Ubuhlungu ngaphansi kwe-scapula elungile kuyinkinga evamile emithi yokwelashwa. Kungaba yinto engenabungozi ngokuphelele (yokwehlisa imisipha), futhi ingabonisa ukuthi izifo eziyingozi empilweni nasezempilo (sarcoma of the bone), ngakho-ke noma yibuphi ubuhlungu obungaphansi kwesigcawu esifanele kufanelekela ngokucophelela futhi kudinga ukunakekelwa kwezokwelapha okufanelekayo.
I-scapula yesokudla: isakhiwo se-anatomical
I-scapula iyingxenye ye-trunk, eboshelwe ngezansi ngendlela enezingqimba ekhishwe emkhawulweni ophansi we-scapula, enelayini eliqondile elihambelana nokubonakala komngcele we-scapula wamaphakathi; phezulu - umugqa osebenza phakathi kwe-appendage ye-vertebra yesibeletho yesishiyagalombili kanye nokuhlanganiswa komgogodla we-acromial, ngaphandle - umngcele ongemuva we-muscle deltoid nomugqa ophakathi we-axillary. Enkabeni yesifunda se-scapular yi-scapula - ithambo eliyisicathulo eliyisicathulo eliseduze nezindiza ezihamba phambili ze-thorax phakathi kwezimbambo zesikhombisa nesesibili. Kunezinhlobo ezahlukene ze-scapula: iyunifomu, ende, emincane, emfushane, ebanzi. Egazini le-scapular zone, amagatsha e-artery subclavia, axhunyaniswe namagatsha e-aorta axillary, ahlanganyele. Ukuphuma kwegazi kuqhutshwa emithanjeni yegama elifanayo, amagatsha e-plexus ye-brachial anikeza isisindo esifundeni se-scapular.
Izinhlobo zobuhlungu ngaphansi kwe-scapula efanele:
- ubuhlungu bendawo (somatic). Ukuzizwa njalo esigabeni esithintekile somzimba noma eduze kwayo, kuhlotshaniswa nenqubo echaphazela izinzwa zamathambo, amalunga, izigulane, izintambo, imisipha. Indlela: ukuvuvukala yisisindo se-muscle. Ngokuvamile kunomlingisi ochithekile. Kungaba buhlungu, buhlungu, bukhulu. "Amaqabunga" lapho kuvuselelwa izicubu / isitho esonakele, uphendula ngokufanele ukwelashwa ngama-analgesics;
- Ubuhlungu obucatshangelwayo. Lendlala ngaphakathi kwemingcele ye-dermatome (izigaba zesikhumba), ezihlobene nokuhlenga kwezitho zangaphakathi ezinenkinga noma izakhiwo ze-vertebral. Kubangelwa izifo zama-pancreas, i-digestive tract, izinso, inhliziyo. Kungaba okujulile, ukukhala, ukuthungatha, kuhlanganiswe nokuvinjelwa kokunyakaza kanye ne-paresthenia (ukuzwela kwesifo);
- ukukhipha ubuhlungu. Ivela ngemuva kwezilonda zesisindo / izimpande, ibonakala ngokuphakama okukhulu, ukufuduka okuphambene nokuvela endaweni yesikhumba esivumelanayo. Kuyinto yemvelo ephathelene neurogenic - ihlotshaniswa nokuhluleka kwesistimu yezinzwa. Kuhambisana nokuphazamiseka kwemifino / motor, ukunciphisa ukugeleza kwegazi, kungavumelani nama-analgesics;
- ubuhlungu obungasebenzi. Isekelwe ezishintsheni esimweni sokusebenza samasayithi wesistimu aphakathi kwezinzwa ezilawula ubuhlungu. Ukuveza izinto ezenzekayo: ezengqondo, ezenhlalakahle, ezingokomzwelo.
Ubuhlungu ngaphansi kwe-scapula efanele - kungaba yini?
Ubuhlungu emhlane ngaphansi kwesigcawu esifanele yisifo esingenasiphelo sezifo eziyishumi nambili. Ihlukanisa futhi isendaweni, ukusika, ukucindezela, ukucindezela, okunzima futhi okungapheliyo. Kungabonisa izifo zezinhlelo / izitho ngaphakathi kwesifunda se-scapular (isikhumba, isisipha, isibambo, umtholampilo we-thoracic, izinzwa ze-intercostal, i-lung lung / pleura) nokungajwayelekile ezingxenyeni zangaphakathi (isibindi, isisu, izinso eziqondile, i-gallbladder).
Ubuhlungu ngaphansi kwesokudla se-scapula-pathology ye-scapula yezinto eziphilayo, ezithathelwanayo, ezibuhlungu:
- ukuhlukumeza okuthuthukisiwe. I-aplasia yama-congenital (ukungaphili kahle / ukungabikho) kwe-scapula elungile iyinqaba engavamile kakhulu, ngokuvamile ihlelwe ngokuhambisana nezinye izifo ezingokwemvelo zesistimu ye-musculoskeletal: i-pterygoid scapula kanye nesimiso esiphezulu se-scapula. I-pterygoid scapula ebusweni kumele ihlukaniswe ne-pterygoid scapula etholakale, okubangelwa ukulimala, i-myopathy, ukukhubazeka komzimba;
- umonakalo / ukuphulwa kwesipapula esifanele. Ukususwa kwe-scapula elungile kuhamba ngezimpawu zokugcoba, ngaphansi kwethonya noma ukwandiswa okuqinile kwezingalo, i-scapula iphenduka, iqhubekele ngaphandle, okubangela ukuqubuka kwemisipha enamathele emngceleni ongaphakathi we-scapula kanye nomgogodla oqondile. Ukuhamba ngokuhlanganyela kwehlombe kunciphise kakhulu ngenxa yobuhlungu ohlangothini olungakwesokudla ngemuva. Emacaleni angu-45-50%, ukulimala kwesigcawu esifanele kuhambisane nokuhlukumezeka emiphakathini nemikhumbi;
- i-exostosis. Kuzibonakalise njengento ephawulekayo yokuhamba ngokuhlanganyela kwesigxoko sokunene, umuzwa wokucindezeleka, izinhlungu ezilinganiselwe ngaphansi kwe-scapula;
- i-osteomyelitis scapula. Kuqala ngemuva kokulimala okuvulekile kwesigxoko sokunene (ukudubula kwesilonda), kuhambisane nezimpawu zokudakwa, ukubonakaliswa kwendawo (umsebenzi ongasebenzi kahle we-scapula, ubuhlungu ngakwesokunxele). Ukuthutha inqubo ye-purulent eya engxenyeni yangaphakathi ye-scapular iholela e-edema ye-muscular ejulile kanye nobuhlungu obukhulu;
- izicubu ze-scapula efanele. I-malignant (i-reticulosarcoma, i-chondrosarcoma) ne-benign (i-chondroma, i-osteoma, i-osteoblastoklastoma, i-osteochondroma) iyingozi futhi ibangela ubuhlungu obungapheli ngaphansi kwe-scapula efanele.
Ubuhlungu ngaphansi kwezifo ezifanele zesifo sangaphakathi:
- i-pyelonephritis engapheli. Esigabeni sesibili saleso sifo, izinguquko ezinxenyeni zezinso ziba yi-sclerotic, okwenza kubonakale ubuhlungu bezinkathi zokudonsa ngezikhathi ezithile ezinikezela emzimbeni ongaphezulu noma phansi. Ngenqubo efanele, izinhlungu zihambela ngaphansi kwesipapula esifanele. Ukubonakaliswa okubonakalayo: isicashu, ukushisa okuncane, ukuvuthwa okubuhlungu. Ubuhlungu obukhulu bungabonisa ukuba khona kwe-purulent engena ngaphakathi kwezinso;
- i-cholecystitis engapheli. Kubonakala ubuhlungu obunzima ngendawo yangakini endaweni ye-scapula elungile ngemuva, enikela ku-epigastrium. Ukuhlaselwa kwenzeka nge-paroxysmally, ngaphandle kokubangela ukukhathazeka okukhethekile. Ihlanganiswe nokuphuziza isikhumba, ukuhlanza, isicanucanu, isimo se-feverish;
- i-dyskinesia ye-bile ducts. Uhlobo lwe-DZHVP hypotonic lubonakala ngentuthuko encane yobunzima e-hypochondrium enhle, ebonakala ngaphansi kwe-scapula kanye nehlombe elungile, liqiniswa ngenkathi iguqulwa, igqozi elijulile. Ingozi eyinhloko yokwehlisa ubuhlungu ngaphansi kwe-scapula efanele ne-dyskinesia ingozi enkulu yokuthuthukisa i-cholelithiasis, i-cholecystitis ephawulekayo, i-gastroduodenitis;
- i-colic hepatic. Kubangela ubuhlungu obunzima bokuqhaqhazela, ukukhanyisa kwesigxathu sokunene kwehlombe, ihlombe lokunene nentamo. Uma i-colic ihlala amahora angu-4-5, izinzwa ezibuhlungu zisakaze endaweni yonke yesisu, zihambisane nokuhlanza nesicanucanu;
- i-cholelithiasis. Ukuhluleka komsebenzi we-gallbladder kubonakala ngezinhlungu ezinzima ngaphansi kwe-scapula efanele, kubonakala entanyeni, emhlathini, ehlombe, kancane kancane - endaweni yangaphakathi yenhliziyo (i-cholecystocoronary syndrome);
- i-pancreatitis. Esigabeni esiyingozi, lesi sifo sihlangene nama-shingles asakazeka ngokulinganayo ngaphansi kokubili kwe-scapulae. Ukuvuvukala kwekhanda lama-pancreas kubangela ubuhlungu, kugxilwe ngaphansi kwesigcawu esifanele futhi uzizwe njengengxenye "yegumbi". Ngokuvamile, ubuhlungu buhlala njalo, abugcini ngesikhathi sokushintsha kwesimo somzimba, aluzuzi amandla ngokukhwehlela, ukuvuselela, ukuhlaziya;
- i-cirrhosis yesibindi. Isithombe esivamile somtholampilo se-cirrhosis (ukushisa okushisa, i-jaundice, i-pruritus, i-ascites) "ekuqaleni" kwe-cirrhosis kuhlanganiswa ubuhlungu ngaphansi kwesigcawu esifanele nesandiso sesibindi;
- i-pneumonia eseceleni kwesokudla. Ema-20-25% amacala ayengenakuqhathaniswa esigabeni sokuqala, azibonakalisa kuphela ngezinhlungu zokushisa ngezikhathi ezithile ngaphansi kwe-scapula efanele. Yini okufanele uqaphele: ukuphefumula okusheshayo, ukujuluka ngokweqile ebusuku, ukungabi nampendulo kwezidakamizwa ze-antipyretic, izinga lokushisa lingaphezu kwama-38 degrees izinsuku ezintathu;
- i-abscess subdiaphragmatic. Isizathu sokwakhiwa kokuqukethwe okuhlanzekile emgodleni phakathi kwe-diaphragm kanye nezitho ezingomakhelwane kukhona ukutheleleka komzimba ngama-bacterium agents. Kukhona ubuhlungu ngaphansi kwe-scapula elungile, okwandisa kakhulu lapho uzama ukuthatha umoya ojulile, ukunyuka okuncane kokushisa komzimba.
Izifo zesistimu ye-musculoskeletal:
- i-osteochondrosis yomgogodla wesibeletho. I-cascade ephazamisayo-e-dystrophic, ngezigaba ezihlukahlukene lapho izici ezihlukahlukene ezibaluleke kakhulu ekwakheni ukuzwa kwemizwa: ukuvinjelwa / ukungazinzi kwamagundane we-vertebral, i-discniveral disvertebral disc, isisu somgogodla we-spinal, i-arthrosis yezihlanganisi zezinhlangothi. Zonke izihlukahluka zibhekene nobuhlungu bokudonsa ngendawo yangasemuva, enikeza ngaphansi kwesigcawu esifanele, emthonjeni, okhalweni. Ezikhathini eziningi, i-osteochondrosis ihambisana nobunzima beminwe yesandla sokunene nekhanda;
- i-scoliosis. Ukuguquka kwezindiza ezintathu zomgogodla (thoracic, cervical, lumbar), okwenza ubuhlungu obuhlungu ngaphansi kwesigcawu esifanele, ngemuva, emahlombe, ukukhathala, ukungasebenzi emathunjini, esiswini, amaphaphu, isisu senhliziyo;
- i-syndrome ye-periarthritis ye-humeroscapular. Ihlanganisa izinkinga ezihlukahlukene ngamathenda wesifunda nehlombe, ama-ligaments, imisipha, okubangelwa ukunyakaza okungaphumeleli, umsebenzi omkhulu we-muscular noma ukugqithiswa okuhleliwe kwesikhwama sehlombe, ukuphazamisa ubuhlungu obuhlinzeka ngaphansi kwe-scapula efanele;
- i-bursitis. Inqubo yokuvuvukala ye-scapula yekhanda le-synovial ye-joint joint shoulder idala ubuhlungu obunzima ngaphansi kwe-scapula efanele;
- isifo sofuba se-scapula;
- shingles. Ubuhlungu obuvuthayo ngaphansi kwe-scapula elungile kanye ne-intercostals bangela ukuba i-ganglionitis ye-herpetic-ukuvuvukala kwama-receptor eseduze-vertebral receptors. Isigaba esiyinkimbinkimbi sesifo sibonakala ukungabi khona kwama-vesicles athile, okuyinto enzima kakhulu ukuxilongwa. Ukubonakala kwe-herpes ukushayeka ezindaweni ezise-intercostal kuchaza isithombe futhi kuyisizathu sokumisa ukwelashwa kwe-antiviral.
- i-syndrome ye-myofascial syndrome. Umthombo - amaphuzu we-trigger, okwakhiwa ema-tendon, fasciae, imisipha. Iphuzu le-trigger yi-zone ye-hypersensitivity, ukucindezelwa okubangelwa isifo sobuhlungu obunzima ngesibindi ("gxuma uphawu"), ubuhlungu endaweni ecacisiwe (ubuhlungu obonakalisiwe), kude nokucindezela. Izindawo ezithandwayo kakhulu zokwakheka ziyizinsizi zekhanda / intamo, ohlangothini lwesokudla ngemuva / ehlombe, okubangela ukubonakala kwekhanda, i-lumbago entanyeni nangaphansi kwesigcawu sokunene, ekhanda ezinyaweni, emthangeni, nasezintweni. Izinto ezibeka phambili: imisindo ye-microtrauma, ukuzikhandla komzimba isikhathi eside, ukuphulwa kokumiswa, i-static overstrain.
Izifo ze-neurological:
- intercostal neuralgia. Ukwephulwa kwezimpande zesibindi kanye nokuhamba kwe-intervertebral disks kuya ngakwesokudla kuvela ngemuva kokucindezela okuqhubekayo kokuphela kwezinzwa endaweni yokuphuma kwayo - "emgodini", okwakhiwa izakhiwo ezihlukahlukene (izicubu ze-articular, i-hernia, i-osteophytes). Njengoba ukuguqulwa kwe-intervertebral ukuqhuma kuqhubekela phambili, isibani "emgodini" siyancipha, ukunikezelwa kwegazi kokuphela kwesibindi kuyadala, i-edema nobuhlungu buvele ngaphansi kwesigcawu esifanele;
- i-dystonia ye-vegetative-vascular. Ekuthuthukiseni isifo se-psychomatous, impendulo enganele ngokwanele yesimiso sezinzwa ezizimelayo kumthelela wezimo ezicindezelayo idlala indima ebalulekile, okuholela ekuphazanyeni ekusebenzeni kwezinhlelo eziningi namalungu omzimba. Umtholampilo i-VSD incike ekutheni kube khona ukuhluleka kwemifino. I-Vagotonia ibonakala ngomuzwa wokuthi "ukushisa" nokuntuleka komoya, isizungu, isicashu, ukuhlukunyezwa okubuhlungu ngemuva, ukugcoba ngaphansi kwesigcawu esifanele.
Ukuhlukaniswa ngohlobo lobuhlungu
Ubuhlungu obunzima ku-scapula efanele kusukela emuva
Kubonisa i-nephritis, i-pyelonephritis noma i-cholecystitis engapheli. Ubuhlungu obunzima emkhakheni we-scapula bubonakala ngezinqubo ezimbi ngezindawo zangaphakathi ezitho zangaphakathi ezikude ngakwesokudla. Ama-neoplasms we-lung lungile, izinso ezilungile, ama-pancrea abonakala ngobuhlungu obukhulu obuhambisana nohlangothi obuvuthayo obuvuthayo ngaphansi kwe-scapula.
Ubuhlungu obunzima ngaphansi kwe-scapula efanele
Uphawu oluvamile lwe-cholelithiasis, i-cholecystitis ephawulekayo, i-colic hepatic. Ezimweni ezingu-30-35%, ubuhlungu obukhulu ngaphansi kwe-scapula "buchaza" ngokwayo i-dyskinesia ye-gallbladder, ngenxa yokudla ngokweqile, ukusetshenziswa okungavunyelwe kokudla okunamafutha / okubabayo, ukukhululeka ngokomzwelo. Ngaphezu kobuhlungu, iziguli zikhononda ngokuthuthumela, ukulala, ukukhathala okwedlulele, ubuthakathaka obukhulu, ukucasula.
Ukwehlisa ubuhlungu ngaphansi kwe-scapula ngakwesokudla
Ubuhlungu besikhathi esifushane, abuhlanganiswa nezifo ze-pathological of systems / izitho zangaphakathi. Ezimweni eziningi, ubuhlungu bokugaya bubonisa ukuphazamiseka kwengqondo ku-osteochondrosis yomgogodla womlomo wesibeletho / umlomo wesibeletho, ucasulwa ngokuzikhandla ngokomzimba, ukuguquka okujulile kwe-trunk noma ukuma okungahambi kahle. Ngezinye izikhathi ubuhlungu obungapheliyo buyisibonakaliso sokuqala kwe-cholecystitis, ukuqala kwe-colic hepatic, noma ukuphazamiseka kwezindonga ze-bile ducts.
Cihla ubuhlungu besikhathi emuva ngaphansi kwe-scapula efanele
"Bakhuluma" ngesigaba sokugcina se-abscess subdiaphragmatic, ukuba khona kwe-purulent ukungena ngaphakathi kwezinso, i-renal colic. Kulesi simo, ubuhlungu buyanda ngesikhathi sokuphefumulela okujulile, kubonakala ehlombe nasentanyeni.
Ukudweba izinhlungu ku-scapula ngakwesokudla
Ehlanganiswe nezinselele zemisipha ebhande lehlombe noma ukuguqulwa kwesakhiwo kwikholomu yomgogodla. I-Osteochondrosis yendawo yomlomo wesibeletho ibhekene nobuhlungu bokudweba, ukuqina ngamandla nge-constant static load, ukushintsha isikhundla somzimba. Kuzo zonke ezinye izifo, ukudonsa izinhlungu kuyisimo esiphuthumayo, ngaphandle kwe-oncology ye-lung lungile, izinso, isibindi, ikhanda le-pancreas.
Ubuhlungu obuvuthayo endaweni ye-scapula ngakwesokudla
Ubuhlungu obuvuthayo bungabonisa ukwephulwa kwezimpande zesibindi noma izimo eziyingozi ezidinga ukunakekelwa okusheshayo - i-pneumonia engakwesokudla, i-angina yama-atypical.
Ubuhlungu obunjalo ku-scapula ngakwesokudla
Ukubonakaliswa kwesimo se-dyskinesia (ukungasebenzi kwe-motor) ye-bile ducts kuyinto enamandla kakhulu. Ubuhlungu bukhula kancane kancane ku-hypochondrium elungile, unikeza ngaphansi kwe-scapula efanele, ehlombe elifanele.
I-Aching ngaphansi kwesigcawu sokunene sehlombe ngemuva
Ubufakazi benqubo engapheli eqhubekayo ezithombeni ezikude. Izinhlungu ezikhungathekile ezibukekayo zibonakaliso ezicacile zokuvuvukala kwamaphakresi, isisindo senyongo, izinso, isibindi, esingenakunakwa, njengoba singakwazi "ukufihla" izifo ezingokwemvelo, ezisezigaba zokuqala ezizibonakalisa njengezivuselela ubuhlungu obuhlungu.
Izimbangela ezikhona zokuhlunguphaza ngezikhathi ezithile:
- inqubo yesisu endaweni efanele ye-LO;
- i-pyelonephritis engapheli / i-cholecystitis;
- i-cholelithiasis, i-osteochondrosis;
- pneumonia / pleurisy esivumelwaneni esifanele emaphaphu;
- isifo sofuba / isifo se-cirrhosis;
- i-bronchitis engapheli, i-pancreatitis.
Kungani kukhona ubuhlungu bokuphunga ngaphansi kwesigcawu esifanele
Ubuhlungu bokuphulukisa endaweni engakwesokudla ngokuvamile ngenxa ye-protrusion ye-disc, ukucindezela okuqhubekayo kokuphela kwezinzwa. I-protrusion iyisigaba sokuqala se-hernia ye-intervertebral, okuyinto ngokuhamba kwesikhathi ingaholela ekwakheni i-hernia intervertebral, "enikeza" ubuhlungu obukhulu.
Izimpawu zokukhathazeka zidinga ukunakekelwa okuphuthumayo
Naphezu kwezimbangela eziningi ezibangelwa ubuhlungu emgodleni wehlombe, kunezibonakaliso ezinobungozi ezingasongela ukuphila: ubuhlungu obukhukhumezayo, obangela "isisu esiswini," i-hyperemia (kufika ku-40 degrees), ukuvuvukala kwezandla, ukuhlanza "umthombo", i-cyanosis yesikhumba , ukuphefumula, ukuphosa okungazelelwe emshinini / ukucindezeleka kwegazi, ukuphelelwa amandla.
Izinyathelo zokuhlola
Ngezinhlungu ngaphansi kwe-scapula elungile, ukuhlolwa okusemtholampilo okusemandleni kwenza kube lula ukuhlukanisa iziguli ezinobunzima obukhulu futhi obuqondile. "Izimpawu zokusongela", okuvumela ukusola izifo ezisongela ukuphila: ukwanda kancane kancane ebuhlungu, ukuqina kohambo, ukukhubazeka, ukukhathazeka kokuzwela, i-oncology ku-anamnesis, ukuguqulwa kwezivivinyo zegazi / umchamo. I-etiology engahlosiwe yobuhlungu kanye nesimo sayo esiqondile, okungabonisa ukuthi kukhona ukuhluleka kwamagciwane, inqubo esithathelwanayo, ukulimala / ukuvuvukala komgogodla we-spinal cord, izifo zesifo se-somatic zezitho zangaphakathi - ithuba lokubonisana nabachwepheshe abakhethekile (i-gastroenterologist, i-neurologist, i-cardiologist, i-traumatologist).
I-Algorithm yokuxilongwa ngokuhlukana kobuhlungu ngaphansi kwe-scapula efanele:
- iqoqo le-anamnesis, incazelo yemigomo yemvelo;
- ukulinganisa kwe-pulse, ukucindezelwa kwegazi;
- i-palpation ye-interscapular zone, emuva;
- ukwenza ukuhlolwa kwamathambo;
- ukuhlonza izibonakaliso zokuhlukumeza;
- Ukukhishwa kwezimo ezimbi ezithinta impilo yesiguli;
- ukuqinisekiswa / ukukhipha umsuka we-psychogenic wezinhlungu;
- Ucwaningo olwengeziwe: i-ultrasound, i-MRI, i-CT, inhliziyo, i-X-ray yomgogodla ne-thorax, i-FGD, i-bronchoscopy, i-urine / i-blood test.
Ubuhlungu obungaphansi kwesigcawu esifanele kufanele kuphathwe udokotela kuphela, kuye, ngokuya kwesifo, ukukhetha indlela yokwelashwa efanele kakhulu yesifo esibucayi nobuhlungu esifundeni se-scapular. Uhlobo lwezokwelapha lungabandakanya izindlela zokuhlinza nokuhlinzeka, ukusikhipha umzimba, ukufudumala, ukucubungula kanye ne-physiotherapy.