Dysarthria ntawm kev hais lus hauv tus menyuam yog ib yam kab mob uas tshwm sim los ntawm kev puas tsuaj rau lub hauv nruab nrab thiab sab hauv ntawm lub paj hlwb. Nws yog tus cwj pwm los ntawm ntau yam kev hais lus thiab kev txav mus los.
Qhov laj thawj tseem ceeb
Dysarthria tsis tshua muaj kev sib cais, feem ntau tshwm sim tawm tsam keeb kwm ntawm ntau yam kab mob ntawm lub paj hlwb. Cov laj thawj rau nws qhov tshwm sim tuaj yeem yog:
- CP;
- meningitis;
- ncephalitis;
- neurosyphilis;
- mob hlwb raug mob;
- stroke;
- purulent otitis media;
- neoplasms hauv hlwb;
- ntau yam sclerosis;
- myasthenia gravis;
- cerebral atherosclerosis;
- oligophrenia.
Ntau tus kab mob yog ib qho tsos mob ntawm cerebral palsy. Raws li qhov tshwm sim ntawm qhov tshwm sim ntawm tus kab mob no zoo ib yam li ua rau mob hlwb palsy.
Yog li ntawd, dysarthria hauv cov menyuam yaus preschool tuaj yeem tshwm sim los ntawm:
- intrauterine hypoxia;
- toxicosis;
- Rh tsis sib haum;
- yug raug mob;
- muaj tus kab mob somatic hauv poj niam;
- genericpathology;
- asphyxia;
- kab mob hemolytic;
- prematurity.
Ua rau lub sijhawm tom qab embryonic
Nyob rau lub sijhawm postembryonic, kev loj hlob ntawm tus kab mob no tuaj yeem tshwm sim los ntawm cov kab mob neuroinfection, piv txwv li:
- meningitis;
- Yhydrocephalus;
- mob hnyav ntawm lub cev;
- mob hlwb raug mob.
Kuj ua rau dysarthria yog ntau yam sclerosis, amyotrophic lateral sclerosis, Parkinson's disease, myotonia, myasthenia gravis, cerebral atherosclerosis.
Symptoms
Muaj qee yam uas yuav pab cov niam txiv pom muaj tus kab mob no hauv tus menyuam.
Tau kawg, yuav tsum sab laj nrog tus kws tshaj lij hauv txhua kis.
Cov tsos mob ntawm dysarthria suav nrog:
- Qhov muaj qhov tsis muaj zog ntawm cov leeg articulatory. Koj tuaj yeem pom nws los ntawm ntau yam, piv txwv li, yog tias tus menyuam lub qhov ncauj qhib thiab tus nplaig ntog tawm, daim di ncauj yog compressed, los yog, conversely, salivation yog nce.
- Xav zoo li tus menyuam hais lus ntawm qhov ntswg (tsis muaj tsos mob ua paug). Muaj ib tug distortion ntawm lub suab nyob rau hauv cov lus, yog vim li cas hais lus tsis meej kiag li.
- Kev hais lus ua pa tsis zoo, thaum hais lus, tus menyuam yuav ua pa thiab pib ua pa nrawm.
- Suab hloov, nws dhau los ua siab thiab squeaky.
- Kev nyuaj siab tshwm sim nrog lub suab nrov ntawm kev hais lus. Cov menyuam yaus uas muaj qhov kev kuaj mob no tsis tuaj yeem hloov suab, lawv cov lus hais yog monotonous, thiab lawv hais nrawm dhau lossismaj mam, tab sis yuav luag txhua zaus lawv cov lus tsis nkag siab.
Niam txiv txoj haujlwm
Cov niam txiv yuav tsum mob siab rau kev loj hlob ntawm lawv tus menyuam. Thaum muaj hnub nyoog ntxov heev, kev hais lus tsis zoo hauv tus menyuam tuaj yeem kuaj pom. Kev kuaj pom qhov ua txhaum cai sai dua, qhov zoo dua, vim tias yuav muaj sijhawm ntau los tiv tauj cov kws kho mob thiab npaj rau tsev kawm ntawv. Qee hom kab mob (los ntawm kev kho mob) tso cai rau cov menyuam kawm ntawv hauv tsev kawm ntawv, thiab lwm yam muaj qee yam kev kawm.
Kev faib tawm
Kev faib tawm ntawm cov kab mob no hauv cov menyuam yaus yog qhov tsis sib haum xeeb. Qhov no yog vim qhov tseeb tias CNS mob kis tau nyob rau hauv lub tsev menyuam los yog thaum yau yog qhov sib txawv ntawm cov kev hloov hauv cov neeg laus.
Tseem tseem ceeb heev yog qhov tseeb tias kev tsis taus ntawm kev hais lus thiab kev txawj tsav tsheb yog superimposed nyob rau lub sijhawm ntawm lawv txoj kev loj hlob.
Muaj ntau hom kev faib tawm ntawm dysarthria hauv cov menyuam yaus, tab sis lawv kuj muaj cov yam ntxwv zoo sib xws. Piv txwv li, yuav luag txhua tus kws kho mob tsis paub qhov txawv ntawm bulbar dysarthria, uas muaj nyob rau hauv cov neeg laus kev faib tawm. Qhov no yog vim lub fact tias lub dysfunction ntawm medulla oblongata pom nyob rau hauv no pathology yog incompatible nrog lub neej ntawm cov me nyuam mos. Rau txhua hom dysarthria, cov tsos mob hauv qab no yog yam ntxwv:
- Kev cuam tshuam hauv kev hais lus thiab nws cov kev txawj tsav tsheb.
- Hloov lossis ua tsis tiav ntawm kev hais lus tempo thiab suab tsim.
- Impaired muscle tone ua rau nyuaj rau lub ntsej muag.
- hais lus qeebkev loj hlob.
- Qee zaum daim duab kho mob tau ntxiv los ntawm kev txav mus los, hloov ntau yam kev nkag siab, kev puas siab puas ntsws, kev txawj ntse.
Qee tus kws kho mob cais cov menyuam dysarthria los ntawm kev hais lus tsis zoo.
Kev hais lus tsis raug rau lwm tus pom tsis pom. Lawv tsuas yog tsim los ntawm tus kws kho hais lus los ntawm kev kuaj tshwj xeeb. Cov theem hauv qab no yog qhov txawv ntawm no:
- Kev hais lus tsis zoo yog qhov pom tau rau cov neeg txawv, tab sis feem ntau nkag siab.
- hais lus slurred. Tsuas yog cov neeg txheeb ze thiaj li ua tau.
- hais lus ploj lossis nkag siab tsis muaj leej twg tuaj yeem ua tau.
Localization
Tseem muaj kev faib tawm ntawm tus kab mob los ntawm qhov chaw:
- pseudobulbar;
- subcortical;
- cortical;
- cerebellar.
Txawm li cas los xij, txoj hauv kev no siv tau ntau dua rau kev faib cov kab mob hauv cov neeg laus.
Tus yam ntxwv ntawm daim ntawv kho mob
Dysarthria yog ib pawg ntawm kev hais lus tsis zoo uas cuam tshuam nrog kev hloov pauv hauv lub paj hlwb. Cov neeg mob muaj ib tug fuzzy plurred articulation, ua txhaum ntawm pace thiab ntim ntawm kev hais lus. Cov ntaub ntawv ntawm dysarthria hauv menyuam yaus:
- Bulbar dysarthria. Koom nrog cov kab mob ntawm lub nuclei ntawm glossopharyngeal, trigeminal, lub ntsej muag, vagus, hypoglossal qab haus huv. Cov neeg mob muaj isflexia (kev ua txhaum ntawm kev ncaj ncees ntawm reflex arc), amimia (qhov nyuaj ntawm lub ntsej muag). Cov neeg mob yws yws ntawm kev nce salivation, nyuaj zom, nqos cov zaub mov. Hais lus slurred. Tag nrhoconsonants raug txo mus rau ib lub suab fricative. Lub suab sib txawv tsis tuaj yeem ua tau. Tej zaum yuav muaj nasalization ntawm timbre, dysphonia (tsis muaj zog, hoarseness ntawm lub suab) los yog aphonia (poob sonority ntawm lub suab thaum tuav lub peev xwm hais lus ntxhi).
- Pseudobulbar obliterated dysarthria hauv menyuam yaus. Kev ua txhaum cai tshwm sim los ntawm spastic paralysis thiab nqaij hypertonicity. Ntawm cov tsos mob ntawm qhov nyuaj ntawm kev tsa thiab txo tus nplaig, txav nws ntawm ib sab mus rau sab, nce salivation. Hloov cov haujlwm articulatory yog qhov nyuaj. Muaj kev ua txhaum ntawm qee qhov kev yeem txav mus los. Kev hais lus yog slurred thiab slurred. Whistling and hissing sound nyuaj.
- Subcortical dysarthria. Cov tsos mob tseem ceeb yog qhov tshwm sim ntawm hyperkinesis (cov leeg tsis muaj zog). Pom tau suav nrog hauv thaj tsam ntawm cov leeg ntawm lub ntsej muag. tshwm sim thaum so thiab thaum sim hais lus. Cov neeg mob yws txog qhov hloov pauv ntawm lub cav thiab lub zog ntawm lub suab. Qee lub sij hawm lawv tuaj yeem ua suab tsis txaus ntseeg.
- Cerebellar dysarthria. Nws tshwm sim los ntawm kev ua txhaum ntawm kev sib koom ua ke ntawm kev hais lus, ua rau muaj kev hais lus tsis sib haum xeeb. Qee lub sij hawm tus kheej lub suab, qw nrov tuaj yeem pom. Cov neeg mob yws ntawm qhov tshee ntawm tus nplaig. Lub suab sab nrauv thiab labial yog qhov nyuaj. Muaj ataxia (kev tshuav tsis taus, tsis khov kho).
- Cortical erased dysarthria hauv menyuam yaus. Nws yog characterized los ntawm lub xub ntiag ntawm deviations nyob rau hauv arbitrary articulation. Muaj kev ua txhaum ntawm timbre thiab lub suab. Tsis muaj prosody. Hauv ntau hom kab mob no, tej zaum yuav muaj teeb meem hauv kev hais suab, nyeem ntawv, sau ntawv,hais lus nkag siab.
Diagnosis
Cov kws kho mob tshwj xeeb tsis kuaj mob dysarthria kom txog thaum lawv kawm cov yam ntxwv ntawm tus menyuam lub siab. Cov kev tshawb fawb saum toj no yuav tsum tau soj ntsuam tag nrho cov duab kev loj hlob thiab txiav txim siab qhov sib txawv hauv kev ua haujlwm ntawm lub hauv nruab nrab paj hlwb. Txhawm rau txheeb xyuas, koj yuav tsum paub cov yam ntxwv ntawm cov theem ntawm kev tsim ntawm lub hauv paus paj hlwb ntawm tus menyuam.
Muaj peb theem:
- thawj theem thaum muaj hnub nyoog rau lub hlis. Nyob rau lub sijhawm no, hauv cov menyuam yaus noj qab haus huv thiab cov menyuam yaus uas tau kuaj pom tias muaj dysarthria, tsis muaj lub cev muaj zog reflexes raug pom, piv txwv li, ib qho kev taw qhia, kev sib tw reflex. Lub cev ntawm tus menyuam yog compressed, caj npab yog nruj, ob txhais ceg yog khoov. Thaum kawg ntawm thawj theem ntawm cov menyuam yaus noj qab nyob zoo, muaj kev hloov pauv mus rau qhov normalization ntawm kev txav. Yog tias qhov no tsis tshwm sim, ces qhov teeb meem ntawm lub hauv paus paj hlwb tau teev tseg hauv tus menyuam.
- theem thib ob thaum muaj hnub nyoog 6 hli txog 11 lub hlis. Cov theem no hauv cov menyuam yaus noj qab haus huv yog tus cwj pwm los ntawm kev hloov pauv los ntawm kev tsis txaus siab rau kev txav mus los, piv txwv li, tus menyuam tuaj yeem zaum ntawm nws tus kheej, paub qhov txawv ntawm lub suab, tib neeg, lub ntsiab lus ntawm cov lus, khoom. Tus me nyuam loj hlob babble los ntawm ib tug vowels.
- Qhov thib peb thaum muaj hnub nyoog ib txog peb xyoos. Nyob rau theem no, tus me nyuam noj qab nyob zoo tau hloov maj mam txav tes. Thaum pib ntawm theem, nws nkag mus, thiab thaum kawg nws pib taug kev. Pib sau cov lus. Hauv cov menyuam yaus uas tau tshem tawm dysarthria, kev hais lus raug tsim. Yog hais tias tus me nyuam loj hlob ib txwm, ces thaum hais cov lus, ua pa yog du thiab tsis muaj inexplicable pauses. Yog tias thaum kawg ntawm theem peb tus menyuam tsis uaCov cim saum toj no raug kuaj pom, tom qab ntawd peb tuaj yeem tham txog qhov teeb meem ntawm lub paj hlwb.
Cov kauj ruam saum toj no tso cai rau koj txhawm rau txheeb xyuas qhov ua txhaum cai ntawm kev hais lus hauv tus menyuam. Kev kho mob dysarthria hauv cov menyuam yaus tsuas yog ua tom qab kuaj pom xwb!
Kho kom raug
Kho cov yam ntxwv ntawm cov menyuam yaus uas muaj dysarthria tuaj yeem raug sau los ntawm kws kho mob paj hlwb, thiab cov txheej txheem nws tus kheej suav nrog kev ntsuas txhawm rau tshem tawm cov kab mob hais lus tsis zoo, vim tias tus kab mob nws tus kheej ua rau kev hais lus tsis zoo, thiab qee zaum nyuaj rau kev hais lus. Kev kho ntawm dysarthria yuav tsum tau ua nyob rau hauv ib qho nyuaj, nrog rau kev kho tshuaj thiab kho lub cev.
Tus kws kho mob hlwb feem ntau sau rau cov neeg mob xws li:
- kev npaj vascular: "Cavinton", "Vinpocetine", "Instenon", "Gliatilin";
- nootropic tshuaj - Pantocalcin, Nootropil, Encephabol, Picamilon;
- tshuaj metabolic - Cerebrolysate, Actovigin, Cortexin, Cerebrolysin;
- vitamin complexes - "Milgamma", "Neuromultivit";
- sedatives - Persen, Novopassit, Tenoten.
Ib txoj hauv kev zoo tshaj plaws ntawm kev kho lub cev kho mob ntawm dysarthria yog zaws. Nws yog ua tiav nrog kev saib xyuas zoo, vim tias lub zog quab yuam tuaj yeem ua rau rov ua kom lub qhov ncauj reflex.automation.
Recommendations
Ua haujlwm nrog menyuam yaus nrog dysarthria suav nrog:
- Massaging lub nasolabial quav. Ua li no, ua los ntawm 5 mus rau 7 txav ntawm lub qhov ntswg mus rau daim di ncauj, lub teeb tapping ntawm nasolabial folds. Koj tuaj yeem zaws qhov no nrog zigzag, wavy thiab kauv txav. Acupressure tuaj yeem ua tiav ntawm cov ces kaum ntawm daim di ncauj.
- massage di ncauj. Nws yog ua tiav nrog ob tug ntiv tes los ntawm nruab nrab ntawm daim di ncauj sab sauv thiab sab qis mus rau cov ces kaum. Tsis tas li ntawd, koj tuaj yeem ua rau kauv txav raws sab sauv thiab sab di ncauj, zoo sib xws txav raws nruab nrab ntawm daim di ncauj. Nws kuj pom zoo kom tingle ntawm nruab nrab ntawm daim di ncauj.
- Ntxhais Ntuj. Ua li no, nrog kev pab ntawm ob tug ntiv tes, lub palate yog massaged, pib ntawm cov hniav pem hauv ntej mus rau nruab nrab ntawm lub qhov ncauj kab noj hniav. Ua ntej txheej txheem, txhais tes yuav tsum tau qhwv hauv gauze.
Kuj ua tapping los ntawm incisors, zigzag, undulating, ncig motions. Tsis tas li ntawd, kev zaws tus nplaig, uas siv cov kev taw qhia saum toj no, yuav pab tau.
Huab cua thiab tiv thaiv
Kev pom zoo rau kev kho cov lus hauv dysarthria tuaj yeem tau txais nrog kev pib kho raws sijhawm. Kev vam meej ntawm kev kho mob feem ntau yog nyob ntawm qhov tseeb ntawm cov txheej txheem kho mob thiab kev mob siab rau tus neeg mob nws tus kheej.
Erased dysarthria muaj qhov pom zoo rau kev ua kom tiav tom qab kho tag nrho. Cov neeg mob uas muaj tus mob dysarthria no tuaj yeem mus kawm cov tsev kawm ntawv tseem ceeb tom qab kho.
Cov ntawv mob dysarthria tag nrhotsis kho. Nyob rau hauv cov neeg mob uas muaj xws li dysarthria, tsuas yog ib qho kev txhim kho ntawm kev hais lus muaj nuj nqi. Kev tiv thaiv ntawm dysarthria hauv cov menyuam yaus raug txo kom siv cov kev kho xws li echolalia thiab echopraxia.
Qhov tshwm sim ntawm dysarthria tshwm sim nws tus kheej hauv cov menyuam mos tom qab ib hlis ntawm lub neej. Yog li ntawd, yog tias thaum yug los muaj cov kab mob uas tuaj yeem ua rau muaj mob, tom qab ntawd kev loj hlob ntawm tus me nyuam los ntawm thawj hnub yuav tsum tau teeb tsa kom txhua yam ua rau muaj kev tsim nyog ntawm nws lub zog thiab lub hlwb.
Kev tiv thaiv hauv qhov no muaj nyob rau hauv kev sib txuas lus tas li ntawm tus menyuam nrog cov neeg laus, uas yuav pab txhawb kev loj hlob ntawm nws lub peev xwm hais lus.
Kev tiv thaiv ntawm dysarthria hauv cov menyuam yaus uas muaj mob hlwb yog txhawm rau tiv thaiv cov kab mob neuroinfections, hlwb raug mob, muaj tshuaj lom.
