Ake sifunde nge-Malignant Hyperthermia, ukusabela okuyingozi kokubulala izinzwa ngesikhathi sokuhlinzwa.

Uma wena noma othile emndenini wakho kudingeka ahlinzwe, uzonikezwa i-anesthesia ngaphambi kokuba ihlinzwe, akunjalo? Kalula nje, kusenza silale ngokuphelele. Kodwa kwabanye abantu, eminye yemithi esetshenziswa kule anesthesia ingabangela ukusabela okubi kakhulu, ngisho nokusongela ukuphila. Namuhla sikhuluma nge- malignant hyperthermia , isimo esiyingozi kodwa esingelapheka uma sitholakala kusenesikhathi.

Kuyini i-Malignant Hyperthermia?

Kalula nje, i-Malignant Hyperthermia yisimo sofuzo. Lokhu kusho ukuthi siyisifo sofuzo. Uma umuntu onalesi simo evezwa ezinhlotsheni ezithile ze-anesthesia ngesikhathi sokuhlinzwa, umzimba wakhe usabela kakhulu. Lesi yisimo esiphuthumayo esisongela ukuphila. Kodwa into ebaluleke kakhulu lapha ukuthi lokhu akwenzeki kuyo yonke imithi esetshenziselwa i-anesthesia ngesikhathi sokuhlinzwa. Inani elincane kakhulu lemithi elibangela lokhu kusabela. Ngaphezu kwalokho, uma kutholakala, kungelashwa ngokushesha. Esikhathini esiningi, umuntu akazi ukuthi une-gene mutation ehlobene nalokhu emzimbeni wakhe. Ngoba akabonisi zimpawu empilweni evamile. Inkinga ivela kuphela lapho lowo muthi othize we-anesthesia ungena emzimbeni.

Ubani osengozini enkulu?

Le ngozi ivame ukuba khona uma othile emndenini enalesi simo.

• Umlando womndeni: Uma isihlobo sakho esiseduze - umama, ubaba, umfowenu, udadewenu, noma ingane - sibe ne-malignant hyperthermia, usengozini enkulu. Ngakho-ke, uma kwenzeka uhlinzwa, kubalulekile ukutshela udokotela wezinzwa ngalo mlando womndeni .
• Izifo ezithile zemisipha : Ngisho noma kungekho muntu emndenini wakho oke waba nale nkinga, abantu abanezifo ezithile zemisipha ezingavamile basengozini enkulu. Isibonelo:
• Isifo esiyinhloko esiphakathi
• Isifo se-Multiminicore
• I-King-Denborough syndrome
• Isifo se-STAC3

Lezi yizimo ezingavamile kakhulu, kodwa uma wena noma othile emndenini wakho enaso, kubalulekile ukwazisa udokotela wakho.

Sivame kangakanani lesi simo?

Empeleni lesi akusona isimo esivamile kakhulu. Ngokwezibalo, lesi simo senzeka cishe kokuhlinzwa okukodwa kwabayi-100,000 kubantu abadala. Phakathi kwezingane ezincane, leli nani liphakeme kancane, okungukuthi, kokuhlinzwa okukodwa kwabayi-30,000. Kuyaphawuleka futhi ukuthi ingxenye yeziguli ezitholakele zingaphansi kweminyaka eyi-19. Kodwa-ke, ososayensi bacabanga ukuthi abantu abanesifo sofuzo salokhu bangase bavame kakhulu emphakathini. Lokhu kungenxa yokuthi, noma ngabe banaso lesi sifo, uma bengatholakali emithini yokubulala izinzwa ebangela lokho kusabela kukho konke ukuphila kwabo, lesi simo ngeke siphinde sivele.

Ziyini izimpawu zalokhu?

Lezi zimpawu zingavela ngesikhathi sokuhlinzwa noma ngemva nje kokuhlinzwa ngenkathi usalulama. Uma unalezi zimpawu ngenkathi ulele futhi ungaphansi kwe-anesthesia, ngeke uzizwe. Kodwa udokotela wakho wezinzwa uzozibona. Uzoqapha izimpawu zakho ezibalulekile ngokucophelela phakathi nokuhlinzwa. Ngakho-ke bazoqala ukwelashwa ngokushesha nje lapho bebona lezi zimpawu.

Kungani lokhu kwenzeka? Iyini imbangela?

Abantu abavame ukuba ne-Malignant Hyperthermia banoshintsho lwezakhi zofuzo, okungukuthi, ukuguquka kwezakhi zofuzo, kwamanye amaprotheni emaseli emisipha yabo. Cabanga ukuthi amangqamuzana ethu emisipha ane-calcium egcinwe ngaphakathi kwawo. Ukukhishwa kwale calcium kulawulwa yinto efana nesango. Uma umuntu ojwayelekile enikezwa imithi yokubulala izinzwa, leli sango lisebenza ngendlela elawulwayo. Lokhu kubangela ukuthi imisipha ifinyele futhi iqine, i-metabolism yomzimba iqala ukushesha, futhi izinga lokushisa lomzimba likhuphuka ngendlela eyingozi. Ekugcineni, amangqamuzana emisipha ayafa, futhi inani elikhulu lezinto ezifana ne-potassium liqoqana egazini. Ezinye izimpawu ezinkulu zivela ngenxa yalezi zizathu.

Yimiphi imithi ebangela lokhu kusabela?

Lesi simo sibangelwa kakhulu amaqembu amabili emithi.

• Izinzwa eziphefumulayo:
• I-Halothane
• I-Desflurane
• I-Sevoflurane
• I-Isoflurane
• Imithi efakwa ngemithambo yegazi:
• I-Succinylcholine (lena iyisiphumuli semisipha esisebenza ngokushesha)

Ukubona futhi ukuqinisekise kanjani lokhu?

Ukutholwa ngesikhathi sokuhlinzwa

Kuvame ukutholakala ngesikhathi sokuhlinzwa. Uma ungazi ukuthi unalesi simo, nodokotela wakho wezinzwa ngeke akwazi. Kodwa uzobe ekuqapha phakathi nokuhlinzwa futhi angase asole ukuthi une-malignant hyperthermia uma ebona izinguquko ezilandelayo:

• Ukwanda kwesilinganiso senhliziyo ngaphandle kwesizathu.
• Ukwenyuka okusheshayo kwezinga lokushisa lomzimba .
• Inani elikhulayo le -carbon dioxide elikhishwayo.
• Ukuqina kwemisipha.

Odokotela ababulala izinzwa baqeqeshwe ukuqaphela lezi zinguquko ngokushesha, ukuze baqale ukwelashwa ngokushesha.

Kungenzeka yini ukwazi kusengaphambili ukuthi kukhona yini ingozi?

Uma usola ukuthi unale ngozi ngenxa yomlando womndeni wakho, kunezivivinyo eziningana ezikhethekile zokuqinisekisa lokho.

• Ukuhlolwa Kokuqunjelwa Kwe-Caffeine Halothane (CHCT): Lokhu kuhilela ukuthatha ingxenye encane kakhulu yomsipha wakho (i-muscle biopsy) bese uyibeka kugesi we-halothane kanye ne-caffeine elabhorethri. Indlela umsipha osabela ngayo ingasetshenziswa ukunquma ukuthi uthambekele kulesi simo yini.
• Ukuhlolwa kofuzo: Lokhu kuhlolwa, okubandakanya ukuthatha isampula yegazi, kungathola izinguquko zofuzo (isb., i-RYR1, i-STAC3, i-CACNA1S) ezihlotshaniswa ne-Malignant Hyperthermia.

Kodwa lezi zivivinyo zibiza kancane, futhi azitholakali yonke indawo eSri Lanka. Ngakho-ke, uma udinga ukuhlinzwa okuphuthumayo futhi othile emndenini wakho enalesi simo, odokotela ngeke balinde izivivinyo futhi bazosebenzisa kuphela izinzwa eziphephile ezingeke zibangele lokhu kusabela kuwe.

Iphathwa kanjani?

Umuthi oyinhloko nosindisa impilo onikezwa uma kwenzeka i-hyperthermia embi yi-dantrolene . Lapho nje udokotela wezinzwa esola lesi simo, umnika lo muthi ngokushesha nge-intravenous. Ngesikhathi esifanayo,

• I-anesthetic ebangela ukusabela iyamiswa ngokushesha.
• Udokotela ohlinzayo uzokwaziswa futhi ukuhlinzwa kuzoqedwa ngokushesha okukhulu.
• Ukuze kuncishiswe izinga lokushisa lomzimba eliphezulu , kunikezwa uketshezi olubandayo lwe-IV emithanjeni, bese umzimba upholiswa ngezinto ezifana nama-ice packs.
• Inikeza umoya-mpilo.
• Yelapha izinkinga zesigqi senhliziyo.

Uma isimo sesilawulekile, uzogcinwa egunjini lokunakekelwa okujulile (ICU) okungenani usuku, lapho ithimba lezokwelapha lizokuqapha khona. Phakathi nalesi sikhathi, bazokwenza ukuhlolwa kwegazi okwengeziwe futhi banikeze ukwelashwa okwengeziwe njengoba kudingeka.

Sizoba njani isimo? Ziyini izinkinga?

Uma ithimba lezokwelapha lithola lesi simo ngokushesha futhi liselapha ngendlela efanele, kungenzeka ukululama okuphelele. Izinkinga ezingavela kulokhu yilezi:

• Ukulimala kwemisipha.
• Ukwehluleka kwezinso.
• Ukwehluleka kwesibindi.
• Ukopha.
• Ukuboshwa kwenhliziyo.
• Ukuquleka.
• Ukuya e-coma.
• Ukufa.

I-Molignant Hyperthermia yisimo esivame ukuba yingozi uma singelashwa. Ngisho noma ukwelashwa kufanele, izinga lokufa liphakathi kuka-3% no-5%.

Ingabe lokhu kungavinjelwa?

Yebo, kungavinjelwa! Indlela engcono kakhulu yokwenza lokhu ukuqaphela ingozi yakho kuwe nakudokotela wakho. Uma wazi ukuthi une-genetic mutation ehlobene nalokhu, noma uma wazi ukuthi othile emndenini wakho unalesi simo, kufanele utshele udokotela wezinzwa ngaphambi kokuhlinzwa. Lapho ekunikeza isibulala-zinzwa, uzosebenzisa imithi ephephile ngokuphelele esikhundleni saleyo mithi eyingozi. Khona-ke lokho kusabela okuyingozi ngeke kwenzeke. Abantu abaningi bathola ukuthi banale ngozi kuphela ngemva kokuba yenzeke kubo. Yingakho kubaluleke kakhulu ukwazi umlando wezokwelapha womndeni wakho. I-Hyperthermia Eyingozi, i-anesthesia, ukuhlinzwa, ukusabela kwe-anesthesia, isifo sofuzo, i-dantrolene, umlando womndeni, ukuphepha kokuhlinzwa, izinkinga ze-anesthesia, izifo zofuzo