Zimayambitsa, Kuchiza, ndi Zofunikira za Mkhalidwe Epilepticus
Matenda a chikhalidwe, kapena kuti 'udindo' ndizochitika mwadzidzidzi kuchipatala zomwe zimafuna chidwi chenicheni - inde, chithandizo chamankhwala mwamsanga chingapulumutse moyo.
Zindikirani : Ngati mukudandaula kuti wina ali ndi matenda odwala matenda a khunyu amachititsa 911. Njira zatsopano zothandizira mankhwala ofulumira 2016 zatsatiridwa pansipa.
Kugunda ndi ntchito yachilendo, yosasokonezeka ya magetsi yomwe imachitika mkati mwa ubongo.
Ngati wina ali ndi vuto lachilendo, matenda a khunyu amapangidwa kuchokera m'maphunziro a magazi, mbiri yakale ya zachipatala, ndi mayesero ena, monga EEG, phokoso la msana , kapena kufufuza. Panthawi imeneyi, wothandizira zaumoyo wanu adzakupatsani mankhwala omwe angayambitse matenda anu.
Ndi khunyu, mudzapeza kuti kugwa kwakukulu kungakhale kwa mphindi zingapo . Nthawi zina, amatha nthawi yaitali ndipo amatha kuwonekera kuti asayime konse. Izi zimatchulidwa kuti ndi matenda a khunyu. Akuti anthu pafupifupi 50,000 mpaka 150,000 ku United States amakhudzidwa ndi matenda a khunyu chaka chilichonse.
Kodi Chikhalidwe Chakuthupi N'chiyani?
Panthawi ya matenda a khunyu, munthu wodwala khunyu adzakhala wosadziwa bwino komanso amatha kupuma mobwerezabwereza kapena kubwereza. Kugonjetsa kwachilendo kungokhala mphindi zochepa chabe. Komabe, pamene kugwidwa kumatenga mphindi zisanu kapena 30 popanda kuzindikira, munthuyo amapezeka kuti ali ndi matenda a khunyu.
Matenda a khunyu ndi matenda ochiza matenda omwe amafunikira chithandizo chamankhwala mwamsanga komanso mosamalitsa ngati sangathe kutero. Zovuta zomwe zingabwere kuchokera ku matenda a khunyu zimaphatikizapo kupweteka kwa mtima kapena mapapo, kusintha kwa kagayidwe kachakudya, kuwonjezeka kwa kutentha kwa thupi, ndipo pamapeto pake, kuvulazidwa kwa ubongo.
Matenda a chikhalidwe amatha kusankhidwa ngati osakanikirana kapena osasunthika. Kusokonezeka kumatanthauza munthu ali ndi zovuta zomveka. Khunyu yosasunthika imatanthawuza za chisokonezo ndi kusokonezeka maganizo. Anthu omwe ali osagwirizana nawo sangakhale ngati akudzidzidzimutsa, komabe akadali ndi magetsi omwe ali mu ubongo omwe ali ogwirizana ndi kulanda. Pambuyo pa kugwidwa kwadzidzidzi ndipo munthuyo sadakhalenso ndi chidziwitso patapita nthawi, wothandizira zaumoyo adzaganiza kuti achite EEG kuti atsimikizire kuti munthuyo sali womasuka.
Nchiyani Chimachititsa Mkhalidwe Wopweteka?
Matenda a khunyu ndi oopsa komanso owopsa kwambiri omwe amafunika kuchiza mwamsanga komanso mwamsanga kuti athetse mavuto ena komanso kusunga ubongo. Matenda a chikhalidwe angakhudze gulu lililonse, ngakhale kuti pali zina zomwe zimapangitsa kuti ana komanso ena ambiri azikhala okalamba. Zinthu izi zikuphatikizapo:
- Matenda opatsirana (matenda opatsirana mbali zazikulu za thupi)
- Febrile (matenda okhudzana ndi malungo)
- Mutu wachisoni
- Sitiroko
- Ena khansa
- Kutaya mwadzidzidzi mankhwala a antiticonvulsant (anti-seizure) mankhwala
- Kusuta mowa mwauchidakwa kapena mankhwala osokoneza bongo
- Matenda a mavitamini (low sodium, low calcium, shuga wotsika kapena wapamwamba kwambiri)
- Kuchuluka kwa mankhwala osokoneza bongo m'magazi
Kusamalira Mwadzidzidzi kwa Mkhalidwe Epilepticus
Njira yoyamba yothandizira imayamba ndi malamulo a ABC: Onetsetsani kuti munthuyo akuwonekera bwino, munthu akupuma ndi kubwezeretsa thupi.
Kuyezetsa magazi kudzachitanso kuti mudziwe chifukwa chake munthuyu adayamba kukhala ndi matenda a khunyu.
Pofuna kuchepetsa kupweteka, mankhwala ena amagwiritsidwa ntchito. Mfundo zatsopano zinayambika mu 2016 ndi American Epilepsy Society.
Mankhwala oyambirira ndi okondedwa omwe amagwiritsidwa ntchito ndi ma IV benzodiazepines, omwe ndi diazepam, lorazepam, ndi midazolam. Lorazepam amagwiritsidwa ntchito nthawi zambiri chifukwa cha kuchitapo kanthu mwamsanga. Pafupifupi 55% a anthu adzalandira njira yoyamba. Ngati simukugwira ntchito, imodzi mwa mankhwalawa ikhoza kubwerezedwa, koma ngati ikulephera kugwira ntchito pambuyo pa mlingo wachiwiri, ndi nthawi yosintha mankhwala osiyanasiyana.
Zosankha zowonjezereka mankhwala ophatikizapo mankhwalawa ndi IV fosphenytoin, valproic acid, kapena levetiracetam. Ngati izi sizigwira ntchito imodzi mwa mankhwalawa akhoza kugwiritsidwa ntchito, kapena phenobarbital ingaperekedwe.
Ngati njira iyi yachiwiri yothandizira mankhwala siigwira ntchito, ndi nthawi yowonjezerapo kuti izi zitheke ndikugwiritsa ntchito njira yowonongeka ya EEG . Mankhwala achiwiri amatha kubwerezedwa kapena wodwala akhoza kuchiritsidwa ndi mankhwala osokoneza bongo thiopental, midazolam, pentobarbital, kapena propofol.
Kufunika ndi Kugonjetsa kwa Mtundu wa Epilepticus
Matenda a khunyu akhoza kukhala oopsa ndipo sayenera kutengedwa mopepuka. Kafukufuku wina adawonetsa kuti chiŵerengero cha imfa cha anthu omwe anadwala matenda a khunyu chinali 22%, ndipo chiwerengero cha anthu 3% mwa ana ndi 26% mwa anthu akuluakulu. Choncho, kuchitapo kanthu mwamsanga n'kofunika kwambiri.
Kuteteza Mkhalidwe Khunyu
Pofuna kuteteza matenda a khunyu, anthu ayenera kumagwirizana ndi mankhwala awo ochepetsa matenda a antiepileptic. Kuwonjezera apo, kuyendera nthawi zonse kwa wothandizira zaumoyo akuyenera kuonetsetsa kuti mankhwala akugwira ntchito bwino, palibe mankhwala ena omwe awonjezera kuchepetsa mankhwala awo ochepetsa matenda a antiepileptic, ndi kuyesa pa zovuta zina (monga uchidakwa, shuga wosayendetsedwa , kusokonezeka kwamadzimadzi) komwe kungathetse kusokoneza.
Zotsatira:
Betjemann, J., ndi D. Lowenstein. Chikhalidwe cha khunyu. Lancet Neurology . 2015. 14 (6): 615-624.
Drislane, F. Kugwidwa khunyu kwa anthu akuluakulu: Kulemba, zochitika zachipatala, ndi matenda. Zaposachedwa. Kusinthidwa 11/20/15. http://www.uptodate.com/contents/convulsive-status-epilepticus-in-adults-classification-clinical-features-and-diagnosis
Glauser, T., Shinnar, S., Gloss, D. Malangizo Otsatira Umboni: Kuchiza Kuchokera Kwambiri kwa Edzipticus kwa Ana ndi Akulu: Lipoti la Lotsogolere Komiti ya American Epilepsy Society. Matenda a khunyu . 2016. 16 (1): 48-61.
Trina, E., Cock, H., Hesdorffer. Ndipo al. Tsatanetsatane ndi mndandanda wa chikhalidwe cha khunyu - Report of the ILAE Task Force on Classification of Status Epilepticus. Epilepsia . 2015. 56 (10): 1515-23.