Koj puas tau xav txog seb yuav muaj li cas yog tias ib txoj hlab ntsha hauv peb lub cev raug thaiv los ntawm ib yam dab tsi? Tej zaum qhov ntawd tsis tau tshwm sim rau koj. Tab sis, qhov no yog ib yam dab tsi uas peb txhua tus yuav tsum paub. Vim tias, ib txoj hlab ntsha raug thaiv zoo li no, ib qho mob hu ua (Embolism), qee zaum tuaj yeem ua rau muaj kev phom sij heev. Yog li, peb puas yuav tham txog qhov no kom ntxaws me ntsis thiab yooj yim hnub no?
Mob embolism yog dab tsi? Hais yooj yim xwb...
Hais yooj yim xwb, qhov mob embolism yog thaum ib qho ntawm koj cov hlab ntsha, lossis qhov chaw uas cov ntshav ntws, raug thaiv los ntawm ib yam dab tsi. Feem ntau, qhov kev thaiv no yog tshwm sim los ntawm cov ntshav txhaws uas tau tsim nyob rau lwm qhov. Txawm li cas los xij, tsis yog cov ntshav txhaws xwb, tab sis kuj muaj lwm yam uas tuaj yeem mus los ntawm ib qho chaw hauv lub cev mus rau lwm qhov thiab thaiv cov hlab ntsha zoo li no.
Xav txog nws zoo li ib daim av uas daig hauv cov kav dej. Qee cov hlab ntsha, vim lawv qhov loj thiab cov duab, yuav raug thaiv ntau dua li lwm cov. Qhov no tuaj yeem tshwm sim tshwj xeeb tshaj yog thaum cov hlab ntsha loj tawg ua cov me dua, lossis thaum cov hlab ntsha tau nqaim vim muaj cov rog (atherosclerosis).
Cov kab mob embolism no tuaj yeem tshwm sim txhua qhov chaw hauv koj lub cev, suav nrog koj lub hlwb, lub ntsws, lub raum, thiab tus po. Hom kab mob embolism feem ntau yog nyob rau hauv lub ntsws. Thaum cov ntshav txhaws tsim nyob rau hauv cov leeg ntawm koj ob txhais ceg thiab mus rau koj lub ntsws, nws hu ua pulmonary embolism, lossis PE .
Muaj ntau txoj kev sib txawv uas ua rau embolism tshwm sim?
Kab mob embolism muaj ntau hom nyob ntawm seb yam khoom twg daig hauv cov hlab ntsha. Saib seb:
- Thromboembolism: Qhov no yog hom ntshav txhaws uas feem ntau pom . Nws yog tshwm sim los ntawm cov ntshav txhaws uas tsim nyob rau lwm qhov hauv lub cev, tshwj xeeb tshaj yog nyob rau hauv cov leeg ntshav tob ntawm ob txhais ceg (Deep Vein Thrombosis - DVT).
- Mob qog nqaij hlav embolism: Ib yam dab tsi zoo li ib daim ntawm cov qog nqaij hlav.
- Kev txhaws ntawm cov rog: Cov rog tuaj yeem sib sau ua ke hauv cov ntshav thaum lub pob txha tawg loj.
- Septic embolism: Ib qho ntshav txhaws uas cuam tshuam nrog kev kis kab mob.
- Kev txhaws ntawm huab cua: Piv txwv li, nws tuaj yeem tshwm sim los ntawm cov pa nitrogen thaum lub sijhawm dhia dej.
- Amniotic kua embolism: Qhov no yog txuam nrog kev yug menyuam thiab tsis tshua muaj.
Ntawm cov no, Venous Thromboembolism , uas yog cov ntshav txhaws uas tsim nyob rau hauv cov leeg thiab thaiv lawv, yog qhov tshwm sim ntau dua li cov ntshav txhaws hauv cov hlab ntsha. Qhov tseeb, hauv lub tebchaws zoo li Asmeskas, nws tau tshaj tawm tias muaj li ntawm 900,000 tus neeg txhua xyoo muaj tus mob no. Tsis tas li ntawd, Pulmonary Embolism yog qhov thib peb ua rau kev tuag ntsig txog lub plawv thiab cov hlab ntsha hauv ntiaj teb. (Tus lej ib thiab ob yog Stroke thiab Heart Attack).
Cov tsos mob ntawm embolism yog dab tsi?
Yog tias muaj kev txhaws hauv koj cov hlab ntsha, nws thaiv cov ntshav ntws. Koj paub, cov ntshav nqa cov pa oxygen uas txhua lub cell hauv peb lub cev xav tau. Yog li, yog tias cov ntshav tsis tuaj yeem hla dhau, cov pa oxygen tsis tuaj yeem hla dhau. Qhov tsis muaj pa oxygen no ua rau muaj mob hu ua "infarct," uas ua rau lub cev uas xav tau cov pa oxygen ntawd puas tsuaj. Qhov no tuaj yeem ua rau mob. Qee zaum, qhov tsis muaj pa oxygen no tuaj yeem ua rau tuag taus.
Xav txog ib qho ntshav txhaws (thrombus) uas tsim nyob rau hauv ib txoj hlab ntsha tob hauv koj ceg, thiab cov me me ntawm nws tawg thiab mus nrog cov ntshav mus rau sab xis ntawm koj lub plawv. Los ntawm qhov ntawd, cov ntshav raug pumped mus rau lub ntsws. Cov ntshav txhaws me me no (pulmonary emboli) daig rau hauv cov hlab ntsha me me hauv lub ntsws, ua rau lub ntsws infarct. Tsis tshua muaj, cov loj loj (pulmonary emboli) tuaj yeem thaiv tag nrho cov ntshav ntws los ntawm sab xis ntawm lub plawv mus rau lub ntsws.
Cov tsos mob ntawm embolism sib txawv nyob ntawm hom thiab qhov chaw ntawm embolism. Ib txhia neeg yuav tsis muaj tsos mob li. Nov yog qee cov tsos mob:
- Ua tsis taus pa
- Cov pa oxygen hauv cov ntshav qis (Hypoxemia)
- Ua pa sai tab sis tsis tob (Tachypnea)
- Tsis muaj zog, qaug zog
- Mob taub hau
- Cov pob liab ntawm daim tawv nqaij (Petechiae)
- Mob hauv siab
- Lub plawv dhia ceev ceev (Tachycardia)
- Ua npaws
- O ntawm ib sab caj npab lossis ceg
- Qaug dab peg
- Kab mob kiv taub hau
- Ntuav thiab xeev siab
- Ntshav siab qis (Hypotension)
Dab tsi yog qhov ua rau embolism tseem ceeb?
Feem ntau, cov hlab ntsha embolism hauv lub ntsws tshwm sim hauv cov ntsws. Qhov ua rau qhov no tseem ceeb yog cov ntshav txhaws hauv cov leeg ntawm ob txhais ceg (Deep Vein Thrombosis - DVT) . Qee zaum, cov hlab ntsha embolism hauv lub ntsws kuj tuaj yeem tshwm sim vim DVT hauv cov leeg ntawm caj npab.
Muaj lwm yam ua rau embolism tshwm sim:
- Kev kis kab mob ntawm sab hauv ntawm lub plawv (infective endocarditis)
- Atrial fibrillation (lub plawv dhia tsis xwm yeem)
- Sab laug ventricular thrombus
- Ib pob txha tawg hauv qhov xwm txheej loj
- Mob qog noj ntshav
- Ntau yam kab mob sib kis
- Mob Pancreatitis
- Kev rho roj
- Kev hloov pob txha
- Kab mob ntshav qab zib thaum cev xeeb tub
- Placenta accreta (qhov placenta txuas tob rau ntawm phab ntsa uterine)
Leej twg muaj feem yuav mob qhov no (embolism) ntau dua?
Muaj ntau yam uas ua rau muaj kev pheej hmoo ntawm cov ntshav txhaws (embolism). Saib seb puas muaj ib qho ntawm cov no cuam tshuam rau koj:
- Kev tsis ua ub ua no: Nyob hauv ib qho chaw ntev dhau, tshwj xeeb tshaj yog tom qab phais mob.
- Kev phais thiab qee yam kev kho mob: Tom qab kev phais loj.
- Lub plawv tsis ua haujlwm
- Mob stroke
- Mob qog noj ntshav
- Kev raug mob ntawm lub cev (Kev raug mob hnyav)
- Ntshav siab (Tshuaj ntshav siab)
- Kev siv cov khoom luam yeeb (haus luam yeeb)
- Kev siv cov tshuaj tiv thaiv kev yug menyuam
- Tej yam mob uas ua rau cov ntshav txhaws tau yooj yim
- Qee cov khoom siv kho mob, xws li cov tshuab pacemakers
Cov teeb meem dab tsi uas tuaj yeem tshwm sim los ntawm embolism?
Cov teeb meem ntawm embolism sib txawv nyob ntawm qhov chaw uas nws tshwm sim. Nws tuaj yeem ua rau muaj kev phom sij heev. Nov yog qee qhov teeb meem:
- Kev ua haujlwm tsis zoo ntawm lub hlwb, xws li kev nco tsis zoo
- Kev tsis sib xws ntawm lub plawv dhia (Arrhythmia)
- Kev nres plawv
- Mob plawv nres
- Kev mob o ntawm lub hlwb
- Mob ntsws o
- Kab Mob Ua Pa Nyuaj Siab (ARDS)
- Poob ib sab caj npab lossis ceg
- Kab mob qog ntawm lub plab
- Kev tuag ntawm cov nqaij hauv lub raum, lub zais zis, lossis lwm yam hauv lub cev uas raug cuam tshuam
- Tricuspid valve regurgitation (cov ntshav ntws rov qab los ntawm lub plawv valve)
- Kev ua haujlwm tsis zoo ntawm lub raum
- Lub plawv tsis ua haujlwm
- Mob stroke
- Txawm tias yuav poob txoj sia los kuj tshwm sim tau.
Qhov ntawd txhais tau tias, qhov no tsis yog ib yam dab tsi uas yuav tsum tau saib yooj yim. Txawm hais tias nws zoo li yog ib yam me me xwb los, yog tias tsis kho raws sijhawm, nws tuaj yeem ua rau muaj teeb meem loj rau lub neej.
Tus kws kho mob yuav kuaj qhov no (embolism) li cas kom meej?
Yog koj muaj cov tsos mob ntawm kev mob embolism, tus kws kho mob yuav kuaj koj ua ntej. Tus kws kho mob yuav pom tej yam xws li kev hloov pauv ntawm daim tawv nqaij lossis ua pa nyuaj. Yog tias xav tias muaj kev mob embolism, nws yuav ua qee qhov kev kuaj mob.
Nyob ntawm seb hom embolism li cas, cov kev ntsuam xyuas hauv qab no yuav ua tau:
- Kev kuaj ntshav
- Kev X-ray hauv siab
- Doppler ultrasound - Saib cov ntshav ntws hauv cov hlab ntsha.
- ECG (Electrocardiogram - EKG) - Xyuas seb lub plawv ua haujlwm li cas.
- Kev luam theej duab CT (Computed Tomography - CT scan)
- Kev xeem MRA(Kev Siv Tshuaj Magnetic Resonance Angiogram - MRA)
- MRI (Kev Siv Duab Sib Nqus Sib Nqus)
- Angiogram - Ib daim duab X-ray ntawm cov hlab ntsha tom qab txhaj tshuaj zas.
- Kev kuaj mob plawv los ntawm kev siv ultrasound: (Transthoracic echocardiogram - TTE) thiab (Transesophageal echocardiogram - TEE)
- Qee zaum yuav ua ib qho biopsy los kuaj ib daim nqaij.
Cov kev kho mob rau embolism yog dab tsi?
Lub hom phiaj tseem ceeb ntawm kev kho mob rau embolism yog tshem tawm qhov txhaws hauv cov hlab ntsha thiab rov qab cov ntshav ntws. Feem ntau, qhov kev xaiv thawj zaug yog kho nrog tshuaj.
Nov yog qee cov kev kho mob rau embolism:
- Cov tshuaj Anticoagulants : Peb hais tias cov no "thrombify" cov ntshav.
- Cov tshuaj Thrombolytics : Cov no ncaj qha yaj cov ntshav txhaws thiab tshem tawm.
- Cov tshuaj tua kab mob rau Embolism
- Cov tshuaj uas ua rau lub plawv ua haujlwm zoo dua (Inotropes)
- Kev kho mob oxygen lossis kev kho mob hyperbaric oxygen
- Kev phais tshem tawm cov embolism (embolectomy)
Hauv cov xwm txheej loj heev, cov neeg uas muaj mob embolism yuav xav tau kev kho mob ntxiv rau kev pab txhawb nqa lub neej, xws li CPR , ECMO (lub tshuab uas ua haujlwm hloov lub plawv thiab lub ntsws), thiab txawm tias cov tshuab los pab lawv ua pa.
Puas muaj tej yam tshwm sim ntawm kev kho mob?
Yog, hmoov tsis zoo muaj qee qhov kev mob tshwm sim. Muaj kev pheej hmoo ntawm kev los ntshav, tshwj xeeb tshaj yog nrog cov tshuaj hu ua anticoagulants thiab thrombolytics. Thaum cov ntshav txhaws raug tshem tawm los ntawm kev phais (embolectomy), tej zaum yuav muaj kev pheej hmoo xws li:
- Kev puas tsuaj rau cov hlab ntsha
- Los ntshav
- Lub plawv dhia qeeb (Bradycardia)
- Ntshav siab qis (Hypotension)
- Kev nres plawv
Yuav ua li cas yog tias muaj embolism tshwm sim?
Tej tus neeg uas muaj mob embolism yuav tsis muaj tsos mob li, thaum lwm tus yuav muaj tsos mob hnyav heev. Yuav kho koj li cas yuav nyob ntawm ntau yam, suav nrog qhov loj thiab qhov hnyav ntawm mob embolism, thiab qhov chaw uas nws pib.
Embolism yog ib qho mob uas ua rau tuag taus, yog li kev kuaj mob thaum ntxov thiab kev kho mob sai sai tuaj yeem ua rau koj muaj feem rov zoo.
Peb ua tau dab tsi los tiv thaiv embolism?
Yog, peb tuaj yeem tiv thaiv qee hom mob embolism. Yog tias koj muaj feem yuav mob embolism, koj tus kws kho mob yuav pom zoo cov hauv qab no:
- Thaum mus ncig teb chaws deb (xws li caij dav hlau lossis caij npav), sawv txhua ob peb teev thiab tsa thiab txo koj cov pob luj taws me ntsis (cov leeg nqaij nyuj).Qhov no tuaj yeem pab tswj kom cov ntshav ncig zoo hauv ob txhais ceg.
- Cov tshuaj uas ua rau cov ntshav nyias (Anticoagulants) .
- Siv cov thom khwm tshwj xeeb compression.
- Ib lub cuab yeej uas siv zog rau ob txhais ceg (Intermittent Pneumatic Compression Device - IPC device) .
- Rau ib txhia neeg, tej zaum yuav muab ib lub lim dej tso rau hauv cov hlab ntsha loj uas nqa cov ntshav los ntawm lub cev qis mus rau lub plawv (lub lim dej inferior vena cava) . Qhov no tiv thaiv cov ntshav txhaws kom tsis txhob mus rau lub plawv thiab lub ntsws.
Kuv yuav saib xyuas kuv tus kheej li cas yog tias kuv muaj mob embolism?
Tom qab muaj mob embolism, tej zaum koj yuav xav tau kev kho mob kom rov zoo. Qhov no yog vim tias qhov embolism tej zaum yuav muaj cov chaw puas tsuaj xws li koj lub hlwb lossis lub ntsws. Qhov kev puas tsuaj no tshwm sim vim tias qhov embolism tau txiav cov pa oxygen mus rau lub cev lossis thaj chaw ntawd.
Kuv yuav tsum mus ntsib kws kho mob thaum twg?
Yog koj muaj cov tsos mob ntawm kev mob plawv dhia tsis xwm yeem, koj yuav tsum nrhiav kev kho mob tam sim ntawd. Tsis txhob ncua sijhawm.
Tom qab muaj mob ntshav txhaws (embolism), koj yuav tsum mus ntsib koj tus kws kho mob thiab ua raws li nws cov lus qhia. Tshwj xeeb tshaj yog tias koj noj tshuaj xws li anticoagulants, koj tus kws kho mob yuav xyuas seb koj puas noj lawv kom raug thiab seb koj qhov kev pheej hmoo ntawm kev los ntshav puas tau hloov pauv.
Kuv yuav tsum nug tus kws kho mob li cas?
Koj tuaj yeem nug koj tus kws kho mob cov lus nug zoo li no:
- Vim li cas kuv thiaj tau qhov no (embolism)?
- Muaj pes tsawg feem pua uas yuav rov zoo raws li kuv tus mob?
- Kev kho mob zoo tshaj plaws rau kuv yog dab tsi?
- Kuv yuav tsum ua li cas thiaj li tiv thaiv tau lwm yam kab mob embolism zoo li no kom tsis txhob tshwm sim dua?
Hauv kev xaus lus (Cov Lus Qhia Txog Kev Coj Mus Tsev)
Nws yog ib qho ib txwm muaj uas yuav txhawj txog ib yam mob hu ua embolism, vim nws tuaj yeem ua rau tuag taus. Yog vim li cas nws thiaj li tseem ceeb heev uas yuav tsum tau kho tam sim ntawd. Yog tias koj muaj cov tsos mob ntawm embolism, nrhiav kev kho mob tam sim ntawd. Tom qab kho, nrhiav kev txhawb nqa los ntawm koj tsev neeg thiab cov phooj ywg. Yog tias koj txhawj xeeb lossis txhawj xeeb txog kev muaj lwm yam embolism, tham nrog tus kws pab tswv yim. Koj tsis nyob ib leeg, thiab tsis txhob ntshai thov kev pab.
Kev mob ntsws embolism, ntshav txhaws, kev thaiv cov hlab ntsha, pulmonary embolism, Pulmonary Embolism, DVT, cov tsos mob, kev kho mob, kev tiv thaiv
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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