Kuchotsa chiwindi: zimayambitsa, mankhwala, zotsatira, zizindikiro

Kuvulala kwa ziwalo za m'mimba ndi chimodzi mwa mitundu yovuta kwambiri, chifukwa nthawi zambiri imaimira kuopseza miyoyo ya ozunzidwa. Zomwe zimayambitsa zowonongeka zingakhale ngozi za pamsewu, kupweteka kwa mimba kapena kugwa kuchokera kutalika kokongola. Pankhaniyi, nthawi zambiri pali kusiyana kwa chiwindi, chifukwa cha kukula kwakukulu ndi kapangidwe ka chiwalo ichi. Kodi kutuluka kwa chiwindi ndi chiyani, kuthandiza bwanji ovulala komanso momwe chithandizochi chidzapitilire ku chipatala? Mudzapeza yankho lanu mutatha kuwerenga nkhaniyi.

Kapangidwe ka chiwindi

Musanayambe kuchita chiwopsezo cha chiwindi, ndi bwino kunena mawu ochepa ponena za kapangidwe kake. Chiwindi ndi chiani, chiwalo ichi chiri kuti ndi momwe chimapwetekera? Chiwindi chili kumtunda kwa peritoneum, kumakhala ndi hypochondrium yoyenera. Kulemera kwa chiwindi cha munthu wamkulu kumakhala pafupifupi kilogalamu imodzi ndi theka. Chiwalocho chili ndi malo awiri: pamwamba, pamwamba pamunsi pa chithunzithunzi, ndi m'munsi.

Chiwindi chimapangidwa ndi magawo awiri: kumanja ndi kumanzere. Magawo amagawidwa wina ndi mzake ndi mliri wa crescent. Nkhumba imayanjana ndi chiwindi, yomwe ili nkhokwe ya bile yomwe imadziwika ndi thupi.

Ntchito za chiwindi

Chiwindi chimapanga ntchito zingapo zofunika. Amatsuka magaziwo, amabala mapuloteni osiyanasiyana oyenerera kuti thupi lizigwira ntchito bwino, amapanga mavitamini komanso amatenga mbali zosiyanasiyana zamagetsi. Pa intrauterine chitukuko cha munthu, chiwindi chimapanga ntchito zamagetsi. Komabe, anthu ambiri sakudziwa pang'ono za izi, mwachitsanzo, chiwindi komwe kuli ndi momwe chiwalochi chimapwetekera. Chidziwitso chimenechi ndi chofunika kwambiri: ngati mukuganiza kuti matendawa amatha, mankhwalawa amabweretsa zotsatira zabwino kwambiri.

Kusokonezeka maganizo

Chiwindi chimakhala chosasunthika, komabe chiwalo ichi chikuwonongeka nthawi zambiri. Ichi ndi chifukwa chakuti chiwindi chimaphimbidwa kokha ndi khoma la m'mimba (kupatulapo kumbuyo kwa pamwamba pa chiwalo). Peitoneum yochepa imalimbikitsa chitetezo chodalirika kuchokera ku zochitika zakunja. Zambiri zingayambitse chiwindi: zomwe zimayambitsa matendawa ndizosiyana kwambiri. Mwachitsanzo, ndi kuvulala kapena kuphulika, minofu ikhoza kuphulika mosavuta.

Chiwindi chikhoza kuonongeka ndi chifuwa kapena chifuwa. Si zachilendo kuti chiwindi chimatha pangozi. Kupangitsa kuti vuto liwonongeke likhoza kukhala chiwopsezo chachikulu ku chiwindi. Izi zimachokera ku malo enieni a chiwalo, komanso zolemera zake. Popeza chiwindi chimasiyana mosiyana komanso chimakhala pakati pa nthiti ndi msana, chimawonongeka nthawi zambiri.

Nthawi zina, kubwezeretsedwa kwa mtima kumapangitsa chiwindi kuphulika, koma izi zimachitika kawirikawiri.

Kodi chiwindi chimatuluka mosavuta?

Chiwopsezo cha chiwindi cha chiwindi ndi chachikulu ngati chiwalo chimakhudzidwa ndi matenda ena. Ndi malungo, syphilis, amyloidosis, ngakhale zofooka za kunja zochepa zingayambitse. Kuwonongeka koteroko sikungangowonjezera chiwindi, komanso minofu ya makina osindikizira, mwachitsanzo, mukakokera. Kusiyana kwa chiwindi mwadzidzidzi kungakhoze kuwonedwa pamaso pa zowopsya zotsekemera mu chiwalo ichi kapena m'mimba yamphamvu.

Kuchokera ku chiwindi chikhoza kuchitika pamsana pa mimba. Matendawa amatchulidwa nthawi 120 kuyambira 1844. Pankhaniyi, amayi ambiri amapezeka kuti ali ndi matenda oopsa.

Chizindikiro cha chiwindi cha chiwindi

Ponena za kuvulaza, kuvulala kumeneku kumagawidwa m'magulu akuluakulu:

• Kuphulika kwa umphumphu wa capsule wokhala ndi magazi pang'ono;
• Pamwamba pa parenchyma, momwe magazi amatha msanga pambuyo pa dokotala wa opaleshoni sutures;
• Ziphuphu zakuya zomwe zimawopsya ndi kutaya chidziwitso zimayang'aniridwa ndi anthu okhudzidwa;
• Pogwiritsa ntchito parenchyma, kuphatikizapo kuphwanya kukhulupirika kwa ziwiya zazikulu - ndi zoterezi, munthu akhoza kufa mwamsanga chifukwa cha kutayika kwa magazi.

Palinso magawo awiri, kapena kuchedwa kwa chiwindi cha chiwindi. Ndi kuwonongeka kotere, mawonekedwe a subcapsulated kapena intrahepatic hematoma, omwe amatha kupyola m'mimba.

Ngati chiwindi chitayika chikuphatikizidwa ndi kukhulupirika kwa chiwalo cha thupi, magazi amalowa m'mimba. Ngati pangakhale kuwonongeka kwa phokoso la magazi, magazi amapezeka pamtendere. Ngati nthendayi ilibe kuwonongeka, magazi amayamba pang'onopang'ono pakati pake ndi parenchyma.

Kodi chimawopsa bwanji chiwindi?

Kuphulika kwa chiwindi nthawi zambiri kumaimira kuopseza moyo wa wogwidwa. Zikhoza kukhala zodziwika kapena zowerengeka: kukula kwa magazi kumadalira izi. Tiyenera kukumbukira kuti parenchyma ndi mitsempha ya chiwindi sizingatheke. Izi zimayambitsa chitukuko cha magazi, omwe sungakhoze kuima pokhapokha. Kuwonongeka kwa magazi kumawonjezanso chifukwa chakuti chiwindi chimayenda nthawi zonse ndi kupuma. Kuonjezera apo, bile imasakanizidwa ndi magazi, omwe amavutitsa kwambiri coagulation. Nthawi zambiri, magazi amatha popanda thandizo lachipatala. Kawirikawiri, izi zimachitika pamene ziwiya zazikulu siziwonongedwa.

Zizindikiro

Zizindikiro zikuluzikulu za chiwindi ndi:

• Ululu m'mimba. Ululu ukhoza kukhala wosamvetsetseka kapena wowala. Kaŵirikaŵiri, ndi kuvulala kwa chiwindi, wogwidwayo amakakamizika kukhala pansi: pamene akuyesera kusintha kusintha, ululu umakula kwambiri (Vanka-vstanka syndrome).
• Kupweteka kumakhala kolimba ngati wodwalayo akutembenukira kumanzere: izi ndi chifukwa chakuti magazi omwe amapezeka pambali ya pamimba amapita kumanzere.
• Milomo ya wogwidwayo ikhoza kutembenukira buluu.
• Atalandira chovulala, mimba imakhala yovuta kwambiri.
• Nsowa ndi kusanza.
• Kuwoneka kwa kutuluka thukuta, kuzizira kwa miyendo.
• Wodwalayo akhoza kumva ludzu lamphamvu.
• Khungu lenileni.
• Kutaya chidziwitso, chodabwitsa kwambiri.

Ngati hematoma ndi yaing'ono ndi chiwindi, chiwindi chake chimakhala chokhutiritsa. Ngati kuwonongeka kuli kofunika kwambiri, ndiye kuti odwala ali ovuta kwambiri. Pakuvulazidwa pang'ono patsiku loyamba atalandira, zizindikiro siziripo. Kawirikawiri ululu umakhala wopanda pake masiku angapo, koma chiwindi chimakula pang'ono. Kutentha kumawonjezeka, nthawi zina chimbudzi chochepa chimayamba. M'tsogolomu, panthawi ina iliyonse yopanda vuto, kapule ikhoza kutha, ndipo hematoma imatsanulira m'mimba.

Kachilombo kamene kamangolandira, kupanikizika kumatuluka, koma pambuyo pakuwonjezeka kwa magazi, imayamba kuchepa. Zimakhulupirira kuti kuponderezedwa kumayamba pamene magazi amatha kufika 800-1500 milliliters.

Kodi chifuwa cha chiwindi chimapezeka bwanji?

Kuzindikira matenda a chiwindi kungabweretse mavuto ena, makamaka ngati wodwala adalandira zovulala zina. Ngati simukuzindikira kuti "chiwindi cha chiwindi" pakapita nthawi, zotsatira zake zingakhale zovuta kwambiri. Mwamwayi, chifukwa cha njira zamakono zoganizira, zolakwika zimachepetsedwa.

Posachedwapa, pozindikira kuti chiwindi chimagwidwa, kupuma kwa m'mimba kumagwiritsidwa ntchito poyambitsa kathete yapadera. Chifukwa cha njirayi, n'zotheka kuti mudziwe mwatsatanetsatane za vutoli komanso kuti mugwiritse ntchito njira zochiritsira zofunikira. Odwala ena akulimbikitsidwa kupanga ultrasound pachiwindi kuti apeze matenda.

Kuti mudziwe kuchuluka kwa kusintha komwe kunayambitsidwa ndi kutaya mwazi, kuyezetsa magazi kumathandiza. Chiwerengero cha maselo ofiira ofiira amayamba kuchepa maola angapo pambuyo pake, kenako amayamba kuchepa kwa magazi. Mlingo wa kuchepa kwa chiwerengero cha maselo ofiira ofiira umakulolani kuti mudziwe kuchuluka kwa kutuluka m'magazi. Mayeso a magazi ayenera kuchitidwa maola angapo ochepa, omwe amakulolani kuyang'anitsitsa mphamvu ya mkhalidwe wa wodwalayo.

Zovuta zimapezeka ndi subcapsular kuchepa kwa magazi: ndi zilonda zotere masiku oyamba, chikhalidwe cha odwala chimakhala chokhutiritsa, pambuyo pake chimachepa mofulumira.

Kuzindikira kungakhale kovuta kuledzeretsa kwa wodwala kapena vuto losadziŵa chifukwa chovulala mutu.

Zochitika zochiritsira

Anthu ambiri amakondwera ndi chithandizo cha chiwindi cha chiwindi ndipo ngati chithandizo chodziletsa cha matendawa n'chotheka. Kuchiza kwa kupweteka kungakhoze kuchitika kokha mwa njira yogwira ntchito. Zithandizani mulimonsemo zosatheka: ngati simusamala za chiwindi, zotsatira zake zingakhale zakupha. Mankhwalawa amaletsa kupha magazi, kuchotsa magazi ochuluka m'mimba ndi m'mimba. Opaleshoniyi iyenera kuchitidwa mofulumira. Nthawi iliyonse yochedwa imachepetsa kufala kwa imfa. Kukana kwa opaleshoni kumakhala koyenera ngati munthu wodwala atalowa m'chipatala mu chikhalidwe chosasokonezeka.

Kutsekula kwa chiwindi cha chiwindi

Ngati wodwalayo ali ndi chiwindi, chifuwachi chimadalira zifukwa zingapo:

• Chiwonongeko cha organ;
• Chikhalidwe cha kuvulala;
• Msinkhu wa wodwala: ana ndi okalamba amavutika ndi chiwindi kwambiri kuposa magulu ena a odwala;
• Kusakhalitsa kwa nthawi yopaleshoni.

N'chiyani chingakhale zovuta?

Chimodzi mwa mavuto aakulu omwe angaperekedwe ndi chiwindi cha chiwindi ndi hemobiology. Ndi hemobiology, magazi ochokera m'ziwiya zomwe zawonongedwa chifukwa cha vutoli zimayambira kuzungulira njira ya ndulu ndipo zimachokera ku tsamba la biliary. Hemobiology ingathetsedwe kokha mwa kuthetsa kuyankhulana pakati pa chotengera ndi ndulu. Apo ayi, wodwala angafe chifukwa cha kuwonongeka kwakukulu kwa magazi.

Chinthu chosavuta kumva ndi biligemia. Matendawa amayamba ngati ma ducts ndi ziwiya zazikulu zimakhudzidwa panthawi yomweyo. Pachifukwa ichi, magazi akhoza kulowa mu bile. Mkhalidwe woterewu umagwiritsidwa ntchito mwa njira yokhayo.

Kawirikawiri chifukwa cha opaleshoni yosachita bwino, amatha kutuluka magazi nthawi yaitali m'madzi kapena m'mimba mwathu. Kawirikawiri, magazi oterewa amapezeka patapita masiku angapo atatha kugwira ntchito. Kuonjezera apo, odwala ena odwala matenda osokoneza bongo, chiwindi cha chiwindi kapena fistula pambuyo pake amapangidwa.

Imfa ya anthu omwe amavutika ndi chiwindi nthawi zambiri imayamba chifukwa cha mphamvu ya magazi yotayika. Chiwerengero cha imfa mu intraoperative nthawi ndi 9%. Ngati wodwalayo awonongera ziwalo zina, ndiye kuti msinkhu wowonongeka ukuwonjezeka (mpaka 24%).

Kuchokera kwa chiwindi, zomwe zimayambitsa zikhoza kukhala zosiyana, ndi chiwopsezo chofunikira kuchipatala mwamsanga. Apo ayi, chiopsezo chotayika ndi chachikulu chifukwa cha kuwonongeka kwakukulu kwa mwazi kophatikizapo mtundu uwu wa kuvulala.