Muaj tsawg tsis paub tias ib tug neeg cov ntshav ntws los ntawm cov hlab ntsha thiab cov hlab ntsha. Ob leeg yog dispersed thoob plaws hauv lub ntim ntawm lub cev, ib txhia ntawm lub heev nto ntawm daim tawv nqaij, lwm leej lwm tus tob nyob rau hauv nws. Nws tsis yog yooj yim los kuaj xyuas cov teeb meem nrog cov hlab ntsha sib sib zog nqus, txij li cov tsos mob sab nraud ntawm tus kab mob tsis muaj zog. Ntau cov tsos mob tuaj rau kev pab ntawm cov kws kho mob - Homans thiab Mauxes, Lowenberg thiab Louvel, Opitz thiab Ramines. Txhua tus ntawm lawv yog lub cim qhia tias ib yam dab tsi tsis ncaj ncees lawm ntawm cov hlab ntsha. Txhawm rau kom paub meej qhov kev kuaj mob, muaj qhov nyuaj, tab sis kev kuaj mob kom raug, txawm li cas los xij, vim li cas thiaj mus ntsib kws kho mob, raws li txoj cai, yog thawj zaug, thawj cov tsos mob. Lawv yog dab tsi, lawv qhia lawv tus kheej li cas thiab lawv hnyav npaum li cas? Cia peb kawm saib.
Dab tsi yog cov ntshav txhaws txaus ntshai
Ua ntej peb tham txog Mauxes cov tsos mob thiab lwm yam tsos mob, cia peb qhia meej txog qhov xwm txheej ntawm cov ntshav txhaws. Qhov tseeb, cov no yog cov ntshav txhaws uas tshwm sim hauv cov hlab ntsha vim muaj kev cuam tshuam hauv hemostasis. Lawv tuaj yeem txav mus los ntawm lub nkoj lossis txuas lawv tus kheejrau nws phab ntsa. Thaum xub thawj, cov hlab ntsha feem ntau me me, tab sis lawv tuaj yeem loj hlob vim tias cov kab mob thrombotic ua rau lawv dhau sijhawm.
Muaj ib lub sijhawm thaum cov thrombus loj hlob tag nrho txhaws lub nkoj, uas tsis muaj kev ceev ceev tuaj yeem ua rau tuag taus. Tab sis qhov kaw ntawm lub nkoj los ntawm 70-75% yog fraught nrog cov teeb meem loj, uas yog, qhov txo qis ntawm cov pa oxygen mus rau cov ntaub so ntswg mus rau theem tseem ceeb thiab cov khoom sib txuas ntawm cov khoom metabolic, uas ua rau qaug cawv. Thaum cov ntshav txhaws tsim nyob rau hauv tus neeg nyob hauv cov hlab ntsha, qhov kev kuaj mob yog thrombosis. Tus kab mob no paub txog 1/5 ntawm lub ntiaj teb cov pej xeem, thiab hauv cov txiv neej nws tshwm sim ntau dua li cov poj niam. Thrombosis tuaj yeem tshwm sim hauv txhua txoj hlab ntsha thiab cov hlab ntsha - hauv caj npab, hauv nruab nrog cev, hauv hlwb, tab sis feem ntau pom nyob rau hauv qis qis. Yog tias koj tsis saib xyuas tus kab mob, nws ua rau muaj teeb meem ua rau ntau txhiab tus neeg nyob hauv ib xyoos.
Ua rau cov ntshav txhaws hauv cov leeg ntawm sab qis
Vim li cas ib txhia thiaj ntshav txhaws thiab lwm tus tsis? Muaj ntau yam txaus ntshai ntawm no, thiab lawv txhua tus tau muab faib ua peb pawg - congenital, tau txais thiab sib xyaw. Mauxes cov tsos mob tseem ceeb sib npaug hauv txhua pab pawg. Congenital yam tseem ceeb rau qhov pib ntawm tus kab mob yog ib qho los yog lwm yam kev ua txhaum ntawm hemostasis thiab kev hloov pauv ntawm qib caj ces.
Ntawm cov uas yuav yog cov hauv qab no:
- Advanced age;
- cev xeeb tub;
- ceg raug mob (piv txwv li pob txha);
- rog;
- ceg phais;
- siv qee yam tshuaj tiv thaiv kab mob;
- lub cev tsis ua haujlwm;
- hormonal ntshawv siab;
- benign ntshav qog (polycythemia);
- mob qog nqaij hlav ntawm pancreas;
- qee yam tshuaj;
- plaster overlay;
- lub xub ntiag ntawm ib tug catheter nyob rau hauv nruab nrab leeg;
- kab mob.
YThrombophlebitis
Moses 'cov tsos mob yog ib qho cim ntawm tsis yog tsuas yog thrombosis, tab sis kuj thrombophlebitis - ib qho mob uas ua ke tsim cov ntshav txhaws thiab o ntawm cov leeg. Cov laj thawj rau nws tshwm sim yog:
- thrombophilia (xav kom tsim cov ntshav txhaws);
- kab mob sib kis;
- vein raug mob;
- ua txhaum ntshav ntws;
- ua xua;
- hloov ntshav muaj pes tsawg leeg;
- rog dhau;
- ntshav siab.
Thrombophlebitis tuaj yeem mob thiab mob ntev. Nws ua rau muaj kev phom sij loj tshaj plaws thaum ib feem ntawm cov ntshav txhaws tawm, nkag mus rau hauv lub plawv lossis cov hlab ntsha pulmonary nrog cov ntshav ntws. Qhov tshwm sim yog nyob ntawm qhov loj ntawm qhov tawg thiab qhov nrawm ntawm kev ua.
Sim pom ntawm cov leeg txhaws
Kev xav tias qhov mob thrombosis tau pib hauv cov hlab ntsha tob ntawm ob txhais ceg yog pab tsis yog los ntawm Mauxes cov tsos mob xwb. Tus kab mob kuj muaj cov tsos mob hauv qab no:
- limb o;
- kev hnov qhov tsis xis nyob, ua kom puv, mob ntawm ceg;
- kub siab (tsis tas yuav tshwm sim).
Yog cov ntshav txhaws txhaws cov hlab ntsha ze rau ntawm daim tawv nqaij, qhov pib ntawm qhov teeb meemunmistakably txiav txim visually los ntawm o cov leeg, ib tug yam ntxwv mesh nyob rau hauv ib tug teeb meem cheeb tsam, ib tug kev hloov nyob rau hauv nws kev ntxhib los mos thiab xim. Yog tias cov ntshav txhaws txhaws cov hlab ntsha sib sib zog nqus, cov cim qhia sab nraud tsis txawv, ntxiv rau lawv yuav qhia tau tias muaj lwm yam kab mob, piv txwv li, o ntawm cov extremities tshwm sim nrog lub plawv tsis ua hauj lwm, qhov mob muaj kev raug mob. Yog li ntawd, cov kws kho mob, ua kev soj ntsuam kuaj mob, coj mus rau hauv tus account cov cim tshwj xeeb ntawm cov hlab ntsha sib sib zog nqus thrombosis nyob rau hauv cov nyuj thiab sab ceg.
Yog tias thrombosis tshwm sim nyob rau hauv cov hlab ntsha ntawm sab sauv thib peb ntawm tus ncej puab, tus neeg mob yuav hnov mob nyob rau hauv qis rov qab, sacrum, nyob rau hauv inguinal cheeb tsam. Ib qho ntawm cov cim qhia ntawm pathology yuav yog qhov kub thiab txias. Nyob rau tib lub sijhawm, cov tsos mob ntawm Mauxes thiab lwm yam kev mob tshwm sim hauv cov kab lus no tsis tuaj. Qee lub sij hawm cov ntshav txhaws hauv cov leeg ntawm tus ncej puab ua rau tsis muaj tsos mob dab tsi, thiab tus kab mob tau paub lig dhau lawm, thaum lub ntsws pulmonary embolism twb tshwm sim lawm.
Hmoob thiab Mauxes cov tsos mob
Kev kuaj mob raws li Homans suav tias yog tus yam ntxwv tshaj plaws thiab yog raws li hauv qab no. Tus neeg mob pw ntawm lub rooj zaum ntawm nws nraub qaum. Lub taub hau nyob rau tib theem nrog lub cev (tsis muaj lub hauv ncoo). Tus neeg mob ob txhais ceg yuav tsum tau khoov me ntsis ntawm lub hauv caug. Tus kws kho mob khoov ko taw ntawm nws ko taw hauv pob taws pob taws los ntawm sab nraub qaum. Ntxiv mus, yog tias muaj thrombosis nyob rau hauv cov hlab ntsha ntawm ob txhais ceg mus txog rau hauv lub hauv caug, tus neeg mob muaj ib tug ntse mob nyob rau hauv cov leeg nqaij ntawm cov nyuj.
Moses 'cov tsos mob yog lwm txoj hauv kev kuaj mob ntawm cov hlab ntsha sib sib zog nqus thiab thrombophlebitis. Nws muaj hauv qab no. Tus kws kho mob nyem tus neeg mob lub ceg qis rau pem hauv ntej thiab tom qab, thiab tom qab ntawd los ntawm ob sab. Yog tias thawj zaug muaj qhov mob hnyav, thiab qhov thib ob nws tsis tuaj, muaj qhov tshwm sim ntawm cov ntshav txhaws hauv cov leeg.
Lwm cov tsos mob ntawm kev kuaj mob
Rau kev ntseeg siab ntau dua rau qhov tseeb ntawm qhov kev kuaj mob ua ntej, cov kws kho mob siv qhov kev sim tsis yog rau Mauxes cov tsos mob xwb. Daim duab qhia txog kev npaj ua ntej kev xeem Lowenberg. Tus kws kho mob ua ntej palpates qhov teeb meem ntawm cov ceg ntawm tus neeg mob, tom qab ntawd muab tso rau ntawm lub sphygmomanometer cuff nyob rau hauv lub hauv paus qis ceg (nruab nrab thib peb) thiab inflates cua mus rau ib tug siab ntawm txog 150 mm Hg. Qhov mob hauv plab qhia tau tias muaj ntshav txhaws.
Koj tuaj yeem, kom paub meej, muab lub cuff rau ntawm tus ncej puab (qis thib peb), tsis yog ntawm sab ceg, thiab tseem tso cua rau hauv nws. Yog hais tias tib lub sij hawm mob tshwm sim nyob rau hauv lub plab mog, qhov no yuav yog ib tug tsos mob ntawm Opitz-Raminetz.
Qee zaum, cov neeg mob muaj mob plab thaum hnoos lossis txham. Qhov no kuj yog ib qho cim ntawm thrombosis, hu ua Louvel cov tsos mob, tab sis ntawm tag nrho nws yog yam tsawg kawg nkaus tus yam ntxwv.
Kev kuaj mob kom raug
Yog tias tus neeg mob xav tias muaj cov hlab ntsha sib sib zog nqus lossis thrombophlebitis, tab sis cov tsos mob ntawm Homans thiab Mauxes tsis zoo, tus neeg mob raug qhia kom kuaj xyuas ntxiv. Nws txoj kev:
- Ultrasound (dopplerography, sonoelastography);
- MRI;
- kuaj ntshav (kev kuaj hemostasis).
Yog tus neeg mob o thiabmob ntawm sab ceg, tab sis tsis muaj cov tsos mob saum toj no, qhov no yuav yog ib qho teeb meem ntawm lwm yam kab mob, piv txwv li, qhov tshwm sim ntawm kev raug mob, lub plawv tsis ua hauj lwm, arthrosis thiab lwm yam. Kev kuaj mob kom raug thiab tau ua tiav txhawm rau txhawm rau txhawm rau txhawm rau txhim kho qhov teeb meem ntawm ko taw.
Kev kho mob
Nws yog ib qho tseem ceeb heev kom kuaj pom cov hlab ntsha sib sib zog nqus nyob rau theem pib ntawm tus kab mob, uas, tau kawg, tau pab los ntawm cov txheej txheem yooj yim tshaj plaws ntawm kev kuaj mob, xws li Homans cov tsos mob thiab Mauxes cov tsos mob. Kev kho mob yog muab los ntawm kws kho mob, coj los ntawm kev kuaj mob, nrog rau cov txiaj ntsig ntawm kev kuaj mob kom raug. Yog tias tus txheej txheem tsis ua haujlwm, txoj kev kho yuav raug txwv rau txoj kev khaws cia:
- siv cov tshuaj pleev rau thaj tsam teeb meem ("Hepanol", "Heparin", "Nise" lossis "Indovazin"), uas txo qhov mob, txo qhov mob, tiv thaiv kev tsim cov ntshav txhaws;
- noj cov tshuaj tiv thaiv coagulants uas yaj cov ntshav txhaws thiab ntxuav lub txaj ntawm cov leeg;
- physiotherapeutic cov txheej txheem (UHF thiab magnetotherapy los txo qhov o, electrophoresis nrog cov tshuaj kom yaj cov ntshav txhaws sai li sai tau);
- hirudotherapy (leeches txhaj tshuaj rau hauv cov ntshav uas tiv thaiv kom tsis txhob txhaws thiab ua kom cov ntshav ntws zoo);
- elastic compression (hnav tshwj xeeb cov hnab looj tes thiab nruj).
Ib yam tseem ceeb ntawm kev kho mob yog pw so.
Raws li cov lus qhia, kev ua haujlwm me me (txiav ntawm cov hlab ntsha hauv cov tshuaj loog hauv zos) tau ua rau ntawm sab qis kom tshem tawm cov ntshav txhaws.
Yog kuaj pom muaj kev hem thawj ntawm thromboembolism(kev thaiv) ntawm cov hlab ntsha pulmonary, tus neeg mob tau ua haujlwm tam sim ntawd.
Kev Tiv Thaiv
Qhov tseeb - txhua yam kab mob yooj yim tiv thaiv dua li tshem tawm. Txhawm rau tiv thaiv kom tsis txhob kis tus kab mob thrombosis thiab cov tsos mob ntawm Mauxes, Homans thiab lwm yam tshwm sim, koj yuav tsum tau ntxiv dag zog rau koj cov leeg. Muaj ntau txoj hauv kev los ua qhov no thiab lawv tsuas yog ua haujlwm zoo hauv kev sib xyaw ua ke. Nov yog:
- noj;
- tawv (dawb sib piv, taug kev taw, ua luam dej);
- kev ua kom lub cev tsim nyog;
- ko taw huv si;
- hnav compression stockings (tshwj xeeb tshaj yog thaum ya);
- zam hypothermia ntawm ob txhais ceg thiab lawv hyperfatigue;
- tshuaj ntsuab uas pab txo qhov mob thiab ntxiv dag zog rau cov phab ntsa ntawm cov hlab ntsha.
