Parasomnia yog ib qho tshwm sim hauv cov menyuam yaus. Lo lus kho mob no txhais tau hais tias ntau yam kev pw tsaug zog tsis zoo ntawm psychogenic keeb kwm. Cov niam txiv feem ntau ntsib qhov xwm txheej uas tus menyuam raug kev ntxhov siab thaum hmo ntuj, npau suav tsis zoo, thiab enuresis. Yog vim li cas rau tej kev tsis sib haum no? Thiab yuav ua li cas nrog lawv? Cov lus nug no thiab lwm cov lus nug tau tham hauv kab lus.
Qhov no yog dab tsi?
Lo lus "parasomnia" hauv Greek txhais tau tias "nyob ze". Lub ntsiab lus dav dav no hais txog ntau yam kev tsis sib haum xeeb ntawm kev tswj hwm cov txheej txheem ntawm inhibition thiab excitation hauv lub hlwb. Lawv tshwm sim thaum pw tsaug zog, nrog rau thaum tsaug zog, lossis tom qab sawv. Cov kws kho mob paub ntau dua 20 hom kev sib txawv. Hauv tshuaj, lub tswv yim ntawm "kev pw tsaug zog" kuj tseem siv.
Thaum menyuam yaus, cov qauv hauv qab no ntawm parasomnia feem ntau tshwm sim:
- tsis meej pem tom qab sawv;
- somnambulism (pw tsaug zog);
- hmo ntuj ntshai;
- npau suav phem;
- hmo ntujurinary incontinence;
- txhuam hniav thaum tsaug zog (bruxism).
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias cov tsos mob saum toj no tuaj yeem ua rau muaj ntau yam kab mob. Qhov no tsis suav nrog lub tswvyim ntawm "parasomnia". Lo lus no tsuas yog hais txog cov kev pw tsaug zog uas tsis cuam tshuam nrog cov kab mob organic.
Cov tsos mob thiab kev kho mob parasomnia hauv cov menyuam yaus nyob ntawm seb hom pw tsaug zog tsis zoo. Cov ntsiab lus ntxiv txog kev kho mob tshwm sim ntawm cov teeb meem no thiab cov txheej txheem kho.
Mechanism ntawm qhov tshwm sim
Nyob nruab hnub, ib tug neeg muaj cov haujlwm hauv qab no ntawm lub paj hlwb cortex:
- Txhob Cia Siab. Lub sijhawm no yog tus cwj pwm los ntawm kev ua haujlwm siab ntawm lub hlwb thiab cov leeg nqaij. Hauv lub xeev no, tus neeg noj qab nyob zoo siv sijhawm ntau hnub.
- Theem ntawm kev pw tsaug zog qeeb. Muaj tshwm sim tam sim tom qab pw tsaug zog. Nws yog tus cwj pwm los ntawm kev txo qis hauv lub hlwb ua haujlwm. Nyob rau theem no, kev npau suav tiag tiag thiab nco tau tshwm sim tsis tshua muaj. Tus neeg no tsaug zog heev thiab nyuaj rau sawv.
- REM tsaug zog. Nyob rau lub sijhawm no, tus neeg ua pa thiab lub plawv dhia ntau zaus, kev txav ntawm lub qhov muag tau sau tseg. Pw tsaug zog tsawg dua nyob rau theem qeeb. Feem ntau muaj kev npau suav uas ib tug neeg feem ntau nco.
Txhua lub xeev no yog tus yam ntxwv los ntawm kev hloov pauv hauv kev ua ntawm lub paj hlwb cortex, ua pa thiab cov leeg. Cov txheej txheem no yog tswj hwm los ntawm lub hauv paus paj hlwb. Thaum ib tug neeg tsaug zog, nws hloov mus tas li ntawm kev pw tsaug zog qeeb thiab pw tsaug zog.
Tus me nyuam feem ntau sib xyawcov kev ua haujlwm saum toj no. Piv txwv li, cerebral cortex tseem ua haujlwm thaum pw tsaug zog. Qhov no ua rau somnambulism, npau suav phem, ntshai thiab lwm yam teeb meem.
Muaj qee zaus tus me nyuam twb tsaug zog lawm, tab sis nws lub paj hlwb tseem pw tsaug zog. Yog li ntawd, tom qab sawv los, tus menyuam tsis meej pem.
Parasomnia hauv cov menyuam yaus tshwm sim vim qhov tsis paub qab hau ntawm lub hauv paus paj hlwb. Nyob rau hauv ib tug me nyuam, lub neuroregulation ntawm cov txheej txheem ntawm inhibition thiab excitation ua hauj lwm tsawg tshaj li nyob rau hauv ib tug neeg laus. Thaum menyuam yaus, kev pw tsaug zog tsis zoo tau raug sau tseg ntau zaus.
Yog vim li cas
Cia peb xav txog cov laj thawj tseem ceeb ntawm parasomnia hauv cov menyuam yaus:
- Kab mob pathologies. Hauv cov kab mob ua npaws, cov menyuam mos feem ntau muaj kev npau suav phem thiab ntshai. Qhov no yog vim lub dav intoxication ntawm lub cev. Qee zaum, parasomnia tuaj yeem tshwm sim tom qab rov zoo.
- Kev ntxhov siab. Yog hais tias tus me nyuam muaj kev ntxhov siab thaum nruab hnub, cov txheej txheem ntawm excitation predominates nyob rau hauv lub cerebral cortex. Vim lub immaturity ntawm lub hauv paus paj hlwb, inhibition yog ncua. Tus mob no tuaj yeem txuas ntxiv thaum pw tsaug zog, ua rau pw tsaug zog taug kev thiab npau suav phem.
- Kev ua txhaum txoj cai niaj hnub. Yog hais tias tus me nyuam tsaug zog me ntsis, mus pw lig thiab sawv ntxov, ces nws feem ntau muaj parasomnias. Qhov no yog vim tsis muaj kev so kom raug. Kev hloov pauv tam sim ntawm lub sijhawm tuaj yeem ua rau pw tsaug zog tsis zoo.
- Heredity. Hauv ntau tshaj li ib nrab ntawm cov xwm txheej, parasomnia tau sau tseg yam tsis muajtsuas yog nyob rau hauv cov me nyuam, tab sis kuj nyob rau hauv niam txiv.
- Noj hmo. Yog tias tus menyuam noj ntau thaum yav tsaus ntuj, ces nws yuav muaj kev pw tsaug zog tsis zoo. Lub plab zom mov yuav tsum zom zaub mov, vim qhov no, cov txheej txheem ntawm inhibition hauv lub paj hlwb qeeb.
- Noj tshuaj. Qee cov tshuaj cuam tshuam rau theem pw tsaug zog. Qhov no yuav ua rau tus menyuam npau suav phem thiab ntshai.
ICD code
Feem ntau ntawm cov kab mob parasomnia raws li ICD-10 muaj nyob rau hauv pab pawg ntawm cov kab mob sib koom ua ke raws li txoj cai F51 ("Pw tsaug zog tsis zoo ntawm cov kab mob etiology"). Yog li, kev pw tsaug zog tau raug cais tawm, uas tsis yog cov tsos mob ntawm ib tus kab mob, tab sis muaj nyob ntawm nws tus kheej.
Peb muab cov lej rau ntau hom kab mob parasomnia thaum yau:
- somnambulism - F51.3;
- hmo ntuj txaus ntshai - F51.4;
- npau suav phem - F.51.5;
- tsis meej pem tom qab sawv - F51.8.
Kev zam yog bruxism thiab nocturnal enuresis. Cov hniav sib tsoo thaum pw tsaug zog yog suav tias yog ib qho teeb meem somatoform. Yog li hu ua mob ntawm psychogenic etiology, tshwm sim nrog somatic manifestations. Bruxism code - F45.8.
Hais txog kev pw tsaug zog, ICD-10 txhais qhov teeb meem no yog kev puas siab puas ntsws. Enuresis code ntawm inorganic keeb kwm - F98.0.
Kev ntxhov siab tom qab pw tsaug zog
Tsis meej pem tom qab sawv los yog ib qho ntawm cov tsos mob ntawm parasomnia hauv cov menyuam yaus. Qhov kev tshwm sim no feem ntau tshwm sim hauv lub hnub nyoogmus txog 5 xyoos.
Txoj kev mob no ntshai heev rau cov niam txiv, vim tus menyuam tus cwj pwm zoo li txawv txawv thiab txawv txawv. Tam sim ntawd tom qab sawv los, tus me nyuam muaj cov kab mob hauv qab no:
- ntseeg ntsej muag;
- tsis muaj lus teb rau niam txiv qhov kev thov;
- lus luag ntxhi thiab hais lus qeeb;
- teb rau cov lus nug tawm ntawm qhov chaw;
- tsis txaus arousal;
- kev tsis sib haum xeeb hauv qhov chaw.
Niam txiv muaj kev xav tias tus me nyuam qhib qhov muag, tab sis tseem nyob twj ywm hauv ntiaj teb kev npau suav. Txhua qhov kev sim ua kom tus menyuam mos tsuas ua rau qhov xwm txheej hnyav dua. Lub sijhawm no, tus menyuam lub paj hlwb yog ib feem ntawm lub sijhawm pw tsaug zog. Lub xeev no kav 5-25 feeb. Nws tsis ua rau muaj kev phom sij tshwj xeeb rau tus menyuam. Kev tsis meej pem feem ntau daws tau tom qab hnub nyoog 5 xyoos.
Nyob deb
Pleepwalking (pw tsaug zog) tshwm sim hauv 17% ntawm cov menyuam yaus. Cov tub ntxhais hluas hnub nyoog 12-14 xyoos yuav raug kev txom nyem los ntawm qhov teeb meem no. Tus me nyuam tsaug zog, tab sis nws cov leeg nqaij tsis so, tab sis nyob rau hauv ib qho kev zoo siab. Qhov no ua rau pw tsaug zog.
Qhov kev tsis sib haum no nrog cov tsos mob hauv qab no:
- Tus me nyuam dhia thaum pw tsaug zog, lossis taug kev ncig chav.
- Cov menyuam yaus tuaj yeem ua ntau yam kev tsis nco qab hauv lub xeev no (xws li hnav khaub ncaws lossis khaws khoom).
- Tsis muaj kev cuam tshuam rau qhov kev thov, vim lub hlwb pw tsaug zog.
- Qhov muag qhib tau, qhov zoo li "glassy". Qee tus me somnambulists taug kev nrog kawob lub qhov muag thiab tib lub sijhawm taw qhia lawv tus kheej hauv qhov chaw.
Tag kis no tus me nyuam tsis nco qab nws taug kev thaum pw tsaug zog. Kev tawm tsam ntawm kev pw tsaug zog tsis cuam tshuam rau kev noj qab haus huv ntawm cov menyuam yaus txhua txoj kev. Txawm li cas los xij, muaj kev pheej hmoo ntau dua ntawm kev raug mob thaum pw tsaug zog.
Hmo ntuj txaus ntshai
Feem ntau, hmo ntuj ntshai tshwm sim hauv cov menyuam yaus thawj ob peb teev tom qab pw tsaug zog. Qhov kev ua txhaum cai no feem ntau pom thaum muaj hnub nyoog 2-6 xyoo. Cov tub hluas no raug mob ntau dua.
Thaum hmo ntuj ntshai, tus me nyuam ua rau tam sim ntawd txav thiab sawv. Nws zoo nkaus li ntxhov siab heev, tsis tu ncua quaj thiab qw. Txhua qhov kev sim ntawm kev lees paub xaus rau qhov ua tsis tiav. Cov me nyuam nyob rau hauv tus mob no tej zaum yuav ua aggressively los yog raug mob rau lawv tus kheej. Lawv ruam thiab tsis teb cov lus ntawm niam txiv.
Tus mob no yog nrog los ntawm cov tsos mob loj heev: xeev siab, ntuav, tachycardia, tawm hws ntau dhau. Lub sijhawm ntawm 15 mus rau 40 feeb. Ces tus me nyuam tsaug zog dua, thiab thaum sawv ntxov tsis nco qab dab tsi.
npau suav phem
Cov menyuam yaus feem ntau muaj kev npau suav tsis txaus siab thiab zoo nkauj heev. Npau suav phem feem ntau tshwm sim thaum REM pw tsaug zog thaum sawv ntxov. Tus me nyuam quaj los yog hais cov kab lus thiab cov lus sib cais thaum pw tsaug zog. Qee zaum thaum npau suav phem nws tuaj yeem nyuaj rau sawv.
Npau suav pom tseeb thiab ntxhov siab heev. Lawv muaj cov xwm txheej ntawm kev caum, kev ua phem, kev nruj kev tsiv thiab lwm yam kev phom sij. Thaum sawv ntxov tus menyuam tuaj yeem nthuav davtham txog qhov koj pom hauv npau suav. Cov menyuam yaus uas npau suav phem zoo li ntshai heev thaum lawv sawv. Lawv feem ntau quaj thaum rov hais dua cov ntsiab lus ntawm lawv txoj kev npau suav phem.
Cov niam txiv qee zaum muaj lub sijhawm nyuaj los qhia qhov kev ntshai hmo ntuj los ntawm kev npau suav phem. Hauv video hauv qab no, koj tuaj yeem pom cov kev xav ntawm Dr. Evgeny Olegovich Komarovsky txog parasomnia thaum yau. Renowned pediatrician piav qhia txog qhov sib txawv ntawm hmo ntuj ntshai thiab npau suav phem.
Enuresis hmo ntuj
Kev pw tsaug zog tshwm sim hauv cov menyuam yaus hnub nyoog qis dua 5 xyoos. Thaum lub hnub nyoog no, tus me nyuam twb tswj tau cov zis reflex. Feem ntau, cov menyuam yaus sawv tam sim ntawd thaum lawv yuav tsum mus rau chav dej thaum pw tsaug zog.
Yog tus menyuam raug kev txom nyem los ntawm nocturnal enuresis, ces nws tsis tuaj yeem sawv thaum lub sijhawm tso zis. Feem ntau qhov no tshwm sim thaum pw tsaug zog.
Yog li no, koj tsis tuaj yeem txaj muag tus menyuam. Nws tswj tsis tau cov txheej txheem tso zis thaum pw tsaug zog. Qhov teeb meem no feem ntau cuam tshuam nrog kev ntxhov siab thaum nruab hnub.
Qee zaum, pw tsaug zog tuaj yeem yog cov tsos mob ntawm ntau yam kab mob ntawm cov kab mob excretory thiab lub paj hlwb. Tsuas yog tus kws kho mob tuaj yeem paub qhov txawv ntawm enuresis nrog parasomnia los ntawm cov tsos mob ntawm cov kab mob organic.
Bruxism
Cov hniav sib tsoo thaum pw tsaug zog kuj yog cov tsos mob ntawm parasomnia. Qhov no yog ib qho kev tsis sib haum xeeb. Nrog rau qhov kev ua txhaum cai no, tus me nyuam hauv npau suav ua rau nws lub puab tsaig thiab zom nws cov hniav. Thaum sawv ntxov, cov menyuam yaus feem ntau yws ntawm qhov mobqhov ncauj kab noj hniav. Tsis muaj lwm yam kab mob pathological raug sau tseg.
Feem ntau, bruxism yog qhov tshwm sim rau kev ntxhov siab. Hauv qhov no, tus me nyuam yuav ntsib teeb meem pw tsaug zog los yog tsaug zog ntxiv. Hom kab mob parasomnia hauv cov menyuam yaus tuaj yeem ua rau cov kab mob ntawm cov hniav: abrasion ntawm cov hniav enamel, caries thiab cov pos hniav.
Diagnosis
Thaum pw tsaug zog tsis zoo, nws yuav tsum tau mus kuaj thiab sab laj nrog ntau tus kws tshaj lij: tus kws kho menyuam yaus, kws kho mob hlwb thiab kws kho mob hlwb. Tom qab tag nrho, qhov tshwm sim ntawm nocturnal parasomnia feem ntau zoo ib yam li cov tsos mob ntawm cov kab mob organic.
Tus kws kho mob ua ib qho kev soj ntsuam ntawm tus menyuam cov niam txiv txhawm rau txheeb xyuas qhov zaus thiab qhov xwm txheej ntawm kev pw tsaug zog tsis zoo, lub sijhawm ntawm ntu, nrog rau kev hloov pauv hloov pauv. Cov niam txiv raug txhawb kom saib xyuas lawv tus menyuam tus cwj pwm thaum pw tsaug zog thiab sau txhua yam kev tsis sib haum xeeb rau hauv phau ntawv tshwj xeeb.
txhawm rau tsim qhov xwm txheej ntawm parasomnia, polysomnography raug sau tseg. Qhov kev sim no ua tiav thaum tus menyuam tsaug zog. Nrog kev pab los ntawm cov cuab yeej tshwj xeeb, lub hlwb ua haujlwm, cov leeg nruj thiab ua pa thaum pw tsaug zog tau kaw.
Nws yog ib qho tseem ceeb heev kom paub qhov txawv ntawm qhov tshwm sim ntawm parasomnia los ntawm kev qaug dab peg thiab lwm yam kab mob ntawm cov hlab ntsha hauv nruab nrab. Rau lub hom phiaj no, ib qho electroencephalogram, MRI ntawm lub hlwb thiab dopplerography ntawm cov hlab ntsha ntawm lub taub hau yog sau.
Yog tus menyuam raug kev txom nyem los ntawm nocturnal enuresis, lub raum thiab zais zis yuav tsum tau kuaj xyuas kom tsis suav nrog cov kab mob urological.
Kev kho mob
Rau qhov kev kho mob zoo ntawm parasomnia, nws yog ib qho tsim nyog yuav tsum ua kom lub neej niaj hnub ua haujlwm zoo. Nyob rau hauv ib nrab hnub, tus me nyuam yuav tsum tau muab zaub mov xwb. Kev pw tsaug zog yuav tsum yog tsawg kawg 9-10 teev tsaus ntuj, thiab txog 1-2 teev thaum nruab hnub. Cov menyuam yaus uas pw tsaug zog xav tau kev tawm dag zog thaum sawv ntxov thiab yav tav su, thiab lub sijhawm ntsiag to thaum yav tsaus ntuj.
Nrog kev pab los ntawm kev nkag rau hauv chaw muag khoom, koj tuaj yeem taug qab: lub sijhawm twg tus menyuam feem ntau pw tsaug zog tsis zoo. Cov kws kho mob pom zoo kom waking koj tus menyuam 10 mus rau 15 feeb ua ntej qhov kev xav tias parasomnia rov thiab muab lawv rov qab pw. Qhov no yog tshwj xeeb tshaj yog tsim nyog rau nocturnal enuresis.
kho tus cwj pwm kuj tseem siv tau. Tus menyuam yuav tsum tau mus ntsib tus kws kho mob rau menyuam yaus. Tus kws kho mob yuav ua cov chav kawm nrog tus menyuam lossis tus tub hluas txhawm rau txo kev ntxhov siab. Hauv tsev, cov niam txiv tuaj yeem siv cov kev cai tshwj xeeb thaum yav tsaus ntuj. Nws tuaj yeem yog da dej so, haus tshuaj yej los ntawm cov tshuaj soothing, gymnastics ntawm qeeb qeeb. Cov dej num zoo li no txhim kho cov txheej txheem ntawm inhibition hauv nruab nrab paj hlwb ua ntej yuav mus pw.
Ntau zaus, kev kho mob ntawm parasomnia hauv cov menyuam yaus yog qhov tsim nyog. Feem ntau, tus menyuam tau txais tshuaj ntsuab sedatives:
- "Persen";
- valerian extract (ntsiav tshuaj);
- tshuaj ntsuab nrog mint lossis motherwort.
Tranquilizers tsis tshua muaj tshuaj rau menyuam yaus. Lub cev sai tau siv rau cov tshuaj no. Siv rau kev pw tsaug zog hnyavKev npaj "Fenibut" thiab "Phezam". Lawv tsis yog cov classic tranquilizers, tab sis yog cov tshuaj nootropic nrog rau cov nyhuv sedative ntxiv. Cov no yog cov tshuaj uas yuav tsum tau muab rau tus menyuam tsuas yog raws li kws kho mob cov lus qhia.
Physiotherapeutic txoj kev kho parasomnia hauv cov menyuam yaus kuj tau siv: electrosleep, massage, da dej nrog decoctions ntawm sedative tshuaj ntsuab. Cov txheej txheem zoo li no tshwj xeeb tshaj yog thaum tav su.
Huab cua
Nyob rau hauv feem ntau ntawm cov neeg mob, pw tsaug zog ib txwm nyob rau hauv cov me nyuam yog rov qab sai sai tom qab kev kho mob. Tsis tas li ntawd, nrog lub hnub nyoog, tus me nyuam lub paj hlwb muaj zog, thiab kev pw tsaug zog ploj mus.
Yog tias tus kab mob parasomnia ua rau ntev, ces nws yuav tsum tau kuaj xyuas tus menyuam txoj kev noj qab haus huv kom ntxaws ntxiv. Hauv qhov no, kev pw tsaug zog tsis zoo yuav yog ib qho cim ntawm kev puas hlwb lossis kev puas siab puas ntsws pathologies.
Kev Tiv Thaiv
Yuav ua li cas tiv thaiv parasomnia hauv menyuam yaus? Pediatricians muab cov lus qhia hauv qab no:
- Nws yog ib qho tsim nyog yuav tsum ua raws li kev coj noj coj ua zoo ntawm hnub. Tus me nyuam yuav tsum tau mus pw thiab sawv tib lub sijhawm.
- Peb yuav tsum tsis txhob ua haujlwm dhau thiab tsis tsaug zog. Cov menyuam yaus yuav tsum tau pw tsawg kawg 10-12 teev hauv ib hnub.
- Tsis txhob muab rau koj tus menyuam hnyav lossis zom zaub mov thaum hmo ntuj.
- Nws yog ib qho tseem ceeb heev los tiv thaiv tus menyuam los ntawm kev ntxhov siab. Nws yog ib qho tsim nyog kom tshem tawm tag nrho saib cov yeeb yaj kiab txaus ntshai thiab TV tsis txaus siab. Cov niam txiv yuav tsum tsis txhob cia kev sib cav sib ceg ntawm tus menyuam. Ib tug me nyuam muaj kev nyuaj siab pw tsaug zog yuav tsum tau kho heevua tib zoo.
- Thaum lub sijhawm tom qab ntawm hnub, yuav tsum tsis pub ua kom lub cev ntau dhau ntawm tus menyuam. Kev ua si sab nraum zoov thiab kev ua kis las thaum yav tsaus ntuj ua rau muaj kev ntxhov siab ntau dhau ntawm lub paj hlwb.
- Nws yog qhov zoo los muab ib khob mis sov rau koj tus menyuam hmo ntuj. Qhov no yuav pab normalize pw tsaug zog.
Cov kev ntsuas zoo li no yuav pab txo qis kev pheej hmoo ntawm tus kab mob parasomnia. Txhua tus niam txiv yuav tsum mloog cov kws kho mob cov lus qhia. Tom qab tag nrho, kev noj qab nyob zoo thiab pw tsaug zog yog qhov tseem ceeb heev rau tus menyuam.
