Ukuphulukana nomsebenzi wemisipha

Ukuphulukana nomsebenzi wemisipha kuxa izihlunu zingasebenzi okanye zihamba ngesiqhelo. Ixesha lonyango lokulahleka ngokupheleleyo kwemisipha kukukhubazeka.

Ukuphulukana nomsebenzi wemisipha kunokubangelwa ngu:

• Isifo semisipha uqobo (myopathy)
• Isifo sendawo apho kudibana khona izihlunu kunye nemithambo-luvo (indlela yokudibana ye-neuromuscular)
• Isifo senkqubo yemithambo-luvo: Ukonakala kwamathambo (i-neuropathy), ukulimala kwethambo lomqolo (myelopathy), okanye ukonakala kwengqondo (ukubetha okanye ukulimala kwengqondo)

Ukuphulukana nomsebenzi wemisipha emva kwezi ntlobo zeziganeko kunokuba nzima. Ngamanye amaxesha, amandla emisipha angangabuyi ngokupheleleyo, nditsho nonyango.

Ukukhubazeka kunokuba yinto yethutyana okanye esisigxina. Inokuchaphazela indawo encinci (eyenzelwe indawo ethile okanye egxile) okanye isasazeke (ngokubanzi). Inokuchaphazela icala elinye (elinye) okanye omabini amacala (omabini).

Ukuba ukukhubazeka kuchaphazela isiqingatha esisezantsi somzimba kwaye yomibini imilenze ibizwa ngokuba yi-paraplegia. Ukuba ichaphazela zombini iingalo kunye nemilenze, ibizwa ngokuba yi-quadriplegia. Ukuba ukukhubazeka kuchaphazela izihlunu ezibangela ukuphefumla, ngokukhawuleza kusongela ubomi.

Izifo zezihlunu ezibangela ilahleko yokusebenza kwemisipha zibandakanya:

• I-myopathy enxulumene notywala
• I-myopathies ye-Congenital (amaxesha amaninzi ngenxa yokuphazamiseka kwemfuza)
• Dermatomyositis kunye ne-polymyositis
• I-myopathy ebangelwa ziziyobisi (i-statins, steroids)
• Isihlunu semisipha

Izifo zenkqubo yemithambo-luvo ebangela ukuphulukana nomsebenzi wemisipha zibandakanya:

• Amyotrophic lateral sclerosis (ALS, okanye isifo sikaLou Gehrig)
• Ukukhubazeka kwentsimbi
• Botulism
• Isifo seGuillain-Barré
• Myasthenia gravis okanye iLambert-Eaton Syndrome
• Neuropathy
• Ityhefu ye-shellfish ekhubazekileyo
• Ukukhubazeka ngamaxesha athile
• Ukulimala kwenzwa
• Ipoliyo
• Intambo yomqolo okanye ukwenzakala kwengqondo
• Ukubetha

Ukuphulukana ngesiquphe kwemisipha yimeko engxamisekileyo yezonyango. Fumana uncedo lwezonyango kwangoko.

Emva kokuba ufumene unyango, umboneleli wakho wokhathalelo lwempilo unokucebisa ngala manyathelo alandelayo:

• Landela unyango lwakho olumiselweyo.
• Ukuba imithambo-luvo ebusweni bakho okanye entloko yonakele, unokuba nobunzima ukuhlafuna nokuginya okanye uvale amehlo. Kule meko, kunokunconywa ukutya okuthambileyo. Uya kudinga uhlobo oluthile lokhuselo lwamehlo, njengepetshi phezu kwamehlo ngelixa uleleyo.
• Ukuhamba ixesha elide kunokubangela iingxaki ezinkulu. Guqula izikhundla rhoqo kwaye unakekele ulusu lwakho. Ukuzilolonga ngokuhambahamba kunokunceda ukugcina ithoni yemisipha.
• Amacwecwe anokunceda ukuthintela ukonwaba kwemisipha, imeko apho izihlunu zifutshane khona ngokusisigxina.

Ukukhubazeka kwezihlunu kuhlala kufuna unyango kwangoko. Ukuba uqaphela ukuba buthathaka ngokuthe ngcembe okanye iingxaki ngesihlunu, fumana unyango ngokukhawuleza.

Ugqirha uya kwenza uvavanyo lomzimba kwaye abuze imibuzo malunga nembali yakho yezonyango kunye neempawu, kubandakanya:

Indawo:

• Ngawaphi amalungu achaphazelekayo emzimbeni wakho?
• Ngaba ichaphazela elinye okanye omabini amacala omzimba wakho?
• Ngaba ikhule ipateni ephezulu ukuya ezantsi (ukwehla kokukhubazeka), okanye ipateni yezantsi ukuya phezulu (ukunyuka kokukhubazeka)?
• Ngaba unengxaki yokuphuma esihlalweni okanye kwizinyuko?
• Ngaba unobunzima bokuphakamisa ingalo yakho ngaphezulu kwentloko yakho?
• Ngaba unayo ingxaki yokwandisa okanye yokuphakamisa isihlahla sakho (ukuhla kwesandla)?
• Ngaba unobunzima bokubamba (ukubamba)?

Iimpawu:

• Ngaba unayo intlungu?
• Ngaba unesihlwitha, ukurhawuzelela, okanye ukulahleka kwemvakalelo?
• Ngaba unobunzima bokulawula isinyi okanye amathumbu akho?
• Ngaba unayo umphefumlo omfutshane?
• Zeziphi ezinye iimpawu onazo?

Umzekelo wexesha:

• Ngaba iziqendu zenzeka rhoqo (eziphindaphindayo)?
• Zihlala ixesha elingakanani?
• Ngaba ukuphulukana nomsebenzi wemisipha kuya kusiba mandundu (ukuqhubela phambili)?
• Ngaba iqhubeka kancinci okanye ngokukhawuleza?
• Ngaba iya isiba mandundu ngokuhamba kwexesha?

Izinto ezigwenxa kunye nokukhulula:

• Yintoni, ukuba ikho, eyenza ukukhubazeka kube kubi ngakumbi?
• Ngaba iba mbi ngakumbi emva kokuba uthathe izongezo zepotassium okanye amanye amayeza?
• Kungcono emva kokuba uphumle?

Uvavanyo olunokwenziwa luya kubandakanya:

• Izifundo zegazi (ezinje nge-CBC, umahluko weeseli ezimhlophe zegazi, amanqanaba ekhemistri yegazi, okanye amanqanaba e-enzyme yemisipha)
• Uvavanyo lwe-CT lwentloko okanye lomqolo
• I-MRI yentloko okanye yomqolo
• Ukugqobhoza iLumbar (impompo yomqolo)
• Imisipha okanye i-nerve biopsy
• Imvelaphi yam
• Izifundo zokuqhutywa kwemithambo kunye ne-electromyography

Ukutya ngaphakathi okanye ukutyisa iityhubhu kunokufuneka kwiimeko ezinobuzaza. Unyango lomzimba, unyango lomsebenzi, okanye unyango lwentetho kunokucetyiswa.

Ukukhubazeka; Paresis; Ukuphulukana nentshukumo; Ukungasebenzi kweemoto

• Imisipha yangaphandle yangaphandle
• Izihlunu zangaphakathi ezinzulu
• Iitendon kunye nezihlunu
• Imisipha yomlenze osezantsi

U-Evoli A, uVincent A. Ukuphazamiseka kokuhanjiswa kwe-neuromuscular. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 394.

USelcen D. Izifo zemisipha. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 393.

IWarner WC, iSawyer JR. Iingxaki ze-Neuromuscular. Ku: Azar FM, Beaty JH, Kanale ST, ii-eds. Umsebenzi weCampbell's Orthopedics. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 35.