ʻO ka disreflexia kūʻokoʻa

ʻO Autonomic dysreflexia kahi mea maʻamau, overreaction o ka ʻōnaehana ʻōnaehana ʻole (autonomic) i ka stimulate. Pili pū paha kēia hopena:

• Hoʻololi i ka helu o ka puʻuwai
• Nui ka hou ʻana i ka hou
• Piʻi koko kiʻekiʻe
• ʻAskeke mākala
• Hoʻololi ka ʻili o ka ʻili (keʻokeʻo, ʻulaʻula, ʻalani polū hina hina)

ʻO ke kumu maʻamau o ka autonomic dysreflexia (AD) ka ʻeha o ke kuamoʻo. ʻO ka ʻōnaehana ʻōiwi o ka poʻe me AD over-pane i nā ʻano stimulate e hoʻopilikia ʻole i ka poʻe olakino.

Nā kumu ʻē aʻe e:

• ʻO Guillain-Barré Syndrome (maʻi i hōʻino hewa ka ʻōnaehana pale o ke kino i kahi ʻāpana o ka ʻōnaehana hopohopo)
• Nā hopena o kekahi mau lāʻau
• ʻEha poʻo poʻo a me nā ʻeha ʻeha ʻē aʻe
• Subarachnoid hemorrhage (kahi ʻano o ke kahe ʻana o ka lolo)
• Hoʻohana i nā lāʻau stimulant kū ʻole i ke kānāwai e like me ka cocaine a me nā amphetamines

Hiki i nā ʻōuli ke hoʻokomo i kekahi o kēia mau mea:

• Hopohopo a hopohopo paha
• Nā pilikia o ka ʻōpū a me ka ʻōpū
• Blurry vision, widened (dilated) haumana
• ʻĀlohilohi, puʻupuʻu, a maule paha
• Fiva
• Goosebumps, ʻulaʻula (ʻulaʻula) ʻili ma luna o ka pae o ka ʻeha o ke kuamoʻo
• Hoʻoikaika ka sweating
• Piʻi koko kiʻekiʻe
• Kuʻi naʻau kū ʻole, lohi a wikiwiki hoʻi ka lāʻau
• Nā spasms Muscle, ʻoi loa i ka iwi ā
• ʻAsalhaʻi ihu
• Uʻi kuʻi poʻo

I kekahi manawa ʻaʻohe hōʻailona, ​​ʻoiai me ka piʻi weliweli o ke kaomi koko.

E hana ka mea mālama ola i kahi ʻōnaehana hopohopo piha a me ka ninaninau ʻana. E haʻi i ka mea hoʻolako e pili ana i nā lāʻau a pau āu e lawe nei i kēia manawa a ua lawe ʻoe i ka wā ma mua. Kōkua kēia i ka hoʻoholo ʻana i nā hoʻokolohua āu e pono ai.

E komo pū paha nā hoʻāʻo:

• Nā hoʻāʻo ʻana o ke koko a me ka mimi
• CT a me MRI scanner
• ECG (ana o ka hana uila o ka naʻau)
• Pahu lumbar
• ʻO ka hoʻāʻo ʻana i ka papa ʻaina (hoʻāʻo o ke kaomi koko e like me ka hoʻololi ʻana o ke kūlana o ke kino)
• Nānā Toxicology (nā hoʻāʻo no nā lāʻau, me nā lāʻau, i kou kahe koko)
• Nā kukuna X

Māhele nā ​​kūlana ʻē aʻe i nā hōʻailona he nui me AD, akā he kumu ʻokoʻa. No laila ke kōkua a me ka hoʻāʻo ʻana e kōkua i ka mea hāʻawi i nā kūlana ʻē aʻe, e like me:

• Carcinoid Syndrome (nā tumors o ka ʻōpū liʻiliʻi, kolona, ​​hoʻopili ʻia, a me nā paipu bronchial i nā akemāmā)
• Neuroleptic malignant syndrome (kahi kūlana i hoʻokumu ʻia e kekahi mau lāʻau e alakaʻi ai i ka ʻāʻī o ka ʻū, ke kunu kiʻekiʻe, a me ka hiamoe)
• Pheochromocytoma (ʻōiwi o ka adrenal gland)
• Serotonin Syndrome (ka hopena o ka lāʻau e kumu ai i ke kino e loaʻa ka serotonin he nui, kahi kemika i hana ʻia e nā hunaola nerve)
• ʻO ka ʻino thyroid (kahi hoʻoweliweli ola mai kahi thyroid overactive)

Hoʻoweliweli ʻo AD i ke ola, no laila he mea nui e ʻike koke a mālama i ka pilikia.

Pono kahi kanaka me nā ʻōuli o AD e:

• Noho a hoʻāla i ke poʻo
• Wehe i nā kapa paʻa

Pili ka mālama kūpono i ke kumu. Inā lāʻau nā lāʻau a i ʻole nā ​​lāʻau kū ʻole i ke kumu o nā ʻōuli, pono e hoʻopau ʻia kēlā mau lāʻau. Pono e mālama ʻia kekahi maʻi. ʻO kahi laʻana, e nānā ka mea hāʻawi i kahi catheter urinary i ālai ʻia a me nā hōʻailona o ka constipation.

Inā ke lohi nei o ka puʻuwai e hoʻokumu iā AD, hiki ke hoʻohana ʻia nā lāʻau i kapa ʻia anticholinergics (e like me atropine).

Pono e mālama wikiwiki ʻia ke koko kiʻekiʻe loa akā akahele, no ka mea hiki ke hāʻule koke ke koko.

Pono paha kahi pacemaker no kahi mele naʻau paʻa ʻole.

Pili ʻo Outlook i ke kumu.

ʻO ka poʻe me AD ma muli o ka lāʻau lapaʻau e ola maʻamau ke kū ʻia kēlā lāʻau. Ke kumu ʻia ʻo AD e nā kumu ʻē aʻe, pili ka hoʻōla i ka maikaʻi e mālama ʻia ai ka maʻi.

Hiki ke hana i nā pilikia ma muli o nā hopena o nā lāʻau i hoʻohana ʻia e mālama ai i ke ʻano. ʻO ka wā lōʻihi, ke kiʻekiʻe o ke koko kiʻekiʻe ke kumu o ka hopu ʻana, kahe ʻana o ke kahe i nā maka, ka hahau ʻana, a i ʻole ka make.

Kāhea koke i kāu mea hāʻawi inā loaʻa nā ʻōuli o AD.

I mea e pale aku ai iā AD, mai lawe i nā lāʻau e kumu ai i kēia ʻano a i ʻole e ʻino ai.

I ka poʻe me ka ʻeha o ke kuamoʻo, hiki i ka mea aʻe ke kōkua i ka pale ʻana iā AD:

• Mai waiho i ka ʻōpū piha piha
• E kāohi ʻia ka ʻeha
• E hoʻomaʻamaʻa i ka mālama pono ʻana i nā ʻōpū e hōʻalo i ka hopena o ka noho
• E hoʻomaʻamaʻa i ka mālama ʻana i ka ʻili kūpono e hōʻalo ai i nā bedores a me nā maʻi o ka ʻili
• Kāohi i nā maʻi maʻi bladder

Hyperreflexia kū kaʻawale; ʻEha iwi kuamoʻo - autonomic dysreflexia; SCI - autonomic dysreflexia

• ʻŌnaehana ʻōnaehana waena a me ka ʻōnaehana ʻōnaehana peripheral

ʻO Cheshire WP. Nā maʻi Autonomic a me kā lākou hoʻokele. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 390.

ʻO Cowan H. Autonomic dysreflexia i ka ʻeha o ke kuamoʻo. Nā wā kahu. 2015; 111 (44): 22-24. PMID: 26665385 pubmed.ncbi.nlm.nih.gov/26665385/.

ʻO McDonagh DL, ʻo Barden CB. ʻO ka disreflexia kūʻokoʻa. I: Fleisher LA, Rosenbaum SH, eds. Nā pilikia ma Anesthesia. ʻEkolu huaʻōlelo. Piladelapia, PA: Elsevier; 2018: chap 131.