{"id":438,"date":"2021-05-29T11:18:20","date_gmt":"2021-05-29T08:18:20","guid":{"rendered":"https:\/\/dermitzaki.gr\/?p=438"},"modified":"2022-09-22T18:56:07","modified_gmt":"2022-09-22T15:56:07","slug":"%ce%bd%ce%b5%cf%85%cf%81%ce%bf%cf%80%ce%b1%ce%b8%ce%b7%cf%84%ce%b9%ce%ba%cf%8c%cf%82-%cf%80%cf%8c%ce%bd%ce%bf%cf%82-%ce%ba%ce%b1%ce%b9-%ce%b1%ce%bd%cf%84%ce%b9%ce%bc%ce%b5%cf%84%cf%8e%cf%80%ce%b9","status":"publish","type":"post","link":"https:\/\/dermitzaki.gr\/sq\/%ce%bd%ce%b5%cf%85%cf%81%ce%bf%cf%80%ce%b1%ce%b8%ce%b7%cf%84%ce%b9%ce%ba%cf%8c%cf%82-%cf%80%cf%8c%ce%bd%ce%bf%cf%82-%ce%ba%ce%b1%ce%b9-%ce%b1%ce%bd%cf%84%ce%b9%ce%bc%ce%b5%cf%84%cf%8e%cf%80%ce%b9\/","title":{"rendered":"DHIMBJE DHE TRAJTIM NEUROPATIKE"},"content":{"rendered":"<p>Dhimbja neuropatike \u00ebsht\u00eb n\u00eb thelb nj\u00eb simptom\u00eb q\u00eb shfaqet n\u00eb kushte t\u00eb ndryshme patologjike. \u00cbsht\u00eb dhimbja q\u00eb shfaqet si pasoj\u00eb e nj\u00eb d\u00ebmtimi ose s\u00ebmundjeje t\u00eb nervave t\u00eb trupit ose t\u00eb sistemit nervor qendror (pra, trurit ose palc\u00ebs kurrizore).<\/p>\n<p>Ka shum\u00eb gjendje patologjike q\u00eb mund t\u00eb shkaktojn\u00eb k\u00ebt\u00eb lloj dhimbjeje:<\/p>\n<ul>\n<li>presion mbi rr\u00ebnj\u00ebt nervore n\u00eb ekstremitetet e sip\u00ebrme ose t\u00eb poshtme nga hernia e disqeve n\u00eb shtyll\u00ebn kurrizore<\/li>\n<li>sindromi i tunelit t\u00eb ky\u00e7it t\u00eb dor\u00ebs,<\/li>\n<li>infeksionet e virusit herpes (pothuajse n\u00eb 1001 TP3T t\u00eb pacient\u00ebve);<\/li>\n<li>SIDA<\/li>\n<li>diabeti mellitus kur \u00ebsht\u00eb i pranish\u00ebm p\u00ebr shum\u00eb vite,<\/li>\n<li>alkoolizmi,<\/li>\n<li>lupus eritematoz,<\/li>\n<li>s\u00ebmundjet inflamatore kronike t\u00eb nervave,<\/li>\n<li>amiloidoza,<\/li>\n<li>paraproteinemit\u00eb,<\/li>\n<li>S\u00ebmundja Lyme,<\/li>\n<li>sifilizi,<\/li>\n<li>lebra,<\/li>\n<li>kanceri mund t\u00eb shfaqet me k\u00ebt\u00eb lloj dhimbjeje, pas kimioterapis\u00eb me substanca specifike t\u00eb etiologjis\u00eb qendrore<\/li>\n<li>Dhimbja neuropatike mund t\u00eb ndodh\u00eb pas nj\u00eb goditjeje n\u00eb nj\u00eb zon\u00eb specifike t\u00eb trurit, talamus - kjo dhimbje do t\u00eb ndodh\u00eb n\u00eb gjymtyr\u00ebn e sip\u00ebrme dhe\/ose t\u00eb poshtme p\u00ebrkat\u00ebse t\u00eb pacientit.<\/li>\n<\/ul>\n<h3>SIMPTOMAT<\/h3>\n<p>Simptomat jan\u00eb zakonisht dhimbje s\u00eb bashku me mpirje ose ndjesi shpimi gjilp\u00ebrash n\u00eb zon\u00ebn ku \u00ebsht\u00eb d\u00ebmtuar nervi, nj\u00eb ndjesi sikur kalon rrym\u00eb, ose sikur zona po digjet - ndjesia e hithrave, ndjeshm\u00ebria e tepruar n\u00eb zon\u00eb (p.sh. fleta), perceptimi i reduktuar i ndjesis\u00eb. Mund t\u00eb jet\u00eb gjithashtu e pak\u00ebndshme q\u00eb thjesht t\u00eb prekni ose p\u00ebrk\u00ebdhelni zon\u00ebn - ky fenomen quhet alodinia. Dhimbja \u00ebsht\u00eb mjaft e vazhdueshme dhe duksh\u00ebm shkakton nj\u00eb p\u00ebrkeq\u00ebsim t\u00eb cil\u00ebsis\u00eb s\u00eb jet\u00ebs s\u00eb pacient\u00ebve.<\/p>\n<h3>DIAGNOZA<\/h3>\n<p>Diagnoza vendoset nga mjek\u00eb me p\u00ebrvoj\u00eb q\u00eb merren me dhimbjen, kryesisht neurolog\u00eb, anesteziolog\u00eb apo neurokirurg\u00eb. Krahas analizave t\u00eb specializuara laboratorike t\u00eb gjakut, t\u00eb cilat mund t\u00eb nevojiten n\u00eb disa raste, mjeku neurolog mund t\u00eb ket\u00eb nevoj\u00eb t\u00eb kryej\u00eb nj\u00eb test neurofiziologjik. Me testin neurofiziologjik, neurologu mund t\u00eb mas\u00eb reagimin e nervave ndaj nj\u00eb stimuli (koha, lart\u00ebsia dhe shpejt\u00ebsia e p\u00ebrgjigjes) dhe t\u00eb kuptoj\u00eb se n\u00eb \u00e7far\u00eb gjendje jan\u00eb nervat.<\/p>\n<h3>TRAJTIMI<\/h3>\n<p>Trajtimi i dhimbjes neuropatike \u00ebsht\u00eb mjaft i v\u00ebshtir\u00eb. K\u00ebrkon durim dhe besim te mjeku kurues pasi \u00ebsht\u00eb nj\u00eb gjendje kronike me t\u00eb cil\u00ebn truri \u00ebsht\u00eb m\u00ebsuar dhe do t\u00eb duhet p\u00ebrpjekje dhe koh\u00eb p\u00ebr ta modifikuar. P\u00ebrve\u00e7 mjekimeve, do t\u00eb ishte ideale q\u00eb k\u00ebtij pacienti t\u00eb s\u00ebmur\u00eb kronik t&#039;i ofrohej mb\u00ebshtetje psikologjike.<\/p>\n<p>Barnat q\u00eb p\u00ebrdoren p\u00ebr dhimbjet neuropatike jan\u00eb:<\/p>\n<p><strong>Ilaqet kund\u00ebr depresionit<\/strong>: t\u00eb tilla si ilaqet kund\u00ebr depresionit triciklik (efektiv por me efekte an\u00ebsore), paroksetina, duloxetine<br \/>\n<strong>Antikonvulsant\u00ebt<\/strong>: si gabapentina, pregabalina, karbamazepina, okskarbamazepina dhe lamotrigina<br \/>\n<strong>Analgjezik\u00ebt<\/strong>: t\u00eb tilla si qet\u00ebsuesi opioid i dhimbjes tramadol<br \/>\n<strong>Lokal<\/strong> <strong>analgjezik\u00ebt<\/strong>: t\u00eb tilla si ngjit\u00ebse e kapsaicin\u00ebs 8%<\/p>\n<p>Kombinimi i barnave t\u00eb m\u00ebsip\u00ebrme \u00ebsht\u00eb i zakonsh\u00ebm.<\/p>\n<p>N\u00eb ve\u00e7anti do t\u00eb doja t\u00eb fokusohesha n\u00eb trajtimin aktual me cop\u00ebz\u00ebn e l\u00ebkur\u00ebs vet\u00ebngjit\u00ebse me mikro-rezervuar t\u00eb kapsaicin\u00ebs 8% wt. \u00cbsht\u00eb nj\u00eb trajtim n\u00eb t\u00eb cilin mjeku i certifikuar vendos nj\u00eb ngjit\u00ebs p\u00ebr 1 or\u00eb n\u00eb zon\u00ebn ku ka dhimbje (pasi e anestezon p\u00ebr nj\u00eb or\u00eb me nj\u00eb krem tjet\u00ebr) dhe m\u00eb pas pacienti shkon n\u00eb sht\u00ebpi. Shkalla e reduktimit t\u00eb dhimbjes \u00ebsht\u00eb e lart\u00eb dhe efekti i ngjit\u00ebsit zgjat 3-4 muaj. P\u00ebr shkak se ila\u00e7i nuk hyn n\u00eb qarkullimin e gjakut, nuk ka efekte an\u00ebsore nga trupi.<\/p>\n<p>&nbsp;<\/p>","protected":false},"excerpt":{"rendered":"<p>\u039f \u03bd\u03b5\u03c5\u03c1\u03bf\u03c0\u03b1\u03b8\u03b7\u03c4\u03b9\u03ba\u03cc\u03c2 \u03c0\u03cc\u03bd\u03bf\u03c2 \u03b5\u03af\u03bd\u03b1\u03b9 \u03bf\u03c5\u03c3\u03b9\u03b1\u03c3\u03c4\u03b9\u03ba\u03ac \u03c3\u03cd\u03bc\u03c0\u03c4\u03c9\u03bc\u03b1 \u03c0\u03bf\u03c5 \u03b5\u03bc\u03c6\u03b1\u03bd\u03af\u03b6\u03b5\u03c4\u03b1\u03b9 \u03c3\u03b5 \u03b4\u03b9\u03ac\u03c6\u03bf\u03c1\u03b5\u03c2 \u03c0\u03b1\u03b8\u03bf\u03bb\u03bf\u03b3\u03b9\u03ba\u03ad\u03c2 \u03ba\u03b1\u03c4\u03b1\u03c3\u03c4\u03ac\u03c3\u03b5\u03b9\u03c2. \u0395\u03af\u03bd\u03b1\u03b9 \u03bf \u03c0\u03cc\u03bd\u03bf\u03c2 \u03c0\u03bf\u03c5 \u03b5\u03bc\u03c6\u03b1\u03bd\u03af\u03b6\u03b5\u03c4\u03b1\u03b9 \u03c9\u03c2 \u03c3\u03c5\u03bd\u03ad\u03c0\u03b5\u03b9\u03b1 \u03bc\u03b9\u03b1\u03c2 \u03b2\u03bb\u03ac\u03b2\u03b7\u03c2 \u03ae \u03c0\u03ac\u03b8\u03b7\u03c3\u03b7\u03c2 \u03c4\u03c9\u03bd \u03bd\u03b5\u03cd\u03c1\u03c9\u03bd \u03c4\u03bf\u03c5 \u03c3\u03ce\u03bc\u03b1\u03c4\u03bf\u03c2 \u03ae \u03c4\u03bf\u03c5 \u03ba\u03b5\u03bd\u03c4\u03c1\u03b9\u03ba\u03bf\u03cd \u03bd\u03b5\u03c5\u03c1\u03b9\u03ba\u03bf\u03cd \u03c3\u03c5\u03c3\u03c4\u03ae\u03bc\u03b1\u03c4\u03bf\u03c2 (\u03c4\u03bf\u03c5 \u03b5\u03b3\u03ba\u03b5\u03c6\u03ac\u03bb\u03bf\u03c5 \u03ae \u03c4\u03bf\u03c5 \u03bd\u03c9\u03c4\u03b9\u03b1\u03af\u03bf\u03c5 \u03bc\u03c5\u03b5\u03bb\u03bf\u03cd \u03b4\u03b7\u03bb\u03b1\u03b4\u03ae). \u039f\u03b9 \u03c0\u03b1\u03b8\u03bf\u03bb\u03bf\u03b3\u03b9\u03ba\u03ad\u03c2 \u03ba\u03b1\u03c4\u03b1\u03c3\u03c4\u03ac\u03c3\u03b5\u03b9\u03c2 \u03c0\u03bf\u03c5 \u03bc\u03c0\u03bf\u03c1\u03b5\u03af \u03bd\u03b1 \u03c0\u03c1\u03bf\u03ba\u03b1\u03bb\u03ad\u03c3\u03bf\u03c5\u03bd \u03b1\u03c5\u03c4\u03cc \u03c4\u03bf \u03b5\u03af\u03b4\u03bf\u03c2 \u03c4\u03bf\u03c5 \u03c0\u03cc\u03bd\u03bf\u03c5 \u03b5\u03af\u03bd\u03b1\u03b9 \u03c0\u03bf\u03bb\u03bb\u03ad\u03c2: \u03c0\u03b9\u03ad\u03c3\u03b5\u03b9\u03c2 \u03c3\u03c4\u03b9\u03c2 [&hellip;]<\/p>","protected":false},"author":3,"featured_media":2584,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[53],"tags":[],"class_list":["post-438","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-53"],"_links":{"self":[{"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/posts\/438","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/comments?post=438"}],"version-history":[{"count":8,"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/posts\/438\/revisions"}],"predecessor-version":[{"id":2588,"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/posts\/438\/revisions\/2588"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/media\/2584"}],"wp:attachment":[{"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/media?parent=438"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/categories?post=438"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dermitzaki.gr\/sq\/wp-json\/wp\/v2\/tags?post=438"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}