腰肌劳损 外科护理学PPT课件

慢性软组织损伤之
腰肌劳损
strain of the lumbar muscles
主讲人：夏婼
2020/7/21
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•概念
• 又称功能性腰痛、腰背肌筋膜炎
• 主要指腰背部肌肉、筋膜、韧带等软组 织的慢性、疲劳性损伤，导致局部无菌 性炎症，引起腰背部一侧或两侧的弥漫 性疼痛的一种病症。
• 为腰痛常见的原因
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• 临床表现
症状
无明显诱因的慢性腰部或腰骶部疼痛，反复发作，疼
痛随气候变化或劳累程度而变化，时轻时重，迁延不愈
呈钝性胀痛或酸痛不适，休息、适当活动或经常改变 体位姿势可使症状减轻。腰部喜热怕冷，局部皮肤感觉 迟钝或粗糙感。
腰部活动：有时在活动时有牵掣不适感。不耐久坐久 站，不能胜任弯腰工作，弯腰稍久，便直腰困难
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•病因
•长期过度负重
•脊柱结构失稳
•长期弯腰工作
其他
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• 病理生理
肌肉、筋膜及韧带持续受到牵拉时，肌肉 内的压力增加，血供受阻，肌纤维在收缩 时消耗的能源得不到补充，产生大量乳酸， 加之代谢产物不能得到及时清除，积聚过 多而引起炎症、粘连，如此反复可导致组 织变性、增厚及痉挛，并刺激相应的神经 引起慢性腰痛
• Always move the waist and avoid
prolonged periods in the same
20p20o/7/2s1 ition
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• Avoid damp, cold
• Sleep hard bed
• Make the waist posture compatible with biomechanics
• When the disease is heavier, bed rest is appropriate and the bed position is often changed
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Comprehensive
treatment:
Physical therapy: waxing, electrotherapy, MedБайду номын сангаасcal massage, acupuncture cupping
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Health guide:
• Explain the etiology, pathology, treatment and prevention of diseases, rehabilitation training methods and precautions
• The waistline method and the use time
Drug therapy:
• The pain point is feasible for adrenal corticosteroid injection.
• When the pain in the waist is obvious,
you can take NSAID to relieve muscle
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Nursing measures
Relieves pain: • Create a quiet, comfortable hospital
environment, distract the attention of patient and guide it. • When the pain is apparent, you can take NSAID to relieve muscle pain. Psychological care
• Keep proper posture in your daily
pain, 2020/7/21 but not long. -term
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Functional exercise
• Quadriceps muscle contraction practice: 5-10 minutes each time, 3-4 times a day
• Back muscle practice: The flying swallow is supported by five-point,, 1-2 weeks and then the 3-point support method, 3-4 times a day, 50 times each time
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principle of management
To eliminate the cause:
• Improve your position, posture, and avoid bending over long
• Use the waistline, take it off when rest, lest the secondary apraxia of muscle atrophy
骶棘肌痉挛征 ：为腰部劳损所致，有单侧或双侧骶 棘肌痉挛征，肌收缩隆起，由于患侧腰肌收缩，骨盆 倾斜，腰部显得板硬，起卧床较费力
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• 辅助检查
X线检查多无异常，少数可有骨质增生或 脊柱畸形；年老或骨质疏松病人，可选 择ECT检查或骨密度检查
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nursing diagnosis
急性发作时，可有明显的肌痉挛，甚至出现腰脊柱侧
弯20，20/7下/21 肢牵擎作痛等症状。.
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体征
压痛：腰背部固定压痛点，多在骶髂关节背面、骶 骨背面和腰椎横突等处。轻者压痛多不明显。常被迫 伸腰双手捶击或叉腰等动作，以减轻疼痛，这是与深 部骨骼疾患的区别之一
放射痛：不同压痛点产生不同部位放射痛，临床常 据此对腰部损伤与椎间盘突出症进行鉴别诊断
• Pain related to tissue chronic injury
• The lack of knowledge related to lack of functional exercise and disease prevention
• Anxiety related to recurrent episodes of disease