Koj puas tau muaj mob taub hau tam sim ntawd thiab hnyav heev uas zoo li xob laim ntaus koj lub taub hau? Muaj coob tus neeg piav txog qhov no tias yog "mob taub hau phem tshaj plaws uas koj tau muaj." Mob taub hau tam sim ntawd thiab hnyav heev zoo li no yog ib yam uas peb yuav tsum tsis txhob saib tsis taus. Nws yuav yog ib qho cim qhia tias muaj kev los ntshav loj hauv lub hlwb. Hnub no, peb yuav tham txog ib qho xwm txheej ceev kho mob, hu ua subarachnoid hemorrhage (SAH).
Hais yooj yim xwb, Subarachnoid Hemorrhage (SAH) yog dab tsi?
Zoo, lub npe no yuav zoo li nyuaj me ntsis, tab sis cia peb ua kom yooj yim. Koj lub hlwb tsis yog zaum hauv qab koj lub taub hau xwb. Nws raug tiv thaiv los ntawm peb txheej ntawm cov ntaub so ntswg. Hauv kev kho mob, peb hu qhov no ua cov meninges.
Xav txog nws zoo li ib lub dos. Sab hauv ntawm lub dos muaj daim tawv nyias nyias nyob ib puag ncig nws, thiab yog li ntawd cov membranes no nyob ib puag ncig lub hlwb.
1. Dura mater: Qhov no yog daim nyias nyias sab nraud, muaj zog uas nyob hauv qab lub pob txha taub hau.
2. Arachnoid: Qhov no yog daim nyias nyias, zoo li daim kab laug sab hauv nruab nrab.
3. Pia mater: Qhov no yog daim nyias nyias sab hauv tshaj plaws uas txuas rau cov ntaub so ntswg ntawm lub hlwb nws tus kheej.
Tam sim no, qhov chaw ntawm daim nyias nyias arachnoid hauv nruab nrab thiab pia mater hauv txheej sab hauv tshaj plaws hu ua 'Subarachnoid space'. 'Sub' txhais tau tias "hauv qab". Yog li qhov no hais txog qhov chaw hauv qab daim nyias nyias arachnoid. Yog tias vim li cas, los ntshav tshwm sim rau hauv qhov chaw no, qhov ntawd yog qhov peb hu ua Subarachnoid Hemorrhage (SAH) .
Qhov no yog ib qho xwm txheej ceev heev uas yuav ua rau tuag taus. Yog tias koj muaj cov tsos mob no, koj yuav tsum mus rau chav kho mob ceev (ETU) ntawm tsev kho mob yam tsis muaj kev ncua.
Qhov txawv ntawm SAH thiab Subdural Hematoma yog dab tsi?
Tej zaum koj kuj tau hnov txog ib qho mob hu ua 'Subdural Hematoma'. Ob qho tib si yog los ntshav hauv thaj chaw ntawm lub hlwb. Tab sis qhov txawv yog qhov twg los ntshav tshwm sim. Cia peb rhuav tshem qhov no kom meej meej.
| Feature | Kev Los Ntshav Hauv Qab (SAH) | Cov ntshav hauv qab ntawm lub cev |
|---|---|---|
| Qhov chaw ntshav | Hauv qab daim nyias nyias arachnoid (hauv qhov chaw subarachnoid) | Nyob rau hauv lub dura mater (nyob rau hauv lub subdural qhov chaw) |
| Cov tsos mob tseem ceeb | Mob taub hau xob laim | Tej zaum yuav mob taub hau maj mam zuj zus, tsis meej pem, thiab qaug zog yuav tshwm sim. |
| Feem ntau yog vim li cas | Ib lub hlwb aneurysm tawg lossis raug mob taub hau. | Ib txoj hlab ntsha tawg, feem ntau yog vim raug mob taub hau. |
Cov tsos mob ntawm ob qho mob no tej zaum yuav zoo sib xws. Thiab ob qho tib si yog xwm txheej ceev uas tuaj yeem ua rau lub hlwb puas tsuaj. Yog li nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev pab kho mob sai li sai tau thaum cov tsos mob tshwm sim.
Leej twg yuav muaj tus mob no ntau tshaj? Dab tsi yog cov yam uas ua rau muaj kev pheej hmoo?
Txawm hais tias leej twg los xij tuaj yeem mob subarachnoid hemorrhage (SAH) tau, nws feem ntau tshwm sim rau cov neeg hnub nyoog 40 thiab 60 xyoo .
Feem ntau SAH yog tshwm sim los ntawm kev raug mob taub hau rau cov neeg laus. Nws tuaj yeem tshwm sim thaum lawv ntog thiab ntaus lawv lub taub hau. Rau cov neeg hluas, qhov ua rau tseem ceeb yog kev sib tsoo tsheb.
Tsis tas li ntawd xwb, muaj ntau yam uas ua rau muaj kev pheej hmoo ntawm kev mob SAH. Cia peb saib seb lawv yog dab tsi.
- Muaj ib lub aneurysm uas tsis tau tawg hauv lub hlwb lossis lwm qhov hauv lub cev: Aneurysm yog qhov tsis muaj zog ntawm phab ntsa ntawm cov hlab ntsha uas loj zoo li lub npas. Qhov no tuaj yeem tawg txhua lub sijhawm.
- Muaj keeb kwm ntawm kev tawg ntawm lub hlwb aneurysm yav dhau los.
- Haus Luam Yeeb: Haus luam yeeb ua rau cov hlab ntsha puas tsuaj loj heev.
- Ntshav Siab (Tshuaj Ntshav Siab): Kev ntshav siab uas tsis tswj tau tuaj yeem ua rau cov hlab ntsha puas tsuaj, ua rau muaj kev pheej hmoo ntawm kev tsim thiab tawg ntawm cov hlab ntsha.
- Qee yam mob caj ces: Cov kab mob uas cuam tshuam rau cov nqaij sib txuas, xws li Fibromuscular Dysplasia (FMD) thiab Ehlers-Danlos syndrome.
- Muaj Kab Mob Raum Polycystic.
- Kev siv tshuaj yeeb: Tshwj xeeb yog cov tshuaj uas ua rau muaj kev xav zoo li cocaine thiab methamphetamine.
- Haus dej cawv ntau dhau.
- Siv cov tshuaj uas ua rau cov ntshav nyias: Piv txwv li, Warfarin.
- Muaj keeb kwm tsev neeg muaj mob aneurysm.
Cov tsos mob ntawm SAH yog dab tsi?
Zoo li peb tau tham ua ntej lawm, qhov tsos mob tseem ceeb thiab tam sim ntawd tshaj plaws yog mob taub hau tam sim ntawd, mob heev hu ua "Thunderclap Headache." Qhov mob no nce mus txog qhov siab tshaj plaws hauv ob peb feeb xwb.
Xav txog seb, koj ua koj txoj haujlwm li qub. Tsis muaj lus ceeb toom dab tsi li, tam sim ntawd, koj hnov mob heev hauv koj lub taub hau, zoo li lub foob pob tau tawg hauv koj, lossis ib tug neeg tau ntaus koj nrog rauj. Qhov no yog qhov koj xav li ntawd.
Yog tias koj muaj ib lossis ntau yam tsos mob hauv qab no nrog rau mob taub hau zoo li no, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd. Qhov no tsis yog ib yam dab tsi uas koj tuaj yeem tos hauv tsev.
| Pawg tsos mob | Kev piav qhia |
|---|---|
| Teeb meem ntsig txog kev paub | Tsis nco qab, qaug zog, tsis nco qab txog tej yam uas tshwm sim ib puag ncig, tsis nco qab. |
| Cov yam ntxwv ntawm lub cev | Xeev siab thiab ntuav, caj dab nruj (nyuaj rau khoov caj dab), qaug zog tam sim ntawd, loog ntawm ib feem ntawm lub cev. |
| Kev hloov pauv ntawm lub hlwb thiab tus cwj pwm | Kev hloov pauv ntawm tus cwj pwm thiab tus cwj pwm, kev npau taws tam sim ntawd, thiab kev nco tsis zoo. |
| Teeb meem pom kev | Kev rhiab heev rau lub teeb ci ntsa iab (Photophobia), pom ob sab, pom tej daim dub, pom tsis meej ib ntus hauv ib lub qhov muag. |
| Lwm yam nta | Kiv taub hau, mob nqaij (tshwj xeeb tshaj yog nyob rau hauv lub caj dab thiab xub pwg nyom), qaug dab peg. |
Cov ua rau muaj SAH yog dab tsi?
Tam sim no cia peb saib cov laj thawj tseem ceeb tom qab qhov xwm txheej txaus ntshai no.
- Raug mob taub hau hnyav: Qhov ua rau SAH feem ntau yog raug mob taub hau hnyav, xws li ntog hnyav lossis raug xwm txheej tsheb.
- Kev tawg ntawm cov hlab ntsha hauv lub hlwb: Qhov no yog qhov ua rau muaj li ntawm 85% ntawm cov hlab ntsha hauv lub hlwb uas tshwm sim yam tsis muaj xwm txheej. Ib qho chaw tsis muaj zog hauv cov hlab ntsha hauv lub hlwb yuav o zoo li lub npas thiab tawg tam sim ntawd. Cov ntshav ces ntws mus rau hauv qhov chaw subarachnoid nyob rau hauv qhov siab.
- Kev tsis zoo ntawm cov hlab ntsha: Kev los ntshav kuj tuaj yeem tshwm sim vim yog cov mob uas cov hlab ntsha sib xyaw ua ke, xws li arteriovenous malformation (AVM).
- Kev Mob Ntshav: Cov mob uas cov ntshav tsis yooj yim txhaws.
- Kev siv cov tshuaj uas ua rau cov ntshav nyias.
- Kev siv tshuaj yeeb: Cov tshuaj yeeb zoo li cocaine tuaj yeem ua rau cov ntshav siab nce siab sai sai thiab ua rau cov hlab ntsha tawg.
Cov kws kho mob kuaj mob li cas?
Thaum koj mus rau tsev kho mob nrog cov tsos mob zoo li no, cov kws kho mob kho qhov ntawd ua qhov xwm txheej ceev thiab ua kev kuaj mob sai sai.
1. CT Scan (Computerized Tomography Scan): Qhov no yog thawj qhov kev kuaj mob thiab tseem ceeb tshaj plaws. Qhov no thaij duab sab hauv ntawm lub taub hau thiab tuaj yeem pom tseeb tias puas muaj ntshav nyob ib puag ncig lub hlwb. Qee zaum yuav muaj kev luam theej tshwj xeeb hu ua CT Angiography (CTA). Hauv qhov no, cov xim zas raug txhaj rau hauv cov leeg ntshav kom paub meej tias cov hlab ntsha zoo li cas.
2. Kev Txhaws Lub Nraub Qaum: Qee zaum kev kuaj CT yuav tsis pom qhov los ntshav me me. Hauv cov xwm txheej zoo li no, cov kws kho mob ua qhov kev kuaj no. Hauv qhov no, ib rab koob nyias nyias raug ntxig rau hauv qab nraub qaum thiab me ntsis cov kua dej cerebrospinal (CSF) raug tshem tawm ntawm thaj chaw ib puag ncig lub hlwb thiab tus txha caj qaum. Cov kua dej raug kuaj xyuas seb puas muaj cov qe ntshav liab lossis xanthochromia (daj). Cov kua dej no hloov mus ua daj tom qab lub sijhawm luv luv ntawm kev los ntshav.
3. Kev Ntsuas MRI (Magnetic Resonance Imaging): Yog tias muaj kev xav tias muaj kev los ntshav tsis ntev los no, qhov kev kuaj no tuaj yeem kuaj pom.
Thaum kuaj pom tseeb lawm, yuav muaj kev kuaj ntxiv, xws li kev kuaj cerebral angiogram, los txiav txim seb qhov ua rau los ntshav yog dab tsi.
Yuav kho li cas?
Vim tias SAH muaj peev xwm ua rau tuag taus, feem ntau tus neeg mob yuav raug xa mus rau chav kho mob hnyav (ICU) hauv tsev kho mob thiab kho los ntawm pab pawg kws kho mob uas tshwj xeeb hauv cov kab mob ntawm lub paj hlwb. Lub hom phiaj tseem ceeb ntawm kev kho mob yog:
- Txuag tus neeg mob lub neej.
- Kho qhov ua rau los ntshav.
- Tswj cov tsos mob.
- Tiv thaiv cov teeb meem (piv txwv li vasospasm, hydrocephalus).
Kev kho mob kom cawm txoj sia thiab tswj cov tsos mob:
- Muab kev txhawb nqa lub neej.
- Muab ib lub raj xa dej kom txo qhov siab hauv lub hlwb.
- Ua cov kauj ruam los tiv thaiv txoj kev ua pa.
- Muab tshuaj IV (intravenous) los tswj ntshav siab.
- Muab tshuaj los tiv thaiv cov hlab ntsha kom tsis txhob nqaim (vasospasm).
- Muab tshuaj tua kab mob thiab tshuaj tiv thaiv kev ntxhov siab rau mob taub hau hnyav.
- Muab tshuaj los tiv thaiv lossis tswj kev qaug dab peg.
Kev kho qhov ua rau los ntshav:
- Yog tias lub aneurysm tau tawg: Yuav muaj kev phais kom kho nws. Qhov no ua tau los ntawm kev siv cov txheej txheem xws li 'Surgical Clipping' (kaw lub caj dab ntawm lub aneurysm nrog ib lub clip) lossis 'Endovascular Coiling' (kaw lub aneurysm nrog ib lub kauj hlau los ntawm cov hlab ntsha).
- Yog tias muaj ntshav sib sau ua ke vim muaj xwm txheej: Tej zaum yuav tsum tau phais kom txo qhov siab rau lub hlwb thiab tshem tawm cov ntshav uas sib sau ua ke.
Feem ntau, ib tus neeg uas muaj SAH yuav tsum tau nyob hauv tsev kho mob li 10 txog 20 hnub lossis ntau dua, nyob ntawm seb tus mob thiab kev kho mob xav tau dab tsi.
Cov teeb meem thiab cov teeb meem uas muaj rau lub sijhawm ntev yog dab tsi?
Qhov no yog ib qho mob hnyav heev. Raws li cov ntaub ntawv suav, kwv yees li ib nrab ntawm cov neeg uas muaj SAH tuag tam sim ntawd. Ntawm cov neeg uas tuaj rau tsev kho mob:
- Ib feem peb tuag hauv tsev kho mob.
- Ib tug ntawm peb tug neeg muaj ib yam kev tsis taus.
- Ib feem peb rov qab mus rau lub neej ib txwm.
SAH tuaj yeem ua rau lub hlwb puas tsuaj, uas tuaj yeem ua rau muaj teeb meem mus sij hawm ntev lossis mus tas li.
- Teeb meem ntawm lub cev: Nkees nkees thiab tsaug zog tas li, tsis muaj zog lossis tsis muaj zog ntawm qhov chaw ntawm lub cev, nyuaj nqos, tsis muaj zog sib npaug.
- Teeb meem kev xav: teeb meem kev nco qab, nyuaj rau tsom ntsoov, nyuaj rau npaj thiab ua cov haujlwm nyuaj.
- Teeb meem hais lus: hais lus tsis meej, hais lus qeeb qeeb, nyuaj nrhiav cov lus zoo.
- Teeb meem kev noj qab haus huv ntawm lub hlwb: Vim tias qhov no yog qhov kev raug mob loj hauv lub neej, cov mob xws li kev nyuaj siab, kev ntxhov siab dav dav, thiab kev ntxhov siab tom qab raug mob (PTSD) tuaj yeem tshwm sim.
Yuav kom tswj tau cov teeb meem mus sij hawm ntev no, kev kho mob xws li kev kho lub cev, kev kho mob ua hauj lwm, kev kho kev hais lus, thiab kev kho hlwb tuaj yeem pab tau zoo heev.
Peb ua tau dab tsi los txo qhov kev pheej hmoo?
Vim tias cov ua rau SAH tseem ceeb yog raug mob taub hau thiab aneurysm tawg, nws yog qhov zoo tshaj plaws los ua cov kauj ruam los tiv thaiv ob qho xwm txheej no.
Yuav kom tsis txhob raug mob taub hau:
- Ib txwm hnav lub kaus mom hlau thaum caij tsheb kauj vab lossis maus taus lossis ua si kis las uas muaj kev pheej hmoo.
- Tsav tsheb kom muaj kev nyab xeeb thiab ua raws li txoj cai tsheb.
- Yog koj ntog ntau zaus, nrhiav kev qhia los ntawm tus kws kho lub cev thiab kawm txoj hauv kev los tiv thaiv kev ntog thiab ua kom koj lub tsev muaj kev nyab xeeb dua.
Yuav kom txo tau qhov kev pheej hmoo ntawm aneurysm:
- Tswj koj cov ntshav siab. Noj koj cov tshuaj raws li koj tus kws kho mob tau hais. Hloov koj txoj kev ua neej (txo kev noj ntsev, ua si nawv).
- Tsum haus luam yeeb kiag li.
- Ua si nawv tsis tu ncua, tab sis tsis txhob tsa cov khoom hnyav ib zaug, vim tias kev ua si ntau dhau tuaj yeem ua rau aneurysm tawg.
- Noj zaub mov kom sib npaug.
- Tsis txhob haus dej cawv thiab siv yeeb tshuaj kiag li, tshwj xeeb yog cov tshuaj stimulants xws li cocaine.
Yog tias koj tus kws kho mob tau hais rau koj tias koj muaj ib qho aneurysm uas tsis tau tawg, nrog nws tham txog cov kev kho mob thiab cov txheej txheem tswj hwm uas muaj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev los ntshav hauv lub hlwb (Subarachnoid hemorrhage - SAH) yog kev los ntshav ntawm lub hlwb thiab cov ntaub so ntswg uas nyob ib puag ncig nws. Qhov no yog ib qho mob hnyav heev, xwm txheej ceev.
- Cov tsos mob tseem ceeb yog mob taub hau tam sim ntawd, "thunderclap headache" uas piav qhia tias yog mob taub hau phem tshaj plaws hauv kuv lub neej.
- Yog tias koj muaj cov tsos mob xws li xeev siab, ntuav, caj dab nruj, thiab tsis nco qab nrog rau hom mob taub hau no, mus rau chav kho mob ceev (ETU) ntawm tsev kho mob tam sim ntawd.
- Cov ua rau mob taub hau tseem ceeb yog raug mob taub hau thiab cov hlab ntsha hauv hlwb tawg.
- Kev tswj cov ntshav siab, tsis txhob haus luam yeeb, thiab tsis txhob siv tshuaj yeeb yuav txo tau qhov kev pheej hmoo.
- Kev kuaj mob thaum ntxov thiab kev kho mob kom zoo ua rau muaj feem ntau dua los cawm txoj sia thiab txo cov teeb meem.
💬 Comments (0)
Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus