I-pelvis (kusuka ku-Latin pelvis) ibhande lamathambo elisekela isisindo somzimba futhi elakha ukuhlangana phakathi kwesiqu nezitho ezingezansi.

I-pelvis, noma i-pelvis, ibhande lamathambo elitholakala ngaphansi kwesisu elisekela umgogodla. Yenziwe ngokuhlangana kwamathambo amabili e-coxal (ithambo le-hip noma ithambo le-iliac), i-sacrum ne-coccyx. Amathambo enqunu uqobo lwawo angumphumela wokuhlanganiswa kwamathambo amathathu: ilium, ischium kanye ne-pubis.

Amathambo we-hip ajoyina ngemuva kwe-sacrum, ngamaphiko e-ilium, ezingeni lamajoyinti we-sacroiliac. Umngcele ongaphezulu wephiko yi-iliac crest, kuyindawo yokufakwa kwezicubu zesisu. Izinsika ze-iliac ziyaphatheka uma ubeka izandla zakho okhalweni.

Amathambo amabili enqunu ahlangana ngaphambili ezingeni lama-pubis. Bajoyina ndawonye yi-pubic symphysis. Ngasesikhundleni sokuhlala, sibekwe emagatsheni e-ischio-pubic (igatsha le-pubis ne-ischium).

I-pelvis inamathele emilenzeni engezansi ezingeni le-hip noma i-coxofemoral joint: i-acetabulum (noma i-acetabulum), umgodi ohlangene obumbeke njengo-C, ithola ikhanda le-femur.

Isikhala esimise okwefaneli, i-pelvis ihlukaniswe izifunda ezimbili: i-pelvis enkulu ne-pelvis encane. Umcengezi omkhulu yingxenye engenhla, enqunywe ngamaphiko e-ilium. Umcengezi omncane ungaphansi kwalezi zimpiko.

Umgodi uhlukaniswe ukuvuleka okubili:

• umgudu ongaphezulu ongukuvula okuphezulu komcengezi. Kubonisa ukuguquka phakathi kwesikhumba esikhulu nesincane. Ingena esikhaleni esinqunyelwe kusuka ngaphambili kuye emuva ngomphetho ophezulu we-pubic symphysis, imigqa ye-arched kanye ne-promontory ye-sacrum (emaphethelweni aphezulu) (3).
• Umugqa ongezansi ukuvulwa okuphansi kwesitsha. Kwakha idayimane. Kukhawulelwe ngaphambili ngumngcele ophansi we-pubic symphysis, ezinhlangothini ngamagatsha e-ischiopubic kanye ne-ischial tuberosities, futhi ekugcineni ngemuva ngemuva kwe-coccyx (4).

Kwabesifazane abakhulelwe, ubukhulu besichibi nobunzima yidatha ebalulekile yokulindela ukudlula kwengane. Amalunga we-sacroiliac kanye ne-pubic symphysis nakho kuthola ukuguquguquka okuncane ngesenzo samahomoni ukukhuthaza ukubeletha.

Kukhona umehluko phakathi kwamachibi abesilisa nabesifazane. Isinqe sowesifazane sithi:

• Okubanzi nokuhlanganisiwe,
• Okuncane,
• I-arch yayo yasesidlangalaleni iyindilinga kakhulu ngoba i-engeli eyakhiwe inkulu,
• I-sacrum ifushane futhi i-coccyx iqonde.

Isinqe siyindawo yokufakwa kwemisipha ehlukahlukene: imisipha yodonga lwesisu, leyo yezinqe, iqolo engezansi kanye nemisipha eminingi yamathanga.

I-pelvis yindawo eniselwa kakhulu yimikhumbi eminingi: umthambo we-iliac wangaphakathi ohlukaniswe ikakhulukazi emthanjeni we-rectal, pudendal noma ilio-lumbar. Imithambo ye-pelvic ifaka phakathi kokunye umthambo we-iliac wangaphakathi nangaphandle, ovamile, onxande…

Umgogodla we-pelvic ugcinwe ngokucebile yi: i-lumbar plexus (isb: i-femal nerve, isikhumba sethanga sangemuva), i-sacral plexus (isib: inzwa yesikhumba engemuva kwethanga, i-sciatica), i-pudus plexus (isb: i-pudendal nerve, ipipi , clitoris) kanye ne-plexus ye-coccygeal (isb: sacral, coccygeal, genitofemoral nerve). Lezi zinzwa zenzelwe i-viscera yomgodi (izitho zangasese, i-rectum, i-anus, njll.) Kanye nemisipha yesisu, i-pelvic ne-upper limb (ithanga).

Indima enkulu ye-pelvis ukuxhasa isisindo somzimba ongaphezulu. Iphinde ivikele izitho zangasese zangaphakathi, isinye nengxenye yamathumbu amakhulu. Amathambo enqunu abuye akhulume ngethambo lethanga, i-femur, evumela ukuhamba.

Ukwephuka kwesikhumba : ingathinta ithambo kunoma yiliphi izinga kodwa izindawo ezintathu ngokuvamile zisengozini enkulu: i-sacrum, i-pubic symphysis noma i-acetabulum (ikhanda le-femur licwila ethangeni bese liyaphula). Ukwephuka kungenzeka kubangelwe ukwethuka okunodlame (ingozi yomgwaqo, njll.) Noma ukuwa okuhambisana nokuthamba kwamathambo (isb osteoporosis) ezifundweni ezindala. I-viscera, imikhumbi, izinzwa nemisipha ye-pelvis kungathinteka ngesikhathi sokuqhekeka futhi kubangele i-sequelae (i-nervous, urinary, njll.).

ubuhlungu Hip : banemvelaphi ehlukahlukene. Kodwa-ke, kubantu abangaphezu kwama-50, bavame ukuxhunyaniswa ne-osteoarthritis. Imvamisa, ubuhlungu obuhambisana nokuphazamiseka kwe-hip kuzoba "okulahlekisayo", okwenzelwe indawo ngokwesibonelo emgodini, ezinqeni, noma emlenzeni noma emadolweni. Ngakolunye uhlangothi, ubuhlungu bungazwakala esinqeni futhi empeleni buqhamuka endaweni ekude kakhulu (emuva noma emgodini, ikakhulukazi).

I-Pudendal neuralgia : uthando lwenzwa ye-pudendal evimbela indawo yesinqe (umgudu we-urinary, i-anus, i-rectum, izitho zangasese…). Kubonakala ngobuhlungu obungapheli (umuzwa ovuthayo, ukuba ndikindiki) obhebhethekiswa ukuhlala. Ngokuvamile kuthinta abantu abaphakathi kweminyaka engama-50 nengama-70 ubudala futhi imbangela yalesi sifo ayikhonjwanga ngokucacile: kungaba ukucindezelwa kwemizwa noma ukufakwa kwayo ezindaweni ezihlukene (okucindezelwe phakathi kwemigqa emibili, emseleni ongaphansi kwenkantini…) noma ngo isimila isibonelo. I-Neuralgia nayo ingabangelwa ukusetshenziswa ngokweqile kwebhayisikili noma ukubeletha.

Ukunyakaza kwepelvic ngesikhathi sokubeletha

Ukunyakaza okuthile ezinhlangothini ze-sacroiliac ezivumela ukulethwa kwesitho sangasese sowesifazane:

• Ukunyakaza okuphikisayo: ukulinganisa kwe-sacrum (ukuhlehla nokuphakama kwe-promontory) kwenzeka uma kuhlotshaniswa nokuthuthuka kanye nokwehliswa kwe-coccyx kanye nokuhlukaniswa kwamaphiko e-iliac. Lokhu kunyakaza kunomphumela wokukhulisa i-upper strait * kanye nokunciphisa i-strait ephansi **.
• Ukunyakaza kwe-Nutation: ukunyakaza okubuyela emuva kuyenzeka: ukuthuthuka nokwehliswa kwesikhundla se-sacrum, ukuhlehla nokuphakama kwe-coccyx kanye nokulinganisa kwamaphiko e-iliac. Lokhu kuhamba kunomphumela wokukhulisa i-strait engezansi nokuncipha komugqa ongaphezulu.

I-hip osteoarthritis (noma i-coxarthrosis) : kufana nokugqokwa koqwanga ezingeni lokuhlangana phakathi kwekhanda le-femur nethambo le-hip. Lokhu kubhujiswa okuqhubekayo kwe-cartilage kubonakala ngobuhlungu ngokuhlanganyela. Azikho izindlela zokwelapha ezingavumela u-cartilage regrowth. I-hip osteoarthritis, noma i-coxarthrosis, ithinta cishe abantu abadala abangama-3%.

Abantu asebekhulile bamele inani labantu abasengozini yokuqhekeka kwezitho zangasese ngoba bathambekele kakhulu ekuweni futhi amathambo abo abuthakathaka kakhudlwana. Kunjalo nangabantu abane-osteoporosis.

Ukuvimbela ukuwa akulula, kepha kuyalulekwa ukuthi kudliwe ukudla okunothe nge-calcium novithamini D ukuqinisa amathambo nokulwa ne-osteoporosis. Kubantu asebekhulile, kubalulekile ukuqeda noma isiphi isithiyo endaweni yabo esingaba yimbangela yokuwa okunodlame (ukususwa kwamata) nokuguqula indlela abaziphatha ngayo (ukufakwa kwamabha ezindlini zangasese, ukugqoka izicathulo ezibamba unyawo) . Kuyalulekwa futhi ukuthi ugweme umkhuba wezemidlalo osengozini yokuwa ngodlame (ngeparachute, ukugibela amahhashi, njll.) (10).

Ukuhlolwa komtholampilo: uma kusolwa ukuphuka okhalo, udokotela uzoqala enze ukuhlolwa komtholampilo. Isibonelo, uzohlola ukuthi bukhona yini ubuhlungu lapho kuhlanganiswa amalunga we-sacroiliac (phakathi kwe-ilium ne-sacrum) noma ukukhubazeka kwesitho esiphansi.

I-Radiography: inqubo yezithombe yezokwelapha esebenzisa ama-X-ray. I-radiography engaphambili neyi-lateral yenza kube lula ukubona ngeso lengqondo ukwakheka kwamathambo nezitho eziqukethwe okhalweni nokugqamisa ukuphuka ngokwesibonelo.

I-MRI (imaging resonance imaging): ukuhlolwa kwezokwelapha ngezinhloso zokuxilonga kwenziwa kusetshenziswa idivaysi enkulu eyindilinga lapho kukhiqizwa khona amandla kazibuthe namagagasi omsakazo. Lapho i-radiography ingakuvumeli khona, ikhiqiza izithombe eziqonde kakhulu. Isetshenziswa ikakhulukazi ezimweni zobuhlungu be-hip ne-pubic. Ukubona ngeso lengqondo izitho, i-MRI ingahlanganiswa nomjovo womkhiqizo ohlukile.

I-pelvic ultrasound: inqubo yezithombe encike ekusetshenzisweni kwe-ultrasound ukubona ngeso lengqondo ukwakheka kwangaphakathi kwesitho. Endabeni yesikhumba, i-ultrasound yenza kube lula ukubona ngeso lengqondo izitho zomgodi (isinye, i-ovary, i-prostate, izitsha, njll.). Kwabesifazane, ukuhlolwa okuvamile kokulandelwa kokukhulelwa.

Iskena: inqubo yokuhlola yokuhlola equkethe “ukuskena” isifunda esinikeziwe somzimba ukuze wakhe izithombe ezihlukanisayo, ngenxa yokusetshenziswa kogongolo lwe-X-ray. Igama elithi "isithwebuli" empeleni yigama ledivayisi yezokwelapha, kepha livame ukusetshenziselwa ukuqamba ukuhlolwa. Siphinde sikhulume nge-computed tomography noma i-computed tomography. Endabeni yesikhumba, i-CT scan ingasetshenziselwa ukubheka ukuphuka okungabonakali ku-x-ray noma isilinganiso se-pelvimetric (ubukhulu be-pelvic) kwabesifazane abakhulelwe.

Isikhathi eside, ukuba ne-pelvis enkulu kwakuhlotshaniswa nokuzala futhi ngenxa yalokho kwakuthathwa njengokuyenga.

Namuhla, kunalokho, isinqe esincane sithandwa isithombe sobukhulu obudumile 36.