Matenda a Guillain-Barré

Matenda a Guillain-Barré (GBS) ndi vuto lalikulu lathanzi lomwe limachitika pomwe chitetezo chamthupi (chitetezo chamthupi) chimalakwitsa molakwika gawo lina lamanjenje. Izi zimabweretsa kutupa kwa mitsempha komwe kumayambitsa kufooka kwa minofu kapena kufooka ndi zina.

Zomwe zimayambitsa GBS sizikudziwika. Zimaganiziridwa kuti GBS ndimatenda amthupi okha. Ndi vuto lokhala ndi chitetezo chamthupi, chitetezo cha mthupi chimadzivulaza mwangozi. GBS imatha kuchitika msinkhu uliwonse. Amakonda kwambiri anthu azaka zapakati pa 30 ndi 50.

GBS imatha kupezeka ndi matenda ochokera kuma virus kapena mabakiteriya, monga:

• Fuluwenza
• Matenda ena am'mimba
• Mycoplasma chibayo
• HIV, kachilombo kamene kamayambitsa HIV / AIDS (kawirikawiri)
• Matenda a Herpes simplex
• Mononucleosis

GBS itha kukhalanso ndi matenda ena, monga:

• Njira lupus erythematosus
• Matenda a Hodgkin
• Pambuyo pa opaleshoni

GBS imawononga magawo amitsempha. Kuwonongeka kwa mitsempha kumeneku kumayambitsa kulira, kufooka kwa minofu, kusakhazikika, komanso kufooka. GBS nthawi zambiri imakhudza chophimba cha mitsempha (myelin sheath). Kuwonongeka uku kumatchedwa kuchotsedwa. Zimapangitsa kuti zizindikiritso zamitsempha ziziyenda pang'onopang'ono. Kuwonongeka kwa mbali zina za mitsempha kumatha kupangitsa kuti minyewa ileke kugwira ntchito.

Zizindikiro za GBS zitha kukulirakulira mwachangu. Zitha kutenga maola ochepa kuti zizindikilo zoopsa kwambiri ziwonekere. Koma kufooka komwe kumawonjezeka masiku angapo kumakhalanso kofala.

Kufooka kwa minofu kapena kutayika kwa minofu (ziwalo) zimakhudza mbali zonse ziwiri za thupi. Nthawi zambiri, kufooka kwa minofu kumayambira m'miyendo ndikufalikira m'manja. Izi zimatchedwa kukwera ziwalo.

Ngati kutupa kumakhudza mitsempha ya pachifuwa ndi diaphragm (minofu yayikulu yomwe ili pansi pamapapu anu yomwe imakuthandizani kupuma) ndipo minofu imeneyo ndi yofooka, mungafunike kuthandizidwa kupuma.

Zizindikiro zina za GBS ndi monga:

• Kutayika kwa tendon reflexes m'manja ndi miyendo
• Kumangirira kapena kufooka (kutayika pang'ono)
• Kupweteka kwa minofu kapena kupweteka (kungakhale kupweteka ngati khunyu)
• Kusagwirizana (sikungayende popanda thandizo)
• Kuthamanga kwa magazi kapena kuthamanga kwa magazi
• Kuchuluka kwa mtima

Zizindikiro zina zitha kuphatikiza:

• Masomphenya osawona komanso masomphenya awiri
• Kusakhazikika ndi kugwa
• Zovuta kusuntha minofu ya nkhope
• Kupanikizika kwa minofu
• Kumva kugunda kwa mtima (kugunda)

Zizindikiro zadzidzidzi (pitani kuchipatala nthawi yomweyo):

• Kupuma kumasiya kwakanthawi
• Sindingapume kwambiri
• Kuvuta kupuma
• Zovuta kumeza
• Kutsetsereka
• Kukomoka
• Kumverera kupepuka kumayang'ana poyimirira

Mbiri yakukula kwa kufooka kwa minofu ndi ziwalo zitha kukhala chizindikiro cha GBS, makamaka ngati panali matenda aposachedwa.

Kuyezetsa kuchipatala kumatha kuwonetsa kufooka kwa minofu. Pakhoza kukhala mavuto ndi kuthamanga kwa magazi komanso kugunda kwa mtima. Izi ndi ntchito zomwe zimayendetsedwa zokha ndi dongosolo lamanjenje. Mayeserowa amathanso kuwonetsa kuti zovuta monga bondo kapena kugwedezeka kwamabondo zimachepa kapena kusowa.

Pakhoza kukhala zizindikilo zakuchepa kwa kupuma komwe kumayambitsidwa ndi kufooka kwa minofu yopuma.

Mayesero otsatirawa akhoza kuchitika:

• Cerebrospinal fluid sampuli (msana wapampopi)
• ECG yowunika momwe magetsi amagwirira ntchito mumtima
• Electromyography (EMG) yoyesa zamagetsi m'minyewa
• Kuyesa kuthamanga kwa ma velocity kuyesa kuti muwone momwe ma sign amagetsi amayendera msanga
• Ntchito yama pulmonary imayesa kuyeza kupuma komanso momwe mapapo amagwirira ntchito

Palibe mankhwala a GBS. Chithandizochi chimathandiza kuchepetsa zizindikilo, kuthana ndi zovuta, komanso kufulumizitsa kuchira.

Kumayambiriro kwa matendawa, chithandizo chotchedwa apheresis kapena plasmapheresis chingaperekedwe. Zimaphatikizapo kuchotsa kapena kutseka mapuloteni, otchedwa ma antibodies, omwe amalimbana ndi ma cell a mitsempha. Chithandizo china ndimitsempha yamagetsi yotchedwa immunoglobulin (IVIg). Mankhwala onsewa amathandizira kusintha mwachangu, ndipo onse ndi ofanana. Koma palibe phindu kugwiritsa ntchito mankhwala onsewa nthawi imodzi. Mankhwala ena amathandiza kuchepetsa kutupa.

Zizindikiro zikakhala zovuta, chithandizo kuchipatala chidzafunika. Thandizo lakupuma limaperekedwa.

Mankhwala ena mchipatala amayang'ana kwambiri kupewa zovuta. Izi zingaphatikizepo:

• Ochepetsa magazi kuti ateteze magazi
• Chithandizo chopumira kapena chubu chopumira ndi chopumira, ngati chifundacho ndi chofooka
• Mankhwala opweteka kapena mankhwala ena othandizira kupweteka
• Kukhazikika koyenera kwa thupi kapena chubu chodyetsera kuti muteteze kutsamwa mukamadyetsa, ngati minofu yogwiritsiridwa ntchito kumeza ndi yofooka
• Thandizo lakuthupi lothandizira kulimbitsa thupi ndi minofu

Izi zitha kukupatsirani zambiri za GBS:

• Guillain-Barré Syndrome Foundation International - www.gbs-cidp.org
• National Organisation for Rare Disways - rarediseases.org/rare-diseases/guillain-barre-syndrome

Kuchira kumatha kutenga milungu, miyezi, kapena zaka. Anthu ambiri amakhala ndi moyo ndipo amachira kotheratu. Kwa anthu ena, kufooka pang'ono kungapitirire. Zotsatira zake zikuyenera kukhala zabwino ngati zizindikirazo zimatha patatha milungu itatu kuchokera pomwe zidayamba.

Mavuto omwe angakhalepo a GBS ndi awa:

• Kupuma kovuta (kulephera kupuma)
• Kufupikitsa minofu m'malumikizidwe (contractures) kapena zolakwika zina
• Kuundana kwamagazi (vein thrombosis) komwe kumachitika munthu amene ali ndi GBS sakugwira ntchito kapena akuyenera kugona
• Kuchulukitsa chiwopsezo cha matenda
• Kuthamanga kapena kusakhazikika kwa magazi
• Kufa ziwalo zomwe ndizokhazikika
• Chibayo
• Kuwonongeka kwa khungu (zilonda)
• Kupumira chakudya kapena madzi m'mapapu

Funani chithandizo chamankhwala nthawi yomweyo ngati muli ndi izi:

• Zovuta kupuma mwamphamvu
• Kuchepetsa kumverera (kutengeka)
• Kuvuta kupuma
• Zovuta kumeza
• Kukomoka
• Kutaya mphamvu m'miyendo kumakulirakulirabe pakapita nthawi

GBS; Matenda a Landry-Guillain-Barre; Pachimake idiopathic polyneuritis; Matenda opatsirana polyneuritis; Pachimake yotupa polyneuropathy; Pachimake yotupa demyelinating polyradiculoneuropathy; Kukwera ziwalo

• Minofu yakunja yakunja
• Mitsempha yotulutsa m'chiuno
• Ubongo ndi dongosolo lamanjenje

Chang CWJ. Myasthenia gravis ndi matenda a Guillain-Barré. Mu: Parrillo JE, Dellinger RP, olemba. Zovuta Zosamalira Mankhwala: Mfundo Zazidziwitso ndi Kuwongolera Kwa Akuluakulu. 5th ed. Philadelphia, PA: Elsevier; 2019: mutu 61.

Katirji B. Kusokonezeka kwamitsempha yotumphukira. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: mutu 107.