Masifunde ngeMalignant Hyperthermia, indlela eyingozi yokusabela kwi-anesthesia ngexesha lotyando.

Ukuba wena okanye umntu kusapho lwakho kufuneka enziwe utyando, uza kunikwa i-anesthesia ngaphambi kokuba yenziwe, akunjalo? Ngamafutshane, isenza silale ngokupheleleyo. Kodwa kwabanye abantu, amanye amayeza asetyenziswa kule anesthesia anokubangela impendulo enzima kakhulu, esongela ubomi. Namhlanje sithetha nge- malignant hyperthermia , imeko eyingozi kodwa enyangekayo ukuba ifunyenwe kwangethuba.

Yintoni iMalignant Hyperthermia?

Ngamafutshane, iMalignant Hyperthermia yimeko yemfuza. Oku kuthetha ukuba yimfuza. Xa umntu onesi sifo evezwa kwiintlobo ezithile ze-anesthesia ngexesha lotyando, umzimba wakhe usabela kabuhlungu kakhulu. Le yingxamiseko esongela ubomi. Kodwa eyona nto ibalulekileyo apha kukuba oku akwenzeki kuzo zonke iziyobisi ezisetyenziselwa i-anesthesia ngexesha lotyando. Linani elincinci kakhulu lamayeza elibangela le mpendulo. Ngaphezu koko, ukuba ichongiwe, inokunyangeka ngokukhawuleza. Uninzi lwexesha, umntu akazi ukuba une-gene mutation enxulumene noku emzimbeni wakhe. Kuba akabonisi zimpawu kubomi obuqhelekileyo. Ingxaki ivela kuphela xa elo yeza le-anesthetic lingena emzimbeni.

Ngubani osengozini enkulu?

Le ngozi ifumaneka kakhulu xa kukho umntu kusapho lwakhe onayo le meko.

• Imbali yosapho: Ukuba isalamane sakho esisondeleyo - umama, utata, umnakwenu, udadewenu, okanye umntwana - sikhe saba ne-malignant hyperthermia, usengozini enkulu. Ke ngoko, ukuba ukhe watyandwa, kubalulekile ukuxelela i -anesthesiologist ngale mbali yosapho .
• Izifo ezithile zemisipha : Nokuba akukho mntu kusapho lwakho okhe waba nale ngxaki, abantu abanezifo ezithile zemisipha ezingaqhelekanga basengozini enkulu. Umzekelo:
• Isifo esiphakathi
• Isifo se-Multiminicore
• Isifo sikaKing-Denborough
• Ingxaki ye-STAC3

Ezi zizifo ezingaqhelekanga kakhulu, kodwa ukuba wena okanye umntu osapho lwakho unayo, kubalulekile ukwazisa ugqirha wakho.

Ixhaphake kangakanani le meko?

Esi asiyongxaki ixhaphakileyo ngokwenene. Ngokwezibalo, esi sifo senzeka malunga notyando olunye kwi-100,000 kubantu abadala. Phakathi kwabantwana abancinci, eli nani liphezulu kancinci, oko kukuthi, olunye kwi-30,000 zotyando. Kuyaphawuleka nokuba isiqingatha sezigulane ezichongiweyo zingaphantsi kweminyaka eli-19 ubudala. Nangona kunjalo, izazinzulu zicinga ukuba abantu abanesifo sofuzo soku banokuba baxhaphake kakhulu kuluntu. Oku kungenxa yokuba, nokuba banaso esi sifo, ukuba abachatshazelwanga ngamayeza okubulala iintlungu abangela loo mpendulo ebomini babo bonke, esi sifo asisayi kuze sivele.

Zithini iimpawu zoku?

Ezi mpawu zinokwenzeka ngexesha lotyando okanye emva nje kotyando ngelixa usaphila. Ukuba unazo ezi mpawu ngelixa ulele kwaye uphantsi kwe-anesthesia, awuyi kuziva. Kodwa ingcali yakho ye-anesthesia iya kuziqaphela. Baza kujonga iimpawu zakho ezibalulekileyo ngononophelo kulo lonke utyando. Ngoko ke baza kuqala unyango kwangoko nje ukuba baqaphele ezi mpawu.

Kutheni oku kusenzeka? Yintoni unobangela?

Abantu abanengxaki ye-Malignant Hyperthermia banotshintsho lwemfuza, oko kukuthi, utshintsho lwemfuza, kwezinye iiproteni kwiiseli zemisipha yabo. Khawuthelekelele ukuba iiseli zethu zemisipha zinecalcium egcinwe ngaphakathi kuzo. Ukukhululwa kwale calcium kulawulwa yinto efana nesango. Xa umntu oqhelekileyo enikwa amayeza okubulala iintlungu, eli sango lisebenza ngendlela elawulwayo. Oku kubangela ukuba izihlunu ziqine kwaye ziqine, imetabolism yomzimba iqala ukukhawulezisa, kwaye ubushushu bomzimba bunyuka ngendlela eyingozi. Ekugqibeleni, iiseli zemisipha ziyafa, kwaye inani elikhulu lezinto ezifana ne-potassium liqokelelana egazini. Ezinye iimpawu ezinzulu zivela ngenxa yezi zizathu.

Ngawaphi amayeza abangela le mpendulo?

Le meko ibangelwa ikakhulu ngamaqela amabini eziyobisi.

• Ii-anesthetics ezifunxwayo:
• IHalothane
• I-Desflurane
• I-Sevoflurane
• I-Isoflurane
• Amayeza afakwa kwimithambo yegazi:
• I-Succinylcholine (le yi-relaxant yemisipha esebenza ngokukhawuleza)

Uyibona kwaye uyiqinisekisa njani le nto?

Ukufunyanwa ngexesha lotyando

Ihlala ifunyaniswa ngexesha lotyando. Ukuba awazi ukuba unale meko, ugqirha wakho we-anesthesiologist akayi kukwazi. Kodwa yena uza kukujonga kulo lonke utyando kwaye unokurhanela ukuba kukho i-malignant hyperthermia ukuba ubona olu tshintsho lulandelayo:

• Ukunyuka kwesantya sentliziyo ngaphandle kwesizathu.
• Ukunyuka ngokukhawuleza kobushushu bomzimba .
• Ukwanda komthamo wekhabhoni dioksayidi ekhutshwayo.
• Ukuqina kwemisipha.

Iingcali zokubulala iintlungu ziqeqeshwe ukuba ziqaphele olu tshintsho ngokukhawuleza, ukuze ziqale unyango ngokukhawuleza.

Ngaba kunokwenzeka ukwazi kwangaphambili ukuba kukho umngcipheko?

Ukuba ukrokrela ukuba unale ngozi ngenxa yembali yosapho lwakho, kukho iimvavanyo ezikhethekileyo ezininzi zokuqinisekisa oko.

• Uvavanyo lweCaffeine Halothane Contracture (CHCT): Oku kuquka ukuthatha iqhekeza elincinci kakhulu lomsipha wakho (i-muscle biopsy) uze ulibeke kwigesi yehalothane kunye necaffeine kwilebhu. Indlela iqhekeza lomsipha elisabela ngayo ingasetyenziswa ukumisela ukuba unesi sifo na.
• Uvavanyo lwemfuza: Olu vavanyo, olubandakanya ukuthatha isampuli yegazi, lunokubona utshintsho lwemfuza (umz., i-RYR1, i-STAC3, i-CACNA1S) olunxulumene ne-Malignant Hyperthermia.

Kodwa ezi mvavanyo zibiza kancinci, kwaye azifumaneki kuyo yonke indawo eSri Lanka. Ke ngoko, ukuba kufuneka wenze utyando olungxamisekileyo kwaye umntu kusapho lwakho unale meko, oogqirha abayi kulinda iimvavanyo kwaye baya kusebenzisa kuphela ii-anesthetics ezikhuselekileyo ezingayi kubangela le mpendulo kuwe.

Iphathwa njani?

Iyeza eliphambili nelisindisa ubomi elinikwayo xa kukho i-malignant hyperthermia yi-dantrolene . Akuba nje i-anesthesiologist ikrokrela le meko, inika eli yeza ngemithambo ngoko nangoko. Kwangaxeshanye,

• I-anesthetic ebangela ukusabela iyamiswa ngoko nangoko.
• Ugqirha uza kwaziswa kwaye utyando luza kugqitywa ngokukhawuleza.
• Ukunciphisa ubushushu bomzimba obuphezulu , ulwelo olubandayo lwe-IV lufakwa emithanjeni, kwaye umzimba upholiswa ngezinto ezifana neepakethe zomkhenkce.
• Inika ioksijini.
• Inyanga iingxaki zesingqisho sentliziyo.

Xa imeko ilawulekile, uza kugcinwa kwigumbi lokhathalelo olunzulu (ICU) ubuncinane usuku, apho iqela lezonyango liza kukubeka esweni. Ngeli xesha, baza kwenza uvavanyo lwegazi olongezelelweyo baze banike unyango olongezelelweyo njengoko kufuneka.

Iza kuba njani imeko? Zithini iingxaki?

Ukuba iqela lezonyango lifumanisa le meko ngokukhawuleza lize liyinyange ngokuchanekileyo, kunokwenzeka ukuba umntu achache ngokupheleleyo. Iingxaki ezinokuvela koku zezi:

• Ukonakala kwemisipha.
• Ukungasebenzi kakuhle kwezintso.
• Ukungasebenzi kakuhle kwesibindi.
• Ukopha.
• Ukubanjwa kwe-cardiac.
• Ukuxhuzula.
• Ukuya kwi-coma.
• Ukufa.

I-Molignant Hyperthermia yimeko edla ngokubangela ukufa ukuba ayinyangwa. Nokuba unyango lufanelekile, izinga lokufa liphakathi kwe-3% kunye ne-5%.

Ngaba oku kungathintelwa?

Ewe, inokuthintelwa! Eyona ndlela ilungileyo yokwenza oku kukwazi umngcipheko wakho kuwe nakugqirha wakho. Ukuba uyazi ukuba une-genetic mutation enxulumene noku, okanye ukuba uyazi ukuba umntu kusapho lwakho unale meko, kufuneka uxelele i-anesthesiologist ngaphambi kotyando. Emva koko xa ekunika i-anesthesia, uya kusebenzisa amayeza akhuselekileyo endaweni yalawo mayeza anobungozi. Emva koko loo mpendulo iyingozi ayizukwenzeka. Abantu abaninzi bafumanisa ukuba banale ngozi kuphela emva kokuba yenzeke kubo. Yiyo loo nto kubaluleke kakhulu ukwazi imbali yezonyango yosapho lwakho. I-Hyperthermia eyingozi, i-anesthesia, utyando, impendulo ye-anesthesia, isifo semfuza, i-dantrolene, imbali yosapho, ukhuseleko lotyando, iingxaki ze-anesthesia, izifo zemfuza