Surgery neih laiin he dinhmun hlauhawm tak lo awm nghal mai hi i zir dawn nia: Malignant Hyperthermia!

Nangmah emaw, i hriat tu emaw chu operation neih a ngai a nih chuan anesthesia tih thumal hi i hre tawh ngei ang. Surgery neih laiin muthilh tir kan ni tihna a ni. Mahse, mi ṭhenkhat chuan heng anesthetic damdawi te hi an ei hian thil hlauhawm tak, nunna atana hlauhawm tak pawh an nei thei tih i ngaihtuah ngai em? Chu chu chutiang natna hmuh tur awm lo, mahse na tak pakhat, Malignant Hyperthermia tih chu a ni. A hming hi a hlauhawm deuhin a lang thei a, mahse a chungchang dik taka hriattir i nih chuan harsatna tam tak chu pumpelh theih a ni. Chuvangin, vawiinah hian chipchiar takin sawi ila.

Malignant Hyperthermia hi eng nge ni?

A awlsam zawngin, `Malignant Hyperthermia` hi genetic condition a ni . Chu chu kan genes-a mutation awm vang a ni tihna a ni. Hetiang natna vei mi chu anesthesia damdawi thenkhat pek a nih chuan an taksa hian a chhe hle a ni. Hei hi emergency a ni a, nunna atana hlauhawm pawh a ni thei.

A tha ber chu, hei hi thlah khat atanga thlah danga kal zel thil ni mahse, a enkawlna tur a awm . Tin, he hlauhawmna hi i hriat hma chuan i inveng thei bawk.

General anesthesia min pek hian operation laiin engmah kan hre thei lo tih kan hria. He anesthesia pe tur hian damdawi chi hrang hrang a awm a. Mahse, chu damdawi zinga tlemte chauh hian he natna hi `Malignant Hyperthermia` an tih hi a thlen thin. Anesthetic damdawi tam zawk hian hetiang hi a thlen lo.

Thil pawimawh dang chu a chang chuan mi pakhatin Malignant Hyperthermia thlen thei genetic mutation a nei tih a hre lo mai thei a, a chhan chu damdawi chiang tak tak sawi tawhte a tawrh hma chuan symptom engmah a lantir lo thei a ni.

Hetiang hi tuin nge nei tam zawk?

He `Malignant Hyperthermia` natna vei thei tur hian tute nge hlauhawm zawk tih i en ang u.

A bul berah chuan i chhungkuaa mi pakhatin `Malignant Hyperthermia` vei a lo neih tawh chuan chu chhungkaw member dangte pawh an hlauhawm thei a ni. A bik takin, first-degree relative (i.e. nu, pa, unau, fate) chuan he natna hi a nei tawh a nih chuan `susceptible` anga ngaih i ni.

Chuvangin, engtikah emaw chuan zai a ngai a nih chuan, i chhungte zingah hetiang thil hi a thleng a nih chuan anesthesiologist hnenah hriattir a pawimawh hle .

Ngaihtuah teh, i chhungte hian hetiang hian `Malignant Hyperthermia` reaction hi an nei ngai lo ang ti ila. Mahse, taksa ruh natna thenkhat nei te pawh hi an hlauhawm zual thei bawk. Chung natna thenkhat chu:

• `Central core natna` tih a ni
• `Multiminicore natna` tih a ni
• `King-Denborough natna` tih a ni
• `STAC3 natna`

Hei hi thil buaithlak deuh angin lang mahse, heng natna nei te tan chuan hei hi hriat chian a tha hle.

Hetiang dinhmun hi engtiang chiahin nge a awm?

He `Malignant Hyperthermia` hi engtiang chiahin nge a awm? Statistics hi a inang lo deuh a, mahse a tlangpuiin puitling surgery 100,000 zinga pakhat vel ah he natna hi a awm thei niin an chhut. Naupang zingah hian he zat hi operation 30,000 zinga pakhat vel a ni. Tin, damlo hmuhchhuah zinga a chanve chu kum 19 hnuai lam an nih thu pawh hriat a tha hle.

Mahse scientist te chuan he `Malignant Hyperthermia` natna vei duhtute hi khawtlang nunah an awm tam zawk mai thei niin an ngai. Mi tam tak chu an dam chhungin a thlentu damdawi bikte an hman loh avangin, hlauhawmah an awm tih pawh an hre lo mai thei.

Hei hi eng symptoms nge ni?

`Malignant Hyperthermia` symptoms hi mi hrang hrangah a inang lo thei hle. Surgery neih lai emaw, surgery atanga i dam leh lai emaw pawhin an rawn lang thei. Entirnan, anesthesia hnuaia i awm a, operation neih laiin heng symptoms te hi i lo lang a nih chuan i hre lo ang. Mahse, i anesthesiologist emaw anesthesia nurse emaw chuan he thil hi a fimkhur hle a ni . Anesthesia hnuaia awm zawng zawngte chu uluk takin an enfiah thin. Heng symptoms te hi an hriat veleh `Malignant Hyperthermia` enkawlna an tan nghal ang.

Hrilhfiahna hmasa ber

Hengte hi i hriat hmasak ber tur chhinchhiahnate chu a ni:

• Heart rate (tachycardia) a sang chhoh dan sawifiah theih loh . Heart rate chu a sang nghal zung zung a.
• Taksa atanga carbon dioxide chhuak zat a pung nghal zung zung . Hei hi damdawi hmanrua hmanga enkawl theih a ni bawk.
• Thâwk lak chakna (tachypnea) a sang . I thawk chhuak nghal vat a, thawk lak i tum ang maiin i thawk chhuak ta a ni.
• Muscle a nghet lo, a nghet lo (`muscle rigidity`). Taksa ruhte chu lungpuiin a tikehsawm ang maiin a nghet ta hle mai.
• Taksa lumna a sang nghal zung zung . Taksa chu a lum tan ta.

Nakin lawka symptoms lo lang thin te

Thil awmdan a chhe zual zel chuan hetiang hian symptoms i hmu thei bawk:

• Taksa lumna chu khawsik pangngai aia sang a ni .
• Zun dum . A rawn sen (brown) pawh a ni thei.
• Thisen test ah chuan taksa ruh a chhe tih hmuhchhuah a ni .
• Heart rhythm mumal lo (arrhythmia) a awm thin. Thinlung chu a na lo hle.
• Thisen chhuak .
• Seizures ang chi dinhmun .

Engvangin nge malignant hyperthermia hi a lo awm?

Tunah chuan he `Malignant Hyperthermia` an tih hi engvangin nge a lo awm tih hi han en ila.

Hetiang natna vei te hian an taksa ruh cell-ah protein danglam tak an nei a. Hei hi an genes inthlak danglamna avang a ni a, chu chu genetic mutation an ti a ni.

A awlsam zawngin kan DNA hi "instruction book" ang a ni a, chutah chuan kan taksa chhunga cell-te'n an hna an thawh theihna tura an mamawh information te a awm a ni. He DNA-ah hian khawi emaw laiah hian information tlem a awm lo a nih chuan, emaw, thil tihchhiat a awm a nih chuan, chutih lai chuan heng ang chi genetic disease hi a lo awm ta a ni.

He genetic mutation hian nun pangngaiah hian symptom a nei lo. Mahse, he mutation nei mi chu a chunga kan sawi tak anesthetic drugs bikte hi a ei a nih chuan – a nih loh leh, a tlem hle a, temperature sang taka a awm emaw, exercise nasa tak a tih chuan – an taksa ruh cell-te chuan calcium chu a pangngai lo takin an chhuah tan thin.

Chuvang chuan taksa ruhte chu a inzawm khawm chhunzawm zel a, a tense emaw, a rigid emaw a, taksa metabolism leh taksa lumna chu a pangngai lo takin a sang chho zel a ni. A tawpah chuan taksa ruh (muscle cells) te chu an thi a, thisenah potassium tam tak a awm khawm ta a ni. Hei hian symptom leh complication dang a thlen thei a ni.

Anesthetic damdawi hian he natna hi a thlen thei a ni.

Mi pakhatin genetically predisposed to the condition `Malignant Hyperthermia` a neih chuan a hnuaia anesthetic drugs te hi pek a nih chuan he reaction hi a tawk thei a ni:

Damdawi inhaled te: 1.1.

• `Halothane` tih a ni
• `Desflurane` tih a ni
• `Sevoflurane` tih a ni
• `Isoflurane` tih a ni

Damdawi thisen zam: 1.1.

• Succinylcholine – Hei hi taksa ruh tichaktu a ni a, a thawk chak hle.

Engtin nge hei hi i hriat chian?

`Malignant Hyperthermia` vei duhna i nei tih hre lovin anesthetic hlauhawm tak hmanga surgery i neih chuan nangmah emaw anesthesiologist emaw pawhin i nei tih chu reaction a thlen hnuah chauh i hre lo vang.

Mahse, nangmah emaw, midang emaw anesthesia pek i nih chuan anesthesiologist emaw nurse emaw chuan i vital signs leh hriselna chu uluk takin a enfiah ang a, operation neih chhung leh operation hnuah pawh a enfiah ang. `Malignant Hyperthermia` i neih chuan a hmaa kan sawi tawh angin vital signs leh reaction pangngai lo tak tak hmangin an hre thei ang. Chu chu:

• Chhan awm lovin heart rate a sang.
• Taksa lumna sang lutuk.
• Taksa atanga carbon dioxide chhuak tam lutuk.
• Muscle a tight lutuk.

Anesthesiologist te hi heng inthlak danglamna te hi hriat hmasak turin zirtir an ni . Tichuan he emergency hi rang takin an chhang thei ta a ni. Diagnosis a rang poh leh a natna hi enkawl leh control theih a ni.

Engtin nge he risk hi i neih leh neih loh i hriat lawk theih ang?

Nangmah emaw i doctor emaw chuan Malignant Hyperthermia vei hlauhawma i ngaih chuan, i chhungkaw chanchin vang emaw, chhan dang vang emaw pawh ni se, hei hi finfiah nan test bik thenkhat tih theih a awm a:

• Caffeine halothane contracture test (CHCT) : He test atan hian i taksa ruh (muscle biopsy) te chu lak a ni a, tissue sample chu halothane leh caffeine solution-ah dahin anesthetic gas a chhang let em tih enfiah a ni.
• Genetic testing : Heng test te hian DNA a genes RYR1, STAC3, leh CACNA1S tih te a mutations te chu a hriat theih a. Malignant Hyperthermia thlen thei mutations 45 chuang hmuhchhuah a ni tawh bawk.

Mahse, `Malignant Hyperthermia` vei theihna tur test te hi a man a to khawp mai , specialized laboratory tlemteah chauh tih theih a ni. Entirnan, `CHCT` test hi United States-ah hmun paliah chauh hman theih a ni. Chuvangin, emergency surgery i neih a ngai a, i chhungte hnai berin `Malignant Hyperthermia` a lo vei tawh a nih chuan, anesthesiologist-te chuan chutiang damdawi hlauhawm tak takte chu ai chuan anesthetic him zawk an hmang tlangpui.

Hei hi eng enkawlna nge ni?

Malignant hyperthermia enkawlna ber chu damdawi dantrolene (brand name Dantrium®) a ni.

Anesthesiologist-te chuan `Malignant Hyperthermia` an tih natna an rinhlelh veleh he `dantrolene` damdawi hi an pe ta a ni. Chutih rual chuan, an natna thlentu anesthetic damdawi chu an pe tawh lo va, surgeon chuan a rang thei ang bera surgery chu a ti zo ta a ni.

Hei bakah hian anesthesia leh surgical team te hian `Malignant Hyperthermia` avanga symptom leh complication dang te pawh an enkawl bawk. Chung enkawlna thenkhat chu:

• Hyperthermia hi cooling methods hmanga enkawl a ni , chu chu cold IV fluid pek leh ice pack hnawih te hi a ni.
• Oxygen hi face mask emaw, trachea chhunga dah tube emaw hmangin pek a ni .
• Heartbeat mumal lo (arrhythmia) a awm chuan damdawi pek thin a ni .

I dinhmun a lo nghet tawh chuan intensive care unit (ICU)-ah ni khat tal enkawl turin i awm ang . Medical team hian test dang (e.g. thisen test) an nei ang a, a tul chuan enkawlna dang an pe leh ang.

Hei hi ven theih a ni em?

Malignant Hyperthermia hi ven a harsa deuh a, a thlentu genetic mutation i nei tih i hriat loh chuan , emaw i chhungte zinga mi pakhatin he natna hi a nei a, i anesthesiologist i hrilh tawh loh chuan. Chutiang a nih chuan anesthesiologist chuan chutiang damdawi hlauhawm tak takte chu i anesthesia plan-ah a hmang dawn lo.

Mahse, thil lungchhiatthlak tak chu, a tam zawkah chuan miten Malignant Hyperthermia an vei theihna tur chu an chunga a thlen hnuah chauh an hrechhuak thin.

Hetiang dinhmun hi a awm hnuah eng nge thleng? Dam theih a ni em?

`Malignant Hyperthermia` symptoms hi hriat hmasak a, uluk taka enkawl a nih chuan a dam kim thei a ni . Hetah hian anesthesia leh surgical team te hmalakna rang tak hi a pawimawh hle.

Mahse, a châng chuan enkawl vat pawhin taksa peng tam tak a chhe thei a, thihna pawh a thleng thei tih kan hriat reng a ngai bawk.

Malignant hyperthermia avanga harsatna dang eng nge lo awm theih?

Malignant Hyperthermia hian harsatna lian tak tak a thlen thei a, chungte chu:

• Muscle tihchhiat a ni
• Kidney tha lo a awm
• Liver a tha lo
• Thisen chhuak
• Lung natna (Cardiac arrest) a awm
• Seizures a awm thin
• Coma ah a awm
• Thihna

Hei hi thihna thlentu a ni em?

Enkawl loh chuan `Malignant Hyperthermia` hi thihna thlen thei a ni . Enkawlna dik tak awm mahse, thihna report chu 3% leh 5% inkar a ni. Chuvang chuan hei hi ngaihthah tur a ni lo.

Hemi chungchangah hian engtikah nge doctor ka hmuh ang?

Surgery atana i inbuatsaih a nih chuan i chhungte zingah tu emaw chuan a hmaa anesthesia lama harsatna an neih tawh chuan doctor-te hrilh a pawimawh hle .

Tin, thisen chhung (biological relative)-a Malignant Hyperthermia thlentu genetic mutation i nei tih hmuhchhuah thar i nih chuan, chu mi chuan Malignant Hyperthermia tih natna a nei tih i hriat chuan i doctor hriattir a pawimawh hle a, chu chu i medical record-ah ziak tel a pawimawh hle bawk.

He thuziaka i hriat reng tur pawimawh ber berte

Malignant Hyperthermia hi anesthetic damdawi thenkhat avanga natna khirh tak, nunna atana hlauhawm tak a ni.

Thu lawmawm tak chu enkawl theih a ni a, hlauhawma i awm tih i hriat chuan ven theih a ni.

A theih chuan i thisen chhungte damdawi lam chanchin kimchang zawng zawng hre vek ang che. Chu thu chu i doctor hnenah hrilh rawh. `Malignant Hyperthermia` hi thlah kal zelah genetic mutation avanga lo awm a nih avangin i chhungkuaa mi pakhatin a neih chuan nang pawhin i hlauhawm zawk bawk.

Surgery leh anesthesia i dawn tur chungchangah zawhna emaw, ngaihtuahna emaw i neih chuan doctor zawt hreh ngai suh. I tanpui turin an awm reng a ni. I medical team nena in hriatna leh inbiakpawhna zau tak hi i tan venhimna tha ber a ni.

` malignant hyperthermia, anesthesia, surgery, genetic diseases, chhungkaw history, anesthesia complication, taksa lumna sang