Ka tuyige ku mbeera eno ey’akabi ebaawo mu bwangu ng’olongooseddwa: Malignant Hyperthermia!

Bw’oba ​​ggwe oba omuntu gw’omanyi alina okulongoosebwa, osanga owulidde ekigambo anesthesia. Kitegeeza nti tuteekebwa mu tulo nga tulongoosebwa. Naye wali olowoozezzaako nti abantu abamu bayinza okuba n’enkola ey’akabi ennyo, n’okutuuka n’okutta obulamu bwabwe olw’eddagala lino eribudamya? Eyo y’emu ku mbeera ng’ezo ezitatera kulabika, naye nga za maanyi nnyo eziyitibwa Malignant Hyperthermia. Erinnya lino liyinza okuwulikika ng’etiisa katono, naye singa otegeezebwa bulungi ku nsonga eno, ebizibu bingi osobola okwewalibwa. Kale, ka twogere ku nsonga eno mu bujjuvu leero.

Obulwadde bw’ebbugumu eringi (Malignant Hyperthermia) kye ki?

Mu ngeri ennyangu, `Malignant Hyperthermia` mbeera ya buzaale . Kwe kugamba, kiva ku nkyukakyuka mu buzaale bwaffe. Omuntu alina embeera eno bw’aweebwa eddagala erimu ery’okubudamya, omubiri gwe gukola bubi nnyo. Eno mbeera ya mangu eyinza n’okuteeka obulamu mu matigga.

Ekisinga obulungi kiri nti, wadde nga kino kitera okuba ekintu ekiyisibwa okuva ku mulembe okudda ku mulala, waliwo obujjanjabi obukijjanjaba . Era, bw’oba ​​omanyi ku kabi kano nga bukyali, osobola okwekuuma okuva ku kabi kano.

Tukimanyi nti bwe tuweebwa eddagala eribudamya abantu bonna, tetulina kye tuwulira nga tulongooseddwa. Waliwo ebika by’eddagala eby’enjawulo okusobola okuwa eddagala lino ery’okubudamya. Wabula eddagala eryo ttono nnyo ku livaako embeera eno eyitibwa `Malignant Hyperthermia`. Eddagala erisinga eriweweeza ku bulwadde buno terireeta kino.

Ekirala ekikulu kiri nti oluusi omuntu ayinza obutamanya nti alina enkyukakyuka mu buzaale eyinza okuvaako Malignant Hyperthermia, kubanga ayinza obutalaga bubonero bwonna okutuusa ng’afunye eddagala eryogerwako.

Ani asinga okukulaakulanya kino?

Ka tulabe ani ali mu bulabe obw’amaanyi obw’okufuna embeera eno eya `Malignant Hyperthermia`.

Mu bukulu, singa omuntu mu maka go abadde n‟obulwadde bwa `Malignant Hyperthermia` , olwo n‟abantu abalala mu maka ago nabo bayinza okuba mu bulabe. Okusingira ddala, singa ow’oluganda ow’eddaala erisooka (i.e. maama, taata, baganda be, abaana) abadde n’embeera eno, otwalibwa okuba `omuzibu`.

N’olwekyo, bw’oba ​​olina okulongoosebwa, kikulu nnyo okutegeeza omusawo asumulula singa wabaawo ekintu kyonna nga kino ekituuse ku muntu yenna mu maka go.

Teebereza, katugambe nti famire yo tebangako na `Malignant Hyperthermia` reaction nga eno. Kyokka, abantu abalina endwadde z’ebinywa ezimu nabo bayinza okuba mu bulabe obw’amaanyi. Ezimu ku ndwadde zino ze zino:

• `Obulwadde obw'omu makkati`
• `Obulwadde bwa Multiminicore`
• `Obulwadde bwa King-Denborough`
• `Obuzibu bwa STAC3`

Wadde kino kiyinza okulabika ng’ekizibu katono, kirungi abalina embeera zino okukimanya.

Embeera eno ya bulijjo etya?

Kino `Malignant Hyperthermia` kya bulijjo kitya? Wadde ng’ebibalo bitabuddwamu katono, okutwalira awamu kiteeberezebwa nti embeera eno esobola okubaawo mu kulongoosa nga kimu ku buli 100,000 mu bantu abakulu. Mu baana, omuwendo guno guli nga gumu ku buli 30,000 abalongoosebwa. Era kyewuunyisa nti kitundu ku balwadde abazuuliddwa tebannaweza myaka 19.

Naye bannassaayansi balowooza nti abantu abatera okubeera n’embeera eno eya `Malignant Hyperthermia` bayinza okuba nga basinga kubeera mu bantu. Olw’okuba abantu bangi tebakwatibwa ddagala lyennyini eribuleeta obulamu bwabwe bwonna, bayinza n’obutamanya nti bali mu kabi.

Bubonero ki obulaga kino?

Obubonero bwa `Malignant Hyperthermia` busobola okwawukana katono okusinziira ku muntu. Ziyinza okulabika ng’olongooseddwa oba ng’otereera oluvannyuma lw’okulongoosebwa. Okugeza bw’oba ​​ng’olina eddagala eriwunyiriza era obubonero buno ne bulabika ng’olongooseddwa, tojja kubuwulira. Wabula omusawo wo ow’okubudamya oba omusawo akubudamya abeera bulindaala nnyo ku nsonga eno. Balondoola n’obwegendereza nnyo buli muntu ali ku bujjanjabi bw’okubudamya. Kasita banaalaba obubonero buno, bajja kutandika mangu obujjanjabi bwa `Malignant Hyperthermia`.

Obubonero obusooka

Buno bwe bubonero obusooka bw’oyinza okwetegereza:

• Okweyongera kw’omutima mu ngeri etategeerekeka (tachycardia). Omutima gweyongera mangu.
• Okweyongera okw'amangu mu bungi bwa kaboni dayokisayidi afulumizibwa mu mubiri . Kino era osobola okukijjanjaba n’ebikozesebwa mu by’obujjanjabi.
• Okweyongera kw’omutindo gw’okussa (tachypnea). Otandika okussa amangu, ng’olinga assa omukka.
• Okukaluba kw’ebinywa, okukaluba (`okukaluba kw’ebinywa`). Ebinywa mu mubiri bikaluba nga bilinga ebibetenta olwazi.
• Ebbugumu ly'omubiri lyeyongera mu bwangu . Omubiri gutandika okubuguma.

Obubonero obulabika oluvannyuma

Embeera bw’egenda yeeyongera okwonooneka, oyinza n’okulaba obubonero nga:

• Okulinnya kw'ebbugumu ly'omubiri okusinga omusujja ogwa bulijjo .
• Omusulo omuddugavu . Kiyinza n’okufuuka kitaka.
• Okukebera omusaayi kulaga nti ebinywa bimenyese .
• Obutabeera bulungi mu nnyimba z’omutima (arrhythmia). Omutima gukuba mu ngeri etaali ya bulijjo.
• Okuvaamu omusaayi .
• Embeera nga okukonziba .

Lwaki obulwadde bwa malignant hyperthermia bubaawo?

Kati ka tulabe lwaki embeera eno eyitibwa `Malignant Hyperthermia` ebaawo.

Abantu abalina embeera eno balina puloteyina etali ya bulijjo mu butoffaali bw’ebinywa byabwe. Kino kiva ku nkyukakyuka mu buzaale bwazo, eyitibwa enkyukakyuka mu buzaale .

Mu ngeri ennyangu, DNA yaffe eringa "ekitabo ky'ebiragiro" ekirimu amawulire obutoffaali mu mubiri gwaffe ge bwetaaga okukola emirimu gyabwo. Singa wabaawo akatono akabulamu awalala mu DNA eno, oba bwe wabaawo okwonooneka kw’ekintu, awo endwadde z’obuzaale nga zino we zibeera.

Enkyukakyuka eno mu buzaale tereeta bubonero bwonna mu bulamu obwa bulijjo. Naye singa omuntu alina enkyukakyuka eno akwatibwa eddagala ery’enjawulo ery’okubudamya eryogeddwako waggulu – oba, si bulijjo nnyo, singa akwatibwa ebbugumu eringi oba singa yeenyigira mu dduyiro ow’amaanyi – obutoffaali bwe obw’ebinywa butandika okufulumya kalisiyamu mu ngeri etaali ya bulijjo.

N’ekyavaamu, ebinywa byeyongera okukonziba ne bifuuka ebinyigirizibwa oba okukaluba, enkyukakyuka y’omubiri n’ebbugumu ly’omubiri byeyongera mu ngeri etaali ya bulijjo. Oluvannyuma obutoffaali bw’ebinywa bufa, era ekirungo kya potassium ekinene kikuŋŋaanyizibwa mu musaayi. Kino kiyinza okuvaako obubonero obulala n’ebizibu.

Eddagala eriweweeza ku bulwadde buno liyinza okuleeta embeera eno.

Omuntu alina obuzaale bw’okulwala embeera ya `Malignant Hyperthermia` ayinza okufuna enkola eno singa aweebwa eddagala lino wammanga eribudamya:

Eddagala erissa mu mubiri:

• `Halothane`
• `Desflurane`
• `Eddagala lya sevoflurane`
• `Eddagala lya Isoflurane`

Eddagala eriweebwa mu misuwa:

• Succinylcholine – Kino ddagala eriwummuza ebinywa ekola amangu.

Kino okitegeera otya?

Bw’oba ​​olongooseddwa ng’okozesa eddagala ery’obulabe erisumulula nga tomanyi nti olina ekizibu ky’okulwala `Malignant Hyperthermia`, ggwe oba omusawo akola ku by’okubudamya temujja kumanya nti olina okutuusa ng’ekizibu kino kiwedde.

Wabula ggwe oba omuntu omulala bw’oweebwa eddagala eribudamya, omusawo oba nnansi ajja kulondoola nnyo obubonero bwo obukulu n’obulamu bwo ng’olongooseddwa n’oluvannyuma lw’okulongoosebwa. Bwoba olina `Malignant Hyperthermia`, bajja kukitegeera olw'obubonero obukulu obutali bwa bulijjo n'engeri gye bikolamu ebyogeddwako emabegako. Ekyo kili:

• Omutima gweyongera okukuba awatali nsonga.
• Okulinnya amangu kw’ebbugumu ly’omubiri.
• Okweyongera okw’amangu mu bungi bwa kaboni dayokisayidi afulumizibwa mu mubiri.
• Okunywezebwa kw’ebinywa.

Abasawo ababudamya batendekebwa okutegeera enkyukakyuka zino nga bukyali . Olwo basobola okwanukula amangu embeera eno ey’amangu. Gy’okoma okuzuula amangu embeera eno, gy’okoma okufunibwa obujjanjabi n’okufuga.

Omanya otya nga bukyali oba olina akabi kano?

Bw’oba ​​ggwe oba omusawo wo olowooza nti oyinza okuba mu bulabe bw’okulwala Malignant Hyperthermia, ka kibeere olw’ebyafaayo by’amaka go oba olw’ensonga endala, waliwo ebikeberebwa eby’enjawulo ebiyinza okukolebwa okukakasa kino:

• Caffeine halothane contracture test (CHCT) : Ku kukebera kuno, akatundu akatono ak’ekinywa kyo (muscle biopsy) kakwatibwa era sampuli y’ebitundu by’omubiri n’eteekebwa mu solutions za halothane ne caffeine okulaba oba eddamu omukka ogubudamya.
• Okukebera obuzaale : Okukebera kuno kusobola okuzuula enkyukakyuka mu buzaale mu DNA eyitibwa RYR1, STAC3, ne CACNA1S. Enkyukakyuka ezisoba mu 45 ze zizuuliddwa eziyinza okuleeta obulwadde bwa Malignant Hyperthermia.

Naye, bino okukebera okuzuula predisposition to `Malignant Hyperthermia` are quite expensive , era bisobola okukolebwa mu laboratory entono ez'enjawulo zokka. Okugeza, okugezesebwa kwa `CHCT` kusangibwa mu bifo bina byokka mu Amerika. N’olwekyo, bw’oba ​​weetaaga okulongoosebwa mu bwangu era ng’owooluganda lw’oku lusegere yali amaze okuba n’obulwadde bwa `Malignant Hyperthermia`, abakugu mu kubudamya batera okukozesa eddagala eriwunyiriza eritali lya bulabe mu kifo ky’eddagala eryo ery’akabi.

Bujjanjabi ki obukolebwa ku kino?

Obujjanjabi obusinga ku bulwadde bwa malignant hyperthermia bwe ddagala lya dantrolene (erinnya ly’ekika Dantrium®).

Kasita abasawo ababudamya bateebereza embeera eyitibwa `Malignant Hyperthermia`, bagaba eddagala lino erya `dantrolene`. Mu kiseera kye kimu, balekera awo okugaba eddagala eriweweeza ku bulwadde eryaleetawo obulwadde buno, era omusawo alongoosa amaliriza okulongoosa mu bwangu nga bwe kisoboka.

Okugatta ku ekyo, ttiimu y’ababudamya n’abalongoosa era ejjanjaba obubonero obulala n’ebizibu ebiva ku `Malignant Hyperthermia`. Ezimu ku bujjanjabi buno ze zino:

• Hyperthermia ejjanjabwa n’enkola z’okunyogoza , gamba ng’okuwa amazzi agannyogoga mu IV n’okusiiga ice packs.
• Oxygen aweebwa oba ng’ayita mu masiki ya ffeesi oba mu ttanka eteekebwa mu nnyindo.
• Singa wabaawo okukuba kw’omutima okutali kwa bulijjo (arrhythmia), eddagala liweebwa .

Embeera yo bw’emala okutereera, ojja kukuumibwa mu kifo awajjanjabirwa abalwadde abayi (ICU) waakiri okumala olunaku lumu okwetegereza . Ttiimu y’abasawo ejja kukola okukeberebwa okulala (e.g. okukebera omusaayi) era n’okugiwa obujjanjabi obulala bwe kiba kyetaagisa.

Kino kisobola okuziyizibwa?

Malignant Hyperthermia is a bit harder to prevent, okujjako nga okimanyi nti olina genetic mutation egireeta , oba omuntu mu maka go alina embeera eno era nga ogambye omusawo wo anesthesiologist. Mu mbeera eyo, omusawo w’okubudamya tajja kukozesa ddagala eryo ery’akabi mu nteekateeka yo ey’okubudamya.

Naye, eky’ennaku kiri nti, ebiseera ebisinga abantu bakizuula nti bali mu bulabe bw’obulwadde bwa Malignant Hyperthermia oluvannyuma lw’okubatuukako.

Kiki ekibaawo oluvannyuma lw’embeera eno? Kisobola okuwona?

Singa obubonero bwa `Malignant Hyperthermia` buzuulibwa nga bukyali era ne bujjanjabwa obulungi, okuwona mu bujjuvu kisoboka . Ekikolwa eky’amangu ekya ttiimu y’ababudamya n’abalongoosa kikulu nnyo wano.

Kyokka era tulina okukijjukira nti oluusi ne bwe tufuna obujjanjabi obw’amangu, ebitundu by’omubiri ebingi okulemererwa n’okufa bisobola okubaawo.

Bizibu ki ebirala ebiyinza okuva ku bulwadde bwa malignant hyperthermia?

Malignant Hyperthermia esobola okuleeta ebizibu eby’amaanyi nga:

• Okwonooneka kw’ebinywa
• Okulemererwa kw’ekibumba
• Ekibumba okulemererwa
• Okuvaamu omusaayi
• Omutima okusiba
• Okukonziba
• Coma
• Okufa

Kino kitta abantu?

Singa tezijjanjabwa, `Malignant Hyperthermia` mbeera eyinza okutta omuntu . Ne bwe baba n’obujjanjabi obutuufu, omuwendo gw’abafa ogwaloopebwa guli wakati wa 3% ne 5%. N’olwekyo, kino si kintu kya kutwalibwa ng’ekitono.

Ddi lwe nnina okulaba omusawo ku nsonga eno?

Bw’oba ​​weetegekera okulongoosebwa, kikulu nnyo okutegeeza abasawo oba waliwo omuntu yenna mu maka go eyabadde n’obuzibu bwonna obw’okubudamya .

Ate era, bw’oba ​​waakazuulibwa ng’olina enkyukakyuka mu buzaale ereeta Malignant Hyperthermia mu luganda lw’omusaayi (ow’oluganda oluzaalibwa), oba bw’okimanya nti omuntu oyo afunye embeera eyitibwa Malignant Hyperthermia, kikulu nnyo okutegeeza omusawo wo n’owandiika ku kino mu biwandiiko byo eby’obujjanjabi.

Ebintu ebikulu by’olina okujjukira mu kitundu kino

Malignant Hyperthermia bulwadde bwa maanyi, obutta obulamu bw’omuntu ng’okozesa eddagala erimu eribudamya.

Amawulire amalungi gali nti kisobola okujjanjabibwa era bw’oba ​​okimanyi nti oli mu bulabe, kisobola okuziyizibwa.

Bwe kiba kisoboka, manya byonna ebikwata ku byafaayo by’obujjanjabi bw’abooluganda lwo mu musaayi. Amawulire ago gagabana n’omusawo wo. Okuva `Malignant Hyperthermia` bwe kiva ku nkyukakyuka mu buzaale eyisibwa mu milembe, singa omuntu mu maka go akifuna, naawe oba mu bulabe bwa maanyi.

Bw’oba ​​olina ekibuuzo kyonna oba ekikweraliikiriza ku kulongoosebwa n’okubudamya kw’ogenda okufuna, tolwawo kubuuza musawo wo. Baliwo okukuyamba. Okumanya kwo n’empuliziganya mu lwatu ne ttiimu yo ey’abasawo bye bisinga okukukuuma.

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