I-Hematoma engaphantsi kwegazi iphuma ephantsi kwexesha elide lobuchopho
Xa intloko ithola umonakalo ngexesha lesiganeko, imithana yegazi ingonakaliswa kwaye iqala ukuphuma ejikeleze ingqondo. Ekubeni i-skull yebony ejikeleze ubuchopho nayo ibizwa ngokuba yi-krano, oogqirha bezokwelapha babhekisela kulo hlobo lwesiganeko sokuphaphaka nje ngokuba "isisu somzimba". Oku kuthetha ukuphaphaza ngaphakathi kwekratshi.
Olunye uhlobo lwe-intracranial hemorrhage libizwa ngokuba yi "Hematoma engezantsi".
I-hematoma engaphantsi kwesiganeko yenzeka xa iimvumba zitholakala phantsi kwexesha elide , ubuncinci beethambo ezibandakanya ingqondo, zonakaliswe kwaye ziqala ukuphuma ngegazi. Njengoko igazi liqokelela kwaye lijika libe yinqanawa, kuba yinto ethiwa "hematoma".
Ukwahlula kunye neMpawu
Iimpawu ze-hematomas (SDH) eziphantsi komhlaba zihlukaniswe zibe zigaba ezintathu. Umntu onesigxina se-SDH uza kufaka ngegazi emva kweentsuku ezingama-1-2 emva kokuxhatshazwa kokuqala. I-SDH ibonisa ukuba malunga neentsuku ezingama-3 ukuya kwe-14 emva kokulimala kwentloko. Ekugqibeleni, i-SDH engapheliyo iza kubakho ngaphezu kweentsuku ezingama-15 emva kokuxhwaleka kwentloko.
Xa umntu one-SDH eqatha, impawu zivame ukubonakala. Ngokomzekelo, malunga nama-50% abantu abane-SDH ekhoyo ikhona nge-coma, okanye ezinye iimpawu ze-neurologic ezicacileyo ezibonisa ukuba kukho uxinzelelo olukhulu ngaphakathi kwengqondo.
I-hebacute kunye neengxaki ezingapheliyo ze-hematomas zingabunzima ukuyiqonda. Iimpawu ziquka ukunganakwa, ukulala, nokuguquka kwengqondo.
Izizathu kunye neengozi
Uninzi lwabantu abaphuhlisa i-SDH benza njalo emva kwengozi yemoto. Ukuhlaselwa kunye nokuwa yizona zinto ezilandelayo zibangelwa ukuphuma kummandla ojikelezayo wengqondo.
Abantu abakhe kwiimveliso ezinqamle igazi ezifana neCoumadin / i-warfarin basengozini yokuphuma kwamanzi.
Oku kuyinyani nokuba ukulimala kwentloko kubumnene kakhulu. Iindleko ezincinci kwiimvenge zegazi zijikeleze kwaye kwingqondo zingakhokelela ekuqhubeni kwegazi okungapheliyo.
Igazi elijongene negazi elincinci legazi liqhelekile kubantu asebekhulile abavame ukuthatha lolu hlobo lwamachiza, ngoko kufuneka unyathelwe ngokunyamekileyo ukuba kuphephe ukukhathazeka kwentloko kule ndawo.
Ukuxilongwa
I-SDH isoloko ixilongwa ngokuba ne-CT scan . Ukuba i-scan scan ifunyanwa ngokukhawuleza emva kokuxhwaleka kwentloko, ingenakuqala ukubonisa ukuba kukho nawuphi na ukuphuma kwamanzi. Nangona kunjalo, ukuba iphinda iphindwe kamva kamva ingaba yinto enesimo se-hematoma. Oku kuba kuthatha ixesha ukuze igazi liqoke kwaye liphawulwe kwisifundo sokucinga. Izinto eziphambili ezifunwa kwi-scan scan ziquka:
- Ubungakanani begazi le-clot
- Ubukho bexinzelelo beengqondo
- Ubukho bokuxinwa okwaneleyo kubangela ukutshintsha kwe- middleline kwengqondo
Iimvavanyo ze-CT zokulandela zichonga ukuba i-clot yegazi iyaqhubeka ikhula, ukuba kukho naziphi iingxaki ezintsha okanye ukuba iqalisa ukulungisa.
Unyango
Ezinye izigulane zingadinga ukuhlinzwa ukuze zimise ukuphuma kwegazi kwaye zisuse igazi elakhiweyo malunga nengqondo. Ngokukhawuleza kwe-SDH, oogqirha baya kuthatha isigqibo sokuba bathathe isigulane ukuhlinzwa xa i-clot yegazi ikhulu kuneemithamitha ezili-10, okanye ukuba kukho i-milimeter-shift shift ye-5-millimeter, kungakhathaliseki ukuba uphapheme okanye uqaphele isiguli.
Nangona kunjalo, iifom ezincinci nazo zingadinga unyango. Isigqibo sokuya kutyando sinokuba nobudlova xa isigulane sichasana okanye sibonisa ukunciphisa amandla abo okucinga, ukuthetha nokukhumbula iziganeko
Ukuba i-SDH yesigulane ibekho ixesha elide kwaye akukho zibonakaliso, utyando aluvumelekanga. Icandelo ngalinye kufuneka lihlolwe ngokwezizathu zonyango kwaye unyango lwezonyango, olunjenge-steroids, lunokuphinda luqhutywe.
Uhlobo lotyando olufunekayo luxhomekeke kubukhulu be-clot yegazi, kunye nezimo zonyango eziphantsi. I-Burr yokungcungcuthekiswa kunye ne-craniotomy yindlela eqhubelekileyo yokuhlinzwa ukuze igxilwe igazi elakhiweyo.
Kwezinye iimeko, i- craniectomy ingadinga ukuphatha uxinzelelo olwandisiweyo.
Indlela efanelekileyo kukuba uthethe nge-neurosurgeon malunga nazo zonke iinketho, kwaye yiyiphi indlela enokuzifumana iziphumo ezilungileyo.
Imithombo:
UHerou, E., Romner, B., & Tomasevic, G. (2015). Iqendu leNqununu: Ukulimala okubuhlungu kweBrainatic Trainatic: Ukufa kwabantu abadala. I-World Neurosurgery , 83 996-1001. i-doi: 10.1016 / j.wneu.2015.02.023
Walcott, BP, Khanna, A., Kwon, C., Phillips, HW, Nahed, BV, & Coumans, J. (2014). Isifundo seKliniki: Ixesha lokuhamba kunye nokuphuma kweziphumo emva kokunyangwa kobuchopho be-hematoma yamathambo angaphantsi. Journal Of Clinical Neuroscience , 21 2107-2111. i-doi: 10.1016 / j.jocn.2014.05.016