EMG (Electromyography): Chii Chinoratidzwa neKuongororwa kweTerve and Tsandanyama? Uye Zvazvisingagone

Key tora kutora

• EMG bvunzo yemuviri, kwete bvunzo yemifananidzo. Electromyography inoyera mashandiro emagetsi; MRI, ultrasound uye chimiro cheX-ray.
• EMG haiwanzo mira yoga. Mukuita kwemaitiro enguva dzose, zvidzidzo zveEMG nekufambisa tsinga zvinoitwa panguva imwe chete uye zvinodudzirwa pamwe chete.
• Kubata nguva kunokosha. Kuchinja mushure mekukuvara kwetsinga kana radiculopathy kunogona kutora mazuva kusvika kumavhiki mashoma kuti kuonekwe, saka kudzidza kwekutanga kunogona kuva kwakajairika.
• Mhedzisiro yacho imhando yezvirwere, kwete kuongororwa kwezvirwere. Zvakawanikwa paEMG zvinoratidza marudzi ezvirwere uye zvinofanirwa kuverengwa pamwe chete nezviratidzo zvako, kuongororwa uye mimwe miedzo nachiremba akakumbira chidzidzo ichi.
• Miganhu ndeyechokwadi. EMG haigone kuongorora tsinga diki dzisina myelin, nzira dzetsinga dzepakati, kana kuti muviri wemunhu zvichikonzera kumanikidzwa kwetsinga.

Pakuona

Uyewo anozivikanwa se

• Kuongororwa kweEMG
• Electromyography
• Kuongororwa kwetsinga / kudzidza kwetsinga (izwi rinowanzo shandiswa nemurwere muIndia)
• Kuongororwa kweEMG-NCV kana NCV (kumhanya kwekufambisa tsinga), zviri pachena kuti chidzidzo chekufambisa, chinowanzo shandiswa kureva chikamu chose
• Needle EMG (kuisiyanisa nesurface EMG inoshandiswa mukutsvaga uye biofeedback)
• Chidzidzo cheElectrodiagnostic (EDX)

Chii chinonzi EMG

Electromyography inoongorora zviratidzo zvemagetsi zvinogadzirwa netsandanyama. Electrode yakanaka isina tsvina inoiswa mutsandanyama yakasarudzwa. Muongorori anotarisa mashandiro emagetsi kana tsandanyama yakasununguka uye paunoibata zvinyoro nyoro uye wobva wawedzera simba. Mabasa asina kujairika ega panguva yekuzorora, uye shanduko muhukuru, chimiro uye maitiro ekugamuchira zviratidzo panguva yekubata, zvinoratidza dambudziko retsinga (neurogenic pattern) kana dambudziko riri mukati metsandanyama pachayo (myopathic pattern).

Zvidzidzo zvekufambisa tsinga zvinoshandisa maerekitirodhi madiki epamusoro uye mapfupi emagetsi paganda kuti zvione kuti tsinga dzinotakura zviratidzo nekukurumidza uye zvakasimba sei. Nekuti matambudziko etsandanyama netsinga anopindirana muzviratidzo zvavo, bvunzo mbiri idzi dzinoenderana; kududzira nendebvu EMG pasina ruzivo rwekufambisa tsinga hazviwanzoitiki.

Chikonzero nei EMG yaitwa

• Kuparadzanisa tsinga kubva kune tsandanyama. Kushaya simba kunogona kukonzerwa nezvirwere zvetsandanyama, kudzvanywa kwemidzi yetsinga, kukuvara kwetsinga dzemumativi, kubatana kwetsinga dzemusana, kana kuti motor neurone pachayo. EMG inobatsira kugadzirisa izvi.
• Kuziva kukuvara kwetsinga. Semuenzaniso, kusiyanisa chirwere checarpal tunnel syndrome paruoko nedambudziko remidzi yetsinga yemuromo wechibereko, kana kuona kuti ndeipi midzi inokanganiswa.
• Kutsanangura chirwere chepfungwa (neuropathy). Kana maitiro acho achikanganisa axon kana myelin sheath, ingave yakaenzana kana kuti ine makwapa, uye kuti yakanyanya sei.
• Kuongorora chirwere chinofungidzirwa chetsinga dzemutsinga zvakaita seamyotrophic lateral sclerosis, uko kupararira kwemasero eropa munzvimbo dzakasiyana dzemuviri kwakakosha.
• Kuongorora chirwere chinofungidzirwa chekuzvimba kwetsandanyama uye kubatsira kusarudza nzvimbo yekuongorora tsandanyama.
• Kutevera kupora mushure mekukuvara kwetsinga, kukuvara kana kuvhiyiwa, uko zvidzidzo zvakatevedzana zvinogona kuratidza kudzoka kwesimba.
• Kutungamira maitiro zvakaita sekunangwa kwejekiseni re botulinum toxin mu dystonia kana spasticity.

Ndiani anofanira kuongororwa uku?

Ongororo dzeEMG nedzekufambisa tsinga dzinokumbirwa kana nhoroondo nekuongororwa zvichiratidza dambudziko retsinga kana tsandanyama uye mhinduro yacho ichichinja manejimendi. Mamiriro ezvinhu akajairika anosanganisira:

• Kunzwa kusanzwa, kukwenya kana kupisa mumaoko kana patsoka, kunyanya kana paine chirwere cheshuga, chirwere chethyroid, kushomeka kwevhitamini B12 kana kushandisa doro.
• Kurwadziwa kwemaoko uye kukwenya kwehusiku zvinoratidza kuti carpal tunnel syndrome, kunyanya vasati vavhiyiwa zvinofungidzirwa
• Kurwadziwa kweruoko kana gumbo kunobva pamutsipa kana pasi pemusana, uko zviratidzo nezviratidzo zvisingaenderane.
• Kushaya simba kunofambira mberi kana kusina tsananguro, kupera simba kwetsandanyama, kudonha kwetsoka kana kuoma kusimuka kubva pachigaro
• Kugwinha kwetsandanyama pamwe nekuneta kana kupera simba (kugwinha kwega, pasina kushaya simba, kazhinji hakuna kuipa)
• Kusasimba kwemuviri, maziso akarembera kana kuona kaviri, uko kuongororwa kwakakosha kwetsinga dzemutsinga dzakadai sekukurudzirwa kwetsinga kakawanda kunowedzerwa
• Kukuvara kwetsinga mushure mekukuvara, kutyoka, kubaiwa jekiseni kana kuvhiyiwa, uko huwandu hwekukuvara uye mukana wekupora zvinoda kuongororwa
• Ma enzymes emhasuru akakwidziridzwa (CPK) ane kushaya simba, kana kuti anofungidzirwa kuti ane hutachiona hwepfungwa

EMG haisi bvunzo yekuongororwa. Haibatsiri pakurwadziwa kwemuviri nguva dzose, kuneta chete, kana sekuongorora muviri wese.

Izvo EMG isingakwanise kuona kana kusabvisa

• EMG haina mufananidzo wechinhu chero chipi zvacho. Electromyography haigone kuratidza kudonha kwediski, kutetepa kwemuzongoza, bundu, kana chimiro chetsandanyama. MRI inodiwa kuti ione kana paine muviri.
• EMG haiongorore uropi kana musana zvakananga. Multiple sclerosis chirwere chinobvisa myelin mumuviri uye hachiongororwi neEMG; MRI, uye mune dzimwe nguva, mhedzisiro dzinoonekwa dzinoshandiswa. Zvinyorwa zvekare zvinoratidza MS seEMG hazvina kururama.
• Standard EMG-NCS haiedze tsinga diki. Tsoka dzinopisa kana kurwadziwa kwe small-fiber neuropathy zvinogona kuitika kana paine chidzidzo chakajairika. Mimwe miedzo yakadai se ganda biopsy kana autonomic testing inogona kudiwa.
• Kutsamwiswa kwemidzi yetsinga dzinonzwa chete kunogona kushaikwa. Needle EMG inoongorora mamotor fibers; radiculopathy inokonzera kurwadziwa pasina kubatanidzwa kwemotor inogona kunge yakajairika.
• Zvakawanikwa pakutanga zvinogona kunge zvisati zvawanikwa. Mushure mekukuvara kwakanyanya kweaxonal, kuita zvinhu zvisina kujairika kunowanzoitika mushure memazuva mashoma kusvika kumavhiki mashoma, saka kudzidza kwekutanga kunogona kunyaradza zvisiri izvo.
• Tsandanyama netsinga zvakatorwa chete ndizvo zvinoongororwa. Chidzidzo ichi chakanangana nepfungwa yacho. Mutemo mudiki hautauri chinhu nezvenzvimbo dzisina kuongororwa.
• EMG yakajairika haina kufanana ne "hapana chirwere". "Hazvizivikanwe" zvinoreva kuti hapana chakaipa chakaonekwa mutsandanyama netsinga dzakaedzwa panguva iyoyo. Kana zviratidzo zvikaramba zvichiwedzera kana kuti zvikawedzera pasinei nemigumisiro yakajairika, dzokera kuna chiremba wako pane kufunga kuti dambudziko racho harina kutaurwa.
• Chikonzero hachiwanzo kuratidzwa. EMG inogona kuratidza chirwere chepfungwa chinonzi sensorymotor axonal neuropathy asi haigone kutaura kana chikonzero chacho chiri chirwere cheshuga, kushomeka kweB12, mushonga kana chimwe chinhu. Kuongororwa kweropa uye kuongororwa kwekiriniki kunopindura izvozvo.

Bvunzo dzakabatana asi dzakasiyana

Kuti ndeipi bvunzo inotanga kutangira zvinoenderana nedambudziko rekiriniki. Kune inofungidzirwa kuti carpal tunnel syndrome, kuongororwa kwemagetsi kazhinji ndiyo nhanho yekutanga ine ruzivo rwakawanda. Kune kurwadziwa kwemusana kwakakomba nekushaya simba kwegumbo uye kufungidzirwa kuti tambo yeropa kana cauda equina, MRI yekukurumidzira ndiyo inonyanya kukoshesa uye EMG haisiyo bvunzo yekukurumidza. Kune inofungidzirwa kuti inokonzerwa nekuzvimba, kuongororwa kweropa uye kuongororwa kwekiriniki kunowanzo tangira EMG.

Maitiro ekugadzirira

Kugadzirira kuri nyore, asi mirairo chaiyo inongoenderana nechikamu chimwe chete. Mirayiridzo yakanyorwa yeyuniti yako yekuyedza ndiyo inonyanya kukosha pane chero chaunoverenga pano.

• Idya uye inwa zvakajairika kunze kwekunge chikwata chako chakuudza zvakasiyana. Kutsanya hakuwanzodiwa.
• Siya mafuta anonhuhwirira, mafuta uye makirimu pamakumbo pazuva rekuongororwa, sezvo zvichikanganisa kubatana kweelectrode. Ganda rakachena uye rakaoma rinoshanda zvakanyanya.
• Pfeka zvipfeko zvisina kusimba zvinobvumira kupinda mumaoko, makumbo kana nzvimbo yaunofarira. Gown rinogona kupihwa.
• Uyai nezvinyorwa zvenyu. Mishumo yeEMG yapfuura, mafirimu eMRI, mishumo yeshuga yeropa uye HbA1c, uye runyorwa rwemishonga iripo parizvino zvese zvinobatsira.
• Rondedzera zviratidzo zvako nemazvo. Ndezvipi zvigunwe kana zvigunwe, kuti zvinoreba sei, kana zvakanyanya kuipa husiku, kana kusasimba kuripo. Izvi zvinoumba tsinga netsandanyama zvinodzidzwa.
• Udza timu pachine nguva Kana ukatora mishonga inobvisa ropa rakawanda kana mishonga inorwisa maplatelet, uine dambudziko rekubuda ropa, uine pacemaker, wakaisirwa defibrillator kana deep brain stimulator, uine lymphoedema kana dialysis fistula mugumbo, kana uine chero hutachiona hweganda kana ronda rakavhurika pedyo nenzvimbo yekuyedzwa.

Musamira, musatanga kana kuchinja chero mushonga wamakanyorerwa uri wega. Kana mushonga wakadai semushonga unorwisa ropa kana mushonga unoshandiswa pakurapa myasthenia uchigona kukanganisa chidzidzo, chikwata chichakurukura izvi nemunyoreri wenyu uye munyoreri ndiye achasarudza.

Kana ukatora mishonga inobvisa ropa kana kuti une katsika kekubuda ropa

Needle EMG inogona kuitwa kuvanhu vazhinji pavanenge vachidzivirira ropa kuti risaungane, kazhinji nekuiswa kwetsandanyama shoma uye kudzivirira tsandanyama dzakadzika. Uyu mutongo unoitwa nachiremba anoongorora mushure mekuongorora mishonga yako uye chero zvabuda muINR kana platelet. Usambofa wakasiya mushonga wega kuti ugadzirire bvunzo.

Kana uine cardiac pacemaker, ICD kana implanted stimulator

Needle EMG pachayo haisi dambudziko. Kukurudzirwa kwemagetsi panguva yekuongorora tsinga kunoda kutarisirwa, kunyanya pedyo nechipfuva kana pamusoro pechinhu chakaiswa kana tambo dzacho, uye pedyo nemitsetse yetsinga iri pakati. Taura mudziyo kuitira kuti nzira yacho igone kugadziriswa.

Kana uine chirwere cheshuga

Inwai chikafu chenyu chamunogara muchidya nemishonga kunze kwekunge makarairwa zvakasiyana, sezvo bvunzo yacho isingade kutsanya. Kana muri kushandisa insulin kana sulfonylurea uye nguva yekusangana nemiedzo ingangononotsa kudya, takurai chikafu chekudya chega chega uye glucometer yenyu.

Caffeine nezvinhu zvinokurudzira

Murayiridzo wekuti usatore caffeine kwemaawa makumi maviri nemana haudiwi nevanhu vose paEMG-NCS uye hautsigirwi semutemo wenguva dzose. Mamwe mayuniti anokumbira usati watora mamwe maitiro chaiwo. Tevedzera mirairo yeyuniti yako pane mutemo wenguva dzose.

Chii chinoitika panguva yebvunzo

Kazhinji unogara kana kurara pasofa muimba inodziya; makumbo anotonhora anochinja maitiro ekufambisa tsinga, saka ganda rinogona kutanga radziirwa.

• Kudzidzira kufambiswa kwetsinga kutanga, mumayuniti mazhinji. Maelectrode epamusoro anonamirwa paganda. Chinhu chidiki chinosimudzira kufema chinopa mapuroteni mapfupi anonzwa sekunge kupomba kwakapinza kana kuvhunduka kwemagetsi zvishoma uye chinoita kuti tsandanyama dzidengenyeke. Kupomba kwega kwega kunogara kwesekondi.
• Needle EMG inotevera. Ganda rinocheneswa uye electrode diki yetsono inopinzwa mutsandanyama yakasarudzwa. Unonzwa kurwadza kwenguva pfupi. Uchakumbirwa kuzorora zvizere, wobva wadzvanya tsandanyama zvinyoro nyoro, wozobva wanyatsosimba. Tsono inogona kuiswa zvishoma mukati metsandanyama kuti iongorore nzvimbo dzakasiyana, uye tsandanyama dzinoverengeka dzinowanzo ongororwa.
• Dudziro iri mhenyu. Zviratidzo zvinoonekwa pachikirini uye zvinonzwika zvakanaka. Chiremba anoongorora anogadzirisa maitiro acho sezvo zvabuda, ndosaka huwandu hwetsandanyama dzakaedzwa huchisarudzwa panguva yekudzidza pane kugadziriswa pachine nguva.
• Hapana kunyaradza. Unoramba wakamuka uye uchishandira pamwe chete kwenguva yese, nekuti kuzvimba kwemuviri nekuzvidira chikamu chebvunzo.

Zvinotora nguva yakareba sei kuti maitiro acho aite

• Chidzidzo chepfungwa chegumbo rimwe chete (semuenzaniso, chirwere chinofungidzirwa kuti checarpal tunnel syndrome): kazhinji chinotora maminetsi angangoita makumi maviri kusvika makumi mana.
• EMG-NCS yakajairika yezvirwere zvepfungwa kana radiculopathy: kazhinji maminetsi makumi matatu kusvika makumi matanhatu.
• Zvidzidzo zvakawanda kufukidza makumbo akati wandei, tsandanyama dzemusana kana tsandanyama dzemusoro, kana kusanganisira kukurudzira kunodzokororwa: kunogona kupfuura awa imwe chete.
• Nguva yese mudhipatimendi yakareba kupfuura bvunzo pachayo kana kunyoreswa, kubvumidzwa, kudziya kweganda uye kuongororwa mushure mekuongororwa kwabatanidzwa.
• Mushumo nekukurukurirana: Chiremba anoongorora anoongorora mafungu emuviri uye anogadzirira mushumo wekududzira; nguva dzekuburitswa kwemasero dzinosiyana pakati pemayuniti, uye mushumo wacho unofanirwa kuverengwa nachiremba wako ari kurapa.

Mushure mezvo, vanhu vazhinji vanotangazve kuita mabasa avo enguva dzose ipapo ipapo, kusanganisira kutyaira, sezvo pasina mushonga unonyaradza. Kurwadza kudiki kana kukuvara kudiki panzvimbo dzakapinzwa netsono kunogona kutora zuva rimwe kana maviri.

Kunzwisisa mushumo wako

Mushumo weEMG-NCS unotsanangura. Unoratidza tsinga netsandanyama zvakadzidzwa, zviyero zvakayerwa zvichienzaniswa nezviratidzo zverabhoritari, uye unoguma nendima yekududzira. Zviratidzo zvinoenderana nerabhoritari uye zera, saka nhamba dzinobva kune rimwe rabhoritari hadzifanirwe kuenzaniswa zvakananga neimwe. Mapatani anowanzotsanangurwa anosanganisira:

• Kudzidza kwakajairika: kukosha kwekufambiswa kwetsinga mukati menzvimbo yakatarwa nerabhoritari, hapana chiitiko chisina kujairika chinongoerekana chaitika panguva yekuzorora, uye saizi yenhengo dzemuviri dzakajairika uye kuunganidzwa kwetsandanyama dzakatorwa.
• Maitiro eNeurogenic: Kuderedzwa kwekushandiswa kwemasero etsinga dzemuviri nemidziyo mikuru yetsinga inogara kwenguva refu, dzimwe nguva nefibrillation potentials kana positive sharp waves. Zvinoratidza kupindira kwetsinga dzetsinga kana dzetsinga dzetsinga; chirwere chetsinga chinogona kufungidzirwa kakawanda.
• Maitiro ekurapa kwemyopathic: Zvishandiso zvidiki zvemuviri zvenguva pfupi zvine simba rekushandisa masero nekukurumidza. Zvinoratidza maitiro ekuita tsandanyama.
• Zvinhu zvinobvisa myelin: kunonoka kwakakura kwekumhanya kwemhepo, kunonoka kwenguva refu, kuvharika kwemhepo kana kupararira kwenguva pfupi.
• Zvinhu zveAxonal: kuderedzwa kwemhinduro dzemhinduro nemafambiro akachengetedzwa zvishoma.
• Kusarongeka kwemaziso: kunonoka kana kuvharika kwakavharirwa kuchikamu chimwe chete, separuoko mune carpal tunnel syndrome kana gokora retsinga ye ulnar.

Mazita aya anotsanangura maitiro emagetsi, kwete zita rechirwere. "Maitiro etsinga" haarevi chirwere chetsinga dzemutsinga, uye kusarongeka kudiki pamushumo hakusi chiratidzo chekuti wakaremara sei. Kududzirwa kwenyaya yako yekiriniki ndekwachiremba akakumbira chidzidzo ichi. Mhedzisiro inosiyana zvichienderana nemamiriro ekiriniki emunhu wega wega.

Kana mhedzisiro inogona kutsausa

Zviwanikwa zvinogona kuoneka zvisina kujairika kana kuti zvakawedzerwa

• Kutonhora mitezo kunonoka kufambisa uye kunogona kutevedzera kana kuwedzeredza kunonoka kana tembiricha ikasadzorwa.
• Zvinhu zvehunyanzvi zvakaita sekusabatana zvakanaka kwema electrode, ganda rakaoma kana rine mafuta, kuzvimba, kufuta kana kukanganiswa kwemagetsi zvinogona kukanganisa amplitude uye latencies.
• Kuzorora kusina kukwana panguva yekushandiswa kwenenji EMG inogadzira basa rinogona kuverengerwa zvakanyanya; kuchengetedza kwekuzvidira nekuda kwekurwadziwa kunoderedzawo kuongororwa kwekushandiswa kwenenji.
• Kuchinja kunokonzerwa nezera. Kudzikira kudiki kwemanzwiro, kunyanya mutsoka dzevakuru, kungave kuri kuwanikwa kwakajairika kwekukwegura kwete chirwere.
• Zviwanikwa zvisina zviratidzo, zvakadai sekunonoka kwetsinga dzepakati peruoko pasina zviratidzo, hazvisi izvo zvega zvinoita kuti kurapwa kuenderane nezvinodiwa.
• Njodzi EMG yazvino inogona kuwedzera CPK muropa kwenguva pfupi, izvo zvinogona kukanganisa kuongororwa kweropa kunoitwa nguva pfupi inotevera.

Zvakawanikwa zvinogona kuoneka sezvisiri zvechokwadi kana kuti zvisina kufanira

• Kuedzwa nekukurumidza mushure mekukuvara kwetsinga kwakanyanya, shanduko dze denervation dzisati dzaitika.
• Neuropathy yefibre diki, izvo zvibvumirano zvemazuva ose zvisingatarise.
• Kunzwa kwe radiculopathy kwakachena kana kutsva kwemidzi kudiki pasina kurasikirwa nemota ye axon.
• Tsandanyama dziri pedyo kana dzakadzika hadzina kutorwa, kana kuti chinhu chisina kujairika chakaganhurirwa munzvimbo isina kuongororwa.
• Myasthenia gravis, chirwere chepfungwa, iyo inowanzoda kukurudzirwa kakawanda kana kuti single-fiber EMG pane kushandisa nendiro EMG yenguva dzose.
• Myopathy isina kunaka, uko tsono inogona kuedza zvikamu zvemhasuru zvisina kukanganiswa.
• Mamiriro ezvinhu anochinja-chinja vanonyararira pazuva rebvunzo.

Njodzi nekuchengetedzeka

Kuongororwa kwemagetsi kunowanzo bvumidzwa zvakanaka, uye matambudziko akakomba haawanzoitiki. Njodzi hadzina kufanana muzvikamu zvakasiyana zvechidzidzo.

Zvidzidzo zvekufambisa tsinga (kukurudzira pamusoro)

Hapana tsono dzinopinda mutsandanyama. Kunzwa kushoma uye kunomira kana kukurudzira kwamira. Kutsvuka kudiki kweganda kunobva kumaelectrodes kana tepi kunogoneka. Kungwarira kwakakosha kunodiwa pedyo nepacemakers yemwoyo, ma defibrillators akaiswa, zvinosimudzira tsinga kana uropi zvakaiswa, uye mitsetse yepakati yevenous kana dialysis; taura nezvezvishandiso izvi usati watanga.

Tsono EMG

Migumisiro inotarisirwa kurwadziwa kwenguva pfupi pakuisa mushonga uye kurwadziwa kwenguva pfupi. Matambudziko asingawanzoitiki anosanganisira mavanga madiki kana kubuda ropa munzvimbo imwe chete, kunyanya kune avo vanoshandisa mishonga inorwisa ropa; hutachiona hweganda remunharaunda, husingawanzoitiki netsono dzisina utachiona dzinoshandiswa kamwe chete; uye dzungu renguva pfupi kana kufenda, ndosaka uchifanira kutaura kana uchinzwa kusagadzikana panguva yekuongororwa. Kashoma, kupinza tsono pedyo nemadziro echipfuva kana axilla kune njodzi ye pneumothorax, uye vaongorori vane ruzivo vanoshandisa nzira dzakati kuti dzideredze. Kukuvara kwetsinga zvakananga kubva patsono hakuwanzoitiki.

Repetitive nerve stimulation

Inowedzera kukurudzira kunodzokororwa, izvo zvinonetsa asi hazvive nenjodzi inogara kwenguva refu mukuita mabasa enguva dzose.

Needle EMG haipindi zvakanyanya pane kuti isapindi, uye magwaro ekare anoitsanangura seisina kupinda haana kururama. Mhedzisiro uye kushivirira kunosiyana zvichienderana nemamiriro ezvinhu ekurapa emunhu mumwe nemumwe.

Mamiriro ezvinhu anokosha

Kuberekwa

Zvidzidzo zveEMG nekufambisa tsinga hazvishandisi mwaranzi ionizing uye hapana musiyano. Carpal tunnel syndrome uye meralgia paraesthetica zvakajairika panguva yekuzvitakura uye zvinogona kuongororwa. Maitiro ekuita anowanzo chengetedzwa, uye nzvimbo yacho inogadziriswa kuti inyaradze. Zivisa timu kuti une mimba kuitira kuti nzvimbo dzekurudziro nenzvimbo dzetsono dzisarudzwe zvakakodzera.

Children

Zvidzidzo zvevana zvinoda muongorori ane ruzivo nezvevana, nzira pfupi dzakatarwa, kukosha kwezviratidzo zvinoenderana nezera, uye kuvapo kwemubereki. Kirimu yeanesthetic yemunzvimbo kana, mune dzimwe nguva, sedation inogona kushandiswa zvichienderana nemutemo weyuniti. Kushandira pamwe kunoganhurira izvo ongororo yekuzvidira-kuvharwa kwevana mudiki zvikuru inogona kuratidza.

Vakuru vakuru

Kunzwa kushoma mumakumbo epasi kunowanzoitika kana munhu akura uye hazvifanirwe kutorwa sechirwere. Ganda rakatetepa netsinga dzisina kusimba zvinoita kuti pave nekukuvadzwa zvishoma. Nzvimbo yakasununguka uye nzira pfupi inowanzo shandiswa.

Chirwere cheshuga nevanhu vari kurapwa nekuderedza shuga yeropa

Chirwere cheshuga chinonzi polyneuropathy ndechimwe chezvikonzero zvinowanzoita kuti munhu atumirwe kuchipatara. Hazvidikanwi kutsanya; ramba uchidya nguva dzose uye mishonga kunze kwekunge waudzwa zvimwe, uye takura chikafu chekudya kana ukatora insulin kana sulfonylurea. Cherechedza kuti chirwere cheshuga chinonzi neuropathy chinorwadza chinogona kunge chiri chinhu chinowanikwa mu small-fiber, saka ongororo yakajairika haibvisi izvi.

Chirwere cheitsvo chisingaperi uye dialysis

Uraemic neuropathy uye carpal tunnel syndrome zvese zvakajairika mu longterm dialysis. Dzivisa maelectrodes, kukurudzira uye kuisa neckline pamusoro pe arteriovenous fistula kana graft limb, uye udza timu kuti nderupi ruoko rwakachengetedzwa. Njodzi yekubuda ropa inogona kunge yakanyanya nekuda kwekusashanda zvakanaka kwemaplatelet uye kudzivirira kuungana kweropa panguva ye dialysis, saka kuronga mazuva e dialysis kunokosha.

Kukundikana kwemoyo uye midziyo yemwoyo yakaiswa

Kuzvimba kwemakumbo kunoderedza kunaka kwemasaini uye kunogona kuchinja mafambiro emuviri. Kurara pasi kunogona kusagadzikana uye sofa rinogona kugadziriswa. Taura nezve pacemaker kana defibrillator kuitira kuti stimulation iri pedyo nemudziyo nemaleads ichinje.

Lymphoedema kana kuti mushure mekuvhiyiwa kwenhengo

Kuisa tsono nekuisa maerekitironi pagumbo rakakanganiswa zvinowanzo dzivirirwa kana kuderedzwa nekuda kwezvirwere uye kuzvimba; taurira timu iyi usati watanga kudzidza.

EMG mumamiriro ezvinhu eIndia

• Mashoko emunharaunda. Varwere vazhinji muIndia vanonzi vanoongororwa "EMG-NCV" kana kungoti "bvunzo yetsinga". Chikamu cheNCV chidzidzo chekufambisa tsinga; chikamu cheEMG kuongororwa kwetsandanyama netsono. Chikumbiro che "NCV chete" chinowanzoitika asi kazhinji hachina kukwana kana paine kusasimba kana kuti kufungidzirwa kuti une radiculopathy.
• Chirwere cheshuga chine chekuita neuropathy ndiyo chikonzero chikuru chekutumirwa kuchipatara, tichifunga nezvemutoro mukuru wechirwere cheshuga cherudzi rwechipiri muIndia. Kuongororwa kweropa nemagetsi kunoshandiswa nenzira yekusarudza, sezvo chirwere chepfungwa chediabetic neuropathy chinowanzoonekwa sechirwere chepfungwa.
• Kurwara kwezvekudya zvinovaka muviri uye kushomeka kwetsinga: kunyanya kushomeka kwevhitamini B12, uko kunowanzoitika mukudya kwevasingadyi nyama zvakanyanya, kunofanira kufungwa pamwe chete nezvakawanikwa pakuongorora chirwere chemagetsi.
• Maperembudzi achiri chikonzero chakakosha che mononeuropathy uye kukora kwetsinga mune dzimwe nzvimbo dzeIndia, uye zvinogona kugadzira mapatani e focal kana multifocal pakuongorora kwekufambisa tsinga.
• Neuropathy ine chekuita nemishonga uye chepfu inofanira kutariswa: mushonga wekurwisa TB (isoniazid), mimwe mishonga yekurapa kenza, uye mishonga yemishonga isina kudzorwa, AYUSH kana mishonga yekuwedzera gym ine heavy metal kana zvinhu zvisina kunyorwa mazita.
• Kutumirwa kuchipatara nekuda kwebasa uye kukuvara kukuvara kwetsinga dzemumakumbo (brachial plexus) kunowanzoitika mushure metsaona dzemumugwagwa, kukuvara kwetsinga dzemudumbu nekuda kwejekiseni, uye kukuvara kwetsinga dzemudumbu nemutsipa (repetitive-strain entrapment neuropathies).
• Kuwanika. Marabhoritari ekuongorora ma electrodiagnostic anowanikwa mumaguta makuru nezvipatara zvekudzidzisa. Hunhu hunoenderana zvakanyanya nekudzidziswa kwevashandisi, kudzora tembiricha uye ruzivo rwekutarisa ruzivo rwemarabhoritari, saka takura mushumo wako wekutanga uye ma waveform printouts kana uchitsvaga imwe pfungwa.

Mutengo neinishuwarenzi muIndia

Mari yeEMG-NCS muIndia inosiyana zvakanyanya pakati pehurumende, trust nenzvimbo dzepachivande uye pakati pemaguta. Mari inotorwa mu? uye inoenderana nehukuru hwechidzidzo pane muripo mumwe chete wakatarwa. Zvinhu zvinokanganisa mutengo zvinosanganisira:

• Huwandu hwemakumbo netsinga dzakadzidzwa: kuongorora chirwere checarpal tunnel syndrome negumbo rimwe chete kunodhura zvishoma pane kuongorora kwegumbo rimwe chete
• Kana needle EMG ichibatanidzwa kana kuti zvidzidzo zvekufambisa tsinga zvinongoitwa chete
• Mamwe maprotocol zvakaita sekudzokorora tsinga dzinokurudzira, mafungu eF, blink reflex, single-fiber EMG kana autonomic testing
• Consumables: maelectrode etsono asingakuvadzi anoshandiswa kamwe chete
• Ndiani anoita uye anoshuma chidzidzo, uye kana kubvunzana kwakabatana
• marongero: murwere ari muchipatara uchienzaniswa nemurwere wekunze, chidzidzo cheICU pamubhedha, chikamu cheguta nechikamu chechipatara
• Kudzokorora kana kuti zvidzidzo zvakatevedzana yekutarisa kupora

Panyaya yeinishuwarenzi: bvunzo dzekuongorora varwere vasiri muchipatara hadziwanzo kuvharwa nehurongwa hwekuchengetedza hutano muIndia kunze kwekunge zvakabatana nekupinda muchipatara kana kuti zvakafukidzwa nerubatsiro rweOPD. Kana EMG ikaitwa panguva yekubvumidzwa muchipatara, inowanzova chikamu chebhiri rekurapwa muchipatara uye zvinoenderana nemitemo yeinishuwarenzi, nguva yekumirira uye kusabatanidzwa. Tarisa nedhipatimendi reinishuwarenzi rechipatara uye kambani yako yeinishuwarenzi usati waongororwa, uye kumbira kuti unyore fungidziro yeprotocol yakarongwa.

Ngano nezvokwadi

Mibvunzo inowanzobvunzwa

EMG yakafanana here neNCV test?

Kwete. Kuedza kumhanya kwetsinga kunoshandisa maelectrode epamusoro uye mapulse madiki emagetsi kuyera kumhanya kwechiratidzo chetsinga nesimba. EMG inoshandisa tsono diki kunyora mashandiro emagetsi etsandanyama. MuIndia zvese zvinowanzoitwa panguva imwe chete uye zvinotaurwa pamwe chete seEMG-NCV, nekuti chimwe nechimwe chinopindura chikamu chemubvunzo.

Ndingakwanisa here kutyaira mota yangu kuenda kumba mushure mezvo?

Kazhinji hongu. Hapana mushonga wekunyaradza kana wekusanzwa kurwadziwa unoshandiswa muEMG-NCS yakajairika, saka kungwarira hakukanganisike. Vamwe vanhu vanonzwa misoro isina kujeka kana kurwadziwa, uye tsandanyama shoma dzemakumbo dzinogona kunzwa kuneta kwenguva pfupi. Kana uchinzwa kupera simba kana kusanzwa zvakanaka mushure mekudzidza, gara pasi, zivisa vashandi uye ronga imwe nzira yekufambisa.

Sei chiremba akaramba achichinja tsandanyama dzakaedzwa?

EMG inotorwa seyakagadzirwa nemunhu. Chiremba anoongorora anogadzira fungidziro sezvo zvawanikwa zvichibuda uye anosarudza dzimwe tsandanyama kana tsinga kuti asimbise kana kubvisa maitiro. Ndokusaka nzira yacho isingagadziriswe nguva isati yasvika uye nei muongorori ane ruzivo achikosha kupfuura michina inoshandiswa.

EMG yangu yakajairika asi maoko angu achiri kurira. Chii chinotevera?

Ongororo yakajairika haibvisi dambudziko. Kurwara nefibre diki, kukuvara kwetsinga nekukurumidza, kutsamwa kwemidzi yemuromo wechibereko pasina kurasikirwa nekushanda kwemuviri uye tsinga dzisina kuongororwa zvese zvinogona kuburitsa zviratidzo kana paine mushumo wakajairika. Dzokera kuna chiremba wako. Kuongororwa kweropa, kutorwa mifananidzo, kuongororwazve mushure menguva pfupi kana bvunzo dzakagadzirwa zvinogona kufungwa.

EMG inogona kudzokororwa here, uye inguva yakareba sei?

Ehe. Zvidzidzo zvinodzokororwa zvinoshandiswa kuteedzera kupora mushure mekukuvara kwetsinga, kutsvaga shanduko dzaive dzisati dzamboonekwa pakutanga, kana kutarisa chirwere chinoramba chichienderera mberi. Nguva yacho inoenderana nemubvunzo wekiriniki, kazhinji mavhiki mashoma mushure mekukuvara kwakanyanya, kana mwedzi yakati wandei kana mushure mekuchinja kunonoka. Chiremba wako anokurapa ndiye anosarudza.

EMG yakachengeteka here kana ndikatora aspirin, clopidogrel kana warfarin?

Needle EMG inowanzo kwanisika, nekuiswa kwetsvina shoma uye kudzivirira tsandanyama dzakadzika, asi sarudzo yacho inoenderana nemushonga wako, mwero weropa rako uye zvakabuda muropa rako munguva pfupi yapfuura. Udza chiremba pachine nguva kuitira kuti chiremba anoongorora agone kuronga uye kutaurirana nechiremba wako. Usarega chero ropa rakanyorwa nachiremba wako.

Ko tsono dzichashandiswazve here?

Maitiro akajairika anoshandisa maelectrode etsono anoraswa kamwe chete, anovhurwa pamberi pako oraswa mushure mekudzidza. Maelectrode epamusoro anoshandiswa pakufambisa tsinga anogona kuraswa kana kucheneswa zvichienderana nemutemo. Unogona kukumbira vashandi kuti vasimbise zviri kushandiswa.

EMG inogona kundiudza chikonzero chepfungwa dzangu dzepfungwa here?

Hazvisi zvega. Zvidzidzo zveElectromyography uye mafambiro etsinga zvinotsanangura maitiro, kupararira uye kuoma kwekubatanidzwa kwetsinga kana tsandanyama. Kuti uzive chikonzero, chirwere cheshuga, kushomeka kwevhitamini B12, chirwere chethyroid, mushonga, chirwere chinogarwa nhaka kana maitiro ekuzvimba, zvinoda nhoroondo, kuongororwa, kuongororwa ropa uye dzimwe nguva kuongororwa kwemajini kana maantibody.

Kukuvara kweEMG kusingawanzoitiki zvinoreva here kuti ndinoda kuvhiyiwa?

Kwete. Mushumo weEMG ndeimwe yemhinduro pakati pedzimwe dzakati wandei. Sarudzo dzekuvhiyiwa kwezvirwere zvakaita secarpal tunnel syndrome kana kumanikidzwa kwemidzi yetsinga dzinoenderana nekuoma kwezviratidzo, kushaya simba kwekushanda, uye mhinduro.