Ukungakhululeki kwe-Vagal, okwaziwa nangokuthi "i-syncope", kuholela ekulahlekelweni ukwazi kwemizuzwana embalwa. Kungenxa yokwehla okungazelelwe kwengcindezi yegazi. Igama elithi "i-vagal" livela emthanjeni we-vagus owela emzimbeni usuke ebuchosheni uye esiswini, unesibopho sokwehlisa ijubane lomsebenzi wenhliziyo lapho ushesha. Ngokuhamba kancane, inhliziyo iletha igazi elincane emithanjeni, ubuchopho bube sebuncane umoya-mpilo, obangela ukulahleka okuzenzekelayo kokuqonda, kepha imvamisa imfushane kakhulu.

Ukungakhululeki kwe-Vagal kuyindlela ejwayelekile kakhulu ye-syncope noma ukulahleka kokwazi. Ngokwasemtholampilo, inqubo nezinqubo zebhayoloji ezibandakanyeka kulolu hlobo lokungakhululeki ziyaziwa, kepha azipheleli.

Ukungakhululeki kungenye yezinkinga ezivamile abantu ababhekene nazo namuhla. izazi zenhliziyo nodokotela abajwayelekile. Ngempela, ngesigameko saminyaka yonke (ukuvela kwamacala amasha we-pathology) aphakathi kwe-1,3 kanye ne-2,7 ngabantu abayi-1, ukungaphatheki kahle kwesitho sangasese sowesifazane kufanele kubhekwe ngokunakwa.

Kunezinhlobo ezahlukene zokungahambi kahle kwesitho sangasese sowesifazane:

• ifomu elincane, okuholele kwifomu le-syncope;
• ifomu elibi kakhulu, elithinta iziguli ezinezifo ezingaphansi, njengokungajwayelekile kwenhliziyo, izifo zemizwa, njll.

I-Syncope, ngakho-ke ukungaphatheki kahle kwesitho sangasese sowesifazane, ichazwa njengokulahleka kwengqondo okungazelelwe futhi okujwayelekile. Ukubuyela "esimweni esijwayelekile" kuyazenzakalela futhi kuyashesha. Kubonakala futhi nge-hypereferebral hypoperfusion yomhlaba. Noma ngokwehla kwe-vascularization ebuchosheni.

Ukucanuzela kwenhliziyo, isiyezi, ubuso obuphaphathekile, ukungaboni kahle, ukujuluka, umlomo owomile, ukushisa okushisayo, ukubhuza ukuzwa, ukwenza buthakathaka jikelele… Lapho umuntu engaphathekile kahle esithweni sangasese, kubalulekile ukuphakamisa imilenze yakhe ukuze umoya-mpilo ubuyise isilinganiso senhliziyo uhlelo.

• Uma umuntu equlekile, kufanele abekwe endaweni ebizwa ngokuthi yi-Lateral Safety Position (PLS). Lesi senzo sosizo sokuqala sisetshenziselwa ukukhulula imigwaqo yomoya yomzimba.
• Uma lo muntu engasangulukile ngokushesha, abezimo eziphuthumayo kumele baziswe ngokushesha.

Uma uzwa ukuthi unale ndlela engaphatheki kahle, zama ukulala phansi noma ukuqhosha, uma uhleli kungcono uhlale lapho ungavuki.  

Yiziphi izimpawu eziyisixwayiso zokungaphatheki kahle kwesitho sangasese sowesifazane?

Ezinye izinkomba zingasiza ekuboneni ukungakhululeki kwesitho sangasese sowesifazane:

• ukushisa okushisayo;
• isicanucanu;
• ukukhathala ngokweqile;
• umbono ongenalutho;
• ukujuluka;
• i-pallor;
• isifo sohudo;
• ukuzamula okulandelanayo;
• izinkinga zokuzwa ezinjenge-tinnitus.

Ezimweni eziningi ukungakhululeki kwesitho sangasese sowesifazane akukubi, kepha ukuwa okubangelwa yikho akuyona ingozi.

Izimbangela zihlukahlukene, zixhunyaniswe ne-hypersensitivity ye-vagal nerve noma ezinye izinto zangaphandle:

• isikhathi sokucindezeleka okukhulu
• ukusebenza ngokweqile
• ukuzwela, ukukhathazeka
• ukushaqeka ngokomzwelo
• isimo sezulu esishisayo
• umuzwa wokwahlukaniswa
• ama-phobias (igazi, isixuku, njll.)
• ngemuva kwe-anesthesia yendawo 
• ukuthatha imithi ethile, njenge-isoproterenol, nitroglycerol noma ngisho ne-clomipramine. 

Kwezinye izimo, izimbangela zokungaphatheki kahle kwesitho sangasese sowesifazane azinakho ukungathí sina. Izinkinga ze-Neurobiological noma zenhliziyo zingenzeka.

Kunoma ikuphi, umuntu othambekele kokungakhululeki okukodwa noma ngaphezulu kwesitho sangasese sangasese kufanele axhumane nochwepheshe wezokunakekelwa kwempilo. Ukuxilongwa nokuhlolwa kwecala lomtholampilo kuzokwenza ukuthi kube nokwenzeka ukucacisa imbangela yokungakhululeki. Isazi sezempilo sizothanda kakhulu umlando wesiguli, indlela yaso yokuphila nesimo sayo senhlalo (isimo somndeni nesobuchwepheshe, njll.).

Izindlela zebhayoloji ezibandakanyeka kukungahambi kahle kwesitho sangasese sangasese zisaziwa kakhulu. Ngaphezu kwalokho, kukhonjisiwe ukuthi ubuchopho buhileleke kakhulu.

Ukungakhululeki kwe-Vagal bese kuba ukusebenza kwe- "reflex" kwe-cerebral cortex, ukuqala kwayo kuyashesha, kudala ukwehla kwenhliziyo nokuncipha kwethoni yemisipha.

Ukusebenza kwalezi zinqubo ze-reflex bese kucasula

• i-bradycardia, ukushaya kwenhliziyo okuhamba kancane;
• i-vasodilation, ukwanda ngosayizi wemithambo yegazi;
• i-hypotension, umfutho wegazi ophansi ngokungajwayelekile.

Iningi labantu abanokungazinzi kwesitho sangasese sowesifazane babika izimpawu ezibalulekile: imizwa yokungalingani lapho umile, isiyezi, ikhanda elibuhlungu, kanye "nokujwayelekile" ngemuva kwemizuzu embalwa.

Kwezinye izimo, ukungakhululeki kungahlala isikhathi eside. Futhi kulo mongo, ukulahleka kokwazi, okubangelwa yi-cerebral hypoperfusion, bese kuholela ekunyakazeni kokuxhuzula noma ngisho nokuquleka kwesithuthwane.

Izimpawu zingavela ngaphambi kokuba kuvele ukungakhululeki, njengokukhathala okukhulu, ubuthakathaka bemisipha, isikhumba esimanzi, ukuphazamiseka okubukwayo noma i-tinnitus.

Ukuxilongwa nokwelashwa kokungahambi kahle kwesitho sangasese sowesifazane

Ukuxilongwa kokungaphatheki kahle kwesitho sangasese sangaphambilini kwenziwa kusengaphambili ngokubuza isiguli nangokuhlolwa kwezokwelapha. Imibuzo nayo kufanele ibuzwe kumongo walesi sigaba sokuqala sokuxilongwa, ikakhulukazi uma ukulahlekelwa ukwazi kufanele kuxhunyaniswe ne-syncope, uma isiguli sinesifo senhliziyo esiyisisekelo noma uma kunemininingwane yokwelashwa kulowo muntu. kungahle kuqondise ukuxilongwa.

Amathuluzi wokuxilonga we-Vagal avumela ukuhlonza kwangaphambi kwalokhu, ngokwesibonelo izinhlelo zokurekhoda ukukhomba ama-arrhythmias angaba khona. Ngemuva kokungakhululeki kokuqala, kwenziwa i-Electroencephalogram (ECG).

Njengengxenye yokuphathwa kokungahambi kahle kwesitho sangasese sowesifazane, ukulaliswa esibhedlela isikhathi esifushane kwesinye isikhathi kuyadingeka.

Imithi yokwelashwa ehambisana nobungozi besitho sangasese sangasese iqukethe ukunciphisa ukuphindeka kokungakhululeki, futhi ngaleyo ndlela kuncishiswe ubungozi bokufa. Ngempela, i-syncope ingaba ezinye zezinto ezinobungozi ezingozini emsebenzini, ngokwesimo sokwenza ngokomzimba kanye / noma kwezemidlalo noma izingozi zansuku zonke.

La ushintsho. nemfundo yesineke iyingxenye yokwelashwa kokuqala kwalesi sifo. Eqinisweni, gwema izinto "ezibangela", njengezindawo nezikhathi ezingadala isimo sokucindezeleka nobungozi bokungakhululeki. Kepha futhi nokufunda kokuthinta okufanele kusetshenziswe ekumisweni kwesiqephu sokuvumelanisa.

Imithi yokwelashwa ayichazwanga ngempela ezigulini ezethule i-syncope eyodwa noma ezimbili kuphela. Kodwa-ke, kumongo wobuningi obukhulu bokungakhululeki, izindlela zokwelashwa ziyatholakala. Phakathi kwalaba kukhona ama-beta blocker, i-disopyramide, i-scopolamine, i-theophylline, nokunye okunjalo.

Ekugcineni, udokotela ubhekene nesibopho sokuvimbela ukushayela esimweni sobungozi be-syncope. Ngempela, ubungozi be-syncopic bungaba yingozi kubashayeli bezimoto, okungabeka isiguli uqobo, engozini kepha nakwabanye.

Ukuvikela ukungaphatheki kahle kwesitho sangasese sowesifazane, kungcono ukudla ukudla okunempilo, okunomsoco, ukulala ngokwanele, nokuzivocavoca umzimba njalo.

Abantu abadala kanye nabantu abane-pathologies eyimbangela bakhathazeke kakhulu ngengcuphe ye-syncope. Ngempela, i-nomfutho wegazi ophezulu,  sikashukela noma ukuguga kuphazamisa ukuzilawula kwe-vascularization ye-cerebral. Ngalo mqondo, ubungozi be-syncope bukhulu kakhulu.

Isigameko nokwanda kubaluleke kakhulu ngeminyaka (kusuka eminyakeni engama-70). EFrance, cishe i-1,2% yamacala okwehla kwesitho sangasese sangasese aholela ekunakekelweni okuphuthumayo. Iziguli ezingama-58% ezinalolu hlobo lokungaphatheki kahle zilaliswa esibhedlela.

Funda futhi: 

• Ukulahlekelwa kokwazi