Rufu rwehupombwe nderimwe rematambudziko anonyanya kuongororwa neurologist anogona kuita. Kusiyana nemhando dzakakomba dze coma, kuongororwa kweuropi kufa kunoreva kuti hakuna kudzoka. Mune mhuka, uropi rufu rufu.
Kana kuongororwa kwakaitwa zvakanaka, zvinogona kuitwa nekuona kuti murwere ari mu coma yezvikonzero zvinozivikanwa uye zvisingabvumirwi, uye kuti zvimwe zviitiko zvekuongorora zvinenge zvisipo, kusanganisira brainstem reflexes uye chero kuedza kufema munguva yekuedzwa kwepnea .
Kuongorora kwepnea kunosanganisira kupa murwere oksijeni asi kubvisa ventilator kubvumira carbon dioxide kuvaka muitiro, iyo inowanzokonzera kuedza kufema. Hapana hutano hwakanyatsozivikanwa hwekuongororwa kwehuropi kufa nekunyatsogadziriswa umo murwere akazova nekuwana kwakanaka.
Zvisinei, pane dzimwe nguva apo kusangana nezvose zvigadzirwa zvehutano muuropi rufu hazvibviri. Semuenzaniso, mukutambudzika kwakakomba kumeso, zvingave zvisingabviri kuita nyanzvi yekuongororwa kwemitsipa yakaoma. Mune vamwe varwere, zvinogona kunge zvisingabviri kuita chirwere chepnea, zvichida nokuti murwere haana kunyatsogadzikana kana kuti akavakira kubvumira carbon dioxide, sezvinoratidzwa kune vamwe varwere vane chirwere chisingaperi chisingagadziriswe cheplmmine kana chirwere chakasimba chokurara. Muzviitiko izvi, kuwedzerwa kuwedzerwa kunodanwa.
Uyezve, nokuti kuongororwa kweuropi kufa kwakaoma, mhuri dzakawanda dzinosarudza kuwedzerwa kuongororwa zvisati zvaita zvisarudzo pamusoro pekuvhara mhepo inopisa kana kutarisa mitezo yomuviri.
Electroencephalography (EEG)
EEG inoshandiswa kuyera basa remagetsi muuropi. Iyo inowanzoshandiswa kana chiremba ane hanya kuti mumwe munhu anogumburwa kana kuora mwoyo. Muhuropi rufu, panzvimbo pokutsvaga basa risingaiti, EEG iri kutsvaga chero rudzi rwebasa zvachose. Zvimwe zvishoma zvekuita magetsi zvinogona kuonekwa kuti zviripo, asi izvi zvinomiririra chigadziriswa nekuda kwechiratidzo kubva kumakona ari pedyo kana kushaya moyo, uye haufaniri kudarika chimwe chikumbaridzo kuitira kuti zvigadzirise zvirongwa zvekuongororwa kweuropi kufa.
Somatosensory Evoked Potentials (SSEP)
Kufanana neEEG, SSEP inotsvaga kuti magetsi anofamba sei mumuviri, kusanganisira uropi. Panzvimbo pokungotarisa basa rehuropi rinenge riripo, SSEP dzinosanganisira hurongwa hwekutya hunosimudzirwa nokutyisa kwegetsi, kazhinji kune mutezo wepakati . Kazhinji, izvi zvinoshungurudza mabhuku sechiratidzo chinogamuchirwa muuropi, chinogona kuyerwa ne electrode yakaiswa pamusoro wemurwere. Kusavapo kwezviratidzo izvi kunoratidza kuti uropi hahukwanisi kugamuchira aya mharidzo.
Angiography
Mucherechedzo chepfungwa, dye yakasiyana inopindwa mumidziyo yemuviri, uye uropi hunoonekwa pane chekuita apo murwere anotarisana ne-X-rays. Izvi zvinobvumira kutsvaga kwekuti ropa riri kufamba sei mumuviri. Mukuropi urofu, midziyo yeuropi haina kuzadza sezvaiwanzoita.
Transcranial Dopplers
A transcranial doppler yokuongorora anoshandisa mazai e-ultrasound kuongorora kubuda kweropa muuropi. Muuropi hunofa, uropi inogona kukura munzira dzinowedzera kushorwa mumidziyo yeropa, kuderedza kubuda kweropa. Izvi zvinoshandiswa muropa rinoyerera zvinogona kuonekwa mumutambo wedoppler.
Nyukliya Mishonga Miedzo
Mishonga yenyukireya inosanganisira kujowa kwe radioisotope muuropi.
Iyi isotopu ikemikari inofamba pamwe neropa ruchiyerera. Iyo isotope inopera, zvichiita kuti kusunungurwa kwesimba kunowanikwa nema sensor uye kuchinjwa kuva chifananidzo che digital. Kana uropi huri hutano hwakanaka uye hunoshanda, huchaita sehuri kujekesa pamusoro pekucherechedza sezvo ropa rinopinda mukati mehutachi tissue. Muuropi yekuongorora kwehupfungwa, isotope inowanzozivikanwa inonzi technetium-99m hexamethylpropyleneamine oxime. Kana murwere akarova uropi, ipapo hakuzovi nehuni hunobva kuuropi mu scan. Iko dzimwe nguva inozivikanwa se "hove yecheek phenomenon."
Kuunza Zvose Pamwe
Aya maitiro anogamuchirwa zvakanyanya sekuwedzerwa, kunyange zvazvo kazhinji kusingakoshi, kuongororwa kweuropi kufa kwekuongorora.
Mimwe miitiro yehutano ingasiyana kubva kune imwe nyika kuenda kune imwe nyika uye kunyange kuchipatara kuchipatara, zvisinei. Kufanana nemhando ipi zvayo yekuedza, imwe neimwe yedzidzo iri pamusoro apa inoda kududzirwa zvakanyatsonaka uye mumamiriro ezvinhu ehurwere anozivikanwa nenyaya yezvoutano. Hapana chiyero chakakwana, saka zvakakosha kuti kunyatsoteerera kunobhadharwa kune tsanangudzo yekuti kuedza kunoshandiswa sei kuitira kuti mukana wekutsanangurirwa kwemigumisiro uri kuderedzwa.
Uropi hwehupenyu hwemudiwa chinhu chinotambudza kumhuri, asi kuwedzerwa kuwedzera kunogona kubatsira kuve nechokwadi kuti avo vanoita zvisarudzo vanoenda mberi vachivimba kuti vari kuremekedza izvo murwere angada.
Sources:
Eelco FM Wijdicks, MD, Ph.D., Panayiotis N. Varelas, MD, Ph.D., Gary S. Gronseth, MD David M. Greer, MD, Evidence-based based guideline update: Kusarudza uropi kufa kuvanhu vakuru, Iko Kunyanzvi Kwemitemo yeAmerican Academy of Neurology, Neurology 74, June 8, 2010.
Jerome B. Posner naFred Plum. Kuongorora kwePlum uye Posner yekunyora uye Coma. New York: Oxford University Press, 2007.