Kev kho mob ntawm ib tug herniated disc (lumbosacral nqaj qaum). Phais kom tshem tawm cov herniated disc

Teeb meem nrog cov nqaj qaum ntawm ntau cov neeg muaj kev txhawj xeeb. Ib txhia ntawm cov zog ua hauj lwm tsim xws li ib tug lub xeev raws li intervertebral hernia ntawm lumbosacral nqaj qaum.

Yuav ua li cas yog nws?

Herniated disc yog feem ntau hu ua ib tug loj mob uas muaj ib tug xaav ntawm lub intervertebral disc ntawm cov nqaj qaum dav hlau. Feem ntau cov feem ntau, tus mob no yog tshwm sim los ntawm ntau ntau tab kaum rau cov nqaj qaum.

Txom nyem los ntawm tus kab mob no feem ntau cov txiv neej nyob nruab nrab ntawm lub hnub nyoog ntawm 20 mus rau 50 xyoo.

Cov xwm txheej ntawm cov kab mob no yog hais txog 100 tus neeg mob ntawm 100,000 tus pejxeem ib xyoo.

Feem ntau ntawm cov ntaub ntawv hernias tshwm sim vim lub cev overload ntawm cov nqaj qaum raws li ib tug tshwm sim ntawm txoj hauj lwm. Tej zaum puas hernia tom qab kev phais rau cov nqaj qaum los yog raws li ib tug tshwm sim ntawm lub yeej. Feem ntau yeej tsis, tab sis muaj congenital txha caj hernia.

Cov neeg laus yog lub npe hu tus neeg mob ntawm hernia nyob rau tom qab ntawm muaj sia muaj zog ntawm lub ligaments ntawm cov nqaj qaum.

Qhov siab tshaj plaws loj heev muaj intervertebral hernia ntawm lumbosacral txha nqaj qaum, vim hais tias lub duav rov sauv yog lub feem ntau yooj yim rau qhov chaw rau txoj kev loj hlob ntawm tus kab mob no.

Lub pathogenesis ntawm herniation

Nyob rau hauv tus ntawm ib tug siab tab kaum rau cov nqaj qaum, muaj yog ib tug gradual compression ntawm lub intervertebral disc. Vim hais tias ntawm no, feem ntau nws tshwm sim kev sib tawg disk ntug txheej (txheej annulus fibrosus), uas tshwm sim tom qab lub intervertebral disc txheem tso zis rau sab nraum.

Sprouted nucleus pulposus yuav ceev raws li lub hauv cov leeg nrob kwj dej, thiab nyob rau hauv lub sab ntawm nws. Nyob rau hauv thawj rooj plaub uas nws muaj pinching ntawm cov leeg nrob qaum, uas yuav ua tau kom irreversible txim. Nyob rau hauv lub thib ob cov ntaub ntawv tej zaum yuav tsim radicular syndrome vim compression ntawm qab haus huv tawm ntawm cov leeg nrob qaum. Nyob rau hauv qhov chaw ntawm compression aseptic o npaj, muaj yog ib tug o ntawm lub surrounding ntaub so ntswg, uas ntxiv worsens qhov teeb meem no.

Raws li ib tug tshwm sim, rau ib tug herniated disc yog yus muaj los ntawm cov tsos mob ntawm radicular syndrome (mob, piav thoob hlo poob thiab povtseg muaj nuj nqi). Thaum lub sij hawm, lub muaj kev zoo nyob rau hauv cov leeg nrob kem.

Raws li yuav pom, ib qho chaw uas feem ntau tshwm sim intervertebral hernia - lumbosacral. Kev kho mob yuav tsum tau muab sai li sai tau, sai li sai raws li nws thiaj paub tias yog slipped disc.

kev kho mob

Nyob rau hauv txhua rooj plaub, koj yuav tsum tam sim ntawd pib kev kho mob ntawm ib tug herniated disc. Lumbosacral tus txha nqaj ua ib tug tseem ceeb heev muaj nuj nqi ntawm lub cev - tshuav nyiaj li cas txij nkawm thiab overlying lub cev upright. Nrog rau txoj kev loj hlob ntawm ib tug hernia nyob rau hauv lub lumbar cheeb tsam mus nqa tawm no muaj nuj nqi yuav ntau npaum li cas yooj yim vim hais tias ntawm qhov khaus mob uas tsim nyob rau hauv hlab compression. Mob worsens untimely txaus siab mus rau cov kws kho mob.

Thaum tus thawj tsos mob yuav tsum tam sim ntawd pib kev kho mob ntawm ib tug herniated disc. Lumbosacral nqaj qaum teb zoo mus uas tsis yog-pharmacological kev ua xws li kev siv cov orthopedic txaj, massage, siv ntawm no compresses. Cov kev muaj ib tug txhob txwm symptomatic orientation (los pab txhawb rau tus neeg mob tus mob) thiab tsuas yog rau ib tug thaum nyob rau hauv kev txiav txim kom tsis txhob muaj qhov teeb meem ntawm ib tug hernia yuav siv tau. Thaum lub xeev ntawm exacerbating ntshaw kom sai li sai tau ua ib lub sij hawm mus rau ib tug neurologist.

tshuaj

Yog hais tias, txawm li cas los, nws tsim ib tug intervertebral hernia, yuav ua li cas los kho nws, thiaj li tsis ua mob rau koj lub cev? Rau lub hom phiaj no, anti-inflammatory siv tshuaj los ntawm cov pab pawg neeg uas tsis yog-tshuaj cov neeg ua hauj. Cov feem ntau lug siv tshuaj pleev, cov gels thiab cream. Nyob rau hauv lawv cov qauv muaj feem ntau "Diclofenac" ( "Rumakar", "Dikloberl"), "Indomethacin" ( "indomethacin", "Rumatsid"). Lub concentration ntawm cov tshuaj nyob rau hauv cov chaw tso cai thim mob mob heev thiab o (tab sis tau txais tib yam koob tshuaj tshuaj hauv tej zaum yuav tsis muaj lub Desired nyhuv, raws li zoo raws li pab mus rau txoj kev loj hlob ntawm pais plab ulcers thiab 12 duodenal rwj).

Tej zaum ib tug ua ke ntawm cov tshuaj anti-inflammatory siv tshuaj nrog glucocorticoids.

Glucocorticoids tsa yog hais ntawm ncauj los yog intravenously rau lub hais kev kawm tau ntawm cov nyhuv. Siv cov tshuaj xws li "Prednisolone" thiab "Dexamethasone". glucocorticoid kev kho mob yuav tsum tau tshuaj tsuas yog tom qab ua hauj lwm ntawm narcotics yuav muab, raws li lub caij nyoog siv corticosteroids coj lub cev tsim kev mob ntau tshaj kev zoo.

Lub cev txoj kev kho nyob rau hauv cov kev kho mob ntawm hernias ntawm cov nqaj qaum

Qhov thib ob siab tshaj plaws zaus ntawm kev siv yog physiotherapy herniated discs. Lumbosacral nqaj qaum yog ib yam ntawm cov feem ntau mus siv cuag qhov chaw ntawm lub licas rau kev siv ntawm ntau yam pab kiag li lawm.

Raws li rau ntau tshwj xeeb, physiotherapy yuav ua rau kom ntau sai rov qab dua nrog tshuaj.

Cov tam sim no feem ntau zoo kev kho mob rau intervertebral hernias yog siv multifunctional electrodes. Lub essence ntawm no txoj kev - tuaj interrupt mob impulses los ntawm txoj kev radiofrequency tsis.

Ntawm qhov ntau zoo-paub txoj kev uas feem ntau siv electrophoresis nrog analgesics, tshuaj da, laser kho. Electrophoresis thiab phonophoresis cia kom xa cov tshuaj ncaj qha mus rau hauv cov leeg nrob kem. Cov nyhuv yog feem ntau pom twb tom qab ib tug ob peb txoj kev kho mob.

Relaxing kub da dej nyob rau hauv tej rooj plaub tej zaum yuav ua rau kom txawj reposition ntawm lub hernia nyob rau hauv qhov chaw.

Yog hais tias muaj yog ib tug deterioration, nyob rau hauv cov kev phem ntawm kev tu ncua kev, yog li nyuab kab mob intervertebral hernia. Yuav ua li cas mus kho nws nyob rau hauv no qhov teeb meem no?

Phais kho mob ntawm intervertebral hernia

Nrog rau cov ineffectiveness ntawm conservative kev kho mob siv los yog thaum ib tug mob loj heev neurological cov tsos mob (tuag tes tuag taw ntawm nqua, tso zis thiab defecation mob, paresis, paresthesia, mob mob heev, mob nyob rau hauv lub rov qab nto lub sab nqua) yuav tsum tau pib tam sim ntawd phais.

Indications rau lub mob kev kho mob ntawm tus txha caj qaum yog pinching, compression hlab ntsha dua nyob ze.

Cov kev kho mob yog dua li nqa tawm nyob rau hauv tshwj xeeb phais departments (feem ntau nyob rau hauv neurosurgery).

Ntawm cov siv txoj kev kho mob yog cov ob lub ntsiab pawg - endoscopic phais thiab cov pa microsurgery.

Nyob ntawm seb yuav ua li cas tus kab mob tshwm sim, txiav txim tactics ntawm online saib.

Kev kho mob tas ua nyob rau hauv kev tshuaj loog thiab nrog rau cov kev pab txhawb nqa ntawm yooj yim tseem ceeb heev functions.

microsurgical tshem tawm

Ua ntej mus rau lub kev taw qhia ntawm rub kom pom nyob rau hauv kev kho mob xyaum, yog hais tias nws tau pom tias kev phais kho mob ntawm herniated discs, lumbar-sacral nqaj qaum yog feem ntau raug rau ntau yam teeb meem nyob rau hauv lub postoperative lub sij hawm (rwj, recurrent). Qhov tiag kiv puag ncig yog siv cov kho qhov muag pab kiag li lawm nyob rau hauv kev kho mob ntawm hernias. Qhov no txo lub vastness ntawm ceev mus saib, uas significantly txo cov xwm txheej ntawm cov teeb meem.

Nyob rau hauv feem ntau tus neeg mob, herniation ntawm intervertebral sacral muab tshem tawm los ntawm ib tug me me seem (tuav laminectomy). Nyob rau hauv high magnification nws yuav tau maj mam tshem tawm cov hernial protrusion tsis ua kom cov uas nyob ib sab lwm ntaub so ntswg.

Activating tus neeg mob pib hnub tom qab. Rau txhua txhua hnub kev ua ub no rau tus neeg mob yog tau tso cai nyob rau hauv 10 hnub, thiab ib lub hlis tom qab ntawd nws yuav tau ua ceev zog tsis muaj txoj kev pheej hmoo ntawm cov teeb meem.

endoscopic phais

Cov hauj lwm kom tshem tawm cov herniated disc yog ib tug tshiab kuj sib nyob rau hauv neurosurgery. Ntau zaus tshaj tsis lawv ua los ntawm ib tug posterolateral endoscopic mus kom ze. Qhov zoo ntawm cov kev yog txawm ntau dua kev ruaj ntseg nyob rau hauv cov creation ntawm lub phais mob (tej zaum ua tej tawv nqaij tej). Txawm li cas los, nws yog ob lub ntsiab disadvantage - nyob rau hauv cov ntaub ntawv no yog tas rau cov tau ua kom tiav excision ntawm lub hernia thiab tshem tawm nws los ntawm qhov tej cheeb tsam. Nyuaj hernia, los yog hernia, nrog los ntawm compression ntawm cov leeg nrob qaum yog tsis muab tshem tawm los ntawm cov hauj lwm.

Tus neeg mob tej zaum yuav muaj nyob rau hauv lub hnub thaum lub lag luam yog nqa tawm, nce, taug kev. Ua hauj lwm yog tso cai txog ib lub lim tiam tom qab tawm hauv tsev kho mob.

teeb meem ntawm hernia

Thaum lub sij hawm, yog hais tias tus hernia pib hlob lub tom ntej no lwm cov ntaub so ntswg tej zaum yuav tsim teeb meem.

Yog hais tias tsim ib qho hernia (intervertebral), lumbosacral kiag loses nws muaj nuj nqi, thiab tus txha caj qaum kev puas tsuaj muaj cai. Tag nrho cov zuj zus thaum lub xaav nyob rau hauv cov kev taw qhia ntawm ib tug hernia ntawm cov leeg nrob kwj dej.

Cov feem ntau txaus ntshai ntawm lawv yog pinching hauv cov leeg nrob qaum. Nyob rau hauv cov ntaub ntawv no ua txhaum tso zis thiab defecation zog, uas poses ib tug kev hem thawj rau lub neej (kev kawm mus rau mob hnyav qaug cawv, ruptures lub zais zis, plob tsis so tswj thiab zis). Nyob rau hauv tas li ntawd, yog hais tias tus mob mus txog rau hauv cov leeg nrob qaum, thiab tej zaum yuav raug nyob rau hauv lub overlying departments nyob rau hauv yuam cai ntawm lub zog ntawm hauv nruab nrog cev, xws li kev tuag.

Lwm heev mob hernia yog radicular syndrome. Nrog heev hav zoov ho worsens tus mob.

Teeb meem muaj ntau paaj txo nyob rau hauv rhiab heev thiab paresthesias.

Rehabilitation thiab kev tiv thaiv

Yuav kom tsim ib tug hernia yuav tsum tau ib lub sij hawm (t. E. Nws yuav arbitrarily hu ua kab mob). yuav tiv thaiv tau nws txoj kev loj hlob thaum saib yuav tsum muaj tswv yim pom zoo.

Yuav kom tiv thaiv tsis tshua mob heev tom qab tshem tawm ntawm herniated discs, nws yog tsim nyog los txaus faib lub load thaum lub sij hawm lub cev qoj ib ce. Koj yuav tsum tsis txhob overreach, vim hais tias nws yuav xaus phem heev.

Tsis tas li ntawd pom zoo rau cov kev tiv thaiv ntawm hernia nqa tawm lub cev kev kawm thiab ce uas ntxiv dag zog rau npag thav duab ntawm lub rov qab (xws li cov deadlift nrog tsim nyog loads).

Thaum qhov ntev thiab zog ua hauj lwm nyob rau hauv thiaj li yuav tiv thaiv kom txhob nws yog pom zoo kom mus coj ib tug relaxing dab dej kub - lawv pab txhawb kom muaj ib tug me ntsis sib xws pob txha caj qaum los tiv thaiv cuam tshuam ntawm cov disc nruab nrab ntawm lawv.

Rehabilitation tom qab niaj hernia tsis txhob nyuaj siab, qoj ib ce kho, massage thiab phau ntawv txoj kev kho kev kho mob los yog acupuncture.