Subdural kukha mwazi: zoyimira ndi zotsatira

ubongo wapangidwa zipolopolo angapo. The wangwiro kwambiri mwa awa ali kunja. Pachifukwa chimenechi amatchedwanso olimba. Nthawi zambiri zosiyanasiyana kuvulala mutu kuyambitsa yatsoka magazi pakati pa khungu lakunja ndi ubongo. Pankhaniyi, wozunzidwayo amawapeza "subdural kukha mwazi." Ndi kudwala izi ayankhidwa m'nkhaniyi lero.

Limagwirira kuwonongeka mapangidwe

Zikamera a kukha mwazi subdural nthawi yoyamba zoopsa. Magazi malo anapanga hematoma, yomwe ikukula mofulumira. Komanso n'loopsa kuthekera kwa minofu akhudzidwa a ubongo zomwe amasiyana kudziwa kukhudzana amenewa. Zotsatira za njira izi ndi zosayembekezereka wa kuvutika ubongo. Chachikulu magazi nthawi zambiri amatha kufa.

Payokha m'pofunika kuganizira aakulu subdural hematoma. Kumachitika ngati kukha magazi yapita nayo nthawi kutha. Hematoma aphimbidwa ndi chigoba chake, chimene angathe kugonjetsa Mitsempha. Against maziko a boma wosakhazikika deta zinthu nthawi zambiri amaphulika, chimalimbikitsa regrowth wa zowonongeka. Madokotala analemba milandu yambiri ya hematoma chimphona popangidwa ndi mtundu uwu.

Monena mfundo zotulutsidwa pamwamba akhoza kunena kuti subdural kukha mwazi muubongo chifukwa cha kuwonongeka kwa yokhudza kotekisi ndi mtima openga. Nthawi zina, nthendayo yoyamba kuphwanya mtsempha wa Galen kapena gulu la mitsempha kugwirizana nazo.

kudwala Zoyambitsa

Zimayambitsa kukha mwazi subdural osiyanasiyana ndithu. Pakati pawo, ambiri ali zotsatirazi:

1. ngozi Car (anagunda "oponya" kapena lakutsogolo). Gulu chiopsezo zikuphatikizapo kutsogolo okwera mpando amene sagwiritsa ntchito malamba.
2. Kugwa pa mutu wa icicles ndi midadada oundana m'nyengo yozizira.
3. Sports kuvulala.
4. kuvulala mutu kupanga amene sanali kugwilizana ndi malamulo chitetezo.
5. M'banja nkhondo.

zifukwa izi anawagawira mantha. Nkofunika kudziwa kuti hematoma akufotokozera mu milandu pang'onopang'ono. Ikuluikulu chotengera kuonongeka, ndi kukha magazi kwambiri ndipo mwamsanga chidawoneka khalidwe matenda chithunzi.

Kuli kuphwanya kumachitika ndi maziko a pathologies cerebrovascular. Izi pazikhalanso oopsa ndi wolumikizira aneurysm. Nthawi zina chifukwa pakutchulidwa wa anticoagulants hematoma phwando. mfundozi chifukwa subdural kukha mwazi nontraumatic.

mfundo za gulu

Anafotokoza m'nkhani kudwala kwa m'kagulu liwiro zizindikiro choyambirira. Pali mitundu itatu ya kukha mwazi:

• pachimake;
• subacute;
• aakulu.

Taonani kuti amaimira aliyense otsatirawa:

1. Pachimake subdural kukha mwazi akufotokozera mwa masiku 1-2 kuchokera tsiku kuvulazidwa. Chinthu chachikulu chomwe hematoma ndi imatengedwa kwambiri ndi kwambiri zotsatira pa ubongo.
2. Mu mawonekedwe subacute chiphaso cha kuwonongeka pamaso zizindikiro choyamba akhoza kuwoloka kuchokera masiku 4 kuti milungu ingapo. zotsatira zoopsa si kwambiri. The likungosonyeza ya chotengera akhudzidwa si waukulu, kotero magazi pang'ono.
3. Ming'oma maonekedwe a mitundu aakulu zimasiyana masabata awiri miyezi ingapo kapena zaka. Ngati tikambirana zifukwa monga choyambitsa ndi chitukuko cha hematoma, mu nkhani iyi izi n'chofunikira sekondale. Nthawi zambiri, mawonekedwe a kukha mwazi aakulu chifukwa cha matenda cerebrovascular.

The mtundu wa kuphwanya Mzimuyo zizindikiro choyambirira.

chithunzi matenda

Subdural kukha mwazi amakhala ndi zizindikiro ndi kusinthana yeniyeni magawo angapo.

Chikadzangotha amadza zoopsa munthu watha kutsitsimuka. kuphwanya otere zimapangidwa potsatira thupi kupweteka kwambiri ndipo mwadzidzidzi, maganizo china. Wodwala wamoyo ndipo akuyamba amadandaula kufooka ndi boma kuyembekezera. Nthawi zina, chithunzi matenda ndi lowonjezera ndi retrograde amnesia - yochepa kuiwala pa zochitika yapitayi zoipa.

Yachiwiri amakhala ndi bwino. Osati munthu aliyense atalandira kuwonongeka tcheru kumvetsera bwino kukhala kukaona dotolo. Chotero kunyalanyaza thanzi lawo kungachititse kuti modetsa kwambiri. Tikuyankhula zokhudza zochitika komwe wovulalayo afika kumbuyo gudumu la galimoto, kapena akugwirabe ntchito.

Gawo lachitatu anatsimikiza ndi maonekedwe a ubongo, mogwirizana ndi zizindikiro meningeal. mitundu Tikambirana pansipa.

Oziziritsa, meningeal ndi zizindikiro focal

Gulu la ubongo monga matenda amene angayambe ndi matenda ena aliwonse. Komabe, maonekedwe awo zikusonyeza kuvulala kwambiri ndithu ubongo. Choyamba, akuvutika pali mutu amphamvu. Munthu akhoza chidwi ndi chidwi ndi zonse zikuchitika. Chithunzi matenda kawirikawiri lowonjezera ndi disorientation mu nthawi ndi malo - wodwalayo kuvutika ndi tanthauzo la tsiku, malo. Mutu amapezeka kamodzi pa nthawi zoipa, ndiye imafoola ndi kukula ndi mwamphamvu chatsopano mu gawo lachitatu.

Ndi mawonetseredwe meningeal matenda akhoza zimachitika akusonyeza zizindikiro za kuwonongeka kwa meninges lapansi. Ena mwa iwo:

• mutu;
• kusanza kuti si chifukwa cha chakudya;
• zabwino meningeal zizindikiro.

Zizindikiro zimenezi nthawi zambiri anamuona pa matenda ena. Ngati zizindikiro oziziritsa ndi kwina kapena wofatsa, matenda a "subdural kukha mwazi wa ubongo" sagwirizana.

Zizindikiro mogwirizana anapereka unilateral mydriasis, pamene kwambiri kuchepetsa anachita yake kuwala. Nthawi zina madokotala akhudzidwa kukonza stupor - maganizo kwambiri za kutsitsimuka. Nthawi makamaka lalikulu, chikomokere.

Makamaka matenda ana

Subdural kukha mwazi makanda si zachilendo. Ndi zotsatira zoopsazo intracranial kubadwa ndi pafupifupi 40% ya kuvutika intrapartum. Mwa zifukwa zazikulu cholemba chake mankhwala zotsatirazi:

• zipatso zazikulu ;
• intracavitary ntchito forceps;
• mwamsanga ndi yobereka kudya;
• Phazi / breech ulaliki.

Amaganiziridwa matenda mwana mosavuta. Onse mwana unconditioned bongo maganizo. Iye si okhoza kutenga bere, kumeza. Psinjika za hematoma ubongo tsinde amakwiya ana dilated, khunyu. zizindikiro izi zimachitika mkati mwa masiku atatu oyamba pambuyo pa kubadwa.

njira matenda

Pambuyo choipa chilichonse zoopsa ubongo afunefune thandizo oyenerera. Musati pachiswe thanzi ndi kunyalanyaza zizindikiro koyamba kukha magazi. Kudwala Matendawa zachokera mbiri kutenga kafukufuku mtima. dokotala ndi kofunika kudziwa zambiri zonse za chikhalidwe cha kuvulala, dongosolo la maonekedwe zizindikiro matenda.

Mfundo yonse za kutanthauzira kwa hematoma akhoza analandira pambuyo CT jambulani. No zochepa nkhani imatengedwa Kujambula. Ngati mukukayikira zoopsa subdural kukha mwazi ndi kutiletsa kuchita ndi puncture lumbar. Ndondomeko Izi zikutanthauza zochepa chabe pamalangizo madzimadzi cerebrospinal kudzera singano wapadera. zotsatira zake zingakhale sizingasinthe.

chithandizo

Pambuyo pa kutsimikizira matenda a wodwalayo kuchipatala mwamsanga. Subdural kukha mwazi - ndi kudwala kwambiri. Choncho, m'pofunika ayamba mankhwala mwamsanga. Only mu nkhani iyi n'zotheka chiyembekezo kwa madokotala ananena zawo zabwino.

Kuthetsa kuyan'anila za ntchito mankhwala opaleshoni ndipo ndiwofatsa. Njira yamasika ntchito ngati yaing'ono kukula hematoma, pakalibe kupitilira angatumize. Odwala Kwalamulidwa mankhwala ndi kanthu odana edematous, mankhwala aziyenda bwino oziziritsa ndipo thupi. Amasonyezanso ndi zakudya za mavitamini ndi analgesics. Zinthu zimenezi akulimbikitsidwa odwala okalamba amene anawapeza pachimake subdural kukha mwazi nontraumatic.

Nthawi zambiri za matenda kukhala opaleshoni. Pa ntchito kutsegula ikuchitika chigaza (trepanation) akutsatiridwa ndi kuchotsa magazi extravasated. Chinthu chomaliza ndi kutsuka kwa M'mimbamo ndi saline kubwezeretsa kukhulupirika kwa cranium ndi khazikitsa ngalande wapadera.

Monga odwala achinyamata, iwo akuyesera kuchitira mankhwala. Pakalibe mphamvu zabwino ndi chifukwa opaleshoni.

Zotsatira ndi madokotala ananena zawo kuti apeze

Nthawi ya kukha mwazi wa ubongo limodzi ndi kusamutsidwa ndi siudzalandilidwa ngathi lamulo la nyumba tsinde lake. Disease chitukuko amatenga malo ndi limakhala kuvulala aakulu a Chigaza, ndi madokotala ananena zawo nthawi zambiri zovuta. Komabe, zotsatira zake zomalizira zimadalira nthawi yolandira chithandizo kwa dokotala ndi kusankha chithandizo chabwino. Ngati wovulalayo akhoza ntchito pasanathe maola 6 pambuyo choipa, kuchira akupezeka 80% ya milandu. Komanso, Mapa bwanji zaka wodwalayo, pamaso pa matenda somatic ndi hematoma buku.

Ndizovuta ndi zotsatira subdural kukha mwazi si yabwino kwambiri. Childs, odwala matenda wopunduka dzanja kapena kufa.