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ヘルニアの時にかかるべき病院と診断

医師

ヘルニアとは、臓器が本来あるべき場所からほかの場所に移転してしまっている症状をさします。そのため、ヘルニアは体の様々な部位で発症する可能性があり、病院での診断方法もさまざまです。それぞれのヘルニアに対して病院ではどのような診断方法をとるのでしょうか。本稿では、ヘルニアの種類とそれに対して病院で行われる診断方法についてまとめていきます。

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ヘルニアの意味と病院での診断方法のいろいろ

ストレッチおじさん

ヘルニアとは体の臓器などが本来あるべき場所からほかの場所に移転してしまっている状態を意味します。ヘルニアというと腰痛(椎間板ヘルニア)を想像される方が多いかもしれませんが、臓器の移転は腰だけではありません。身体中の様々な場所で臓器が本来あるべき場所から他の場所に移転してしまうことがあります。例えば、脳が頭蓋骨内から飛び出してしまう脳ヘルニアというものもあります。

ヘルニアについては、まず第一に病院の診断によってヘルニアであるかどうかを確認してもらうことが大切となります。病院で実施されるヘルニアの診断方法としてはどのような方法があるのでしょうか。

椎間板ヘルニアの病院での診断方法

ヘルニアといえば椎間板ヘルニアを指すということができるほど、椎間板ヘルニアは有名です。椎間板とは、背骨の骨と骨との間のクッションの働きをしているものですが、この椎間板が飛び出してしまい、神経を圧迫している状態が椎間板ヘルニアです。神経が圧迫されるので、非常に痛みます。椎間板ヘルニアを患ってしまうのは、小さな子供や20代から40代の男性が多い傾向にあります。

椎間板ヘルニアかどうかを病院で診断する場合、病院では、レントゲンに加えてMRI検査というものを実施します。MRI検査とは、磁石と電波による体の断面図の描写を可能とする検査技術です。病院でMRI検査を実施すれば椎間板ヘルニアかどうかは一目瞭然となります。

鼠径ヘルニアの病院での診断方法

鼠径ヘルニアは、一般的には脱腸などと呼ばれています。腹膜や小腸、大腸、卵巣などが飛び出してしまう状態です。鼠径ヘルニアになってしまった場合、太ももの付け根の内側などが膨れ上がってしまいます。また、さらにそのまま放置しておくと飛び出た腸などが元に戻らなくなってしまいます。この状態を「嵌頓」(かんとん)と呼びます。

嵌頓になってしまうと、そのまま臓器が腐ってしまうこともあり、病院での緊急手術が必要となります。

鼠径ヘルニアに対しての病院での診断は、出っ張りに対する触診でわかります。鼠径ヘルニアの診断は病院で行えば一般的には難しいことはありません。ただ、出っ張りがない場合などにはCTなどを利用して検査を行うことになります。

鼠径ヘルニア部位的な恥ずかしさから病院に行くことをためらわれる方もおられます。しかし、鼠径ヘルニアは放置しておくことで嵌頓となってしまい、臓器が腐ってしまうという恐ろしい可能性がありますので、病院へは早めに行くようにしましょう。

脳ヘルニアの病院での診断方法

ヘルニアの中でも直接命に関わるおそれがあるのが脳ヘルニアです。脳ヘルニアとは、脳が頭蓋骨の隙間から外部へ飛び出してしまう状態をいいます。脳ヘルニアの状態になると、呼吸や心臓など生命への働きを直接つかさどっている生命維持中枢である脳幹を圧迫するので、命に関わる状態となります。

脳ヘルニアが起きる原因は外傷が多いものの、脳腫瘍などの病気によってももたらされます。

脳ヘルニアに対する病院での診断方法としては、瞳孔異常の確認、まひやけいれん等の異常症状などから脳ヘルニアの可能性を診断します。頭部をCTで撮影して原因や部位を確認します。脳ヘルニアは一刻を争う症状として病院での専門的な手術が必要不可欠となります。

その他さまざまなヘルニアの診断

ヘルニアには本文で述べました頚椎ヘルニア・鼠径ヘルニア・脳ヘルニアの他にも食道裂孔ヘルニア・臍ヘルニアなどのさまざまな種類があり、病院での診断方法もそれぞれ異なります。

冒頭でも述べましたようにヘルニアは腰痛症状をもたらす椎間板ヘルニアだけではありません。生命に危険をもたらす鼠径ヘルニアや脳ヘルニアなどもあります。ヘルニアという症状を決して「甘く見る」ことなく対処することが大切です。特に鼠径ヘルニアについてはためらわずに病院へ行かれることがとても大切となります。

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まとめ:ヘルニアと病院での診断のまとめ

以上、本文で述べましたそれぞれのヘルニアの特徴とそれに対する病院での診断方法をまとめますと以下のようになります。

  • 椎間板ヘルニア-椎間板(骨と骨との間のクッション)が飛び出てしまい神経を圧迫している状態。病院での診断はレントゲンに加えてMRIを用いて行われます。
  • 鼠径ヘルニア-いわゆる脱腸のこと。腹膜や腸などが本来あるべき場所から飛び出てしまい、太ももの付け根などが膨れ上がる症状。鼠径ヘルニアに対しては病院では、触診に加えて、CTなどを利用して判断します。
  • 脳ヘルニア-脳が頭蓋骨内部から飛び出している状態。脳幹を圧迫し、呼吸や心臓の働きに影響を与えるので命に関わる病気です。病院では瞳孔状態やけいれん・麻痺の状態などを確認した上でCTでの撮影を行います。

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