Ukufa kwengqondo kungenye yezinkinga ezibucayi kakhulu i- neurologist engayenza . Ngokungafani nezinhlobo ezimbi ze-coma, ukuxilongwa kokufa kobuchopho kusho ukuthi akukho ukubuya. Ngokwemvelo, ukufa kobuchopho ukufa.
Uma ukuxilongwa kwenziwa kahle, kungenziwa kuphela ngokuqinisekisa ukuthi isiguli sise-coma yocwaningo eyaziwa futhi esingenakuphikisana, nokuthi ukuhlolwa okungokwenyama okungokoqobo akukhona, kufaka phakathi i- brainstem reflexes kanye nomzamo wokuphefumula ngesikhathi sokuhlolwa kwe-apnea .
Ukuhlolwa kwe-apnea kuhilela ukunikeza i-oksijeni yesiguli kodwa kugweme umoya wokuvota ukuze kuvunyelwe i-carbon dioxide ohlelweni, okuvame ukudala umzamo wokuphefumula. Awekho amacala aqoshwe kahle okuthola ukuxilongwa kokufa kwengqondo okwenziwe ngokucophelela lapho isiguli sathola khona ukululama okunembile.
Kodwa-ke, kunezikhathi lapho ukuhlangabezana nazo zonke iziqu zezobuchwepheshe zokufa kwengqondo kungenakwenzeka. Isibonelo, lapho uhlaselwa isifo esibi kakhulu, kungenzeka ukuthi akunakwenzeka ukuhlolwa okuthembekile kwemizwa ye-cranial. Kwezinye iziguli, kungenzeka ukuthi akunakwenzeka ukwenza ukuhlolwa kwe-apnea, kungenxa yokuthi isiguli asizinzile kakhulu noma ngenxa yokuthi zakha ukubekezelelana kwe-carbon dioxide, njengoba kubonakala kwezinye iziguli ezinezifo ezingavamile zokuphazamiseka kwamaphaphu noma i-apnea enkulu yokulala. Kulezi zimo, ukuhlolwa okwengeziwe kuyadingeka.
Ngaphezu kwalokho, ngoba ukuxilongwa kokufa kwengqondo kunzima kangaka, imindeni eminingi ikhetha ukuhlolwa okungeziwe ngaphambi kokwenza izinqumo mayelana nokuyeka umoya wokumisa umoya noma ukucubungula iminikelo yomzimba.
I-Electroencephalography (EEG)
I- EEG isetshenziselwa ukukala umsebenzi kagesi ebuchosheni. Kuvame ukusetshenziselwa uma udokotela ekhathazeka ukuthi othile uhlaselwe noma uyashona. Ekufeni kwengqondo, kunokuba afune umsebenzi ongajwayelekile, i-EEG ifuna noma yimuphi uhlobo lomsebenzi nhlobo. Eminye izinga elincane lomsebenzi kagesi lingase livele likhona, kodwa lokhu empeleni limelela ubuciko ngenxa yesignali esivela kumadivayisi aseduze noma ukushaya kwenhliziyo, futhi akumele kudlule umbandela othize ukuze kuhlangabezane nemigomo yokuxilongwa kokufa kwengqondo.
Ama-Somatosensory Amakhono Okuvuthwa (i-SSEP)
Njenge-EEG, i- SSEP ihlola ukuthi ugesi ugeleza kanjani emzimbeni, kuhlanganise nobuchopho. Esikhundleni sokubheka nje umsebenzi wezobuchopho, ama-SSE ahlanganisa isimiso sezinzwa esivuselelwa ukwethuka kwamandla kagesi, ngokuvamile ku- nerve median . Ngokuvamile, lezi zithuko zibhalisa njengesignali ezitholwe ebuchosheni, ezingalinganiswa ngombane obeka ekhanda lesiguli. Ukungabikho kwalezi zimpawu kubonisa ukuthi ubuchopho abukwazi ukuthola lemilayezo.
Angiography
E-angiogram ye-cerebral, idayisi ehlukile iyafakwa emzimbeni womzimba, futhi ubuchopho bubukwa kumqapha ngenkathi isiguli sibhekene nochungechunge lwe-X-ray. Lokhu kuvumela ukuhlolisisa ukuthi igazi lihamba kanjani emzimbeni. Ekufeni kobuchopho, izitsha zobuchopho azigcwala njengoba zivame ukuzenza.
Ama-Dopplers we-Transcranial
Ukuhlolwa kwe-doppler yokudlulisa amehlo kusetshenziswa amagagasi e-ultrasound ukuhlola ukugeleza kwegazi ebuchosheni. Ngesikhathi sokufa kwengqondo, ubuchopho bungakhula ngezindlela zokwandisa ukumelana emithanjeni yegazi, ukunciphisa ukugeleza kwegazi. Lezi zinguquko ekugezeni kwegazi zingabonakala ku-doppler ye-transcranial.
Ukuhlolwa Kwemithi Yenyukliya
Umuthi we-nyukliya uhlanganisa umjovo we-radioisotope ebuchosheni.
Le isotophi yikhemikhali ehamba ngokuhamba kwegazi. I-isotopay decays, okuholela ekukhululweni kwamandla atholakalayo ngamasenter futhi aguqulwe abe yisithombe sedijithali. Uma ubuchopho buphilile futhi busebenza, buzobukeka sengathi bukhanyisa phezu kweqapha njengoba igazi ligeleza emathisini ebuchopho. Ekuhloleni kokufa kwengqondo, isotophe ejwayelekile kakhulu ibizwa ngokuthi technetium-99m hexamethylpropyleneamine oxime. Uma isiguli siphelile ebuchosheni, khona-ke ngeke kube khona isignali ebuchosheni ekuskena. Ngezinye izikhathi lokhu kuthiwa yi-"skull engavamile".
Ukuletha konke okuhlangene
Lezi zindlela zamukelwa kabanzi njengezengeziwe, nakuba ngokuvamile kungadingekile, ukuhlolwa kokuhlolwa kobuchopho.
Amanye amazinga wezobuchwepheshe angase ahluke kusuka esimweni kuya esifundeni ngisho nasesibhedlela esibhedlela, noma kunjalo. Njenganoma yiluphi uhlobo lokuhlolwa, ukuhlolwa okukodwa okudingekile ngenhla kudinga ukuhunyushwa ngokucophelela futhi kumongo womlando wezokwelapha owaziwayo wezokwelapha. Akukho ukuhlolwa okuphelele, ngakho-ke kubalulekile ukuthi ukunakekelwa okujulile kubhalwa imininingwane yokuthi indlela yokuhlola iqhutshwa ngayo ukuze ithuba lokungaqondisisi kahle kwemiphumela linciphise.
Ukufa kwengqondo komuntu othandekayo kuyinto ehlukumeza imindeni, kodwa ukuhlolwa okungeziwe kungasiza ukuqinisekisa ukuthi abenzi bezinqumo eziqhubekayo baqhubeka phambili ngokuqiniseka ukuthi bahlonipha lokho isiguli esingafuna.
Imithombo:
U-Eelco FM Wijdicks, MD, Ph.D., iPanayiotis N. Varelas, MD, Ph.D., uGary S. Gronseth, MD David M. Greer, MD, Isibuyekezo esisekelwe ekuqondiseni iziqondiso: Ukunqunywa kokufa kwengqondo kubantu abadala, Umbiko we i-Quality Standards Subcommittee ye-American Academy of Neurology, Neurology 74, Juni 8, 2010.
UJerome B. Posner noFred Plum. Ukuhlolwa kwePlum ne-Posner yokuHlola nokuComa. I-New York: Oxford University Press, 2007.