Igama le- coma linombono othusayo kubantu abaninzi. Abantu abaninzi baye bafunda phantse bonke abayaziyo malunga ne-coma ngokubukela umabonwakude, apho i-coma yimeko apho i-reca ifumaneke ngokuqinisekileyo kubabukeli kwaye imangalisa kubalinganiswa. Enyanisweni, kuxhomekeke kwisizathu kunye nobuqili be-coma, ukubuyiswa kungaqinisekiswa ngokuphantse okanye kungenakwenzeka.
Inkcazo ye-coma nayiphi na imeko apho isiguli esingazi kakuhle ngamehlo abo avaliweyo kwaye akakwazi ukuvuswa ngentshiseko okanye evuselela ubuhlungu. Oku akunjalo into efanayo nokulala ngenxa yokuba ingqondo ayifumani umsebenzi oqhelekileyo ohambelana nokulala ngexesha le-coma. Nangona umntu oleleyo angashenxa ukuba awanakulungeleki, umntu odibanisayo akayi kuthi, ngaphandle kweengcamango zomgogodla.
Qaphela ukuba ngale nkcazo, oogqirha bavame ukubeka abantu ngeenjongo ngethuba lonke xa basebenzisa i-anesthesia jikelele kwinkqubo yokucanda. Ngokufanayo, abantu abaninzi kwizibhedlele bathatha ixesha elide ukukrazula izinto zabo zangaphandle, nokuba ngaba ezo zinto zinyango okanye izifo. Kule meko, singalindela ukuba umntu avuke xa umzimba ekugqibeleni ugqubuthela ngokwaso usulelo, amayeza okanye i-toxin.
Ngakolunye uhlangothi, kukho iintlobo ze-coma apho kungenakukwazi ukuvuka khona.
Ngokuchasene noko sasiyicinga ukuba, iiseliti zesitya zingakwazi ukuvuselela, kodwa zenza kuphela kwiindawo ezithile zobuchopho, nangona kunjalo, ngokukhawuleza. Ukuba iisetyiti ezaneleyo zifa kwindawo efunekayo ukuze uhlale uphaphama, njenge-thalamus, ubuchopho be-brainstor okanye ezinkulu kwi-cortex ye-cerebral, mhlawumbi umntu akayi kuphinda aphinde ahlale eqonda.
Ezinye iiMerika zeNgqiqo
Nangona wonke umntu ebonakala egxininisa kwi-coma, kukho iindawo ezinzima ngakumbi zokungazi. Ngokomzekelo, ezinye iindidi ze-coma zigqitywa ngokugqithiswa yinto ebizwa ngokuba yi-vegetative state. Nangona izigulane ezixhamlayo zibonakala zilele, abantu baseburhulumenteni bendalo bafumana kwakhona isantya sokuvusa, okwenza ukuba amehlo avule. Amehlo anokude ahambe, ebonakala ekhangele izinto ezisegumbini. Nangona kunjalo, abantu abakwizityalo zityalo ababonisi naluphi na ukuqonda okwenyaniso ngokwabo okanye kwindawo yabo. Ukuba i-brainstem ihlala ihambile, intliziyo, imiphunga, kunye namatye emathumbu iyaqhubeka ukusebenza. Ukuba le meko ihlala iinyanga, isigulane sithathwa njengesimo sezityalo eziqhubekayo.
Ukufa kweBongo yimeko enzima nakakhulu apho imisebenzi yengqondo yobuchopho iyancitshiswa kwisigulane sokuxhamla, kwaye umntu akakwazi ukuphefumula ngokwabo. Ukukwazi ukunyusa isigulane okanye ukunciphisa intliziyo yabo ngokufanelekileyo, kunokuchaphazeleka. Akubangakho na matyala afanelekileyo okuxilongwa ngokuchanekileyo ngokuxhomekeka kobuchopho obuye bafumana naluphi na uhlobo lokubuyisela okunenjongo. Nangona ugqirha ofanelekileyo unokukwazi ukuxilongwa kwengqondo yokufa esekelwe kwisifundo somzimba kuphela, enikwe ubungqina bokuxilongwa, ezinye iintsapho zikhetha ukufumana iimvavanyo ezongezelelweyo.
Nangona kunjalo, ukuba uvavanyo lwebhedlele lwenziwa ngokupheleleyo nangokuchanekileyo, iimvavanyo ezongezelelweyo akunakwenzeka ukuba zibonise nayiphi na into entsha okanye ethemba ngakumbi. Ukuba i-autopsy eyenziwa kwisigulane esiphefumula ingqondo, ezininzi iiseli zengqondo ziya kutshabalalisa.
I-Amancial Conscious States
Ngenxa yokugqithiswa okukhulu kwezi meko, izazi ze-neurologists zithemba ukufumana uphawu lokuba isigulane sawo asiyi kuba seburhulumenteni bokwenyani okanye i-vegetative state, kodwa kunokwimeko encinane. Iimfuno ezincinci zibonakalisa ukulahleka okukhulu ekuqondiseni, kodwa ubuncinane ubuncinane bokugcina ulwazi ngokwabo okanye kwindawo ejikelezileyo.
Oku kunokuba yinto ecacileyo yokuzala ngokulandelelana, ukunika ngokufanelekileyo u-yego / akukho mpendulo, ukubonisa ukuziphatha okunenjongo ezifana nokumemeza okanye ukukhala okufanelekileyo, okanye ukulungelelanisa izandla ngezandla kunye nobujamo bezinto ezigcinwe. Ngokuqhelekileyo, abantu abakwaziyo kwiimeko ezincinci banemiphumo engcono kakhulu kunezigulane kwi-comas eqhubekayo.
Ukugqiba ukuba umntu usemgangathweni okanye u-coma unzima kunokuba umntu aqale acinge. Umuntu odibanisayo angahamba ngendlela ebonakala ngathi avukile, abahlobo kunye nosapho abalahlekayo. Ngokomzekelo, izigulane ezidibanisayo zinokuthi i-grimace if i-stimulus ebuhlungu isetyenziswe kumnwe okanye inzwane. Basenokubonakala bekhenkceza inqwelana le ntlungu. Kwizinto ezibizwa ngokuba nguLazaru syndrome, i-reflex eyomeleleyo ingakhokelela isigulane sokuxhamla ukuhlala. Nangona kunjalo, ezi mpendulo ziyi-reflexes nje, efana nento eyenzekayo emlenzeni wakho xa i-neurologist igubha ngamadolo akho ngesondo. Ukunyuka okunjalo akuthethi ukuba umntu uvukile.
Ukufumana kwakhona kwiComa
Xa abaninzi abantu bebuza ukuba umhlobo wabo uhlala e-coma, into enqwenela ukuba bayayazi kukuba kungekudala isigulane siza kuvuka njani, ukuba nanini. Njengoko ubonile, oku kuyahluka kuye kuxhomekeke kwisibindi kunye nobunzima belizwe elingenalwazi. Ngokomzekelo, i-coma ngenxa yokulimala kongqondo kubangela ukuba i-prognosis engcono kunokugqithisa ukugula . Izigulane ezincinci zivame ukwenza ngcono kunezikhulile. Omnye umntu okhutshwe ngeziyobisi angasuka ngokuqhelekileyo njengoko isicatshulwa sisuswe kwinkqubo yaso, kanti umntu onesilonda esingasigxina sengqondo angathuthuka kwiimeko eziqhubekayo zityalo okanye nokuba ukufa kwengqondo. Ngokuqhelekileyo, xa umntu esele engahlali engazi, mhlawumbi banako ukuhlaziya.
Nangona kunjalo, kwanokuba izikhokelo ezingentla zingabakho into yokunyusa. Iingcali ze-neurologist zingenza izibikezelo malunga nekamva, kodwa oku akufani nebhokisi le-crystalal. Ngelishwa, indlela yodwa yokwazi ngokuqinisekileyo ukuba umntu uya kubuya kwi-coma kukulinda ixesha elifanelekileyo kwaye ubone. Ixesha elingakanani lokulinda lingaba yisigqibo esinzima, kuxhomekeka kwiimeko ezizodwa zegulane kunye nosapho, kwaye kufuneka zixoxwe ngokucophelela ngeqela lonke lezonyango.
Imithombo
- UJerome B. Posner noFred Plum. I-plum kunye ne-Posner's Diagnosis ye-Stupor neComa. ENew York: i-Oxford University Press, ngo-2007.
- I-Hal Blumenfeld, i-Neuroanatomy ngokusebenzisa iiKliniki zeeKliniki. I-Sunderland: Abapapashi be-Sinauer Associates 2002