Ukuvinjelwa Paravertebral - kuyini?

Ukuqedwa lumbar radicular ubuhlungu kanye nezinye kwasendaweni usubhekwa njengoba enye yazo, kodwa imisebenzi ebaluleke kakhulu. Ukubuka ekuhlehleni ubuhlungu, ungakwazi ukufinyelela kwesakho isiphetho mayelana nokushaya khona ukwelashwa abakhethiwe. Ngokuhambisana imiqondo yesimanje Spine, ubuhlungu acute uvele nasemilenzeni aphansi noma emgogodleni kufanele kususwe ngokushesha ngangokunokwenzeka. In the state inguqulelo wesiyaluyalu okungamahlalakhona kungase kube psychogenic. Bona layering on izimpawu ezivamile, zivimbela therapy ne kakhulu lesi Izibikezelo. Kule ndaba, Ochwepheshe silwele ukuhlakulela ikhono lokusebenzisa njengoba short ngangokunokwenzeka futhi ngesikhathi esifanayo izindlela eziphumelelayo. Omunye ukuvinjelwa paravertebral ezinjalo. Ukuthi kuyini, it is indlela eyenziwa - kule kamuva esihlokweni.

Uhlolojikelele

ukuvinjelwa zokwelapha ezibhekwa izindlela eziphumelela kakhulu ubuhlungu ukuphathwa, kanye nezinye izenzo pathologies zezinzwa. Izinqubo zisekelwe ukwethulwa isifo singene maphakathi izidakamizwa. Lapho, uma iqhathaniswa nezinye izindlela zokwelashwa (massage, ukubhucunga nokunyakazisa umzimba, imithi, ukutshopa, ukwelashwa mathupha), nokuvinjelwa izidakamizwa isetshenziswa hhayi kudala - hhayi engaphezu kwekhulu edlule. Nokho, kukho konke lokhu ngesikhathi izinqubo ubé indlela ephumelela kakhulu ukuqeda ubuhlungu. Yileyo injongo nokuvinjelwa. Ubuhlungu kufanele ziqondiswe angabacwasi ngokushesha, nge okungenani side effects, isikhathi kanye nezindleko impahla. Lezi zimo ukuwugcina ngokuphelele, okuyinto ncamashi indlela ukuvinjelwa zokwelapha.

incazelo

Ukuvinjelwa kuyinto ukuvala shaqa yesikhashana omunye izixhumanisi impendulo arc ubuhlungu. Ngaphezu kwalokho zokwelapha, le nqubo sinenai zokuxilonga. Kwezinye izimo, uchwepheshe ikuthola kunzima ukwenza ukusazi ngokunembile isifo esikuphethe. Lokhu kungase kube ngenxa yokuthi ukubonakaliswa emitholampilo ayimpinda noma cha ngokucacile waphawula ubudlelwano phakathi izimpawu kanye nedatha umgomo. Ngezinye izikhathi kuyenzeka ukuthi izimpawu zokungasebenzi kahle kwemizwa kungukuthi kuqinisekiswa i-MRI. Noma, kunalokho, izinkomba CT noma i-magnetic resonance imaging hhayi isifo nyama. Ezimweni ezinjalo, liwusizo olukhulu ukumisela ukusazi ngokunembile isifo esikuphethe ngeke okukhethwayo ukuvinjelwa.

Izici

Uma ubuhlungu kuyehla esebenzisa izinzwa eqondene izakhiwo yokwakheka, lokhu kusikisela ukuthi kukhona umthombo ubuhlungu. Ezithile umjovo abakhethayo Kwenziwa ngaso endaweni ethile. Lokhu kuqinisekisa wendawo ezinzwa izinzwa enikezela endaweni eshiwo. Thrust zingenziwa futhi ngaphakathi ingxenye yokwakheka, isib, egobolondweni lelunga noma ngokuhlanganyela. Ngenxa nociceptors ivinjiwe kule zoni. Uma, ngaphezu izinzwa wendawo ukungezwa corticosteroids, umjovo angakholelwa Ezimweni ezinjalo kungase kusinikeze isilinganiso esithile umphumela eside oqabulayo izinzwa. umjovo Intraarticular kwezidakamizwa kunciphisa ukuvuvukala ekunciphiseni ukungaphatheki kahle ehambisana nakho. imijovo ezinjalo zisetshenziswa uma amalunga omzimba ungaphenduli imiphumela yendabuko - ukuphumula, imithi, ukwelashwa komzimba. Nokuvinjelwa osebenza nge myositis, radiculitis, neuralgia, sympathalgia. Ngaphandle ukuthi ubuhlungu sesehla bebonisa intuthuko ephawulekayo kumsebenzi Neuro-trophic.

izinzuzo inqubo

ukuqala Rapid wokukhululeka bunikezwa Ukungena ngqo zomuthi ku focus sokugembula kanye nomthelela izidakamizwa ekugcineni futhi izintambo, esakaza ubuhlungu. Ngesikhathi inqubo amathuba okuba nemiphumela engemihle lincishisiwe. Lokhu kungenxa yokuthi waphinda ukuthi izidakamizwa lingena wokuqala kule zokugula we eziko, bese kuphela - ku kwegazi. Nge ngamunye exacerbation entsha yalesi sifo lingasetshenziswa ngokuphindaphindiwe lokuvimbezela. Prakthiza esungulwe nomphumela omuhle oqabulayo umjovo. Ngokusetshenziswa ukuvinjelwa incipha imisipha ukungezwani, spasm semithambo, ekuqedeni impendulo ukuvuvukala kule ubuhlungu nokuvuvuka kwemizi.

ukuvinjelwa paravertebral

Lo mqondo kufanele kubhekwe ndawonye. Igama elithi kubonisa kuphela umjovo Kwenziwa eduze ikholomu umgogodla. Umjovo kungaba intradermal, ongama, perineural, esicutshini noma radicular. Kwezinye izimo, ukuvinjelwa paravertebral isicelo kwi ganglia we nozwela isiqu umngcele. Ngokwesibonelo, isiguli isicaba disk. Kuyaqapheleka convergence amathambo eduze nokwehlisa ububanzi mpo foramen intervertebral. Izingxenye anterior ukubaluleka kwalo inyuka ngenxa ukuthuthukiswa osteophyte nezinye amathambo neziqu. Ukunciphisa ubukhulu emgodini kwenzeka ngesikhathi spondylarthrosis ukuthuthukiswa, ukuqina ophuzi, nemisipha interarticular nezinye izinqubo ngenxa osteochondrosis. Ngenxa yokuthi uhlobo okuholela kuphazamiseka izinzwa ngesikhathi esifanayo kuyinto kokucindezelwa kanye ukucasuka cord, kodwa hhayi ukusabela ezithathelwanayo kanye ukuvuvukala ulwelwesi kanye izimpande, le ndlela ibizwa ngokuthi funikulitom egunjini lokuhlolwa kwezifo. Kususelwa kule ukuvinjelwa sisetshenziswa funikulyarnogo paravertebral. Ukuthaka imithi iqondiswa ngenaliti kwangaphandle kusuka emigodini zokulala zone intambo, kodwa hhayi umgogodla intambo impande.

ngezigaba

imijovo zokwelapha zihlukaniswe izinhlobo ngokuvumelana wasebenzisa izidakamizwa futhi ukuchayeka ndawo. Ngakho, kukhona:

• ukuvinjelwa Paravertebral ka yomgogodla wesibeletho.
• Imijovo nge intercostal neuralgia.
• Thoracic ukuvinjelwa paravertebral.
• Piriformis.
• Ezingeni lumbosacral.
• ezinzwa Sciatic nabanye.

Ukusetshenziswa glucocorticoids

Paravertebral nge ukuvaleka "diprospanom" lisetshenziswe collagenosis letindzala. Imithi emangqamuzaneni, aqede ukuthuthukiswa ukuvuvukala. Ngaphambi abaphathi ndawo eduze inqubo spinous siqede imithi yokubulala izinzwa: izidakamizwa "lidocaine" noma "Novocaine". Ngemva kwalokho, inaliti indawo analgesia eside futhi mkhulu futhi akhiqiza lwaleli vertebral. Ngemva kwalokho, ingxube ukuthi ukujovwa nge isidakamizwa izinzwa "Diprospan". Izimo inqubo isifo sikashukela, thrombosis, ukukhumuzeka kwamathambo uzwakalise ngesikhathi, sengqondo, hypersensitivity, zokugula ezithathelwanayo.

Ukusetshenziswa izinzwa

Paravertebral novocaine block yinqubo, ngokuyisisekelo okuyinto ukwethula izidakamizwa kule ndawo ye obukhulu kunabo bonke. Ngokucacile, izindawo zibala inhlamvu amaphuzu uma ogcwele kakhulu amalunga nemisipha buhle, nezinzwa odlula izindawo futhi indawo plexuses yabo. ukuvinjelwa Paravertebral usebenzisa umphumela izinzwa anganika emifushane (imizuzu 20-30). Noma kunjalo, ngisho sikhathi kwanele ukwenza kusebenze ithoni evamile imisipha spastic.

Ukuphumelela inqubo kanye contraindications

Ukuphumelela ekususeni spasm wabonakaliswa kulo lonke fibre imisipha nekwandzisa umtsamo motor emalungeni, ekunciphiseni izinhlungu ukuzwela endaweni umfutho noma ingxenye innervation emsipheni impande. Akunconyelwe paravertebral ukuvinjelwa amasu okuzokwenziwa ezichazwe ngezansi kanye bradycardia ezinzima syndrome ubuthaka engeyokuqala itheku, atrioventricular block yesibili / degrees wesithathu (ngaphandle kube Ezimweni lapho ngoba ventricular EHAMBAHAMBA wangena probe), ukushaqeka cardiogenic, hypotension (liphinyiselwe), hypersensitivity . Izimo zihlanganisa ukutholakala idatha epileptiform Ukudlikizela emlandweni cuphuluza imithi yokubulala izinzwa, kanye ukuhlukumeza umsebenzi sesibindi.

Ukuthuthukisa inqubo

kanjani ukuvinjelwa paravertebral? ukusebenza nqubo ihilela enifeza manipulations thize. Isiguli is kuqala ibekwe esiswini. palpation indlela ingxenye ubuhlungu esiphezulu echaziwe. Njengoba ungalindela, le esifundeni sifana Iwumbono intambo, iyathinteka kakhulu. Isetshenziswa njengesici ukuhlolwa zezinzwa ukusiza ukwenza indawo lapho kuyoba ukuvinjelwa paravertebral. Ukufakwa inqubo kumele kahle nguchwepheshe.

Uzungu iphathwa ngotshwala noma iodine. Kusetshenziswa inaliti esihle kule ndawo ehlongozwayo umjovo injected izinzwa ( "Novocaine") ukwakha "ulamula ikhasi". Ukuze isilinganiselo ukuba ingxenye yesibili intambo ophumayo inaliti (eside) yethulwa ngakujantshi izinqubo spinous (at ibanga 3-4 cm) ngokuhambisana isikhawu oyifunayo. Njengoba lithwalwa nesenzakalo ujova 0.5% isixazululo "Novocaine". Inalidi sifakwe kuze kuziwa mbeni inqubo transverse. ukunyakaza Eminye wayebaphathele ngokudlula ke kusukela ngezansi noma ngenhla isiqondiso maqondana yomgogodla i-engela degrees 30. mayelana indiza sagittal. Inalidi sifakwe ngomunye 2 cm ejulile futhi 10-20 ml izinzwa is injected noma hydrocortisone emulsion. Ngakho, ngokuvamile, aphethwe ukuvinjelwa paravertebral. enza nqubo ihilela ufaka inaliti ngokuvamile 5-6 cm.

Ezimweni acute

Kukhona izindlela eziningana ngawo eyenziwa ukuvinjelwa paravertebral. endaweni Lumbosacral ubhekwa kunalokho eziyinkinga, ikakhulukazi ubuhlungu oyingozi futhi yokuntuleka ecacile monoradikulyarnogo syndrome. Kule ndaba umjovo ngempumelelo kusukela amaphuzu amathathu. Isingeniso wenziwa phakathi amathambo futhi Liv Lv, Lv futhi S1 esifundeni emgodini lokuqala sacral. Ukujova izidakamizwa "Hydrocortisone" kuwukuthi lezi zindawo kubangelwa Ukulimala okuvame kakhulu ukuthi izintambo zabo umgogodla. Sibekezele emaceleni ukuvinjelwa paravertebral ingasatshenziswa. Lumbosacral siqede Kuleli cala amaphuzu ayisithupha. Ngokuhambisana isimo isiguli, umfutho kanye kwasendaweni yobuhlungu ngemithamo ehlukene zomuthi "Hydrocortisone" lisetshenziswa. Lapho efingqa izinto ukuze intambo eyodwa (1 umjovo) usebenzisa ayi-10-30 mg. Nge ukuqaliswa efanele inqubo wancipha ubuhlungu ngokushesha emva kusungulwa nomuthi. Ukuvinjelwa kungaba liphindwe uma kunesidingo. imijovo okuphindaphindayo lingabe ngaphambi kwezinsuku ezinga-2-3. Emva inqubo Kunconywa yisiguli embhedeni ukuphumula.

Okunye amasu

Isiguli kuthatha isikhundla elele ngesisu sakhe. Ikhanda + lakhe kufanele waphendukela esesayidini emkhakheni, lapho kuyoba umcimbi wokwethula ukuvinjelwa paravertebral. emgogodleni wesibeletho ubhekwa isayithi ezihambayo kakhulu. Kule ndaba, le izoni ngokuvamile kwalimala nabanye. Ngesikhathi inqubo esetshenziswa 0.25% isixazululo izinzwa at umthamo 70-100 mg. Inalidi umjovo sifakwe perpendicular ebusweni isikhumba esiseduzane umngcele elingaphandle extensor emuva. ukunyakaza Ngaphezu kwalokho okwenzeka ngaphambili ukuxhumana vertebra noma inqubo transverse lilimele. Inalidi lithuthela 0.5-1 cm side. imijovo Okwalandela abazenzi at ibanga 1.5 cm kusukela esedlule. Kwezinye izimo, inhlanganisela izidakamizwa "Novocaine" futhi "Hydrocortisone". Kugcine ukuthatha 50-75 mg futhi owokuqala kushintshwe 100 ml.

Ukusebenzisa Izingxube Afonina

Lena ngenye indlela lumbosacral ukuvinjelwa paravertebral. Ukuze ingxenye intambo ophumayo imbobo (intervertebral) ephathwa 1.5-8 mg. Umthamo inani yesixazululo ububanzi phakathi 30-80 ml. Umthamo kuncike inani lamaphuzu elisetshenziswa nokuvinjelwa. Inkambo zokwelapha kufaka kokuziphatha olulodwa, uma umphumela uyeza masinyane ngokwanele. Uma umphumela ubonakala kancane, ufaka isicelo 2-4 ukuvinjelwa okuphindaphindiwe. Ngamunye umjovo elilandelayo Kwenziwa izinsuku 5-6 emva zokugcina. Lapho zaphathwa isiguli bangezwa emizweni ezihlukene kule innervation abafanele yezinzwa. Ngokwesibonelo, isiguli kungenzeka ukuthola umuzwa wobukhulu, paresthesia, ingcindezi, ubuhlungu ezidabukile.