Ugqirha uthathwa njengedwendwe lokugqibela xa zonke ezinye iinketho zihluleka
I-cingulotomy ye-Bilateral yindlela yokuhlinzwa kwengqondo esicatshulwa njengesigqibo sokugqibela kubantu abaneengxaki zokunyanzela (OCD). Isetyenziselwa ukuphatha uxinzelelo olukhulu kunye neentlungu ezingapheliyo kubantu abangazange bafumane uncedo nakweyiphi indlela yokwelapha.
Olu uphando lujolise kwiindawo ezimbini zobuchopho:
- I-cingulate gyrus, eyanceda ukulawula iimvakalelo nentlungu
- I-lobes yangaphambili, imisebenzi yayo ibandakanya ukuqiqa, ukulawula umgudu, kunye nesigwebo
Iinkqubo zokuphanda kwi-psychiatry ziphikisana, kwaye oogqirha abaninzi abayi kwenza i-cingulotomy ngaphandle kokuba zonke ezinye iindlela zonyango ziphelile. Uninzi lwama-neurosurgeons, enyanisweni, luya kufuna imvume evela kwisigulane kunye nelungu losapho ngaphambi kokuba uqhubeke nokusebenza.
I-cingulotomy ye-Bilateral yaphakanyiswa okokuqala njengenye indlela eya kwi-lobotomy ngo-1947 ngu-physics waseMelika uJohn Farquhar Fulton.
Isizathu soBucateral Cingulotomy
I-cingulate gyrus isebenzela injongo ekhethekileyo kwingqondo, amava kunye nokuvalelwa kwimiyalezo emnandi okanye engathandekiyo. Phakathi kwezinye izinto, iyakwenza impendulo yempembelelo kwaye iyakwazi ukudibanisa loo mpendulo kwisinye okanye ngaphezulu kweengqondo zethu (ukubona, iphunga, ukunambitha, ukuthintela, isandi). I-cingulate gyrus iphinda igcwalise isiphaluka kwenye inxalenye yengqondo ebizwa ngokuthi i-core caudate, enomsebenzi wayo ukwenza imikhwa.
Kukholelwa ukuba ngokuphazamisa ezi zijikelezo, ukudibanisa phakathi kweemvakalelo ezibuhlungu kunye nokuziphatha okuqhelekileyo kuya kuphazamiseka.
Indlela Uphando olwenziwa ngayo
Ukwenza i-cingulotomy yamanye amazwe, i-electrode okanye i-gamma umsi (i-radiation targeted device) ikhokelwa kwi-gyrus esebenzisa i-imaging magnetic imaging (MRI).
Kulapho, ugqirha uya kwenza i-intshi yeesentimitha igqitywe okanye itshise kakhulu kwisiphaluka.
Ukubuyiselwa kwintsebenzo kuthatha iintsuku ezine. Imiphumo emibi ngokuqhelekileyo imnene, kunye nabanye bafumana intloko, isicathulo, kunye nokuhlanza ezinsukwini ezilandelayo ukuhlinzwa. Utyando lunokubangela ukuba umntu athabathe i-seizures kwezinye, nangona oko kwenzeka ngokukodwa kulabo abaneembali zangaphambili.
Abanye abantu bayakhalaza ngokunganakwa emva kokuhlinzwa, ngelixa abanye baya kubona ukukhunjulwa kweememori . Ezi ziqhamo eziqhelekileyo kodwa iziganeko ezinobungozi bonyango kufuneka ziqwalaselwe.
Ukuphumelela kweCatulotomy ephakathi
Nangona i-cingulotomy ephakathi ikwazi ukuphucula abanye ngokuhlala ne-OCD, ayikho into yokunyanga-konke. Ukuhlaziywa kwee-klinikhi ze-2016 kwagqitywa ukuba ama-41 eepesenti zezigulane ezazithobela i-cingulotomy yamazwe ngamazwe ziye zaphendulwa kwenkqubo kunye neepesenti ezili-14 zifumana imiphumo emfutshane yexeshana kunye neepesenti ezintlanu zineempembelelo ezibi kakhulu.
I-cingulotomy ye-Bilateral ibonakala ingenabasebenzi kubantu abane-OCD yokukhankanya unyango. I-OCD ye-Treatment-refractory ifunyaniswa kubantu abaye bafezekisa encinci, ukuba kukho na, impendulo kwizinto ezimbini ezikhethiweyo ze-serotonin reuptake inhibitor (SSRI) ezikhethiweyo .
Kwakhona kubonakala kungenakuncedo kubantu abanobunzima obubonakalayo besifo, kubandakanywa i-OCD-related hoarding.
I-cingulotomy esebenzayo isetyenziselwe ukuphatha abantu abaneentlungu ezingenasiphelo (intlungu engenakuphathwa ngayo nayiphi na indlela eyaziwayo). Ukuphononongwa ngokuchanekileyo kwezifundo kubonise ukuba le nkqubo yabangela ukukhululeka kwentlungu e-60 engama-gulane ukuya kunyaka olandelayo emva kokuhlinzwa. Kule ndawo, ngaphezu kwesiqingatha sale nto ibonise ukuba ayisekho imfuneko yokudinga i-painkillers.
Nangona uphando oluthile lucebise i-cingulotomy ebantwini kubantu abane-disability bipolar disorder, izifundo ziye zazingekho.
Ngaloo ndlela, okwangoku akuvunyelwanga njengendlela yokunyangwa kwe-bipolar.
> Imithombo:
> Brown, L .; Mikell, C; Youngerman, B; okqhubekayo. "I-Dorsal Anterior Cingulotomy kunye ne-Anterior Capsulotomy ye-Greatness, Refractory Obsessive-Compulsive Disorder: Uhlolo lokuHlola lweeNkcazo zeNgxelo." Journal of Neurosurgery . 2016; 124 (1): 77-89.
> Shah, D .; Pesiridou, A .; Baltuch, G; okqhubekayo. "I-Neurosurgery esebenzayo kwiNyango ye-Obsessive Compulsive Disorde r kunye noxinzelelo oluPhambili: Uhlolo-nkcukacha lweeNtsholongwane zeZifo kunye noThgethitic Targeting kwi-Clinic." Psychiatry . 2008; 5 (9): 24-33.
> Iintlanga, A .; Lopes, A .; Ubungqina, D .; okqhubekayo. "Ukukhusela iimpawu kunye nokubikezela kwempendulo engalunganga kwi-Limbic System Surgery ye-Treatment-Refractory Obsessive-Compulsive Disorde r." Journal of Neurosurgery . 2014; 121 (1): 123-30.
> Zhang, Q; Wang, W .; no-X. Wei. Ukusebenza kwexesha elide le-Stereotactic yangaphakathi yeCingulotomy kunye neBatteral Anterior Capsulotomy njengeNyango yoKhuselo lwe-Obsessive-Compulsive Disorder. " I-Stereotactic neSebenza ye-Neurosurgery . 2013; 91 (4): 258-61.