M'mimba abscess: Zoyambitsa ndi Zotsatira

Woonda serosa - peritoneum - zomwe m'njira ina ili mbali zapamwamba ziwalo, ali katundu yeniyeni zozitetezera. Mwachitsanzo, mu nkhani ya kutupa, zikhoza delimit malo anakhudzidwa, kupanga abscess m'mimba. Mu slang zachipatala umatchedwa "soldering", ndiye mapangidwe adhesions pakati pa ziwalo pafupi kuti itenge malo chatsekedwa.

tanthauzo

M'mimba abscess - ndi purulent kutupa chiwalo kapena mbali yake, ndi zina limatsogolera minofu ndi kapisozi mapangidwe M'mimbamo mozungulira icho. Iwo akhoza kupangidwa kwathunthu mu aliyense "pansi" kwa zonse m'mimba ndi limodzi mwa zizindikiro za kuledzera, malungo ndi sepsis.

Komanso wodwalayo zidzakhalapo ululu anati chitetezo minofu m'mimba, nkotheka kunyansidwa ndi kusanza. Nthawizina, mu Zikavuta, adhesions chifukwa cha kutsekeka m'matumbo.

EPIDEMIOLOGY

M'mimba abscess, osati n'zosadabwitsa opangidwa kutsatira opaleshoni ndi kutanthauziridwa monga vuto la mtundu uwu wa mankhwala. Polingalira za kukula kwa chiwerengero cha ntchito anachita chaka chilichonse, chiwerengero cha mavuto zimenezi kumawonjezera pang'onopang'ono. A mbali yaikulu iyi ndi kuchepa kwa chitetezo chokwanira ndipo ambiri ntchito mankhwala mu tizilombo kupanga bata ndi kumalepheretsa kupewa mavuto postoperative.

Malinga ndi mfundo ya zowonjezera, gawo limodzi la odwala opaleshoni osauka postoperative abscess. chiwerengerochi ndi apamwamba ngati alowererepo anali mwamsanga ndipo nthawi yokonza preoperative sanali.

Zina mwa zifukwa

Waukulu ngozi chinthu, chifukwa umene angakhale abscess wa zonse m'mimba - zoona, cavernous opaleshoni. Ndi ambiri amangoti zikadzatha mankhwala matenda pancreatic, chikhodzodzo ndulu, matumbo kuzungulira stitching.

Maonekedwe a kutupa chifukwa kukhudzana ndi nkhani m'mimba mwa peritoneum, ndi kudetsedwa ake mu chipinda cha opareshoni. Mwina chifukwa cha zoopsa yosamveka m'mimba. Mu malo ya psinjika opangidwa aseptic kutupa, amene anali nayenso zomera sekondale.

Anthu oposa theka abscess ndi mwina parietal (parietal) chidutswa cha peritoneum, kapena pakati parietal ake ndi mapepala choipidwa.

zifukwa

abscesses m'mimba (ICD10 - K65) zotsatira zake zikhala zotani zoopsazo wa pamimba Mwachitsanzo, nthawi compressions kapena mantha, matenda opatsirana a chubu matumbo (iersiteoz, salmonellosis, typhoid malungo), chitukuko njira yotupa ziwalo kapena mucosa, komanso pambuyo perforation zam'mimba kapena matumbo.

Pali zifukwa zitatu:

1. Pamaso pa peritonitis sekondale chifukwa chotupa cha kumapeto, insolvency matumbo anastomoses pambuyo ntchito m'mimba, necrosis mutu pancreatic, zoopsa m'mimba.
2. Purulent kutupa kwa ziwalo m'chiuno, monga salpingitis, magawo piosalpinks, tubo-yamchiberekero abscess ndi ena.
3. Pachimake kutupa kapamba ndi ndulu, anam'peza matenda a m'matumbo.

Kuwonjezera pa pamwamba, nthawi zina chifukwa cha abscess mwina kutupa minofu perinephric, osteomyelitis, lumbar msana, tuberculous spondylitis. Nthawi zambiri mu kutupa seeded staphylococci, streptococci, clostridia ndi isherihy, mwachitsanzo, nyama, zomwe zambiri kumachitika mu matumbo.

pathogenesis

Abscess postoperative m'mimba zikuoneka chifukwa kwambiri zimene chitetezo cha m'thupi kanthu chilengedwe mkati kapena kubereka tizilombo. Nthumwi Mwina mkatikati kuti patsekeke peritoneal ndi m'magazi kapena lymph, komanso seep khoma matumbo. Komanso, pali matenda ndi dokotala kuika manja ake, zipangizo kapena zipangizo pa ntchito. Chinanso protrude matupi kulankhulana ndi chilengedwe kunja, monga machubu mazira kapena matumbo.

Sitingathe kukusalani maonekedwe a infiltrates yotupa pambuyo ozama mabala m'mimba, zilonda ndi perforations divergence sutures pambuyo opaleshoni.

Peritoneum sagwirizana maonekedwe a popatsana Chinthu (kutupa) stereotypically, ndicho, iyo imapanga Ulimbo pamwamba pake umene muzigwirizana mbali ya mucosa ndipo potero delimits ndi moto kwa minofu wathanzi. Ngati chitetezo uyu awonongedwa chifukwa cha mafinya, ndi yotupa detritus amalowa matumba a danga pamimba ndi shelving. Ndi chitukuko cha amenewa Tiyerekezenso kutchula sepsis.

zizindikiro

Kodi chimachitika n'chiyani munthu pamene iye anapanga abscess m'mimba? Zizindikiro ofanana ndi matenda aliwonse yotupa:

1. Mkulu, ndi isanayambike mwadzidzidzi watentha thupi ndi kuzizira ndi profuse thukuta.
2. Mafanizo ululu pamimba, amene nakweza kuti zowawa kapena chipsyinjo.
3. Pafupipafupi pokodza, monga peritoneum ndi lidakali ndipo umasokoneza chikhodzodzo khoma baroreceptors.
4. Chopondapo monyanyira mu mawonekedwe a kudzimbidwa.
5. Kunyansidwa ndi kusanza kutalika kwa malungo.

Komanso, moleza mtima palpitations. Zimachitika pa zifukwa ziwiri: kutentha kuledzera. Ndipo ngati chizindikiro pathognomonic ndi minofu mavuto atolankhani. Izi ndi reflex zoteteza, amene kumathandiza zina kuvulaza m'dera chofuna.

Ngati abscess ndi ili mwachindunji m'munsimu chifundamtima, kuwonjezera zizindikiro zofanana amene akulozera Mbali imeneyi. Kusiyana choyamba n'chakuti ululu isanafalikire mu hypochondrium ndi kuchuluka pa kudzoza ndi chimachokera kwa dera scapular. Kusiyana chachiwiri - kusintha gait. Munthu amayamba involuntarily kusamalira odwala akutsamira kwa iye, kuchepetsa minofu kukungika.

zosokonezeka

abscesses m'mimba (ICD-10 - K65) zikhale undiagnosed ngati akutukuka pa maziko a zinthu zina zazikulu, kapena wodwala safuna chithandizo. Koma tiyenera kukumbukira kuti chifukwa cha khalidwe kunyalanyaza angathe moyo pachiswe zinthu, monga sepsis ndipo akakufunsani peritonitis.

abscesses Subdiaphragmatic akhoza anasungunuka kabowo kuswa kuti patsekeke pleural, kupanga adhesions kumeneko. Zoterezi zikhoza kuyambitsa choipa m'mapapo. Choncho, ngati pambuyo opaleshoni kapena choipa, muli ndi malungo kapena kuwawa kulikonse, musaganize kuti zonse ndidzadutsa palokha. M'magazini ino ya macheke owonjezera siyingawapweteke.

diagnostics

Postoperative m'mimba abscess kuchipatala kudziwa mwachilungamo mosavuta. The njira kwambiri nkhani ndi x-ray, ultrasound, CT ndi Kujambula a chifuwa ndi ziwalo pamimba. Komanso, n'zotheka kuti akazi kupanga puncture ukazi m'chipinda chotetezeka kufufuza ngati pali purulent milozo m'madera mumbali.

Komanso, musaiwale za matenda zasayansi. Ambiri, kusanthula magazi anaona kuwonjezeka lakuthwa mu mlingo erythrocyte sedimentation (ESR), wbc adzakhala ndi kosangalatsa kutsindika lamanzere, n'zotheka ngakhale mitundu anyamata ndi chiwerengero mtheradi maselo zingawonjezere chifukwa neutrophils.

Standard ku matenda a abscess ndi m'mimba ultrasound. Pali zizindikiro zomveka bwino zimene zimasonyeza pamaso pa yotupa adzalowerera:

• mapangidwe ali zazikulu bwino ndi wandiweyani kapisozi;
• mkati ndi madzi;
• zili inhomogeneous kapangidwe ndi lagawidwa zigawo;
• Ndi pamwamba mpweya madzi.

Chithandizo abscesses m'mimba

The njira yaikulu ya chithandizo cha abscesses, ndithudi, ndi opaleshoni. M'pofunika kukhetsa abscess M'mimbamo ndi wosambitsa antiseptic ndi njira mankhwala. chithandizo ndiwofatsa sapereka chitsimikizo aliyense kuti kutupa umatsika, ndi madzimadzi mkati abscess ndi nokha anasamutsidwa.

Kumene, pambuyo cholinga atachotsedwa, wodwalayo ali wofunikila kuti mankhwala mankhwala antimicrobial kwa yotakata sipekitiramu mankhwala. Kawirikawiri, dokotala n'kukulemberani nthawi yomweyo mankhwala awiri ndi njira zosankha zake ndi bwino kuwononga oimira zosiyanasiyana za zomera tizilombo tating'onoting'ono.

Nthawi zonse ofunika kuti akachenjeze mtima wa zotheka zotsatira za mankhwala, monga kusanza, kusafuna kudya, kutupa wosanjikiza papillary lilime, litsipa, ndiponso pafupipafupi pokodza. Ndipo kwa dokotala ayenera kukumbukira ndi kuwonjezera iwo cipangizo matenda a matenda.

Kuneneratu ndi kapewedwe

abscesses m'mimba (malamulo ICD 10 - K65) - ndithu vuto lalikulu, kotero odwala ndi madokotala ayenera kumasonkhana ndi kupewa vuto limeneli. M'pofunika mokwanira ndi kwathunthu kwa kuchiza matenda yotupa aliyense mwa zonse m'mimba, onetsetsani kuchita zi- ndipo pambuyo kugwira ntchito yokonza wodwala, komanso bwino chosawilitsidwa zida ndi manja dotolo.

Pakuti amaganiziridwa appendicitis kapena ngati nyamuka mwadzidzidzi kutentha Sikuti kudikira chizindikiro chochokera kumwamba, ndipo muyenera yomweyo dokotala malangizo. Iwo sakanakhoza kupulumutsa moyo wanu ndi thanzi.

Imfa ku abscess m'mimba ukufika peresenti makumi anai. Izi zidalira pa mmene ambiri ndondomeko, kumene ili ndiponso mmene zimayambitsa matendawo ayi. Koma ndi chithandizo yake kuchipatala mosavuta ndi zotsatira akumane yafupika.