Cov ntshav txhaws sab nrauv, feem ntau hu ua paraphlebitis, hais txog kev thaiv cov hlab ntshav los ntawm cov ntshav khov. Nws yog tus kab mob nquag thiab me me, uas kho tau yooj yim. Cov tsos mob yog dab tsi? Kev kuaj mob ua tiav li cas?

Phlebitis (venous thrombosis) yog lub sijhawm qub thiab tseem nquag siv los xaiv cov ntshav khov "thrombus" uas tsim thiab ib nrab lossis tag nrho thaiv cov hlab ntshav tob tob. Ob hom venous network sib koom ua ke: lub network venous sib sib zog nqus thiab lub network venous superficial. 

Yog tias nws tshwm rau ntawm cov leeg ntshav pom nyob hauv qab daim tawv nqaij, tom qab ntawd peb tuaj yeem tham txog "cov leeg ntshav tsis txaus". Kev phlebitis sab nrauv tsis yog mob hnyav thaum nyob ib leeg, tab sis txij li cov tes hauj lwm sib txuas lus, nws tuaj yeem sib kis tau thiab nyuaj los ntawm cov hlab ntshav sib sib zog nqus.

Qhov sib txawv yog: 

• Hauv paraphlebitis, cov hlab ntshav tuaj yeem tsim nyob rau hauv cov hlab ntshav, cov leeg me me nyob nruab nrab ntawm daim tawv nqaij thiab cov leeg (cov leeg saphenous). Cov hlab ntsha saphenous yog ib feem ntawm cov txheej txheem txheej txheem ntawm cov leeg nyob hauv qab ntawm daim tawv nqaij thiab uas tuaj yeem yog qhov chaw ntawm cov leeg leeg leeg. Varicose leeg tshwm tuaj tshwm los yog nyob ntawm qhov muaj feem cuam tshuam thiab tseem yog qhov tshwm sim feem ntau ntawm paraphlebitis hauv txhais ceg;
• Paraphlebitis uas tshwm sim los ntawm cov leeg "noj qab nyob zoo" feem ntau yog tus yam ntxwv ntawm lub hauv paus xws li caj ces lossis tau txais kev tsis txaus ntawm cov ntshav khov, mob qog noj ntshav, lossis mob vascular mob tsawg (Behçet's disease, Burger's disease);
• Ib qho cim ntawm kev tsis txaus ntshav tuaj yeem yog qhov qhia tias tuaj txog ntawm paraphlebitis.

Hmoov tsis zoo, cov cim qhia tsis yog ib txwm muaj tseeb. Txawm li cas los xij, nws ua rau muaj qhov tshwm sim ntawm kev raug mob uas tuaj yeem kav ntev li ob peb hnub. Cov leeg leeg tom qab zoo li o, liab, kub, tuab thiab tawv rau qhov kov ua rau tsis xis nyob. Ib qho ntxiv, nws yog qhov tshwj xeeb tshaj yog kom ceev faj thaum muaj xwm txheej cuam tshuam nrog.

Nyob rau hauv rooj plaub ntawm phlebitis sab nrauv, kev kuaj mob tau ua thaum lub sijhawm tshuaj xyuas, tab sis kev siv tshuaj Doppler ultrasound yog qhov muaj txiaj ntsig zoo los txiav txim qhov muaj nyob ntawm phlebitis sib sib zog nqus, nthuav tawm ib zaug hauv plaub.

Lub hom phiaj ntawm kev kho mob yuav ua kom cov ntshav nyias nyias. Qhov tseeb, nws yog qhov tsim nyog kom zam kev ua kom hnyav thiab txuas ntxiv ntawm cov hlab ntshav uas tuaj yeem:

• Kev nce qib mus rau qhov sib sib zog nqus venous network thiab tom qab ntawd ua rau phlebitis lossis cov hlab ntsha sib sib zog nqus;
• Migrate mus rau lub plawv thiab ua rau mob pulmonary embolism los ntawm thaiv cov hlab ntsha hauv lub ntsws.

Feem ntau ntawm cov neeg mob, thaum pib kho mob, cov hlab ntshav txuas rau ntawm phab ntsa thiab tsis muaj kev vam meej ntxiv vim kev kho tshuaj tiv thaiv kab mob los yog cov thwj cim.

Anticoagulant kev kho mob

Ua thawj qhov kev xaiv, ncaj qha qhov ncauj anticoagulants (DOA) tau siv rau ntau hom kev mob thrombosis nyob ntawm cov tsos mob thiab cov cim pom thaum lub sijhawm tshuaj xyuas: qhov chaw, qhov loj thiab txuas ntxiv ntawm cov khov. Lawv siv tau yooj yim dua, tsis cuam tshuam nrog zaub mov lossis lwm yam kev kho mob thiab tsis xav tau kev tshuaj xyuas ntshav tas li. 

Compression vuam txwv ntev

Ntxiv nrog rau kev kho tshuaj, thom khwm thom khwm tuaj yeem sau tseg nyob rau theem pib. Lawv yuav pab daws qhov edema hauv txhais ceg thiab txo qhov mob. Nws tseem tuaj yeem ua tau tias lawv ua ib feem ntawm qhov rov ua dua ntawm cov ntshav khov. Kev thom khwm thom khwm yuav tsum hnav tshwj xeeb thaum nruab hnub thiab ntev dua.

Muaj ntau chav kawm sib txawv tab sis chav kawm 3 feem ntau yuav raug qhia (muaj 4 chav kawm ntawm kev ua kom lub zog nruj). Qhov kev sib zog no yuav ua kom muaj kev kho mob ntawm cov leeg leeg leeg.

Thaum kawg, paraphlebitis tshwm sim hauv cov leeg leeg ntshav yog qhov kev sib cav rau kev kho cov leeg leeg leeg txhawm rau txhawm rau tiv thaiv nws rov tshwm sim tom qab. Txhawm rau ua qhov no, kev tshuaj ntsuam xyuas txhawm rau nrhiav qhov ua rau. Ntawm cov kev kuaj mob no, muaj kev kuaj hluav taws xob, lossis kuaj ntshav txhawm rau saib, piv txwv li, tsev neeg lossis caj ces ntshav txawv txav, txhawb kev pheej hmoo ntawm phlebitis.

Nyob ntawm cov txiaj ntsig, kev kho tshuaj anticoagulant tuaj yeem ua ntev.

Cov xwm txheej hauv qab no tuaj yeem nyiam qhov tshwm sim ntawm phlebitis:

• Venous stasis (ntshav stagnates nyob rau hauv cov hlab ntsha, vim hais tias ntawm ib tug ntev heev dag los yog motionless txoj hauj lwm. Qhov no yog lub tseem ceeb tshaj plaws caij);
• Teeb meem ntshav (koj cov ntshav txhaws yooj yim dua vim yog mob lossis kho mob);
• Kev hloov pauv ntawm phab ntsa ntawm cov hlab ntshav (yog tias muab cov kua dej tso rau hauv cov hlab ntshav ntev, phab ntsa ntawm cov hlab ntshav tuaj yeem puas thiab tuaj yeem thaiv tau);
• Hnub nyoog tshaj 40;
• Rog;
• Kev haus luam yeeb;
• Kev tsis txav chaw (plaster, tuag tes tuag taw, mus ntev);
• Cev xeeb tub, tiv thaiv kev xeeb tub lossis kev kho tus poj niam cev xeeb tub uas muaj tshuaj estrogen;
• Keeb kwm ntawm phlebitis;
• Mob qog noj ntshav, kho mob qog noj ntshav (kho tshuaj kho mob);
• Mob ntev mob;
• Kab mob caj ces lom, txheeb xyuas los ntawm kev kuaj ntshav.

Cov kev cai dav dav ntxiv tseem muaj txiaj ntsig zoo rau kev tiv thaiv phlebitis:

• Mobilization ntawm koj cov leeg los ntawm kev taug kev thiab cov leeg ua haujlwm;
• Tsa taw ntawm lub txaj;
• Venous compression los ntawm thom khwm hnav thaum nruab hnub;
• Venous compression pom zoo thaum caij dav hlau.