Èse be ame aɖe si xɔ abi le eƒe aklã me la ƒe
ʋusɔgbɔdɔ , taɖuame sesẽ, kple dzesi bubuwo dze edzi zi ɖeka kpɔa? Esiae nye nɔnɔme si ŋu míele nu ƒom tsoe egbea, si woyɔna be Autonomic Dysreflexia, alo AD kpuie. Mègatsi dzi o, ne ènya esia la, àte ŋu aɖu edzi.
Nukae nye AD?
Kpuie ko la, Autonomic Dysreflexia (AD) nye nuwɔna si mesɔ o, si nu sẽ le lãmeka siwo kpɔa wò ŋutilã ƒe dɔwɔwɔ le eɖokui si dometɔ aɖewo dzi (míeyɔa esia be Autonomic
Nervous System ). Ele abe dzidziƒoame gã aɖe na nu sue aɖe ene.
Wokpɔa esia zi geɖe le amesiwo ƒe aklã, si nye lãmeka si le aklãa me, gblẽ nu le ŋu . Afɔku sia lolo wu ne nu gblẽ le akɔta ƒe akpa si le etame ŋu, míegblɔna be T6 ƒe agbɔsɔsɔ (Sixth Thoracic Vertebrae) alo esi wu nenema. Fifia ɖewohĩ èle eŋu bum be nukae nye akɔta ƒe akɔtaƒu sia hã. Eyae nye míaƒe akɔta ƒe titina. Esiae nye akpa si didi wu tso kɔ gbɔ va se ɖe akɔta ƒe nuwuwu. Akɔtaƒu 12 le esi, T1 va ɖo T12. AD ƒe dzesi vevitɔe nye
ʋu ƒe sisi ƒe dzidziɖedzi kpata ( ʋusɔgbɔdɔ ) . Tsɔ kpe ɖe esia ŋu la, taɖuame sesẽ hã nye dzesi vevi aɖe. Zi geɖe la, AD dzena zi gbãtɔ le ɣleti eve va ɖo etɔ̃ megbe le abi si woxɔ le aklã ŋu eye dzidziƒoame si dona tso eme (Aklã ƒe Ʋuʋudedi, Ahɔhɔ̃mekawo ƒe Ʋuʋudedi) nu fa vɔ megbe. Ame geɖe ate ŋu ato nɔnɔme sia me zi geɖe le woƒe agbe me. Wogblɔ be ame aɖewo, vevietɔ amesiwo ƒe nu gblẽ wu T6 ƒe sesẽme la, toa eŋu zi gbɔ zi 40 gbesiagbe. Woyɔa AD sia ŋkɔ bubu geɖe hã, eye wò ɖɔkta ate ŋu ayɔe be ŋkɔ siawo dometɔ ɖeka hã: Autonomic Hyperreflexia, Hypertensive
Autonomic Crisis, Sympathetic Hyperreflexia.
Mina míasrɔ̃ nu vi aɖe tso míaƒe Autonomic Nervous System ŋu.
Enyo, azɔ mina míalé ŋku ɖe nusi Autonomic Nervous System sia nye ŋu. Esiae nye míaƒe ŋutilã ƒe akpa si kpɔa ŋusẽ ɖe nu geɖe dzi evɔ míebua wo ŋu o. Nuwo abe gbɔgbɔ,
dzi ƒe tsotso ,
ʋu ƒe sisi , kple nuɖuɖumeŋusẽ ene. Esia le abe míaƒe ŋutilã ƒe ɖoɖo si wowɔna le eɖokui si ene. Akpa vevi etɔ̃e le lãmeka sia si le eɖokui si la ŋu:
- Veveseseɖeamenu ƒe Lãmetsiŋusẽ (SNS): Esiae dzraa mí ɖo ɖe nɔnɔme kpatawo kple afɔkuwo ŋu. Enye ɖoɖo si ʋãa ‘aʋawɔwɔ alo sisi’ ƒe ŋuɖoɖo.
- Parasympathetic Nervous System (PNS): Esia wɔa nusi to vovo na nusi veveseseɖeamenuwɔla wɔna. Eyae nye be enaa ŋutilãa ƒe dzi dzea eme eye wòkpena ɖe ame ŋu le ‘gbɔɖeme kple nuɖuɖumeŋusẽ’ ƒe dɔwɔwɔ me.
- Enteric Nervous System (ENS): Esia koŋue kpɔa míaƒe nuɖuɖumeŋusẽ dzi.
Aleke AD va dzɔnae?
Azɔ na míalé ŋku ɖe nusi dzɔna ne èxɔ AD ŋu. Ne wò akɔta gblẽ, le afisi nèxɔ abi le te la, wò veveseseɖeamenu ƒe lãmeka (SNS) wɔa dɔ. Abe ɖe SNS la le eŋu ɖom be èle afɔku me ene. Esia wɔnɛ be ʋuka siwo le wò ŋutilã ƒe akpa si le ete (abe wò afɔwo, dɔgbo ene) la xena (woyɔa esia be ʋukawo ƒe ʋuʋu). Esia wɔnɛ be wò ʋu ƒe sisi dzina ɖe edzi kpata. Zi geɖe la, ne wò ʋu ƒe sisi dzi ɖe edzi alea la, wò parasympathetic nervous system (PNS) wɔa dɔ, si nana ʋukawo kekena (woyɔa esia be vasodilation), si wɔnɛ be wò ʋu ƒe sisi gaɖoa nɔnɔme nyuitɔ me. Míeyɔa nuwɔna sia be baroreflex. Gake le amesi xɔ abi le aklã me gome la, gbedasi sia si me veveseseɖeamenu le mate ŋu aɖiɖi tso afisi wòxɔ abi le o. Eyata nusi dzɔna enye be ʋukawo kekena le ŋutilã ƒe akpa si le etame (le abi la tame) ko. Esia tae, esi ʋuka siwo le ŋutilã ƒe akpa si le anyime la yi edzi le ʋuʋum (le SNS ƒe dɔwɔwɔ ta) ta la, ʋu ƒe sisi gakpɔtɔ le dzi yim afɔkutɔe.
Ele vevie be míase esia gɔme: Esia tae amesi ŋu AD le ate ŋu akpɔ dzesi vovovowo le woƒe ŋutilã ƒe akpa vovovowo le ɣeyiɣi ɖeka me. Le kpɔɖeŋu me, ŋutigbalẽ si le abi la ƒe kɔkɔme dzi (abe mo, kɔ, kple abɔwo ene) ate ŋu abiã eye fifia le eme. Gake ŋutigbalẽ si le abi la te (abe ƒodo ƒe akpa si le anyime kple afɔwo ene) ate ŋu anɔ ɣie, fafa, eye wòaƒu.
Amekae ate ŋu axɔ AD wu?
Ne èlé ŋku ɖe amesiwo xɔa AD wu ŋu la, amesiwo ƒe aklã gblẽ
le T6 ƒe seƒe alo esi wu nenema (akɔta ƒe akɔtaƒu adelia) ye . Gake menye amesiamee xɔae o. Ènyaa, míaƒe aklã le abe mɔ si tsɔa gbedasiwo tso ahɔhɔ̃a me yia ŋutilã bliboa me ene. Eƒe akɔtaƒuwo (akɔtaƒuwo) kpɔa eta. Zi geɖe la, abixɔxɔ le aklã me dzɔna le afɔku me, ne wogbã akɔta sia to ƒoƒo sesẽ aɖe me. Emegbe ƒu gbagbãawo tea aklãa, eye wògblẽa nu le lãmeka siwo le teƒe ma ŋu.
Afɔku si le AD xɔxɔ me dzina ɖe edzi ne alesi aklãa gblẽe kple alesi gbegbe wògblẽe (abe alesi wògbã keŋkeŋ ene). Wobu akɔnta be amesiwo xɔ abi le aklã me le vidzidɔ ƒe akɔta alo akɔta ƒe akɔta si lolo la dometɔ siwo ade 90% axɔ AD. Gakpe ɖe eŋu la, funɔ siwo ƒe aklã xɔ abi le T6 alo esi wu nenema la le afɔku me be woaxɔ AD le vidzidzi me. Eyata ele be woabu esia hã ŋu. Nukawoe nye AD ƒe dzesiwo?
AD ƒe dzesiwo ate ŋu ato vovo vie tso ame ɖeka gbɔ yi bubu gbɔ, gake zi geɖe la, wova dona kpata. Dzesi vevi gbãtɔe nye taɖuame sesẽ si le ƒoƒom. Esia tsoa ʋu ƒe sisi ƒe dzidziɖedzi kpata, si nu sẽ ŋutɔ gbɔ. Tsɔ kpe ɖe eŋu la, AD ate ŋu ahe dzesi siwo gbɔna hã vɛ:- Fifia si gbɔ eme wu akɔtave ƒe seƒe.
- Dzi ƒe tsotso blewu wu alesi wòle dzɔdzɔmee (woyɔa esia be dzitodzito ƒe ʋuʋu).
- Ŋutilã si le abi si le akɔta la tame ƒe biã kple ŋutigbalẽ si le ɣie eye wòle ƒuƒuie le abi la te.
- Goosebumps le ŋutilã ŋu le akɔtave ta.
- Ŋutilã si fa miamiamia.
- No me ʋuʋu.
- Aɖuɖɔtoe, ʋuʋudedi.
- Nukpɔkpɔ si me mekɔ o.
- Dzimaɖitsitsi kple vɔvɔ̃ vevie ƒe seselelãme.
Vevietɔ: Ne èkpɔ dzesi siawo la, ele vevie ŋutɔ be nàdi atikewɔlawo ƒe aɖaŋuɖoɖo kaba ale si nàte ŋui. Esia ate ŋu anye nudzɔdzɔ kpata.
Nukawoe hea AD vɛ?
Nu vevitɔ si gbɔ AD tsonae nye abi si woxɔna le aklã ŋu si ŋu míeƒo nu tsoe xoxo. Ame siwo ŋu AD le ƒe lãmeka siwo wɔa dɔ le wo ɖokui si la wɔa nu ɖe nusiwo doa ŋusẽ ame aɖewo ŋu fũ akpa. Zi geɖe la, ne ŋutilãa kpɔ nusi gblẽa nu le ame ŋu si mede akɔta ƒe abi ƒe seƒe o la, veveseseɖeamenu ƒe lãmekawo wɔa dɔ vevie, si wɔnɛ be ʋuka gbogbo aɖewo tsia (vasoconstriction). ‘Dziɖuɖu si gblẽa nu le ame ŋu’ sia nye nusianu si gblẽa nu le lãmekawo ŋu ŋutɔŋutɔ eye ate ŋu ana woase veve, gake ɣeaɖewoɣi la, womesea vevea o. Ate ŋu anye nusianu tso ʋuʋudedi si màte ŋu aƒo o dzi va ɖo tsinyegoe si yɔ fũ dzi. To vovo na abi siwo woxɔna le aklã me la, nɔnɔme bubu aɖewo li siwo ate ŋu ahe AD vɛ, gake ƒã ŋutɔ:- Intramedullary Astrocytoma - Kansa si le lãmekawo ƒe dɔwɔwɔ me.
- Dɔléle si nye Multiple Sclerosis (MS) ƒe dɔléle.
- Guillain-Barré ƒe Dɔléle.
- Atike aɖewo ƒe nugbegblẽ le ame ŋu.
- Ta ƒe abi sesẽwo kple ahɔhɔ̃medɔ bubuwo.
- Subarachnoid Hemorrhage (SAH) - ʋu si dona le ahɔhɔ̃ me.
- Atike siwo ŋu se meɖe mɔ ɖo o siwo doa ŋusẽ ame abe cocaine kple amphetamines ene zazã.
Nusiwo hea AD vɛ
Ne èle afɔku me be yeaxɔ AD la, ele vevie be nànya nusiwo ate ŋu ahe nɔnɔme sia vɛ. To mɔ sia dzi la, àte ŋu aƒo asa na wo eye nàda wo kaba ne AD ƒe dzesiwo dze. Zi geɖe la, kuxi siwo do ƒome kple:- Tsinyegoe.
- Dɔgbo (si gɔmee nye dɔgbowo).
- Ŋutigbalẽ.
Nusiwo do ƒome kple tsinyegoe
Tsinyegoe me kuxiwoe nye nu vevitɔ si hea AD vɛ - woawoe nye AD dɔnɔwo ƒe 85% lɔƒo. Zi geɖe la, nusi gbɔ wòtsonae nye be mɔ si me wò aɖuɖɔ tona la xe, si wɔnɛ be wò tsinyegoe yɔ fũ akpa (Bladder Distension). Esia ate ŋu atso:- Ne Foley-ka si wotsɔna ƒoa ka na wò la, ate ŋu aƒo alo axe mɔ na wò.
- Tsinyegoe ƒe ʋuʋu.
- Tsinyegoe me kpewo.
- Aɖuɖɔtoe me Dɔlékuiwo (UTIs).
Ɣeaɖewoɣi la, dodokpɔwo abe cystoscopy alo urodynamic testing hã ate ŋu ahe AD vɛ. Nusiwo gbɔ wòtsona siwo do ƒome kple dɔgbo gã la
Dɔgbo gã, alo dɔgbo, ye nye nu evelia si hea AD vɛ wu. AD ate ŋu adzɔ ne dɔgboa te ɖe edzi akpa. Susu siwo tae wòle alea ɖoe nye:- Aɖuɖɔ ƒe ʋuʋu.
- Miléle.
- Flatulence, aɖuɖɔtoe ƒe ʋuʋu.
- Enemas (Enemas) ƒe dɔwɔwɔ.
- Asiɖeɖe le aɖuɖɔ me.
Eye dɔléle bubu siwo xɔa dɔlékuiwo le dɔgboa me, le kpɔɖeŋu me:- Dɔmetɔtrɔ.
- Diverticulitis ƒe dɔléle.
- Crohn ƒe dɔlélea.
- Anal ƒe gbagbãƒewo.
- Ʋusisidɔ.
Nu siawo tɔgbe ate ŋu aʋã AD hã. Nusiwo gbɔ ŋutigbalẽ tsona
Ŋutilãmekuxiwoe nye nu etɔ̃lia si gbɔ AD tsona wu. Nu geɖe li siwo ate ŋu ahe esia vɛ:- Nyaƒoɖeamenu ƒe abi / Abadzivɔ.
- Lãɖeɖe, abidede.
- Ŋutilã ƒe ʋuʋudedi.
- Awuwo ƒe ƒoƒo, ƒoƒo, lolo akpa.
- Ʋuʋudedi si womate ŋu ase alo aƒoe o.
- Afɔbidɛ siwo tsi ɖe eme.
Aleke nàwɔ anya ne AD le ŋuwò?
Dodokpɔ ɖeka aɖeke meli si ate ŋu anya AD godoo o. Eyata nusiwo gbɔna koŋ dzie ɖɔktawo kple amesiwo léa be na wò anɔ te ɖe woƒe dɔlélea didi dzi:- Wò atikewɔwɔ ŋutinya , vevietɔ nyatakaka siwo ku ɖe abi si nèxɔ le akɔta ŋu.
- Wò ʋu ƒe sisi fifia ne wotsɔe sɔ kple wò ʋu ƒe sisi si sɔ. Zi geɖe la, ne wò ʋu ƒe sisi le ʋuka me wu 150 mmHg, alo abe 40 mmHg ene wu wò agbɔsɔsɔ si sɔ la, wobua esia be enye AD ƒe dzesi.
- Dzesiwo , vevietɔ taɖuame sesẽwo.
Ne AD ƒe dzesiwo le ŋuwò gake mèsusu be yeƒe aklã mexɔ abi o la, wò ɖɔkta adi be yeado wò lãmekawo kpɔ bliboe eye yeawɔ dodokpɔ bubuwo atsɔ adi nusi gbɔ wò dzesiawo tso. Esiawo ate ŋu anye:- Ʋu kple aɖuɖɔ dodokpɔ.
- CT-dɔdamɔnu (CT - Computed Tomography scan) alo MRI-dɔdamɔnu (MRI - Magnetic Resonance Imaging scan).
- ECG (Elektrikdzitodzito - EKG).
- Spinal tap / Akɔta ƒe ʋuʋu.
- Tilt-table dodokpɔ.
- Atikewo zazã ƒe dodokpɔwo.
- X-ray-wo wɔwɔ.
Aleke wowɔa atike na AD?
Afɔɖeɖe gbãtɔ si woawɔ le AD dada mee nye be woana dɔnɔa namlɔ anyi, aɖiɖi woƒe afɔwo ɖe anyi, eye woaɖe awu ɖesiaɖe si me wobla sesĩe la ɖa. Esia kpena ɖe ame ŋu wòɖea ʋu ƒe sisi dzi kpɔtɔna. Zi geɖe la, AD nu yina ne woɖe nusi ʋãa ame la ɖa. Eyata afɔɖeɖe si kplɔe ɖoe nye be nàde dzesi nusi hea dɔlélea vɛ ahaɖee ɖa, ne anya wɔ, hafi ana atike. Le kpɔɖeŋu me, nu aɖewo siwo wò ɖɔkta alo dɔnɔdzikpɔla ate ŋu awɔ atsɔ ade dzesi nusi gbɔ wòtso ahaɖɔe ɖoe nye esi:- Kpɔkpɔ be aɖuɖɔ le sisim nyuie hã, alo eɖɔɖɔɖo.
- Ne Foley catheter le ame aɖe si la, lé ŋku ɖe eŋu be exe alo gblẽ hã eye nàɖɔe ɖo.
- Aɖuɖɔtoe dodokpɔ be woakpɔe ɖa be aɖuɖɔtoe me dɔléle (UTI) aɖe li hã, eye ne ele nenema la, dɔlékuiwutikewo nana.
- Do aɖuɖɔtoea me kpɔ be aɖuɖɔ aɖe le eŋu hã, eye ne ele nenema la, ɖe aɖuɖɔa ɖa.
Ame geɖe siwo si nuteƒekpɔkpɔ le le AD ŋu nya esia nyuie eye wole klalo be yewoawɔ atikewɔwɔ ƒe ɖoɖo aɖe. Le nɔnɔme kpata aɖe me: Ne womete ŋu ke ɖe nusi aʋãe ŋu o, eye afɔɖeɖe veviwo meɖe ʋu ƒe sisi dzi kpɔtɔ o la, ehiã be woawɔ atike kpata be woatsɔ aɖe ʋu ƒe sisi dzi akpɔtɔ. Ne edzɔ alea la, ƒo ka na 119 (alo xexlẽdzesi kpata si sɔ), alo nàdi atikewɔlawo ƒe kpekpeɖeŋu enumake.
Emegbe woana atike siwo wɔa dɔ kabakaba abe nitrates, hydralazine, labetalol, alo nifedipine ene wò be wòaɖe wò ʋu ƒe sisi dzi akpɔtɔ. Le atikewɔwɔ me la, wò atikewɔlawo ƒe ƒuƒoƒoa alé ŋku ɖe wò dzesi veviwo ŋu eye woalé ŋku ɖe wò ʋu ƒe sisi ŋu enuenu. Ðe woate ŋu axe mɔ ɖe AD nua?
Menye ɣesiaɣie wòanya wɔ be woaxe mɔ ɖe AD nu o. Gake ne abi aɖe le wò aklã me, vevietɔ esi wu T6 ƒe agbɔsɔsɔ la, nu siawo ate ŋu akpe ɖe ŋuwò nàxe mɔ ɖe AD nu:- Tsinyegoea kɔklɔ edziedzi kple beléle be màgayɔe o.
- Vevesese dzi ɖuɖu.
- Wò dɔgbowo dzi kpɔkpɔ le vevie be nàxe mɔ ɖe aɖuɖɔ ƒe xexe kple dɔgbo ƒe ʋuʋu nu.
- Beléle na wò ŋutigbalẽ nyuie le vevie be nàxe mɔ ɖe abadzivɔwo kple ŋutigbalẽ me dɔlékuiwo nu.
- Mɔxexe ɖe aɖuɖɔtoe me dɔlékuiwo (UTIs) nu.
Aleke AD ƒe nɔnɔmea anɔ? (Nukpɔsusu) .
Zi geɖe la, AD ƒe ŋgɔdonya nyo, gake ne nusiawo dzɔ ko hafi:- Ne wò, wò dɔnɔdzikpɔla, alo wò atikewɔlawo ƒe ƒuƒoƒoa de dzesi esia kaba.
- Ne wodze atikewɔwɔ kpata si woatsɔ aɖɔ ame ɖo gɔme kaba.
- Ne wò kple/alo wò dzikpɔlawo nya nu tso AD ƒe dzesiwo kple nusiwo hea dɔlélea vɛ ŋu nyuie.
- Ne wò, wò dɔnɔdzikpɔla, alo wò atikewɔha mieɖɔ ŋu ɖo nyuie be woaxe mɔ ɖe AD nu.
Gake AD ƒe nɔnɔme sesẽ siwo womekpɔna kaba o eye womekpɔa wo gbɔ nyuie o la ate ŋu ahe emetsonu sesẽwo vɛ. Le kpɔɖeŋu me:- Ahɔhɔ̃ ƒe gbegblẽ le ʋusɔgbɔdɔ (Hypertensive Encephalopathy) ta.
- Gbagbãdᴐ.
- Dzi ƒe dɔmawɔmawɔ nyuie.
- Nudzisesẽ.
- Ku.
Dzɔgbenyuietɔe la, ame siwo kuna le AD ta la mebɔ kura o. Ne èle afɔku me be yeaxɔ AD la, nukae wòle be nàwɔ?
Ele be wò kple wò lɔlɔ̃tɔwo miakpɔ gome le AD ƒe dzesiwo nyanya me. Ne ènya dze AD ƒe dzesiwo sese gɔme ko la, nɔ anyi nàdze atikewɔwɔ gɔme. Àte ŋu adze anyi, ade abi ɖokuiwò ŋu, alo màtsi dzimaɖi o, eyata yɔ kpekpeɖeŋu. Ne mète ŋu kpɔ nusi aʋã wò o, alo ne atikewɔwɔ nyuitɔ mekpe ɖe ŋuwò o la, ele be ame aɖe naƒo ka na 119 (alo xexlẽdzesi si sɔ na nudzɔdzɔ kpata). Ele vevie hã be nàtsɔ Atikewɔwɔ Kpata ƒe Agbalẽvi ɖe asi, ne wò ɖɔkta ŋlɔe na wò, kple agbalẽvi si me nyatakaka siwo ku ɖe AD ŋu le. Esia akpe ɖe amesiwo menya nu tso AD ŋu o gɔ̃ hã ŋu. Ne AD ƒe dzesiwo dze ŋuwò kpɔ la, ele be nàna wò ɖɔktawo, dɔnɔdzikpɔlawo, kple wò lɔlɔ̃tɔwo katã nanya nu tso wò nɔnɔmea ŋu. Ale be ne egadzɔ ake la, woanya, ne ɣeyiɣi mele asiwò nàbia kpekpeɖeŋu o gɔ̃ hã. Ðo ŋku edzi abe nya kpui aɖe ene
Autonomic dysreflexia (AD) nye dɔléle si ate ŋu ade ame ƒe agbe afɔku me. Gake nya nyuia enye be woateŋu adae – zi geɖe to nusi ʋãa ame la ɖeɖeɖa alo asitɔtrɔ le eŋu me. Ne èle afɔku me be yeaxɔ AD la, ele vevie be wò kple wò lɔlɔ̃tɔwo miasrɔ̃ nusianu si miate ŋui tso eŋu. Emegbe àte ŋu ade dzesi dzesiawo ahaxɔ AD ƒe atike kaba. Ƒo nu kple wò atikewɔlawo ƒe ƒuƒoƒo tso mɔ siwo dzi nàto aƒo asa na nusiwo aʋã wò ŋu. Wole klalo be yewoakpe ɖe ŋuwò. Ðo ŋku edzi be esia menye naneke si ŋu wòle be woavɔ̃ ɖo o, sidzedzee nye ametakpɔnu gãtɔ kekeake!
💬 Comments (0)
Womeɖo nya aɖeke ɖe amewo haɖe o. Tsɔ wò nyaŋuɖoɖo kpe ɖe afisia zi gbãtɔ.
Tsɔ wò nyaŋuɖoɖo kpee