Wenza njani crisis myasthenic? unyango

Nawuphi crisis - kuba imeko yabantu, apho ngequbuliso, ziyonakala indlela kwesi sifo ngokukhawuleza, iimpawu kwandisa-emngciphekweni ngokukhawuleza kakhulu. Myasthenic kunye cholinergic lobunzima, Ulidlelane myasthenia gravis, ukuba kuyingozi ngenxa yokuba isigulane kungaphela zokuphefumla bayeka ukumbetha intliziyo yakhe. Maxa wambi ubomi bomntu ngokoqobo ekuthini imizuzu, apho abantu zonyango okanye ekufutshane kufuneka babe nelungelo lokuba abe nexesha ukunceda. Kutheni na ke zisiba mandundu, kubonakala, akukhona myasthenia sisifo esibulalayo gravis? Sinikezela ulwimi olulula kuvakala ukuba bangaxeleli nabani na ngoko wonke kufuneka wazi: oonobangela lentlekele myasthenic kunye cholinergic, ikliniki, ukhathalelo olungxamisekileyo kwabo abo kwenzeka loo inkathazo. Mhlawumbi umntu osondeleyo kuthi, xa ngequbuliso kwezothutho okanye nje kwisitrato kuya kuba kubi, ulwazi kweli nqaku liza kukunceda ugcine ubomi.

myasthenia

Ibali isiqalo Stroke ngokuchaza ingqiqo myasthenia gravis. Ngamanye amaxesha ukuthatha le sifo ngaphandle kwindawo yesohlwayo, njengoko abaphethwe myasthenia rhoqo ezikhala ukudinwa, silale, akakwazi ukwenza nawuphi na umsebenzi wezandla, nje ilula. Enyanisweni, myasthenia gravis na isifo neuromuscular, enxulumene kudidi samathambo, okubangelwe ukwahluleka emzimbeni ukuvelisa omzimba ekunene okanye ekuveliseni iiseli ezingababulali ezihlasela tissue esempilweni kunye neeseli eziyifaneleyo inkathazo enkulu.

nengxaki Myasthenic ukuvela imvelaphi kwezifo jikelele, yaye uneempawu ezifana kuye, sibonakalisa kuphela ngokwabo kangangoko enkulu kakhulu kangangokuba ngaphambili kwakhokelela ukufa nama-40% yezigulane. Ngoku, ukuba unyango iqalwa ngokukhawuleza, ukufa uya kuziphepha. Ndingathanda ukuqaphela ukuba myasthenia 10 abagulayo 100 amawaka zonke abemi Umhlaba, nabafazi abachatshazelwa izihlandlo-3 rhoqo kunamadoda. Myasthenia gravis kunokuzibonakalisa ebuntwaneni, kodwa iimeko ezinjalo zinqabile. Oku ikakhulu waphawula kwizigulane ukusuka kwiminyaka 20 ukuya kwiminyaka engu.

Iimpawu ze myasthenia gravis

Ngaphandle myasthenia gravis, ukuba ekhona umntu, emaxongo myasthenic ngeke kwenzeke. Noko ke, loo nto ngamanye amaxesha zingathathela ezinye izifo nezinye iimpawu ezifanayo, umz, ezifana ngentla silale, ubuthathaka, ukudinwa. Iimpawu ezongezelelweyo kwiintsana:

- netshiki lamehlo, ephawuleka ngokuhlwa, kunye nokunciphisa kusasa emva ukulala ebusuku;

- andiboni kakuhle;

- ediniwe, emva imithwalo fatigue eliphezulu eqhelekileyo ukuba abanye abantu, ezifana benyuka ngezinyuko;

- Iimpawu bulbar yokuqala (ngeempumlo imbonakalo ilizwi emva kwesidlo kwaye intetho elide, ubunzima pronunciation oonobumba ngamnye);

- tshintshayo Iimpawu bulbar (ubunzima igwinya, ukomiwa rhoqo);

- kwekhono yawo (paresis isisu, tachycardia);

- iimpawu zobuso (ebunzi imibimbi anzongonzongo kakhulu, yobuso uphawu);

- izinkcwe kakhulu;

- ubunzima ngokubamba intloko;

- ubunzima ukuhamba.

A isici esasenza myasthenia - zonke ezi mpawu zingasentla ngakumbi emva kokuba amandla omzimba kunye ngokuhlwa, yaye emva luphumlo elungileyo kuyacuthwa okanye unyamalale ngokupheleleyo.

Symptomatology lobunzima myasthenic

Ukuba umntu unesifo myasthenia gravis, phantsi kweemeko ezithile, loo nto inokuba ingxaki myasthenic. Iimpawu zesifo engundoqo, ingakumbi ezifana tachycardia, ukudinwa eliphezulu umsipha ebalulekileyo (yokuphefumla, igazi), ukuvuza izinkcwe, ngexesha elifanayo komelezwa. Ezi mpawu zilandelayo okufana ntlekele:

- ukushwabana izihlunu kukuginya kwaye ulwimi, ukuze bakwazi ukufumana kwisiqwenga yokuphefumla yencindi, ematheni, ukutya;

- ndiphume umphefumlo;

- yokususa onamandla yaye kwaba ngenxa yokunqongophala zezulu;

- a xhopho ebandayo;

- ukuchama kulogo kunye / okanye defecation;

- ukulahlekelwa lokuqonda;

- isikhumba owomileyo;

- uxinzelelo lwegazi siphinda-;

- abafundi inimba;

- ukusilela intliziyo etsolo, oko kukwaphula intliziyo.

nengxaki Myasthenic ke izidanga ezininzi:

- lula;

- avareji;

- enzima;

- umbane.

Umahluko amanga obubonakala amandla ngaphezu iimpawu. Ingakumbi imibane yingozi ntlekele enzima apho umntu ngokukhawuleza kakhulu, nje imizuzu embalwa, iphuhlise ubuthathaka kwemisipha bokuphefumla ligwinya. Ukuphefumla uba ekhawulezileyo ekuqaleni, ubuso obomvu, exhumaxhuma uxinzelelo, izinga intliziyo ifikelela malunga 160 ibetha ngomzuzu. Ngoko ke umoya eqalisa iphazanyiswe, yaye shwaka ngokupheleleyo, ubuso bakhe ajike aluhlaza (amayeza ibizwa ngokuba cyanosis), xi kunciphisa, ukubetha bi uvalo.

Oonobangela obunzima myasthenic

Myasthenia gravis angaba naso okanye lufundiwe. Eyokuqala ibangelwa kuguquka kwi zofuzo. Elesibini olubakho xa umntu iye:

- iingxaki le ndlala thymus;

- ezinye iintlobo zomhlaza (umzekelo, ibele, umphunga, zamaqanda);

- hyperthyroidism;

- kobuchopho ecubhukile.

Ngokuchasene imvelaphi ezi zifo ntlekele myasthenic lunokwenzeka kwezi meko zilandelayo:

- izifo ezihlasela zosulele ezosulelayo, kuquka SARS, umkhuhlane, iphika;

- ukusebenza;

- a xi psychological womelele;

- umsebenzi High ngokomzimba;

- ngokuthatha amayeza athile (umzekelo, okudambisa);

- izifo hormone;

- izigulane myasthenia yokupasa ukuthatha iipilisi, nokuhluthwa ke imithi.

crisis cholinergic

ntlekele Myasthenic kunye cholinergic akholisa ukubakho ngaxeshanye, nto leyo esisizathu sokuba kukho iimpazamo iyantlukwano, ngenxa unyango. Nangona kunjalo, ezi mpawu into efanayo lwangaphandle ezimbini urhulumente okubangelwa izizathu ezahlukeneyo yaye umyalezo ezahlukeneyo.

Ngoko, xa myasthenic receptors kaxaka cholinergic unciphisa lexinene i inwebu ngenxa kwiintshabalaliso zabo, kwaye usindileyo ukutshintsha umsebenzi wabo. Ingxaki cholinergic kwenzeka ukusebenza xa ngokugqithiseleyo receptors cholinergic (of the nicotinic kunye / okanye muscarinic). Iqhuba inkqubo ulwamkelo ngamalungiselelo yonyango myasthenia gravis ngeedosi eziphakamileyo, ngokunjalo iindlela engavumelekanga kwesi sifo.

Ukuhlola ingxaki akukho lula, kuba iimpawu zayo eziphambili idibana kunye myasthenic. Nceda ubone ngokuchanekileyo ukuba kwenzeka ntoni na umntu, ibe enjalo ingaba imeko yayo, uphawu lentlekele cholinergic: isigulane ubonisa iimpawu kunxilwe: isisu buthi, ivula ukugabha, urhudo iqala. Kuba intlekele myasthenic wabonakalisa zonke ngaphandle ezo mpawu.

Lo msebenzi osemqoka sesibini ingxaki cholinergic - eziba iimpawu myasthenia gravis ngaphandle ukwenza imisebenzi yomzimba, kodwa emva iziyobisi cholinesterase.

crisis ingxubevange

Yeyona impilo kunye nobomi yingozi uhlobo ngezifo. Luhlanganisa ntlekele myasthenic kunye cholinergic, ebonisa kanye zonke iimeko ziye ingxelo kunye zombini iimpawu. Oku kwenza kube nzima ukulungisa sifo, kodwa nkqu nangaphezulu - unyango, ngenxa yokuba abo amayeza ukugcina lobunzima myasthenic, ekhulisa cholinergic ngakumbi. Xa ngeentlekele flow mixed bahlule nezigaba ezibini:

1. myasthenic. Izigulana babona ukuphazamiseka bulbar zomlomo wakhe, iingxaki zokuphefumla, dukuthamba ebangela ukudinwa, kodwa ulawulo amachiza ( "Klamin", "Neostigmine") oko baxabane ezibi.

2. Cholinergic luphawulwa iimpawu kunxilwe.

Practice lubonise ukuba iingxaki oluxubeneyo akholisa ukubakho abantu abaza okanye abasele bethathe phezulu le okanye ukuba nengxaki xa iintsana.

Ingaba nengxaki usola exube iimpawu ezinjalo ukubonakaliswa:

- izigulana yabonakala ngokucacileyo kunzima nokuphefumla kunye bulbar ukungathobeli kunye nomsebenzi lwemoto kwamalungu zatshintsha kancinane;

- akanayo imali ekuthatheni amayeza kunciphisa iimpawu lwezidumbu, ezifana nokuphucula umsebenzi ngeemoto ngenkankulu kunceda basingathe ukuphefumla.

ekuxilongweni

Ukuthintela iimpazamo ngokukhawuleza nokunika uncedo elinemveliso busezingxakini myasthenic, kubalulekile ukubeka uxilongo isigulane kakuhle. Njengoko sele kutshiwo ngentla apha, ezinye iimpawu abe yengxakeko engeneyo myasthenic kuzo izifo ezinxulumene myasthenia gravis (umz, ubunzima ukuphefumla, ukubetha kwentliziyo kakubi). Symptomatology ntlekele cholinergic efanayo eyenzeka ngexesha ukunxila, yaye ezinye iingxaki kunye lokugaya. Ukuba isigulana umntu umlondolozi, uyakwazi ukunika inkcazelo malunga phambi myasthenia kwakhe kunye namayeza ukuba bathabathe nabo, uxilongo ngokusemthethweni lula kakhulu. Ukuze ezohlula uhlobo lobunzima, oogqirha benza prozerinovuyu isampulu.

ubunzima Special loxilongo kuvandlakanywa kwi-Stroke exutyiweyo. Ukuze kumiselwe impazamo-free isigaba yayo yokuqala ikhutshwa phandle uhlalutyo kwezonyango isigulane, ngokunjalo nohlolo electrophysiological ye isiphumo ezifunyenwe ngokufumana anticholinesterase iziyobisi.

kanye phambi komntu gravis (phambi kokuba crisis) ibanjiwe ngokusebenzisa electromyography, ukubalwa Itomography, amayeza kunye iimvavanyo ngumzimba.

Emergency Care kwintlekele myasthenic kunye cholinergic

Ukuba isigulane kunye myasthenia ngequbuliso yonakale (kuza ntlekele), xa impilo iyaqhubeka umzuzu. Eyona nto ephambili ekufuneka wenziwe - ngoko nangoko ubize inqwelo yezigulana. Ngelishwa, eneneni wethu, kukho amaxesha xa unonophelo ezizodwa ilityazisiwe. Singenza njani ukunceda kufela kwimeko enjalo? Okokuqala, zama ukubonelela kuye umoya, susa yencindi ukusuka emqaleni wakhe. Ngokutsho mithetho, kufuneka abaphethwe myasthenia kufuneka ube inqaku of ukuba unaso esi sifo, kunye namachiza (ezifana "Neostigmine") kunye nesirinji. Ukuba akukho ukufika ngokukhawuleza ngokukhawuleza kangangoko kunokwenzeka, umntu nengxaki myasthenic kuyimfuneko ukwenza ngenaliti ngokolwazi kule ncwadi.

Beza nokuhlangula, oogqirha kufuneka hospitalize njengesigulana okudibene nokungxama, kwaye kwiyunithi labagula kakhulu, apho unyango olungxamisekileyo kakhulu:

- ukunika umgudu;

- ioksijini;

- hardware kunye umoya ngomatshini.

Ukuba isigulana ngakubanampawu lentlekele cholinergic (ukugabha, urhudo), laqalisa amayeza zilandelayo: "Neostigmine", "Atropine". Phambi iimpawu zonyango olungxamisekileyo ukunxila oko kuphela mpilo kunye isitofu kwala machiza, "Atropine", "immunoglobulin", kwakunye nezinye izixhobo ezithile zonyango xa kuboniswe.

unyango

Ukuba umntu waba nengxaki myasthenic, unyango emva unyango olungxamisekileyo eqhutywe ngokusekelwe iimvavanyo zonyango kunye elebhu, kwaye ahlalutye Dynamics esi sifo. yomatshini (oko kukuthi, umoya enziweyo kwemiphunga), ngokuxhomekeke kwimeko bezonyango isigulana, kwakunye ubungqina kukho ioksijini egazini enokwenziwa ukuya kwiintsuku ezintandathu, kodwa ukuba isigulane emva-16 okanye iiyure okanye ngaphezulu kukho indlela entle "Neostigmine" mpilo obenziwe . Ngokubanzi, inkqubo le mpilo kunobuzaza kakhulu futhi ephendulayo, efuna esweni ngokuqhubekayo respirators,% kuhlanganiselo iigesi igazi, igazi, ubushushu, ukulungelelana ulwelo emzimbeni kunye nabanye.

Indlela ebalaseleyo ukumelana nazo zonke iintlobo iingxaki kwiintsana ke plasmapheresis exchange. Xa oku isampuli yegazi lwenziwa ukusuka central (okanye engqinibeni) Kusenjalo, centrifuged, utshintsho plasma mali okanye ngumntu. Le ndlela inika iziphumo ezibalaseleyo - phakathi nje ezimbalwa iiyure imeko yomguli is ngcono kakhulu. Plasmapheresis lwenziwa kwikhondo-7 ukuya kwiintsuku ezili-14.

Enye amanqanaba unyango unyango ngamachiza. Ngokutsho ubungqina lezigulana kubalelwa immunoglobulins, antioxidants, iziyobisi anticholinesterase, kwaye phambi ukudumba - antibiotics.

Ipredikshini kunye nokuthintela

iminyaka engamashumi amathathu okanye amane eyadlulayo, iziphumo sibulale izigulane myasthenia ngexesha exacerbation kwesi sifo kwenzeka impela njalo. Ke kaloku izinga lokusweleka liye lathotywa yi izihlandlo ezili-12. Kufuneka baqonde ukuba ngamanye amaxesha ngenxa yezenzo zethu nawe kuxhomekeke ubomi bomntu, nto leyo waba nengxaki myasthenic. uncedo Emergency kufuneka zinikwe ngokukhawuleza kakhulu. Ngoko ke, ukuba ngesiquphe esitratweni, kwezothutho zoluntu, naphi na apho sibona umntu uqalisa ziliminxe, kufuneka ubize inqwelo yezigulana ngoko nangoko.

izigulane Myasthenia ngokwawo kufuneka athobele eziliqela amanyathelo okuthintela ingxaki:

- kuba phantsi kweliso kwagqirha, yaye zilandele ngqo unyango emiselweyo;

- Kuphephe khulu, luvo breakdowns;

- unogada kunokwenzeka izifo ezosulelayo;

- musa ukubeka ukunxila umzimba wakho;

- yomxhesho ukufaka ukutya zizityebi potassium (umzekelo, iitapile izitya, zeerasintyisi).