Encephalopathy, unspecified - ib tug kab mob ntawm chav kawm VI (cov kab mob ntawm lub paj hlwb), uas muaj nyob rau hauv lub block G90-G99 (lwm yam kab mob ntawm lub paj hlwb) thiab muaj ib tug kab mob code G93.4.
Kev piav qhia kab mob
Encephalopathy yog ib yam kab mob uas tsis yog nyob hauv lub hlwb. Nws tau nthuav tawm los ntawm kev tuag ntawm cov paj hlwb vim kev raug ntes, oxygen tshaib plab thiab kab mob.
txhawm rau txheeb xyuas cov kab mob, cov kws kho mob tshwj xeeb yuav tsum paub qhov chaw hais tawm ntawm qhov txhab, qhov chaw ntawm tus kab mob hauv cov teeb meem grey lossis dawb ntawm lub hlwb, nrog rau qib ntawm cov ntshav tsis txaus. Yog tias qhov laj thawj ntawm tus kab mob tsis tuaj yeem tsim, ces lawv hu ua encephalopathy tsis tau teev tseg (idiopathic, uas yog, tshwm sim ntawm nws tus kheej). Feem ntau yog vascular.
Ua rau kab mob
Unspecified encephalopathy (ICD-10 kuaj kab mob G93.4) yog muab faib ua ob hom: congenital thiab kis tau. Congenital yog muab faib ua prenatal (thaum kev puas tsuaj tshwm sim txawm nyob rau hauv lub tsev menyuam) thiab perinatal (nyob rau hauv cov kev tshwm sim hais tias qhov kev puas tsuaj tshwm sim nyob rau hauv lub lis piam dhau los ua ntej yug me nyuam los yogtom qab ntawd). Hom kab mob no hu ua:
- tsis zoo, muaj cov txheej txheem txawv txav ntawm lub hlwb kev loj hlob;
- metabolic ntshawv siab hauv lub cev tshwm sim los ntawm caj ces;
- yog qhov ua rau tus menyuam tsis zoo thaum cev xeeb tub;
- mob hlwb raug mob uas tshwm sim hauv tus menyuam thaum yug menyuam.
YMitochondrial encephalopathy
Mitochondrial unspecified encephalopathy nyob rau hauv cov me nyuam mos yog cais raws li ib pab pawg neeg ntawm congenital kab mob. Nws yog tsim los ntawm kev ua txhaum ntawm kev ua haujlwm thiab cov qauv ntawm mitochondria.
Acquired encephalopathy
Acquired encephalopathy tau muab faib ua ntau hom vim muaj ntau yam kev puas tsuaj:
- Post-traumatic yog tshwm sim los ntawm kev raug mob craniocerebral ntawm nruab nrab thiab hnyav (piv txwv li, ntog los ntawm qhov siab, raug mob taub hau hauv cov kis las, kev sib tsoo, thiab lwm yam). Nrog rau hom kab mob no, ntau yam kab mob ntawm lub paj hlwb ntawm lub frontal thiab temporal lobes, atrophic hloov pauv (shrinkage thiab shrinkage ntawm lub paj hlwb), hydrocephalus raug soj ntsuam.
- Toxic encephalopathy, tsis tau qhia rau cov neeg laus, tshwm sim vim muaj tshuaj lom los ntawm ntau yam co toxins: cawv, tshuaj tua kab ntau, hlau hnyav, roj av, thiab lwm yam. Nws yog feem ntau tshwm sim los ntawm ntau yam kev ntxhov siab thiab kev puas siab puas ntsws (insomnia, ntxhov siab vim, chim siab, hnov lus, mob taub hau ntev, thiab lwm yam).
- Radiation yog qhov tshwm sim ntawm ionizing hluav taws xob ntawm lub cev thaum lub sijhawmmob hluav taws xob. Nrog rau cov kab mob no, ntau yam kev puas siab puas ntsws tau pom.
- Metabolic tshwm sim vim muaj cov kab mob metabolic tiv thaiv keeb kwm ntawm cov kab mob hauv nruab nrog cev: daim siab, ob lub raum, pancreas. Nws manifests nws tus kheej nyob ntawm seb cov khoom ntawm lub hauv paus pathology.
- Vascular encephalopathy. Qhov ua rau ntawm qhov tshwm sim tuaj yeem yog kev quav yeeb quav tshuaj, kev raug mob qub, atherosclerosis, ntshav qab zib, raug hluav taws xob thiab lwm yam uas ua rau mob hlwb. Cov tsos mob ntawm tus kab mob no yog: poob ntawm cov qauv thiab kev ntseeg siab, nquag mob taub hau, kev nyuaj siab, ib feem poob ntawm nws tus kheej nco.
- Hypoxic yog qhov tshwm sim ntawm kev tshaib plab ntev oxygen. Ua rau muaj teeb meem loj neuralgic.
Thiab qhov no tsis yog txhua yam.
Nyob rau me nyuam
Muaj ib qho kev mob encephalopathy uas tsis tau teev tseg hauv cov menyuam yaus. Yog li, vim muaj kev raug mob hauv plab, kab mob los yog lwm yam ua rau, qhov seem encephalopathy raug kuaj pom hauv cov menyuam yaus. Daim ntawv venous yog ib yam ntawm cov vascular daim ntawv, uas yog manifested los ntawm stagnation ntawm venous ntshav nyob rau hauv lub hlwb vim yog ua txhaum ntawm nws outflow.
Metabolic encephalopathy tau muab faib ua ntau hom:
- Bilirubin pom tsuas yog hauv cov me nyuam mos xwb. Nws tsim tawm tsam keeb kwm yav dhau los ntawm kev tsis sib haum xeeb ntawm cov ntshav ntawm leej niam thiab tus menyuam hauv plab, nrog rau cov kab mob toxoplasmosis, jaundice, thiab ntshav qab zib hauv leej niam. tshwm simqaug zog, tsis muaj zog, tsis qab los noj mov, belching, ntuav.
- Gaye-Wernicke encephalopathy tshwm sim vim tsis muaj vitamin B1. Cov xwm txheej tsis zoo tuaj yeem tshwm sim vim kev haus dej cawv, hnyav beriberi, HIV, malignant neoplasms. Feem ntau tshwm sim los ntawm hallucinogenic syndrome, ntxhov siab vim xeev.
- Leukoencephalopathy yog tshwm sim los ntawm kev ua txhaum ntawm cov teeb meem dawb ntawm lub hlwb. Tus kab mob no zuj zus. tshwm sim tom qab kis kab mob vim qhov txo qis hauv kev tiv thaiv lub cev.
- Atherosclerotic txhim kho feem ntau yog vim kev ua txhaum ntawm lipid metabolism hauv lub cev. Manifested los ntawm kev qaug zog ntxiv, tsis muaj zog, kiv taub hau, mob taub hau, pw tsaug zog, kev sib cais.
Cov kws tshawb fawb tau hais tias qhov ua rau ntawm txhua hom kev mob encephalopathy yog feem ntau lub hlwb hypoxia (tsis muaj oxygen). Qhov no tshwm sim vim qhov tseeb hais tias lub cev pib ntxuav nrog cov ntshav tsis zoo, ntau dhau venous accumulations, edema, thiab hemorrhages tshwm. Anoxic encephalopathy tuaj yeem tshwm sim vim qhov tsis txaus ntawm cov as-ham rau cov neurons thiab nws thiaj li sawv tawm raws li cov kab mob sib cais. Metabolic encephalopathy yog ib qho tshwj xeeb ntawm cov tshuaj lom, thaum co toxins tsis tawm, vim lawv nkag mus rau hauv cov hlab ntsha.
Muaj ntau theem hauv kev txhim kho tus kab mob no. Cov kws tshaj lij paub qhov txawv ntawm lawv cov hauv qab no:
- Thaum pib lossis thawj theem, tus neeg mob lub cim xeeb qis, nwschim siab, pw tsis tsaug zog thiab pw tsaug zog ntxhov siab, thiab mob taub hau.
- Thaum tus kab mob thib ob tau tshaj tawm, txhua tus tsos mob hnyav dua. Ntxiv nrog rau kev mob taub hau thiab pw tsaug zog, tus neeg mob tuaj yeem yws txog kev tsis txaus siab thiab qaug zog.
- Nyob rau theem thib peb, kev hloov pauv loj hauv lub hlwb raug kuaj pom, muaj paresis, kev hais lus cuam tshuam, vascular parkinsonism tshwm sim.
Symptoms
Kev tshwm sim ntawm qhov tsis paub meej encephalopathy txawv heev nyob ntawm qhov hnyav, hom, hnub nyoog, thiab kev kho mob siv. Raws li txoj cai, nyob rau hauv thawj theem ntawm tus kab mob, pw tsaug zog cuam tshuam, lethargy, pw tsaug zog nyob rau hauv nruab hnub, tsis nco qab-mindedness, tearfulness, tsis txaus siab, nce qaug zog, nco tsis tau, muaj peev xwm puas hlwb raug sau tseg. Mob, suab nrov thiab lub suab nrov hauv lub taub hau, txo qis kev hnov lus thiab pom kev ua haujlwm, lub siab hloov pauv, kev ua haujlwm tsis zoo, kev chim siab kuj yuav pib tshwm sim.
Cov tsos mob tshwm sim li cas thaum tus kab mob loj tuaj?
Nyob rau hauv cov neeg mob siab heev, cov tsos mob tuaj yeem tshwm sim, ua rau Parkinsonism (kev txav qeeb ua ke nrog kev tshee tshee) thiab pseudobulbar tuag tes tuag taw (tshem tawm los ntawm kev ua txhaum ntawm kev hais lus, zom thiab nqos dej). Tsis tas li ntawd, tsis txhob hnov qab tias kev puas siab puas ntsws (kev nyuaj siab, kev xav tua tus kheej, phobias) tuaj yeem txhim kho. Xav txog yuav ua li cas encephalopathy, tsis tau qhia G 93.4, kuaj pom hauv cov menyuam mos thiab cov laus.
Kev kuaj mob encephalopathy, tsis qhia meej
Yuav kom tsim tau tus kab mob kom raug, tus kws kho mob yuav tsumUa tib zoo txheeb xyuas tus neeg mob keeb kwm rau kev puas tsuaj rau lub hlwb, qaug zog, atherosclerosis, raum, siab, ntsws, kab mob pancreatic, kub siab, raug hluav taws xob, nrog rau kev kis tau lossis cov kab mob metabolic.
Txhawm rau kuaj mob encephalopathy, tsis tau qhia G 93.4, cov txheej txheem hauv qab no tau ua:
- Tau suav suav.
- Ua tiav urinalysis.
- Ntau yam kev ntsuas metabolic (siab enzymes, qabzib, electrolytes, ammonia, lactic acid, ntshav oxygen).
- ntsuas ntshav siab.
- CT thiab MRI (kom kuaj pom cov qog hlwb, ntau yam anatomical anomalies, kab mob).
- Tshuaj thiab tshuaj lom (cocaine, cawv, amphetamines).
- YDoppler ultrasound.
- EEG lossis encephalogram (kom kuaj pom lub hlwb tsis ua haujlwm).
- Autoantibody testing.
Cov no nyob deb ntawm txhua qhov kev sim uas xav tau los kuaj xyuas. Tsuas yog tus kws kho mob tuaj koom tuaj yeem sau qee yam kev sim raws li tus neeg mob cov tsos mob thiab keeb kwm kho mob.
Kev kho mob encephalopathy
Kev kho mob ntawm tus mob encephalopathy uas tsis tau teev tseg yog txhawm rau tshem tawm cov laj thawj thiab cov tsos mob uas ua rau muaj kev cuam tshuam rau kev loj hlob ntawm tus kab mob no. Yeej, kev saib xyuas thiab kev kho mob yog siv los kho.
Yog tus kab mob mob hnyav, ces kho thawj qhov chawtsom rau txo intracranial siab thiab tshem tawm qaug dab peg. Rau qhov no, ua kom lub ntsws ua pa, ua kom cov ntshav ua kom huv, thiab cov as-ham yog muab los ntawm ib lub dropper.
Tshuaj
Tus neeg mob tau muab tshuaj noj rau ob peb lub hlis:
- ntau yam lipotropic tshuaj uas pab normalize cov metabolism ntawm cov roj cholesterol thiab cov rog (cov tshuaj noj nrog choline, methionine, carnitine, lecithin, "Lipostabil");
- tshuaj tiv thaiv thrombosis (Ginkgo Biloba, Aspirin, Cardiomagnyl);
- angioprotectors tau sau rau ntau yam kab mob hauv lub plawv kom normalize cov phab ntsa ntawm cov hlab ntsha, txav thiab tawm ntawm cov ntshav venous ("Troxerutin", "Detralex", "Indovazin");
- neuroprotectors rau nourishing paj hlwb (pawg B vitamins, Piracetam;
- tranquilizers thiab sedatives kom tsis tshua muaj cov hlab ntsha nrawm nrawm hauv cov neurons cuam tshuam ("Sibazon");
- vitamins thiab amino acids;
- ntau yam kev ua haujlwm stimulants.
Kuj, kom rov zoo sai, kho lub cev, kho mob acupuncture, taug kev, gymnastics, zaws, thiab qee qhov kev so kom zoo. Dab tsi yog qhov kev mob tshwm sim rau kev kuaj mob encephalopathy, tsis tau teev tseg?
kab mob prognosis
Rau txhua yam encephalopathy yog qhov tshwm sim los ntawm ntuav, xeev siab, kiv taub hau thiab mob taub hau. Yog hais tias mob hlwb puas (los yog edema) tshwm sim, ces tus kab mob no heev sharply, tshwmkiv taub hau, mob taub hau heev, nyob tsis tswm, tsis pom kev thiab lwm yam.
Cov teeb meem ntawm encephalopathy ntawm lub hauv paus tsis tau qhia yog:
- coma;
- tus kab mob;
xav
Yog tias koj ua raws li koj tus kws kho mob cov lus pom zoo, koj tuaj yeem cia siab tias yuav muaj qhov tshwm sim zoo. Txawm li cas los xij, yog tias tus kab mob pib, ces lawv tuaj yeem txhim kho:
- mob vwm;
- tus tuag tes tuag taw, ntau yam kev txav mus los;
- poob lub hlwb ua haujlwm, nco, kev txawj ntse;
- kev tsis txaus siab, kev nyuaj siab, kev xav hloov;
- kev tsis taus.
