Cauda Equina Syndrome (CES) yog kev kho mob xwm txheej ceev uas xav tau kev kuaj mob sai thiab kho sai. Kev kho sai dua (ntawm kev phais decompression ntawm tus txha nqaj qaum) tau txais, qhov zoo dua yog qhov uas koj yuav rov zoo. Txhawm rau txheeb xyuas CES, nws yog qhov tseem ceeb uas koj paub txog cov tsos mob thiab cov tsos mob thiab, yog tias koj tab tom ntsib lawv, tias koj mus rau Chav Kho Mob Kub Ceev tam sim ntawd. Koj tus kws kho mob tuaj yeem ua ntu ntu ntawm kev kuaj mob thiab tshuaj xyuas uas tuaj yeem lees paub qhov kev kuaj mob ntawm CES, ntxiv rau txheeb xyuas qhov ua rau, yog li nws tuaj yeem kho sai li sai tau.
Cov kauj ruam
Ntu 1 ntawm 3: Paub Cov Cim thiab Cov tsos mob
Kauj Ruam 1. Saib xyuas mob ceg thiab/lossis teeb meem taug kev
Vim tias Cauda Equina Syndrome (CES) cuam tshuam rau qab haus huv hauv qab ntawm koj tus txha caj qaum, thiab vim tias ntau ntawm cov hlab ntsha mus rau koj ob txhais ceg, CES thaum ntxov yuav tshwm sim raws li qhov mob nthuav tawm ib lossis ob txhais ceg, thiab/lossis teeb meem txav mus los koj ob txhais ceg lossis taug kev nrog qhov yooj yim ib yam li ua ntej.
Kauj Ruam 2. Mus ntsib koj tus kws kho mob tam sim yog tias koj tab tom ntsib kev zais zis thiab/lossis lub plab ua haujlwm tsis zoo
Yog tias koj tsis tuaj yeem tso zis (piv txwv li nws tau ntim ntau hauv koj lub zais zis thiab koj tsis tuaj yeem tso zis), mus rau Chav Kho Mob Kub Ceev. Yog tias koj tsis tuaj yeem tswj koj cov zis (piv txwv li yog tso zis tso zis yam tsis xav ua), qhov no yog lwm qhov cim ntawm CES. Ib yam nkaus, tsis muaj peev xwm tswj tau koj lub plab sai sai (xws li quav quav tsis raug lossis quav quav los ntawm koj lub qhov quav) yog qhov ua tau ntawm CES. Tag nrho cov lus pom zoo tam sim kho mob thiab tshuaj xyuas.
Kauj Ruam 3. Tshaj tawm yog tias koj ntsib teeb meem kev sib deev txawv txav
Yog tias koj tab tom ntsib kev poob qis thiab txawv txav hauv koj qhov kev xav ntawm kev sib deev, thiab/lossis koj lub peev xwm rau kev txhim kho erection thiab/lossis orgasm, qhov no yuav yog qhov muaj peev xwm kos npe ntawm CES. Nrhiav kev kho mob tam sim.
Kauj Ruam 4. Saib xyuas kom loog hauv "thaj chaw eeb
"Yog tias koj pom loog hauv" thaj chaw eeb "(duab thaj tsam ntawm koj lub plab uas yuav cuam tshuam nrog lub eeb yog tias koj yuav zaum ntawm ib qho), thaj chaw no nws yog" chij liab "(txhawj xeeb) cov tsos mob thiab koj yuav tsum mus ntsib kws kho mob tam sim. Qhov tsis hnov lus ntawm qhov chaw mos ("eeb") tsis zoo li qub, thiab tej zaum yuav yog ib qho cim ntawm yuav los (lossis tam sim no) CES.
Kauj Ruam 5. Ua tib zoo saib mob nraub qaum
Koj tuaj yeem hnov qhov mob thiab mob hnyav hauv koj lub nraub qaum, uas tuaj yeem ua rau tsis txaus ntseeg. Nov yog lwm tus chij liab cov tsos mob thiab nws tuaj yeem sib txawv hauv kev siv lossis loj hlob qeeb zuj zus.
Kauj Ruam 6. Paub txog qhov ua tsis tau zoo
Koj tuaj yeem pom tias koj lub pob taws thiab lub hauv caug cuam tshuam tau ploj zuj zus. Koj kuj tseem yuav muaj kev cuam tshuam tsis zoo hauv qhov quav thiab cov leeg bulbospongiosus, nyob nruab nrab ntawm qhov quav thiab qhov chaw mos.
Kauj Ruam 7. Xav seb koj puas tau muaj "xwm txheej tshwm sim tsis ntev los no
Ntau zaus, CES ua raws qhov xwm txheej uas ua rau muaj kev raug mob lossis lwm yam teeb meem hauv tus txha nqaj qaum.
- Kev kis tus kab mob tsis ntev los no (nws muaj peev xwm tias qhov no yuav kis mus rau tus txha nqaj qaum)
- Tsis ntev los no phais phais
- Kev raug mob nraub qaum tsis ntev los no, xws li raug xwm txheej lossis lwm yam raug mob
- Keeb kwm mob qog noj ntshav (qee zaum mob qog noj ntshav tuaj yeem kis mus rau tus txha nqaj qaum ua rau txhaws ntawm cov hauv paus paj hlwb)
Kauj Ruam 8. Mus rau Chav Kho Mob Kub Ntxov tam sim yog tias koj pom tias muaj “chij liab” cov tsos mob
Yog tias koj tab tom ntsib ib qho ntawm cov tsos mob tau piav qhia hauv kab lus no - mob ceg thiab/lossis muaj teeb meem taug kev, mob nraub qaum los yog mob lossis loog hauv thaj chaw eeb, zais zis thiab/lossis lub plab tsis ua haujlwm, txo qis kev xav hauv qhov qis, hloov pauv sai hauv kev sib deev muaj nuj nqi, ua rau muaj teeb meem tshwm sim - nws yog qhov tseem ceeb uas koj mus ncaj nraim rau chav kho mob xwm txheej ceev tam sim ntawd. Lub sijhawm siv tos lossis tos yog lub sijhawm muaj nuj nqis poob uas tuaj yeem ua rau koj lub luag haujlwm thiab kev noj qab haus huv nyob ntev.
Ntu 2 ntawm 3: Tau Txais Kev Tshuaj Ntsuam Xyuas thiab Tshuaj Ntsuam Xyuas
Kauj Ruam 1. Kom koj tus kws kho mob kuaj mob paj hlwb
Koj tus kws kho mob yuav ntsuas koj qhov kev xav rov qab, koj lub peev xwm txav koj txhais ceg qis, koj lub zog thaum nws ua haujlwm tiv thaiv koj cov leeg nqaij, thiab koj lub siab thaum nws kuaj koj cov tawv nqaij nrog ntau yam khoom. Yog tias ib qho ntawm cov no txawv txav, nws yuav yog qhov qhia txog qhov muaj peev xwm Cauda Equina Syndrome (CES).
- Koj tus kws kho mob yuav sim koj qhov kev txav mus los thiab kev sib koom tes los ntawm kev thov koj taug kev ntawm koj pob taws thiab ntiv taw.
- Nws lossis nws yuav tshuaj xyuas qhov mob thaum koj khoov rau pem hauv ntej, rov qab, thiab rau txhua sab.
- Koj tus kws kho mob yuav tshuaj xyuas koj qhov kev xav thiab kev xav rov qab, vim qhov txawv txav ntawm no yog qhov tseem ceeb ntawm kev kuaj mob CES.
Kauj Ruam 2. Tau txais CT lossis MRI
Yog tias koj cov tsos mob qhia tias koj tuaj yeem muaj CES, nws yog qhov tseem ceeb uas koj tau txais kev kuaj pom duab (ib qho CT lossis MRI) sai li sai tau. Kev ntsuas duab yuav tso cai rau tus kws kho mob pom koj tus txha caj qaum, suav nrog cov hauv paus paj hlwb, thiab ntsuas seb dab tsi, yog tias muaj dab tsi, tej zaum yuav ua rau lawv raug kaw. Cov peev txheej ua tau ntawm tus txha nqaj qaum uas tuaj yeem kuaj pom ntawm CT lossis MRI suav nrog:
- Thawj qog nqaij hlav qog lossis mob qog noj ntshav metastases
- Ib qho herniated disc hauv koj lub nraub qaum
- Cov pob txha
- Kev kis kab mob uas tau nkag rau hauv koj tus txha nqaj qaum
- Ib qho tawg ntawm tus txha nqaj qaum
- Kev nqaim ntawm tus txha nqaj qaum vim li cas
- Teeb meem txha nraub qaum xws li ankylosing spondylitis (mob caj dab mob)
- Ntshav los ntshav
Kauj Ruam 3. Tau txais myelogram
Ntxiv nrog rau tus qauv CT lossis MRI, koj kuj tseem yuav tau txais qee yam hu ua myelogram. Qhov no yog thaum cov khoom sib piv tau tso rau hauv cov kua dej hauv lub cev ntawm koj tus txha caj qaum, thiab tom qab ntawd muab duab x-ray duab.
- Qhov sib txawv tso cai rau pom kev pom tseeb seb puas muaj qhov txawv txav lossis hloov chaw hauv koj tus txha caj qaum.
- Myelogram tuaj yeem qhia pom herniated discs, pob txha spurs, lossis qog, txhua yam uas yuav muaj lub luag haujlwm ua rau CES.
Kauj Ruam 4. Tau txais kev kuaj mob paj hlwb ntawm qis qis qis
Kev kuaj mob paj hlwb tuaj yeem pab txheeb xyuas CES thiab yuav tsum ua kom sai li sai tau. Koj tus kws kho mob yuav ua qhov kev ntsuam xyuas hauv qab no:
- Nerve conduction velocity (NCV) - Qhov kev ntsuas no yuav ntsuas qhov nrawm ntawm hluav taws xob tsis zoo thaum nws txav los ntawm cov hlab ntsha. Qhov kev ntsuas no tuaj yeem txiav txim siab yog tias muaj cov hlab ntsha puas thiab tuaj yeem ntau npaum li cas. Cov hlab ntsha yuav raug txhawb los ntawm ib qho electrode thaj txuas ntawm ib kawg thiab lub zog hluav taws xob tau sau tseg los ntawm lwm thaj.
- Electromyography (EMG) - Qhov kev ntsuas no feem ntau ua tiav tib lub sijhawm NCV thiab nws ntsuas cov hluav taws xob ua haujlwm hauv koj cov leeg.
Ntu 3 ntawm 3: Kho Cauda Equina Syndrome
Kauj Ruam 1. Tau txais kev phais mob xwm txheej ceev
Yog tias koj tau kuaj pom tias muaj Cauda Equina Syndrome (CES), nws yog qhov tseem ceeb kom pom tus kws kho mob paj hlwb rau kev phais tam sim. Kev phais yuav tsum tau ua nyob rau hauv 48 teev ntawm qhov pib ntawm cov tsos mob, yog tias ua tau, thiab sai dua nws ua tiav zoo dua.
- Kev phais yuav suav nrog tshem tawm cov khoom siv twg (xws li qog, lossis kab mob) uas tab tom ua rau koj tus txha caj qaum.
- Lub hom phiaj yog, los ntawm kev kho lub hauv paus ua rau (ua rau txha nraub qaum), qhov nro yuav raug tshem tawm ntawm koj cov hauv paus hniav, thiab koj yuav tsum cia siab tias yuav tuaj yeem rov ua haujlwm tau.
Kauj Ruam 2. Npaj rau qhov yuav tshwm sim mus sij hawm ntev tom qab CES
Nyob ntawm seb koj tau txais kev kho mob sai npaum li cas tom qab pib muaj cov tsos mob, nrog rau qib ntawm kev puas siab puas ntsws (cuam tshuam txog paj hlwb) uas tau tshwm sim hauv koj tus txha nraub qaum, koj tuaj yeem xaus nrog cov tsos mob mus sij hawm ntev lossis xiam oob qhab tom qab CES. Cov no yuav suav nrog:
- Mob ntev-qee tus neeg xav tau tshuaj kho mob mus ntev kom yooj yim mob ntsig txog cov hlab ntsha txuas ntxiv tom qab CES.
- Lub zais zis lossis lub plab ua haujlwm tsis zoo - qee cov tib neeg tseem niaj hnub tawm tsam nrog lub zais zis thiab/lossis kev tswj lub plab, txawm tias tom qab phais kev daws teeb meem ntawm lawv CES. (Txawm li cas los xij, xov xwm zoo ntawm no yog lub zais zis thiab lub plab ua haujlwm feem ntau txhim kho nyob rau xyoo tom qab kev phais; nws tsuas yog siv sijhawm ntev dua kom rov ua haujlwm zoo dua li lwm qhov chaw cuam tshuam.)
- Teeb meem kev sib deev - cov neeg mob feem ntau tau qhia kom mus ntsib kws kho mob sib deev kom pab tau yog tias lawv tawm tsam kom rov ua haujlwm tau deev.
- Teeb meem lub cev muaj zog - teeb meem taug kev lossis ua lwm yam haujlwm txav chaw, tshwj xeeb nrog koj txhais ceg qis.
Kauj Ruam 3. Nkag siab tias yog vim li cas thiaj tseem ceeb kom nrhiav kev kho mob sai
Yog tias koj tab tom pom cov cim thiab tsos mob ntawm CES muaj peev xwm thiab tsis tau txais kev kho mob tam sim, nws yuav ua rau tuag tes tuag taw tas mus li ntawm koj txhais taw qis, poob tas li ntawm kev ua haujlwm thiab kev xav, thiab/lossis lub zais zis tsis zoo lossis ua haujlwm tsis zoo. Tsis tas yuav hais, cov no yog yam koj xav zam! Yog li ntawd, yog tias muaj qhov tsis ntseeg, mus rau hauv Chav Saib Xyuas Xwm Ceev hauv koj cheeb tsam txhawm rau tshuaj xyuas koj cov cim thiab tsos mob kom ntseeg tau tias, yog tias koj tab tom txhim kho CES, nws raug kho thiab daws sai li sai tau.
