Compartment syndrome imayamba chifukwa cha kuwonjezereka kwachilendo kwa minofu yomwe ili mkati mwa chipinda cha minofu chotchedwa compartment. Mu mawonekedwe ake osatha, zimachitika molimbika, kuchititsa kupweteka kwa minofu ndi minyewa mosiyanasiyana mosiyanasiyana. Acute syndrome imathanso kuchitika pambuyo povulala, zomwe zimafunikira opaleshoni yadzidzidzi. Opaleshoni imakhalanso yankho pamene palibe njira yachipatala yomwe yapezeka mu mawonekedwe osatha.

Tanthauzo

Compartment syndrome, kapena compartment syndrome, ndi zotsatira za kuwonjezeka kwa kupanikizika kwa intra-tissue mu chipinda chimodzi kapena zingapo, ndiko kunena kuti m'magulu a minofu omwe amatsekedwa ndi nembanemba yosadziwika bwino yotchedwa aponeurosis yomwe imapezeka mwendo, mkono kapena dzanja. . Matenda opwetekawa amatha kutsagana ndi kuchepa kwa magazi (ischemia) omwe amawonjezera kuvutika kwa ulusi wa minofu ndi minyewa.

Kuopsa kwake kumasiyanasiyana malinga ndi kufunikira kwa kupsyinjika kwakukulu.

Mu gawo limodzi mwa magawo atatu a milandu, pali zotupa za minofu: m'malo, minyewa ya minofu imatha kutuluka m'chidebe chawo kudzera mu aponeurosis yophulika.

Zimayambitsa

Zotsatira chipinda syndrome ku mkangano chidebe (a aponeurosis) ndi nkhani (minofu minofu, komanso mitsempha ndi mitsempha). The kuwonjezera mphamvu minofu akhale ofanana ndi minofu chidule, edema kapena hematoma mapangidwe, kapena ngakhale venous kapena minofu kuvutika. Kuwonongeka kwa nkhokwe, mwachitsanzo kukhuthala kwa aponeurosis pambuyo pa fibrosis kapena kuvulala, zithanso kuchitika.

Mu matenda aakulu a compartment, khama limayambitsa kuwonjezereka kwakukulu kwa minofu, kusinthika mkati mwa nthawi yosiyana pambuyo poyima. Ng'ombe ndi malo zambiri. kuukira ndi amgwirizano 50 80% ya milandu.

Mawonekedwe owopsa amalumikizidwa ndi kuwonjezereka kwadzidzidzi kupsinjika pambuyo pa kuvulala ndi / kapena kupanikizidwa kwambiri ndi bandeji kapena kuponyera, zomwe zimapangitsa kuti minofu ikhale yolimba. Timalankhula za Volkmann syndrome ikakhudza mkono wakuponya. The compression element iyenera kuchotsedwa mwamsanga.

matenda

Mu matenda owopsa a compartment, mawonetseredwe opweteka amachitika panthawi yoyeserera kokha, pokhudzana ndi chipinda chokhudzidwa komanso nthawi zonse mofanana (kuyesetsa komweko, kuchedwa komweko).

Kuyezetsa thupi kumakhala koyenera panthawi yopuma, koma zipinda zimakhala zovuta komanso zowawa pambuyo poyesa kupanikizika (mwachitsanzo pa treadmill) ndipo minofu ya chophukacho imauma.

Kuyeza kwa intramuscular pressure

Kuyeza kwa kuthamanga kwa intramuscular pogwiritsa ntchito chipangizo chokhala ndi singano yoyikidwa m'chipindacho kumapangitsa kuti zitsimikizire kuti ali ndi matenda. Njira yachikale imakhala ndi miyeso itatu: popuma, mphindi imodzi mutatha masewera olimbitsa thupi ndi mphindi 1 mutatha masewera olimbitsa thupi. Makhalidwe abwino pakupuma ndi a dongosolo la 5 mm Hg. Kupanikizika pamwamba pa mtengo uwu kuposa mphindi 15 mutatha kuchita masewera olimbitsa thupi, kapena zomwe zimaposa 6 kapena 30 mm za mercury mutangochita masewera olimbitsa thupi zimaganiziridwa kuti ndizopweteka.

mayesero osiyana kungakhale kofunika kuti akatsimikizire diagnoses ena:

• kuyezetsa magazi,
• MRI,
• x-ray,
• Doppler echo,
• scintigraphy,
• electromyogram (EMG) yoyeza ntchito ya neuromuscular.

Zizindikiro zachipatala zikakwanira kuzindikira matenda aacute compartment syndrome, kuyeza kwamphamvu sikofunikira ndipo musachedwe kuchitidwa opaleshoni.

Ndani akukhudzidwa?

Kasanu ndi kamodzi mwa anthu khumi ali ndi matenda osachiritsika. Izi nthawi zambiri zimakhala wothamanga wachinyamata wazaka zapakati pa 20 ndi 30. Kuwonjezeka kwa mchitidwewu nthawi zambiri kumakhala chiyambi cha zochitika zake.

Ogwira ntchito pamanja kapena oyimba amatha kudwala matenda a compartment kumtunda.

Zowopsa

Masewera ena amaika kupsinjika mopitirira muyeso ndi mobwerezabwereza pa minofu yomweyi ndikulimbikitsa chitukuko cha compartment syndrome.

Bokosi syndromes mu ng'ombe makamaka nkhawa kutali ndi pakati mtunda othamanga kapena gulu masewera timu kugwirizana ndi akuthamanga monga mpira. Maseŵera otsetsereka otsetsereka, kuyenda mothamanga, kusambira ndi ma roller skating kapena kusambira ndi zipsepse ndi masewera owopsa.

Ma syndromes am'zipinda zam'mwamba amatha kulumikizidwa ndi chizolowezi chamotocross, kusefukira kwamphepo, kusefukira kwamadzi, kukwera ...

Chronic compartment syndrome

Ululu ndiye chizindikiro chachikulu. Kuphatikizidwa ndi kumverera kwachisokonezo, kumakukakamizani kuti musiye kuyesetsa. Zimakhala zamphamvu mosiyanasiyana ndipo zimatha mwachitsanzo kufooketsa pang'ono kapena m'malo mwake kukhala zachiwawa kwambiri.

zomverera nthenda ya kumva kulasalasa, dzanzi kapena kumva kulasalasa (paresthesias), komanso chosakhalitsa ziwalo za chipinda akhudzidwa likhoza kulumikizidwa.

Ululu umakhala wocheperako kapena wocheperako popuma, koma zowawa zimatha kupitilira kwa masiku angapo.

Popanda kuthandizidwa, matenda a compartment amatha kuwonjezereka pang'onopang'ono, ndi kupweteka kumawoneka ndi khama lochepa kwambiri, komanso chiopsezo chokhala ndi mawonekedwe opweteka omwe ululu umapitirirabe pambuyo poyesera.

Acute compartment syndrome

Ululu waukulu kwambiri kapena wosapiririka ndi kupsinjika kapena kupsinjika. Samasuka ndi kusintha kwa malo ndipo amatsimikizira kugonjetsedwa ndi mankhwala oletsa ululu. Bokosi lidakali pa palpation.

Kuperewera kwa chidwi cha minyewa yomwe imalowa mkati mwa chipinda chowonongeka kumawoneka mwachangu. Paresthesia imakula mpaka kutayika kwa chidwi ndikutsatiridwa ndi anesthesia.

Ngati chithandizocho chikuchedwa, kusowa kwa ulimi wothirira (ischemia) kumayambitsa kutayika kwa mitsempha ya m'mphepete mwa nyanja ndi kuwonongeka kwa galimoto zomwe zimapangitsa kuwonongeka kwa minofu ndi mitsempha.

Kusintha kochita masewera olimbitsa thupi komanso chithandizo chamankhwala kumatha kuthana ndi matenda amtundu uliwonse. Chithandizo cha opaleshoni chingakambidwe mwa othamanga omwe akuvutika kwambiri, podziwa kuti kusiya masewera olimbitsa thupi ndi njira ina. Opaleshoni imachitika pakalephera chithandizo chamankhwala pakatha miyezi 2 mpaka 6. Iyenera kuchitidwa mwachangu mukamakumana ndi acute compartment syndrome.

Kupewa masewera ndi kukonzanso

Zimaphatikizapo kuchepetsa mphamvu ya zoyesayesa kapena kusintha ntchito, kusintha mtundu wa maphunziro (kutambasula, kutentha), kusintha zipangizo kapena manja, ndi zina zotero.

Chithandizo cha mankhwala

Mankhwala a venotonic kapena kuvala masokosi oponderezedwa nthawi zina amaperekedwa.

Physiotherapy imagwira ntchito nthawi zina. Zimachokera ku machitidwe otambasula (pamphuno) komanso pamitundu yosiyanasiyana ya matisita.

Chithandizo cha opaleshoni

Cholinga chake ndi kupeza decompression potsegula zipinda zomwe zikukhudzidwa (aponeurotomy). Kuchitapo kanthu kwachikale kumafuna kudulidwa kwapakhungu kwakukulu, opaleshoni yaing'ono-invasive arthroscopic kupanga njira ina.

Zovuta (mikwingwirima, kuwonongeka kwa mitsempha, kuwonongeka kwa machiritso, matenda, ndi zina zotero) ndizosowa. Nthawi zambiri, opaleshoni imathetsa ululu wonse. Pambuyo pokonzanso (physiotherapy, kuyenda, etc.), nthawi zambiri ndizotheka kuyambiranso masewera pakatha miyezi iwiri mpaka 2.

Komano, kuchedwa kwa kasamalidwe ka pachimake chipinda syndrome limodzi ndi chiopsezo chachikulu cha unsembe wa zotupa zosasinthika (minofu necrosis, fibrosis, minyewa kuwonongeka, etc.), ndi zotsatira kwambiri kapena zochepa kwambiri: kubweza minofu , zomverera ndi zovuta zamagalimoto…

Kutentha koyenera, masewero otambasula komanso masewera olimbitsa thupi omwe amagwirizana ndi luso la munthu, ndi kuwonjezeka kwapang'onopang'ono kwa mphamvu ndi nthawi ya khama, kungathandize kupewa matenda a compartment.

Pamene chitsulo kapena bandeji ndi yothina kwambiri, musazengereze kukanena kwa dokotala.