Neuroleptic ajọ syndrome akpọ ...

Neuroleptic ajọ syndrome bụ a obere na-fraught na ya pụta maka ndụ nke aghara mere site oriri nke psychotropic ọgwụ ọjọọ, karịsịa neuroleptics nke ìgwè dị iche iche nke phenothiazines, thioxanthenes na butirofenonov. NMS pụrụ ịkpasu ojiji nke ngwaọrụ dị ka amphetamine, "Amoksalin" "Fluoxetine", "desipramine", "phenelzine" cocaine ma ọ bụ "metoclopramide".

ihe

Puru ihe akpụ neuroleptic syndrome nwere ike:

• ochichi nke ọgwụ ọjọọ ruo ogologo oge n'ebe;
• vysokopotentnyh ojiji nke ego;
• itinye na NMS nwere ọgwụ ọjọọ eme ọnụ na anticholinergic ọgwụ ọjọọ;
• antidepressants;
• Ikuku okpomọkụ;
• Electroconvulsive ọgwụgwọ na elu iru mmiri.

Nkpasu-iwe nke ọrịa nwere ike ime ka ihe na-weere na ọ na-n'ahụ ọdịmma nke onye ọrịa. Iji ndị na-agụnye:

• akpịrị ịkpọ nkụ;
• psychomotor mmalite;
• aṅụrụma;
• eme iberibe ;
• na ọbara oge;
• intercurrent na-efe efe;
• enweghị ígwè;
• anụ ahụ ike ọgwụgwụ;
• traumatic mmerụ ahụ n'ụbụrụ;
• thyroid dysfunction.

State of incoherence, agadi, obi nchegbu, nwoke mmekọahụ - niile a na-agbakwụnye na neuroleptic ajọ syndrome. ZNR mgbaàmà pụrụ ịbụ nnọọ dị iche iche - si obere ka gbara ọkpụrụkpụ.

Easy dịgasị iche iche nke

Neuroleptic ajọ syndrome ji na-esonụ na-egosi: okpomọkụ adahade subfebrile ime somatovegetativnye obere mmejọ (ọbara mgbali usu n'ime 150 / 90-110 / 70 mm HG, tachycardia - ruo 100 gafere kwa nkeji ..) Dị ka nke ọma dị ka abnormalities laabu data (ụba ESR ka 18-30 mm / h, na ala ọnụ ọgụgụ nke lymphocytes - si 15 na 19%). Ọ dịghị ọrịa nke homeostasis na hemodynamic ibu. Psychopathological steeti a kpụrụ oneiric-catatonic ma ọ bụ affective nkwenkwe ụgha ọgụ.

The nkezi ogo

Nke bụ eziokwu na mmadụ bụ onye na-arịa ọrịa neuroleptic ajọ syndrome agafeghị oke, gosiri site ndị na-esonụ ama:

• egosipụta somatovegetativnye ọrịa (ụkwara ume ọkụ na tachycardia 120 gafere kwa nkeji);
• fever (38-39 degrees);
• ịrịba mgbanwe laabu data (ESR enwekwu na 35-50 mm / h, na leukocytosis - elu 10J109 / l, na nke ukwu nke leukocytes mbelata na 10-15%);
• ụba creatine phosphokinase etoju na tranzaminaza ọbara;
• A obi umeala mata hypokalemia na hypovolemia.

Psychopathological ọrịa ji ụdị mmetụta amentivnopodobnoy na oneiric ogo. Catatonic mgbaàmà gosipụtara ịnọrọ negativism, mụbara ugboro (na mgbede) ikpe nke iyatesịt ịma jijiji, ije na ikwu okwu echiche.

mgbagwoju usoro

Na ndabere nke hyperthermia nwere ike ime neuroleptic ajọ syndrome. Mgbaàmà nke ọzọ oké ugbua, ya bụ:

• adịkwu somatovegetativnye ọdịda (. dyspnea 30 ume kwa 1 nkeji, tachycardia iru 120-140 gafere kwa nkeji);
• dịkwuo mmiri na electrolyte ọrịa;
• ụba hemodynamic disturbances.

The àgwà kasị mara ahụrụ na laabu ọgụgụ. ESR enwekwu na 40-70 mm / h Leucocytes - elu 12J109 / l, ọnụ ọgụgụ nke lymphocytes na 3-10%, budata enwekwu ogo creatine, alanine na asparagine transaminase ke iyịp. Clouding uche nwere ike iru elu comatose, na soporous amential nzọụkwụ. Stupor, negativism, jupụtara iyatesịt, lethargy, na a ọnụ ke Akwara ụda ma, na karịsịa oké njọ mgbe, na zuru ịnọrọ na areflexia - niile neuroleptic ajọ syndrome.

ọgwụgwọ

Early njirimara nke ọrịa bụ isi ihe. Nke bụ eziokwu na mmadụ bụ onye na-arịa ọrịa neuroleptic ajọ syndrome nwere ike na-egosi muscular erughị ala, tachycardia, fever, ọbara mgbali elu, ọsụsọ na-agba ahụrụ mgbe na-anata neuroleptics, dysphagia.

Ihe mbụ ị ga-eme a dọkịta, n'ihi ya, ọ kagbuo neuroleptics na ndị ọzọ na neurotoxic ọgwụ ọjọọ. Ọzọkwa-achọ na-akwado usoro iji mee ka ala na okpomọkụ na-eme ka elu maka enweghị ọmụmụ. Electrolyte imbalances ga-erila. Chọrọ na-ebu ịkpachara anya nlekota nke akụkụ okuku ume na mkpa ọrụ, na-arụ ọrụ nke nwere ike agbajikwa ọzọ mgbe akpụ oké njọ muscular rigidity na enweghị enyemaka na expectorate bronchial secretion.

Ị mkpa iji nlezianya nyochaa gbasara akụrụ ọrụ. Otú ọ dị, e nweghị ihe àmà na osmotic nkewa accelerates agbake site NMS, nanị ya nwere ike inyere nkwado nke gbasara akụrụ ọrụ. Ọ bụ mgbe a chọrọ iji na-emepụta a ọgwụ na a ọnọdụ enwekwukwa ọgwụgwọ.

ọgwụ

Na-emeso neuroleptic ajọ syndrome ọgwụ na-achọsi ike na mgbagwoju ikpe. N'ihi nke a, muscle relaxants ( "Dantrolene") ma ọ bụ dopamine agonists ( "Amantadine" na "bromocriptine"). Enwe ahụ belatara na ojiji nke ma ụdị nke ọgwụ ọjọọ. Doses ịdị iche iche kpam kpam, ma n'ihi na "Bromocriptine" usoro na-kọwara na isi mmalite ke ichekwa si 2.5 5 mg ugboro 3 a ụbọchị ọnụ.

Dopamine agonists, karịsịa na ibu òkè, nwere ike ịkpalite psychosis ma ọ bụ vomiting, na bụ ike budata njọ ọnọdụ ahụ ike nke onye ọrịa neuroleptic ajọ syndrome. Direct eme muscle relaxant eji na doses nke 10 mg / n'arọ. Nzube nke ya iji - mbenata muscle rigidity, nakwa dị ka ndị metabolism nke skeletal muscle, onye na-abawanye nke bụ obere maka hyperthermia. "Dantrolene" dị iche hepatotoxicity nwere ike kpasuo ịba ọcha n'anya na ọbụna ọnwụ n'ihi mmebi imeju. Ma mgbe ahụ a ga-enweghị ihe mere ịnọgide na-emeso neuroleptic ajọ syndrome.

NMS nwekwara tutu amama site a Nchikota dopamine na "dantrolene" agonists. Anticholinergic ọgwụ ọjọọ na n'ọtụtụ ebe, na-eji maka ọgwụgwọ nke pseudoparkinsonism mere site antipsychotic ọgwụ ọjọọ, adịghị inye ịrịba results, Ọzọkwa, ike n'ihu akpaghasị thermoregulation.

E nwere onye na update na mmetụta nke "carbamazepine" na ọtụtụ ndị ọrịa gosiri a ngwa ngwa-agwụ ike nke NSA àmà. Otú ọ dị, e nweghị ihe ọ data on irè nke eji benzodiazepines maka ọgwụgwọ nke a syndrome. Otú ọ dị, mgbe ọnọdụ mma, ndị a ọgwụ ọjọọ nwere ike ịbụ bara uru iji belata ụfụ na ọrịa na-enwe neuroleptic ajọ syndrome.

hyperthermia

The ọrịa pụrụ ịchọta ihe dị otu ugboro kwa 100 tysyach ná Nkụnwụ iji depolarizing muscle relaxants ( "Miorelaksina", "ditilina" na "listenon"), nakwa dị ka inhalation ọgwụ na-akụnwụ si n'etiti halogen hydrocarbons ( "methoxyflurane", "Ftorogana" na "Halothane") . Hyperthermia na-egosi na ọrịa na-elu susceptibility ndị a ọgwụ ọjọọ eme ihe, nke mekọrịtara na ọdịda nke calcium metabolism na muscle uka. N'ihi bụ a generalized muscle twitching, na mgbe ụfọdụ muscle ọrịa, nke a na-guzobere n'ihi nke nnukwu ego nke okpomọkụ, ahu okpomọkụ instantaneously esịmde 42 degrees. Neuroleptic ajọ ọrịa na-akpata ọnwụ na 20-30% nke ikpe.

ụgbọ ihe mberede

N'elu nchọpụta nke a ngwa-ngwa-eto eto hyperthermia mkpa ịkwụsị ịṅụ n'elu kwuru banyere ọgwụ ọjọọ. N'ihi anestetiiki ọgwụ ọjọọ, adịghị akpasu ọrịa, nwere ike mata barbiturates "pancuronium", "Tubocurarine" na nitrous oxide. Dị nnọọ na ha ga-eji, ma ọ bụrụ na ọ dị mkpa, na ndọtị nke ná Nkụnwụ na-elekọta.

N'ihi na ihe gbasara nke puru nke guzobere ventricular fibrillation na-aha prophylactic "Phenobarbital" na "Procainamide" ọgwụgwọ Dosages. Ọ dịkwa mkpa iji dozie obi jụrụ usoro, ịtụkwasị n'elu nnukwu ọbara arịa akpa na mmiri oyi ma ọ bụ ice. Ọ na-achọ ozugbo normalize na-eku ume ikuku, igba sodium hydrogencarbonate / na (400 ml nke 3% ngwọta). Na ize ndụ mgbe, ọ na-atụ aro mmejuputa iji tụtee mmadụ. Ụlọ ọgwụ - nke a bụ ihe mbụ na-eme ma ọ bụrụ na a chọpụtara neuroleptic ajọ syndrome.

ele ihe anya

Ugbu ke akụkọ ihe mere eme nke NSA bụ mgbe enwekwu ohere ndị dị otú ahụ a ala nke abụọ eruba na ike N'ezie agbasokarị malaise. Ọzọkwa, ọrịa abụrụ na a syndrome na-fọrọ nke nta mgbe emebiwo ụbụrụ Ọdịdị enweghị a Chọpụta, eke ndị ma ọ bụ ndị ọzọ akwara ozi ọrịa. N'ihi ya, ihe neuroleptic ajọ syndrome? Ọ bụ a na ọrịa na budata gaghịzi a ndụ mmadụ, na ọbụna nwere ike iduga ọnwụ.