Mawu akuti coma ali ndi zizindikiro zochititsa mantha kwa anthu ambiri. Anthu ambiri aphunzira pafupifupi zonse zomwe amadziwa zokhudza coma poonera televizioni, komwe kuli chikhalidwe chomwe anthu onse amawonekeratu ndizozizwitsa komanso zozizwitsa. Zoonadi, malingana ndi chifukwa choopsa cha coma, chidziwitso chikhoza kukhala chotsimikizika kapena chosatheka kwambiri.
Tsatanetsatane wa coma ndizochitika zomwe wodwalayo sakudziwa ndi maso awo otsekedwa ndipo sangathe kudzutsidwa ndi mphamvu zowonjezera kapena zopweteka. Izi sizinthu zofanana ndi kugona kuyambira ubongo sungapite kuntchito yowonongeka ndi kugona nthawi ya coma. Ngakhale munthu amene akugona angasunthike ngati sakumvetseratu, munthu wosasangalatsa sangathe, kupatulapo maginito a msana.
Tawonani kuti mwa tanthawuzoli, madokotala nthawi zambiri amapanga anthu mwachisawawa nthawi iliyonse akamagwiritsa ntchito anesthesia pofuna kuchita opaleshoni. Mofananamo, anthu ambiri m'mzipatala amatenga nthawi yaitali kuti achotse zinthu zakunja, kaya ndizo mankhwala kapena matenda. Zikatero, tingayembekezere munthuyo kuti adzuke pamene thupi litadziteteza yekha, mankhwala kapena poizoni.
Kumbali ina, pali mitundu yosiyanasiyana yomwe imakhala yosatheka kudzuka.
Mosiyana ndi zomwe tinkakonda kuganiza, maselo a mitsempha amatha kusintha, koma amangochita mbali zina za ubongo, komanso ngakhale pang'onopang'ono. Ngati maselo a mitsempha okwanira amafa m'dera lomwe liri lofunikira kuti akhalebe maso, monga thalamus, ubongo, kapena malo akuluakulu a cerebral cortex, ndiye munthuyo sangayambirenso chidziwitso.
Maiko Ena Opanda Chidziwitso
Pamene aliyense akuwoneka kuti akungoyang'ana pa coma, pali zifukwa zowonjezereka zodziwa. Mwachitsanzo, mitundu ina ya coma imasinthidwa ndi zomwe zimatchedwa vegetative. Ngakhale kuti odwala amaoneka ngati akugona, anthu omwe ali ndi zamasamba amakhalanso osangalala, ndipo amatha kutseguka. Maso angayambe kusuntha, akuwoneka kuti akuyang'ana zinthu zomwe zili mu chipinda. Komabe, anthu odyetserako zamasamba samasonyeza kudzidziwitseni kwenizeni kweniyeni kapena malo awo. Ngati ubongo ulipobe, mitima, mapapo, ndi timapepala ta m'mimba zimapitiriza kugwira ntchito. Ngati matendawa amatha miyezi, wodwalayo akuwoneka kuti ali m'chilengedwe chokhazikika.
Imfa ya ubongo ndi mkhalidwe wovuta kwambiri momwe ntchito za ubongo zimagonjetsedwa ndi wodwalayo, ndipo wina sangathe kudzipuma yekha. Wodwala wopanda chidziwitso amatha kuwonjezera kapena kuchepetsa kuyima kwake kwa mtima moyenerera akhoza kuthandizidwa. Sipanakhalepo zolemba zabwino za anthu omwe amadziwika bwino kuti ali ndi ubongo wamtima omwe ali ndi mtundu uliwonse wa machiritso othandiza. Ngakhale dokotala woyenerera angathe kuwona kuti ubongo wamwalira chifukwa cha kuunika kwake yekha, kupatsidwa kuopsa kwa matendawa, mabanja ena amasankha kukhala ndi mayesero ena.
Komabe, ngati kuyang'ana kwa pambali pa bedi kungapangidwe kwathunthu ndi molondola, mayesero ena sangawonetseke kuti asonyeze chidziwitso chatsopano kapena choposa china chilichonse choyembekeza. Ngati autopsy ikuchitidwa pa wodwala ubongo-wakufa, maselo ambiri a ubongo adzakhala atatha.
Mayiko Odziŵa Zinthu Zochepa
Chifukwa cha matendawa, akatswiri a sayansi ya zamoyo akuyembekeza kupeza chizindikiro chakuti wodwalayo sangathe kukhala ndi vutolo kapena zamasamba, koma m'malo odziwika bwino. Minimally conscious states akutanthauzanso kuperewera kwakukulu pakuzindikira, koma pali pang'ono chabe za kudzidziwitsidwa nokha kapena malo ozungulira.
Izi zikhonza kukhala chidziwitso chodziwika bwino chotsatira malamulo ophweka, moyenera kupereka inde / ayi, mayankho, kuwonetsa khalidwe loyenera monga kusangalatsa kapena kulira, kapena kusintha manja awo kukula ndi mawonekedwe a zinthu. Kawirikawiri, anthu omwe ali m'mayiko ozindikira amakhala ndi zotsatira zabwino kwambiri kuposa odwala omwe amakhala osungulumwa.
Kudziwa ngati munthu ali mu chidziwitso chochepa kapena coma ndi chovuta kwambiri kuposa momwe poyamba amaganizira. Munthu wosakanizika amatha kusuntha m'njira zomwe zimawoneka ngati akuuka, abwenzi ndi mabanja osochera. Mwachitsanzo, odwala amodzi amatha kugwiritsidwa ntchito ngati mankhwala opweteka amagwiritsidwa ntchito pa chala kapena chala. Iwo angaoneke ngati akuchotsa chiwalocho kumbuyo kwa ululu umenewo. M'thupi lomwe limatchedwa Lazaro, chimangokhala cholimba kwambiri chingathandize munthu wodwalayo kuti azikhala wolunjika. Komabe, mayankho awa ndi osowa chabe, ofanana ndi zomwe zimachitika mwendo wanu pamene katswiri wa zamaganizo akugwada ndi nyundo. Kusamuka koteroko sikukutanthauza kuti wina ali maso.
Kuchokera ku Coma
Anthu ambiri akamapempha ngati wokondedwa wawo ali pachibwenzi, zomwe akufunadi kudziwa ndizoti wodwalayo adzauka msanga, ngati atatero. Monga mwawonera, izi zingasinthe malinga ndi chifukwa ndi kuuma kwa chidziwitso. Mwachitsanzo, nthendayi chifukwa cha kuvulala kwa ubongo kumapangitsa kuti thupi liziyenda bwino kusiyana ndi kumangidwa kwa mtima . Odwala okalamba amakonda kuchita bwino kusiyana ndi okalamba. Munthu amene ali ndi mankhwala osokoneza bongo amatha kudzuka ngati mankhwala akuchotsedwa ku machitidwe awo, pamene munthu amene ali ndi vuto la ubongo losatha angapite patsogolo ku chikhalidwe chokhazikika cha ubongo kapena ngakhale imfa ya ubongo. Kawirikawiri, ngati wina atakhalabe wosadziŵa, ndiye kuti sangathe kukhala maso.
Komabe, ngakhale ziganizo zapamwambazi zingakhale zowonjezereka. Akatswiri a zachipatala amatha kufotokozera zam'tsogolo, koma izi si zofanana ndi zojambulajambula. Mwamwayi, njira yokhayo yodziwira motsimikiza kuti wina angachiritse ku coma ndi kuyembekezera nthawi yeniyeni ndikuwona. Kodi ndi nthawi yochuluka yotani yomwe ingakhale yovuta kusankha, malinga ndi momwe wodwala ndi banja lawo alili, ndipo ayenera kukambirana bwino ndi gulu lonse lachipatala.
Zotsatira
- Jerome B. Posner ndi Fred Plum. Kuthamanga ndi Kutulukira kwa Posner Kufufuza ndi Kusunga. New York: Oxford University Press, 2007.
- Hal Blumenfeld, Neuroanatomy Kupyolera M'zipatala. Sunderland: Sinauer Associates Publishers 2002