Pain pasi pezvakarurama scapula: zvakasikwa, zvinokonzera, kuongororwa

Pain pasi pezvakarurama scapula inonyanya kunetseka mukurapa kwechiremba. Inogona kunge isina kukuvadza zvachose (kutarisa musimba), uye inogona kuratidza hutachiona hunotyisa hwehupenyu uye hutano (sarcoma yemapfupa), saka marwadzo ose ari pasi pekodzero yakakodzera anofanirwa kunyatsotarisirwa uye inoda kurapwa kwakakodzera.

Zvakakodzera scapula: chimiro cheatomical

Iko-scapula chikamu chedu, rakanamirwa pasi nechepamusoro-soro rakatenderedzwa kubva kumucheto wakadzika we scapula, ine mutsara wakafanana unofananidzwa nehuwandu hwemuganhu wepakati memapapu; kumusoro - mutsetse unomhanya pakati pezvinyorwa zvechinomwe chevervic vertebra uye mutsara wepinini-acromial, kunze - kumucheto kwemashure emusana we deltoid uye mutsara wepadillary wepakati. Pakati penzvimbo ye scapular inonzi sopapula - gorofa rakapetwa katatu rakatarisana nemhepo yakasimudza yemukati pakati pemakwenzi manomwe neechipiri. Kune maitiro akasiyana e-scapula: yunifomu, yakareba, yakamanikana, yakfupi, yakareba. Muropa rinopa nzvimbo ye scapular, matavi e-subclavia arteri, akabatanidzwa nematavi e-axillary aorta, anobatanidzwa. Kubuda kweropa kunoitwa mumaketani ezita rimwe chete, mapazi e brachial plexus anopa mitsipa kune nzvimbo inopisa.

Mhando dzekutambudzika pasi pezvakarurama scapula:

• nzvimbo (somatic) kurwadziwa. Nguva dzose anonzwa munharaunda inobatwa nemuviri kana pedyo nayo, inobatanidza nehutano hunobata marwadzo emapfupa, mafundo, magirasi, maitiro, misumbu. Mamiro: kuvhiringidzika kunokanganisa musimba. Kazhinji kacho kazhinji kacho kava nemafuta. Inogona kuva yakaoma, inopera, yakaoma. "Anosiya" kana achigadzirisa mhuka yakakanganisika / nhengo, inopindura zvakakwana kurapwa neanalgesics;
• Kuratidza kurwadziwa. Inopararira mukati memiganhu yedermatome (zvikamu zveganda), izvo zvinopindirana nekusachengetedzwa kwezvinetso zvemukati mukati kana zvivako zvegungwa. Inokonzerwa nechirwere chepancreas, chikafu chekudya, mafungiro, mwoyo. Inogona kuva yakadzika, kuputa, kuora, kusanganiswa nekuregererwa kwekutama uye paresthenia (kushungurudza chirwere);

• radiating pain. Inoitika mushure mezvipembenene zvehutano / midzi, inoratidzwa nepamusoro-soro, kurega kubuda kubva kune imwe yenheyo inomirirana. Icho chinonzi neurogenic mumasikirwo - iyo inobatanidza nehutachiona hwehutano hwemitsipa. Icho chiri pamwe chete nevirongwa / motokari kukanganiswa, kuderera kweropa rekuyerera, kunodzivirira kune analgesics;
• kunetseka kunorwadza. Inobva mukushandura muhutano hwehutano hwepakati penheyo system masayiti anotarisa marwadzo. Kunyora zvinhu zvezvinoitika: mupfungwa, zvepabonde, mupfungwa.

Marwadzo ari pasi pechirwere chakarurama - chii chingave?

Pain mushure pasi pechiratidzo chakarurama chiratidzo chisingatauriki chezvirwere gumi. Inopararira uye inharaunda, kudzvora, kukanganisa, kuomesa, kwakanyanya uye kusingaperi. Inogona kuratidza zvirwere zvemaitiro / nhengo mukati memharaunda (ganda, musimba, nharo, thoracic musana, intercostal nerve, right lung / pleura) uye kusakanganiswa mukati memukati (chiropa, mukati, hono dzakanaka, gallbladder).

1. Pain pasi pekodzero yekudzivirira-pathology ye scapula yehutachiona, hutachiona, hunotyisa:

   • developmental anomalies. Congenital aplasia (underdevelopment / absence) yekodha yakarurama isingawanzoitiki, inowanzogadziriswa pamwe chete nedzimwe maitiro akasiyana-siyana emushuloskeletal system: pterygoid scapula uye yakakwirira simbi. Iyo congenital pterygoid scapula inofanira kusiyaniswa neipi yakawanikwa pterygoid scapula, inokonzerwa nekukuvara, myopathy, kuora mutezo;
   • kukanganisa / kuputsika kwezvakanyorwa zvakanaka. Kusiyana kwechirwere chekodha chinopfurikidza nezviratidzo zvakanyoroveswa, pasi pesimba kana kuwedzerwa kwakasimba kwesimba, shanduko inotendeuka, ichidonera kune kunze, iyo inokonzera kuputika kwemisungo inonamatira kumuganhu wepakati wekwakanaka kwechikofu uye musana. Kufambisa mubatanidzwa wepafudzi kwakanyanya kuderera nekuda kwekutambudzika kune rumwe rutivi rwemashure. Muna 45-50% yezviitiko, kukuvadzwa kwekwakagadzika kwakarurama kunosangana nekushungurudzika kumitsipa nemidziyo;

   • exostosis. Zvinoratidzika sechimiro chechimiro chechimiro chekutenderera kwemafudzi akabatana, manzwiro ekurwadza, marwadzo akaenzana pasi pe scapula;
   • osteomyelitis scapula. Iyo inokura mushure mekukuvadzwa kwakasununguka kumusana webudyi (pfuti ronda), pamwe chete nezviratidzo zvekumwa doro, kuonekwa kwemukati (kusina simba basa re scapula, kurwadziwa kuri kurudyi). Kushandura chirongwa che purulent kusvika kune chikamu chinotaridzika chinopinza chinotungamirira kumadziro eudema yakadzika uye kuwedzera kurwadziwa;
   • matumbo e-scapula yakarurama. Malignant (reticulosarcoma, chondrosarcoma) uye benign (chondroma, osteoma, osteoblastoklastoma, osteochondroma) inokuvadza, inokonzera marwadzo asingagumi pasi pechiratidzo chakarurama.

2. Pain pasi pezvakakodzera - zvirwere zvezvikamu zvemukati:

   • chronic pyelonephritis. Muchikamu chechipiri chechirwere, kushanduka mumagunwe eimpvo kunopisa, zvichiita kuti kuonekwa kwepanguva dzinokonzera marwadzo anopa kumusoro wepamusoro kana kuderedza shure. Muchikamu chekakarurama, marwadzo anomhanya pasi pechiratidzo chekodzero. Kushandura kwezviratidzo: kushungurudza, kufungidzira kwekushisa, kurwadza kunorwadza. Kunetseka kwakanyanya kunogona kuratidza kuvapo kwe purulent kupinda mukati meinso;
   • chronic cholecystitis. Inoratidzika kuburikidza nekurwadziwa kunorwadza nekunzvimbo yepamunharaunda munharaunda ye right scapula kubva kumashure, ichipa mu epigastrium. Kurwiswa kunoitika paroxysmally, pasina kukonzera kusakosha kunokosha. Inosanganiswa nekukona kweganda, kurutsira, kushungurudza, kufara kwemamiriro;

   • Dyskinesia of bile ducts. DZHVP hypotonic iyo inoratidzika nekukurumidza kukura kwekutambudzika mukanani hypochondrium, iyo inoratidzwa pasi pe scapula uye nebandauko rorudyi, inosimbiswa panguva yekufamba, kufemerwa kwakadzika. Dambudziko guru rekusava nemarwadzo kunotarisa pasi pechipula chakarurama ne dyskinesia ingozi yakakura yekugadzira chilelithiasis, chilecystitis, gastroduodenitis;
   • hepatic colic. Zvinokonzera kupwanya kwakanyanya kupisa, kupenya kumusana webandauko rworudyi, bhetani rorudyi nemutsipa. Kana iyo colic inopedza maawa 4-5, manzwiro anorwadza akapararira kumativi ose emimba, pamwe chete nekurutsira nekunyunyuta;

   • cholelithiasis. Kukundikana kweguruva kushanda kunoratidzwa nemarwadzo akadzika pasi pechiratidzo chakarurama, chinoratidzwa mumutsipa, musha, mafudzi, kazhinji-mukati memwoyo nzvimbo (cholecystocoronary syndrome);
   • pancreatitis. Muchikamu chakaoma, chirwere chacho chinosanganiswa nemapuranga akapararira pamwe chete pasi pemapapula maviri. Kuvhiringidza musoro wepascora kunokonzera marwadzo, kuiswa pasi pechiratidzo chakarurama uye kunzwa se "kamuri". Kazhinji, kurwadziwa kunogara kwenguva refu, hakusviki panguva yekuchinja kwomuviri wemuviri, hazviwanisi kuwedzera nekukanganiswa, kushushikana, kuchenesa;

   • chirwere chechiropa. Chimiro chechirwere chechirwere chekushongedza (kutumbuka kwekushisa, jaundice, pruritus, ascites) pa "kutanga" kwechirrhosis kunowedzererwa nekurwadziwa pasi pechirwere chakarurama uye kuwedzera kwechiropa;
   • kurudyi-rutivi rwepineumonia. Muna 20-25% yematambudziko inenge isina simba pamutambo wekutanga, zvichiratidza pachake chete nemarwadzo ekupisa periodic pasi pechiratidzo chakarurama. Chii chatinofanira kuchenjerera: kufema nokukurumidza, kupfugama kwakanyanyisa usiku, kusava nemhinduro kune antipyretic zvinodhaka, kutonhora kunopfuura madigiri 38 kwemazuva matatu;

   • subdiaphragmatic abscess. Chikonzero chekuumbwa kwe purulent mukati mechiri pakati pemakumbo uye nhengo dzomukati ndiko chirwere chemuviri nemaabhakitiriya. Kune marwadzo pasi pechiratidzo chakarurama, ichiwedzera zvikuru apo ichiedza kutora kufema kwakadzika, kuwedzera kuduku kwekushisa kwemuviri.

3. Zvirwere zve musculoskeletal system:

   • osteochondrosis ye cervical spine. Icho chinokonzera-dystrophic cascade, pamatanho akasiyana-siyana ayo zvinhu zvakasiyana-siyana zvinonyanya kukosha pakuumbwa kwekunzwa kurwadziwa: kubvisa / kusagadzikana kwezvikamu zvemavara, zvinonzi herniated intervertebral disc, stenosis yemugwagwa wepinini, arthrosis wezvikamu zvomuviri. Zvose zvakasiyana-siyana zvinoratidzirwa nekurwadziwa kunokonzerwa nekunzvimbo yekunze kumucheto, zvichipa pasi pechiratidzo chakarurama, mumucheka, chiuno. Mune dzimwe nguva, osteochondrosis inofambidzana nehuwandu hweminwe yoruoko rworudyi uye musoro;
   • scoliosis. Zvinyorwa zvitatu zvechipembenene (thoracic, cervical, lumbar), zvinokonzera marwadzo anorwadza pasi pechirwere chakarurama, kumashure, mapepa, kuneta, kusagadzikana mumatumbo, mudumbu, mapapu, musimba wemwoyo;

   • a syndrome of a humeroscapular periarthritis. Inobatanidza zvakasiyana-siyana matambudziko nefudzi refudzi / mapepa tendon, ligaments, mitsipa, zvichikonzerwa nekufamba kusina kubudirira, kushanda kwakanyanya kwemumuviri kana kugadziriswa kuwandisa kwebhanhire refudzi, zvichiita kuti pave nekurwadzisa pasi pekodzero yakarurama;
   • bursitis. Izvo zvinopisa zvinokonzerwa ne scapula ye synovial membrane yejoka yepafudzi yakarurama inokonzera marwadzo asingagadzi pasi pechiratidzo chekarurama;
   • tuberculosis of scapula;
   • shingles. Kupisa kunopisa pasi pechirwere chakarurama uye mukati-kati kunokonzera hutachiona hwehutachiona hwake - kuputika kweva pedyo-vertebral nerve receptors. Iyo yakajeka nzvimbo yechirwere inoratidzirwa nekusavapo kwezvinhu zvakasara zve vesicles, izvo zvinonyanya kuoma kunzwisisa. Kuonekwa kwemakumbo emvura kunzvimbo dzakasiyana-siyana kunotsanangura mufananidzo uye kunoshanda sechikonzero chekurapa kurapwa kwemishonga inorwisa maitiro.

   • myofascial pain syndrome. Chitubu - trigger mapepa, kuumba mu tendons, fasciae, muscle. Chimwe chinhu chinokonzera nzvimbo inonzi hypersensitivity, kukanganiswa kunokonzera chirwere chinopinza chirwere chinopisa ("svika chiratidzo"), kurwadziwa munzvimbo yakanyatsorondedzerwa (kuratidza marwadzo), kure nekumanikidza. Nzvimbo dzinonyanya kuzivikanwa dzakagadzirwa nemisungo yemusoro / mutsipa, rutivi rworudyi rwemashure / pefudzi, izvo zvinokonzera kuonekwa kwemusoro, lumbago mumutsipa uye pasi pebandauko rorudyi, zvichiyerera kune rutsoka, pfumo, pfuti. Kunyora zvinhu: microtrauma yemasumbu, kushanda kwenguva yakareba, kupesana kwekutsvaga, kugadzikana kwepamusoro.

4. Neurological disorders:

   • intercostal neuralgia. Kupindirana kwemasinga emisipiresi nekuparadzanisa kwemasikirwo emakumbo kusvika kune kurudyi kunotarisana nechekuguma kwekumanikidzwa kwemagetsi ekuguma kwekubuda kwavo - mu "corridor", iyo inoumbwa nezvivako zvakasiyana-siyana (articular tissue, hernia, osteophytes). Sezvo kuora kwemukati-intervertebral kunotanga kuenderera mberi, lumen iri mu "korani" inoperera, ropa rinopa kuguma kwemagetsi rinowedzera, edema uye marwadzo anoonekwa pasi pechiratidzo chekodzero;
   • vegetative-vascular dystonia. Mukukurudzirwa kwepfungwa yepathymatous, kusagadzikana kwakakwana kwehutongi hwehutongi hwehutongi hunoenderana nemamiriro ezvinhu anonetsa kunotora basa rinokosha, rinotungamirira mukuvhiringidzwa kwekushanda kwemitemo yakawanda uye nhengo dzomuviri. Kiriniki VSD inofanirwa nehutano hwekukundikana kwezvinomera. Vagotonia inoratidzika nekunzwa kwe "chilliness" nekushayikwa kwemweya, chizuru, kushungurudzika, kushungurudzika kusuruvara kunorwadza kumashure, kunopisa pasi pechiratidzo chakarurama.

Urongwa hwehupenyu hwekutambudzika

Kutambudzika kunorwadza mune sopapula yakarurama kubva kumashure

Inoratidza nephritis, pyelonephritis kana kusingaperi cholecystitis. Kutambudzika kunorwadza muSapapula kunowanzoonekwa kune zvakaipa zvinoshandiswa nekunzvimbo yepanyika mukati mhengo dzomukati dziri kurudyi. Neoplasms yekodha yakarurama, itsvo dzakarurama, mapascasi zvinoratidzwa nehutano hwakakombama hunoita huri huri pasi pe scapula.

Kunetseka kwakanyanya pasi pechiratidzo chakarurama

Chimwe chiratidzo chechilelithiasis, chakanyanya cholecystitis, hepatic colic. Muna 30-35% yezviitiko, kurwadziwa kwakanyanya pasi pe scapula "inotaura" pachayo dyskinesia ye gallbladder, inobva mukudya zvakanyanya, kusadzora kushandiswa kwemafuta / zvinonhuwira, kuwedzerwa mupfungwa. Mukuwedzera kune kurwadziwa, varwere vanonyunyuta nezvekutuka, kusuruvara, kuwedzerwa kuneta, kushaya simba kwose, kusagadzikana.

Kunyorera kurwadziwa pasi peSpapula kurudyi

Kutambudzika kwenguva pfupi, kusabatanidzwa nezvirwere zvehutano zvemukati masangano / nhengo. Mune zviitiko zvakawanda, kushungurudza kunorwa kunoratidza kuora kwehutano mu osteochondrosis ye thoracic / cervical spine, inokonzerwa nekushingaira kwemuviri, kutendeuka kwakasimba kweguru kana kusagadzikana. Dzimwe nguva kurwadziwa kwemazuva mashoma ndiko chiratidzo chokutanga chekuwedzera kwecholecystitis, kutanga kwe hepatic colic, kana maruva emasvingo e bile ducts.

Dzorera kurwadziwa shure shure kweshoko rakanaka

Ivo "vanotaura" pamusoro pechigarire chekupedzisira chebumbiro rekupedzisira, kuvapo kwe purulent kunopinda muinso, renal colic. Muchiitiko ichi, kurwadziwa kunowedzera nokukurumidza panguva yekufuridzirwa kwakadzika, kunoratidzwa mufudzi nemutsipa.

Kuchirwa marwadzo mu scapula kurudyi

Kushamwaridzana nemasaisai emisungo yebhanhire remapfudzi kana kushandiswa kwemaitiro emutsara wepinini. Osteochondrosis yecervical zone inoratidzwa nekurwadziwa, kuwedzera simba nekugara kwechigarire, kuchinja nzvimbo yemuviri. Kune dzimwe humwe zvirwere, kukwevera marwadzo kune atypical, kusabvisa oncology yekodzero yakarurama, itsvo, chiropa, pancreas musoro.

Kupisa zvinorwadza munzvimbo ye scapula kurudyi

Kupisa zvinorwadza kunogona kuratidza kukanganisa kwemidzi yehutano kana mamiriro ezvinhu ane ngozi anoda chiremba kuchimbidzika-kurudyi-pedumine pneumonia, atypical angina.

Kurwadziwa nguva dzose mu scapula kurudyi

Chiratidzo chinoratidza dyskinesia (kusashanda kwe motokari) ye bile ducts ine hutachiona. Iyo kurwadziwa inowedzera zvishoma nezvishoma muhana yakarurama hypochondrium, inopa pasi pechiratidzo chakarurama, mubandauko rakarurama.

Ari pasi pebandauko rorudyi rebandauko shure

Uchapupu hwehupenyu husingagumi hunofambira mberi nhengo dziri kure. Kuratidza kurwadziwa kunorwadza chiratidzo chekuvhiringidza mukati mepancreas, nduru yevuru, itsvo, chiropa, izvo zvisingagoni kuregererwa, sezvo zvinogona "kuvanza" zvirwere zvepachikafu, izvo muzvikamu zvokutanga zvinoratidzika sechirwere chekurwadziwa kunorwadza.

Zvimwe zvikonzero zvinokonzera kurwadziwa kwe periodic:

• tsvina iri muchikamu chakanaka che LO;
• chronic pyelonephritis / cholecystitis;
• cholelithiasis, osteochondrosis;
• latent pneumonia / pleurisy mukodzero yakarurama;
• hepatitis / cirrhosis;
• chronic bronchitis, pancreatitis.

Chikonzero nei kune hurombo hwekuputika pasi pechiratidzo chekodzero

Kurwadziwa kwekuputika mune chikamu chakanaka kazhinji kunokonzerwa nekudzivirira kwe disc, kuwedzera kwekushanduka kwemagetsi. Kudzivirira ndiko danho rokutanga remudziro wekunamatira, iyo inogona kutungamirira pakuumbwa kwepisterbral hernia, iyo inopa "kurwadziwa kukuru.

Zviratidzo zvekuzvidya mwoyo zvinoda kuchengetedzwa nokukurumidza

Pasinei nezvikonzero zvakawanda zvinokonzera marwadzo mubandauko rorudyi, pane zviratidzo zvinotyisa zvinokonzera kutyisidzira hupenyu: marwadzo anokonzerwa nekuzvinyima, zvichiita "mimba yakaoma," hyperemia (kusvika kune 40 degrees), kupfugama kwemaoko, kurutsa "tsime", cyanosis yeganda , kukurumidza kufema, kufema kunononoka mumhepo / kupera kweropa, kupera simba.

Kuongorora zviyero

Nokurwadziwa pasi pekodzero yakarurama, kukwanisa kuongororwa kwekliniki kunoita kuti zvive nyore kuparadzanisa varwere vane nonspecific uye marwadzo chaiwo. "Zviratidzo zvekutyisidzira", zvichibvumira kufungidzira zvirwere zvinotyisa: kuwedzera zvishoma nezvishoma mukurwadziwa, kuoma kwekufamba, kuora mitezo, kushungurudzika kwekunzwisisa, kuongorora kweancler in the anamnesis, kuchinja kweropa / urini kuongororwa. Zvisina kufanirwa etiology yemarwadzo uye maitiro ake chaiwo, izvo zvinogona kuratidza kuvepo kwekukundikana kwemagetsi, kupindira, tsvina / kupisa kwemutsipa wechipfuva, zvirwere zve somatic zvenhengo dzomukati - chiitiko chekukurukurirana nevanoongorora nyanzvi (gastroenterologist, neurologist, cardiologist, traumatologist).

Algorithm yekusiyanisa kusarudzwa kwehutwa pasi pezvakakodzera scapula:

• kuunganidza anamnesis, chinangwa chinangwa chemaitiro ekutambudzika;
• muyero wekupisa, ropa;
• kunyoresa kwenzvimbo interscapular, kumashure;
• kutakura kuongorora kwemapfupa;
• kuzivikanwa kwezvinokonzera zviratidzo zvekutambudzika;
• Kusabatwa nemamiriro ezvinhu akaoma anotakura kutyisa kuhupenyu hwomurwere;
• chisimbiso / kusagadzikana kwepfungwa inokonzerwa nemarwadzo;
• Zvimwe zvidzidzo: ultrasound, MRI, chirwere chemwoyo, cardiogram, X-ray yemukona uye thorax, FGD, bronchoscopy, urine / kuongorora ropa.

Kurwadziwa pasi pechiratidzo chakakodzera kunofanira kurapwa chete nachiremba uyo, zvichienderana nehutachiona, anosarudza nzira yakanakisisa yekurapa kwechirwere chepakati uye marwadzo munharaunda inopararira. Kurapa kwokurapa kunogona kusanganisira nzira dzokuvhiya uye dzokuvhiya, kupisa, kupisa, reflexology uye physiotherapy.