Nrov Kev Tshawb Fawb: Meniere's disease

Clinically, Kuv feem ntau ntsib ib chav kawm ntawm tus neeg mob. Cov lus tsis txaus siab feem ntau yog kiv taub hau, nrog nrog xeev siab thiab ntuav. Lawv feem ntau yog tinnitus ntawm ib sab, hnov ​​lus tsis zoo, thiab taug kev tsis ruaj khov. Lawv tsuas yog pw ncaj nraim hauv chav zoo li qub thaum lub caij tawm tsam. Thaum txoj haujlwm hloov me ntsis, lawv yuav tig rov qab. zoo nkaus ntawm. Cov neeg mob no yuav muaj Meniere kab mob.

1

txhais tau

Meniere's disease yog kab mob idiopathic sab hauv pob ntseg nrog qhov tsis paub tias muaj tus kab mob ntawm lub ntsws puas. Cov kab mob kev soj ntsuam yog paroxysmal vertigo, hloov pauv ntawm lub pob ntseg tsis hnov ​​lus, tinnitus thiab pob ntseg pob ntseg.

2

Qeb

Vestibular Meniere's mob: Cov tsos mob tseem ceeb yog mob taub hau o thiab mob pob ntseg.

Cochlear Meniere's disease: nrog kev hloov pauv hauv kev hnov ​​lus thiab tinnitus yog cov tsos mob tseem ceeb.

3

Cause

Vim li cas tiag tsis paub. Muaj feem ntau yog cov hauv qab no theories:

Endocytic kua dej tsis txaus siab: endolymph kua ntau lawm, nqus tsis txaus;

Kev txhaj tshuaj tiv thaiv kab mob: kev ua xua, cov tshuaj tiv thaiv kab mob thiab autoimmune tsis meej;

Cochlear microcirculatory tsis meej;

Membrane tawg;

Lwm yam: kev ua raws caj ces, endocrine kawg, kis kab mob, thiab lwm yam.

4

pathology

Membrane labyrinth dej o tuaj tube cochlear raj, zais lub ntsej muag → vestibular membrane thawb rau tom ntej kauj ruam → membrane labyrinth dej nce ntxiv, elliptical capsule thiab semicircular canal ampulla expansion → membrane labyrinth siab nce, membrane labyrinth rupture;

Cov plaub hau hlwb, txhawb nqa cov hlwb, cov hlab ntsha hlwb, cov kab mob kev mob caj dab (ganglion cell degeneration lesions, vascular voos) ine sensorineural tsis hnov ​​lus;

Lub hnab ntim epithelial folds ua qis lossis ploj → epithelial cell degeneration, cystic phab ntsa fibrosis → endolymph kua dej tsis haum.

5

Cov chaw kuaj mob

Kiv taub hau: ntau lub sijhawm uas nws20 minYuav12 teev, feem ntau nrog rau xeev siab, ntuav thiab lwm lub zog ua tsis taus pa thiab taug kev tsis ruaj khov thiab lwm yam kev ua tsis tiav, nco ploj; sib quas ntus ntawm lub hnub nyoog kawg, tab sis tej zaum yuav cuam tshuam nrog kev ua kom lub cev tsis sib xws. Cov neeg mob nrog ob leeg Meniere tus kab mob tuaj yeem nrog kiv taub hau, tsis khov, tshee lossis co tshee;

Hnov tsis hnov ​​lus: Feem ntau, qhov tsis haum ntawm lub teeb tsa ntawm lub suab tsis hnov ​​lus, thiab thaum ntxov feem ntau tsis tshua muaj siab, thiab lub rooj sib hais sib hloov tuaj yeem rov zoo li qub. Thaum tus kab mob no zuj zus, qhov tsis hnov ​​lus zuj zus zuj zus, thiab kev sib hais tsis txaus ntseeg yuav tsis rov qab mus nyob li qub los yog cov lus qhia ua ntej. Feem ntau ntawm cov neeg mob yuav muaj kev rejuvenation;

Tinnitus: Feem ntau ntawm lawv yog nrog tinnitus, uas tuaj yeem tshwm ua ntej lossis tom qab nres, thiab tuaj yeem txo lossis ploj tom qab rov tawm tsam. Hauv cov theem pib ntawm tinnitus, feem ntau ntawm lawv yog lub suab qis suab qis lossis khiav suab, thiab tom qab suab siab kawg suab nrov los yog nplawm;

Mloog zoo li o ntawm lub pob ntseg: Muaj qhov hnov ​​zoo siab los yog siab ntawm pob ntseg ntawm tus neeg mob thaum lub caij tawm tsam.

6

Soj ntsuam kev mob

Ua ntej, kev kuaj xyuas yooj yim

Xws li otoscopy, ntshiab suab audiometry thiab acoustic impedance kuaj.

Thib ob, raws li qhov xwm txheej tuaj yeem xaiv qhov kev soj ntsuam ua haujlwm

1, kuaj lub suab: nrog rau tus neeg saib xyuas lub cev qhuav dej, cochlear electrogram, otoacoustic emission,ABRthiab thiaj li nyob.

2Kev ntsuas ua haujlwm Forecourt: suav nrog cov nystagmus zoo li qub, ntsia pom nystagmus, pom lub suab, khiav ceev, saccade, txoj haujlwm kuaj, ntsuas qhov txias thiab cua sov, kev sib hloov, ntsuas lub taub hau, kuaj lub plawv dhia, vestibular dawb kev sib hloov, vestibular evoked myogenicity Peev Xwm(PEB)Kev pom lub zeem muag ntsug / qib pom lub zeem muag.

3Kev ntsuas kev ua haujlwm tsis sib luag: lub cev kom zoo li qub lossis lub cev nqaij daim tawv zoo sib xws, ntsuas qhov sib txuam ua ke muaj peev xwm ntsuas thiab ntsuas kev ntsuas.

4Kev kuaj mob Tinnitus: tinnitus tone thiab qhov siv txuam ntau.

5Kev soj ntsuam kev ntsuam xyuas: lub hlwb nrog lub kaum ntse ntse me me ntawm lub puab ntawm cov kav dej sab hauvMRIYog tias muaj mob, nws yog qhov ua tau rau tawm ntawm lub ntsej muag sab hauvMRIKev kos duab.

6Kev kuaj mob etiological: suav nrog kev kuaj tshuaj tiv thaiv kab mob, kev kuaj mob ua xua, kev tshuaj ntsuam genetic test, kev tshuaj xyuas endocrine muaj nuj nqi, thiab lwm yam.

7

kuaj mob

()Kev kuaj mob

1,2或 或2Ntau tshaj peb ntu sijhawm ntawm vertigo20 minYuav12 teev.

2Tsawg kawg ntawm kev kuaj kab mob thaum lub sij hawm ua kom paub tseeb tias tus mob muaj pob ntseg pom tias pob ntseg muaj qhov tsawg los ntawm ntu nruab nrab ntawm lub suab tsis hnov ​​lus.

3, kev txom nyem los ntawm kev tsis haum, hnov ​​pob ntseg, tinnitus thiab(Or)Lub pob ntseg yog txhaws.

4Tsis suav vertigo tshwm sim los ntawm lwm yam kab mob, xws li vestibular migraine, tuag tes tuag taw ib ce, benign paroxysmal txoj hauj lwm vertigo, labyrinthitis, vestibular neuritis, vestibular paroxysmal kab mob, tshuaj hob vertigo, posterior ncig ischemia, cranial Internal occupies lesions, thiab lwm yam.; Ntxiv rau, theem nrab membrane labyrinth hydrops yuav tsum tau tshem tawm.

(ob)Soj ntsuam theem

Raws li tus neeg mob nyuam qhuav dhau los6Sib quas ntus sib hais lub hli yog qhov phem tshaj0.5,1.0thiab2.0 kHzNruab nrab ntawm qhov ntsuas lub suab ntawm lub suab ntshiab yog staged. Cov theem kho mob ntawm Meniere tus kab mob cuam tshuam txog kev xaiv ntawm kev kho mob thiab kev kwv yees. Txog ob sab Meniere tus kab mob, qhov chaw kho mob rau ob tog yuav tsum txiav txim cais.

Theem I: ntsuas pob ntseg nruab nrab ≤25 dBHL;

Theem II: Qhov ntsuas ntawm lub suab nruab nrab yog26~40 dBHL;

Theem III: Qhov ntsuas ntawm lub suab nruab nrab yog41~70 dBHL;

Plaub theem: qhov ntsuas nruab nrab ntawm qhov ntsuas> 70 dBHL.

8

Cov chaw kho mob

Ua ntej, kev kho mob ntawm kev tawm tsam

Cov ntsiab lus khomob: tswj kev kiv taub hau, kho cov tsos mob.

()Vestibular inhibitor

Nrog rau cov tshuaj antihistamines, benzodiazepines, tshuaj anticholinergic thiab tshuaj tiv thaiv dopamine, tuaj yeem tswj tau qhov mob sai ntawm qhov pib ntawm vertigo, hauv txoj ntsiab cai, siv tsis ntau tshaj72 teevCov. Cov tshuaj siv rau hauv kev siv tshuaj kho mob suav nrog promethazine, diphenhydramine, diazepam, meclizine, prochlorperazine, droperidol thiab lwm yam.

(ob)Glucocorticoid

Yog hais tias cov tsos mob ntawm tus kab mob ntsug loj heev lossis hnov ​​lus tsis zoo yog qhov tseem ceeb, glucocorticoids yuav muab tshuaj rau qhov ncauj lossis tso ntshav raws li tsim nyog.

(peb)Pab txhawb kev kho mob

Yog tias cov tsos mob ntawm xeev siab thiab ntuav yog mob hnyav, koj tuaj yeem siv lub cev dej kom pab txhawb kev kho mob.

Thib ob, kev kho mob sib quas ntus

Kev siv tshuaj: Txo, tswj lossis tiv thaiv qhov pib ntawm vertigo thaum ua kom zoo tshaj plaws kev tiv thaiv ntawm tus neeg mob uas twb muaj lawm sab hauv pob ntseg.

()Kev kawm siab ntev

Piav qhia rau cov neeg mob txoj kev paub ntawm Meniere tus kab mob, kom nkag siab txog chav kawm ntawm tus kab mob, tej zaum yuav muaj lwm yam xwm txheej, kev kho mob thiab kev kwv yees. Ua haujlwm zoo hauv kev tawm tswv yim txog kev puas siab ntsws thiab kev tawm tswv yim kom tshem tawm kev ntshai ntawm cov neeg mob.

(ob)Hloov kev ua neej

Kev ua haujlwm tsis tu ncua thiab chaw so, zam kev ua ntej xws li lub siab tsis zoo thiab ntxhov siab. Cov neeg mob tau qhia kom txo cov ntsev kom tsawg thiab zam cov khoom uas muaj caffeine, haus luam yeeb thiab cawv.

(peb)betastatin

Nws tuaj yeem txhim kho cov ntshav mus rau sab hauv pob ntseg, ua kom sib npaug ntawm ob sab sib luag vestibular nucleus kev tso tawm, thiab ua tiav lub hom phiaj ntawm kev tswj hwm qhov pib ntawm vertigo los ntawm khi rau lub hauv paus central receptor.

(plaub)Diuretic

Nws muaj cov nyhuv ntawm relieving hydronephrosis thiab tuaj yeem tswj hwm qhov pib ntawm vertigo. Cov tshuaj yeeb yaj kiab uas nquag siv hauv kev siv tshuaj kho mob suav nrog hydrochlorothiazide, triamterene, thiab lwm yam. Cov ntshav poov tshuaj concentration yuav tsum tau soj ntsuam kom tsis tu ncua thaum tswj hwm.

()Tympanic txhaj ntawm glucocorticoid

Nws tuaj yeem tswj hwm qhov pib ntawm vertigo hauv cov neeg mob, thiab kho kev kho mob yuav cuam tshuam nrog txhim kho cov xwm txheej ntawm endolymphatic hydrops thiab kev tswj kev ua haujlwm. Cov txheej txheem tsis muaj kev puas tsuaj rau cochlea thiab vestibular kev ua haujlwm ntawm tus neeg mob, thiab cov nyhuv tshuaj tiv thaiv thaum pib yog qhov tsis zoo, thiab kev tswj hwm tympanic tuaj yeem rov ua dua txhawm rau txhim kho tus nqi vertigo.

()Tympanic tsis tshua muaj siab kev kho cov mem tes

Nws tuaj yeem txo qhov tsawg zaus ntawm cov kev siv ntsug thiab tsis muaj qhov cuam tshuam txog lub rooj sib hais. Cov txheej txheem kho mob tsis meej thiab tej zaum yuav cuam tshuam nrog kev ntxhov siab-txhawb nqa endolymphatic nqus. Lub tympanic membrane feem ntau muab tso ua ntej, thiab tus naj npawb ntawm kev kho mob yog nyob ntawm qhov zaus thiab qhov mob hnyav heev ntawm cov tsos mob.

(xya)Tympanic txhaj ntawm gentamicin

Ua tau zoo tswj cov tsos mob ntawm vertigo nyob rau hauv cov neeg mob feem ntau(80~ ~90%)Qhov tshwm sim ntawm kev hnov ​​lus nyob hauv cov pob ntseg txhaj yog kwv yees li ntawm10~ ~30%, lub tshuab muaj feem xyuam nrog kev tsis sib thooj tshuaj labyrinthectomy.

(yim)Kev phais mob

Xws li kev phais endolymphatic lub hnab phais, peb lub pob txha semicircular thaiv, vestibular neurotomy, labyrinthectomy thiab lwm yam. Qhov ntsuas qhov yog tias tus thib ob huam heev thiab nquag.6Cov neeg mob uas tsis tau raug kho rau kev kho mob tshwj xeeb tsis yog rau kev kho mob rau ib hlis.

Txuas :Nrov Science: Meniere's disease

REF: Hnov Lus NugTus Hais Kom Mloog Kom Ntsej Muag BTE Hnov Lus Siv
Kab lus los ntawm Internet. Yog tias muaj kev ua txhaum cai, thov hu rau service@jhhearingaids.com kom tshem tawm nws.

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