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median nerve palsy

  โรคคอร์ดดิ้งหรือที่เรียกว่า ซินโดโรมความผิดทางร่องแบนเอาะร์ไนท์ คือ ภาวะที่เส้นประสาทกลางถูกกดดันในช่องโครงของมือเมื่อโครงของมืออยู่ในบริเวณหลังของมือ ช่องโครงนี้ตั้งอยู่ที่ฐานของมือ ด้านล่างและด้านข้างประกอบด้วยกระดูกของอายุวาตร์ และมีสองด้านของผิวหนังคาบตรงข้ามกัน จึงทำให้เกิดช่องโครงที่หน้าตัดคล้ายกระดูก-纤维通道。

  手和腕长期过度使用引起慢性损伤,腕横韧带及内容肌腱均可发生慢性损伤性炎症,使管腔狭窄是最常见的原因。其次是腕部急性损伤,桡骨远端骨折,月骨脱位可引起正中神经急性或继发受压。某些全身疾病可通过腕管内容物增大,引起自发性正中神经损害。

  好发年龄为30~60岁,女性为男性的5倍,一般为单侧发病,也可双侧。起病缓慢,正中神经支配区疼痛,麻木,发胀,常入睡数小时后痛醒,活动后缓解。正中神经分配区皮肤感觉迟钝,过敏。大鱼际可有萎缩,拇指笨拙无力。叩击腕部可出现Tinel征,腕关节极度屈曲60秒,手的感觉异常可加重(Phalen试验),腕管内压增高。血压计充气超过收缩压30~60秒可诱发患手疼痛。过度伸腕与屈腕试验同样引起感觉异常和疼痛加重。腕管掌侧卡压点压痛放射痛。正中神经传导速度减慢。

  非手术治疗使腕制动于中立位,腕管内注射皮质激素。反复发作,非手术治疗难以缓解者需行手术减压。有利用内窥镜手术的报道。

 

目录

1.正中神经麻痹的发病原因有哪些
2.正中神经麻痹容易导致什么并发症
3.正中神经麻痹有哪些典型症状
4.正中神经麻痹应该如何预防
5.正中神经麻痹需要做哪些化验检查
6.正中神经麻痹病人的饮食宜忌
7.西医治疗正中神经麻痹的常规方法

1. 正中神经麻痹的发病原因有哪些

  手和腕长期过度使用引起慢性损伤,腕横韧带及内容肌腱均可发生慢性损伤性炎症,使管腔狭窄是最常见的原因。其次是腕部急性损伤,桡骨远端骨折,月骨脱位可引起正中神经急性或继发受压。某些全身疾病可通过腕管内容物增大,引起自发性正中神经损害。

 

2. 正中神经麻痹容易导致什么并发症

  正中神经麻痹除了其临床表现外,还可引起其他疾病。正中神经富于交感神经纤维,损伤后易发生灼性神经痛。并出现桡侧三个手指的感觉障碍、麻木和疼痛,以及鱼际瘫痪。

3. 正中神经麻痹有哪些典型症状

  1, motor impairment is manifested by weakened or lost grip strength and pronator muscle strength of the forearm.

  上臂受损时正中神经支配的肌肉完全麻痹,前臂不能旋前,屈腕力弱,拇指、食指和种中指不能屈曲,握拳无力,拇指,食指也不能过伸,拇指不能对掌和外展,大鱼际肌萎缩,状如猿手;手指功能严重损害,持物困难,表现手严重伤残。

  前臂中或下1/3损伤时,旋前圆肌、腕屈肌、指屈肌功能仍可保存,运动障碍仅限于拇指外展、屈曲和对掌。

  2, sensory disturbances are mainly the palmar surface of the radial first joint and thumb, index finger, middle finger, the radial side of the little finger, and the palmar side of the distal phalanx of the middle and index fingers. The median nerve is rich in sympathetic nerve fibers, and it is easy to develop caustic neuralgia after injury.

  3, carpal tunnel syndrome: The carpal tunnel is formed by the carpal flexor retinaculum and the carpal groove, and when compressed, it can cause median nerve palsy to occur between them. There are sensory disturbances, numbness, and pain in the three radial fingers, as well as thenar paralysis. It is more common in middle-aged women, more common on the right side, exacerbated after work, and alleviated after rest.

 

4. 正中神经麻痹应该如何预防

  正中神经损伤常见的原因是肘前区静脉注射药物外渗,以及腕部被利器割伤、肱骨或前臂骨折及穿通伤、腕管综合征压迫所致。设法祛除以上因素可有效减少或避免本病发生。

 

5. การตรวจเทสที่ต้องทำเมื่อมีอาการบวมประสาทกลาง

  การตรวจสอบประจำช่วงประจำวิชาประสาทวิทยา

  1, motor impairment is manifested by weakened or lost grip strength and pronator muscle strength of the forearm.

  2, sensory disturbances are mainly the palmar surface of the radial first joint and thumb, index finger, middle finger, the radial side of the little finger, and the palmar side of the distal phalanx of the middle and index fingers. The median nerve is rich in sympathetic nerve fibers, and it is easy to develop caustic neuralgia after injury.

  3, carpal tunnel syndrome: The carpal tunnel is formed by the carpal flexor retinaculum and the carpal groove, and when compressed, it can cause median nerve palsy to occur between them. There are sensory disturbances, numbness, and pain in the three radial fingers, as well as thenar paralysis. It is more common in middle-aged women, more common on the right side, exacerbated after work, and alleviated after rest.

 

6. dietary taboos for patients with median nerve palsy

  dietary nutrition porridge for patients with neuralgia:

  1, nourishing Yin and moistening dryness porridge: coix seed50g, white flower9g, Poria cocos20g, dried tangerine peel6g, first boil coix seed into porridge, then boil the other three ingredients in water and filter out the residue and add to the coix seed porridge. Take it daily1dosage, take for several days in a row. The efficacy is to invigorate the spleen and transform dampness, resolve phlegm and unblock meridians. Suitable for symptoms of spleen failure, phlegm dampness blocking, such as facial twitches, epigastric distension, loss of appetite, and poor appetite.

  2, porridge to remove wind and dispel cold: ginger10g, healthy pigeon1only. Boil coix seed into porridge first, then boil the other three ingredients in water and filter out the residue and add to the coix seed porridge. Take it daily1only. The efficacy is to invigorate Qi and nourish blood, subdue the wind and relax the spasm. The formula uses pigeon meat to nourish the liver and kidneys, invigorate Qi and blood, ginger to subdue the wind and relax the spasm, and together they are used to treat facial paralysis caused by blood deficiency and wind generation.

  3, porridge to remove dampness and moisten the lungs: coix seed50g, fried mung bean15g, hawthorn 10g, brown sugar, glutinous rice in appropriate amount. Boil together to make porridge. Add brown sugar before eating, for breakfast and dinner. The efficacy is to invigorate the spleen and transform dampness, activate blood and unblock meridians. Diet therapy for facial paralysis patients, in this method, coix seed and mung bean treat spleen deficiency with dampness, hawthorn activates blood and resolves phlegm; brown sugar nourishes blood and unblocks meridians. The whole formula makes the spleen healthy, phlegm transformed and dampness removed, and the facial meridians unblocked. Suitable for symptoms of spleen deficiency and dampness, meridians blocked.

 

7. conventional methods of Western medicine for the treatment of median nerve palsy

       the treatment of median nerve palsy with splint can fix the wrist joint on the middle position on the palm side. Local immobilization is performed. At the same time, take anti-inflammatory drugs such as ibuprofen and diclofenac orally. Severe cases can use prednisolone 0.5ml added2%Procaine 0.5ml into the carpal tunnel, every week1times, if injection2if there is no effect after more than one time, electromyography shows that the thenar muscles are denervated and surgical treatment should be performed.

แนะนำ: การตัดขาตาของหัวเท้า , ขาที่เบาหวาน , โรคบางอาการปัสสาวะหลังคา , แกล็ดเท้า , หัวเท้าเปิดกว้างนอกฝ่า , ตับหนังตาล

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