èžéåºå£çå矀ãšåŸéºé害

ç£ä¿®çŠå²¡æ³åŸäºåæ æé· åŒè·å£« è°·å· èæ²»åŒè·å£«æ³äººALG&Associates
亀éäºæ
ã«éã£ãåŸãè
ã®çã¿ããã³ããã ãããæ¡åã®äœäžçã®çç¶ãã¿ãããå Žåã¯ãèžéåºå£çå矀ïŒTOSïŒThoracic Outlet SyndromeïŒãçºçããŠãããããããŸããã
èžéåºå£çå矀ãšã¯ãã©ã®ãããªçŸæ£ãªã®ã§ããããïŒ
åŸéºé害ççŽèªå®ã®ç³è«ã®åé¡ã«çŠç¹ãåœãŠãªããã説æããŠãããŸãã
亀éäºæ 被害è å°çš çžè«çªå£ãŸãã¯äº€éäºæ ã®åä»ã¹ã¿ãããäžå¯§ã«ã察å¿ããããŸã
24æéäºçŽåä»ã»å¹Žäžç¡äŒã»éè©±ç¡æ
â»æ³åŸçžè«ã¯ãåä»äºçŽåŸãšãªããŸãã®ã§ãçŽæ¥åŒè·å£«ã«ã¯ãç¹ãã§ããŸããã
â»åœéæ¡ä»¶ã®çžè«ã«é¢ããŸããŠã¯å¥éãã¡ããã芧ãã ããã
亀éäºæ ã«éããå°ãã®æ¹ãž
ç®æ¬¡
- 1 èžéåºå£çå矀ãšã¯
- 2 æ²»çæ¹æ³
- 3 èžéåºå£çå矀ã®çç¶
- 4 èžéåºå£çå矀ãšé¢ä¿ã®ããåŸéºé害ççŽãšæ °è¬æ
- 5 èžéåºå£çå矀ã®èšºææ¹æ³
- 6 èžéåºå£çå矀ã®åŸéºé害ççŽèªå®ã¯é£ãã
- 7 åŒè·å£«ã«ãçžè«ãã ãã
- 8 èžéåºå£çå矀ã®åŸéºé害ãèªããããè£å€äŸ
èžéåºå£çå矀ãšã¯
èžéåºå£çå矀ãšã¯ãèžéåºå£ãšåŒã°ããéšåãå§è¿«ããããããéãç¥çµïŒè ç¥çµå¢ïŒãè¡ç®¡ïŒé骚äžåèã»éèïŒãå§è¿«ãããããã«çããäžé£ã®çç¶ããããŸãã èžéåºå£ãšã¯ãç¥çµã®æãè¡ç®¡ãéã£ãŠãããé骚ãšäžçªäžã®è骚ã®éã«ããçãééã®ããšã§ããèžéåºå£ã«ã¯ç©ççã«çãå§è¿«ããããã空éããããççªéšäœãåå ããšã«ãããããæè§ççå矀ãèé(ããã)çå矀ãå°èžççå矀ãé è(ãããã)çå矀ã®4ã€ã«åé¡ã§ããŸãããããã®çå矀ãç·ç§°ããŠãèžéåºå£çå矀ãšåŒã³ãŸãã 亀éäºæ ã«ãã£ãŠãèžéåºå£çå矀ãçºçããŠããŸã£ãããç é¢ã§é©åãªæ²»çãåããŸãããã
æ²»çæ¹æ³
ç é¢ã§ã¯ãä¿åçæ³ãšåçºäºé²ãç®çãšãããªãããªãäžå¿ãšããæ²»çãè¡ããŸããå ·äœçã«ã¯ã次ã®ãããªæ²»çã§ãã
âä¿åçæ³
ã»è©ãå°ãããããç¶æ
ãä¿ã¡å®éã«ãããïŒãªããè£
å
·ãçšããããšãããïŒ
ã»æ¶çé®çå€ããã¿ãã³B1çã®æäžãšãã£ã察ççæ³
âåçºäºé²
ã»ãªãããªããŒã·ã§ã³âŠå§åžœçãè©ç²æçã®åŒ·å
ã»åçºäºé²ã®ããã®åäœæå°âŠè
ãæããäœçœ®ã§ã®ä»äºãéããã®ãæã¡äžããããšãé·æéã®ãã¹ã¯ã¯ãŒã¯ãé¿ããããæå°ããç
ä¿åçæ³ã§çç¶ãæ¹åãããçç¶ãåçºããå Žåã«ã¯ãç¥çµãè¡ç®¡ãå§è¿«ããŠããæ§é ã®é€å»ãè¡ãæè¡çæ³ãéžæãããŸãã
âæè¡çæ³âŠç¥çµãè¡ç®¡ãå§è¿«ããŠããæ§é ã®é€å»
ã»é èåé€è¡
ã»ç¬¬1è骚åé€è¡
ã»çèåé€è¡
èžéåºå£çå矀ã®çç¶
èžéåºå£çå矀ã¯ãç¥çµãè¡ç®¡ãå§è¿«ãããããšã§çºçãããããçç¶ãšããŠãç¥çµæ©èœãè¡ç®¡æ©èœã®ç°åžžã«é¢ããå
容ãå€ãã¿ãããŸãã
以äžãå
·äœçãªçç¶ãã玹ä»ããŠãããŸãã®ã§ãå¿åœããããªããã確èªãã ããã
ç¥çµçç¶
- é ç
- è©ãã
- äžè¢ã®åºããããªçã¿ãã¡ãã¡ãæ
- äžè¢ã®ãã³ããåŠæ æ
- æ¡åã®äœäž
- å·§ç·»æ§é害âŠç®žãããŸã䜿ããªãããã¿ã³ãããŸããããããªããåãããŸãæžããªãç
è¡ç®¡çç¶
- è¡è¡é害âŠç®èã®å€è²ïŒçœã¿ããã£ããé玫è²ã«ãªã£ããããïŒãçã¿ãå·æç
- æèŠé害âŠè§ŠèŠã»çèŠã»æž©åºŠèŠãšãã£ãæèŠã®æžéããã³ãç
èžéåºå£çå矀ãšé¢ä¿ã®ããåŸéºé害ççŽãšæ °è¬æ
亀éäºæ
ã«ããèžéåºå£çå矀ã§ç¥çµçç¶ãçºçããçç¶ãåŸéºçãšããŠæ®ã£ãŠããŸãã±ãŒã¹ããããŸãã
ãã®å ŽåãåŸéºé害ãšããŠèªããããã¹ããççŽèªå®ã®ç³è«ãè¡ããŸãããã
èªå®ããããšãåŸéºé害åã®æ
°è¬æçãè«æ±ã§ããããã«ãªããæå®³è³ åã®å¢é¡ã«å€§ãã圱é¿ãäžããå¯èœæ§ãããããã§ãã
ã§ã¯ãåŸéºé害ãšããŠèªããããç¥çµçç¶ãšã¯ã©ã®ãããªãã®ãªã®ãã詳现ãã¿ãŠãããŸãããã
ç¥çµçç¶
èžéåºå£çå矀ã®ç¥çµçç¶ã§ã¯ãäž»ã«ç¥çµã®å§åãæå·ãåå ãšããŠãäžè¢ã®çã¿ã麻çºãšãã£ãæèŠãçŸããŸãã
ãã®ãããå°æ¥çã«åŸéºçãæ±ãç¶ããããšã«ãªã£ãå Žåã«ã¯ãç¥çµãžã®åœ±é¿ã«èµ·å ããç¥çµçç¶ã®äžçš®ãšããŠã12çŽ13å·ãããã¯14çŽ9å·ã®ççŽã§åŸéºé害èªå®ããªãããèŠèŸŒã¿ããããŸãã
ãã ããèªå®ç²åŸã«ããã£ãŠã¯ãçç¶ã®å»åŠçãªç«èšŒãããã¯èª¬æãå¿
èŠã§ãç«èšŒå
容ã«ãã£ãŠççŽæ°ãå€åããŸãã
è¡ç®¡é åœ±æ€æ»ãçç¶èªçºãã¹ãçã§ã®ç«èšŒæ¹æ³ãèããããŸãããèªè³ 責ã§ãã®ãããªæ€æ»çµæåç¬ã§ã¯ããªããªã12çŽ13å·ã®åŸéºé害ççŽã¯èªå®ãããŸããã
ããããèžéåºå£çå矀ã亀éäºæ
ã«ãããã¡ãã¡ã«ãããçºçããã®ããšããç¹ãå»åŠäžãæ ¹åŒ·ãäºãããããããšèããããŸãã
äžæ¹ã§ãä»èŠçãªç»åæèŠã¯ãªããã®ã®ãåå·ä»¥éäžè²«ããŠçç¶ã蚎ãç¶ããŠããçµéçãæ ¹æ ã«ã14çŽ9å·ãèªå®ãããå¯èœæ§ã¯ååãããŸãã
è«æ±ã§ããåŸéºéå®³æ °è¬æ
ççŽ | èªè³ è²¬åºæºâ» | åŒè·å£«åºæº |
---|---|---|
12çŽ13å· | 94äžå | 290äžå |
14çŽ9å· | 32äžå | 110äžå |
â»èªè³ è²¬åºæºã¯æ°åºæºãåæ ããŠããŸãã什å2幎4æ1æ¥ããåã«çºçããäºæ ã®å Žåã¯ãæ§åºæºãé©çšãããŸãã
亀éäºæ 被害è å°çš çžè«çªå£ãŸãã¯äº€éäºæ ã®åä»ã¹ã¿ãããäžå¯§ã«ã察å¿ããããŸã
24æéäºçŽåä»ã»å¹Žäžç¡äŒã»éè©±ç¡æ
â»æ³åŸçžè«ã¯ãåä»äºçŽåŸãšãªããŸãã®ã§ãçŽæ¥åŒè·å£«ã«ã¯ãç¹ãã§ããŸããã
â»åœéæ¡ä»¶ã®çžè«ã«é¢ããŸããŠã¯å¥éãã¡ããã芧ãã ããã
亀éäºæ ã«éããå°ãã®æ¹ãž
èžéåºå£çå矀ã®èšºææ¹æ³
èžéåºå£çå矀ã¯ãäž»ã«åŸè¿°ã®èªçºãã¹ãã«ãã£ãŠèšºæãããŸãã
èžéšXç·æ€æ»ãCTãMRIç»åæ€æ»ãçµã¿åããã骚ã®å€åœ¢ã骚æçã«ããç¥çµã®å§è¿«ãæå·ããªãããè¡ç®¡é åœ±æ€æ»çã§è¡ç®¡ã®å§è¿«ããªããçã調ã¹ãããšããããŸãããè£å©çãªãã®ã«çãŸããŸãã
èªçºãã¹ã
èªçºãã¹ããšã¯ãçç¶ãèªçºããåäœãè¡ããå®éã«çç¶ãçºçãããåŠãã調ã¹ãæ€æ»æ¹æ³ããããŸãã èžéåºå£çå矀ã¯ãæè§ççå矀ãèéçå矀ãå°èžççå矀ãé èçå矀ãšãããåå ã®ç°ãªã4çš®é¡ã®çå矀ã®ç·ç§°ã§ãããããã®çå矀ã¯ãç¥çµãè¡ç®¡ã®å§è¿«éšäœãç°ãªããããæ²»çããã«ã¯ã©ã®éšäœãå§è¿«ãããŠããã®ããèŠæ¥µããå¿ èŠããããŸããããã§åœ¹ç«ã€ã®ããæ¬¡ã®5çš®é¡ã®èªçºãã¹ãã§ãã
ã¢ãŒã¬ã€ãã¹ãïŒã¢ãŒãªãŒãã¹ãïŒ
è
ç¥çµå¢ãšããé骚äžã®ããŒãã ãšããïŒæè§çïŒã«ç¥çµã®éåéšåããããŸãããã®æè§çã®ããŒãã æããçåžããå§¿å¢ã§ãæã§æŒããŠãããã¹ãã§ãã
å§çãŸãã¯æŸæ£çãã¿ãããå Žåã«ã¯éœæ§ãšãªããæè§ççå矀ãé èçå矀ã䌎ã£ãŠãããããããªããšå€æãããŸãã
ã¢ããœã³ãã¹ã
座ã£ãç¶æ ã§ãçç¶ã®ããè åŽã«éŠãåæãããåŸãé¡ãäžããç¶æ ã§æ·±åŒåžãããæ©éªšåèã®èæã®å€åã確èªããæ€æ»ã§ããèæãå°ãããªããªããæ¶å€±ããå Žåã¯éœæ§ã§ãæè§ççå矀ãããã¯é èçå矀ã®çãããããŸãã
ãšãã³ãã¹ã
ãŸããçåžããå§¿å¢ã®ãŸãŸèžã匵ããŸãããããŠãäžæ¹åã«åããçç¶ãã¿ãããåŽã®è
ãåŒããŠããããšã§ãæ©éªšåèã«ãããèæã®å€åããã§ãã¯ãããšããå
容ã§ãã
çµæãèæã®æžå°ãããã¯æ¶å€±ã確èªãããå Žåã«ã¯ãèéçå矀ã䌎ã£ãŠãããšçãããŸãã
ã©ã€ããã¹ãïŒéå€è»¢ãã¹ãïŒ
座ã£ãç¶æ
ã§ãæ©éªšåèãèšããªãããäž¡æãªããçæãå€åŽããé äžãžäžããèæã®å€åã確èªããæ€æ»ã§ããèæãå°ãããªããªããæ¶å€±ããå Žåã¯éœæ§ã§ãå°èžççå矀ã®çãããããŸãã
15%ã®ç¢ºçã§åœã®éœæ§åå¿ãåºããããã«ãŒã¹ãã¹ããšäœµçšããããšãæšå¥šãããŸãã
ã«ãŒã¹ãã¹ãïŒäžåéæäžè² è·ãã¹ãïŒ
çåžããäž¡æ¹ã®è
ãäžã«åããŠçŽè§ã«æ²ããäœå¢ããšããŸãããããŠãæãæ¡ããéããšããå埩åäœã3åéè¡ããšããå
容ã§ãã
ãã¹ãäžã«ãæã®æã«ãã³ããçŸããããããŸãã¯åè
ã«åŠæ æãæããããããã«è
ãæããããšãã§ããªããªã£ãããäžå身ã®è²ãéçœãå€åããããããšãã£ãçç¶ãçºçŸããå Žåã«ã¯ãå°èžççå矀ã䌎ã£ãŠããå¯èœæ§ããããŸãã
ãªããã©ã€ããã¹ããšæ¯èŒãããšãããé«ç¢ºçã§æ£ç¢ºãªéœæ§çµæãçŸãããããæ€æ»æã«ã¯ã«ãŒã¹ãã¹ããšã©ã€ããã¹ãã®äœµçšãæãŸãããšãããŠããŸãã
èžéåºå£çå矀ã®åŸéºé害ççŽèªå®ã¯é£ãã
èžéåºå£çå矀ã蚺æããããããšãã£ãŠãåœç¶ã«åŸéºé害ççŽãèªããããããã§ã¯ãããŸãããã©ã®ãããªå Žåã«èžéåºå£çå矀ãã亀éäºæ
ã®å€å·ã«ãããçºçãããšããããã亀éäºæ
ãšã®å æé¢ä¿ã蚌æãã¥ãããèžéåºå£çå矀ã®åŸéºé害ççŽèªå®ã¯é£ãããšãããããåŸãŸããã
ãªããªãã
①èžéåºå£çå矀ã®çºçã«ã¯ããªã§è©ãçè質ãšãã£ã身äœçãªçŽ å ãå¯äžããŠããå Žåãããããš
②çç¶ã®å»åŠçãªèšŒæã説æãé£ããããš
ãšãã£ãçç±ãããããã§ãã
åŒè·å£«ã«ãçžè«ãã ãã
åŸéºé害ççŽã®èªå®ãåããããã«ã¯ã亀éäºæ ã«ãã£ãŠåŸéºçãçºçããããšãã€ãŸã亀éäºæ ãšã®å æé¢ä¿ã®èšŒæãšãçç¶ã®å»åŠçãªèšŒæãŸãã¯èª¬æãå¿ èŠã§ãã èžéåºå£çå矀ã®å Žåããããã®èšŒæã説æãé£ãããšããããŠããŸãããèžéåºå£çå矀ã®åŸéºçã§æ©ãŸããŠããæ¹ãããã£ãããã®ãäºå®ã§ãã èžéåºå£çå矀ã®åŸéºçã§ãæ©ã¿ã®æ¹ã¯ãç¹ã«å»çã«åŒ·ãåŒè·å£«ã«ãçžè«ãã ããã亀éäºæ ãšåŸéºçãšã®å æé¢ä¿ã®èšŒæãçç¶ã®å»åŠçãªèšŒæãŸãã¯èª¬æãã§ãããšèªããããããã«ã¯ãåŸéºé害ççŽèªå®ç³è«ã®çµéšãå»åŠçç¥èãæ¬ ãããŸããã é©åãªåŸéºé害ççŽã®èªå®ãåãã驿£ãªè³ åãåããããã«ããåŸéºé害ççŽèªå®ç³è«ã®çµéšããããå»çåé¡ã«åŒ·ãåŒè·å£«ãéãŸãåŒè·å£«æ³äººALGã«ãçžè«ããäŸé Œãã ããã
亀éäºæ 被害è å°çš çžè«çªå£ãŸãã¯äº€éäºæ ã®åä»ã¹ã¿ãããäžå¯§ã«ã察å¿ããããŸã
24æéäºçŽåä»ã»å¹Žäžç¡äŒã»éè©±ç¡æ
â»æ³åŸçžè«ã¯ãåä»äºçŽåŸãšãªããŸãã®ã§ãçŽæ¥åŒè·å£«ã«ã¯ãç¹ãã§ããŸããã
â»åœéæ¡ä»¶ã®çžè«ã«é¢ããŸããŠã¯å¥éãã¡ããã芧ãã ããã
亀éäºæ ã«éããå°ãã®æ¹ãž
èžéåºå£çå矀ã®åŸéºé害ãèªããããè£å€äŸ
ãåå€å±å°æ¹è£å€æãå¹³æ24幎3æ30æ¥å€æ±ºã
ïŒäºæ¡ã®æŠèŠïŒ
被åéè»¢ã®æ®éä¹çšèªåè»ããååãåä¹ããŠããæ®éä¹çšèªåè»ã«è¿œçªãååãåå·ããããã被åã«å¯ŸããŠæå®³è³ åãè«æ±ããäºæ¡ã§ãã ååããæ¬ä»¶äºæ ã«ãããå·Šå€å·æ§èžéåºå£çå矀çã®å·å®³ãè² ãåŸéºéå®³ãæ®ã£ããšäž»åŒµãããšããã被åãåŠå®ãããããäºããšãªããŸããã
ïŒè£å€æã®å€æïŒ
è£å€æã¯ãååãéé¢ãã倿¥èšºçé²ãææ¥éæŽ»åèšé²è¡šãããæ¬ä»¶äºæ åŸãååãé éšåã³å·Šè©åšèŸºã®çã¿ããã³ãã蚎ããæ€æ»ã®çµæãå€å·æ§å·Šèžéåºå£çå矀ãšèšºæãããããšããåç é¢ã®èšºçé²ã§èžéåºå£çå矀ã瀺ãèšèŒããã£ãäºå®çã確èªãããããã®äºå®ãèžãŸããååããæ¬ä»¶äºæ ã«ããèžéåºå£çå矀ãšãªã£ãããšãèªããŸããã
被åã¯ãååã«ã¯ãXç·ãMRIç»åäžãæãããªç°åžžæèŠã¯èªããããããŸãçé»å³æ€æ»ããµãŒã¢ã°ã©ãã£æ€æ»ã«ãããŠãæãããªå·Šå³å·®ããªããç çåå°ããªããå·Šäžè¢çèçž®ãèªããããªãããšãããå€å·æ§èžéåºå£çå矀ãçºçãããšã¯èªããããªãçãšäž»åŒµããŸããã
ããããè£å€æã¯ãæ¬ä»¶äºæ ã«ããè©ãè ã®çã¿ããã³ããšã€ãªããçç¶ãæ¬ä»¶äºæ çŽåŸã«èŠãããªãã£ããšããããšã¯ãªããšå€æãããŸããèžéåºå£çå矀ã§ã¯éçãªçç¶ãçŸããããšã¯çšã§ãããããååã®èžéåºå£çå矀ãåŠå®ããããšã¯ã§ããªããšå€æããŸãããå ããŠãçç¶åºå®ã蚺æããããã®ã®ãæªã çã¿ã®ããã«å·Šæã«ããŸãåãå ¥ãããããéãç©ã¯æãŠãªããšããç¶æ ã«ããäºå®ãèªããåŸéºé害ççŽ12çŽ13å·ãå±éšã«é åºãªç¥çµçç¶ãæ®ããã®ãã«è©²åœãããšèªããŸããã
亀éäºæ 被害è å°çš çžè«çªå£ãŸãã¯äº€éäºæ ã®åä»ã¹ã¿ãããäžå¯§ã«ã察å¿ããããŸã
24æéäºçŽåä»ã»å¹Žäžç¡äŒã»éè©±ç¡æ
â»æ³åŸçžè«ã¯ãåä»äºçŽåŸãšãªããŸãã®ã§ãçŽæ¥åŒè·å£«ã«ã¯ãç¹ãã§ããŸããã
â»åœéæ¡ä»¶ã®çžè«ã«é¢ããŸããŠã¯å¥éãã¡ããã芧ãã ããã
亀éäºæ ã«éããå°ãã®æ¹ãž


亀éäºæ
äºä»¶ã®çµéšè±å¯ãª
åŒè·å£«ãå
šé¢ãµããŒã
åŒè·å£«è²»çšç¹çŽã䜿ãå Žå
æ¬äººååè² æ
ãªãâ»ä¿éºäŒç€Ÿã®æ¡ä»¶ã«ãã£ãŠã¯
æ¬äººè² æ
ãçããããšããããŸãã
åŒè·å£«å ±é ¬ïŒæåå ±é ¬å¶
â»æ»äº¡ã»åŸéºé害ççŽèªå®æžã¿ãŸãã¯èªå®ãèŠèŸŒãŸããå Žå
â»äºæ¡ã«ãã£ãŠã¯å¯Ÿå¿ã§ããªãããšããããŸãã
â»åŒè·å£«è²»çšç¹çŽãå©çšããå Žåãå¥éã®æéäœç³»ãšãªããŸãã