Koj puas muaj qhov mob txawv txawv no hauv koj lub plab? Cia peb tham txog (Rectus Sheath Hematoma)!

Koj puas tau muaj mob plab sai sai uas zoo li pob hauv koj lub plab? Los yog koj puas tau hnoos tawv thiab tom qab ntawd pom ib qho xiav ntawm koj lub plab? Txawm hais tias cov no tsis tshua muaj ntau, qee zaum lawv tuaj yeem yog cov tsos mob ntawm tus mob hu ua '(Rectus Sheath Hematoma)' uas tshwm sim hauv peb lub plab. Yog li hnub no, cia peb tham txog qhov no kom ntxaws me ntsis, vim nws tseem ceeb heev uas yuav tsum paub txog qhov no.

Ua ntej, cia peb saib seb qhov '(Rectus Sheath)' no yog dab tsi?

Hais yooj yim xwb, koj lub "(Rectus Sheath)" yog ib daim ntaub uas muaj zog thiab ua los ntawm cov fiber uas nyob ib puag ncig cov leeg nqaij ntawm koj lub plab pem hauv ntej. Yog hais kom meej, nws yog ib daim nyias nyias (tseem hu ua "aponeurosis"). Sab hauv daim ntaub no yog ob lub leeg nqaij tseem ceeb ntawm koj lub plab, "(rectus abdominis)" (uas peb feem ntau hu ua cov leeg nqaij "rau pob") thiab "(pyramidalis)" (cov leeg nqaij no hu ua "six-pack").

Xav txog, qhov '(Rectus Sheath)' no muaj phab ntsa pem hauv ntej (anterior) thiab phab ntsa tom qab (posterior). Cov phab ntsa no yog ua los ntawm tib lub fascia ('(fascia)') uas nyob ib puag ncig lwm cov leeg nqaij hauv koj lub plab. Ntawd yog:

• Koj cov leeg nqaij sab nraud (external abdominal obliques) (cov leeg nqaij sab nraud ntawm lub plab)
• Koj cov leeg nqaij "(sab hauv plab obliques)" (cov leeg nqaij sab hauv plab oblique)
• Koj cov leeg nqaij plab (transversus abdominis) (cov leeg nqaij plab hla)

Lub "Rectus Sheath" yog tsim los ntawm cov ntaub npog ntawm cov meatus no.

Tsis tas li ntawd, cov hlab ntsha sab saud thiab sab qis epigastric, uas yog cov hlab ntsha tseem ceeb uas muab ntshav rau koj cov leeg nqaij plab, hla dhau qhov '(Rectus Sheath)' no. Yog li lub luag haujlwm tseem ceeb ntawm qhov '(Rectus Sheath)' no yog los tiv thaiv cov leeg nqaij, cov hlab ntsha, thiab cov kabmob nyob ib puag ncig hauv phab ntsa plab.

Tiam sis muaj ib qho me me. Qhov '(Rectus Sheath)' no tsis npog tag nrho yam uas nyob sab hauv. Sab saum toj ntawm koj cov leeg '(rectus abdominis)' raug npog los ntawm '(Rectus Sheath)' no ntawm ob sab, pem hauv ntej thiab nraub qaum. Txawm li cas los xij, muaj ciam teb ntawm sab saum toj thiab hauv qab ntawm cov leeg no, uas hu ua '(arcuate line)'. Cov kab no yog li ib feem peb ntawm txoj kev nqes los ntawm koj lub pij ntaws mus rau qhov chaw uas koj ob lub pob txha pelvic ntsib pem hauv ntej ('(pubic symphysis)').

Qhov tseem ceeb yog, hauv qab no '(kab arcuate)', qhov qis ntawm koj cov leeg '(rectus abdominis)' tsuas yog npog los ntawm '(Rectus Sheath)' los ntawm pem hauv ntej. Tsis muaj '(posterior rectus sheath)' los ntawm nraub qaum! Qhov ntawd txhais tau tias tsis muaj lub sheath zoo li no los tiv thaiv qhov qis ntawm '(rectus abdominis)' cov leeg. Nco ntsoov qhov no, vim qhov no tseem ceeb rau '(Rectus Sheath Hematoma)' mob uas peb tab tom tham txog.

Yog li ntawd, "(Rectus Sheath Hematoma)" yog dab tsi?

Ib qho '(Hematoma)' yog, hais yooj yim xwb, cov ntshav sib sau ua ke hauv koj cov nqaij. Tam sim no, yog tias cov '(epigastric arteries)' hauv '(Rectus Sheath)' uas peb tau tham txog ua ntej pib los ntshav qee txoj kev, cov ntshav ntawd tuaj yeem sib sau ua ke hauv thaj chaw ntawd ntawm koj lub plab. Cov ntshav sib sau ua ke no hu ua '(Rectus Sheath Hematoma).'

Hauv qhov no, kev los ntshav, tshwj xeeb tshaj yog los ntawm cov hlab ntsha epigastric qis dua, tuaj yeem ua rau mob hnyav dua me ntsis. Vim tias, raws li peb tau hais ua ntej, tsis muaj daim npog hauv qab kab arcuate, thiab yog tias cov ntshav pib ntws los ntawm qhov ntawd, tsis muaj cov ntaub so ntswg los tiv thaiv cov ntshav kom tsis txhob kis mus. Yog li ntawd, ntau cov ntshav tuaj yeem sib sau ua ke.

Leej twg raug kev cuam tshuam ntau tshaj plaws los ntawm qhov xwm txheej no?

Rectus Sheath Hematoma feem ntau tshwm sim rau cov poj niam ntau dua li cov txiv neej, thiab kuj tseem tshwm sim ntau dua rau cov neeg hnub nyoog tshaj 60 xyoo .

Tus mob no feem ntau tshwm sim li cas?

Rectus Sheath Hematoma yog ib qho mob tsis tshua muaj . Nws tsuas cuam tshuam rau 1% txog 2% ntawm cov neeg mob uas mob plab. Yog li ntawd, koj yuav tsis hnov ​​​​​​txog nws ntau zaus.

Cov tsos mob yog dab tsi?

Cov tsos mob feem ntau ntawm tus mob no yog mob plab . Qhov mob no:

• Koj tuaj yeem pib tam sim ntawd.
• Nws tuaj yeem yog qhov mob ntse, mob tsis tuaj yeem ua tau.
• Nws kuj tseem tuaj yeem ua rau mob tas li.
• Qhov mob yuav nce ntxiv thaum koj co, khoov, lossis ua kom koj cov leeg nqaij plab nruj.

Ntxiv rau, qee zaum thaum koj kov koj lub plab, koj yuav hnov ​​​​​​zoo li lub pob .

Lwm cov tsos mob uas yuav pom muaj xws li:

• Xeev siab thiab ntuav
• Ua npaws
• Daim tawv nqaij xiav los yog mob nqaij (tshwj xeeb tshaj yog nyob rau hauv thaj tsam plab)
• Anemia (uas txhais tau tias txo cov ntshav ntim)
• Lub plawv dhia ceev (tachycardia)
• Ntshav siab qis (hypotension)

Dab tsi ua rau qhov no?

Qhov ua rau muaj 'Rectus Sheath Hematoma' yog los ntshav rau hauv '(Rectus Sheath.' Qhov no feem ntau tshwm sim thaum muaj qee yam kev raug mob rau ntawm phab ntsa plab .

Hais yooj yim xwb, qhov mob no tuaj yeem tshwm sim yog tias '(epigastric artery)', cov hlab ntsha me me uas tawm ntawm nws, lossis cov leeg nqaij '(rectus abdominis)' nws tus kheej raug puas tsuaj. Raws li peb tau hais ua ntej, cov leeg nqaij plab tau txais ntshav los ntawm cov hlab ntsha sab saud thiab sab qis '(epigastric arteries)'. Dua li no, yog tias '(inferior epigastric artery)' raug puas tsuaj, qhov xwm txheej yuav hnyav dua me ntsis, vim tias nws tsis muaj kev tiv thaiv tom qab nws hauv qab '(arcuate line)'.

Xav txog seb, yog tias koj raug ntaus ncaj qha rau koj lub plab, lossis yog tias koj siv zog ntau dhau rau cov leeg nqaij hauv plab (piv txwv li, yog tias koj hnoos ntev ntev, lossis yog tias koj mob koj lub plab thaum nqa ib yam dab tsi hnyav), cov hlab ntsha epigastric no tuaj yeem tawg thiab pib los ntshav, tsim cov ntshav (hematoma).

Cov yam ua rau muaj kev pheej hmoo no yog dab tsi?

Qhov ua rau muaj kev pheej hmoo loj tshaj plaws rau kev tsim cov 'Rectus Sheath Hematoma' yog kev siv cov tshuaj uas tiv thaiv cov ntshav txhaws ('(anticoagulants)' lossis 'cov tshuaj ua kom cov ntshav nyias') . Yuav luag 70% ntawm cov neeg uas muaj 'Rectus Sheath Hematoma' noj qee yam tshuaj '(anticoagulant)'. Cov tshuaj no ua rau cov txheej txheem los ntshav qeeb qeeb, ua rau nws muaj feem ntau dua uas '(hematoma)' yuav tshwm sim.

Lwm yam tseem ceeb uas ua rau muaj kev pheej hmoo yog kab mob raum ntev . Yuav luag 60% ntawm cov neeg uas muaj cov ntshav hauv lub raum muaj kab mob raum theem 3 lossis siab dua.

Lwm yam kev pheej hmoo suav nrog:

• Kev phais plab tsis ntev los no
• Siv cov tshuaj steroids lossis cov tshuaj immunosuppressant
• Hnoos hnyav heev thiab tsis tu ncua
• Noj tshuaj Antiplatelet (tshuaj uas tiv thaiv cov ntshav platelets kom tsis txhob sib sau ua ke)
• Cev xeeb tub
• Cov mob ntev ntev, xws li mob ntshav siab thiab mob atherosclerosis (cov hlab ntsha nyias vim muaj cov rog tso rau ntawm phab ntsa ntawm cov hlab ntsha)

Tseem Ceeb: Yog tias koj noj cov tshuaj anticoagulant zoo li no, koj yuav tsum ceev faj tshwj xeeb yog tias koj mob plab tam sim ntawd.

Yuav kuaj mob li cas?

Qee zaum cov ntshav tawm hauv lub plab tuaj yeem nyuaj rau kuaj mob, vim nws cov tsos mob zoo ib yam li lwm yam mob hauv plab.

Koj tus kws kho mob yuav ua qhov kev kuaj ntshav ua ntej kom ntsuas koj cov hemoglobin thiab hematocrit. Ntau tshaj ib nrab ntawm cov neeg uas muaj rectus sheath hematoma yuav muaj cov hemoglobin qis heev (txhais tau tias lawv muaj cov ntshav tsawg).

Tom ntej no, koj tus kws kho mob yuav ua qhov ultrasound ntawm koj lub plab phab ntsa. Qhov no tuaj yeem pab txiav txim siab seb puas muaj cov kua dej zoo li ntshav hauv phab ntsa plab thiab qhov hematoma loj npaum li cas.

Qee zaum, kev siv CT scan yuav ua tau kom pom tseeb dua thiab meej dua txog qhov mob. Kev siv CT scan, tshwj xeeb tshaj yog siv cov xim sib txawv, yuav qhia tau meej tias cov xim ntawd tawm qhov twg los ntawm cov hlab ntsha uas puas lawm. Qhov no kuj tseem yuav pab tus kws kho mob nrhiav seb cov ntshav los qhov twg.

Yuav kho li cas?

Qhov xov xwm zoo yog tias feem ntau cov ntshav hauv lub rectus sheath hematomas yuav zoo li qub thiab tsis tas yuav muaj kev kho mob tshwj xeeb. Kev kho mob rau tus mob no feem ntau suav nrog:

• Siv cov pob dej khov (dej khov los yog cov compresses txias)
• So
• Kev siv cov tshuaj tua kab mob (analgesics) uas feem ntau siv

Kwv yees li 80% ntawm cov rectus sheath hematomas kho tau nrog kev kho mob yooj yim zoo li no.

Txawm li cas los xij, yog tias cov kev kho mob yooj yim no tsis pab, lossis yog tias qhov mob hnyav dua, tus kws kho mob yuav siv kev kho mob hu ua "angioembolization." Qhov no tsis yog kev phais. Nws suav nrog kev sib xyaw ua ke "angiography" (ib txoj kev thaij duab ntawm cov hlab ntsha) thiab "embolization" (ib txoj kev kaw cov hlab ntsha), los nrhiav cov hlab ntsha uas los ntshav thiab kaw nws.

Yog tias txoj kev "angioembolization" no tsis ua tiav, tej zaum yuav tsum tau phais ua qhov kawg. Thaum lub sijhawm phais, cov ntshav txhaws (hematoma) uas tau sib sau ua ke yuav raug tshem tawm thiab cov leeg ntshav uas los ntshav yuav raug kaw.

Thaum lub sijhawm kho mob thiab tom qab kho mob, koj tus kws kho mob yuav saib xyuas koj tus mob los ntawm kev kuaj ntshav thiab ultrasound. Qhov no tuaj yeem pab nrhiav pom tias muaj kev rov qab los ntshav lossis kev kis kab mob.

Yuav muaj dab tsi tshwm sim tom ntej? Nws puas yuav zoo dua?

Feem ntau cov ntshav tawm ntawm daim tawv nqaij rectus sheath hematomas yuav ploj mus yam tsis tau npaj tseg hauv ob mus rau peb lub hlis . Cov neeg feem coob uas muaj tus mob no yuav zoo rov zoo thiab tsis muaj teeb meem ntxiv lawm.

Txawm li cas los xij, qee zaum - tshwj xeeb tshaj yog ntawm cov neeg noj tshuaj anticoagulants - qhov mob no tuaj yeem ua rau tuag taus . Txawm li cas los xij, nws tsis tshua muaj. Raws li cov ntaub ntawv tshiab kawg, tsawg dua 2% ntawm cov neeg tuag los ntawm Rectus Sheath Hematoma.

Ib yam li lwm yam mob, kev kuaj mob thaum ntxov thiab kev kho mob thaum ntxov ua rau muaj feem rov zoo . Yog li ntawd, yog tias koj xav tias koj muaj cov tsos mob ntawm 'Rectus Sheath Hematoma', nco ntsoov nrhiav kev pab kho mob.

Thaum kawg, tej yam uas yuav tsum nco ntsoov

Koj lub '(Rectus Sheath)' yog ib lub plhaub tseem ceeb uas tiv thaiv cov kabmob, cov nqaij, thiab cov hlab ntsha hauv koj lub plab. Yog tias koj lub plab raug mob rau txhua txoj kev, '(epigastric artery)' tuaj yeem tawg thiab ua rau '(Rectus Sheath Hematoma)'.

Feem ntau, tus mob no tsis tas yuav kho mob loj. Tej yam yooj yim xws li muab dej khov rau, so, thiab noj tshuaj tua kab mob yuav pab tau.

Txawm li cas los xij, qee kis tuaj yeem ua rau mob hnyav dua. Yog tias koj mob plab hnyav, mob tam sim ntawd, nws yog ib qho tseem ceeb uas yuav tsum mus ntsib kws kho mob kom paub seb koj puas xav tau kev kho mob. Tsis txhob ntshai, tab sis nws yog ib qho tseem ceeb rau koj thiab koj tsev neeg kom paub txog cov no.

Rectus Sheath Hematoma, mob plab, los ntshav hauv plab, epigastric artery, anticoagulants, mob plab, mob plab