Ziyini izimpawu agcwele somatoform ukungasebenzi autonomic isimiso sezinzwa?

Somatoform ukungasebenzi autonomic - eziyinkimbinkimbi ngokuya ekuxilongeni isifo. It has izimpawu eziningi ezifana empilweni ngokomzimba nangokwengqondo. Ngaphezu kwalokho, iziguli kubo, uzwa izimpawu zesifo acute ngokwanele okwephula ukugcwaliseka babo bomsebenzi. Ngenxa yakho konke lokho siphathelene isifo, kufanele uqonde ngokuningiliziwe.

Uhlolojikelele Kusho ukuthini ukuba umKristu isifo

Somatoform ukungasebenzi autonomic (Kusho ukuthini ukuba umKristu) kutholakale njalo amadoda abasezingeni lokuya empini, noma ezigulini ibhekane slozhbu esiphuthumayo noma epini oqondile. Lesi sifo, esizibonakalisa isisindo izimpawu ze-non-ethize futhi kudinga ukuhlola okunemininingwane. Inhloso yayo ukuqeda kwezinso isakhi inhliziyo futhi arrhythmias kanye nezifo we isimiso sezinzwa esiyinhloko.

Kukholakala ukuthi somatoform ukungasebenzi autonomic ukungalingani eziphikelelayo phakathi nozwela futhi parasympathetic isimiso sezinzwa. Kusho ukuthini ukuba umKristu ngokwayo uhlukaniswe ezintathu izinhlobo: Kusho ukuthini ukuba umKristu ngoba inhliziyo, hypotonic kanye nohlobo hypertonic. Kufanele ingafani yisifo senhliziyo, lwemithambo hypo- kanye nomfutho wegazi ophezulu, okuyinto ixazululwe ngokuhamba izenzakalo ngesikhathi socingo inkonzo yezempi. Ngenxa yalesi sizathu, abesifazane Kusho ukuthini ukuba umKristu Kutholwe kancane njalo kuka amadoda nabafana. Nakuba u-80% uphethwe obala is hhayi ukuqinisekisile yi-central ekomidini vrachebnokonsultatsionnoy.

symptomatology Kusho ukuthini ukuba umKristu

Somatoform ukungasebenzi kwekhono autonomic nervous system kubonakala izimpawu mass nonspecific. Ngokuvamile zibonakala ngokungalandelani zangokwasemuva zezinhlelo ukucindezeleka futhi lwahlolwa ezimweni ethule. Okubalulekile, IRS Ngokushumayela kungabizwa ngokuthi a syndrome ngoba ngempela kufaka inombolo enkulu izimpawu. Zikhonjisiwe izinketho syndromes ezilandelayo: inhliziyo, hypotonic, hypertonic. Futhi, kungase kube simtpomy ezivamile, izimpawu dyspepsia, iziyaluyalu zokuphefumula, disadaptative ngokomzimba. Lezi zimpawu kuzoxoxwa ngakho ngokuningiliziwe.

ukuhlola Basics

Lezi zindlela eziyinhloko ukuze kuhlonzwe letibalulekile Kusho ukuthini ukuba umKristu yilezi: isikhathi izimpawu (iminyaka mkhulu kunezinhliziyo 2) kanye gemodinamicheskiznachimyh ukungabi noma ezisongela ukuphila arrhythmias inhliziyo noma isakhiwo. Empeleni, bonke kwezinso ezincane inhliziyo hhayi okuholela izinguquko inhliziyo isigqi neziyaluyalu, noma izimbobo emazinyweni, ingahlanganiswa.

Sifo "ukungasebenzi Somatoform autonomic" lingatholakala kuhlangene, isibonelo, tricuspid (mitral, yomthambo i-aorta noma yamaphaphu) ukwehluleka, arrythmia ezingavamile, lezivakashi WPW syndrome noma isifo CLC. Nokho, kufanele iziguli enjalo waphawula 2 izikhathi ngonyaka ukuhlonza ukwephula okuthuthukile. Kusobala ukuthi iningi izifo Kusho ukuthini ukuba umKristu ababuthiwe dalula intsha, alinalo ilungelo khona. Ngokuvamile, uphethwe udokotela yena ngaphandle isikhalazo kuphela ngesisekelo khona ukukhubazeka encane ezihlelekile inhliziyo. Ngoba mayelana 80% izifo kuthiwa uphikise, kodwa ukubaluleka emitholampilo babe kuphela izikhalazo kanye comorbidities kanye syndromes.

izimpawu ezivamile Kusho ukuthini ukuba umKristu

In izifo ezifana, njengoba ukungasebenzi somatoform autonomic, izimpawu jikelele baningi. Lokhu isimo thuthuva, dysphoria, dysthymia, ukungafuni ukwenza noma yimuphi umsebenzi ngokomzimba, ukuphazamiseka ukudla, ukuba buthakathaka kwezicubu, ikhanda yansukuzonke, ikakhulukazi zendawo parietal nesifunda occipital. Ngezinye izikhathi isiguli ngokuthi isiyezi kanye ukuncinza ezindaweni podlozhechkovoy akuhlobene ukulamba noma satiety.

isikhalazo okunjalo libhekene asthenic syndrome somatoform ukungasebenzi autonomic. Iziguli avame ukuba angasebenzi, ngezinye izikhathi yokuntuleka isinyathelo futhi kalula ecasukile. Ngayinye yalezi zici isici bayanqikaza ukusithatha ibhizinisi elisha. Bayanda bona akuphelelanga. Nokho, kuyindida ukuthi introversion, okuyinto eba ngenxa impumelelo ezincane kwezemidlalo noma ukungawuvivinyi umzimba kuholela yokuthi izingane zivama isinxephezeliso kulolu cwaningo. Ziyakwazi ezinhle ngesikhathi kukhunjulwe, kodwa ezicindezelayo izimo ukucabanga izinto ezingenangqondo. Ukugwema ukucindezeleka futhi zokungazimiseli iqhaza ezindabeni ezidinga injabulo ngokomzwelo, isici sobuntu kweziguli autonomic ukungasebenzi somatofrmnoy.

Ukuvivinya umzimba ngesikhathi Kusho ukuthini ukuba umKristu

ukubekezelelana okuphansi ukuze ukuvivinya umzimba - ke kuwuphawu ejwayelekile ka Kusho ukuthini ukuba umKristu. Iziguli bayanqikaza kuthathe umzimba ekilasini ngoba imfundo ngokomzimba, ikakhulukazi uma kudinga amandla. Ngokuvamile, imidlalo mobile lula kulezi ziguli, kuyilapho amandla umzimba kubangele asemrarweni. Ungase uphawule ukuthi ngemva egijima ke dyspnea ngaphezu kwezinye izingane we Yakha efanayo. Ngaphezu kwalokho, lezi iziguli ngokushesha niphele, ukukhuthazela kwabo ingaphansi kwe-abanye. Futhi ku umthwalo isizinda zingavela kwemigudu yokuphefumula noma ukumelwa inhliziyo Kusho ukuthini ukuba umKristu izimpawu ezichazwe ngezansi.

Senhliziyo (inhliziyo) isikhalazo iziguli

Somatoform ukungasebenzi kwekhono autonomic nervous system livezwa izimpawu eziningi zazo zibangelwa Ukungadli phakathi sympathico futhi parasimpatikoy innervated isitho. Inhliziyo izikhalazo, kusukela umzimba innervation autonomic, kukhona phakathi ebaluleke kakhulu. Izimpawu ezivame kakhulu Kusho ukuthini ukuba umKristu phezu ingxenye izitsha inhliziyo negazi yilezi: ubuhlungu inhliziyo, tachycardia, anda noma kunciphisa umfutho wegazi.

Ubunjalo okungikhathazayo enhliziyweni akuyona sicaciselwe isifo esithile. Ubuhlungu ngokuvamile wagwaza futhi ngezinye izikhathi ngokucindezela. Indawo yabo - inhliziyo base (3-6 cm kuya kwesokunxele sternum) kanye phezulu (5 cm kuya kwesokunxele sternum ngesikhathi 5th intercostal isikhala). Tachycardia kungadalwa nokucindezeleka ngokomzwelo noma ukucindezeleka ngokomzimba. Kubalulekile ukuthi sibangelwa umthwalo ongalingani eyalo adonsela phansi. Ngokwesibonelo, tachycardia livela ngokushesha ngaphambi umsebenzi noma ekuqaleni, hhayi njengoba enzeke.

Kubalulekile ukuthi ubuhlungu enhliziyweni yami, uma umlingisi esivuthayo, futhi (noma) ukugxisha futhi avele imizuzu 20-30, kumelwe zibhekwe njengezindawo okungamelwe ischemic, okudinga ukuqopha electrocardiography okwesikhathi esifitshane kungenzeka isikhathi. Lokhu kungenxa yokuba khona izinhlangano zokwelapha ezifana okufana angina futhi inhliziyo syndrome X. Kulezi pathologies izikhathi 50-100 ephakeme amathuba okungazelelwe ukufa yenhliziyo.

Hypotension noma umfutho wegazi ophakeme

Kwegazi eba njalo. Lolu uhlobo ezingavamile kakhulu Kusho ukuthini ukuba umKristu, ngoba ngokuvamile kakhulu ubonakala izinhlobo inhliziyo noma abanomfutho wegazi ophakeme. Noma kunjalo uhlobo hypotonic Kusho ukuthini ukuba umKristu kokuvela ngezikhathi bebek blood pressure ku zombili izingalo. Kubalulekile ukuthi sitholakele lolu hlobo isifo okudingekayo ukwenza echocardiography futhi electrocardiography, okukuvumela ukukhipha khona isifo senhliziyo noma arrhythmias. Yokufikelwa nazo izimpawu Kusho ukuthini ukuba umKristu, nakuba nonspecific.

Kwegazi - ukukhononda okuvamile. Iziguli staradayut ingcindezi kuyanda ngaphambi kokwenza umsebenzi ngokomzimba, kunokuba adabule phakathi kwawo. Ingcindezi ngokuvamile lenyuka todvwa kuvuselwa 160 systolic blood pressure, kuyilapho diastolic uyefana. Uma kucatshangelwa kuyaqina yegazi e intsha kanye amantombazana babe somatoform ukungasebenzi autonomic enhliziyweni kuyingozi kutholakala ukuthi uphethwe yini kaningi, diastolic blood pressure can futhi enza ukwehla kancane.

Lokhu kungenxa ukungalingani nonozwela futhi parasympathetic isimiso sezinzwa, imisipha ayakhukhumala lapho norepinephrine Umthambo, nokuncipha neuropathy ukumelana semithambo. Kubalulekile ukuthi ingcindezi luyanda njalo, ngoba uphethwe nomfutho wegazi ophezulu ayikwazi ukusethwa.

izikhalazo zokuphefumula

Ngo isifo esinjengo somatoform ukungasebenzi kwekhono autonomic nervous system nazo izimpawu uhlamvu zokuphefumula. Imithetho ngokubukeka kwabo ezifana nalezo esimweni cardialgia, hypotension noma umfutho wegazi ophakeme. Okungukuthi, izimpawu zokuphefumula zenzeka lapho uvivinya umzimba. Futhi, ukuthi zibhekene ngqo Kusho ukuthini ukuba umKristu, bangakwazi avele emva kokuphothulwa izivivinyo esikhathini ukuphumula. Lokhu kwehluke kakhulu ngezikhalazo zokuphefumula Kusho ukuthini ukuba umKristu izimpawu somoya zokucindezeleka ngokomzimba.

Izibonelo izikhalo Kusho ukuthini ukuba umKristu: uzwakalise dyspnea okuxubile ku ukuzikhandla noma isikhathi ukuphumula ngemva kokusebenza, esifubeni yobunzima ukuphefumula yayo nobunzima. Ukuze uqhathanise, somoya ngobugebengu okhishwa ngamakhala. Bekanye izikhalazo zokuphefumula at isifo esinjengo somatoform ukungasebenzi kohlelo autonomic wabonakaliswa inhliziyo. Umbala wawo ngokuhlanganyela - ulwazi, kodwa uphawu non-ethize, pozvolyayuy ukwenza kokutshelwa ngokukhubazeka kwengane.

Dyspepsia nge Kusho ukuthini ukuba umKristu

Ngo isifo esinjengo somatoform ukungasebenzi kwekhono autonomic nesimiso sezinzwa, izimbangela eziningi. Bona Sihlala ukungalingani kwamanani abantu izinhlelo parasympathetic nozwela sezinzwa. Ngaphezu kwalokho, yonke pheshana emathunjini nawo uhilelekile kule nqubo, ngoba ngokugcwele innervated uhlelo parasympathetic. Emsipheni vagus ilawula uketshezi esiswini, amanyikwe, amathumbu. Yena unesibopho motor amakhono futhi zonke ukugaya. Ngoba lapho Kusho ukuthini ukuba umKristu livela kaningi dyspepsia, futhi ubuhlungu besisu.

Izenzakalo ezivamile sohudo kumele abelwe isicanucanu ngaphandle ukuhlanza, ubuhlungu yansukuzonke esifundeni epigastric, izimpawu ukuchoboza noma ukugwaza. Umbala wawo akuxhomekile ukudla: ke kunezinxushunxushu futhi lihlotshaniswa ikakhulukazi nokucindezeleka. Futhi, ubuhlungu kungenziwa isebenze iyiphi enye indawo esiswini. Futhi zavele noma lapho uvivinya umzimba. Lezi izinhlungu kungukuthi kwenziwe kwezinye izingxenye esiswini kuhambisana imfiva, uhudo noma ukuhlanza.

Kubalulekile ukuthi izimpawu ezibalwe ngenhla zenzeka futhi engaphathekile wamathumbu syndrome. Kukholakala ukuthi lezi zifo ezahlukene. Nokho, kungase kungabi sobala ukuthi IBS futhi ongenakulinganisela motility colonic. Ngoba, mhlawumbe, kufanele sithathwe njengehlelo IBS uphawu Kusho ukuthini ukuba umKristu. Ngaphezu kwalokho, kuyinto evamile ngaphezulu iziguli Kusho ukuthini ukuba umKristu. Izimpawu ze-syndrome emathunjini kuthiwa imisiwe sezinyawo, ukuvuvukala kanye kwentaba esiswini.

okuyikona ka Kusho ukuthini ukuba umKristu

Ngo isifo esinjengo somatoform ukungasebenzi kwekhono autonomic nesimiso sezinzwa, impatho kuyakhethwa ngamunye kuncike izimpawu linqoba. Kusho ukuthini ukuba umKristu uphethwe ayikwazi ukuhlelwa ngaphandle izikhalazo lesiguli, ebonakaliswa iminyaka 2 noma ngaphezulu ukuze kuhlangatshezwane nalezi zindlela ezingenhla. Kubalulekile futhi ukuba ukuqeda zonke izifo organic: azalwa naso (noma bathenga) ukukhubazeka inhliziyo, arrhythmias, abanale nkinga, izilonda esiswini (noma 12 isilonda duodenal), kolwelwesi, isifo Crohn, diverticulosis emathunjini.

Kuyadingeka ukuba ugweme kungenzeka isifo sengqondo, okuyinto sibonakalise somatoform iziyaluyalu. Lokhu kusho ukuthi isiguli kudingeke uyocwaninga: ukwenza jikelele kanye kwamakhemikhali kwegazi, urinalysis, igazi glucose hormone schitovdidnoy ndlala ukuqopha ECG, enze echocardiography, FEGDS, ultrasonography ka brachiocephalic ekhipha igazi enhliziyweni yegilo. Imiphumela yocwaningo liphetha ngokuthi kungakhathaliseki kutholakala ukuthi uphethwe yini noma ukubonakaliswa uphawu Kusho ukuthini ukuba umKristu esifanayo siyasebenza nakwezinye izifo.

Somatoform ukungasebenzi autonomic: ukwelashwa

Kusho ukuthini ukuba umKristu iphathwa ngu izindlela eziningana ukuthi sihlanganise pharmacotherapy, ukwelashwa Vitamin, zinsiza esele samaminerali umzimba, occupational therapy kanye athole ukwelashwa komzimba. Ngo pharmacotherapy ezibalulekile ukuba silinganisele nootropics (noma antidepressant) nge cardiotropic. Isibonelo salokhu ukulungiselela inhlanganisela "Phenibutum" noma "Noofen" at umthamo we-250 mg kathathu ngosuku izinyanga 2 "Thiotriazoline" 100 mg 2 izikhathi ngosuku izinyanga 2. Ekuqashweni antidepressant kufanele baxoxe Udokotela wezifo zengqondo owelapha uzohlola engu futhi potenialnuyu ingozi izidakamizwa esigulini.

Ngo isifo esinjengo somatoform ukungasebenzi kwekhono autonomic nesimiso sezinzwa, impatho sihlanganisa mineralotherapy. Fakazela ukuthi, ngokwesibonelo, mitral valve prolapse , noma ezinye ukwehluleka valve elihlobene ne-interstitial magnesium ukungalingani. Kuletha amazinga ayo kusiza ukunciphisa izimpawu izikhalazo inhliziyo nobukhali hypotension noma umfutho wegazi ophakeme.

Vitamin, ikakhulukazi libuyisele amavithamini C, E no-D, kanye B1, B2, B5 kanye B6 kuyimfuneko okunengqondo. Nokho, lezi izinto kabi ugxile Vitamin ngesikhathi coadministration. Ngoba kudingeka amaqembu ukwelashwa exchange 1 inyanga amavithamini C, E no-D, bese 1 inyanga amavithamini B1 kanye B2, abese 1 inyanga B6 futhi B5. Yiqiniso, njengoba emathunjini enkulu idatha abangabantu kwemiqondo amavithamini ngokwabo, futhi kufanele udle imifino kanye namakhambi ngaphandle kokwelashwa ukushisa.

Njengoba lezi zindawo zibe khona Kusho ukuthini ukuba umKristu udlala indima intshisekelo ongaphakeme ezimpilweni zabo siqu kanye nokunganakwa yomzimba, umthamo wemvula amavithamini namaminerali, kuyasiza ukunciphisa ububi besimo sokuguquka izimpawu. I-Occupational Therapy ngesikhatsi ukwelashwa kulesi sibhedlela (pay-njengoba emtholampilo kungukuthi amavawusha ekhishwe iziguli ezine-Kusho ukuthini ukuba umKristu) kuyodingeka umphumela okuningi esitebeleni. Kodwa bekezela ukuchaza kangcono ukuthi ngisho okunye ikhambi okungenani kuye ngoba phakathi nazo kwadingeka asikhali ngalutho.

Somatoform ukungasebenzi kwekhono autonomic nervous system (ICD-10)

Esikhathini ngezigaba international lesi sifo lapho kusukela ngo-1993. Lokhu zokugula yesikhukhula itholakala kuwo wonke umhlaba futhi akuxhomekile izici uhlanga oluthile noma isizwe. I-ICD 10 somatoform ukungasebenzi autonomic V Revised futhi VI izihloko. Eyokuqala ihlanganisa "ngengqondo futhi ezibangela ukuziphatha okuyinqaba" (code ikhodi F0-99), kanti eyesibili - "Neurotic, ezihlobene nokucindezeleka futhi somatoform iziyaluyalu" (code ikhodi F45-F48).

F45 Isigaba ihlanganisa pathologies ezilandelayo: disorder somatisation, undifferentiated somatoform sifo, somatoform ukungasebenzi autonomic ngqo, disorder hypochondriacal, esimeme somatoform ubuhlungu disorder nakwezinye iziyaluyalu esingavezwanga ukulawulwa sezinzwa. Yena somatoform autonomic ikhodi ukungasebenzi F45.3 kuyinto anekhodi futhi kudinga ukuqedwa izitho onesifo innervated neuropathy autonomic nesimiso sezinzwa.

isiphetho

Ososayensi abaningi sebekholelwa ukuthi somatoform ukungasebenzi autonomic kufanele kubhekwe kabanzi. Lesi sifo lithathelwe lesiguli nomphakathi. Ngo eziningi ngiye ngabona inkulumo ohlangene Kusho ukuthini ukuba umKristu futhi anomalies ezihlelekile sedrtse. Umkhuba ebanzi echocardiography bavunyelwe ukuthola ukuthi khona ukulele ngaphezulu i-ventricle engakwesobunxele kanye valve mitral prolapse degrees esiphansi kanye regurgitation omncane. Kwakamuva zokugula arrhythmias yinkimbinkimbi futhi asihole congestive inhliziyo ukwehluleka ngeminyaka.

Lokhu kusho ukuthi ukungasebenzi somatoform autonomic kufanele sithathwe njengehlelo uphawu (syndrome), okudinga kudokotela uphethwe okwengeziwe, okuhloswe ngaso ukuhlonza comorbidities. Nakuba uqale okumsulwa - isifo neurogenic, okuyinto sihlotshaniswa ukungalingani kwamanani abantu nozwela futhi parasympathetic neuropathy isimiso sezinzwa. Futhi, uma sicabangela ukubaluleka komphakathi zokugula, kubalulekile usungule indlela ecacile inkinga Kusho ukuthini ukuba umKristu. Lokhu kuzovumela ukuthi bahlukanise izifo psychogenic futhi ukuphathwa kwabathintwayo ekwenzeni imisebenzi ukubiza inkonzo yezempi.