Iimpawu ezimangalisa ze-POTS kwi-Children and Young Adult
Mhlawumbi awuzange uve nge- postural orthostatic tachycardia syndrome okanye i-POTS, nangona ichaphazela abantu abaninzi, kubandakanywa nentsha, kwaye yabonwa ekuqaleni kwawo-1990. I-Dysautonomia Research Foundation ichaza abantwana abanezi ngxaki njengokuba bengabonakali kubantu abangaphandle, abanokucinga ukuba bayazifaka iimpawu zabo.
Ukuba akukwazi kakhulu ukukwazi ukuxhalabisa ngenxa yokuba i-POTS ingabangela iimpawu ezinjalo ezidakisayo, kuquka ukuxakeka, ukuxhwaba, kunye nokukhathala.
I-Postural Orthostatic Tachycardia Syndrome - Inkcazo kunye neenkcukacha
I-postural orthostatic tachycardia syndrome (i-POTS) ibangelwa ukuguqulwa okanye ukungasebenzi kwiinkqubo ze-nervous system ( dysautonomia) .
Unokuba ungaqhelani nenkqubo ye-nervous autonomic system, kodwa mhlawumbi uyazi nezinye iimeko ezihambelana nokungafezeki kwenkqubo ye-neon autonomic system. Ezi zingabandakanya ukugula kwesifo sofuba , i- fibromyalgia , kunye nesifo esingapheliyo.
Ukongeza kwinkqubo yesiseko yomnyo (ubuchopho kunye nentambo yomthambo), sinesistim se-nervousic system esinceda ukulawula ngokuzikhethela izinto ezininzi umzimba wethu ozenzayo, njenge:
- Ukunciphisa abafundi bethu xa singena kwigumbi elimnyama
- Ukwandisa ukuveliswa kwemali xa sisidla
- Kusenza sikhuphe xa sishushu
Inkqubo ye-nerveous autonomic inceda ukulawula izinga lentliziyo kunye negazi. Le nxaxheba ibaluleke ngakumbi xa sitshintsha isikhundla, njengokuba sisuka kwi-supine (silele phantsi) okanye sihleli kwindawo yokuma.
Xa sisukuma, izinto ezininzi zenzeka emzimbeni wethu esingaboniyo, okanye ubuncinci asiboni ukuba kwenzeka ntoni ngokuchanekileyo. Ekuphenduleni umthamo omkhulu wegazi ohamba emzimbeni wethu ophantsi, oqala ukuphosa uxinzelelo lwegazi, inkqubo ye-nerveous autonomic yenza intliziyo yethu isilinganise, inqande okanye ifake imithwalo yegazi kunye nokwandisa uxinzelelo lwegazi, konke ukugcina ukuhamba kwegazi kwingqondo yethu.
Imisipha emilenzeni nasemilonyeni yethu iphinde ixinzelele imithanjeni kule mizimba yomzimba kwaye incede kwinkqubo.
I-POTS kucatshangelwa ukuba iyenzeka xa le nkqubo ingasebenzi kakuhle, kubangela abantu abachaphazelekayo ukuba bahlalise xa bemi, phakathi kwezinye iimpawu.
I-POTS ixhaphake kakhulu kubasetyhini, ingakumbi abasetyhini abaphakathi kweminyaka eyi-15 kunye ne-50 ubudala (ukukhawuleza ukuphuma kwimizuzu). Nangona kungaziwa oko kubangela i-POTS, iqala rhoqo emva kokugula kwexesha elide, njengomkhuhlane okanye i- mono .
Iimpawu zePostural Orthostatic Tachycardia Syndrome
Inkcazo yeklasi ye-POTS kwintsholongwane ivakalelwa yinto elula kwaye ibe nezinga lentliziyo ephakama ngaphezu kwe-40 ngeengqungquthela ngomzuzu (okanye intlawulo yenhliziyo engaphezu kwe-120 ibetha ngomzuzu), ngaphaya kwemizuzu eyi-10 yokuma.
Ukongeza kwinto yokuba uziva uhlazo, ezinye iimpawu zePOTS zingaquka:
- Intloko
- Ubuthathaka, ukukhathala, nokunyamezela
- Ukukhathazeka kwesisu kunye nesisu esiswini
- I-Tachycardia (iqondo lentliziyo elikhawulezayo) kunye neepilpitations
- Ephantse syncope (uzive ngathi uya kuphelelwa amandla)
- Umbono ongezantsi
- Ukuxhalabisa
- Ukuphala kakubi
- Ingxaki yokulala
- Unzima ukugxila
Ukongeza kwimiqondiso ye-classic, ukuhlolwa kwetafile-tilt kunokwenziwa ukuze kuncedwe ukuxilonga abatsha abane-POTS. Uvavanyo olujikelezayo luyakwenziwa emva kokuba umntwana esele elele (elele phantsi) emizuzu emi-5, ukulinganisa intliziyo yakhe kunye nexinzelelo lwegazi, emva koko emva kokuma 3, 5, 7 kunye nemizuzu eyi-10.
Utywala kunye nokuPhalala kunye nePOTS
Ukuxakeka nokuxinwa ( syncope ) ngokwenene impawu eziqhelekileyo kubaselula.
Enyanisweni, kucatshangelwa ukuba ukuya kuma-15 kweepesenti zolutsha kuya kuphelelwa ngumlinganiselo ubuncinane kanye ngaphambi kokuba ngumdala, ngokuqhelekileyo uneminyaka engama-15 ubudala. Ngenhlanhla, abaninzi balaba bafana abanesidumbu kunye nokuphelelwa amandla abayi kuba nePOTS. Kunoko, baya kuba neengxaki eziqhelekileyo, ezifana ne:
- I-Vasovagal syncope - Ebizwa ngokuba yi-postural syncope, i- vasovagal syncope ingabangela xa umile ixesha elide endaweni enye (izibilini zegazi ezandleni zakho nasemilenzeni, ingakumbi ukuba awuhambisani nabo) okanye ukuphendula intlungu okanye ukwesaba.
- Ukungalondeki okwexesha elifutshane - Ukunyamezelana komzimba okwenzeka emva kwexesha kungenzeka xa ugula ngumkhuhlane, isifo seesisu, okanye ezinye iimeko zonyango, ekubangela ukuba ube yincinci kwaye udideke xa usukuma.
- I-Orthostatic hypotension - Njenge-POTS, i -hypotension ye-orthostatic iyenzeka xa usukuma.
Umehluko omkhulu phakathi kweemeko ezingentla kunye ne-POTS kukuba nge-POTS iimpawu zenzeka rhoqo imihla kwaye zihlala zikhubaza.
Ukongezelela ukunyanga naziphi na izifo zokungcoliswa kwamanzi, izibonelelo ezintle kwezo zizathu ze syncope zivame ukunyanzela ukukhusela ukuba zenzeke. Kwisibonakaliso sokuqala ukuba umntwana wakho uvakalelwa kukuba unokuphelelwa amandla, ngokuqhelekileyo ukhuthazwa ukuba ahlale, ahlasele okanye alala phantsi. Ukufumana okwaneleyo ityuwa namanzi ekudleni kwabo kubalulekile.
Iincinci zePOTS
Akunabo bonke abane-POTS abaneempawu ezifanayo, kwaye kubonakala ukuba kukho iifom zokuqala ezintathu okanye i-subtypes yolu meko, elo elo lidibene neendlela ezahlukeneyo. Ukuqonda i-subtype ethile ye-POTS kunokukunceda ukhokela ugqirha wakho kwizinto ezikhethiweyo zokunyanga. Ezi ziquka:
- POTS ye-Neuropathic
- I-POTS ye-Hyperadrenergic
- Hypovolemic POTS
Unyango lwe-Postural Orthostatic Tachycardia Syndrome
Ekubeni i-POTS ingaba nzima, ukufumana unyango olufanelekileyo kubalulekile. Iinjongo zokuqala eziphambili zivame ukunyuka kwevolumu (kunye nokusetyenziswa kwamanzi kunye netyuwa), ukuzivocavoca kunye nemfundo. Unyango luquka:
- Ukuphakamisa intloko yombhede wengane yakho ngo-4-6 intshi.
- Ukukhuthaza umntwana wakho ukusela okungenani ii-2 ukuya kwi-3 ilitha ze-nonfeffeinated, i-liquids ecacileyo imihla ngemihla kwaye ahlale e-hydrated kahle.
- Ukwandisa inani leetyuwa ekudleni komntwana-ukuya ku-3-5g / d, xa kuthelekiswa nokuqhelekileyo kwi-1500-2300mg ityuwa kubantwana abangenayo i-POTS.
- Ukuphepha ukutya okukhulu kwaye kunokutya ukutya rhoqo, kodwa ukutya okuncinci (ukutya okukhulu kukunyusa inani legazi emanzini.)
- Inkqubo yokuzilolonga okanye yokubuyisela inkqubo yokubandakanya umsebenzi we-aerobic kunye nokuqiniswa komzimba ophantsi okwandisa ngokunyuka inani lomsebenzi wakho umntwana ufumana ngosuku ngalunye. Oku kubaluleke ngakumbi kuba iingcali ezininzi zikholelwa ukuba ukuphumla nokulala ngokulala kunokudlala indima ekubangela ukuba i-POTS ibangele.
Amachiza kwiPOTS
Amaxesha amaninzi asetyenziswa ekuncediseni abatsha abane-POTS, kuquka i-metoprolol (i-beta-blocker), i-midodrine (i-alpha-agonist), okanye i-fludrocortisone (i-mineralocorticoid enokukunceda ukwandisa ityuwa kunye nokugcinwa kwamanzi), yimimiselo yamachiza enokuba tyenziswa.
Nangona i-tricyclic anti-depressants asebekhulile icinga ukuba i-POTS ibe yimbi, i-SSRI entsha yokuxhatshazwayo (njenge-Prozac) ithathwa njengonyango olunokwenzeka.
I-Ivabradine yonyango olutsha olubonakala luncedo kwabanye abantu abanePOTS.
Ukuza kunye neSicwangciso soTyango
Akukho sikhokelo sokuchaneka sonyango kwabaselula abane-POTS. Amanye amanqaku eendaba angavumelani nokuba ngaba ezinye izibonelelo zonyango, njenge-beta-blockers okanye ii-SSRI, zinceda. Ukufumana uncedo kuya kubandakanya inzame kunye nesiphene ukuze ufumane unyango olulungileyo olwenza umntwana wakho kunye nePOTS.
Oko Okufuneka Ukwazi NgePOTS
- Nangona kungekho nonyango kwi-POTS, intsha eninzi ibonakala iphuma kuyo. Ubuncinane abantu abangama-500 000 eUnited States bacinga ukuba banePOTS.
- Ukutshatyalaliswa ngexesha lokuzilolonga ngumfuziselo obomvu ngeyona nto ibangela i- syncope , ingakumbi kubantwana kunye nembali yentsapho yokufa ngokukhawuleza. Uvavanyo lwenzululwazi yakho kunye / okanye i-cardiologist yabantwana kufuneka kwenziwe ngokukhawuleza.
- I-POTS ngamanye amaxesha inxulumene nokuba ne- hypermobility syndrome , i-Chiari malformation, okanye ukukhathala okungapheliyo.
- Umgangatho wobomi uncitshiswa kubantu abancinci abanePOTS baze bafikelele kwisiqingatha sabaselula kunye nabaselula abanesifo esichengeni sokuzibulala. Ukufumana inzululwazi enokuthi umntwana wakho angavulelwa kunye nayo inokuba yinxalenye ebalulekileyo yesicwangciso sonyango.
- Ingcali ye-neurologist yezilwanyana inokukunceda ukuxilonga nokuphatha umntwana wakho ngePOTS. Iinkonzo zee-POTS nazo zifumaneka kwezinye izibhedlele zezingane.
Imithombo
- I-Heyer, G. Postural Tachycardia Syndrome: Ukuxilonga kunye nokuLawula kwi-Adolescents kunye nabaNtsundu abadala. Amanqaku omntwana . 2017. 46 (4): e145-154.
- Pederson, C., noJro Brook. Ubunjani bokuphila kunye neengozi yokuzibulala kwi-Postural Tachycardia Syndrome. Uphando lwezonyango lwezonyango . 2017. 27 (2): 75-81.
- I-Pilcher, T., no-E. Saarel. Umfaki weNtshontsha (i-Dizziness, Syncope, Postural Orthostatic Tachycardia Syndrome). Iiklinikhi zezilwanyana zaseNyakatho Melika . 2014. 61 (1): 29-43.
- Zheng, X., Chen, Y., noJu Du. Uphuhliso olusandul 'ukuSondlo lweNkqubo ezisisiseko se-Postural Tachycardia Syndrome kwaBantwana: Impembelelo eSebenzayo yokuPhathiswa. I-Cardiology kwi-Young . 2016 Dec 12. (Epub ngaphambi kokuprinta).