Cov tsos mob ntawm intracranial siab yog dab tsi? Intracranial hypertension yog ib yam kab mob nyob rau hauv txoj kev loj hlob uas nce intracranial siab, nyob rau hauv lwm yam lus, nws yog nce intracranial siab. Muaj ntau ntau yam nyob rau hauv kev cuam tshuam ntawm cov xwm txheej zoo li no tuaj yeem tshwm sim. Nws tuaj yeem yog kab mob thiab mob hlwb, mob metabolic, lom.
Cov tsos mob
Cov tsos mob ntawm intracranial siab muaj xws li:
- mob taub hau;
- nausea;
- ntua;
- Kev ua txhaum ntawm kev ua haujlwm ntawm lub cev ntawm kev pom.
Tej zaum yuav muaj qhov tshwm sim ntxiv ntawm tus kab mob. Qhov hnyav ntawm cov tsos mob ntawm intracranial siab yog nyob ntawm qhov ua rau thiab qhov hnyav ntawm tus kab mob. Txhawm rau txheeb xyuas tus kab mob, nws yog qhov yuav tsum tau ua kom tiav kev kuaj mob. Nyob rau hauv tus txheej txheem ntawm kev kho mob, ob qho tib si conservative thiab phais txoj kev yog siv. Yog tias ib qho ntawm cov tsos mob ntawm intracranial siab tshwm sim, koj yuav tsum tauNrhiav kev kho mob tam sim ntawd vim kev noj tshuaj rau tus kheej tuaj yeem ua rau muaj teeb meem kev noj qab haus huv.
Kev faib tawm thoob ntiaj teb ntawm Kab Mob Code
Cov tsos mob ntawm intracranial siab (ICD-10 G93.2) suav nrog:
- migraine;
- xav kiv taub hau;
- ntuav.
Cov tsos mob ntxiv tuaj yeem tshwm sim. Nws tag nrho yog nyob ntawm qhov hnyav ntawm pathology. Raws li cov xwm txheej zoo li no, koj yuav tsum tsis txhob noj cov tshuaj uas tsis pom zoo los ntawm kws kho mob.
Cov tsos mob tseem ceeb ntawm intracranial siab hauv cov menyuam yaus (ICD-10 code G93.6) yog:
- cerebral edema;
- tus me nyuam quaj;
- pab nqus nqus reflex.
Nyob rau hauv cov xwm txheej zoo li no, nws yog ib qho tseem ceeb uas yuav tsum tau ua kom tiav kev kuaj mob ntawm cov crumbs thiab pib kho.
Qhov laj thawj tseem ceeb ntawm kev txhim kho tus kabmob
Tib neeg lub hlwb nyob rau hauv cov kab noj hniav cranial, qhov ntev uas tsis tuaj yeem hloov pauv. Nyob rau hauv lub pob txha taub hau nyob tsis tau tsuas yog lub paj hlwb, tab sis kuj cov cerebrospinal tshuaj thiab cov ntshav. Ua ke, cov qauv no tuav lub ntim tsim nyog.
Cerebrospinal kua tuaj yeem tsim nyob rau hauv kab noj hniav ntawm lub ventricle ntawm lub hlwb. Nws ntws raws cov kua cerebrospinal mus rau lwm qhov ntawm lub hlwb. Ib nrab absorbed rau hauv cov hlab ntsha thiab ntws mus rau hauv subarachnoid cheeb tsam ntawm tus txha caj qaum.
Ntshav ntws los ntawm cov hlab ntsha thiab cov hlab ntsha. Yog hais tias qhov ntim ntawm ib qho ntawm cov kua hauv lub cranial kab noj hniav nce, lub siab nyob rau hauv lub pob txha taub hau kuj yuav nce. Thaum muaj kev cuam tshuam hauv cov txheej txheem ncigcerebrospinal tshuaj tsub kom intracranial siab. Xws li qhov tshwm sim tuaj yeem tshwm sim nyob rau hauv qhov kev tshwm sim ntawm kev nce hauv kev tsim khoom thiab kev ua txhaum ntawm nws cov khoom tawm. Nrog stagnation ntawm cov ntshav hlab ntsha, cov txheej txheem ntawm cov ntshav ncig yog cuam tshuam. Yog tias qhov o tshwm sim vim kev loj hlob ntawm cov qog, ces qhov ntim ntawm cov ntaub so ntswg ntawm lub hlwb nce.
Raws li qhov kev txiav txim siab, peb tuaj yeem hais tias qhov xwm txheej zoo li no tuaj yeem tshwm sim rau ntau qhov laj thawj. Tsuas yog tom qab kuaj xyuas kom zoo, tus kws kho mob tuaj yeem txheeb xyuas qhov xwm txheej uas cuam tshuam rau kev loj hlob ntawm tus kab mob.
Ntawm cov laj thawj tseem ceeb ntawm intracranial siab yog:
- mob hlwb raug mob - concussion, bruise, intracranial hematoma, yug raug mob;
- mob plawv - mob lossis mob ntev (stroke, thrombosis);
- kev loj hlob ntawm cov qog hauv pob txha taub hau lossis nws cov metastasis mus rau lwm cov ntaub so ntswg;
- txheej txheem mob - nrog encephalitis, meningitis, abscess, intracranial siab yuav nce;
- congenital anomaly ntawm lub hlwb hlab ntsha, pob txha taub hau;
- tshuaj lom thiab kab mob metabolic;
- pathologies ntawm cov kabmob sab hauv uas cuam tshuam cov ntshav ncig.
Muaj lwm yam laj thawj uas yuav ua rau mob ntshav siab. Cov neeg mob feem ntau kuaj pom tias muaj benign intracranial siab. Nrog rau qhov kev kuaj mob no, lub siab nyob rau hauv lub pob txha taub hau tshwm rau tsis muaj laj thawj, yog li muaj kev kho mob zoo. Qhov tseem ceeb tshaj plaws yog nrhiav kev pab los ntawm tus kws tshaj lij uas tsim nyog raws sijhawm.
Vim yog nce intracranial siab, lawv raug nyempaj hlwb, uas cuam tshuam lawv txoj haujlwm. Intracranial ntshav siab tuaj yeem tshwm sim nws tus kheej nyob rau hauv daim ntawv ntawm arching diffuse mob taub hau thiab tsis xis nyob rau hauv lub taub hau - hnov thaum hmo ntuj los yog sawv ntxov, qhov mob ntawm ib tug dull xwm, uas yog nrog los ntawm ib tug zoo siab ntawm lub qhov muag los ntawm sab hauv.
Tus neeg mob qhov kev noj qab haus huv hloov pauv li cas hauv cov txheej txheem ntawm kev txhim kho pathology?
Qhov ua rau thiab cov tsos mob ntawm intracranial siab yuav tsum tau tham nrog tus kws kho mob vim tias txhua yam nyob ntawm tus neeg mob. Thaum hnoos, txham, straining, tawm dag zog lub cev, mob hnyav zuj zus.
Ntxiv ntxiv tshwm:
- kiv taub hau. Yog hais tias intracranial siab nce me ntsis, ces hnyav nyob rau hauv lub taub hau, xeev siab thiab ntuav. Cov tsos mob no tuaj yeem tshwm sim sai sai. Kev ntuav pib tsis hais txog qhov ua rau sab nraud. Feem ntau, gag reflex tshwm sim vim mob taub hau loj. Cov tsos mob tsis zoo li no tsis cuam tshuam nrog kev noj zaub mov. Kev ntuav tuaj yeem muaj zog thiab zoo li tus ciav. Tom qab ntawd, tus neeg mob tsis hnov mob, mob taub hau tsis txo.
- Muaj kev qaug zog thiab qaug zog thaum lub hlwb lossis lub cev tawm dag zog. Nyob rau hauv cov xwm txheej zoo li no, kev ntxhov siab tsis txaus ntseeg, kev xav tsis txaus ntseeg, kev chim siab thiab kua muag tshwm sim.
- Meteosensitivity yog ib qho tsos mob ntawm intracranial siab. Nyob rau hauv cov ntaub ntawv no, tus neeg mob tsis zam lub atmospheric siab poob thiab cov tsos mob ntawm tus kab mob hnyav.
- Nyob zooua txhaum cai. Manifested nyob rau hauv daim ntawv ntawm hws, siab poob, palpitations.
- Impaired pom - cov duab yog fuzzy thiab qhov muag plooj. Nyob rau hauv tus txheej txheem ntawm txav lub pob muag, muaj mob hnyav thiab tsis xis nyob.
Qhov hnyav ntawm cov tsos mob ntawm intracranial siab nyob rau hauv cov neeg laus yog nyob ntawm qhov hnyav ntawm tus kab mob thiab tus yam ntxwv ntawm tus neeg mob. Nyob rau hauv tus txheej txheem ntawm kev loj hlob ntawm pathological mob, qhov tshwm sim ntawm intracranial siab nce.
Yuav muaj teeb meem dab tsi tshwm sim?
Yog tias kev kho tsis tau zoo tsis ua raws sijhawm, muaj teeb meem tshwm sim, uas tshwm sim lawv tus kheej li:
- tawv ncauj, txhua hnub, ntuav thaum sawv ntxov tiv thaiv keeb kwm ntawm mob taub hau;
- hnub tom qab ntuav, tuaj yeem tshwm sim hnyav, uas ua rau tsis xis nyob thiab cuam tshuam rau lub neej ib txwm;
- nce kev nyuaj siab ntawm kev puas siab puas ntsws ua haujlwm - lethargy tshwm, muaj kev ua txhaum ntawm kev nco qab, muaj kev nce ntshav siab;
- kev nplawm tshwm sim.
Yog tias ib qho ntawm cov tsos mob ntawm intracranial siab tshwm sim rau cov neeg laus lossis menyuam yaus, nws yog ib qho tseem ceeb kom hu rau lub tsheb thauj neeg mob tam sim ntawd lossis mus rau tsev kho mob, raws li cov cim qhia tias muaj teeb meem tshwm sim tuaj yeem ua rau tuag taus.
Cov tsos mob ntawm tus kab mob qhia tias qhov tshwm sim ntawm cerebral edema loj tuaj. Nyob rau hauv cov xwm txheej zoo li no, kev ua txhaum cai tuaj yeem tshwm sim, uas feem ntau ua rau tus neeg mob tuag. Yog tsis raws sijhawmmus ntsib kws kho mob, cov txheej txheem ntawm qhov muag tsis pom kev nce zuj zus.
Ua ntej tshaj plaws, tus kws tshaj lij yuav tsum saib cov nyiaj txiag. Nyob rau hauv lub fundus, nrog ophthalmoscopy, tus kws kho mob yuav qhia ib tug congestive optic paj hlwb taub hau thiab nws edema. Tej zaum qhov me me hemorrhage hauv cheeb tsam no. Yog hais tias xws li ib tug tshwm sim ntawm intracranial hypertension tshwm sim nyob rau lub sij hawm ntev, ces qhov zoo ntawm qhov muag tsis pom kev, thiab lub lo ntsiab muag tsis pab daws qhov teeb meem. Vim yog atrophy ntawm lub paj hlwb, ua tiav qhov muag tsis pom kev tshwm sim.
Nyob rau hauv tus txheej txheem ntawm kev tsim intracranial hypertension, pob txha hloov tau tsim. Lub phaj ntawm pob txha taub hau tuaj yeem ua nyias, thiab sab nraub qaum ntawm lub eeb Turkish tuaj yeem tawg. Nyob rau hauv lub xub ntiag ntawm phenomena ntawm nce intracranial siab, tej zaum yuav tsis muaj kev ua txhaum cai. Tsis tshua muaj, tus kws kho mob pom qhov kev txwv ntawm kev tshem tawm ntawm lub qhov muag mus rau sab, kev hloov pauv ntawm kev xav, kev ua txhaum ntawm kev txawj ntse. Tab sis cov tsos mob zoo li no tsis yog qhov tshwj xeeb, uas yog, lawv tsis tuaj yeem qhia tus kab mob tshwj xeeb.
Cov kws kho mob cov lus pom zoo
Txhawm rau txiav txim siab qhov muaj tus mob, nws yog qhov yuav tsum tau ua qhov kev ntsuam xyuas tag nrho ntawm lub cev ntawm tus neeg mob. Hauv tsev, nws tsis tuaj yeem txiav txim siab txog qhov muaj lossis tsis muaj tus kabmob, yog li nws yog ib qho tseem ceeb uas yuav tsum tau sab laj nrog kws kho mob raws sijhawm. Thaum pib ntawm txoj kev loj hlob ntawm tus kab mob, kev kho mob sai dua thiab zoo dua. Txhawm rau tiv thaiv kev phais mob, koj yuav tsum mus ntsib cov neeg ua haujlwm kho mob uas tsim nyog rau lub sijhawm thiab kuaj xyuas.
ntsuas ntsuas
Yog muaj ib qhov tsis txaus ntseegnce intracranial siab, ib tug xov tooj ntawm kev kuaj ntxiv yog xav tau. Cov txheej txheem sau cov lus tsis txaus siab, anamnesis thiab kuaj los ntawm tus kws kho mob hlwb tsis txaus. Ua ntej tshaj plaws, koj yuav tsum mus ntsib tus kws kho qhov muag. Tus kws kho mob tshuaj xyuas lub fundus. Ua tsaug rau kev suav tomography thiab magnetic resonance imaging, koj tuaj yeem txheeb xyuas cov pob txha ntawm pob txha taub hau thiab ntsuas nws tus mob. Raws li kev kuaj mob tau txais, nws tuaj yeem txheeb xyuas qhov ua rau muaj qhov nce siab hauv pob txha taub hau.
Nrog kev pab ntawm tus txha caj qaum thiab ib qho cuab yeej tshwj xeeb, lub siab tau ntsuas ntau xyoo dhau los. Niaj hnub no, cov kws kho mob tsis siv txoj kev kuaj mob no, vim lawv xav tias nws tsis tsim nyog.
Thaum tus kws kho mob kuaj tus neeg mob, kev kho mob tuaj yeem pib. Raws li cov txiaj ntsig ntawm txoj kev tshawb fawb, suav nrog tus kheej thiab cov yam ntxwv ntawm lub cev ntawm tus neeg mob lub cev, tus kws kho mob tau sau cov tshuaj uas yuav pab ua kom lub siab nyob hauv lub pob txha taub hau. Feem ntau, intracranial siab tsis yog ib qho kab mob ywj pheej. Xws li ib tug pathological mob tshwm sim vim muaj lwm yam kab mob. Ua ntej tshaj plaws, kev kho tus kab mob tseem ceeb yuav tsum tau pib. Yog hais tias tus kws kho mob tau pom ib tug neoplasm nyob rau hauv lub hlwb los yog ib tug intracranial hematoma nyob rau hauv ib tug neeg mob, ces nws yog ib qho tseem ceeb rau kev kho mob phais.
Vim tshem tawm cov qog lossis cov kua dej ntau dhau, kev noj qab haus huv ntawm tus neeg mob txhim kho thiab intracranial siab normalizes. Raws li cov xwm txheej zoo li no, koj tuaj yeem ua yam tsis muaj kev ua si nrog.
Yog intracranial siab nce los ntawmyog vim li cas rau kev loj hlob ntawm encephalitis thiab meningitis, ces koj yuav tsum tau noj tshuaj tua kab mob. Nrog txhua yam extraction ntawm cerebrospinal tshuaj, intracranial siab txo.
Cov tshuaj uas txo qis intracranial siab tuaj yeem txhim kho kev noj qab haus huv tag nrho ntawm tus neeg mob. Nws yog nrog pab pawg ntawm cov tshuaj no uas txoj kev kho mob benign intracranial siab pib.
Qhov tseem ceeb ntawm kev kho mob
Nyob rau hauv neurology, cov tsos mob ntawm intracranial siab tshwm sim nyob rau hauv ob leeg me nyuam thiab cov neeg laus. Nrog rau kev kuaj mob zoo li no, nws tsis pom zoo kom noj Furosemide rau lub sijhawm ntev, vim tias cov tshuaj no cuam tshuam rau kev ua haujlwm ntawm lwm yam kabmob hauv nruab nrog cev thiab tuaj yeem ua rau muaj kev phiv tshwm sim. Nyob rau hauv tus txheej txheem ntawm kev kho mob nrog Furosemide, nws yog ib qho tsim nyog yuav tau ntxiv cov tshuaj potassium. Tus kws kho mob tau sau cov tshuaj "Diakarb" nrog ntau yam txheej txheem. Raws li kev kho mob qhia, cov kws tshaj lij pom zoo kom noj Diakarb hauv cov chav kawm 5 hnub, tom qab ntawd so ntawm 3 hnub. Ua tsaug rau cov tshuaj no, koj tuaj yeem tshem tawm cov kua dej ntau dhau ntawm lub pob txha taub hau thiab txo qis cov tshuaj cerebrospinal, yog li txo qis intracranial siab.
Ntxiv nrog rau kev kho tshuaj, tus kws kho mob tau sau cov kev haus dej tshwj xeeb rau tus neeg mob (tsis pub ntau tshaj 1.3 litres ib hnub), uas txo cov kua dej nkag mus rau hauv lub hlwb. Nrog kev pab ntawm acupuncture, phau ntawv kho mob thiab kev tawm dag zog kho mob, koj tuaj yeem txhim kho tag nrho kev noj qab haus huv ntawm tus neeg mob thiab ua kom cov txheej txheem kho kom zoo. Qee qhov xwm txheej, siv rauphais txoj kev kho mob. Tus kws kho mob tshwj xeeb txiav txim seb hom kev phais mob nyob ntawm seb qhov chaw kho mob tshwj xeeb ntawm tus neeg mob.
Tsuas yog kws kho mob yuav tsum tau sau tshuaj kho mob intracranial siab rau cov neeg laus. Cov tsos mob ntawm pathology nyob rau theem pib ntawm txoj kev loj hlob tuaj yeem tsis tuaj, yog li nws raug nquahu kom mus ntsib kws kho mob tsis tu ncua. Feem ntau, nrog rau qhov kev kuaj mob no, shunting yog ua.
Yog hais tias tus kab mob no dhau heev lawm thiab lub siab nyob rau hauv lub pob txha taub hau nce intensive, muaj kev hem thawj rau tus neeg mob lub neej. Nyob rau hauv cov xwm txheej zoo li no, nws yog ib qho tseem ceeb los muab kev pab thaum muaj xwm ceev. Nws yog ib qho tsim nyog yuav tau txhaj tshuaj hyperosmolar intravenously. Kev ceev intubation thiab kev tso pa tawm ntawm lub tshuab ua pa yog ua tiav. Tus neeg mob tau muab tso rau hauv kev kho mob coma. Ua tsaug rau ventriculopuncture, tshaj CSF raug tshem tawm. Nyob rau hauv tsawg zaus, decompressive craniotomy yog ua. Nyob rau hauv tus txheej txheem ntawm xws li manipulation, ib tug pob txha taub hau raug tsim nyob rau hauv ib sab kom lub hlwb tsis "so" tawm tsam pob txha taub hau.
Qhov kev cia siab ntawm kev kho mob ncaj qha yog nyob ntawm qhov mob hnyav, kev noj qab haus huv ntawm tus neeg mob thiab kev paub dhau los ntawm tus kws kho mob, yog li nws yog ib qho tseem ceeb kom tsis txhob mus rau qhov chaw kho mob dubious txhawm rau txhawm rau kho. Tus kab mob no txaus ntshai heev vim nws tuaj yeem ua rau muaj mob hnyav, uas feem ntau ua rau tuag taus.
Kab mob hauv me nyuam
Muaj ntau cov tsos mob ntawm intracranial siab nyob rau hauv tus me nyuam. Cov no suav nrog:
- Kev nqus dej txo qis.
- Zoo nce ib ncigtaub hau.
- Ntxhais nkauj hmoob toj siab.
- Cov hlab ntsha hauv lub taub hau yog dilated heev.
- Muaj cov leeg pob txha.
- Gref's syndrome tshwm sim.
- Tseem muaj qhov tshwm sim.
- Cranial sutures yuav sib nrug.
- Tus me nyuam quaj nrov yog ib qho tsos mob ntawm intracranial siab nyob rau hauv cov me nyuam mos.
- Gag reflex tshwm sim.
Tsis txhob ntshai yog tias koj tus menyuam hnoos ntau heev. Feem ntau, cov tsos mob zoo li no tsis qhia tias muaj tus kab mob no. Yog hais tias tus me nyuam yog overfed, ces tej zaum yuav tshwm sim. Nrog rau kev ua kom pom tseeb ntawm cov tsos mob, kev kuaj xyuas zoo los ntawm tus kws kho mob yuav tsum tau ua. Thaum ib qho ntawm cov tsos mob ntawm intracranial siab tshwm sim nyob rau hauv ib tug me nyuam, nws yog ib qho tseem ceeb kom ceev ceev hu rau lub tsheb thauj neeg mob los yog mus rau lub tsev kho mob, vim hais tias cov me nyuam yog heev yooj yim mus rau tej yam kab mob. Raws li cov xwm txheej no, kev noj tshuaj rau tus kheej raug txwv nruj heev.
Dab tsi ua rau intracranial siab hauv cov menyuam mos?
Muaj ntau yam ua rau menyuam yaus mob. Cov no suav nrog:
- nquag cerebrospinal kua secretion;
- poorly absorbed cerebrospinal kua;
- ncig hauv CSF txoj hauv kev tau cuam tshuam.
Muaj ntau yam uas tuaj yeem ua rau cov tsos mob ntawm intracranial siab hauv cov menyuam mos:
- mob taub hau;
- meningitis thiab encephalitis;
- tshuaj lom;
- tsis txaus ntseeg hauv kev txhim khohlwb;
- cerebral hemorrhage;
- qog nqaij hlav thiab lwm yam.
Tus me nyuam lub siab intracranial nce rau ntau yam, xws li:
- txhim kho cov teeb meem thaum lub sijhawm yug menyuam;
- prematurity;
- txhim kho kev kis kab mob hauv plab thiab neuroinfection;
- congenital malformations ntawm lub hlwb.
Cov tsos mob thiab kev kho mob ntawm intracranial siab nyob rau hauv cov me nyuam yog ib lub ntsiab lus uas yuav tsum tau tham nrog ib tug kws kho mob. Yog tias ib qho ntawm cov tsos mob tshwm sim, nws yog ib qho tseem ceeb uas yuav tsum tau ua ultrasound, echoencephalography, xam tomography. Raws li kev kuaj mob tau txais, tus kws kho mob yuav sau ib qho kev kho mob uas yuav pab kho tus kab mob. Kev xaiv txoj kev kho yog nyob ntawm daim duab kho mob tshwj xeeb.
Kev kho mob ntawm tus menyuam
Nyob ntawm qhov mob hnyav, tus kws kho mob tau sau ib txoj kev kho mob tshwj xeeb. Feem ntau, kev kho mob yog nqa tawm los ntawm txoj kev kho mob, thiab physiotherapy thiab massage yuav tsis tau dispensed nrog. Cov txheej txheem yuav txhim kho kev noj qab haus huv ntawm tus menyuam. Cov tsos mob thiab kev kho mob ntawm intracranial siab nyob rau hauv cov me nyuam yog ib yam dab tsi uas txhawj xeeb ntau tus niam txiv.
Yog tias tsim nyog, cov kws phais neeg ua haujlwm phais mob thaum lub sijhawm tso cov shunt. Cov kua dej ntau dhau raug tshem tawm los ntawm cov khoom siv zoo li no. Lub shunt tuaj yeem ntsia tau ob qho tib si rau lub neej thiab rau lub sijhawm ntawm kev phais. Yog tias kho tau raws sijhawm, tom qab ua haujlwm, tus menyuam txoj kev noj qab haus huv tau rov qab los.
Feem ntau tshwm sim nrog intracranial siab, ib qho tsos mob ntawm kev puas siab puas ntsws vim kev tsis zoo ntawm kev noj qab haus huv.mob. Raws li cov xwm txheej zoo li no, xav tau kev sab laj ntawm ntau tus kws tshaj lij.
