I-Autonomic dysreflexia

I-Autonomic dysreflexia yinto engaqhelekanga, egqithisileyo yenkqubo yokuzibandakanya (yokuzimela) yenkqubo yeemvakalelo yokukhuthaza. Le mpendulo inokubandakanya:

• Guqula kwinqanaba lentliziyo
• Ukubila okugqithisileyo
• Igazi elonyukayo
• Ukudumba kwezihlunu
• Utshintsho kumbala wolusu (ubumhlophe, ubomvu, umbala oluhlaza-grey)

Unobangela oqhelekileyo we-autonomic dysreflexia (AD) kukonzakala kwethambo lomqolo. Inkqubo yemithambo-luvo yabantu abane-AD bayaphendula kwiindidi zokukhuthaza ezingabakhathazi abantu abasempilweni.

Ezinye izizathu zibandakanya:

• I-Guillain-Barré syndrome (ingxaki apho amajoni omzimba ahlasela ngempazamo inxalenye yenkqubo yemithambo-luvo)
• Iziphumo ebezingalindelekanga zamanye amayeza
• Intlungu enkulu entloko kunye nokunye ukwenzakala kwengqondo
• I-Subarachnoid hemorrhage (uhlobo lokopha kwengqondo)
• Ukusetyenziswa kweziyobisi ezikhuthazayo ngokungekho mthethweni ezinje ngecocaine kunye neamphetamines

Iimpawu zinokubandakanya nayiphi na kwezi zinto zilandelayo:

• Ixhala okanye ixhala
• Ingxaki yesinyi okanye yamathumbu
• Umbono ongacacanga, abafundi abanzi (abahluziweyo)
• Ubumhlophe obukhanyayo, isiyezi, okanye ukuphelelwa ngamandla
• Ifiva
• Goosebumps, ulusu (olubomvu) ulusu ngaphezulu kwenqanaba lokwenzakala kwethambo lomqolo
• Ubile kakhulu
• Igazi elonyukayo
• Ukubetha kwentliziyo ngokungaqhelekanga, ukubetha kade okanye ngokukhawuleza
• Ukudumba kwemisipha, ngakumbi emhlathini
• Ukuxinana kwempumlo
• Intloko ebuhlungu

Ngamanye amaxesha akukho zimpawu, nokuba kukho ukwanda okuyingozi koxinzelelo lwegazi.

Umboneleli wezempilo uya kwenza inkqubo epheleleyo yeemvakalelo kunye novavanyo lonyango. Xelela umniki-nkonzo ngawo onke amayeza owasebenzisayo ngoku kunye nowawathethayo ngaphambili. Oku kunceda ukufumanisa ukuba zeziphi iimvavanyo ozifunayo.

Uvavanyo lunokubandakanya:

• Uvavanyo lwegazi kunye nomchamo
• Ukuskena i-CT okanye iMRI
• ECG (umlinganiso wentsebenzo yombane wentliziyo)
• Ukugqobhoza iLumbar
• Ukuvavanywa kwetafile yokuvavanywa (ukuvavanywa koxinzelelo lwegazi njengoko imeko yomzimba itshintsha)
• Ukuvavanywa kwetyhefu (uvavanyo lalo naliphi na iziyobisi, kubandakanya amayeza, kwigazi lakho)
• X-reyi

Ezinye iimeko zabelana ngeempawu ezininzi ne-AD, kodwa zinesizathu esahlukileyo. Ke uvavanyo kunye nokuvavanywa kunceda umboneleli akhuphe ezinye iimeko, kubandakanya:

• Isifo seCarcinoid (izilonda zamathumbu amancinci, ikholoni, isihlomelo, kunye neetyhubhu ezinobunzima kwimiphunga)
• I-Neuroleptic syndrome ebulalayo (imeko ebangelwa ngamanye amayeza akhokelela ekuqineni kwemisipha, umkhuhlane omkhulu kunye nokozela)
• Pheochromocytoma (ithumba le-adrenal gland)
• I-Serotonin syndrome (ukusabela kweziyobisi okubangela ukuba umzimba ube ne-serotonin eninzi, ikhemikhali eveliswa ziiseli zemithambo-luvo)
• Isiphepho se-thyroid (imeko esongela ubomi kwi-thyroid engasebenzi)

I-AD isongela ubomi, ke kubalulekile ukuba ufumane kwaye unyange ingxaki ngokukhawuleza.

Umntu oneempawu ze-AD kufuneka:

• Hlala uphakamise intloko
• Susa iimpahla eziqinileyo

Unyango olufanelekileyo luxhomekeke kwisizathu. Ukuba amayeza okanye iziyobisi ezingekho mthethweni zibangela iimpawu, ezo ziyobisi kufuneka ziyekwe. Nasiphi na isigulo kufuneka sinyangwe. Umzekelo, umboneleli uya kujonga i-catheter evaliweyo kunye neempawu zokuqunjelwa.

Ukuba ukucotha kwenqanaba lentliziyo kubangela i-AD, iziyobisi ezibizwa ngokuba yi-anticholinergics (ezinje ngeatropine) zinokusetyenziswa.

Uxinzelelo lwegazi oluphezulu kakhulu kufuneka lunyangwe ngokukhawuleza kodwa ngononophelo, kuba uxinzelelo lwegazi lunokuhla ngesiquphe.

Isincedisi-ntliziyo sinokufuneka kwisingqi sentliziyo esingazinzanga.

Imbonakalo ixhomekeke kwisizathu.

Abantu abane-AD ngenxa yeyeza bahlala bechacha xa limisiwe iyeza. Xa i-AD ibangelwa zezinye izinto, ukuchacha kuxhomekeke kwindlela esinokunyangwa ngayo esi sifo.

Iingxaki zinokwenzeka ngenxa yeziphumo ebezingalindelekanga zamayeza asetyenziselwa ukunyanga imeko. Ixesha elide, uxinzelelo lwegazi olunamandla kunokubangela ukuxhuzula, ukopha emehlweni, ukubetha, okanye ukufa.

Tsalela umnikezeli wakho ngoko nangoko ukuba uneempawu ze-AD.

Ukuthintela i-AD, musa ukuthatha amayeza abangela le meko okanye ayenze mandundu.

Kubantu abanokulimala kwentambo yomqolo, oku kulandelayo kunokunceda ekuthinteleni i-AD:

• Ungavumeli ukuba isinyi sigcwale kakhulu
• Intlungu kufuneka ilawulwe
• Ziqhelanise nolondolozo olufanelekileyo lwamathumbu ukunqanda ukungasebenzi kwesitulo
• Ziqhelanise nokhathalelo lolusu olufanelekileyo ukunqanda ukosulelwa zizifo kunye nokosuleleka kwesikhumba
• Thintela usulelo lwesinyi

I-Autonomic hyperreflexia; Ukulimala kwentambo yomqolo - i-autonomic dysreflexia; I-SCI-yedysreflexia ezimeleyo

• Inkqubo ye-nervous central kunye ne-peripheral system

ICheshire WP. Ukuphazamiseka okuzenzekelayo kunye nolawulo lwabo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahl. 390.

ICowan H.I-Autonomic dysreflexia ekwenzakaleni kwethambo lomqolo. Amaxesha oNesi. Ngo-2015; 111 (44): 22-24. IINKCUKACHA: 26665385 pubmed.ncbi.nlm.nih.gov/26665385/.

UMcDonagh DL, iBarden CB. I-Autonomic dysreflexia. Ku: IFleisher LA, iRosenbaum SH, ii-eds. Iingxaki kwiAnesthesia. Ngomhla wesi-3. IPhiladelphia, PA: Elsevier; I-2018: isahluko 131.