Guillain-Barré chirwere

Guillain-Barré syndrome (GBS) idambudziko rakakomba rehutano rinoitika kana dziviriro yemuviri (immune) system ichikanganisa kurwisa chikamu chehurongwa hwemitsipa. Izvi zvinotungamira mukutsva kwemitsipa kunokonzeresa kushomeka kwemhasuru kana kuoma mitezo nezvimwe zviratidzo.

Chikonzero chaicho cheGBS hachizivikanwe. Inofungidzirwa kuti GBS chirwere chemuviri. Nedambudziko re autoimmune, immune immune system inozvirwisa pachayo nekukanganisa. GBS inogona kuitika chero zera. Inowanzoitika kune vanhu vari pakati pemakore makumi matatu kusvika makumi mashanu.

GBS inogona kuitika nezvirwere kubva kumavirusi kana mabhakitiriya, akadai se:

• Furuwenza
• Zvimwe zvirwere zvemudumbu
• Mycoplasma mabayo
• HIV, hutachiona hunokonzera HIV / AIDS (zvisingawanzoitika)
• Herpes simplex
• Mononucleosis

GBS inogona zvakare kuitika nemamwe mamiriro ekurapa, akadai se:

• Systemic lupus erythematosus
• Hodgkin chirwere
• Mushure mekuvhiyiwa

GBS inokuvadza zvikamu zvetsinga. Uku kukuvara kwetsinga kunokonzeresa kutetepa, kushaya simba kwemhasuru, kurasikirwa nehuremu uye kuoma mitezo GBS kazhinji inobata iyo inovhara tsinga (myelin sheath). Uku kukuvara kunonzi demyelination. Izvo zvinoita kuti tsinga masaini afambe zvishoma zvishoma. Kukuvadza kune zvimwe zvikamu zvetsinga kunogona kukonzera kuti tsinga imire kushanda.

Zviratidzo zveGBS zvinogona kukurumidza kukurumidza. Zvinogona kutora maawa mashoma chete kuti zviratidzo zvakanyanya kuoneka. Asi kushaya simba kunowedzera pamusoro pemazuva akati wandei kwakajairika.

Tsvina kushaya simba kana kurasikirwa kwemhasuru basa (kuoma mitezo) inokanganisa mativi ese emuviri. Muzviitiko zvakawanda, kushaya simba kwemhasuru kunotanga mumakumbo uye kunopararira kumaoko. Izvi zvinonzi kukwira kuora mitezo.

Kana iko kuzvimba kuchikanganisa tsinga dzechipfuva uye diaphragm (iyo hombe mhasuru iri pasi pemapapu ako iyo inokubatsira iwe kufema) uye iyo mhasuru isina kusimba, ungangoda rubatsiro rwekufema.

Zvimwe zviratidzo uye zviratidzo zveGBS zvinosanganisira:

• Kurasikirwa kwetendon reflexes mumaoko nemakumbo
• Kuchenesa kana kushaya simba (kurasikirwa kwakapusa kwekunzwa)
• Tsitsi nyoro kana kurwadziwa (inogona kunge iri kurwadziwa-senge kurwadziwa)
• Kufambidzana kusingaenderane (hakugone kufamba pasina rubatsiro)
• Kuderera kweropa kana kudzvinyirira BP
• Asina kujairika kurova kwemoyo

Zvimwe zviratidzo zvinogona kusanganisira:

• Kuona kwakashata uye kuona zvakapetwa
• Kusindimara uye kudonha
• Zvakaoma kufambisa kumeso mhasuru
• Tsvina yemhasuru
• Kunzwa moyo kurova (palpitations)

Emergency zviratidzo (tsvaga rubatsiro rwechiremba ipapo):

• Kufema kunombomira
• Haugone kutora mweya wakadzika
• Kunetseka kufema
• Zvakaoma kumedza
• Kudonhedza mvura
• Kufenda
• Kunzwa mwenje wakanangiswa kana wakamira

Nhoroondo yekuwedzera mhasuru kushaya simba uye kuoma mitezo inogona kunge iri chiratidzo cheGBS, kunyanya kana paine chirwere chazvino.

Kuongororwa kwechiremba kunogona kuratidza kushaya simba kwemhasuru. Panogona zvakare kuve nematambudziko neiyo BP uye kurova kwemoyo. Aya mabasa anodzorwa otomatiki nehurongwa hwekutyaira. Iyo bvunzo inogona zvakare kuratidza kuti mafungidziro akaita senge ankle kana mabvi jeki anoderedzwa kana kushayikwa.

Panogona kuve nezviratidzo zvekudzikira kufema kunokonzerwa nekuoma mitezo yekufema mhasuru.

Iyi bvunzo inotevera inogona kuitwa:

• Cerebrospinal fluid sampuro (musana wepombi)
• ECG kutarisa mashandiro emagetsi mumoyo
• Electromyography (EMG) kuyedza chiitiko chemagetsi mumhasuru
• Tsinga conduction velocity bvunzo kuyedza kuti mamhanyisa magetsi emasaini anofamba sei mutsinga
• Pulmonary basa bvunzo kuyera kufema uye mashandiro emapapu ari kushanda

Iko hakuna mushonga weGBS. Kurapa kunoitirwa kudzikisa zviratidzo, kurapa matambudziko, uye nekukurumidza kukurumidza kupora.

Mumatanho ekutanga ehurwere, kurapwa kunonzi apheresis kana plasmapheresis kunogona kupihwa. Inosanganisira kubvisa kana kuvhara mapuroteni, anonzi antibodies, ayo anorwisa maseru etsinga. Kumwe kurapwa ndeyekuisa intravenous immunoglobulin (IVIg). Ose marapirwo anotungamira mukukurumidza kuvandudza, uye ese ari maviri anoshanda zvakafanana. Asi hapana chakanakira kushandisa marapirwo maviri panguva imwe chete. Kumwe kurapwa kunobatsira kudzora kuzvimba.

Kana zviratidzo zvakakomba, kurapwa muchipatara kuchazodiwa. Kufema kufema kunogona kupihwa.

Mamwe marapirwo muchipatara anotarisa kudzivirira kusagadzikana. Izvi zvinogona kusanganisira:

• Ropa rakapfava kudzivirira kuvhara ropa
• Kufema rutsigiro kana yekufema chubhu uye mweya, kana diaphragm isina kusimba
• Mishonga yemarwadzo kana mimwe mishonga yekurapa kurwadziwa
• Kumira kwakakodzera kwemuviri kana chubhu yekudzivirira kudzivirira kudzipwa panguva yekudya, kana mhasuru dzinoshandiswa kumedza dzisina kusimba
• Kurapa kwepanyama kubatsira kuchengetedza majoini nemhasuru zvine hutano

Izvi zviwanikwa zvinogona kupa rumwe ruzivo nezve GBS:

• Guillain-Barré Syndrome Foundation International - www.gbs-cidp.org
• National Sangano reRare Dambudziko - rarediseases.org/rare-diseases/guillain-barre-syndrome

Kudzoreredza kunogona kutora vhiki, mwedzi, kana makore. Vanhu vazhinji vanorarama uye vanopora zvakakwana. Mune vamwe vanhu, hutera hushoma hunogona kuenderera. Mhedzisiro yacho inogona kuve yakanaka kana zviratidzo zvikaenda mukati memasvondo matatu mushure mekunge vatanga.

Zvinogona kuitika matambudziko eGBS anosanganisira:

• Kufema kunetseka (kufema kutadza)
• Kupfupisa matukisi mumajoini (zvibvumirano) kana zvimwe zvakashata
• Ropa rakagwamba (deep vein thrombosis) iyo inogadzira kana munhu ane GBS asingashandi kana kugara pamubhedha
• Kuwedzera kwengozi yezvirwere
• Yakaderera kana isina kugadzikana BP
• Kuoma mitezo inogara zvachose
• Chirwere chemabayo
• Ganda kukuvara (maronda)
• Kufema chikafu kana zvinwiwa mumapapu

Tsvaga rubatsiro rwechiremba ipapo kana uine chimwe chezviratidzo izvi:

• Dambudziko kutora mweya wakadzika
• Kupera kwekunzwa (kunzwa)
• Kunetseka kufema
• Zvakaoma kumedza
• Kufenda
• Kurasikirwa kwesimba mumakumbo zvinowedzera kuwedzera nekufamba kwenguva

GBS; Landry-Guillain-Barre chirwere; Yakasimba idiopathic polyneuritis; Inotapukira polyneuritis; Chirwere chinoputika polyneuropathy; Kuvhunika kwakasimba kudzvinyirira polyradiculoneuropathy; Kukwira kuremara

• Mashura epamberi epamusoro
• Tsinga kupa kune chiuno
• Ubongo uye huta hurongwa

Chang CWJ. Myasthenia gravis uye Guillain-Barré syndrome. Mune: Parrillo JE, Dellinger RP, eds. Critical Kuchengetedza Mushonga: Nheyo dzeKuongorora uye Management muVakuru. 5 ed. Philadelphia, PA: Elsevier; 2019: chits. 61.

Katirji B. Kukanganisika kwemitsipa yekunze. Mune: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology muClinical Dzidzira. 7th ed. Philadelphia, PA: Elsevier; 2016: chits. 107.