Spinal cord hliam nei mi pakhatin
thisen sang , lu na nasa tak, leh thil dang a neih thu i hre tawh em? Hei hi tunlaia kan sawi tur dinhmun hi a ni a, Autonomic Dysreflexia, a tawi zawngin AD tih a ni. Lungngai suh, hei hi i hriat chian chuan i thunun thei ang.
AD chu eng nge ni?
A awlsam zawngin, Autonomic Dysreflexia (AD) hi nervous system-a thil awm dan pangngai lo, na tak a ni a, chu chuan i taksa automatic function thenkhat a control a (hei hi Autonomic
Nervous System kan ti a ni ). Thil tenau takah chuan shock lian tak ang mai a ni. Hei hi
mi ruhro, ruh chhunga nerve cord tihchhiat tawhte zingah hmuh a ni ber . He risk hi a sang zawk chu a rilru chunglam a chhiat chuan a sang zawk a, T6 level (Sixth Thoracic Vertebrae) emaw a chunglam kan ti a ni. Tunah chuan he thoracic spine hi eng nge a nih i ngaihtuah mai thei. Chu chu kan ruhro lairil lam a ni. Hei hi kawr atanga ruh tawp thlenga sei ber a ni. Vertebrae 12 a nei a, T1 atanga T12 thleng a ni. AD chhinchhiahna ber chu
thisen sang ( hypertension ) sang tak ( hypertension ) a ni . Hemi rual hian lu na na tak pawh hi a lan chhuahna lian tak a ni. AD hi spinal injury atanga thla hnih atanga thla thum hnuah a lo lang hmasa fo thin a, chuta chhuak shock (Spinal Shock, Neurogenic Shock) chu a reh tawh bawk. Mi tam tak chuan an nunah vawi tam tak he natna hi an tawng thei a ni. Mi thenkhat, a bik takin T6 level aia tam chhiatna nei te chuan ni khatah vawi 40 thleng an tawng thin niin an sawi. He AD hi hming dang engemaw zat an vuah bawk a, i doctor pawhin heng hming zinga pakhat a vuah thei bawk: Autonomic Hyperreflexia, Hypertensive
Autonomic Crisis, Sympathetic Hyperreflexia.
Kan Autonomic Nervous System chungchang tlem han zir ila.
Okay, tunah chuan he Autonomic Nervous System hi eng nge a nih kan en ang. Hei hi kan taksa peng pakhat, thil tam tak kan ngaihtuah lova thunun theitu a ni. Thâwk lak,
thinlung thawk ,
thisen sang , leh chaw ei dan ang chi thilte. Hei hi kan taksa automatic system ang a ni. He autonomic nervous system-ah hian thil pawimawh pathum a awm a, chungte chu:
- Sympathetic Nervous System (SNS): Hei hi emergency leh hlauhawm laka min buatsaihtu a ni. ‘Fight-or-flight’ response tichhuaktu system a ni.
- Parasympathetic Nervous System (PNS): Hei hian sympathetic-in a tih ang lo takin a ti a. Chu chu taksa a ti thlamuang a, ‘rest and digest’ kalpui danah a pui tihna a ni.
- Enteric Nervous System (ENS): Hei hi kan chaw ei dan enkawltu ber a ni.
Engtin nge AD hi a lo awm?
Tunah chuan AD i vei hian eng nge thleng tih i lo en ang u. I ruhro a chhiat chuan, hliam na hmun hnuai lamah chuan i sympathetic nervous system (SNS) chu a thawk chhuak thin. SNS hian hlauhawmah i awm tih a chhang ang maiin. Chuvang chuan i taksa hnuai lam (i ke, pum ang chi) thisen kalna kawngte chu a inzawm khawm a (hei hi vasoconstriction an ti a). Hei hian i thisen sang a tisang nghal a ni. A tlangpuiin hetiang hian i thisen sang a san chuan i parasympathetic nervous system (PNS) chu a thawk chhuak a, thisen kalna kawng a tizau (hei hi vasodilation an ti a), i thisen sang chu a pangngaiah a awm leh ta a ni. Hetiang kalphung hi baroreflex kan ti a. Mahse, ruhro hliam nei tan chuan he parasympathetic message hi hliamna hmun atang hian a tla thla thei lo. Chuvangin, thil thleng chu thisen kalna kawngte chu taksa chunglam (hliam chunglam)-ah chauh a zau a ni. Hei vang hian taksa hnuai lam thisen kalna kawngte chu a inzawm khawm chhunzawm zel avangin (SNS hnathawh vang) thisen sang chu hlauhawm takin a sang reng a ni.
Hei hi hriatthiam a pawimawh: Hei vang hian AD vei hian a rualin an taksa hmun hrang hrangah symptom hrang hrang a nei thei a ni. Entirnan, vun chu a hliam level aia sang (hmai, kawr leh kut te ang chi) chu a sen a, a thawmhnaw a chhuak thei bawk. Mahse, a hliam hnuai vun (a pum hnuai lam leh ke te ang chi) chu a hring thei a, a vawt a, a vawt thei bawk.
Tute nge AD vei tam zawk?
AD vei tam ber i en chuan
T6 level (the sixth thoracic vertebra) emaw a aia sang emawa spinal cord chhiatna nei te an ni . Mahse, mi zawng zawngin kan hmu vek lo. I hria em, kan ruhro hi thluak atanga thuchah taksa pum puia phurh chhuaktu kawng ang a ni. Vertebrae (back bones) te hian a venghim a ni. A tam zawkah chuan ruhro hliam hi accident-ah a thleng a, chu chu he ruhro hi vuakna nasa tak avanga tihchhiat a nih chuan a ni. Tichuan ruh tliak chuan ruhro chu a compress a, chu hmuna nerve te chu a tichhia a ni.
AD vei theihna hi spinal cord chhiatna level leh a chhiatna nasat dan (rupture kimchang ang chi) a zirin a sang chho zel a ni. Cervical spine emaw high-thoracic spine-a spinal cord hliam nei zinga 90% vel chuan AD an vei dawn niin an chhut. Chubakah, naupai T6 emaw a aia sang emawa spinal injury nei te chu nau neih laiin AD vei an hlauhawm hle bawk. Chuvangin hei pawh hi ngaihtuah tel a ngai a ni. AD natna lan chhuah dan chu engte nge ni?
AD natna lan chhuah dan hi mi hrang hrangah a inang lo deuh thei a, mahse a lo lang nghal fo thin. Symptom lian ber hmasa ber chu lu na na tak, throbbing tak a ni. Hei hi rang taka thisen sang sang lutuk avanga lo awm a ni. Tin, AD hian a hnuaia symptoms te hi a thlen thei bawk.- Back pain level aia tam thawk hah lutuk.
- Heart rate pangngai aia hniam zawk (hei hi bradycardia an ti a).
- A hnungzang a lesion chunglam vun sen leh lesion hnuai lama vun dum, vawt.
- Back na vangin taksaah goosebumps a awm thin.
- Vun a vawt.
- Hnar hnar (hnar congestion) a awm.
- Nausea, luak chhuak.
- Mit hmuh a fiah lo.
- Lungkhamna leh hlauhna nasa tak nei.
Pawimawh: Heng symptoms te hi i tawng a nih chuan a rang thei ang bera damdawi lam pan a pawimawh hle. Hei hi emergency a ni thei.
AD natna thlentu engte nge ni?
AD awm chhan ber chu kan sawi tawh angin spinal cord injury hi a ni. AD vei te autonomic nervous system hian stimuli thenkhatah a over-responsive thin. A tlangpuiin taksain spinal cord hliam level hnuai lama noxious stimulus a neih chuan sympathetic nervous system chu a thawk nasa hle a, thisen kalna kawng tam tak a inzawm khawm (vasoconstriction) a ni. He ‘noxious stimulus’ hi tissue tichhe tak tak leh natna thlen thei thil eng pawh a ni a, mahse a chang chuan a natna chu hriat theih loh a ni. I scratch theih loh itch atanga full bladder thlengin eng pawh a ni thei. Spinal cord hliam bakah hian AD thlen thei natna dang engemaw zat a awm a, mahse a tlem hle:- Intramedullary Astrocytoma - Kan rilru a buai em em a, a rilru a hah em em bawk a.
- Multiple Sclerosis (MS) natna a ni.
- Guillain-Barré natna vei a ni.
- Damdawi thenkhat side effects te.
- Lu hliam na tak leh thluak lama harsatna dang.
- Subarachnoid Hemorrhage (SAH) - thluaka thisen chhuak.
- Dan loa stimulant drugs cocaine leh amphetamines hman.
AD thlentu (triggers) te
AD vei theihna hlauhawm i nih chuan he natna thlen thei thilte hi hriat a pawimawh hle. Hetiang hian i pumpelh thei a, AD symptoms a lo lan chuan i enkawl vat thei bawk. AD hi harsatna hrang hrang avanga lo awm a ni fo thin:- Bladder a ni.
- Bowel (chu chu intestines tihna a ni).
- Vun.
Bladder nena inzawm thil
Bladder lama harsatna hi AD thlentu ber a ni - AD vei zinga 85% vel an ni. A tam zawkah chuan a chhan chu i zun kalna kawngpuiah a inkharkhip a, chu chuan i zun (bladder) a khat lutuk (Bladder Distension) a ni. Hei hi a chhan chu:- Foley catheter i dah chuan a kinked emaw block emaw a ni thei.
- Bladder a lo chhuak thin.
- Bladder lung a awm.
- Zun kawng natna (UTIs) te.
A châng chuan cystoscopy emaw urodynamic testing ang chi test te pawhin AD a thlen thei bawk. Intestine lian tak nena inzawm chhan
AD natna thlentu lian ber pahnihna chu intestine lian emaw, bowel emaw a ni. AD hi intestine a overstretched hian a awm thei. Hei hi a chhante chu:- Fecal impaction a awm.
- Ek khal.
- Flatulence, rilru hahna.
- Enemas te pawh a awm.
- Kut hmanga bawlhhlawh paih chhuah.
Tin, intestine-a hri kai theihna dang, entirnan:- Kawthalo.
- Diverticulitis natna a ni.
- Crohn natna a ni.
- Anal fissures a awm.
- Hemorrhoids natna (Hemorrhoid) a awm.
Hetiang thil hian AD a tichhuak thei bawk. Vun nena inzawm chhan
Vun lama harsatna hi AD thlentu pathumna a ni. A chhan awm thei engemaw zat a awm a:- Pressure hliam / Bedsore a awm.
- Cuts, hliam tuar.
- Vun a rawn chhuak.
- Thawmhnaw a tight, a snagging, a lian lutuk.
- Hriat theih loh leh hrual theih loh itch.
- Ke ruhro (toenails) a lo thang lian (ingrown toenails).
Engtin nge AD i vei tih i hriat theih ang?
AD hi chiang taka hriat theihna test pakhat mah a awm lo. Chuvangin, doctor leh nangmah enkawltute chuan an diagnosis chu a hnuaia mi ang hian an nghat ber ang:- I medical history , a bik takin hnungzang hliam chungchanga hriat tur.
- Tuna i thisen sang hi i thisen sang pangngai nen khaikhin chuan. A tlangpuiin i systolic blood pressure 150 mmHg aia tam, emaw, i level pangngai aia 40 mmHg vel a san chuan AD chhinchhiahna anga ngaih a ni.
- Symptoms , a bik takin lu natna nasa tak.
AD symptoms nei mahse spinal injury nei nia i ngaih loh chuan i doctor chuan i nervous system full examination tihsak a duh mai thei a, i symptoms awm chhan hriat tumin test dang pawh tihsak a duh mai thei bawk. Chûng zîngah chuan:- Thisen leh zun test a ni.
- CT scan (CT - Computed Tomography scan) emaw MRI scan (MRI - Magnetic Resonance Imaging scan) emaw hmanga tih theih a ni.
- ECG (Electrocardiogram - EKG) hmanga tih a ni.
- Spinal tap / Lumbar puncture tih a ni.
- Tilt-table hmanga test a ni.
- Ruihhlo test te.
- X-ray hmanga tih a ni.
AD hi engtin nge enkawl a nih?
AD enkawlna atana hmalakna hmasa ber chu damlo chu mut tir a, a ke tihhniam a, thawmhnaw tight eng pawh paih chhuah hi a ni. Hei hian thisen sang tihhniam nan a pui a ni. A tam zawkah chuan AD hi trigger lakchhuah a nih chuan a bo vek thin. Chuvangin, a dawt leh tur chu damdawi pek hmain a trigger chu hriatchhuah leh tihbo a ni a, a theih chuan tihbo a ni. Entirnan, i doctor emaw, i enkawltu emaw chuan a trigger hriatchhuah leh siamthatna atana a tih theih thenkhat chu hetiang hi a ni:- Zun a luang tha em tih enfiah, a nih loh leh siamthat.
- Miin Foley catheter a neih chuan blockage emaw defect emaw a awm leh awm loh enfiah la, siamthat rawh.
- Zun sample test a, urinary tract infection (UTI) a awm leh awm loh enfiah a, a awm a nih chuan antibiotics pek.
- Rectum chu fecal impaction a awm leh awm loh enfiah la, a awm a nih chuan stool chu la chhuak rawh.
AD natna tawnhriat nei tam tak chuan hei hi an hre chiang hle a, enkawlna ruahmanna kalpui turin an inpeih reng a ni. Emergency-ah: Trigger hmuh theih a nih loh chuan, leh basic measures-in thisen sang a tihhniam loh chuan, thisen sang tihhniam nan emergency treatment a ngai a ni. Chutiang a nih chuan 119 (a nih loh leh a kaihhnawih emergency number) call la, a nih loh leh damdawi lam ṭanpuina zawng nghal rawh.
Chumi hnuah chuan i thisen sang tihhniam nan damdawi chak tak tak, nitrates, hydralazine, labetalol, emaw nifedipine te pek i ni ang. Enkawl lai hian i medical team chuan i vital signs te chu an enfiah ang a, i thisen sang pawh an enfiah fo ang. AD hi ven theih a ni em?
AD ven theih reng reng a ni lo. Mahse, spinal injury i neih chuan, a bik takin T6 level aia sang i neih chuan heng thilte hian AD venna kawngah a pui thei ang:- Bladder kha hlip fo leh a khat loh nan fimkhur.
- Natna enkawl dan.
- I intestines enkawl hi stool blockage leh constipation venna atan a pawimawh hle.
- I vun uluk taka enkawl hi khum natna leh vun natna laka invenna atan a pawimawh hle.
- Urinary tract infection (UTI) laka invenna.
AD dinhmun hi eng ang nge ni ang? (Hmuh dan tur) .
AD prognosis hi a tlangpuiin a tha a, mahse heng thilte hi a thlen chauhvin:- Nangmah emaw, i enkawltu emaw, i medical team emaw pawhin hei hi in hriat hma chuan.
- Emergency corrective treatment tan thuai a nih chuan.
- Nang leh/ emaw i enkawltute hian AD natna lan chhuah dan leh a thlen chhante in hriat chian chuan.
- Nangmah emaw, i enkawltu emaw, i medical team emaw chuan AD laka invenna tur fimkhur dan tur dik tak i neih chuan.
Mahse, AD natna khirh tak tak enkawl vat loh leh uluk taka enkawl loh chuan nghawng na tak a nei thei a ni. Entir nan:- Thisen sang (Hypertensive Encephalopathy) avanga thluak chhiatna.
- Thai.
- Lung natna (Cardiac arrest) a awm.
- Kaih.
- Thihna.
Vanneihthlak takin AD vanga thi hi an tlem hle. AD vei hlauhawm i nih chuan eng nge i tih ang?
AD symptoms hriatchhuahnaah hian nang leh i hmangaih te in inrawlh a ngai a ni. AD natna lan chhuah dan i hriat tan meuh chuan thu la, enkawl tan rawh. I tlu thei a, i inhliam thei a, i hriatna i hloh thei bawk a, chuvangin tanpuina dil rawh. Trigger i hmuh loh chuan, emaw, enkawlna dik takin a puih loh chuan, mi pakhatin 119 (or emergency number dik tak) a call tur a ni. Tin, Emergency Treatment Pack i neihpui a pawimawh bawk a, i doctor-in a lo hrilh tawh a nih chuan, AD chungchang ziakna leaflet pawh i dah tel a pawimawh bawk. Hei hian AD chungchang hre lo tan pawh a pui dawn a ni. AD symptoms i neih tawh chuan i doctor zawng zawng, enkawltu leh i hmangaih zawng zawngte hnenah i dinhmun hi hriattir vek tur a ni. Chutiang chuan a lo thleng leh a nih chuan an hriat theih nan, tanpuina dil hun i nei lo a nih pawhin. Thuhmahruai angin hre reng ang che
Autonomic dysreflexia (AD) hi nunna atana hlauhawm tak a ni. Mahse thu lawmawm tak chu enkawl theih a ni – a tam zawkah chuan trigger chu paih emaw, siam danglam emaw hmangin. AD vei theihna hlauhawma i awm a nih chuan nang leh i hmangaih tak takte tan chuan i theih ang ang in hriat a pawimawh hle. Tichuan a natna lan chhuah dan chu i hre thei ang a, AD enkawlna pawh i hmu thuai thei ang. I medical team nen triggers laka inven dan tur sawiho rawh. I tanpui turin an inpeih reng a ni. Hei hi hlauh tur a ni lo tih hre reng ang che, awareness hi venhimna ropui ber a ni!
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