Mob ntshav qab zib polyneuropathy: ICD-10 code, tsos mob, ua rau thiab kho mob

Ntshav qab zib polyneuropathy yog ib qho mob cuam tshuam rau ntshav qab zib ntau dua. Nws ntseeg tias kev mob ntshav qab zib mob ntshav qab zib muaj ntau dua ntau dua 70-90% ntawm txhua tus neeg mob ntshav qab zib tshaj 5 xyoos. Ntawm cov theem pib, cov ntaub ntawv asymptomatic txoj kev yeej, uas tuaj yeem pom tsuas yog nrog cov kev soj xyuas lub hlwb thiab / lossis nrog cov hau kev ntawm kev tshawb fawb

Cov ntaub ntawv rau cov kws kho mob. Txhawm rau nkag siab txog kev kuaj mob ntshav qab zib polyneuropathy, kev cai G63.2 * raws li ICD 10 yuav tsum tau siv. Qhov no, qhia qhov sib txawv ntawm tus kabmob (hnov, lub cev muaj zog, autonomic, lossis cov sib xyaw ua ke), qhov sib txawv ntawm cov tsos mob pom. Thawj qhov kuaj mob yuav tsum tau qhia txog tus kab mob ntshav qab zib mellitus ncaj qha (ICD 10 tus lej E10-E14 + uas muaj qhov cim plaub 4).

Kev txhim kho ntawm tus kabmob yog cuam tshuam nrog lub xeev kev ua haujlwm hyperclycemic, insulin deficiency (tsis paub lossis tus txheeb ze), microcirculation cuam tshuam nyob rau hauv cov hlab ntsha leeg. Kev puas ntsoog axon puas feem ntau txhim kho, tab sis segmental demyelination tuaj yeem tshwm sim. Kev sib xyaw ntawm polyneuropathy thiab angiopathy ntawm qhov xaus yog qhov ua rau trophic mob nyob rau hauv cov ntshav qab zib mellitus, tshwj xeeb ua rau kev txhim kho mob ntshav qab zib taw.

Kev faib tawm

Los ntawm hom kev tshwm sim thiab hauv cheeb tsam ntawm cov tsos mob, cov ntawv hauv qab no ntawm cov ntshav qab zib polyneuropathies tau txawv:

• Cov kab mob sib thooj tam sim no polyneuropathy (amyotrophy).
• Asymmetric tso siab neuropathy ntawm cov hlab ntsha loj (feem ntau yog ua pob txha, poj niam txiv neej los yog nruab nrab).
• Neuropathies ntawm cov leeg cranial.
• Asymptomatic polyneuropathies.
• Hom mob uas sib txawv ntawm cov mob polyneuropathy.

Distal polyneuropathy yog hom mob ntshav qab zib ntau tshaj. Nws nyob ntau dua 70% ntawm txhua hom kabmob no. Lo lus distal qhia qhov yeej ntawm qhov chaw ntawm qhov kawg mus deb ntawm lub cev (txhais tes, taw). Teas cuam tshuam qis qis ceg sai dua. Nyob ntawm qhov xwm txheej ntawm qhov chaw txhab, cov ntawv hauv qab no yog qhov txawv:

• Hnov.
• Lub cev muaj zog.
• Nroj Tsuag.
• Sib xyaw (sensorimotor, lub cev muaj zog-piav thoob-vegetative, piav thoob hlo-vegetative).

Cov duab hauv chav soj ntsuam ntawm tus kab mob nyob ntawm daim ntawv ntawm polyneuropathy, qhov ntsuas ntawm lub paj hlwb puas, thiab ntshav qab zib.

• Txo polyneuropathies yog cov yam ntxwv, ua ntej txhua yam, los ntawm kev txhim kho kev cuam tshuam ntawm cov leeg trophism, poob phaus ntawm tag nrho cov ceg tawv, thiab txo nws lub zog. Kev noj qab haus huv thiab muaj lub zog ua haujlwm tsawg dua cuam tshuam.
• Mob ntshav qab zib neuropathies ntawm cov leeg cranial sib txawv raws cov neeg kawm ntawv ntawm kev puas tsuaj rau ib khub twg. Yog li, feem ntau cov qhov txhab txhab ntawm oculomotor cov hlab ntsha, uas ua tau nws tus kheej ntau dua nyob rau hauv daim ntawv ntawm ib qho kev mob hnyav ntawm tus mob ophthalmoplegia. Lub yeej ntawm optic lub cev yog tus cwj pwm los ntawm lub cim txo hauv lub zeem muag, muaj qhov muag plooj hauv lub qhov muag, pom kev tsis pom kev ntawm twilight. Tsawg feem ntau, ua rau ntawm cev, thaiv, ntsej muag leeg puas yog cuam tshuam. Qhov tshwm sim feem ntau ntawm qhov mob CFN txhab yog lawv qhov mob ischemia, thiab lub sijhawm pib ntawm kev kho feem ntau ua rau cov txiaj ntsig zoo.
• Asymptomatic polyneuropathies feem ntau pom los ntawm lub caij nyoog, nrog kev soj ntsuam cov leeg hlwb. Lawv pom tshwm los ntawm kev txo qis hauv cov leeg hauv siab dua, ntau zaus ntau dua li lub hauv caug.
• Cov ntaub ntawv distal polyneuropathy yog manifested, raws li txoj cai, pom tseeb heev. Yog li, qhov pom ntawm qhov kev paub tab yog qhov tshwm sim nws tus kheej nyob rau hauv lub xub ntiag ntawm qhov chaw mos nyob hauv tus neeg mob, mob kub hnyiab, ua rau lub cev tsis muaj zog. Tsis tas li, ib tug neeg yuav pom qhov ua txhaum cai ntawm qhov tsis hnov ​​qhov tseeb, yuav sau qhov kev xav zoo li "taug kev hauv ncoo" uas nws tsis xav tias muaj kev txhawb nqa thiab nws lub cev tsis zoo. Nrog rau daim ntawv distal ntawm cov mob ntshav qab zib polyneuropathy ntawm qis dua qhov qis, mob ntswj mob feem ntau. Kev ua txhaum ntawm gait tuaj yeem ua rau muaj kev txhim kho ntawm deformity ntawm ko taw thiab, tom qab ntawd, cov tsos ntawm tus mob taw.

Lub cev tsis zoo yuav ua rau tachycardia, hypotensive orthostatic tshua, ua haujlwm ntawm lub plab thiab zais zis, lub zog qis dua, thiab kev tawm hws. Txoj kev pheej hmoo ntawm lub plawv dhia ua ke kuj tseem nce ntxiv.

Lub cev muaj zog cuam tshuam nyob rau hauv daim ntawv distal ntawm polyneuropathy yog qhov tsis haum, tshwj xeeb tshaj yog nyob rau hauv daim ntawv cais. Lawv tsiag ntawv los ntawm kev txhim kho hauv kev tsis zoo ntawm cov pab pawg neeg mob distal, txo lawv lub zog.

Kev kuaj mob

Kev kuaj mob ntawm tus kab mob yog ua raws cov duab hauv chaw soj ntsuam, kev soj ntsuam cov leeg mob hauv lub cev thiab sau cia qhov tseeb ntawm qhov muaj ntshav qab zib ntev ntev. Hauv cov xwm txheej nyuaj, nws yog ib qho tsim nyog yuav tsum tau ua rau electroneuromyography, uas tso cai txhawm rau txheeb xyuas qhov pib hloov pauv ntawm kev coj ua ntawm txoj hlab ntaws raws cov hlab ntsha, kev sib tham ntxiv ntawm tus kws kho mob endocrinologist.

Yees duab txog cov mob ntshav qab zib polyneuropathy

Kev kho mob ntshav qab zib polyneuropathy yuav tsum muaj txhij txhua, nqa tawm ua ke nrog tus kws kho mob endocrinologist thiab kws kho mob. Ua ntej tshaj plaws, kev tswj ntshav qab zib yog tsim nyog. Kho cov pluas noj, cov kev kho mob yooj yim rau ntshav qab zib. Nws tseem yog qhov yuav tsum tau ua kom tsis txhob muaj cov micro- thiab macroangiopathies, yog tias tsim nyog, nqa tawm txoj kev kho mob uas tsim nyog.

Txhawm rau cheem cov neurological tshwm sim, thioctic (alpha-lipoic) acid npaj (berlition thiab nws cov analogues) yog qhov feem ntau siv. Kev siv tshuaj kho mob yog nqa tawm hauv qhov tshuaj txaus (thawj qhov yuav tsum yog tsawg kawg 300 mg ib hnub) thiab cov kev kawm ntev (tsawg kawg 1,5 hlis). Kev kho mob kuj tseem tuaj yeem ntxiv nrog ipidacrine hydrochloride npaj (Axamon, Ipigrix, Neuromidine). Cov vitamins B kuj tseem siv dav.

Nyob rau ntawm qhov muaj mob chua leeg, anticonvulsants (nyem ntawm neuropathic mob), tshuaj tiv thaiv kev ntxhov siab, opioids tuaj yeem siv (rau cov ntsiab lus ntxiv, saib kuv tsab xov xwm kev tshawb fawb).

Ib qho chaw tseem ceeb hauv kev kho mob ntshav qab zib polyneuropathy yog kev kho mob tawm dag zog, kho lub cev, thiab zaws. Yog tias muaj cov cim ntawm deformation ntawm txhais ko taw, xaiv orthopedic ntawm insoles thiab khau yog qhov tsim nyog. Hauv txhua qhov teeb meem, lub luag haujlwm tseem ceeb tshaj plaws yog ua los ntawm kev saib xyuas daim tawv nqaij zoo thiab kev tiv thaiv kab mob microdamage.

Dab tsi yog qhov no

Polyneuropathy yog qhov tseem ceeb tshaj plaws ntawm kev mob ntshav qab zib, tag nrho cov ntsiab lus ntawm qhov uas ua tiav ntawm cov kev muaj zog ntawm txoj kev tiv thaiv tsis muaj zog.

Kev puas ntsoog hauv polyneuropathy

Feem ntau nws ua tau nws tus kheej los ntawm lub sijhawm zoo uas tau dhau los txij li kev txheeb xyuas ntawm kev cuam tshuam ntawm cov kab mob endocrine. Tshwj xeeb tshaj yog, kab mob tuaj yeem tshwm sim nees nkaum tsib xyoos tom qab pib mob nrog teeb meem ntawm kev tsim cov tshuaj insulin hauv tib neeg.

Tab sis, muaj qee qhov mob thaum pom tus kab mob hauv cov neeg mob ntawm endocrinologist tsis pub dhau tsib xyoos los ntawm kev pom ntawm cov kab mob pathologies ntawm tus txiav. Txoj kev pheej hmoo ntawm kev muaj mob yuav zoo ib yam rau cov neeg mob ntshav qab zib, ob hom thawj thiab thib ob.

Ua rau

Raws li txoj cai, nrog lub caij nyoog ntev ntawm tus kabmob thiab muaj kev cuam tshuam ntawm cov ntshav qab zib, cov kab mob metabolic tsis txaus nyob hauv txhua qhov nruab nrog cev thiab kab mob ntawm lub cev tau kuaj pom.

Thiab lub paj hlwb yog thawj txoj kev txom nyem. Raws li txoj cai, cov hlab ntaws ua rau noj cov hlab ntsha me tshaj plaws.

Nyob rau hauv lub caij nyoog ntev ntawm carbohydrates, qhov thiaj li hu ua hlab ntsha-noj kev tsis sib haum. Yog li ntawd, lawv poob rau hauv lub xeev hypoxia thiab, vim li ntawd, cov thawj cov tsos mob ntawm tus kab mob tshwm sim.

Nrog nws cov chav kawm txuas ntxiv thiab tsis tu ncua, cov teeb meem uas twb muaj lawm nrog cov hlab ntsha hlwb, uas maj mam dhau los ua ib qho tshwm sim uas tsis muaj kev cuam tshuam, yog qhov nyuaj.

Txij li thaum tshwj xeeb cov vitamins thiab cov zaub mov muaj qhov tsim nyog rau kev ua haujlwm ntawm lub paj hlwb thiab kev tiv thaiv cov glitches hauv nws, thiab cov ntshav qab zib, kev nqus thiab kev ua ntawm txhua yam tshuaj muaj txiaj ntsig yog qhov cuam tshuam, cov ntaub so ntswg mob txom nyem los ntawm kev noj zaub mov tsis zoo thiab, raws li, kev tsim kho yam tsis tsim nyog ntawm polyneuropathy.

Muaj yam phom sij los tsim tus mob ntshav qab zib polyneuropathy

Txij li qhov tseem ceeb ua rau mob ntshav qab zib polyneuropathy (ICD 10 code - G63.2) yog nce ntxiv ntawm cov ntshav qab zib, tus kws kho mob endocrinologist tau pom zoo rau cov neeg mob uas muaj cov tsos mob ntawm lub paj hlwb peripheral puas. Tus kws kho mob tswj xyuas cov ntshav qab zib, txiav txim siab qhov concentration ntawm cov piam thaj ntawm lub plab khoob thiab tom qab noj mov. Cov kws kho qhov muag, kws kho mob hlwb, kws phais ntshav nrhiav kev soj ntsuam rau kev puas tsuaj rau lub qhov cub me me ntawm lub qhov muag, ob lub raum, nqua. Tsuas yog kev qhia rau tus kheej los kho tus mob ntshav qab zib polyneuropathy txhim kho cov kev mob thiab lub neej zoo ntawm cov neeg mob, pab txhawb kev thim rov qab cov tsos mob ntawm tus mob puas nyob hauv ntshav qab zib mellitus.

Cov kev pheej hmoo tseem ceeb rau kev txhim kho polyneuropathy ntawm cov neeg mob uas muaj hom 1 ntshav qab zib mellitus yog qib ntawm kev nce ntxiv hauv cov ntshav qabzib concentration, lub sijhawm ntawm tus kabmob thiab lub hnub nyoog ntawm tus neeg mob. Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus, mob ntshav siab ntawm lub cev thiab cov roj ntsha tsis ua hauj lwm lipid yog qhov tseem ceeb.

Peripheral neuropathies, feem ntau distal symmetric sensorimotor polyneuropathy, kom ntau dua li qhov nruab nrab neuropathy, hem qhov zoo ntawm lub neej thiab lub neej ntawm cov neeg mob lawv tus kheej. Cardiac autonomic (autonomous peripheral insufficiency), uas yog ib feem ntawm cov kab mob sib tov ntawm cov mob ntshav qab zib polyneuropathy, 50% ntsuas qhov tsis raug rau lub neej kev cia siab ntawm cov neeg mob ntshav qab zib mellitus. Qhov tsim ntawm ntshav qab zib ko taw syndrome yog fraught nrog tom qab txiav tu ncua ntawm nqua. Mob ntsws mob hauv txhua tus neeg mob thib tsib uas mob ntshav qab zib ua rau lub neej zoo, tshwj xeeb tshaj yog tias nws tshwm sim nws tus kheej nrog allodynia (mob mob teb rau qhov tsis hnov ​​mob stimuli).

Cov txheej txheem rau kev txhim kho cov mob ntshav qab zib polyneuropathy

Feem ntau cov leeg txuas nrog qhov sib xyaw. Lawv muaj lub cev muaj zog, ua kom hnov ​​mob thiab lub zog ntawm tus kheej. Cov tsos mob nyuab siab ntawm qhov mob hlab ntsha yog suav nrog lub cev muaj zog, kev hnov ​​qab thiab ua kom mob siab.

Txhua axon (cov txheej txheem ntev ntawm cov xov paj ntawm lub paj hlwb) yog npog nrog lub plhaub ntawm Schwann cell, nyob rau hauv rooj plaub uas cov fiber hu ua tsis-myelinated, los yog puag ncig los ntawm concentrically dag ntawm daim nyias nyias ntawm Schwann hlwb. Hauv rooj plaub thib ob, cov fiber hu ua myelinated. Txoj hlab ntaws muaj ob qho tib si tsis-myelinated thiab myelinated fibers. Tsuas yog cov-tsis-myelinated cov fibers muaj autonomous efferent thiab ib feem ntawm cov khoom tawg yooj yim afferent. Tuab ib txheej myelinated coj ua kev co thiab kiv (mob nqaij). Nyias cov myelinated thiab cov pob txha tsis-myelinated ua lub luag haujlwm rau qhov hnov ​​ntawm mob, kub thiab kov. Kev ua haujlwm tseem ceeb ntawm cov hlab ntaws yog kev ua kom tsis muaj zog.

Lub tshuab ntawm peripheral polyneuropathy yog ua raws li cov kev ploj zuj zus ntawm myelinated fibres, axon degeneration thiab qeeb qeeb hauv kev sib txuas ntawm lub paj impulse. Lub luag haujlwm tseem ceeb hauv kev txhim kho cov mob ntshav qab zib polyneuropathy yog ua si los ntawm cov mob hyperglycemia (ntshav qab zib ntau ntau).

Lwm yam ua rau kev mob ntshav qab zib polyneuropathy yog:

• microangiopathy (hloov hauv cov nkoj me me),
• hypoxia (oxygen starvation) ntawm qab haus huv,
• tsis hnov ​​qab cov metabolism hauv qabzib,
• glycation ntawm cov protein uas ua myelin,
• oxidative kev nyuaj siab
• tsis muaj peev xwm ntawm endothelial so yam - nitric oxide (tsis muaj),
• alpha lipoic acid tsis txaus.

Txheeb cais

Raws li WHO, ntawm 2 txog 8% ntawm lub ntiaj teb cov pej xeem ntsib tus mob neuritis. Hauv lub hnub nyoog laus, tus kab mob tshwm sim ntau dua, vim nws nrog cov kev cuam tshuam ntawm cov leeg hlwb, qhov tsis muaj zog ntawm cov leeg hlwb thiab ua rau cov nqaij mos ua kom rov ua haujlwm dua.

Ib qho puas tsuaj hu ua mononeuropathyCov. Ua raws li ICD-10, tus kabmob tau muab cov cim G56 - mononeuropathy ntawm sab sauv thiab, raws li, G57 - mononeuropathy ntawm qis qis dua.

Lwm hom mob yog polyneuropathy.Cov. Raws li hauv qab no los ntawm etymology ntawm lub npe ("ntau + qab haus huv + kab mob") - qhov no yog ntau lub qhov txhab ntawm cov hlab ntsha leeg.

Polyneuropathy yog qhov pom los ntawm qhov kev mob hnyav, uas feem ntau cuam tshuam nrog kev nyuaj ntawm kev kho kom rov zoo thaum lub sijhawm ua kom tiav: vim tias lub siab sib txawv ua kom cov leeg sib txawv, cov ceg ntawm lub cev yog ib feem lossis tag nrho, yog li kev rov qab los yuav tsum pib nrog kev siv dag zog ua kom ntev. Raws li kev faib tawm ntawm cov kab mob, polyneuropathy belongs rau cov chav kawm G60-G64.

Hom mob pathology thiab tsos mob

Lub ntsiab ntawm neuropathy:

1. Hnov.
2. Lub cev muaj zog.
3. Ib Leeg.

Nws ua tau nws tus kheej hauv kev txiav txim siab ntawm tus mob: mob, kub hnyiab, tingling, loog ntawm nqua.

Nws yog txuam nrog kev ua txhaum ntawm kev zam tsis tau ntawm cov leeg thiab tom qab atrophy ntawm nqaj nce mus ua kom tiav qhov kawg. Hauv qhov xwm txheej no, cov kab mob (sensory pathologies) tsis tshwm sim (hauv qee qhov tsis tshua muaj, muaj qhov tsis muaj peev xwm nkag siab txog kev vibration).

Ceev Faj! Lub cev muaj zog neuropathy tau nrog ua ke los txhim kho cov leeg tsis muaj zog, qhov nce qis hauv cov leeg nqaij. Lub ntsej muag ntawm lub cev muaj zog neuropathy yog qhov mob siab rau lub cev ntawm nqua.

Tus mob etiology ntawm hom neuropathy no feem ntau cuam tshuam nrog cov kab mob muaj keeb thiab noob caj noob ces. Muaj 6 yam ntawm lub cev muaj zog neuropathy:

• CongenitalCov. Ua los ntawm cov tsis xws luag hauv TRPV4 lub noob. Kev tshwm sim thawj zaug yog pom txij thaum yug los, yav tom ntej, cov kab mob zuj zus.
• Hom 2ACov. Txuam nrog cov tsis xws luag hauv HSPB8 gene. Nws yog ib qho ntawm ntau yam ntawm peroneal amyotrophy. Nws cuam tshuam cov menyuam yaus hnub nyoog laus dua. Hom no yog tus cwj pwm muab los ntawm kev nce siab hauv kev puas tsuaj ntawm tes: cov leeg lub cev tsis muaj zog (txog atrophy), tactile insensibility.
• Hom 2DCov. Nws tshwm sim vim cov kev tsis sib xws ntawm FBXO38 gene nyob rau ntawm tus lej 5 Nws tawm hauv cov neeg hluas nrog tsis muaj zog ntawm txhais ceg, cramps ntawm qhov qis qis, tom qab kis mus rau cov leeg ntawm tes.
• Distal (tsis sib luag) hom 5 neuropathy. Feem ntau hom muaj feem cuam tshuam nrog cov tsis xws luag hauv BSCL2 gene (cov lej chromosome No. 11). Nws ua tau nws tus kheej hauv kev hluas thiab deev hauv daim ntawv ntawm qhov tsis muaj zog, txhais tes tshee. Hauv kev ncua sijhawm tom qab, nws npog cov nqua qis.
• Hom 1 leeg mob hlwb pob txhaCov. Muaj tshwm sim vim qhov ua tsis tiav ntawm IGHMBP2 noob. Nws ua tau nws tus kheej txawm nyob hauv lub sijhawm yug menyuam hauv daim ntawv ntawm kev tsis zoo ntawm caj npab cov leeg. Tom qab, nws tuaj yeem cuam tshuam cov leeg nqaij ntawm cov kab mob thiab ua rau tuag taus.
• Hom AHCov. Nws tshwm sim los ntawm kev hloov noob rau ntawm X chromosome. Nws cuam tshuam rau cov txiv neej hauv cov menyuam yaus thaum ntxov, ua rau qhov mob ntawm lub cev ntawm txhua nqua.

Lub cev muaj zog neuropathy muaj tsawg kawg (0.004% ntawm tus neeg mob). Tsuas yog cov kev kho mob uas twb muaj lawm yog kev txhawb nqa cov tshuaj thiab muaj cov vitamin complex. Kev tawm dag zog siv yog contraindicated txij li thaum accelerates ntaub so ntswg degeneration.

Ib Leeg

Ntau tshaj li 90% ntawm cov neeg mob ntshav qab zib mellitus raug kev mob ntshav qab zib neuropathy (DN), cuam tshuam rau cov leeg hlwb tsis zoo thiab mob caj dab vim yog cov teeb meem metabolic tsis txaus siab.

DN tshwm sim ua ob hom:

• Tub Nuj - cuam tshuam rau qee qhov ntawm lub cev.
• Txawv Plaub Hau - ua rau muaj kev cuam tshuam ntau ntawm cov hlab ntsha hluav taws xob ntau.

Ib qho ntawm cov ntaub ntawv ntawm diffuse neuropathy yog autonomous, nyob rau hauv uas ua tsis ua haujlwm ntawm cov kabmob nruab nrog sab hauv nrog cov tsos mob tshwm sim:

• Lub plab zom mov: Cov tsos mob dyspeptic, tso quav tsis taus, nce pob zom, mob epigastric, mob hnyav ntawm peristalsis, mob plab nocturnal (nrog rau kev koom tes ntawm cov hlab ntsha lub luag haujlwm rau txoj haujlwm ntawm cov hnyuv).

Lub plab zom mov yog qhov tshwj xeeb cuam tshuam rau mob neuropathy vim qhov muaj qhov tsis haum ntawm cov leeg nkag mus rau cov hlab ntsha, tus naj npawb ntawm cov hlab hlwb uas sib piv nrog lawv tus lej hauv lub hlwb.

• Lub Hauv Paus Nruab Nrab: tsis tuaj yeem tso zis vim tias lub zais zis tsis muaj zog, kab mob theem ob.
• Tus qau: nyob rau hauv tus txiv neej - tsis muaj qhov txhim kho erection thaum muaj kev pov hwm kev ntshaw ntawm kev sib deev, nyob rau hauv cov poj niam - kev txo qis ntawm qhov chaw mos tso tawm thaum sib deev.
• Kev kho plawv: tachycardia, lub plawv dhia tsis ua hauj lwm, angina pectoris.
• Daim tawv nqaij integument: qhuav tes thiab taw, nce hws lossis tawm hws.

Qhov kev cuam tshuam dav dav tseem muaj sau tseg: vertigo, ploj ntawm qhov tsis nco qab, asthenia.

Sciatic hlab ntsha

Qhov ntev tshaj plaws thiab loj tshaj plaws (1 cm inch) lub cev ntaj ntsug ntawm lub cev, uas pib ntawm 4 txha caj qaum thiab, dhau los ntawm qhov qhib hauv lub plab pob txha, nqis mus rau popliteal fossa, qhov twg nws tau muab faib ua cov ceg ntoo thiab leeg. Kev zaws tuaj yeem tshwm sim hauv lub plab mog, hauv plab (piriformis), ntawm tus ncej puab.

Cov leeg neuritis Sciatic Qib thib ob hauv feem ntau ntawm cov leeg nqaj ntawm cov leeg neuropathies (qhov tshwm sim yog 0.025%, feem ntau hauv cov neeg muaj hnub nyoog 40 txog 50 xyoo). Lwm qhov tshwj xeeb ntawm tus kab mob no - tsis yog symmetry - tsuas yog ib qho povtseg ntog mob.

Cov hlab ntsha hauv sciatic ua rau cov leeg pob txha khoov ntawm lub hauv caug, yog li ntawd, cov tsos mob hauv qab no yog cov yam ntxwv ntawm tus kabmob:

• Mob tob hau tsis nco ceev ceev nraub qaum ncej puabradiating rau sab ceg thiab ko taw.
• Taug kev nrog cov ceg ncaj, tshwm sim vim yog qhov nyuaj ntawm khoov ntawm lub hauv caug (paresis ntawm biceps thiab cov leeg nqaij leeg ib txhij nrog nce tonus ntawm plaub qoj plaub caug).
• Thickening ntawm stratum mob ntsws ntawm daim tawv nqaij ntawm pob taws, xiav txhais ko taw, ua txhaum kev tawm hws.
• Deterioration hauv kev co rhiab.

Poj niam hlab ntsha

Noj thaum pib los ntawm keeb kwm ntawm 2-4 caj pas, cov hlab ntaws ntawm lub cev no kis tau sab hauv qab txoj leeg pob txha rau sab pem hauv ntej ntawm tus ncej, tom qab ntawd - raws cov ceg qis, ko taw, thiab xaus rau hauv cov ntiv taw loj.

Lub luag haujlwm tseem ceeb ntawm cov hlab ntsha femoral: kev pom sab hauv ntawm cov leeg ua lub luag haujlwm rau lub duav flexion, rov qab qis dua, txuas hauv caug.

Nrog rau cov kab mob, ob qho tib si piav thoob hlo thiab lub cev muaj zog tuaj yeem pom:

• Qhov qaug zog ntawm qhov txuas ntawm lub hauv caug, - vim li ntawd, lub cev tsis tuaj yeem sawv ntawm cov ntaiv, khiav.
• Kev ua txhaum ntawm kev nkag siab ntawm cov neeg hnov, kev paub tab ntawm lub cev, nrog rau daim tawv nqaij raws txoj kev ntawm txoj hlab ntsha.

Nrog neuritis ntawm qhov hlab ntsha femoral, lub hauv caug tsis kam lees.

Axillary

Txoj hlab ntaws (axillary) txoj hlab ntaws yog ib ceg ntawm lub pob tw brachial plexus. Nws kis hauv qab lub xub pwg sib koom ua ke thiab lus dag ntawm sab nraub qaum ntawm humerus ua ntej faib ua ob ceg: sab xub ntiag thiab tom qab. Nws lub ntsiab muaj nuj nqi yog qhov sib nrug ntawm qhov hloov me me thiab cov leeg nqaij.

Axillary hlab ntsha puas tsuaj yog yuav luag ib txwm mob los ntawm kev raug mob hnyav: sab xub pwg los yog lub viav vias sib sib zog nqus.Cov. Cov neeg ua kis las koom nrog kev ua kis las (wrestlers, nce toj siab, thiab lwm yam) tau ntsib tus kab mob no tsis tu ncua. Tsawg ntau zaus, tsev neeg yam muaj qhov tshwm sim: nyem nrog tus pas nrig, txwv hauv tus npau suav, thiab lwm yam.

Cov tsos mob ntawm kev puas tsuaj tuaj yeem sib txawv heev nyob ntawm qhov mob ntawm kev raug mob:

1. Qhov pom ntawm lub teeb lossis qhov uas tseem ceeb ntawm sab xub pwg vim paresis ntawm deltoid cov leeg. Hauv cov xwm txheej hnyav - ua rau tuag tes ntawm qhov povtseg.
2. Plam ntawm qhov tsis hnov ​​hluav taws xob zoo sab qaum thiab sab nraud ntawm sab caj npab.
3. Kev xoob ntawm lub xub pwg sib koom tes.
4. Deltoid cov leeg tsis ua hauj lwm.

Qhov ntsuas ntawm kev kho mob yog qhov txaus siab. Yog tias kev txuag thiab kev siv dag zog ua kom tsis muaj txiaj ntsig, rov ua haujlwm los ntawm kev sib txuas los ntawm lub cev tsis muaj zog, qee zaum - hloov cov leeg paj.

Ko taw puas

Pathology ntawm ko taw nrog neuritis yog tsis thawj. Nws cuam tshuam nrog pinching ntawm tibial hlab ntsha, innervating ob txhais ceg leeg, flexors thiab extensors ntawm ko taw.

Yog hais tias tus patella ntawm cov hlab ntsha ib txwm muaj raug puas ntsoog, qhov kev rau txim loj tshaj plaws rau tus txhais taw tshwm sim: ua kom tsis muaj zog thiab sagging kom txog thaum ua immobilized kiag li.

Tus neeg mob qhov mob nrog rau qhov mob ntawd yog tus yam ntxwv: nws tsa nws txhais taw siab, zaum sab ntiv taw, tom qab ko taw tag nrho ("nees gait"). Tus neeg mob sawv tsis tau ntawm nws tus ntiv taw. Kev nce qib ntawm tus kabmob tuaj yeem ua rau neeg xiam oob khab thiab xiam oob khab.

Pathology ntawm lub taw tsis tshua tshaj tawm nrog txoj kev yeej ntawm txoj kev sib sib zog nqus ceg ntawm cov hlab ntsha peronealCov. Hauv qhov no, qhov ua kom tsis muaj zog me me ntawm pob taws tshwm sim ua ke nrog kev xav ntawm cov ntiv tes.

Thaum muaj kev raug mob rau lub cev ntu tom qab ntawm txoj hlab ntaws, cov tsos mob tseem ceeb yog kev txwv ntawm kev sib hloov ntawm ko taw, kev hnov ​​mob, ua rau mob hmo ntuj, ua rau tsis pom kev ntawm kev tshee.

Ib qho teebmeem mob ntshav qab zib yog yam mob ntshav qab zib hu ua ko tawCov. Qhov no yog tus mob uas cov tawv nqaij ntawm ob txhais ceg tau them nrog kev kho kom zoo tsis muaj qhov txhab tsis huv nrog cov mob sib txuas nrog. Nyob rau hauv cov mob hnyav, tus kab mob loj zuj zus mus rau kev ua laib thiab ua rau txiav ceg.

Tes mob neuropathy

Zoo li ko taw pathology, kab mob ntawm txhais tes yog yam thib ob thiab yog tshwm sim los ntawm tus xov tooj ntawm cov leeg hlwb (neuropathic syndromes):

• Radial NeuritisCov. Nws ua rau lub cev muaj zog puas rau ntawm txhais tes, - thaum koj tsa koj txhais tes, nws sags. Tsis tas li, tus kabmob muaj nrog cov cim kev hnov ​​mob hauv daim ntawv ntawm poob ntawm cov ntiv tes rhiab.
• Ulnar mob hlwbCov. Nws yog tus cwj pwm los ntawm paresis ntawm qhov hloov pauv thiab txuas ntxiv ntawm cov ntiv tes, qhov tsis zoo ntawm kev ua kom lub cev muaj zog ntawm txhais tes.
• Median Nerve NeuritisCov. Qhov tshwm sim: loog mus txog rau thaum ob txhais tes tau kiag li ploj mus rhiab heev, qhov mob ntawm tus ntiv tes, mob leeg.

Ceev Faj! Kev mob tes taw kuj tseem yuav cuam tshuam nrog qee yam ntawm polyneuropathy.

Cov hau kev kho

Qee qhov xwm txheej, kev kho mob raug txo kom txo qis kev ua kom zoo ntawm cov hlab ntsha: tshem cov gypsum, hloov cov ntoo tsis haum, thiab cov khau nqaim. Feem ntau siv txoj kev txuag tshuaj (kev siv tshuaj thiab kev tawm dag zog tshwj xeeb)Cov. Yog tias cov kev ntsuas no ua tsis tau zoo, tom qab ntawd lawv mus rau kev pab ntawm neurosurgeon.

Txom Txwm Pov

Tus kws kho mob hlwb yuav sau tshuaj rau tus neeg mob, suav nrog:

• Kev muab tshuaj loogCov. Ntau cov tshuaj tsis-steroidal los tiv thaiv cov leeg mob (NSAIDs): Diclofenac, Ibuprofen, Meloxicam thiab lwm yam NSAIDs tsis yog tsuas yog thaiv qhov mob, uas tseem ceeb heev rau kev tiv thaiv cov leeg mob, tab sis kuj tshem tawm edema thiab o rau cov hlab ntaws, khiav ceev rov qab. Nws yog ib qho tseem ceeb uas yuav tsum tau ceev faj, nruj me ntsis txwv qhov ntau thiab tsawg ntawm cov chav kawm ntawm kev kho vim yog muaj mob loj tshwm sim los ntawm cov tshuaj no.
• Cov tshuaj vasodilating xws li Trental, Cavinton thiab lwm tus. Lawv muaj cov nyhuv vasodilating, nyias cov ntshav, txhim kho cov ntshav ncig, ua kom lub zog rov ua dua ntawm cov ntaub so ntswg uas puas lawm.
• Tsom tshuaj txhawb zog: Neuromidin, Proserin, Ipidacrine. Lawv nrawm rau kev coj ua ntawm cov leeg lub cev, hnov ​​cov leeg ntawm cov pob txha.
• AntioxidantsCov. Thiogamma, Berlition thiab lwm yam tshuaj uas txhim kho cov leeg nqaij.

Antioxidants los ntawm hom kev ua yog ze rau cov vitamins B, tab sis tsis hloov lawv.

Cov ntsiab lus tseem ceeb uas txhawb kev noj qab haus huv cov kab mob yog B vitamins: thiamine, nicotinic acid, cyancobalamin, choline, inositol, thiab lwm yam.

Cov tshuaj no txhawb lub zais ntawm cov tshuaj hormones thiab hemoglobin, muab lub zog ntawm cov nqaij mos, thiab muaj cov nyhuv analgesic..

Yog li, cov tshuaj xws li Milgama, Neurorubin, Multivit, Vitrum yog qhov tseem ceeb tsis tau thaum lub sijhawm kev kho mob nquag lossis ntawm kev kho kom rov zoo.

Dab tsi ntawm kev mob nkeeg yog xws li mob ntshav qab zib polyneuropathy: ICD-10 code, chaw kuaj mob thiab kev kho mob

Polyneuropathy yog qhov nyuaj ntawm cov kab mob, uas suav nrog qhov sib ntxiv sib txuas ntawm cov hlab ntsha leeg.

Qhov mob feem ntau yuav nkag mus rau hauv cov npe hu ua mob ntev thiab muaj qhov nce ntawm txoj kev faib tawm, uas yog, cov txheej txheem no pib cuam tshuam rau cov nqaij me me thiab maj mam ntws mus rau cov ceg loj.

Kev kho mob ntshav qab zib polyneuropathy

Yuav cais tawm txoj kev txhim kho ntawm kev tsis tuaj yeem txhim kho cov kev puas tsuaj vim yog kev kho mob dhau lawm, tus kws kho mob endocrinologist thiab kws kho mob hauv tuam tsev kho mob Yusupov pib kho cov mob ntshav qab zib ua ntej. Kev taw qhia tseem ceeb hauv kev tiv thaiv kab mob ntshav qab zib yog qhov ua tiav ntawm ib qib dhau los ntawm cov piam thaj hauv cov ntshav. Tswj lub cev tsis xwm yeem ntawm cov piam thaj hauv ntshav mus ntev ntev hauv cov neeg mob uas muaj mob hnyav ua rau mob polyneuropathy ua rau qhov kev ncua sij hawm ntawm kev txhim kho ntawm kev puas tsuaj rau cov leeg ntshav ntawm lub cev, tab sis tsis pab txhawb kom tshem tawm sai sai ntawm nws cov kev mob tshwm sim. Nrog kev ua haujlwm li qub ntawm cov piam thaj hauv cov neeg mob, cov tsos mob neurological yuav sib zog los yog tshwm sim yog tias lawv tau qhaj ntawv ntxov dua. Qhov no yog vim qhov thim rov qab ntawm cov kev pauv hloov uas tau tshwm sim hauv cov hlab ntsha. Qhov tsis zoo yog qhov hloov hauv qhov thiab sai sai ploj, muab kev pom zoo ntawm cov suab thaj hauv cov ntshav nyob ze rau qhov qub.

Cov kws kho mob neurologists muaj ntshav qab zib polyneuropathy ua rau kev kho mob pathogenetic thiab tsos mob. Tam sim no, thioctic (lip-lipoic) acid, tshwj xeeb tshaj yog Thiogamma, yog suav tias yog kev kho mob zoo tshaj plaws rau kev kho mob peripheral polyneuropathy. Cov vitamins ntawm pab pawg B muaj qhov cuam tshuam ncaj qha rau cov ntaub so ntswg uas puas lawm Cov kws kho mob tau sau thiamine (vitamin B rau cov neeg mob ntshav qab zib polyneuropathy).₁), pyridoxine (vitamin B₆), cyanocobalamin (vitamin B₁₂) Cov neeg mob uas mob ntshav qab zib polyneuropathy zoo dua zam cov rog-soluble daim ntawv ntawm thiamine - benfotiamine. Nws muaj nyob hauv Milgamma dragee.

Qhov zoo tshaj plaws yog qhov kev pom zoo ntawm peb-theem kev kho rau cov mob ntshav qab zib polyneuropathy:

• koob tshuaj benfotiamine ntau nyob rau hauv kev sib xyaw nrog pyridoxine (Milgamma dragee), tom qab ntawd noj ib hnub ntawm Milgamma dragee,
• nrog qhov tsis muaj txiaj ntsig ntawm thawj theem, cov neeg mob niaj hnub txhaj nrog 600 mg ntawm Tiogamma tso siab rau ob lub lis piam,
• nyob rau hauv cov ntawv hnyav ntawm polyneuropathy, ib tus neeg raug coj tawm hauv lub Milgamma thiab Thiogamm yog muab tshuaj rau niam txiv.

Cov pawg tseem ceeb ntawm cov tshuaj rau kev kho mob neuropathic mob ntshav qab zib polyneuropathy yog cov tshuaj tiv thaiv kab mob, anticonvulsants, opioids thiab tshuaj loog hauv zos. Cov kws kho mob hlwb siv dav tricyclic cov tshuaj tiv thaiv kev ntxhov siab. Cov tshuaj siv tau zoo tshaj plaws yog amitriptyline hauv kev noj tshuaj los ntawm 25 txog 150 mg rau ib hnub. Txoj kev kho mob pib nrog ib koob tshuaj qis (10 mg / hnub) thiab maj mam dhau los kom nce ntxiv. Qhov no tso cai rau koj kom txo qhov kev phiv tshuaj.

Anticonvulsants txo qis mob neuropathic zoo. Neurologists nrog cov mob hnyav siv cov carbamazepine thiab phenytoin. Lawv tsis suav hais tias yog thawj kab tshuaj vim muaj kev phiv. Qhov thib ob ntawm cov tshuaj anticonvulsants muaj cov kev ua kom muaj zog: gabapentin thiab pregabalin.

Tramadol txo qhov mob tsawg, nce kev sib raug zoo thiab lub cev ntawm cov neeg mob. Txhawm rau txo txoj kev pheej hmoo ntawm cov kev mob tshwm sim thiab kev quav yeeb tshuaj, kev siv cov tshuaj tramadol tau pib nrog kev txhaj tshuaj qis (50 mg 1 lossis 2 zaug hauv ib hnub) thiab tom qab ntawd suav nrog txhua 3-7 hnub txog ntau kawg ntawm 100 mg 4 zaug ib hnub. Tramadol tseem tseem yog ib feem ntawm kev npaj ua ke zaldiar.

Thaj ua rau thaj thiab gels nrog 5% lidocaine muaj cov nyhuv ua kom loog hauv zos. Capsaicin (ib qho tshuaj loog hauv zos) yog siv los kho mob ntshav qab zib polyneuropathy. Cov tshuaj nkag mus rau hauv lub khw muag tshuaj hauv daim ntawv ntawm kev siv tshuaj pleev, cov gels, cov tshuaj pleev thiab cov neeg thov pob uas muaj cov tshuaj ua kom lub cev muaj zog hauv cov concentration ntawm 0.025%, 0.050% lossis 0.075%. Lawv tau siv 4 zaug hauv ib hnub rau tag nrho cov chaw mob.

Kev mob rau cov mob ntshav qab zib polyneuropathy tsawg dua tom qab siv tshuaj botulinum toxin yam A rau cov neeg mob. Glyceryl trinitrate yog ib txwm siv rau angina pectoris. Nws tseem ua kom cov hlab ntshav thiab txo qis qhov mob txuam nrog mob ntshav qab zib polyneuropathy.

Nrog rau kev txhim kho cov mob ntshav qab zib ko taw mob ntshav qab zib, cov tshuaj tua kab mob ntau yam, tshuaj tua kab mob rheological, tshuaj anticoagulants, thiab kev cais tawm tsis suav nrog hauv kev kho mob. Yog tias tus neeg mob pib mob txhab rau ko taw, cov kws kho mob hlwb ua haujlwm kho cov qhov txhab kom raug:

• tshem tawm hyperkeratosis
• ntxuav cov txhab kiav txhab,
• lub rwj yog khaws qhib, tsim kom muaj qhov zoo tshaj plaws ntawm kev tso tawm ntawm nws,
• muab cov dej noo tas li rau qhov txhab,
• Tsis txhob hnav khaub ncaws hnyav
• ntxuav kiav txhab nrog cov kev daws teeb meem uas tsis muaj tshuaj lom rau granulation nqaij.

Cov neeg mob tau raug tso cai pw lub txaj rau 2 lub lis piam, thiab tom qab ntawd lawv raug pom zoo los hnav cov khau orthopedic. Txhawm rau yauv mus kuaj mob thiab ib chav ntawm kev kho kom zoo rau kev mob ntshav qab zib, koj yuav tsum teem sijhawm nrog tus kws kho mob hlwb hauv xov tooj ntawm lub tsev kho mob Yusupov, qhov chaw hu ua haujlwm 24 teev nyob rau ib hnub, 7 hnub hauv ib asthiv thiab tsis muaj sijhawm so. Tus kws kho mob yuav siv sijhawm rau koj yooj yim rau koj.

Siv tshuaj kho

Nrog neuralgia thiab neuritis, cov pawg hauv qab no ntawm cov tshuaj yog kws kho:

1. Cov tshuaj tsis raws plab (nonsteroidal anti-inflammatory drugs) - muaj cov nyom ua rau lub cev muaj zog heev. Tsom ntawm kev tshem tawm kev mob, o thiab o. Siv tau Diclofenac, Nimesulide, Xefocam.

Koj yuav tsum tau noj lawv nkaus xwb raws li koj tus kws kho mob tau qhia.

Diclofenac yog cov tshuaj siv tau zoo, zwm rau pawg NSAIDs. Nws muaj cov lus tshaj tawm analgesic, antipyretic thiab anti-inflammatory nyhuv. Cov tshuaj muaj nyob rau hauv ntau hom: ntsiav tshuaj, tshuaj ntxiv, daws teeb meem, tshuaj pleev thiab tee. Nws yog tshuaj rau cov menyuam yaus txij li 15 xyoo thiab cov neeg laus tsis ntau tshaj 150 mg ib hnub 2-3 zaug.

Nimesulide tseem hais txog cov tshuaj tsis-tshuaj steroidal los tiv thaiv. Qhov txawv yog tias Nimesulide tseem muaj cov txiaj ntsig antiplatelet - nws txwv tsis pub cov ntshav txhaws.

Cov tshuaj yog coj tom qab noj mov ntawm 50-100 mg.

2. Lub cev tiv thaiv kab mob. Piv txwv li, Berlition, Lipin. Lawv muaj immunostimulating, neurotransmitter, hypotoxic thiab lwm yam khoom. Ua tsaug rau cov tshuaj no, nws muaj peev xwm ntxiv dag zog rau kev tiv thaiv kab mob, txhim kho ntshav ncig thiab ua haujlwm ntawm cov nruab nrog sab hauv.

Berlition yog ib qho tshuaj zoo rau mob neuropathy vim hloov mus rau ntshav qab zib mellitus lossis quav dej cawv.

Cov tshuaj tsis tuaj yeem siv rau cov menyuam yaus hnub nyoog qis dua 18 xyoo, cev xeeb tub thiab lactating cov poj niam, nrog rau cov neeg muaj kev tiv thaiv tsis zoo.

Lipin txhim kho lub cev ua pa thiab cov txheej txheem hauv lub cev.

3. Cov vitamins ntawm pab pawg B (B1, B2, B6, B12).

4. Cov tshuaj noj uas ua rau kev coj ua ntawm cov leeg kev puas hlwb - raug kho rau kev txhim kho neuritis, raws li lawv pab kho qhov mob rhiab thiab cov leeg ua haujlwm. (Neuromidine, Proserinum).

Fibrosarcoma thiab osteosarcoma ntawm tus cwj pwm ntawm tibia: ua rau, kuaj mob ...

Yuav kho cov ceg ceg pob txha caj qaum: tshuaj ntsuab rau hauv tsev li cas ...

Rov qab los ntawm kaw thiab qhib tibial pob txha lov ...

Proserine yog ib qho tshuaj siv hluavtaws uas siv los kho cov kab mob ntawm cov hlab hlwb poob siab. Nws yog tsom rau normalizing neuromuscular conduction, txhim kho cov leeg nqaij thiab txhim kho txoj haujlwm ntawm cov kabmob sab hauv. Qhov ntau thiab tsawg zaus ntawm kev tswj hwm yog txiav txim los ntawm tus kws kho mob.

5.Cov tshuaj txhawm rau txhim kho cov ntshav khiav - pab tshem tawm cov mob thrombosis thiab txhim kho cov nqaij mos trophic hauv qab qis. Pab pawg no suav nrog Caviton, Trental.

Caviton yog tus yam ntxwv ntawm cov yam ntxwv pharmacological. Nws lub hom phiaj yog ua kom ntshav khiav rov qab, txo cov ntshav viscosity, txhim kho cov teeb meem metabolic.

Cov tshuaj yog contraindicated rau cov neeg muaj hnub nyoog qis dua 18 xyoo, cev xeeb tub thiab lactating cov poj niam, nrog rau muaj cov kab mob loj heev ntawm cov hlab plawv. Cov ntsiav tshuaj pib noj nrog 15 mg, maj mam nce koob tshuaj, tab sis nws yuav tsum tsis pub ntau tshaj 30 mg ib hnub twg.

Cov txheej txheem siv lub cev ua haujlwm

Kev tawm dag zog lub zog txhawm rau txhawm rau txo qis o ntawm qhov qis qis, ua kom ntshav sai sai thiab cov kev hloov pauv metabolism. Yog li ntawd, trophism ntawm cov nqaij mos yog qhov qub, thiab neuromuscular conduction tau rov qab los.

Txog kev kho, thov:

• Reflexotherapy
• Hlau nplaum kho.
• Zaws
• Kev txhawb hluav taws xob.

Lub sijhawm siv dag zog hauv lub cev yog txiav txim los ntawm tus kws khomob mus kawm raws qhov mob hnyav thiab hom pathology. Raws li txoj cai, cov hau kev ntawm kev siv lub cev siv tshuaj pleev ib ce hauv qhov nyuaj, cov chav kawm.

Ib qho txiaj ntsig zoo hauv kev kho mob neuropathy muab zaws. Nws pab txhawb kom rov kho qee qhov chaw atrophic.

Kev siv dag zog yuav pab ua kom ntshav khiav thiab cov metabolism hauv kev ua haujlwm.

Zaws yuav tsum tau ua hauv tsev kho mob nrog tus kws tshwj xeeb nkaus xwb. Nws yog contraindicated los zaws koj ob txhais ceg ntawm koj tus kheej, yog li koj tuaj yeem tsis tsuas yog txo cov hauj lwm zoo ntawm kev kho, tab sis kuj tseem cuam tshuam koj kev noj qab haus huv.

Cov lus qhia luv luv

Pom zoo
Cov Sawv Cev Koom Tes rau Cov Kev Pab Kho Mob Zoo
Ministry of Health Cov koom pheej ntawm Kazakhstan
kos rau lub Kaum Ib Hlis 28, 2017
Nqe Lus Cog Tseg No. 33

Mob neuropathy mob ntshav qab zib - Cov hlab ntsha puas tsuaj vim cov ntshav qab zib, mob hauv tsev kho mob lossis pom meej, nyob hauv qhov tsis muaj lwm txoj kev xav (WHO). Cov kev kawm ntau tshaj thiab cov hom mob ntshav qab zib neuropathy yog distal symmetric polyneuropathy. DSPN - qhov tshwm sim ntawm cov tsos mob ntawm distal peripheral hlab ntsha ua haujlwm hauv cov neeg mob ntshav qab zib mellitus tom qab tsis suav lwm yam ua rau.

ICD-10 code (s):

Cov txheej txheem kev txhim kho / kho dua hnub: 2017 xyoo.

Cov tsiaj ntawv luv siv nyob rau hauv cov txheej txheem:

Cov siv raws tu qauv: cov kws kho neurologists, endocrinologist, cov kws kho mob dav dav.

Tus neeg mob qeb: neeg laus.

Qib pov thawj:
Kem 1 - qhov ntsuas ntawm qib ntawm cov pov thawj

Kev kuaj mob sib txawv

Kev kuaj mob sib txawvthiab cov laj thawj rau kev tshawb fawb ntxiv
DSPN yog kev zam kev zam. Qhov muaj ntshav qab zib mellitus thiab cov tsos mob ntawm polyneuropathy tsis tau txhais tau tias yog qhov muaj ntshav qab zib mob polyneuropathy. Ib qhov kev kuaj mob meej meej kom pom tseeb qhov kev kuaj mob txawv txav.

Rooj 3 - Kev kuaj mob txawv ntawm DSPN 2,14,15

* asymmetric / feem ntau lub cev muaj zog / laus hauv ceg nqaum / thaj chaw loj tsim polyneuropathy
Kev kho mob kev ncig ua si

Tau txais kev kho mob hauv Kaus Lim Kauslim, Ixayees, Lub Tebchaws Yelemees, Asmeskas

Tau txais tswv yim kho mob
×

Kev kho mob txawv teb chaws

Daim Ntawv Thov Tshuaj Kho Mob

Xaiv ib cheeb tsam ntawm kev txaus siab thiab meditsinyAkusherstvo ginekologiyaAllergologiyaAllergologiya detskayaAngiohirurgiyaVrozhdennye zabolevaniyaGastroenterologiyaGastroenterologiya detskayaGematologiyaGematologiya detskayaDermatovenerologiyaDermatokosmetologiyaDermatologiya detskayaImmunologiyaInfektsionnye kab mob nyob rau hauv deteyInfektsionnye thiab cab bolezniKardiologiyaKardiologiya detskayaKardiohirurgiyaKardiohirurgiya detskayaKombustiologiyaKombustiologiya detskayaMammologiyaMeditsinskaya reabilitatsiyaNarkologiyaNevrologiyaNevrologiya detskayaNeyr hirurgiyaNeonatologiyaNeotlozhnaya meditsinaNefrologiyaNefrologiya detskayaOnkogematologiyaOnkogematologiya detskayaOnkologiyaOnkologiya detskayaOrfannye zabolevaniyaOtorinolaringologiyaOtorinolaringologiya detskayaOftalmologiyaOftalmologiya detskayaPalliativnaya pomoschPediatriyaProktologiyaProfessionalnaya patologiyaPsihiatriyaPulmonologiyaPulmonologiya detskayaRadiologiyaRevmatologiyaRevmatologiya detskayaStomatologiyaStomatologiya detskayaSurdologiyaToksikologiyaTorakalnaya hirurgiyaTravmatologiya thiab ortopediyaTravmatologiya thiab orthopedics d tskayaTransplantologiyaTransplantologiya detskayaUrologiyaUrologiya detskayaFtiziatriyaHirurgiyaHirurgiya detskayaHirurgiya neonatalnayaChelyustno-pem hauv ntej hirurgiyaEndokrinologiyaEndokrinologiya detskayaYadernaya tshuaj

Txoj kev yooj yim tshaj plaws los hu rau koj yog dab tsi?

Ntaus koj tus lej xov tooj lossis email chaw nyob
Kev kho mob kev ncig ua si

Related videos

Tus neeg sib tw ntawm Medical Science txog mob polyneuropathy hauv cov neeg mob ntshav qab zib:

• Tshem tawm cov ua rau muaj kev nyuaj siab
• Normalizes siab tsis pub dhau 10 feeb tom qab tswj hwm

Dab tsi ntawm kev mob nkeeg yog xws li mob ntshav qab zib polyneuropathy: ICD-10 code, chaw kuaj mob thiab kev kho mob

Polyneuropathy yog qhov nyuaj ntawm cov kab mob, uas suav nrog qhov sib ntxiv sib txuas ntawm cov hlab ntsha leeg.

Qhov mob feem ntau yuav nkag mus rau hauv cov npe hu ua mob ntev thiab muaj qhov nce ntawm txoj kev faib tawm, uas yog, cov txheej txheem no pib cuam tshuam rau cov nqaij me me thiab maj mam ntws mus rau cov ceg loj.

Dab tsi yog qhov no

Polyneuropathy yog qhov tseem ceeb tshaj plaws ntawm kev mob ntshav qab zib, tag nrho cov ntsiab lus ntawm qhov uas ua tiav ntawm cov kev muaj zog ntawm txoj kev tiv thaiv tsis muaj zog.

Kev puas ntsoog hauv polyneuropathy

Tab sis, muaj qee qhov mob thaum pom tus kab mob hauv cov neeg mob ntawm endocrinologist tsis pub dhau tsib xyoos los ntawm kev pom ntawm cov kab mob pathologies ntawm tus txiav. Txoj kev pheej hmoo ntawm kev muaj mob yuav zoo ib yam rau cov neeg mob ntshav qab zib, ob hom thawj thiab thib ob.

Ua rau

Raws li txoj cai, nrog lub caij nyoog ntev ntawm tus kabmob thiab muaj kev cuam tshuam ntawm cov ntshav qab zib, cov kab mob metabolic tsis txaus nyob hauv txhua qhov nruab nrog cev thiab kab mob ntawm lub cev tau kuaj pom.

Thiab lub paj hlwb yog thawj txoj kev txom nyem. Raws li txoj cai, cov hlab ntaws ua rau noj cov hlab ntsha me tshaj plaws.

Nyob rau hauv lub caij nyoog ntev ntawm carbohydrates, qhov thiaj li hu ua hlab ntsha-noj kev tsis sib haum. Yog li ntawd, lawv poob rau hauv lub xeev hypoxia thiab, vim li ntawd, cov thawj cov tsos mob ntawm tus kab mob tshwm sim.

Nrog nws cov chav kawm txuas ntxiv thiab tsis tu ncua, cov teeb meem uas twb muaj lawm nrog cov hlab ntsha hlwb, uas maj mam dhau los ua ib qho tshwm sim uas tsis muaj kev cuam tshuam, yog qhov nyuaj.

Mob ntshav qab zib polyneuropathy ntawm qis qis raws li ICD-10

Nws yog qhov kev kuaj mob no uas feem ntau tau hnov ​​los ntawm cov neeg mob uas mob ntshav qab zib.

Tus kab mob no cuam tshuam rau lub cev thaum lub nruab nraub qaum thiab nws cov ntaub ua rau muaj qhov cuam tshuam loj. Nws tuaj yeem tsim los ntawm ntau yam.

Raws li txoj cai, cov neeg nruab nrab cov neeg feem ntau cuam tshuam. Nws yog qhov tsim nyog kawg, tab sis txiv neej tau mob ntau tas li. Nws tseem tsim nyog sau cia tias polyneuropathy tsis yog qhov tsis tshua muaj tshwm sim hauv cov menyuam yaus thiab cov hluas.

Ntshav qab zib yog ntshai ntawm cov tshuaj no, zoo li hluav taws!

Nws tsuas yog tsim nyog thov.

Tus kab mob, pom tsuas yog nyob rau qis qis, muaj ntau ntawm cov tsos mob:

• Hnov kev mob siab rau ntawm txhais ceg
• o ntawm txhais taw thiab txhais ceg,
• lub siab mob uas tsis nco qab thiab stitching,
• leeg tsis muaj zog
• nce lossis txo qhov rhiab siab ntawm nqua.

Txhua daim ntawv ntawm neuropathy sib txawv ntawm cov tsos mob.th:

Kev kuaj mob

Vim tias ib hom kev kawm tsis tuaj yeem qhia cov duab tag nrho, kev kuaj mob ntshav qab zib siv tshuaj tiv thaiv kab mob ntshav qab zib uas siv cov cai ICD-10 tau coj los siv ntau txoj kev nrov:

Raws li txoj cai, thawj txoj kev tshawb fawb muaj kev soj ntsuam ntxaws los ntawm ntau tus kws tshaj lij: tus kws kho mob neurologist, kws phais mob thiab endocrinologist.

Thawj tus kws kho mob tau koom nrog kev kawm txog cov tsos mob sab nraud, xws li: mob ntshav hauv qhov qis qis thiab lawv qhov kev hnov ​​mob ntau ntxiv, muaj txhua qhov tseem ceeb xav tau, kuaj xyuas kev o thiab kawm cov tawv nqaij.

Raws li kev tshawb fawb hauv chav kuaj, qhov no suav nrog: kev soj ntsuam ntawm cov zis, ntshav qabzib concentration, cov roj cholesterol, nrog rau kev txiav txim siab txog qib uas muaj tshuaj lom neeg hauv lub cev thaum nws xav tias nws yog tshuaj lom neuropathy.

Tab sis cov ntsiab lus ntsuas kev kuaj pom tias muaj cov ntshav qab zib mob ntshav qab zib hauv cov neeg mob lub cev raws li ICD-10 koom nrog MRI, nrog rau electroneuromyography thiab cov hlab ntsha me.

Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias kev kho yuav tsum muaj txhij txhua thiab sib xyaw. Nws yuav tsum muaj cov tshuaj uas tau hais txog txhua yam ntawm cov txheej txheem kev tsim kho.

Nws yog ib qho tseem ceeb heev uas kev kho mob suav nrog kev noj cov tshuaj no:

Raws li kev tshawb pom yam uas mob ntshav qab zib polyneuropathy ICD-10 pom, tus kws kho mob tau sau ntawv tawm kev kho mob tshaj lij uas tshem tawm cov tsos mob ntawm tus mob. Hauv qhov no, ib tus tuaj yeem cia siab rau qhov kho kom zoo.

Tus kws tshaj lij tshwj xeeb tau sau tseg ob qho tib si tshuaj thiab tsis siv tshuaj yeeb.

Nws yog ib qho tseem ceeb heev ua ntej ntawm kev txo qis cov ntshav qab zib kom ntau thiab tsuas yog tom qab ntawd ua kev kho mob ntshav qab zib polyneuropathy raws li ICD. Yog tias qhov no ua tsis tiav, ces txhua lub dag zog yuav ua rau tsis muaj kev ntseeg dab tsi.

Related videos

Tus neeg sib tw ntawm Medical Science txog mob polyneuropathy hauv cov neeg mob ntshav qab zib:

• Tshem tawm cov ua rau muaj kev nyuaj siab
• Normalizes siab tsis pub dhau 10 feeb tom qab tswj hwm

Vim li cas rau kev loj hlob

Lub ntsiab tseem ceeb etiological uas ua rau kev loj hlob ntawm mob ntshav qab zib polyneuropathy tau txiav txim siab:

1. Haus luam yeeb thiab cawv
2. Tsis ua raws li cov ntshav qab zib tswj,
3. Lub hnub nyoog
4. Ua ntshav siab
5. Kev ua txhaum ntawm qhov sib piv ntawm lipids (cov roj zoo li roj) ntawm cov ntshav,
6. Qhov ntshav tsis txaus sab hauv
7. Lub sijhawm ntev ntev ntawm mob ntshav qab zib.

Ntau cov kev tshawb fawb qhia tias kev soj ntsuam tas li ntawm cov piam thaj thiab ntshav siab tuaj yeem txo txoj kev loj hlob ntawm pathology. Thiab kev siv tshuaj tua cov tshuaj insulin raws sij hawm txo kev pheej hmoo txoj kev loj hlob los ntawm ib nrab.

Cov tsos mob ntawm tus mob ntshav qab zib polyneuropathy tshwm sim los ntawm qhov mob nyob rau hauv qis qis. Kev kub hnyiab, npub lossis khaus khaus, tsis tshua mob heev, txhav thiab tho. Nws feem ntau tshwm sim hauv ko taw thiab sib zog thaum yav tsaus ntuj. Yav tom ntej, mob tuaj yeem tshwm sim nyob rau hauv qis thib peb ntawm txhais ceg thiab caj npab.

Cov neeg mob yws ntawm cov leeg ib ce heev, mob sib koom tes, gait ntxhov. Qhov no yog vim txoj kev loj hlob ntawm kev tsis sib haum xeeb hauv lub paj hlwb. Kub rhiab heev ploj, mob rau sab hauv yuav tshwm sim.

Tus neeg mob tsis xis nyob los ntawm kov cov khaub ncaws. Kev hnov ​​mob nyob rau hauv cov rooj plaub zoo li no tas mus li thiab qhov ua rau mob siab rau tus neeg mob.

Yuav ua li cas txheeb xyuas thiab qhia meej qhov kev kuaj mob?

Kev kuaj mob ntawm cov mob polyneuropathy pib nrog kev mus ntsib tus kws kho mob uas ua tib zoo sau pob txha taws thiab sau tshuaj rau cov kev kawm tsim nyog.

Raws li kev kawm tseem ceeb, kev nyiam yog muab rau electroneuromyography. Ntxiv rau, cov kev tshawb fawb ntawm VKSP (autonomic cutaneous sympathetic potentials) tuaj yeem siv.

Kev kho pathology

Hauv kev kho tshuaj rau kab mob oxidative kev nyuab siab, kom rov qab muaj qhov cuam tshuam, muab tshuaj kho nrog qhov ua kom muaj zog antioxidant. Kev lees txais tshuaj yog nqa tawm hauv cov chav kawm rau lub sijhawm ntev txaus. Nyob rau lub sijhawm no, muaj kev tswj thiab saib xyuas tus neeg mob.

Txhawm rau daws qhov mob, analgesics thiab anti-inflammatory tshuaj yog kws kho. Tab sis, raws li cov kws tshaj lij taw qhia, lawv tsis muaj peev xwm ua kom txo qis qhov mob, thiab kev siv lub sijhawm ntev tuaj yeem cuam tshuam kev ua haujlwm ntawm lub plab.

Rau cov tsos mob ntawm tus mob neuropathic, ua kom loog, tshuaj tiv thaiv kev ntxhov siab, thiab cov tshuaj tiv thaiv kev puas siab ntsws tau sau tseg. Ua cov tshuaj ntxiv rau cov tshuaj, nws raug nquahu kom siv cov duav nrog lidocaine, gels, ointments thiab cream.

Raws li kev tso ua ke ntawm txoj kev kho mob ntshav qab zib mob ntshav qab zib, nyob ntawm seb tus mob li cas, tsa:

• kev kho mob lub cev
• magneto thiab kws khomob,
• Electrophoresis thiab dej tsaws ntxhee
• kev tsim kho hluav taws xob leeg,
• Kev Siv Tshuaj Tua Tsiaj
• hyperbaric oxygenation,
• monochromatic duab liab hluav taws xob.

Kev kho mob nrog kho mob pej xeem tsuas yog tso cai los ntawm kev pom zoo los ntawm tus kws kho mob nkaus xwb. Raws li ib qho kev ntxiv rau cov kab ke ntawm kev kho mob, tshuaj ntsuab tshuaj ntsuab thiab siv cov tshuaj pleev kho kom zoo tuaj yeem siv.

Ib txoj kev kho zoo rau tus mob ntshav qab zib polyneuropathy yog suav tias yog tus kws kho mob ib tus zuj zus rau txhua tus neeg mob nrog txoj kev ua haujlwm zoo rau kev kho.

Pib ntaus ntawv thiab nias qhov Enter mus nrhiav.