Payra chirwere: zvinokonzera, zviratidzo, kurapwa

Kune vanhu vashoma vasina kumbova mudumbu kurwadza. Kazhinji, zvinoitika zviratidzo chokuita nokushaya zvokudya zvinovaka muviri kana zvirwere zvomudumbu nadzo dzakadai gastritis, gastric urikanwi kana cholecystitis. Kana abdominal kurwadziwa unopinza, uye ndinoiitawo murwere ane kuda kurutsa uye kurutsa, kazhinji rokuongorora appendicitis. Uye mhaka matambudziko izvi zvose zvinogona Payra urwere utano. Chii chinonzi chirwere ichi uye kuti chinoratidza pacharo, asingadi kunyange kuziva chiremba ose, sei, uye basa zvakaipa kurapwa. Panyaya iyi, murwere haasi chete hapana kuvandudzika kunoitika, asiwo yakawedzera dambudziko. Somugumisiro, zvinokosha kugadzirisa chete kuvhiyiwa. Kuti nokururamisira kutaura kuti akaora chirwere Payra chirwere kunobva vachingoshandisa kare uye palpation pakati mudumbu uye pasina michina kuongorora zvabuda, kundiomera. Asi chirwere ichi pane zvimwe zvinhu kuti kusiyanisa kubva nezvimwe zvirwere gastrointestinal. Kuti mashoko kuziva sei chirwere ichi ngozi uye kana zvichibvira kurapa chirwere pasina kuvhiya - yedu nyaya.

Payra chirwere - chii?

Yeuka chikoro anatomi. Zvose zvokudya zvatinodya hunotanga ozeyewa mudumbu, uye ipapo zvinofamba mukati ura duku apo kugaya kwacho kunogumira. Ikoko zvokudya muropa auya zvose zvinokosha, uye hakubatsiri nokuti muviri zvinoenda guru ura. Pano, kubvira vakawanda iyi mvura kunyura, kusiya gobvu kusachinja-chinja tsvina kuti tinoti mutsvina yadzo. The muura ane zvikamu zvakawanda, wakarebesa iyo - the muura. Simplistically inogona anomirirwa muchimiro negomba chubhu ine dhayamita vanenge 7 cm rakafanana nomukombero inoganhurana vaduku ura. The muura rakakamurwa kuva zvikamu zvitatu. Vachikwira chidimbu iri kurutivi rworudyi mudumbu. Anoenda chiropa, iyo akatsunga panguva necheparutivi pedyo 90 ° uye unobuda panzvimbo transverse chidimbu. Chikamu ichi muura zvasvika munzvimbo chirwatata (muviri avete kuruboshwe yokumusoro quadrant), ndeyokubvisa zvakare, unopinda uchiburuka chidimbu gare gare muna sigmoid muura uye mugaranhoko. Chitsiko, otanga aumbe panguva mbudo yacho ura duku, vanosangana zvose nenzira iyi refu, zvishoma nezvishoma thickened. Somugumisiro, mashoko goho isu vakaumba gobvu zvokuti Cal arambe achirema. Payra urwere kana chirwere Payra vakachengeta apo vanobwembura wechipiri muura (munharaunda yacho chirwatata) iri yakakura zvikuru kupfuura kuva physiologically. Panguva iyi, kuti dhayamita kuti dumbu mhango akamanikana zvikuru kuti mushonga unonzi stenosis. Rakamanikana hwomukova ane thicken pachituru havana nguva kutamira zvakasimba zvakakwana kuti nzvimbo nokumhanya njanji. Mugumisiro ndiko Mash kubva chokwadi imwe mhando kuti muviri anoedza goho. Kazhinji akawedzera pachituru magasi anobudiswa panguva kugaya zvokudya.

Chii ngozi Payra urwere

Munguva duku ura kupinda ropa kubva zvokudya kupfuura kubatsira zvisaririra okunze, mavhitaminzi nezvimwe zvinhu, uye zvose zvisingakoshi uye kunotokuvadza vari dzichiumbwa chetsoka. Kazhinji tine navo zuva rimwe nerimwe kubvisa muviri, ndiko, kuti chiito defecation. Kana pachituru iri kunonoka kuti kunoitika pamwe kupatira, ropa anotanga iyerere varipo izvi zvinokuvadza, hunotanga zvishoma nezvishoma chepfu muviri (chikokiyana). Ndiro huru njodzi, izvo hunokonzera Payra syndrome. Kudhaka ane migumisiro yakaipa mizhinji, mumwe rinogona kunzi immunosuppression. Izvi zvinozoita kunotungamirira kuti akaderedza kuramba siyana zvirwere. Uyezve, chakasimba chetsoka kutsvinyira intestinal rusvingo, zvichiguma ulceration dzavo, uye munhu kuedza kupatira kungaita chimiro Mamota. Chimwe chinetso chakakomba anokonzerwa chirwere Payra - nayo kolonoptoz kuti zvinoreva kusiya ari muura. Izvi zvinotungamirira intestinal mhingaidzo uye dzimwe nguva kuti volvulus.

etiology

Payra chirwere akanga yakarondedzerwa chiremba wokuGermany Irwin Pyro ari kare kure 1905. Kwemakore anopfuura 100, kuwanda chirwere ichi yakawedzera uye ukasvika anenge 40% of vakura Vagari panyika. muura inzwi iri kuchengetwa vachiberekwa intestinal pathological yakarongeka, zvakadai somunhu elongated muchinjikwa-chidimbu kubva muura. Sezvo izvi zviri vachiberekwa anomalies, zvinangwa zvavo pasi chero kukundikana paumbwe ura panguva padariro embryo. Pakati pavo vane vanoshorwa kwezvakatipoteredza, kurwara amai pavanenge vakazvitakura, mishonga, zvakaipa tsika, huta kushushikana, pamuviri doro nezvimwe achifurira zvikonzero pamusoro pokumuka azvarwa. Medical Statistics vakawana kuti vana, baba naamai vanotambura nezvirwere ari zvomudumbu turakiti, vanozvarwa vaine chirwere Payra kazhinji pane vana vabereki zvachose utano.

pathogenesis

Payra chirwere zviratidzo ndiye chiyereso zvimwe zvirwere zviri zvomudumbu turakiti zhinji, uye saka kazhinji zvisiri chirwere. Varwere vanogona:

- kupatira;

- svoto;

- kurasikirwa havi;

- marwadzo mudumbu;

- kurutsa;

- kuzvimba dumbu (nokuti kuti magasi havagoni kutiza huru ura);

- nomusoro;

- kugumbuka.

Uyewo zvakanga Payra chirwere zvingaratidza kuonekwa akadai:

- paroxysmal marwadzo vasingazivikanwi localization (nokuda kuzara kutoda inzwi bowel gasi uye mutsvina yadzo);

- kurwadziwa mumwoyo nzvimbo nzvimbo (dzimwe nguva vanopa pasi pafudzi chipande kana kuruboshwe);

- rutapudzo kurwadziwa, kana murwere nhema yakatambarara.

Kurega kunotanga kubva mutsvina yadzo hunokonzera kuzvimba intestinal rusvingo uye muvira ura duku kuti ndepana Payra chirwere kazhinji kunotungamirira reflux ileitis. Muzviitiko izvi, tainge zviratidzo zvirwere izvi mahara:

- madzihwa ari pachituru, dzimwe nguva neropa;

- kuwedzera tembiricha.

dolichosigma

Mumwe zvikamu muura ndiwo sigmoid muura, saka zita nekuda chimiro chayo, yakati chakatodzana tsamba «S». Riri zvakananga pamberi mugaranhoko, iro basa iri kutama yabudiswa chetsoka. Dolihosigmoy akadana zvokurwara, kana munhu akaumba mumwe sigmoid muura kupfuura zvakafanira anatomically. Panguva iyoyo zvangoitikawo kuzvironga hunhu kurega kunotanga kubva mutsvina yadzo, uye zviratidzo vakafanana Payra syndrome. Dolichosigma anogona kuva chokuziva kwete chete, asi vakawana. Zvinonzi vaidavira kuti sigmoid muura inogona elongated pamwe kwenguva refu (mumakore), murombo muviri, pakushandisa mhuka yakawandisa chikafu uye makabhohaidhiretsi, pamwe ndakagara basa. Chimwe chikuru zviratidzo chirwere ichi ndicho kupatirwa. Uyewo, varwere chokunyunyuta pamusoro marwadzo subcostal kuruboshwe uye guvhu, pamusoro flatulence, kunopindirana kudzikira utano.

Diagnostics

Payra chirwere mune vakuru nevana chirwere hakusi nyore. Nhoroondo Medical chirwere ichi zvikuru zvakafanana nemamwe matambudziko pamwe nemudumbu. Zvinoitika kuti varwere pamwe chirwere Payra kunyange chirwere appendicitis uye oparesheni. Panguva ino, pane nzira yakarurama kwazvo nechirwere pamusoro zvokurwara ichi - ergography. Ndiyo nzira inonyatsobudirira kuziva zvakarurama kwazvo murwere kuvapo inzwi pakati muura. The nzira yakanga raitwa achishandisa barium kuturika. Muitiro chourongwa kwayo murwere rinodzorwa X-ray chidzitiro. Kana rokuzadza muura mufananidzo yaakaita murwere akarara pasi, uye kana nokuisa ari bowel - vakamira.

Vana vezera boka makore 10-15 anoshandiswa kudzidza muura radioisotope nzira. Saka radioactive goridhe colloidal mhinduro.

Kana urwere Payra pamufananidzo unogona kuona kuti muura, kufanana korona, sagging munzvimbo pelvic munharaunda.

Features Payra urwere muvana

Zvinosuruvarisa Payra chirwere muvana kwave akadzidza zvishoma, saka hapana zvachose vanorumbidza sei zvakarurama rokuongorora varwere mudiki-kwakakodzera ake, uye kuti zvinobudirira kubata. Vakaperekedza zvokurapa masayendisiti ongororo yakaratidza kuti vasikana chirwere ichi kunoitika kakawanda kupfuura vakomana.

Nekuratidzwa chirwere Payra kunotanga 12 mwedzi wokutanga pashure pokuberekwa, kazhinji panguva apo mwana kutanga kunyengera. New zvokudya kunoita zvakawanda gobvu chetsoka mwana kuti inosimudzira chengetedzo dzavo panzvimbo muura inzwi.

Zviratidzo wokutanga chirwere, zvichiratidza Payra chirwere vari: mukuru pakanyorwa zvinonyatsorehwa hutano mwana kuoneka kupatirwa uye abdominal kurwadziwa. Naizvozvo akawedzera kudhaka zviratidzo (kuda kurutsa, kurutsa) nokuda kuunganidza mutsvina yadzo uye mazhinji dzavo vari dumbu. Pasina kurapwa, vana 12-15 Makore vakachengeta chete zviratidzo Payra urwere, uyewo nedzevakuru. Paanoongorora vana vanofungidzirwa iye Payra urwere, chiremba anofanira kuva nechokwadi kuti kufunga kuti pamuviri akapfuurawo, kana pane mhuri chinotevera hama nezvinetso gastrointestinal, kudzivisa anogumbura pezvakaitwa ari ura ane ropa kutungamirira bvunzo. Kwokupedzisira Dambudziko kuva pahwaro barium ongororo zvabuda.

Payra chirwere: kurapwa Kudya

Kana urwere ichi yakawanda nzeve, varwere vanofanira kupiwa kudya zvinovaka muviri. Food vanofanira kuva mukuru-mafuta, asi panguva imwe chete nyore, harina yakawanda muchetura. The Muterere anofanira kuvapo yokurenda chizi, ruomba, anovava ruomba, mondo. Kuwedzera peristalsis ura, varwere vanofanira kutaura kuti zvaunodya whey, kefir, zvinobata zvakabikwa mukaka, yogati. Hazvifaniri kusiyiwa uye zvihwitsi, izvo vanoswedera mvura kupinda ura, izvo zvinoita kuti rive dete pamusoro mutsvina yadzo uye defecation nyore rikurumidze. Varwere vanofanira kudya zvibereko zvakawanda, uchi, idya muchero syrups.

In pamberi chirwere Payra sezvo kupatirwa mamwe etiology, zvinobatsira kunwa miriwo broths nokuzvinwira michero uyewo dzichangobva akaita muto makarotsi uye mbishi matapiri.

Kudhayeta haadi kubvisa chirwere, asi zviri nyore kwaari.

kuchinja mabatiro

Kazhinji vanachiremba vanogona kuona zvinhu vanotya kuvhiyiwa uye uchida kutanga kuedza zvinodhaka kurapa, varwere akawana Payra syndrome. Kurapa Chii mapiritsi vanogona kukurira chirwere ichi? Doctors ringavakurudzira mishonga lactulose. Vanogona kupiwa vana mangwanani sezvo paucheche. Lactulose zvishoma dilutes chetsoka, kunowedzera peristalsis uye panguva imwe chete anogara ari dumbu anoshanda microflora. Vakuru munhu ne kupatirwa nokuda kwenguva refu kuzvimba intestinal rusvingo rakatanga, akarayira Anti-anogumbura zvinodhaka. Nokuti kurwadziwa anogona mazano antispasmodics "Drotaverinum" kana "Platifillin" kosi zvakare kubatsira prebiotics, probiotics, mavhitaminzi.

Payra chirwere kurapwa chete panguva kwokutanga nzendo chirwere, uye migumisiro muitiro kwenguva pfupi. In kufanana mapiritsi vanachiremba varayire physiotherapy (electrophoresis pamwe novocaine mhinduro, Paraffin kushanda ari mudumbu, diathermy, UHF, kwairayirwa mudumbu masaja, uye basa kurovedza kusimbisa masvingo aro.

kuvhiya kupindira

Ndiyo nzira inonyatsobudirira yokurapa, umo vose zviratidzo zvapfuura zvachose, uye nokusingaperi, uye kwete nguva, sezvo nevamwe nzira kurapwa. Operations vari kuitwa nzira dzakasiyana, zvichienderana anatomical zvairatidza. On mumwe wavo yakatakura evaMedhia laparotomy, resection pamusoro transverse muura Division yokunzvenga pakati chikamu, kumanikidza zvakananga anastomosis. Uyezve, transverse muura kunoita laterally pasi pechingoro-gastric shwashwa uye yakatarwa chaiwo chichiitwa, zvokuti Bends munzvimbo chiropa uye chirwatata vakasungwa.

Somunhu yechipiri nzira resected shwashwa, asunga yakakura ura (muura-splenic uye muura-diaphragmatic) laparoscopy zvinoshatisa kuti splenic flexure kuti atsaudzire kure ura. The oparesheni rinoitwa nokushandiswa yezvokurapa trocars uye electrocautery.

Aibatanidza akavhiyiwa yaitwa vaya chirwere "Payra chirwere dolichosigma". Reviews wevarwere pashure kurapa kwakadaro zvakanaka chaizvo. Vanhu zvachose marwadzo, kumisa kupatira, uye zviratidzo kudhaka kunyangarika navo. Munguva kuvhiyiwa zvabatanidzwa kuwedzera kumonyanisa varwere muura uye splenic munhu transverse mugove flexure anoshanda laparoscopy resection yacho sigmoid muura.

mataridzikiro

Kuchinja kurapwa pave nemigumisiro mukutanga nzendo chirwere, asi nokuti kunokonzerwa anatomical zvokurwara ari intestinal mamiriro, chete kuvhiyiwa kunobatsira kukunda zvachose chirwere Payra. pevairwara mishonga Treatment chete kushandiswa webetsero. mushonga Traditional anopa infusions uye decoctions, rive dete chetsoka (laxatives) uye nzira kuwedzera motility ari muura. Rinopawo zvishandiso kuti kusimbisa zvirwere, anovandudza mukuru ezvinhu. Use inogona yakabikwa plantain, mbatatisi muto, ine muto vanorichekerera, akaomeswa zvibereko. Zvakakosha kuziva kuti vane chirwere Payra enemas vari contraindicated.

The fungidziro wevarwere vachangobva vaita zvakarurama kurapwa, chose zvakanaka. Kana Payr chirwere akatanga, pangava yematambudziko zvinouraya zvakadai namamota, ulceration masvingo, Mamota zvichiitika kubva zvachose zvinokuvadza kuti bowel mutsvina yadzo.