Pachimake pamimba syndrome: Zizindikiro, Zoyambitsa ndi Chithandizo

ululu m'mimba kubweretsa mavuto akuluakulu komanso ana. Gastritis, chapamimba chilonda, gastroduodenitis, Reflux esophagitis, khansa chapamimba - awa ndi matenda ena ambiri pa mundawo m'mimba, omwe nthawi zambiri amapita ku siteji aakulu. Ngozi makamaka ndi pachimake pamimba syndrome. thandizo Emergency chofunika. matenda osati amayambitsa kupweteka, koma loopsa mwachindunji kwa moyo wa munthu. zofunika kwambiri ndi chithandizo yake ya mankhwala opaleshoni.

Kodi tanthauzo la matenda

Mawu amenewa ntchito mankhwala kutanthauza ululu waukulu nawo mu zonse m'mimba ndi opaleshoni mwamsanga. pachimake pamimba syndrome bwino zimayamba ndi blockage wa zonse m'mimba kapena matenda m'mimba. syndrome Izi ngozi moyo wodwalayo.

Tanthauzo la matenda a "pamimba pachimake" anaonekera yochizira matenda pambuyo buku lakuti Genri Mondora "matenda mwadzidzidzi. Belly "imene inafalitsidwa mu 1940. Buku anatchula dokotala ponena - ". ngoziyo m'mimba" Ndi pambuyo buku lino mu zochiritsira anayamba kukambirana matenda ndi mankhwala a matenda monga matenda pachimake pamimba. Zizindikiro ndi Zoyambitsa anayamba kufufuza mozamirapo.

Henri Mondor sanali dokotala yekha amene anafotokoza matenda. Russian dokotala N. Samarin anaphunzira boma, ndipo mu mabuku ake, ananena kuti wodwala matenda ayenera kuchipatala mwamsanga. M'mabuku ake, amene anali kufalitsidwa kangapo, iye akutero, kuti pambuyo zizindikiro woyamba wodwalayo maola 6 okha.

zizindikiro

Pakuti kumvetsa chithunzi matenda a matenda aliwonse m'pofunika kudziwa zizindikiro. Pamene tanthauzo la pachimake pamimba syndrome, zizindikiro zotsatirazi:

• kupweteka kwambiri pamimba.
• Mkulu kutentha.
• Mofulumira kugunda.
• Kusanza.
• Magazi.
• Mantha.

Koma amadandaula yaikulu ya mtima amakhalabe ululu. Kuchokera pa zizindikiro zakumwamba, madokotala mukhonza kupanga chibwana ndi kukhulupirira kuti matenda ena. Mwachitsanzo, ululu mwina zimasonyeza peritonitis zowombetsa mkota, kusanza - mfundo ndi poyizoni chakudya. The chifukwa cha chithandizo kumatengera matenda zolondola udzakhazikitsidwa posachedwa.

pachimake pamimba syndrome: Zoyambitsa

Chifukwa cha matenda mwina chifukwa:

• Kapamba, cholecystitis, appendicitis, peritonitis, khansa ya m'matumbo, embolism, thrombosis, abscesses.
• Yopuma kapena perforation m'mimba, matumbo.
• Anathyola kapamba, ndulu, chiwindi, chiberekero, zokhudzana, kumene limodzi ndi magazi mu zonse m'mimba.
• Ileus.
• Matenda a ziwalo kuti zili kunja zonse m'mimba.

Otuluka pamwamba, pali gulu la zimayambitsa matenda:

• matenda yotupa omwe amafunika chisamaliro mwadzidzidzi opaleshoni.
• Pachimake magazi mu kapepala m'mimba (Mallory-weiss, wopangidwa syndrome, magazi chilonda, anorectal magazi, chapamimba chotupa haemorrhagic gastritis).
• mwakayakaya m'mimba kapena ozama bala, mmene kuonongeka chiwindi, ndulu, kapamba kapena intestine.
• Matenda pa mundawo m'mimba, amene si opaleshoni mwadzidzidzi (chiwindi, peritoneal carcinomatosis, gastroenteritis, yersiniosis, kwa chiwindi porphyria, kwa chiwindi colic, pachimake cholecystitis, pseudomembranous enterocolitis).
• matenda matenda (dysmenorrhea kupweteka syndrome pakati pa kuzungulira kusamba, salpingitis).
• matenda a impso (pyelonephritis, aimpso infarction, aimpso colic, paranephritis, hydronephrosis mu gawo pachimake).
• Zamtima matenda (kung'ambika aneurysm, m'mnyewa wamtima infarction, pericarditis).
• Ubongo matenda (herniated chimbale, herniated SHmorlja).
• Pleuropulmonary (m'mapapo mwanga embolism, pleurisy, chibayo).
• matenda Urogenital (yamchiberekero volvulus, pachimake mkodzo posungira).
• Msana choipa (zoopsa, myelitis), zikukhudza nthiti, vertebrae.
• matenda ena (kuledzera pamene poizoni ndi Arsenic, kutsogolera uremic chikomokere, mavuto leukemic, ashuga chikomokere, mavuto hemolytic, matenda Verlgofa).

Kodi kudziwa matenda

Kaya chikhalidwe cha madokotala mtima kuchita diagnostics lomwe lili ndi chiwembu ena. Matenda a matenda a "pamimba pachimake" ndi motere:

1. Anamnesis.
2. Investigation la dziko la wodwalayo.

mbiri kumaphatikizapo limati makamaka ngati: mmatumbo chilonda kapena chapamimba, kwa chiwindi, aimpso colic, ntchito, voiding kapena mpando, matenda matenda. Doctor woyamba imatiuza kuti nthawi ya zowawa ndi kutanthauzira kwake, dyspepsia, kutentha, matenda akale ndi matenda achikazi, kulephera kupita kumwezi. Izi ndi zofunika, monga pachimake pamimba syndrome kumachitika chifukwa cha enaake owononga yamchiberekero kapena mimba ectopic. Kusonkhanitsa mfundo zonsezi, zingatenge nthawi yaitali, koma ndi zofunika kwa matenda zolondola.

Investigation matupi ndi anayendera, palpation, percussion, kuphunzira imachitika kudzera ku nyini, ndi rectum. Doctor woyamba imatiuza kuti chifooko, wotumbululuka khungu, kupatukana, madzi m'thupi. Ndikatha kumfunsafunsa dokotala n'kukulemberani zotsatirazi mayesero zasayansi:

• Urinalysis.
• Khama la gulu magazi ndi RH china.
• Mlingo wa hemoglobin, hematocrit.
• ESR.
• Complete magazi kusanthula kufalitsidwa leukocyte chilinganizo.
• Michere kapamba ndi chiwindi.

Laboratory maphunziro si ulamuliro komaliza, kotero dokotala n'kukulemberani ultrasound wa zonse m'mimba, retroperitoneal danga. Ultrasound n'kofunika kudziwa kuvutika kuti akhale opanda bwino matenda chithunzi. Komanso, dokotala n'kukulemberani auscultation wa pamimba kudziwa m'mimba motility utithandize mtima kapena kusowa mawu matumbo. Kuwonjezera ultrasound, dokotala n'kukulemberani kudzifufuza thumbo ndi akazi ukazi. Izi ndi zofunika popeza Kafukufuku izi zingasonyeze kupweteka mafupa a chiuno, zimene masquerade ngati pamimba pachimake. M'pofunikanso njira cheza kafukufuku mu syndrome wa pamimba pachimake.

Palpation ku matenda a matenda

Njira imeneyi matenda ayenera kuchitidwa mosamala. Muyenera kumva dzanja ofunda ndi superimposed pa lonse pamimba mosabisa. Choyamba, Adokotala madera sabweretsa chisoni ndi kuphunzitsa wodwalayo zomverera zosasangalatsa. Kenako dokotalayu palpates pamimba m'madera chopweteka. dokotala sayenera kudziona dzanja m'mimba pa mlingo woyenerera. Njira imeneyi matenda limasonyeza minofu mavuto, ululu waukulu, infiltrates, chotupa mapangidwe ndi invaganity.

matenda malangizo kuphunzira

Pamene wodwala akadzafika mu chipinda mwadzidzidzi, iwo anasankha maphunziro zotsatirazi:

• Radiography wa pamimba ndi thorax, kuti ndi koyenera kuti matenda Iris boma (sayenda ake, kudzikundikira gasi, mlingo madzi m'matumbo).
• X-ray Mosiyana Kupenda m'mimba.
• Irrigoscopy (amaganiziridwa kutsekeka colonic).
• Laparoscopy (mu milandu yovuta matenda).

Kodi kuthandiza wodwalayo

thandizo kwa syndrome pachimake pamimba Nthawi yomweyo m'chipatala. Pa hospitalization wodwala ayenera yomweyo kuzindikiritsidwa mu dipatimenti opaleshoni.

Mmene mankhwala pa alili

Kuthandiza ndi matenda a "pachimake pamimba" kukusalani othetsa ululu. Izi imakhudzanso analgesics onse chomwa mankhwalawa ndipo sanali chomwa mankhwalawa, amene osati lubricates chithunzi matenda, komanso kulepheretsa matenda wodwalayo. Komanso, mankhwala akhoza kuvutika chikhalidwe cha wodwala, kuchotsa mawu a opaleshoni, zikhoza kuphipha wa sphincter wa Oddi. Komanso saloledwa ntchito nootropic, psychotropic, Mankhwalawa, mankhwala ndi kuyika mankhwala oyeretsera.

chithandizo

Ngati zizindikiro zonse pachimake m'mimba matenda, mankhwala tichipeza mu njira zotsatirazi. dokotala angagwiritse ntchito spasmolytics - 2 ml njira "shpy" kapena 1 ml "atropine" intramuscularly kapena kudzera m'mitsempha. Kuchiza matenda ndi opaleshoni, amene zimatheka pambuyo olimba zizindikiro yofunika ntchito. Malinga boma la pokonzekera opaleshoni wodwalayo zingatenge nthawi yaitali. A mtima amene anavomereza ndi magazi, kutsekeka m'matumbo, mu mkhalidwe mantha, ayenera kukonzekera opaleshoni pokhapokha kuwonongedwa kwa matenda kagayidwe kachakudya. matenda kagayidwe kachakudya (kuchepa Bcc, kusokonezeka kwa madzi ndi electrolyte bwino, kuchepa madzi m'thupi, kukanika ziwalo zofunika, chosokoneza kosamala asidi-m'munsi) Padzakhala odwala anavomereza mu chikhalidwe kwambiri.

Nthawi kukonzekera ntchito amadalira alili. Mu chipinda mwadzidzidzi wodwala ayenera kulowa kafukufuku nkhani m'mimba kwa chiyembekezo. Ndiye kusamba m'mimba pamaso gastroscopy ndi kulamulira magazi ngati wodwala anavomereza izo. The chikhodzodzo catheter matenda kuvulala zotheka, ndipo ambiri Chofunika - kuwayang'anira paola mkodzo linanena bungwe pa mankhwala magazi.

Ngati ndi kotheka, utsogoleli wa mankhwala m'nsinga, madzi kapena maselo ofiira ayenera akabweretsa catheter mu mtsempha subclavian kwa kubwezeretsa mofulumira kutaya magazi, normalization kosamala asidi-m'munsi, madzi electrolyte vutoli ndi kudziwa venous kuthamanga kwambiri.

Mu matenda limasonyeza kulowetsedwa mankhwala:

• A shuga njira.
• The oyamba a njira electrolyte.
• Mawu oyamba a madzi-njira.
• Kukhazikitsa njira "Albumin".
• Chiyambi cha magazi, ngati n'koyenera.
• Mawu oyamba a madzi.
• Mankhwala kwa amaganiziridwa kutsekeka m'matumbo, kapena perforation ziwalo.

Mankhwalawa kale akuyamba, ndi yabwino kwambiri ndi zotsatira za phukusi la. Kukonzekera opaleshoni udzachitika pa nthawi yomweyo ndi ntchito yomweyo.

pachimake pamimba syndrome ndi ana

Ululu syndrome ana akhoza kukhala chizindikiro cha matenda osiyanasiyana. Nthawi zambiri angakhale mkwiyo wa Kakhungu mucous, ndi peritoneum, osati pachimake pamimba syndrome ana. Zizindikiro za matenda ana ndi chimodzi mwa akulu. gwero kungakhale osati thupi limene lili zonse m'mimba.

Zimayambitsa kupweteka m'mimba mwa ana:

• Dysbacteriosis.
• Kutukusira kwa kholingo.
• Matenda a m'matumbo.
• Enteritis.
• Enterocolitis.
• Gastro.
• Duodenitis.
• Gastritis.
• Chapamimba chilonda.
• Reflux esophagitis.
• Anam'peza matenda a m'matumbo.
• Kudzimbidwa.
• Kapamba.
• Cholecystitis.
• Chiwindi.
• Mphutsi, giardia, njokazi.
• Biliary dyskinesia.
• Matumbo matenda.
• ARI.
• Chikuku.
• Katsabola.
• Cystitis.
• Pyelonephritis.
• Urolithiasis.

Mulimonsemo, ngati panali syndrome - ululu waukulu m'mimba, monga chizindikiro cha aliyense wa matenda, ndi woyamba "belu" kupempha thandizo. Schitaetsya kuti ngati munthu mokwanira ophunzira ndi ali chikhalidwe, ndi kudziwa pa zizindikiro mphuno siteji pachimake. Nthawi zambiri, si. Malinga ndi kafukufuku, chifukwa mavuto aakulu mu pachimake appendicitis chofunikira kunyalanyaza wodwala mawonetseredwe oyambirira a matenda. Popeza mwadzidzidzi syndrome chowawa - uwu si chifukwa cha chisangalalo, popeza kungasonyeze chophukacho wa chofuna matumbo khoma. Nthawi zambiri, pamene wodwala aperekedwa mochedwa, zotsatira za opaleshoni amadalira luso dokotala ndi chithandizo postoperative.

pachimake pamimba syndrome - matenda oopsa, makamaka kwa makolo. Choncho, Dziwani kuti pamaso osadziŵa koipa, m'pofunika kudziwa kuti ndi chifukwa wamba ululu ana ndi pachimake appendicitis mu gawo kapena kutupa zakumapeto kwa cecum ndi. Nkofunika kudziwa kuti pachimake appendicitis ululu ana aang'ono ndi bwino chionetsedwe. Koma mwanayo lethargic, si kugona, wosamvera. Pasanapite m'mimba limapezeka amene ntchofu alipo. Chifukwa cha chizindikiro ngati kusokonezedwa ndi appendicitis poyizoni kapena matenda matumbo.

Kodi kusiyanitsa appendicitis ku chiphe kapena matenda m'mimba? Ululu wa appendicitis amapezeka mu gawo chapamwamba kapena dera umbilical, koma osati mu lamanja iliac fossa (malo kumapeto ili). Pali milandu kumene ana aang'ono zakumapeto ali m'dera la thumbo, pafupi chikhodzodzo. Mu nkhani iyi, appendicitis mwachizolowezi akhoza kuzindikira okha dokotalayo ndi kuzolowera. Zizindikiro zina kugwirizana (nseru, kusanza ndi malungo) mwina kukhala nthawi zina. Mu nkhani ya aakulu gangrenous leukocytes appendicitis sangathe kuchuluka, ndipo m'mimba minofu mavuto tingalisiye.

Nkofunika kudziwa kuti ana kudzikonda zosavomerezeka. Sikuti ndi ululu ndipo sangathe nthabwala mosasamala kupereka asatayike kwa ana, komanso ndi chimfine yosavuta trifled ndi. Enemas, chapamimba lavage, sorbents kapena mankhwala ena akhoza kuperekedwa ndi poyizoni chakudya, kuledzera kapena kutsekeka m'matumbo, angawonjezere pachimake appendicitis, pachimake pamimba kapena matenda zotheka. Iwo ayenera yomweyo itanani ambulansi, musati mafuta chithunzi ndipo sanali kupezerapo madokotala "njira zonama" asanafike pa. mwana sayenera kumwetsedwa madzi kapena chakudya. Ngati kumene ambulansi anachedwa, ndi mwana n'lalikulu, mukhoza dokotala kuti iye angathe kulangiza inu za mmene tingachitire zimenezi. Komanso, ngati zoyendera kunyumba, inu mukhoza kutenga mwana ku dipatimenti mwadzidzidzi m'chipatala.