Ingabe uzwa ubuhlungu obungavamile esiswini sakho? Ake sixoxe nge-(Rectus Sheath Hematoma)!

Wake wabhekana nobuhlungu besisu obungazelelwe, obukhulu obuzwakala njengeqhubu esiswini sakho? Noma wake wakhwehlela kanzima wabe usubona ibala eliluhlaza okwesibhakabhaka olwelwesini lwesisu sakho? Nakuba lezi zinto zingavamile kakhulu, ngezinye izikhathi zingaba izimpawu zesimo esibizwa ngokuthi `(Rectus Sheath Hematoma)` esenzeka olwelwesini lwesisu sethu. Ngakho-ke namuhla, ake sixoxe ngalokhu ngemininingwane ethe xaxa, ngoba kubaluleke kakhulu ukuqaphela lokhu.

Okokuqala, ake sibone ukuthi iyini le `(Rectus Sheath)`?

Kalula nje, i-`(Rectus Sheath)` yakho iyisimbozo esiqinile, esinemicu esizungeze imisipha engaphambili kwesisu sakho. Ukuze kube sobala, iyi-membrane ejiyile (ebizwa nangokuthi `(aponeurosis)`). Ngaphakathi kwalesi simbozo kunemisipha emibili eyinhloko yesisu sakho, i-`(rectus abdominis)` (lokho esivame ukukubiza ngokuthi imisipha "eyisithupha") kanye ne-`(pyramidalis)`.

Cabanga nje, lo `(Rectus Sheath)` unodonga lwangaphambili (olungaphambili) kanye nodonga lwangemuva (olungemuva). Lezi zindonga zakhiwe nge-fascia efanayo (`(fascia)`) ezungeze eminye imisipha esiswini sakho. Okungukuthi:

• "Imisipha yakho yesisu engaphandle (imisipha engaphandle yesisu)" (imisipha engaphandle yesisu engaphandle)
• "Imisipha yakho yangaphakathi yesisu" (imisipha yangaphakathi yesisu)
• Isisu sakho esidlulayo (imisipha yesisu esiwelayo)

"I-Rectus Sheath" yakhiwe ngezimbozo zalezi nyama.

Futhi, imithambo yegazi ephezulu nengaphansi kwe-epigastric, okuyimithambo yegazi eyinhloko ehlinzeka ngegazi emisipheni yesisu sakho, idlula kule `(Rectus Sheath). Ngakho-ke umsebenzi oyinhloko wale `(Rectus Sheath)` ukuvikela le misipha, imithambo yegazi, kanye nezitho ezizungezile odongeni lwesisu.

Kodwa kukhona into encane. Lo `(Rectus Sheath)` awumbozi ngokuphelele okungaphakathi. Ingxenye ephezulu yomsipha wakho we-`(rectus abdominis)` imbozwe yilo `(Rectus Sheath)` ezinhlangothini zombili, ngaphambili nangemuva. Kodwa-ke, kunomngcele phakathi kwengxenye ephezulu nephansi yalo msipha, obizwa ngokuthi `(umugqa we-arcuate)`. Lo mugqa cishe uyingxenye yesithathu yendlela eya phansi kusukela enkabeni yakho kuya lapho amathambo akho amabili e-pelvic ahlangana khona ngaphambili (`(pubic symphysis)`).

Into ebalulekile ukuthi, ngaphansi kwalo `(umugqa we-arcuate)`, ingxenye engezansi yomsipha wakho we-`(rectus abdominis)` imbozwe kuphela yi-`(Rectus Sheath)` ngaphambili. Akukho `(posterior rectus sheath)` ngemuva! Lokho kusho ukuthi ayikho i-sheath enjalo yokuvikela ingxenye engezansi yomsipha we-`(rectus abdominis)`. Khumbula lokhu, ngoba lokhu kubalulekile esimweni se-`(Rectus Sheath Hematoma)` esikhuluma ngaso.

Ngakho-ke kuyini `(Rectus Sheath Hematoma)`?

Kalula nje, i-`(Hematoma)` iyiqoqo legazi ngaphakathi kwezicubu zakho. Manje, uma i-`(epigastric arteries)` ngaphakathi kwe-`(Rectus Sheath)` esikhulume ngayo ekuqaleni iqala ukuphuma igazi ngandlela thile, lelo gazi lingaqongelela kuleyo ndawo yesisu sakho. Leli qoqo legazi libizwa ngokuthi i-`(Rectus Sheath Hematoma).`

Kulesi simo, ukuphuma kwegazi, ikakhulukazi okuvela emthanjeni we-epigastric ongaphansi, kungaba kubi kakhulu. Ngoba, njengoba sishilo ngaphambili, akukho ukumbozwa ngaphansi komugqa we-arcuate, futhi uma igazi liqala ukugeleza lisuka lapho, akukho zicubu zokuvimba igazi ukuthi lingasabalali. Ngakho-ke, igazi eliningi lingaqongelela.

Ubani othinteka kakhulu yilesi simo?

I-Rectus Sheath Hematoma ivame kakhulu kwabesifazane kunakwabesilisa, futhi ivame kakhulu nakubantu abaneminyaka engaphezu kwengu-60 .

Sivame kangakanani lesi simo?

I-Rectus Sheath Hematoma empeleni iyisimo esingavamile kakhulu . Sithinta kuphela i-1% kuya ku-2% yeziguli ezizwa ubuhlungu besisu. Ngakho-ke, ungase ungazwa ngakho njalo.

Ziyini izimpawu?

Uphawu oluvame kakhulu lwalesi simo ubuhlungu besisu . Lobu buhlungu:

• Ungaqala ngokushesha.
• Kungaba ubuhlungu obukhulu, obungabekezeleleki.
• Kungaba futhi ubuhlungu obungapheli.
• Ubuhlungu bungase bukhule uma uthuthumela, ugoba, noma ucindezela imisipha yesisu sakho.

Ngaphezu kwalokho, ngezinye izikhathi uma uthinta isisu sakho, ungase uzizwe sengathi kukhona okufana neqhubu .

Ezinye izimpawu ezingase zibonakale zifaka:

• Isicanucanu nokuhlanza
• Imfiva
• Isikhumba esiluhlaza okwesibhakabhaka noma ukuklwebheka (ikakhulukazi esiswini)
• I-anemia (okusho ukwehla komthamo wegazi)
• Ukwanda kwesilinganiso senhliziyo (i-tachycardia)
• Umfutho wegazi ophansi (i-hypotension)

Yini ebangela lokhu?

Imbangela eyinhloko ye-'Rectus Sheath Hematoma' ukuphuma kwegazi ku-'(Rectus Sheath).' Lokhu kuvame ukwenzeka uma kukhona uhlobo oluthile lokulimala odongeni lwesisu .

Kalula nje, lesi simo singase senzeke uma `(umthambo we-epigastric)`, imithambo yegazi emincane ephuma kuwo, noma umsipha we-`(rectus abdominis)` wonakele. Njengoba sishilo ngaphambili, imisipha yesisu inikezwa igazi yimithambo ye-`(epigastric)` ephezulu nengaphansi. Futhi, uma `(umthambo we-epigastric ongaphansi)` wonakele, isimo singaba sibi kakhulu, ngoba asinaso isivikelo ngemuva kwaso ngaphansi kwe-`(umugqa we-arcuate)`.

Cabanga nje, uma ushaywa ngqo esiswini sakho, noma uma ngokuzumayo usebenzisa amandla amaningi emisipheni yesisu (isibonelo, uma ukhwehlela kanzima isikhathi eside, noma uma ucindezela isisu sakho ngenkathi uphakamisa into esindayo), lo `(umthambo we-epigastric)` ungaqhuma bese uqala ukopha, wakhe `(i-hematoma)`.

Yiziphi izinto ezibangela lokhu?

Isici esikhulu sengozi yokuthola i-'Rectus Sheath Hematoma' ukusetshenziswa kwemithi evimbela ukujiya kwegazi (`(ama-anticoagulants)` noma ``ama-blood thinners``) . Cishe abantu abangu-70% abathola i-`Rectus Sheath Hematoma`` bathatha uhlobo oluthile lwemithi ``(ama-anticoagulant)``. Le mithi inciphisa inqubo yokopha, okwenza kube lula ukuthi i-``(hematoma)`` ivele.

Esinye isici esiyingozi esikhulu yisifo sezinso esingamahlalakhona . Cishe abantu abangu-60% abathola i-rectus sheath hematoma banesifo sezinso sesigaba sesi-3 noma ngaphezulu.

Ezinye izinto eziyingozi zifaka:

• Ukuhlinzwa kwesisu kwakamuva
• Ukusetshenziswa kwama-steroid noma imithi yokucindezela amasosha omzimba
• Ukukhwehlela okunzima kakhulu nokuqhubekayo
• Ukuthatha 'Ukwelashwa Okulwa Nezinhlayiya Zegazi' (umuthi ovimbela ama-platelet egazi ukuthi ahlangane ndawonye)
• Ukukhulelwa
• Izimo ezingapheli, njengomfutho wegazi ophakeme kanye ne-atherosclerosis (ukuncipha kwemithambo yegazi ngenxa yokugcwala kwamafutha ezindongeni zemithambo yegazi)

Okubalulekile: Uma uthatha imithi yokuvimbela ukuvuza kwegazi efana nale, kufanele uqaphele kakhulu uma uzwa ubuhlungu besisu ngokuzumayo.

Kwenziwa kanjani ukuxilongwa?

I-rectus sheath hematoma ngezinye izikhathi ingaba nzima ukuyixilonga, njengoba izimpawu zayo zingafana nezezinye izimo zesisu.

Udokotela wakho cishe uzoqala ngokukwenza ukuhlolwa kwegazi ukuze alinganise amazinga e-hemoglobin kanye ne-hematocrit yakho. Abantu abangaphezu kwengxenye abane-rectus sheath hematoma bazoba namazinga e-hemoglobin aphansi kakhulu (okusho ukuthi banevolumu yegazi ephansi).

Okulandelayo, udokotela wakho angenza i-ultrasound yodonga lwesisu sakho. Lokhu kungasiza ekunqumeni ukuthi kukhona yini uketshezi olufana negazi ngaphakathi kodonga lwesisu nokuthi i-hematoma inkulu kangakanani.

Ngezinye izikhathi, i-CT scan ingenziwa ukuze kutholakale isithombe esinembile nesicacile salesi simo. I-CT scan, ikakhulukazi esebenzisa idayi yokuhlukanisa, ingabonisa ngqo ukuthi idayi ivuza kuphi emthanjeni wegazi owonakele. Lokhu kungasiza nodokotela ukuthola ukuthi ukuphuma kwegazi kuvelaphi.

Iphathwa kanjani?

Izindaba ezinhle ukuthi ama-hematomas amaningi e-rectus sheath ayaziphulukisa ngokwawo futhi awadingi ukwelashwa okukhethekile. Ukwelashwa kwalesi simo kuvame ukufaka:

• Ukusebenzisa amaphakethe eqhwa (iqhwa noma ama-compress abandayo)
• Ukuphumula
• Ukusebenzisa izidakamizwa ezivamile zokunciphisa ubuhlungu (`(izidakamizwa zokunciphisa ubuhlungu)`)

Cishe ama-80% ama-rectus sheath hematomas aphulukiswa ngokwelashwa okulula kanje.

Kodwa-ke, uma lezi zindlela zokwelapha ezilula zingasizi, noma uma isimo sibi kakhulu, udokotela angase asebenzise ukwelashwa okubizwa ngokuthi "i-angioembolization." Lokhu akusikho ukuhlinzwa. Kuhilela ukuhlanganisa "i-angiography" (indlela yokuthatha izithombe zemithambo yegazi) kanye "ne-embolization" (indlela yokuvala umthambo wegazi), ukuthola umthambo wegazi bese uwuvala.

Uma le ndlela ethi "angioembolization" ingaphumeleli, ukuhlinzwa kungadingeka njengendlela yokugcina. Ngesikhathi sokuhlinzwa, ihlule legazi eliqongelelekile (``hematoma``) liyasuswa bese umthambo ophuma igazi uvalwa.

Ngesikhathi sokwelashwa nangemva kokwelashwa, udokotela wakho uzoqapha isimo sakho ngokuhlolwa kwegazi kanye ne-ultrasound. Lokhu kungasiza ekutholeni noma yikuphi ukuphinda kokuphuma kwegazi noma ukutheleleka.

Kuzokwenzekani ngokulandelayo? Ingabe uzolulama?

Iningi lama-rectus sheath hematomas liphela ngokuzenzakalelayo zingakapheli izinyanga ezimbili kuya kwezintathu . Iningi labantu abathola lesi simo bayalulama kahle futhi ababi nezinkinga ezengeziwe.

Kodwa-ke, kwezinye izimo - ikakhulukazi phakathi kwabantu abathatha ama-anticoagulant - lesi simo singaba yingozi . Kodwa-ke, asivamile kakhulu. Ngokusho kwedatha yakamuva, abantu abangaphansi kuka-2% bafa ngenxa ye-Rectus Sheath Hematoma.

Njenganoma yisiphi isimo sezokwelapha, ukuxilongwa kusenesikhathi kanye nokwelashwa kusenesikhathi kwandisa amathuba okululama . Ngakho-ke, uma ucabanga ukuthi unezimpawu ze-'Rectus Sheath Hematoma', qiniseka ukuthi ucela iseluleko sezokwelapha.

Okokugcina, izinto okufanele uzikhumbule

I-`(Rectus Sheath)` yakho iyisivikelo esibalulekile esivikela izitho, izicubu, kanye nemithambo yegazi odongeni lwakho lwesisu. Uma udonga lwakho lwesisu lulimele nganoma iyiphi indlela, `(umthambo we-epigastric)` ungaqhuma futhi ubangele `(Rectus Sheath Hematoma)`.

Esikhathini esiningi, lesi simo asidingi ukwelashwa okukhulu. Izinto ezilula njengokufaka iqhwa, ukuphumula, kanye nokuthatha imithi yobuhlungu kungasiza.

Kodwa-ke, ezinye izimo zingaba zimbi kakhulu. Uma unezinhlungu zesisu ezinzima, ezingazelelwe, kuhlale kuwukuhlakanipha ukubona udokotela ukuze anqume ukuthi udinga ukwelashwa yini. Ungesabi, kodwa kubalulekile ukuthi wena nomndeni wakho niqaphele lezi zinto.

I - Hematoma ye-Rectus Sheath, ubuhlungu besisu, ukopha kwesisu, umthambo we-epigastric, ama-anticoagulant, isisindo sesisu, ubuhlungu besisu