropathy evuthayo; Okubukhali ukudumba ukudambisa ipyryradiculoneuropathy; Ukunyuka kokukhubazeka

• Imisipha yangaphandle yangaphandle
• Ukunikezelwa kwemithambo kwi-pelvis
• Ingqondo kunye nenkqubo yovalo

Utshintsho CWJ. IMyasthenia gravis kunye nesifo sikaGuillain-Barré. Ku: Parrillo JE, Dellinger RP, ii-eds. Unyango oluKhathalelayo oluBalulekileyo: Imigaqo yokuchongwa kunye noLawulo kuLuntu oluDala. Umhla we-5. IPhiladelphia, PA: Elsevier; I-2019: isahluko 61.

Katirji B.Ukuphazamiseka kwemithambo yoluvo. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 107.