Delirium

Delirium ndi chisokonezo chadzidzidzi chifukwa chakusintha kwakanthawi kwamaubongo komwe kumachitika ndimatenda amthupi kapena amisala.

Delirium nthawi zambiri imayambitsidwa ndi matenda amthupi kapena amisala ndipo nthawi zambiri amakhala osakhalitsa ndikusintha. Matenda ambiri amayambitsa matenda amisala. Nthawi zambiri, izi sizimalola kuti ubongo utenge mpweya kapena zinthu zina. Zitha kupanganso mankhwala owopsa (poizoni) kuti apange muubongo. Delirium imapezeka m'chipinda cha anthu odwala mwakayakaya (ICU), makamaka okalamba.

Zoyambitsa zimaphatikizapo:

• Mowa kapena mankhwala osokoneza bongo kapena kusiya
• Kugwiritsa ntchito mankhwala osokoneza bongo kapena kumwa mopitirira muyeso, kuphatikizapo kukhala mu ICU
• Electrolyte kapena zovuta zina zamthupi
• Matenda monga matenda amkodzo kapena chibayo
• Kusowa tulo kwambiri
• Ziphe
• Anesthesia wamba ndi opaleshoni
  

Delirium imakhudza kusintha mwachangu pakati pamaganizidwe (mwachitsanzo, kuchoka ku ulesi mpaka kukhumudwa ndikubwerera ku ulesi).

Zizindikiro zake ndi izi:

• Zosintha kukhala tcheru (nthawi zambiri tcheru m'mawa, osakhala tcheru usiku)
• Zosintha pakumverera (kutengeka) ndi kuzindikira
• Zosintha pamlingo wazidziwitso kapena kuzindikira
• Kusintha kwa kayendedwe (mwachitsanzo, kumatha kuyenda pang'onopang'ono kapena kosakhazikika)
• Kusintha kwa magonedwe, kugona
• Kusokonezeka (kusokonezeka) za nthawi kapena malo
• Chepetsani kukumbukira kwakanthawi kochepa ndikukumbukira
• Maganizo olakwika, monga kuyankhula munjira yosamveka
• Zosintha m'malingaliro kapena umunthu, monga mkwiyo, kupsa mtima, kukhumudwa, kukwiya, komanso kukhala wosangalala kwambiri
• Kusadziletsa
• Kusuntha kumayambitsidwa ndi kusintha kwamanjenje
• Vuto lakukhazikika

Mayeso otsatirawa atha kukhala ndi zotsatira zoyipa:

• Kuwunika kwamanjenje (kuwunika kwa mitsempha), kuphatikiza kuyesa kwakumva (kutengeka), malingaliro, kulingalira (magwiridwe antchito), ndi magwiridwe antchito
• Maphunziro a Neuropsychological

Mayesero otsatirawa atha kuchitidwanso:

• Kuyesa magazi ndi mkodzo
• X-ray pachifuwa
• Kusanthula kwa Cerebrospinal fluid (CSF) (tapampopi, kapena kuboola lumbar)
• Electroencephalogram (EEG)
• Mutu wa CT
• Sinthani mutu wa MRI
• Kuyesedwa kwamalingaliro

Cholinga cha chithandizo ndikuwongolera kapena kusintha zomwe zimayambitsa zizindikirazo. Chithandizo chimadalira zomwe zimayambitsa kusokonekera. Munthuyo angafunike kukhala mchipatala kwakanthawi kochepa.

Kuyimitsa kapena kusintha mankhwala omwe amakulitsa chisokonezo, kapena omwe siofunikira, kumatha kukonza magwiridwe antchito amisala.

Zovuta zomwe zimabweretsa chisokonezo ziyenera kuthandizidwa. Izi zingaphatikizepo:

• Kuchepa kwa magazi m'thupi
• Kuchepetsa mpweya (hypoxia)
• Mtima kulephera
• Mpweya waukulu wa carbon dioxide (hypercapnia)
• Matenda
• Impso kulephera
• Kulephera kwa chiwindi
• Matenda a zakudya
• Matenda amisala (monga kukhumudwa kapena psychosis)
• Matenda a chithokomiro

Kuchiza zovuta zamankhwala ndi zamaganizidwe nthawi zambiri kumakulitsa magwiridwe antchito amisala.

Mankhwala angafunike kuti muchepetse zipsinjo kapena kukwiya. Izi nthawi zambiri zimayambira pamiyeso yotsika kwambiri ndikusinthidwa momwe zingafunikire.

Anthu ena omwe ali ndi delirium atha kupindula ndi zothandizira kumva, magalasi, kapena opaleshoni yamaso.

Mankhwala ena omwe angakhale othandiza:

• Kusintha kwamakhalidwe kuwongolera machitidwe osavomerezeka kapena owopsa
• Zochitika zenizeni kuti muchepetse kusokonezeka

Zinthu zoyipa zomwe zimayambitsa kusokonekera zimatha kuchitika ndi zovuta zazitali zomwe zimayambitsa matenda amisala. Ma syndromes abongo amatha kusintha chifukwa chothana ndi vutolo.

Delirium nthawi zambiri imakhala pafupifupi sabata limodzi. Zitha kutenga milungu ingapo kuti ntchito yamaganizidwe ibwerere mwakale. Kuchira kwathunthu ndikofala, koma zimadalira chomwe chimayambitsa delirium.

Mavuto omwe amabwera chifukwa cha delirium ndi awa:

• Kutaya ntchito kapena kudzisamalira
• Kutaya kulumikizana
• Kupita patsogolo mpaka kugona kapena kukomoka
• Zotsatira zoyipa za mankhwala omwe amagwiritsidwa ntchito kuchiza matendawa

Itanani yemwe akukuthandizani ngati pali kusintha kwakanthawi pamalingaliro.

Kuchiza zomwe zimayambitsa delirium kumatha kuchepetsa ngozi. Kwa anthu omwe ali mchipatala, kupewa kapena kugwiritsa ntchito mankhwala ochepetsa mankhwala osokoneza bongo, kuthandizira mwachangu mavuto am'magazi ndi matenda, komanso kugwiritsa ntchito njira zowunikira zenizeni kumachepetsa chiopsezo cha omwe ali pachiwopsezo chachikulu.

Boma lachisokonezo; Matenda ovuta aubongo

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje
• Ubongo

Guthrie PF, Rayborn S, Wogulitsa HK. Malangizo okhudzana ndi umboni: delirium. J Gerontol Namwino. 2018; 44 (2): 14-24. PMID: 29378075 www.ncbi.nlm.nih.gov/pubmed/29378075. (Adasankhidwa)

Inouye SK. Delirium mwa wodwalayo. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 25.

Mendez MF, Padilla CR. Delirium. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 4.