Ukuthola ikhanda kuyinselele eyodwa, kodwa ukuthola umuthi wokwelapha osebenzela umuntu, kungaba okulinganayo uma kungenangqondo ngaphezulu. Ukuze uhlolwe ikhanda , kunezinhlobo eziningi zemithi yokuvimbela nokuvimbela, kanye nezinye izindlela zokwelapha - kulabo bantu abangaphenduli imithi. Ake sibukeze lezi zelashwa ngezansi.
Imithi Elula
U-oksijeni uhlobo olulodwa lwezokwelapha ezinzima ezisetshenziselwa ukuphathwa ikhanda.
Umthamo ngokuvamile u-100% we-oksijeni uvuthwe ku-7-10L / min imizuzu engu-15-20. Esinye isici esithembisayo se-oksijini yilokho akusikho imiphumela emibi. Ngakolunye uhlangothi, ukutholakala kwe-tank oksijini nganoma isiphi isikhathi, futhi ukuhlukunyezwa kokuthwala okuzungezile, kungaba umthwalo.
I-Triptans , ikakhulukazi i- sumatriptan (i-Imitrex) ne-zolmitriptan (i-Zomig), itholwe ukuthi iphumelela ekuqedeni ikhanda lekhanda. Amanani ajwayelekile ngo-6mg we-subcutaneous - ajowe ngenaliti emathisini amafutha - ama-sumatriptan, ama-20mg we-sumatriptan intranasally, noma ngekhala, noma ama-5-10mg we-zolmitriptan intranasally. Njengawo wonke ama-triptan, lezi zidakamizwa kufanele zigwenywe ekukhulelwe nasabantu abanesifo senhliziyo nokucindezelwa kwegazi okungalawulwa kalula. Imiphumela emibi ye-triptans ihlanganisa: i-nausea, i- paresthesias , ukukhathala nesifuba noma ukuqina komphimbo.
I-Dihydroergotamine (i-DHE 45, i-Migranal) iyindlela yokukhetha - nakuba ingavamile ukusetshenziswa - ukunciphisa ikhanda lokuhlukumeza ikhanda.
Ukucubungula - noma ngokusebenzisa ukuphathwa kwe-vein kucatshangwa ukuthi kuyona ephumelelayo kakhulu-nakuba lokhu kukhawulela ngenxa yesikhathi esifushane sokuhlaselwa kwamaqoqo. I-Dihydroergotamine ayikwazi ukusetshenziselwa kanye ne-triptans, ekukhulelweni, noma kubantu abanegazi elicindezelwe kabi kanye / noma isifo senhliziyo.
I-Lidocaine ingase inikeze ukukhululeka okulinganiselayo kwekhanda lokuhlukumeza ikhanda futhi ngezinye izikhathi lisetshenziselwa ukuhlanganiswa ne-sumatriptan. I-Lidocaine inikezwa ngamaconsi emisipha, nomuntu elele phansi nekhanda lakhe liphendukele eceleni kobuhlungu.
I-Octreotide - imithi efana ne-hormone somatostatin - iyindlela engenzeka ngayo kubantu abanesifo senhliziyo kanye nekhanda lezinhlanzi, njengoba ukusetshenziswa kwalo kungavunyelwanga kulezi ziguli. I-Somatostatin iyi-hormone evimbela ukukhululwa kwempahla P - amaprotheni ahilelekile emithethweni yokuhlunguphazwa. Imiphumela emibi ye-octreotide ihlanganisa ubuhlungu be-injection side, isicanucanu, ukungavimba kwesisu kanye namazinga aphezulu ashukela.
Imithi yokuvimbela
I-Verapamil imithi esetshenziselwa ukuphatha umfutho wegazi ophezulu, kodwa futhi isetshenziselwa ukuvimbela ikhanda lezinhlanzi. Ngenkathi i-verapamil, udokotela wakho uzoqapha izinga lokushaya kwenhliziyo yakho nesigqi. Ukuqokwa kuyisici esivamile kakhulu se-verapamil.
I-lithium ivame ukukhethwa okwesikhashana ukuba i-verapamil ngenxa yokusebenzisana kwayo kwezidakamizwa eziningi, nemiphumela emibi engabangela ubuthi kanye nemiphumela eyingozi ezinso nezinso. Imiphumela emibi ingafaka isifo sohudo, ukuthuthumela, nokwanda kwamanzi.
I-Topiramate (i-Topamax) ingenye indlela yokwelashwa kwemigqa yesibili yokuvimbela ikhanda lamakhanda.
Imiphumela emibi ingabandakanya: ukulahlekelwa isisindo, ukukhathala, isizungu, i-paresthesias, ukungasebenzi komqondo, nokunciphisa ukunambitheka.
Okunye ukwelashwa okuvimbela ukufaka imishanguzo yokuhlukunyezwa njengoGabapentin (Neurontin) noValproic acid - okungabangela imiphumela emibi njengokwenyuka kwesisindo nokukhathala. I-Valproic acid idinga ukuqapha kwegazi, ikakhulukazi kwesibindi.
I-poisonous botulinum - eyaziwa ngegama lohwebo iBotox - isebenza ngokuvimbela ukuxhuma kwenzwa. Ucwaningo olulodwa luka-2007 e -Journal of Headache and Pain lwathola ukuthi i-Botox ingaba nenzuzo njengendlela yokwelapha yokuvimbela isandulela ngenani elilinganiselwe leziguli ezinezinsizwa ezingapheli.
I-Corticosteroids - njenge-prednisone - ingasetshenziselwa ukulawula ukuphathwa ikhanda yamagqabha futhi inikeze uhlelo lokunakekela isikhashana sokuzivikela. Ngeshwa, kuvamile ukuba ikhanda libuyele emuva njengoba i-prednisone igugile.
Kuthiwani Uma Ngingaphenduli Imithi?
Iziguli ezisezinhlungwini zezinhlayiyana naphezu kwemithi zingadinga ukwelashwa okunamandla okukhulu, njengamabhlogo athile noma ukukhushulwa kobuchopho obujulile. Lezi zinqubo eziphuthumayo zithwala izingozi zazo futhi zidinga ukucatshangelwa ngokucophelela ngawe, udokotela wakho nodokotela wakho ohlinzayo.
Amaphuzu Ekhaya Lokuthatha
• Amakhanda e-Cluster ayizinhlanzi ezibuhlungu kakhulu lapho kukhona khona izinketho zokwelashwa ezilukhuni nokuvimbela ezitholakalayo.
• Nakuba iningi labahlukumezekile bezinhlobonhlobo ze-cluster liphendula isifo semithi yemithi, izinqubo ezingenasisindo ezinjengezici ezijulile zokuvuselela ubuchopho noma izinyathelo zomzimba zingacatshangwa - nakuba zithwala izingozi zabo.
• Yiba ngummeli wempilo yakho futhi ufaneleke nge-neurologist yakho noma ochwepheshe bekhanda mayelana nezinkinga zakho zokwelapha ikhanda. Thola ukulawula ngalezi zinhloko ezikhubaza futhi ukwandise izinga lakho lokuphila.
Imithombo
I-Ashkenazi A & Schwedt T. Cluster ekhanda - ukwelashwa okunamandla ne-prophylactic. Izinwele . 2011 Feb; 51 (2): 272-86.
U-Beck E, uSieber WJ noTrjo R. Ukuphathwa kwe-Cluster Headache. Am Fam Physician . 2005 Feb 15; 71 (4): 717-724.
I-Caleri D, i-Marabini S, i-Panconesi A & Pietrini U. Indlela yokwelapha ekusetshenzisweni kwe-somatostatin ekhanda lekhanda. Ric Clin Lab . 1987 Apr-Jun; 17 (2): 155-62.
Ikomidi Lokuhlukanisa Amakhanda Ye-International Headache Society. "I-International Classification of Headache Disorders: I-3rd Edition (i-beta version)". I-Cephalalgia 2013; 33 (9): 629-808.
I-Sostak P, i-Krause P, i-Förderreuther S, i- Reinisch V, ne-Straube A. Botulinum uhlobo lwe-toxin uhlobo-A ukwelapha ekhanda lomzimba: isifundo esivulekile. I-J Headache Pain . 2007 Sep; 8 (4): 236-41.
Inhloko ye-Weaver-Agostoni J. Cluster. Am Fam Physician . 2013 Jul 15; 88 (2): 122-8.
QAPHELA: Ulwazi olukulesi sayithi lungenjongo yokwaziswa kuphela. Akufanele isetshenziswe njengengxenye yokunakekelwa ngumuntu udokotela olayisenisi. Sicela ubone udokotela wakho ukuthola iseluleko, ukuxilongwa, nokwelashwa kwanoma yikuphi okuphathelene nezimpawu noma isimo sezokwelapha .