I-Compartment syndrome ibangelwa ukwanda okungavamile kwengcindezi ezicutshini eziqukethwe ngaphakathi kwekhomishana yemisipha ebizwa ngokuthi i-compartment. Ngendlela yayo engapheli, kwenzeka ngokuzikhandla, okubangela ubuhlungu bemisipha nezinzwa ezinobunzima obuhlukahlukene. I-Acute syndrome ingase yenzeke ngemva kokuhlukumezeka, okudinga ukuhlinzwa okuphuthumayo. Ukuhlinzwa futhi kuyimpendulo lapho kungekho sixazululo sezokwelapha esiye satholakala kumafomu angapheli.

Incazelo

I-Compartment syndrome, noma i-compartment syndrome, iwumphumela wokwanda kwengcindezi ye-intra-tissue engxenyeni eyodwa noma ngaphezulu, okusho ukuthi ezingxenyeni zemisipha ezivalwe ulwelwesi olungenakunwebeka olubizwa ngokuthi i-aponeurosis olukhona emlenzeni, engalweni noma esandleni. . Le pathology ebuhlungu ingahambisana nokuncipha kokujikeleza kwegazi (ischemia) okwandisa ukuhlupheka kwemisipha yemisipha nezinzwa.

Ubunzima buyahlukahluka kuye ngokubaluleka kokucindezela ngokweqile.

Esimweni sesithathu, kukhona i-muscle hernias: ezindaweni, izicubu zemisipha zigcina ziphuma esitsheni sazo nge-aponeurosis ephukile.

Izimbangela

I-Compartment syndrome ibangelwa ukungqubuzana phakathi kwesitsha (i-aponeurosis) nokuqukethwe (izicubu zemisipha, kodwa nezinzwa nemithambo yegazi). Ukwanda kwevolumu yemisipha kungase kuhlotshaniswe nokuvinjelwa kwemisipha, i-edema noma ukwakheka kwe-hematoma, noma ngisho nokungahambi kahle kwe-venous noma kwemisipha. Ukungajwayelekile kwesitsha, isibonelo i-aponeurosis eshubile elandela i-fibrosis noma ukuhlukumezeka, nakho kungabandakanyeka.

Ku-syndrome ye-compartment engapheli, umzamo ubangela ngokuqondile ukwanda okweqile kwevolumu ye-muscle, ukuguqulwa phakathi nesikhathi esiguquguqukayo ngemva kokuma. Ithole liyindawo evame kakhulu. Ukuhlasela kuhlangene namazwe amabili emacaleni angama-50 kuye kwangama-80.

Ifomu elibuhlungu lixhunyaniswa nokwenyuka okungazelelwe kwengcindezi kulandela ukuhlukumezeka kanye / noma ukucindezelwa kakhulu ngebhandeshi noma ukhonkolo, okubangela ukugoba kwemisipha. Sikhuluma nge-Volkmann syndrome uma ithinta umphambili we-cast. Isici sokucindezela kufanele sisuswe ngokushesha ngangokunokwenzeka.

kwesifo

Ku-syndrome ye-compartment engapheli, ukubonakaliswa okubuhlungu kwenzeka ngesikhathi somzamo kuphela, ngokuphathelene negumbi elithintekayo futhi njalo ngokufanayo (uhlobo olufanayo lomzamo, ukubambezeleka okufanayo).

Ukuhlola umzimba kuvamile lapho uphumule, kodwa izingxenye ziqinile futhi zibuhlungu ngemva kokuhlolwa kokucindezeleka (isb. kumshini wokunyathelisa) futhi imisipha yemisipha iyaqina.

Ukulinganisa ingcindezi ye-intramuscular

Ukulinganisa ukucindezela kwe-intramuscular kusetshenziswa idivayisi ehlanganisa inaliti efakwe engxenyeni yenza kube nokwenzeka ukuqinisekisa ukuxilongwa. Inqubo yakudala iqukethe izilinganiso ezintathu: ekuphumuleni, umzuzu o-1 ngemuva kokuzivocavoca kanye nemizuzu emi-5 ngemuva kokuzivocavoca. Amanani ajwayelekile ekuphumuleni aku-oda lika-15 mm Hg. Izingcindezi ezingaphezu kwaleli nani ngaphezu kwemizuzu engu-6 ngemva kokuzivocavoca, noma amanani angaphezu kwama-30 noma ngisho nama-50 mm we-mercury ngemva nje kokuzivocavoca abhekwa njenge-pathological.

Kungase kudingeke ukuhlolwa okuhlukile ukuze kukhishwe ezinye izifo:

• ukuhlolwa kwegazi,
• I-IRM,
• i-x-ray,
• I-Doppler echo,
• i-scintigraphy,
• i-electromyogram (EMG) yokulinganisa umsebenzi we-neuromuscular.

Uma izimpawu zomtholampilo zanele ukuxilonga i-acute compartment syndrome, ukulinganiswa kwengcindezi akudingekile futhi akufanele kubambezele ukuhlinzwa.

Ngubani othintekayo?

Izikhathi eziyisishiyagalolunye kwabayishumi abantu abane-chronic compartment syndrome. Lokhu kuvame ukuba ngumsubathi osemusha oneminyaka ephakathi kuka-20 no-30. Ukuqina kwalo mkhuba kuvame ukuba umsuka wokwenzeka kwawo.

Abasebenzi abasebenza ngezandla noma abaculi bangaphathwa yi-compartment syndrome yesitho esingaphezulu.

Izici zengozi

Eminye imidlalo ibeka ukucindezeleka ngokweqile nokuphindaphindiwe emisipha efanayo futhi ikhuthaza ukuthuthukiswa kwe-compartment syndrome.

Ama-syndromes ebhokisi etholeni ikakhulukazi athinta abagijimi bebanga elide nebanga eliphakathi noma ababambiqhaza kumidlalo yeqembu ehambisana nokugijima efana nebhola lezinyawo. Ukushushuluza eqhweni, ukuhamba ngokushesha, ukushushuluza nge-roller noma ukubhukuda ngamaphiko nakho kuyimidlalo eyingozi.

I-syndromes yezingxenye zemilenze engaphezulu ingahlotshaniswa nomkhuba we-motocross, i-windsurfing, ukushushuluza emanzini, ukukhuphuka ...

I-Chronic compartment syndrome

Ubuhlungu buyisibonakaliso esiyinhloko. Kuhambisana nomuzwa wokungezwani, kukuphoqa ukuthi umise umzamo. Inamandla aguquguqukayo futhi ngokwesibonelo ingabangela ukuxhuga noma ngokuphambene ibe nodlame kakhulu.

Ukuzwa okungavamile kokuthinta, ukuba ndikindiki noma ukugubha (ama-paresthesias), kanye nokukhubazeka kwesikhashana kwengxenye ethintekile kungase kuhlotshaniswe.

Ubuhlungu buvela ngokushesha noma kancane lapho uphumule, kodwa ubuhlungu bungase buqhubeke izinsuku ezimbalwa.

Uma ingalashwa, i-compartment syndrome ingase ibe yimbi kancane, nobuhlungu obuvela ngemizamo encane futhi eqinile, kanye nengozi yokuthuthukisa ifomu elibuhlungu lapho ubuhlungu buqhubeka khona ngemva komzamo.

I-Acute compartment syndrome

Ubuhlungu obukhulu kakhulu noma obungabekezeleleki i-cramp noma uhlobo lwe-tension. Akakhululi ngokushintsha kwesimo futhi ubonisa ukumelana nama-analgesics. Ibhokisi leluliwe phezu kwe-palpation.

Ukushoda kokuzwela kwenzwa engavimbeli indawo eyonakele kuvela ngokushesha. I-Paresthesia iqhubekela ekulahlekelweni kokuzwela okulandelwa yi-anesthesia.

Uma ukwelashwa kubambezelekile, ukuntuleka kokunisela (ischemia) kubangela ukunyamalala kwe-peripheral pulses kanye nokuntuleka kwemoto okuholela ekulimaleni kwemisipha kanye nenzwa.

Ukujwayela ukuzijwayeza kwezemidlalo kanye nokwelashwa kunganqoba i-chronic compartment syndrome. Ukwelashwa kokuhlinzwa kungaxoxwa kubasubathi abahlushwa ukungakhululeki okuphawulekayo, ukwazi ukuthi ukuyeka umkhuba wezemidlalo kungenye indlela. Ukuhlinzwa kwenzeka uma kwenzeka ukwehluleka kokwelashwa ngemva kwezinyanga ezimbili kuya kweziyisi-2. Kumele kwenziwe ngokushesha lapho kubhekene ne-acute compartment syndrome.

Ukuvimbela kanye nokuvuselelwa kwezemidlalo

Kubandakanya ukunciphisa ukushuba kwemizamo noma ukushintsha imisebenzi, ukulungisa uhlobo lokuqeqeshwa (ukuzelula, ukufudumala), ukulungisa izinto zokusebenza noma ukuthinta, njll.

Ukwelashwa

Izidakamizwa ze-Venotonic noma ukugqoka amasokisi okucindezela ngezinye izikhathi kuyaphakanyiswa.

I-Physiotherapy iyasebenza kwezinye izimo. Ngokuyinhloko kusekelwe ekuzilolongeni kokuzivocavoca (kwengalo) nasezinhlotsheni ezahlukene zokubhucunga.

Ukwelapha okuhlinzwa

Ihlose ukuthola ukucindezelwa ngokuvula amagumbi athintekayo (i-aponeurotomy). Ukungenelela kwakudala kudinga ukusikwa kwesikhumba okukhulu kakhulu, ukuhlinzwa kwe-arthroscopic micro-invasive okwenza enye indlela.

Izinkinga (imihuzuko, ukulimala kwezinzwa, ukukhubazeka kokuphulukisa, izifo, njll.) azivamile. Ezimweni eziningi, ukuhlinzwa kubuqeda unomphela ubuhlungu. Ngemuva kokuvuselelwa (i-physiotherapy, ukuhamba, njll.), ngokuvamile kungenzeka ukuthi uqalise kabusha imisebenzi yezemidlalo ngemva kwezinyanga ezimbili kuya kwezi-2.

Ngakolunye uhlangothi, ukubambezeleka ekuphathweni kwe-acute compartment syndrome kuhambisana nengozi enkulu yokufakwa kwezilonda ezingaphenduki (i-muscle necrosis, fibrosis, ukulimala kwezinzwa, njll.), nemiphumela emibi kakhulu noma encane: ukuhlehliswa kwemisipha , izinzwa kanye ukuphazamiseka kwezimoto…

Ukufudumala okufanelekile, ukuvivinya umzimba okunwebekayo kanye nokuzilolonga kwezemidlalo okuvumelaniswe namakhono omuntu, ngokukhula kancane kancane kokuqina kanye nobude bemizamo, kungasiza ekuvimbeleni i-compartment syndrome.

Uma ukhonkolo noma ibhandishi liqine kakhulu, ungangabazi ukubika kudokotela.