He aha te Myasthenia Gravis? Ngā Tōmhanga, Ngā Take, me te Maimoatanga

Ko te myasthenia gravis he mate ārai-tinana roa e whakaiti ana i te kaha o ngā uaua, ā, ka ngāwari te ngenge i te wā e mahi ana. Ka whakaeke te pūnaha ārai-tinana o tō tinana i ngā hononga i waenganui i ō pūtau io me ō uaua, ā, ka uaua ai te whiwhi a ō uaua i ngā tohu e hiahiatia ana kia pakaru tika.

E pā ana tenei mate ki te 20 o te mano tangata, ā, he mea tino onge, engari ehara i te mea tino onge. Ko te tikanga o te ingoa, ko te "ngākaha uaua nui," engari kaua e manukanuka. Mā te maimoatanga tika, ka taea e te nuinga o te hunga e pangia ana e te myasthenia gravis te ora i ngā oranga katoa, ngā oranga mahi.

He aha ngā tōmhanga o te myasthenia gravis?

Ko te tohu tino nui ko te ngoikore o ngā uaua e kaha ake ana te kino i te wā e mahi ana, ā, ka pai ake i te wā e okioki ana. Ka kite pea koe i te kaha o ō uaua i te ata, engari ka ngoikore haere i te rā.

Tāea tatou te haere i ngā tōmhanga tino noa ka pā pea ki a koe, mā te mahara ko te haerenga o te tangata katoa me tenei mate he rerekē.

• Ngā kamo e heke ana (ptosis): Ka heke pea tetahi kamo, te rua rānei, ina koa ka ngenge koe, kua roa rānei te pānui.
• Te kite rua: Ka kite pea koe i ngā whakaahua e rua o tetahi mea kotahi, ina koa ka titiro ki ētahi atu huarahi.
• Te uaua ki te ngau, ki te horomia: Ka ngāwari pea te ngenge o ngā uaua o tō kauae i te wā e kai ana, te piri rānei te kai ki tō korokoro.
• Te kōrero ngākau, te ihu: Ka rereke pea tō reo, ina koa i muri i te kōrero mō te wā roa.
• Te ngoikore o ngā ringa me ngā waewae: Ka uaua pea ki te kawe i ngā mea, ki te piki i ngā kaupae, ki te hikoi i ngā tawhiti roa.
• Te ngoikore o ngā uaua kanohi: Ka uaua pea te ataata, te pupuhi, te hanga rānei i ētahi atu āhua kanohi.

I ētahi wā, ka pā pea te uaua ki te manawa ki a koe ki te pā te ngoikore ki ngā uaua e whakahaere ana i te manawa. He mea tino onge tenei, engari e hiahia ana ki te tiaki hauora tonu ina puta.

He aha ngā momo o te myasthenia gravis?

Ka whakarōpūtia e ngā tākuta te myasthenia gravis ki ētahi momo, e whakaū ana ki ngā uaua e pā ana, me te wā e tīmata ana ngā tōmhanga. Ko te mārama ki tō momo motuhake ka āwhina i ngā whakatau maimoatanga.

Te myasthenia gravis kanohi: E pā ana ki ngā uaua o ō kanohi anake. Ko te 15% o te hunga e pangia ana e tēnei momo ka kite i ngā tōmhanga e noho ana ki ō rātou kanohi, ka whanake pea ētahi atu ki te momo whānui i muri mai.

Te myasthenia gravis whānui: E pā ana ki ngā rōpū uaua maha puta noa i tō tinana. Ko te momo tino noa tenei, e 85% o ngā keehi. Ka tīmata ngā tōmhanga i ngā kanohi, engari ka horapa ki ētahi atu wāhi.

Te myasthenia gravis whānau: He momo tuku iho onge tenei e puta mai ana i te whānau. Kāore i rite ki ngā momo ārai-tinana, ka puta mai tenei i ngā rerekētanga ira e pā ana ki te hononga uaua-io.

He aha ngā take o te myasthenia gravis?

Ka whanake te myasthenia gravis ina whakaeke te pūnaha ārai-tinana o tō tinana i ngā kaiwhiwhi acetylcholine i te hononga i waenganui i ngā io me ngā uaua. Whakaarohia ēnei kaiwhiwhi hei pouaka mēra iti e whiwhi ana i ngā karere matū e kī ana ki ngā uaua kia pakaru.

Koinei ngā mea e puta ana i roto i tō tinana ina pangia koe e tēnei mate:

• Te whakaputa antibodi: Ka hanga e te pūnaha ārai-tinana o tō tinana ngā antibodi e aukati ana, e whakangaro rānei i ngā kaiwhiwhi acetylcholine.
• Te whakaroa i te tohu: Mā te iti o ngā kaiwhiwhi mahi, kaore e taea e ngā tohu io te tae tika ki ō uaua.
• Te ngoikore o ngā uaua: Ka whiwhi ngā uaua i ngā tohu ngoikore, ā, ka ngāwari te ngenge.
• Te whakauru o te whatukuhu thymus: E 75% o te hunga e pangia ana e ngā rerekētanga o te whatukuhu thymus e taea ana te whakaoho i te whakautu ārai-tinana.

Kāore i te marama tonu te whakaoho tika mō tēnei whakautu ārai-tinana, engari e whakapono ana ngā kairangahau kei roto i te whakakotahitanga o te ngoikore ira me ngā take taiao. Ko te nuinga o ngā keehi ka whanake mai kahore he kaupapa whakamārama.

Nōhea te haere ki te tākuta mō te myasthenia gravis?

Me whakapiri atu koe ki te kaiwhakarato hauora mena ka kite koe i te ngoikore o ngā uaua e kaha ake ana te kino i te wā e mahi ana, ā, ka pai ake i te wā e okioki ana. He mea tino motuhake tēnei tauira, ā, e hiahia ana ki te arotake hauora.

Rapua te tiaki hauora tonu mena ka pā te uaua ki te manawa, te uaua nui ki te horomia, te kino rānei o te ngoikore o ngā uaua. Ka taea e ēnei tōmhanga te tohu i te mate myasthenic, e hiahia ana ki te maimoatanga āwhina.

Kaua e tatari mena kei te pā te kite rua tonu, ngā kamo e heke ana e āwangawanga ana i tō kitenga, ngā huringa kōrero rānei e uaua ai ki ētahi atu te mārama ki a koe. Ka taea e te taumata whakamārama me te maimoatanga te āwhina i te aukati i te whanake me te whakapai ake i tō kounga ora.

He aha ngā take morearea mō te myasthenia gravis?

He maha ngā take ka piki ake ai tō tūponotanga ki te whanake i te myasthenia gravis, ahakoa te whai i ēnei take morearea kāore e kī ka whanake koe i te mate.

Ka taea e te mārama ki ēnei take te āwhina i a koe me tō tākuta ki te tiaki mō ngā tōmhanga whakamutunga:

• Te tau me te ira tangata: Ko ngā wāhine te nuinga e pā ana i mua i te 40 tau, ko ngā tāne te nuinga e whakamāramatia ana i muri i te 60 tau.
• Ētahi atu mate ārai-tinana: Ko te whai i te mate rheumatoid, te lupus, te mate thyroid rānei ka piki ake ai tō morearea.
• Te hītori whānau: Ahakoa kāore i tuku iho kaha, ko te whai i ngā whānau e pangia ana e ngā mate ārai-tinana ka piki ake pea te morearea.
• Ngā mate pūngao o te whatukuhu thymus: E 10-15% o te hunga e pangia ana e te myasthenia gravis e whai ana i ngā thymomas (ngā mate pūngao o te whatukuhu thymus).
• Ētahi rongoā: Ka taea e ētahi rongoā mate huaketo, ngā rongoā ngakau, me ngā kaiwhakangenge uaua te whakaiti i ngā tōmhanga i roto i ngā tangata e pā ana.

He mea tika te kī ko te nuinga o te hunga e pangia ana e te myasthenia gravis kāore he take morearea marama. Ka taea te whanake i te mate i tetahi tangata, ahakoa tōna papamuri, tōna hītori hauora rānei.

He aha ngā raruraru pea o te myasthenia gravis?

Ahakoa ko te nuinga o te hunga e pangia ana e te myasthenia gravis e whakahaere pai ana mā te maimoatanga, he mea nui te mārama ki ngā raruraru pea kia taea ai te mohio ki ngā tohu whakatūpato whakamutunga.

Ko te raruraru tino nui ko te mate myasthenic, e puta mai ana ina ngoikore rawa ngā uaua manawa. E pā ana tenei ki te 15-20% o te hunga e pangia ana e te myasthenia gravis i tētahi wā, ā, e hiahia ana ki te noho whare hauora tonu.

Ko ētahi atu raruraru me mōhio koe ki a rātou ko:

• Te mate huaketo aspiration: Ka taea e ngā uaua horomia ngoikore te tuku kai, wai rānei ki ō ngā paru.
• Te mate cholinergic: Ka taea e tēnei raruraru onge te puta mai i te nui o te rongoā, ā, ka puta te ngoikore o ngā uaua e rite ana ki te mate anō.
• Ngā mate pūngao o te whatukuhu thymus: E 10-15% o te hunga e whanake ana i ngā thymomas, e hiahia ana pea ki te tango waewae.
• Ētahi atu mate ārai-tinana: Ka piki ake pea tō morearea ki te whanake i ngā mate ārai-tinana atu.

Mā te tirotiro tika me ngā whakatikatika maimoatanga, ka taea te aukati, te whakahaere rānei i te nuinga o ēnei raruraru. Ka mahi tahi tō rōpū hauora ki a koe ki te whakaiti i ēnei morearea.

Me pēhea te whakamārama i te myasthenia gravis?

Ko te whakamārama i te myasthenia gravis e whakauru ana i ngā whakamātautau maha, no te mea ka taea e ngā tōmhanga te rite ki ētahi atu mate. Ka tīmata tō tākuta me te hītori hauora taipitopito me te whakamātautau tinana, mā te arotahi ki ngā tauira ngoikore o ngā uaua.

Ko te tukanga whakamārama e whakauru ana i ēnei whakamātautau matua:

• Ngā whakamātautau toto: Ka tirotirohia ēnei mō ngā antibodi motuhake e whakaeke ana i ngā kaiwhiwhi acetylcholine, ētahi atu pūtau e pā ana rānei.
• Te electromyography (EMG): Ka ine tenei whakamātautau i te mahi hiko i roto i ō uaua, ā, ka taea te kite i ngā tauira āhuatanga.
• Ngā rangahau araio: Ka aromatawaihia ēnei i te pai o te haere o ngā tohu mai i ngā io ki ngā uaua.
• Te whakamātautau edrophonium: Ka hoatu tētahi rongoā poto-mahi kia kite mena ka pai ake te kaha o ngā uaua.
• Te CT, te MRI rānei o te uma: Ka tirotirohia ēnei whakaahua mō ngā rerekētanga, ngā mate pūngao rānei o te whatukuhu thymus.

Ka taea pea e tō tākuta te mahi i te whakamātautau putea huka, kei reira te putea huka e whakatakotoria ana ki ngā kamo e heke ana kia kite mena ka pai ake te ngoikore o te makariri. Ka taea e tēnei whakamātautau ngāwari te whakarato i ngā tohu whakamārama nui.

He aha te maimoatanga mō te myasthenia gravis?

Ko te maimoatanga mō te myasthenia gravis e whai ana ki te whakapai ake i te kaha o ngā uaua, ki te whakaiti i ngā tōmhanga, ki te āwhina i a koe ki te pupuri i tō kounga ora. Ko te rongo pai ko te maha o ngā whiringa maimoatanga whai hua e wātea ana.

Ka whakauru pea tō mahere maimoatanga i tētahi, maha rānei o ēnei huarahi:

• Ngā kaiwhakaiti cholinesterase: Ka āwhina ngā rongoā penei i te pyridostigmine ki te whakapai ake i te whakawhitiwhiti korero i waenganui i ngā io me ngā uaua.
• Ngā rongoā immunosuppressive: Ka āwhina ngā corticosteroids me ētahi atu rongoā ki te whakaiti i te whakautu ārai-tinana.
• Te plasmapheresis: Ka tangohia e tēnei tukanga ngā antibodi kino i tō toto, mā te whakarato i te whakapainga wā poto.
• Te immunoglobulin intravenous (IVIG): Ka taea e ēnei whakauru te āwhina i te whakahaere i tō pūnaha ārai-tinana.
• Te thymectomy: Ko te tango waewae o te whatukuhu thymus ka whakarato pea i ngā painga roa, ina koa i ngā tāngata kōhungahunga.

He mea tino motuhake te maimoatanga, ā, ka mahi tahi tō tākuta ki a koe ki te kimi i te whakakotahitanga e pai ana mō tō āhuatanga motuhake. Ko te nuinga o te hunga e kite ana i te whakapainga nui mā te maimoatanga tika.

Me pēhea te whakahaere i te myasthenia gravis i te kāinga?

Ko te whakahaere i te myasthenia gravis i te kāinga e whakauru ana i te hanga i ngā whiringa ora mohio e āwhina ana ki te tiaki i tō kaha me te whakaiti i ngā whakaoho tōmhanga. Ka taea e ngā whakatikatika iti te whakarereke nui i tō āhua i te rā.

Koinei ngā rautaki mahi ka taea te āwhina i a koe ki te pai ake:

• Whakaritehia ngā mahi mō ō wā kaha: Whakaritehia ngā mahi nui ina kaha rawa ō uaua, i te ata.
• Tangohia ngā okioki auau: Okioki i mua i tō ngenge kia aukati ai i te ngoikore o ngā uaua kei te kino rawa.
• Kai iti, auau: He mea ngāwari tenei ki ngā uaua ngau me te horomia ngenge.
• Noho makariri: Ka taea e te wera te whakaiti i ngā tōmhanga, no reira whakamahia te whakamātao hau me te karo i ngā taiao wera ina taea.
• Whakahaerehia te ahotea: Ka taea e te ahotea ngākau te whakaoho i ngā whakaoho tōmhanga, no reira whakamahia ngā tikanga whakangāwari.

Whakaarohia te hanga i tō taiao kāinga kia pai ake mā te tāuta i ngā pou hopu, mā te whakamahi i ngā taputapu māmā, mā te pupuri rānei i ngā mea e whakamahia pinepine ana i roto i te rohe.

Me pēhea te whakarite mō tō hui tākuta?

Ko te whakarite mō ō haerenga ki te tākuta ka taea te āwhina i te whakarite kia whiwhi koe i te nuinga o tō wā tahi. Ko te whakarite pai ka ārahi ki te whakawhitiwhiti korero pai ake me ngā whakatikatika maimoatanga pai ake.

I mua i tō hui, pupurihia he tātai tōmhanga e tohu ana i te wā e puta mai ana te ngoikore, he aha ngā mea e whakaoho ana, me te aha e āwhina ana ki te whakapai ake. Ka āwhina ēnei korero i tō tākuta ki te mārama ki tō tauira tōmhanga motuhake.

Kawe mai he rārangi katoa o ngā rongoā, ngā taapiri, me ngā hua hua katoa e inu ana koe, tae atu ki ngā horoinga me te wā. Whakamahia hoki ngā pātai mō tō mahere maimoatanga, ngā pānga taha pea, me ētahi atu āwangawanga mō tō mate.

Whakaarohia te kawe mai i tētahi mema whānau, hoa rānei e taea te āwhina i a koe me te mahara ki ngā korero nui i te wā o te haerenga. Ko te whai tautoko ka tino nui ina kōrerohia ngā whakatau maimoatanga uaua.

He aha te mea nui mō te myasthenia gravis?

Ko te myasthenia gravis he mate roa e taea te whakahaere e pā ana ki te kaha o ngā uaua, engari kāore e hiahiatia kia whakatau i tō oranga. Mā te maimoatanga tika me ngā whakatikatika ora, ka taea e te nuinga o te hunga e pangia ana e tēnei mate te haere tonu ki te mahi i ngā mea e aroha ana rātou.

Ko te kī ki te ora pai me te myasthenia gravis ko te mahi tata atu ki tō rōpū hauora, te noho pumau ki ngā maimoatanga, me te hanga i ngā whiringa mohio mō te whakamahi i tō kaha. Kia mahara ko te whakahaere i ngā tōmhanga ka pai ake i te wā e whakarite ana koe me tō tākuta i tō mahere maimoatanga.

Noho whakaaro pai me te manawanui ki te tukanga. Ko te nuinga o te hunga e pangia ana e te myasthenia gravis ka haere tonu ki te mahi, ki ngā whānau, ki ngā oranga mahi. Ko tō whakamārama ko te tīmatanga anake o te ako ki te whakahaere i tēnei mate pai.

Ngā pātai e ui pinepinetia ana mō te myasthenia gravis

Q1. He mea tuku iho te myasthenia gravis?

Kāore te myasthenia gravis e tuku iho, ahakoa pea he ngoikore te whakarite ira ki ngā mate ārai-tinana whānui. Ko te momo whānau te mea tuku iho, engari koinei te iti iho i te 5% o ngā keehi katoa. Ko te nuinga o te hunga e pangia ana e te myasthenia gravis kāore he mema whānau e pangia ana e te mate.

Q2. Ka taea te whakaora i te myasthenia gravis?

I tēnei wā, kāore he rongoā mō te myasthenia gravis, engari he mea tino taea te maimoatanga. Ko te nuinga o te hunga e whiwhi ana i te whakahokinga roa mā te maimoatanga tika. Ko ētahi tangata, ina koa rātou e mahi ana i te pokanga thymectomy, ka kite pea i te whakapainga nui, te whakatau rānei i ngā tōmhanga mō ngā wā roa.

Q3. Ka kino ake te myasthenia gravis i te wā?

He rerekē te whanake mai i te tangata ki te tangata. Ko ētahi tangata e kite ana i ngā tōmhanga pumau mō ngā tau, ko ētahi atu pea e whai ana i ngā wā e kino ake ana, ka whai muri i te whakapai ake. Mā ngā maimoatanga hou, ko te nuinga o te hunga e tumanako ana kia whakahaeretia pai tō rātou mate, kāore i te kino haere.

Q4. Ka taea e au te whakakori tinana me te myasthenia gravis?

Ae, ka taea e koe te whakakori tinana me te myasthenia gravis, engari me whakarerekē koe i tō huarahi. Ko te whakakori tinana māmā ki te reo ka taea te whai hua, engari karohia te nui o te mahi. Mahi tahi me tō rōpū hauora ki te whakawhanake i te mahere whakakori tinana e rite ana ki ō taumata kaha me ngā tauira kaha o ngā uaua.

Q5. He kai me karo ahau me te myasthenia gravis?

Kāore he kai motuhake me karo koe, engari ko ētahi tangata e kite ana ko ētahi kai e whakaiti ana i ō rātou tōmhanga. Ko te quinine (kei roto i te wai tonic) ka taea te whakaiti i te ngoikore o ngā uaua i ētahi tangata. Arotake ki te kai i te kai rite me te noho makuku, kōrerohia ngā āwangawanga kai ki tō tākuta.