Ingabe nawe uvele uphelelwe amandla bese uyawa? (I-Syncope) - Ake sixoxe ngalokhu!

Wake wambona umuntu equleka ngokuzumayo? Noma ingabe kwenzeke kuwe? Cabanga ngengane iquleka ngesikhathi somhlangano wasekuseni esikoleni, noma othile equleka ngokuzumayo elinde emgqeni. Lokhu kuyesabeka kancane. Thina odokotela sikubiza ngokuthi i-syncope . Kalula nje, lokhu kuwukuquleka, noma ukulahlekelwa ingqondo. Ake sixoxe ngalokhu ngokuningiliziwe namuhla, akunjalo?

Kuyini ngempela i-Syncope?

Kalula nje, i-syncope ukwehla okungazelelwe, okwesikhashana kwenani legazi eligeleza ebuchosheni bakho. Yilapho siphelelwa amandla noma silahlekelwa ukwazi. Isikhathi esiningi, kubangelwa yinto encane futhi ehlala isikhathi esifushane.

Ungakwazi:

• Uma umfutho wegazi lakho wehla ngokuzumayo.
• Uma ukushaya kwenhliziyo yakho kwehla.
• Uma kukhona izinguquko enanini legazi ezingxenyeni ezahlukene zomzimba wakho.

Uma uquleka, uzophinde uqaphe ngemizuzwana noma imizuzu. Kodwa-ke, ungase uzizwe unesizungu futhi ukhathele isikhashana ngemva kwalokho. Kungathatha imizuzu noma amahora ukuthi ululame ngokugcwele.

Kodwa-ke, lesi simo esibizwa ngokuthi i-syncope ngezinye izikhathi singaba uphawu lwesimo esibucayi kakhulu. Ngakho-ke, uma uquleka, kubaluleke kakhulu ukubona udokotela ukuze uthole imbangela bese uthola ukwelashwa. Iningi labantu lingalawula lesi simo uma lixilongwa kahle futhi lithola ukwelashwa okufanele.

Ingabe kunezinhlobo ezahlukene ze-syncope?

Yebo, kunezinhlobo ezahlukene ze-syncope . Ake sibone ukuthi ziyini:

• I-Vasovagal syncope: Ebizwa nangokuthi i-neurocardiogenic syncope , lolu uhlobo oluvame kakhulu lwe-syncope. Lubangela cishe ingxenye yazo zonke izimo zokuquleka.
• I-syncope yesimo: Lolu futhi uhlobo lwe- vasovagal syncope, oluchazwe ngenhla. Okusho ukuthi, kwenzeka kuphela ezimweni ezithile.
• I-Postural noma i-orthostatic syncope: Ebizwa nangokuthi i-postural hypotension , lesi yisimo esenzeka uma ushintsha indawo (isibonelo, lapho uvuka ngokuzumayo elele embhedeni).
• Ukuphazamiseka kwenhliziyo: Lokhu kwenzeka lapho ukugeleza kwegazi ebuchosheni kuncipha ngenxa yenkinga yenhliziyo noma imithambo yegazi.
• I-neurologic syncope: Lokhu kungabangelwa yisifo sesimiso sezinzwa.
• I-Postural Orthostatic Tachycardia Syndrome (i-POTS):Okwenzekayo kulokhu ukuthi ukushaya kwenhliziyo kukhula ngokuzumayo kakhulu uma usukuma uhleli noma ulele phansi.
• I-syncope enembangela engaziwa: Ngezinye izikhathi kunzima ukuthola imbangela eqondile yokuquleka.

Kuvamile kangakanani lokhu?

I-syncope yisimo esivame kakhulu. Sithinta cishe amaphesenti amathathu amadoda kanye namaphesenti amathathu namashumi amahlanu abesifazane ngesikhathi sokuphila kwabo. Siba sivame kakhulu ngokweminyaka, sithinta cishe amaphesenti ayisithupha abantu abangaphezu kweminyaka engu-75. Singenzeka kunoma yimuphi ubudala, kubantu abanezinye izimo zezokwelapha noma abangenazo.

Yiziphi izimpawu ozizwayo ngaphambi kokuquleka?

Ngokuvamile, ngaphambi kokuquleka, ungase ube nezimpawu ezifana nalezi:

• Ukuzizwa sengathi amehlo aphenduka abe luhlaza okwesibhakabhaka (amnyama).
• Ukuzizwa unekhanda elibuhlungu, unesiyezi.
• Ukuhudulelwa phansi ngaphandle kwesizathu.
• Ukuzizwa ulele noma uthukuthele.
• Ukuzizwa ubuthakathaka, ikakhulukazi ngemva kokudla noma ukuzivocavoca.
• Ukuzizwa ungazinzile noma ubuthakathaka lapho umi noma uhamba.
• Ukushintsha kombono - njengokubona amachashazi phambi kwamehlo, noma umbono womhubhe (njengokubuka ngepayipi).
• Ikhanda elibuhlungu.

Okubalulekile: Uma uhlangabezana nalezi zimpawu njalo, qiniseka ukuthi ubona udokotela.

Kungani sizizwa sibuthakathaka kangaka? (Ziyini izizathu?)

Imbangela eyinhloko yokuquleka ukungafiki kwegazi elanele ebuchosheni. Lokhu kungaba nezimbangela ezahlukahlukene, okuhlanganisa nezinhlobo ze -syncope esixoxe ngazo ekuqaleni. Abantu abaningi bangase babe nesimo sezokwelapha esingaphansi esithinta uhlelo lwabo lwezinzwa noma inhliziyo abangasazi. Noma, ungase ube nesimo esithinta ukugeleza kwegazi emzimbeni wakho, okubangela umfutho wegazi wakho wehle uma ushintsha izikhundla (isibonelo, lapho usukuma ulele phansi).

Izimbangela ze-Vasovagal Syncope

Lokhu kwenzeka ngoba umfutho wegazi wakho wehla ngokuzumayo, kunciphisa inani legazi eliya ebuchosheni bakho. Lokhu kuvame ukwenzeka ngemva kokuma isikhashana, noma lapho ubhekene nokucindezeleka okukhulu, ukudabuka, noma ukwesaba. Cabanga nje, umi elangeni isikhathi eside ehholo elikhulu lesikole sakho ukuze uhlangane ekuseni, bese uzizwa unesizungu futhi uphelelwe amandla. Ngokuvamile, lapho sima, amandla adonsela phansi abangela ukuba igazi lethu lihlangane ezingxenyeni ezingezansi zomzimba wethu, ngaphansi kwe-diaphragm . Uma lokhu kwenzeka, inhliziyo yethu kanye nesistimu yezinzwa ezizimele zisebenza ndawonye ukugcina umfutho wegazi wethu uzinzile.

Kodwa, lokhu kuyi -vasovagal syncope.Kulesi simo, izinga lokushaya kwenhliziyo yakho kanye nomfutho wegazi kwehla ngokuzumayo kakhulu, okungaholela ekwehleni kokugeleza kwegazi kuya ebuchosheni, okungaholela ekuqulekeni. Esikhathini esiningi, lokhu akulona ingozi.

Izimbangela ze-Situational Syncope

Lokhu kwenzeka kuphela ezimweni ezithile lapho uhlelo lwakho lwezinzwa luthinteka khona bese uphelelwa yingqondo. Ezinye zalezi zimo zifaka:

• Ukuphelelwa amanzi emzimbeni.
• Ukucindezeleka okukhulu ngokomzwelo, ukudabuka, ukukhathazeka.
• Ukwesaba.
• Ubuhlungu obukhulu.
• Indlala.
• Ukusetshenziswa kotshwala noma izidakamizwa.
• Ukuphefumula Okukhulu - Lokhu kusho ukungenisa umoya-mpilo omningi nokukhipha i-carbon dioxide ngokushesha kunokuba kudingeka.
• Uma ukhwehlela kakhulu, uphendula intamo, noma ugqoke ikhola ( ukwanda kwe-carotid sinus ).
• Uma uchama ( i-micturition syncope ).

Izimbangela ze-postural syncope

Lokhu kubizwa nangokuthi i-postural hypotension noma i-orthostatic hypotension . Kwenzeka uma ushintsha isikhundla ngokuzumayo, isibonelo, uma usukuma ulele phansi, futhi umfutho wegazi wakho wehla ngokuzumayo. Eminye imithi kanye nokuphelelwa amanzi emzimbeni kungabangela lesi simo. Abantu abanalolu hlobo lokuquleka bathola ukwehla komfutho wegazi okungenani ongu-20 mmHg (inombolo ephezulu) kanye no-10 mmHg (inombolo engezansi) lapho besukuma.

Izimbangela ze-syncope yenhliziyo

Uma unesifo enhliziyweni yakho noma emithanjeni yegazi esithinta ukugeleza kwegazi ebuchosheni bakho, ungase ube nokuphazamiseka kwenhliziyo . Lezi zimo zifaka:

• Ukuphazamiseka kwenhliziyo ( arrhythmia ).
• Ukuphazamiseka kokugeleza kwegazi enhliziyweni ngenxa yesakhiwo senhliziyo ( hypertrophic cardiomyopathy ).
• Ukuvaleka kwemithambo yegazi enhliziyweni ( i-myocardial ischemia ).
• Isifo se-valve yenhliziyo.
• I-Aortic stenosis - Lokhu kusho ukuncishiswa kwe-aorta.
• Ihlule legazi.
• Ukwehluleka kwenhliziyo.

Uma une -cardiac syncope , kubaluleke kakhulu ukubonana nodokotela wenhliziyo bese uthola ukwelashwa okufanele, njengoba lokhu kungaba kubi kakhulu.

Izimbangela ze-Neurologic Syncope

Lokhu kungenzeka uma unesifo sezinzwa njengokuxhuzula, isifo sohlangothi, noma ukuhlaselwa yi-ischemic okuhamba kancane (TIA) . Futhi, i-migrainesFuthi izimo ezingavamile njengengcindezi evamile i-hydrocephalus nazo zingabangela i-neurologic syncope .

I-Postural Orthostatic Tachycardia Syndrome (i-POTS)

Uma une -POTS , izinga lokushaya kwenhliziyo yakho lingakhuphuka kakhulu ( i-tachycardia ) uma usukuma uhleli noma ulele. Izinga lokushaya kwenhliziyo yakho lingakhuphuka ngokushaya okungu-30 ngomzuzu noma ngaphezulu. Lokhu kukhula kuvame ukwenzeka zingakapheli imizuzu eyi-10 yokuma.

I-syncope engenambangela ecacile

Cishe abantu abangu-33% abaquleka abakwazi ukuthola imbangela eqondile yokuquleka kwabo. Kodwa-ke, eminye imithi ingandisa nengozi yokuquleka njengomphumela ongemuhle. Uma ungazi ukuthi yini ebangela ukuquleka kwakho, qiniseka ukuthi ubona udokotela.

Udokotela ukubona kanjani lokhu?

Uma uquleka, kufanele nakanjani ubonane nodokotela. Angakudlulisela kuchwepheshe we-syncope ukuze akuhlole ngokugcwele.

Uchwepheshe uzokuhlola ngokomzimba futhi athathe umlando wezokwelapha ophelele. Uzokubuza ngezimpawu zakho kanye nezikhathi owaquleka ngazo - ukuthi ngabe wawunazo yini izimpawu ngaphambili, nini futhi kuphi lapho waquleka khona.

Angalinganisa nokushaya kwenhliziyo yakho kanye nomfutho wegazi ngenkathi usezindaweni ezahlukene (ulele phansi, uhleli, umile).

Ngemuva kwalokho, kungadingeka ukuthi wenze ukuhlolwa okukodwa noma ngaphezulu ukuze uthole imbangela yokuquleka kwakho. Lokhu kuhlolwa kubheka izinto ezifana nalezi:

• Isimo senhliziyo yakho.
• Isilinganiso senhliziyo yakho.
• Inani legazi emzimbeni wakho.
• Indlela igazi lakho elijikeleza ngayo uma usezikhundleni ezahlukene.

Yiziphi izivivinyo ezenziwayo ngalokhu?

Ukuhlolwa kokuthola imbangela yokuquleka yilezi:

• Ukuhlolwa kwelebhu: Hlola ukuthi kukhona yini ukuntuleka kwegazi noma izinguquko ze-metabolic.
• I-Electrocardiogram (EKG): Ukuhlolwa okuqopha ukusebenza kukagesi kwenhliziyo yakho.
• Ukuhlolwa kokucindezeleka kokuzivocavoca: Kunezivivinyo eziningi ezenziwa ngenkathi uzivocavoca noma ngokunikeza inhliziyo yakho umuthi wokuyicindezela. Ezinye izivivinyo zokucindezeleka zifuna izinguquko ze-EKG noma zenze i-ultrasound yenhliziyo. Ukuhlolwa kokucindezeleka kungenziwa nange -nuclear imaging .
• I-Ambulatory monitor: Idivayisi oyigqokayo eqopha ulwazi mayelana nokushaya kwenhliziyo yakho kanye nesigqi ngama-electrode.
• I-Echocardiogram: Ukuhlolwa okusebenzisa amaza omsindo ukudala isithombe sesakhiwo senhliziyo yakho.
• Ukuhlolwa kwetafula lokutsheka (ukuhlolwa kokutsheka kwekhanda): Umfutho wegazi lakho kanye nokushaya kwenhliziyo yakho kuqoshwa umzuzu nomzuzu noma ukushaqeka ngokushaya njengoba ulele etafuleni futhi itafula litsheka emazingeni ahlukene. Lokhu kuhlolwa kungabona ukusabela okungavamile kwenhliziyo okungabangela ukuquleka.
• Ukuhlolwa kwe-Autonomic Reflex: Uchungechunge lwezivivinyo ezilinganisa umfutho wegazi lakho, ukugeleza kwegazi, izinga lokushaya kwenhliziyo, izinga lokushisa kwesikhumba, kanye nokujuluka ngenxa yezisusa ezihlukahlukene. Lezi zilinganiso zingasiza udokotela wakho ukuthi anqume ukuthi uhlelo lwakho lwezinzwa oluzimele lusebenza kahle noma ukuthi unomonakalo wezinzwa.

Ungase ube nezinye izivivinyo, njengezifundo ze-electrophysiology , ukuhlolwa kwesistimu yezinzwa ezizimele , ukuhlolwa kwezinzwa, kanye ne-CT scan (Computed Tomography - CT scan) . Ungase futhi ube nokuhlolwa kokusebenza kwe-vestibular ukuqinisekisa ukuthi azikho izinkinga ngendlebe yakho yangaphakathi. Uma udinga noma yiziphi izivivinyo ezengeziwe, udokotela wakho uzochaza ukuthi ziyini nokuthi kungani uzidinga.

Senzenjani uma umuntu equleka?

Uma umuntu equleka, landela lezi zinyathelo:

1. Hlola ukuthi uyaphefumula yini.

2. Mlale phansi, noma uphumule ikhanda lakhe phakathi kwamadolo akhe, okungenani imizuzu eyi-10-15.

3. Mnike amanzi abandayo ukuze aphuze.

Yiziphi izindlela zokwelapha ukuquleka?

Izinketho zokwelapha zincike ekutheni yini ebangela ukuquleka kwakho nokuthi imiphumela yokuhlolwa kwakho ikhombisa ini. Umgomo wokwelashwa ukukuvimbela ukuthi ungaphinde uquleke.

Izindlela zokwelapha i-syncope yilezi:

• Ukuthatha imithi, noma ukwenza izinguquko emithini osuvele uyisebenzisa.
• Ukugqoka izingubo ezisekelayo noma amasokisi okucindezela ukuze kuthuthukiswe ukujikeleza kwegazi.
• Ukwenza izinguquko ekudleni kwakho. Udokotela wakho angase akutshele ukuthi udle ukudla okuncane, okuvamile, engeza usawoti omncane (i-sodium) ekudleni kwakho, uphuze amanzi amaningi, wandise inani le-potassium ekudleni kwakho, futhi uyeke i-caffeine notshwala.
• Ukuqaphela kakhulu lapho uvuka.
• Gcina ikhanda lombhede liphakeme ngenkathi ulele. Ungakwenza lokhu ngokusebenzisa imicamelo eyengeziwe noma ukubeka izikhuphuli ngaphansi kwemilenze ekhanda lombhede.
• Ukugwema izimo noma "izinto ezibangela ukuquleka" (njengokuma isikhathi eside, ukushisa, kanye nezimo ezicindezelayo).
• Ukuqeqeshwa kwe-Biofeedback ukulawula ukushaya kwenhliziyo okusheshayo.
• Uma kunezifo zenhliziyo ezihambisana nokwakheka kwazo, zitholele ukwelashwa.
• I-Pacemaker yokugcina izinga lokushaya kwenhliziyo lijwayelekileUkulungisa eyodwa (lokhu kungokwezinye izimo zezokwelapha ezithile kuphela).
• Ukuthola i -defibrillator ye-cardioverter (ICD) efakelwayo . Le divayisi iqapha njalo ukushaya kwenhliziyo yakho kanye nesigqi futhi ilungisa noma yiziphi izigqi ezisheshayo nezingavamile (futhi, kuphela ezimweni ezithile).

Ithimba lakho lezokwelapha lizokwakha uhlelo lokwelashwa olufanele wena futhi lixoxe nawe ngezinketho zakho zokwelashwa.

Ingabe ikhona imithi yalokhu?

Eminye imithi esetshenziswa ukwelapha ukuquleka ihlanganisa:

• I-Midodrine
• I-Fludrocortisone (amagama omkhiqizo i-Astonin® noma i-Florinef®)

Le mithi ingabangela eminye imiphumela emibi, njengobuhlungu besifuba, isicanucanu, isiyezi, ubunzima bokuchama, ukuphazamiseka kwesisu, kanye nokubanda. Ngakho-ke, kubalulekile ukusebenzisa imithi njengoba nje udokotela wakho ekutshelile.

Ingabe ukuquleka kungancishiswa/kungavinjelwa?

Ukuze unciphise ingozi yakho yokuquleka, udinga ukwazi ukuthi yini ebangela lokhu. Uma inkinga yokuphelelwa amanzi emzimbeni, ukuhlala unamanzi amaningi nokuphuza amanzi amaningi kungasiza ekunciphiseni ingozi yakho. Uma uquleka ngenxa yesifo senhliziyo, ungadinga imithi noma ithuluzi lokwelapha izigqi zenhliziyo ezingavamile.

Ngokuvamile, uzizwa sengathi usuzoquleka. Ungase uzizwe unesizungu, unesicanucanu, noma ube nokushaya kwenhliziyo okungajwayelekile okuzwakala sengathi kushaya ngokushesha kakhulu noma "kushaya" esifubeni sakho. Ungasiza ekuvimbeleni ukuquleka uma:

• Hlala phansi noma ulale phansi ngokushesha bese uphakamisa imilenze yakho.
• Beka izandla zakho ndawonye.
• Qinisa izandla zakho.
• Hlanganisa imilenze yakho noma ucindezele amathanga akho ndawonye.

Kwenzekani uma uquleka? Ingabe kuyinto okufanele uyesabe?

Ngokuhlonza nokwelashwa okufanele, ungalawula i-syncope . Uma wake waquleka kanye, unethuba elingama-30% lokuquleka futhi. Ingozi yakho yokuquleka futhi nokuthi ikuthinta kanjani incike ezintweni eziningana - njengembangela, iminyaka yakho, ubulili, nezinye izimo zezokwelapha onazo. Uma unemibuzo mayelana nengozi yakho, khuluma nodokotela wakho.

Uma utholakale une- syncope , hlola imithetho ezweni/esifundeni sakho. Kwamanye amazwe/esifundeni, abashayeli abaqulekayo kumele babike ehhovisi lelayisensi yokushayela. Udokotela uzokutshela ukuthi uthole imbangela bese uthola ukwelashwa ngaphambi kokuba ushayele.

Esikhathini esiningi, ukuquleka akuyona ingozi. Kodwa-ke, uma unesigqi senhliziyo esingajwayelekile noma isimo sezinzwa, kungaba yingozi empilweni. Abantu abanesifo senhliziyo noma izimo zezinzwa kufanele nakanjani bafune ukwelashwa kudokotela.

Kufanele ngimbone nini udokotela? Iyunithi Yokwelapha Eziphuthumayo (ETU)Zikhona yini izikhathi lapho kudingeka uhambe khona?

Kuye ngokuthi imbangela yokuquleka kwakho iyini, kuzodingeka ubone udokotela ukuze akulandelele cishe amasonto amabili kuya kwamane ngemuva kokuthola ukwelashwa esibhedlela noma emnyangweni weziguli ezingalaliswa esibhedlela. Uma udokotela ethola inkinga ngesakhiwo noma isigqi senhliziyo yakho, kuzodingeka wenze amanye ama-aphoyintimenti okulandelela.

Uma umuntu equleka futhi eyeka ukuphefumula, njengokungathi uhlaselwa yisifo senhliziyo, kufanele umnike i-CPR (Cardiopulmonary Resuscitation) bese ushayela i-ambulensi. Abantu abaningi baya eMnyangweni Wezimo Eziphuthumayo (ETU) ngemva kokuquleka. Uma uquleka, ikakhulukazi okokuqala, noma uma unesihlungu esifubeni, ubunzima bokuphefumula, noma ezinye izimpawu ezinkulu, kufanele nakanjani ufune iseluleko sezokwelapha.

Imibuzo ebalulekile okufanele uyibuze udokotela wakho

Ungabuza udokotela wakho le mibuzo:

• Uyazi ukuthi yini eyangenza ngaquleka?
• Yini okufanele ngiyenze ukuze ngivimbele uhlobo lokuquleka enganginalo ukuthi lungaphinde lwenzeke?
• Ingabe ngidinga ukuhlolwa okwengeziwe noma ama-aphoyintimenti okulandelela?

Ngamafuphi (Umyalezo Wokuya Ekhaya)

I-syncope , noma ukuquleka, kungabonakala kungathi sína kakhulu kunalokho okuyikho ngempela ngoba kwenzeka ngokuzumayo futhi kudonsela ukunaka kwabanye. Kodwa-ke, kubantu abaningi, kuyisimo sesikhashana futhi asikhombisi inkinga enkulu yempilo. Ukubona udokotela ngemva kokuquleka kungakusiza uzizwe uqiniseka ukuthi awunaso isimo esingathi sína. Uma ukuquleka kwakho kubangelwa yisimo senhliziyo, kubalulekile ukuthola ukwelashwa kwaso.

Khumbula, uma unokungabaza noma ukukhathazeka ngempilo yakho, kungcono ukukhuluma nodokotela.

Ukuquleka , i-syncope, ukulahlekelwa ukwazi, i-cerebral ischemia, i-vasovagal syncope, i-cardiac syncope, izimbangela zokuquleka, ukwelashwa kokuquleka