Myasthenic dambudziko sei? mabatiro

Chero dambudziko - ndiwo mamiriro kwevanhu, umo pakarepo, nokukurumidza kuderera weboka chirwere, zviratidzo chinouraya inowedzerawo nokukurumidza chaizvo. Myasthenic uye cholinergic dambudziko, ndiye shamwari myasthenia gravis, vari ngozi nekuti murwere anogona kunyangarika kufema uye mwoyo wake varega kurova. Dzimwe nguva upenyu hwomunhu chaizvoizvo kuverengerwa maminitsi, izvo zvokurapa kana pedyo vanhu vanofanira kuva nekodzero nguva yokubatsira. Ko achiipa, zvingaita sokuti, harisi chirwere chinouraya myasthenia gravis? Tinopa nyore mutauro zvinonzwisisika kuudza munhu pamusoro chii vose vanofanira kuziva: zvinokonzera myasthenic uye cholinergic dambudziko, kiriniki, nechimbichimbi uchenjerere vaya uyo padambudziko chakaitika. Zvichida mumwe munhu pedyo nesu, kana pakarepo muna zvekufambisa kana kungoti mumugwagwa zvichava zvakaipa, mashoko ari munyaya ino ichakubatsira kuponesa upenyu.

myasthenia

Nyaya mbonje kutanga nokutsanangura pfungwa myasthenia gravis. Dzimwe nguva kutora kumativi chirwere ichi kunze kumurango nzvimbo, sezvo chirwere myasthenia kuramba chokunyunyuta pamusoro kuneta, lethargy, asingakwanisi kuita chero basa remaoko, chete nyore. Kutaura zvazviri, myasthenia gravis ari chirwere neuromuscular, vakarondedzera muchikwata che autoimmune, kuti anokonzerwa kukundikana mumuviri pave rworudyi antibodies kana kugadzirwa muurayi masero anorwisa munyama utano uye masero kuti ave dambudziko guru.

Myasthenic dambudziko hwapedyo pamusoro pakanyorwa vakawanda chirwere, uye ane zvakafanana zviratidzo kwaari chete anozviratidza yakakura chikuru kuti kare zvakatungamirira rufu anenge 40% wevarwere. Zvino, kana kurapa iri rakatanga nokukurumidza, rufu zvinogona kudziviswa. Ndinoda kuona kuti myasthenia vanorwara 10 vanhu ose 100 zviuru vagari Nyika, uye vakadzi vanokanganiswa naro ka3 kakawanda kupfuura vanhu. Myasthenia gravis kungazviratidza pauduku, asi nyaya dzakadaro hadziwanzowaniki. Zvinonzi ainyanya kuchengetwa varwere makore 20 uye kusvikira akwegura.

Zviratidzo myasthenia gravis

Pasina myasthenia gravis, kana zviri ndiripo munhu, myasthenic dambudziko haagoni kuitika. Zvisinei, dzimwe nguva izvozvo tora pamusoro vamwe zvirwere zvakafanana zviratidzo, semuenzaniso, akadai chambotaurwa nezvacho lethargy, utera, kurukutika. Zvimwe Zviratidzo zviri vacheche:

- vachirembedza anopenya, vakawanda kuoneka manheru, uye kudzikira mangwanani pashure usiku zororo;

- chiono miviri;

- yapera, pashure kwakajairika mukuru kuneta mitoro vamwe vanhu, akadai kukwira masitepisi;

- kwokutanga bulbar zviratidzo (izwi nasal chitarisiko pashure zvokudya uye hurukuro refu, kunetseka ezita nomumwe tsamba);

- emuchina bulbar zviratidzo (zvakaoma kumedza, kakawanda kukachidzwa);

- autonomic dysfunction (intestinal paresis, tachycardia);

- pameso hazvishandi (pahuma zvikuru wrinkles, mamirire zvaanoita chiso chake);

- kunyanya salivation;

- nematambudziko akabata musoro;

- kuome kufamba.

A pachena kuchiitwa myasthenia - zvose zviri pamusoro zviratidzo vari kuipa pashure mumuviri nesimba uye ari manheru, uye pashure zororo rakanaka vari kuderedzwa kana zvachose kunyangarika.

Symptomatology pamusoro myasthenic dambudziko

Kana munhu anotambura myasthenia gravis, zvadai, zvingava myasthenic dambudziko. Zviratidzo runotikurudzira chirwere, kunyanya zvakadai tachycardia, mukuru kuneta tsandanyama zvinokosha (kufema, cardiac), salivation, panguva imwe chete kunosimbiswa. Zvinotevera zvinhu anowanzoramba nokuti dambudziko:

- kuoma tsandanyama ose pakuparadza uye mutauro, saka anogona kupinda kufema turakiti madzihwa, nemate, zvokudya;

- femo;

- simba kugadzikana uye kutya nokuda kwokushayiwa mhepo;

- kuchitonhora ziya;

- dzimwe nguva vaingoerekana weti uye / kana defecation;

- kurasikirwa pfungwa;

- ganda rakaoma;

- BP akasvetuka;

- dilated vadzidzi;

- chenjera mwoyo kukundikana, kuti kutyora pamwoyo.

Myasthenic dambudziko iri rworwendo akawanda:

- nyore;

- avhareji;

- rinorema;

- mheni.

Kusiyana vanovandira simba kuratidzwa pamusoro zviratidzo. Kunyanya ngozi mheni inoremerwa dambudziko umo munhu nokukurumidza, chete maminitsi mashoma, anovandudza neutera ari kufema tsandanyama uye kumedza. Kufema anova nokukurumidza pakutanga, vanotarisana mutsvuku, vachisvetuka kumusoro kumanikidzwa, kwemwoyo rinosvika anenge 160 anorova paminiti. Ipapo mweya anotanga kwaizombomiswa, uye anogona zvachose, chiso chake chokuchinja zvitema (mu mushonga kunonzi cyanosis), kumanikidza zvinoderedza, kupomba nepaburi palpable.

Zvinokonzera myasthenic dambudziko

Myasthenia gravis inogona vachiberekwa kana vawana. Wokutanga kunokonzerwa nokuziva mutation ari majini. Chechipiri hwapedyo kana munhu:

- nezvinetso thymus shwanu;

- kumwe kenza (semuenzaniso, chipfuva, bapu, ovaries);

- hyperthyroidism;

- encephalitis lethargic.

Tikafunga zvirwere izvi myasthenic dambudziko kunogona kuitika munguva inotevera nyaya:

- chenjera zvirwere, kusanganisira SARS, yokuSpain, bronchitis;

- oparesheni;

- rakasimba mupfungwa mupfungwa;

- High kurovedza muviri;

- kutora vamwe mishonga (semuenzaniso, mapiritsi);

- hormone zvirwere;

- vanopfuura myasthenia varwere vachitora mapiritsi, ari kutyora kurapwa kosi.

cholinergic dambudziko

Myasthenic dambudziko uye cholinergic kazhinji dzinoitika zvakafanana, ndokusaka pane zvikanganiso zviri Kusiyanisa uye, sezvo migumisiro yokurapa. Zvisinei, izvi zvekunze zviviri kuratidzwa fananei pamusoro mamiriro kunokonzerwa zvakasiyana zvikonzero uye dzakasiyana etiology.

Saka, kana myasthenic dambudziko cholinergic receptors zvinoderedza kuti arambe achirema ari Kamudzira nokuda kuparadzwa kwavo, uye vanosara kuchinja basa ravo. A cholinergic dambudziko kunoitika apo kunyanya activation pakati cholinergic receptors (the nicotinic uye / kana muscarinic). Anomhanyira mabiko muitiro kugadzirira kurapa myasthenia gravis pamatunhu mishonga, uyewo zvinoreva kuti hazvibvumidzwe mune chirwere ichi.

Rokuongorora dambudziko hakusi nyore, nokuti ayo chikuru zviratidzo uwirirane myasthenic. Batsirai nemazvo kusarudza chii chinoitika munhu, kwakadaro inoti angava ayo ezvinhu, hunhu cholinergic dambudziko: murwere achiratidza kudhaka: mudumbu kurwadza, anovhura kurutsa, manyoka inotanga. For myasthenic dambudziko inozivikanwa navose kunze Zviratidzo iwayo.

Chechipiri chine chinhu cholinergic dambudziko - kuwedzera zviratidzo myasthenia gravis pasina mabasa mumuviri mabasa, asi pashure kutora cholinesterase zvinodhaka.

yakavhenganiswa dambudziko

Icho utano uye upenyu ngozi mhando zvokurwara. Chine myasthenic dambudziko uye cholinergic, achiratidza kamwe mamiriro zvose zvakaiswa kushumwa pamwe nezviratidzo. Izvi zvinoita nyore kugadzirisa nechirwere, asi zvakatonyanya - kurapwa, nekuti avo mishonga kuti aponese kubva myasthenic dambudziko, cholinergic mberi sembura. Kana yakavhenganiswa chokubuda nematambudziko kusiyanisa maitikiro maviri:

1. myasthenic. Varwere vari kuchengetwa iziviswe bulbar zvinetso, matambudziko kufema, kurovedza muviri kunokonzera kuneta, asi rokutarisira zvinodhaka ( "Klamin", "Neostigmine") haakonzeri nenjodzi.

2. Cholinergic dzinoratidzwa zviratidzo kudhaka.

Practice yaratidza kuti vakavhengana nematambudziko kazhinji dzinoitika vanhu akatowana iyi kana kuti dambudziko iri vacheche.

Zvinogona fungira vakavhengana dambudziko zvakadaro zvinhu kuratidzwa:

- varwere zvakajeka kuchengetwa zvakaomera kufema uye bulbar kutyora uye gwenya kushanda Mbabvu zvakachinja zvishoma;

- asingadi wakabura kutora mushonga kunoderedza pathological zviratidzo, zvakadai nani gwenya basa uye kashoma kunobatsira dzikamisa kufema.

Diagnostics

Kudzivisa zvikanganiso uye nokukurumidza chokubatsira zvibereko mune myasthenic dambudziko, zvinokosha kuti kuisa chirwere kuti murwere zvakanaka. Sezvataurwa pamusoro apa, zvimwe zvingaratidza kuvapo myasthenic dambudziko iri zvirwere kwete ukama myasthenia gravis (semuenzaniso, zvakaoma kufema, mugari kwemwoyo). Symptomatology cholinergic dambudziko rakafanana vatambure mumazuva kudhaka, uye zvimwe zvinetso pamwe zvomudumbu turakiti. Kana murwere ane maintainer, kupa ruzivo pamusoro pamberi myasthenia kwake uye mushonga kutora kwavari, yakarongwa chirwere iri nyore zvikuru. Kusiyanisa mhando dambudziko, vanachiremba vanoita prozerinovuyu mharidzo.

Special kuoma nechirwere zvinochengetwa panguva yakavhenganiswa nevanga. Kuti uone ayo isina zvikanganiso wokutanga kutotanga rinoitwa kunotoda kuongorora murwere, uyewo electrophysiological tinyatsonzwisisa kushanda vakawana nokugamuchira anticholinesterase zvinodhaka.

Kungovapo munhu gravis (pamberi dambudziko) iri dzakaonekwa pachishandiswa electromyography, computed Tomography, pharmacological uye immunological nemiedzo.

Emergency hanya myasthenic uye cholinergic dambudziko

Kana murwere chete myasthenia pakarepo dzakaderera (kuuya dambudziko), rakanyorwa upenyu anoenderera mberi zvishoma. Chinhu chikuru kuti zvinofanira kuitwa kumativi - pakarepo kudaidza amburenzi. Zvinosuruvarisa kwedu chokwadi, pane nguva apo kushandiswa nokutarisirwa kunonoka. Tingabatsira sei kufa pakadai? Chokutanga, edza kupa naye yokufema, kubvisa madzihwa kubva mumutsipa wake. Maererano nemitemo, anofanira kutambura kubva myasthenia unofanira kuva kucherechedza kana vane chirwere, uye zvinodhaka (akadai se "Neostigmine") uye sirinji. Kana pasina anokurumidza kusvika nekukurumidza, munhu myasthenic dambudziko zvakakodzera kuita jekiseni maererano mashoko ari kucherechedza.

Vakapindira, vanachiremba vanofanira hospitalize murwere panyaya yokukurumidzira, uye mune yevanenge, uko ndichibvunza zvashata kurapwa:

- kupa munhu kufema;

- nerubatsiro okisijeni;

- Hardware uye zvokuimba kufefetedza.

Kana murwere asina zviratidzo cholinergic dambudziko (kurutsa, manyoka), akasuma zvinotevera mishonga: "Neostigmine", "Atropine". In pamberi zviratidzo kudhaka zvashata kurapwa ndiko chete ventilator uye jekiseni kwezvinodhaka izvi, "Atropine", "immunoglobulin", uyewo nevamwe vanachiremba mano kana akaratidza.

mabatiro

Kana munhu aiva myasthenic dambudziko, kurapwa mushure nechimbichimbi kurapwa kuitwa pahwaro kurapwa uye rabhoritari nemiedzo, uye inotaura simba pamusoro chirwere. Zvokuimba kufefetedza (kureva, chakagadzirwa kufefetedza pakati mapapu), zvichienderana navanachiremba ezvinhu omurwere, uyewo uchapupu pamberi okisijeni muropa anogona kuitwa kusvika namazuva matanhatu, asi kana murwere mushure maawa 16 kana kuti kana kupfuura pane zvakanaka sei "Neostigmine" ventilator kudarika . Kazhinji, nzira iri zvakakura chaizvo ventilator uye vachiteerera, rinoda kuramba richiona nezvezvabuda haende,% muna Zvinoumba magasi ropa, ropa kuparadzirwa, tembiricha, mvura mwero mumuviri uye nevamwe.

An nzira yakanakisisa kutsungirira mhando dzose nematambudziko ari vacheche ndiyo Exchange plasmapheresis. Kana ropa ichi zvakabudiswa rinoitwa kubva nechepakati (kana kugokora) tsinga, centrifuged, kuchinja anyatsoronga yeplasma kana chokunyepera. Nzira iyi inopa nemigumisiro yakanaka - mukati vaviri maawa murwere mamiriro ezvinhu akavandudzika zvikuru. Plasmapheresis rinoitwa kubva kosi 7 mazuva 14.

Mumwe nzendo kurapwa zvinodhaka mishonga. Maererano uchapupu varwere kunoitwa immunoglobulins, antioxidants, zvinodhaka anticholinesterase, uye pamberi chokutsva - mishonga inorwisa mabhakitiriya.

Kufembera uye kudzivirira

makore matatu kana mana apfuura, zvinouraya zvaitika mu varwere myasthenia panguva exacerbation denda kwakaitika zvikuru kakawanda. Zvino mwero wokufa kwevanhu kwave kuderedzwa ka12. Unofanira kunzwisisa kuti dzimwe nguva kubva zvatinoita nemi kunotsamira upenyu hwomunhu, aiva myasthenic dambudziko. Emergency rubatsiro inofanira yakapiwa nokukurumidza chaizvo. Naizvozvo, kana pakarepo mumigwagwa, munzvimbo mabhazi, chero tinoona munhu anotanga kumudzipa, unofanira kushevedzera amburenzi pakarepo.

Myasthenia varwere pachavo vanofanira kutevedza zvinoverengeka matanho kudzivisa dambudziko:

- kuva pasi yachiremba cherechedzo, uye zvakasimba zvinoenderana ramakanzi kurapwa;

- Usave zvakapfurikidza, huta breakdowns;

- zvinoita kungwarira zvirwere;

- regai kufumura muviri wako kudhaka;

- vari kudya kuti zvinosanganisira zvokudya zvine potassium yakawanda (semuenzaniso, mbatatisi ndiro, akaomeswa).