Delirium

Delirium ke pherekano e matla ka tšohanyetso ka lebaka la liphetoho tse potlakileng ts'ebetsong ea boko tse etsahalang ka bokuli ba 'mele kapa ba kelello.

Delirium hangata e bakoa ke bokuli ba 'mele kapa ba kelello mme hangata ke ba nakoana ebile bo ka khutlisoa. Mathata a mangata a baka delirium. Hangata, tsena ha li lumelle boko ho fumana oksijene kapa lintho tse ling. Li ka baka likhemik'hale tse chefo bokong. Delirium e tloaelehile lefapheng la tlhokomelo e matla (ICU), haholo ho batho ba baholo.

Lisosa li kenyelletsa:

• Joala kapa meriana e feteletseng kapa ho tlohela
• Ts'ebeliso ea lithethefatsi kapa tšebeliso e mpe ea lithethefatsi, ho kenyeletsoa le ho luloa ICU
• Electrolyte kapa litšitiso tse ling tsa lik'hemik'hale tsa 'mele
• Tšoaetso e kang mafu a tšoaetso ea moroto kapa pneumonia
• Ho hloka boroko haholo
• Chefo
• Anesthesia e akaretsang le ho buuoa
  

Delirium e kenyelletsa phetoho e potlakileng lipakeng tsa maemo a kelello (mohlala, ho tloha bothateng ho ea ho ferekane le ho khutlela ho botsoa).

Matšoao a kenyelletsa:

• Liphetoho ho falimeheng (hangata ho ba seli haholoanyane hoseng, ho se hlokomele bosiu)
• Liphetoho ho maikutlo (maikutlo) le temoho
• Liphetoho boemong ba kutloisiso kapa tlhokomeliso
• Liphetoho mokhatlong (ka mohlala, li kanna tsa tsamaea butle kapa tsa fetoha matla)
• Liphetoho mokhoeng oa ho robala, ho otsela
• Pherekano (ho ferekana) ka nako kapa sebaka
• Fokotsa mohopolo oa nakoana le ho hopola
• Monahano o sa hlophisehang, joalo ka ho bua ka tsela e sa utloahaleng
• Liphetoho maikutlong kapa botho, joalo ka khalefo, ho ferekana, khatello ea maikutlo, ho teneha le ho thaba haholo
• Ho hloka taolo
• Litšisinyeho li bakoa ke liphetoho tsamaisong ea methapo
• Ho ba le bothata ba ho tsepamisa mohopolo

Liteko tse latelang li ka ba le liphetho tse sa tloaelehang:

• Tlhahlobo ea tsamaiso ea methapo (tlhahlobo ea methapo ea pelo), ho kenyeletsoa liteko tsa maikutlo (maikutlo), boemo ba kelello, monahano (ts'ebetso ea kelello) le ts'ebetso ea makoloi.
• Lithuto tsa Neuropsychological

Liteko tse latelang le tsona li ka etsoa:

• Liteko tsa mali le moroto
• X-ray sefubeng
• Tlhatlhobo ea Cerebrospinal fluid (CSF) (pompo ea mokokotlo, kapa ho hlaba lumbar)
• Electroencephalogram (EEG)
• Hlooho ea CT scan
• Hlooho ea MRI ea hlooho
• Teko ea boemo ba kelello

Morero oa kalafo ke ho laola kapa ho khutlisa sesosa sa matšoao. Kalafo e ipapisitse le boemo bo bakang delirium. Motho eo a ka hloka ho lula sepetlele nako e khuts'oane.

Ho emisa kapa ho fetola meriana e mpefatsang pherekano, kapa e sa hlokahaleng, ho ka ntlafatsa ts'ebetso ea kelello.

Mathata a tlatsetsang pherekanong a lokela ho phekoloa. Tsena li ka kenyelletsa:

• Khaello ea mali
• Ho fokotsa oksijene (hypoxia)
• Ho hloleha ha pelo
• Maemo a phahameng a carbon dioxide (hypercapnia)
• Tšoaetso
• Ho hloleha ha liphio
• Ho hloleha ha sebete
• Mathata a phepo e nepahetseng
• Maemo a kelello (joalo ka khatello ea maikutlo kapa psychosis)
• Mathata a qoqotho

Ho phekola mathata a bongaka le a kelello hangata ho ntlafatsa ts'ebetso ea kelello.

Ho ka hlokahala meriana ho laola boitšoaro bo mabifi kapa bo ferekaneng. Hangata tsena li qala ka litekanyo tse tlase haholo ebe li fetoloa kamoo ho hlokahalang.

Batho ba bang ba nang le delirium ba ka rua molemo ka lithuso tsa kutlo, likhalase, kapa ho buuoa ka leihlo.

Mefuta e meng ea kalafo e ka thusang:

• Phetoho ea boits'oaro ho laola boits'oaro bo sa amoheleheng kapa bo kotsi
• Tloaelo ea 'nete ho fokotsa ho ferekana maikutlo

Maemo a hlobaetsang a bakang delirium a ka hlaha ka mathata a nako e telele (a sa foleng) a bakang 'dementia'. Li-syndromes tse matla tsa boko li ka khutlisoa ka ho sebetsana le sesosa.

Delirium hangata e nka beke e le 'ngoe. Ho ka nka libeke tse 'maloa hore ts'ebetso ea kelello e khutlele setloaeling. Pholiso e felletseng e tloaelehile, empa ho latela sesosa sa pherekano.

Mathata a ka bakoang ke delirium a kenyelletsa:

• Ho lahleheloa ke bokhoni ba ho sebetsa kapa ho itlhokomela
• Ho lahleheloa ke matla a ho sebelisana
• Tsoelo-pele ho isa bohameng kapa ho akheha
• Litla-morao tsa meriana e sebelisetsoang ho phekola lefu lena

Bitsa mofani oa tlhokomelo ea bophelo haeba ho ka ba le phetoho e potlakileng maemong a kelello.

Ho sebetsana le maemo a bakang delirium ho ka fokotsa kotsi ea ona. Ho batho ba sepetlele, ho qoba kapa ho sebelisa litekanyetso tse tlase tsa litlhare, kalafo e potlakileng ea ts'oaetso ea ts'oaetso le ts'oaetso, le ho sebelisa mananeo a 'nete a tla fokotsa menyetla ea ho ferekana maikutlo ho ba kotsing e kholo.

Boemo bo matla ba pherekano; Lefu la boko bo matla

• Sisteme ea methapo e bohareng le methapo ea methapo
• Boko

Guthrie PF, Rayborn S, Butcher HK. Tataiso ea boits'oaro e thehiloeng bopaking: delirium. Mooki oa J Gerontol. 2018; 44 (2): 14-24. PMID: 29378075 www.ncbi.nlm.nih.gov/pubmed/29378075. (Lebokose)

Inouye SK. Delirium ho mokuli ea tsofetseng. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 25.

Mendez MF, Padilla CR. Delirium. 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 4.