Kutetemeka husababisha matibabu. Kutetemeka: sababu, dalili, utambuzi, matibabu Jinsi tetemeko linatambuliwa

Panina Valentina Viktorovna

Mwigizaji, Msanii Aliyeheshimiwa wa RSFSR

Fungua ukaguzi wa ukaguzi

Safu ( => 107 [~ID] => 107 => [~CODE] => => 107 [~XML_ID] => 107 => Valentina Viktorovna Panina [~NAME] => Valentina Viktorovna Panina => [~TAGS] => => 100 [~SORT] => 100 =>

Niligundua juu yako kwenye mtandao - ninahitaji MRI haraka.

Na hapa niko baada ya utendaji. Nilipenda sana wafanyikazi wako. Asante kwa umakini wako, fadhili na usahihi.

Kila kitu kiwe sawa katika roho yako kama mimi sasa, licha ya shida zote ...

Kuwa!!! Tuna furaha! Panina yako V.V.

[~PREVIEW_TEXT] =>

Niligundua juu yako kwenye mtandao - ninahitaji MRI haraka.

Na hapa niko baada ya utendaji. Nilipenda sana wafanyikazi wako. Asante kwa umakini wako, fadhili na usahihi.

Kila kitu kiwe sawa katika roho yako kama mimi sasa, licha ya shida zote ...

Kuwa!!! Tuna furaha! Panina yako V.V.

=> Safu ( => 50 => 07.02.2018 14:11:01 => iblock => 800 => 577 => 87769 => picha/jpeg => iblock/d82 =>.jpg => pic_comments2-big.jpg => => => [~src] => => /upload/iblock/d82/d823d79d608bd750c9be67d6f85f03ca.jpg => /upload/iblock/d82/d823d79d608bd750c9be67d6f85f03ca.jpg => /upload/iblock/d82/d823d79d608bd750c9be67d6f85f03ca.jpg => Panina Valentina Viktorovna => Panina Valentina Viktorovna) [~PREVIEW_PICTURE] => 50 => [~DETAIL_TEXT] => => [~DETAIL_PICTURE] => => [~DATE_ACTIVE_FROM] => => [~ ACTIVE_FROM] => => [~DATE_ACTIVE_TO] => => [~ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID] => 10 => uhakiki [~IBLOCK_CODE] => uhakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 06.02.2018 19:41:18 [~DATE_CREATE] => 06.02.2018 19:4 :18 => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] => (msimamizi) => 02/07/2018 14:1 1:01 [~TIMESTAMP_X] => 02/07/2018 14:11:01 => 1 [~MODIFIED_BY] => 1 => (msimamizi) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] = > = > /content/detail.php?ID=107 [~DETAIL_PAGE_URL] => /content/detail.php?ID=107 => /content/index.php?ID=10 [~LIST_PAGE_URL] => /content/ index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE] => maandishi => html [~PREVIEW_TEXT_TYPE] => html => / [~LANG_DIR] => / => 107 [~ EXTERNAL_ID] => 107 => s1 [~ LID] => s1 => => => => Safu () => Safu ( => 107 => => 107 => Valentina Viktorovna Panina => => 100 =>

Niligundua juu yako kwenye mtandao - ninahitaji MRI haraka.

Na hapa niko baada ya utendaji. Nilipenda sana wafanyikazi wako. Asante kwa umakini wako, fadhili na usahihi.

Kila kitu kiwe sawa katika roho yako kama mimi sasa, licha ya shida zote ...

Kuwa!!! Tuna furaha! Panina yako V.V.

=> Safu ( => 50 => 07.02.2018 14:11:01 => iblock => 800 => 577 => 87769 => picha/jpeg => iblock/d82 =>.jpg => pic_comments2-big.jpg => => => [~src] => => /upload/iblock/d82/d823d79d608bd750c9be67d6f85f03ca.jpg => /upload/iblock/d82/d823d79d608bd750c9be67d6f85f03ca.jpg => /upload/iblock/d82/d823d79d608bd750c9be67d6f85f03ca.jpg => Panina Valentina Viktorovna => Panina Valentina Viktorovna) => => => => => => => => => maudhui => 10 => kitaalam => Maoni => => 06.02.2018 19:41:18 = > 1 => (admin) => 02/07/2018 14:11:01 => 1 => (msimamizi)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37: 56 => 10 => Nani aliacha uhakiki => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 241 => Panina Valentina Viktorovna => => => => [~VALUE] => Panina Valentina Viktorovna [~DESCRIPTION] => [~NAME ] => Nani aliacha ukaguzi [~D EFAULT_VALUE] =>) => Safu ( => 26 => 2018-02-06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 242 => Mwigizaji, Msanii Tukufu wa RSFSR = > => => => [~VALUE] => Mwigizaji, Msanii Tukufu wa RSFSR [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37:56 => 10 => Nani aliacha uhakiki => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 241 => Valentina Viktorovna Panina => => => => [~VALUE] = > Panina Valentina Viktorovna [~DESCRIPTION] => [~NAME] => Nani aliacha ukaguzi [~DEFAULT_VALUE] => => Panina Valentina Viktorovna) => Mkusanyiko ( => 26 => 2018-02- 06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 242 => Mwigizaji, Msanii wa Heshima wa RSFSR => => = > = > [~VALUE] => Mwigizaji, Msanii Tukufu wa RSFSR [~DESCRIPTION] => [~NAME] => Saini [~DEFAULT_VALUE] => => Mwigizaji, Msanii Tukufu wa RSFSR)) => Mkusanyiko ( => 1 => Safu ( => 50 => 07.02.2018 14:11:01 => iblock => 800 => 577 => 87769 => picha/jpeg => iblock/d82 =>.jpg => pic_comments2- big.jpg => = > => [~src] => => /upload/iblock/d82/d823d79d608bd750c9be67d6f85f03ca.jpg) => Mpangilio ( => /upload/resize_cache/iblock/d82/264_d69/38/38/38/38 d64_386664_386664_3864_3864_38664_3864_3864_364_38649393939/39/38/3644_364_364_38_364_364_384_364_364_38_364_38264_3839393333393333333333d79d82/d823d79d608bd750c9be67d6f85f03ca.jpg) 2664 49035) => retina retina-x2-src="/upload/resize_cache/iblock/d82/264_380_1/d823d79d608bd750c9be67d6f85f03ca.jpg" => Array ( => /upload/resize_cache/iblock/d82/132_190_1/d823d79d608bd750c9be67d6f85f03ca.jpg => 132 => 183 => 14952 => Panina Valentina Viktorovna)))

Sergei Shnurov

Mwanamuziki wa mwamba wa Urusi, muigizaji wa filamu, mtangazaji wa Runinga na msanii.

Ts. M. R. T. "Petrogradsky" asante!

Safu ( => 108 [~ID] => 108 => [~CODE] => => 108 [~XML_ID] => 108 => Sergey Shnurov [~NAME] => Sergey Shnurov => [~TAGS] => => 120 [~SORT] => 120 => Ts. M. R. T. "Petrogradsky" asante! [~PREVIEW_TEXT] => Ts. M. R. T. "Petrogradsky" thanks! => Array ( => 47 => 02/07/2018 14: 11:01 => iblock => 183 => 132 => 13218 => picha/png => iblock/922 =>.png => Tabaka 164 copy.png => => => [~src] => => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png => Сергей Шнуров => Сергей Шнуров ) [~PREVIEW_PICTURE] => 47 => [~DETAIL_TEXT] => => [~DETAIL_PICTURE] => => [~DATE_ACTIVE_FROM] => => [~ACTIVE_FROM] => => [~DATE_ACTIVE_TO] => => [~ ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID] => 10 => hakiki [~IBLOCK_CODE] => hakiki ws => Maoni [~IBLOCK_NAME] => Maoni => [~IBLOCK_EXTERNAL_ID] => => 02/06/2018 19:42:31 [~DATE_CREATE] => 02/06/2018 19:42:31 => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] => (msimamizi) => 02/07/2018 2:11:01 PM [~TIMESTAMP_X] => 02/07/2018 02:11:01 PM => 1 [~MODIFIED_BY] => 1 => (msimamizi) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => => /content/detail.php?ID=108 [~DETAIL_PAGE_URL] = > /content/detail.php?ID= 108 => /content/index.php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE] => maandishi = > maandishi [~PREVIEW_TEXT_TYPE] => maandishi = > / [~LANG_DIR] => / => 108 [~EXTERNAL_ID] => 108 => s1 [~LID] => s1 => => => => Mkusanyiko () => Safu ( => 108 => = > 108 => Sergey Shnurov => => 120 => Ts. M. R. T. "Petrogradsky" shukrani! => Safu ( => 47 => 07.02.2018 14:11:01 => iblock => 183 => 132 => 13218 => picha/png => iblock/922 =>.png => Tabaka 164 copy.png => => => [~src] => => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png => Sergey Shnurov => Sergey Shnurov) => => => => => => => => => maudhui => 10 => kitaalam => Ukaguzi => => 06.02.2018 19:42:31 => 1 => (msimamizi) => 02/07/2018 14:11:01 => 1 => (msimamizi)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37:56 = > 10 => Nani aliacha uhakiki => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N = > N = > N => N => 1 => => => => 243 => Sergey Shnurov => => => => [~VALUE] => Sergey Shnurov [~DESCRIPTION] => [~NAME] => Aliyeacha maoni [~DEFAULT_VALUE] =>) => Mkusanyiko ( => 26 => 2018-02-06 19:37: 56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 244 => Mwanamuziki wa muziki wa rock wa Kirusi, mwigizaji wa filamu, mtangazaji wa TV na msanii. => => => => [~VALUE] => Mwanamuziki wa muziki wa rock wa Kirusi, mwigizaji wa filamu, mtangazaji wa TV na msanii. [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37:56 => 10 => Nani kushoto mapitio => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 243 => Sergey Shnurov => => => => [~VALUE] => Sergey Shnurov [~DESCRIPTION] => [~NAME] => Nani aliondoka kwenye kagua [ ~DEFAULT_VALUE] => => Sergey Shnurov) => Mpangilio ( => 26 => 2018-02-06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 244 = > Mwanamuziki wa muziki wa rock wa Kirusi, mwigizaji wa filamu, mtangazaji wa TV na msanii => => => => [~VALUE] => Mwanamuziki wa muziki wa rock wa Urusi, mwigizaji wa filamu, mtangazaji wa TV na msanii [~DESCRIPTION] => [~NAME] => Saini [~ DEFAULT_VALUE] => => Mwanamuziki wa roki wa Kirusi, mwigizaji wa filamu, mtangazaji wa TV na msanii.)) => Array ( => 1 => Arr ay ( => 47 => 02/07/2018 2:11:01 pm => iblock => 183 => 132 => 13218 => picha/png => iblock/922 =>.png => Tabaka 164 nakala. png => => => [~src] => => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png) => Mpangilio ( => /upload/iblock/922/922fe0007755edp9 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 = 1 ) =13218 > retina retina-x2-src="/upload/iblock/922/922fe0007755edf562516e5f3b399b75.png" => Mpangilio ( => /upload/iblock/922/922fe0007755edf562516e5f3b399b75.png" => Mkusanyiko ( => /upload/iblock/922/922fe0007755ed =1y25529 =1b Sergey25>5169 =1b25555569 =5555565555). )))

Asante sana kwa huduma hiyo nzuri, ya kitaalamu katika kliniki yako. Nzuri, starehe! Watu wazuri, mazingira mazuri.

Fungua ukaguzi wa ukaguzi

Safu ( => 115 [~ID] => 115 => [~CODE] => => 115 [~XML_ID] => 115 => Kiseleva I.V. [~NAME] => Kiseleva I.V. => [~TAGS] => => 500 [~SORT] => 500 => Asante sana kwa huduma nzuri, ya kitaalamu katika kliniki yako. Nzuri, starehe! Watu wazuri, hali nzuri.[~PREVIEW_TEXT] => Asante sana kwa hii nzuri. , huduma ya kitaalamu katika kliniki yako. Nzuri, starehe! Watu wa kupendeza, hali nzuri. => Array ( => 57 => 07.02.2018 14:11:01 => iblock => 800 => 561 => 154991 => picha / jpeg => iblock/bf4 =>.jpg => pic_comments7-big.jpg => => => [~src] => => /upload/iblock/bf4/bf4cefd9296b73518435a3fcfd00636b.jpg/block /f.jpg => /upload/iblock/bf4/bf4cefd9296b73518435a3fd0000636b.jpg => kiseleva i.v. => ] => => [~ACTIVE_FROM] => => [~DATE_ACTIVE_TO] => => [~ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID] => 10 => hakiki [~IBLOCK_CODE] => hakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 02/07/2018 12:40:21 [~DATE_CREATE] => 02/07/ 2018 12:40 :21 => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] => (admin) => 02/07/2018 02:11:01 PM [~TIMESTAMP_X] => 02 /07/2018 02:11:01 PM => 1 [~MODIFIED_BY] => 1 => (msimamizi) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => => /content/detail.php ?ID=115 [~DETAIL_PAGE_URL] => /content/detail.php?ID=115 => /content/index.php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE] => maandishi => maandishi [~PREVIEW_TEXT_TYPE] => maandishi => / [~LANG_DIR] => / => 115 [~EXTERNAL_ID] => 115 => s1 [~LID] => s1 => => => => Safu () = > Safu ( => 115 => => 115 => Kiseleva I.V. => => 500 => Asante sana kwa huduma nzuri, ya kitaalamu katika kliniki yako. Nzuri, starehe! Watu wazuri, mazingira mazuri. => Safu ( => 57 => 02/07/2018 14:11:01 => iblock => 800 => 561 => 154991 => picha/jpeg => iblock/bf4 =>.jpg => pic_comments7-kubwa .jpg => => => [~src] => => /upload/iblock/bf4/bf4cefd9296b73518435a3fcfd00636b.jpg => /upload/iblock/bf4/bf4cefd9296b73518435a3fcfd00636b.jpg => /upload/iblock/bf4/bf4cefd9296b73518435a3fcfd00636b.jpg => Kiseleva I. V. => Kiseleva I.V.) => => => => => => => => => => maudhui => 10 => uhakiki => Uhakiki => => 07.02.2018 12:40:21 => 1 => (msimamizi) => 02/07/2018 14:11:01 => 1 => (msimamizi)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37:56 = > 10 => Nani aliacha uhakiki => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N = > N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Nani aliacha kagua [~DEFAULT_VALUE] =>) => Safu ( => 26 => 2018-02-06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko () => Mkusanyiko ( => 1 => Mkusanyiko ( => 57 => 02/07/2018 14:11:01 => iblock => 800 => 561 => 154991 => picha/jpeg => iblock/bf4 =>.jpg => pic_comments7-big.jpg => => => [~src] => => /upload/iblock/bf4/bf4cefd9296b73518435a3fcfd00636b.jpg) => => /upload/resize_cache/iblock/bf4/264_380_1/bf4cefd9296b73518435a3fcfd00636b.jpg => 264 => 376 => 70332) => retina retina-x2-src="/upload/resize_cache/iblock/bf4/264_380_1/bf4cefd9296b73518435a3fcfd00636b.jpg " => Mkusanyiko ( => /upload/resize_cache/iblock/bf4/132_190_1/bf4cefd9296b73518435a3fcfd00636b.jpg => 132 => 188 => 18203 =>) Kiseleva))

Rusanova

Fungua ukaguzi wa ukaguzi

Safu ( => 114 [~ID] => 114 => [~CODE] => => 114 [~XML_ID] => 114 => Rusanova [~NAME] => Rusanova => [~TAGS] => => 500 [~SORT] => 500 => Ninataka kuwashukuru wafanyakazi kwa mtazamo wao wa usikivu na wa kirafiki. Ni vyema ukawa na kliniki kama hiyo.
[~PREVIEW_TEXT] => Ninataka kuwashukuru wafanyakazi kwa mtazamo wao wa usikivu na wa kirafiki. Ni vizuri kuwa na kliniki kama hiyo. => Safu ( => 56 => 07.02.2018 14:11:01 => iblock => 800 => 575 => 175172 => picha/jpeg => iblock/ae8 =>.jpg => pic_comments6-big.jpg => => => [~src] => /pakia/iblock/ae8/ae8e1a20dc0f51db073a5d7e6c8ffb7b.jpg Rusanov => Rusanov) [~PREVIEW_PICTURE] => 56 => [~DETAIL_CTURE] => PICHA => => [~DATE_ACTIVE_FROM] => => [~ACTIVE_FROM] => => [~DATE_ACTIVE_TO] => => [~ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID] => 10 => uhakiki [ ~IBLOCK_CODE] => uhakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 02/ 07/2018 12:39:29 [~DATE_CREATE] => 02/07/2018 12:39:29 => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] => (msimamizi) => 02/07/2018 14:11:01 [~TIMESTAMP_X] => 02/07/2018 14 :11:01 => 1 [~MODIFIED_BY] => 1 => (msimamizi) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => => /content/detail.php?ID=114 [~ DETAIL_PAGE_URL] => /content/detail.php?ID=114 => /content/index.php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE] = > maandishi => maandishi [~PREVIEW_TEXT_TYPE] => maandishi => / [~LANG_DIR] => / => 114 [~EXTERNAL_ID] => 114 => s1 [~LID] => s1 => => => => Array () => Array ( => 114 => => 114 => Rusanova => => 500 => Nataka kuwashukuru wafanyakazi kwa mtazamo wao wa usikivu na wa kirafiki. Ni vizuri kuwa na kliniki kama hiyo.
=> Safu ( => 56 => 07.02.2018 14:11:01 => iblock => 800 => 575 => 175172 => picha/jpeg => iblock/ae8 =>.jpg => pic_comments6-big.jpg => => => [~src] => /upload/iblock/ae8/ae8e1a20dc0f51db073a5d7e6c8ffb7b.jpg Rusanova => Rusanova) => => => => => => => => => maudhui => 10 = > kitaalam => Maoni => => 07.02.2018 12:39:29 => 1 => (msimamizi) => 02/07/2018 14:11:01 => 1 => (msimamizi)) => Mkusanyiko ( => Safu ( => 25 => 2018-02-06 19:37:56 => 10 => Nani aliacha ukaguzi => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 247 => Rusanova => => => = > [~VALUE] => Rusanova [~DESCRIPTION] => [~NAME] => Nani aliacha ukaguzi [~ DEFAULT_VALUE] =>) => Mkusanyiko ( => 26 => 2018-02-06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) = > Safu ( => Safu ( => 25 => 2018-02-06 19:37:56 => 10 => Nani aliacha ukaguzi => Y => 500 => NAME => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => 247 => Rusanova => => => => [~VALUE] => Rusanova [~DESCRIPTION] => [~NAME] => Nani aliacha ukaguzi [~DEFAULT_VALUE] => => Rusanova)) => Mkusanyiko ( => 1 => Mkusanyiko ( = > 56 => 02/07/2018 14:11:01 => iblock => 800 => 575 => 175172 => picha/jpeg => iblock/ae8 =>.jpg => pic_comments6-big.jpg => = > => [ ~src] => => /upload/iblock/ae8/ae8e1a20dc0f51db073a5d7e6c8ffb7b.jpg) => Mpangilio ( => /upload/resize_cache/iblock/ae8/264_380_1/a3058f70 ad70 ad70 ad70 ad70 ad70 ad70 ad7016161581/1561/1561/1561/15616165616561616161616161616151/15/15/1999. ffb7b.jpg => 264 => 367 => 76413) => retina retina-x2-src="/upload/resize_cache/iblock/ae8/264_380_1/ae8e1a20dc0f51db073a5d7eb => 63a5d7e /ae8/132_190_1/ae8e1a20dc0f51db073a5d7e6c8ffb7b.jpg => 132 => 183 => 19499 => Rusanova)))

Kila kitu ni uwezo sana, huduma ya kirafiki sana. Nitapendekeza kliniki hii kwa marafiki zangu. Bahati njema!!!

Fungua ukaguzi wa ukaguzi

Safu ( => 113 [~ID] => 113 => [~CODE] => => 113 [~XML_ID] => 113 => Asiyejulikana [~NAME] => Asiyejulikana => [~TAGS] => => 500 [~SORT] => 500 => Kila kitu ni bora sana, huduma ya heshima sana. Nitapendekeza kliniki hii kwa marafiki. Bahati nzuri!!![~PREVIEW_TEXT] => Kila kitu ni bora sana, huduma ya heshima sana. Nitapendekeza kliniki hii kwa marafiki.Mafanikio! !! => Array ( => 55 => 02/07/2018 14:11:01 => iblock => 778 => 572 => 46441 => picha/jpeg => iblock/348 =>.jpg => pic_comments5-big .jpg => => => [~src] => => /upload/iblock/348/348950e3a3aa606332cb5c05e3b767d0.jpg => /upload/i48895a/348950e3a3aa606332cb5c05e3b767d0.jpg => /upload/i488958/348735ac348257267258c35a upload/iblock/348/348950e3a3aa606332cb5c05e3b767d0.jpg => Asiyejulikana => Asiyejulikana) [~PREVIEW_PICTURE] => 55 => [~DETAIL_TEXT] => => [~ MAELEZO_PICTURE => ACT_PICTURE] ~ACTIVE_FROM] => => [~ DATE_ACTIVE_TO] => => [~ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_STAR T] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID] => 10 => uhakiki [~IBLOCK_CODE] => uhakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 02/07/2018 12:37:43 PM [~DATE_CREATE] => 02/07/2018 12:37:43 PM => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME ] => (admin) => 02/07/2018 02:11:01 PM [~TIMESTAMP_X] => 02/07/2018 02:11:01 PM => 1 [~MODIFIED_BY] => 1 => (admin ) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => /content/detail.php?ID=113 [~DETAIL_PAGE_URL] => /content/detail.php?ID=113 => /content/index .php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE] => maandishi => maandishi [~PREVIEW_TEXT_TYPE] => maandishi => / [~LANG_DIR] = > / => 113 [~ EXTERNAL_ID] = > 113 => s1 [~LID] => s1 => => => => Safu () => Safu ( => 113 => => 113 => Asiyejulikana => => 500 => Kila kitu ni smart sana, huduma ya kirafiki sana. Nitapendekeza kliniki hii kwa marafiki zangu. Bahati njema!!! => Safu ( => 55 => 02/07/2018 14:11:01 => iblock => 778 => 572 => 46441 => picha/jpeg => iblock/348 =>.jpg => pic_comments5-kubwa .jpg => => => [~src] => => /upload/iblock/348/348950e3a3aa606332cb5c05e3b767d0.jpg => /upload/iblock/348/348950e3a3aa606332cb5c05e3b767d0.jpg => /upload/iblock/348/348950e3a3aa606332cb5c05e3b767d0.jpg => Asiyejulikana => Asiyejulikana) => => => => => => => => => maudhui => 10 => hakiki => Uhakiki => => 07. 02.2018 12:37:43 => 1 => (admin) => 02/07/2018 14:11:01 => 1 => (admin)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018- 02- 06 19:37:56 => 10 => Nani aliacha uhakiki => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~ THAMANI] => [~MAELEZO] => [~NAME ] => Aliyeacha maoni [~DEFAULT_VALUE] =>) => Mkusanyiko ( => 26 => 2018-02-06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko () => Mkusanyiko ( => 1 => Safu ( => 55 => 02/07/2018 14:11:01 => iblock => 778 => 572 => 46441 => picha/jpeg => iblock/348 =>.jpg => pic_comments5- big.jpg => => => [~src] => => /upload/iblock/348/348950e 3a3aa606332cb5c05e3b767d0.jpg) => Array ( => /upload/resize_cache/iblock/348/264_380_1/348950e3a3aa606332cb5c05e3b767d0.jpg => 264 => 359 => 48124) => c-retina retina-x2" /348/264_380_1/348950e3a3aa606332cb5c05e3b767d0. jpg" => Mkusanyiko ( => /upload/resize_cache/iblock/348/132_190_1/348950e3a3aa606332cb5c05e39b767d0.jpg => 149 => Asiyejulikana ))

Kuznetsov V.A.

Fungua ukaguzi wa ukaguzi

Safu ( => 112 [~ID] => 112 => [~CODE] => => 112 [~XML_ID] => 112 => Kuznetsov V.A. [~NAME] => Kuznetsov V.A. => [~TAGS] => => 500 [~SORT] => 500 => Msimamizi msikivu sana, mstaarabu, mtamaduni, mkarimu.
[~PREVIEW_TEXT] => Msimamizi anayesaidia sana. Adabu, tamaduni, fadhili. => Safu ( => 53 => 02/07/2018 14:11:01 => iblock => 783 => 560 => 69584 => picha/jpeg => iblock/58a =>.jpg => pic_comments4-kubwa .jpg => => => [~src] => => /upload/iblock/58a/58a0be58e116e783ec9345d2b58017f2.jpg => /upload/iblock/58a/58a0be58e116e783ec9345d2b58017f2.jpg => /upload/iblock/58a/58a0be58e116e783ec9345d2b58017f2.jpg => Kuznetsov V.A. => Kuznetsov V.A.) [~PREVIEW_PICTURE] => 53 => [~DETAIL_TEXT] => => [~DETAIL_PICTURE] => => [~DATE_ACTIVE_FROM] => => [~ ACTIVE_FROM] => => [~DATE_ACTIVE_TO] => => [~ ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID ] => 10 => uhakiki [~IBLOCK_CODE] => uhakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 07.02.2018 12:35:47 [~DATE_CREATE] => 07.02. 2015 12:3 :47 => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] => (msimamizi) => 02/07/2018 14:11:01 [~TIMESTAMP_X] => 07.0 2.2018 14:11:01 => 1 [~MODIFIED_BY] => 1 => (msimamizi) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => => /content/detail.php?ID=112 [~DETAIL_PAGE_URL] => /content/detail.php?ID=112 => /content/index.php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE ] => maandishi => maandishi [~PREVIEW_TEXT_TYPE] => maandishi => / [~LANG_DIR] => / => 112 [~ EXTERNAL_ID] => 112 => s1 [~LID] => s1 => => => => Safu () => Safu ( => 112 => => 112 => Kuznetsov V.A. => => 500 => Msimamizi msikivu sana. Adabu, tamaduni, fadhili.
=> Safu ( => 53 => 02/07/2018 14:11:01 => iblock => 783 => 560 => 69584 => picha/jpeg => iblock/58a =>.jpg => pic_comments4-kubwa .jpg => => => [~src] => => /upload/iblock/58a/58a0be58e116e783ec9345d2b58017f2.jpg => /upload/iblock/58a/58a0be58e116e783ec9345d2b58017f2.jpg => /upload/iblock/58a/58a0be58e116e783ec9345d2b58017f2.jpg => Kuznetsov V.A. => Kuznetsov V.A.) => => => => => => => => maudhui => 10 => hakiki => Ukaguzi => 07.02.2018 12: 35:47 => 1 => (admin) => 02/07/2018 14:11:01 => 1 => (msimamizi)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19: 37:56 => 10 => Nani aliacha uhakiki => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 246 => Kuznetsov V.A. => => => => [~VALUE] => Kuznetsov V.A. [ ~DESCRIPTION] => [~NAME] => Mkaguzi [~DEFAULT_VALUE] =>) => Mkusanyiko ( => 26 => 2018-02-06 19 :37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37:56 => 10 => Mkaguzi => Y => 500 => NAME => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 246 = > Kuznetsov V.A. => => => => [~VALUE] => Kuznetsov V.A. [~DESCRIPTION] => [~NAME] => Nani aliacha ukaguzi [~DEFAULT_VALUE] => => Kuznetsov V.A.)) => Mkusanyiko ( => 1 => Mkusanyiko ( => 53 => 07.02.2018 14 :11 :01 => iblock => 783 => 560 => 69584 => picha/jpeg => iblock/58a =>.jpg => pic_comments4-big.jpg => => => [~src] => =>/ upload/iblock/58a/58a0be58e116e783ec9345d2b58017f2.jpg) => Array ="/upload/resize_cache/iblock/58a/264_380_1/58a0be58e116e783ec9345d2b58017f2.jpg" => Array ( => /upload/resize_cache/iblock/58a/132_190_1/58a0be58e116e783ec9345d2b58017f2.jpg => 132 => 184 => 18518 => Кузнецов В .LAKINI.)))

Khrabrova V.E.

Fungua ukaguzi wa ukaguzi

Safu ( => 111 [~ID] => 111 => [~CODE] => => 111 [~XML_ID] => 111 => Khrabrova V.E. [~NAME] => Khrabrova V.E. => [~TAGS] => => 500 [~SORT] => 500 => Natoa shukrani zangu nyingi kwa msimamizi Kristina na Rinat Chubarov kwa mtazamo wao wa usikivu na wa kirafiki wakati wa utafiti.Natamani kungekuwa na wafanyikazi wengi kama hao, ambayo ni nadra siku hizi.
[~PREVIEW_TEXT] => Natoa shukrani zangu nyingi kwa msimamizi Kristina na Rinat Chubarov kwa mtazamo wao wa usikivu na wa kirafiki wakati wa utafiti.Natamani kungekuwa na wafanyikazi wengi kama hao, jambo ambalo ni nadra siku hizi. => Safu ( => 54 => 07.02.2018 14:11:01 => iblock => 795 => 566 => 59952 => picha/jpeg => iblock/4f6 =>.jpg => pic_comments3-big.jpg => => => [~src] => /upload/iblock/4f6/4f6a1cf8d5ae2b88db75270e0ab7cc95.jpg Khrabrova V.E. => Khrabrova V.E.) [~PREVIEW_PICTURE] => 54 =>~TAIL =~TAIL_PICTURE => [~TAIL] => => [~DATE_ACTIVE_FROM] => => [~ACTIVE_FROM] => => [~DATE_ACTIVE_TO] => => [~ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID ] => 10 => uhakiki [~IBLOCK_CODE] => uhakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 07.02.2018 12:34:11 [~DATE_CREATE] => 07.02. 2018 12:34:11 => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] => (msimamizi) => 02/ 07/2018 14:11:01 [~TIMESTAMP_X] => 07.0 2.2018 14:11:01 => 1 [~MODIFIED_BY] => 1 => (msimamizi) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => => /content/detail.php?ID=111 [~DETAIL_PAGE_URL] => /content/detail.php?ID=111 => /content/index.php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE ] => maandishi => maandishi [~PREVIEW_TEXT_TYPE] => maandishi => / [~LANG_DIR] => / => 111 [~ EXTERNAL_ID] => 111 => s1 [~LID] => s1 => => => => Safu () => Safu ( => 111 => => 111 => Khrabrova V.E. => => 500 => Natoa shukrani zangu za dhati kwa msimamizi Kristina na Rinat Chubarov kwa mtazamo wao wa usikivu na wa kirafiki wakati wa utafiti.Natamani kungekuwa na wafanyikazi wengi kama hao, ambayo ni nadra siku hizi.
=> Safu ( => 54 => 07.02.2018 14:11:01 => iblock => 795 => 566 => 59952 => picha/jpeg => iblock/4f6 =>.jpg => pic_comments3-big.jpg => => => [~src] => /upload/iblock/4f6/4f6a1cf8d5ae2b88db75270e0ab7cc95.jpg Khrabrova V.E. => Khrabrova V.E.) => => => => => => => => => maudhui => 10 => uhakiki => Uhakiki => => 07.02.2018 12: 34:11 => 1 => (msimamizi) => 02/07/2018 14:11:01 => 1 => (msimamizi)) => Safu ( => Safu ( => 25 => 2018-02-06 19: 37:56 => 10 => Nani aliacha ukaguzi => Y => 500 => NAME => => S => 1 => 30 => L => N => => => 5 => => 0 = > N => N => N => N => 1 => => => => 245 => Khrabrova V.E. => => => => [~VALUE] => Khrabrova V.E. [ ~DESCRIPTION] => [~NAME] => Mkaguzi [~DEFAULT_VALUE] =>) => Mkusanyiko ( => 26 => 2018-02-06 19 :37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37:56 => 10 => Mkaguzi => Y => 500 => NAME => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => 245 = > Khrabrova V.E. => => => => [~VALUE] => Khrabrova V.E. [~DESCRIPTION] => [~NAME] => Nani aliacha ukaguzi [~DEFAULT_VALUE] => => Khrabrova V.E.)) => Mkusanyiko ( => 1 => Mkusanyiko ( => 54 => 02/07/2018 14 :11:01 => iblock => 795 => 566 => 59952 => picha/jpeg => iblock/4f6 =>.jpg => pic_comments3-big.jpg => => => [~src] => = > /upload/iblock/4f6/4f6a1cf8d5ae2b88db75270e0ab7cc95.jpg) => Array ( => /upload/resize_cache/iblock/4f6/264_380_1/4f6a1cf8d5ae2b88db75270e0ab7cc95.jpg => 264 => 370-retinax6) => 497 retinax6) ="/upload /resize_cache/iblock/4f6/264_380_1/4f6a1cf8d5ae2b88db75270e0ab7cc95.jpg" => Array ( => /upload/resize_cache/iblock/4f6/132_190_1/4f6a1cf8d5ae2b88db75270e0ab7cc95.jpg => 132 => 185 => 15022 => Храброва В .E.) ))

Safu ( => 110 [~ID] => 110 => [~CODE] => => 110 [~XML_ID] => 110 => Evgeniya Andreeva [~NAME] => Evgeniya Andreeva => [~TAGS] => => 500 [~SORT] => 500 => Ninatoa shukrani zangu nyingi kwa Ekaterina Korneva kwa uvumilivu, taaluma, fadhili na mtazamo mzuri kuelekea wagonjwa.
[~PREVIEW_TEXT] => Ninatoa shukrani zangu za dhati kwa Ekaterina Korneva kwa uvumilivu, taaluma, fadhili na mtazamo mzuri kuelekea wagonjwa. => Safu ( => 49 => 02/07/2018 14:11:01 => iblock => 183 => 132 => 35147 => picha/png => iblock/f27 =>.png => Tabaka 164. png = > => => [~src] => => /upload/iblock/f27/f272783daa9de38c00293fbbd9983097.png => /upload/iblock/f27/f272783daa9de38c00293fbbd9983097.png => /upload/iblock/f27/f272783daa9de38c00293fbbd9983097.png = > Евгения Andreeva => Evgenia Andreeva) [~PREVIEW_PICTURE] => 49 => [~DETAIL_TEXT] => => [~DETAIL_PICTURE] => => [~DATE_ACTIVE_FROM] => => [~ ACTIVE_FROM] => => [ ~DATE_ACTIVE_TO ] => => [~ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SHOW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID] => 10 = > uhakiki [~IBLOCK_CODE] => uhakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 02/06/2018 19:44:06 [~DATE_CREATE] => 02/06/2018 19:44:06 = > 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] => (msimamizi) => 2018-02-07 14:11:01 [~TIMESTAMP_X] => 02.07.2 018 14:11:01 => 1 [~MODIFIED_BY] => 1 => (msimamizi) [~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => => /content/detail.php?ID=110 [~DETAIL_PAGE_URL] => /content/detail.php?ID=110 => /content/index.php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE ] => maandishi => maandishi [~PREVIEW_TEXT_TYPE] => maandishi => / [~LANG_DIR] => / => 110 [~ EXTERNAL_ID] => 110 => s1 [~LID] => s1 => => => => Array () => Array ( => 110 => => 110 => Evgenia Andreeva => => 500 => Ninatoa shukrani zangu za kina kwa Ekaterina Korneva kwa uvumilivu wake, taaluma, fadhili na mtazamo mzuri kuelekea wagonjwa.
=> Safu ( => 49 => 02/07/2018 14:11:01 => iblock => 183 => 132 => 35147 => picha/png => iblock/f27 =>.png => Tabaka 164. png = > => => [~src] => => /upload/iblock/f27/f272783daa9de38c00293fbbd9983097.png => /upload/iblock/f27/f272783daa9de38c00293fbbd9983097.png => /upload/iblock/f27/f272783daa9de38c00293fbbd9983097.png = > Евгения Andreeva => Evgeniya Andreeva) => => => => => => => => => maudhui => 10 => kitaalam => Maoni => => 06.02.2018 19:44:06 => 1 = > (admin) => 02/07/2018 14:11:01 => 1 => (msimamizi)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018-02-06 19:37:56 => 10 = > Nani aliacha maoni => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N = > N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Mkaguzi [~ DEFAULT_VALUE] =>) => Mkusanyiko ( => 26 => 2018-02-06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko () => Safu ( => 1 => Safu ( => 49 => 02/07/2018 14:11:01 => iblock => 183 => 132 => 35147 => picha/png => iblock/f27 => .png => Mkusanyiko => 183 => 35147) => retina retina-x2-src="/upload/iblock/f27/f272783daa9de38c00293fbbd9983097.png" => Mkusanyiko ( => /upload/iblock/f272783daa9de38c00293fbbd9983097.png" => Mpangilio ( => /upload/3308097969655. > 1833 => 35147 => Evgenia Andreeva)))

Asante sana kwa mashauriano na uchunguzi ... Heshima sana, kupatikana na kuelezewa kwa undani kozi na matokeo.

Safu ( => 109 [~ID] => 109 => [~CODE] => => 109 [~XML_ID] => 109 => Asiyejulikana [~NAME] => Asiyejulikana => [~TAGS] => => 500 [~SORT] => 500 => Asante sana kwa mashauriano na uchunguzi... Maelezo ya upole, yanayofikika na ya kina ya kozi na matokeo [~PREVIEW_TEXT] => Asante sana kwa mashauriano na uchunguzi. .. Adabu sana, inafikika na => Mpangilio ( => 48 => 07.02.2018 14:11:01 => iblock => 183 => 132 => 24647 => picha/png => iblock/2db =>.png = > Tabaka 165.png => => => [~src] => => /upload/iblock/2db/2db2b520cb9bbfd8f6f4195b6998bf18.png => /upload/iblock/2db/2db2b520cb6fb89f8fb9 /120cb6fb9 /2db.png => Asiyejulikana => Asiyejulikana) [~PREVIEW_PICTURE] => 48 => [~DETAIL_TEXT] => => [~ MAELEZO_PICHA] => ACT_KUTOKA_TOKA] [~ MAELEZO_PICHA] => => KUTOKA_KUTOKA] > = > [~DATE_ACTIVE_TO] => => [~ACTIVE_TO] => => [~SHOW_COUNTER] => => [~SH OW_COUNTER_START] => => maudhui [~IBLOCK_TYPE_ID] => maudhui => 10 [~IBLOCK_ID] => 10 => uhakiki [~IBLOCK_CODE] => uhakiki => Uhakiki [~IBLOCK_NAME] => Uhakiki => [~IBLOCK_EXTERNAL_ID] => => 02/06/2018 19:43:22 [~DATE_CREATE] => 02/06/2018 19:43:22 => 1 [~CREATED_BY] => 1 => (msimamizi) [~CREATED_USER_NAME] = > (msimamizi) => 02/07/2018 02:11:01 PM [~TIMESTAMP_X] => 02/07/2018 02:11:01 PM => 1 [~MODIFIED_BY] => 1 => (admin) [ ~USER_NAME] => (msimamizi) => [~IBLOCK_SECTION_ID] => => /content/detail.php?ID=109 [~DETAIL_PAGE_URL] => /content/detail.php?ID=109 => /content/index .php?ID=10 [~LIST_PAGE_URL] => /content/index.php?ID=10 => maandishi [~DETAIL_TEXT_TYPE] => maandishi => maandishi [~PREVIEW_TEXT_TYPE] => maandishi => / [~LANG_DIR] = > / => 109 [~ EXTERNAL_ID] = > 109 => s1 [~LID] => s1 => => => => Safu () => Safu ( => 109 => => 109 => Asiyejulikana => => 500 => Asante sana kwa ushauri na uchunguzi wako ... Pole sana, unapatikana na una maelezo ya kina kuhusu alielezea kozi na matokeo. => Safu ( => 48 => 02/07/2018 14:11:01 => iblock => 183 => 132 => 24647 => picha/png => iblock/2db =>.png => Tabaka 165. png = > => => [~src] => => /upload/iblock/2db/2db2b520cb9bbfd8f6f4195b6998bf18.png => /upload/iblock/2db/2db2b520cb9bbfd8f6f4195b6998bf18.png => /upload/iblock/2db/2db2b520cb9bbfd8f6f4195b6998bf18.png = > Анонимное => Asiyejulikana) => => => => => => => => => maudhui => 10 => mapitio => Maoni => => 06. 02.2018 19:43:22 => 1 => (admin) => 02/07/2018 14:11:01 => 1 => (admin)) => Mkusanyiko ( => Mkusanyiko ( => 25 => 2018- 02- 06 19:37:56 => 10 => Nani aliacha uhakiki => Y => 500 => JINA => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~ THAMANI] => [~MAELEZO] => [~NAME ] => Aliyeacha maoni [~DEFAULT_VALUE] =>) => Mkusanyiko ( => 26 => 2018-02-06 19:37:56 => 10 => Sahihi => Y => 500 => MAELEZO => => S => 1 => 30 => L => N => => => 5 => => 0 => N => N => N => N => 1 => => => => => => => => => [~VALUE] => [~DESCRIPTION] => [~NAME] => Sahihi [~DEFAULT_VALUE] =>)) => Mkusanyiko () => Mkusanyiko ( => 1 => Safu ( => 48 => 02/07/2018 14:11:01 => iblock => 183 => 132 => 24647 => picha/png => iblock/2db =>.png => Tabaka 165 .png => => => [~src] => => /upload/iblock/2db/2db2b520cb9bbfd8 f6f4195b6998bf18.png) => Array ( => /upload/iblock/2db/2db2b520cb9bbfd8f6f4195b6998bf18.png => 132 => 183 => 24647) => retina retina-x2-src="/upload/iblock/2db/2db2b520cb9bbfd8f6f4195b6998bf18.png " => Mkusanyiko ( => /upload/iblock/2db/2db2b520cb9bbfd8f6f4195b6998bf18.png => 132 => 183 => 24647 => Asiyejulikana)))

59226 3

Aina ya kawaida ya harakati za misuli bila hiaritetemeko- Hizi ni mabadiliko ya mara kwa mara ya utungo unaosababishwa na mkazo mbadala wa vikundi tofauti vya misuli.

Kutetemeka ni dalili ya kawaida ya matatizo ya cerebellar na extrapyramidal, pamoja na athari ya dawa fulani na madawa ya kulevya.

Aina kuu za tetemeko:

Kutetemeka kwa kupumzika. Inatokea wakati wa kupumzika, wakati mtu hachukui hatua yoyote na amepumzika. Aina hii ya tetemeko ni tabia ya ugonjwa wa Parkinson.

Tetemeko la hatua, au tetemeko la kitendo. Hutokea unapojaribu kufanya harakati fulani. Aina hii ya tetemeko ni tabia ya ugonjwa wa uondoaji wa pombe.

tetemeko la mkao. Aina hii ya tetemeko hutokea wakati wa kujaribu kudumisha mkao fulani, nafasi ya mwili.

Sababu zinazowezekana za tetemeko:

1. Ugonjwa wa kuacha pombe. Kwa utegemezi mkubwa katika siku za kwanza bila pombe, wagonjwa wanaweza kupata tetemeko la hatua. Inatokea masaa 6-8 baada ya kinywaji cha mwisho na inazidi haraka. Dalili zingine za mapema ni pamoja na: kuwashwa, wasiwasi, kukosa usingizi, maumivu ya kichwa, tachycardia, shinikizo la damu, kichefuchefu, na kutapika. Katika hali mbaya, hallucinations na udanganyifu, kukamata kunaweza kutokea.

2. Alkalosis - mabadiliko katika pH ya damu kwa upande wa alkali. Alkalosi kali inaweza kusababisha mtetemeko mkubwa wa harakati, kutetemeka kwa misuli, fadhaa, jasho, na kupumua kwa kasi. Wagonjwa wanaweza kulalamika kwa kizunguzungu, kupigia masikioni na paresthesia (kuharibika kwa unyeti).

3. Mtetemeko muhimu wa kifamilia. Ugonjwa huu hutokea kwa vijana. Inaonyeshwa na mtetemeko wa pande mbili ambao kawaida huanza kwenye vidole na mikono na unaweza kuenea hadi kichwa, taya, midomo na ulimi. Kushiriki kwa larynx husababisha kutetemeka kwa sauti.

4. Tumor ya cerebellum. Tetemeko la hatua ni kipengele muhimu cha ugonjwa huu. Ishara nyingine ni pamoja na ataksia, nistagmasi, kutopatana na uratibu, udhaifu wa misuli na kudhoofika, na kudhoofika au kutokuwepo kwa reflexes ya tendon ya kina.

5. Paresis ya jumla. Hali hii inaweza kuwa matokeo ya neurosyphilis, ikifuatana na tetemeko la hatua. Maonyesho mengine: ataxia, ishara nzuri ya Babinski, maumivu ya kichwa.

6. Ugonjwa wa makaburi. Dalili za ugonjwa huu ni kutetemeka kwa mkono, kupoteza uzito, udhaifu, uvumilivu wa joto, kupumua kwa pumzi. Pia tabia ni ongezeko la tezi ya tezi (goiter) na exophthalmos (makazi ya mbele ya eyeballs, "protrusion").

7. Hypercapnia. Kuongezeka kwa shinikizo la sehemu ya dioksidi kaboni (CO2) katika damu inaweza kusababisha kutetemeka kwa viungo wakati wa harakati. Ishara za kuongezeka kwa viwango vya CO2 ni maumivu ya kichwa, kutoona vizuri, udhaifu, usingizi, kupungua kwa kiwango cha fahamu.

8. Hypoglycemia - sukari ya chini ya damu. Katika hypoglycemia ya papo hapo, tetemeko la hatua linakua, linalohusishwa na kuchanganyikiwa, udhaifu, tachycardia, jasho, na baridi, ngozi ya clammy. Malalamiko ya mapema kawaida hujumuisha maumivu ya kichwa, njaa kali, woga, kuona mara mbili au kutoona vizuri. Wakati hali inazidi kuwa mbaya, tetemeko linaweza kutoweka, hypotension hutokea, na ufahamu unafadhaika.

9. Kwashiorkor. Katika hatua za mwisho za ugonjwa huu, kutetemeka kunaweza kutokea, kwa kupumzika na kwa harakati kubwa. Uchunguzi unaonyesha myoclonus, rigidity ya viungo vyote, hyperreflexia, uvimbe wa mikono na miguu, kupoteza nywele, ukavu na ngozi ya ngozi.

10. Multiple sclerosis ni ugonjwa mkali, unaoendelea wa neurodegenerative. Kutetemeka kunaweza kuonekana na kutoweka wakati wa harakati - hii ni moja ya ishara za mwanzo za ugonjwa huo. Usumbufu wa kuona na hisia, nistagmasi, udhaifu wa misuli, kupooza, spasms, hyperreflexia, matatizo ya kumeza, na ataxia pia hutokea. Inaweza kusumbuliwa na kuvimbiwa, hamu ya mara kwa mara ya kukojoa na kutokuwepo kwa mkojo, kutokuwa na uwezo.

11. Ugonjwa wa Parkinson. Ishara ya classic ya ugonjwa huu wa kuzorota ni tetemeko wakati wa kupumzika. Kawaida huanza kwenye vidole na huathiri mikono na miguu, kope, taya, midomo na ulimi. Mikono ya wagonjwa hutetemeka polepole, kwa sauti. Kujaribu kufunga kope husababisha "kupepea".

Taya zinaweza kusonga kwa mdundo juu na chini. Ulimi unaojitokeza unaweza kusonga mbele na nyuma kwa mdundo na sehemu nyingine za mwili. Mzunguko wa tetemeko unabaki mara kwa mara, lakini amplitude yake inabadilika kwa muda. Ishara nyingine za tabia: bradykinesia, kuharibika kwa kutembea na mkao, sauti ya monotonous, uso kama mask, ugonjwa wa kumeza, blepharospasm (kope zinaweza kufungwa kabisa).

12. Porfiria. Kuhusika kwa ganglia ya msingi katika porphyria kunaweza kusababisha mtetemeko wa kupumzika, chorea, na ugumu wa misuli. Ugonjwa unapoendelea, mshtuko wa jumla hutokea kwa aphasia na hemiplegia.

13. Ugonjwa wa Thalamic. Aina tofauti za dalili za thalamic zinaweza kusababisha michanganyiko tofauti ya tetemeko, upotezaji mkubwa wa hisi, na hemiataxia.

14. Thyrotoxicosis. Madhara ya neuromuscular ya ugonjwa huu ni pamoja na tetemeko la hatua, myoclonus, na hyperreflexia. Ishara zingine za thyrotoxicosis: tachycardia, arrhythmias, wasiwasi, upungufu wa kupumua, jasho, uvumilivu wa joto, kupoteza uzito dhidi ya asili ya hamu ya kuongezeka, kuhara. Kuna tezi ya tezi iliyopanuliwa na exophthalmos.

15. Encephalitis ya Wernicke ni ugonjwa unaotokea kutokana na upungufu wa vitamini B1 (thiamine), hasa kwa walevi. Husababisha kutetemeka wakati wa kusonga. Ishara nyingine za ugonjwa huo: kutojali, ataxia, nystagmus, hypotension orthostatic, tachycardia, kuchanganyikiwa na wengine.

16. encephalitis ya Nile Magharibi. Maambukizi haya ya virusi ni tabia ya Afrika na Mashariki ya Kati, yanayoambukizwa na kuumwa na mbu wa ndani. Kesi za ugonjwa pia huzingatiwa kati ya watalii. Maambukizi kidogo huambatana na homa, maumivu ya kichwa, na maumivu ya misuli, ambayo kawaida huambatana na upele na nodi za limfu zilizovimba. Katika aina kali za ugonjwa huo, homa ni kali, ugumu wa shingo, kuchanganyikiwa, usingizi, coma, kutetemeka, kukamata na kupooza hutokea. Wakati mwingine husababisha kifo.

17. Ugonjwa wa Wilson - ukiukwaji wa kimetaboliki ya shaba katika mwili. Kutetemeka kwa ugonjwa wa Wilson hutokea mapema na huendelea kama ugonjwa unavyoendelea. Ishara ya tabia ya ugonjwa huo ni pete za Kaiser-Fleischner kwenye cornea. Ishara zingine: kukosekana kwa uratibu, chorea, ataxia, spasms ya misuli na ugumu, udhaifu, shida ya utu, mshtuko wa moyo, hypotension. Jaundice, hyperpigmentation (ngozi ya shaba), upanuzi wa ini na wengu, na ascites inaweza kutokea.

18. Dawa. Phenothiazines (fluphenazine) na dawa zingine za antipsychotic zinaweza kusababisha kutetemeka wakati wa kupumzika. Metoclopramide na metyrosine pia wakati mwingine husababisha kutetemeka. Kulewa kwa viwango vikubwa vya lithiamu, terbutaline, pseudoephedrine, amfetamini na phenytoini husababisha mitetemeko ambayo huisha kwa kupunguzwa kwa dozi.

19. Mimea ya dawa. Bidhaa za mitishamba zilizo na ephedrine (ma huang na aina zingine za ephedra) zinaweza kusababisha athari nyingi kutoka kwa mfumo wa moyo na mishipa na neva, pamoja na kutetemeka.

20. Sumu ya manganese. Ishara za mapema za sumu ya manganese: kutetemeka wakati wa kupumzika, chorea, amnesia, mabadiliko ya utu, uso kama mask.

21. Sumu ya zebaki. Sumu ya zebaki ya muda mrefu ina sifa ya kuwashwa, mate kupita kiasi, kupoteza jino, ugonjwa wa fizi, kuzungumza kwa sauti, na kutetemeka.

22. Kutetemeka kwa watoto wachanga kunaweza kutokana na sababu maalum za watoto, ikiwa ni pamoja na kupooza kwa ubongo, ugonjwa wa pombe wa fetasi, na matumizi ya dawa za uzazi wakati wa ujauzito.

: Mwalimu wa Famasia na Mtafsiri wa Kitaalamu wa Matibabu

Hata hivyo, kwa nini mtu anatetemeka, jambo hili linahusishwa na patholojia, umri au usumbufu wa muda, daktari pekee anaweza kusema. Mara nyingi huzingatiwa kwa watu wazee, lakini pia hutokea kwa vijana wenye hypothermia, joto la juu, na magonjwa fulani.

Sababu

Sababu zinazohusiana na magonjwa, upekee wa majibu ya mtu kwa hali fulani na hali ya mazingira husababisha tukio la kutetemeka.

Katika moyo wa kundi zima la sababu ni ulevi. Inasababishwa na pombe, madawa ya kulevya, dozi kubwa za madawa ya kulevya, sumu na vipengele vya kemikali.

Kutetemeka kwa muda kunaonekana na hypothermia, ongezeko la joto la mwili linalohusishwa na magonjwa ya kuambukiza.

Kikundi kingine cha sababu za kuchochea ni pamoja na zile za kisaikolojia: mafadhaiko, phobias, kuongezeka kwa wasiwasi, tabia ya unyogovu. Katika kesi hiyo, ni desturi ya kuzungumza juu ya kutetemeka kwa neva.

Maonyesho ya kudumu ya kutetemeka yanahusishwa na patholojia zinazoendelea katika mwili wa binadamu. Hii ni tukio la neoplasms, magonjwa ya endocrine, kuongezeka kwa shinikizo la ndani, usumbufu katika utendaji wa mfumo wa moyo na mishipa, majeraha ya craniocerebral. Kutetemeka husababisha matatizo ya kazi za shina, cerebellum, uti wa mgongo, mchakato wa uhamisho wa msukumo wa ujasiri.

Moja ya sababu zinazosababisha kuonekana kwa kutetemeka bila hiari ni magonjwa ya urithi. Udhihirisho wa kawaida ni tetemeko muhimu kwa sababu ya mabadiliko ya jeni au utabiri wa urithi. Kulingana na takwimu, katika kizazi kimoja cha jamaa kunaweza kuwa na zaidi ya nusu ya wagonjwa.

Aina

Aina nyingi za udhihirisho na sifa za tetemeko huturuhusu kutofautisha sababu kadhaa za uainishaji wake:

  1. Tabia ya mchakato. Kwa msisimko mkali wa kihemko, kufanya kazi kupita kiasi, mikono na kidevu mara nyingi hutetemeka. Wakati hypothermia, homa hutokea baridi. Walakini, wachache wanaweza kufikiria kuzingatia jambo hili kama dhihirisho la ugonjwa. Kutetemeka vile ni mchakato wa kawaida wa kisaikolojia. Tofauti na tetemeko la patholojia linalosababishwa na matatizo mbalimbali.
  2. frequency ya contraction ya misuli. Mbinu za ala hukuruhusu kutathmini ni mara ngapi contraction ya misuli hutokea. Kutetemeka kwa misuli dhaifu, nadra ni sifa ya mzunguko wa hadi 5 Hertz, mkali - 6-12 Hertz.
  3. Ujanibishaji. Sababu hii inaruhusu sisi kuzungumza juu ya lesion tofauti ya viungo, uso, mwili mzima, macho.
  4. Ukali. Mapafu hayaongoi usumbufu katika maisha ya kawaida, hata hivyo, husababisha usumbufu wa kihemko. Kwa mtu wa kawaida, ana uwezo wa kukabiliana na mambo na kujitunza mwenyewe. Ukali unahusishwa na vikwazo vya huduma binafsi na inahitaji tahadhari na msaada wa mara kwa mara kutoka kwa wengine.
  5. Umri wa kuumia. Kulingana na wakati dalili za kwanza zinaonekana, zinazungumzia aina za watoto, vijana, watu wazima. Katika mwisho, ni kawaida kutofautisha tetemeko la umri wa kukomaa (miaka 21-44), presenile (miaka 45-64) na senile (baada ya miaka 65).

Katika hatua tofauti za maisha, karibu kila mtu anakabiliwa na jambo lisilo la kufurahisha, ambalo liliitwa na wataalam. tetemeko. Je, ni sababu gani ya kuonekana kwake na inawezekana kuepuka kutembelea mtaalamu? Je, kuna matibabu ya madawa ya kulevya na jinsi dawa za watu zinafaa? Kwa dalili gani mgonjwa anaweza kuelewa kwamba ziara ya daktari haiwezi kuepukwa?

Chini ya tetemeko wataalam wanaelewa kutikisika kidogo bila hiari kwa viungo au sehemu zingine za mwili. Katika baadhi ya matukio, harakati za oscillatory za mwili mzima wa mgonjwa zinajulikana. Kutetemeka hutokea kwa wanadamu na wanyama, kama vile mbwa.

Uainishaji wa tetemeko

Wataalam hutoa uainishaji kadhaa wa ugonjwa huo, kuruhusu kuamua aina ya mchakato wa patholojia na kuchagua chaguo bora zaidi cha matibabu:

Kutetemeka kwa kisaikolojia. Katika kesi hii, tunazungumza juu ya kutetemeka kidogo kwa mikono, haswa katika nafasi iliyopanuliwa. Kuna mtetemeko wa amplitude ya chini ya mikono, vidole, au kiungo kizima. Inajidhihirisha kwa watu wengi baada ya kuchukua kipimo kikali cha pombe au kwa msisimko mkali. Amplitude ya kutetemeka ni kutoka 8 hadi 12 Hz, kulingana na hali ya mgonjwa.

Tetemeko muhimu. Kulingana na matokeo ya masomo ya kliniki ya muda mrefu, inatambulika kama postural na mara chache sana hugunduliwa wakati wa kupumzika. Hii ni tetemeko la harakati. Katika hali nyingine, madaktari wanaona kuwa tetemeko muhimu hukua kikamilifu katika uzee na inaweza kuwekwa katika kikundi maalum cha misuli. Kwa mfano, kutetemeka tu kwa miguu, kichwa, au kutetemeka kwa mkono kunatambuliwa. Amplitude yake ni kuhusu 4-8 Hz. Kulingana na eneo la patholojia, dalili zinaweza kutofautiana sana.

serebela au kwa maneno mengine, kutetemeka kwa nia. Inajidhihirisha kwa kasi zaidi wakati wa harakati za kiholela. Mzunguko usio na maana ndani ya 3-4 Hz. Katika hali nadra, wagonjwa wanaweza kuathiriwa tu na shina, na viungo na kichwa havishiriki katika mchakato wa patholojia.

Kutetemeka kwa kupumzika au, kwa maneno mengine, kutetemeka kwa Parkinson kwa viungo vya mgonjwa. Harakati za oscillatory hutamkwa zaidi wakati wa kupumzika na mzunguko wa oscillation ni kuhusu 3-7 Hz.

Uainishaji ufuatao unategemea ukubwa wa harakati za oscillatory. Katika kesi hii, tenga:

Haraka tetemeko wakati mzunguko wa oscillation unafikia 6-12 Hz;
Polepole tetemeko ambalo mzunguko wa oscillation ni 3-5 Hz.

Uainishaji ufuatao unategemea aina ya harakati zisizo za hiari zilizofanywa:

Andika ndiyo-ndiyo;
Hapana hapana;
Movements kukumbusha dawa rolling au kutengeneza mipira;
Harakati zinazofanana na kuhesabu sarafu, nk.

Uainishaji kulingana na etiolojia ya ugonjwa:

Kihisia. Inatokea wakati wa msisimko mkali au hofu.
Senile kuundwa katika uzee.
Ya hysterical, ambayo inajidhihirisha wakati wa msisimko mkubwa wa mfumo wa neva.
muhimu au tetemeko la harakati.
Kutetemeka kwa kupumzika au tetemeko linaloashiria kutetemeka kwa ncha za ugonjwa wa Parkinson.
Mlevi kuzingatiwa kwa wagonjwa wanaosumbuliwa na utegemezi wa pombe. Hii ndio inayoitwa tetemeko la kuruka. Inaweza pia kuzingatiwa katika kushindwa kwa ini na katika coma ya hypoglycemic.
tetemeko la iatrogenic. Katika hali nyingi, inabadilishwa na dhana ya "tetemeko la zebaki". Inatokea kwa sumu ya zebaki na inaweza kutumika kama moja ya dalili za ugonjwa. Ni kawaida kwa sumu ya papo hapo na sugu.
Kutetemeka kuzingatiwa katika thyrotoxicosis.
Kutetemeka kwa vijijini hutokea wakati sehemu za kati za ubongo zimeathiriwa na ina sifa ya mchanganyiko wa tetemeko la kupumzika na tetemeko la harakati.

Dalili na ishara za tetemeko

Wataalamu wanasema kuwa udhihirisho wa tetemeko ni sawa, lakini hutofautiana katika eneo la lesion. Weka tetemeko:

Eyelid au jicho;
Mikono;
vidole;
Acha;
lugha;
vichwa;
Kiwiliwili;
Kidevu;
Taya;
midomo;
Na kadhalika.

Mgonjwa anabainisha harakati za oscillatory za sehemu fulani ya mwili. Kulingana na kiwango cha uharibifu na ukali wa ugonjwa huo, ukali wa harakati zisizo za hiari zinaweza kutofautiana. Wataalamu wanasema kwamba mchakato wa patholojia unaweza kuongezeka chini ya ushawishi wa mambo mabaya na kupungua kwa kiasi fulani wakati mgonjwa anapumzika. Kwa hiyo, katika kesi ya tetemeko la kihisia lililogunduliwa, wakati mgonjwa ana msisimko, mzunguko wa harakati za oscillatory huongezeka kwa kasi, na katika hali ya utulivu, mtu huyo huyo hawezi kuathiriwa sana na harakati zisizo za hiari za viungo.

Katika dawa, kesi zinaelezwa wakati mgonjwa mmoja hana aina fulani tu ya tetemeko, lakini michakato kadhaa ya pathological mara moja. Kwa mfano, tetemeko la kupumzika lililotamkwa na tetemeko kidogo la mkao. Au tetemeko la wazi la mkao dhidi ya msingi wa tetemeko la kukusudia linaloonekana kidogo. Ikumbukwe kwamba hata uwepo wa, kwa mtazamo wa kwanza, harakati ndogo za oscillatory ambazo hutofautiana na tetemeko kuu lina thamani muhimu ya uchunguzi.

Wataalamu wanasema kwamba bila kujali aina ya tetemeko na ishara za ugonjwa huo, mchakato huu wa patholojia unaonyesha kuwepo kwa ugonjwa mbaya zaidi katika mwili wa mgonjwa. Ndiyo maana, katika matibabu ya harakati za oscillatory kwa mgonjwa, kutambua sababu kuu ya maendeleo ya ugonjwa huo ni muhimu sana, na kuondoa dalili ni hatua ya pili tu.

Wataalam wamegundua sifa kadhaa za kila aina ya tetemeko:

Kutetemeka kwa kisaikolojia, kama sheria, huongezeka na hypothermia, mvutano wa misuli, uchovu, au msisimko wa kihemko wa mgonjwa. Inajulikana kwa kutetemeka vizuri na kwa haraka kwa viungo.
Senile au, kwa maneno mengine, tetemeko la senile. Kwa ugonjwa huu, kuna kutetemeka kidogo kwa kidevu, taya ya chini, kichwa na vidole. Wakati huo huo, wagonjwa hawana shida na kufanya udanganyifu wowote.
Kutetemeka kwa Mercury huanza kwa mgonjwa wakati wa kupumzika, na baadaye huongezeka wakati wa kufanya harakati zozote. Awali hutokea kwenye misuli ya uso, kisha huenda kwa viungo.
Kutetemeka kwa pombe hujidhihirisha na dalili za uondoaji, sumu ya pombe au matumizi ya pombe kupita kiasi. Mgonjwa ana kutetemeka kidogo kwa vidole vilivyoachwa, pamoja na kutetemeka kwa ulimi na misuli ya uso.
Kwa tetemeko la hysterical kwa wagonjwa wakati wa mfiduo wa kisaikolojia, harakati za oscillatory za viungo na ongezeko la mwili. Ikumbukwe kwamba wanaweza kuwa wote paroxysmal na kudumu. Amplitude ya oscillations si sawa na mzunguko wa contractions ya misuli inaweza kutofautiana kwa kiasi kikubwa.
Kutetemeka hutokea wakati cerebellum imeharibiwa ina sifa ya ukweli kwamba wakati kiungo kinaletwa kwa lengo lililokusudiwa, amplitude ya harakati za oscillatory huongezeka, na kudanganywa ni vigumu. Katika baadhi ya matukio, inajidhihirisha wakati wa kujaribu kudumisha usawa au mkao fulani. Lakini kuna matukio wakati tetemeko linazidi katika nafasi ya wima, na kutoweka wakati wa kuhamia nafasi ya usawa.

Matatizo ya tetemeko

Wataalam hugundua shida kadhaa za kawaida, ambazo ni pamoja na:

Ukiukaji katika uwanja wa marekebisho ya kijamii, pamoja na kutokuwa na uwezo wa kufanya vitendo fulani mahali pa kazi;
Hotuba ngumu na tetemeko la taya ya chini na misuli ya uso;
Ugumu wa kufanya shughuli za kawaida kama vile kunyoa, kujipodoa, kunywa na kula. Kutowezekana kwa kufanya vitendo rahisi husababisha ukiukwaji wa hali ya kisaikolojia-kihisia ya mgonjwa.

Ikumbukwe kwamba haiwezekani kuondoa kabisa tetemeko hata kwa matumizi ya dawa na mbinu za kisasa. Utaratibu huo utazidishwa kwa muda, na kutoa shida zaidi na zaidi kwa mgonjwa.

Sababu za tetemeko

Licha ya maendeleo ya kazi ya dawa katika miongo ya hivi karibuni na uwezekano wa kiufundi wa kuchunguza mgonjwa, wataalam bado hawajafikia makubaliano kuhusu sababu za tetemeko.

Imethibitishwa kwa uhakika kwamba tukio la tetemeko linaweza kuwa kutokana na sababu ya maumbile. Katika idadi ya familia, zaidi ya vizazi kadhaa, aina moja au zaidi ya tetemeko hujulikana katika wazao. Katika kesi hii, hatuzungumzi juu ya tetemeko la senile, lakini kuhusu aina nyingine za mchakato wa pathological.

Pia kuna nadharia kulingana na ambayo tetemeko linaweza kutokea kama matokeo ya dhiki kali. Katika kesi hiyo, ni sahihi kuzungumza juu ya tetemeko la hysterical au tetemeko kwenye historia ya kihisia. Tetemeko muhimu husababishwa na mabadiliko ya kromosomu. Osteochondrosis pia inaweza kusababisha kutetemeka kwa miguu na kichwa.

Wataalam pia wanazungumza juu ya uwepo wa tetemeko sio tu kwa watu wazima, bali pia kwa watoto wachanga. Kutetemeka kwa kichwa kwa watoto wachanga kunaweza kuwa kutokana na magonjwa ya maumbile au kiasi kikubwa cha norepinephrine katika damu ya mtoto. Kutetemeka kwa mikono na miguu kunaonyesha maendeleo duni ya mfumo wa neva, pamoja na hypoxia ya fetasi.

Utambuzi na matibabu ya tetemeko

Kila mgonjwa anayekuja kuwaona wataalamu hufanyiwa uchunguzi wa kina. Kusudi lake ni kufafanua mienendo ya mchakato wa patholojia, mwelekeo na asili ya harakati, pamoja na ukubwa wa vibrations ya misuli.

Madaktari hufanya uchunguzi unaojumuisha hatua kadhaa:

Uchunguzi na maswali ya mgonjwa. Katika hatua hii, wakati wa mwanzo wa ugonjwa huo, pamoja na pathologies zinazofanana, huanzishwa.
Uchunguzi wa neva, ambayo inaruhusu kutambua matatizo katika utendaji wa mfumo wa neva.
Uchunguzi wa maabara, kutoa taarifa kuhusu hali ya tezi ya tezi na mfumo wa endocrine. Uzalishaji mkubwa wa homoni unaweza kusababisha kutetemeka.
Vipimo vya kazi ili kuamua uwezo wa kimwili wa mgonjwa. Hizi ni pamoja na maombi ya kuleta kikombe cha maji kwa midomo yako au kuchora ond.

Inapaswa kueleweka kuwa hakuna matibabu maalum ya kutetemeka. Matumizi ya madawa ya kulevya yanaweza kupunguza kidogo tu maonyesho ya harakati za oscillatory ya misuli. Kwa kusudi hili, beta-blockers hutumiwa.

Mambo ya Kuvutia
Mzunguko wa tetemeko muhimu hupungua kwa umri. Wakati huo huo, wataalam wanasema kuwa mwanzo wa ugonjwa huo katika umri mkubwa husababisha kuongezeka kwa kasi kwa dalili na kuzorota kwa hali hiyo.
Kutetemeka kwa watoto wachanga hauhitaji matibabu hadi umri wa miezi 3 na mtoto anapaswa kuwa chini ya usimamizi wa karibu wa wataalamu. Ikumbukwe kwamba hali hii inaweza kuonyesha pathologies kubwa.
Matumizi ya pombe katika hatua za awali za maendeleo ya tetemeko inaweza karibu kuondoa kabisa harakati za oscillatory zisizo na hiari. Baada ya muda mfupi, dalili zinarudi kwa nguvu mpya na ulevi wa muda mrefu hujiunga na tetemeko hilo.


Ikiwa mgonjwa hugunduliwa na tetemeko la hysterical, daktari ataagiza tranquilizers au sedatives. Matokeo mazuri yanapatikana kwa matumizi ya anticonvulsants.

Matumizi ya taratibu za physiotherapy ilisababisha mgawanyiko wa wataalamu katika kambi mbili. Wafuasi wa matibabu hayo wanasema kuwa mafunzo ya misuli yana athari ya manufaa kwa mgonjwa, wakati wapinzani wanapendekeza kujiepusha na mizigo ya ziada.

Katika hali mbaya zaidi, matibabu ya upasuaji yanaweza kuhitajika. Kusudi lake ni kuchochea vituo fulani vya ubongo na hutumiwa kwa kutokuwepo kabisa kwa athari za matumizi ya matibabu ya madawa ya kulevya.

Kuzuia Tetemeko

Shughuli ya kimwili ya wastani, lishe sahihi na yenye lishe, uchunguzi wa wakati na mtaalamu ikiwa kuna historia ya familia ya ugonjwa huu, kufuata kikamilifu mapendekezo yote ya daktari na kuacha sigara na pombe itapunguza hatari ya kuendeleza tetemeko au kuchelewesha kwa kiasi kikubwa mwanzo wake.

Matibabu ya watu kwa tetemeko

Madaktari wa mitishamba wanapendekeza tiba kadhaa za ufanisi sana za kupunguza dalili za tetemeko:

Mimea iliyopigwa iliyochukuliwa kwa uwiano sawa (melissa, wort St. John, mizizi ya rosehip, mint, majani ya rosemary na mbegu za hop) huchanganywa kabisa. Mimina 500 ml ya vodka ndani ya 50 g ya mchanganyiko unaosababishwa na kusisitiza mahali pa giza, baridi kwa wiki tatu. Inashauriwa kutikisa chombo kwa upole na tincture kila siku 2-3. Mwishoni mwa kipindi, shida na kuchukua matone 2 mara tatu kwa siku kabla ya chakula na kunywa glasi ya maji. Muda wa kozi ni wiki 7, kisha mapumziko ya mwezi. Muda wote wa matibabu ni mwaka 1.

Decoction ya oats inaweza kupunguza kwa kiasi kikubwa tetemeko la mikono au miguu. Kwa vijiko 9 vya oats, unahitaji kuchukua lita 3 za maji na kupika juu ya moto mdogo kwa saa. Kisha inashauriwa kuondoka usiku mmoja mahali pa joto. Asubuhi, chuja na kunywa mchuzi mzima siku inayofuata. Ufanisi wa dawa ni kutokana na athari ya manufaa ya vipengele vya shayiri kwenye mfumo wa neva wa mgonjwa.

Kutetemeka ni hyperkinesis, ambayo inadhihirishwa na harakati zisizo za hiari za oscillatory za sehemu (miguu, kichwa) au mwili mzima kama matokeo ya kurudia mara kwa mara kwa contraction ya misuli na kupumzika. Ni mojawapo ya matatizo ya kawaida ya extrapyramidal. Mara nyingi, tetemeko hilo ni la kifamilia, katika hali zingine ni duni na lina kozi kali sana.

Tetemeko: sababu na sababu za maendeleo

Miundo ya mfumo wa neva inayohusika na tukio la tetemeko haielewi vizuri.

Kutetemeka kwa pathological ni postural, makusudi, tuli, mchanganyiko.

Kutetemeka kwa tuli huzingatiwa katika parkinsonism, tetemeko muhimu, dystrophy ya hepato-cerebral, sumu ya zebaki.

Kutetemeka kwa postural huzingatiwa na sumu ya lithiamu, pombe, thyrotoxicosis, parkinsonism.

Kutetemeka mara nyingi huzingatiwa katika hali ya uchovu, wasiwasi.

Kutetemeka kwa makusudi hutokea wakati cerebellum au uhusiano wake umeharibiwa.

Aina za ugonjwa: uainishaji wa tetemeko

Kulingana na mzunguko wa harakati za oscillatory wakati wa kutetemeka:

  • tetemeko la polepole (3-5 Hz);
  • tetemeko la haraka (6-12 Hz).

Kwa asili ya harakati:

  • kutetemeka kwa aina ya "hapana-hapana";
  • tetemeko la aina ya "ndiyo-ndiyo";
  • tetemeko kama vile vidonge vya kutembeza;
  • tetemeko kama kuhesabu sarafu.

Kulingana na eneo la tetemeko:

  • kutetemeka kwa kichwa;
  • tetemeko la mikono;
  • tetemeko la ulimi;
  • kutetemeka kwa miguu.

Kulingana na hali ya tukio:

  • tetemeko la tuli - hutokea katika sehemu ya mwili ambayo imepumzika;
  • kwa makusudi (nguvu) - inaonekana wakati wa shughuli za misuli;
  • postural - hutokea wakati wa kudumisha msimamo, kudumisha mkao;
  • mchanganyiko - hutokea wote wakati wa kupumzika na wakati wa harakati.

Kulingana na sababu:

  • hysterical;
  • uzee;
  • kihisia;
  • zebaki;
  • pombe;
  • na thyrotoxicosis;
  • na vidonda vya cerebellum;
  • muhimu;
  • parkinsonian.

Dalili za tetemeko: jinsi ugonjwa unavyojidhihirisha

  • Kutetemeka kwa kisaikolojia- tetemeko la haraka na rahisi la kope, vidole, kichwa, ambayo hutokea wakati wa shughuli za misuli, mvutano, baridi, kazi nyingi, msisimko wa kihisia.
  • Senile (au senile) tetemeko- kutetemeka mchanganyiko wa vidole, taya ya chini, kichwa, ambayo haiathiri sana harakati za binadamu.
  • tetemeko la dawa- aina hii ya tetemeko husababishwa na inhibitors ya phosphodiesterase (caffeine, aminophylline), glucocorticosteroids, agonists ya receptor ya β-adrenergic, maandalizi ya lithiamu, antipsychotics, valproate, antidepressants tricyclic, amiodarone, psychostimulants.
  • Kutetemeka kwa Mercury kuzingatiwa na sumu ya zebaki, hutokea wakati wa kupumzika, huongezeka kwa harakati za misuli ya hiari. Kutetemeka kwa Mercury hujidhihirisha kwenye misuli ya uso, na kisha miguu.
  • Kutetemeka kwa pombe inajidhihirisha kwa namna ya kutetemeka kwa vidole vya mikono iliyopanuliwa, ambayo ni talaka, pamoja na misuli ya uso, ulimi. Kutetemeka kwa pombe hutokea kwa ulevi wa pombe, ulevi, ugonjwa wa kujiondoa.
  • tetemeko la hysterical kuzingatiwa katika hysteria, ina amplitude ya kutofautiana na rhythm, ni mara kwa mara au paroxysmal katika asili, huongezeka chini ya ushawishi wa mambo ya kisaikolojia.
  • Kutetemeka kwa jeraha la cerebellar ni kimakusudi na hudhihirishwa na mitetemo midundo ya viungo inapokaribia lengo (kwa mfano, wakati mkono unagusa ncha ya pua). Kutetemeka kunaweza kuwa mkao kwa asili, kutokea wakati wa kudumisha mkao fulani, kushikilia mvuto.
  • Tetemeko muhimu inaweza kutokea wakati wa kufanya vitendo, na wakati wa kudumisha msimamo, kudumisha mkao. Tetemeko hilo ni la nchi mbili, lakini linaweza kuwa la asymmetrical. Mbali na viungo, kichwa (hapana-hapana au aina ya ndiyo-ndiyo), taya ya chini, miguu, kamba za sauti zinaweza kuhusishwa. Uwezo wa kiakili umehifadhiwa. Katika nusu ya visa, tetemeko muhimu ni ugonjwa wa urithi na aina kuu ya urithi wa autosomal, ingawa kuna maoni juu ya uwezekano wa uharibifu wa njia za cerebellum.

Jibu la mgonjwa kwa tetemeko

Kuonekana kwa tetemeko ni sababu ya kwenda kwa daktari na uchunguzi. Ni muhimu kuamua aina ya tetemeko, sababu za maendeleo yake, pamoja na kutekeleza hatua muhimu za matibabu ili kuondoa tatizo na kuboresha ubora wa maisha ya mgonjwa.

Utambuzi wa surua

Kwa tetemeko, madaktari hufanya mfululizo wa mbinu za uchunguzi wa ala ili kujua sababu za maendeleo ya dalili. Miongoni mwa njia za uchunguzi wa tetemeko, zinazotumiwa zaidi ni:

  • Mbinu ya "Haraka" (upigaji picha wa filamu) ni upigaji wa masafa ya juu unaofuatwa na makadirio ya fremu zilizonaswa katika mwendo wa polepole.
  • Tremography - usajili wa tetemeko katika ndege tatu.
  • Upigaji picha wa giza - vipengele vya mwanga vimewekwa kwenye sehemu fulani za kiungo, ambacho kinahusika katika tetemeko. Katika giza, vibrations ya vipengele vya mwanga hupigwa picha kwenye filamu ya picha.
  • Electromyography ni utafiti wa misuli ambayo inatoa wazo la sifa za hyperkinesis ya rhythmic.
  • Njia nyingine za utafiti - hutumiwa kwa hiari ya daktari, kulingana na hali ya afya ya mgonjwa na ukali wa ishara za pathological.

Ikiwa tetemeko linaonyeshwa kwa fomu kali, basi matibabu yake yanapunguzwa kwa uteuzi wa mbinu za kufurahi. Ni muhimu kujifunza jinsi ya kuepuka matatizo na kupunguza mvutano kwa msaada wa mazoezi ya kupumua na mbinu nyingine ambazo daktari wako atakushauri. Bafu ya kupumzika na matumizi ya mafuta muhimu ya kupendeza na mimea husaidia. Mgonjwa anaweza kuagizwa sedatives asili au synthetic. Ikiwa tetemeko si la asili mbaya na linaendelea kwa fomu kali, basi, kama sheria, taratibu zilizo juu zinapaswa kutosha ili kuondoa dalili za uchungu na kupunguza mvutano wa neva.

Kuhusu tetemeko kali, ambalo huzuia mgonjwa kuishi na kufanya kazi kwa kawaida, katika kesi hii, madawa ya kulevya yenye nguvu hutumiwa ambayo hupunguza tatizo hili. Kama sheria, hizi ni beta-blockers, ambazo, kwa kipimo cha chini cha kutosha, zinaweza kupunguza amplitude ya kutetemeka. Dawa hizi huboresha sana hali ya mgonjwa na kuondoa haraka udhihirisho wa kliniki wa mchakato wa patholojia.

Katika matibabu ya tetemeko muhimu, wapinzani wa β-adrenergic, benzodiazepines (clonazepam), primidone hutumiwa. Uvumilivu unaweza kuendeleza kwa hatua ya madawa haya, kwa hiyo wanapendekezwa kutumika tu wakati wa lazima.

Tiba ya matibabu kwa tetemeko la serebela kawaida haifai. Kuna ripoti za matumizi ya mafanikio ya clonazepam, primidone.

Njia za upasuaji zinafaa katika matibabu ya tetemeko kali la cerebellar - thalamotomy ya stereotaxic, microstimulation ya thalamus. Hii ndiyo njia ya hivi punde ya matibabu, ambayo sasa inatumika kwa mafanikio Ulaya, Israel, Marekani na Japan. Kwa msukumo wa kina wa ubongo, electrodes huwekwa katika eneo la ubongo wa mgonjwa, kuchochea (au kukandamiza) shughuli za kanda za kibinafsi zinazohusika na uratibu wa harakati na tetemeko. Njia hii ya matibabu kwa sasa inaboreshwa, na inatumika kikamilifu katika matibabu ya magonjwa kama vile ugonjwa wa Parkinson, kifafa na wengine.

Matatizo ya tetemeko

Shida kuu inayozingatiwa na tetemeko ni kupungua (au upotezaji kamili) wa uwezo wa kufanya kazi. Katika aina kali za tetemeko, ni vigumu kwa mgonjwa hata kufanya mambo ya msingi: kula au kuvaa. Katika hali hiyo, mgonjwa hawezi kufanya bila msaada wa nje.

Kuzuia Tetemeko

Kukataa tabia mbaya, pamoja na kuchukua dawa ambazo zinaweza kusababisha kutetemeka.