Kuthekani ukuba inkqubo yakho yemithambo-luvo isengozini? Masifunde ngengozi ethi 'Neurogenic Shock'!

Sonke silivile igama elithi "shock," akunjalo? Ngamanye amaxesha sicinga ngalo njengento eyahlukileyo xa ngequbuliso soyika okanye sicaphukile. Kodwa kwezonyango, "shock" ibhekisa kwimeko embi kakhulu. Namhlanje siza kuthetha ngohlobo olufanayo, kodwa olwahlukileyo kancinci "loshock." Oku kubizwa ngokuba 'yi-neurogenic shock.' Ngamafutshane, kwenzeka xa kukho ukwenzakala okukhulu kwinkqubo yethu yemithambo-luvo, ingakumbi i-spinal cord .

Yintoni kanye kanye 'i-Neurogenic Shock'?

Cinga ngenkqubo yakho yemithambo-luvo njengenkqubo yefowuni kwilizwe elithile. Le mithambo-luvo ithwala imiyalezo esuka engqondweni iye kuwo onke amalungu omzimba. Ngoku, xa kukho ukwenzakala kwenkqubo yemithambo-luvo, ingakumbi kumthambo womqolo, njengokuqhekeka komqolo okanye ukudumba, inkqubo ethwala le miyalezo iyaphazamiseka.

Ukothuka okubangelwa yi-neurogenic yimeko apho isantya sentliziyo yakho, uxinzelelo lwegazi, kunye nobushushu bomzimba zingalawulekiyo emva kwengozi. Njengezinye iintlobo zokothuka, le yimeko enzulu kakhulu, kwaye ngamanye amaxesha inokubulala. Isizathu soku kukuba ukuhamba kwegazi emzimbeni wonke kuyaphazamiseka. Xa igazi lingahambi kakuhle, iiseli zethu azifumani ioksijini kunye nezondlo ezizidingayo. Emva koko iiseli azikwazi ukwenza imisebenzi yazo.

Ngoko ke, kubalulekile ukufuna unyango lomothuko ngokukhawuleza.

Yintoni umahluko phakathi kwe-'Neurogenic Shock' kunye ne-'Spinal Shock'?

Nangona zombini zinxulumene nokwenzakala komqolo, kukho umahluko omncinci. Kwi-spinal shock, izihlunu zakho ziyafa kwaye i-reflexes yakho iyalahleka emva kokwenzakala komqolo wakho. Kwi-neurogenic shock, iziphumo eziphambili zikwizinga lentliziyo yakho kunye noxinzelelo lwegazi.

Yintoni umahluko phakathi kwe-'Neurogenic Shock' kunye ne-'Hypovolemic Shock'?

Ukothuka kwe-Hypovolemic yimeko ebangelwa kukulahleka kolwelo oluninzi kakhulu, ingakumbi igazi, emzimbeni. Umahluko ophambili phakathi kwezi zimbini kukubetha kwentliziyo.

• Umntu one-neurogenic shock unentliziyo ebetha kancinci (bradyarrhythmia).
• Umntu one-hypovolemic shock unesantya sentliziyo esinyukayo (i-tachycardia).

Ngubani ochaphazeleka kakhulu yile meko? Ixhaphake kangakanani?

Umothuko we-neurogenic uyenzeka kubantu abenzekele umqolo kwaye babonakalise inkqubo ye-nervous.

Uphando lubonisa ukuba phakathi kwe-19% kunye ne-31% yabantu abaye benzakala emgogodleni baya kuba neengxakiOku kubizwa ngokuba yi-'Neurogenic Shock'. Kwanakwilizwe elifana neMelika, abantu abaphakathi kwama-8,000 nama-10,000 bafumana ukwenzakala komqolo minyaka le. Izizathu eziphambili zoku ziingozi zeemoto kunye nokuwa ukusuka phezulu. Iingozi ezinjalo zixhaphakile kwilizwe lethu, akunjalo?

'I-Neurogenic Shock' iyichaphazela njani umzimba wam?

Ngamafutshane, xa kukho ukwenzakala kwintambo yomqolo, imithambo-luvo yethu ayikwazi ukuthumela imiqondiso kwimithambo yegazi, isithi, "Kulungile, ngoku nciphisa kancinci." Xa lo myalezo ungamkelwanga kakuhle, imithambo yegazi iba mikhulu kakhulu, okubizwa ngokuba yi -'vasodilation' . Kufana nombhobho wamanzi okhula ngequbuliso. Okwenzekayo kukuba uxinzelelo lwegazi luyehla ngequbuliso 'hypotension' . Xa uxinzelelo lwegazi luyehla, ukuhamba kwegazi emzimbeni wonke nako kuyehla. Oku kuthetha ukuba amalungu ethu abalulekileyo awafumani ioksijini ayidingayo.

Zithini iimpawu zoku?

Iimpawu zokothuka kwe-neurogenic ziquka:

• Uxinzelelo lwegazi oluphantsi (Hypotension): Olu luphawu oluphambili.
• Isantya sentliziyo esicothayo (iBradyarrhythmia): Inani leebeats ngomzuzu lidla ngokuncipha.
• Ulusu luba bomvu luze lutshise, emva koko lube lukhuni, lube manzi, lube mdaka.
• Imilebe kunye neenzipho zijika zibe luhlaza okwesibhakabhaka: Oku kungenxa yokunqongophala kweoksijini egazini.
• Ukulahlekelwa ngokupheleleyo yingqondo okanye ukuncipha kwengqondo: Oku kungenzeka ngenxa yokuncipha kokuhamba kwegazi ukuya engqondweni.

Ukuba umntu unenye okanye ngaphezulu kwezi mpawu, ingakumbi ukuba wenzekele umqolo, kufuneka anikwe ingqalelo ngokukhawuleza.

Zithini izizathu ze-'Neurogenic Shock'?

Kukho izizathu ezininzi eziphambili zale meko:

• Ukulimala komqolo: Le yeyona nto ixhaphakileyo. Ingabangelwa zizinto ezifana nengozi yemoto, ukuwa kwindawo ephakamileyo, okanye ingozi yezemidlalo.
• Iityhefu ezichaphazela inkqubo ye-autonomic nervous.
• Isifo sikaGuillain-Barré: Esi sisifo esingaqhelekanga esichaphazela inkqubo yemithambo-luvo.
• I-anesthesia yomqolo: Le anesthesia inikwa kwezinye ii-operation. Inokwenzeka rhoqo njengengxaki.
• I-Transverse myelitis: Le ikwayintsholongwane yemithambo-luvo ekwi-spinal cord.

Oogqirha bayixilonga njani le nto?

Ukufumanisa ukuba une-neurogenic shock, ugqirha uya kwenza oku kulandelayo:

1. Uvavanyo lomzimba lwenziwa: Imeko yakho kunye nohlobo lokwenzakala kuyahlolwa.

2. Iimpawu ezibalulekileyo ziyajongwa: uxinzelelo lwegazi, izinga lokubetha kwentliziyo, izinga lokuphefumla, kunye nobushushu buyalinganiswa.

3. Uvavanyo lwegazi lwenziwa:Funda ngemeko yangaphakathi yomzimba kunye nokusebenza kwamalungu omzimba.

4. Kuyenziwa iiskeni: Ukuvavanya ngokuchanekileyo umonakalo womqolo.

Luhlobo luni lweskeni ezenziwayo?

Ezi zezona ntlobo zimbini ziphambili zeskeni:

• I-CT Scan (i-Computed Tomography - i-CT scan): Oku kunokubona ngokucacileyo umonakalo emathanjeni.
• I-MRI scan (Magnetic Resonance Imaging - MRI scan): Oku kunokujonga kakuhle umonakalo kwizicubu ezithambileyo zomqolo, oko kukuthi, intambo yomqolo kunye nemithambo-luvo.

Inyangwa njani i-Neurogenic Shock?

Le yingxamiseko yezonyango, ngoko ke unyango lufanele luqale ngoko nangoko.

Okokuqala, oogqirha baza kukufaka i-brace entanyeni yakho. Oku kwenzelwa ukuthintela umqolo ukuba ungabi mbi, kuba ukuhambisa intamo yakho kunokwenza ukwenzakala kube kubi ngakumbi.

Okulandelayo, eyona nto ibalulekileyo kukulawula uxinzelelo lwegazi oluphantsi (hypotension). Oku kwenziwa ngokunika ulwelo olufana ne-saline nge-IV (efakwa emthanjeni).

Emva koko, kunikwa amayeza okulawula isantya sentliziyo esicothayo (bradyarrhythmia).

Ngelixa unyanga le 'Neurogenic Shock', uza kunyangwa nakweminye imiphumo yokwenzakala onokuba uyenzile ngenxa yengozi.

Luhlobo luni lwamayeza asetyenziswayo?

Oogqirha banokusebenzisa iintlobo ezahlukeneyo zamayeza ukulawula ukothuka kwe-neurogenic:

• I-Phenylephrine
• I-Norepinephrine `(i-Norepinephrine)`
• I-Epinephrine
• I-Atropine
• I-Glycopyrrolate `(I-Glycopyrrolate)`
• I-Isoproterenol `(Isoproterenol)`
• I-Theophylline
• I-Aminophylline

La mayeza anikwa phantsi kweliso elibukhali likagqirha, kuthathelwa ingqalelo izinto ezininzi ezifana nemeko yesigulana, uxinzelelo lwegazi, kunye nokubetha kwentliziyo.

Ngaba kukho naziphi na iingxaki okanye iziphumo ebezingalindelekanga zonyango?

Naliphi na iyeza linokubangela iziphumo ebezingalindelekanga. Kodwa oogqirha bakhetha iyeza kuphela ukuba inzuzo kwisigulane ingaphezulu komngcipheko. Kwakhona, ukuba ubungakanani bolwelo olunikwa nge-IV ngamanye amaxesha luphezulu kakhulu, kukho ithuba elincinci lokuba umzimba uya kudumba.

Ndingayinciphisa njani le ngozi?

Ekubeni eyona nto ibangela ukothuka yi-neurogenic shock kukwenzakala komqolo, kubalulekile ukuthintela ukwenzakala okunjalo. Kukho izinto ezininzi onokuzenza ukunceda:

• Musa ukuqhuba uphantsi kwempembelelo yotywala okanye iziyobisi. Qhuba ngenyameko nangononophelo.
• Soloko unxibe ibhanti xa ukhwela imoto. Qhuba ngokukhuselekileyo ngeemoto ezinamavili amathathu kunye neebhayisekile.
• Musa ukuntywila kwiindawo ezingaziwayo okanye emanzini angajulileyo. Oku kunokubangela ukwenzakala okukhulu entanyeni.
• Lumka ngokhuseleko xa ukhwela imithi kwaye usebenza kwiindawo eziphakamileyo.

Yintoni endinokuyilindela ukuba ndine-neurogenic shock?

Ukuba ukwenzakala komqolo kubangela ukothuka okubangelwa yimithambo-luvo, uxinzelelo lwegazi oluphantsi (hypotension) lunokuhlala ixesha elide ukuya kuthi ga kwiiveki ezintlanu.

Kwakhona, ezinye iingxaki zinokuvela ngale meko. Umzekelo:

• Amahlwili egazi kwimithambo yemilenze (Deep Vein Thrombosis - DVT)
• Izilonda zoxinzelelo
• I-pneumonia yokuphefumla ibangelwa kukutya okanye ezinye izinto ezingena kwindlela yomoya .

I-neurogenic shock inokuhlala ixesha elingakanani?

Ngokwesiqhelo, iimpawu zokothuka okubangelwa yimithambo-luvo zinokuhlala malunga neeveki ezine ukuya kwezintlanu . Nangona kunjalo, oku kunokwahluka ukusuka kumntu ukuya komnye kwaye kuxhomekeke kuhlobo lwengozi.

Ndiza kukwazi ukubuyela emsebenzini/esikolweni?

Nokuba ungabuyela kwimisebenzi yakho yesiqhelo, emsebenzini, okanye esikolweni kuxhomekeke kubukhulu bokwenzakala komgogodla wakho kunye nohlobo lwolunye umonzakalo onokuba ulufumene. Ngamanye amaxesha kunokufuneka wenze utshintsho olukhulu ebomini bakho, ingakumbi ukuba unengxaki yokuhamba.

Iyintoni imbonakalo yokothuka okubangelwa yi-neurogenic shock?

Ukuba ayinyangwa, uninzi lweemeko zokothuka ziyabulala. Nangona kunjalo, unyango olukhawulezileyo nolufanelekileyo lunokusindisa ubomi bakho. Impilo yakho yexesha elizayo ixhomekeke kwizinto ezininzi, kuquka:

• iminyaka yakho.
• Ubunzima bengozi.
• Ukonakala kwamanye amalungu omzimba.
• Ezinye izifo ezingapheliyo onazo (ezinye iingxaki zempilo).
• Kuthathe ixesha elingakanani ukufumana unyango?
• Ezinye iingxaki ezinje ngokungakwazi ukuthetha kunye nokulahlekelwa yibhalansi.
• Indlela umzimba wakho osabela ngayo kunyango.

Okubuhlungu kukuba, umntu oye wenzakala emgogodleni unamathuba amabini ukuya kwamahlanu okufa ngaphambi kwexesha kunalowo ungazange enze njalo. Umngcipheko wokufa uphezulu kunyaka wokuqala emva kokwenzakala emgogodleni.

Ndingazinyamekela njani?

Xa unesifo somqolo, usenokuba neengxaki zempilo ezifana ne-Deep Vein Thrombosis (DVT), njengoko bekutshiwo ngaphambili. Kwakhona, i-neurogenic shock, imeko apho ukuhamba kwegazi kuncipha kwaye ilungu elinye okanye ngaphezulu lonakele.

Imeko yomntu wonke yahlukile, kodwa kuye nabani na oye wahlangabezana nomothuko wemithambo-luvo, kubalulekile ukulandela unyango lomzimba kunye neengcebiso zonyango ngononophelo ukuze kuthintelwe iingxaki zexesha elizayo.

Ndifanele ndimbone nini ugqirha wam?

Ukuba ubona naluphi na utshintsho kwimeko yakho, njengotshintsho kwiimpawu ezibalulekileyo okanye iintlungu, kufuneka wazise ugqirha wakho ngoko nangoko.

Ndingaya nini kwiSebe leeNgxamiseko (i-ETU) ?

Ufanele ufune unyango olungxamisekileyo ngoko nangoko ukuba unezi mpawu:

• Iintlungu zesifuba
• Isiyezi
• Isicaphucaphu

Ezi zisenokuba ziimpawu zesinye isifo esinzima.

Ndingayibuza yiphi imibuzo ugqirha wam?

Ungabuza ugqirha imibuzo efana nale:

• Injani imeko yam ethile?
• Ngaba amalungu am omzimba onzakele ngenxa ye-'Neurogenic Shock'?
• Zeziphi izinto ezibalulekileyo ekufuneka ndizenze xa ndijonga imeko yam?

Isishwankathelo kunye nomyalezo oya nawo ekhaya

Kulungile, ngoko ke 'i-Neurogenic Shock' esithethe ngayo namhlanje yimeko eyingozi kakhulu enokwenzeka ngenxa yokwenzakala okukhulu kumqolo. Kule meko, umonakalo kwinkqubo yemithambo-luvo ubangela ukuba umzimba uphulukane nolawulo lwezinto ezifana nokubetha kwentliziyo kunye noxinzelelo lwegazi.

Eyona nto ibalulekileyo kukuhlala ukhuselekile kangangoko unako kwaye uzame ukunqanda ukwenzakala emqolo wakho. Lumka kakhulu xa uqhuba, usebenza kwiindawo eziphakamileyo, kwaye utsiba emanzini.

Ukuba kwenzeka ingozi, ukufuna uncedo lwezonyango ngokukhawuleza kunokukunceda usindise ubomi bakho. Emva koko, ukuqhubeka nonyango lomzimba njengoko uyalelwe ngugqirha wakho kuya kukunceda uhlale usempilweni kangangoko. Iqela lakho lezonyango liya kukunceda woyise olu celomngeni.

Ukothuka kweNeurogenic , Ukulimala koMgogodla, Uxinzelelo lwegazi, Inkqubo yeNervous, Ingxamiseko, Uxinzelelo lwegazi oluphantsi, iBradyarrhythmia