Isifo se-Guillain-Barré

I-Guillain-Barré syndrome (i-GBS) iyinkinga enkulu yezempilo eyenzeka lapho izivikeli zomzimba (amasosha omzimba) ngephutha zihlasela ingxenye yohlelo lwemizwa lomngcele. Lokhu kuholela ekuvuvukeni kwemizwa okubangela ukuba buthakathaka kwemisipha noma ukukhubazeka nezinye izimpawu.

Imbangela ngqo ye-GBS ayaziwa. Kucatshangwa ukuthi i-GBS iyi-autoimmune disorder. Ngokuphazamiseka komzimba, amasosha omzimba azihlasela ngephutha. I-GBS ingenzeka nganoma yisiphi isikhathi. Kuvame kakhulu kubantu abaphakathi kweminyaka engama-30 nengama-50.

I-GBS ingenzeka ngezifo ezivela kuma-virus noma amabhaktheriya, njenge:

• Umkhuhlane
• Ezinye izifo zamathumbu
• I-Mycoplasma pneumonia
• I-HIV, igciwane elibangela i-HIV / AIDS (okungajwayelekile)
• I-Herpes simplex
• I-Mononucleosis

I-GBS nayo ingenzeka nezinye izimo zezokwelapha, njenge:

• Uhlelo lupus erythematosus
• Isifo se-Hodgkin
• Ngemuva kokuhlinzwa

I-GBS ilimaza izingxenye zezinzwa. Lokhu kulimala kwezinzwa kubangela ukuncipha, ubuthakathaka bemisipha, ukulahlekelwa ibhalansi, nokukhubazeka. I-GBS ivame ukuthinta ukumbozwa kwezinzwa (i-myelin sheath). Lo monakalo ubizwa ngokuthi yi-demyelination. Kubangela ukuthi amasignali wezinzwa ahambe kancane. Ukulimala kwezinye izingxenye zenzwa kungadala ukuthi inzwa iyeke ukusebenza.

Izimpawu ze-GBS zingakhula ngokushesha. Kungathatha amahora ambalwa kuphela ukuthi kuvele izimpawu ezinzima kakhulu. Kepha ubuthakathaka obukhula ngaphezu kwezinsuku ezimbalwa buvamile.

Ubuthakathaka bemisipha noma ukulahleka kwemisipha (ukukhubazeka) kuthinta izinhlangothi zombili zomzimba. Ezimweni eziningi, ubuthakathaka bemisipha buqala emilenzeni futhi busabalale buye ezingalweni. Lokhu kubizwa ngokuthi ukukhuphuka kokukhubazeka.

Uma ukuvuvukala kuthinta izinzwa zesifuba ne-diaphragm (umsipha omkhulu ongaphansi kwamaphaphu akho okusiza ukuthi uphefumule) futhi leyo misipha ibuthakathaka, ungadinga usizo lokuphefumula.

Ezinye izimpawu nezimpawu ezijwayelekile ze-GBS zifaka:

• Ukulahleka kwezimpawu zemisipha ezingalweni nasemilenzeni
• Ukulinganisa noma ukuphazamiseka (ukulahlekelwa okuncane kokuzwa)
• Ubumnene bemisipha noma ubuhlungu (kungaba yizinhlungu ezinjenge-cramp)
• Ukuhamba okungahambisani (akukwazi ukuhamba ngaphandle kosizo)
• Umfutho wegazi ophansi noma ukulawula umfutho wegazi ophansi
• Ukushaya kwenhliziyo okungavamile

Ezinye izimpawu zingafaka:

• Ukubona okufiphele nokubona kabili
• Ubudlabha nokuwa
• Kunzima ukuhambisa imisipha yobuso
• Ukuncipha kwemisipha
• Ukuzwa ukushaya kwenhliziyo (ukushaya kwenhliziyo)

Izimpawu zezimo eziphuthumayo (funa usizo lwezokwelapha zisuka):

• Ukuphefumula kuyama okwesikhashana
• Ayikwazi ukudonsa umoya
• Kunzima ukuphefumula
• Kunzima ukugwinya
• Ukumunca amathe
• Ukuquleka
• Ukuzwa ukukhanya kukhanya lapho kumile

Umlando wokwanda kobuthakathaka bemisipha nokukhubazeka kungaba uphawu lwe-GBS, ikakhulukazi uma kube nokugula kwakamuva.

Ukuhlolwa kwezokwelapha kungakhombisa ubuthakathaka bemisipha. Kungase kube nezinkinga ngomfutho wegazi nokushaya kwenhliziyo. Le yimisebenzi elawulwa ngokuzenzakalela yisistimu yezinzwa. Ukuhlolwa kungakhombisa nokuthi ukucabanga okufana neqakala noma idolo kungancipha noma akukho.

Kungaba nezimpawu zokwehla kokuphefumula okubangelwa ukukhubazeka kwezicubu zokuphefumula.

Ukuhlolwa okulandelayo kungenziwa:

• Isampula yeCerebrospinal fluid (umpompi womgogodla)
• ECG ukuhlola umsebenzi kagesi enhliziyweni
• I-Electromyography (EMG) yokuhlola umsebenzi kagesi emisipheni
• Ukuhlolwa kwe-velocity velocity test ukuhlola ukuthi amasiginali kagesi ashesha kangakanani ngokusebenzisa inzwa
• Ukuhlolwa komsebenzi wePulmonary ukukala ukuphefumula nokuthi amaphaphu asebenza kahle kanjani

Alikho ikhambi le-GBS. Ukwelashwa kuhlose ukunciphisa izimpawu, ukwelapha izinkinga, nokusheshisa ukululama.

Esigabeni sokuqala sokugula, ukwelashwa okubizwa nge- apheresis noma i- plasmapheresis kunganikezwa. Kubandakanya ukususa noma ukuvimba amaprotheni, okuthiwa ama-antibodies, ahlasela amangqamuzana ezinzwa. Olunye ukwelashwa i-immunoglobulin (IVIg) efakwa emithanjeni. Kokubili ukwelashwa kuholela ekuthuthukisweni okusheshayo, futhi kokubili kusebenza ngokulinganayo. Kepha akukho nzuzo yokusebenzisa zombili izindlela zokwelashwa ngasikhathi sinye. Ezinye izindlela zokwelapha zisiza ukunciphisa ukuvuvukala.

Lapho izimpawu zinzima, ukwelashwa esibhedlela kuyodingeka. Ukuxhaswa kokuphefumula kungenzeka kunikezwe.

Ezinye izindlela zokwelashwa esibhedlela zigxila ekuvikeleni izinkinga. Lokhu kungafaka:

• Ama-thinner egazi ukuvimbela amahlule egazi
• Ukwesekwa kokuphefumula noma ishubhu lokuphefumula nomoya ophefumulayo, uma uvalo lubuthakathaka
• Imithi yezinhlungu noma eminye imithi yokwelapha ubuhlungu
• Ukuma komzimba okufanele noma ishubhu yokudla ukuze uvimbele ukuminyana ngesikhathi sokudla, uma imisipha esetshenziselwa ukugwinya ibuthakathaka
• Ukwelashwa ngokomzimba ukusiza ukugcina amalunga nemisipha iphilile

Lezi zinsizakusebenza zinganikeza imininingwane eminingi nge-GBS:

• IGuillain-Barré Syndrome Foundation International - www.gbs-cidp.org
• Inhlangano Kazwelonke Yezinkinga Ezingajwayelekile - rarediseases.org/rare-diseases/guillain-barre-syndrome

Ukubuyiselwa kungathatha amasonto, izinyanga, noma iminyaka. Iningi labantu liyasinda futhi lilulame ngokuphelele. Kwabanye abantu, ubuthakathaka obuthile bungaqhubeka. Umphumela kungenzeka ube muhle lapho izimpawu ziphela kungakapheli amasonto ama-3 ngemuva kokuqala kwazo.

Izinkinga ezingaba khona ze-GBS zifaka:

• Ubunzima bokuphefumula (ukwehluleka ukuphefumula)
• Ukunciphisa izicubu emajoyini (izinkontileka) noma okunye ukukhubazeka
• Amahlule egazi (deep vein thrombosis) akha lapho umuntu one-GBS engasebenzi noma kufanele ahlale embhedeni
• Ingozi eyengeziwe yokutheleleka
• Umfutho wegazi ophansi noma ongazinzile
• Ukukhubazeka okungunaphakade
• Inyumoniya
• Ukulimala kwesikhumba (izilonda)
• Ukuphefumulela ukudla noma uketshezi emaphashini

Funa usizo lwezokwelapha ngokushesha uma unanoma iyiphi yalezi zimpawu:

• Inkinga yokuphefumula kanzima
• Ukwehla kwemizwa (ukuzwa)
• Kunzima ukuphefumula
• Kunzima ukugwinya
• Ukuquleka
• Ukuphelelwa ngamandla emilenzeni okuya ngokuya ngokuhamba kwesikhathi

I-GBS; Isifo seLandry-Guillain-Barre; I-polyneuritis enamandla ye-idiopathic; I-polyneuritis ethathelwanayo; I-polyneuropathy enamandla yokuvuvukala; Ukuvuvukala okukhulu kwe-demyelinating polyradiculoneuropathy; Ukunyuka ukukhubazeka

• Imisipha yangaphandle engaphezulu
• Ukunikezwa kwemisipha okhalweni
• Ubuchopho nesistimu yezinzwa

I-Chang CWJ. I-Myasthenia gravis ne-Guillain-Barré syndrome. Ku: Parrillo JE, Dellinger RP, ama-eds. Imithi Yokunakekelwa Okubalulekile: Izimiso Zokuxilongwa Nokuphathwa Kwabantu Abadala. Umhlaka 5. IPhiladelphia, PA: Elsevier; 2019: isahluko 61.

I-Katirji B. Ukuphazamiseka kwemizwa yangaphakathi. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 107.