Chorea ndi ... Chorea ana. Rheumatic chorea

Chorea ndi matenda a dongosolo lamanjenje. Izo ndi za mitundu ya hyperkinesis. Matendawa amaphatikizidwa ndi mavuto omwe ali ndi ubongo wa ubongo. Dziwani kuti izi zikhoza kukhazikitsidwa pa zizindikiro: zozizwitsa, zopanda pake, zosokoneza mmanja ndi mapazi, nthawizina mu thunthu. M'masitepe a pambuyo pake, pali mavuto a maganizo ndi nzeru, mavuto ogwirizana ndi kudzikonda. Kwa ana, chorea nthawi zambiri amatengedwa monga ntchito yowonjezera yowonjezera. Ndipotu, ndi maonekedwe oyambirira a matenda, muyenera kupeza thandizo loyenerera.

Mawu akuti "chorea"

Mawuwa amagwiritsidwa ntchito m'magulu awiri. Zikhoza kutanthauza matenda odziimira omwe ali a gululi (mwachitsanzo, aang'ono chorea kapena a Huntington a chorea). Amagwiritsidwanso ntchito pofotokoza zina mwa syndromes zomwe zimapezeka mu matenda osiyanasiyana. Mawu omwewo akuti "chorea" amatengedwa kuchokera ku Chigriki, kumene amatanthauza mtundu wina wa kuvina. Izi zikulongosola zizindikiro zoyamba za matendawa, zomwe zimawonetseredwa pamtunda wambiri, wosasunthika, wouma, mwamsanga wa thunthu ndi mapeto. Makhalidwe a wodwalayo ali ngati kusasamala, kuvina kwadongosolo. Nthawi ina, chorea imatchedwa "kuvina kwa St. Witt." Dzina limeneli likugwirizana ndi chikhulupiliro chakale chokhudza St. Witte, yemwe akufalitsa mwakhama Chikristu, chimene anazunzidwa ndi asirikali achiroma. Pambuyo pa imfa yake, nthanoyo inadzitchuka, kuti ngati wina akuchita kuvina mwakhama pafupi ndi manda ake pa tsiku la kubadwa kwake, adzalandira chilango cha vivacity ndi mphamvu kwa chaka chonse.

Zimayambitsa

Zomwe zimayambitsa chitukukochi zimakhala zosiyana, koma nthawi zambiri chorea imayambitsidwa chifukwa cha cholowa kapena matenda opatsirana.

Zosavomerezeka ndi chorea zimayambitsidwa ndi matenda opatsirana monga matenda ophera tizilombo , tizilombo ta tizilombo toyambitsa matenda, tizilombo toyambitsa matenda, neurosyphilis, borreliosis, chifuwa chokhwima. Zochitika za chorea zikhoza kugwirizananso ndi matenda a kagayidwe kachakudya (ngati pali matenda a Fabry, hyperglycemia, hyperthyroidism kapena matenda a Wilson-Konovalov), mowa (poizoni ndi mankhwala opatsirana pakamwa, mercury, lithium, digoxin, neuroleptics, levodopa), matenda a autoimmune (monga antiphospholipid syndrome , Systemic lupus erythematosus, multiple sclerosis). Zina mwa zifukwa zomwe zimayambitsa matendawa, madokotala amatchedwanso kuwonongeka kwa kapangidwe ka ubongo. Izi zimaphatikizapo kupangika kwa tumimba, matenda a hypoxic, ululu wa craniocerebral, strokes.

Zomwe zimachitika

Chorea ndi matenda omwe amadziwonetsera muzinthu zosaoneka, zosokonezeka komanso zochepa. Nthawi zina, kayendetsedwe kameneka kamangotengedwa ngati yachilendo, yokwanira, chikhalidwe kwa munthu wathanzi, ndi chinachake chowopsya. Kwa ena, iwo amafanana ndi kuvina kwa maganizo, kosasinthasintha. Nsomba zazitali zingakhale chimodzi kapena ziwiri, koma zimatsutsidwa pang'ono ndi mtundu umodzi wa synchronism.

Malingana ndi mtundu wa matenda omwe amadziwika, mawonetseredwe a chorea ndi osiyana. Ngati munthu wasonyeza choreic hyperkinesis, ndiye kuti kayendetsedwe kake kamakhala ndi nkhawa pang'ono, mothandizidwa ndi magalimoto osokoneza bongo, kuwonjezereka maganizo, kukhumudwa kwina, kusinthasintha kwapadera, manja osayenera.

Mitundu yodziwika bwino ya chorea imayesedwa ngati mawonekedwe apadera a "mdierekezi pa ulusi." Mtundu wotchulidwa wa trochaic hyperkinesis umasokoneza kayendetsedwe ka kuyenda, kulankhula ndi nkhope. Kuyenda kwa wodwala sizodabwitsa, komanso "kothamanga". Chorea, zizindikiro zake ndizovuta kwambiri, musalole kuyenda kulikonse. Odwala omwe ali ndi matenda akuluakulu amadalira malo awo, chifukwa sangathe kuyenda ndi kumadzipereka okha pa moyo wao wa tsiku ndi tsiku.

Houteon Huntington

Nthawi zambiri matendawa amapezeka ali ndi zaka 35 mpaka 45. Chorea, zizindikiro zake, kuphatikizapo hyperkinesia, zimakhala ndi zovuta zaumtima komanso matenda a maganizo (kutaya nzeru), zimayamba pang'onopang'ono, nthawi zina zimakhala zovuta kudziwa nthawi yomwe idayamba kuwonetsa. Maulendo oyambirira achiwawa, monga lamulo, amapezeka pamaso. Iwo akhoza kusokonezeka ndi machitidwe osayendetsa magalimoto (awa ndi lilime lopota, lachisoni, milomo yonyoza, kutsegula pakamwa). Kuwonjezeka kwa matendawa kumaonekera pakukula kwa hyperkinesis m'munda wa thunthu ndi mapeto. Maonekedwe akuluakulu amadziwika ndi kulankhula molakwika, kukumbukira, kumeza njira, kudzipangira okhaokha komanso kutha kwa matenda a maganizo. Choyamba cha Huntington cha chorea ndi matenda osokonekera maganizo monga mawonekedwe a kupembedza, opusa komanso ovuta.

Neuroacanthocytosis

Odwala omwe ali ndi neuroacanthocytosis amadwala osati choreic hyperkinesis, komanso ndi acanthocytosis (mawonekedwe a erythrocytes akusintha). Chinthu chosiyana pa matendawa ndi atrophy (zofooka mu minofu ya kumtunda ndi kumapeto kwenikweni). Zina mwa zizindikiro za matendawa ndi: oral hyperkinesis ndi kusaka, kusuntha kwa milomo, kutuluka kwa lilime ndi zina zotupa. Pogwiritsa ntchito neuroacanthocytosis, wodwalayo amaluma lilime, milomo ndi mkati mwa masaya mpaka magazi. Zokakamiza zomwe zili mu matendawa ndizochititsa kuti munthu azidwala matenda a maganizo komanso matenda a khunyu.

Matenda a Lesha-Naikhan

Matenda opatsirana a mitsempha amateteza munthu kuti asakhale ndi moyo wathanzi. Matendawa ndi matenda a Lesha-Naikhan. Chimene chimayambitsa kukula kwa matenda ndi vuto lobadwa mwa hypoxanthine-guanine phosphoribosyltransferase. Ichi chorea mwa ana chimaphatikizidwa ndi matenda aakulu mu kayendetsedwe ka kayendedwe ka mantha. Komanso, matendawa amachititsa kuti uric acid iwonjezeke.

Kuyambira miyezi yoyamba ya moyo, mwanayo ali ndi nthawi yofulumira. Kulemera kwa miyendo kumaoneka kuchokera mwezi wachitatu. Kuchokera m'chaka chachiwiri cha moyo, mwanayo ali ndi nkhope zakuda, zomwe zimaphatikizapo zizindikiro za zilonda za pyramidal ndi kuchedwa kwa chitukuko cha m'maganizo. Mwana amatha kuchita zovulaza thupi lake podula milomo yake kapena zala zake.

Benign chorea

Benign chorea mwa ana amadziwonetsera kuyambira ali wakhanda kapena akadakali ana. Matendawa amatanthauza matenda. Matenda a hyperkinesis omwe amadwala matendawa amatha pokhapokha ngati mwana wagona. Kuchokera ku Huntington's chorea, mtundu uwu wa matenda umakhala ndi mafunde osapitirira komanso kukula kwa nzeru. Mukakalamba, mutakhala ndi chorea, ndizotheka kuchepetsa hyperkinesis ngati mutalumikizana ndi chipatala pa nthawi.

Mitundu yachiwiri ya chorea

Njira zofala kwambiri za matendawa ndi ziwiri: chorea ndi chorea ya amayi apakati.

Yoyamba imatchedwa Sidenham's chorea. Kuchititsa kuti izi zitheke zingapangitse kuti matenda a streptococcal kapena rheumatism awonjezere. Maonekedwe ofatsa amadziwika ndi zowonongeka, zozizwitsa zowonongeka, kusinthasintha. Mitundu yovuta kwambiri ya choreic hyperkinesis imasonyeza kuti n'zovuta kuti wodwala asunthire, kulankhula mwachizolowezi, kapena kupuma. Pamene matendawa amapezeka, "kugwedeza" bondo ndi "kugwedeza" maganizo, maganizo ndi zovuta, matenda oopsa.

Chorea woyembekezera ndi matenda omwe amabwera kuchokera ali mwana. Izi zikutanthauza kuti amayi omwe anakumana ndi ubwana ndi ang'onoang'ono chorea amalowa m'dera loopsa. Matendawa amatha kupezeka pa mimba yoyamba kwa miyezi 2-5. Ndi zotsatira zotsatila za "zosangalatsa" malo, chorea angathenso kupezeka. Chithandizo pazochitika zotere si zachilendo, chifukwa matendawa amatha pokhapokha atatha kutenga mimba kapena kubereka.

Chorea rheumatism

Kuyamba kwa matendawa kumayambitsa motsutsana ndi vuto la rheumatism kapena endocarditis, lomwe likuphatikizapo kuwonongeka kwa valves pamtima. Matenda ambiri a matendawa sagwirizana ndi izi, ndipo matendawa amadziwonetsera okha.

Rheumatic chorea nthawi zambiri imakhudza ana a zaka zoyambira 6 mpaka 15. Kwa atsikana, matenda amakhala ofala kwambiri. Pa gawo loyambirira, matendawa sangathe kudetsa nkhaŵa, chifukwa zizindikirozo zimakhala zochepa chabe, ndipo makolo amazitenga ngati nthabwala. Njirayi imapitirizabe kuyenda kwazing'ono zopanda manja, kuyambira pazola zala ndi kufalikira pang'onopang'ono mthupi lonse. Patangotha sabata, pakubwera nthawi ya mawonetseredwe, pamene kayendetsedwe ka mwana kamakhala kofulumira komanso kothamanga. Mtundu uwu umalepheretsa mwanayo kuti apitirize kugwira ntchito bwinobwino, ndiko kudya, kuyenda, kulemba.

Rheumatic chorea imasokoneza nkhope ya mwanayo ndi masauzande ambirimbiri. Mitundu yoopsa ya matendawa imapangitsa wodwala kuti ayime pamapazi ake, kumeza, kulankhula, pamene thupi likuyenda nthawi zonse. Ngati chorea ikupezeka, mankhwala ayenera kuchitidwa mosamala komanso mwamsanga.

Zofufuza

Zolakwa za chorea zimachokera ku khalidwe lachilendo la munthu. Poyamba kukayezetsa dokotala ayenera kukambirana ndi wodwala kapena achibale ake. Makamaka, ndikofunika kudziwa ngati wina ali ndi matenda m'banjamo, kodi zizindikiro za chorea zidawoneka bwanji, kaya wodwalayo amamwa mankhwala, kaya akudwala matenda opweteka. Kuwonjezera apo katswiri ayenera kupereka kulingalira kwa kayendetsedwe kosasamala. M'pofunikanso kudziwa kuti ndi matenda otani omwe angayende nawo nthawi zambiri, chifukwa chosowa nzeru. Zizindikiro za matenda ngati amenewa siziwonekera nthawi zonse. Nthaŵi zina, kuti azindikire matenda omwewo kumayambiriro, akuyezetsa machitidwe osiyanasiyana. Kuyezetsa magazi kudzawonetsa mlingo wa mkuwa m'magazi ndi kukhalapo kapena kupezeka kwa zizindikiro za zotupa zotupa. Kuphatikizanso apo, kompyuta tomography, kujambula kwa maginito, ndi electroencephalography zimachitika.

Chithandizo

Chorea ndi matenda omwe samalola wodwalayo kuti azikhala ndi moyo wambiri, kotero kuti mankhwala ake ayenera kukhala oyenera nthawi zonse. Njira zamankhwala zothandizira mwachindunji zimadalira zomwe zimayambitsa matendawa. Mwachitsanzo, pogwiritsa ntchito matenda a Wilson-Konovalov, wodwalayo amalamula kuti azidya zakudya zamkuwa ndi mankhwala osokoneza bongo.

Pankhani ya Huntington's chorea, odwala matenda a neuroleptics ndi benzodiazepine amalembedwa. Ngati chorea imayambitsidwa ndi ubongo wosaneneka wa ubongo, ndiye kuti mankhwala omwe amachepetsa kuchuluka kwa magazi amafunikira. Pamene vasulitis ndi mankhwala ophatikiza. Ngati pali zizindikiro zowonjezera, mankhwala ayenera kukhala omveka bwino.

Kuthamanga kwa kayendetsedwe kodzidzimutsa kungachepetsere pochita opaleshoni, pamene phokoso la ventralateral la thalamus likuwonongedwa. Pogwiritsa ntchito mankhwalawa, mumayenera kumwa mankhwala omwe amathandiza kuti ubongo komanso ntchito zabwino zikhale bwino, komanso mavitamini a gulu B.