梨状肌发炎

2025-03-01 13:18:11
推荐回答(2个)
回答1:

梨状肌起自于骨盆的后壁,肌纤维发自第2、3、4骶椎椎体前面,向外集中穿坐骨大孔进入臀部,而是止于股骨大转子上缘的后部。梨状肌并非全部将坐骨大孔占满,将其分为梨状肌上、下孔。梨状肌上孔介于坐骨大切迹和梨状肌之间,有臀上神经和血管通过;梨状肌下孔在梨状肌之下,坐骨棘和骶棘韧带之上,有臀下神经、坐骨神经和血管等通过梨状肌坐骨神经一般经梨状肌下缘穿出坐骨大孔离开骨盆,约占84%,但许多人的坐骨神经与梨状肌之间有一定的解剖变异,或是在未穿出骨盆前就分为两支:一支从梨状肌中间穿出,将梨状肌分为两个头,另一支由梨状肌下缘穿出约占11.7%;或是坐骨神经分支后,分别从梨状肌上、下缘穿出约占3.3%;或是虽未分支,但全部从梨状肌中间穿出,将梨状肌分为两部分约占0.8%。梨状肌为外旋肌,收缩时能使大腿外旋、外展。在正常情况下,梨状肌收缩时对坐骨神经无妨碍,但在解剖变异的基础上,由于梨状肌急、慢性损伤或由于炎性反应,肌肉痉挛等刺激或压迫坐骨神经,引起臀部疼痛和坐骨神经放射痛,称为梨状肌综合征。
1)梨状肌综合征的临床表现:一侧臀部疼痛,以梨状肌相对应的部位最明显。疼痛可放射至整个下肢,可伴小腿及足外侧麻木,咳嗽、打喷嚏时多无放射痛,症状严重的患者疼痛可为刀割样、撕裂样的剧痛,行走困难。
检查时可在痛侧摸到紧张的梨状肌,局部可触及条索状隆起,压痛明显,并有放射痛。压痛点在后髂嵴上,即尾骨的中点与大粗隆连线的中点,梨状肌紧张试验多为阳性,直腿抬高试验为阳性。
2)本病与腰椎间盘突出症因都有臀部及下肢放射性疼痛症状而容易相混淆。主要鉴别点为:
1.梨状肌综合征患者,腰部无明显压痛和畸形,活动不受限;
2.梨状肌紧张试验阳性;
3.用长针头局部封闭压痛点后,疼痛立即解除。
3)梨状肌综合征非手术疗法有哪些?�
非手术疗法治疗梨状肌综合征包括手法、局部封闭、肌注、理疗、中草药、针灸等。局部封闭对缓解疼痛有一定作用,常用25%葡萄糖水18毫升加入2%普鲁卡因2毫升进行局部注射,每3天1次,每2--3次为一疗程。也可用2%普鲁卡因6毫升加强的松龙25毫升进行局部封闭,每周2次,每3--5次为一疗程。肌注胎盘组织液,可治疗坐骨神经盆腔出口处的组织粘连,每日一次,每次2毫升,30次为1疗程。
1.怎样用手法治疗梨状肌综合征?�
手法是治疗梨状肌综合征的主要方法,可以明显改善症状,缓解病人的痛苦。采用手法治疗时,首先要选准部位。患者可取俯卧位,双下肢后伸,使腰臀部肌肉放松,术者自髂后上棘到股骨大粗隆做一连线,连线中点直下2厘米处即为坐骨神经出梨状肌下孔之部位,其两侧即为梨状肌。手法治疗围绕此部位进行,常用的手法有以下几种:
①按摩揉推法:术者双手交叉用力揉按臀部痛点,患者可有发热舒适感。
②弹拔点拔法:术者双手拇指相叠压,在钝厚或变硬的梨状肌部位用力深压并来回拔动,应注意的是,弹拔方向应与梨状肌纤维方向垂直。弹拔10--20次左右,若拇指力量不够,不能深达梨状肌,术者可用肘尖替代进行治疗。
③按压法:医者双手交叉按压痛点1分钟左右。
以上手法可循序进行。按压后,术者双手握住患者踝部,微用力做连续小幅度的上下牵抖10--20次左右而结束。
2.手法治疗需要每天都做吗?�
手法治疗不需每天都做,每周2次即可,连续治疗2--3周。应该提醒患者的是,应去正规医院的相关科室进行治疗,以确保安全有效,不宜去非法行医的个体按摩处求医。手法治疗对于接受过正规学习和训练的操作者而言是安全有效的,但如果是没有学习过解剖知识的个体按摩人员,难免粗野蛮干,仍有一定的危险性。

回答2:

只要是出现水肿,就证明是炎症没有得到改善,可以使用红外线照射加速水肿消除,水肿消除后就可以找到引起该病症继发问题,这样就好治疗了,如果是梨状肌粘连造成的炎症,可以到当地权威的中医院开展“小针刀”治疗就可以了!

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