Coma

I-koma yisimo sokulahlekelwa uqaphelo isikhathi eside. Ingaba nezimbangela ezihlukahlukene, kufaka phakathi ukulimala kwekhanda okubangelwa ubudlova, isiguli, i-tumor yengqondo, noma ukudakwa yizidakamizwa noma utshwala. I-koma lingabangelwa yisifo esiyisisekelo, njengoshukela noma ukutheleleka.

I-koma yiphuthuma lokudingeka ukunakekelwa kwezokwelapha. Kudingeka isenzo esisheshayo ukuvikela ukuphila nokusebenza kwengqondo. Abachwepheshe bezempilo ngokuvamile bayala uchungechunge lwezivivinyo zegazi kanye nokukhenya ingqondo ukuze bazame ukufunda ukuthi yini ebangela i-koma ukuze ukwelashwa okuqondile kuqale.

I-koma alihlali isikhathi eside kunamasonto ambalwa. Abantu abangaziqapheli isikhathi eside bangase badlulele esimweni esingaphelili sokuhlala bephilile, okwaziwa ngokuthi isimo sokuhlala bephilile, noma ukufa kwengqondo.

Izimpawu ze-coma zivame ukubandakanya: Amehlo avuliwe. Ukucindezeleka kwe-brainstem reflexes, njengokungaphenduli kwabafundi ekukhanyeni. Ayikho impendulo yezingalo ngaphandle kwe-reflex movements. Ayikho impendulo ezinhlungwini ngaphandle kwe-reflex movements. Ukuphefumula okungajwayelekile. I-coma yisimo esiphuthumayo sezokwelapha. Funani ukunakekelwa kwezokwelapha ngokushesha umuntu ophethwe yi-coma.

I-koma yisimo esiphuthumayo sezokwelapha. Funani ukunakekelwa kwezokwelapha ngokushesha umuntu ophethwe yi-koma.

Izinhlobo eziningi zezinkinga zingabangela i-coma. Amanye izibonelo yi:

• Ukulimala kokuzwakala kwengqondo. Lokhu kuvame ukubangelwa yizigameko zezimoto noma izenzo zobuqalekiso.
• Isikhubekiso. Ukunciphisa noma ukuyeka ukunikezwa kwegazi ebuchosheni, okwaziwa njengesiphuphuma, kungabangelwa yimithambo yegazi evaliwe noma i-blood vessel ephukile.
• Ukuvuvukala. Ukuvuvukala ebuchosheni noma e-brainstem kungabangela i-coma.
• I-Diabetes. Amazinga e-shuga egazini amakhulu kakhulu noma amancane kakhulu angabangela i-coma.
• Ukwehluleka kokusizwa komoya. Abantu abasindile ekubhadeleni noma abaphilile ngemva kokuhlasela kwenhliziyo bangase bangaphili ngenxa yokushoda kokusizwa komoya ebuchosheni.
• Ukutheleleka. Ukutheleleka okunjengesi-encephalitis ne-meningitis kubangela ukuvuvukala ebuchosheni, e-spinal cord noma ezicutshini ezizungezile ubuchopho. Izehlakalo ezinkulu zalezi zifo zingabangela ukonakala kobuchopho noma i-coma.
• Ukuhlanza. Ukuhlanza okuqhubekayo kungabangela i-coma.
• I-toxins. Ukubonisana ne-toxins, njenge-carbon monoxide noma i-lead, kungabangela ukonakala kobuchopho ne-coma.
• Imithi no-alcohol. Ukudlula ngokweqile imithi noma i-alcohol kungabangela i-coma.

Izimbangela ezingobungozi be-coma zihlanganisa:\nUkulimala kabi kwekhanda.\nIsiguli.\nUkuphuza igazi ngaphakathi nangaphandle kwengqondo, okwaziwa ngokuthi ukopha okungaphakathi kwengqondo.\nUbuhlungu bobuchopho.\nI-Diabetes nge-shuga yegazi eliphezulu kakhulu noma eliphansi kakhulu.\Nezinye izimo zezempilo, njenge-hypothyroidism noma i-sodium ephansi kakhulu egazini.\nUxinzelelo lwegazi oluphansi kakhulu oluvela ekuhlulekeni okukhulu kwenhliziyo.\nUkuhlinzwa, kufaka phakathi ukubamba okuphephela ngaphezu kwemizuzu emihlanu noma okuqhubekayo ngakunye ngaphandle kokuthi umuntu aphinde azwe.\nUkutheleleka okukhulu, njenge-sepsis, i-encephalitis noma i-meningitis.\nUkucwila eduze, okunciphisa i-oksijini ebuchosheni.\nUkusetshenziswa okukhulu kokutshwala noma ukusetshenziswa kwezidakamizwa ezingasemthethweni.\nUkuvezwa kwi-carbon monoxide, i-lead noma ezinye izinto eziyingozi. Ingozi ye-coma iyanda ngokwanda kweminyaka. Lokhu kuyiqiniso ikakhulukazi uma abantu abadala:\nBanesifo sobuchopho noma enye isimo njenge-diabetes, uxinzelelo lwegazi oluphezulu noma isifo sezinso.\nBathatha imithi eminingi, okungabangela ukusebenzisana kwemithi noma ukudlula ngephutha.

Nakuba abantu abaningi bephulukana kancane kancane ne-coma, abanye bangena esimweni esingapheli sokungabi namqondo noma bafa. Abanye abantu abaphulile kwi-coma baphela bekhubazekile kakhulu noma kancane.

Phakathi ne-coma, ama-bedsores, ukutheleleka kwezindlela zokukhishwa kwamaleng, iziqubu zegazi ezinyaweni nezinye izinkinga zingase zivele.

• Izenzakalo ezaholele ekufeni, njengokugabha noma izikhathi zikhanda.
• Imininingwane mayelana nendlela umuntu otholwe esengozini aphulukana ngayo ukwazi, kufaka phakathi ukuthi kwenzeke ngokushesha noma kancane kancane.
• Izimpawu ezibonakalayo ngaphambi kokulahlekelwa ukwazi.
• Umlando wezokwelapha, kufaka phakathi ezinye izimo umuntu angaba nazo esikhathini esidlule. Lokhu kufaka phakathi ukuthi umuntu uke waba nesifo sohlangothi noma i-ministroke.
• Ukushintsha kwamuva empilweni yomuntu noma ekuziphatheni kwakhe.
• Ukusetshenziswa komuntu izidakamizwa, kufaka phakathi imithi yokwelapha kanye nemithi engelona iresiphi, imithi engavunyelwe, kanye nezidakamizwa ezingamthetho.

Uvivinyo cishe luzofaka:

• Ukubheka ukuhamba komuntu otholwe esengozini kanye nezinqubo zokubonisa, impendulo ekubeni ubuhlungu, kanye nobukhulu bebhubhane.
• Ukubuka izindlela zokuphefumula ukuze kusize ekutholeni imbangela yokufa.
• Ukubheka isikhumba ukuze kubonakale izimpawu zeziphukuphuku ezingabangelwa ukwenzakala.
• Ukuhlola ukuhamba kwamehlo okuqondile ukuze kusize ekutholeni imbangela yokufa kanye nendawo yokonakala kwengqondo.
• Ukushukumisa amanzi abandayo noma afudumele emakhanaleni ezinzwa zomuntu otholwe esengozini nokubuka izimpendulo zamehlo.

Izihlangano zegazi ngokuvamile zithathwa ukuze kuhlolwe:

• Inani eliphelele legazi.
• Ama-electrolytes noshukela. Ushukela ubizwa nangokuthi i-glucose.
• Imisebenzi ye-thyroid, isibindi kanye nezinso.
• Ukuphuza i-carbon monoxide.
• Ukudlula ngokweqile kwezidakamizwa noma utshwala.

Ukugwazwa kwesundu, okwaziwa nangokuthi ukugwazwa kwe-lumbar, kungahlola izimpawu zokutheleleka ohlelweni lwezinzwa. Phakathi nokugwazwa kwesundu, ochwepheshe bezempilo ufake unhlangothi emgodini wesundu futhi aqoqe inani elincane le-fluid ukuze lihlolwe.

Izivivinyo zokuthwebula zisisiza ekutholeni izindawo zokulimaza ingqondo. Izivivinyo zingafaka:

• I-CT scan. Lokhu kusebenzisa uchungechunge lwe-X-rays ukudala isithombe esiningiliziwe sengqondo. I-CT scan ingabonisa ukuphuza ebuchosheni, iziphukuphuku, izifo sohlangothi nezinye izimo. Lo mvivinyo ngokuvamile usetshenziswa ekutholeni nasekutholeni imbangela yokufa.
• I-MRI. Lokhu kusebenzisa amaza amandla kakhulu kanye nensimu ye-magnetic ukudala umbono oningiliziwe wengqondo. I-MRI scan ingathola ukuphuza ebuchosheni, ingqondo eyonakele yi-ischemic stroke nezinye izimo. I-MRI scans isebenziseka kakhulu ekubhekeni i-brainstem kanye nezindawo eziyinhloko zengqondo.
• Electroencephalogram (EEG). Lokhu lilinganisa umsebenzi wamagetsi ngaphakathi kwengqondo ngezindiza ezincane zethusi ebizwa ngokuthi ama-electrodes afakwe ekhanda. Umgwaqo omncane wamagetsi uhamba ngama-electrodes, aqopha izimpumputhe zamagetsi zengqondo. Lo mvivinyo ungabona ukuthi izifo zingaba yimbangela yokufa.