Dhibaatada neerfaha ee dhexdhexaadka ah

Dhibaatada neerfaha ee 'Distal median dysfunction' waa nooc ka mid ah neuropathy durugsan oo saameeya dhaqdhaqaaqa ama dareenka gacmaha.

Nooca caadiga ah ee cillad dareemayaasha dhexdhexaadka ah waa cilladda tunnel tunnel.

Cilad-darrada hal koox oo neerfaha ah, sida neerfaha durugsan, waxaa loo yaqaan 'mononeuropathy'. Mononeuropathy waxaa loola jeedaa inay jirto sababo maxalli ah oo dhaawaca dareemayaasha ah. Cudurada ku dhaca jirka oo dhan (cilladaha nidaamka) waxay sidoo kale sababi karaan dhaawac dareemayaasha oo go'doon ah.

Xaaladani waxay dhacdaa marka neerfaha ay bararsan yihiin, xanniban yihiin, ama ay ku dhaawacmaan dhaawac. Sababta ugu badan ayaa ah dabin (dabin). Dabinku wuxuu cadaadis saaraa neerfaha meesha ay ka marayso meel cidhiidhi ah. Jabka jabku wuxuu dhaawici karaa neerfaha dhexdhexaadka ah. Ama, waxay kordhin kartaa halista xididdada xididdada goor dambe.

Caabuq ku dhaca dareemaha (tendonitis) ama kalagoysyada (arthritis) ayaa sidoo kale cadaadis saaraya dareemaha. Dhaqdhaqaaqyada soo noqnoqda qaarkood waxay kordhiyaan fursadda samaynta dabin tunnel carpal ah. Dumarku way ka saamayn badan yihiin ragga.

Dhibaatooyinka saameeya unugyada u dhow neerfaha ama sababa dhigaal ah inay ku sameysmaan unugyada ayaa xannibaya socodka dhiigga waxayna u horseedi karaan cadaadis dareemayaasha. Xaaladaha noocaas ah waxaa ka mid ah:

• Hormoon koritaan aad u tiro badan oo jirka ku jira (acromegaly)
• Sonkorowga
• Qanjirka 'thyroid' oo aan firfircooneyn (hypothyroidism)
• Cudurka kilyaha
• Kansarka dhiigga ee loo yaqaan myeloma badan
• Uurka
• Cayilka

Xaaladaha qaarkood, sabab looma heli karo. Sonkorowgu wuu sii xumeyn karaa xaaladan.

Calaamadaha waxaa ka mid noqon kara mid ka mid ah kuwan soo socda:

• Xanuun ku dhaca curcurka ama gacanta oo laga yaabo inay daran tahay oo ku toosi kara habeenkii, lagana dareemi karo aagag kale, sida cududda sare (tan waxaa lagu magacaabaa xanuun la soo gudbiyey)
• Dareenku wuu isbeddelayaa suulka, tusmada, dhexda, iyo qayb ka mid ah faraha giraanta, sida dareenka gubashada, dareenka oo yaraada, kabuubyo iyo xoqid
• Tabar darrida gacanta oo kuu keenta inaad wax tuurto ama ay kugu adkaato inaad wax qabato ama aad shaatiga ku garaacdo

Bixiyahaaga daryeelka caafimaadka ayaa baari doona curcurkaaga wuxuuna weydiin doonaa taariikhdaada caafimaad. Tijaabooyinka la qaadi karo waxaa ka mid ah:

• Electromyogram (EMG) si loo hubiyo dhaqdhaqaaqa korantada ee muruqyada
• Tijaabooyinka dareeraha dareeraha si loo hubiyo sida dhakhsaha badan ee calaamadaha korantadu ugu dhex wareegaan neerfaha
• Ultrasound-ka Nuromuscular si loo daawado dhibaatooyinka muruqyada iyo neerfayaasha
• Cad ka-qaadista neerfaha ee unugyada neerfaha laga soo saaro si loo baaro (marar dhif ah ayaa loo baahan yahay)
• 'Magnetic resonance neurography' (sawir aad u faahfaahsan oo ku saabsan neerfaha durugsan)

Daaweyntu waxaa loola jeedaa sababta asalka ah.

Haddii neerfaha dhexdhexaadku ay saameeyaan cilladda tunnel tunnel syndrome, kabay goos goos ah wuxuu yareyn karaa dhaawac dheeraad ah oo ku dhaca dareemaha wuxuuna caawin karaa yareynta calaamadaha. Xidhitaanka kabniinka habeenkii wuxuu nasiyaa aagga wuxuuna yareeyaa bararka. Cirbadeynta gacanta ayaa laga yaabaa inay ka caawiso calaamadaha, laakiin ma hagaajin doonto dhibaatada aasaasiga ah. Qalliin ayaa loo baahan karaa haddii kab ama daawooyin aysan ku caawin.

Sababaha kale awgood, daaweyntu waxay ku lug yeelan kartaa mid ka mid ah kuwan soo socda:

• Daawooyinka lagu xakameeyo xanuunka neerfaha (sida gabapentin ama pregabalin)
• Daweynta dhibaatada caafimaad ee keeneysa dhaawaca dareemaha, sida sonkorowga ama cudurka kalyaha
• Daaweynta jireed si ay uga caawiso ilaalinta muruqyada

Haddii la ogaan karo oo la daweyn karo waxa sababay cilladda neerfaha, waxaa jirta fursad wanaagsan oo soo kabasho buuxda ah. Xaaladaha qaarkood, waxaa jira xoogaa ama gebi ahaanba luminta dhaqdhaqaaqa ama dareenka. Xanuunka neerfaha wuxuu noqon karaa mid daran oo soconaya muddo dheer.

Dhibaatooyinka waxaa ka mid noqon kara:

• Cillad la'aanta gacanta (dhif)
• Qayb ahaan ama gebi ahaanba luminta dhaqdhaqaaqa gacanta
• Faraha ama gebi ahaanba luminta dareenka faraha
• Dhaawac soo noqnoqda ama aan la ogaan oo gacanta ah

Wac daryeel bixiyahaaga haddii aad leedahay astaamo cillad xagga neerfaha ah oo aan shaqeyneynin. Ciladda hore iyo daaweynta waxay kordhisaa fursadda daaweynta ama xakameynta calaamadaha.

Ka-hortaggu wuu kala duwan yahay, iyadoo kuxiran sababta. Dadka qaba sonkorowga, xakamaynta sonkorta dhiigga waxay yareyn kartaa halista ah inuu ku dhaco cilladaha neerfaha.

Dadka leh shaqooyin ku lug leh dhaqdhaqaaqa curcurka oo soo noqnoqda, isbeddel ku yimaada habka shaqada loo qabto ayaa loo baahan karaa. Nasashooyinka soo noqnoqda ee dhaqdhaqaaqa ayaa sidoo kale kaa caawin kara.

Neuropathy - dareemaha dhexdhexaadka ah

• Nidaamka neerfaha iyo nidaamka neerfaha ee durugsan

Craig A, Richardson JK, Ayyangar R. Baxnaaninta bukaanada qaba neuropathies. Gudaha: Cifu DX, ed. Daawada Jirka ee Braddom iyo Baxnaaninta. 5aad. Philadelphia, PA: Elsevier; 2016: cutubka 41.

Katirji B. Cilladaha neerfaha durugsan. Gudaha: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology ee Tababbarka Caafimaadka. 7aad ed. Philadelphia, PA: Elsevier; 2016: cutubka 107.

Toussaint CP, Ali ZS, Zager EL. Cilladaha qabashada ee kala fog: tunnel carpal, tunnel cubital, peroneal, iyo tunnel tarsal. Gudaha: Winn HR, ed. Youmans iyo Qalliinka neerfaha ee Winn. 7aad ed. Philadelphia, PA: Elsevier; 2017: cutubka 249.

Waldman SD. Cudurka 'tunpal tunnel syndrome'. Gudaha: Waldman SD, ed. Atlas of Syndromes xanuunada caadiga ah. 4aad. Philadelphia, PA: Elsevier; 2019: cutubka 50.