Ngaba umama wakho, utata, okanye umakhulu wakho osele ekhulile ukhe wakufumanisa kunzima ukuhamba ngequbuliso? Ngaba uhamba kancinci kakhulu? Okanye uziva ngathi inkumbulo yakho iya isiba mandundu kancinci? Sihlala sicinga ngezi zinto njengezinto eziqhelekileyo ezenzekayo njengoko sikhula. Kodwa ngamanye amaxesha, ezi zinokuba ziimpawu zemeko enokunyangwa. Ngokufanayo, i-NPH yimeko abantu abaninzi abayicinga ngokuba yi-dementia, kodwa eneneni yimeko enokunyangwa. Masifumanise okungakumbi ngayo namhlanje.
Kalula nje, yintoni i-NPH?
Intsingiselo epheleleyo ye-NPH yi-Normal Pressure Hydrocephalus. NgesiSinhala, ithetha "i-normal pressure hydrocephalus". Kodwa kulula ukuyiqonda kunelo gama xa usazi ukuba le yinto eyenzeka engqondweni.
Ngamafutshane, i-NPH yimeko apho ulwelo olungaphakathi nolujikeleze ingqondo yethu (ngokwezonyango silubiza ngokuba yi-Cerebrospinal Fluid - CSF) luqokelelana kwaye luphazamisana nokusebenza kwengqondo. Olu lwelo, olubizwa ngokuba yi-CSF, londla ingqondo yethu kwaye lunceda ekususeni inkunkuma engqondweni. Kwakhona lolu lwelo lukhusela ingqondo ekuxinanisweni ngaphakathi kwentloko kwaye lubangele ukwenzakala.
Ingqondo yomntu omdala eqhelekileyo inamalunga ne-150 milliliters zale fluid. Imizimba yethu ihlala isenza olu lwelo, ilujikelezisa, kwaye iphinda ifunxe ulwelo oludala. Ukuba nje lo mjikelo uqhubeka ngendlela efanelekileyo, akukho ngxaki.
Kodwa kwimeko ye-NPH, ngesizathu esithile, ukuphinda kufakwe okanye ukujikeleza kolu lwelo kuyaphazamiseka. Emva koko, olu lwelo luqala ukuqokelelana kancinci kancinci kwi-ventricles ngaphakathi kwengqondo. Ngenxa yokuba oku kwenzeka rhoqo, uxinzelelo olungaphakathi kwekhakayi alunyuki ngequbuliso kakhulu. Yiyo loo nto lubizwa ngokuba yi-"Normal Pressure". Kodwa ngokuhamba kwexesha, olu lwelo luqokelelweyo luqala ukucinezela izicubu zobuchopho kwaye luzonakalisa. Kulapho ke kuvela khona iimpawu ze-NPH.
Ngubani onokuthi abe nale meko ye-NPH?
I-NPH sisifo esichaphazela kakhulu abantu abangaphezu kweminyaka engama-65 ubudala. Umngcipheko wokufumana esi sifo uyanda ngokuhamba kweminyaka. Ubudala obuqhelekileyo bokuqala bumalunga neminyaka engama-70.
Oku akuxhomekanga kwizinto ezifana nohlanga, unqulo, okanye isini. Ukwaluphala yeyona nto iphambili ebangela umngcipheko. Ngokwezibalo, i-0.2% yabantu abaphakathi kweminyaka engama-70 nama-80 kunye ne-5.9% yabantu abangaphezu kweminyaka engama-80 banale sifo. Oko kuthetha ukuba abantu abangaphezu kwezigidi ezi-8 kwihlabathi liphela banesifo.
Ziziphi iimpawu eziphambili ze-NPH? "I-Hakim's Triad"
Kukho iimpawu eziphambili ezi-3 ze-NPH. Ezi zibonakala kancinci kancinci kwixesha leenyanga ezi-3 ukuya kwezi-6. Oogqirha babiza ezi mpawu ziphambili zintathu ngokuthi "yiHakim's Triad." Phakathi kwama-50% nama-75% ezigulane ze-NPH zifumana zonke ezi mpawu zintathu kunye.
Makhe sibone ukuba zeziphi ezi mpawu zintathu.
| Uphawu | Inkcazo |
|---|---|
| 1. Imiba yokuhamba | Olu lolona phawu luqhelekileyo lwe-NPH. 80% - 95% yezigulane zinale nto. Kuvakala ngathi iinyawo zazo zinamathele emhlabeni. Kunzima kakhulu ukuphakamisa inyathelo. Amanyathelo mancinci kakhulu, ngokungathi imilenze irhuqa emhlabeni. Ngenxa yoko, zihlala ziwa. Ngamanye amaxesha ziyema ngequbuliso xa zihamba, ngokungathi azikwazi ukufumana indlela yokuthatha inyathelo elilandelayo. Zinokubonwa zihamba nobunzima bazo kumacala omabini, njengepenguin. |
| 2. Ukungakwazi ukulawula umchamo (Ukungakwazi ukuzibamba komchamo) | Kuqala ngokufuna ukuchama rhoqo. Kwaye xa kufuneka uchame, uziva unqwenela ukuchama ngokungalawulekiyo. Ekuhambeni kwexesha, uqala ukuvuza umchamo ungaqondanga. Abanye abantu baziva beneentloni ngale nto, kodwa ngenxa yokusebenza kwengqondo okungasebenzi kakuhle, abanye abaguli basenokungazi nokuba banawo umchamo ovuzayo. |
| 3. Ubunzima bokuqonda | Oku kufana kakhulu ne-dementia. Isantya sokucinga nokusebenza siyancipha. Yonke into yenziwa kancinci kakhulu. Inkumbulo iyancipha, kwaye izinto zihlala zilibaleka. Kuba nzima ukwenza izigqibo nokulawula iimvakalelo. Ulahlekelwa ngumdla kwizinto obukade uzonwabela. |
Eyona nto ibalulekileyo kukufuna ingcebiso kagqirha, endaweni yokuzityeshela ezi mpawu njengento eqhelekileyo yokwaluphala, kuba i-NPH sisifo esinokunyangwa.
Kutheni le NPH iphuhla? Zithini izizathu?
Kukho iintlobo ezimbini eziphambili ze-NPH, kuxhomekeke kwizizathu.
1. I-NPH ePhambili (engacacanga)
Olu lolona hlobo luxhaphakileyo. Malunga nesiqingatha sezigulane zinalo olu hlobo. Igama elithi "Idiopathic" lithetha ukuba unobangela ochanekileyo awaziwa.Okwangoku kukholelwa ukuba oku kwenzeka ngenxa yotshintsho oluthile ekujikelezeni kwegazi nasekufunxeni kolwelo lwe-CSF ebuchotsheni njengoko sikhula.
2. I-NPH yesibini
Oku kwenzeka ngenxa yesinye isifo okanye ingozi. Oko kukuthi, kukho esinye isizathu esiphazamisa ukuhamba kolwelo lwe-CSF engqondweni. Ezinye zezi zizathu ziquka:
- Ukulimala Kwengqondo Okubuhlungu
- Iintsholongwane zobuchopho
- Istroke
- Ukopha kwegazi ngaphakathi kwentloko
- I-Aneurysm yobuchopho
- Usulelo lobuchopho olufana ne-meningitis
- Utyando lobuchopho
Ugqirha uyixilonga njani ngokuchanekileyo i-NPH?
Ukufumanisa i-NPH kunokuba nzima kuba iimpawu zayo zifana kakhulu neemeko ze-dementia ezifana nesifo sika-Alzheimer. Ngamanye amaxesha, i-NPH inokuhamba nesifo sika-Alzheimer.
Ugqirha usebenzisa iimvavanyo ezininzi ukufumanisa esi sifo.
- Uvavanyo lomzimba nolwemithambo-luvo: Ugqirha uza kujonga indlela ohamba ngayo, ibhalansi yakho, amandla akho okusebenza, kunye namandla emisipha yakho.
- Ukubuza ngeempawu kunye nembali yezonyango: Buza amalungu osapho lwakho malunga nendlela ezi mpawu eziqale ngayo kunye nexesha ezibekho ngalo.
- Uvavanyo lobuchopho: Olu lolona vavanyo lubalulekileyo. Uvavanyo lwe-MRI (Magnetic Resonance Imaging) lunokubona ngokucacileyo ukuba ii-ventricles, apho ulwelo lwe-CSF luqokelelana khona, ziyanda na. Ngamanye amaxesha uphononongo lwe-CT (Computed Tomography) lwenziwa ukuze kuthintelwe ezinye iimeko.
- Ukubetheka koMgogodla/Ukubhaxabula iLumbar: Olu luvavanyo olubaluleke kakhulu. Apha, kufakwa inaliti encinci kwintambo yomqolo kwaye kuthathwa isampuli yolwelo lwe-CSF. Olu vavanyo lungasetyenziselwa ukujonga ezinye izifo. Kwakhona, okubaluleke kakhulu, kubalulekile ukubona ukuba iimpawu zesigulana, ezinje ngobunzima bokuhamba, ziyaphucuka okwethutyana emva kokususa ulwelo olongezelelweyo lwe-CSF. Ukuba luyenzeka, luphawu oluqinileyo lokuba kukho i-NPH.
Ngaba ikhona indlela yokunyanga oku? Ngaba inganyangeka?
Ewe! Ezi ziindaba ezimnandi malunga ne-NPH. Nangona isenokubonakala ngathi yi-dementia, i-NPH idla ngokuba sisifo esinokunyangwa . Amayeza awasebenzi kakuhle. Unyango oluphambili nolusebenzayo lutyando.
Olu tyando lubandakanya ukudibanisa isixhobo esincinci esifana nombhobho esibizwa ngokuba yi-shunt ebuchotsheni.
- Cinga ngale nto njengombhobho okhupha amanzi angaphezulu.
- Isiphelo esinye sale shunt siqhagamshelwe kwigumbi elisebuchotsheni apho ulwelo lwe-CSF luqokelele khona.
- Esinye isiphelo sifakwa phantsi kwesikhumba kwisisu (isisu) okanye esifubeni.
- Ulwelo lwe-CSF olongezelelekileyo oluqokelelana engqondweni luhamba ngesantya salo mbhobho luze luthululele kwindawo efana nomngxuma wesisu, apho umzimba unokufunxa khona ulwelo kwakhona.
Emva kolu tyando, iimpawu zezigulane ziqala ukuphucuka kakhulu kwiiyure okanye iintsuku ezimbalwa. Oku kuphumela kwiziphumo ezilungileyo kakhulu, ingakumbi xa kunzima ukuhamba.
Kwimeko ye-NPH yesibini, isifo esibangele i-NPH (umz., umhlaza wobuchopho) sinyangwa kuqala.
Ziziphi iingxaki ezinokwenzeka emva konyango?
Nangona utyando lwe-shunt lukhuselekile ngokubanzi, njengalo naluphi na utyando, kukho iingozi ezithile.
- Usulelo.
- I-shunt ivaliwe okanye ayisebenzi kakuhle.
- I-shunt ikwi-verr.
- Ukuphuma kolwelo lwe-CSF olugqithisileyo engqondweni (oku kunokubangela iimpawu ezifana neentloko ezibuhlungu).
Ukuba into efana nale iyenzeka, inokuchongwa kwaye inyangwe ngokukhawuleza. Kungoko ke, kubaluleke kakhulu ukulandela imiyalelo kagqirha kanye emva kotyando kwaye uye kwiikliniki ngemihla ebekiweyo.
Yintoni onokuyilindela xa uhlala ne-NPH?
Iziphumo ze-NPH zihlala zixhomekeke ekubeni isifo sifunyanwa ngokukhawuleza kangakanani kwaye sinyangwa njani . Unyango olunikwa kamva, kokukhona kunokwenzeka ukuba umonakalo wengqondo uhlale uhleli.
Ekubeni isigulana sisenokungazi iimpawu zaso, usapho kunye nabantu esibathandayo banoxanduva olukhulu koku. Ukuba ubona ezi mpawu kumntu omthandayo, kubaluleke kakhulu ukumsa kugqirha, endaweni yokucinga ukuba yinxalenye eqhelekileyo yokwaluphala.
Nazi iindlela zokuphela kweempawu emva konyango:
- Ubunzima bokuhamba: Malunga nama-85% ezigulana ziyachacha.
- Ukungakwazi ukuzibamba komchamo: Malunga nama-80% ezigulana ziyachacha.
- Ukuphazamiseka kokucinga nokukhumbula: Malunga nama-80% ezigulana ziyachacha.
Makhe sijonge izinto ezichaphazela isiphumo sesifo se-NPH kwitheyibhile engasezantsi.
| Izinto ezandisa amathuba okuba nesiphumo esihle | Izinto ezinciphisa amathuba okuba nesiphumo esihle |
|---|---|
| Ukuxilongwa kwangethuba kunye nonyango lwesifo. | Ukulibaziseka ekuxilongweni nasekunyangweni kwesi sifo. |
| Kuqala kwakukho ubunzima bokuhamba, kwalandela iingxaki zokukhumbula. | Okokuqala, iingxaki zenkumbulo ziyaqala. |
| Iimpawu ziyaphucuka okwethutyana emva kokusela amanzi ngasemva. | Ukuphazamiseka kwengqondo okunzulu kunye nokungacingi kakuhle. |
| I-NPH yesibini ibangelwa sisifo esinyangekayo. | Ukubakho kwezinye izifo zobuchopho ezifana ne-Alzheimer's. |
Ndifanele ndimbone nini ugqirha? Ngawaphi amaxesha okuya kwi-ETU?
Ukuba kukho umntu kusapho lwakho one-shunt, kufuneka uqaphele ngakumbi iimpawu ezithile. Ezi zinokuba ziimpawu zengxaki nge-shunt okanye usulelo.
Ukuba kukho naziphi na kwezi mpawu zilandelayo, fowunela ugqirha wakho ngoko nangoko okanye uye kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele .
- Intloko ebuhlungu kakhulu: Ukuba intloko iba mandundu, ingakumbi xa uhleli okanye umile, oku kungaba luphawu lokuba ukuphuma kwamanzi kwi-shunt kuyancipha okanye kuyanda.
- Umkhuhlane okanye ukubanda: Oku kungaba luphawu losulelo emva kotyando. Ungaze ungazihoyi ezi ntlobo zosulelo kuba zinokusasazeka ngokukhawuleza.
- Intamo eqinileyo.
- Intlungu esifubeni okanye esiswini apho ityhubhu ye-shunt idlula khona.
- Ukuvela kwakhona kweempawu ze-NPH zakudala (ubunzima bokuhamba, iingxaki zomchamo).
Umyalezo Wokuya Ekhaya
- Musa ukugxeka ubunzima bokuhamba, ukungakwazi ukuzibamba komchamo, kunye nokulahlekelwa yinkumbulo njengokwaluphala okuqhelekileyo. Ezi zinokuba ziimpawu zesifo esibizwa ngokuba yi-NPH.
- I-NPH yimeko ebangelwa kukuqokelelana kolwelo lwe-cerebrospinal (CSF) engqondweni.
- Nangona inokuba neempawu ezifana ne-dementia, i-NPH sisifo esinokunyangwa rhoqo ngotyando.
- Okukhona isifo sifunyanwa ngokukhawuleza, kokukhona iziphumo ziba ngcono. Ke ngoko, ingqalelo yosapho kunye nabantu obathandayo ibaluleke kakhulu apha.
- Ukuba umntu omthandayo unezi mpawu, nceda ubone ugqirha ofanelekileyo ngaphandle kokulibazisa.
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