Zachidule za Postural Orthostatic Tachycardia Syndrome

Zizindikiro Zodabwitsa za POTS kwa Ana ndi Achinyamata Achikulire

Mwina simunamvepo za matenda a tachycardia orthostatic kapena POTS, ngakhale kuti amakhudza anthu ambiri, kuphatikizapo achinyamata, ndipo adadziwika kumayambiriro kwa zaka za m'ma 1990. Nyuzipepala ya National Dysautonomia Research Foundation imalongosola ana omwe ali ndi matendawa ngati osawonekera kwa akunja, omwe angaganize kuti akuwoneka kuti akuwoneka.

Zomwe sizikudziwika bwino zingakhale zokhumudwitsa kwambiri chifukwa POTS ingayambitse zizindikiro zoterozo, kuphatikizapo chizungulire, kupweteka mutu, ndi kutopa.

Postural Orthostatic Tachycardia Syndrome - Tanthauzo ndi Makhalidwe

Matenda otchedwa postural orthostatic tachycardia syndrome (POTS) amayamba chifukwa cha kusintha kapena kusagwirizana ndi dongosolo la mantha la autonomic ( dysautonomia) .

Mwinamwake simudziwa kachitidwe ka mantha kameneka, komabe zikudziwikiratu ndi zina zomwe zili zokhudzana ndi kusagwirizana kwa kayendedwe ka mantha. Izi zingaphatikizepo kupweteka kwa m'mimba , fibromyalgia , ndi matenda otopa.

Kuphatikiza pa dongosolo lalikulu la mitsempha (ubongo wathu ndi chingwe cha msana), tili ndi mitsempha yodzitetezera yomwe imathandiza kudziletsa mosamala zinthu zambiri zomwe thupi lathu limachita, monga:

• Kusokoneza ophunzira athu tikamalowa m'chipinda chamdima
• Kuchulukitsa kupanga mateti tikamadya
• Zimatipangitsa thukuta tikatentha

Ndondomeko yamadzimadzi imatithandizanso kuika mtima wathu komanso kuthamanga kwa magazi. Maudindo amenewa ndi ofunika kwambiri tikasintha malo, monga kuchoka ku supine (kugona pansi) kapena kukhala pamalo oima.

Tikamayimilira, zinthu zambiri zimachitika mthupi mwathu zomwe sitiziwona, kapena sitidziwa pamene zichitika bwino. Poyankha kuchuluka kwa magazi omwe akuthamangira ku thupi lathu la pansi, lomwe limayamba kutaya magazi athu, mawonekedwe amanjenje amadzimadzi amachititsa kuti mtima wathu ukhale wothamanga, kumanga kapena kumayika mitsempha ya magazi komanso kuwonjezera mphamvu ya magazi, zonsezi kuti zisunge magazi ku ubongo wathu.

Misendo m'milingo yathu ndi mimba imathandizanso kuti mitsempha ikhale m'magulu amenewa komanso kuthandizira pulogalamuyi.

POTS imaganiza kuti ikuchitika pamene dongosolo ili lisagwire ntchito bwino, kuchititsa anthu okhudzidwa kuti azimvetsetsa pamene akuima, pakati pa zizindikiro zina.

Amayi ambiri amapezeka pakati pa zaka 15 ndi 50 (kumayambiriro kwa kutha kwa nthawi). Ngakhale kuti sizikudziwika chomwe chimayambitsa POTS, nthawi zambiri chimayambira pambuyo pa matenda a tizilombo, monga chimfine kapena mono .

Zizindikiro za Postural Orthostatic Tachycardia Syndrome

Kutanthauzira kwachidule kwa POTS achinyamata kumakhala kumutu komanso kumakhala ndi mtima wokwera kwambiri wopitirira 40 pamphindi (kapena mpweya wa mtima pamwamba pa 120 umagunda pa mphindi), mkati mwa mphindi khumi zowimirira.

Kuwonjezera pa nthawi zambiri kumverera chizungulire, zizindikiro zina za POTS zingaphatikizepo:

• Mutu
• Kufooka, kutopa, ndi kulekerera
• Nausea ndi kusamva kwa m'mimba
• Tachycardia (kuthamanga kwa mtima pamtima) ndi mapiritsi
• Pafupi ndi syncope (kumverera ngati kuti mukulephera)
• Masomphenya obisika
• Nkhawa
• Kutenga mopanda pake
• Zovuta kugona
• Kuvuta kuika maganizo

Kuphatikiza pa kukhala ndi zizindikiro zapachiyambi, kuyesera-tebulo kuyesedwa kungathandize kuthandizira achinyamata omwe ali ndi POTS. Mayesero otha msinkhu amatha kuchitanso atsikana atakhala pansi (akugona) kwa mphindi zisanu, kuyerekezera mtima wake ndi kuthamanga kwa magazi, ndiyeno atatha kuimira 3, 5, 7, ndi 10 minutes.

Chizunguliro ndi Kutaya POTS

Chizungulire komanso ngakhale kutaya ( syncope ) kwenikweni zizindikiro za achinyamata.

Ndipotu, zikuganiziridwa kuti mpaka 15 peresenti ya achinyamata akutha msinkhu kamodzi asanakhale wamkulu, kawirikawiri ali pafupi zaka 15. Mwamwayi, ambiri mwa achinyamatawa ndi chizungulire ndi kutaya sadzakhala ndi POTS. M'malo mwake, adzakhala ndi zovuta zambiri, monga:

• Vasovagal syncope - Umatchedwanso postural syncope, vasovagal syncope ikhoza kuyambitsa pamene iwe uima motalika pamalo amodzi (zida zamagazi mmanja mwako ndi miyendo, makamaka ngati sukusunthira kwambiri) kapena chifukwa cha ululu kapena mantha.

• Kusamvana kwachizoloŵezi kosavomerezeka - Kusagwirizana kwachizoloŵezi kwachizoloŵezi kungatheke pamene mukudwala ndi chimfine, matenda a m'mimba, kapena matenda ena, kuti mukhale ochepa thupi ndikukhala osokonezeka pamene mukuyimirira.
• Kuthamanga kwa Orthostatic - Monga POTS, hypotension orthostatic imachitika pamene iwe uimirira.

Kusiyana kwakukulu pakati pa zochitika pamwambapa ndi POTS ndi kuti POTS zizindikiro zingachitike tsiku ndi tsiku ndipo nthawi zambiri zimalepheretsa.

Kuphatikizapo kuchiza matenda alionse omwe amachititsa kuti madzi asapitirire kumwa madzi, mankhwala abwino kwambiri chifukwa cha izi zimayambitsa syncope nthawi zambiri zothandizira kuti asawoneke. Pachizindikiro choyamba chimene mwana wanu akuganiza kuti akhoza kutaya, nthawi zambiri amalimbikitsidwa kuti akhale pansi, azikhala pansi, kapena azigona pansi. Kupeza mchere wokwanira ndi madzi mu zakudya zawo n'kofunikanso.

Zophatikiza za POTS

Osati aliyense amene ali ndi POTS ali ndi zizindikiro zomwezo, ndipo zikuwoneka kuti pali mitundu itatu yapadera kapena mawonekedwe a chikhalidwecho, chilichonse chimene chimagwirizana ndi njira zosiyana siyana. Kumvetsetsa gawo lapadera la POTS kungathandize kutsogolera dokotala ku zosankha zabwino zothandizira. Izi zikuphatikizapo:

• POTS yaukali
• POTS ya Hyperadrenergic
• Hypovolemic POTS

Kuchiza kwa Postural Orthostatic Tachycardia Syndrome

Popeza kuti POTS ikhoza kukhala yolepheretsa, kupeza mankhwala othandiza ndi ofunikira. Zolinga zoyambirira zoyamba nthawi zambiri zimakhala kukula (ndi madzi ndi mchere), masewera olimbitsa thupi, ndi maphunziro. Mankhwala angaphatikizepo:

• Kukwezera mutu wa bedi la mwana wanu ndi masentimita 4-6.
• Kulimbikitsa mwana wanu kumwa zakumwa ziwiri kapena 3 zamadzimadzi osakanizidwa, zakumwa tsiku lililonse komanso kukhala osungunuka bwino.
• Kuonjezera kuchuluka kwa mchere mu chakudya cha mwana wanu mpaka 3-5g / d, poyerekezera ndi mchere wamba wa 1500-2300mg kwa achinyamata omwe alibe POTS.
• Kupewa kudya zazikulu m'malo modyera kawirikawiri, koma zakudya zochepa (kudya kwakukulu kumawonjezera kuchuluka kwa magazi m'matumbo.)
• Pulogalamu yochita masewera olimbitsa thupi kapena kubwezeretsa ntchito yomwe imaphatikizapo kugwira ntchito yochepetsera thupi komanso kuchepetsa thupi kuti pang'onopang'ono kumawonjezera kuchuluka kwa maseŵera olimbitsa thupi tsiku lililonse. Izi ndizofunikira makamaka popeza akatswiri ambiri amakhulupirira kuti kupuma kwa bedi ndi kulembetsa malamulo kungathandize kwambiri POTS.

Mankhwala a POTS

Nthawi zina amagwiritsidwa ntchito kuthandiza achinyamata omwe ali ndi POTS, kuphatikizapo metoprolol (beta-blocker), midodrine (alpha-agonist), kapena fludrocortisone (mineralocorticoid yomwe ingathandize kuwonjezera mchere ndi kusunga madzi), ndi zitsanzo za mankhwala omwe angakhalepo ntchito.

Ngakhale kuti akuganiza kuti akuluakulu a antibiotic antiretroviral (agricyclic anti-compressants) amachititsa kuti POTS ikhale yovuta, SSR yatsopano yotetezera matenda (monga Prozac) imaonedwa kuti ndi yotheka.

Ivabradine ndi mankhwala atsopano omwe amawoneka othandiza kwa anthu ena omwe ali ndi POTS.

Kubwera ndi Mapulani a Chithandizo

Palibe ndondomeko yothandizira achinyamata omwe ali ndi POTS. Magazini ena samagwirizana ngakhale ngati mankhwala ena, monga beta-blockers kapena SSRIs, ndi othandiza. Kupeza thandizo kungaphatikizepo mayeso ndi zolakwika kuti mupeze mankhwala abwino omwe amathandiza mwana wanuyo ndi POTS.

Zimene Mukuyenera Kudziwa POTS

• Ngakhale kuti palibe mankhwala a POTS, achinyamata ambiri amaoneka kuti ali kunja. Anthu osachepera 500,000 ku United States akuganiza kuti ali ndi POTS.
• Kutaya pa zolimbitsa thupi ndi mbendera yofiira chifukwa chachikulu cha syncope , makamaka kwa ana omwe ali ndi mbiri ya banja la imfa mwadzidzidzi. Kufufuza kwa dokotala wanu wa ana komanso / kapena katswiri wa matenda a ana ayenera kuchitidwa mwamsanga.
• Nthawi zina POTS imakhudzana ndi matenda oopsa , Chiari malformation, kapena kutopa kwachilendo.
• Umoyo umachepetsedwa kwa achinyamata omwe ali ndi POTS ndipo mpaka theka la achinyamata ndi achinyamata omwe ali ndi matenda ali pangozi yoti adziphe. Kupeza chithandizo chabwino chomwe mwana wanu angakhoze kutsegulira nacho chingakhale gawo lofunika pa dongosolo la mankhwala.
• Katswiri wa matenda a ubongo angakuthandizeni kupeza ndi kuchiritsa mwana wanu ndi POTS. Matenda apadera a POTS amapezeka m'mabungwe ena a Ana.

_Zotsatira

• _{Heyer, G. Postural Tachycardia Syndrome: Kuzindikira ndi Utsogoleri pa Achinyamata ndi Achinyamata Achikulire. Matenda Achipatala . 2017. 46 (4): e145-154.}
• _{Pederson, C., ndi J. Brook. Moyo Wokhudzana ndi Umoyo ndi Kuopsa Kwodzipha ku Postural Tachycardia Syndrome. Clinical Autonomic Research . 2017. 27 (2): 75-81.}
• _{Pilcher, T., ndi E. Saarel. Wofera Achinyamata (Chizungulire, Syncope, Postural Orthostatic Tachycardia Syndrome). Mapatala Achipatala a North America . 2014. 61 (1): 29-43.}
• _{Zheng, X., Chen, Y., ndi J. Du. Zomwe Zachitika Posachedwa Kumvetsetsa Njira Zogwiritsira Ntchito Postus Tachycardia Syndrome mu Ana: Zotsatira Zothandiza pa Chithandizo. Maphunziro a Zamoyo mu Achinyamata . 2016 Dec 12. (Epub patsogolo pa kusindikiza).}