Ngaba ukuhlolwa kwegazi kunokunceda ukuxilonga ingxubusho?
Ngomhla kaFebruwari 14, 2018, i-US Food and Drug Administration (i-FDA) ivume ukuhlolwa kwegazi ukuze kusetyenziswe ukuxilongwa kwezimpikiswano.
Iingqungquthela ngumzekelo ogqithisileyo wendlela umendo wezokwelapha ubugcisa kunye nesayensi. Kwiminyaka emininzi, ukulimala kwengqondo ebuhlungu (TBI) eyaziwayo njengengxubusho yayingaqondwa kakuhle. Ingxaki yeengcambu zathinteka njani, imiphumo yexesha elide, unyango, kunye nokuqonda okucacileyo kweempawu kunye neempawu azizange ziqalise ukuqina kuze kube sekupheleni kwekhulu lama-20.
Imidlalo yokuthintana, ngokukodwa ibhola lezemidlalo kunye nemisebenzi yokulwa emkhosini inempembelelo enkulu (ayikho into ejoliswe kuyo) ekuqondeni kwezonyango zokulimala ngokukhawuleza, ngokukodwa ukuba ukuphindaphindiweyo kwintloko kwadala umonakalo kwimizimba yengqondo. Njengoko ingozi yomcibisholo yacaca ngakumbi, ababoneleli bezempilo bafuna ukucaca indlela yokuyiqonda.
Indlela iVavanyo leGazi eliSebenza ngayo
Uvavanyo lwegazi lubizwa ngokuba ngumqondiso weBanyan Brain Trauma Indicator kwaye lilinganisa amanqanaba eeprotheni, ezaziwa ngokuba yi-UCH-L1 ne-GFAP, ezikhutshwa kwiisisu zengqondo kwigazi. Xa lilinganiselwa kwiiyure ezili-12 zokulimala, amanqanaba ala maprotheni anokunceda ukuba ngaba isiguli singenayo izilonda engqondweni ekuboneni nge- CT scan okanye i-MRI .
Ukuxhatshazwa kwengqondo ebuhlungu-iingxaki-kaninzi azibonisi izilonda kwimifanekiso yengqondo. Okubi kakhulu, inani elikhulu lokubakho ukukhanya kweemitha ezifunekayo ukufumana i-CT scan ingaba nemiphumo emibi ngokuhamba kwesikhathi.
Umngcipheko ufanelekile ukufumanisa ukulimala okungasongela ubomi, kodwa iimvavanyo ze-CT ezingadingekile zifanele zigwenywe.
Uvavanyo lweGazi luni
Uphawu lweBanyan Brain Trauma Indicator lunceda oogqirha banqume ukuba okanye bangenzi i-CT scan. Kuphando olwenziwe ngu-FDA ukuvuma ukuvavanywa, kwachaneka kwangaphambili ukuba izigulane ziza kuba nezilonda ezibonakalayo kwi-CT i-97.5% yexesha.
Uvavanyo oluchanekileyo luqikelele ukuba izigulane aziyi kuba nezilonda ezibonakalayo nge-CT scan 99.6% yexesha.
Ngoko ke, xa zisetyenziswe njengesicatshulwa sokuqala sokuxilonga, uvavanyo luyakusiza ukulawula ezo zigulane ezingenayo ukunyamezela umbane we-brain scan. Uvavanyo lukhawuleza ngokwaneleyo ukuba lusetyenziswe ngaphambi kwe-CT scan ngaphandle kokubangela ukulibaziseka okukhulu.
Oko kuhlolwa kweGazi akukwenzi
Ayifuzanga iziphumo. Kubalulekile ukuqonda umahluko, kuba akufani noogqirha banokukhupha uhlobo oluthile lwe-doohickey ebonakala ngathi i-glucometer kunye nokuxilonga iingcamango nge-drop of blood ngaphandle komdlalo omkhulu.
Ubuncinane, kungekhona.
Olu vavanyo alunagqithisi ngokwalo. Akusiyo i-panacea. Nangona kunjalo, kuya kunceda oogqirha bahambe kwizigulane ezingenako ukulimala kanobuchopho obubi kakhulu. Ukusebenzisa olu vavanyo kunye neendlela eziqhelekileyo zokuxilongwa-iGlasgow Coma Scale kunye nezinye iimvavanyo ze-neurolo-ziya kunceda oogqirha banqume ukuba ngaba baya kugulisa isigulane kwimisebe. Akuyinto encinci.
Iingxoxo zixutyushwa njani
Kwiminyaka emininzi, iingqungquthela zineendlela ezimbini zokuxilonga:
- Isigulana sinqatshelwe ngesikhashana.
- Isigulane asikhumbuli into ebethayo.
Okwesithathu, ngamanye amaxesha, ukungaxilwanga, iimeko zokuxilongwa kukuba kwakufuneka zixinzeleleke. Isigulane kufuneka sitshitshwe kwi-noggin ukuze sikwazi ukucinga ingcamango njengendlela yokuxilonga. Eneneni kuphela imilinganiselo ekhoyo. Akuyi kuba ngumngcipheko ngaphandle kokulahla entloko.
Inkcazo yezoLutsha kunye neSebe lezoKhuselo lonyango lwezonyango zokulawula ukulimala koluvo lobuchopho obunomdla, lenza umsebenzi omkhulu wokubeka amanyathelo anamhlanje okufumanisa iingcamango. Into ebaluleke kakhulu ukuyikhumbula kukuba oku kukuxilongwa kokungabikho. Injongo kukulawula (ukuqinisekisa ukuba isigulane asinalo ukulimala kwengqondo ebuhlungu.
Ukuba akanako ukulimala kwengqondo ebuhlungu besifo, ngoko isigulane sinokuba nomngcipheko. Ezinye zeempawu zeengqungquthela kunye neempawu ezisetyenziselwa ukucacisa ubunzima zibandakanya:
- Ukuphuka ngokunyanisekileyo kwinqanaba lokuqonda (ngokuqhelekileyo usebenzisa iGlasgow Coma Scale)
- Ukuhlaziya ngokunyanisekileyo ukuhlolwa kwegazi (kwenziwa ngumboneleli wezempilo)
- Abafundi abangalinganiyo (uphawu oluphawulekayo lokulimala kwengqondo ebuhlungu)
- Iziqu (ngakumbi xa isiguli singakaze sibe nazo ngaphambili)
- Ukuhlanza okuphindaphindiweyo
- Ukulahleka kweengqondo: i-motor (ayikwazi ukuhamba ngokuchanekileyo) okanye inzwa (ayikwazi ukuthetha ngokuchanekileyo)
- Umbono ombini
- Ukunyuka kwengqondo kwentlungu
- Ayikwazi ukuqonda abantu okanye ukuphazamiseka kwindawo (kwimidlalo, isiguli asikwazi ukukhumbula igama leqela elichaseneyo)
- Intetho edibeneyo
- Ukuziphatha okungavamile (utshintsho lomntu, umzekelo)
Ukuba isigulane sinikeza nayiphi na le miqathango, inokubangelwa yingozi ekhuselekileyo yengqondo kwaye isigulane siyakunikwa i-CT scan ukuze sibone ukulimala okunokunyangwa ngokuhlinzwa (umzekelo okanye i-hematoma epidural).
Umehluko omkhulu phakathi kovavanyo lwendabuko nolwanamhlanje kukuba izigulane asisayi kukhankanywa kubaboneleli bezempilo ukuba zixhalabele ngeengxoxo. Enyanisweni, uqeqesho lwezonyango luyaqhubeka lufunda indlela ukuthotywa kwentloko kwinto kwaye kungabangela ukulimala.
Ukuhlolwa kweGazi kunokunceda njani
Ezinye zeempawu kunye neempawu ezingentla zikhona kwizigulane ezinobungozi obunzima obuthathaka. Ngaphandle kwemigangatho yokuxubusha, ingaba yincinci.
Yilapho ukuhlolwa kwegazi kungena khona.
Kwizigulane ezineembali zokungena kwi-dome ephethe intloko okanye ukuhlanza, kodwa ungabonakali nayiphi na enye imiqondiso iboniswe, i-CT scan ingaqinisekiswa kwaye ingenako. Kuze kuphuhliswe uvavanyo lwegazi, eso sigqibo sawa kumboneleli wezempilo ukuze akwenze ngaphandle kobuphi ubungqina obuxhasayo ngenye indlela okanye enye.
Ngoku, ugqirha unokuvavanya ama-biomarkers enxubileyo kwigazi. Ukuba uvavanyo lubi, lithetha ukuba ama-99.6 amaxesha angama-100, isiguli asiyi kubakho into ebonakalayo kwi-CT scan. Oko kunika ugqirha indlela ecacileyo yokugxila uvavanyo kwizixhobo ezingaphantsi kwamandla. Akuthethi ukuba isigulane asikho kwi-0.4% eya kuba nebonakalayo kwi-CT scan, kodwa umboneleli wolondolozo lwezempilo uya kugcina isigulane ukuqinisekisa ukuba yonke into iyaqhubeka ngokufanelekileyo.
Ixesha elizayo le-TBI Ukuhlolwa kwegazi
Oku mhlawumbi kungokuqala. Ukusetyenziswa kwamaprotheni athile njengama-biomarkers kwafundwa iminyaka emininzi ngaphambi kokufakwa kovavanyo lokuqala. Uphando olongezelelweyo lunokugxila kumanqanaba aya kusixelela xa isiguli sisengozini enkulu yokulimala kwengqondo ebuhlungu. I-Biomarkers iya kudlala indima ekuboneni xa izigulane ziphiliswa.
Nangona ukuba i-drop of blood ngasemva ayikho indlela okwenziwa ngayo ngoku, ayithethi ukuba akuyiyo ikamva lokuhlolwa kwegazi nge-biomarker. Khawucinge nje ngecandelo logqirha kwimidlalo yezemidlalo okanye kwiyeza lokulwa kwimida yangaphambili ekwazi ukuvavanya ngokukhawuleza ijoni okanye umdlali olimele ukuba afune ukuba ngaba kukho ingqungquthela okanye cha.
Okwangoku, isigqibo sokubeka isigulane kwakhona kwimeko ekhokelela ekwenzeni ukulimala, isigqibo esinengcinezelo enkulu kumntu ononophelo, senziwa ngokusekelwe kukuqiqa. I-kliniki isoloko isebenzisa ukuhlolwa kweengqungquthela zokuqhelanisa ukucacisa ukusebenza okusemgangathweni kwegazi, emva koko ibuyisela umdlali okanye ijoni kwindawo yokulimala. Ukuba isiguli asenzi okwesibini (phantsi kwengcinezelo yakhe ukwenza) angasuswa kwintsimi aze athunyelwe unyango olongezelelweyo.
Uvavanyo lwegazi luba ngummakishi wokuvuselela umdlalo okanye imfazwe. Ukusetyenziswa kusele kubonakala.
> Imithombo:
> Ulawulo lweNgqungquthela / i-MTBI Iqela lokuSebenza. I-VA / DoD Isikhokelo seNkcazo yokuSebenza ngokuPhathwa kweNgqungquthela / Ubunzima bokuBala Ubunzima. J Rehabil Res Dev . 2009; 46 (6): CP1-68.
> Papa, L., Edwards, D., & Ramia, M. (2015). Ukuhlolisisa i-Serum Biomarkers nge-Brain Traumatic Injury Injury. ICCC Press / Taylor & Francis . Efumaneka kwi-https: //www.ncbi.nlm.nih.gov/books/NBK299199/
> Papa, L. (2016). Iingxaki zeBeomorers based Based Blood. Ukuhlaziywa kweMidlalo kunye nokuHlola kweArthroscopy , 24 (3), 108-115. http://doi.org/10.1097/JSA.0000000000000117