Ubuhlungu phantsi kwe-scapula efanelekileyo yisishala esiqhelekileyo kwiyeza zonyango. Inokuba yinto engenakonakalisa nantoni (ukululalisa i-muscle), kwaye ingabonisa ukuba inkunkuma iyingozi kubomi kunye nempilo (i-sarcoma ithambo), ngoko nayiphi na intlungu phantsi kwe-scapula eyiyo ifanelekileyo ingqalelo kwaye ifuna unyango olufanelekileyo.
I-scapula efanelekileyo: isakhiwo se-anatomical
I-scapula iyingxenye ye-trunk, eboshwe ngezantsi ngelayini elingqamlekiweyo eligqitywe kumgca ongezantsi we-scapula, ngomgca omileyo ohambelana nokubonakaliswa komda we-scapula; phezulu - umgca osebenza phakathi kwe-appendi ye-vertebra yesixhenxe yomlomo wesibeleko kunye nomxube we-spinal-acromial, ngaphandle-umda ongaphantsi komgca we-deltoid kunye nomgca we-axillary ophakathi. Kwinqanaba le-scapular esifundeni yi-scapula - ithambo elincinci elincinci elisecaleni kwendiza engaphaya kwe-thorax phakathi kwembombo yesixhenxe neyesibini. Kukho imilo eyahlukeneyo ye-scapula: ifanayo, ende, inqabile, imfutshane, ibanzi. Kwi-blood supply ye-scapular zone, amasebe e-subclavia, ehlangene namasebe e-axillary aorta, athatha inxaxheba. Ukuphuma kwegazi kuqhutyelwa kwimifuno yegama elifanayo, amagatsha e-plexus ye-brachial anikezela iimbasa kwiindawo ezixhamlayo.
Iintlobo zentlungu phantsi kwe-scapula efanelekileyo:
- intlungu (somatic) yendawo. Uhlala uvakalelwa kwicandelo elichaphazelekayo lomzimba okanye kufuphi nalo, lidibene nenkqubo echaphazela intlungu yamathambo, amajoyina, iigaments, i-tendon, imisipha. Indlela: ukuvuvukala kuyisifo se-muscular spasm. Uninzi lwamaxesha amaninzi unomgca ocolileyo. Ingaba nzima, ibuhlungu, ibuhlungu. "Amaqabunga" xa uvuselela izicubu / isici esonakalisiweyo, uphendule ngokwaneleyo unyango ngama-analgesics;
- Intlungu ebonakalayo. Isasazeka ngaphakathi kwemida yedermatome (amacandelo ekhumba), ahambelana nokugcinwa kwamalungu angaphakathi angxaki okanye izakhiwo ze-vertebral. Yibangelwa zizifo zepascreas, i-digestive tract, izintso, intliziyo. Unokuba lunzulu, ugubuke, utyumle, udibaniswe nokuthintela ukuhamba kunye ne-paresthenia (ukuphazamiseka kwengqondo);
- i ntlungu. Ivela kwimvelaphi yezilonda zesigulane / ingcambu, ibonakaliswa ngokuphakama okuphezulu, ukufuduka kwezinto ezikude kummandla wesondlo. Yintlobo ye-neurogenic - inxulumene nokungasebenzi komsebenzi wesifo. Ihamba kunye neengxaki zemifuno / imoto, ukunciphisa ukuhamba kwegazi, ikhuselekile kwi-analgesics;
- intlungu engasebenzi. Isekelwe kwiinguqu kwiimeko zokusebenza ezisemgangathweni kwiisayithi zesistim ezilawula intlungu. Iziganeko zokubangela ukuba kwenzeke: ingqondo yengqondo, intlalo, imvakalelo.
Intlungu phantsi kwe-scapula eyiyo-ingaba yintoni?
Ubuhlungu emva ngaphantsi kwe-scapula elungileyo luphawu olungabonakaliyo lwezifo ezilishumi. Ikwahlukana kunye neendawo zendawo, ukusika, ukunyanzelisa, ukucindezela, ukuphazamiseka nokukhupha. Ingabonisa izifo zeenkqubo / izitho ngaphakathi kwendawo yesalathisi (isikhumba, umsila, umbhobho, umlenze we-thoracic, i-intercostal neerve, ilungelo lempompo / i-pleura) kunye nokungaqhelekanga kwizitho zangaphakathi (isibindi, isisu, isifo esifanelekileyo, i-gallbladder).
Ubuhlungu phantsi kwe-scapula-pathology ye-scapula ye-scapula ye-oncological, infectious,
- iziphulo zokuphuhlisa. I-aplasia yama-Congenital (ukungaphuhliswanga / ukungabikho) kwe-scapula efanelekileyo yinto engavumelekanga kakhulu, ngokuqhelekileyo ichanekileyo kunye nezinye iimpazamo zofuzo ze-musculoskeal system: i-pterygoid scapula kunye ne-scapula ephezulu. I-stapitalital pterygoid scapula kufuneka ihlukaniswe kunye ne-pterygoid scapula efunyenwe, eyabangela ukulimala, i-myopathy, ukukhubazeka kwesisu;
- umonakalo / ukuphulwa kwe-scapula eyiyo. Ukutshintshwa kwe-scapula eyiyo kuqhutyelwa ngeempawu ezityumbileyo, phantsi kwempembelelo okanye ukongezwa okomeleleyo kwengalo, i-scapula iyajika, iqhubekele ngaphandle, ephazamisa ukuphuka kwemisipha enamathele kumda we-scapula ofanelekileyo kunye nomgudu. Ukuhamba ngokubambisana kwegxalaba kunciphise kakhulu ngenxa yentlungu ekhohlo kumqolo. Kwi-45-50% yamatyala, ukulimala kwe-scapula elungileyo kuhamba kunye neengxakini kumathambo kunye neempahla;
- exostosis. Ibonakalisa njengento ephawulekayo yokuhamba kunye nokunyuka kwamalungu ehlombe, ukuvakalelwa, ubunzima bokulinganisela phantsi kwe-scapula;
- i-osteomyelitis scapula. Ikhula emva kokulimala okuvulekileyo kwinqanaba lehlombe elifanelekileyo (ibhulophu inxeba), ihamba kunye neempawu zokuxhatshazwa, ukubonakaliswa kwendawo (umsebenzi ongenakunzima we-scapula, intlungu ephezulu ngasemva). Ukufuduka kwinkqubo ye-purulent ukuya kwingxenyana yangaphambili ye-scapular iholela kwi-edema ye-muscular ejulile kunye nentlungu eyongeziweyo;
- izicubu zesalathula esifanelekileyo. I-Malignant (i-reticulosarcoma, i-chondrosarcoma) kunye ne-benign (i-chondroma, i-osteoma, i-osteoblastoklastoma, i-osteochondroma) ibuhlungu, ibangela iintlungu ezingapheliyo phantsi kwe-scapula eyiyo.
Ubuhlungu phantsi kwe-scapula yesifo esifanelekileyo sezitho zangaphakathi:
- pyelonephritis engapheliyo. Kwisigaba sesibini sesi sifo, utshintsho kwiisilini zezintso luba buhlungu, obangela ukuba kubonakale ubuhlungu bexesha elidityanisiweyo elinikezela kumzimba ophezulu okanye ngaphantsi. Kwinkqubo yokunene, intlungu ihambela ngaphantsi kwe-scapula eyiyo. Ubonakaliso obuthileyo: isicongconi, ubushushu obuncinane, ukuvuthwa okubuhlungu. Intlungu ebuhlungu ingabonisa ubukho be-purulent entiltrate kwizintso;
- cholecystitis engapheliyo. Ibonakaliswa yintlungu ebuhlungu kunye neendawo ezisemgangathweni kwinqanaba le-scapula elungileyo ukusuka ngasemva, linikezela kwi-epigastrium. Ukuhlaselwa kwenzeka nge-paroxysmally, ngaphandle kokubangela nantoni na ekhethekileyo. Ihlanganiswe nokuphuka kolusu, ukuhlanza, isicathulo, isifo somkhuhlane;
- i-dyskinesia ye-bile ducts. Uhlobo lwe-DZHVP lwe-hypotonic lubonakaliswa ngokuphucotha kweentlungu kwi-hypochondrium efanelekileyo, ebonakaliswa phantsi kwe-scapula kunye nesigxina sokunene. Ingozi enkulu yokungafumani intlungu phantsi kwe-scapula eyiyo kunye ne-dyskinesia yingozi enkulu yokuphuhlisa i-cholelithiasis, i-cholecystitis ephawulekayo, i-gastroduodenitis;
- colic hepatic. Kubangelwa ukugqabhuka kakhulu intlungu, ukukhawuleza ukuya kwinqanaba elisekunene, umgca wekunene nentamo. Ukuba i-colic ihlala kwiiyure ezingama-4 ukuya kwimizuzu engama-4, ukuvakalelwa okubuhlungu kwandiswa kwinqanaba lomhlaba wonke, kuhamba kunye nokuhlanza kunye nesisulu;
- cholelithiasis. Ukungaphumeleli kokusebenza kwe-gallbladder kubonakaliswe yimilenze ephantsi phantsi kwe-scapula eyiyo, kuboniswe entanyeni, emhlathini, emagxeni, ngaphantsi kwexesha elide-kwiindawo zentliziyo (i-cholecystocoronary syndrome);
- pancreatitis. Kwinqanaba eliqatha, isifo sidibaniswe kunye neengqungquthela ezazisasazeka ngokufanayo phantsi kwee-scapulae zombini. Ukuvuvukala kwentloko ye-pancreas kubangela intlungu, kugxilwe phantsi kwe-scapula eyiyo kwaye uzive ngathi "igumbi". Ngokuqhelekileyo, intlungu isisigxina, ayinakudluli ngexesha lotshintsho kwisimo somzimba, alufumani amandla ngokukhwehlela, ukuxhoma, ukucima;
- i-cirrhosis yesibindi. Umfanekiso oqhelekileyo wekliniki we-cirrhosis (ukuhamba kweqondo lokushisa, i-jaundice, i-pruritus, i-ascites) "ekuqaleni" kwe-cirrhosis incediswa yintlungu phantsi kwe-scapula eyiyo kunye nokwandiswa kwesibindi;
- pneumonia. Kwi-20-25% yamatyala ayimfuneko kwisigaba sokuqala, ezibonakalisa kuphela ngeentlungu ezivuthayo phantsi kwe-scapula eyiyo. Yintoni emele iqaphele: ukuphefumula ngokukhawuleza, ukufufuma okugqithiseleyo ebusuku, ukungabi nampendulo kwizidakamizwa ze-antipyretic, ukushisa kunentla kwama-38 degrees iintsuku ezintathu;
- ikhefu lesibini. Isizathu sokubunjwa kwesiqulatho esingenasiphelo emkhatsini wesangqa kunye namalungu angummelwane sisifo sobulwelwe ngama-bacterial agents. Kukho intlungu phantsi kwe-scapula eyiyo, ukwandisa kakhulu xa uzama ukuthatha umoya ophezulu, ukwanda kancinci kwindlubhiso yomzimba.
Izifo zesistim ye-musculoskelet system:
- i-osteochondrosis yomlenze wesibeleko. I-cascade ephazamisayo-i-dystrophic, kwizigaba ezahlukahlukeneyo apho izinto ezahlukahlukeneyo zibaluleke kakhulu ekubunjweni kweentlungu: ukukhusela / ukungazinzi kwamagqabeni e-vertebral, i-disnibrated intervertebral disc, i-stenosis ye-canal spinal, i-arthrosis yamalungu e-facet. Zonke iindidi zibonakaliswa ngentlungu yokudonsa kunye neendawo zangasemuva, ukunika phantsi kwesigapula esifanelekileyo, kwisithambiso, esinqeni. Kwiimeko ezininzi, i-osteochondrosis ihamba kunye neenkwenkwezi zeminwe yesandla sokunene kunye neentloko;
- i-scoliosis. Ukuguqulwa kweentlobo ezintathu zomgudu (thoracic, cervical, lumbar), obangela ubuhlungu obuhlungu phantsi kwe-scapula efanelekileyo, emva, emahlombe, ukuxhala, ukungasebenzi kwimathumbu, isisu, imiphunga, imisipha yenhliziyo;
- isifo se-periarthritis ye-humeroscapular. Idibanisa iindidi zeengxaki kunye neendlela zegxalaba / iigxina, iigaments, imisipha, okubangelwa ukunyuka okungafezekanga, umsebenzi osisigxina somsi okanye ukugqithisa ngokucwangcisiweyo kwebhande legxala, ukuphazamisa intlungu phantsi kwe-scapula eyiyo;
- bursitis. Inkqubo yokuvuvukala ye-scapula ye-synovial membrane yesigxina segxala elilungileyo lidala iintlungu ezibuhlungu phantsi kwe-scapula eyiyo;
- isifo sofuba se-scapula;
- ngxinwa. Iintlungu ezivuthayo phantsi kwe-scapula elungileyo kunye ne-intercostals kubangela ukuba i-ganglionitis ye-herpetic-inflammation ye-ne-vertebral nererve receptors. Isigaba esiqatha sesi sifo sibonakala ngokungabikho kwee-vesicle ezithile, eziyinkimbinkimbi kakhulu. Ukubonakala kwee-herpes kwi-intercostal izikhala zicacisa umfanekiso kwaye zisebenza njengesizathu sokumisela unyango lwe-antiviral.
- isifo sengqondo somzimba. Umthombo - iziqalo zokuqala, ezenziwe kwiitoni, fasciae, imisipha. Ingqungquthela yokubangela ingxube ye-hypersensitivity, ingcinezelo ebangela i-syndrome ebuhlungu ebuhlungu ("gxuma uphawu"), intlungu kwindawo ecacisiweyo (intlungu ebonakalisiweyo), kude nexinzelelo. Iindawo ezithandwa kakhulu zakhiwo ziyimisipha yentloko / intamo, ecaleni lekunene lomqolo / umxhwele, obangela ukubonakala kweentloko, i-lumbago entanyeni nangaphantsi kwesigxina sokunene, ukukhanyisa entanyeni, kwintambo, kwintlambo. Izinto ezithintekayo: i-microtrauma yezihlunu, ukunyanzelisa umzimba, ukuphulwa kwe-posture, static overstrain.
Iingxaki ze-neurological:
- intercostal neuralgia. Ukuphulwa kweengcambu zentsholongwane kunye nokufuduka kweediski ze-intervertebral ukuya kwicala lasekunene kuvela kwimvelaphi yoxinzelelo lweentsholongwane kwindawo ekuphumeni kwayo - "kwikorori", eyenziwa yimimandla eyahlukeneyo (izicubu ze-articular, i-hernia, i-osteophytes). Njengoko ukuguqulwa kwe-intervertebral disks kuqhubeka, i-lumen "kwikorori" iyanciphisa, ukunikezelwa kwegazi kweziphephelo zesifo kunzima, i-edema kunye nentlungu ibonakale phantsi kwe-scapula eyiyo;
- i-dystonia ye-vegetative-vascular. Ekuphuhliseni inkathazo ye-psychomatous, impendulo enganeleyo yenkqubo ye-nervous autonomic kwiimpembelelo zeemeko zibangela indima ebalulekileyo, ekhokelela ekuphazamiseni ukusebenza kweenkqubo ezininzi kunye namalungu omzimba. Iklinikhi i-VSD incike kwi-orientation ye-failure failments. I-Vagotonia ibonakalisa imvakalelo "yobunzima" kunye nokungabi nomoya, ukuxakeka, isisulu, isantya, ukuhlunguphazeleka okungenakushukunyiswa emva, ukuphazamiseka phantsi kwe-scapula eyiyo.
Ukwahlula ngohlobo lwentlungu
Intlungu ebuhlungu kwi-scapula eyiyo emva
Ibonisa i-nephritis, i-pyelonephritis okanye i-cholecystitis engapheliyo. Intlungu ebuhlungu kwi-scapula iyinto ebonakalayo kwiinkqubo ezimbi kunye neendawo zangaphakathi ezisecaleni. Iipopu zompompo wesokudla, izintso ezilungileyo, i-pancreas zibonakaliswa ngentlungu ephilileyo yamanxeba aphihliweyo phantsi kwe-scapula.
Intlungu ebuhlungu phantsi kwe-scapula eyiyo
Uphawu oluqhelekileyo lwe-cholelithiasis, i-cholecystitis ephawulekayo, i-colic hepatic. Kwi-30-35% yamatyala, iintlungu eziphantsi kwe-scapula "zichaza" ngokwazo i-dyskinesia ye-gallbladder, ephuma ekudleni, ukusetyenziswa kakubi kokutya okunamafutha / okwebhisikizi, ukugqithiswa kwengqondo. Ukongeza kwintlungu, izigulana zikhalaza ukuthuthumela, ukulala, ukunyuka, ukhathala okubanzi, ukukhubeka.
Ukubethelela intlungu phantsi kwe-scapula ngakwesokudla
Intlungu yesikhashana, engahambelanisi nezifo zesifo seenkqubo zangaphakathi / izitho zangaphakathi. Kwiimeko ezininzi, ubuhlungu bokubamba ubuhlungu bubonisa ukuphazamiseka kwengqondo kwi-osteochondrosis ye-thoracic / cervical spine, ichukunyiswa ngumzimba, ukuguquka okubukhali kwesiqu okanye ukungahambi kakuhle. Ngamanye amaxesha ubuhlungu besikhathi esifanelekileyo bubonakaliso bokuqala koxinzelelo lwe-cholecystitis, ukuqala kwe-colic hepatic, okanye i-spasms yeendonga ze-bile ducts.
Ukubuhlungu intlungu emva kwe-scapula eyiyo
'Bathetha' malunga nesigaba sokugqibela senkcenkcazo yesigxina, ubukho be-purulent entiltrate kwiimpso, colic renal. Kule meko, intlungu ikhula ngokukhawuleza ngexesha lokuphefumlelwa okukhulu, kuboniswe kwiphepha nentamo.
Ukubonisa ubuhlungu kwi-scapula ngakwesokudla
Ukudibanisa kunye neentsholongwane zeemisipha zebhande lesigxina okanye ukuguqulwa kwesakhiwo somqolo wamagxa. I-Osteochondrosis yommandla wentsholongwane ibonakaliswe ngokubangela intlungu, ukufumana umthwalo ngamandla rhoqo, ukuguqula isikhundla somzimba. Kuzo zonke ezinye izifo, ukudonsa ubuhlungu be-atypical, ngaphandle kwe-oncology yelungelo lempompo, isifo, isibindi, intloko ye-pancreas.
Iintlungu ezivuthayo kwindawo yecrafula ngakwesokudla
Iintlungu ezitshisayo zingabonisa ukuphulwa kweengcambu zentsholongwane okanye izimo ezinobungozi ezifuna ukunakekelwa kwangoko-ntsho-pneumonia yangasese, i-angypical angina.
Intlungu ehlala rhoqo kwi-scapula ngakwesokudla
Ubonakaliso obunjani be-dyskinesia (ukungasebenzi kwemoto) yee-ducts i-bile iphezulu. Intlungu ikhula kancane kwi-hypochondrium efanelekileyo, inika phantsi kwe-scapula eyiyo, kwicala elifanelekileyo.
Ngaphantsi kwegxala elingakwesokunene
Ubungqina benkqubo engapheliyo eqhubekayo kwizitho ezikude. Ukubonakalisa iintlungu ezibuhlungu zibonakaliso ezicacileyo zokuvuvukala kwi-pancreas, i-gall bladder, izintso, isibindi, ezingenakukunyanzelwa, kuba "zifihla" izifo ze-oncological, eziseziqaleni zokuqala zibonakalisa ngokwazo njengezibuhlungu ezibuhlungu.
Izizathu ezinokubangela iintlungu ezibuhlungu:
- inkqubo yexhamla kwindawo efanelekileyo ye-LO;
- i-pyelonephritis engapheliyo / i-cholecystitis;
- i-cholelithiasis, i-osteochondrosis;
- i-pneumonia evulekile / pleurisy kwimpompo elungileyo;
- i-hepatitis / cirrhosis;
- i-bronchitis engapheliyo, i-pancreatitis.
Kutheni kukho intlungu yokuphosa phantsi kwe-scapula eyiyo
Iintlungu ezithintekayo kwicandelo elungileyo liqhelekile ngenxa yokukhutshwa kwidiski, ukunyanzeliswa kokuqhubeka kweentlungu. I-protrusion iyona nqanaba lokuqala le-hernia ye-intervertebral, ekuhambeni kwexesha kunokukhokelela ekwakheni i-hernia intervertbral, "eyenza" ubuhlungu obukhulu.
Iimpawu zokuxhalabisa ezifuna ukunakekelwa ngxamisekileyo
Nangona zimbangela ezininzi ezibangela intlungu ehlathini elisekunene, kunezibonakaliso ezinobungozi ezibeka ingozi ebomini: iintlungu ezikhula ngokukhawuleza, zenza "isisu esiswini," i-hyperemia (kufika kuma-40 degrees), ukuvuvuka kwezandla, ukuhlanza "umthombo", i-cyanosis yolusu , ukuphefumula okufutshane, ngokukhawuleza kwehla kwi-pulse / uxinzelelo lwegazi, ukuphelelwa amandla.
Amanyathelo okuchonga
Ngentlungu phantsi kwe-scapula eyiyo, ukuhlolwa kweekliniki ezifanelekileyo kwenza ukuba kube lula ukuhlula izigulane ezingenakucatshulwa kunye nentlungu ethile. "Iimpawu zokusongela", ukuvumela ukukrokrela izifo ezisongela ubomi: ukunyuka kancane kwintlungu, ubunzima bokuhamba, ukukhubazeka, ukuphazamiseka kwengqondo, i-oncology kwi-anamnesis, utshintsho kwiimvavanyo zegazi / umchamo. I-etiology engabonakaliyo yentlungu kunye nesimo sayo esithile, engabonakalisa ubukho bokungaphumeleli komzimba, inkqubo yokusuleleka, ukulimala / ukuvuvukala kwentlungu yomgudu womzimba, izifo zesifo se-somatic zeziganeko zangaphakathi-ithuba lokubonisana neengcali ezizodwa (i-gastroenterologist, i-neurologist, i-cardiologist, i-traumatologist).
I-Algorithm yokuxilongwa ngokuhlukileyo kwentlungu phantsi kwe-scapula eyiyo:
- ukuqokelela i-anamnesis, inkcazo yenjongo yobume bentlungu;
- ukulinganisa kwe-pulse, uxinzelelo lwegazi;
- ukubethelwa kwendawo yendawo, ubuyele;
- kuqhuba uvavanyo lwamazinyo;
- ukuchongwa kweempawu zentlungu;
- Ukukhutshwa kweemeko ezinzima ezisongela ubomi bomguli;
- ukuqinisekiswa / ukungabikho kwemvelaphi yengqondo yengqondo;
- Izifundo ezongezelelweyo: i-ultrasound, i-MRI, i-CT ye-cardiogram, i-cardiogram, i-X-ray yomlenze kunye ne-thorax, i-FGD, i-bronchoscopy, i-urine / yegazi.
Intlungu phantsi kwe-scapula eyiyo kufuneka iphathwe kuphela ngugqirha, oxhomekeke kwisifo, ukhetha indlela efanelekileyo yokwenza unyango kunye nesifo esikuyo ndawo. I-regimen yokwelapha ingabandakanya iindlela zokugonywa kunye nokugqirha, ukuxilisa, ukufudumala, i-reflexology kunye ne-physiotherapy.