Matendawa amadziwika ndi zovuta za kusokoneza komanso kusintha kwakukuru mu ubongo wa chibadwa cha ischemic chifukwa cha mtima wamatenda a atherosulinosis. Kuperewera kwamphamvu kwa magazi kumabweretsa kusintha kwa ubongo, komwe kumakhudza ntchito zake.
Discirculatory encephalopathy ili ndi magawo atatu, mitundu ingapo, komanso chidziwitso chosiyanasiyana cha gawo lililonse. Kuphatikiza apo, matendawa, ngati sanapatsidwe, amatha kutsogolera munthu wathanzi yemwe ali ndi vuto la dementia ndikulephera kwathunthu kusintha magwiridwe antchito.
Kulumikizana pakati pa atherosulinosis ndi encephalopathy ndikudziwikiratu ndikuwatsimikizira asayansi ambiri. Ndi kuwonjezeka kwa plasma cholesterol, cholesterol plaques amapangidwa, omwe amavala ziwiya m'thupi la munthu. Chifukwa cha izi, kufalikira kwamagazi kwabwinobwino kumasokonezeka mu minyewa ya ubongo, ndipo samalandira mpweya wofunikira.
Discirculatory encephalopathy, code malinga ndi ICD-10 yomwe ili mu rubric I60-I69 "Cerebrovascular matenda", ikhoza kukhala yamitundu ingapo:
- Atherosulinotic encephalopathy, yomwe imachitika pamaso pa matenda amisempha. Ndi imodzi mwazomwe zimapezeka kwambiri matendawa. Nthawi zambiri, atherosulinosis imakhudza mitsempha yayikulu, yomwe imayendetsa kuchuluka kwa magazi kuubongo, ndikuwongolera kuchuluka kwa magazi amitsempha yonse. Ichi ndichifukwa chake, ngati matenda a m'magazi amapita patsogolo, kuthamanga kwa magazi mu kuchuluka kofunikira kumakhala kovuta, komwe kumabweretsa zosokoneza mu ntchito za ubongo;
- Mbali yodziwika bwino ya discirculatory hypertensive atherosulinotic encephalopathy ndi mwayi wopezeka mwa achinyamata. Pathology imagwirizanitsidwa ndi kukhalapo kwa matenda oopsa komanso oopsa. Pakubwera kwawo, zimachulukana. Kupita patsogolo kwamatendawa kumawonedwa, komwe kumakhudzana ndi zovuta zomwe zimakulitsa vutoli;
- Kusakaniza kwa encephalopathy. Kuphatikiza zomwe zimapangidwa ndi matenda oopsa komanso atherosselotic discirculatory encephalopathy. Pankhaniyi, pali kuphwanya ntchito ya ziwiya zazikulu za ziwombo, zomwe zimakulitsidwa ndikuwoneka kwamavuto oopsa. Izi zimadzetsa kuchulukitsa kwa zizindikiro zomwe zilipo kale za matendawo;
- Venous encephalopathy. Izi zimapezeka m'magazi mukamatuluka magazi a venous kuchokera m'matumbo a cranial. Kusasunthika kwa plasma kumabweretsa kuti mitsempha mkati ndi kunja kwa chigaza imakhala yovuta. Ntchito yamaubongo imasokonekera nthawi yayitali chifukwa cha edema, yomwe imachitika chifukwa chovuta kutuluka kwa magazi kudzera m'mitsempha.
Kutengera mawonetseredwe azachipatala, magawo angapo a discepulopathy a encephalopathy amadziwika:
Gawo loyamba limadziwika ndi kukhalapo kwa zizindikiro zofatsa za kuwonongeka kwa ubongo. Pankhaniyi, mawonekedwe a asymmetry am'mapazi a nasolabial amatha kuonedwa; kupatuka kwa chilankhulo; kukula kwa tendon ndi khungu kumaonekera mbali yakumanzere ndi kumanja kwa thupi.
Odwala nthawi zambiri amadandaula za mutu, chizungulire, tinnitus, kuiwalika, kusokonezeka pang'ono kwa chidwi ndi magwiridwe. Odwala samakhala opanda malingaliro, osakwiya, osisoka, zomwe amakhala ndi nkhawa nthawi zambiri amakhala opsinjika. Ndizovuta kuti asinthe mtundu wina wamachitidwe kupita ku wina;
Gawo lachiwiri la matendawa limadziwika ndi kusokonezeka kukumbukira kwapang'onopang'ono (komanso akatswiri). Munthu amakhala ndi malire pazokonda zake, pamakhala kusintha kwa luntha ndi umunthu wodwala. Pakadali pano, kugona tulo kumakulirakulira, ndipo masana wodwala amatha kugona. Poyerekeza ndi gawo loyamba, zizindikiro za minyewa yachilengedwe zimakulirakulira, kuchuluka kwawo kumawonjezeka. Dysarthria yofatsa, mawonekedwe a pathological, zizindikiro za amiostatic zimachitika: bradykinesia, minofu mamasukidwe amaso. Ngati poyambira gawo loyambalo limasungidwa, ndiye kuti lachiwiri limachepetsedwa kwambiri.
Pa gawo lachitatu, mawonekedwe a kusintha kwakukulu m'matumbo amkati ndi subcortical amadziwika. Izi zimathandizira kukulitsa kuchuluka ndi kuopsa kwa zizindikiro za organic, komanso kuchuluka kwazovuta zam'maganizo komanso kukula kwa zizindikiro zamitsempha:
- Pseudobulbar syndrome, yomwe ndi dysphonia, dysarthria ndi dysphagia, zomwe zimaphatikizidwa ndi kuwonjezereka kwa pharyngeal ndi mandibular reflexes, kulira kwachiwawa ndikuseka. Amayamba ndi kusintha kocheperako pang'ono pazinthu zoyera za ma hemispheres onse kapena ubongo woyambira ndikuwonongeka kwa njira zazikuluzikulu mbali zonse ziwiri. Zizindikiro za extrapyramidal: kusuntha kwa magonero, kuuma kwambiri, kuyenda pang'onopang'ono, kunjenjemera, etc. kumachitika pamene mawonekedwe amtundu wa subcortical;
- Vesi la vestibulo-cerebellar limawonetsedwa ndi chizungulire, kusakhazikika, kuyendayenda poyenda ndipo amayamba chifukwa cha kuwonongeka kwa ma vestibulo-cerebellar.
Kukula kwa encephalopathy kungayambike chifukwa cha zinthu zingapo. Kodi chimayambitsa matendawa ndi chiani kwenikweni?
Choyamba, kupezeka kwa matenda monga atherosulinosis, komwe kumapangitsa kukula kwa encephalopathy koposa milandu makumi asanu. Zotsatira zake zimakhudzana ndi kusokonezeka kwa magazi, komanso kuphwanya kayendedwe ka magazi m'mitsempha mu ubongo.
Kachiwiri, kuwonongeka kwa mitsempha kumakhala ndi mphamvu yayitali pakulimbitsa thupi la mitundu yonse ya zinthu za poizoni. Izi zimaphatikizapo zakumwa zoledzeretsa, mankhwala osiyanasiyana, zitsulo zolemera.
Chachitatu, kukhalapo kwa mitundu yonse yamatenda oyamba a ziwalo zamkati mwa odwala. Amayambitsa kusokonezeka kwa kagayidwe kachakudya mthupi, kamene kamakhudza kayendedwe ka mtima. Mwachitsanzo, mwachitsanzo, uremic encephalopathy, yomwe imayambitsidwa ndi kuphwanya ntchito ya impso, imakhudza kuyambika kwa matenda oopsa. Kuthamanga kwa magazi, ndi chimodzi mwazomwe zimayambitsa kukula kwa dyscircular encephalopathy.
Rediation encephalopathy imachitika chifukwa chakuwonongeka kwa ubongo komwe kumayatsidwa ndi ma radiation;
Nthawi zambiri, madera a ischemic amapangika chifukwa chovulala muubongo. Amapanga zododometsa zomwe zimalepheretsa mpweya kuti usalowe.
Gawo lirilonse la matendawa limadziwika ndi zingapo mwazizindikiro zake, komabe, titha kusiyanitsa zizindikiro zodziwika bwino za matenda a m'mimba omwe amakhalapo mosiyanasiyana.
Wodwalayo amadera nkhawa za mutu; chizungulire, kusokonezeka kwa chidwi, kusokonezeka kwa chidwi chazima, ntchito yoperewera. Mayiko okhumudwitsawa akusintha kosiyanasiyana, kusokonezeka kwa chisokonezo, komanso kutayika pang'onopang'ono kwa ufulu.
Ngati chimodzi mwazizindikiro zomwe zalembedwa zikuwoneka, ndikulimbikitsidwa kukaonana ndi katswiri wamitsempha kuti mupeze matenda athunthu, ndipo ngati kuli koyenera, kuikidwa kwa chithandizo china.
Kuzindikira matendawa, njira zingapo zimagwiritsidwa ntchito, zomwe zimagwiritsidwa ntchito kwambiri zomwe ndi:
- Kuyesedwa kwa magazi konse, mkodzo, madzimadzi am'mimba;
- MRI yaubongo, yomwe mutha kuzindikira nayo kukhalapo kwa zovuta zosiyanasiyana;
- Multispiral computed tomography, yopatsa mayankho osiyanasiyana ndi matenda;
- Duplex angioscanning ya ziwiya zaubongo ndi khosi - zimakuthandizani kuti muzindikire zamitsempha yama brachiocephalic;
- Electroencephalography kuzindikira cholinga cha zochitika zaubongo;
- Kujambula kwa Neuroenergy - kumakuthandizani kuti muwunike zochita za ubongo.
- Kuwona kwa zotengera za khosi ndi ubongo - zimakuthandizani kuti mufotokoze bwino za kufooka kwa manzeru ndi kuwonekera kumene.
Chithandizo cha matenda ikuchitika m'njira zingapo.
Kukonzanso ziwiya zomwe zakhudzidwa ndikuti ndi njira imodzi yothandiza.
Kuphatikiza apo, ngakhale njira za opaleshoni zinagwiritsidwira ntchito kapena ayi, kudya kwapadera kumafunika, mankhwala amasonyezedwa:
- Phenotropil yokhudzana ndi ma neuromodulators. Chifukwa cha kugwiritsidwa ntchito kwake, zimatha kukonzanso wodwalayo. Mankhwala amaloledwa bwino ndi thupi;
- Mexicoidol, yemwe ali m'gulu la antioxidants. Kufunika kwake kudya kumachitika chifukwa chofulumira njira za necrosis zama minofu ya muubongo. Mankhwalawa amapaka jekeseni 2 kawiri patsiku kwa masabata awiri, pambuyo pake amasinthana ndi mafomu apiritsi;
- Cytoflavin, yomwe imaphatikizapo succinic ndi nicotinic acid, rifoflavin ndi riboxin. Amagwiritsidwa ntchito ngati mawonekedwe a dontho wokhazikika pa glucose kapena saline. Ndondomeko ikuchitika 1 nthawi 2-3 milungu.
Chithandizo cha opaleshoni ya matenda am'mimba chimachitika pa makoma a ziwiya zazikulu pakagwiritsidwe ntchito ka mankhwala sikamabweretsa zotsatira zabwino.
Stenosis (mtima stenting) ndi njila, pambuyo pake canal lumen imabwezeretseka. Kuti muchite izi, chubu chapadera chimayikidwamo, mothandizidwa ndi adokotala kuti ayambitsa zida zina. Pomwe chidacho chimapendekera, khoma lapadera limayikidwa.
Ndi chithandizo chake, kuunikira kwa artery kumakulira mpaka kukula komwe kukufunika.
Matenda opita patsogolo kwambiri ali ndi zotsatira zabwino pang'onopang'ono poyerekeza ndi kukula kwapang'onopang'ono kwa matenda. Chofunikira ndichakuti m'badwo wa wodwala ndi wokulirapo - momwe angatchulidwire, ndi zomwe zimatchulidwa kwambiri ndizizindikiro za discirculatory encephalopathy.
Ndi mitundu yoyambirira ya matendawa komanso kupezeka kwa nthawi yake, nthawi zambiri zimakhala zotheka kukwaniritsa zabwino pochiza matendawa, ndipo nthawi zina kuti mupeze machiritso athunthu.
Mu gawo lachiwiri, kukhululuka kumathanso kuchitika. Chosavomerezeka kwambiri pokhudzana ndi kudwala kwam'mimba ndi gawo lachitatu la matendawa, pomwe wodwala sachira.
Kodi encephalopathy akufotokozedwa mu kanema munkhaniyi.
