Lefu la Guillain-Barré

Guillain-Barré syndrome (GBS) ke bothata bo tebileng ba bophelo bo botle bo hlahang ha sesole sa 'mele se itšireletsa ka phoso karolo e' ngoe ea methapo ea methapo. Sena se lebisa ho ruruheng ha methapo e bakang bofokoli ba mesifa kapa ho holofala le matšoao a mang.

Lebaka le tobileng la GBS ha le tsejoe. Ho nahanoa hore GBS ke boloetse bo ikemetseng. Ka lefu la ho itšireletsa mafung, sesole sa 'mele se itlhasela ka phoso. GBS e ka hlaha ka lilemo tsohle. E atile haholo bathong ba pakeng tsa lilemo tse 30 ho isa ho tse 50.

GBS e ka hlaha ka tšoaetso ea livaerase kapa libaktheria, tse kang:

• Mokakallane
• Maloetse a mang a tsoang ka mpeng
• Pneumonia ea Mycoplasma
• HIV, vaerase e bakang HIV / AIDS (e sa tloaelehang haholo)
• Herpes simplex
• Mononucleosis

GBS e kanna ea etsahala le maemo a mang a bongaka, joalo ka:

• Sesebelisoa sa lupus erythematosus
• Lefu la Hodgkin
• Ka mor'a ho buuoa

GBS e senya likarolo tsa methapo. Ts'enyo ena ea methapo e baka ho hlohlona, ​​bofokoli ba mesifa, ho lahleheloa ke botsitso le ho holofala. Hangata GBS e ama methapo e koahelang (myelin sheath). Tšenyo ena e bitsoa demyelination. E etsa hore matšoao a methapo a tsamaee butle haholo. Tšenyo ea likarolo tse ling tsa methapo e ka etsa hore methapo e emise ho sebetsa.

Matšoao a GBS a ka mpefala kapele. Ho ka nka lihora tse 'maloa feela hore matšoao a matla haholo a hlahe. Empa bofokoli bo eketsehang ka matsatsi a 'maloa le bona bo atile.

Bofokoli ba mesifa kapa tahlehelo ea mesifa (ho shoa litho) e ama mahlakore ka bobeli a 'mele. Maemong a mangata, bofokoli ba mesifa bo qala maotong ebe bo namela matsohong. Hona ho bitsoa ho holofala ho holang.

Haeba ho ruruha ho ama methapo ea sefuba le diaphragm (mosifa o moholo tlasa matšoafo a hau o o thusang ho hema) mme mesifa eo e fokola, o kanna oa hloka thuso ea ho phefumoloha.

Matšoao a mang a tloaelehileng a GBS a kenyelletsa:

• Ho lahleheloa ke maikutlo a tendon matsohong le maotong
• Ho lla kapa ho shoeloa (ho lahleheloa ke maikutlo a bonolo)
• Bonolo ba mesifa kapa bohloko (e ka ba bohloko bo kang ba mokokotlo)
• Motsamao o sa lumellaneng (o sitoa ho tsamaea ntle le thuso)
• Khatello ea mali e tlase kapa khatello e tlase ea khatello ea mali
• Lebelo le sa tloaelehang la pelo

Matšoao a mang a kenyeletsa:

• Pono e lerootho le pono e habeli
• Ho kgukguna le ho wa
• Ho thata ho tsamaisa mesifa ea sefahleho
• Ho fokotsa mesifa
• Ho utloa ho otloa ha pelo (palpitations)

Matšoao a tšohanyetso (batla thuso ea bongaka hang-hang):

• Ho hema ho emisa ka nakoana
• Ha o khone ho hema haholo
• Ho phefumoloha ho thata
• Ho thata ho koenya
• Ho rotha ka metsi
• Ho akheha
• Ho utloa leseli le habile ha le eme

Nalane ea ho eketseha ha bofokoli ba mesifa le ho holofala e kanna ea ba sesupo sa GBS, haholo haeba ho bile le bokuli ba morao tjena.

Tlhahlobo ea bongaka e ka bontša bofokoli ba mesifa. Ho ka ba le mathata le khatello ea mali le ho otla ha pelo. Tsena ke mesebetsi e laoloang ka boiketsetso ke tsamaiso ea methapo. Teko e kanna ea bonts'a hore likhakanyo tse kang maqaqailana kapa leqeba la lengole lia fokotseha kapa ha li eo.

Ho ka ba le matšoao a ho hema ho fokotsehileng ho bakoang ke ho holofala ha mesifa ea ho hema.

Liteko tse latelang li ka etsoa:

• Cerebrospinal fluid sampole (lesapo la mokokotlo)
• ECG ho lekola ts'ebetso ea motlakase ka pelong
• Electromyography (EMG) ho leka ts'ebetso ea motlakase mesifa
• Teko ea khatello ea methapo ea kutlo ho lekola hore na matšoao a motlakase a feta kapele hakae methapong
• Mosebetsi oa pulmonary o leka ho lekanya ho hema le hore na matšoafo a sebetsa hantle hakae

Ha ho na pheko bakeng sa GBS. Kalafo e reretsoe ho fokotsa matšoao, ho phekola mathata le ho potlakisa ho fola.

Ha motho a qala ho kula, a ka fuoa kalafo e bitsoang apheresis kapa plasmapheresis. E kenyelletsa ho tlosa kapa ho thibela liprotheine, tse bitsoang li-antibodies, tse hlaselang lisele tsa methapo. Kalafo e 'ngoe ke immunoglobulin e kenang methapong (IVIg). Kalafo tsena ka bobeli li lebisa ntlafatsong e potlakileng, 'me ka bobeli li sebetsa ka ho lekana. Empa ha ho na molemo oa ho sebelisa litlhare ka bobeli ka nako e le 'ngoe. Mefuta e meng ea kalafo e thusa ho fokotsa ho ruruha.

Ha matšoao a le matla, ho tla hlokahala kalafo sepetlele. Ts'ehetso ea phefumoloho e kanna ea fanoa.

Mefuta e meng ea kalafo sepetlele e shebile ho thibela mathata. Tsena li ka kenyelletsa:

• Lisebelisoa tsa mali tse thibelang mali ho thibela mali
• Ts'ehetso ea ho hema kapa tube e phefumolohang le moea o kenang moeeng, haeba moferefere o fokola
• Meriana ea bohloko kapa meriana e meng ho phekola bohloko
• Boemo bo nepahetseng ba mmele kapa phaephe ea ho fepa ho thibela ho bipetsoa nakong ea phepo, haeba mesifa e sebelisetsoang ho koenya e fokola
• Phekolo ea 'mele ho thusa ho boloka manonyeletso le mesifa li phetse hantle

Lisebelisoa tsena li ka fana ka tlhaiso-leseling e batsi ka GBS:

• Guillain-Barré Syndrome Foundation International - www.gbs-cidp.org
• Mokhatlo oa Naha oa Mathata a Rare - rarediseases.org/rare-diseases/guillain-barre-syndrome

Ho hlaphoheloa ho ka nka libeke, likhoeli kapa lilemo. Batho ba bangata ba a phela mme ba fola ka botlalo. Ho batho ba bang, bofokoli bo bonolo bo ka phehella. Sephetho se kanna sa ba hantle ha matšoao a fela nakong ea libeke tse 3 kamora hore a qale.

Mathata a ka bang teng a GBS a kenyelletsa:

• Bothata ba ho hema (ho hloleha ho hema)
• Ho khutsufatsa lisele tsa manonyeletso (likonteraka) kapa bofokoli bo bong
• Maqeba a mali (deep vein thrombosis) a bang teng ha motho ea nang le GBS a sa sebetse kapa a tlameha ho robala betheng
• Kotsi e eketsehileng ea tšoaetso
• Khatello ea mali e tlase kapa e sa tsitsang
• Ho shoa litho tse sa feleng
• Nyomonea
• Tšenyo ea letlalo (liso)
• Ho hema lijo kapa maro ka matšoafong

Batla thuso ea bongaka hang-hang haeba u e-na le matšoao ana:

• Mathata a ho hema haholo
• Ho fokotsa maikutlo (maikutlo)
• Ho phefumoloha ho thata
• Ho thata ho koenya
• Ho akheha
• Ho felloa ke matla maotong ho mpefalang ha nako e ntse e feta

GBS; Lefu la Landry-Guillain-Barre; Bohloko bo feteletseng ba idiopathic polyneuritis; Tšoaetso ea polyneuritis; Bohloko bo boholo ba ho ruruha ha pelo; Hlobaetsang hlabang demyelinating polyradiculoneuropathy; Ho nyoloha ho holofala

• Mesifa ea ka ntle e kantle
• Phepelo ea methapo pelvis
• Boko le tsamaiso ea methapo

Chang CWJ. Myasthenia gravis le lefu la Guillain-Barré. Ka: Parrillo JE, Dellinger RP, bahlophisi. Meriana e Hlokahalang ea Tlhokomelo: Melao-motheo ea Tlhahlobo le Tsamaiso ho Motho e Moholo. La 5th. Philadelphia, PA: Elsevier; 2019: khaolo ea 61.

Katirji B. Mathata a methapo ea kutlo. Ka: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, bahlophisi. Neurology ea Bradley ho Tloaelo ea Bongaka. La 7th. Philadelphia, PA: Elsevier; 2016: khaolo ea 107.