I-Polyneuropathy iyiqembu lezifo zesistimu ye-peripheral neva eyenzeka ngesikhathi sokubhujiswa kwemicu yezinzwa.
Izimbangela zalezi zifo zengqondo zingahluka, kepha ukubonakaliswa kwazo kliniki kuyafana. Zibonakaliswa yithoni yemithambo engasebenzi kahle, ukungondleki okwanele kwezicubu, izinguquko zokuzwela kanye nokukhubazeka kwemilenze.
Uma siqhathanisa i-polyneuropathy yesifo sikashukela ne-alcoholic, ukuthi iyini futhi isibonisa kanjani, khona-ke uphawu olujwayelekile luzoba ukuphulwa kokuhlinzekwa kwegazi kanye ne-innervation ngaphansi kwethonya lezinto ezinobuthi - ushukela ne-ethanol.
Izizathu zokukhula kwe-polyneuropathy
Ama-polyneuropathies awobuhlakani obahlukahlukene, futhi akhula ngokuchayeka okubi kakhulu noma okungamahlalakhona kokulimazayo kokuthile okulimazayo kwimicu yezinzwa. Lokhu kungahle kube ngenxa yomphumela onobuthi wegciwane le-diphtheria noma igciwane ekuthelelekeni nge-HIV, ukulimala, nezinqubo zesimila.
Imithi, kufaka phakathi ICordaron, Furadonin, Metronidazole ne-Isoniazid zingaphazamisa ukuthinteka kwezinzwa ngesikhathi sokusetshenziswa isikhathi eside.
Ama-Neuropathies ezifweni zesimila angaba khona okwesibili - ngomdlavuza we-lymphoma, i-myeloma nomdlavuza wamaphaphu, futhi ube yingxaki ye-chemotherapy yalezi zifo.
Ama-neuropathies angamahlalakhona adala izimo ezinjalo ze-pathological:
- Izifo ze-Autoimmune.
- Ukuphazamiseka kwemetabolic - isifo sikashukela, i-amyloidosis, i-hypothyroidism, ukuntuleka kukaVithamini B12.
- Izifo ezithiwe.
- Utshwala
- Ukwehluleka kwangempela
- Isifo sokuqina kwesibindi.
Kwi-polyneuropathy yesifo sikashukela notshwala, ukuqhubekela phambili ngesipiliyoni eside sesifo kanye nokwenza ngcono kwezinkomba zomtholampilo ezinokwehla kokudla kweglucose noma utshwala kuyimpawu.
Kungani imicu yezinzwa ithintwa yisifo sikashukela notshwala?
Ku-mellitus yesifo sikashukela, ama-polyneuropathies akhula ngokubhujiswa okwandayo kwama-neurons engxenyeni engaphandle yesistimu yezinzwa. Ukufa kweseli okunjalo kuvame ukungaphenduki ngenxa yokulungiswa kwezicubu ezithintekayo kwisifo sikashukela.
Ukwanda kwe-glucose egazini elijikelezayo kuholela ekuqineni kwezindonga zemithambo yegazi, i-patency engasebenzi kahle, ukwakheka kwezigaba zegazi kanye namachashaza odongeni. Ngokudla okuphansi okunjalo, amangqamuzana ezinzwa ayafa, athathelwa indawo izicubu ezithintekayo ezingasebenzi.
Ukuvela kaningi kwe-neuropathy emadodeni amade sekufakazelwe. Isici esiyinhloko esinquma ukuthi ubudisi benkambo yesifo yizinga le-hyperglycemia. Izimo zokuhlinzeka zikhuluphele, ukubhema nokusebenzisa kabi utshwala.
Ubungozi be-polyneuropathy yesifo sikashukela banda ngalezi zinto ezilandelayo:
- Inkambo ende yesifo sikashukela.
- I-hyperglycemia ephezulu, izinguquko ezivame ngamazinga kashukela.
- Ebudaleni.
Ngokuthola kwe-neuropathy etshwaleni, i-trigger ingaba yi-hypothermia, ukutheleleka kanye nokulimala kwesibindi. I-Ethanol ngokwayo nemikhiqizo yayo ye-metabolic iphula imicu yezinzwa. Ngokushoda okuhambisanayo kwevithamini B1 (thiamine), ukubonakaliswa kokunyuka kwe-polyneuropathy.
I-Hypovitaminosis B1 ivela ngokudla okunganele kokudla nokungangeni kahle emathunjini. Ukuphuza utshwala kukhulisa isidingo se-thiamine, ngakho-ke ukubonakaliswa kwayo kuyachaphazeleka. Kulokhu, izicubu zezinzwa ziba nozwela kunoma yimuphi umonakalo.
I-Alcohol idala ukwakheka ngokweqile kwama-radicals mahhala ahambisa umkhondo wangaphakathi wemikhumbi, ngenxa yalokho i-hypoxia yakhela ezintanjeni zezinzwa bese iyabhujiswa.
Izimpawu zesifo sikashukela se-polyneuropathy
Ukuphazamiseka ekunikezelweni kwegazi, izinguquko ekuqhubekeni kwezicubu zezinzwa ezinesifo sikashukela kwakha izinhlobo ezintathu zezilonda zamaphethelo aphansi: i-neuropathic, ischemic, exubile.
I-Neuropathic syndrome ibonakaliswa ngumbono ohlanekezelwe wobuhlungu, lapho, ngokuthinta okuncane, kuzwakala ukuqaqamba, nalapho uhamba ngonyawo ushibilika. Ukuthunga, izinhlungu ezivuthayo noma imizwa evuthayo ezinyaweni nakho kungenzeka.
Ukushisa okungahambi kahle kanye nokuzwela kobuhlungu kuholela ekulimaleni kwesikhumba. Amalunga emilenzana akhubazekile ngenxa yobuthakathaka bemisipha nokuma okulingene kwemilenze lapho uhamba, kwenzeka ama-subluxations. Isikhumba some, siqweqwe, ngokuqhubeka kwalesi sifo endaweni yokuqhekeka noma ukulimala, kuba nesici esibuhlungu.
Isici esiyingqayizivele senketho ye-neuropathic ukuba khona kwe-ishayela ezinyaweni, isikhumba esifudumele nokwakheka kwezilonda emathanjeni we-metatarsal.
Ukuhlukahluka kwe-ischemic kokuthuthukiswa kwesifo sikashukela polyneuropathy kuhambisana:
- Ukunqotshwa kwemithambo yemithambo yegazi kanye nama-capillaries.
- Isimo se-cholesterol ne-calcium odongeni lwe-vascular.
- Ukwakheka kwama-plaque kanye nokuqhekeka kwegazi.
- Udonga lwe-vascular liba lukhuni futhi lube lukhuni.
- Ukunikezwa kwegazi kuyehla.
Ukunyuka kwegazi kungena embhedeni we-venous nokuqina kulo kufaka isandla ekwakhekeni kwe-edema nokuqina kwesikhumba esikhunjeni. Isikhumba siba mncane, silimale kalula, amanxeba nezilonda. Isibonakaliso se-ischemia siyisibonakaliso sokucaphuka ngezikhathi ezithile, lapho isiguli kufanele sime lapho sihamba ngenxa yobuhlungu obukhulu emilenzeni.
Uhlobo oluhlanganisiwe liboniswa ngokufinyeza kwama-tendon kanye nokubekwa kwamaphrotheni okuxinana ne-glucose ezindaweni eziqondile ze-articular. Izimpawu zokuphulwa okunjalo yilezi:
- Ukuqina emalungeni.
- Isifo samathambo, ukhubazeka okuhlanganyelwe kanye nokusatshalaliswa.
- Izinyawo zibanda ekuthinteni.
- Isikhumba sibomvu nge-tint eblue,
- Izilonda zivela emaqakaleni noma esithendeni.
Izilonda ekuguleni okunzima ziyatheleleka, ezingaba yinkimbinkimbi yi-osteomyelitis nenqubo ye-septic, ukuqhubekela phambili kwe-ischemia kuholela ebulilini.
Unyawo lwesifo sikashukela luyimbangela evamile yokunqunywa konyawo.
Izimpawu ze-prolineuropathy ku-alcohol
Ukwahlukaniswa kwezinhlobo zombili ze-alcoholne ne-diabetesic polyneuropathy kunemibandela, ngoba akukho monakalo owenziwe wedwa ohlelweni lwezinzwa nokujikeleza kwegazi. Izinhlobo ezitholakala kakhulu zalesi sifo zitholakala.
Ukubonakaliswa komtholampilo kwe-polyneuropathy yotshwala kuvezwa ama-syndromes anjalo: inzwa, motor, exubekile, i-atactic.
I-sensor neuropathy ibonakaliswa wubuhlungu bonyawo, ukukhubazeka, ukushiswa, ukuqina kwemilenze, izinhlungu zemisipha. Ukwephulwa kokuzwela, kufaka phakathi ukwanda noma ukuncipha kobuhlungu nokushisa kunciphile kuhlobo "lwamasokisi nemicu." Ukusabela kwemithambo yomzimba kuboniswa ngokugqamisa kwesikhumba, kudlule ukujuluka.
Kuvezwa ifomu lezimoto:
- Kwehliswe ukuguquguquka kwezinyawo noma izinzwani.
- Ukwephulwa kokujikeleza kwezinyawo.
- Ukungakwazi ukuhamba kuzwane.
Uma i-peroneal nerve ithinteka, amafomu “onyawo olubunjiwe,” lapho kunzima ukwelula unyawo.
Ifomu elixubekile lenzeka ngesimo se-paresis noma sokuqina kwezinyawo, izandla, izinhlungu, ukuqaqanjelwa izandla noma izinyawo. Imisipha yezandla nemikhono yezandla ngaphambili. Endaweni ethintekile kungenzeka kube nokuzwela okukhulayo noma okuncishisiwe.
I-peripheral pseudotabes, noma ifomu le-atactic le-polyneuropathy yotshwala, libangelwa ukuphazamiseka kokuzwela okukhulu. Ezigulini, ukuhlangana kokunyakaza nokushintshana kwe-gait kuyahlanekezelwa, imilenze iyaqina, ukuzwela kuyancipha, ngesikhathi sokuhlolwa, ama-Achilles kanye ne-knee reflexes akakho.
Kuqala, iziguli ziba nobuthakathaka bemisipha nokuqunjelwa ezingalweni nasemilenzeni, bese kuthi esiteji esikhulisiwe se-paresis noma ukukhubazeka komzimba kukhule, futhi ukuzwela kwengaphezulu kukhubazeke.
Ezigabeni ezinzima, izicubu zokuphefumula, izicubu zenhliziyo ziba buthaka, okukhonjiswa ukuphazamiseka kwesigqi nokuncipha kwengcindezi.
Ukwelashwa nokuvimbela i-neuropathy kushukela
Ukwelapha i-neuropathy ezigulini ezinesifo sikashukela, amazinga kashukela egazi kumele azinze. Ngaphezu kwalokho, izinkomba zenkambo yesifo sikashukela encishisiwe yokwehla kwezinga le-hemoglobin ye-glycated, izinkomba ze-lipid metabolism, kufaka phakathi i-cholesterol, nomfutho wegazi.
Lokhu kutholakala ngokulandela ukudla kanye nokuyalela ukwelashwa kwe-insulin yohlobo lokuqala lwesifo sikashukela. Iziguli ezinesifo sikashukela esingancikeli i-insulin nazo zingadluliselwa okwesikhashana kwi-insulin, uma izidakamizwa zokunciphisa ushukela kumathebulethi zingakwazi ukwehlisela ezingeni elinconyiwe.
Ngemuva kokujwayelekile kwezinkomba ze-carbohydrate kanye ne-fat metabolism, ukwehla okuphawuleka kokubonakaliswa kwe-polyneuropathy yesifo sikashukela kuqala ezinyangeni ezimbili.
Ukwelashwa kwezidakamizwa kwenziwa kusetshenziswa amalungiselelo we-thioctic acid: i-Berlition, i-Thiogamma, i-Espa-lipon. Kuboniswa inkimbinkimbi yamavithamini we-B - iMilgamma yesifo sikashukela, Neurobeks Neo, Neurovitan, Neuroorubin.
Ama-analgesia, izidakamizwa ezilwa nokuvuvukala ziyasetshenziswa - Indomethacin, Diclofenac, Nimesulide, kanye nama-anticonvulsants - Gabalept, Iculo. Ngokwezinkomba, ama-antidepressant angabekwa - i-amitriptyline, i-clofranil, imipramine, i-venlafaxine.
Izithako ezisetshenziswa endaweni yakho nge-lidocaine - iVersatis noma ngezidakamizwa ezingezona ze-anti -idalidal - uKetoprofen, iDolgit.
Izindlela ezingezona ezokwelapha zisetshenziselwa ukwelashwa kwe-polyneuropathy kushukela: i-hyperbaric oxygenation, i-balneotherapy, i-electrophoresis, ukukhuthaza ngama-module moderate, i-magnetotherapy, i-electroneurostimulation ye-percutaneous. Zingabekwa uma kungekho zifo ezinamandla kakhulu.
Ekwelapheni i-syndrome eqhubekayo yobuhlungu, engasuswa yimithi, kushukumisa ugesi womgogodla.
Ukuvimbela ukuthuthukiswa kwe-polyneuropathy ukulawula izinga ushukela nokulungiswa kwamthamo kwemithi enciphisa ushukela. Ngaphezu kwalokho, iziguli ezinesifo sikashukela zinconywa ukuhlolwa kwegazi njalo kwe-hemoglobin ye-glycated, i-renal kanye ne-hepatic tata, kanye namazinga e-lipoprotein.
Kungenzeka ukuvikele ukubhujiswa kwemithambo yegazi nemicu yezinzwa kuncike kulezi zincomo ezilandelayo:
- Gcina umfutho wegazi ku-130/80 ukuze ungalimazi ukuhanjiswa kwegazi kwizicubu ezithintekile.
- Khipha ushukela nefulawa emhlophe ekudleni, bese ufaka imifino kanye nemikhiqizo yamaphrotheni enamafutha amancane.
- Noma ikuphi utshwala nokubhema kufanele kuvinjelwe.
- Thatha ukuhamba nsuku zonke, gcina umzimba ulungile.
- Bheka inhlanzeko futhi uhlole izinyawo nsuku zonke.
Ukwelashwa kwe-polyneuropathy yotshwala
Ukwelashwa kwe-polyneuropathy okubangelwa ukusetshenziswa kabi kotshwala, kubalulekile ukulahla ukudla okudla utshwala nokunempilo, kufaka phakathi inani elanele lamavithamini kanye ne-fiber yokudla, kanye ne-protein ephelele.
Ukwelashwa kwe-physiotherapeutic, i-electromyostimulation, galvanization kanye ne-electrophoresis yamavithamini, i-novocaine iyasetshenziswa.
Faka isicelo se-magnetotherapy, i-laser therapy, imisinga eyenziwe nge-sinusoidally, i-acupuncture. Iziguli zikhonjiswa ngokuzivocavoca umzimba, ukuzivocavoca, ukubhukuda nokuhamba.
Ukwelashwa kwezidakamizwa kwe-neuropathy yotshwala kwenziwa ngalezi zidakamizwa ezilandelayo:
- Amavithamini e-B: i-Milgamma, i-Neurorubin, i-Thiamine chloride, i-Pyridoxine hydrochloride, iCyanocobalamin (intravenous noma intramuscularly).
- I-Ascorbic acid iyajova.
- I-Pentoxifylline, iTrental noma iPentilin, i-Cytoflavin yokuthuthukisa i-microcirculation.
- I-Actovegin yesifo sikashukela yokumelana ne-hypoxia.
- I-Neuromidin yokuthuthukisa ukwenziwa kwe-neuromuscular.
- I-Anesthesia: Izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala iVoltaren, Revmoxicam; ama-anticonvulsants - IGabalept, Finlepsin; antidepressants - I-Anafranil, iVenflaxin.
- Izidakamizwa ze-Anticholinesterase ze-paresis noma zokukhubazeka - Neuromidine, Galantamine, Proserin.
Ama-Hepatoprotectors (Essentiale, Hepabene, Liv) akhonjisiwe ezigulini ezinjalo ukwenza ngcono ukutholwa kwemithi nokuvikelwa kwamaseli wesibindi. Futhi, imiphumela emihle yatholakala lapho kusetshenziswa izidakamizwa ezine-thioctic acid - i-Thiogamma, i-Espa Lipon, iThioctacid, i-Berlition.
Yini isifo sikashukela se-polyneuropathy? Imininingwane ngale ndaba inikezwe kuvidiyo ekulesi sihloko.
