I-Styloid Stenosis TENOSYNOVITIS iyindlela yokuvuvukala e-adeptic ebangelwa ubuhlungu nokuvuvukala kwePoland yePolicis kanye ne-Extensor Pollicis Brevis Terpal Sheath. Izimpawu ziba zimbi ngokwengeziwe ngokunwetshwa kwesithupha nokuphambuka kwe-calimor. Lesi sifo sabikwa okokuqala ngudokotela waseSwitzerland uSurgeon dealth ngo-1895, ngakho-ke i-radial styloid stenosis tenosynovitis yaziwa nangokuthi isifo sikaServain.
Lesi sifo sivame kakhulu kubantu ababandakanyeka ku-Wrist Wrist and Palmar Finger imisebenzi, futhi saziwa nangokuthi "isandla sikamama" kanye "nomunwe womdlalo". Ngokuthuthukiswa kwe-Intanethi, inani labantu abathintwe yisifo liyanda futhi lincane. Ngakho-ke ungakuthola kanjani nokwelapha lesi sifo? Lokhu okulandelayo kuzokunikeza isingeniso esifushane kusuka ezicini ezintathu: Isakhiwo se-anatomical, ukutholakala kwemitholampilo kanye nezindlela zokwelashwa!
I.anatomy
Inqubo ye-styloid ye-radius inesisindo esincane, esingajulile esimbozwe yi-corsal carpal ligament eyakha umhlanga we-bony. I-Abvuctor Pollicis Longus Tendon kanye ne-Extensor Pollicis Brevis Tendon idlula kule Sheath bese igoba nge-angle futhi inqanyulwe esisekelweni sethambo lokuqala le-metacarpal kanye nesisekelo se-phalan ye-Phalanx yesithupha, ngokulandelana (isithombe 1). Lapho i-tendon islayida, kukhona amandla amakhulu okungqubuzana, ikakhulukazi lapho isihlakala sokuphambuka noma ukunyakaza kwesithupha, i-angle ye-fold yanda, yandisa ukungqubuzana phakathi kwe-tendon nodonga lwe-sheath. Ngemuva kokukhuthaza okungapheli okuphindaphindwayo, i-synovium iveza izinguquko ezivuvukala ezifana ne-edema ne-hyperplasia, zibangele ukuqina, ukunamathela noma ukuncipha kodonga lwe-tendon no-sheath, okuholela ekubonakalisweni komtholampilo kwe-stenosis tenosynovitis.
Fig.1 Umdwebo we-anatomical wenqubo ye-styloid yemisebe
II.Clonical Ukuxilongwa
1.Umlando wezokwelapha uvame kakhulu kuma-gain-aged, opharetha ngesandla, futhi evame kakhulu kwabesifazane; Ukuqala kuhamba kancane, kepha izimpawu zingenzeka ngokuzumayo.
2.Signs: Ubuhlungu obuhleliwe kwinqubo ye-styloid ye-radius, engakhanyisa isandla kanye ne-forearm, ubuthakathaka besithupha, ukwandiswa kwesithupha okukhawulelwe, ukwanda kwezimpawu lapho kuphambuka kwesithupha kanye nokuphambuka kwesithupha; Ama-nontules angenakuqhathaniswa angahle aphile ngenqubo ye-styloid ye-radius, afana nokuvelela kwe-bony, ngesisa esimakiwe.
3.Ukuhlolwa kukaFinkwelstein (okusho ukuthi, isivivinyo se-Ulnar Purch Tever) siyabonakala (njengoba kukhonjisiwe kuMdwebo 2)
Ukuhlolwa okusizayo: Ukuhlolwa kwe-X-ray noma ukuhlolwa kombala kwe-ultrasound kungenziwa uma kunesidingo sokuqinisekisa ukuthi ngabe kukhona ukungahambi kahle kwamathambo noma i-synovitis. Imihlahlandlela yokwelashwa okuhlukahlukene kwe-styloid stenosis stenosis tenosynovitis ye-radius yaphana ukuthi ezinye izivivinyo zomzimba zidingeka ukuhlukanisa phakathi kwe-osteoarthritis, ukuphazamiseka kwegatsha elisezingeni eliphezulu le-radial nerve nerve nerve, kanye ne-foreaearm cruciate syndrome ngesikhathi sokuxilongwa.
I-III.Treatement
I-Conservative TherappyLilocal Therapy Therapy: Eseqophelweni lokuqala, iziguli zingasebenzisa umfakeli we-fitnal wangaphandle ukuze zisebenzise umlenze othintekile ukuze zinciphise imisebenzi yasendaweni futhi zinciphise ukungqubuzana kwethende ku-tendon sheath ukufeza inhloso yokwelashwa. Kodwa-ke, ukungasebenzi kahle kungenzeka kungaqinisekisi ukuthi umlenze othintekile usendaweni, futhi ukuphefumula okuhlala isikhathi eside kungahle kube nokuqina kokunyakaza kwesikhathi eside. Yize ukungasebenzi kahle - okusize ezinye izindlela zokwelapha zisetshenziswa ngokwezifiso emtholampilo, ukusebenza kahle kokwelashwa kuhlala kuyimpikiswano.
Ukwelashwa kwe-Local Occlusion: Njengokwelashwa okukhethwa kukho okulondoloziwe kokwelashwa kwemitholampilo, ukwelashwa kwe-occlusion yendawo kubhekisele emjovo wokungenela esizeni sobuhlungu sendawo ukufeza inhloso yokulwa nokuvuvukala kwasendaweni. Ukwelashwa okuvelayo kungafaka izidakamizwa endaweni ebuhlungu, i-Joint Sheath Sac, isiqu sezinzwa nezinye izingxenye, esinganciphisa ukuvuvukala futhi sidlale indima enkulu ekwelapheni izilonda zasendaweni. I-Therapy iqukethe ikakhulukazi i-Triamcinolone Acetonide neLidocaine Hydrocloworide. Imijovo ye-sodium hyaluronate nayo ingasetshenziswa. Kodwa-ke, ama-hormone angaba nezinkinga ezinjengobuhlungu bemijovo yangemva kokujovelwa, imibala yesikhumba sendawo, ukulimala kwezicubu zasendaweni, ukulimala kwe-radial ye-radial nerve ye-radial, kanye ne-glucose yegazi eliphakeme. I-Contrailication eyinhloko i-hormone allergy, ekhulelwe futhi iyakhuthaza iziguli. I-Sodium Hyaluronate ingahle iphephe futhi ingavimba ukudonswa kwama-adhesions azungeze i-tendon nokukhuthaza ukuphulukiswa kwe-tendon. Umphumela wemitholampilo we-Occlusive Therapy usobala, kepha kunemibiko yezempilo ye-Necrosis Eminwe Evenud Odged ngumjovo wendawo ongafanele (Umdwebo 3).
I-FIG.3 I-Occcusion Engxenye Yesibindi iholela ku-Necrosips of the Finger yenkomba: A. Isikhumba sesandla siyi-patchy, futhi b, ikhasi eliphakathi lomunwe
Izindlela zokuqapha zokwelashwa okuvelele ekwelashweni kwe-radius styloid stenosis stenosis tenosynovitis: 1) Isikhundla sinembile, futhi lesi sikhundla kufanele sikhishwe ngaphambi kokufaka isici segazi; 2) Ukungasebenzi kahle komlenze othintekile ukugwema ukusebenza ngaphambi kwesikhathi; 3) Ngemuva kokujova kwe-hormoneclusion, kuvame ukuba namazinga ahlukene obuhlungu, ukuvuvukala, kanye nobuhlungu obude, uma kuvela ubuhlungu be-antiogrant, futhi ukuvela kwe-antiogrant kufanele kwenziwe ngokushesha uma kunesidingo, ukuze kuphuze isimo; 4) Izikhundla ze-Hormonal ezinjenge-Hypertension, isifo sikashukela, isifo senhliziyo, njll., Akufanele ziphathwe nge-Occlusion yendawo.
I-Shocmave: Ukwelashwa okulondoloziwe, okungahlaseli okunenzuzo yokukhiqiza amandla ngaphandle komzimba nokukhiqiza imiphumela ezindaweni ezihlosiwe ezijulile zomzimba ngaphandle kokulimaza izicubu ezizungezile. Kunomphumela wokukhuthaza imetabolism, ukuqinisa igazi kanye nokujikeleza kwegazi, ukuthuthukisa ukondliwa kwezicubu, ukukhishwa kwama-capillaries okuvinjelwe, kanye nokukhululwa kwezicubu ezihlanganisiwe. Kodwa-ke, kwaqala ukwelashwa kwe-styloid stenosis tenosynovitis yerediyo, futhi imibiko yayo yocwaningo inezifundo ezimbalwa ezilawulwa ngokungahleliwe zisadingeka ukuhlinzeka ngokusetshenziswa kwayo ekwelapheni i-styloid stenosis denosynovitis isifo se-styloid stenosis tenosynovitis yesifo se-tenosynovitis yesifo se-stynosynovitis yesifo se-styloid.
Ukwelashwa kwe-Acupuncture: Ukwelashwa okuncane kwe-acupuncture kuyindlela yokukhishwa evaliwe phakathi kokwelashwa okuhlisiwe nokungenisa kanye nokusakazwa kwezicubu zendawo ezungezile kuthuthukiswa ngokuvuselelwa kwe-acupuncture, ukuncipha kokuvuselelwa kwe-vascular, futhi kunciphise ukukhishwa kwemali Ukulwa nokuvuvukala kanye ne-analgesic.
Umuthi wendabuko waseChinese: I-radial styloid stenosis tenosynovitis ingeyesigaba sesigaba se- "Bravil Syndrome" engomeni yezwe, kanti lesi sifo sisuselwa ekushoneni nasezingeni. Ngenxa yomsebenzi wesikhathi eside we-Wrist Joint, Hrain ngokweqile, okuholela ekusholeni kwe-QI ne-QI yendawo, lokhu kubizwa ngokuthi ukuntuleka koqobo; Ngenxa yokuntuleka kwe-QI ne-ge yegazi, imisipha nemithambo ilahlekile ekondlisweni nasekushelelayo, futhi ngenxa yomuzwa womoya, futhi ukuncipha kwe-Qi kunqunyelwe kakhulu, ngakho-ke kutholakale ukuthi ubuhlungu be-metacarpophalangeal yokuqala ekhuthaze emtholampilo, okuyindinganiso. Kwatholakala ngokomtholampilo ukuthi ukwelashwa kwe-moxibusion, ukwelashwa kwama-massage, ukwelashwa kwangaphandle kwemithi yendabuko yaseChina kanye nokwelashwa kwe-acupuncture kunemiphumela ethile yemitholampilo.
Ukwelashwa okuhlinza Ukulashwa kwe-Dorsal Carpal Ligament yeRadius kanye ne-Excision Emikhawulwe kungenye yezindlela zokwelapha ze-Stenosis Thnosynovitis kwinqubo ye-stroids yeRadius. Ilungele iziguli ezine-tenosynovitis ephindaphindekayo ye-radius styloid stenosis, obekungasebenzi ngemuva kokungemuva kwamanye amazwe amaningi kanye nezinye izindlela zokwelapha ezilondoloziwe, futhi izimpawu zinzima. Ikakhulu ezigulini ezinama-tenosynovitis athuthukile athuthukile, anciphise ubuhlungu obukhulu nobuqili.
Ukuhlinzwa okuvulekile okuqondile Ukuhlinzwa okuvulekile okuqondile kuyashesha ukufeza, kepha kuthwala uchungechunge lwezingozi zokuhlinza njengokutheleleka, futhi ngenxa yokususwa okuqondile kwebhendi yokuxhaswa kwe-dorsal ngesikhathi sokuhlinzwa, ukungcola kwe-radial nerve kanye nethambo kungenzeka.
1st Septelysis: Le ndlela yokuhlinza ayifinyeleli i-tendon sheath ethambile, kepha isuse i-ganglion cyst etholakala kwi-septum yokuqala yokuqala noma ukusika i-septum phakathi kwePolarus yePorvis u-Odus ukuze ukhulule i-porsor septum yokuqala ye-dorsal. Le ndlela iyafana nokuhlinzwa okuvulekile okuqondile, ngomehluko omkhulu wokuthi ngemuva kokusika i-Extensor Support Band, kukhishwe i-tendon sheath bese kukhishwa i-tendon sheath esikhundleni sokuvuselelwa kwe-tendon sheath. Yize i-tendon Subluxiation ingaba khona ngale ndlela, ivikela i-1ST Dorsal Septum futhi inempumelelo enkulu yesikhathi eside yokuqina kwe-tendon kunokuvunyelwa kabusha kwe-tendon sheath. Ukungathandeki kwale ndlela kungenxa yokuthi i-tendon sheath ekhushulwayo ayisuswanga, futhi i-tendon sheath ekhushulwayo ingahle ibe nokuvuvukala, i-edema, kanye nokuxabana nethendan kuzoholela ekuphindweni kwalesi sifo.
I-Arthroscopic Osteofibrous aucuretion Aucurt: Ukwelashwa kwe-arthroscopic kunezinzuzo zokuhlukumezeka okuncane, umjikelezo wethethi elifushane, ukuphepha okuphezulu, ukululama okusheshayo nokululama okusheshayo, futhi ngeke kube khona ukuhanjiswa kwethempeli. Kodwa-ke, kusenempikiswano, futhi ezinye izazi zikholelwa ukuthi ukuhlinzwa kwe-arthroscopic kuyabiza futhi kudla isikhathi, futhi izinzuzo zawo zokuhlinzwa eziqondile zisobala azibonakali ngokwanele. Ngakho-ke, ukwelashwa kwe-arthroscopic ngokuvamile akukhethwa yiningi labodokotela neziguli.
Isikhathi sePosi: Oct-29-2024
