Cavernous sinus thrombosis: iimpawu, isifo, unyango

Cavernous sinus thrombosis yi occlusion thrombus sinus cavernous, nto leyo imi Amaza kumacala omabini loo turcica sella.

Umsebenzi sinus cavernous i kuphuma lwemithambo ukusuka kummandla iziseko iliso kwaye nobuchopho, kwakunye nokulawulwa kwegazi lobuchopho.

Le ngezifo kakhulu inqabile, kodwa inokubangela nemiphumela emibi kakhulu. Kwakhona kwakunzima ukufumana thrombosis le sigmoid kunye sinus ezinqamlezayo.

Ezibangela isifo

Cavernous sinus thrombosis kunokwenzeka ngenxa yezizathu ezahlukeneyo. Kuye ezibabeka:

• Izifo ezosulelayo leyo kwenzeka ngohlobo yayiyazi kwi maxillary sinuses, iindlebe, amazinyo, impumlo kunye emqaleni;
• phambi trauma cranial;
• Izifo komzimba (systemic lupus zomzimba, isifo samathambo);
• iinkqubo hemostasis yezifo ezo zihamba ngokwanda ukubunjwa thrombi (phambi politsetemii);
• semithambo kunye nesifo kwentliziyo (ukonakala intliziyo kobuchopho, intliziyo isingqi ukuphazamiseka et al.);
• iswekile osegazini;
• isisu;
• ukusukela ekuzalweni komntwana.

amahlwili igazi indalo esosulelayo kunye noninfectious. Okwangoku, kwaphawuleka imvelaphi non-esosulelayo. Oku kungenxa yokusetyenziswa rhoqo-ntsholongwane ezithintela iingxaki kakhulu. Kule meko kulisiko ukuthetha uhlobo idiopathic of thrombosis lwemithambo.

symptomatology kwesifo

Ziintoni iimpawu zezifo ezifana cavernous sinus thrombosis? Clinic oko inzima kakhulu. Maxa wambi sifo kuba nzima ukubona usaqala, kuba iimpawu zidla ezinxitywa kwindalo kwaye iyafana iimpawu zezinye izifo.

Phakathi izalathisi ezingundoqo zesi sifo kufuneka ziphawuliwe:

• ubukho yintloko obukhulu;
• isicaphucaphu nokugabha;
• ukulahlekelwa kunye nokudideka;
• coma;
• ivela ukuxhuzula.
• intlungu entanyeni kwi flexion kwicala phambili;
• umkhuhlane;
• ubukho exophthalmos (Buze lweliso lakho phambili kulandele ukufuduka kwicala).
• Uphuhliso ophthalmoplegia (ukushwabana izihlunu iliso kwi ngokoyiswa luvo elawula intshukumo yamehlo);
• okuvela nokudumba kwindawo luvo optic iinkophe;
• yehle umbono;
• diplopia;
• iziseko intlungu cyanosis, ibunzi kunye impumlo lwesiseko;
• ukulahleka Uvakalelo luvo yobuso;
• thrombophlebitis mithambo zobuso.

Cavernous sinus thrombosis iphawulwa lobushushu kwibakala ephantsi, asthenia, eziva ihlaba in imisipha namalungu. Kwimeko amahlwili egazi nature ezasulelayo ezifana mpawu zingabonakali.

Iimpawu Cerebral kuvela iimpawu meningeal. Ngenxa uphuhliso sifo kwandisa nokuhlutha zisembundwini wawo. Kwiimeko kakhulu, isigulane nagaxeleka ezilingweni isiqaqa.

Imbonakalo Iimpawu ezibi bawuphikisa CSF kuphuma, ukwanda koxinzelelo intracranial, ukwanda nokudumba yobuchopho, nto leyo ekugqibeleni kukhokelela ukufa isigulane.

ekuxilongweni

Njengoko kutyhilwa cavernous sinus thrombosis? Uxilongo isekelwe kwiindlela ezahlukeneyo iimviwo. Kwakhona kuthathelwa ingqalelo izikhalazo yomguli kunye imbali yezonyango.

Migraine, umzekelo, kukho iqela lemisebenzi esemqoka:

• Iqala wayibona yaye liya ezingapheliyo. Iintlungu uba ukumelana ntlungu.
• Pain mandundu umzimba kwindawo lisalele. Oku kubonisa yintloko lubonisa ukuba sinus kwabantu thrombosis feathery.
• Xa icinezelwe kwi ngongoma Greenstein isigulane ikhalazela intlungu. na ukudumba Kukho kunye neziseko eye equmbile lweliso lakho.

Zonke izigulane ezineempawu luvo efanayo efunekayo utyelelo kwi-ofisi zamehlo ngayo.

Xa fundus ibonakala ubukho tortuosity neempahla, iindumbisa optic disc.

Ukususela izifundo kwilebhu iindlela ezisetyenziswayo moshilongo:

• ngokupheleleyo wegazi.
• collection of igazi nenkcubeko ukuze inzalo.
• eqhuba coagulation,
• Isalathisi isigqibo D-dimer
• Uhlalutyo cerebrospinal fluid.

Uphando olunjalo zinika ithuba ukuchonga sisilonda esidumbileyoesingaphakathi ezosulelayo, kwakunye ukuphazamiseka hemostatic.

Kufanele kuphawulwe Ukusuka Iindlela instrumental:

• opacification ngu CT;
• ukwenza umfanekiso liyenza magnetic;
• angiography lobuchopho.

Basics therapy

Cavernous sinus thrombosis, kwakunye sigmoid kunye ezinqamlezayo, iindlela ezifanayo zifuna unyango. Therapy kunokuba emithethweni futhi yotyando. Lo mqathango yokugqibela eboniswe izifo ziyatyeshelwa.

Iindlela unyango

Njengoko ebekwe cavernous sinus thrombosis? Unyango iindlela endala iphila inani iinjongo:

• ubuthi;
• ukulwa ukuyilwa egazi;
• ekupheliseni nokudumba ingqondo;
• zokubopha inkqubo usulelo;
• therapy neuroprotective.

Ukukhutshwa kwetyhefu nonyango zintsholongwane oku kusetyenziswa xa kukho thrombosis of imvelaphi esosulelayo. Ukukhutshwa kwetyhefu inika ithuba ukuphelisa uzise izinto eziyityhefu. Ukulungiselela le njongo zisetyenziswa ukumnika isisombululo isotonic sodium chloride, "reopoligljukin" "gemodez".

Emva collection of igazi nenkcubeko elimisiweyo antibiotics. Ngokutsho prescribers uhlalutyo kunye kuluhlu olubanzi amanyathelo. Ngaxeshanye, antibiotics ukuze ezimiselweyo isiqabu losulelo anaerobic ( "Metronidazole").

Ukuze ukubuyisela krovobrascheniya eqhelekileyo kufuneka ususe ihlwili. Ukuza kuthi ga ngoku, kwanonyango lweeHedfowuni. Ngaphezu koko kuqeshwa anticoagulants ngqo, ezo ithathwa iinyanga ezintathu.

Emva kwekhosi kuyacetyiswa ukuba izigulane abafumana arhente antiplatelet ezifana "aspirin", "Dipyridamole" "Clopidogrel".

Kwiimeko kakhulu, uphuhliso lwenkqubo isifo nokudumba yobuchopho iyapheliswa yi womchamo.

unyango Neuroprotective ibhalwa sokubuyisa ixesha ekuphulukenwe nalo. Luqhutywa ngendlela arhente ekhuthaza vasodilatation kunye neendlela neurometabolic.

ukungenelela operative

Lo msebenzi ngotyando iboniswe kwimeko apho iindlela ngendeb 'ukuba ezi zinto isiphumo efanelekileyo. Ngu sinus cavernous kunzima kakhulu indlela ngenxa kwindawo yayo yokwakheka. Ngoko ke, lo msebenzi ubandakanya ukuvulwa sinuses kunye nococeko ziphambili agxininisa esosulelayo.

iingxaki kunokwenzeka

Cavernous sinus thrombosis (umfanekiso izigulana na kwesi sifo inikwa kweli nqaku) kungakhokelela kubunzima ezinzulu. Iinkqubo ngaphambili zokuxilonga kunye nonyango laqalisa bathwalwa phandle, maninzi amathuba okuba ngaphantsi kwe iingxaki.

Iingxaki zahlulwe phambi kwexesha nasemva kwexesha.

Of kwexesha kufanele kuphawulwe:

• ukulahlekelwa acuity olubonakalayo;
• paresis of abducens ;
• ubukho ptosis (netshiki kwinkulungwane);
• uphuhliso arachnoiditis;
• hypopituitarism;
• anisocoria.

Early:

• nokudumba ubuchopho;
• zesifo ubuso;
• iqhosha lobuchopho.

Amaxesha amaninzi, cavernous sinus thrombosis kukhokelela isigulane:

• yimfama iyonke.
• stroke (disorder yegazi etsolo ebuchotsheni, nto leyo edla kudale ukukhubazeka kunye nokufa);
• ukuphazamiseka ukusebenza esinobubovu pineal ukuba linoxanduva inhibition yokukhululwa growth hormone;
• unciphisa inkqubo yophuhliso ithumba;
• ukuphazamiseka zophuhliso ngokwesondo kunye nokuziphatha.

iingxaki ezinjalo kuvandlakanywa isinye kwisithathu lamatyala.

amanyathelo othintelo

Ukwenzela ukuphepha izifo ezifana yokugula kufuneka balandele amanye amanyathelo othintelo ukunceda ukuthintela ukunwenwa kwesifo:

• unyango kwangethuba iinkqubo ukudumba emzimbeni;
• ukunamathela ngendlela enempilo;
• ukufikelela ngexesha umntu onobuchule kuzo izifo ezifumaneka ezingapheliyo kwaye mazihambe utshintsho noshowo iindonga isitya kunye ukubonakala hyperviscosity.

abantu abane

Abantu abane kwesifo ixhomekeke ngqo kwi uxilongo kwangethuba kunye nonyango. I ngaphambili wamisa phambi sifo, kwaye unyango iqalwa, ngcono amathuba achache.

Iindlela zonyango, iyeza kwakubandakanya mihla yini kunciphisa kakhulu ukubulawa kwesi umbundu sifo. Umfanekiso yi-20%. Bamalunga nama-10% amatyala thrombosis yokuphinda kwisithuba sonyaka omnye emva konyango.

isiphelo

Cavernous sinus thrombosis, iimpawu eziye ichazwe kweli nqaku, sisifo esibi kakhulu. Esi sifo nzima ukunyanga.

Kwiimeko ezininzi, ezi ngezifo ebangela ukukhubazeka yesigulane, yaye ngokufuthi kuphelela ekufeni. Ngoko ke, kubalulekile ukuba iinkqubo kwangethuba zokuxilonga kunye nonyango.