Raynaud's syndrome yog ib qho kev sib txawv ntawm cov tsos mob cuam tshuam nrog spasm ntawm peripheral hlab ntsha. Nws tuaj yeem yog ib qho kab mob sib cais lossis ib qho cim ntawm lwm yam pathology. Feem ntau, mob tshwm sim yog nyob rau hauv cov hlab ntsha ntawm ob txhais tes. Cov tsos mob no yog nrog los ntawm blanching thiab blueness ntawm daim tawv nqaij ntawm ob txhais tes, mob thiab loog. Cov tsos mob zoo li no tshwm sim los ntawm kev ua txhaum loj ntawm cov ntshav. Hauv cov xwm txheej zoo, cov ntaub so ntswg necrosis tshwm sim. Raynaud's syndrome muaj ntau ntau rau cov poj niam dua li cov txiv neej. Tshwj xeeb yog raug rau tus kab mob no yog cov neeg hluas hnub nyoog 20 txog 40 xyoo. Lub pathology tau piav qhia thawj zaug hauv xyoo 1862 los ntawm Fabkis tus kws kho mob hlwb Maurice Raynaud. Tus kab mob no hu ua tus kws kho mob no.
Causes of the Syndrome
Cov tsos mob ntawm Raynaud's syndrome tshwm sim vim vasospasm thiab ua rau lub cev tsis zoo. Raws li twb tau hais lawm, cov ntiv tes feem ntau cuam tshuam. Muaj tsawg zauscov ntshav ncig yog cuam tshuam rau thaj tsam ntawm ko taw, taub ntswg lossis lub puab tsaig.
Cov laj thawj hauv qab no ntawm kev txhim kho ntawm tus mob tuaj yeem paub qhov txawv:
- kab mob autoimmune nrog los ntawm cov ntaub so ntswg puas;
- kev sib txawv hauv kev ua haujlwm ntawm cov qog endocrine;
- mob plawv thiab ntshav txhaws;
- ua haujlwm ntsig txog kab mob;
- kev mob tshwm sim ntawm qee yam tshuaj.
Vaspasm feem ntau tshwm sim tom qab hypothermia lossis kev ntxhov siab. Tom ntej no, cov laj thawj tseem ceeb ntawm tus mob no yuav tau tham kom ntxaws.
Syndrome thiab Raynaud's disease
Hauv cov tshuaj, nws yog txoj cai los faib cov ntsiab lus - Raynaud's syndrome thiab kab mob. Yog hais tias tus neeg mob muaj spasm ntawm peripheral hlab ntsha raws li ib tug thib ob kos npe rau ntawm pathologies uas twb muaj lawm, ces cov kws kho mob tham txog Raynaud's syndrome. Yog tias cov tsos mob no tshwm sim raws li tus kab mob sib cais, ces nws hu ua Raynaud's disease. Qhov ua rau thawj pathology tsis nkag siab tag nrho. Nws yog assumed tias nws tshwm sim los ntawm hereditary predisposition.
Autoimmune pathologies
Feem ntau, tus mob tshwm sim hauv cov neeg mob rheumatic autoimmune kab mob. Cov kab mob xws li kab mob lupus erythematosus, rheumatoid mob caj dab, scleroderma ua rau cov ntaub so ntswg puas. Feem ntau cov neeg mob uas muaj xws li pathologies muaj Raynaud's syndrome. Cov phab ntsa ntawm cov hlab ntsha yog tsim los ntawm cov ntaub so ntswg sib txuas, thiab nws qhov kev puas tsuaj ua rau muaj qhov tshwm sim spastic.
Nyob rau ntawm qhov mob khaub thuas lossis kev ntxhov siab hauv cov neeg mobmuaj spasm ntawm cov hlab ntsha thiab cov hlab ntsha. Feem ntau, cov tsos mob ntawm pathological (kev mob loog, blanching ntawm daim tawv nqaij, qhov mob) tau sau tseg hauv thaj tsam ntawm cov ntiv tes thiab ntiv taw, nrog rau lub qhov ntswg thiab lub puab tsaig. Qhov no yog vim qhov tseeb tias cov ntshav tsis ntws zoo mus rau hauv cov hlab ntsha me me ntawm qhov deb ntawm lub cev. Tom qab ntawd cyanosis (cyanosis) tau pom. Cov ntshav ntim rau hauv cov leeg, lawv o, uas ua rau lub ntsej muag xiav rau ntawm daim tawv nqaij.
YEndocrine ntshawv siab
Qhov tshwm sim ntawm tus mob no tuaj yeem cuam tshuam nrog kev ua haujlwm tsis zoo ntawm cov qog adrenal. Hauv cov qog ntawm medulla (piv txwv li, pheochromocytoma), cov qog no tsim ntau ntau ntawm epinephrine thiab norepinephrine. Cov tshuaj hormones zoo li no muaj cov nyhuv vasoconstrictive thiab tuaj yeem ua rau muaj qhov txhab ntawm cov hlab ntsha ntawm cov extremities.
Cov thyroid hormone triiodothyronine muaj cov txiaj ntsig zoo sib xws. Yog li, tus mob no feem ntau tau sau tseg nrog hyperthyroidism.
kab mob vascular thiab kab mob tsis zoo
Kev tsis txaus siab ntawm peripheral ncig feem ntau tau sau tseg hauv vasculitis thiab periarteritis nodosa. Inflammatory thiab degenerative txheej txheem nyob rau hauv cov hlab ntsha ua rau lawv spasm. Raws li qhov tshwm sim, cov ntshav muab rau cov ceg ceg sab sauv raug cuam tshuam.
Tus mob no kuj pom muaj ntshav txhaws. Kev txhaws ntawm cov hlab ntsha tseem ceeb cuam tshuam cov ntshav ncig. Yog li ntawd, kev noj haus ntawm cov ntaub so ntswg nyob deb ntawm lub cev raug cuam tshuam.
Ib kis tshwj xeeb ntawm thrombosis yog cryoglobulinemia. Nrog rau qhov no pathology, txhaws ntawm cov hlab ntsha tsuas yog tshwm sim nyob rau hauv lub qis kub. Qhov no yog vim qhov tsim tshwj xeeb"txias" proteins uas provoke thrombosis. Thaum ib tug neeg nyob hauv chav sov, cov ntshav txhaws.
Tshuaj
Kev siv tshuaj nrog adrenaline zoo li kev ua haujlwm tuaj yeem ua rau muaj qhov tshwm sim ntawm tus mob. Ua ntej tshaj plaws, qhov no siv rau cov tshuaj rau ntshav siab. Adrenoblockers muaj cov khoom no: Propranolol, Metoprolol. Cov tshuaj no nthuav cov hlab ntsha, tab sis txwv cov peripheral.
Tshuaj kho mob migraine kuj muaj cov nyhuv vasoconstrictive: Nomigren, Syncapton. Nrog rau qhov ua rau muaj qhov tshwm sim spastic, koj yuav tsum tsis txhob noj cov tshuaj no. Cov kws kho mob tau pom tias cov tsos mob ntawm Raynaud's syndrome hauv cov poj niam uas mob migraine tshwm sim ntau dua li lwm pawg ntawm cov neeg mob. Cov kws tshaj lij qhia tias qhov no yog vim kev siv cov tshuaj vasoconstrictor rau mob taub hau.
Kev ua haujlwm pathology
Tus mob no feem ntau tshwm sim hauv cov neeg ua haujlwm uas nws txoj haujlwm ua haujlwm cuam tshuam nrog kev co. Mechanical yoj irritates lub receptors ntawm daim tawv nqaij thiab paj hlwb. Qhov no provokes ntau lawm ntawm cov tshuaj norepinephrine, uas muaj vasoconstrictive nyhuv.
Feem ntau cov neeg mob, nws txoj haujlwm yog txuam nrog kev nce ntxiv ntawm txhuam. Tus mob no feem ntau pom nyob rau hauv typists thiab pianists.
ICD classification
Nyob hauv ICD-10, Raynaud's syndrome yog coded nyob rau hauv lub npe ntawm tus kab mob hauv qab yog paub qhov ua rau nws tshwm sim. Txawm li cas los xij, yog tias cov tsos mob no nyuajTus kab mob ywj pheej lossis nws cov etiology tsis tau txheeb xyuas, ces tus mob no feem ntau txawv nyias.
Raws li ICD, Raynaud's syndrome belongs rau chav kawm 170-179. Raws li cov cai hauv kev faib tawm, cov kab mob ntawm cov hlab ntsha, cov hlab ntsha thiab cov hlab ntsha tau sau tseg. Ntxiv mus, qhia txog Raynaud's syndrome nrog rau ICD code 173. Cov pab pawg no suav nrog cov kab mob peripheral vascular. Tag nrho cov cai rau Raynaud's syndrome yog 173.0. Txoj cai no kuj qhia txog gangrene, uas yog ib qho teeb meem ntawm cov kab mob no.
Cov tsos mob thiab theem ntawm pathology
Cov tsos mob ntawm Raynaud's syndrome feem ntau pom ntawm cov ntiv tes, tsis tshua muaj nyob ntawm ob txhais ceg, taub ntswg lossis puab tsaig. Pathology manifests nws tus kheej nyob rau hauv daim ntawv ntawm qaug dab peg, lawv cov chav kawm yuav muab faib ua 3 theem:
- Tom qab tawm mus rau qhov txias lossis kev ntxhov siab, tus neeg mob muaj blanching ntawm daim tawv nqaij ntawm tes lossis lwm qhov chaw cuam tshuam. Qhov no yog vim vasospasm thiab circulatory disorders. Vim qhov tsis zoo ntawm cov ntaub so ntswg nrog oxygen, qhov mob tshwm sim. Nws yog nrog los ntawm loog loog thiab tingling sensation.
- Cov tawv nqaij ntawm thaj chaw cuam tshuam dhau los ua xim xiav. Vim spasm ntawm cov hlab ntsha me, cov ntshav stagnates hauv cov leeg. Muaj cov ntaub so ntswg o me ntsis.
- Cov hlab ntsha tawg dua, thiab pom cov tawv nqaij liab. Qhov loog loog thiab tingling hnov mob yuav maj mam ploj mus, nrog kev mob rov tshwm sim.
Nov yog thawj theem ntawm Raynaud's syndrome. Cov duab ntawm cov tsos mob ntawm pathology tuaj yeem pom hauv qab no.
Lub sijhawm dhau mus, tus kab mob no tuaj yeem ua tiav. Yog hais tias thaum pib ntawm tus kab mob spasms yog ib ntustus cwj pwm, ces nyob rau hauv lub thib ob theem ntawm tus kab mob lawv ua mus tas li. Cov chaw cuam tshuam ib txwm saib xiav thiab o.
theem thib peb ntawm tus mob no yog qhov ua txhaum loj ntawm cov ntshav xa mus rau thaj chaw cuam tshuam. Vim tsis noj zaub mov, rwj thiab foci ntawm daim tawv nqaij necrosis.
Cov tsos mob thiab kev kho mob ntawm Raynaud's syndrome nyob ntawm theem ntawm tus kab mob. Qhov muaj zog ntawm kev puas tsuaj rau cov hlab ntsha, qhov nyuaj dua nws yog kom tsis txhob muaj qhov tshwm sim ntawm pathology. Yog tias cov tshuaj feem ntau pab tau rau theem thawj thiab thib ob, tom qab ntawd hauv cov xwm txheej siab heev nws yog ib qho tsim nyog yuav tsum tau mus rau kev cuam tshuam kev phais.
Muaj Teeb Meem
Cov teeb meem tsis tshua muaj nyob rau theem thawj thiab thib ob ntawm tus kab mob. Cov txiaj ntsig txaus ntshai ntawm tus mob syndrome tshwm sim hauv cov neeg mob siab heev. Lawv feem ntau tshwm sim nyob rau theem peb ntawm tus kab mob. Cov kab mob thiab cov kab mob necrotic ntawm daim tawv nqaij qhia tias muaj kev noj zaub mov tsis zoo thiab cov ntshav txaus rau cov ntaub so ntswg. Qhov no tuaj yeem ua rau gangrene thiab txiav cov ntiv tes los yog ib feem ntawm cov ceg. Yog li ntawd, nws yuav tsum tau mus ntsib kws kho mob ntawm thawj cov tsos mob ntawm Raynaud's syndrome.
Diagnosis
Tus kws kho mob rheumatologist tuaj yeem xav tias tus kab mob no nyob ntawm tus neeg mob qhov kev tsis txaus siab. Daim tawv nqaij blanching ntawm qhov kub thiab txias, loog loog thiab mob yog cov cim qhia. Thaum lub sij hawm soj ntsuam, ib qho kev ntsuas txias yog ua. Tus neeg mob txhais tes muab tso rau hauv dej txias thiab pom cov tshuaj tiv thaiv ntawm cov hlab ntsha.
Feem ntau tus mob no tshwm sim tawm tsam keeb kwm ntawm lwm yam pathologies. Yog li ntawd, kev kuaj mob hauv chaw kuaj mob yog siv los txheeb xyuas qhov ua taurheumatic, endocrine, vascular kab mob, nrog rau cov kab mob circulatory. Rau lub hom phiaj no, cov kev ntsuam xyuas hauv qab no tau sau tseg:
- kuaj ntshav dav dav. Hauv cov kab mob autoimmune, anemia thiab txo qis ntawm cov platelets thiab leukocytes tau sau tseg.
- Kev tsom xam rau biochemistry. Cov neeg mob pom tias nce qib ntawm cov enzymes koom nrog hauv cov txheej txheem metabolic, nrog rau alpha thiab gamma globulins.
- kuaj ntshav rau rheumatoid factor thiab immunoglobulins. Yog hais tias spastic phenomena tshwm sim los ntawm autoimmune pathologies, ces qhov tshwm sim ntawm kev soj ntsuam rau RF thiab IgE yuav zoo.
- Kev kuaj ntshav rau adrenal thiab thyroid hormones. Txoj kev tshawb no tau ua tiav thaum xav tias muaj qhov endocrine etiology ntawm tus mob.
Ntxiv rau, nws yog ib qho tsim nyog los txheeb xyuas cov kev hloov pauv hauv cov hlab ntsha me. Muab angiography ntawm peripheral hlab ntsha thiab capillaroscopy ntawm tus ntsia thawv txaj (nyob rau hauv cov ntaub ntawv ntawm kev puas tsuaj rau cov ntiv tes). Dopplerography ntawm cov hlab ntsha me kuj tau ua nyob rau ntawm qhov chaw ntawm qhov txhab txhawm rau ntsuas cov ntshav microcirculation.
txoj kev kho
Kev kho mob ntawm Raynaud's syndrome muaj nyob rau hauv kev kho mob ntawm cov kab mob hauv qab, uas ua rau muaj qhov tshwm sim spastic hauv cov hlab ntsha me. Feem ntau, kev ua tiav ntawm kev tso tawm hauv cov mob rheumatoid lossis endocrine pathology ua rau qhov ploj ntawm qaug dab peg. Nyob rau tib lub sijhawm, cov tshuaj tau sau tseg kom nthuav cov hlab ntsha thiab txhim kho cov ntshav microcirculation:
- "Trental";
- "Nifedipine";
- "Verapamil";
- "Vazaprostan";
- "Diltiazem";
- "Fentolamine";
- "Nicardipine".
Tus mob no feem ntau nrog mob hnyav ntawm cov ntiv tes thiab tes thaum muaj kev tawm tsam. Txhawm rau kom tsis txhob muaj qhov tsis xis nyob, sau cov tshuaj uas tsis yog-steroidal anti-inflammatory. Yog hais tias tus mob yog tshwm sim los ntawm rheumatic pathologies, ces cov tshuaj no yog thawj xaiv tshuaj rau lub ntsiab txoj kev kho. Cov hauv qab no txhais tau tias yog siv:
- Y "Diclofenac";
- "Indomethacin";
- "Ibuprofen";
- "Butadion";
- "Reopirin".
Nws yog ib qho tseem ceeb kom nco ntsoov tias cov tshuaj no ua aggressively ntawm lub plab hnyuv mucosa. Lawv siv sijhawm ntev tuaj yeem ua rau muaj kab mob peptic ulcer. Yog li, nrog rau lawv, lawv yog cov tshuaj uas tiv thaiv plab: Omeprazole thiab Cimetidine.
Nyob rau lub sijhawm mob autoimmune, corticosteroids ("Prednisolone", "Dexamethasone") thiab cytostatics ("Methotrexate") tau qhia. Kev siv cov tshuaj no yuav tsum tau ceev faj, lawv cov koob tshuaj raug xaiv ib tus zuj zus.
Yog tias qhov kev tawm tsam qeeb, ces txhaj tshuaj antispasmodics: Drotaverine, Diazepam, Platiphyllin. Nyob hauv tsev, koj tuaj yeem sov koj txhais tes hauv dej sov los yog rub lawv nrog ib daim ntaub woolen. Qhov no yuav pab txo qhov mob sai sai.
Tshuaj kho mob ntawm Raynaud's syndrome yog ntxiv nrog kev kho lub cev. qhiasiv cov txheej txheem hauv qab no:
- Kev Kho Mob Siab Heev (EHF);
- magnetic therapy;
- reflexology.
Yog tias kev kho mob tsis zoo, ces mus rau kev phais. Txhawm rau tshem tawm cov hlab ntsha ntawm lub sijhawm, ib feem ntawm lub paj hlwb raug tshem tawm. Yog li ntawd, cov kab mob pathological tso tseg tsis nkag mus rau hauv cov hlab ntsha, uas ua rau muaj kev sib txuam ntawm lawv cov phab ntsa. Tam sim no, lawv sim ua qhov haujlwm no hauv txoj kev raug mob tsawg kawg nkaus uas siv lub endoscope. Txawm li cas los xij, txawm tias tom qab phais, qhov rov tshwm sim ntawm pathology tom qab 2-3 xyoos tsis tuaj yeem txiav tawm.
Huab cua
Kev kuaj mob ntawm tus kab mob yog nyob ntawm qib ntawm pathology. Nyob rau hauv thawj thiab thib ob theem, tus kab mob no teb zoo rau kev kho mob. Hauv cov xwm txheej hnyav, necrosis thiab gangrene tuaj yeem tshwm sim. Cov teeb meem zoo li no feem ntau xaus rau ntawm limb amputation.
Qee qhov xwm txheej, kev kho tus kheej ntawm tus mob no hauv thawj theem tau sau tseg nrog kev hloov pauv huab cua lossis kev ua neej. Txawm li cas los xij, ib tus yuav tsum tsis txhob cia siab rau qhov txiaj ntsig zoo li no. Qhov no tsis tshua pom. Ntau zaus, tsis saib xyuas pathology ua rau cov nqaij mos necrosis thiab kev loj hlob ntawm cov teeb meem loj. Yog li ntawd, nws yuav tsum tau mus ntsib kws kho mob ntawm thawj cov cim qhia ntawm spastic phenomena nyob rau hauv peripheral hlab ntsha.
Kev Tiv Thaiv
Yuav ua li cas tiv thaiv kev txhim kho ntawm kev tawm tsam nrog vasospasm? Cov neeg uas muaj mob rheumatic thiab autoimmune yuav tsum tau tiv thaiv lawv lub cev los ntawm hypothermia. Thaum qhov kub thiab txias, hnab looj tes lossis mittens yuav tsum hnav. KujKev xav ntau dhau yuav tsum zam thaum twg los tau.
Koj yuav tsum xyuam xim rau koj cov zaub mov. Haus dej tshuaj yej thiab kas fes muaj zog yuav tsum zam. Cov khoom noj muaj txiaj ntsig zoo hauv omega-polyunsaturated fatty acids. Cov no suav nrog qee hom ntses (salmon, mackerel, trout, salmon, tuna), walnuts, avocados, txiv roj roj thiab roj sunflower.
Tus neeg mob yuav tsum tsis txhob haus luam yeeb, vim nicotine provokes vasospasm. Nws yog ib qho tsim nyog kom tsis txhob noj tshuaj nrog adrenergic blockers, ephedrine, ergotamine. Yog tias koj yuav tsum siv cov tshuaj no rau ntshav siab lossis mob migraine, koj yuav tsum sab laj nrog koj tus kws kho mob txog kev hloov cov tshuaj no nrog analogues rau kev kho mob. Cov kev ntsuas no yuav pab tiv thaiv kev tawm tsam.
