Uma umuntu egula futhi elaliswe esibhedlela enamazinga aphansi amanzi nosawoti emzimbeni, odokotela bazomnika usawoti ukuze alungise ukuntuleka kwawo. Lokho kuvamile. Kodwa bewazi ukuthi ngezinye izikhathi, uma amazinga aphansi e-sodium emzimbeni ekhuphuka ngokuzumayo nangokushesha, angalimaza ubuchopho? Yilokho esikubiza ngokuthi isimo esingavamile kodwa esibi esibizwa ngokuthi i-Central Pontine Myelinolysis. Nakuba igama liyinkimbinkimbi kancane, ake sixoxe ngakho kalula.
Kalula nje, hlobo luni lwesimo lolu?
Lesi yisifo esihlobene nesimiso sezinzwa. Izimpawu zikagesi umzimba ozidingayo zihamba ngamaseli ezinzwa (ama-neurons) ebuchosheni bethu. Kukhona isembozo esivikelayo esizungeze la maseli ezinzwa. Siyibiza ngokuthi i-myelin sheath . Ifana ne-plastic sheath ezungeze ucingo lukagesi . Le sheath ye-myelin yiyo evumela izimpawu zikagesi ukuthi zihambe ngokushesha futhi ngaphandle kwezithiyo.
I-Central Pontine Myelinolysis (CPM) yenzeka lapho ama-myelin sheaths endaweni ethile yobuchopho, ikakhulukazi ama-pons, elimala. Lo monakalo ungathinta ukusebenza kwezingxenye ezahlukene zomzimba.
Ngezinye izikhathi, cishe ezimweni eziyi-10%, lo monakalo ungathinta hhayi ama-pons kuphela, kodwa nezinye izingxenye zobuchopho. Ngakho-ke, lesi simo saziwa ngelinye igama elibanzi. Leyo yi -Osmotic Demyelination Syndrome (ODS) .
Lesi simo asivamile, kodwa kutholakale ukuthi cishe ama-2.5% eziguli ezilaliswe ezikhungweni zokunakekelwa okujulile (ama-ICU) asengozini yokuthola i-ODS.
Iyini imbangela yalesi simo?
Isizathu esiyinhloko salokhu ukuthi lapho izinga le-sodium emzimbeni (okuyilokho okukusawoti esikudlayo) liphansi kakhulu, likhuphuka ngokuzumayo nangokushesha kakhulu . Le ngozi iyanda ikakhulukazi uma izinga le-sodium emzimbeni seliphansi izinsuku ezingaphezu kwezimbili futhi kunikezwa ukwelashwa.
Into ebalulekile ukuthi, lokhu akuyona into esiyidlayo noma esiyiphuzayo. Lokhu kuyinto engenzeka esibhedlela, lapho i-sodium inikezwa ngemithambo yegazi , okungukuthi, nge-saline, njengokwelashwa.
Cabanga ngalokhu. Umuntu ubelokhu ehlanza kakhulu izinsuku eziningi, noma enesifo sohudo. Khona-ke, akuzona nje amanzi kuphela, kodwa nosawoti ofana ne-sodium uyalahleka emzimbeni wakhe. Uma befika esibhedlela, amazinga abo e-sodium aphansi kakhulu. Manje odokotela babanika usawoti ukuze bazame ukubuyisela amazinga abo e-sodium esimweni esijwayelekile. Kodwa-ke, uma bengazazi ezinye izici eziyingozi isiguli esinazo, bangakwazi ukwandisa amazinga e-sodium ngokushesha.
Uma lokho kwenzeka, amanzi angaphakathi kwamangqamuzana obuchopho aphuma ngokuzumayo emaseli. Amangqamuzana ancipha njengegilebhisi elomile. Lolu shintsho oluzumayo yilona olulimaza ama-myelin sheath esiwashilo.
Ubani osengozini enkulu?
Akuwona wonke umuntu othola lesi simo uma amazinga abo e-sodium ekhuphuka ngokushesha kakhulu, kodwa abanye abantu basengozini enkulu.
| Iqembu lezingozi | Incazelo |
|---|---|
| Imilutha yotshwala | Ukuntuleka kokudla okunempilo kanye nokungalingani kosawoti kuvamile kubantu abaphuza utshwala isikhathi eside. |
| Iziguli ezifakelwa isibindi | Le ngozi iphezulu kakhulu kulabo abaye bahlinzwa ukufakelwa isibindi. |
| I-Hyperemesis ngesikhathi sokukhulelwa | I-Hyperemesis Gravidarum, isimo sokuhlanza okungapheli ngesikhathi sokukhulelwa, singabangela ukwehla okukhulu kwamazinga kasawoti emzimbeni. |
| Izifo zesikhathi eside | Noma yisiphi esinye isimo sezokwelapha sesikhathi eside esenza umzimba ube buthaka noma sibangele ukungondleki kahle sandisa ingozi. |
Ziyini izimpawu zalesi sifo?
Izimpawu zivame ukuqala ukuvela zingakapheli izinsuku ezimbili kuya kwezintathu zokulungisa amazinga e-sodium emzimbeni. Kunezimpawu ezibonakala kusenesikhathi, kanye nezimpawu ezibonakala emavikini kamuva.
| Izimpawu ze-CPM | |
|---|---|
| Izimpawu zokuqala (zingakapheli izinsuku ezingu-2-3) | |
| |
| Izimpawu ezingase zivele kamuva (ngemva kwamasonto noma izinyanga ezimbalwa) | |
|
Kodwa ungesabi. Nakuba ekuqaleni kwakucatshangwa ukuthi izinga lokufa liphezulu, lokho kwanqunywa ngokuhlolwa kwesidumbu. Ngokusho kwedatha entsha, abantu abangu-94% abathola lesi simo bayasinda . Futhi, phakathi kuka-25% no-40% wabo bayalulama ngokuphelele . Kodwa-ke, phakathi kuka-25% no-30% bangase bashiywe benokukhubazeka okungapheli.
Odokotela bakuthola kanjani lokhu?
Indlela engcono kakhulu yokuxilonga lesi sifo iwukusebenzisa i-MRI (Magnetic Resonance Imaging) . Udokotela wakho uzobheka izithombe ze-MRI zobuchopho bakho futhi ahlole izinguquko ezithile ezibonisa umonakalo kuma-myelin sheaths.
Ngezinye izikhathi lomonakalo awubonakali ngokushesha ku-MRI, ngakho udokotela wakho angase akucele ukuthi wenze enye i-MRI ngesonto elilodwa noma amabili.
I-CPM ingabukeka njengezinye izimo eziningana ezithombeni ze-MRI. Ngakho-ke, odokotela bayaqaphela kakhulu ukuthi bangadidanisi lesi simo nezifo ezilandelayo.
- I-Multiple Sclerosis
- I-autoimmune noma i-infectious encephalitis (ukuvuvukala kobuchopho)
- I-vasculitis yesistimu yezinzwa ephakathi
- Ezinye izinhlobo zomdlavuza
Uma i-MRI iyodwa ingakwazi ukukhombisa umonakalo ngokucacile, udokotela uzokwenza ukuhlolwa okujulile kwezinzwa. Lokhu kungafaka phakathi ukuhlolwa okukala izimpawu zikagesi ebuchosheni, njenge-EEG (electroencephalography).
Ukwelapha kanjani? Ukuvimbela kungcono kakhulu!
Eqinisweni, ukwelashwa okuyinhloko kwe-Central Pontine Myelinolysis ukuvimbela lesi simo ukuthi singabi khona .
Kubaluleke kakhulu ukwazisa ithimba lakho lezokwelapha nganoma yiziphi izinto eziyingozi onazo (isibonelo, uma uphuza utshwala, uma unezinye izimo zezokwelapha) ukuze bakwazi ukwandisa amazinga akho e-sodium ngokuphepha nangokuhamba kancane.
Uma uba nalesi simo, ukwelashwa kuzoncika ezimpawini ozizwayo. Ezimweni eziningi, kudingeka izinyanga zokwelapha ngokomzimba kanye nezinye izindlela zokwelapha zokuvuselela umzimba.
Uma uba nezimpawu ezifana nesifo sikaParkinson, njengokuthuthumela, udokotela wakho angase akunike imithi ye-dopaminergic .
Ngesikhathi uhlala esibhedlela, ukuvimbela ezinye izinkinga zesibili nakho kuyingxenye ebalulekile yokwelashwa. Ithimba lezokwelapha lizohlala liqapha izinto ezifana nalezi:
- Ukuthembela kumshini wokuphefumula
- Ukutheleleka komgudu womchamo
- Inyumoniya
- Ukugoba kwegazi emthanjeni (i-Deep vein thrombosis)
- Ukuwohloka kwemisipha
Kukhona ngisho nokuhlolwa kwezokwelapha okuqhubekayo kwalesi sifo, futhi udokotela wakho angase akuncome.
Umlayezo Wokuya Nawe Ekhaya
- I-Central Pontine Myelinolysis (CPM) yisimo esibi esibangelwa ukulimala kwe-myelin sheaths ebuchosheni ngenxa yokwanda okusheshayo nokungazelelwe kwamazinga aphansi e-sodium (usawoti) emzimbeni.
- Ukwelashwa okungcono kakhulu kwalokhu ukuvimbela . Ngaphambi kokuthola noma yikuphi ukwelashwa, tshela udokotela wakho umlando wakho wezokwelapha ophelele, ikakhulukazi mayelana nokusebenzisa utshwala noma ezinye izifo.
- Uma lesi simo sivela, amathuba okusinda aphezulu, kodwa ukululama okuphelele kungathatha isikhathi eside, okuhlanganisa nokwelashwa ngokomzimba.
- Uma wena noma othile omaziyo eba nalezi zimpawu, ikakhulukazi ngemva kokwelashwa ngokushintsha i-sodium esibhedlela, yazisa udokotela ngokushesha.
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