Ke ʻike nei ʻoe i kēia ʻeha ʻē i loko o kou ʻōpū? E kamaʻilio kākou e pili ana i ka (Rectus Sheath Hematoma)!

Ua loaʻa anei iā ʻoe kahi ʻeha ʻōpū koʻikoʻi koke e like me kahi puʻupuʻu i loko o kou ʻōpū? A i ʻole ua loaʻa paha iā ʻoe kahi ʻū paʻakikī a laila ʻike i kahi kiko polū ma kou ʻōpū? ʻOiai ʻaʻole maʻamau kēia mau mea, hiki i kekahi manawa ke lilo i mau hōʻailona o kahi maʻi i kapa ʻia ʻo (Rectus Sheath Hematoma) e kū mai ana i loko o ko kākou ʻōpū. No laila i kēia lā, e kamaʻilio kākou e pili ana i kēia me nā kikoʻī hou aku, no ka mea, he mea nui loa ka ʻike ʻana i kēia.

ʻO ka mea mua, e nānā kākou he aha kēia (Rectus Sheath)?

I ka ʻōlelo maʻalahi, ʻo kou (Rectus Sheath) he uhi ikaika a fibrous e hoʻopuni ana i nā ʻiʻo ma ke alo o kou ʻōpū. I ka pololei, he membrane mānoanoa ia (i kapa ʻia hoʻi he (aponeurosis)). Aia i loko o kēia uhi nā ʻiʻo nui ʻelua o kou ʻōpū, ʻo ia ka (rectus abdominis) (ka mea a mākou e kapa pinepine ai he mau ʻiʻo "ʻeono-pack") a me ka (pyramidalis).

E noʻonoʻo, he paia mua (anterior) a he paia hope (posterior) ko kēia (Rectus Sheath). Hana ʻia kēia mau paia i ka fascia like ((fascia)) e hoʻopuni ana i nā ʻiʻo ʻē aʻe i loko o kou ʻōpū. ʻO ia hoʻi:

• Kou "(nā ʻiʻo oblique ʻōpū o waho)" (nā ʻiʻo oblique ʻōpū o waho)
• ʻO kou "(nā obliques ʻōpū kūloko)" (nā ʻiʻo oblique ʻōpū kūloko)
• Kou ʻiʻo ʻōpū keʻa (transversus abdominis)

Hoʻokumu ʻia ka "Rectus Sheath" mai nā uhi o kēia mau ʻiʻo.

Eia kekahi, ʻo nā aʻa epigastric kiʻekiʻe a me lalo, ʻo ia nā kīʻaha koko nui e hoʻolako i ke koko i kou mau ʻiʻo ʻōpū, e hele ana ma o kēia (Rectus Sheath). No laila, ʻo ka hana nui o kēia (Rectus Sheath) ʻo ia ka pale ʻana i kēia mau ʻiʻo, nā kīʻaha koko, a me nā ʻōpū e hoʻopuni ana i ka paia ʻōpū.

Akā, aia kekahi mea liʻiliʻi. ʻAʻole uhi piha kēia (Rectus Sheath) i nā mea o loko. Ua uhi ʻia ka piko o kou ʻiʻo (rectus abdominis) e kēia (Rectus Sheath) ma nā ʻaoʻao ʻelua, mua a hope. Eia nō naʻe, aia kahi palena ma waena o luna a me lalo o kēia ʻiʻo, i kapa ʻia ʻo (arcuate line). ʻO kēia laina ma kahi o hoʻokahi hapakolu o ke ala i lalo mai kou piko a i kahi e hui ai kou mau iwi pelvic ʻelua i mua ((pubic symphysis)).

ʻO ka mea nui, ma lalo o kēia (laina ʻākuʻi), ʻo ka ʻaoʻao haʻahaʻa o kou ʻiʻo (rectus abdominis) ua uhi wale ʻia e ka (Rectus Sheath) mai ke alo. ʻAʻohe (posterior rectus sheath) mai ke kua! ʻO ia hoʻi, ʻaʻohe ʻano uhi e pale aku i ka ʻaoʻao haʻahaʻa o ka ʻiʻo (rectus abdominis). E hoʻomanaʻo i kēia, no ka mea, he mea nui kēia no ke kūlana (Rectus Sheath Hematoma) a mākou e kamaʻilio nei.

No laila he aha ka (Rectus Sheath Hematoma)?

ʻO ka (Hematoma), i ka ʻōlelo maʻalahi, he hōʻiliʻili koko i loko o kou mau ʻiʻo. I kēia manawa, inā hoʻomaka nā (epigastric arteries) i loko o (Rectus Sheath) a mākou i kamaʻilio ai ma mua e kahe koko ma kekahi ʻano, hiki i kēlā koko ke hōʻiliʻili ma kēlā wahi o kou ʻōpū. Ua kapa ʻia kēia hōʻiliʻili koko ʻo (Rectus Sheath Hematoma).

I kēia hihia, hiki ke ʻoi aku ka koʻikoʻi o ke kahe ʻana o ke koko, ʻoiai mai ke aʻa epigastric haʻahaʻa. No ka mea, e like me kā mākou i ʻōlelo ai ma mua, ʻaʻohe uhi ma lalo o ka laina arcuate, a inā hoʻomaka ke koko e kahe mai laila mai, ʻaʻohe ʻiʻo e pale i ka laha ʻana o ke koko. No laila, hiki ke hōʻiliʻili i ka nui o ke koko.

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ʻO wai ka mea i hoʻopilikia nui ʻia e kēia kūlana?

ʻOi aku ka maʻamau o ka Rectus Sheath Hematoma i nā wahine ma mua o nā kāne, a ʻoi aku ka maʻamau i ka poʻe ma luna o 60 mau makahiki .

Pehea ka maʻamau o kēia ʻano?

He maʻi laha ʻole ka Rectus Sheath Hematoma. Hoʻopilikia wale ia i ka 1% a i ka 2% o nā maʻi e hōʻike ana i ka ʻeha o ka ʻōpū. No laila, ʻaʻole paha ʻoe e lohe pinepine e pili ana i ia mea.

He aha nā hōʻailona?

ʻO ka hōʻailona maʻamau o kēia ʻano, ʻo ia ka ʻeha o ka ʻōpū . ʻO kēia ʻeha:

• Hiki iā ʻoe ke hoʻomaka koke.
• He ʻeha ʻoi a hiki ʻole ke hoʻomanawanui.
• Hiki nō hoʻi ke lilo i ʻeha mau.
• Hiki ke hoʻonui ʻia ka ʻeha ke lulu ʻoe, kūlou, a hoʻoluhi paha i kou mau ʻiʻo ʻōpū.

Eia kekahi, i kekahi manawa ke hoʻopā ʻoe i kou ʻōpū, hiki iā ʻoe ke manaʻo i kahi mea e like me kahi puʻupuʻu .

ʻO nā hōʻailona ʻē aʻe e ʻike ʻia paha:

• Ka luaʻi a me ka luaʻi
• kuni
• ʻIli ʻulaʻula a ʻeha paha (ʻoi aku hoʻi ma ka ʻōpū)
• Anemia (ʻo ia hoʻi ka emi ʻana o ka nui o ke koko)
• Hoʻonui ʻia ka helu o ka puʻuwai (tachycardia)
• Ke koko haʻahaʻa (hypotension)

He aha ke kumu o kēia?

ʻO ke kumu nui o ka Rectus Sheath Hematoma ʻo ke kahe ʻana o ke koko i loko o ka (Rectus Sheath). Hana pinepine ʻia kēia i ka wā e loaʻa ai kekahi ʻano trauma i ka paia o ka ʻōpū .

I ka ʻōlelo maʻalahi, hiki ke loaʻa kēia ʻano inā ua hōʻino ʻia ka (epigastric artery), nā kīʻaha koko liʻiliʻi e lālā ana mai ia mea, a i ʻole ka ʻiʻo (rectus abdominis) ponoʻī. E like me kā mākou i ʻōlelo ai ma mua, ua hoʻolako ʻia nā ʻiʻo ʻōpū me ke koko e nā (epigastric arteries) luna a me lalo. Eia hou, inā ua hōʻino ʻia ka (inferior epigastric artery), hiki ke ʻoi aku ka koʻikoʻi o ke kūlana, no ka mea, ʻaʻohe ona pale ma hope ona ma lalo o ka (arcuate line).

E noʻonoʻo, inā loaʻa iā ʻoe kahi hahau pololei i kou ʻōpū, a inā paha ʻoe e hoʻopili koke i ka ikaika nui i nā ʻiʻo ʻōpū (no ka laʻana, inā ʻoe e ʻū nui no ka manawa lōʻihi, a inā paha ʻoe e hoʻoluhi i kou ʻōpū i ka wā e hāpai ana i kahi mea kaumaha), hiki i kēia (epigastric artery) ke pohā a hoʻomaka ke kahe ʻana o ke koko, e hana ana i kahi (hematoma).

He aha nā kumu pilikia no kēia?

ʻO ke kumu pilikia nui loa no ka hoʻomohala ʻana i kahi Rectus Sheath Hematoma ʻo ia ka hoʻohana ʻana i nā lāʻau lapaʻau e pale ai i ke kāpili ʻana o ke koko ("(anticoagulants) a i ʻole "nā mea hoʻomāmā koko") . Kokoke i ka 70% o ka poʻe e loaʻa ana i kahi Rectus Sheath Hematoma ke lawe nei i kekahi ʻano lāʻau "(anticoagulant)". Hoʻolohi kēia mau lāʻau i ke kaʻina hana kahe koko, e ʻoi aku ka nui o ka hiki ke ulu aʻe kahi (hematoma).

ʻO kekahi kumu pilikia nui ka maʻi puʻupaʻa mau loa . Kokoke i ka 60% o ka poʻe i loaʻa i kahi hematoma rectus sheath he maʻi puʻupaʻa pae 3 a ʻoi aku paha.

ʻO nā kumu pilikia ʻē aʻe:

• ʻO ke ʻoki ʻōpū hou loa
• Ka hoʻohana ʻana i nā steroids a i ʻole nā ​​​​lāʻau immunosuppressant
• ʻŪhū nui loa a mau loa
• ʻO ka lawe ʻana i ka 'Antiplatelet therapy' (lāʻau lapaʻau e pale ai i ka hui pū ʻana o nā platelets koko)
• Hāpai keiki
• ʻO nā maʻi mau loa, e like me ke koko kiʻekiʻe a me ka atherosclerosis (ka lahilahi o nā aʻa ma muli o nā waihona momona ma nā paia o nā aʻa)

He mea nui: Inā ʻoe e lawe nei i nā lāʻau anticoagulant e like me kēia, pono ʻoe e makaʻala loa inā loaʻa koke iā ʻoe ka ʻeha o ka ʻōpū.

Pehea e hana ʻia ai ka hōʻailona?

Hiki i kekahi manawa ke paʻakikī ke ʻike i kahi hematoma rectus sheath, no ka mea, ua like kona mau hōʻailona me nā maʻi ʻōpū ʻē aʻe.

E hana mua paha kāu kauka i kahi hoʻāʻo koko e ana i kou mau pae hemoglobin a me hematocrit. ʻOi aku ma mua o ka hapalua o ka poʻe me ka hematoma rectus sheath e loaʻa nā pae hemoglobin haʻahaʻa loa (ʻo ia hoʻi, he haʻahaʻa ko lākou nui o ke koko).

ʻO ka mea aʻe, e hana paha kāu kauka i kahi ultrasound o kou paia ʻōpū. Hiki i kēia ke kōkua i ka hoʻoholo ʻana inā he wai koko i loko o ka paia ʻōpū a pehea ka nui o ka hematoma.

I kekahi manawa, hiki ke hana ʻia kahi scan CT e loaʻa ai kahi kiʻi pololei a maopopo o ke kūlana. Hiki i kahi scan CT, ʻoiai kekahi e hoʻohana ana i ka dye contrast, ke hōʻike pololei i kahi e kahe ai ka dye mai ke kīʻaha koko i hōʻino ʻia. Hiki i kēia ke kōkua i ke kauka e ʻike i kahi e puka mai ai ke kahe koko.

Pehea e mālama ʻia ai?

ʻO ka nūhou maikaʻi, ʻo ka hapa nui o nā hematomas rectus sheath e ho'ōla iā lākou iho a ʻaʻole pono kekahi lāʻau lapaʻau kūikawā. ʻO ka mālama ʻana no kēia maʻi e komo pū me:

• Ke kau nei i nā ʻeke hau a i ʻole nā ​​​​​​ʻūlū anu)
• Hoʻomaha
• Ke hoʻohana nei i nā lāʻau ʻeha maʻamau ((analgesics))

Ma kahi o 80% o nā hematomas rectus sheath ua ho'ōla ʻia me nā lāʻau lapaʻau maʻalahi e like me kēia.

Eia nō naʻe, inā ʻaʻole kōkua kēia mau lāʻau lapaʻau maʻalahi, a inā ʻoi aku ka koʻikoʻi o ke kūlana, hiki i ke kauka ke hoʻohana i kahi lāʻau i kapa ʻia ʻo "angioembolization." ʻAʻole kēia he ʻoki kino. Pili ia i ka hoʻohui ʻana i ka "angiography" (kahi ʻano hana o ke kiʻi ʻana i nā kīʻaha koko) a me ka "embolization" (kahi ʻano hana o ka pani ʻana i ke kīʻaha koko), e ʻike i ke kīʻaha koko a pani iā ​​ia.

Inā ʻaʻole holomua kēia ʻano hana "angioembolization", pono paha ke ʻoki ʻana ma ke ʻano he koho hope loa. I ka wā o ke ʻoki ʻana, wehe ʻia ke koko i hōʻiliʻili ʻia (hematoma) a pani ʻia ke aʻa koko.

I ka wā a ma hope o ka mālama ʻana, e nānā kāu kauka i kou kūlana me nā hoʻāʻo koko a me nā ultrasound. Hiki i kēia ke kōkua i ka ʻike ʻana i kekahi hoʻi hou ʻana o ke kahe koko a i ʻole ka maʻi.

He aha ka mea e hiki mai ana? E hoʻomaikaʻi anei ʻo ia?

Hoʻopau koke ka hapa nui o nā hematomas rectus sheath i loko o ʻelua a ʻekolu mahina . Hoʻōla maikaʻi ka hapa nui o ka poʻe i loaʻa i kēia maʻi a ʻaʻole e loaʻa hou nā pilikia.

Eia nō naʻe, i kekahi mau hihia - ʻoi aku hoʻi i waena o ka poʻe e lawe ana i nā anticoagulants - hiki i kēia kūlana ke make . Eia nō naʻe, he mea kākaʻikahi loa ia. Wahi a ka ʻikepili hou loa, ʻaʻole i hiki i ka 2% o ka poʻe e make mai ka Rectus Sheath Hematoma.

E like me nā kūlana olakino āpau, ʻo ka ʻike mua ʻana a me ka mālama mua ʻana e hoʻonui i nā manawa kūpono o ka hoʻōla ʻana . No laila, inā manaʻo ʻoe he mau hōʻailona kou o ka 'Rectus Sheath Hematoma', e ʻimi pono i ka ʻōlelo aʻoaʻo lapaʻau.

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai

ʻO kou (Rectus Sheath) kahi uhi koʻikoʻi e pale ana i nā ʻōkana, nā ʻiʻo, a me nā kīʻaha koko i loko o kou paia ʻōpū. Inā ua ʻeha kou paia ʻōpū ma kekahi ʻano, hiki i kahi (epigastric artery) ke haki a hana i kahi (Rectus Sheath Hematoma).

I ka hapa nui o ka manawa, ʻaʻole pono kēia ʻano i ka mālama lapaʻau nui. Hiki i nā mea maʻalahi e like me ke kau ʻana i ka hau, ka hoʻomaha ʻana, a me ka lawe ʻana i nā lāʻau hōʻeha ke kōkua.

Eia nō naʻe, hiki i kekahi mau hihia ke ʻoi aku ka koʻikoʻi. Inā loaʻa iā ʻoe ka ʻeha ʻōpū koʻikoʻi a koke, he mea naʻauao mau ke ʻike i ke kauka e hoʻoholo ai inā pono ʻoe i ka lāʻau lapaʻau. Mai hopohopo, akā he mea nui iā ʻoe a me kou ʻohana e makaʻala i kēia mau mea.

ʻO ka Hematoma o ka ʻōpū rectus, ʻeha ʻōpū, kahe koko ʻōpū, aʻa epigastric, anticoagulants, puʻupuʻu ʻōpū, ʻeha ʻōpū