Lub paj hlwb rov ua haujlwm

Kev kho pob txha caj qaum ua haujlwm yog kev phais kho kom thiaj li ua pob qij txha hauv pob txha. Qhov no yog thaj chaw tsis muaj zog nyob hauv phab ntsa cov hlab ntsha uas ua rau lub nkoj thawb lossis zais lub pob tawm thiab qee zaum tawg (tawg). Tej zaum nws yuav ua rau:

• Los ntshav rau hauv cov hlab hlwb cerebrospinal kua (CSF) nyob ib ncig ntawm lub hlwb (tseem hu ua subarachnoid hemorrhage)
• Los ntshav rau hauv lub hlwb uas sau cov ntshav (hematoma)

Muaj ob txoj hauv kev siv los kho cov leeg pob txha:

• Clipping ua tiav thaum qhib craniotomy.
• Kev kho endovascular (phais), feem ntau siv cov coil lossis coiling thiab stenting (ntxaij leeg), tsis tshua muaj kev cuam tshuam thiab ntau txoj hauv kev los kho tus mob aneurysms.

Thaum lub sij hawm aneurysm clipping:

• Koj tau muab cov tshuaj loog dav dav thiab lub tshuab ua pa.
• Koj daim tawv taub hau, pob txha taub hau, thiab qhov npog ntawm lub hlwb raug qhib.
• Ib qho xaim hlau tso rau ntawm lub hauv paus (caj dab) ntawm pob qij txha los tiv thaiv nws ntawm tawg qhib (tawg).

Thaum kho endovascular (phais) ntawm pob taws ua pob txha:

• Tej zaum koj yuav muaj kev tso tshuaj kom tsaug zog thiab lub ntsws ua pa. Lossis, koj tuaj yeem muab tshuaj rau koj maj mam so, tab sis tsis txaus koj yuav tsum pw.
• Tus kws ntsuas txoj hlab ntshav yog taw qhia los ntawm kev txiav me me hauv koj lub puab tais mus rau cov leeg ntshav thiab tom qab ntawd mus rau cov hlab ntshav hauv koj lub hlwb qhov twg pob txha caj dab nyob.
• Cov khoom sib dhos yog txhaj los ntawm cov raj yas. Qhov no tso cai rau tus kws phais neeg tuaj yeem saib cov ntshav thiab lub pob taws ntawm lub ntsej muag ntawm tus saib hauv chav ua haujlwm.
• Cov hlau hlau hlau tau muab tso rau hauv pob taws ua pob taws. Lawv mam li coil rau hauv ib lub pob mesh. Vim li no, cov txheej txheem kuj tseem hu ua coiling. Cov ntshav txhaws tsim nyob ib ncig ntawm lub kauj no tiv thaiv cov hlab pob txha ntshav txhaws tawm thiab los ntshav. Qee zaum stents (ntxaij leeg) kuj tau muab tso rau hauv kom tuav lub kauj rau hauv qhov chaw thiab ua kom txoj hlab ntshav nyob twj ywm qhib.
• Lub sijhawm thiab tom qab qhov txheej txheem, koj yuav tau muab cov ntshav ua kom ntshav dawb, xws li heparin, clopidogrel, lossis tshuaj aspirin. Cov tshuaj no tiv thaiv cov ntshav txhaws txaus ntshai los ntawm qhov sau ua kav.

Yog tias qhov mob pob taws hauv lub hlwb tawg qhib (tawg), nws yog qhov xwm txheej ceev uas yuav tsum tau kho mob hauv tsev kho mob. Feem ntau kev sib tawg yog kho nrog kev phais mob, tshwj xeeb tshaj yog kev phais mob endovascular.

Ib tus neeg yuav muaj pob taws tsis cuam tshuam yam tsis muaj tsos mob. Hom pob qij txha no tau pom thaum ntsuas MRI lossis CT scan ntawm lub hlwb ua rau lwm qhov laj thawj.

• Tsis yog txhua txhua cov hlab pob taws yuav tsum tau kho tam sim ntawd. Aneurysms uas tsis tau los ntshav, tshwj xeeb tshaj yog tias lawv me me (tsawg dua 3 hli ntawm lawv qhov loj tshaj plaws), tsis tas yuav kho mob tam sim ntawd. Cov pob leeg me me no tsis tshua muaj kev sib tawg.
• Koj tus kws phais yuav pab koj txiav txim siab tias nws muaj kev nyab xeeb dua rau kev phais kom thaiv cov leeg pob txha caj qaum ua ntej nws tuaj yeem tsoo qhib lossis saib xyuas lub pob taws ntawm pob txha rov ua dua kom txog thaum phais mob tsim nyog. Qee qhov nqaij me me tsis muaj qhov xav phais.

Kev phom sij ntawm cov tshuaj loog thiab phais feem ntau yog:

• Kev tshuaj tiv thaiv
• Cov teeb meem ua pa
• Los ntshav, txhaws ntshav, lossis kis tus kab mob

Kev phom sij ntawm lub hlwb phais yog:

• Cov ntshav txhaws lossis los ntshav hauv lossis ib ncig ntawm lub hlwb
• Lub hlwb o
• Tus kab mob nyob rau hauv lub hlwb los yog qhov chaw nyob ib ncig ntawm lub hlwb, xws li lub pob txha taub hau los yog tawv taub hau
• Qaug dab peg
• Mob stroke

Kev phais mob rau ib qho ntawm ib cheeb tsam ntawm lub paj hlwb yuav ua teeb meem uas yuav ua tau mob me lossis hnyav. Lawv yuav kav ib ntus luv lossis lawv yuav ploj mus.

Cov tsos mob ntawm lub hlwb thiab lub paj hlwb (lub paj hlwb) muaj teeb meem suav nrog:

• Kev coj cwj pwm pauv
• Tsis meej pem, teeb meem nco
• Kev poob ntawm kev tshuav lossis kev sib koom tes
• Looj
• Cov teeb meem pom yam nyob ib puag ncig koj
• Teeb meem hais lus
• Cov teeb meem tsis pom kev (txij li dig muag mus rau qhov teeb meem nrog lub zeem muag)
• Nqaij tsis muaj zog

Cov txheej txheem no feem ntau ua tiav yog thaum muaj xwm txheej ceev. Yog tias nws tsis yog xwm ceev:

• Qhia koj tus kws kho mob tias koj noj tshuaj lossis tshuaj ntsuab dab tsi thiab yog koj tau haus cawv ntau heev.
• Nug koj tus kws kho mob seb koj yuav tsum tau noj cov tshuaj twg rau tag kis thaum ntxov ntawm kev phais mob.
• Sim txiav luam yeeb.
• Ua raws li cov lus qhia kom tsis txhob noj thiab haus ua ntej phais mob.
• Noj cov tshuaj uas koj tus kws kho mob hais kom koj nqa nrog lub pas dej me me.
• Mus txog tsev kho mob kom ncav sijhawm.

Lub tsev kho mob nyob hauv kev kho cov leeg pob txha caj dab ntev txog li 1 txog 2 hnub yog tias tsis muaj ntshav tawm ua ntej kev phais mob.

Lub tsev kho mob nyob tom qab craniotomy thiab aneurysm clipping feem ntau yog 4 rau 6 hnub. Yog tias muaj ntshav los yog lwm yam teeb meem, xws li cov hlab ntshav nqaim hauv lub hlwb lossis cov kua dej hauv lub hlwb, cov tsev kho mob tuaj yeem ntev txog 1 txog 2 asthiv, lossis ntev dua.

Tej zaum koj yuav muaj kev sim ntsuas cov hlab ntshav (angiogram) hauv lub hlwb ua ntej koj xa mus tsev, thiab tej zaum ib xyoos ib zaug rau ob peb xyoos.

Ua raws li cov lus qhia hais txog kev tu koj tus kheej hauv tsev.

Nug koj tus kws kho mob yog tias nws yuav muaj kev nyab xeeb rau koj los ua cov duab ntsuas xws li angiogram, CT angiogram, lossis MRI kuaj xyuas lub taub hau yav tom ntej.

Tom qab phais mob tiav rau qhov ntshav tawm ua ntshav tawm, tsis zoo li nws tau los ntshav dua.

Qhov kev txheeb xyuas kuj tseem nyob ntawm seb puas lub hlwb puas tshwm sim los ntshav los ntshav ua ntej, thaum, lossis tom qab phais tas.

Feem ntau, kev phais mob tuaj yeem tiv thaiv lub hlwb pob txha uas tsis ua rau cov tsos mob ua kom loj dua thiab tawg qhib.

Tej zaum koj yuav muaj ntau dua ib lub pob taws lossis pob taws uas ua hau khov ua zaum yuav rov qab los. Tom qab kho coiling, koj yuav tsum tau pom koj tus kws kho mob nyob rau txhua xyoo.

Aneurysm kho - cerebral; Cerebral aneurysm kho; Txheej Hlau; Kev Kho Saccular aneurysm; Berry aneurysm kho; Kev kho fusiform aneurysm; Kev faib cov pob taws ua dej taws; Kev kho endeascular aneurysm - lub paj hlwb; Cov kab mob hauv lub cev subarachnoid - aneurysm

• Kho lub paj hlwb aneurysm - kev tso tawm
• Kev phais mob hlwb - tso tawm
• Kev saib xyuas cov leeg mob lossis txha pob txha
• Sib txuas lus nrog ib tus neeg nrog aphasia
• Sib txuas lus nrog ib tug neeg nrog dysarthria
• Dementia thiab tsav tsheb
• Kev dementia - kev coj cwj pwm thiab teeb meem pw tsaug zog
• Dementia - kev saib xyuas txhua hnub
• Dementia - ua kom muaj kev nyab xeeb hauv tsev
• Epilepsy hauv menyuam yaus - kev tso tawm
• Mob Stroke - tawm
• Nqos teeb meem

Altschul D, Vats T, Unda S. Endovascular kev kho mob ntawm lub hlwb pob txha. Hauv: Ambrosi PB, ed. Cov Lus Qhia Tshiab Ntxiv Rau Cov Cerebrovascular Kab Mob - Ib qho Kev Ntsuam Xyuas Dua Tshiab. www.intechopen.com/books/Nyob-insight-into-cerebrovascular-diseases-an-updated-comprehensive-review/endovascular-treatment-of-brain-aneurysms. IntechOpen; 2020: chap: 11. Soj ntsuam Lub Yim Hli 1, 2019. Nkag mus Lub Tsib Hlis 18, 2020.

American Stroke Association lub vev xaib. Dab tsi koj yuav tsum paub txog cerebral aneurysms. www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds/what-you-should-know-about-cerebral-aneurysms#. Hloov kho thaum Lub Kaum Ob Hlis 5, 2018. Nkag mus Lub Xya Hli 10, 2020.

Le Roux PD, Winn HR. Kev txiav txim siab kev txiav txim siab rau kev kho mob ntawm cov leeg pob txha caj dab. Hauv: Winn HR, ed. Youmans thiab Winn Neurological phais. 7 tus ed. Philadelphia, PA: Elsevier; 2017: cha 379.

Lub koom haum National of Neurological Disorders thiab Stroke lub vev xaib. Cerebral aneurysms cov ntawv pov thawj tseeb.www.ninds.nih.gov/Disorders/Patient-Caregiver- Education-Fact-Sheets/Cerebral-Aneurysms-Fact-Sheet. Hloov kho thaum Lub Peb Hlis 13, 2020. Nkag mus Lub Xya Hli 10, 2020.

Hmob J, Macdonald RL. Kev tswj xyuas ntu ntawm subarachnoid hemorrhage. Hauv: Winn HR, ed. Youmans thiab Winn Neurological phais. 7 tus ed. Philadelphia, PA: Elsevier; 2017: chap 380.