Abscesses chiropa: kurapwa, zviratidzo, zvinokonzera, dziviriro

Chiropa abscesses vari ngozi nokuti kunogona migumisiro, dzimwe nguva kusvika sepsis uye rufu. Zviya, chirwere ichi chinogona kunge chikuru kana yechipiri. Maererano nenhamba, imwe mota anooneka pamusoro yaitwa nezvimwe zvirwere chiropa, kwete kupfuura 3-5% nyaya.

Kunyange zvakadaro, vanhu vakawanda vanofarira mibvunzo pamusoro mukurwara yakadaro, nekuti nokukurumidza kuchaonekwawo kutyorwa, kuti nokukurumidza munhu achagamuchira yakakodzera kurapwa. Saka riripi chiropa muvanhu, uye ndedzipi pfungwa zvikonzero zvayo kukundwa? How kuziva zviratidzo pute rokutanga? Iyo yematambudziko anogona kukonzera zvirwere? Ndinofanira chero oparesheni kana chirwere chinogona kurapwa pachishandiswa kuchinja mushonga? Mhinduro dzemibvunzo iyi vari ichifarirwa vaverengi vazhinji.

Pute: Chii ichi?

Sezvingatarisirwa, vanhu vakawanda vanoda kutanga kubata inokosha anatomical mashoko uye tsanangudzo. Apo munhu ane chiropa iri? Ichi nhengo guru riri munzvimbo yepamusoro zvakanaka dumbu mativi (kurudyi yokumusoro quadrant).

Zvinokosha kucherechedza kuti, nokuda kushaya marwadzo receptors pamuviri, kana kuti anogona kukuvadza chiropa uye haina pamwe panyama kusanzwa kana kurwadziwa. Naizvozvo zvakafanira kuti kunyatsotevera kuongorora basa rose muviri. Nhengo iyi inokosha Unochenura ropa nevanhu muchetura uye noxious zvinhu unotora iri muviri, chitoro kuti glycogen (nesimba reserves) kunobereka uye inodzora bile asidhi kugaya.

Sezvineiwo, vamwe vanhu takatarisana yakadaro chirwere chakaoma, sezvo pute. Chii? Izvi purulent kuzvimba munyama, izvo pamwe anonzi utsotso. Somugumisiro kwakadaro kwacho mukati pute mhango aumba apo purulent makore kutanga kuunganidza. Sezvo dhigirii kuwedzera kukura, uye dzimwe nguva, vavhunike, kusunungura purulent mukati.

Maererano Statistical zveBhaibheri, chiropa abscesses, kazhinji mugumisiro zvimwe zvirwere mumuviri. Men vanotambura nezvirwere zvakadai zvishoma kakawanda kupfuura mukadzi. The chirwere chinonyanya nevakawanda kumatunhu ane pasi azvipire utsanana uye mvura yakasvibiswa. boka iri rinosanganisira Chile, Brazil, Peru, India, Tibet, Nepal, Pakistan, Iraq, Iran, nyika South Africa.

chirwere kupatsanura hurongwa

Nhasi, kune Mufungo kupatsanura pakati zvokurwara ichi vazhinji. Somuenzaniso, chiropa abscesses zvinogona chikuru (purulent kwacho anogadzirwa chiropa parenchyma utano) uye yechipiri (kumashure ikaonekwa zvimwe zvirwere anogumbura). Zvichienderana ari chirwere, hosha rakakamurwa parasitic uye kwemabhakitiriya.

Kana tikatora sechinhu chokuratidza nzira chirwere, rokusunungura:

• hematogenous pute (chirwere anopinda muropa);
• holangiogennye chimiro chirwere (utachiona hwakakura rinomupotsa ari biliary turakiti);
• kuonana (kuzvimba rinopararira kubva dzakavakidzana nhengo);
• post-zvinorwadza (iri kuomesa pashure pakukuvara kana murwere);
• cryptogenic (zvinokonzera pathologies kwakadaro hakusi aizvinzwisisa).

Chiropa abscesses inogona kuroorwa kana kakawanda, kuti makuru kana madiki hukuru. Govera kuoma uye nyore chimiro chirwere.

Chiropa pute: Zvinokonzera

The kupfuura kakawanda kukonzera purulent kushoma ndiko kupinda chirwere ari tishu. Kazhinji, basa nayo utachiona kwemabhakitiriya tupukanana tusingaoneki, kusanganisira E. coli, anonzi Staphylococcus, streptococcus, uye nevamwe.

Uyezve, zvinoita parasitic tishu kukuvara. Somuenzaniso, kuzivikanwa zviri amebic chiropa pute (achitsva chimiro chirwere). Uyewo purulent kuzvimba angatanga pamusoro pakanyorwa Ascaris infestation Echinococcus, alveococcus.

Saka, pute uye, sezvo migumisiro payo, chiropa angatanga kana:

• Kupinda pakati utachiona muchiropa vachishandisa bile mutsinga dzinofamba nemukaka. Kwakadaro kuchengetwa zvirwere zvakadai cholangitis, cholelithiasis, cholecystitis, kenza maronda ari bile mutsinga dzinofamba nemukaka.
• Chirwere rinokwanisa kusvika pamwe neropa nokuyerera kuburikidza portal uye hepatic mutsinga. An pute anogona kuva kuomesa iri septic maronda womwoyo, ura, chirwatata, dumbu uye rwatata.
• Dzimwe nguva Utachiona kupinda munzvimbo zvinyama uye chiropa masero pamberi ane chirwere kuzvimba pedyo nhengo. Saka, zvinhu pangozi zvinosanganisira appendicitis, diverticular chirwere (kuzvimba connective zvinyama huru ura masvingo), maronda colitis, peritonitis, purulent peritonitis.
• An pute kungakonzerwa zvinokuvadza chiropa anowanika Somuenzaniso, rakapinza mavanga ari abdominal mhango.
• HweHIV zvinyama kungaitwa pakuvhiya pamusoro abdominal zvomukati.

Zviratidzo chirwere rokutanga

Ndezvipi zviratidzo chiropa pute? Zviratidzo zvinogona kupatsanurwa muzvikwata zviviri. Mukutanga nguva chirwere zvisinganyanyi zviratidzo kudhaka. Chokutanga, sezvo mutemo, pane fivha, vakawanda simba, chills, muviri pari. Murwere anonyunyuta tinyanye kuneta uye Hope, dzungu, tinnitus, nomusoro. Nzara iri zvikuru ipfupi.

Zvadaro, zviratidzo kuva raidudzwa. Somuenzaniso, kusarudzwa inogona kuchengetwa vakawanda tacky ziya. madzerere sezvinobvira, aone zvinhu zvisipo, havachanyatsogoni kutarisirwa uye ndangariro. Varwere chokunyunyuta pamusoro dzose svoto. Kubva nguva nenguva pane kurutsa, uye bowel zviri.

Zviratidzo pute chokuita havachanyatsogoni chiropa shanda

Sezvo chirwere mberi zviratidzo kudhaka uye vanobatana zvimwe zvirwere. Kazhinji, ivo vanoti chakakomba pakakuvara chiropa basa rava kuwanika.

Varwere vanotsutsumwa kurwadziwa zvakarurama hypochondrium. Pakutanga chete kusagadzikana kuti pamwe kukura pute iri kuramba ichiva raidudzwa. Marwadzo chirwere anogona kuderera zvichienderana chikafu yaunodya, kurovedza muviri, zvinodhaka kurapa vamwe zvirwere, uye zvichingodaro. D.

Maererano rutapudzo kuti kudya, kuda kurutsa uye kurutsa, zvishoma nezvishoma kuderera uremu muviri. Panguva kuongororwa yezvokurapa chiremba anogona kuona pamberi hepatomegaly (chiropa nedumbu kukura) uye splenomegaly (akawedzera chirwatata).

Ukuwo, vamwe varwere akashuma nokukurumidza kufuta, riri chokuita pokumuka ascites. Free Urume anotanga kuunganidza ari abdominal mhango, saka varwere kunowedzera, kunyange bulging dumbu.

Zviratidzo pute uye zvingasanganisira yellowing ganda, izvo chokuita kukura jaundice. Kazhinji pakanyorwa zvokurwara iri achengeta chidzoke kana kuwedzera pamusoro Mamota. Kana kuzvimba chiropa rinenge zvichiteverwa kuwedzera nevezera ari hepatic mumidziyo ropa, zvinokwanisika kuti ropa kubva mutsinga ari nemudumbu. yematambudziko kwakadaro kungaratidzwa Somuenzaniso kurutsa, kusachinja-chinja nowenyika kofi nzvimbo, kana kuumba dema garai chitsiko.

Modern nzira nechirwere

Kana zviratidzo kukurumidza vanofanira chiremba. Purulent pute ndiko kusimba ngozi. Nokukurumidza mumwe rubatsiro murwere vanokwanisa zvichagoverwa, nani mikana akabudirira kupora.

Kutanga nyanzvi ichaongorora zvichemo kwevanhu kuitisa zvayo vaongo-. Pfungwa nechirwere inokosha zvikuru ndiyo kuongorora. Somuenzaniso, zvinogona kucherechedzwa vasanyanye Chizenga yomuropa, ungaderedza ropa masero matsvuku uye maplatelet panguva ropa count. Pamwe ichi rakawedzera pamwero ESR, uwandu ropa masero machena, izvo pachazvo inoratidza pamberi chokutsva yekudyidzana yakawedzera.

Kana pute rinowanzoshandiswa vakachengeta achiipa kubva weti. Panguva Murabhoritari nemiedzo inogona kuonekwa vanokara nhamba masero matsvuku eropa uye ropa masero machena. Uyewo, chiropa basa kuongorora zviri kuitwa, umo munogona kuwana mberi rokurera chechetere pamusoro alkaline phosphatase, yakananga uye zvachose bilirubin. Dzimwe nguva mberi vakatapwa coagulogram iyo kana munhu chiropa pute rinoratidza kuderera kweropa. Nokuti chirwere ichi kunoratidzwa atindivare mutsvina yadzo. Ari kuongorora pachituru anogona kuona pane ropa.

Danho rinokosha nechirwere uye richishanda zvidzidzo. Kupfuura dzakakurumbira oornag ari X-ray ine mudumbu, izvo zvingaratidza pamberi kumativi mhango unopinza mativi, akaisa mukati parenchyma chiropa - iyi ndiyo mota. Achibatsirwa Ultrasound kunogona kusimbisa chirwere uye kuona kukura pus inotungamirwa.

Quite yakarurama, asi tiri zvidzidzo anodhura akadai CT uye MRI. Matanho aya anobatsira kuti chirwere, kuti tione nzvimbo, nhamba uye kukura abscesses, uye dzimwe nguva kunyange kuona mhaka kushoma. Dzimwe nguva varwere vari ushandiswe uye biopsy - panguva nzira vakatakura fenzi dzakawanda zviri kuzvibatanidza neoplasm pamwe unozotevera kuongorora murabhoritari.

Ndoda ari inoitwa chirwere laparoscopy, panguva iyo chiremba anoongorora zvomukati (chiropa iyi nyaya) pachishandiswa anokosha makamera kwakamboitwa kuburikidza abdominal rusvingo ponji. The nzira rakanyatsojeka ngozi nekuti yakakwirira njodzi kukuvara pute nguva imwe atsamwira kuti purulent zvavo.

Ndezvipi yematambudziko zvinobvira?

Chiropa abscesses - zvakakomba kutyorwa, izvo chero zvazvingava hazvigoni kungotariswa. Untreated inotungamirwa anogona atsamwira, muchisunungura kunze purulent kugutsikana. Mhedzisiro pakakoromoka ichi angava purulent gastritis (purulent mukati anosvika zvinyama mudumbu), peritonitis (pashure atsamwira purulent gobvu kupararira pamusoro abdominal mhango), pleurisy (mukati pute rinomupotsa ari pleural mhango), pericarditis (pus ari pericardial mhango, izvo ngozi chaizvo nokuti mwoyo tsandanyama), enteritis (budiriro dzidzo kunoitika muura).

Kune dzimwe, shoma zvakakomba matambudziko. Somuenzaniso, muna nechokumashure discontinuity zvingamuka subdiaphragmatic pute, umo vazhinji purulent makore vaunganidza zvakananga pasi diaphragm. Migumisiro zvingasanganisira ropa rakawanda somugumisiro ropa kubva chiropa. Dzimwe nguva varwere kuva ascites, izvo pamwe kuunganidza yakawanda mvura iri abdominal mhango. Somugumisiro, kuwedzera iripo pute portal neBP - mamiriro riri chokuita yakawedzera BP iri portal tsinga, izvo zvinozoita achabatsirwa ropa kubva tsinga yacho zvomudumbu turakiti.

Sezvinogona kuoneka, pamwe chiropa - hazvina chinhu chinogona kurerutswa. Kana uine chinhu zviratidzo vanofanira kwachiremba.

Drug pakurapa pute

Chii zvakabayirwa vanachiremba varwere vane chirwere "chiropa pute '? kutanga nzendo kurapwa angava mishonga, kunyanya kana kushoma mberi zvishoma nezvishoma, bundu haasi kukura, hapana mukana wayo atsamwira.

The kurapa wokutanga nechinangwa kubvisa zvinokonzera chokutsva, kureva. E. At kubvisa hweHIV. Panguva nechirwere vanachiremba havagoni edza chii chaiva pasi pokudzora microorganism akazviratidza pute. Kana chiri kwemabhakitiriya chimiro chirwere, riri basa nemishonga. The inonyatsoshanda nhasi vanoonekwa kuti rechitatu-chizvarwa cephalosporins ( "Tsefoperazol" "Ceftriaxone") kuti vari akadzivirira penicillins ( "Amoxiclav", "Augmentin"), fluoroquinolones parudzi rwechitatu kana chechina ( "Ciprofloxacin", "Levofloxacin", "norfloxacin").

Kana mota iri chokuita basa chisvetasimba, murwere ushandiswe kosi antiprotozoal kurapa, zvikurukuru, kutora metronidazole kana ayo analogues. Pakarepo zvinokosha kuziva kuti kurapa rinoitwa muchipatara ezvinhu. The chipimo chemushonga zvaiitwa uye vatarisire zvinodhaka unogona chete pakutsvaga kupinda chiremba.

Uyezve, zvichienderana ezvinhu omurwere, dzakabatwa symptomatic kurapa:

• detoxification dzine Kuropafadza Ringer anogadzirisa kana 5% shuga;
• pamberi kurwadziwa ushandiswe mishonga yakadai se "No-Spa" (kunobvisa spasm) uye "Ibuprofen" (kunobvisa marwadzo uye fivha, kuchititadzisa kukura kushoma);
• anodawo mabiko ehnterosorbentov semuenzaniso "Smecta" pakati kudya;
• pamwe munyika ropa raitongwa yavaibvisa etamzilat kumabasa namashoko kurasikirwa neropa;
• Kana murwere anotambura kuramba kurutsa anogona basa antiemetics Somuenzaniso, "Metoklopromida" kana "Reglan".

Kuvhiya kurapwa kana zvichidikanwa?

Mune zvimwe zviitiko, zvinodhaka kurapwa haagoni kubvisa chiropa pute. The kuvhiyiwa muzviitiko izvozvo. Uyezve, kuvhiya kupindira chinodiwa yedambudziko (semuenzaniso, atsamwira ane pute).

To musi, pane nzira dzinoverengeka kuvhiya kurapwa. Nyore anonzi abudise ane pute. Musimboti nzira iri sezvinotevera: kuburikidza cheka maduku maviri chaiwo chubhu iri akaiswa mukati mhango pakati pute. Pashure mumwe wavo ari kugara yaipiwa pamwe inorwisa utachiona mhinduro, uye kunze kuburikidza nevamwe mukati goho purulent inotungamirwa. Kazhinji, kurapa kwakadaro rinovapo anenge 3-4 mazuva.

Zvinosuruvarisa, chidobi ichi haisi kunyatsobudirira pane atsamwira kana pute pamberi vakawanda maronda. Muzviitiko zvakadaro, mumwe laparotomy. Access kuti chiropa chiremba anowana kuburikidza abdominal incision. Panguva oparesheni, mumwe pute kuzarurwa, uye ipapo, kushandisa aspirator, purulent zviri kubviswa. The chinhu capsules makashambidzwa pamwe akambozvishandisa kuuraya utachiona mhinduro, akabva abvisa, panguva imwe chete ushivaya utano chiropa tishu. Sezvingatarisirwa, oparesheni iyi ngozi (mukana wokutapukirwa), uye nguva yakawanda, uye rokuchinjwa nguva runogara kwenguva refu. Kunyange zvakadaro, mune zvimwe zviitiko, nzira bedzi kuponesa upenyu murwere.

Zviya, pamwe pakuvhiya rinowanzoshandiswa akaita uye zvinodhaka mishonga. Zvinofanira kucherechedzwa kuti vaizviita nezvirwere izvi zvaisambobvumirwa, sezvo paine vakurirwe nzira, kana kunyange mishonga decoction, aigona sembura zvinhu. chiremba chete anekodzero mishonga.

Diet nokuti pute

Nokuti chiropa - muviri iyo chokuita zvomudumbu turakiti uye hematopoietic gadziriro zvakananga, simba nerubatsiro runobva Chinonyanya kukosha varwere chirwere zvimwe zvirwere. Zvokudya zvakakodzera kuchaita mhanyisa mishonga kwacho, batsirai muviri kupora pashure pokuvhiyiwa, kudzivisa kwaita zvazvo.

Varwere panguva uye pashure pute kurapwa inokurudzirwa kuti chinja Makakamura zvokudya - panofanira kuva kakawanda (6-7 kanomwe pazuva), asi migove vanofanira kuva diki. Izvi zvichaita aivabatsira chirongwa kugaya uye kubatsira kudzivirira kukura dzinotsanagura putrefaction uye chinovira ari dumbu.

Kubva Kudya zvakafanira kuti asava yakasimba uye roughage. Nyanzvi vanokurudzira kudya zviyo uye vamwe Porridge, miriwo muto, wakawondereiko kudai nyama, uye dzimwe mhando hove. Muriwo nemichero vanofanira kuvapo muna zvokudya, asi chero zvakadaro haana yakachena - vanoda kubika, kubheka, braise. The Muterere ingasanganisira dheri zvigadzirwa, asi ane pasi chikamu mafuta. Recommend kunwa tii, muto hudyu, zvinwiwa zvemichero uye zvinwiwa muchero.

Kune zvigadzirwa, iyo panguva kurapwa uye vapore vanofanira kutaura bhayibhayi. Izvi zvinosanganisira mazita nuna zvakakangwa, aisvuta zvokudya, akasiyana-siyana mufushwa, zvinochengetedza uye marinades, sauces, mafuta mamakisi nyama uye yehuku, inonhuhwira. Varwere uyewo vanofanira kuramba zvihwitsi uye pastries, mazai, wose mukaka uye pasoda. Doro iri zvachose contraindicated.

Yakarurama uye inonyanya kukosha, nguva aipedza kurapa anopa nemigumisiro yakanaka. Kazhinji zvinobvira kuita kunaya zvakakwana.