Myositis ntawm lub hauv siab yog ib yam mob uas nrog kev loj hlob ntawm o nyob rau hauv cov pob txha pob txha ntawm lub hauv siab. Hom kab mob no yog tus cwj pwm los ntawm: qhov mob tseem ceeb uas txwv tsis pub txav mus los, tsim cov ntsaws ruaj ruaj ntawm cov leeg, kev loj hlob ntawm atrophy hauv cheeb tsam cuam tshuam.
Raws li ICD, myositis ntawm lub hauv siab tau muab tus lej M60.
Kev kho mob tshwm sim
Thoracic myositis, tsis zoo li lwm hom kab mob hauv lub cev myofasciculitis, muaj cov yam ntxwv tshwj xeeb:
- Mob tshwm sim maj mam, tsim los ntawm cov ntsiab lus ntawm qhov mob thiab kis mus thoob plaws lub cev.
- Thaum soj ntsuam, kev tsim ntawm cov duab kheej kheej tau pom meej meej - inflammatory foci nyob rau hauv uas cov leeg nqaij yog reorganized rau hauv cov khoom ntom ntom nodules.
- Mob mob nyob rau hauv myositis ntawm thaj av thoracic yog tas li, nws kuj yog tus cwj pwm los ntawm ntau haiv neeg - mob mob sai sai hloov los ntawm kev mob hnyav. Pathology ua rau kev txav mus los nyuaj dua.
- Atrophicphenomena nyob rau hauv cov leeg nqaij nce nyob rau hauv lub cuam tshuam ntawm catarrhal phenomena.
- Cov tsos mob hauv qab no ntawm lub hauv siab myositis kuj yog yam ntxwv: tshwm sim ntawm spasms, kev ua haujlwm tsis zoo, kev ua tsis taus pa, hyperthermia, ua tsis taus pa, hnoos, migraine tawm tsam, kiv taub hau.
Kev tshwm sim
Cov kws tshaj lij txheeb xyuas ntau yam uas ua rau muaj kev txhim kho ntawm lub hauv siab myositis:
- kab mob kis, mob tonsillitis, tuberculosis, kab mob sib txuas (scleroderma, SLE, vasculitis, collagenosis), kab mob autoimmune, kab mob sib koom ua ke (osteochondrosis, mob caj dab rheumatoid).
- Kev qaug rau lub cev nrog cov khoom pov tseg (cov tshuaj tua kab, tshuaj lom neeg).
- Kab mob kab mob (bovine tapeworm, nqaij npuas tapeworm, trichinella, echinococcus), intoxication nrog cov khoom pov tseg ntawm cov kab mob cab.
- Hypocooling vim raug cua txias hauv huab cua kub, cua ntsawj ntshab. Txoj kev loj hlob ntawm myofasciculitis yog yooj yim los ntawm ib tug ntse hypothermia ntawm cov nqaij ntshiv.
- Taumatic cuam tshuam - pob txha, pob txha, leeg pob txha, raug mob, bruises. Kev raug mob kis las cuam tshuam nrog kev thauj khoom ntau dhau ib zaug, nqa hnyav, nqa hnyav.
- Kev raug mob tshwm sim los ntawm kev ua ub no cuam tshuam nrog kev nyob tsis tu ncua nyob rau hauv qhov chaw ruaj khov thiab kev tawm dag zog ntau dhau los ntawm kev txav mus los tsis tu ncua monotonous txav.
- Kab mob anaerobic, pneumococcal, staphylococcal,kab mob streptococcal. Nws feem ntau txhim kho ua txhaum txoj cai ntawm asepsis, tsis muaj menyuam nyob hauv thaj chaw, kis kab mob ntawm lub qhov txhab thaum lub sijhawm kho mob.
- Nerve puas los ntawm pathologies ntawm endocrine system (hormonal cuam tshuam, ntshav qab zib, hyperthyroidism), cev xeeb tub.
- Kev kho mob, cov kev mob tshwm sim uas yuav yog myofasciculitis (cov txheej txheem kho hniav ntawm cov hniav carious, kev siv tshuaj raws li tus nab venoms, vincristine).
Symptomatics
Myositis ntawm lub hauv siab (ICD-10 M60) yog tshwm sim los ntawm cov tsos mob hauv qab no:
- Externally manifested raws li txoj kev loj hlob ntawm puffiness, o nyob rau hauv lub projection ntawm lub hom phiaj ntawm o, focal hardening, softening ntawm cov leeg nqaij. Palpation ntawm cov cheeb tsam cuam tshuam qhia qhov nro, nodular formations ntawm ib tug ntom qauv, kev hloov nyob rau hauv sib xws, tuberosity. Cov tsos mob ntawm cov leeg hauv siab myositis yuav tsum tsis txhob hnov qab.
- Ib qho mob hnyav zuj zus. Qhov mob tuaj yeem mob, stabbing, tua hauv qhov xwm txheej. Nws tshwm sim nrog kev txav ntawm lub xub pwg hniav, tsa caj npab, txav ntawm lub cev, nqus pa tob thiab exhalations. Irradiation rau caj npab, xub pwg, caj dab, dorsal cheeb tsam yog tsis txiav tawm. Tawm tsam keeb kwm ntawm myositis, cerebroalgia (mob hnyav hauv lub taub hau) kuj tuaj yeem txhim kho.
- Catarrhal syndrome, uas muaj feem ntau tsis muaj zog, kub siab, ua pob khaus.
- Thaum sawv ntxov thiab yav tsaus ntuj myositis ntawm lub hauv siab cov leeg ntawm sab laug lossis sab xis tuaj yeem tshwm sim nws tus kheejloog, tingling.
- Redness, hyperthermia ntawm daim tawv nqaij ntawm lub hauv siab.
- Nws tsis suav nrog kev nkag mus ntawm kev puas tsuaj rau cov kabmob nyob ze - o ntawm cov leeg pob txha, cardialgia, ua tsis taus pa, hnoos.
Kev kuaj mob myositis
Kev kuaj pom thawj zaug ntawm lub hauv siab myositis yog los kuaj xyuas sab nraud, ua keeb kwm, palpation.
Yog tias kev kuaj mob los ntawm cov tsos mob thiab palpation yog qhov nyuaj, kev kuaj ntshav kuaj pom muaj eosinophils, cov tshuaj tiv thaiv tshwj xeeb, ntsuas qhov mob, kev ua haujlwm enzyme raug pom zoo. Tsis tas li ntawd, kuaj ultrasound ntawm cov leeg, electromyography, X-ray kuaj, MRI, CT tau qhia. Nrog rau myositis siab heev, nws raug nquahu kom ua qhov kev kuaj mob histological ntawm cov qauv ntawm cov leeg nqaij uas raug cuam tshuam los ntawm biopsy.
Differential Diagnosis
Differential diagnosis tso cai rau koj los txiav txim seb hom kev puas tsuaj ntawm cov leeg nqaij thiab txiav txim siab txog kev kho mob. Myofasciculitis yog qhov txawv ntawm angina pectoris, chondrosis, kab mob ntsws, pleura.
Kev faib tawm
Ib yam ntawm cov leeg nqaij uas ua rau atrophy yog o ntawm cov leeg nqaij intercostal. Pathology yog tus cwj pwm los ntawm qhov tshwm sim ntawm qhov mob thaum yav tsaus ntuj thiab hmo ntuj (tom qab ua haujlwm dhau, kev ntxhov siab), o ntawm daim tawv nqaij, nruj ntawm kev txav. Qee zaum, purulent inflammatory foci tuaj rau saum npoo. Tus neeg mob raug mob los ntawm qhov mob hauv hypochondrium, uas tuaj yeem ua taumuaj ib tug paroxysmal cim thiab intensified nrog siab, ib tug hloov nyob rau hauv lub cev txoj hauj lwm. Kuj tseem muaj qhov nro hauv cov leeg nqaij intercostal, ua pa nyuaj.
Sab laug thiab txoj cai localization
Myositis tuaj yeem muaj sab laug thiab sab xis hauv zos. Raws li hom kev kawm, myositis tau muab faib ua mob hnyav thiab mob ntev.
Kev mob ntawm cov leeg loj ntawm lub hauv siab, feem ntau tshwm sim ntawm ib sab tes, nrog rau qhov mob thiab zoo li lub plawv pathologies. Nws tsis suav nrog qhov tshwm sim ntawm loog loog ntawm txhais tes, mob hauv caj dab los ntawm qhov chaw ntawm qhov mob, ua rau nws ploj mus.
Kev kho mob hauv siab myositis
Kev kho rau intercostal myositis yuav tsum tau ua tiav thiab xaiv rau txhua tus neeg mob ib leeg. Lub hauv paus ntsiab lus ntawm kev kho mob yog ua kom tiav so thiab pw so, khoom noj khoom haus kom zoo, kev noj zaub mov zoo nrog microelements, vitamins, tsis suav nrog cov nqaij haus luam yeeb, ntsim tais diav, thiab cawv. Nws tseem yog ib qho tseem ceeb uas yuav tau haus cov dej ntxhia ntau uas muaj cov ntsiab lus alkaline.
Tshuaj kho mob myositis suav nrog kev siv cov tshuaj hauv qab no:
- Tshuaj tua kab mob, sulfonamides ("Azithromycin", "Ampicillin", "Amoxiclav", "Erythromycin"). Cov tshuaj no tso cai rau koj los cuam tshuam qhov tshwm sim ntawm pathology.
- Non-steroidal anti-inflammatory tshuaj uas tuaj yeem tshem tawm cov kab mob catarrhal, o, mob. Feem ntau, tus neeg mob tau pom zoo cov ntawv txhaj tshuaj, dragees, thaj ua rau thaj, tshuaj pleev "Voltarena", "Diclofenac",Ibuprofen, Ketofen.
- Cov tshuaj Steroid ("Prednisolone", "Methylprednisolone", "Hydrocortisone"), cov tshuaj tiv thaiv kab mob, yog tias cov txheej txheem pathological tshwm sim los ntawm qhov hnyav, thiab tsis muaj kev cuam tshuam los ntawm kev siv NSAIDs.
- Nyob rau hauv myositis ntawm parasitic etiology, kev siv cov tshuaj desensitizing, tshuaj anthelmintic ("Nemozol", "Vermox") yog qhia.
Physiotherapy
Nrog rau kev kho tshuaj rau lub hauv siab myositis (ICD code M60), physiotherapy txoj kev nquag siv: hirudotherapy, apitherapy, reflexology, balneotherapy, electrophoresis, diathermy, phonophoresis siv hydrocortisone, magnetotherapy, cov ntaub so ntswg neurostimulation, laser kho, myostimulation, cua sov, daim ntaub ntawv ozokerite, paraffin.
Txoj kev kho lub cev tsuas yog siv tau thaum tsis muaj exacerbation.
Ua tau zoo tshem tawm congestion, txo spasm, txhim kho microcirculation tso cai rau zaws. Ua ke nrog kev kho lub cev, nws muaj peev xwm ua kom rov qab tau cov cheeb tsam cuam tshuam tag nrho.
Surgery
Hauv qhov tsis tshua muaj tshwm sim, kev phais yuav raug qhia. Kev ua haujlwm yog ua tau yog tias myositis muaj daim ntawv ossifying thiab tshem tawm cov pob txha ossification yuav tsum tau. Nyob rau hauv tas li ntawd, conservative kev kho mob yog tsis muaj zog. Tsis tas li ntawd, kev cuam tshuam kev phais yog qhia rau purulent myositis, thaum qhib lub pyogenic capsule thiab tshem tawm yog xav tau. Cov ntsiab lus ntawm cov kab mob.
Ua ke nrog kev kho ib txwm siv, kev siv lwm txoj hauv kev kho tau raug tso cai:
- Compresses raws li cawv, tshuaj ntsuab, zaub.
- Sov liniments raws li cinquefoil.
- Homemade decoctions, tinctures raws St. John's wort, willow bark.
Yuav Muaj Teeb Meem
Thaum kuaj xyuas tsis tu ncua thiab kho myofasciculitis, muaj peev xwm ua rau mob ntev, ntxiv rau ntau yam teeb meem. Cov teeb meem feem ntau ntawm intercostal myositis yog:
- Kev txwv lub cev muaj zog nrog kev hloov pauv kom ua tiav immobilization. Thaum mob hnyav, tus kab mob tuaj yeem hloov tsis tau thiab ua rau muaj kev tsis taus.
- Txhob muab lub plexus ntawm cov hlab ntsha nyob rau hauv lub thoracic ntawm lub torso, tshwm sim ntawm loog loog ntawm caj npab, mus paresis ntawm ob txhais tes.
- tshwm sim ntawm qhov tsis txaus siab crunch, nyem rau ntawm thaj chaw cuam tshuam. Nws tshwm sim los ntawm kev hloov pauv ntawm cov txheej txheem ntawm o mus rau pob txha mos.
- Txhim kho qhov tsis xis nyob thiab tsis xis nyob thaum lub sijhawm thiab tom qab qoj ib ce.
- o, mob pob qij txha.
- Cov leeg nqaij atrophy ua rau tsis muaj zog txhawb rau sab qaum. Cov teeb meem zoo li no yog fraught nrog qhov tshwm sim ntawm tus txha caj qaum - scoliosis, pathological kyphosis, lordosis, kiv cua-zoo li hloov pauv ntawm vertebrae.
- Ntev o tuaj yeem ua rau cov kab mob sib txuas los ntawm qhov chaw ntawm qhov txhab. Yog li ntawd, purulent o tshwm sim, nrog raumelting ntawm ib puag ncig cov ntaub so ntswg, tsim ntawm fistulas, kis kab mob ntawm cov kab mob uas nyob ib sab nrog cov kab mob.
Txhawm rau tiv thaiv cov teeb meem tsis txaus ntseeg uas ua rau muaj kev phom sij rau lub neej, nws yog ib qho tseem ceeb kom mus ntsib kws kho mob raws sij hawm thiab kuaj tus kab mob.
Peb saib cov tsos mob thiab kho mob hauv siab myositis.
