Ingabe uyazwela kakhulu ekubulaweni yizinzwa? Ake sifunde ngokuthi (Pseudocholinesterase Deficiency)?

Wake wazizwa wesaba kancane nge-anesthesia oyinikwayo lapho uhlinzwa? Kujwayelekile ukuthi abanye abantu bazizwe ngaleyo ndlela. Kodwa cabanga ukuthi bekuzokwenzekani uma eminye yemithi ye-anesthesia oyinikwayo ibingafanele umzimba wakho. Namuhla sizokhuluma ngesimo esingavamile, kodwa esibaluleke kakhulu okufanele usiqaphele. Leso yisimo esibizwa ngokuthi `(Pseudocholinesterase Deficiency)`.

Kuyini `(Pseudocholinesterase Deficiency)`? Ake sikuqonde kalula, akunjalo?

Kulungile, leli gama lizwakala lide kancane, akunjalo? Ake sikwenze kube lula. `(Pseudocholinesterase)` iyi-enzyme ekhethekile `(Enzyme)` emzimbeni wethu. Omunye wemisebenzi eyinhloko yale `(Enzyme)` ukuphula (okungukuthi, `(metabolize)`) emzimbeni eminye yemithi enikezwa ukuphumula imisipha , ikakhulukazi uma sidakwa (siyibiza ngokuthi `(Choline esters)`). Cabanga nje, ngesikhathi sokuhlinzwa, imisipha yakho idinga ukukhubazeka isikhashana. Lena yimithi enikezwa lokho.

Manje, esimweni esibizwa ngokuthi `(Pseudocholinesterase Deficiency)`, okwenzekayo ukuthi le `(Enzyme)` ebizwa ngokuthi `(Pseudocholinesterase)` emzimbeni wakho ayikhiqizwa ngokwanele , noma ayisebenzi kahle . Kwenzekani-ke? Imithi enikezwa ukukhulula imisipha (`(Succinylcholine)` kanye `(Mivacurium)` iyizibonelo ezimbili zalokhu) ayisuswa emzimbeni ngokushesha. Ihlala emzimbeni isikhathi eside.

Ngenxa yalokho, imisipha yakho ingase ihlale indikindiki isikhathi eside ngemva kokuhlinzwa, futhi ungase ube nobunzima bokuphefumula. Lokhu kusho ukuthi ungase ungakwazi ukunyakaza noma ukuphefumula wedwa kuze kube yilapho imiphumela yomuthi iphela.

Sivame kangakanani lesi simo?

Empeleni, lesi simo esibizwa ngokuthi `(Pseudocholinesterase Deficiency)` asivamile kangako . Ngokwesilinganiso, cishe umuntu oyedwa kwabangu-3,200 noma abangu-5,000 emphakathini ubhekana nalesi simo. Okusho ukuthi, inani elincane kakhulu.

Ziyini izimpawu? Ukubona kanjani lokhu?

Iningi labantu abanalesi simo abazi kuze kube yilapho bethola uhlobo lomuthi wokubulala izinzwa engikhulume ngawo ekuqaleni, obizwa ngokuthi "ama-Choline esters." Yilapho izimpawu eziyinhloko zivela khona:

• Imisipha ekhululeke kakhulu (okungukuthi, engaphili) isikhathi eside kunalokho obekulindelekile.
• Ngisho nemisipha ekusiza ukuphefumula ayisebenzi okwesikhashana .

Kungathatha amahora ambalwa ukuthi lezi zimpawu ziphele. Lesi sikhathi siyahlukahluka kuye ngomuntu nomuntu. Phakathi nalesi sikhathi, ithimba lakho lezokwelapha lizokugcina ungaphansi kwe-anesthesia futhi likusize uphefumule nge-"ventilator", umshini wokuphefumula owenziwe, uze ukwazi ukuphefumula wedwa.

Ziyini izimbangela? Lokhu kwenzeka kanjani?

Lesi simo (Pseudocholinesterase Deficiency) singatholakala njengefa (okungukuthi, sitholakale njengefa), noma singakhula kamuva ekuphileni..

Izimbangela ezizuzwe njengefa

Abantu abazalwa benalesi simo banoshintsho, noma ukuguquka, ku-gene ebizwa ngokuthi `(BCHE)`. Le gene `(BCHE)` yiyo etshela umzimba wethu ukuthi wenze i-enzyme `(Pseudocholinesterase)`. Ngakho-ke, uma kukhona ushintsho kule gene, umzimba wakho ukhiqiza okuncane kakhulu kwale enzyme, noma ungase ungayikhiqizi nhlobo.

Izimbangela ezikhula ngesikhathi sokuphila (Ezitholwe)

Ngezinye izikhathi, lesi simo (Pseudocholinesterase Deficiency) singase senzeke impilo yonke. Singabangelwa izifo ezahlukahlukene kanye nemithi ethile.

Ezinye izifo ezingadala lesi simo:

• Ukungondleki kahle
• Ukulimala okukhulu kokusha
• Isifo sezinso
• Isifo sesibindi
• I-Hypothyroidism (i-thyroid engasebenzi kahle)
• Umdlavuza
• Ukukhulelwa

Eminye imithi engandisa ingozi yalesi simo ihlanganisa:

• Ama-MAO inhibitors (isb. Phenelzine (Nardil®))
• Amaphilisi okuvimbela inzalo (Imithi yokuvimbela inzalo ngomlomo)
• Amaconsi eso e-Echothiophate
• I-Metoclopramide
• I-Cyclophosphamide
• I-Pyridostigmine

Odokotela bakuthola kanjani lokhu?

Uma unenkinga yokulawula imisipha yakho noma ukuphefumula ngemva kokubulala izinzwa okuvamile, udokotela wakho angase asole ukuntuleka kwe-pseudocholinesterase. Ukuqinisekisa lokhu, bangenza ukuhlolwa kwegazi ukuhlola amazinga akho e-enzyme i-pseudocholinesterase.

Uma othile emndenini wakho enalesi simo, udokotela angenza ukuhlolwa kofuzo ukuze athole ukuthi nawe unayo yini. Lokhu kuhilela ukuthatha isampula yegazi bese ehlola ukuthi unayo yini i-gene mutation (BCHE).

Uma udokotela wakho esola ukuthi unalesi simo, uzosebenzisa ezinye izinhlobo zeziphumuli zemisipha ezingancikile ku-enzyme ethi ``Pseudocholinesterase''.

Iyini indlela yokwelapha?

Uma uba nezimpawu zokuthi `(Pseudocholinesterase Deficiency)` ngemva kokunikezwa i-anesthesia ejwayelekile, ungase udinge ukunakekelwa kwezokwelapha okuphuthumayo. Ithimba lezokwelapha lizokuqapha eduze uze ululame. Uma kudingeka, bazokugcina ngaphansi kwe-anesthesia futhi basebenzise umshini `womoya womshini`` ukuze bakusize uphefumule uze ukwazi ukuphefumula wedwa.

Yini okufanele uyilindele uma unalesi simo?

Uma kutholakale ukuthi unesifo `(Pseudocholinesterase Deficiency)`, into engcono kakhulu ongayenza ukwazisa odokotela bakho ngakho - ikakhulukazi odokotela abazokubona ukuze uhlinzwe .

Futhi, udinga ukutshela umndeni wakho ngalokhu., khona-ke bangahlolwa ukuze kubonakale ukuthi banayo yini i-`(BCHE)` yokuguqulwa kwezakhi zofuzo. Uma kunjalo, kufanele futhi bazise odokotela babo ngaphambi kokuhlinzwa.

Kungumqondo omuhle futhi ukugqoka isongo se-medical ID ukuze odokotela bazi ukuthi udinga ukuhlinzwa okuphuthumayo.

Ingabe lokhu kungavinjelwa?

Ukuntuleka kwe-Pseudocholinesterase kuyisimo sokuzalwa esingenakuvinjelwa. Kodwa-ke, uma othile emndenini wakho enaso, ungahlolwa ukuthi une-BCHE gene mutation ngaphambi kokwenza i-anesthesia ejwayelekile. Lokhu kungasiza ekuvimbeleni izinkinga ngesikhathi sokuhlinzwa.

Uma une-genetic mutation, udokotela wakho cishe uzokweqa ama-Choline esters bese ekhetha i-anesthetic ehlukile. I-Rocuronium iyi-anesthetic esetshenziswa kakhulu kubantu abane-Pseudocholinesterase Deficiency.

Ungase ukwazi ukunciphisa ingozi yakho yokuthola i-Acquired Pseudocholinesterase Deficiency kamuva empilweni ngokwelapha izimo eziyisisekelo, njengokungondleki kahle noma isifo sezinso esingamahlalakhona (CKD). Futhi, uma uthatha noma yimiphi imithi enciphisa ukukhiqizwa kwe-enzyme i-Pseudocholinesterase, ungase ufune ukukhuluma nodokotela wakho mayelana nokushintsha imithi yakho.

Yiziphi izinto ezingahambisani nalokhu, okungukuthi, yimiphi imithi engalungile ukuyisebenzisa kubantu abanalesi simo?

Uma utholakale une-`(Pseudocholinesterase Deficiency)`, kufanele ugweme izinhlobo ezilandelayo zemithi yokubulala izinzwa :

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

Imibuzo okufanele uyibuze udokotela wakho

Uma unesifo esibizwa ngokuthi "i-Pseudocholinesterase Deficiency", kungakhathaliseki ukuthi wazalwa unaso noma wasithola kamuva, ungase ufune ukubuza udokotela wakho imibuzo efana nalokhu:

• Yiziphi izithiyo eziqondile kimi, okungukuthi, yimiphi imithi okufanele ngiyigweme?
• Ingabe lesi simo siyinto engazalwa nayo noma sibangelwa esinye isifo?
• Ingabe kuwumqondo omuhle ukuba kwenziwe ukuhlolwa kofuzo emndenini wami?

Ukuya ekuhlinzweni kungaba yinto ecindezelayo kancane. Iningi lethu ligxile kakhulu ekuhlinzweni kangangokuthi asicabangi ngisho nangokuba khona kokusabela okubi ekubulaweni yi-anesthesia. Akukho ukwelashwa kwe-Pseudocholinesterase Deficiency. Kodwa-ke, ukwazi ukuthi unayo yini kungakusiza ugweme ubuthakathaka besikhashana bemisipha kanye nobunzima bokuphefumula obungenzeka ngemva kokuhlinzwa. Uma une-Pseudocholinesterase Deficiency, tshela amalungu omndeni wakho ngakho. Bangaphinde bahlolwe i-gene futhi bagweme noma yiziphi izinkinga ezingadingekile ezingase zivele phakathi nohambo lwabo lwezempilo.

Okokugcina, izinto okufanele uzikhumbule

Ngakho-ke, igama elithi `(Pseudocholinesterase Deficiency)` liyesabeka kancane, kodwa kubaluleke kakhulu ukuliqaphela. Ikakhulukazi uma uzohlinzwa, noma uma othile emndenini wakho eke wabhekana nento efana nale , kungcono ukukhuluma nodokotela bakho ngalokhu. Khumbula, ukuqwashisa ngokuvamile kuyisivikelo esihle kakhulu esingasisindisa ezinkingeni ezingadingekile!

I - Anesthesia, i-pseudocholinesterase, ukuntuleka kwama-enzyme, izinkinga zokuhlinzwa, isimo sofuzo, ukungasebenzi kahle kwemisipha, imithi yokubulala izinzwa