Kodi kuyezetsa magazi kungakuthandizeni kupeza chithandizo?
Pa February 14, 2018, United States Food and Drug Administration (FDA) inavomereza kuyesa magazi kuti agwiritsidwe ntchito pozindikira zotsatira.
Zokambirana ndizo chitsanzo chabwino cha momwe mankhwala amachitira ndizojambula ndi sayansi. Kwa zaka zambiri, kuvulala koopsa kwa ubongo (TBI) yotchedwa concussion sikunamvetsetse bwino. Momwe minofu ya ubongo inakhudzidwira, zotsatira za nthawi yaitali, chithandizo, komanso ngakhale kumvetsetsa bwino kwa zizindikiro ndi zizindikiro sizinayambe kukhazikika mpaka kumapeto kwa zaka za zana la 20.
Masewera olimbitsa thupi, makamaka mpira wa masewera olimbitsa thupi , ndi magulu ankhondo omenyera nkhondo anali ndi zotsatira zazikulu (palibe chilango chomwe chinkafuna) pakumvetsa kwachipatala za kuvulala kwa concussve, makamaka momwe kubwereza kwa mutu kumabweretsa mavuto ku ubongo wa ubongo. Pamene kuopsa kwa mgwirizano kunayamba kumveka bwino, opereka chithandizo cha zaumoyo amafufuzira momveka bwino momwe angachitire.
Mmene Kuyesedwa kwa Magazi Kumagwirira Ntchito
Kuyezetsa magazi kumatchedwa Banyan Brain Trauma Indicator ndipo imayesa kuchuluka kwa mapuloteni, omwe amadziwika kuti UCH-L1 ndi GFAP, omwe amamasulidwa ku matenda a ubongo m'magazi. Poyerekeza mkati mwa maola 12 a kuvulala, mapuloteniwa angathandize kudziwa ngati wodwalayo angakhale ndi zilonda pamtima zomwe zimapezeka ndi CT kapena MRI .
Zowononga zovulaza za ubongo-zokambirana-nthawi zambiri siziwonetsa zilonda pazithunzi za ubongo. Choipa kwambiri, kuchuluka kwa mankhwala omwe amafunika kuwunikira kuti apeze CT ingakhale ndi zotsatirapo zoipa pa nthawi.
Kuopsa kwake kumakhala koyenera kuti tipeze kuvulala koopsa, koma zofunikira za CT zosafunika kuzipewa.
Zimene Mwazi Umayesa
Chizindikiro cha Banyan Brain Indicator chimathandiza madokotala kusankha ngati ayi kapena ayi. Mu kafukufuku wogwiritsidwa ntchito ndi FDA kuti avomereze mayeserowo, adaneneratu kuti odwala adzakhala ndi zilonda zomwe zingawonongeke pamatenda awo 97.5%.
Chiyesocho chinaneneratu kuti odwala sangakhale ndi zilonda zomwe zimawoneka ndi CT scan 99.6% nthawiyo.
Choncho, ngati tigwiritsidwa ntchito ngati chida choyamba choyesa, chithandizochi chimathandiza kuti odwala omwewo asamavutike kupirira kuwala kwa ubongo wa CT. Mayesowa ndi ofulumira kwambiri kuti asagwiritsidwe ntchito asanayambe khungu la CT popanda kuchititsa kuchedwa kwakukulu.
Zimene Oyesera Magazi Sangachite
Sichimazindikira zotsatira. Ndikofunika kumvetsetsa kusiyana kwake, chifukwa sizili ngati madotolo amatha kuchotsa mtundu wina wa doohikey umene umawoneka ngati glucometer ndikuzindikira zotsatira ndi dontho la magazi pambali pa masewerawa.
Osachepera, osati pano.
Mayesowa sali otsimikizirika okha. Sizowonjezera. Komabe, zidzathandiza madokotala kuyenda odwala omwe alibe vuto lalikulu la ubongo. Pogwiritsa ntchito mayesowa pamodzi ndi njira zambiri zochiritsira-Glasgow Coma Scale ndi zina zokhudzana ndi matenda a ubongo-zidzathandiza madokotala kusankha ngati angapereke wodwalayo kuti awone. Icho si chinthu chaching'ono.
Momwe Zidakwaniritsidwira
Kwa zaka zambiri, zokambiranazo zinali ndi zifukwa ziwiri zowunikira:
- Wodwala wagwedezeka pang'onopang'ono.
- Wodwala sakumbukira zomwe zinamugunda.
Kachitatu, nthawi zina osayimika, njira zoyenera kugwiritsira ntchito ndikuti ziyenera kukhala zowonongeka. Wodwala amayenera kukodwa pa noggin kuti ife tiganizire mozama ngati kugonana. Ndicho chikhalidwe chokha chomwe chidalipobe. Sichikanakhala chisokonezo popanda mutu pamutu.
A Veterans Affairs / Dipatimenti ya Chitetezo cha Chidziwitso cha Kugonjetsa Kukhumudwa kwa ubongo ndi ubongo ndi ntchito yabwino yopezera njira zamakono zowunikira zokambirana. Chinthu chofunika kwambiri kukumbukira ndi chakuti izi ndizidziwitso za kusalidwa. Lingaliro ndikutulutsa (kutsimikizira) kuti wodwalayo alibe vuto lalikulu la ubongo wa ubongo.
Ngati sangathe kuvulaza ubongo, ndiye kuti wodwala angakhale ndi vuto. Zina mwa zizindikiro ndi zozizwitsa zomwe zimagwiritsidwa ntchito pofuna kudziwa kuuma zikuphatikizapo:
- Kupitirizabe kuchepetsa chidziwitso (makamaka kugwiritsa ntchito Glasgow Coma Scale)
- Kupewera pang'onopang'ono mayeso a ubongo (wochitidwa ndi wothandizira zaumoyo)
- Osafanana (chizindikiro chachikulu cha kuvulala kwa ubongo)
- Kugonjetsa (makamaka ngati wodwalayo sanakhale nawo kale)
- Kusanza kubwezva zvakare
- Kulephera kwapadera: magalimoto (sangathe kuyenda molondola) kapena kumva (sangathe kumverera bwino)
- Masomphenya awiri
- Kupweteka kwambiri mutu
- Kulephera kuzindikira anthu kapena kusokonezeka kuti aike (mu masewera, wodwalayo sangakumbukire dzina la gulu losiyana)
- Kulankhulidwa
- Chizoloŵezi chachilendo (kusintha kwa umunthu, mwachitsanzo)
Ngati wodwala akupereka chimodzi mwazifukwazi, zikhoza kuvulaza kwambiri ubongo ndipo wodwalayo angapatsidwe kachilombo ka CT pofuna kuyang'ana kuvulala komwe kungapangidwe ndi opaleshoni (subdural kapena epidural hematoma).
Kusiyanitsa kwakukulu pakati pa kafukufuku wamakono ndi wamakono ndikuti odwala safunikiranso kugwedezeka kwa ogwira ntchito zachipatala kuti azidera nkhawa za zokambiranazo. Inde, madokotala akupitirizabe kudziwa mmene kupweteka kwa mutu kumakhala komanso kumapwetekabe.
Mmene Kuyesera Magazi Kungathandizire
Zina mwa zizindikiro zomwe zili pamwambazi zikhoza kukhalapo kwa odwala omwe amavutika kwambiri ndi ubongo. Ngakhale ndi zikhalidwe zomveka, zingakhale zochepa.
Ndi pamene kuyesa magazi kumabwera.
Kwa odwala omwe ali ndi mbiri yomwe amatha kupita ku dome omwe ali ndi kupweteka mutu kapena kusanza, koma osawonetsa zizindikiro zina zomwe zalembedwa, CT ingakhale yoyenera ndipo sizingatheke. Kufikira kukula kwa kuyesedwa kwa magazi, chisankho chimenecho chinagwera kwa wothandizira zaumoyo kuti asapange umboni uliwonse wovomerezeka mwa njira imodzi kapena ina.
Tsopano, wodwala akhoza kuyesa zotsutsa zapadera m'magazi. Ngati mayeserowa ndi olakwika, amatanthauza kuti 99.6 pa 100, wodwala sangakhale ndi kalikonse pa CT scan. Izi zimapereka dokotala njira yoyenera kuti aganizire zowonongeka pa zipangizo zochepa. Sitikutanthauza wodwala uyu si pa 0.4% omwe ali ndi chinachake chowonekera pa CT scan, koma wotsogolera wabwino wathanzi adzapitirizabe kumuwona wodwala kuti atsimikizire kuti chirichonse chikukuyenda moyenera.
Tsogolo la TBI Kuyesedwa kwa Magazi
Izi zikhoza kukhala chiyambi chabe. Kugwiritsiridwa ntchito kwa mapuloteni ena monga zowonongeka kunaphunziridwa kwa zaka zingapo isanayambe kuyesedwa koyeso. Kafukufuku wowonjezereka amatha kuganizira pazomwe zingatiuze pamene wodwalayo ali pangozi yaikulu ya kuvulala kwa ubongo. Amisiri amathandizanso kuti adziwe ngati odwala amachiritsidwa.
Ngakhale kuti dontho la magazi pambali sikuti likuchitika pakalipano, sizikutanthauza kuti sizomwe zimayendera kuyesera magazi. Tangoganizirani dokotala wa timu mu masewera olimbitsa thupi kapena mankhwala olimbana ndi mzere kutsogolo kuti athe kuyesa msilikali wovulala kapena wosewera mpira kuti adziwe ngati pakhala pali vuto kapena ayi.
Pakali pano, chisankho chobwezeretsa wodwala kumbuyo komweko, chomwe chimakhala ndi mavuto aakulu kwa womusamalira, chimapangidwa molingana ndi kulingalira kwakukulu. Wogwira ntchito nthawi zambiri amagwiritsa ntchito kuyesedwa kwapadera kuti azindikire momwe ntchitoyo ikuyendera, kenaka imabwezeranso wosewera mpira kapena msilikali panthawi yovulazidwa. Ngati wodwala sakuchita kachiwiri mozungulira (pansi pa zovuta zake) akhoza kuchotsedwa m'munda ndikuwatumizira mankhwala ena.
Kuyezetsa magazi kungakhale chizindikiro cha kubwezeretsa masewera kapena nkhondo. Zogwiritsira ntchito zimakhala zikuwoneka.
> Zotsatira:
> Management of Concussion / mTBI Gulu logwira ntchito. VA / DoD Malangizo Othandizira Otsogolera Otsogolera Otsogolera / Kuwongolera Ubongo Woopsa. J Rehabil Res Dev . 2009; 46 (6): CP1-68.
> Papa, L., Edwards, D., & Ramia, M. (2015). Kufufuza Serum Biomarkers Chifukwa cha Kuvulaza Kwambiri Ubongo. CRC Press / Taylor & Francis . Ipezeka kuchokera ku https://www.ncbi.nlm.nih.gov/books/NBK299199/
> Papa, L. (2016). Anthu Odzipereka Omwe Amagawira Magazi Kuti Apeze Mavuto. Ndemanga ya Zamankhwala ndi Kujambula Kwambiri , 24 (3), 108-115. http://doi.org/10.1097/JSA.0000000000000117