Ukuba umntu ugule kwaye esibhedlele ngenxa yokuba amanqanaba amanzi emzimbeni kunye netyuwa aphantsi, oogqirha baya kumnika i-saline ukuze ahlawulele ukungabikho kwayo. Yinto eqhelekileyo leyo. Kodwa ubusazi ukuba ngamanye amaxesha, ukuba amanqanaba aphantsi esodium emzimbeni anyuka ngequbuliso nangokukhawuleza, anokonakalisa ingqondo? Yiloo nto siyibiza ngokuba yimeko engaqhelekanga kodwa embi ebizwa ngokuba yiCentral Pontine Myelinolysis. Nangona eli gama liyinkimbinkimbi kancinci, masithethe ngalo ngokulula.
Ngamafutshane, hlobo luni lwemeko olu?
Esi sisifo esinxulumene nenkqubo yemithambo-luvo. Imiqondiso yombane efunekayo emzimbeni ihamba ngeeseli zemithambo-luvo (ii-neurons) ebuchotsheni bethu. Kukho isigqubuthelo esikhuselayo esijikeleze ezi seli zemithambo-luvo. Siyibiza ngokuba yi-myelin sheath . Ifana neplastiki sheath ejikeleze ucingo lombane . Le sheath ye-myelin yiyo evumela imiqondiso yombane ukuba ihambe ngokukhawuleza kwaye ingenazo naziphi na izithintelo.
I-Central Pontine Myelinolysis (CPM) yenzeka xa i-myelin sheaths kwindawo ethile yengqondo, ingakumbi ii-pons, yonakele. Lo monakalo unokuchaphazela ukusebenza kwamalungu ahlukeneyo omzimba.
Ngamanye amaxesha, malunga ne-10% yamatyala, lo monakalo awunakuchaphazela kuphela ii-pons, kodwa nezinye iindawo zobuchopho. Ke ngoko, le meko yaziwa ngegama elibanzi. Oko kukuthi i-Osmotic Demyelination Syndrome (ODS) .
Le meko ayiqhelekanga, kodwa kufumaniseke ukuba malunga ne-2.5% yezigulana ezilaliswe kwiiyunithi zokhathalelo oluphezulu (ii-ICU) zisengozini yokufumana i-ODS.
Yintoni unobangela wale meko?
Isizathu esiphambili soku kukuba xa inqanaba le-sodium emzimbeni (elikwityuwa esiyityayo) liphantsi kakhulu, liyanda ngequbuliso nangokukhawuleza . Lo mngcipheko uyanda ngakumbi xa inqanaba le-sodium emzimbeni liphantsi kangangeentsuku ezingaphezu kwezimbini kwaye kunikwa unyango.
Into ebalulekileyo kukuba, le asiyonto siyityayo okanye esiyiselayo. Le yinto enokwenzeka esibhedlele, xa i-sodium ifakwa ngemithambo yegazi , oko kukuthi, nge-saline, njengonyango.
Cinga ngale ndlela. Umntu ebehlanza kakhulu kangangeentsuku, okanye enesifo sorhudo. Emva koko, akupheleli nje emanzini, kodwa neetyuwa ezifana nesodium ziyalahleka emzimbeni wakhe. Xa befika esibhedlele, amanqanaba abo esodium aphantsi kakhulu. Ngoku oogqirha babanika i-saline ukuzama ukubuyisela amanqanaba abo esodium kwimeko eqhelekileyo. Nangona kunjalo, ukuba abazi ezinye izinto ezinobungozi isigulane esinazo, banokukwazi ukunyusa amanqanaba esodium ngokukhawuleza.
Xa oko kusenzeka, amanzi angaphakathi kwiiseli zobuchopho aphuma ngequbuliso kwiiseli. Iiseli ziyancipha njengediliya eyomileyo. Olu tshintsho lukhawulezileyo lolona lonakalisa iisheath ze-myelin esizikhankanyileyo.
Ngubani osengozini enkulu?
Asinguye wonke umntu ofumana le meko xa amanqanaba e-sodium enyuka ngokukhawuleza, kodwa abanye abantu basengozini enkulu.
| Iqela lomngcipheko | Inkcazo |
|---|---|
| Abantu abaxhomekeke kutywala | Ukunqongophala kwezondlo kunye nokungalingani kwetyuwa kuqhelekile kubantu abasela utywala ixesha elide. |
| Izigulana ezifakelwe isibindi | Lo mngcipheko uphezulu kakhulu kwabo baye benza utyando lokufakelwa isibindi. |
| I-Hyperemesis ngexesha lokukhulelwa | I-Hyperemesis Gravidarum, imeko yokuhlanza okungapheliyo ngexesha lokukhulelwa, inokubangela ukwehla okukhulu kwamanqanaba etyuwa emzimbeni. |
| Izifo zexesha elide | Nasiphi na esinye isifo sexesha elide esiwenza buthathaka umzimba okanye esibangela ukungondleki kakuhle siyandisa umngcipheko. |
Zithini iimpawu zesi sifo?
Iimpawu zihlala ziqala ukubonakala kwiintsuku ezimbini ukuya kwezintathu emva kokulungiswa kwamanqanaba esodium emzimbeni. Kukho iimpawu ezibonakala kwangethuba, kunye neempawu ezibonakala kwiiveki kamva.
| Iimpawu ze-CPM | |
|---|---|
| Iimpawu zokuqala (kwiintsuku ezi-2-3) | |
| |
| Iimpawu ezinokuvela kamva (emva kweeveki okanye iinyanga ezimbalwa) | |
|
Kodwa ungoyiki. Nangona izinga lokufa ekuqaleni lalicingelwa ukuba liphezulu, oko kwamiselwa ngokuhlolwa kwesidumbu. Ngokwedatha entsha, ama-94% abantu abafumana le meko bayasinda . Kwakhona, phakathi kwama-25% nama-40% abo bayaphila ngokupheleleyo . Nangona kunjalo, phakathi kwama-25% nama-30% banokushiyeka benokukhubazeka okusisigxina.
Oogqirha bayifumana njani le nto?
Eyona ndlela ilungileyo yokuxilonga esi sifo kukusebenzisa i-MRI (Magnetic Resonance Imaging) . Ugqirha wakho uza kujonga imifanekiso ye-MRI yengqondo yakho aze ajonge utshintsho oluthile olubonisa umonakalo kwi-myelin sheaths.
Ngamanye amaxesha lo monakalo awubonakali kwangoko kwi-MRI, ngoko ugqirha wakho unokukucela ukuba wenze enye i-MRI kwiveki okanye ezimbini.
I-CPM ingabonakala njengezinye iimeko ezininzi kwimifanekiso ye-MRI. Ke ngoko, oogqirha balumkile kakhulu ukuba bangabhidanisi le meko nezi zifo zilandelayo.
- Isifo sokugubhuka
- I-Autoimmune okanye i-infectious encephalitis (ukudumba kwengqondo)
- I-vasculitis yenkqubo ye-nervous central
- Ezinye iintlobo zomhlaza
Ukuba i-MRI yodwa ayinakubonisa ngokucacileyo umonakalo, ugqirha uya kwenza uvavanyo olunzulu lwe-neurological. Oku kungabandakanya iimvavanyo ezilinganisa imiqondiso yombane engqondweni, njenge-EEG (electroencephalography).
Indlela yokunyanga? Ukuthintela yeyona ndlela ilungileyo!
Enyanisweni, unyango oluphambili lweCentral Pontine Myelinolysis kukuthintela ukuba imeko ingenzeki .
Kubaluleke kakhulu ukwazisa iqela lakho lezonyango ngazo naziphi na izinto ezikubangela umngcipheko (umzekelo, ukuba usela utywala, ukuba unezinye izifo) ukuze bakwazi ukunyusa amanqanaba akho e-sodium ngokukhuselekileyo nangokuthe chu.
Ukuba unesifo esinjalo, unyango luya kuxhomekeka kwiimpawu ozifumanayo. Kwiimeko ezininzi, kuya kufuneka iinyanga zonyango lomzimba kunye nolunye unyango lokubuyisela imeko esiqhelweni.
Ukuba ubonakalisa iimpawu ezifana nesifo sikaParkinson, ezifana nokungcangcazela, ugqirha wakho unokukunika amayeza e-dopaminergic .
Ngexesha lokuhlala kwakho esibhedlele, ukuthintela ezinye iingxaki zesibini kukwayinxalenye ebalulekileyo yonyango. Iqela lezonyango liza kuhlala libeka esweni izinto ezifana nezi:
- Ukuxhomekeka kwi-ventilator
- Usulelo lwendlela yomchamo
- Ukukrala kwemiphunga
- Ukuqhekeka kwegazi emthanjeni (i-Deep vein thrombosis)
- Ukuwohloka kwemisipha
Kukwakho novavanyo lweklinikhi oluqhubekayo ngesi sifo, kwaye ugqirha wakho angacebisa olunye.
Umyalezo Wokuya Ekhaya
- I-Central Pontine Myelinolysis (CPM) yimeko embi kakhulu ebangelwa kukonakala kwe-myelin sheaths ebuchosheni ngenxa yokunyuka ngequbuliso nangokukhawuleza kwamanqanaba aphantsi esodium (ityuwa) emzimbeni.
- Unyango olungcono loku kukuthintela . Ngaphambi kokuba ufumane naluphi na unyango, xelela ugqirha wakho imbali yakho epheleleyo yezonyango, ingakumbi malunga nokusetyenziswa kotywala okanye ezinye izifo.
- Ukuba le meko iyenzeka, amathuba okusinda aphezulu, kodwa ukuchacha ngokupheleleyo kungathatha ixesha elide, kuquka nonyango lomzimba.
- Ukuba wena okanye umntu omaziyo ufumana ezi mpawu, ingakumbi emva kokufumana unyango lokutshintshwa kwesodium esibhedlele, yazisa ugqirha ngokukhawuleza.
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