Izimpawu ezingavamile ze-POTS ku-Children and Young Adult
Kungenzeka ukuthi awukaze uzwe nge- postural orthostatic tachycardia syndrome noma i-POTS, nakuba kuthinta abantu abaningi, kubandakanya intsha, futhi yabonakala ekuqaleni kwawo-1990. I-Dysautonomia Research Foundation ichaza izingane ezilezi zinkinga njengokungabonakali kwabangaphandle, abangase bacabange ukuthi bazama izimpawu zabo.
Ukuthi akukwaziwa kakhulu kungadabukisa nakakhulu ngoba ama-POTS angabangela izimpawu ezinjalo ezikhubaza, kuhlanganise ukuzondeka, ikhanda, nokukhathala.
I-Postural Orthostatic Tachycardia Syndrome - Incazelo kanye nezici
I-postural orthostatic tachycardia syndrome (i-POTS) ibangelwa ukuguqulwa noma ukungasebenzi emsebenzini wesimiso sezinzwa (i- dysautonomia) .
Ungahle ungajwayele isimiso sezinzwa ze-autonomic, kodwa cishe uyazi ezinye izimo ezihlobene nokungasebenzi kwesistimu yezinzwa ezizimele. Lezi zingase zihlanganise nesifo sofuba esiswini , i- fibromyalgia , nesifo esingapheliyo sokukhathala.
Ngaphandle kwesistimu yezinzwa zomphakathi (ubuchopho bethu nomthambo womgogodla), sinesimiso sezinzwa esizimele esiza ukulawula ngokungahambisani izinto eziningi umzimba wethu ozenzayo, njenge:
- Ukunciphisa abafundi bethu lapho singena ekamelweni elimnyama
- Ukwandisa ukukhiqizwa kwesikhala uma sidla
- Kusenza sikhukhume lapho sishisa
Isistimu ye-neon autonomic iyasiza ekulawuleni izinga lokushaya kwenhliziyo nokucindezela kwegazi. Lezi zindima zibaluleke kakhulu uma sishintsha isikhundla, njengokuthi sivela ku-supine (silele phansi) noma sihlezi endaweni yokuma.
Uma sisukuma, izinto eziningi zenzeka emzimbeni wethu esingaboni, noma okungenani asiqapheli uma kwenzeka kahle. Ngokuphendula inani elikhulu legazi elihamba emzimbeni wethu ophansi, oqale wehlisa ukucindezelwa kwegazi, isimiso sezinzwa esizimele sikhulisa izinga lokushaya kwenhliziyo, sigxila noma sigcizelele imithwalo yegazi futhi sandisa ukucindezelwa kwegazi, konke ukugcina ukugeleza kwegazi ebuchosheni bethu.
Imisipha emilenzeni nasesisu yethu iphoqelela imivamisa kulezi zingxenye zomzimba wethu futhi isize ngenqubo.
Ama-POTS acatshangwa ukuthi ayenzeka uma lesi simiso singasebenzi kahle, kubangele abantu abathintekayo ukuba bahlaziye lapho bekhona, phakathi kwezinye izimpawu.
I-POTS ivame kakhulu kwabesifazane, ikakhulukazi abesifazane abaneminyaka engama-15 no-50 ubudala (ukuqala kokuya esikhathini sokuya esikhathini). Nakuba kungaziwa ukuthi yini ebangela i-POTS, ivame ukuqala ngemva kokugula okungapheli kakhudlwana, njengemfuluwenza noma i- mono .
Izimpawu ze-Postural Orthostatic Tachycardia Syndrome
Izincazelo zakudala ze-POTS ezisencane zizwa zinezinwele ezincane futhi zinezinga lenhliziyo elikhuphuka okungaphezulu kwezingu-40 ngomzuzu (noma izinga lokushaya kwenhliziyo elingaphezulu kwezingu-120 ngomzuzu), kungakapheli imizuzu engu-10 yokuma.
Ngaphandle kokuvame ukuzizwa uhlaziyekile, ezinye izimpawu ze-POTS zingabandakanya:
- Izinsizwa
- Ubuthakathaka, ukukhathala, nokubekezelelana ngokweqile
- Ukukhathazeka kwesisu nesisu somzimba
- I-Tachycardia (isilinganiso senhliziyo esisheshayo) kanye nama-palpitations
- I-syncope eseduze (uzizwa sengathi uzokuphelelwa amandla)
- Umbono ophundlekile
- Ukukhathazeka
- Ukushaya ngokungafanele
- Inkinga yokulala
- Ukubunzima ukugxila
Ngaphandle kokuthola izimpawu zakudala, ukuhlolwa kwe-tilt-table kungenziwa ukusiza ukuxilongwa kwentsha nge-POTS. Ukuhlolwa okunamandla kungenziwa futhi ngemuva kokuba ingane isulele (ilele phansi) imizuzu engu-5, ilinganisa izinga lenhliziyo nengcindezi yegazi, bese emva kokuma imizuzu 3, 5, 7, nemizuzu engu-10.
Ukuzivocavoca nokuhluleka ngokumelene ne-POTS
Ukuzivocavoca ngisho nokuphelelwa amandla ( syncope ) empeleni izimpawu ezivamile ezinganeni.
Eqinisweni, kucatshangwa ukuthi amaphesenti angama-15 amantombazane aphelelwe yisikhathi okungenani kanye kuphela ngaphambi kokuba afike emdala, ngokuvamile ephakathi kweminyaka engu-15. Ngenhlanhla, iningi lalabo abasha abanesizungu nokuphelelwa amandla ngeke babe ne-POTS. Esikhundleni salokho, bazoba nezinkinga ezivamile, njenge:
- I-syncope ye-Vasovagal - Ebizwa ngokuthi i-postural syncope, i-syncope ye- vasovagal ingabangelwa uma umile isikhathi eside endaweni eyodwa (amachibi egazi ezandleni zakho nasemilenzeni, ikakhulukazi uma ungahambisani nabo) noma ekuphenduleni ubuhlungu noma ukwesaba.
- Ukungabekezelelani okungahle kwenzeke esikhathini esizayo - Ukungabekezelelani kwe-orthostatic okungapheliyo kungenzeka uma ugula ngophuhlane, igciwane lesisu, noma ezinye izimo zezokwelapha, okubangela ukuba ube nokungcola kancane futhi uthole ukuzulazula uma usukuma.
- I-Orthostatic hypotension - Njenge-POTS, i- orthostatic hypotension kwenzeka uma usukuma.
Umehluko omkhulu phakathi kwezimo ngenhla futhi i-POTS yukuthi nge-POTS izimpawu zingase zenzeke nsuku zonke futhi zivame ukukhubaza.
Ngaphandle kokwelapha noma yikuphi ukuphelelwa amandla kwamanzi, ukuphulukisa okungcono kakhulu kulezi zimbangela ze-syncope kuvamise ukungalingani ukusiza ukuba kungabikho okwenzekayo. Ngesibonakaliso sokuqala ukuthi ingane yakho izwa sengathi ingase iphele, kuvame ukunconywa ukuba ahlale, ahlasele noma alele phansi. Ukuthola usawoti kanye namanzi okwanele ekudleni kwabo kubalulekile.
Ama-subtypes we-POTS
Akuwona wonke umuntu onama-POTS onezimpawu ezifanayo, futhi kubonakala sengathi kunezinhlobo ezintathu eziyinhloko noma ama-subtypes wesimiso, ngasinye esithinta izindlela ezihlukile. Ukuqonda i-subtype ethize ye-POTS kungasiza ukuqondisa udokotela wakho ekukhethweni okungcono kakhulu kokwelashwa. Lokhu kufaka:
- I-POTS ye-Neuropathic
- I-POTS ye-Hyperadrenergic
- I-Hypovolemic POTS
Ukwelashwa kwe-Postural Orthostatic Tachycardia Syndrome
Njengoba i-POTS ingaba yinkinga enkulu, ukuthola ukwelashwa okuphumelelayo kubalulekile. Imigomo yokuqala yokuqala ivame ukukhulisa ivolumu (nge-fluids nosawoti), ukuzivocavoca, kanye nemfundo. Ukwelapha kungafaka:
- Ukuphakamisa ikhanda lombhede wengane yakho ngamasentimitha angu-4-6.
- Ukukhuthaza ingane yakho ukuthi iphuze okungenani ama-2 kuya ku-3 amalitha ayizinhlayiya ezingcolile, ophuzo olucacile usuku ngalunye nokuhlala kahle.
- Ukwandisa inani losawoti ekudleni kwengane yakho-kufika ku-3-5g / d, uma kuqhathaniswa ne-ovamile ka-1500-2300mg kasawoti kwabasha ngaphandle kwe-POTS.
- Gwema ukudla okukhulu futhi esikhundleni sokudla kaningi, kodwa ukudla okuncane (ukudla okukhulu kukhulisa inani legazi emanzini.)
- Uhlelo lokuzivocavoca noma lokuvuselela ukufaka umsebenzi we-aerobic nokuqiniswa komzimba okuphansi okwandisa kancane kancane inani lokuzivocavoca ingane yakho lithola usuku ngalunye. Lokhu kubaluleke ikakhulukazi njengoba ochwepheshe abaningi bakholelwa ukuthi ukuphumula kombhede nokuhlaselwa komzimba kungadlala indima ekwenzeni ngempela i-POTS.
Imithi ye-POTS
Imithi iphinde isetshenziswe ukusiza intsha ene-POTS, kufaka phakathi i-metoprolol (i-beta-blocker), i-midodrine (i-alpha-agonist), noma i-fludrocortisone (i-mineralocorticoid engasiza ukwandisa usawoti nokugcinwa kwamanzi), yizibonelo zemithi okungenzeka ibe esetshenzisiwe.
Nakuba kucatshangwa ukuthi i-tricyclic endala ye-anti-depressants idala i-POTS imbi kakhulu, ama-anti-pressure anti-SSRI amasha (njenge-Prozac) abhekwa njengokwelashwa okungenzeka.
I-Ivabradine yindlela yokwelapha entsha ebonakala ibasiza kwabanye abantu abane-POTS.
Ukuza Nendlela Yokwelapha
Ayikho uhlelo olucacile lokulashwa kwentsha ene-POTS. Ezinye izihloko zezincwadi azivumelani ngisho ngokuthi ezinye izindlela zokwelashwa, njenge-beta-blockers noma i-SSRI, ziyasiza nakakhulu. Ukuthola usizo kuzofaka phakathi isilingo nesiphambeko ukuthola izinyathelo ezingcono kakhulu ezisebenzela ingane yakho nge-POTS.
Okudingayo Ukuze Ukwazi Nge-POTS
- Nakuba kungekho ukwelashwa kwe-POTS, intsha eningi ibonakala ihlehlisiwe. Abantu abangaba ngu-500 000 e-United States bacatshangwa ukuthi banePOTS.
- Ukwehla ngesikhathi sokuzivocavoca ifulegi elibomvu ngesibangela esiyinhloko se- syncope , ikakhulukazi kubantwana abanomlando womndeni wokufa okungazelelwe. Ukuhlolwa kwezingane zakho kanye / noma i-cardiologist yezingane kufanele kwenziwe ngokushesha.
- I-POTS ngezinye izikhathi ihlotshaniswa nokuba ne- hypermobility syndrome , iphutha le-Chiari, noma ukukhathala okungapheli.
- Ikhwalithi yokuphila iyancipha kubantu abasha abane-POTS futhi kuze kube yingxenye yabasha kanye nabantu abadala abasha abane-syndrome basengozini yokuzibulala. Ukuthola umuthi omuhle ingane yakho ekwazi ukuyivula nayo kungaba yingxenye ebalulekile yepulani yokwelapha.
- I-neurologist yezinsana zezingane ingasiza ekuhloleni nasekuphatheni ingane yakho nge-POTS. Imitholampilo ekhethekile ye-POTS nayo iyatholakala kwezinye izibhedlela zezingane.
Imithombo
- UHeyer, G. Postural Tachycardia Syndrome: Ukuxilongwa nokuphathwa kwabantwana abasha nabadala. Amanothi wezingane . 2017. 46 (4): e145-154.
- UPederson, uC., NoJ. Brook. Ikhwalithi ehlobene nezeMpilo yokuPhila nokuzibulala e-Postural Tachycardia Syndrome. Ucwaningo lwe-Clinical Autonomic . 2017. 27 (2): 75-81.
- Pilcher, T., no-E. Saarel. I-Fainter ye-Teenage (Insizi, i-Syncope, i-Postural Orthostatic Tachycardia Syndrome). Imitholampilo yabantwana baseNyakatho Melika . 2014. 61 (1): 29-43.
- UZheng, X., Chen, Y., noJu Du. Izinqubekela phambili zamuva ekuqondeni izindlela ezisekelwe ngaphansi kwe-Postural Tachycardia Syndrome e-Children: Impumelelo Ewusizo Yokunakekelwa. I-cardiology in the Young . 2016 Dec 12. (Epub ngaphambi kokuphrinta).