Compartment syndrome inokonzerwa nekuwedzera kusingaenzaniswi kwekumanikidzwa mumatishu ari mukati mechikamu chetsandanyama chinonzi compartment. Mune chimiro chayo chisingaperi, chinoitika pakushanda nesimba, zvichikonzera tsandanyama uye tsinga kurwadziwa kwehukukutu hwakasiyana. Acute syndrome inogonawo kuitika mushure mekushungurudzika, inoda kuvhiyiwa kwekukurumidzira. Kuvhiya zvakare mhinduro kana pasina mhinduro yekurapa yakawanikwa mumhando dzisingaperi.

tsananguro

Compartment syndrome, kana compartment syndrome, mhedzisiro yekuwedzera kwemukati-tisu kumanikidza mune imwe kana kupfuura, kureva muscular compartments yakavharwa neinextensible fibrous membrane inonzi aponeurosis iyo iripo mugumbo, forearm kana ruoko. . Iyi pathology inorwadza inogona kuperekedzwa nekuderera kwekutenderera kweropa (ischemia) iyo inowedzera kutambura kwetsandanyama fiber uye tsinga.

Kuomarara kunosiyana zvichienderana nekukosha kwekuwandisa.

Muchikamu chetatu chezviitiko, kune mhasuru hernias: munzvimbo, masasi emhasuru anopedzisira abuda mumudziyo wavo kuburikidza nekuputika aponeurosis.

Zvinokonzera

Compartment syndrome inokonzerwa nekukakavadzana pakati pemudziyo (iyo aponeurosis) uye zviri mukati (tsandanyama, asiwo tsinga nemidziyo yeropa). Kuwedzera kwevhoriyamu yemhasuru kunogona kuve kwakabatana nekubatana kwemhasuru, edema kana hematoma kuumbwa, kana kunyange venous kana tsandanyama kusagadzikana. Zvisizvo zvemumidziyo, semuenzaniso gobvu aponeurosis inotevera fibrosis kana trauma, inogona zvakare kuve nechekuita.

Muchigarire compartment syndrome, kuedza kunokonzera zvakananga kuwedzera kwakanyanya kwehuwandu hwemhasuru, kudzoserwa mukati menguva yakasiyana-siyana mushure mokumira. Mhuru ndiyo inogara iri nzvimbo. Kurwiswa kwacho kuri pakati pe50 kusvika 80% yezviitiko.

Iyo acute fomu inobatanidzwa nekukasira kuwedzera kwekumanikidza kunotevera kushungurudzika uye / kana yakawandisa kudzvanywa nebhandeji kana kukanda, zvichikonzera engorgement yemamhasuru. Isu tinotaura nezveVolkmann syndrome kana inobata forearm yakakandwa. Iyo compression element inofanira kubviswa nekukurumidza sezvinobvira.

chirwere

Mune chronic compartment syndrome, zviratidzo zvinorwadza zvinowanzoitika panguva yekuedza chete, maererano nekamuri inobatanidzwa uye nguva dzose yakafanana (mhando imwechete yekuedza, kunonoka kwakafanana).

Kuongororwa kwemuviri kwakajairwa pakuzorora, asi zvikamu zvinonetsa uye zvinorwadza mushure mekuedzwa kwekunetsekana (semuenzaniso pane treadmill) uye tsandanyama hernias kuoma.

Kuyera kwe intramuscular pressure

Chiyero che intramuscular pressure uchishandisa mudziyo unosanganisira tsono wakaiswa mucompartment inoita kuti zvikwanise kusimbisa kuongororwa. Iyo yekirasi maitiro ine zviyero zvitatu: pakuzorora, 1 miniti mushure mekuita maekisesaizi uye maminetsi mashanu mushure mekurovedza muviri. Yakajairika tsika pakuzorora ndeyekurongeka kwe5 mm Hg. Dzvinyiriro dziri pamusoro peiyi kukosha kupfuura maminetsi matanhatu mushure mekuita maekisesaizi, kana hunhu hunodarika makumi matatu kana makumi mashanu mamirimita emercury mushure mekuita maekisesaizi anoonekwa sechirwere.

Kuongororwa kwakasiyana kungave kuri madikanwa kuti ubvise zvimwe zvirwere:

• kuongororwa ropa,
• MRI,
• x-ray,
• Doppler echo,
• scintigraphy,
• electromyogram (EMG) kuyera neuromuscular basa.

Kana zviratidzo zvekiriniki zvakakwana kuti uongorore acute compartment syndrome, kuyerwa kwekumanikidza hakudiwi uye hakufanirwe kunonoka kuvhiyiwa.

Ndiani ane hanya?

Kapfumbamwe pavanhu gumi vane chronic compartment syndrome. Izvi zvinowanzova mutambi wechidiki pakati pemakore makumi maviri nemakumi matatu nemakumi matatu.

Vashandi vemaoko kana vaimbi vanogona kutambura necompartment syndrome yekumusoro kwemakumbo.

Zvinhu zvinotyisa

Mimwe mitambo inoisa yakawandisa uye inodzokororwa kunetseka pamamhasuru mamwe chete uye inosimudzira kukura kwecompartment syndrome.

Bhokisi syndromes mumhuru inonyanya kubata vamhanyi vedaro refu uye daro repakati kana vatori vechikamu mumitambo yetimu ine chekuita nekumhanya senhabvu. Kutsvetera nenyika, kufamba uchimhanya, kutsveta mumakumbo kana kushambira nezvimbi mitambo ine njodzi zvakare.

Iwo masyndromes emakamuri ekumusoro emakumbo anogona kubatanidzwa netsika yemotocross, windsurfing, mvura skiing, kukwira ...

Chronic compartment syndrome

Marwadzo ndiwo chiratidzo chikuru. Inoperekedzwa nekunzwa kwekunetseka, zvinokumanikidza kumisa kuedza. Iyo ndeyekusimba kwakasiyana uye inogona semuenzaniso kukonzera kukamhina kuri nyore kana zvinopesana kuve nechisimba chakanyanya.

Kunzwa kusina kujairika kwekunzwa, kupera kana kurira (paresthesias), pamwe nekuora mitezo kwenguva pfupi yekamuri yakakanganiswa inogona kubatanidzwa.

Marwadzo anopa nzira zvakanyanya kana zvishoma nekukurumidza pakuzorora, asi kurwadziwa kunogona kuramba kwemazuva mashoma.

Zvisina kurapwa, compartment syndrome inogona kuwedzera zvishoma nezvishoma, nekurwadziwa kunoratidzika nekuedza kushoma uye kushoma kwakasimba, uye njodzi yekukudziridza chimiro chakaoma umo marwadzo anoenderera mushure mekuedza.

Acute compartment syndrome

Kurwadza kwakanyanya kana kusingatsungirike ndeye cramp kana tension type. Haana kusunungurwa nekuchinja kwechinzvimbo uye anoratidza kusagadzikana neanalgesics. Bhokisi racho rakatambanudzwa pane palpation.

Kuperevedza kwekunzwa kwetsinga inogara mukamuri yakakuvadzwa kunoonekwa nekukurumidza. Paresthesia inofambira mberi kusvika pakurasikirwa kwekunzwa kunoteverwa neanesthesia.

Kana kurapwa kwakanonoka, kushaikwa kwekudiridza (ischemia) kunokonzera kunyangarika kweparipheral pulses uye kuperevedza kwemota kunokonzera kukanganisa kwemhasuru uye tsinga.

Kugadziriswa kwemaitiro emitambo uye kurapwa kwekurapa kunogona kukunda chronic compartment syndrome. Kurapa kwekuvhiya kunogona kukurukurwa kune vatambi vanotambura nekusagadzikana kukuru, vachiziva kuti kumisa tsika yemitambo ndiyo imwe nzira. Kuvhiya kunoitika kana kukundikana kwekurapa kurapwa mushure memwedzi miviri kusvika ku2. Inofanirwa kuitwa nekukurumidza mukutarisana neacute compartment syndrome.

Kudzivirirwa kwemitambo nekugadzirisa

Zvinosanganisira kudzikisira kusimba kwekuedza kana kushandura zviitiko, kugadzirisa rudzi rwekudzidziswa (kutambanudza, kudziya-ups), kugadzirisa zvishandiso kana majeti, nezvimwe.

Kurapwa

Venotonic zvinodhaka kana kupfeka masokisi e compression dzimwe nguva zvinokurudzirwa.

Physiotherapy inoshanda mune dzimwe nguva. Inonyanya kuenderana nemaitiro ekutambanudza (ye forearm) uye pamhando dzakasiyana dzemasaji.

Kuvhiya kurapa

Inovavarira kuwana decompression nekuvhura makamuri ane chekuita (aponeurotomy). Kupindira kwechinyakare kunoda ganda rakakura zvakaringana, micro-invasive arthroscopic oparesheni inoumba imwe nzira.

Matambudziko (mavanga, kukuvara kwetsinga, kuporesa kukanganisa, zvirwere, nezvimwewo) hazviwanzoitiki. Muzviitiko zvakawanda, kuvhiyiwa kunobvisa zvachose marwadzo. Mushure mekugadzirisa (physiotherapy, kufamba, nezvimwewo), zvinowanzoita kuti utangezve mitambo yemitambo mushure memwedzi miviri kusvika ku2.

Kune rimwe divi, kunonoka kwekutonga kweacute compartment syndrome kunoperekedzwa nenjodzi huru yekuiswa kwemaronda asingadzoreki (muscle necrosis, fibrosis, kukuvara kwetsinga, nezvimwewo), zvine zvimwe kana zvishoma zvakakomba mhedzisiro: tsandanyama retraction , kunzwa uye mota kusagadzikana…

Kwakakodzera kudziya-ups, kutambanudza maekisesaizi pamwe nemitambo yekudzidzira yakachinjirwa kune kugona kwemunhu, nekuwedzera zvishoma nezvishoma mukusimba uye nguva yekuedza, inogona kubatsira kudzivirira compartment syndrome.

Kana jira kana bhandeji ranyanya kusimba, usazeza kuzvizivisa kuna chiremba.