Neuroleptic zilonda matenda otchedwa ...

Neuroleptic zilonda syndrome ndi osowa ndipo zinadzala ndi mavuto pa moyo wa matenda chifukwa cha kudya cha mankhwala psychotropic, makamaka neuroleptics yoperekedwa kwa magulu a phenothiazines, thioxanthenes ndi butirofenonov. NMS kungakhale ntchito zida monga amphetamine, "Amoksalin" "Fluoxetine", "desipramine", "phenelzine" bongo kapena "metoclopramide".

zifukwa

Mwina zinthu kupanga syndrome neuroleptic zingakhale:

• utsogoleli wa mankhwala yaitali padzuwa;
• vysokopotentnyh ntchito ndalama;
• chotsatira NMS yokhala mankhwala pamodzi ndi mankhwala anticholinergic;
• antidepressants;
• mpweya kutentha;
• chithandizo Electroconvulsive ndi chinyezi mkulu.

Aggravation matenda zingachititse zifukwa mwachindunji choikidwa kwa thupi umoyo wa wodwalayo. Kuti zinthu monga:

• madzi m'thupi;
• psychomotor kukondoweza;
• uchidakwa;
• retardation maganizo ;
• nthawi postpartum;
• matenda intercurrent;
• kusowa kwa ayironi;
• thupi kutopa;
• zoopsa ubongo choipa;
• chithokomiro kukanika.

State wa incoherence, okalamba, maganizo nkhawa, chiwalo chachimuna - zonsezi komanso ikupereka syndrome neuroleptic zilonda. ZNR zizindikiro kungakhale yosiyana - kuchokera zing'onozing'ono chogwirika.

Easy zosiyanasiyana

Neuroleptic zilonda matenda yodziwika ndi izi zikuonetsa: kutentha limatuluka kuti subfebrile zimachitika somatovegetativnye Timachimo tating'onoting'ono (magazi zimachitika mu 150 / 90-110 / 70 mamilimita Hg, tachycardia - mpaka kumenyedwa 100 pa mphindi ..) Monga komanso kuvutika mu deta zasayansi (kuchuluka ESR kwa 18-30 mamilimita / h, otsika chiwerengero cha lymphocytes - kuchokera 15 mpaka 19%). No matenda a homeostasis ndi kukula hemodynamic. boma Psychopathological aumbike oneiric-catatonic kapena affective kuukira onyenga.

Mlingo avareji

Chakuti munthu akamadwala neuroleptic zilonda syndrome zolimbitsa, anasonyeza mwa zizindikiro zotsatirazi:

• anasonyeza matenda somatovegetativnye (mphumu ndi tachycardia kuti kumenyedwa 120 pa mphindi imodzi);
• malungo (38-39 madigiri);
• kusintha kwambiri deta zasayansi (ESR kumawonjezera kwa 35-50 mamilimita / h, ndi leukocytosis - mpaka 10J109 / l, kuchuluka kwa leukocytes amachepetsa kuti 10-15%);
• kuchuluka misinkhu creatine phosphokinase ndi magazi tranzaminaza;
• A wodzichepetsa anaulula hypokalemia ndi hypovolemia.

matenda Psychopathological yodziwika ndi mtundu wa maganizo amentivnopodobnoy ndi digiri oneiric. Zizindikiro Catatonic akuwonetseredwa kulephera kuyenda negativism, kuchuluka pafupipafupi (madzulo) milandu kuyabwa mantha, kulankhula ndi kuyenda stereotype.

ndondomeko zovuta

Pa maziko a hyperthermia kumachitika neuroleptic zilonda matenda. Zizindikiro za kale kwambiri, akuti:

• nakweza zolephera somatovegetativnye (. dyspnea kuti mpweya 30 pa mphindi 1, tachycardia kufika kumenyedwa 120-140 pa mphindi);
• kuonjezera matenda madzi ndi electrolyte;
• kuchuluka hemodynamic chisokonezo.

The kusintha kwakukulu makhalidwe wapezeka mu mawerengero zasayansi. ESR kumawonjezera kwa 40-70 mamilimita / h Leucocytes - mpaka 12J109 / l, chepetse chiwerengero cha lymphocytes ndi 3-10%, kwambiri kumawonjezera mlingo wa creatine, alanine ndi asparagine transaminase m'magazi. Clouding maganizo angafikire mpaka comatose, ndi soporous masitepe amential. Stupor, negativism, wachisokonezo mkwiyo, ulesi, ndi kuchepa minofu kamvekedwe ndi Nthawi makamaka akuluakulu, ndiponso kulephera kuyenda mtheradi ndi areflexia - onse neuroleptic zilonda matenda.

chithandizo

akadziwika msanga matenda ndi mfundo yaikulu. chakuti munthu akudwala neuroleptic zilonda syndrome zingasonyeze minofu kukungika, tachycardia, malungo, matenda oopsa, thukuta wapezeka atalandira neuroleptics, dysphagia.

Chinthu choyamba chimene inu muyenera kuchita dokotala, choncho zimafika neuroleptics ndi mankhwala ena neurotoxic. Ziyeneranso akuthandiza njira kuti atsitse kutentha ndipo amapanga chifukwa chosowa madzimadzi. Electrolyte imbalances ayenera analetsa. Amafuna kuchita polojekiti mosamala ntchito kupuma yofunika kwambiri ntchito yomwe lingathetsedwe pamene kupanga aakulu akulu chinthu chimodzimodzi ndi kusowa chochita kuti expectorate bronchial katulutsidwe.

Muyenera mosamala kuwunika ntchito aimpso. Komabe, palibe umboni kuti kulekana osmotic Iyamba atachira NMS, kungoti izo angathandize thandizo la ntchito aimpso. Nthawi chofunika kutulutsa mankhwala mu malo kumatheka chithandizo.

mankhwala

Azichitira neuroleptic zilonda syndrome mankhwala ndi ofunika kwambiri nkhani zikuluzikulu. Chifukwa chaichi, relaxants minofu ( "Dantrolene") kapena dopamine agonists ( "Amantadine" ndi "bromocriptine"). Imfa anachepetsedwa mu ntchito za mitundu onse a mankhwala. Mlingo zosiyanasiyana momasuka, koma "Bromocriptine" njira zafotokozedwa mu njira ndalama kuchokera 2.5 kuti 5 mg 3 pa tsiku pakamwa.

Dopamine agonists, makamaka mu zigawo zikuluzikulu mwina hule psychosis kapena kusanza, ndipo akhoza kwambiri kuvutika ukupeza wodwalayo neuroleptic matenda oopsa. Direct akuchita minofu anasiya ntchito ndi mlingo wa 10 mg / kg. Cholinga cha ntchito - kuchepetsa minofu chinthu chimodzimodzi, komanso kagayidwe minofu chigoba, kuchuluka kwa zomwe china udindo hyperthermia. "Dantrolene" n'chosiyana hepatotoxicity imfayo chiwindi ndi imfa chifukwa cholephera chiwindi. Ndiyeno sipadzakhala chifukwa kupitiriza kuchitira neuroleptic zilonda matenda.

NMS komanso likuchotsedwa ndi osakaniza dopamine ndi "dantrolene" agonists. mankhwala Anticholinergic ankagwiritsa ntchito zochizira pseudoparkinsonism chifukwa cha mankhwala antipsychotic, Musapereke zotsatira kwambiri Komanso akhoza zina kusokoneza thermoregulation.

Pali pomwe pa zotsatira za "carbamazepine" odwala ambiri anasonyeza kufooka mofulumira umboni NSA. Komabe, palibe deta zodalirika mphamvu ya ntchito benzodiazepines zochizira matenda izi. Komabe, pamene mkhalidwe bwino, mankhwala zikhonza kukhala zothandiza kuchepetsa mkwiyo odwala ndi neuroleptic zilonda matenda.

hyperthermia

matenda angapezeke pafupifupi kamodzi pa 100 tysyach ochititsa dzanzi ntchito depolarizing relaxants minofu ( "Miorelaksina", "ditilina" ndi "listenon"), komanso inhalation dzanzi pakati chimasanduka halogen ( "methoxyflurane", "Ftorogana" ndi "Halothane") . Hyperthermia limapezeka odwala chiwopsezo mkulu mankhwala awa, amene chilamulira chikhalidwe ndi zolephera kagayidwe kashiamu mu minofu misa. Chifukwa ndi zowombetsa mkota kukokana kwa minofu ndi zina matenda a minofu, amene anapanga chifukwa cha zedi kutentha, kutentha thupi yomweyo ukufika madigiri 42. Neuroleptic Yapakhungu Syndrome imfa mwa 20-30% ya milandu.

ambulansi

Pa kudziwika ndi hyperthermia mofulumira kukula ayenera kusiya kumwa mankhwala tatchulazi. Chifukwa mankhwala mankhwala ochititsa, musati zoyambitsa matenda, tingaone barbiturates "pancuronium", "Tubocurarine" ndi nitrous oxide. Monga iwo ayenera kugwiritsidwa ntchito ngati n'koyenera, kutambasuka kwa chisamaliro ochititsa dzanzi.

Chifukwa Mwina mapangidwe fibrillation yamitsempha yamagazi m'kaundula prophylactic "Phenobarbital" ndi "Procainamide" Mlingo achire. M'pofunikanso kukonza ndondomeko yozizira, kuwayika pa lalikulu Mitsempha chidebe ndi madzi ozizira kapena ayezi. Pamafunika nthawi yomweyo matenda kupuma mpweya, bayani ndi sodium hydrogencarbonate / mu (400 ml ya 3% njira). Nthawi yoopsa, yovomereza kukhazikitsa kuwatsitsimula. M'chipatala - ichi ndi chinthu choyamba kuchita ngati matenda neuroleptic zilonda matenda.

kaonedwe

Pano mu mbiri ya NSA nthawi zonse kumachititsa a boma zokhudza otaya sekondale ndipo Inde kovuta mosavuta malaise. Komanso, matenda n'zimene zikuchitika syndrome lino pafupifupi konse molambalala dongosolo ubongo popanda kufufuza ndi kupanga anthu kapena matenda ena a ubongo. Nanga neuroleptic zilonda matenda? Ndi matenda amene kwambiri impairs moyo wa munthu, ngakhale kungachititse kuti imfa.