Kei te pāngia koe e tēnei mamae rerekē i roto i tō puku? Me kōrero tātou mō te (Rectus Sheath Hematoma)!

Kua pāngia koe e te mamae puku ohorere, kino, e rite ana ki te puku kei roto i tō puku? Kua pāngia rānei koe e te maremare kaha, kātahi ka kite i tētahi ira kikorangi i te arai o tō puku? Ahakoa ehara ēnei i te mea noa, i ētahi wā he tohu pea nō tētahi mate e kiia nei ko te `(Rectus Sheath Hematoma)` e puta ana i roto i te arai o tō tātou puku. Nō reira, i tēnei rā, me kōrero tātou mō tēnei mea me ētahi atu taipitopito, he mea nui kia mōhio ki tēnei.

Tuatahi, kia kite tātou he aha tēnei `(Rectus Sheath)`?

He whakarāpopototanga noa iho, ko tō `(Rectus Sheath)` he uhi pakari, he muka e karapoti ana i ngā uaua o mua o tō puku. Hei whakamārama, he kiriuhi matotoru (e kiia ana ko te `(aponeurosis)`). Kei roto i tēnei uhi ko ngā uaua matua e rua o tō puku, ko te `(rectus abdominis)` (e kiia ana e tātou ko ngā uaua "six-pack") me te `(pyramidalis)`.

Whakaarohia, he pakitara o mua (o mua) tēnei `(Rectus Sheath)`, he pakitara o muri (o muri). He mea hanga ēnei pakitara i te fascia (`(fascia)`) kotahi e karapoti ana i ētahi atu uaua o tō puku. Arā:

• Ō "(ngā uaua puku o waho)" (ngā uaua puku o waho)
• Ō "(ngā uaua puku ā-roto)" (ngā uaua puku ā-roto)
• Tō `(transversus abdominis)` (uaua whakawhiti puku)

Ka hangaia te "Uwhi Tuturu" mai i ngā hipoki o ēnei kiko.

Waihoki, ko ngā uaua epigastric o runga me o raro, arā, ko ngā uaua toto matua e tuku toto ana ki ngā uaua o tō puku, ka haere mā roto i tēnei `(Rectus Sheath). Nō reira, ko te mahi matua o tēnei `(Rectus Sheath)` he tiaki i ēnei uaua, i ngā uaua toto, me ngā whekau e karapoti ana i te pakitara o te puku.

Engari he mea iti tēnei. Kāore tēnei `(Rectus Sheath)` e taupoki katoa i ngā mea o roto. Ko te tihi o tō uaua `(rectus abdominis)` kua hipokina e tēnei `(Rectus Sheath)` i ngā taha e rua, o mua me muri. Heoi anō, he rohe kei waenganui i te tihi me te raro o tēnei uaua, e kiia nei ko te `(arcuate line)`. Ko tēnei rārangi he tata ki te hautoru o te hekenga iho mai i tō pito ki te wāhi e tūtaki ai ō wheua pelvic e rua i mua (`(pubic symphysis)`).

Ko te mea nui, i raro i tēnei `(rārangi arcuate)`, ko te wāhanga o raro o tō uaua `(rectus abdominis)` ka kapi noa i te `(Rectus Sheath)` mai i mua. Kāore he `(posterior rectus sheath)` mai i muri! Ko te tikanga kāore he `container` pērā hei tiaki i te wāhanga o raro o te uaua `(rectus abdominis)`. Kia maumahara ki tēnei, nā te mea he mea nui tēnei mō te mate `(Rectus Sheath Hematoma)` e kōrerohia nei e tātou.

Nā, he aha te `(Rectus Sheath Hematoma)`?

Ko te `(Hematoma)`, he kohinga toto i roto i ō kiko. Inaianei, ki te tīmata te toto o ngā `(epigastric arteries)` i roto i te `(Rectus Sheath)` i kōrerotia e tātou i mua ake nei, ka taea e taua toto te kohikohi ki taua wāhi o tō puku. Ka kiia tēnei kohinga toto ko `(Rectus Sheath Hematoma).`

I tēnei āhuatanga, ka nui ake te kino o te toto, inā koa mai i te uaua epigastric o raro. Nā te mea, e ai ki tā mātou i kōrero ai i mua, kāore he taupoki i raro i te rārangi arcuate, ā, ki te tīmata te rere o te toto mai i reira, kāore he kiko hei aukati i te horapa o te toto. Nō reira, ka nui te toto ka kohia.

Ko wai te mea tino pāngia e tēnei āhuatanga?

He nui ake te kitea o te Rectus Sheath Hematoma i roto i ngā wāhine i ngā tāne, ā, he nui ake hoki te kitea i roto i te hunga neke atu i te 60 tau te pakeke .

He pēhea te noa o tēnei āhuatanga?

He tino onge te mate Rectus Sheath Hematoma. Kotahi ki te rua ōrau anake o ngā tūroro e mamae ana te puku ka pāngia . Nō reira, kāore pea koe e rongo pinepine mōna.

He aha ngā tohu?

Ko te tohu tino kitea o tēnei mate ko te mamae o te puku . Ko tēnei mamae:

• Ka taea e koe te tīmata tonu.
• He mamae koi, e kore e taea te manawanui.
• Ka taea hoki te mamae tonu.
• Ka piki ake pea te mamae ina rūrū koe, ina piko, ina pēhia rānei ngā uaua o tō puku.

Hei tāpiritanga, i ētahi wā ka pā koe ki tō puku, ka rongo pea koe i tētahi mea pērā i te puku .

Ko ētahi atu tohu ka kitea pea ko:

• Whakapairuaki me te ruaki
• Kirika
• He kiri kikorangi, he maru rānei (ina koa i te puku)
• Te mate toto iti (arā, te hekenga o te nui o te toto)
• Te pikinga o te tere o te ngakau (tachycardia)
• Te toto toto iti (hypotension)

He aha te take o tēnei?

Ko te tino take o te 'Rectus Sheath Hematoma' ko te toto e puta ana ki roto i te '(Rectus Sheath).' Ka puta pinepine tēnei ina he whara kei te pakitara o te puku .

Ki te kī ngāwari, ka puta tēnei āhuatanga mēnā ka pakaru te uaua `(epigastric artery)`, ngā oko toto iti e peka atu ana i a ia, te uaua `(rectus abdominis)` rānei. E ai ki tā mātou i kōrero ai i mua ake nei, ka tukuna te toto ki ngā uaua puku e ngā uaua `(epigastric artery)` o runga me raro. Anō, mēnā ka pakaru te uaua `(inferior epigastric artery)` o raro, ka nui ake te kino o te āhuatanga, nā te mea kāore he parenga i muri i a ia i raro i te `(arcuate line)`.

Whakaarohia, ki te pā tika atu tō puku ki a koe, ki te pēhia ohoreretia rānei e koe te kaha nui ki ngā uaua o te puku (hei tauira, ki te maremare nui koe mō te wā roa, ki te pēhia rānei tō puku i a koe e hiki ana i tētahi mea taumaha), ka pakaru pea tēnei `(epigastric artery)` ka tīmata te toto, ka puta he `(hematoma)`.

He aha ngā āhuatanga mōrearea mō tēnei?

Ko te take nui rawa atu mō te whakawhanaketanga o te 'Rectus Sheath Hematoma' ko te whakamahinga o ngā rongoā hei ārai i te toto totoka ("anticoagulants"), "ngā rongoā whakangawari toto" rānei . Tata ki te 70% o te hunga e whakawhanake ana i te "Rectus Sheath Hematoma" kei te tango i tētahi momo rongoā "(anticoagulant)". Ka whakaroa ēnei rongoā i te tukanga toto, ka nui ake te tūponotanga ka puta he "(hematoma)".

Ko tētahi atu āhuatanga mōrearea nui ko te mate tākihi mau tonu . Tata ki te 60% o te hunga e pāngia ana e te hematoma rectus sheath he mate tākihi wāhanga 3, neke atu rānei.

Ko ētahi atu āhuatanga mōrearea ko:

• Te pokanga puku tata nei
• Te whakamahinga o ngā steroids, ngā rongoā immunosuppressant rānei
• Maremare tino kino, ā, pumau tonu
• Te tango i te 'whakaora Antiplatelet' (he rongoā hei ārai i te piri o ngā pereti toto)
• Te haputanga
• Ngā mate pūmau, pērā i te toto toto tiketike me te atherosclerosis (te angiangi o ngā uaua nā te mea he ngako kei runga i ngā pakitara o ngā uaua)

He mea nui: Ki te mea kei te tango koe i ngā rongoā ārai toto pēnei, me tino tupato koe mēnā ka pāngia koe e te mamae o te puku.

Me pēhea te tautuhi i te mate?

He uaua pea te tautuhi i te hematoma o te rectus sheath i ētahi wā , nā te mea he rite tonu ōna tohu ki ērā o ētahi atu mate puku.

Tērā pea ka whakamātauhia e tō tākuta te toto hei ine i ō taumata hemoglobin me te hematocrit. Neke atu i te haurua o te hunga he hematoma rectus sheath ka tino iti ō rātou taumata hemoglobin (arā, he iti te rahinga toto).

Muri iho, ka taea e tō tākuta te tirotiro i te pakitara o tō puku mā te whakamahi i te ultrasound. Mā tēnei ka āwhina ki te whakatau mēnā he wai toto kei roto i te pakitara o tō puku, me te rahi o te hematoma.

I ētahi wā, ka taea te mahi i tētahi matawai CT hei tiki i tētahi pikitia tika ake, mārama ake hoki o te āhua. Ka taea e te matawai CT, inā koa ko tētahi e whakamahi ana i te tae rerekē, te whakaatu tika i te wāhi e turuturu ana te tae mai i te oko toto kua pakaru. Ka taea hoki e tēnei te āwhina i te tākuta ki te kimi i te wāhi e puta mai ai te toto.

Me pēhea te rongoā?

Ko te rongo pai ko te nuinga o ngā hematoma o te rectus sheath ka ora ake i a rātou anō , ā, kāore e hiahiatia he maimoatanga hauora motuhake. Ko te maimoatanga mō tēnei mate ko:

• Te tāpiri i ngā kete hukapapa (he kōpeke hukapapa, he kōpeke makariri rānei)
• Okiokinga
• Te whakamahi i ngā rongoā whakamamae mamae noa (`(analgesic)`)

Tata ki te 80% o ngā hematoma o te whitiki rectus ka ora mā ngā maimoatanga māmā pēnei.

Heoi, ki te kore ēnei maimoatanga ngāwari e āwhina, ki te kino rawa atu rānei te āhua, ka taea e te tākuta te whakamahi i tētahi maimoatanga e kiia nei ko te "angioembolization." Ehara tēnei i te pokanga. Kei roto ko te whakakotahi i te "angiography" (he tikanga tango pikitia o ngā oko toto) me te "embolization" (he tikanga kati i te oko toto), hei kimi i te oko toto e toto ana, ā, hei kati anō hoki.

Ki te kore e angitu tēnei tikanga "angioembolization", me mahi pea te pokanga hei huarahi whakamutunga. I te wā o te pokanga, ka tangohia te toto toto kua kohia ("hematoma") ā, ka kati te uaua toto.

I te wā e rongoatia ana, ā, i muri hoki i te maimoatanga, ka tirotirohia tō āhua e tō tākuta mā te whakamahi i ngā whakamātautau toto me ngā ultrasound. Ka āwhina tēnei ki te kite i te hokinga mai o te toto, te mate rānei.

He aha te mea ka tupu i muri mai? Ka ora ake ia?

Ko te nuinga o ngā hematoma o te rectus sheath ka memeha noa iho i roto i ngā marama e rua ki te toru . Ko te nuinga o te hunga e pāngia ana e tēnei mate ka ora pai, ā, kāore he raruraru anō e pāngia ana.

Heoi, i ētahi wā – inā koa i waenga i te hunga e tango ana i ngā rongoā ārai toto – ka mate pea tēnei mate . Heoi, he tino onge. E ai ki ngā raraunga hou, he iti iho i te 2% o te hunga e mate ana i te Rectus Sheath Hematoma.

Pērā i ngā mate hauora katoa, mā te tautuhi wawe me te maimoatanga wawe ka nui ake te tūponotanga o te ora . Nō reira, ki te whakaaro koe kei a koe ngā tohu o te 'Rectus Sheath Hematoma', me rapu tohutohu hauora.

Hei whakamutunga, ngā mea hei maumahara

He mea nui tō `(Rectus Sheath)` hei tiaki i ngā whekau, ngā kiko, me ngā uaua toto i roto i tō pakitara puku. Mēnā ka whara tō pakitara puku i tētahi ara, ka pakaru te `(epigastric artery)` ka puta he `(Rectus Sheath Hematoma)`.

I te nuinga o te wā, kāore e hiahiatia he maimoatanga hauora nui mō tēnei mate. He āwhina pea ngā mahi māmā pēnei i te paninga hukapapa, te okioki, me te tango i ngā rongoā whakamamae.

Heoi anō, ka nui ake te kino o ētahi āhuatanga. Mēnā ka pāngia koe e te mamae puku nui, ohorere, he mea whakaaro nui kia toro atu koe ki te tākuta hei whakatau mēnā me rongoā koe. Kaua e mataku, engari he mea nui kia mōhio koe me tō whānau ki ēnei mea.

` Hematoma o te Uhi Rectus, mamae puku, toto i roto i te puku, uaua epigastric, rongoā anticoagulants, puranga puku, mamae puku