Odwala chiwindi: mankhwala, zizindikiro, zimayambitsa, kupewa

Ziphuphu za chiwindi ndizoopsa chifukwa zingayambitse mavuto aakulu, nthawi zina mpaka kupha ndi kufa. Mwa njira, matenda ngati amenewa angakhale awiri apamwamba ndi apamwamba. Malingana ndi ziwerengero, abscess imawonetseredwa motsatira maziko a matenda ena a chiwindi mobwerezabwereza kuposa 3-5% mwa milandu.

Komabe, anthu ambiri amakhudzidwa ndi mafunso okhudza momwe matendawa amachitikira, chifukwa posachedwa kuphulika kumachitika, mwamsanga munthuyo adzalandira chithandizo choyenera. Nanga chiwindi chili kuti munthu ndi chiyani chomwe chimayambitsa kugonjetsedwa kwake? Momwe mungadziwire zizindikiro zoyamba za abscess? Kodi mavutowa angayambitse chiyani? Kodi opaleshoni ndi yofunikira kapena kodi matenda angapangidwe ndi mankhwala osamalitsa? Owerenga ambiri amafunitsitsa kuyankha mafunso awa.

Kupanda pake: ndi chiyani?

Mwachidziwikire, anthu ambiri amayamba kufuna kumvetsetsa mawu ndi kufotokozera kwake. Kodi chiwindi cha munthu chili pati? Ndilo likulu lalikulu lomwe lili kumtunda kumene kuli pamimba (hypochondrium).

Tiyenera kukumbukira kuti, pokhudzana ndi kupezeka kwa zilonda zopweteka m'thupi, izi kapena zowononga chiwindi mwina sizingakhale ndikumva zowawa kapena kupweteka. Choncho, ndi bwino kuyang'anitsitsa ntchito ya thupi lonse. Chiwalo chofunika kwambiri chimasambitsa magazi a munthu ku poizoni ndi zinthu zovulaza, zimatenga mbali mu kagayidwe kake, ndi malo otchedwa glycogen (nkhokwe zowonjezera mphamvu), zimapanga bile acid ndikupanga chimbudzi.

Mwamwayi, anthu ena amakumana ndi zovuta ngati matendawa. Ndi chiyani? Ichi ndi kutupa kwa purulent kwa tizilombo, komwe kumatsagana ndi awo otchedwa kusungunuka. Chifukwa cha ndondomeko yotereyi, chimango chimapangidwa mkati mwa abscess, kumene masamba a purulent amayamba kuwonjezeka. Pamene chitukuko chikuyamba, mapangidwe amakula kukula, ndipo nthawi zina akhoza kutha, kumasula zinthu zopanda pake.

Malinga ndi kafukufuku wa chiwerengero, abambo a chiwindi amakhala ambiri chifukwa cha matenda ena a chiwalo ichi. Amuna amavutika ndi matendawa nthawi zambiri kuposa oimira akazi. Matendawa amapezeka m'madera omwe ali ndi malo ochepetsetsa komanso madzi osokonezeka. Gululi likuphatikiza Chile, Brazil, Peru, India, Tibet, Nepal, Pakistan, Iraq, Iran, mayiko a South Africa.

Matenda oyendera matenda

Pakalipano, pali mitundu yambiri yowonetsera matendawa. Mwachitsanzo, ziphuphu za chiwindi zingakhale zoyambirira (purulent ndondomeko imapangidwa parenchyma ya chiwindi chabwino) ndi yachiwiri (imawonekera motsutsana ndi maziko a matenda ena opweteka). Malinga ndi chikhalidwe cha matendawa, matendawa agawanika kukhala tizilombo toyambitsa matenda ndi bakiteriya.

Ngati titenga njira ya matenda monga chithunzi, ndiye tikhoza kusiyanitsa:

• Ziphuphu zosaoneka bwino (matenda amabwera ndi magazi);
• Mitundu ya cholangiogenic ya matenda (tizilombo toyambitsa matenda timachokera ku tsamba la biliary);
• Lumikizanani (kutupa kumafalikira kuchokera ku ziwalo zoyandikana);
• Zolemba zoopsa (ndizovuta pambuyo povulazidwa kapena opaleshoni);
• Cryptogenic (zomwe zimayambitsa matenda oterowo sizikumveka bwinobwino).

Matenda a chiwindi sangakhale amodzi kapena angapo, akulu kapena ang'onoang'ono. Perekani mitundu yovuta komanso yovuta ya matendawa.

Chifuwa cha chiwindi: zimayambitsa

Chifukwa chofala kwambiri cha chitukuko cha kutupa kwa purulent ndikutuluka kwa matenda m'thupi. Monga lamulo, udindo wa tizilombo toyambitsa matenda umayimbidwa ndi tizilombo toyambitsa matenda, kuphatikizapo E. coli, staphylococci, streptococci ndi ena ena.

Komanso, parasitic minofu kuwonongeka n'zotheka. Mwachitsanzo, absebic abscess (matenda otentha otentha) amadziwika kwambiri. Kutupa kwa purulent kungapangitse kusokonekera kwa ascarids, echinococci, alveococcus.

Choncho, abscess ndipo, monga chifukwa chake, kuchepa kwa chiwindi kungapangidwe ndi:

• Kuchulukitsa tizilombo toyambitsa matenda m'chiwindi kudzera mu tsamba la biliary. Izi zimawonedwa mu matenda monga cholangitis, cholelithiasis, cholecystitis, khansa ya zilonda za bile.
• Katemera akhoza kulowa mkati ndi magazi omwe akudutsa pamsewu kapena mitsempha yamtundu. Kusadziŵa kukhala kovuta kumakhala kovuta m'maganizo a mtima, matumbo, nthata, m'mimba, kapangidwe.
• Nthawi zina tizilombo toyambitsa matenda timalowa m'magazi ndi ma maselo pamaso pa kutupa kwa ziwalo zozungulira. Choncho, zifukwazi zimaphatikizapo appendicitis, diverticulosis (kutupa kwa ziwalo zamkati zamatumbo), ululu wa ululu, kutupa kwa peritoneum, purulent peritonitis.
• Chiphuphu chingakhale chifukwa cha kuvulala kwa chiwindi, chomwe chikuchitika, mwachitsanzo, ndi chilonda chokwanira m'mimba.
• Katemera wa tizilombo amatha kuchitika pa opaleshoni pa ziwalo za m'mimba.

Zizindikiro zoyambirira za matendawa

Kodi abscess ya chiwindi ndi yotani? Zizindikiro zingagawidwe m'magulu awiri. Kumayambiriro kwa chitukuko cha matendawa, zizindikiro za kuledzera kwa thupi zimadziwonetsera makamaka. Choyamba, monga lamulo, palinso malungo, kufooka kwathunthu, kuzizira, ma aches m'thupi. Wodwala akudandaula za kutopa nthawi zonse ndi kugona, chizungulire, tinnitus, mutu. Zakudya zimachepa kwambiri.

Pambuyo pake zizindikirozo zimawonjezeka kwambiri. Mwachitsanzo, mungathe kuona kutuluka kwa thukuta lalikulu. Ndiponso, masomphenya olakwika, malingaliro, osanyalanyaza chidwi ndi kukumbukira. Odwala amadandaula chifukwa chosowa nsomba. Nthaŵi ndi nthaŵi, kusanza kumapezeka, ndi zomwe zili m'matumbo.

Zizindikiro za kuperewera kwa chiwindi chogwira ntchito

Pamene matendawa akupita, vuto lina limagwirizana ndi zizindikiro za kumwa mowa. Monga lamulo, amachitira umboni kuti pali kuphwanya kwakukulu kwa chiwindi.

Odwala amayamba kudandaula chifukwa cha ululu wa hypochondrium. Poyamba, izi zimangokhala zovuta, zomwe zimatchulidwa kwambiri ngati abscess ikukula. Matenda opweteka amatha kupweteka malingana ndi kudya, zochitika zolimbitsa thupi, mankhwala opatsirana a matenda ena, ndi zina zotero.

Pokhudzana ndi kuchepa kwa njala, kunyoza ndi kusanza, kuchepa pang'ono pang'onopang'ono kulemera kwa thupi kumawonedwa. Pa nthawi ya kuchipatala, dokotala akhoza kudziwa kuti alipo hepatomegaly (kukula kwa chiwindi ndi kukula) ndi splenomegaly (kuonjezera kukula kwa nthata).

Komabe, odwala ena amadziwa kuti phindu lolemera, lomwe limagwirizana ndi chitukuko cha ascites. Madzi aulere amayamba kusonkhanitsa m'mimba, kotero odwala amakula, ngakhale chiphuphu chikuwuluka.

Zizindikiro za kupwetekako zimatha kukhala chifukwa cha chikasu cha khungu, chomwe chikugwirizana ndi chitukuko cha jaundice. Kawirikawiri pambali ya matendawa, pali maonekedwe kapena kuchulukitsa kwa ziwalo za m'mimba. Ngati kutupa kwa chiwindi cha chiwindi kukuphatikizidwa ndi kuwonjezeka kwazitsulo mu zotengera zowonongeka, nkotheka kutuluka magazi kuchokera m'mitsempha ya m'mimba. Izi zingathe kuwonetseredwa, mwachitsanzo, ndi kusanza, mosasinthasintha ngati malo a khofi, kapena kupanga chithunzithunzi chakuda chakuda.

Njira zamakono zothandizira

Ngati muli ndi zizindikiro, muyenera kuchipatala mwamsanga. Kupumula kwa purulent ndi koopsa kwambiri. Posakhalitsa wodwalayo apatsidwa chisamaliro choyenera, amachepetsa mwayi wopuma bwino.

Choyamba, katswiri adzidziŵa yekha ndi zodandaula za munthuyo, adzayesa kafukufuku. Pofufuza, kufotokoza ndikofunika kwambiri. Mwachitsanzo, panthawi yoyezetsa magazi, mukhoza kuona kuchepa kwa hemoglobin, kuchepa kwa chiwerengero cha maselo ofiira ndi mapiritsi. Pamodzi ndi izi, msinkhu wa ESR ukuchuluka, chiwerengero cha leukocyte chikuwonjezeka kwambiri, chomwecho chokha chimatsimikizira kukhalapo kwa kutupa.

Pamene kupumula kumawoneka mdima wa mkodzo. Pakati pa mayesero a ma laboratory, maerythrocyte ambiri ndi leukocytes amatha kuwona. Mayesero amachititsanso kuti panthawiyi pakhale kuchuluka kwa alkaline phosphatase, yeniyeni yeniyeni ndi bilirubin. Nthaŵi zina coagulogram yowonjezera imachitidwa, yomwe, ndi chifuwa cha chiwindi, imasonyeza kuchepa kwa magazi. Kwa matendawa, kutsekedwa kwa nkhuku ndi khalidwe. Pomwe mukusinkhasinkha chitseko, mukhoza kuzindikira kupezeka kwa magazi.

Gawo lofunika pa matendawa ndi maphunziro apadera. Chodziwika kwambiri ndi chotheka kwambiri ndi X-ray ya ziwalo za m'mimba, zomwe zingasonyeze kukhalapo kwa mpanda wozungulira, womwe uli m'chiwindi parenchyma - ichi ndi chiphuphu. Mothandizidwa ndi zipangizo za ultrasound, n'zotheka kutsimikizira kuti matendawa ndi otani ndipo amadziwa kukula kwa mapangidwe a purulent.

Zolondola ndithu, komanso zopindulitsa kwambiri monga maphunziro monga kompyuta ndi maginito resonance imaging. Njira zoterezi zimathandiza kudziŵa molondola, kudziŵa malo enieni, chiwerengero ndi kukula kwa abambo, ndipo nthawi zina zimakhazikitsa chifukwa cha kutupa. Nthawi zina odwala amapatsidwa mankhwala - panthawiyi, mkati mwazomwe zimapezeka m'mimbayi, timaphunziridwa ndikusanthula mu laboratori.

Kawirikawiri matenda a laparoscopy amavomereza, pamene dokotala amayesa ziwalo za mkati (pakalipa, chiwindi) mothandizidwa ndi zipinda zapadera zomwe zimalowetsedwa mkati mwa khoma la m'mimba. Ndondomekoyi ndi yoopsa, chifukwa chiopsezo cha abscess ndi kutuluka msanga kwa masamba a purulent ndi okwera.

Ndi mavuto otani omwe angathe?

Mafupa a chiwindi ndi matenda aakulu, omwe sangathe kunyalanyazidwa. Ngati palibe mankhwala, mapangidwe angasokonezeke, kusungunula zopanda pake. Chotsatira cha kupumula koteroko kungakhale purulent gastritis (mankhwala osokoneza bongo amalowa m'mimba minofu), peritonitis (pambuyo poyeretsa matupi a purulent akufalikira pamimba pamimba), pericarditis (pus in pericardial cavity, yomwe ili yoopsa kwambiri kwa mtima Minofu), enteritis (kupanga mapangidwe amkati mumatumbo).

Palinso mavuto ena ochepa. Mwachitsanzo, motsutsana ndi vuto la kupweteka, kachilombo kakang'ono kamene kangapangidwe kamene kamakhalapo, komwe kuchulukana kwa minofu kumawonjezeka mwachindunji pansi pa chithunzithunzi. Zotsatira zake zimaphatikizapo kutayika kwambiri kwa magazi chifukwa cha kutuluka kwa chiwindi. Nthawi zina odwala amapanga ascites, omwe amaphatikizapo kuchuluka kwa madzi m'mimba. Chifukwa cha kuwonjezeka kwa abscess, zotsekula m'mimba zimatheka - chikhalidwe chomwe chikukhudzana ndi kuwonjezeka kwa kuthamanga kwa magazi mu mitsempha yam'nyumba, yomwe imachokera ndi magazi kuchokera m'mitsempha ya m'mimba.

Monga mukuonera, chiwindi chodwala si chinthu chomwe chingatengedwe mopepuka. Ngati muli ndi zizindikiro zilizonse, muyenera kuwona dokotala.

Mankhwala osokoneza bongo

Madokotala amapereka chiyani kwa odwala amene amapezeka ndi "abscess pachiwindi"? Kuchiza pazigawo zoyamba kungakhale mankhwala, makamaka ngati kutukuka kukupita pang'onopang'ono, kukula sikukulirakulira, palibe chiopsezo cha kuphulika kwake.

Choyamba, mankhwalawa akuthandiza kuchotsa chifukwa cha kutupa, mwachitsanzo, kuthetsa matendawa. Pa matendawa, madokotala amatha kupeza, pogwiritsa ntchito kuti microorganism inawoneka abscess. Ngati ndi matenda a bakiteriya, ndiye kuti maantibayotiki amalembedwa. Njira yabwino kwambiri masiku ano ndi cephalosporins wa m'badwo wachitatu ("Cefoperazol", "Ceftriaxone"), kuteteza penicillin (Amoxiclav, Augmentin), m'badwo wachitatu kapena wachinayi fluoroquinolones (Ciprofloxacin, Levofloxacin, Norfloxacin).

Ngati abscess ikugwirizana ndi ntchito ya tizilombo toyambitsa matenda, wodwala akulamulidwa njira yothetsera antiprotozoal, makamaka, ntchito ya metronidazole kapena zofanana zake. Nthawi yomweyo muyenera kuzindikira kuti mankhwalawa akuchitika kuchipatala. Mlingo wa mlingo ndi mlingo ukhoza kutsimikiziridwa ndi dokotala yemwe akupezekapo.

Kuonjezera apo, malingana ndi chikhalidwe cha wodwalayo, chithandizo chamankhwala chimaperekedwa:

• Kuchulukitsidwa kumaphatikizapo kayendedwe ka Ringer's solution kapena 5% glucose;
• Pamaso pa ululu waukulu, perekani mankhwala ngati "No-shpa" (amatsitsimutsa mpweya) ndi "Ibuprofen" (amachepetsa kupweteka ndi malungo, amaletsa chitukuko cha kutupa);
• Ndikofunika kuti mutenge zakudya zowonongeka, mwachitsanzo, "Smekty" pakati pa chakudya;
• Pamaso mwa kutuluka magazi mkati mwake muike etamzilat sodium, yomwe imasiya kutayika kwa magazi;
• Ngati wodwalayo amatha kusanza, mankhwala osokoneza bongo angaperekedwe, mwachitsanzo, Metoclopromide kapena Cerucal.

Chithandizo cha opaleshoni: Ndi liti pamene kuli kofunikira?

Nthawi zina, mankhwala samatha kuthetsa abscess ya chiwindi. Kugwira ntchito pazochitika zotere n'kofunikira. Kuonjezera apo, opaleshoni yoperekedwa opaleshoni ndi yowonjezera muzochitika zofunikira (mwachitsanzo, kutuluka kwa abscess).

Pakalipano, pali njira zambiri zochiritsira. Chosavuta ndi madzi a abscess. Chofunika kwambiri cha ndondomekoyi ndi motere: kudzera m'magulu ang'onoang'ono, zida ziwiri zapadera zimapangidwira kumtunda. Kupyolera mwa imodzi mwa iwo njira yothetsera antibacterial imaperekedwa nthawi zonse, ndipo kupyolera mu zina kunja kwapangidwe zopangidwa ndi purulent. Kawirikawiri, mankhwalawa amatha pafupifupi masiku 3-4.

Mwamwayi, njira yotereyi siili ndi zotsatirapo pamene abscess ikuphuka kapena ngati pali zilonda zambiri. Zikatero, laparotomy imachitidwa. Kufikira kwa dokotala wa opaleshoni wa chiwindi kumadutsa kupindika kwa m'mimba. Panthawi ya opaleshoni, abscess iliyonse imatsegulidwa, ndiye, pogwiritsa ntchito aspirator, mankhwala ochotsera opaleshoni amachotsedwa. Pakani makapulisi amatsukidwa ndi mankhwala a antiseptic, kenako amachotsedwa panthawi imodzimodziyo akugwiritsira ntchito matenda a chiwindi. Mwachibadwa, opaleshoni yotereyi ndi yoopsa (pali chiopsezo chotenga kachilombo ka HIV) ndipo zimakhala zovuta, ndipo nthawi yowonetsera nthawi yayitali. Komabe, nthawi zina iyi ndi njira yokhayo yopulumutsira moyo wa wodwalayo.

Mwa njira, kuphatikizapo opaleshoni, njira zamankhwala nthawi zambiri zimachitika. Tiyeneranso kukumbukira kuti kudziletsa kwa matendawa sikuletsedwa, chifukwa njira iliyonse yosasinthika, ngakhale mankhwala osokoneza bongo, akhoza kukulitsa mkhalidwewo. Dokotala yekha yemwe akupezekapo ali ndi ufulu kupereka mankhwala.

Kudya ndi abscess

Chifukwa chiwindi ndi chiwalo chomwe chikugwirizana kwambiri ndi kapangidwe kakang'ono ka zakudya ndi mavitamini a hematopoiesis, zakudya ndizofunikira kwambiri kwa wodwala akuvutika ndi matenda ena. Chakudya choyenera chidzafulumizitsa njira yothandizira, kuthandizira thupi kuti lichiritsidwe kuchokera ku opaleshoni, kuchepetsa kuchitika kwa kubwereranso.

Odwala panthawi yomwe amatha kuchipatala komanso atatha kuchipatala akulangizidwa kuti asinthire ku zakudya zochepa - palifunika nthawi zambiri (mpaka 6-7 pa tsiku), koma zigawo ziyenera kukhala zazing'ono. Izi zidzathandiza kupanga chimbudzi ndikuthandizira kuti chitukuko cha njira zowonongeka ndi kuthirira m'matumbo chikhalepo.

Zakudya n'kofunika kuti achotse motsimikiza ndi roughage. Akatswiri amalangiza kudya mbewu monga chimanga ndi zina phala, msuzi masamba, nyama zowonda ndiponso ena mitundu ya nsomba. Masamba ndi zipatso ayenera kupezeka mu chakudya, koma Mulimonsemo sizatsopano - ayenera kuphika, kuphika, braise. menyu zikuphatikizapo mkaka, koma ndi kuchuluka otsika mafuta. Amalangiza kumwa tiyi, msuzi m'chiuno, zakumwa zipatso ndi Zakumwa zipatso.

Pali mankhwala, amene pa nthawi yolandira chithandizo ndi konzanso ayenera kunena tiwonana. Zikuphatikizapo mndandanda wa mafuta, yokazinga zakudya kusuta zosiyanasiyana Nkhaka, umatetezera ndi marinades, sauces, sukulu mafuta a nyama ndi nkhuku, zonunkhira. Odwala ayeneranso amakana maswiti ndi mitanda, mazira, mkaka wonse, koloko. Mowa mwamtheradi contraindicated.

Olondola ndipo ambiri Chofunika, nthawi imene mankhwala amapereka zotsatira zabwino. Nthawi zambiri n'zotheka kukwaniritsa kuchira bwino.