I-Delirium vs. ne-dementia: Thelekisa oonobangela, iimpawu, unyango kunye nokunye

Imfundo yezeMpilo

Ukuba ukhathalele umntu omthandayo kwaye uqala ukubona utshintsho kwimeko yabo yengqondo, njengokuhla kwenkumbulo okanye ukudideka, ingcinga yakho yokuqala inokuba sisifo sengqondo esixhalabisayo. Nangona kunjalo, kunokubakho omnye umgwebi: i-delirium. Ukwabelana ngeempawu ezifanayo, ezi meko zimbini zinokuba yinkohliso ukwahlula omnye komnye. Makhe sixoxe ngomahluko phakathi kwesifo sengqondo esixhalabisayo kunye nokuphambana.

Oonobangela

Delirium

I-Delirium iqhelekileingathityazwaUtshintsho kwisimo sengqondo kunye / okanye ukuphazamiseka kokuziphatha, ngesiqhelo ngesiquphe (kodwa hayi rhoqo), utshilo uLili Barsky, MD, isibhedlele esisekwe e-LA kunye nonyango olukhawulezileyo. Ucacisa oonobangela abaqhelekileyo besiphithiphithi: Inokwenzeka ekuphenduleni kusulelo, ukuphazamiseka komzimba, utshintsho kulwakhiwo, amayeza okanye ityhefu, uvakalelo okanye ukungalali, utyando okanye ukulaliswa esibhedlele.

Amayeza athile anokukhokelela kule meko yokudideka, kubandakanya i-anticholinergic kunye neyeza lokuthomalalisa ubuchopho. Imbali yezonyango, iimviwo, kunye neziphumo zebhabhu zonke ziyanceda ukufumanisa isifo se-delirium.

Isifo sengqondo esiyingozi

Umahluko omnye phakathi kwe-delirium kunye ne-dementia kukuba i-dementia ihlala ikhula ngokuhamba kwexesha njengoko iqhubeka ngokwendalo kwaye iyaqhubeka okanye iyaqhubeka. Isifo sengqondo esixhalabisayo sinokubangelwa zizifo ezingenayo imithambo-luvo, ityhefu, iziphene zemithambo yegazi, usulelo, izifo ezenzakala ngamalungu omzimba okanye isifo sokudumba, izifo ze-neurometabolic, umothuko, i-neoplasia okanye olunye utshintsho olwenzeka kwingqondo, utshilo uGqirha Barky.

Isifo sengqondo esiyingozi sibonakala kubantu abadala. Kukho iimeko ezahlukeneyo ezibangela isifo sengqondo esixhalabisayo. Ezinye zeemeko eziqhelekileyo zibandakanya isifo se-Alzheimer's, isifo sengqondo esixhalabisayo esinemizimba enamanyala, kunye nesifo sikaParkinson. Ubungqina bubonisa oko ukuphazamiseka kwengqondo kubantu abanesifo sengqondo esixhalabisayo.

I-Delirium vs isifo sengqondo esixhalabisayo
Delirium	Isifo sengqondo esiyingozi
Usulelo, njengosulelo lomchamo Ukuphazamiseka kweMetabolic Utshintsho kulwakhiwo olungaphakathi Amayeza okanye ityhefu Imvakalelo okanye ukungalali ngokwaneleyo Ugqirha okanye isibhedlele Ityhefu yeziyobisi	Izifo ze-Neurodegenerative Ityhefu Iziphene zemithambo Usulelo Izifo ezizimeleyo okanye ezivuthayo Izifo ze-Neurometabolic Umonzakalo I-Neoplasia okanye ezinye iinguqu kubume bengqondo Ukuphazamiseka kwemfuza

Ubuninzi

Delirium

Ngokwe- Incwadana yeMerck , malunga ne-15% -50% yabantu abadala abafumana i-delirium ngexesha elithile lokuhlala esibhedlele. Olunye uphononongo lufumanise ukuba i-delirium yayixhaphake kakhulu kwabo babenotyando lwentliziyo, i-neurosurgery, i-trauma, i-radiotherapy, kunye nezigulana ze-neurology. Unyango lweCandelo leZonyango (ICU), olunxulunyaniswa nobude be-ICU bokuhlala, bunokuqikelelwa kwi-31.8% njengoko kumiselwe ngu isifundo se-2018 .

Isifo sengqondo esiyingozi

Ngokwe-World Health Organisation, Izigidi ezingama-50 zabantu kwihlabathi liphela banesifo sengqondo esixhalabisayo — ngezigidi ezili-10 zamatyala amatsha minyaka le. Eyona ndlela ixhaphakileyo yesifo sengqondo esixhalabisayo sesifo i-Alzheimer's, esenza i-60% -70% yamatyala. I-WHO iqikelela ukuba i-5% -8% yabantu abadala abangama-60 nangaphezulu banesifo sengqondo esixhalabisayo.

Ukuxhaphaka kwe-Delirium vs.
Delirium	Isifo sengqondo esiyingozi
I-15-50% yabantu abadala bahlangabezana ne-delirium ngamanye amaxesha ngexesha lokuhlala esibhedlele. Ixhaphake kakhulu kotyando lwentliziyo, i-neurosurgery, trauma, radiotherapy, kunye nezigulana ze-neurology. I-ICU delirium inokuxhaphaka okuqikelelwa kwi-31.8%.	Izigidi ezingama-50 zabantu kwihlabathi liphela banesifo sengqondo esixhalabisayo. Kukho izigidi ezili-10 zamatyala amatsha minyaka le. I-60-70% yezigulo zesifo sengqondo esixhalabisayo zivela kwisifo se-Alzheimer's. I-5-8% yabantu abadala abaneminyaka engama-60 nangaphezulu banesifo sengqondo esixhalabisayo.

Iimpawu

Delirium

Iimpawu ze-delirium zihlala ziqala ngesiquphe. Ngokuqhelekileyo baphendula kumbandela wezonyango. Iimpawu zibandakanya:

• Ukudideka
• Ukudideka
• IParanoia
• Ukuba nemibono
• Ukuphazamiseka
• Ukozela
• Ukukhubazeka kwememori yexesha elifutshane
• Iingxaki ngokuqwalaselwa kunye nokuqonda

Ubude bezi mpawu ziyahluka kwaye ziyahlengahlengiswa.

Isifo sengqondo esiyingozi

Ngelixa inokuba nezinto ezininzi ezifanayo kwiimpawu zesifo sokudakumba, isifo sengqondo esixhalabisayo sisiphazamiso esiqhubela phambili sokuqonda esihambelana nokwehla komsebenzi uphela, oqhele ukukhula kancinci kancinci, utshilo uGqirha Barsky.

Iimpawu zesifo sengqondo esiyingozi esikwinqanaba lokuqala zihlala zibandakanya:

• Ukufunda kunye nokuphazamiseka kwememori
• Ubunzima bokujonga
• Ukudideka kunye nemisebenzi yesiqhelo
• Imiba yokufumana amagama
• Imood iyatshintsha
• Ayikwazi ukuqhelanisa ixesha kunye nendawo, ukulahleka
• Umsebenzi wokuqonda weemoto

Kubalulekile ukuba uqaphele ukuba iimpawu zesifo sengqondo esixhalabisayo ziyahluka phakathi kweemeko ezihamba nazo.

I-Delirium vs. iimpawu zesifo sengqondo esixhalabisayo
Delirium	Isifo sengqondo esiyingozi
Ukudideka Ukudideka IParanoia Ukuba nemibono Ukuphazamiseka Ukozela Ukukhubazeka kwememori yexesha elifutshane	Ukuphazamiseka kwimemori Ubunzima bokujonga Ukudideka kunye nemisebenzi yesiqhelo Imiba yokufumana amagama Imood iyatshintsha ngakumbi ukucaphuka Ukudideka

Uxilongo

Delirium

UKUYA Indlela yovavanyo lokudideka (CAM) Isetyenziselwa ukuchonga ubukho besifo sokudideka, ucacisa uGqr. Barky. I-CAM ijonge izinto ezine:

1. Ukuqala okukuko kunye nekhosi eguquguqukayo
2. Ngqalelo
3. Ukucinga okungalungelelananga
4. Inqanaba elitshintshileyo lokuqonda

I-Delirium ifunyaniswa ukuba umntu uneempawu ezimbini zokuqala ukongeza kwinxalenye yesithathu okanye yesine.

Uvavanyo lwezonyango lunokwenziwa kwakhona ngexesha lokufumanisa isifo se-delirium, oku kunokubandakanya ukuvavanywa kwemeko yengqondo ebanzi, uvavanyo lomzimba, izifundo zelebhu, okanye ukuskena kwengqondo ukulawula ezinye iimeko ezinje ngokubetha. Ukongeza, kunokuba luncedo ukuthetha namalungu osapho okanye abanonopheli abanokuthi babonelele ngembali eyongezelelweyo kunye nomxholo. Uvavanyo lwelabhoratri ukumisela unobangela wesifo sokudakumba njengokujonga amanqanaba ahlukeneyo egazini okanye kumchamo nawo angenziwa.

Isifo sengqondo esiyingozi

Uvavanyo lokuqonda isifo lunokusetyenziselwa ukufumanisa isifo sengqondo esixhalabisayo. Kukho iimvavanyo ezininzi ezinokusetyenziswa kuvavanyo lokuqonda. Uvavanyo oluqhelekileyo luvavanyo lobume bemeko yengqondo mini (MMSE) okanye uvavanyo lweMini-Cog. Ezi mvavanyo zijonga ubuchule bengqondo kwaye zibandakanya indawo zememori, ulwimi, ukusombulula iingxaki, ukuqhelanisa, kunye nokunye ukusebenza kwengqondo. Kwakhona, ukuthetha namalungu osapho okanye abanonopheli kungabonelela ngenani elibalulekileyo lolwazi malunga nemeko yomntu.

Zintathu iintlobo eziqhelekileyo zokuvavanywa kwengqondo ukuvavanya isifo sengqondo esixhalabisayo. Babandakanya ukuskena kwecomputer tomography (CT), imaging resonance imaging (MRI), kunye ne-positron emission tomography (PET) scan.

Uvavanyo lwelabhoratri njengokutsala igazi kunye nokujonga kumanqanaba ahlukeneyo, anje ngee-electrolyte kunye namanqanaba e-thyroid, nazo ziya kwenziwa ukulawula nantoni na, enje nge-delirium. Uvavanyo lwe-Genetic lunokuba sisalathiso esihle sengqondo esixhalabisayo.

I-Delirium vs. isifo sengqondo esixhalabisayo
Delirium	Isifo sengqondo esiyingozi
Imbali egqibeleleyo kunye novavanyo lomzimba Udliwanondlebe nabantu abaxhasayo Indlela yoVavanyo lokuDideka (CAM) Uvavanyo lwezonyango Uvavanyo lwelebhu Uviwo lomzimba	Imbali egqibeleleyo kunye novavanyo lomzimba Udliwanondlebe nabantu abaxhasayo Uvavanyo lobuchwephesha bobuchwephesha: I-MMSE okanye uvavanyo lweMini-Cog Ukucinga ngobuchopho kuchonga utshintsho kulwakhiwo. Uvavanyo lwelebhu

Unyango

Delirium

Unyango lwe-delirium okokuqala nokuphambili kukufumana oyena nobangela we-delirium kunye nokusombulula le ngxaki. Oku kunokubandakanya ukunyanga usulelo okanye ukuyeka iyeza. Unyango luya kuthi emva koko lujolise ekujonganeni nazo naziphi na ezinye iingxaki kunye neemeko zonyango ezinokuthi zenzeke ngenxa yesiphithiphithi. Oku kunokubandakanya izinto ezinje ngokubonelela ngesondlo esaneleyo, ukulawula iintlungu, kunye nokufundisa amalungu osapho, abanonopheli kunye nesigulana.

Isifo sengqondo esiyingozi

Njengokuba izifo ezahlukeneyo zinokubangela isifo sengqondo esixhalabisayo, unyango luxhomekeke kwisizathu. Okwangoku, akukho lunyango lwesifo sengqondo esixhalabisayo. Nangona kunjalo, kukho ezinye iziyobisi ezinokuphucula iimpawu ixesha elithile. La machiza mabini avunyiwe nguRhulumente wase-US Ukutya noLawulo lweeMithi (FDA) ukunceda ukunyanga ukugula kwengqondo kubandakanya:

• I-cholinesterase inhibitors: Aricept ( yenziwepezil hcl ), Okhutshelweyo ( wivdigine )
• Imemorine: Namenda Xr ( Imemori hcl er )

Olunye ukhetho kukuthatha inxaxheba kwizifundo zeklinikhi kunye novavanyo lwesifo sengqondo esixhalabisayo. Umbutho we-Alzheimer unolwazi ngakumbi malunga nokukhetha okunokwenzeka Apha .

Zininzi iindlela zonyango ezingasebenzisi iziyobisi, nazo. Uqeqesho lwenkumbulo, ukuzilolonga, ukukhuthaza intlalontle, ukucebisa, kunye nokusebenza komzimba ziindlela nje ezimbalwa zokuphucula ukusebenza kwengqondo.

I-Delirium vs unyango lwe-dementia
Delirium	Isifo sengqondo esiyingozi
Ukujongana nomcimbi osisiseko obangela ukuphazamiseka Ukunyanga iingxaki	Uqeqesho lokukhumbula Ukukhuthaza intlalo Zilolonge Amayeza Uvavanyo lwezonyango

Imiba yomngcipheko

Delirium

Ngokwe- Ufundo luka-2014 , ezona zinto zixhaphakileyo kumngcipheko we-delirium zibandakanyiwe:

• Isifo sengqondo esiyingozi
• Ukwaluphala
• Ubungqongqo bokugula
• Ukungaboni kakuhle
• Ukucoca umchamo ngokuchama
• Inqanaba eliphantsi le-albin (iproteni yegazi)
• Ixesha lokuhlala esibhedlele

Isifo sengqondo esiyingozi

Ngokwe- Umbutho we-Alzheimer Owona mngcipheko uphezulu wesifo sengqondo esixhalabisayo uquka:

• Ubudala
• Imbali yosapho
• Imfuza
• Ukwenzakala entloko
• Iimeko ezonakalisa intliziyo

I-Delirium vs. i-dementia yomngcipheko
Delirium	Isifo sengqondo esiyingozi
Isifo sengqondo esiyingozi Ukwaluphala Ubungqongqo bokugula Ukungaboni kakuhle Ukucoca umchamo ngokuchama Inqanaba eliphantsi le-albin (iproteni yegazi) Ixesha lokuhlala esibhedlele	Ubudala Imbali yosapho Imfuza Ukwenzakala entloko Iimeko ezonakalisa intliziyo

Uthintelo

Delirium

Uthintelo lwe-delirium lwenziwa ngokumiswa ngaphambi kokuba luqale ngokuchonga abo basemngciphekweni omkhulu.

Abantu abasemngciphekweni omkhulu wokukhula kwe-delirium babandakanya abo banengxaki yokuqonda, yokuziva bengenako ukulala, ukungakwazi ukuhamba, kunye nokuphelelwa ngamanzi emzimbeni okanye ezinye izinto eziphazamisayo, utshilo uGqirha Barsky. Ukuchongwa kwangoko kunye nolawulo lwenyango okanye okusingqongileyo kubalulekile ekuthinteleni ukukhula kwe-delirium.

Isifo sengqondo esiyingozi

Ukuthintela isifo sengqondo esixhalabisayo lixesha elide, uGqirha Barsky uyaqhubeka. Kukho ubungqina bokuba ukutya ukutya okusempilweni, ukuhlala ukhuthele, ukunqanda icuba kunye notywala, kunye nokugcina ingqondo yakho isebenza ngokuguga konke oko kunganceda ukuthintela okanye kulibazise ukuqala kwesifo sengqondo esixhalabisayo. Kukwabalulekile ukubeka esweni uxinzelelo lwegazi kunye ne-cholesterol, njengoko amanqanaba aphakamileyo ezi zinto anokubeka kwimeko yesifo sengqondo esixhalabisayo.

Ungayikhusela njani i-delirium vs.
Delirium	Isifo sengqondo esiyingozi
Uthintelo ngokuchonga abo basemngciphekweni omkhulu	Indlela yokuphila esempilweni Ukutya okusempilweni Ukuzivocavoca Ukuphepha icuba notywala Ukujonga rhoqo uxinzelelo lwegazi kunye necholesterol

Uza kubona nini ugqirha kwisifo se-delirium okanye isifo sengqondo esixhalabisayo

Okwangoku xa ubona utshintsho kwimeko yengqondo okanye ukwehla kwengqondo kubandakanya ukudideka, ukulahleka kwememori, ukudideka, okanye iimpawu ezidweliswe apha ngasentla, kubalulekile ukubona ingcali kwezempilo. Ukufumanisa kwangoko zombini kwezi meko kukhokelela kwiziphumo ezilungileyo.

Izixhobo

• Unyango woNyango kunye neNgcaciso yeNcwadi yokuPhazamiseka kwengqondo (DSM-5), Umbutho wezengqondo zaseMelika
• Ukuphazamiseka kwengqondo kunye nokuphazamiseka kwengqondo: i-Epidemiology, isifo, kunye nonyango, I-NCBI
• Incwadana yeMerck
• Isifo sengqondo esixhalabisayo, I-World Health Organization
• Malunga neTrialMatch: Inkonzo yokuthelekisa ulingo lwezonyango ye-Alzheimer's kunye nenye isifo sengqondo esixhalabisayo, Umbutho we-Alzheimer
• Oonobangela kunye nemingcipheko yezifo ze-Alzheimer's, Umbutho we-Alzheimer