Lub hauv siab tsis xis nyob tuaj yeem tshwm sim ntawm nws tus kheej thiab qhia tias muaj teeb meem hauv ib lossis ntau lub cev. Ntawm cov kws kho mob, qhov mob hauv siab hu ua thoracalgia. Tawm tsam keeb kwm yav dhau los ntawm tus mob no, muaj kev ua pa nyuaj, nrog rau kev txwv ntawm lub cev muaj zog. Kev mob hnyav tuaj yeem qhia txog kev txhim kho ntawm lub plawv nres, yog li nws tseem ceeb heev kom nrhiav kev pab raws sijhawm.
mob hnyav nyob rau hauv lub sternum yog ib tug yam ntxwv tsos mob ntawm ntau yam kab mob. Hauv qhov no, qhov mob syndrome tuaj yeem qhia ob qho tib si pib ntawm cov txheej txheem pathological thiab exacerbation ntawm tus kab mob uas twb muaj lawm.
pain localization
Ib qho tseem ceeb hauv kev kuaj mob sib txawv ntawm lub hauv siab tsis xis nyob yog qhov kev txiav txim siab ntawm qhov mob hauv cheeb tsam. Hauv cheeb tsam no, qhov mob tuaj yeem tshwm sim ntawm sab xis, sab laug, thiab tseem nyob hauv nruab nrab, nruab nrab ntawm lub xub pwg hniav lossis hauv qab lawv. Lub hauv siab cheeb tsam muaj cov hlab ntsha thiabpaj hlwb xaus, yog li qhov mob tuaj yeem tawg mus rau ntau qhov chaw ntawm lub cev. Thoracalgia tuaj yeem tshwm sim los ntawm kev rub cov kev xav ib txhij hauv lub hauv siab thiab ib qho ntawm caj npab. Kev ntseeg ib txwm hais tias qhov tshwm sim ntawm qhov tsis xis nyob hauv lub hauv siab ntawm sab laug yog ib qho cim ntawm kab mob plawv yog yuam kev. Nyob deb ntawm qhov mob ib txwm hais txog teeb meem ntawm cov hlab plawv, nws yuav yog neuralgia.
Kab mob ntawm lub plawv thiab cov hlab ntsha: ua rau thiab cov tsos mob
Lub hauv siab tsis xis nyob tuaj yeem qhia tau tias muaj teeb meem plawv. Lub ntsiab pathologies ntawm cov hlab plawv system uas tuaj yeem ua rau pom qhov mob yog ob peb pawg kab mob.
1. Ischemia ntawm lub plawv ntawm angina pectoris hom. Qhov mob yog ntse, kub hnyiab, nyem thiab nias. Qhov mob hnyav ntawm qhov mob tuaj yeem tshwm sim los ntawm ib lub hlis twg ntawm ib feeb mus rau ib lub hlis twg ntawm ib teev. Kev hnov qhov tsis xis nyob hauv lub hauv siab ntawm sab laug lossis tom qab nws nyob hauv zos, qhov mob tuaj yeem muab rau sab laug caj npab, lub xub pwg hniav, caj dab, epigastrium. Tawm tsam keeb kwm ntawm angina pectoris zoo tib yam, qhov mob kis mus rau lub puab tsaig thiab cov hniav. Cov tsos mob tshwm sim nws tus kheej tom qab lub cev ua haujlwm ntawm ib qho kev siv zog. Nws tuaj yeem ua kis las, nce ntaiv, nqa hnyav, taug kev nrawm. Ib tug yam ntxwv feature ntawm theem ntawm kev loj hlob ntawm pathology yog hais tias ib tug tshiab nres yuav tsum tau tsawg thiab tsawg load. Txoj hauv kev zoo tshaj plaws los tiv thaiv kev tawm tsam ntawm angina pectoris yog noj "Nitroglycerin". Nws yuav txo qhov nro, txo qhov mob uas tshwm sim, thiab tseem pab txo qhov tsis xis nyob hauv lub mis sab laug.
2. plawv nresmyocardium. Kev mob tshwm sim rau thaj tsam tom qab lub sternum. Kev tawm tsam yuav kav ntev li 15 feeb, tab sis tuaj yeem kav ntev li ob peb teev. Kev tsis xis nyob hauv lub hauv siab sab laug yog qhov tshwm sim los ntawm kev kub hnyiab, nyem, nyem thiab tawg qhov hnov hauv. Myocardial infarction tuaj yeem txhim kho ob qho tib si tom qab kev tawm dag zog thiab nyob rau hauv lub xeev siab. Kev tawm tsam tuaj yeem pom ntau zaus thiab nyob hauv lub xub pwg hniav, nraub qaum, caj dab thiab caj npab. Cov cim qhia ntawm lub plawv nres yog xeev siab thiab ntuav, hyperhidrosis, ua tsis taus pa, arrhythmia, kev ntshai thiab kev ntxhov siab. "Nitroglycerin" hauv qhov no yuav tsis muaj zog.
3. Myocardial dystrophy thiab pericarditis. Hauv qhov no, ntxiv rau qhov mob, ua npaws, palpitations, ua tsis taus pa luv thiab tsaug zog yog tshwm sim. Qhov mob yog piav raws li stabbing, txiav, tshwm nyob rau hauv cheeb tsam tom qab lub sternum. Qhov mob syndrome tuaj yeem tawg mus rau lub xub pwg nyom, caj dab, epigastrium, nraub qaum thiab lub xub pwg nyom. Txhawm rau txo qhov kev siv ntawm qhov tshwm sim ntawm qhov mob yuav pab tau ib qho chaw zaum nrog me ntsis qaij ntawm lub cev rau pem hauv ntej. Koj tuaj yeem nres lub hauv siab tsis xis nyob nrog kev pab ntawm cov tshuaj uas tsis yog tshuaj narcotic.
4. Dissecting aortic aneurysm. Qhov mob zoo li lub plawv nres, tab sis qhov kev siv zog ntau dua. Qhov mob syndrome yog nyob rau hauv cheeb tsam tom qab lub sternum thiab muab rau lub plab mog, qaum thiab ceg. Qhov ua rau ntawm txoj kev loj hlob ntawm tus kab mob yog kev xav ntau dhau, kev siv lub cev ntau dhau ntawm lub cev, nrog rau kev poob qis hauv cov ntshav siab. Qhov mob yog dov thiab mob hauv qhov xwm txheej, yog paroxysmal, tuaj yeem kav ntev li ob peb hnub. Associated cov tsos mob ntawm aneurysm yogasymmetric mem tes, palpable ntawm carotid lossis radial hlab ntsha. Lub siab nyob rau hauv no pathology yog nquag poob, thaum cov ntsuas yuav txawv ntawm ob txhais tes. Qhov mob tsis yog ib txwm daws tau tom qab txhaj tshuaj loog ib zaug. Txawm li cas los xij, tej zaum yuav muaj lwm yam ua rau lub siab tsis xis nyob.
5. Thromboembolism nyob rau hauv cov hlab ntsha ntawm lub ntsws. Nws manifests nws tus kheej raws li ib tug pronounced mob syndrome nyob rau hauv lub hauv paus ntawm lub hauv siab, tab sis nyob rau hauv tej rooj plaub nws yog localized nyob rau hauv sab xis los yog sab laug cheeb tsam. Lub sijhawm ntawm kev tawm tsam yog tsawg kawg 15 feeb thiab tuaj yeem ncav cuag li ob peb teev. Thromboembolism yog nrog los ntawm kev txo qis hauv siab, ua pa luv, tsis nco qab. tshwm sim raws li qhov teeb meem tom qab kev phais ntawm cov hlab ntsha sib sib zog nqus. Nws muaj peev xwm tshem tawm qhov mob mob nkaus xwb nrog kev mob narcotic analgesics.
Ntxiv rau tag nrho cov saum toj no, ib qho kab mob ntawm lub plab zom mov tuaj yeem dhau los ua qhov tsim nyog rau qhov mob thiab tsis xis nyob hauv siab.
kab mob plab
Qee qhov pathologies ntawm txoj hlab pas tuaj yeem tshwm sim nrog mob hauv siab. Yog li, feem ntau ntawm lawv yog cov qog nqaij hlav, mob plab, gastroesophageal reflux, esophagitis, thiab lwm yam. Tag nrho cov pathologies no nyob rau hauv txoj hlab pas thiab tsiv mus rau sternum hauv cov txheej txheem nqos thiab dhau cov zaub mov los ntawm txoj hnyuv.
Ntxiv rau qhov tseeb tias lub sijhawm no muaj qhov tsis xis nyob hauv siab, cov cim qhia ntawm cov kab mob ntawm txoj hlab pas yog:
- xeev siab thiab ntuav;
- burp;
- xav qaub saj hauv qhov ncauj;
- siab kub;
- hlawv hauv thaj chaw epigastric.
Lwm kab mob uas ua rau mob hauv siab yog hernia nyob rau hauv lub diaphragmatic qhib ntawm txoj hlab pas. Nyob rau hauv cov ntaub ntawv no, cov kev xav zoo li angina pectoris, qhov mob syndrome yuav tshwm sim nyob rau hauv qis thib peb ntawm lub hauv siab, kab noj hniav los yog substrate. Ib tug yam ntxwv ntawm qhov mob ntawm txoj hlab pas hernia yog ib qho kev siv zog thaum zaum thiab pw, thaum sawv ntsug, qhov hnyav yuav txo qis lossis nres kiag li.
Kab mob ntawm txoj hlab pa
Kev tsis xis nyob hauv lub mis sab xis, nrog rau sab laug, tuaj yeem tshwm sim tawm tsam keeb kwm ntawm kev raug mob, pleurisy, pneumothorax, neoplasms thiab pulmonary infarction. Cov cim tseem ceeb ntawm cov teeb meem ua pa yog:
- mob ntev ntev, ua pa hnyav ntxiv;
- txhim kho ua tsis taus pa, tachycardia, cyanosis thiab qhov tsos ntawm hws txias;
- txo qis hauv cov hlab ntsha, pallor ntawm daim tawv nqaij;
- xav txog kev qaug zog.
Tawm tsam keeb kwm ntawm mob ntsws, qhov mob hnyav tuaj yeem tshwm sim, tig mus rau hauv kev sib tsoo thiab nrog rau cov tsos mob ntawm kev qaug cawv. Qhov txaus ntshai ntawm tus mob no yog lub ntsws abscess. Localization ntawm qhov mob tuaj yeem yog ob qho tib si hauv nruab nrab ntawm lub hauv siab, thiab sab xis thiab sab laug. Nyob rau hauv cov ntaub ntawv no, cov kev phiv tsis zoo nyob rau hauv daim ntawv ntawm chills, kub taub hau, kub siab tuaj yeem pom. Nrog rau qhov tshwm sim ntawm mob hauv siab tiv thaiv keeb kwm yav dhau los ntawm kev mob khaub thuas ntev,kub taub hau thiab hnoos heev, hu rau lub tsheb thauj neeg mob tam sim.
Kab mob ntawm cov kab mob vertebral
Feem ntau, qhov mob hauv siab tuaj yeem yog ib qho cim ntawm kev hloov pauv hauv cov pob txha caj qaum, thiab tseem qhia tau tias osteochondrosis lossis thoracic sciatica. Cov yam ntxwv ntawm vertebral pathologies yog:
- compressive, mob, kub hnyiab, ntev thiab nquag tshwm sim qhov mob hauv lub sternum;
- maj mam hloov ntawm qhov mob mus rau lub ncauj tsev menyuam thiab lub lumbar;
- mob hnyav zuj zus thaum nqa caj npab, nqa khoom hnyav, txav, khoov dua, nrog rau qhov zoo li qub ntawm lub cev;
- mob ntxiv nrog kev tshoov siab tob, palpation thiab lub taub hau qaij;
- daim duab kho mob tau txheeb xyuas nrog cov tsos mob ntawm ischemia;
- mob tau kho nrog tshuaj tua kab mob thiab mustard plasters;
- tawm tsam keeb kwm ntawm qhov mob, loog ntawm caj dab, mob taub hau thiab kiv taub hau;
- Nyob rau nruab hnub thiab tsaug zog tau pom.
kab mob vertebral tuaj yeem muaj ntau qhov tshwm sim thiab muaj teeb meem, yog li cov cim piav qhia yuav tsum tau ua tib zoo saib xyuas.
mob plab hauv poj niam
Ib yam kab mob uas tshwm sim los ntawm lub hauv siab tsis xis nyob hauv cov poj niam yog mastopathy. Qhov no pathology yog provoked los ntawm kev ua txhaum ntawm qhov sib piv ntawm epithelial thiab connective cov ntaub so ntswg, uas ua rau lub tsim ntawm cystic-fibrous focal.swb. Tawm tsam keeb kwm yav dhau los ntawm mastopathy, muaj kev ua txhaum ntawm cov ntshav ncig hauv cov hlab ntsha ntawm cov qog mammary, cov mis lobules yog deformed thiab paj hlwb receptors thiab ducts yog nyem. Tag nrho cov no ua rau congestion thiab exudation ntawm cov kua los ntawm ducts. Compression ntawm cov hlab ntsha xaus ua rau kom muaj kev ua haujlwm ntawm qhov mob. Kev kho mob mastopathy tshwm sim nrog kev siv tshuaj tshwj xeeb. Qee zaum, kev phais yuav raug txiav kom tshem tawm cov qog nqaij hlav hauv mammary.
Ntxiv rau mastopathy, mob hauv siab thiab tsis xis nyob hauv tus poj niam hauv thaj tsam ntawm cov qog mammary nyob rau hnub kawg ntawm kev coj khaub ncaws yuav qhia tau tias cev xeeb tub. Raws li txoj cai, mob nyob rau hauv cov ntaub ntawv no yog nrog los ntawm lawv o thiab kis thoob plaws hauv lub hauv siab. Qhov kev siv ntawm qhov mob nce nyob rau hauv txoj hauj lwm supine. Yog tias ib tug poj niam pom cov tsos mob no, tab sis nws yeej tsis xeeb tub, nws yuav tsum tau mus kuaj mob qog noj ntshav tam sim ntawd.
Kev phom sij thiab qhov tshwm sim tshwm sim
Nws yog qhov nyuaj heev los txiav txim siab qhov txaus ntshai ntawm qhov tsis xis nyob hauv siab thiab hauv caj npab. Qib ntawm kev pheej hmoo nyob ntawm qhov ua rau mob. Yog li, yog tias peb tab tom tham txog cov kab mob ntawm cov hlab plawv, ces nws yog ib qho tsim nyog yuav tsum tau ntsuas kev kub ntxhov, vim tias ncua sij hawm tuaj yeem ua rau muaj kev phom sij rau tib neeg lub neej. Xws li pathologies tuaj yeem ua rau thrombosis, mob stroke, thromboembolism thiab lwm yam kab mob hnyav dua.
Kev tsis txaus ntseeg hauv kev ua haujlwm ntawm lub plab zom mov thiab ua pa tsis muaj kev saib xyuas zoo tuaj yeem ua rau mob ntev, ua rau muaj teeb meem, suav nrogqhov tsos ntawm malignant qog thiab tuag. Cov teeb meem txha caj qaum tuaj yeem ua rau poob ntawm lub cev muaj zog, nrog rau cov leeg nqaij atrophy.
Yog tias koj muaj cov tsos mob hauv qab no, nrhiav kev kho mob tam sim:
- kev xav ntawm ploj mus hauv lub siab, nws qhov compression thiab tsis muaj cua;
- mob siab ua pa luv thiab hnov qhov hnyav hauv siab;
- hloov mob rau sab caj npab, nraub qaum thiab hniav;
- xeev siab thiab ntuav;
- mob kiv taub hau, ua pa ntau ntxiv thiab lub plawv dhia;
- nqos nyuaj, lub cev kub;
- ntshav siab hloov pauv;
- mob hauv siab thaum so;
- sib npaug thiab siv sijhawm ntev ntawm kev mob.
Kev tsis quav ntsej cov tsos mob tau piav qhia tuaj yeem ua rau tuag.
Tsuas yog tus kws kho mob tshwj xeeb uas tsim nyog tuaj yeem teb cov lus nug vim li cas lub hauv siab tsis xis nyob thiab qhov nws yuav qhia tau.
YKev kuaj mob ntawm pathology
Qhov xwm txheej ntawm qhov tshwm sim ntawm qhov mob hauv siab hauv ntau yam kab mob tsis txawv, yog li, ib kauj ruam tseem ceeb yog kev kuaj mob sib txawv. Kev ntsuam xyuas yuav tsum suav nrog ntau yam kev ntsuas sib txawv.
1. Sau ntawm anamnesis. Tus kws kho mob tshwj xeeb hais kom tus neeg mob piav qhia qhov mob ntawm qhov mob, nws qhov hnyav thiab lub sijhawm, nrog rau cov tsos mob tshwm sim, yog tias muaj. Tsis tas li ntawd, ib qho kev tshawb fawb txog cov kab mob uas twb muaj lawm.
2. Mloog thiab tapping lub plawv, hloov lub siab ntawm cov hlab ntsha, lub mem tes.
3. Electrocardiogram. Yog tias qhov kev tshawb fawb no qhia txog pathology ntawm lub plawv, tus neeg mob raug xa mus rau angiography, echocardiography thiab coagulogram. Txhua txoj hauv kev no tso cai rau kev ntsuas lub xeev ntawm lub plawv thiab cov hlab ntsha. Tsis tas li ntawd, cov roj (cholesterol) hauv cov ntshav tau saib xyuas txhua hnub.
4. X-ray ntawm lub hauv siab.
5. Ultrasound kuaj ntawm plab hnyuv thiab lwm yam kab mob.
6. Kev kuaj ntshav thiab zis.
Ntxiv rau, suav tomography thiab cov duab sib nqus resonance yuav raug sau tseg kom paub meej qhov kev kuaj mob.
Kev kho mob hauv siab
Txoj kev kho mob uas tus kws tshaj lij xaiv nyob ntawm qhov kev kuaj mob. Qee zaum, nws yuav tsum tau noj tshuaj los ntawm pab pawg ntawm cov tshuaj tiv thaiv kab mob, vasodilators lossis tshuaj tua kab mob, thiab lwm yam. Nyob ntawm qhov ua rau mob hauv siab, qee cov tshuaj tau sau tseg.
- Rau kev kho mob plawv pathologies - antiarrhythmics, beta-blockers, statins, ACE inhibitors, nitrates, anticoagulants.
- Rau kev kho mob ntawm cov teeb meem vertebral - chondroprotectors, cov tshuaj tsis-steroidal anti-inflammatory.
- Thaum mob hnyav, tshuaj narcotic thiab non-narcotic analgesics tuaj yeem raug tshuaj.
- Kev kho ntawm lub plab zom mov yog ua los ntawm kev noj tshuaj antacids thiab antispasmodics.
- Rau kab mob ntswsCov tshuaj tua kab mob, carbapenems, macrolides, thiab lwm yam.
Tiv thaiv kab mob
Txhawm rau tiv thaiv kev mob hauv siab, tsis hais qhov ua rau, tsis txhob coj tus cwj pwm phem thiab ua raws li kev tiv thaiv kev coj noj coj ua uas suav nrog kev noj qab haus huv, kev tawm dag zog, noj zaub mov kom zoo, zam kev ntxhov siab thiab mus ntsib kws kho mob raws sijhawm.
Thaum muaj qhov tsis xis nyob hauv lub hauv siab, nws yog qhov zoo tshaj plaws mus cuag tus kws kho mob tam sim ntawd, yog tias tsim nyog, yuav xa tus neeg mob mus rau tus kws kho mob tshwj xeeb. Nws tsis pom zoo kom sim ua kom tsis txhob mob hauv siab ntawm koj tus kheej, vim qhov no yuav ua rau mob nyuaj.
