Maxay yihiin calaamadaha sifaha cillad somatoform autonomic of habka dareemayaasha jirka?

Somatoform cillad autonomic - adag marka la eego baaritaanka cudurka. Waxay leedahay astaamo badan sida caafimaadka jidhka iyo maskaxda. Waxaa intaa dheer, dadka buka ee iyaga ka, dareemaan calaamadaha cudurka ba'an ku filan oo ku xadgudba ay xaqiijinta xirfadeed. Sababta oo ah in ay la xidhiidho cudur oo dhan, waa in aad fahamtaa in si faahfaahsan.

cudurka Overview SvD

cillad autonomic Somatoform (SvD) la ogaado inta ugu badan ee ragga da'da military, ama bukaan mari slozhbu degdeg ah ama ku lug leh dagaalka tooska ah. Cudurkaan, taas oo u muuqato miisaanka calaamadaha non-gaar ah oo u baahan Baadhista faahfaahsan. Ujeedadiisu waa in la baabi'iyo ah cilladaha dhismaha of wadnaha iyo garaaca iyo sidoo kale cudurada of habka dhexe ee neerfayaasha.

Waxaa la rumeysan yahay in cillad autonomic somatoform waa dheelitir la'aanta joogto ah u dhexeeya habdhiska ah oo garawsi iyo parasympathetic. SvD laftiisa waxaa loo qaybiyaa saddex nooc: SvD waayo, wadnaha, hypotonic iyo nooca hypertonic. Waa in loo kala cudur wadnaha ah, hypo- halbowlaha iyo dhiig-karka, kaas oo la xallin ee koorsada dhacdooyinka at call for adeegga militariga. Sababtan awgeed, dumarka SvD inta badan ka yar la ogaado ka badan ragga iyo wiilasha. In kasta oo 80% ka mid ah cudurka bandhigi aan la xaqiijiyay by vrachebnokonsultatsionnoy guddiga dhexe.

symptomatology SvD

cillad Somatoform of habdhiska ku autonomic lagu muujiyey calaamadaha mass nonspecific. Inta badan aan kala sooc lahayn ay u muuqdaan on asalka ah ee walbahaarka iyo baaro xaaladaha xasilloon. Muhiimsan, IRS ayaa sidoo kale laga yaabaa in loo yaqaan syndrome ah sababtoo ah waxa ay dhab ahaantii ku lug leedahay tiro badan oo ah calaamadaha. Waxay ku muujisan yihiin ee syndromes fursadaha soo socda: wadnaha, hypotonic, hypertonic. Sidoo kale, waxaa laga yaabaa in simtpomy caadiga ah, calaamado dyspepsia, xanuunada neefsashada, disadaptative jirka. Calaamadahaas waxaa ka wada xaajoon doonaa si faahfaahsan.

Baadhista xanuunada Basics

Shuruudaha ugu muhiimsan ee cudurka ee ku tacaluqa in SvD yihiin: muddada calaamadaha (ka badan 2 sano) iyo gemodinamicheskiznachimyh maqan yahay ama uu naf-gooyada ah garaaca wadnaha ama qaab-dhismeedka. Si adag u hadlaya, oo dhan aan caadi ahayn u yar wadnaha ma taasoo keentay in isbedel ah xanuunada garaaca wadnaha, ama godadka, la isku dari karaa.

Cilad-"cillad autonomic Somatoform" ka dibna waxaa la dhigan kara, tusaale ahaan, tricuspid (mitral, aortic ama sambabada) failure, arrythmia dhif ah, transient WPW syndrome ama CLC. Si kastaba ha ahaatee, bukaanka sida waa in la arkay 2 jeer sanadkii si ay u aqoonsadaan xadgudubyo dheeraad ah. Waa wax iska cad in badan oo cudurka ku SvD waajibaadka ciidamada qaawan oo dadka dhallinyarada ah, waxa uu xaq u lahayn in ay ka jiraan. Inta badan, cudurka waa dhakhtar qudhiisa aan cabasho oo kaliya ku salaysan joogitaanka cilladaha yar yar oo dhisme ah ee wadnaha. Maxaa yeelay, ku saabsan 80% ka mid ah cudurka waxa lagu muransan yahay, laakiin muhiimadda ay leedahay clinical cabashooyinka kaliya oo comorbidities iyo syndromes.

Calaamadaha caadiga ah ee SvD

In cudurada sida, sida a cillad autonomic somatoform, calaamadaha guud tiro badan yihiin. Tani rabshooyin niyadda, daal, dysthymia, colnimadiinna in shaqo kasta oo jirka sameeyo, rabshooyin xumo, tabar-dari muruq, madax xanuun noqnoqonaysa, inta badan ku kooban ee parietal iyo gobolka occipital. Mararka qaarkood bukaanka ka walwalsan ah oo ku saabsan wareer iyo dareen gubasho meelaha podlozhechkovoy ma la xiriira gaajada ama dheregtaan ah.

cabasho noocan oo kale ah waxa lagu gartaa somatoform syndrome asthenic cillad autonomic. Bukaan-socodka waxa ay noqon aan firfircoonayn, mararka qaarkood la'aan initiative iyo si fudud u xanaaqsan. Mid kasta oo ka mid ah muuqaalada caan ku yihiin diidan in ay qaataan on ganacsi cusub. Waxana si, ay lama dhammaystirin. Habka, si kastaba ha ahaatee, introversion, taas oo uu yeesho sabab u ah guulaha yar yar ee cayaaraha ama jimicsi la'aan jirka u keenaysaa in xaqiiqda ah in carruurta u muuqdaan in ay ku buuxin karaan daraasaddan. Waxay ku fiican tahay xusuusanaya yihiin, laakiin in walaaca xaalado waalli qabaa. Ka fogaanshada stress iyo wax qabad la'aanta ay ka qayb qaataan arrimaha u baahan farax dareenka, feature a caan ku bukaanka qaba somatofrmnoy cillad autonomic.

dhaqdhaqaaqa jirka ee SvD

dulqaad Low inay jimicsi - waa calaamad caadiga ah ee SvD. Bukaan-socodka waa diidan kor u qaado jimicsi fasalka ee waxbarashada jirdhiska, gaar ahaan haddii ay u baahan tahay xoog. Caadi ahaan, kulan mobile waa u fududahay bukaanadaan, halka jimicsi xoog keeni dhibaato badan. Waxaad arki kartaa in ka dib markii ay soo ordaya dyspnea ka badan caruurta kale ee dhismaha la mid ah. Intaa waxaa dheer, bukaan, kuwaas oo si deg deg ah u hesho daal, samirkoodii Dartiis waa ka hooseeyaa kuwa kale. Sidoo kale on load asalka u muuqan karaan astaamaha neefsashada ama wadnaha SvD hoos ku qeexan.

cabasho Wadnaha ee bukaanka (qalbiga)

cillad Somatoform of habdhiska ku autonomic la muujiyey by calaamadaha badan oo waxaa sababa iskudheellitir la'aanta u dhexeeya sympathico iyo parasimpatikoy innervated xubin. cabashooyinka Heart, tan iyo jidhka ayaa innervation ku autonomic, ka mid ah kuwa ugu muhiimsan yihiin. Calaamadaha ugu caansan ee SvD ku saabsan qayb ka mid ah wadnaha iyo xididada dhiiga waa: xanuunka wadnaha, tachycardia, kor u kacay ama hoos u cadaadiska dhiigga.

nooca xanuun qalbigayga kuma saabsana cudur gaar ah. Xanuun waxaa inta badan mindi iyo mararka qaar ku cidhiidhinaya. Goobta - qalbiga salka (3-6 cm bidixda ee sternum) iyo hogaanka (5 cm bidixda ee sternum ee bannaan ee intercostal 5aad). Tachycardia waxaa keeni kara walwalka shucuureed ama stress jirka. Waxaa muhiim ah in ay ku horumarineyso culays ku munaasab ahayn qaadeen cuf. Tusaale ahaan, tachycardia u muuqataa isla markiiba ka hor inta layliga ama bilowga aad u, oo aadan ahaan sida ay u kaca.

Waxaa muhiim ah in xanuunka ay ku jiraan qalbigayga, haddii ay qof ku gubatay, iyo (ama) compressing iyo muuqdaan 20-30 daqiiqo, waa in loo arkaa ischaemic, taas oo u baahan wax lagu qoro ee electrocardiography muddo gaaban waqtiga laga yaabo in. Tan waxa u sabab joogitaanka hay'adaha clinical sida angina kala duwanaansho iyo X. syndrome wadnaha In heley kuwaas 50-100 jeer ka suurtagalnimada dhimashada wadnaha lama filaan ah.

Hypotension ama hypertension

Hypertension qabsiyada yeesho. Tani waa nooca ugu badan dhif u ah ee SvD, maxaa yeelay waxa ay inta badan waxaa loo arkaa nooc wadnaha ama hypertensive. Si kastaba ha ahaatee nooc hypotonic SvD muuqashada xilliyo da'a in cadaadis dhiig oo labada hubka. Waxaa muhiim ah in cudurka noocan ah ee cudurka in loo baahan yahay si ay u qabtaan echocardiography iyo electrocardiography, kaasoo u ogolaanaya in ay ka horjoogsanaya in ay joogaan of cudurada wadnaha ama garaaca. Suuxid sidoo kale waxaa ku sugan calaamado ee SvD, inkastoo nonspecific.

Hypertension - waa cabasho caadi ah. u kaca cadaadiska Bukaanka staradayut ka hor inta performing jimicsi, halkii ay ka dhex. Cadaadiska waxaa guud ahaan kor u kacay in go'doon lagu sara 160 systolic cadaadiska dhiigga, halka diastolic waa isku mid. In view of barti marinnada dhiigga ee dhallinyarada iyo dumarka da'da yar ee qaba cillad somatoform autonomic qalbiga ku badan yahay badanaa la baaraa, cadaadiska dhiigga kartaan oo sameeya hoos u yara.

Tan waxa u sabab dheelitir la'aanta ah ee habdhiska ah oo garawsi iyo parasympathetic, muruqa ballaarinaya marka norepinephrine halbowlaha, hoos iska caabin dhuumaha ugu sarreeya. Waxaa muhiim ah in cadaadiska si joogto ah kor u kacay, maxaa yeelay, cudurka dhiigkarka aan la hagaajin karo.

cabashooyinka neefsashada

In cudurka noocan oo kale ah sida cillad somatoform of habdhiska ku autonomic sidoo kale astaamaha qof neefsashada. Sharciyada ay muuqaalka la mid ah kuwa ay dhacdo cardialgia, hypotension ama hypertension. Taasi waa, calaamadaha neef mareenka dhacaan inta lagu guda jiro jimicsi. Sidoo kale, u gaarka ah SvD ka, waxay u muuqan karaan marka la dhameystiro ee layliyada ee wakhtiga soo hadhay. Tani waa in la barbardhigo cabashooyinka neefsashada SvD calaamadaha neefta of stress jirka.

Tusaalooyinka cabashooyinka la SvD: muujiyeen dyspnea isku qasan on dadaalka badan ama muddo inteeda kale ka dib markii dhibaato ay fulinta, cidhiidhi xabadka iyo neefsashada. Wixii la barbardhigo, in neef jebiyey oo katimaada. Wada jir ah ula cabashooyinka neefsashada ee cudurka sida cillad somatoform nidaamka autonomic muujiyey wadnaha. Muuqashadii wadajir ah - wargelin ah, laakiin calaamad non-gaar ah, pozvolyayuy ogaado noocan oo kale ah.

Dyspepsia la SvD

In cudurka noocan oo kale ah sida cillad somatoform of habdhiska ku autonomic, sababaha ay yihiin kala duwan. Waxay ugu dhuuntaan in dheelitir u dhexeeya nidaamka neerfaha parasympathetic iyo waji furnaan leh. Waxaa intaa dheer, mareenka caloosha iyo mindhicirka oo dhan ayaa waxaa sidoo kale ku lug lahaa habkan, maxaa yeelay waxa ay si buuxda waxaa innervated by nidaamka parasympathetic. dareemaha vagus gacanta ku dheecaan ee caloosha, xameetida, xiidmaha. Wuxuu mas'uul ka yahay xirfadaha dhaqdhaqaaqa iyo dheefshiidka oo dhan. Sababta oo ah marka SvD u muuqataa inta badan dyspepsia, iyo calool xanuun.

Oo ka mid ah dhacdooyinka ugu badan shubanka waa in loo qoondeeyey lalabo aan matag, xanuun soo noqnoqday ee gobolka gaastari, oo waxaa lagu gartaa burburiyo ama mindi. Muuqashadii kuma xirna cunto, waayo, waa fowdo iyo inta badan la xidhiidha walaaca. Sidoo kale, xanuunka la kooban karaa meel kasta oo kale ee caloosha. Waxa kale oo ay u muuqdaan si lama filaan ah ama inta lagu guda jiro jimicsi. xanuunnadan ay la ma fuliyey qaybaha kale ee caloosha iyo waxaa la socda qandho, shuban ama matag.

Waxaa muhiim ah in calaamadaha kor ku qoran dhacaan iyo Irritable Bowel Syndrome. Waxaa la rumeysan yahay in cudur oo kala duwan. Si kastaba ha ahaatee, marka Jidka IBS sidoo kale waa motility colonic qaloocan. Sababtoo ah, laga yaabee, waa in la tixgeliyaa sida calaamad IBS SvD. Intaa waxaa dheer, waxaa ku badan yahay ee bukaanka ka cabanaya SvD. Calaamadaha xiidmaha syndrome waxaa dib u saxarada, dibbiro iyo xiinka caloosha.

cudurka saxda ah ee SvD

In cudurka noocan oo kale ah sida cillad somatoform of habdhiska ku autonomic, daaweynta waxaa si gaar ah loo doortay ku xiran tahay calaamadaha jirta. cudurka SvD aan la hagaajin karo iyada oo aan cabashooyinka bukaan-socodka, muujiyey 2 sano ama ka badan si ay u buuxiyaan shuruudaha kor ku xusan. Waxaa kaloo muhiim ah in la baabi'iyo dhammaan cudurada organic: dhasho (ama helay) cilladaha wadnaha, garaaca, cudurka thyroid, nabar caloosha (ama 12 boog dyspepsia), gastritis, cudurka Crohn, xiidmaha diverticulosis.

Waxa kale oo lagama maarmaan ah si looga fogaado in ay suurto gal ah cudurka maskaxda, taas oo muujin xanuunada somatoform. Taas macnaheedu waa in bukaan-socodka u baahan tahay in la sameeyo cilmi-baaris qaar ka mid ah: in la sameeyo baaritaan dhiig guud iyo lagmamaarmaanna, urinalysis, sonkorta dhiigaaga iyo hormoonnada schitovdidnoy qanjirka, u qoraan ECG ah, qabtaan echocardiography, FEGDS, ultrasonography ee halbowlayaasha brachiocephalic iyo thyroid. Natiijada cilmi-baaris ku soo gebogebeeyay, in, haddii cudurka ama muujinta calaamad SvD isla khusaysaa cudurada kale.

cillad autonomic Somatoform: daaweynta

SvD waxaa lagu daaweeyaa by habab dhowr ah isku dawooyin, therapy vitamin, dheeri ah dheelitirka macdanta oo jidhka ah, daaweynta waxqabadka iyo daawaynta jirka ah. In dawooyin muhiim ah in la isu dheelli nootropics (ama murugada) la cardiotropic. Tusaale waxaa ah diyaarinta isku darka "Phenibutum" ama "Noofen" at dose oo ah 250 mg saddex jeer maalintii muddo 2 bilood "Thiotriazoline" 100 mg 2 jeer maalintii muddo 2 bilood ah. On magacaabidda murugada inay la tashadaan maskaxda kuwaas oo qiimeyn doona khatar da'da iyo potenialnuyu ee daawooyinka bukaanka.

In cudurka noocan oo kale ah sida cillad somatoform of habdhiska ku autonomic, daaweynta kale oo ka mid mineralotherapy. Tijaabi in, tusaale ahaan, prolapse waalka mitral , ama failure kale ee filtarka la xidhiidha dheelitir la'aanta magnesium interstitial. Celisay heerarka ay ka caawisaa si ay u yareeyaan calaamadaha cabashooyinka wadnaha iyo adkaanta hypotension ama hypertension.

Vitamin, gaar ahaan replenishing vitamins C, E iyo D, iyo sidoo kale B1, B2, B5 iyo B6 waa shuruud caqligal ah. Si kastaba ha ahaatee, walxaha kuwan waxaa si liidata nuugo vitamin inta lagu guda jiro coadministration. Sababtoo ah fitamiinada loo baahan yahay daaweyn sarrifka 1 kooxaha bisha C, E iyo D, ka dibna 1 bil vitamins B1 iyo B2, ka dibna B6 1 bil iyo B5. Dabcan, sida in xiidmaha waaweyn xogta aadanaha waxaa ku dhexsameeysmo vitamins naftooda, waa in sidoo kale cunaan khudaarta cusub iyo caleemo aan la daaweyn kulaylka.

Tan iyo horumarinta SvD ka ciyaartaa door ah oo xiiso hoose ee caafimaadkooda iyo dayaca ee jirka, badalkooda ee fitamiin iyo macdan, waxay ka caawisaa si ay u yareeyaan calaamadaha halista. Occupational Therapy inta lagu jiro daaweynta sanatorium (pay-as ee rugta la vouchers soo saartay dadka qaba SvD) saamayn badan ka xasilloon yeelan doonaan. Laakiin qofka bukaanka ah si fiican u sharax in tan iyo inta kale waa daawo ugu yaraan isaga sababtoo ah inta lagu jiro inta ka lahaa cabashooyinka jirin.

cillad Somatoform of habdhiska ku autonomic (ICD-10)

In soocidda caalamiga ah ee cudurka waxaa tan iyo 1993. cudurada Tani waxaa laga helaa dunida oo dhan oo aanu ku xiran tahay sifooyinka jinsiyad gaar ah ama quruun. The ICD 10 somatoform cillad autonomic V dib loo saxay iyo VI cinwaanka. marka hore waxaa ka mid ah "Maskaxda iyo cudura habdhaqanka" (code suntan F0-99), iyo labaad - "waalan, xanuunada la xiriira culeyska maskaxda iyo somatoform" (suntan code F45-F48).

F45 Category ka mid ah heley soo socda: disorder somatisation, disorder somatoform qasaya, cillad autonomic somatoform si toos ah, disorder hypochondriacal, disorder waara somatoform xanuunka iyo xanuunada kale cayimin of regulation dareemayaasha jirka. Waxay somatoform autonomic code F45.3 cillad waa encoded iyo waxay u baahan tahay tirtiridda xubnaha buka innervated habdhiska autonomic durugsan.

gunaanad

saynisyahano badan oo haatan aaminsan yihiin in cillad ku somatoform autonomic waa in la tixgeliyaa in faahfaahin dheeraad ah. Cudurkaan wuxuu saameeyaa la qabsashada bulshada bukaanka. In tiro ka mid ah xaaladaha ku tijaabiyey muujinta isu geeyey oo ka mid ah SvD iyo cillado dhismaha ee sedrtse. Dhaqanka balaadhan oo ah echocardiography ogol yahay si aad u ogaato in joogitaanka chords badan oo ventricle bidix iyo waalka mitral dhicida darajo hoose la regurgitation yar. cudurada garaaca Recent adag oo hogaanka si gabsiiya wadnaha da'da.

Taas macnaheedu waa in a cillad autonomic somatoform waa in la tixgeliyaa sida calaamad (syndrome), u baahan in dhakhtar loogu talogalay cudurka dheeraad ah, loogu talagalay aqoonsiga ee comorbidities. Inkastoo HIC daahir ah - cudur neurogenic, kaas oo la xidhiidha dheelitir u dhexeeya nidaamka garawsi iyo parasympathetic durugsan dareemayaasha. Sidoo kale, in view of muhiimadda ay bulshada ee cudurada, waxaa muhiim ah in la dhiso shuruudaha ogaanshaha cad SvD. Tani waxay u ogolaaneysaa in la kala saaro cudurrada psychogenic iyo degaaankaaga, in waxqabadka hawlaha la wacdo si adeeg ciidan.