Rushewar hannu: haddasawa, ganewar asali, magani

Manufar haɗin hannu ya haɗa da wuyan hannu, tsakiyar carpal, intercarpal da carpometacarpal haɗin gwiwa. Rushewar hannu (bisa ga lambar ICD-10 - S63) yana haifar da raguwa na haɗin wuyan hannu, wanda ya lalace fiye da wasu kuma yana da haɗari ta lalacewar jijiyar tsakiya da tsalle. Wannan hadadden hadadden tsari ne wanda aka samar dashi daga saman kasusuwa na hannu da hannu.

Representedangaren kusancin yana wakiltar saman saman radius da ulna. An kafa ɓangaren nesa ta saman ƙasusuwan hannu na jere na farko: scaphoid, lunate, triangular and pea-shaped. Raunin da yafi kowa shine rabuwa, wanda a ciki akwai ƙaura daga saman abubuwan da ke da alaƙa da juna. Halin da ake ciki na rauni shine babban motsi na hannu, wanda ke haifar da rashin kwanciyar hankali da kuma saurin saurin rauni.

Dalilin

A cikin ilimin ilimin yanayin rarrabuwa, babban matsayin nasa shine faduwa da busawa:

• Faduwar:
  • a kan miƙe hannuwa;
  • yayin wasan kwallon raga, kwallon kafa da kwallon kwando;
  • yayin gudun kan kan kan (kan kankara, kan kan kankara)
• Darussa:
  • tuntuɓar wasanni (sambo, aikido, dambe);
  • dagawa.
• Tarihin raunin wuyan hannu (rauni mai rauni).
• Hadarin hanyoyin mota.
• Raunin aiki (faɗuwar mai keke).

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Kwayar cututtuka

Babban alamun alamun rabuwa bayan rauni sun hada da:

• abin da ya faru na kaifi mai zafi;
• ci gaba mai tsanani edema a cikin minti 5;
• jin nutsuwa ko raɗaɗɗen ciki a kan buguwa, kazalika da yin ƙyalƙyali a cikin jijiya na jijiyar tsakiya;
• canji a cikin siffar hannun tare da bayyanar fitarwa a cikin yankin jakar mahaɗa;
• iyakancewar kewayon motsin hannu da zafi lokacin da ake kokarin yin su;
• raguwa a cikin ƙarfin jujjuyawar hannu.

Yadda za a rarrabe rarrabuwa daga rauni da karaya

Taimako na farko

Idan ana zargin rabuwa, ya zama dole a sanya hannun da ya ji rauni ta hanyar ba shi matsayi mai girma (ana ba da shawara don ba da tallafi tare da taimakon ɓarna mara kyau, wanda ana iya yin aikinsa da matashin kai na yau da kullun) da kuma amfani da jakar kankara a cikin gida (dole ne a yi amfani da kankara cikin awanni 24 na farko bayan rauni, ana neman 15 -20 mintuna zuwa yankin da abin ya shafa).

Lokacin amfani da takalmin da aka yi a cikin gida, babban gefensa ya kamata ya tsallake bayan gwiwar hannu da gaban yatsun kafa. Yana da kyau a sanya wani abu mai laushi mai laushi (dunkulen yadi, auduga ko bandeji) a cikin goga. Da kyau, hannun da ya ji rauni ya kasance sama da matakin zuciya. Idan ya cancanta, ana nuna gudanarwar NSAIDs (Paracetamol, Diclofenac, Ibuprofen, Naproxen).

A nan gaba, ya kamata a kai wanda aka azabtar zuwa asibiti don yin shawarwari tare da likitan mai fama da rauni. Idan fiye da kwanaki 5 sun shude tun lokacin raunin, ana kiran rabuwa na kullum.

Irin

Dogaro da wurin raunin, rarrabe rarrabuwa ya bambanta:

• kashi scaphoid (da wuya ake bincikar sa);
• kashi mara nauyi (na kowa);
• kasusuwa na metacarpal (musamman babban yatsa; rare);
• hannu tare da sauya dukkan ƙasusuwan wuyan hannu a ƙasa da abincin, zuwa baya, sai dai na ƙarshe. Irin wannan rushewar ana kiransa perilunar. Yana da in mun gwada da na kowa.

Ragewar wata da haɗari na faruwa a cikin kashi 90% na raunin hannun da aka binciko.

Rikice-rikice, kazalika da rarrabuwar kai na gaskiya - dorsal da palmar, sanadiyyar sauyawar layin sama na ƙashin wuyan hannu dangane da farfajiyar radius - suna da wuya ƙwarai.

Ta hanyar matsuguni, ana tabbatar da rarrabuwa don:

• cikakke tare da cikakken rabuwa da kasusuwa na haɗin gwiwa;
• bai cika ba ko subluxation - idan saman saman ya ci gaba da taɓawa.

A gaban cututtukan cututtukan cuta, raguwa na iya zama al'ada ko haɗuwa, tare da cikakke / lalacewar fata - rufe / buɗe.

Idan raguwa ta sake dawowa fiye da sau 2 a shekara, ana kiransu al'ada. Haɗarinsu ya ta'allaka ne a kan ƙarancin ƙwayoyin jikin mutum sannu a hankali tare da ci gaban cututtukan zuciya.

Diagnostics

Ana yin binciken ne bisa ga koke-koken mara lafiyan, bayanan halitta (wanda ke nuna raunin), sakamakon bincike na haƙiƙa tare da kimantawar tasirin abubuwan da ke faruwa a asibiti, da kuma gwajin X-ray a tsinkaye biyu ko uku.

Dangane da yarjejeniyar da masanan cututtukan suka ɗauka, ana yin aikin rediyo sau biyu: kafin fara magani da kuma bayan sakamakon raguwa.

Dangane da ƙididdiga, tsinkaya daga gefe sune mafi fa'ida.

Rashin dacewar X-ray shine a gano karayar kashi ko fashewar jijiya. Don bayyana ganewar asali, ana amfani da MRI (hoton maganadisu) don gano karayar kashi, daskararren jini, fashewar jijiyoyi, maganin necrosis da osteoporosis. Idan ba za a iya amfani da MRI ba, ana amfani da CT ko duban dan tayi, waɗanda ba su da daidai.

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Jiyya

Dogaro da nau'in da kuma tsananin, za a iya aiwatar da ragin a ƙarƙashin na cikin gida, na maganin rigakafi ko maganin saurara (don shakatar da jijiyoyin hannu). A cikin yara ƙasa da shekara 5, ana yin ragin koyaushe a ƙarƙashin maganin sa barci.

Rufe raguwa a rufe

Warewar wuyan hannu ya zama sauƙaƙe ta hannun likitan ƙashi. A algorithm na ayyuka kamar haka:

• Stretchedungiyar wuyan hannu an miƙe ta jawo gaban goshi da hannu a wasu kwatancen, sa'annan a saita.
• Bayan ragi, idan ya cancanta, ana ɗaukar hoto na X-ray, bayan haka ana amfani da bandejin gyaran filastar zuwa yankin rauni (daga yatsun hannu zuwa gwiwar hannu), an saita hannun a kusurwar 40 °.
• Bayan kwanaki 14, an cire bandejin ta matsar da hannu zuwa matsakaici; idan sake yin bincike ya nuna rashin kwanciyar hankali a cikin haɗin gwiwa, ana yin gyare-gyare na musamman tare da wayoyi Kirschner.
• An sake gyara burushi tare da simintin gyaran filastin sati 2.

Mutuwar hannu mai nasara yawanci ana tare da danna haruffa. Don hana yiwuwar matse jijiyar a tsakiya, ana bada shawara akai-akai a duba yanayin yatsun filastar simintin gyaran kafa.

Masu ra'ayin mazan jiya

Tare da raguwar rufe nasara, an fara magungunan mazan jiya, wanda ya haɗa da:

• Magungunan ƙwayoyi:
  • NSAIDs;
  • opioids (idan sakamakon NSAIDs bai isa ba):
  • • gajeren aiki;
    • dogon lokaci;
  • tsoffin shakatawa na aikin tsakiya (Mydocalm, Sirdalud; ana samun matsakaicin sakamako yayin haɗuwa da ERT).
• FZT + aikin motsa jiki don hannun da ya ji rauni:
  • maganin warkewa na kyallen takarda mai laushi;
  • micromassage ta amfani da duban dan tayi;
  • gyaran orthopedic ta amfani da daskararre, na roba ko hadewar hade;
  • thermotherapy (sanyi ko zafi, dangane da matakin rauni);
  • motsa jiki na motsa jiki da nufin miƙawa da haɓaka ƙarfin tsokoki na hannu.
• Magunguna (analgesic) far (glucocorticoid kwayoyi da maganin sa barci, misali, Cortisone da Lidocaine, ana allurar su a cikin haɗin haɗin da aka shafa).

Tiyata

Ana yin amfani da magani don lokacin da rage rufewa ba zai yiwu ba saboda rikitarwa na rauni da kuma kasancewar matsaloli masu haɗuwa:

• tare da lalacewar fata mai yawa;
• fashewar jijiyoyi da jijiyoyi;
• lalacewar radial da / ko jijiyar ulnar;
• matsawa na jijiyar tsakiya;
• haɗuwa da haɗuwa tare da ɓarkewar kasusuwa na ƙashin hannu;
• karkatarwa da kashin scaphoid ko lunate;
• tsufa da lalacewar al'ada.

Misali, idan mai haƙuri yana da damuwa fiye da makonni 3, ko kuma raguwar an yi shi ba daidai ba, ana nuna maganin tiyata. A wasu lokuta, ana shigar da kayan aiki na jan hankali. Rage gabobin jijiyoyin kasusuwa galibi ba zai yuwu ba, wanda kuma shi ne tushen aikin tiyata. Lokacin da alamun matsawa na jijiya na tsakiya suka bayyana, ana nuna tiyatar gaggawa. A wannan yanayin, lokacin gyarawa na iya zama watanni 1-3. Bayan an sake dawo da gabar jikin, mai gyaran kafa ya motsa hannun ta amfani da filastar filastik na musamman har tsawon makonni 10.

Sauye-sauye sau da yawa ana gyara su na ɗan lokaci tare da wayoyi (sanduna ko fil, sukurori da takalmin kafa), waɗanda suma ana cire su tsakanin makonni 8-10 bayan kammala warkarwa. Amfani da waɗannan na'urori ana kiransa haɗin ƙarfe.

Gyarawa da motsa jiki

Lokacin dawowa yana hada da:

• FZT;
• tausa;
• wasan motsa jiki na likita.

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Irin waɗannan matakan suna ba da izinin daidaita aikin kayan musculo-ligamentous na hannu. Maganin motsa jiki yawanci ana ba da umarnin makonni 6 bayan rauni.

Babban darasin bada shawarar sune:

• ionarƙwara-motsa jiki (motsa jiki yana kama da motsi mai laushi (jinkirin shanyewar jiki) tare da buroshi lokacin rabuwa);

• ctionarɓar zamewa (farawa - tsayawa da bayanku zuwa bango, hannaye a gefuna, dabino a gefen ƙananan yatsun suna kusa da cinyoyi; ya zama dole yin motsi tare da burushi a cikin jirgin sama na gaba (wanda bangon yake a bayan baya) ko dai zuwa ɗan yatsan hannu ko zuwa babban yatsa );

• supination-pronation (ƙungiyoyi suna wakiltar juya hannu bisa ka'idar "miyar da aka ɗauka", "miyar da aka zube");

• tsawo-haduwar yatsu;

• matse wuyan mai fadada;

• darussan isometric

Idan ya cancanta, ana iya yin atisaye tare da nauyi.

Gidaje

ERT da aikin motsa jiki ana fara aiwatar dasu ne bisa tsarin kula da marasa lafiya kuma ƙwararren masani ne ke sarrafa su. Bayan mai haƙuri ya saba da cikakken motsa jiki da kuma dabarun da ya dace don yin su, likita ya ba shi izinin yin aiki a gida.

Daga cikin magungunan da aka yi amfani da su akwai NSAIDs, man shafawa mai tasiri (Fastum-gel), bitamin B12, B6, C.

Lokacin dawowa

Lokacin gyarawa ya dogara da nau'in wargajewa. Bayan wasu takamaiman makonni:

• jinjirin wata - 10-14;
• mai haɗari - 16-20;
• scaphoid - 10-14.

Saukewa a cikin yara ya fi na manya sauri. Kasancewar ciwon sukari yana kara tsawon lokacin gyarawa.

Rikitarwa

Dangane da lokacin abin da ya faru, rikitarwa sun kasu kashi biyu:

• Farkon (yana faruwa a cikin farkon awanni 72 bayan rauni):
  • iyakancewar motsi na mahaɗan haɗin gwiwa;
  • lalacewar jijiyoyi ko jijiyoyin jini (lalacewar jijiyar ta tsakiya babbar matsala ce);
  • edema mai laushi na kyallen takarda mai laushi;
  • hematomas;
  • nakasawa daga hannu;
  • jin narkar da fata;
  • hyperthermia.
• Late (ci gaba kwanaki 3 bayan rauni):
  • shiga cikin kamuwa da cuta ta biyu (ɓarna da phlegmon na daban daban na gida, lymphadenitis);
  • cututtukan rami (rashin jin daɗi na jijiyar tsakiya tare da jijiya ko jijiyar hawan jini);
  • amosanin gabbai da cututtukan zuciya;
  • amentididdigar ligament;
  • atrophy na tsokoki na hannu;
  • keta ikon motsi.

Matsalolin rabuwa da wata wata galibi ne cututtukan zuciya, ciwon ciwo mai tsanani, da rashin kwanciyar hankali.

Menene haɗarin rabuwa a cikin yara

Hadarin ya ta'allaka ne da cewa yara ba sa son kulawa da amincinsu, suna yin ƙungiyoyi masu yawa, don haka rabuwarsu na iya sake dawowa. Sau da yawa tare da raunin kashi, wanda, idan ya sake lalacewa, na iya canzawa zuwa rabewa. Iyaye suna buƙatar yin la'akari da wannan.

Rigakafin

Don hana sakewa daga maimaitawa, ana nuna aikin motsa jiki, da nufin ƙarfafa tsokoki na hannu da ƙashin ƙashi. Don wannan, an kuma tsara abincin da ke cike da Ca da bitamin D. Ya zama dole a dauki matakan rage barazanar faduwa, tare da kebe wasu motsa jiki da ke haifar da tashin hankali (kwallon kafa, wasan motsa jiki) Electrophoresis tare da lidase da magnetotherapy matakai ne masu tasiri don hana ci gaban cutar ramin rami.

Kalli bidiyon: Atiku Yana Da Hannu Wajen Rushewar Bank PHB inji Ministan Labarai Lai Muhd (Nuwamba 2024).