II. DAU DAY THAN KINH GIAN SUON
1. Giai phau benh h<?c
Cac re than kinh khi rdi khoi tuy tao thanh nhieu bo sdi, dUdc bao boc bdi mang nhen, (noi tiep vdi mang mem). Cac nhom te bao bieu mo phu cac re th in kinh d cac doan noi, tao dieu kien thuan ldi cho cac qua trinh viem.
2. Trieu chiing
Khdi dau thudng dot ngot trong lu d ^ a n g sUc hoac chan thUdng. Bieu hien lam,, sang bang hoi chUng that lUng - hong (syndrom e lum bo - sciatique) gom 2
hoi chUng:
a. Hoi chiing cot song that ltfng:
- Trieu chUng chu quan.
+ Dau d cot song va canh song that lung do cac re than kinh that lung cung bi kich thich ngay tai re than kinh (phan nam trong ong) hoac nhanh quat n gU d c cua mang tuy (recurent meninge) chi phoi cho mang cUng phia trudc ong song va day ch&ng d phia sau. Dau cung co the xuat phat tU day ch&ng doc sau, mang x U d n g , gan
cd canh song, to chUc canh kh6p song hoac kh6p dot song. Can phan biet:
+ Dau til cac re than kinh thtfdng co khu tru ro rang, dau lan xuong chi dtfdi theo dai phan bo cam giac cua re than kinh do.
+ Dau ttf mang ctfng thtfdng khong dtf doi.
+ Dau ttf cac td chtfc co nguon goc cau true trung bi nhtf mang xtfdng, gan, to chtfc canh kh6p dot song, co tinh chat dau sau, e dm, khong khu tru.
+ Dau ttf day ch&ng doc sau thtfdng khu tru khong ro rang, dau co tinh chat e am, xuat hien dot ngot hoac l't dot ngot.
+ Dau d cac cd canh that ltfng thtfdng kem theo co ctfng cd canh song that ltfng mot ben hoac ca hai ben.
- Trieu chtfng khach quan:
Co diem dau cot song, diem dau canh song, co ctfng cd canh song that ltfng, bien dang cot song (tfdn, gu, veo), ttf the chong dau (dau hieu gap goc), mat dtfdng cong sinh ly cua cot song that ltfng, tam hoat dong cua cot song that ltfng bi han che (nghiem phap Schober,- do cong, do nghieng va do xoay cua cot song that ltfng bi giam).
Hinh 6.4: Thtfdc do va phtfdng phap do do cong cot song a) Thtfdc do do cua cot song d vi tri so 0