Tam sim no mob ntshav qab zib neuropathy yog ib yam li ntshav qab zib hom 2. Pathology yog nrog los ntawm lub cev thiab kev ncaj ncees kev txom nyem ntawm ib tug neeg. Hauv ICD 10, ntshav qab zib neuropathy yog coded E10-E14+ nrog rau tus yam ntxwv thib plaub.4.
Raws li koj paub, cov suab thaj ntau dhau sijhawm ua rau muaj kev cuam tshuam tsis zoo rau cov ntaub so ntswg hauv lub cev, suav nrog cov paj hlwb. Lawv lub plhaub puas lawm, cov hlau mechanisms ntawm cov hlab ntsha impulses cuam tshuam. Tom qab ntawd, cov kws kho mob kuaj mob neuropathy. Nws yog dab tsi - mob ntshav qab zib neuropathy, nws tshwm sim nws tus kheej li cas thiab yuav ua li cas nrog nws, yuav piav qhia hauv qab no.
Kev tshwm sim
Tus kab mob no tshwm sim vim raug lub sijhawm ntev ntawm cov suab thaj ntau ntawm cov paj hlwb. Yog li ntawd, lawv qhov kev puas tsuaj pib. Txog rau tam sim no, cov kws tshawb fawb tsis tuaj yeem teb tau tseeb tias yog dab tsi yog lub tswv yim rau kev txhim kho ntshav qab zib neuropathy. Tab sis nws paub tias qee yam tsis zoo tuaj yeem ua rau qhov pib ntawm lub xeev:
- Kev ua txhaum ntawm cov txheej txheem metabolic, vim yogRaws li qhov tshwm sim, cov ntshav qab zib nce siab, ntshav qab zib ua kom ntev, insulin txo qis, thiab cov ntshav rog nce mus rau qhov txawv txav.
- Neurovascular yam. Vim yog cov ntsiab lus ntawm cov piam thaj hauv cov ntshav nce ntxiv, cov paj hlwb nres xa cov cim, thiab cov hlab ntsha los ntawm cov pa oxygen thiab lwm yam khoom muaj txiaj ntsig nkag mus rau cov paj hlwb ua mos thiab ua tsis zoo.
- Cov kab mob autoimmune uas ua rau mob hauv cov hlab ntsha.
- Kev puas tsuaj rau cov paj hlwb.
- caj ces, vim lub cev muaj kev cuam tshuam rau lub paj hlwb.
- Kev ua neej tsis zoo, tshwj xeeb yog haus luam yeeb thiab haus cawv.
Symptoms. Peripheral neuropathy
Nrog rau ntshav qab zib neuropathy, tej zaum yuav muaj ntau yam tsos mob, txhua yam yuav nyob ntawm seb hom kab mob. Muaj peb hom, ib qho yog peripheral neuropathy.
Tus mob no tuaj yeem txhim kho tau ntev. loog, tingling thiab kub hnyiab tau hnov nyob rau hauv ntau qhov chaw ntawm lub cev. Maj mam, qhov mob nqis mus rau ko taw. Outwardly, tus kab mob kuj manifests nws tus kheej: ko taw qhuav, daim tawv nqaij ntawm lawv tawg. Calluses daim ntawv, tus ntsia thawv ingrown tshwm ntawm tus ntiv tes xoo. Tus mob no hu ua mob ntshav qab zib ko taw.
Keeb kwm ntawm tus mob ntshav qab zib ko taw
Feem ntau ntawm cov ntshav qab zib limbutations yog vim muaj mob xws lipolyneuropathy, thaum mob ntshav qab zib ko taw tsim. Nyob ntawm seb cov tsos mob ntawm tus mob ntshav qab zib neuropathy twg muaj yeej nyob rau hauv rooj plaub no, neuropathic, ischemic thiab cov ntaub ntawv sib xyaw ntawm tus kab mob tuaj yeem paub qhov txawv.
Tab sis daim ntawv mob ntshav qab zib neuropathic feem ntau kuaj pom. Vim yog kev ua txhaum ntawm hws, daim tawv nqaij ua thinner, qhuav thiab raug rau ntau yam kev puas tsuaj. Dilated hlab ntsha nyob rau hauv uas cov ntshav accumulates ua edema uas kis mus rau tag nrho cov ceg. Lawv qhov txawv ntawm lub plawv edema yog tias lawv tsis ploj nrog pw so.
Vim kev noj zaub mov tsis txaus, tsis tsuas yog cov hlab ntsha raug kev txom nyem, tab sis kuj muaj cov leeg thiab ligaments, nrog rau qhov swb ntawm tus neeg mob txoj kev hloov pauv. Thiab vim hais tias ntawm kev xa rov qab ntawm cov khoom thauj, cov pob txha metatarsal yog deformed, rhiab heev ntawm ceg qis, thiab cov kab mob neuropathic tsim.
Thawj zaug, pob ntawm tus ntiv tes xoo raug cuam tshuam, uas muaj cov kab mob sib kis. Tom qab ntawd, tus kab mob yuav nkag mus los yog osteomyelitis tshwm sim. Lub cim ntawm tus mob ntshav qab zib ko taw yog qhov tsis muaj mob.
Yog tias mob ntshav qab zib neuropathy nrog qhov mob muaj daim ntawv ischemic, tom qab ntawd cov yam ntxwv tshwj xeeb hauv qab no yuav raug pom:
- Tsis muaj mem tes hauv ko taw.
- tawv nqaij txias thiab xiav.
- Mob yog thaum so thiab mob hnyav thaum hmo ntuj.
- Tus neeg pib qaug rau ib ceg.
Autonomic neuropathy
Nrog autonomic neuropathy, paj hlwb raug puas tsuaj uas dhau los ntawm ntau lub cev ntawm lub cev:vascular, digestive, genitourinary, hws qog, pob txha cov ntaub so ntswg, ua pa kab mob. Tawm tsam keeb kwm yav dhau los no, cov kab mob theem nrab tsim. Piv txwv li, cystitis, mob plawv atherosclerosis, thiab lwm yam. Cov mob txaus ntshai tshaj plaws yog thaum muaj kev pheej hmoo ntawm kev mob plawv loj.
Daim ntawv no ntawm ntshav qab zib neuropathy raug kuaj pom nyob rau theem tom qab, vim nws tsis tshwm sim nws tus kheej ntev. Nyob rau hauv no hais txog, tus mob muaj ib tug unfavorable prognosis, vim hais tias qhov tshwm sim ntawm ib tug tuag tshwm sim nce tsib zaug. Qhov no yog qhov tseeb tshwj xeeb tshaj yog rau cov kev mob plawv ntawm lub cev tsis muaj zog neuropathy, nws tuaj yeem tshwm sim hauv daim ntawv ntawm tachycardia thaum so, ib qho elongated QT lub sijhawm kuaj pom ntawm ECG, lub siab txo qis nrog kev nce siab, thiab mob plawv feem ntau tsis tuaj.
Ua tsis tiav hauv lub plab zom mov tshwm sim vim kev ua txhaum ntawm lub cev muaj zog. Lawv tshwm raws li hauv qab no:
- Tom qab noj mov me me, muaj kev zoo siab.
- mob plab.
- Ntaus thiab ntuav.
- Tom qab noj zaub mov, raws plab tuaj yeem pib, tshwj xeeb yog hmo ntuj.
- Fecal incontinence.
Local Diabetic neuropathy
Neuropathy ntawm chav kawm hauv zos yog tus cwj pwm los ntawm kev puas tsuaj rau lub paj hlwb. Tus kab mob manifests nws tus kheej thaum hmo ntuj los yog thaum lub sij hawm so ntawm ib tug neeg. Muaj qhov tsis muaj zog thiab mob hauv cov ceg. Kev sib koom tes ntawm kev txav yog cuam tshuam, cov pob qij txha ua tsis tshua muaj zog, cov leeg nqaij tsis muaj zog. Yog hais tias cov hlab ntsha hauv cov leeg nqaij ntawm lub qhov muag raug puas, ces ib tug neeg muaj ob lub zeem muag thiab mob hauvpob muag.
Tus mob no yog nrog los ntawm qhov mob hnyav uas ploj mus ntawm nws tus kheej, thiab tom qab ob peb lub hlis ntawm lub paj hlwb hauv zos, tsis muaj qhov mob hlo li.
Ntxiv rau, cov kab mob ntxiv txhim kho:
- Kev nyuaj siab.
- Qhov tshwm sim ntawm qhov pom ntawm ob lub zeem muag.
- Pab ib nrab ntawm lub ntsej muag.
- Mob tshwm sim hauv ob txhais ceg, ko taw, sab nraub qaum, lub duav, hauv siab, pob qhov muag thiab lub plab.
Tsis tas li, mob ntshav qab zib neuropathy ntawm qis qis tuaj yeem nrog los ntawm kev txo qis ntawm cov rog ntawm ob txhais taw (thiab xib teg), tsis muaj zog thermoregulation, qhov tsos ntawm apnea thiab maj mam nce kev qaug zog.
Risk group
Ntawm pab pawg muaj kev pheej hmoo, ua ntej ntawm tag nrho, yog cov neeg mob ntshav qab zib. Tab sis muaj cov xwm txheej uas tuaj yeem ua kom nrawm lossis ua rau muaj kev loj hlob ntawm ntshav qab zib neuropathy. Yog li, pawg pheej hmoo suav nrog cov neeg muaj teeb meem xws li:
- Hnub keeb kwm ntawm kab mob ntshav qab zib.
- kab mob raum uas feem ntau tshwm sim ntawm keeb kwm ntawm ntshav qab zib mellitus, vim qhov no, co toxins hauv cov ntshav nce, uas ua rau cov hlab ntsha tawg.
- phaus ntxiv.
- Kev haus luam yeeb. Xws li tus cwj pwm tsis zoo tuaj yeem ua rau cov hlab ntsha, thiab cov ntshav ntws tsis zoo rau cov ceg. Raws li qhov tshwm sim, qhov txhab ua tsis zoo, thiab qhov no ua txhaum txoj kev ncaj ncees ntawm cov hlab ntsha peripheral.
- Cov neeg uas tswj tsis tau cov ntshav qab zib.
Diagnosis
Vim qhov chaw ntawm tus kab mob hauv ib feem ntawm tib neeg lub cev, kev kuaj mob qee zaum nyuaj. Yog li ntawd, ntau qhov kev tshawb fawb yuav tsum tau kuaj pom ntshav qab zib neuropathy.
- Ua ntej, tus kws kho mob tham nrog tus neeg mob, mloog nws cov lus tsis txaus siab. Cov lus nug yog nug txog qhov muaj kiv taub hau, mob taub hau, mob plawv, mob plab, plab tsis xis nyob, thiab lwm yam, seb puas muaj mob ntawm caj dab, seb puas tshwm sim.
- kuaj lub cev. Cov yam ntxwv xws li txo cov tawv nqaij rhiab heev, tsis khov kho, poob ntawm daim tawv muag, thiab neuritis hauv lub ntsej muag yuav ua rau tus kws kho mob xav txog kev mob ntshav qab zib neuropathy. Tshwj xeeb, tus kws kho mob tshuaj xyuas ko taw, uas feem ntau cuam tshuam los ntawm tus kab mob.
- Neurological tsom xam. Tus kws kho mob siv ntau yam khoom siv los tsim cov tactile, mob, kub thiab vibration rhiab heev ntawm tus neeg. Yog tias qhov ntsuas tau txo qis, peb tuaj yeem tham txog kev ua txhaum ntawm cov paj hlwb.
- Electroneurography - txoj kev no txiav txim siab qhov ceev ntawm impulses raws cov paj hlwb thiab lawv cov lus teb. Lub xub ntiag ntawm tus kab mob tuaj yeem qhia tau los ntawm kev ua haujlwm tsis zoo thiab tsis muaj cov leeg nqaij contraction.
- Kev kuaj mob. Nrog lawv pab, kuaj pom cov piam thaj ntau ntxiv hauv cov zis thiab ntshav.
Txij li cov cim qhia ntawm tus kab mob tuaj yeem sib txawv, koj tseem yuav xav tau kev kuaj mob sib txawv txhawm rau txheeb xyuas cov kab mob ntawm lub raum, lub plawv, plab, qaug dej qaug cawv ntawm lub cev vim kev quav dej caw, qog nqaij hlav, mob ntsws. Kev kuaj mobyog raws li cov txiaj ntsig ntawm ultrasound ntawm lub plab zom mov.
Kev kho mob
Txog tam sim no, cov kws kho mob tab tom nrhiav kev kho mob zoo tshaj plaws rau tus kab mob no, txij li cov txheej txheem ntawm nws txoj kev loj hlob tsis tau kawm tiav.
Txog hnub no, kev kho mob ntshav qab zib neuropathy txo qis rau cov haujlwm hauv qab no:
- Kev ua ntawm cov kws kho mob txhawm rau tiv thaiv kev loj hlob ntawm pathology. Ua ntej, nws yog ib qho tsim nyog los tswj cov qib ntawm cov piam thaj hauv cov ntshav nyob rau hauv ib txwm muaj, yog li kev txhim kho ntawm tus kab mob yuav tsis tsuas yog raug tshem tawm, tab sis qee qhov ntawm nws cov cim tseem yuav ploj mus.
- Kev ntsuas txhawm rau txo qhov mob. Hauv qhov no, cov tshuaj tua kab mob xws li Desipramine, Gabapentin, Phenytoin, Duloxetine yog siv.
- Sib ntaus cov teeb meem thiab kho lub cev poob haujlwm. Feem ntau, cov tshuaj los ntawm pab pawg ntawm tricyclic antidepressants suav nrog hauv kev kho mob nyuaj. Tab sis tus kws kho mob txiav txim siab lawv cov koob tshuaj, vim nws yuav tsum tsawg dua nrog kev nyuaj siab. Kev tsaug zog yog ib qho kev mob tshwm sim, yog li nws pom zoo kom noj cov tshuaj ua ntej yuav mus pw.
tshuaj tiv thaiv kab mob vwm yog sau raws li xav tau. Txhawm rau kom tsis txhob muaj kev phiv tshuaj, cov tshuaj tau muab rau hauv ib qho me me, maj mam nce nws. Nws yuav tsum raug sau tseg tias kev kho mob ntshav qab zib neuropathy ntawm qis qis tsis txwv rau kev kho hauv zos, yuav tsum muaj kev sib koom ua ke.
ntsuas kev tiv thaiv
Cov kev tiv thaiv hauv qab no txo qis kev pheej hmoo ntawm kev tsim mob ntshav qab zib neuropathy:
- Kev saib xyuas ntshav siab tas li. Feem ntau, cov ntshav siab siab hauv cov neeg mob ntshav qab zib yog ib qho tshwm sim. Yog tias nws tsis tswj tau, ces cov teeb meem yuav pib tshwm sim los ntawm kev puas tsuaj ntawm cov hlab ntsha thiab cov ntshav tsis zoo.
- khoom noj kom raug. Nws yog tsom rau kev tswj hwm qhov hnyav ntawm tus neeg noj qab haus huv, yog li ntawd, nws suav nrog ntau tshaj plaws ntawm cov zaub mov cog thiab nplej. Cov khoom noj yuav tsum tau txo qis, rog thiab ntsim zaub mov tsis suav nrog.
- Khawv txoj sia. Kev tawm dag zog lub cev txhua hnub txhim kho kev ua haujlwm ntawm lub plawv thiab cov hlab ntsha, normalizes ntshav siab.
- Kev tsis lees paub tus cwj pwm phem. Qhov no yog nicotine thiab haus cawv.
Reviews
Tus neeg mob tawm tswv yim qhia tias mob ntshav qab zib neuropathy tuaj yeem tswj tau. Ua li no, koj yuav tsum tsis tu ncua mus ntsib kws kho mob ntawm ntau yam tshwj xeeb. Qhov no yog ib tug gastroenterologist, cardiologist, dermatologist, urologist thiab ophthalmologist. Txhua yam yuav nyob ntawm seb qhov pathology tshwm sim nws tus kheej li cas.
