Dothi la Herniated la lumbar msana - kutuluka kwa disc yophatikizira kunja kwa matupi oyenda m'chigawo cha lumbar. Malo: L3-L4, nthawi zambiri L4-L5 ndi L5-S1 (pakati pa lumbar yachisanu ndi woyamba sacral vertebrae). Kuzindikiritsidwa kutengera mbiri yazachipatala, zizindikiritso zamankhwala, komanso zotsatira za CT kapena MRI. Muzochita zamankhwala, kuti zitheke, mabulogu opitilira 5-6 mm kupitirira annulus fibrosus nthawi zambiri amatchedwa chophukacho, kutulutsa pang'ono.
Masamba a Hernia
Kusintha kwa chophukacho kumadutsa magawo angapo:
- Prolapse ndikusintha mothandizidwa ndi zinthu zakunja mthupi la disc, ndikuchotsanso komwe kumabwezeretsedwanso.
- Kutulutsa - chimbale sichidutsa malire amthupi, koma chimasintha kwambiri mawonekedwe ake.
- Extrusion - nyukiliya pulposus imapitilira matupi amtundu.
- Kukhazikitsa - kutuluka kwa zamkati kupita panja.
Ngati kutulutsa kwa hernial kwasamukira m'thupi la vertebra yayikulu kapena yotsika, kusintha kwamatenda kumatchedwa hernia ya Schmorl.
Maonekedwe a chophukacho pamtundu wama vertebrae. © rh2010 - stock.adobe.com
Zoyambitsa ndi zizindikiro
Zomwe zimayambitsa hernia ndizo:
- Kuwonongeka kwa trophism ndikukula kwa kusintha kosasintha m'dera la intervertebral disc, chifukwa cha:
- zolimbitsa thupi;
- kunenepa kwambiri chifukwa cha kunenepa kwambiri;
- njira zoperewera (ankylosing spondylitis);
- matenda opatsirana (chifuwa chachikulu);
- Kugawa kolakwika kwa katundu pamsana chifukwa cha:
- nyamakazi;
- zoopsa pantchito (kuyendetsa nthawi zonse);
- anomalial chitukuko cha msana kapena chiuno olowa;
- kupindika (scoliosis);
- Kupsinjika kwakukulu pamsana:
- kukweza zolemera pamalo ovuta;
- kupwetekedwa mtima.
Matendawa amawonetsedwa ndi lumbodynia, yomwe poyambirira imakhala yosinthasintha komanso ma vertebral syndrome (asymmetric muscular-tonic changes yomwe imapangitsa kuti zinthu zizikhala bwino pakukula kwa scoliosis).
Zingakhale zovuta:
- Matenda opweteka kwambiri, osalamuliridwa bwino ndi othetsa ululu.
- Radiculopathy (radicular syndrome kapena lumboischialgia), limodzi ndi zovuta zamatenda am'miyendo:
- kuchepa kapena kusintha pakumverera kwa khungu (paresthesias);
- hypotrophy ndi kufooka kwa minofu.
- Myelopathy, yodziwika ndi:
- kutha kwa ma tendon reflexes ndi kukula kwa flaccid paresis pamapazi;
- kusokonezeka kwa ziwalo za m'chiuno (zovuta kukodza ndi / kapena kutulutsa chimbudzi, kutayika kwa erectile, kutha kwa libido, mawonekedwe a frigidity).
Zovuta zomwe zafotokozedwa pamwambapa zikuwonetsa chithandizo chamankhwala. Kuwonekera kwa zizindikiritso za discogenic myelopathy ndiye maziko othetsera vuto la opareshoni mwadzidzidzi (mtengo wake ndiwokwera kwambiri ndipo zotsatirapo zake zitha kukhala zowopsa paumoyo).
Ndi dokotala uti amene amachiza
Katswiri wa matenda a ubongo (neuropathologist) amachiza nthenda. Wachipatala aliyense, yemwe akuganiza kuti ali ndi matendawa, atumiza wodwalayo kwa katswiri wa zamitsempha kuti akafunse, yemwe, malinga ndi chithunzi cha matendawa, zotsatira za mankhwala ndi mankhwala a MRI, atha kupereka upangiri wa a neurosurgeon kuti aganizire za chithandizo chamankhwala choyenera.
MRI. © Olesia Bilkei - stock.adobe.com
Njira zochiritsira
Chithandizo cha Hernia chimatha kukhala chosamala komanso chogwira ntchito. Kutengera ndi njira zomwe zasankhidwa, chithandizo chosachita opaleshoni chitha kukhala mankhwala, physiotherapy, manual kapena opaleshoni.
Mankhwala othandizira
Njira yopangira "kuchepetsa" kwa ma disc. Nthawi yayitali ndimachitidwe 10-15 masiku awiri alionse.
© glisic_albina - stock.adobe.com
Mankhwala osokoneza bongo
Mankhwala otsatirawa amagwiritsidwa ntchito pochiza mankhwala:
- NSAIDs (mankhwala osagwiritsa ntchito steroidal odana ndi zotupa mwa mawonekedwe a mafuta kapena mapiritsi - Diclofenac, Movalis); kugwiritsa ntchito ndalama ndikuthandizira kuthetsa zowawa.
- zotsekemera zapakati (Midocalm, Sirdalud); mankhwala amalimbikitsa kupumula kofewa kwa minofu kukumana ndi kukwiya kowopsa kuchokera m'mitsempha yamitsempha yomwe imakhudzidwa ndi matendawa.
- glucocorticoids (Diprospan, Dexamethasone); mankhwala kusiya kutupa, kupereka yosalunjika analgesic kwenikweni.
- paravertebral novocaine blockade, yomwe imagwiritsidwa ntchito kuthana ndi matenda opweteka omwe ndi ovuta kuwachiza ndi ma NSAID;
- chondroprotectors ndi kukonzekera ndi hyaluronic acid (Alflutop, Teraflex, Karipain, Rumalon); Kutanthauza kuti trophic imakhudza minofu ya cartilage, yomwe imapangitsa kuti isinthidwe.
- mavitamini a gulu B (amathandizira kubwezeretsa minofu yamanjenje ndi mitengo ikuluikulu ya mitsempha).
Physiotherapy
Mankhwalawa akuphatikizapo:
- samatha (kumachepetsa katundu pa zimbale intervertebral);
- kutema mphini (point reflexology); njira zachokera reflex kuchepa kwa matenda a minofu ndi zimandilimbikitsa syndrome;
- phonophoresis ndi electrophoresis (njira zimathandizira kuti kuchuluka kwa mankhwala kudera lomwe lakhudzidwa; kusankha ndalama kumatsalira ndi dokotala amene akupezekapo);
- Chitani masewera olimbitsa thupi (omwe amagwiritsidwa ntchito popanga corset yam'mimba kuchokera ku minofu yolumikizana kumbuyo, yokonzedwa kuti ikhazikitse msana ndi kutsitsa pang'ono pang'ono);
- kutikita (kutsekula kamvekedwe ka minofu)
© DedMityay - stock.adobe.com
Ntchito
Nthawi zomwe chithandizo chamankhwala sichinapereke zotsatira zomwe zikuyembekezeredwa, kapena disc ya herniated yasintha ndikupereka zovuta zowopsa, chithandizo chamankhwala chikuwonetsedwa, chigawikidwenso:
- kuboola laser valorization (kumathandizira kuchotsa chinyezi m'matumbo opunduka kuti chiwonjezere mphamvu ya intervertebral disc ndikuletsa kuwonjezeka kwowonjezera);
- electrothermal therapy (ntchito yofanana ndi laser valorization);
- microdiscectomy (yochitidwa pamene hernia kukula kwake ndi ochepera 6 mm);
- discectomy (kuchotsa kwathunthu kwa chophukacho);
- laminectomy (kukula kwa opaleshoni ya ngalande ya msana; opaleshoni yovuta kwambiri, yodziwika ndi nthawi yayitali yochira);
- Kukhazikitsa kwa B-Twin-implants (opareshoniyo imachitika pambuyo pa discectomy kuti pakhale mtunda woyenda bwino kwambiri ndikukhazikika msana).
Nthawi zambiri, panthawi yodziletsa, akatswiri amayesa kuphatikiza mankhwala ndi njira zolimbitsa thupi limodzi ndi ERT. Chithandizo chovutikachi ndicholinga chotsitsa msana polimbitsa minofu ya corset ndi minofu yakuya kumbuyo.
Zovuta zimatha kupezeka mwa amayi ali ndi pakati chifukwa chotsutsana ndi kugwiritsa ntchito mankhwala ndi njira zingapo.
Mankhwala achikhalidwe
Amatengera momwe zinthu zimakhudzira dera lomwe lakhudzidwa.
Amagwiritsidwa ntchito ngati ma compress opangidwa ndi 96% ya mankhwala azachipatala:
| Dzina la ndalama | Njira yophikira | Njira yogwiritsira ntchito |
| Tincture wa muzu wa cinquefoil | Mizu youma imadzazidwa ndi ethanol. Kupirira masabata atatu. | Tincture amathiridwa pakamwa mu supuni imodzi yosungunuka mu 70 ml ya madzi. |
| Powonjezeredwa, Dimexide imagwiritsidwa ntchito pamutu kupaka miyendo ndikutsikira kumbuyo. | ||
| Comfrey mafuta | 500 g wa muzu watsopano umasakanizidwa ndi 500 g wa mafuta osungunuka a nkhumba, pambuyo pake 300 ml ya mowa imatsanulidwa. | Amagwiritsidwa ntchito ngati compress. Ikani kumalo okhudzidwawo pansi pa nsalu ofunda kwa mphindi 30-40 kapena usiku wonse. |
| Limbanani ndi aloe ndi uchi | Msuzi watsopano wa aloe umasakanizidwa ndi uchi ndi mowa mu chiyerekezo cha 1: 2: 3 ndikuphatikizidwa kwamaola 24. | Amagwiritsidwa ntchito kupyapyala ndikugwiritsidwa ntchito kudera lomwe lakhudzidwa kwa ola limodzi pansi pa nsalu yofunda. |
Chitani masewera olimbitsa thupi
Kutalika kwa kulimbitsa thupi kumachokera mphindi 10 mpaka theka la ora. Zokha ntchito kunyumba. Udindo wabwinobwino wagona chagada. Chowongolera chiyenera kuikidwa pansi pa dera lumbar. Malo okhazikika kapena ofananira nawo amagwiritsidwanso ntchito.
Tiyenera kukumbukira kuti tikamachita masewera olimbitsa thupi, mayendedwe amachitika bwino, ndipo ma gymnastics amayenera kubweretsa kutonthoza.
© Jacob Lund - stock.adobe.com. Chitani masewera olimbitsa thupi kumbuyo kwanu.
Masewera olimbitsa thupi pamalo abodza:
- Manja ali motsatira thupi. Kutulutsa mpweya ndi kutulutsa mpweya kumachitika. Mukamakoka mpweya, mikono ndi mapazi zimatambasukira kwa iwowo, zikamatuluka, mikono imabwerera pamalo pomwe idali, miyendo imatsitsimuka.
- Malo oyambira omwewo. Mutu utembenukira kumanzere ndi kumanja, uku uli pakati. Kawirikawiri mutu umatembenukira kumanzere, kuwerengera awiri pakati, kuwerengera atatu kumanja, kuwerengera kanayi pakati.
- Mutu umaweramira kuchifuwa, masokosi kuli wekha, powerengera awiri, mutu uli pamphasa, miyendo imatsitsimuka.
- Manja akumata zibakera, miyendo ingopatukana pang'ono. Kusuntha kozungulira kumachitika ndi manja ndi miyendo kanayi panja ndi mkati.
- Manja pamapewa anu. Kusuntha kozungulira m'magulu amapewa, 4 kupita kutsogolo ndi kumbuyo.
- Mwendo wakumanja wapindika pa bondo ndipo kuwerengera 2 kumayikidwa pambali, kuwerengera 3 kumayikanso bondo, kuwerengera 4 poyambira. Zomwezo zimabwerezedwanso ndi mwendo wamanzere.
- Dzanja lamanja ndi mwendo wamanzere zimabwezeretsedwa nthawi imodzi kumbali. Zomwezo zimabwerezedwanso ndi ziwalo zina.
- Phazi limadziyang'ana lokha, kuyesa kutambasula kumbuyo kwa mwendo.
- Manja mthupi, miyendo yokhotakhota pamafundo a bondo. Minofu yam'mimba imakhala yolimba.
- Manja kumbuyo kwa mutu, miyendo molunjika. Torso limakwera, miyendo siyimachokera pansi.
Pakukonzanso, njira zakuchiritsa madokotala zafalikira: Sergei Bubnovsky ndi Valentin Dikul.
Njira ya V. Dikul
Maluso a Valentin Dikul amatengera kutambasula kwamphamvu kwa msana ndi kulimbitsa kwamphamvu kwa minofu yakumbuyo molingana ndi pulogalamu yaumwini pazida zapadera zokonzanso zomwe zimapangidwira minofu yanu ndikulimbikitsa madera ovuta. Zotsatira za njirayi ndi kukonza kwa scoliosis, kyphosis, kyphoscoliosis yamitundu yosiyanasiyana.
Kuchita masewera olimbitsa thupi ndi bandeji yotanuka malinga ndi njira yosavuta mutha kuchitira kunyumba, apa tikambirana zina mwazotheka. Kuyambira pamalo ataima.
- Chitani kupindika ndi msana wowongoka. Miyendo ndiyotakata pang'ono kuposa mapewa, bandeji ili pansi pa mapazi, ndipo malekezero ake ali m'manja kumbuyo kwa mutu, mikono ili yopindika, zigongono zili mbali. Ndibwino kupendeketsa thupi, ndikusiya miyendo molunjika, bandage imakoka. Bwererani poyambira.
- Ntchito ina: Kwezani manja anu mbali. Mapazi nthawi ino phewa-m'lifupi padera, bandeji pansi pa mapazi, ndi malekezero ake m'manja. Nthawi yomweyo kwezani manja molunjika kupyola mbali mpaka phewa.
- Ndipo ntchito yomaliza: kusakaniza manja. Miyendo ndiyotalikiranso paphewa, mikono yayimitsidwa pang'ono m'zigongono, bandejiyo imadutsa m'manja ndikumagona pamaphewa. Bweretsani manja anu patsogolo pa chifuwa chanu ndikubwerera koyambira.
Zochita zonse zimachitidwa nthawi 10 mpaka 20, kutengera momwe zinthu ziliri, ndikofunikira kukaonana ndi dokotala.
Zochita zovuta za S. Bubnovsky
| Chitani dzina | Kufotokozera malo okhala kunyumba | Njira yakuphera |
| Mtengo wa Birch | Atagona chagada ndi manja ake atakweza mmwamba, adotolo amakonza miyendo yawo ndi chingwe ku simulator ya MTB. | Wodwala amakweza m'chiuno ndi miyendo pamalo ake opendekera kumutu. |
| Kutembenuza mwendo | Kugona mbali yanu, kugwiritsitsa choyimira cha simulator ndi manja anu. | Wodwala amachita kutambasula ndi mwendo wowongoka (kukweza mwendo wogwira ntchito, pomwe mwendo sumawerama) pamtunda waukulu kwambiri. Kubwerera pamalo ake oyamba. Amapanga mizere 2-3 pa mwendo uliwonse ngati zingatheke. |
| Chule | Kugona m'mimba mwako, mikono imapita patsogolo. Dokotala amakonza pulogalamu yoyeseza yolemera pamiyendo imodzi. | Wodwala amapinda mwendo, kutsanzira mayendedwe a amphibian. |
Chitani masewera olimbitsa thupi
Njira yopangira kusinthasintha mwendo
Njira yochitira "Chule"
Masewera ndi chophukacho cha lumbar msana
Ndi matenda opatsirana opatsirana pogonana, izi ziyenera kupewedwa:
- katundu ofananira pa msana;
- katundu wodabwitsa (sitepe ya aerobics, kudumpha);
- kuchita kunyamula.
Kuchita masewera olimbitsa thupi a lumbar msana ndi othandiza:
- kusambira (mu chikhululukiro, bwino - kukwawa);
- Ma pulogalamu olimbitsa thupi (pafupifupi 500);
- maphunziro olimbitsa thupi;
- masewera olimbitsa thupi pa fitball;
- kukoka pa bala yopingasa (ya amuna).
Kupewa
Kutengera:
- Kuwongolera kulemera kwa thupi kuti muchepetse katundu pama discs a intervertebral, makamaka zigawo za lumbosacral ndi lumbar.
- Kuchotsedwa kwa hypodynamia, hypothermia yakumunsi kwakanthawi komanso katundu wautali (gwirani ntchito pansi - apa mwatsatanetsatane za kuopsa kokhala chete).
- Kugwiritsa ntchito matiresi apadera a mafupa.
- Kuvala ma brace mafupa ndi ma corsets omwe amachepetsa dera lumbar.
- Chitani masewera olimbitsa thupi. Gulu la masewera olimbitsa thupi limalimbikitsa kulimbitsa minofu yakumbuyo ndipo amasankhidwa payekhapayekha ndi wophunzitsa.
- Kuchiritsa kuyenda. Muyenera kuyenda bwino kuyambira chidendene mpaka kumapazi.
- Kupewa nkhawa mwadzidzidzi pa msana; mayendedwe ayenera kukhala osalala momwe angathere.
- Kudya zakudya zokhala ndi mavitamini a B ndi zotumphukira.
