Gangrenous appendicitis: Zvinokonzera, Zviratidzo, kuongorora chirwere

Gangrenous appendicitis - iri zvokurwara kuti kunoratidzwa zvinyama necrosis pamusoro okuwedzera pamusoro chidimbu uye chaiwo kunotoda mufananidzo kuti anotibvumira kusiyanisa kubva kumwe kuzvimba zvakananga okuwedzera. Kakawanda izvozvo rikauya acutely chinokurwadzai zvakakwana dzakabudirira zvakakomba zvoutano zvaitika. Ndokusaka zvichikosha kuti kukurumidza kutsvaka rubatsiro chiremba, uyo anosarudza zvinokonzera kuti pathological kwacho uye taurira kurapwa.

tsananguro

Gangrenous appendicitis - imwe mhando purulent kuzvimba kwacho musiyano wezvinyorwa, kunobva vakavanda kuparadzwa kusingarapiki. Kakawanda kuchinja necrotic hunhu vari kuchengetwa munzvimbo duku pakati okuwedzera. Gangrenous kuzvimba inzira rikwanise musiyano wezvinyorwa chirwere uye rinooneka chete pane imwe neimwe yayo kukura (mazuva 2-3 kuzvimba).

The kukonzera chirwere kukura

Chenjera gangrenous appendicitis hwapedyo apo kushoma ari kwacho haana kuchengetwa panguva rokutanga. Zvadaro haarambi chakaipa aikanganiswa tsinga harinzwi saka marwadzo anogona kunyangarika. Varwere vakawanda vanosarudza kuti ngozi kwapfuura, rinogona kumbosiyiwa kwenguva yakati kuti vaone chiremba. Kushaya hanya kwakadaro utano hwavo pachavo vanogona kutungamirira peritonitis.

Huru zvinokonzera ngozi panowanikwa nezvirwere zvakadai zvinosanganisira zvinotevera vanachiremba:

• Older zera.
• Paumbwe ropa.
• Atherosclerosis pakati arteries ari ura.

All izvi zvinoita zvinoratidza kuti yepakarepo zvinokonzera chirwere ndivo vanonzi microcirculatory vachivavhiringidza. Vari kuonekwa mugumisiro Kuvhiringidza ropa kuparadzirwa, sezvinoita mugumisiro - necrosis repfupa. Zvimwe zvinhu zviri pathogenesis (chirwere autoaggression zvirwere masero) vari akabatana chete yechipiri dzokai, chete Chinowedzera zvokurwara.

Ndezvipi zviratidzo zvinoratidza zvokurwara?

Munguva chenjera kutotanga pane inodzokororwa kurutsa, uko kunoramba uchimhanya murwere akasaunza-refu akamirirwa zororo. Nemhaka kudhaka nokuda kukura putrefactive kushoma tembiricha ugare zvakajairika kana kuderedzwa.

Gangrenous appendicitis kunooneka pachayo iri chimiro urwere pakati "chepfu chigero." Murwere akaratidza tachycardia (kwemwoyo anenge 100 anorova paminiti), asi tembiricha rukasafashukira.

rurimi murwere pakaoma ane maitiro yellowish unhani. Kana chikuru gangrenous appendicitis zviratidzo zvingasiyana zvishoma:

• Rwadza kusanzwa zvakanaka iliac nharaunda, izvo pakarepo anooneka uye nokukurumidza aserera.
• Dumbu zvakaoma, kunorwadza.
• Murwere ezvinhu anoonekwa zvakakura.

Kana munhu haagamuchiri zvakakwana uye nenguva kurapwa, ipapo chimiro ichi chirwere hwapedyo kare gangrenous, Perforated okuwedzera. The zvokurwara kunoratidzwa perforation porusvingo zvakananga okuwedzera. Panguva yake pakarepo kwemasikati munhu pavanorwadziwa kurwadziwa, izvo pamusoro nguva zvishoma nezvishoma rakapararira mudumbu. Pamusana kuwedzera kudhaka tembiricha rinobuda, pane pachena tachycardia. Rurimi inofambidzana akaoma kwazvo, unhani anowana brownish tint. Murwere anotambura zvikuru kurutsa.

chirwere matanho

Kana uine pamusoro zviratidzo, unofanira pasina kunonoka kutsvaka rubatsiro kubva chiremba. Kana uchifungidzira kuti ichi zvokurwara nyanzvi pakutanga inoitisa munhu kuongorora murwere. kazhinji Palpation vakachengeta kusungika pamusoro abdominal rusvingo, mudumbu mwero zvimba. Zvadaro basa dzinotevedzana Murabhoritari nemiedzo, kusanganisira ropa uye weti kuongorora. Uyezve, ungada Ultrasound, X-ray uye computed tomography. Zvichienderana migumisiro aongorora chiremba anogona kusimbisa zvokuongorora kuti gangrenous appendicitis.

kurapwa

Zvipatara kunosanganisira kuvhiya nokubviswa okuwedzera. Appendectomy rinoitwa mune zvetsika nzira, kana nokuda laparoscopy.

Muchiitiko chokutanga, chiremba anobvisa okuwedzera kuburikidza incision ari abdominal pamadziro. Kazhinji, nzira yakadaro rinoitwa kushandisa talk yokutindivadza.

Operation yokuva appendicitis nokuda laparoscopy yakasiyana chaizvo diki. The chiremba anoita punctures akawanda duku mune abdominal rusvingo kuburikidza iyo kuisa zviridzwa evanhu. Anokosha aya ndiwo laparoscope - kumicheto aine kamera kuguma. Munguva oparesheni, chiremba anogamuchira mufananidzo wake pakombiyuta, vachibvumira kuti aite zvakarurama kwazvo maoparesheni.

The postoperative kumwedzi

The postoperative nguva varwere kumbonyanya kunowanzoitika ane dzakawanda zvinhu:

• Kushandisa zvinodhaka antibacterial uye analgesics.
• Aizomupa detoxification mushonga kushandisa munyu zvinogadzirisa refortane, shuga, uye sealbumin.
• Daily miedzo ropa.
• Kudzivirira nemaronda uye thromboembolic matambudziko. Mugore postoperative nguva wevarwere raitongwa gastric secretion blocker ( "Kvamatel", "Omez"), anticoagulants ( "Clexane").
• Daily ligation uye kugeza maronda.
• Physical kurapa, inokosha masaja, kurovedza kufema.

Operation appendicitis - chinhu chakakomba kuvhiyiwa. Kudzivirira kukura yematambudziko mune ramangwana, unofanira kushandisa nhungamiro yakapiwa pazasi.

Ngatimbotaura kudya

Nokuti zvokurwara ichi kunoratidzwa nezvinetso intestinal peristalsis, saka pashure kuvhiya Kudya inofanira kupiwa vainyatsotarisirwa.

Pazuva rokutanga akabvumidza kushandiswa nonfat yogati, chicherwa mvura pasina chiedza magasi uye huku muto. Pazuva rechipiri, kana post-kushanda nguva haina kuoma nemashoko akaipa migumisiro iri kudya kunogona kuwedzera mashed nembatatisi, Porridge mvura uye koteji chizi Casserole. Zuva pashure simba zvakakodzera kuti Siyanisai mukati zvokudya №5. Zviri nani kurega zara mafuta, Spicy zvokudya uye kusvuta.

fungidzira yematambudziko

zvokurwara iri kuonekwa nengozi zvikuru sezvo kungakonzera zvikuru ngozi dzoutano matambudziko. Zvikurukuru kutsoropodza kwakadaro muitiro varwere vaduku.

Migumisiro ipi akaipa anogona pamwe gangrenous appendicitis?

1. Purulent peritonitis. Ichi chimiro ine ngozi kuti kunoda pakarepo kuvhiya kupindira. Kana rubatsiro haripi yakakodzera, chepfu ropa kunogona kuitika.
2. Appendicular nda. Mugore zvomoto okuwedzera zvishoma nezvishoma vakaumba munharaunda conglomerate rinosanganisira runonyanya zvomukati uye munyama. nyaya iyi nguva dzose chinoda refu kuchinja kurapa.
3. Septic thrombophlebitis. Kushoma iri kukura venous pamadziro. Somugumisiro, inotungamirira kuti paumbwe ropa clots vari lumen pamusoro tsinga.
4. Local purulent pute. idzodzo kwakadaro advantageously munguva diaphragm nzvimbo.

Hazvifaniri kusiyiwa vasina akavatarisa appendicitis. Purulent gangrenous musiyano wezvinyorwa chirwere ichi zvinoda kurapwa pakarepo. Zvikasadaro, kunowedzera mukana wokuti yematambudziko uye kunyange rufu. Kunyanya ngozi ndiyo kuzvimba vana, vose pathological pezvakaitwa vari kakawanda nokukurumidza.