Cov txheej txheem xwm txheej kub ntxhov rau kev los ntshav tom qab daim siab biopsy
Nov 24, 2022
Lub siab yog lub cev loj tshaj plaws nyob rau hauv lub plab kab noj hniav, lub luag haujlwm rau cov haujlwm tseem ceeb ntawm lub cev ntawm tib neeg lub cev. Lub siab ua haujlwm tsis zoo rau hypoxia, yog li muaj cov hlab ntsha hauv siab thiab cov hlab ntsha portal muab cov ntshav txaus, thiab cov ducts thiab cov hlab ntsha los thauj cov kua tsib. Nws nyob tob rau hauv lub plab sab xis thiab tiv thaiv los ntawm sab hauv siab phab ntsa thiab diaphragm. Txawm li cas los xij, vim qhov loj me thiab nkig zoo nkauj ntawm daim siab, ib zaug raug kev tsim txom, nws yooj yim rau kev puas tsuaj, qhov tshwm sim ntawm cov ntshav hauv plab lossis cov kua tsib to, ua rau hemorrhagic shock thiab / lossis biliary peritonitis, qhov tshwm sim loj heev, yuav tsum. kuaj tau raws sijhawm thiab kho kom raug.
Qhib kev raug mob, raws li qhov chaw ntawm lub qhov txhab, qhov tob thiab kev taw qhia ntawm lub qhov txhab kab mob, qhov kev kuaj mob ntawm daim siab mob tsis yog qhov nyuaj. Kev kuaj mob ntawm kev kaw qhov tseeb hepatic laceration nrog pom tseeb intraperitoneal los ntshav thiab peritoneal irritation tsis yooj yim. Tej zaum nws yuav nyuaj rau kev kuaj mob daim siab tsuas yog thaum cov tsos mob thiab cov tsos mob tsis pom tseeb hauv subcapsular daim siab laceration, subcapsular hematoma thiab central laceration. Nws yog ib qho tsim nyog yuav tsum tau ua kom tiav kev soj ntsuam raws li kev raug mob thiab kev kho mob tshwm sim, thiab ua tib zoo saib xyuas cov kev hloov ntawm cov cim tseem ceeb thiab cov tsos mob plab. Cov kev ntsuam xyuas hauv qab no yuav pab tau rau kev kuaj mob:
(1) Diagnostic abdominal puncture needle Txoj kev no yog qhov muaj txiaj ntsig zoo rau kev kuaj mob ntawm intraperitoneal rupture, tshwj xeeb tshaj yog rau cov kab mob hauv nruab nrog cev. Feem ntau tsis txhob txhaws ntshav tuaj yeem suav tias muaj kev puas tsuaj visceral. Txawm li cas los xij, tej zaum yuav muaj cov txiaj ntsig tsis zoo thaum cov ntshav poob me me, yog li qhov tsis zoo puncture tsis tuaj yeem suav nrog kev raug mob visceral. Yog tias tsim nyog, ua ntau yam tho rau hauv qhov chaw sib txawv thiab lub sijhawm sib txawv, lossis ua qhov kev kuaj mob lavage hauv plab kab noj hniav kom pab kuaj mob.
(2) Kev ntsuas ib ntus ntawm cov qe ntshav liab, hemoglobin thiab hematocrit los soj ntsuam lawv cov kev hloov pauv hloov pauv, yog tias muaj ntshav tsis txaus, qhia tias los ntshav sab hauv.
(3) B-hom ultrasound xeem txoj kev tuaj yeem tsis tsuas yog nrhiav tau hauv plab plab hematoma, tab sis kuj tseem tuaj yeem pab kuaj mob ntawm subcapsular hematoma thiab intrahepatic hematoma, uas feem ntau siv hauv tsev kho mob.
(4) X-ray kuaj, yog tias muaj subcapsular hematoma, kab noj hniav raug mob.
(5) Lub siab radionuclide scan tuaj yeem siv los kuaj xyuas qhov raug mob kaw uas tseem tsis tau meej thiab xav tias muaj subcapsular lossis intrahepatic hematoma. Yog tias qhov kev raug mob tsis ceev heev, isotope daim siab scan tuaj yeem ua tau thaum tus neeg mob tso cai. Muaj cov xov tooj cua tsis zoo hauv daim siab ntawm cov neeg mob hematoma.
(6) Kev xaiv cov kab mob hepatic angiography tuaj yeem siv rau qee qhov kev raug mob kaw uas nyuaj heev rau kev kuaj mob, xws li xav tias muaj kab mob intrahepatic hematoma thiab tsis yog mob ceev heev. Kev tsim ntawm intrahepatic arterial ceg aneurysms lossis qhov sib txawv extravasation thiab lwm yam kev kuaj mob tau pom. Tab sis qhov no yog ib qho kev ntsuam xyuas, kev ua haujlwm yog qhov nyuaj, tsuas yog ua tau raws li qee qhov xwm txheej, tsis tuaj yeem siv raws li kev tshuaj xyuas niaj hnub.
