Izinto ezinobungozi zeLeliri kwiSibhedlele seZibhedlele

I-State Acute Confusional State

Iimeko ezidibeneyo zokudideka, ezaziwa nangokuthi i-delirium okanye i-encephalopathy, ixhaphake kwizibhedlele ezithatyathwa njengesiqhelo ngabasebenzi abaninzi esibhedlele. Phakathi kwama-14 ukuya kuma-56 ekhulwini kwizigulane zonke ezibhedlele zihlaziyike. Izigulane ezingenayo i- unit care center zinomlinganiselo ophezulu, zifikelela kuma-82 ekhulwini.

Ngelixa i-delirium isaziqhelana nabasebenzi basezibhedlele, ayinakunqabisa kwaye inzima kubahlobo nakumalungu entsapho.

Umthandane wabo, isigulane, abanako ukuwaqonda. Kwezinye iimeko, isigulane sinokumangalela izihlobo okanye abahlobo bezenzo ezinjengezinto zokuzama ukufaka entolongweni okanye ukumbulala. Kungabonakala ngathi umntu ongasemzimbeni ongenazifo unomzimba wesigulane.

I-Delirium idla ngokukhawuleza kwaye iphucula njengoko isigulane siphulukisa kwisifo. Nangona kunjalo, oko akuthethi ukuba i-delirium iyingozi. I-Delirium inxulumene kunye nokunyuka kweenyanga ezimbini kwiinyanga ezili-12, nangona emva kokulungiswa kwezifo ezinzima. Kwakhona kudibaniswa nokuhlala kwesibhedlele ixesha elide kunye nomngcipheko okhulayo wokuphuhliswa kwe- dementia .

Iimpawu zeDeliyam

Izigulane ezithethwe yi-delirium zikwazi ukuba ziphi na okanye ziyazi ukuba unyaka onjani. Basenokuphosakela ubungqina beziqhelo eziqhelekileyo eziza kuzivakashela. Iingqungquthela ziqhelekile ngokunjalo. Esinye sezibonakaliso eziqinileyo ezinokuqhelaniswa kwimeko edidekileyo yinkalo kunzima ukunyamekela nantoni na ixesha elide.

Ngamanye amaxesha i-delirium inokubangela umntu ukuba athukutheke, apho kwenzeka ukuba angakhwaza okanye aphume nzima ukuphuma ebhedeni. Ezi zigulane eziphazamisayo zizama kwakhona ukususa iibhulo okanye ii-IV imigca enika imishanguzo yokugcina ubomi. Ngethamsanqa, kuphela iipesenti ezi-10 zezigulane ezidliwayo zibizwa ngokuba yi-"subperpe" engaqhelekanga.

Uninzi lwexesha, i-delirium ayibonakali kangangoko kwaye izigulana zinokuhlala zithe ngqengqele embhedeni, kodwa ngaphandle kwengcamango yangempela yento eyenzekayo malunga nabo. Aba bantu banokuba yi-lethargic okanye bengayithobeli. Oku kwaziwa ngokuba yi "hypoactive" delirium, kwaye malunga neepesenti ezingama-40 zezigulane ezidliwayo ziya kuba nale hlobo. Iipesenti ezingama-50 zezigulane ezine-delirium "zidibene,

Iintlukwano kwixinzelelo ziphawulekayo ze-delirium. Ngomzuzu isigulane sinokubonakala ngathi siqhelekileyo, kwaye ngomzuzu olandelayo ungenza njengomnye umntu ngokupheleleyo. Ezi zintlukwano zingapheli kunye neeyure. I-Delirium idla ngokugqithiseleyo ngelixa isigulane sasiya kulala, into eyaziwayo kwizibhedlele njenge "sundowning."

Izizathu zeDeliyam

Indlela ekhoyo yokucinga nge-delirium kukuba umntu unokuba nemingcipheko yokudideka, apho phantsi kweemeko ezithile kunokunciphisa i-delirium epheleleyo. Ngokomzekelo, isigulane esikhulileyo sinokukhubazeka okucacileyo , kodwa ke uhlakulele ukusuleleka kwe- urinary tract that leads to a state confusional state. Ukusetyenziswa kotywala, ukuxinezeleka, ukungondleki, unyango oluthile, kunye nokuphazamiseka kombono kunye nokuphulaphula kunokubangela ukuba umntu angene kwi-delirium.

Kukho uluhlu olude kakhulu lwezinto ezinokubangela ukuba umntu enomngcipheko ophantsi kwimeko edidekileyo yokudideka. Kunokuba luncedo ukuthembela kwi-mnemonic "delirium" ukukhumbula ezinye zezizathu ezibangela ukuba:

D - Izidakamizwa: Oku mhlawumbi iyona nto ibangela i-delirium. Ukongeza amayeza amathathu amatsha kwisibhedlele ukuhlala kwandisa umngcipheko we-delirium kathathu kwizigulane ezigugile. Abaphambukeli abaqhelekileyo ngamachiza e-anticholinergic njengamanye amaninzi asetyenziswa ukunyanga kokungcola. I-Benzodiazepines kunye ne-opiates nazo zihlala zihlaselwa. Nangona kunjalo, uluhlu lwamanye amayeza anokubangela ukuba i-delirium ibandakanye i- antihistamines , i- antiepileptics , i-steroids, i-antibiotics, kunye nabanye abaninzi.

I-E - Epilepsy: Nangona ukuxhatshazwa ngokuqhelekileyo kuye kwacatshulwa njengesizathu esincinci sokutshintsha kwimo yengqondo, uphando olutshanje luye lwabonisa ukuba ipesenti ephakamileyo yezigulane, ingakumbi kwii-ICUs, ngokwenene zixhamla kwiimeko ezingenasimangalo , isantya ukuba zihlala zibamba ngaphandle kokunyanzeliswa kwesigxina.

I-Lung: I- oxygen encinci okanye i-carbon dioxide kakhulu ngenxa yobunzima bokuphefumula ingaba negalelo kwiindawo ezidibeneyo. Ukukhusela i-apnea yokulala ingxaki.

Mna-Ukukhulelwa: Ngokuxhomekeka kwindlela umntu ayenzileyo ngayo ngenxa yeso sikhundla sokudideka, malunga naluphi na isifo esinokubakhuphaza kumgca kwi-delirium, kubandakanya ukusuleleka kwezifo zentsholongwane. Okuqhelekileyo, ukusuleleka kwe-urinary tract, pneumonia, okanye intsholongwane yesikhumba yimbangela.

R-Ukugcinwa: Oku kunokuthetha ukugcinwa kwe-urine okanye isitulo. Ukutyunjwa kukunikela rhoqo kwi-delirium.

I-Ukuvutha: Le nxalenye ebanzi ngokuzithandela kuba izinto ezininzi emzimbeni zinokubangela impendulo yokuvuvukala. Ukuphendulwa komzimba kuyinto enokwenzeka. Uphando luba negalelo eliqhelekileyo kwi-delirium. Ukuvinjelwa kwamathumbu okanye ukuphazamiseka kunokukwenza oku kanye.

U-Unstable: Amazwe adibeneyo adibeneyo anokusebenza njengesilumkiso sokuba isiguli sigula kakhulu. Uxinzelelo lwegazi oluphantsi kakhulu okanye oluphakamileyo kakhulu lunokubangela ukuphazamiseka kwengqondo, njengokuba kunakho ukutshatyalaliswa kwe-myocardial (intliziyo yesifo). Izibetho aziqabanga ukuba zenze i-delirium ngaphandle kwesinye isibonakaliso sesifo , njengobuthakathaka bengalo okanye umlenze, kodwa ngokungaqhelekanga kubangele ukudideka.

I-M-Metabolic: Oku kuquka iingxaki ze-thyroid kunye nesifo sikashukela, esinokukhokelela kwizinga leshukela legazi eliphantsi kakhulu (u- hypoglycemia ) okanye phezulu kakhulu (hyperglycemia). Amanye amahomoni afana ne-cortisol angakhokelela ekutshintsheni ekucingeni. Ukungondleki kunye nokungaphumeleli kwindlala kungabandakanywa kule nkalo.

Njengoko ubona, kukho isibalo esikhulu sezigulane ukudideka esibhedlele. Uninzi lwabantu abadidekile kwizigulane banomngcipheko ongaphezu kweyodwa kwi-delirium. Uluhlu olukhankanywe apha ngasentla alubandakanyi nezinye izithintelo eziqhelekileyo zokunciphisa ukulala, i-catheterizations kunye neenkqubo ezininzi eziqhelekileyo kwizibhedlele. Ngamanye amaxesha oogqirha kufuneka bahambe umgca omhle ekulawuleni i-delirium. Ngokomzekelo, ngelixa intlungu ingabangela i-delirium, ngokunjalo unokunyanga amaninzi. Nangona kuthethwa ngamanye amaxesha ukukhutshwa kwesigulane kwisigulane sokukhupha imigca kunye nama-tubes, izibambiso zenyama zibuhlungu ngakumbi.

Ngethamsanqa, kukho iindlela ezongezelelweyo ezenziwa ngabasebenzi bezonyango kunye namalungu entsapho ukuze bancede ukukhusela i-delirium ekuphumeni kwesandla ngelixa iingxaki ezisemgangathweni zilungiswa. I-Delirium iyethusa, kodwa phantse ayizange ihlale isigxina. Ukunyamekela kakuhle isigulane kunokunceda ukuqinisekisa ukuba wonke umntu ufumana amava ngokukhawuleza kangako.

_Imithombo:

_{Dubois MJ et al. Delerium kwi-ICU, uphando lwezinto ezibeka umngcipheko kwiyeza ezinonophelo zonyango. 2001 27 1297-1304}

_{Ely EW, Shintani A, Truman B. et al. I-Delirium njengendlela yokufa kwabantu kwizigulane ezisebenza ngomoya okhuselekileyo kwiyunithi yokunyamekela. JAMA 2004; 291 (14): 1753-1762.}

_{Peterson JF, Delerium kunye ne-motoric subtypes, J. Geriat. I-Soc 54 (3) 479-484, 2006.}

_{UVanja C. Douglas, uA. Andrew Josephson, uDelirium. I-Continuum: Ukufunda yonke i-Neurol 2010; 16 (2) 120-134}