Whakarōpū syndrome wehenga myofascial

E rave rahi mau taata fifili: "syndrome wehenga - he aha te mea te reira?" Ka taea te kite i tēnei māuiuitanga i roto i ngā wāhi katoa te wahi e karapotia nga uaua e te fascia totoka - he wāhi o te papa, hope, pokohiwi, hope, me te hoki.

syndrome wehenga - he huinga o nga huringa whakapataritari e te hua i roto i te pēhanga i roto i te iti rohe o te tinana. I runga anō i te mea i whakapataritari na te whakanui ake i te pēhanga i roto i te kikokiko, te tikanga kitea mate whakapeka ma'i ranei.

Ko te take o te whanaketanga mate

Ka rite ki nga take tino noa o te mate ko:

• whati;
• nui o disorders kiko ngohengohe;
• takahi tapatahi iaia;
• kōpeketanga o te e alangá ina te tubu tū;
• maka tika superimposed;
• weranga;
• roa pokanga pāmamae.

I roto i te rongoā, kua kīia te take ki te whakataki o te rua pēhanga uaua ranei fluids, me te werewere nakahi ngau.

mōrea High te vai me te māuiuitanga ka taero e whakahaeretia ana, thinners toto, a te tikanga i te mate toto coagulation. Ehara i waho, me take iatrogenic, inattention ki tūroro e e mauri.

Ko te ahua ma'i o te syndrome

syndrome wehenga e te natura ma'i i roto i te take o te wā roa-mahi auau. Kei te pā ana hoki e ia ki rahi te pēhanga i roto i te kopa i roto i te waewae. ngā mahi kaha tinana e nui nga rohe o rohe manakohia, whakapataritari he hua i roto i te rōrahi uaua o te 20%, e ai kōpeketanga o te wāhanga hāngai. Kei te maha pāngia wehenga syndrome i roto i kaitiaki ngaio.

pūtake pathophysiological

Pathophysiology meinga te syndrome e homeostasis kiko rohe i raro i te mana o te whara, nui haere te pēhanga i roto i te kopa, me uaua o ratou take, whakaiti rere toto i roto i te tōiti, waimaero matamua venous o toto, a ka nga rerenga toto. I te pae hopea te whakawhanake i te reira necrosis kiko e tika ana ki te kore o te hāora.

tohutanga

Tohu syndrome wehenga e rerengia ana i roto i te puka whakapeka, faaite i roto i tere nei te piki ngawhatanga, whakaritea nei e palpation (huinga tohu o te lesion kiato). Ano putanga mirumiru tohua mamae i roto i ngā uaua kaupapa hāngū (flexion me toronga o te waewae), ngaro te tūtohutanga e.

Me kï reira e te āhuatanga tino nui o te māuiuitanga pērā i wehenga syndrome he mamae, i tohu i te taumata o te kino kaha. E mea pinepine e kore e taea ki te mutu noa i muri i te whakahaere o te raau taero analgesic.

he āhuatanga hoki hau kikohangatia tenei tohu.

Ko te momo matua o te wehenga syndrome

kia puta wehenga syndrome i roto i ngā puka e rua: puku, me te myofascial (pēhanga hua ischemia syndrome muri rohe).

āhua Myofascial faaite te whakaiti i roto i te perfusion o uaua, ischemia, necrosis me te whanaketanga contracture. Ngā take mō te whakatairanga i takoto pēhanga pidfastsialnogo i roto i te kanokanototo posttraumatic, edema inflammatory, te kōpeketanga tū, puku ahu whakamua.

syndrome wehenga Myofascial pāngia te roto i whakamātautau tinana.

Ka mau ia ki pūkete te tohu e whai ake nei:

• te wa pahure i muri i te wharanga i mua i whakauru ki te whare hauora;
• te wa i te ahua o te puffiness;
• pupuhi tere o te hua (i roto i 6-12 haora i muri i whara);
• wā whakamahi o te pāpuni , me te ārai o te ischemia (tango o te pukupuku mo te wa poto).

Ko te mamae e pumanawa hohonu pūāhua. rerekē ratou kaha nui atu i roto i te noa pakaru, e kore Katohia e immobilizing te rohe kafó me Pë i roto i pota tikanga.

puta mamae i roto i te hāngū totoro o nga uaua i raro ki te kino. Ka huri tēnei te tūranga o te maihao.

He tikanga o te pēhanga inenga i roto i te kikokiko

Ka rite ki whakakitea syndrome wehenga? hanga Pathology tātaritanga e te tikanga o Whiteside (1975), tuku ki te ine i te pēhanga interstitial.

fokotu'u mai e ia te whakamahi o:

• pūnaha ngā he manometer mēkuri;
• toru-ara katiwai;
• werohanga ngira nei diameter he kore iti iho i te 1 mm;
• ngongo;
• rōrahi pūwero o 20 ml.

I tēnei wā, ki te whakatau i te pēhanga tono apparatuses pidfastsialnogo e mahi aroturuki wā roa-. Kua whakaritea nga hua ki te taupū o te pēhanga cardiac. Te pēhanga i roto i te rohe myofascial pito e kore e nui 10 mm HG. Art. whakapumautia te aroaro o te wehenga syndrome te, ki te nui te pēhanga te tohu pidfastsialnogo te taumata tino o 40 mm HG. Art. me diastolic i raro. Ko tōna hua i runga i 4-6 haora kia whakapataritari i te takanga o te ischemia.

puka myofascial Whakarōpū

• mate Lung - te wāhanga e alangá distal ki te ongo mahana. I runga i nga pera matua o te pini tuhipoka haumaru. pēhanga podfastsialnogo tohu i 40 mm HG. Art. diastolic raro.
• Mean lesion - kiri i runga i wahi alangá pakaru he pāmahana raro atu hauora. hyperesthesia tohua e alangá mo rehunga ranei maihao. Pulse he ngoikore. Podfastsialnoe ki pēhanga diastolic ko te taua.
• He hinga taimaha - te pini o te pera nui e kore he detectable. rehunga maihao ua faariro. Podfastsialnoe runga ake te pēhanga diastolic.

Ko te pārōnaki o te tātaritanga

kia kitea wehenga syndrome i kino ki te oko matua, te aroaro o te matua Thrombosis, kino ki te kahiwi karere o clostridial me myositis kore-clostridial.

kia kawea te tātaritanga pārōnaki i roto i roto i te runga ki te maha o paearu:

• pulsations aroaro;
• huamo;
• kore o sensation i te wahi;
• Toto paihana;
• te whakatairanga leukocytes;
• tohu pēhanga pidfastsialnogo.

Ko te hinganga o nga uaua o te kikowhiti

E wehea e toru wheua fascial takotoranga uaua i roto i te fascia o te kikowhiti: kurupae lateral i roto i uaua, mua (uaua kawenga mō te flexing nga maihao) me whakaara (uaua whai wāhi i roto i te maihao whakawhānui).

Ki te kore e taea e te manawanui tika ana maihao, ka whakatakoto ana te reira i te tātaritanga, rite te mua o te syndrome kikowhiti kompartament. Ki te kore e taea e te manawanui e whakapiko i tana maihao, ka patua te take muri.

Ko te mate o uaua waewae

Kuao uaua fascia wehea e takotoranga wha wheua-fascial:

• lateral (uaua peroneal);
• Mua (te kawenga mō te toronga o te waewae);
• Rear (mata soleus uaua);
• muri hohonu (kawenga mō te flexion).

Ki te taea e ki whakapakari i te waewae me matimati, me te ngana o taua mahi te manawanui ko ai ia mamae kino, ka taea tatou te kōrero e pā ana ki te aroaro o te mārōrō wehenga syndrome, a ki te kore ia e taea e tika ana maihao, he mea he tirohanga muri.

puku

Pūnoa tohu pēhanga i roto i te kōhao puku tei runga i te taimaha tinana, me te he āhua rite ki te kore. Ko te puku ko te awa mo te wai, ai te pēhanga ki runga ki te mata, me te i roto i ngā wāhi katoa rite. taea ana te ruri kōtuitui-puku pēhanga i roto i tetahi tari kopu.

He aha e nga āhuatanga mōrearea mō te syndrome puku o takawhita? Ko te take matua i roto i te manakohia intestinal paresis, whētuki maha, laparotomy whawhati tata i roto i te manawanui e riro te therapy whaowhia kaha. faarahi tenei te rōrahi o te wai i roto i te puku.

Na ka nui haere te mano o tūroro i muri i te pokanga i roto i te tohu pēhanga puku i roto i tona kōhao e 3-13 mm HG. Art. kahore tetahi tohu haumanu

A, no te riro te pēhanga i roto i te abdominoplasty puku ki runga ake i te 15 mm HG. st., e whakaoho te whanaketanga o te syndrome wehenga puku.

Ki te toharite 25 mm HG. Art. me te kore i tohua i roto i te tohanga o oko nui i roto i te peritoneum, ārahi ki hēnga o ōna whatukuhu, me te whakararuraru, o te ngakau, me te toto oko.

Te pēhanga i roto i te rohe puku i runga 35 mm HG. Art. taea tīmata te hopu cardiac tonu.

Nahea syndrome wehenga puku?

whakakitea syndrome wehenga puku te i roto i te manawa uauatanga mata me te whakaiti i putanga cardiac. tuhipoka hoki te aroaro o te putanga mimi, toto hāora waiwai.

wha hoki nga tu o te takawhita i te peritoneum tukua te i roto i te rongoa:

• tohu 1 - he tohu o te pēhanga o 12-15 mm HG. Art.
• 2 pēhanga mehua stepen- o 16-20 mm HG. Art.
• tohu 3 - he tohu te pēhanga 21-35 mm HG o. Art.
• tohu 4 - he tohu o te pēhanga i runga 35 mm HG. Art.

Methods mō te ine i te pēhanga i roto i te peritoneum

Ka rite ki te tikanga, whanganga te pēhanga i roto i te rohe puku te mā te tōngāmimi. mahi taiepa stretchable pai rite te kaiwhakahaere pēhanga intraabdominal hāngū ki te kore rōrahi inu i roto i te peritoneum e nui ake 50-100 ml. Ki te rōrahi nui o te inenga awe e uaua pēhanga tōngāmimi.

Therapy mō te syndrome puku

Ka rite ki tāmau syndrome wehenga? Treatment tā te ako ranei whakakorenga o nga take (tango o kōpeketanga hosiery, papahamo tu tiketike, sedatives). therapy hāora kawea, i roto i nei whakamahia ko te ngongo nasogastric.

Hei aukati i hemodynamic decompensation whakahokia waiwai toto hāora me te coagulation papaitia. whakaaturia hoki ko te pēhanga i roto i te peritoneum me te aroturuki i te tahi atu mahi.

Wehenga syndrome o tafa puku whakakorea e decompression laparostomy. catheterization whakamana ki te whakapiki ake i te peritoneum.

Ko te ngā matua i roto i te maimoatanga momo

A, no te maimoatanga momo, te mau ohipa e whai ake nei:

• faaore kōpeketanga o te wāhi kua pā (tango o tapo'io, kiri te raima, he vaivai o te pamu kōhiwi, te wāhi o te e alangá pāngia i te taumata kotahi ki te ngakau e faataupupû i te whanaketanga o te ischemia);
• tohanga papaitia, kua whakakorea i roto i te spasm iaia me nui haere coagulation;
• whakapiki i tohu rere toto;
• Pë tīpakongia (Pë whakapōauau hāngai matū, me te tikanga ano āhua kore-whakapōauau);
• relieves tetere;
• acidosis tāmau.

Ki te kahore i kawea mai i te hua e tūmanakohia ana maimoatanga momo, i reira te mea he pēhanga taumata podfastsialnogo tino runga ake te taumata kitea reo uaua, me te edema, te wawaotanga hāparapara whakaahua (tono o te fasciotomy decompression). Ka taea e kawe te reira i te haumanu, me te ārai i roto i te natura.

He aha te mea fasciotomy decompressive?

fasciotomy Decompressive - he tukanga hāparapara e hāngai ana te ārai me te awhina o wehenga syndrome. Na roto i te paitanga mahi, ki te pera pakaru me uaua o te pokohiwi. Hoki, kua whakakorea ai e te wehenga syndrome o te wāhanga medial o te tahi whatīanga, te mau hopearaa o whara me te tuke fossa pera me uaua i raro i te turi. kawea Fasciotomy mo te wahi tino i roto i roto i te topito o raro.

Tuhinga mō te fasciotomy ārai

Ko te tohu matua ngā:

• te aroaro o te iti hoki venous;
• pera kino i raro i te turi;
• kore ki te whakaoti i te hangaia anō o te pera;
• i muri i te anō o te pera;
• korerotia kiko ngohengohe huamo o te wahi.

A faatere fasciotomy hauora

whakamana te mahi i roto i te tūroro ki te pēhanga subfascial korerotia kitea i roto i te ako. Index i runga 30 mm HG. Art. no ki te kāwai o te pathological.

Te whakanui ake i te pēhanga subfascial ko te tohu tino mo tafa curative.

Ko te tohu e whai ake nei ko nga tohu matua mō tenei pokanga:

• te aroaro o paresthesias;
• mamae i roto i nekehanga hāngū o te alangá;
• aroaro o te pāpāngia ka tiaki io;
• heke he pini piringa.

whakatūpato

e kore e kawe i roto i te mahi taua i roto i te hip pokohiwi ranei. "Mannitol" me paturopi e anake i te ngarahu pai o te tākuta.

Fasciotomy - mahi, e ai meinga me pōauautanga (mate, āhua ma'i o te mamae, aroaro o paresthesia, pupuhi, te tapû-). Me kï reira e puta pinepine ratou, engari ko reira tonu te tūponotanga. Na reira, i mua i te wawaotanga titau whakamātautau tupato o te manawanui.

fasciotomy Decompressive i roto i te kikowhiti

Pokanga ki te tango i taua māuiuitanga rite te syndrome kikowhiti wehenga, whai wāhi te whakamahi o rehunga rohe. kawea te kokoti e i te epicondyle ki te rohe ringa. whakatuwheratia te fascia te i runga i te uaua flexor i roto i te rohe whatīanga. neke ia medially. uaua ausia kawenga mō te flexion, huri lateral. tapahia te fascia te runga ake te flexor hohonu. Ia fascia uaua whakakitea te wāhanga roa.

Ki te kō atu volar tika hikumārō kokoti. pupuhi tonu ringa Live. Kitea tona hyperemia whakautu.

tae uaua Devitalized (te tikanga he bender, kei roto i te hohonu) i roto i kōwhai, i te mea angamaheni o necrosis. E kore te te fascia sutured. patunga waihakihaki sutured kahore mānukanuka. Ki te kore e taea te whakatinanatanga o taua whawhe, mahue te motu kiri e tuwhera i roto i te puka o te takai.

Takai tono antiseptics sorbents ranei. Muri whakamahia matou hinu whakaehunga wai.

superimpose hononga Tuarua ra e rima i muri i te pokanga. I te tahi taime tonu tuwhera mo te marama te marutanga. I roto i ētahi wā, ki te kati i te motu te tono motu wāhine atu momo rerekē o te tafa kirihou ranei.

Technique o fasciotomy i runga i te paraihe

Ko te mahi Ko tā te kōmihana o te wāhanga roa i roto i te rohe o te tikanga o te wheua metacarpal tuatahi. kawea te kokoti taua i roto i roto i te whakarara wheua carpal tuarima. I te wa ano e kore e whakawhiti reira te ngä o te karere ulnar. intercostals Decompression uaua i hanga o ngā wāhanga motuhake i runga i te muri o te paraihe.

E mau ana i runga i te fasciotomy waewae raro

whakakorea raro syndrome waewae wehenga e pokanga ki rehunga rohe.

Ki te he uaua te manawanui ki whakapiko i te waewae me matimati no o te mamae whakapeka, he reira taea ki te whakawa i te aroaro o te mārōrō wehenga syndrome. Ki te kore ia e taea e tika i te waewae o raro, ko reira te muri tāhau wehenga syndrome.

Hei hura wā katoa, kua haere ki te rua, e toru ngā wāhanga ahopou i roto i te waewae, te roa o te mea 15 cm. Ki te kia whai kokoti fascia tika he puka Z-āhua.

Ki te kore te te tohanga toto i roto i te waewae whakaritea i roto i te meneti torutoru, faahohonu te kokoti medial ka whakatuwheratia he take i runga i te muri e te tikanga o kutikuti. e kore e kokoti o te fascia mau he scalpel, rite koutou kia tūkino i te iatuku posterior tibial me karere tibial.

Ko te fascia kokoti i roto i te āhua tuwhera. Ki te taea, te motu i runga i te kiri sutured kahore mānukanuka. Ki te kore e taea te tuitui, tonu te patunga tuwhera i raro i te tipare. Kei te nuinga o te wā tāpae mekameka Tuarua i muri i te 5 ra.

Technique o te mahi i runga i te waewae

titau te mahi taua te aroaro o wha huarahi. hanga e rua kokoti hikumārō te haere te 2, me te 4 wheua metatarsal, i roto i nei whakatuwhera wha ngā āputa i waenganui i nga wheua me te putea pokapū i roto i te tāpae. Ko tētahi atu tokorua o motu rerekë me medially mahi. whakatuwhera ratou take.

Mahi whakahaere ki te uaua kiko necrosis, he nui rawa o te pai. I te toru o nga ra i muri i decompression heke ngawhatanga, a ko reira taea ki te maru ia katinga. Ki te mea kua kua tāutuhia decompression necrosis o te kiko uaua, ka tango i te wahi mate. hiki kōpeketanga Whakamutunga i roto i tenei take e hoki te wiki.

waitohunga

Waitohunga o te mate, ko te tika ti'aturi i runga i te tanoraa o te therapy me te whakatinanatanga ki tonu o te pokanga. Ki te tāmau te mamae kei, reira he mate neurological, reira te tikanga tohu te huringa pathological tina heke. Atu necrectomy whakatinanatanga me ētahi atu ngā tukanga e kore e taea e ki te whakaora i te tapuhia e alangá o ona whakaaturanga. I roto i te tikanga e kore e ki te kawea te āhuatanga ki te tino, e tūtohu ana i roto i te wā ki te kawe i roto i ngā mahi katoa e kua hāngai ana aukati i te syndrome whanaketanga komparment.