Ngaba uvakalelwa kukusetyenziswa kwe-anesthesia? Masifunde nge-(Pseudocholinesterase Deficiency)?

Ngaba wakha waziva uloyiko malunga ne-anesthesia oyinikwayo xa utyando? Kuqhelekile ukuba abanye abantu bazive ngaloo ndlela. Kodwa khawucinge ukuba bekuya kwenzeka ntoni ukuba amanye amayeza e-anesthesia owanikwayo ebengafanelekanga emzimbeni wakho. Namhlanje siza kuthetha ngemeko engaqhelekanga, kodwa ebaluleke kakhulu ekufuneka uyiqaphele. Leyo yimeko ebizwa ngokuba yi-`(Pseudocholinesterase Deficiency)`.

Yintoni `(Pseudocholinesterase Deficiency)`? Masiyiqonde ngokulula, akunjalo?

Kulungile, eli gama livakala lide kancinci, akunjalo? Masiligcine lilula. `(Pseudocholinesterase)` yienzyme ekhethekileyo `(Enzyme)` emzimbeni wethu. Omnye wemisebenzi ephambili yale `(Enzyme)` kukuqhekeza (oko kukuthi, `(metabolize)`) emzimbeni amanye amayeza anikwa ukuphumza izihlunu , ingakumbi xa sithomalaliswa yi-anesthesia (sibiza ezi `(Choline esters)`). Khawuthelekelele, ngexesha lotyando, izihlunu zakho kufuneka zingasebenzi okwethutyana. La ngamayeza anikwa loo nto.

Ngoku, kwimeko ebizwa ngokuba yi-`(Pseudocholinesterase Deficiency)`, okwenzekayo kukuba le `(Enzyme)` ebizwa ngokuba yi-`(Pseudocholinesterase)` emzimbeni wakho ayiveliswanga ngokwaneleyo , okanye ayisebenzi kakuhle . Kwenzeka ntoni ke ngoko? Amayeza anikwa ukuphumza izihlunu (`(Succinylcholine)` kunye ne-`(Mivacurium)` yimizekelo emibini yoku) awasuswa emzimbeni ngokukhawuleza. Ahlala emzimbeni ixesha elide.

Ngenxa yoko, izihlunu zakho zisenokuhlala zindindisholo ixesha elide emva kokusebenzisa i-anesthesia, kwaye usenokuba nobunzima bokuphefumla. Oku kuthetha ukuba usenokungakwazi ukushukuma okanye ukuphefumla wedwa de imiphumo yeyeza iphele.

Ixhaphake kangakanani le meko?

Enyanisweni, le meko ibizwa ngokuba yi-`(Pseudocholinesterase Deficiency)` ayiqhelekanga kangako . Ngokwesiqhelo, malunga nomntu omnye kuphela kwabayi-3,200 okanye abangama-5,000 kubemi abahlangabezana nale meko. Oko kukuthi, linani elincinci kakhulu.

Zithini iimpawu? Uyibona njani le nto?

Uninzi lwabantu abanale meko abayazi de bafumane uhlobo lweyeza lokubulala iintlungu endilikhankanyileyo ngaphambili, elibizwa ngokuba yi-"Choline esters." Kulapho ke iimpawu eziphambili zibonakala khona:

• Izihlunu eziphumle kakhulu (oko kukuthi, ezingenabomi) ixesha elide kunokuba bekulindelwe.
• Nezihlunu ezikuncedayo ukuphefumla azisebenzi okwethutyana .

Kungathatha iiyure ezimbalwa ukuba ezi mpawu ziphele. Eli xesha liyahluka kumntu nomntu. Ngeli xesha, iqela lakho lezonyango liza kukugcina uphantsi kwe-anesthesia kwaye likuncede uphefumle nge-"ventilator", umatshini wokuphefumla owenziweyo, ude ukwazi ukuphefumla wedwa.

Zithini izizathu? Kwenzeka njani oku?

Le meko (i-Pseudocholinesterase Deficiency) inokuthi ifunyanwe njengelifa (oko kukuthi, ifunyanwe njengelifa), okanye ingavela kamva ebomini..

Izizathu ezizuzwe njengelifa

Abantu abazalwa benale meko banotshintsho, okanye utshintsho, kwijini ebizwa ngokuba yi-`(BCHE)`. Le jini ye-`(BCHE)` yiyo exelela umzimba wethu ukuba wenze i-enzyme `(Pseudocholinesterase)`. Ngoko ke, xa kukho utshintsho kule jini, umzimba wakho uvelisa okuncinci kakhulu kule enzyme, okanye usenokungayivelisi konke konke.

Izizathu ezibangelwa kukuphila (ezifunyenweyo)

Ngamanye amaxesha, le meko (Pseudocholinesterase Deficiency) inokwenzeka ubomi bonke. Ingabangelwa zizifo ezahlukeneyo kunye namayeza athile.

Ezinye izifo ezinokubangela le meko:

• Ukungondleki kakuhle
• Ukulimala okukhulu kokutsha
• Isifo sezintso
• Isifo sesibindi
• I-Hypothyroidism (i-thyroid engasebenzi kakuhle)
• Umhlaza
• Ukukhulelwa

Amanye amayeza anokunyusa umngcipheko wale meko aquka:

• I-MAO inhibitors (umz. Phenelzine (Nardil®))
• Iipilisi zokulawula ukukhulelwa (Iipilisi zokuthintela ukukhulelwa ezithathwa ngomlomo)
• Amaconsi eliso e-Echothiophate
• I-Metoclopramide
• I-Cyclophosphamide
• I-Pyridostigmine

Oogqirha bayixilonga njani le nto?

Ukuba unengxaki yokulawula izihlunu zakho okanye ukuphefumla emva kwe-anesthesia eqhelekileyo, ugqirha wakho unokurhanela ukuba une-pseudocholinesterase enqongopheleyo. Ukuqinisekisa oku, banokwenza uvavanyo lwegazi ukujonga amanqanaba e-enzyme yakho ye-pseudocholinesterase.

Ukuba kukho umntu kusapho lwakho onale meko, ugqirha angenza uvavanyo lwemfuza ukuze afumanise ukuba nawe unayo na. Oku kuquka ukuthatha isampuli yegazi nokujonga ukuba unayo na i-(BCHE) gene mutation.

Ukuba ugqirha wakho ukrokrela ukuba unale meko, uza kusebenzisa ezinye iintlobo zeziphumzi zemisipha ezingaxhomekekanga kwi-enzyme ethi ``Pseudocholinesterase''.

Luthini unyango?

Ukuba ubonakalisa iimpawu ze-`(Pseudocholinesterase Deficiency)` emva kokuba unikwe i-anesthesia eqhelekileyo, unokufuna uncedo olukhawulezileyo lwezonyango. Iqela lezonyango liza kukujonga ngokusondeleyo ude uphile. Ukuba kuyimfuneko, baza kukugcina phantsi kwe-anesthesia baze basebenzise umatshini we-``mechanical ventilation``` ukukunceda uphefumle ude ukwazi ukuphefumla wedwa.

Yintoni omele uyilindele ukuba unale meko?

Ukuba ufunyaniswe une-`(Pseudocholinesterase Deficiency)`, eyona nto ingcono onokuyenza kukwazisa oogqirha bakho ngayo – ingakumbi oogqirha abaza kukubona ukuze utyando .

Kwakhona, kufuneka uxelele nosapho lwakho ngale nto., emva koko banokuvavanywa ukuze kubonwe ukuba banayo na i-`(BCHE)` yenguqu yezakhi zofuzo. Ukuba kunjalo, kufuneka baxelele oogqirha babo ngaphambi kokuba benze naluphi na utyando.

Kukwangumbono olungileyo ukunxiba isongo sesazisi sezonyango ukuze oogqirha bazi ukuba kufuneka wenze utyando olungxamisekileyo.

Ngaba oku kungathintelwa?

Ukunqongophala kwe-Pseudocholinesterase yimeko yokuzalwa engenakukhuselwa. Nangona kunjalo, ukuba kukho umntu kusapho lwakho onayo, unokuvavanywa ukuba awunayo na i-BCHE gene mutation ngaphambi kokuba wenze i-anesthesia jikelele. Oku kunokunceda ukuthintela iingxaki ngexesha lotyando.

Ukuba une-genetic mutation, ugqirha wakho usenokungayisebenzisi i-Choline esters aze akhethe enye i-anesthetic. I-Rocuronium yeyona anesthetic isetyenziswa kakhulu kubantu abane-Pseudocholinesterase Deficiency.

Usenokukwazi ukunciphisa umngcipheko wakho wokuba ne-Acquired Pseudocholinesterase Deficiency kamva ebomini ngokunyanga iimeko ezingaphantsi, ezinje ngokungondleki kakuhle okanye isifo sezintso esingapheliyo (CKD). Kwakhona, ukuba uthatha nawaphi na amayeza anciphisa ukuveliswa kwe-enzyme Pseudocholinesterase, unokufuna ukuthetha nogqirha wakho malunga nokutshintsha amayeza akho.

Zithini izinto ezingachanekanga, oko kukuthi, zeziphi amayeza angalunganga ukusetyenziswa kubantu abanesifo esinjalo?

Ukuba ufunyaniswe une-`(Pseudocholinesterase Deficiency)`, kufuneka uziphephe ezi ntlobo zilandelayo zamayeza okubulala iintlungu :

• I-Succinylcholine `(Succinylcholine)`
• I-Mivacurium
• I-Procaine
• I-Chloroprocaine
• IBenzocaine
• I-Tetracaine

Imibuzo omele uyibuze ugqirha wakho

Ukuba unesifo esibizwa ngokuba yi-"Pseudocholinesterase Deficiency", nokuba wazalwa unaso okanye wasifumana kamva, ungabuza ugqirha wakho imibuzo efana nale:

• Zeziphi izinto ezichasene ngqo nam, oko kukuthi, zeziphi amayeza endifanele ndiwaphephe?
• Ingaba le meko yinto endazalwa nayo okanye ibangelwa sisifo esithile?
• Ingaba kulungile na ukuba kwenziwe uvavanyo lwemfuza kusapho lwam?

Ukuya kutyando kunokuba yinto ebangela uxinzelelo. Uninzi lwethu lugxile kakhulu kutyando kangangokuba asicingi nokuba kunokwenzeka ukuba kubekho impendulo engalunganga kwi-anesthesia. Akukho nyango lwe-Pseudocholinesterase Deficiency. Nangona kunjalo, ukwazi ukuba unayo na kunokukunceda uphephe ubuthathaka bemisipha okwethutyana kunye nobunzima bokuphefumla obunokwenzeka emva kotyando. Ukuba une-Pseudocholinesterase Deficiency, xelela amalungu osapho lwakho ngayo. Banokuvavanywa i-gene kwaye baphephe naziphi na iingxaki ezingafunekiyo ezinokuvela ngexesha lohambo lwabo lwempilo.

Okokugqibela, izinto ekufuneka uzikhumbule

Ngoko ke, igama elithi `(Pseudocholinesterase Deficiency)` liyoyikisa kancinci, kodwa kubaluleke kakhulu ukuliqaphela. Ingakumbi ukuba uza kutyandwa, okanye ukuba umntu kusapho lwakho ukhe wahlangabezana nento efana nale , kungcono ukuthetha noogqirha bakho ngale nto. Khumbula, ukuqonda kudla ngokuba lolona khaka lilungileyo elinokusisindisa kwiingxaki ezingeyomfuneko!

I - Anesthesia, i-pseudocholinesterase, ukungabikho kwee-enzyme, iingxaki zotyando, imeko yemfuza, ukungasebenzi kakuhle kwemisipha, amayeza okubulala iintlungu