Polyneuropathy Toxic wemikhawulo aphansi: Izimbangela, Izimpawu kanye Ukwelashwa. polyneuropathy Toxic emva nokwelashwa ngamakhemikhali

umqondo Polineytropatii kuhlanganisa leqembu lezifo, izimbangela zezinkumbulo bangahluka. Faka ekuhlanganiseni lezi zifo ilandelana - kuba ukusebenza okungavamile neuropathy isimiso sezinzwa noma emsipheni izinyanda ezithile.

izici Isici kukhona ziyalingana ukuphazamiseka polineytropatii kwemisipha wemikhawulo yasenhla nemithombo yasenzansi. Kulokhu, kukhona Ukwehla wegazi ukugeleza kanye nokuzwela Ukuwohloka ezandleni nasezinyaweni. Isikhathi esiningi, lesi sifo sithinta nemilenze aphansi.

Polyneuropathy genesis ezinobuthi of ICD-10

Omunye lwezinhlobo ezivame kakhulu lesi sifo kuyinto polyneuropathy anobuthi. Kusukela igama sifo kuyacaca ukuthi is phetho imiphumela ku isimiso sezinzwa ezihlukahlukene ejenti anobuthi. Ubuthi ukungena emzimbeni kusukela ngaphandle noma kube umphumela isifo.

Ukuze kube lula ukuzimisela uhlobo lesi sifo, liye okuphakanyiswe sokucabanga ngezizathu ukuthi kwabangelwa polyneuropathy anobuthi. ICD-10, noma International Ukwahlukanisa Diseases Ukubuyekeza 10th, linikeza ifomu elula kakhulu ngokuhlukana lesi sifo. Iphuzu liwukuthi yokunika ikhodi uhlobo oluthile sifo, esekelwe nezimbangela zayo. Ngakho, peripheral anobuthi abizwa ngokuvumelana uhlu ICD 10 ikhodi G62. Okulandelayo kuba kunqunywe ngaphezulu:

• G62.0 - ukubiza polyneuropathy okwelapha benethuba ukucacisa izidakamizwa;
• G62.1 - lekhodi libizwa ifomu oludakayo lesi sifo;
• G62.2 - cipher ngoba polyneuropathy zibangelwa ngezinye ezinobuthi (kungenzeka bethela ikhodi ushevu);
• G62.8 - a ukubiza ezinye polyneuropathy esibekiwe, okuhlanganisa ifomu emisebeni lesi sifo;
• G62.9 - ikhodi ifomu esingavezwanga peripheral (NOS).

Njengoba kuphawuliwe ngaphambili, i-peripheral anobuthi kungadalwa izinhlobo ezimbili izizathu:

• Have izimo exogenous (kulolu hlobo zihlanganisa idiphtheria, i-herpes, kubangelwa HIV, phambili, i-arsenic, i-alkhoholi, kubangele ushevu Fos, imithi, emisebeni peripheral).
• Be ngenxa endogenous izici (isib sikashukela noma kubangelwa paraproteinemia disproteinimiey, ehlasela umzimba izilonda zezinzwa izicubu).

muva peripheral Toxic isibe ngempela ukucinana ezivamile ngenxa yokwanda kwabantu nge ubuthi emithonjeni ehlukahlukene. Lezi imithi enobungozi yonke indawo: they are ukudla, ezidayiswayo, imithi kanye nemvelo. Izifo ezithathelwanayo bavame imbangela yalesi sifo. Amagciwane bawenze abulale ezithinta umzimba womuntu, kuthinte isimiso sezinzwa.

Exogenous polineytropatii anobuthi

Njengoba kuphawuliwe ngaphambili, zonke lezi zinhlobo izifo zenzeka lapho zihlatshwa umzimba womuntu izici zangaphandle: ubuthi of amagciwane namagciwane, izinsimbi ezisindayo, amakhemikhali, imithi. Njengoba olunye uhlobo polineytropatii, lezi zifo kungenzeka esingamahlalakhona noma oyingozi.

idiphtheria polyneuropathy

Kusukela igama sifo kuyacaca ukuthi kuphakama ngenxa idiphtheria ezinzima, ephelezelwa isenzo exotoxin. Iningi ngokuvamile Lokhu kwenzeka ngo abadala. Kulokhu, kukhona umthelela ulwelwesi we izinzwa skull nokubhujiswa kwabo. I izimpawu zesifo manifest ngokwabo noma yokuqala ngesonto (ikakhulukazi eziyingozi inhliziyo ukwehluleka kanye nenyumoniya), noma ngemva 4 th ngesonto emva kokutheleleka. Basuke obonakaliswe izilonda imisebenzi iso, inkulumo, ukugwinya, kungase ubhekana iphika tachycardia. Cishe njalo, izimpawu ziqale iyanyamalala ngemuva amasonto 2-4 noma izinyanga ezimbalwa.

herpetic polineytropatiya

Lolu hlobo lwe-isifo kwenzeka ngenxa umsebenzi Epstein-Barr igciwane Herpes simplex I neyesi-II izinhlobo, varicella, cytomegalovirus. Ukutheleleka ala magciwane zenzeka izingane, kodwa ngemva isifo ekhiqizwa amasosha omzimba. Uma umzimba ozivikela kuthiwa buthaka, ungakwazi ukuthuthukisa peripheral nge isici ukuqubuka wonke umzimba.

Polyneuropathy ezihambisana ne-HIV

Ngo ezimbili amacala amathathu iziguli nokutheleleka nge-HIV ziyabonakala yezinkinga esithinta izinzwa, avame evela izigaba ngasekupheleni lesi sifo.

Umthelela anobuthi igciwane, sokuhlasela kwamasosha omzimba ukuphendula ukutheleleka yesibili, ukuthuthukiswa izimila kanye nemiphumela imithi ekuhlanganisweni phambili uma iphazamiseka we ukusebenza evamile umzimba. Ngenxa yalokho, lapho encephalopathy, meningitis polineytropatiya nezinzwa cranial. ukugula Kugcine ngokuvamile wezwakalisa wokwehla nozwela izinyawo, ubuhlungu esifundeni lumbosacral. Ziyakwazi esilaphekayo kodwa igcwele yezinkinga ebulalayo.

polyneuropathy phambili

Le ndlela lesi sifo kwenzeka ngenxa kungaholela poisoning, okungase ukungena emzimbeni womuntu ngokusebenzisa ukuphefumula noma ngokusebenzisa pheshana emathunjini. Yena zibekwe amathambo isibindi. Ukuhola kuyinto polyneuropathy anobuthi (ICD ikhodi 10 - G62.2) sivezwe kula nesineke ngesimo ubuthakathaka, ukukhathala okusezingeni eliphezulu "eziyizimungulu" ikhanda, ekunciphiseni inkumbulo nokunakwa, encephalopathy, ukuntuleka kwegazi emzimbeni, nesifo, ubuhlungu emikhawulweni, eliqhaqhazelayo yezandla. Ngenxa yalesi sifo libhekene ukulahlekelwa uvumelanise futhi peroneal izinzwa. Ngakho ngokuvamile kuba khona syndromes 'ulengise ibhulashi "futhi" Iqhude Gait. " Kulezi zimo, kungagcini ngokuphelele ukuxhumana umthofu. Ukubikezela of ukususa lesi sifo - evumayo.

polyneuropathy arsenic

Arsenic Ungangenela umzimba womuntu kanye zinambuzane, imithi, upende. Lesi sifo is a professional e smelters. Uma ukuchayeka into enobuthi kwaba olulodwa, ekuthuthukiseni hypotension semithambo, isicanucanu nokuhlanza. Ngemva kwamasonto 2-3 livela polyneuropathy, ubuthakathaka inzima kunemisipha yomlenze. Uma kukhona okuphindaphindiwe arsenic elinobuthi, khona-ke kukhona ziyalingana distal kungokoqobo-motor kuwukubonakaliswa sifo. Endabeni ezingamahlalakhona anobuthi izidakamizwa ukudakwa waphawula nokugxaza amathe, trophic neziyaluyalu semithambo (hyperkeratosis kwesikhumba ku amathe nezintende zezandla, ukuqubuka, emapheshana on izinzipho, lesikhumba ku esiswini ngesimo amaconsi, uyaxebuka), ataxia. polyneuropathy arsenic sitholakale ngokusebenzisa ukuhlaziya umchamo Ukwakheka, izinwele nezinzipho. Ukubuyiselwa isiguli emva isifo ihlala izinyanga.

peripheral Alcoholic

Kwezokwelapha, kunenkolelo yokuthi ngezinye anobuthi utshwala polyneuropathy isizinda ayiqondakali kahle, lo mshini ukuthuthukiswa yawo ayiqondakali ngokuphelele. Isizathu esiyinhloko ukuntuleka thiamine emzimbeni futhi gastro ezivukayo on isizinda ophuzweni. Ngaphezu kwalokho, utshwala ngokwayo kunomphumela anobuthi nesimiso sezinzwa.

Toxic polyneuropathy oludakayo kungaba poodostroy, acute, kodwa ifomu evamile subclinical avelayo lapho ngihlola nesineke. Lubonakaliswa ingane ukwephulwa stop ukuzwela, nokucekelwa noma ukungabi khona ingqondo Achilles umsipha ubuhlungu ithole imisipha phezu palpation. Ngokuvamile polyneuropathy anobuthi obonakaliswe paresis lesinesitfombe-sibuko, yoma kwemisipha senyawo flexor nasezinzwanini, ukunciphisa esishintshashintshayo ukuzwela "amagilavu" futhi "amasokisi" ubuhlungu ezinyaweni nasemilenzeni noma i-DC shanela uhlobo, evutha ukuzwa e amathe, edema, ukubukeka izilonda nezitho zomzimba isikhumba hyperpigmentation. Ngezinye izikhathi kungase lesi sifo ezihambisana nge komqondo, ukonakala cerebellar, uphawu epileptiformii. Isiguli uyalulama kancane. Impumelelo ukwelashwa incike ukubuya noma lelicala ukusebenzisa uphuzo oludakayo. Ikhodi ye-ICD anobuthi polyneuropathy ku ngemuva zokusetshenziswa kabi kotshwala okungukuthi G62.1.

Polyneuropathy futhi Fos ushevu

Fos noma compounds organophosphorus ezibanjwa emzimbeni womuntu kanye zinambuzane, uthambise kanye plasticizers. Ngo ubuthi acute nala makhemikhali kukhona zimpawu ezilandelayo: ukujuluka, amathe, miosis, izinkinga zesisu, bronchospasm, incontinence urinary, faskulyatsii, Ukudlikizela, kungenzeka ukufa. Ngemva kwezinsuku ezimbalwa sibangelwa polyneuropathy nge motor zamehlo. Ukukhubazeka kunzima ukuba alulame.

polyneuropathy izidakamizwa olubangelwa

Lolu hlobo iziyaluyalu zezinzwa kubangelwa yokwamukela izidakamizwa ezilandelayo:

• Ekwelapheni "Pergeksilenom" at umthamo 200-400 mg ngelanga polyneuropathy kwenzeka ngemva nje kwamasonto ambalwa. It kuzibonakalisa zokunciphisa ukuzwela, ataxia, esitho paresis. Kulezi zimo, umuthi wayeka, isimo lesiguli lula.
• peripheral isoniazid eba nokuntuleka vitamin B ₆ kubantu nge kofuzo umzimba walo. Kulokhu, uqoke pyridoxine ngaphakathi.
• I ngokweqile "pyridoxine" (50-300 mg / usuku) kuholela ekwakhekeni polineytropatii sezinzwa, izinhlungu zekhanda ezinamandla, ukukhathala ukucasuka.
• ukwelashwa isikhathi eside "Gidrolazinom" kungaholela polineytropatii dysmetabolic futhi kudinga yokuvuma Vitamin B _6.
• Umuthi 'Teturam "at umthamo we 1.0-1.5 g / ngosuku singawathola e paresis, ukulahlekelwa ukuzwa, neuritis optic.
• Ukwelashwa "kordaron" umthamo 400 mg / usuku enkathini eyiminyaka ngaphezu konyaka kungabangela polineytropatiyu anobuthi.
• Nge ukuntuleka vitamin B _6, no-E kwenzeke polineytropatii, kanye ngokweqile yabo.

Izidakamizwa polyneuropathy anobuthi ICD 10 ikhodi G62.0.

Endogenous polineytropatii anobuthi

Lolu hlobo lwe-isifo kwenzeka ezimweni eziningi ngenxa ukungasebenzi kwekhono nezindlala endocrine ngenxa kusilela hormone kudingekile noma ehlukumeza nemisebenzi ezinye izitho zangaphakathi. Kukhona lezi zinhlobo ezilandelayo:

• peripheral Diabetic ungase uqale babazi, intuthuko kancane noma ngokushesha ngokwanele. Kubonakaliswa lokuqala ngesimo ubuhlungu futhi ndikindiki emikhawulweni.
• Polyneuropathy elihlobene ne paraproteinimeey futhi dysproteinemia kuphakama abantu ikakhulu abadala futhi lihlotshaniswa nezifo ezifana myeloma amaningi futhi macroglobulinemia. ukubonakaliswa Clinical kuvetwa usezinhlungwini bese paresis we ephansi kanye engenhla emikhawulweni.
• Polyneuropathy futhi eba izifo ezifana ngokukhukhumala kwentamo ezicutshini periarthritis nodular, i-rheumatoid arthritis, omzimba izicubu erythematosus, scleroderma.
• peripheral Hepatic is phetho sikashukela futhi ukuluthwa utshwala, futhi kubonakaliswa emitholampilo efanayo.
• iziyaluyalu kwemizwa ku yezifo pheshana emathunjini elihlobene ne-pathology wokugaya ukudla, okuholela beriberi. yesifo celiac kungabangela polyneuropathy, okuyinto lubonakaliswa lengqondo iziyaluyalu, isifo sokuwa, iziyaluyalu ezibukwayo, ataxia.

Polyneuropathy emva nokwelashwa ngamakhemikhali

polyneuropathy Toxic emva nokwelashwa ngamakhemikhali eqenjini ehlukile izifo, njengoba kungaba side-kusukela ngomhla ka-imithi, noma kube umphumela we nokwahlukana isimila cells. Sibangelwa ukuvuvukala letindzala, njengoba amangqamuzana ezinzwa e zilimele bese komgwaqo. Lesi simo esiyingqayizivele sibangelwa angadida khona sikashukela, ukuba umlutha wotshwala, isibindi ukungasebenzi kanye nezinso. Wazwakalisa lesi sifo ayephuli sezinzwa kanye motor neziyaluyalu, ukulahlekelwa imisipha ithoni emikhawulweni. Polyneuropathy emva nokwelashwa ngamakhemikhali, izimpawu ezichazwe ngenhla ingabagulisa ukubukeka motor dysfunctions. Ukuphulwa autonomic futhi uqondiswe isimiso sezinzwa esiyinhloko mancane ezivamile.

Ukwelashwa nokuvikelwa lolu hlobo isifo kuyehla yokwelapha lingaze. Isiguli ezingahle zinqunywe eqeda ukuvuvukala, analgesics, immunosuppressants, amahomoni, amavithamini "Neyromultivit" futhi "thiamine".

uphethwe isifo

polyneuropathy Toxic wemikhawulo aphansi ngomshini izifundo ezilandelayo:

• Ultrasound futhi-X-ray yezitho zangaphakathi;
• Ukuhlaziya cerebrospinal fluid;
• Ukutadisha ikhaliphe nesivinini ukudluliselwa kwawo eduze izinzwa;
• biopsy.

Ukunemba kanye Ukwenza uphethwe incike impumelelo ukwelashwa polyneuropathy.

Ikakhulukazi ekwelapheni lesi sifo

polyneuropathy Toxic, kwelashwa ngokuyinhloko okunomkhawulo ukuqedwa izimbangela zalo kufanele kubhekwe ngokucophelela.

Kuye uhlobo lwesifo nokugasela ngamandla ukugeleza babelwa imithi ezilandelayo:

• "Tramadol" futhi "analgina" - indawo ngeminjunju eqinile.
• "Methylprednisolone" - e isifo esiyingozi kakhulu.
• "Pentoxifylline," "Pot", "Trental" - ukuze okhulisa legazi imikhumbi yezinzwa.
• B amavithamini
• "Piracetam" futhi "Mildronat" - ukuthuthukisa izakhi ukumuncwa izindwangu.

Ngo singasetshenziswa njengoba izindlela physiotherapeutic:

• ukushukuma kagesi isimiso sezinzwa;
• massage ezelaphayo;
• ukushukuma kazibuthe isimiso sezinzwa;
• umthelela engaqondile ezithweni;
• hemodialysis, ngegazi lenkawu.
• LFK.

Yini indlela esiphatha ngayo polyneuropathy afanelekile kakhulu endabeni ethile, udokotela kufanele unqume. Ziba izimpawu isifo, akufanele. polyneuropathy olunamandla bangaba okungamahlalakhona, okuyinto kusongela ukulahlekelwa esitho ukuzwela, imisipha yoma baxhashazwe ephelele.