Lumbar fracture - kuphwanya kukhulupirika kwa ma vertebra (s). Pathogenesis ndiyopindika mwachilengedwe pakugwa, kugunda kumbuyo. Matendawa amayambitsa matenda opweteka kwambiri, kuuma kwa mayendedwe, kupsinjika kwa minofu ndi edema patsamba la chotupacho. Kusokonezeka pakugwira ntchito kwa ziwalo zam'mimba, ziwalo, paresis kumatha kuwonedwa. Kuti mupeze matenda, njira zamakono zowunika zogwiritsira ntchito zimagwiritsidwa ntchito. Pakakhala zovuta, mtundu wa mankhwala wodziletsa umasankhidwa. Pazovuta zazikulu, kuchitira opaleshoni ndikofunikira.
Zifukwa
Matendawa nthawi zambiri amapezeka pamene:
- Kufika kumbuyo kwanu.
- Kulowetsa m'madzi m'madzi osaya.
- Kupindika kwakuthwa kapena kukulitsa. Izi zimachitika nthawi zambiri mabuleki osayembekezereka kapena pakagunda choletsa china, galimoto yomwe wovutikayo ali.
- Kuphulika kumunsi kumbuyo. Komanso, kuvulala kwamtunduwu kumalandiridwa ndi anthu omwe amachita nawo masewera olimbitsa thupi kapena olimbitsa thupi.
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Chitukuko
Mipata nthawi zambiri imagawidwa:
- psinjika;
- dislocation fractures;
- wogawanika.
Mtundu woyamba umakwiyitsa:
- psinjika kwa dera lakunja kwa vertebra;
- kugawanika kwake;
- mphete woboola pakati.
Pali madigiri atatu opanikiza:
- I - mothandizidwa ndi mphamvu yonyamula, thupi limakhazikika (limakhala lalifupi) ndi 30% kapena kuchepera;
- II - pofika 30-50%;
- III - 50% kapena kuposa.
Kuphwanya mafupa nthawi zambiri kumaphatikizapo vertebra imodzi (kawirikawiri). Zophwanya zimawonedwa mthupi lake lokha. Nthawi zambiri, kuvulala kumachitika pakugwa pachisanu chachisanu kapena pamawondo otsika. Ndi mtundu wopanikizika, zofunikira zonse zowunikira zimafunikira, popeza Nthawi zambiri zimaphatikizana ndi kuphwanya kwa calcaneus kapena mafupa amchiuno.
© Artemida-psy - stock.adobe.com. Mitundu yovutikira
Mtundu wogawanika umadziwika ndikulowera kwa khoma lakunja kwa vertebra mthupi lomwe lili pansipa. Kuvulala uku ndikokulirapo kuposa mtundu wam'mbuyomu chifukwa:
- disc ya intervertebral imatha kugawanika m'magulu awiri kapena kupitilira apo;
- chidutswacho chimasunthidwa kuchokera kumbuyo kupita kutsogolo (nthawi zina kokha kumbuyo), komwe kumabweretsa kuwonongeka kwa mitsempha yapakati yomwe ili mumtsinje wamtsempha.
Ndikusokonekera, zigawo zakumtunda zimasamukira kutsogolo. Itha kukhala limodzi ndi:
- kusuntha kwa ma vertebrae oyandikira;
- kusweka kwa mafupa ndi mabwalo.
© Artemida-psy - stock.adobe.com. Zosankha zakusunthira kwa Vertebral zakuthwa kozungulira
Matendawa amabweretsa zoyipa zomwe zimapangitsa dongosolo lamanjenje (NS):
- kuwapapira mphamvu zosiyana;
- kufinya kapena kuphwanya kwa kutha kwa mitsempha, kuvulala kwa msana.
Kuwonongeka kumagawidwa mu:
- zovuta (NS sizinawonongeke);
- zovuta (panali kupanikizika, chiwonongeko, kuphulika kwa NS).
Kugawidwa ndi pathogenesis:
- zoopsa;
- matenda.
Mtundu woyamba umawonedwa pambuyo povulaza, kugwa. Mtundu wamatenda amayamba ndimatenda omwe adalipo kale, omwe adapangitsa kufooka kwa minofu. Izi zimachitika motsutsana ndi matenda awa:
- chotupa chosaopsa kapena chowopsa;
- kufooka kwa mafupa;
- chifuwa chachikulu cha mafupa;
- osteomyelitis.
Mtundu wamatenda amatha kukula ndikamanyamula pang'ono m'dera lumbar. Nthawi zina ngakhale thupi lanu limakhala lokwanira.
Zizindikiro
Pankhani yovulala, chithunzi chachipatala chotsatirachi chimawonedwa:
- ululu;
- kuuma kwa kayendedwe;
- yaitali mavuto a kumbuyo minofu;
- kutupa pamalo owonongeka.
Ululu ukhoza kudziwika motere:
Zochitika | Kufotokozera |
Kutanthauzira | Malo ophulika. |
Kufalitsa | Mutha kusunthira kumatumba oyandikana nawo. |
Khalidwe | Kupweteka. |
Kulankhula | Sing'anga mpaka mphamvu. Zowawa zimakulira ndimayendedwe. |
Nthawi yochitika | Nthawi zambiri panthawi yovulala. Koma mwina sangawonekere nthawi yomweyo, koma patadutsa maola angapo kuwonongeka. |
Kusuntha kochepa kumachitika chifukwa cha:
- kutchinga ndi chopindika cha vertebra;
- kuwonongeka kwa mitsempha yam'magazi yomwe imayendetsa magalimoto;
- kumva kuwawa kwambiri ndi wodwalayo (amayesera mozama kuti asasunthire kuti apewe kumverera kosasangalatsa).
Kupanikizika kwa minofu ndi kutupa ndimomwe thupi limayankhira pakavulala.
Nthawi zina (mosasamala kanthu kuti nyumba zina zavutika kapena ayi), zizindikiro zotsatirazi zitha kuchitika:
- kunyada;
- kudzimbidwa;
- kumva kunyansidwa;
- kusanza, pambuyo pake vutolo silisintha.
Ndi kugonjetsedwa kwa NS, izi zikuwoneka:
- kuchepa kapena kutaya chidwi;
- kulimbikitsa kapena kufooka kwa malingaliro;
- kufooka kwa minofu pansi pa malo ovulala (nthawi zina ziwalo ndizotheka);
- mavuto pokodza.
Ndi mtundu wopanikizika, zizindikirazo sizimveka bwino. Nthawi zambiri wodwalayo samamusamala ndipo samapangana ndi dokotala. Matenda nthawi zambiri amapezeka mwangozi.
Mu mtundu wamatenda omwe amayambitsidwa ndi kufooka kwa mafupa, ma fracture angapo omwe asokonezeka kale amapezeka. Izi zimayambitsa kupindika kwa msana, mpaka mapangidwe a hump.
Ndi zophulika zomwe zimasinthidwa, zizindikilo zomwe zatchulidwa pamwambapa zimawonedwa. Komabe, zizindikilozi zimadziwika kwambiri.
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Thandizo ladzidzidzi
Ndikofunikira kwambiri kupeza chithandizo choyamba pambuyo povulala. Kupambana kwa chithandizo china kumadalira izi. Kuchita zolondola kumachepetsa mwayi wazovuta ndikuwonjezera mwayi wazabwino.
Choyamba, muyenera kuyitanitsa ambulansi. Asanabwere wovulalayo, ikani pamalo opindika molimba, mosalala. Ikani pilo yotsika pansi pamutu, ndi chowongolera pansi pamunsi kumbuyo (chitha kupangidwa kuchokera ku matawulo).
Povulala kwambiri, wodwalayo samatha kumva thupi lotsika. Amakumana ndi mantha owawa, amataya chidziwitso, amasanza. Ndikofunikira kwambiri kuti anthu omwe akuthawa asalowe munjira yopumira ndipo munthuyo asawatsamwitse. Pofuna kupewa izi, wozunzidwayo ayenera kutembenuzidwira modekha mbali imodzi ndikukhazikika pamalowo ndi mapilo.
Chingwe chiyenera kugwiritsidwa ntchito pamalo ovulala. Kuti muchepetse vutoli, apatseni mankhwala ochepetsa ululu omwe amapezeka mukabati yanyumba. Ndibwino kuti mupake ayezi kapena china chake chozizira kuti chiwonongeko. Mutha kumusuntha wodwalayo pamachira okhwima kapena bolodi.
Mankhwala onse
Ngati mafupawo sanasamuke ndipo msana wa msana sunakhudzidwe, ndiye kuti mankhwalawa ndi osamala. Cholinga chake ndikubwezeretsa magwiridwe antchito popanda kupweteka komanso kusapeza bwino, kubwezeretsa malo achilengedwe a msana. Gawo ndi gawo zochita:
- Pumulani pabedi la mafupa.
- Lumbar block yokhala ndi jakisoni wothandizira kupweteka.
- Kutenga mankhwala osagwiritsa ntchito zotupa ndi ma analgesics.
- Mankhwala a calcium.
- Kuthetsa mafupa.
- Kukweza mwendo wa bedi ndi 30 °.
- Kukulitsa kulemera kwa 14 kg pa chidendene kapena pakhosi.
- Kutulutsa madera omwe asinthidwa.
- Kuvala corset (masabata asanu mutayamba chithandizo).
- Mankhwala a vertebroplasty (vertebra yowonongeka imakhazikika ndi simenti yachipatala, izi zimathandizira kuti kuchira kukhale kovuta). Kugwiritsa ntchito molakwika kumaloledwa pokhapokha ngati ma disc a intervertebral asunthika.
Corset
Valani kukonza, kugawa katundu. Zimapangidwa payekha kwa wodwala aliyense, poganizira zomwe munthuyo akuchita.
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Chitani masewera olimbitsa thupi ndi kutikita minofu
Physiotherapy ndi njira yothandizira yomwe imaperekedwa pambuyo pa chithandizo chamankhwala kapena opaleshoni.
Kuti mubwerere m'moyo wabwinobwino, muyenera kutsatira mosamalitsa malingaliro onse a dokotala, chitani zolimbitsa thupi tsiku lililonse.
Ngati kulibe matenda opweteka kwambiri, chithandizo chamankhwala chimaperekedwa kwa masiku 3-5 a chithandizo:
- Zochita zolimba komanso zopumira. Izi zimatenga milungu ingapo.
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- Mu sabata yoyamba, mutha kusuntha miyendo yanu mutagona pabedi. Zidendene sizimachoka, mwendo umodzi umayenda mosinthana. Simungathe kukhala ndi mwendo wowongoka!
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Ngati kumapeto kwa sabata yoyamba wodwalayo atha kukweza mwendo wowongoka kwa masekondi 15 ndipo samva kupweteka, ndiye kuti akuchira.
- Pambuyo milungu iwiri, kutembenukira kumimba ndikololedwa. Motsogozedwa ndi dokotala, wodzigudubuza anayikidwa pansi pa chifuwa ndi mapazi (10-15 cm wachiwiri). Momwemonso, wodwala amagona mphindi 20 mpaka 30 2-3 tsiku.
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- Patatha milungu itatu kapena inayi, njinga imatha kusinthana mwendo uliwonse. Zochita zina ndikukweza miyendo mutagona kumbuyo kapena m'mimba ndizololedwa.
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- Pamapeto pake, amaloledwa kukwera pamalo ogwada (simungathe kuyimirira pamakhala!). Kuyenda osapanikizika mopitirira muyeso pamapazi ndikololedwa. Mayendedwe onse umalimbana kulimbitsa minofu ya m'munsi malekezero, wofooka yopuma yaitali. Kutsamira mtsogolo kumaloledwa miyezi 3.5 yokha kuyamba kuyenda. Ndiponso, makalasi mu dziwe amalimbikitsidwa kuti achire mwachangu.
Kuti masewerowa apindule, muyenera kutsatira malamulo osavuta:
- chitani tsiku ndi tsiku;
- Chitani chilichonse mwaluso, popanda ulesi;
- gawani moyenera katunduyo (kusowa kwake kumapangitsa kuti zinthu zisamayende bwino, ndipo kupitilira apo kumatha kukulitsa vutoli).
Mukadzichulukitsa ndi masewera olimbitsa thupi, zovuta zotsatirazi zitha kuchitika:
- kuchepetsa kapena kuimitsa kukonza kwa minofu;
- kumasula kwa ma vertebrae;
- chophukacho;
- kufooka kwa mafupa;
- mitsempha;
- ziwalo za m'munsi malekezero;
- kusadziletsa kwamikodzo;
- kuphwanya ntchito yobereka.
M'magawo oyamba, kotala la ola patsiku limaperekedwa kuti muzichita masewera olimbitsa thupi. Pang'onopang'ono onjezerani nthawiyo kukhala mphindi 60, kutsatira zomwe mumachita tsiku ndi tsiku:
- kulipiritsa;
- kuyenda masana;
- Kuchita masewera olimbitsa thupi kwa mphindi zisanu;
- makalasi mu gulu lapadera la masewera olimbitsa thupi, masewera olimbitsa thupi, dziwe losambira.
Cholinga cha kutikita minofu ndikuthandizira kusintha kwa magazi ndikulimbitsa minofu. Zimatetezanso kukula kwa zovuta. Njirayi imathandizira paresis ndi ziwalo, zimabwezeretsanso kuchita bwino.
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Kupititsa patsogolo ntchito
Ngati ma vertebrae sanasamuke kwawo, kyphoplasty imachitika: kudzera pamagwiridwe ang'onoang'ono, mabuloni amakhala okhazikika, akukonzekera thupi lanyama. Dera lomwe lakhudzidwa limadzaza ndi simenti ya mafupa. Ntchito yochepetsayi imayikidwa kuti ikwaniritse momwe wodwalayo alili, kupewa kuwonongedwa mobwerezabwereza kwa umphumphu wa ma vertebrae. Kuchita opaleshoni kumachitidwa pansi pa opaleshoni ndipo sikutanthauza kukhala nthawi yayitali kuchipatala.
Kyphoplasty ili ndi maubwino otsatirawa:
- ululu umadutsa;
- kukhazikika kolondola kumabwezeretsedwanso;
- zovuta sizimakhala;
- pafupifupi zipsera zosaoneka zimatsalira;
- mutha kuchira kwanu;
- mafupa a msana amalimba;
- Kuphulika kwapadera kumachiritsidwa kwathunthu ngati palibe kusuntha kwama disc.
Gawo ndi gawo ntchito:
- Kutsekemera kwa malo opareshoni.
- Jekeseni wamankhwala am'deralo.
- Ikani chubu chapadera mumdulidwe.
- Kutenga chitsanzo cha minofu kuti mupimidwe.
- Kuyika buluni yosweka.
- Kudzaza ndi mpweya kapena madzi.
- Kuchotsa buluni.
- Kudzaza ma void omwe akutuluka ndi simenti.
© dissoid - stock.adobe.com. Zovuta
Kuphatikizira opaleshoni kumawonetsedwanso pazilonda zazikulu. Pochita izi, zidutswa zamafupa zimachotsedwa, timatenda tating'onoting'ono timatulutsidwa, ndikuyika ziboliboli ngati kuli kofunikira. Ma mbale a titaniyamu amagwiritsidwa ntchito nthawi zambiri.
Pambuyo pa opaleshoniyi, m'pofunika kuvala corset kwa miyezi iwiri.
Kukonzanso
Pambuyo pa zotsatira za opaleshoni, chisamaliro chapadera chiyenera kulipidwa panthawi yokonzanso. Ndikofunikira kwambiri kutsatira malangizo onse a dokotala wopezeka, chifukwa kukhalapo kwathunthu kumatengera izi. Pambuyo pa opaleshoni, izi zikuperekedwa:
- kutikita;
- magetsi;
- akupanga;
- kugwiritsa ntchito parafini;
- ultraviolet walitsa;
- zochitika za balneological.
Zovuta
Kukula kwa zovuta zotere ndizotheka:
- Kupanikizika kwa kama wamagetsi. Zotsatira zake, pali madera m'malo omwe adadyetsa njirayi.
- Kutsina kwa mathero a mitsempha, komwe kumabweretsa kuphwanya gawo la zikhumbo. Chifukwa cha izi, mayendedwe a wodwalayo ndi ochepa.
- Zofooka za Kyphotic, mapangidwe a hump. Izi sizimangowononga mawonekedwe, komanso zimakhudzanso ntchito ya ziwalo zapafupi.
- Matenda azungulira, chifukwa atavulala, wodwalayo sanatengeke kwanthawi yayitali. Chifukwa cha ichi, mabedi amapangidwa, minofu yofewa imafa.
- Matenda a m'mimba: kusadziletsa kwamikodzo, kufalikira kwa chiberekero, kusowa mphamvu.
- Kutayika kwamagalimoto (munthu atha kukhala wolumala).
Zikakhala zovuta, munthu sangathenso kubwerera kumoyo wake wamba. Chifukwa chake, muyenera kukhala osamala kwambiri: pewani kugwa, kumenyedwa kumbuyo. Pomwe mukukayikira pang'ono zovulala, pitani kuchipatala kuti mupeze matenda.