Kev txhim kho cov ntshav khov hauv koj txhais ceg kuj tseem hu ua sib sib zog nqus cov hlab ntshav txhaws (DVT). Nws yog ib qho mob hnyav uas xav tau kev kho mob vim tias cov hlab ntshav tuaj yeem tawg xoob thiab taug kev mus rau koj lub ntsws ua rau mob ntsws ntsws (PE), uas tuaj yeem ua rau tuag taus. Pulmonary embolism tuaj yeem tua sai yog tias lub embolus loj txaus, nrog txog li 90% ntawm cov cuam tshuam tuag nyob hauv thawj ob peb teev. Lub xub ntiag ntawm emboli me me yog ntau dua thiab tau ua tiav kev kho mob feem ntau. Txawm hais tias DVT yuav tsis tuaj yeem pom ib qho cim twg, los ntawm kev txheeb xyuas cov tsos mob thiab tau txais kev kho mob kom raug, koj tuaj yeem kuaj ntshav ntshav hauv koj txhais ceg.
Cov kauj ruam
Ntu 1 ntawm 3: Txheeb Xyuas Cov tsos mob ntawm DVT
Kauj Ruam 1. Saib xyuas koj txhais ceg seb puas o
Vim tias cov ntshav khov tuaj yeem thaiv cov ntshav ntws hauv koj txhais ceg, nws yuav ua rau muaj ntshav thaub qab. Ib qho tsis muaj ntshav txaus vim yog khov tuaj yeem ua rau o ntawm cov ceg cuam tshuam. Qee zaum qhov o tuaj ib leeg tsuas yog qhia pom tus tsos mob ntawm DVT.
- Nco ntsoov tias qhov o yuav tsuas yog nyob hauv ib txhais ceg, tab sis nws kuj tseem tuaj yeem ua caj npab.
- Hnov koj txhais ceg nrog koj txhais tes maj mam muab sib piv rau lwm ceg uas tsis muaj kev cuam tshuam. Qhov o tuaj yeem tsuas yog me ntsis thiab tsis tuaj yeem pom los ntawm kov, tab sis koj yuav pom nws thaum tso cov khoom ntawm cov khaub ncaws xws li ris, hnav lub cev ua haujlwm, lossis khau siab.
- Nco ntsoov saib thiab hnov zoo li cov leeg ntawm koj txhais ceg rau o thiab.
Kauj Ruam 2. Pom qhov mob ko taw lossis mob rwj
Coob leej neeg nrog DVT tseem muaj mob ceg thiab mob siab rau. Hauv ntau qhov xwm txheej, lawv piav qhia qhov no zoo li mob plab lossis Charley nees ntawm koj txhais ceg.
Khaws ib lub cav ntawm thaum koj pom mob ko taw lossis mob siab rau txiav tawm yam xws li raug mob. Sau tseg yog tias tus nees me lossis Charley nees tuaj thaum lub sijhawm lossis tom qab tawm dag zog lossis yog nws tshwm sim thaum koj tsuas yog taug kev yooj yim lossis zaum. Koj tsuas tuaj yeem hnov qhov mob siab rau thaum koj sawv lossis taug kev. Hauv ntau qhov xwm txheej, qhov mob yuav pib hauv koj lub plab hlaub thiab tuaj yeem tawg tawm ntawm qhov ntawd
Kauj Ruam 3. Xav tias koj txhais ceg sov
Qee qhov xwm txheej, koj txhais ceg lossis txhais caj npab yuav sov rau qhov kov. Thaum kuaj xyuas lwm cov tsos mob, yuav tsum tso koj txhais tes ntawm txhua feem ntawm koj txhais ceg kom pom tias ib ntu xav tias sov dua li lwm qhov.
Nco ntsoov tias qhov sov sov tuaj yeem tsuas yog nyob hauv thaj chaw uas o o lossis ua rau mob; txawm li cas los xij, nws yog lub tswv yim zoo kom hnov koj txhais ceg tag nrho kom koj tuaj yeem pom tau yooj yim dua ntu uas sov sov ib qho yam tsis muaj qhov kub thiab txias sib txawv
Kauj Ruam 4. Saib rau ntawm daim tawv nqaij tsis zoo
Cov tawv nqaij ntawm txhais ceg raug mob los ntawm DVT kuj tseem tuaj yeem ua rau pom xim. Saib rau ntawm daim tawv nqaij uas muaj xim liab lossis xim daj tuaj yeem qhia tias koj muaj ntshav khov hauv koj txhais ceg.
Yuav tsum paub tias kev hloov xim tuaj yeem zoo li qhov nqaij ntuag uas tsis ploj mus. Nco ntsoov saib ib qho xim tsis zoo ntawm koj txhais ceg kom pom tias lawv hloov xim lossis nyob liab lossis daj. Yog tias lawv tsis hloov pauv, nws tuaj yeem ua rau pom qhov khov
Kauj Ruam 5. Txheeb xyuas cov tsos mob ntawm PE
Cov ntshav khov hauv koj txhais ceg yuav tsis muaj qhov pom lossis pom tau zoo; txawm li cas los xij, yog tias tag nrho lossis ib nrab pob tawg tawm thiab nkag rau hauv koj lub ntsws, koj yuav muaj cov tsos mob cuam tshuam nrog koj ua pa. Yog tias koj muaj cov tsos mob hauv qab no, nrhiav kev kho mob tam sim:
- Ua tsis taus pa sai
- Ntsej muag lossis raug mob thaum ua pa uas ua rau mob hnyav zuj zus
- Lub plawv dhia ceev
- Ua npaws sai sai, uas tej zaum yuav muaj ntshav los yog hnoos qeev
- Hnov taub hau los yog kiv taub hau
- Tsaus muag
- Kev hnov qab kiv taub hau lossis tsaus muag
Kauj Ruam 6. Paub txog koj qhov kev pheej hmoo rau kev tsim DVT
Yuav luag txhua tus neeg tuaj yeem txhim kho ntshav khov hauv nws txhais ceg. Muaj ntau yam kev pheej hmoo uas yuav ua rau muaj DVT. Koj yuav muaj kev pheej hmoo ntau ntxiv los tsim cov ntshav khov hauv koj txhais ceg yog tias koj muaj ib lossis ntau qhov ntawm cov xwm txheej hauv qab no:
- Muaj kev phais ntawm txhua yam, tab sis tshwj xeeb tshaj yog nyob ntawm lub plab, plab, hauv siab lossis hauv caug
- Haus luam yeeb
- Noj tshuaj tiv thaiv yug menyuam
- Ib qho femoral (ncej puab) pob txha
- Kev kho cov tshuaj hormone hloov
- Nyob ntawm lub txaj so ntev
- Raug mob
- Ua rog lossis rog dhau
- Cev xeeb tub lossis yug menyuam
- Muaj mob qog noj ntshav
- Kev txom nyem los ntawm kab mob plab hnyuv
- Muaj lub plawv tsis ua haujlwm lossis lub plawv nres
- Muaj keeb kwm ntawm tus kheej lossis tsev neeg
- Koj muaj mob stroke yav dhau los
- Ua dhau hnub nyoog 60 xyoo
- Zaum tau ntev, tshwj xeeb yog tsav tsheb lossis ya
Ntu 2 ntawm 3: Tau Txais Kev Kho Mob
Kauj Ruam 1. Tham nrog koj tus kws kho mob
Tib txoj hauv kev kom paub yog tias koj muaj ntshav khov hauv koj txhais ceg yog kom tau txais kev kuaj mob. Yog tias koj muaj cov tsos mob ntawm cov ntshav khov hauv koj txhais ceg yam tsis muaj cim PE, teem sijhawm teem sijhawm nrog koj tus kws kho mob kom sai li sai tau. Nco ntsoov qhia rau lub chaw haujlwm paub tias vim li cas koj thiaj hu xov tooj tuaj kom lawv tuaj yeem teem sijhawm koj yam tsis ncua sijhawm. Koj tus kws saib xyuas kev noj qab haus huv yuav ua qhov kev tshuaj xyuas tag nrho, ntsuas kev kuaj mob, thiab sau ntawv lossis qhia kom paub kho kom raug raws li koj tus mob.
Teb txhua lo lus nug koj tus kws kho mob yuav muaj txog koj cov tsos mob thiab thaum lawv pib nrog rau yam uas ua rau lawv zoo dua lossis tsis zoo. Nco ntsoov qhia rau koj tus kws kho mob paub txog cov tshuaj uas koj tab tom noj, yog tias koj puas tau kho tus mob qog noj ntshav, lossis yog tias koj tau muaj kev phais lossis kev raug mob tsis ntev los no
Kauj Ruam 2. Mus kuaj lub cev
Ua ntej koj tus kws kho mob xaj kom koom nrog ntau qhov kev sim, lawv yuav ua qhov kev kuaj mob lub cev txhawm rau txheeb xyuas cov cim ntawm DVT uas koj yuav tau saib tsis dhau. Koj tus kws kho mob yuav tshuaj xyuas koj ob txhais ceg kom pom cov tsos mob ntawm DVT. Ib qho ntxiv, koj tus kws kho mob yuav ntsuas koj cov ntshav siab thiab mloog koj lub plawv thiab lub ntsws.
Qhia rau koj tus kws kho mob paub yog tias muaj ib feem ntawm qhov kev kuaj mob uas ua rau koj mob, xws li yog koj hnov mob thaum ua pa tob tob thaum kws kho mob mloog koj lub plawv thiab lub ntsws nrog lub tshuab raj mloog
Kauj Ruam 3. Tau txais kev kuaj mob
Koj tus kws kho mob yuav xaj kuaj ntxiv txhawm rau txiav txim siab seb koj puas muaj DVT lossis koj qhov mob hnyav npaum li cas. Cov kev kuaj mob feem ntau rau DVT yog:
- Ultrasound, uas yog qhov kev sim ntau tshaj plaws rau DVT. Nws ua ib daim duab ntawm cov leeg thiab cov hlab ntsha hauv koj txhais ceg yog li koj tus kws kho mob tuaj yeem tshuaj xyuas qhov ua tau zoo dua.
- D-dimer test, uas ntsuas cov khoom hauv koj cov ntshav uas tau tso tawm thaum cov ntshav tawg. Cov qib siab tuaj yeem qhia pom cov hlab ntshav sib sib zog nqus.
- Muab kauv CT ntawm lub hauv siab lossis tso pa tawm/tso pa tawm (VQ) luam tawm txhawm rau txiav tawm kev mob ntsws ntsws.
- Venography, uas ua tiav thaum lub ultrasound tsis muab koj tus kws kho mob kuaj pom meej. Cov txheej txheem no yuav tsum tau txhaj tshuaj zas xim thiab tom qab ntawd tau xoo hluav taws xob uas ua rau pom cov leeg ntshav. Xoo hluav taws xob tuaj yeem qhia tau yog tias cov ntshav ntws qeeb, uas tuaj yeem txhais tau tias koj muaj cov hlab ntshav sib sib zog nqus.
- Sib nqus resonance imaging (MRI) lossis computer tomography (CT) scan, uas ua cov duab ntawm lub cev. Cov kev ntsuas no tsis yog ib qho rau DVT, tab sis feem ntau siv rau kev kuaj PE.
Ntu 3 ntawm 3: Kho Kab Mob Ntshav Qab Zib
Kauj Ruam 1. Noj tshuaj anticoagulants
Yog tias koj tus kws kho mob kuaj pom koj nrog DVT, lawv yuav ua kom koj cov ntshav tsis txhob loj tuaj, tiv thaiv nws kom tsis txhob tawg thiab txav mus rau lub ntsws, thiab txo koj txoj kev pheej hmoo ntawm lwm qhov khov. Feem ntau txoj hauv kev uas koj tus kws kho mob yuav ua qhov no yog los ntawm kev sau tshuaj anticoagulants, lossis ntshav ua kom yuag. Cov tshuaj no tuaj yeem siv tau ua ib qho tshuaj, txhaj tshuaj hauv qab daim tawv nqaij, lossis txhaj tshuaj. Cov neeg mob uas muaj mob DVT yuav tsum tau mus pw hauv tsev kho mob rau kev kho ntshav khov.
- Nco ntsoov nug cov lus nug txog cov ntshav thim koj tab tom noj. Qhov ob feem ntau yog warfarin thiab heparin. Thaum pib koj yuav pib nrog heparin tom qab ntawd hloov mus rau warfarin. Warfarin tau muab rau hauv cov ntsiav tshuaj thiab tej zaum yuav muaj kev phiv xws li mob taub hau, ua pob, thiab plaub hau poob. Heparin los hauv ntau hom ntawv - koj tus kws kho mob yuav tham txog qhov kev xaiv zoo tshaj rau koj. Heparin tuaj yeem tuaj nrog cov kev mob tshwm sim xws li los ntshav, tawv nqaij tawv, mob taub hau, thiab mob plab.
- Nco ntsoov tias koj tus kws kho mob yuav sau ntawv rau koj Heparin thiab warfarin tib lub sijhawm. Lawv kuj tseem yuav sau ntawv lwm cov tshuaj ntshav ua kom yuag xws li enoxaparin (Lovenox), dalteparin (Fragmin) lossis fondaparinux (Arixtra).
- Ua raws koj tus kws kho mob cov lus qhia rau kev noj tshuaj kom raug. Noj ntau dhau lossis tsawg dhau ntawm koj cov tshuaj tuaj yeem muaj kev phom sij loj. Ua raws txhua lub lim tiam rau kev ua ntshav lossis raws li koj tus kws kho mob pom zoo.
Kauj Ruam 2. Muab lub lim dej tso rau
Qee tus neeg yuav tsis tuaj yeem siv cov tshuaj ua kom ntshav qis lossis anticoagulants tej zaum yuav tsis muaj txiaj ntsig zoo los kho cov ntshav khov. Hauv cov xwm txheej no, koj tus kws kho mob yuav hais kom ntxig lub lim dej rau hauv vena cava, uas yog cov hlab ntshav loj hauv koj lub plab. Lub lim tuaj yeem tiv thaiv cov ntshav txhaws uas tau tawg hauv koj txhais ceg los ntawm kev nyob hauv koj lub ntsws.
Kauj Ruam 3. Ua kom cov hlab ntshav khov nrog cov hlab ntshav
Cov mob hnyav ntawm DVT yuav xav tau tshuaj hu ua thrombolytics, uas tseem hu ua clot busters. Cov tshuaj no ua rau cov ntshav khov, uas koj lub cev yuav tsis zoo ib yam nrog lwm cov tshuaj.
- Paub txog tias thrombolytics ua rau muaj kev pheej hmoo ua rau los ntshav, uas yog vim li cas lawv thiaj tseg rau qhov mob hnyav lossis ua rau neeg tuag taus.
- Nco ntsoov tias vim yog qhov mob hnyav, thrombolytics tsuas yog muab rau hauv chav saib xyuas mob hnyav ntawm tsev kho mob. Tus kws kho mob yuav tshuaj cov tshuaj hla kab IV lossis los ntawm txoj hlab ntshav uas tau tso ncaj qha rau hauv cov hlab ntshav.
Kauj Ruam 4. Hnav cov thom khwm kom nruj
Ua ntxiv rau ib qho kev kho mob rau DVT, koj tus kws kho mob yuav sau ntawv hnav thom khwm thom khwm. Cov no tuaj yeem tiv thaiv kev o ntxiv rau ntshav los ntawm kev sib sau ua ke thiab khov hauv koj ob txhais ceg.
- Kom koj lub hnab ntim khoom haum los ntawm koj tus kws kho mob lossis kws tshaj lij kho mob. Ua qhov no tuaj yeem pab xyuas kom koj tau txais kev sib zog txaus kom ua tau zoo tiv thaiv txhaws. Kev yuav ib khub niam txiv uas haum rau ntau lub cev sib txawv yuav tsis zoo li ib khub tshwj xeeb tau ua rau koj.
- Hnav koj cov thom khwm rau ob rau peb xyoos yog tias ua tau.
Kauj Ruam 5. Tau phais
Thrombectomy yog ib hom kev phais siv los tshem cov quav los ntawm koj txhais ceg. Cov txheej txheem no tau siv tsawg zaus, xws li yog tias koj cov ntshav khov tshwj xeeb, hnyav dua, lossis tsis teb tshuaj.
