Styloid stenosis tenosynovitis numuriro wa aseptic uterwa nububabare no kubyimba kwa ba rushimusi pollicis longus hamwe na extensor pollicis brevis tendons kuri dorsal carpal sheath kuri radiyo styloide. Ibimenyetso bikomera hamwe no kwagura igikumwe no gutandukana kwa calimor. Iyi ndwara yavuzwe bwa mbere n’umuganga w’ubuvuzi w’Ubusuwisi de Quervain mu 1895, bityo radial styloid stenosis tenosynovitis izwi kandi ku ndwara ya Quervain.
Iyi ndwara ikunze kugaragara ku bantu bakora ibikorwa byinshi by'intoki n'intoki, kandi bizwi kandi ko ari “ukuboko kwa nyina” na “urutoki rw'imikino”. Hamwe niterambere rya interineti, umubare wabantu banduye iyi ndwara uragenda wiyongera. Nigute dushobora gusuzuma no kuvura iyi ndwara? Ibikurikira bizaguha intangiriro ngufi mubice bitatu: imiterere ya anatomique, gusuzuma ivuriro nuburyo bwo kuvura!
I.Anatomy
Inzira ya styloide ya radiyo ifite sulcus ntoya, itagabanije itwikiriwe na dorsal carpal ligament ikora fibrous sheath of bone. Abashimusi ba pollicis longus tendon na extensor pollicis brevis tendon banyura mururu rubuto hanyuma bakazenguruka ku mfuruka hanyuma bikarangirira munsi yamagufwa ya metacarpal yambere hamwe nigitereko cya phalanx yegeranye yintoki, (Ishusho 1). Iyo igitereko kinyerera, haba imbaraga nini zo guterana, cyane cyane iyo intoki ulnar gutandukana cyangwa kugenda igikumwe, inguni yiyongera, byongera ubushyamirane hagati yigitereko nurukuta rwicyatsi. Nyuma yigihe kirekire gisubiramo imbaraga zidakira, synovium yerekana impinduka zumuriro nka edema na hyperplasia, bigatera umubyimba, gufatana cyangwa kugabanuka kurukuta rwimitsi hamwe nicyatsi, bikaviramo kwigaragaza kwa stenosis tenosynovitis.
Igishushanyo.1 Igishushanyo cya Anatomical yuburyo bwa styloide ya radiyo
II.Gusuzuma indwara
1.Amateka yubuvuzi aramenyerewe cyane mumyaka yo hagati, abakora intoki, kandi bikunze kugaragara mubagore; Gutangira biratinda, ariko ibimenyetso birashobora kugaragara gitunguranye.
2.Ibimenyetso: ububabare bwaho muburyo bwa styloide ya radiyo, ishobora gukwirakwira mukiganza no kuboko, intege nke zintoki, kwagura urutoki ruto, kwiyongera kwibimenyetso mugihe kwagura igikumwe no gutandukana kwintoki ulnar; Imitsi ishobora guhinduka irashobora kugaragara neza kuri styloide ya radiyo, isa na bony eminence, ifite ubwuzu bugaragara.
3.Ikizamini cya Finkelstein (ni ukuvuga, ikizamini cya fist ulnar deviation) ni cyiza (nkuko bigaragara ku gishushanyo cya 2), igikumwe kirahindagurika kandi gifashwe mu kiganza, ukuboko kwa ulnar kiratandukana, kandi ububabare kuri radiyo styloide bwiyongera.
4.Ikizamini gifasha: Ikizamini cya X-ray cyangwa ibara rya ultrasound rishobora gukorwa nibiba ngombwa kugirango hamenyekane niba hari amagufwa adasanzwe cyangwa synovitis. Amabwiriza yubuvuzi butandukanye bwo kuvura Styloid Stenosis Tenosynovitis ya Radius Menya ko ibindi bizamini bisabwa gutandukanya osteoarthritis, ihungabana ryishami ryimbere ryimyakura ya radial, hamwe na syndrome de coiffure mugihe cyo kwisuzumisha.
III.Umuti
Ubuvuzi bwa Konserwatori Ubuvuzi bwa immobilisation bwaho: Mugihe cyambere, abarwayi barashobora gukoresha igitereko cyo hanze kugirango bahindure ingingo zanduye kugirango bagabanye ibikorwa byaho kandi bagabanye ubushyamirane bwururondogoro mumatongo kugirango bagere kuntego yo kuvura. Ariko, ubudahangarwa ntibushobora kwemeza ko ingingo yanduye ihari, kandi kumara igihe kirekire bishobora kuviramo gukomera kwigihe kirekire. Nubwo ubundi buvuzi bufashwa na immobilisation bukoreshwa muburyo bwubuvuzi, ingaruka zo kuvura zikomeje kutavugwaho rumwe.
Ubuvuzi bwaho bwo kwifata: Nkubuvuzi bwatoranijwe bwo kuvura kwa muganga, ubuvuzi bwaho bwerekeza ku gutera inshinge aho ububabare bwabereye kugirango bugere ku ntego yo kurwanya inflammatory. Ubuvuzi bwihariye bushobora gutera ibiyobyabwenge ahantu hababaza, isakoshi ihuriweho, imitsi yumutima nibindi bice, bishobora kugabanya kubyimba no kugabanya ububabare no kugabanya spasms mugihe gito, kandi bigira uruhare runini mukuvura ibikomere byaho. Ubuvuzi bugizwe ahanini na triamcinolone acetonide na lidocaine hydrochloride. Sodium hyaluronate inshinge nazo zirashobora gukoreshwa. Nyamara, imisemburo irashobora kugira ibibazo nkububabare nyuma yo guterwa inshinge, pigmentation yuruhu rwaho, atrophy ya tissue subutaneous tissue atrophy, gukomeretsa imitsi ya radial nervice, hamwe na glucose yamaraso. Ibintu nyamukuru bibuza ni imisemburo ya allergie, abarwayi batwite n'abonsa. Sodium hyaluronate irashobora kuba ifite umutekano kandi irashobora gukumira inkovu zifatika zifata imitsi kandi igatera gukira kw'imitsi. Ingaruka zivura zo kuvura zidasanzwe ziragaragara, ariko hari raporo z’amavuriro zerekana urutoki rwa nérosose zatewe no gutera inshinge zidakwiye (Ishusho 3).
Igishushanyo.3 Gufunga igice biganisha kuri necrosis yintoki zintoki zintoki: A. Uruhu rwikiganza ruba rworoshye, na B, C. Igice cyo hagati cyurutoki rwerekana intera iri kure cyane, kandi urutoki ni necrosis
Icyitonderwa cyo kuvura bidasanzwe mu kuvura radius styloid stenosis tenosynovitis: 1) Umwanya urakwiye, kandi singe igomba gukurwaho mbere yo gutera imiti kugirango urushinge rwo gutera rutinjira mu maraso; 2) Gukingira bikwiye ingingo zanduye kugirango wirinde gukora imburagihe; 3) Nyuma yo guterwa imisemburo ya hormone, hakunze kubaho urugero rutandukanye rwububabare, kubyimba, ndetse no kongera ububabare, mubisanzwe bikabura muminsi 2 ~ 3, niba ububabare bwurutoki na pallor bugaragaye, imiti igabanya ubukana bwa antispasmodic na anticoagulant igomba gutangwa vuba, kandi angiografiya igomba gukorwa kugirango isuzume neza niba bishoboka, kandi ubushakashatsi bwamaraso bugomba gukorwa vuba bishoboka; 4) Kwanduza imisemburo nka hypertension, diyabete, indwara z'umutima, nibindi, ntibigomba kuvurwa hamwe na hamwe.
Shockwave: ni imiti igabanya ubukana, idatera kandi ifite inyungu zo kubyara ingufu hanze yumubiri no gutanga ibisubizo ahantu hagenewe imbere mu mubiri bitarinze kwangiza imyenda ikikije. Ifite ingaruka zo guteza imbere metabolisme, gushimangira amaraso no gutembera kwa lymphatike, kunoza imirire yumubiri, gutobora capillaries zifunze, no kurekura ingingo zifatika zifatika. Icyakora, byatangiye bitinze kuvura styloid stenosis tenosynovitis ya radiyo, kandi raporo z’ubushakashatsi zayo ni nkeya, kandi ubushakashatsi bunini bwagenzuwe buracyakenewe kugira ngo hatangwe ibimenyetso byinshi bishingiye ku buvuzi kugira ngo buteze imbere ikoreshwa mu kuvura indwara ya styloide stenosis tenosynovitis ya radiyo.
Ubuvuzi bwa Acupuncture: kuvura acupuncture ntoya nuburyo bufunze bwo gufunga hagati yubuvuzi bwo kubaga no kutavurwa, binyuze mu gutobora no gutobora ibikomere byaho, gufatira hamwe kurekurwa, kandi kwinjiza imitsi yimitsi iva mu mitsi byoroha cyane, kandi gutembera kwamaraso kwinyama ziyikikije bigatezwa imbere no gukanguka kwa acupuncture, no kugabanya gusohora kwa acupuncture, no kugabanya gusohora kwa acupuncture, no kugera ku gusohora kwa acupuncture, no kugera ku gusohora kwa acupuncture, no kugera ku musemburo wa acupuncture, no kugera ku gusohora kwa acupuncture, no kugabanya gusohora kwa acupuncture.
Ubuvuzi gakondo bw'Abashinwa: Radial styloid stenosis tenosynovitis iri mu cyiciro cya “syndrome de paralise” mu buvuzi bwa kavukire, kandi indwara ishingiye ku kubura no ku gipimo. Bitewe nigihe kirekire cyibikorwa byintoki, kunanirwa cyane, bikavamo qi yaho no kubura amaraso, ibi byitwa kubura umwimerere; Bitewe na qi yaho hamwe no kubura amaraso, imitsi nimiyoboro yabuze mugutunga no kunyerera, kandi kubera kumva umuyaga, ubukonje nubushuhe, ibyo bikaba byongera inzitizi ya qi no gukora amaraso, bigaragara ko kubyimba kwaho hamwe nububabare nibikorwa bigabanijwe, kandi kwirundanya kwa qi namaraso birakomeye cyane kandi bikaboneka ko metha ya mbere ya meta. gufatanya kwiyongera mu ivuriro, bikaba bisanzwe. Byagaragaye mubuvuzi ko kuvura moxibustion, kuvura massage, kuvura hanze yubuvuzi gakondo bwabashinwa no kuvura acupuncture bifite ingaruka zimwe mubuvuzi.
Ubuvuzi bwo kubaga: Kubagwa kwa dorsal carpal ligament ya radiyo hamwe no kugabanuka gake ni bumwe mu buryo bwo kuvura stenosis tenosynovitis muri styloide ya radiyo. Irakwiriye kubarwayi barwaye tenosynovitis ya radius styloid stenosis, itagize icyo ikora nyuma yibibazo byinshi byaho ndetse nubundi buryo bwo kuvura indwara, kandi ibimenyetso birakomeye. Cyane cyane kubarwayi barwaye stenotic yateye imbere ya tenosynovitis, igabanya ububabare bukabije kandi butavunika.
Kubaga mu buryo butaziguye: Uburyo busanzwe bwo kubaga ni ugukora ibice bitaziguye ku isoko, gushyira ahagaragara septum ya mbere ya dorsal, gukata icyuma cyijimye, no kurekura icyatsi kugira ngo igitereko gishobore kunyerera mu bwatsi. Kubaga kumugaragaro byihuse kubigeraho, ariko bitwara urukurikirane rwingaruka zo kubaga nko kwandura, kandi kubera kuvanaho mu buryo butaziguye umugozi wa dorsal mugihe cyo kubagwa, kwimura imitsi no kwangiza imitsi ya radiyo nu mitsi bishobora kubaho.
Septolysis ya 1: Ubu buryo bwo kubaga ntibukata ururenda rwinshi, ariko rukuraho ganglion cyst iboneka muri septum ya 1 ya extensor cyangwa igabanya septum hagati yabashimusi ba polisis ndende na extensor pollicis brevis kugirango irekure septum ya 1 ya dorsal. Ubu buryo busa nuburyo bwo kubaga butaziguye, hamwe n’itandukaniro nyamukuru ni uko nyuma yo guca umugozi wa extensor, umugozi wa tendon urekurwa hanyuma icyatsi cya tendon kikavaho aho gukomeretsa icyatsi kibisi. Nubwo insimburangingo ya tendon ishobora kuba muri ubu buryo, irinda septum ya 1 ya dorsal extensor kandi ikagira ingaruka ndende ndende yo guhagarara neza kuruta kwangirika kwicyatsi. Ingaruka zubu buryo ziterwa ahanini nuko icyatsi kibisi cyikuweho kidakuweho, kandi icyatsi cyinshi gishobora gukomeza kuba umuriro, kuribwa, no guterana amagambo bizatuma indwara yongera kubaho.
Kwiyongera k'umuyoboro wa Arthroscopique osteofibrous: kuvura arthroscopique bifite ibyiza byo guhahamuka gake, kuvura igihe gito, umutekano muke, ingorane nke no gukira vuba, kandi inyungu nini ni uko umukandara wo kwaguka utagizwe, kandi ntihazabaho gutandukana. Icyakora, haracyari impaka, kandi intiti zimwe zemeza ko kubaga arthroscopique bihenze kandi bitwara igihe, kandi ibyiza byayo kubaga kumugaragaro ntibigaragara bihagije. Kubwibyo, kuvura arthroscopique muri rusange ntabwo byatoranijwe nabenshi mubaganga nabarwayi.
Igihe cyo kohereza: Ukwakira-29-2024
