Mphamvu ileus: gulu, zimayambitsa, zizindikiro ndi mankhwala

Ileus - Disease, amene integrates kuipidwa zizindikiro kuti yodziwika ndi imfa mtheradi kapena tsankho la matumbo kulumala, onse zivute zitani. Pakuti ndi chibadidwe kusowa kwa kayendedwe ka mtundu uliwonse wa chakudya, kuphatikizapo thanthwe ndi madzi, komanso pamaso kutupa kwambiri M'mimbamo peritoneal. Matumbo kutsekeka ndi amphamvu ndi makina.

maonekedwe a matenda

Mphamvu ileus - mtundu osiyana matenda anati ndipo akupezeka 10% odwala ndi matumbo kutsekeka. Matenda uyu wa madokotala nthawi zambiri amakankhira kufunika kuthetsa kutsekeka makina, ndiwo akufunika thandizo kwa opaleshoni.

The vuto Kupeza Vuto matenda tichipeza mu chakuti pathogenesis wa ileus wochitachita osati yodziwika ndi kukhalapo kwa chokwawa zopinga timadziti lomveka ndi makombo chakudya thirakiti. Pankhaniyi, chabe yochepa chibadidwe kuchepetsa njira thupi.

Komabe, kuopsa kwa matenda kwagona kuti zingayambitse neurohormonal kukanika mu mtima, komanso bwanji magwiridwe za m'mimba ang'ono ndi lalikulu. Taganizirani zimene zimakhudza yatsoka za matenda monga kutsekeka zazikulu m'mimba.

The zimayambitsa matenda

Ngakhale sayansi yamakono ikusonyezedwa ndi nyota lingamutsatire ndi zina zomwe mankhwala, koma iye alibe anakwanitsa kuthetsa njira yeniyeni zimene zimachititsa kuti maonekedwe a matenda funso. Zikamera wa mavuto monga kutsekeka zazikulu m'mimba ingayambe ndi zinthu zotsatirazi:

• peritonitis zimenezi zingachititse appendicitis kapena kapamba;
• pachimake mesenteric infarction;
• poizoni megacolon (matenda amene amatupitsa, Hirschsprung a, anam'peza matenda a m'matumbo);
• zinthu reflex (postoperative chikhalidwe, colic, magazi, m'mimba zoopsa, msana fractures monga akuchuluka makina ileus);
• matenda a chikhalidwe neurogenic;
• kusintha madzi a m'thupi (mwachitsanzo, mimba);
• matenda kagayidwe kachakudya (hypokalemia, ketoacidosis, uremia, kuledzera).

Gawo zazikulu ileus

Mu mankhwala, matenda a aliyense ali malamulo ake, dzina ndi mfundo zambiri analandira chithandizo. Ndi nazonso ndi matenda monga zazikulu m'mimba kutsekeka. ICD-10 (mayiko gulu la Matenda) limatchula matendawa funso motere:

• Maphunziro XI "Matenda a dongosolo m'mimba" (K00-K93);
• Onani "Other matumbo matenda" (K55-K63);
• matenda kachidindo - K56.6;
• dzina - "The Other ndi mosadziwika matumbo kutsekeka."

Mu yochizira matenda, kusiyanitsa mitundu iwiri zofunika cha kutsekeka zazikulu m'mimba:

• chonsechi;
• manjenje.

Chonsechi kutsekeka matumbo

Zochita matenda ndi zachilendo, kaŵirikaŵiri anakumana mu nsapato ndi matenda ena. Nthawi zambiri chifukwa cha matenda ndi matenda a thupi ndi nyongolotsi kapena pilorospazm, monga chotsatira cha zoopsa kubadwa. Palinso zinthu zina zimene mtundu wa matenda monga: matenda ya ubongo, neuroses, dyskinesia.

Kuchotsa vuto zingakhale basi mwa njira ndiwofatsa, monga amachita alowererepo opaleshoni Pankhaniyi sizimatanthauza.

Chonsechi matumbo kutsekeka: zizindikiro

Pa akuluakulu matenda kumachitika kwambiri kambirimbiri kuposa ana, koma zizindikiro zake zimafanana pa msinkhu uliwonse. matenda yodziwika ndi isanayambike mwadzidzidzi. Wodwala anadandaula kuukira yochepa ankakhala ululu m'mimba, amene alibe kutanthauzira yeniyeni.

Odwala matenda limeneli anati mu zizindikiro zotsatirazi:

• skhvatkopodobnye ululu m'mimba;
• kutupa m'goli ndi kumverera kwa chidzalo;
• nseru, kusanza zotheka, kudzimbidwa.

Pa palpation wa pamimba ndi kuchisonyeza gawo odwala za m'mimba pang'ono chabe, m'mimba ndi zofewa kwambiri. Zipolowe ku kachitidwe winayo anati. The chikhalidwe ambiri wodwala si kofunika.

Pseudoileus

Anafunitsitsa manjenje peristalsis intestine, limodzi ndi mwadzidzidzi mgwirizano zinchito vivacity nyumba neuromuscular. Kusiyanitsa reflex ndi postoperative manjenje ileus.

Pamene matenda kumachitika monga kukondoweza reflex nthambi wachifundo mantha dongosolo autonomic. Postoperative ileus ndi zovuta mochulukirachulukira Genesis pambuyo ntchito zosiyanasiyana ziwalo m'mimba.

Imautsa mapangidwe ndi chitukuko cha matenda ndi zinthu zotsatirazi:

• njira yotupa m'dera m'mimba;
• yotupa (abscess) retroperitoneal m'dera;
• chithunzithunzi chonse zimawonedwa pambuyo opareshoni monga laparotomy;
• zotsatira za matenda pathological monga pleurisy, chibayo, m'mnyewa wamtima infarction;
• mesenteric thrombosis mtima;
• matenda, kuphatikizapo paresis poizoni.

Pali magawo angapo a matenda:

Ine siteji. "Kulipidwa wakuswa" - Matanthawuzo kuti mmene postoperative matumbo paresis. Nthawi zizindikiro kumatenga masiku 2-3.

Gawo II. "Subcompensated wakuswa" - amakhala ndi chakuti pali chotupa kwambiri, pali zizindikiro za kuledzera ndi pseudoperitonitis thupi. Sanamvere phokoso peristalsis. A zizindikiro zosiyanasiyana anaona pa radiographs.

Gawo III. "Matenda Decompensated" - thupi mu mkhalidwe kuledzera ndithu. Inu mukhoza kuona kufooka matumbo, kusanza, zili matumbo. Pali zizindikiro za kukhumudwa peritoneal, mimba yatupa kwambiri. X-ray kusanthula limasonyeza kuchuluka misinkhu yopingasa wa madzi mu malupu wa matumbo (ang'ono ndi lalikulu pa nthawi yomweyo).

Gawo IV. "The ziwalo za kapepala m'mimba" - panthawi imeneyi pali kuphwanya ziwalo zonse zofunika kachitidwe moyo wa munthu. dongosolo zoipa moti anadwala mosalekeza.

Popeza mankhwala amakono kulibe koma-otukuka masiyanidwe mbali matenda a pathologies zosiyanasiyana zimene zimachitika mu nthawi postoperative, matenda mwamsanga matendawa kuli kovuta

Manjenje ileus: Zizindikiro

Akuluakulu, matenda pa maziko a chikhalidwe ambiri kokha aziwonjezereka. Iye akumverera kupweteka m'thupi amene amatayika m'chilengedwe. Komabe, si monga kwambiri monga umakaniko matumbo kutsekeka. Kusanza wobiriwira wodetsedwa. Wodwala taonera ponso exsicosis zizindikiro za kawopsedwe ndi maganizo a mtima.

Pamene wodwala manjenjeyo ileus amawonjezereka m'mimba wodwalayo, kudzera mpanda wake kutsogolo Tingaone kuwonjezeka mu buku la matumbo kuzungulira neperistaltiruyuschih. Ngati zizindikiro peritoneal ali kwina, ndiye pamimba ndi wofewa kwambiri.

Chifukwa matenda ndi gawo ndondomeko, ndi kuwonjezeka mu nthawi ya boma matenda a wodwalayo chatsitsa. Mu magawo patapita akhoza taonera tachycardia ndi kufupika kwa mpweya, bloating, languid peristaltic Siimva kuti kawirikawiri amapatutsidwa. Kusanza poipa.

Mu masiteji otsiriza, kufala lakuthwa kusintha morphological mu zida za neuromuscular. Wodwala anadandaula kwa mpweya ndi chopondapo kuchedwa ali infrequent pokodza.

Mphamvu matumbo chopingasa ana

Ana ali ambiri zazikulu pachimake matumbo kutsekeka, zomwe nthawi zambiri ndinawona mu mawonekedwe manjenje. The zifukwa zotsatirazi zingathe kudziŵika, n'zothandiza chitukuko cha matenda ana:

• obstructive kapena strangulation kutsekeka;
• zochepa kapena akakufunsani peritonitis;
• mwakayakaya m'mimba;
• chibayo;
• empyema;
• matenda a ntchito matumbo.

Nthawi zambiri, ileus zazikulu kupweteka ana mu nthawi postoperative. Zimachititsanso manjenje kusasitsa mitundu ya matenda kungakhale hypokalemia.

Ngozi ya matenda a ana ndi imfa zotheka ndalama zambiri madzimadzi ndi mchere chifukwa kusanza zonse, kusowa chilakolako cha kumaliseche potaziyamu impso hypoproteinemia. Kusalekerera chikhalidwe akhoza kulimbikitsa ndi chikoka cha zinthu chowawa poizoni ndi bakiteriya.

Mphamvu ileus mu akhanda akhoza zidzayambike ndi zifukwa zotsatirazi:

• prematurity;
• Alowererepo kuphwanya;
• ntchito mankhwala (kuphatikizapo akubereka pa mimba);
• gipermagniemiya;
• ntchito heroin abadwe;
• ntchito hexamethonium;
• sepsis;
• enteritis;
• CNS matenda;
• necrotizing enterocolitis;
• endocrine matenda.

Mphamvu matumbo chopingasa ana nthaŵi zambiri, koma mosavuta matenda ndi amalola kulandira chithandizo mwamsanga. Pankhani ya kukayikitsa pamaso pa obstructions ngati Chofunika - musati kuti aperekedwe kwa mayesero a kudziletsa mankhwala, ndi mosamalitsa kutsatira malangizo operekedwa ndi katswiri zogwirizana. Woopsa zotsatira - n'zotheka ndithu zikuchitika ndi vuto monga kutsekeka zazikulu m'mimba.

matenda a matenda

Zizindikiro za matenda enieni ndiponso yomveka bwino, kuti sikungalepheretse ndondomeko ya matenda. Ntchito zotsatirazi njira yodziwira:

• mbiri zachipatala
• Kuphunzira wodwalayo;
• X-ray Kupenda ziwalo m'dera m'mimba (amawerengedwa pamaso mpweya pamwamba mlingo madzi mu intestine ndi);
• Ultrasound (sikuti phunziro chifukwa si mokwanira nkhani chizindikiro);
• wathunthu magazi.

Mphamvu matumbo kutsekeka: chithandizo

Nthawi zambiri, chithandizo umalimbana kuthetsa matenda zifukwa koyamba kuti tifulumizane chitukuko (opatsirana chikhalidwe cha matenda, chibayo, peritonitis ndi ena.). Pankhaniyi matenda ndi zotsatirapo za zinthu zakupha kapena reflex yoyenera ndiwofatsa chithandizo, chomwe mu mankhwala a zochitika zoipa zimene zingachititse kuti kukatseka muyezo matumbo peristalsis. mankhwala amenewa angathe kukwanitsidwa mwa kuyambitsa mu thupi la mankhwala monga sodium kolorayidi, pamodzi ndi shuga. Ndiye mukufuna kusambitsana intestine ndi mankhwala, ngati n'koyenera - kuchita oyamba a chubu muzituluka. Pa ululu mkulu zomverera akhoza kulandira mankhwala othetsa ululu.

Ngati pamene mankhwala maola asanu zachipatala alili si bwino opaleshoni imagwiridwa. Komanso opaleshoni mwadzidzidzi imagwiridwa mu kobadwa nako matumbo kutsekeka.

Childs, ntchito ndizo kuchotsedwa tsankho m'mimba, omwe salinso amakwaniritsa ntchito zake. Mu nkhani aakulu ayenera kuumiriza yaikulu (chotulukira yokumba mpanda m'mimba mwa zomwe kusuntha chopondapo ndi mwayi kupita mu thumba lapadera hitched).

Kodi kuchotsa m'matumbo gawo zimatheka ngati intussusception. Izi zikachitika n'zotheka kufalitsa intestine mwakugwirabe Air intestine ndi zina kulamulira chithunzithunzi chonse ntchito X-ray.

chithandizo Postoperative tichipeza zakudya munthu, potsata voliyumu ya alowererepo pa opaleshoni. Woyamba masiku awiri pambuyo opaleshoni, wodwala ayenera kukhala mu malo Fowler, amafunika kuchita kupuma kokoka. Komanso pa nthawi imeneyi adzamva mankhwala, disintoxication mankhwala monga, normalization wa kagayidwe electrolyte, kugwiritsa ntchito mankhwala yotakata-sipekitiramu, wothandizila m'mimba popatsana ngati anasonyeza - mankhwala m'thupi.

Pamene mavuto mu nthawi postoperative akhoza kukulitsa mabala, magazi, peritonitis, zomatira matenda a peritoneum lapansi.

Ndi ileus amphamvu, monga matenda ena aliwonse, n'kofunika osati chithandizo kwambiri komanso kupewa vuto limeneli. njira kupewa monga:

• kuwukonza bwino electrolyte;
• mankhwala prokinetic;
• mankhwala;
• yoyenera zakudya kuti ndi otsika mafuta, mkaka ndi mbewu chakudya ndi okhutira mkulu wa zigawo zikuluzikulu zomwe si digested mwa thupi.