Ukuvinjelwa umgogodla: izinhlobo, injongo, izidakamizwa, imiphumela

Ubuhlungu syndrome ukubonakaliswa esemqoka ye zokugula emitholampilo of the system zemisipha, ikakhulukazi yomgogodla. Okuvela acute ubuhlungu vertebral kufanele ibekwe ngokushesha, ngisho unikezwa iqiniso lokuthi nilwe soreness akuyona yokwelapha esiyimbangela. Nokuvinjelwa emgogodleni - esinye sezenzakalo ezenzeka ukuphathwa eziyinkimbinkimbi zezinkinga Spine.

imiqondo Jikelele

Labo nekhono nzima ukuyeka ubuhlungu chronic, ubuhlungu acute kuka emhlane, ngoba isibonisi uqale kokuba uhlamvu emaphakathi. Lokho, ukugxila kuwukubonakaliswa buhlungu kwakhiwa ezingeni excitation ka-receptor zendawo ubuchopho. Ukwelashwa nokuvikelwa kulesi simo isikhathi eside futhi kudinga ukusetshenziswa antidepressant futhi neuroleptics.

Ukuze ugweme lokhu, ukwelashwa lingaze kusaqalwa zesifo isebenzisa zokukhwabanisa ezifana ukuvinjelwa umgogodla. Kuyini futhi uyini inqubo kuchaziwe ngezansi.

Ukuvinjelwa ngokuthi ukukhishwa kwanoma yimuphi isixhumanisi indlela yokulwa ubuhlungu ngokusebenzisa analgesics medicated. Ngaphezu Okuqondiwe zokwelapha, block umgogodla isetshenziselwa uphethwe. Ubuhlungu indawo elingacacisiwe kudinga ukwethulwa imithi yokubulala izinzwa, okuvumela inqubo ukuqedwa ukucacisa umnyango zokugula. Ngokuvamile, ubuhlungu "ucishiwe" ngokushesha ngemva zokukhwabanisa.

ubufakazi

Izifo uhlelo zemisipha, ezidinga ukusetshenziswa ukuvinjelwa, kumele sihambisane izimpawu ezibuhlungu. Endabeni okuphambene, ukusetshenziswa imithi le njongo akuyona efanele. Inqubo uqhutshwa ngaphansi pathologies ezilandelayo:

• ukhwaliti ubuhlungu emuva;
• khona herniated akwazi ukugcina;
• spondylosis deformans;
• radiculopathy;
• ukulimala kuhlasimulise;
• neoplasms isikhala intervertebral;
• ukuvaleka lateral ka umsele umgogodla.

Inqubo wenziwa ezimweni lapho kungekho nomphumela ukwelashwa ngoludala. Nokho, ukusebenza kahle kuza emva umjovo wokuqala, amafomu ezinzima izifo okufuna 2-3 15 zokukhwabanisa olwenziwa ngezikhawu izinsuku ezimbalwa.

Izinzuzo ukuvinjezelwa ukusebenza ngokushesha, ubuncane side effects njengoba ehlonipha imithetho, kungenzeka ukusetshenziswa amaningi. Ngaphandle analgesia, ukuxhaphaza has nomphumela eqeda ukuvuvukala kanye spasmolytic, kuncike izidakamizwa akhethiwe.

blockades Ukwahlukanisa vertebral

Ngokuya ngenombolo izidakamizwa yethulwa kuleli elilodwa esiteji, ukuhlukanisa zokukhwabanisa:

• monocomponent (ngenye indlela);
• dikomponentnye (izinhloli ezimbili);
• multicomponent (ejenti ezintathu noma ngaphezulu).

Painkillers imijovo yaphathwa izigaba ezilandelayo ezicacile zomzimba:

1. emgogodleni - thoracic, wesibeletho, lumbar, sacrum.
2. Sagcina - Sciatic, occipital, tibial, suprascapular, amagatsha ezingemuva izinzwa emgogodleni.
3. uhlelo kwemisipha - imisipha, ikhanda lalo kanye piriformis imisipha, ngaphambili ezitebhisini.
4. isikhala Epidural futhi epidural.
5. Facet amalunga omzimba.
6. Kuhambisana - sacroiliac futhi sacrococcygeal.

Ukuvinjelwa hernia emgogodleni lahlukaniswa izinhlobo:

1. Libhekene vkalyvaniem transforaminal ukwethulwa izidakamizwa emgodini ophumayo kwalapho kuhlangana khona imizwa.
2. Lapho intralaminar inqubo nomuthi sifakwe phakathi izinqubo vertebral e cartilaginous drive ngqo.

Izimo

ukuvinjelwa umgogodla has Izimo ezithile ukuthi udokotela uyazicabangela isiguli ngesikhathi luhlolo. Esimweni ngasinye yomtholampilo kubhekwa ngamunye, ecacisa sengcupheni amathuba okuba nemiphumela engemihle. Inqubo ngeke kwenziwe ngaphansi isifo uthi ezilandelayo:

• izifo, izimpawu ukuthambekela ukopha;
• izifo ezithathelwanayo eluhlelweni kanye ukubonakaliswa sendawo endaweni wokubhoboza;
• nesineke equlekile;
• nemithi isici esiyingqayizivele isicelo;
• inhliziyo futhi semithambo izifo;
• isithuthwane;
• hypotension;
• ukugula ngengqondo;
• ubudala zezingane;
• phakathi nokukhulelwa kanye lactation;
• izilonda eziphilayo isibindi kanye nezinso.

ukubulala izinzwa engxenyeni ethile

Izinto okuyinto nomphumela analgesic, asetshenziselwa zonke izinhlobo ukuvalwa usebenzisa izidakamizwa e ifomu ezimele noma lihambisana namanye amaqembu ukuthaka imithi.

Novocaine ukuvinjelwa yomgogodla wenziwa kaningi kunamanye izinzwa wendawo. "Novocaine" ikhiqizwa ngendlela isixazululo imijovo ne lokuhlala ezihlukahlukene kwakwakhe esebenzayo (kusuka 0.25% 2%). Umthelela analgesic eba kwamaminithi ambalwa ngemva ukuvinjelwa kwenziwa. Thrust usebenzisa "Novocain" anaesthetises amahora angu-2.

"Marcaine" futhi lisetshenziswa okudambisa ubuhlungu. Waba yini umphumela wesibindi nokuphathwa ejenti has isiqalo ngasekupheleni. Ubuhlungu ubalekela emva kwemizuzu 20, kodwa isikhathi yesenzo lingafika amahora 5-6. Ukusebenzisa "marcaine" Kwenziwa kuphela emva ukuxilongwa okujuli- ezisekujuleni kwenhliziyo futhi igazi izitsha nesineke.

Kulandela ukubulawa izinzwa wendawo, ekwelapheni ubuhlungu ka vertebral kuyinto "Lidocaine". Inani lentengo lomuthi ungaphakathi esigabeni aphansi (ruble angu-30 iphakethe ngalinye), okwenza kube iyatholakala ukuba isetshenziswe. I nomuthi libhekene isinyathelo ngokushesha futhi isikhathi eside ukwedlula "Novocaine".

"Novocaine" futhi "Lidocaine", intengo zazo ezingaphezu kuka iyatholakala, asetshenziswa njalo uma ziqhathaniswa nezinye ukubulala izinzwa engxenyeni ethile. Ngaphambi kokufaka isicelo kunoma iziphi ukuze uhlole nozwela nesineke ngazinye, ukuvimbela ukuthuthukiswa komzimba nezinto.

ukwelashwa kwama-hormone

Amalungiselelo Ukwakheka hormone ekwelapheni pathologies yomgogodla ngesimo self-administration kuyaqabukela esetshenziswa. Ngokuvamile bajwayele ekwelapheni amalunga omzimba. Ukuvinjelwa yomgogodla kudinga inhlanganisela ngama-corticosteroid nezinye izidakamizwa (isib imithi yokubulala izinzwa). ejenti kwama-hormone ekunciphiseni izinhlungu, ukunqampunwa ukuvuvukala, ukunciphisa ukuvuvukala nokungezwani komzimba.

Izidakamizwa asetshenziswe Spine:

1. "Prednisolone" ixubene omunye izidakamizwa analgesic ( "procaine" "Lidocaine" "Novocaine"). Ngokuphumelelayo esetshenziselwa nokuvinjelwa hernia umgogodla, radiculitis, osteochondrosis.
2. "Hydrocortisone" isetshenziselwa emsipheni amabhlogo. Ngokuphelele exutshwe izinzwa ngaphambi kokwenziwa.
3. "Diprospan" isetshenziselwa noma yiluphi uhlobo ukukhululeka ubuhlungu. Umuthi kuyinto ukuthuthukiswa ezinhle futhi fast of umphumela isenzo isikhathi eside.
4. Kusho "Kenalog" kodwa anti-iguliswa futhi eqeda ukuvuvukala, kuba nethonya immunosuppressive. Isetshenziselwa yiluphi uhlobo okuvimba kanye nokwelashwa emalungeni.

Amanye amaqembu izidakamizwa

Ezinye izindlela nethonya analgesic. Zisetshenziswa ukubunjwa ukuvalwa multicomponent futhi zihlanganisa imikhiqizo elandelayo:

• non-steroidal anti-inflammatory ( "Voltaren");
• B amavithamini;
• enzyme ( "Lidaza" "papain");
• "ATP";
• antispasmodics ( "Platifillin");
• "Trombolizin";
• hondroprotektory ( "rumalon").

Isibonelo inqubo

Cabanga ngesibonelo sika-zokukhwabanisa. Novocaine ukuvinjelwa yomgogodla lumbar wenziwa isikhundla yizikhukhula. Palpable ngokuchaza isayithi umjovo, it is ziphathwe isixazululo isinqandakuvunda. Kusetshenziswa inaliti amahle, isidakamizwa injected intradermally ukwakha "ulamula ikhasi".

Okulandelayo inaliti indawo a ezidingekayo eside futhi ifakwe phakathi amathambo ngamasentimitha ambalwa lateral ukuze izinqubo spinous. Njengoba inaliti Ukufakwa izingxenye ekhiqizwa esincane isixazululo. Ingabe ifakwe ngokugcwele inqubo. Inalidi oko kususwe ingxenye ethile futhi ibuyise ngaphansi ingalo ezingekho ngaphezu 2 cm. 5 ml ikhambi yethulwa ezingeni ingxenye ikholomu umgogodla ngamunye.

Ukuvinjelwa olwenziwa amaphuzu amathathu amakhulu: phakathi 4th futhi 5th lumbar amathambo, phakathi lumbar 5th futhi sacral 1-m, in the 1st imbobo sacral. Lapho uzwakalise ubuhlungu syndrome kunesithembiso zokukhwabanisa zamazwe amabili usebenzisa amaphuzu ayisithupha. Inqubo kuthatha cishe 40 imizuzu isikhathi. Kwaphela amahora ambalwa ngemva izinzwa isiguli ngaphansi kokuqondisa ochwepheshe.

Epidural ukuvinjelwa umgogodla - kuyini?

Epidurit kanye sciatica ziyinkomba kwezokuphatha epidural izidakamizwa analgesic. Lapho izinzwa iyona lumbosacral emgogodleni isiguli ohlangothini lwakhe, efingqa ngamadolo kusontwe ukuze esiswini. Ingquza isehlane usebenzisa amathawula oyinyumba noma amashidi. Disinfected ensimini esikhundleni ekuphathweni esizayo izidakamizwa.

Ngo projection we ephansi sacral imbobo ukulungiselela iqondiswa intradermally. Khona-ke, ukushintsha inaliti bafake ke parallel ihlaba ulwelwesi ukungena emgudwini sacral. Okulandelayo, inaliti yehla kakhulu nendawo kuya engekho ngaphezu kuka-5 cm ukujula, ukudweba control uketshezi yi piston tensioning. izidakamizwa iqondiswa ngokungabi bikho okuqukethwe. Isiguli bangazizwa ingcindezi futhi distension ku coccyx.

Inani eliphelele izidakamizwa yaphathwa a zokukhwabanisa olulodwa, 60 ml. block Epidural ingasetshenziswa:

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

yezinkinga kungenzeka

Zonke izinhlobo izinzwa kufanele kwenziwe kuphela izisebenzi eziqeqeshiwe ngaphansi kwezimo oyinyumba. ukuvinjelwa Sheer umjovo, ensimini processing units kanye nazo zonke ezinye izinqubo ezidinga ekuhambisaneni inqubo aseptic. Ukunganakwa inqubo kungathinta impilo lesiguli kanye kuholele nezinkinga ezilandelayo ngemuva ukuvinjelwa umgogodla:

• ukopha ngenxa ukulimala ubuqotho semithambo;
• ubuhlungu obukhulu ngesikhathi indawo umjovo;
• nokuvaleka kwemigudu yokuphefumula lapho hit kusho e isikhala subarachnoid ;
• komzimba;
• igoqe;
• ukuphazamiseka esinyeni urinary;
• isifo emgogodleni endaweni wokubhoboza;
• ukusabela zezinzwa;
• ukulimala, ekupholiseni izinzwa, imithambo yegazi, nemisipha noma imisipha apharathasi e inqubo bahlawuliselwe ababulawa.

isiphetho

Nokuvinjelwa yomgogodla, okuyinto ukuqinisekisa omuhle inqubo impendulo ubhekwa cishe okuwukuphela kwendlela ngokungabi bikho ukusebenza yokwelapha olandelanayo. izimo okuphoqelekile kukhona umphumela omuhle wokuhlola ngokucophelela nesineke futhi ukunamathela ngokuqinile imithetho asepsis futhi antisepsis ngesikhathi zokukhwabanisa.