Cudurka dabaysha ee 'polyneuropathy' oo sii daciifa

Cudurka 'polyneuropathy' ee loo yaqaan 'demyelinating demyelinating polyneuropathy (CIDP) waa cillad ku lug leh bararka dareemayaasha iyo xanaaqa (caabuq) taasoo keenta luminta xoog ama dareen.

CIDP waa hal sabab oo dhaawac ku ah neerfaha ka baxsan maskaxda ama laf-dhabarka (peripheral neuropathy). Polyneuropathy macnaheedu waa dhowr neerfayaal ayaa ku lug leh. CIDP badanaa waxay saameysaa labada dhinac ee jirka.

CIDP waxaa sababa jawaab celin aan caadi aheyn. CIDP wuxuu dhacaa marka nidaamka difaaca jirka uu weeraro daboolka myelin ee neerfaha. Sababtaas awgeed, CIDP waxaa loo maleynayaa inuu yahay cudur isdifaaca jirka.

Bixiyeyaasha daryeelka caafimaad sidoo kale waxay u tixgeliyaan CIDP inay tahay nooca joogtada ah ee cudurka Guillain-Barré syndrome.

Waxyaabaha kiciya ee gaarka ah ee CIDP way kala duwan yihiin. Xaalado badan, sababta lama aqoonsan karo.

CIDP waxay la imaan kartaa shuruudo kale, sida:

• Cagaarshowga joogtada ah
• Sonkorowga
• Infekshinka bakteeriyada Campylobacter jejuni
  
• HIV / AIDS
• Cilladaha habka difaaca jirka ee kansarka awgood
• Cudurka caloosha ee caabuqa leh
• Nidaamka lupus erythematosus
• Kansarka nidaamka qanjirada
• Qanjirka 'Thyroid'
• Dhibaatooyinka ay keento daawooyinka ee lagu daweeyo kansarka ama HIV

Calaamadaha waxaa ka mid ah kuwa soo socda:

• Dhibaatooyinka socodka sababo daciifnimo ama dareen la'aan cagaha
• Dhibaato isticmaalka gacmaha iyo gacmaha ama lugaha iyo cagaha daciifnimo darteed
• Dareemku wuu isbeddelaa, sida kabuubyo ama dareemid hoos u dhac ah, xanuun, gubasho, gariirid, ama dareemo kale oo aan caadi ahayn (inta badan cagaha ayuu ku dhacaa marka hore, ka dib gacmaha iyo gacmaha)

Calaamadaha kale ee ku dhici kara CIDP waxaa ka mid ah:

• Dhaqdhaqaaq aan caadi ahayn ama aan isuduweysneyn
• Dhibaatooyinka neefsashada
• Daal
• Hoos-u-qaadid ama cod beddelasho ama hadal dabacsan

Bixiyuhu wuxuu sameyn doonaa baaritaan jireed wuxuuna weydiin doonaa astaamaha, isagoo diirada saaraya nidaamka neerfaha iyo murqaha.

Tijaabooyinka la dalban karo waxaa ka mid ah:

• Electromyography (EMG) si loo hubiyo murqaha iyo neerfaha xakameynaya muruqyada
• Tijaabooyinka dareeraha dareeraha si loo hubiyo sida dhakhsaha badan ee calaamadaha korantadu ugu dhex wareegaan neerfaha
• Cad ka-qaadista dareemayaasha si looga soo qaado gabal yar oo neerfaha ah si baaritaan loogu sameeyo
• Tubada lafdhabarta (lumbar puncture) si loo hubiyo dareeraha ku xeeran maskaxda iyo xudunta lafdhabarta
• Baadhitaanada dhiigga ayaa loo samayn karaa si loo raadiyo borotiinno cayiman oo sababa weerarka difaaca ee neerfaha
• Tijaabooyinka shaqada sanbabada si loo hubiyo in neefsashadu saamayso

Waxay kuxirantahay sababta looga shakisan yahay CIDP, baaritaano kale, sida raajo, baaritaanada sawirka, iyo baaritaanada dhiiga, waa la sameyn karaa.

Ujeedada daaweynta ayaa ah in laga laabto weerarka ku dhaca dareemayaasha. Xaaladaha qaarkood, neerfayaasha way bogsan karaan oo shaqadooda dib ayaa loo soo celin karaa. Xaaladaha kale, neerfaha si xun ayey wax u gaareen oo ma bogsan karaan, sidaa darteed daaweynta waxaa loogu talagalay in looga hortago in cudurku ka sii daro.

Daaweynta la siinayo waxay kuxirantahay sida astaamuhu u daran yihiin, iyo waxyaabo kale. Daaweynta ugu gardarrada badan waxaa la siiyaa oo keliya haddii ay kugu adag tahay socodka, neefsashada, ama haddii astaamaha aysan kuu oggolaanayn inaad daryeesho naftaada ama aad shaqeyso.

Daaweynta waxaa ka mid noqon kara:

• Corticosteroids si looga caawiyo yareynta caabuqa iyo yareynta astaamaha
• Daawooyinka kale ee xakameynaya nidaamka difaaca jirka (xaaladaha qaarkood ee daran)
• Plasmapheresis ama plasma isdhaafsiga si dhiiga looga saaro unugyada difaaca jirka
• Xididada difaaca jirka ee xididka loo yaqaan (IVIg), oo ku lug leh kudarsashada tiro badan oo unugyada difaaca jirka ah plasma dhiigga si loo yareeyo saameynta unugyada difaaca jirka ee dhibaatada u keenaya.

Natiijadu way kala duwan tahay. Cillada ayaa laga yaabaa inay sii socoto muddo dheer, ama waxaad yeelan kartaa dhacdooyin soo noqnoqda oo astaamo ah. Dib u soo kabasho buuxda ayaa suurtagal ah, laakiin luminta joogtada ah ee shaqada neerfaha maahan wax aan caadi ahayn.

Dhibaatooyinka CIDP waxaa ka mid ah:

• Xanuun
• Hoos u dhac joogto ah ama luminta dareenka meelaha jirka
• Daciifnimo joogto ah ama curyaannimo ku timaada meelaha jirka ka mid ah
• Dhaawac soo noqnoqday ama lama dareemo oo ku yimid meel jirka ka mid ah
• Dhibaatooyinka ay keento daawooyinka loo isticmaalo daaweynta cilladda

Wac daryeel caafimaad haddii aad lumiso dhaqdhaqaaq ama dareemid meel kasta oo jirka ka mid ah, gaar ahaan haddii astaamahaadu ka sii daraan.

Cudurka dabadheeraad ah ee dillaaca ee polyradiculoneuropathy; Polyneuropathy - caabuq joogto ah; CIDP; Cudurka 'polyneuropathy chronic'; Guillain-Barré - CIDP

• Nidaamka neerfaha iyo nidaamka neerfaha ee durugsan

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.

Smith G, Xishood ME. Cudurka neuropathies ee durugsan. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: baab 392.