Delirium - kuyini? Etiology ka delirium. Ukwelashwa nemiphumela

Delirium - kuyini? Isayensi has definition ayo - kuba sengqondo exogenous, kokuba imvelo yesikhashana. Ngokuvamile kuthatha athathe amahora ambalwa kuya ezinsukwini ezimbalwa. Umsuka kungaba:

• isilulu samafayela;
• ukudakwa;
• semithambo;
• esibuhlungu.

Etiology futhi pathogenesis ka delirium

Delirium (kuyini, bheka isihloko esithi) avame eba ku:

• ukuluthwa utshwala (ibizwa ngokuthi "delirium tremens");
• izidakamizwa (delirium isidakamizwa);
• ezinzima ezithathelwanayo isifo kobukhulu (at izinguquko esibucayi lokushisa komzimba);
• intoxications (futhi imithi ikakhulukazi);
• komqondo senile ;
• izifo kohlelo eziphathelene nenhliziyo (umfutho wegazi ophakeme, isifo sohlangothi, ukuquleka);
• ukulimala kobuchopho esikhungathekisayo noma okunzima ukopha;
• ukuhlinza (delirium ukucindezeleka, ukuqwasha, imfiva).

Iziguli eziye zamukela esesimweni esinjalo, ngaphansi kwezimo ezifanayo, zithambekele Ukuphinda.

izimpawu ezivamile delirium

Ngokuvamile, ekuqaleni esesimweni esinjalo iza ifomu oyingozi. Nokho, uma kuza delirium, ezinye izimpawu zingase zibonise ukuthi ekuqaleni. Zibizwa ngokuthi prodromal. Lezi zihlanganisa:

• ukukhathazeka ngokweqile;
• ukukhathazeka;
• umuzwa kokwesaba;
• anda nokuzwela ekukhanyeni noma umsindo;
• didekile ngiqaphele nesineke, disorientation.

Uma uhlangabezana lezi zimpawu, ungasho ukuthi manje iyisimo delirium. Umuntu kulesi simo kungenzeka amaphupho bedidekile futhi ngokoqobo ukwephulwa isikhathi cyclical sokulala futhi sihlale siphapheme. Futhi, iziguli amaphupho izakhamuzi zaseBosnia zifana futhi babone izinto ezingekho kweqiniso. ukunakwa encishisiwe ezintweni asihlobene kulula sasivumela yokuyivula. Ngaphezu kwalokho, kanye nezinye izinqubo sengqondo kuthiwa ehlile kakhulu. Umuntu akakwazi ukukhumbula lokho okwenzekile kuye ngesikhathi delirium, noma balithatha ubuthongo phezu nje ngekhanda yizicucu ngabanye.

sitholakele isifo

Kukhona izimfuneko ezithile ezisiza ukuxilonga delirium:

1. ukunakwa okungalindelekile, isiguli akakwazi ukugxila endabeni ethile. Ngokwesibonelo, umuntu onjalo udinga eziningi izikhathi ukuphinda umbuzo ukuzwa impendulo.
2. Disorganization yokucabanga, okuyinto lubonakaliswa yokuthi isiguli nge delirium weqa ukusuka Thobelanani, noma ithi ongaziwa elithi ezizungezile.
3. ezingeni encishisiwe ukwazi (nobunzima ekugcineni isimo sihlale siphapheme emini), ukuphazamiseka okuqonda (ukuqaphela ukungakwazi inkohliso noma ukusangana, amaphupho ezimibalabala, okuyinto ziqondakala iziguli njengento engokoqobo), ukwephulwa kwamalungelo cyclicity sokulala futhi sihlale siphapheme, kukhuphuke lengqondo umsebenzi, noma, kunalokho, ukwehla yayo , inkumbulo ukungakhuli. Lezi zimpawu zokuhlola Ingase ithanyelwe hhayi ngesikhathi esifanayo, kodwa omunye wabo.
4. isimo Kutfutfukiswa delirium ngokushesha ngangokunokwenzeka. Ngokuvamile ayidluli kwezinsuku ezimbalwa.
5. Disorientation ngesikhathi.

Izici ukuxilongwa

Delirium libhekene kuqala ngokushesha futhi ngokuzumayo izimpawu, okuvumela ukuxilonga isifo ekhaya. Abaningi bazizwa njengodade izinguquko ethi yezimpawu zesifo esithile emini. Lula uphethwe kuzosiza ulwazi olunembile khona kokulimala ikhanda noma isifo ethize ngokomzimba noma ezithathelwanayo, kanye umlutha wotshwala noma izidakamizwa umlutha.

Delirium (siyini lesi, echazwe ngaphambilini) libhekisela izifo ukuthi kukhona esilaphekayo. Uma isikhathi ukuthola imbangela ngalo aye wakubangela, ukuphathwa wamanje kungaba nemiphumela emihle. Kwezinye izimo isifo siphela yayo, kodwa ningakwenqabi isimo, ngoba ngenxa yezinkinga kungenzeka.

Imithetho nokwelashwa delirium

Uma ethola ukuthi unesifo "delirium", ukuphathwa kufanele kube impoqo ukufeza udokotela. Isimiso eyisisekelo ukwelashwa - ukuzimisela izimbangela. Ngemva kwalokho ukuqoqwa kanye nokuhlaziywa ucwaningo nesineke. Ngokusekelwe imiphumela udokotela etholwe esabela izinhlobo zokwelashwa noma kuhlinzwa.

Ngaphezu izimbangela ka delirium, ezifana ekwelapheni ukuluthwa utshwala, kuthathwa izinyathelo ezifanele okuhloswe lula ukugeleza sifo, kanye nokuvinjelwa izinkinga kungenzeka. Ukuze wenze lokhu, isiguli isekelwa ukudla okuthile, kanye electrolyte ibhalansi eziwuketshezi.

Ngaphezu imbangela delirium, kukhethwa ukwelashwa kuthonywa imvelo uvele lapho izimpawu, ubudala lesiguli kanye bakhe isimo zezinzwa. Phakathi inqubo yokutakula, kubalulekile ukuhlinzeka isiguli nezimo zokuphila ntofontofo.

Ngokwesibonelo, ekwelapheni delirium tremens kwenzeka ngokuvumelana uhlelo ezilandelayo:

• reception "sibazona" futhi "sodium oxybutyrate";
• ukwehla kwezinga of electrolyte ibhalansi;
• Kokulinganisa kwezimila futhi wamaphaphu umsebenzi (usebenzisa ukulungiselela "Mannitol");
• Reconstitution ka isibindi nezinso;
• zincishiswe noma ukuqedwa komzimba;
• ekwelapheni izifo concomitant.

Ukuze ezigulini zesaba noma ezinodlame, esimisiwe sedatives (onjani umthamo kunqunywa udokotela ukuba khona).

Delirium tremens kanye izici zayo

Ngo ukuba umlutha wotshwala, ngaphezu kwezinye isimo esibi esiguli, delirium tremens kungenzeka, noma, ngamanye amazwi, lo tremens delirium.

Delirium tremens (izimpawu iyefana uthi kwezinye imvelaphi) - lokhu i sengqondo acute bedle utshwala. isimo esinjalo libhekene delirium okungazelelwe, ukuhhema scary, disorientation emkhathini kanye nesikhathi, ukukhanya nasebumpungeni, ukwesaba ofuna ukuphumela obala nolaka, kanye nenjabulo enkulu.

Lesi simo ngokuvamile kwenzeka ezinsukwini ezimbili emva isiguli siyeke le iziqubu. Kwezinye izimo, kukhona ngokwako isikhathi udakiwe. Eyokuqala kuhlasela delirium tremens singenzeka emva ngokwanele eside isikhathi ukuzitika. Zonke ukuhlaselwa okwalandela angadingi ukuzitika eside.

Indlela ukuqaphela delirium tremens?

delirium syndrome lula angabacwasi ukuqaphela, ngoba kukhona ezinye zezimpawu:

1. I isiguli siyeke ukuphuza utshwala ngemva kokufobela ngezizathu anakho.
2. Kusihlwa kwenzeka imizwa yethu ishintshashintsha, futhi ngokwanele ngokuzumayo. Phakathi nale nkathi, isiguli kungenzeka ube nexhala kakhulu futhi udlubulunda, esephoshophosho ngokungaphezi, uwela ngaphandle.
3. Enhanced nemilenze ukuthuthumela.
4. Unenkinga elele. Uba ukubuyisa futhi ngesikhathi esifushane, ngokuvamile isiguli ubona elokhu ephupha kabi. Ngemva ukuqwasha ngokuphelele kungenzeka, okuyinto sithuthukisa babenakho ukwesaba, ukukhathazeka.
5. Ukusangana avele bezwa futhi ezibukwayo. Isiguli singase siqale ngendlela ukuzwa amazwi ezahlukene nokusolakala ukwesatshiswa kuye. ebukwayo ezingavela ngempela okwesabisayo. Usuku ngalunye oludlulayo kwandisa ubukhulu lezi ngamaphupho nje la.

Lokhu isimo umuntu uhlushwa ukuba umlutha wotshwala, kungathatha izinsuku ezimbalwa.

Izimpawu delirium tremens

Izimpawu eyinhloko delirium Lokudabuka oludakayo yilezi:

1. ukusangana Visual. Ngokuvamile, ukuhlaselwa iqala ntambama futhi uthuthuka ngokushesha okwanele. Omunye eqala ukubona ebukwayo ngengqondo, ukuthatha umthunzi ezintweni ezilo. Ukusangana zincike ukwesaba lesiguli. Kwezinye izimo, lezi ukusangana kungukuthi ziqondakala umuntu njengento engokoqobo nokuningi like ukubukela ibhayisikobho.
2. ukusangana sokuzwa. Abanaso zenzeka kwabanye, kodwa njengoba umthetho, ngokuhlanganiswa ezibukwayo futhi ngokugcwele nabo izifundo ezihlobene nazo. Isiguli ungezwa imisindo ehlukene, ememeza, izicelo yokudlala usizo noma izixwayiso. Unomuzwa wokuthi ziyazula ukuthi kuyinto embi kakhulu, ufuna ukusiza, kodwa olimele esabe ukukwenza. Ngezinye izikhathi kungase ukuqhuba inkhulumomphendvulwano interlocutors engokomfanekiso.
3. ukusangana Okuthintekayo. Ukunyakaza futhi isimo sobuso somuntu nge delirium tremens zivumelana ngokugcwele umbono ushushiswa. Isiguli iqala ukwakhela kulezo izilo, okuyinto ebona, ngiyabaxosha, ukufihla, lokushaya ekhoneni. Ngaphezu kwalokho, umuntu onjalo uzizwa ngokucacile bite yakhe, hit noma ngenye ubuhlungu. Ngezikhathi ezinjalo, kuyingozi kakhulu kwabanye ngoba kungaba ubambe into futhi ekuqaleni Kusolakala kulondolozwa othile. Omunye umphumela othi awunalo igciwane kungaba ukuzibulala, okuyinto ngomzamo ukuba ubalekele labo namazwi ukuthi isiguli ezwa ngaphakathi.
4. Disorientation ngesikhathi nendawo. Ukuze isimo delirium libhekene i orientation yokuphambuka emkhathini futhi ngesikhathi. Isiguli Ngeke wazi kahle lapho ethola ukuthi uyamthanda, ayiboni abantu bomdabu, isikhathi ukuma nayo ngobugebengu. Nokho, ukubiza igama, igama noma enye idatha can ngaphandle kobunzima.

Njengomthetho, uma delirium kweqiniso lesiguli, izimpawu ziya ziba zimbi nakakhulu e zakusihlwa. Ntambama isimo esifanayo kungenzeka kancane kangcono, kodwa namanje ngeke kukusize ngalutho-ke ukuba bangayeki ukwelashwa.

Kukhona izikhathi uma isiguli cishe zinyamalale ngokuphelele kuwukubonakaliswa delirium. Lesi simo kuthiwa i-gap lyutseidny. Ngalesi sikhathi, isiguli kalula niyikhulume zonke ukusangana anakho.

imiphumela kungenzeka

Uma kwesokunxele delirium ingelashwa (lokho okushiwo ekuqaleni kwalesi sihloko), kungaholela yezinkinga, ikakhulukazi yezinguquko bokuphila:

• imfiva, kwezinye izimo kuze kufinyelele ku-40 °;
• ingcindezi enkulu, okungajwayelekile inhliziyo isigqi;
• amanzi emzimbeni;
• ukwandisa asidi;
• kunzima ukunyakaza;
• eliqhaqhazelayo;
• Ukugodola kushintshana ne ukujuluka, ngezinye izikhathi kuba nephunga ezinyawo ezingahlanjiwe;
• isibindi ukwandisa;
• ukuphaphatheka isikhumba, noma, Ngakolunye uhlangothi, ububomvu yayo.

Uma ungaqali ngesikhathi ekwelapheni delirium, lezi zinguquko akunakugwenywa. Lapho ukubonakaliswa lezi yezinkinga ungakhuluma mayelana irreversibility yenqubo.

izifo ngokuvamile kakhulu imbangela yokufa delirium tremens ezihlobene ezifana nenyumoniya (esihambisana ngesikhathi delirium obukhulu 30% amacala), ukungasebenzi kwezicubu zenhliziyo (ukuhluleka kwenhliziyo), pancreatitis acute (esinye sezifo ezivamile ezingosomathuba tremens delirium), ukwehluleka oyingozi so-renal, edema ubuchopho, rhabdomyolysis (rhabdomyolysis).

Ukuvimbela delirium

Ukuze bazivikele ukubonakaliswa okungenzeka delirium zasezindaweni ezihlukahlukene, kubalulekile ukuba bafeze zokuvimbela. Kuhlanganisa imisebenzi elandelayo:

• nokugcina ngendlela enempilo zokuphila, ikakhulukazi ekwelapheni ukuluthwa utshwala nezidakamizwa;
• ukwelashwa esifike ngesikhathi futhi lulungile izifo ezihlukahlukene zezinzwa ukuphathwa kwabathintwayo ukuze ligweme izinkinga ezingase zivele kungenzeka;
• ethatha abazi imithi, non-self, e antidepressant ethile, hypnotics, anxiolytics;
• ubuhlengikazi siqaphe kwesikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa, ikakhulukazi asebekhulile.

Yini odokotela kungasiza?

Uma usola le ukuthuthukiswa emndenini noma abangane bakho delirium, uthintane kudokotela oyisazi sezinzwa ngezindleko noma narcologist. Khona-ke ukugwema nemiphumela engathandeki ngempela iphumelele.