Upper limb polyneuropathy yog ib qho pathology ntawm peripheral paj hlwb uas tuaj yeem cuam tshuam rau cov hlab ntsha peripheral. Tom ntej no, cia peb tham txog cov tsos mob, txoj kev kho mob thiab kev kuaj mob ntawm tus kab mob no.
About tus kab mob
Los ntawm Greek, tus kab mob no tuaj yeem txhais tau tias "ib kab mob ntawm ntau lub paj hlwb." Qhov kev txhais lus no qhia meej meej lub ntsiab lus ntawm pathology. Nrog rau kev txhim kho ntawm polyneuropathy hauv tib neeg, yuav luag tag nrho cov hlab ntsha me me tuaj yeem cuam tshuam. Qhov ua rau ntawm tus kab mob no txawv, tab sis cov tsos mob ntawm polyneuropathy ntawm lub sab sauv sab sauv yeej ib txwm zoo sib xws, tsis hais qhov tseeb los ntawm tus kab mob.
Ua rau kev loj hlob ntawm pathology
Qhov feem ntau ua rau polyneuropathy ntawm extremities yog cov hauv qab no:
- Muaj kab mob hauv tib neeg.
- Qhov tshwm sim ntawm sab nraud thiab sab hauv.
- Qhov tshwm sim ntawm cov kab mob metabolic.
- Kev txhim kho ntawm beriberi hauv tus neeg mob.
Cov spectrum ntawm somatic pathologies uas ua rau polyneuropathy ntawm sab sauv thiab sab qis yog ntau haiv neeg. Mob ntshav qab zib, hyperthyroid thiab hypothyroid endocrinopathies tuaj yeem ua rau cov hlab ntsha peripheral puas. Cov txheej txheem pathological tsim nyob rau hauv ntau yam kab mob, piv txwv li, tawm tsam keeb kwm ntawm periarteritis nodosa, lupus erythematosus, scleroderma, thiab lwm yam. Tus kab mob no tshwm sim rau tib neeg thaum muaj uremic, hepatic, amyloid, los yog metabolic teeb meem. Polyneuropathy ntawm sab qaum yog qee zaum tshwm sim ntawm cov ntshav pathologies, cawv thiab yeeb tshuaj intoxication, nrog rau paraproteinemia.
Type of pathology
Subacute hom polyneuropathy nce hauv yim lub lis piam. Kev puas tsuaj rau cov hlab ntsha peripheral suav nrog inflammatory, metabolic thiab lom. Nrog rau cov kab mob no, cov tsos mob tshwm sim tshwm sim ntau lub hlis lossis ntau xyoo. Daim ntawv mob ntev ntawm sab sauv qaum polyneuropathy suav nrog:
- Tus mob inflammatory demyelinating polyneuropathy.
- Hereditary, Diabetic, dysproteinemic thiab hepatic.
- Polyneuropathy vim kev loj hlob ntawm cov kab mob amyloidosis, hypothyroidism, vitamin deficiency, kab mob sib txuas hauv cov ntaub so ntswg thiab kab mob ua pa ntev.
- Paraneoplastic polyneuropathy ntawm sab sauv thiab sab qis hauv cov neeg mob qog nqaij hlav, ntau yam myeloma thiab mob qog noj ntshav.
Nyob rau hauv polyneuropathy ntawm extremities, myelin sheaths lossis axial thooj voos kheej kheej feem ntau cuam tshuam. Nyob rau hauv cov ntaub ntawv ntawm kis kab mob polyneuropathies nyob rau hauv cov neeg mob, cov tshuaj tiv thaiv ntawm daim nyias nyias thiab cov hlab ntsha uas pub cov hlab ntsha predominate. Yog hais tias ib tug neeg muaj tus mob kis tau tus mob polyneuropathy ntawm sab qaum, infiltrates tshwm sim los ntawm polyblasts thiab lymphocytes.
Tom ntej, cia peb tham txog cov yam ntxwv ntawm cov tsos mob ntawm cov kab mob hauv nqe lus nug.
Cov tsos mob ntawm sab sauv qaum polyneuropathy
Cov kev kho mob tshwm sim ntawm polyneuropathies yog ua raws li kev hnov lus, lub cev muaj zog thiab cov tsos mob vegetative. Raws li qhov ua rau ntawm tus kab mob, cov cim qhia ntawm tus kheej lossis lawv cov kev sib xyaw ua ke tuaj yeem kov yeej. Cov tsos mob rhiab heev yog yam ntxwv ntawm metabolic thiab lom polyneuropathy. Tsis zoo tshwm sim tshwm sim nyob rau hauv lub xub ntiag ntawm inflammatory demyelinating polyneuropathy. Tsis tas li, cov tsos mob tuaj yeem pom nyob rau hauv cov ntaub ntawv tsis txaus ntawm cov vitamins E thiab B 12, thiab, ntxiv rau, tawm tsam keeb kwm ntawm kev qaug cawv thiab paraneoplastic polyneuropathy. Qhov tshwm sim ntawm tus kab mob no yog tus cwj pwm los ntawm kev txo qis ntawm qhov rhiab heev ntawm cov ceg tawv hauv daim ntawv "s thom khwm" thiab "pob looj tes", nrog rau hauv plab plab.
Sensory symptomatology
Rau cov tsos mob xws li:
- Kev mob tshwm sim.
- Kev xav tias nkag los yog loog yam tsis uakev khaum.
- Tau qhov kub hnyiab.
- Nyob rhiab.
- Kev txhim kho ntawm hyperalgesia, uas yog qhov txawv txav siab ntawm lub cev rau ntau yam mob stimuli.
- Qhov tshwm sim ntawm dysesthesia, uas yog, perversion ntawm rhiab heev, tawm tsam qhov txias yog perceived li sov.
- Kev loj hlob ntawm hyperpathy, uas yog, perversion ntawm rhiab heev, tshwm sim los ntawm kev nce hauv qhov pib ntawm kev xaav thaum lub sij hawm khaus. Nyob rau tib lub sijhawm, tsis muaj qhov tseeb ntawm qhov kev xav.
- Txoj kev loj hlob ntawm allodynia, uas yog, mob thaum raug stimuli uas feem ntau tsis ua rau nws.
Cov tsos mob ntawm cov tsos mob rhiab kws kho mob koom nrog kev kho cov txheej txheem ntawm cov hlab ntsha. Tawm tsam keeb kwm yav dhau los ntawm kev puas tsuaj rau cov fibers uas ua rau muaj zog rhiab heev, muaj rhiab heev ataxia. Nrog tus kab mob no, cov neeg mob feem ntau ntsib kev tsis khov thaum taug kev, ua rau mob hnyav hauv qhov tsaus ntuj thiab kaw qhov muag.
Dab tsi lwm cov tsos mob ntawm polyneuropathy ntawm sab sauv thiab sab qis yog muaj?
Cov tsos mob zoo lub cev muaj zog
Cov tsos mob zoo ntawm lub cev muaj xws li:
- Neuromyotonia, uas yog ib qho mob uas muaj qhov nro tas li, spasms, lossis ncua kev so ntawm cov leeg nqaij tam sim ntawd tom qab contraction.
- Kev txhim kho ntawm fasciculations. Hauv qhov no, peb tab tom tham txog kev txo qis ntawm ib lossis ob peb fibers ib zaug.
- Qhov tshwm sim ntawm myokymia, uas yog, kev sib txuas ntawm tus neegcov leeg.
- Tshuaj zawv plaub hau nyob rau hauv cov leeg pob txha.
- Kev txhim kho ntawm qhov tsis hnov tsw ceg ceg.
Cov tsos mob tshwm sim
Qhov tshwm sim ntawm cov tsos mob zoo ntawm lub cev muaj feem cuam tshuam nrog kev hloov pauv hloov pauv ntawm cov paj hlwb thaum lub sijhawm rov tsim dua tshiab. Cov tsos mob zoo li no tshwm sim lawv tus kheej los ntawm kev puas tsuaj rau lub paj hlwb autonomic, nws tau muab faib ua visceral, vasomotor thiab trophic manifestations. Cov tsos mob visceral yog qhov tshwm sim ntawm cov ntshav qab zib, amyloid, porphyria, cawv thiab tshuaj lom polyneuropathies. Ntawm cov tsos mob visceral yog:
- Mob plawv tshwm sim hauv daim ntawv ntawm kev txo qis hauv kev tiv thaiv keeb kwm yav dhau los ntawm kev hloov pauv hauv lub cev.
- Urogenital tshwm sim, thaum muaj kev ua txhaum ntawm kev ua haujlwm ntawm sphincters thiab erectile kawg.
- Digestive dysmotility.
- Qhov tshwm sim ntawm kev ua pa tsis zoo.
- Ua txhaum tawm hws, tsis ua haujlwm ntawm thermoregulation thiab cov lus teb ntawm cov menyuam yaus.
Cov tsos mob trophic zoo
Cov tsos mob trophic ntawm tus kab mob muaj xws li cov ntsia hlau deformity nrog rau kev tsim cov kab mob ntawm cov leeg, thinning ntawm daim tawv nqaij thiab kev loj hlob ntawm neuroarthropathy. Cov tsos mob vasomotor cov tsos mob tshwm sim, raws li txoj cai, los ntawm kev hloov pauv ntawm qhov kub thiab txias ntawm daim tawv nqaij ntawm ob txhais tes thiab taw, thiab, ntxiv rau, los ntawm lawv cov xim marbled thiab o.
Kev kuaj mob ntawm polyneuropathy
Kev kuaj mob ntawm polyneuropathy yog suav tias yog feem ntau yog syndromic. Nws cov kws kho mob tsim los ntawm qhov tseem ceeb ntawm cov tsos mob kho mob. Nyob rau tib lub sijhawm, kev saib xyuas yog them rau kev hnov mob, lub cev muaj zog thiab vegetative manifestations. Tsis muaj qhov tseem ceeb tsawg dua yog qhov xwm txheej ntawm tus kab mob, uas yog, cov kws kho mob tshwj xeeb tau kos rau seb nws puas mob, subacute lossis mob ntev. Tag nrho cov nuances no yog qhov tseem ceeb rau kev tawm tswv yim ua rau pathology thiab sau ntawv kho kom txaus. Neurologists sib txawv ntawm axonal thiab demyelinating polyneuropathy. Qhov no ua lub luag haujlwm tseem ceeb rau kev kho kom txaus thiab kev kuaj pom tus kab mob.
txhawm rau tsim kom muaj tus kab mob, nrog rau thaj chaw ntawm cov txheej txheem pathological thiab qib ntawm cov hlab ntsha puas, cov kws kho mob siv cov txheej txheem hauv qab no ntawm kev ntsuas thiab kuaj kuaj:
- Electroneuromyography.
- Ua CBC.
- Kev kuaj mob daim siab.
- Tsim kom muaj qib ntawm urea, glycated hemoglobin thiab creatinine.
Tom qab tau txais cov txiaj ntsig ntawm kev tshuaj xyuas, kev kuaj mob ntawm polyneuropathy ntawm cov extremities raug tsim, thiab tib lub sijhawm, cov kws kho mob tshwj xeeb suav nrog cov tsos mob ntawm tus kab mob thiab sau ntawv kho kom txaus.
Txoj Cai Kev Kho Mob
Nyob rau hauv kev kho mob ntawm polyneuropathies ntawm lub sab sauv extremities, uas yog tshwm sim los ntawm somatic pathologies, neurologists sau ntawv etiological therapy aims kho cov kab mob hauv qab uas ua rau puas peripheral qab haus huv. Tsis tas li ntawd, kev kho mob pathogenetic ntxiv yog nqa tawm, uasLub hom phiaj yog los kho cov txheej txheem hauv qab uas ua rau kev txhim kho ntawm limb polyneuropathy. Siv los ntawm cov kws kho mob thiab cov tshuaj uas muaj cov tshuaj antioxidants. Rau cov hom phiaj no, cov neeg mob tau muab tshuaj lipoic acid npaj. Ntxiv nrog rau cov nyhuv antioxidant, lawv kuj muaj cov nyhuv zoo li insulin. Lipoic acid pab txhawb kev rov qab los ntawm cov hlab ntsha ntawm cov hlab ntsha hauv myelinopathy. Ua tsaug rau cov kua qaub no, qhov kev coj ua ntawm impulses raws cov paj hlwb rov qab los.
Dab tsi ntxiv yog kev kho mob polyneuropathy ntawm sab qis thiab sab sauv koom nrog? Txhawm rau txhim kho microcirculation thiab ntshav txaus hauv cov qauv ntawm lub paj hlwb, cov tshuaj hu ua "Actovegin" yog siv. Nws yog siv nyob rau hauv mob ntshav qab zib polyneuropathy. Cov txheej txheem ntawm kev ua ntawm "Actovegin" yog txhawm rau txhim kho cov txheej txheem ntawm lub zog metabolism, txhim kho microcirculation thiab txo qis cov piam thaj.
Kho qhov mob syndrome
Lub hauv paus ntawm kev kho mob yog kho qhov mob. Kev kho tus kab mob neuropathic yog ib txoj haujlwm nyuaj heev. Cov tshuaj loog hauv zos yog siv los tswj qhov mob nrog rau opioid analgesics thiab anticonvulsants. Hauv pawg carbamazepines, Gabapentin yog suav tias yog qhov zoo tshaj plaws. Hauv kev kho mob ntawm qhov mob, tricyclic antidepressants tau siv. Tab sis lawv tsis raug sau tseg rau autonomic lossis visceral polyneuropathy nyob rau hauv rooj plaub ntawm cov tsos mob hauv qab no:
- Tawm tsam keeb kwm ntawm kev tsis txaus ntawm lub plawv thiab cov hlab ntsha.
- Nyob rau hauv lub xub ntiag ntawm intracardiac disordersconductivity.
- Ntawm keeb kwm ntawm obstructive kab mob ntawm cov kab mob genitourinary.
- Yog tus neeg mob muaj glaucoma.
- Ntawm keeb kwm ntawm orthostatic hypotension
Kev sib xyaw ntawm cov tshuaj tiv thaiv kev ntxhov siab nrog cov tshuaj "Gabapentin" txhim kho cov txiaj ntsig ntawm kev kho tshuaj. Rau lub hom phiaj ntawm kev kho kom rov zoo, cov tshuaj siv los pab kho myelin (peb tab tom tham txog B vitamins thiab lipoic acid npaj). Cov nyiaj zoo li no txhim kho kev ua haujlwm ntawm paj hlwb.
Cov tsos mob thiab kev kho mob ntawm polyneuropathy ntawm sab sauv thiab sab qis yog cuam tshuam.
Cov lus pov thawj tus neeg mob
Raws li cov neeg mob kev tshuaj xyuas, thaum kho polyneuropathy ntawm cov extremities tshwm sim los ntawm somatic ailments, neurologists feem ntau sau etiological therapy rau cov neeg mob, uas yog tsom rau tshem tawm cov kab mob hauv qab uas ua rau puas tsuaj rau cov hlab ntsha peripheral.
Kuj nyob rau hauv cov lus, tib neeg sau hais tias nyob rau hauv tus txheej txheem ntawm kev kho mob lawv kuj tau mus kho pathogenetic, lub hom phiaj ntawm cov feem ntau yog kho lub ntsiab mechanism uas coj ib tug neeg mus rau txoj kev loj hlob ntawm tus kab mob.
Peb tau saib cov tsos mob ntawm kev kho mob caj dab sab sauv polyneuropathy.
