Ƙashin ƙashin ƙugu (daga ƙashin ƙashin Latin) bel ɗin ƙashi ne wanda ke goyan bayan nauyin jiki wanda ke haifar da haɗin gwiwa tsakanin gangar jikin da ƙananan gaɓɓai.

Ƙashin ƙashin ƙugu, ko ƙashin ƙugu, bel ɗin kashi ne wanda ke ƙarƙashin ciki wanda ke goyon bayan kashin baya. An yi shi daga haɗuwa da ƙasusuwan coxal guda biyu (ƙashin hip ko kashi na iliac), sacrum da coccyx. Kasusuwan hip sune kansu sakamakon hadewar kashi uku: ilium, ischium da pubis.

Kasusuwan hip suna haɗuwa a bayan sacrum, ta fikafikan ilium, a matakin haɗin gwiwa na sacroiliac. Babban gefen reshe shine jijiyar iliac, shine wurin shigar da tsokoki na ciki. Ƙaƙƙarfan ƙashin ƙugu suna da zafi lokacin da kuka sanya hannuwanku a kan kwatangwalo.

Kasusuwan hips biyu suna haduwa a gaba a matakin pubis. Suna haɗuwa tare da pubic symphysis. A cikin wurin zama, an nuna mu a kan rassan ischio-pubic (reshe na pubis da ischium).

An haɗa ƙashin ƙugu tare da ƙananan ƙafafu a matakin hip ko haɗin gwiwa na coxofemoral: acetabulum (ko acetabulum), wani nau'i mai siffar C, yana karɓar shugaban femur.

Wani rami mai siffar mazurari, ƙashin ƙugu ya kasu kashi biyu: babban ƙashin ƙugu da ƙananan ƙashin ƙugu. Babban kwano shine ɓangaren sama, wanda fikafikan ilium ke iyakance shi. Ƙananan kwandon yana ƙarƙashin waɗannan fuka-fuki.

An iyakance kogon da buɗewa biyu:

• babban magudanar ruwa wadda ita ce babbar buɗaɗɗen kwandon. Yana nuna alamar canji tsakanin babba da ƙananan ƙashin ƙugu. Ya dace da sararin samaniya da aka keɓe daga gaba zuwa baya ta gefen sama na symphysis na pubic, layukan da ba a iya gani ba da kuma haɓakar sacrum (banshi na sama) (3).
• Ƙarƙashin ƙasa shine ƙananan buɗewa na kwandon. Yana samar da lu'u-lu'u. An iyakance shi a gaba ta ƙananan iyaka na pubic symphysis, a gefe ta hanyar rassan ischiopubic da ischial tuberosities, kuma a ƙarshe a baya ta ƙarshen coccyx (4).

A cikin mata masu juna biyu, ma'auni na basin da ƙuƙuka sune mahimman bayanai don tsammanin wucewar jariri. Sacroiliac haɗin gwiwa da pubic symphysis kuma suna samun ɗan sassauci ta hanyar aikin hormones don haɓaka haihuwa.

Akwai banbanci tsakanin wuraren waha maza da mata. Kashin mata shine:

• Fadi kuma mafi zagaye,
• Mai zurfi,
• Ƙarfinsa ya fi zagaye saboda kusurwar da aka kafa ta fi girma,
• Sacrum ya fi guntu kuma coccyx madaidaiciya.

Ƙashin ƙashin ƙugu shi ne wurin shigar tsokoki daban-daban: tsokoki na bangon ciki, na duwawu, ƙananan baya da mafi yawan tsokoki na cinyoyin.

Ƙashin ƙashin ƙugu wani yanki ne wanda tasoshin ruwa da yawa ke shayar da shi sosai: jijiyar iliac na ciki wanda aka raba musamman zuwa cikin dubura, pudendal ko ilio-lumbar artery. Jijiyoyin ƙashin ƙugu sun haɗa da wasu jijiyar iliac na ciki da na waje, gama gari, dubura…

Kogon ƙwanƙwasa yana cike da wadatuwa ta hanyar: lumbar plexus (misali: jijiyar femoral, fata na gefe na cinya), sacral plexus (misali: jijiya na fata na cinya, sciatica), plexus pudendal (misali: jijiya pudendal, azzakari. , clitoris) da kuma coccygeal plexus (misali: sacral, coccygeal, genitofemoral jijiya). Wadannan jijiyoyi an yi niyya don viscera na rami (al'aura, dubura, dubura, da dai sauransu) da kuma tsokoki na ciki, pelvic da babba (cinya).

Babban aikin ƙashin ƙugu shine don tallafawa nauyin jikin babba. Hakanan yana kare al'aurar ciki, mafitsara da sashin babban hanji. Har ila yau, kasusuwa na hip suna bayyana tare da kashin cinya, femur, wanda ke ba da damar tafiya.

Karyewar ƙashin ƙugu : zai iya rinjayar kashi a kowane mataki amma wurare uku sun fi dacewa da haɗari: sacrum, pubic symphysis ko acetabulum (kan femur ya nutse cikin ƙashin ƙugu kuma ya karya shi). Karayar ko dai ta faru ne ta hanyar girgiza mai tsanani (hadarin hanya, da sauransu) ko faɗuwa tare da raunin kashi (misali osteoporosis) a cikin tsofaffin batutuwa. Za a iya shafan viscera, tasoshin, jijiyoyi da tsokoki na ƙashin ƙugu a lokacin karaya kuma suna haifar da sequelae (jijiya, fitsari, da dai sauransu).

hip zafi : suna da asali iri-iri. Koyaya, a cikin mutane sama da 50, galibi ana danganta su da osteoarthritis. Sau da yawa, ciwon da ke hade da ciwon hanji zai zama "masu yaudara", a cikin gida misali a cikin makwanci, buttock, ko ma a cikin kafa ko gwiwa. Sabanin haka, ana iya jin zafi a cikin kwatangwalo kuma a zahiri ya zo daga wuri mai nisa (baya ko makwancin gwaiwa, musamman).

Pudendal neuralgia : qaunar jijiyar jijiyar da ke shiga cikin yankin ƙashin ƙugu (tsarin fitsari, dubura, dubura, al'aura...). Yana da halin ciwo mai tsanani (ƙonawa, jin dadi) ya tsananta ta wurin zama. Gabaɗaya yana rinjayar mutane tsakanin 50 zuwa 70 shekaru kuma ba a gano dalilin wannan cutar ba a fili: yana iya zama matsi na jijiyoyi ko ɓoyewa a wurare daban-daban (wanda aka tsunkule tsakanin ligaments biyu, a cikin canal karkashin pubic ...) ko ta hanyar wani ƙari misali. Hakanan ana iya haifar da neuralgia ta yawan amfani da keke ko haihuwa.

Motsa jiki a lokacin haihuwa

Takamaiman motsi a cikin mahaɗin sacroiliac waɗanda ke ba da izinin bayarwa na farji:

• Motsi na nutation: a tsaye na sacrum (ja da baya da haɓakawa na promontory) yana faruwa lokacin da aka haɗa shi da ci gaba da ragewa na coccyx da rabuwa da fuka-fuki na iliac. Wadannan motsi suna da tasirin fadada mashigin sama * da rage mashigin kasa **.
• Motsi na Nutation: motsi na baya yana faruwa: ci gaba da ragewa na promontory na sacrum, ja da baya da hawan coccyx da kimanin fuka-fukan iliac. Wadannan motsin suna da sakamakon fadada mashigin kasa da kuma takaita mashigin sama.

Hip osteoarthritis (ko coxarthrosis) : yayi daidai da lalacewa na guringuntsi a matakin haɗin gwiwa tsakanin shugaban femur da kashin hip. Wannan ci gaba da lalacewa na guringuntsi yana bayyana ta ciwo a cikin haɗin gwiwa. Babu jiyya da zasu ba da damar haɓakar guringuntsi. Hip osteoarthritis, ko coxarthrosis, yana shafar kusan kashi 3% na manya.

Tsofaffi suna wakiltar al'ummar da ke cikin haɗarin ɓarkewar ƙashin ƙugu saboda sun fi fuskantar faɗuwa kuma ƙasusuwansu sun fi rauni. Haka abin yake ga masu ciwon kashi.

Hana faduwar ba abu ne mai sauki ba, amma yana da kyau a rika amfani da abinci mai dauke da sinadarin calcium da bitamin D domin karfafa kashi da yaki da ciwon kashi. Ga tsofaffi, yana da mahimmanci don kawar da duk wani cikas a cikin muhallinsu wanda zai iya zama sanadin faɗuwar tashin hankali (cire tabarma) da kuma daidaita halayensu (saka sanduna a cikin bayan gida, saka takalma masu riƙe da ƙafa). . Hakanan yana da kyau a guji yin wasanni cikin haɗarin faɗuwar tashin hankali (parachuting, hawan doki, da sauransu) (10).

Gwajin asibiti: idan ana zargin karaya ta kashin baya, likitan zai fara yin gwajin asibiti. Misali, zai bincika ko akwai jin zafi yayin tattara haɗin sacroiliac (tsakanin ilium da sacrum) ko kuma naƙasasshen ƙafar ƙafa.

Radiography: dabarar hoton likitanci da ke amfani da hasken X-ray. Radiyo na gaba da na gefe yana ba da damar ganin tsarin kasusuwa da gabobin da ke cikin ƙashin ƙugu da kuma haskaka karaya misali.

MRI (hoton maganadisu na maganadisu): gwajin likita don dalilai na bincike da aka gudanar ta amfani da babban na'urar silindi wanda aka samar da filin maganadisu da igiyoyin rediyo. Inda radiyon ba ya ƙyale shi, yana sake fitar da ingantattun hotuna. Ana amfani da shi musamman a lokuta na hip da ciwon ciki. Don ganin gabobin, ana iya haɗa MRI tare da allurar samfurin bambanci.

pelvic duban dan tayi: fasaha na hoto wanda ya dogara da amfani da duban dan tayi don ganin tsarin ciki na gabobin jiki. A cikin yanayin ƙashin ƙugu, duban dan tayi yana ba da damar ganin gabobin cikin rami (mafitsara, ovary, prostate, tasoshin, da dai sauransu). A cikin mata, jarrabawa ce ta kowa don bibiyar ciki.

Scanner: fasaha na hoto na bincike wanda ya ƙunshi "nau'i-nau'i" da aka ba da yanki na jiki don ƙirƙirar hotuna masu ban sha'awa, godiya ga amfani da katako na X-ray. Kalmar “Scanner” ita ce ainihin sunan na’urar likitanci, amma ana yawan amfani da ita wajen suna jarrabawar. Har ila yau, muna magana game da na'ura mai kwakwalwa ko na'ura mai kwakwalwa. A cikin yanayin ƙashin ƙugu, ana iya amfani da CT scan don nemo karayar da ba a iya gani akan x-ray ko ma'aunin pelvimetric (girman pelvic) a cikin mata masu juna biyu.

Na dogon lokaci, samun babban ƙashin ƙugu yana haɗuwa da haihuwa kuma don haka an dauke shi a matsayin ma'auni na lalata.

A zamanin yau, akasin haka, an fi son kunkuntar ƙashin ƙugu fiye da hoton sanannen girman 36.