ciwon hip

Ƙungiyar hip, babban haɗin gwiwa a cikin jikin mutum, yana fuskantar damuwa na yau da kullum sakamakon aikin jiki, yana tallafawa nauyin jiki. Mutane da yawa suna tunanin cewa haɗin gwiwa yana ciwo ne kawai a lokacin tsufa. Tabbas, yayin da muke tsufa, guringuntsin da ke yin aikin motsa jiki lokacin da haɗin gwiwa ya zama mai laushi, kuma adadin ruwan da ke cikin haɗin gwiwa yana raguwa, yana haifar da bayyanar zafi. Duk da haka, ba kawai shekaru ba, har ma da yawan cututtuka suna taimakawa wajen faruwar ciwo na tsanani daban-daban daga m zuwa rashin iya jurewa. Jin zafi a cikin haɗin gwiwa na hip yana iya zama maras nauyi, kaifi, latsawa, ko jin zafi a yanayi. Yawancin lokaci ya dogara da kaya, lokacin rana da sauran dalilai. Abubuwan da ke haifar da ciwo suna ƙayyade ta amfani da rediyo, CT, MRI, duban dan tayi, arthroscopy, da sauran nazarin. Har sai an gano ganewar asali, ana ba da shawarar magungunan kashe zafi da sauran ƙananan ƙafafu.

Abubuwan da ke haifar da ciwo a cikin haɗin gwiwa na hip

Rauni mai laushi

Mafi yawan abin da ke haifar da ciwo mai tsanani shine rauni na haɗin gwiwa na hip, sakamakon faduwa a gefe ko daga kai tsaye, motsi yana da iyakancewa. Yiwuwar kumburi.

Ciwon ciwo a hankali yana dushewa kuma ya ɓace bayan mako guda. Lalacewa ga ligaments a cikin haɗin gwiwa na hip yawanci yana faruwa ne a sakamakon hatsarori na hanya da raunin wasanni, tare da ciwo mai zafi mai zafi tare da ƙwannafi. Ciwo saboda kumburi sau da yawa yana ƙaruwa kuma, yana motsawa zuwa makwancin gwaiwa da cinya.

Idan akwai raunin ligament, ayyukan motsa jiki suna fama da matsananciyar ƙayyadaddun motsi na ƙananan ƙafar ƙafa don rashin iya tsayawa a kan ƙafafu kuma ya dogara da raunin raunin da ya faru kamar: sprain, hawaye, rupture. Ciwo yana ƙaruwa lokacin da aka karkatar da jiki a hanyar da ta saba da ligament mai lalacewa.

Raunin kashi da haɗin gwiwa

Ƙunƙarar wuyan mata yakan faru a cikin tsofaffi saboda rauni. Siffar sifa ta osteoporosis ita ce kasancewar ƙananan kumburi idan babu ciwo mai tsanani a hutawa. Hanyoyi masu raɗaɗi suna ƙaruwa sosai tare da motsi. Alamar dunƙule diddige alama ce ta al'ada wacce ba ta yiwuwa a ɗaga madaidaiciyar kafa yayin kwance.

Saboda raunin kuzari mai ƙarfi, matasa da masu matsakaicin shekaru sukan haifar da ɓarna na pertrochanteric, waɗanda ke tare da kaifi da zafi mai zurfi. Motsi yana iyakance, ba zai yiwu a tsaya a kan ƙananan gaɓoɓin ba saboda tsananin kumburin haɗin gwiwa da ya shafa.

Warewa karaya daga cikin mafi girma trochanter da wuya a samu a cikin yara da matasa saboda faɗuwa, kai tsaye bugu, kaifi na tsoka ƙanƙara da kuma suna tare da m, tsanani zafi, wanda aka gano a waje da haɗin gwiwa. A wannan batun, marasa lafiya suna guje wa motsi masu aiki.

Abin da ya faru na raguwa na hip tare da ciwo mai tsanani wanda ba zai iya jurewa ba ya riga ya fadi daga tsawo, masana'antu da raunin hanyoyi.

Ana iya lanƙwasa ƙafar ko kuma a tsawaita sakamakon nakasar haɗin gwiwa. Lokacin ƙoƙarin tsayawa akan ƙafafunku ko yin motsi, motsi na bazara yana bayyana, a kan bangon zafi mai tsanani, wanda baya raguwa har sai an rage haɗin gwiwa. Karyawar acetabular suna haɓaka da kansa ko kuma ana iya haifar da su ta hanyar ɓarnawar hip. Ana nuna su da matsanancin ciwo mai fashewa mai zurfi a cikin haɗin gwiwa na hip, wanda ke sa duk wani motsi mai wahala. Ana iya rage ƙafar ƙafa kuma a juya waje, don haka goyon baya akan shi ba zai yiwu ba.

Hanyoyin lalacewa

A mataki na farko na coxarthrosis, bayan gagarumin aiki ko kuma a ƙarshen rana, marasa lafiya sun fara raguwa saboda bayyanar lokaci-lokaci, ciwo mai raɗaɗi wanda ke haskakawa ga haɗin gwiwa ko gwiwa tare da ƙananan motsi. Bugu da ƙari, ana lura da zafi ba kawai a lokacin motsi ba, amma har ma a hutawa.

Tare da coxarthrosis mai tsanani, marasa lafiya sun dogara da sanda. Motsa jiki yana iyakance, ƙafar ƙafar da aka shafa ta rage, wannan yana haifar da ƙarar kaya akan haɗin gwiwa. Jin zafi yana ƙaruwa ba kawai lokacin tafiya ba, har ma lokacin da yake tsaye. Chondromatosis na hip hadin gwiwa yana faruwa kamar subacute arthritis. Matsakaici, ciwo na wucin gadi yana tare da crunching da iyakataccen motsi. Lokacin da ƙarshen jijiyoyi a cikin haɗin gwiwa ke tsunkule, zafi mai zafi yana faruwa, yana iyakance motsi. Tare da arthrosis na hip hadin gwiwa, trochanteritis yawanci yakan haifar, tare da kumburi da degenerative lalacewa ga tendons na gluteal tsokoki a cikin yankin da aka makala zuwa mafi girma trochanter. Ciwon ciwo yana bayyana lokacin da yake kwance a gefen raɗaɗi, zafi yana ƙaruwa lokacin ƙoƙarin motsa hip zuwa gefe.

Matsalolin abinci mai gina jiki

A cikin yara da matasa, rashin jin daɗi, ciwo mai zurfi a cikin gwiwa da hip yana tasowa a baya na cutar Perthes, wanda ke da alamun necrosis na shugaban femoral. Ciwon yana ƙaruwa bayan ƴan watanni, ya zama akai-akai, mai tsanani, da rashin ƙarfi. Akwai kumburin haɗin gwiwa, iyakancewar motsi, da gurguwa. Daga bisani, ciwon ciwo yana raguwa kuma ana mayar da ayyukan motar ta hanyoyi daban-daban.

Aseptic necrosis na femoral shugaban a cikin manya yana faruwa ne saboda rikice-rikice na jini da kuma ci gaba kamar cutar Perthes, amma ƙasa da kyau, tunda a cikin rabin lokuta yana da alaƙa.

Da farko dai ciwon da ake fama da shi yana faruwa lokaci-lokaci, sannan yana ƙaruwa, ta yadda mutum ya rasa ikon tsayawa kan ƙafarsa gabaɗaya saboda lalata haɗin gwiwa saboda rashin isasshen jini. A hankali ciwon zafi yana raguwa. Ƙuntatawa na ci gaba na motsi sama da shekaru biyu ya zama sakamakon arthrosis na haɗin gwiwa na hip da kuma rage ƙananan ƙafafu.

A cikin proximal metaphysis na femur a cikin yara maza masu shekaru 10-15, ƙwayoyin kasusuwa guda ɗaya suna samuwa, tare da lokaci-lokaci, zafi mai laushi a cikin haɗin gwiwa na hip. A cikin yara ƙanana babu kumburi. Saboda alamun bayyanar da ba a bayyana ba, dalilin ziyartar likita shine karaya na pathological ko ƙara iyakancewar motsi.

Ciwon hip yana iya haifar da necrosis na avascular necrosis na kan femoral. Cutar tana faruwa ne saboda cututtukan jini a cikin haɗin gwiwa da ke da alaƙa da yin amfani da hormones na glucocorticoid na dogon lokaci (an wajabta su don cutar asma, rheumatoid amosanin gabbai da wasu cututtukan da yawa), dogaro da barasa, da ciwon sukari mai tsanani. Necrosis na haɗin gwiwa na iya gaba da rauni, amma a wasu lokuta ba za a iya tantance ainihin dalilin ba. Jin zafi a cikin wannan yanayin yana da tsanani kuma yana faruwa lokacin tafiya da kuma lokacin ƙoƙarin tsayawa a kan ƙafar da aka shafa.

Arthritis

Raɗaɗi-kamar zafi daga m zuwa mai tsanani da kuma dindindin, iyakance ayyukan motsa jiki a cikin haɗin gwiwa na hip da safe shine alamar cututtuka na aseptic. Alamomi irin su taurin kai, kumburi, jajaye, yawan zafin jiki, da zafi lokacin da aka danna ana lura dasu.

Ciwo na lokaci-lokaci a cikin rheumatoid amosanin gabbai yana bayyana saboda canje-canjen yanayin yanayi saboda canjin yanayi, sakamakon canjin hormonal bayan haihuwa ko lokacin menopause. Jin zafi na iya zama matsakaici da rauni, tashin hankali da jin zafi, yana ƙaruwa sosai tare da palpation, wanda ke tare da synovitis, edema, hyperemia, hyperthermia, da iyakacin motsi.

Tsanani, jujjuyawa, ciwo mai raɗaɗi, duka a lokacin hutawa da lokacin motsi, yana tasowa ne sakamakon yaduwar kamuwa da cuta a kan tushen cututtukan cututtukan fata. Saboda haka, sashin jiki yana ɗaukar matsayi na tilastawa. Cutar tana tare da zazzabi, sanyi, gumi, rauni mai tsanani, kumburi, jajayen haɗin gwiwa, da yawan zafin jiki. Idan ba a kula da shi ba, cututtukan arthritis na kwayan cuta na iya haɓaka zuwa panarthritis - matsanancin kumburin ƙumburi na haɗin gwiwa tare da matsanancin zafi mai zafi, zazzabi mai zafi, rauni, suma, hyperemia da hyperthermia.

Sauran cututtuka masu kumburi

A kan bangon buɗaɗɗen karaya, raunin da ya faru bayan tiyata, saboda bayyanar kumburi, jin zafi a cikin haɗin gwiwa tare da osteomyelitis yana ƙaruwa tsawon makonni 1-2 tare da alamun kumburi. Synovitis, tendinitis, da bursitis suna tasowa tare da raunuka da sauran cututtuka na haɗin gwiwa na hip, kuma sau da yawa yakan zama bayyanar cututtuka. A cikin synovitis mai tsanani, haɗin gwiwa yana jin zafi kadan, amma zafi zai iya tsananta saboda karuwar kumburi da ruwa a ciki. Na kullum synovitis yana tare da raɗaɗi mai raɗaɗi. Tare da hydroarthrosis na lokaci-lokaci, haɗin gwiwar hip yana jin zafi kadan, tare da iyakacin motsi, wanda ya ɓace a cikin kwanaki 3-5 kuma ya sake dawowa bayan wani lokaci na lokaci, saboda tarin ruwa a cikin haɗin gwiwa.

Musamman cututtuka

Tare da tarin fuka na haɗin gwiwa na hip, rauni da gajiya sun fara faruwa, sa'an nan kuma rauni mai rauni ko ciwon tsoka yana bayyana a cikin haɗin gwiwa lokacin tafiya. Mai haƙuri ya fara keɓe gaɓar. Yayin da yake ci gaba, zafi yana haskakawa zuwa gwiwa tare da kumburi, ja, da synovitis. Ja, karkatar da zafi tare da zazzabi, lymphadenopathy, da rashes na fata na iya bayyana tare da brucellosis mai tsanani. A cikin yanayin rashin lafiya na yau da kullum, nakasa yana tasowa a tsawon lokaci.

Cututtukan da aka haifa

Dysplasia na hip yana ƙaddara ta matakin rashin daidaituwa tsakanin shugaban mata da acetabulum. Tare da ɓarna na haihuwa, jin zafi yana bayyana daga lokacin da yaron ya fara tafiya, tare da gurgu. Tare da matsakaicin subluxation, ciwon da ke faruwa a cikin shekaru 5-6 yana hade da nauyin da ke kan kafa. Tare da subluxation, pathology yana faruwa ba tare da bayyanar cututtuka na dogon lokaci ba, tare da ci gaban coxarthrosis na dysplastic a cikin shekaru 25-30, zafi yana faruwa a hutawa, wanda ke ƙaruwa da motsi. Duk nau'ikan dysplasia suna tare da asymmetry na folds fata da iyakataccen motsi. Idan akwai raguwa, an lura da raguwar kafa.

Neoplasms

Alamun ciwo na farko na ciwace-ciwacen da ba su da kyau ba su da ƙananan kuma marasa ƙarfi, waɗanda ba sa ci gaba na dogon lokaci. Ci gaban ƙwayar cuta yana haifar da ciwo a cikin yankin hip don karuwa a hankali. M ciwace-ciwacen daji (osteogenic sarcomas, chondrosarcomas) suna halin ƙanana, jin zafi na ɗan gajeren lokaci, wanda wani lokaci ya tsananta da dare. Bayan haka, bayyanar cututtuka sun zama m, akai-akai, yankan, kewayawa, yadawa zuwa ga dukan haɗin gwiwa, wanda ya kumbura da lalacewa. Marasa lafiya suna fuskantar asarar nauyi, rauni da ƙananan zazzabi. A cikin lokuta masu ci gaba, zafi ya zama mai banƙyama kuma ba zai iya jurewa ba har za a iya kawar da shi kawai tare da taimakon magungunan narcotic.

Wasu dalilai

Ciwo a cikin haɗin gwiwa wani lokaci yana bayyana a cikin ƙananan baya, a baya saboda neuropathy na jijiyar sciatic, amma yana raguwa a baya idan aka kwatanta da ciwo mai tsanani a baya na gindi da cinya, rauni a cikin ƙananan ƙafar ƙafa tare da damuwa na hankali. . Ƙunƙara da zafi mai zafi yana faruwa tare da osteochondrosis, disc herniation, spondylitis, deforming spondyloarthrosis da curvature na kashin baya saboda wuce gona da iri na gidajen abinci, ci gaban coxarthrosis, da rashin lafiya na tunani.

Bincike

Don ganewar asali na farko, likita na gaba ɗaya yana ciki. Ana aiwatar da matakan bincike don raunin da ya faru ta hanyar traumatologists na asibitin. Don cututtukan cututtuka na degenerative da kumburi - likitocin orthopedists da rheumatologists. Don magance hanyoyin purulent, halartar likitocin tiyata ya zama dole. Jarabawar ta ƙunshi tattara gunaguni, nazarin anamnesis, gwajin jiki, da ƙarin hanyoyin bincike na kayan aiki. Yin la'akari da halaye na tsarin pathological, ana amfani da hanyoyi masu zuwa:

• X-ray na kashin baya na sacrolumbar, haɗin gwiwa na hip da femur shine babban hanyar don yawancin cututtuka, ciki har da gano fractures, dislocations, canje-canje a cikin ma'auni na acetabulum da shugaban femoral, ƙananan lahani da intraosseous, haɓakar kasusuwa, da ƙunshewar ƙwayar cuta. sararin haɗin gwiwa.
• Binciken duban dan tayi (ultrasound) shine mafi kyawun fasaha don gano wuraren ƙididdiga, masu kumburi da ƙananan ƙwayoyin cuta a cikin kyallen takarda.
• Magnetic resonance da lissafta tomography (MRI da CT) su ne hanyoyin bayyana hanyoyin da za a iya yi tare da wani bambanci wakili don bayyana yanayi, girman da wuri na pathological mayar da hankali.
• Huda haɗin gwiwa hanya ce ta warkewa da bincike don kawar da zub da jini, nazarin abubuwan da ke cikin ruwan da ke cikin haɗin gwiwa, da tantance kamuwa da cuta ta amfani da gwaje-gwajen dakin gwaje-gwaje.
• Arthroscopy hanya ce ta duban gani don tantance yanayin sifofin kashi da nama mai laushi, idan ya cancanta, ɗaukar samfurin biopsy don nazarin tarihi.
• Laboratory na asibiti gwaje-gwajen jini domin sanin kumburi da alamomi na rheumatological cututtuka domin tantance general yanayin jiki, da aiki na gabobin a cikin cututtuka ko tsarin pathologies.

A nan gaba, ƙarin ƙwararrun ƙwararrun ƙwararrun na iya shiga cikin bincike: likitocin physiotherapy da tiyata, neurologists.

Magani mai rikitarwa

Taimako kafin ganewar asali

Idan akwai mummunan rauni daban-daban na rauni, ya zama dole don gyara haɗin gwiwa ta hanyar yin amfani da tsage daga ƙafa zuwa hamma. Idan akwai ƙananan raunuka, ya isa ya huta kafa ta hanyar amfani da sanyi. Idan ciwon ya yi tsanani, ana ba da maganin analgesic. An haramta sosai don kawar da ɓarna da kanku ta hanyar yin ayyuka masu aiki da ƙafar ƙafa. Ya kamata a kula da ƙananan bayyanar cututtuka marasa ciwo tare da yin amfani da magungunan kashe zafi da magungunan ƙwayoyin cuta, tabbatar da sauran ƙananan ƙafa. Idan kun fuskanci zazzaɓi, rauni, ciwo mai tsanani, saurin karuwa a cikin kumburi da hyperemia, ana bada shawara don neman taimakon likita nan da nan.

Maganin Conservative

Ya kamata a rage raguwa mai tsanani nan da nan. Don karyewar ƙafa, ana amfani da ƙwanƙwasa ƙwanƙwasa, sannan a yi wa marasa lafiya tiyata ko sanya su a cikin filasta bayan bayyanar callus. A cikin tsofaffi marasa lafiya tare da raunin wuyan mata na mata, an ba da izinin yin motsi tare da takalma mai lalacewa don hana motsin juyawa a cikin haɗin gwiwa. Ga sauran marasa lafiya, ana ba da shawarar sauke haɗin gwiwar hip ɗin ta amfani da orthoses ko ƙarin na'urori irin su crutches ko sanda. An tsara hanyoyin physiotherapeutic, ciki har da tausa, motsa jiki na warkewa, maganin hannu, da kuma hanyoyin kamar:

• Laser far;
• maganadisu far;
• UHF;
• duban dan tayi;
• reflexology;
• electrophoresis tare da kwayoyi;
• UVT

Don rage jin zafi, maganin miyagun ƙwayoyi yana yiwuwa ta amfani da kwayoyi irin su magungunan anti-inflammatory marasa steroidal (NSAIDs), abubuwa masu cutarwa. Don ƙarfafa ƙwayar guringuntsi na ƙashin ƙugu, an wajabta chondroprotectors, kuma an wajabta masu shakatawa na tsoka don kawar da spasms na tsoka. Ana amfani da wakilai na gida sosai - man shafawa, creams tare da analgesic da anti-mai kumburi sakamako.

Bisa ga alamun likitoci, ana yin huda haɗin gwiwa, toshewar ciki da na periarticular tare da magungunan hormonal, alluran intra-articular na chondroprotectors, da maye gurbin ruwan synovial.

Tiyata

Ana yin aikin tiyata a kan haɗin gwiwa na hip biyu ta hanyar budewa da kuma tare da taimakon kayan aikin arthroscopic. Ana gudanar da ayyuka la'akari da nau'in pathology:

• Raunin raunin da ya faru: sake ginawa na acetabulum, osteosynthesis na wuyansa, trochanteric fractures.
• Hanyoyin lalacewa: arthrotomy, arthroscopy, kawar da sassan jikin intra-articular mara kyau.
• Tumors: cirewa, gyaran kashi, disarticulation na haɗin gwiwa na hip.
• Don ankylosis da tabo na periarticular kyallen takarda, ana yin gyaran fuska, arthroplasty, da arthrodesis. Endoprosthetics wata hanya ce mai tasiri don mayar da aikin motsa jiki na ƙananan ƙafar ƙafa saboda lalata haɗin gwiwa.

Rigakafi

A sedentary salon barnatar da musculoskeletal tsarin kowane mutum da aggravates ci gaban rashin jin daɗi a cikin hip hadin gwiwa, sabili da haka, don manufar m matakan, an bada shawarar yin musamman jiki motsa jiki da kuma sarrafa nauyi jiki ta hanyar rage cin abinci, tun normalizing nauyi. da farko, yana taimakawa rage damuwa akan haɗin gwiwa na hip. Wani hadadden tsarin jiyya na jiki (jiki na jiki) da shirin gyaran gyare-gyare zai taimaka kawo haɗin gwiwa zuwa yanayin al'ada; suna da nufin haɓaka ingancin rayuwa da inganta lafiyar maza da mata.