Oye Awọn ohun amorindun Nafu: Ṣiṣayẹwo ati Ṣiṣakoṣo Irora Ọgbẹ

Fun awọn ẹni-kọọkan ti o niiṣe pẹlu irora irora, ṣe le ṣe ilana ilana idena nafu ara ṣe iranlọwọ lati dinku ati ṣakoso awọn aami aisan?

Awọn bulọọki Nerve

Àkọsílẹ nafu ara jẹ ilana ti a ṣe lati da gbigbi / dena awọn ifihan agbara irora nitori ailagbara nafu tabi ipalara. Wọn le ṣee lo fun iwadii aisan tabi awọn idi itọju, ati awọn ipa wọn le jẹ kukuru tabi igba pipẹ, da lori iru ti a lo.

• A ibùgbé nafu Àkọsílẹ le kan ohun elo tabi abẹrẹ ti o da awọn ifihan agbara irora duro lati tan kaakiri fun igba diẹ.
• Fun apẹẹrẹ, ni oyun, abẹrẹ epidural le ṣee lo lakoko iṣẹ ati ibimọ.
• Awọn bulọọki nafu ara ayeraye kan gige/pinpin tabi yiyọ awọn apakan kan ti nafu ara lati da awọn ifihan agbara irora duro.
• Awọn wọnyi ni a lo ni awọn ọran pẹlu awọn ipalara nla tabi awọn ipo irora onibaje miiran ti ko ni ilọsiwaju pẹlu awọn ọna itọju miiran.

Lilo Itọju

Nigbati awọn olupese ilera ṣe iwadii ipo irora onibaje ti o fa nipasẹ ipalara nafu tabi aiṣedeede, wọn le lo bulọọki nafu ara lati wa agbegbe ti n ṣe awọn ifihan agbara irora. Wọn le ṣe electromyography ati/tabi a iyara ifọnọhan nafu / idanwo NCV lati ṣe afihan idi ti irora nafu ara onibaje. Awọn bulọọki aifọkanbalẹ tun le ṣe itọju irora neuropathic onibaje, gẹgẹbi irora ti o fa nipasẹ ibajẹ nafu tabi funmorawon. Awọn bulọọki aifọkanbalẹ ni a lo nigbagbogbo lati ṣe itọju ẹhin ati irora ọrun ti o fa nipasẹ awọn disiki herniated tabi stenosis ọpa-ẹhin. (Johns Hopkins Oogun. Ọdun 2024)

orisi

Awọn oriṣi mẹta pẹlu:

• agbegbe
• Neurolytic
• ise abe,

Gbogbo awọn mẹta le ṣee lo fun awọn ipo ti o fa irora irora. Bibẹẹkọ, neurolytic ati awọn bulọọki iṣẹ-abẹ jẹ ayeraye ati pe a lo nikan fun irora nla ti o buru si pẹlu awọn itọju miiran ti ko le pese iderun.

Awọn bulọọki igba diẹ

• Bulọọki agbegbe jẹ ṣiṣe nipasẹ abẹrẹ tabi lilo awọn anesitetiki agbegbe, bii lidocaine, si agbegbe kan.
• Epidural jẹ bulọọki nafu ara agbegbe ti o fa awọn sitẹriọdu tabi awọn analgesics sinu agbegbe ti o wa ni ayika ọpa ẹhin.
• Awọn wọnyi ni o wọpọ nigba oyun, iṣẹ, ati ibimọ.
• Epidurals tun le ṣee lo lati ṣe itọju ọrun onibaje tabi irora ẹhin nitori irọra ọpa ẹhin ti a fisinuirindigbindigbin.
• Awọn bulọọki agbegbe nigbagbogbo jẹ igba diẹ, ṣugbọn ninu eto itọju kan, wọn le tun ṣe ni akoko pupọ lati ṣakoso irora onibaje lati awọn ipo bii arthritis, sciatica, ati awọn migraines. (NYU Langone Ilera. Ọdun 2023)

Awọn bulọọki Yẹ

• Bulọọki neurolytic nlo ọti, phenol, tabi awọn aṣoju igbona lati tọju irora nafu ara onibaje. (National Institute of Neurological Disorders and Stroke. Ọdun 2023) Awọn ilana wọnyi ba awọn agbegbe kan ti ipa ọna nafu ara lori idi ti awọn ifihan agbara irora ko le gbejade. Bulọọki neurolytic jẹ lilo akọkọ fun awọn ọran irora onibaje ti o lagbara, bii irora lati akàn tabi aarun irora agbegbe eka / CRPS. Wọn lo nigba miiran lati tọju irora ti nlọ lọwọ lati pancreatitis onibaje ati irora ninu ogiri àyà lẹhin iṣẹ abẹ. (Johns Hopkins Oogun. Ọdun 2024) (Alberto M. Cappellari et al., 2018)
• Neurosurgeon n ṣe bulọọki nafu ara ti iṣẹ abẹ ti o kan yọkuro tabi bajẹ awọn agbegbe kan pato ti nafu ara. (National Institute of Neurological Disorders and Stroke. Ọdun 2023) Bulọọki nafu ara iṣẹ abẹ nikan ni a lo fun awọn ọran irora nla, gẹgẹbi irora alakan tabi neuralgia trigeminal.
• Botilẹjẹpe neurolytic ati awọn bulọọki nafu ara abẹ jẹ awọn ilana ti o yẹ, awọn aami aiṣan irora, ati awọn ifarabalẹ le pada ti awọn ara ba ni anfani lati tun dagba ati tun ara wọn ṣe. (Eun Ji Choi et al., Ọdun 2016) Sibẹsibẹ, awọn aami aisan ati awọn ifarabalẹ le ma pada awọn osu tabi ọdun lẹhin ilana naa.

Oriṣiriṣi Awọn agbegbe Ara

Wọn le ṣe abojuto ni ọpọlọpọ awọn agbegbe ti ara, pẹlu: (Ile-iwosan fun Iṣẹ abẹ Pataki. Ọdun 2023) (Stanford Oogun. Ọdun 2024)

• Ibẹrẹ
• oju
• ọrùn
• Egungun kola
• ejika
• Awọn ohun ija
• Back
• àyà
• Igigun
• Ipa
• Pelvis
• Akara
• ese
• kokosẹ
• ẹsẹ

Awọn igbelaruge ẹgbẹ

Awọn ilana wọnyi le ni eewu ti o pọju ti ibajẹ nafu ara ayeraye. (Orin BlueCross. Ọdun 2023) Awọn ara jẹ ifarabalẹ ati tun pada laiyara, nitorinaa aṣiṣe kekere le fa awọn ipa ẹgbẹ. (D O'Flaherty et al., Ọdun 2018) Awọn ipa ẹgbẹ ti o wọpọ pẹlu:

• Isan paralysis
• Weakness
• Loorekoore numbness
• Ni awọn iṣẹlẹ ti o ṣọwọn, bulọọki naa le binu nafu ara ki o fa irora ti o ṣafikun.
• Awọn oṣiṣẹ ilera ti o ni oye ati iwe-aṣẹ gẹgẹbi awọn oniṣẹ abẹ, awọn dokita iṣakoso irora, akuniloorun, ati awọn onísègùn ti ni ikẹkọ lati ṣe awọn ilana wọnyi ni pẹkipẹki.
• Nigbagbogbo eewu ti ibajẹ nafu tabi ipalara wa, ṣugbọn pupọ julọ awọn bulọọki nafu lailewu ati ni aṣeyọri dinku ati iranlọwọ lati ṣakoso irora onibaje. (Orin BlueCross. Ọdun 2023)

Kini lati Nireti

• Olukuluku le ni rilara numbness tabi ọgbẹ ati/tabi ṣe akiyesi pupa tabi ibinu nitosi tabi agbegbe agbegbe ti o jẹ igba diẹ.
• O tun le jẹ wiwu, eyiti o rọ nafu ara ati pe o nilo akoko lati ni ilọsiwaju. (Stanford Oogun. Ọdun 2024)
• A le beere lọwọ ẹni kọọkan lati sinmi fun iye akoko kan lẹhin ilana naa.
• Ti o da lori iru ilana, awọn eniyan kọọkan le ni lati lo awọn ọjọ diẹ ni ile-iwosan kan.
• Diẹ ninu awọn irora le tun wa, ṣugbọn eyi ko tumọ si ilana naa ko ṣiṣẹ.

Olukuluku yẹ ki o kan si alagbawo pẹlu olupese ilera kan nipa awọn ewu ati awọn anfani lati rii daju pe o tọ itọju.

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Sciatica, Awọn okunfa, Awọn aami aisan, ati Awọn imọran

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Johns Hopkins Oogun. (2024). Awọn bulọọki aifọkanbalẹ. (Ilera, Oro. www.hopkinsmedicine.org/health/conditions-and-diseases/nerve-blocks

NYU Langone Ilera. (2023). Ohun elo aifọkanbalẹ fun migraine (Ẹkọ ati Iwadi, Oro. nyulangone.org/conditions/migraine/treatments/nerve-block-for-migraine

National Institute of Neurological Disorders and Stroke. (2023). Irora. Ti gba pada lati www.ninds.nih.gov/health-information/disorders/pain#3084_9

Johns Hopkins Oogun. (2024). Itọju pancreatitis onibaje (Ilera, Ọrọ. www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-pancreatitis/chronic-pancreatitis-treatment

Cappellari, AM, Tiberio, F., Alicandro, G., Spagnoli, D., & Grimoldi, N. (2018). Intercostal Neurolysis fun Itoju ti Irora Thoracic Postsurgical: Apejọ Ọran kan. Isan & iṣan, 58 (5), 671-675. doi.org/10.1002/mus.26298

Choi, EJ, Choi, YM, Jang, EJ, Kim, JY, Kim, TK, & Kim, KH (2016). Ablation Neural ati Isọdọtun ni Iwa Irora. Iwe akọọlẹ Korean ti irora, 29 (1), 3-11. doi.org/10.3344/kjp.2016.29.1.3

Ile-iwosan fun Iṣẹ abẹ Pataki. (2023). Akuniloorun agbegbe. www.hss.edu/condition-list_regional-anesthesia.asp

Stanford Oogun. (2024). Awọn oriṣi ti awọn bulọọki nafu (Fun Awọn alaisan, Ọrọ. med.stanford.edu/ra-apm/for-patients/nerve-block-types.html

Orin BlueCross. (2023). Awọn bulọọki aifọkanbalẹ agbeegbe fun itọju ti irora neuropathic. ( Ilana Iṣoogun, Oro. www.anthem.com/dam/medpolicies/abc/active/policies/mp_pw_c181196.html

O'Flaherty, D., McCartney, CJL, & Ng, SC (2018). Ipalara nafu lẹhin idena nafu agbeegbe-oye lọwọlọwọ ati awọn itọnisọna. Ẹkọ BJA, 18 (12), 384-390. doi.org/10.1016/j.bjae.2018.09.004

Stanford Oogun. (2024). Awọn ibeere alaisan ti o wọpọ nipa awọn bulọọki nafu. (Fun Awọn alaisan, Oro. med.stanford.edu/ra-apm/for-patients/nerve-block-questions.html