Compartment syndrome yog tshwm sim los ntawm qhov txawv txav ntawm qhov siab hauv cov ntaub so ntswg uas muaj nyob rau hauv cov leeg nqaij hu ua compartment. Hauv nws daim ntawv mob ntev, nws tshwm sim ntawm kev tawm dag zog, ua rau cov leeg nqaij thiab paj hlwb ntawm qhov sib txawv ntawm qhov hnyav. Cov mob hnyav kuj tuaj yeem tshwm sim tom qab raug mob, yuav tsum tau phais xwm txheej ceev. Kev phais kuj yog ib qho lus teb thaum tsis muaj cov tshuaj kho mob tau pom nyob rau hauv cov ntaub ntawv mob ntev.

Lus txhais

Compartment syndrome, los yog compartment syndrome, yog qhov tshwm sim ntawm qhov nce hauv cov ntaub so ntswg nyob rau hauv ib los yog ntau lub compartments, uas yog hais nyob rau hauv cov nqaij mos compartments kaw los ntawm ib tug inextensible fibrous membrane hu ua aponeurosis uas muaj nyob rau hauv cov ceg, forearm los yog tes. . Qhov mob pathology no tuaj yeem nrog los ntawm kev txo qis hauv cov ntshav ncig (ischemia) uas ua rau muaj kev txom nyem ntawm cov leeg nqaij thiab cov hlab ntsha.

Qhov hnyav yog qhov sib txawv nyob ntawm qhov tseem ceeb ntawm qhov overpressure.

Hauv ib feem peb ntawm cov neeg mob, muaj cov leeg nqaij hernias: nyob rau hauv qhov chaw, cov leeg nqaij kawg tuaj tawm ntawm lawv lub thawv los ntawm ruptured aponeurosis.

Ua rau

Compartment syndrome tshwm sim los ntawm kev tsis sib haum xeeb ntawm lub thawv (aponeurosis) thiab cov ntsiab lus (cov leeg nqaij, tab sis kuj cov hlab ntsha thiab cov hlab ntsha). Kev nce hauv cov leeg nqaij tuaj yeem cuam tshuam rau cov leeg nqaij, edema lossis hematoma tsim, lossis txawm tias venous lossis leeg nqaij txawv txav. Cov thawv ntim khoom txawv txav, piv txwv li qhov tuab aponeurosis tom qab fibrosis lossis raug mob, kuj tuaj yeem koom nrog.

Hauv cov kab mob sib kis mob ntev, kev siv zog ncaj qha ua rau muaj kev nce siab hauv cov leeg nqaij, thim rov qab hauv lub sijhawm hloov pauv tom qab nres. Lub calf yog qhov chaw nquag tshaj plaws. Kev tawm tsam yog ob sab hauv 50 txog 80% ntawm cov neeg mob.

Daim ntawv mob hnyav yog txuas mus rau qhov nce sai sai tom qab kev raug mob thiab / lossis ntau dhau los ntawm cov ntaub qhwv los yog lub cam khwb cia, ua rau engorgement ntawm cov leeg. Peb hais txog Volkmann syndrome thaum nws cuam tshuam rau lub puab tsaig. Lub ntsiab compression yuav tsum tau muab tshem tawm sai li sai tau.

diagnostic

Hauv cov kab mob sib kis mob ntev, qhov mob tshwm sim tshwm sim thaum lub sij hawm siv zog nkaus xwb, hais txog qhov kev txhawj xeeb thiab ib txwm zoo ib yam (tib hom kev siv zog, tib lub sijhawm qeeb).

Kev ntsuam xyuas lub cev yog ib txwm nyob ntawm so, tab sis cov chav tsev yog nruj thiab mob tom qab kuaj kev ntxhov siab (xws li ntawm lub treadmill) thiab cov leeg nqaij tawv tawv.

Kev ntsuas ntawm intramuscular siab

Kev ntsuas ntawm lub siab intramuscular siv ib lub cuab yeej suav nrog ib rab koob implanted nyob rau hauv lub compartment ua rau nws muaj peev xwm kom paub meej tias qhov kev kuaj mob. Cov txheej txheem classic muaj peb qhov kev ntsuas: thaum so, 1 feeb tom qab kev tawm dag zog thiab 5 feeb tom qab kev tawm dag zog. Cov txiaj ntsig zoo li qub yog nyob ntawm qhov kev txiav txim ntawm 15 mm Hg. Kev kub siab saum toj no tus nqi ntau dua 6 feeb tom qab kev tawm dag zog, lossis qhov tseem ceeb tshaj 30 lossis 50 hli mercury tsuas yog tom qab kev tawm dag zog yog suav tias yog pathological.

Cov kev ntsuam xyuas sib txawv yuav tsim nyog los txiav txim rau lwm yam kev kuaj mob:

• ntshav kuaj,
• MRI,
• x-ray,
• Doppler ncha,
• scintigraphy,
• electromyogram (EMG) ntsuas kev ua haujlwm neuromuscular.

Thaum cov tsos mob tshwm sim txaus los kuaj pom tus mob ua rau mob plab, kev ntsuas siab tsis tsim nyog thiab yuav tsum tsis txhob ncua kev phais.

Leej twg txhawj?

Cuaj zaug ntawm kaum tus neeg muaj mob chronic compartment syndrome. Qhov no feem ntau yog cov tub ntxhais hluas ncaws pob ntawm hnub nyoog ntawm 20 thiab 30. Qhov kev siv zog ntawm kev xyaum feem ntau yog nyob rau hauv keeb kwm ntawm nws tshwm sim.

Cov neeg ua haujlwm hauv phau ntawv lossis cov kws ntaus suab paj nruag tuaj yeem raug kev txom nyem los ntawm kev sib koom ua ke ntawm cov ceg tawv.

Risk yam tseem ceeb

Qee qhov kev ua kis las tso ntau dhau thiab rov ua rau tib cov leeg nqaij thiab txhawb kev loj hlob ntawm cov kab mob hauv lub cev.

Box syndromes nyob rau hauv calf feem ntau txhawj xeeb txog kev ncua deb thiab nruab nrab-ntev khiav los yog koom nrog pab pawg kis las cuam tshuam nrog kev khiav xws li kev ncaws pob. Kev caij ski hla teb chaws, taug kev nrawm, cov menyuam skating lossis ua luam dej nrog cov fins kuj tseem muaj kev pheej hmoo kis las.

Cov tsos mob ntawm cov kab mob ntawm cov ceg tawv tuaj yeem cuam tshuam nrog kev xyaum ntawm motocross, windsurfing, dej skiing, nce toj ...

Chronic compartment syndrome

Mob yog tus yam ntxwv tseem ceeb. Nrog rau qhov kev xav ntawm qhov nro, nws yuam koj kom tsis txhob siv zog. Nws yog qhov sib txawv ntawm qhov sib txawv thiab tuaj yeem ua piv txwv ua rau ib qho yooj yim limp lossis ntawm qhov tsis sib xws yuav ua phem heev.

Kev hnov ​​​​lus txawv txav ntawm tingling, loog loog lossis tingling (paresthesias), nrog rau kev tuag tes tuag taw ntawm qhov cuam tshuam tuaj yeem cuam tshuam.

Qhov mob ua rau ntau dua los yog tsawg dua thaum so, tab sis qhov mob yuav nyob ntev li ob peb hnub.

Tsis kho, compartment syndrome yuav ua rau qeeb qeeb, nrog qhov mob tshwm sim nrog kev siv zog tsawg thiab tsis tshua muaj zog, thiab muaj kev pheej hmoo ntawm kev tsim ib daim ntawv mob uas mob tshwm sim tom qab siv zog.

Mob plab hnyuv syndrome

Qhov mob hnyav heev lossis txawm tias mob tsis taus yog mob pob qij txha lossis nro. Nws tsis muaj kev ntxhov siab los ntawm kev hloov ntawm txoj hauj lwm thiab ua pov thawj resistant rau analgesics. Lub thawv yog ncab ntawm palpation.

Ib qho tsis txaus ntawm rhiab heev ntawm cov hlab ntsha innervating lub puas compartment tshwm sai sai. Paresthesia nce mus rau qhov poob ntawm rhiab heev tom qab tshuaj loog.

Yog tias kev kho mob qeeb, qhov tsis muaj dej tsis txaus (ischemia) ua rau ploj ntawm cov pulses peripheral thiab lub cev muaj zog ua rau muaj kev puas tsuaj rau cov leeg thiab cov hlab ntsha.

Kev hloov kho ntawm kev xyaum ua kis las thiab kev kho mob tuaj yeem kov yeej tus mob chronic compartment syndrome. Kev kho phais tuaj yeem tham txog hauv cov neeg ncaws pob uas muaj kev tsis xis nyob, paub tias kev txwv kev ua kis las yog lwm txoj hauv kev. Kev phais yuav tshwm sim thaum tsis muaj kev kho mob tom qab 2 mus rau 6 lub hlis. Nws yuav tsum tau xyaum sai sai nyob rau hauv lub ntsej muag ntawm mob compartment syndrome.

Kev tiv thaiv kev ua kis las thiab kev kho kom rov zoo

Nws suav nrog kev txo qis kev siv zog los yog hloov kev ua ub no, hloov kho hom kev cob qhia (stretching, warm-ups), hloov kho cov cuab yeej lossis kev taw qhia, thiab lwm yam.

Kho mob

Cov tshuaj Venotonic los yog hnav cov thom khwm compression yog qee zaum qhia.

Physiotherapy muaj txiaj ntsig zoo hauv qee kis. Nws yog tsuas yog raws li stretching ce (rau forearm) thiab ntawm ntau hom massages.

Kev phais mob

Nws aims kom tau decompression los ntawm qhib lub compartments muaj kev txhawj xeeb (aponeurotomy). Cov kev cuam tshuam classic yuav tsum muaj qhov loj ntawm daim tawv nqaij incisions, micro-invasive arthroscopic phais tsim ib qho kev xaiv.

Cov teeb meem (bruises, paj hlwb puas, kho tsis xws luag, kab mob, thiab lwm yam) yog tsawg. Hauv feem ntau ntawm cov xwm txheej, kev phais tas li tshem tawm qhov mob. Tom qab kev kho mob (physiotherapy, taug kev, thiab lwm yam), feem ntau tuaj yeem rov pib ua kis las tom qab 2 txog 6 lub hlis.

Ntawm qhov tod tes, qhov kev ncua sij hawm ntawm kev tswj cov kab mob sib kis mob hnyav yog nrog los ntawm kev pheej hmoo loj ntawm kev teeb tsa ntawm cov kab mob tsis tuaj yeem (cov leeg nqaij necrosis, fibrosis, paj hlwb puas tsuaj, thiab lwm yam), nrog rau ntau dua lossis tsawg dua qhov tshwm sim: cov leeg thim rov qab, kev xav thiab motor disorders…

Tsim nyog ua kom sov so, ncab kev tawm dag zog nrog rau kev xyaum ua kis las yoog raws li ib tus neeg lub peev xwm, nrog rau qhov kev siv zog maj mam nce ntxiv thiab lub sijhawm ntawm kev siv zog, tuaj yeem pab tiv thaiv kev sib koom ua ke.

Thaum lub cam khwb cia los yog ntaub qhwv nruj heev, tsis txhob yig tshaj qhia rau tus kws kho mob.