Chvostek izimpawu, Trousseau, Lust. uphawu Chvostek ezinganeni: ukwelashwa

Lapho ukuphazamiseka calcium-phosphorus umzimba, okuyinto kuhambisana ngokulinganisela yamathambo ezinzima, 4% izingane ukuthuthukisa spazmofiliya ebizwe futhi tetany kwezinsana. Lokhu zokugula kuhambisana zibe of imisipha wemikhawulo, ubuso, amalaka, kanye ukuvela Ukudlikizela ezivamile clonic kanye tonic. Lembula, njengoba umthetho, esikhathini kusuka ezinyangeni ezintathu ubudala futhi kuze kufinyelele eminyakeni emibili. Omunye ukubonakaliswa esicace sifo ziya abasafufusa izimpawu chvostek, Trousseau futhi Lust ukusiza ukuthola kobukhulu isifo egeleza. Ukuze ufunde indlela ukuchaza lezi zimpawu ziphathwa nokuthi sizobe ngani kulesi sihloko.

Indlela hlola izimpawu spazmofilicheskie

Ukuze uqinisekise khona izimpawu chvostek, idluliselwe kwenye mkhuba emsipheni ebusweni, ingane ibekwe embhedeni ngaphandle umcamelo. Imilenze ngesikhathi esifanayo kufanele kube liqonde, futhi izandla - amanga kanye umzimba.

Uphawu ihlolwe ukukhanya evunyelwe eshaywayo isando izinzwane noma endaweni uphume emsipheni trigeminal (ngenhla lwaleli zygomatic). Uma isiguli iza ukudikiza okungalindelekile ka kweyikhulu ekhoneni udebe eliphezulu, wabe esethi uphawu kubhekwa omuhle. Yakhe, ngasendleleni, uhlole kokubili izihlathi.

Izimpawu chvostek babe 3 lamadigri ukubonakaliswa:

1. Imisipha lonke endaweni innervation we emsipheni ebusweni.
2. Imisipha ekhoneni emlonyeni kanye nekhala iphiko.
3. Ukusikwa imisipha nje ekhoneni lomlomo wakhe.

Uma manifest tetany esiboniswe degree ingane yokuqala uphawu ngisho nge touch ukukhanya endaweni emsipheni ebusweni.

izindlela engeziwe iqinisekiswa izimpawu antispasmodic

Ayikho zincane ngokuya sokunquma kobukhulu isimo somntwana kuwuphawu Trousseau futhi Lust.

• Uphawu Trousseau Kutholwe ehlombe kokucindezelwa phakathi kwengane. Kulokhu, udokotela kufanele azame ukuthatha ngangokunokwenzeka izicubu zomzimba ezithambile wezandla zakhe. Uma ngenxa yalesi (cishe 2-3 imizuzu ngemva kokucindezela) endaweni iminwe nesineke ukuthatha isimo ophoqelelwe, ngokuthi "isandla obelethisayo" (ie, isithupha kunikezwa entendeni, index ngomunwe futhi phakathi zenzeka, futhi esiyingini umunwe kancane - flexed), uphawu kuthathwa omuhle. Ukuze uhlole ubukhona bamagama izingane ezindala noma abadala ungasebenzisa cuff sokulinganisa blood pressure ngu efutha yona ugaye ukunqanyulwa.
• Ungakhanuki uphawu ihlolwe esebenzisa isando, okuyinto uthephwe ngemuva ekhanda encane tibia, noma ukusikwa imisipha gastrocnemius ku Achilles umsipha ndawo. Uma isiguli lapho kukhona sokuhoxisa okungalindelekile senyawo ( "unyawo Ballerina"), uphawu angabhekwa omuhle. It iyenziwa zombili emikhawulweni.

Chvostek izimpawu, Trousseau, Lust kubhekwe spazmofilicheskimi. Njengoba eqhubeka ehamba aba omuhle, uma kwenzeka ingane egulayo egazini ushintshe inani calcium obhekene imisipha. Ukuze lokhu kungaholela hhayi kuphela kuze kube sekubeni khona yamathambo, kodwa futhi nezinye izifo.

Kuyini tetany

Chvostek Izimpawu kanye izimpawu kukhona spazmofilii Tissaurd (tetany). Lesi sifo libhekene anda excitability kwemizwa, okuyinto kubonakala imisipha amajaqamba nemilenze noma umphimbo. Ngokuvamile, lokhu zokugula is ebonwe abafana ezinyangeni zokuqala eziyisithupha zokuphila.

A isisekelo walesi sifo igazi ongaphakeme calcium ionized ingane.

Yeka indlela okuyingozi uphawu ezinganeni chvostek

Izithombe izingane tetany, esisiza ukuba siqonde yiziphi izimpawu zesifo. The main wabo - laryngospasm, okuyinto waveza umoya basebenzile, ubuso okhanyayo, ukujuluka, futhi ngezinye izikhathi nokulahlekelwa ukwazi. Libhekene njengoba zibe gqwa izinyawo nezandla (karpopedalny spasm) edlulisela amahora ngezinye izikhathi eziningana. Kukhona nezinye izinhlungu zibe kwemisipha namaqembu - zokuphefumula, ukuhlafuna iso, njll ...

Kodwa uphawu ezinzima iningi isifo ubhekwa ngokuhlasela eclampsia - nokuquleka clonic-tonic aqala imisipha ukunyakazisa ubuso badlulele zibe of izitho futhi laryngospasm. Ingane ne avame ilahlekelwa ukwazi, Foam liyavela izindebe, kukhona ukuchama okungalindelekile. Eclampsia Ubungozi kungenzeka ukuboshwa kwemigudu yokuphefumula noma ukumelwa inhliziyo.

Ubani singenzeka tetany

Ezinsukwini zokuqala zokuphila nezimo convulsive futhi hypocalcemia ngokuvamile zenzeka ezizalwa ngaphambi kwesikhathi, amaphahla, futhi baye bahlupheka jaundice noma izifo ezithathelwanayo.

Chvostek uphawu e abantwana bakwa ezinyangeni zokuqala zokuphila futhi kungenziwa senziwa ukwehla ne-calcium eyanele kwezingane, anda uketshezi of calcitonin. Lesi simo yezokwelapha elihlobene ne ukungena kahle ne phosphorus ne-calcium ehlome ukudluliswa ingane zidla ubisi cow sika, kanye (ezimweni ezingajwayelekile) ngenxa yokuntula vitamin D ne-calcium umzimba kamama.

Njengomthetho, izingane wabonakaliswa hypocalcemia kwamanyuroni excitability, Ukudlikizela, ukuhlanza, tachycardia, futhi izimpawu zokuphefumula.

ukwelashwa tetany

Eclampsia ukuhlaselwa udinga usizo ngokushesha ingane, futhi esimweni engasayi ukuphefumula noma inhliziyo - futhi yokusiza umuntu ukuba aphefumule.

Kunoma yiluphi uhlobo lokusebenzelana tetany ingane esimisiwe anticonvulsants ( "Sibazon" intramuscularly noma ngemithambo yegazi, "sodium Oksibarbutirat" esicutshini, "Phenobarbital" rectally, ngemlomo nobe suppositories nokunye. P.). Liphinde eboniswe abaphathi emthanjeni 10% isixazululo of calcium gluconate noma esicutshini 25% isixazululo of magnesium sulfate.

Spazmofiliya izimpawu okubangela chvostek futhi Trousseau, ngokuvamile has a Izibikezelo evumayo ezimweni eziningi. Ingozi iba laryngospasm nokuthatha isikhathi eside kuphela, okuyinto okusongelayo ukumisa ukuphefumula.

Lapho kokufinyelela eminyakeni ewu ingane iminyaka 2-3 isimo sokugembula siqedwa ngenxa kuqiniswa ezingeni igazi ukhiphe i-calcium ne phosphorus.

Hypoparathyroidism - isifo kuhambisana izimpawu chvostek

uphawu Chvostek - liphinde uphawu olucacile of isimo sokugembula ngokuthi hypoparathyroidism, lapho ukwehla umsebenzi we nezindlala parathyroid. Ngokuvamile, le nkinga kwenzeka ngenxa uhlinzwe ukuze kwelashwe isifo yegilo noma khona kuwo we ukuvuvukala. Ngezinye izikhathi ukungasebenzi kungadalwa izinqubo ezithathelwanayo ezifana nesimungumungwana noma umkhuhlane.

Neonates hypoparathyroidism eba esimweni ukungabi azalwa naso we nezindlala parathyroid futhi nokucindezela operation babo yanda osenyameni unina ngesikhathi sokukhulelwa i-hormone parathyroid.

Isiguli ngaleyo ndlela ngokuvamile ukutholwa ukwehla igazi calcium parallel okwandisa phosphorus okuhlushwa. Futhi ngokusobala isivele sobala tetany kuchaziwe, izenzakalo emathunjini, ukukhula okungavamile amazinyo, izinwele nezinzipho, kanye nezinguquko esikhumbeni.

Ezimweni ezinjalo, izimpawu chvostek futhi Trousseau, kanye ukuhlolwa laboratory usizo ngokunembile bona okuyinto athuthukiswe isimo tetanic futhi uphethwe isiguli.

ekwelapheni hypoparathyroidism

Ukuze ekwelapheni lesi sifo kubalulekile ukucabangela izizathu zokushaywa ivela khona nobukhali izimpawu. Ngo ukugula acute nge izimpawu phakathi kokuphathwa eziphuthumayo tetany Kunconywa 10% of calcium chloride noma calcium gluconate ngemithambo yegazi. Lokhu kwenziwa kancane, ikhumbula iqiniso lokuthi isixazululo lokuqala okukhulunywe iqukethe 27% izinto homonymous futhi okwesibili kuba% 9 kuphela.

Ngokuvamile, ukuze kuqede izimpawu chvostek ezidinga imithi yokwelashwa calcium izinsuku okungenani 10. umphumela omuhle ubeka ne-calcium eyanele, odokotela belulekwa ukuba wenze lokhu by Ukuqedwa izidakamizwa ubisi womuntu, ukuvimbela ukuthuthukiswa kolwelwesi.

isimo hypoparathyroidism Okungalapheki kudinga yokwamukela uvithamini D, sithome bolus (200-300 eziyinkulungwane. U. Per ngosuku), kanye nokulawula esiyisibopho phosphorus kanye le-calcium egazini kanye nezinga labo emva ukuzinza umthamo sehliselwe ayizinkulungwane 50. U. ngelanga e izingane ezingaphansi konyaka, noma kuze kube izinkulungwane 125. amayunithi. - in iziguli ngemva konyaka.

Ngasiphi nezinye izifo unezimpawu Trousseau futhi chvostek

Ngaphezu izifo ezibangelwa kuphela ukwehla nganoma yisiphi isizathu, i-calcium-plasma yegazi, izimpawu chvostek, Trousseau futhi Lust kungavela kwezinye izifo. Lezi zihlanganisa:

• Neurasthenia nge isimo ukukhathazeka-hypochondriac, ebonakaliswa ngesimo hyperventilation syndrome. Isiguli e ngako kulendzaba kusho kwati gqwa ukuphefumula disorder isigqi ukuthi ulingisa isifuba somoya, nge umuzwa yinhlama emphinjeni, Ukuphelelwa, futhi ngezinye izikhathi nge nokulahlekelwa ukwazi kanye nokugoqana komzimba.
• izinqubo Dyscirculatory, kuhlangene asthenic futhi asthenic-Neurotic syndrome, elinesimo isimo njalo ukukhathala nokutubeka, kanye ikhanda, ubuthongo thuthuva, futhi inzululwane.
• Hysteria, isithuthwane kanye nezinye izifo.

Ukuvimbela iziyaluyalu izinga le-calcium ingane

Njengoba cishe kakade kubonakala izifo obuhambisana uphawu chvostek ezinganeni ukwelashwa kuyehla ekubuyiselweni elibalulekile ukuze amazinga evamile nge-calcium ne phosphorus igazi. Ngakho-ke, nokuvinjelwa pathologies futhi kudinga ngokuyinhloko ukulawula lokuhlushwa izinto okuyinto eyenziwa nodokotela bezingane Precinct.

Kubalulekile ukwakha kwezimo ezifanele ukuthuthukiswa umbungu kwabesifazane abakhulelwe. Kuze kube yimanje, uma umama okhulelwe baphila ezimweni zenhlalo abampofu noma basengozini (isifo sikashukela, nephropathy, umfutho ophezulu wegazi kanye rheumatism), wakhe wokugcina 2 izinyanga yokukhulelwa linqume kavithamini D. Ngo sokukhulelwa evamile ukunamathela eyanele umsoco futhi umzimba.

Usana, ngakho waqhubeka ekhula ehlala ehlane eqinile nenempilo, kubalulekile ukuba khona ibele, isingeniso ngesikhathi esifanele ukudla aphelele, ukuhlala nsuku zonke endaweni evulekile, swaddling khulula ukubhucungwa, ejimini futhi ukukhanya emoyeni nokugeza.