Peb lub cev yog tswj los ntawm cov hlab ntsha. Cov no yog cov cim qhia uas tau xa mus raws cov xov nyias ntawm cov hlab ntsha los ntawm lub hlwb mus rau txhua qhov ntawm tib neeg lub cev, thiab tom qab ntawd ua rau lawv txoj kev rov qab los. Hauv qhov no, nws tsis yog qhov xav tsis thoob tias cov kab mob NS ua rau muaj kev noj qab haus huv tsis zoo.
Cov kws kho mob koom ua ke tag nrho cov kab mob neurological nyob rau hauv lub tswv yim dav dav thiab muab nws lub npe "neuropathy". Cov no yog cov kab mob NS uas tshwm sim vim tsis muaj kev puas tsuaj rau cov hlab ntsha vim raug mob lossis mob.
Kev faib tawm
Neuropathy yog ib yam kab mob uas tuaj yeem cuam tshuam ntau qhov chaw ntawm lub cev cov paj hlwb. Muaj ib qho kev faib tawm ntawm tus kab mob no, cov creation ntawm uas coj mus rau hauv tus account hom thiab qhov chaw ntawm lub pathological cheeb tsam. Yog li, hom kev noj qab haus huv no yog:
- Peripheral neuropathy. Qhov no yog ib qho mob uas tuaj yeem tshwm sim los ntawm ob qho tib si kev puas tsuaj thiab ib lossis lwm yam kab mob. Qhov no yog tawm tsampathology ntawm peripheral paj hlwb. Nws thaj chaw hauv cheeb tsam yog cov lus qhia ntawm cov ntiv taw thiab tes, nrog rau ko taw thiab xib teg.
- Proximal neuropathy. Cov kab mob no yog qhov txawv ntawm qhov muaj cov tsos mob mob hauv pob tw thiab ncej puab.
- Cranial neuropathy. Qhov no yog ib qho ntawm ntau yam ntawm pathology uas tshwm sim vim kev ua haujlwm tsis zoo ntawm ib qho ntawm kaum ob khub ntawm cov hlab ntsha cranial. Nyob rau hauv lem, cranial neuropathy muab faib ua auditory thiab pom. Thawj ntau yam yog hais nyob rau hauv cov ntaub ntawv ntawm kev puas tsuaj rau lub auditory, thiab qhov thib ob - rau lub paj hlwb.
- Autonomic neuropathy. Lawv tham txog nws nyob rau hauv pathologies ntawm lub paj hlwb autonomic. Cov kab mob no cuam tshuam rau kev ua haujlwm ntawm lub zais zis thiab txoj hnyuv motility. Autonomic neuropathy cuam tshuam rau lub plab zom mov. Nws kuj muaj qhov tsis zoo rau cov leeg nqaij.
- Local neuropathy. Cov tsos mob ntawm hom mob no tshwm sim sai sai, thiab tsuas yog nyob rau hauv ib feem ntawm lub cev.
- Post-traumatic neuropathy. Nws qhov ua rau yog kev puas tsuaj rau cov hlab ntsha vim yog compression vim o ntawm cov ntaub so ntswg, pob txha los yog tsim ntawm cov caws pliav tsis tu ncua. Feem ntau, cov kab mob cuam tshuam rau sciatic, ulnar, thiab cov hlab ntsha radial thiab ua rau cov leeg nqaij atrophy thiab txo qis reflexes.
Post-traumatic neuropathy, nyob rau hauv lem, muaj xws li qhov thiab compression-ischemic hom neuropathy. Thawj ntawm lawv tshwm sim los ntawm compression ntawm cov leeg los yog ligaments. Qhov thib ob (compression-ischemic neuropathy) - cov hlab ntsha thiab cov hlab ntsha. Qhov no tshwm sim thaum koj zaum ntev ntev lossis yog tiastus neeg tsaug zog thiab nyob rau tib qho chaw txhua lub sijhawm so.
Ua rau neuropathy
Dab tsi ua rau muaj kev cuam tshuam ntawm lub paj hlwb? Txoj kev loj hlob ntawm pathology pab txhawb rau ntau yam, uas tau muab faib ua ob pawg. Thawj ntawm lawv yog endogenous, thiab qhov thib ob yog exogenous.
Qee lub sij hawm ua rau neuropathy nyob hauv lub cev nws tus kheej. Pathology tshwm sim hauv ib tus neeg ua rau muaj kev puas tsuaj rau ib lossis ntau lub paj hlwb. Cov laj thawj zoo li no hu ua endogenous. Cov no tuaj yeem yog kab mob ntawm hom endocrine, nrog rau autoimmune thiab demyelinating.
Cov npe ntawm cov ua rau exogenous suav nrog cov uas cuam tshuam lub cev los ntawm sab nraud. Cov no yog kev raug mob, kis kab mob thiab intoxications.
Endogenous ua rau
Neuropathy tuaj yeem tshwm sim los ntawm endocrine pathologies, hauv cov npe ntawm cov ntshav qab zib mellitus nyob hauv qhov chaw tseem ceeb. Tus kab mob no tuaj yeem cuam tshuam rau tib neeg lub paj hlwb thiab tag nrho cov hlab ntsha.
Neuropathy ntawm qis extremities feem ntau tsim hauv ntshav qab zib mellitus. Qhov tshwm sim ntawm tus kab mob no pib nrog kev noj zaub mov tsis txaus ntawm cov paj hlwb. Qhov kev ua haujlwm tsis zoo no yog qhov tshwm sim ntawm kev puas tsuaj rau cov hlab ntsha me, uas yog thawj zaug raug mob ntshav qab zib mellitus. Yog li ntawd, cov ntaub so ntswg puas tsuaj sai sai, uas ua rau muaj kev cuam tshuam ntawm nws txoj haujlwm. Neuropathy ntawm qis extremities manifests nws tus kheej nyob rau hauv daim ntawv ntawm goosebumps, tshav kub los yog ib qho kev xav ntawm txias. Ntxiv nrog rau ntshav qab zib, xws li pathology tuaj yeem tshwm sim los ntawm Itsenko-Cushing tus kab mob, cov kab mob ntawm cov qog adrenal thiab cov thyroid caj pas.
Lwm yamendogenous xwm yuav demyelinating kab mob. Qhov no yog ib pawg ntawm cov kab mob nrog rau kev puas tsuaj ntawm myelin sheath ntawm lub paj hlwb. Nyob rau hauv cov ntaub ntawv no, lub instantaneous passage ntawm impulses los ntawm lub hlwb mus rau ib tug tshwj xeeb lub cev thiab rov qab yog cuam tshuam. Cov tsos mob ntawm qhov tsis ua haujlwm no tuaj yeem ua tau nrog:
- ntau thiab concentric sclerosis;
- Devic's disease;
- Ydiffuse leukoencephalitis;
- mob kis mob encephalomyelitis.
Nyob rau hauv cov kab mob no, ob qho tib si peripheral thiab cranial qab haus huv raug cuam tshuam. Feem ntau, qhov tshwm sim ntawm neuropathy provokes ntau yam sclerosis. Tus kab mob no feem ntau cuam tshuam rau lub ntsej muag, trigeminal, lossis oculomotor qab haus huv. Hauv qhov no, kev ua txhaum ntawm lub ntsej muag rhiab heev tshwm sim, qhov muag txav tau txwv thiab tsis muaj zog tshwm sim hauv cov leeg ntawm lub ntsej muag.
Cov kab mob autoimmune tuaj yeem ua rau mob neuropathy. Feem ntau nws yog Guillain-Barré syndrome, uas yog tshwm sim los ntawm kev ua pa thiab plab hnyuv. Cov kab mob pathogenic thiab cov kab mob ua rau cov txheej txheem ntawm cov tshuaj tiv thaiv autoimmune, thiab lub cev pib tsim cov hlwb tawm tsam nws cov paj hlwb. Yog li ntawd, kev puas tsuaj ntawm myelin lossis cellular qauv ntawm cov neuron tshwm sim. Nyob rau hauv ob qho tib si, qhov no ua rau pathology.
Neuropathy kuj tuaj yeem tshwm sim los ntawm:
- mob caj dab rheumatoid;
- scleroderma;
- Sjögren's syndrome;
- Wegener's granulomatosis.
Cov kab mob hauv lub paj hlwb tsis hloov pauv nrog kev haus cawv ntau dhau, nrog rau nws cov surrogates. Raws li txoj cai, cov tsos mob ntawm tus kab mob yog tshwm sim los ntawm kev ua txhaum ntawm kev mus. Nyob rau hauv cov ntaub ntawv no, peripheral alcoholic neuropathy tshwm sim, qhov ua rau uas yog ib tug symmetrical lesion ntawm extremities, feem ntau cov qis dua. Nyob rau hauv thawj theem, tus kab mob no manifests nws tus kheej raws li ib tug "spanking" ntawm ob txhais taw thaum taug kev. Tom qab ntawd, qhov mob thiab loog loog tshwm sim.
Thaum haus cawv lossis nws tus neeg sawv cev, cov hlab ntsha hauv lub cev feem ntau cuam tshuam. Nyob rau theem tom qab ntawm tus kab mob, hnov, pom, lossis lub ntsej muag neuropathy tshwm sim.
Kev txhim kho ntawm pathology tuaj yeem tshwm sim los ntawm beriberi. Ntxiv mus, ntau hom neuropathy tshwm sim vim tsis muaj cov vitamins B hauv lub cev, uas yog qhov tsim nyog rau kev siv cov txheej txheem metabolic hauv cov paj hlwb. Hauv qhov no, muaj kev ua txhaum ntawm statics thiab rhiab heev, nrog rau cov leeg tsis muaj zog. Tsis tas li ntawd, lub ntsej muag, abducens, thiab ophthalmic hlab ntsha raug cuam tshuam.
Exogenous ua rau
Ib qho ntawm feem ntau yuav tsum tau ua ua ntej rau kev loj hlob ntawm neuropathy yog ib qho kev puas tsuaj. Yog li, nrog rau lub cev muaj zog cuam tshuam rau tib neeg lub cev, kev ncaj ncees ntawm cov paj hlwb raug ua txhaum. Qee lub sij hawm instantaneous impulse conduction ua tsis tau vim yog kev ua txhaum ntawm cov qauv ntawm myelin sheath.
Qhov ua rau ntawm pathology tuaj yeem ua rau lub sijhawm ntev ntawm cov hlab ntsha fiber ntau, nrog rau nws qhov pinching. Nyob rau hauv cov ntaub ntawv no, tus kab mob no tshwm sim vim yog ib tug ua txhaum ntawm cov ntshav mov mus rau qhov chaw puas. Cov ntaub so ntswg muaj kev tshaib plab thiab maj mam pib atrophy. Feem ntau, cov txheej txheem zoo sib xws tau pom nyob rau hauv cov neeg uas, raws li kev puas tsuaj, poob rau hauv lub pob zeb, ntev ntev nyob hauv qhov chaw ruaj khov. Tom qab cawm, lawv feem ntau tsim sciatic thiab peroneal neuropathy. Cov cheeb tsam ntawm qhov qis thib peb ntawm lub hauv pliaj, ci ntsa iab, tes, taw kuj nyob rau hauv qhov chaw muaj kev pheej hmoo siab, vim nyob rau hauv cov khoom ntawm lub cev, thaum nias los yog nyem, qhov tseem ceeb tshaj plaws tsis muaj ntshav txaus tshwm sim.
Pathology ntawm cov hlab ntsha cranial feem ntau pom hauv kev raug mob taub hau. Qee lub sij hawm tus kab mob ua rau kev phais, nrog rau kev kho lossis tshem tawm cov hniav. Tshuaj lom nrog tshuaj, ntsev hlau thiab cov tshuaj organophosphorus kuj tseem ua rau muaj qhov tshwm sim ntawm neuropathy. Cov tshuaj no muaj cov nyhuv neurotoxic ncaj qha. Tshwj xeeb txaus ntshai nyob rau hauv cov ntaub ntawv no yog:
- mercury;
- arsenic;
- Yisoniazid;
- phosphane derivatives;
- lead.
Ntau hom kab mob neuropathy tuaj yeem tshwm sim tom qab kis kab mob dhau los. Nyob rau hauv cov ntaub ntawv no, lub mechanism rau kev loj hlob ntawm pathology yog txuam nrog ib tug tshuaj lom nyhuv, uas yog ncaj qha mus rau lub paj hlwb los ntawm cov kab mob thiab cov kab mob. Feem ntau tus kab mob no tshwm sim tom qab mob diphtheria. Cov rods siab phem ua rau peripheral polyneurology, nrog rau cov neuropathy ntawm cov hlab ntsha oculomotor. Tus kab mob tuaj yeem tshwm sim los ntawm tus kab mob herpes hom 3, nrog rau tus kab mob HIV.
Ntawm qhov ua rau mob neuropathy, kuj muaj cov kab mob sib txawv. Nyob rau hauv cov ntaub ntawv no, lub pathology yog kis los ntawm tiam mus rau tiam thiab tshwm sim los ntawm nws tus kheej. Raws li txoj cai, muskev hnov lus thiab lub cev muaj zog neuropathies yog keeb kwm.
Cov cim qhia ntawm pathology
Cov tsos mob ntawm neuropathy yog dab tsi? Cov tsos mob ntawm tus kab mob yog ntau haiv neeg thiab tshwm sim nyob ntawm seb hom ntawm cov hlab ntsha cuam tshuam. Tsis tas li ntawd, cov tsos mob ntawm neuropathy nyob ntawm seb hom fibers uas ua rau cov hlab ntsha no. Yog li, nrog kev swb ntawm lub cev muaj zog fibers, lub cev muaj zog tsis zoo pib tsim. Lawv manifest lawv tus kheej nyob rau hauv daim ntawv ntawm gait cuam tshuam, tsis muaj zog nyob rau hauv cov leeg. Nrog rau qhov xwm txheej hnyav ntawm neuropathy, tus neeg mob ua rau tuag tes tuag taw nrog kev loj hlob ntawm atrophy ntawm cov leeg sib xws.
Thaum kev hnov mob fibers raug cuam tshuam, ib tug neeg poob rhiab heev. Nws tau txais goosebumps, txias, thiab lwm yam.
Cov cim qhia ntawm lub ntsej muag neuropathy
Cov tsos mob ntawm hom kab mob no muaj ntau haiv neeg thiab nyob ntawm thaj chaw cuam tshuam. Cov cim tseem ceeb ntawm neuropathy ntawm lub ntsej muag paj hlwb suav nrog:
- ntsej muag asymmetry;
- qhov ncauj qhuav thiab tsis saj;
- tsis hnov lus.
Qhov tshwm sim ntawm tus kab mob pib nrog qhov mob. Qhov no ua rau loog thiab tingling ntawm lub qhov muag, pob ntseg, hauv pliaj thiab cheekbones. Cov tsos mob zoo li no tsis kav ntev, tsuas yog 1-2 hnub, tom qab ntawd cov neuropathy qhia nws cov cim tseem ceeb. Nyob rau tib lub sijhawm, tus neeg mob yws ntawm qhov ncauj qhuav, uas yog tshwm sim los ntawm cov qog ua kua qaub.
Cov cim qhia ntawm trigeminal neuropathy
Qhov tshwm sim ntawm cov kab mob no kuj tseem nyob ntawm thaj chaw cuam tshuam. Cov tsos mob tseem ceeb ntawm hom neuropathy no yog:
- mob lub ntsej muag;
- tus tuag tes tuag taw muaj cov leeg masticatory;
- poob kev xav hauv daim tawv nqaij ntawm lub ntsej muag.
Cov cim qhia ntawm ulnar neuropathy
Nrog rau hom kab mob no, kev tsis sib haum xeeb ntawm kev hnov mob thiab lub cev muaj zog tau pom ib txhij. Cov tsos mob tseem ceeb ntawm cov kab mob no yog:
- txhim kho kev cog lus;
- tsis muaj peev xwm nqa tau thiab kis ntiv tes, thiab khoov tes;
- tsis hnov ntxhiab ntiv tes thiab ntiv tes me me eminence.
Raws li muaj ntau hom kab mob neuropathy, tus kab mob no pib nrog kev hnov qab, nrog rau kev nkag mus. Thiab tsuas yog me ntsis tom qab, qhov mob koom nrog cov tsos mob no, yuam ib tus neeg kom nws txhais caj npab nyob rau hauv txoj hauj lwm khoov. Tom qab ntawd, cov leeg ntawm tes atrophy. Tus neeg mob tsis tuaj yeem tuav lub hnab, khaws lub raj mis, thiab lwm yam. Lub sijhawm ntev neuropathy ua rau kev loj hlob ntawm kev cog lus, uas tau qhia nyob rau hauv kev txwv tsis pub sib koom ua ke.
Drug therapy
Yuav ua li cas nrog tus kab mob zoo li neuropathy? Kev kho mob ntawm pathology pib nrog kev tshem tawm cov hauv paus hniav. Piv txwv li, lawv ua kev kho mob rau cov kab mob sib kis, ntshav qab zib, beriberi, thiab lwm yam. Qhov no yuav ua rau tus neeg mob zoo dua. Neuropathy yog kho nrog cov tshuaj tiv thaiv kev nyuaj siab thiab opiates, tshuaj tropical, thiab tshuaj tiv thaiv kab mob. Cov npe ntawm cov tshuaj tau sau tseg yog heevyog qhov dav thiab nyob ntawm cov tsos mob ntawm tus kab mob.
Ntau zaus neuropathy yog nrog los ntawm convulsions. Lawv tshwm sim, raws li txoj cai, nyob rau hauv daim ntawv ntawm lub sij hawm tawm tsam. Txhawm rau tshem tawm cov tsos mob no, cov tshuaj anticonvulsants tau sau tseg. Cov npe ntawm lawv yog qhov zoo nkauj heev, tab sis feem ntau siv yog:
- YCarbamazepine.
- Gabantin.
- Gabagamma.
- Finpepsin.
- Tebantine.
Cov tshuaj tiv thaiv kab mob ntau tshaj plaws yog Carbamazepine. Analogues ntawm cov tshuaj no kuj muaj muag nyob rau hauv Lavxias teb sab chaw muag tshuaj. Cov tshuaj "Carbamazepine" yog qhov zoo tshaj plaws hauv trigeminal neuropathy, tiv thaiv qhov tshwm sim ntawm qhov mob. Nws tseem raug sau tseg rau post-herpetic neuralgia, post-traumatic paresthesias thiab qaum qaum tacis.
Muaj cov tshuaj "Carbamazepine" analogues: "Actinerval" thiab "Stazepin", "Zeptol" thiab "Apo-Carbamazepine", "Karbapin" thiab "Storilat", "Tegretol" thiab "Epial", thiab lwm yam.
kho lub cev kho mob
Txhawm rau kho cov haujlwm ntawm cov paj hlwb hauv lub sijhawm tsis ua haujlwm ntawm tus kab mob, cov hauv qab no tau sau tseg:
- massage;
- reflexology;
- electrophoresis;
- Yhydrotherapy;
- magnetic therapy.
Kev kho lub cev yuav tsum yog 7 txog 10 kev kho.
