Zamkatimu
Kodi khunyu ndi chiyani?
khunyu ndi matenda odziwika bwino a neuropsychiatric omwe amakhala ndi chikhalidwe chobisika cha maphunzirowo. Ngakhale izi, zimachitika mwadzidzidzi khunyu khunyu ndi mmene matenda. Zimayambitsidwa ndi mawonekedwe azinthu zambiri zachisangalalo chodzidzimutsa (kutuluka kwa mitsempha) m'madera ena a ubongo.
Kachipatala, kugwidwa kotereku kumadziwika ndi kusokonezeka kwakanthawi kwa zomverera, zamagalimoto, zamaganizidwe ndi autonomic.
Kuchulukirachulukira kwa matendawa kumakhala pafupifupi 8-11% (kuukira kokulirapo) pakati pa anthu ambiri adziko lililonse, mosasamala kanthu za malo anyengo ndi chitukuko chachuma. Ndipotu, munthu aliyense wa 12 nthawi zina amakhala ndi zizindikiro za khunyu.
Anthu ambiri amakhulupirira kuti matenda a khunyu ndi osachiritsika, ndipo ndi mtundu wa “chilango chaumulungu.” Koma mankhwala amakono amatsutsa kotheratu lingaliro loterolo. Antiepileptic mankhwala kuthandiza kupondereza matenda 63% ya odwala, ndi 18% kuchepetsa kwambiri matenda mawonetseredwe.
Chithandizo chachikulu ndi chithandizo chanthawi yayitali, chokhazikika komanso chokhazikika chokhala ndi moyo wathanzi.
Zomwe zimayambitsa khunyu ndizosiyana, WHO idaziika m'magulu otsatirawa:
Idiopathic - izi ndizochitika pamene matendawa amatengera, nthawi zambiri kupyolera mu mibadwo yambiri. Mwachilengedwe, ubongo suwonongeka, koma pali momwe ma neuroni amagwirira ntchito. Fomu iyi ndi yosagwirizana, ndipo kugwidwa kumachitika popanda chifukwa;
Symptomatic - nthawi zonse pamakhala chifukwa chakukula kwa zikhumbo zamatenda. Izi zikhoza kukhala zotsatira za kupwetekedwa mtima, kuledzera, zotupa kapena cysts, zolakwika, ndi zina zotero. Izi ndizo "zosayembekezereka" za khunyu, popeza kuukira kungayambitsidwe ndi zokhumudwitsa pang'ono, monga mantha, kutopa kapena kutentha;
Cryptogenic - sizingatheke kutsimikizira molondola chifukwa chenicheni cha zochitika za uncharacteristic (nthawi yake) yokakamiza.
Kodi khunyu imachitika liti?
Khunyu nthawi zambiri zimawonedwa mwa ana obadwa kumene ndi kutentha kwa thupi. Koma zimenezi sizikutanthauza kuti m’tsogolo munthu adzakhala ndi khunyu. Matendawa akhoza kukhala mwa aliyense komanso pa msinkhu uliwonse. Komabe, ndizofala kwambiri pakati pa ana ndi achinyamata.
75% ya anthu omwe ali ndi khunyu ndi anthu osakwana zaka 20. Kwa anthu opitirira makumi awiri, mitundu yosiyanasiyana ya kuvulala kapena sitiroko nthawi zambiri imakhala ndi mlandu. Gulu lachiwopsezo - anthu opitilira zaka makumi asanu ndi limodzi.
Zizindikiro za khunyu
Zizindikiro za khunyu zimatha kusiyana ndi wodwala. Choyamba, zizindikiro zimadalira madera a ubongo kumene kutulutsa kwa pathological kumachitika ndikufalikira. Pankhaniyi, zizindikirozo zidzakhala zogwirizana mwachindunji ndi ntchito za mbali zomwe zakhudzidwa za ubongo. Pakhoza kukhala kusokonezeka kwa kayendetsedwe ka kayendetsedwe kake, kusokonezeka kwa kulankhula, kuwonjezeka kapena kuchepa kwa minofu, kusokonezeka kwa njira zamaganizo, podzipatula komanso mosakaniza zosiyanasiyana.
Kuopsa kwake ndi zizindikiro zake zidzadaliranso mtundu wa khunyu.
Jacksonian khunyu
Chifukwa chake, pakukomoka kwa Jacksonian, kukwiya kwapathological kumakwirira gawo lina laubongo, popanda kufalikira kwa oyandikana nawo, chifukwa chake mawonetsedwewa amakhudzidwa kwambiri ndi magulu a minofu. Nthawi zambiri matenda a psychomotor amakhala osakhalitsa, munthuyo amadziwa, koma amadziwika ndi chisokonezo komanso kutaya kugwirizana ndi ena. Wodwalayo sadziwa za kukanika ndipo amakana zoyesayesa zothandizira. Pambuyo pa mphindi zingapo, mkhalidwewo ndi wabwino kwambiri.
Kugwedezeka kapena dzanzi kumayambira m'manja, phazi, kapena m'munsi mwendo, koma zimatha kufalikira theka lonse la thupi kapena kusanduka kukomoka kwakukulu. Pamapeto pake, amalankhula za kukomoka kwachiwiri.
Grand mal seizure imakhala ndi magawo otsatizana:
Otsogolera - maola angapo musanayambe kuukira, wodwalayo amagwidwa ndi vuto loopsya, lomwe limadziwika ndi kuwonjezeka kwa chisangalalo cha mantha. Cholinga cha zochitika za pathological mu ubongo zimakula pang'onopang'ono, ndikuphimba madipatimenti onse atsopano;
tonic kukomoka - minofu yonse imalimbitsa kwambiri, mutu umaponyera kumbuyo, wodwalayo akugwa, akugunda pansi, thupi lake limagwedezeka ndikugwiridwa pamalo awa. Nkhope imasanduka yabuluu chifukwa cha kuyimitsidwa kwa kupuma. Gawoli ndi lalifupi, pafupifupi masekondi 30, kawirikawiri - mpaka miniti;
Kukomoka kwa clonic - Minofu yonse ya thupi imagwira ntchito mwachangu. Kuchuluka kwa salivation, komwe kumawoneka ngati thovu kuchokera mkamwa. Kutalika - mpaka mphindi 5, pambuyo pake kupuma kumabwezeretsedwa pang'onopang'ono, cyanosis imachoka pa nkhope;
Stupor - poyang'ana ntchito yamagetsi yamagetsi, kuletsa mwamphamvu kumayamba, minofu yonse ya wodwalayo imamasuka, kutulutsa mkodzo ndi ndowe kumatheka. Wodwala amataya chikumbumtima, reflexes palibe. Gawoli limatenga mphindi 30;
ndimalota.
Pambuyo podzuka wodwalayo kwa masiku ena a 2-3, mutu, kufooka, ndi kusokonezeka kwa magalimoto kumatha kuzunza.
Kuukira kochepa
Ziwopsezo zazing'ono sizikuyenda bwino. Pakhoza kukhala minyewa yambiri ya minofu ya nkhope, kutsika kwakukulu kwa minofu (chifukwa chake munthu amagwa) kapena, mosiyana, kumangika kwa minofu yonse pamene wodwalayo amaundana pamalo enaake. Chidziwitso chimasungidwa. Mwina "kusakhalapo" kwakanthawi - kusakhalapo. Wodwala amaundana kwa masekondi angapo, akhoza kutembenuza maso ake. Atamuukira, sakumbukira zimene zinachitika. Kukomoka kwazing'ono nthawi zambiri kumayamba m'zaka za kusukulu.
Mkhalidwe wa khunyu
Status epilepticus ndi mndandanda wa khunyu zomwe zimatsatana. Mu intervals pakati pawo, wodwalayo sabwereranso chidziwitso, wachepetsa minofu kamvekedwe ndi kusowa reflexes. Ana ake amatha kukhala otambalala, ophwanyidwa kapena makulidwe osiyanasiyana, kugunda kwake kumakhala kofulumira kapena kovuta kumva. Izi zimafuna chithandizo chamankhwala mwamsanga, chifukwa zimadziwika ndi kuwonjezeka kwa hypoxia ya ubongo ndi edema yake. Kupanda thandizo lachipatala panthawi yake kumabweretsa zotsatira zosasinthika ndi imfa.
Matenda onse a khunyu amayamba mwadzidzidzi ndipo amatha mwadzidzidzi.
Zomwe zimayambitsa khunyu
Palibe chomwe chimayambitsa khunyu chomwe chingafotokoze zomwe zimachitika. Khunyu si matenda obadwa nawo m’lingaliro lenileni, komabe m’mabanja ena kumene mmodzi wa achibale anadwala matendawa, mpata wa matendawo ndi wochuluka. Pafupifupi 40% ya odwala khunyu ali ndi achibale apamtima omwe ali ndi matendawa.
Pali mitundu ingapo ya khunyu. Kuvuta kwawo ndi kosiyana. Kuwukira komwe gawo limodzi lokha la ubongo ndi lomwe liri ndi mlandu kumatchedwa kuukira pang'ono kapena kolunjika. Ngati ubongo wonse ukukhudzidwa, kuukira koteroko kumatchedwa generalized. Pali kuukira kosakanikirana: kumayamba ndi gawo limodzi la ubongo, kenako kumaphimba chiwalo chonse.
Tsoka ilo, mu makumi asanu ndi awiri pa zana pa milandu, chifukwa cha matendawa sichidziwika bwino.
Zotsatirazi za matendawa nthawi zambiri zimapezeka: kuvulala koopsa kwa ubongo, sitiroko, zotupa za ubongo, kusowa kwa mpweya ndi magazi pa kubadwa, kusokonezeka kwa ubongo (zowonongeka), meningitis, matenda a tizilombo ndi parasitic, abscess ya ubongo.
Kodi khunyu ndi yotengera kwa makolo?
Mosakayikira, kukhalapo kwa zotupa muubongo m'makolo kumabweretsa mwayi waukulu wa kufalikira kwa zovuta zonse za matendawa kwa mbadwa - izi ndizosiyana ndi idiopathic. Komanso, ngati pali chibadwa cha CNS maselo kuti hyperreactivity, khunyu ali ndi kuthekera pazipita mawonetseredwe mu mbadwa.
Pa nthawi yomweyo, pali njira ziwiri - symptomatic. Chofunikira apa ndikukula kwa kufalikira kwa ma genetic a organic neurons muubongo (katundu wa excitability) ndi kukana kwawo ku zikoka zakuthupi. Mwachitsanzo, ngati munthu yemwe ali ndi majini abwinobwino amatha "kupirira" kumenyedwa kwamtundu wina kumutu, ndiye kuti wina, wokhala ndi predisposition, adzachitapo kanthu ndi khunyu.
Ponena za mawonekedwe a cryptogenic, samaphunzira pang'ono, ndipo zifukwa za chitukuko chake sizikumveka bwino.
Kodi ndingamwe ndi khunyu?
Yankho losakayikira n’lakuti ayi! Ndi khunyu, mulimonse, simungamwe zakumwa zoledzeretsa, apo ayi, ndi chitsimikizo cha 77%, mutha kuyambitsa kukomoka kokhazikika, komwe kungakhale komaliza m'moyo wanu!
Khunyu ndi matenda oopsa kwambiri a minyewa! Kutengera malingaliro onse komanso moyo "olondola", anthu amatha kukhala mwamtendere. Koma ngati kuphwanya dongosolo lamankhwala kapena kunyalanyaza zoletsa (mowa, mankhwala osokoneza bongo), vuto likhoza kukwiyitsa lomwe lingawononge thanzi lanu mwachindunji!
Ndi mayeso ati omwe amafunikira?
Pofuna kudziwa matendawa, dokotala amafufuza anamnesis a wodwalayo, komanso achibale ake. Ndizovuta kwambiri kuti adziwe bwinobwino. Dokotala amachita ntchito zambiri izi zisanachitike: amayang'ana zizindikiro, nthawi zambiri amagwidwa, kugwidwa kumafotokozedwa mwatsatanetsatane - izi zimathandiza kudziwa kukula kwake, chifukwa munthu amene wagwidwa sakumbukira kalikonse. M'tsogolomu, chitani electroencephalography. Njirayi siyimayambitsa kupweteka - ndikulemba ntchito za ubongo wanu. Njira monga computed tomography, positron emission ndi magnetic resonance imaging ingagwiritsidwenso ntchito.
Kodi nyengo yake ndi yotani?
Ngati khunyu imachiritsidwa bwino, ndiye kuti makumi asanu ndi atatu mwa anthu XNUMX aliwonse omwe ali ndi matendawa amakhala opanda khunyu komanso opanda zoletsa pazochitika.
Anthu ambiri amayenera kumwa mankhwala oletsa khunyu moyo wawo wonse kuti asagwidwe. Nthawi zina, dokotala akhoza kusiya kumwa mankhwala ngati munthu sanakhudzidwe kwa zaka zingapo. Khunyu ndi yoopsa chifukwa mikhalidwe monga kufupikitsidwa (komwe kungachitike ngati munthu wagwa pansi pa pilo, ndi zina zotero) kapena kugwa kumayambitsa kuvulala kapena imfa. Kuphatikiza apo, khunyu imatha kuchitika motsatizana kwakanthawi kochepa, zomwe zingayambitse kupuma.
Ponena za kukomoka kwa tonic-clonic, kumatha kupha. Anthu amene amakumana ndi vutoli amafunika kuwayang'anira nthawi zonse, makamaka achibale awo.
Zotsatira zake ndi zotani?
Odwala khunyu nthawi zambiri amapeza kuti kukomoka kwawo kumawopseza anthu ena. Ana angavutike chifukwa chakuti anzawo akusukulu amanyansidwa nawo. Komanso, ana aang'ono omwe ali ndi matenda oterewa sangathe kutenga nawo mbali pa masewera a masewera ndi mpikisano. Ngakhale kusankhira koyenera kwa mankhwala oletsa khunyu, khalidwe labwino kwambiri komanso zovuta kuphunzira zimatha kuchitika.
Munthu angafunike kuletsedwa kuchita zinthu zina - mwachitsanzo, kuyendetsa galimoto. Anthu omwe akudwala kwambiri khunyu ayenera kuyang'anitsitsa momwe maganizo awo alili, omwe sangasiyane ndi matendawa.
Kodi kuchitira khunyu?
Ngakhale kuopsa ndi kuopsa kwa matendawa, ndi matenda a nthawi yake ndi chithandizo choyenera, khunyu imachiritsidwa mu theka la milandu. Chikhululukiro chokhazikika chikhoza kutheka mwa odwala 80%. Ngati matendawa apangidwa kwa nthawi yoyamba, ndipo chithandizo chamankhwala chikuchitidwa nthawi yomweyo, ndiye kuti magawo awiri mwa atatu a odwala omwe ali ndi khunyu, kukomoka sikungabwerenso m'moyo wawo wonse, kapena kuzimiririka kwa zaka zingapo.
Chithandizo cha khunyu, malingana ndi mtundu wa matenda, mawonekedwe, zizindikiro ndi zaka za wodwalayo, ikuchitika ndi opaleshoni kapena ndiwofatsa njira. Nthawi zambiri amapita komaliza, chifukwa kumwa mankhwala oletsa khunyu kumapereka zotsatira zabwino pafupifupi 90% ya odwala.
Chithandizo cha mankhwala khunyu chimaphatikizapo magawo angapo akuluakulu:
Diagnostics osiyanasiyana - amakulolani kudziwa mawonekedwe a matendawa ndi mtundu wa khunyu kuti musankhe mankhwala oyenera;
Kukhazikitsa zifukwa - mu symptomatic (yofala) mawonekedwe a khunyu, kufufuza bwinobwino ubongo n'kofunika kuti pakhale zolakwika zowonongeka: aneurysms, benign kapena malignant neoplasms;
Kupewa Kugwidwa - ndikofunikira kuchotseratu zinthu zomwe zingawopseze: kugwira ntchito mopitilira muyeso, kusowa tulo, kupsinjika, hypothermia, kumwa mowa;
Thandizo la chikhalidwe cha epilepticus kapena kukomoka kamodzi - amachitidwa popereka chithandizo chadzidzidzi ndi kupereka mankhwala amodzi a anticonvulsant kapena gulu la mankhwala.
Ndikofunika kwambiri kudziwitsa malo omwe akupezekapo za matenda ndi khalidwe lolondola pa nthawi ya kugwidwa, kuti anthu adziwe momwe angatetezere wodwala khunyu kuvulala panthawi ya kugwa ndi kugwedezeka, kuteteza kumira ndi kuluma lilime ndi kusiya kupuma.
Chithandizo chamankhwala a khunyu
Kumwa mankhwala omwe amaperekedwa nthawi zonse kumakupatsani mwayi wowerengera molimba mtima moyo wabata popanda kukomoka. Mkhalidwe womwe wodwala ayamba kumwa mankhwala pokhapokha ngati khunyu aura ikuwonekera ndizosavomerezeka. Mapiritsi akadamwedwa pa nthawi yake, zowunikira zomwe zikubwera, mwina, sizikanabwera.
Pa nthawi ya ndiwofatsa chithandizo cha khunyu, wodwalayo ayenera kutsatira malamulo awa:
Mwatsatanetsatane ndandanda kumwa mankhwala ndipo musasinthe mlingo;
Mulimonsemo simuyenera kupereka mankhwala ena nokha paupangiri wa abwenzi kapena wa pharmacy;
Ngati pakufunika kusinthana ndi analogue ya mankhwala otchulidwa chifukwa cha kusowa kwa ma pharmacy network kapena mtengo wokwera kwambiri, dziwitsani dokotala ndikupeza upangiri wosankha m'malo oyenera;
Osasiya chithandizo mukafika kumphamvu kokhazikika popanda chilolezo cha katswiri wa zaubongo;
Dziwitsani dokotala munthawi yake zazizindikiro zonse zachilendo, kusintha kwabwino kapena koyipa kwa chikhalidwe, malingaliro ndi thanzi.
Oposa theka la odwala pambuyo koyamba matenda ndi mankhwala a antiepileptic mankhwala moyo popanda khunyu kwa zaka zambiri, nthawi zonse kutsatira monotherapy anasankha. Ntchito yayikulu ya neuropathologist ndikusankha mlingo woyenera. Yambani mankhwala a khunyu ndi ang'onoang'ono Mlingo, pamene mkhalidwe wa wodwalayo mosamala kuyang'aniridwa. Ngati kugwidwa sikungathe kuimitsidwa nthawi yomweyo, mlingo umakulitsidwa pang'onopang'ono mpaka chikhululukiro chokhazikika chichitike.
Odwala omwe ali ndi khunyu pang'ono amapatsidwa magulu awa:
Carboxamide - Carbamazepine (ma ruble 40 pa phukusi la mapiritsi 50), Finlepsin (ma ruble 260 pa phukusi la mapiritsi 50), Actinerval, Timonil, Zeptol, Karbasan, Targetol (300-400 rubles pa phukusi la mapiritsi 50);
Valproates Depakin Chrono (ma ruble 580 pa paketi yamapiritsi 30), Enkorat Chrono (ma ruble 130 pa paketi ya mapiritsi 30), Konvuleks (madontho - ma ruble 180, mumadzi - ma ruble 130), Convulex Retard (ma ruble 300-600 pa paketi iliyonse). 30 -60 mapiritsi), Valparin Retard (380-600-900 rubles pa paketi mapiritsi 30-50-100);
Phenytoins - Difenin (40-50 rubles pa paketi ya mapiritsi 20);
Phenobarbital - kupanga zoweta - 10-20 rubles pa paketi ya mapiritsi 20, analogue yachilendo Luminal - 5000-6500 rubles.
Mankhwala oyamba ochizira khunyu amaphatikizapo ma valproates ndi carboxamides, amapereka chithandizo chabwino chamankhwala ndipo amayambitsa zovuta zochepa. Wodwalayo amapatsidwa 600-1200 mg wa Carbamazepine kapena 1000-2500 mg wa Depakine patsiku, malingana ndi kuopsa kwa matendawa. Mlingo umagawidwa mu 2-3 Mlingo masana.
Mankhwala a phenobarbital ndi phenytoin amaonedwa kuti ndi osatha masiku ano, amapereka zotsatira zoopsa zambiri, amakhumudwitsa dongosolo la mitsempha ndipo amatha kukhala osokoneza bongo, kotero akatswiri amakono a neuropathologists amawakana.
Zosavuta kugwiritsa ntchito ndi mitundu yayitali ya ma valproates (Depakin Chrono, Encorat Chrono) ndi carboxamides (Finlepsin Retard, Targetol PC). Ndikokwanira kumwa mankhwalawa 1-2 pa tsiku.
Malingana ndi mtundu wa khunyu, khunyu amachiritsidwa ndi mankhwala awa:
Kukomoka kwanthawi zonse - zovuta za valproates ndi Carbamazepine;
Idiopathic mawonekedwe - valproates;
Zosatheka - Ethosuximide;
Myoclonic khunyu - valproate, phenytoin ndi carbamazepine okha alibe mphamvu.
Zatsopano zaposachedwa pakati pa mankhwala a antiepileptic - mankhwala a Tiagabine ndi Lamotrigine - adzitsimikizira okha pochita, kotero ngati adokotala akuvomereza ndipo ndalama zilola, ndi bwino kusankha.
Kusiya mankhwala mankhwala akhoza kuganiziridwa patatha zaka zisanu khola chikhululukiro. Chithandizo cha khunyu chimatsirizidwa ndi kuchepetsa pang'onopang'ono mlingo wa mankhwala mpaka kulephera kwathunthu mkati mwa miyezi isanu ndi umodzi.
Kuchotsa udindo wa epilepticus
Ngati wodwalayo ali ndi vuto la khunyu (kuukira kumatenga maola ambiri kapena masiku), amalowetsedwa ndi mankhwala aliwonse a gulu la sibazon (Diazepam, Seduxen) pa mlingo wa 10 mg pa 20 ml ya shuga. yankho. Pambuyo pa mphindi 10-15, mutha kubwereza jekeseni ngati matenda a khunyu akapitilira.
Nthawi zina Sibazon ndi ma analogue ake sagwira ntchito, ndiyeno amapita ku Phenytoin, Gaxenal kapena sodium thiopental. Yankho la 1-5% lomwe lili ndi 1 g ya mankhwalawa limaperekedwa kudzera m'mitsempha, ndikupumira kwa mphindi zitatu pambuyo pa 5-10 ml iliyonse kuti mupewe kuwonongeka kowopsa kwa hemodynamics ndi / kapena kupuma.
Ngati palibe jakisoni yemwe amathandizira kuti wodwalayo achoke ku khunyu, ndikofunikira kugwiritsa ntchito njira yopumira ya okosijeni yokhala ndi nayitrogeni (1: 2), koma njirayi sigwira ntchito ngati kupuma movutikira, kukomoka kapena chikomokere. .
Opaleshoni mankhwala khunyu
Pankhani ya zizindikiro za khunyu chifukwa cha kutsekula m'mimba, abscess, kapena chotupa muubongo, madokotala amayenera kuchita opaleshoni kuti athetse zomwe zimayambitsa khunyu. Izi ndi zovuta kwambiri maopareshoni, omwe nthawi zambiri amachitidwa pansi pa opaleshoni ya m'deralo, kotero kuti wodwalayo amakhalabe tcheru, ndipo malinga ndi momwe alili, n'zotheka kulamulira umphumphu wa zigawo za ubongo zomwe zimagwira ntchito zofunika kwambiri: galimoto, kulankhula, ndi zowoneka.
Matenda a khunyu omwe amati ndi akanthawi amathandiziranso pakuchiza opaleshoni. Panthawi ya opareshoni, dokotalayo amatha kupanga kukonzanso kwathunthu kwa lobe yanthawi yaubongo, kapena amachotsa amygdala ndi/kapena hippocampus. Kuchita bwino kwa njira zoterezi ndizokwera kwambiri - mpaka 90%.
Nthawi zina, mwachitsanzo, ana omwe ali ndi congenital hemiplegia (underdevelopment of the hemispheres of the brain), hemispherectomy imachitidwa, ndiko kuti, matenda a hemisphere amachotsedwa kwathunthu kuti ateteze ma pathologies apadziko lonse a dongosolo lamanjenje, kuphatikizapo khunyu. Kuneneratu za tsogolo la makanda amenewa ndi zabwino, chifukwa mphamvu ya ubongo wa munthu ndi yaikulu, ndipo dziko limodzi ndi zokwanira kwa moyo wathunthu ndi kuganiza bwino.
Ndi mtundu wodziwika bwino wa khunyu, ntchito ya callosotomy (kudula corpus callosum, yomwe imapereka kulumikizana pakati pa magawo awiri a ubongo), ndiyothandiza kwambiri. Izi zimalepheretsa kuyambiranso kwa khunyu pafupifupi 80% ya odwala.
Chithandizo choyambira
Kodi mungathandizire bwanji munthu wodwala ngati ali ndi vuto? Chifukwa chake, ngati munthu adagwa mwadzidzidzi ndikuyamba kugwedeza manja ndi miyendo mosadziwika bwino, kuponya mutu wake mmbuyo, yang'anani ndikuwonetsetsa kuti ophunzirawo akutuluka. Ichi ndi khunyu.
Choyamba, chokani kwa munthuyo zinthu zonse zomwe angathe kuzigwetsa pa nthawi ya khunyu. Kenako mutembenuzire kumbali yake ndikuyika chinthu chofewa pansi pamutu kuti musavulale. Ngati munthu akusanza, tembenuzirani mutu kumbali, pamenepa, izi zingathandize kupewa malowedwe a masanzi mu kupuma thirakiti.
Panthawi ya khunyu, musayese kumwa wodwala ndipo musayese kumugwira mwamphamvu. Mphamvu zanu sizokwanira. Funsani ena kuti ayitane dokotala.
Choyamba, chokani kwa munthuyo zinthu zonse zomwe angathe kuzigwetsa pa nthawi ya khunyu. Kenako mutembenuzire kumbali yake ndikuyika chinthu chofewa pansi pamutu kuti musavulale. Ngati munthu akusanza, tembenuzirani mutu kumbali, pamenepa, izi zidzathandiza kuti masanzi asalowe m'njira yopuma.
Panthawi ya khunyu, musayese kumwa wodwala ndipo musayese kumugwira mwamphamvu. Mphamvu zanu sizokwanira. Funsani ena kuti ayitane dokotala.