Izimpawu nokwelashwa kwe-herniated intervertebral disc yomgogodla we-thoracic

I-disc ye-Herniated yomgogodla we-thoracic - ukuqhuma kwe-disc intervertebral ye-vertebra ye-thoracic (ICD-10 M51). Kubonakala ngobuhlungu, ukuzwela okungakhubazekile kwesikhumba kanye nokuphazamiseka kwesomatic. Ukuxilongwa kwenziwa ngesisekelo sedatha: imiphumela yokuhlolwa kwezitho nezinhlelo zokukhipha i-pathologies ngenxa yezinye izizathu, kanye ne-MRI. Ama-Disc we-thoracic vertebrae engezansi (Th8-Th12) athinteka kakhulu.

Ukwelashwa kuyadla ngoludala futhi kuyasebenza. I-Hernia ye-shmorl yomgogodla we-thoracic - ukuqubuka kwe-hernial emzimbeni ongenhla noma ngaphansi kwe-vertebra ngenxa yokuqhuma kwezicubu zomzimba zediski ye-intervertebral. Akukho ukwelashwa okudingekayo.

Izizathu

I-etiology yalesi sifo isuselwa kuzinqubo eziholela ekubonakaleni kwemifantu nokwehla kwamandla we-annulus fibrosus:

• indlela yokuphila;
• imithwalo yesikhathi eside ye-static ne-static-dynamic yokuqina okukhulu;
• ukuhlukumezeka;
• i-osteochondrosis yomgogodla we-thoracic;
• izifo ze-dysmetabolic;
• izifo ezizimele.

Ukuvela kwe-hernial protrusion

Ekuthuthukisweni kwabo, ama-prolaps ahamba ngezigaba eziningana:

1. Ukuvezwa okusemaceleni kwediski kuze kufike ku-1-5 mm ngokulondolozwa kongqimba lwangaphandle lwendandatho enezintambo. Kubizwa ngokuthi yi-protrusion.
2. I-extrusion noma i-hernia eyakhiwe ngokwephula ubuqotho bendandatho nokuqhuma kwe-5-8 mm.
3. Ukulandelwa kwemigwaqo kubonakala nge-aseptic necrosis kanye nokuhlukaniswa kwezicubu ze-hernia (ubukhulu bayo obuvame ukudlula u-8 mm), kulandelwe ukufuduka kwabo emgodini womgogodla, ogcwele izinkinga ezikhubazayo.

Ngokwesilinganiso sokuncipha komsele womgogodla, ama-hernial protrusions ahlukaniswe amancane (0-10%), aphakathi (10-20%) kanye namakhulu (> 20%).

Izimpawu nokuxilongwa okwehlukile

Banqunywa ngokuziphatha kwe-hernia, kwasendaweni kanye nezinga lokuphambuka. Lokhu kungaba ukucindezelwa kwezimpande zemizwa yomgogodla noma into yomgogodla. Ngokuya ngemibandela yesimo sendawo, ukuvezwa ngu:

• eceleni,
• i-ventral (imele ingozi encane kakhulu);
• maphakathi (maphakathi noma ngemuva), okuyingozi kakhulu ezinkingeni zayo;
• owezimo eziphuthumayo.

Amanye ama-neurosurgeons ahlukanisa i-dorsal, median (njengokuhluka kokuvela kwe-dorsal), okuyisiyingi, okwangaphakathi kanye nokwenziwa kwendawo okwenziwe ngamehlo.

Ngokuphathelene nezingxenye zomgogodla - i-thoracic engenhla, emaphakathi naphansi.

Futhi:

• Ngendawo emaphakathi, ukucinana komgogodla kuyabonakala, kuhambisana nokwakhiwa kokucindezelwa kwe-myelopathy ngokubonakala kwe-spastic mono- noma i-papararesis ephansi, kanye nokuphazamiseka kwe-pelvic.
• Ngokusetshenziswa kwendawo okwenzeka ngasikhathi sinye, uphawu lwesixina sokucindezelwa kwezimpande zomgogodla ngokubonakala kokuphazamiseka luphuma ngaphezulu:
  • ukuqonda kwezinzwa esifubeni;
  • i-somatic innervation lapho i-hernia ithinta amagatsha e-visceral, okudala ushintsho ekusebenzeni kwezitho zangaphakathi.

Ubunzima bokuxilongwa bubangelwa ukucaciswa kwezimpawu zesifo. Ukuphuma, kuye ngendawo, kuyakwazi ukulingisa izimpawu zezifo zesifuba nezesisu. Ngakho-ke, ukuqinisekisa ukuxilongwa, isazi sezinzwa singabandakanya ochwepheshe abangochwepheshe.

© Alexandr Mitiuc - stock.adobe.com. Ukumelwa kokuhlelwa kwendawo ye-hernia emgogodleni we-thoracic.

Ukuhlolwa kwe-Nitroglycerin noma i-Corvalol kungasiza ekuhlukaniseni i-disc prolapse kusukela ekubonisweni kwesifo esiyinkimbinkimbi se-angina pectoris, lapho ubuhlungu obubangelwa ukucindezelwa kwezimpande zezinzwa ngeke bumiswe.

Lapho kwenziwa ukuxilongwa okwehlukile kwe-discogenic pathogenesis (i-disc protrusion) enezifo zomgudu wamathumbu, kufanele kukhunjulwe ukuthi ubuhlungu esiswini abuhlobene neze nokudla.

Izimpawu zingahluka kwabesifazane nakwabesilisa. Lokhu kungenzeka ukuthi kwehle ukungasebenzi kahle kwe-libido ne-erectile. Abesifazane bathambekele ekukhulelweni kwama-ovari, ukungahambi kahle kokuya esikhathini, okuholela ekwehliseni amathuba okukhulelwa, ubuhlungu esifundeni se-areolar, esivame ukudideka ukuqala kwe-mastitis (ukutheleleka kwesifuba).

Ukuxilongwa

Ukuxilongwa kusekelwe ku:

1. izikhalazo ezijwayelekile zesiguli (ukuphazamiseka kwesigaba emikhakheni ebucayi neyezimoto, ushintsho lwe-pathological ekusebenzeni kwezitho zangaphakathi ezingenakuthinteka yisiqu somzimba esiminyene);
2. idatha yokuhlolwa kwemizwa nesithombe somtholampilo sesifo;
3. Imiphumela ye-MRI (ngokuphikisana ngqo, ngokwesibonelo, ukuba khona kwe-pacemaker yokufakelwa, i-CT yomgogodla kungasetshenziswa, kepha ukunemba kwesifundo kuncane kune-MRI);
4. idatha evela ezifundweni zaselabhorethri, ukuxilongwa kwezinsimbi nokubonisana kochwepheshe abahlobene, okuvumela ukuxilongwa okwehlukile (ukusiza ukuqinisekisa i-hernia nokukhipha i-angina pectoris, iqoqo lomlando eliningiliziwe, idatha ye-ECG nokuhlolwa kokusebenza okukhombisa ukungabikho kwe-myocardial ischemia kuzosiza).

Ubunzima bokwenza ukuxilongwa bungaba ngenxa yezifo ezahlukahlukene. Isiguli singakhathazwa yi-thoracalgia kanye ne-angina yokuzikhandla etholakele ngemuva kokuqhuma okukhona emgogodleni we-thoracic. Futhi, i-hernia ingadala ukuhlaselwa kwe-angina pectoris.

Amasu okwelashwa anganqunywa ngochwepheshe ababili - udokotela wezinzwa nodokotela (noma udokotela wenhliziyo).

Ukwelashwa

Ihlukaniswe yaba ngoludala kanye nokuhlinzwa. Ukwelashwa okulondolozayo kwenziwa ezimeni ezigulisayo nezasekhaya, ukuhlinzeka ngezinyathelo ezihlose:

• ukuqedwa noma ukunciphisa i-thoracalgia;
• ukuvimbela ukukhula kwe-protrusion.

Ukwelashwa kwezidakamizwa

Kufaka phakathi ukuqokwa:

• Ama-NSAID (Naproxen, Ibuprofen, Celecoxib, Ketoprofen, Carprofen, njll.);
• i-corticosteroids (i-metipred);
• ama-blockades wendawo (ama-anesthetics + ama-corticosteroids);
• ukuphumula kwemisipha okunesifo esibi se-spastic (Tolperisone, Mydocalm, Sirdalud);
• ama-chondroprotectors (i-Glucosamine, i-Aorta - asetshenziselwa ukuthuthukisa i-trophism ye-nucleus pulposus, akhombisa ukusebenza kahle okuphezulu esigabeni sokudonswa kwe-disc intervertebral);
• Amavithamini B (B1 no-B6, evuselela ukubuyiselwa kwemicu yezinzwa).

Indlela yokusebenzisa izidakamizwa ikuvumela ukuthi unqande i-pain syndrome futhi udale isizinda esihle sokusetshenziswa kwezinye izindlela zokwelapha ezilandelanayo.

Umphumela wokuzivocavoca umzimba (i-Exercise Therapy)

I-gymnastics yokwelapha isiza ukwandisa ukunikezwa kwegazi, ikhulule ama-spasms futhi yakhe i-corset yemisipha, esiza ukuqeda uhlelo lwe-musculoskeletal. Ukuzivocavoca kwe-hernia yomgogodla we-thoracic kunqunywe ngokuqinile ngakunye ngesikhathi sokuxolelwa, imvamisa ekuqaleni kwesifo, noma ngesikhathi sokululama ngemuva kokuhlinzwa. Ukuzivocavoca umzimba ezigabeni zokuqala kwenziwa ngaphansi kweso lomqeqeshi ejimini. Amasethi wokuncoma wokuzivocavoca angenziwa ekhaya.

Ukukhanda, i-reflexology

Zisetshenziselwa ukuqeda ubuhlungu kanye nokuqina kwemisipha.

Ukwelashwa okwenziwa ngesandla kanye nokudonswa komgogodla

Zisetshenziselwa ukwandisa ibanga phakathi kwemizimba ye-vertebral.

© Mulderphoto - stock.adobe.com. Ukwelula umgogodla.

Umthelela wokubhucungwa

Ukubhucungwa kunqunyelwe ukukhulula ithoni ekhuphukile yemisipha ye-paravertebral. Isetshenziselwa ukuphumula nokwenza ngcono ukunikezwa kwegazi ezingeni lokuqala lesifo esigabeni sokuxolelwa.

I-Physiotherapy

Isetshenziselwa ukuhlinzeka ngemisipha yokuphumula nokulwa nokuvuvukala kuzo zonke izigaba zokuvela kwe-hernia ngesikhathi sokuxolelwa. Isetshenzisiwe: i-hydrocortisone ultraphonophoresis, i-electrophoresis, i-magnetotherapy ne-UHF.

Uma kungekho mphumela wokwelashwa okulondolozayo kanye / noma ukuvela kwezimpawu ze-myelopathy, baphendukela ekwelashweni kokuhlinzwa.

Umphumela omuhle we-ERT ufakazelwe ngokomtholampilo ngemuva kokuhlinzwa esigabeni sokuqala sokululama (izikhathi ze-EHF, i-laser ne-magnetotherapy, i-electromyostimulation).

Inqubo kaSolwazi Bubnovsky

UDkt Bubnovsky uncoma isethi yokuzivocavoca egxile ekunwebeni imisipha yangemuva:

• Ukuma uqonde futhi uhlukanise izinyawo ububanzi-ehlombe, kufanele wenze kahle ugoba phambili, uzama ukunamathisela ikhanda nezandla phakathi kwamadolo akho.

• Ukubeka umlenze wakho oqondile ngemuva kwesihlalo, kufanele uzame ukubeka umzimba wakho ethangeni ngenkathi ukhipha umoya, uzama ukubamba isokisi ngezandla zakho.

• Ulele esiswini sakho, welula izingalo zakho phambili, uphakamise umzimba uphonsa phansi njengoba uphuma.

• Ngokuma umile, welulela phezulu, uzama ukuphakama ezinzwaneni zakho phezulu ngangokunokwenzeka.

Ukuhlinzwa

Kuboniswa lapho indlela elandelwayo ingasebenzi izinyanga eziyisithupha. Le ndlela ifaka phakathi:

• i-laminotomy noma i-laminectomy - ukuvuselelwa okuphelele noma okuyingxenye yesakhiwo se-vertebral sokunciphisa ukucindezelwa komsele we-vertebral; kuvame ukuhlanganiswa nokuhlanganiswa - ukulungiswa kwama-vertebrae aseduze we-fusion;
• i-laminoplasty - i-tomia ye-vertebral arch ukuze kwandiswe isikhala esizungeze izimpande futhi kudale i-hinge;
• disc extirpation (microdiscectomy (njengenketho - endoscopic), discectomy).

Ngemuva kokwelashwa kokuhlinzwa, izinkinga zingenzeka:

• ezithathelwanayo - i-myelitis, i-arachnoiditis yomgogodla;
• okungathathelani:
  • ukuqala - ukuphuma kwegazi, ukuguqulwa kwemizwa yomgogodla noma i-dura mater;
  • sekwephuzile - ukwakheka kwe-ankylosis (fusion) yemizimba yama-vertebrae aseduze.

Ezemidlalo zokwanda komgogodla we-thoracic (ezemidlalo ezivunyelwe nezenqatshelwe)

Imisebenzi yezemidlalo inqunyelwe. Izinhlobo ezivunyelwe zifaka:

• i-aqua aerobics nokubhukuda (njengezindlela zokwelapha nezokuvikela):
  • imisipha iyakhululeka, umthwalo emgogodleni uyancipha, imisipha namalunga kuyaqiniswa;
  • ukuqinisa uhlelo lokuphefumula, ukuthuthukisa ukunikezwa kwegazi.
• ukuqeqeshwa ejimini ngaphansi kweso lomqeqeshi wokwelapha ukuzivocavoca;
• Ama-Pilates;
• ukujima;
• amakilasi okuqina kanye neyoga;
• ukuzivocavoca nama-simulators;
• ukuhlala ku-fitball;
• ulenga kubha ovundlile;
• Ukuhamba ngebhayisikili ngesigqi sokuphumula;
• squats (ngesikhathi sokuxolelwa).

Noma ikuphi kokuzivocavoca okungenhla kufanele kwenziwe kuphela ngaphansi kweso lochwepheshe. Ukujima okudinga ukuhlala noma ukuma kufanele kungafakwa:

1. Phakamisa izinsimbe ezisindayo;
2. ukweqa okuphezulu nokude;
3. ibhola, basketball, umbhoxo, ukushushuluza;
4. ukuhamba umjaho;
5. ezemidlalo zamandla.

Izinkinga nemiphumela yokuqhuma

Ukuqhubeka kwe-nosology kungaholela ku:

• i-intercostal neuralgia ebizwa;
• ukuguqulwa kokucindezelwa kwentambo yomgogodla (omunye wemiphumela eyingozi kakhulu):
  • i-paresis yezitho;
  • ukulahlekelwa okuphelele kwemisebenzi yezitho ze-pelvic.
• ukuphazamiseka emsebenzini wenhliziyo nezitho zokuphefumula (izinhlungu esifubeni nokuphazamiseka emsebenzini wenhliziyo kuyezwakala; ukuphefumula kuyenzeka, kuba nzima ukuphefumula);
• ukuqhubeka kwezifo zamathambo (scoliosis, kyphosis);
• ukwakheka kwe-hernias ye-intervertebral kwezinye izingxenye zomgogodla - ngenxa yokwabiwa kabusha kwemithwalo yemithwalo kanye nokwanda kwesifo.

Ngenxa yokwephulwa kwe-innervation, impendulo evela kwesinye noma kwesinye isitho se-visceral ihlupheka. Uhlelo lokulawulwa kwalo okuzimele luyabhujiswa. IColon dyskinesia ingaguqukela ekubeni yi-colitis, futhi ukuphazamiseka kokusebenza kwamanyikwe kungashintsha kube ukwelashwa kwamaphaphu. Ngaphezu kwalokho, i-prolapse ingaholela ekuphazamisweni okusongela impilo kohlelo lwe-cardiovascular system (i-acute myocardial infarction, i-angina yokuzikhandla kanye ne-angina engazinzile; ukuboshwa okungazelelwe kwenhliziyo).

Ukuvimbela

Iqembu eliyingozi lifaka abamele lezo zici nemisebenzi ehilela imithwalo emide eqinile emile emgogodleni: odokotela abahlinzayo, abasubathi, abathengisi, abasebenzi basehhovisi.

Kulula kakhulu ukuvimbela ukwakheka kwe-hernia kunokuyelapha. Ukuzivocavoca nsuku zonke kuzokusiza ukukugwema. Ukunyakaza okuhlukahlukene kunikela hhayi kuphela ekukhiqizeni i-synovial fluid kanye ne-hydration yama-disc, kodwa futhi nokuqinisa imisipha ejulile yangemuva, eyehlisa umthwalo emgogodleni.

Lapho wenza izivivinyo zeprophylactic, kubalulekile ukukhumbula ukuthi:

1. Ama-discs alungele kangcono imithwalo emi mpo kunemithwalo evundlile noma ye-oblique. Lokhu kusho ukuthi lapho uphakamisa into esindayo, kufanele ugaxe, kodwa ungaguqi.
2. Ukwenza umsebenzi wokuhlala phansi, kubalulekile ukushintsha ukuma komzimba izikhathi eziningana ngosuku, ngenkathi wenza izivivinyo zokuzivikela, zama ukuhlala kancane ngangokunokwenzeka.
3. Ukubhukuda namanzi okuvivinya umzimba kuyasiza kakhulu emigomweni yokuvimbela, njengoba kukuvumela ukuthi uqinise i-corset yemisipha, ngenkathi ukhulula umgogodla.

Bukela ividiyo: Thoracic Mid-Back Pain or Disc? Absolute Best Self-Treatment - McKenzie Method (Novemba 2024).