Qhov no puas yog ib qho ntshav txhaws hauv lub taub hau uas txaus ntshai? Qhov no puas yog Cavernous Sinus Thrombosis?

Koj puas tau muaj kev raug mob me me ntawm lub ntsej muag lossis teeb meem ntawm lub qhov ntswg uas ua rau koj mob taub hau hnyav? Koj puas tau muaj qhov muag o thiab pom tsis meej? Qee zaum peb tsis quav ntsej txog cov no, tab sis lawv tuaj yeem ua rau muaj kev phom sij heev thiab xav tau kev kho mob tam sim ntawd. Niaj hnub no peb tab tom tham txog ib qho mob loj heev uas ntau tus neeg tsis paub txog, hu ua Cavernous Sinus Thrombosis .

Qhov no cavernous sinus thrombosis yog dab tsi?

Hais yooj yim xwb, Cavernous Sinus Thrombosis yog thaum cov ntshav txhaws tsim nyob rau hauv cov qhov me me hauv koj lub taub hau, tshwj xeeb tshaj yog tom qab koj lub qhov muag, hauv qab koj lub hlwb hu ua 'Cavernous Sinuses' . Xav txog cov sinuses no ua cov qhov me me uas ntau cov leeg ntshav sib sau ua ke. Ntau cov leeg ntshav tseem ceeb uas ntws cov ntshav ntawm koj lub ntsej muag thiab lub hlwb khiav los ntawm cov no. 'Jugular Vein', ib txoj leeg ntshav loj hauv koj lub caj dab, kuj txuas nrog cov cavernous sinuses no. Yog li, yog tias cov ntshav txhaws tsim nyob rau hauv cov leeg ntshav no (feem ntau yog los ntawm kev kis kab mob), cov ntshav txhaws thaiv cov ntshav ntws tawm ntawm koj lub hlwb. Qhov no yog qhov txaus ntshai heev, vim nws tuaj yeem ua rau koj lub hlwb, qhov muag, thiab cov hlab ntsha puas tsuaj mus sij hawm ntev. Qhov no yog ib qho mob uas tuaj yeem ua rau tuag taus yog tias tsis kho sai.

Tus mob no feem ntau tshwm sim li cas?

Qhov tseeb, tus mob no hu ua Cavernous Sinus Thrombosis yog ib qho mob tsis tshua muaj. Qhov ntawd yog, nws tsis yog ib yam dab tsi uas pom ntau zaus. Nws nyuaj rau hais tias muaj pes tsawg tus neeg mob tau tshaj tawm hauv ib xyoos, nws tsawg heev. Tab sis cov xov xwm zoo yog tias tom qab kev tshawb pom cov tshuaj tua kab mob , tus lej ntawm cov lus ceeb toom ntawm tus kab mob no tau txo qis ntau. Vim tias cov kab mob, uas yog cov ua rau cov ntshav txhaws no, tuaj yeem kho tau nrog cov tshuaj tua kab mob, cov kab mob tam sim no tsis tshua muaj feem yuav loj hlob tuaj.

Cov tsos mob ntawm qhov no yog dab tsi? Yuav ua li cas thiaj paub txog nws?

Qhov txaus ntshai tshaj plaws txog qhov no yog tias cov tsos mob tuaj yeem zuj zus sai heev. Ib qho ntawm cov tsos mob tseem ceeb uas los ua ntej yog mob taub hau hnyav. Qhov no tsis zoo li mob taub hau ib txwm muaj. Nws yog ib qho uas tsis ploj mus txawm tias tom qab noj tshuaj tua kab mob, thiab nws zuj zus zuj zus txhua hnub. Nws tuaj yeem tshwm sim sai sai thiab hnyav, lossis nws tuaj yeem maj mam nce ntxiv rau ob peb hnub. Qhov mob no feem ntau hnov ​​​​​​nyob ib puag ncig ib lub qhov muag, nyob ib puag ncig ob lub qhov muag, lossis tom qab lub qhov muag.

Cov tsos mob no yog tshwm sim los ntawm kev nce siab hauv lub qhov ntswg cavernous vim yog cov ntshav txhaws. Ceev faj kom paub seb koj puas muaj cov tsos mob no:

• Mob taub hau hnyav heev uas tsis ploj mus txawm tias tom qab noj tshuaj lawm los xij.
• O ntawm ib lossis tom qab ob lub qhov muag, qee zaum nrog kev xav tias lub qhov muag o.
• Qhov muag poob qis, zoo li lub qhov muag kaw ib nrab ('droopy eyelids').
• Hnov mob heev thaum sim txav ib lossis ob lub qhov muag.
• Tsis muaj peev xwm txav ib lossis ob lub qhov muag, daig rau ib sab.
• Pom kev tsis meej, tsis pom kev meej.
• Pom ob npaug.
• Tsis muaj zog lossis tsis muaj kev xav ntawm lub ntsej muag, tshwj xeeb tshaj yog nyob ib ncig ntawm lub qhov muag.
• Kub heev.
• Ib txhia neeg yuav muaj mob qaug dab peg.

Tseem Ceeb Heev: Yog tias tsis kho, qhov mob cavernous sinus thrombosis tuaj yeem maj mam zuj zus tuaj, ua rau tus neeg mob tsis meej pem thiab tsaug zog. Qhov no tuaj yeem ua rau tsis nco qab thiab txawm tias tuag. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev kho mob sai li sai tau thaum koj pom cov tsos mob no, ua ntej tus mob loj hlob mus txog rau theem no.

Qhov no tshwm sim sai npaum li cas?

Feem ntau, qhov mob cavernous sinus thrombosis tshwm sim 5 txog 10 hnub tom qab tsis tau kho tus kab mob hauv koj lub ntsej muag lossis taub hau (piv txwv li, sinus, hniav, lossis pob ntseg). Lub cim thawj zaug yog mob taub hau. Cov tsos mob ntawm qhov muag (xws li o, bulging) yuav tshwm sim sai sai, tsis ntev tom qab mob taub hau, lossis lawv yuav maj mam tshwm sim.

Ua li cas thiaj ua rau qhov no? Vim li cas qhov no thiaj tshwm sim?

Xav txog nws li no. Koj muaj ib lub pob me me ntawm koj lub ntsej muag, tej zaum ntawm sab ntawm koj lub qhov ntswg, lossis ntawm koj daim di ncauj sab saud. Lossis koj mob hniav. Koj tsis quav ntsej txog nws ntau, xav tias, 'Nws tsuas yog ib qho me me xwb, nws yuav ploj mus ntawm nws tus kheej.' Tab sis, kev kis kab mob hauv qhov chaw me me ntawd feem ntau ua rau muaj qhov mob txaus ntshai no hu ua Cavernous Sinus Thrombosis . Ntawd yog, nws los ua ib qho teeb meem ntawm kev kis kab mob.

Qhov tshwm sim yog qhov no: Cov ntshav hauv koj cov hlab ntsha hauv lub qhov ntswg ua rau cov ntshav txhaws kom tiv thaiv kev kis tus kab mob. Nws yog ib txoj hauv kev tiv thaiv lub cev. Tab sis es tsis txhob tiv thaiv kev kis tus kab mob, cov ntshav txhaws no ntes cov kab mob. Tom qab ntawd cov ntshav tsis ntws tawm ntawm lub hlwb. Qhov no ua rau lub siab hauv lub qhov ntswg ua rau nce ntxiv, ua rau cov tsos mob tau hais ua ntej.

Cov hom kab mob uas feem ntau cuam tshuam rau qhov no yog:

• Kab mob Sinus (sinusitis). Kab mob hauv cov qhov ntswg.
• Cov pob khaus los yog cov pob khaus uas tsim nyob rau hauv qab daim tawv nqaij ntawm lub ntsej muag, tshwj xeeb tshaj yog nyob ib ncig ntawm lub qhov ntswg thiab daim di ncauj sab saud.
• Cov kab mob hniav.
• Kab mob pob ntseg, tshwj xeeb tshaj yog kab mob pob ntseg nruab nrab.

Feem ntau, kwv yees li 70% ntawm cov neeg mob, qhov ua rau yog cov kab mob 'Staphylococcus aureus' . Qhov no yog ib hom kab mob uas pom ntau heev. Dua li ntawm qhov ntawd, lwm hom kab mob thiab qee hom fungi kuj tuaj yeem ua rau muaj kev kis kab mob uas ua rau cavernous thrombosis. Tsis ntev los no, ntau tus neeg mob cavernous sinus thrombosis uas cuam tshuam nrog kev kis kab mob 'COVID-19' tau tshaj tawm.

Tsis tshua muaj, cov ntshav txhaws no tuaj yeem tsim los ntawm kev raug mob taub hau hnyav, tsis yog los ntawm kev kis kab mob.

Cov kws kho mob kuaj mob li cas?

Nws yuav nyuaj me ntsis rau kev kuaj mob, vim nws cov tsos mob zoo ib yam li lwm yam mob uas tshwm sim, xws li kev kis kab mob ntawm qhov muag, mob taub hau loj heev, lossis lwm yam mob ntawm lub paj hlwb.

Txawm li cas los xij, raws li koj cov tsos mob, tshwj xeeb tshaj yog tias koj tam sim no muaj kab mob ntawm lub ntsej muag lossis sinus lossis tau muaj ib qho tsis ntev los no, koj tus kws kho mob yuav xav tias cavernous sinus thrombosis .

Ib lossis ntau qhov kev kuaj no yuav ua tau los xyuas kom meej tias muaj tus kab mob no:

• Kev ntsuam xyuas duab.
• MRI (Magnetic Resonance Imaging): Qhov no tso cai rau koj pom lub hlwb thiab thaj chaw cavernous sinus kom meej meej, uas yog qhov tseem ceeb heev rau kev nrhiav seb puas muaj ntshav txhaws.
• Kev luam theej duab 'CT' (Computed Tomography): Qhov no kuj tseem tuaj yeem nrhiav cov ntshav txhaws thiab cov cim ntawm kev kis kab mob.
• MRV (Magnetic Resonance Venogram nrog MRI): Qhov no yog txoj kev kuaj mob uas yoo tshaj plaws. Hauv MRV no, tus kws kho mob txhaj tshuaj tshwj xeeb (contrast dye) rau hauv koj cov leeg ntshav. Lub MRI ces pom tau meej meej txog cov ntshav ntws thiab cov khoom thaiv hauv cov leeg ntshav.
• Kev kuaj kab mob bacterial. Koj tus kws kho mob yuav kuaj koj cov ntshav lossis lwm cov kua dej hauv lub cev (xws li cov kua dej los ntawm koj lub qhov ntswg lossis cov kua qaub los ntawm qhov txhab) kom pom tias puas muaj cov kab mob bacterial lossis lwm yam kab mob uas ua rau muaj kev kis kab mob. Qhov no tuaj yeem pab txheeb xyuas cov kab mob tseeb thiab sau cov tshuaj tua kab mob kom raug.
• Kev siv lub qhov (spinal tap / lumbar puncture). Qhov kev kuaj no tuaj yeem pom tias tus kab mob puas tau kis mus rau cov ntaub so ntswg uas npog lub hlwb thiab tus txha caj qaum (meninges). Yog tias nws tau kis, nws hu ua meningitis . Meningitis yog ib qho teeb meem txaus ntshai ntawm cavernous sinus thrombosis. Hauv qhov kev kuaj no, tus kws kho mob ntxig ib rab koob nyias nyias rau hauv koj lub nraub qaum qis thiab coj ib qho qauv ntawm cov kua qaub qaum. Cov kua qaub qaum raug kuaj rau cov kab mob thiab lwm yam cim ntawm kev kis kab mob.

Tseem Ceeb: Vim tias qhov mob cavernous sinus thrombosis yog ib yam kab mob uas txaus ntshai thiab kis mus sai heev, tus kws kho mob yuav pib kho mob raws li qhov xav tau ua ntej kuaj pom tias muaj tseeb. Vim tias txhua ob feeb tseem ceeb ntawm no.

Yuav kho qhov no li cas? Puas kho tau?

Yog, kev kho mob sai thiab raug cai tuaj yeem tswj tau qhov mob no thiab cawm tau txoj sia. Txawm li cas los xij, yog tias kev kho mob qeeb, qhov mob tuaj yeem hnyav zuj zus. Tej zaum koj yuav raug xa mus rau chav kho mob hnyav (ICU) hauv tsev kho mob.Koj yuav raug tso cai nkag mus. Tom qab ntawd cov kws kho mob thiab cov neeg ua haujlwm tu mob tuaj yeem saib xyuas koj ze 24 teev hauv ib hnub.

Cov kev kho mob tseem ceeb hauv qab no:

• Tshuaj tua kab mob. Qhov no yog kev kho mob tseem ceeb. Koj tus kws kho mob yuav pib muab tshuaj tua kab mob rau koj kom txhaj rau hauv cov hlab ntshav (IV) kom tua tau tus kab mob uas ua rau cov ntshav txhaws. Raws li tau hais ua ntej lawm, qhov no yog ib qho txheej txheem siv sijhawm ntau, yog li koj yuav tau txais tshuaj tua kab mob ua ntej kev kuaj mob tuaj yeem qhia meej txog qhov ua rau muaj tus kab mob (kab mob lossis pwm). Yuav kom muaj kev nyab xeeb, koj yuav tau txais tshuaj tua kab mob dav dav uas tuaj yeem tua ntau hom kab mob (tshwj xeeb tshaj yog cov kab mob xws li S. aureus) . Tom qab ntawd, thaum cov txiaj ntsig ntawm kev kuaj mob rov qab los, koj yuav raug hloov mus rau tshuaj tua kab mob uas tsim nyog dua. Koj yuav tsum tau txuas ntxiv kev kho mob no hauv tsev kho mob rau ob peb lub lis piam.
• Cov tshuaj ua kom cov ntshav nyias (anticoagulants). Tej zaum koj yuav tau txais cov tshuaj ua kom cov ntshav nyias (blood thinners) xws li heparin los tiv thaiv cov ntshav txhaws kom tsis txhob loj hlob, kom maj mam yaj, thiab tiv thaiv cov ntshav txhaws tshiab kom tsis txhob tsim.
• Cov tshuaj Anticoagulants (cov tshuaj ua kom cov ntshav nyias) muab tau rau hauv cov hlab ntsha lossis hauv qab daim tawv nqaij. Koj yuav tsum tau noj cov tshuaj ua kom cov ntshav nyias no ua cov tshuaj ntsiav rau ob peb lub hlis tom qab kev kho mob thawj zaug.
• Cov tshuaj Corticosteroids. Koj tus kws kho mob yuav sau ntawv kom muab cov tshuaj steroids los txo qhov o thiab o uas ua rau muaj kev nyem hauv koj lub qhov ntswg. Txawm li cas los xij, cov tshuaj no tsuas yog muab tom qab koj tau pib siv tshuaj tua kab mob los tswj kev kis kab mob thiab kev kis kab mob tau tswj hwm lawm.
• Phais Mob. Qee zaum, yuav tsum tau phais mob kom ntxuav qhov chaw uas muaj kab mob (piv txwv li, kab mob hauv qhov ntswg, kab mob hauv cov hniav) thiab tshem tawm cov kua qaub lossis lwm yam kua uas tau sib sau ua ke. Qhov no tuaj yeem pab tswj kev kis kab mob sai dua.

Yog qhov no tshwm sim, peb yuav xav li cas? Yuav muaj teeb meem dab tsi?

Ua ntej nrhiav tau cov tshuaj tua kab mob, cov kab mob cavernous sinus thrombosis feem ntau ua rau tuag taus. Tab sis tam sim no, nrog kev nce qib hauv kev kho mob, ntau dua 70% ntawm cov neeg uas muaj tus kab mob no tseem muaj sia nyob. Qhov ntawd yog ib qho kev ua tiav loj heev.

Txawm li cas los xij, txawm tias lawv tseem muaj sia nyob los xij, ntau tus neeg tuaj yeem muaj teeb meem vim qhov no yog ib qho mob uas cuam tshuam rau lub hlwb thiab cov hlab ntsha. Piv txwv li, kwv yees li 20% ntawm cov neeg uas rov zoo los ntawm cavernous sinus thrombosis yuav txuas ntxiv muaj teeb meem pom kev (pom kev tsis zoo, dig muag) thiab teeb meem ntawm lub paj hlwb (lub ntsej muag tsis muaj zog, nyuaj rau txav lawv lub qhov muag) .

Lwm yam teeb meem uas yuav tshwm sim tau yog:

• Mob taub hau hnyav heev.
• Tsis pom kev kiag li hauv ib lossis ob lub qhov muag.
• Mob qaug dab peg tas li.
• Mob hlwb (kev kis kab mob ntawm cov ntaub so ntswg uas npog lub hlwb).
• Sepsis (kev kis tus kab mob mus rau cov ntshav).

Ib qho ntxiv yog tias muaj qhov mob cavernous sinus thrombosis ua rau koj muaj kev pheej hmoo ntawm kev tsim lwm yam ntshav txhaws txaus ntshai, xws li ntshav txhaws hauv koj ob txhais ceg ( Deep Vein Thrombosis - DVT ), ntshav txhaws mus rau koj lub ntsws ( Pulmonary Embolism - PE ), lossis ntshav txhaws tsim nyob rau lwm qhov hauv koj lub hlwb ( Stroke ).

Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum qhib siab rau koj tus kws kho mob txog tej teeb meem uas yuav tshwm sim ntawm koj tus mob. Nws tseem yog ib qho tseem ceeb kom paub cov cim ceeb toom ntawm tej teeb meem kom koj thiaj li tiv thaiv tau lawv thaum twg ua tau.

Thaum twg koj yuav tsum nrhiav kev kho mob tam sim ntawd?

Yog koj muaj ib qho ntawm cov tsos mob no, nrhiav kev pab kho mob tam sim ntawd yam tsis muaj kev ncua:

• Mob taub hau hnyav heev uas txawm tias noj tshuaj tua kab mob lawm los tsis ploj mus, thiab mob zuj zus tuaj.
• Yog tias mob taub hau nrog rau qhov mob uas hnyav zuj zus thaum koj pw lossis khoov.
• Yog tias ib lossis ob lub qhov muag pib mob, o, liab, lossis o.
• Yog koj mob heev, qaug zog, lossis tsaug zog heev.
• Yog koj ua pa nyuaj.
• Yog tias koj muaj mob hnyav heev, mob taub hau thiab kiv taub hau.

Cov tsos mob zoo li no qhia tau tias tej zaum yuav muaj xwm txheej ceev.

Cov lus nug tseem ceeb uas yuav nug tus kws kho mob yog dab tsi?

Yog koj tus kws kho mob qhia rau koj tias koj muaj tus mob no, tej zaum koj yuav ntxhov siab. Tiam sis, kom koj lub siab tus thiab nkag siab meej txog koj tus mob thiab kev kho mob, tsis txhob hnov ​​qab nug koj tus kws kho mob cov lus nug no:

• Kuv muaj dab tsi tiag? Qhov no loj npaum li cas?
• Kuv xav tau kev kho mob hom twg? Yuav siv sijhawm ntev npaum li cas?
• Cov kev kho mob no muaj cov kev mob tshwm sim li cas?
• Kuv yuav tau nyob hauv tsev kho mob ntev npaum li cas?
• Muaj feem yuav muaj teeb meem ntev npaum li cas los ntawm cov ntshav txhaws no? Lawv yog dab tsi? Puas tuaj yeem tiv thaiv tau?
• Vim muaj tej teeb meem no, kuv yuav tau hloov dab tsi hauv kuv lub neej txhua hnub?
• Muaj feem yuav ua li cas rau kuv kom rov qab tau tus mob no dua? Kuv yuav tsum ua li cas thiaj li tiv thaiv tau nws?
• Tom qab kuv mus tsev lawm, kuv yuav tsum ua dab tsi ntxiv?

Cov lus teb rau cov lus nug no yuav tseem ceeb heev rau koj.

Thaum kawg, tej yam uas yuav tsum nco ntsoov

Nws yuav ua rau ntshai heev thaum paub tias qee yam xws li kev kis kab mob sinus lossis ib lub pob me me ntawm koj lub ntsej muag tuaj yeem ua rau cov ntshav txhaws uas txaus ntshai rau lub neej. Cavernous sinus thrombosis - cov ntshav txhaws uas tsim nyob rau hauv koj lub ntsej muag lossis lub taub hau los teb rau kev kis kab mob - qhov tseeb yog ib qho mob tsis tshua muaj. Yog li, nws tsis zoo li koj lub taub hau lossis mob qhov muag yog ib qho cim ntawm qee yam loj dua. Nws yuav yog ib qho cim ntawm qee yam tsis loj heev.

Txawm li cas los xij, qhov tseem ceeb tshaj plaws uas yuav tsum nco ntsoov yog kho txhua yam kab mob - txawm tias nws zoo li me me li cas los xij - sai thiab raug. Ceev faj tshwj xeeb rau cov kab mob uas tshwm sim ntawm lub ntsej muag, qhov ntswg, qhov ncauj, thiab qhov muag. Kev kho mob sai li sai tau tuaj yeem pab tau ntau yam hauv kev tiv thaiv tus mob hnyav no kom tsis txhob loj hlob. Yog li ntawd, nws yog qhov zoo los nrhiav kev pab kho mob yog tias koj muaj cov tsos mob txawv txawv, txawm tias lawv me me los xij. Ua tib zoo mloog cov cim qhia uas koj lub cev muab rau koj!

Cavernous Sinus Thrombosis, Ntshav txhaws hauv lub hlwb, Kab mob ntawm daim tawv taub hau, Kab mob ntawm lub ntsej muag, Mob taub hau hnyav, Qhov muag o, Tshuaj tua kab mob, Kab mob ntawm lub paj hlwb