Kodi zizindikiro zimaonetsa somatoform autonomic kukanika ya ubongo?

Somatoform autonomic kukanika - lovuta mawu a Kupeza Vuto matenda. Iwo ali ndi zizindikiro zambiri monga thupi ndi maganizo. Komanso, odwala matenda iwo, kumva zizindikiro za matenda pachimake zokwanira zimene zimatsutsana ndi kuzindikira awo akatswiri. Chifukwa cha zonse zimene zikukhudzana ndi matenda, muyenera kumvetsetsa mwatsatanetsatane.

Mwachidule matenda SVD

Somatoform autonomic kukanika (SVD) wapezeka kawirikawiri anthu a m'badwo asilikali, kapena odwala amene kukumana mwamsanga slozhbu kapena kumenya nawo nkhondo mwachindunji. matenda, amene kumaonekera kulemera zizindikiro si yeniyeni ndipo amafuna diagnostics mwatsatanetsatane. cholinga chake ndi kuthetsa kuvutika structural za mtima ndi arrhythmias komanso matenda a chapakati mantha dongosolo.

Akukhulupirira kuti somatoform autonomic kukanika ndi vutoli kulimbikira pakati pa dongosolo wachifundo ndi parasympathetic mantha. SVD yokha lagawidwa mitundu itatu: SVD kwa mtima, hypotonic ndi hypertonic mtundu. Iwo ayenera kusiyanitsidwa ndi matenda a mtima, wolumikizira hypo- ndi oopsa, amene kuthetsedwa mu njira ya zochitika pa kuitana usilikali. Pachifukwa ichi, akazi SVD wapezeka kamodzikamodzi kuposa abambo ndi anyamata. Ngakhale 80% matenda poyera si anatsimikizira ndi komiti vrachebnokonsultatsionnoy chapakati.

symptomatology SVD

Somatoform kukanika wa mantha dongosolo autonomic akuwonekera zizindikiro misa nonspecific. Nthawi zambiri iwo amaoneka mosintha pa maziko a maganizo ndi kuyesedwa zinthu chete. Chofunika, ndi IRS amathanso adzatchedwa syndrome chifukwa limaphatikizapodi ambiri zizindikiro. Iwo amaoneka mungachite zotsatirazi syndromes: mtima, hypotonic, hypertonic. Komanso, pangakhale wamba simtpomy, zizindikiro dyspepsia, matenda kupuma, disadaptative thupi. Zizindikiro zimenezi tikambirana mwatsatanetsatane.

diagnostics ndizosowa

I chachikulu matenda a kufunika kwa SVD ndi: nthawi ya zizindikiro (zaka kuposa 2) ndiponso kusapezeka gemodinamicheskiznachimyh kapena moyo pachiswe arrhythmias mtima kapena dongosolo. Kwenikweni, ang'ono mtima kuvutika zonse osati chifukwa kusintha matenda mtima mungoli, kapena mphako, mwina pamodzi.

Matendawa "Somatoform autonomic kukanika" kenako pamodzi Mwachitsanzo, tricuspid (mitral, kung'ambika kapena m'mapapo mwanga) Kulephera, arrythmia yosowa chosakhalitsa WPW matenda kapena CLC. Komabe, odwala ngati uyenera kuchitika nthawi 2 chaka kudziwa kuyan'anila zina. N'zachionekere kuti ambiri a diagnoses ndi SVD poyera moti ankaweruzidwa ndi achinyamata alibe ufulu kulibe. Nthawi zambiri, matenda ndi dokotala yekha popanda dandaulo kokha pamaziko a pamaso vuto yaing'ono kandalama mtima. Chifukwa pafupifupi 80% ya diagnoses ndi kutsutsana, koma tanthauzo matenda ndi madandaulo yekha ndi comorbidities ndi syndromes.

zizindikiro zosonyeza SVD

Mu matenda, monga somatoform autonomic kukanika, zizindikiro ambiri achuluka. Izi maganizo zipolowe, dysphoria, dysthymia, kusafuna kuchita ntchito iliyonse thupi, zipolowe kudya, kufooka kwa thupi, mutu kobwereza, makamaka isanafalikire mu parietal ndi occipital dera. Nthawi zina wodwala nkhawa chizungulire ndi moto kutengeka m'madera podlozhechkovoy zosagwirizana ndi njala kapena satiety.

Chotero dandaulo la amakhala ndi asthenic syndrome somatoform autonomic kukanika. Odwala amakhala wofooka, nthawi zina kupanda kanthu ndi sindichedwa kupsa mtima. Aliyense wa zinthu izi khalidwe zikuwavuta kutenga bizinesi yatsopano. Makamaka, iwo anamaliza. Zodabwitsa Komabe, introversion, amene akufotokozera chifukwa cha kupambana zazing'ono masewera kapena wongokhala kumabweretsa chakuti ana amakhala azilipira ino. Iwo ali bwino kukumbukira, koma wopsinjika zinthu ndikuganiza mosaganizira. Kupewa nkhawa komanso kusafuna kuchita nawo zinthu zimene zimafuna chisangalalo maganizo, mbali khalidwe la odwala autonomic kukanika somatofrmnoy.

zolimbitsa thupi pa SVD

Low wololera kwa thupi - ndi chizindikiro ankaikira SVD. Odwala zikuwavuta nyamulani kokoka kalasi maphunziro thupi, makamaka ngati kumafuna kulimba. Childs, masewera mafoni n'zosavuta kwa odwala awa, pamene mphamvu Zochita chifukwa mavuto ambiri. Mungaone kuti pambuyo akuthamanga izo dyspnea kuposa ana ena a kumanga chomwecho. Komanso, odwala awa mofulumira asatope, kupirira kwawo ndi poyerekeza ena. Komanso pa katundu maziko angaoneke kupuma kapena mtima SVD zizindikiro pansipa.

Mtima (mtima) dandaulo odwala

Somatoform kukanika wa mantha dongosolo autonomic akuwonetseredwa ndi zizindikiro zambiri zomwe zimapangidwa ndi vutoli pakati sympathico ndi parasimpatikoy innervated limba. madandaulo mtima, popeza thupi ali innervation autonomic, ndi mwa zofunika kwambiri. Zizindikiro ambiri SVD ya zipangizo mtima ndi magazi: mtima ululu, tachycardia, kuchuluka kapena kuchepa magazi.

Chikhalidwe cha ululu mu mtima mwanga si yeniyeni ndi matenda makamaka. Ululu nthawi kubaya ndi zina kukanikiza. malo - mitima ya m'munsi ndi (3-6 masentimita kumanzere kwa sternum) ndipo pamwamba (5 cm kumanzere kwa sternum pa 5 intercostal danga). Tachycardia bwino zimayamba ndi maganizo kapena maganizo thupi. Nkofunika kuti akufotokozera katundu akanagwiritsa adatengedwa ndi yokoka. Mwachitsanzo, tachycardia limapezeka asanalankhule zolimbitsa thupi kapena pa chiyambi, ndipo si monga kuwuka kwake.

Nkofunika kuti ululu mu mtima mwanga, ngati iwo ali ndi khalidwe la yoyaka moto, ndi (kapena) compressing kuwoneka mphindi 20-30, ayenera kuonedwa ngati ischemic, chimene chimafuna chojambulira wa electrocardiography kwa yayifupi zotheka nthawi. Ichi ndi chifukwa kukhalapo mabungwe matenda monga zosinthika angina ndi mtima syndrome X. Mu pathologies izi nthawi 50-100 apamwamba mosavuta imfa yadzidzidzi inatsekeratu.

Hypotension kapena matenda oopsa

Oopsa akufotokozera infrequently. Iyi ndi njira ambiri osowa wa SVD, chifukwa nthawi zambiri waona mitundu mtima kapena hypertensive. Komabe hypotonic mtundu SVD kuwonekera nthawi kusiya magazi pa manja onse. Nkofunika kuti matenda a mtundu wa matenda chofunika kuchita echocardiography ndi electrocardiography, moti kuchotsa pamaso pa matenda a mtima kapena arrhythmias. Kukomoka komanso ndi zizindikiro za SVD, ngakhale nonspecific.

Matenda oopsa - dandaulo lililonse. Odwala staradayut kuthamanga kuwuka pamaso kuchita masewera olimbitsa thupi, osati mu izo. Kuthamanga ambiri kuchuluka kwayekha liukitsidwa kwa 160 systolic magazi, pamene diastolic ali yemweyo. Polingalira za elasticity Mitsempha mu achinyamata ndi amayi achichepere amene ali somatoform autonomic kukanika a mtima ndi matenda zambiri, diastolic magazi ndi amene angathe kuchepa penapake.

Ichi ndi chifukwa vutoli a dongosolo wachifundo ndi parasympathetic mantha, minofu zambiri pamene norepinephrine mtsempha wamagazi, kucheperachepera zotumphukira mtima kukana. Nkofunika kuti kuthamanga kwambiri chifukwa nthawi zonse, chifukwa ali ndi matenda a matenda oopsa sangathe anapereka.

madandaulo kupuma

Mu matenda monga somatoform kukanika wa mantha dongosolo autonomic komanso ndi zizindikiro za khalidwe kupuma. Malamulo ndi maonekedwe awo ofanana ndi amene ali ndi mlandu wa cardialgia, hypotension kapena matenda oopsa. Ndiye zizindikiro kupuma kumachitika nthawi thupi. Komanso, amene ali omveka kwa SVD, iwo akhoza kuoneka Titamaliza zokambirana mu nyengo zina. Zimenezi n'zosiyana ndi madandaulo kupuma SVD zizindikiro mphumu pampanipani thupi.

Zitsanzo za madandaulo ndi SVD: anasonyeza wosanganiza dyspnea pa yaikulu kapena zina nthawi pambuyo kukhazikitsa, zikayamba ndi kupuma ake mavuto. Yerekezerani, mu mphumu wosweka mpweya. Pamodzi ndi madandaulo kupuma pa matenda monga somatoform kukanika a dongosolo autonomic akuwonetseredwa mtima. olowa maonekedwe awo - zapadera, koma chizindikiro si yeniyeni, pozvolyayuy kupanga matenda amenewa.

Dyspepsia ndi SVD

Mu matenda monga somatoform kukanika wa mantha dongosolo autonomic, zoyambitsa n'zambiri. Iwo zimayambitsa mu vutoli pakati pa parasympathetic ndi wachifundo machitidwe mantha. Komanso, lonse thirakiti m'mimba ndi nawo ntchito ndondomeko imeneyi, chifukwa kwathunthu innervated mwa dongosolo parasympathetic. Mitsempha vagus akulamulira katulutsidwe mmimba, kapamba, intestine. Iye ali ndi udindo kwa luso galimoto ndi onse chimbudzi. Chifukwa pamene SVD amapezeka pafupipafupi dyspepsia, ndi ululu m'mimba.

La ambiri zochitika otsegula m'mimba ayenera allocated nseru popanda kusanza, kupweteka kobwereza m'dera epigastric, amene yodziwika mwa kuphwanya kapena kubaya. maonekedwe awo sikudalira chakudya: ndi wachisokonezo ndipo amagwirizana makamaka nkhawa. Komanso, ululu akhoza isanafalikire mu malo ena aliwonse a pamimba. Iwo amaoneka mwadzidzidzi kapena pa thupi. zowawa izi si ikuchitika m'madera ena a pamimba ndi limodzi ndi malungo, kutsekula m'mimba kapena kusanza.

Nkofunika kuti zizindikiro tatchulazi zimachitika ndi azitsegula. Akukhulupirira kuti matenda osiyanasiyana. Komabe, pamene chifukwa cha IBS ndi akamakonda colonic motility. Chifukwa mwina ayenera kutengedwa ngati IBS chizindikiro SVD. Komanso, ndi ambiri mu odwala matenda SVD. Zizindikiro za matenda matumbo ali anachedwa chopondapo, bloating ndi kugunda mu pamimba.

Olondola matenda a SVD

Mu matenda monga somatoform kukanika wa mantha dongosolo autonomic, mankhwala amusankha payekha malinga zizindikiro mosavuta. SVD matenda sangathe anapereka popanda kudandaula wodwalayo, akuwonetseredwa zaka 2 kapena zambiri kukumana i pamwamba. M'pofunikanso kuthetsa matenda onse organic: kobadwa nako (kapena kugula) mtima zopindika, arrhythmias, matenda a chithokomiro, zilonda zam'mimba (kapena 12 mmatumbo chilonda), gastritis, matenda amene amatupitsa, diverticulosis intestine.

M'pofunikanso kupewa zotheka maganizo matenda, zomwe kumawonetsera matenda somatoform. Izi zikutanthauza kuti wodwalayo ayenera kuchita kafukufuku: kuti ambiri ndi amuzolengedwa MAGAZI, urinalysis, magazi shuga timadzi schitovdidnoy England, muzilemba ECG, kuchita echocardiography, FEGDS, ultrasonography ya mitsempha brachiocephalic ndi chithokomiro. Zotsatira za kafukufuku amanena kuti, kaya matenda kapena chizindikiro mawonetseredwe SVD N'chimodzimodzinso matenda ena.

Somatoform autonomic kukanika: chithandizo

SVD mankhwala ndi njira zingapo kuti kuphatikiza pharmacotherapy, vitamini mankhwala supplementation a muyezo mchere wa m'thupi, mankhwala kuntchito ndiponso chithandizo thupi. Mu pharmacotherapy zofunika moyenera nootropics (kapena antidepressants) ndi cardiotropic. Chitsanzo ndi osakaniza kukonzekera "Phenibutum" kapena "Noofen" pa mlingo wa 250 mg katatu pa tsiku kwa miyezi 2 "Thiotriazoline" 100 mg 2 pa tsiku kwa miyezi 2. Pa poika antidepressants ayenera kuonana ndi zamaganizo amene amapenda msinkhu ndi potenialnuyu ngozi mankhwala wodwala.

Mu matenda monga somatoform kukanika wa mantha dongosolo autonomic, mankhwala mulinso mineralotherapy. Kutsimikizira kuti Mwachitsanzo, mitral vavu prolapse , kapena kulephera ena kuli nthambi amagwirizana ndi interstitial mankhwala enaake a vutoli. Limabwezeretsa milingo yake kumathandiza kuchepetsa zizindikiro za madandaulo mtima ndiponso azikhala hypotension kapena matenda oopsa.

Vitamini, makamaka chimathandiza mavitamini C, E ndi D, komanso B1, B2, B5 ndi B6 chofunikira zomveka. Komabe, zinthu izi bwino chosakanikirana vitamini pa coadministration. Chifukwa chofunika kuwombola chithandizo 1 mwezi magulu mavitamini C, E ndi D, kenako 1 mwezi mavitamini B1 ndi B2, ndiye 1 mwezi B6 ndi B5. Kumene, monga m'mimba deta anthu apanga mavitamini okha, ayenera kudya masamba atsopano ndi zitsamba popanda kutentha mankhwala.

Popeza Kukula kwa SVD atenge mbali ya chidwi otsika mu umoyo wawo ndi kunyalanyaza thupi, kubwezeretsa mavitamini ndi mchere, kumathandiza kuchepetsa zovuta zizindikiro. Pantchito Therapy pa chithandizo chipatala chaching'ono (malipiro monga kuchipatala si chikalata mavocha odwala SVD) kumakhudza kwambiri wolimba kwambiri. Koma wodwala bwino kufotokoza kuti ngakhale ena ndiwo mankhwala osachepera kwa iye chifukwa nthawi zina anali kudandaula ayi.

Somatoform kukanika wa mantha dongosolo autonomic (ICD-10)

Mu gulu lonse la matenda pamenepo kuyambira 1993. kudwala amenewa amapezeka padziko lonse ndipo sikudalira makhalidwe a mtundu kapena mtundu. The ICD 10 somatoform autonomic kukanika Revised V ndi VI yakeyi. Woyamba zikuphatikizapo "Mental ndi matenda khalidwe" (chokhudza malamulo F0-99), ndipo chachiwiri - "Neurotic, nkhawa zokhudzana ndi somatoform matenda" (yosiyanasiyana F45-F48 kachidindo).

F45 Category zikuphatikizapo pathologies zotsatirazi: somatisation chisokonezo undifferentiated somatoform chisokonezo somatoform autonomic kukanika mwachindunji, matenda hypochondriacal, zisathe somatoform ululu chisokonezo ndi matenda ena yosadziŵika ya lamulo mantha. Iye somatoform autonomic kukanika F45.3 malamulo ndi ozimbayitsidwa ndipo amafuna kuwonongedwa kwa ziwalo matenda innervated zotumphukira autonomic mantha dongosolo.

Pomaliza

Asayansi ambiri amakhulupirira kuti somatoform autonomic kukanika tiyenela kuiganizila mwatsatanetsatane. matenda amakhudza anatengera wodwalayo chikhalidwe. Chiwerengero cha milandu anatsimikizira mawu kuphatikiza wa SVD ndi anomalies kandalama sedrtse. Mchitidwe lonse la echocardiography wandilora kupeza kuti kukhalapo kwa makodi zambiri za ventricle kumanzere ndi valavu mitral prolapse madigiri m'munsi regurgitation kochepa. Recent kudwala kobvuta arrhythmias ndi kutsogolera kwa congestive kulephera mtima ndi zaka.

Izi zikutanthauza kuti somatoform autonomic kukanika ayenera kutengedwa ngati chizindikiro (matenda), zofuna dokotala kwa matenda zina, umalimbana chizindikiritso cha comorbidities. Ngakhale choyera HIC - matenda neurogenic, amene amagwirizana ndi vutoli pakati pa dongosolo wachifundo ndi parasympathetic zotumphukira mantha. Komanso, popeza kufunika chikhalidwe cha kudwala, ndikofunika kukhazikitsa muyezo matenda momveka kwa SVD. Izi adzalola kusiyanitsa matenda psychogenic ndi somatic mu ntchito zomwe kuitana usilikali.