Koj puas tau muaj mob taub hau uas hnyav heev ua rau koj tsis tuaj yeem ua tau? Zoo li xob laim ntaus koj lub taub hau, lossis zoo li lub foob pob tawg? Qee zaum peb xav tias cov no tsuas yog mob taub hau ib txwm muaj, tab sis lawv tuaj yeem yog ib qho cim ntawm ib qho mob hnyav heev. Ib qho mob uas yuav tsum tau saib xyuas sai yog qhov peb tab tom tham txog hnub no, "Brain Aneurysm ." Hnov lub npe no tuaj yeem ua rau ntshai, tab sis nws yog ib qho tseem ceeb heev uas yuav tsum paub txog nws.
Hauv lwm lo lus, aneurysm yog dab tsi?
Xav txog tias muaj ib lub yeeb nkab uas nqa dej. Ib feem ntawm lub yeeb nkab no tsis muaj zog me ntsis, nws qub lawm. Tom qab ntawd, thaum dej ntws sai dua, qhov tsis muaj zog ntawd pib nthuav tawm me ntsis, zoo li lub pob me me. Tib yam tshwm sim yog tias muaj dab tsi tshwm sim rau cov hlab ntsha, lossis cov hlab ntsha, hauv peb lub hlwb .
Ib qho aneurysm hauv lub hlwb, lossis raws li cov kws kho mob hu nws, aneurysm hauv lub hlwb, yog ib phab ntsa tsis muaj zog hauv cov hlab ntsha nyob ib puag ncig lossis hauv lub hlwb uas nthuav tawm raws li lub siab ntawm cov ntshav, tsim ib qho o.
Txhua zaus peb lub plawv dhia, cov ntshav ntws los ntawm cov hlab ntsha ntawm lub hlwb thaum muaj kev nyuaj siab. Thaum qhov kev nyuaj siab no txuas ntxiv mus rau thaj chaw uas tsis muaj zog ntawd, nws maj mam loj zuj zus. Ib yam li thaum peb tshuab cua rau hauv lub npas, nws yuav nyias dua thiab loj dua. Qhov loj dua nws, qhov muaj feem ntau nws yuav tawg.
Txawm hais tias cov aneurysms no tuaj yeem tsim nyob rau txhua qhov chaw hauv lub hlwb, lawv feem ntau tsim nyob rau hauv cov hlab ntsha loj ntawm lub hauv paus ntawm peb lub pob txha taub hau. Ib txhia neeg (kwv yees li 10% - 30%) yuav muaj ntau dua ib qho aneurysm. Tab sis qhov xov xwm zoo yog tias feem ntau ntawm cov aneurysms no me heev. Lawv tsis ua rau muaj tsos mob.
Cov tsos mob tsuas yog pib tshwm sim thaum lub aneurysm loj txaus los nias rau cov ntaub so ntswg lossis cov hlab ntsha nyob ib puag ncig lub hlwb. Qhov xwm txheej txaus ntshai tshaj plaws yog thaum lub aneurysm xau ntshav lossis tawg tag. Qhov no tuaj yeem ua rau los ntshav hauv lub hlwb.
Qhov no yog ib qho xwm txheej ceev uas yuav ua rau tuag taus. Yog tias lub aneurysm ntev dua tom qab nws tawg, ces yuav muaj kev pheej hmoo ntawm kev tuag lossis kev tsis taus loj heev.
Yuav ua li cas yog tias aneurysm tawg?
Thaum lub aneurysm tawg, cov ntshav ntws mus rau hauv cov nqaij ntawm lub hlwb ib puag ncig. Qhov no hu ua hemorrhage.Cov ntshav no ua rau muaj kev nyuaj ntxiv rau cov ntaub so ntswg ntawm lub hlwb, ua rau lub hlwb o. Cov tsos mob tseem ceeb uas feem ntau tshwm sim los ntawm qhov no yog qhov peb hu ua " mob taub hau xob laim," uas yog mob taub hau tam sim ntawd, hnyav heev uas tsis xav txog.
Ib qho aneurysm tawg tuaj yeem ua rau muaj teeb meem kev noj qab haus huv loj, xws li:
- Kev Los Ntshav Hauv Paus (Subarachnoid Hemorrhage - SAH): Qhov no yog kev los ntshav rau hauv qhov chaw nruab nrab ntawm lub hlwb thiab daim nyias nyias uas npog lub hlwb (txheej arachnoid). 90% ntawm cov kev los ntshav no yog tshwm sim los ntawm kev tawg ntawm cov hlab ntsha hauv lub hlwb.
- Mob stroke Hemorrhagic : Mob stroke uas tshwm sim los ntawm kev ntshav mus rau hauv qhov chaw ntawm lub taub hau thiab lub hlwb.
Cov mob no tuaj yeem ua rau lub hlwb puas tsuaj mus tas li thiab lwm yam teeb meem loj heev.
| Kev nyuaj siab | Piav qhia yooj yim xwb |
|---|---|
| Vasospasm | Cov hlab ntsha hauv lub hlwb raug thaiv lossis nqaim, ua rau cov pa oxygen mus txog lub hlwb tsawg dua. |
| Hydrocephalus | Muaj kev ntxhov siab ntxiv rau lub hlwb vim muaj cov kua dej hauv lub hlwb (CSF) lossis cov ntshav nyob ib puag ncig lub hlwb sib sau ua ke. Peb kuj hu qhov no ua "hydrocephalus." |
| Qaug dab peg | Muaj kev ua haujlwm hluav taws xob hauv lub hlwb uas tsis tuaj yeem tswj tau. Qhov no tuaj yeem ua rau lub hlwb puas tsuaj ntxiv yog tias aneurysm tawg. |
| Coma | Ib qho xwm txheej tsis nco qab, zoo li pw tsaug zog tob, uas tuaj yeem kav ntev li ntau lub lis piam. |
| Kev tuag | Tu siab kawg li, kwv yees li 50% ntawm cov aneurysm ruptures xaus rau hauv kev tuag. |
Leej twg muaj cov hlab ntsha aneurysm? Nws feem ntau tshwm sim li cas?
Tus mob no tuaj yeem tshwm sim thaum twg los tau, thiab leej twg los tau tuaj yeem tshwm sim. Txawm li cas los xij, cov neeg hnub nyoog ntawm 30 thiab 60 xyoo muaj feem yuav mob ntau dua. Tsis tas li ntawd, kev tshawb fawb tau qhia tias tus mob no feem ntau tshwm sim rau cov poj niam dua li cov txiv neej.
Txawm hais tias tsis muaj cov ntaub ntawv tshwj xeeb txog qhov no hauv Sri Lanka, kwv yees li ntawm 6% ntawm cov pej xeem hauv cov tebchaws zoo li Tebchaws Meskas muaj cov hlab ntsha aneurysm uas tsis tau tawg. Qhov no txhais tau tias qhov no tsis yog qhov tsawg heev li ib tus neeg xav. Txawm li cas los xij, cov hlab ntsha aneurysm tawg tsis yog qhov tshwm sim ntau.
Cov tsos mob ntawm aneurysm yog dab tsi?
Cov tsos mob ntawm qhov no sib txawv nyob ntawm seb lub aneurysm puas tau tawg lossis tsis tau. Kev nkag siab txog qhov txawv no tuaj yeem pab cawm koj txoj sia.
| Cov tsos mob ntawm lub aneurysm tawg (xwm txheej ceev!) | Cov tsos mob ntawm ib qho aneurysm loj (tsis tawg) |
|---|---|
| Yog koj muaj cov tsos mob no, mus rau ETU ( Emergency Treatment Unit ) ntawm tsev kho mob tam sim ntawd! | |
| - Mob taub hau tam sim ntawd phem tshaj plaws hauv kuv lub neej (Thunderclap Headache) - Xeev siab thiab ntuav - Caj dab nruj, tsis muaj peev xwm khoov - Pom kev tsis meej los yog pom ob sab - Tsis muaj peev xwm saib lub teeb (Photophobia) - Muaj kev ntxhov siab (Seizure) - Qhov muag poob thiab qhov muag dub loj - Mob saum thiab tom qab lub qhov muag - Kev poob siab, kev tsis muaj zog - Mob loog los yog tsis muaj zog nyob rau hauv ib feem ntawm lub cev - Tsis nco qab | - Mob taub hau (ntau zaus los yog qee zaum) - Kev hloov pauv ntawm kev pom kev - Kev loj hlob ntawm tus menyuam kawm ntawv ntawm lub qhov muag - Mob taub hau los yog ntsej muag tsis muaj zog - Mob saum thiab tom qab lub qhov muag - Qee zaum qhov haum los txog. |
Qee zaum, ua ntej lub aneurysm tawg, nws tuaj yeem xau me ntsis ntshav. Qhov no hu ua sentinel bleed . Thaum lub sijhawm no, mob taub hau ceeb toom (sentinel headache) tuaj yeem tshwm sim ob peb hnub lossis ob peb lub lis piam ua ntej mob taub hau loj. Yog tias koj muaj mob taub hau txawv txawv, hnyav heev, tsis txhob tsis quav ntsej nws. Mus ntsib kws kho mob tam sim ntawd.
Vim li cas cov aneurysms no thiaj tsim? Cov yam uas ua rau muaj kev pheej hmoo yog dab tsi?
Cov hlab ntsha aneurysm tshwm sim thaum cov phab ntsa ntawm cov hlab ntsha hauv lub hlwb nyias thiab tsis muaj zog. Feem ntau lawv tshwm sim ntawm cov ceg ntawm cov hlab ntsha. Qee zaum ib tug neeg yug los nrog lub zog tsis muaj zog ntawm cov phab ntsa ntawm cov hlab ntsha. Tsis tas li ntawd, ntau lwm yam tseem ceeb tuaj yeem cuam tshuam rau qhov no.
Cov yam ntxwv uas los ntawm kev xeeb tub
Cov no yog tej yam uas peb tswj tsis tau thiab yog cov uas tau txais los ntawm noob caj noob ces.
- Qee yam mob uas los ntawm noob caj noob ces: Piv txwv li, `Vascular Ehlers-Danlos syndrome`, `Autosomal dominant polycystic kidney disease`, `Marfan syndrome`, `Fibromuscular dysplasia`.
- Arteriovenous malformation yog qhov kev sib txuas tsis zoo ntawm cov hlab ntsha thiab cov leeg ntshav hauv lub hlwb.
- Yog tias ib tug neeg hauv tsev neeg (niam, txiv, kwv tij neej tsa) tau muaj aneurysm, koj kuj muaj feem yuav muaj mob ntau dua.
Peb txoj kev ua neej thiab lwm yam mob nkeeg
Cov no yog tej yam uas peb hloov tau thiab tswj tau.
- Haus luam yeeb: Qhov no yog tus yeeb ncuab loj uas ua rau cov phab ntsa ntawm cov hlab ntsha puas tsuaj.
- Ntshav Siab: Ntshav siab uas tsis tswj tau ua rau muaj kev nyuaj siab tas li rau ntawm phab ntsa ntawm cov hlab ntsha.
- Kev siv tshuaj yeeb: Tshwj xeeb yog cov tshuaj yeeb zoo li cocaine.
- Haus dej cawv ntau dhau.
Dab tsi yog cov ua rau aneurysm tawg?
Cov yam tseem ceeb uas ua rau muaj aneurysm kuj ua rau nws tawg. Cov kws tshawb fawb ntseeg tias ntshav siab yog qhov ua rau aneurysm tawg. Thaum ntshav siab nce ntxiv, ntshav yuav thawb hnyav dua rau ntawm phab ntsa ntawm cov hlab ntsha.
Thaum cov ntshav siab nce siab sai sai thiab aneurysm tuaj yeem tawg:
- Muaj ib qho kev xav muaj zog, xws li kev ntxhov siab tas li lossis kev npau taws sai sai.
- Qhov kev siv zog uas yuav tsum tau nqa ib yam dab tsi hnyav (thaum nqa cov khoom hnyav, thaum txav cov rooj tog).
- Paub tias koj muaj ntshav siab tab sis tsis noj tshuaj kom raug.
Tsis tas li ntawd xwb, tej yam xws li qhov loj me, cov duab, thiab qhov chaw ntawm lub aneurysm kuj cuam tshuam rau seb nws puas yuav tawg lossis tsis tawg.
Yuav paub qhov mob no li cas?
Muaj coob tus neeg uas muaj cov hlab ntsha aneurysm uas tsis tau tawg tsis paub tias lawv muaj ib qho. Feem ntau lawv pom lawv tus kheej thaum lub sijhawm MRI lossis CT scan ntawm lub hlwb rau lwm yam laj thawj.
Txawm li cas los xij, yog tias koj muaj cov tsos mob ntawm lub aneurysm tawg (tshwj xeeb tshaj yog mob taub hau hnyav), koj yuav tsum mus rau chav kho mob ceev hauv tsev kho mob tam sim ntawd. Nyob ntawd, cov kws kho mob yuav ua ntau qhov kev kuaj mob kom paub tseeb tias puas muaj ntshav.
- Kev Ntsuas CT (Computed Tomography): Qhov no tuaj yeem kuaj xyuas sai sai seb puas muaj ntshav hauv lub hlwb. Qee zaum yuav muaj kev ntsuas tshwj xeeb hu ua 'CT Angiogram (CTA)', uas tuaj yeem tau txais cov duab meej dua ntawm cov hlab ntsha.
- MRI (Magnetic Resonance Imaging): Qhov no tuaj yeem tsim cov duab ntxaws ntxaws ntawm lub hlwb thiab cov hlab ntsha.
- Kev kuaj mob Cerebral Angiography: Hauv qhov no, tus kws phais hlwb ntxig ib lub raj me me (catheter) los ntawm qhov chaw mos lossis dab teg, coj nws mus rau hauv cov hlab ntsha ntawm lub hlwb, thiab kuaj xyuas qhov chaw, qhov loj me, thiab cov duab ntawm lub aneurysm kom meej heev.
- Kev kuaj cov kua hauv lub hlwb (CSF): Kev xuas lub lumbar tuaj yeem pom cov ntshav ntws ncig lub hlwb.
Cov kev kho mob yog dab tsi?
Lub hom phiaj tseem ceeb ntawm kev kho mob yog kom tsis txhob los ntshav ntawm lub aneurysm. Lub aneurysm tawg yog ib qho xwm txheej ceev uas yuav tsum tau phais mob ceev. Seb puas yuav kho lub aneurysm uas tsis tawg lossis tsis yog nyob ntawm koj tus mob.
Cov kev kho mob tseem ceeb
1. Kev Txiav Cov Nroj Tsuag Me Me: Qhov no yog kev phais qhib. Tus kws phais hlwb ua ib lub qhov me me hauv lub taub hau thiab mus rau qhov chaw ntawm aneurysm. Tom qab ntawd, zoo li tus pas ntoo khaub ncaws, ib lub clip hlau me me raug muab tso rau ntawm lub caj dab ntawm aneurysm, txiav tag nrho cov ntshav ntws mus rau nws.
2. Kev Siv Txoj Hlua Endovascular Coiling: Qhov no yuav tsum tau ua ib qho kev phais me me. Ib lub raj me me (catheter) uas ntxig los ntawm lub qhov ncauj lossis lub dab teg yog siv los ntxig cov hlau me me rau hauv lub aneurysm. Cov hlau no ua rau cov ntshav txhaws hauv lub aneurysm, ua rau cov ntshav ntws tsis tau.
3. Cov Stents Hloov Cov Ntshav: Qhov no kuj ua tau yam tsis muaj kev phais. Ib lub raj zoo li daim ntaub mesh (stent) raug ntxig rau hauv cov hlab ntsha uas muaj aneurysm nyob. Qhov no coj cov ntshav mus ncaj qha los ntawm cov hlab ntsha, hla dhau aneurysm.
Koj ua dab tsi rau aneurysm uas tsis tawg?
Yog tias koj muaj ib qho aneurysm me me, tsis muaj tsos mob thiab tsis muaj lwm yam kev pheej hmoo, koj tus kws kho mob yuav txiav txim siab tsis kho nws.
Tiamsis qhov ntawd tsis tau txhais hais tias koj yuav tsum tsis txhob hnov qab txog nws. Koj yuav tsum tau kuaj xyuas tas li kom pom tias puas muaj kev hloov pauv. Tsis tas li ntawd, yog tias koj haus luam yeeb, koj yuav raug qhia kom tsum thiab tswj koj cov ntshav siab .
Qhov kev txiav txim siab yuav phais lossis tsis phais yog ua raws li ntau yam, suav nrog koj lub hnub nyoog, kev noj qab haus huv tag nrho, qhov loj thiab qhov chaw ntawm lub aneurysm, thiab koj keeb kwm tsev neeg. Tham nrog koj tus kws kho mob txog qhov no.
Koj hais li cas txog yav tom ntej?
Yog tias muaj ib qho aneurysm tawg, qhov tshwm sim nyob ntawm koj lub hnub nyoog, kev noj qab haus huv, qhov ntshav poob ntau npaum li cas, thiab koj tau txais kev kho mob sai npaum li cas. Tu siab, muaj li ntawm 25% ntawm cov neeg tuag hauv 24 teev tom qab muaj aneurysm tawg. Tus nqi tuag yog li ntawm 50% hauv peb lub hlis.
Kwv yees li ntawm 66% ntawm cov neeg uas muaj sia nyob raug kev puas tsuaj rau lub hlwb mus tas li. Txawm li cas los xij, nrog kev kho mob thaum ntxov thiab kev kho kom rov zoo , qee tus rov zoo los ntawm kev tsis muaj lossis tsis muaj kev tsis taus.
Txawm li cas los xij, ntau tus neeg uas muaj cov hlab ntsha me me, tsis tawg, nyob tau ntev yam tsis muaj tsos mob lossis muaj teeb meem dab tsi los ntawm nws.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Ib qho aneurysm hauv lub hlwb yog ib qho chaw tsis muaj zog hauv cov hlab ntsha hauv lub hlwb uas loj zoo li lub npas.
- Mob taub hau sai sai thiab hnyav heev (mob taub hau 'thunderclap') yog ib qho cim tseem ceeb ntawm aneurysm tawg. Qhov no yog xwm txheej ceev hauv kev kho mob. Mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
- Feem ntau cov aneurysms uas tsis tau tawg tsis ua rau muaj tsos mob thiab tej zaum yuav tsis tas yuav kho.
- Kev tswj cov ntshav siab, tsis txhob haus luam yeeb, thiab tsis txhob siv tshuaj yeeb yog cov yam zoo tshaj plaws uas koj ua tau los txo qhov kev pheej hmoo no.
- Yog tias koj tau kuaj pom tias muaj aneurysm, nrog koj tus kws kho mob tham txog koj cov kev pheej hmoo, cov kev xaiv kho mob, thiab kev tswj hwm kom txiav txim siab zoo.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus