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Ortopedi ve Travmatoloji Uzman\u0131 Dr. Burak \u00d6nvural, el ve koldaki sinir s\u0131k\u0131\u015fmalar\u0131n\u0131n kad\u0131nlarda daha s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc s\u00f6yledi.<\/p>\nOrtopedi ve Travmatoloji Uzman\u0131 Dr. Burak \u00d6nvural, el ve koldaki sinir s\u0131k\u0131\u015fmalar\u0131n\u0131n kad\u0131nlarda daha s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc s\u00f6yledi.<\/p>\n
El parmaklar\u0131n\u0131n hareket ve hissinin sa\u011flanmas\u0131nda \u00f6nemli bir rol\u00fc bulunan ve median sinir olarak isimlendirilen sinirin el bile\u011fi hizas\u0131nda karpal t\u00fcnel ad\u0131 verilen ba\u011f dokusu alt\u0131nda s\u0131k\u0131\u015fmas\u0131na ba\u011fl\u0131 olarak ortaya \u00e7\u0131kan a\u011fr\u0131l\u0131 bir durum oldu\u011funu ifade eden Dr. Burak \u00d6nvural, \u201cSinir s\u0131k\u0131\u015fmalar\u0131 i\u00e7inde en s\u0131k g\u00f6r\u00fclen rahats\u0131zl\u0131kt\u0131r. Median sinir, el bile\u011finin avu\u00e7 i\u00e7i taraf\u0131nda parmaklar\u0131 hareket ettiren tendonlar ile birlikte karpal t\u00fcnel ad\u0131 verilen dar bir bo\u015fluktan ge\u00e7er. G\u00f6revi ba\u015fparmak, i\u015faret parma\u011f\u0131 ve orta parma\u011f\u0131n i\u00e7 y\u00fcz\u00fcn\u00fcn tamam\u0131 ile y\u00fcz\u00fck parma\u011f\u0131n\u0131n i\u00e7 y\u00fcz\u00fcn\u00fcn d\u0131\u015f yar\u0131s\u0131n\u0131n hissetmesini sa\u011flamakt\u0131r. Sinirin karpal t\u00fcnel i\u00e7inde bir \u015fekilde uzun s\u00fcreli ya da tekrarlayan bas\u0131nca maruz kalmas\u0131 karpal t\u00fcnel sendromuna neden olur\u201d dedi.<\/p>\n
Sinir s\u0131k\u0131\u015fmas\u0131n\u0131n \u00f6zellikle el bile\u011finin s\u00fcrekli b\u00fck\u00fcl\u00fc pozisyonda kald\u0131\u011f\u0131 durumlarda (daktilo, klavye kullanmak vb.) veya el ve el bile\u011fine s\u00fcrekli y\u00fck binen i\u015flerde \u00e7al\u0131\u015fanlarda daha s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fcn\u00fc belirten Dr. Burak \u00d6nvural, \u201cKad\u0131nlarda erkeklere g\u00f6re daha s\u0131k g\u00f6r\u00fcl\u00fcr. \u00d6zellikle hamilelik d\u00f6neminin sonlar\u0131ndan itibaren v\u00fccutta su tutulmas\u0131na ba\u011fl\u0131 olarak ya da emzirmekte olan kad\u0131nlarda el bile\u011finin pozisyonuna ba\u011fl\u0131 olarak s\u0131k kar\u015f\u0131m\u0131za \u00e7\u0131kar. Ayr\u0131ca \u015feker hastal\u0131\u011f\u0131, romatoid artrit, hipotroidi, a\u015f\u0131r\u0131 \u015fi\u015fmanl\u0131k, gut gibi di\u011fer ba\u015fka problemlerin etkisiyle de ortaya \u00e7\u0131kabilir. Ba\u015flang\u0131\u00e7 d\u00f6neminde ilk bulgular genellikle elde g\u00fc\u00e7s\u00fczl\u00fck, \u00e7abuk yorulma ve \u00f6zellikle ilk \u00fc\u00e7 parmakta kar\u0131ncalanma hissidir. \u0130lerleyen d\u00f6nemlerde a\u011fr\u0131 \u015fiddetlenirken parmaklarda uyu\u015fmalar\u0131n ba\u015flad\u0131\u011f\u0131 g\u00f6r\u00fcl\u00fcr. A\u011fr\u0131 ve uyu\u015fukluk hissi genellikle geceleri hastay\u0131 uykudan uyand\u0131racak kadar \u015fiddetli olabilir. Bunun sebebi a\u011fr\u0131y\u0131 bask\u0131layan hormonun geceleri v\u00fccutta en alt seviyeye inmesidir. Hasta uykudan uyan\u0131p ellini sallad\u0131\u011f\u0131nda ve bile\u011fini hareket ettirdi\u011finde belirtiler azal\u0131r. Bu d\u00f6nemde hastan\u0131n elinde bardak, tabak tutamay\u0131p d\u00fc\u015f\u00fcrmesi \u00e7ok tipiktir\u201d \u015feklinde konu\u015ftu.<\/p>\n
Dr. Burak \u00d6nvural, sinir s\u0131k\u0131\u015fmas\u0131 hastal\u0131\u011f\u0131n\u0131n tedavisi hakk\u0131nda \u015fu bilgileri verdi:<\/p>\n
\u201cBa\u015flang\u0131\u00e7 d\u00f6neminde el bile\u011fi hareketlerinin k\u0131s\u0131tlanmas\u0131 ve al\u0131nacak antiinflamatuar ila\u00e7lar semptomlar\u0131 hafifletebilir. Steroid enjeksiyonlar\u0131 da sinir etraf\u0131ndaki \u015fi\u015flikleri azaltarak semptomlar\u0131n gerilemesine yard\u0131mc\u0131 olabilir ancak sinir k\u0131l\u0131f\u0131na yap\u0131lma ihtimalinden ve olas\u0131 zararlar\u0131ndan \u00f6t\u00fcr\u00fc \u00e7ok dikkat edilerek uygulanmal\u0131d\u0131r. Birka\u00e7 ay s\u00fcresince ge\u00e7meyen ve cerrahi d\u0131\u015f\u0131 \u00f6nlemlere ra\u011fmen devam eden karpal t\u00fcnel sendromunda ameliyat gerekir. Burada geleneksel a\u00e7\u0131k y\u00f6ntemle, mikroskop e\u015fli\u011finde yada yeni kamera yard\u0131ml\u0131 kapal\u0131 y\u00f6ntemle karpal t\u00fcnele ula\u015f\u0131l\u0131r ve t\u00fcnelin \u00e7at\u0131s\u0131n\u0131 olu\u015fturan ba\u011f tamamen kesilerek karpal t\u00fcnel a\u00e7\u0131l\u0131r. \u0130lerlemi\u015f olgularda kal\u0131nla\u015fm\u0131\u015f sinir k\u0131l\u0131f\u0131na mikroskop alt\u0131nda sinir gev\u015fetmesi yapmak gerekir. B\u00f6ylelikle sinir etraf\u0131ndaki bas\u0131n\u00e7 ortadan kald\u0131r\u0131lm\u0131\u015f olur. Ameliyat sonras\u0131 \u015fikayetler hemen ge\u00e7meyebilir. Hatta ameliyat sonras\u0131 ilk ay i\u00e7inde ameliyata ba\u011fl\u0131 \u015fi\u015flikler nedeni ile sinirdeki s\u0131k\u0131\u015fma devam edebilir ve bu sebeple \u015fikayetlerde artma bile olabilir. Ancak ilk aydan sonra \u015fikayetlerde belirgin bir azalma hissedilir. Baz\u0131 \u00e7ok a\u011f\u0131r ve ge\u00e7 kal\u0131nm\u0131\u015f olgularda ameliyattan sonra \u015fikayetler azalmakla beraber tam olarak ortadan kalkmayabilir. Hastan\u0131n sigara i\u00e7mesi, yeterince beslenmemesi, mevcut \u015feker hastal\u0131\u011f\u0131 olmas\u0131, ileri ya\u015fta olmas\u0131 gibi fakt\u00f6rler de cerrahi tedaviden al\u0131nacak sonucu olumsuz olarak etkileyebilir. Hastalar ameliyat \u00f6ncesi beklentilerini net bir \u015fekilde doktorlar\u0131na belirtirse sonu\u00e7 her iki taraf i\u00e7in de daha tatmin edici olur.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
ORTOPED\u0130 VE TRAVMATOLOJ\u0130 UZMANI DR. BURAK \u00d6NVURAL, EL VE KOLDAK\u0130 S\u0130N\u0130R SIKI\u015eMALARININ KADINLARDA DAHA SIK G\u00d6R\u00dcLD\u00dc\u011e\u00dcN\u00dc S\u00d6YLED\u0130.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,20],"tags":[4992,29758,6708],"class_list":["post-161862","post","type-post","status-publish","format-standard","hentry","category-saglik","category-turkiye","tag-dikkat","tag-sikismalarina","tag-sinir"],"_links":{"self":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts\/161862","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=161862"}],"version-history":[{"count":0,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=\/wp\/v2\/posts\/161862\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=161862"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=161862"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.erzhaber.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=161862"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}