Likotsi tsa lipapali
1K 14 05.05.2019 (e ntlafalitsoeng la ho qetela: 01.07.2019)
Bohloko ba lumbar ke letšoao le tloaelehileng ho isa tlhokomelong ea bongaka.
Kakaretso ea lisosa tse ka bakang bohloko
The etiology ea lumbodynia e fapane. E ka bakoa ke:
- mejaro e matla e tsitsitseng le e sa sisinyeheng ho li-vertebrae tsa lumbar;
- maloetse a mokokotlo:
- osteochondrosis ea mokokotlo oa lumbar;
- ho hlahisa kapa li-discs tsa herniated intervertebral;
- mafu a tšoaetsanoang (osteomyelitis, lefuba, brucellosis);
- ho holofatsa spondylosis;
- scoliosis, pathological Lordosis le kyphosis;
- lefu la ho fokola ha masapo;
- ho robeha le likotsi tsa 'mele ea' mele;
- li-neoplasms tsa mantlha le tsa metastatic tsa 'mele ea' mele;
- ankylosing spondylitis;
- ramatiki;
- lefu la liphio:
- li-neoplasms tsa mantlha le tsa bobeli;
- pyelonephritis e matla;
- ICD;
- atherosclerosis ea karolo ea mpa ea aorta le makala a eona;
- lefu la ho hlohlona la aortic
- liphetoho pathological ka noka lenonyello;
- ho ruruha ha lera le thata le bonolo la mokokotlo;
- tšitiso e matla le e sa foleng ea mala;
- tsela e sa tloaelehang ea appendicitis e matla;
- mafu a hlobaetsang ea ajoa lesapo la mokokotlo;
- mafu a litho tsa pelvic, ho kenyelletsa le karolo ea ho ikatisa:
- endometriosis;
- kankere ea popelo;
- adnexitis;
- prostatitis;
- kankere ea tšoelesa ea senya;
- Li-STD;
- maloetse a tšoaetso ea lijo (mafu a mangata a tsoang mala, sebete, gallbladder, manyeme).
Sehlopha sa bohloko
Systematization ya bolwetse e etsoa ka ho ya ka litekanyetso tse nkiloeng e le motheo. E ka ba ho latela:
- matšoao a etiological:
- mathomo (a bakoang ke liphetoho tse ka sehloohong tsa pathological ho vertebrae) - protrusion le hernia ea li-disc tsa intervertebral;
- mahareng (ka lebaka la maloetse a litho le litsamaiso, litlamorao tsa ona ke lumbodynia) - ICD, LCB.
- nako ea ponahalo:
- hlobaetsang (ho fihlela ho libeke tse 12);
- sa foleng (ho feta libeke tse 12);
- mabapi le ntho e halefisang:
- hang-hang (kotsi ea mokokotlo);
- lieha (bohloko bo tlase ba mokokotlo kamora ho ja lijo tse mafura le lefu la gallstone);
- boemo ba ponahalo:
- phatlalatsa:
- itekanetseng;
- tlhahiso ea lehae:
- topographically e tsamaellanang le sepheo sa liso;
- ho tsamaya kapa ho lelera;
- setšoantšo sa bongaka:
- hatella;
- ho tsuba;
- ho hlaba;
- ho thunya;
- ho itšeha;
- ho pota-pota;
- ho chesa;
- hlokang kelello;
- qobella.
Bohloko ba senyepa
E tloaelehileng haholo bakeng sa pancreatitis e matla, cholecystopancreatitis, cholelithiasis, cholecystitis e matla le intercostal neuralgia. Ka tšenyo ea sebete le manyeme, bohloko bo ka tsoa sebakeng sa sefuba.
Cholecystitis kapa pancreatitis ha e fumanehe hangata. Hangata, lefu lena le kopantsoe mme le nka semelo sa cholecystopancreatitis. Ho utloa bohloko ha molomo, hammoho le ho se utloise bohloko ho hypochondrium e nepahetseng, e ka sebetsa e le letšoao le khethollang.
Ka lebaka la boima ba "pathological pathological" bo nang le ponahalo ea bohloko ba shingles, li-antispasmodics (Papaverine, Platifillin) li lokela ho sebelisoa ho e imolla. Ho ke ke ha khoneha ho sebelisa li-NSAID (non-steroidal analgesics) ka lebaka la hore ts'ebeliso ea tsona e ka fetola matšoao mme ea thatafatsa tlhahlobo ea ngaka e buoang.
Litlhahlobo tsa pele
Bakeng sa ho etsa tlhahlobo ea pele, ho sebelisoa liteko tse ngata tsa tlhahlobo:
| Liteko tsa Lumbosacral osteochondrosis | |
| Lebitso la matšoao | Tlhaloso |
| Dejerine | Ha mesifa ea mesifa ea mpa e thatafalloa, bohloko ba sebaka sa lumbar boa eketseha. |
| Neri | Ha motho a kobehile hloohong pele a kopana le sefuba mokokotlong, bohloko boa eketseha. |
| Lasegue | Boemong bo tloaelehileng, le lokela ho chenchana ho phahamisa maoto a otlolohileng. Ka lumboischialgia, bohloko bo tla eketseha mme bo phatsime haufi le methapo ea mahlale ea lehlakoreng la batho ba bang. |
| Lorrey | Ha u lula sebakeng se tloahelehileng ka maoto a otlolohileng, bohloko bo khahlano le semelo sa lumboischialgia bo tla eketseha le methapo ea methapo. |
O ka ikopanya le mang
Haeba sesosa sa bohloko ha se tsejoe, ngaka e lokela ho botsoa. Maemong a moo etiology e hlakile, ho fokotsa litsebi, ho etsa mohlala, ho ngaka ea basali (bohloko bo hlahile trimester ea bobeli ea bokhachane) kapa ngaka ea methapo ea mafu (ho na le lipontšo tsa hernia ea li-intervertebral ho anamnesis).
Hangata, rheumatologist le traumatologist le bona ba ameha kalafong ea bohloko ba mokokotlo.
Ketelo ea lingaka, litlhahlobo le liteko
Ho fumanoa ho le thata ka lebaka la ho se totobetse ha matšoao le polytiology ea eona. Ho hlokahala pokello e felletseng ea anamnesis, tlhahlobo ea litletlebo tsa mokuli, le tlhahlobo ea hae e phethahetseng.
Har'a mekhoa ea laboratori, ho lokela ho khetholloa liteko tsa mali le tsa moroto ka kakaretso le biochemical, hammoho le teko ea mali bakeng sa matšoao a hlahala.
Mekhoa ea lipatlisiso e sebelisoang khafetsa e kenyelletsa X-ray le mekhoa ea endoscopic, ultrasound ea mpa le sebaka sa retroperitoneal, CT le MRI.
Mekhoa ea kalafo
Morero le mekhoa ea kalafo e ipapisitse le ts'oaetso. Ka kakaretso li arotsoe ka:
- mekhoa e tloaetsoeng:
- ho noa meriana (li-NSAID, li-vasodilator, li-relaxation tsa mesifa tse bohareng, li-chondroprotectors, livithamini tsa B, lithethefatsi tsa steroid, jj) ka sebopeho sa:
- mafura;
- matlapa le li-capsules;
- liente (paravertebral blockade);
- FZT:
- ho futhumala (ho sebetsa sethaleng sa ntlafatso bakeng sa mafu a bohloko a aseptic);
- cryotherapy (e sebetsang hantle mohatong o matla oa ho ruruha ha aseptic, ka mohlala, ka ts'oaetso);
- Phekolo ea boikoetliso (boikoetliso bo etselitsoeng ho nts'etsapele tsamaiso ea mesifa);
- sililoa;
- phekolo ea matsoho;
- ho noa meriana (li-NSAID, li-vasodilator, li-relaxation tsa mesifa tse bohareng, li-chondroprotectors, livithamini tsa B, lithethefatsi tsa steroid, jj) ka sebopeho sa:
- ho sebetsa (li-neoplasms, matšoao a khatello ea methapo ea methapo ea mokokotlo, joalo-joalo).
© Yakobchuk Olena - stock.adobe.com
Ho ikoetlisa, ho ikoetlisa
| Boemo ba pele | Tlhaloso ea boikoetliso |
| Ho robala ka mokokotlo | Phahamisa maoto a otlolohileng ka ho le letšehali le ka ho le letona, o tšoere boima ba metsotsoana e 10-15.
|
| Ho robala ka mokokotlo | Koba mangole ka lehlakoreng le letona, ho sekamela ka lehlakoreng le letona le le letšehali ho fihlela le emisa.
|
| E eme | Butle-butle hantle ka nqa tse fapaneng (ka morao ka kotloloho).
|
| E eme ka maoto a mane | Sesa ka nako e le 'ngoe le maoto le matsoho a letsoho (letsoho le letona le leoto le letšehali).
|
| Borokho bo khanyang | Ho phahamisa noka boemong bo phahameng.
|
| "Borokho" | Koba mokokotlo oa hau, o leka ho lokisa 'mele boemong bona.
|
Ka bohloko sebakeng sa lumbar, ho bapala lipapali ho sa rateheng haholo ka lebaka la monyetla o moholo oa tlokotsi e tlatselletsang manonyeletso a lipakeng ka lebaka la motsamao oa tšohanyetso (volleyball, bolo ea maoto).
Ho roaloa ha masela a tlamiloeng sebakeng sa lumbar hoa bontšoa, haholo ha ho lebelletsoe mejaro e phahameng ea tuli kapa e matla.
Mahlaba a morao haholo ho baatlelete
Mokokotlo oa baatlelete o ba le meroalo ea bohlokoa ea axial, rotational le flexion, e khethollang ho khetheha ha khatello ea maikutlo. Hangata e fumanoa:
- ho otlolla lisebelisoa tsa musculo-ligamentous tsa lumbar vertebrae;
- spondylolysis (sekoli se ka har'a vertebra, se fumanoang ho li-gymnast, li-pole vaulters, libapali tsa bolo ea maoto);
- sondylolisthesis (ho thellisoa ha li-vertebrae tse amanang le tsona);
- osteocondritis ea mokokotlo;
- hernia le protrusion ea li-disc tsa intervertebral;
- kyphosis ea bocha ea Scheuermann-Mao;
- scoliosis.
Ka lebaka la kotsi e kholo ea kotsi, baatlelete ba litsebi ba lokela ho beoa leihlo khafetsa. Ha lefu lena le fumanoa, kalafo e laoloa ke ngaka e eang teng mme e khethoa ke mofuta oa eona.
