Lub tshuab ntawm qhov tshwm sim ntawm hematomas thiab etiology ntawm cov txheej txheem ua ntej muaj kev cuam tshuam zoo. Encapsulated hematoma nyob rau hauv cov ntaub ntawv no yog tsis muaj kev zam. Yuav kom nkag siab txog qhov ua rau nws tshwm sim thiab kawm txog cov kev kho mob, koj yuav tsum paub koj tus kheej nrog cov ntaub ntawv hauv qab no.
Ib me ntsis ntawm lub cev
Daim tawv nqaij muaj 3 txheej nrog lawv tus kheej cov khoom tshwj xeeb: epidermis, dermis, hypodermis (subcutaneous rog txheej).
Cov epidermis yog txheej saum toj kawg nkaus thiab thinnest, tsis muaj cov hlab ntsha hauv nws thiab tsuas yog ob peb txheej ntawm cov hlwb xwb. Nws pub rau diffusion ntawm cov khoom los ntawm qis qis ntawm daim tawv nqaij. Nrog kev raug mob kaw, nws tseem nyob tsis tau. Nws txoj haujlwm yog tiv thaiv.
Lub dermis, lossis daim tawv nqaij tiag tiag, yog cov ntaub so ntswg sib txuas. Tseem muaj qee cov hlab ntsha thiab cov hlab ntsha hauv daim ntawv ntawm capillaries. Lub dermis plays lub luag hauj lwm nyob rau hauv cov tsos ntawm subcutaneous hematomas, tab sis nyob rau hauv qhov tseeb tsis muaj hemorrhage ntawm no. Qhov no yog vim qhov tseeb tias kev sib txuascov fibers tau ua nruj nreem thiab tsis muaj qhov chaw rau cov kab noj ntshav los tsim ntawm no. Nerve endings hnov mob thaum raug mob.
Subcutaneous rog yog txheej tob tshaj plaws. Ua nyob rau hauv daim ntawv ntawm cov hlwb uas muaj cov cheeb tsam ntawm cov rog, sib cais los ntawm connective cov ntaub so ntswg septa.
Cov khoom noj khoom haus thiab cov hlab ntsha me me yog nyob ntawm no. Nyob rau hauv cov cheeb tsam muaj ib tug deposition ntawm kev noj haus los yog muaj ib tug khiav, yog hais tias tsim nyog. Hematomas tsim ntawm no vim tias cov ntaub so ntswg adipose yog softer thiab yooj yim rub sib nrug rau kab noj hniav. Cov ntshav tseem nchuav rau ntawm no thaum cov hlab ntsha loj dua puas lawm.
Kev sib cais ntawm lub tswv yim
Thaum daim tawv nqaij puas lawm, intra- lossis subcutaneous hemorrhages tuaj yeem tshwm sim, uas yog hu ua txawv, feem ntau xav txog lawv qhov piv txwv. Tab sis lawv txhua tus txawv. Qhov kev raug mob tseem hu ua bruise, thiab hematoma, thiab pob, tab sis cov no tsis yog cov ntsiab lus. Piv txwv li, hematoma thiab nqaij ntshiv: lawv tsuas muaj ib qho ua rau - sab nraud lossis sab hauv lossis kab mob. Tab sis nrog hematoma, yuav tsum muaj kab noj hniav uas cov ntshav tau nchuav tawm thiab cov ntaub so ntswg puas lawm. Nws tshwm sim vim delamination ntawm cov ntaub.
Yog tias tsis muaj kab noj hniav, qhov no tsis yog hematoma, nws tuaj yeem tshwm sim tsis yog hauv daim tawv nqaij, tab sis kuj nyob rau hauv lub cev. Piv txwv li, nyob rau hauv lub cranial kab noj hniav, raws li localization, lawv txawv:
- epidural (extradural) hematoma - nruab nrab ntawm cov pob txha ntawm pob txha taub hau thiab dura mater;
- subdural hematoma (hauv qab dura mater);
- subarachnoid hematoma (hauv pia mater);
- intracerebral, los yogparenchymal nyob rau hauv cov khoom ntawm lub hlwb, subcutaneous hemorrhage ntawm lub taub hau feem ntau hu ua pob - nyob rau hauv cov neeg laus.
Bruising kuj yog ib qho hemorrhage rau hauv cov ntaub so ntswg, tab sis tus qauv tsis tawg ntawm no, thiab kab noj hniav tsis tshwm. Colloquially, hu ua bruise.
Kev Txhaum tsuas yog lo lus hais xwb, tsis yog kev kho mob. Nws tsis yog siv rau hauv cov ntaub ntawv raug cai. Qee tus neeg nyiam siv cov ntsiab lus kho mob thiab hu rau qhov nqaij ntuag hematoma, txawm hais tias qhov no yog qhov tsis ncaj ncees lawm. Yuav kom meej, qhov no yog hemorrhagic impregnation ntawm daim tawv nqaij.
Vim li cas nws thiaj tseem ceeb kom cais cov ntsiab lus no? Vim tias lawv muaj qhov sib txawv, kev kho mob thiab qhov hnyav. Qib ntawm kev raug mob tuaj yeem txiav txim siab qhov pom ntawm qhov nqaij tawv lossis hematoma.
Bruises yog 3 degrees. Nyob rau qib 1, tsuas muaj qhov nqaij tawv, uas yuav daws tau nws tus kheej thiab tsis txaus ntshai. Lwm qib ua rau cov tsos ntawm hematomas. Hematomas yog unpredictable, tsis ploj ntawm lawv tus kheej, tuaj yeem nyuaj thiab xav tau kev kho mob. Lawv tuaj yeem tshwm sim yam tsis muaj kev raug mob, thaum lub nkoj spontaneously ruptures - qhov no yog ib tug spontaneous hematoma. Cov tawv nqaij ntawm qhov chaw raug mob mus txog txhua theem ntawm kev hloov xim: liab, liab-xiav lossis daj-ntsuab.
- thawj degree ntawm qhov nqaij tawv yog qhov nqaij me me. Ua pom tau hnub tom qab. Mob me ntsis thiab tsis muaj qhov o ntawm no.
- Thib ob - qhov mob tshwm sim tam sim ntawd thiab qhov chaw cuam tshuam o. Qhov nqaij ntuag tshwm sim hauv 4-5 teev.
- Third degree - o thiab mob nce hauv ib teev. Qhov mob hnyav, ntev, ceg yuav tig xiav.
Yog vim li cas thiaj pomhematoma
Qhov laj thawj tseem ceeb yog kev raug mob ntawm cov ntaub so ntswg: mob hnyav, tawg, nyem, ntog, ncab, pinching. Nyob rau hauv cov ntaub ntawv no, cov hlab ntsha puas lawm, cov ntshav yog nchuav tawm ntawm lawv, uas, nrog ib tug loj tsub zuj zuj, tsis tuaj yeem absorbed thiab accumulates nyob rau hauv ib qho chaw.
Lwm qhov laj thawj yog ntshav pathologies (leukemia, hemorrhagic vasculitis). Kev tawg ntawm cov hlab ntsha tuaj yeem tshwm sim tom qab cov tshuaj tiv thaiv coagulants.
Tsis yog tshuab ua rau muaj xws li:
- Mallory-Weiss Syndrome - tawg nyob rau hauv lub plab sab sauv lossis hauv qab txoj hlab pas uas tshwm sim vim kev ntuav thaum ntuav, tom qab noj ntau dhau lossis haus cawv.
- Atherosclerosis - cholesterol plaques tsim nyob rau hauv cov hlab ntsha thiab tuaj yeem ua rau lub nkoj puas.
- Hemorrhagic vasculitis - capillary puas.
- Intramuscular hematoma - tshwm tom qab txhaj tshuaj intramuscular hauv pob tw.
- Postoperative hematomas - hauv cov poj niam cev xeeb tub tom qab phais mob, uas nyob ntawm vascular permeability thiab ntshav siab.
YKev faib tawm ntawm hematomas
Hematomas los ntawm hom hemorrhage yog:
- arterial;
- venous;
- mixed.
Raws li qhov chaw:
fascia;
Ntawm qhov chaw kho mob:
- limited;
- diffuse;
- pulsing;
- bagged.
Hematoma los ntawm qhov loj thiab qhov tob ntawm kev puas tsuajtshwm sim:
- light;
- medium;
- hnyav.
me me hematoma tsim nyob rau hauv ib hnub tom qab raug mob. Qhov mob yog qhov tsis tseem ceeb, lub zog tsis cuam tshuam. Tsis muaj qhov o. Absorb sai.
Nruab nrab - txhim kho 3-5 teev tom qab raug mob. Qhov mob hnyav dua, cov ntaub so ntswg cuam tshuam ntau dua. Qhov chaw ntawm qhov raug mob o thiab qee zaum cuam tshuam nrog kev txav mus los.
Havy - tsim nyob rau hauv ib teev ntawm kev cuam tshuam. Qhov dav dav thiab hauv cheeb tsam kub tuaj yeem nce siab, qhov mob tsis tu ncua, hnyav, txav txav tau txwv.
Los ntawm kev kho mob tshwm sim, hematomas tau muab faib ua cov hauv qab no:
- Tsawg ntawm lub periphery - nyob rau hauv xws li cas, cov npoo yeej ntom, softening hauv plawv.
- Encapsulated hematomas - nyob rau hauv lub tsub zuj zuj ntawm cov kua dej ntau. Lawv tuaj yeem yaj ntawm lawv tus kheej ntawm qhov me me xwb.
- Diffuse - nyiam loj hlob sai thiab xav tau qhib sai.
Raws li lub xeev ntawm cov ntshav ntau ntxiv, hematomas yog txhaws thiab tsis txhaws (tshiab), tsis muaj kab mob thiab kis kab mob paug, pulsating thiab tsis-pulsating.
Los ntawm qhov tsos, hematomas faib:
- ntawm cov hlab ntsha - muaj xim liab ci thiab lawv thaj chaw loj dua;
- venous - cyanotic ntshav;
- mixed - feem ntau.
By localization:
- subcutaneous;
- submucosal;
- intramuscular;
- subfascial;
- subserous (feem ntau hauv plab lossis ntsws);
- retrochorial (hauv cov poj niam cev xeeb tub);
- qhov txaus ntshai tshaj plaws: hauv lub hlwb thiabqub hematomas.
Yog tias qhov encysted hematoma tsis daws thiab nws cov ntaub so ntswg loj hlob, lub cyst yog tsim. Xws li hematoma yog ib txwm elastic rau qee qhov thiab hloov nws cov duab thaum txoj haujlwm ntawm tib neeg lub cev hloov.
Cov tsos mob ntawm encysted hematoma
Cov tsos mob tseem ceeb yog kev hloov ntawm cov xim ntawm daim tawv nqaij nyob rau hauv qhov chaw ntawm kev puas tsuaj, ua ntej rau crimson-liab, tom qab ntawd burgundy, cyanotic, daj-ntsuab. Daim duab kho mob tag nrho yog txiav txim siab los ntawm qhov hnyav ntawm hematoma.
Yog tias qhov encysted hematoma nyob hauv thaj chaw ntawm daim tawv nqaij, ces nws tshwm sim los ntawm o. Nws mob ntawm palpation, daim tawv nqaij saum toj no yog me ntsis hyperemic.
Intermuscular qhov chaw ua rau o ntawm cov ceg ceg, txav tau txwv thiab qhov mob tau hais ntau dua. Rau kev kuaj mob, ultrasound lossis kev kuaj mob puncture yog siv.
Ntawm qhov me me, qhov encysted hematoma tuaj yeem daws nws tus kheej, tab sis ntau zaus nws tshwm sim rau lub sijhawm ntev thiab lub sijhawm no nws tuaj yeem ua rau cov ntsev calcium ntsev thiab tuab.
Yog tias hematoma tsis daws, yuav tsum muaj kev cuam tshuam kev phais. Nyob rau hauv lub xub ntiag ntawm abrasions, xws li ib tug hematoma feem ntau suppurates. Tom qab ntawd nws nce qhov loj me, qhov kub thiab txias yuav tsum tau ua haujlwm sai.
Yog cov qog tsis ua haujlwm raws sijhawm, muaj teeb meem tshwm sim.
Txoj cai pab thawj zaug rau bruises
Kev kho mob ntawm cov hematoma pib nrog kev siv tshuaj txias 2 zaug hauv ib teev rau 5-10 feeb. Yog tias lub tshuab tsis tseem ceeb, polimedel yuav pab tau (ib zaj duab xis tshwj xeeb rautxhim kho capillary ntshav khiav), ces hematoma tsis tsim txhua. Qhov no muaj tseeb, tshwj xeeb, rau lub ntsej muag.
Yog tias lub tshuab yog qhov hnyav, nws yog qhov zoo dua los siv cov ntaub qhwv elastic nruj rau 1-2 teev. Koj tuaj yeem tsuas qhwv cov ceg. Thaum tshav kub kub tsuas yog siv rau hnub peb xwb. Nws yog thov rau 40 feeb 2 zaug hauv ib hnub.
Noj tshuaj kho mob tsuas yog tias cov hematoma tsis nyob hauv plab kab noj hniav thiab tsis nyob hauv lub taub hau. Tus neeg mob yuav tsum tau ceev faj. Tsis tas li nyob rau hnub 3, koj tuaj yeem pib siv tshuaj pleev thiab gels.
Nyob rau hauv cov ntaub ntawv ntawm lub ntsej muag raug mob, cov tshuaj pleev zoo tshaj plaws rau bruises thiab hematomas yog "Bruise-OFF". Nws muaj leech extract. Cov tshuaj pleev tsis tau tsuas yog ib qho kev daws teeb meem, tab sis kuj yog ib tug tonic. Nws muaj ntxhiab tsw qab, thiab tsis muaj qhov tsis xis nyob.
Ntev npaum li cas qhov encysted hematoma ntawm lub ntsej muag daws? Feem ntau hauv ib lub lis piam, tab sis qee zaum txog 8-9 hnub.
Dab tsi yog qhov txaus ntshai hematoma
Nrog rau qhov hemorrhages nyob rau hauv cov kab noj hniav ntawm cov kab mob hauv nruab nrog cev, tom qab ib ntus cov ntshav tawm pib decompose nrog kev tawg ntawm hemoglobin. Muaj endotoxicosis - qhov sib txuam thiab lom ntawm cov ntaub so ntswg los ntawm cov khoom lwj.
Ib hematoma loj ntawm ceg, piv txwv li, tuaj yeem ua rau muaj teeb meem hauv qab no:
- chronic synovitis - o ntawm synovial daim nyias nyias ntawm qhov sib koom ua ke, effusion pib nkag mus rau hauv cov kab noj hniav sib koom;
- hemarthrosis - hemorrhage hauv kev sib koom tes.
Thiab intracranial hemorrhages ua rau muaj kev hloov hauv lub hlwb: amnesia, impaired cov tshuaj tiv thaiv thiab mloog, nceKev ntxhov siab, qaug dab peg, hloov tus cwj pwm.
kho hematoma
Me me encysted hematomas tuaj yeem kho tau zoo. Siv txias rau lub hematoma tshiab pab tau zoo.
Cov tshuaj pleev yog siv los ua haujlwm. Cov tshuaj pleev zoo tshaj plaws rau bruises thiab hematomas yog Lyoton, Troxevasin-gel, Heparin ointment thiab Vishnevsky ointment. Tsis ntev los no, "Bruise-off", "Rescuer" balm, "SOS" cream-balm, "911" ointment, "Mederma" tau siv. Tag nrho cov ntawm lawv muaj kev daws teeb meem. Tsis tas li ntawd, lawv muaj cov nyhuv rov tsim dua thiab metabolic stimulating.
Tus nqi ntawm Lyoton nyob ntawm qhov loj ntawm lub raj. Cov tshuaj pleev uas txhawb cov hlab ntsha muaj txiaj ntsig zoo: troxevasin, troxerutin.
NSAID tshuaj pleev muaj cov tshuaj tiv thaiv kab mob, cov tshuaj tiv thaiv kab mob: Fastum-gel, Ketonal, Diclofenac, Voltaren emulgel.
Tus nqi ntawm Lyoton yog lwm qhov ntawm nws qhov zoo, nws yog qis (los ntawm 340 rubles) thiab tsis txawv ntau hauv cheeb tsam sib txawv. Qhov peculiarity ntawm cov tshuaj pleev yog tias nws tuaj yeem siv rau qhib qhov chaw tom qab kev puas tsuaj.
Physiotherapy kuj tau sau tseg (Solux, infrared lossis xiav teeb, magnetotherapy, UHF, electrophoresis). Tom qab qee lub sijhawm, thaj chaw puas ntawm daim tawv nqaij pib hloov xim hauv cov txheej txheem resorption.
Tsis tas li ntawd, tus kws kho mob tuaj yeem sau tshuaj ntxiv rau cov phab ntsa ntawm cov hlab ntsha: Ascorutin, Capilar, Troxevasin2, Rutin, thiab lwm yam. Capilar yog qhov tshwj xeeb tshaj yog rau cov hlab ntsha.laus.
kho mob phais
Loj, festering thiab bulging lossis pulsating encysted hematomas yuav tsum tsuas yog kho los ntawm kev qhib hauv qab tshuaj loog hauv zos. Feem ntau nws txhawj xeeb txog intermuscular hematomas. Los ntawm qhov incision, cov ntsiab lus yog nyem tawm. Thiab tom qab ntawd cov kab noj hniav yog kho nrog peroxide. Siv daim ntaub qhwv nruj.
Qee zaum, thaum lub sijhawm ua haujlwm kom tshem tawm cov hematoma nrog kev puas tsuaj rau cov hlab ntsha loj, tus kws phais pom lub nkoj puas thiab qhwv nws.
Thaum kis tus kab mob hematomas, kab noj hniav uas muaj cov kua qaub tsim. Cov txheej txheem rau qhib lub encysted hematoma, nyob rau hauv cov ntaub ntawv no, kuj qhia rau nws kim heev hematomas. Tus kws phais yuav qhib cov kab noj hniav zoo li no, yaug nws nrog cov tshuaj tua kab mob thiab muab tso rau hauv dej kom ntws cov kua dej. Tom qab ntawd, siv cov tshuaj tua kab mob thiab tshuaj tua kab mob. Feem ntau qhov no tshwm sim nrog hematomas ntawm lub plab kab noj hniav. Cov stitches raug tshem tawm tom qab 10 hnub. Txhua lub sijhawm no tus neeg mob noj tshuaj tua kab mob.
Ib qho teeb meem tom qab ntawm hematoma yog nws lub koom haum. Qhov no yog hais txog impregnation nrog calcium ntsev nrog tsim cov tshuaj ntsiav. Xws li lub capsule kuj excised.
Hematoma tom qab lub caij nplooj zeeg nrog qhov nqaij ntawm lub plab, lub taub hau thiab hauv siab yuav tsum tau mus ntsib kws kho mob tam sim ntawd, vim tias muaj peev xwm ua rau cov kab mob hauv nruab nrog cev lossis lub hlwb puas. Nrog intracranial hematomas, kev saib xyuas kev kho mob yog ua tau nrog hematoma ntim txog li 40 ml thiab tsis muaj cov tsos mob ntawm lub paj hlwb. Txwv tsis pub, trepanation ntawm pob txha taub hau yog ua. Cov pob txha pob txha raug txiav tawm, nrog kev pab los ntawm tus aspirator, cov ntshav raug tshem tawm ntawm hematoma, kab noj hniav.yog ntxuav, cov pob txha nrov plig plawg rov qab thiab cov ntaub so ntswg yog sutured nyob rau hauv rov qab kev txiav txim.
Huab cua
Feem ntau, cov kws kho mob muab qhov kev pom zoo rau cov nqaij mos raug mob. Qhov tsis zoo tshaj plaws tuaj yeem tau txais nrog TBI nrog epidural lossis subdural hematoma. Nrog rau kev raug mob hnyav, cov txheej txheem resorption qeeb tau ntau xyoo.
ntsuas kev tiv thaiv
Kev tiv thaiv yog ceev faj, txo qis ntawm kev raug mob, tsis suav nrog kev kis kab mob. Nyob rau hauv ib lub tsev nrog cov menyuam yaus, tus naj npawb ntawm cov kaum ntse ntse yuav tsum tau khaws cia kom tsawg li tsawg tau. Thaum caij tsheb kauj vab lossis rollerblading lossis skating, lub hauv caug ncoo, lub luj tshib thiab lub kaus mom hlau yuav tsum hnav. Nws yog ib qho tseem ceeb kom sov so ua ntej txhua qhov kev tawm dag zog.
