I-Autonomic dysreflexia

I-Autonomic dysreflexia ukungajwayelekile, ukusabela okweqile kwesistimu yezinzwa engazimisele (yokuzimela) ekuvuseleleni. Lokhu kusabela kungabandakanya:

• Shintsha ekushayeni kwenhliziyo
• Ukujuluka okweqile
• Umfutho wegazi ophezulu
• Ukudumba kwemisipha
• Izinguquko zombala wesikhumba (ukuphaphatheka, ububomvu, umbala wesikhumba oluhlaza okwesibhakabhaka)

Isizathu esivame kakhulu se-autonomic dysreflexia (AD) ukulimala komgogodla. Uhlelo lwezinzwa lwabantu abane-AD luphendula ngokweqile ezinhlotsheni zokugqugquzela ezingabakhathazi abantu abaphilile.

Ezinye izimbangela zifaka:

• I-Guillain-Barré syndrome (ukuphazamiseka lapho amasosha omzimba ahlasela ngephutha ingxenye yesistimu yezinzwa)
• Imiphumela engemihle yeminye imithi
• Ukuhlukumezeka okukhulu ekhanda nokunye ukulimala ebuchosheni
• I-Subarachnoid hemorrhage (uhlobo lokopha ebuchosheni)
• Ukusetshenziswa kwezidakamizwa ezingekho emthethweni ezifana ne-cocaine nama-amphetamine

Izimpawu zingafaka noma yikuphi okulandelayo:

• Ukukhathazeka noma ukukhathazeka
• Izinkinga zesinye noma zamathumbu
• Ukubona okufiphele, abafundi abanwetshiwe (abahluziwe)
• Inwele elikhanyayo, isiyezi, noma ukuquleka
• Imfiva
• Isikhumba esijiyile, esibomvu (esibomvu) ngaphezulu kwezinga lokulimala komgogodla
• Ukujuluka okukhulu
• Umfutho wegazi ophezulu
• Ukushaya kwenhliziyo okungajwayelekile, ukushaya kwenhliziyo okuhamba kancane noma okusheshayo
• Ukudumba kwemisipha, ikakhulukazi emhlathini
• Ukuminyana emakhaleni
• Ukudinwa ikhanda

Kwesinye isikhathi azikho izimpawu, noma ngabe ukukhuphuka okuyingozi komfutho wegazi.

Umhlinzeki wezokunakekelwa kwempilo uzokwenza uhlelo oluphelele lwezinzwa nokuhlolwa kwezokwelapha. Tshela umhlinzeki ngayo yonke imithi oyiphuzayo manje nokuthi uyisebenzise esikhathini esedlule. Lokhu kusiza ukunquma ukuthi iziphi izivivinyo ozidingayo.

Ukuhlolwa kungafaka:

• Ukuhlolwa kwegazi nomchamo
• Iskena se-CT noma se-MRI
• I-ECG (ukulinganiswa komsebenzi kagesi wenhliziyo)
• Ukubhoboza i-lumbar
• Ukuhlolwa kwetafula lokutsheka (ukuhlolwa kwengcindezi yegazi lapho isimo somzimba sishintsha)
• Ukuhlolwa kwe-Toxicology (ukuhlolwa kwanoma imuphi umuthi, kufaka phakathi imithi, egazini lakho)
• Ama-X-ray

Ezinye izimo zabelana ngezimpawu eziningi ne-AD, kepha zinembangela ehlukile. Ngakho-ke ukuhlolwa nokuhlolwa kusiza umhlinzeki ukukhipha lezi ezinye izimo, kufaka phakathi:

• I-Carcinoid syndrome (izicubu zamathumbu amancane, i-colon, isithasiselo, namashubhu e-bronchial emaphashini)
• I-Neuroleptic malignant syndrome (isimo esidalwa yimithi ethile eholela ekuqineni kwemisipha, emkhuhlane omkhulu nasekozeni)
• I-Pheochromocytoma (isimila se-adrenal gland)
• I-Serotonin syndrome (ukusabela kwezidakamizwa okwenza umzimba ube ne-serotonin eningi kakhulu, ikhemikhali elenziwa ngamangqamuzana ezinzwa)
• Isiphepho se-thyroid (isimo esisongela impilo esivela ku-thyroid esisebenza ngokweqile)

I-AD isongela impilo, ngakho-ke kubalulekile ukuthola ngokushesha nokwelapha inkinga.

Umuntu onezimpawu ze-AD kufanele:

• Ahlale phansi aphakamise ikhanda
• Susa izingubo eziqinile

Ukwelashwa okufanele kuxhomeke embangela. Uma imithi noma izidakamizwa ezingekho emthethweni zidala izimpawu, leyo mithi kufanele imiswe. Noma yikuphi ukugula kudinga ukwelashwa. Isibonelo, umhlinzeki uzohlola i-catheter evinjiwe yomchamo nezimpawu zokuqunjelwa.

Uma ukwehla kwenhliziyo kubangela i-AD, izidakamizwa ezingabizwa ngokuthi i-anticholinergics (njenge-atropine) zingasetshenziswa.

Umfutho wegazi ophakeme kakhulu udinga ukwelashwa ngokushesha kodwa ngokucophelela, ngoba umfutho wegazi wehla ngokungazelelwe.

I-pacemaker ingadingeka kwisigqi senhliziyo esingazinzile.

I-Outlook incike embangela.

Abantu abane-AD ngenxa yomuthi bavame ukululama lapho lowo muthi umiswa. Lapho i-AD ibangelwa ezinye izinto, ukululama kuncike ekutheni lesi sifo singelashwa kanjani.

Izinkinga zingavela ngenxa yemiphumela emibi yemithi esetshenziselwa ukwelapha lesi simo. Isikhathi eside, umfutho wegazi ophakeme kakhulu ungadala ukuquleka, ukopha emehlweni, isifo sohlangothi noma ukufa.

Shayela umhlinzeki wakho ngokushesha uma unezimpawu ze-AD.

Ukuvimbela i-AD, ungathathi imishanguzo edala lesi simo noma uyenze ibe yimbi kakhulu.

Kubantu abanokulimala kwentambo yomgogodla, okulandelayo kungasiza futhi ekuvimbeleni i-AD:

• Ungavumeli isinye sigcwale kakhulu
• Ubuhlungu kufanele bulawulwe
• Zijwayeze ukunakekelwa kwamathumbu okufanele ukuze ugweme ukungqubuzana nendle
• Prakthiza ukunakekelwa kwesikhumba okufanele ukugwema izilonda zokugula kanye nezifo zesikhumba
• Vimbela izifo zesinye

I-Autonomic hyperreflexia; Ukulimala komgogodla - i-autonomic dysreflexia; I-SCI - i-autonomic dysreflexia

• Isistimu yezinzwa emaphakathi nesistimu yezinzwa ezungezayo

I-Cheshire WP. Izinkinga ze-Autonomic kanye nokuphathwa kwazo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 390.

I-Cowan H. Autonomic dysreflexia ekulimaleni komgogodla. Izikhathi zabahlengikazi. 2015; 111 (44): 22-24. I-PMID: 26665385 pubmed.ncbi.nlm.nih.gov/26665385/.

UMcDonagh DL, iBarden CB. I-Autonomic dysreflexia. Ku: UFleisher LA, uRosenbaum SH, ama-eds. Izinkinga ku-Anesthesia. 3rd ed. IPhiladelphia, PA: Elsevier; 2018: isahluko 131.