Cov leeg muaj nuj nqi poob

Cov leeg ua haujlwm poob yog thaum lub zog ua haujlwm lossis txav tsis tau zoo. Lub sij hawm kho mob rau kev ua tiav ntawm cov leeg ua haujlwm tuag tes tuag taw.

Poob rau cov leeg ua haujlwm tuaj yeem tsim los ntawm:

• Kab mob ntawm cov leeg nws tus kheej (myopathy)
• Tus kab mob ntawm thaj chaw uas cov leeg thiab cov leeg sib ntsib (neuromuscular hlws ris)
• Ib tug kab mob ntawm cov leeg hlwb: Hlwb puas (neuropathy), mob hlwb txha caj qaum (myelopathy), lossis hlwb puas (mob hlab ntsha tawg lossis lwm yam paj hlwb)

Kev poob ntawm cov leeg ua haujlwm tom qab cov xwm txheej no tuaj yeem ua rau hnyav. Muaj qee kis, mob leeg yuav tsis rov qab los tau, txawm tias muaj kev kho mob.

Tuag tes tuag taw yuav yog ib ntus lossis tas mus li. Nws tuaj yeem cuam tshuam thaj chaw me me (hauv zos lossis focal) lossis dav dav (dav dav). Tej zaum nws yuav cuam tshuam rau ib sab (tsis suav) lossis ob tog (ob tog).

Yog hais tias tus tuag tes tuag taw cuam tshuam rau qis dua ib nrab ntawm lub cev thiab ob txhais ceg nws hu ua paraplegia. Yog tias nws cuam tshuam ob sab caj npab thiab txhais ceg, nws hu ua quadriplegia. Yog hais tias tus tuag tes tuag taw cuam tshuam rau cov leeg uas ua rau ua pa, nws yog txoj sia sai sai.

Cov kab mob ntawm cov leeg uas ua rau cov leeg ua haujlwm poob: suav nrog:

• Cawv-txuam nrog myopathy
• Congenital myopathies (feem ntau vim yog muaj caj ces tsis zoo)
• Dermatomyositis thiab mob polymyositis
• Qaug tshuaj noj myopathy (statins, steroids)
• Nqaij ua tej leeg

Cov kab mob ntawm cov leeg hlwb uas ua rau cov leeg ua haujlwm poob: suav nrog:

• Amyotrophic lateral sclerosis (ALS, lossis Lou Gehrig kab mob)
• Tswb Siv Yis
• Botulism
• Guillain-Barré mob
• Myasthenia gravis lossis Lambert-Eaton Syndrome
• Neuropathy
• Paralytic shellfish lom
• Lub sij hawm tuag tes tuag taw
• Suab raug mob
• Kab mob polio
• Tus txha nqaj qaum lossis hlwb raug mob
• Mob stroke

Kev ua haujlwm sai hauv cov leeg nqaij yog qhov mob ceev ceev. Mus nrhiav kev pab kho mob sai li sai tau.

Tom qab koj tau txais kev kho mob, koj tus kws kho mob yuav pom zoo kom ua qee yam hauv qab no:

• Ua raws li koj txoj kev kho mob.
• Yog tias cov leeg ntshav ntawm koj lub ntsej muag lossis lub taub hau puas, koj yuav muaj teeb meem zom thiab nqos lossis kaw qhov muag. Hauv cov xwm txheej no, kev noj zaub mov zoo rau kev pom zoo. Koj tseem yuav xav tau qee hom kev tiv thaiv qhov muag, xws li ib qho npog qhov muag thaum koj tsaug zog.
• Lub sij hawm ntev immobility tuaj yeem ua rau muaj mob hnyav. Hloov pauv ntau zaus thiab saib xyuas koj cov tawv nqaij. Kev qoj ib ce sib luag yuav pab tswj qee cov leeg nqaij ua kom nruj.
• Kev sib cais yuav pab tiv thaiv cov leeg kev cog lus, qhov mob uas ua rau lub cev nqaij ib ce luv.

Mob tuag tes tuag taw ib txwm yuav tsum tau kev kho mob sai. Yog tias koj pom tias muaj teebmeem me lossis cov leeg tsis muaj zog, nrhiav kev kho mob sai li sai tau.

Tus kws kho mob yuav kuaj ib ce thiab nug txog koj li keeb kwm kev mob thiab cov tsos mob, suav nrog:

Qhov chaw nyob:

• Dab tsi feem (cov) ntawm koj lub cev cuam tshuam?
• Nws puas cuam tshuam rau ib sab lossis koj ob sab ntawm koj lub cev?
• Nws puas tau tsim kho hauv cov qauv saum toj-rau-hauv qab (nqis qis tuag tes tuag taw), lossis hauv qab-rau-saum cov qauv (nce toj tuag tes tuag taw)?
• Koj puas muaj teeb meem tawm ntawm lub rooj zaum lossis nce ntaiv?
• Koj puas muaj teebmeem nyuaj tshem koj sab caj npab saum taub hau?
• Koj puas muaj teeb meem ncua lossis tshem koj lub dab teg (dab teg poob)?
• Koj puas muaj teeb meem tuav (tuav)?

Cov tsos mob:

• Koj puas mob?
• Koj puas muaj loog, tingling, lossis tsis hnov ​​hnov ​​zoo?
• Koj puas muaj teebmeem nyuaj tswj koj lub zais zis lossis lub qhov quav?
• Koj puas muaj txog siav?
• Koj muaj lwm cov tsos mob zoo li cas?

Qauv sijhawm:

• Puas yog ntu tshwm sim ntau zaug (rov muaj dua)?
• Lawv kav ntev li cas?
• Puas yog cov leeg ua haujlwm poob qis dua (hnyav zuj zus)?
• Puas yog kawm qeeb lossis sai?
• Puas yog nws tsis zoo rau thaum dhau hnub?

Aggravating thiab relieving lwm yam:

• Dab tsi, yog tias dab tsi, ua rau tuag tes tuag taw?
• Puas yog nws mob heev ntxiv tom qab koj noj cov tshuaj potassium lossis lwm yam tshuaj?
• Puas zoo dua tom qab koj so?

Kev ntsuam xyuas uas yuav ua muaj:

• Kev tshawb nrhiav ntshav (xws li CBC, qe ntshav dawb muaj qhov sib txawv, sib luag ntawm cov ntshav, lossis cov leeg ntshav enzyme)
• CT scan ntawm lub taub hau lossis tus txha nraub qaum
• MRI ntawm lub taub hau lossis qaum
• Xaus caj pas (txha caj qaum)
• Tso zis rau cov leeg nqaij lossis cov hlab ntshav
• Myelography
• Kev Tshawb Nrhiav Kev Tshawb Fawb thiab electromyography

Tej zaum kuj yuav tau txhaj tshuaj rau hauv plab los yog pub rau cov menyuam pub mis. Kev qhia kho lub cev, kev kho kom lub cev, lossis kho hais lus.

Tuag tes tuag taw; Paresis; Poob ntawm kev txav; Lub cev muaj zog kawg

• Sab nqaij tawv ntawm xub ntiag
• Sib sib zog nqus anterior leeg
• Tendons thiab cov leeg
• Sab ceg qis hauv cov leeg

Evoli A, Vincent A. Kev tsis sib haum ntawm cov hlab ntaws neuromuscular. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 394.

Selcen D. Cov leeg nqaij. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 393.

Warner WC, Sawyer JR. Neuromuscular mob. Hauv: Azar FM, Beaty JH, Canale ST, eds. Campbell's Kev Ua Haujlwm OrthopedicsCov. 13th ed. Philadelphia, PA: Elsevier; 2017: chap 35.