Paravertebral anatseka misewu - ndichiyani?

Kucotsa ululu lumbar radicular ndi kutanthauzira zina tsopano monga mmodzi chovuta, koma ntchito yofunika kwambiri. Zochitika mgwirizano wa ululu, mungapeze mfundo za chikonzero cha mankhwala osankhidwa. Malinga ndi mfundo ano msana, ululu waukulu anaonekera mu miyendo m'munsi kapena msana ayenera kuchotsedwa mwamsanga. Mu kusintha mkhalidwe matenda aakulu angakhale psychogenic. Iwo layering pa zizindikiro wamba, ziletsa mankhwala ndipo kwambiri kumawonjezera madokotala ananena zawo. Pankhani imeneyi, akatswiri kuyesetsa luso logwiritsa ntchito yaifupi ngati n'kotheka ndipo nthawi yomweyo njira zothandiza. Mmodzi mwa anthu amenewo paravertebral anatseka misewu. Chimene icho chiri, mmene ikuchitika - pa lino nkhaniyi.

mwachidule

anatseka misewu achire amaonedwa njira zothandiza kwambiri kasamalidwe ululu, ndi zinthu zina pathologies ubongo. njira zochokera oyamba matenda ku likulu la mankhwala. Poyerekezera ndi njira zina zochizira (kutikita mankhwala thupi, kumwa mankhwala, kutema mphini, Buku mankhwala), ndi anatseka misewu ya mankhwala ntchito osati kale - osapitirira zaka zana. Komabe, kwa nthawi zonse njira asonyeza kuti ndi njira yabwino kwambiri kuthetsa ululu. Kuti cholinga cha anatseka misewu ya. ululu ayenera analankhula mwachilungamo msanga, ndi osachepera mavuto, nthawi ndi ndalama zakuthupi. zinthu izi kwathunthu kutsatira ndendende njira ya achire anatseka misewu.

mafotokozedwe

Anatseka misewu ndi shutdown zosakhalitsa imodzi mwa mfundo za Arc ululu ayankhe. Komanso achire, njirayi imakhala ndi phindu matenda. Nthawi zina, katswiri amavutika kupanga matenda zolondola. Izi zikhoza kukhala chifukwa chakuti mawonetseredwe matenda ali lingafanane kapena ayi bwino anati ubale zizindikiro ndi deta cholinga. Nthawi zina zimachitika kuti zizindikiro ubongo si anatsimikizira ndi Kujambula. Kapena M'malo mwake, mmene CT kapena chapamwamba kwambiri si kukomoka wolungama. Zikatero, n'lothandiza kwambiri pokhazikitsa ndi matenda zolondola adzakhala kusankha anatseka misewu.

Features

Ngati ululu yafupika mwa mankhwala ochititsa dzanzi pokha nyumba anatomical, izi zikusonyeza kuti iwo ali gwero la zowawa. Ena jekeseni kusankha ikuchitika pa malo enaake. Izi zipangitsa m'dera mankhwala ochititsa mitsempha kuti amapereka malo yake. Adaponya zikhoza kupangidwa ndi mu gawo anatomical, mwachitsanzo, olowa kapisozi kapena olowa. Chifukwa cha nociceptors oletsedwa m'dera lino. Ngati, kuwonjezera pa mankhwala ochititsa m'dera anawonjezera kuti corticosteroids, kusankha jekeseni mu Zikatero amapereka zotsatira yaitali achire wa mankhwala ochititsa dzanzi. Intraarticular jekeseni wa mankhwala kumachepetsa kutupa ndi kuchepetsa kusapeza kugwirizana nazo. jakisoni oterowo ntchito pamene malo salabadira zotsatira za makolo - zina, mankhwala mankhwala thupi. The anatseka misewu imagwiranso myositis, radiculitis, neuralgia, sympathalgia. Kuwonjezera kuti ululu atazikocheza, amalembedwa kusintha ntchito neuro-trophic.

ubwino wochita

Rapid isanayambike mpumulo amaperekedwa ndi malowedwe mwachindunji mankhwala chidwi ndi pathological ndi zotsatira za mankhwala pa mapeto ndi mawaya, kufalitsa ululu. Pa ndondomeko mosavuta mavuto ali chabe. Ichi ndi chifukwa chakuti kamodzinso mankhwala likulowerera choyamba mu kudwala wa moto, ndi pamenepo pokha - mu makope zokhudza zonse. Ndi aliyense exacerbation watsopano wa matendawa akhoza kugwiritsidwa ntchito mobwerezabwereza wazingidwa. Khalani okhazikika zabwino achire zotsatira za jekeseni. Pogwiritsa ntchito anatseka misewu amachepetsa minofu mavuto, mtima kuphipha, kuchotsa yankho yotupa mu ululu ndi kutupa moto.

paravertebral anatseka misewu

Mfundo imeneyi tiyenera kuziganizira pamodzi. Mawu akuti limasonyeza yekha kuti jekeseni wa ikuchitika pafupi ndi ndime msana. Jakisoni kungakhale intradermal, subcutaneous, perineural, mu mnofu kapena radicular. Nthawi zina, paravertebral anatseka misewu ntchito pa ganglia ya kumalire wachifundo thunthu. Mwachitsanzo, wodwala flattened litayamba. Iwo amatchuka mgwirizano wa vertebrae moyandikana ndi kuchepetsa m'mimba mwake ofukula za foramen intervertebral. Mbali zapambuyo phindu ukuwonjezeka chifukwa chitukuko cha osteophytes ndi zophuka ena fupa. Kuchepetsa awiri a mdzenje zidzachitika spondylarthrosis chitukuko, thickening chikasu, Mitsemphayi interarticular ndi njira zina chifukwa osteochondrosis. Chifukwa chakuti chikhalidwe kutsogolera matenda a ubongo nthawi yomweyo ndi psinjika ndi mkwiyo wa chingwe, koma osati opatsirana ndi yotupa zochita nembanemba ndi mizu, njirayi imatchedwa funikulitom kudwala. Kuchokera pa anatseka misewu imeneyi umagwiritsidwa paravertebral funikulyarnogo. Medicaments kutumikiridwa ndi singano kunja kwa tizibowo zofunda zone chingwe, koma msana muzu chingwe.

Gawo

Achire jakisoni anawagawa mitundu monga mankhwala komanso kukhudzana m'dera ntchito. Choncho, pali:

• Paravertebral anatseka misewu ya msana khomo lachiberekero.
• Majekeseni ndi intercostal neuralgia.
• Thoracic paravertebral anatseka misewu.
• Piriformis.
• Pa mlingo lumbosacral.
• Sciatic mitsempha ndi ena.

Ntchito glucocorticoids

Paravertebral ndi blockage "diprospanom" ntchito zokhudza zonse collagenosis. Mankhwala pa mlingo ma, relieves chitukuko kutupa. Pamaso m'dera makonzedwe pafupi ndondomeko spinous anadula dzanzi: mankhwala "lidocaine wa" kapena "Novocaine". Kenako, singano m'malo ndi wautali ndi thicker ndi kutulutsa analgesia kwa Chipilala vertebral. Kenako, osakaniza anali jekeseni ndi mankhwala ochititsa mankhwala "Diprospan". Contraindications kwa ndondomeko monga a shuga, thrombosis, kufooka kwa mafupa anasonyeza mkati psychosis, hypersensitivity, matenda kudwala.

Kugwiritsa ntchito mankhwala ochititsa

Paravertebral novocaine chipika ndi ndondomeko, akamanena za amene ali kuyambitsa mankhwala mu zone ya ululu kwambiri. Mwachindunji, mbali zoterozo monga mfundo choyambitsa pamene lomwa mafupa ndi minofu ndi mavuto, misempha kudutsa m'madera ndi malo plexuses awo. Paravertebral anatseka misewu ntchito zotsatira mankhwala ochititsa angapereke yochepa (20-30 Mphindi). Komabe, ngakhale nthawi imeneyi yokwanira yambitsa mawu yachibadwa minofu chonsechi.

Mphamvu ya ndondomeko ndi contraindications

Mphamvu ya kuchotsa kuphipha kuwonetseredwa mu mnofu CHIKWANGWANI kukula voliyumu ya galimoto mu olowa, kuchepetsa ululu tilinazo kwanuko mwamphamvu kapena gawo la mitsempha muzu innervation. Osavomerezeka paravertebral anatseka misewu njira zomwe zili m'munsizi ndi bradycardia aakulu syndrome kufooka mu mfundo nkusani, atrioventricular chipika wachiwiri / madigiri chachitatu (kupatula amadwala kumene AKUYENDA yamitsempha yamagazi analowa kafukufuku), cardiogenic mantha, hypotension (kutchulidwa), hypersensitivity . Contraindications monga kupezeka kwa deta pa zopweteka epileptiform mu mbiri chikwiyire ndi dzanzi, komanso kuphwanya ntchito chiwindi.

Development wochita

Kodi paravertebral anatseka misewu? Njira ntchito kumaphatikizapo wozengereza mwai mu ndondomeko yeniyeni. Wodwala koyamba anaika pa pamimba. palpation njira kumatanthauza gawo la zowawa zambiri. Childs, dera lino limafanana ndi ziyerekezo wa chingwe, ndi amene akhudzidwa kwambiri. Ntchito ngati mayesero a ubongo kuthandiza kukhazikitsa malo adzakhala paravertebral anatseka misewu. njira jekeseni ayenera bwino anakamba ndi katswiri.

chiwembu amaliona ndi mowa kapena ayodini. Kugwiritsa ntchito singano chabwino mu zone ya akufuna jekeseni jekeseni mankhwala ochititsa ( "Novocaine") kupanga "ndimu peel". Pakuti chiyerekezo gawo la chachiwiri chingwe kuchoka singano (yaitali) umayamba pafupi ndi mzere wa njira spinous (pa mtunda wa masentimita 3-4) mogwirizana ndi imeneyi ankafuna. Monga ikuchitika yatsoka jekeseni 0.5% njira "Novocaine". The singano ndi anaikapo mpaka izo zifika ku kukhudzana ndi ndondomeko yopingasa. kayendedwe Komanso anagwira anyalanyaza izo m'munsi kapena kuchokera pamwamba pa malangizo kwa msana pa makona a madigiri 30. ndi kulemekeza ndege sagittal. singano ndi anaikapo ndi masentimita wina 2 kwambiri ndipo 10-20 ml ya mankhwala ochititsa ndi jekeseni kapena hydrocortisone emulsion. Choncho, ambiri unachitika paravertebral anatseka misewu. kuchita njira kumafuna kulowetsa singano ambiri 5-6 cm.

Nthawi pachimake

Pali njira zingapo imene ikuchitika paravertebral anatseka misewu. m'dera Lumbosacral amaona kuti m'malo mabvuto, makamaka ululu waukulu komanso kusowa syndrome bwino monoradikulyarnogo. Pankhani imeneyi jekeseni ogwira mfundo zitatu. Chiyambi imagwiridwa pakati pa vertebrae ndi Liv lv, lv ndi S1 m'chigawo cha bowo loyamba sacral. Jekeseni mankhwala "Hydrocortisone" ndi madera awa chifukwa cha kuvulala ambiri zingwe zake msana. Wodwala amaganiza paravertebral anatseka misewu angathe kuperekedwa. Lumbosacral anadula Pankhaniyi mfundo zisanu. Malinga ndi chikhalidwe cha wodwala, mphamvu ndi kutanthauzira ululu Mlingo yosiyanasiyana ya mankhwala "Hydrocortisone" ntchito. Ponena mwachidule kuti chingwe chimodzi (1 jekeseni) pogwiritsa 10-30 mg. Ndi kukhazikitsa olondola a ndondomeko yafupika kapena inathetsedwa ululu yomweyo pambuyo kumayambiriro medicament. Anatseka misewu Mungathe kubwereza ngati n'koyenera. Mobwerezabwereza jakisoni mwina palibe kale kuposa masiku 2-3. Pambuyo ndondomeko analimbikitsa ndi mtima bedi zina.

njira zina

Wodwala akutenga malo a atagona pa mimba yake. mutu wake zikuyenera ziziperekedwa kwa mbali ina ya munda, kumene idzakhala nthaŵi paravertebral anatseka misewu. Khomo lachiberekero msana imatengedwa kuti ndi malo ambiri avundulidwe. Pa nkhani imeneyi, woyendera nthambi izi kawirikawiri anavulala ena. Pa ndondomeko ntchito 0,25% mankhwala ochititsa yankho pa mlingo wa 70-100 mg. The singano jekeseni ndi anaikapo perpendicular pamwamba khungu pafupi ndi malire kunja kwa extensor kumbuyo. kayendedwe Komanso chikuchitika pamaso kukhudzana ndi linkawonongeka kuonongeka kapena ndondomeko yopingasa. The singano chimatsatira masentimita 0.5-1 mu mbali. jakisoni wotsatira zimagwiridwa pa mtunda wa 1.5 masentimita ya anthu m'mbuyomo. Nthawi zina, chisakanizo cha mankhwala "Novocaine" ndi "Hydrocortisone". Last kutenga 50-75 mg wa woyamba kusintha kwa 100 ml.

Kugwiritsa ntchito zosakaniza Afonina

Iyi ndiyo njira ina lumbosacral paravertebral anatseka misewu. Gawo la chingwe kuchoka dzenje (intervertebral) ndi kutumikiridwa 1.5-8 mg. Buku okwana njira ranges pakati pa 30-80 ml. Mlingo zimadalira chiwerengero cha mfundo ntchito anatseka misewu ya. Njira achire chikuphatikizapo kusalola umodzi, ngati zotsatira amabwera msanga zokwanira. Ngati mmene limapezeka pang'onopang'ono, ndiye ntchito 2-4 mobwerezabwereza anatseka misewu. Aliyense wa jekeseni lotsatira ikuchitika masiku 5-6 pambuyo otsiriza. Pamene kutumikiridwa ndi kuleza mtima nacho zomverera osiyana mu innervation ziwalo ulusi mitsempha. Mwachitsanzo, wodwala angalandire kumverera kwa kulemera, paresthesia, kuthamanga, kupweteka ululu.