Isizathu esivamile sobuhlungu behlombe obubuhlungu, i-subacromial bursitis ibonakala ngokuvuvukala kwe-subacromial bursa, uhlobo lwephedi eliyisicaba elikhuthaza ukushelela kwezakhiwo ze-anatomical zehlombe. Ngokuvamile kuhlotshaniswa ne-tendon pathology. Uma kwenzeka ubuhlungu obungapheli, ukwelashwa kwezokwelapha kukhethwa, ukuhlinzwa kuyindlela yokugcina.

Incazelo

I-Subacromial bursitis ukuvuvukala kwe-bursa ye-subacromial, i-serous bursa - noma i-synovial bursa - efana ne-sac flattened, etholakala ngaphansi kwe-protrusion ye-scapula ebizwa ngokuthi i-acromion. Njengoba igcwele uketshezi lwe-synovial, le pad itholakala esibonakalayo phakathi kwethambo kanye nemisipha ye-rotator cuff evala ikhanda le-humerus. Isiza ukushelela lapho ihlombe elihlangene lihlanganiswa.

I-subacromial bursa ixhumana nenye i-serous bursa, i-subdeltoid bursa, ephakathi kwe-tubercle enkulu yekhanda le-humerus ne-deltoid. Kwesinye isikhathi sikhuluma nge-subacromio-deltoid bursa.

I-Subacromial bursitis ibangela ubuhlungu obukhulu noma obungapheli futhi ngokuvamile ibangela ukulinganiselwa kokunyakaza.

Izimbangela

I-Subacromial bursitis ivamise ukuvela emishinini futhi ingase ihlotshaniswe ne-rotator cuff tendinopathy noma ukuqhekeka kwe-tendon. 

Ukungqubuzana kwe-subacromial kuvame ukuba khona: isikhala esingaphansi kwe-acromion sincane kakhulu futhi ukukhululeka kwamathambo kuvame "ukubamba" i-tendon lapho ihlombe lihlanganiswa, okubangela ukusabela okubuhlungu kokuvuvukala ku-bursa. i-subacromial.

Ukuvuvukala kwe-bursa kubangela ukushuba, okwandisa amandla okungqubuzana, nomphumela wokusekela ukuvuvukala. Ukuphindaphinda ukunyakaza kukhulisa lesi simo: ukungqubuzana kwe-tendon kukhuthaza ukwakheka koqhwaku lwe-bony (i-osteophyte) ngaphansi kwe-acromion, okubuye kukhuthaze ukugqoka kwe-tendon nokuvuvukala.

I-Bursitis ngezinye izikhathi iphinde ibe yinkimbinkimbi yokubala i-tendinopathy, ukubala kuyimbangela yobuhlungu obukhulu kakhulu.

kwesifo

Ukuxilongwa kusekelwe ikakhulukazi ekuhlolweni komtholampilo. Ihlombe elibuhlungu lingaba nezimbangela ezihlukene futhi, ukuze abone izilonda okukhulunywa ngazo, udokotela uhlola kanye nochungechunge lwezindlela zokuqondisa izinto (ukuphakama noma ukuzungezisa kwengalo kuhambisana nezimbazo ezihlukene, ukwelulwa kwendololwane noma ukugoba, ngokumelene nokumelana noma cha ... ) ezimvumela ukuthi ahlole ukuhamba kwehlombe. Ikakhulukazi, ihlola amandla emisipha kanye nokunciphisa ububanzi bokunyakaza futhi ibheka izikhundla ezibangela ubuhlungu.

Ukusebenza kwesithombe kuqeda ukuxilongwa:

• ama-x-ray awanikezi ulwazi nge-bursitis, kodwa angathola ukubala futhi abone ngeso lengqondo umumo we-acromion lapho kusolwa ukuthi i-subacromial impingement.
• I-Ultrasound iyisivivinyo esikhethwayo sokuhlola izicubu ezithambile ehlombe. Kwenza kube nokwenzeka ukubona ngeso lengqondo izilonda ze-rotator cuff futhi ngezinye izikhathi (kodwa hhayi njalo) bursitis.
• Okunye ukuhlolwa kwe-imaging (i-arthro-MRI, i-arthroscanner) kungase kudingeke.

Abantu abathintekayo

Kanye nendololwane, ihlombe liyilunga elihlaselwe kakhulu yizifo ze-musculoskeletal. Ubuhlungu behlombe buyisizathu esivamile sokubonisana emithini evamile, futhi i-bursitis ne-tendinopathy ibusa isithombe.

Noma ubani angathola i-bursitis, kodwa ivame kakhulu kulabo abaneminyaka engamashumi amane namashumi amahlanu kunabantu abasha. Abasubathi noma ochwepheshe labo umsebenzi wabo odinga izenzo eziphindaphindiwe bavezwa ngaphambilini.

Izici zengozi

• Ukwenza ukunyakaza okuphindaphindayo amahora angaphezu kwama-2 ngosuku
• Sebenza izandla ngaphezu kwamahlombe
• Ukuthwala imithwalo esindayo
• ukuhlukumezeka
• Ubudala
• Izici ze-morphological (umumo we-acromion)…

Ubuhlungu

Ubuhlungu buwuphawu oluyinhloko lwe-bursitis. Iziveza esifundeni sehlombe, kodwa ivame ukuphumela endololwaneni, noma ngisho nasesandleni ezimweni ezinzima kakhulu. Kubhebhethekiswa ukunyakaza okuthile kokuphakamisa ingalo. Ubuhlungu basebusuku bungenzeka.

Ubuhlungu bungaba buhlungu ngesikhathi sokuhlukumezeka, noma buqale kancane kancane bese bungapheli. Kungaba bukhali kakhulu ezimweni ze-hyperalgesic bursitis exhunywe ukubala i-tendonitis.

Ukukhubazeka kokuhamba

Kwesinye isikhathi kuba nokulahlekelwa uhla lokunyakaza, kanye nobunzima bokwenza ukuthinta okuthile. Abanye abantu babuye bachaze umuzwa wokuqina.

Ukuphumula nokuvuselela ukusebenza

Okokuqala, ukuphumula (ukususwa kwezimpawu ezibangela ubuhlungu) kuyadingeka ukuze kuncishiswe ukuvuvukala.

Ukuvuselelwa kufanele kuhambisane nesimo se-bursitis. Uma kwenzeka i-impingement ye-subacromial, ukuzivocavoca okuthile okuhloswe ukunciphisa ukungqubuzana phakathi kwethambo nama-tendon ngesikhathi sokunyakaza kwehlombe kungase kube usizo. Ukuzivocavoca kokuqinisa imisipha kungase futhi kunconywe kwezinye izimo.

I-Ultrasound inikeza ukusebenza kahle lapho i-bursitis ibangelwa ukubala kwe-tendonitis.

Ukwelashwa

Isebenzisa izidakamizwa ezingezona ukuvuvukala (ama-NSAID) nama-analgesics, avame ukusebenza ngesikhathi esifushane.

Imijovo ye-Corticosteroid esikhaleni se-subacromial ingase inikeze impumuzo.

Ukuhlinzwa kuyisixazululo sokugcina ngemuva kokwelashwa okwenziwa kahle.

I-Acromioplasty ihlose ukucindezela ukungqubuzana phakathi kwe-bursa, i-rotator cuff kanye nezakhiwo zamathambo (i-acromion). Yenziwa ngaphansi kwe-anesthesia evamile noma yendawo yendawo, isebenzisa indlela encane yokuhlasela (i-arthroscopy) futhi ihlose ukuhlanza i-subacromial bursa futhi, uma kunesidingo, "ukuhlela" umlomo wethambo ku-acromion.

Izinhlungu zokuqwashisa akufanele zishaywe indiva. Ukwamukela ukuthinta okuhle ngesikhathi somsebenzi, ezemidlalo noma ngisho nemisebenzi yansuku zonke kungavimbela i-subacromial bursitis ekubeni ingapheli.

Odokotela bomsebenzi kanye nodokotela bezemidlalo bangasiza ekuboneni izenzo eziyingozi. Umelaphi womsebenzi angaphakamisa izinyathelo ezithile (ukulungiswa kwezindawo zokusebenza, inhlangano entsha ukuze kugwenywe ukuphindaphindwa kwezenzo, njll.) eziwusizo ekuvimbeleni.