Chomwe chimayambitsa kupweteka kwa mapewa, subacromial bursitis imadziwika ndi kutupa kwa subacromial bursa, mtundu wa pad flattened womwe umalimbikitsa kutsetsereka kwa mapangidwe a mapewa a mapewa. Nthawi zambiri zimagwirizanitsidwa ndi tendon pathology. Pakachitika ululu wosatha, chithandizo chamankhwala chimasankhidwa, opaleshoni ndiyo njira yomaliza.

Tanthauzo

Subacromial bursitis ndi kutupa kwa subacromial bursa, serous bursa - kapena synovial bursa - yopangidwa ngati thumba la flattened, lomwe lili pansi pa protrusion ya scapula yotchedwa acromion. Wodzazidwa ndi madzimadzi a synovial, pad iyi ili pamalo olumikizirana pakati pa fupa ndi minyewa ya khafu yozungulira yomwe imakuta mutu wa humerus. Zimathandizira kutsetsereka pamene mapewa aphatikizidwa.

The subacromial bursa imalankhulana ndi serous bursa wina, subdeltoid bursa, yomwe ili pakati pa tubercle yaikulu ya mutu wa humerus ndi deltoid. Nthawi zina timalankhula za subacromio-deltoid bursa.

Subacromial bursitis imayambitsa kupweteka kwakukulu kapena kosalekeza ndipo nthawi zambiri kumapangitsa kuchepetsa kuyenda.

Zimayambitsa

Subacromial bursitis nthawi zambiri imayambira pamakina ndipo imatha kulumikizidwa ndi rotator cuff tendinopathy kapena kusweka kwa tendon. 

Mkangano wa subacromial umakhalapo nthawi zambiri: malo omwe ali pansi pa acromion ndi ochepa kwambiri ndipo mpumulo wa bony umakonda "kugwira" tendon pamene mapewa amasonkhanitsidwa, zomwe zimayambitsa kutupa kopweteka mu bursa. subacromial.

Kutupa kwa bursa kumapangitsa kuti ikhale yolimba, yomwe imawonjezera mphamvu zotsutsana, ndi zotsatira zolimbikitsa kutupa. Kubwereza mayendedwe kumawonjezera chodabwitsa ichi: kukangana kwa tendon kumalimbikitsa kupanga mlomo wa bony (osteophyte) pansi pa acromion, zomwe zimalimbikitsa kuvala kwa tendon ndi kutupa.

Bursitis nthawi zina imakhalanso vuto la calcifying tendinopathy, calcifications yomwe imayambitsa kupweteka kwambiri.

matenda

Matendawa amachokera makamaka pakuwunika kwachipatala. Mapewa opweteka amatha kukhala ndi zifukwa zosiyanasiyana ndipo, kuti adziwe zotupa zomwe zikufunsidwa, adotolo amayesa komanso njira zingapo zowongolera (kukweza kapena kuzungulira kwa mkono pa nkhwangwa zosiyanasiyana, chigongono chotambasulidwa kapena kupindika, kukana kapena ayi ... ) zomwe zimamulola kuyesa kuyenda kwa phewa. Makamaka, imayang'ana mphamvu ya minofu komanso kuchepetsa kayendetsedwe kake ndikuyang'ana malo omwe amayambitsa ululu.

Kujambula zithunzi kumamaliza kuzindikira:

• X-ray sapereka zambiri za bursitis, koma amatha kuzindikira mawerengedwe ndikuwona mawonekedwe a acromion pamene akukayikira kuti kulowetsedwa kwa subacromial kukuganiziridwa.
• Ultrasound ndiyeso yosankha yowunika minofu yofewa pamapewa. Zimapangitsa kuti zitheke kuwona zotupa za rotator cuff ndipo nthawi zina (koma osati nthawi zonse) bursitis.
• Mayesero ena ojambula zithunzi (arthro-MRI, arthroscanner) angakhale ofunikira.

Anthu okhudzidwa

Pamodzi ndi chigongono, phewa ndilolumikizana kwambiri ndi matenda a minofu ndi mafupa. Kupweteka kwa mapewa ndi chifukwa chodziwika bwino chamankhwala, ndipo bursitis ndi tendinopathy zimalamulira chithunzicho.

Aliyense akhoza kutenga bursitis, koma amapezeka kwambiri mwa omwe ali ndi zaka makumi anayi ndi makumi asanu kuposa achichepere. Othamanga kapena akatswiri omwe ntchito yawo imafuna kuchitapo kanthu mobwerezabwereza amawululidwa kale.

Zowopsa

• Kuchita mayendedwe obwerezabwereza kwambiri kwa maola opitilira 2 patsiku
• Gwirani manja pamwamba pa mapewa
• Kunyamula katundu wolemera
• Zovuta
• Age
• Zinthu za morphological (mawonekedwe a acromion)…

ululu

Ululu ndi chizindikiro chachikulu cha bursitis. Imawonekera m'dera la phewa, koma nthawi zambiri imawonekera ku chigongono, kapena ngakhale kudzanja pazovuta kwambiri. Zimakulitsidwa ndi mayendedwe ena okweza mkono. Kupweteka kwausiku kumatheka.

Ululu ukhoza kukhala wovuta kwambiri panthawi yachisokonezo, kapena kuyamba pang'onopang'ono kenako ndikupitiriza. Itha kukhala yakuthwa kwambiri pakakhala hyperalgesic bursitis yolumikizidwa ndi calcifying tendonitis.

Kusayenda bwino

Nthawi zina pamakhala kutayika kosiyanasiyana koyenda, komanso kulephera kuchita zinthu zina. Anthu ena amafotokozanso kumverera kouma.

Kupumula ndi kukonzanso ntchito

Choyamba, kupumula (kuchotsa zizindikiro zoyambitsa ululu) ndikofunikira kuti muchepetse kutupa.

Kukonzanso kuyenera kusinthidwa ndi chikhalidwe cha bursitis. Pakachitika vuto la subacromial impingement, masewera ena omwe cholinga chake ndi kuchepetsa kukangana pakati pa fupa ndi tendon pakuyenda kwa mapewa kungakhale kothandiza. Zolimbitsa thupi zolimbitsa thupi zitha kulimbikitsidwanso nthawi zina.

Ultrasound imapereka mphamvu pamene bursitis imayamba chifukwa cha calcifying tendonitis.

Chithandizo cha mankhwala

Amagwiritsa ntchito mankhwala osagwiritsidwa ntchito poletsa kutupa (NSAIDs) ndi analgesics, omwe nthawi zambiri amagwira ntchito pakapita nthawi.

Majekeseni a Corticosteroid mu subacromial space angapereke mpumulo.

Opaleshoni ndi njira yomaliza pambuyo pa chithandizo chamankhwala chochitidwa bwino.

Acromioplasty cholinga chake ndi kupondereza mkangano pakati pa bursa, rotator cuff ndi mafupa (acromion). Kuchitidwa pansi pa anesthesia wamba kapena wachigawo, amagwiritsa ntchito njira yochepetsera pang'ono (arthroscopy) ndipo cholinga chake ndi kuyeretsa subacromial bursa ndipo, ngati kuli kofunikira, "kukonzekera" mlomo wa bony pa acromion.

Zowawa zochenjeza siziyenera kunyalanyazidwa. Kutengera manja abwino pantchito, masewera kapena zochitika zatsiku ndi tsiku kumatha kuletsa subacromial bursitis kuti ikhale yosatha.

Madokotala ogwira ntchito ndi madokotala a masewera angathandize kuzindikira zochitika zoopsa. Katswiri wa zantchito atha kupereka njira zinazake (kusintha kwa malo ogwirira ntchito, bungwe latsopano kuti apewe kubwerezabwereza zochita, ndi zina zotero) zothandiza popewa.