Amyotrophic lateral sclerosis (ALS)

Amyotrophic lateral sclerosis, kapa ALS, ke lefu la lisele tsa methapo bokong, bakoang ba boko le lesapo la mokokotlo le laolang motsamao oa boithatelo ba mesifa.

ALS e boetse e tsejoa e le lefu la Lou Gehrig.

E le 'ngoe ho tse 10 tsa ALS e bakoa ke bofokoli ba lefutso. Lebaka ha le tsejoe maemong a mang a mangata.

Ho ALS, lisele tsa methapo ea kutlo (neurons) lia senyeha kapa lia shoa, 'me ha li sa khona ho romella melaetsa mesifa. Sena se qetella se lebisa ho fokotseheng ha mesifa, ho tsitsinyeha, le ho se khone ho tsamaisa matsoho, maoto le 'mele. Boemo bo mpefala butle-butle. Ha mesifa e sefubeng e emisa ho sebetsa, ho ba thata kapa ho se khone ho hema.

ALS e ama batho ba ka bang 5 ho ba bang le ba bang ba 100 000 lefatšeng ka bophara.

Ho ba le setho sa lelapa se nang le mofuta oa lefu lena ke kotsi ea ALS. Likotsi tse ling li kenyelletsa tšebeletso ea sesole mabaka a sena ha a hlake, empa e kanna ea amana le ho pepesehela chefo tikolohong.

Matšoao hangata ha a hlahe ho fihlela kamora lilemo tse 50, empa a ka qala ho batho ba bacha. Batho ba nang le ALS ba felloa ke matla le tšebelisano-mmoho e qetellang e mpefala le ho ba thatafalletsa ho etsa mesebetsi e tloahelehileng joalo ka ho nyoloha litepisi, ho tsoa setulong kapa ho koenya.

Bofokoli bo ka ama matsoho kapa maoto pele, kapa bokhoni ba ho hema kapa ho koenya. Ha lefu lena le ntse le mpefala, lihlopha tse ngata tsa mesifa li ba le mathata.

ALS ha e ame litho tsa kutlo (ho bona, ho fofonela, ho latsoa, ​​ho utloa le ho ama). Batho ba bangata ba khona ho nahana ka mokhoa o tloaelehileng, leha palo e nyane e ba le 'dementia', e baka mathata a mohopolo.

Bofokoli ba mesifa bo qala karolong e le 'ngoe ea' mele, joalo ka letsoho kapa letsoho, 'me butle-butle bo mpefala ho fihlela bo lebisa ho tse latelang:

• Ho thatafalloa ho phahamisa, ho hloa litepisi le ho tsamaea
• Ho phefumoloha ho thata
• Ho thata ho metsa - ho bipetsa habonolo, ho koenya mathe kapa ho koenya molomo
• Ho theoha hoa hlooho ka lebaka la bofokoli ba mesifa ea molala
• Mathata a ho bua, joalo ka mokhoa o liehang kapa o sa tloaelehang oa ho bua (ho sotla mantsoe)
• Liphetoho tsa lentsoe, hoarsars

Liphetho tse ling li kenyelletsa:

• Ho tepella maikutlo
• Maqhubu a mesifa
• Ho satalla ha mesifa, ho bitsoang botsitso
• Li-contraction tsa mesifa, tse bitsoang fasciculations
• Ho fokotsa boima ba 'mele

Mofani oa tlhokomelo ea bophelo o tla u hlahloba ebe o botsa nalane ea hau ea bongaka le matšoao a hau.

Tlhahlobo ea 'mele e ka bonts'a:

• Bofokoli, hangata bo qalang sebakeng se le seng
• Ho thothomela ha mesifa, ho qepha, ho tsitsinyeha, kapa ho lahleheloa ke lisele tsa mesifa
• Ho tsitsinyeha ha leleme (le tloaelehileng)
• Maikutlo a sa tloaelehang
• Ho tsamaea ka thata kapa ka thata
• Ho fokotseha kapa ho eketseha ha maikutlo ho manonyeletso
• Bothata ba ho laola ho lla kapa ho tšeha (ka linako tse ling ho thoe ke ho hloka taolo ea maikutlo)
• Ho lahleheloa ke gag reflex

Liteko tse ka etsoang li kenyelletsa:

• Liteko tsa mali ho felisa maemo a mang
• Teko ea ho hema ho bona hore na mesifa ea matšoafo e amehile
• Cervical spine CT kapa MRI ho netefatsa hore ha ho na lefu kapa kotsi ho molala, e ka etsisang ALS
• Electromyography ho bona hore na ke methapo efe kapa mesifa e sa sebetseng hantle
• Ho etsa liteko tsa lefutso, haeba ho na le nalane ea lelapa ea ALS
• Hlooho CT kapa MRI ho laola maemo a mang
• Ho koenya lithuto
• Pompo ea mokokotlo (ho hlaba lumbar)

Ha ho na pheko e tsebahalang ea ALS. Moriana o bitsoang riluzole o thusa ho liehisa matšoao mme o thusa batho ho phela nako e teletsana.

Ho na le meriana e 'meli e thusang ho fokotsa tsoelo-pele ea matšoao mme e ka thusa batho ho phela haleletsana:

• Riluzole (Rilutek)
• Edaravone (Radicava)

Kalafo ea ho laola matšoao a mang e kenyelletsa:

• Baclofen kapa diazepam bakeng sa spasticity e sitisang mesebetsi ea letsatsi le letsatsi
• Trihexyphenidyl kapa amitriptyline bakeng sa batho ba nang le mathata a ho metsa mathe a bona

Phekolo ea 'mele, ntlafatso, ts'ebeliso ea lithupa kapa setulo sa likooa, kapa mehato e meng e ka hlokahala ho thusa mesifa le bophelo bo botle ka kakaretso.

Batho ba nang le ALS ba atisa ho theola boima ba 'mele. Bokuli ka bo bona bo eketsa tlhoko ea lijo le likhalori. Ka nako e ts'oanang, mathata a ho khangoa le ho koenya a etsa hore ho be thata ho ja lijo tse lekaneng. Ho thusa ka ho fepa, mothapo o ka kenngoa ka mpeng. Setsebi sa phepo e khethehileng sa ALS se ka fana ka likeletso mabapi le ho ja hantle.

Lisebelisoa tsa ho hema li kenyelletsa mechini e sebelisoang bosiu feela, le moea o kenang ka mehla oa mochini.

Moriana oa khatello ea maikutlo o ka hlokahala haeba motho ea nang le ALS a hloname. Ba boetse ba lokela ho bua ka litakatso tsa bona mabapi le moea o entsoeng ka maiketsetso le ba malapa a bona le bafani ba tsona.

Ts'ehetso ea maikutlo e bohlokoa ho sebetsana le bokuli, hobane ts'ebetso ea kelello ha e amehe. Lihlopha tse kang ALS Association li ka ba teng ho thusa batho ba sebetsanang le bothata bona.

Ts'ehetso bakeng sa batho ba hlokomelang motho ea nang le ALS le eona ea fumaneha, mme e ka ba thuso haholo.

Ha nako e ntse e ea, batho ba nang le ALS ba lahleheloa ke bokhoni ba ho sebetsa le ho itlhokomela. Lefu hangata le hlaha nakong ea lilemo tse 3 ho isa ho tse 5 tsa ho fumanoa. Hoo e ka bang motho a le mong ho ba bane o phela lilemo tse fetang 5 kamora ho fumanoa. Batho ba bang ba phela halelele ho feta, empa hangata ba hloka thuso ea ho hema ho tsoa mochining oa moea kapa sesebelisoa se seng.

Mathata a ALS a kenyelletsa:

• Ho hema ka lijo kapa mokelikeli (aspiration)
• Ho lahleheloa ke bokhoni ba ho itlhokomela
• Ho hloleha ha mapafu
• Nyomonea
• Liso tsa khatello
• Ho fokotsa boima ba 'mele

Bitsa mofani oa hau haeba:

• U na le matšoao a ALS, haholo haeba u na le nalane ea lelapa ea lefu lena
• Uena kapa motho e mong o fumanoe a e-na le ALS 'me matšoao a mpefala kapa matšoao a macha a hlaha

Ho thatafalloa ke ho koenya, ho hema ka thata, le linako tsa ho koaleha moea ka nakoana ka nakoana ke matšoao a hlokang tlhokomelo e potlakileng.

U kanna ua batla ho bona moeletsi oa liphatsa tsa lefutso haeba u na le nalane ea lelapa ea ALS.

Lefu la Lou Gehrig; ALS; Boloetse bo phahameng le bo tlase ba methapo ea methapo; Lefu la motor neuron

• Sisteme ea methapo e bohareng le methapo ea methapo

Fearon C, Murray B, Mitsumoto H. Mathata a li-motor neurons tse holimo le tse tlase. 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 98.

Shaw PJ, Cudkowicz ME. Amyotrophic lateral sclerosis le maloetse a mang a methapo ea kutlo. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 391.

van Es MA, Hardiman O, Chio A, et al. Amyotrophic lateral sclerosis. Lancet. 2017; 390 (10107): 2084-2098. PMID: 28552366 phatlalalitsoe.ncbi.nlm.nih.gov/28552366/.