Autonomic dysreflexia

Autonomic dysreflexia ndichinthu chosazolowereka, chopitilira muyeso chamachitidwe amanjenje (odziyimira pawokha) olimbikitsira. Izi zingaphatikizepo:

• Sinthani kugunda kwa mtima
• Kutuluka thukuta kwambiri
• Kuthamanga kwa magazi
• Kupweteka kwa minofu
• Kusintha kwa khungu: utoto, kufiira, khungu la imvi

Chifukwa chodziwika kwambiri cha autonomic dysreflexia (AD) ndi kuvulala kwa msana. Dongosolo lamanjenje la anthu omwe ali ndi AD limayankha pamitundu yolimbikitsira yomwe siyivutitsa anthu athanzi.

Zina mwa zifukwa zake ndi izi:

• Matenda a Guillain-Barré (vuto lomwe chitetezo chamthupi chimalowerera molakwika gawo lina lamanjenje)
• Zotsatira zoyipa za mankhwala ena
• Zowopsa pamutu komanso kuvulala kwina kwamaubongo
• Kutaya magazi kwa Subarachnoid (mawonekedwe amwazi wamagazi)
• Kugwiritsa ntchito mankhwala osokoneza bongo osavomerezeka monga cocaine ndi amphetamines

Zizindikiro zimatha kuphatikizira izi:

• Kuda nkhawa kapena kuda nkhawa
• Mavuto a chikhodzodzo kapena matumbo
• Masomphenya osawona, ophunzira okulitsidwa (owonjezera)
• Kupepuka, chizungulire, kapena kukomoka
• Malungo
• Ziphuphu, zotupa (zofiira) khungu pamwamba pa msana wovulala
• Thukuta lolemera
• Kuthamanga kwa magazi
• Kugunda kwamtima kosasintha, kugunda pang'onopang'ono kapena mwachangu
• Matenda a minofu, makamaka nsagwada
• Kuchulukana m'mphuno
• Kupweteka mutu

Nthawi zina sipakhala zizindikiro, ngakhale kuwuka kowopsa kwa kuthamanga kwa magazi.

Wothandizira zaumoyo adzayesa dongosolo lathunthu lamanjenje ndikuwunika zamankhwala. Uzani wothandizira za mankhwala onse omwe mukumwa tsopano ndi omwe mudamwa kale. Izi zimathandiza kudziwa mayeso omwe mukufuna.

Mayeso atha kuphatikiza:

• Kuyesa magazi ndi mkodzo
• Kujambula kwa CT kapena MRI
• ECG (muyeso wamagetsi amtima)
• Lumbar kuboola
• Kuyesedwa kwa tebulo (kuyesa kuthamanga kwa magazi momwe thupi limasinthira)
• Kuyeza poizoni (kuyesa mankhwala aliwonse, kuphatikiza mankhwala, m'magazi anu)
• X-ray

Zina zimagawana zizindikilo zambiri ndi AD, koma zimakhala ndi chifukwa china. Chifukwa chake kuyezetsa ndikuyesa wothandizirayo kuthana ndi izi, kuphatikiza:

• Matenda a Carcinoid (zotupa za m'matumbo ang'ono, colon, zowonjezera, ndi ma bronchial machubu m'mapapu)
• Matenda a Neuroleptic malignant (matenda omwe amayamba chifukwa cha mankhwala ena omwe amachititsa kuti minofu iume, kutentha thupi, komanso kugona)
• Pheochromocytoma (chotupa cha adrenal gland)
• Matenda a Serotonin (mankhwala osokoneza bongo omwe amachititsa kuti thupi likhale ndi serotonin wambiri, mankhwala opangidwa ndi maselo amitsempha)
• Chimphepo cha chithokomiro (chowopseza moyo kuchokera ku chithokomiro chambiri)

AD ikuwopseza moyo, chifukwa chake ndikofunikira kupeza vutoli mwachangu.

Munthu amene ali ndi zizindikiro za AD ayenera:

• Khalani tsonga ndikukweza mutu
• Chotsani zovala zolimba

Chithandizo choyenera chimadalira chifukwa. Ngati mankhwala kapena mankhwala osokoneza bongo akuchititsa zizindikilozo, mankhwalawo ayenera kuyimitsidwa. Matenda aliwonse amafunika kuthandizidwa. Mwachitsanzo, wothandizirayo ayang'ane katemera wotsekedwa wa mkodzo komanso zizindikiritso za kudzimbidwa.

Ngati kuchepa kwa mtima kumayambitsa AD, mankhwala omwe amatchedwa anticholinergics (monga atropine) atha kugwiritsidwa ntchito.

Kuthamanga kwambiri kwa magazi kumafunika kuthandizidwa mwachangu koma mosamala, chifukwa kuthamanga kwa magazi kumatha kutsika mwadzidzidzi.

Wopanga pacem angafunike kuti mukhale ndi mtima wosakhazikika.

Maonekedwe amatengera choyambitsa.

Anthu omwe ali ndi AD chifukwa cha mankhwala nthawi zambiri amachira atamwa mankhwalawo. AD ikayambitsidwa ndi zinthu zina, kuchira kumadalira momwe matendawa angathandizire.

Zovuta zimatha kuchitika chifukwa cha zoyipa zamankhwala omwe amagwiritsidwa ntchito kuthana ndi vutoli. Kutalika kwa nthawi yayitali, kuthamanga kwambiri kwa magazi kumatha kuyambitsa khunyu, kutuluka magazi m'maso, sitiroko, kapena kufa.

Itanani omwe akukuthandizani nthawi yomweyo ngati muli ndi zizindikiro za AD.

Pofuna kupewa AD, musamwe mankhwala omwe amachititsa vutoli kapena kukulitsa.

Kwa anthu omwe avulala msana, zotsatirazi zingathandizenso kupewa AD:

• Musalole kuti chikhodzodzo chikhale chodzaza kwambiri
• Ululu uyenera kuwongoleredwa
• Gwiritsani ntchito chisamaliro choyenera cha matumbo kuti mupewe zovuta
• Yesetsani kusamalira khungu moyenera kuti musapewe matenda opatsirana pogonana komanso matenda a khungu
• Pewani matenda a chikhodzodzo

Autonomic hyperreflexia; Msana kuvulala - autonomic dysreflexia; SCI - chidziwitso cha dysreflexia

• Central dongosolo lamanjenje ndi zotumphukira zamanjenje

Cheshire WP. Matenda a Autonomic ndi kuwongolera kwawo. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chaputala 390.

Cowan H. Autonomic dysreflexia kuvulala kwa msana. Nurs Times. 2015; 111 (44): 22-24. PMID: 26665385 pubed.ncbi.nlm.nih.gov/26665385/.

McDonagh DL, Barden CB. Autonomic dysreflexia. Mu: Fleisher LA, Rosenbaum SH, olemba., Eds. Zovuta mu Anesthesia. Wachitatu ed. Philadelphia, PA: Elsevier; 2018: mutu 131.