Ngakolunye uhlangothi, umsebenzi we-cortex we-cerebral we-cortex yocerebral ingaphazanyiswa nezinguquko zemethamo ezifana ne-hypoglycemia (izinga eliphansi lokushukela kwegazi), ukungakwazi ukusebenza kwe-hepatic kanye ne-renal, noma i-ketoacidosis yesifo sikashukela (namazinga aphezulu kashukela), kanye nezinye izindlela eziyingozi. Kulesi sihloko esithi "I-Coma kanye ne-degrees zayo, izizathu zalokho kwenzeka" uzothola ulwazi oluwusizo kakhulu kuwe.
• Izinqubo ezithinta u-brainstem ngokuqondile, futhi ziphazamise umsebenzi we-BPF, njenge-hemorrhages ebuchosheni, ama-tumor noma ama-abscesses, noma imiphumela yezidakamizwa.
• Izinqubo ezilimaza ubuchopho buya ngokungaqondile, okungukuthi, okuholela ekucindezelweni nasekulimazeni i-VRF. Lezi, isibonelo, i-clot yegazi eyenza ukuqhuma kwengqondo nokuguquka kwe-lobe yesikhashana eduze kwe-stem yobuchopho, noma isisu noma i-abscess, okuholela ekunyuseni kwengcindezi yokungasebenzi.
Ezinye izimbangela ze-coma
Ngokuvamile, ngaphandle kokulimala ekhanda kanye nezinye izifo ze-neurosurgical, cishe ama-40% ama-coma amacala abangelwa ukudlulela kwezidakamizwa, okuvame ukuhambisana nokuphuza utshwala. Kwama-40% asele, iziguli ziboshwe inhliziyo, 33% zine-stroke kanti cishe u-25% ukuphazamiseka noma ukutheleleka, i-coma eqondile yi-pathology ephuthumayo, lapho kwenzeka ukuphathwa kokuqala kufana nokuphathwa kwamanye iziguli esimweni esibucayi.Isinyathelo sokuqala ngaso sonke isikhathi siyisinyathelo sokuqala sokuvuselela ukuqinisekisa eniya umgudu patency ukuvumela umoya-mpilo ukulethwa, singadinga lesiguli endotracheal tube intubation nokushaya komoya mechanical kwegazi inakekelwa elibukhali blood pressure ..
Ukuhlolwa okwengeziwe
Uma imbangela ye-coma ingacacile, ukuhlolwa okuqhubekayo kuyadingeka. Lokhu kuhlanganisa ukuhlaziywa kwamakhemikhali egazi kanye nomchamo, ukuhlolwa kwezidakamizwa kanye ne-toxin.
Isimo semifino engapheli
Abanye abasindile ngemuva kokuba i-coma iwele esimweni esingavamile semifino (HVS). Lezi ziguli ziphefumulela ngokuzimela futhi zinezikhathi zokuvulwa nokuvala amehlo, okuhambisana nomjikelezo wokulala nokuvuka. Kungase kube nokunye ukuphendulela kokuqala kwezinguquko kumathonya angaphandle, njengokuncelisa nokubamba. Noma kunjalo, iziguli ze-CVC azibonisi izibonakaliso zokuqaphela ngokwazo noma imvelo yazo, noma enye imisebenzi ephakeme yokwesaba - ayikhulumi, ayixhumane noma ayibonise noma yikuphi ukusabela okungaqondile. Kulesi simo, iziguli zingaphila iminyaka eminingi. Ucwaningo lwama-pathologic lwabantu abashonile ababeku-XIV, lwembule umonakalo omkhulu ekhenteksi ye-cerebral (le ndawo ibhekene nomsebenzi omkhulu we-nervous), kodwa ukulondolozwa kobuchopho buba khona, okwakungavumela ukugcina imisebenzi eyisisekelo yomzimba ngaphandle kokuba khona komqondo.
Ukucabangela ukuziphatha
Isimo sama-vegetative esingapheli akusona nje inkinga yezokwelapha, kodwa futhi nesimo sokuziphatha esisodwa. Abanakekeli noma izihlobo zabanye abagulayo abanokuhluleka kwenhliziyo okungapheli ngezinye izikhathi banomuzwa wokuthi lesi simo asikho ithemba futhi sinciphisa ukuthi bangathanda ukuvala izinhlelo ezisekela impilo yesiguli ngokumvumela ukuba afe. Abanye bacabanga ukuthi izenzo ezinjalo azikho emthethweni. Ukuzikhethela kunzima nakakhulu ukuthi akukho mqondo owemukelekile ngokujwayelekile mayelana nombuzo wokuthi ngabe kukhona yini izibonakaliso zomsebenzi ophezulu wezinzwa nokukhulumisana, ngisho noma ezinye iziguli zivamile kwi-HVS, ngokuhlolwa ngokucophelela kweziguli endaweni yezimila ezingapheli. Ikhono lokugcina ukuphefumula kanye nokusabalalisa endaweni eyinkimbinkimbi eholela ekwenzeni ukuthi ezinye iziguli zigcinwe ezibhedlela ngaphandle kwempawu zokusebenza kobuchopho. Lesi simo sokungabikho okuphelele nokungenakuphikiswa kwanoma yikuphi umsebenzi ebuchosheni nase-brainstem ngokuvamile kuthiwa "ukufa kwengqondo". Kodwa-ke, okwamanje, odokotela bakhetha igama elithi "ukufa kwe-brainstem," njengoba kwacaca ukuthi ukufa kwe-brainstem kufana nokufa kwengqondo yonke.
Ukuxilongwa kobuchopho kubangela ukufa
Ukuxilongwa kobuchopho obangela ukufa kuqhutshwa ngokuhambisana nenqubo evamile, esebenzisa izivivinyo ezenzelwe ukuqinisekisa ukulahlekelwa komsebenzi ojwayelekile wobuchopho. Ukubonakaliswa kokuntuleka okuphelele kobuchopho busebenza njengesiqinisekiso esanele sokuthi ukutakula ngeke kulandele. Uma isiguli esihlangabezana nemigomo yokufa kwengqondo yobuchopho iqhubeka nokuphuza umoya okwejwayelekile futhi ukwelapha okujwayelekile, inhliziyo iyoyeka ngokwemvelo ezinsukwini ezimbalwa.