Los ntshav tam sim ntawd hauv lub taub hau? (Subarachnoid Hemorrhage - SAH) Hnub no peb yuav tham txog nws!

Koj puas tau muaj mob taub hau tam sim ntawd, mob heev uas zoo li koj lub taub hau tawg, lossis zoo li xob laim ntaus koj? Ib txhia neeg hu nws tias "mob taub hau phem tshaj plaws hauv koj lub neej." Qhov no tsis yog lus tso dag. Qhov no tuaj yeem yog ib qho mob txaus ntshai heev. Hauv kev kho mob, peb hu qhov mob no tias '(Subarachnoid Hemorrhage)' lossis '(SAH)' . Qhov no yog qhov xwm txheej ceev hauv kev kho mob tiag tiag. Yog li cia peb tham txog qhov no kom ntxaws me ntsis, hauv cov lus yooj yim, puas yog?

Qhov no yog dab tsi tiag (Subarachnoid Hemorrhage)? Cia peb nkag siab yooj yim, puas yog?

Hais yooj yim xwb, '(Subarachnoid Hemorrhage)' yog thaum muaj ntshav ntws hauv qhov chaw nruab nrab ntawm peb lub hlwb thiab daim nyias nyias uas nyob ib puag ncig lub hlwb . Xav txog nws, peb lub hlwb zoo li lub pov haum muaj nqis. Yog li ntawd, txhawm rau tiv thaiv nws, xwm tau muab peb txheej nyias nyias rau peb. Peb hu cov no '(Meninges)'. Nws zoo li daim tawv nqaij ntawm dos, lossis ntau txheej zoo li cov tawv ntawm txiv maj phaub.

Cov peb daim npog no yog:

• Dura mater: Qhov no yog qhov npog sab nraud me ntsis hauv qab lub pob txha taub hau.
• Arachnoid mater: Qhov no yog qhov npog nruab nrab. Ib daim nyias nyias uas zoo li lub vas kab laug sab.
• Pia mater: Qhov no yog qhov nyias nyias, sab hauv tshaj plaws uas txuas nrog lub hlwb nws tus kheej.

Tam sim no, qhov tshwm sim hauv qhov '(Subarachnoid Hemorrhage)' no yog tias kev los ntshav tshwm sim hauv qab daim nyias nyias arachnoid hauv nruab nrab (uas yog, hauv qhov chaw "sub-arachnoid"). Qhov no txaus ntshai heev, vim tias qhov kev los ntshav no tuaj yeem ua rau lub hlwb muaj kev nyuaj siab, thiab cov hlwb hlwb tuaj yeem puas tsuaj. Yog vim li cas qhov no thiaj suav tias yog xwm txheej ceev hauv kev kho mob.

Qhov txawv ntawm (Subarachnoid Hematoma) thiab (Subdural Hematoma) yog dab tsi?

Tej zaum koj yuav tau hnov ​​txog lwm yam mob hu ua "Subdural Hematoma". Ob qho tib si yog los ntshav hauv lub hlwb. Qhov txawv yog qhov twg los ntshav tshwm sim .

• Hauv "Subdural Hematoma", cov ntshav ntws mus rau hauv qhov chaw hauv qab lub npog sab nraud, "dura mater" uas peb tau hais ua ntej.
• Hauv kev mob subarachnoid hemorrhage, cov ntshav ntws mus rau hauv qhov chaw hauv qab daim nyias nyias arachnoid .

Cov tsos mob ntawm ob qho tib si qee zaum yuav zoo sib xws, ob qho tib si tuaj yeem ua rau lub hlwb puas tsuaj, thiab ob qho tib si yog cov mob uas xav tau kev kho mob ceev.

Leej twg muaj feem yuav mob SAH ntau dua? Dab tsi yog cov yam uas ua rau muaj kev pheej hmoo?

Tus mob no, hu ua "Subarachnoid Hemorrhage," tuaj yeem tshwm sim rau txhua tus neeg. Txawm li cas los xij, nws feem ntau tshwm sim rau cov neeg hnub nyoog ntawm 40 thiab 60 xyoo .

Kev raug mob taub hau (SAH) feem ntau tshwm sim rau cov neeg laus vim muaj kev pheej hmoo ntawm kev ntog thiab poob qhov sib npaug thaum cov neeg laus zuj zus. Ntawm cov neeg hluas, kev sib tsoo tsheb yog qhov ua rau muaj kev sib tsoo loj tshaj plaws.

Tsis tas li ntawd xwb, muaj ntau yam kev pheej hmoo uas tuaj yeem pab txhawb rau kev loj hlob ntawm SAH. Lawv yog:

• Muaj ib lub aneurysm uas tsis tau tawg hauv koj lub hlwb lossis lwm qhov hauv koj lub cev (aneurysm yog ib txoj hlab ntshav uas loj zoo li lub npas).
• Muaj keeb kwm ntawm kev tawg ntawm lub hlwb aneurysm yav dhau los.
• Haus luam yeeb. (Qhov no yog qhov ua rau muaj ntau yam kab mob, puas yog?)
• Muaj ntshav siab (Hypertension). (Peb hais tias "siab siab").
• Qee yam mob caj ces, piv txwv li, cov kab mob ntawm cov nqaij sib txuas xws li "Fibromuscular dysplasia (FMD)" thiab "Ehlers-Danlos syndrome".
• Muaj kab mob raum hu ua "(Polycystic kidney disease)".
• Siv cov tshuaj yeeb xws li cocaine thiab/lossis methamphetamine.
• Haus dej cawv ntau dhau.
• Siv cov tshuaj ua kom cov ntshav nyias xws li Warfarin (Cov no tsuas yog yuav tsum tau siv raws li kev qhia ntawm tus kws kho mob).
• Yog tias ib tug neeg hauv koj tsev neeg tau muaj aneurysm (qhov ntawd txhais tau tias muaj keeb kwm tsev neeg muaj zog).

Tseem Ceeb: Yog tias koj muaj ib lossis ntau yam ntawm cov yam no, nws tsis tau txhais hais tias koj yuav muaj SAH. Txawm li cas los xij, nws txhais tau hais tias koj muaj feem yuav muaj SAH ntau dua. Yog li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum nrhiav kev pab kho mob.

Cov tsos mob ntawm tus mob txaus ntshai no yog dab tsi? Koj paub nws li cas?

Cov tsos mob tseem ceeb thiab txaus ntshai tshaj plaws ntawm kev los ntshav hauv lub hlwb yog "mob taub hau xob laim" uas peb tau hais ua ntej. Qhov no yog mob taub hau loj heev, tam sim ntawd. Nws tuaj yeem zoo li muaj qee yam tawg hauv koj lub taub hau. Muaj ntau tus neeg hais tias, "Kuv yeej tsis tau mob taub hau zoo li no hauv kuv lub neej."

Yog tias koj muaj mob taub hau loj heev, tam sim ntawd zoo li no, tshwj xeeb tshaj yog tias koj muaj lwm cov tsos mob hauv qab no, thov hu rau 911 (1990 Suwaseriya hauv Sri Lanka) yam tsis muaj kev ncua sijhawm, lossis mus rau chav kho mob ceev ze tshaj plaws sai li sai tau. Qhov no tuaj yeem cawm koj txoj sia!

Lwm cov tsos mob yog:

• Tsis nco qab thiab nyuaj rau sawv.
• Xeev siab thiab ntuav.
• Xav tias lub caj dab nruj, nyuaj rau khoov lub caj dab (Lub caj dab nruj) .
• Zoo li koj cia li poob koj lub neej tam sim ntawd.
• Kev hloov pauv ntawm tus cwj pwm thiab tus cwj pwm (piv txwv li, kev ntxhov siab, kev chim siab).
• Kiv taub hau .
• Photophobia (qhov muag rhiab heev rau lub teeb ci) .
• Mob nqaij , tshwj xeeb tshaj yog mob caj dab thiab xub pwg.
• Kev tsis muaj zog ntawm ib feem ntawm lub cev.
• Muaj ib qho mob (qaug dab peg) `(Seizures)` .
• Kev hloov pauv ntawm qhov muag : Pom ob sab, pom tej daim dub hauv qhov muag, pom ib lub qhov muag tsis pom kev ib ntus.

Yog tias ib lossis ntau yam ntawm cov tsos mob no nrog rau qhov mob taub hau hnyav ntawd, muaj feem ntau uas nws yog 'SAH'.

Vim li cas qhov no (Subarachnoid Hemorrhage) thiaj tshwm sim? Cov laj thawj tseem ceeb yog dab tsi?

Muaj ob qho laj thawj tseem ceeb uas ua rau muaj kev ntshav hauv subarachnoid.

1. Kev raug mob taub hau: Qhov no yog qhov ua rau feem ntau tshwm sim. Piv txwv li, kev poob hnyav lossis kev sib tsoo tsheb tuaj yeem ua rau raug mob taub hau hnyav.

2. Kab mob aneurysm hauv lub hlwb tawg: Qhov no kuj yog ib qho ua rau muaj ntau heev. Raws li peb tau hais ua ntej lawm, kab mob aneurysm yog ib qho chaw tsis muaj zog hauv phab ntsa ntawm cov hlab ntsha hauv lub hlwb uas loj zoo li lub npas. Yog tias nws tawg tam sim ntawd, cov ntshav ntws ncaj qha mus rau hauv qhov chaw hauv qab daim nyias nyias arachnoid. Qhov no yog qhov ua rau 85% ntawm cov kab mob aneurysm tawg tam sim ntawd (SAH) yam tsis raug mob taub hau.

Ntxiv rau ob qho laj thawj tseem ceeb no, muaj ntau lwm yam laj thawj uas tsis tshua muaj neeg pom:

• Los ntshav ntawm thaj chaw ntawm cov hlab ntsha uas sib xyaw ua ke. Qhov no hu ua "Arteriovenous malformation (AVM)"
• Qee cov teeb meem ntshav.
• Siv cov tshuaj ua kom cov ntshav nyias (thaum siv yam tsis tau kev qhia los ntawm kws kho mob).
• Siv cov tshuaj yeeb xws li cocaine thiab/lossis methamphetamine.

Cov kws kho mob kuaj mob li cas? Lawv ua cov kev kuaj dab tsi?

Yog tias, tom qab koj saib xyuas koj cov tsos mob thiab kuaj thawj zaug, tus kws kho mob xav tias koj muaj "Subarachnoid Hemorrhage", nws yuav hais kom koj "CT scan" (Computerized Tomography scan) tam sim ntawd.

Kev thaij duab CT tuaj yeem thaij tau cov duab ntxaws ntxaws ntawm cov nqaij hauv peb lub cev. Kev thaij duab CT ntawm lub hlwb yog ib txoj hauv kev zoo heev los saib seb puas muaj SAH. Qee zaum, kev thaij duab CT angiography (CTA), uas yog kev txhaj tshuaj tshwj xeeb rau hauv cov leeg ntshav, kuj tuaj yeem saib xyuas cov hlab ntsha.

Txawm li cas los xij, yog tias nws yog SAH me me heev, lossis yog tias nws tshwm sim tsawg dua ob lub lis piam dhau los, nws yuav tsis pom los ntawm CT scan. Yog li ntawd, tus kws kho mob yuav tsum tau ua ob peb qhov kev kuaj ntxiv.

Lawv yog:

• Kev tho qhov ntawm lub duav: Qhov no suav nrog kev ntxig ib rab koob nyias nyias rau hauv koj lub nraub qaum qis thiab coj cov kua dej uas nyob ib puag ncig koj lub hlwb thiab cov hlab ntsha hauv lub hlwb (hu ua cerebrospinal fluid - CSF). Cov kua dej no ces raug kuaj seb puas muaj xanthochromia (zoo li daj). Yog tias nws muaj, nws txhais tau tias koj muaj SAH.
• Kev thaij duab magnetic resonance imaging (MRI): Qhov no kuj tseem tuaj yeem kuaj xyuas seb puas muaj ntshav hauv lub hlwb tsis ntev los no.

Thaum kuaj pom tias muaj SAH, kev kho mob hauv tsev kho mob pib nrog kev nrhiav thiab kho qhov ua rau, nrog rau kev tswj hwm txhua yam teeb meem uas yuav tshwm sim. Vim tias ntau dua 80% ntawm SAHs uas tsis raug mob taub hau yog tshwm sim los ntawm aneurysm, cov kws kho mob feem ntau ua qhov kev kuaj mob hu ua cerebral angiogram, uas thaij duab ntawm cov hlab ntsha hauv lub hlwb, thiab kho qhov aneurysm.

Yuav kho qhov no li cas? Yuav siv sijhawm ntev npaum li cas thiaj rov zoo?

Kev los ntshav hauv lub hlwb yog ib qho xwm txheej ceev uas ua rau tuag taus thiab feem ntau kho hauv chav kho mob hnyav (ICU) , qhov chaw uas muaj kev txawj ntse hauv cov kab mob ntawm lub paj hlwb. Lub hom phiaj tseem ceeb ntawm kev kho mob yog:

• Txuag koj txoj sia.
• Txheeb xyuas qhov ua rau los ntshav thiab kho nws.
• Txo cov tsos mob.
• Tiv thaiv cov teeb meem (piv txwv li Vasospasm - cov hlab ntsha nqaim, Hydrocephalus - cov kua dej hauv lub hlwb, kev puas tsuaj rau lub hlwb mus tas li).

Kev kho mob cawm siav thiab kev tswj cov tsos mob yuav suav nrog:

• Cov txheej txheem txhawb nqa lub neej.
• Muab ib lub raj tso rau hauv lub hlwb kom txo qhov siab.
• Cov txheej txheem tiv thaiv txoj hlab pa.
• Tshuaj kom txo qhov o ntawm lub taub hau.
• Tshuaj muab rau hauv cov hlab ntsha kom tswj tau ntshav siab.
• Cov tshuaj siv los tiv thaiv vasospasms.
• Cov tshuaj tua mob rau mob taub hau thiab cov tshuaj tiv thaiv kev ntxhov siab.
• Cov tshuaj siv los tiv thaiv lossis kho qhov mob.

Tej zaum koj yuav xav tau kev phais kom kho SAH thiab nws qhov ua rau:

• Yog tias SAH yog los ntawm kev raug mob, tshem tawm cov ntshav txhaws loj uas tau sib sau ua ke, lossis txo qhov siab rau lub hlwb.
• Yog tias ib qho aneurysm tau tawg thiab dhau los ua "SAH", kho qhov aneurysm.

Lub sijhawm ntev npaum li cas koj nyob hauv tsev kho mob yuav txawv nyob ntawm koj tus mob. Feem ntau cov neeg uas muaj SAH yuav nyob hauv tsev kho mob li 10 txog 20 hnub , nyob ntawm lawv tus mob thiab seb lawv puas xav tau kev kho mob.

Peb ua tau dab tsi los tiv thaiv SAH kom tsis txhob loj hlob?

Feem ntau cov mob ntshav hauv lub hlwb yog los ntawm kev raug mob taub hau thiab/lossis cov hlab ntsha hauv lub hlwb tawg. Yog li ntawd, qhov zoo tshaj plaws uas peb ua tau kom tsis txhob muaj mob ntshav hauv lub hlwb yog sim tswj cov yam uas ua rau muaj ob yam mob no.

Ceev faj kom tsis txhob raug mob taub hau:

• Ib txwm hnav lub kaus mom hlau thaum caij tsheb kauj vab, maus taus, lossis ua si kis las uas muaj kev pheej hmoo siab.
• Tsav tsheb kom muaj kev nyab xeeb thiab ua raws li txoj cai tsheb.
• Yog koj ntog ntau zaus, mus ntsib kws kho lub cev lossis kws kho mob ua haujlwm kom kawm paub tiv thaiv kev ntog, thiab ua kom koj lub tsev nyob nyab xeeb dua.

Yuav kom txo tau qhov kev pheej hmoo ntawm kev mob hlwb aneurysm thiab/lossis tiv thaiv kom tsis txhob muaj aneurysm uas twb muaj lawm tawg:

• Tham nrog koj tus kws kho mob txog yam koj ua tau kom noj qab nyob zoo. Nws feem ntau yuav pom zoo cov hauv qab no:
• Tswj cov ntshav siab (nrog kev siv tshuaj thiab kev hloov pauv hauv lub neej).
• Tsis txhob haus luam yeeb.
• Ua si nawv tsis tu ncua (tab sis tsis txhob tsa cov khoom hnyav ib zaug, vim qhov no tuaj yeem ua rau aneurysm tawg).
• Noj zaub mov kom sib npaug.
• Yog koj muaj teeb meem nrog kev haus dej cawv lossis siv tshuaj yeeb, nrhiav kev pab. Tsis txhob siv cov tshuaj stimulants xws li cocaine.

Yuav muaj dab tsi tshwm sim tom qab tus mob no? (Kev kwv yees thiab teeb meem)

Qhov kev kwv yees tom qab muaj ntshav hauv lub hlwb subarachnoid nyob ntawm seb ua rau muaj dab tsi, nws hnyav npaum li cas, thiab seb puas muaj lwm yam teeb meem lossis raug mob.

Qhov no yog ib qho mob hnyav heev . Kwv yees li ib nrab ntawm cov neeg uas muaj SAH tuag tam sim ntawd . Ntawm cov neeg uas mus tau rau tsev kho mob:

• Kwv yees li ib feem peb tuag hauv tsev kho mob.
• Kwv yees li ib feem peb ntawm cov neeg muaj kev tsis taus.
• Kwv yees li ib feem peb rov qab mus rau qhov qub.

Cov teeb meem tam sim ntawd ntawm SAH yog:

• Muaj kev mob nkeeg (Seizures).
• Vasospasm (kev nqaim ntawm cov hlab ntsha hauv lub hlwb, thaiv cov ntshav ntws).
• Los ntshav dua tom qab kev kho mob thawj zaug.
• Hydrocephalus (kev sib sau ua ke ntawm cov kua dej hauv lub hlwb).
• Nce siab intracranial.
• Kev tawg ntawm lub hlwb.
• Kev mob hlwb infarction / ischemic stroke yog tshwm sim los ntawm kev txo qis ntawm cov ntshav mus rau lub hlwb.
• Kev tuag.

Cov teeb meem mus sij hawm ntev ntawm SAH yog dab tsi?

Vim tias qhov ntshav hauv lub hlwb (subarachnoid hemorrhage) tuaj yeem ua rau lub hlwb puas tsuaj, nws tuaj yeem ua rau muaj teeb meem mus sij hawm ntev, txawm tias mus tas li. Tej zaum yuav muaj teeb meem mus sij hawm ntev xws li:

• Teeb meem ntawm lub cev: Ntshai thiab qaug zog ntau zaus, loog lossis tsis muaj zog ntawm qhov chaw ntawm lub cev, nyuaj rau nqos, tsis muaj zog.
• 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 lossis hais lus qeeb qeeb. Nyuaj nrhiav cov lus uas koj xav tau.
• Teeb meem kev noj qab haus huv ntawm lub hlwb: SAH yog ib qho kev raug mob loj hauv lub neej. Nws tuaj yeem ua rau muaj mob xws li kev nyuaj siab, kev ntxhov siab dav dav, thiab kev ntxhov siab tom qab raug mob hnyav (PTSD).

Muaj ntau txoj kev kho mob rau cov teeb meem ntev no. Piv txwv li:

• Kev kho lub cev.
• Kev kho mob ua haujlwm.
• Kev kho mob hais lus.
• Kev kho mob hlwb (kev kho mob tham).

Qee cov tshuaj kuj pab tau qhov no. Yog tias koj muaj ib qho ntawm cov teeb meem no, tham nrog koj pab neeg kho mob.

Yog tias tsis kho, SAH muaj 65% feem pua ​​​​​​ntawm kev tuag hauv ib xyoos. Txawm li cas los xij, yog tias kuaj pom thiab kho kom zoo, qhov feem pua ​​​​​​ntawm kev tuag hauv ib xyoos tuaj yeem txo qis mus txog li 18%.

Yog tias koj tau kuaj pom tias muaj tus kab mob SAH, koj yuav tsum tau mus ntsib koj pab neeg kho mob tsis tu ncua los saib xyuas koj txoj kev noj qab haus huv thiab kev nce qib. Tej zaum koj kuj yuav xav tau kev kho lub cev, kev kho mob ua haujlwm, thiab/lossis kev kho kev hais lus yog tias muaj teeb meem tshwm sim.

Cov Lus Qhia Txog Kev Coj Mus Tsev

Zoo, yog li kuv vam tias koj tam sim no nkag siab zoo txog yam peb tau tham txog hnub no, '(Subarachnoid Hemorrhage).' Nov yog qee yam tseem ceeb tshaj plaws uas yuav tsum nco ntsoov:

• Mob taub hau tam sim ntawd, hnyav, thiab xob laim tuaj yeem yog ib qho tsos mob tseem ceeb ntawm SAH.
• `(SAH)` yog ib qho xwm txheej ceev hauv kev kho mob . Yog tias koj muaj cov tsos mob, nrhiav kev pab kho mob sai li sai tau.
• Kev raug mob taub hau thiab cov hlab ntsha hauv lub hlwb tawg yog cov ua rau qhov no.
• Kev pheej hmoo ntawm kev mob SAH tuaj yeem txo tau los ntawm kev tswj cov yam txaus ntshai thiab kev ua neej nyob nyab xeeb.
• Txawm hais tias tus mob no loj heev los xij, muaj lub sijhawm los cawm txoj sia thiab ua neej zoo los ntawm kev kho mob sai thiab kev kho kom rov zoo.

Yog li ntawd, yuav tsum paub txog qhov no thiab. Yog tias koj lossis ib tus neeg koj paub muaj cov tsos mob no, ua tam sim ntawd. Nyob zoo!

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