Ntawm lwm cov kev puas siab puas ntsws, kev hnov lus ntawm ib qho xwm txheej yog ib qho teeb meem uas tus neeg mob yuav ua rau hnov lus. Lub zeem muag tuaj yeem haunt tsis tu ncua, lwm txoj kev xaiv yog kev rov qab ua ntu zus. Feem ntau cov no yog cov duab pom lossis hnov zoo li tshwm sim. Ib tug neeg thaum lub sij hawm tawm tsam tswj kom meej meej ntawm kev nco qab. Ib txhia to taub lub ntsiab ntawm qhov uas pom thiab hnov, ib txhia tsis paub tias qhov no yog ib tug hallucination. Qee qhov xwm txheej, kev txhais lus tsis zoo ntawm qhov tshwm sim raug pom, txawm hais tias qhov ua tau ntawm kev xav zoo yog feem ntau khaws cia.
Differential Diagnosis
Qhia meej txog tus mob hallucinosis, nws yog ib qho tseem ceeb kom kuaj xyuas kom raug. Cov txheej txheem rau kev faib cov ntaub ntawv tau piav qhia hauv thoob ntiaj teb ICD classifier hauv kab F06. Thaum kuaj xyuas qhov ua tau zoo ntawm cov cim pom hauv tus neeg mob, nws tseem yuav tsum tau nco ntsoov tias qhov kev hnov mob ntau npaum li cas, seb lawv nyob li cas, thiab seb puas muaj kev xav rov qab los. Kev tsim yuav tsum yog qhov tseeb. Thaum qhia meej rau lub xeev, nws yuav tsum tau ntsuas qhov kev txawj ntse - yuav tsum tsis txhob muaj qhov txo qis.
Raws li ICD 10,Organic hallucinosis tsis nrog qee qhov kev xav tsis meej, uas tau pom ntau lub sijhawm. Tsis muaj kev xav tsis zoo. Yog tias tus neeg mob tuaj yeem txheeb xyuas cov tsos mob ntawm tus kab mob no, yuav tsum tau kuaj xyuas qhov txawv ntawm cov kab mob pathological hauv nqe lus nug.
About the nuances of diagnostics
Raws li qhov kev faib tawm ICD tam sim no, cov organic hallucinosis suav nrog lub xeev tsis muaj cawv thiab dermatozoic delusions.
Shizophrenia lossis kev hnov lus nyob hauv qab cawv yuav tsum tsis txhob suav nrog hauv qhov kev kuaj mob no. Lawv nyob rau hauv pab pawg ntawm kev kuaj mob coded li F20 thiab F10.52.
Kev kuaj mob thiab cov lej
Muaj ntau pawg hauv pawg F06. Txhua qhov xwm txheej tau muab rau ib pab pawg tshwj xeeb, raws li cov tsos mob ntawm kev hnov lus, qhov ua rau nws ua rau nws thiab cov yam ntxwv ntawm chav kawm.
Cov pab pawg xoom suav nrog cov kab mob tshwm sim los ntawm lub hlwb raug mob, thawj - kab mob cerebrovascular, thib ob - mob vwm. Pab pawg thib peb suav nrog cov xwm txheej vim muaj cov txheej txheem qog nqaij hlav hauv hlwb, plaub - HIV, thib tsib - syphilis uas cuam tshuam rau lub paj hlwb. Pab pawg thib rau suav nrog cov xwm txheej cuam tshuam nrog lwm cov kab mob thiab cov kab mob uas tau kis tus kab mob hauv lub paj hlwb. Pawg xya yog cov organic hallucinosis vim cov kab mob uas tsis yog cov uas tau hais los saum toj no, qeb yim yog cov kab mob sib xyaw, thiab qeb cuaj yog cov kab mob uas tsis tau teev tseg.
Nuances of case
Nyob rau hauv cov organic hallucinosis, qhov qhia tau meej tshaj plaws ntawm daim duab kho mob yog kev dag ntxias. Ntxiv nrog rau qhov tsis muaj peev xwm pom thiab hnov, muaj kev pheej hmoo ntawm tactile daim ntawv ntawm hallucinosis. Cov chav kawm kho mob yuav tsum raug xaiv tam sim ntawd, sai li sai tau raws li kev kuaj mob kom raug. Kev kho mob ntawm cov organic hallucinosis kav ib lub sij hawm ntev unpredictably - raws li cov yam ntxwv ntawm manifestations ntawm pathology.
Txhawm rau txo qhov tshwm sim ntawm qhov teeb meem, nws raug nquahu kom siv cov tshuaj tiv thaiv kab mob. Cov tshuaj antipsychotics nrov tshaj plaws yog amisulpiride thiab haloperidol. Hauv kev xyaum kho mob, zuclopenthixol thiab risperidone tau siv dav heev. Cov koob tshuaj yuav tsum raug xaiv raws li txoj hauv kev uas tus neeg mob lub cev zam cov tshuaj, thaum pom tias muaj txiaj ntsig zoo. Cov ntim yuav tsum khaws cia kom tsawg. Txhawm rau xaiv cov tshuaj uas tsim nyog tshaj plaws, monotherapy yog xyaum, ua tiav sim cov tshuaj sib txawv kom txog rau thaum qhov kev pom zoo tuaj yeem txiav txim siab.
About kho
Vim li cas qhov teeb meem ntawm cov organic hallucinosis dhau los ua mob hnyav dhau los? Lub neej expectancy nyob rau hauv cov neeg laus tau ntev lawm, thiab cov kws tshawb fawb pom tias qhov no ua rau muaj kev pheej hmoo ntawm kev puas hlwb. Kev nplua nuj ntawm kev ntxhov siab thiab kev puas tsuaj ntawm lub paj hlwb, qaug zog ntawm lub hlwb thiab ntau yam tsis zoo ua rau muaj qhov tseeb tias thaum muaj hnub nyoog laus, qhov tshwm sim ntawm kev puas siab puas ntsws nce ntxiv, thiab tus neeg laus dua, cov kev pheej hmoo loj dua.. Cov kev cov nyom ntxiv suav nrog qhov nyuaj ntawm kev xaiv tshuaj uas cov neeg laus tuaj yeem zam tau.
Qee zaum, kev kho ua ke tuaj yeem raug sau, siv ob yam tshuaj tib lub sijhawm. Feem ntau qhov no yog tsav los ntawm kev mob hallucinosis, nyob rau hauv uas peb successively siv tshuaj tsis qhia ib tug pronounced nyhuv. Nws raug coj mus rau hauv tus account tias qhov ntau npaum li cas yuav tsum txaus, thiab cov kev xaiv sim lawv tus kheej yuav tsum koom nrog ntau pawg ntawm cov tshuaj. Lub sijhawm sim tsis tseem ceeb - txhua txoj kev yuav tsum tau siv tsawg kawg peb lub lis piam, kom nws thiaj li ua tau kom raug txiav txim siab txog nws cov txiaj ntsig lossis tsis muaj nws.
Yuav ua li cas?
Yog tias cov organic hallucinosis xav tau kev sib xyaw ua ke ntawm cov tshuaj sib txawv, koj yuav tsum, yog tias ua tau, siv cov kev txhais tau tias qhov kev pheej hmoo ntawm kev tsim cov teebmeem extrapyramidal raug ntsuas tsawg heev. Cov no suav nrog cov tshuaj muaj clozapine thiab risperidone. Kev kho mob ntawm kev siv amisulpride thiab sertindole hauv kev kho ua ke yog qhov dav heev. Kuj tseem muaj kev nyab xeeb zoo (txog li nws ua tau raws li hauv paus ntsiab lus rau pab pawg tshuaj hauv kev xav) yog olanzapine.
Cov tshuaj tiv thaiv kev puas siab puas ntsws siv rau hauv cov organic hallucinosis txo qis cov tshuaj tiv thaiv kab mob, uas ua rau muaj teeb meem ntxiv yog tias tsim nyog los kho cov neeg mob uas muaj mob vwm. Clozapine, ua ke nrog phenothiazine formulations, txo qhov barrier ntau dua lwm tus.
Tsis txhob siv cov tshuaj tiv thaiv kab mob ntev ntev thaum twg ua tau.
Thaum xaiv haloperidol ib hnub twg, tus neeg mob tau muab tshuaj 5-15 mg, rau risperidone qhov koob tshuaj zoo tshaj plaws yog los ntawm 2 mg mus rau ob zaug ntawm qhov ntim. Zuclopenthixol raug tshuaj nyob rau hauv ib tug npaum li ntawm 2-10 mg ib hnub twg, nyob rau hauv tsawg thiab tshwj xeeb tshaj yog mob hnyav - 20 mg.
Txais tau ntim ntawm trifluoperazine sib txawv ntawm 5-15 mg, clozapine - 50-200 mg. Thaum muab tshuaj amisulpride, tus kws kho mob feem ntau pom zoo kom tus neeg mob noj 400-800 mg ib hnub. Thaum xaiv olanzapine, qhov kev pom zoo yog 510 mg rau ib hnub.
Hais txog tus kab mob: qee yam nta
Ntawm qhov nruab nrab, cov organic hallucinosis raug kuaj pom hauv cov poj niam 10% ntau dua li cov txiv neej. Cov pab pawg muaj kev pheej hmoo yog cov txiv neej hnub nyoog 55 txog 60 xyoo, rau cov poj niam qhov kev txwv siab dua - los ntawm 75 txog 80 xyoo. Tus kab mob no yog nyob rau hauv chav kawm ntawm cov kab mob uas muaj kev phom sij rau kev sib raug zoo raug ntsuas raws li qhov qis los yog tsis muaj kiag li. Pathogenesis yuav tsum tau siv cov tshuaj uas tswj cov ntshav khiav hauv lub hlwb, cov txheej txheem metabolic hauv lub cev. Xws li kev kho mob xav tau ob qho tib si nyob rau theem ntawm tus mob hnyav thiab thaum kho kho.
Feem ntau cov organic hallucinosis tshwm sim ntawm keeb kwm ntawm qaug dab peg. Yog tias qaug dab peg thab tus neeg rau ib xyoo caum lossis ntau dua, qhov tshwm sim ntawm kev tsim kho hallucinosis yog kwv yees siab heev. Txawm li cas los xij, qaug dab peg tsis yog tib qho laj thawj uas tuaj yeem ua rau muaj tus mob pathological. Cov ntaub ntawv tau paub thaum twgorganic hallucinosis tau pom tom qab raug mob, encephalitis, nyob rau hauv tus ntawm neoplasm, sclerosis. Organic hallucinosis tuaj yeem tshwm sim nrog kev siv ntev thiab tsis raug cai ntawm steroids, hallucinogens thiab lwm yam sib txuas uas cuam tshuam rau lub hlwb ntawm tus neeg. Ntev ntev manganese lom tuaj yeem ua lub luag haujlwm.
State Clinic
Tawm tsam keeb kwm ntawm cov organic hallucinosis, tus neeg mob feem ntau qeeb qeeb dua tus neeg noj qab haus huv, nkag siab txog qhov tshwm sim ib puag ncig. Nws muaj ib tug tsis zoo associative array. Cov neeg zoo li no tsis nyiam tham thiab qhia txog kev xav dryness, callousness. Feem ntau lawv zoo li qaug zog, thaum lawv tuaj yeem ua rau dysphoria, euphoria.
Muaj cov xwm txheej thaum cov neeg mob uas muaj cov kab mob hallucinosis tau txhoj puab heev yam tsis muaj laj thawj. Nws yog ib qho nyuaj rau lawv tswj lawv impulses, xwm ua impulsive. Koj tuaj yeem pom kev hnov lus los ntawm qee yam kev coj cwj pwm: tus neeg zoo li no hais lus stereotypically thiab tso dag monotonously.
Thaum tus mob loj tuaj, tus neeg mob yuav qaug zog, nco tsis zoo, thiab nws nyuaj rau rov tsim cov ntaub ntawv. Tsis ntev los sis tom qab, qhov no tuaj yeem ua rau dementia. Yog tias koj pib kho raws sijhawm, qhov kev cia siab feem ntau yog qhov zoo, tab sis ntau nyob ntawm tus kheej tus yam ntxwv ntawm tus neeg mob thiab kev ua tiav ntawm kev xaiv cov chav kawm kho mob. Kev noj tshuaj thiab kev kho mob thaum lub sijhawm txhawb nqa tsis muaj qhov tseem ceeb dua li ntawm theem ntawm kev puas siab puas ntsws.
Hallucinosis: yog dab tsi?
lo lus no yog siv los qhiaib lub xeev uas ib tug neeg raug kev txom nyem los ntawm hallucinations, thaum nco ntsoov khaws cia. Hauv feem pua ntawm cov neeg mob, kev hnov lus ib txwm nyob rau tib hom. Cov kab mob pathological nrog ib tus neeg tau ntau xyoo thiab tuaj yeem ua rau delirium.
Tam sim no nws nyuaj rau hais kom paub tseeb tias txhua yam ua rau hnov qab paub. Lawv tuaj yeem tshwm sim hauv schizophrenia, qaug dab peg, thiab tej zaum yuav yog qhov xwm txheej somatic. Hallucinosis tuaj yeem ua rau muaj kev puas siab puas ntsws bipolar, kab mob malignant, kev ua haujlwm tsis zoo ntawm lub cev. Muaj cov mob hallucinosis nyob rau hauv migraine, vim yog kev tsim txom ntawm cawv, narcotic compounds, surrogates.
Qee hom kev hnov lus tuaj yeem ua rau ua txhaum txoj haujlwm ntawm lub plawv, cov hlab ntsha, cov thyroid caj pas.
Hallucinosis: Puas yog nws tsuas yog organic?
Ntxiv rau qhov sib txawv uas tau hais los saum toj no, muaj atherosclerotic, alcoholic hallucinosis. Thawj yog kuaj tau yog tias nws txoj kev loj hlob tau piav qhia los ntawm atherosclerosis. Nws yog ib txwm muaj kab mob pathology, cov tsos mob ntawm cov tsos mob maj mam nce raws li kev loj hlob ntawm tus kab mob hauv qab.
Alcoholic hallucinosis yog tus yam ntxwv ntau dua ntawm lub sijhawm tsis kam haus cawv thiab nrog rau kev mob somatic. Tsis tshua muaj tshwm sim thaum haus. Tus neeg mob yog taw qhia hauv qhov chaw, nws tus kheej tus kheej, thiab kev hnov lus yog qhov feem ntau hais lus. Lub suab thiab cov lus tau hnov, thaum xub thawj nruab nrab. Vim tsis muaj qhov tseem ceeb ntawm kev nkag siab ntawm tus neeg mobsim nrhiav lub hauv paus ntawm lub suab, uas yog nrog los ntawm kev ntxhov siab thiab ntshai heev. Kev hnov lus ua kom muaj zog, ntau lub suab tau hnov txog kev sib tham txog tus neeg mob tus kheej. Polyphonic scenes yog ua tau (piv txwv li, lub tsev hais plaub). Txij li thaum tsis muaj tus cwj pwm tseem ceeb rau tus mob, tus neeg mob tau haunted los ntawm kev xav tsis zoo uas cuam tshuam nrog cov phiaj xwm ntawm ib qho kev pom.
