Kukuvara Head: kupatsanura. kukuvadzwa Head: zviratidzo, rwekutanga uye kurapwa

Kukuvara Head, zvakaipira iyo ingava yakasiyana (kusanganisira rufu) ndiyo imwe inonyanya kukonzera kuremara muduku uye pakati zera. About hafu zvose zviitiko zvinorwadza kukuvara uropi. Maererano nenhamba, vanenge 25-30% kukuvara zvose azvidavirire uropi. Pamwe chete, zviitiko izvi pamusana inopfuura hafu kufa. Gare gare munyaya iri kupatsanura kukuvara, rondedzero vamwe vavo.

tsananguro

Dzechimwe Kukuvara uropi inonzi kuvadza dehenya pfupa kana nyoro tishu. Vapedzisira Somuenzaniso, inosanganisira meninges, tsinga, tsinga uye nezvimwe. Kukuvara mumusoro vanokamurwa mumapoka akawanda. Ngatimbokurukurai dzimwe dzacho zvizere.

kupatsanura kukuvara

Damage ngaarambe. Muchiitiko chino, zviri akuvara aponeurosis uye ganda. Sezvo pasi ronda mabasa sezvo pfupa kana zvinyama, izvo nhema zvikuru. Rakapinza kukuvadzwa kunotevera inozivikanwa reDhura. Sezvo imwe nyaya inogona kunzi otlikvorreya nokuda bvupa iri mujinga dehenya. Zvingaitika uye namahwindo kukuvara musoro. Panyaya iyi, ganda inogona dzaparadzwa, uye fascia anoramba kuvimbika kwayo. Uyewo, pane zvinotevera mapoka:

• Chakamira pakunodengenyeka zvine. kunotevera ichi musoro, usingagoni dzinoratidzwa kuramba abnormalities muuropi. kuratidzwa Vose wehurumende pashure nguva (kazhinji dzakawanda mazuva) inonyangarika pachavo. A zvakawanda Kuramba zviratidzo zvikaramba, pane zvimwe zvikuru musoro kunotevera pamwe fungidzira uropi. Huru dzekuziva kuti tinyatsonzwisisa ehurumende anoita nguva ukapisa murwi (kubva masekonzi kuti maawa) uye kuva kudzika mamiriro vakazoroorwa isa kukanganwa uye kurasikirwa chavanoziva. Pakati non-chaizvo zviratidzo zvinofanira kucherechedzwa kurutsa, kuda kurutsa, kuvhiringidzika cardiac basa, blanching ganda.
• Compression pachoto kukuvadzwa kwouropi, mhepo, vatorwa muviri, hematoma.
• Subarachnoid ropa.
• Diffuse axonal kukuvara.

In tsika, izvozvo akanyora zvakawanda Muzviitiko zvabatanidzwa. Zvabatanidzwa Somuenzaniso, compression anogona hematoma uye contusion contusion pamwe subarachnoid ropa uye compression, diffuse kukuvara uye kukuvara uye nevamwe. zvakakanganisika zvinowanzoitika somugumisiro kukuvara kumeso.

pfungwa contusion

It inoitika pakanyorwa akuvara musoro. Kurova kutyora kuvimbika kwouropi fuma pane imwe shoma nzvimbo. Kazhinji, nharaunda iyi ndepana achitandadza chikumbiro simba. Zvisinei, pane zviitiko apo mbundishire anozviratidza pakatarisana (kubva protivoudara). On pakanyorwa wehurumende ichi collapses chikamu uropi, midziyo ropa, iro histological sero zvisungo pamwe unozotevera inotungamirwa wakapona edema. Nzvimbo maronda aya-siyana. Kunyanya ngozi iri yakadaro kukuvara musoro ari mwana.

tonhorera

Kwakadaro kukuvara musoro inozivikanwa nokuzviparadzanisa kuziva kwenguva pfupi - kusvikira zvakawanda makumi ezviuru maminitsi. Yangopedzwa anowanzoramba zvichemo zviri svoto. Uyewo, murwere marwadzo uye nzwa dzungu. Pangave kurutsa, mune zvimwe zviitiko kakawanda. Mune zvimwe zviitiko, pane mwero bradycardia - achideredza kwemwoyo 60 uye zvishoma pane imwe miniti. Murwere angava wevasungwa, retro- uye anterograde kukanganwa - ndangariro vanotaura muchimiro nokurasikirwa kugona kuponesa playback kuti kare nezivo. Pashure munyoro kukuvara musoro akacherekedza tachycardia (zvakawedzera kwemwoyo 90 bpm. / Min). Vamwe varwere vanogona kumutsa kumanikidzwa. Panyaya iyi muviri tembiricha uye afemeruke, kazhinji vanoramba kuchinja. Kana chetsinga zviratidzo, zviratidzo kazhinji zviri nyore hunhu. Somuenzaniso, mumwe murwere anogona kuona simba, hope, nystagmus clonic (biphasic mutinhimira involuntary fambisa maziso). Panewo anisocoria diki, meningeal zviratidzo, pyramidal insufficiency. Zviratidzo izvi kazhinji kubva atanga pamusoro 2-3 vhiki mushure kukuvara musoro.

Zvinoitwa kutyorwa

On pakanyorwa zvinokuvadza ari kuona microscopically kukuvadza zvayakaita kusagadzikana medulla. Kunoratidza pacharo sezvo nzvimbo omunzvimbo kuzvimba, minyato cortical pfungwa, zvimwe pachiimbwa mashoma subarachnoid ropa. It, akavapindurawo, kunokonzerwa atsamwira pamusoro pial nhumbi. Subarachnoid ropa kana ropa kupinda munharaunda yacho arachnoid uye anoparadzira pamusoro basal kumadziva, makatsemuka uye mihoronga uropi. Zvinogona yomunharaunda kana rokuzadza nzvimbo yose nokuumbwa clots. Condition anovandudza zvikuru chakasimba. Murwere pakarepo anonzwa a "kuridza kusvika musoro", nokukurumidza sokuti photophobia, kurutsa, kwazvo nomusoro. Zvimwe akadzokorora generalized nokugwinha. Kazhinji mamiriro haisi achiperekedzwa rutivi rwomuviri. Zvisinei, mukana meningeal zviratidzo. Zvikurukuru, pangava nomutsipa mukukutu tsandanyama (pagungano kwakarerekera musoro hazvigoni kubata murwere sternum chirebvu) uye kerning chiratidzo (havagoni ruramisa ibvi vanobwembura mairi uye hudyu gumbo). Kana pane zviratidzo meningeal kutsamwa kunoitika meninges vakamhanyira ropa.

minyato nepakati

Izvi kukuvara musoro dzinoratidzwa kwenguva refu shutdown kuti pfungwa (anoverengeka maawa). Murwere ane mucherechedzo kukanganwa. Panewo zviratidzo akuvara musoro zvinotevera: anotemwa nemusoro, akadzokorora kurutsa, chirwere chepfungwa. Zvimwe zvinopfuura kuvhiringidzika anokosha. Zvikurukuru, rinogona akacherekedza bradycardia kana tachycardia, yakawedzera kuomesa, tachypnea (nokukurumidza kufema shoma nzira pasina nokutyora mwero uye permeability), fivha yakaderera wegiredhi (tembiricha muviri ichiwedzerwa kuti 37-37.9 cant.). Kakawanda ndivo hunde uye goko zviratidzo dissociation ose mudzira hunenge uye tsandanyama matauriro, bilateral pathological anokuzviratidza. Ko zvakakwana pachena zvatichiri zviratidzo. hunhu wake anokonzerwa localization yacho zvinokuvadza. Found oculomotor uye pupillary zvinetso, kutaura zvirwere, nehanya, paresis wamativi uye nezvimwe. Zviratidzo izvi mukati matatu shanu vhiki, zvishoma nezvishoma ndokudzora kunze, ave mutemo. Zvisinei, mune zvimwe zviitiko, rakarondedzera chiremba mufananidzo anoponeswa refu zvakakwana. Kana zvakuvadza mwero nekuomarara kakawanda kuwana mitswe mu mapfupa nechigadziko uye calvarium, yakakura subarachnoid ropa. CT zvatichiri kuchinja dzakaonekwa sezvo inclusions akanaka kana mukuru arambe achirema homogeneous mwero kuwedzera arambe achirema. Izvi unoenderana zvishoma ropa munzvimbo yokukuvadzwa kana Hemorrhagic impregnation kuti uropi pasina kwakakomba kudzikisirana.

Zvakakomba kukuvara musoro

Muchiitiko chino, intracerebral hematoma aona zvose frontal lobes sezvo zvakawanda ropa kuwanda panguva dzakasiyana-siyana vascular maronda atsamwira. Izvi zvikonzero mhango kuti rine coagulated ropa kana mvura. Kukuvara kwazvo kunoratidzwa mazhinji shutdown kuti pfungwa (anoverengeka mavhiki). Kazhinji anyatsoona motokari excitation. Also anozivikanwa kusagadzikana anokosha pamuviri. Zvisinei, kana tichienzanisa paavhareji dhigirii rinorema, vanonyatsokurukura raidudzwa. Somuenzaniso, pane kukanganisika kufema basa iri kutyora mutinhimira pamakwara uye mamiriro enzvimbo. The murwere kuchengetwa pyrexia, kutonga chinonyanya hunde chetsinga zviratidzo. Zvikurukuru, rairatidza pakuparadza zvirwere, akayangarara kufamba kwemaziso, ptosis, kana mydriasis, paresis anopenya, decerebrate Rigidity, kufamba, kukura kana chinovhiringidza kuti hunenge, mucous membranes, ganda, nemarunda uye zvichingodaro. Chetsinga Zviratidzo zviri pakutanga nguva (panguva yokutanga maawa kana mazuva) chitonge zvatichiri hemispheric zviratidzo. Murwere tinganetseka muzvidimbu paresis, subcortical kusagadzikana tsandanyama matauriro, uye zvichingodaro. Mune zvimwe zviitiko, zvichida zvatichiri kana generalized pfari. Regression zvatichiri kuratidzwa kuitika zvishoma nezvishoma zvakakwana. The ngozi yakadaro kukuvara musoro? Migumisiro inogona kunyatsonanga zvakakomba. Kazhinji pane anozivikanwa residual zvinokonzerwa, kunyanya mune pfungwa uye motokari.

zviratidzi CT

In chakakomba kukuvadzwa mune chetatu zviitiko yakashuma zvatichiri maronda uropi muchimiro non-dzakafanana arambe achirema munharaunda vawedzere. Muchiitiko chino, pane alternation kuti zvikamu. Dzinounzwa nzvimbo dzakakwirira uye vakaderera arambe achirema. In wakakura zvikuru mamiriro ezvinhu kuparadzwa rinotungamirirwa medulla uye anogona kusvika vanyura ventricular maitiro uye subcortical nuclei. emuchina zvakawanika vanoratidza zvishoma nezvishoma kuderera iri rakavhara kunzvimbo yavo Fusion uye kushanduka kuva homogeneous guru. It kunouya 8 kana 10 maawa pashure pokunge zvaitika. Regression pathological substrate komberedza nezvinozoitika nomumugwagwa kwaitora nguva, zvichiratidza kuvapo vasiri resorbed ndokuputsa clots uye zvinyama zviri kutaurwa zvinokuvadza. Panguva iyi, vanova panongova ravnoplotnymi dzakapoteredza edematous pfungwa fuma. Kutsakatika pashure pemazuva 30-40. Vhoriyamu zvazviri inoratidza resorption uye paumbwe substrate pachinzvimbo nzvimbo atrophy kana cystic in.

Kuvadza posterior fossa hurongwa

lesion iri kuonekwa wakakura zvikuru zvose kukuvara mumusoro. Nokuti mamiriro kunoratidzwa anotevera zviratidzo: mwoyo pamusoro pfungwa uye wemishonga hunde, cerebellar, chepfungwa uye meningeal zviratidzo nokuda nokukurumidza compression uye doro kutenderera zvirwere.

Kuchirapa matanho kana kukuvara

Zvisinei kukura kwakaita kukuvara, murwere kutarisirwa utano zvinofanira inopiwa. Kana kukuvara musoro wemunhu akuvara kuti kutakurwa kuchipatara nokukurumidza sezvingabvira. Nokuti kuongororwa zvakarurama inoratidza X-ray uye CT. Murwere anoda mubhedha zororo. nguva yaro pamwe nounyoro - mazuva 7-10, neavhareji -. mazuva 14. Kana zvikuru dzechimwe kukuvara uropi zvinofanira nokumutswa. Ivo kutanga vakararama muchipatara nguva uye akaramba akatsiga-mamiriro ezvinhu. Kuti normalize ari kufema zvakafanira nechokwadi rusununguko muchinjikwa nyika iri repamusoro kufema turakiti - kuzvisunungura kubva madzihwa, ropa, mumarutsi. It anotanga mhepo mutsinga dzinofamba nemukaka, mumwe tracheostomy rinoitwa (zvinyama kwetsinga uye trachea cannula chokugadza kana dzichiumbwa kuramba makomba - stoma). Also kushandiswa inhalation uchishandisa oxy-mhepo nezvakasanganiswa. Kana zvakakodzera, shandisa zvokuimba kufefetedza.

Therapy nokuti chipaparadzungu

Kana zvikaonekwa kuti murwere ane kukuvara musoro, marapirwo anofanira kuitwa muchipatara neurosurgical. Kana chipaparadzungu anoratidza mubhedha shanu zororo. Pasina yematambudziko murwere anogona asunungurwa pazuva 7-10. Zvinonzi basa outpatient kurapwa, nguva iyo - kusvikira mazuva 14. Kurapwa nokuti chipaparadzungu nechinangwa pakudzikamisa ari dzichipfekeka mamiriro uropi, marwadzo zvakanaka, kushaya hope, kuzvidya mwoyo. Kazhinji, mishonga ushandiswe chikuva rinosanganisira hypnotics, sedatives uye analgesics. Sezvo analgesics vaishandisa zvinodhaka zvakadai se "Baralgin" "Pentalgin" maksigan "" sedalgin Reglan "uye vamwe. Kunoreva vangaendeswa kuti dzungu." "Kuna sedatives zvinosanganisira mishonga yakadai se" Valocordin "" Corvalol " uye mumwe ane phenobarbital. Shandisa mishonga infusions (motherwort, valerian).

Ndaizoitwa mapiritsi. Izvi zvinosanganisira Somuenzaniso, kusanganisira vamiririri akadai "Rudotel", "Nozepam", "Phenazepam", "Sibazon", "elenium" uye vamwe. Kuwedzera symptomatic kurapwa yakatarwa Course metabolic uye vascular kurapwa. Zvinoita kuti zvikuru nokukurumidza uye kwakakwana kudzorerwa anetseka pfungwa basa, kunotadzisa siyana postkommotsionnye zviratidzo. Kugadzwa tserebrotropnoy uye vasotropic kurapa kungava mazuva 5-7 mushure zvinokuvadza. Advantageously mubatanidzwa nootropic (zvinodhaka "Pikamilon" "aminolone", etc.) uye vasotropic (mishonga "Teonikol" stugeron "" Cavinton ") rinoreva kukunda asthenic kuratidzwa varwere vanotumirwa vhitamini zvivako." Centrum "" Complivit "" . Vitrum "uye dzimwe tonics vari yakarumbidza: zvibereko Schisandra, Siberian ginseng mushoma . ginseng mudzi zvinofanira kutaurwa kuti kuzungura hariwaniki chero Organic maronda, tinofanira kutaura zvakawanda zvakakomba kana paine chero nokuchinja MRI kana CT. mukunyombwa - kukuvara uropi.

kushanda kupindira

Kukuvara Mechanical zvinoda kuvhiyiwa. Kuvhiya inoratidzwa pane zvakaitika apwanye kukuvara pamwe uropi. Kazhinji, kukuvara zvemaziso yakadaro munguva zvenyama danda uye nzvimbo yacho frontal lobes. Somunhu kuvhiya anoshanda osteoplastic trepanation. The oparesheni ndiko kuumbika mumakomba pfupa dawo kupinda mhango uye detritus leaching mhinduro kubva yavaibvisa chloride (0,9%).

mataridzikiro

Munyoro kukuvara kazhinji zvikuru zvakanaka zvaizoitika (nokuti zvaidiwa kunenge murwere chokuita kurapwa uye kurapa). At mwero ezvinhu kazhinji zvichiita kuti vawane kwakakwana apore uye kudzorerwa mumagariro uye basa basa vakaurayiwa. Vamwe varwere vanogona yomumuzongoza uye hydrocephalus, afunge asthenia, vascular dysfunction, marwadzo, kusagadzikana kufambisa, kunofambira mberi uye vamwe chetsinga zviratidzo. Muchirwisa colour nomwaka kukuvara muna 30-50% nyaya rufu kunoitika. Pakati vakapona kwakakurumbira chaizvo urema, zvinova zvinokonzera chikuru chirwere chepfungwa, wakaipa kutaura uye injini nenyonganiso, pfari. In akazaruka kukuvara mumusoro vanogona anogumbura matambudziko. Kunyanya, muprista pangozi yokuita uropi pute, ventriculitis, encephalitis, yomumuzongoza. Uyewo zvichida liquorrhea rinomirira water drainage pakati cerebrospinal mvura (CSF) kubva dzinongoitika kana makomba kuumbwa nokuda siyana zvinoita mapfupa nomuzongoza uye dehenya. Hafu fatalities vari zvinokuvadza musoro chakaita kuti (RTA) tsaona mumigwagwa.