Dau than kinh toa Hau qua cua nhieu benh

Tags: dau than kinh, day than kinh, mat sau dui, viem cot song, ton thuong, that lung, dia dem, cang chan, benh nhan, thoat vi, xuong, mong, thang, hoat, nguoi


Than kinh toa con goi la than kinh hong to la day than kinh lon nhat co the di tu that lung mong xuong mat sau dui va cang chan. Benh dau than kinh toa gap o nam nhieu hon nu va thuong o lua tuoi tu 30-50. Ðau day than kinh toa do ton thuong re chiem 90-95%, so con lai la do ton thuong day va dam roi than kinh.


Nhung benh dan den dau than kinh toa

Cac nghien cuu cho thay co nhieu benh dan den dau than kinh toa, gom hai nhom: cac benh toan than va nhung ton thuong tai cho. Cac benh toan than gay dau than kinh toa thuong gap la: cum, thap tim, thuong han, sot ret, giang mai giai doan III, lau… Nhom benh tai cho dan den dau than kinh toa gom: thoat vi dia dem hay gap o nguoi tre, dang do tuoi lao dong, bi thoat vi dia dem cap tinh sau cac dong tac gang suc manh, khong dung tu the cua cot song nhu cui xuong nang vat nang sai tu the, cu dong dot ngot cua than...
 
Dau than kinh toa Hau qua cua nhieu benh
 Thoat vi dia dem gay chen ep than kinh - mot nguyen nhan gay dau than kinh toa.

Thoai hoa dia dem o nguoi cao tuoi gay dau that lung hong man tinh va tai phat. Ton thuong dia dem do vi chan thuong keo dai nhu tai xe lai xe duong dai, ngoi lai o tu the lech nguoi sang mot ben hay cui ra truoc trong thoi gian dai, khi do chi mot gang suc nhe cung co the gay thoat vi dia dem. Thoai hoa cot song that lung cung do loang xuong, nhuyen xuong, gai xuong, bien dang than dot song, gai xuong kem theo phi dai day chang, thoat vi dia dem.

Truot cot song la tinh trang dot song bi truot ra phia truoc hoac sau, do bam sinh hay chan thuong, ton thuong cac re than kinh, hep ong song that lung. Viem dot song, thuong gap o nguoi cao tuoi, gay chen ep cac re than kinh, hep ong song that lung… Viem cot song dinh khop: voi bieu hien dau that lung hong va mong, cung khop cot song vao buoi sang, khong do dau khi nghi.

Chan thuong truc tiep vao day than kinh toa, gay xuong cot song that lung, gay xuong chau, do tiem truc tiep vao day than kinh toa hay do tiem thuoc thuoc dang dau o mong lan toi day than kinh toa, phau thuat ap-xe mong. Cac khoi u: mang tuy, dot song, u than kinh, u di can tu cac ung thu bieu mo tuyen tien liet, vu, phoi, than, duong tieu hoa, benh da u tuy xuong, u lympho. Nhiem khuan cot song: viem cot song do tu cau, thuong gap sau cac nhiem khuan ngoai da, tiet nieu, phoi; viem cot song do lao, thu phat sau lao phoi; ap-xe ngoai mang cung…  

Bieu hien benh the nao?

Khoi dau dau day than kinh toa rat khac nhau tuy tung nguyen nhan. Nhin chung co nhung dau hieu sau:

Dau tu nhien, xuat phat tu that lung va lan xuong duoi chan, co khi chi xuong toi mong, toi dui hay xuong tan ban chan. Neu ton thuong that lung (L5) thi lan tu that lung xuong mong ra mat ngoai dui, mat truoc ngoai cang chan, truoc mat ca ngoai, mu ban chan, den ngon chan cai. Ton thuong that lung cung (S1) thi dau tu that lung lan xuong mong, mat sau dui, mat sau cang chan, got, long ban chan, bo ngoai ban chan den ngon ut. Thuong dau lien tuc, co khi co con boc phat, nhung cung co the giam hay het dau khi nam... Muc do dau rat thay doi tu dau am i cho toi dau du doi khong chiu duoc, dau tang len khi ho, hat hoi, co khi chi thay di cam ma khong thay dau.

Ðau khi tham kham: an dau o giua hay ben canh cot song tu duong giua ra 2cm ngang vung that lung L4, L5, S1. Dau khi an doc theo duong di cua day than kinh toa qua thong diem Valleix 2cm tu giua cot song ra ngang dot song L5, S1, giua lan mong, giua mat sau dui, hom khoeo chan, diem co xuong mac, diem bap chan va diem hom mat ca ngoai. Ðau do cang day than kinh, dau hieu Lasegue: benh nhan nam ngua, nang thang chan benh nhan tung ben mot len cao, neu chua toi 70° ma benh nhan keu dau o mat sau dui hay cang chan la duong tinh…
Dau than kinh toa Hau qua cua nhieu benh
Phan xa gan got cua benh nhan giam hay mat trong ton thuong re S1. Benh nhan khong di bang ngon duoc khi ton thuong S1, con ton thuong L5 thi khong di bang got duoc. Benh nhan bi teo co mac trong ton thuong L5, con ton thuong S1 thi teo co bap chan. Benh co the bieu hien cac the: the teo co nhanh con goi la the liet; the hoi chung duoi ngua, thuong do thoat vi dia dem chinh giua, ton thuong day chang gay liet mem hai chan, roi loan cam giac hai chan va vung yen ngua, kem bi tieu, tao bon, bat luc; the dau than kinh toa hai ben: dau xuong ca hai chan nhung khong roi loan co tron va khong roi loan cam giac vung yen ngua, co khi dau ben nay roi chuyen sang dau ben kia.

Xet nghiem: chup Xquang thay dia dem hep. Chup cat lop hay cong huong tu thay ro ton thuong nhieu loai va xac dinh duoc vi tri thoat vi.   

Cac phuong phap chua tri

Cac phuong phap dieu tri dau than kinh toa la: nghi ngoi tuyet doi, benh nhan phai nam giuong cung, tranh nam vong hay ngoi ghe dua. Tranh van dong manh nhu xoay nguoi dot ngot, chay nhay, cui gap nguoi... Vat ly tri lieu: keo gian cot song, nan cot song, the duc tri lieu, hong ngoai, song ngan, dap sap nen... Dung thuoc: giam dau, chong viem khong steroide, phong be re than kinh bang corticoid hay novocain ket hop voi vitamin B12. Thuoc gian co, an than, vitamin nhom B lieu cao ket hop voi acid folic. Dieu tri nguyen nhan nhu dung khang sinh chong nhiem khuan. Phau thuat cac truong hop: the liet, hoi chung duoi ngua, hep ong song that lung, dau khong the chiu duoc mac du da dung thuoc giam dau hoac hay tai phat.

Co the su dung mot trong nhung bai thuoc duoi day:

Bai thuoc: Can khuong thuong truat linh phu thang gia giam:

Can khuong 4g, thuong truat 8g, bach linh 12g, cam thao 4g, duong quy 12g, xuyen khung 8g, bach chi 12g, phu tu che 4g. Sac uong ngay mot thang.

The thap nhiet: Dau buot tu mong xuong got chan, co diem dau, dau nhuc nhu kim cham, co sot, reu luoi vang, mach sac.

Phap dieu tri: Thanh nhiet, tru thap, hanh khi, hoat huyet.

Bai thuoc: Y di nhan thang + nhi dieu thang gia giam:

Khuong hoat 8g, doc hoat 8g, phong phong 8g, y di 12g, duong quy 12g, cam thao 4g, nguu tat 12g, thuong truat 8g, hoang ba 8g. Sac uong ngay mot thang.

The huyet u: Dau tu mong den got chan, dau du doi o mot diem, dot ngot lan xuong hai chan

Phap dieu tri: Tan u, hanh khi, hoat huyet.

Bai thuoc: Tu vat dao hong gia giam:

Sinh dia 12g, xich thuoc 8g, xuyen khung 8g, duong quy 12g, dao nhan 8g, hong hoa 4g. Sac uong ngay mot thang.

The can than am hu: Dau am i ngang that lung lan xuong mong, chan, lung dau nhieu, hoa mat chong mat, nguoi met moi, an ngu kem, mach tram nhuoc.

Phap dieu tri: Khu phong, tru thap, bo can than, kien ty, thong kinh lac.

Bai thuoc: Doc hoat tang ky sinh gia giam:

Doc hoat 8g, phong phong 8g, tang ky sinh 12g, te tan 4g, tan giao 12g, que chi 4g, sinh dia 8g, bach thuoc 12g, xuyen khung 8g, duong quy 12g, dang sam 12g, phuc linh 12g, cam thao 4g, nguu tat 12g, do trong 10g. Sac uong ngay mot thang.

Tap luyen phuc hoi sinh ly cot song va chi bi benh:

Phuong phap 5 diem nhu sau: nguoi benh nam ngua tren giuong, dung 5 diem ty xuong mat giuong la dau, hai khuyu tay va hai got chan, uon cong lung len khoi mat giuong. Moi ngay tap 1-2 lan, nang, moi lan nang ha khoang 50 den 100 cai trong khoang 15-30 phut.

Phuong phap 3 diem: Khi tap bai 5 diem da quen, khoi co lung khoe hon, nen su dung 3 diem: dau va hai got chan lam diem ty va tap nhu tren.

Phuong phap tap xa don: nguoi benh can tao mot cho bam chac chan nhu xa don. Du nguoi va keo xa ra sau gay, lung uon cong. Tuy dieu kien va suc khoe de dieu chinh thoi gian va cuong do tap phu hop.

Mot vai dong tac khac nhu: di thut lui o duong phang va khieu vu co the giup tang cuong suc khoi co canh song, giam chen ep re than kinh va phuc hoi chuc nang cot song.

Dung thuoc:

Tuy thuoc vao nguyen nhan gay benh ma co cac bai thuoc phu hop nhu sau:

- Dau than kinh toa do sang chan voi cac trieu chung dau ngang that lung, lan xuong mong hoac sau dui, xuong phia sau hoac truoc ngoai cang chan. Nen dung bai thuoc gom: to moc 12 g, huyet giac 12 g, nghe cu 8 g, ngai cuu 12 g, la mong tay 12 g, nguu tat 12 g, sac uong ngay 1 thang trong 7-10 ngay. Bai thuoc nham hoat huyet, tieu u va giam dau.

- Dau than kinh toa do lanh: ngoai cac trieu chung dau nhu tren, benh con dau tang khi bi am, lanh, neu duoc chuom am se thay de chiu. Nen cung bai thuoc nam: re la lot 12 g, ray son thuc 12 g, cau tich 16 g, que chi 8 g, ngai cuu 8 g, vo quyt 8 g, re co xuoc 12 g, re cay kien co 8 g; sac uong ngay 1 thang. Phuong phap nay giup khu phong tan han, hanh khi hoat huyet.

Neu o the man tinh (ket hop cac nguyen nhan phong, han, thap) nen dung bai Doc hoat tang ky sinh co tac dung khu phong tan han, tru thap, bo can than va thong kinh hoat lac. Bai thuoc gom: doc hoat 4 g, tang ky sinh 4 g, te tan 2 g, tan giao 4 g, phong phong 4 g, nguu tat 4 g, que tam 2 g, do trong 8 g, dang sam 8 g, phuc linh 8 g, cam thao 2 g, sinh dia 12 g, bach thuoc 8 g, xuyen khung 4 g, duong quy 8 g. Sac uong ngay 1 thang, dung tu 20 den 50 thang. Luu y la uong lien tuc 10 thang va nghi vai ngay truoc khi tiep tuc.

Ngoai ra, dau than kinh toa con co the duoc dieu tri bang cach ket hop Dong - Tay y nhu cac thuoc giam dau, chong viem, vitamin (B1, B6, B12), thuy cham vao huyet...

Can luu y la nguoi benh khong nen boi loi de tranh nhiem lanh, am, anh huong xau den viec chua tri. Nen nam nghi ngoi tren giuong cung, tranh lam nang hoac van dong nhieu trong nhung dot dau cap (dau nhieu).
Viet Bao (Tong hop )
Tìm hiểu: dau than kinh, day than kinh, mat sau dui, viem cot song, ton thuong, that lung, dia dem, cang chan, benh nhan, thoat vi, xuong, mong, thang, hoat, nguoi

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