Kusanthula mutu kumakhala kovuta, koma kupeza njira yothandizira munthu, ingakhale yofanana ngati siyikwanitsa. Kwa mutu wa masango , pali mankhwala ochuluka ochotsera mimba komanso njira zothandizira, komanso mankhwala ena amodzi - omwe samvera mankhwala. Tiyeni tiwerenge mankhwala awa m'munsimu.
Mankhwala Ovuta
Oxygen ndi mtundu umodzi wa mankhwala opweteka omwe amagwiritsidwa ntchito m'mutu wa mutu.
Mlingowo ndi okosijeni 100% opopedwa pa 7-10L / min kwa mphindi 15-20. Mbali imodzi yokha ya okosijeni ndi yakuti palibe zotsatira zake. Kumbali ina, kupezeka kwa tank ya oksijeni panthawi iliyonse, ndi vuto la kunyamulira pafupi, lingakhale lolemetsa.
Triptans , makamaka sumatriptan (Imitrex) ndi zolmitriptan (Zomig), apezeka kuti ndi othandiza kuthetsa mutu wamagulu a masango. Mlingo ndi 6mg wa subcutaneous - jekeseni ndi singano m'matumbo - sumatriptan, 20mg wa sumatriasan intranasally, kapena mphuno, kapena 5-10mg wa zolmitriptan intranasally. Mofanana ndi mitundu yonse ya triptans, mankhwalawa ayenera kupeŵedwa pa mimba ndi anthu omwe ali ndi matenda a mtima komanso kuthamanga kwa magazi. Zotsatirapo za triptans zimaphatikizapo: kunyoza, paresthesias , kutopa ndi chifuwa kapena kupweteka kwa mmero.
Dihydroergotamine (DHE 45, Migranal) ndizosankha - ngakhale kuti sizinagwiritsidwe ntchito - kuchepetsa kupweteka kwa mutu wa masango.
Kusokoneza - kapena kupyolera mu mitsempha - kuganiza kuti ndi kotheka kwambiri - ngakhale, izi zikulepheretsa chifukwa cha kuwonongeka kwa masango. Dihydroergotamine sichitha kugwiritsidwa ntchito limodzi ndi triptans, pathupi, kapena anthu omwe ali ndi vuto la magazi losalamulirika komanso / kapena matenda a mtima.
Lidocaine angapereke chithandizo chokwanira ku mutu wa masango ndipo nthawi zina amagwiritsidwa ntchito kuphatikiza ndi sumatriptan. Lidocaine amaperekedwa ndi madontho a m'mphuno, ndi munthu amene wagona pansi ndi mutu wake amatembenukira kumbali ya ululu.
Octreotide - mankhwala omwe ali ofanana ndi hormone somatostatin - ndi mwayi wosankha anthu omwe ali ndi matenda a mtima ndi masana a masana, monga momwe amagwiritsira ntchito sagwirizana ndi odwalawa. Somatostatin ndi hormone yomwe imaletsa kutulutsidwa kwa mankhwala P - mapuloteni okhudzidwa ndi malamulo opweteka. Zotsatira za octreotide zimaphatikizapo kupweteka kumbali, kupweteketsa, kupweteka m'mimba komanso shuga.
Mankhwala Oletsa
Verapamil ndi mankhwala ogwiritsira ntchito kuthamanga kwa magazi, koma amagwiritsidwanso ntchito popeweratu mutu wa masango. Pomwe pali dokotala, dokotala wanu adzayang'ana kuchuluka kwa mtima wanu ndi nyimbo. Kutseka ndi mbali yowonjezera ya verapamil.
Lithium nthawi zambiri imasankhidwa kukhala verapamil chifukwa cha kugwirizanitsa mankhwala osiyanasiyana, komanso zotsatira zake za poizoni ndi zotsatira zovulaza pa impso ndi chithokomiro. Zotsatirapo zingaphatikizepo kutsegula m'mimba, kunjenjemera, ndi kuwonjezeka kwa kukwera.
Topiramate (Topamax) ndi njira ina yachiwiri yothandizira kupewa matenda a mutu.
Zotsatirapo zingaphatikizepo: kulemera kwa thupi, kutopa, chizungulire, paresthesias, kusokonezeka kwa chidziwitso, ndi kusintha kwa kukoma.
Njira zina zothandizira ndi mankhwala osokoneza bongo monga Gabapentin (Neurontin) ndi Valproic acid - zomwe zingayambitse mavuto monga kulemera ndi kutopa. Valproic acid imayesetsanso kufufuza magazi, makamaka chiwindi.
Poizoni wotchedwa Botulinum - yomwe imadziwika ndi dzina la malonda Botox - imateteza kuzimitsa mitsempha. Kafukufuku wina wa 2007 mu Journal of Headache and Pain anapeza kuti Botox ikhoza kukhala yopindulitsa monga chithandizo chowonjezera chachithandizo kwa chiwerengero chochepa cha odwala omwe ali ndi mutu wachisanu.
Corticosteroids - monga prednisone - ikhoza kugwiritsidwa ntchito kuti ikhale ndi mphamvu yolamulira mutu wa masango ndikupereka ndondomeko yothandizira yachangu. Mwatsoka, zimakhala zachilendo kuti mutu umabwerere ngati prednisone atasiya.
Kodi Ndingatani Ngati Sindimayankha Mankhwala?
Odwala omwe ali ndi mutu wamagulu ngakhale mankhwalawa angafunikire chithandizo choopsa, monga mitsempha inayake kapena kukakamiza kwambiri ubongo. Njira zowonongekazi zimakhala ndi zoopsa zawo ndipo zimafunikanso kulingalira mosamala ndi inu, dokotala wanu, ndi dokotala wanu opaleshoni.
Tengani Mfundo Zomangira
• Kumutu kwa mutu kumakhala ululu wopweteka kwambiri omwe ali ndi njira zochizira komanso zochizira zomwe zilipo.
• Ngakhale kuti ambiri omwe ali ndi mutu wa masana amatha kuyankha pa mankhwala amodzi, njira zowonongeka zowonjezereka monga kukakamiza ubongo kwambiri kapena mitsempha zingaganizidwe - ngakhale zili ndi zoopsa zawo.
• Khalani wovomerezeka pa thanzi lanu ndipo mukhale omasuka ndi katswiri wanu wa zamaganizo kapena katswiri wa mutu pamaganizo anu a mankhwala a mutu. Khalani ndi mphamvu pa mutu uwu wofooketsa ndikuwonjezera moyo wanu.
Zotsatira
Mankhwala a Ashkenazi A & Schwedt T. Cluster - mankhwala opatsirana ndi othandizira. Mutu . 2011 Feb; 51 (2): 272-86.
Beck E, Sieber WJ & Trejo R. Kulamulira mutu wa mutu wa Cluster. Am Phys Physician . 2005 Feb 15; 71 (4): 717-724.
Caleri D, Marabini S, Panconesi A & Pietrini U. Njira yowonjezeretsa zamagetsi poyesa njira yogwiritsira ntchito seatostatin mu mutu wa masana. Ric Clin Lab . 1987 Apr-Jun; 17 (2): 155-62.
Komiti Yoyang'anira Mutu ya Komiti Yapadziko Lonse Yamutu. "International Classification of Headache Disorders: Edition 3 (beta version)". Cephalalgia 2013; 33 (9): 629-808.
Sostak P, Krause P, Förderreuther S, Reinisch V, & Straube A. Botulinum mtundu wa poizoni-Njira yothandizira kumutu: phunziro loyera. J Mutu wa Mutu . 2007 Sep; 8 (4): 236-41.
Mutu wa Weaver-Agostoni J. Cluster. Am Phys Physician . 2013 Jul 15; 88 (2): 122-8.
KUDZIZIRANI: Zomwe zili patsamba lino ndizomwe mukudziwiratu. Sitiyenera kugwiritsidwa ntchito ngati choloweza m'malo mwa chisamaliro cha munthu wodwala wovomerezeka. Chonde funsani dokotala wanu kuti akuthandizeni, akudziwitsani, ndi chithandizo cha chirichonse chokhudza zizindikiro kapena matenda .