Ukwazi Oko Kukulindele Unokukunceda Ulungiselele
Ukuba usandul 'ukuvavanywa nge- amyotrophic lateral sclerosis (ALS) okanye esinye isifo se-neuron, mhlawumbi unemibuzo kunye nexhala malunga nekamva lakho. Njengokuba kunjalo, akukho pheko kwezi zifo. Kodwa oko akuthethi ukuba awukwazi ukufumana uncedo. Kukho izixhobo ezininzi ezikhoyo, ezinokukwenza ukhululeke ngokusemandleni akho, kunye nezinye ezinokusichaphaza ukuba ungaphila ixesha elide.
Ukutya kwi-ALS
I-ALS ihlutha ngokukhawuleza abantu abanamandla okufuneka bahambe. Njengoko ukondla okwaneleyo kubalulekile ukugcina amandla, kulula ukucinga ukuba kubaluleke kangakanani ukutya okunomntu ojongene ne-ALS. Kodwa ukutya akusoloko kulula, ngokukodwa kwizigaba eziphambili zesifo. Izihlunu ezinceda ukugwinya zingasebenzi kwakhona. Ukukwazi ukukhwehlela xa ukutya kuhla kwebhubhe engalunganga kunokuthi kuphazamiseke. Ngenxa yoko, kubalulekile ukuqinisekisa ukuba akukho zibonakaliso zokukhahla xa udla.
Ngesinye isikhathi, izigulane ezine-ALS ziza kuxhamla ekuvavanyeni kwabo amandla okugwinya, njengengxubusho yokugwinya i-barium . Basenokukwazi kuphela ukutya kunye nokusela nokutya kunye nokusetyenziswa kwamanzi athile, njengokutya okuncinci okanye utywala. Ekugqibeleni, i-endoscopy tube (PEG) yecandelo elilodwa linye liza kuba liyimfuneko ukubonelela ngeendlela ezaneleyo zokutya. Nangona i-PEG mhlawumbi iphucula ixesha lokuphila ngokunyusa izinga lokondla ngokubanzi, akukho vincin ekhethekileyo okanye enye i-supplement iboniswe ngempumelelo ekuncediseni i-ALS.
Ukuphefumula kwi-ALS
Awudingi ukuba ube yingcali yezempilo ukuze uqaphele ukuba ukuphefumla kubalulekile, okanye ukuba kuthatha umzamo othile wokuphefumula. Njengoko i-ALS iqhubela phambili, ke, isenzo esilula sokuphefumula sinokuba nzima, kwaye sidinga iqela leengcali zonyango. Ukongezelela ukwandisa ubomi be-ALS, ukunyamekelwa kokuphefumula kunokuphucula amandla, ubunzima, ubuthongo bemini, ubunzima bokugxilwa, ubunzima bokulala, ukuxinezeleka kunye nokukhathala.
Ngenxa yezi zizathu, kungaba yinto efanelekileyo ukuphefumula kwakho ukuvavanya kwangaphambili kwaye kaninzi, nangona ungazivakalelwa kukuba unobunzima.
Uncedo lokuphefumula lunokuqala ngokuqala ebusuku ngeendlela ezingenasiphelo zokungenisa umoya ezifana ne- CPAP okanye i-BiPAP. Ezi zixhasa umoya kwaye ziqinisekisa ukuba nangona umzimba uphumle kakhulu, ufumana i-oxygen eyaneleyo kwaye uphuphe ngokwaneleyo i-carbon dioxide. Njengoko i-ALS iqhubela phambili, ukuphuphuma umoya okungenakuvakala kungadingeka emini nasemini. Ekugqibeleni, iindlela ezininzi ezingenayo njenge- air ventical will need to consider. Enye inketho yindlela yokunyakaza, apho i-muscle ejongene nokwandisa imiphunga ivuselelwa ngombane ukukunceda ukuba ivumelwano xa i-motor neurons ingasithumeli lo myalezo. Zonke ezi zikhethiweyo zixutyushwa kakhulu ngeliqela kubandakanya i-neurologist, ophefumulayo, mhlawumbi ne-pulmonologist.
Ukukhusela i-Airway kwi-ALS
Ukongeza kwisenzo sokwandisa imiphunga, ukuphefumula kudinga ukuba zonke i-airways zivulekele, kunokuba zixutywe nge-mucous, imfihlo yomlomo, okanye ukutya. Xa sisempilweni siyasikhusela indlela yethu yokuhamba ngomoya ngokugwinya rhoqo, ukukhwehlela, nokuthatha ukuphefumula ngokukhawuleza, konke ngaphandle kokucinga ngoku.
Ukuba sinamandla kakhulu ukugwinya okanye ukukhwehlela kakuhle, uncedo lufunekayo ukukhusela indlela yokuhamba.
Amasu amaninzi ayatholakala ukuze ancede ukuvula imiphunga. Ukulala neentloko ngokuthe tye kunokukunceda ukukhusela imfihlo ekuhlaleni ithubhu engalunganga ebusuku. Abaphefumli be-respiratory bafundisa abahlobo kunye nosapho indlela yokuncedisa ngesandla ukukhwehlela ukuze usebenze ngakumbi. Ezinye iindlela eziphambili zezobuchwepheshe ziquka ukungena kwe-mechanical / exsufflation (MIE), okubandakanya isixhobo esithatha ngokukhawuleza imiphunga, kwaye utshintshe ngokukhawuleza uxinzelelo ukuba ufanise ukukhwehlela. Ukuphakanyiswa kwesigxina sesigxina se-chest (HFCWO) kubandakanya intsimbi ephazamisayo, xa igqunywe isigulane, inceda ukuphula i-mucous emapapeni ukuze idibaniswe kalula.
Ngelixa iingxelo zangaphambili malunga nokusebenza kwe-HFCWO zixutywe, izigulane ezininzi zivakalelwa kukuba zincedo.
Enye inxalenye yokukhusela umoya wokunciphisa umoya ukunciphisa inani leemfihlo eziveliswa yimpumlo nomlomo. Zingabangela ukubola, kunye nokubeka isigulane kwingozi enkulu yokuphefumla loo mfihlo kwimiphunga. Iindidi ezahlukahlukeneyo zonyango ziyafumaneka ukukunceda ukulawula le mfihlo.
Cwangcisa phambili kwi-ALS
Akukho ndlela ejikeleze kuyo. Ekugqibeleni, sonke siyafa, kwaye abantu abane-ALS bafa kungekudala kunabanye. Ngexesha elininzi lwezikhetho ezingaphezulu ezifunekayo ngasentla ziyafuneka, abantu abane-ALS baya kuba neengxaki ezinzulu ekunxibelelaneni kwabo. Abanye baya kuba neengxaki ze-ALS ezinxulumene ne-ALS, kwaye abanye baya kulahleka ukulawula umlomo wabo, ulwimi lwabo, kunye neentambo. Kule ngongoma, oogqirha ababandakanyekayo nokunyamekela isigulane baya kufuna ukuxhomekeka kwiinkcazo zangaphambili malunga nesigulane esinokufuna malunga nokunyamekela kwabo, okanye bathembele kwisigqibo somenzi.
Ngaphantsi kweemeko, ukuba ngaba ukhona, ngaba ufuna ukunyuswa kwexesha lokuphila kunye ne-ventilation mechanical, tubes feed, nokunye ukuyeka? Ezi zigqibo zodwa, ngokwasemthethweni, eziphathekayo, kunye nenkolo. Kubalulekile ukucwangcisa kwangaphambili ngokucwangcisa ukuthanda okanye amandla okuphila , ukuze ukwazi ukufikelela ekupheleni kobomi ngesithunzi esifanelekileyo.
Imithombo:
Miller, RG, et al. (2009). Qalisa ukuhlaziywa kweParameter: Ukunyamekelwa kwesigulane nge-amyotrophic lateral sclerosis: Iziyobisi, izondlo kunye nempilo yokuphefumula (ukuhlaziywa okusekelwe kwisiseko). Ingxelo yeComitric Subcommittee ye-American Academy ye-Neurology, i- Neurology , 73 (15): 1218-26
Miller, RG, et al. (2009). Qalisa ukuhlaziywa kweParameter: Ukunyamekelwa kwesigulane nge-amyotrophic lateral sclerosis: Ukunakekelwa kwemimiselo emininzi, ukulawulwa kwezibonakaliso, kunye nokuphazamiseka kwengqondo / ukuziphatha (ukuhlaziywa okusekelwe kwisiseko). Ingxelo yeComitric Subcommittee ye-American Academy ye-Neurology, i- Neurology, 73 (15): 1227-33.
Orla Hardiman, (2011). Ukulawula iimpawu zokuphefumula kwi-ALS. Umbhalo we-Neurology , 258 (3): 359-65.
INKCAZELO: Ulwazi olukule ndawo lusezinjongo zemfundo kuphela. Akufanele isetyenziswe njengendawo yokunyamekelwa ngumntu ogqirha. Nceda ubone ugqirha wakho ukuze ufumane unyango kunye nonyango malunga nayiphi na impawu okanye imeko yonyango .