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胸肋部常見疾病與健康護理

醫用護理

胸肋部常見疾病與健康護理

2020-09-17

1、肋(lei)骨的構(gou)造與功(gong)能:

  人體的肋(lei)(lei)(lei)骨(gu)(gu)共有(you)12對(dui),左(zuo)右對(dui)稱(cheng),平分(fen)于(yu)胸(xiong)(xiong)(xiong)(xiong)(xiong)部兩側(ce)。上端(duan)第(di)1~7肋(lei)(lei)(lei)借助于(yu)軟(ruan)(ruan)骨(gu)(gu),與(yu)胸(xiong)(xiong)(xiong)(xiong)(xiong)骨(gu)(gu)相(xiang)(xiang)連接,稱(cheng)為真肋(lei)(lei)(lei)。第(di)8~12肋(lei)(lei)(lei)稱(cheng)為假(jia)肋(lei)(lei)(lei),其中,第(di)8~10肋(lei)(lei)(lei)借肋(lei)(lei)(lei)于(yu)軟(ruan)(ruan)骨(gu)(gu),與(yu)上一肋(lei)(lei)(lei)的軟(ruan)(ruan)骨(gu)(gu)相(xiang)(xiang)連,形(xing)成(cheng)(cheng)肋(lei)(lei)(lei)弓(gong),而第(di)11、12肋(lei)(lei)(lei)前端(duan)游離(li),又稱(cheng)浮肋(lei)(lei)(lei)。肋(lei)(lei)(lei)骨(gu)(gu)前與(yu)胸(xiong)(xiong)(xiong)(xiong)(xiong)骨(gu)(gu)、后(hou)與(yu)胸(xiong)(xiong)(xiong)(xiong)(xiong)椎(zhui)相(xiang)(xiang)連,構成(cheng)(cheng)整個胸(xiong)(xiong)(xiong)(xiong)(xiong)腔的框架,具有(you)維持人體正常(chang)形(xing)態(tai),保護肺、心臟、肝(gan)臟等內部器(qi)官,幫助肺部呼(hu)吸的功能(neng)。肋(lei)(lei)(lei)骨(gu)(gu)后(hou)端(duan)稍膨(peng)大,稱(cheng)為肋(lei)(lei)(lei)頭(tou)(tou),有(you)關(guan)(guan)節面(mian)與(yu)胸(xiong)(xiong)(xiong)(xiong)(xiong)椎(zhui)體的肋(lei)(lei)(lei)凹形(xing)成(cheng)(cheng)肋(lei)(lei)(lei)頭(tou)(tou)關(guan)(guan)節。從肋(lei)(lei)(lei)頭(tou)(tou)向(xiang)(xiang)后(hou)外變細,稱(cheng)為肋(lei)(lei)(lei)頸,再(zai)向(xiang)(xiang)外變扁成(cheng)(cheng)肋(lei)(lei)(lei)體。頸與(yu)體的結合處的后(hou)面(mian)突(tu)起稱(cheng)為肋(lei)(lei)(lei)結節,有(you)關(guan)(guan)節面(mian)與(yu)胸(xiong)(xiong)(xiong)(xiong)(xiong)椎(zhui)橫突(tu)肋(lei)(lei)(lei)凹形(xing)成(cheng)(cheng)肋(lei)(lei)(lei)橫突(tu)關(guan)(guan)節。

1-1

  肋體(ti)向外(wai)轉為向前(qian)的(de)轉彎(wan)(wan)處(chu)稱為肋角(jiao)(jiao),肋體(ti)下(xia)緣內面(mian)(mian)有容神經(jing)血管經(jing)過的(de)肋溝。肋體(ti)前(qian)端(duan)粗糙,接(jie)透明肋軟(ruan)骨(gu)(gu)(gu)(gu),與(yu)胸骨(gu)(gu)(gu)(gu)側緣相關節(jie)(jie)。第(di)1肋骨(gu)(gu)(gu)(gu)短(duan)小而彎(wan)(wan)曲,頭和頸(jing)稍(shao)低于肋體(ti),肋體(ti)呈扁狀(zhuang),可分為上(shang)、下(xia)兩面(mian)(mian)和內、外(wai)兩緣。上(shang)面(mian)(mian)內緣處(chu)有前(qian)斜角(jiao)(jiao)肌附著形成的(de)前(qian)斜角(jiao)(jiao)肌結節(jie)(jie),結節(jie)(jie)的(de)前(qian)、后方各有淺溝,是鎖骨(gu)(gu)(gu)(gu)下(xia)靜(jing)脈和鎖骨(gu)(gu)(gu)(gu)下(xia)動脈的(de)壓跡(ji)。下(xia)面(mian)(mian)無(wu)肋溝,前(qian)端(duan)借肋軟(ruan)骨(gu)(gu)(gu)(gu)直接(jie)與(yu)胸骨(gu)(gu)(gu)(gu)相結合(he)。第(di)2肋比第(di)1肋稍(shao)長,更(geng)近似于一般肋骨(gu)(gu)(gu)(gu)。第(di)11、12肋無(wu)肋結節(jie)(jie)、肋頸(jing)及肋角(jiao)(jiao),肋體(ti)直而短(duan),末端(duan)鈍圓(yuan),肋軟(ruan)骨(gu)(gu)(gu)(gu)終身(shen)不骨(gu)(gu)(gu)(gu)化。

  肋(lei)骨也是眾(zhong)多重要肌(ji)(ji)(ji)(ji)肉的附著點,如胸(xiong)鎖乳突(tu)肌(ji)(ji)(ji)(ji)、前(qian)斜(xie)角肌(ji)(ji)(ji)(ji)、中斜(xie)角肌(ji)(ji)(ji)(ji)、后(hou)斜(xie)角肌(ji)(ji)(ji)(ji)、前(qian)踞(ju)肌(ji)(ji)(ji)(ji)、上后(hou)踞(ju)肌(ji)(ji)(ji)(ji)、下后(hou)踞(ju)肌(ji)(ji)(ji)(ji)、肋(lei)間肌(ji)(ji)(ji)(ji)、豎脊(ji)肌(ji)(ji)(ji)(ji)、胸(xiong)小肌(ji)(ji)(ji)(ji)、胸(xiong)大(da)肌(ji)(ji)(ji)(ji)、腹直肌(ji)(ji)(ji)(ji)、腹斜(xie)肌(ji)(ji)(ji)(ji)、腰方肌(ji)(ji)(ji)(ji)等,同時可以(yi)參與正(zheng)常的呼(hu)吸協助運動。

  胸神經(jing)(jing)前(qian)支(zhi)(zhi)共12對,第1~11對胸神經(jing)(jing)前(qian)支(zhi)(zhi)位于(yu)(yu)相(xiang)應的肋間隙(xi)中,稱(cheng)肋間神經(jing)(jing)(intercostalnerve),第12對胸神經(jing)(jing)前(qian)支(zhi)(zhi)位于(yu)(yu)第12肋下緣,稱(cheng)肋下神經(jing)(jing)(subcostalnerve)。其中,下6對胸神經(jing)(jing)前(qian)支(zhi)(zhi)除(chu)支(zhi)(zhi)配相(xiang)應的肋間肌及皮膚外,還支(zhi)(zhi)配腹前(qian)、外側壁的肌肉和皮膚。

 
2、胸肋部(bu)傷病的種類、原因、癥狀及治(zhi)療(liao)方法:

  肋骨(gu)依靠強勁(jing)的(de)(de)(de)韌帶組織和彈性良好的(de)(de)(de)肋軟骨(gu)將(jiang)后方(fang)12塊胸(xiong)椎(zhui)骨(gu)和前方(fang)的(de)(de)(de)胸(xiong)骨(gu)連為一體(ti),形(xing)成(cheng)穩固的(de)(de)(de)筒狀(zhuang)胸(xiong)廓(kuo),具有維持人體(ti)正常形(xing)態,保護(hu)心、肺、肝臟等(deng)內部(bu)器官,協助肺部(bu)呼吸等(deng)重要功能(neng)。因其位(wei)置(zhi)特殊,形(xing)狀(zhuang)扁小,又是(shi)眾多肌肉的(de)(de)(de)附(fu)著點,因此,肋部(bu)也是(shi)急(ji)性損(sun)(sun)傷和慢性勞損(sun)(sun)的(de)(de)(de)易發部(bu)位(wei)。

(1)、肋(lei)骨骨折 

  人體(ti)的(de)肋(lei)(lei)(lei)(lei)骨(gu)(gu)(gu)是一(yi)種弧形小骨(gu)(gu)(gu),屬扁骨(gu)(gu)(gu),共12對,左右(you)對稱(cheng)。其(qi)后端與(yu)(yu)胸椎相關節(jie),前(qian)端僅第(di)1-7肋(lei)(lei)(lei)(lei)借軟骨(gu)(gu)(gu)與(yu)(yu)胸骨(gu)(gu)(gu)相連(lian)接,稱(cheng)為(wei)真肋(lei)(lei)(lei)(lei)。第(di)8-12肋(lei)(lei)(lei)(lei)稱(cheng)為(wei)假肋(lei)(lei)(lei)(lei),其(qi)中第(di)8-10肋(lei)(lei)(lei)(lei)借肋(lei)(lei)(lei)(lei)軟骨(gu)(gu)(gu)與(yu)(yu)上一(yi)肋(lei)(lei)(lei)(lei)的(de)軟骨(gu)(gu)(gu)相連(lian),形成肋(lei)(lei)(lei)(lei)弓(gong)。第(di)11、12肋(lei)(lei)(lei)(lei)前(qian)端游離,又稱(cheng)浮肋(lei)(lei)(lei)(lei)。

  肋骨(gu)(gu)(gu)是胸(xiong)廓的(de)主(zhu)要框架(jia),保護肺(fei)、心臟(zang)、肝臟(zang)等胸(xiong)腔臟(zang)器(qi),參加(jia)正常的(de)呼吸(xi)運(yun)動。胸(xiong)肋部(bu)在(zai)直接(jie)暴力的(de)作用下,如打(da)擊(ji)、角抵、沖撞、跌倒、墜落、壓(ya)軋等,首先(xian)極易發(fa)生(sheng)的(de)是肋骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe),約(yue)占胸(xiong)廓骨(gu)(gu)(gu)折(zhe)的(de)90%。劇烈咳嗽(sou)或打(da)噴嚏等致使胸(xiong)部(bu)肌肉突然強力收縮,也可(ke)引起(qi)自發(fa)性肋骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe),多發(fa)生(sheng)在(zai)腋窩部(bu)的(de)第(di)6~9肋。其中,骨(gu)(gu)(gu)質疏松者更為多見(jian),屬于(yu)肋骨(gu)(gu)(gu)疲勞(lao)性骨(gu)(gu)(gu)折(zhe)者居多。當(dang)肋骨(gu)(gu)(gu)本身有如原(yuan)發(fa)性腫瘤(liu)(liu)或轉移瘤(liu)(liu)等病變時(shi),在(zai)很輕的(de)外(wai)(wai)力或沒有外(wai)(wai)力的(de)作用下,亦可(ke)發(fa)生(sheng)病理性肋骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe)。

2-1

  肋(lei)骨骨折(zhe)根據皮膚是否(fou)完整,可(ke)分為(wei)閉合性骨折(zhe)和(he)開放性骨折(zhe)。由于作用(yong)力的(de)(de)方向(xiang)不(bu)同(tong),肋(lei)骨可(ke)向(xiang)內或(huo)向(xiang)外折(zhe)斷(duan)轉位。肋(lei)骨骨折(zhe)多發(fa)生在第(di)4~7肋(lei)。第(di)1~3肋(lei)有(you)鎖骨、肩(jian)胛骨及肩(jian)帶(dai)肌(ji)群的(de)(de)保護,因而不(bu)易傷折(zhe)。第(di)8~10肋(lei)漸次變短,且連接于軟骨肋(lei)弓上,有(you)彈性緩沖(chong),骨折(zhe)的(de)(de)機會相應減少。第(di)11和(he)12肋(lei)為(wei)浮肋(lei),活(huo)動度(du)較(jiao)大,極少骨折(zhe)。然而,當(dang)暴(bao)力強大時,任(ren)何肋(lei)骨都有(you)可(ke)能發(fa)生骨折(zhe)。

  依據外力(li)作用的不同,可出現不完(wan)全骨(gu)(gu)(gu)折(zhe)、單(dan)純性骨(gu)(gu)(gu)折(zhe)、復雜性骨(gu)(gu)(gu)折(zhe)或(huo)粉碎性骨(gu)(gu)(gu)折(zhe)。肋(lei)(lei)(lei)骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe)可以(yi)同時發生在雙側胸部。每肋(lei)(lei)(lei)僅一(yi)處(chu)(chu)折(zhe)斷(duan)者稱為(wei)單(dan)處(chu)(chu)骨(gu)(gu)(gu)折(zhe),有兩處(chu)(chu)以(yi)上折(zhe)斷(duan)者稱為(wei)雙處(chu)(chu)或(huo)多(duo)(duo)處(chu)(chu)骨(gu)(gu)(gu)折(zhe)。序(xu)列性多(duo)(duo)根多(duo)(duo)處(chu)(chu)肋(lei)(lei)(lei)骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe)或(huo)多(duo)(duo)根肋(lei)(lei)(lei)骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe)合并多(duo)(duo)根肋(lei)(lei)(lei)軟骨(gu)(gu)(gu)骨(gu)(gu)(gu)骺脫離,或(huo)雙側多(duo)(duo)根肋(lei)(lei)(lei)軟骨(gu)(gu)(gu)骨(gu)(gu)(gu)折(zhe)或(huo)骨(gu)(gu)(gu)骺脫離,則造成胸壁軟化,稱為(wei)胸壁浮動(dong)傷,又稱為(wei)連枷(jia)胸。

  肋(lei)骨骨折很明顯的(de)(de)(de)癥狀是局部(bu)疼(teng)痛,在(zai)深呼(hu)(hu)(hu)吸(xi)、咳嗽或轉(zhuan)動(dong)體位(wei)時(shi)尤(you)為明顯,有時(shi)也伴有呼(hu)(hu)(hu)吸(xi)困難。另外,還有諸如局部(bu)腫脹,呼(hu)(hu)(hu)吸(xi)淺快,不敢(gan)咳嗽、有壓(ya)痛感(gan)等。任意部(bu)位(wei)對(dui)(dui)稱擠壓(ya)胸(xiong)廓(kuo)時(shi),均可(ke)產(chan)生(sheng)傳導性疼(teng)痛。用手在(zai)骨折部(bu)位(wei)的(de)(de)(de)前后胸(xiong)處(chu)(chu)相(xiang)對(dui)(dui)擠壓(ya)時(shi),可(ke)以聽到骨折處(chu)(chu)發出(chu)明顯的(de)(de)(de)骨擦音。若(ruo)骨折后的(de)(de)(de)骨質尖銳(rui)部(bu)刺(ci)傷(shang)胸(xiong)膜或肋(lei)間(jian)動(dong)脈(mo)等胸(xiong)內大(da)血管,則(ze)會出(chu)現血胸(xiong)或氣胸(xiong)等。當外力打(da)擊巨大(da)、相(xiang)鄰的(de)(de)(de)幾根(gen)肋(lei)骨同時(shi)兩處(chu)(chu)以上骨折時(shi),則(ze)極易造(zao)成連(lian)枷胸(xiong),產(chan)生(sheng)呼(hu)(hu)(hu)吸(xi)窘迫綜(zong)合(he)征,嚴重影響呼(hu)(hu)(hu)吸(xi)和循(xun)環功(gong)能,甚至損傷(shang)臟器,造(zao)成肺部(bu)感(gan)染,導致(zhi)死亡的(de)(de)(de)發生(sheng)。

  骨脆(cui)性(xing)隨年齡增(zeng)長而增(zeng)加,所以(yi)肋(lei)骨骨折一般多發(fa)(fa)生(sheng)于中(zhong)老(lao)年人群(qun),尤其是骨質疏松人群(qun),而兒童則較(jiao)少發(fa)(fa)生(sheng)肋(lei)骨骨折。肋(lei)骨骨折后應及(ji)時(shi)就診。若為自(zi)發(fa)(fa)性(xing)骨裂或(huo)(huo)單(dan)純性(xing)肋(lei)骨骨折等(deng)癥(zheng)狀(zhuang)較(jiao)輕者,通(tong)過(guo)護(hu)具固定、冷敷、理療(liao)、口服(fu)或(huo)(huo)注射消炎止痛藥物、外敷止痛藥貼、手法(fa)(fa)按(an)摩(mo)等(deng)保守療(liao)法(fa)(fa),可獲(huo)得良好的康復(fu)(fu)效果。若為開(kai)放性(xing)、復(fu)(fu)雜性(xing)或(huo)(huo)粉碎性(xing)等(deng)骨折嚴重(zhong)者,則需進行清(qing)創、鎮痛、清(qing)理呼吸道(dao)分泌物、固定胸廓、恢(hui)復(fu)(fu)胸壁功能等(deng)急(ji)救(jiu)治療(liao),以(yi)免造成血胸或(huo)(huo)氣胸、連枷(jia)胸或(huo)(huo)感染肺部,引(yin)發(fa)(fa)其它并發(fa)(fa)癥(zheng),甚(shen)至危及(ji)生(sheng)命。

  肋(lei)骨(gu)骨(gu)折時(shi),為(wei)配合保(bao)守療(liao)法或手術等常規性治療(liao),應持續使用(yong)專業設(she)計的(de)肋(lei)骨(gu)固(gu)定(ding)(ding)帶或胸(xiong)部固(gu)定(ding)(ding)帶等醫用(yong)護具,通過對肋(lei)部的(de)施壓與固(gu)定(ding)(ding),增強胸(xiong)腔壓力,穩(wen)定(ding)(ding)骨(gu)折后(hou)胸(xiong)廓的(de)生物力學(xue)構造,提(ti)高(gao)患部的(de)穩(wen)定(ding)(ding)性,減輕疼痛感,確保(bao)受損的(de)骨(gu)骼和韌帶、筋膜、軟(ruan)骨(gu)、神經等軟(ruan)組(zu)織處于(yu)相(xiang)對安(an)全的(de)靜養狀態,視其恢復程度,逐步(bu)進行功(gong)能性鍛(duan)煉(lian)。若因骨(gu)質疏松導致的(de)肋(lei)骨(gu)疲勞性骨(gu)折,則應同時(shi)注意(yi)補充鈣和維生素D,可(ke)有效提(ti)高(gao)骨(gu)折后(hou)的(de)康復護理效果。

(2)、肋軟骨炎

  肋(lei)(lei)軟(ruan)骨(gu)(gu)位于肋(lei)(lei)的(de)(de)腹側,由透明軟(ruan)骨(gu)(gu)構成。第(di)1~7肋(lei)(lei)的(de)(de)肋(lei)(lei)軟(ruan)骨(gu)(gu)直接(jie)與(yu)胸(xiong)骨(gu)(gu)相(xiang)連(lian),第(di)8~10肋(lei)(lei)的(de)(de)肋(lei)(lei)軟(ruan)骨(gu)(gu)通過肋(lei)(lei)弓與(yu)上一肋(lei)(lei)的(de)(de)軟(ruan)骨(gu)(gu)相(xiang)連(lian)。第(di)11、12肋(lei)(lei)的(de)(de)前(qian)端無(wu)連(lian)接(jie),呈游離狀(zhuang)。肋(lei)(lei)的(de)(de)軟(ruan)骨(gu)(gu)部(bu)分在硬(ying)骨(gu)(gu)前(qian)端與(yu)胸(xiong)骨(gu)(gu)連(lian)接(jie),參與(yu)胸(xiong)廓的(de)(de)組成,起到軟(ruan)連(lian)接(jie)的(de)(de)作用,可增加(jia)胸(xiong)廓的(de)(de)良好彈性。

  肋(lei)軟(ruan)(ruan)骨(gu)炎是指發生(sheng)在(zai)肋(lei)軟(ruan)(ruan)骨(gu)部(bu)位的(de)慢性非(fei)特異性炎癥,又稱前胸(xiong)(xiong)壁綜合征、非(fei)化膿性肋(lei)軟(ruan)(ruan)骨(gu)炎、肋(lei)軟(ruan)(ruan)骨(gu)增生(sheng)病等(deng)(deng)。其(qi)病因(yin)一般與勞損(sun)(sun)、精(jing)神緊(jin)張、壓(ya)力增大、情緒抑郁或(huo)外傷有關。肋(lei)軟(ruan)(ruan)骨(gu)炎與搬運重物、急(ji)劇扭轉(zhuan)或(huo)胸(xiong)(xiong)部(bu)受(shou)擠壓(ya)所導致的(de)胸(xiong)(xiong)肋(lei)關節軟(ruan)(ruan)骨(gu)急(ji)性損(sun)(sun)傷,或(huo)因(yin)慢性勞損(sun)(sun)、傷風感冒所引(yin)起(qi)的(de)病毒感染等(deng)(deng)密切相關。其(qi)基本(ben)病理改變則表現為胸(xiong)(xiong)肋(lei)關節面(mian)軟(ruan)(ruan)骨(gu)水腫、增厚的(de)無菌性炎癥反應(ying)。

2-2

  肋(lei)軟(ruan)(ruan)骨(gu)(gu)(gu)(gu)炎的病變部(bu)(bu)位(wei)多在胸前(qian)第(di)(di)2~5肋(lei)軟(ruan)(ruan)骨(gu)(gu)(gu)(gu)處,以第(di)(di)2、3肋(lei)軟(ruan)(ruan)骨(gu)(gu)(gu)(gu)較為常見,也可侵犯胸骨(gu)(gu)(gu)(gu)柄、鎖骨(gu)(gu)(gu)(gu)內側(ce)和(he)前(qian)下諸肋(lei)軟(ruan)(ruan)骨(gu)(gu)(gu)(gu)。其主要(yao)癥狀表現為受累肋(lei)軟(ruan)(ruan)骨(gu)(gu)(gu)(gu)處自感胸部(bu)(bu)鈍痛(tong)(tong)或(huo)(huo)(huo)銳(rui)痛(tong)(tong),有(you)壓痛(tong)(tong)和(he)腫(zhong)(zhong)大(da)隆(long)起。深(shen)吸(xi)氣、咳嗽(sou)或(huo)(huo)(huo)活(huo)(huo)動(dong)患側(ce)上肢時疼痛(tong)(tong)加劇,有(you)時向肩部(bu)(bu)或(huo)(huo)(huo)背(bei)部(bu)(bu)擴散(san),甚(shen)(shen)至(zhi)不(bu)能舉(ju)臂,但局(ju)部(bu)(bu)皮膚無改變。疼痛(tong)(tong)輕重程度不(bu)等,往往遷延不(bu)愈,影響日(ri)常活(huo)(huo)動(dong)。疼痛(tong)(tong)消失(shi)后(hou),腫(zhong)(zhong)大(da)的肋(lei)軟(ruan)(ruan)骨(gu)(gu)(gu)(gu)甚(shen)(shen)至(zhi)可持(chi)續數月(yue)或(huo)(huo)(huo)數年之久。發病有(you)急有(you)緩,在不(bu)知不(bu)覺中使肋(lei)骨(gu)(gu)(gu)(gu)與肋(lei)軟(ruan)(ruan)骨(gu)(gu)(gu)(gu)交界處呈弓狀,伴(ban)有(you)腫(zhong)(zhong)脹、鈍痛(tong)(tong),有(you)時放射至(zhi)肩背(bei)部(bu)(bu)、腋部(bu)(bu)、頸胸部(bu)(bu),深(shen)呼吸(xi)、咳嗽(sou)、平臥、挺胸與疲(pi)勞后(hou)則疼痛(tong)(tong)加重。

  肋軟(ruan)骨(gu)(gu)(gu)炎(yan)是前胸部(bu)(bu)(bu)疼(teng)痛較為常見的(de)原因。因其疼(teng)痛部(bu)(bu)(bu)位在(zai)前胸,容易與心絞痛相混淆。肋軟(ruan)骨(gu)(gu)(gu)炎(yan)好發于(yu)20~30歲的(de)女性人群,男女比例(li)大約(yue)為1:9。一般情況(kuang)下,肋軟(ruan)骨(gu)(gu)(gu)炎(yan)通(tong)過(guo)保(bao)守治(zhi)(zhi)療(liao)便可治(zhi)(zhi)愈(yu)。發病疼(teng)痛期間應(ying)注(zhu)(zhu)意休息(xi),減(jian)少(shao)活動,在(zai)通(tong)過(guo)口服藥物(wu)或注(zhu)(zhu)射、理(li)療(liao)等方(fang)法予以(yi)治(zhi)(zhi)療(liao)的(de)同(tong)時,應(ying)使用專業設(she)計(ji)的(de)胸部(bu)(bu)(bu)固(gu)定(ding)帶、肋骨(gu)(gu)(gu)固(gu)定(ding)帶等醫用護(hu)具,通(tong)過(guo)物(wu)理(li)施壓(ya)與固(gu)定(ding),增強胸腔壓(ya)力,穩定(ding)患部(bu)(bu)(bu)的(de)生物(wu)力學結(jie)構,可減(jian)輕因炎(yan)癥帶來的(de)疼(teng)痛感,有(you)效提高康復護(hu)理(li)效果。

(3)、肋間神經痛

  脊神(shen)(shen)經(jing)(jing)共(gong)有31對,其中由脊髓胸(xiong)段發(fa)出的(de)(de)(de)胸(xiong)神(shen)(shen)經(jing)(jing)共(gong)12對。胸(xiong)神(shen)(shen)經(jing)(jing)的(de)(de)(de)前(qian)根屬(shu)(shu)運(yun)動(dong)性,后根屬(shu)(shu)感覺性,均相連于脊髓兩(liang)側,在椎間(jian)孔(kong)處合為一條(tiao)極短的(de)(de)(de)脊神(shen)(shen)經(jing)(jing)干(gan),感覺和(he)(he)運(yun)動(dong)纖(xian)維(wei)在干(gan)中混合。神(shen)(shen)經(jing)(jing)干(gan)均從同序(xu)數椎骨下方的(de)(de)(de)椎間(jian)孔(kong)穿(chuan)出,穿(chuan)出后即刻分為前(qian)支、后支、脊膜(mo)支和(he)(he)交通支。肋間(jian)神(shen)(shen)經(jing)(jing)即歸屬(shu)(shu)于前(qian)支的(de)(de)(de)大部分神(shen)(shen)經(jing)(jing)。

  胸(xiong)(xiong)(xiong)(xiong)神(shen)經后(hou)支(zhi)(zhi)(zhi)(zhi)(zhi)較(jiao)細,經相鄰(lin)椎骨(gu)橫突之間(jian)(jian)向后(hou)行(xing)走(zou),有(you)(you)肌(ji)支(zhi)(zhi)(zhi)(zhi)(zhi)和皮(pi)支(zhi)(zhi)(zhi)(zhi)(zhi)分(fen)布于胸(xiong)(xiong)(xiong)(xiong)椎棘突附近的(de)(de)(de)(de)(de)短(duan)肌(ji)與長肌(ji)及皮(pi)膚。胸(xiong)(xiong)(xiong)(xiong)神(shen)經前(qian)(qian)支(zhi)(zhi)(zhi)(zhi)(zhi)粗大,共12對(dui),有(you)(you)明顯(xian)的(de)(de)(de)(de)(de)節段性。其(qi)中(zhong),第(di)1對(dui)胸(xiong)(xiong)(xiong)(xiong)神(shen)經前(qian)(qian)支(zhi)(zhi)(zhi)(zhi)(zhi)的(de)(de)(de)(de)(de)大部分(fen)參(can)(can)加臂叢(cong)的(de)(de)(de)(de)(de)組成,第(di)12對(dui)胸(xiong)(xiong)(xiong)(xiong)神(shen)經前(qian)(qian)支(zhi)(zhi)(zhi)(zhi)(zhi)的(de)(de)(de)(de)(de)小(xiao)部分(fen)參(can)(can)加腰(yao)叢(cong)的(de)(de)(de)(de)(de)組成,其(qi)余的(de)(de)(de)(de)(de)第(di)1胸(xiong)(xiong)(xiong)(xiong)神(shen)經前(qian)(qian)支(zhi)(zhi)(zhi)(zhi)(zhi)和第(di)2至第(di)11對(dui)胸(xiong)(xiong)(xiong)(xiong)神(shen)經前(qian)(qian)支(zhi)(zhi)(zhi)(zhi)(zhi)分(fen)別(bie)位于相應的(de)(de)(de)(de)(de)肋(lei)間(jian)(jian)隙中(zhong),稱為肋(lei)間(jian)(jian)神(shen)經。第(di)12對(dui)胸(xiong)(xiong)(xiong)(xiong)神(shen)經前(qian)(qian)支(zhi)(zhi)(zhi)(zhi)(zhi)的(de)(de)(de)(de)(de)大部分(fen)位于第(di)12肋(lei)下(xia)方(fang)(fang),故(gu)名肋(lei)下(xia)神(shen)經。肋(lei)間(jian)(jian)神(shen)經在肋(lei)間(jian)(jian)內、外肌(ji)之間(jian)(jian),肋(lei)間(jian)(jian)血管的(de)(de)(de)(de)(de)下(xia)方(fang)(fang),沿各肋(lei)溝(gou)前(qian)(qian)行(xing),在腋前(qian)(qian)線(xian)附近離開,支(zhi)(zhi)(zhi)(zhi)(zhi)配(pei)相應胸(xiong)(xiong)(xiong)(xiong)椎旁背部和胸(xiong)(xiong)(xiong)(xiong)壁(bi)肌(ji)肉的(de)(de)(de)(de)(de)分(fen)支(zhi)(zhi)(zhi)(zhi)(zhi)及沿肋(lei)間(jian)(jian)走(zou)行(xing)的(de)(de)(de)(de)(de)感(gan)覺分(fen)支(zhi)(zhi)(zhi)(zhi)(zhi)。

2-3

  肋(lei)間(jian)神經(jing)(jing)痛是指從胸(xiong)背部沿肋(lei)間(jian)向前方放射至胸(xiong)腹(fu)前壁(bi)中(zhong)線帶狀(zhuang)區(qu)的(de)(de)疼痛,主要因胸(xiong)椎椎間(jian)盤退變(bian)性突出、關節囊和(he)韌帶增厚(hou)或(huo)骨(gu)化常導致神經(jing)(jing)通(tong)道(dao)狹窄變(bian)形,刺激或(huo)壓(ya)迫胸(xiong)神經(jing)(jing)根,引起肋(lei)間(jian)神經(jing)(jing)炎癥,產生疼痛癥狀(zhuang),出現(xian)以胸(xiong)部肋(lei)間(jian)或(huo)腹(fu)部帶狀(zhuang)疼痛的(de)(de)綜合征,又名肋(lei)間(jian)神經(jing)(jing)炎。同樣累(lei)及(ji)肋(lei)間(jian)神經(jing)(jing)的(de)(de)病(bing)變(bian)還有胸(xiong)椎結核、胸(xiong)椎骨(gu)折或(huo)脫位、脊(ji)椎或(huo)脊(ji)髓腫瘤、強(qiang)直性脊(ji)柱炎以及(ji)肋(lei)骨(gu)、縱隔、胸(xiong)膜病(bing)變(bian),其中(zhong)帶狀(zhuang)皰(pao)疹性肋(lei)間(jian)神經(jing)(jing)痛常疼痛劇(ju)烈。

  肋(lei)間神(shen)經(jing)(jing)痛的(de)主要癥狀表現為一(yi)個或(huo)(huo)幾(ji)個肋(lei)間部位從(cong)背部沿(yan)肋(lei)間向胸腹前壁放射,呈(cheng)半環狀分(fen)布。常(chang)見于(yu)(yu)第2或(huo)(huo)第3肋(lei)軟骨與胸骨聯合(he)處,偶見于(yu)(yu)其(qi)他肋(lei)或(huo)(huo)胸鎖關(guan)節。多為單側受(shou)累(lei),也可(ke)以雙側同時(shi)受(shou)累(lei)。咳(ke)嗽、大笑、深呼吸或(huo)(huo)打噴嚏(ti)、打哈欠等(deng)往往會使疼(teng)痛加重。病程可(ke)持續幾(ji)小時(shi)或(huo)(huo)幾(ji)天,但可(ke)復發。常(chang)在數月內自(zi)愈(yu),個別可(ke)持續數年。查體可(ke)有(you)(you)胸椎(zhui)棘(ji)突(tu)、棘(ji)突(tu)間或(huo)(huo)椎(zhui)旁(pang)壓痛和叩痛,少(shao)數患者(zhe)沿(yan)肋(lei)間有(you)(you)壓痛,受(shou)累(lei)神(shen)經(jing)(jing)支配區可(ke)有(you)(you)感覺異常(chang)。其(qi)疼(teng)痛性質多為刺痛或(huo)(huo)灼痛,有(you)(you)沿(yan)肋(lei)間神(shen)經(jing)(jing)放射的(de)特點(dian)。

  目前(qian)沒有特別有效(xiao)的(de)(de)方法(fa)治療(liao)(liao)肋(lei)間(jian)(jian)神(shen)經痛(tong),可適當(dang)進行理療(liao)(liao)、熱敷、針灸、按摩,或口服、外(wai)敷消(xiao)炎(yan)止痛(tong)藥(yao)物(wu)(wu)以及(ji)局部(bu)(bu)注(zhu)射(she)等(deng)。在疼痛(tong)嚴重或常規(gui)性(xing)治療(liao)(liao)期間(jian)(jian),應同(tong)時使用專(zhuan)業設計的(de)(de)胸部(bu)(bu)固(gu)(gu)定(ding)帶(dai)、肋(lei)骨固(gu)(gu)定(ding)帶(dai)等(deng)醫用護具,通過物(wu)(wu)理施(shi)壓(ya)與固(gu)(gu)定(ding)方式,增強胸腔壓(ya)力,穩定(ding)肋(lei)椎部(bu)(bu)的(de)(de)生物(wu)(wu)力學(xue)結構,提高患部(bu)(bu)的(de)(de)穩定(ding)性(xing),增強保(bao)暖效(xiao)果,確保(bao)肋(lei)間(jian)(jian)神(shen)經等(deng)軟組織處于相(xiang)對安全的(de)(de)靜養狀(zhuang)態,以達(da)到減輕(qing)炎(yan)癥(zheng)和疼痛(tong)感的(de)(de)康復目的(de)(de)。

 
3、胸肋(lei)部(bu)傷病的預防與治療:

  隨年齡(ling)增長,骨(gu)脆(cui)性(xing)也(ye)隨之(zhi)增加(jia),肋骨(gu)骨(gu)折也(ye)成為中(zhong)老年人群常見的(de)骨(gu)折之(zhi)一。中(zhong)老年人的(de)骨(gu)質含鈣量(liang)(liang)少,骨(gu)質疏松,脆(cui)性(xing)較(jiao)大,應(ying)盡(jin)量(liang)(liang)避免外傷。平時應(ying)注(zhu)意調整飲食結構,適(shi)當地(di)參加(jia)體育鍛煉,加(jia)強(qiang)運動防護(hu),增加(jia)骨(gu)骼的(de)承受(shou)力,可有(you)效預防胸(xiong)肋部(bu)傷病的(de)發生。

  胸肋(lei)(lei)(lei)部(bu)傷(shang)病主要有肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)骨(gu)(gu)(gu)(gu)折、肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)骨(gu)(gu)(gu)(gu)裂(lie)(lie)、胸肋(lei)(lei)(lei)部(bu)軟(ruan)組(zu)織(zhi)損傷(shang)、肋(lei)(lei)(lei)軟(ruan)骨(gu)(gu)(gu)(gu)炎、肋(lei)(lei)(lei)間神經痛(tong)等。尤(you)其是肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)骨(gu)(gu)(gu)(gu)折或骨(gu)(gu)(gu)(gu)裂(lie)(lie),一般均可(ke)(ke)自(zi)行愈(yu)合,但對(dui)嚴重呼(hu)吸功能障礙病人,應及時行氣(qi)管切開,輔(fu)助呼(hu)吸,吸除(chu)呼(hu)吸道(dao)分泌物(wu),保(bao)持呼(hu)吸道(dao)通暢,防止肺不張和肺部(bu)感(gan)染等。單(dan)(dan)(dan)根(gen)或多根(gen)單(dan)(dan)(dan)處肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)骨(gu)(gu)(gu)(gu)折或肋(lei)(lei)(lei)間神經痛(tong)、肋(lei)(lei)(lei)軟(ruan)骨(gu)(gu)(gu)(gu)炎等患者,可(ke)(ke)使用(yong)專(zhuan)業設計的(de)、與(yu)肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)骨(gu)(gu)(gu)(gu)折相(xiang)關的(de)的(de)肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)固(gu)(gu)定(ding)帶(dai)、胸部(bu)固(gu)(gu)定(ding)帶(dai)等醫用(yong)護具(ju)先行加(jia)壓(ya)(ya)包(bao)扎固(gu)(gu)定(ding),緩解疼痛(tong),使傷(shang)者能有效(xiao)呼(hu)吸和咳嗽。總而(er)(er)言之,針對(dui)肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)骨(gu)(gu)(gu)(gu)折而(er)(er)言,使用(yong)肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)固(gu)(gu)定(ding)帶(dai)(胸部(bu)固(gu)(gu)定(ding)帶(dai)),在(zai)由肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)組(zu)成(cheng)的(de)呈軟(ruan)骨(gu)(gu)(gu)(gu)籠狀(zhuang)的(de)胸腔外(wai)圍予以施壓(ya)(ya)和固(gu)(gu)定(ding),可(ke)(ke)增(zeng)強胸腔壓(ya)(ya)力,穩(wen)定(ding)肋(lei)(lei)(lei)椎結構(gou),使斷裂(lie)(lie)的(de)肋(lei)(lei)(lei)骨(gu)(gu)(gu)(gu)自(zi)行復位愈(yu)合。此舉簡單(dan)(dan)(dan)有效(xiao),可(ke)(ke)避免發生肺不張、肺炎等并(bing)發癥,防止胸壁反常(chang)運(yun)動造(zao)成(cheng)縱隔(ge)擺動、引起循環功能紊(wen)亂而(er)(er)致急性死亡事故(gu)的(de)發生。

 

4、博(bo)道胸部固定帶(dai)(肋骨固定帶(dai))的產品(pin)介紹:

  博道(大連)醫療器械(xie)有限公司依(yi)據(ju)臨(lin)床經(jing)驗和(he)人體工學的科學數據(ju),專業設計、生產的胸(xiong)(xiong)(xiong)部(bu)固(gu)定(ding)(ding)帶(肋骨(gu)固(gu)定(ding)(ding)帶)等康(kang)復(fu)系列(lie)產品主(zhu)要由透氣性彈力本體和(he)強力粘(zhan)貼固(gu)定(ding)(ding)部(bu)組成,以物(wu)理施壓(ya)與固(gu)定(ding)(ding)方式(shi)施力于胸(xiong)(xiong)(xiong)腔(qiang),增強胸(xiong)(xiong)(xiong)腔(qiang)壓(ya)力,矯(jiao)正胸(xiong)(xiong)(xiong)肋部(bu)損傷后胸(xiong)(xiong)(xiong)廓整體的生物(wu)力學結構,穩(wen)定(ding)(ding)胸(xiong)(xiong)(xiong)腔(qiang)空間(jian),可促使斷(duan)裂的肋骨(gu)自(zi)行(xing)復(fu)位愈(yu)合,減輕(qing)因患部(bu)承壓(ya)帶來的疼痛感,促進(jin)呼吸順暢,有效提高(gao)患部(bu)固(gu)定(ding)(ding)和(he)康(kang)復(fu)護理效果(guo)。

  博道胸(xiong)部(bu)(bu)?肋(lei)(lei)(lei)骨(gu)固定帶系(xi)列產品吸(xi)濕(shi)透氣(qi),舒適可體,穿脫(tuo)簡單,具有固定力(li)強、易動性好、重量輕等特點,覆蓋面積(ji)小(xiao),不影響血液循環,可自由調節施壓(ya)強度,適用(yong)于胸(xiong)腔術后(hou)(hou)固定、肋(lei)(lei)(lei)骨(gu)骨(gu)折后(hou)(hou)的(de)(de)急救固定,以及肋(lei)(lei)(lei)骨(gu)骨(gu)裂(lie)、肋(lei)(lei)(lei)骨(gu)疲勞(lao)性骨(gu)折、胸(xiong)肋(lei)(lei)(lei)部(bu)(bu)軟(ruan)組(zu)織損傷、肋(lei)(lei)(lei)軟(ruan)骨(gu)炎、肋(lei)(lei)(lei)間神經痛(tong)、胸(xiong)背肌筋膜(mo)炎、胸(xiong)椎壓(ya)縮(suo)性骨(gu)折等胸(xiong)肋(lei)(lei)(lei)部(bu)(bu)及肋(lei)(lei)(lei)椎部(bu)(bu)傷病的(de)(de)固定護(hu)理,是胸(xiong)肋(lei)(lei)(lei)部(bu)(bu)及肋(lei)(lei)(lei)椎部(bu)(bu)患者可以信賴的(de)(de)固定防護(hu)和康(kang)復(fu)護(hu)理產品。


溫馨提示:

  如果您想進一步(bu)了解博道產品(pin)或有更好的(de)(de)建議,可(ke)通過(guo)博道公司的(de)(de)網站或郵箱(xiang)聯系我(wo)們(men),以便共同(tong)研討更多關(guan)于相關(guan)產品(pin)以及(ji)疾(ji)病的(de)(de)康復護理方面的(de)(de)知識(shi)。


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