Polyneuropathy Diabetic: code ICD-10, hōʻailona, ​​kumu a me nā mea mālama

ʻO ka polyneuropathy Diabetic kekahi o nā hoʻopiʻi pinepine loa o ka maʻi diabetes. Ke manaʻoʻiʻo ia e hoʻomohala nei ka polyneuropathy diabetes i mea ma mua o 70-90% o nā poʻe āpau me ka maʻi ma mua o 5 mau makahiki. I nā manawa mua, lanakila nā ʻano asymptomatic, hiki ke ʻike ʻia me ka nānā loiloi a neurological a / a i ʻole me nā mea hoʻokele o ka noiʻi.

ʻIke no nā kauka. E hoʻopili i ka ʻike ʻana i ka maʻi maʻi o ka polyneuropathy maʻi, e pono ke hoʻohana ʻia ke code G63.2 * e like me ICD 10. Ma kēia hihia, e hōʻike i ka ʻano o ke ʻano o ka maʻi (sensory, motor, autonomic, a i hui pū me ia), ka nui o ka hōʻike. Pono ka maʻi maʻi mua e hōʻike pololei i ka maʻi mellitus maʻi (ICD 10 mau code E10-E14 + me kahi hōʻailona maʻamau ʻehā).

Hoʻopili ʻia ka hoʻomohala ʻana o ka maʻi me ka mokuahi maʻi hyperclycemic maʻi, hemahema o ka insulin (kūʻiʻo a pili ʻole paha), ka maʻi microcirculation ma nā nipili peripheral. Hoʻokomo pinepine ka pōʻino axon, akā hiki nō hoʻi i ka demyelination segmental. ʻO ka hui pū ʻana o ka polyneuropathy a me ka angiopathy o nā mea i hoʻopulapula, ʻo ia ke kumu nui o nā pilikia trophic i ka mellitus maʻi diabetes, i ke kumu o ka hoʻomohala ʻana o ka wāwae maʻi maʻi.

Kahi helu

Ma ke ʻano o nā hōʻike a me ka hoʻokala ʻana i nā hōʻailona, ​​e hōʻike ʻia nā hiʻohiʻona o nā polyneuropathies diabetes.

• Proximal symmetric polyneuropathy (amyotrophy).
• Nā Asymmetric proximal neuropathy o nā nui nui (ma ka maʻamau o ka wahine, sciatic a i ʻole median).
• Nā Neuropathies o nā nerve cranial.
• ʻO nā polyneuropathies Asymptomatic.
• ʻO nā ʻano mea like o polyneuropathy.

ʻO ka polyneuropathy Distal ka maʻamau maʻamau o ka polyneuropathy diabetes. Noho ia ʻoi aku ma mua o 70% o nā maʻi āpau. ʻO ka ʻōlelo mamao e hōʻike ai i ka hāʻule ʻana o nā ʻāpana o nā papa kahi mamao loa mai ke kino (nā lima, nā wāwae). Hoʻokomo nui nā ʻeha i nā wāwae liʻiliʻi i lalo. Wahi a ke ʻano o ke mele, he ʻokoʻa kēia mau ʻano:

• Na olahaa.
• Uahi.
• Nā mea kanu.
• Kāwili ʻia (sensorimotor, motor-sensory-vegetative, sensory-vegetative).

ʻO ke kiʻi o ka maʻi maʻi o ka maʻi e hilinaʻi i ke ʻano o ka polyneuropathy, ka nui o ka pohō o ka nerve, a me ke kō koko.

• Hoʻohālikelike ka polyneuropathies Proximal, ka mea mua, ma ka hoʻomohala ʻana i nā pilikia o ka hōʻole trophism o ka mākala, ke kaupaona ʻana o ka paona holoʻokoʻa, a me ka kaohi ʻana o kona ikaika. Hoʻopau iki nā hana i ka meaʻai a me ka naʻau.
• Hoʻololi nā neuropathies Diabetic i nā nane cranial ma ke ʻano o ka hōʻino ʻana i kahi pālua. No laila, ʻo ka loiloi maʻamau o ka nerve oculomotor, e hōʻike pinepine iā ia iho i ke ʻano o kahi ulu ulu i kahi maʻi ophthalmoplegia. Hōʻike ʻia ka nalowale o nā nerve optic e kahi hōʻemi i ʻike ʻia, i ka ʻike ʻana o ka pupū i nā maka, ka mea ʻike maka kino ʻole. Hoʻopilikia ʻia nā mea maʻamau, trigeminal, poloka, nā ʻōpū o nā maka. ʻO ke kumu kumu maʻamau o nā maʻi CFN ko lākou ischemia maʻa, a ʻo ka hoʻomaka ʻana o ka hōʻola e hiki ke alakaʻi i nā hopena maikaʻi.
• Hoʻomaʻama pinepine ʻia ka Asymptomatic polyneuropathies me ka manawa kūpono, me ka hōʻike neʻe ʻana o ka neurological paʻa. Hōʻike lākou ia e ka hoʻohaʻahaʻa ʻana i nā tendon reflexes, ʻoi aku ka pinepine ma mua o ke kuli.
• Hōʻike ʻia nā ʻano ʻokoʻa o ka polyneuropathy, ma ke ʻano he kānāwai, maopopo. No laila, ka ʻike nuiʻana o nā maʻi hoʻokalakupua i ka manawa i kū mai ai kahi sensing a holo ʻana i ka mea maʻi, ʻeha ʻeha, hōʻeha i ka umauma. Eia kekahi, ʻike paha kekahi i kahi kuhi hewa ʻana i ka nānā ʻana, e ʻike paha ia i ka manaʻo o ka "hele ʻana ma kahi uluna" ʻaʻole ia e manaʻo i ke kākoʻo a ua kīleʻa ʻia kāna gait. Me nā mea mamao o ka polyneuropathy diabetic o nā haʻahaʻa haʻahaʻa, e ulu pinepine ana nā hōʻeha hōʻeha. ʻO nā hōʻeha o ka gait hiki ke alakaʻi i ka hoʻomohala o ka deformity o ka wāwae, a ma hope aku hoʻi o ke ʻano o nā wāwae maʻi maʻi.

Hiki i nā maʻi Autonomic ke alakaʻi i ka hoʻomohala ʻana i ka tachycardia, nā hopena orthostatic hypotensive, ka pīpī i pākuhi a me nā hana o ka wahie, hōʻemi i ka potency, a me ka hoʻoluliluli ʻana. Hoʻonui pū ʻia ka pilikia o ka make puʻuwai wikiwiki.

ʻO ka haunaele o nā kaʻa ma ke ala mamao o ka polyneuropathy he mau maʻi, heʻano kūlike loa ia ma kahi ʻano hoʻokaʻawale. Hoʻohālikelike lākou e ka hoʻomohala ʻana o ka maʻi hōʻino o nā pūʻulu musle distal, kahi hoʻohaʻahaʻa i ko lākou ikaika.

Naʻi hoʻolika

Kuhi ʻia ka maʻi maʻi o ka maʻi maʻi ma ke kiʻi kaukau, loiloi neurological a me ka ʻoiaʻiʻo hōʻike ʻia o ka hele ʻana o ka maʻi diabetes no ka manawa lōʻihi. I nā pilikia paʻakikī, pono ia e hoʻokō i ka electroneuromyography, e hiki ai ke hoʻomaopopo i nā loli mua o ka hana ʻana i ke ʻano o ka puhoi o ka nerve ma nā fibers, ke kūkākūkā hou o ka endocrinologist.

Video e pili ana i ka polyneuropathy maʻi maʻi

Pono ka mālama ʻana i ka polyneuropathy diabetes, e hoʻomohala ʻia me ka ʻoihana endocrinologist a me nā mea lapaʻau. ʻO ka mea mua, pono ke kāohi koko koko. Hoʻoponopono i ka meaʻai, ke ʻano kumu no ka maʻi diabetes. Ua kauoha ʻia nō hoʻi e haʻalele i ka hana o ka micro- a me ka macroangiopathies, inā pono, e hoʻokō i kahi kūpono kūpono.

No ka pani ʻana i nā hōʻike neurological, ʻoi ka hoʻohana nui ʻana o ka metioct thioctic (alpha-lipoic) (berlition a me kāna analogues). Lawe ʻia nā lāʻau lapaʻau ma kahi kūpono loa (ʻo ka ʻōlelo mua loa ma kahi o 300 mg no hoʻokahi lā) a me nā haʻawina lōʻihi (ma ka liʻiliʻi ʻo 1.5 mau mahina). Hiki ke hoʻohui ʻia i ka lāʻau maʻi Symptomatic me ka hoʻomākaukau ʻana i ka papa hoʻomākaukau ipidacrine hydrochloride (Axamon, Ipigrix, Neuromidine). Ua hoʻohana nui ʻia ka mau huaora B.

I ka loaʻa ʻana o nā maʻi hōʻeha, nā anticonvulsants (hōʻoluʻolu i ka hōʻeha o ka mamae neuropathic), nā antidepressants, nā opioid e hiki ke hoʻohana (no nā kikoʻī hou, e ʻike i kaʻu ʻikepili ʻepekema.

He wahi koʻikoʻi i ka mālamaʻana i ka polyneuropathy diabetes, ʻo ka hoʻoikaika kino, ka physiotherapy, a me ka hoʻoulu. Inā he mau hōʻailona e hoʻohuli ai ka wāwae, pono ke koho orthopedic o nā keiki a me nā kāmaʻa. I nā hihia a pau, ʻo ka hana nui ma ke ʻano mālama kino me ka pale ʻana i ka microdamage.

He aha kēia

ʻO Polyneuropathy ka mea i kapa ʻia he hoʻopiʻi o ka maʻi maʻamau, ʻo ke ʻano holoʻokoʻa o ka pau ʻana o ka pauna o ka palaka o ke aʻalolo.

Hoʻopilikia ka mālama i ka polyneuropathy

Hōʻike pinepine ia iā ia iho ma o kahi manawa kupanaha o ka manawa i hala ma hope o ka loaʻaʻana o nā maʻi i ka hoʻopiʻi i ka hopena endocrine. ʻOi aku kaʻoi aku o ka maʻi, hiki i ka maʻi he iwakāluakūmālima mau makahiki ma hope o ka hoʻomaka ʻana o nā pilikia me ka hoʻokumu ʻana o ka insulin i ke kanaka.

Eia nō naʻe, aia kahi mau mea i ʻike ʻia ka maʻi i ka poʻe maʻi o ka endocrinologists i loko oʻelima mau makahiki mai ka loaʻa ʻana o nā pathologies o nā pancreas. ʻO ka hopena o ka hele ʻana i ka maʻi like ʻole i nā mea maʻi me ka maʻi maʻi, ka ʻano mua a me ka lua.

ʻO nā kumu hanana

E like me ke kānāwai, me ka papa lōʻihi o ka maʻi a me nā pēpē pinepine o nā maʻi i ke kō, ʻoi aku ka hopena o ka metabolic i nā hanana āpau a me nā ʻōnaehana o ke kino.

A ʻo ka ʻōnaehana o ka pilikia ka mea mua e ʻeha. E like me ke kānāwai, e hānai i nā kinipona palupalu i nā moku koko liʻiliʻi loa.

Ma lalo o ka mana o ka pahū o ka mau o nā kalaiwa, hele mai nā mea i kapa ʻia ʻo ka ʻai. A ke hopena, hāʻule lākou i kahi kūlana o hypoxia a, ma muli ke ʻano, ʻike ʻia nā hōʻailona mua o ka maʻi.

Me kona mau hopena a me ka decompensation pinepine, i nā pilikia e noho nei me ka ʻōnaehana nūnū, kahi e loaʻa mau ai ke ʻano maʻi i hiki ʻole ke paʻakikī.

No ka mea pono ke nui o nā vitamina a me nā minela no ka hana ʻana o ka pīkī a me ka pale ʻana i nā glitches i loko, a ma ka maʻi diabetes, ka hoʻōla ʻana a me ka hana ʻana o nā mea pono a pau, hoʻopilikia ʻia nā ʻili o ke aʻalolo ma nā pōʻino a, ma laila, e hoʻomau ʻia ai ka hoʻomohala ʻana i ka polyneuropathy.

ʻO nā mea kūpono no ka hoʻomohala ʻana i ka polyneuropathy diabetes

Mai ke kumu nui o ka polyneuropathy diabetes (ICD 10 code - G63.2) ke hoʻonui nei i ka glucose o ke koko, e hoʻomaikaʻi kekahi endocrinologist i nā mea maʻi me nā hōʻailona o ka hoʻopōʻino nerve peripheral. Ke nānā nei ke kauka i ke kō koko, hoʻoholo i ke kaʻe o ka glucose i kahi ʻōpū ʻole a ma hope o ka ʻai ʻana. ʻO nā ʻenthalmologist, nā neurologists, nā vascular lapaʻau e mālama i kahi hoʻokolokolo no ka hoʻopōʻino i nā microvessels o nā eyeball, nā keiki, nā manamana. ʻO kahi ala kūpono loa i ka mālamaʻana i ka polyneuropathy maʻi maʻi e hoʻomaikaʻi i ke kūlana maʻamau a me ke ola o ke ola o nā maʻi, e kōkua ai i ka hoʻoulu hou ʻana o nā hōʻailona o ka hanaʻino a peripheral nerve i ka maʻi mellitus.

ʻO nā mea koʻikoʻi koʻikoʻi no ka hoʻomohala ʻana i ka polyneuropathy ma waena o nā mea maʻi me ka diabetes mellitus type 1 ke kiʻekiʻe o ka hoʻonui ʻana o ke kaʻe o ka glucose o ke koko, ʻo ka lōʻihi o ka maʻi a me ka makahiki o ka mea maʻi. I nā mea maʻi me ka diabetes type mellitus type 2, he mea nui ke alahaka o ka arterial a me ka metabolism lipid impaired.

Nā neuropathies peripheral, mua o ka symmetric sensorimotor polyneuropathy, i kahi mea ʻoi aku ka nui ma mua o ka neuropathy kikowaena, hoʻoweliweli i ka maikaʻi o ke ola a me ke ola o nā mea maʻi iā lākou iho. Cardiac autonomic (autonomous) kahawai peripheral, kahi o ka hoʻohui o nā syndromes o ka polyneuropathy diabetes, 50% hoʻopilikia i ka prognosis no ka manaʻolana o ke ola o nā mea maʻi me ka mellitus maʻi. Kūkulu ʻia ke ʻano o nā maʻi maʻi maʻi diabetes me nā ʻōpua o hope o ka wāwae. ʻO ka maʻi ʻeha ma kēlā me kēia ʻelima mau maʻi me ka maʻi maʻi e hoʻopilikia i ka maikaʻi o ke ola, ka mea nui inā ke hōʻike ʻia ʻo ia iho me ka allodynia (ʻeha i pane i ka hōʻeuʻeu ʻole o ka hōʻehaʻeha).

Nā mīkini hana no ka hoʻomohala ʻana i ka polyneuropathy diabetes

Ua hui ʻia ka hapanui o nā ʻili peripheral. ʻO lākou ka motona, sensory a me nā fibton autonomous. Hoʻololi ʻia ka hōʻailona o ke ʻano o ka lesion a me ka kuʻuna, ka ʻōpū a me nā autonomic.

Hoʻopili ʻia kēlā me kēia axons (kahi kaʻina lōʻihi cylindrical o kahi nīne) me nā ʻili o kahi sela Schwann, kahi i kapa ʻia ai ke kulu a he noneline, a i hoʻopuni ʻia e nā membanes kūloko o nā cell Schwann. I ka lua o nā kūlana, ua kapa ʻia ʻo ia ka myeline. Hoʻokomo ʻia nā mea pono i nā lua-me myelinated a me myelinated fibers. Loaʻa wale nō nā fibel non-myelinated me ka efferent autonomous a me kahi ʻāpana o ka liper afferent koʻikoʻi. Hoʻokomo ʻia nā fibel myelinated palipihi i ka wili a me ka proprioception (ʻike naʻau). ʻO myin myelinated a me myelined fibers ka kuleana no ka ʻaʻa ʻana o ke ʻeha, ke kū ʻana a me ka pā. ʻO ka hana nui o ka nerve nerve ke hana i kahi kolohe.

Kuhi ka hana o nā polyneuropathy peripheral i ke neʻe o ka holomua o nā fibel myelinated, axon degeneration a me ka hoʻolohi ʻana i ka lawe ʻana o kahi neʻenee neʻe. ʻO kahi hana nui i ka hoʻomohala ʻana o ka polyneuropathy diabetes, e hoʻokani ʻia e ka maʻi hyperglycemia (kiʻekiʻe koko koko).

ʻO nā kumu ʻē aʻe o ka hoʻomohala ʻana o ka polyneuropathy diabetic:

• microangiopathy (hoʻololi i loko o nā moku liʻiliʻi),
• hypoxia (oxygen starness) o nā nires,
• pehu ka pāpaʻaluna glucose,
• glycation o ka protein e hana i luna myelin,
• hāpau pōpilikia
• ka nele o ka hopena hoʻomaha hoʻomaha endothelial - nitric oxide (no),
• ʻōpū kik alpha lipoic acid.

Kumuhana

Wahi a WHO, mai 2 a 8% o ka nui o ka honua e kū ana i ka neuritis. I ka ʻelemakule, hele pinepine ʻia ka maʻi, no ka mea me ka maʻi neurological nui, nāwaliwali o ka ʻōnaehana musculoskeletal, a hoʻolohi i nā hanana hoʻoponopono hou ʻana.

ʻO kaʻohi kino kū hoʻokahi i kapa ʻia ʻo mononeuropathy. ^ E Ha yM. E like me a ICD-10, ua kau ʻia ka maʻi i nā code G56 - mononeuropathy o nā luna o luna a, e like me ia, i ka G57 - mononeuropathy o nā hopena haʻahaʻa.

ʻO kekahi ʻano maʻi ʻē aʻe he polyneuropathy.. ^ E Ha yM. E like me ka ʻōlelo ʻana o ka etymology o ka inoa ("nui + nives + maʻi") - kēia mau ona lesiona o nā nūpepa peripheral.

Hōʻike ʻia ka polyneuropathy e ke ʻano paʻakikī loa, ka mea i hoʻopili pū ʻia me ka paʻakikī o ka hoʻolaʻa i ka wā o ka manawa hoʻomāliʻina i waena o ka manawa. Wahi a ka heluʻana o nā maʻi, aia ka polyneuropathy i nā papa G60-G64.

Nā ʻano o ke ʻano a me nā hōʻailona

ʻO nā ʻano nui o ka neuropathy:

1. Na olahaa.
2. Uahi.
3. ʻIkeʻa.

Hōʻike ia iā ia iho i ke ʻano o ka hōʻeha o ka naʻau: ʻeha, hōʻoki, ʻike, nā ʻōpū o nā wāwae.

Hoʻohui ʻia ia me ka hala ʻole o ka hiki o ka kūʻiha o ka ʻili a me ka atrophy ma hope o ke akea a hoʻopau i ka dysfunction. I kēia hihia, ʻaʻole ma ka pae sensory (i nā hihia maʻamau, aia ke ʻano o ka hoʻouka ʻana i ka wīwī).

Polokalamu! Hoʻokomo ʻia ka neuropathy motor me ka lohi ʻana i ka nāwaliwali o ka ʻiʻo, kahi hoʻemi i ka nui o ka iwi. ʻO kahi hiʻohiʻona o ka neuropathy motor he lesy symmetrical o nā wāwae.

ʻO ka etiology o kēia ʻano o ka neuropathy e hoʻopili pinepine ʻia me nā maʻi hoʻohemo a me nā kūloko genetic. Aia he 6 mau ʻano o ka neuropathy kaʻa:

• Congenital. ^ E Ha yM. I kumu e nā hemahema o ka gen TRPV4. Hōʻike ʻia nā hōʻikeʻike mua mai ka hānau ʻana, i ka wā e hiki mai ana, ke hoʻomau nei ka maʻi.
• ʻAno 2A. ^ E Ha yM. Ua pili pū me nā hemahema i ka gen HSPB8. ʻO ia kekahi o nā ʻano o ka peroneal amyotrophy. Hoʻopilikia ʻia i nā keiki kahiko. Hōʻike ʻia kēia ʻano ma ka hoʻonui mau ʻana i ka hōʻino lima: nāwaliwali o ka naʻau (a hiki i ka atrophy), tactens insensibility.
• ʻAno 2D. ^ E Ha yM. Aia nō ia ma muli o nā pilikia pili kino o ka gen FBXO38 i loaʻa i ka chromosome No. 5. Hoʻoulu i ka ʻōpio me ka nāwaliwali o nā wāwae, nā puʻupuʻu o nā haʻahaʻa haʻahaʻa, ma hope i ka pālahalaha ʻana i nā mākeke o nā lima.
• ʻĀina (symmetrical) ʻano 5 neuropathy. ʻO ka ʻano maʻamau maʻamau e pili pū ana me nā hemahema o ka hua BSCL2 (chromosome No. 11). Ua hōʻike ʻia ʻo ia iho i ka wā o ka ʻōpio a me ka wā ʻelemakule ma ke ʻano o ka nāwaliwali, nā lima haʻalulu. I ka wā hope, ua uhi i nā ʻōpū haʻahaʻa.
• Pākuʻi i ka neuropathy spinal 1. ^ E Ha yM. ʻO nā hanana ma muli o ka hana hewa o ka gen IGHMBP2. Ua hōʻike ʻia ʻo ia iho i ka manawa o ka prenatal ma ke ʻano o ka degeneration o nā uaua lima. Ma hope aʻe, hiki ke hoʻopilikia i nā ʻunina palalike o ka ʻōnaehana o ka ʻōpū a hiki i ka make hoʻi.
• ʻAno AH. ^ E Ha yM. Hoʻopilikia ʻia e ka gen mutation ma ka chromosome X. Hoʻopilikia wale ia i nā kāne i ka wā kamaliʻi, e hoʻokau i nā ʻeha pūkaha o nā wāwae āpau.

He ʻokoʻa loa ka neuropathy motor (0.004% o nā hihia). ʻO nā lāʻau kūpono i loaʻa wale nō ke kākoʻo o nā lāʻau lapaʻau a me kahi mālamalama huaʻai. Hoʻopau ke ʻano o nā hoʻomaʻamaʻa ʻana mai ka manawa hoʻoholomua i ka ʻōpū hoʻoneʻe.

ʻIkeʻa

ʻOi aku ma mua o ka 90% o nā maʻi me ka maʻi mellitus i loaʻa i ka neuropathy maʻi maʻi (DN), e hoʻopiʻi ana i ka ʻōnaehana autonomic a me peripheral ma muli o nā maʻi metabolic.

ʻElua mau DN i nā ʻano ʻelua:

• Kūpono - pili i nā ʻāpana o ke kino.
• Hoʻohālikelike - ke kumu o ka haunaele ʻana o nā ʻano o nā aʻa.

ʻO kekahi o nā ʻano o ka neuropathy diffuse he autonomous, ma laila ka holo ʻana o nā kino o nā ʻōpū i loko me nā hōʻailona e pili ana:

• ʻŌpala Gastrointestinal: nā maʻi dyspeptic, hōʻeha i ka ʻaihue, hoʻonui lemela, ʻeha ʻana o ka epigastric, ka piʻo ʻana o peristalsis, nocturnal huehue (me ka hoʻopili ʻana o nā pona nerve e kuleana no ka hana ʻoi).

ʻO ka ʻeha gastrointestinal e pili pono ana i ka neuropathy ma muli o ka mea nui o ka nāwaliwali o ka pūnao enteric, ka nui o nā selamela neʻe e hoʻohālikelike ʻia i kā lākou helu ma ka lolo.

• ʻŌnaehana Genitourinary: ka hoʻihoʻi ʻana ma muli o ka nāwaliwali o ka pāheʻe, nā maʻi maʻi luaʻi.
• Nā ʻōpū: i loko o nā kāne - ka hapa ʻole o kahi neʻe i waena o ka mālama ʻana i nā kuko moekolohe, i loko o nā wahine - kahi i hoʻohaʻahaʻa i loko o ka hoʻoweliweli ʻana i ka wā o ka moekolohe.
• ʻŌnaehana Cardiovascular: tachycardia, heart rhythm failed, angina pectoris.
• ʻIli kūloko: nā lima maloʻo a me nā wāwae, hoʻonui a hoʻohaʻahaʻa paha i ka hoʻoluʻu ʻana.

Kuhi ʻia nā haunaele nui: vertigo, nalowale o ka ʻike, asthenia.

Nā iwi sciatic

ʻO ka lōʻihi loa a me ka hapa nui (1 cm i ka lōʻihi) ka iwi nui o ke kino, e hoʻomaka ana ma ka 4 o vertebra a me ka hele ʻana i ka wehe i ka iwi pelvic, iho i ka popliteal fossa, kahi i hoʻokaʻawale ʻia ai i nā lālā fibular a tibial. Hiki i ke komohana ke loaʻa i nā pelvis, ma ka piriformis, ma ka ʻāʻī.

Hoʻokomo ka nīnoi a sciatic nerve i ka lua ma ka wao i waena o nā neuropathies haʻahaʻa haʻahaʻa (ʻo 0.025% ka pilikia ma mua, ma ka lehulehu mai 40 a 50 mau makahiki paha). ʻO kekahi hiʻohiʻona ʻē aʻe o kēia maʻi - ʻaʻohe symmetry - hoʻokahi wale maʻi maʻi e maʻi ana.

Hoʻokomo ʻia ka pehu sciatic i nā ʻuhane a kūlou i ke kulinolaila, eia ke ʻano o kēia mau hōʻailona o ka maʻi.

• Ke kaumaha nei ka immobilizing ma hope o ka ʻūhāradiating a ma ka wāwae haʻahaʻa a me ka wāwae.
• Ke hele nei me ka wāwae kūpono, e kū mai ana ma muli o nā pilikia i ka wāwili i ke kuli (paresis o nā ʻōkō a me nā mus-tendon tendon i ka manawa like me ka nui o nā tonus o ka puʻuwai quadriceps).
• ʻO ka uhi ʻana o ke stratum corneum o ka ʻili i ka kuʻekuʻe, wāwae ʻula, pale o ka luhilahi.
• ʻO ka hoʻonāʻana i nā loli maʻaila.

ʻO ke ʻano wahine

Ke lawe nei i ka hoʻomaka mai nā aʻa o ka 2-4 vertebrae, ua neʻe kēia neʻe hoʻonaninani ma lalo o ka ligu inguinal i mua o ka ihu o ka ʻūhā, a laila - ma ka wāwae o lalo, wāwae, a hoʻopau i ka manamana nui.

ʻO nā hana nui o ka nerve femoral: ka loko o nā ʻōpū e pili ana i ka ʻohi ʻana i ka hip, haʻahaʻa haʻahaʻa, hoʻonui i ke kuli.

Me ka maʻi, hiki ke ʻike ʻia nā maʻi a me nā kaʻa.

• ʻO ka nāwaliwali o ka hoʻonuiʻana o ke kuli - ma muli o ka hopena, ʻo ka hiki ʻole ke hele i luna o nā ʻōpū, holo.
• ʻO ka hōʻino ʻana i ka ʻike maka, hoʻokūkū tactile, a me ka paresthesia ma ke ala o ka nalo.

Me ka neuritis o ka nerve femoral, hoʻomau ka ʻūhaka kuli.

Axillary

ʻO ka huaila axillary (axillary) kahi lālā o ka ʻōpala plexus brachial. Hele ia ma lalo o ka ʻūhā kuʻekuʻe a kau ana ma ka ʻaoʻao ma hope o ka humerus ma mua o ka hoʻokaʻawale i nā ʻāpana ʻelua. ʻO kāna hana nui, ʻo ia ka loko o ka pehu liʻiliʻi a me nā uaua deltoid.

Hoʻopilikia pinepine ʻia kahi pōʻino o Axillary e ka trauma koʻikoʻi: kahi poʻohiwi wāwahi a hōʻeha iki paha.. ^ E Ha yM. Hoʻokomo ʻia nā mea pāʻani i nā haʻuki traumatic (wrestlers, climbers, etc.) i kēia manawa. ʻO ka liʻiliʻi iki ka hopena, ʻo ka hopena o ka hale i ka hopena: ʻo ka hoʻoulu ʻana me kahi puʻupuʻu, kaohi ʻana i ka moeʻuhane, etc.

Hiki ke loli nui nā hōʻailona o ka hōʻino i kēlā me ka nui o ka ʻeha.

1. Mālamalama ʻole paha a koʻikoʻi i ka ʻūlau ʻenehana ma muli o ka paresis o ka ʻiʻo deltoid. I nā hihia koʻikoʻi - paralisis o ka wāwae.
2. Loko o ka ʻike sensory ma ke kua a me na hope o ka lima.
3. Hoʻokuʻu ʻia i ka ʻāʻī o ke poʻohiwi.
4. Hoʻokokoke ka puʻe kele ʻana.

Loaʻa ka hoʻomaikaʻi ʻia ʻana o ka hoʻomaʻamaʻa. Inā ʻaʻole i hāʻawi aku ka hopena conservative a me ka hana lapaʻau i ka hopena, e hoʻohana ʻia ka haʻalele ʻana i ka cicatricial fusion, i kekahi manawa - ke kahuli o ka nerve nerve.

ʻO ka ʻūhā wāwae

Hōʻele ka pae ʻana o ka wāwae me ka neuritis ma mua. Pākuʻi ʻia me ka ʻili ʻana i ka nerve tibial, hoʻopaʻa i ka naʻau o ka wāwae, nā ʻaluna a me nā mea hoʻonui o ka wāwae.

Inā make ka patella o ka nerve tibial maʻamau, ʻo nā hopena koʻikoʻi loa no ka wāwae: nāwaliwali a kau ʻana a hiki i ke kikoo piha ʻana.

ʻO ke ʻano hana a ka mea maʻi me ka leʻaleʻa like ʻole: hāpai ʻo ia i kona wāwae kiʻekiʻe, hoʻomaha ʻo ia ma ka wāwae, a laila ma ka wāwae āpau ("ka hana 'kuda"). ʻAʻole kū i ka mea maʻi ma ka manamana wāwae. ʻO ka holomua o ka maʻi hiki ke alakaʻi i ka pilikia a me ka hemahema.

ʻAʻole iki ka ʻōlelo ʻana o ka wāwae me ka hoʻohewa ʻana o ka lālā hohonu o ka nerve peroneal. ^ E Ha yM. I kēia hihia, nā wīwīwīwīwīwīwīwīwī hōʻaha nā hōʻiliʻili i hui pū ʻia me nā hōʻeha ʻana o nā manamana lima.

I ka hihia i ka trauma i ka hapa i ka subutanutan o ka nerve o ka peroneal, ʻo nā hōʻailona nui ka palena o ka neʻe ʻana o ka wāwae, ke kū ʻana o ka maʻi, ka hōʻeha ʻana i ka pō pōkole, ka ʻike ʻana i ka wī.

ʻO kekahi o nā hoʻopiʻi o ka maʻi diabetes i kapa ʻia ʻo ka wāwae maʻi maʻi. ^ E Ha yM. He pena kēia ma nā ʻano o ka ʻili ma nā wāwae i uhi ʻia e nā maʻi ululinal purulent me nā maʻi ʻelua e hoʻopili ʻia. I nā pilikia koʻikoʻi, holomua ka maʻi ma ke gangrene a alakaʻi i ka amputation o ka wāwae.

Loaʻa lima lima

E like me ka pathology o ka wāwae, he mauʻu nā maʻi o nā lima a ua kumu ʻia e nā helu neuropathic neuropathic:

• Neuritis Radial. ^ E Ha yM. E alakaʻi iā ia i ka pōʻino o ka mīkini i ka lima, - i ka manawa e hāpai ai i kou lima, kau sags. Eia pū kekahi, ua hele pū ʻia ka maʻi me nā hopena sensory ma ke ʻano o ka nalowale o ka nānā ʻana o ka lima.
• Ulnaritisitis. ^ E Ha yM. Hoʻohālikelike ʻia e ia me ka paresis o nā mīkini a me nā extensors o nā manamana lima, ka pale ʻana i nā loea kaʻa maikaʻi o nā lima lima.
• Neuritis Hoʻolilo Median. ^ E Ha yM. Nā hopena: ʻoi ʻole a hiki i nā lima ke pau loa i ka hoʻoweliweli ʻana, ʻehaʻeha ma nā manamana lima, pili a musaki.

Polokalamu! Hoʻololi pū kekahi lima lima i kekahi mau polyneuropathy.

Nā lāʻau lapaʻau

I kekahi mau hihia, hoʻemi ʻia ka mālama ʻana i ka hoʻopau ʻana i nā pinching mekanika o ke aʻa: ke hoʻokuʻu ʻana i ka gypsum, ke hoʻololi ʻana i nā kīʻaha pono ʻole, a me nā kāmaʻa paʻa. ʻO ka ʻoi aku ka lāʻau lapaʻau maʻamau maʻamau (lāʻau lapaʻau a me nā hana kūikawā). ^ E Ha yM. Inā ʻaʻole i kū maikaʻi kēia mau kaʻina, a laila e kōkua aku lākou i ke kōkua o kahi neurosurgeon.

Conservative

Hiki i kekahi neurologist ke kuhikuhi i ka lāʻau lapaʻau i kahi mea maʻi, me ka:

• Analgesika. ^ E Ha yM. ʻO kahi pālahalaha o nā lāʻau anti-inflammatory non-steroidal (NSAID): Diclofenac, Ibuprofen, Meloxicam a me nā NSAIDs ʻaʻole wale i hoʻopaʻa ʻia ʻana o ka ʻeha, he mea nui loa ia no ka pale ʻana i ka atraphula, akā hemo pū me ka edema a me ka mumū o ka nerve nerve, e wikiwiki ana ka hoʻolaʻa. He mea nui ia e makaʻala, hoʻopiʻi paʻa i ka nui o ka maʻi a me ka lōʻihi o ka papa o ka lāʻau ma muli o nā hopena koʻikoʻi o kēia mau lāʻau.
• ʻO nā lāʻau kanu Vasodilating e like me Trental, Cavinton a me nā mea ʻē aʻe iā lākou he hopena vasodilating, keʻoki i ke koko, hoʻomaikaʻi i ke kahe ʻana o ke koko, e hoʻomaikaʻi i ka hōʻola hou ʻana o nā ʻōpala i hoʻopau ʻia.
• Nā mea hōʻeuʻeu iʻike: Neuromidin, Proserin, Ipidacrine. Hoʻopono lākou i ka hana o nā hana o ke aʻalolo, ke kani ʻana i nā io o ka huila o ka ʻāla.
• Antioxidants. ^ E Ha yM. Thiogamma, Berlition a me nā lāʻau ʻē aʻe e hoʻomaikaʻi i ka conduction muscle.

Ua kokoke nā Antioxidants e ke ʻano o ka hana me nā huaora B, akā ʻaʻole e hoʻololi iā lākou.

ʻO nā mea waiwai e hānai nei i ka ʻōnaehana o nā nīpī he mau huaora B: thiamine, acid acid nicotinic, cyancobalamin, choline, inositol, etc.

ʻO kēia mau mea e hoʻowalewale i ka huna ʻana o nā hormone a me ka hemoglobin, e hoʻolako i ka ikehu o ka iwi, a loaʻa kahi hopena analgesic..

No laila, ʻo nā lāʻau lapaʻau e like me Milgama, Neurorubin, Multivit, Vitrum he mea nui loa i ka wā o ka mālama ʻana i ka hana a i ka papa hōʻola.

He aha ke ʻano o ka maʻi maʻi i ka polyneuropathy diabetic: ʻo code ICD-10, nā kiʻi maʻi a me nā ʻano mālama

ʻO ka Polyneuropathy kahi paʻakikī i nā maʻi, kahi e loaʻa ai nā inoa he nui o nā ʻōlima he nui.

Ma ke kino he mea i hele ʻia i loko o kahi i kapa ʻia ʻo ke ʻano a me ke ala e piʻi aʻe ana, ʻo ia hoʻi, ma mua kēia o ka hana ʻana no nā hua liʻiliʻi o ka palu a me ka neʻe lohi i nā lālā nui.

Ke mālama nei i ka polyneuropathy diabetes

E kaawale i ka hoʻomohala ʻana o ka hoʻopale ʻana i ka hoʻoneʻe umauma ma muli o ka mālama ʻana i ka hopena, hoʻomaka ka endocrinologists a me neurologists o ke haukapila ʻo Yusupov e hoʻomaka ana i ka mālama ʻana i ka polyneuropathy maʻi maʻamau. ʻO ke kumu nui i ka pale ʻana i ka polyneuropathy diabetes, ʻo ka loaʻa o kahi pae o ka glucose i ke koko. Ke hoʻomau nei i kahi kaila maʻamau o ka glucose i loko o ke koko no ka manawa lōʻihi i nā poʻe maʻi me nā hōʻike koʻikoʻi o ka polyneuropathy alakaʻi i ka lohi i ka hoʻomau ʻana o ka hōʻino o nā nīpeka peripheral, akā ʻaʻole ia i kōkua i ka wikiwiki o ka hoʻomaʻamaʻa ʻana o kona mau ʻike. Me ka hana o ka pae glucose o nā maʻi, e hoʻomāhuahua a ʻike paha paha nā hōʻailona neurological inā ʻike lākou i ka wā ma mua. ʻO kēia ma muli o ka hoʻoulu ʻana o kēlā mau loli i hōʻea i nā fibers nerve. He palua ke kūlohelohe i ka kūlohelohe a haʻalele koke ʻia, i ʻike ʻia ka ʻike o ke kaʻona o ka glucose i ke koko.

Hoʻopilikia ka poʻe neurologists me polyneuropathy maʻi i ka mālama pathogenetic a me ka hōʻailona. I kēia manawa, ka waika thioctic (α-lipoic), like me Thiogamma, i manaʻo ʻia ʻo ka hoʻomaikaʻi loa ʻana no ka polyneuropathy peripheral. ʻO nā huaora o ka pūʻulu B kahi hopena pololei i ka kino nalo i hōʻino ʻia. Ua kuhikuhi ka poʻe Neurologists i ka thiamine (huaʻai B no nā mea maʻi me ka polyneuropathy maʻi maʻi).₁), nā pyridoxine (vitama B₆), cyanocobalamin (vitama B₁₂) ʻO nā mea maʻi e hoʻomanawanui nei mai ka polyneuropathy maʻi maʻi e hoʻomanawanui i ka momona-soluble o ka thiamine - benfotiamine. Aia i ka Milgamma dragee.

ʻO ka ʻoi loa ka mea i hōʻoia ʻia i ka papa hana no nā lākau ʻekolu no ka polyneuropathy maʻi.

• nā dosis nui o benfotiamine i hui pū me ka pyridoxine (Milgamma dragee), a laila he la helu o Milgamma dragee,
• me ka like ʻole o ka hana mua, ʻike ka poʻe maʻi i kēlā me kēia lā me 600 mg o Tiogamma intravenously no ʻelua pule,
• i nā mea koʻikoʻi o ka polyneuropathy, ua kau ʻia he dragee i loko o ka Milgamma a me Thiogamm e mālama ʻia ai ka makua.

ʻO nā hui nui o nā lāʻau lapaʻau no ka mālamaʻana i ka hōʻeha o ka neuropathic ma ka polyneuropathy diabati he antidepressants, anticonvulsants, opioids a me nā mea hoʻoponopono kūloko. Hoʻohana nui ka poʻe Neurologists i nā antidepressants tricyclic. ʻO ka lāʻau kūpono ʻoi loa ka amitriptyline ma dosages mai 25 a 150 mg i kēlā me kēia lā. Hoʻomaka ka mālamaʻana i kahi laʻa haʻahaʻa (10 mg / lā) a hoʻonui pinepine ʻia e hoʻonui iā ia. Hāʻawi kēia iā ʻoe e hōʻemi i ka hopena o ka lāʻau.

Hoʻopau maikaʻi loa nā Anticonvulsants i ka hōʻeha o ka neuropathic. Hoʻopilikia ka poʻe Neurologists me kahi hōʻeha koʻikoʻi i nā carbamazepine a me ka phenytoin. ʻAʻole lākou i manaʻo ʻia he mau lālani mua ma muli o nā hopena hopena. Loaʻa i ka lua o nā hanauna anticonvulsants ka hana analgesic kiʻekiʻe: gabapentin a me pregabalin.

Hoʻonui nui ʻo Tramadol i ka hōʻeha, hoʻonui i ka hana a me ka hana kino a nā mea maʻi. No ka hōʻemi i ka hopena o nā hopena a me ka hilinaʻi o ka lāʻau, hoʻomaka ka hoʻohana ʻana o tramadol me nā dosis haʻahaʻa (50 mg 1 a i 2 mau manawa i ka lā) a laila hoʻokaʻawale i kēlā me kēia 3-7 mau lā i kahi maʻa loa o 100 mg 4 mau manawa i ka lā. ʻO Tramadol kekahi ʻāpana o ka hui zaldiar hoʻomākaukau.

ʻO nā kuʻikahi a me nā mea hila me 5% lidocaine i kahi hopena analgesic kūloko. Hoʻohana ʻia ka Capsaicin (kahi hana kūloko kūloko) e mālama i ka polyneuropathy maʻi. Ke hoʻokomo nei ka lāʻau lapaʻau i loko o ka pūnaewele olakino ma ke ʻano o ka palona, ​​nā mea holohelena, nā kāmela a me nā mea noi nā pōpō i loaʻa nā mea ikaika i ka hoʻokalakupua o 0,025%, 0,050% a i ʻole 0,075%. Ua hoʻopili ʻia lākou ma 4 mau lā i ka lā a me ka hōʻeha ʻeha.

ʻO ka ʻeha ma ka polyneuropathy maʻi maʻi e hōʻemi ma hope o ke kaʻi ʻana o ka lālani lālani o ka hua ʻaluna A i ka poʻe maʻi. ʻO Glyceryl trinitrate ka hana maʻamau no ka angina pectoris. Mālama ʻia hoʻi i nā kīʻaha koko a hōʻoluʻolu nui loa i ka hōʻeha e pili ana i ka polyneuropathy maʻi.

Me ka hoʻomohala ʻana o ka maʻi maʻi maʻi diabetes, nā ʻalopō ākea ākea, nā hoʻoponopono rheological, nā anticoagulants, a me nā ʻokoʻa ʻole i loko o ka regimen mālama. Inā ulu ka mea maʻi i nā ʻōpū o nā wāwae, hana ka limahana lapaʻau ʻo neurology me ka mālama kūpono ʻana i nā hōʻeha:

• kāpae i ka hyperkeratosis
• hoʻomaʻemaʻe i ka ʻeha,
• wehe ka ulia, hana i ka puka nui o ka hoʻokuʻu ʻana mai ia mea,
• Hāʻawi i ka makika mau i ka ʻeha,
• Hōʻalo i nāʻaʻahu traumatic
• holoi ʻia nā hōʻeha me nā mea hoʻonā ʻole-hiki ke hoʻopalapula i ka paena.

Hoʻomaopopo ʻia nā mea maʻi i kahi hoʻomaha moe no 2 mau pule, a laila e ʻōlelo ʻia e pāpale i nā kāmaʻa orthopedic. I mea e hoʻomaʻamaʻa ai i nā hoʻokolololo a me kahi papa o ka ʻoihana pono no ka polyneuropathy maʻi, pono ʻoe e hana i kahi manawa me ka neurologist ma ke kelepona ma ka hale kūʻai ʻo Yusupov, kahi e hana ai ka hale kikowaena 24 mau lā i ka lā, ʻehiku lā o ka hebedoma a ʻaʻohe hoʻomaha. E lawe ka kauka iā ʻoe i kahi manawa kūpono no ʻoe.

ʻO ka lāʻau lapaʻau

Me nā neuralgia a me ka neuritis, ua kuhikuhi ʻia nā pūʻulu like me nā lāʻau lapaʻau.

1. ʻO nā lāʻau anti-inflammatory nonsteroidal - loaʻa kahi hopena therapeutic paʻakikī. Hoʻohana ʻia i ka pale ʻana i ka ʻeha, ka ʻīwī a me ke ʻano o ka puhi. Nānaehana Diclofenac, Nimesulide, Xefocam.

Pono ʻoe e lawe iā lākou e like me ka kauka ʻana o kāu kauka.

He lāʻau lapaʻau ka Diclofenac, nona nā pūʻulu o nā NSAID. Ua loaʻa ia kahi analgesic, antipyretic a me anti-inflammatory hopena. Loaʻa ka lāʻau lapaʻau i kekahi mau ʻano: papa, suppositories, hoʻonāʻauola, poni a me nā hāʻule. Ua kuhikuhi ʻia no nā keiki mai 15 mau makahiki a me nā pākeke ʻaʻoleʻoi aku ma mua o 150 mg i ka lā 2-3 mau manawa.

Kuhi pū kekahi ʻo Nimesulide i nā lāʻau lapaʻau anti-inflammatory. ʻO ka ʻokoʻa e loaʻa iā Nimesulide kahi hopena antiplatelet - pale iā ia i ka hoʻokumu ʻana o nā māka koko.

Lawe ʻia ka lāʻau ma hope o ka ʻai ʻana o ka 50-100 mg.

2. Antioxidants. ʻO ka laʻana, Berlition, Lipin. Aia lākou i immunostimulate, neurotransmitter, hypotoxic a me nā mea waiwai'ē aʻe. Mahalo i kēlā mau lāʻau, hiki ke hoʻoikaika i ka ʻōnaehana pale, hoʻomaikaʻi i ke kahe o ke koko a me ka hana o nā kino kūloko.

ʻO ka Berlition he hopena maikaʻi loa ia no ka neuropathy ma muli o ka laweʻana o ka maʻi mellitus o ka maʻi diabetes a i ʻole ka alakine.

ʻAʻole hiki ke hoʻohana ʻia ka lāʻau lapaʻau no nā keiki ma lalo o nā makahiki he 18 a ka wahine, hapai a me nā wahine lactating, ʻo ia hoʻi ka poʻe me ka hypersensitivity.

Hoʻomaikaʻi ʻo Lipin i ka hanu a me ka hana metabolic.

3. Nā huaora o ka hui B (B1, B2, B6, B12).

4. ʻO nā lāʻau lapaʻau e hoʻokaʻawale i ke ʻano o nā hana o ka nerve - ua kuhikuhi ʻia no ka hiki ʻana i ka neuritis, ke kōkua lākou e hoʻihoʻi i ka naʻau a me ka hana ʻoi. (Neuromidine, Proserinum).

Fibrosarcoma a me nā osteosarcoma o ka tibia o ka tibia: nā hopena, ka hopena, ...

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ʻO ka Proserine kahi lāʻau lapaʻau i hana ʻia e hoʻohana nui ʻia e mālama i nā maʻi o ka wahī. Hoʻomaopopo ia i ka hoʻoponopono ʻana i ka hoʻokele neuromuscular, hoʻonui i ka leo kani a hoʻomaikaʻi i nā hana o nā kino o loko. Hoʻoholo ʻia ka ʻākāka a me ka ʻike pinepine ʻana o ke kauka.

5.ʻO nā lāʻau lapaʻau e hoʻomaikaʻi ai i ke kahe koko - kōkua i ka hoʻopauʻana i ka trombosis a hoʻomaikaʻi i ka kiko trophic i nā puʻu haʻahaʻa. Aia pū i kēia pūʻulu Caviton, Trental.

Hōʻike ʻia ʻo Caviton e nā huaʻōlelo pharmacological i haʻi ʻia. ʻO kāna kumu i ka hoʻihoʻi ʻana i ke kahe o ke koko, e hōʻemi i ka nānā i ke koko, hoʻomaikaʻi i nā hopena metabol.

Hoʻopilikia ka lāʻau lapaʻau no nā poʻe ma lalo o 18 mau makahiki o ka wahine, hāpai a hāpai i nā wahine lactating, a me ka noho ʻana i nā maʻi nui o ka ʻōnaehana cardiovascular. Hoʻomaka ka papa ʻōlelo me 15 mg, e hoʻonui lōlō i ka nui, akā ʻaʻole ia e ʻoi aku ma mua o 30 mg i kēlā me kēia lā.

ʻŌnaehana physiotherapeutic

Hāpai ka Physiotherapy i ka hōʻemi ʻana i ka pehu o nā haʻahaʻa haʻahaʻa, e hoʻolōʻihi i ka kahe o ke koko a me ka hopena o ka metabolic.

No ka mālama ʻana, e noi:

• Hakalolaola
• ʻĀnikopa.
• Lāʻā
• Hoʻoulu uila.

Hoʻoholo ʻia ka lōʻihi o ke kikoʻī ʻana e ke kauka hele e pili ana i ka hōʻeha a me ke ʻano o ka pathology. Ma ke ʻano he kānāwai, ua kau ʻia nā ʻano hana o ke kino ma ka paʻakikī, nā papa.

Loaʻa ka hopena maikaʻi i ka mālama ʻana i ka neuropathy. Hoʻouku ia i ka hoʻihoʻi ʻana o kekahi mau wahi atrophic.

E kōkua i ka neʻe ʻana i ka neʻe e hoʻolōʻihi i ke kahe o ke koko a me nā kaʻina o ka metabolic.

Pono ka Massage e hana wale i kahi haukapila me kahi loea. Hoʻopili ʻia e hoʻohaki i kou mau wāwae ma luna iho o kāu, no laila, ʻaʻole hiki ʻoe ke hōʻemi wale i ka hopena o nā maʻi, akā hōʻeha pū kekahi i kou olakino.

ʻO ka wehewehe pōkole

Aponoia
Ua hui i ke Komisina ʻĀkau no ka hōʻoia no nā lawelawe lapaʻau
Ke Keena Oihana Ola o Repubalika o Kazakhstan
tanggal 28 Novema 2017
Palapala No. 33

ʻO ka neuropathy maʻi maʻi - Mea poʻokela ke kino ma muli o ka maʻi diabetes, ʻike paʻa a paʻa paha i ka maʻi, me ka ʻole o nā etiology ʻē aʻe (WHO). ʻO ke aʻo nui a me nā ʻano maʻamau o ka maʻi neuropathy diabetes isal isal symmetric polyneuropathy. DSPN - ka puka ʻana o nā hōʻailona o ka neʻe ʻana o ka nerve peripheral nerve i loko o nā mea maʻi me ka maʻi mellitus ma hope o ke kaawale ʻana i nā kumu ʻē aʻe.

Ka ʻCDlelo ICD-10 (s):

Hoʻomoe i ka lā e kūkulu ai ka hoʻoponopono: 2017 makahiki.

Hoʻohālikelike ʻia ia i loko o ka protocol:

Nā mea hoʻohana ʻocollelo: nā neurologists, nā endocrinologists, nā mea hoʻohana maʻamau.

Kākau Pelekane: makua.

Ka pae o nā hōʻike:
Palapala 1 - ke ʻano o nā pae o nā hōʻike

ʻOkoʻa ka maʻi ʻokoʻa

ʻOkoʻa ka maʻi ʻokoʻaa ʻo ka pono no ka ʻimi noiʻi hou aku
ʻO ka DSPN kahi maʻi maʻi hōʻokoʻa. ʻO ka hele ʻana o ka maʻi mellitus a me nā hōʻailona o ka polyneuropathy, ʻaʻole pololei ke ʻano o ka manawa o ka maʻi polyneuropathy maʻi. Pono kahi maʻi maʻi maʻi i ka hopena maʻi ka hopena.

Papa 3 - Nā maʻi ʻokoʻa ʻokoʻa o DSPN 2,14,15

* asymmetric / hana i kaʻaila / localized ma nā wāwae o luna / nui i kūkulu ʻia ka polyneuropathy
Hōʻikeʻike kaiela

E mālama i ka mālama ʻana ma Korea, ʻIseraʻela, Kelemānia, USA

E kiʻi i nā ʻōlelo lapaʻau
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He aha ka mea e maʻalahi i ka kontak?

E hoʻokomo i kāu helu kelepona a i ʻole leka uila
Hōʻikeʻike kaiela

Nā wikiō pili

Nānō o nā Kauka Hoʻonaʻauao ʻĀpau e pili ana i ka polyneuropathy i nā maʻi me ka maʻi maʻi:

• Hoʻopau i nā kumu hoʻokaumaha o ke koʻikoʻi
• Hoʻohālikelike i ke kaumaha ma loko o 10 mau minuke ma hope o ka lawelawe ʻana

He aha ke ʻano o ka maʻi maʻi i ka polyneuropathy diabetic: ʻo code ICD-10, nā kiʻi maʻi a me nā ʻano mālama

ʻO ka Polyneuropathy kahi paʻakikī i nā maʻi, kahi e loaʻa ai nā inoa he nui o nā ʻōlima he nui.

Ma ke kino he mea i hele ʻia i loko o kahi i kapa ʻia ʻo ke ʻano a me ke ala e piʻi aʻe ana, ʻo ia hoʻi, ma mua kēia o ka hana ʻana no nā hua liʻiliʻi o ka palu a me ka neʻe lohi i nā lālā nui.

He aha kēia

ʻO Polyneuropathy ka mea i kapa ʻia he hoʻopiʻi o ka maʻi maʻamau, ʻo ke ʻano holoʻokoʻa o ka pau ʻana o ka pauna o ka palaka o ke aʻalolo.

Hoʻopilikia ka mālama i ka polyneuropathy

Eia nō naʻe, aia kahi mau mea i ʻike ʻia ka maʻi i ka poʻe maʻi o ka endocrinologists i loko oʻelima mau makahiki mai ka loaʻa ʻana o nā pathologies o nā pancreas. ʻO ka hopena o ka hele ʻana i ka maʻi like ʻole i nā mea maʻi me ka maʻi maʻi, ka ʻano mua a me ka lua.

ʻO nā kumu hanana

E like me ke kānāwai, me ka papa lōʻihi o ka maʻi a me nā pēpē pinepine o nā maʻi i ke kō, ʻoi aku ka hopena o ka metabolic i nā hanana āpau a me nā ʻōnaehana o ke kino.

A ʻo ka ʻōnaehana o ka pilikia ka mea mua e ʻeha. E like me ke kānāwai, e hānai i nā kinipona palupalu i nā moku koko liʻiliʻi loa.

Ma lalo o ka mana o ka pahū o ka mau o nā kalaiwa, hele mai nā mea i kapa ʻia ʻo ka ʻai. A ke hopena, hāʻule lākou i kahi kūlana o hypoxia a, ma muli ke ʻano, ʻike ʻia nā hōʻailona mua o ka maʻi.

Me kona mau hopena a me ka decompensation pinepine, i nā pilikia e noho nei me ka ʻōnaehana nūnū, kahi e loaʻa mau ai ke ʻano maʻi i hiki ʻole ke paʻakikī.

ʻO ka polyneuropathy diabetic o nā mea haʻahaʻa haʻahaʻa e like me ICD-10

ʻO kēia ka maʻi maʻa ka mea pinepine i lohe ʻia e nā poʻe maʻi e loaʻa ʻana i ka maʻi maʻi.

Hoʻopilikia ʻia kēia maʻi i ke kino inā pilikia ka lula a me ka nui o kāna mau fibers. Hiki ke hoʻohewa ʻia e nā ʻano o nā ʻano.

Ma ke ʻano he kānāwai, ua pili nui ka poʻe i waena o nā kānaka waena. He mea kuhihewa ʻia, akā maʻi pinepine ʻia nā kāne. He mea pono hoʻi e hoʻomaopopo i ka mea ʻole ka polyneuropathy ma nā keiki kula mua a me nā ʻōpio.

Hoʻowahāwahā ka maʻi maʻi i kēia lāʻau e like me ke ahi!

Pono wale ke noi.

ʻO ka maʻi, ka mea i hōʻike nui ʻia e nā pae haʻahaʻa haʻahaʻa, he nui ka nui o nā hōʻailona:

• Manaʻeha koʻikoʻi i ka wāwae
• ka ʻōpū ʻana o nā wāwae a me nā wāwae.
• hōʻeha a me ka pena ʻole,
• nāwaliwali mānoʻi
• hoʻonui a hōʻemi paha i ka hoʻoweliweli ʻana o nā wāwae.

ʻO kēlā me kēia ʻano o ka neuropathy like a like me ke ʻano like.th:

Naʻi hoʻolika

No ka mea, ʻaʻole hiki i kahi ʻano noiʻi ke hōʻike i ke kiʻi holoʻokoʻa, ua hoʻokau ʻia ka maʻi me ka polyneuropathy diabetes me ka hoʻohana ʻana i ka code ICD-10.

Ma ke ʻano he kānāwai, ʻo ka noiʻi mua noiʻi ka mea hōʻike i kahi kikoʻī kikoʻī o kekahi mau mea loea: he neurologist, lapaʻau a me ka endocrinologist.

Hoʻolima ka kauka mua i ka hoʻopaʻa ʻana i nā hōʻailona o waho, e like me: ke kō o ke koko ma nā haʻahaʻa haʻahaʻa a me ko lākou piʻi ʻana, ka ʻike ʻana i ka ʻoluʻolu e pono ai, e nānā ana i ka huehue a me ke aʻo ʻana i ke ʻano o ka ʻili.

E like me ka noiʻi noiʻi, ua komo kēia: ka nānā ʻana o ka urine, ka hoʻoliʻi glucose glucose, a me ka kolamu, a me ka hoʻoholo ʻana i ka pae o nā mea laʻa i ke kino i ka wā e manaʻo ʻia he makeʻe ia o ka neuropathy.

Akā ʻo ka nānā pū ʻana me ka hele ʻana o ka polyneuropathy diabetic ma ke kino o ka mea maʻi e like me ICD-10 e komo ai i kahi MRI, me ka electroneuromyography a me ka biopsy nerve.

He mea nui e hoʻomanaʻo e pono e hoʻomohala a hui ʻia nā ʻano. Pono e hoʻokomo i nā lāʻau lapaʻau e pili ana i nā wahi āpau o ka hana hoʻomohala.

He mea nui loa ia e pili ana i ka mālama ʻana i nā lāʻau lapaʻau.

E pili ana i ke ʻano o ke ʻano o ka maʻi diabetes polyneuropathy ICD-10, ke kauka nei ke kauka hele i ka hoʻomaʻamaʻa ma ke ʻano he mea e pau loa ai nā hōʻailona o ka maʻi. I kēia hihia, hiki i ka mea ke manaolana no ka ho'ōla holoʻokoʻa.

Ua kuhikuhi aku kekahi loea akamai i ka lāʻau a me nā lāʻau lapaʻau ʻole.

He mea koʻikoʻi loa ia ma mua o ka hoʻohaʻahaʻa nui i ke kōpaʻa koko koko a hiki wale nō me ka hoʻomau ʻana me ka mālama ʻana i ka polyneuropathy maʻi maʻi e like me ka ICD. Inā ʻaʻole hana ʻia kēia, a laila pau ʻole nā ​​hana a pau.

Nā wikiō pili

Nānō o nā Kauka Hoʻonaʻauao ʻĀpau e pili ana i ka polyneuropathy i nā maʻi me ka maʻi maʻi:

• Hoʻopau i nā kumu hoʻokaumaha o ke koʻikoʻi
• Hoʻohālikelike i ke kaumaha ma loko o 10 mau minuke ma hope o ka lawelawe ʻana

Mea kumu hoʻomohala ʻana

ʻO nā mea nui etiological nui e hoʻonāukiuki i ka hoʻomohala ʻana o ka polyneuropathy maʻi maʻi i manaʻo ʻia:

1. Uahi a me ka inu wai
2. ʻO ka hoʻokomo ʻole ʻana i ka kaʻe koko glucose,
3. Makau
4. Paʻai koko
5. Hōʻemi i ka ratio o nā lipids (nā mea like-momona) o ke koko,
6. ʻO ka insulin koko haʻahaʻa
7. ʻO ke ala lōʻihi o ka maʻi maʻi.

Hōʻike nā haʻawina lehulehu i ka mālama mau ʻana i ka glucose a me ke kahe koko e hōʻemi pono ana i ka hoʻomohala ʻana o ka pathology. A me ka hoʻohanaʻana i ka manawa o ka insulin therapy e hōʻemi i ka hopena o ka hoʻomohala e ka hapalua.

Hōʻike ʻia nā hōʻailona o ka polyneuropathy diabetes i nā ʻeha i nā haʻahaʻa haʻahaʻa. ʻAe ʻā, hoʻokeo a i ʻole ka ʻeha ʻeha, emi pinepine i ke kūpaʻa, pili a me ka ʻā. Hōʻike pinepine ia i ka wāwae a hoʻonui i ke ahiahi. I ka wā e hiki mai ana, hiki i ke ʻeha ke hōʻeha i lalo o ke kolu o ka wāwae a me nā lima.

Hoʻopiʻi ka poʻe maʻi i ka palau pinepine ʻana o ka ʻāʻī o ke kino, ke kuʻi ʻana, me ka haunaele. ʻO kēia ma muli o ka hoʻomohala ʻana o kahi pilikia kino i ka ʻōnaehana hoʻokoe. Ua hala nā ʻano wela, hiki ke nānā ʻia nā ʻōpio trophic.

Hoʻomaʻamaʻa ka mea maʻi mai ka ʻaʻa ʻana i nā lole. ʻO ka ʻeha i nā hanana like he mau loa a kaumaha nui i ka pono o ka mea maʻi.

Pehea e maopopo ai a wehewehe i ka maʻi maʻi?

Hoʻomaka ka maʻi maʻi o ka polyneuropathy me ke kipa ʻana i kahi kauka i hōʻiliʻili pono i kahi anamnesis a kuhikuhi i nā ʻano loina kūpono.

E like me ke aʻo nui, hāʻawi ʻia ka makemake i ka electroneuromyography. Eia kekahi, hiki ke hoʻohana ʻia nā aʻo ʻana o VKSP (hiki i ke ʻano cutaneous aurotomic cutaneous)).

Hoʻohana ʻia

I loko o ka hoʻoponopono ʻia no ka hoʻāliʻi oxidative, e hoʻihoʻi i ka mea i hoʻopili ʻia, e kuhikuhi i nā lāʻau lapaʻau me ka hopena antioxidant i haʻi ʻia. Lawe ʻia nā lāʻau lapaʻau i nā papa no ka manawa lōʻihi. I loko o kēia manawa, ke kāohi a me ka nānā ʻana i ka mea maʻi.

E hōʻoluʻolu i ka ʻeha, ua kuhikuhi ʻia nā analgesics a me nā lāʻau lapaʻau anti-inflammatory. Akā, e like me ka hōʻike ʻana o nā loea, ʻaʻole hiki iā lākou ke hoʻōla i ke kaumaha, a me ka hoʻohana lōʻihi ʻana e hiki ke hōʻino i ka hana kūpono o ka ʻōpū.

No nā hōʻailona o ka mamae neuropathic maʻi, anesthetics, antidepressants, a me nā lāʻau antiepileptic i kuhikuhi ʻia. Ma ke kīnā i nā lāʻau lapaʻau, ua ʻōlelo ʻia e hoʻohana i nā pāpale me ka lidocaine, nā kele, nā mea aila a me nā mea momona.

ʻO ka hoʻohui ʻana o ka hoʻomaʻamaʻa paʻakikī o ka polyneuropathy maʻi, e pili ana i ke kūlana o ka mea maʻi, koho:

• ka mālama kino
• magneto a me ka uila
• ʻO ka ʻilikai a me nā me nā wai
• hooulu uila
• Acupuncture
• kaaaea
• kaʻaahi uila inframchaticatic.

ʻAe ʻia ka lāʻau lapaʻau me nā kūlohelohe kanaka me ka ʻae ʻia o ke kauka komo ʻana. He keu e pili ana i ka hana maʻamau o ka mālama ʻana, hiki ke hoʻohana ʻia ka lāʻau lapaʻau a me ka hoʻohana ʻana i nā ʻaila hoʻōla.

Hoʻohana ʻia ka mālama ʻia ʻana o ka polyneuropathy diabetic i kahi kokoke i ke kauka ponoʻī o kēlā me kēia kanaka e maʻi ai me kahi paʻakikī o nā hana mālama mālama.

Hoʻomaka ka hana pākuʻi a hoʻopaʻa i ka Enter e huli.