Ndezvipi zviratidzo zvinoumba somatoform autonomic dysfunction pakati tsinga?

Somatoform autonomic dysfunction - kunzwisisa panyaya diagnosing chirwere. Rine zviratidzo zvizhinji zvakadai muviri nepfungwa. Uyezve, varwere kutambura kwavari, vanonzwa zviratidzo chirwere chakasimba zvakakwana anoputsa nyanzvi Kuziva kwavo. Nekuti zvose chokuita chirwere, unofanira kunzwisisa zvizere.

Overview SVD chirwere

Somatoform autonomic dysfunction (SVD) padzakacherechedza kakawanda muna varume muchiuto zera, kana mune varwere vanosangana rokukurumidzira slozhbu kana kuita zvakananga kurwa. chirwere ichi, iyo inoratidza pacharo uremu vasiri chaizvo zviratidzo uye kunoda hwakadzama Diagnostics. Chinangwa charo kubvisa STRUCTURAL abnormalities nomwoyo uye arrhythmias uyewo zvirwere zviri nechepakati tsinga.

Zvinofungidzirwa kuti somatoform autonomic dysfunction chinhu anosimbirira kusaenzana pakati tsitsi uye parasympathetic tsinga. SVD pacharo rakakamurwa zvitatu mhando: SVD nokuda cardiac, hypotonic uye hypertonic mhando. Vanofanira kusiyaniswa chemwoyo, arterial hypo- uye BP, iyo kugadziriswa nzira zviitiko panguva kukumbirwa muchiuto. Nokuda kwechikonzero ichi, vakadzi SVD padzakacherechedza zvishoma kazhinji pane varume uye vakomana. Kunyange zvazvo 80% of pachena nechirwere haisi akatsinhira nechepakati komiti vrachebnokonsultatsionnoy.

symptomatology SVD

Somatoform dysfunction pakati ari autonomic tsinga kunoratidzwa gobvu nonspecific zviratidzo. Kazhinji vanoonekwa randomly pamusoro pakanyorwa mupfungwa uye kuedzwawo kunyarara ezvinhu. Pazvese, kuti IRS zvinogona kunzi chirwere nokuti zvechokwadi kunosanganisira vakawanda zviratidzo. Vanoratidzwa pfungwa dzinotevera syndromes: cardiac, hypotonic, hypertonic. Uyewo, pangava zvakakurumbira simtpomy, dyspepsia zviratidzo, kufema zvirwere, panyama disadaptative. Zviratidzo izvi zvichakurukurwa munyaya zvakadzama.

Diagnostics Basics

Huru dzekuziva nadzo nechirwere kukosha kuna SVD ndiwo: ya zviratidzo (kupfuura 2 years) uye kusavapo gemodinamicheskiznachimyh kana upenyu-kutyisidzira cardiac arrhythmias kana mamiriro. Kutaura zvazviri, mashoko cardiac abnormalities duku zvose kwete zvichiita rokuchinja mwoyo mutinhimira zvirwere, kana in, anogona vasanganiswa.

Chirwere "Somatoform autonomic dysfunction" inogona pamwe Somuenzaniso, tricuspid (mitral, kutsemuka kana pulmonary) kukundikana, arrythmia isingawanzowanikwi, zvinopfuura WPW chirwere kana CLC. Zvisinei, varwere kwakadaro kunofanira kuchengetwa 2 pagore kuziva zvimwe kutyorwa. Zviri pachena kuti vakawanda diagnoses SVD vakafumura muchiuto uye vechidiki, haana kodzero iripo. Kazhinji, chirwere ari chiremba pachake pasina kunyunyuta chete pahwaro kuvapo duku STRUCTURAL urema mumwoyo. Nekuti vanenge 80% kubva diagnoses vari nharo, asi kurapwa kukosha vane chete zvichemo comorbidities uye syndromes.

Common zviratidzo SVD

In zvirwere zvakadai, somunhu somatoform autonomic dysfunction, vakawanda zviratidzo zvakawanda. Izvi Mamiriro vachivavhiringidza, dysphoria, dysthymia, kusada kuita chero basa remaoko, nenyonganiso ose kudya, tsandanyama simba, idzokororo nomusoro, kunyanya vemunyika vari parietal uye occipital nharaunda. Dzimwe murwere kutyira pamusoro dzungu nokupisa manzwiro ari podlozhechkovoy munzvimbo dzisina chokuita nenzara kana mukaguta.

chichemo kwakadaro kunoratidzwa asthenic chirwere somatoform autonomic dysfunction. Varwere muitiro basa, dzimwe nguva kushaya zvokuita uye nyore kugumbuka. Mumwe nomumwe izvi maitiro zvinhu vachizengurira kutora bhizimisi idzva. Kuwedzera, havasi vapedza. Zvisinei, zvinoshamisa, introversion, iyo achikura somugumisiro kubudirira zviduku mumutambo kana nokusarovedza muviri kunoita kuti chokwadi kuti vana vanowanzotevedzera kuripa chidzidzo ichi. Vane zvakanaka kuyeuka, asi anonetsa ezvinhu vanofunga rinopikira ramangwana rakaita. Kudzivisa mupfungwa uye kusada kubatanidzwa munyaya kuti zvinoda mupfungwa mufaro, tsika kuchiitwa varwere autonomic dysfunction somatofrmnoy.

basa Physical pa SVD

Low achishivirira kuti kurovedza - ndiwo chaiwo chiratidzo SVD. Varwere havadi kutora kurovedza mukirasi kuti dzidzo panyama, kunyanya kana kunoda simba. Kazhinji, mobile mitambo tiri nyore varwere izvi, apo simba kurovedza kukonzera zvinetso zvakawanda. Ungacherechedza kuti pashure achimhanya kakawanda dyspnea kupfuura vamwe vana chete kuvaka. Uyezve, varwere izvi nokukurumidza kuneta, kutsungirira kwavo kuvatumwa vamwe. Uyewo ari kumashure mutoro kuonekwe kufema kana cardiac SVD Zviratidzo zvinorondedzerwa pazasi.

Cardiac (mwoyo) chichemo wevarwere

Somatoform dysfunction of autonomic tsinga kunoratidzwa Zviratidzo yakawanda izvo zvinokonzerwa ane kusaenzana pakati sympathico uye parasimpatikoy innervated nenyere. Heart zvichemo, sezvo muviri une autonomic innervation, vari pakati inokosha. Vakawanda zviratidzo SVD pamusoro chikamu mwoyo uye ropa nemidziyo: cardiac kurwadziwa, tachycardia, vakawedzera kana kunoderedza BP.

The hunhu kurwadziwa mumwoyo mangu hakusi wakananga imwe chirwere. Pain Kazhinji kubaya uye dzimwe nguva kudzvanya. nzvimbo yavo - moyo pechingoro (3-6 masendimita kuruboshwe pamusoro sternum) uye pamusoro (5 masendimita kuruboshwe pamusoro sternum panguva 5th intercostal nzvimbo). Tachycardia zvinogona kukonzerwa mupfungwa kana mumuviri kunetseka. Zvakakosha kuti nezvechinhu chimwe disproportionate mutoro akatakurwa negiravhiti. Somuenzaniso, tachycardia anooneka pakarepo pamberi muviri kana pakutanga chaipo, uye kwete sezvinoita kwayo kuwedzerazve.

Zvakakosha kuti kurwadziwa mumwoyo mangu, kana vane hunhu pomoto, uye (kana) compressing uye kuoneka maminitsi 20-30, anofanira sechinoitika ischemic, izvo zvinoda kurekodha electrocardiography nokuda pfupi zvaibvira nguva. Izvi imhaka pamberi kurapwa akadai seChechi musiyano wezvinyorwa angina uye cardiac chirwere X. In pathologies izvi 50-100 nguva yakakwirira mukana wokuti kungoerekana coronary rufu.

Hypotension kana BP

NeBP hwapedyo Kazhinji. Izvi zvinonyanya isingawanzowanikwi mhando SVD, nokuti kakawanda kumboona cardiac kana vane chirwere cheBP marudzi. Asi hypotonic mhando SVD kuonekwa nguva nenguva kusiyira BP zvose maoko. Zvakakosha kuti nechirwere ichi Chirwere kunodiwa kuita echocardiography uye electrocardiography, hunoita kuti haabatanidzi kuvapo chemwoyo kana arrhythmias. Kufenda tiri zviratidzo SVD, kunyange nonspecific.

NeBP - chaiwo kunyunyuta. Varwere staradayut kumanikidzwa richisimuka vasati kuita muviri, pane napo. The kumanikidzwa unowanzoonekwa akawedzera oga vanomutsirwa 160 systolic BP, apo diastolic ndiyo chete. Tichifunga elasticity rwengarava ropa kuyaruka uye vasikana vane somatoform autonomic dysfunction mwoyo iri panoonekwa kazhinji, diastolic BP anogona uye anoita kuderera zvishoma.

Izvi nokuda kusaenzana ari tsitsi uye parasympathetic tsinga, tsandanyama anowedzera apo norepinephrine tsinga, kudzikira peripheral vascular nemishonga. Zvakakosha kuti kumanikidzwa rwuchiwanzwa nguva dzose, nokuti chirwere pamusoro neBP hazvigoni kuisa.

kufema kunyunyuta

Zvakadaro chirwere sezvo somatoform dysfunction ari autonomic tsinga vari zvakare zviratidzo kufema hunhu. Mitemo chitarisiko chavo zvakafanana vari nyaya cardialgia, hypotension kana BP. Chinova kufema zviratidzo munguva yechiitwa. Uyewo, kuti dzakananga kuna SVD, vanogona kuonekwa mushure okuguma kurovedza vamwe munguva. Izvi mukusiyana kufema zvichemo SVD kuti asima zviratidzo zvinooneka mupfungwa.

Mienzaniso akanyunyuta SVD: akaratidza yakavhenganiswa dyspnea pamusoro nesimba kana ndakazorora nguva yaro Implementation, chipfuva tightness uye kufema. Enzanisa mu asima wakaputsika nedzinovengwa. Pamwe chete zvichemo kufema panguva chirwere akadai somatoform dysfunction ari autonomic hurongwa richiratidzwa cardiac. Dzavo kwemajoini chitarisiko - anodzidzisa, asi dzisiri zvakananga chiratidzo, pozvolyayuy kuti chirwere chakadai.

Dyspepsia pamwe SVD

Zvakadaro chirwere sezvo somatoform dysfunction ari autonomic tsinga, zvinokonzera ndivo vakawanda. Vanozvivandira ari kusaenzana pakati parasympathetic uye tsitsi huta nehurongwa. Uyezve, yose nemudumbu iri munyaya iyi, nokuti zvizere innervated nokuda parasympathetic hurongwa. The vagus tsinga anodzora secretion mudumbu, rwatata, ura. Ndiye anokonzera injini unyanzvi uye zvose kugaya. Nokuti kana SVD rinowanika kakawanda dyspepsia, uye abdominal kurwadziwa.

Zvikuru zvakafanana chemanyoka zviitiko zvinofanira dzinounzwa svoto pasina kurutsa, idzokororo kurwadziwa epigastric nharaunda, ayo nokupwanywa kana kubaya inozivikanwa. pakuonekwa hakubvi zvokudya: zviri runobva uye inobatanidzwa kunyanya kushushikana. Uyewo, kurwadziwa inogona vemunyika neimwe nzvimbo mudumbu. Ivowo kuonekwa pakarepo kana panguva yechiitwa. marwadzo aya haana kuitwa dzimwe mudumbu uye achiperekedzwa fivha, manyoka kana kurutsa.

Zvakakosha kuti zviratidzo pamusoro apa kuitika uye kusagadzikana bowel syndrome. Zvinofungidzirwa kuti zvirwere zvakasiyana izvi. Zvisinei, kana mhaka IBS ndiye kunyanyisa colonic motility. Nokuti, zvichida, inofanira kukurukurwa sezvinoitwa IBS chiratidzo SVD. Uyezve, zviri zvikuru nevakawanda varwere vanenge SVD. Zviratidzo intestinal chirwere vari kunonoka chetsoka, bloating uye kutinhira mudumbu.

Rairira kuongorora chirwere pamusoro SVD

Zvakadaro chirwere sezvo somatoform dysfunction ari autonomic tsinga, marapirwo anosarudzwa nomumwe zvichienderana hwakapararira zviratidzo. SVD chirwere harigoni kuisa pasina murwere zvichemo, hwakaratidzwa 2 kana kupfuura makore kundosangana pamusoro zvinodiwa. Zvinokoshawo kubvisa zvose Organic zvirwere: vachiberekwa (kana vawana) mwoyo kuremara, arrhythmias, thyroid chirwere, dumbu nemaronda (kana 12 duodenal urikanwi), gastritis, Crohn, chirwere diverticulosis ura.

Zvinokoshawo kuti vadzivise zvichibvira mupfungwa chirwere, izvo vanoratidza somatoform zvirwere. Izvi zvinoreva kuti murwere vanofanira kuita tsvakurudzo: kuti mukuru uye nokukanganisika miedzo ropa, urinalysis, ropa shuga uye mahormone schitovdidnoy shwanu, kunyora ECG, kuita echocardiography, FEGDS, ultrasonography kuti brachiocephalic arteries uye thyroid. Migumisiro tsvakurudzo anogumisa kuti, kana akaonekwa kana chiratidzo kuratidzwa SVD zvinoshandawo zvimwe zvirwere.

Somatoform autonomic dysfunction: kurapwa

SVD ari kubatwa nzira dzakawanda kuti zvinobatana pharmacotherapy, vhitamini kurapa, supplementation pamusoro chicherwa pakuenzanisa muviri, Occupational kurapa uye mumuviri kurapa. In pharmacotherapy inokosha yokufudza nootropics (kana antidepressants) pamwe cardiotropic. Muenzaniso kugadzirira wemishonga "Phenibutum" kana "Noofen" pane imwe dose 250 MG katatu pazuva 2 months "Thiotriazoline" 100 MG 2 nguva zuva rimwe nokuda 2 months. On kugadzwa antidepressants vanofanira kutanga chiremba wepfungwa ndiani kuongorora zera uye potenialnuyu pangozi zvinodhaka kumurwere.

Zvakadaro chirwere sezvo somatoform dysfunction ari autonomic tsinga, mishonga anosanganisirawo mineralotherapy. Ratidza kuti Somuenzaniso, mitral vharafu prolapse , kana zvimwe kukundikana mavharuvhu chokuita interstitial magnesium kusaenzana. Pavezve ayo nhanho kunobatsira kuderedza zviratidzo cardiac zvichemo nekuomarara hypotension kana BP.

Vhitamini, kunyanya marambi mavhitaminzi C, E uye D, uyewo B1, B2, B5 uye B6 chinhu ndaisagona chinodiwa. Zvisinei, izvi zvinhu zviri havaratidzi kunyura vhitamini panguva coadministration. Nekuti zvaida mapoka Exchange kurapwa 1 mwedzi mavhitaminzi C, E uye D, uye ipapo 1 month mavhitaminzi B1 uye B2, ipapo 1 mwedzi B6 uye B5. Zvechokwadi, sezvo iri guru ura dzevanhu Data dziri synthesized mavhitaminzi pachavo, anofanira kudya matsva miriwo uye nemiriwo pasina kupisa kurapwa.

Sezvo kukura SVD kuridza basa yakaderera kufarira pachavo utano hwavo uye kurega mumuviri, replenishment mavhitamini uye zvicherwa, kunobatsira kuderedza kukuvadza zviratidzo. Occupational Yokurapa panguva pachipatara pacho kurapwa (muripo-sezvo pakiriniki havasi rakapa vouchers varwere SVD) achava nezvakawanda yakatsiga zvikuru kushanda. Asi murwere nani tsanangura kuti kunyange vamwe ndiwo mushonga Kanenge kwaari nekuti panguva zororo haana kunyunyuta.

Somatoform dysfunction of autonomic tsinga (ICD-10)

In yemarudzi kupatsanura pakati chirwere ikoko kubva muna 1993. zvokurwara ichi inowanikwa munyika yose uye hakubvi zvinoitwa zvikuru rudzi kana nyika. The ICD 10 somatoform autonomic dysfunction Revised V uye VI misoro. Yokutanga inosanganisira "Mental uye maitiro asina kutsarukana" (coded bumbiro F0-99), uye wechipiri - "Neurotic, yokuzvidya uye somatoform zvirwere" (coded F45-F48 yekubvuma).

F45 Category zvinosanganisira zvinotevera pathologies: somatisation nyonganyonga, undifferentiated somatoform wenyonganyonga, somatoform autonomic dysfunction zvakananga, hypochondriacal wenyonganyonga, inogona kuenderera somatoform marwadzo chirwere uye zvimwe kutaurwa nepfungwa yacho huta mutemo. Iye somatoform autonomic dysfunction F45.3 code encoded uye kunoda kubviswa hosha nhengo innervated peripheral autonomic tsinga.

mhedziso

Masayendisiti akawanda zvino vanodavira kuti somatoform autonomic dysfunction dzinofanira kuzokurukurwa zvizere. chirwere ichi chinobata murwere nemagariro kwadzakabva. In Muzviitiko zvakawanda akaratidza yaisanganisa okuti ari SVD uye STRUCTURAL anomalies mu sedrtse. The akasiyana tsika echocardiography akabvumira kuwana kuti kuvapo zvakawanda chords or the ose ventricle kuruboshwe uye mitral vharafu prolapse madhigirii kudzika shoma regurgitation. Recent zvokurwara kuoma arrhythmias uye kutungamirira kune congestive mwoyo kukundikana nezera.

Izvi zvinoreva kuti mararamiro evanhu vemazuva ano anofanira kuonekwa sechiratidzo chakaoma (syndrome), ichida chiremba kuti awedzere kufungidzira, chinangwa chekuziva kuwirirana kwezvirwere. Kunyangwe muhupenyu hwahwo hwakachena, SVD chirwere chinonzi neurogenic chinosanganiswa nekusawirirana pakati pekunzwira tsitsi uye parasympathetic peripher system system. Uyezve, tichifunga nezvekukosha kwevanhu mune hutachiwana, zvinokosha kuti tive nechokwadi chekuongorora zvirwere zveSVD. Izvi zvichaita kuti zvikwanisike kuparadzanisa zvirwere zvepfungwa uye zvepfungwa paunenge uchiita mabasa ekunyorwa kwekukurumidza basa remauto.