Ingabe ukuhlolwa kwegazi kungasiza ukuxilonga ingxabano?
Ngo-February 14, 2018, i-US Food and Drug Administration (FDA) ivume ukuhlolwa kwegazi ukuze kusetshenziswe ukuxilongwa kwezimpikiswano.
Izimpendulo ziyisibonelo esiphelele sendlela umkhuba wokwelapha ubuciko nesayensi. Kwaphela amashumi eminyaka, ukulimala okubuhlungu kwengqondo (TBI) eyaziwa ngokuthi i-concussion kwakungaqondakali kahle. Indlela izicubu zobuchopho ezithinteka ngayo, imiphumela yesikhathi eside, ukwelashwa, ngisho nokuqonda okucacile kwezibonakaliso nezimpawu ngempela akuzange kuqale ukuqinisa kuze kube sekupheleni kwekhulu lama-20.
Imidlalo yokuthintana, ikakhulukazi ibhola lomsebenzi, kanye nemisebenzi yokulwa empini yaba nomthelela omkhulu (akukho ukujeziswa okuhlosiwe) ekuqondeni kwezokwelapha ukulimala okukhanga, ikakhulukazi ukuthi ukuphindaphindiwe kwekhanda kwaholela kanjani ekulimazeni izicubu zobuchopho. Njengoba izingozi zengxabano zacaca, abahlinzeki bezempilo bafuna ukucaca ukuthi bangayibona kanjani.
Indlela Ukuhlolwa Kwegazi Kusebenza Kanjani
Ukuhlolwa kwegazi kuthiwa yi-Banyan Brain Trauma Indicator futhi lilinganisa amazinga amaprotheni, awaziwa ngokuthi u-UCH-L1 no-GFAP, akhululwa emathisini ebuchopho egazini. Uma kulinganiswa zingakapheli amahora angu-12 wokulimala, amazinga ala maprotheni angasiza ekunqumeni ukuthi isiguli singaba nezilonda yini ebuchosheni obonakalayo nge- CT scan noma i-MRI .
Ukulimala okubuhlungu kwengqondo-izimpikiswano-ngokuvamile akubonakali izilonda emifanekisweni yobuchopho. Okubi nakakhulu, inani elikhulu lokudonswa kwemisebe edingekayo ukuthola i-CT scan kungaba nemiphumela emibi ngokuhamba kwesikhathi.
Inengozi kufanelekile ukuthola ukuthi kungenzeka yini ukulimala okubangelwa ukuphila, kodwa ukuhlolwa okungadingekile kwe-CT kufanele kugwenywe.
Lokho okuhlolwa kwegazi
Isibonakaliso se-Banyan Brain Trauma isiza odokotela banqume ukuthi noma bangenzani i-CT scan. Ucwaningo olusetshenziswa yi-FDA ukuvuma ukuhlolwa, lwalungabikezela ukuthi iziguli zizokwazi ukuthola izilonda ezikhathini zazo ze-CT 97.5% wesikhathi.
Isivivinyo ngokunembile sabikezela ukuthi iziguli ngeke zibe nezilonda ezitholakalayo nge-CT scan 99.6% yesikhathi.
Ngakho-ke, uma isetshenziswe njengethuluzi lokuqala lokuxilonga, ukuhlolwa kusiza ukulawula lezo ziguli ezingadingeki ukukhuthazelela ukukhanya kwe-CT engqondweni. Ukuhlolwa kuyashesha ukusetshenziselwa ngaphambi kwe-CT scan ngaphandle kokubambezeleka okukhulu.
Lokho ukuhlolwa kwegazi akukwenzi
Ayitholi izimpikiswano. Kubalulekile ukuqonda umehluko, ngoba akufani nodokotela ongakhipha uhlobo oluthile lwe-doohickey olubukeka njenge-glucometer kanye nokuxilongwa ngokuxoshwa kwegazi eceleni komdlalo omkhulu.
Okungenani, hhayi okwamanje.
Lokhu kuhlolwa akuqinisekisi ngokwayo. Akuyona i-panacea. Kodwa-ke, kuzosiza odokotela ukuba bahambe iziguli ezingenalo ukulimala okukhulu kobuchopho obukhulu kakhulu. Ukusebenzisa lolu luhlolo kanye nezindlela ezijwayelekile zokuxilongwa-iGlasgow Coma Scale kanye nokunye ukuhlolwa kwezinzwa-kuzosiza odokotela banqume ukuthi bangabeka isiguli emisebeni. Akuyona into encane.
Indlela Izimpikiswano Ezitholwa Ngayo
Sekuyiminyaka eminingi, izimpikiswano zinezizathu ezimbili zokuxilongwa:
- Isiguli sigodliwe singenalutho okwesikhashana.
- Isiguli asikhumbuli ukuthi yini eyamshaya.
Indlela yesithathu, ngezinye izikhathi engazange ikhulunywe, indlela yokuxilongwa ngayo ukuthi kwakufanele kube nokuhlobene nokuhlukunyezwa. Isiguli sasifanele sitholakale kwi-noggin ukuze sikwazi ngisho nokucabangela ukuxilongwa njengendlela yokuxilongwa. Yilokho kuphela izinga elikhona okwamanje. Ngeke kube yinkinga ngaphandle kokuqhafaza ekhanda.
I- Veterans Affairs / uMnyango wezokuVikela isiqondiso somtholampilo wokulawulwa kokulimala okubuhlungu kwengqondo ngokucindezeleka kwenza umsebenzi omkhulu wokubeka izinyathelo zanamuhla zokuhlola izimpendulo. Into ebaluleke kakhulu okumele uyikhumbule ukuthi lokhu kutholakala ukuxoshwa. Umqondo ukukhipha (ukuqinisekisa) ukuthi isiguli asinayo ukulimala okubuhlungu ebuchosheni.
Uma engenalo ukulimala kokuchofoza ebuchosheni obusongela ukuphila, khona-ke isiguli singase sibe nengxabano. Ezinye zezibonakaliso nezimpawu zokuncintisana ezisetshenziselwa ukucacisa ubukhulu zihlanganisa:
- Ukunciphisa izinga lokuqonda (ngokujwayelekile usebenzisa i-Glasgow Coma Scale)
- Ukunciphisa ngokuqhubekayo ukuhlolwa kwegazi (okwenziwa ngumhlinzeki wezempilo)
- Abafundi abangalingani (isibonakaliso esibalulekile sokulimala kobuchopho obuhlungu)
- Ukuzizwa (ikakhulu uma isiguli singakaze sibe nazo ngaphambili)
- Ukuhlanza okuphindaphindiwe
- Iphutha lezinzwa: imoto (ayikwazi ukuhamba kahle) noma inzwa (ayikwazi ukuzwa ukuthinta kahle)
- Umbono kabili
- Ukuhlukumeza ikhanda ngokuqhubekayo
- Ayikwazi ukubona abantu noma ukudideka endaweni (ezemidlalo, isiguli singase singakhumbuli igama leqembu elihlukile)
- Inkulumo emisiwe
- Ukuziphatha okungavamile (izinguquko zobuntu, isibonelo)
Uma isiguli sinikeza nganoma iyiphi yalezi zindlela, kungenzeka ukuthi ukulimala okubuhlungu kwengqondo kubangele futhi isiguli sinikezwa i-CT scan ukuze sibone ukulimala okungaphathwa ngokuhlinzwa (isibonelo, i-subdural noma i-epidural hematoma).
Umehluko omkhulu phakathi kokuhlolwa kwendabuko nesimanje ukuthi iziguli akudingeki ukuba zikhishwe kubanikezeli bezempilo ukuze zikhathazeke ngezimpikiswano. Ngempela, ochwepheshe bezokwelapha bayaqhubeka befunda ukuthi ukuthungatha ikhanda kungaba kanjani futhi kubangele ukulimala.
Yeka ukuthi ukuhlolwa kwegazi kungasiza kanjani
Ezinye zezibonakaliso nezimpawu ezingenhla zingatholakala ezigulini ezinokulimala kakhulu kwengqondo ebuhlungu kakhulu. Ngisho nezindinganiso zokuncintisana, zingase zibe ezincane.
Yilapho ukuhlolwa kwegazi kungena khona.
Ezigulini ezinezimlando zokungena kumdome onomama noma ukuhlanza, kodwa ungabonakali noma yiziphi ezinye izibonakaliso ezibalwe, i-CT scan ingaqinisekiswa futhi ingase ingabi. Kuze kube ukuthuthukiswa kokuhlolwa kwegazi, leso sinqumo sabona umhlinzeki wezempilo ukuze enze ngaphandle kobufakazi obusekelayo ngendlela eyodwa noma enye.
Manje, umtholampilo angakwazi ukuhlola ama-biomarkers enkingeni egazini. Uma ukuhlolwa kungalungile, kusho ukuthi izikhathi ezingu-99.6 ezingaphezu kwengu-100, isiguli ngeke sibe nokubonakala ku-CT scan. Lokho kunika udokotela indlela ecacile yokugxila ekuhloleni kumathuluzi angenawo amancane. Akusho ukuthi lesi sigulane asikho ku-0.4% okuzobonakala okuthile ku-CT scan, kodwa umhlinzeki omuhle wezempilo uzoqhubeka egcina isiguli ukuqinisekisa ukuthi konke kuqhubeka kahle.
Ikusasa le-TBI Ukuhlolwa Kwegazi
Lokhu kungenzeka nje ukuqala. Ukusetshenziswa kwamaprotheni athile njengama-biomarkers kwafundwa iminyaka eminingana ngaphambi kokuba kuqalwe uhlolo lokuqala. Ucwaningo olwengeziwe luzogxila emazingeni azositshela lapho isiguli sisengozini enkulu yokulimala kwengqondo ebuhlungu. Ama-biomarkers azophinde ahlanganyele ekuboneni lapho iziguli ziphulukiswa.
Naphezu kokuthi ukwehla kwegazi eceleni akukona ukuthi kwenziwa kanjani manje, akusho ukuthi akulona ikusasa lokuhlolwa kwegazi le-biomarker. Cabanga udokotela weqembu emidlalweni yezemidlalo noma imithi yokulwa emigqeni yangaphambili ekwazi ukuhlola masinyane isosha elimele noma umdlali ukuze anqume ukuthi kubekhona yini inkinga noma cha.
Okwamanje, isinqumo sokubeka isiguli emuva esimweni esifanayo esiholele ekulimazeni, isinqumo esinokucindezeleka okukhulu kumnakekeli, senziwe ngokusekelwe kokuqagela okungcono kakhulu. Umtholampilo uvame ukusebenzisa ukuhlolwa kokuqala kokucubungula ukuze anqume ukusebenza okuyisisekelo kwe-neurological, bese ephindaphinda isidlali noma isosha ngesikhathi sokulimala. Uma isiguli singenzi kahle okwesibili nxazonke (ngaphansi kwengcindezi yakhe yokwenza) angasuswa ensimini futhi athunyelwe ukwelashwa okwengeziwe.
Ukuhlolwa kwegazi kungaba uphawu lokuvuselela umdlalo noma empini. Ukusetshenziswa kuhlale kubonakala.
> Imithombo:
> Ukuphathwa kwe-Concussion / mTBI Group Working. Isiqondiso se-VA / DoD Clinical Practice Yokuphathwa Kokuncintisana / Ukulimala Kobunzima Bobunzima. J Rehabil Res Dev . 2009; 46 (6): CP1-68.
> Papa, L., Edwards, D., & Ramia, M. (2015). Ukuhlola ama-Serum Biomarkers we-Brain Traumatic Injury. I-CRC Press / Taylor & Francis . Itholakala ku-https: //www.ncbi.nlm.nih.gov/books/NBK299199/
> Papa, L. (2016). Ama-biomarker asekelwe ngegazi okwenziwe ngegazi. Ukuhlolwa Kwezemidlalo Nokubuyekeza Kwe- Arthroscopy , 24 (3), 108-115. http://doi.org/10.1097/JSA.0000000000000117