I-Tholos-Hunt syndrome: ukuxilongwa nokunyangwa

Nangona izinga eliphezulu lokuphuhliswa kweyeza, ezinye iintsholongwane zihlala zingachangeki kude kube sekupheleni. Esinye sezi zifo sisifo se-Tholos-Hunt. Okwangokunje, kuphela iimpawu zale pathologia zaziwa, ngelixa izizathu zingakabonakaliswa ngokupheleleyo. Oku kunokwenzeka ukuba oku kubangelwa kukuba eso sifo asiqabile kwaye sivulekanga kungekudala. Ukongeza, i-Tholos-Hunt syndrome isoloko "igxininiswe" kwezinye izifo, kwaye kulula ukudibanisa. Uphawu oluphambili ngumonakalo kwamehlo kunye neentsholongwane ze-cranial. Kuyaziwa ukuba enye yeepropati zesi sifo kukuba ibolekisa kwi-hormonal therapy, emva koko kukho ukuphuculwa ngokukhawuleza. Nangona kunjalo, ukuphindaphinda kungenzeka nanini na.

Inkcazo ye-Tholos-Hunt syndrome

Ukukhankanywa kokuqala kwesi sifo kubonakala kungekudala. Kwachazwa ngo-1961 ngu-Hunt ophthalmologist Hunt. Ukongezelela kwigama eliphambili, i-pathology ikwabizwa ngenye indlela, umzekelo, "i-chameleon". Oku kubangelwa kukuba iimpawu zakhe zifana nezinye izifo ezininzi. Phakathi kwazo: iintloko ze-tumors, i-encephalitis, i-myositis-orbit kunye nezifo ze-hematopoietic system. Ukongezelela, i-patlosgy yeTholos-Hunt ibizwa ngokuba ngumqondiso we-globular fissure, engakhange ibonakalise ngokuchanekileyo intsingiselo yenkinga. Umfanekiso weklinikhi wesi sifo uthembele kwiimbono zeengqondo ezichaphazelekayo. Ngokuqhelekileyo, isifo se-Tholos-Hunt sibonakalisa intlungu kwindawo yokuhamba, ukungakwazi ukuhambisa amehlo, nge-diplopia. Xa unyango olusisiseko lwama-hormonal luqalise, ukunyanga okupheleleyo okanye ukuphumelela kwimeko yokugcina isisombululo.

I-etiology ye-Tholos-Hunt syndrome

Ngenxa yokuba i-pathology inezibonakaliso ezahlukahlukeneyo kwaye iqala ngokukhawuleza, ayikwanakwenzeka ukuseka i-etiology. Oku kubangelwa neziganeko eziphantsi zesifo. Ngenxa yoko, oogqirha abanalo ithuba lokufunda ngokufanelekileyo lesi sifo. Kukho iingcamango ezininzi ngokubhekiselele ekutheni i-pathology iyakhula. Kukho izinto ezilandelayo ze-etiological ezifumaneka kwizigulane ezine-Tolosa-Hunt syndrome:

1. Malformatsiya. Eli gama lithetha ukuphuhliswa okungavumelekanga kwenkqubo ye-vascular eye. Ngenxa yesiphumo, kukho ukuxutywa kwegazi kunye negazi elimnyama, okungafanelekanga. Oku kwaphulwa ngokuqhelekileyo phakathi kwabantu besetyhini.
2. Ulwahlulo oluzenzekelayo. Le nto yindlela yokuqala yezifo ezininzi. Nangona kunjalo, ukuphendula umbuzo othi kutheni amangqamuzana omzimba aqala ukutshabalalisa izicubu zomzimba, akunakwenzeka. Kwiimeko ezininzi, "ulwaphulo" lwenzeka emva kokunyanzeliswa koxinzelelo kunye neenkqubo eziqhubekayo zokusasazeka.
3. Iinkalo ezahlukeneyo zobuchopho kunye neentsholongwane zomzimba. Ingaba yimizimba yomzimba, ibe yintsholongwane.

Indlela yophuhliso lwe-syndrome

Ukuqwalasela ukuba i-etiology yesi sifo ayisaziwa, i-pathogenesis ayikwazi ukufunda ngokupheleleyo. Kungakhathaliseki ukuba zezizathu zokuphuhliswa kwentsholongwane, zikhona izakhiwo ezithile zamehlo kunye nezicubu zeentlungu ezichaphazelekayo. Njengoko kwaziwa, igama lesibili lesifo sisifo se-globular fissure. Oku kubangelwa yi-pathogenesis, kuba iimbasa kunye neempahla ezidlulayo zichaphazelekayo. Okokuqala, kukho utshintsho kwi-vein ophthalmic and artery. Ngenxa yoko, izicubu ze-trophic ziphazamiseka. Ukongezelela, i-cavernous sinus yonakalisiwe, edibene neyengxube ye-orbital ephezulu. Iimitha zegazi, ukunikezelwa kwegazi, zivutha, kwaye izicubu zixhomekeka. Njengoko kuyaziwa, le mijelo ye-cranial elandelayo idlula kwi-cleft : ukuvimba, ukukhenkcela, inxalenye yeentlanzi kunye ne-oculomotor nervo . Kwezinye iimeko zonke ezi zibini zichaphazelekayo. Ngelo xesha, ukukwazi ukujikeleza i-eyeball ibona. Ngamanye amaxesha umsebenzi womnye okanye ezimbini ezibini zeentlungu ziphazamiseka.

I-Tholos-Hunt syndrome: iimpawu zesifo

I-Pathology kaninzi iyenza ibe yinto evelele kwixesha elidala kunye nelidala. Le syndrome inokuchaphazeleka ngabafazi kunye namadoda. Umfanekiso wekliniki wesi sifo ukhula ngokukhawuleza, ngaphandle kokufunwa. Ukwabela iimpawu ezilandelayo:

1. Ubuhlungu kwindawo engabonakaliyo. Imvakalelo engavumelekanga yokuqala ibonakale ebunzini, iinqonga eziphezulu, intloko. Kamva, ubukhulu bentlungu buyanda, buya kwanda kwamehlo.
2. Diplomacy. Esi sibonakaliso sibonakala emva kokuphuhliswa kweentlungu zesifo. Kubonakala kwisigulane ukuba zonke izinto azijongayo zihambelana. Ukugxininisa imbono kunzima.
3. Ukuphambana nokuhamba kwe-eyeball-ophthalmoplegia. Idla ngokugqithiseleyo kwelinye icala. Isiganga sawo sincike ekutheni ubuninzi kunye nenani leentsholongwane ezichaphazelekayo.
4. I-Edema ye-conjunctiva.
5. Exophthalmos. Kuyabonakala ekungabikho kwonyango kunye nokuphindaphindiwe kwakhona.
6. Strabismus. Kuyenzeka xa iimbilini zichaphazeleka kuphela kwicala elinye.
7. Ukugqithisa ukushisa nokuhlaselwa.

Ezi zimpawu zikhula ngokuthe ngcembe kwaye zitshintshana. Kwezinye iimeko, zonke ziyaqwalaselwa ngokufanayo. Imiqondiso yesifo iyakonakala ngokukhawuleza, njengoko yabonakala. Nangona kunjalo, ngaphandle kokonyango, ukukhubazeka kusoloko kubonakala kwakhona. Ixesha lokuphindaphinda lihlukile kubo bonke, kwakunye nobude bokuxolelwa.

I-Tholos-Hunt syndrome: ukuxilongwa kwe-pathology

Ukutyhila le pathology akulula, kuba iimpawu zayo zifana nezinye izifo ezininzi. Ngoko ke, i-Tholos-Hunt syndrome ithathwa njengesifo sokuxilongwa. Okokuqala, isigulane sibuzwa malunga neempawu zesifundo sesi sifo (apho saqala khona, indlela iimpawu eziphuhlisiwe ngayo). Emva koko, uphando lwebhubhoratri kunye nokuxilongwa kwezixhobo zenziwa. Kubaluleke kakhulu ukuqhuba uvavanyo lwe-ophthalmologic ne-neurological. Ukungabandakanyi izicubu zengqondo, i-MRI yenziwa. Kwakhona kubalulekile ukuqhuba i-ultrasound kunye nokuhlolwa kwe-X ye-eyeballs. Ubukho be-malformation ye-vascular buchongwa ngu-angiography. Ukongezelela, enye yeendlela zokuxilonga kukusebenza kwe-hormone therapy. Ukuba kwii-laboratory kunye nezixhobo zeengqungquthela azikho iinguqu ezitshintshiweyo, kwaye iimpawu ziyeka ngokukhawuleza emva kokunyanga, ngoko ke, mhlawumbi, ukuxilongwa yi-sylos of Tholos-Hunt. I-Prednisolone isetyenziselwa unyango kakhulu.

Ukuxilongwa ngokwahlukileyo kwezinye izifo

Esi sifo siqhathaniswa nezinye izifo zamehlo kunye nenkqubo yesifo. Okokuqala, kuyimfuneko ukukhuphela iinkqubo ezivuthayo zengqondo kunye nezibilini zayo, kunye nezicubu. Xa ukhunjulwa nge-meningitis okanye nge-encephalitis, ukutyhulwa komgudu kwenziwa. Ukuze ungabandakanyi izicubu ezinomdla kunye nomhlaza, isigulane singena kwi-MRI, CT yengqondo kunye ne- X-ray yeckull. Esi sifo sichasene ne-lymphomas, i-cavernous sinus cyst kunye ne-thrombosis yayo. Kwakhona, iimpawu ezifanayo zingabonwa kwi-pathologies yenkqubo, njenge-sarcoidosis, i-myositis, i-migraine, njl. Ukwenza i-diagnostic echanekileyo, isigulane kufuneka ihlolwe ngabachwepheli abahlukahlukeneyo: i-ophthalmologist, i-neuropathologist, i-surgeon ye-vascular, i-endocrinologist.

Unyango lwe-Tholos-Hunt unyango

Unyango lwesifo se-Tholos-Hunt kukulawulwa kweziyobisi ezinqanda umzimba wokuzivikela. Ukwenza oku, amayeza anama-hormone asetyenziswa: "Prednisolone", "Hydrocortisone". Ezi zi yobisi zinefuthe kwezinye izifo ezithintekayo, kodwa nangaloo sifo iimpawu sele zisezinsukwini eziyi-3-4. Unyango lwe-Tholos-Hunt syndrome kunye ne-prednisolone lwenziwa ngezinga le-1-2 mg / kg yesisindo somzimba. Ukuba isilwanyana sisetyenziswe ngendlela yesisombululo, ngoko imiselwe ukususela kwi-500 ukuya ku-1000 mg ngosuku. Ukongeza, i-anesthetics kunye namavithamini zisetyenziswa.

I-Tolos-Hunt syndrome

Ngokuqhelekileyo kunye nokuxilongwa, umsebenzi wegulane uyagcinwa. Kubalulekile ukuqinisekisa ukuba isiguli sinesifo seTolos-Hunt. Ukukhubazeka kule nkathalo kuyinto engavumelekanga. Nangona kunjalo, ngokuphindaphinda kwakhona, amaqela a-3 anganyulwa. Isigulane sifanele sithunyelwe kumsebenzi olula ongafuneki umzamo. Kwakhona, nangomonakalo oqhubekayo wenzwa, isigulane asikwazi ukuqhuba isithuthi ngenxa yokuphulwa kwentshukumo ye-eyeballs kunye ne-diplopia.

I-Tholos-Hunt syndrome prophylaxis

Akunakwenzeka ukuqikelela ukuphuhliswa kwe-Tholos-Hunt syndrome kwangaphambili, ngoko akukho nto inqandekileyo yokukhusela. Ukuba iimpawu ezinjengeentlungu emehlweni nasebunzini, i-diplopia ikhona, ngoko kufuneka kuqhutywe i-diagnostic. Kwi-sylos ye-Tholos-Hunt, ukukhusela okwesibini kuyimfuneko. Iquka unyango lwama-hormone ngexesha elifanelekileyo, inkxaso yokukhuselana. Kwakhona kuyimfuneko ukuphepha iingxaki ezixinzelelekileyo kunye neenkqubo ezivuthayo.