Kugonjetsa matenda amkati mwa khutu kumakhala kovuta kwambiri zomwe zimapangitsa kuchepa msanga mukumva kwanu ndipo nthawi zina zizindikiro monga chizungulire kapena kutayika.
Kodi Matenda Opatsirana Okha Amkati Ndi Chiyani Amayambitsa Izi?
Matenda osokoneza thupi omwe amakhudza khutu la mkati sizimveka bwinobwino, komabe, makamaka zimaphatikizapo zigawo zina za chitetezo cha m'thupi (maselo a chitetezo cha thupi kapena ma antibodies) omwe pazifukwa zosadziwika amayamba kuyambitsa zida zomwe zimapanga khutu lamkati.
Pali zifukwa zambiri zokhudzana ndi momwe izi zimachitikira koma izi zimachitika mosiyana ndi matenda ena omwe alipo monga:
- Nthendayi (nthawi zambiri zokhudzana ndi zakudya)
- Matenda a Cogan
- Mankhwala a lupus erythematosus (omwe amaganiza kuti ndi osowa koma vuto lakumva lingakhalenso lokhudzana ndi zotsatira za mankhwala omwe amachiza matendawa)
- Sjogren's (nthawi zina amatchedwa matenda ouma-diso)
- Matenda a nyamakazi (otsutsana)
- Ankylosing spondylitis
- Ulcerative colitis
- Granulomatosis ya Wegener
- Scleroderma
- Psoriatic nyamakazi
- Matenda a Behcet
- Kubwereranso kwa polychondritis (wamba)
- Polyarteritis nodasa
Matenda ena opatsirana amathandizidwa ndi kutaya kwakumva kwaokha. Izi zikuphatikizapo:
- Matenda a Lyme
- Chizindikiro
Matendawa amaganiziridwa kuti akugwiritsidwa ntchito ndi kuwonjezeka kwa mankhwala opatsirana komanso kuthamanga kwa mkati mwa khutu ndi ma antibodies. Zina zomwe zingayambitse kapena zochitika zina ndizo:
- Mankhwala otsekemera a post-traumatic (chinthu chosavuta chomwe chimapezeka pambuyo povulazidwa pamutu)
- Kupweteka kwa opaleshoni kapena kupweteka kwa panthawi yam'thupi
- Matenda a Meniere
Kutayika kumayambika chifukwa cha matenda a autoimmune ndi chifukwa chosawerengeka cha kuchepa kwakumvetsera kwa pafupifupi 1 peresenti ya milandu.
Zizindikiro za Matenda Akumva Amkati Amkati
Chizindikiro chodziwika bwino cha matenda a mkati mwa khutu ndikumva mwadzidzidzi kumvetserako komwe kumachitika m'makutu onse awiri (bilaterally).
Kupweteka kwamvekedwe kameneka kumatchulidwa kuti ndizosamalidwa ndipo nthawi zambiri kumakhala ndi zizindikiro zobisika monga chizungulire kapena kutayika. Nthawi zambiri kumvetsera kumapezeka pakapita miyezi ingapo.
Kuzindikira Matenda Odzimva Okha Amkati
Ngati muli ndi zizindikiro za matenda a mkati mwa khutu lanu, dokotala angagwiritse ntchito mayesero angapo kuti atsimikizire izi. Nazi zina mwa mayesero omwe dokotala angasankhe kulamula:
- Mayeso a magazi kuti atsimikizire kapena kuthetsa matenda omwe amachititsa kuti thupi liziyenda bwino (ANA, erythrocyte sedimentation rate, rheumatoid factor, anti-leukocyte antigen, C-reactive protein).
- Mayeso ena a magazi angaphatikizepo: kuyesa anti-cochlear antibody test, kuyesera kusintha kwa lymphocyte, dzina la Lyme.
- Zojambula zosiyanasiyana zokhudzana ndi kumva monga: audiometry, ABR, kuyezetsa magazi , ECOG (electrocochleography).
- Dokotala wanu angasankhenso kuyesa mankhwala osamalitsa thupi kapena corticosteroid ndikuwone ngati muwayankha. Kuyankha moyenera kumatithandiza kutsimikizira kuti matenda a mkati mwa khutu amatha. Komabe, ngati simumayankha mankhwalawo sizikutanthauza kuti mulibe matenda amkati a mkati.
- Kuyezetsa katemera: Kuyezetsa kumeneku kumathandiza kudziwa ngati vuto lozunguza kapena kuchepetsa vuto limachokera kumalo ovala kapena mbali ina ya thupi.
Palibe mayesero omwe tatchulidwa pamwambawa ndi achindunji wa matenda a khutu amkati mkati koma amagwiritsidwa ntchito kuthandizira kutulutsa kapena kutsimikizira zofanana. Chidziwitsochi chimachokera ku zizindikiro zosiyana siyana, mbiri yachipatala, zomwe adokotala anapeza panthawi ya kuyezetsa thupi komanso zotsatira zake zoyenera.
Kuchiza Matenda Akumva Kwambiri Amkati
Kawirikawiri mzere woyamba wa mankhwala ndi mankhwala a oral steroid monga prednisone, dexamethasone, kapena evenldosterone. Amagwiritsidwa ntchito kwa nthawi ya mwezi umodzi. Steroids siigwiritsidwe ntchito kwa anthu omwe ali ndi shuga, chilonda cha zilonda zam'mimba, glaucoma, kapena kuthamanga kwa magazi.
Steroids ndi othandiza pafupifupi 60 peresenti ya nthawiyo. Steroids sayenera kuleka mwadzidzidzi, koma m'malo mwake mwapang'onopang'ono.
Ma steroid ovomerezeka amatha kuvulaza anthu ena. Pa chifukwa chimenechi dokotala angasankhe kuika steroid mkati mwa khutu lanu lamkati (njira yoperekera mankhwalayo imatchedwa transtympanic). Izi zimaphatikizapo kugwiritsira ntchito pang'onopang'ono kumatchera (kumatchedwa myringotomy ) yomwe ikhoza kuchitidwa ndi mankhwala am'deralo kapena, ngati n'koyenera, kuchipatala kapena malo opaleshoni pansi pa anesthesia. Chizindikiro cha tympanostomy chimayikidwa kuti chitetezo chikhale chotseguka kuti chithandizo chikhoza kupitiriridwa kwa nthawi. Ndondomekoyi ndi yophweka ndipo sizimayambitsa ululu waukulu. Bulu likatha kuchotsedwa, mankhwalawa amachiritsidwa mwamsanga.
Ngati simunapemphere mankhwala a steroid kapena ngati mankhwala a steroid sakugwira ntchito, adokotala angasankhe mankhwala ena.
Mankhwala a cytotoxic monga methotrexate ndi cyclophosphamide angakhale othandiza pochiza matenda a m'makutu amkati mkati mwake pamene steroid imalephera kapena sizosankha, komabe zowawa zingachepetse ntchito yawo. Methotrexate imagwiritsidwa ntchito chifukwa imakhudzidwa ndi zotsatira zochepa kusiyana ndi mankhwala ena a cytotoxic ndipo ngati zotsatira zake zimakhala zovuta zimakhala zofewa komanso zowonongeka.
Zotsatira za methotrexate ndi cyclophosphamide zingaphatikizepo: kuchepa kwa magazi m'thupi, thrombocytopenia, impso kapena chiwindi poizoni, kusabereka kapena kuperewera kwa mafupa. Pamene mukugwiritsa ntchito mankhwalawa, thanzi lanu liyenera kuyang'anitsitsa ndi dokotala komanso mayesero a magazi kuti aone ngati impso kapena chiwindi chimagwira ntchito. Kuchiza ndi methotrexate kumapambana bwino pafupifupi 69 peresenti.
Mankhwala ena omwe dokotala angasankhe kuyesa ndi awa:
- Zovomerezeka (wotsutsana ndi tumor-necrosis)
- N-acetylcysteine
Kafukufuku wotsimikizira kuti mankhwalawa ndi othandizira kwambiri kotero dokotala wanu angosankha kuyesa ngati mankhwala ena alephera.
Chithandizo chinanso chotheka chomwe chiyenera kufufuzidwa kwambiri ndi plasmapheresis. Plasmapheresis ndiyo ndondomeko yowononga magazi a munthu kuchotsa ziwalo za chitetezo cha m'thupi zomwe zimalingalira kuti zimayambitsa khutu la mkati (antigen, antibodies, etc.). Zinthu za chitetezo cha mthupi zomwe zimachotsedwa zimachotsedwa ndi saline kapena puloteni yotchedwa albumin (kapena onse). Mankhwalawa akhoza kukhala okwera mtengo ndipo sangathe kugwiritsidwa ntchito ngati mankhwala oyamba.
Mosasamala kanthu za mankhwala omwe agwiritsidwa ntchito, kafukufuku wasonyeza kuti chithandizo chofulumira chinayambika bwino kwambiri chomwe chikhoza kukhala. Pa chifukwa chimenechi muyenera kupita kuchipatala mwamsanga ngati muli ndi zizindikiro za matenda a mkati mwa khutu.
> Zotsatira:
> Kugonjetsa Magulu Amkati Amkati (AIED). Webusaiti ya American Hearing Research Foundation. http://american-hearing.org/disorders/autoimmune-inner-ear-disease-aied/. Idasinthidwa Oktoba 2012. Idapezeka pa June 17, 2017.
> Kugonjetsa Magulu Amkati Akumva (AIED's): Kugonjetsa Magulu ndi Kuphatikizana kwa Audio-Vestibular. Ondiology Online webusaiti. http://www.audiologyonline.com/articles/autoimmune-inner-ear-disease-aieds-1160. Idasinthidwa mu August 2002. Inapezeka pa June 17, 2017.
> Matenda Odzipiritsa Omwe Amamva Pakamwa Pogwiritsa Ntchito Ntchito. Webusaiti ya Masewera. http://emedicine.medscape.com/article/857511-kutengeka. Idasinthidwa December 2016. Idapezeka pa June 17, 2017.
> Chitukuko Choyendetsa Kuyesa. Webusaiti ya Masewera. http://emedicine.medscape.com/article/1832765-overview. Idasinthidwa pa February 2016. Ifikira pa June 17, 2017.