Yog tias ib tug neeg mob thiab pw hauv tsev kho mob vim lub cev tsis muaj dej thiab ntsev txaus, cov kws kho mob yuav muab cov ntsev rau lawv kom them rau qhov tsis txaus. Qhov ntawd yog ib txwm muaj. Tab sis koj puas paub tias qee zaum, yog tias lub cev cov ntsev tsawg zuj zus sai sai, nws tuaj yeem ua rau lub hlwb puas tsuaj? Qhov ntawd yog qhov peb hu ua tus mob tsis tshua muaj tab sis loj heev hu ua Central Pontine Myelinolysis. Txawm hais tias lub npe nyuaj me ntsis, cia peb tham txog nws yooj yim.
Hais yooj yim xwb, qhov xwm txheej no yog dab tsi?
Qhov no yog ib yam kab mob uas cuam tshuam nrog lub paj hlwb. Cov teeb liab hluav taws xob uas lub cev xav tau mus ncig los ntawm cov hlwb hlwb (neurons) hauv peb lub hlwb. Muaj ib daim ntaub tiv thaiv nyob ib puag ncig cov hlwb hlwb no. Peb hu nws ua myelin sheath . Nws zoo li lub hnab yas nyob ib puag ncig ib txoj hlua hluav taws xob . Lub myelin sheath no yog qhov uas tso cai rau cov teeb liab hluav taws xob mus ncig sai thiab tsis muaj kev cuam tshuam.
Central Pontine Myelinolysis (CPM) tshwm sim thaum cov myelin sheaths hauv ib cheeb tsam tshwj xeeb ntawm lub hlwb, tshwj xeeb tshaj yog cov pons, raug puas tsuaj. Qhov kev puas tsuaj no tuaj yeem cuam tshuam rau kev ua haujlwm ntawm ntau qhov ntawm lub cev.
Qee zaum, kwv yees li 10% ntawm cov neeg mob, qhov kev puas tsuaj no tuaj yeem cuam tshuam tsis yog rau cov pons xwb, tab sis kuj rau lwm qhov ntawm lub hlwb. Yog li ntawd, tus mob no hu ua lwm lub npe dav dua. Ntawd yog Osmotic Demyelination Syndrome (ODS) .
Tus mob no tsis tshua muaj, tab sis pom tias kwv yees li 2.5% ntawm cov neeg mob uas tau nkag mus rau hauv chav kho mob hnyav (ICUs) muaj feem yuav mob ODS.
Vim li cas ho muaj qhov teeb meem no?
Qhov laj thawj tseem ceeb rau qhov no yog thaum lub cev cov ntsev (uas yog cov ntsev uas peb noj) qis heev, nws yuav nce sai heev . Qhov kev pheej hmoo no tshwj xeeb tshaj yog thaum lub cev cov ntsev qis tshaj ob hnub thiab tab tom muab kev kho mob.
Qhov tseem ceeb yog, qhov no tsis yog ib yam dab tsi uas peb noj lossis haus. Qhov no yog ib yam dab tsi uas tuaj yeem tshwm sim hauv tsev kho mob, thaum muab sodium rau hauv cov hlab ntsha , uas yog, los ntawm saline, ua kev kho mob.
Xav txog nws li no. Ib tug neeg tau ntuav ntau hnub, lossis raws plab. Tom qab ntawd, tsis yog tsuas yog dej xwb, tab sis kuj tseem muaj ntsev xws li sodium poob ntawm lawv lub cev. Thaum lawv tuaj txog tsev kho mob, lawv cov ntsev sodium qis heev. Tam sim no cov kws kho mob tab tom muab cov ntsev ntsev rau lawv kom sim coj lawv cov ntsev sodium rov qab mus rau qhov qub. Txawm li cas los xij, yog tias lawv tsis paub txog lwm yam kev pheej hmoo uas tus neeg mob muaj, lawv yuav muaj peev xwm ua kom cov ntsev sodium nce ntxiv sai dua me ntsis.
Thaum qhov ntawd tshwm sim, cov dej hauv cov hlwb hlwb mam li ntws tawm ntawm cov hlwb. Cov hlwb no ntsws zoo li txiv hmab qhuav. Qhov kev hloov pauv tam sim no yog qhov ua rau cov myelin sheaths uas peb tau hais puas tsuaj.
Leej twg muaj kev pheej hmoo siab dua?
Tsis yog txhua tus neeg yuav muaj tus mob no thaum lawv cov ntsev sodium nce sai dhau, tab sis qee tus neeg muaj feem yuav mob ntau dua.
| Pawg neeg muaj kev pheej hmoo | Kev piav qhia |
|---|---|
| Cov neeg quav dej cawv | Kev tsis txaus zaub mov zoo thiab kev tsis sib npaug ntawm cov ntsev yog qhov tshwm sim ntau rau cov neeg uas haus cawv ntev. |
| Cov neeg mob hloov siab | Qhov kev pheej hmoo no tshwj xeeb tshaj yog rau cov neeg uas tau phais hloov siab. |
| Hyperemesis thaum cev xeeb tub | Hyperemesis Gravidarum, yog ib qho mob uas ntuav tsis tu ncua thaum cev xeeb tub, tuaj yeem ua rau cov ntsev hauv lub cev poob qis heev. |
| Cov kab mob ntev | Lwm yam mob uas ua rau lub cev tsis muaj zog lossis ua rau tsis muaj zaub mov zoo ua rau muaj kev pheej hmoo ntau ntxiv. |
Cov tsos mob ntawm tus kab mob no yog dab tsi?
Feem ntau cov tsos mob yuav pib tshwm sim li ntawm ob mus rau peb hnub tom qab kho cov sodium hauv lub cev. Muaj cov tsos mob uas tshwm sim thaum ntxov, thiab cov tsos mob uas tshwm sim tom qab ntau lub lis piam.
| Cov tsos mob ntawm CPM | |
|---|---|
| Cov tsos mob thaum ntxov (tsis pub dhau 2-3 hnub) | |
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| Cov tsos mob uas yuav tshwm sim tom qab (tom qab ob peb lub lis piam lossis ob peb lub hlis) | |
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Tiamsis tsis txhob ntshai. Txawm hais tias tus nqi tuag thaum xub thawj xav tias siab, qhov ntawd tau txiav txim siab los ntawm kev kuaj lub cev tuag. Raws li cov ntaub ntawv tshiab, 94% ntawm cov neeg uas muaj tus mob no tseem muaj sia nyob . Tsis tas li ntawd, ntawm 25% thiab 40% ntawm lawv rov zoo tag nrho . Txawm li cas los xij, ntawm 25% thiab 30% yuav muaj qee qhov kev tsis taus mus tas li.
Cov kws kho mob nrhiav tau qhov no li cas?
Txoj kev zoo tshaj plaws los kuaj mob no yog siv MRI (Magnetic Resonance Imaging) . Koj tus kws kho mob yuav saib cov duab MRI ntawm koj lub hlwb thiab xyuas seb puas muaj kev hloov pauv tshwj xeeb uas qhia txog kev puas tsuaj rau myelin sheaths.
Qee zaum qhov kev puas tsuaj no tsis tshwm sim ntawm MRI tam sim ntawd, yog li koj tus kws kho mob yuav hais kom koj ua lwm MRI hauv ib lossis ob lub lis piam.
CPM zoo li lwm yam mob ntawm cov duab MRI. Yog li ntawd, cov kws kho mob yuav tsum ceev faj kom tsis txhob xav tias qhov mob no yog ib yam kab mob hauv qab no.
- Kab mob Multiple Sclerosis
- Kab mob autoimmune los yog kab mob infectious encephalitis (mob hlwb)
- Kab mob vasculitis ntawm lub paj hlwb nruab nrab
- Qee hom mob qog noj ntshav
Yog tias MRI nkaus xwb tsis tuaj yeem qhia meej txog qhov puas tsuaj, tus kws kho mob yuav ua qhov kev kuaj mob hlwb kom tob dua. Qhov no yuav suav nrog kev kuaj uas ntsuas cov teeb liab hluav taws xob hauv lub hlwb, xws li EEG (electroencephalography).
Yuav kho li cas? Kev tiv thaiv yog qhov zoo tshaj plaws!
Qhov tseeb, txoj kev kho mob tseem ceeb rau Central Pontine Myelinolysis yog tiv thaiv kom tsis txhob muaj qhov mob no .
Nws yog ib qho tseem ceeb heev uas yuav tsum qhia rau koj pab neeg kho mob txog tej yam uas ua rau koj muaj kev pheej hmoo (piv txwv li, yog tias koj haus cawv, yog tias koj muaj lwm yam mob) kom lawv thiaj li ua rau koj cov sodium nce ntxiv tau zoo thiab maj mam.
Yog koj muaj tus mob no, kev kho mob yuav nyob ntawm cov tsos mob uas koj tab tom ntsib. Feem ntau, yuav tsum tau siv ntau lub hlis ntawm kev kho lub cev thiab lwm yam kev kho kom rov zoo.
Yog tias koj muaj cov tsos mob zoo ib yam li tus kab mob Parkinson, xws li tshee hnyo, koj tus kws kho mob yuav sau ntawv rau cov tshuaj dopaminergic .
Thaum koj nyob hauv tsev kho mob, kev tiv thaiv kom tsis txhob muaj teeb meem ntxiv yog ib feem tseem ceeb ntawm kev kho mob. Pawg neeg kho mob yuav saib xyuas tas li xws li:
- Kev vam khom rau lub tshuab ua pa
- Kab mob ntawm txoj hlab zis
- Mob ntsws o
- Ntshav txhaws hauv cov hlab ntsha (Deep vein thrombosis)
- Cov leeg nqaij qaug zog
Tseem muaj kev sim tshuaj kho mob rau tus kab mob no, thiab koj tus kws kho mob yuav pom zoo ib qho.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab mob Central Pontine Myelinolysis (CPM) yog ib qho mob hnyav uas tshwm sim los ntawm kev puas tsuaj rau cov myelin sheaths hauv lub hlwb vim muaj kev nce ntxiv sai sai ntawm cov sodium (ntsev) qis hauv lub cev.
- Txoj kev kho mob zoo tshaj plaws rau qhov no yog kev tiv thaiv . Ua ntej koj tau txais kev kho mob, qhia rau koj tus kws kho mob txog koj keeb kwm kev kho mob tag nrho, tshwj xeeb tshaj yog txog kev haus dej cawv lossis lwm yam kab mob.
- Yog tias qhov mob no tshwm sim, qhov muaj feem yuav ciaj sia nyob tau ntau, tab sis kev rov zoo tag nrho tuaj yeem siv sijhawm ntev, suav nrog kev kho lub cev.
- Yog tias koj lossis ib tus neeg koj paub muaj cov tsos mob no, tshwj xeeb tshaj yog tom qab tau txais kev kho mob sodium hloov hauv tsev kho mob, qhia rau kws kho mob tam sim ntawd.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus