Ukwazi Okwakulindelwe Kungakusiza Ulungiselele
Uma usanda kutholakala ukuthi une- amyotrophic lateral sclerosis (ALS) noma esinye isifo se-neuron, cishe unemibuzo kanye nokukhathazeka mayelana nekusasa lakho. Njengamanje, alukho ukwelashwa kwezi zifo. Kodwa lokho akusho ukuthi awukwazi ukuthola usizo. Kunezinsiza eziningi ezitholakalayo, ezingenza ube mnandi ngangokunokwenzeka, futhi ezinye ezingathinta ngisho nokuthi uhlala isikhathi eside kangakanani.
Ukudla ku-ALS
I-ALS ihlwitha kancane abantu bamandla adingekayo ukuhambisa. Njengoba ukudla okunomsoco okubalulekile kubalulekile ekugcineni amandla, kulula ukucabanga ukuthi umsoco obalulekile kungaba kanjani kumuntu ophethwe yi-ALS. Kodwa ukudla akulula ngaso sonke isikhathi, ikakhulukazi ezigabeni eziphambili zesifo. Imisipha esiza ukugwinya ingase ingasebenzi kahle. Ikhono lokukhwehlela uma ukudla kudlula ithubhu engalungile kungase kukhishwe. Ngenxa yalokho, kubalulekile ukuqinisekisa ukuthi azikho izimpawu zokwaba ngenkathi bedla.
Ngesinye isikhathi, iziguli ezine-ALS zizozuza ekuhloleni kwamandla abo okugwinya, njengokuhlola kwesimiso se- barium . Bangakwazi kuphela ukudla nokuphuza ukudla nokuketshezi okunomthelela othile, njengokudla okulula noma uketshezi oluqiniwe. Ekugcineni, kuyodingeka ukuthi i-endoscopy tube (PEG) ibe yinto edingekayo ukuhlinzekela amazinga anelungelo lokudla. Ngenkathi i-PEG mhlawumbe ithuthukisa isikhathi sokusinda ngokukhulisa izinga lokudla okunomsoco, akukho vithamini ethile noma okunye okungeziwe okuqinisekisiwe okuphumelele ekusizeni nge-ALS.
Ukuphefumula ku-ALS
Awudingi ukuba ube ngumphathi wezezempilo ukuze uqaphele ukuthi ukuphefumula kubalulekile, noma ukuthi kuthatha umzamo othile wokuphefumula. Njengoba i-ALS iqhubeka, noma kunjalo, isinyathelo esilula sokuphefumula singaba nzima, futhi sidinga iqembu labachwepheshe bezokwelapha. Ngaphezu kokukhulisa impilo yabantu abane-ALS, ukunakekelwa okuhle kokuphefumula kungaphinde kuthuthukise amandla, amandla, ukulala kwansuku zonke, ubunzima bokugxila, izinga lokulala, ukucindezeleka nokukhathala.
Ngenxa yalezi zizathu, kungaba umqondo omuhle ukuba ukuphefumula kwakho kuhlolwe kusenesikhathi futhi kaningi, ngisho noma ungazizwa unenkinga.
Usizo lokuphefumula lungase luqale ebusuku ngobusuku obungenasidingo bokungenisa umoya njengokufana ne- CPAP noma i-BiPAP. Lawa asekela umoya womoya futhi aqinisekise ukuthi ngisho nalapho umzimba ukhululekile kakhulu, uthola oksijini okwanele futhi uphumule ngokwanele carbon dioxide. Njengoba i-ALS iqhubeka, ukungena umoya okungavumelekile kungadingeka phakathi nosuku kanye nobusuku. Ekugcineni, izindlela eziningi ezingenasidingo ezifana ne- ventilation mechanical kuzodingeka zicatshangelwe. Enye indlela i-diaphragmatic pacing, lapho umsizi obhekene nokwandisa amaphaphu uhlelwe ngokomzimba ngogesi ukuze usize ukuvumelanisa lapho ama-neurons engasithumeli lo mlayezo. Zonke lezi zikhetho zixoxwa kakhulu ngeqembu elibandakanya isazi sezinzwa, isazi sokuphefumula, mhlawumbe ne-pulmonologist.
Ukuvikela i-Airway ku-ALS
Ngaphezu kwesenzo sokwandisa amaphaphu, ukuphefumula kudinga ukuba yonke imimoya ivulekele, kunokuba ixhunyiwe nge-mucous, imfihlo yomlomo, noma ukudla. Uma siphilile sivikela umoya wethu ngokugwinya njalo, ukukhwehlela, nokuthatha ukuphefumula okwezinye izikhathi, konke ngaphandle kokucabanga ngakho.
Uma sibuthakathaka kakhulu ukugwinya noma ukukhwehlela kahle, usizo luyadingeka ukuze kuvikelwe umoya.
Izindlela eziningi zitholakala ukusiza ukugcina amaphaphu avulekele. Ukulala nekhanda kancane kuqondile kungasiza ekuvimbeleni ukufihla ekuhlaleni ithubhu engalungile ebusuku. Abahlinzeki bokuphefumula bangafundisa abangani nomndeni indlela yokusiza ngomuntu ukukhwehlela ukuze kuphumelele. Izinketho eziningi ezithuthukisiwe kwezobuchwepheshe zibandakanya ukungenwa kwe-mechanical / exsufflation (MIE), okubandakanya idivaysi ehamba kancane kancane emaphashini, bese ishintsha ngokushesha ukucindezela ukulinganisa ukukhwehlela. Ukukhishwa kwesigxobo se-high-frequency chest (HFCWO) kuhilela isitsha esivusa amadlingozi ukuthi, lapho sigqoke isiguli, sisiza ukudiliza ama-mucous emaphashini ukuze akhishwe kalula.
Ngenkathi imibiko yokuqala ekusebenzeni kwe-HFCWO ixutshwe, iziguli eziningi zizwa ukuthi ziyasiza.
Enye ingxenye yokuvikela umoya womoya ukunciphisa inani lemfihlo eyenziwa yiphunga nomlomo. Zingabangela ukubola, futhi zibeke isiguli engozini enkulu yokuphefumula lezo zimfihlo emaphashini. Imithi eminingi ehlukahlukene iyatholakala ukusiza ukulawula lezi zimfihlo.
Hlela phambili ku-ALS
Ayikho indlela okuzungezile. Ekugcineni, sonke siyafa, futhi abantu abane-ALS bafa ngokushesha kunabanye. Ngesikhathi isikhathi esiningi sezinyathelo ezingaphezulu ezidingekayo ngenhla kuyadingeka, abantu abane-ALS cishe bazobhekana nezinguquko ezinkulu ekukhulumeni kwabo. Abanye bazohlushwa yi-ALM-ne-dementia ehlobene no-ALS, kanti abanye bayomane balahlekelwe ukulawula umlomo, ulimi, kanye namakhodi abo. Kuleli qophelo, ochwepheshe bezokwelapha abathintekayo ekunakekeleni lesi siguli kuzodinga ukuncika ezitatimendeni zangaphambili ngalokho okumele isiguli sifune ngokuphathelene nokunakekelwa kwabo, noma sincike kumuntu owenza isinqumo.
Ngaphansi kweziphi izimo, uma ngabe ukhona, ungathanda yini ukwelashwa okuqhubekayo nokuvuselela umoya, ukuphefumula, nokunye okuningi ukuyeka? Lezi izinqumo zomuntu siqu, ezinomthetho, ezokuziphatha nezenkolo. Kubalulekile ukuhlela phambili ngokuhlela intando ephilayo noma amandla ommeli , ukuze ukwazi ukusondela ekupheleni kokuphila ngesithunzi ofanelwe.
Imithombo:
Miller, RG, et al. (2009). Ukuzivocavoca Ukubuyekezwa kweParametha: Ukunakekelwa kwesiguli nge-amyotrophic lateral sclerosis: Imishanguzo, imithi, kanye nokuphefumula (ukubuyekezwa okusekelwe ebufakazini). Umbiko weKomidi Eliphansi Lezilinganiso Ze-American Academy of Neurology, Neurology , 73 (15): 1218-26
Miller, RG, et al. (2009). Ukuzivocavoca Ukubuyekezwa kweParametha: Ukunakekelwa kwesiguli nge-amyotrophic lateral sclerosis: Ukunakekelwa kweminyango eminingi, ukuphathwa kwezimpawu, nokukhubazeka kwengqondo / ukuziphatha (ukubuyekezwa okusekelwe ebufakazini). Umbiko we-Standards Standards Subcommittee we-American Academy of Neurology, Neurology, 73 (15): 1227-33.
U-Orla Hardiman, (2011). Ukuphathwa kwezimpawu zokuphefumula ku-ALS. Journal of Neurology , 258 (3): 359-65.
QAPHELA: Ulwazi olukulesi sayithi lunguzinhloso zemfundo kuphela. Akufanele isetshenziswe njengengxenye yokunakekelwa ngumuntu udokotela olayisenisi. Sicela ubheke udokotela wakho ukuze ahlolwe futhi aphathwe noma yiziphi izimpawu noma isimo sezokwelapha .