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Dau than kinh toa

Toi bi dau o that lung va chay dai xuong hai chan tu hon nam nay. Kham benh vien BS ghi "viem than kinh toa", khoang nam lan kham nhu vay benh van con nhu truoc khi kham. Xin BS cho biet con cach nao tri het dau khong?

(Nguyen Van Tu)

- Tra loi cua Phong mach cua Online:

Dau tu that lung lan doc xuong chan thuong duoc chan doan la “dau day than kinh toa”. Dau day than kinh toa bieu hien dac trung bang cam giac dau lan doc xuong phia dui theo re than kinh lung 5 (L5) va re than kinh song 1 (S1). Neu re than kinh L5 bi ton thuong thi co hien tuong dau doc tu lung eo phia ngoai xuong chan toi tan ngon chan ut. Neu re than kinh S1 bi ton thuong thi dau doc ra phia sau mong, thang xuong sau dui, sau bap cang chan toi phia ngoai ban chan. Neu bi benh than kinh toa tren (than kinh hong) thi dau thuong toi phia tren dau goi; neu bi than kinh toa duoi thi dau toi mat ca ngoai ban chan.

Nguyen nhan gay dau day than kinh toa cung co rat nhieu nhung hay gap la do thoat vi dia dem, hep ong song nguyen phat hay thu phat do hau qua cua hu dia dem, gay chen ep re than kinh lien quan, hep lo gian dot song, viem ngoai mang cung… Dau day than kinh toa khong nhat thiet cu phai gap o nguoi lon tuoi ma ngay ca nhung nguoi tre tuoi do dac thu nghe nghiep nhu cong nhan boc vac, nghe si xiec, cu ta, hoac nguoi hay phai lam nhung viec nang gay thoai hoa dia dem deu co the gay nen hoi chung dau that lung kem dau day than kinh toa. Cac dau hieu dau day than kinh toa ma ban co the nhan biet:

+ Dau giua cot song hay lech mot ben, dau tang len khi bi rung nguoi (di xe qua o ga, vap vao da).

+ Cam giac dau lan tu lung xuong, lech sang mot ben mong, xuong dui, khoeo, got chan. Hoac thay dau nguoc lai, tu got chan len.

+ Nhoi lung khi ho, khi hat xi hoi, khi cuoi.

+ Cot song cung, bi dau khi nghieng nguoi, chi can chuyen dich mot chut cung dau.

+ Co the thay teo co ben chan dau neu tinh trang dau keo dai.

+ Lam dong tac cui nguoi xuong khong duoc vi dau.

Cac nguyen nhan gay dau than kinh toa gom: ton thuong o cot song that lung gay chen ep re than kinh, thoat vi dia dem vung cot song that lung, cac ton thuong thuc the khac o vung that lung (di dang bam sinh, chan thuong, thoai hoa cot song that lung, u, viem cot song dinh khop, viem dot song do nhiem khuan).

Phan lon truong hop chi dau than kinh toa mot ben. Nguoi benh co tu the ngay lung hay veo ve mot ben de chong dau. Tuy theo ton thuong, ho co the khong nhac duoc got hay mui chan, dan dan xuat hien teo co dui, mong, cang chan ben ton thuong. Khi benh nang, chan te bi mat cam giac, phan xa di tieu di tieu co the mat. Truong hop cua ban phai duoc chup cot song can than moi dinh benh ro rang. Theo nhu mo ta thi co the day la do chan thuong vung cot song gay chen ep re than kinh ca hai ben nen moi dau nhu vay. Cung chinh vi the nen ban da uong thuoc than kinh toa khong hieu qua.

Phau thuat duoc chi dinh khi: dieu tri noi khoa khong do sau sau thang hoac co bien chung liet, teo co, roi loan co tron; benh nhan dau du doi, dau tai phat nhieu lan, anh huong nghiem trong den sinh hoat va lao dong.

Hien tai ban nen den benh vien chup cong huong tu hat nhan de tim vi tri ton thuong. Tuy theo tinh trang ma bac si phoi hop cham cuu, chieu tia hong ngoai, dung thuoc giam dau khong steroid… Neu lech dia dem hoac dot song bi chen ep qua muc thi moi co chi dinh mo de giai phong re than kinh o vung bi chen ep.

BS LE THUY TUOI

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De chinh xac ve noi dung, van de can hoi, xin ban doc vui long go co dau (font chu unicode). Xin chan thanh cam on!

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