Chenjera dumbu chirwere: Zviratidzo, Zvinokonzera neMarapirwo

Abdominal marwadzo kuunza dambudziko vakuru nevana. Gastritis, gastric urikanwi, gastroduodenitis, reflux esophagitis, gastric kenza - izvi ndezvimwe zvikuru nevakawanda zvirwere nemudumbu, izvo kazhinji kugume chisingaperi Danho. A mungozi chaiyo iri rikwanise dumbu syndrome. Emergency rubatsiro runodiwa. chirwere ichi kwete chete chinokonzera marwadzo, asi zvakananga upenyu hwevanhu. Zvikuru ndiye nenguva dambudziko kuvhiya kurapwa.

Sei tsanangudzo chirwere

Izwi inoshandiswa mukurapa kureva kurwadziwa nawo abdominal mhango uye inoda pakarepo kuvhiyiwa. chenjera dumbu chirwere chinogona yakakonzerwa blockage of abdominal mhango kana gastrointestinal chirwere. chirwere ichi nengozi chaiyo nokuda murwere upenyu.

Definition of urwere pakati "rikwanise dumbu" yakabuda munzvimbo okurapa mushure bhuku rinonzi Genri Mondora "nechimbichimbi kuongorora chirwere. Belly ", yakabudiswa muna 1940. Bhuku raireva chiremba fanano - ". Abdominal dambudziko" Zviri pashure bhuku rino iri okurapa vakatanga kukurukura chirwere uye kurapwa zvirwere zvakadai chakasimba dumbu syndrome. Zviratidzo uye Zvinokonzera vakatanga kuongorora kunyatsoongororazve.

Henri Mondor akanga asiri oga chiremba uyo akarondedzera chirwere. Russian chiremba N. Samarin akadzidza mamiriro ichi, uye mumabhuku ake, iye anoti murwere chirwere ichi anofanira kuendeswa kuchipatara nokukurumidza chaizvo. Mumabhuku ake, izvo dzakabudiswa kakati, anoti, kuti pashure okutanga zviratidzo murwere ane maawa 6 chete.

zviratidzo

Nokuti kunzwisisa kunotoda mufananidzo upi chirwere zvakafanira kuziva zviratidzo. Kana zvinoreva kusachengeteka kukuru dumbu urwere, zvinotevera zviratidzo:

• Kurwadziwa mudumbu.
• High tembiricha.
• Kukurumidza kurova kwehana.
• Kurutsa.
• Ropa.
• Shock.

Asi chikuru chichemo murwere anoramba marwadzo. Inobva kumusoro zviratidzo, vanachiremba vanogona vanokanganisa uye vanoti ivo nevamwe zvirwere. Somuenzaniso, marwadzo angava anoratidza generalized peritonitis, kurutsa - wamuratidza poizeni. Mugumisiro kurapwa kunoenderana zvakarurama chirwere vachasimbiswa nokukurumidza.

chenjera dumbu urwere: Zvinokonzera

Mhaka chirwere angava nokuti:

• Pfungwa nomuviri zvemwana asati, cholecystitis, appendicitis, peritonitis, kenza muura, embolism, thrombosis, abscesses.
• Hwatsvuka kana perforation mudumbu, ura.
• Anoparadza rwatata, chirwatata, chiropa, dumbu, zvinoshandiswa, izvo angaperekedzwa ropa munzvimbo abdominal mhango.
• Ileus.
• Hosha zvomukati kuti dziri kunze abdominal mhango.

Unobva kumusoro, pane kupatsanura zvezvinokonzera chirwere:

• Anogumbura zvirwere izvo zvinoda kukurumidzirwa kuvhiya hanya.
• Chenjera ropa iri nemudumbu (Mallory-Trappers urwere, ropa urikanwi, anorectal ropa, gastric bundu, haemorrhagic gastritis).
• Abdominal kunotevera kana rakapinza ronda, sezvamakaropafadzwa zvakakuvadza chiropa, chirwatata, rwatata kana ura.
• Zvirwere zviri nemudumbu, izvo regai zvinoda Kuvhiya zvashata (chiropa, peritoneal carcinomatosis, gastroenteritis, yersiniosis, hepatic porphyria, hepatic colic, rikwanise cholecystitis, pseudomembranous enterocolitis).
• Gynecological zvirwere (dysmenorrhea, chinorwadza chirwere ari pakati kumwedzi, salpingitis).
• Cheitsvo (pyelonephritis, renal infarction, renal colic, paranephritis, hydronephrosis iri rikwanise Danho).
• Zvemwoyo chirwere (kutsemuka aneurysm, myocardial infarction, pericarditis).
• Chetsinga chirwere (herniated Disc, herniated SHmorlja).
• Pleuropulmonary (pulmonary embolism, pleurisy, mabayo).
• Urogenital zvirwere (ovarian volvulus, chenjera Urinary chengetedzo).
• Musana Kukuvara (kunotevera, myelitis), musoro mbabvu, vertebrae.
• Other zvirwere (kudhaka kana rakacheturwa Arsenic, kutungamirira, uremic pakoma, leukemic dambudziko, chirwere cheshuga pakoma, hemolytic dambudziko, Verlgofa chirwere).

Sei kuziva chirwere

Zvisinei mamiriro murwere vanachiremba Diagnostics, iro rine zvimwe zano. Chirwere pamusoro urwere pakati "rikwanise dumbu" riri sezvinotevera:

1. Anamnesis.
2. Kuongorora mamiriro murwere.

Nhoroondo zvinosanganisira kunyanya vakadaro inoti: duodenal urikanwi kana gastric, hepatic, renal colic, kushandiswa, voiding kana cheya, gynecological zvirwere. Doctor kutanga inotiratidza nguva marwadzo uye ayo localization, dyspepsia, tembiricha, zvekare Zvirwere Gynecology, kumwedzi hadzina kufambiswa zvakanaka. Izvi zvinokosha, sezvo chakasimba dumbu chirwere kunogona kuitika somugumisiro ovarian apoplexy kana ectopic pamuviri. Kuunganidza zvose izvi, zvingatora nguva yakareba, asi ivo zvakakodzera kuti zvakarurama kuongorora chirwere.

Investigation miviri ndiyo rokuongorora, palpation, percussion, imwe ongororo kuburikidza nepanhengo, iyo mugaranhoko. Doctor kutanga inotifungisa nekuneta, ganda rakachenuruka, kuparadzana, kupera mvura mumuviri. Mushure kuongororwa chiremba prescribes zvinotevera rabhoritari nemiedzo:

• Urinalysis.
• Kutsunga ropa boka uye kusapindirana kweropa chikonzero.
• Padanho Chizenga, hematocrit.
• ESR.
• Complete ropa kuongorora muAtlantic leukocyte fomura.
• Makemikari rwatata uye chiropa.

Laboratory ongororo havasivo simba yokupedzisira, saka chiremba prescribes Ultrasound pamusoro abdominal mhango, retroperitoneal nzvimbo. Ultrassom zvakafanira kuona abnormalities kuti arege kuva akajeka kunotoda mufananidzo. Uyewo, chiremba prescribes auscultation ari mudumbu kuziva intestinal motility dzekugonesa murwere kana kushaya bowel kurira. Kuwedzera Ultrasound, chiremba prescribes munhu rectal kuongororwa uye vakadzi kusangana nekutsi kwemukadzi. Izvi zvinokosha, nokuti anoona izvi anogona kuzivisa marwadzo ari chiuno, izvo zvinogona anoedzesera somunhu rikwanise dumbu. Zvinokoshawo chidobi nemwaranzi ongororo yakaitwa urwere pakati rikwanise dumbu.

Palpation iri nechirwere zvirwere

nzira iyi nechirwere yaifanira nokungwarira. Unofanira kunzwa noushamwari ruoko kuti seari yose dumbu sandarara. Chokutanga, chiremba anoongorora nyarara dzine nokudzidzisa murwere kuti zvisingafadzi nezvekufadza. Ipapo chiremba palpates mudumbu zvinorwadza munzvimbo. Chiremba harifaniri kunzwa mudumbu ruoko pane zvakanaka akachinjikana. nzira iyi nechirwere inoratidza tsandanyama makakatanwa, kurwadziwa, infiltrates, bundu inotungamirwa uye invaganity.

Instrumental kudzidza chirwere

Kana murwere anosvika zvashata kamuri, zviri basa zvidzidzo zvinotevera:

• Radiography pakati mudumbu uye thorax, kuti zvinokosha kuti chirwere Iris nehurumende (ayo mufambo, kuunganidza gasi, nemvura pamwero iri dumbu).
• X-ray musiyano pakuongorora mudumbu.
• Irrigoscopy (vanofungidzirwa colonic mhingaidzo).
• Laparoscopy (mu dzakaoma rokuongorora).

How kubatsira murwere

chinobatsira kuti chenjera dumbu chirwere rokutanga pakarepo muchipatara. Panguva muchipatara murwere hwobva kuonekwa mune kuvhiya dhipatimendi.

Mugumisiro zvinodhaka pamusoro murwere nemamiriro

Rubatsiro pamwe chirwere kuti "chakasimba dumbu" siya inonyaradza marwadzo omusoro. Izvi zvinoshanda zvose marwadzo uye vasiri marwadzo analgesics, izvo kwete chete kugonyesa ari kurapwa mufananidzo, asi kudzivisa murwere zvawanikwa. Mukuwedzera, zvinodhaka anogona achiipa mamiriro murwere, kubvisa mashoko Kuvhiya, zvingakonzera spasm pamusoro sphincter pakati oddi. Uyewo haana kubvumirwa kushandisa nootropic, psychotropic, laxatives, mishonga uye akaisa enema kucheneswa.

mabatiro

Kana zvinoratidza zvose zviri chakasimba abdominal urwere, kurapwa kuri anotevera. Chiremba anogona kushandisa spasmolytics - 2 Rine mamiririta mhinduro "shpy" kana 1 Rine mamiririta "Atropine" intramuscularly kana nomutsinga. Kurapa chirwere ichi chiri kuvhiya, izvo zvinoita chete pashure Kudzikamiswa kuti zviratidzo basa rinokosha. Zvichienderana murwere mamiriro wokugadzirira oparesheni zvingavatorera nguva. A murwere anenge akabvuma pamwe ropa, intestinal mhingaidzo, vari mamiriro nehana, inofanira kugadzirira vavhiyiwa chete pashure kuchaitwa metabolic zvirwere. Metabolic zvirwere (kuderera Nyorera mumwe zvisingaoneke, nokuvhiringidzirwa mvura uye electrolyte mwero, kupera muviri, dysfunction dzinokosha nhengo, kuvhiringidza asidhi-chawo mwero) Zvichangoerekana zvaitika varwere akabvuma chakakomba ezvinhu.

Time wokugadzirira oparesheni kunobva murwere ezvinhu. Munguva kwechimbichimbi mukamuri murwere unofanira kupinda vachiongorora mudumbu zviri kuti chido. Zvadaro kugeza dumbu pamberi gastroscopy uye kuzvidzora ropa kana murwere vakabvuma kuti. The dundira anobudisa mushonga zvishoma nezvishoma rokuongorora kukuvara zvichibvira, uye Chikurukuru - kuongorora Hourly weti goho panguva kurapa mishonga.

Kana zvakakodzera, inotungamirira kwezvinodhaka nomutsinga, yeplasma kana masero matsvuku eropa vanofanira yokusuma anobudisa mushonga zvishoma nezvishoma kunyika subclavian tsinga kuti nokukurumidza replenishment kurasikirwa neropa, normalization pamusoro asidhi-chawo nepakati, mvura-electrolyte kusaenzana, uye kusarudza musimboti venous kumanikidzwa.

In chirwere ichi zvinoratidza aizomupa kurapa:

• A shuga mhinduro.
• Musumo yacho electrolyte mhinduro.
• Pakatanga plasma-mhinduro.
• Nhanganyaya chemhinduro "sealbumin".
• Nhanganyaya ropa, kana zvichidikanwa.
• Pakatanga plasma.
• Mishonga nokuti vanofungidzirwa intestinal mhingaidzo kana perforation zvomukati.

The yapfuura kurapwa atanga, zvikuru yakanaka ndiye Zvaizobuda kupindira. Kugadzirira kuvhiyiwa kunoitika panguva imwe chete pakarepo oparesheni.

chenjera dumbu urwere uye vana

Marwadzo chirwere muvana angava chiratidzo zvirwere zvakasiyana-siyana. Kazhinji kungava kutsamwa ari mucous Kamudzira, ari peritoneum, uye kwete kusachengeteka kukuru dumbu chirwere vana. Zviratidzo chirwere ichi muna vana vakafanana nedzevakuru. Panobva kungava muviri kuti iri mune abdominal mhango kwete chete.

Zvinokonzera abdominal marwadzo muvana:

• Dysbacteriosis.
• Kuzvimba yegurokuro.
• Colitis.
• Enteritis.
• Enterocolitis.
• Gastro.
• Duodenitis.
• Gastritis.
• Gastric urikanwi.
• Reflux esophagitis.
• Maronda colitis.
• Kupatira.
• Pfungwa nomuviri zvemwana asati.
• Cholecystitis.
• Hepatitis.
• Honye, giardia, roundworm.
• Biliary dyskinesia.
• Intestinal chirwere.
• Ari.
• Gwirikwiti.
• Chibhokisi.
• Cystitis.
• Pyelonephritis.
• Urolithiasis.

Chero zvazvingava, kana paiva chirwere - chakasimba abdominal marwadzo, kunyange sezvo chiratidzo chipi zvirwere izvi, ndiyo yokutanga "bhero" kushevedzera kuti ubatsirwe. Schitaetsya kuti kana munhu zvakakwana akadzidza uye ane tsika, zviri kukwanisa kuona panguva zvomusejari zviratidzo iri rikwanise danho. Kazhinji, hachisi. Maererano nenhamba, kukonzera yakanyanya yematambudziko ari rikwanise appendicitis danho iri kufuratira murwere mangwanani zvinoratidza chirwere. The kamwe kusavapo chinorwadza chirwere - ichi hachisi chikonzero nomufaro, sezvo zvingaratidza aparadzanisa pamusoro zvomoto bowel rusvingo. Muzviitiko zvakawanda, kana murwere uchakumikidzwa kunonoka, mugumisiro wacho kuvhiyiwa anoenderana chiremba unyanzvi uye postoperative kurapwa.

chenjera dumbu chirwere - nechirwere inotyisa, kunyanya vabereki. Naizvozvo, zvinokosha kuziva kuti asati suspecting zvakaipisisa, zvakakosha kuziva kuti chikonzero zvinowanzovapo kurwadziwa muvana iri rikwanise appendicitis ari padanho kana kuzvimba okuwedzera pamusoro cecum. Zvakakosha kuziva kuti mune rikwanise appendicitis achirwadziwa vaduku vana havaratidzi akaratidza. Asi mwana lethargic, asingadi kurara, misikanzwa. Nokukurumidza manyoka anooneka umo madzihwa aripo. Nokuda Chiratidzo kwakadaro kuvhiringidzwa appendicitis chepfu kana intestinal chirwere.

How kusiyanisa appendicitis muchetura kana intestinal chirwere? Marwadzo appendicitis rikaitika rokumusoro mugove kana achiine rukuvhute nharaunda, asi kwete ari kurudyi iliac fossa (nzvimbo okuwedzera iri). Pane zviitiko apo vaduku okuwedzera iri munzvimbo rectal munharaunda, pedyo dundira. Panyaya iyi, zvatinosiita appendicitis anogona kuziva chete chiremba mamwe ruzivo. Other chokuita zviratidzo (kuda kurutsa, kurutsa uye fivha) kurege kuva mune zvimwe zviitiko. Kana chakakomba gangrenous appendicitis leukocytes hazvigoni wakawedzera, uye abdominal tsandanyama makakatanwa chinogona kusiyiwa.

Zvakakosha kuziva kuti vana kuzvidzora isingagamuchiriki. Kwete chete kurwadziwa uye haagoni majee kutsarukana kupa Pharmaceuticals vana, asi ane chikosoro kuti vakandinyengedza. Enemas, gastric lavage, sorbents kana zvimwe zvinodhaka kuti kupiwa pamwe poizeni, kudhaka kana intestinal mhingaidzo, anogona sembura rikwanise appendicitis, rikwanise dumbu kana zvichibvira syndrome. Zvinofanira pakarepo kudaidza amburenzi, regai girisi mufananidzo uye havana kunyengedza vanachiremba "muhwezva venhema" vasati vasvika. Mwana haafaniri kupiwa mvura kana chikafu. Kana apo amburenzi iri kunonoka, uye mwana kunowedzera, unogona kudana chiremba kuitira kuti anogona ndikurayire mberi sei. Uyewo, pane nyaya chokufambisa kumba, unogona kutora mwana kuti kwechimbichimbi dhipatimendi muchipatara.