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.

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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.