Iimpawu Chvostek, Trousseau, Lust. uphawu Chvostek kubantwana: unyango

Xa disorder ikhalsiyam-phosphorus ukutya, nto leyo sikhatshwa olungephi ukuya yamathambo kakhulu, 4% abantwana baphuhlise spazmofiliya, ebizwa kwakhona tetany usana. Le ngezifo lukhatshwa ziba izihlunu kweqondo, ubuso, kwingqula, kwakunye ukuvela unditsho eziqhelekileyo clonic kunye tonic. Lityhila, njengoko umthetho, kwisithuba ukususela kwiinyanga ezintathu ubudala yaye ukuya kwiminyaka emibini. Enye mpawu zicacileyo sifo ezisakhulayo iimpawu chvostek, Trousseau kunye Lust ukunceda bana phandle ubungqongqo sifo ugeleza. Ukuze ufunde ukuchaza indlela ezi mpawu baphathwa kwaye uza nendlela esiza kuxubusha ngayo kweli nqaku.

Indlela ukuhlola iimpawu spazmofilicheskie

Ukuze uqinisekise ubukho iimpawu chvostek, wabhekisela kwenye mkhuba le luvo yobuso, umntwana obekwe kwi ebhedini ngaphandle komqamelo. Imilenze ngexesha elinye kufuneka ngqo, kunye nezandla - alale ecaleni umzimba.

Uphawu wahlola ukukhanya uthinte iinzwane zibuphekhashini izando okanye kwindawo yokuphuma ye-luvo trigeminal (ngaphezu arch zygomatic). Ukuba isigulane uza twitching ngokuzenzekelayo yenkulungwane kunye oluphezu iindevu, adanduluke, wathi ngoko uphawu uthathwa HIV. Yakhe, endleleni, khangela kuzo zombini ezidleleni.

Iimpawu chvostek iyahluka 3 ukubonakaliswa:

1. Muscle nokuncipha kuyo yonke indawo innervation ye-luvo yobuso.
2. Muscle nokuncipha kwikona yomlomo kunye nephiko impumlo.
3. Yindibanisela izihlunu nje ekoneni yomlomo wakhe.

Ukuba bubonakale tetany ebonakaliswa umntwana zesidanga sokuqala uphawu nokuba ngokundibamba ukukhanya kwingingqi ye-luvo yobuso.

iindlela ezongezelelweyo okuqinisekisa iimpawu antispasmodic

Akukho kangako ngokwemiqathango yokumisela ubuzaza imeko usana yeyona iliphawu Trousseau kunye Lust.

• Uphawu Trousseau ibhaqwe igxalaba ucinezelo umntwana eliphakathi wakhe. Kulo mzekelo, ugqirha kufuneka azame ukuthabatha kangangoko kunokwenzeka kwizihlunu ezithambileyo kwezandla zakhe. Ukuba ngenxa yale (malunga 2-3 imizuzu emva ucinezelo) ngendlela iminwe nomonde ukuthatha imeko ngenkani, ebizwa ngokuba "obstetrician isandla" (oko kukuthi, nasesithupheni inikwa wesundu, umnwe ophakathi eyitwabulule, kwaye umsesane kunye Ucikicane - imisipha), uphawu Oku kucingwa HIV. Ukujonga ubukho abantwana abadala okanye abadala ungasebenzisa i cuff umlinganiselo ukuba uxinzelelo lwegazi afakwe umoya ukuba imifino avalwe.
• Nenkanuko uphawu bahlolwe ngokuthi isando, leyo yasentabeni emva kwentloko encinane lesiquluba, okanye yindibanisela esihlunwini gastrocnemius kwi imicu kummandla Achilles. Ukuba isigulana xa kukho emuva ngokuzenzekelayo le unyawo ( "unyawo webhaleyi"), kungaba uphawu ulungile. Ikhangelwe kuzo zombini yesiqephu.

Iimpawu Chvostek, Trousseau, Lust ingqalelo spazmofilicheskimi. Baba HIV, ukuba umntwana egazini kwenzeka ukutshintsha ubungakanani calcium elinoxanduva imisipha. Ukuze oku kunokukhokelela nje kuphela ubukho yamathambo, kodwa nezinye izifo.

Yintoni tetany

Chvostek Iimpawu kunye iimpawu spazmofilii Tissaurd (tetany). Esi sifo sizibonakalisa ngokwanda excitability luvo, nto leyo ebonakalisa imisipha amahlaba imilenze okanye kwingqula. Amaninzi, le leengxaki uyaqapheleka amakhwenkwe kwiinyanga zokuqala ezintandathu zobomi.

A isiseko eziphilayo kwesi sifo igazi eliphantsi calcium insimbi umntwana.

Njani yingozi uphawu ebantwaneni chvostek

Iifoto abantwana tetany, ukuvumela ukuba siqonde ukuba yintoni na iimpawu zesi sifo. Eyona kubo - laryngospasm, nto leyo kubonakaliswa ukuphefumla babulalekile, ubuso luthuthu, ukubila, yaye ngamanye amaxesha ilahleko lokuqonda. Kwachazwa ngokuthi aqaqambayo ngamaxesha iinyawo nezandla (karpopedalny spasm) ukwandisa iiyure maxa wambi eziliqela. Kukho nezinye inkantsi kwimisipha kunye namaqela - zokuphefumla, ukuhlafuna, iliso, etc ...

Kodwa uphawu ngokuqatha esi sifo luthathwa kokuhlaselwa eclampsia - ukuxhuzula clonic-tonic eziqala twitching izihlunu kobuso, badlulele ziba imilenze kunye laryngospasm. Umntwana kunye kakhulu ulahlekelwa ezingqondweni, lo alephuze amagwebu kubonakala phezu komlomo, kukho ukuchama ngokuzenzekelayo. Eclampsia Umngcipheko ukubanjwa kunokwenzeka zemiphunga okanye intliziyo.

Ngubani na khona tetany

Ngemihla yokuqala yobomi iimeko convulsive kunye hypocalcemia ngokuqhelekileyo kwenzeka ezizalwa ngaphambi kwexesha, la mawele, kwaye ubunzima senyongo okanye izifo ezosulelayo.

Chvostek uphawu ebantwaneni iinyanga yokuqala yobomi yaye kuxhokonxwa ukuncipha calcium lokuthathwa abantwana, kunye nokunyusa secretion kwe calcitonin. Le imeko yempilo ezinxulumene yokungena nkene iphosphate kunye calcium ne usana transfer elibukhali lusidla ubisi lwenkomo, kwakunye (kwiimeko ezinqabileyo) kunye kukungabi ivithamin D kunye calcium emzimbeni sikanina.

Ngokuqhelekileyo, abantwana wabonakalisa hypocalcemia neuromuscular excitability, unditsho, ukugabha, tachycardia, kunye neempawu sokuphefumla.

unyango tetany

ukuhlaselwa Eclampsia zifuna uncedo ngoko nangoko umntwana, yaye kwimeko engasayi zokuphefumla okanye intliziyo - yokurhaxwa.

Xa naluphi uhlobo umntwana tetany elimisiweyo anticonvulsants ( "Sibazon" intramuscularly okanye yegazi, "sodium Oksibarbutirat" intramuscular, "Phenobarbital" rectally, ngomlomo okanye suppositories njalo-njalo. P.). Oku kubonakala ulawulo efakwa ka-10% isisombululo ikhalsiyam gluconate okanye intramuscular-25% nesisombululo wemagniziyam sulfate.

Spazmofiliya iimpawu ezibangela chvostek kunye Trousseau, idla ALS elihle kwiimeko ezininzi. Ingozi laryngospasm elide kuphela, nto leyo esongela ukuyeka ukuphefumla.

Akuba eneminyaka lomntwana kwiminyaka 2-3 imeko zophendlo lwezifo iyapheliswa ngenxa nokuzinzisa kwinqanaba egazini calcium phosphorus.

Hypoparathyroidism - sisifo lukhatshwa iimpawu chvostek

uphawu Chvostek - kukwayinto entle ngumqondiso ocacileyo imeko lwezidumbu ekuthiwa hypoparathyroidism, apho ukuhla umsebenzi kwamadlala parathyroid. Amaninzi, le ngxaki kwenzeka ngenxa ahlinzwe ngenxa yesifo lengqula okanye ubukho kuyo ngokwenkqubo arhabaxa. Ngamanye amaxesha kwekhono ezinokubangelwa ziinkqubo ezasulelayo ezifana imasisi okanye umkhuhlane.

Neonates hypoparathyroidism senzeka kwimeko yokungabikho naso kwamadlala parathyroid kunye kwezithandani yokusebenza babo zanda kukhululeka unina ngexesha lokukhulelwa hormone parathyroid.

Isigulana zazidla okufunyenweyo ukuhla calcium egazini ngaxeshanye kunye ekwandiseni phosphorus ingqalelo. Yaye kuyabonakala ukuba sele tetany kwacaca kuchaziwe, izenzakalo isisu, ukukhula okungaqhelekanga kwamazinyo, iinwele kunye nezikhonkwane, kwakunye notshintsho esikhumbeni.

Kwiimeko ezinjalo, iimpawu chvostek kunye Trousseau, kunye nemvavanyo zaselaborathri kunokukunceda ngokuchanileyo qwalasela eyathi yaqulunqa imeko tetanic kunye lokufunyaniswa isigulane.

ukuphathwa hypoparathyroidism

Kuba unyango esi sifo kubalulekile ukuba siqwalasele izizathu livela nobukhali iimpawu. Xa isifo etsolo iimpawu ngexesha nolawulo likaxakeka tetany ekucetyiswa-10% ikhalsiyam chloride okanye calcium gluconate yegazi. Oku kwenziwa kancinane, kuthathelwa ingqalelo into yokuba isisombululo ekhankanywe kuqala iqulethe 27% izinto homonymous kunye yesibini ngayo yi-9% kuphela.

Ngokuqhelekileyo, ukuze ukuphelisa iimpawu chvostek efuna amachiza onyango calcium iintsuku ezili-10. ukusebenza Good ibonelela calcium eyanele, oogqirha bacetyiswa ukuba ukwenza oku ezinyibilikayo ichiza elubisini yabantu, ukuze iyaluthintela uphuhliso gastritis.

imeko hypoparathyroidism Chronic kufuna nangokwamkela ivithamin D, kuqalwa bolus (200-300 amawaka. Kaya ngosuku), kunye ulawulo olusisinyanzelo phosphorus kunye calcium egazini kwaye inqanaba labo emva ithamo ukuzinza yancitshiswa ku-50 amawaka. Kaya ngosuku kubantwana abangaphantsi konyaka omnye, okanye ukuya ku-125 lamawaka. units. - kwizigulane emva konyaka.

Ngeliphi ezinye izigulo uneempawu Trousseau and chvostek

Ukongeza izifo ezibangelwa ukuhla kuphela ngenxa yaso nasiphi na isizathu, calcium kwi plasma yegazi, iimpawu chvostek, Trousseau kunye Lust kuboniswe kwezinye izifo. Ezi ziquka:

• Neurasthenia ne karhulumente nexhala-hypochondriac, wabonakaliswa ngokohlobo hyperventilation syndrome. Isigulana kule meko luhlangabezana ngamaxesha ukuphefumla disorder rhythm olungele isifuba, kunye nemvakalelo yokuba iqhuma emqaleni, Ukuphelelwa, yaye ngamanye amaxesha kunye nokulahlekelwa sezingqondweni yombono.
• iinkqubo Dyscirculatory, kudityaniswe syndrome asthenic kwaye asthenic-bangonwabi, lubonakala lilizwe rhoqo lidiniwe nokudinwa, ngokunjalo nentloko, ukuphazamiseka kokulala, kunye vertigo.
• Babesaba, sokuwa kunye nezinye izifo.

Uthintelo ukuphazamiseka yamanqanaba icalcium umntwana

Njengokuba mhlawumbi sele kubonakala izifo okuhambisana uphawu chvostek kunyango abantwana azezi ukubuyiselwa edlalwa kumanqanaba eqhelekileyo calcium negazi phosphorus. Ngoko ke, uthintelo lwe ezimbi nayo ifuna becala ukulawula uyondelelwano lwee- izinto leyo luyenziwa bezifo iindawo.

Kubalulekile ukudala iimeko kangangoko ukwenzela uphuhliso osadaleka abafazi abakhulelweyo. Ukuza kuthi ga ngoku, ukuba umama okhulelweyo ahlala ebugxwayibeni zentlalo okanye abasemngciphekweni (seswekile, nephropathy, lwegazi kunye rheumatism), kwiinyanga zakhe zokugqibela 2 zokukhulelwa ukumisela novithamini D. In lokukhulelwa oqhelekileyo ukubambelela eyaneleyo yesondlo kunye nomsebenzi ngokwasemzimbeni.

A usana, ngoko ke wakhulela womelele kwaye usempilweni, kubalulekile phambi lokuncancisa, ukuqaliswa kwangethuba kutya ngokubambisana, ukuhlala imihla emoyeni evulekileyo, eziqhiyeni free, yokuthanjiswa, ejimini neebhafu ukukhanya-moya.