Neuropathie Ya Système Nerveuse Autonome

Neuropathie ya système nerveuse autonome ibaho iyo hari ikibazo ku mitsi igenzura imikorere y'umubiri itari iy'ubushake. Ishobora kugira ingaruka ku miterere y'amaraso, kugenzura ubushyuhe bw'umubiri, ku gushobora kw'igogorwa ry'ibiribwa, ku mikorere y'umwijima ndetse no ku mibonano mpuzabitsina.

Akababaro k'imitsi kagira ingaruka ku butumwa buva mu bwonko bugana mu zindi nzego n'ibice bya système nerveuse autonome. Ibi bice birimo umutima, imiyoboro y'amaraso n'ibice by'umubiri bisohora umusemburo.

Diabete niyo ntandaro ikunze kugaragara ya neuropathie ya système nerveuse autonome. Ishobora kandi guterwa n'izindi ndwara, virusi cyangwa bagiteri, cyangwa imiti imwe n'imwe. Ibimenyetso n'uburyo bwo kuvura bitandukanye bitewe n'imitsi yangiritse.

"Ibimenyetso n'ibibonwa bya autonomic neuropathy biterwa n'imitsi yangiritse. Bishobora kuba birimo:\n\n* Kuzenguruka no gucika intege igihe uhagaze, biterwa n'igabanuka ry'umuvuduko w'amaraso ryihuse.\n* Ibibazo by'umukobwa, nko kugorana gutangira kwinjira, gutakaza ubushobozi bwo kugenzura umukobwa, kugorana kumva umukobwa wuzuye no kudakwisha umukobwa rwose. Kudakwisha umukobwa rwose bishobora gutera indwara z'inzira y'umukobwa.\n* Ibibazo by'imibonano mpuzabitsina, birimo ibibazo byo kugera cyangwa gukomeza imibonano mpuzabitsina (impotence) cyangwa ibibazo byo kubona imbuto. Ku bagore, ibibazo birimo umwuma mu gitsina, libido nke no kugorana kugera ku ndetse.\n* Gukoma mu nda, nko kumva wuzuye nyuma yo kurya utudodo duke, gutakaza ubushake bwo kurya, impiswi, kubabara mu nda, kubyimba mu nda, isereri, kuruka, kugorana kwishima no kubabara mu gituza. Ibi bibazo byose biterwa n'impinduka mu mikorere y'igogorwa.\n* Kudashaka kumenya isukari yo hasi mu maraso (hypoglycemia), kuko ibimenyetso byo kuburira, nko guhinda umushyitsi, biba bitahari.\n* Ibibazo byo gucana ibyuya, nko gucana ibyuya cyane cyangwa bike. Ibi bibazo bigira ingaruka ku bushobozi bwo kugenzura ubushyuhe bw'umubiri.\n* Guhinduka gake kw'amaso, bigorana guhindukira mu mwijima no kubona neza igihe utwaye ijoro.\n* Kudakunda imyitozo, bishobora kubaho niba umuvuduko w'umutima wawe ugumye kimwe aho guhinduka ukurikije urwego rw'imikorere yawe."

Shaka ubufasha bwa muganga vuba bishoboka niba utangiye kugira ibimenyetso bya neuropathy ya autonome, cyane cyane niba ufite diabete idakurikiranwa neza.

Niba ufite diabete yo mu bwoko bwa 2, ihuriro ry'Amerika ryita ku diabete riragira inama ko ubujyenjye bwa neuropathy ya autonome bukorwa buri mwaka uhereye igihe ubimenyeshejwe. Ku bantu bafite diabete yo mu bwoko bwa 1, iri huriro rigira inama ko ubujyenjye bukorwa buri mwaka uhereye imyaka itanu nyuma yo kumenyeshwa.

Indwara nyinshi z'ubuzima zishobora gutera neuropathy ya autonome. Irashobora kandi kuba ingaruka mbi y'ubuvuzi bw'izindi ndwara, nka kanseri. Bimwe mu bintu bisanzwe bitera neuropathy ya autonome birimo:

• Diabete, cyane cyane iyo idakurikiranwa neza, ni yo ntandaro ikomeye ya neuropathy ya autonome. Diabete ishobora gutera gahoro gahoro kwangirika kw'imijyana mu mubiri wose.
• Kwirundanya kw'imikorere idasanzwe ya poroteyine mu ngingo (amyloidose), bigira ingaruka ku ngingo n'urwungano rw'imijyana.
• Indwara ziterwa n'ubudahangarwa bw'umubiri, aho ubudahangarwa bw'umubiri bugaba igitero kandi bugangiza ibice by'umubiri wawe, harimo n'imijyana. Ingero harimo Sjogren syndrome, systemic lupus erythematosus, rheumatoid arthritis na celiac disease. Guillain-Barre syndrome ni indwara iterwa n'ubudahangarwa bw'umubiri ibaye vuba kandi ishobora kugira ingaruka ku mijyana ya autonome.

Neuropathy ya autonome ishobora kandi guterwa n'igitero cy'ubudahangarwa bw'umubiri gitangizwa na kanseri zimwe na zimwe (paraneoplastic syndrome).

• Imiti imwe, harimo imiti imwe ikoreshwa mu kuvura kanseri (chimiotherapie).
• Virusi na bagiteri zimwe, nka virusi itera SIDA (HIV) n'izitera botulism na Lyme disease.
• Indwara zimwe na zimwe zirakomoka zishobora kandi gutera neuropathy ya autonome.

Ibintu bishobora kongera ibyago byo kwibasirwa na neuropathy ya autonome birimo:

• Diabete. Diabete, cyane cyane iyo idakurikiranwe neza, yongera ibyago byo kwibasirwa na neuropathy ya autonome n'ibindi bibazo by'imiterere. Uri mu kaga cyane iyo ugira ikibazo cyo kugenzura isukari yawe mu maraso.
• Indwara zindi. Indwara zimwe na zimwe zirimo amyloidose, porphyria na hypothyroidism zishobora kongera ibyago byo kwibasirwa na neuropathy ya autonome. Kanseri nayo irashobora kubikora, akenshi bitewe n'ingaruka ziterwa n'ubuvuzi.

Indwara zimwe na zimwe zirakomoka ku babyeyi, zigushyira mu kaga ko kwibasirwa na autonomic neuropathy, ntabwo zishobora kwirindwa. Ariko ushobora kugabanya uburyo zigaragara cyangwa uburyo zikomeza kwiyongera witaye ku buzima bwawe muri rusange kandi ugafata neza indwara ufite. Kugira ngo ugenzure indwara n'ibibazo by'ubuzima,kurikira inama muganga wawe akugira ku bijyanye no kubaho k'ubuzima bwiza. Iyo nama ishobora kuba irimo ibi bikurikira:

• Genzura isukari yawe mu maraso niba ufite diyabete.
• Irinde inzoga n'itabi.
• Fata imiti ikwiye niba ufite indwara y'umubiri urwanya imiterere y'umubiri wawe.
• Fata ingamba zo gukumira cyangwa kugenzura umuvuduko ukabije w'amaraso.
• Gerageza kugira ibiro bikwiye kandi ubikomeze.
• Kora imyitozo ngororamubiri buri gihe.

Neuropathie ya système nerveuse autonome ni ingaruka zishoboka z'indwara zimwe na zimwe. Ibizamini uzakenera biterwa n'ibimenyetso byawe n'ibintu byongera ibyago bya neuropathie ya système nerveuse autonome.

Niba ufite diabete cyangwa izindi ndwara zikubera ibyago bya neuropathie ya système nerveuse autonome kandi ufite ibimenyetso bya neuropathie, umuvuzi wawe azakora isuzuma ngaruka mbere akakubaza ibibazo ku bimenyetso byawe.

Niba uri kuvurwa kanseri hakoreshejwe imiti izwiho gukomeretsa imitsi, umuvuzi wawe azasuzumira ibimenyetso bya neuropathie.

Niba ufite ibimenyetso bya neuropathie ya système nerveuse autonome ariko nta bintu byongera ibyago, ikurikiranwa ry'uburwayi rishobora kugorana. Umuvuzi wawe ashobora gusubiramo amateka yawe y'ubuzima, agakuganira ku bimenyetso byawe agakora isuzuma ngaruka mbere.

Umuvuzi wawe ashobora kugutegurira ibizamini byo gusuzuma imikorere ya système nerveuse autonome, birimo:

Ikizamini cya tilt-table. Iki kizamini gipima uko igitutu cy'amaraso n'umuvuduko w'umutima bisubiza ihindagurika ry'imiterere n'umwanya. Gikora nk'icyo ukora iyo uhagurutse umaze kuryama. Uryama usongeye ku meza, maze ukazamuwe kugira ngo igice cyo hejuru cy'umubiri wawe kizamuke. Ubusanzwe, imiyoboro y'amaraso irahana kandi umuvuduko w'umutima wiyongera kugira ngo ubone uburyo bwo kugabanya igitutu cy'amaraso. Iyi gisubizo gishobora kugenda buhoro niba ufite neuropathie ya système nerveuse autonome.

Ikizamini cyoroshye kuri iyi gisubizo kirimo gusuzuma igitutu cy'amaraso iyo uryamye, wicaye kandi uhagaze nyuma y'iminota itatu. Ikindi kizamini kirimo guhagarara umunota umwe, hanyuma ukagendera hasi umunota umwe hanyuma ugahaguruka ukongera igitutu cy'amaraso n'umuvuduko w'umutima bigakurikiranwa.

• Ibizamini byo gusuzuma imikorere ya système nerveuse autonome. Ibi bizamini bipima uko umuvuduko w'umutima n'igitutu cy'amaraso bisubiza imyitozo nk'umwuka mwinshi no guhumeka cyane (Valsalva maneuver).
• Ikizamini cya tilt-table. Iki kizamini gipima uko igitutu cy'amaraso n'umuvuduko w'umutima bisubiza ihindagurika ry'imiterere n'umwanya. Gikora nk'icyo ukora iyo uhagurutse umaze kuryama. Uryama usongeye ku meza, maze ukazamuwe kugira ngo igice cyo hejuru cy'umubiri wawe kizamuke. Ubusanzwe, imiyoboro y'amaraso irahana kandi umuvuduko w'umutima wiyongera kugira ngo ubone uburyo bwo kugabanya igitutu cy'amaraso. Iyi gisubizo gishobora kugenda buhoro niba ufite neuropathie ya système nerveuse autonome.

Ikizamini cyoroshye kuri iyi gisubizo kirimo gusuzuma igitutu cy'amaraso iyo uryamye, wicaye kandi uhagaze nyuma y'iminota itatu. Ikindi kizamini kirimo guhagarara umunota umwe, hanyuma ukagendera hasi umunota umwe hanyuma ugahaguruka ukongera igitutu cy'amaraso n'umuvuduko w'umutima bigakurikiranwa.

• Ibizamini by'igogorwa. Ibizamini byo gusuzuma uko ifunguro rimenyekana ni ibizamini bisanzwe byo gusuzuma ibibazo by'igogorwa nk'igogorwa ridafite umuvuduko no gutinda kw'ifunguro mu gifu (gastroparesis). Ibi bizamini bikorwa n'abaganga b'inzobere mu ndwara z'igogorwa (gastroenterologist).
• Ikizamini cya quantitative sudomotor axon reflex. Iki kizamini kiperereza uko imitsi igenzura imisemburo y'umubiri isubiza istimuli. Umuvuduko muto w'amashanyarazi unyura mu bipfundikizo byashyizwe ku kuboko kwawe, ku gice cyo hejuru n'icy'hepfo cy'ukuguru, no ku kirenge. Mudasobwa isesengura uko imitsi yawe n'imisemburo y'umubiri bisubiza. Ushobora kumva ubushyuhe cyangwa ikintu gisa n'umuriro mu gihe cy'ikizamini.
• Ikizamini cyo gusuzuma ubushyuhe. Urashizweho umukungugu uhindura ibara iyo uhindutse. Mu gihe uryamye mu cyumba gifite ubushyuhe buzamuka buhoro buhoro, amafoto y'ikoranabuhanga yandika ibisubizo uhereye igihe utangiye guhindurwa.
• Ibizamini byo gusuzuma imikorere y'impyiko n'umuyoboro w'inkari. Niba ufite ibimenyetso by'indwara z'umuyoboro w'inkari, ubusanzwe ibizamini by'inkari n'umuyoboro w'inkari bishobora gusuzuma imikorere y'umuyoboro w'inkari.
• Ultrasound. Niba ufite ibimenyetso by'indwara z'umuyoboro w'inkari, umuvuzi wawe ashobora kugutegurira ultrasound y'umuyoboro w'inkari. Muri iki kizamini, ibishushanyo by'amajwi byinshi by'umuvuduko bikora ishusho y'umuyoboro w'inkari n'ibindi bice by'umuyoboro w'inkari.

Ubuvuzi bwa neuropathy ya autonome burimo:

Umuganga wawe ashobora kugutegurira:

Umuganga wawe ashobora kugusaba:

Ku bagabo bafite ibibazo byo kubura ubushobozi bwo kwikinisha, abaganga bashobora kugutegurira:

Imiti ituma umuntu ashobora kwikinisha. Imiti nka sildenafil (Viagra), vardenafil, tadalafil (Cialis) na avanafil (Stendra) irashobora kugufasha kugera ku gikorwa cyo kwikinisha no kuguma muri icyo gikorwa. Ingaruka mbi zishoboka zirimo igitutu cy'amaraso gito, kubabara umutwe gake, guhindagurika kw'uruhu, kubabara mu gifu no guhinduka kw'ibara ry'amaso.

Niba ufite amateka y'indwara z'umutima, arrhythmia, stroke cyangwa igitutu cy'amaraso kiri hejuru, koresha iyi miti witonze. Irinde kandi gufata iyi miti niba ufashe ubwoko ubwo arirwo bwose bwa nitrates zikomoka ku bimera. Shaka ubufasha bw'abaganga vuba niba ufite ubushobozi bwo kwikinisha bumaze amasaha arenga ane.

Ku bagore bafite ibimenyetso by'imyororokere, abaganga bashobora kugutegurira:

Neuropathy ya autonome ishobora gutera ibibazo by'umuvuduko w'amaraso n'umutima. Umuganga wawe ashobora kwandika:

Imiti igamije kuzamura igitutu cy'amaraso. Niba wumva ugiye kugwa cyangwa ukagira ubusembwa iyo uhagurutse, umuganga wawe ashobora kugusaba imiti. Fludrocortisone ifasha umubiri wawe kubika umunyu, ibintu bifasha kugenzura igitutu cy'amaraso.

Midodrine (Orvaten) na droxidopa (Northera) bishobora gufasha kuzamura igitutu cy'amaraso. Ariko iyi miti ishobora gutera igitutu cy'amaraso kiri hejuru iyo uri kuryamye. Octreotide (Sandostatin) ishobora gufasha kuzamura igitutu cy'amaraso mu bantu barwaye diyabete bafite igitutu cy'amaraso gito nyuma yo kurya, ariko ishobora gutera ingaruka mbi. Pyridostigmine (Mestinon) ishobora gufasha kugumisha igitutu cy'amaraso gishyizeho iyo uhagaze.

Niba ukanka cyane, umuganga wawe ashobora kwandika imiti igabanya ibyo kunka. Glycopyrrolate (Cuvposa, Robinul, izindi) ishobora kugabanya kunka. Ingaruka mbi zishobora kuba harimo impiswi, umunwa wumye, kubura ubushobozi bwo kwinjira, amaso adakora neza, guhinduka kw'umuvuduko w'umutima, kubabara umutwe, kubura uburyohe no gusinzira. Glycopyrrolate ishobora kandi kongera ibyago by'indwara ziterwa n'ubushyuhe, nko gukama, kubera kugabanuka kw'ubushobozi bwo kunka.

• Kuvura indwara y'ibanze. Intego ya mbere yo kuvura neuropathy ya autonome ni ugucunga indwara cyangwa ikibazo cyangiza imiyoboro y'imbere. Niba diyabete ari yo itera imiyoboro y'imbere kwangirika, ugomba kugenzura neza isukari mu maraso kugira ngo wirinde kwangirika gukomeza. Hafi kimwe cya kabiri cy'igihe, nta mpamvu y'ibanze ya neuropathy ya autonome iba iboneka.

• Gucunga ibimenyetso byihariye. Bimwe mu buvuzi bishobora kugabanya ibimenyetso bya neuropathy ya autonome. Ubuvuzi bushingiye ku gice cy'umubiri wawe cyangizwa cyane n'imiterere y'imbere.

• Guhindura imirire. Ushobora kuba ukeneye ibinyamisogwe byinshi n'amazi. Ibintu byongera ibinyamisogwe, nka Metamucil cyangwa Citrucel, bishobora kandi gufasha. Ongera buhoro buhoro umubare w'ibinyamisogwe ubone kugira ngo wirinde imyuka mibi n'ububabare mu nda.

• Imiti ifasha igifu guhita kigabanya. Imiti yanditswe na muganga yitwa metoclopramide (Reglan) ifasha igifu guhita kigabanya vuba binyuze mu kongera imikorere y'igogorwa. Iyi miti ishobora gutera ubusembwa kandi ntigomba gukoreshwa igihe kirenga ibyumweru 12.

• Imiti igabanya impatwe. Imiti igabanya impatwe ushobora kugura utabanje kujya kwa muganga ishobora gufasha kugabanya impatwe. Baza umuganga wawe umubare w'inshuro ukwiye gukoresha imiti igabanya impatwe.

• Imiti igabanya iseseme. Antibiyotike ishobora gufasha kuvura iseseme binyuze mu kuburizamo ukwiyongera kw'ibinyabuzima byinshi mu mara. Imiti igabanya iseseme iboneka utabanje kujya kwa muganga ishobora gufasha.

• Gusubiramo imyitozo y'umwijima. Gukurikiza gahunda y'igihe cyo kunywa amazi n'igihe cyo kunyara bishobora gufasha kongera ubushobozi bw'umwijima no gusubiramo imyitozo y'umwijima kugira ngo umwijima ushyireho neza mu gihe gikwiye.

• Imiti yo gucunga ibimenyetso by'umwijima. Umuganga wawe ashobora kwandika imiti igabanya umwijima ukabije. Izindi miti ishobora gufasha gushyira umwijima hanze.

• Ubufasha bwo kunyara (catheterization). Umuyoboro ujyanywa mu muyoboro wawe kugira ngo umwijima ushyire hanze.

• Imiti ituma umuntu ashobora kwikinisha. Imiti nka sildenafil (Viagra), vardenafil, tadalafil (Cialis) na avanafil (Stendra) irashobora kugufasha kugera ku gikorwa cyo kwikinisha no kuguma muri icyo gikorwa. Ingaruka mbi zishoboka zirimo igitutu cy'amaraso gito, kubabara umutwe gake, guhindagurika kw'uruhu, kubabara mu gifu no guhinduka kw'ibara ry'amaso.

  Niba ufite amateka y'indwara z'umutima, arrhythmia, stroke cyangwa igitutu cy'amaraso kiri hejuru, koresha iyi miti witonze. Irinde kandi gufata iyi miti niba ufashe ubwoko ubwo arirwo bwose bwa nitrates zikomoka ku bimera. Shaka ubufasha bw'abaganga vuba niba ufite ubushobozi bwo kwikinisha bumaze amasaha arenga ane.

• Ipompe ya vacuum yo hanze. Iki gikoresho gifasha gukurura amaraso mu gitsina gabo hakoreshejwe icupa ry'intoki. Uruziga rw'umuvuduko rufasha kugumisha amaraso aho ari, rukagumisha ubushobozi bwo kwikinisha mu gihe kigera ku minota 30.

• Amavuta yo mu gitsina yo kugabanya umwuma no koroshya imibonano mpuzabitsina no kuyishimisha.

• Imwe mu miti mike yemewe ku bagore batarageza mu gihe cyo gucura kugira ngo bagabanye ubushake buke bw'imibonano mpuzabitsina.

• Imirire ifite umunyu mwinshi n'amazi menshi. Niba igitutu cy'amaraso kigabanuka iyo uhagurutse, imirire ifite umunyu mwinshi n'amazi menshi ishobora gufasha kugumisha igitutu cy'amaraso. Ubu buvuzi bushobora gutera igitutu cy'amaraso kiri hejuru cyangwa kubyimba mu birenge, mu maguru cyangwa mu birenge. Bityo, rusanzwe rugirwa inama gusa ku bibazo bikomeye by'igitutu cy'amaraso. Kandi ubu buvuzi ntibugomba gukoreshwa mu bantu barwaye gucika intege kw'umutima.

• Imyenda ihambirira. Umugozi wambaye ku kiuno cyangwa amasogisi maremare ashobora gufasha kunoza amaraso.

• Imiti igamije kuzamura igitutu cy'amaraso. Niba wumva ugiye kugwa cyangwa ukagira ubusembwa iyo uhagurutse, umuganga wawe ashobora kugusaba imiti. Fludrocortisone ifasha umubiri wawe kubika umunyu, ibintu bifasha kugenzura igitutu cy'amaraso.

  Midodrine (Orvaten) na droxidopa (Northera) bishobora gufasha kuzamura igitutu cy'amaraso. Ariko iyi miti ishobora gutera igitutu cy'amaraso kiri hejuru iyo uri kuryamye. Octreotide (Sandostatin) ishobora gufasha kuzamura igitutu cy'amaraso mu bantu barwaye diyabete bafite igitutu cy'amaraso gito nyuma yo kurya, ariko ishobora gutera ingaruka mbi. Pyridostigmine (Mestinon) ishobora gufasha kugumisha igitutu cy'amaraso gishyizeho iyo uhagaze.

• Imiti yo kugenzura umuvuduko w'umutima. Ubwoko bw'imiti bwitwa beta blockers bufasha kugenzura umuvuduko w'umutima niba ugiye hejuru cyane mu gihe cy'imikino ngororamubiri.

Getting Up Safely and Comfortably

Getting up quickly can sometimes cause dizziness or lightheadedness. Here are some simple tips to help you get up and around more easily and safely:

Gentle Transitions:

• Slow and Steady: When you get out of bed, stand up slowly, in stages. This helps your body adjust to the change in position and can prevent dizziness. Think of it like a ramp, not a jump. Give yourself a moment to adjust at each stage.

• Prepare Your Body: Before you stand, sit on the edge of the bed with your legs dangling for a few minutes. This allows your blood to redistribute more evenly. Also, flex your feet and make your hands into fists for a few seconds. This gently squeezes your muscles, helping to increase blood flow to your brain and body.

• Boosting Blood Pressure: Once you're standing, gently tense your leg muscles by crossing one leg over the other a few times. This helps to increase blood pressure, making you feel more stable and less likely to feel dizzy.

Other Helpful Tips:

• Elevated Bed: If you have low blood pressure, raising the head of your bed by about 4 inches (10 centimeters) can make a difference. You can use blocks or risers under the head of the bed to accomplish this. This helps your blood flow better when you first wake up.
• Improved Digestion: If you have digestive issues, eating small, frequent meals throughout the day can help. Drinking plenty of fluids is also important. Choosing foods that are low in fat and high in fiber can often improve digestion.
• Managing Diabetes: Good blood sugar control is crucial for people with diabetes. Keeping your blood sugar levels stable can significantly lessen symptoms and help prevent or delay new health problems. Working closely with your doctor is essential for managing diabetes effectively.