Ko te styloid stenosis tenosynovitis he mumura aseptic i puta mai i te mamae me te pupuhi o ngā uaua abductor pollicis longus me te extensor pollicis brevis i te dorsal carpal sheath i te radial styloid process. Ka kino ake ngā tohu i te toronga o te koromatua me te calimor deviation. I tuatahitia te pūrongo a te taote pokanga o Switzerland a de Quervain i te tau 1895, nō reira e mōhiotia ana te radial styloid stenosis tenosynovitis ko te mate a de Quervain.
He nui ake te kitea o te mate i roto i te hunga e mahi pinepine ana i ngā mahi o te ringaringa me ngā maihao nikau, ā, e mōhiotia ana hoki ko te "ringa o te whaea" me te "maihao kēmu". I te whanaketanga o te Ipurangi, kei te piki haere te tokomaha o te hunga e pāngia ana e te mate, ā, kei te rangatahi ake. Nā, me pēhea te tautuhi me te rongoā i tēnei mate? Ka hoatu e whai ake nei he whakataki poto mai i ngā āhuatanga e toru: te hanganga tinana, te tautuhi haumanu me ngā tikanga rongoā!
I.Anatomy
He whāiti, he pāpaku te sulcus o te styloid process o te radius, ā, he mea hipoki ki te hononga carpal dorsal e hanga ana i te anga wheua muka. Ka haere te uaua abductor pollicis longus me te uaua extensor pollicis brevis mā roto i tēnei anga, ka piko i te koki, ka mutu ki te pūtake o te wheua metacarpal tuatahi me te pūtake o te proximal phalanx o te koromatua (Pikitia 1). Ina paheke te uaua, he nui te kaha o te waku, inā koa ka neke te ringa ki te ulnar, ka piki ake te koki piko, ka piki ake te waku i waenga i te uaua me te pakitara o te anga. I muri i te whakaohooho roa, ka puta he huringa mumura i te synovium pēnei i te edema me te hyperplasia, ka puta he matotoru, he piri, he whaiti rānei o te uaua me te pakitara o te anga, ka puta he tohu haumanu o te stenosis tenosynovitis.
Pikitia 1 Te hoahoa hanganga o te tukanga styloid o te radius
II. Tātaritanga haumanu
1. He nui ake te kitea o te hītori hauora i roto i te hunga pakeke, ngā kaimahi ā-ringa, ā, he nui ake te kitea i roto i ngā wāhine; He puhoi te tīmatanga, engari ka puta ohorere pea ngā tohu.
2. Ngā Tohu: mamae ā-rohe i te tukanga styloid o te radius, ka horapa ki te ringa me te ringaringa, te ngoikore o te koromatua, te toronga iti o te koromatua, te kaha haere o ngā tohu ina toronga te koromatua me te peka ke o te ringaringa; Ka taea te pā atu i ngā pona i te tukanga styloid o te radius, he rite ki te koiwi e kitea ana, me te mamae nui.
3.He pai te whakamātautau a Finkelstein (arā, te whakamātautau peka ke o te ringa) (e whakaaturia ana i te Pikitia 2), kua piko te koromatua, kua puritia ki te nikau, kua peka ke te ringaringa o te ringa, ā, ka kino haere te mamae i te tukanga radius styloid.
4. Whakamātautau āwhina: Ka taea te whakahaere i te whakamātautau hihi-X, te whakamātautau ultrasound tae rānei mēnā e tika ana hei whakaū mēnā he rerekētanga wheua, he synovitis rānei. Ngā Aratohu mō te Maimoatanga Maha-mātauranga o te Styloid Stenosis Tenosynovitis o te Radius Kia mahara me whai whakamātautau tinana anō hei wehewehe i waenga i te osteoarthritis, ngā mate o te peka o runga o te io radial, me te forearm cruciate syndrome i te wā e tātaritangahia ai.
III. Maimoatanga
Whakaora ā-roheWhakaora ā-rohe ārai-nekehanga: I te wā tōmua, ka taea e ngā tūroro te whakamahi i tētahi whitiki whakapiri o waho hei ārai i te waewae e pāngia ana kia whakaitihia ai ngā mahi ā-rohe, kia māmā ake ai hoki te waku o te uaua i roto i te pūkahu uaua kia tutuki ai te whāinga o te maimoatanga. Heoi, kāore pea te ārai-nekehanga e whakarite kia mau tonu te waewae e pāngia ana, ā, mā te ārai-nekehanga roa ka roa pea te uaua o te nekehanga. Ahakoa e whakamahia ana ētahi atu maimoatanga āwhina-ā-whakakore i roto i te mahi haumanu, kei te tautohetia tonutia te whai huatanga o te maimoatanga.
Te rongoā ārai ā-rohe: Hei rongoā ārai ā-rohe pai mō te maimoatanga haumanu, ko te rongoā ārai ā-rohe e pā ana ki te werohanga ā-roto ki te wāhi mamae ā-rohe hei whakatutuki i te kaupapa o te ārai-mumura ā-rohe. Ka taea e te rongoā ārai te werohanga i ngā rongoā ki te wāhi mamae, ki te putea hononga, ki te pūtake io me ētahi atu wāhanga, ka taea te whakaiti i te pupuhi me te whakamamae i te mamae me te whakamamae i ngā ānini i roto i te wā poto, ā, he mahi nui ki te rongoā i ngā whara ā-rohe. Ko te nuinga o te rongoā he triamcinolone acetonide me te lidocaine hydrochloride. Ka taea hoki te whakamahi i ngā werohanga sodium hyaluronate. Heoi, tera pea he raruraru o ngā homoni pēnei i te mamae i muri i te werohanga, te tae kiri ā-rohe, te ngoikore o te kiko kiri ā-rohe, te whara o te io radial tohu, me te huka toto teitei. Ko ngā contraindications matua ko te mate pāwera homoni, ngā tūroro hapu me ngā tūroro e whāngai ana. He haumaru ake pea te sodium hyaluronate, ā, ka taea te ārai i te kiripiri o te piri ki te uaua me te whakatairanga i te whakaora o te uaua. He mārama te pānga haumanu o te rongoā ārai, engari he pūrongo haumanu mō te nekrosis o ngā maihao i puta mai i te werohanga ā-rohe hē (Pikitia 3).
Pikitia 3 Ka hua te pirau o ngā pito o ngā maihao tohu i te ārai hapa: A. He papatahi te kiri o te ringa, ā, B, C. He tawhiti rawa te wāhanga waenga o te maihao tohu, ā, kua pirau ngā pito o ngā maihao tohu.
Ngā whakatūpato mō te rongoā ārai i te tenosynovitis stenosis radius styloid: 1) Kia tika te tūnga, me tango te ngira i mua i te werohanga i te rongoā kia kore ai te ngira werohanga e uru ki roto i te oko toto; 2) Me ārai tika te nekehanga o te peka e pāngia ana kia kore ai e kaha wawe te mahi; 3) I muri i te werohanga homoni ārai, he maha ngā momo mamae, te pupuhi, tae atu ki te whakanui ake i te mamae, ka ngaro i roto i ngā rā e 2-3, ki te puta te mamae me te kiri mā o ngā maihao, me tere te hoatu rongoā ārai-hau me te ārai-waihanga, ā, me mahi te angiography kia mārama ai te tautuhi mēnā ka taea, ā, me mahi wawe tonu te tirotiro i ngā oko toto mēnā e tika ana, kia kore ai e whakaroa te mate; 4) Ko ngā ārai homoni pērā i te toto toto tiketike, te mate huka, te mate ngakau, me ētahi atu, kaua e rongoātia ki te ārai-ā-rohe.
Ko te Shockwave: he maimoatanga ā-pūmau, kāore e pokanoa, he painga ki te whakaputa pūngao i waho o te tinana, ā, ka puta he hua ki ngā wāhi kua tohua i roto i te tinana, me te kore e kino ki ngā kiko e karapoti ana. He pānga tōna ki te whakatairanga i te pākia o te tinana, te whakapakari i te rere o te toto me te lymphatic, te whakapai ake i te kai o te kiko, te tango i ngā capillaries kua āraia, me te wetewete i ngā hononga ngohengohe o te kiko. Heoi, i tīmata i te mutunga o te maimoatanga o te styloid stenosis tenosynovitis o te radius, ā, he iti noa iho āna pūrongo rangahau, ā, me whai tonu ngā rangahau matapōkere nui hei whakarato i ngā taunakitanga hauora e ahu mai ana i ngā taunakitanga hei whakatairanga i tōna whakamahinga i roto i te maimoatanga o te mate styloid stenosis tenosynovitis o te radius.
Maimoatanga wero ngira: ko te maimoatanga wero ngira iti he tikanga tukunga kati i waenga i te maimoatanga pokanga me te maimoatanga kore-pokanga, mā te keri me te tihore i ngā whara o te rohe, ka tukuna ngā piri, ā, ka pai ake te whakaora i te mau o te paihere io toto, ā, ka pai ake te rere o te toto o ngā kiko e karapoti ana mā te whakaoho pai o te wero ngira, te whakaiti i te putanga mumura, me te whakatutuki i te kaupapa o te ārai-mumura me te whakamamae.
Rongoā Hainamana Tuku Iho: Ko te radial styloid stenosis tenosynovitis kei roto i te kāwai o te "syndrome paralysis" i roto i te rongoā o te whenua tupu, ā, ko te mate e ahu mai ana i te ngoikore me te paerewa. Nā te roa o te mahi a te hononga o te ringaringa, te taumahatanga nui, ka hua ake te ngoikore o te qi me te toto ā-rohe, ka kiia tēnei ko te ngoikore taketake; Nā te ngoikore o te qi me te toto ā-rohe, ka ngaro ngā uaua me ngā uaua i te kai me te pahekeheke, ā, nā te hau, te makariri me te haukū, e whakanui ana i te aukati o te qi me te toto, ka kitea te pupuhi me te mamae me te mahi ā-rohe, ā, ka nui ake te kino o te kohikohinga o te qi me te toto, ā, ka nui ake te mamae o te rohe, nō reira ka kitea ko te mamae o te hononga o te ringaringa neke me te hononga metacarpophalangeal tuatahi ka nui ake i roto i te whare hauora, he paerewa. I kitea i roto i te haumanu he pānga haumanu te rongoā moxibustion, te rongoā mirimiri, te maimoatanga o waho o te rongoā Hainamana tuku iho me te maimoatanga acupuncture.
Maimoatanga pokanga: Ko te tapahi pokanga o te hononga carpal dorsal o te radius me te tango iti i tētahi o ngā maimoatanga mō te stenosis tenosynovitis i roto i te tukanga styloid o te radius. He pai mō ngā tūroro e pāngia ana e te tenosynovitis auau o te radius styloid stenosis, kāore i whai hua i muri i ngā aukati ā-rohe maha me ētahi atu maimoatanga tiaki, ā, he kino ngā tohu. Ina koa mō ngā tūroro e pāngia ana e te tenosynovitis stenotic matatau, ka whakamamae i te mamae kino me te uaua.
Pokanga tuwhera tika: Ko te tikanga pokanga tuku iho ko te tapahi tika i te wāhi mamae, te whakaatu i te hononga uaua tuara tuatahi, te tapahi i te uhi uaua matotoru, ka tuku i te uhi uaua kia taea ai e te uaua te neke noa i roto i te uhi uaua. He tere te whakatutuki i te pokanga tuwhera tika, engari he maha ngā tūponotanga pokanga pērā i te mate, ā, nā te tango tika i te whitiki tautoko tuara i te wā pokanga, ka puta pea te nekenekehanga o te uaua me te kino ki te io radial me te uaua.
Te septolysis tuatahi: Kāore tēnei tikanga pokanga e tapahi i te uhi uaua matotoru, engari ka tangohia te pukupuku ganglion i kitea i roto i te septum extensor tuatahi, ka tapahia rānei te septum i waenganui i te abductor pollicis longus me te extensor pollicis brevis hei tuku i te septum extensor dorsal tuatahi. He rite tēnei tikanga ki te pokanga tuwhera tika, ko te rerekētanga matua ko te tapahi i te whitiki tautoko extensor, ka tukuna te uhi uaua, ā, ka tangohia te uhi uaua hei utu mō te tapahi i te uhi uaua matotoru. Ahakoa kei roto pea te subluxation o te uaua i roto i tēnei tikanga, ka tiakina e ia te septum extensor dorsal tuatahi, ā, he nui ake te whai huatanga mō te pumau o te uaua i te tango tika i te uhi uaua. Ko te ngoikoretanga o tēnei tikanga ko te mea kāore i tangohia te uhi uaua matotoru, ā, tera pea kei te mumura tonu te uhi uaua matotoru, kei te pupuhi, ā, ka hoki anō te mate i te waku ki te uaua.
Te whakanui i ngā awaawa osteofiberous arthroscopic: ko ngā painga o te maimoatanga arthroscopic he iti ake te whara, he poto te huringa maimoatanga, he haumaru teitei, he iti ake ngā raruraru me te tere o te whakaoranga, ā, ko te painga nui ko te kore e tapahia te whitiki tautoko extensor, ā, kāore he nekehanga o te uaua. Heoi, kei te tautohe tonu, ā, e whakapono ana ētahi tohunga he utu nui, he roa hoki te pokanga arthroscopic, ā, kāore i te tino kitea ōna painga i te pokanga tuwhera tika. Nō reira, ko te nuinga o ngā tākuta me ngā tūroro kāore i te whiriwhiri i te maimoatanga arthroscopic.
Wā tuku: Oketopa-29-2024
