Polyneuropathy yog ib pab pawg ntawm cov kab mob ntawm cov hlab hlwb paj hlwb uas tshwm sim thaum rhuav tshem cov hlab ntaws.
Cov laj thawj ntawm cov kab mob pathology no yuav txawv, tab sis lawv cov chaw kuaj mob zoo sib xws. Lawv tsiag ntawv los ntawm kev ua kom tsis muaj zog ntawm lub cev, cov nqaij tsis txaus ntawm lub cev kev noj qab haus huv, kev hloov pauv thiab tus kab mob tuag tes ntawm lub ceg.
Yog tias peb piv cov mob ntshav qab zib thiab haus dej haus cawv haus cawv, nws yog dab tsi thiab lawv tshwm sim li cas, tom qab ntawd qhov kev nkag siab zoo yuav yog kev ua txhaum ntawm cov ntshav thiab sab hauv qab los ntawm cov tshuaj phem - cov piam thaj thiab ethanol.
Cov laj thawj rau kev txhim kho polyneuropathy
Polyneuropathies yog ntawm ntau cov kev qhia, thiab txhim kho nrog mob hnyav los yog mob ntev ua rau muaj kev puas tsuaj ntawm cov hlab ntsha. Qhov no tuaj yeem yog vim cov tshuaj lom cov kab mob hauv cov kabmob ua rau kabmob lossis kabmob hauv cov kabmob HIV, kev raug mob, thiab cov qog ntshav.
Tshuaj noj qab haus huv, suav nrog Cordaron, Furadonin, Metronidazole thiab Isoniazid tuaj yeem cuam tshuam nrog cov hlab ntsha cuam tshuam thaum lub sijhawm siv ntev.
Neuropathies hauv cov qog mob tuaj yeem tshwm sim ob zaug - nrog cov qog nqaij hlav, mob myeloma thiab mob ntsws, thiab yog ib qho kev nyuaj ntawm kev kho mob ntawm cov kab mob no.
Mob puas hlwb ua rau mob tsis nco qab:
- Cov kab mob autoimmune.
- Kev mob plab zom mov - ntshav qab zib, amyloidosis, hypothyroidism, vitamin B12 tsis txaus.
- Tau cov kab mob.
- Kev quav cawv
- Tsis hlauv.
- Cov mob ua paug rau daim siab.
Rau cov ntshav qab zib thiab haus dej haus cawv haus luam yeeb, kev nce ntxiv nrog kev paub ntev ntawm tus kab mob thiab kev txhim kho hauv kev ntsuas pom nrog kev txo qis hauv cov dej qabzib lossis cawv yog cov yam ntxwv.
Vim li cas cov hlab ntsha tsaws cuam tshuam los ntawm ntshav qab zib thiab cawv cawv?
Hauv cov ntshav qab zib mellitus, polyneuropathies tsim nrog kev nthuav dav ntawm cov neurons hauv ntu ntu ntawm cov leeg hlwb. Xws li kev tuag ntawm tes yog feem ntau tsis tuaj yeem ua tau vim yog kev kho cov ntaub so ntswg kho hauv cov ntshav qab zib.
Cov piam thaj hauv cov ntshav mus zuj zus ua rau cov phab ntsa hauv cov hlab ntshav nce siab, ua tsis taus pa, txhim kho cov ntshav txhaws thiab cov plahaum ntawm phab ntsa. Nrog xws li cov zaub mov tsis zoo, cov leeg paj tuag, hloov los ntawm cov tsis ua haujlwm ntawm cov ntaub so ntswg.
Qhov tshwm sim ntau dua ntawm cov neuropathy hauv cov txiv neej siab tau ua pov thawj. Lub hauv paus tseem ceeb los txiav txim siab qhov hnyav ntawm cov chav kawm ntawm tus kab mob yog qib ntawm hyperglycemia. Cov kev mob tshwm sim yog qhov hnyav dhau, haus luam yeeb thiab quav dej quav cawv.
Kev pheej hmoo ntawm ntshav qab zib polyneuropathy nce nrog rau cov hauv qab no:
- Lub sijhawm ntev ntev ntawm mob ntshav qab zib.
- High hyperglycemia, cov kev hloov pauv hauv qab zib theem.
- Hnub nyoog laus.
Txog cov mob neuropathy hauv kev quav dej caw, qhov tshwm sim tuaj yeem yog hypothermia, kab mob, thiab mob siab. Ethanol nws tus kheej thiab nws cov khoom lag luam metabolic zom cov leeg hauv cov hlab ntsha. Nrog concomitant tsis muaj peev xwm ntawm cov vitamin B1 (thiamine), qhov kev pom ntawm polyneuropathy nce.
Hypovitaminosis B1 tshwm sim nrog kev tsis txaus ntawm cov zaub mov thiab lub cev tsis haum rau txoj hnyuv. Haus dej cawv ntau ntxiv qhov xav tau ntawm thiamine, yog li nws cov kev qhia cuam tshuam ntau dua. Hauv qhov no, cov ntaub so ntswg cov hlab ntaws yoog rau ib qho kev puas tsuaj.
Cov dej cawv ua rau muaj ntau dhau ntawm cov dawb radicals uas ua rau mob lub sab hauv ntawm cov hlab ntsha, vim tias cov hypoxia ua rau cov hlab ntsha sib luag thiab lawv tau rhuav tshem.
Cov tsos mob ntawm tus mob ntshav qab zib polyneuropathy
Kev cuam tshuam ntawm cov ntshav tsis txaus, hloov pauv ntawm kev coj ua ntawm cov hlab ntaws hauv cov ntshav qab zib ua peb hom mob txhab ntawm cov qis qis: neuropathic, ischemic, sib xyaw.
Cov tsos mob Neuropathic yog pom los ntawm qhov pom tias tsis xis nyob ntawm qhov mob, uas, nrog kev chwv me, qhov hnov mob mob, thiab thaum taug kev ko taw yog loog. Ua tawv muag, kub ib ce mob los sis hnov hauv qhov taw kuj tseem yuav dhau.
Kev ua tsis zoo ntawm qhov kub thiab qhov mob rhiab ua rau lub cev nqaij ntuag raug mob. Cov pob qij txha ntawm ob txhais ceg tau deformed vim tias cov leeg tsis muaj zog thiab lub cev tsis zoo ntawm lub cev thaum taug kev, subluxations tshwm sim. Cov tawv nqaij qhuav, ua tuab tuab, nrog kev muaj mob ntawm tus kabmob ntawm qhov chaw ntawm cov kab nrib pleb los yog kev puas tsuaj, lub qhov txhab mob tshwm sim.
Ib qhov tshwj xeeb ntawm qhov kev xaiv neuropathic yog qhov muaj cov mem tes nyob ntawm ko taw, cov tawv nqaij sov thiab tsim kom muaj qhov mob ua paug hauv cov pob txha metatarsal.
Lub ischemic variant ntawm kev txhim kho mob ntshav qab zib polyneuropathy yog nrog:
- Lub yeej ntawm cov hlab ntsha thiab cov hlab ntsha.
- Kev tso tawm ntawm cov roj (cholesterol) thiab calcium nyob hauv cov hlab ntsa.
- Qhov tsim cov quav hniav thiab ntshav txhaws.
- Lub vascular phab ntsa ua stiffer thiab thicker.
- Ntshav ntshav tsawg tsawg.
Kev nce ntshav ntws mus rau hauv lub txaj venous thiab stagnation nyob rau hauv nws pab txhawb kev tsim ntawm edema thiab hemorrhage nyob rau hauv daim tawv nqaij. Cov tawv nqaij ua nyias, yooj yim raug mob, mob thiab mob txhab. Cov tsos mob ntawm ischemia yog cov tsos mob ntawm tus cwj pwm sib quas ntus, thaum tus neeg mob yuav tsum nres thaum taug kev vim mob hnyav hauv ob txhais ceg.
Hom sib xyaw ua tau pom los ntawm kev luv luv ntawm txoj leeg thiab qhov tso cia ntawm cov protein ua nrog qabzib rau ntawm thaj chaw articular. Cov tsos mob ntawm cov kev ua txhaum yog:
- Lub cev khov kho ntawm cov pob qij txha.
- Mob caj dab, sib koom tes deformities thiab cuam tshuam.
- Taw txias kom kov.
- Daim tawv yog xim liab nrog lub ntsej muag xiav,
- Cov nqaij mob tshwm ntawm pob taws lossis pob taws.
Kev mob qog nqaij hlav nyob hauv kev mob hnyav tau kis tus kab mob, uas tuaj yeem ua tus mob osteomyelitis thiab cov txheej txheem ua paug, cov txheej txheem ntawm ischemia ua rau mob caj dab.
Kev mob ntshav qab zib yog ib qho uas nquag ua rau txiav tes taw.
Cov tsos mob ntawm tus mob prolineuropathy hauv kev quav dej quav cawv
Txoj kev faib mus rau ob qho tib si cawv thiab ntshav qab zib polyneuropathy muaj xwm txheej, txij li tsis muaj kev puas tsuaj los ntawm kev puas siab puas ntsws thiab ntshav qab zib. Feem ntau hom sib xyaw ntawm tus kabmob yog pom.
Cov kab mob kev soj ntsuam ntawm cov dej cawv polyneuropathy yog sawv cev los ntawm cov syndromes: hnov thoob, lub cev muaj zog, sib xyaw, atactic.
Hnov leeg mob neuropathy yog tus cwj pwm mob los ntawm mob ko taw, loog, hlawv, mob ceg, mob leeg. Kev ua txhaum ntawm kev nkag siab, nrog rau nce lossis tsawg dua qhov mob thiab qhov kub thiab txias yog yam ntxwv ntawm hom "thom khwm thiab luam tawm." Vascular kev mob tshwm sim los ntawm marbling ntawm daim tawv nqaij, dhau hws.
Lub cev muaj zog daim ntawv yog manifested:
- Txo tsis kam ntawm txhais taw lossis ntiv taw.
- Kev ua txhaum ntawm kev sib hloov ntawm taw.
- Txoj kev tsis tuaj yeem taug ko taw.
Yog tias qhov ua rau cov leeg puas ib leeg mob, qhov "ceg ntoo ko taw", uas nws nyuaj rau ncab ko taw.
Daim ntawv sib xyaw ua ke tshwm sim hauv daim ntawv ntawm paresis lossis tuag tes tuag taw ntawm tes, tes, mob, loog ntawm txhais tes lossis taw. Cov leeg ntawm tes thiab caj npab atrophy. Hauv thaj chaw muaj kev cuam tshuam yuav muaj qhov nce lossis txo rhiab.
Peripheral pseudotabes, los yog atactic daim ntawv ntawm cov dej cawv polyneuropathy, yog tshwm sim los ntawm kev xav paub tob tob hauv lub cev. Hauv cov neeg mob, kev sib koom tes ntawm kev txav thiab gait yog qhov tsis sib xws, ob txhais ceg mus loog, qhov rhiab zuj zus, thaum kuaj, Achilles thiab lub hauv caug tsis tuaj.
Thaum pib, cov neeg mob tau txhim kho cov leeg lub cev tsis muaj zog thiab yoog nyob hauv caj npab thiab ceg, tom qab ntawd nyob rau theem nthuav dav paresis lossis tuag tes tuag taw kev txhim kho, thiab qhov muaj peev xwm saum npoo tsis zoo.
Hauv cov qib theem hnyav, cov leeg ua pa, mob plawv tsis muaj zog, uas tau tshwm sim los ntawm kev cuam tshuam kev sib dhos thiab kev poob siab.
Kev kho thiab tiv thaiv neuropathy mob ntshav qab zib
Txhawm rau kho neuropathy hauv cov neeg mob ntshav qab zib, ntshav qab zib cov ntshav yuav tsum nyob ruaj khov. Tsis tas li, ntsuas ntawm cov nyiaj them ntshav qab zib cov ntshav qab zib yog qhov txo qis ntawm glycated hemoglobin, qhov ntsuas ntawm lipid metabolism, nrog rau cov roj cholesterol, thiab ntshav siab.
Qhov no yog ua tiav los ntawm kev ua raws li kev noj haus thiab kev kho mob rau cov tshuaj insulin rau thawj hom ntshav qab zib. Cov neeg mob uas tsis muaj ntshav qab zib kom tsis txhob mob insulin kuj tseem tuaj yeem hloov mus rau insulin tau ib ntus, yog tias cov tshuaj txo cov ntshav qab zib hauv cov ntsiav tshuaj tsis tuaj yeem txo nws mus rau qib uas tau pom zoo.
Tom qab normalization ntawm qhov ntsuas ntawm carbohydrate thiab rog metabolism, ib qho kev ceeb toom txo qis hauv kev tshwm sim ntawm cov mob ntshav qab zib polyneuropathy pib hauv ob lub hlis.
Kev kho tshuaj yog nqa tawm siv cov tshuaj tiv thaiv thioctic acid: Berlition, Thiogamma, Espa-lipon. Cov kab mob ntawm cov vitamins B yog pom - Milgamma rau ntshav qab zib, Neurobeks Neo, Neurovitan, Neuroorubin.
Rau kev siv tshuaj tiv thaiv kab mob, siv cov tshuaj tiv thaiv kev tiv thaiv siv - Indomethacin, Diclofenac, Nimesulide, thiab cov tshuaj anticonvulsants - Gabalept, Lyrics. Raws li qhov ntsuas, tshuaj tiv thaiv kev ntxhov siab tuaj yeem kho tau - amitriptyline, clofranil, imipramine, venlafaxine.
Cov tshuaj pleev hauv zos siv nrog lidocaine - Versatis lossis nrog cov tshuaj tsis-steroidal anti-inflammatory tshuaj - Ketoprofen, Dolgit.
Cov txheej txheem tsis siv tshuaj yog siv rau kev kho mob polyneuropathy hauv ntshav qab zib: hyperbaric oxygenation, balneotherapy, electrophoresis, kev txhawb nqa nrog cov kev hloov kho tam sim no, kev kho mob siv tshuaj kho mob, kho hluav taws xob percutaneous electroneurostimulation. Lawv tuaj yeem raug kho nyob rau thaum tsis muaj cov kab mob concomitant hnyav.
Hauv kev kho mob ntawm tus mob pheej mob ib ce, uas tsis tau raug tshem tawm los ntawm kev siv tshuaj kho mob, txha caj qaum qaum hluav taws xob kev ua haujlwm.
Kev tiv thaiv ntawm kev txhim kho polyneuropathy yog los tswj cov qib suab thaj thiab kev hloov pauv ntawm cov tshuaj txo cov piam thaj. Ntxiv rau, cov neeg mob ntshav qab zib tau pom zoo kom kuaj ntshav mus kuaj glycated hemoglobin, lub raum thiab hepatic complex, thiab lipoprotein ntau ntau.
Nws muaj peev xwm tiv thaiv kev puas tsuaj ntawm cov hlab ntsha thiab cov hlab ntsha raws li cov lus pom zoo hauv qab no:
- Tswj cov ntshav siab ntawm 130/80 txhawm rau kom tsis txhob cuam tshuam cov ntshav mus rau cov nqaij mos.
- Tsis suav cov piam thaj thiab cov hmoov nplej dawb los ntawm cov khoom noj, thiab ntxiv cov zaub thiab cov zaub mov muaj protein tsawg.
- Yuav txwv tus cawv thiab haus luam yeeb.
- Mus taug kev txhua hnub, tswj xyuas lub cev ua si kom tsim nyog.
- Saib xyuas kev tu cev thiab kuaj lub taw txhua hnub.
Kev kho mob dej cawv polyneuropathy
Rau kev kho mob polyneuropathy tshwm sim los ntawm kev haus cawv, nws yog ib qho tseem ceeb kom tso dej cawv thiab ua kom tiav, nrog rau kom muaj txaus cov vitamins thiab zaub mov muaj fiber ntau, nrog rau cov protein ua tiav.
Rau kev kho mob hauv lub cev, electromyostimulation, galvanization thiab electrophoresis ntawm cov vitamins, novocaine yog siv.
Thov magnetotherapy, kho laser, sinusoidally simulated tam sim no, acupuncture. Cov neeg mob tau qhia kev tawm dag zog lub dag zog, zaws, ua luam dej thiab taug kev.
Kev kho tshuaj ntawm dej cawv neuropathy yog nqa nrog cov tshuaj hauv qab no:
- Cov vitamins B: Milgamma, Neurorubin, Thiamine chloride, Pyridoxine hydrochloride, Cyanocobalamin (tso ncaj los yog intramuscularly).
- Ascorbic acid yog ib yam tshuaj tau.
- Pentoxifylline, Trental lossis Pentilin, Cytoflavin txhawm rau txhim kho microcirculation.
- Actovegin rau cov ntshav qab zib rau kev tiv thaiv rau hypoxia.
- Neuromidin txhawm rau txhim kho neuromuscular conduction.
- Tshuaj loog: tshuaj uas tsis yog tshuaj steroidal Voltaren, Revmoxicam; anticonvulsants - Gabalept, Finlepsin; tshuaj tiv thaiv kab mob - Anafranil, Venflaxin.
- Anticholinesterase tshuaj rau paresis lossis tuag tes tuag taw - Neuromidine, Galantamine, Proserin.
Hepatoprotectors (Essentiale, Hepabene, Liv) yog qhia rau cov neeg mob zoo li no txhawm rau txhim kho cov kab mob sib kis ntawm cov tshuaj thiab tiv thaiv cov qog hlwb. Tsis tas li, cov txiaj ntsig tau zoo yog tau txais thaum siv tshuaj nrog thioctic acid - Thiogamma, Espa Lipon, Thioctacid, Berlition.
Mob ntshav qab zib polyneuropathy yog dab tsi? Cov ntaub ntawv hais txog qhov tshwm sim no tau muab hauv video hauv cov lus no.
