Msana anatseka misewu: mitundu, cholinga mankhwala, zotsatira za

Ululu syndrome ndi mawonetseredwe yaikulu ya kudwala matenda a dongosolo minofu ndi mafupa, makamaka msana. Nthawi ya ululu waukulu vertebral ayenera atazikocheza yomweyo, anapatsa chakuti nkhondo ndi soreness si causal mankhwala. The anatseka misewu msana - chimodzi mwa zinthu zimene zinachitika pa matenda zovuta mavuto msana.

Zikhulupiriro General

Anthu aluso kovuta koletsa ululu aakulu, pachimake ululu kuposa mmbuyo, chifukwa anasonyeza ndi kuyamba kukhala ndi khalidwe lapadera. Kuti, kuganizira maonekedwe a ululu si anapanga pa mlingo wa malemeredwe ya maselo m'dera ndi ubongo. Chithandizo cha chikhalidwe ichi yaitali ndipo amafuna kugwiritsa ntchito antidepressants ndi neuroleptics.

Popewa izi, symptomatic mankhwala mu magawo oyambirira a matenda umagwiritsa mpheto monga anatseka misewu msana. Ndichiyani nanga ndondomeko pansipa.

Anatseka misewu otchedwa osati kugwirizana aliyense wa limagwirira ndi kulimbana ululu kutsatira analgesics mankhwala. Kuwonjezera mipherezero achire, msana chipika ntchito matenda. Ululu mosadziwika malo liyenela kukhazikitsa dzanzi, amene amalola ndondomeko Kupha kudziwa dipatimenti ya kudwala. Childs, ululu ndi "wazimitsa" yomweyo pambuyo mpheto lapansi.

umboni

Matenda a dongosolo minofu ndi mafupa, napempha ntchito anatseka misewu, ayenera kukhala limodzi ndi zizindikiro chopweteka. Pankhani anyamata, kugwiritsa ntchito mankhwala Mwaichi si zogwirizana. Kayendesedwe wochititsidwa pansi pa pathologies zotsatirazi:

• otsika kupweteka kwa msana;
• pamaso pa herniated zimbale;
• spondylosis deformans;
• radiculopathy;
• zoopsa choipa;
• neoplasms wa danga intervertebral;
• lateral kuchepetsa wa ngalande msana.

Ndondomeko anachita pa nthawi imene palibe zotsatira za mankhwala ndiwofatsa. Mwachangu The akudza pambuyo jekeseni Koma poyamba, mitundu choopsa cha matenda amafuna kuchokera 2-3 kwa mpheto 15 imachitika pa intervals wa masiku angapo.

Ubwino azingidwa ndi kudya ntchito, osachepera mavuto pamene kulemekeza malamulo a, n'zotheka ntchito angapo. Kupatula analgesia, mpheto ali wotsutsa-yotupa ndi spasmolytic tingati malingana ndi mankhwala anasankha.

Gawo blockades vertebral

Malinga ndi kuchuluka kwa mankhwala koyamba siteji imodzi, kusiyanitsa mpheto:

• monocomponent (njira imodzi);
• dikomponentnye (nthumwi ziwiri);
• multicomponent (nthumwi zitatu kapena zambiri).

Othetsa ululu jakisoni ndi kutumikiridwa mu izi zigawo anatomic:

1. msana - thoracic, khomo lachiberekero, lumbar, sacrum.
2. Misempha - Sciatic, occipital, tibial, suprascapular, nthambi kumbuyo kwa mitsempha msana.
3. Akulu dongosolo - minofu ya mutu, ndi piriformis minofu, ndi masitepe kutsogolo.
4. Epidural ndi epidural danga.
5. Mbali mafupa.
6. Articulation - sacroiliac ndi sacrococcygeal.

Anatseka misewu ya chophukacho msana ogaŵikana mitundu iwiri:

1. Yodziwika vkalyvaniem transforaminal oyamba a mankhwala mu dzenje kuchoka mitsempha mathero.
2. Pamene intralaminar ndondomeko medicament ndi anaikapo pakati njira vertebral mu galimoto cartilaginous mwachindunji.

contraindications

msana anatseka misewu ali contraindications ena kuti dokotala asamalira wodwala pa kumupima. Onsewa matenda imatengedwa payekha, kuwapatsa malangizo chiopsezo zotheka mavuto. Ndondomeko osati ikuchitika pansi zotsatirazi limati matenda:

• matenda, amene yodziwika ndi chizolowezi kukha mwazi;
• matenda opatsirana zokhudza zonse ndi mawonetseredwe m dera puncture ya;
• chikomokere wodwalayo;
• mbali yapadera ntchito mankhwala;
• mtima ndi mtima matenda;
• khunyu;
• hypotension;
• matenda a misala;
• zaka ana;
• pa mimba ndi mkaka wa m'mawere;
• zotupa organic a chiwindi ndi impso.

dzanzi m'dera

Zinthu zimene zimakhudzanso analgesic, ntchito mitundu yonse ya kutsekedwa ntchito mankhwala mu mawonekedwe palokha kapena osakaniza ndi magulu ena a medicaments.

Novocaine anatseka misewu msana imagwiridwa zambiri kuposa mankhwala ochititsa zina. "Novocaine" amapangidwa mu mawonekedwe a njira yothetsera jakisoni ndi woipa zosiyanasiyana pawiri yogwira (kwa 0,25% kuti 2%). Zotsatira analgesic akufotokozera mkati mphindi zochepa pambuyo anatseka misewu inali ikuchitika. Adaponya ntchito "Novocain" anaesthetises maola 2.

"Marcaine" komanso ntchito kupweteka. The chifukwa cha utsogoleli wa wothandizila ali ndi mochedwa chiyambi. Ululu Mwamsanga pambuyo pa maminitsi 20, koma nthawi ya kanthu kungakhale kwa maola 5-6. Kugwiritsa "marcaine" ikuchitika pokhapokha bwinobwino mtima ndi magazi zotengera za wodwalayo.

Utatha mankhwala ochititsa m'deralo, ntchito pofuna kuthana ndi ululu wa vertebral ndi "lidocaine wa". Mtengo wa mankhwala ali m'gulu wotsikitsitsa (pafupifupi 30 rubles pa paketi), kupanga izo logwiritsidwa ntchito. medicament The amakhala ndi kanthu mofulumira ndi nthawi yaitali kuposa "Novocaine".

"Novocaine" ndi "lidocaine wa", mtengo umene kuposa alipo, ntchito kambirimbiri kuposa mankhwala opha zina. Patsogolo ntchito aliyense wa iwo kuti aletse tilinazo wodwala aliyense, kupewa chitukuko cha thupi lawo siligwirizana.

mankhwala mahomoni

Kukonzekera m'thupi zikuchokera mankhwalawa pathologies a msana mu mawonekedwe a kudziletsa makonzedwe kawirikawiri ntchito. Nthawi zambiri iwo amagwiritsa ntchito mankhwala a mafupa. Anatseka misewu msana amafuna corticosteroid limodzi ndi mankhwala ena (mwachitsanzo, dzanzi). wothandizila m'thupi kuchepetsa ululu, cropped kutupa, kuchepetsa kutupa ndi thupi lawo siligwirizana.

Mankhwala ntchito mu msana:

1. "Prednisolone" ndi wothira wina wa mankhwala analgesic ( "procaine" "lidocaine wa" "Novocaine"). Mogwira ntchito anatseka misewu ya chophukacho msana, radiculitis, osteochondrosis.
2. "Hydrocortisone" ntchito midadada mitsempha. Bwinobwino wothira mankhwala ochititsa isanafike utsogoleli.
3. "Diprospan" ntchito mtundu uliwonse wa mpumulo ululu. The mankhwala ndi zabwino ndi kusala chitukuko zotsatira za zochita yaitali.
4. Amatanthauza "Kenalog" koma odana ndi matupi awo sagwirizana ndi odana ndi yotupa, ali zimakhudzanso immunosuppressive. Izo ntchito mtundu uliwonse wa blockages ndi mankhwala a mafupa.

magulu ena a mankhwala

njira zina kukhudza analgesic. Iwo ntchito zikuchokera kutsekedwa multicomponent ndi monga mankhwala zotsatirazi:

• sanali steroidal odana ndi yotupa ( "Voltaren");
• mavitamini B;
• michere ( "Lidaza" "papain");
• "ATP";
• MANKHWALA OLETSA VUTOLI ( "Platifillin");
• "Trombolizin";
• hondroprotektory ( "rumalon").

Chitsanzo cha ndondomeko

Taganizirani chitsanzo cha mpheto. Novocaine anatseka misewu ya lumbar msana ikuchitika mu malo mosabvuta. Palpable liwulo jekeseni malo, alandire ndi njira antiseptic. Kugwiritsa ntchito singano chabwino, mankhwala jekeseni intradermally kupanga "ndimu peel".

Kenako singano m'malo mwa Tinaleka ndipo anaikapo pakati pa vertebrae wa masentimita pang'ono ofananira kuti njira spinous. Monga singano mayikidwe mbali kutulutsa pang'ono njira. Kodi anaikapo kwathunthu mu ndondomekoyi. The singano anali ndiye pang'ono pochotsa ndipo anatumiza mmbuyo pansi pa dzanja la osapitirira 2 cm. 5 ml wa njira umayamba pa mlingo uliwonse gawo la ndime msana.

Anatseka misewu imachitika mfundo zitatu: pakati pa 4 ndi 5 lumbar vertebrae, pakati pa lumbar 5 ndi sacral 1-m, mu dzenje 1 sacral. Pamene asonyeza ululu syndrome akugwirizira mpheto amgwirizano ntchito mfundo zisanu ndi imodzi. Ndondomeko limatenga 40 Mphindi nthawi. Kwa maola angapo pambuyo mankhwala ochititsa dzanzi pa wodwala kuyang'aniridwa ndi akatswiri.

Epidural msana anatseka misewu - ndichiyani?

Epidurit ndi sciatica ali ndi chidziwitso cha utsogoleli epidural mankhwala analgesic. Pamene mankhwala ochititsa dzanzi ndi lumbosacral msana wodwala pa mbali yake, mwachidule mawondo anawerama kwa m'mimba. Chotulukira n'kopanda ntchito matawulo wosabala kapena mapepala. Kupopera mankhwala kumunda malo utsogoleli tsogolo la mankhwala.

Mu ziyerekezo a m'munsi sacral dzenje kukonzekera chikuyendetsedwera intradermally. Kenako, kusintha singano ndi jekeseni mu analemba kuboola pakhomo Kakhungu mu ngalande sacral. Kenako, singano akutsika zayamba horizontally kuti akuya palibe masentimita oposa 5, kujambula ulamuliro madzimadzi ndi pisitoni tensioning. mankhwala ndi kutumikiridwa, pakalibe nkhani. Wodwala kumva kuthamanga ndi distension mu coccyx lapansi.

The pazipita kuchuluka kwa mankhwala kutumikiridwa mu mpheto limodzi, 60 ml. Epidural chipika angagwiritsidwe ntchito:

• procaine;
• cyanocobalamin;
• thiamine;
• corticosteroids.

zosokonezeka zotheka

mitundu yonse ya mankhwala ochititsa dzanzi ayenera kuchitika kokha chifukwa ogwira oyenerera pansi wosabala. Obweretsa anatseka misewu jekeseni munda mayunitsi processing ndi njira zina zonse zimafuna potsatira kwambiri njira aseptic. Kusasamalira ndondomeko zingakhudze thanzi wodwalayo ndi kuyambitsa mavuto kutsatira anatseka misewu msana:

• magazi chifukwa kuwononga kukhulupirika mtima;
• kupweteka kwambiri pa malo jekeseni;
• kulephera kupuma pamene kugunda akutanthauza danga subarachnoid ;
• thupi lawo siligwirizana;
• kusokonekera;
• kusokonezeka kwa chikhodzodzo mkodzo;
• matenda a chingwe msana ndi dera puncture ya;
• zochita minyewa;
• kuwonongeka kwa mitsempha, mitsempha ya magazi, Mitsemphayi kapena zida minofu mu ndondomeko inaccurately anaphedwa.

Pomaliza

The anatseka misewu msana, zomwe chinatsimikizira zabwino maganizo ndondomeko akuti ndi pafupifupi njira yokhayo yotulukira, pakalibe mphamvu ya mankhwala ndiwofatsa. zinthu kuvomerezedwa ndi yabwino zotsatira za bwinobwino zimene wodwalayo komanso mosamalitsa ndondomeko ndi malamulo a asepsis ndi antisepsis pa mpheto.