Lub tswv yim ntawm polyneuropathy suav nrog ib pawg kab mob, ua rau muaj qhov sib txawv. Qhov tshwj xeeb uas sib sau cov kab mob no hauv ib kab yog qhov ua haujlwm tsis zoo ntawm lub paj hlwb peripheral lossis cov paj hlwb ib leeg.
Cov yam ntxwv ntawm polyneuropathy yog kev cuam tshuam ntawm cov leeg ntawm sab sauv thiab sab qis. Nyob rau hauv cov ntaub ntawv no, muaj ib tug qeeb ntawm cov ntshav khiav thiab ib tug deterioration ntawm rhiab heev ntawm ob txhais tes thiab taw. Feem ntau tus kab mob no cuam tshuam rau sab qis.
Polyneuropathy ntawm toxic genesis raws li ICD10
Ib yam ntawm cov kab mob no feem ntau yog tshuaj lom polyneuropathy. Los ntawm lub npe ntawm tus kab mob, nws paub tseeb hais tias nws yog tshwm sim los ntawm raug rau lub paj hlwb ntawm ntau yam tshuaj lom. Cov tshuaj lom tuaj yeem nkag mus rau hauv lub cev los ntawm sab nraud los yog tshwm sim los ntawm tus kab mob.
txhawm rau pab txhawm rau txheeb xyuas hom kab mob no, nws tau raug thov kom xav txog qhov ua rau muaj mob polyneuropathy tshwm sim. ICDL 10,los yog International Classification of Diseases, 10th Revision, muab ib daim ntawv yooj yim heev ntawm kev faib cov kab mob. Cov kab hauv qab yog muab tus lej rau ib hom kab mob tshwj xeeb, raws li qhov ua rau nws tshwm sim. Yog li, toxic neuropathies raug xaiv raws li ICD 10 daim ntawv teev npe nrog code G62. Cov hauv qab no yog kev faib ua kom zoo dua qub:
- G62.0 - kev xaiv rau kev siv tshuaj yeeb-tshuaj polyneuropathy nrog qhov muaj peev xwm ntawm kev qhia cov tshuaj;
- G62.1 - txoj cai no hu ua daim ntawv cawv ntawm tus kab mob;
- G62.2 - code rau polyneuropathy tshwm sim los ntawm lwm yam tshuaj lom (toxin code tuaj yeem raug txheeb xyuas);
- G62.8 - kev xaiv rau lwm qhov tshwj xeeb polyneuropathies, uas suav nrog daim ntawv hluav taws xob ntawm tus kab mob;
- G62.9 is code for neuropathy unspecified (NOS).
Raws li tau sau tseg ua ntej, tshuaj lom polyneuropathy tuaj yeem tshwm sim los ntawm ob yam ua rau:
- Muaj cov kab mob exogenous (hom no suav nrog kab mob diphtheria, herpetic, HIV-txog, lead, arsenic, cawv, tshwm sim los ntawm FOS lom, tshuaj, hluav taws xob neuropathy).
- Yog qhov tshwm sim ntawm cov yam ntxwv endogenous (xws li, ntshav qab zib, tshwm sim los ntawm paraproteinemia lossis dysproteinemia, diffuse cov ntaub so ntswg sib txuas).
Toxic neuropathy tsis ntev los no tau dhau los ua cov kab mob sib luag vim muaj kev sib cuag ntawm tus neeg uas muaj co toxins ntau ntau. Cov khoom txaus ntshai no nyob ib puag ncig peb txhua qhov chaw: lawv nyob hauv zaub mov, hauv cov khoomnoj, tshuaj thiab ib puag ncig. Cov kab mob sib kis kuj yog feem ntau ua rau tus kab mob no. Cov kab mob microorganisms tsim cov co toxins uas cuam tshuam rau tib neeg lub cev thiab cuam tshuam rau lub paj hlwb.
Exogenous toxic polyneutropathies
Raws li tau sau tseg ua ntej, cov kab mob no tshwm sim thaum tib neeg lub cev raug cuam tshuam rau sab nraud: co toxins los ntawm cov kab mob thiab cov kab mob, cov hlau hnyav, tshuaj, tshuaj. Zoo li lwm hom polyneutropopathy, cov kab mob no tuaj yeem ua mob ntev lossis mob.
YDiphtheria polyneuropathy
Los ntawm lub npe ntawm tus kab mob nws pom tseeb tias nws tshwm sim los ntawm ib qho mob hnyav ntawm kab mob diphtheria, nrog rau exotoxin. Feem ntau, qhov tshwm sim no tshwm sim hauv cov neeg laus. Nyob rau hauv rooj plaub no, muaj kev cuam tshuam rau lub sheaths ntawm cov hlab ntsha ntawm pob txha taub hau thiab lawv puas. Cov tsos mob ntawm tus kab mob tshwm sim lawv tus kheej nyob rau hauv thawj lub lim tiam (tshwj xeeb tshaj yog txaus ntshai nrog lub plawv nres thiab mob ntsws), los yog tom qab lub lim tiam thib 4 ntawm lub caij kis kab mob.
Lawv tau qhia los ntawm qhov mob ntawm lub qhov muag, hais lus, nqos, ua pa nyuaj thiab tachycardia tuaj yeem tshwm sim. Yuav luag ib txwm, cov tsos mob pib ploj tom qab 2-4 lub lis piam lossis tom qab ob peb lub hlis.
YHerpetic polyneutropopathy
hom kab mob no tshwm sim vim yog kev ua haujlwm ntawm Epstein-Barr tus kab mob ntawm herpes simplex hom I thiab II, pox pox, cytomegalovirus. Kev kis tus kab mob no tshwm sim hauv menyuam yaus, thiab tom qab muaj mobkev tiv thaiv tshwm sim. Yog tias lub cev tiv thaiv tsis muaj zog, ces polyneuropathy tuaj yeem tshwm sim nrog cov pob liab liab thoob plaws hauv lub cev.
Polyneuropathy vim HIV
Ob ntawm peb kis ntawm tus kab mob HIV ua rau muaj teeb meem hauv paj hlwb, feem ntau nyob rau theem kawg ntawm tus kab mob.
Cov tshuaj lom ntawm tus kab mob, tshuaj tiv thaiv kab mob autoimmune, kis kab mob thib ob, kev loj hlob ntawm cov qog thiab qhov tshwm sim ntawm kev noj tshuaj ua ke ua rau muaj kev cuam tshuam hauv kev ua haujlwm ntawm lub cev. Yog li ntawd, encephalopathy, meningitis, thiab cranial paj hlwb polyneutropopathy tshwm sim. Cov kab mob tom kawg yog feem ntau qhia nyob rau hauv qhov txo qis hauv qhov rhiab heev ntawm ko taw, mob hauv cheeb tsam lumbosacral. Lawv kho tau tab sis tuaj yeem ua rau tuag taus.
Y Lead polyneuropathy
Hom kab mob no tshwm sim vim muaj tshuaj lom lom neeg, uas tuaj yeem nkag mus rau tib neeg lub cev los ntawm kev ua pa lossis los ntawm txoj hnyuv. Nws muab tso rau hauv cov pob txha thiab daim siab. Lead toxic polyneuropathy (ICD code 10 - G62.2) yog qhia nyob rau hauv tus neeg mob nyob rau hauv daim ntawv ntawm lethargy, siab qaug zog, mob taub hau "dull", tsis nco qab thiab mloog, encephalopathy, anemia, colitis, mob nyob rau hauv cov ceg, tshee hnyo. tes. Tus kab mob no tshwm sim los ntawm kev puas tsuaj rau cov hlab ntsha radial thiab peroneal. Yog li ntawd, cov tsos mob ntawm "dai tes" thiab "cock's gait" feem ntau tshwm sim. Hauv cov xwm txheej no, kev sib cuag nrog cov hlau lead yog txwv tag nrho. Qhov kev cia siab rau kev tshem tus kab mob no yog qhov zoo.
Arsenic polyneuropathy
Arsenic tuaj yeem nkag mus rau tib neeg lub cev nrog rau tshuaj tua kab, tshuaj, pleev xim. Cov kab mob no yog cov kws tshaj lij hauv smelters. Yog hais tias cov nyhuv ntawm cov tshuaj lom yog ib leeg, ces vascular hypotension, xeev siab thiab ntuav. Tom qab 2-3 lub lis piam, polyneuropathy manifests nws tus kheej, qhia nyob rau hauv tsis muaj zog ntawm cov leeg ceg. Yog tias rov ua tshuaj lom nrog arsenic tshwm sim, ces symmetrical distal sensorimotor tshwm sim ntawm tus kab mob tshwm sim. Nyob rau hauv cov ntaub ntawv ntawm intoxication ntev nrog ib tug tshuaj lom, hypersalivation, trophic thiab vascular kab mob (daim tawv nqaij hyperkeratosis ntawm ob txhais taw thiab xib teg, pob khaus, kab txaij ntawm cov rau tes, pigmentation ntawm lub plab nyob rau hauv daim ntawv ntawm tee, tev), ataxia raug pom. Arsenic polyneuropathy yog kuaj pom los ntawm kev txheeb xyuas cov zis, plaub hau thiab rau tes. Kev rov zoo ntawm tus neeg mob tom qab tus kab mob no tau ntev li ob hlis.
Hauv cov tshuaj, muaj kev xav tias tshuaj lom polyneuropathy ntawm keeb kwm ntawm cawv tsis tau kawm txaus, cov txheej txheem ntawm nws txoj kev loj hlob tsis nkag siab tag nrho.
Qhov laj thawj tseem ceeb yog qhov tsis muaj thiamine hauv lub cev thiab gastroduodenitis, uas tshwm sim tawm tsam keeb kwm ntawm kev haus cawv. Tsis tas li ntawd, cawv nws tus kheej muaj tshuaj lom rau lub paj hlwb.
Cov kua dej cawv polyneuropathy tuaj yeem ua rau mob subacute, mob, tab sis feem ntau daim ntawv subclinical, kuaj pom thaum kuaj tus neeg mob. Nws yog qhia nyob rau hauvme ntsis kev ua txhaum ntawm lub rhiab heev ntawm ko taw, degradation los yog tsis muaj reflexes ntawm lub Achilles leeg, mob ntawm cov nqaij ntshiv ntawm palpation. Feem ntau cov tshuaj lom polyneuropathy yog qhia nyob rau hauv symmetrical paresis, atrophy ntawm cov nqaij ntshiv ntawm lub flexors ntawm ob txhais taw thiab ntiv tes, txo rhiab heev ntawm "hnab looj tes" thiab "s thom khwm", mob nyob rau hauv lub ob txhais taw thiab ob txhais ceg ntawm ib tug tas mus li los yog tua hom, hlawv nyob rau hauv lub soles, edema, rwj thiab hyperpigmentation ntawm daim tawv nqaij ntawm extremities. Qee lub sij hawm tus kab mob no tuaj yeem ua ke nrog dementia, cerebellar degeneration, ib qho tsos mob ntawm epileptiformia. Tus neeg mob rov zoo li qub. Kev ua tiav ntawm kev kho mob yog nyob ntawm kev rov qab los lossis tshem tawm ntawm cawv. ICD code rau tshuaj lom polyneuropathy ntawm keeb kwm ntawm cawv yog G62.1.
Polyneuropathy thiab FOS lom
FOS, lossis organophosphorus tebchaw, tuaj yeem nkag mus rau tib neeg lub cev nrog rau cov tshuaj tua kab, cov roj lubricating thiab cov yas yas. Hauv kev mob hnyav nrog cov tshuaj no, cov tsos mob hauv qab no tshwm sim: tawm hws, hypersalivation, miosis, plab hnyuv, bronchospasm, urinary incontinence, fasciculations, convulsions, thiab tuag. Ob peb hnub tom qab, polyneuropathy tshwm sim nrog lub cev muaj zog. Kev tuag tes tuag taw nyuaj heev.
Kev kho mob polyneuropathy
hom kab mob paj hlwb no tshwm sim los ntawm kev noj cov tshuaj hauv qab no:
- Thaum kho nrog "Perhexylen" ntawm qhov ntau npaum ntawm 200-400 mg ib hnub, polyneuropathy tshwm sim tom qab ob peb lub lis piam. Nws manifests nws tus kheej nyob rau hauv ib tug txo nyob rau hauv rhiab heev, ataxia, paresis ntawm cov ceg. Hauv cov xwm txheej notshuaj tau tso tseg, tus neeg mob tau kho lawm.
- Isoniazid polyneuropathy txhim kho nrog qhov tsis txaus ntawm cov vitamin B 6 hauv cov neeg uas muaj caj ces ntawm nws cov metabolism. Hauv qhov no, pyridoxine tau muab tshuaj rau qhov ncauj.
- Tshaj "Pyridoxine" (50-300 mg / hnub) ua rau muaj kev hnov mob polyneutropopathy, mob taub hau hnyav, qaug zog thiab chim siab.
- Kev kho mob ntev nrog Hydrolazine tuaj yeem ua rau dysmetabolic polyneuropathy thiab xav tau cov vitamin B ntxiv 6.
- Txais cov tshuaj "Teturam" ntawm koob tshuaj 1.0-1.5 g / hnub tuaj yeem qhia hauv paresis, tsis hnov tsw, optic neuritis.
- Kev kho nrog Kordaron ntawm koob tshuaj 400 mg / hnub rau ntau tshaj ib xyoos tuaj yeem ua rau muaj mob polyneutropopathy.
- Nrog tsis muaj cov vitamins B 6 thiab E, polyneutropathies kuj tshwm sim, nrog rau lawv cov ntau dhau.
Tshuaj lom polyneuropathy ICD 10 tsim tus lej G62.0.
Endogenous toxic polyneutropathies
Hom kab mob no tshwm sim feem ntau vim yog kev ua haujlwm tsis zoo ntawm cov qog endocrine, vim yog qhov tsis txaus ntawm cov tshuaj hormones tsim nyog, lossis ua txhaum txoj haujlwm ntawm lwm yam kabmob sab hauv ntawm tus neeg. Muaj cov hauv qab no:
- Mob ntshav qab zib polyneuropathy tuaj yeem pib mob hnyav, nce qeeb lossis sai sai. Nws tshwm sim thawj zaug hauv daim ntawv ntawm qhov mob thiab tsis hnov tsw ntawm caj dab.
- Polyneuropathy cuam tshuam nrogParaproteinemia thiab dysproteinemia feem ntau tshwm sim hauv cov neeg laus thiab cuam tshuam nrog cov kab mob xws li ntau yam myeloma thiab macroglobulinemia. Kev kho mob tshwm sim tau tshwm sim nyob rau hauv qhov mob thiab paresis ntawm cov ceg qis thiab sab sauv.
- Polyneuropathy kuj tsim muaj kab mob sib kis kab mob: periarthritis nodosa, rheumatoid mob caj dab, kab mob lupus erythematosus, scleroderma.
- Hepatic polyneuropathy yog qhov tshwm sim ntawm ntshav qab zib thiab haus dej cawv thiab muaj cov lus qhia zoo sib xws.
- Neurological mob nyob rau hauv cov kab mob ntawm lub plab hnyuv kab mob yog txuam nrog cov pathology ntawm lub plab zom mov, ua rau beriberi. Kab mob Celiac tuaj yeem ua rau mob polyneuropathy, uas tau qhia hauv psychomotor ntshawv siab, qaug dab peg, tsis pom kev, ataxia.
Polyneuropathy tom qab kws khomob
Toxic polyneuropathy tom qab kws khomob tau muab cais tawm ua ib pawg ntawm cov kab mob, vim tias nws tuaj yeem ua rau muaj kev phiv los ntawm kev noj tshuaj lossis yog qhov tshwm sim ntawm kev lwj ntawm cov qog hlwb. Nws ua rau lub cev o, paj hlwb thiab txoj hauv kev puas. Qhov tshwm sim no tuaj yeem cuam tshuam los ntawm kev muaj ntshav qab zib, cawv, mob siab thiab raum tsis ua haujlwm. Cov kab mob no tau qhia nyob rau hauv kev ua txhaum ntawm rhiab heev thiab kev txav tsis zoo, txo qis hauv cov leeg ntawm cov leeg nqaij. Polyneuropathy tom qab kws khomob, cov tsos mob uas tau piav qhia saum toj no, tuaj yeem ua rau lub cev tsis muaj zog. Autonomic thiab central nervous system disorders tsis tshua muaj.
Kev kho tus kab mob no txo qis raukev kho mob. Tus neeg mob tuaj yeem muab tshuaj tua kab mob, tshuaj tua kab mob, tshuaj tiv thaiv kab mob, tshuaj hormonal, vitamins Neuromultivit thiab Thiamine.
kuaj mob
Tshuaj lom polyneuropathy ntawm qis qis yog kuaj los ntawm cov kev sim hauv qab no:
- Ultrasound thiab X-ray ntawm lub cev sab hauv;
- cerebrospinal kua tsom xam;
- kawm txog kev cuam tshuam thiab qhov nrawm ntawm nws txoj kev hla ntawm cov hlab ntsha;
- biopsy.
Kev vam meej ntawm kev kho mob polyneuropathy nyob ntawm qhov raug thiab sijhawm ntawm kev kuaj mob.
Txoj kev kho tus kab mob
Toxic polyneuropathy, kev kho mob uas feem ntau ua rau kub hnyiab kom tshem tawm qhov ua rau nws tshwm sim, yuav tsum tau txiav txim siab dav.
Nyob ntawm hom kab mob thiab qhov hnyav ntawm nws cov chav kawm, cov tshuaj hauv qab no tau sau tseg:
- "Tramadol" thiab "Analgin" - rau qhov mob hnyav.
- "Methylprednisolone" - nyob rau hauv rooj plaub tshwj xeeb ntawm tus kab mob hnyav.
- "Pentoxifylline", "Vazonite", "Trental" - txhawm rau txhim kho cov ntshav ntws ntawm cov hlab ntsha ntawm cov hlab ntsha.
- "Piracetam" thiab "Mildronate" - txhawm rau txhim kho kev nqus ntawm cov as-ham los ntawm cov ntaub so ntswg.
Vitamin B.
Raws li txoj kev kho lub cev tuaj yeem siv tau:
- electrostimulation ntawm lub paj hlwb;
- kho mob massage;
- magnetic stimulation ntawm lub paj hlwb;
- kev cuam tshuam ncaj qha rau lub cev;
- hemodialysis, ntshav purification.
- kev tawm dag zog.
Tus kws kho mob yuav tsum txiav txim siab seb txoj kev kho mob polyneuropathy yog qhov tsim nyog tshaj plaws hauv ib kis. Nws yog qhov tsis yooj yim sua kom tsis quav ntsej cov tsos mob ntawm tus kab mob. Mob polyneuropathy tuaj yeem dhau los ua mob ntev, uas cuam tshuam nrog kev tsis hnov tsw ntawm cov ceg, leeg nqaij atrophy thiab ua kom tsis muaj zog.
