Ziintoni iimpawu ziimpawu kwekhono somatoform yawo-luvo?

Somatoform kwekhono yawo - entsonkothileyo ngokwemiqathango zokufumanis isifo. It uneempawu ezininzi ezifana nempilo ngokwasemzimbeni nasengqondweni. Ngaphezu koko, izigulane ukubandezeleka kubo, yiva iimpawu zesi sifo etsolo ngokwaneleyo eyaphula ekuqondeni zabo abaqeqeshiweyo. Ngenxa zonke enokuthanani esi sifo, kufuneka uqonde ngokweenkcukacha.

isifo SVD Overview

kwekhono Somatoform yawo (SVD) ukubonakala rhoqo ngakumbi amadoda ubudala emkhosini, okanye izigulane baye slozhbu engxamisekileyo okanye ukubandakanyeka ukulwa ngqo. Esi sifo, esizibonakalisa ubunzima iimpawu non-ngqo kwaye ifuna uxilongo eneenkcukacha. Injongo yalo ukuphelisa izinto ezingaqhelekanga noshowo intliziyo arrhythmias kwakunye usulelo kwinkqubo luvo.

Kukholelwa ukuba kwekhono somatoform yawo i ukungalingani gqolo phakathi kwenkqubo novelwano kunye parasympathetic luvo. SVD ngokwayo zohlulwa ngokwendidi ezintathu: SVD ngenxa yesifo senhliziyo, hypotonic kunye nohlobo hypertonic. Kufuneka umahluko kusuka isifo sentliziyo, emithanjeni esihanahanisa- kunye noxinzelelo lwegazi, leyo isonjululwe ngexesha iziganeko ikhwelo emkhosini. Ngenxa yesi sizathu, abafazi SVD ibhaqhe ngaphantsi rhoqo kunabantu kunye namakhwenkwe. Nangona 80% ye uxilongo kwabenza akukho kuqinisekiswa yi-vrachebnokonsultatsionnoy yikomiti engundoqo.

symptomatology SVD

Somatoform kwekhono yale nkqubo yawo luvo lubonakala iimpawu mass nonspecific. Ngokufuthi zibonakale ngokungakhethiyo kwisiqalo yoxinezeleko sivavanywe kwiimeko cwaka. Okubalulekileyo, i IRS naye ngokuba sifo kuba ngenene ibandakanya inani elikhulu iimpawu. Siboniswa khetho syndromes zilandelayo: kwentliziyo, hypotonic, hypertonic. Kwakhona, kusenokubakho simtpomy eqhelekileyo, iimpawu ukuqunjelwa, ukuphazamiseka nokuphefumla, disadaptative emzimbeni. Ezi mpawu ziya ibixoxwa ngokunzulu.

ekuxilongweni Basics

Indlela emisiweyo uxilongo ezibalulekileyo SVD zezi: ixesha iimpawu (kweminyaka ngaphezulu kwama-2) kunye gemodinamicheskiznachimyh ukungabikho okanye ezisongela ubomi arrhythmias senhliziyo okanye isakhiwo. Ngokwenene, zonke izinto ezingaqhelekanga ezincinane kwentliziyo nto ibangele utshintsho ukuphazamiseka intliziyo isingqisho, okanye angabi nemingxuma, inokudityaniswa.

Uxilongo "kwekhono yawo Somatoform" ke kufuneka zidityaniswe, ukusilela umzekelo, tricuspid (mitral, aortic okanye pulmonary), arrythmia ezinqabileyo, zezomzuzwana WPW syndrome okanye CLC. Noko ke, izigulana ezo kufuneka waphawula amaxesha 2 ngonyaka ukuchonga ezinye ukwaphulwa. Kucacile ukuba inkoliso iSifo SVD conscripts kungafihlwa yaye nabantu abatsha, akanalo ilungelo lokuba khona. Ngokufuthi, le uphethwe ugqirha ngokwakhe ngaphandle isikhalazo kuphela ngokusekelwe ebusweni iziphene ezincinane nenesakhiwo entliziyweni. Ngokuba malunga ne-80% ye iSifo ichaswa, kodwa ukubaluleka lwezonyango kufuneka izikhalazo kuphela kunye comorbidities kunye syndromes.

Iimpawu eziqhelekileyo SVD

Xa izifo ezifana, njengokuba kwekhono somatoform yawo, iimpawu ngokubanzi baninzi. Le meko neziphithiphithi, ongase, dysthymia, ukungafuni ukuba enze nawuphi na umsebenzi wezandla, ukuphazamiseka emnyama, buthathaka kwezihlunu, yintloko nezolo, uninzi yenzelwe le Parietal kunye kummandla Occipital. Ngamanye amaxesha isigulane yayindikhathaza nesiyezi kunye nokushisa kwimimandla podlozhechkovoy ezinganxulumananga ukulamba okanye kuhluthe.

Loo isikhalazo luphawulwa asthenic syndrome somatoform kwekhono yawo. Izigulane badla lutho, maxa wambi ukunqongophala nyathelo kunye ngokulula kwamcaphukisa. Nganye kwezi mpawu uphawu bamathidala ukuba bathathe ishishini elitsha. Iya isanda, kodwa akuphelelanga. Ngumzali, Noko ke, introversion, nto leyo iqalisa ngenxa lokuphumelela engephi kwezemidlalo okanye bangenzi emzimbeni kukhokelela kukuba abantwana badla ukuvala esi sifundo. Bathe kakuhle bokukhumbula, kodwa uxinzelelo kwiimeko bacinga ngokungakhathali. Ukuphepha uxinzelelo kunye nokuba mathidala ukuba bathathe inxaxheba kwizinto ezifuna uchulumanco ngokweemvakalelo, uphawu uphawu kwizigulane kunye yawo kwekhono somatofrmnoy.

umsebenzi Physical e SVD

unyamezelwano Luphantsi ukuya umthambo - kuba luphawu eziphawuleka SVD. Izigulane bengaxeli ukuthatha imithambo eklasini yemfundo ngokwasemzimbeni, ingakumbi ukuba kufuneka amandla. Ngokuqhelekileyo, imidlalo mobile kulula ukuba ezi zigulane, ngoxa imithambo amandla kunokubangela ezininzi iingxaki. Ungase uphawule ukuba emva kokwenza oko dyspnea ngaphezu kwabanye abantwana yokwakha efanayo. Ukongeza, ezi zigulane ngokukhawuleza ukufumana udiniwe, ukunyamezela babo lingaphantsi ngaphezu kwabanye. Kwakhona kwi umthwalo kwisiqalo ukuze babonakale iimpawu zemiphunga okanye kwentliziyo SVD echazwe ngezantsi.

Wentliziyo (intliziyo) isikhalazo lwezigulane

Somatoform kwekhono kwenkqubo yawo luvo lubonakala iimpawu amaninzi zibangelwa kukho ukungalingani phakathi sympathico kunye parasimpatikoy innervated omzimba. izikhalazo Heart, ekubeni umzimba unalo innervation yawo, ziphakathi ibalulekileyo. Ezi mpawu zixhaphakileyo of SVD kwicala iimpahla intliziyo igazi: intlungu kwentliziyo, tachycardia, ukwanda okanye ukuncipha uxinzelelo lwegazi.

Uhlobo Intlungu entliziyweni yam ngqo ukuba isifo esithile. Iintlungu lidla ukuhlatywa kwaye ngamanye amaxesha ngokucindezela. indawo yabo - intliziyo isiseko (3-6 cm ukuya ekhohlo kwentamo) kunye phezulu (5 cm ukuya ekhohlo kwentamo kwi isithuba intercostal 5). Tachycardia ezinokubangelwa luxinzelelo ngokweemvakalelo okanye ntshikilelo emzimbeni. Kubalulekile ukuba uqala uxanduva olukhulu olwenziwe yi womxhuzulane. Umzekelo, tachycardia livela ngokukhawuleza phambi kokuba ukusetyenziswa okanye kwasekuqaleni, yaye hayi suka yayo.

Kubalulekile ukuba Intlungu entliziyweni yam, ukuba babe nesimilo eluvundwini, kwaye (okanye) ngokuveza kwaye kuvela imizuzu 20-30, kufuneka ithathwe kobuchopho, nefunwa ukurekhodwa electrocardiography okwelona xesha lifutshane kangangoko ixesha. Oku kungenxa yokuba ubukho ezikhoyo zonyango ezifana lobeko angina kunye kwentliziyo syndrome X. Kula ezimbi maxesha 50-100 ephezulu okuba lokufa coronary ngequbuliso.

Hypotension okanye umfutho

Lwegazi senzeka manqaphanqapha. Olu hlobo engaqhelekanga SVD, ngenxa yokuba kaninzi kubonwa Iintlobo senhliziyo okanye unesifo. Kunjalo uhlobo hypotonic SVD ukuvela athile ngo uxinzelelo lwegazi kwi zombini iingalo. Kubalulekile ukuba lokufunyaniswa olu hlobo sifo efunekayo ukwenza echocardiography kunye electrocardiography, ezivumela ukuba ngaphandle ubukho nesifo sentliziyo okanye arrhythmias. Niphele nazo iimpawu SVD, nangona nonspecific.

Lwegazi - isikhalazo eqhelekileyo. Izigulane staradayut xi suka phambi kokwenza umthambo, kunokuba ngawo. Uxinzelelo ngokubanzi banda bodwa bavuselwa 160 iSystolic uxinzelelo lwegazi, lo gama ukuzala iyafana. Ngenxa okubuyela kwimo yazo imithambo yegazi abafikisayo kunye namabhinqa aselula abaye kwekhono somatoform yawo ye intliziyo kwafunyaniswa nangakumbi rhoqo, uxinzelelo lwegazi ukuzala luyakwazi ukuhla thile.

Oku kubangelwa ukungalingani kwenkqubo novelwano yaye parasympathetic luvo, izihlunu luyanda xa norepinephrine kwemithambo, ukuhla uxhathiso neuropathy nemithambo. Kubalulekile ukuba xi banda rhoqo, ngenxa uxilongo nomfutho ayinako zingacwangciswa.

izikhalazo zemigudu

Xa isifo efana somatoform kwekhono kwenkqubo yawo nervous nayo iimpawu ngesimilo sokuphefumla. Laws imbonakalo yazo efana naleyo kwimeko cardialgia, hypotension okanye lwegazi. Oko kukuthi, iimpawu nokuphefumla zenzeke ngexesha umthambo. Kwakhona, ukuba ethile SVD, ukuba kuvela emva kokugqitywa imithambo kwixesha lokuphumla. Oku kuchasene izikhalazo nokuphefumla SVD iimpawu sombefu loxinzelelo emzimbeni.

Imizekelo izikhalazo SVD: wavakalisa dyspnea bedidekile kuso okanye kwithuba lokuphumla emva kokuba ukuqaliswa, isifuba yengxinano nokuphefumla iingxaki zayo. Thelekisa, somoya baphuke zingumphunga. Kunye nezikhalazo nokuphefumla kwi izifo ezifana somatoform kwekhono kwenkqubo yawo wabonakalaliswa inhliziyo. imbonakalo yazo joint - ulwazi, kodwa uphawu non-ngqo, pozvolyayuy wenze isifo esinjalo.

Ukuqunjelwa ne SVD

Xa isifo efana somatoform kwekhono yenkqubo yawo luvo, oonobangela zizinto ezininzi. Sihlala ukungalingani phakathi kweenkqubo parasympathetic novelwano luvo. Ngaphezu koko, yonke iphecana zesisu nalo liya kuthatha inxaxheba kule nkqubo, kuba innervated ngokupheleleyo inkqubo parasympathetic. Le nerve vagus ulawula secretion esiswini, injeke, emathunjini. Unoxanduva izakhono motor bonke ekugayeni. Ngenxa yokuba xa SVD kuvela rhoqo ukuqunjelwa, kunye neentlungu esiswini.

Iziganeko zixhaphakileyo sotyatyazo kufuneka zabelwe isicaphucaphu ngaphandle ukugabha, iintlungu nezolo kummandla epigastric, obubonakala ngokuba ngokukhanywa okanye ukuhlatywa. imbonakalo yazo akuxhomekekanga kwi nokutya: oko ingalawuleki kwaye enxulumene kakhulu nonxunguphalo. Kwakhona, iintlungu ke yenzelwe nayiphi na enye indawo esiswini. Baya kuvela kwakhona ngequbuliso okanye ngexesha umthambo. Ezi namahlaba akwenziwanga ngendlela kwezinye iindawo esisu kunye lukhatshwa fever, isifo sorhudo okanye nokugabha.

Kubalulekile ukuba mpawu ezidweliswe ngasentla kwenzeka kwaye ocaphuka msinya kwamathumbu syndrome. Kukholelwa ukuba ezi zifo ahlukeneyo. Noko ke, xa unobangela IBS kwakhona motility engalungelelananga colonic. Ngokuba, mhlawumbi, kufuneka luthathwe IBS uphawu SVD. Ukongeza, kuqhelekile kakhulu izigulane abanengxaki SVD. Iimpawu isisu syndrome thile isitulo, nokuqunjelwa kwaye ukuduma esiswini.

uxilongo Lungisa of SVD

Xa isifo efana somatoform kwekhono yenkqubo yawo luvo, unyango ikhethwe ngamnye kuxhomekeka iimpawu ezikhoyo. SVD Uxilongo kumiselwa ngaphandle izikhalazo yesigulane, wabonakalisa kweminyaka emi-2 okanye ngaphezulu ukuhlangabezana neenqobo ngasentla. Kubalulekile kwakhona ukuba ukuphelisa zonke izifo eziphilayo: iziphene (okanye lufundiwe) iziphene intliziyo, arrhythmias, isifo lengqula, izilonda esiswini (okanye 12 isilonda duodenal), gastritis, isifo Crohn kaThixo, diverticulosis emathunjini.

Kuyimfuneko ukuba aphephe kunokwenzeka isigulo sengqondo, nto leyo kombisa ukuphazamiseka somatoform. Oku kuthetha ukuba isigulana kufuneka benze uphando: ukwenza iimvavanyo zegazi jikelele kunye kwemichiza, urinalysis, iswekile yegazi kunye iihomoni schitovdidnoy nobubovu, bhala phantsi ECG, enze echocardiography, FEGDS, ultrasonography ezincinane brachiocephalic kunye ndlala. Iziphumo zophando iqukumbela ukuba, nokuba unesifo okanye njengokubonisa uphawu SVD okufanayo kwezinye izifo.

Somatoform kwekhono yawo: unyango

SVD iphathwa ngeendlela eziliqela ezidibanisa pharmacotherapy, vitamin unyango, nokongezwa ibhalansi izimbiwa lomzimba, emsebenzini nonyango lwezigulo zasemsebenzini kunye nonyango ngokwasemzimbeni. Xa pharmacotherapy Kubalulekile ukulungelelanisa nootropics (okanye yokunciphisa) kunye cardiotropic. Umzekelo ekulungiseleleni indibaniselwano "Phenibutum" okanye "Noofen" kwi ne nedosi ye-250 mg kathathu ngemini iinyanga-2 100 izihlandlo mg 2 ngosuku "Thiotriazoline" iinyanga 2. Sokuqeshwa lakhula kufuneka ukuba bajonge wengqondo oza kuhlola ubudala potenialnuyu ingozi kwamachiza kumguli.

Xa isifo efana somatoform kwekhono yenkqubo yawo luvo, unyango nayo iquka mineralotherapy. Bonisa ukuba, umzekelo, mitral vana prolapse , okanye ezinye ukusilela semigudu ezinxulumene Embi wemagniziyam ukungalingani. Ibuyisela amanqanaba yayo inceda ukwehlisa iimpawu lezikhalazo ezesifuba nobukhali hypotension okanye lwegazi.

Vitamin, ingakumbi bazalisa neevithamini C, E no-D, kwakunye B1, B2, B5 kunye B6 yimfuneko nenengqiqo. Nangona kunjalo, ezi izinto abalufumani wendele vitamin ngexesha coadministration. Ngenxa yokuba kufuneka unyango exchange 1 amaqela ngenyanga iivithamini C, E no-D, uze 1 iivithamini ngenyanga B1 kunye B2, ngoko ngenyanga 1 B6 kunye B5. Kakade ke, njengoko ethunjini elikhulu data abangabantu kuhlelwe iivithamini ngokwabo, kufuneka utye imifuno fresh inemithana ngaphandle unyango ubushushu.

Ukususela nophuhliso SVD idlala indima onomdla eliphantsi xa impilo yabo kunye nokungahoywa umzimba, wemvula iivithamini kunye neeminerali, inceda ukwehlisa ubuzaza iimpawu. Occupational Therapy ngexesha unyango kwisibhedlele (pay-njengoko ekliniki na kwiivawutsha ezikhutshwa izigulane SVD) kuya kuba nefuthe kakhulu womelele ngakumbi. Kodwa ke isigulane achaze ngcono ukuba oko lingakuphumlanga ke unyango ubuncinane kuye ngenxa ngexesha abanye akukho zikhalazo.

Somatoform kwekhono kwenkqubo yawo nervous (ICD-10)

Xa ngokuhlelwa ngamazwe zesi sifo apho ukususela ngowe-1993. Le ngezifo sifumaneka kulo lonke ihlabathi yaye komntu akuxhomekekanga ekuzithandeleni neempawu uhlanga oluthile okanye isizwe. I-ICD 10 somatoform kwekhono yawo V eHlaziyiweyo kunye VI zihloko. Eyokuqala ibandakanya "Mental kunye neengxaki zokuziphatha" (ukhowudi ikhowudi F0-99), kwaye eyesibini - "bangonwabi, ezinxulumene-stress kunye somatoform ukuphazamiseka" (coded F45-F48 code).

F45 Category ibandakanya ezimbi zilandelayo: disorder somatisation, undifferentiated somatoform disorder, kwekhono somatoform yawo ngqo, ukuphazamiseka hypochondriacal, iintlungu somatoform ezinzileyo disorder kunye nezinye izifo elingachazwanga zommiselo luvo. Yena somatoform yawo ikhowudi kwekhono F45.3 ifakwe kwaye ifuna nokupheliswa amalungu zizifo innervated luvo yawo peripheral.

isiphelo

Ngoku izazinzulu ezininzi bakholelwa ukuba kwekhono somatoform yawo kufuneka kucingwe banzi. Esi sifo sichaphazela lithathelwe lwentlalo yesigulana. Xa inani lamatyala babonisa ibinzana edibeneyo SVD kunye mgaqweni kumaziko sedrtse. Le ndlela ebanzi echocardiography ukuba ukufumanisa ukuba ubukho taxi ngaphezulu ventricle yasekhohlo nesivalo mitral prolapse izidanga sezantsi regurgitation encinci. ngezifo arrhythmias nzima Recent kwaye ikhokelela ukusilela intliziyo congestive kunye nobudala.

Oku kuthetha ukuba kwekhono somatoform yawo kufuneka luthathwe nje uphawu (syndrome), efuna gqirha moshilongo ngakumbi, ejolise ukuchongwa comorbidities. Nangona uqale enyulu - isifo neurogenic, nto leyo kunokuba- ukungalingani phakathi luvo peripheral enovelwano kunye parasympathetic. Kwakhona, ngenxa ukubaluleka loluntu ngezifo, kubalulekile ukuba wenze kube kho iimpawu ezicacileyo diagnostic for SVD. Oku kuya kuvumela ukuba umahluko izifo psychogenic kwaye somatic ekwenzeni imisebenzi ukubiza emkhosini.