Egwuregwu mmerụ ahụ
1K 14 05.05.2019 (nke ikpeazụ edegharịrị: 01.07.2019)
Ọrịa Lumbar bụ ihe mgbaàmà kachasị emetụta nke na-eduga na nlekọta ahụike.
Isi ihe kpatara mgbu
Etiology nke lumbodynia dị iche iche. Enwere ike kpatara ya:
- ihe siri ike na ibu na-agbanwe agbanwe na lumbar vertebrae;
- ọkpụkpụ azụ ọrịa:
- osteochondrosis nke lumbar spine;
- protrusion ma ọ bụ herniated intervertebral discs;
- ọrịa na-efe efe (osteomyelitis, ụkwara nta, brucellosis);
- nrụrụ spondylosis;
- scoliosis, enweghị ọgwụgwọ lordosis na kyphosis;
- ọrịa ogbu na nkwonkwo;
- mgbaji ọkpụkpụ na mmerụ ahụ nke akụkụ vertebral;
- isi na metastatic neoplasms nke akụkụ vertebral;
- ankylosing spondylitis;
- ọrịa ogbu na nkwonkwo;
- akụrụ ọrịa:
- isi neoplasms;
- nnukwu pyelonephritis;
- ICD;
- atherosclerosis nke akụkụ afọ nke aorta na alaka ya;
- aortic na-ekewa aneurysm;
- mgbanwe ngbanwe agbanwe agbanwe na nkwonkwo hip;
- mbufụt nke akpụkpọ ahụ siri ike ma dị nro nke eriri afọ;
- nnukwu na eriri afọ mgbochi;
- atypical N'ezie nke nnukwu appendicitis;
- nnukwu nsogbu nke ọkpụkpụ azụ;
- ọrịa nke akụkụ pelvic, gụnyere akụkụ ọmụmụ:
- ọrịa endometriosis;
- cancer nke akpanwa;
- adnexitis;
- prostatitis;
- ọrịa prostate;
- STDs;
- ọrịa nke tract digestive (ọtụtụ pathologies site na eriri afọ, imeju, gallbladder, pancreas).
Mgbu mgbu
A na-eme usoro nhazi nke ọrịa na-adabere n'ụkpụrụ ndị a na-ewere dị ka ihe ndabere. Ọ nwere ike ịbụ dị ka:
- etiological ịrịba ama:
- isi (kpatara site na isi mgbanwe nrịanrịa na vertebrae) - protrusion na hernia nke disks intervertebral;
- nke abụọ (n'ihi ọrịa nke akụkụ na sistemụ, nke sitere na ya bụ lumbodynia) - ICD, LCB.
- oge nke dị:
- nnukwu (ruo izu 12);
- adịghị ala ala (karịa izu iri na abụọ);
- njikọ na ihe na-akpasu iwe:
- ozugbo (mmerụ ahụ);
- egbu oge (azụ mgbu mgbe iri nri abụba na ọrịa gallstone);
- ogo nke ngosipụta:
- akpọ:
- agafeghị oke;
- mpaghara:
- topographically kwekọrọ na ọnya;
- na-agagharị ma ọ bụ na-awagharị awagharị;
- Clinical foto:
- mmegbu;
- na-akụda;
- agbagbu;
- agbapụ;
- ịcha;
- gbara okirikiri;
- na-ere ọkụ;
- onye nzuzu;
- mkpakọ
Gbuo mgbu
Ihe a na-ahụkarị maka nnukwu pancreatitis, cholecystopancreatitis, cholelithiasis, nnukwu cholecystitis na intercostal neuralgia. Site na imebi imeju na pancreas, ihe mgbu nwere ike ịmịpụ n'akụkụ obi.
Cholecystitis ma ọ bụ pancreatitis anaghị adịkarịpụrụ iche. Ọtụtụ mgbe, a na-agwakọta ọrịa ahụ ma na-ewere àgwà nke cholecystopancreatitis. Mmetụta obi ilu na ọnụ, yana mmetụta na-adịghị mma na hypochondrium kwesịrị ekwesị, nwere ike ịbụ ihe ịrịba ama dị iche.
N'iburu oke nke ọrịa na-enweghị ike ịkọwa ọrịa n'oge ngosipụta nke ihe mgbu nke ụdị shingles, a ga-eji antispasmodics (Papaverine, Platifillin) belata ya. Ọ gaghị ekwe omume iji NSAID (ndị na-abụghị steroidal analgesics) n'ihi eziokwu ahụ bụ na ojiji ha nwere ike ịgbanwe ihe mgbaàmà ahụ ma mee ka nchoputa ahụ sie ike.
Nchoputa nke mbu
Iji mee nyocha mbido, a na-eji ọtụtụ nyocha nyocha:
Lumbosacral osteochondrosis na-anwale | |
Aha nrịbama | Nkọwa |
Ekene | Mgbe akwara nke uru ahụ nke afọ na-agwụ ike, ihe mgbu na mpaghara lumbar na-abawanye. |
Neri | Site na ihulata dị nkọ tupu ị kpọtụrụ obi dị n'azụ ala, ihe mgbu na-abawanye. |
Lọ Lasegue | N'ebe a na-adọkpụkarị, ị kwesịrị ịtụgharị iji bulie ogologo ụkwụ. Site na lumboischialgia, ihe mgbu ga-abawanye ma na-enwu n'akụkụ akwara sciatic nke akụkụ homolateral. |
Lorrey | Mgbe ị na-anọdụ ọdụ site n'ọnọdụ dị mfe na ụkwụ kwụ ọtọ, ihe mgbu megide ndabere nke lumboischialgia ga-abawanye tinyere akwara sciatic. |
Onye kpọtụrụ
Ọ bụrụ na amaghị ihe kpatara mgbu ahụ, a ga-enyocha dọkịta. N'ihe banyere etiology doro anya, ka ndị ọkachamara dị warara, dịka ọmụmaatụ, na ọkachamara n'ọrịa ụmụ nwanyị (ihe mgbu na-ebilite n'afọ nke abụọ nke afọ ime) ma ọ bụ onye na-agwọ ọrịa akwara (enwere ihe ngosi nke hernia intervertebral na anamnesis).
Ọtụtụ mgbe, onye na-ahụ maka ọgwụ na ndị na-agwọ ọrịa na-etinyekwa aka na ọgwụgwọ mgbu dị ala.
Nleta dọkịta, nyocha na nyocha
Nchoputa a siri ike n'ihi nonspecificity nke mgbaàmà ya na polyetiology. Nchịkọta anamnesis zuru ezu, nyocha gbasara mkpesa nke onye ọrịa, yana nyocha ya zuru oke ka achọrọ.
N’etiti ụzọ nyocha ụlọ, nnwale ọbara na mmamịrị nke mmiri ọgwụ na mmiri, yana ule ọbara maka nrịbama etuto, kwesịrị ịkpa oke.
Researchzọ nyocha akụrụngwa kachasị eji eme ihe gụnyere usoro X-ray na usoro endoscopic, ultrasound nke oghere afọ na ohere ịla azụ, CT na MRI.
Usoro ọgwụgwọ
Atụmatụ na usoro ọgwụgwọ dabere na nchoputa. E kewara ha na:
- mgbanwe:
- na-a medicationsụ ọgwụ (NSAIDs, vasodilators, ndị na-eme ahụ ike na-ahụkarị, chondroprotectors, vitamin B, ọgwụ ndị na-agwọ ọrịa steroid, wdg) n'ụdị:
- ude mmanụ;
- mbadamba na capsules;
- injections (mgbochi paravertebral);
- FZT:
- na-ekpo ọkụ (dị irè na ogbo nke nhazigharị na traumatic aseptic pathologies);
- cryotherapy (dị irè na nnukwu akụkụ nke aseptic mbufụt, dịka ọmụmaatụ, na trauma);
- Mmega mmega (usoro omume emere iji mepụta sistemu ogwu);
- ịhịa aka n'ahụ;
- usoro ọgwụgwọ;
- na-a medicationsụ ọgwụ (NSAIDs, vasodilators, ndị na-eme ahụ ike na-ahụkarị, chondroprotectors, vitamin B, ọgwụ ndị na-agwọ ọrịa steroid, wdg) n'ụdị:
- arụ ọrụ (neoplasms, ihe ịrịba ama nke mkpakọ site na intervertebral hernias nke eriri afọ, wdg).
B Yakobchuk Olena - stock.adobe.com
Mmega mmega, mmega
Ọnọdụ mbụ | Ngosiputa mmega |
Dina n'azụ gị | Bilie ogologo aka ekpe na aka nri n'aka nri, na-ejide ibu maka 10-15 sekọnd.
|
Dina n'azụ gị | Bido ikpere gị n'akụkụ aka nri, na-ehulata n'aka nri na n'akụkụ aka ekpe ruo mgbe ọ kwụsịrị. |
Guzo | Jiri ire ụtọ gbagoo dị iche iche (azụ azụ).
|
Na-eguzo na ụkwụ anọ | Ngabiga n'otu oge ya na aka ya dị iche iche (aka nri na aka ekpe).
|
Gluteal akwa | Zụlite pelvis site na ọnọdụ ike.
|
"Akwa" | Bend gị azụ, na-agbalị idozi ahụ na ọnọdụ a.
|
Na ihe mgbu na mpaghara lumbar, igwu egwuregwu bụ ihe na-adịghị mma n'ihi nnukwu ohere nke trauma ọzọ na nkwonkwo intervertebral n'ihi mmegharị na mberede (volleyball, football).
A na-egosipụta ejiji nke bandeeji na mpaghara lumbar, ọkachasị mgbe a na-atụ anya ibu dị oke elu ma ọ bụ na-atụ egwu.
Obere ihe mgbu na-eme egwuregwu
Ọkpụkpụ azụ nke ndị na-eme egwuregwu na-ahụ nnukwu ọrụ axial, ntụgharị na nrụgharị, nke na-ekpebi etu esemokwu dị. A na-achọpụtakarị ya:
- na-agbatị ngwa musculo-ligamentous nke lumbar vertebrae;
- spondylolysis (nkwarụ na njiko nke vertebra, nke a hụrụ na egwuregwu mmega ahụ, osisi vaulters, ndị na-agba bọl);
- sondylolisthesis (ukwu nke vertebrae metụtara ibe ya);
- osteocondritis nke spain;
- hainia na ntanye nke disks intervertebral;
- kyphosis na-eto eto nke Scheuermann-Mao;
- scoliosis.
N'iburu nnukwu ihe mmerụ ahụ, ndị ọkachamara na-eme egwuregwu kwesịrị ịdị na-enyocha mgbe niile. Mgbe achọpụtara ihe ọmụmụ, onye dọkịta na-abịa nyere iwu ka usoro ọgwụgwọ ahụ wee bụrụ nke ya.
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