Çàðåãèñòðèðîâàòüñÿ

Ïîõîæèå òåìû

  1. íåïðàâèëüíîå ââåäåíèå ïàíàâèðà
    îò miraba â ðàçäåëå Âåíåðîëîã-äåðìàòîëîã
    Îòâåòîâ: 15
    : 22.11.2006, 22:34
  2. ââåäåíèå ãëþòåíîâûõ êàø
    îò Þëèÿ â ðàçäåëå Ïåäèàòð - âñå î äåòÿõ.
    Îòâåòîâ: 1
    : 01.08.2005, 15:37
  3. Îòâåòîâ: 13
    : 01.07.2005, 16:16
  4. Ââåäåíèå èìóíîãëîáóëèíîâ ïðè íåâûíàøèâàíèè
    îò î.îõîòà â ðàçäåëå Ãèíåêîëîã-àêóøåð, áåðåìåííîñòü, ðîäû
    Îòâåòîâ: 7
    : 01.09.2004, 20:30
  5. ïðàâèëüíî ââåäåíèå âëàãàëèù. òàìïîíîâ
    îò faradada â ðàçäåëå Ãèíåêîëîã-àêóøåð, áåðåìåííîñòü, ðîäû
    Îòâåòîâ: 1
    : 31.08.2004, 18:19
  1. merkur
    #1
    ×èòàòåëü Íåäóã.Ðó
    Äëÿ êîíñóëüòàöèè ïî ñíÿòèþ äëèòåëüíîãî áîëåâîãî ñèíäðîìà, ÿ áûë íàïðàâëåí ïðîôåññîðîì Íàéäèíûì (ó êîòîðîãî ïðîõîäèë ëå÷åíèå è î÷åíü ìíîþ óâàæàåìûì) ê äîêòîðó Èâàíîâó â äåòñêóþ ãîðîäñêóþ áîëüíèöó íà Ëåíèíñêîì ïðîñïåêòå.(Äîêòîð Èâàíîâ áûë îòðåêîìåíäîâàí, êàê ñïåöèàëèñò ïî ëå÷åíèþ ñëó÷àåâ, ïîäîáíûõ ìîåìó).



    Ïîñëå îñìîòðà è ïðîâåäåíèÿ íåêîòîðûõ ìàíèïóëÿöèé ñî ìíîþ, äîêòîð ïîäòâåðäèë äèàãíîç:

    Äèñêîãåííàÿ ïðàâîñòîðîííÿÿ ëþìáîèøèàëãèÿ â ñòàäèè çàòÿíóâøåãîñÿ îáîñòðåíèÿ.Êîðåøêîâûé ñèíäðîì S1 ñïðàâà.

    Ôîðàìèíàëüíàÿ ãðûæà L5S1.

    Ïîðåêîìåíäîâàòü îí èç ëè÷íîãî âðà÷åáíîãî îïûòà îí ñìîã òîëêî äâà âàðèàíòà:

    1. Îïåðàòèâíîå âìåøàòåëüñòâî

    2. Ñäåëàòü âíóòðèäèñêîâîå ââåäåíèå ãëþêîêîðòèêîèäà äëèòåëüíîãî äåéñòâèÿ ïîä âèçóàëèçàöèåé (êîìïüþòåðíàÿ òîìîãðàììà),è, ïîòîì, ÷åðåç íåäåëþ, ïðîâåñòè íåñêîëüêî ìàíóàëüíûõ ìàíèïóëÿöèé, ÷òîáû îñâîáîäèòü êîðåøîê.

    Âíóòðèäèñêîâîå ââåäåíèå ïðîñòûì ÿçûêîì íàäóâàåò èçíîøåííûé äèñê, êàê áû âîññòàíàâëèâàÿ åãî ïðåæíþþ ôîðìó,à ãëþêîðòèêîèä îáåçáîëèâàåò è ñíèìàåò îòåê, ÷òî ïîçâîëÿåò áåç îñîáîãî ðèñêà ïóòåì àêêóðàòíûõ ìàíèïóëÿöèé (ýòî ïî ñëîâàì äîêòîðà Èâàíîâà) îñâîáîäèòü íåðâíûé êîðåøîê îò äàâëåíèÿ ãðûæè (ôîðàìèíàëüíàÿ ãðûæà, ïî îáúÿñíåíèÿì âðà÷åé, äàâèò íåïîñðåäñòâåííî â îòâåðñòâèå, ãäå ðàñïîëîæåí êîðåøîê íåðâà.

    Ýòî âíóòðèäèñêîâîå ââåäåíèÿ ïîä êîìïüþòåðíîé òîìîãðàììîé ÿâëÿåòñÿ òîæå ñâîåãî ðîäà îïåðàöèåé (êàê è ýïèäóðàëüíàÿ áëîêàäà), êîòîðóþ íåîáõîäèìî ïðîâîäèòü â ñïåöèàëüíîì ìåä. ó÷ðåæäåíèè.

    Ïî ñëîâàì äîêòîðà Èâàíîâà, â Ãåðìàíèè î÷åíü ðàñïðîñòðàíåí ýòîò ìåòîä ëå÷åíèÿ, è òàêèå îïåðàöèè ïðîâîäÿòñÿ ÷àñòî â ðàçëè÷íûõ êëèíèêàõ.

    Â Ðîññèè ìíå áûë ðåêîìåíäîâàí äëÿ ýòèõ öåëåé Öåíòð Ýíäîõèðóðãèè è ëèòîòðèïñèè â Ìîñêâå, êóäà ÿ è îòïðàâèëñÿ íà êîíñóëüòàöèþ ê êìí íåéðîõèðóðãó äîêòîðó Õîäíåâè÷ó.

    Äîêòîð Õîäíåâè÷ ïîñëå îñìîòðà ñòàë îòãîâàðèâàòü ìåíÿ îò ýòîãî óêîëà, ñíà÷àëà óïèðàÿ íà òî, ÷òî ýòî íåäåøåâîå óäîâîëüñòâèå, êîòîðîå â ìîåì ñëó÷àå âðÿä ëè áóäåò ïðèíåñåò íóæíûé ðåçóëüòàò.

    Óïîìÿíóë òàê æå, ÷òî ýòà ïðîöåäóðà ìîæåò áûòü îïàñíîé èç-çà ðàçðûâà äèñêà â äðóãîì ìåñòå.

     êîíöå êîíñóëüòàöèè, îí ïîðåêîìåíäîâàë ìíå ñäåëàòü îïåðàöèþ çà 3 - 4 òûñÿ÷è äîëëàðîâ.

    Â èòîãå ìíå íå óäàëîñü ïðîâåðèòü ýòîò ìåòîä íà ñåáå â Ìîñêâå.

    Åñëè êòî-íèáóäü ñëûøàë î ïîäîáíûõ îïåðàöèÿõ èëè äåëàë, ïîæàëóéñòà, ïîäåëèòåñü ñâîèì ìíåíèåì.

    Âîçìîæíî ýòî äåéñòâèòåëüíî óñïåøíûé è ìèíèìàëüíî òðàâìàòè÷íûé ìåòîä ëå÷åíèÿ ïîçâîíî÷íûõ ãðûæ, à ìû íå çíàåì î íåì â ñèëó îòñóòñòâèÿ âðà÷åáíîé ïðàêòèêè â íàøèõ ëå÷åáíûõ çàâåäåíèÿõ.

    Áûëî áû òàêæå èíòåðåñíî óñëûøàòü êîììåíòàðèé ñïåöèàëèñòà.

    Èçâèíèòå, åñëè ÿ áûë íå òî÷åí â òåðìèíîëîãèè.

    Ñïàñèáî.

  2. LoveFlame
    #2
    ×èòàòåëü Íåäóã.Ðó
    Óâ. Ãðèíîê!

    Ñàìàÿ ëó÷øàÿ îïåðàöèÿ ýòî òà, êîòîðîé óäàëîñü èçáåæàòü. À îïåðàöèÿ íà ïîçâîíî÷íèêå âñåãäà íåñ¸ò çà ñîáîé ðèñê îñòàòüñÿ èíâàëèäîì íà âñþ æèçíü. Êîíå÷íî, ïðè ïðîâåäåíèè å¸ ñïåöèàëèñòîì ðèñê ìèíèìàëåí, íî âñ¸ æå. Ê òîìó æå, ê îïåðàöèè åñòü îïðåäåë¸ííûå ïîêàçàíèÿ - ñäàâëåíèå ñïèííîãî ìîçãà ãðûæåé, äîëãîå âðåìÿ íå êóïèðóþùèéñÿ áîëåâîé ñèíäðîì, íàðàñòàþùèé ïàðåç íèæíåé (èõ) êîíå÷íîñòè (åé) è ò.ä. Åñëè ó Âàñ åñòü ýòè ïîêàçàíèÿ è èñ÷åðïàíû âñå êîíñåðâàòèâíûå ìåòîäû ëå÷åíèÿ - òîãäà îá îïåðàöèè ñëåäóåò çàäóìàòüñÿ âñåðü¸ç.

    À î âûáîðå ìåòîäà îïåðàòèâíîãî âìåøàòåëüñòâà ëó÷øå, áåçóñëîâíî, ïîäñêàæóò íåéðîõèðóðãè.

  3. Ëþëå÷êà
    #3
    ×èòàòåëü Íåäóã.Ðó
    Íå ïî ïîâîäó îïåðàöèè…

    Øâåäñêîå àãåíòñòâî ïî îöåíêå ìåäèöèíñêèõ òåõíîëîãèé âûïóñòèëî îáçîðû ïî áîëè â ñïèíå è øåå (2000 ãîä) è äîêàçàòåëüíîé ôèçèîòåðàïèè ïðè áîëè â íèæíåé ÷àñòè ñïèíû (1999 ãîä). Òàì æå ìîæíî ñêà÷àòü ïäô íà àíãëèéñêîì.

    http://www.sbu.se/www/index.asp

    Summary and conclusions (pdf)



    Ìîæåò áûòü ññûëêè áóäóò ïîëåçíû êàê âðà÷àì, òàê è ïàöèåíòàì





    Back and neck pain



    Author: Nachemson A (chair), Carlsson C-A, Englund L, Goossens M, Harms-Ringdahl K, Linton S, Jonsson E (project coordinator), Marké L-Å, Norlund A, Söderström M, van Tulder M, Waddell G, Vingård E, Engström C (project secretary), Norwall M (project assistant), Persson I (project secretary), Wallmark J (project assistant)



    Contact person: Alf Nachemson

    E-mail: alf.nachemson@orthop.gu.se

    Publicationdate: 2000

    ISBN: 91-87890-60-7

    Report number: 145



    This is an 800-page report on the epidemiology, diagnosis, and treatment of back and neck pain. Also covered in the report are the economic, social, and psychosocial aspects of back pain. An international working group of 13 researchers in the fields of medicine, epidemiology, psychology, and economics did a systematic review of the findings from clinical research of different options to treat back pain. Report took 4 years to complete. Altogether 25 000 studies were identified of wich 2000 were finally referenced in this report. The evidence was graded as strong (A), moderate (B), limited (C), or no evidence (D).



    The scientific basis for more than 30 different treatments was systematically reviewed. For the majority of these thare are either no evidence or limited evidence in favor of treatment. For some modalities there is strong or moderate evidence against their effectiveness, eg, by traction, aerobics, stretching, and bed rest. For a minority of treatments there isstrong evidence of effectiveness, eg, for antiinflammatory and muscle relaxant drugs, manual treatment, manipulation, exercise, multidisciplinary treatment, spa treatment, and continuation of normal activities.





    For diagnosing: Systematic anamnesis and physical examination are good foundations for correct diagnosis (B). Radiographic studies are of limited value.





    For acute low back pain: Normal activities result in faster recovery and fewer chronic functional disorders (A), anti-inflammatory and muscle relaxant drugs offer effective pain relief (A), while bed-rest is not effective (A).





    For chronic back pain: Manual treatment/manipulation, back training, and multidisciplinary treatment effectively relieve pain (A). Intensive treatment at a health resort reduces pain in the short term for elderly patients (>60 years of age) with chronic low back problems (A).





    Surgery: For herniated discs, effective (A). For surgical fusion, no evidence (D).





    For neck pain, the evidence is sparse. The only firm evidence is that acupuncture is not effective (A). Psychological and social factors may have a strong influence on back and neck pain.





    SBU conclusions include:



     Back and neck pain is common. Healing is promoted by staying active, returning to work, and exercising at an appropriate intensity.

     A thorough anamnesis and physical examination is important for relieving anxiety about the consequences of pain and sufficient for identifying those who should be referred to a specialist.

     For most patients with back pain, the interventions that can be offered in primary care are the only ones needed.

     Back pain and its consequences are not isolated physical problems but are associated with other conditions such as social, psychological, and workplace-related factors.

     Knowledge on how to prevent back pain has been applied and assessed to a surprisingly minor degree.

     There is little scientific evidence on the effectiveness of most treatments.







    Evidence-based physiotherapy for patients with low-back pain



    Author: Karin Harms-Ringdahl, Eva Holmström, Torsten Jonsson, Ingalill Lindström PROJECT GROUP: Margareta Möller (Chairperson), Birgitta Bergman, Jane Carlsson, Karin Harms-Ringdahl, Eva Holmström, Gun-Britt Jarnlo, Torsten Jonsson, Ingalill Lindström, Staffan Norlander, Britta-Lena Rundcrantz, Gunilla Lamnevik, Maria Norrlander



    Publicationdate: 1999

    ISBN: 91-87890-59-3

    Report number: EVS 102



    This report is intended to be used as reference and educational material. It represents one of two documents that critically review the scientific evidence underlying the therapies and interventions provided by physiotherapists. The report presents a systematic literature review of the scientific basis for treating low-back problems by physiotherapy. It reveals a need for further research and more studies to strengthen the foundation for evidence-based physiotherapy. The report is published in collaboration with the federation of licensed physiotherapists in Sweden (LSR) and a Swedish foundation that supports research in health care and allergy care (Vårdalstiftelsen).



    Summary, Conclusions, and Recommendations



    In summary, the literature review supports the following conclusions and recommendations for interventions in patients who self-refer or are referred to a physiotherapist for low-back problems.



    - Patients with acute problems that have persisted less than 3 weeks should be thoroughly examined by a physiotherapist to identify their mobility-related condition (impairment), capability (activity), and behavior (participation), and be given the opportunity to discuss attitudes and possible apprehension toward their problem. Considering the findings from examination, the physiotherapist should challenge the patient to continue to be physically active. The physiotherapist should offer personalized, oral (in addition to written) advice on the importance of changing positions often, suggest how the patient can find positions that generate less pain where movement can be carried out, encourage the patient to think about how he/she can move different parts of the body without increasing pain, and suggest how tasks might be modified so the patient can continue working. During the first days, excessive physical activity or treatments which subject body tissue to major stress should be avoided.



    - Patients with sub-acute problems lasting 3 to 6 weeks should be examined thoroughly by a physiotherapist to identify their mobility-related condition (impairment), capability (activity), and behavior (participation), and be given the opportunity to discuss attitudes and possible apprehension toward their problem. Manual treatment methods and certain behavioral modification methods may be valuable complements to physiotherapy for some groups of patients. Treatment and intervention should be goal related, and the physiotherapist should set appropriate limits so the patient can carry out the exercises independently, regularly, and over a long period. Exercises my cover different types of activity that engage major muscle groups and continue for at least 20 minutes per occasion, during work-time or free time, and over a longer period, ie, for as long as the patient wants to see results from training. Different means should be used to monitor patient training, since changes in exercise habits appear to depend on the physiotherapist taking notice of the patients exercise habits. In cases where work capability is impaired, the interventions should also be work-oriented.



    - Patients with chronic problems that last more than 12 weeks should be thoroughly examined by a physiotherapist to identify their mobility-related condition (impairment), capability (activity), and behavior (participation), and be given the opportunity to discuss attitudes and possible apprehension toward their problem. Treatment and intervention should be goal related, and the physiotherapist should set appropriate limits so the patient can carry out the exercises independently, regularly, and over a long period. Methods aimed exclusively at pain relief have fewer, if any, effects, eg, manual treatment methods. The focus should be placed on function-oriented exercises in combination with behavioral modification aimed at increasing the patients ability to be active. Patient compliance with treatment is higher with individual treatment (or if the individual has access to a physiotherapist) than with group treatment. Multi-program treatment, where physiotherapy interventions are carried out in collaboration with other team members and people at the workplace, has an impact on work capacity.

  4. lessia2000
    #4
    ×èòàòåëü Íåäóã.Ðó
    Óâ. Ãðèíîê!

    Ñàìàÿ ëó÷øàÿ îïåðàöèÿ ýòî òà, êîòîðîé óäàëîñü èçáåæàòü. À îïåðàöèÿ íà ïîçâîíî÷íèêå âñåãäà íåñ¸ò çà ñîáîé ðèñê îñòàòüñÿ èíâàëèäîì íà âñþ æèçíü. Êîíå÷íî, ïðè ïðîâåäåíèè å¸ ñïåöèàëèñòîì ðèñê ìèíèìàëåí, íî âñ¸ æå. Ê òîìó æå, ê îïåðàöèè åñòü îïðåäåë¸ííûå ïîêàçàíèÿ - ñäàâëåíèå ñïèííîãî ìîçãà ãðûæåé, äîëãîå âðåìÿ íå êóïèðóþùèéñÿ áîëåâîé ñèíäðîì, íàðàñòàþùèé ïàðåç íèæíåé (èõ) êîíå÷íîñòè (åé) è ò.ä. Åñëè ó Âàñ åñòü ýòè ïîêàçàíèÿ è èñ÷åðïàíû âñå êîíñåðâàòèâíûå ìåòîäû ëå÷åíèÿ - òîãäà îá îïåðàöèè ñëåäóåò çàäóìàòüñÿ âñåðü¸ç.

    À î âûáîðå ìåòîäà îïåðàòèâíîãî âìåøàòåëüñòâà ëó÷øå, áåçóñëîâíî, ïîäñêàæóò íåéðîõèðóðãè.



    Áîëüøîå ñïàñèáî, Âàì çà îòâåò, íî, ïîõîæå Âû ìåíÿ íåñîâñåì ïîíÿëè.



    Îïðåäåëåííî ó ìåíÿ åñòü ïîêàçàíèÿ ê îïåðàöèè.

     ÷àñòíîñòè, ýòî ñëåäóåò èç äèàãíîçà - ó ìåíÿ ÷åòûðåõìåñÿ÷íûé íå êóïèðóþùèéñÿ áîëåâîé ñèíäðîì.

    Ìíîãèå ìåòîäû êîíñåðâàòèâíîãî ëå÷åíèÿ, êàê òî:

    - ìåäèêàìåíòîçíîå;

    - ââåäåíèå êàðèïàçèìà ñ ýëåìåíòàìè ôèçèîòåðàïèè;

    - 2 ýïèäóðàëüíûå áëîêàäû (àáñîëþòíî áåçðåçóëüòàòíûå)

    - èãëîòåðàïèÿ ó äâóõ ðàçíûõ ñïåöèàëèñòîâ



    È âîïðîñ ìîé ñîñòîÿë â èñïîëüçîâàíèè ìåòîäà ââåäåíèÿ ãëþêîêîðòèêîèäà íåïîñðåäñòâåííî â ïîâðåæäåííûé äèñê. Èìåííî â ìîåì êîíêðåòíîì ñëó÷àå.

    Ìíå õîòåëîñü óçíàòü ìíåíèå ñïåöèàëèñòîâ îá ýòîì ìåòîäå, êàê ðåøåíèè ìîåé ïðîáëåìû.

    Áåçóñëîâíî ëþáàÿ îïåðàöèÿ - ýòî êðàéíÿÿ ìåðà, è ÿ íå â âîñòîðãå ïðîâîäèòü ýêñïåðèìåíòû íà ñâîåì ñòðàäàþùåì òåëå, íî âûõîä íàäî èñêàòü. ×åì ÿ è çàíèìàþñü, ñîáèðàÿ èíôîðìàöèþ î ìåòîäàõ îïåðàòèâíîãî âìåøàòåëüñòâà èëè ëþáîãî äðóãîãî.



     Ìîñêâå ìíå, íàïðèìåð, íåéðîõèðóðãè ñðàçó ïðåäëîæèëè îïåðàöèþ. Ïîíÿòíî, ýòî èõ ðàáîòà è èõ õëåá. Ìíå òî õî÷åòñÿ íàéòè îïòèìàëüíûé âûõîä.

  5. îÿ
    #5
    ×èòàòåëü Íåäóã.Ðó
    Ëàòåðàëüíûå ãðûæè äèñêîâ — ñáîðíàÿ ãðóïïà, îáúåäèíÿþùàÿ ãðûæè, ðàñïîëîæåííûå âíóòðè ïîçâîíêîâîãî îòâåðñòèÿ èëè çà åãî ïðåäåëàìè (ôîðàìèíàëüíûå è ýêñòðàôîðàìèíàëüíûå ñîîòâåòñòâåííî),âñëåäñòâèè ôîðàìèíàëüíûé ñòåíîç ñ ðàçâèòèåì äèñêî-ðàäèêóëÿðíîãî êîíôëèêòà.Ëå÷åíèå òàêèõ ãðûæ ïðè ñîîòâåòñòâóþùåé êëèíè÷åñêîé êàðòèíå è âèçóàëèçàöèè õèðóðãè÷åñêîå. Ïîëîæèòåëüíûå ðåçóëüòàòû â õèðóðãèè ëàòåðàëüíûõ ãðûæ äèñêîâ äîñòèãàþòñÿ òîëüêî ïðè àäåêâàòíîé ïðåäîïåðàöèîííîé äèàãíîñòèêå (ÊÒ è ÌÐÒ) è ïðàâèëüíîì âûáîðå õèðóðãè÷åñêîãî ïîäõîäà ñ ó÷åòîì íåéðîàíàòîìè÷åñêèõ îñîáåííîñòåé è ëîêàëèçàöèè ãðûæè â êàæäîì êîíêðåòíîì ñëó÷àå.

  6. Âàñ
    #6
    ×èòàòåëü Íåäóã.Ðó
    Ëàòåðàëüíûå ãðûæè äèñêîâ — ñáîðíàÿ ãðóïïà, îáúåäèíÿþùàÿ ãðûæè, ðàñïîëîæåííûå âíóòðè ïîçâîíêîâîãî îòâåðñòèÿ èëè çà åãî ïðåäåëàìè (ôîðàìèíàëüíûå è ýêñòðàôîðàìèíàëüíûå ñîîòâåòñòâåííî),âñëåäñòâèè ôîðàìèíàëüíûé ñòåíîç ñ ðàçâèòèåì äèñêî-ðàäèêóëÿðíîãî êîíôëèêòà.Ëå÷åíèå òàêèõ ãðûæ ïðè ñîîòâåòñòâóþùåé êëèíè÷åñêîé êàðòèíå è âèçóàëèçàöèè õèðóðãè÷åñêîå. Ïîëîæèòåëüíûå ðåçóëüòàòû â õèðóðãèè ëàòåðàëüíûõ ãðûæ äèñêîâ äîñòèãàþòñÿ òîëüêî ïðè àäåêâàòíîé ïðåäîïåðàöèîííîé äèàãíîñòèêå (ÊÒ è ÌÐÒ) è ïðàâèëüíîì âûáîðå õèðóðãè÷åñêîãî ïîäõîäà ñ ó÷åòîì íåéðîàíàòîìè÷åñêèõ îñîáåííîñòåé è ëîêàëèçàöèè ãðûæè â êàæäîì êîíêðåòíîì ñëó÷àå.



    Åñëè íå òðóäíî, íå ìîãëè áû Âû, óêàçàòü èñòî÷íèê ýòîé âûäåðæêè, òàê êàê ÿ ïûòàþñü ñîáðàòü ìàêñèìóì èíôîðìàöèè ïî ñâîåé ïðîáëåìå. Õîòåëîñü áû òàêæå óñëûøàòü Âàøå ëè÷íîå ìíåíèå íà ñåé ñ÷åò.

    Ñïàñèáî.

  7. bastik
    #7
    ×èòàòåëü Íåäóã.Ðó
    Åñëè íå òðóäíî, íå ìîãëè áû Âû, óêàçàòü èñòî÷íèê ýòîé âûäåðæêè, òàê êàê ÿ ïûòàþñü ñîáðàòü ìàêñèìóì èíôîðìàöèè ïî ñâîåé ïðîáëåìå. Õîòåëîñü áû òàêæå óñëûøàòü Âàøå ëè÷íîå ìíåíèå íà ñåé ñ÷åò.

    Ñïàñèáî.



     êàæäîì êîíêðåòíîì ñëó÷àå ïîäõîä èíäèâèäóàëåí ïî äàííûì êëèíèêè è ìåòîäîâ íåéðîâèçóàëèçàöèè

  8. Vladimir580
    #8
    ×èòàòåëü Íåäóã.Ðó
    Âíóòðèäèñêîâîå ââåäåíèå ïðîñòûì ÿçûêîì íàäóâàåò èçíîøåííûé äèñê, êàê áû âîññòàíàâëèâàÿ åãî ïðåæíþþ ôîðìó,à ãëþêîðòèêîèä îáåçáîëèâàåò è ñíèìàåò îòåê, ÷òî ïîçâîëÿåò áåç îñîáîãî ðèñêà ïóòåì àêêóðàòíûõ ìàíèïóëÿöèé (ýòî ïî ñëîâàì äîêòîðà Èâàíîâà) îñâîáîäèòü íåðâíûé êîðåøîê îò äàâëåíèÿ ãðûæè (ôîðàìèíàëüíàÿ ãðûæà, ïî îáúÿñíåíèÿì âðà÷åé, äàâèò íåïîñðåäñòâåííî â îòâåðñòâèå, ãäå ðàñïîëîæåí êîðåøîê íåðâà.Íàäåþñü, ÷òî â äàííîì ñëó÷àå óâ. Ãðèíîê ïðîñòî íåâåðíî ïåðåäàë ñîäåðæàíèå áåñåäû ñ ä-ðîì. èç äåòñêîé áîëüíèöû.  ïðîòèâíîì ñëó÷àå ïîëó÷àåòñÿ, ÷òî ïðåäëîæåííûé åìó ìåòîä ëå÷åíèÿ - åñòü ïîëíàÿ áåññìûñëèöà: è ïðî "íàäóâàíèå äèñêà", è ïðî "îñâîáîæäåíèå êîðåøêà ìàíèïóëÿöèÿìè", äà è óêàçàííàÿ ëîêàëèçàöèÿ äåëàåò âñå ýòè ïðîöåäóðû áåññìûñëåííûìè, äàæå, åñëè âäðóã ïðåäïîëîæèòü, ÷òî èõ ýôôåêò - íå ïóñòàÿ âûäóìêà (êàê ýòî åñòü íà ñàìîì äåëå).



    PS: Ïîëàãàþ òàêæå, ÷òî óâàæàåìûé äîêòîð Õîäíåâè÷, îòãîâàðèâàÿ ïàöèåíòà îò ýòîé ïðîöåäóðû, íå óòî÷íèë åìó âûøåóïîìÿíóòûé ôàêò ïðîñòî èç ñîîáðàæåíèé ýòèêè.

    Ïî ïîâîäó æå íåîáõîäèìîñòè îïåðàöèè ñëåäóåò ñêàçàòü, ÷òî ýòî íå òîò âîïðîñ, êîòîðûé ìîæåò áûòü ðåøåí íà ôîðóìå.

  9. EKA
    #9
    ×èòàòåëü Íåäóã.Ðó
    ß îïèñàë ïîñòàâëåííóþ ìíå çàäà÷ó äîêòîðîì Èâàíîâûì ñëîâî â ñëîâî.

    Âîçìîæíî Âàñ ñìóòèëî ñëîâî íàäóâàíèå äèñêà. Äàâàéòå ýòî âûðàæåíèå îïóñòèì.

    Òåïåðü îïåðàöèÿ, ïðåäëîæåííàÿ äîêòîðîì Èâàíîâûì èìååò ñìûñë?

    ß âåäü ðåêîìåíäàöèþ è íàïðàâëåíèå íà ëå÷åíèå îò íåãî íå íà âå÷åðèíêå ïîëó÷èë, à çà ñâîè äåíüãè è çà ñâîå ïîòðà÷åííîå âðåìÿ.

    Âîò ÿ è ïûòàþñü ðàçîáðàòüñÿ â ñîâåòàõ âðà÷åé.

    ß çàäàë ýòîò âîïðîñ âîâñå íå ïîòîìó, ÷òî ìíå íå ÷åì çàíÿòüñÿ â ñâîáîäíîå âðåìÿ, à ïîòîìó ÷òî ÿ æèâó áîëåå 4 ìåñÿöåâ ñ ïîñòîÿííîé áîëüþ è íå ìîãó äâèãàòüñÿ, êàê íîðìàëüíûé çäîðîâûé ÷åëîâåê â ñâîè 35 ëåò.

    Åñëè Âû ñïåöèàëèñò, òî, âîçìîæíî, ñëûøàëè, î ëå÷åíèè â Ðîññèè ãðûæè ÌÏÄ êàðèïàçèìîì, êîòîðûé ó Âàñ â Àìåðèêå ïðèäóìàëè ïîä íàçâàíèåì ïàïàèí.

    Â Ðîññèè â èíñòèòóòå íåéðîõèðóðãèè èì.Áóðäåíêî åñòü îòäåëåíèå ðåàáèëèòàöèè, çàâåäóåò êîòîðûì ïðîôåññîð Íàéäèí.

    Äîêòîð Íàéäèí ïðîïàãàíäèðóåò ëå÷åíèå êàðèïàçèìîì (ïàïàèíîì) ìíîãî ëåò. Îí è áûë ìîèì ëå÷àùèì âðà÷îì.

    Äîêòîð Íàéäèí ñ÷èòàåò, íà îñíîâå ñâîåãî ìíîãîëåòíåãî îïûòà, ÷òî êàðèïàçèì,ïîñëå äëèòåëüíîãî ïåðèîäà ââåäåíèÿ ñ ïîìîùüþ ýëåêòðîôîðåçà è ôîíîôîðåçà, óìåíüøàåò ãðûæó ÌÏÄ.

    Îäíàêî ýòîò ìåòîä äëèòåëüíûé è íå ïîçâîëÿåò ñíÿòü îòåê è áîëåâîé ñèíäðîì.

    ß ïðîõîäèë êóðñû ìåäèêàìåíòîçíîãî êîíñåðâàòèâíîãî ëå÷åíèÿ ñ öåëüþ êóïèðîâàíèÿ áîëåâîãî ñèíäðîìà. Ðåçóëüòàòà ýòî íå ïðèíåñëî.Áîëåå òîãî.Äâà ðàçà ÿ ñäåëàë ýïèäóðàëüíóþ áëîêàäó - òàêæå áåçðåçóëüòàòíî. Ïðèâîæó íèæå çàêëþ÷åíèÿ âðà÷à àíåñòåçèîëîãà-ðåàíèìàòîëîãà:



    Ýïèäóðàëüíàÿ áëîêàäà.

     àñåïòè÷åñêèõ óñëîâèÿõ ïîä ì.à. ð-ðîì íîâîêàèíà 0.5% - 5 ìë âûïîëíåíà ïóíêöèÿ ýïèäóðàëüíîãî ïðîñòðàíñòâà íà óðîâíå L3-L4 ( çàêëþ÷åíèå îñìîòðà íàïèñàíî ãðûæà äèñêà L5-S1, ìîæåò áûòü íàäî áûëî êîëîòü â ïðîñòðàíñòâî L4-L5 ?).

    Ýïèäóðàëüíî ââåäåíî: ð-ðà Íàðîïèíà 0.2%- 10 ìë + êåíàëîã 40 ìã.





    Ïîñëå âûïîëíåíèÿ ýïèäóðàëüíîé áëîêàäû ñîõðàíÿåòñÿ âûðàæåííûé ñïàçì ìûøö ÿãîäè÷íîé ãðóïïû, áîëü ïî õîäó ñåäàëèùíîãî íåðâà.



    - âûïîëíåíà áëîêàäà ãðóøåâèäíîé ìûøöû – ìàðêàèí 0.5% - 8 ìë

    - â.â (êàïåëüíèöà) – Ìàíèò 15% - 200 ìë

    (ýòî óæå äîïîëíèòåëüíûå ïðîöåäóðû)



    Îäíàêî äèíàìèêè â ñîñòîÿíèè ïàöèåíòà íå îòìå÷àåòñÿ.

    Ñ öåëüþ èñêëþ÷åíèÿ íåêîðåøêîâîãî ãåíåçà áîëåâîãî ñèíäðîìà (êîìïðåññèÿ ñåäàëèùíîãî íåðâà íà óðîâíå ÿãîäè÷íîé îáëàñòè) ðåêîìåíäîâàíî ßÌÐÒ îáëàñòè òàçà, ìÿãêèõ òêàíåé ÿãîäè÷íîé îáëàñòè äî óðîâíÿ ÿãîäè÷íîé ñêëàäêè ñ âèçóàëèçàöèåé ñåäàëèùíîãî íåðâà.





    Åäèíñòâåííîå, ÷åãî äîáèëèñü äîêòîðà - ó ìåíÿ ïîëíîñòüþ îòêàçàëà ïðàâàÿ íîãà íà 24 ÷àñà. Áîëè ïðè ýòîì îñòàëèñü.

    Äîëæåí çàìåòèòü, ÷òî ýòî áûëà óæå âòîðàÿ áåçðåçóëüòàòíàÿ áëîêàäà.



    Ò.å. íà ìîìåíò, êîãäà ïðîôåññîð Íàéäèí íàïðàâèë ìåíÿ ê äîêòîðó Èâàíîâó äëÿ êîíñóëüòàöèè, ó ìåíÿ íà ðóêàõ áûëî ñëåäóþùåå çàêëþ÷åíèå è ðåêîìåíäàöèÿ îò âðà÷åé èç öåíòðà ñíÿòèÿ áîëåâûõ ñèíäðîìîâ:



    Îáúåêòèâíî: Àíòàëãè÷åñêàÿ ïîçà, ïîõîäêà - àíòàëãè÷åñêèé êèôîñêîëèîç ïîÿñíè÷íîãî îòäåëà ïîçâîíî÷íèêà. Âûðàæåííûé äåôàíñ ìûøö ïîÿñíèöû. Ñèìïòîì Ëàñåãà ñ óãëà 20 ãðàäóñîâ ñïðàâà, ïåðåêðåñòíûé ñ óãëà 60 ãðàä. Ëåãêàÿ ãèïîòðîôèÿ ìûøö çàäíåé ïîâåðõíîñòè ïðàâîé ãîëåíè.Ïðàâûé àõèëëîâ è ïîäîøâåííûé ðåôëåêñû ñíèæåíû. ×óâñòâèòåëüíîñòü íå íàðóøåíà.



    Ðåêîìåíäîâàíî:

    ýóôèëëèí 2.4% - 10 +âèò Â12 500 ìêã + âèò. Â1(5%) - 2,0+ äåêñàìåòàçîí 8ìã + áàðàëãèí 5,0 â/â êàïåëüíî. çàòåì ìàíèòîë 400 ìë â/â êàïåëüíî - 3 äíÿ, (ñ 4-ãî äíÿ 200 ìë -3 äíÿ), ïîñëå ìàíèòîëà ëàçèêñ â/â 20 ìã ñòðóéíî.Êåòîðîë 2,0 â/ì Õ 2 ðàçà, ìèäîêàëì â/ì õ 2 ðàçà. ÄÎÍÀ 1 àìï. â/ì

    ÷åðåç äåíü - 5 äíåé. Ôèíëåïñèí (êàðáàìàçåïèí) 100 ìã õ 3 äíÿ.

    ×åðåç 3 äíÿ äåãèäðîòèðóþùåé òåðàïèè - ïîâòîðèòü ýïèäóðàëüíóþ àíåñòåçèþ.



    ß ïîêàçàë ýòó ðåêîìåíäàöèþ ïðîôåñîðó Íàéäèíó, íà ÷òî îí îòðåàãèðîâàë ñ êðàéíèì ñîìíåíèåì èç-çà îáèëèÿ ñèëüíîäåéñòâóþùèõ ïðåïàðàòîâ çà ñòîëü êîòîòêèé ïåðèîä âðåìåíè.

    Ñ ýòèì ïðåäïèñàíèåì ÿ è áûë îòïðàâëåí ê äîêòîðó Èâàíîâó, ÷òîáû ïðåäëîæèòü ìíå íàèáîëåå îïòèìàëüíûé ìåòîä áëîêàäû áîëåâîãî ñèíäðîìà.

    Òî, ÷òî ïðåäëîæèë äîêòîð Èâàíîâ, ÿ îïèñàë. Åñëè ýòî ïðåäëîæåíèå àáñóðäíî, òàê è ñêàæèòå ìíå.

    Çàðàíåå áëàãîäàðåí.

  10. igorekm
    #10
    ×èòàòåëü Íåäóã.Ðó
    Íàäåþñü, ÷òî â äàííîì ñëó÷àå óâ. Ãðèíîê ïðîñòî íåâåðíî ïåðåäàë ñîäåðæàíèå áåñåäû ñ ä-ðîì. èç äåòñêîé áîëüíèöû.  ïðîòèâíîì ñëó÷àå ïîëó÷àåòñÿ, ÷òî ïðåäëîæåííûé åìó ìåòîä ëå÷åíèÿ - åñòü ïîëíàÿ áåññìûñëèöà: è ïðî "íàäóâàíèå äèñêà", è ïðî "îñâîáîæäåíèå êîðåøêà ìàíèïóëÿöèÿìè", äà è óêàçàííàÿ ëîêàëèçàöèÿ äåëàåò âñå ýòè ïðîöåäóðû áåññìûñëåííûìè, äàæå, åñëè âäðóã ïðåäïîëîæèòü, ÷òî èõ ýôôåêò - íå ïóñòàÿ âûäóìêà (êàê ýòî åñòü íà ñàìîì äåëå).



    PS: Ïîëàãàþ òàêæå, ÷òî óâàæàåìûé äîêòîð Õîäíåâè÷, îòãîâàðèâàÿ ïàöèåíòà îò ýòîé ïðîöåäóðû, íå óòî÷íèë åìó âûøåóïîìÿíóòûé ôàêò ïðîñòî èç ñîîáðàæåíèé ýòèêè.

    Ïî ïîâîäó æå íåîáõîäèìîñòè îïåðàöèè ñëåäóåò ñêàçàòü, ÷òî ýòî íå òîò âîïðîñ, êîòîðûé ìîæåò áûòü ðåøåí íà ôîðóìå.



    Åñëè ðàññìàòðèâàòü èìåííî ìîþ öèòàòó, òî ýòî ìîÿ ïîïûòêà ïåðåäàòü îïèñàíèå ïðîöåññà ñíà÷àëà äîêòîðîì Èâàíîâûì, à çàòåì äîêòîðîì Õîäíåâè÷åì.Êîíå÷íî, ýòî íå ñëîâî â ñëîâî.Ïîä ýòèì ÿ èìåë ââèäó ïîñòàíîâêó çàäà÷è.

    Åñëè íàðóøåíà ëîãèêà, ïîæàëóéñòà, ïîïðàâüòå ìåíÿ. Ìû æå íå íà ñèìïîçèóìå. ß ïðîñòî ñî ñâîåé áîëüþ èùó îòâåòà ó ïðîôåññèîíàëîâ. Õîòÿ, êîíå÷íî, ó êàæäîãî åñòü ïðàâî îáâèíèòü äðóãîãî â íåâåæåñòâå. Ýòî, ïîæàëóé, íå ñàìûé ñëîæíûé âàðèàíò.

    Ñïàñèáî.

  11. Ìàðèÿ Ä
    #11
    ×èòàòåëü Íåäóã.Ðó
    ×åñòíî ãîâîðÿ, ó ìåíÿ è â ìûñëÿõ íå áûëî ïðèäèðàòüñÿ ê Âàøåìó, óâ. Grinok, èçëîæåíèþ. Sorry. Ïðîñòî ÿ äåéñòâèòåëüíî ñ÷èòàþ ïîñëåäíþþ, ïîëó÷åííóþ Âàìè, ðåêîìåíäàöèþ àáñóðäíîé. Ïîïûòêè âîññòàíîâèòü íàðóøåííóþ ïîääåðæèâàþùóþ ôóíêöèþ äèñêà äåéñòâèòåëüíî ïðåäïðèíèìàþòñÿ â íàñòîÿùåå âðåìÿ. Îäíàêî, ýòî ñîâñåì íå ìåòîä âíóòðèäèñêîâîé èíúåêöèè, à íàñòîÿùåå îïåðàòèâíîå âæèâëåíèå ìåòàëëè÷åñêîãî êàðêàñà, ñêðåïëÿþùåãî ñîñåäíèå ïîçâîíêè. (Îòíîøåíèå ê ýòîìó âàðèàíòó ó ìåíÿ ëè÷íî òîæå ïîêà äîâîëüíî ñêåïòè÷å÷êîå, íî äàííàÿ îïåðàöèÿ ïî êðàéíåé ìåðå ìîæåò áûòü ëîãè÷åñêè îáîñíîâàíà). "Íàäóâàíèå" æå èëè "çàïîëíåíèå" äèñêà, èëè íàçûâàéòå îïèñàííóþ ðàíåå ïðîöåäóðó, êàê õîòèòå, íå ìîæåò ïðåòåíäîâàòü äàæå íà òåîðåòè÷åñêóþ âîçìîæíîñòü ïîëüçû.

    ×òî êàñàåòñÿ ââåäåíèÿ ïàïàèíà, òî ýòî äåéñòâèòåëüíî äîâîëüíî äàâíî èçâåñòíàÿ ïðîöåäóðà, íî îíà íå èìååò íè÷åãî îáùåãî ñ òåì, î ÷åì Âû ðàññêàçàëè.



    PS: Ïîñêîëüêó Âû óæå íà÷àëè ëå÷åíèå êàðèïàçèìîì, äà åùå è óñêîðåííîå (èíòåðíåò - òà æå äåðåâíÿ - ïðî âñåõ âñå èçâåñòíî), ðàçóìíî ïîñìîòðåòü ñíà÷àëà íà åãî ðåçóëüòàò.

  12. Kalamit
    #12
    ×èòàòåëü Íåäóã.Ðó
    Óâàæàåìûé Grinok, ïîêàçàíèÿ ê îïåðàòèâíîìó ëå÷åíèþ ó Âàñ èìåþòñÿ. Åñëè âûáèðàòü ìàëîèíâàçèâíûå õèðóðãè÷åñêèå ìåòîäû, òî öåëåñîîáðàçíåå âûáðàòü -

    The aim of percutaneous laser disc decompression (PLDD) is to vaporize a small portion of the nucleus pulposus of an intervertebral disc, thereby reducing the volume of a diseased disc and the pressure within it. - ÷ðåñêîæíóþ ëàçåðíóþ äåêîìïðåññèþ äèñêà. Äàííûé ìåòîä îòíîñèòåëüíî íîâûé, çàêëþ÷àåòñÿ â ââåäåíèè ïîëîé èãëû â ìåæïîçâîíî÷íûé äèñê ïîä êîíòðîëåì ðåíãåíîãðàôèè è çàòåì âûïàðèâàíèå ëàçåðîì

    ïóëüïîçíîãî ÿäðà äèñêà.

    Ðåçóëüòàòû:

    The most extensive experience in the literature was published by Choy and Ascher, who used an Nd:YAG laser. They observed 333 patients for a mean duration of 26 months. The success rate was 78.4% (as measured by a good or fair response) according to MacNab.



    Siebert (1995) reported on his first 100 patients treated with Nd:YAG. The success rate was 78% at mean follow-up point of 17 months.



    Davis reported an 85% success rate with the KTP laser, with success rate defined as minimal discomfort and the ability to return to gainful employment (follow-up duration was not specified). Yeung (2000) reported preliminary assessment of more than 1000 patients whose herniated lumbar discs were treated with KTP laser. The reported success rate (good or excellent results) was 84%. No specifics were supplied.





    Sherk and colleagues used Ho:YAG laser in a comparison of laser discectomy and conservative treatment. No differences were noted between treated and control groups. They concluded that laser discectomy is a safe procedure that appears to be effective in relieving symptoms in some patients. The author uses Ho:YAG laser, and successful results are approximately 80% (comparable to those of other investigators). According to Kramer, the best clinical results were found in discographic stages 7 and 8. In cases of epidural leak of contrast medium and in cases of total degeneration, the clinical results were significantly poor (stages 6 and 9).



    The literature now includes 23 well-documented cases of erectile dysfunction caused by spinal cord disc herniation. PLDD is a minimally invasive procedure that that can be used to treat such herniation.



    From 1991-1993, 31 patients with herniated cervical discs were treated with PLDD. In 1990, a few of these patients were treated with the Nd:YAG laser with no complications. Since 1991, the authors have used the Ho:YAG laser; 28 of 31 patients experienced pain relief in a 6-week follow-up period. PLDD is a viable therapy for cervical discs. Ò.å. ýôôåêò îïèñàí äëÿ 70-85% ïàöèåíòîâ.



    The rapid acceptance of minimally invasive surgery in the United States has occurred largely without statistical proof of its superiority over traditional methods. All members of the healthcare field now see the need for valid outcome studies supporting the efficacy of new treatment techniques. PLDD will gain wide acceptance only if it is demonstrated statistically to be a safe and effective alternative treatment to lumbar disc herniation.

    Ò.å. â íàñòîÿùåå âðåìÿ íå èìååòñÿ ñòàòèñòè÷åñêèõ äàííûõ ïðåâîñõîäñòâà ýòîãî ìåòîäà íàä òðàäèöèîííûìè õèðóðãè÷åñêèìè ìåòîäàìè è ïðè íàëè÷èè òàêèõ äàííûõ ìåòîä ïîëó÷èò îäîáðåíèå äëÿ øèðîêîãî èñïîëüçîâàíèÿ â ïðàêòèêå. Ýòî çàÿâëåíèå íå óêàçûâàåò íà íåýôôåêòèâíîñòü ìåòîäà, à ëèøü óêàçûâàåò íà íåîáõîäèìîñòü ïðîâåäåíèÿ ñðàâíèòåëüíûõ èññëåäîâàíèé ñ òðàäèöèîííûìè õèðóðãè÷åñêèìè ìåòîäàìè.

  13. Öûãàíêîâà
    #13
    ×èòàòåëü Íåäóã.Ðó
    ×åñòíî ãîâîðÿ, ó ìåíÿ è â ìûñëÿõ íå áûëî ïðèäèðàòüñÿ ê Âàøåìó, óâ. Grinok, èçëîæåíèþ. Sorry. Ïðîñòî ÿ äåéñòâèòåëüíî ñ÷èòàþ ïîñëåäíþþ, ïîëó÷åííóþ Âàìè, ðåêîìåíäàöèþ àáñóðäíîé. Ïîïûòêè âîññòàíîâèòü íàðóøåííóþ ïîääåðæèâàþùóþ ôóíêöèþ äèñêà äåéñòâèòåëüíî ïðåäïðèíèìàþòñÿ â íàñòîÿùåå âðåìÿ. Îäíàêî, ýòî ñîâñåì íå ìåòîä âíóòðèäèñêîâîé èíúåêöèè, à íàñòîÿùåå îïåðàòèâíîå âæèâëåíèå ìåòàëëè÷åñêîãî êàðêàñà, ñêðåïëÿþùåãî ñîñåäíèå ïîçâîíêè. (Îòíîøåíèå ê ýòîìó âàðèàíòó ó ìåíÿ ëè÷íî òîæå ïîêà äîâîëüíî ñêåïòè÷å÷êîå, íî äàííàÿ îïåðàöèÿ ïî êðàéíåé ìåðå ìîæåò áûòü ëîãè÷åñêè îáîñíîâàíà). "Íàäóâàíèå" æå èëè "çàïîëíåíèå" äèñêà, èëè íàçûâàéòå îïèñàííóþ ðàíåå ïðîöåäóðó, êàê õîòèòå, íå ìîæåò ïðåòåíäîâàòü äàæå íà òåîðåòè÷åñêóþ âîçìîæíîñòü ïîëüçû.

    ×òî êàñàåòñÿ ââåäåíèÿ ïàïàèíà, òî ýòî äåéñòâèòåëüíî äîâîëüíî äàâíî èçâåñòíàÿ ïðîöåäóðà, íî îíà íå èìååò íè÷åãî îáùåãî ñ òåì, î ÷åì Âû ðàññêàçàëè.



    PS: Ïîñêîëüêó Âû óæå íà÷àëè ëå÷åíèå êàðèïàçèìîì, äà åùå è óñêîðåííîå (èíòåðíåò - òà æå äåðåâíÿ - ïðî âñåõ âñå èçâåñòíî), ðàçóìíî ïîñìîòðåòü ñíà÷àëà íà åãî ðåçóëüòàò.



    Íà êîíñóëüòàöèþ ê äîêòîðó Èâàíîâó ìåíÿ íàïðàâèë ïðîôåññîð Íàéäèí, ÷òîáû íàéòè àäåêâàòíûé ñïîñîá áîðüáû ñ ìîèì áåñïðåðûâíûì áîëåâûì ñèíäðîìîì.

    Ëå÷åíèå êàðèïàçèìîì-ïàïàèíîì äåéñòâèòåëüíî íè÷åãî îáùåãî ñ ýòèì íå èìååò. Ñîáñòâåííî, ïðîôåññîð Íàéäèí è íå îáåùàë, ÷òî ìíå ñíèìåò â îáîçðèìûé ñðîê áîëè ýòîò êàðèïàçèì. Îí ñ÷èòàë, ÷òî â ìîåì ñëó÷àå ëå÷åíèå ñ áîëüøîé äîëåé âåðîÿòíîñòè â êîíöå êîíöîâ ïðèâåäåò ê óìåíüøåíèþ ãðûæè, ÷òî, âîçìîæíî, â èòîãå óìåíüøèò áîëè.

    Ê äîêòîðó Èâàíîâó ÿ ïîåõàë. ÷òîáû âûáðàòü ñïîñîá áëîêàäû áîëè. Îí è ïðåäëîæèë âíóòðèäèñêîâîå ââåäåíèå ãëþêîêîðòèêîèäà.

    Íàñêîëüêî ÿ ïîíÿë, ýòà îïåðàöèÿ îòëè÷àåòñÿ îò ýïèäóðàëüíîé áëîêàäû, êîòîðûå ìíå íå ïðèíåñëè îáåçáîëèâàíèÿ äâàæäû.

    Âîò ÿ è õîòåë óçíàòü ìíåíèå ñïåöèàëèñòîâ íà ñåé ñ÷åò. Âðÿä ëè äîêòîð Èâàíîâ ïðèäóìàë ýòó ïðîöåäóðó, ññûëàÿñü íà îïûò ãåðìàíñêèõ óíèâåðñèòåòñêèõ êëèíèê.

    Îäèí óñêîðåííûé êóðñ êàðèïàçèìà ÿ ñäåëàë. Ïîòîì, ïî èäåå, äîëæåí áûòü ïåðåðûâ, à ïîòîì ìîæíî îïÿòü ïðîäîëæàòü ââåäåíèå.

     ïåðåðûâå ÿ îòïðàâèëñÿ íà ëå÷åíèå â Àâñòðèþ, ãäå, êàê íè ñòðàííî,áóêâàëüíî 3 äíÿ íàçàä ó ìåíÿ ïîÿâèëàñü ïîëîæèòåëüíàÿ äèíàìèêà â ëå÷åíèè. Áîëè îñòàëèñü, íî ÿ ðàñïðÿìèëñÿ.

    Ïðî îïåðàöèþ òåïåðü ñòàë äóìàòü íå òàê àêòèâíî, íî âàðèàíòû áîðüáû ñ ýòèì íåäóãîì ìåíÿ âñå ðàâíî ïðîäîëæàþò âîëíîâàòü, òàê êàê ÿ ïîíèìàþ, ÷òî ÷óäåñ íå áûâàåò.

  14. Greny
    #14
    ×èòàòåëü Íåäóã.Ðó
    Áîëüøîå ñïàñèáî Âàì çà ó÷àñòèå, ÿ íåïðåìåííî ïîäêîëþ, ïîëó÷åííóþ îò Âàñ èíôîðìàöèþ â ñâîþ ïàïêó ñ íàäïèñüþ "ëå÷åíèå".Óâåðåí, ÷òî ïðàâèëüíûé âûáîð ìåòîäà îïåðàòèâíîãî âìåøàòåëüñòâà êðàéíå íåîáõîäèì, îñîáåííî, êàê ÿ ïîíÿë, â ìîåì ñëó÷àå, ò.å. ñ ëàòåðàëüíûìè ãðûæàìè.

    Íàäåþñü, âîïðîñ îá îïåðàöèè ïîêà îòëîæèòñÿ íà íåêîòîðîå âðåìÿ (õîòåëîñü áû äóìàòü - íàâñåãäà), òàê êàê íàìåòèëñÿ óñòîé÷èâûé ïðîãðåññ â ìîåì êîíñåðâàòèâíîì ëå÷åíèè.

     ëþáîì ñëó÷àå, ïîêà áîëè íå îòñòóïÿò íàäîëãî, ÿ áóäó èíòåðåñîâàòüñÿ ýòèì âîïðîñîì.

    Åùå ðàç ñïàñèáî.

Êëèíèêà ñòîìàòîëîãèè è êîñìåòîëîãèè â Ìîñêâå

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