Uma wena noma othandekayo wakho nihlelelwe ukuhlinzwa, uyazi ukuthi i-anesthesia iyingxenye ejwayelekile yenqubo. Empeleni, ikwenza ulale ukuze ungezwa ubuhlungu. Kodwa-ke, abanye abantu banempendulo engavamile kakhulu, esongela ukuphila emithini ethile ye-anesthesia. Kwa-Nirogi Lanka, sifuna ukukhuluma ngalesi simo esibi, kodwa esingelapheka esaziwa ngokuthi i-malignant hyperthermia .
Kuyini i-Malignant Hyperthermia?
Kalula nje, i-malignant hyperthermia yisimo sofuzo . Sizuzwa ngemindeni. Uma unalesi simo, umzimba wakho ungase usabele ngobudlova uma ubhekene nemithi ethile yokubulala izinzwa ngesikhathi sokuhlinzwa. Lesi yisimo esiphuthumayo sezokwelapha esingaba yingozi uma singaphathwa ngokushesha.
Into ebaluleke kakhulu okufanele uyikhumbule ukuthi akuyona yonke imithi yokubulala izinzwa ebangela lokhu kusabela. Yiqembu elithile kuphela lemithi elibangela lokhu. Ngaphezu kwalokho, uma kutholakala ngokushesha, kungelapheka kakhulu.
Iningi labantu alazi ukuthi baphethe lolu shintsho lwezakhi zofuzo ngoba ababonisi zimpawu empilweni yansuku zonke. Inkinga iphakama kuphela uma imithi ethile yokubulala izinzwa ingena ohlelweni lwakho.
Ubani Osengozini Ephakeme?
Ingozi ihlobene kakhulu nomlando womndeni wakho.
- Umlando Womndeni: Uma isihlobo esiseduze —njengomzali, umfowabo, noma ingane—sike saba nokushisa okukhulu emzimbeni, usengozini. Kumelwe wazise udokotela wakho wezinzwa ngalo mlando womndeni ngaphambi kokuhlinzwa.
- Izinkinga ezithile zemisipha : Ngisho noma bengenawo umlando womndeni, abantu abanezinkinga ezithile zemisipha ezingavamile basengozini enkulu, okuhlanganisa:
- Isifo esiyinhloko esiphakathi
- Isifo se-Multiminicore
- I-King-Denborough syndrome
- Isifo se-STAC3
Lezi yizimo ezingavamile, kodwa uma wena noma ilungu lomndeni wakho nitholakale ninaso, kubalulekile ukudalula lokhu eqenjini lakho lezokwelapha.
Kuvamile Kangakanani?
I-hyperthermia ebulalayo ayivamile. Izibalo zisikisela ukuthi yenzeka cishe kokuhlinzwa okukodwa kwabantu abadala okungu-100,000. Kuvame kakhulu ezinganeni, kuthinta cishe kokuhlinzwa okukodwa kwangu-30,000. Okuphawulekayo ukuthi ingxenye yazo zonke izimo ezitholakele zenzeka kubantu abangaphansi kweminyaka engu-19 ubudala.
Kodwa-ke, ochwepheshe bakholelwa ukuthi abantu abaningi bangase babe nesifo sofuzo bengazi. Ngenxa yokuthi lesi simo sihlala singalali ngaphandle kokuba sitholakale kulezo zidakamizwa ezithile, abaningi abasiphethe bangase baphile impilo yabo yonke bengakaze babhekane nokusabela.
Ziyini Izimpawu?
Izimpawu zingavela ngesikhathi sokuhlinzwa noma ngemva nje kokuhlinzwa egumbini lokululama. Njengoba ungaphansi kwe-anesthesia, ngeke uzizwe lezi zimpawu wena ngokwakho. Kodwa-ke, udokotela wakho wezinzwa uzozibona ngokushesha. Uqapha izimpawu zakho ezibalulekile eduze kuyo yonke inqubo futhi uzoqala ukwelashwa okusindisa impilo ngokushesha nje lapho lezi zimpawu zivela.
| Izimpawu Zokuqala | Izimpawu Ezinzima Zakamuva |
|---|---|
| Ukwanda okungazelelwe kwesilinganiso senhliziyo (i-tachycardia) okungachazeki. | Ukushisa komzimba okuphezulu kakhulu. |
| Ukwenyuka okungazelelwe kwamazinga e-carbon dioxide (CO2). | Umchamo onombala omnyama (onsundu noma omnyama). |
| Ukuphefumula okusheshayo (i-tachypnea) . | Ukuhlolwa kwegazi okubonisa izimpawu zokuphuka kwemisipha. |
| Ukuqina kwemisipha noma ukuqina kwayo. | Ukungalingani kwesigqi senhliziyo (i-arrhythmia) . |
| Ukwenyuka okusheshayo kwezinga lokushisa lomzimba. | Ukopha okungalawuleki. |
| Ukuquleka. |
Yini Ebangela Lokhu?
Kubantu abavame ukuba ne-malignant hyperthermia, kukhona ukuguquka kwezakhi zofuzo okuthinta amaprotheni athile emaseli emisipha.
Cabanga ngamaseli emisipha yakho "njengesango" elilawula ukukhishwa kwe-calcium egciniwe. Kubantu abaningi, imithi yokubulala izinzwa ivumela leli sango ukuthi lisebenze ngendlela evamile.
Kodwa-ke, kulabo abanalolu shintsho lwezakhi zofuzo, imithi ethile yokubulala izinzwa isebenza njengesango eliphukile, okubangela ukugcwala okungazelelwe kwe -calcium emangqamuzaneni emisipha.
Lokhu kubangela ukuthi imisipha ifinyele ngokungalawuleki futhi iqine, kuphoqele ukuthi i-metabolism yomzimba ikhuphuke kakhulu, futhi kuholele ekukhuphukeni okuyingozi kokushisa komzimba. Ekugcineni, amangqamuzana emisipha ayawohloka, akhiphe izinto ezifana ne-potassium egazini, okuholela ezimpawini ezinzima okukhulunywe ngazo ngenhla.
Yimiphi imithi ebangela lokhu kusabela?
Kunezinhlobo ezimbili eziyinhloko zemithi ezibangela lokhu kusabela:
- Amagesi okubulala izinzwa aphefumulayo:
- I-Halothane
- I-Desflurane
- I-Sevoflurane
- I-Isoflurane
- Imithi efakwa ngemithambo yegazi:
- I-Succinylcholine (isiphumuli semisipha esisebenza ngokushesha)
Kuhlonzwa futhi kuqinisekiswa kanjani?
Ukuhlonza ngesikhathi sokuhlinzwa
Ngokuvamile, lesi simo sitholakala kuphela ngesikhathi sokuhlinzwa. Uma ungazi ukuthi unalesi simo, udokotela wakho wezinzwa naye uzokwazi. Kodwa-ke, ngoba bakuqapha njalo kulo lonke inqubo, baqeqeshwe ukusola ngokushesha i-Malignant Hyperthermia uma bebona lezi zimpawu ezilandelayo:
- Ukwenyuka kwesilinganiso senhliziyo yakho okungachazeki.
- Ukwenyuka okusheshayo kwezinga lokushisa komzimba .
- Amazinga aphezulu e -carbon dioxide akhishwayo.
- Ukuqina kwemisipha.
Odokotela ababulala izinzwa baqeqeshwe ngokukhethekile ukuqaphela lezi zinguquko kusenesikhathi, okubavumela ukuthi baqale ukwelashwa okusindisa impilo ngokushesha.
Ngingathola yini ukuthi ngisengozini kusengaphambili?
Uma usola ukuthi ungase ube sengozini ngenxa yomlando wezokwelapha womndeni wakho, kunezivivinyo ezikhethekile ezitholakalayo ukuqinisekisa lokhu.
- Ukuhlolwa Kokuqiniswa Kwe-Caffeine-Halothane (CHCT): Lokhu kuhilela ukuthatha isampula encane yemisipha yakho (i-muscle biopsy) bese uyibeka kugesi we-halothane kanye ne-caffeine elabhorethri. Ngokubheka indlela izicubu zemisipha ezisabela ngayo, odokotela banganquma ukuthi unesifo salesi simo.
- Ukuhlolwa Kwezakhi Zofuzo: Ukuhlolwa kwegazi kungakhomba izinguquko ezithile zezakhi zofuzo ezihlobene ne-Malignant Hyperthermia (njenge-RYR1, STAC3, noma i-CACNA1S).
Kodwa-ke, lezi zivivinyo zingabiza kakhulu futhi azitholakali kuzo zonke izikhungo zezokwelapha. Uma udinga ukuhlinzwa okuphuthumayo futhi unomlando womndeni walesi simo, odokotela ngeke balinde imiphumela yokuhlolwa; kunalokho, bazosebenzisa ngokuqinile imithi yokubulala izinzwa ephephile engabangeli lokhu kusabela .
Iphathwa kanjani?
Umuthi oyinhloko, osindisa impilo osetshenziswa ukwelapha i-Malignant Hyperthermia yi-dantrolene .
Uma nje udokotela wezinzwa esola lesi simo, unikeza lo muthi ngemithambo yegazi. Ngesikhathi esifanayo, bazokwenza okulandelayo:
- Misa ngokushesha ukuphathwa kwe-trigger anesthetic.
- Yazisa udokotela ohlinzayo bese uphetha ukuhlinzwa ngokushesha okukhulu.
- Phakamisa uketshezi olubandayo lwe-IV bese usebenzisa izindlela zokupholisa zangaphandle njengezingqwembe zeqhwa ukuze wehlise izinga lokushisa lomzimba wakho oyinhloko.
- Nikeza ukwesekwa komoya-mpilo.
- Yelapha noma yikuphi ukungasebenzi kahle kwenhliziyo.
Uma isimo sesizinzile, uzoqashwa e- Intensive Care Unit (ICU) okungenani amahora angama-24, lapho ithimba lezokwelapha lizokwenza khona ukuhlolwa kwegazi futhi linikeze noma yikuphi ukunakekelwa kokulandelela okudingekayo.
Iyini inhloso futhi yiziphi izinkinga?
Uma ithimba lezokwelapha lithola isimo ngokushesha futhi linikeze ukwelashwa okunembile, kungenzeka kakhulu ukuthi umuntu alulame ngokugcwele.
Kodwa-ke, ngisho nangokwelashwa okusheshayo, lokhu kusalokhu kuyisimo esibi esingaholela ekuhlulekeni kwezitho eziningi noma ekufeni.
Izinkinga ezingaba khona zifaka:
- Ukulimala kwemisipha.
- Ukwehluleka kwezinso.
- Ukwehluleka kwesibindi.
- Izinkinga zokopha.
- Ukuboshwa kwenhliziyo.
- Ukuquleka.
- I-Coma.
- Ukufa.
Uma ingelashwa, i-Malignant Hyperthermia ivame ukubulala. Ngisho noma ukwelashwa kusezingeni eliphezulu, izinga lokufa lilinganiselwa phakathi kuka-3% no-5%.
Ingabe kungavinjelwa?
Yebo, kungakwenza! Indlela ephumelela kakhulu yokukuvimbela lokhu ukuqinisekisa ukuthi wena kanye nethimba lakho lezokwelapha ninolwazi oluphelele mayelana nephrofayili yakho yengozi.
Uma wazi ukuthi une-genetic mutation efanele, noma uma ilungu lomndeni like labhekana nalesi simo, kufanele wazise udokotela wakho wezinzwa ngaphambi kokuhlinzwa. Bazosebenzisa kuphela imithi ephephile, ehlukile engabangeli ukusabela , okuvimbela ngempumelelo inkinga ukuthi ingenzeki.
Abantu abaningi bathola ukuthi basengozini kuphela ngemva kokuba bezwe ukusabela okuthile. Yingakho ukuqonda umlando wezokwelapha womndeni wakho kubalulekile.
Umlayezo Wokuya Nawe Ekhaya
- I-Molignant Hyperthermia iyimpendulo engavamile, ezuzwa njengefa, futhi enzima emithini ethile yokubulala izinzwa.
- Akuyona into yokungezwani komzimba; kuyisimo sofuzo.
- Isinyathelo esibaluleke kakhulu ongasithatha ukwazisa udokotela wakho kanye nodokotela wezinzwa ngaphambi kokuhlinzwa uma kukhona ilungu lomndeni elike laba nenkinga ehlobene ne-anesthesia.
- Uma ochwepheshe bezokwelapha beqaphela ingozi yakho, bangasebenzisa imithi ephephile ukuvimbela ngokuphelele lokhu kusabela.
- Nakuba kuyisimo esibucayi, singelapheka kakhulu uma sitholakale ngokushesha. Hlala unolwazi futhi unamandla, kunokwesaba.
I-Hyperthermia Eyingozi, i-anesthesia, ukuhlinzwa, ukusabela kwe-anesthesia, isifo sofuzo, i-dantrolene, umlando womndeni, ukuphepha kokuhlinzwa, izinkinga ze-anesthesia, izinkinga zofuzo
