Amatchedwanso: PCD, PCD ndi situs solitus & immotile cilia matenda
Matenda oyambirira a ciliary dyskinesia (PCD) ndi matenda osadziwika omwe amachititsa pafupifupi 1 mwa anthu 16,000. Cilia ndizofanana ndi ziwalo zooneka ngati tsitsi zomwe zimayendera mbali zina za thupi monga chubu ndi tchechea. Cilia imagwira ntchito yofunikira yosunthira mucous ndi zina zakuthupi kutali ndi ziwalo zoti zichotsedwe m'thupi.
Mu PCD, cilia siigwira ntchito moyenera yomwe imachititsa kuchedwa kwa kuchotsedwa kwa zinyalala kumawonjezera chiopsezo cha matenda. Mu PCD ziwalo za m'mimba ndi chifuwa zimakhala pamalo awo oyenera.
Palinso magawo a PCD monga matenda a Kartagen (inversus totalis), omwe ali ndi PCD, komanso amasonyeza ziwalo za ziwalo zosiyana ndi thupi. Mwachitsanzo mmalo mwa nthata ili kumbali ya kumanzere kwa thupi, ili kumbali ya kumanja kwa thupi. Ziwalo zina zomwe zimakhudzidwa ndi matenda a Kartagener zikuphatikizapo: mtima, chiwindi, ndi matumbo. Matenda a Kartagener ndi osowa kwambiri ndi chiwerengero cha anthu 1 pa 32,000.
Zinthu Zowopsa kwa Dyskinesia Yoyamba Kwambiri
Matenda akuluakulu a dyskinesia si matenda opatsirana. Mukhoza kulandira PCD pokhapokha mutabadwa ngati makolo anu onse ali ndi matendawa kapena odwala matendawa. Ndizofala kwambiri kukhala wonyamulira wa PCD chifukwa uli ndi kachitidwe kawiri kawiri kaulendo .
Izi zikutanthauza kuti ngati kholo limodzi limakupatsani jini la PCD koma kholo lanu silikupatsani jini, simungalandire PCD koma mumadziwika ngati chotengera.
Pali matenda ambiri a jini amene angayambitse PCD ngakhale kuti simungathe kudziŵa pakadali pano otsogolera odwala matenda a dyskinesia.
Jini iliyonse yomwe imakhudza mapuloteni a cilia ikhoza kutsogolera PCD. Kusintha kwa mapuloteni okhudzana ndi cilia akhoza kuchepa, kuwonjezeka, kapena kuyimitsa kayendetsedwe ka mawonekedwe omwe amagwiritsidwa ntchito ndi maselo abwino. Kusintha kwa ntchito ya cilia kungayambitse zizindikiro zotsatirazi zokhudzana ndi ciliary cysary dyskinesia:
- matenda osokoneza minofu , rhinitis , kapena matenda a sinus
- matenda otitis otere ( matenda a khutu ) kapena kutaya kwa kumva
- kusabereka
- Matenda opatsirana kawirikawiri ngati chibayo
- chifuwa
- atelectasis (mapapo akugwa)
Kusanthula Dyskinesia Yoyamba Kwambiri
Dokotala wanu sangayang'ane choyambirira cha ciliary dyskinesia, monga zizindikiro zingagwirizane ndi mavuto ambiri omwe angaoneke mwa ana ndi akulu. Pamene inversus totaliyiti (ziwalo zomwe zimapezeka mosavuta kumbali zonse za thupi) zimazindikira, matendawa akhoza kukhala ovuta. Komabe, pamene gulu likhale labwino, dokotala wanu adzafunika kuchita mayeso ena. Kuyezetsa magazi ndi imodzi mwa njira zazikulu zomwe zimagwiritsidwa ntchito kuti muzindikire PCD, komabe pali njira ziwiri zomwe zimagwiritsidwa ntchito poyesa kuwona mavuto anu ndi cilia: makina osakaniza ndi mavidiyo . Kusiyana pakati pa mayesero awiriwa ndi mtundu wa microscope yogwiritsidwa ntchito.
Mayesero onse awiriwa amafuna dokotala kuti atenge zitsanzo kuchokera kumtambo wanu wamphongo kapena pandege kuti mufufuze pa microscope.
Mafunde omwe amagwiritsidwa ntchito pang'onopang'ono, omwe amadziwika kuti radiolabeled particles , akhoza kutsekedwa. Dokotala wanu adzayesa kuchuluka kwa tinthu tomwe timabwerera panthawi yopuma. Pakadutsa mapangidwe ochepa omwe amayembekezeredwa, zimakhala zokayikitsa. Dokotala wanu akhoza kukupatsani inu inhale nitric oxide . Chiyeso chimenechi sichimvetsetsedwa, komabe mutatulutsa zotsatira zochepa, PCD ikhoza kukayikira.
Ntchito yachibadwa ya cilia ndiyenso kufunika kwa njira yolera yobereka.
Chifukwa cha kuchepa kwa cilia mu njira yobereka, kusanthula kamuna kungathandizenso kupeza kachilombo ka PCD kwa akuluakulu. Chitsanzo cha umuna chimayambitsidwa pansi pa microscope.
Mlingo wa golide woyesa ndi electron microscopy. Izi zikhoza kufotokoza ngati ziri zosiyana ndi zomangamanga komanso zosavuta kugwira ntchito ndi cilia. ENT yanu ingatenge chitsanzo kuchokera kumphuno kapena mpweya wanu kuti mupeze chitsanzo cha mayesero awa. Kuyeza kwa majeremusi kumatha kudziwa, komabe pafupifupi 60 pa 100 alionse a PCD ali ndi ma coding omwe amadziwika.
Chithandizo cha Primary Dyskinesia Ciliary
Palibe chithandizo cha pulayimale ciliary dyskinesia. Chithandizo chikugwirizana ndi kuyang'anira zizindikiro ndikuyesera kupewa matenda. Pofuna kuteteza matenda a khutu, ENT yanu ikhoza kuika makutu kuti mumve makutu anu, chifukwa kutumiza kudzera mu chubu la eustachian sikulephereka. Mankhwala ena angaphatikizepo maulendo afupipafupi a nasal komanso mankhwala osokoneza bongo.
Kuchiza chifukwa cha kupuma kumayesetsa kukonza kukwanitsa kwanu. Popeza kufooka kwa cilia kumachepetsa kuthetsa kwanu kumalo osokoneza bongo, kukhwima kumathandiza kuthandizira thupi lanu kusunthira ntchentche kunja. Kuti mukwaniritse izi, mukhoza kuitanitsidwa:
- Chifuwa cha physiotherapy - zipangizo zamakina kapena njira zamanja zolimbikitsira kukometsera
- Kuchita masewera olimbitsa thupi - kujambula kwa cardio kumapangitsa kuti mupume kupuma kwambiri komwe kumathandiza kukonza zobisika pamsewu
- Mankhwala - bronchodilators ndi anti-inflammatories amathandiza kuchepetsa kutupa ndi kutsegula maulendo kuti akuthandizeni kutsokomola kapena kusuntha ntchentche iliyonse.
Pa zochitika zovuta kwambiri, PCD yomwe imakhudza mapapo ingapangitse bronchiectasis. Mavuto aakulu sangathe kuchiritsidwa ndipo kuika mapapo kudzakhala kofunikira. Kuika opaleshoni kumachiritsa PCD m'mapapu. Komabe muyenera kuthana ndi zofunikira zonse zothandizira pakapita nthawi. Ichi ndi chithandizo chachikulu pamene kuli kofunikira, koma si njira yoyamba yothetsera PCD.
Zotsatira:
Kliegman, Stanton, St. Geme & Schor. (2015). Nelson Buku Lophunzitsa za Ana. 20th ed. Dyskinesia ya Primary Ciliary Dyskinesia (Immotile Cilia Syndrome Kartagener Syndrome). https://www.clinicalkey.com/#!/ (Kulembetsa Kuyenera).
National Heart, Lung, ndi Blood Institute. (2011). Kodi Chinthu Chofunika Kwambiri Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chakudya Chamtundu Wambiri https://www.nhlbi.nih.gov/health/health-topics/topics/pcd.
National Organisation of Disorders. (2015). Dyskinesia ya Ciliary Primary. http://rarediseases.org/rare-diseases/primary-ciliary-dyskinesia/