Sindromul de Tunel Carpian Oli
-
Upload
ioana-trifan -
Category
Documents
-
view
241 -
download
8
Transcript of Sindromul de Tunel Carpian Oli
![Page 1: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/1.jpg)
SINDROMUL DE TUNEL CARPIAN
![Page 2: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/2.jpg)
LOCALIZAREA TUNELULUI CARPIAN
![Page 3: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/3.jpg)
EPIDEMIOLOGIE
• Femei: 9 %• Barbati: 0,6%• Varful intre 40-60 ani
![Page 4: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/4.jpg)
FACTORI DE RISC
GreutateSarcinaDZHipo/hipertiroidismOvarectomieDeviere anatomica (traumatic / congenital) Profesionali
![Page 5: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/5.jpg)
CURSUL NATURAL AL BOLII
• ¼ - 1/3 ameliorare semnificativa dupa 1 an
• 50% asimptomatic postsarcina
![Page 6: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/6.jpg)
FIZIOPATOLOGIE
• Canal ingust
• Compresia nervului median in tunelul carpian
• 90% idiopatic
![Page 7: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/7.jpg)
DIAGNOSTIC = ANAMNEZA !
• Parestezii• Furnicaturi nocturne• Tulburarea somnului• Furnicaturi/durere • Scuturare usoara a mainii (semnul Flick)• Stadii avansate: furnicaturi in timpul zilei
![Page 8: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/8.jpg)
INERVARE SENZORIALA NERVUL MEDIAN
![Page 9: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/9.jpg)
LOCALIZARI ATIPICE ALE SENZATIEI DE FURNICATURA
• Adesea in afara zonei nervului median
• Uneori in zona nervului ulnar
![Page 10: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/10.jpg)
EXAMINARE NEUROFIZIOLOGICA
• Verificarea diagnosticului clinic inainte de operatie
![Page 11: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/11.jpg)
TRATAMENT
![Page 12: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/12.jpg)
ATELA• Zi si noapte
• Eficienta pe termen scurt
• Simptome minore / recente
![Page 13: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/13.jpg)
CHIRURGIE:• Foarte eficace
• Simptome major/ recurente Dorinta pacientului
• Deschis / endoscopic
• Succes: 75-90%
• Complicatii: deteriorarea nervului, durere, rana, sindrom regional complex)
![Page 14: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/14.jpg)
INJECTII CU CORTICOSTEROZI
• Eficacitate pe termen scurt +
• 50% fara simptome dupa un an
![Page 15: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/15.jpg)
IGIENA
• Spalarea mainilor, purtarea de manusi sau dezinfectarea degetelor
• Fiole folosite o singura data
• Schimbarea acelor
• Dezinfectia pielii
![Page 16: Sindromul de Tunel Carpian Oli](https://reader036.fdocument.pub/reader036/viewer/2022062302/577cc9d01a28aba711a4af7c/html5/thumbnails/16.jpg)
MULŢUMESC !