Styloid stenosis tenosynovitis bụ mbufụt aseptic nke ihe mgbu na ọzịza nke abductor pollicis longus na extensor pollicis brevis tendons na dorsal carpal sheath na usoro radial styloid na-akawanye njọ. Ihe mgbaàmà na-akawanye njọ site na mgbatị mkpịsị aka na mgbanwe calimor. Dọkịta Switzerland de Quervain kọrọ ọrịa ahụ na mbụ na 1895, yabụ a makwaara radial styloid stenosis tenosynovitis dị ka ọrịa de Quervain.
Ọrịa a na-ahụkarị n'etiti ndị na-eme ihe ugboro ugboro n'aka na mkpịsị aka, a makwaara ya dị ka "aka nne" na "mkpisi aka egwuregwu". Site na mmepe nke ịntanetị, ọnụọgụgụ ndị ọrịa ahụ na-abawanye ma na-eto eto. Yabụ kedu ka esi achọpụta ma gwọọ ọrịa a? Ihe ndị a ga-enye gị okwu mmalite dị mkpirikpi site na akụkụ atọ: nhazi ahụ, nchọpụta ahụike na ụzọ ọgwụgwọ!
I.Anatomi
Usoro styloid nke radius nwere sulcus dị warara, dị omimi nke ejikọta azụ carpal nke na-emepụta mkpuchi ọkpụkpụ. Akwara pollicis longus na extensor pollicis brevis na-agafe n'ime sheath a ma na-apịachi n'akụkụ ma kwụsị na ntọala nke ọkpụkpụ metacarpal mbụ na ntọala nke proximal phalanx nke mkpịsị aka ukwu, n'otu n'otu (Foto 1). Mgbe akwara na-amị amị, enwere ike esemokwu dị ukwuu, karịsịa mgbe nkwojiaka ulnar divideration ma ọ bụ mmegharị mkpịsị aka ukwu, akụkụ mpịachi na-abawanye, na-eme ka esemokwu dị n'etiti akwara na mgbidi sheath dịkwuo elu. Mgbe mkpali na-adịghị ala ala ugboro ugboro, synovium na-egosipụta mgbanwe mkpali dịka edema na hyperplasia, na-eme ka akwara na mgbidi sheath dịkwuo njọ, na-arapara ma ọ bụ na-ebelata akwara na sheath, na-ebute ngosipụta ahụike nke stenosis tenosynovitis.
Fig.1. Ihe osise anatomiki nke usoro styloid nke radius
II. Nchọpụta ahụike
1. Akụkọ ahụike na-adịkarị n'etiti ndị agadi, ndị na-arụ ọrụ aka, ma na-adịkarị n'etiti ụmụ nwanyị; Mmalite na-adị nwayọ, mana ihe mgbaàmà nwere ike ime na mberede.
2. Ihe ịrịba ama: ihe mgbu mpaghara na usoro radius nke radius, nke nwere ike ịgbasa n'aka na aka, adịghị ike mkpịsị aka ukwu, mbelata mgbatị mkpịsị aka, mmụba nke mgbaàmà mgbe mgbatị mkpịsị aka ukwu na mgbanwe ulnar nkwojiaka; Enwere ike ịhụ ntụpọ ndị a na-ahụ anya na usoro radius nke radius, dị ka ọkpụkpụ dị elu, yana obere nro.
3.Nnwale Finkelstein (ya bụ, ule nkewa nke fist ulnar) dị mma (dịka egosiri na Foto nke 2), a na-agbanwe mkpịsị aka ukwu ma jide ya n'ọbụ aka, a na-agbanwe aka n'úkwù, ihe mgbu dị na usoro radius styloid na-akawanye njọ.
4.Nnyocha enyemaka: Enwere ike ime nyocha X-ray ma ọ bụ ultrasound agba ma ọ bụrụ na ọ dị mkpa iji chọpụta ma enwere nsogbu ọkpụkpụ ma ọ bụ synovitis. Ntuziaka maka Ọgwụgwọ Ọtụtụ Nkà nke Styloid Stenosis Tenosynovitis nke Radius Rịba ama na a chọrọ nyocha anụ ahụ ndị ọzọ iji mata ọdịiche dị n'etiti osteoarthritis, nsogbu nke alaka elu nke akwara radial, na ọrịa forearm cruciate syndrome n'oge a na-achọpụta ọrịa ahụ.
III. Ọgwụgwọ
Ọgwụgwọ na-agbanwe agbanwe Ọgwụgwọ na-egbochi mmegharị ahụ n'ógbè: Na mbido, ndị ọrịa nwere ike iji ihe nkwado mpụta iji gbochie mmegharị ahụ aka ahụ metụtara iji belata ihe omume mpaghara ma belata esemokwu nke akwara dị n'ime ihe mkpuchi akwara iji mezuo ebumnuche ọgwụgwọ. Agbanyeghị, nkwụsị ahụ nwere ike ọ gaghị eme ka akụkụ ahụ metụtara dị n'ọnọdụ ya, nkwụsị ahụ ogologo oge nwere ike ibute nrụgide mmegharị ahụ ogologo oge. Ọ bụ ezie na a na-eji ọgwụgwọ ndị ọzọ enyere aka ịkwụsị mmegharị ahụ eme ihe n'ụzọ ọgwụ, irè nke ọgwụgwọ ka na-arụ ụka.
Ọgwụgwọ mkpọchi mpaghara: Dịka ọgwụgwọ a na-ahọrọ nke ọma maka ọgwụgwọ ahụike, ọgwụgwọ mkpọchi mpaghara na-ezo aka n'ịgbụ ọgwụ n'ime ebe mgbu mpaghara iji mezuo ebumnuche nke mgbochi mbufụt mpaghara. Ọgwụgwọ mkpọchi nwere ike ịgbanye ọgwụ n'ime ebe mgbu, akpa mkpuchi nkwonkwo, ogwe akwara na akụkụ ndị ọzọ, nke nwere ike ibelata ọzịza ma belata ihe mgbu ma belata spasms n'ime obere oge, ma rụọ ọrụ kachasị na ọgwụgwọ nke mmerụ ahụ mpaghara. Ọgwụgwọ ahụ gụnyere isi triamcinolone acetonide na lidocaine hydrochloride. Enwere ike iji ọgwụ sodium hyaluronate. Agbanyeghị, homonụ nwere ike inwe nsogbu dịka mgbu mgbe a gbasịrị ya, agba akpụkpọ ahụ mpaghara, atrophy anụ ahụ dị n'okpuru ala mpaghara, mmerụ ahụ akwara radial symptomatic, na mmụba glucose ọbara. Ihe ndị na-egbochi ya bụ nfụkasị homonụ, ndị ọrịa dị ime na ndị na-enye nwa ara. Sodium hyaluronate nwere ike ịdị nchebe ma nwee ike igbochi ọnya nke njikọta gburugburu akwara ma kwalite ọgwụgwọ akwara. Mmetụta ahụike nke ọgwụgwọ mkpọchi doro anya, mana enwere akụkọ ahụike nke necrosis mkpịsị aka nke ọgwụ mgbochi mpaghara na-ekwesịghị ekwesị kpatara (Foto 3).
Fig.3 Nchikota nke akụkụ na-eduga na necrosis nke mkpịsị aka nke mkpịsị aka index: A. Akpụkpọ aka ahụ na-achagharị agbagharị, na B, C. Akụkụ etiti nke mkpịsị aka index dị anya nke ukwuu, mkpịsị aka ya bụkwa necrosis
Ihe Ndị A Ga-eme Maka Ọgwụgwọ Okpuchi N'ọgwụgwọ radius styloid stenosis tenosynovitis: 1) Ọnọdụ ahụ ziri ezi, a ga-ewepụ sirinji ahụ tupu etinye ọgwụ ahụ iji hụ na agịga ahụ abanyeghị n'ime arịa ọbara; 2) Ịkwụsị mmegharị ahụ kwesịrị ekwesị nke akụkụ ahụ metụtara iji zere nrụgide tupu oge eruo; 3) Mgbe etinyere ya na hormone, a na-enwekarị ụdị mgbu dị iche iche, ọzịza, na ọbụna njọ nke ihe mgbu, na-apụ n'anya n'ime ụbọchị 2-3, ọ bụrụ na mgbu mkpịsị aka na akpụkpọ ahụ apụta, a ga-enye ọgwụgwọ antispasmodic na anticoagulant ngwa ngwa, a ga-emekwa angiography iji mee nchọpụta doro anya ma ọ bụrụ na o kwere mee, a ga-emekwa nchọpụta akwara ozugbo enwere ike ma ọ bụrụ na ọ dị mkpa, ka a ghara igbu oge maka ọnọdụ ahụ; 4) Ekwesighi iji mpaghara gwọọ ihe mgbochi hormonal dị ka ọbara mgbali elu, ọrịa shuga, ọrịa obi, wdg.
Shockwave: bụ ọgwụgwọ a na-anaghị ahụkarị, nke na-anaghị emerụ ahụ nke nwere uru nke imepụta ike n'èzí ahụ ma na-emepụta nsonaazụ n'ebe ndị a na-elekwasị anya n'ime ahụ na-emebighị anụ ahụ gbara ya gburugburu. Ọ nwere mmetụta nke ịkwalite metabolism, ime ka ọbara na mgbasa lymphatic sie ike, ime ka nri anụ ahụ ka mma, iwepụ capillaries akpọchiri akpọchi, na ịtọpụ njikọ anụ ahụ dị nro nkwonkwo. Agbanyeghị, ọ malitere n'oge na-adịghị anya na ọgwụgwọ nke styloid stenosis tenosynovitis nke radius, akụkọ nyocha ya dịkwa ole na ole, a ka chọrọ ọmụmụ ihe ndị a na-achịkwa nke ukwuu iji nye ihe akaebe ahụike ndị ọzọ iji kwalite ojiji ya na ọgwụgwọ nke styloid stenosis tenosynovitis ọrịa radius.
Ọgwụgwọ acupuncture: obere ọgwụgwọ acupuncture bụ ụzọ mwepụta mechiri emechi n'etiti ọgwụgwọ ịwa ahụ na ọgwụgwọ na-abụghị ịwa ahụ, site na ịpịpụ na iwepụ ọnya ndị dị n'ógbè ahụ, a na-ahapụ njikọta ahụ, a na-ebelatakwa njide nke akwara akwara vaskụla nke ọma, a na-emekwa ka mgbasa ọbara nke anụ ahụ gbara ya gburugburu ka mma site na mkpali dị mma nke acupuncture, na-ebelata mmịpụta mkpali, na imezu ebumnuche nke mgbochi mbufụt na mgbu.
Ọgwụ ọdịnala nke ndị China: Ọrịa radial styloid stenosis tenosynovitis so na ụdị "ọrịa mkpọnwụ" n'ọgwụ nke ala nna, ọrịa ahụ dabere na enweghị na ọkọlọtọ. N'ihi ọrụ ogologo oge nke nkwonkwo aka, oke nrụgide, nke na-ebute enweghị qi na ọbara mpaghara, a na-akpọ nke a enweghị nri mbụ; N'ihi enweghị qi na ọbara mpaghara, akwara na akwara na-efunahụ nri ma na-amị amị, nakwa n'ihi mmetụta nke ifufe, oyi na mmiri mmiri, nke na-eme ka mkpọchi nke ọrụ qi na ọbara ka njọ, a na-ahụ na ọzịza na ihe mgbu na ọrụ mpaghara dị oke njọ, mkpokọta nke qi na ọbara dịkwa njọ karị, spasm mpaghara dịkwa njọ karị, yabụ achọpụtara na ihe mgbu nke nkwonkwo aka na-agagharị agagharị na nkwonkwo metacarpophalangeal mbụ na-akawanye njọ na ụlọ ọgwụ ahụ, nke bụ ọkọlọtọ. A chọpụtara na ọgwụgwọ moxibustion, ọgwụgwọ ịhịa aka n'ahụ, ọgwụgwọ mpụga nke ọgwụ ọdịnala ndị China na ọgwụgwọ acupuncture nwere ụfọdụ mmetụta ahụike.
Ọgwụgwọ ịwa ahụ: Mbibi ịwa ahụ nke ligament carpal nke radius na mkpụcha dị oke mma bụ otu n'ime ọgwụgwọ maka stenosis tenosynovitis na usoro styloid nke radius. Ọ dị mma maka ndị ọrịa nwere tenosynovitis nke radius styloid stenosis ugboro ugboro, nke na-adịghị arụ ọrụ mgbe emechara ọtụtụ mkpọchi mpaghara na ọgwụgwọ ndị ọzọ na-adịghị mma, mgbaàmà ya dịkwa oke njọ. Karịsịa na ndị ọrịa nwere stenotic advanced tenosynovitis, ọ na-ebelata mgbu siri ike na nke na-adịghị mma.
Ịwa ahụ mepere emepe ozugbo: Ụzọ ịwa ahụ nkịtị bụ ime mbepụ ozugbo n'ebe dị nro, ikpughe septum akwara azụ mbụ, bepụ mkpuchi akwara gbara ọkpụrụkpụ, ma hapụ mkpuchi akwara ka akwara ahụ wee nwee ike ịmịgharị n'ime mkpuchi akwara ahụ. Ọ dị ngwa imezu ịwa ahụ mepere emepe ozugbo, mana ọ nwere ọtụtụ ihe egwu ịwa ahụ dịka ọrịa, nakwa n'ihi mwepụ nke eriri nkwado azụ ozugbo n'oge ịwa ahụ, mgbanwe akwara na mmebi nke akwara radial na akwara nwere ike ime.
Septolysis nke Mbụ: Usoro ịwa ahụ a anaghị ewepụ ihe mkpuchi akwara siri ike, kama ọ na-ewepụ ihe mkpuchi ganglion dị na septum extensor nke Mbụ ma ọ bụ na-egbutu septum dị n'etiti ihe mkpuchi azụ nke mbụ pollicis longus na ihe mkpuchi azụ nke mbụ pollicis brevis iji wepụta septum extensor nke Mbụ. Usoro a yiri ịwa ahụ mepere emepe ozugbo, isi ihe dị iche bụ na mgbe e bepụchara ihe nkwado extensor, a na-ahapụ ihe mkpuchi akwara ma wepụ ihe mkpuchi akwara kama site na mbepụ nke ihe mkpuchi akwara siri ike. Ọ bụ ezie na subluxation akwara nwere ike ịdị na usoro a, ọ na-echebe septum extensor nke Mbụ ma nwee arụmọrụ dị elu ogologo oge maka nkwụsi ike akwara karịa mwepụ ozugbo nke ihe mkpuchi akwara. Ihe ọghọm nke usoro a bụ isi n'ihi na ewepụghị ihe mkpuchi akwara siri ike, ihe mkpuchi akwara siri ike ka nwere ike ịbụ ihe mkpali, ọzịza, esemokwu na akwara ga-eduga na ọrịa ahụ ọzọ.
Mgbakwunye ọkpụkpụ ọkpụkpụ arthroscopic osteofibrous: Ọgwụgwọ arthroscopic nwere uru dị ka obere mmerụ ahụ, usoro ọgwụgwọ dị mkpirikpi, nchekwa dị elu, obere nsogbu na mgbake ngwa ngwa, uru kachasị bụ na eriri nkwado extensor anaghị agbaji, ọ gaghịkwa enwe nkwarụ akwara. Agbanyeghị, enwere esemokwu, ụfọdụ ndị ọkà mmụta kwenyere na ịwa ahụ arthroscopic dị oke ọnụ ma na-ewe oge, uru ya karịa ịwa ahụ mepere emepe ezughị oke. Ya mere, ọtụtụ ndị dọkịta na ndị ọrịa anaghị ahọrọ ọgwụgwọ arthroscopic.
Oge ozi: Ọktoba-29-2024
