Autonomic dysreflexia

Autonomic dysreflexia ke mokhoa o sa tloaelehang, o feteletseng oa tsamaiso ea methapo ea boithatelo (autonomic) ho susumetsa. Karabelo ena e ka kenyelletsa:

• Fetola lebelo la pelo
• Ho fufuleloa ho feteletseng
• Khatello ea mali e phahameng
• Ho phatloha ha mesifa
• Liphetoho tsa 'mala oa letlalo (bosoeu, bofubelu,' mala o moputsoa o moputsoa)

Lebaka le tloaelehileng ka ho fetisisa la autonomic dysreflexia (AD) ke kotsi ea mokokotlo oa mokokotlo. Tsamaiso ea methapo ea batho ba nang le AD e arabela ka mefuta ea ts'usumetso e sa khathatseng batho ba phetseng hantle.

Lisosa tse ling li kenyelletsa:

• Guillain-Barré syndrome (boloetse boo sesole sa 'mele sa' mele se hlaselang ka phoso karolo ea tsamaiso ea methapo)
• Litla-morao tsa meriana e meng
• Ho sithabela hlooho haholo le likotsi tse ling tsa boko
• Ho tsoa mali ho Subarachnoid (mofuta oa ho tsoa mali bokong)
• Ts'ebeliso ea lithethefatsi tse matlafatsang tse seng molaong joalo ka cocaine le amphetamine

Matšoao a ka kenyelletsa efe kapa efe ea tse latelang:

• Ho tšoenyeha kapa ho tšoenyeha
• Mathata a senya kapa a mala
• Pono e lerootho, baithuti ba atolositsoeng (ba atolositsoeng)
• Hlooho e bobebe, ho tsekela, kapa ho akheha
• Feberu
• Letlalo la mokoti, letlalo le lefubelu (le lefubelu) kaholimo ho kotsi ea lesapo la mokokotlo
• Ho fufuleloa haholo
• Khatello ea mali e phahameng
• Ho otla ha pelo ka mokhoa o sa tloaelehang, ho otla butle kapa ka potlako
• Ho ba le mesifa, haholo mohlahareng
• Ho ferekana ka nko
• Ho opeloa ke hlooho

Ka linako tse ling ha ho na matšoao, leha keketseho e kotsi ea khatello ea mali e le teng.

Mofani oa tlhokomelo ea bophelo o tla etsa tsamaiso e felletseng ea methapo le tlhahlobo ea bongaka. Bolella mofani ka meriana eohle eo u e sebelisang hona joale le eo u ileng ua e noa nakong e fetileng. Sena se thusa ho tseba hore na o hloka liteko life.

Liteko li ka kenyelletsa:

• Liteko tsa mali le moroto
• Tlhatlhobo ea CT kapa MRI
• ECG (tekanyo ea tšebetso ea motlakase oa pelo)
• Lumbar e phunya
• Ho lekola tafole e sekameng (ho lekoa khatello ea mali ha boemo ba mmele bo fetoha)
• Ho hlahloba toxicology (liteko tsa lithethefatsi life kapa life, ho kenyeletsoa meriana, maling a hao)
• Li-X-ray

Maemo a mang a arolelana matšoao a mangata le AD, empa a na le sesosa se fapaneng. Kahoo tlhahlobo le liteko li thusa mofani ho lahla maemo ana a mang, ho kenyeletsoa:

• Carcinoid syndrome (lihlahala tsa mala a manyane, li-colon, sehlomathiso le methapo ea bronchial matšoafong)
• Neuroleptic malignant syndrome (boemo bo bakoang ke meriana e meng e lebisang ho thatafala ha mesifa, feberu e matla le ho otsela)
• Pheochromocytoma (hlahala ea adrenal gland)
• Serotonin syndrome (karabelo ea lithethefatsi e etsang hore 'mele o be le serotonin e ngata haholo, khemik'hale e hlahisoang ke lisele tsa methapo)
• Sefefo sa qoqotho (boemo bo sokelang bophelo bo tsoang ho qoqotho e feteletseng)

AD e beha bophelo kotsing, kahoo ho bohlokoa ho fumana bothata kapele le ho bo phekola.

Motho ea nang le matšoao a AD o lokela ho:

• Lula 'me u phahamise hlooho
• Tlosa liaparo tse thata

Kalafo e nepahetseng e ipapisitse le sesosa. Haeba meriana kapa lithethefatsi tse seng molaong li baka matšoao, litlhare tseo li tlameha ho emisoa. Boloetse bofe kapa bofe bo hloka ho phekoloa. Mohlala, mofani o tla hlahloba catheter e thibetsoeng ea mosese le matšoao a ho patoa.

Haeba ho lieha ha sekhahla sa pelo ho baka AD, lithethefatsi tse bitsoang anticholinergics (joalo ka atropine) li ka sebelisoa.

Khatello ea mali e phahameng haholo e hloka ho phekoloa kapele empa ka hloko, hobane khatello ea mali e ka theoha ka tšohanyetso.

Mochine o etsang pacemaker o ka hlokahala bakeng sa morethetho oa pelo o sa tsitsang.

Ponahalo e ipapisitse le sesosa.

Batho ba nang le AD ka lebaka la moriana hangata baa fola ha moriana oo o emisoa. Ha AD e bakoa ke mabaka a mang, ho hlaphoheloa ho latela hore na lefu lena le ka phekoloa joang.

Mathata a ka hlaha ka lebaka la litla-morao tsa meriana e sebelisetsoang ho phekola boemo boo. Nako e telele, khatello e phahameng ea mali e ka baka tsitsipano, ho tsoa mali mahlong, stroke kapa lefu.

Bitsa mofani oa hau hang-hang haeba u e-na le matšoao a AD.

Ho thibela AD, u se ke ua noa meriana e bakang boemo bona kapa ea e mpefatsa.

Ho batho ba nang le kotsi ea mokokotlo, tse latelang li ka thusa ho thibela AD:

• Se ke oa lumella senya hore se tlale haholo
• Bohloko bo lokela ho laoloa
• Itloaetse tlhokomelo e nepahetseng ea mala ho qoba ho ts'oaroa ke setuloana
• Itloaetse tlhokomelo e nepahetseng ea letlalo ho qoba ho robala le ho tšoaetsoa ke letlalo
• Thibela tšoaetso ea senya

Autonomic hyperreflexia; Mokokotlo oa mokokotlo kotsi - autonomic dysreflexia; SCI - autonomic dysreflexia

• Sisteme ea methapo e bohareng le methapo ea methapo

Cheshire WP. Mathata a Autonomic le tsamaiso ea ona. Ka: Goldman L, Schafer AI, li-eds. Phekolo ea Goldman-Cecil. La 26th. Philadelphia, PA: Elsevier; 2020: khaolo ea 390.

Cowan H. Autonomic dysreflexia ka kotsi ea mokokotlo. Linako tsa Baoki. 2015; 111 (44): 22-24. PMID: 26665385 e fetotsoe.ncbi.nlm.nih.gov/26665385/.

McDonagh DL, Barden CB. Autonomic dysreflexia. Ho: Fleisher LA, Rosenbaum SH, lingoloa. Mathata ho Anesthesia. 3rd ed. Philadelphia, PA: Elsevier; 2018: khaolo ea 131.