Kodi mavuto myasthenic? chithandizo

vuto lililonse - ndi vuto anthu, limene mwadzidzidzi, unayamba kuwonongeka njira ya matenda, zizindikiro za ukuwonjezeka kufa msanga kwambiri. Myasthenic ndi cholinergic mavuto, ndi mnzawo wa myasthenia gravis, ndi oopsa chifukwa wodwala akhoza kutha kupuma ndipo mtima wake anasiya kumenya. Nthawi zina moyo wa munthu kwenikweni anayesedwa Mphindi, zomwe anthu kuchipatala chapafupi ayenera ali ndi ufulu kukhala ndi nthawi kuthandiza. Nanga n'chifukwa chiyani akuchuluka Zingaoneke, si woopsa matenda myasthenia gravis? Tikupereka ndi osavuta bwino kwa munthu wina zimene aliyense ayenera kudziwa: zimayambitsa myasthenic ndi cholinergic mavuto, chipatala, chisamaliro mwadzidzidzi amene mosavuta chinachitika. Mwina munthu kutseka kwa ife, ngati mwadzidzidzi mu mayendedwe kapena kungoti pa msewu zidzakhala zoipa, zimene zili mu nkhani imeneyi kudzakuthandizani kupulumutsa miyoyo.

myasthenia

Nkhani za kufa ziwalo kuyamba mwa kufotokoza mfundo za myasthenia gravis. Nthawi zina kutenga padziko matenda kunja m'dera chilango, monga akudwala myasthenia kudandaula za kutopa, ulesi, sanathe kuchita ntchito iliyonse thupi, basi yophweka. Ndipotu, myasthenia gravis ndi matenda neuromuscular, zokhudzana ndi gulu la autoimmune, kuti chifukwa cha kulephera thupi apange chitetezo chabwino kapena yopanga maselo wakupha kuti aukire zimakhala wathanzi ndi maselo kukhala ndi mavuto aakulu.

Myasthenic mavuto akufotokozera pa maziko a matenda ambiri, ndipo ali ndi zizindikiro zofanana kwa iye, kokha zimapezeka Pamlingo kwambiri kuti poyamba linaphetsa pafupifupi 40% odwala. Tsopano, ngati mankhwala ali anayamba mwamsanga, imfa zikhoza kupewedwa. Ndikufuna kuona kuti myasthenia odwala anthu 10 mwa aliyense 100 zikwi nzika ya Dziko Lapansi, ndi akazi amakhudzidwa ndi maulendo 3 zambiri kuposa abambo. Myasthenia gravis angasonyeze ana, koma Zikatero n'zochepa. Iwo makamaka anati odwala kuyambira azaka 20 mpaka m'badwo kucha akale.

Zizindikiro za myasthenia gravis

Popanda myasthenia gravis, ngati chili mwa munthu, myasthenic mavuto sangathe zimachitika. Komabe, nthawi zina pa matenda ena ndi zizindikiro zofanana, mwachitsanzo, monga zatchulidwazi ulesi, kufooka, kutopa. Zizindikiro zina mwa makanda:

- kuŵeramitsa zikope, ambiri noticeable madzulo, ndi kucheperachepera m'mawa pambuyo zina usiku;

- awiri masomphenya;

- wotopa, pambuyo ochiritsira mkulu kutopa katundu kwa anthu ena, monga kukwera masitepe;

- zizindikiro koyamba bulbar (m'mphuno mawu maonekedwe pambuyo chakudya ndi nkhani yaitali, amavutika katchulidwe ka zilembo munthu);

- mphamvu bulbar zizindikiro (vuto kumeza pafupipafupi kutsamwa);

- autonomic kukanika (matumbo paresis, tachycardia);

- nkhope (pa mphumi tatikulu makwinya, khalidwe nkhope akuti);

- salivation kwambiri;

- mavuto atagwira mutu;

- vuto kuyenda.

Chinthu chapadera cha myasthenia - onse zizindikiro zakumwamba ndi poipa pambuyo zofuna kukhetsa thukuta ndi madzulo, ndipo patapita mpumulo wabwino ndi kuchepetsedwa kapena kwathunthu kutha.

Symptomatology zamavuto myasthenic

Ngati munthu amadwala myasthenia gravis, pa zochitika zina, kungakhale mavuto myasthenic. Zizindikiro za matenda chachikulu, makamaka monga tachycardia, mkulu kutopa zofunika minofu (kupuma, mtima), salivation, nthawi yomweyo mphamvu. Mbali Zotsatirazi zikusonyeza kuti vutoli:

- ziwalo za minofu ya Pomeza ndi chinenero, kotero kuti akhoza kulowa mu kapepala kupuma ntchofu, malovu, chakudya;

- awonongedwa;

- amphamvu mukubwadamuka ndi mantha chifukwa cha kusowa mpweya;

- thukuta ozizira;

- zina mowiriza pokodza ndi / kapena defecation;

- imfa ya chikumbumtima;

- khungu youma;

- magazi kudumpha;

- dilated ana;

- pachimake mtima kulephera, kuti ndi kuphwanya mtima.

Myasthenic yovuta madigiri zingapo:

- zosavuta;

- pafupifupi;

- adalemeradi;

- mphezi.

Kusiyanaku kugona mu mphamvu mawonetseredwe pamwamba zizindikiro. Makamaka oopsa mphezi ndi vuto lalikulu lomwe munthu mofulumira kwambiri, basi angapo Mphindi, akufotokozera kufooka kwa minofu kupuma ndi kumeza. Kupuma amakhala mofulumira poyamba, maso ofiira, kulumpha mmwamba kuthamanga, kugunda kwa mtima ukufika m'ma 160 kumenyedwa pa mphindi. Ndiye mpweya wayamba udzasokonezedwa, ndipo akhoza kutha palimodzi, nkhope yake kutembenukira buluu (mankhwala umatchedwa cyanosis) anzawo amachepetsa, zimachitika sadzachitanso palpable.

Zimayambitsa mavuto myasthenic

Myasthenia gravis kungakhale kobadwa nako kapena kugula. Woyamba chifukwa cha kusintha chibadwa. The chachiwiri akufotokozera munthu atakhala:

- mavuto ndi thymus England;

- mitundu ina ya khansa (mwachitsanzo, chifuwa, m'mapapo, mazira);

- hyperthyroidism;

- encephalitis lethargic.

Against maziko a matenda amenewa myasthenic mavuto angayambe milandu zotsatirazi:

- matenda opatsirana pachimake, kuphatikizapo SARS, fuluwenza, matenda;

- kugwira ntchito;

- amphamvu maganizo nkhawa;

- High zolimbitsa thupi;

- mankhwala ena (mwachitsanzo, asamakhale ndi nkhawa);

- matenda m'thupi;

- chikudutsa myasthenia odwala kutenga mankhwala, kuphwanya kwa Inde mankhwala.

mavuto cholinergic

Myasthenic mavuto ndi cholinergic amayambira mu kufanana, nchifukwa chake pali zolakwika zosiyanasiyana ndi, monga chotsatira cha mankhwala. Komabe, awiriwa chinachake chofanana mawonetseredwe kunja boma chifukwa cha zifukwa osiyanasiyana ndipo ali etiology osiyana.

Choncho, pamene myasthenic mavuto cholinergic zolandilira amachepetsa kachulukidwe nembanemba chifukwa chiwonongeko, ndi otsala amasokoneza ntchito zawo. Mavuto cholinergic amapezeka kutsegula pamene chosefukira cha zolandilira cholinergic (a nicotinic ndi / kapena muscarinic). Akuthamanga phwando ndondomeko kukonzekera mankhwala a myasthenia gravis mu mlingo waukulu, komanso njira zimene zomangidwa matenda.

Oterewa vutoli n'kovuta, chifukwa zizindikiro zake zazikulu lifanane ndi myasthenic. Thandizeni molondola kudziwa zimene zimachitika kwa munthu, mbali zimenezi zingakhale zabwino m'malo mwake, khalidwe la mavuto cholinergic: wodwala amasonyeza zizindikiro za kuledzera: m'mimba mukupweteka, akutsegula kusanza, kutsekula m'mimba wayamba. Pakuti mavuto myasthenic yodziwika ndi onse kupatula zizindikiro zimenezo.

Mbali yachiwiri ndi mavuto cholinergic - akuchuluka zizindikiro za myasthenia gravis osachita zinthu zakuthupi, koma pambuyo kumwa mankhwala cholinesterase.

mavuto wosanganiza

Ndi mtundu thanzi ndi moyo yoopsa kudwala. Chili myasthenic mavuto ndi cholinergic, kusonyeza kamodzi zinthu zonse zalembedwa ndi zizindikiro onse. Izi zimapangitsa kukhala kovuta kukonza matenda, koma makamaka - mankhwala, chifukwa mankhwala amene kupulumutsa vuto myasthenic, cholinergic zina kukulitsa. Pamene otaya mavuto wosanganiza kusiyanitsa mbali ziwiri:

1. myasthenic. Odwala anati matenda kutchulidwa bulbar, mavuto kupuma, masewera olimbitsa thupi amachititsa kutopa, koma utsogoleli wa mankhwala ( "Klamin", "Neostigmine") sayambitsa zosiyanasiyana chokhwima.

2. Cholinergic yodziwika ndi zizindikiro za kuledzera.

Khalani wasonyeza kuti mavuto wosanganiza zambiri zimachitika anthu amene kale izi kapena kuti vuto mu makanda.

Angakhale akuganiza wosanganiza vuto la ziwalo mawonetseredwe:

- odwala bwino anati movutikira ndipo bulbar kuphwanya ndi galimoto ntchito ya nthambi anasintha pang'ono;

- Kodi zosakhudza kumwa mankhwala kuchepetsa zizindikiro pathological, monga ntchito bwino galimoto ndipo kunalibe amathandiza ziziyenda kupuma.

diagnostics

Kupewa mofulumira kupereka thandizo aphindu mavuto myasthenic, ndi kofunika matenda m'thupi la wodwalayo bwino. Monga taonera, zizindikiro zina zikhoza kupezeka myasthenic mavuto matenda zosagwirizana myasthenia gravis (mwachitsanzo, movutikira, osasamba kugunda). Symptomatology mavuto cholinergic ofanana ndi amene amakumana nawo kuledzera, ndi mavuto ena ndi kapepala kakuti m'mimba. Ngati wodwalayo maintainer, amatha kupereka mfundo zokhudza kukhala myasthenia wake ndi mankhwala kutenga nawo, matenda ofunda ndi wosalira kwambiri. Kusiyanitsa mtundu wa mavuto, madokotala kuchita prozerinovuyu nyemba.

movutikira Special matenda ali anamuona kusisita losanganikirana. Pofuna kudziwa zolakwa-free gawo lake loyamba ikuchitika kusanthula matenda a mtima, komanso electrophysiological ziyenera mmene akamagwira kulandira mankhwala anticholinesterase.

Pamaso pa munthu gravis (pamaso mavutowo) ndi wapezeka mwa electromyography, yopangidwa Tomography, pharmacological ndi mayesero immunological.

chisamaliro Emergency mavuto myasthenic ndi cholinergic

Ngati wodwala ndi myasthenia mwadzidzidzi sakuyenda (kubwera mavuto), ndi moyo umapitilira miniti. Chinthu chachikulu kuti ziyenera kuchitika padziko - yomweyo itanani ambulansi. Mwatsoka, kwenikweni wathu, pali nthawi zina pamene chisamaliro apadera anachedwa. Kodi tingathandize bwanji akufa mu zikachitika? Choyamba, yesani kupereka iye ndi mpweya, kuchotsa ndi ntchofu ku mmero wake. Malinga ndi malamulo, ayenera kudwala myasthenia muyenera kukhala ndi mawu ngati ali ndi matendawa, ndi mankhwala (monga "Neostigmine") ndi syringe. Ngati palibe kufika mwamsanga posachedwapa, munthu mavuto myasthenic m'pofunika kuti jakisoni malinga ndi mfundo cholemba.

Unathandizapo, madokotala zifunika hospitalize wodwala mu nkhani yofunika, ndi odwala mwakayakaya, komwe tima mwadzidzidzi mankhwala:

- kupeleka airway;

- kotunga mpweya;

- hardware ndi makina mpweya wabwino.

Ngati wodwala alibe zizindikiro za mavuto cholinergic (kusanza, kutsekula m'mimba), anayambitsa mankhwala zotsatirazi: "Neostigmine", "atropine". Mu kukhalapo kwa zizindikiro za kuledzera chithandizo mwadzidzidzi yekha mu othandizira ndi jekeseni wa mankhwala awa, "atropine", "immunoglobulin", komanso ena zipangizo zina mankhwala pamene anasonyeza.

chithandizo

Ngati munthu anali ndi mavuto myasthenic, mankhwala mankhwala mwadzidzidzi ikuchitika pamaziko a mayesero matenda ndi zasayansi, ndi kusanthula mphamvu ya matenda. Mawotchi mpweya (ie, yokumba magawanidwe a m'mapapo), malingana ndi chikhalidwe matenda a mtima, komanso umboni wa kukhalapo kwa mpweya magazi akhoza kuchitika kwa masiku asanu ndi limodzi, koma ngati wodwalayo pambuyo 16 kapena maola kapena zambiri pali anachita zabwino "Neostigmine" othandizira kunyalanyaza . Nthawi zambiri zimatenga kwambiri othandizira ndi kumva, napempha polojekiti kopitirira respirators,% mu zikuchokera mpweya magazi, magazi, kutentha, madzimadzi bwino mu thupi ndi ena.

Njira yabwino kuthana ndi mitundu yonse ya ngozi mu makanda ndi plasmapheresis kuwombola. Pamene zitsanzo zosankhidwazi magazi ikuchitika ku chapakati (kapena chigongono) mtsempha, centrifuged, kusintha plasma mwiniwake kapena yokumba. Njira imeneyi amapereka zotsatira zabwino - mkati maola angapo a alili ali bwino kwambiri. Plasmapheresis imagwiridwa njira 7 masiku 14.

Imodzi mwa magawo a mankhwala mankhwala. Malinga ndi umboni wa odwala zimachitika immunoglobulins, antioxidants, mankhwala anticholinesterase, ndi pamaso kutupa - mankhwala.

Kuneneratu ndi kapewedwe

zaka makumi atatu kapena makumi anayi zapitazo, zakambidwa amapha odwala ndi myasthenia pa exacerbation la matenda zachitika nthawi zambiri ndithu. Tsopano amafa wakhala yafupika ndi maulendo 12. Muyenera kumvetsetsa kuti zina zochita zathu ndi inu zimadalira moyo wa munthu, wokhala nacho mavuto myasthenic. thandizo Emergency ayenera kupatsidwa mofulumira kwambiri. Choncho, ngati mwadzidzidzi pa msewu, mu mabasi ndi magalimoto, kulikonse kumene ife tikuona munthu amene wayamba zitsamwitsa, muyenera itanani ambulansi yomweyo.

Myasthenia odwala ayenera kugwiritsa zingapo amayesetsa kupewa mavuto:

- kukhala moyang'aniridwa ndi dokotala, ndipo kutsatira mankhwala akuchipatala;

- Pewani chogwira ntchito mopitirira muyeso, kusokonezeka wamanjenje;

- zotheka chenjerani ndi matenda opatsirana;

- musati kuonetsa matupi kuledzera;

- chakudya kuti monga zakudya zokhala ndi potaziyamu (mwachitsanzo, mbale mbatata, zoumba).