Kodi amayi anu okalamba, abambo anu, kapena agogo anu achikulire mwadzidzidzi akupeza kuti n'kovuta kuyenda? Kodi akuyenda pang'onopang'ono kwambiri? Kapena mumamva ngati kukumbukira kwanu kukuchepa pang'onopang'ono? Nthawi zambiri timaganiza kuti izi ndi zinthu zachilendo zomwe zimachitika tikamakalamba. Koma nthawi zina, izi zitha kukhala zizindikiro za matenda ochiritsika. Mofananamo, NPH ndi matenda omwe anthu ambiri amawaganizira kuti ndi matenda a dementia, koma kwenikweni ndi matenda ochiritsika. Tiyeni tidziwe zambiri za izi lero.
Mwachidule, kodi NPH ndi chiyani?
Tanthauzo lonse la NPH ndi Normal Pressure Hydrocephalus. Mu Chisinhala, limatanthauza "normal pressure hydrocephalus". Koma n'zosavuta kumvetsa kuposa mawu amenewo mukadziwa kuti izi zimachitika ku ubongo.
Mwachidule, NPH ndi vuto lomwe madzi omwe ali muubongo wathu ndi kuzungulira (monga momwe timachitcha kuti Cerebrospinal Fluid - CSF) amasonkhana ndikusokoneza magwiridwe antchito a ubongo. Madzi awa, otchedwa CSF, amadyetsa ubongo wathu ndipo amathandiza kuchotsa zinyalala muubongo. Ndi madzi awa omwe amateteza ubongo kuti usasunthike mkati mwa chigaza ndikupangitsa kuvulala.
Ubongo wa munthu wamkulu umakhala ndi mamililita 150 a madzi amenewa. Matupi athu nthawi zonse amapanga madzi amenewa, kuwazungulira, ndi kuyamwanso madzi akale. Bola ngati izi zikuchitika bwino, palibe vuto.
Koma pa nkhani ya NPH, pazifukwa zina, kuyamwanso kapena kuyenda kwa madzi awa kumachepa. Kenako, madzi awa amayamba kusonkhana pang'onopang'ono m'ma ventricles mkati mwa ubongo. Chifukwa izi zimachitika kawirikawiri, kuthamanga kwa magazi mkati mwa chigaza sikukwera mwadzidzidzi. Ichi ndichifukwa chake amatchedwa "Normal Pressure". Koma pakapita nthawi, madzi osonkhanitsidwawa amayamba kufinya minofu ya ubongo ndikuiwononga. Pamenepo ndi pomwe zizindikiro za NPH zimawonekera.
Ndani amene ali ndi mwayi waukulu wopeza NPH imeneyi?
NPH ndi matenda omwe nthawi zambiri amakhudza anthu azaka zopitilira 65. Chiwopsezo chotenga matendawa chimawonjezeka ndi ukalamba. Avereji ya zaka zoyambira matendawa ndi pafupifupi zaka 70.
Izi sizidalira zinthu monga mtundu, chipembedzo, kapena jenda. Ukalamba ndiye chinthu chachikulu chomwe chimayambitsa matendawa. Malinga ndi ziwerengero, 0.2% ya anthu azaka zapakati pa 70 ndi 80 ndi 5.9% ya anthu azaka zopitilira 80 ali ndi matendawa. Izi zikutanthauza kuti anthu opitilira 8 miliyoni padziko lonse lapansi ali ndi matendawa.
Kodi zizindikiro zazikulu za NPH ndi ziti? "Hakim's Triad"
Pali zizindikiro zitatu zazikulu za NPH. Izi zimawonekera pang'onopang'ono kwa miyezi itatu mpaka isanu ndi umodzi. Madokotala amatcha zizindikiro zitatu zazikuluzi kuti "Hakim's Triad." Pakati pa 50% ndi 75% ya odwala NPH amakumana ndi zizindikiro zonse zitatu pamodzi.
Tiyeni tiwone makhalidwe atatu awa.
| Chizindikiro | Kufotokozera |
|---|---|
| 1. Nkhani Zokhudza Kuyenda | Ichi ndi chizindikiro chofala kwambiri cha NPH. 80% - 95% ya odwala ali ndi izi. Zimakhala ngati mapazi awo agwira pansi. N'zovuta kwambiri kukweza sitepe. Masitepewo ndi ang'onoang'ono kwambiri, ngati kuti miyendo ikukoka pansi. Chifukwa chake, nthawi zonse amagwa. Nthawi zina amasiya mwadzidzidzi akuyenda, ngati kuti sangathe kudziwa momwe angapitire sitepe yotsatira. Amatha kuwoneka akuyenda ndi kulemera kwawo mbali zonse ziwiri, ngati penguin. |
| 2. Kulephera kulamulira mkodzo (Kusadziletsa kwa mkodzo) | Zimayamba ndi kufunikira kukodza pafupipafupi. Ndipo mukayenera kukodza, mumamva chilakolako chosalamulirika chofuna kukodza. Pakapita nthawi, mumayamba kutulutsa mkodzo osazindikira. Anthu ena amachita manyazi ndi izi, koma chifukwa cha kusokonekera kwa ntchito ya ubongo, odwala ena sangazindikire kuti atulutsa mkodzo. |
| 3. Mavuto Okhudza Kuzindikira | Izi zikufanana kwambiri ndi matenda amisala. Liwiro la kuganiza ndi kugwira ntchito limachepa. Chilichonse chimachitika pang'onopang'ono kwambiri. Kukumbukira kumachepa, ndipo nthawi zambiri zinthu zimaiwalika. Zimakhala zovuta kupanga zisankho ndikuwongolera malingaliro. Mumataya chidwi chonse pazinthu zomwe munkasangalala nazo kale. |
Chofunika kwambiri ndikupempha upangiri kwa dokotala, m'malo monyalanyaza zizindikirozi ngati gawo labwinobwino la ukalamba, chifukwa NPH ndi matenda ochiritsika.
Nchifukwa chiyani NPH iyi imayamba? Kodi zimayambitsa chiyani?
Pali mitundu iwiri ikuluikulu ya NPH, kutengera zomwe zimayambitsa.
1. NPH Yoyamba (Yopanda Chidziwitso)
Uwu ndi mtundu wofala kwambiri. Pafupifupi theka la odwala ali ndi mtundu uwu. "Idiopathic" amatanthauza kuti chomwe chimayambitsa matendawa sichikudziwika.Pakadali pano akukhulupirira kuti izi zimachitika chifukwa cha kusintha kwina kwa kayendedwe ka magazi ndi kuyamwa kwa madzi a CSF muubongo pamene tikukalamba.
2. NPH yachiwiri
Izi zimachitika chifukwa cha matenda ena kapena ngozi. Izi zikutanthauza kuti, pali chifukwa china chomwe chikusokoneza kayendedwe ka madzi a CSF muubongo. Zina mwa zifukwazi ndi izi:
- Kuvulala kwa Ubongo Koopsa
- Ziphuphu za muubongo
- Stroke
- Kutuluka magazi m'mutu
- Aneurysm ya Ubongo
- Matenda a muubongo monga meningitis
- Opaleshoni ya ubongo
Kodi dokotala amazindikira bwanji matenda a NPH molondola?
Kuzindikira matenda a NPH kungakhale kovuta chifukwa zizindikiro zake zimafanana kwambiri ndi matenda a dementia monga matenda a Alzheimer's. Nthawi zina, NPH imathanso kutsagana ndi matenda a Alzheimer's.
Dokotala amagwiritsa ntchito mayeso angapo kuti adziwe matendawa.
- Kuwunika thupi ndi mitsempha: Dokotala adzayang'ana momwe mukuyendera, momwe thupi lanu limakhalira, momwe minofu yanu imagwirira ntchito, komanso momwe minofu yanu imagwirira ntchito.
- Kufunsa za zizindikiro ndi mbiri ya matenda: Funsani abale anu za momwe zizindikirozi zinayambira komanso nthawi yomwe zakhalapo.
- Kujambula ubongo: Iyi ndi njira yofunika kwambiri. Kujambula MRI (Magnetic Resonance Imaging) kumatha kuona bwino ngati ventricles, komwe madzi a CSF amasonkhana, zakula. Nthawi zina CT scan (Computed Tomography) imachitidwanso kuti ipewe matenda ena.
- Kuboola Msana / Kuboola Lumbar: Iyi ndi njira yofunikira kwambiri. Apa, singano yaying'ono imayikidwa mu chingwe cha msana ndipo chitsanzo cha madzi a CSF chimatengedwa. Izi zingagwiritsidwe ntchito pofufuza matenda ena. Komanso, chofunika kwambiri, ndikofunikira kuwona ngati zizindikiro za wodwalayo, monga kuvutika kuyenda, zikuchepa kwakanthawi atachotsa madzi ena a CSF owonjezera. Ngati zitatero, ndi chizindikiro champhamvu chakuti pali NPH.
Kodi pali mankhwala a izi? Kodi zingatheke kuchiritsidwa?
Inde! Iyi ndi nkhani yabwino yokhudza NPH. Ngakhale kuti ingawoneke ngati matenda a dementia, NPH nthawi zambiri ndi matenda ochiritsika . Mankhwala sagwira ntchito bwino. Chithandizo chachikulu komanso chothandiza kwambiri ndi opaleshoni.
Opaleshoni iyi imaphatikizapo kulumikiza chipangizo chaching'ono chofanana ndi chubu chotchedwa shunt ku ubongo.
- Taganizirani izi ngati chitoliro chomwe chimatulutsa madzi ochulukirapo.
- Malekezero ena a shunt iyi amalumikizidwa ndi chipinda muubongo komwe madzi a CSF amasonkhana.
- Mbali ina imayikidwa pansi pa khungu m'mimba (m'mimba) kapena pachifuwa.
- Madzi owonjezera a CSF omwe amasonkhana muubongo amatsika mu chubu ichi ndikutuluka m'malo ngati m'mimba, komwe thupi limatha kuyamwanso madziwo.
Pambuyo pa opaleshoni iyi, zizindikiro za odwala zimayamba kusintha kwambiri mkati mwa maola kapena masiku ochepa. Izi zimapangitsa kuti pakhale zotsatira zabwino kwambiri, makamaka kwa anthu omwe amavutika kuyenda.
Pankhani ya NPH yachiwiri, matenda omwe adayambitsa NPH (monga chotupa cha muubongo) amachiritsidwa kaye.
Kodi ndi mavuto otani omwe angachitike mutalandira chithandizo?
Ngakhale opaleshoni ya shunt nthawi zambiri imakhala yotetezeka, monga opaleshoni ina iliyonse, pali zoopsa zina.
- Matenda.
- Shunt yatsekedwa kapena sikugwira ntchito bwino.
- Shunt ili pa verr.
- Kutuluka kwa madzi ambiri a CSF muubongo (izi zingayambitse zizindikiro monga mutu).
Ngati chinthu chonga ichi chichitika, chikhoza kuzindikirika ndikuchiritsidwa mwachangu. Chifukwa chake, ndikofunikira kwambiri kutsatira malangizo a dokotala mutatha opaleshoni ndikupita kuzipatala pa masiku omwe akonzedwa.
Kodi mungayembekezere chiyani mukakhala ndi NPH?
Zotsatira za NPH nthawi zambiri zimadalira momwe matendawa amapezekera komanso kuchiritsidwa mwachangu . Chithandizo chikaperekedwa pambuyo pake, m'pamene kuwonongeka kwa ubongo kumakhala kofala kwambiri.
Popeza wodwalayo sangadziwe zizindikiro zake, achibale ake ndi okondedwa ake ali ndi udindo waukulu pa izi. Ngati muwona zizindikiro izi mwa wokondedwa wanu, ndikofunikira kwambiri kupita naye kwa dokotala, m'malo moganiza kuti ndi gawo lachibadwa la ukalamba.
Nazi mwayi woti zizindikiro zitha kutha pambuyo pa chithandizo:
- Kuyenda movutikira: Pafupifupi 85% ya odwala amachira.
- Kulephera kudziletsa mkodzo: Pafupifupi 80% ya odwala amachira.
- Kulephera kuganiza ndi kukumbukira: Pafupifupi 80% ya odwala amachira.
Tiyeni tiwone zinthu zomwe zimakhudza zotsatira za matenda a NPH mu tebulo ili m'munsimu.
| Zinthu zomwe zimawonjezera mwayi wopeza zotsatira zabwino | Zinthu zomwe zimachepetsa mwayi wopeza zotsatira zabwino |
|---|---|
| Kuzindikira matendawa msanga komanso kuchiza. | Kuchedwa kupeza matenda ndi kuchiza matendawa. |
| Choyamba panali vuto loyenda, kenako mavuto okumbukira. | Choyamba, mavuto a kukumbukira amayamba. |
| Zizindikiro zimachepa kwakanthawi mukamwa madzi kumbuyo. | Kulephera kukumbukira bwino komanso kuganiza bwino. |
| NPH yachiwiri imayamba chifukwa cha matenda ochiritsika. | Kupezeka kwa matenda ena a muubongo monga Alzheimer's. |
Kodi ndiyenera kupita kwa dokotala liti? Kodi nthawi zopita ku ETU ndi ziti?
Ngati wina m'banja mwanu ali ndi vuto la shunt, muyenera kudziwa bwino zizindikiro zina. Izi zitha kukhala zizindikiro za vuto la shunt kapena matenda.
Ngati pali zizindikiro zotsatirazi, imbani dokotala wanu nthawi yomweyo kapena pitani nokha ku Chipatala cha Emergency Treatment Unit (ETU) .
- Mutu waukulu: Ngati mutu ukukulirakulira, makamaka mukakhala pansi kapena mutaimirira, izi zitha kukhala chizindikiro chakuti kutuluka kwa madzi kuchokera ku shunt kwachepa kapena kwawonjezeka.
- Malungo kapena kuzizira: Ichi chingakhale chizindikiro cha matenda mutachita opaleshoni. Musanyalanyaze mitundu iyi ya matenda chifukwa imatha kufalikira mofulumira.
- Khosi lolimba.
- Ululu pachifuwa kapena m'mimba momwe chubu cha shunt chimadutsa.
- Kubwereranso kwa zizindikiro zakale za NPH (kuvutika kuyenda, mavuto a mkodzo).
Uthenga Wopita Nawo Kunyumba
- Musanyalanyaze mavuto oyenda, kusadziletsa mkodzo, ndi kuiwala zinthu ngati "ukalamba wabwinobwino." Izi zitha kukhala zizindikiro za matenda otchedwa NPH.
- NPH ndi vuto lomwe limayamba chifukwa cha kuchuluka kwa madzi a m'mitsempha ya ubongo (CSF) muubongo.
- Ngakhale kuti imatha kuwonetsa zizindikiro zofanana ndi matenda amisala, NPH nthawi zambiri ndi matenda ochiritsika ndi opaleshoni.
- Matendawa akapezeka msanga, zotsatira zake zimakhala zabwino kwambiri. Chifukwa chake, chisamaliro cha achibale ndi okondedwa ndi chofunikira kwambiri pano.
- Ngati wokondedwa wanu ali ndi zizindikiro izi, chonde pitani kwa dokotala wodziwa bwino ntchito yake mwamsanga.
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