I-Delirium tremens

I-Delirium tremens uhlobo olunzima lokuhoxiswa kotshwala. Kubandakanya izinguquko ezingazelelwe nezimbi zomqondo noma zezinzwa.

Ama-Delirium tremens angenzeka lapho uyeka ukuphuza utshwala ngemuva kwesikhathi sokuphuza kakhulu, ikakhulukazi uma ungadli ukudla okwanele.

Ama-Delirium tremens nawo angabangelwa ukulimala ekhanda, ukutheleleka, noma ukugula kubantu abanomlando wokusetshenziswa kotshwala obunzima.

Kwenzeka kaningi kubantu abanomlando wokuhoxiswa kotshwala. Kuvame kakhulu kulabo abaphuza amapayipi ayi-4 kuye kwayi-5 (amalitha ayi-1.8 kuye kwangama-2.4) wewayini, amapayinti ayi-7 kuye kwayi-8 (amalitha ayi-3.3 kuye kwayi-3.8) kabhiya, noma ipayinti elilodwa (1/2 litre) lotshwala "obunzima" nsuku zonke izinyanga ezimbalwa. I-Delirium tremens ibuye ithinte kakhulu abantu asebenzise utshwala iminyaka engaphezu kwengu-10.

Izimpawu zivame ukwenzeka kungakapheli amahora angama-48 kuye kwangama-96 ngemuva kokuphuza kokugcina. Kepha, zingavela ezinsukwini eziyi-7 kuya kwezingu-10 ngemuva kokuphuza kokugcina.

Izimpawu zingase zibe zimbi kakhulu ngokushesha, futhi zingafaka:

• I-Delirium, okuwukudideka okukhulu okungazelelwe
• Ukuthuthumela komzimba
• Izinguquko ekusebenzeni kwengqondo
• Ukuyaluzela, ukucasuka
• Ukulala okujulile okuhlala usuku noma ngaphezulu
• Injabulo noma ukwesaba
• Ama-hallucinations (ukubona noma ukuzwa izinto ezingekho lapho)
• Ukuqhuma kwamandla
• Izinguquko zemizwa esheshayo
• Ukungahlaliseki
• Ukuzwela ekukhanyeni, umsindo, ukuthinta
• Isiphukuphuku, ubuthongo, ukukhathala

Ukuquleka (kungenzeka ngaphandle kwezinye izimpawu ze-DTs):

• Okuvame kakhulu emahoreni ayi-12 kuya kwangama-48 okuqala ngemuva kwesiphuzo sokugcina
• Okuvame kakhulu kubantu abanezinkinga ezedlule ekuhoxisweni kotshwala
• Imvamisa ukuquleka okujwayelekile kwe-tonic-clonic

Izimpawu zokuhoxiswa kotshwala, kufaka phakathi:

• Ukukhathazeka, ukudangala
• Ukukhathala
• Ubuhlungu bekhanda
• Ukuqwasha (kunzima ukuwa nokulala)
• Ukuthukuthela noma ukujabula
• Ukuphelelwa isifiso sokudla
• Isicanucanu, ukuhlanza
• Ukwesaba, ukugxuma, ukuqhaqhazela, ukushaya kwenhliziyo (umuzwa wokuzwa ukushaya kwenhliziyo)
• Isikhumba esiphaphathekile
• Izinguquko zemizwa ezisheshayo
• Ukujuluka, ikakhulukazi ezintendeni zezandla noma ebusweni

Ezinye izimpawu ezingase zivele:

• Ubuhlungu besifuba
• Imfiva
• Ubuhlungu besisu

I-Delirium tremens yisimo esiphuthumayo sezokwelapha.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba. Izimpawu zingafaka:

• Ukujuluka okukhulu
• Ukwenyuka kwe-reflex yokwanda
• Ukushaya kwenhliziyo okungajwayelekile
• Izinkinga ngokunyakaza kwemisipha yamehlo
• Ukushaya kwenhliziyo okusheshayo
• Ukuzamazama kwemisipha esheshayo

Ukuhlolwa okulandelayo kungenziwa:

• Izinga le-magnesium yegazi
• Izinga le-phosphate yegazi
• Iphaneli yemethodi ephelele
• I-Electrocardiogram (ECG)
• I-Electroencephalogram (EEG)
• Isikrini se-Toxicology

Izinhloso zokwelashwa uku:

• Londoloza impilo yomuntu
• Yehlisa izimpawu
• Vimbela izinkinga

Ukuhlala esibhedlela kuyadingeka. Ithimba lezokunakekelwa kwempilo lizohlola njalo:

• Imiphumela ye-chemistry yegazi, njengamazinga we-electrolyte
• Amazinga oketshezi lomzimba
• Izimpawu ezibalulekile (izinga lokushisa, ukushaya kwenhliziyo, izinga lokuphefumula, umfutho wegazi)

Ngenkathi esesibhedlela, umuntu uzothola imishanguzo:

• Hlala uzolile futhi ukhululekile (uhlale phansi) kuze kube yilapho ama-DTs eseqedile
• Phatha ukuquleka, ukukhathazeka, noma ukuthuthumela
• Phatha ukuphazamiseka kwengqondo, uma kukhona

Ukwelashwa kwesikhathi eside kufanele kuqale ngemuva kokuthi umuntu elulame ezimpawu ze-DT. Lokhu kungabandakanya:

• Isikhathi "sokoma", lapho kungavunyelwe khona utshwala
• Ukugwema okuphelele kanye nokuphila konke kotshwala (ukuyeka)
• Ukwelulekwa
• Ukuya kumaqembu okusekela (njenge-Alcoholics Anonymous)

Ukwelashwa kungadingeka kwezinye izinkinga zezokwelapha ezingenzeka ngokusetshenziswa kotshwala, kufaka phakathi:

• I-cardiomyopathy ephuzile
• Isifo sesibindi esidakayo
• I-neuropathy yotshwala
• Isifo seWernicke-Korsakoff

Ukuya eqenjini lokusekelwa njalo kuyisihluthulelo sokululama ekusebenziseni utshwala.

I-Delirium tremens inzima futhi ingahle isongele impilo. Ezinye izimpawu ezihlobene nokuhoxiswa kotshwala zingahlala unyaka noma ngaphezulu, kufaka phakathi:

• Ukushintsha kwemizwelo engokomzwelo
• Ukuzizwa ngikhathele
• Ukungalali

Izinkinga zingafaka:

• Ukulimala okuwa ngesikhathi sokuwa
• Ukuzilimaza wena noma abanye okubangelwa isimo sengqondo (ukudideka / i-delirium)
• Ukushaya kwenhliziyo okungajwayelekile, kungaba yingozi empilweni
• Ukuquleka

Iya egumbini labezimo eziphuthumayo noma ushayele inombolo yendawo ephuthumayo (efana ne-911) uma unezimpawu. I-Delirium tremens yisimo esiphuthumayo.

Uma uya esibhedlela ngesinye isizathu, tshela abahlinzeki uma ngabe uphuze kakhulu ukuze bakwazi ukukuqapha izimpawu zokukhishwa kotshwala.

Gwema noma nciphisa ukusetshenziswa kotshwala. Thola ukwelashwa ngokushesha ngezimpawu zokuhoxiswa kotshwala.

Ukuphuza ngokweqile - i-delirium tremens; Ama-DTs; Ukuhoxiswa kotshwala - i-delirium tremens; I-delirium yokuhoxiswa kotshwala

UKelly JF, uRenner JA. Izinkinga ezihlobene notshwala. Ku: Stern TA, Fava M, Wilens TE, Rosenbaum JF, ama-eds. IMassachusetts General Hospital Comprehensive Clinical Psychiatry. Okwesibili. IPhiladelphia, PA: Elsevier; 2016: isahluko 26.

UMirijello A, D'Angelo C, uFerrulli A, et al. Ukukhonjwa nokuphathwa kwesifo sokuhoxiswa kotshwala. Izidakamizwa. 2015; 75 (4): 353-365. I-PMID: 25666543 www.ncbi.nlm.nih.gov/pubmed/25666543.

O'Connor PG. Izinkinga zokusebenzisa utshwala. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 33.