Koj puas muaj teeb meem nrog koj lub hlwb thiab koj tus txha caj qaum tam sim ntawd? Cia peb kawm txog ADEM (Acute Disseminated Encephalomyelitis)!

Koj puas tau hnov ​​txog lo lus 'ADEM' (Acute Disseminated Encephalomyelitis)? Qhov no tej zaum yuav yog ib yam tshiab rau koj. Nws yog ib yam mob tsis tshua muaj, txhais tau tias nws cuam tshuam rau ob peb tus neeg xwb, tab sis nws tuaj yeem tshwm sim sai sai thiab cuam tshuam rau peb lub paj hlwb. Tsis txhob txhawj, peb yuav tham txog nws yooj yim, hauv txoj kev uas koj nkag siab tau.

ADEM yog dab tsi? Cia peb nkag siab yooj yim.

Hais yooj yim xwb, ADEM yog qhov mob o lossis o ntawm peb lub paj hlwb nruab nrab - uas yog, lub hlwb thiab tus txha caj qaum. Xav txog nws li no, ib yam li thaum peb raug mob , peb lub cev o tuaj, qhov no ua rau o nyob rau qee qhov chaw ntawm lub hlwb thiab tus txha caj qaum.

Qhov kev o no tuaj yeem ua rau lub plhaub tiv thaiv uas nyob ib puag ncig peb cov hlab ntsha puas tsuaj. Lub plhaub no hu ua lub plhaub myelin . Nws zoo li cov yas uas npog ib ncig ntawm cov xov hluav taws xob. Nws pab cov lus mus ncig raws cov hlab ntsha sai dua. Yog li, thaum lub plhaub myelin no puas lawm, cov lus ntawm cov hlab ntsha tsis mus ncig zoo. Thaum ntawd muaj ntau yam tsos mob tshwm sim. Qee tus kws kho mob kuj hu qhov mob no ua "demyelinating".

Lo lus "acute" hauv ADEM txhais tau tias nws tshwm sim sai sai, tam sim ntawd . Feem ntau, nws tsuas yog tshwm sim ib zaug hauv ib sim neej xwb. Txawm li cas los xij, nws muaj peev xwm rov tshwm sim tsawg heev.

Qhov no feem ntau tshwm sim li cas?

ADEM yog ib qho mob tsis tshua muaj . Cov kev tshawb fawb qhia tau tias nyob rau hauv lub tebchaws zoo li Asmeskas, nws tshwm sim rau kwv yees li ib ntawm ob thiab ib nrab lab tus tib neeg. Yog li, qhov no tsis yog ib qho mob uas cuam tshuam rau txhua tus.

Cov tsos mob ntawm tus mob no yog dab tsi?

Cov tsos mob ntawm ADEM feem ntau tshwm sim ob peb hnub tom qab kis tus kab mob los yog kab mob bacterial . Cov tsos mob no tuaj yeem sib txawv ntawm ib tus neeg mus rau ib tus neeg, thiab kuj nyob ntawm seb qhov mob nyob qhov twg hauv lub hlwb lossis tus txha caj qaum.

Qee cov tsos mob uas pom muaj xws li:

• Ua npaws
• Mob taub hau.
• Xeev siab los yog ntuav
• Kev tsis meej pem
• Kev qaug zog

Ntxiv rau, cov tsos mob ntsig txog lub paj hlwb yuav suav nrog:

• Kev hnov ​​​​​​mob loog lossis tingling hauv cov ceg
• Nyuaj nqos
• Poob lossis tsis pom kev zoo (optic neuritis)
• Cov leeg tsis muaj zog
• Kev taug kev nyuaj
• Qaug dab peg

Raws li koj tuaj yeem pom, cov tsos mob no thiab lawv qhov hnyav tuaj yeem sib txawv ntawm ib tus neeg mus rau ib tus neeg . Qee tus neeg yuav muaj cov tsos mob me me, thaum lwm tus yuav raug cuam tshuam hnyav dua.

Vim li cas qhov no thiaj tshwm sim? Dab tsi yog cov ua rau muaj ADEM?

Qhov ua rau muaj ADEM tseem tsis tau paub meej . Txawm li cas los xij, kev tshawb fawb qhia tias thaum ib tug kab mob lossis cov kab mob nkag mus rau hauv peb lub cev, peb lub cev tiv thaiv kab mob yuav tawm tsam nws. Txawm li cas los xij, rau ib tug neeg uas muaj ADEM, lub cev tiv thaiv kab mob yuav tawm tsam qee qhov ntawm nws lub paj hlwb hauv nruab nrab . Nws zoo li tawm tsam ib tug ntawm nws cov tswv cuab, xav tias nws yog ib tug yeeb ncuab. Qhov kev tawm tsam yuam kev no ua rau muaj kev o (o) uas tau hais ua ntej, uas tom qab ntawd ua rau muaj cov tsos mob.

Tau pom tias muaj li ntawm 70% thiab 80% ntawm cov neeg uas muaj tus kab mob ADEM muaj kev kis kab mob lossis muaj mob ua ntej cov tsos mob ntawm ADEM tshwm sim. Cov tsos mob ntawm ADEM feem ntau pib li 7 txog 14 hnub tom qab kis kab mob. Qee cov kab mob uas feem ntau cuam tshuam nrog ADEM suav nrog:

• Mob khaub thuas lossis mob ntsws
• Kab mob qhua pias
• Kab mob qog
• Rubella
• Kab mob qaib
• Tus kab mob Epstein Barr
• Cytomegalovirus
• Kab mob Herpes simplex ('Herpes simplex virus')

Txawm hais tias muaj ntau yam kab mob me me, cov kab mob sib kis, thiab lwm yam kev kis mob uas cuam tshuam nrog ADEM, nws zoo li tsis yog los ntawm ib tus neeg kis kab mob xwb.

Tsis ntev los no, lwm yam ua rau ADEM, tshwj xeeb tshaj yog rau cov menyuam yaus, tau raug txheeb xyuas tias yog Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD). Qhov no kuj suav tias yog tus mob autoimmune. Qhov no txhais tau tias lub cev lub cev tiv thaiv kab mob tawm tsam nws lub paj hlwb. MOGAD no kuj tuaj yeem ua rau ADEM.

Leej twg muaj feem yuav mob ADEM ntau dua?

Txhua tus neeg yeej muaj peev xwm kis tau tus kab mob ADEM. Txawm li cas los xij, nws feem ntau tshwm sim rau cov menyuam yaus dua li cov neeg laus . Tsis tas li ntawd, yog tias koj nyuam qhuav kis tus kab mob, koj qhov kev pheej hmoo ntawm kev kis tus kab mob ADEM yuav siab dua me ntsis.

Tej yam teeb meem uas yuav tshwm sim ntawm ADEM yog dab tsi?

ADEM tuaj yeem ua rau muaj qee yam teeb meem, suav nrog:

• Kev tsis nco qab
• Kev ua haujlwm ntawm lub hlwb qeeb
• Coma

Tsis tshua muaj, cov tsos mob ntawm ADEM tuaj yeem ua rau tuag taus yog tias lawv hnyav zuj zus. Tab sis qhov ntawd tsis tshua muaj .

Tej tus neeg yuav muaj tej tsos mob uas tseem muaj txawm tias tom qab kho tas lawm los xij:

• Mob taub hau hnyav heev.
• Kev tsis muaj zog
• Muaj teeb meem nrog kev sib koom tes
• Pom kev tsis meej

Yuav kuaj mob ADEM li cas?

Yog tias koj muaj cov tsos mob ntawm ADEM, tus kws kho mob yuav sau keeb kwm txog koj tus mob, nug txog koj cov tsos mob, thiab ua kev kuaj mob hlwb , kev kuaj lub cev dav dav, thiab ntau yam kev kuaj ntxiv kom paub tseeb tias koj puas muaj ADEM .

Kuj tseem muaj kev kuaj mob los xyuas seb puas muaj lwm yam mob uas ua rau ADEM. Cov kev kuaj mob uas feem ntau siv los kuaj mob ADEM suav nrog kev kuaj ntshav thiab:

• Kev kuaj MRI
• Kev kuaj cov kua dej ntawm tus txha caj qaum

Kev kuaj MRI nrhiav dab tsi?

MRI (Magnetic Resonance Imaging) yog ib txoj kev siv tshuab thaij duab tshwj xeeb uas tuaj yeem nrhiav kev hloov pauv tob hauv lub hlwb. Cov kws kho mob nrhiav cov qhov txhab lossis cov pob uas tshwm sim los ntawm ADEM hauv peb qhov chaw tseem ceeb ntawm lub paj hlwb hauv nruab nrab: lub hlwb, cov hlab ntsha caj qaum, thiab cov hlab ntsha pom.

• Cov khoom dawb : Qhov no yog qhov chaw uas cov hlab ntsha raug npog nrog myelin. Cov no tshwm sim dawb ntawm MRI.
• Cov khoom xim grey : Qhov no muaj cov cev ntawm cov hlwb paj hlwb. Lawv zoo li tsaus ntuj ntawm MRI vim tias lawv tsis muaj myelin.

Ob peb lub hlis tom qab thawj zaug MRI, tus kws kho mob yuav hais kom ua lwm daim MRI kom pom tias cov cheeb tsam no hloov pauv li cas raws sijhawm.

Yuav tsum nrhiav dab tsi thaum kuaj cov kua dej hauv tus txha nqaj qaum?

Qhov no kuj hu ua lumbar puncture . Qhov no yog ib qho kev kuaj mob tseem ceeb kom nrhiav tau qhov ua rau muaj cov tsos mob ntawm lub paj hlwb. Nws suav nrog kev noj me me ntawm koj cov kua dej hauv lub hlwb (CSF). CSF yog cov kua dej ntshiab, tsis muaj xim uas nyob ib puag ncig, tiv thaiv, thiab pub zaub mov rau koj lub hlwb thiab cov hlab ntsha hauv lub hlwb.

Hauv ADEM, cov kua dej hauv lub hlwb muaj cov qe ntshav dawb ntau ntxiv, tshwj xeeb yog cov lymphocytes . Cov qe ntshav no yog cov feem ntawm peb lub cev tiv thaiv kab mob. Cov qauv CSF no yog siv los saib seb cov qe ntshav no teb li cas rau cov kab mob lossis cov kab mob uas xav tias ua rau ADEM, thiab los xyuas seb puas muaj lwm yam kab mob neuroinflammatory.

Cov kev kho mob rau ADEM yog dab tsi?

Lub hom phiaj tseem ceeb ntawm kev kho mob ADEM yog kom txo qhov o ntawm lub hlwb thiab tus txha caj qaum . Cov kev kho mob hauv qab no siv tau:

• Cov tshuaj steroidCov tshuaj steroid: Kab kev kho mob thawj zaug rau ADEM yog cov tshuaj steroids uas txhaj rau hauv cov hlab ntsha (IV). Qhov no yuav muab rau hauv cov hlab ntsha rau ob peb hnub. Tom qab ntawd koj yuav tau txais cov tshuaj steroid noj rau ob peb hnub.
• Tshuaj immunoglobulin rau hauv cov hlab ntsha (IVIG) : Qhov no yog kev kho mob uas muaj cov tshuaj tiv thaiv kab mob uas ua los ntawm cov ntshav plasma uas pub dawb. Qhov no kuj tseem muab rau hauv cov hlab ntsha.
• Kev pauv ntshav hauv lub cev (los yog plasmapheresis): Qhov no suav nrog kev rho ib feem ntawm koj cov ntshav, khiav nws los ntawm lub tshuab uas tshem tawm qee yam uas ua rau koj lub cev tiv thaiv kab mob tsis muaj zog, thiab tom qab ntawd muab nws rov qab rau hauv koj lub cev. Kev kho mob no tuaj yeem siv sijhawm ntau teev thiab yuav ua tau ntau zaus.

Kev tshawb nrhiav tseem niaj hnub kawm ntxiv txog tus mob no thiab nrhiav kev kho mob tshiab.

Nco ntsoov, cov kev kho mob no yog koj tus kws kho mob txiav txim siab. Nws/nws yuav xaiv qhov zoo tshaj plaws rau koj tus mob.

Puas muaj tej yam tshwm sim tsis zoo rau cov kev kho mob no?

Ib yam li kev kho mob twg los xij, tej zaum yuav muaj qee qhov kev mob tshwm sim.

Cov kev mob tshwm sim ntawm kev kho mob steroid luv luv feem ntau yog ib ntus xwb, tab sis lawv tuaj yeem suav nrog:

• Cov ntshav qab zib nce ntxiv
• Cov qib potassium txo qis
• Nyuaj siab tsaug zog
• Kev hloov pauv ntawm lub siab (kev chim siab, quaj, ntxhov siab)
• Qhov hnyav nce
• Liab ntawm sab plhu
• Hnov ​​​​qhov saj hlau hauv qhov ncauj

Cov kev mob tshwm sim thiab cov teeb meem ntawm kev kho mob 'IVIG' :

• Kev ua xua
• Kev kis kab mob
• Ua pa nyuaj
• Cov ntshav txhaws
• Kev puas tsuaj rau lub raum
• Mob taub hau.

Cov teeb meem ntawm Plasmapheresis :

• Tsis yooj yim
• Los ntshav
• Kev kis kab mob
• Kev puas tsuaj rau lub raum
• Tsis muaj ntshav txaus rau ib feem ntawm lub cev ('Ischemia')

Tham nrog koj tus kws kho mob txog cov kev mob tshwm sim no. Feem ntau, lawv tuaj yeem tswj tau.

Yuav siv sijhawm ntev npaum li cas thiaj rov zoo tom qab kho tas?

Feem ntau cov neeg uas tau kho ADEM pib zoo dua hauv ob peb hnub tom qab kho . Txawm li cas los xij, nyob ntawm seb koj cov tsos mob hnyav npaum li cas, nws yuav siv sijhawm txog rau lub hlis kom rov zoo tag nrho. Tsis tshua muaj neeg, qee tus neeg yuav tsis rov zoo tag nrho. Txawm li cas los xij, feem ntau cov neeg rov zoo.

Puas muaj ib txoj kev los tiv thaiv ADEM?

Tsis muaj ib txoj kev tshwj xeeb los tiv thaiv ADEM. Txawm li cas los xij, koj tuaj yeem txo koj qhov kev pheej hmoo los ntawm kev xyaum ua kom huv si kom tsis txhob muaj kab mob kis thiab kab mob (piv txwv li, ntxuav koj txhais tes ntau zaus thiab nyob deb ntawm cov neeg mob).

Tus kab mob ADEM yuav zoo li cas? Puas kho tau?

Feem ntau cov neeg uas muaj ADEM rov zoo tag nrho lossis yuav luag zoo tag nrho tom qab kho mob.Yog tias qhov o tuaj yeem hnyav heev, nws tsis tshua muaj peev xwm ua rau tuag taus. Koj tus kws kho mob tuaj yeem muab lub tswv yim zoo tshaj plaws rau koj txog koj qhov xwm txheej.

Cov tsos mob ntawm ADEM feem ntau tsuas tshwm sim ib zaug xwb , tab sis tuaj yeem rov tshwm sim dua nyob ntawm qhov ua rau muaj teeb meem (xws li MOGAD). ADEM feem ntau ploj mus nrog kev kho mob, tab sis cov tsos mob tuaj yeem rov tshwm sim dua. Cov neeg feem coob muaj lub neej zoo li qub.

Kuv yuav tsum mus ntsib kws kho mob thaum twg?

Yog koj muaj cov tsos mob zoo li ADEM, tshwj xeeb tshaj yog tom qab muaj kev kis kab mob , nco ntsoov mus ntsib kws kho mob. Yog tias pom ntxov, ces kev kho mob yuav pib tau sai dua.

Cov lus nug tseem ceeb uas yuav tsum nug koj tus kws kho mob

Yog tias koj raug kuaj pom tias muaj ADEM, tej zaum koj yuav xav nug koj tus kws kho mob cov lus nug no:

• Kuv yuav tsum npaj li cas rau cov kev xeem?
• Koj pom zoo kom siv hom kev kho mob twg?
• Cov kev mob tshwm sim ntawm kev kho mob yog dab tsi?
• Kuv cov tsos mob puas yuav tseem muaj tom qab kho mob?

Nws yog ib qho ib txwm muaj kev ntxhov siab thiab ntshai thaum koj tam sim ntawd muaj cov tsos mob xws li tsis tuaj yeem taug kev, poob koj lub zeem muag, lossis muaj kev qaug dab peg uas tsis paub meej. Koj pab neeg kho mob yuav pab koj daws qhov teeb meem no. Qee qhov kev kho mob yuav siv sijhawm ob peb hnub lossis txawm tias ob peb teev. Thaum lub sijhawm no, nyeem ib phau ntawv lossis ua ib yam dab tsi uas ua rau koj so. Nco ntsoov, qhov no yog ib zaug xwb rau cov neeg feem coob, tab sis nws tuaj yeem tshwm sim dua.

Cov ntsiab lus luv luv uas yuav tsum nco ntsoov

• ADEM yog kev o ntawm lub hlwb thiab tus txha caj qaum tam sim ntawd.
• Qhov no tsis tshua muaj thiab feem ntau tshwm sim tom qab muaj kev kis kab mob.
• Xav tias qhov no tshwm sim thaum peb lub cev tiv thaiv kab mob tawm tsam lub paj hlwb tsis raug.
• Cov tsos mob sib txawv thiab tuaj yeem suav nrog kub taub hau, mob taub hau , loog, pom kev tsis meej, thiab nyuaj rau taug kev.
• Feem ntau nws raug kuaj pom los ntawm MRI thiab kev kuaj cov kua dej ntawm tus txha nqaj qaum.
• Muaj kev kho mob xws li tshuaj steroids, IVIG, thiab kev pauv plasma.
• Feem ntau cov neeg zoo rov zoo, tab sis kev zoo tag nrho yuav siv sijhawm ntau lub hlis.
• Txawm hais tias tsis muaj txoj hauv kev tshwj xeeb los tiv thaiv nws los xij, nws yog ib qho tseem ceeb uas yuav tsum tiv thaiv koj tus kheej ntawm kev kis kab mob.

Vam tias cov ntaub ntawv no yuav pab tau koj. Yog koj muaj lus nug ntxiv, tsis txhob hnov ​​qab nrog kws kho mob tham.