Payra syndrome: zimayambitsa, zizindikiro, chithandizo

Pali anthu ochepa amene sanakhalepo ndi m'mimba mukupweteka. Nthawi zambiri, zizindikiro zosasangalatsa kugwirizana ndi kuperewera kwa zakudya m'thupi kapena matenda ziwalo m'mimba monga gastritis, chapamimba chilonda kapena cholecystitis. Ngati kupweteka m'mimba lakuthwa, kuphatikiza wodwalayo kunyansidwa ndi kusanza, nthawi zambiri matenda appendicitis. Ndipo chifukwa cha mavuto onsewa angathe kukhala Payra syndrome thanzi. Kodi matenda ndi mmene kumaonekera, samadziwa nkomwe dokotala aliyense, bwanji, ndipo apatsidwa mankhwala cholakwika. Pankhaniyi, wodwalayo si palibe kusintha kumachitika, komanso kulimbikitsa vuto. Chifukwa cha zimenezi, m'pofunika kuthetsa yekha ndi opaleshoni. Kuti m'pomveka kunena kuti kukomoka matenda Payra syndrome chokhazikika pa mbiri ndi palpation wa pamimba ndi mopanda kusanthula luso zotsatira, molimba kwenikweni. Koma matenda pali zina zimene kuwasiyanitsa ndi matenda ena m'mimba. Kuti mudziwe mmene kuzindikira matenda oipa ndipo ngati n'zotheka kuchiza matenda popanda opaleshoni - Nkhani wathu.

Payra syndrome - ndichiyani?

Kumbukirani thunthu sukulu. chakudya chonse chimene timadya liyamba m'mimba m'mimba, kenako inapitiriza mu intestine kakang'ono komwe chimbudzi ndondomeko ikutha. Kumeneko chakudya mu magazi amachokera zonse zopindulitsa, ndipo ndi yopanda phindu kwa thupi akudutsa mu m'mimba. Apa, kwa unyinji uwu wa madzi odzipereka, kusiya wandiweyani kugwirizana zinyalala kuti timatcha ndowe. M'matumbo ali zigawo zingapo, wautali kuposa omwe - m'matumbo. Simplistically akhoza akuimira mu mawonekedwe a chubu dzenje ndi awiri a za 7 cm, ofanana m'mphepete m'malire intestine yaing'ono. m'matumbo lagawidwa zigawo zitatu. gawo akwera ili kumanja wa pamimba. Iye amapita kwa chiwindi, amene akuyesetsa pa ngodya ndi pafupi 90 ° ndi chimaposa mu gawo yopingasa. Mbali imeneyi ya m'matumbo umalandira dera ndulu (thupi m'manja mwa kumanzere nusu chapamwamba), akufunitsitsa kachiwiri, zipita atsikira gawo kenaka sigmoid m'matumbo, rectum. Chopondapo, kuyambira kupanga pa kuchoka za m'mimba yaing'ono, azipita njira iyi wonse, pang'onopang'ono unakhuthala. Chifukwa, linanena bungwe ife anapanga lakuda zokwanira cal osalimba. Payra matenda kapena matenda Payra anaona pamene unakhota yachiwiri ya m'matumbo (m'dera la ndulu ya) ndi yokulirapo kuposa zikhale physiologically. Pa nthawi imeneyi, awiri a m'matumbo M'mimbamo kuchepera kwambiri kuti mankhwalawo amatchedwa stenosis. Kudzera kutsegula yopapatiza ali thicken ndi chopondapo mulibe n'kuyamba kudya mokwanira kuti malo a njanji kuthamanga. Chifukwa ndi mtundu wa phala chakuti thupi amayesetsa linanena bungwe. Nthawi zambiri anawonjezera kuti mpweya ndi chopondapo opangidwa pa chimbudzi cha chakudya.

ngozi Payra syndrome Kodi

Mu intestine tating'ono magazi chakudya pochitika kufufuza zinthu zothandiza, mavitamini ndi zinthu zina, ndi zonse kosafunikira ndipo ngakhale zovulaza zapangika chopondapo. Bwinobwino tili nawo tsiku lililonse kuchotsa thupi, ndiye kuti akuchita defecation. Ngati chopondapo anachedwa kuti kumachitika ndi kudzimbidwa, magazi umayamba kuyenda pano pa zinthu zimenezi zoipa amayamba poyizoni pang'onopang'ono kwa thupi (kuledzera). Izi ndi ngozi yaikulu, kamene kamayambitsa matenda Payra. Kuledzela ali zotsatira ambiri chowawa, mmodzi amene angatchedwe immunosuppression. Zimenezi kumapangitsa chakuti yafupika kukana kwa mitundu yosiyanasiyana ya matenda. Komanso, olimba chopondapo limakhumudwitsa khoma matumbo, chifukwa mu ulceration awo, komanso kuyesetsa anthu kudzimbidwa zikhoza kuoneka zotupa. Koma vuto lina lalikulu chifukwa cha matenda Payra - izo kolonoptoz izo zikutanthauza kuchotsa m'matumbo. Zimenezi zimabweretsa kutsekeka m'matumbo ndipo nthawi zina volvulus.

etiology

syndrome Payra amanenedwa ndi German dokotala Irwin Pyro mu kale kutali 1905. Kwa zaka zoposa 100, kuchuluka kwa matenda chawonjezeka n'kukafika pafupifupi 40% ya anthu achikulire a dziko. m'matumbo Kukweza mawu zimawonedwa mu kobadwa nako m'mimba dongosolo pathological, monga elongated mtanda gawo ya m'matumbo. Popeza ndife obadwa nawo anomalies, zimayambitsa wawo zoopsa aliyense wa mapangidwe intestine pa siteji ya Ndisanaumbidwe lapansi. Ena mwa iwo ndi chilengedwe akumane, matenda a mayi ali woyembekezera, mankhwala, zizolowezi zoipa, nkhawa mantha, mowa pakati ndi zinthu zina kumamukopa pa chitukuko cha mwana wosabadwayo. Medical Kafukufuku anapeza kuti ana, bambo ndi mayi amene amadwala matenda a thirakiti m'mimba, amabadwa ndi Payra syndrome zambiri kuposa ana makolo wathanzi mwamtheradi.

pathogenesis

Payra zizindikiro syndrome ndi muyezo pa matenda ena ambiri pa mundawo m'mimba, choncho nthawi zambiri molondola matenda. Odwala nacho:

- kudzimbidwa;

- nseru;

- kusowa chilakolako;

- ululu pamimba;

- kusanza;

- kutupa pamimba (chifukwa chakuti mpweya wa sangathawe m'mimba);

- mutu;

- irritability.

Ndiponso Payra syndrome zingasonyeze mawonetseredwe ake amenewa:

- paroxysmal ululu wa kutanthauzira osadziwika (chifukwa kuchulukana pa nsonga ya Kukweza mawu matumbo mpweya ndi ndowe);

- kupweteka kwambiri mitima ya malo a m'dera (nthawizina iwo kupereka pansi tsamba mapewa kapena ku dzanja lamanzere);

- kuchepetsa ululu, pamene wodwala lagona horizontally.

Stagnation wa ndowe amachititsa kutupa khoma matumbo ndi kuwaponya mu intestine kakang'ono kamene limapezeka pa matenda Payra zambiri kumayambitsa Reflux ileitis. Mu milandu, zizindikiro anawonjezera a matenda amenewa kwaulere:

- ntchofu m'manyi, nthawi zina ndi magazi;

- kuwonjezeka kutentha.

dolichosigma

Mmodzi mwa zigawo ya m'matumbo ndi sigmoid m'matumbo, otchedwa chifukwa cha mawonekedwe ake, penapake chokhala ndi kalata «S». Malowa ali pamtunda kutsogolo kwa rectum, amene ntchito ndi anthu atuluke excreted chopondapo. Dolihosigmoy otchedwa kudwala, pamene munthu wapanga ndi sigmoid m'matumbo yaitali kuposa zofunika anatomically. Pa nthawi yomweyo chigweranso posakonzekera chikhalidwe cha stagnation wa ndowe, ndi zizindikiro amafanana syndrome Payra. Dolichosigma kungakhale osati titadziwa, koma kuthi. Akukhulupirira kuti sigmoid m'matumbo akhoza elongated ndi yaitali (zaka), zakudya m'thupi, kugwiritsa ntchito nyama chakudya kwambiri ndi chakudya, ndi ntchito amangokhala. Chimodzi mwa zizindikiro zazikulu za matenda ndi kudzimbidwa. Komanso, odwala amadandaula kuwawa mu subcostal kumanzere ndi m'michombo, pa flatulence, akukhudzidwira kuwonongeka thanzi.

diagnostics

Payra matenda akuluakulu ndi ana matenda si kophweka. Medical mbiri ya matenda ndi zofanana kwambiri ndi mavuto ena ndi kapepala kakuti m'mimba. Zimachitika kuti odwala matendawa Payra ngakhale matenda appendicitis ndi opaleshoni. Panthawi imeneyi, pali njira yolondola kwambiri za matenda a kudwala ichi - ergography. Izi ndi njira yabwino kwambiri kudziwa molondola kwambiri wodwala pamaso pa Kukweza mawu a m'matumbo. Ndondomeko zinachitikadi pogwiritsa ntchito barium kuyimitsidwa. The ndondomeko ya ulamuliro umenewu kwa wodwala ankalamulira X-ray chophimba. Pamene kudzaza m'matumbo chithunzi anapangana ndi mtima chigonere, ndipo pamene kuchotsa matumbo - ataima.

Ana a zaka gulu zaka 10-15 ntchito kuphunzira njira m'matumbo radioisotope. golide Choncho nyukiliya colloidal njira.

Pamene syndrome Payra mu M'chithunzithunzi munakwanisa kuona kuti m'matumbo, ngati nkhata yamaluwa ndi sagging m'dera m'chiuno.

NKHANI Payra syndrome ana

Mwatsoka Payra syndrome ana wakhala pang'ono kuphunzira, choncho palibe malangizo okhazikika pa momwe molondola kwambiri oterewa msinkhu wake achinyamata amene akudwala, ndi mmene bwino kuchitira. Imachitika zachipatala asayansi kafukufuku anasonyeza kuti atsikana matenda izi zimachitika kawirikawiri kuposa anyamata.

Chiwonetsero cha matenda Payra kumayambira miyezi 12 kuchokera pamene anabadwa pa nthawi imene mwana amayamba kunyengerera. chakudya kuvumbitsira zambiri wandiweyani chopondapo mwana amene amalimbikitsa posungira awo mu malo ya m'matumbo Kukweza mawu.

Zizindikiro zoyambirira za matenda, kusonyeza syndrome Payra ndi: maziko onse a thanzi wonse wa mwana kuoneka kudzimbidwa ndi ululu m'mimba. Kenako anawonjezera zizindikiro kuledzera (nseru, kusanza) chifukwa kudzikundikira ndowe ndi ukhale awo m'matumbo. Popanda mankhwala, ana zaka 12-15 ankaona zizindikiro zomwezo Payra matenda, komanso akulu. Pamene kufufuza ana ndi amaganiziridwa iye Payra syndrome, dokotala ayenera kuonetsetsa kuti muganize momwe mimba anachita, ngati pali banja la wotsatira wa abale ndi mavuto a m'mimba, kupewa njira yotupa mu intestine ya atayezetsa patsogolo. Matenda komaliza ayenera kukhala pa maziko a zotsatira barium bwino.

Payra syndrome: mankhwala zakudya

Pamene matendawa kwambiri chidwi, odwala ayenera kudya zakudya zopatsa nthanzi. Chakudya ayenera kukhala mkulu-kalori, koma pa nthawi yomweyo zosavuta, lilibe kwambiri za poizoni. menyu Payenera kukhala kanyumba tchizi, batala, wowawasa kirimu, odzola. Kuonjezera peristalsis intestine, odwala ayenera timathandiza kuti zakudya zanu whey, kefir, thovu yakeyi mkaka, yogurt. Sayenera anasiya ndi maswiti, amene kujambula madzimadzi mu intestine, amene kumathandiza kuti kupatulira wa ndowe ndi defecation mosavuta ndondomeko. Odwala ayenera kudya kwambiri wa zipatso, uchi, kudya mankhwala zipatso.

Pamaso pa vuto Payra monga kudzimbidwa etiology zina, m'pofunika kumwa broths masamba ndi zakumwa zipatso komanso mwatsopano anapanga madzi a kaloti ndi mbatata zosaphika.

Kudya pang'ono sichimachotsa matenda, koma zimakhala zosavuta kwa iye.

chithandizo ndiwofatsa

Madokotala amakonda akhoza kuwona zinthu amaopa opaleshoni ndipo ndikufuna woyamba yesani mankhwala mankhwala odwala amene anapeza syndrome Payra. Chithandizo Kodi mankhwala akhoza kulimbana ndi matenda? Madokotala angakulangizeni mankhwala lactulose. Angapatsidwe ana mwamsanga wakhanda. Lactulose penapake dilutes chopondapo, kumawonjezera peristalsis ndi imodzi amakhala m'matumbo a microflora zothandiza. Akulu ndi aliyense ndi kudzimbidwa chifukwa kutupa yaitali khoma matumbo anayamba, mankhwala mankhwala odana ndi yotupa. Mpumulo ululu angathe kulangiza MANKHWALA OLETSA VUTOLI "Drotaverinum" kapena "Platifillin" maphunziro komanso ndi wofunika prebiotics, probiotics, mavitamini.

Payra syndrome ankachitira ndi mankhwala okha pa magawo koyamba matenda, ndipo zotsatira amakhala sakhalitsa. Limodzi ndi mankhwala madokotala mankhwala physiotherapy (electrophoresis ndi novocaine njira, paraffin ntchito pa pamimba, diathermy, UHF, lamulo mu kutikita m'mimba, ndi ntchito anatumizidwa kulimbitsa mpanda wake.

alowererepo opaleshoni

Izi ndi njira zothandiza kwambiri mankhwala, imene zizindikiro zonse kutha kwathunthu, ndi kwanthawizonse, osati nthawi, ndi njira zina zochizira. Ntchito akutsatiridwa ndi njira zosiyanasiyana, malingana ndi zizindikiro anatomical. Pa mmodzi mwa iwo ndi laparotomy apakatikati, resection wa yopingasa m'matumbo Division kulambalala mu gawo pakati, amalowerera anastomosis mwachindunji. Komanso, yopingasa m'matumbo amasuntha laterally pansi pa mitsempha m'munsi-muzituluka ndi kuliika ndi ndondomeko yapadera, kotero kuti anaŵerama m'dera la chiwindi ndi ndulu anagwidwa.

Monga ndondomeko chachiwiri resected mitsempha, Kupeza m'mimba (m'matumbo-splenic ndi m'matumbo-diaphragmatic) laparoscopy amanyoza flexure splenic kuti maondo kutali intestine. opaleshoni imagwiridwa ndi ntchito trocars zachipatala ndi electrocautery.

ntchito ophatikizana akutsatiridwa amene anapezeka "Payra syndrome dolichosigma". Reviews odwala mankhwala amenewa ndi yabwino kwambiri. Anthu kwathunthu ululu, siyani kudzimbidwa, ndi zizindikiro za kuledzera kutha nawo. Pa ntchito zimagwira kuwonjezera odwala mpheto ndi m'matumbo ndi yopingasa gawo splenic flexure ntchito laparoscopy resection wa sigmoid m'matumbo.

kaonedwe

chithandizo ndiwofatsa zotsatira mu magawo oyambirira a matenda, koma chifukwa chimapangidwa ndi kudwala anatomical mu dongosolo m'mimba okha opaleshoni amathandiza kuthetsa kwathunthu matenda Payra. mankhwala wowerengeka Chithandizo kokha ntchito ngati othandiza ndi. mankhwala amapereka infusions ndi decoctions, kupatulira chopondapo (Mankhwalawa) ndi njira utithandize motility wa matumbo. Bukuli lilinso ndi zida zimene kulimbikitsa chitetezo cha m'thupi, bwino chikhalidwe ambiri. Ntchito akhoza yophika plantain, madzi mbatata, stewed prunes, zouma zipatso. Nkofunika kudziwa kuti ndi matendawa Payra enemas ali contraindicated.

Kuti madokotala ananena zawo odwala amene chabe wopereka chithandizo yolondola, ndi zabwino mokwanira. Ngati matenda Payr anayamba, pangakhale mavuto moyo pachiswe monga zotupa, ulceration makoma, ndi zotupa, akutulukira kuchokera choipa yothetseratu matumbo ndowe.