Kulephera kwina ndi dongosolo lodzidzimitsa la mantha makamaka likufala, makamaka pamene tikukalamba. Mwachitsanzo, anthu oposa 25 peresenti ya anthu opitirira zaka 75 amavutika ndi hypotension yofatsa, yomwe zingakhale zovuta kuti anthu ayime popanda kumva chizunguzidwe chifukwa cha dongosolo lachitsekemera laumadzi silingathe kusintha moyenera kuthamanga kwa magazi .
Pafupifupi vuto lililonse lachipatala-kapena ngakhale chithandizo-lingakhudze dongosolo lachitetezo lazodziŵika mwachindunji kapena mwachindunji. Vuto ndi dongosolo lodzidzimitsa la mantha limatchedwa dysautonomia . Musanayambe kuthetsa vutoli, ndibwino kuyesa bwino kuti mutsimikizire kuti dysautonomia imamveka bwino.
Kuthamanga kwa Magazi a Orthostatic
Njira yodziwika kwambiri yodziyesera kayendedwe ka mantha kamene imatha kuchitidwa ndi chikhomo cha magazi, ulonda, ndi bedi. Kuthamanga kwa magazi kumayesedwa ndipo kutengeka kumatengedwa pamene wodwala wagona pansi, atakhala, ndikuyimirira, ndi pafupi maminiti awiri pakati pa malo. Mwa anthu ozoloŵera, kuthamanga kwa magazi sikuyenera kusiyana mosiyana ndi 10 diastolic (chiwerengero cha magazi pansi) kapena systolic 20 (nambala yapamwamba), ngakhale kuti malangizowa amasiyana kuchokera malo ndi malo.
Ngati kuthamanga kwa magazi kukugwa, sikungakhale kovuta ndi kayendedwe ka mantha: kungakhale kosakhala ndi magazi okwanira kuti azikhala ndi vuto lokwanira.
Chifukwa chachizolowezi cha izi ndi kutaya kwa madzi m'thupi, ndiye chifukwa chake timayang'ananso kutulutsa. Ngati kuthamanga kwa magazi kukugwa, kuthamanga kumafunika kukula pamene thupi likuyesera kuwonjezera kupsyinjika kwa magazi ndi kutenga magazi ku ubongo. Ngati sizingatheke, pangakhale vuto ndi nthendayi yokhudzana ndi vagus nerve, yomwe imakhala ndi ubongo wambiri womwe umatulutsa mtima.
Zovuta Zina zapanyumba
Kugwiritsira ntchito electrocardiogram (ECG kapena EKG) pamene mukuchita zinthu zina zosavuta kungapangitse chidwi cha mayeso a dysautonomia. Mwachitsanzo, chiŵerengero cha mtunda wa pakati pa mafunde a magetsi awiri ndi makumi asanu ndi atatu pambuyo poima pampando wokhalapo (chomwe chimatchedwa R-to-R chiwerengero) chingasonyeze vuto ndi vagus nerve. Izi zingachitenso panthawi yopuma. Mpaka zaka 40, mpweya wozizira kufikira pansi pa 1.2 ndi wodabwitsa. Chiŵerengero chimenechi chikuyembekezeka kuchepa pamene tikukalamba komanso kumachepetsanso ngakhale matenda odwala matenda a shuga ochepa kwambiri.
Chiŵerengero cha Valsalva ndi chiyeso china chosavuta, chosagwiritsidwa ntchito pambali pa bedi chimene chingagwiritsidwe ntchito poyeza dysautonomia. Wodwala amatha kupuma ndi pakamwa pake kutseka kuti mpweya usathawe. Izi zimachititsa kuti mtima wawonjezeke mpaka mpweya utatulutsidwa , pomwe peresenti ya parasympathetics imatha kukwera, kuchititsa kamphindi kakang'ono ka bradycardia , pamene kuthamanga kwa mtima kumatsika pansi. Ngati chiwerengero cha mtima sichikuwonjezeka pa Valsalva, mwachidziwikire zimakhala zomvetsa chisoni. Ngati sizingatheke pang'onopang'ono, izo zimaphatikizapo kupweteka kwapasympathetic.
Njira zina zowonjezera zimasintha kukanikiza kwa magazi pambuyo pa kuthamanga kwa mitsempha kwa mphindi zingapo, kapena mutatha kusunga nthambi kumizidwa m'madzi ozizira.
Kuyesera Kwambiri Kwambiri
Pamene mayesero a pambali sali okwanira, pali njira zowonjezereka zowunikira zomwe zilipo m'maofesi ena. Izi zingaphatikize kuti wodwalayo aziyika pa tebulo losungunuka , zomwe zimathandiza kuti wodwalayo asinthidwe mofulumira komanso m'njira yomwe ingakhale yosavuta kuyeza.
Kuchita khungu kumatha kuyesedwa pambuyo poti mankhwala amathiridwa kupanga chigoba chokhacho kuti afotokoze kusiyana kwakukulu pakati pa zigawo zosiyanasiyana za thupi.
Nthawi zina majeremusi a ma seroni ngati norepinephrine amatha kuyeza poyang'ana njira yowonongeka, koma kuyesera sikungodabwitsa.
Mayeso Otukwana
Ndondomeko yamanjenje yachisoni imayambitsa kutsekemera kuchokera kumatenda a thukuta. Taganizirani izi ngati njira yowonetsetsa kuti thupi lathu likhale lozizira kuti lithawe ndi tigalu.
Nthawi zina kusungidwa mwachifundo kwa mbali ya thupi kumatayika, ndipo gawo ili silikugwedeza. Izi sizimveka nthawi zonse, popeza thukuta limatha kuchokera kumadera ena a thupi kuti liphimbe gawo lomwe silikutha. Mu kuyamwa thukuta, thupi limaphimbidwa ndi ufa womwe umasintha mtundu pamene ukutumpha, ndikupangitsa malo opanda denga laderalo kukhala omveka bwino. Chokhumudwitsa ndichoti mayesowa ndi ovuta kwambiri.
Kuyesedwa kwa Mbali Zosiyana za Thupi
Chifukwa chitetezo cha mitsempha chokhazikika chimaphatikizapo mbali iliyonse ya thupi, pangakhale kofunikira kufufuza momwe mitsempha yodziimira ikugwira ntchito mu gawo lina m'malo mwa mitsempha ya mtima.
Mankhwala amodzi angagwiritsidwe ntchito poyesa kusungulumwa kwodziona kwa maso. Kutayika kwa maso kungayesedwe poika pepala lochepa la pepala lofewa pamphuno la diso kuti muwone kuchuluka kwa madzi omwe pepalalo limatenga. Chikhodzodzo chimatha kuyang'aniridwa ndi chitsime, ndipo motility ya m'mimba machitidwe angayesedwe ndi maphunziro a radiographic.
Ife tangolongosola zina mwa mayesero ambiri omwe amagwiritsidwa ntchito poyesa dongosolo lokhazikika la mantha. Chowonadi ndi chakuti ma dysautonomias amadziwika bwino, ndipo mabungwe ambiri alibe zochuluka kuposa zoyesedwa zoyambira pambali. Izi zikhoza kukhala chifukwa chakuti ambiri a dysautonomi amachokera ku mavuto omwe amakhudza mbali zina za thupi m'njira zosawoneka bwino, zomwe zimalepheretsanso kuyesedwa. Mwachitsanzo, matenda a shuga ndi omwe amachititsa kuti dysautonomia iyambe ndiyesedwa ndi kuyesedwa kwa magazi kwa shuga, m'malo moyamba ndi dongosolo lachitetezo.
Ngati vuto ndi dongosolo lodzidzimitsa lachitseketelo likudandaula ndi kutsimikiziridwa, ndikotheka kuti kuyesedwa kotere kudzafunika kuti mudziwe chifukwa. M'malo moyesera kuthana ndi zizindikiro za matendawa, kuthetsa vuto lenileni la matenda ndi njira yabwino kwambiri yothetsera vuto laumitsemphali.
Zotsatira:
Hiitola P, Enlund H, Kettunen R, Sulkava R, Hartikainen SJ Hum Postural amasintha kupsyinjika kwa magazi komanso kuchuluka kwa chikhalidwe cha anthu okalamba omwe ali ndi zaka 75 kapena kuposerapo. Mafinya. 2009 Jan; 23 (1): 33-9. lembani: 10.1038 / jhh.2008.81. Epub 2008 Jul 24.
Ropper AH, Samuels MA. Adams ndi Victor's Principles of Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
Blumenfeld H, Neuroanatomy kupyolera m'zipatala. Sunderland: Sinauer Associates Publishers 2002.