Malabsorption - chii ichi? Kupatsanura uye zvikonzero

Small ura - mumwe ura. It anoita zvakasiyana siyana mashandiro, kukonzera ari kugaya zvokudya uye Absorção de Água nezvinovaka muviri. With dzimwe zvirwere kwakakanganiswa ichi dhipatimendi - pachena malabsorption chirwere, riri rakapfupikiswa sezvo CMA. Chii ichi izwi? chirwere ichi kunokonzerwa chii zvikonzero?

Decoding pfungwa

Mumabhuku zvokurapa, unogona kuwana izwi akadai "malabsorption". Shoko iri rinoshandiswa kureva malabsorption intestinal mucosa yenhengo zvokudya. Panewo izwi akadai "maldigestion". kutyora kutendeuka uku dzinotsanagura mafuta, mapuroteni uye carbohydrate kugaya zvinogadzirwa absorbable.

Nyanzvi vanobatanidza pamusoro apa rokuti ( "malabsorption" uye "maldigestion") vose, kana munhu anotaura malabsorption syndrome. Zvinoreva zvakaoma zvekuchipatara kuratidzwa, yomuka kubva kutyorwa mhango, rusvingo, Kamudzira kugaya uye yokufambisa ari ura duku. Nokuda kuchinja kuitika mumuviri womunhu nokuda kwaita malabsorption chirwere, metabolic zvirwere kuoneka. Vanhu vanotanga anopisa zvinoitika zviratidzo.

The zvinokonzera SMA

malabsorption chirwere kuchengetwa zvirwere zvakawanda nhaka uye vachiberekwa umo vachanetseka Absorção de Água pamusoro zvinhu, akaderedza enzayemu basa. Somuenzaniso, cystic fibrosis. In chirwere ichi, kuti AGR nezvechinhu nokuda tikarega enzayemu basa uye pancreatic nepfungwa zvakavanzika viscosity.

To kukonzera malabsorption chirwere zvirwere zvinokonzerwa noutachiona uye tupukanana, zvemamiriro nhengo dzinobudisa uye kweropa nehurongwa. CMA ari vakacherechedzawo pakuparwa kuzotadzira ura duku uye kuderedza Absorção de Água nharaunda (inonzi kuchinja mumuviri, kuva chikonzero chakakura nenyonganiso pakati siyana exchanges, mumuviri uye stunting pfungwa dzakawanda).

Saka, malabsorption - kutaridza zvisingafadzi zviratidzo zvinogona kukonzera yakawanda yakasiyana zvikonzero. Vanogona kubatanidzwa sezvinotevera:

1. Preenteralnaya boka. Izvi zvinosanganisira biliary turakiti zvirwere, chiropa, mudumbu, cystic fibrosis.
2. Postenteralnaya boka. Chinosanganisira node uye kufamba kweropa zvirwere iri refu ura, riri pakati mudumbu uye muura, exudative enteropathy, lymphosarcoma, chirwere Hodgkin vake.
3. Enteral boka zvikonzero. Izvi zvinosanganisira galactose malabsorption, celiac chirwere, disaccharidase kukundikana, giardiasis, dermatitis herpetiformis.

Zviratidzo wakananga SMA

Pasinei nokuti malabsorption chirwere kuri mumashoko zvirwere zvakasiyana-siyana, vanogona kusiyaniswa ine hunhu pake. Apo CMA kuda kurutsa, kurutsa. In varwere ungaderedza kudya. Zviratidzo izvi vari kuonekwa bloating, shanduko chetsoka (manyoka rinowanzoberekera). zviratidzo zvose izvi zvinonzi dyspeptic syndrome. Ari kutungamirira zvekuchipatara kuratidzwa SMA.

Special nzeve inofanira chair. Kuzviona hunhu mutsvina yadzo, nyanzvi vanogamuchira mashoko anokosha kuti dzinovabvumira kuisa zvakarurama zvokuongorora:

• uye frothy mvura chetsoka ane acidic kwakanaka - chiratidzo chingava kuri mumashoko pathologies akadai shuga-galactose malabsorption, disaccharidase kushaikwa;
• zara mafuta chetsoka iri chisingaperi pfungwa nomuviri zvemwana asati, cystic fibrosis, dermatitis herpetiformis, exudative enteropathy chirwere Pearson, intestinal dysbacteriosis;
• zara mafuta chaizvo zvituru kuchengetwa cystic fibrosis, vachiberekwa lipase kushaikwa;
• mvura manyoka - chiratidzo kuti zvingaitika kana utachiona anopinda muviri, kukura enterocolitis, malabsorption kuti shuga uye galactose.

Apo MCA dzimwe nguva pane kurwadziwa. Kakawanda, vanovakonzera intestinal utachiona uye infestations. Marwadzo chirwere chinogona kuitika mushure mabhodhoro dheri zvigadzirwa. Iye pamwe foamy cheya ane yakashapa kwakanaka, flatulence kunoratidza lactase kukanganisika. Abdominal marwadzo panguva CMA pamwe zvokudya nezvimwe zvinhu, intestinal abnormalities, Whipple nechirwere, maronda colitis, chirwere Crohn vake. Zvinotevera Zviratidzo zvinochengetwa kunyange apo malabsorption chirwere:

• ganda upundu;
• nekuneta;
• kunzwa simba;
• bloating;
• neanorexia.

Malabsorption muvana pamwe wakareruka syndromes. Anetseka kwomuviri. Izvi wakaratidzwa rutapudzo kurema muviri, kukura kwezvokudya zvinovaka muviri, kukakanganiswa kukura. On vhitamini kushaikwa inoratidza mamiriro ganda. The ganda inova yakaoma uye otanga peel they and and kure. On sokuti rima makwapa. Hair rive dete uye kutanga vabude. The zvipikiri kuva patainzwa matauriro uye exfoliate. Kana karusiyamu kushaikwa kuitika chinyamunhari chinorwadza, kurwadziwa tsandanyama uye mapfupa. Kushaikwa simbi, mhangura zinc inotungamirira chimiro ganda mapundu, simbi-kushaikwa kupererwa, kuwedzera tembiricha muviri.

aripo kupatsanura

malabsorption chirwere zvinosanganisira zvirwere anopfuura 70 vakasiyana. Panyaya iyi, vanamazvikokota vasangana mamwe matambudziko ari kupatsanura rekugadzirira. Anobudirira zvikuru ndiyo weboka nhaka uye akava malabsorption syndromes:

1. Chokutanga yezvizvi dzakaonekwa muna 10% nyaya. Nhaka SMA wabva vabereki kuti mwana. Naiye nokuda Gene kunotouraya.
2. Vawana malabsorption chirwere - mugumisiro intestinal uye extraintestinal zvirwere (semuenzaniso namamota, immunodeficiencies, nerwatata).

Panewo kupatsanura iyo inobva kwokuomerwa malabsorption chirwere:

• Grade I (nyoro chimiro) - vana akaderedzwa zvishoma muviri uremu, zviratidzo muka multivitamin kukundikana vakachengeta disharmonious kwomuviri;
• II dhigirii (avhareji chimiro) - murwere ane body mass dhefisiti (zvokutsauka kubva ndeyokuva kupfuura 10%) iri kuchengetwa lag mu kwomuviri, wakaona akazivisa zviratidzo electrolyte kushaikwa uye insufficiency multivitamin;
• Grade III (kwazvo) - vana mumuviri underdeveloped, body mass dhefisiti kwazvo 20%, mune vamwe varwere pane kunonoka psychomotor kukura.

mhando malabsorption

Muna 1977 rakaitirwa VIII World Congress of Gastroenterology. It nyanzvi dzinoti mhando dzakawanda malabsorption, zvichienderana ayo zvinokonzera:

• intracavitary;
• posttsellyulyarnaya;
• enterotsellyulyarnaya.

Kushaikwa bile secreted nerwatata uye zvinhu izvo kunokanganisa recessed kugaya uye chinokonzera pakakoromoka, - malabsorption intracavitary mhando. Nendumure ivo simuka nokuda cystic fibrosis, vachiberekwa hypoplasia pakati rwatata. In vana vakura chitarisiko intracavitary malabsorption chirwere vanotsamwisa zvirwere zvakadai cirrhosis, chisingaperi pfungwa nomuviri zvemwana asati.

The mhando wechipiri SMA - posttsellyulyarnaya malabsorption. chirwere ichi, iyo inozivikanwa nokuva kurasikirwa yeplasma kuburikidza intestinal madziro. Akaona pamwe anomalies pamusoro kweropa uye nhengo dzinobudisa nehurongwa. Mumwe zvirwere - ane idiopathic intestinal lymphangiectasia. Iye tinoberekwa anorema kurasikirwa calcium, lipids uye mapuroteni ari nemudumbu.

Enterotsellyulyarny mhando rinobatanidza nyaya avo apo kugurwa Kamudzira kugaya kana Absorção de Água nokuda kuti kuremara enzayemu mugadziriro epithelial masero intestinal. Kwakadaro kunogona kuitika munyika vana nokuda enhaka zvirwere chokuita kutyora vaduku:

• kubvisa;
• Kamudzira kugaya;
• kugaya uye Absorção de Água.

Vana vakura pazera enterotsellyulyarny mhando malabsorption chirwere kunoitika nokuda kukuvadza ura muchitokisi rufu nokuda kufurirwa utachiona kana tupukanana, tibhii, namamota ari ura duku, chirwere Crohn vake.

Mienzaniso intracavitary malabsorption

With ichi mhando AGR zvikuru anetseka mafuta kugaya. hydrolysis yavo kuitwa pancreatic lipase, izvo kusashanda kubudikidza bile. With kwaiva izvi zvinhu rinowanika Chiratidzo akadai steatorrhea. Izvi kusarudzwa pamwe mutsvina yadzo zvakawandisa mafuta. Izvi zvakajeka zvikuru richiratidzwa chirwere pfungwa nomuviri zvemwana asati steatorrhea. Chisanyanya kuoneka chiratidzo ichi mu chiropa uye biliary turakiti.

Pakati zvinokonzera intracavitary malabsorption, vanofanira kufunga vachiberekwa hypoplasia pakati rwatata (hypoplasia). Zviratidzo kuonekwa pamazuva okutanga kana vhiki upenyu. Pane mvura akapfuma nokukurumidza cheya malodorous uye zara mafuta kubwinya. Fat anogona kunyange kuramba achigarira maoko kubva horo.

Mienzaniso posttsellyulyarnoy malabsorption

Posttsellyulyarnaya intestinal malabsorption kunoitika apo exudative enteropathy. Ichi chirwere umo yeplasma akarasika kubudikidza mucosa. The chinokonzera exudative enteropathy kungava pamberi vachiberekwa malformation kuti nhengo dzinobudisa bowel midziyo. Kakawanda kukonzera chirwere chirwere Whipple vake, Crohn, chirwere diki bowel namamota, zvokudya chisimbwa.

Exudative enteropathy dzimwe nguva kunoitika pasina dzakajeka zvekuchipatara kuratidzwa. Tinganetseka zviratidzo zvakadai manyoka uye steatorrhea. Varwere kuonekwa peripheral edema, vemunyika pachiso, musana, perineum, maoko nemakumbo.

Mienzaniso enterotsellyulyarnoy malabsorption

Enterotsellyulyarny mhando AGR malabsorption angava nokuda mumwe zvokurwara akadai shuga-galactose malabsorption. Iri nhaka chirwere apo yakaputsika rinoita chokufambisa kuti shuga uye galactose iri diki ura mucosa. Kurwara mumazuva okutanga muupenyu kunoratidzwa manyoka. Fecal dzinounzwa kubva 10 kusvika ka20 pazuva. Vane emvura, akafanana weti. Mwana zvinomutsa muviri tembiricha, kurutsa kunoitika. Kana kubvisa mukaka rive vari zviratidzo. Murombo kubvumirawo zvimwe zvihwitsi uye mukaka anoramba hwose.

Mumwe muenzaniso enterotsellyulyarnogo CMA - fructose malabsorption. Izvi haiwanzowaniki nemagene malabsorption. Zviratidzo kuitika mushure kudyiwa emichero facial, rine ayo maumbirwo yakawanda fructose. Izvi maapuro nemaorenji, uye Cherry cherry. Kuti fructose haisi yokuita zvinoitwa muviri, kuchikonzera flatulence, mvura manyoka, colicky kurwadziwa mudumbu. Mune zvimwe zviitiko, kune kurutsa. Kwokuomerwa zviratidzo kunoenderana chitsama fructose akapinda muviri.

The inonyanya chikonzero enterotsellyulyarnoy malabsorption pamwe havachanyatsogoni Kamudzira kugaya - nayo disaccharidase kukanganisika. Kana isina chose akatsemura disaccharides. Havana kunyura kana kupinda distal ura uye vanosangana kwemabhakitiriya chinovira pamwe shanduka rehydrogen. Kune tichibatwa intestinal colic, bloating, manyoka, ungaderedza kudya, kurutsa, kurutsa.

Enterotsellyulyarnaya intestinal malabsorption malabsorption uye kugaya munogona celiac chirwere. Zviri chirwere nhaka chirwere umo zvakakuvadza villi pamusoro ura duku nokuda zvimwe zvokudya. Celiac chirwere kunoratidzwa muna vana mwedzi mishomanana pashure pakatanga Eenhede glyutensoderzhaschih zvigadzirwa. Apo chirwere:

• defecation maitikiro kakapetwa 2 kusvika 5 pazuva;
• chetsoka riri mushy, dzimwe nguva frothy, zviri tinoberekwa munhu fetid hwezvinonhuhwira, kuvhenekera;
• anowedzera dumbu;
• pane havakwanisi kufuta (papera nguva kune vakawanda dhefisiti anobatana kukura kushaikwa).

Kuita Diagnostics vane malabsorption chirwere

Chirwere malabsorption haina kuitwa. Nyanzvi panoongororwa SMA zviratidzo ushandiswe avo varwere shanduko dzinokosha miedzo uye inoongorora kusimbisa nzira imwe kana mumwe zvokurwara vanofungidzirwa kushatiriswa havachanyatsogoni Absorção de Água kana kugaya.

Kana tichiita Diagnostics, vanachiremba vanotungamirirwa neMweya pazasi algorithm yakatanga neWorld Gastroenterology Organization:

• tanga kuitwa kwazvo nhoroondo, anounganidza ruzivo pamusoro mishonga akaita ichangobva kufamba, kushandisa chikafu uye anonwa haana kuiswawo pakati senguva kudya;
• vadzidza nhoroondo yemhuri;
• nokuda kuongororwa mumuviri zviratidzo malabsorption;
• vakadzidza chetsoka, kufungisisa unhu hwavo;
• rabhoritari miedzo zviri kuitwa kuti mamwe mashoko.

Humwe chirwere kuti malabsorption chirwere zvinosanganisira kwokugara kuferefeta kuti vanofungidzirwa celiac chirwere, kuvapo Giardia, mabhakitiriya uye tupukanana mumuviri. mashoko anokosha chirwere rinobvumira kuwana Ultrasound pamusoro zvomukati ari abdominal mhango. Kuburikidza Ultrasound zvinobvira kufungidzira mamiriro chiropa, rwatata, nduru dundira, node nodes.

Ndezvokukutsausai kubva kwatiri kana kusimbisa autoimmune gastritis, celiac chirwere, chirwere Crohn Zvavanoda esophagogastroduodenoscopy pamwe biopsy mudumbu uye duodenum. Kuzosimbisa kushaya exocrine pancreatic nerevane wakaitwa chetsoka zvidzidzo, kombiyuta uye rinobva resonance tomography, retrograde cholangiopancreatography kufungidzira ducts. Kuti udzidze pamusoro kuvapo kana kusavapo maronda ose ileum, penyanzvi vakagadzwa ileokolonoskopiyu aine biopsy wetsvakurudzo nzvimbo uye muura.

Mabatirwo malabsorption chirwere

Mushure diagnosing zvinokonzera malabsorption Vanachiremba etiotropic varayire kurapwa zvainanga noWokumusoro vanozivikanwa chirwere. Somuenzaniso:

• Kana celiac hosha dzakaonekwa, chiremba wacho anokurudzira murwere kwoupenyu hwose gluten isina kudya;
• kana kuona malabsorption pamusoro makabhohaidhiretsi kana chikafu kusashivirira, zvino ari akatumirwa unoenderana An kuchaitwa kana zvinhu kudya;
• kutapuriranwa pezvakaitwa kuratidzwa inorwisa mabhakitiriya;
• mu metabolic uye kwemakemikari anobudiswa zvirwere kunoda yakakwana pathogenetic kurapa.

Kana akaratidza chemanyoka chirwere iyo chinokonzera malabsorption, kurapwa angava etiologic, uye pathogenetic symptomatic. Patogenetichekaya etiological kurapa uye anogona kuva yaunodya anotevera nzira:

• mishonga nokuti kwemabhakitiriya manyoka;
• "Metronidazole" pamwe amebiasis;
• anthelmintic zvinodhaka helminthiasis;
• glucocorticoids, cytostatics, "infliximab" iri anogumbura bowel chirwere;
• "Tetracycline", "Ceftriaxone", "Co-trimoxazole" chirwere Whipple raMwari;
• "Octreotide" pamwe kwemakemikari anobudiswa mapundu pamusoro nemudumbu.

Symptomatic kurapwa kunosanganisira kugamuchira probiotics, opiates, "Loperamide" absorbent mumiririri (bismuth kugadzirira "Diosmektita").

Kuzvinzwira hazviiti iri huye zviratidzo SMA. Hazvina kupa migumisiro yakanaka. Uyezve, malabsorption - chinoratidza dzakakomba uye ngozi zvirwere. Kana mukawana zviratidzo SMA Zvinokurudzirwa kuti chiremba. Chete nyanzvi anogona kunzi mhaka chirwere wechokwadi uye kuti agadze zvinobudirira kurapa nokuda kubviswa chirwere chirwere.