Zizindikiro ndi chithandizo cha herniated intervertebral disc ya msana wa thoracic

Dothi la Herniated la msana wam'mimba - kufalikira kwa disc yophatikizika ya vertebra ya thoracic (ICD-10 M51). Amadziwika ndi kupweteka, kuwonongeka kwa khungu komanso kusokonezeka kwa somatic. Matendawa amapangidwa pamaziko a deta: zotsatira za kuwunika ziwalo ndi machitidwe kuti atulutse zovuta zina pazifukwa zina, ndi MRI. Ma discs am'munsi mwa thoracic vertebrae (Th8-Th12) amakhudzidwa kwambiri.

Chithandizo ndiwofatsa ndi opareshoni. Hernia wa shmorl wa thoracic msana ndikutuluka kwa hernial m'thupi la pamwambapa kapena pansi pa vertebra chifukwa chakuthyoka kwa mafupa a intervertebral disc. Palibe chithandizo chamankhwala chomwe chimafunikira.

Zifukwa

Etiology ya kudwala kumeneku kutengera njira zomwe zimatsogolera ku ming'alu ndikuchepa kwa mphamvu ya annulus fibrosus:

• kungokhala;
• Kutalika kwanthawi yayitali komanso kusunthika kwamphamvu kwambiri;
• kupwetekedwa mtima;
• osteochondrosis wa msana wamtundu;
• matenda osokoneza bongo;
• Matenda osokoneza bongo.

Kusintha kwa kutulutsa kwa hernial

Pakukula kwawo, ma prolaps akudutsa magawo angapo:

1. Kutulutsa kwakumbuyo kwa disc mpaka 1-5 mm ndikusungidwa kwa gawo lakunja la annulus fibrosus. Amatchedwa kutulutsa.
2. Kutulutsa kapena kupanga chophukacho ndikuphwanya umphumphu wa mpheteyo ndikutuluka kwa 5-8 mm.
3. Kutsekemera kumadziwika ndi aseptic necrosis komanso kupindika kwa zotupa za hernia (kukula kwake nthawi zambiri kumadutsa 8 mm) ndikusunthira kwawo mumtsinje wamtsempha, womwe umakhala ndi zovuta zambiri.

Malinga ndi kuchepa kwa ngalande ya msana, zotupa za hernial zidagawika zazing'ono (0-10%), sing'anga (10-20%) ndi zazikulu (> 20%).

Zizindikiro ndi kusiyanitsa matenda

Amatsimikizika ndi machitidwe a chophukacho, kutanthauzira kwake komanso kuchuluka kwa kutuluka. Izi zikhoza kukhala kupanikizika kwa mizu ya mitsempha ya msana kapena chinthu cha msana. Kutengera mawonekedwe am'malo, kutulutsa ndi:

• mbali,
• ventral (imayimira ngozi yaying'ono kwambiri);
• chapakati (chapakatikati kapena cham'mbuyo), chowopsa kwambiri pazovuta zake;
• wachipatala.

Ma neurosurgeon ena amasiyanitsa kupindika, kwapakatikati (monga kusiyanasiyana kwa dorsal), kozungulira, kozungulira komanso kwam'masamba.

Pogwirizana ndi ziwalo za msana - chapamwamba, chapakati komanso chapansi pa thoracic.

Komanso:

• Ndi malo apakati, kupanikizika kwa msana kumawonekera, limodzi ndi kukula kwa kupsinjika kwa myelopathy ndikuwonekera kwa spastic mono- kapena papararesis, komanso zovuta zam'mimba.
• Ndikukhazikika kwakanthawi, chizindikirocho chazovuta zakuthwa kwa mizu ya msana ndikuwonetsedwa kwamatenda akutuluka:
  • malingaliro ozindikira pachifuwa;
  • kusasunthika kwakanthawi komwe chophukacho chimakhudza nthambi za visceral, zomwe zimayambitsa kusintha kwa magwiridwe antchito am'kati.

Zovuta zakuzindikira zimayambitsidwa chifukwa cha kutsimikiza kwa matendawa. Kutuluka, kutengera komwe kuli, kumatha kutsanzira zizindikilo za matenda a thoracic ndi m'mimba. Chifukwa chake, kuti atsimikizire kuti ali ndi matendawa, katswiri wamaubongo atha kukhala ndi akatswiri.

© Alexandr Mitiuc - stock.adobe.com. Chiwonetsero chazomwe zili ndi hernia mumsana wamtundu wa thoracic.

Kuyesedwa kwa Nitroglycerin kapena Corvalol kumatha kusiyanitsa kufalikira kwa disc kuchokera kuwonekera kwa chizindikiro chovuta cha angina pectoris, momwe kupweteka komwe kumayambitsidwa ndi kupanikizika kwa mizu ya mitsempha sikudzatha.

Pochita kusiyanitsa kwa discogenic pathogenesis (disc protrusion) ndi matenda am'mimba, tiyenera kukumbukira kuti kupweteka m'mimba sikungakhudzidwe ndi kudya.

Zizindikiro zimatha kusiyanasiyana mwa amayi ndi abambo. Zomalizazi mwina zatsitsa kukanika kwa libido ndi erectile. Women amakonda nthenda yamchiberekero, kusamba monyanyira, imbaenda ku kuchepa kwa kuthekera kwa pakati, kupweteka m'dera doko, amene nthawi zambiri amasokonezeka ndi isanayambike mastitis (matenda a m'mawere).

Kuzindikira

Matendawa amatengera:

1. madandaulo amtundu wa wodwala (kusokonekera kwa magawo azigawo zazing'ono ndi zamagalimoto, kusintha kwamatenda mu ntchito ya ziwalo zamkati zomwe zimasungidwa ndi thunthu lamagetsi);
2. deta ya kuwunika kwamitsempha ndi chithunzi cha matendawa;
3. Zotsatira za MRI (motsutsana mwachindunji, mwachitsanzo, kupezeka kwa pacemaker yokumba, CT ya msana ingagwiritsidwe ntchito, koma kulondola kwa phunziroli ndikotsika kuposa MRI);
4. Zambiri kuchokera ku kafukufuku wa labotale, kuthandizira kuzindikira ndi kufunsa kwa akatswiri ena, kulola kusiyanitsa (kuthandiza kutsimikizira chophukacho ndikuchotsa angina pectoris, mbiri yakale, deta ya ECG ndi mayesero ogwira ntchito osonyeza kusapezeka kwa myocardial ischemia).

Zovuta pakupanga matendawa zimatha kuchitika chifukwa cha matenda opatsirana. Wodwalayo amatha kuvutika ndi thoracalgia komanso kupezeka ndi angina wolimba kumbuyo kwakuchuluka kwa msana wamtundu wa thoracic. Komanso, chophukacho chimatha kuyambitsa angina pectoris.

Njira zamankhwala zitha kutsimikiziridwa ndi akatswiri awiri - katswiri wazamisala komanso othandizira (kapena katswiri wamtima).

Chithandizo

Amagawidwa m'magulu osamala komanso ochita opaleshoni. Thandizo lodziletsa limachitika mukakhala kuchipatala komanso kunyumba, ndikupereka njira zowunikira:

• kuchotsa kapena kuchepetsa thoracalgia;
• kupewa kukula kwa protrusion.

Mankhwala osokoneza bongo

Zimaphatikizapo kusankhidwa:

• NSAIDs (Naproxen, Ibuprofen, Celecoxib, Ketoprofen, Carprofen, etc.);
• corticosteroids (metipred);
• blockades am'deralo (anesthetics + corticosteroids);
• zotsekemera zamatenda omwe ali ndi vuto lalikulu la spastic (Tolperisone, Mydocalm, Sirdalud);
• ma chondroprotectors (Glucosamine, Aorta - amagwiritsidwa ntchito pokonzetsa trophism ya pulposus yaukadaulo, amawonetsa kukhathamira kwakukulu pakatikati pa disc ya intervertebral disc);
• Mavitamini a B (B1 ndi B6, opatsa mphamvu kubwezeretsa kwa ulusi wamitsempha).

Njira yogwiritsira ntchito mankhwalawa imakuthandizani kuti muchepetse zowawa ndikupanga maziko abwino ogwiritsira ntchito njira zina zochiritsira.

Zotsatira za masewera olimbitsa thupi (masewera olimbitsa thupi)

Kuchita masewera olimbitsa thupi kumathandizira kukulitsa kupezeka kwa magazi, kuchepetsa kuphulika ndikupanga corset ya minofu, yomwe imathandizira kuthana ndi mafupa amisempha. Kuchita zolimbitsa thupi kwa msana wamtundu wa thoracic kumaperekedwa mosamalitsa pamunthu pakukhululukidwa, nthawi zambiri kumayambiriro kwa matendawa, kapena munthawi yanthawi yochira. Kuchita masewera olimbitsa thupi koyambirira kumachitika moyang'aniridwa ndi aphunzitsi kumalo ochitira masewera olimbitsa thupi. Masewera olimbitsa thupi omwe achitidwewo atha kuchitidwa kunyumba.

Kutema mphini, kusinkhasinkha

Amagwiritsidwa ntchito kuti athetse ululu komanso kusokonezeka kwa minofu.

Buku lothandizira ndi kugwidwa kwa msana

Amagwiritsidwa ntchito kuonjezera mtunda pakati pa matupi owoneka bwino.

© Mulderphoto - stock.adobe.com. Kutambasula msana.

Zotsatira za kutikita

Kuchulukitsa kumaperekedwa kuti muchepetse kamvekedwe kowonjezera kamitsempha ka paravertebral. Amagwiritsidwa ntchito kupumula ndikusintha magazi m'magawo oyambilira a matendawa munthawi yakhululukidwe.

Physiotherapy

Amagwiritsidwa ntchito kupatsa mphamvu zotsitsimula komanso zotsutsana ndi zotupa pazigawo zonse za chophukacho pakusintha. Ntchito: ultraphonophoresis wa Hydrocortisone, electrophoresis, magnetotherapy ndi UHF.

Ngati palibe chithandizo chamankhwala chodziletsa komanso / kapena kuwoneka kwa zizindikiritso za myelopathy, amayamba kuchipatala.

Zotsatira zabwino za ERT zatsimikiziridwa mwachipatala pambuyo pochita opaleshoni koyambirira koyambira (magawo a EHF, laser ndi magnetotherapy, electromyostimulation).

Njira ya Pulofesa Bubnovsky

Dr. Bubnovsky amalimbikitsa gulu la masewera olimbitsa thupi omwe amayang'ana kwambiri kutambasula minofu yam'mbuyo:

• Imani molunjika ndikuyika mapazi anu m'lifupi, muyenera kuyenda bwino mozama, kuyesera kumata mutu ndi manja pakati pa mawondo anu.

• Kuyika mwendo wanu wowongoka kumbuyo kwa mpando, muyenera kuyesa kuyika thupi lanu pa ntchafu yanu mutatulutsa mpweya, kuyesera kugwira sokoyo ndi manja anu.

• Kugona m'mimba mwanu, tambasulani manja anu patsogolo, kukweza thupi ndikukankhira pansi mukamatuluka.

• Mutaimirira, tambasulani mmwamba, kuyesera kukweza zala zanu zazitali kwambiri momwe mungathere.

Opaleshoni

Zikuwonetsedwa posagwira ntchito kwa njira yosasinthasintha kwa miyezi isanu ndi umodzi. Njirayi ikuphatikizapo:

• laminotomy kapena laminectomy - kutulutsa kwathunthu kapena pang'ono pang'ono pamtambo wamtundu wam'mimba pothetsa kupindika kwa ngalande ya m'mimba; Nthawi zambiri kuphatikiza kusakanikirana - kukhazikika kwa ma vertebrae oyandikana ndi maphatikizidwe;
• laminoplasty - tomia wa vertebral arch kuti akweze malo ozungulira mizu ndikupanga chingwe;
• disc extirpation (microdiscectomy (ngati njira - endoscopic), discectomy).

Pambuyo pa chithandizo cha opaleshoni, zovuta ndizotheka:

• matenda - myelitis, msana arachnoiditis;
• osapatsirana:
  • kumayambiriro - kutuluka magazi, kusintha kwa mitsempha ya msana kapena nthawi yayitali;
  • mochedwa - mapangidwe a ankylosis (maphatikizidwe) a matupi a vertebrae oyandikira.

Masewera obwerezabwereza msana (masewera ololedwa ndi oletsedwa)

Zochita zamasewera ndizochepa. Mitundu yololedwa ikuphatikizapo:

• aqua aerobics ndi kusambira (monga njira zochiritsira komanso zodzitetezera):
  • minofu imatsitsimuka, katundu wa msana amachepetsedwa, mitsempha ndi mafupa amalimbikitsidwa;
  • kulimbikitsa kupuma, kukonza magazi.
• kuphunzitsa masewera olimbitsa thupi moyang'aniridwa ndi wophunzitsa zolimbitsa thupi;
• Oyendetsa ndege;
• zokankhakankha;
• olimba ndi makalasi a yoga;
• Chitani masewera olimbitsa thupi;
• kukhala pa fitball;
• atapachikidwa pa bala yopingasa;
• Kupalasa njinga mopumira;
• squats (panthawi yokhululukidwa).

Zomwe zili pamwambazi ziyenera kuchitidwa moyang'aniridwa ndi katswiri. Zochita zolimbitsa thupi zomwe zimafuna kukhala pansi kapena kuyimirira ziyenera kuchotsedwa:

1. kunyamula zitsulo;
2. kudumpha kwakukulu ndi kwakutali;
3. mpira, basketball, rugby, skiing;
4. kuthamanga;
5. masewera amphamvu.

Zovuta ndi zovuta zakuchuluka

Kupita patsogolo kwa nosology kumatha kubweretsa ku:

• kutchulidwa kwa intercostal neuralgia;
• kusintha kwa msana kwa msana (chimodzi mwazoopsa kwambiri):
  • paresis ya miyendo;
  • kutha kwathunthu kwa ziwalo za m'chiuno.
• kusokonezeka kwa ntchito ya mtima ndi ziwalo zopumira (zowawa m'chifuwa ndi zosokoneza pantchito yamtima zimamveka; kupuma pang'ono kumachitika, kumakhala kovuta kupuma);
• kukula kwa mafupa (scoliosis, kyphosis);
• mapangidwe a intervertebral hernias mbali zina za msana - chifukwa cha kufalitsa kwachiwerewere kwa katundu ndi kukulitsa matendawa.

Chifukwa chophwanya kusungidwa, malingaliro ndi chimodzi kapena china chiwalo cha visceral chimavutika. Dongosolo lodziyimira palokha lawonongedwa. Colon dyskinesia imatha kusintha kukhala colitis, ndipo zovuta zamagulu zimatha kusintha kapamba. Kuphatikiza apo, kuphulika kumatha kubweretsa zovuta zowononga moyo wa mtima (pachimake m'mnyewa wamtima wam'mutu; angina wolimbikira komanso angina wosakhazikika; kumangidwa kwamtima kwadzidzidzi).

Kupewa

Gulu lowopsa limaphatikizapo oyimira ukatswiri ndi ntchito zomwe zimakhudza nthawi yayitali komanso zolimba pamsana: ochita opaleshoni, othamanga, ogulitsa, ogwira ntchito m'maofesi.

Ndikosavuta kupewa mapangidwe a chophukacho kuposa kuchiza. Kuchita masewera olimbitsa thupi tsiku lililonse kudzakuthandizani kupewa. Kusunthika kosiyanasiyana kumathandizira osati pakupanga ma synovial fluid ndi ma hydration hydration, komanso kulimbitsa minofu yakuya kumbuyo, yomwe imachepetsa katundu wa msana.

Pochita masewera olimbitsa thupi, ndikofunikira kukumbukira kuti:

1. Ma disc ndi oyenera kutengera zowoneka bwino kuposa katundu wopingasa kapena oblique. Izi zikutanthauza kuti mukakweza chinthu cholemera, muyenera kunyinyirika, koma osagwada.
2. Pochita ntchito yokhazikika, m'pofunika kusintha thupi kangapo patsiku, kuchita masewera olimbitsa thupi, kuyesa kukhala pang'ono momwe mungathere.
3. Kusambira ndi madzi aerobics ndi othandiza kwambiri munjira zodzitetezera, chifukwa zimakulolani kulimbitsa corset yaminyewa, kwinaku mukuthetsa msana.

Onerani kanemayo: What Is A Herniated Disc - Symptoms, Causes, Treatments (November 2024).