Tej zaum koj yuav tsis tau hnov txog ib tug kws tshwj xeeb uas kuaj xyuas seb koj lub paj hlwb, uas suav nrog koj lub hlwb, tus txha caj qaum, thiab cov hlab ntsha uas khiav thoob plaws koj lub cev, puas ua haujlwm zoo. Ib yam li ib tug kws tshwj xeeb uas kuaj xyuas seb cov xov hlau hauv koj lub tsev puas ua haujlwm zoo, puas muaj qhov luv luv, lossis yog tias tam sim no qis, tus kws kho mob no kuj kuaj xyuas "lub cev hluav taws xob" ntawm koj lub cev. Hnub no peb tab tom tham txog tus kws tshwj xeeb no, tus kws kho mob hlwb.
Hais yooj yim xwb, leej twg yog tus kws kho mob hlwb?
Tus kws kho mob hlwb yog ib tus kws tshwj xeeb uas kawm txog kev ua haujlwm ntawm peb lub paj hlwb, tshwj xeeb tshaj yog nws cov haujlwm hluav taws xob , thiab ua cov kev kuaj mob thiab kuaj mob ntsig txog.
Xav txog nws, peb lub cev yog ib lub tshuab nyuaj heev. Chav tswj hwm ntawm lub tshuab no yog lub paj hlwb. Ntawd yog, lub hlwb, cov hlab ntsha caj qaum, thiab cov hlab ntsha uas nqa cov ntaub ntawv thoob plaws lub cev. Txhua yam koj xav, hnov, thiab ua yog tswj hwm los ntawm lub cev no. Txij thaum koj tsa koj txhais tes mus txog thaum koj lub plawv dhia, nws yog ib feem ntawm nws.
Yog li ntawd, yog tias muaj teeb meem nrog lub kaw lus no, txawm tias nws yog teeb meem nrog kev ntws ntawm cov ntaub ntawv lossis teeb meem nrog cov teeb liab hluav taws xob, tus kws kho mob hlwb yuav pab nrhiav nws.
Kws kho mob hlwb thiab kws kho mob hlwb - qhov txawv ntawm ob qho no yog dab tsi?
Ob lub npe no feem ntau tsis meej pem. Ob leeg yog cov kws kho mob uas ua haujlwm rau lub paj hlwb. Tab sis muaj qhov sib txawv me ntsis. Cia peb nkag siab qhov no nrog ib qho piv txwv.
Xav txog seb puas muaj teeb meem nrog lub teeb pom kev hauv koj lub tsev. Ua ntej koj yuav nrog ib tug kws kho hluav taws xob tham. Nws tuaj yeem saib tag nrho cov xov hluav taws xob hauv tsev, saib seb lub fuse puas tawg, lub qhov hloov puas puas lawm, lub teeb puas kub hnyiab, thiab pom ib daim duab loj. Tus kws kho mob hlwb zoo li ntawd. Nws yog ib tug kws kho mob uas muaj kev paub ntau txog txhua yam ntawm lub paj hlwb, uas yog, nws cov qauv, kev ua haujlwm, thiab txhua yam kab mob uas cuam tshuam nrog nws. Tus kws kho mob hlwb sau ntawv rau koj cov tshuaj thiab npaj koj txoj kev kho mob.
Tam sim no xav txog tias muaj teeb meem nyuaj heev uas tus kws hluav taws xob nrhiav tsis tau. Lub zog ntawm cov hluav taws xob txo qis, zoo li muaj qhov xau me me qhov twg. Tom qab ntawd nws coj ib tus neeg uas siv cov ntsuas tshwj xeeb, tus kws tshaj lij hauv kev ntws hluav taws xob. Qhov ntawd yog qhov uas tus kws kho mob hlwb zoo li. Nws yog ib tus kws tshaj lij hauv kev ua haujlwm ntawm lub paj hlwb, tshwj xeeb tshaj yog hauv txoj kev uas cov teeb liab hluav taws xob mus ncig. Qhov nws ua yog ua ntau yam kev sim, tshuaj xyuas cov txiaj ntsig, thiab nrhiav seb qhov teeb meem yog dab tsi hauv kev ua haujlwm ntawm cov hlab ntsha.
Hais yooj yim xwb, tus kws kho mob hlwb kuaj mob thiab kho cov kab mob. Tus kws kho mob hlwb ua cov kev kuaj mob tshwj xeeb thiab muab cov ntaub ntawv tseem ceeb uas xav tau rau kev kuaj mob ntawd. Tab sis feem ntau lawv tsis sau ntawv kom kho.
Ob lub luag haujlwm tseem ceeb ntawm tus kws kho mob hlwb
Peb tuaj yeem faib cov kws kho mob hlwb ua ob pawg tseem ceeb, nyob ntawm seb lawv ua haujlwm li cas.
1. Cov neeg ua haujlwm hauv kev phais mob (Cov kws kho mob hlwb phais)
2. Cov neeg uas kuaj mob hauv cov chaw kho mob (Clinical Neurophysiologists)
Cia peb saib lub luag haujlwm ntawm txhua tus neeg no sib cais.
1. Lub Luag Haujlwm ntawm Tus Kws Kho Mob Hlwb Hauv Kev Phais Mob
Qhov no yog ib qho tseem ceeb heev. Xav txog tias ib tug neeg tab tom phais loj rau lawv tus txha nqaj qaum lossis lub hlwb. Thaum ua qhov kev phais, cov kws phais yuav tsum saib xyuas seb puas muaj kev puas tsuaj rau cov hlab ntsha. Yog tias muaj qhov yuam kev me me, ib tug neeg tuaj yeem ua rau tuag tes tuag taw, tsis hnov lus zoo, lossis muaj mob stroke.
Thaum ntawd tus kws kho mob hlwb koom nrog pab pawg phais. Nws siv cov khoom siv tshwj xeeb los saib xyuas qhov hluav taws xob ntawm tus neeg mob lub paj hlwb thoob plaws hauv kev phais. Qhov no hu ua Kev Saib Xyuas Kev Ua Haujlwm Hauv Lub Cev (IONM) . Thaum cov hlab ntsha raug cuam tshuam me ntsis, nws cov teeb liab hluav taws xob hloov pauv. Thaum tus kws kho mob hlwb pom qhov kev hloov pauv ntawd, nws ceeb toom rau tus kws phais. Tus kws phais tuaj yeem ua cov kauj ruam tsim nyog ua ntej muaj kev puas tsuaj.
| Hom kev phais mob | Lub luag haujlwm ntawm tus kws kho mob hlwb |
|---|---|
| Kev phais mob pob txha caj qaum | Yuav tsum saib xyuas seb puas muaj kev puas tsuaj rau cov hlab ntsha hauv lub paj hlwb thiab cov hlab ntsha uas los ntawm nws. Yuav tsum pab tiv thaiv kom tsis txhob poob ceg. |
| Kev phais hlwb | Txhawm rau saib seb cov feem tseem ceeb ntawm lub hlwb, piv txwv li, cov feem cuam tshuam nrog kev hais lus, kev pom kev, thiab kev txav mus los, puas puas lawm. |
| Kev phais pob ntseg, qhov ntswg, thiab caj pas (ENT procedures) | Tiv thaiv kev hnov lus tsis zoo vim yog kev puas tsuaj rau cov hlab ntsha pob ntseg, tshwj xeeb tshaj yog thaum lub sijhawm phais pob ntseg. |
| Kev phais mob hlab ntsha | Saib xyuas kev ua haujlwm ntawm lub hlwb kom tiv thaiv kev puas tsuaj los ntawm kev txo cov ntshav ntws mus rau lub hlwb (ischemia). |
2. Kws kho mob hlwb uas kuaj mob
Nov yog tus kws kho mob hlwb uas peb feem ntau pom, tus uas peb tus kws kho mob xa peb mus rau. Lawv nyob hauv tsev kho mob lossis chaw kho mob. Lawv ua ntau yam kev kuaj mob los saib seb lub paj hlwb ua haujlwm li cas. Nws yog raws li cov txiaj ntsig ntawm cov kev kuaj mob no uas koj tus kws kho mob hlwb yuav txiav txim siab seb koj muaj mob dab tsi.
Nov yog qee qhov kev ntsuam xyuas tseem ceeb uas lawv ua:
- EMG (Electromyography): Qhov kev kuaj no saib xyuas kev noj qab haus huv ntawm koj cov leeg thiab cov hlab ntsha uas tswj lawv. Yog tias koj muaj kev loog, tingling, lossis tsis muaj zog hauv koj txhais caj npab, qhov kev kuaj no tuaj yeem pab txiav txim siab seb qhov teeb meem puas yog nyob rau hauv cov leeg nws tus kheej lossis hauv cov hlab ntsha uas muab nws. Qhov no yog qhov tseem ceeb rau kev kuaj mob xws li Carpal Tunnel Syndrome (cov hlab ntsha pinched hauv lub dab teg) thiab Peripheral Neuropathy (kev puas tsuaj rau cov hlab ntsha hauv caj npab thiab ceg vim yog cov mob xws li ntshav qab zib).
- NCS (Kev Kawm Txog Kev Coj Hluav Taws Xob): Qhov no ntsuas seb nws siv sijhawm ntev npaum li cas rau lub teeb liab hluav taws xob mus ncig raws ib lub hlab ntsha thiab nws mus ncig sai npaum li cas. Yog tias ib lub hlab ntsha puas lawm, qhov ceev uas lub teeb liab mus ncig yuav txo qis. Feem ntau, ob qho kev kuaj EMG thiab NCS ua ke.
- EEG (Electroencephalogram): Tej zaum koj yuav tau hnov txog qhov no. Qhov no suav nrog kev txuas cov electrodes me me rau ntawm lub taub hau thiab sau cov haujlwm hluav taws xob ntawm lub hlwb . Qhov kev kuaj no yog qhov tseem ceeb rau kev kuaj mob xws li qaug dab peg thiab nrhiav seb qhov twg hauv lub hlwb ua rau muaj qhov teeb meem no.
- Kev Ntsuas Peev Xwm Ua Rau Muaj Kev Xav: Qhov no suav nrog kev muab ib qho kev txhawb zog, xws li lub teeb rau lub qhov muag lossis lub suab rau pob ntseg, thiab ntsuas qhov kev ua haujlwm hluav taws xob hauv lub hlwb thiab tus txha caj qaum teb rau nws. Ntawd yog, nws ntsuas seb yam koj pom nrog koj lub qhov muag mus txog lub hlwb sai npaum li cas, thiab yam koj hnov nrog koj pob ntseg mus txog lub hlwb sai npaum li cas.
- Kev kawm txog kev pw tsaug zog (Kev kawm txog kev pw tsaug zog / Polysomnography):Muaj ib txhia neeg muaj teeb meem xws li ua pa nrov nrov, taug kev thaum pw tsaug zog, thiab ua pa nrov nrov thaum pw tsaug zog. Yuav kom kuaj tau cov teeb meem pw tsaug zog no, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob thiab saib xyuas ntau yam haujlwm ntawm lub cev (xws li lub hlwb, ua pa, thiab lub plawv dhia) thaum hmo ntuj. Tus kws kho mob hlwb kuj ua qhov no thiab.
Yuav ua li cas los ua tus kws kho mob hlwb?
Qhov no yog ib txoj kev taug kev ntev thiab mob siab heev. Tus kws kho mob hlwb yog ib tus kws kho mob. Yog li ntawd, koj yuav tsum xub sau npe kawm ntawv kho mob thiab ua tiav daim ntawv kawm tiav qib siab (MD/MBBS).
Ces:
- Koj yuav tsum ua tiav ib xyoos kev xyaum ua haujlwm.
- Tom qab ntawd, koj yuav tsum tau kawm tiav qib siab ntau xyoo (Residencies/MD) kom tau txais kev paub tshwj xeeb hauv kev kho mob hlwb.
- Tom qab kev cob qhia ntawd, koj yuav kawm txog kev ua haujlwm ntawm lub paj hlwb kom tob dua thiab tau txais kev cob qhia hauv ib qho kev tshwj xeeb hu ua Neurophysiology.
Qhov no xav tau ntau lub sijhawm, kev kawm, thiab kev mob siab rau.
Yog li ntawd, yog tias koj tus kws kho mob xa koj mus rau kev kuaj mob xws li EMG lossis EEG, tam sim no koj paub tias koj yuav mus ntsib kws kho mob hlwb. Nws yog ib tus neeg uas yuav tshuaj xyuas koj lub paj hlwb kom tob thiab pab koj kuaj mob kom raug tshaj plaws. Yog li ntawd, tsis txhob ntshai, nug tus kws kho mob ntawd txhua yam lus nug lossis kev txhawj xeeb uas koj muaj. Lawv nyob ntawd los pab koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Tus kws kho mob hlwb yog tus kws kho mob uas tshwj xeeb hauv kev ua haujlwm hluav taws xob ntawm peb lub paj hlwb (lub hlwb, cov hlab ntsha).
- Tus kws kho mob hlwb kho cov kab mob hlwb, thaum tus kws kho mob hlwb pab kuaj mob cov kab mob ntawd los ntawm kev kuaj tshwj xeeb (xws li EMG, EEG).
- Thaum lub sijhawm phais loj (qaum qaum, lub hlwb), kev pab los ntawm tus kws kho mob hlwb yog qhov tseem ceeb kom ntseeg tau tias cov hlab ntsha tsis raug puas tsuaj.
- Yog koj raug xa mus kuaj xws li EMG, NCS, lossis EEG, koj yuav raug kuaj los ntawm tus kws kho mob hlwb (Neurophysiologist). Tsis txhob ntshai nug koj tus kws kho mob txog qhov ntawd.
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