Kurapa kwe intervertebral hernia (lumbosacral spine). Kuvhiya kuti ubvise chinonzi intervertebral hernia

Matambudziko nemusana wenyonganyonga vanhu vazhinji. Vamwe vanhu, nokuda kwekushanda zvakaoma, vanoita mamiriro akadai seanopindira bhudziro re lumbosacral musana.

Chii ichocho?

Intervertebral hernia inowanzonzi chirwere chakakomba, umo intervertebral disc inofamba kubva mundiro yepamusoro. Kazhinji kazhinji, iyi mamiriro ezvinhu anowedzera semugumisiro wemutoro unorema pamutsara wemugunha.

Kutambura kubva kune chirwere ichi kunyanya varume pakati pemakore makumi maviri nemakumi mashanu.

Chiitiko chechirwere ichi chinenge mamiriyoni zana ne100 000 evanhu pagore.

Mazhinji emaronda aya anoonekwa nekuda kwekunyanyisa muviri wepamusoro semugumisiro webasa. Kunogona kuratidzwa kwehutu hunotambudza mushure mekuvhiyiwa pamutsara wemusana kana sechikonzero chechionda. Kazhinji, asi kune hutano hwemutsara.

Muvanhu vakwegura pane zviitiko zvekukura kwemharanias pamusana pehutano hwehuviri hwemitsipa yepamusoro.

Yakawanda ndiyo inonzi intervertebral hernia ye lumbosacral musana, sezvo pasi rezasi ndiyo nzvimbo inonyanya kunetseka pakukura kwechirwere ichi.

Pathogenisis of hernia development

Pasi pemubatanidzwa wemutoro wakakura pamutsara wemusana, iyo intervertebral disc inowedzerwa. Nokuda kweizvi, muromo wegomba rekunze (ring outer fiber) rinowanzoputika, mushure mokunge zvinyorwa zve intervertebral disk zvichibuda kunze.

Nzira yakasunungurwa yakasununguka inogona kubviswa mukati memugero wepelinha, uye kumativi acho. Muchiitiko chekutanga, kukanganisa kwemutsipa wesipinha kunowedzera, izvo zvinogona kutungamirira kumigumisiro isingaoneki. Muchiitiko chechipiri, chirwere chinonzi radicular syndrome chinogona kukura nekukanganiswa kwemitsipa inobva mumutsipa wepelinha. Munharaunda yekudzvinyirira, aseptic kutuka kunowedzera, kune kuvhuvhuta kwezvakakomberedzwa, izvo zvinowedzera kuipa mamiriro acho ezvinhu.

Somugumisiro, iyo intervertebral hernia inozivikanwa nezviratidzo zve radicular syndrome (kurwadziwa, kushungurudzika kwekunzwisisa uye nhengo dzebasa). Nokufamba kwemazuva, kufamba mumutsara wepelinha hakuna kukwana.

Sezviri pachena, nzvimbo iyo inonzi intervertebral hernia inowanzomuka ishami re lumbosacral. Mishonga inofanira kugoverwa nokukurumidza apo disk inogadziriswa inowanikwa.

Kurapa

Chero zvazvingaitika, pakarepo utange kurapwa kwe-intervertebral hernia. Iyo lumbosacral musana unoita basa rinokosha zvikuru yemuviri - kuchengetedza kuenzanisa uye nhengo dzepamusoro panzvimbo yakarurama. Nekubudirira kwemharaunda munharaunda yechiparadzi, basa iri rinova rakaoma zvikuru nekuda kwehutano hunorwadza hunoitika apo mishonga inomanikidzwa. Mamiriro acho akawedzererwa nehuwandu hunotapurirwa kuvarapi.

Apo zviratidzo zvokutanga zvikaonekwa, pakarepo utange mushonga we intervertebral hernia. Iyo lumbosacral spine inopindura zvakanaka nenzira dzakadaro dzisiri-mishonga sekushandiswa kwemastare emasopa, kushambadza, kushandiswa kwemvura inotonhora. Aya maitiro ane maitiro ekutsanangurira zviratidzo (kunoderedza mamiriro ezvinhu emuurwere) uye anogona kungoshandiswa chete kwechinguva kuti arege kunetseka kweropa. Nekukurira kwechiitiko, zvinodiwa kuti uite pakarepo nguva yekusangana neyeurologist.

Zvinodhaka

Kana zvakadaro zvisati zvichitengesa hutachiona, nzira yekuchibata nayo kuti isasakuvadza muviri wayo? Kuti uite izvi, shandisa zvinopesana nezvinokonzera zvinodhaka kubva muboka revanhu vasiri steroid. Yakawanda inowanzove mafuta, mafuta uye zvisikwa. Vanowanzova ne "Diclofenac" ("Rumakar", "Diclobert"), "Indomethacin" ("Metindol", "Rumacid"). Kunyanya kwezvinodhaka mumishonga iyi kunokubvumira kuti ubvise zvakanyanya kurwadziwa chirwere nekuputika (zvisinei, kutora chiyero chakafanana chemishonga mukati kunogona kunge kusina kukodzera, uyewo kunobatsira pakukura kwechironda chemuviri kana 12 duodenal ulcer).

Zvinokwanisika kusonganisa kwete-steroidal anti-inflammatory drugs ne glucocorticoids.

Glucocorticoids inoshandiswa kana iri mukati-kati kana intravenously kuitira kukurumidza kukurumidza kuitika. Akashandisa zvinodhaka zvakadai saPrednisolone uye Dexamethasone. Kurapa ne glucocorticoids kunofanira kurongerwa chete kana NSAID isingabatsiri, sezvo nguva yakareba yekugamuchira corticosteroids inounza muviri kukuvadza kupfuura kunaka.

Physiotherapy pakuchengetedzwa kwetsika yemaruva

Munzvimbo yechipiri maererano nehuwandu hwekushandiswa ndiko chirwere chepotheotherapeutic ye intervertebral hernia. Iyo lumbosacral musana ndeimwe yemapato akawanda anowanikwa kune musculoskeletal system yekushandiswa kwemichina yakasiyana-siyana.

Maererano nenyanzvi dzakawanda, physiotherapy inogona kuita kuti kukurumidze kupora, pane kushandisa kwemishonga.

Parizvino, nzira yakanakisisa yekurapa intervertebral hernias inoshandisa multifunctional electrodes. Chinokosha chemuitiro uyu ndiko kukanganisa kwemaitiro ekurwadziwa anouya kuburikidza neredhiyo-frequency waves.

Pakati penzira dzinonyatsozivikanwa, electrophoresis ane analgesics, mabhedha ekurapa, uye laser therapy inowanzoshandiswa. Electrophoresis uye phonophoresis vanobvumira kuendeswa kwezvinodhaka zvakananga kumucheto. Mhedzisiro inowanzowonekwa mushure memaitiro akawanda.

Kuchengetedza kushambidza kushambidza mune zvimwe zviitiko kunogona kuita kuti kuchengetwa kwepanyika kunenge kuripo.

Kana pane kuwedzera kwechiitiko chacho, pasinei nezviito zvakatorwa, iyo intervertebral hernia chirwere yava yakaoma zvikuru. Nzira yekurapa sei mumamiriro ezvinhu aya?

Kuvhipwa kwekodzero yekupindirabral hernia

Kana chirwere chinoshandiswa chinoshandiswa chisingabatsiri kana kana zvirwere zvakakomba zvehutano (chirwere chemuviri, kukwepa uye defecation, paresis, paresthesia, kurwadziwa kwakanyanya chirwere, kurwadziwa kumucheto kwemagumisiro akadzika) kuonekwa, kurapwa kunopirwa kunofanira kutanga pakarepo.

Zviratidzo zvekurapa kwekukurumidzira zvinopesana nemutsipa wepelinha, kuwedzerwa kwemidziyo inopfuura kana kuitika pedyo.

Mishonga inowanikwa zvikurukuru mumatareji anovhiya anonyanya kushandisa (akawanda anowanzo muuropiyurgery).

Pakati pemitemo yekurapa inoshandiswa mapoka makuru maviri - chirwere chekupedzisira nekugadzira microsurgery.

Zvichienderana nehutano hwechirwere ichi, sarudza mazano ekushanda kwekushanda.

Kurapa kunogadziriswa pasi pehuwandu hweanesthesia uye nekutsigirwa kwezvinhu zvinokosha zvinokosha.

Microsurgical removal

Asati yatanga microscopes kuchipatara, kana chirwere chokuvhiya chinonzi intervertebral hernia chakaratidzirwa, chikamu chinonzi lumbosacral chikamu chakanga chakawanzogadziriswa nezvinetso zvakasiyana-siyana mumashandisirwo emashure (kupera, kudzokerazve). Ikokugadzirisa kwechokwadi kwaive kushandiswa kwezvipikiso zvinoshandiswa mukurapwa kwema-hernias. Izvi zvakabvumira kuderedza ukuru hwekushanda kwekushanda, izvo zvakaderedza zvakanyanya kukanganisa kwekuwedzera matambudziko.

Kazhinji kazhinji, nzvimbo inopindirana yevas sacral inobviswa kuburikidza nekukanganiswa kukuru (amininectomy inoitwa). Pasi pekuwedzera kukuru, zvinokwanisika kubvisa zvinyorwa zvinyorwa zvisingatauri kunze kwekukuvadza huwandu hwehutachiona huri pasi.

Kushandura murwere kuri kutova zuva rinotevera. Murwere anobvumirwa zuva rega rega kushanda mumazuva gumi, uye mwedzi gare gare anogona kutotanga kuita basa rekushandisa pasina ngozi yezvinetso.

Endoscopic operation

Aya maitiro ekubvisa kushandiswa kwepisitori inonzi hernia inotungamirira mutsva muuropiyurori. Kazhinji kazhinji inowanikwa kuburikidza nehutungamiri hwemashure endoscopic approach. Zvakanakira nzira idzi ndechekuchengeteka kukuru mukugadzira vanga rekushanda (dzimwe nguva kugadzirwa kweganda kunowanzoitwa). Zvisinei, izvi ndizvo zvakare kusagadzikana kukuru - munyaya iyi, mikana yekunyatsokwana kweseji uye kubviswa kwayo kubva munzvimbo inoputika ishoma. Dambudziko-kusvika-kuwanika hernias, kana hernias, pamwe chete nekudzvinyirira kwemutsipa wepelinha, nerubatsiro rwemabasa akadaro haabviswi.

Murwere anokwanisa kunge atova zuva iro basa racho raitwa, enda, famba. Basa rinobvumirwa kana vhiki imwe mushure mokunge yabuda kubva kuchipatara.

Matambudziko emakwenzi ake

Nokufamba kwenguva, kana hernia inotanga kufambisa pedo nheyo dzisina kukwana, zvinogona kuitika kukura kwezvinetso.

Kana iyo inowanzoitwa hernia (intervertebral) yakagadzirwa, chikamu che lumbosacral hachikanganisi zvachose basa rayo, uye rwonzi rwomusana haruviri. Zvose zvinotambudza apo mutsara unoshandurirwa kumugero wepinini.

Chinhu chinonyanya kuipa kwavari ndechekukanganisa kwemutsara wepelinha. Muchiitiko ichi, mabasa ekugunzva uye kusvibiswa zvinokanganisa, izvo zvinokonzera kutyisa kuhupenyu (kudhakwa kwakanyanya, kupera kwechivako, matumbo uye urethra). Mukuwedzera, kana kutuka kuchienda kumutsipa wepelinha, zvinokonzera kukanganisa nzvimbo dzepamusoro nekuputsa kwemaitiro emitumbi yechipfuva, kusvika pamigumisiro inouraya.

Imwe nyanzvi inowanzozivikanwa yehania ndiyo radicular syndrome. Nokuvapo kwenguva refu zvinowedzera kuipa mamiriro acho ezvinhu.

Zvimwe zvinonetsa zvinokonzerwa nehuwandu hwekunzwisisa uye paresthesia.

Kuvandudza nekudzivirira

Nokuti kufambiswa kwetsika kunotora nguva (ie, mumamiriro ezvinhu zvinogona kunzi chirwere chisingaperi). Kana hurukuro huru ichinyatsoonekwa, kubudirira kwayo kunogona kudziviswa.

Kuti udzivise kudzokorora, mushure mekubviswa kwepisterbrbral hernia, mutoro unofanirwa kugoverwa zvakakwana panguva yepanyama. Hazvifananidzi kushanda zvakanyanya, nokuti zvinogona kuguma zvakashata.

Uyewo pakudzivirira maharanias, kudzidzira muviri uye maitiro zvinokurudzirwa zvinosimbisa muscular back skeleton (somuenzaniso, kufa kwepfungwa nemitoro inonzwisisika).

Nebasa rakakura uye rakakomba mukudzivirira, zvinokurudzirwa kutora kusununguka kutsvaira kushambidza - zvinobatsira kuti kuve nekusiyana kuduku kwe vertebrae, iyo inodzivisa dhoni kuti irege kuputsa.

Kugadziriswa mushure mekupedzisira kunosanganisira kudzivirirwa kwekurovedza muviri, kurapa muviri , massage uye manual therapy kana zvirongwa zvekugadzirisa.