Cov kev ua si ntaus kis las
1K 14 05.05.2019 (hloov tshiab: 01.07.2019)
Lumbar mob yog cov tsos mob feem ntau uas ua rau muaj kev kho mob.
Txheej txheem cej luam tias ua li cas rau qhov mob
Lub etiology ntawm lumbodynia yog ntau haiv neeg. Nws tuaj yeem tshwm sim los ntawm:
- hnyav hnyav thiab zoo li qub-dynamic thauj ntawm lub lumbar vertebrae;
- mob nraub qaum:
- osteochondrosis ntawm tus nqaj qaum;
- protrusion lossis herniated intervertebral discs;
- cov kab mob sib kis (osteomyelitis, tuberculosis, brucellosis);
- deforming spondylosis;
- scoliosis, pathological lordosis thiab kyphosis;
- osteoporosis metabolic;
- pob txha lov thiab raug mob ntawm lub cev nqaij daim tawv;
- thawj thiab metastatic neoplasms ntawm lub cev vertebral;
- ankylosing spondylitis;
- rheumatoid kev mob caj dab;
- mob raum:
- thawj thiab theem nrab neoplasms;
- mob pyelonephritis;
- ICD;
- atherosclerosis ntawm lub plab ntu ntawm aorta thiab nws cov ceg ntoo;
- aortic dissecting aneurysm;
- pathological kev hloov ntawm lub duav sib koom tes;
- o ntawm cov leeg nyuaj thiab muag ntawm daim pob txha caj qaum;
- mob hnyuv thiab mob plab hnyuv;
- atypical chav ntawm mob pob txuv;
- mob tsis zoo ntawm cov leeg nrob qaum;
- cov kab mob ntawm lub plab mog plab hnyuv siab raum, suav nrog kev muaj me nyuam:
- endometriosis;
- mob cancer ntawm lub tsev menyuam;
- adnexitis;
- prostatitis;
- prostate cancer;
- STDs;
- kab mob ntawm lub plab zom mov (ntau pathologies los ntawm txoj hnyuv, mob siab, gallbladder, txiav).
Kev faib tawm mob
Kev tsim kho cov kab mob pathology yog ua tiav raws cov qauv uas tau coj los ua lub hauv paus. Nws tuaj yeem yog raws li:
- etiological cov cim qhia:
- thawj (tshwm sim los ntawm thawj txoj kev hloov pauv hauv pob txha caj qaum) - protrusion thiab hernia ntawm intervertebral discs;
- theem nrab (vim muaj kab mob ntawm cov plab hnyuv siab raum thiab lub kaw lus, lub txiaj ntsig ntawm uas yog lumbodynia) - ICD, LCB.
- lub sij hawm ntawm cov tsos:
- mob (txog 12 lub lis piam);
- mob nyhav (ntau tshaj 12 lub lis piam);
- kev sib txuas nrog qhov tseeb:
- nrawm nroos (mob txha caj qaum);
- ncua sijhawm (mob nraub qaum tom qab noj zaub mov rog nrog cov kab mob pob zeb);
- degree ntawm manifestation:
- hais tias:
- tsis txaus;
- localization:
- topographically sib raug rau cov lesion tsom;
- tsiv los sis wandering;
- saib mob duab:
- kev tsim txom;
- mem tes;
- nkaug;
- tua neeg;
- txiav;
- kev xaib;
- hlawv;
- ruam;
- zaws.
Hnov mob
Feem ntau raug rau cov mob pancreatitis, cholecystopancreatitis, cholelithiasis, cholecystitis thiab intercostal neuralgia. Nrog kev puas tsuaj rau daim siab thiab tus kav thuv, qhov mob tuaj yeem cuam tshuam rau thaj chaw hauv siab.
Cholecystitis lossis pancreatitis tsis tshua muaj cais. Ntau zaus, cov kab mob pathology tau koom ua ke thiab coj tus cwj pwm ntawm cholecystopancreatitis. Lub siab ntawm qhov tsis txaus ntseeg nyob rau hauv lub qhov ncauj, nrog rau cov kev tsis txaus siab nyob rau hauv txoj cai hypochondrium, tuaj yeem ua qhov txawv txav.
Muab qhov hnyav ntawm qhov ua tau nosological pathologies nrog rau kev ua kom pom qhov mob ntawm qhov mob txha caj dab, antispasmodics (Papaverine, Platifillin) yuav tsum siv los daws nws. Nws tsis tuaj yeem siv NSAIDs (tsis siv tshuaj steroidal analgesics) vim qhov tseeb tias lawv txoj kev siv tau tuaj yeem hloov cov tsos mob thiab ua rau kev kuaj mob nyuaj los ntawm tus kws phais mob.
Kev kuaj mob ua ntej
Txhawm rau kom kuaj tau ua ntej, ntau qhov kev kuaj mob siv:
| Lumbosacral osteochondrosis kev ntsuam xyuas | |
| Cov tsos mob npe | Kev piav qhia |
| Dejerine | Thaum cov leeg hauv plab cov leeg hauv plab tau txhawm, mob hauv thaj chaw lumbar nce. |
| Neri | Nrog txoj siv tawv nruj ntawm lub taub hau ua ntej sib cuag nrog lub hauv siab ntawm sab nraub qaum, mob nce. |
| Lasegue | Hauv txoj haujlwm ntxim nyiam, koj yuav tsum lem mus tsa ceg ncaj. Nrog lumboischialgia, qhov mob yuav nce thiab tawg raws cov hlab sciatic ntawm homolateral sab. |
| Lorrey | Thaum noj txoj hauj lwm los ntawm qhov chaw nws nyiam nrog cov ceg ncaj ncaj, qhov mob tiv thaiv keeb kwm ntawm lumboischialgia yuav nce ntxiv ntawm cov hlab ntsha sciatic. |
Yuav hu rau leej twg
Yog tias qhov ua rau mob tsis paub meej, kws kho mob yuav tsum tau sab laj. Nyob rau hauv cov xwm txheej uas kev txheeb xyuas tau pom meej, kom nqaim tshwj xeeb, piv txwv li, mus rau tus kws kho mob poj niam (kev hnov mob tshwm sim hauv lub hlis thib ob ntawm cev xeeb tub) lossis tus kws kho paj hlwb (muaj qhov qhia tau ntawm tus mob intervertebral hernia hauv anamnesis).
Feem ntau, ib tus kws kho mob rheumatologist thiab kws kho mob tsaj lij kuj tseem koom tes nrog kho mob nrob qaum.
Tus kws kho mob tuaj kuaj, kuaj mob thiab kuaj mob
Kev kuaj mob yog qhov nyuaj vim yog qhov tsis muaj tseeb ntawm cov tsos mob thiab nws cov polyetiology. Cov ncauj lus kom ntxaws txog tus mob anamnesis, kev tshuaj xyuas tus neeg mob cov lus tsis txaus siab, nrog rau nws ua tib zoo tshuaj xyuas.
Ntawm cov kev sim, kev kuaj ntshav dav thiab biochemical, thiab ntxiv rau kev kuaj ntshav rau cov cim qog, yuav tsum paub qhov txawv.
Kev siv cov khoom siv tshawb nrhiav feem ntau muaj xws li xoo hluav taws xob thiab kev siv cov duab endoscopic, ultrasound ntawm lub plab plab thiab qhov chaw retroperitoneal, CT thiab MRI.
Cov hau kev kho
Cov txheej txheem thiab cov hau kev ntawm kev kho yog ua raws li kev kuaj mob. Lawv muab faib tau yooj yim:
- txhag cia:
- kev noj tshuaj (NSAIDs, vasodilators, hauv nruab nrab sawv cev ua kom lub zog nqaij, chondroprotectors, B vitamins, tshuaj steroids, thiab lwm yam) hauv daim ntawv ntawm:
- tshuaj pleev;
- ntsiav tshuaj thiab tsiav tshuaj;
- kev txhaj tshuaj (paravertebral blockade);
- FZT:
- ua kom sov (pib nyob rau theem ntawm kev kho kom rov zoo li thaum muaj mob aseptic pathologies);
- cryotherapy (ua tau zoo nyob rau hauv cov kev mob tshwm sim ntawm qhov mob aseptic, piv txwv, hauv kev raug mob);
- Kev tawm dag zog tawm dag zog (cov kev qoj ib ce tsim los txhim kho cov leeg hlwb);
- zaws;
- phau ntawv kho;
- kev noj tshuaj (NSAIDs, vasodilators, hauv nruab nrab sawv cev ua kom lub zog nqaij, chondroprotectors, B vitamins, tshuaj steroids, thiab lwm yam) hauv daim ntawv ntawm:
- kev ua haujlwm (neoplasms, cov cim ntawm kev nias los ntawm intervertebral hernias ntawm tus txha nqaj qaum, thiab lwm yam).
© Yakobchuk Olena - stock.adobe.com
Kev qoj ib ce, kev tawm dag zog
| Pib txoj haujlwm | Kev Piav Qhia Tawm |
| Dag koj nraub qaum | Tsa ob txhais ceg sab laug sab xis thiab sab xis, lem mus rau qhov hnyav li 10-15 feeb.
|
| Dag koj nraub qaum | Khoov koj lub hauv caug sab xis, qaij rau sab xis thiab sab laug kom txog thaum nws nres.
|
| Sawv | Nyo hau nyob rau hauv ntau cov lus qhia (rov qab ncaj).
|
| Sawv ntawm txhua plaub | Ua viav vias ib txhij nrog cov ceg txhav (ceg sab xis thiab sab lauj).
|
| Gluteal choj | Kev tsa lub plab mog ntawm txoj haujlwm supine.
|
| "Choj" | Khoov koj lub nraub qaum, ua kom kho lub cev hauv txoj haujlwm no.
|
Nrog kev mob hauv thaj chaw lumbar, kev ua si kis las yog qhov tsis muaj kev cia siab vim qhov muaj feem ntau ntawm kev raug mob ntxiv rau cov pob qij txha intervertebral vim muaj kev txav ceev (ntaus pob, ncaws pob).
Kev hnav ntawm cov ntaub qhwv rau thaj tsam lumbar yog qhia, tshwj xeeb tshaj yog thaum muaj qhov siab zoo li qub lossis zoo li qub-thauj khoom yuav tsum.
Qaug qis nraub qaum hauv cov kis las
Lub nraub qaum ntawm cov neeg ncaws pob muaj kev cuam tshuam loj ntawm cov axial, kev sib hloov thiab kev hloov pauv, uas txiav txim siab tshwj xeeb ntawm kev raug mob. Feem ntau hais tias kuaj tau:
- ncab lub cev musculo-ligamentous apparatus ntawm lub lumbar vertebrae;
- spondylolysis (muaj teeb meem nyob hauv koov ntawm tus txha caj qaum, pom muaj nyob hauv cov neeg dhia tes taw, cov pov pob, cov kws ntaus pob ncaws pob);
- sondylolisthesis (swb ntawm tus txha caj qaum sib raug zoo)
- osteocondritis ntawm tus txha nqaj qaum;
- hernia thiab protrusion ntawm intervertebral discs;
- cov hluas kyphosis ntawm Scheuermann-Mao;
- scoliosis.
Muab qhov kev pheej hmoo siab ntawm kev raug mob, cov kws ncaws pob yuav tsum raug saib xyuas tsis tu ncua. Thaum pom cov kab mob pathology, txoj kev kho mob yog kho los ntawm tus kws kho mob koom nrog thiab txiav txim siab los ntawm nws hom.
