Ukulimala kwezemidlalo
1K 14 05.05.2019 (kugcine ukubuyekezwa: 01.07.2019)
Ubuhlungu be-Lumbar uphawu oluvame kakhulu oluholela ekwelashweni.
Sibutsetelo sezimbangela ezingaba khona zobuhlungu
I-etiology ye-lumbodynia yehlukile. Kungabangelwa:
- imithwalo eqinile ye-static ne-static-dynamic kuma-vertebrae e-lumbar;
- izifo zomgogodla:
- i-osteochondrosis yomgogodla we-lumbar;
- ukukhipha noma ama-discs e-herniated intervertebral;
- izifo ezithathelwanayo (i-osteomyelitis, isifo sofuba, i-brucellosis);
- ukukhubaza i-spondylosis;
- i-scoliosis, i-pathological Lordosis ne-kyphosis;
- ukukhubazeka kwamathambo emzimbeni;
- ukuphuka nokulimala kwemizimba ye-vertebral;
- ama-neoplasms ayisisekelo kanye ne-metastatic emizimbeni ye-vertebral;
- i-ankylosing spondylitis;
- isifo samathambo;
- isifo sezinso:
- izimila zokuqala nezesibili;
- i-pyelonephritis enamandla;
- ICD;
- i-atherosclerosis yengxenye yesisu ye-aorta namagatsha ayo;
- i-aortic dissecting aneurysm;
- izinguquko ze-pathological ku-hip joint;
- ukuvuvukala kolwelwesi oluqinile noluthambile lwentambo yomgogodla;
- ukuvimbela okukhulu kwamathumbu;
- inkambo ye-appendicitis enamandla;
- ukuphazamiseka okukhulu kokujikeleza komgogodla;
- izifo zezitho zangasese, kufaka phakathi isigaba sokuzala:
- i-endometriosis;
- umdlavuza wesibeletho;
- i-adnexitis;
- i-prostatitis;
- umdlavuza wendlala yesinye;
- Ama-STD;
- izifo zomgudu wokugaya ukudla (izifo eziningi ezivela emathunjini, isibindi, i-gallbladder, amanyikwe).
Ukuhlukaniswa kobuhlungu
Ukuhlelwa kwesifo ngezifo kwenziwa ngesisekelo senqubo ethathwa njengesisekelo. Kungaba ngokuya nge:
- izimpawu ze-etiological:
- okuyisisekelo (okubangelwa izinguquko eziyinhloko ze-pathological ku-vertebrae) - ukuhanjiswa kanye ne-hernia yama-disc intervertebral;
- okwesibili (okubangelwa izifo zezitho nezinhlelo, umphumela wazo okuyi-lumbodynia) - ICD, JCB.
- isikhathi sokubukeka:
- acute (kuze kube amasonto ayi-12);
- okungamahlalakhona (ngaphezu kwamasonto ayi-12);
- ukuxhumana nento ecasulayo:
- ngokushesha (ukulimala komgogodla);
- ukubambezeleka (ubuhlungu beqolo ngemuva kokudla ukudla okunamafutha ngesifo senyongo);
- izinga lokubonakaliswa:
- kubiziwe:
- ngokulinganisela;
- okwenziwa kwasendaweni:
- ngokwezwe okuhambisana nokugxila kwesilonda;
- ukuhamba noma ukuzulazula;
- isithombe somtholampilo:
- ukucindezela;
- ukudonsa;
- ukugwaza;
- ukudubula;
- ukusika;
- ukuzungeza;
- ukushisa;
- isilima;
- ukucindezela.
Ubuhlungu bebhande
Kuyinto ejwayelekile kakhulu ye-pancreatitis ebukhali, i-cholecystopancreatitis, i-cholelithiasis, i-cholecystitis ebukhali kanye ne-intercostal neuralgia. Ngokulimala kwesibindi namanyikwe, ubuhlungu bungaphuma buye endaweni yesifuba.
I-Cholecystitis noma i-pancreatitis ayivamile ukuhlukaniswa. Ngokuvamile, lesi sifo sihlangene futhi sithatha uhlamvu lwe-cholecystopancreatitis. Ukuzwa komunyu emlonyeni, kanye nemizwa engathandeki ku-hypochondrium elungile, kungasebenza njengesibonakaliso sokwehlukanisa.
Njengoba kunikezwe ubunzima bezifo ezikhona ze-nosological ngokubonakaliswa kobuhlungu bemvelo ye-shingles, i-antispasmodics (Papaverine, Platifillin) kufanele isetshenziselwe ukuyikhulula. Akunakwenzeka ukusebenzisa ama-NSAID (ama-analgesics angewona ama-steroidal) ngenxa yokuthi ukusetshenziswa kwawo kungashintsha izimpawu futhi kube nzima ukuxilongwa ngudokotela ohlinzayo.
Ukuxilongwa kokuqala
Ukuze kwenziwe ukuxilongwa kokuqala, kusetshenziswa izivivinyo eziningi zokuxilonga:
| Ukuhlolwa kweLumbosacral osteochondrosis | |
| Igama lesimpawu | Incazelo |
| UDejerine | Lapho imisipha yezicubu zesisu ihlushwa, ubuhlungu esifundeni se-lumbar buyanda. |
| UNeri | Ngokuthambekela okubukhali kwekhanda ngaphambi kokuthinta isifuba, ubuhlungu obungemuva emuva buyakhula. |
| ULasegue | Esimweni esithandekayo, kufanele nishintshane ukuphakamisa imilenze eqondile. Nge-lumboischialgia, ubuhlungu buzokhuphuka futhi bukhanye eceleni kwesibindi se-sciatic sohlangothi olusebenzayo. |
| ULorrey | Lapho uthatha isikhundla sokuhlala endaweni elele ngemilenze eqondisiwe, ubuhlungu obungemuva kwe-lumbar ischialgia buzokhuphuka ngaphakathi kwe-nerve sciatic. |
Ungaxhumana nobani
Uma kungaziwa imbangela yobuhlungu, kufanele kuboniswane nodokotela. Ezimweni lapho i-etiology icacile - ukunciphisa ochwepheshe, ngokwesibonelo, kudokotela wezifo zabesifazane (ukuvela kobuhlungu ku-trimester yesibili yokukhulelwa) noma i-neurologist (kunezinkomba ze-intervertebral hernias ku-anamnesis).
Imvamisa, i-rheumatologist kanye ne-traumatologist nabo bayabandakanyeka ekwelapheni izinhlungu eziseqolo.
Ukuvakasha kodokotela, ukuxilongwa kanye nokuhlolwa
Ukuxilongwa kunzima ngenxa yokungacacisi kwezimpawu kanye ne-polyetiology yayo. Iqoqo elinemininingwane le-anamnesis, ukuhlaziywa kwezikhalazo zesiguli, kanye nokuhlolwa kwalo ngokuphelele kuyadingeka.
Phakathi kwezindlela zaselabhorethri, kufanele kuhlukaniswe ukuhlolwa kwegazi nomchamo okujwayelekile nokwenziwe ngamakhemikhali, kanye nokuhlolwa kwegazi kwezimpawu zomzimba.
Izindlela ezisetshenziswa njalo zocwaningo lwezinsimbi zifaka ama-X-ray namasu we-endoscopic, i-ultrasound yomgodi wesisu kanye nesikhala se-retroperitoneal, i-CT neMRI.
Izindlela zokwelapha
Isikimu nezindlela zokwelashwa kususelwa ekuxilongweni. Bahlukaniswe ngokujwayelekile baba:
- olandelanayo:
- uthatha imishanguzo (ama-NSAID, ama-vasodilator, ama-relaxant muscle asebenza maphakathi, ama-chondroprotectors, amavithamini e-B, izidakamizwa ze-steroid, njll.)
- Amafutha;
- amaphilisi kanye amaphilisi;
- imijovo (paravertebral blockade);
- FZT:
- ukufudumeza (okusebenzayo esigabeni sokuvuselelwa kwezifo ezihlukumezayo ze-aseptic);
- i-cryotherapy (esebenza kahle esigabeni esibucayi sokuvuvukala kwe-aseptic, ngokwesibonelo, ekuhlukunyezweni);
- Ukuzivocavoca umzimba (iqoqo lokuzivocavoca elenzelwe ukuthuthukisa uhlelo lwe-musculoskeletal);
- ukubhucungwa umzimba;
- ukwelashwa okwenziwa ngesandla;
- uthatha imishanguzo (ama-NSAID, ama-vasodilator, ama-relaxant muscle asebenza maphakathi, ama-chondroprotectors, amavithamini e-B, izidakamizwa ze-steroid, njll.)
- ukusebenza (ama-neoplasms, izimpawu zokucindezelwa ngama-intervertebral hernias of the spinal cord, njll.
© Yakobchuk Olena - stock.adobe.com
Ukuzivocavoca umzimba, ukuzivocavoca umzimba
| Isikhundla sokuqala | Incazelo Yokuzivocavoca |
| Ulele ngomhlane | Phakamisa imilenze eqonde kwesokunxele nangakwesokudla ngokulandelana, ubambelele esisindweni semizuzwana eyi-10-15.
|
| Ulele ngomhlane | Gobisa amadolo akho nge-engeli engakwesokudla, utshekele kohlangothi lwangakwesokudla nangakwesokunxele ize iyeke.
|
| Ukuma | Smoothly bend tinkhombandlela letehlukene (emuva iqonde).
|
| Imile kuzo zozine izinyawo | Swing kanyekanye nezitho zomzimba (ingalo yangakwesokudla nomlenze wesobunxele).
|
| Ibhuloho elikhazimulayo | Ukukhulisa i-pelvis endaweni ephakeme.
|
| "Ibhuloho" | Goba umhlane wakho, uzama ukulungisa umzimba kule ndawo.
|
Ngobuhlungu esifundeni se-lumbar, ukudlala imidlalo akuthandeki ngokweqile ngenxa yamathuba aphezulu okuhlukumezeka okwengeziwe kumajoyinti we-intervertebral ngenxa yokuhamba okungazelelwe (i-volleyball, ibhola).
Ukufakwa kwamabhandeshi esifundeni se-lumbar kuyakhonjiswa, ikakhulukazi lapho kulindelwe imithwalo ephezulu ye-static noma ye-static-dynamic.
Ubuhlungu obuphansi emuva kubadlali
Umgogodla wabasubathi uhlangabezana nemithwalo ebaluleke kakhulu ye-axial, ejikelezayo neye-flexion, enquma ukucaciswa kokuhlukumezeka. Okuvame ukutholakala:
- ukunwetshwa kwesisetshenziswa se-musculo-ligamentous se-lumbar vertebrae;
- i-spondylolysis (isici ku-arch ye-vertebra, etholakala kuma-gymnast, ama-pole vaulters, abadlali bebhola);
- i-sondylolisthesis (ukwehla kwama-vertebrae ngokuhlobene)
- i-osteocondritis yomgogodla;
- i-hernia nokuphrinta kwama-disc intervertebral;
- i-kyphosis yobusha be-Scheuermann-Mao;
- scoliosis.
Njengoba kunikezwe ingozi enkulu yokulimala, abagijimi abangochwepheshe kufanele babhekwe njalo. Lapho kutholakala i-pathology, umuthi wokwelashwa unqunywa ngudokotela ohambelayo futhi unqunywa ngohlobo lwawo.
