Chithandizo cha chimbale herniated (lumbosacral msana). Opaleshoni kuchotsa chimbale herniated

Mavuto ndi msana wa anthu ambiri nkhawa. Ena mwa ntchito yovuta kukhala boma monga intervertebral chophukacho msana lumbosacral.

Ndi chiyani icho?

Herniated chimbale mChipangano chikhalidwe oopsa amene ali kusamutsidwa kwa chimbale intervertebral a msana ndege. Nthawi zambiri, chikhalidwe ichi chifukwa ndi katundu kwambiri pa msana.

Amadwala matenda makamaka amuna a zaka zapakati pa zaka 20 mpaka 50.

Kuchuluka kwa nthendayi ili ndi pafupifupi 100 milandu pa anthu 100,000 alionse pa chaka.

Ambiri mwa hernias deta zimachitika chifukwa zimamuchulukira thupi la msana chifukwa cha ntchito. Mwina zoopsa chophukacho pambuyo maopaleshoni pa msana kapena chifukwa cha kugonjetsedwa ndi. Kawirikawiri, koma pali kobadwa nako msana chophukacho.

Anthu achikulire amadziwika milandu chophukacho pa maziko a kufooka thupi la Mitsemphayi msana.

Kuchuluka apamwamba ali intervertebral chophukacho msana lumbosacral, chifukwa m'chiuno ndi malo pachiopsezo chifukwa chitukuko cha matenda.

The pathogenesis wa herniation

Mothandizidwa ndi katundu pamwamba pa msana, pali psinjika pang'onopang'ono ya chimbale intervertebral. Chifukwa cha zimenezi, nthawi zambiri kumachitika chotupa litayamba akunja nkombero (akunja annulus fibrosus), lomwe limapezeka pambuyo intervertebral zili chimbale linanena bungwe kunja.

Utakula phata pulposus akhoza kuloza monga mkati mwa ngalande msana, ndi mbali za izo. Mbali yoyamba akufotokozera kukanikiza pakati pa chingwe msana, omwe angakhale ndi zotsatira sizingasinthe. Ngati chachiwiri angathe syndrome radicular chifukwa psinjika za misempha akutulukira kuchokera chingwe msana. Mu malo ya psinjika aseptic kutupa akufotokozera, pali kutupa kwa minofu ozungulira, zomwe zina worsens zinthu.

Motero, kwa chimbale herniated amakhala ndi zizindikiro za matenda radicular (ululu, imfa kwenikweni ndi nthambi ntchito). M'kupita kwa nthawi, sayenda chakhungu mu ndime msana.

Monga mmene taonera, malo nthawi zambiri amapezeka intervertebral chophukacho - lumbosacral. Chithandizo ayenera kuperekedwa nthawi yomweyo, mwamsanga pamene amawapeza ndinazembera chimbale.

chithandizo

Mulimonsemo, muyenera yomweyo anayamba mankhwala a chimbale herniated. Lumbosacral msana imagwira ntchito yofunika kwambiri ya thupi - bwino kukonza ndi overlying matupi woongoka. Ndi kukula ndi chophukacho m'chigawo lumbar kugwira ntchito amakhala ovuta kwambiri chifukwa cha ululu kuti akufotokozera mu psinjika mitsempha. Ulili worsens mwadzidzidzi pempho kwa madokotala.

Pamene zizindikiro choyamba ayenera yomweyo anayamba mankhwala a chimbale herniated. Lumbosacral msana amalabadira njira sanali pharmacological monga kugwiritsa ntchito mphasa mafupa kutikitirako ntchito compresses ozizira. Njirazi ndi kuloza mwangwiro symptomatic (kuti magawowa alili) okhaokha kanthawi pofuna kupewa mavuto a chophukacho angathe kugwiritsidwa ntchito. Pamene boma la zachititsanso wolakalakika yomweyo yokumana ndi matenda okhudza ubongo a.

mankhwala

Koma ngati iye anayamba ndi chophukacho intervertebral, mmene tiyenera kuchitira izo, kuti kuwononga thupi lanu? Chifukwa chaichi, odana ndi yotupa mankhwala ku gulu la wothandizila si steroidal. The mafuta ambiri chimagwiritsidwa ntchito kwambiri, angakhale angelo ndi creams. Mu dongosolo lawo pali zambiri "Diclofenac" ( "Rumakar", "Dikloberl"), "Indomethacin" ( "indomethacin", "Rumatsid"). The ndende ya mankhwala mu nyumba amalola mupewe ululu ndi kutupa (koma kulandira mlingo wofanana wa mankhwala mkati ikhoza kukhala anthu a mtima, komanso amathandiza kuti chitukuko cha zilonda muzituluka ndi 12 mmatumbo chilonda).

Mwina osakaniza sanali steroidal mankhwala odana ndi yotupa ndi glucocorticoids.

Glucocorticoids amaikidwa kapena kuwauza kapena kudzera m'mitsempha chifukwa kupambana othamanga mphamvu. Ntchito mankhwala monga "Prednisolone" ndi "Dexamethasone". glucocorticoid chithandizo ayenera mankhwala pokhapokha kulephera kwa NSAIDs, monga yaitali ntchito corticosteroids kuvulaza thupi kwambiri.

mankhwala thupi mankhwalawa hernias msana

Pafupipafupi chiwiri kwa yaikulu ya ntchito ndi physiotherapy herniated zimbale. Lumbosacral msana ndi imodzi mwa mbali kwambiri lomwenso a dongosolo minofu ndi mafupa ntchito zipangizo zosiyanasiyana.

Malinga ndi akatswiri ambiri, physiotherapy zingachititse zambiri mofulumira kuchira kusiyana ndi mankhwala.

Mankhwalawa panopa yabwino kwambiri hernias intervertebral ndi ntchito maelekitirodi multifunctional. Akamanena za njira imeneyi - ukubwera usokoneze ululu zikhumbo mwa mafunde radiofrequency.

Njira zambiri odziwika amagwiritsidwa ntchito electrophoresis ndi analgesics, osambira mankhwala mankhwala laser. Electrophoresis ndi phonophoresis kulola kupulumutsa mankhwala mwachindunji mu ndime msana. Zotsatira zambiri zooneka kale pambuyo mankhwala ochepa.

Ulesi kusamba otentha zina zimachititsa kuti mowiriza muyike pena wa chophukacho mu malo.

Ngati pali kuwonongeka, ngakhale kuyesetsa kwa nthaŵi zonse, choncho zovuta matenda intervertebral chophukacho. Kodi kuchitira izo imeneyi?

Opaleshoni chithandizo cha chophukacho intervertebral

Ndi kupanda chithandizo ndiwofatsa ntchito kapena pamene chaukali zizindikiro ubongo (ziwalo za miyendo pokodza ndi defecation matenda, paresis, paresthesia, ululu, kupweteka kumbuyo padziko miyendo m'munsi) ayenera kuyamba pomwepo opaleshoni.

Zikuonetsa zochizira wokonda chingwe msana ndi kukanikiza pakati, ziwiya psinjika akudutsa pafupi.

chithandizo ndi makamaka ikuchitika m'madipatimenti apadera opaleshoni (zambiri mu neurosurgery).

Mwa njira ntchito mankhwala ndi magulu ziwiri zazikulu - endoscopic opaleshoni ochiritsira microsurgery.

Malinga ndi mmene matenda kumachitika, kudziwa njira za Intaneti.

Chithandizo kwenikweni anachita pogonekedwa ndi mankhwala ambiri ndi thandizo ntchito zofunika kwambiri.

microsurgical kuchotsa

Isanafike oyamba microscopes mu yochizira matenda, ngati wasonyeza chithandizo opaleshoni ya zimbale herniated, lumbar-sacral msana nthawi zambiri pansi mavuto osiyanasiyana mu nthawi postoperative (abscess, kobwereza). Kukwera weniweni ndi ntchito zipangizo kuwala mankhwala a hernias. Izi yafupika kukula kwa mwayi mwamsanga, zomwe kwambiri yafupika ndi zochitika za mavuto osauka.

Nthawi zambiri, herniation wa sacral intervertebral chikachita kuchotsedwa ndi gawo tosaoneka (unachitikira laminectomy). Pansi magnification mkulu kumakhaladi zotheka Pang'ono pang'ono chotsani protrusion hernial popanda kuwononga pafupi zimakhala zakuya.

Mphamvu wodwala akuyamba tsiku lotsatira. Zintchito wodwalayo ali ololedwa pasanathe masiku 10, ndipo patatha mwezi umodzi n'kutheka kuti ntchito yamanja popanda chiopsezo zosokonezeka.

opaleshoni endoscopic

ntchito izi kuchotsa chimbale herniated ndi azimuth watsopano neurosurgery. nthawi zambiri imachitikira kupyolera posterolateral njira endoscopic. Ubwino wa njira izi ndi chitetezo kwambiri chilengedwe cha chilonda opaleshoni (zimachitika zachilendo khungu puncture). Komabe, onse sangathe chachikulu - Pankhaniyi okha kuthekera excision wathunthu wa chophukacho ndi kuchotsa izo kwa malo puncture. Zovuta chophukacho, kapena chophukacho, limodzi ndi psinjika za chingwe msana kuchotsedwa ndi ntchito imeneyi.

Wodwalayo mwina tsiku pamene opaleshoni zinachitikadi, kukwera, kuyenda. Ntchito amaloledwa pafupi sabata pambuyo kumaliseche kwa kuchipatala.

mavuto a chophukacho

M'kupita kwa nthawi, ngati chophukacho wayamba compress yotsatira minofu chimapangitsa angathe zosokonezeka.

Ngati anayamba chophukacho wamba (intervertebral), lumbosacral kwathunthu wotaya ntchito yake, ndipo msana kuwonongeka unkachitika. Zonse zoipa pamene kusamutsidwa motsogozedwa ndi chophukacho wa ngalande msana.

The owopsa a iwo kukanikiza pakati pa chingwe msana. Pankhaniyi linaphwanya pokodza ndi defecation ntchito, lomwe n'loopsa moyo (phunziro kwa kuledzera kwambiri, utaphulika ndi chikhodzodzo, matumbo ndi mkodzo). Komanso, ngati kutupa zimapita kwa chingwe msana, ndipo angachotsedwe m'madipatimenti a overlying kuphwanya ntchito za ziwalo, kuphatikizapo imfa.

Wina Vuto kawirikawiri chophukacho ndi radicular syndrome. Ndi kukhalapo yaitali kwambiri worsens chikhalidwe.

Zovuta ndi yabwino kwambiri kuchepa tilinazo ndi paresthesias.

Konzanso ndi kapewedwe

Kukhala chophukacho kumafuna nthawi (T. E. Iwo akhoza amangosankha amatchedwa matenda aakulu). chingalepheretse chitukuko pamene lokhudza malangizo ofunika.

Pofuna kupewa zisadzachitikenso pambuyo kuchotsa zimbale herniated, m'pofunika mokwanira kugawira katundu pa thupi. Musagwiritse overreach, chifukwa angathe kuchotsa zoipa.

Analimbikitsanso kupewa chophukacho wozengereza mwa- kuthupi ndi ntchito kuti kulimbikitsa akulu chimango kumbuyo (monga deadlift ndi katundu zomveka).

Pamene mwakhama ntchito pofuna kupewa Ndi bwino kutenga ulesi miphika otentha - amathandiza kuti pang'ono zikusiyana vertebrae kuteteza siudzalandilidwa ngathi lamulo la chimbale pakati pawo.

Konzanso pambuyo likufa chophukacho kupewa maganizo, kuchita masewera olimbitsa thupi mankhwala, kutikita ndi Buku mankhwala mankhwala kapena kutema mphini.