Kuyenye yeendlela ukwenzakala axonal: Iimpawu, iimpawu isifo

umothuko cranial kunokukhokelela umonakalo omkhulu engqondweni, umcimbi hina. Nabo ke, kunokubangela uphuhliso kwezifo ezinzima yaye ngokufuthi ayibuyiseki umva ezisongela ubomi babantu. Okulandelayo, cinga enye yale miphumela - kwentamo ukwenzakala axonal, yintoni na, ngaphezu ingozi isimo esinjalo.

Overview

Okokuqala kufuneka ukunika kudidi ngokufutshane amanqanaba yokwenzakala yokakayi:

• Easy. Le wokwenzakala kunye yokwenzakala kancinane kwaye mala.
• I-avareji. Kulo mzekelo, iqondo yokwenzakala luphawulwa njengophakathi.
• Enzima. Kweli nqanaba, ukucudisa kunye kwentamo ukwenzakala ebuchotsheni axonal. Ukwenzakala ngoxa enxibe umlinganiswa inertial.

incazelo

Ehlasela Ukwenzakala axonal (WCT) yi iinkqubo intshabalalo omkhulu weeseli luvo kunye hemorrhages ezincinane evelele. Ngokutsho yezonyango, ugxininiso zophendlo lwezifo senziwa kwi kumda mba engwevu namhlophe. Ehlasela Ukwenzakala axonal (WCT) kunciphisa kakhulu umgangatho wobomi kunye nomsebenzi engqondweni nexhoba. imeko yesigulane, ngaphandle kwamathandabuzo, abaya kuthathelwa ingqalelo kakhulu. Oku kubangelwa ubukhulu becala ngenxa yenyaniso yokuba kukho isoyikiso enkulu ebomini bakhe. Xa ukwenzakala kuyenzeka bazigruzule, ukudumba esivelayo, kukho hygroma subdural. Zaphazanyiswa ephuma CSF ukusuka kwindawo ventricular, ngokufuthi ibhaqwe zaphuka odandathekileyo. La kwenzeka ngaphambi kokuba ekuphuhliseni umonakalo ehlasela kwengqondo axonal. Ukwenzakala kuvame kakhulu kangangokuba hayi kuzo zonke iimeko kusenokwenzeka ukubuyisela umsebenzi umzimba endala. Ixhoba kunqabile, njengokuba kusenziwa imiboniso, ibuyisela kule ngxuba zangaphambili eqhelekileyo. Emva kokuba unyango kunye nokuvuselelwa izigulane walimala kwentamo kwengqondo axonal kufuneka ubone ugqirha wakho rhoqo. Uhlolo ziyimfuneko ukuze imeko umzimba kunye ubhaqo imandundu kwangoko ukulawula.

Kuyenye yeendlela ukwenzakala axonal: iimpawu, iimpawu, isifo

njani imeko zophendlo lwezifo? yokulimala abaninzi ingqondo, ukwenzakala ehlasela axonal ingakumbi, ekhatshwa kwikhoma elide. Le meko yenzeka ngalo mzuzu yokwenzakala, yaba lukakayi. Ukongeza, kukho utshintsho kakhulu kwezihlunu. Kuyenye yeendlela axonal kukwenzakala syndrome meningeal eyayihamba kunye ibonwa gross ngoku. Kuye ukuncipha elibukhali uxinzelelo kwaye ukuwa. Isigulana sayiyeka imisebenzi yabo bonke iinzululwazi ngokucinga. Isiqaqa kungaba kakhulu elide, abantu abane lwezonyango kwimeko enjalo, njengoko umthetho, akukho nto intle kakhulu. Kukho kungenzeka ukuba isigulana ukuze sife, kwaye ngaphandle kokubuyela ezingqondweni. Kwenye mzekelo, isigulane uyakwazi ukufumana kuphuma isiqaqa, kodwa emva kwexesha ngokwaneleyo elide. Lutho ingahlala kwiiveki 2-3. Isiqaqa kufuneka sikhatshwe utshintsho zifaka palsy kwemisebenzi zobuchopho. Kulo mzekelo, ogulayo intlungu isici.

isimo kwezityalo

Kuyenye yeendlela ukulimala axonal zobuchopho esibonakala utshintsho olukhawulezayo emfanekisweni clinical. Ngoko ke, ukufa isiqaqa ungaya zibe kwimeko kwezityalo okanye transistor. Ngokwezonyango, ukonakala kwengqondo ehlasela axonal wabonakaliswa ngeendlela ezahlukeneyo. Nangona ezinye iziboniso enye kunye Velocity sezingeni eliphezulu. karhulumente kwezityalo luphawulwa yoqhawulo esebenzayo kule ndawo zifaka nedumbe lengqondo. Kunokuba ziqhubeka iinyanga eziliqela. Kwisikolo sikarhulumente kwezityalo, kukho iimpawu lomonakalo ezisebenzayo kwizakhiwo subcortical-yeentonga ebuchotsheni. Ukuphazamiseka kwiinkqubo ezibalulekileyo kuphakamisa bulbar imbonakalo, pupillary kunye nezinye ukuboniswa efanayo. Xa ukutshintsha kwezihlunu pozdnotonicheskie kwenzeka kunye nempendulo abangenagama zokhuselo. Ezi ziquka, ingakumbi, aquka mde imilenze ephezulu nesezantsi, nokwandisa awo semibutho intloko yakhe, waguqa, ukuba nedumbe, babesima entsokothileyo umzimba. Njengoko kukhankanyiwe ngasentla, wabonakala lonyango zahlukile ngokukhawuleza kakhulu. Kangangeyure, umzekelo, kungenzeka eyahlukileyo ingqondo zophendlo lwezifo. Ekuchongeni utshintsho kwezityalo izigulane zikarhulumente livela zeDyskinesia, iqinelwa ataxic, kukho intetho kunye nokuphazamiseka engqondweni. Phakathi yokugqibela, kubalulekile ukukhumbula aspontannost, kunesifo, waphelelwa yokuziphatha.

Le enye ikhosi inkqubo zophendlo lwezifo

Kuyenye yeendlela ukwenzakala ebuchotsheni axonal utshintsho ezahlukeneyo ukusuka isiqaqa elide kwindawo bufutshane ezingisayo kwezityalo karhulumente. Oku kuboniswa obubonakala ezitsha, nto leyo engazange khona ngaphambili. Umzekelo, isiguli ngokugqith ekugxilwe krwaqu yokudanyaza okanye basabela njani ezenzeka ngaphandle. Ukuba ngaba urhulumente kwezityalo siqhubekeka ixesha elide, ityhileke imiqondiso ezintsha zesi sifo. Ngokukodwa, kukho ukungondleki kwezihlunu carpal fibrillation lomzimba izihlunu. Kule meko kukho okukhawulezayo inkqubela paroxysmal ithi. Bathi thaca tachycardia, yokucoca, lwegazi, kunye nezinye iimpawu ezingaqhelekanga. Kamva ephawulwe kubola. Ehlasela kukwenzakala axonal ngoku kunye ukuqina kwezihlunu, discoordination, gipomimiya, oligofaziey, bradykinesia, discoordination, Ataxia. Buninzi intloko yesigulana. Liqala ukuphuhlisa emetic syndrome, kukho ubunzima kunye nokujikeleza entloko kunye nomlenze izandiso, kukho izihlunu intamo. Izigulane ezininzi olwenze komzimba (imivumbo cortical ndazigcina ukwanda ngokwaneleyo elibukhali kwamaqondo obushushu) ptyalism, ukwanda ukubila. Ngaloo ndlela, sinokugqiba ukuba ukwenzakala ehlasela axonal Uxhokonxwa iinkqubo ayibuyiseki umva zophendlo lwezifo emzimbeni.

Ukuhlolisisa yesigulana

Ehlasela kukwenzakala axonal ibanjiwe kuphela ngokusebenzisa CT kunye MRI. Ezi Ubuchule kuvumela isifundo mkhanya obonakalayo ukwanda ezingaqhelekanga hyperemia emzimbeni okanye nokudumba ngenxa ucinezelo le ventricles. Ezishicilelweyo kunye nezinye iimpawu inkunzi. Ngoncedo yeengcali CT banethuba ukuvavanya umfanekiso lwezonyango kunye enze uqikelelo lweThutyana elizayo. MRI ebonisa zonke utshintsho lwezidumbu, nomsindo ukopha buso okanye zinabile eziyelelene ukwenzakala ehlasela axonal. Ubungakanani imeko zophendlo lwezifo uzimisele kwakhona ngokusekelwe livakale ngemagnethi ufundo tomographic. Iziphumo ukuvumela ukuba ukhethe uthomalaliso kangangoko umguli. ukuxilongwa kwi okuhlatywa basis empontshwa. Le nkqubo kubaluleke kakhulu ukuba ekufumanekeni legazi subarachnoid yokuqala. Nale okuhlatywa lubonisa ubukho koxinzelelo oluphezulu intracranial. Le nkqubo contraindicated kwizigulane kunye neenkqubo umthamo intracranial ezibangela dislocation ingqondo.

CT aphumela kwi ixesha yayiyazi

Kuyenye yeendlela ukonakala kwengqondo axonal ephawuleka ukuziphawula ilungu okanye umqulu ngomlinganiselo. Kwakhona, isithintelo emsebenzini, kwaye kwezinye iimeko ucinezelo epheleleyo III kunye ventricles osecaleni, amaqula isiseko convexital kunye neendawo subarachnoid. Utshintsho esiqwini ezixineneyo, njengoko umgaqo, kuba ubhalo normodensitivnym, kodwa waqaphela ukwanda okanye ukuncipha. Xa umcimbi emhlophe, I-, isiqu kunye nezakhiwo subcortical amaninzi zifumaneka hemorrhages ezincinane focal. Nceda uqaphele ukuba i-CT umfanekiso isigulane kuhlala ibanga lobudala imigangatho. Dynamics ezigulane ababonisa yokwenzakala ehlasela axonal zobuchopho, luphawulwa uphuhliso inkqubo atrophic. Ngokukodwa, ziphawuleka ventriculomegaly, ukwanda convexital carcinomas izithuba subarachnoid. Ngamaxesha kamva emva kokonzakala (emva malunga 3-4 iiveki) sivame ukuqokelelana ulwelo fluid kwimimandla ngokungqalileyo, fissure interhemispheric (kwiindawo zawo cipande kwindawo ethile). Zishenxiswe ngethuba nokuzinziswa yengqondo kunye nobume luvo. Obu bubungqina engangqalanga umthamo ekuphulukenwe nalo emva umonakalo ebuchotsheni. ukwenzakala ebuchotsheni lakha abantwana rhoqo kwaye ngaphezu abadala anganikela kunyango.

Iziphumo ze-CT

ipateni Ngokutsho ingaba kulingane ukugweba ubukho okanye ukungabikho wegazi intracranial. Ukuba CT awukhuselekanga isiseko itanki kunye ventricle, okanye kubonakaliswa ezikhoyo ucinezelo zabo ezimbi ye linokuba ich eliphezulu. Oku kunokuba kusengqiqweni ufakelo probe xi intracranial kunye nokulungiswa kwayo okwalandela. Ukuba CT ngokucacileyo CSF kuphuma phecana, ingakumbi ventricle kunye amaqula, ICP, mhlawumbi phakathi umngxuma. Akuthandeki ukuba amanyathelo ejolise ekunciphiseni yayo, kuya kuba luncedo kwixhoba. Izigulane wabonisa zibangwa isiqu umonakalo lokuqala okanye ezenqanaba lesibini nezakhiwo hypothalamic-yebhinqa ebalulekileyo osmotic homeostasis disorder. Xa izigulane hyperosmolar oluphakathi karhulumente waphawula iziphumo ezithandekayo ngakumbi, ngaphezu kukubi kakhulu kaninzi kwenzeka ekufeni.

Pathogenesis

zoviwo kokukhulu sibone ukuba akukho lutshintsho etshabalalisayo izitho carcinomas kwiindawo zangaphandle. Ngelo xesha kwi mba ezimhlophe kukho iinkalo izilonda enzonzobila. Kananjalo kubonakele hemorrhages basekuhlaleni kwiindawo ezahlukeneyo zobuchopho. Kuya kuvavanywa histologically. Oku uyakwazi ukubona ubukho "iibhola axonal." Ezi zinto zenza iinkalo discontinuity kwi kwalapho. Ukongeza, iimviwo histological lubonisa utshintsho isilinda ubhalo etshabalalisayo kunye thickenings varicose asakhulayo. Inyanga emva yokuduka ukonzakala iibhola nonyebeleziso macrophage kwindawo ngokulungiswa. Olunye utshintsho kwenzeka lisesingxobeni myelin, nokuqhubeka iinkqubo zophendlo lwezifo kwi luvo lwe iinxalenye peripheral-luvo. Kwakhona ukuphuhlisa luvo neerhali umnqonqo.

Treatment: Ubume

Izigulane ababonisa ukwenzakala ehlasela axonal, unyango unikwe enobuzaza kubandakanya iindlela ezininzi. Ngokukodwa, izigulane kufuneka ukuba aqhube umoya elide ngomatshini (umoya) eyenze mode hyperventilation. Abelwa therapy ekusebenziseni equka ukusetyenziswa kweziyobisi vasoactive kunye nootropics, nokugcina uzinzo kwiinkqubo pathways usebenzisa amacala (enteral) kunye nesondlo parenteral. ungenelelo Surgical kuvame wabelwa kuba akukho zeendawana, nto leyo isuswe. izakhi Surgical ubhaqo elenzelwa ezinye ukungaqheleki phambili ngokubonelela uxinzelelo phezulu ubuchopho kwanangamacandelo alo. Ngenxa izehlo eliphezulu iingxaki extracranial (yemiphunga nezengekho pyoinflammatory, kubhetele) zifakiwe kwi ikhondo kwezonyango iziyobisi antibacterial kunye nemisebenzi immunocorrecting.

Icebo ukungenelela zonyango

Izigulane kwentamo ukwenzakala ebuchotsheni axonal esibhedlele esibhedlele. Ukusekwa kwe zakhiwo yeMilinganiselo uhlobo zonyango kunye nokuhlenga. Kule nkqubo, ngakumbi, oko kuquka:

• Mpilo ukugcina ukusebenza nokuzinzileyo isixokelelwano sokuphefumla.
• Tube ukutya.
• labagula kakhulu amayeza.
• Ukugcina yesiqhelo balance fluid kunye electrolyte.
• Kwezinye iimeko, ukusetyenziswa neurotransmitters, zokukhuthaza biogenic.
• imithambo kwezonyango, ukukhuthaza kut- ukusebenza okuqhelekileyo imilenze, ukunqanda izifo omzimba.
• iiseshoni unyango kwintetho ngomsebenzi ilizwi sinjalo.

Emva msebenzi ufuna akukho sokubuyisa ixesha ekuphulukenwe ngokukhawuleza emva esibhedlele ixesha elide. Ukuzinzisa le meko luvo, ingqondo ukuvala umsebenzi kakuhle, ukukhawulezisa isantya kwimeko yesiqhelo kufuneka babe ukuqeshwa olujikeleza kunye arhente neuroprotective. Kusenokwenzeka kufuna ukusetyenziswa mziba biogenic, iziyobisi echaphazela izihlunu ukutya kunye, ngokutsho nezalathisi, neurotransmitters (lithetha "Madopar", "L-Dopa," "Lac" kunye nabanye), kunye neziyobisi anticholinesterase. Ukuba DAP akukho mfuneko yokuqeshwa unyango hormone.

Outlook

Amathuba izigulane unyango kunye WCT iya kuxhomekeka ubukhulu bomonakalo ukuya axons, ubukho nokudumba, kungenzeka wokujoyina iinkqubo zophendlo lwezifo extracranial. Ekwenzeni i zokungenelela entsonkothileyo kwezonyango kwixesha elifutshane yabaneziphumo ezihle kakhulu amathuba okuba. Nge waqhubeka ixesha elide isiqaqa kwandisa umngcipheko iingxaki. Xa kunabela kwenyusa amathuba neziphumo ezibi, ngokulandelelana, kunciphise kwaye kungenzeka achache. Okubaluleke ngokulinganayo ubunzulu okanye ukuba khokhoma. I nzima oko, kubi nesiphumo. Inqununu ingaqatshelwa ithuba recovery ngokupheleleyo okanye olungaphelelanga ezilahlekileyo imisebenzi yengqondo Isemantiki ukuphazamiseka luvo, nakumatyala umonakalo apho isigulane emva isiqaqa elide wambumba iwonga kwezityalo elide ukusuka kwiiveki ezimbalwa iinyanga. Esi simo singachaza ukuba kukho amathuba ukuyilungisa kunye nembuyekezo neurotransmitter nokuphazamiseka beemeko ezisisiseko ukuphazamiseka ezingisileyo umsebenzi ezisebenzayo kwi ingqondo emva kwentamo ukwenzakala axonal.