Kev mob ntawm lub ncauj tsev menyuam qaum (ICD 10 S10) yog suav tias yog kev raug mob txaus ntshai uas tuaj yeem ua rau muaj qhov tshwm sim loj rau lub cev. Nws tuaj yeem thaiv cov leeg nqaij ib txwm ua haujlwm thiab limb txav mus los, nrog rau cov ntshav tsis zoo.
Kev raug mob zoo li no yuav tsum tau ua tib zoo saib, txawm tias qhov nqaij ntshiv me ntsis tuaj yeem ua rau muaj kev puas tsuaj loj rau tus txha caj qaum. Qhov kev puas tsuaj zoo li no muaj ntau heev. Feem ntau, cov kev raug mob no tshwm sim rau cov txiv neej hnub nyoog 35-45.
Txoj kev ua txhaum cai
Contusion ntawm lub ncauj tsev menyuam nqaj qaum (raws li ICD 10 S10) yog kev raug mob ntawm tus txha caj qaum, uas muaj kev puas tsuaj rau cov hlab ntsha, cov leeg, nrog rau cov ntaub so ntswg necrosis thaum tswj kev ncaj ncees ntawm vertebrae thiab qaum qaum. Kev puas tsuaj tuaj yeem tshwm sim hauv cov neeg mob ntawm txhua lub hnub nyoog. Kev raug mob caj dab tuaj yeem ua rau nyuaj lossis tsis yooj yim. Cov mob hnyav tshaj plaws ntawm lub ncauj tsev menyuam raug mob yog nrog los ntawm:
- pinch paj hlwb xaus thiab txhav qaum;
- hematoma tsim rauthaj chaw puas;
- kev tsis txaus siab ntawm cov kua cerebrospinal, provoked los ntawm compression ntawm tus txha caj qaum.
Kev raug mob nyob rau hauv uas muaj qhov deformation ntawm tus txha caj qaum thiab bruising ntawm cov qog nqaij hlav muaj qhov tsis meej meej. Kev tuag nrog xws li kev raug mob yog ntau dua 35%. Qhov kev cia siab ntawm lub neej rau cov neeg mob muaj sia nyob yog nyob ntawm seb qhov kev kho mob raug thiab sai npaum li cas.
Txhob Cia Siab. Hom
Kev mob ntawm lub ncauj tsev menyuam qaum (ICD code 10 S10) yog hais txog kev raug mob txaus ntshai. Nws muab faib ua hom xws li:
- compression;
- tsis muaj mob txha caj qaum;
- kev puas tsuaj.
Thaum muaj kev raug mob ntawm tus txha nraub qaum tshwm sim compression ntawm vertebrae, uas ua rau compression ntawm tus txha caj qaum. Muaj ntau qhov laj thawj rau qhov tshwm sim ntawm qhov raug mob, tab sis feem ntau qhov nqaij ntuag yog provoked:
- tsheb sib tsoo;
- osteoporosis;
- poob;
- muag tsaws ntawm ko taw.
Kev raug mob compression yog tus cwj pwm los ntawm qhov mob hnyav thiab mob hnyav, tsis muaj zog, loog loog, squeezing ntawm cov hlab ntsha xaus. Cov txiaj ntsig tuaj yeem ua rau mob hnyav heev, ua rau kev txhim kho osteochondrosis, kyphoscoliosis.
Txhob ntawm tus txha nraub qaum yam tsis muaj kev puas tsuaj rau tus txha caj qaum yog nrog cov tsos mob xws li:
- cov ntaub so ntswg o;
- pain;
- hematoma thiab bruising.
Qhov kev mob tshwm sim zoo heev thiab feem ntau cov tsos mob ntawm kev raug mob ploj hauv 2-3 lub lis piam. Qee zaum qhov tshwm sim tuaj yeem yog tom qab mob osteochondrosis.
Kev mob ntawm lub ncauj tsev menyuam tuaj yeem ua rau muaj ntau yam kev raug mob ntawm tus txha caj qaum, uas yog:
- squeezing;
- gap;
- ntshav siab.
Symptomatology tuaj yeem sib txawv, txhua yam nyob ntawm qhov mob hnyav. Lub sijhawm kho kom rov zoo tuaj yeem kav ntev txog 6 lub hlis, tab sis cov teebmeem seem tseem nyob mus ib txhis.
Severity
Traumatologists bruise lub ncauj tsev menyuam nqaj qaum yog muab faib raws li qhov hnyav ntawm qhov raug mob:
- Lub ntsws yog tus cwj pwm los ntawm qhov tseeb tias kev puas tsuaj feem ntau cuam tshuam rau cov ntaub so ntswg nyob ze. Tsis muaj kev hloov pauv neurological. Kev kho yuav siv li 45 hnub.
- Qhov nruab nrab qib tau kuaj pom tias muaj kev sib kis ntawm cov pob txha caj qaum nrog kev cuam tshuam ntawm tus txha caj qaum. Cov mob no yog nrog los ntawm cov kev hloov hauv neurological uas cuam tshuam rau kev txav mus los ntawm thaj chaw cuam tshuam. Lub sijhawm kho dua tshiab yuav siv sijhawm li 4 lub hlis.
- Kev puas tsuaj rau tus txha nraub qaum yog ua ke nrog kev sib kis ntawm tus txha caj qaum. Subcutaneous hemorrhages provoked los ntawm kev raug mob ua rau necrosis. Nyob rau hauv cov ntaub ntawv no, muaj ib tug ua txhaum ntawm ib txwm microcirculation ntawm lub cerebrospinal kua, raws li zoo raws li ib tug muaj zog squeezing ntawm cov hlab ntsha xaus. Nyob rau tib lub sijhawm, cov tsos mob neurological tau hais. Kev kho kom rov zoo siv sijhawm 6 lub hlis, thiab tom qab ntawd cov kab mob pathological yuav tshwm sim.
Kev raug mob
Qhov tseem ceeb ntawm qhov ncauj qhov ntswgntawm tus txha nraub qaum yog suav tias yog txhua yam cuam tshuam, xws li:
- mechanical shock;
- ntaus lub taub hau hauv qab thaum dhia dej;
- tsev neeg thiab kis las raug mob;
- raug mob los ntawm tsheb sib tsoo;
- fight.
Qhov kev raug mob hnyav yog feem ntau cuam tshuam los ntawm lub hnub nyoog thiab qhov hnyav ntawm tus neeg raug tsim txom, nws lub xeev kev noj qab haus huv, nrog rau lub zog thiab kev siv zog ntawm kev siv tshuab.
Cov tsos mob tseem ceeb
Cov cim tseem ceeb ntawm qhov nqaij tawv ntawm lub ncauj tsev menyuam yog:
- tub kawm ntawv constriction;
- o ntawm cov ntaub so ntswg hauv thaj tsam cuam tshuam;
- hematoma tsim;
- kiv taub hau thiab tsis nco qab;
- spinal deformity.
Nyob rau hauv rooj plaub ntawm kev raug mob hnyav, nrog rau kev puas tsuaj ntawm tus txha caj qaum thiab nws cov compression, tus neeg mob muaj kev tsis hnov tsw ntawm caj dab, ua kom tiav ntawm kev ua pa, ua pa tsis ua haujlwm. Yog tias koj tsis muab kev pab ceev, tus neeg mob tsuas yog tuag xwb.
Yog tias muaj mob hnyav thiab mob hnyav hauv cheeb tsam cuam tshuam, ces qhov no tuaj yeem ua rau muaj qhov tshwm sim loj heev. Qhov no tej zaum yuav yog qhov txwv tsis pub txav mus rau qhov tsis taus.
Kev pab ib zaug
Yog ib tug neeg muaj qhov txhab ntawm lub ncauj tsev menyuam, ces nws yuav tsum tau muab kev pab rau nws. Ua li no, nteg tus neeg raug tsim txom ntawm lub tiaj tus, tawv tawv. Yog tias ua tau, kho lub caj dab nrog splint lossis nrog lub dab tshos orthopedic. Qhov no yog tsim nyog nyob rau hauv thiaj li yuavtxhawm rau tiv thaiv kev tawg ntawm cov hlab ntsha, qhov kev pheej hmoo ntawm kev nce ntxiv nrog kev raug mob rau lub ncauj tsev menyuam nqaj qaum.
Nws yog ib qho tseem ceeb heev uas yuav tsum tau hu rau lub tsheb thauj neeg mob tam sim ntawd, nrog rau ceeb toom raws nraim li cas tus neeg raug mob thiab nws nyob qhov twg. Tshawb xyuas tus neeg raug tsim txom kom zoo. Yog hais tias nws muaj hematoma, ces koj yuav tsum tau thov txias rau nws.
Yog tus neeg mob tseem ceeb heev, nws yog ib qho tseem ceeb uas yuav tsum tau ua cov kev ntsuas resuscitation, suav nrog lub hauv siab compressions thiab tshuab ua pa.
Yog tias nws muaj peev xwm xa tus neeg raug tsim txom mus rau hauv tsev kho mob nws tus kheej, thaum lub sijhawm thauj mus los yuav tsum tau ua kom ntseeg tau tias thaj chaw muaj kev cuam tshuam. Rau qhov no, nws raug nquahu kom siv Shants dab tshos. Kev ua txhaum txoj cai no tuaj yeem ua rau muaj teeb meem loj.
Diagnostics
Ib qho mob ntawm lub ncauj tsev menyuam nqaj qaum tuaj yeem kuaj tau tsuas yog tom qab kev tshawb fawb. Cov no yuav tsum suav nrog:
- kev tshuaj ntsuam dav dav;
- kuaj mob hlwb;
- x-ray;
- tomography.
Thaum xub thawj, tus kws kho mob tshuaj xyuas thiab xam phaj tus neeg raug tsim txom, palpating thaj chaw puas. Kev tshawb fawb pab tsim kom muaj kev raug mob, txhawm rau kuaj cov kab mob ntev uas yuav tsum tau txiav txim siab thaum xaiv txoj kev kho mob.
Kev kuaj mob paj hlwb pab txhawm rau taug qab qhov ua txhaum ntawm qhov rhiab ntawm cov ceg ceg, lawv txoj kev txav mus los, nrog rau kev ua tsis zoo ntawm kev xav. X-ray yog siv los kuaj xyuas qhov mob ntawm lub vertebrae. Nws pab txheeb xyuas cov kab nrib pleb, tawg thiab dislocations. MRI tso cai rau koj los txiav txim qhov kev puas tsuaj rau daim nyias nyias ntawm tus txha caj qaum, cov hlab ntsha, nrog rau cov xwm txheej ntawm intervertebral discs.
Txoj Kev Kho Mob
Cervical spine raug kho hauv Department of Neurosurgery lossis Traumatology. Kev tiv thaiv kev poob siab yog nqa tawm nrog kev tswj lub siab tas li, thiab nws tseem yuav tsum tau tswj xyuas cov haujlwm ntawm lub cev puas tsuaj. Cov tshuaj tua kab mob thiab tshuaj tua kab mob yuav pab txo qhov mob tshwm sim. Tsis tas li ntawd, cov tshuaj anticoagulants thiab angioprotectors raug sau.
Nyob ntawm cov tsos mob uas twb muaj lawm, ntau lwm yam tshuaj thiab cov txheej txheem raug sau tseg. Yeej, cov neeg mob tau qhia cov chav kawm zaws, physiotherapy, physiotherapy ce thiab hnav corset. Raws li kws kho mob tau sau tseg, rau qee lub sij hawm qhov chaw ntawm qhov nqaij ntuag yog lubricated nrog sov thiab tshuaj loog. Thaum kawg ntawm lub sijhawm mob hnyav, kev ntsuas kev kho mob tau ua tiav. Lub sijhawm ua haujlwm tau teem sijhawm tshwj xeeb.
Drug therapy
Vim tias muaj peev xwm ua rau muaj qhov tshwm sim loj heev ntawm lub ncauj tsev menyuam nqaj qaum, kev kho mob yuav tsum tau pib tam sim tom qab pib tshwm sim. Lub ntsiab kev kho mob yog tshuaj. Hauv lub sijhawm mob hnyav, cov tshuaj xws li "Polyglukin" lossis "Reopoliglyukin" tuaj yeem raug sau tseg. Nco ntsoov siv cov tshuaj calcium ntxiv.
Nws yog qhov tsis tsim nyog siv cov tshuaj yeeb dej caw rau kev kho mob, vim tias qhov kev raug mob no tuaj yeem ua rau muaj kev puas tsuaj loj rau lub ntsws.chaw. Yog li, cov kws kho mob feem ntau sau cov tshuaj "Ketorol" thiab nws cov analogues. Qee zaum, Promedol tuaj yeem tso cai.
Kom normalize ntshav ncig, nrog rau tiv thaiv qhov tshwm sim ntawm puffiness, "Etamzilat", "Prodectin", "Heparin" tuaj yeem raug sau. Txhawm rau tiv thaiv qhov tshwm sim ntawm necrosis, kev tswj hwm cov piam thaj hauv cov ntshav nrog cov tshuaj xws li Cavinton, Actovegin, Cinnarizine yuav tsum tau ua. Cov tshuaj tua kab mob yog siv los tiv thaiv cov teeb meem inflammatory.
Physiotherapy
Tom tau ua tiav qhov kev ruaj khov ntawm tus neeg mob tus mob, nws tau muab cov txheej txheem physiotherapeutic, tshwj xeeb, xws li zaws thiab kho kev tawm dag zog. Nco ntsoov xav tau kev ua kom muaj zog ntxiv uas tau ua thaum pw hauv txaj. Lawv pab ntxiv dag zog rau cov leeg thiab normalize ntshav ncig.
Massage yog nqa tawm nrog kev siv nruab nrab, tsis muaj zog txav thiab muaj zog. Txhawm rau tshem tawm cov tsos mob thiab qhov tshwm sim ntawm lub ncauj tsev menyuam nqaj qaum, tus kws kho mob tau sau cov txheej txheem kho lub cev, tshwj xeeb, xws li magnetotherapy, laser kho, yoj raug.
Kev ua haujlwm
Yog tias hematoma ntawm qhov chaw ntawm qhov nqaij tawv tsis daws tau ntev, ces nws yuav tsum tau phais, uas yog, los ntawm kev sib tsoo. Kev ntsuas radical tsuas yog siv rau hauv qhov tshwj xeeb tshaj plaws, yog tias cov txheej txheem pathological cuam tshuam nrog kev puas tsuaj rau tus txha caj qaum.
Kev ua haujlwm sai li sai tau tom qab raug mob. Kev ncua tuaj yeem ua rau rov qab tsis tauhloov lossis txawm tuag ntawm tus neeg mob.
Vim li cas kev kho raws sijhawm tseem ceeb?
Qhov tshwm sim ntawm lub ncauj tsev menyuam nqaj qaum tuaj yeem loj heev yog tias tsis kho raws sijhawm. Nyob rau lub sij hawm ntev, lawv tuaj yeem ua rau muaj teeb meem loj heev hauv paj hlwb. Feem ntau yog xws li:
- poob tawv rhiab;
- paresis;
- ncig qaum.
Qee zaum qhov tshwm sim ntawm kev raug mob hnyav thiab nqaij tawv ntawm lub ncauj tsev menyuam nqaj qaum tuaj yeem ua rau muaj kev phom sij heev, mus txog qhov tsis nco qab.
