Chikomokere: Zoyambitsa, Mitundu ndi Matenda

mwachidule 

Coma ndi mawu omwe anthu amawadziwa kapena kumva kuchokera m'mafilimu ndi nkhani. Koma anthu ambiri sangakhale otsimikiza za zomwe zimayambitsa, njira zodziwira matenda, ndi mankhwala omwe alipo. Blog iyi imayankha zonse zokhudzana ndi coma, zomwe zimayambitsa, komanso njira zamankhwala.  

Kodi chikomokere ndi chiyani? 

Nthawi yotalikirapo ya chikomokere imatchedwa chikomokere. Munthu amene ali chikomokere sadziwa zomwe zazungulira ndipo amaoneka ali mtulo. Mosiyana ndi tulo tofa nato, odwala chikomokere sangathe kudzutsidwa ndi kuputa kulikonse, kuphatikizapo ululu. 

Kodi mitundu yosiyanasiyana ya chikomokere ndi iti? 

Comas ndi amitundu yosiyanasiyana. Ali:  

• Nthawi zonse zomera: Ichi ndi chikomokere kwambiri. Munthuyo sangayende paokha ndipo sadziwa malo omwe amakhala. Munthu amene ali ndi chikhalidwe chokhazikika cha zomera akhoza kukhala maso koma sadzakhala ndi luso lapamwamba la chidziwitso. Mu mkhalidwe uwu, amapitiriza kupuma, kuyendayenda kwa magazi kumachitika, ndipo amatsatira kugona-kudzuka. 
• Poizoni metabolic encephalopathy: Chisokonezo ndi kuona zilubwelubwe Ndi zizindikiro za vuto lovuta kwambiri la ubongo ndipo nthawi zambiri limachiritsidwa. Zinthu zosiyanasiyana zimatha kuyambitsa toxic-metabolic encephalopathy. Matenda a systemic, matenda, kulephera kwa ziwalo, ndi zina mwazoyambitsa. 
• Zamankhwala: Ndi mtundu wa chikomokere chachifupi kapena kugona tulo tofa nato kochititsidwa ndi akatswiri azachipatala kuti apewe kutupa muubongo pambuyo povulala ndikupatsa thupi nthawi yochira. Kuchuluka kolamulidwa kwa mankhwala ochititsa dzanzi kumaperekedwa kwa wodwalayo, zomwe zimapangitsa kuti asamve kapena kuzindikira. Madokotala amayang'anitsitsa zizindikiro zofunika kwambiri za wodwalayo. 

Kodi nchiyani chimachititsa munthu kukomoka? 

Zoposa 50% za chikomokere zimachitika chifukwa cha kuvulala kwa mutu kapena mavuto akuyenda kwa magazi ku ubongo. Kuchulukana kwamphamvu, kutulutsa magazi, kutayika kwa okosijeni kapena kuchuluka kwa poizoni kungayambitse kuvulala kwaubongo. Nthawi zina kuwonongeka kumatha kukhala kwakanthawi komanso kubwezeredwa, pomwe nthawi zina kumatha kukhala kwanthawi yayitali. 

Zinthu zotsatirazi zingayambitse chikomokere: 

• Kuwonongeka kwa ubongo kwa Anoxic: Vuto la minyewa imeneyi ndi chifukwa chakuti ubongo umalandira ziro oxygen - mphindi zochepa popanda mpweya kumabweretsa imfa ya maselo a ubongo. Matenda amtima (kumangidwa kwa mtima), kumwa mankhwala osokoneza bongo, kuvulala mutu kapena kupwetekedwa mtima, kumira, kapena kupha poizoni kungayambitse ubongo wa anoxic. 
• Kutupa: Kutupa konse sikuyenera kuchitika chifukwa cha zoopsa. Kuperewera kwa okosijeni, kusalinganika kwa electrolyte, kapena matenda angayambitse kutupa. 
• Kuvulala m'mutu: Kutaya magazi muubongo kapena kutupa kumatha chifukwa chovulala m'mutu. Madzi a mu ubongo amakankhira mmwamba ku chigaza pamene chifufuma chifukwa cha zoopsa. Chifukwa cha kukulitsidwa, ubongo ukhoza kukanikiza tsinde la ubongo, kuvulaza RAS (Reticular Activating System), gawo la ubongo lomwe limathandiza kudzutsa ndi kuzindikira. 
• Kutuluka magazi mkati: Nthawi zina, chilonda chimapangitsa kuti gawo lina la ubongo likhale lotupa ndi kupanikizana, zomwe zimapangitsa kuti magazi azilowa mu ubongo. Ubongo umasintha chifukwa cha kukanikiza uku, kuwononga tsinde la ubongo ndi RAS. Zingayambitse chikomokere. Zomwe zimayambitsa kutayika kwa magazi muubongo sizikhala zowopsa BP ndi malignancies. 
• Chilonda: Chikomokere chingayambe pamene gawo lalikulu la ubongo sililandira magazi kapena pamene magazi atayika ndi kutupa. 
• Kugonjetsa: Chikomokere sichichitika kawirikawiri chifukwa chokomoka kamodzi. Kukomoka kosalekeza kungayambitse chikomokere. Kukomoka pafupipafupi kumatha kulepheretsa ubongo kuchira pambuyo pa kukomoka, zomwe zimapangitsa kuti chikomokere. 
• Shuga wamagazi: Mlingo wa shuga m'magazi ukakwera kwambiri, munthu amatha kukomoka. Mawu azachipatala oterowo ndi hyperglycemia. Chikomokere chikhoza kuchitika chifukwa cha hypoglycemia kapena shuga wotsika kwambiri. Shuga wa m'magazi akakhazikika, chikomokerechi chimatha kuchira. Koma hypoglycemia yosalekeza imatha kuwononga ubongo wamoyo wonse komanso kukomoka. 
• Matenda: Chikomokere chikhoza kubweretsedwanso ndi matenda a mitsempha, monga meningitis ndi encephalitis. 
• Mavuto a Moyo: Mpweya wa okosijeni ndi wofunikira kuti ubongo uzigwira ntchito bwino. Kumangidwa mwadzidzidzi kwa mtima kungayambitse kutha kwa magazi mwadzidzidzi komanso kutulutsa mpweya ku ubongo. Opulumuka kumangidwa kwa mtima nthawi zambiri amakhala chikomokere atalandira kutsitsimutsidwa kwa mtima (cardiopulmonary resuscitation).CPR). Kutsamwitsidwa kapena kumira kungayambitsenso kusowa kwa okosijeni. 
• Zoopsa: Ngati thupi silingathe kuchotsa moyenera zinthu zina, monga ammonia, carbon dioxide ndi urea, zimatha kupanga poizoni ndikuwononga. Kuchuluka kwa mowa ndi mankhwala osokoneza bongo kungathenso kusokoneza ntchito ya ubongo. 

Kodi chikomokere chimadziwika bwanji? 

Kuti mudziwe za chikomokere, dokotala amafunikira thandizo la abwenzi ndi achibale a wodwalayo. Angathandize pazochitika zilizonse kapena zizindikiro zomwe zapangitsa kuti wodwalayo asamazindikire. Kuonjezera apo, wothandizira zaumoyo adzafunsa za kusintha kwa moyo wa munthuyo posachedwapa, chithandizo chamankhwala, ndi kugwiritsa ntchito mankhwala, mankhwala ogulitsidwa, ndi mankhwala osangalatsa.  

Kufufuza kungaphatikizepo:

Mayeso akuthupi

Kuwunikaku kukhoza kukhala:

1. Kuyang'ana njira zopumira kuti mudziwe chomwe chimayambitsa chikomokere 
2. Kuyang'ana momwe munthu wokhudzidwayo akukhudzidwira, kusuntha ndi kuyankhidwa ku zowawa zowawa, ndi kukula kwa ana.
3. Kukanikiza pakona ya nsagwada kapena kuyimilira mokweza kapena pabedi la misomali pamene mukuyang'ana zizindikiro za kudzutsidwa, monga kusuntha, kutsegula maso kapena phokoso la mawu. 
4. Kuyang'ana khungu ngati pali zizindikiro za mikwingwirima chifukwa cha zoopsa
5. Kutulutsa kutentha kapena kuzizira m'makutu a munthu wokhudzidwayo ndi momwe diso likuyendera 
6. Kuyesa kayendedwe ka maso kuti athandizire kudziwa chomwe chimayambitsa chikomokere komanso komwe ubongo wawonongeka

Mayeso a Laboratory

Zitsanzo za magazi zidzatengedwa kuti zitsimikizidwe:

1. Glucose, electrolytes, chithokomiro, chiwindi ndi impso ntchito
2. Mpweya wa carbon monoxide
3. Kuchuluka kwa magazi
4. Mowa kapena mankhwala osokoneza bongo
5. Kuboola m'chiuno (msana wa msana) kumatha kuyang'ana zizindikiro za matenda mu dongosolo lamanjenje

Ma scan a ubongo

Kuyeza kwa zithunzi kumathandiza madokotala kudziwa madera omwe ubongo wavulala. Mayeso angaphatikizepo:

• Electroencephalography (EEG)
• MRI
• CT scan

Kodi sikelo ya Glasgow coma ndi chiyani? 

Glasgow coma scale ndi njira yowonera kusintha kwa wodwala pakapita nthawi ndikuwunika ngati chidziwitso cha wodwalayo chikukulirakulira, kukhazikika, kapena kutsika. Amagwiritsidwanso ntchito poyesa kuopsa kwa zizindikiro panthawi yoyeza thupi. Dongosololi limayesa zinthu ngati 'mawu ochita kumva' pa sikelo ya 1 mpaka 5. 

• 5 - yokhazikika 
• 4 - kusokonezeka 
• 3 - mawu osayenera 
• 2 - mawu osamvetsetseka 
• 1 - palibe kuyankha pakamwa 

Kodi pali mankhwala othandiza kukomoka? 

Chikomokere nthawi zambiri amathandizidwa ndi chithandizo chothandizira. Anthu omwe ali pachikomokere amasamalidwa othandizira odwala ndipo nthawi zambiri amafunikira chithandizo chamoyo chonse podikirira kuti matenda awo asinthe. Komanso, chithandizo cha chikomokere chimadalira woyambitsa. Mothandizidwa ndi achibale ndi abwenzi, dokotala akhoza kudziwa komwe matendawa amachokera. 

Chithandizo cha chikomokere chomwe chingathe kuchiritsidwa ndi kotheka ndi chithandizo chamankhwala mwamsanga. Madokotala amatha kupereka maantibayotiki ngati matenda a muubongo ndi chifukwa. Matenda a shuga akakomoka, thupi limafunikira glucose ndipo limatha kuchiza matendawa. Opaleshoni ingafunikirenso kuchotsa chotupa kapena kuchepetsa kupanikizika kwa ubongo ngati wothandizira akutupa. Kutupa kungathenso kuthandizidwa ndi mankhwala. N'chimodzimodzinso ndi khunyu. Angathenso kuthandizidwa ndi mankhwala.   

Kutsiliza 

Chikomokere chomwe chimabwera chifukwa chovulala m'mutu nthawi zambiri chimakhala ndi chikomokere chochulukirapo kuposa chikomokere chomwe chimadza chifukwa cha kusowa kwa okosijeni. Chikomokere chomwe chimabwera chifukwa chogwiritsa ntchito mankhwala amatha kuchizidwa ndi chithandizo chamankhwala munthawi yake. Choncho, machiritso ambiri amadalira chifukwa chake. 

Pamene munthu ali mu coma, kuyembekezera kuchira kungakhale kovuta kwambiri. Popeza munthu aliyense ndi wapadera, kulankhula ndi dokotala ndikofunikira. Kutalikira kwa nthawi ya chikomokere, m'pamenenso matendawa amakhala ovuta. Ngakhale zili choncho, anthu ambiri amatha kudzuka kukomoka pakatha milungu ingapo. Angakhale, komabe, akuvutika ndi kulumala kwakukulu. Koma nthawi zonse ndi bwino kupitiriza chithandizo chamankhwala. 

Mafunso Ofunsidwa Kawirikawiri (FAQs) 

Kodi kuchira kukomoka ndi kotheka? 

Kuchira kwa chikomokere kumadalira chifukwa chake. Ena akhoza kuchiritsidwa ndi mankhwala, chithandizo kapena opaleshoni. Panthaŵi imodzimodziyo, ena amakhalabe m’gawo limenelo kwa moyo wonse. Kuchira kwa odwala chikomokere ndi pafupifupi zosayembekezereka.  

Ndi mayeso otani omwe amagwiritsidwa ntchito pozindikira chikomokere? 

Kufufuza magazi, kufufuza mkodzo, ndi kuyesa kulingalira kwa ubongo monga MRI, CT scans, ndi EEG zikhoza kuchitidwa kuti amalize njira yothandizira odwala chikomokere.  

Kodi imfa ya ubongo ndi chikomokere ndizofanana? 

Ayi. Kufa kwaubongo kumasiyana ndi kukomoka pankhani ya kuchira. Imfa yaubongo siisinthika, pomwe chikomokere chimapereka mwayi wobwerera.