Amanye amazinga okungahambi kahle nesistimu ye-neon autonomic cishe isakazeke kakhulu, ikakhulukazi njengoba sikhula. Isibonelo, abangaphezu kwamaphesenti angama-25 abantu abangaphezu kweminyaka engama-75 bahlushwa ukuxilongwa komzimba okwemvelo , lapho kungase kube nzima abantu ukuthi bame ngaphandle kokuzizwa behlaziye ngenxa yesistimu yezinzwa ezizimele ezingakwazi ukulungisa ukucindezeleka kwegazi ngendlela efanele.
Cishe noma iyiphi inkinga yezokwelapha-noma ngisho nokwelashwa-ingathinta isimiso sezinzwa sokuzimela ngokuqondile noma ngokungaqondile. Inkinga ngesistimu ye-neon autonomic ibizwa ngokuthi i- dysautonomia . Ngaphambi kokulungisa le nkinga, kubalulekile ukuthi uhlolwe kahle ukuqinisekisa ukuthi uhlobo lwe-dysautonomia luqondwa kahle.
Izindlela zokucindezelwa kwegazi le-Orthostatic
Indlela evamile kakhulu yokuhlola isimiso sezinzwa ze-autonomic singenziwa nge-cuff pressure yegazi, i-watch kanye nombhede. Umfutho wegazi ulinganiswa futhi umfutho uthathwa lapho isiguli silele phansi, sihlezi, futhi simile, cishe imizuzu emibili phakathi kwezikhundla. Kubantu abavamile, ingcindezi yegazi akufanele ihluke ngaphezu kwe- diastolic engaba ngu-10 (inombolo ephansi yengcindezi yegazi) noma i-systolic engu-20 (inombolo ephezulu), nakuba lezi ziqondiso zihlukahluka ngezindawo.
Uma ingcindezi yegazi iwa, kungase kungabi yinkinga ngesistimu yezinzwa ezizimele: kungase kungabi khona igazi elanele ukugcina ingcindezi eyanele.
Isizathu esivamile salokhu ukukhipha amanzi emzimbeni, yingakho siphinde sihlole ukushayela. Uma ukucindezeleka kwegazi kuwela, umfutho kufanele ukwandise njengoba umzimba uzama ukwandisa ukucindezeleka kwegazi futhi uthole igazi ebuchosheni. Uma kungenjalo, kungase kube nenkinga nge-arc reflex ehilela i-vagus nererve, enezintambo zomzimba ezilawulayo ezilawula izinga lenhliziyo.
Ezinye izivivinyo zebhedi
Ukusebenzisa i- electrocardiogram (ECG noma i-EKG) ngenkathi wenza ukuhamba okulula kungakhuphula ukuzwela kokuhlolwa kwe-dysautonomia. Isibonelo, isilinganiso sobude phakathi kwamagagasi amabili kagesi kuma-heartbeats angu-15 no-30 ngemuva kokuma endaweni ehlezi (isilinganiso esibizwa ngokuthi i-R-to-R ratio) singabonisa inkinga nge-vagus nerve. Lokhu kungenziwa futhi ngesikhathi sokuphefumula okujulile. Kuze kube neminyaka engu-40, ukuphefumula okuphefumulelwe okungaphansi kwe-1.2 akuvamile. Lesi silinganiso kulindeleke ukuba sinciphise njengoba sineminyaka yobudala futhi siyancipha ngisho ne- neuropathy elula kakhulu yesifo sikashukela .
I-Valsalva isilinganiso yinye yokuhlola okulula, engavumelekile yokubheja kombhede engasetshenziswa ukuhlola i-dysautonomia. Isiguli sigxila ngokukhipha umlomo wakhe ivaliwe ukuze kungabikho moya ophunyukayo. Lokhu kuvame ukudala izinga lokushaya kwenhliziyo kuze kube yilapho sekuphelile umoya, lapho i-parasympathetics ijwayele ukuqhubekela phezulu, okwenza umzuzwana omfushane we- bradycardia , lapho izinga lenhliziyo liwela phansi ngezansi. Uma izinga lezinhliziyo lingakhuphuki ngesikhathi seValsalva, kungenzeka ukuthi kukhona ukungasebenzi komzwelo. Uma ihluleka ukuhamba kancane ngemva kwalokho, iphakamisa ukungasebenzi kahle kwe-parasympathetic.
Amanye amasu ahlukanisa ukuguqulwa kwengcindezi yegazi ngemva kokuvinjelwa kwemisipha emaminithini ambalwa, noma ngemuva kokugcina umlenze ubanjwe emanzini abandayo.
Ukuhlolwa Okuzenzekelayo Okuzenzakalelayo
Uma izivivinyo zombhede zinganele, kunezinqubo eziningi zokuxilonga ezihilelekile ezitholakalayo kwezinye izikhungo. Lokhu kungase kuhileleke ukuthi isiguli sibekwe etafuleni elithambile , okuvumela isimo sesiguli ukuba sishintshwe ngokushesha futhi ngendlela engalinganiswa kalula.
Ukuziphatha kwekhanda kungalinganiswa ngemva kokuba imakhemikhali ingenwe ukwenza leso sifo sokujula ukuze kuhlolwe umehluko ocashile phakathi kwezifunda ezahlukene zomzimba.
Ngezinye izikhathi ama-hormone ama-hormone afana ne-norepinephrin angalinganiswa ngokuphendula ukucindezeleka kwesistimu, kodwa ukuhlolwa okunjalo akuvamile.
Izivivinyo ze-Sweat
Isistimu yomzwelo enozwela inesibopho sokubangela ukufihla emigodini yokuthuthumela. Cabanga njengendlela yokuqinisekisa ukuthi umzimba wethu uhlala upholile ngokwanele ukubalekela ngempumelelo ngogwebu ohlasela.
Ngezinye izikhathi ukulungiswa kokuzwelana kwengxenye yomzimba kulahlekile, futhi le ngxenye ayisekho izithukuthuku. Lokhu akusobala ngaso sonke isikhathi, ngoba ukuphefumula kungagijima kusuka kwesinye isifunda somzimba ukumboza ingxenye engasapheli. Ngokuhlolwa kwesithukuthuku, umzimba uhlanganiswe ne-powder eguqula umbala uma ugubula, okwenza ukungabi nesikhutha kwesifunda kubonakale kakhudlwana. Ukuphazamiseka ukuthi lokhu kuvivinywa kubi kakhulu.
Ukuhlolwa Kwezingxenye Zemizimba Ehlukile
Ngenxa yokuthi isimiso sezinzwa esizimele sikhiphe cishe zonke izingxenye zomzimba, kungase kudingekile ukuhlola ukuthi lezi zinzwa ezizimele zisebenza kanjani ingxenye eyodwa kunokuba nje isistimu yenhliziyo.
Kunezinhlobonhlobo zamaconsi ezamehlo angase asetshenziselwe ukuhlola ukugcinwa kwamehlo okuzenzekelayo. Ukukhishwa kwamehlo kungenziwa kuhlolwe ngokufaka isikhwama esincane somqulu esikhwameni saso ukuze sibone ukuthi umswakama ubamba kangakanani. Umsebenzi wesisindo ungahlolwa ngendawo yangaphandle, futhi i-motility yamasu emathunjini angase ahlolwe ngezifundo ze-radiographic.
Sichaze kuphela ezinye zezivivinyo eziningi ezisetshenziselwa ukuhlola isimiso sezinzwa ezizimele. Iqiniso liwukuthi ama-dysautonomias ajwayelekile angaziwa, futhi izikhungo eziningi azikho izivivinyo eziyisisekelo. Lokhu kungaba yingxenye ngoba ama-dysautonomi amaningi ngenxa yezinkinga eziphazamisa ezinye izingxenye zomzimba ngezindlela ezicacile, ezenza kube lula ukuhlolwa okuqhubekayo. Isibonelo, isifo sikashukela siyimbangela evamile ye-dysautonomia etholakala ngokuhlolwa kwegazi okwejwayelekile ngesifo sikashukela, kunokuqala ngesistimu ye-neon autonomic.
Uma inkinga ngesistimu ye-neon autonomic isolwe futhi iqinisekisiwe, kungenzeka ukuthi ukuhlolwa okuningi kuyodingeka ukucacisa imbangela. Esikhundleni sokuzama nje ukuphatha izimpawu zomshoshaphansi, ukubhekana nesisusa esiyinhloko salesi sifo kuyindlela engcono kakhulu yokuthola isimiso sezinzwa ze-autonomic emuva kokulinganisela.
Imithombo:
Hiitola P, Enlund H, Kettunen R, Sulkava R, Hartikainen SJ Hum Postural izinguquko ekucindezelweni kwegazi kanye nokusabalalisa kwe-hypotension ephakathi kwamakhaya asebekhulile abaneminyaka engama-75 noma ngaphezulu. Ama-Hypertens. 2009 Jan; 23 (1): 33-9. i-doi: 10.1038 / jhh.2008.81. Epub 2008 Jul 24.
I-Ropper AH, ama-Samuels MA. Adams kanye Nemigomo kaVictor ye-Neurology, 9th ed: The McGraw-Hill Companies, Inc., 2009.
I-Blumenfeld H, i-Neuroanatomy ngokusebenzisa ama-Clinical Cases. I-Sunderland: Abakwa-Sinauer Associates Publishers 2002.