Afferent loop chirwere: kuongorora chirwere uye kurapwa

Nzira dzokuvhiya vari dzinenge nguva dzose chokuita pangozi. Kuwedzera zvichibvira ropa pakuvhiya, pane zvakawanda kwenguva refu matambudziko. Izvi ndezvechokwadi kunyanya zvakawanda manipulations umo rokubvisa rinoitwa nhengo kana mugove waro. Muenzaniso kuvhiyiwa Billroth-2. Chaizvoizvo Its kunoratidzwa kusukwa dzakawanda mudumbu uye pakusika munhu anastomosis pamwe ura diki. afferent loop chirwere kazhinji anova pashure kuvhiyiwa uku. yematambudziko kwakadaro kunogona simuka pakarepo pashure pokuvhiyiwa, uye kwapera mwedzi mishomanana. With kukura ichi ari vanofungidzirwa, kana zvakafanira kuti mumwe murwere.

Pfungwa afferent loop chirwere

Afferent loop chirwere pashure gastric resection kunoitika munenge 13% nyaya. mufananidzo uyu dzinosiyana 1 kusvika 50%, maererano vanachiremba. chikuru chiratidzo chacho ari kurutsa bile, ukama chikafu yaunodya. Afferent loop chirwere - mamiriro umo chikamu ura ndiko, sezvo vakanga "akatendeukira chose" kubva kugaya rikurumidze. Somugumisiro, mashoko bile rinoungana muDhipatimendi uye pamberi rwakashata zvinhu inorasikira kunze. Chimwe zita kuomesa ichi - duodenobilliarny syndrome. mamiriro Ichi chiratidzo ngozi, uye saka kunoda kuvhiya kurapwa.

Zvinokonzera kuti urwere

The chikuru chinokonzera afferent loop chirwere chiri kuvhiyiwa Billroth-2. Zviri hombe kuvhiyiwa uye kunokanganisa muviri wose. A yakafanana mashandiro ari kuitwa gastric kenza, kukura yematambudziko ose peptic urikanwi chirwere, zvisingagone kubviswa nzira mamwe munyoro. Somugumisiro bata iyi duodenum uye duku ura havasisiri kuitika achiita kugaya. Nokuda kukura chirwere ichi afferent loop.

Zvinhu kuti itibatsire panowanikwa kuomesa ichi, ndedzinotevera kutyorwa:

1. Zvokuimba chikonzero. Below nayo chinorehwa zvokudya makore kupinda lumen "kubvisa" zvamagonhi. Uyewo, pane ari akazviunganidzira bile, iyo rinononotsa chirongwa kugaya.
2. Kurasikirwa tsandanyama mukatanga pechikamu "kubvisa". chikonzero ichi kunowanzokonzera chisingaperi urwere pakati afferent loop pashure resection.
3. Spasm pakati anastomosis - panosangana chigutsa mudumbu uye ura diki. tsandanyama unogonawo kuderedzwa uye loop nzira yokubudisa.
4. Maronda kuremara munguva anastomosis. It inotungamirira chimiro zvokuimba chikonzero afferent loop syndrome. Zvingaita vawande chikuru (avhiyiwa), uye kechipiri.
5. Inzwi afferent loop. Kazhinji zvinoita zvakare.

Afferent loop chirwere: pathogenesis chirwere

The mashandiro pamusoro afferent loop chirwere rinoumbwa vezvikwata anoverengeka. Chokutanga pane kukanganisa muviri dzose anatomical uye dzichipfekeka mukukurukurirana. Somugumisiro "chakagadzirwa" kugadzirisa zvomudumbu hurongwa muitiro zvokudya dzinosiyana kubvisa. Food, rakava mu "kubvisa" intestinal loop, haangaupfuuri mberi. Naizvozvo pane urirasire shure - reflux. Mukuwedzera, muna pathogenesis pakati kushoma chipo. It kunoitika nokuda kurega kunotanga nevanhuwo zvavo uye zvomudumbu hypotension KDP. Zvinoguma yechipiri intestinal dysbiosis. Zvadaro inotungamirira kuzvimba zvomudumbu turakiti: cholecystitis, pfungwa nomuviri zvemwana asati, esophagitis.

The kunotoda mune afferent loop chirwere

The chikuru Kuratidza kuomesa uyu marwadzo uye kurutsa. Abdominal kusanzwa zvingaitika pakarepo kana avhiyiwa pamusoro nguva. Muchiitiko chokutanga pane chikuru, rikwanise afferent loop syndrome. It kunoratidzwa cramping uye kurwadziwa Expander hunhu zvakarurama hypochondrium uye epigastric. In chisingaperi chirwere zvichiguma kunotoda mufananidzo loop kunoratidzirwa kwete zvikuru. Pain kunoitika kunyanya pashure zvokudya, kazhinji - panguva negashiro mafuta zvokudya. Zvisinei nguva panowanikwa yematambudziko (chakasimba kana chirwere nguva) iri kuchengetwa kurutsa. Inouya pashure kuwedzera marwadzo mudumbu, kazhinji apa kudya. Nokuda kakawanda kurutsa anogona govera kusvika Rine mamiririta 500 pazuva kubva bile. Zvinoguma kunoramba Kuparadzwa muviri. Varwere nokukurumidza uremu, kunzwa mukuru utera.

Afferent loop chirwere: chirwere zvokurwara

Chirwere chirwere inotanga anamnesis (Kutamiswa gastrectomy) uye kuzviongorora murwere. Chekutanga unofanira kuziva nezvokuva marwadzo uye kakawanda kurutsa, kubatana wake pamwe unyanzvi zvokudya. On ongororo, vanofanira kuteerera abdominal asymmetry: rworudyi dhipatimendi zvimiti. chiratidzo ichi anoenda kure pashure kurutsa, sezvo zviri loop chinobuda. Chimwe chinhu chiri jaundice pamusoro sclera uye ganda.

Kuwedzera kunyatsoongorora kunotoda kurapwa data, murabhoritari uye richishanda Diagnostics. Kuchinja kungava KLA (B-12 kushaikwa kupererwa neropa), zodzera ropa, coprogram (chimiro leukocytes, undigested mafuta). Apo X-ray akabuda vakachengeta chiratidzo chimwe niche iri afferent loop, gipermotornaya dyskinesia. Musiyano mumiriri anozadza kunoguma loop. Uyewo akaita endoscopic kuzviongorora. In chisingaperi afferent loop chirwere kazhinji segwapa anogumbura zvachinja gallbladder uye ducts. Mune zvimwe zviitiko, pfungwa nomuviri zvemwana asati hwapedyo. Kana kuzvimba uyu pachena uye rwatata. Kana kudyara zviri intestinal kwemabhakitiriya kasvisto ari kuchengetwa, nhamba vasingadzoreki pancreatic makemikari. Kwokuomerwa chirwere vagara vandifungira Kuparadzwa nomuviri, kukura kurasikirwa bile murwere.

Chii ngozi afferent loop chirwere: yematambudziko

Zvinofanira kurangarirwa kuti afferent loop chirwere haisi kuomesa kwakaita gastric resection. The kuramba kurasikirwa bile zvingaitika chakakomba Kuparadzwa muviri. Zvokudya anopinda muviri haagoni zvakanaka kugaya (nokuda "kubvisa" ari KDP uye chikamu ura diki), uye zvokudya zvisina kunyura. Somugumisiro kukura intestinal dysbiosis gastrointestinal nhengo kupesvedzera anogumbura kwendangariro. With kukura reflux esophagitis kuti dziri zviratidzo zviri kuwedzera kurwadziwa muchipfuva, kunzwa "bundu iri huro." Cholecystitis achabatsirwa zvinovava kuravira mumuromo, kuda kurutsa. Kana anobatana kuzvimba rwatata, marwadzo inogona yakakura kuva herpes hunhu. Kana ya magetsi pfungwa nomuviri zvemwana asati zvingamuka chirwere cheshuga. Matambudziko chenjera afferent loop chirwere zvinosanganisira peritonitis, intestinal mhingaidzo. zvirwere izvi zvinoda nokukurumidza kuvhiya hanya.

Pakurapa chirwere pakati afferent loop

Pakusarudza marapirwo anoenderana murwere, rabhoritari Data uye richishanda bvunzo. Zvakakosha kuziva kuti kwokuomerwa ari chirwere ane afferent loop. Kunokwanisa kuchinja uye zvomusejari. Munyoro taurira rinokosha kudya, anogumbura uye zvinodhaka antibacterial (medicaments "Tsefriakson", "Tsiprolet"). Mune zvimwe zviitiko vanoda kugara gastric lavage. At mwero uye zvikuru kudiwa kuvhiya kurapwa. Zvinofanira zvainanga Achabvisa kurega kunotanga zvokudya. Kakawanda zvinosvibisa vavakezve anastomosis. Kana iye anokotama zvichiita zvishwe vasiyana zvakarurama chinzvimbo uye sutured kuna peritoneum. Huwandu mufananidzo kuvhiya kurapwa uye anogona kuva zvakasiyana uye zvinoenderana chikonzero matambudziko.

Kudzivirira afferent loop chirwere

Pari, kuvhiya kuna Billroth-2 edza kutsiva dzimwe maoparesheni. Izvi zvinoitwa kuitira kuchengetedza physiology ari zvomudumbu turakiti. Kana Billroth-2 kushanda asi zvakaitwa, zvinokosha kuita matanho ose chairayirwa chiremba. Zvikurukuru izvi zvinosanganisira zvokudya. Pashure resection haagoni kudya mafuta uye zvokudya zvisingavaki muviri. Tora chikafu rwaunoda 6-7 kanomwe pazuva migove zviduku uye Semi-mvura mamiriro (bota, soups).