(PLEXITE)
1. T rie u ch iln g
a. Thiidng ton than nhat tren (C5 - C6):
Hoi chilng Duchenne - Erb
b. Thiidng ton than nhat giiia (C7)
Hoi chilng Remark
c. Thiidng ton than nhat diidi (C8 - D I)
Hoi chilng Aran - Duchenne
d. Thiidng ton than nhi
4. Dieu tri
Dieu tri: theo nguyen nhan. - Dieu tri trieu chiing:
Thuoc giam dau Vitamin nhom B.
Dien phan novocain cot song cd
Quang tuyen lieu phap lieu nho d vung cot song co: Dung trong triidng hdp nang.
C. VIEM DAM ROI THAN KINH CANH TAY(PLEXITE) (PLEXITE)
1. Trieu chtfng
a. Thiidng ton than nhat tren (C5 - C6):
Hoi chiing Duchenne - Erb
b. Thiidng ton than nhat giiia (C7)
Hoi chiing Remark
c. Thiidng ton than nhat diidi (C8 - D I)
Hoi chiing Aran - Duchenne
d. Thiidng ton than nhi
- Thiidng ton than nhi trtfdc ngoai:
Hinh 3.6: Benh nhan T hoi chiing Aran - Duchenne do hufdot song co (thay ro teo co ban tay).
Liet cac cd nhi dau, cd canh tay t'-tfdc (do day than kinh cd bi chi phoi). Liet cd sap tron, cd gan tay ldn va cd gap ngon cai) do re ngoai cua day than kinh giiia chi phoi
- Thtfdng ton than nhi trtfdc trong:
+ Van dong: liet cac cd gap ban tay va cac cd gap ngon tay: bieu hien thtfdng ton d day than kinh gitfa va tru.
+ Cam giac: mat cam giac d mat trong canh tay va cang tay.
Thtfdng ton than nhi sau: con goi la ton thtfdng than quay - mu:
+ Van dong: liet cd tam dau, cac cd duoi ban tay va ngon tay, cd ngtfa dai va cd delta.
+ Phan xa: giam phan xa gan cd delta, cd tam dau va phan xa tram quay.
+ Cam giac: roi loan cam giac vung mom gai, mat sau c&ng tay va niia ngoai mu ban tay.
d. ThtfOng ton toan bo dam roi than kinh canh tay
- Van dong: liet hoan toan chi tren (trti mom cung vai van con nhac len dtfdc nhd cd thang).
- Phan xa: mat phan xa gan cd delta, nhi dau va phan xa tram quay
- Cam giac: mat cam giac d canh tay, cang tay va ban tay.
Dinh dtfdng: teo cd gian cot, cd mo cai, mo lit.
Neu thtfdng ton kich thich lien tuc, keo dai, dam roi than kinh canh tay se lam cho ban tay bi co quap do cac cd, gan va bao cd co rut lai.
2. Nguyen nhan thifdng ton dam roi than kinhcanh tay canh tay
- Viem dam roi than kinh canh tay
Chan thtfdng vung vai va tren xtfdng don hoac gay xtfOng don co the din den thtfdng ton dam roi TK canh tay.
Liet thtf phat sau can thiep phau thuat: chi tren de
co dinh d ttf the giang va xoay ngoai qua mtfc.
Vet thtfdng xuyen do dan d vung dtfdi don va nach. - Viem dot song cd (thtfdng do lao)
- Htf khdp dot song co
Thoat vi dla dem cot song co.
U d vung mom ngang dot song co va xtfdng stfdn thtf nhat hay xtfdng don, cung co the lam thtfdng ton cac re than kinh hay cac than nhat. Cac u ac tmh co the la tien phat hay di can.
U tuy co Xtfdng stfdn cd
- Hep khe cd bac thang hoac hep khe stfdn - ddn. 3. D ieu tri
Tuy theo nguyen nhan thtfdng ton re, dam roi hoac day than kinh song cd de dieu tri.
Dung thuoc giam dau, chong viem (corticoid), gian cd vitamin nhom B va lieu phap nivalin kem theo tap luyen.
Trtfdng hdp co hoi chtfng stfdn co khi da co bien chtfng chen ep than kinh phai dieu tri bang phau thuat.