Vitreous detachment yog ib qho kev sib haum xeeb, uas yog tshwj xeeb tshaj yog rau cov neeg laus. Nws yuav tsum tau hais tam sim ntawd tias feem ntau tus kab mob teb tau zoo rau kev kho mob, txawm tias thaum tsis kho, muaj teeb meem tshwm sim, qee zaum nce mus txog qhov tsis pom kev.
Ib txwm, cov neeg uas ntsib teeb meem tab tom nrhiav cov ntaub ntawv ntxiv. Qhov mob yog dab tsi? Cov tsos mob dab tsi los saib xyuas? Thaum twg koj yuav tsum tau ceev nrooj hu rau qhov chaw ntawm laser pom kev kho? Cov lus teb rau cov lus nug no txaus siab rau ntau tus nyeem.
Vim yog dab tsi?
Ua ntej ntawm tag nrho, nws tsim nyog ua haujlwm nrog cov ntaub ntawv qhia anatomical. Nruab nrab ntawm lub retina thiab lub lens ntawm lub qhov muag yog ib yam khoom zoo li jelly, uas, qhov tseeb, hu ua lub cev vitreous. Nws yog lub cev no uas muab kev txhawb nqa thiab kev sib raug zoo ntawm txhua yam ntawm lub qhov muag.
Nyob rau hauv cov menyuam yug tshiab, cov qauv no yog homogeneous. Tab sis raws li lub cev maturescov vitreous pib cais ua ob feem, uas yog kua (nws muaj 95% dej) thiab fibrous (tsim los ntawm kev sib txuas cov protein ntau).
kab mob yog dab tsi?
Vitreous detachment yog ib yam kab mob uas tshwm sim, uas yog qhov tshwm sim ntawm kev hloov pauv ntawm cov qauv ntawm cov protein nyob rau hauv cov fibrous ib feem ntawm lub cev. Raws li kev cuam tshuam ntawm qee yam, kev sib cais ntawm ib txheej los ntawm lwm qhov pib. Txij li thaum lub cev vitreous nyob ze ze rau lub retina, ib qho kev ua txhaum ntawm nws cov qauv yog fraught nrog kev tsis pom kev.
Nws tsim nyog hais tam sim ntawd tias feem ntau tus mob no tau kuaj pom hauv cov neeg muaj hnub nyoog tshaj tsib caug xyoo. Raws li kev txheeb cais, cov poj niam muaj feem cuam tshuam rau tus kab mob, txawm tias cov txiv neej feem ntau ntsib teeb meem zoo sib xws. Raws li cov cim qhia, cov neeg mob feem ntau yws ntawm " yoov ntawm qhov muag." Qhov ua rau thiab kev kho mob ntawm cov mob no yuav raug tham hauv qab no.
Qhov laj thawj tseem ceeb ntawm pathology
Feem ntau, cov txheej txheem pathological pib nyob rau tom qab ntawm lub qhov muag, yog li lo lus "posterior vitreous detachment" feem ntau tshwm hauv cov tshuaj.
Vim li cas tus kab mob no pib? Qhov tseeb, cov laj thawj yuav txawv. Vitreous detachment tej zaum yuav yog vim li cas hauv qab no.
- Raws li twb tau hais lawm, hnub nyoog yog qhov pheej hmoo, vim tias kab mob feem ntau tshwm sim hauv cov neeg mob hnub nyoog 50 xyoo. Qhov tseeb yog tias nrog kev laus, ntau yam kev hloov pauv degenerative pib hauv cov qauv ntawm lub qhov muag. Tsis tas li ntawd, tus naj npawb ntawm collagen fibers uas txhawb cov qauv ntom ntawm lub cev vitreous kuj txo.
- Predisposed rau ib tug zoo xws li pathology thiab cov neeg mob raug kev txom nyem los ntawm nquag inflammatory kab mob ntawm choroid thiab retina. Cov kab mob no nrog rau kev hloov pauv ntawm pH li qub. Cov kua qaub ib puag ncig cuam tshuam tsis zoo rau kev ua haujlwm ntawm cov qauv ntawm tes, thiab tseem ua rau txo qis ntawm qib adhesion ntawm posterior hyaloid membrane ntawm retina thiab sab hauv limiting membrane ntawm lub cev vitreous.
- Cov npe ntawm cov kev pheej hmoo tseem suav nrog qee cov kab mob hauv lub cev, tshwj xeeb, thyroid pathologies, ntshav qab zib mellitus thiab Marfan's syndrome. Qhov tseeb yog tias cov teeb meem no tau nrog cov kev hloov pauv tseem ceeb hauv keeb kwm hormonal. Raws li qhov tshwm sim ntawm cov txheej txheem no, qhov kev sib xyaw ua ke ntawm hyaluronic acid thiab glycosaminoglycans raug cuam tshuam, uas feem ntau cuam tshuam rau cov qauv ntawm lub cev vitreous.
- Kev tshem tawm tuaj yeem yog qhov tshwm sim ntawm qhov txhab nkag hauv qhov muag, nrog rau cov kev phais yav dhau los ntawm qhov muag.
Kev faib tawm: hom kab mob tseem ceeb
Nyob rau hauv cov tshuaj niaj hnub no, muaj ntau lub tswv yim los faib cov kab mob. Nyob ntawm qhov xwm txheej ntawm kev sib cais, ob hom kev sib cais yog qhov txawv:
- Ua tiav detachment yog nrog los ntawm kev sib cais ntawm cov ntaub qhwv los ntawm lub taub hau ntawm lub paj hlwb, uas ua rau muaj kev tsim ntawmqhov chaw peripapillary. Daim ntawv ntawm pathology no feem ntau pom nyob rau hauv cov neeg mob hluas, txij li thaum lub vitreous lub cev gel nyob rau theem no muaj ntau formalized qauv. Tsis tas li ntawd, qhov ua rau ua tiav detachment tuaj yeem yog hemorrhage lossis nkag mus ntawm exudate rau hauv qhov chaw nruab nrab ntawm retina thiab lub cev vitreous.
- Ib nrab detachment, raws li txoj cai, los ntawm lub hauv paus ntawm lub vitreous. Tsis tas li ntawd, cov ntaub qhwv tuaj yeem cais tawm ntawm qhov chaw tawm ntawm qhov muag pom. Yog tias tsis kho, kev tshem tawm ib nrab yuav ua tiav.
Vitreous detachment: cov tsos mob
Tau kawg, qhov teeb meem tseem ceeb rau txhua tus nyeem ntawv yog daim duab kho mob. Qhov tseeb, ntau tus neeg mob tig mus rau tus kws kho mob ophthalmologist yws ntawm " yoov" hauv lawv lub qhov muag. Ua rau thiab kho yog yam uas cov neeg mob txaus siab rau.
Cov tsos mob zoo sib xws tuaj yeem nrog los ntawm kev ua txhaum ntawm cov qauv ntawm lub cev vitreous. Tau kawg, cov yam ntxwv ntawm daim duab kho mob feem ntau yog nyob ntawm daim ntawv thiab qib ntawm detachment. Yog tias peb tab tom tham txog ib feem ntawm kev ua txhaum ntawm adhesion, ces qee cov tsos mob tshwj xeeb yuav tsis tuaj. Raws li txoj cai, pathology cuam tshuam rau ob lub qhov muag ib zaug, thiab qhov muag pom kev tuaj yeem nyob li qub - yog vim li cas cov neeg mob tsis tshua mus ntsib kws kho mob. Qee lub sij hawm tus kab mob no dhau los ua qhov nrhiav tsis tau.
Ua tiav kev tshem tawm ntawm lub cev vitreous ntawm lub qhov muag yog nrog los ntawm cov teeb meem tshwm sim. Ntau yam kev suav nrog tuaj yeem tshwm sim hauv kev pom ntawm cov neeg mob - cov no tuaj yeem yog ob qho tib si tsaus nti " yoov" thiab cov duab loj.cov duab. Kuj tseem muaj qhov pom ntawm photopsies thiab "flashes" uas tshwm sim thaum lub sijhawm txav ntawm lub qhov muag.
Tus kab mob txaus ntshai yog dab tsi? Common Complications
Ntau tus neeg, tshwj xeeb tshaj yog thaum nws los txog rau cov neeg mob laus, tau ntsib teeb meem xws li detachment ntawm lub cev vitreous ntawm lub qhov muag. Dab tsi yog qhov txaus ntshai ntawm tus kab mob no.
Raws li muaj pov thawj los ntawm kev tshuaj xyuas ntawm cov kws kho mob thiab cov txiaj ntsig ntawm kev tshawb fawb, cov kab mob teb tau zoo rau kev kho, tab sis tsuas yog kuaj tau raws sijhawm. Hauv cov xwm txheej siab, qhov kev pheej hmoo ntawm cov teeb meem nyuaj heev.
Nws tsim nyog sau cia tias kev cais tawm ib nrab yog qhov txaus ntshai tshaj plaws. Nrog rau daim ntawv zoo sib xws ntawm tus kab mob, cov fibers ntawm daim nyias nyias yog txuas rau retina nyob rau hauv qee qhov chaw, uas yog nrog los ntawm ib tug muaj zog traction los ntawm tag nrho cov loj ntawm lub vitreous lub cev. Qhov no ua rau muaj kev ntxhov siab ntxiv rau qee qhov chaw ntawm retina. Hauv kwv yees li 8-15% ntawm cov neeg mob, qhov no tshwm sim hauv peripheral retinal tear.
Raws li kev txheeb cais, kwv yees li 13-19% ntawm cov neeg mob, pathology yog nrog los ntawm hemorrhage rau hauv lub cev vitreous. Qhov teeb meem no tsis ua rau tsis pom kev, tab sis yuav tsum tau kho tam sim.
Qee zaum, kev ua txhaum ntawm cov qauv ntawm lub cev vitreous yog nrog los ntawm kev sib cais thiab detachment ntawm lub retina, uas, ntawm chav kawm, cuam tshuam rau lub zeem muag thiab qee zaum ua rau nws ua tiav.
ntsuas ntsuas
Yog koj mus ntsib kws kho mob nrog cov lus tsis txaus siab saum toj no, tus kws kho mob tshwj xeeb yuav xub ua cov qauv kev kawm,suav nrog ophthalmoscopy, kuaj pom kev pom, ophthalmometry, biomicroscopy.
Cov ntaub ntawv yog kev kuaj xyuas ultrasound ntawm lub qhov muag - thaum lub sijhawm ua haujlwm, tus kws kho mob tuaj yeem txiav txim siab qhov chaw nyob ntawm qhov detachment, nrog rau pom kev hloov pauv ntawm cov qauv ntawm lub cev vitreous nws tus kheej. Cov txiaj ntsig tau tseeb dua tuaj yeem tau txais los ntawm kev siv kho qhov muag pom tomography. Cov xwm txheej zoo li no ua rau nws tuaj yeem ua tib zoo tshuaj xyuas lub xeev ntawm retina, nrog rau ntsuas qhov tuab ntawm daim nyias nyias ntawm lub cev vitreous thiab lub retina.
Vitreous Detachment: Kev Kho Mob
Raws li cov ntaub ntawv tau txais thaum lub sijhawm tshawb fawb, tus kws kho mob tuaj yeem kuaj xyuas thiab txiav txim siab txog kev kho mob. Hauv qhov no, tsuas yog kev phais tuaj yeem kho qhov xwm txheej, yog li koj yuav tsum hu rau lub chaw kho qhov muag pom kev zoo.
Raws li txoj cai, cov neeg mob tau muab tshuaj rau vitrectomy, txheej txheem uas suav nrog kev tshem tawm tag nrho lossis ib feem ntawm lub cev vitreous.
Qee zaus vitreolysis zoo. Qhov no yog qhov kev cuam tshuam me me uas cuam tshuam nrog qee qhov evaporation, dislocation lossis fragmentation ntawm pathological inclusions ntawm lub cev vitreous siv cov cuab yeej laser tshwj xeeb lossis los ntawm kev siv tshuaj.
ntsuas kev tiv thaiv zoo
Raws li twb tau hais lawm, kev tshem tawm cov kab mob vitreous yog fraught nrog ntau yam teeb meem. Ntawm chav kawm, cov pathology yog ib qho yooj yim los kho, tab sis cov prognosis tsuas yog nyob rau hauvyog tias tus neeg mob tau ntsib kws kho mob raws sijhawm. Nyob rau hauv lub xub ntiag ntawm retinal detachment thiab lwm yam teeb meem, txoj kev kho tej zaum yuav tsis coj cov kev xav tau.
Raws li kev tiv thaiv, nws yog tsom rau txo qhov kev pheej hmoo ntawm qee yam teeb meem. Cov kab mob sib xws xws li ntshav qab zib lossis cov thyroid lesions yuav tsum tau kho kom zoo raws sijhawm. Hom kev ua haujlwm raug thiab so rau lub qhov muag yog qhov tseem ceeb (qhov no feem ntau siv rau cov neeg uas, los ntawm kev tsim txiaj ntawm lawv txoj haujlwm, yuav tsum tsis tu ncua strain lawv ob lub qhov muag, piv txwv li, thaum ua haujlwm hauv computer). Yog tias koj txoj haujlwm cuam tshuam qhov muag raug mob, tsis txhob hnov qab txog tsom iav thiab lwm yam khoom siv.
Yog tias koj muaj cov tsos mob tshwm sim, tsis txhob yig - koj yuav tsum hu rau tus kws kho qhov muag kom sai li sai tau.
