Lesapo la mokokotlo thibela likepe: mefuta e, morero, lithethefatsi, liphello tsa

Bohloko syndrome, ke pontšo e ka sehloohong ea ho bolwetse ea tleleniki ea tsamaiso ea musculoskeletal, haholo-holo lesapo la mokokotlo. The ketsahalo e ea bohloko hlobaetsang vertebral lokela ho emisa ho tsona hang-hang, esita le fuoa ha e le hantle hore u loane le soreness e seng e bakang phekolo. The thibela likepe la mokokotlo - e mong oa liketsahalo tse ileng tsa o ile a nka sebaka ea ho phekola e rarahaneng ya mathata lesapo la mokokotlo.

bopa dikgopolo tsa kakaretso

Tseo setsebi boima le ho feta hore ba khaotse ho bohloko bo sa foleng, a hlobaetsang le bohloko ba ho feta ka morao, hobane bontshiweng qala ho ba le botho ba bohareng. Ke hore, a tsitsinkela liponahatso tsa bohloko e sa thehoa ka boemong ba nyakallo ea receptors moo le bokong. Kalafo ea boemo ena e sa le hloka ho sebelisa antidepressants le neuroleptics.

Ho qoba sena, bontshang matshwao phekolo ka mekhahlelo ea pele ea lefu lena le sebedisa mellwane kang thibela likepe lesapo la mokokotlo. Ke eng 'me se ea ka mokhoa o hlalosoa e mona ka tlase.

Thibela likepe bitsoa kenngwe ha kgokahanyo e 'ngoe ea mochine sa ho loantša bohloko ka ho sebelisa analgesics medicated. Ho phaella ho liphofu phekolo, lesapo la mokokotlo le literata e sebediswa bakeng sa ho fumanoe. Bohloko bo sa hlalosoang saeteng hloka ho qaloa ho thethefatsang, e leng lumella tshebetso ya ho ntsha ho fumana hore na lefapha ya malwetse. Ka tloaelo ho, bohloko e "lithuto tsa theoha" hang-hang ka mor'a mellwane ena.

ya litatoli na

Mafu a ea tsamaiso ea musculoskeletal, hlokang hore tshebediso ya thibela likepe, e lokela ho tsamaea le matšoao a bohloko. Tabeng bo fapaneng, ho sebelisoa ha meriana bakeng sa morero ona ha se tshwaneleha. Tsamaiso e khanna tlasa pathologies latelang:

• tlaase morao bohloko;
• ho ba teng ha herniated discs;
• spondylosis deformans;
• radiculopathy;
• sithabetsang mo ntša kotsi;
• neoplasms tsa sebaka sa intervertebral;
• lateral narrowing tsa kanale lesapo la mokokotlo.

Tsamaiso e etsoa ka Maemong a moo ho se nang liphello tsa kalafo mekhoa e tloaetsoeng. bokgoni ho fihla ka mor'a ente pele, leha ho le joalo, liforomo tse matla tsa mafu a hlokang ho tloha 2-3 ho mellwane 15 tšoareloa mekgahlelo ya matsatsi a 'maloa.

Melemo ea ho thibelloa hoo ha ba itima lijo tshebetso, bonyane ba litla-morao ha mabapi le melao ea, monyetla oa ho sebelisoa tse ngata. Ntle le analgesia, mellwane na-ba khahlanong le a hlabang le spasmolytic e le hantle, ho itšetlehile ka ea lithethefatsi khethileng.

Classification blockades vertebral

Ho itšetlehile ka palo ea lithethefatsi hlahiswa sethaleng se le seng, khetholla mellwane:

• monocomponent (tsela e 'ngoe);
• dikomponentnye (mahlahana a mabeli);
• multicomponent (mahlahana a tse tharo kapa ho feta).

Dipilisi liente li tsamaisoa ka karolong tse latelang anatomic:

1. lesapo la mokokotlo - thoracic, cervical, lumbar, sacrum.
2. Methapo - Sciatic, occipital, tibial, suprascapular, makala ka morao ya methapo lesapo la mokokotlo.
3. Muscular oona tsamaisong - mesifa ya hlooho, ho piriformis mesifa, ho boipelaetso litepising ka pele.
4. Epidural le epidural sebaka.
5. Tšobotsi manonyeletso.
6. Articulation - sacroiliac le sacrococcygeal.

Thibela likepe tsa hernia lesapo la mokokotlo arotsoe ka mefuta e 'meli:

1. Khetholleha vkalyvaniem transforaminal kenyelletso ea lithethefatsi ka lesoba tsoa methapo ea kutlo e qetellong.
2. Ha intralaminar Tsamaiso moriana o e kenngoa pakeng tsa dithulaganyo vertebral ka drive cartilaginous tobileng.

Contraindications

lesapo la mokokotlo thibela likepe na contraindications itseng hore ngaka e nka le mamello nakong eo ho hlahloba ka ho. E mong le e sebetsana le nyeoe ea tleleniki e nkoa e le batho ka bomong, ho ba le kotsi khoneha tsa litla-morao. Tsamaiso e sa atlehe tlas'a tse latelang e re lefu:

• mafu a, tse tsejoang ka tšekamelo ea ho ba hemorrhage;
• mafu systemic tšoaetsanoang le liponahatso ea moo ka sebaka sa tshebetso sa puncture ea;
• ilibane le mamello;
• idiosyncrasy sebelisoa meriana;
• pelo le vascular mafu;
• sethoathoa;
• hypotension;
• lefu la kelello;
• lilemo tsa bana;
• nakong ea bokhachane le ho diabolololo;
• diso manyolo ea sebete 'me liphio.

thethefatsang ea moo

Dintho tseo na le phello e analgesic, li sebelisoa bakeng sa mefuta eohle ea kwalwa ho sebelisa lithethefatsi ka foromo ikemetseng kapa hammoho le lihlopha tse ling tsa medicaments.

Novocaine thibela likepe la mokokotlo o etsoa hangata ho feta thethefatsa tse ling tsa moo. "Novocaine" hlahisoang ka sebōpeho sa tharollo bakeng sa ente le concentrations tse sa tšoaneng tsa motsoako a sebetsang a (ho tloha ho 0,25% ho 2%). Phello analgesic develops mor'a metsotso e seng mekae ka mor'a se thibela likepe ba ile phethahatsoa. Sepheo se ka ho sebelisa "Novocain" anaesthetises lihora tse 2.

"Marcaine" hape e sebelisoa ho imolla bohloko. Le ka lebaka la tsamaiso ea le moemeli na le morao e qale. Bohloko disappears mor'a metsotso e 20, empa ka nako ya bohato ka ba ho fihlela ho lihora tse la 5-6. Sebelisa "marcaine" e etsoa feela ka mor'a hore a hlahlobe ka ho phethahetseng ba pelo 'me mali a lijana tsa mokuli.

Latelang e thethefatsang kutlo ea moo, o ile a sebelisa ho loantša bohloko ba ho vertebral ke "Lidocaine". Theko ea lithethefatsi e ka sehlopha se tlaase-tlaase (ka bang 30 li-ruble ka pakete), etsa hore e be teng bakeng sa ho sebelisoa. moriana o le e tšoauoa ka bohato itime lijo 'me ka nako e telele ho feta "Novocaine".

"Novocaine" le "Lidocaine", theko ea eona e ho feta e teng, ho sebelisoa hangata ho feta thethefatsang tse ling tsa moo. Pele ho sebelisa leha e le efe ba bona ba ho sheba nahanela ba le mamello motho, ho thibela ntshetsopele ya kulisa.

mekhoa ea phekolo e hormonal

Litokisetso hormonal sebopeho ea ho phekola ba pathologies ba lesapo la mokokotlo ka mokgwa wa ho intša tsamaiso di ka seoelo sebelisa. Hangata ka ho fetisisa ba ho sebelisoa bakeng sa ho phekoloa manonyeletso. Thibela likepe la mokokotlo hloka corticosteroid hammoho le lithethefatsi tse ling tse (mohlala, meriana e thethefatsang kutlo). mahlahana hormonal fokotsa bohloko, cropped ruruha, fokotsa ho ruruha le kulisa.

Lithethefatsi sebelisoa ka lesapo la mokokotlo le:

1. "Prednisolone" e tsoakane le e mong oa lithethefatsi analgesic ( "procaine" "Lidocaine" "Novocaine"). Ka katleho a sebelisa ho thibela likepe tsa hernia lesapo la mokokotlo, radiculitis, osteochondrosis.
2. "Hydrocortisone" e sebediswa bakeng sa ho na le masakana methapo ea kutlo. Ka ho feletseng tsoakane le thethefatsa pele ho tsamaiso.
3. "Diprospan" e sebediswa bakeng sa mofuta ofe kapa ofe ea liphallelo e bohloko. Lithethefatsi molemo le ho itima lijo ntshetsopeleng ya phello ea bohato ka nako e telele.
4. Le bolela "Kenalog" empa-ba khahlanong le alejiki le-ba khahlanong le a hlabang, o na le phello immunosuppressive. E sebediswa bakeng sa mofuta ofe kapa ofe mapheko le kalafo ea manonyello.

lihlopha tse ling tsa lithethefatsi

ka mekhoa e meng le phello analgesic. Di le sebelisitsoe ka ho hlophisoa ha kwalwa multicomponent le kenyeletsa lihlahisoa tse latelang:

• bao e seng steroidal-ba khahlanong le a hlabang ( "Voltaren");
• livithamine B;
• enzyme ( "Lidaza" "papain");
• "ATP";
• antispasmodics ( "Platifillin");
• "Trombolizin";
• hondroprotektory ( "rumalon").

Mohlala oa Tsamaiso ea

Nahana ka mohlala oa mellwane. Novocaine thibela likepe tsa lumbar lesapo la mokokotlo e phethahatsoa ka boemo ba le tsekamelo ea. Palpable hlalosang ente site, e tšoaroa ka ya tharollo sebolaya dikokwana-hloko. Sebelisa nale e metle, re sa lithethefatsi e tshelwa intradermally ho theha e "sirilamunu lekhapetleng".

Next nale e nkeloa sebaka ke e sa hlokahala le e kenngoa pakeng tsa vertebrae a emetse disentimitara maloa lateral ho dithulaganyo le spinous. Ka nale ho kenyeletswa likarolo ya hlahiswa e nyenyane ea tharollo. E kenngoa ka botlalo ka tshebetso. The nale Joale mokhoa o sa fellang tlositse le khutlisetsoa ka tlas'a letsoho la sa feteng tse 2 cm,. 5 di ml ea tharollo e hlahiswa ka boemo ba e mong le e karolo ea karolong e ngotsoeng lesapo la mokokotlo.

Thibela likepe khanna lintlha mararo a ka sehloohong: pakeng tsa 4th le 5th lumbar vertebrae, pakeng tsa lumbar 5th le sacral 1-limithara, ka lesoba 1st sacral. Ha a bontša hore bohloko ba lefu nang mellwane omimvo sebelisa lintlha tse tšeletseng. Tsamaiso ea nka ka bang 40 metsotso e nako e telele. Ka lihora tse 'maloa ka mor'a thethebatso le mokuli e tlas'a bookameli ba ditsebi.

Epidural lesapo la mokokotlo thibela likepe - ke eng?

Epidurit le sciatica ke sesupo bakeng sa tsamaiso epidural ea lithethefatsi analgesic. Ha thethebatso ke lumbosacral lesapo la mokokotlo le mamello ea ka lehlakoreng la hae, Ha a akaretsa mangole ikemiselitse ho mpeng. Haha thōko sebelisa lithaole nyopa kapa maqephe a. Disinfected tšimo sebakeng sa tsamaiso bokamoso ba lithethefatsi.

Ka boqapi ba ka tlaase sacral lesoba ho lokisetsa e laolwa intradermally. Ka mor'a moo, fetola nale le a nkente ka yona ho ya ka e tšoanang, e hlaba monyako lera ka kanale sacral. Ka mor'a moo, nale ea theohang haholo tsekaletse ho ka botebo ba se cm, ho feta 5, le ntse le taolo mokelikeli ke piston tensioning. lithethefatsi o laolwa ka ho ba sieo ha dikahare. Mokuli a ka ikutloa khatello le distension ka coccyx ena.

Chelete e lebetsoeng le ea lithethefatsi tsamaisoa ka mellwane e le 'ngoe, e ka bang 60 di ml. Epidural le literata e ka sebediswa:

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

mathata khoneha

mefuta eohle ea thethebatso lokela ho phethwa ka ho khetheha ke basebeletsi ba tšoanelehang tlas'a maemo a nyopa. Fetisisang thibela likepe ente, tšimo diyuniti sebetsa le mekhoa ea ba bang kaofela hloka ho khomareloe ka thata-thata ho mokhoa aseptic. Hlokomoloha Tsamaiso e ka 'na ea ama bophelo ba mokuli le ho etsa hore mathata a latelang ka mor'a se thibela likepe lesapo la mokokotlo:

• tsoa mali ka lebaka la ho senya botšepehi ba vascular;
• utloe bohloko bo boholo ka site ente;
• hloleha ho hema ha thutsoe bolela ka sebaka sa subarachnoid ;
• kulisa;
• putlama;
• kgoreletsego tsa senya mosese;
• tshwaetso ya khoele lesapo la mokokotlo le sebakeng puncture ea;
• liphetoho methapo ea kutlo;
• senya methapo ea kutlo, methapo ea mali, ligaments kapa sethusathuto mesifa ka mokhoa o inaccurately bolaoa.

bofello

The thibela likepe la mokokotlo, e netefatse tse ntle ditshwaelo tsa Tsamaiso e nkoa e le hoo e ka bang tsela feela ho tsoa ka ho ba sieo ha e sebetsa phekolo mekhoa e tloaetsoeng. maemo a tlamang tse tšoanelang phello ea hore a hlahlobe ho phethahetseng oa mamello le ka thata-thata hore ho khomareloe melao ea asepsis le antisepsis nakong mellwane.