Koj puas tau muaj ib zaug uas koj ua pa nyuaj, mob hauv siab thaum koj ua pa tob tob? Los yog koj puas tau muaj ib zaug uas koj lub plawv dhia ceev dua, tawm hws, thiab ntxhov siab yam tsis muaj laj thawj? Txawm hais tias peb feem ntau xav tias qhov no yog kev mob plawv nres, nws tuaj yeem yog ib yam dab tsi txawv thiab muaj peev xwm txaus ntshai heev. Hnub no peb yuav tham txog ib qho mob hnyav heev, tab sis cawm tau txoj sia hu ua 'Pulmonary Embolism'.
Hauv lwm lo lus, Pulmonary Embolism yog dab tsi?
Kab mob Pulmonary Embolism (PE) yog ib qho ntshav txhaws uas tsim nyob rau hauv ib txoj hlab ntsha (vein) uas muab ntshav rau koj lub ntsws. Tam sim no koj yuav xav tsis thoob tias, "Cov ntshav txhaws tsim li cas hauv lub ntsws?" Qhov tseeb yog, cov ntshav txhaws no tsis tsim nyob rau hauv lub ntsws. Feem ntau, nws tsim nyob rau lwm qhov hauv peb lub cev, tshwj xeeb tshaj yog nyob rau hauv cov hlab ntsha tob ntawm peb ob txhais ceg lossis caj npab. Peb hu qhov no tias Deep Vein Thrombosis (DVT).
Xav txog cov hlab ntsha hauv koj lub cev zoo li ib txoj kev sib txuas. Cov ntshav txhaws no uas tsim nyob rau hauv koj ceg, zoo li lub tsheb, mus ncig raws txoj kev ntawd nrog cov ntshav, mus dhau lub plawv, thiab thaum kawg daig rau hauv ib txoj hlab ntsha me me hauv lub ntsws. Nws zoo li lub tsheb loj daig ntawm txoj kev me me.
Thaum cov ntshav txhaws hauv lub ntsws, muaj peb yam tseem ceeb tshwm sim:
1. Cov ntshav ntws mus rau lub ntsws raug txwv.
2. Cov pa oxygen hauv lub ntsws txo qis.
3. Ntshav siab nce ntxiv hauv cov hlab ntsha uas txuas nrog lub ntsws.
Qhov no yog ib qho xwm txheej ceev hauv kev kho mob. Yog tias tsis kho sai sai, nws tuaj yeem ua rau lub plawv lossis lub ntsws puas tsuaj thiab txawm tias tuag tau. Kev tshawb fawb qhia tau tias kwv yees li ib feem peb (33%) ntawm cov neeg uas muaj tus mob no tuag ua ntej lawv raug kuaj pom thiab kho.
Tiamsis qhov xov xwm zoo yog tias yog tias kuaj pom tus kab mob raws sijhawm thiab kho kom zoo, tus mob no tsis tshua muaj neeg tuag taus.
Cov tsos mob ntawm tus mob no yog dab tsi? Ua tib zoo saib tam sim ntawd!
Cov tsos mob ntawm tus kab mob pulmonary embolism (PE) yuav txawv ntawm ib tus neeg mus rau ib tus neeg. Nws nyob ntawm qhov loj ntawm cov ntshav txhaws thiab cov teebmeem uas nws muaj. Ib txhia neeg yuav tsis muaj tsos mob li. Txawm li cas los xij, feem ntau cov neeg yuav muaj ib lossis ntau cov tsos mob.
Cov tsos mob tseem ceeb thiab thaum ntxov tshaj plaws yog ua pa luv luv tam sim ntawd thiab mob hauv siab uas yuav mob ntxiv thaum ua pa tob lossis siv zog.
Yog koj muaj ib lossis ntau yam ntawm cov tsos mob no, nrhiav kev pab kho mob tam sim ntawd. Zoo tshaj plaws yog mus rau chav kho mob ceev (ETU) ntawm tsev kho mob. Kev kho mob sai sai tuaj yeem txo qhov kev pheej hmoo ntawm kev tuag.
Lub rooj hauv qab no qhia txog cov tsos mob feem ntau ntawm tus mob no.
| Cov tsos mob | Kev piav qhia |
|---|---|
| Ua pa nyuaj sai sai | Txawm tias koj tsuas zaum ntawd tsis ua dab tsi los xij, koj tuaj yeem ua tsis taus pa. |
| Mob hauv siab ntse | Qhov mob no yuav mob zuj zus thaum ua pa, hnoos, lossis khoov. Qee zaum nws yuav zoo li mob plawv nres. Nws yuav tshwm sim rau hauv lub hauv siab, caj npab, xub pwg nyom, caj dab, lossis thaj tsam lub puab tsaig. |
| Hnoos | Kuj tseem yuav muaj ntshav tawm nrog cov hnoos qeev. |
| Lub plawv dhia ceev | Lub plawv dhia (pulse) yuav nce ntxiv sai sai. |
| Kiv taub hau los yog tsaus muag | Tej zaum yuav kiv taub hau , tsaus muag, lossis tsis nco qab li. |
| Lwm yam nta | Tawm hws ntau dhau, tawv nqaij dawb los yog xiav, ua pa nrov nrov, thiab ntxhov siab tsis paub vim li cas. |
Rau ib txhia neeg, cov tsos mob no yuav maj mam tshwm sim hauv ob peb hnub lossis ob peb lub lis piam. Cov tsos mob yuav hnyav dua raws sijhawm. Txawm li cas los xij, rau ib txhia neeg, cov tsos mob hnyav tshwm sim hauv ob peb feeb tom qab pib mob.
Vim li cas qhov no thiaj tshwm sim? Cov yam uas ua rau muaj kev pheej hmoo yog dab tsi?
Zoo li kuv tau hais ua ntej lawm, Kab mob Pulmonary Embolism (PE) yog tshwm sim los ntawm cov ntshav txhaws (DVT) uas tsim nyob rau lwm qhov hauv lub cev, tshwj xeeb tshaj yog nyob rau hauv ob txhais ceg, tawg xoob thiab daig rau hauv lub ntsws. Yog li, txhua yam uas tuaj yeem ua rau cov ntshav txhaws no tsim kuj tuaj yeem ua rau PE.
Qee qhov laj thawj tseem ceeb:
- Ua kom lub cev nyob twj ywm ntev: Thaum koj pw hauv txaj tom qab phais, lossis thaum koj nyob tib qho chaw thaum lub dav hlau ntev lossis caij tsheb npav, cov ntshav ncig hauv ob txhais ceg tuaj yeem qeeb thiab cov ntshav txhaws tuaj yeem tsim tau.
- Kev puas tsuaj rau cov leeg ntshav: Kev sib tsoo, pob txha tawg (tshwj xeeb tshaj yog ntawm lub duav, lub hauv caug, lossis ceg), thiab kev phais loj tuaj yeem ua rau cov leeg ntshav puas tsuaj thiab ua rau muaj kev pheej hmoo ntawm cov ntshav txhaws.
- Lwm yam mob: Cov mob xws li lub plawv tsis ua haujlwm, mob qog noj ntshav, thiab mob hlwb.
- Kev Hloov Pauv ntawm Cov Ntshav Kaug: Tej zaum ib txhia neeg yuav muaj cov teeb meem ntshav txhaws uas yog los ntawm noob caj noob ces. Tsis tas li ntawd, qhov kev pheej hmoo no yuav nce me ntsis rau cov neeg uas noj tshuaj tswj kev yug me nyuam lossis kev kho mob hloov tshuaj hormones.
Hauv qab no yog qee tus neeg uas muaj feem yuav mob no ntau dua . Yog tias koj muaj ib lossis ntau yam ntawm cov yam no, nws yog ib qho tseem ceeb uas yuav tsum nrog koj tus kws kho mob tham txog qhov no.
- Muaj lossis tau muaj ntshav txhaws hauv ceg (Deep Vein Thrombosis - DVT).
- Ua phais mob los yog pw hauv txaj ntev heev.
- Haus luam yeeb.
- Muaj hnub nyoog tshaj 60 xyoo.
- Cev xeeb tub los yog thawj 6 lub lis piam tom qab yug menyuam.
- Muaj mob qog noj ntshav.
- Kev siv cov tshuaj hormones xws li cov tshuaj tiv thaiv kev yug menyuam.
- Kev Rog Phem - Qhov Ntsuas Qhov Hnyav Ntawm Lub Cev (BMI) ntau dua 30.
- Muaj keeb kwm tsev neeg ntawm cov ntshav txhaws.
- Muaj lwm yam kab mob ntev xws li ntshav qab zib thiab kab mob plawv.
- Muaj ib lub raj xa dej mus ntev rau hauv cov hlab ntsha hauv nruab nrab (ib lub raj uas ntxig rau hauv cov hlab ntsha hauv caj npab lossis ceg) los xa cov khoom xws li saline.
Yuav kuaj mob li cas? (Kev kuaj mob)
Thaum koj mus rau tsev kho mob, tus kws kho mob yuav ua tib zoo tshuaj xyuas koj cov tsos mob thiab cov yam uas ua rau muaj kev pheej hmoo. Tom qab ntawd, lawv yuav xaj ntau qhov kev kuaj mob kom paub tseeb tias koj tau kuaj mob.
| Kev Ntsuas | Hais yooj yim xwb, nws ua dab tsi? |
|---|---|
| Kev Ntsuas Ntshav | Nov yog qhov kev sim D-dimerQhov kev kuaj no yog tshwj xeeb. Nws ntsuas cov protein uas tsim tawm thaum cov ntshav txhaws yaj hauv lub cev. Yog tias qib no qis, qhov muaj feem yuav muaj PE tsawg. |
| CT Angiogram | Qhov no yog ib daim duab CT scan tshwj xeeb. Ib qho xim tshwj xeeb (contrast) raug txhaj rau hauv cov hlab ntsha hauv koj txhais caj npab, thiab cov duab peb-seem (3D) raug thaij ntawm cov hlab ntsha hauv koj lub ntsws. Yog tias muaj cov ntshav txhaws, nws tuaj yeem pom tseeb. |
| Kev Ntsuas Ultrasound ntawm Ob Txhais Ceg | Daim scan no yog ua los xyuas seb puas muaj cov ntshav txhaws (DVT) nyob rau hauv cov leeg ntshav tob ntawm ob txhais ceg. Yog tias muaj DVT, nws yuav yog qhov ua rau muaj cov tsos mob ntawm lub ntsws. |
| Lwm yam kev ntsuam xyuas | Tsis tas li ntawd xwb, kuj tseem yuav ua kev thaij duab X-ray hauv siab, Echocardiogram los xyuas seb lub plawv ua haujlwm li cas, thiab lub pulse oximeter los ntsuas cov pa oxygen. |
Yuav kho li cas?
Kev kho mob rau PE feem ntau yog ua nyob rau hauv tsev kho mob, vim tias koj tus mob yuav tsum tau saib xyuas zoo. Lub sijhawm kho mob nyob ntawm seb cov ntshav txhaws hnyav npaum li cas.
Txoj kev kho mob tseem ceeb yog muab cov tshuaj uas tiv thaiv cov ntshav txhaws . Peb hu cov tshuaj no ua anticoagulants lossis cov tshuaj ua kom cov ntshav nyias .
Qhov tseem ceeb yog tias cov tshuaj no tsis yaj cov ntshav txhaws uas twb muaj lawm. Lawv tsuas yog tiv thaiv cov ntshav txhaws tshiab kom tsis txhob tsim thiab cov ntshav txhaws uas twb muaj lawm kom tsis txhob loj hlob tuaj. Cov ntshav txhaws uas twb muaj lawm maj mam yaj los ntawm lub cev cov txheej txheem ntuj tsim.
- Cov tshuaj tiv thaiv kev ntshav khov: Cov no yog muab los ua cov tshuaj txhaj lossis cov tshuaj ntsiav. Tej zaum koj yuav tsum tau noj cov tshuaj no rau 3-6 lub hlis, lossis qee zaum ntev dua. Tsis txhob tsum noj cov tshuaj no rau txhua qhov laj thawj tshwj tsis yog koj tus kws kho mob hais kom koj ua.
- Kev Kho Mob Thrombolytic: Qhov no yog kev kho mob uas muab rau cov mob hnyav heev, uas muaj kev phom sij rau lub neej. Cov tshuaj no ua haujlwm los ntawm kev yaj cov ntshav txhaws sai sai. Lawv raug muab rau hauv kev saib xyuas ze ntawm cov kws kho mob hauv chav kho mob hnyav (ICU).
- Lwm txoj kev:Qee zaum, yog tias tshuaj tsis txaus, yuav tsum tau phais lossis siv lub catheter los tshem cov ntshav txhaws. Lwm txoj kev xaiv yog ntxig lub Vena Cava Filter. Qhov no yog siv los lim thiab ntes cov ntshav txhaws ntawm ob txhais ceg ua ntej lawv mus txog lub ntsws.
- Cov thom khwm nias: Koj tus kws kho mob yuav qhia koj kom hnav cov thom khwm tshwj xeeb no kom cov ntshav ncig zoo hauv koj ob txhais ceg.
Puas zam tau qhov xwm txheej no?
Yog, nws ua tau rau ntau yam. Qhov tseem ceeb ntawm no yog kom txo qhov kev pheej hmoo ntawm cov ntshav txhaws.
- Ua kom nquag: Ua kom tawm dag zog txhua hnub. Yog tias koj zaum ntev (dav hlau, caij tsheb npav, ua haujlwm hauv chaw ua haujlwm), sawv thiab taug kev tsawg kawg ib teev ib zaug, txav koj ob txhais ceg thiab caj npab.
- Tsis txhob hnav khaub ncaws nruj: Kev hnav khaub ncaws nruj tuaj yeem ua rau cov ntshav ntws tsis zoo.
- Tsis txhob khoov koj ob txhais ceg: Tsis txhob zaum nrog koj ob txhais ceg khoov rau lub sijhawm ntev.
- Tswj koj qhov hnyav kom noj qab nyob zoo.
- Tsis txhob haus luam yeeb kiag li.
- Haus dej ntau: Kev qhuav dej tuaj yeem ua rau cov ntshav tuab.
- Paub txog koj cov yam ua rau muaj kev pheej hmoo: Yog tias koj tau phais, cev xeeb tub, lossis muaj lwm yam ua rau muaj kev pheej hmoo, nrog koj tus kws kho mob tham txog cov kauj ruam uas koj tuaj yeem ua los tiv thaiv cov ntshav txhaws.
Koj yuav tsum pib zoo dua hauv ib lub lim tiam tom qab kho mob. Txawm li cas los xij, nws yuav siv sijhawm ntau lub hlis lossis txawm tias ntau xyoo rau cov ntshav txhaws kom yaj tag. Thaum lub sijhawm no, nws yog ib qho tseem ceeb uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia kom zoo.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kab mob ntsws txhaws (PE) yog ib qho ntshav txhaws uas tsim nyob rau hauv cov hlab ntsha hauv lub ntsws. Qhov no yog ib qho xwm txheej ceev hauv kev kho mob uas tuaj yeem ua rau tuag taus.
- Cov tsos mob tseem ceeb yog ua pa luv luv tam sim ntawd, mob hauv siab thaum ua pa tob tob, thiab lub plawv dhia ceev. Yog tias cov no tshwm sim, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
- Cov ntshav txhaws no feem ntau tsim nyob rau hauv ob txhais ceg (DVT). Kev tsis txav mus los ntev, phais mob, haus luam yeeb, thiab rog dhau yog cov yam tseem ceeb uas ua rau muaj kev pheej hmoo.
- Muaj peev xwm cawm tau neeg txoj sia heev thaum kuaj pom tus kab mob raws sijhawm thiab kho nrog cov tshuaj anticoagulants.
- Nws yog ib qho tseem ceeb heev uas yuav tsum noj cov tshuaj uas koj tus kws kho mob tau sau tseg rau lub sijhawm tag nrho thiab ua raws li cov lus qhia kom tiv thaiv qhov mob no kom tsis txhob rov tshwm sim dua.
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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