Ingabe umama wakho osekhulile, ubaba, noma ugogo wakho uke wakuthola kunzima ukuhamba ngokuzumayo? Ingabe uhamba kancane kakhulu? Noma uzizwa sengathi inkumbulo yakho iyawohloka kancane kancane? Sivame ukucabanga ngalezi zinto njengezinto ezivamile ezenzeka njengoba sikhula. Kodwa ngezinye izikhathi, lezi zingaba izimpawu zesimo esingelapheka. Ngokufanayo, i-NPH yisimo abantu abaningi abasicabanga ngokuthi yi-dementia, kodwa empeleni yisimo esingelapheka. Ake sithole okwengeziwe ngaso namuhla.
Kalula nje, iyini i-NPH?
Incazelo ephelele ye-NPH ithi i-Normal Pressure Hydrocephalus. NgesiSinhala, isho ukuthi "i-normal pressure hydrocephalus". Kodwa kulula ukuyiqonda kunalelo gama uma wazi ukuthi lokhu kuyinto eyenzeka ebuchosheni.
Kalula nje, i-NPH yisimo lapho uketshezi olungaphakathi noluzungezile ubuchopho bethu (ngokwezokwelapha silubiza ngokuthi i-Cerebrospinal Fluid - CSF) luqoqana futhi luphazamise ukusebenza kobuchopho. Lolu ketshezi, olubizwa nge-CSF, londla ubuchopho bethu futhi lusize ekususeni imfucuza ebuchosheni. Futhi yilolu ketshezi oluvikela ubuchopho ekucindezelweni ngaphakathi kwekhanda bese lubangela ukulimala.
Ubuchopho obujwayelekile bomuntu omdala buqukethe cishe amamililitha ayi-150 alolu ketshezi. Imizimba yethu ihlala ikhiqiza lolu ketshezi, ilujikelezisa, futhi imunca uketshezi oludala. Uma nje lo mjikelezo uqhubeka kahle, akukho nkinga.
Kodwa uma kwenzeka i-NPH, ngesizathu esithile, ukumuncwa kabusha noma ukujikeleza kwegazi kwalolu ketshezi kuyaphazamiseka. Bese, lolu ketshezi luqala ukunqwabelana kancane kancane kuma-ventricle angaphakathi kobuchopho. Ngenxa yokuthi lokhu kwenzeka kaningi, ingcindezi engaphakathi kogebhezi ayikhuphuki ngokuzumayo kakhulu. Yingakho ibizwa ngokuthi "Ingcindezi Ejwayelekile". Kodwa ngokuhamba kwesikhathi, lolu ketshezi oluqongelelekile luqala ukucindezela izicubu zobuchopho futhi luzilimaze. Yilapho kuvela khona izimpawu ze-NPH.
Ubani okungenzeka kakhulu ukuthi athole lesi simo se-NPH?
I-NPH yisifo esivame ukuhlasela abantu abangaphezu kweminyaka engama-65. Ingozi yokuthola lesi sifo iyanda njengoba iminyaka ikhula. Isilinganiso sobudala bokuqala kwalesi sifo sicishe sibe yiminyaka engama-70.
Lokhu akuxhomekile ezintweni ezifana nohlanga, inkolo, noma ubulili. Ukuguga kuyisici esiyinhloko sengozi. Ngokwezibalo, u-0.2% wabantu abaneminyaka ephakathi kuka-70 no-80 kanye no-5.9% wabantu abaneminyaka engaphezu kuka-80 banalesi sifo. Lokho kusho ukuthi abantu abangaphezu kwezigidi ezingu-8 emhlabeni wonke bahlushwa yilesi sifo.
Yiziphi izimpawu eziyinhloko ze-NPH? "I-Hakim's Triad"
Kunezimpawu ezintathu eziyinhloko ze-NPH. Lezi zivela kancane kancane esikhathini esiyizinyanga ezintathu kuya kweziyisithupha. Odokotela babiza lezi zimpawu ezintathu eziyinhloko ngokuthi “i-Hakim's Triad.” Phakathi kuka-50% no-75% weziguli ze-NPH zibhekana nazo zonke lezi zimpawu ezintathu ndawonye.
Ake sibone ukuthi lezi zimpawu ezintathu ziyini.
| Isibonakaliso | Incazelo |
|---|---|
| 1. Izinkinga Zokuhamba | Lesi yisibonakaliso esivame kakhulu se-NPH. 80% - 95% yeziguli zinalesi simo. Kuzwakala sengathi izinyawo zazo zinamathele phansi. Kunzima kakhulu ukuphakamisa isinyathelo. Izinyathelo zincane kakhulu, sengathi imilenze ihudula phansi. Ngakho-ke, zihlala ziwela phansi. Ngezinye izikhathi ziyema ngokuzumayo ngenkathi zihamba, sengathi azikwazi ukuthola ukuthi zingathatha kanjani isinyathelo esilandelayo. Zingabonakala ngisho nokuhamba nesisindo sazo nhlangothi zombili, njenge-penguin. |
| 2. Ukungakwazi ukulawula umchamo (Ukungakwazi ukuzibamba) | Kuqala ngesidingo sokuchama njalo. Futhi uma kufanele uchame, uzizwa unesifiso esingalawuleki sokuchama. Ngokuhamba kwesikhathi, uqala ukuvuza umchamo ungaqapheli. Abanye abantu bazizwa benamahloni ngalokhu, kodwa ngenxa yokusebenza kobuchopho okungasebenzi kahle, ezinye iziguli zingase zingaqapheli nokuthi zivuza umchamo. |
| 3. Ubunzima Bokuqonda | Lokhu kufana kakhulu ne-dementia. Ijubane lokucabanga nokusebenza liyancipha. Konke kwenziwa kancane kakhulu. Inkumbulo iyancipha, futhi izinto zivame ukulibaleka. Kuba nzima ukwenza izinqumo nokulawula imizwa. Ulahlekelwa yisithakazelo ezintweni obuzijabulela. |
Into ebaluleke kakhulu ukufuna iseluleko sezokwelapha, kunokuchitha lezi zimpawu njengengxenye evamile yokuguga, ngoba i-NPH iyisifo esingelapheka.
Kungani le NPH ikhula? Ziyini izimbangela?
Kunezinhlobo ezimbili eziyinhloko ze-NPH, kuye ngezimbangela.
1. I-NPH Eyinhloko (Engajwayelekile)
Lolu uhlobo oluvame kakhulu. Cishe ingxenye yeziguli inalolu hlobo. Igama elithi "Idiopathic" lisho ukuthi imbangela eqondile ayaziwa.Okwamanje kukholelwa ukuthi lokhu kwenzeka ngenxa yezinguquko ezithile ekujikelezeni kwegazi kanye nokumuncwa koketshezi lwe-CSF ebuchosheni njengoba siguga.
2. I-NPH yesibili
Lokhu kwenzeka ngenxa yesinye isimo sezokwelapha noma ingozi. Okusho ukuthi, kunesinye isizathu esiphazamisa ukuhamba koketshezi lwe-CSF ebuchosheni. Ezinye zalezi zizathu zifaka:
- Ukulimala Kobuchopho Okubuhlungu
- Izimila Zobuchopho
- Isifo sohlangothi
- Ukopha Kwangaphakathi Kwekhanda
- I-Aneurysm yobuchopho
- Ukutheleleka kobuchopho njenge-meningitis
- Ukuhlinzwa kobuchopho
Udokotela uyixilonga kanjani i-NPH ngokunembile?
Ukuxilonga i-NPH kungaba nzima ngoba izimpawu zayo zifana kakhulu nezimo ze-dementia ezifana nesifo i-Alzheimer's. Ngezinye izikhathi, i-NPH ingahambisana nesifo i-Alzheimer's.
Udokotela usebenzisa izivivinyo eziningana ukuze axilonge lesi sifo.
- Ukuhlolwa ngokomzimba nangokwezinzwa: Udokotela uzohlola ukuhamba kwakho, ibhalansi, ukusabela komzimba, kanye namandla emisipha.
- Ukubuza ngezimpawu nomlando wezokwelapha: Buza amalungu omndeni wakho ukuthi lezi zimpawu zaqala kanjani nokuthi sezinesikhathi esingakanani zikhona.
- Ukuskena kobuchopho: Lokhu ukuhlolwa okubaluleke kakhulu. Ukuskena kwe-MRI (Magnetic Resonance Imaging) kungabona ngokucacile ukuthi ama-ventricle, lapho uketshezi lwe-CSF luqongelela khona, akhulisiwe yini. Ngezinye izikhathi ukuskena kwe-CT (Computed Tomography) kwenziwa futhi ukuze kunqunywe ezinye izimo.
- Ukubhoboza Umgogodla/Ukushaya Ithambo: Lokhu futhi kuyindlela ebaluleke kakhulu yokuhlola. Lapha, kufakwa inalithi encane emgogodleni bese kuthathwa isampula yoketshezi lwe-CSF. Lokhu kungasetshenziswa ukuhlola ezinye izifo. Futhi, okubaluleke kakhulu, kubalulekile ukubona ukuthi izimpawu zesiguli, njengobunzima bokuhamba, ziyathuthuka yini okwesikhashana ngemva kokususa olunye uketshezi lwe-CSF olwengeziwe. Uma kwenzeka, kuyisibonakaliso esinamandla sokuthi kukhona i-NPH.
Ingabe ikhona indlela yokwelapha lokhu? Ingabe ingelapheka?
Yebo! Lezi yizindaba ezinhle nge-NPH. Nakuba kungase kubonakale sengathi yi-dementia, i-NPH ivame ukuba yisifo esingelapheka . Imithi ayisebenzi kahle. Ukwelashwa okuyinhloko nokuphumelela kakhulu ukuhlinzwa.
Lokhu kuhlinzwa kuhilela ukuxhuma idivayisi encane efana nethubhu ebizwa ngokuthi i-shunt ebuchosheni.
- Cabanga ngalokhu njengepayipi elikhipha amanzi engeziwe.
- Esinye isiphetho sale shunt sixhunywe ekamelweni ebuchosheni lapho uketshezi lwe-CSF luqoqene khona.
- Esinye isiphetho sifakwa ngaphansi kwesikhumba emgodini wesisu (isisu) noma esifubeni.
- Uketshezi lwe-CSF oluthe xaxa oluqongelela ebuchosheni luhamba ngaleli payipi luthululele endaweni efana nomgodi wesisu, lapho umzimba ungaphinde umunce khona uketshezi.
Ngemva kwalokhu kuhlinzwa, izimpawu zeziguli ziqala ukuthuthuka kakhulu emahoreni ambalwa noma ezinsukwini ezimbalwa. Lokhu kuphumela emiphumeleni emihle kakhulu, ikakhulukazi uma kunzima ukuhamba.
Uma kwenzeka i-NPH yesibili, isifo esibangele i-NPH (isib., isimila sobuchopho) siphathwa kuqala.
Yiziphi izinkinga ezingaba khona ngemva kokwelashwa?
Nakuba ukuhlinzwa kwe-shunt ngokuvamile kuphephile, njenganoma yikuphi ukuhlinzwa, kunezingozi ezithile.
- Ukutheleleka.
- I-shunt ivinjiwe noma ayisebenzi kahle.
- I-shunt itholakala ku-verr.
- Ukuphuma koketshezi lwe-CSF oluningi ebuchosheni (lokhu kungabangela izimpawu ezifana nobuhlungu bekhanda).
Uma kwenzeka into efana nale, ingatholakala futhi yelashwe ngokushesha. Ngakho-ke, kubaluleke kakhulu ukulandela imiyalelo kadokotela ngemva kokuhlinzwa kanye nokuya emitholampilo ngezinsuku ezihleliwe.
Yini ongayilindela uma uhlala ne-NPH?
Umphumela we-NPH uvame ukuxhomeka ekutheni lesi sifo sitholakala futhi selashwe ngokushesha kangakanani . Uma ukwelashwa kunikezwa kamuva, kulapho amathuba okuba umonakalo wobuchopho ube khona unomphela.
Njengoba isiguli singase singazi izimpawu zaso, umndeni nabathandekayo banomthwalo wemfanelo omkhulu kulokhu. Uma ubona lezi zimpawu kothandekayo wakho, kubaluleke kakhulu ukumyisa kudokotela, kunokucabanga ukuthi kuyinto evamile yokuguga.
Nanka amathuba okuphela kwezimpawu ngemva kokwelashwa:
- Ubunzima bokuhamba: Cishe ama-85% eziguli ayalulama.
- Ukungakwazi ukuzibamba komchamo: Cishe ama-80% eziguli ayalulama.
- Ukukhubazeka kokucabanga kanye nokukhumbula: Cishe ama-80% eziguli ayalulama.
Ake sibheke izici ezithinta umphumela wesifo se-NPH kuthebula elingezansi.
| Izici ezandisa amathuba okuthola umphumela omuhle | Izici ezinciphisa amathuba okuthola umphumela omuhle |
|---|---|
| Ukuxilongwa kusenesikhathi kanye nokwelashwa kwalesi sifo. | Ukuphuza ukuxilongwa nokwelashwa kwalesi sifo. |
| Okokuqala kwaba nobunzima bokuhamba, kwabe sekuba nezinkinga zokukhumbula. | Okokuqala, izinkinga zenkumbulo ziyaqala. |
| Izimpawu ziyathuthuka okwesikhashana ngemva kokuthatha amanzi ngemuva. | Ukukhubazeka okukhulu kwenkumbulo nokucabanga. |
| I-NPH yesibili ibangelwa yisifo esingelapheki. | Ukuba khona kwezinye izifo zobuchopho ezifana ne-Alzheimer's. |
Kufanele ngibone nini udokotela? Zingaki izikhathi zokuya e-ETU?
Uma othile emndenini wakho ene-shunt, kufanele uqaphele kakhulu izimpawu ezithile. Lezi kungaba izimpawu zenkinga nge-shunt noma ukutheleleka.
Uma kuvela noma yiziphi izimpawu ezilandelayo, shayela udokotela wakho ngokushesha noma uye eMnyangweni Wezimo Eziphuthumayo (ETU) wesibhedlela .
- Ikhanda elibuhlungu kakhulu: Uma ikhanda liba libi kakhulu, ikakhulukazi lapho uhleli noma umile, lokhu kungaba uphawu lokuthi ukuphuma kwamanzi kusuka ku-shunt kunciphile noma kuyanda.
- Umkhuhlane noma ukubanda: Lokhu kungaba uphawu lokutheleleka ngemva kokuhlinzwa. Ungalokothi ungazinaki lezi zinhlobo zokutheleleka ngoba zingasakazeka ngokushesha.
- Intamo eqinile.
- Ubuhlungu esifubeni noma esiswini lapho ipayipi le-shunt lidlula khona.
- Ukuvela kabusha kwezimpawu ze-NPH ezindala (ubunzima bokuhamba, izinkinga zomchamo).
Umlayezo Wokuya Nawe Ekhaya
- Ungakunaki ukuhamba, ukungakwazi ukuzibamba, kanye nokulahlekelwa yinkumbulo njengokuguga okuvamile. Lokhu kungaba izimpawu zesimo esibizwa ngokuthi i-NPH.
- I-NPH yisimo esibangelwa ukuqongelela koketshezi lomgogodla (CSF) ebuchosheni.
- Nakuba ingavela nezimpawu ezifana ne-dementia, i-NPH yisifo esivame ukwelashwa ngokuhlinzwa.
- Uma lesi sifo sitholakala ngokushesha, umphumela uba ngcono. Ngakho-ke, ukunakwa komndeni nabathandekayo kubaluleke kakhulu lapha.
- Uma othandekayo wakho enalezi zimpawu, sicela ubonane nodokotela ofanelekayo ngokushesha.
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