Malignant Hyperthermia Chii? Zviratidzo, Zvinokonzera, & Kurapa

Malignant hyperthermia chirwere chisingawanzoitika asi chine ngozi chinoitika kana munhu aine makemikari anowanikwa panguva yekuvhiya. Inoitika kana maseji emuviri wako akasangana nemakemikari aya, zvichiita kuti tembiricha yemuviri wako ikwire nekukurumidza uye maseji ako aome.

Chirwere ichi chinotapukira vanhu vangangosvika 1 pakati pe5,000 kusvika ku1 pakati pe50,000 vanowana anesthesia yakajairika. Kunyange zvazvo zvichinzwa zvine njodzi, zvinorapika kana zvikaonekwa nekukurumidza, uye makamuri ekushandira anozivikanwa nekuzvigadzirira zvakanaka kuti azvigadzirire.

Zviratidzo zveMalignant Hyperthermia Ndezvipi?

Zviratidzo zvemalignant hyperthermia zvinoonekwa nekukurumidza panguva kana mushure mekuiswa kweanesthesia. Timu yako yezvokurapa inotarisa zviratidzo izvi zvakanyatsonaka panguva yekuvhiya chero kupi kwakashandiswa mishonga inokonzera chirwere ichi.

Zviratidzo zvinowanzoonekwa pakutanga zvinosanganisira:

• Kuwedzera kwakanyanya kwetembiricha yemuviri (dzimwe nguva kusvika ku106°F kana kupfuura)
• Kuomarara kwemhasuru, kunyanya mumaseji emuromo
• Kuwedzera kweropa uye kurova kwemoyo kusina kujairika
• Kuderera kweropa
• Kufema kukurumidza, kushoma
• Kuwedzera kwekuzvara
• Ruvara rweganda rwakasviba kana rwakatsvuka

Mumagariro akaoma, ungave uine kuparara kwemhasuru, matambudziko etsinga, kana kuchinja kwengozi mumakemikari eropa. Mashoko akanaka ndeakuti mapoka anoshanda mukamuri rekushandira anodzidziswa kuona zviratidzo izvi nekukurumidza uye kutora matanho nekukurumidza.

Chii Chinokonzera Malignant Hyperthermia?

Malignant hyperthermia inokonzerwa nechirwere chemagwenga chinoita kuti maseji emuviri wako asashande zvakanaka necalcium. Kana wakasangana nemishonga yakatarwa yeanesthesia, musiyano uyu wemagwenga unokonzera kupindura kwemhasuru kusina kujairika.

Zvinhu zvikuru zvinokonzera zvinosanganisira mishonga yakatarwa yeanesthesia:

• Gasi reanesthesia (semuenzaniso sevoflurane, isoflurane, uye halothane)
• Succinylcholine (mushonga unodzorera maseji)

Unogona kuwana chirwere ichi kubva kuvabereki vako. Chinobatanidzwa nekuchinja kwemajini anodzora kubudiswa kwe calcium mumaseji, kunyanya majini eRYR1 neCACNA1S. Kana majini aya asingashande zvakanaka, kushandiswa kwemishonga inokonzera chirwere ichi kunokonzera calcium kuzadza maseji ako zvisina kudzorwa.

Chirwere ichi chinofamba mumhuri, asi kuva negene hachirevi kuti uchava nechinetso. Vamwe vanhu vane gene asi havaone zviratidzo, nepo vamwe vangave nekutambura kwakanyanya panguva yavo yekutanga yekushandiswa kwemishonga inokonzera chirwere ichi.

Rini Unofanira Kuona Chiremba Nezve Malignant Hyperthermia?

Kana wakaronga kuvhiyiwa, unofanira kutaura nachiremba wako weanesthesia usati watanga kana uine nhoroondo yemhuri yematambudziko neanesthesia. Kukurukura uku kunobatsira timu yako yezvokurapa kuronga nzira yakachengeteka yekuvhiya kwako.

Unofanira kutaura zvakanyanya kana mumwe munhu wemhuri yako akawana:

• Feva dzisinganzwisisiki panguva yekuvhiya
• Kuporesa kwakaoma mushure meanesthesia
• Matambudziko emhasuru kana kushaya simba
• Malignant hyperthermia inozivikanwa

Panguva yekuvhiya, timu yako yeanesthesia inokutevera nguva dzose, saka haufanirwe kunetseka nezvekuziva zviratidzo iwe pachako. Zvisinei, kana wakaongororwa kuti une chirwere ichi, taura nechiremba wako usati wapihwa anesthesia kana mishonga yakatarwa.

Zvinhu Zvinowedzera Ngozi yeMalignant Hyperthermia Ndezvipi?

Chinhu chikuru chinowedzera ngozi ndechekuva nenhoroondo yemhuri ye malignant hyperthermia kana matambudziko asinganzwisisiki panguva yeanesthesia. Sezvo iri chirwere chemagwenga, chinowanzoitika mumhuri kuburikidza nemazuva.

Zvimwe zvinhu zvinogona kuwedzera ngozi yako zvinosanganisira:

• Kuva murume (varume vanowanzova nechinetso)
• Kuva mudiki (vana nevakuru vaduku vane huwandu hukuru)
• Kuva nemamwe matambudziko emhasuru senge central core disease
• Matambudziko asinganzwisisiki neanesthesia kare

Mamwe matambudziko emhasuru asingawanzoitika anobatanidzwawo nengozi yakakwira. Izvi zvinosanganisira congenital myopathies, muscular dystrophies, uye periodic paralysis syndromes. Kana uine chero chirwere chemhasuru chakaongororwa, timu yako yeanesthesia ichaita zvakawanda kuti ikudzivirire.

Zvinokosha kucherechedza kuti kushushikana, kupisa, kana kurovedza muviri hazvikonzeri malignant hyperthermia pachayo. Kupindura kunoda kushandiswa kwemishonga yakatarwa yeanesthesia muvanhu vane chirwere ichi.

Matambudziko Anogona Kuitika neMalignant Hyperthermia Ndezvipi?

Kana ikarapwa nekukurumidza, vanhu vazhinji vanopora zvakakwana kubva kune malignant hyperthermia pasina migumisiro yakareba. Zvisinei, kana kupindura kukasazivikanwa uye kurapwa nekukurumidza, kunogona kukonzera matambudziko akaoma.

Matambudziko anotyisa zvikuru anosanganisira:

• Kuparara kwemhasuru (rhabdomyolysis) kunogona kukuvadza itsinga dzako
• Matambudziko emoyo anogona kuuraya
• Kukuvadzwa kwepfungwa nekuda kwetembiricha yakakwira kwazvo yemuviri
• Matambudziko ekugwamba kweropa
• Kuora mwero kwakanyanya uye kusawirirana kwema electrolytes
• Kuora kwezvikamu zvakawanda zvemukati memumuviri

Kiyi yekudzivirira matambudziko aya ndeyekuziva nekukurumidza uye kurapwa nekukurumidza. Makamuri ekushandira anozivikanwa nekuve nemidziyo yekutarisa tembiricha uye mishonga yekukurumidza, zvichiita kuti matambudziko akaoma ave mashoma kupfuura kare.

Nekurapwa kwakakodzera, huwandu hwevanhu vanopona hunopfuura 95%. Vanhu vazhinji vanowana malignant hyperthermia vanorarama hupenyu hunowanzoitika, kunyange zvazvo vachifanira kudzivisa mishonga inokonzera chirwere ichi mune ramangwana.

Malignant Hyperthermia Inozwiwa Sei?

Malignant hyperthermia inozwiwa zvichienderana nezviratidzo zvako uye kupindura kwako kurapwa panguva yeanesthesia. Timu yako yeanesthesia inoita kuongororwa uku nekuona zviratidzo zvakajairika uye kuona kuti unopindura sei kumishonga yekukurumidza.

Panguva yekutambura, vanachiremba vanotarisa kusanganiswa kwefeva yakakwira, kuomarara kwemhasuru, uye kuchinja kwakatarwa mumakemikari eropa. Vanotarisawo kupindura kwako kudantrolene, mushonga wekurapa.

Mushure mekunge wapora, kuongororwa kwemagwenga kunogona kubatsira kusimbisa kuti une chirwere ichi uye kunotungamira kurapwa kwako kwemangwana. Kuongororwa uku kunotarisa kuchinja kwemajini anowanzoenderana ne malignant hyperthermia. Zvisinei, kuongororwa kwemagwenga hakuwani nyaya dzose, saka mhinduro yakajairika hairevi kuti hauna chirwere ichi.

Kune nhengo dzemhuri, kuongororwa kwemhasuru kwakashandiswa kuva nzira huru yekuongorora. Izvi zvinosanganisira kutora chidimbu chidiki chemaseji uye kuichengeta kune zvinhu zvinokonzera chirwere ichi murabhoritari. Zvisinei, kuongororwa uku kunowanikwa chete kumacenre akasarudzwa uye kunoshandiswa zvishoma sezvo kuongororwa kwemagwenga kwavapo.

Kurapa kweMalignant Hyperthermia Ndeapi?

Kurapa kwe malignant hyperthermia kunotarisa pakumisa nekukurumidza mushonga unokonzera chirwere ichi uye kupa mushonga unonzi dantrolene. Mushonga uyu unovhara kubudiswa kwe calcium mumaseji ako, uchideredza kupindura kwengozi.

Timu yako yezvokurapa ichaitwa matanho aya nekukurumidza:

1. Misa mishonga yose yeanesthesia inokonzera chirwere ichi nekukurumidza
2. Papa dantrolene kuburikidza ne IV yako (kazhinji 2.5 mg pa kg yeuremu hwemuviri)
3. Dzora muviri wako ne ice packs, mvura inotonhora ye IV, uye mablanketi anotonhora
4. Papa oksijeni uye tsigira kufema kwako
5. Tarisa uye gadzirisa chero matambudziko emoyo
6. Tarisa uye gadzirisa makemikari eropa rako

Kurapa kwe dantrolene kunoda kudzokororwa maawa mashoma kusvika zviratidzo zvako zvamira zvachose. Vanhu vazhinji vanoda zvikamu zvakawanda kwemaawa 24 kusvika ku 48 kuti vadzivise kupindura kudzokera.

Timu yako yezvokurapa ichaongororawo kushanda kwetsinga dzako uye ichakupa mvura yakawanda kubatsira kubvisa zvigadzirwa zvekuparara kwemhasuru. Mumagariro akaoma, ungada dialysis kuti utsigire itsinga dzako sezvo dziri kupora.

Nzira Yekugadzirisa Kupora Kubva kuMalignant Hyperthermia?

Kupora kubva ku malignant hyperthermia kunowanzoitika mu intensive care unit uko timu yako yezvokurapa inogona kukutevera pedyo. Vanhu vazhinji vanotanga kunzwa zvakanaka mukati memaawa mushure mekuwana dantrolene, kunyange zvazvo kupora zvakakwana kunogona kutora mazuva akawanda.

Panguva yekupora kwako, timu yako yehutano icharamba ichikupa dantrolene uye ichatarisa zviratidzo zvako zvakakosha, kushanda kwetsinga dzako, uye ma enzymes emhasuru. Ungagara muchipatara kwemaawa anenge 24 kusvika ku 48 kuti uve nechokwadi chekuti kupindura hakudzoki.

Kana wapora, unofanira zorora uye kubvumira muviri wako kupora zvizere. Vamwe vanhu vanonzwa kurwadziwa kwemhasuru kana kushaya simba kwemazuva mashoma, izvo zvakajairika. Kunwa mvura yakawanda kunobatsira itsinga dzako kushandisa zvigadzirwa zvakasara zvekuparara kwemhasuru.

Chikamu chakakosha chekupora kwako ndechekuwana magwaro akakwana ekupindura kwako uye mazano emagwenga kana akakurudzirwa. Mashoko aya anokosha kune chero maitiro ezvokurapa mangwana uye kuzivisa nhengo dzemhuri dzine ngozi.

Malignant Hyperthermia Inogona Kudzivirirwa Sei?

Kudzivirira kwakanakisa kwe malignant hyperthermia ndekudzivisa mishonga inokonzera chirwere ichi. Kana unozivikanwa kuva nechinetso kana uine nhoroondo yemhuri, timu yako yeanesthesia ichaita mishonga inokodzera iwe.

Mishonga yakachengeteka yeanesthesia inosanganisira:

• Propofol nemamwe mishonga yeanesthesia isingakonzere chirwere ichi
• Mishonga yeanesthesia yemunharaunda senge lidocaine
• Anesthesia yemunharaunda (spinal kana epidural blocks)
• Mishonga isingakonzere chirwere ichi
• Nitrous oxide (gasi rekuseka)

Kana uine nhoroondo yemhuri ye malignant hyperthermia, funga nezvekuongororwa kwemagwenga usati waita kuvhiya. Izvi zvinobatsira timu yako yezvokurapa kuita sarudzo dzakachengeteka pamusoro pekurapa kwako kweanesthesia.

Nguva dzose pfeka bhureki rekuzivisa kana kutakura kadhi rinoratidza kuti une malignant hyperthermia. Mumagariro ekukurumidza, mashoko aya anogona kuponesa upenyu uye anobatsira mapoka ezvokurapa kusarudza mishonga yakakodzera nekukurumidza.

Kune kuronga mhuri, mazano emagwenga anogona kukubatsira kunzwisisa ngozi yekuendesa chirwere ichi kuvana vako uye kukurukura nzira dzekuongorora nhengo dzemhuri.

Ungagadzirira Sei Kune Chiremba Wako?

Kana uri kunetseka nezvengozi ye malignant hyperthermia, tanga nekuunganidza ruzivo rwakakwana pamusoro penhoroondo yemhuri yako yezvokurapa. Tarisa zvikuru pane chero matambudziko nhengo dzemhuri dzave nadzo neanesthesia kana matambudziko asinganzwisisiki panguva yekuvhiya.

Usati wasvika pakuchataura nachiremba, nyora pasi:

• Chero nhoroondo yemhuri yematambudziko neanesthesia kana malignant hyperthermia
• Kuvhiya kwawakaita kare uye maitiro awakapora
• Chero matambudziko emhasuru kana kushaya simba mumhuri yako
• Mibvunzo pamusoro pekuongororwa kwemagwenga kana kuchengetedzwa kweanesthesia
• Mishonga iri kushandiswa ikozvino neallergies

Kana uri kugadzirira kuvhiya, ronga kukurukura neanesthesiologist wako usati watanga. Izvi zvinokupa nguva yekukurukura zvinokunetsa uye zvinovabvumira kuronga nzira yakachengeteka yeanesthesia yekuvhiya kwako.

Uyisa chero magwaro ezvokurapa kare ane chekuita nekupindura kweanesthesia, migumisiro yekuongororwa kwemagwenga, kana mishumo yekuongororwa kwemhasuru kana uine. Mashoko aya anobatsira timu yako yehutano kuita sarudzo dzakanyatsojeka pamusoro pekurapa kwako.

Chii Chinonyanya Kukosha Nezve Malignant Hyperthermia?

Malignant hyperthermia chirwere chakakomba asi chinorapika chinoitika muvanhu vane chirwere chemagwenga kumishonga yakatarwa yeanesthesia. Kunyangwe zvingave zvine ngozi kana zvisingazivikanwi nekukurumidza, kurapwa kwazvino kwakaita kuti zvive nyore kupona nekurapwa kwakakodzera.

Chinhu chakakosha kukurangarira ndechekuti ruzivo ndiro dziviriro yako yakanakisa. Kana uine nhoroondo yemhuri yematambudziko neanesthesia, taura nachiremba wako usati waita kuvhiya. Vanogona kushandisa mishonga inokodzera uye vagadzirire kurapwa kwekukurumidza kana zvichidiwa.

Nekuchengetedzwa kwakakodzera uye kuziva kwezvokurapa, vanhu vane malignant hyperthermia vanogona kuvhiyiwa zvakachengeteka uye kurarama hupenyu hunowanzoitika. Kiyi ndeyekuve nechokwadi chekuti timu yako yezvokurapa inoziva nezvengozi yako kuitira kuti vagone kutora matanho akakodzera.

Mibvunzo InowanzoBvunzwa Nezve Malignant Hyperthermia

Mubvunzo 1: Malignant hyperthermia inogona kuitika pasina anesthesia here?

Malignant hyperthermia inoda kushandiswa kwemishonga yakatarwa yeanesthesia. Kunyangwe zvisingawanzoitika zvakataurwa nezve kupisa kwakanyanya kana mamwe mishonga, zviitiko zvizhinji zvinoitika panguva yekuvhiya nemishonga yeanesthesia kana succinylcholine.

Mubvunzo 2: Kana mubereki wangu aive ne malignant hyperthermia, iniwo ndichava nayo here?

Kwete zvakakodzera. Malignant hyperthermia inogona kuwanikwa kubva kuvabereki, asi haitevere muenzaniso wakapusa. Une mukana we50% wekuwana chirwere ichi kana mubereki mumwe chete aine, asi kuva negene hachirevi kuti uchava nechinetso. Vamwe vanhu vane gene asi havaone zviratidzo.

Mubvunzo 3: Malignant hyperthermia inokura nekukurumidza sei panguva yekuvhiya?

Malignant hyperthermia inogona kukura mukati memaminitsi mushure mekuiswa kwemishonga inokonzera chirwere ichi, kunyange zvazvo dzimwe nguva zvichiita kuti zviome kuona. Kupindura kunowanzoonekwa mukati meawa yekutanga yeanesthesia, ndosaka timu yako yezvokurapa ichikutevera pedyo panguva ino.

Mubvunzo 4: Ndingaita basa rezino here kana ndine malignant hyperthermia?

Hongu, unogona kuita basa rezino zvakachengeteka. Mishonga yeanesthesia yemunharaunda senge lidocaine ne novocaine yakachengeteka kune vanhu vane malignant hyperthermia. Ingova nechokwadi chekuudza dentist wako nezvechirwere chako kuitira kuti vadzivise mishonga inokonzera chirwere ichi kana zvichidiwa.

Mubvunzo 5: Ndichafanira kudzivisa kuvhiya kwese kwemangwana here kana ndave ne malignant hyperthermia?

Kwete zvachose. Unogona kuvhiyiwa zvakachengeteka uchishandisa mishonga yeanesthesia isingakonzere chirwere ichi. Timu yako yeanesthesia ichaita mishonga inokodzera iwe. Vanhu vazhinji vane malignant hyperthermia vane kuvhiya kwakawanda kwakabudirira muhupenyu hwavo nekutora matanho akakodzera.