Pancreatic abscess > Matenda a shuga

Pancreatic abscess - Uwu ndi khosi lodzaza ndi mafinya ndi ma necrotic ophatikizika mumatumbo a gland. Milandu yambiri, imayamba pambuyo pathunthu wovuta wa chidakwa cha kapamba. Amadziwika ndi kuwoneka kwa malungo, kupweteka m'chi m'chiuno, leukocytosis, chotupa pakupanga kwamatumbo pafupifupi masabata awiri pambuyo povutitsidwa ndi kapamba. Kuzindikira kumachitika pambuyo poti wapangika ma ultrasound, MRI kapena CT ya m'mimba, kusanthula kwa magawo amomwe ammagazi komanso ambiri azachipatala. Njira yokhayo yothandizirana ndikutsuka kwa chotupa, ndikutsatira mankhwala othandizira.

Zambiri

Pancreatic abscess ndi nthenda yayikulu yomwe imayamba mwa odwala omwe adachitapo pancreatitis (pachimake kapena kubwereza kutulutsa) kapena kupindika kwa necosis ndi mapangidwe a purcinited purulent patsekeke. Matendawa ndi owopsa pamoyo wa wodwalayo, ndipo kuperewera kwake kumagona pachipatalacho poyerekeza ndi chithandizo chamankhwala othandizira. Ichi ndichifukwa chake mu gastroenterology yamakono ndichizolowezi kupaka mankhwala opha pancreatitis pokhapokha ngati zotupa za mabiliary kapena zovuta zotsimikiziridwa ndi bakiteriya. Milandu yonse ya kutentha thupi komanso kupweteka kwam'mimba mkati mwa masabata awiri pambuyo pancreatitis iyenera kuganiziridwa ngati chida cham'mimba. Njira yokhayo yomwe imatsogolera kuchira ndi kuthandizira kukhetsa kwa chimbudzi. Popanda opaleshoni, anthu omwe amafa m'matendawa amafika 100%.

Katemera wa pancreatic amakula motsutsana ndi maziko a kapamba kapamba, amatha kukhala mu mtundu uliwonse wa matenda, kupatula pa edema, 3-4% ya milandu yamatendawa imapangitsa kupangika kwa abscess. Nthawi zambiri amadziwika motsutsana zakumwa zoledzera pancreatitis. Zomwe zimayambitsa kupangika kwa purulent patsekeke sizikudziwika bwino. Amaganizira kuti matendawa amatha kuyambitsidwa ndi mtsinje wamagazi, ndi punse pseudocyst (ngati aseptic siziwoneka), ndikupanga fistula ya cyst ndi matumbo.

Mwambiri, nthawi zambiri, pakulakalaka ndikuwonetsa zomwe zili pamatopo, Escherichia coli kapena enterobacteria amatulutsidwa. Malinga ndi maphunziro omwe ali m'munda wa gastroenterology, kuwonjezeranso matenda ena achiwonetsero kumawoneka pafupifupi 60% ya milandu yamatenda a kapamba, chifukwa chake, pakuchiza matendawa, kufalikira kwa patsekeke wokhala ndi zotsukira za purulent kuyenera kukumbukiridwa. Kukula kwa chithupsa kumalimbikitsidwa ndi chifuwa chachikulu cha pancreatitis chokhala ndi zinthu zopitilira katatu, postoperative pancreatitis, oyambirira laparotomy, kuyambika koyambirira kwa zakudya zamagulu, komanso mankhwala osokoneza bongo.

Pancreatitis yachilengedwe ikadzachitika, minyewa ya m'mimba imawonongeka, chifukwa choti ma enzyme amalowetsa ndulu zonsezo komanso tinthu tating'onoting'ono, ndikuziwononga. Chifukwa cha izi, pancreatic necrosis imatha kuyamba, ma pseudocysts amapangidwa - zikhomo zodzaza ndimadzi zomwe zimakhala ndi ma necrotic. Mukalowa m'dera la matenda a matenda, pancreatic phlegmon akufotokozera - kwathunthu puroses fusion, kapena abscess mitundu. Dziwani kuti phlegmon ndiyowopsa komanso yopanda tanthauzo, yomwe kuchipatala sichimasiyana ndi chikho chimodzi. Kuphatikiza apo, ndi abscess mu minofu, ma abscesses angapo amatha kupanga.

Zizindikiro za Kuperewera

Ma pancreatic abscess kwa nthawi yayitali - nthawi zambiri osachepera masiku 10-15. Chifukwa chake, pakatha milungu iwiri kapena inayi kuchokera pomwe chikhansa chikuyambika, kutentha kumayamba kuchuluka, kuzizira, kuoneka tachycardia, kupweteka pamimba kumakulirakulira. Ululu umakhala ngati lamba, wamphamvu kwambiri. Wodwalayo amatchulira kufooka, kutopa, kusowa kudya, kuchuluka thukuta. Kuda nkhawa ndi nseru, kusanza, pambuyo pake kuwawa kumamveka pakamwa kwanthawi yayitali. Pali zizindikiro zonse za kuledzera. Pa palpation pamimba, kupezeka kwa chotupa ndi kupsinjika kwa minofu khoma lakumbuyo kwamimba ndizofunikira.

Mavuto

Chotupa cha kapamba nthawi zambiri chimakhala chovuta chifukwa cha kufalikira kwa kachilomboka, kupangika kwa zilonda zingapo m'matumbo momwemo ndi ziwalo zozungulira. Pus imatha kutuluka mobwerezabwereza, kulowa m'matumbo (matumbo, m'mimba), minofu ndi mafinya a pateriocardial, chifukwa chake pathumba lamatumbo, chotupa cha subphrenic, purulent pleurisy ndi pericarditis. Komanso, botolo limatha kutuluka pakhungu pakhungu. Ngati makoma a chotengera awonongedwa ndi ma enzymes, magazi amatuluka kwambiri, ndipo nthawi zina amatha.

Zizindikiro

Katemera wa pancreatic amadziwika ndi katswiri pakuchita opaleshoni yambiri atatha kumuunika bwinobwino wodwalayo. Pakufufuza kwaponsekonse kwa magazi, pali leukocytosis yayikulu, kusintha kosangalatsa kwa leukocyte kumanzere, kuwonjezeka kwa ESR, kuchepa magazi. Pakuwunika kwamwazi wamagazi, kuchuluka kwa michere ya pancreatic, hyperglycemia ndi yofunika. Mlingo wa amylase amtundu umakwezedwa, ngakhale pakapangidwa chophuka kuchuluka kwake kumatha kuchepera.

Kuunika kwa X-ray pancreatic abscess kumakhala ndizinthu zina. Popeza gland ili kumbuyo kwa m'mimba, mthunzi wa abscess patsekeke ukhoza kudutsa ndi kuwira kwa mpweya m'mimba. Chifukwa chake, chiwonetserochi chikuyenera kukhala chotalikirapo, ndipo ngati cholakwika chikayikiridwa, sing'anga yolowererapo imalowetsedwa m'matumbo am'mimba ndipo chithunzi chotsimikizika chimatengedwa pang'onopang'ono - motere, mthunzi wozungulira wokhala ndi mzere wamadzimadzi (abscess) udzakhala kumbuyo kwa m'mimba. Kusiyanaku ndikulowa mkati mwa chikopa, titha kulankhula za kukhalapo kwa fistula. Komanso pazithunzi mutha kuona zizindikiro zosakanikirana zamatumbo, kutuluka kwa ziwalo. Mtundu wamanzere wa diaphragmatic ndiwokwera, kuyenda kwake kuli kochepa, pakhoza kukhalapo kuphatikizika kwa pleural patsekeke.

Ultrasound wa kapamba, CT scan ya pamimba ndi yomwe izindikire malo ndi kukula kwa chotupa, kuchuluka kwa zotupa. Ngati ndi kotheka, munthawi yomweyo kulumikizira mosilira ndi kusilira, kupenda ndikufesa zomwe zili mkati ndizotheka. Kuzindikira kosiyanaku kumachitika ndi pseudocyst wa kapamba, pancreatic necrosis.

Chithandizo cha pancreatic

Kuchiza kumachitika ndi dokotala wa m'mimba. Chofufumira ndichizindikiro chokwanira chokonzanso madzi. Zochita zikuwonetsa kuti kukoka kwa ma abscesses kumabweretsa kuchiritsa pokhapokha 40% ya milandu, kuphatikiza apo, pogwiritsa ntchito njira zoterezi, phlegmon, ma abscesses angapo, ndikufalikira kwa matenda kumatenda oyandikana ndi pancreatic amatha kudumpha. Ichi ndichifukwa chake endoscopic kapena classic laparotomy excision ndi kukhetsa kwa abscess kukhala njira yabwino yothetsera.

Nthawi ya opareshoni, kuunikira mosamala ziwalo zozungulira, zotsekemera zotsekemera za sekondale imachitidwa. Mofananamo, wodwalayo amapatsidwa mankhwala opha maantibayotiki malinga ndi zikhalidwe zomwe zalandiridwa, ma painkillers, antispasmodics, enzyme inhibitors. Anachita kulowetsedwa mankhwala ndi cholinga detoxization.

Zotsogola ndi kupewa

Popeza zomwe zimayambitsa kupangika kwa ma pancreatic abscesses sizimamveka bwino, mpaka pano palibe njira zodzitetezera pakukula kwa mankhwalawa pambuyo pancreatitis ndi pancreatic necrosis. Chifukwa chake, kupewa kupewetsa kwa katemera ndiko kupewa kapamba - chifukwa chifuwa chimatha kupangika kumbuyo kwake.

Momwe matendawa amapangidwira matumba ndi akulu: popanda kuchitidwa opareshoni, kufa ndi 100%, atachitidwa opaleshoni, kuchuluka kwa kupulumuka kumafikira 40-60%. Zotsatira za matendawa zimatengera nthawi yayitali ya chithandizo, kuzindikira msanga komanso kuchitira opareshoni. Zomwe matendawa adapangidwa ndikuti opareshoniyo ichitike, zotsatira zake zimakhala zabwino kwa nthawi yayitali.

Zinthu zomwe zimayambitsa chitupa

Pancreatitis wa purulent wa kapamba, kapena mwanjira ina, chithupsa, amatha kupanga mothandizidwa ndi mndandanda wonse wazinthu zopangitsa. Zomwe zikuluzikulu ndizoyipa zam'mimba mu kapamba, zomwe zimachitika kuyambira pakubadwa komanso kupita patsogolo kwa kutupa mu ziwalo kuchokera m'mimba. Kuphatikiza apo, kufalikira kwa dera la gland kumatha kuyambitsa zotsatirazi:

kumwa mopitirira muyeso kwa zinthu zomwe zimakhala ndi mowa, gawo lomwe limapitilira kumwa mowa, lomwe limapezeka kwambiri mwa abambo kuposa amayi,
Njira za kuledzera kwamthupi lathunthu,
Kukula kwa matenda opatsirana a ma virus,
kuphwanya magwiridwe a bile ducts ndi chikhodzodzo,
matenda a m'magazi am'mimba, komanso m'chiwindi.
opaleshoni yosiyanasiyana yogwiritsira ntchito parenchymal organ,
kugwiritsa ntchito mankhwala kwa nthawi yayitali.

Komanso, kukulira kwa abscess kungayambitse kukulira kwa yotupa mkati mwa zowonjezera.

Kukula kwa ntchito ya pancreatic enzyme

Kafukufuku wina adawonetsa kuti pancreatic abscess imatha kukhala mkati mwa ntchito yayikulu ya ma pancreatic enzi omwe amapangidwa ndi gland palokha.

Izi zikufotokozedwa ndikuti ntchito yayikulu ya chiwalo chomwe chikufunsidwa ndikubisalira kwa zinthu zamafuta - insulin ndi michere ya pancreatic, yomwe imathandizira kugaya chakudya. Kamodzi m'matumbo am'mimba, ma enzyme amenewa amayamba kugwira ntchito ndikuwononga mapuloteni, mafuta ndi chakudya, ndikuthandizira thupi kuyamwa bwino mbali zonsezi. Ma enzesere asanakhale m'matumbo, amakhala osagwira komanso osavulaza.

Koma, pancreatitis pachimake, kapena kuchulukitsa kwa kutupa kosakhazikika, kumayambitsa kulephera kwa njira zonse mu kapamba, zomwe zimayambitsa kukonzekera msanga kwa michere ya pancreatic ikadali gland yokha.

Zonsezi zimakhala zoyambitsa chitukuko cha njira zodzipukutsira tinthu timene timayamwa. Zotsatira zake, minofu ya chiwalo imakwiya, kuwonekera kwambiri, umphumphu wawo umaphwanyidwa ndipo chotupa chimapangidwa, kumayambitsa imfa.

Katemera wamkati

Chotupa cham'mimba chimangoyang'ana kutukusira kwa purulent m'matumbo a matumbo. Gastroenterology imawona njira iyi ngati njira yodutsira m'mimba m'mimba, kusintha kwa njira yoyeretsera kuchokera kwa ziwalo zoyandikana kapena ngati gawo lochita opaleshoni yam'mimba. Matimu a anatomical ndi zokhudza thupi zam'mimbamo, kuphatikizapo mphamvu ya peritoneum, komanso mawonekedwe a ziwalo zam'mimba zimapangitsa kupangika kwa chiwonetsero chochepa cha matumbo. Nthawi zina, chithupsa m'matumbo chimatha kukhazikika chifukwa cha matenda ammimba (otaya magazi) kapena matenda amitsempha, ngakhale amachokera patreat purulent, mwachitsanzo, ndi angina, osteomyelitis, furunculosis. Mu 8% ya milandu, sizotheka kukhazikitsa chifukwa chomwe chimayambitsa matumbo am'mimba.

Zimayambitsa matumbo

Chofunikira kwambiri pakukula kwa matendawa ndi Escherichia coli - woposa theka la milandu, wothandizila wa causative amathanso kukhala staphylococcus - 9-11%, streptococcus - 7-10%, Pseudomonas aeruginosa - 7-8%, Proteus - 5-8%, mpaka 25 % - zomera za anaerobic.

Thumba lachiberekero limatha kuchitika chifukwa cha kusinthika kwachindunji (kukhudzana) kwa matenda kuchokera kumadera oyandikana nawo, chifukwa chodzola mafuta, kulowa kwa chilonda cha duodenal kapena gawo lina la matumbo, chiwopsezo cha appendicitis, peritonitis. Chovuta chofananacho ndimavuto obwera pambuyo pake: chotupa chitha kukhala chifukwa cha kukoka kosakwanira, kuchotsedwa kwa zosakwanira kapena zowonongeka, kukhazikika kwa hematoma ya postoperative, ndipo imatha kupangika m'mphepete mwa ngalande, kuzungulira matupi akunja (kuphatikiza zotayidwa).

Kuchepa kwa puritis yotupa kumatha kuchitika m'njira zingapo: ndikupanga chotupa pamalo operekera kachilomboka, kuchuluka kwa kachilombo koyambitsa matenda, kudzikundikira magazi kapena ndulu m'malo opangira opaleshoni, komanso poletsa njira ya pathological yomwe imachokera ku ziwalo zoyandikana, kuphatikizapo peritonitis.

Bowel abscess chithandizo

Maziko othandizira matumbo am'mimba ndikuwachotsa kwa abscess osakanikirana ndi maantibayotiki ambiri. Maantibayotiki amaikidwa m'magulu a cephalosporins, aminoglycosides, fluoroquinolones, othandiza motsutsana ndi maluwa aerobic, anaerobic.

Chithandizo cha opaleshoni chimakhala ndikutsegula poyang'ana kutukusira kwa purulent, kukonzanso kwake, komanso kutulutsa madzi. Kufikira kwa Laparotomic kumagwiritsidwa ntchito, kutulutsa komwe kumatsimikiziridwa ndi malo a chotupacho. Ngati kutulutsa kwatsimikizidwe koyipa sikumafotokozeredwa bwino kapena ngati pali zovuta zina zodziwitsa, laparotomy yapakati imachitidwa, ndikulola dokotalayo kufikira mbali zonse zamatumbo. Ndi kuwonongeka kwa magawo omaliza a m'matumbo, opaleshoni kudzera mu njira yothandizira ndiyotheka. Onetsetsani kuti kutsukidwa kwatsukidwa kumayeretsedwera pambuyo pake pakukonzekera ndi kuchapa.

Phlegmon wam'mimba

Phlegmon wam'mimba - pachimake chamadzimadzi chodontha cham'mimba chonse kapena gawo lake ndi kufalikira kwa zigawo zonse za khoma la m'mimba. Matendawa ndi osowa kwambiri, nthawi zambiri amuna azaka 40-60.

Phlegmon yoyamba ndi yachiwiri yam'mimba imayesedwa. Phlegmon yachiwiri ndi yolumikizana kapena yosakanikirana, i.e. Khalani ngati vuto la matenda. The etiology ndi pathogenesis yamatumbo oyamba a m'mimba sichidziwika bwinobwino.

The causative wothandizila wa gastric phlegmon ndi zoyera ndi golide staphylococci, streptococci, E. coli, etc. Nthawi zambiri, gastric phlegmon imayamba motsutsana ndi maziko a matenda otupa (gastritis, zilonda zam'mimba zam'mimba) kapena kuwonongeka kwa nembanemba ya mucous (matupi achilendo, kuwotcha, ndi zina). The causative wothandizila matendawa amatha kulowa khoma la m'mimba kuchokera kumbali ya mucous membrane komanso kuchokera kumbali ya serous membrane (yachiwiri phlegmon). Nthawi zambiri, matendawa amayambanso ndi m'mimba, ngakhale amathanso kuyamba ndi mtima.

Khoma lonse la m'mimba, lomwe lili ndi mawonekedwe obowoka olimbirana ndi ma membrane a mucous ndi chivundikiro cha serous, limagwira nawo mbali ya purifani. Mchitidwewo umakonda kufalikira, nthawi zambiri pamakhala chotupa chochepa cha m'mimba. Mukuya kwa kulowa ndikuchita mafinya, omwe amatha kupezeka ndi punction ndi singano yakuda. Mimba yokhala ndi zotupa za purulent imakhala yoopsa komanso yovuta.

Kufufuza kwa mbiri yakale m'magawo oyambilira kumawonetsa edema ndi plethora ya zigawo zonse za khoma lam'mimba pamalowa. Matendawa akamakula, edema ndi hyperemia ya minofu imakulirakulira, kulowa kwawo kwa leukocyte kumakulirakulira.

Chithunzi cha kuchipatala

Phlegmon wam'mimba amatanthauza matenda oopsa. Maphunziro azachipatala amatengera gawo la matendawa, kuchuluka kwa thupi, mtundu (woyamba kapena wachiwiri) ndi mtundu wa phlegmon (wocheperako kapena wofala), zaka za wodwalayo, zovuta.

Matendawa amayamba. Kutentha kumawonjezeka kwambiri mpaka 3940 ° C.Odwala amadandaula za kupweteka kwambiri pamimba yam'mimba, yomwe imachepera, koma osasiya kwathunthu, kufooka kwambiri, nseru, kusanza, kuphulika kwa mpweya, kutulutsa. Peristalsis m'magawo oyamba amayamba kufooka, kenako nkuyima. Lilime louma, yokutidwa ndi zoyera kapena zokutira. Kugunda kumawonjezeka mpaka 140 pamphindi, kudzazidwa kwake kukuipiraipira. Kuthamanga kwa magazi kumachepa.

Mu gawo la kuledzera kwamphamvu ya purulent, kutsekemera kwa mucous nembanemba kungawoneke. Mimba imatupa pang'ono, osapumira komanso osakhudzidwa konse. Khoma lam'mimba ndilovuta komanso zowawa kwambiri m'madipatimenti onse, makamaka kumtunda, komwe nthawi zina kumatha kumva kuzungulira, kofewa, kowawa kwambiri komwe kumakhala m'chigawo chonse cha epigastric.

Zizindikiro za kuyimitsidwa kwamatenda kumayambiriro kwa matendawa sikufotokozedwa bwino, koma phlegmon ikamakula ndikufalikira, imayamba kutchulidwa. Mawonetsedwe awa onse ali ndi mawonekedwe a phlegmon wapadera wam'mimba.

Kuyesedwa kwa magazi kukuwonetsa njira yotupa - kuchuluka kwa leukocytes kumawonjezeka kufika 15-18 x 109 / l, ESR imawonjezeka, kusintha kwa fomula ya leukocyte kumanzere kumawonedwa. Chothandiza kwambiri pakuwunika kwa gastric phlegmon ndi kuwunika kwa X-ray, komwe kutsekeka ndi kusasiyana kwa mapangidwe a mucous membrane ndi kusowa kwa peristalsis mu gawo ili la m'mimba. Ndi kukula kwa matenda, chilema chodzaza ndi, ngakhale masamba opyapyala amatha kupezeka.

Mwayi wa ultrasound wokhala ndi phlegmon ya m'mimba ulibe malire, koma CT imapereka chidziwitso chofunikira - makulidwe ochepa a khoma lam'mimba, kufutukula kwake, nthawi zina kumawululira mpweya pakhoma la m'mimba.

Kufufuza kwa endoscopic kumathandizira kuzindikira kwa matendawa. Esophagogastroscopy ndi laparoscopy ndi njira zodziwikiratu mu ntchito yolumikizira matenda ndi kutsimikiza kwa mankhwalawa m'mimba.

Ndi mayeso a gastroscopic, mucous membrane wam'mimba, nthawi zambiri dipatimenti yake ya pyloric, imakutidwa ndi deprinits ya fibrinous, ndipo imatupa. Njira yoyeretsa ikadutsa ziwalo zoyandikana mpaka m'mimba (yachiwiri phlegmon), munthu amatha kuwona kugundana kwa khoma lam'mimba m'chigawo chakhudzidwa. Gastroscopy iyenera kuchitidwa mosamala kwambiri, chifukwa ndi phlegmon yam'mimba, kutsitsimuka kwa khoma ndi chida kumatha kuchitika mosavuta pomwe m'mimba mutatambasuka ndi mpweya.

Kuwonongeka kwa laparosopic ya phlegmon yam'mimba koyamba gawo limazindikira kuchuluka kwa omentum m'mimba, pakhoza kukhala ma fibrinous amana mu omentum. M'mimba muli hyperemic m'dera lomwe lakhudzidwa, lotupa, lophimbidwa ndi fibrin. Ndi kukula kwa matendawo, serous exudate imayamba kuwonekera pamimba, kenako purulent.

Kuzindikira kumakhala kovuta, chifukwa matendawa ndi osowa, ndipo zizindikiro zake ndizofanana ndi matenda ena am'mimba am'mimbamo: chilonda cham'mimba cham'mimba kapena chilonda cha duodenal, cholecystitis ya pachimake, pancreatitis yacute, gastroenteritis. Ndi zovuta za peritonitis, kuzindikira kwa gastric phlegmon kumakhala kovuta kwambiri kukhazikitsa. Kuunika kwa endoscopic kapena laparoscopy kungathandize ndi matendawa.

Poyambirira kwamatenda, kuzindikira komwe kumatheka kokha ndi kufufuza kwa endoscopic, mutha kudziletsa kuti muchepetse chithandizo chamankhwala: othandizira opaleshoni, chithandizo chamankhwala osokoneza bongo komanso chidziwitso, kudya, komanso kupenya kwamphamvu.

Mankhwala opaleshoni akuwonetsa pang'onopang'ono matendawo, komanso osagwiritsa ntchito mosamala mankhwala amtundu wamatumbo a phlegmon. Ndi phlegmon yachiwiri yam'mimba, ndikofunikira kuchitira mwachangu matenda omwe amayambitsa. Opaleshoniyo ikangoyamba kuchitika, zimakhala bwino zotsatira zake.

Zochitika zambiri za phlegmon m'mimba: kukhazikika kwake mkati mwa minofu yathanzi, gastrostomy, kukhetsa kwam'mimba. Kuchuluka kwa maopareshoni kumatengera momwe wodwalayo alili, kakulidwe ndi mtundu wa zochita zake (zochepa, zofala), zovuta. Kulowerera koyenera ndi kupatsanso kwa m'mimba, komwe kumatha kuchitika popanda zovuta komanso zovuta zomwe wodwala akuchita.

Ngakhale ndi opaleshoni iyi, zotupa zam'mimba, zotupa za khoma la m'mimba zimangofunika osati njira yayikulu yochitira opaleshoni, komanso njira yoyenera ndi zida. Mikhalidwe ya peritonitis, njira yofala, ndizothandiza kwambiri kudzipatula kuti gastroenteroanastomosis kapena gastrostomy molumikizana ndi notches khoma lam'mimba mpaka minofu, chithandizo chakhoma ndi antiseptics, kugwa ndi njira zoteteza ku mankhwalawa ndikutha kugwira ntchito ndi kutulutsa kwa m'mimba.

Chapamwamba chapakati chikutseguka m'mimba. Ndi phlegmon, yokhudza gawo la m'mimba, kuyambiranso kumachitika. Ndi kuwonongeka kwathunthu kwa chiwalo, ngati gastenessomy singathe kuchitika chifukwa cha kuopsa kwa vuto la wodwalayo, opaleshoniyo imakhudza kutulutsa kwam'mimbamo poyambitsa machubu am'madzi ndikuchepetsa ma tampon. Kudzera pang'onopang'ono kumanzere kwa hypochondrium, kukhetsa kumachitika ndikutseguka kosiyanasiyana kwadongosolo lamanzere mpaka pansi pamimba.

Kutsitsa kwachiwiri ndi tampon kumachitika kudzera mu kuwoneka bwino mu hypochondrium ndikuwatsogolera kudutsa gawo laling'ono kupita ku omentum yaying'ono. Thumba lachitatu loyikira limatengedwa m'thumba lodzikongoletsa kudzera potsegula m'mimba; m'matumbo limatsitsidwa kukhoma lam'mimba ndipo limatulutsidwa. Opaleshoniyo imatsirizidwa ndikuyambitsa kafukufuku wokhazikika m'mimba.

Ndi phlegmon yam'mimba, yovuta ndi puritis peritonitis, yopanda matenda, matenda a laparostomy amapangidwa ndi kuyeretsa kwapang'onopang'ono kwa m'mimba.

Mu nthawi yogwira ntchito, chithandizo chachikulu cha antiotic, detoxification mankhwala, peritoneal dialysis, mtima ndi chizindikiro othandizira amasonyezedwa. Kuyambira masiku oyamba, ndikofunikira kumenya nkhondo molimba ndi m'matumbo. Detoxification chithandizo chimaphatikizapo kukakamiza diuresis, njira zina zakunja zochotsera, kukonza kwa volemic, mapuloteni, kusokonezeka kwa elekitirodi. Immunotherapy imakhala m'malo ofunika - kugwiritsa ntchito ma immunoglobulins, pentaglobin, sandobulin, ndi gabriglobin.

Mankhwalawa peritonitis, anakonza ukhondo wam'mimba kudzera laparostomy ntchito, ntchito yolankhulidwa neculaniomy, kutsuka m'mimba ndi ziwopsezo antiseptic. Mimba imatsukidwa kudzera pofupipika kosasintha 1-2 patsiku ndi yankho la 1-2% ya sodium bicarbonate kuti madzi oyera.

Kuyambira masiku oyamba, matumbo amayenda.

Mwa zovuta za chapamimba phlegmon, puritis peritonitis, sepsis, kufooka kwa ziwalo, zomwe zimapangitsa kuti wodwalayo afe.

Kukula kwake kumadalira pamlingo womwe wodwalayo ali nawo, kuchuluka kwa wodwalayo, kuchuluka kwake komanso kuthamanga kwa matendawa, kuledzera kwa mtima, zovuta, ndipo, pamapeto pake, pa nthawi yodziwika bwino wodwalayo komanso momwe amathandizira wodwalayo. Matenda a gastric phlegmon ndi osavomerezeka, kumwalira kuli kwakukulu.

Mimba phlegmon

Mimba phlegmon - pachimake purulent kutupa kwamatumbo khoma. Matendawa ndi osowa, amawonedwa makamaka ali ndi zaka 35-55 zaka moyenera nthawi zambiri mwa abambo ndi amayi, komanso amapezeka mwa ana a miyezi iwiri ndi okulirapo. Pestgmon wamkati amatha kukhala woyamba kapena wachiwiri (metastatic kapena kulumikizana).

The etiology ndi pathogenesis ya phlegmon yoyamba sichidziwika bwinobwino. Omwe amathandizira matendawa ndi E. coli, staphylococci, ochepera streptococcus. Matenda otupa, ziwalo zakunja, kuwukira kwa helminthic, kusokonezeka kwamagazi m'matumbo a mesentery chifukwa cha matenda omatira, cirrhosis ingayambitse matumbo a phlegmon. Nthawi zina, phlegmon ndi zovuta za enteritis ndi colitis.

Nthawi zambiri, matumbo phlegmon amapangidwira pang'onopang'ono mu terminal ileum ndi pambuyo pake imafalikira ku lonseum ndi jejunum. Nthawi zina njira yotupa imatha kugwira kolulu: yakhungu, ikukwera, imayenda mosinthana, ikatsika ndi sigmoid. Kukula kwa kutupa kumatha kusiyanasiyana: kutalika pang'ono mpaka mita kapena kuposerapo, ndipo mwina zotupa zamatumbo.

Kutupa kovuta kumayambira mu gawo la submucosal ndikufalikira limodzi ndi m'matumbo ndikukula konse kwa khoma lake. Kufalikira kwa kutukusira kwa peritoneum kumatha kuyambitsa kukonzekera kwamatumbo. Kutupa kumalowa kwambiri kumapangitsa kuti matumbo asamayende bwino chifukwa cha kutayika kwa minyewa yakumaso. Chakumapeto, pamene matumbo a paresis amalumikizana ndi kutupa, mawonekedwe a m'mimba amatuluka kwambiri.

Ndi matumbo phlegmon, osati chotupa chathunthu cham'mimba chimachitika, koma kusinthana kwa malo omwe akhudzidwa ndi osasinthika. Poyerekeza ndi kuphipha ndi matumbo kulowa, gawo lakuthwa la serous chivundikiro limatsimikiza. Angapo petechiae amawoneka pansi pa mucous membrane. Pambuyo pake, nembanemba ya serous ya m'matumbo imakutidwa ndi zolembera za fibrinous.

Kupereka magazi kwa m'matumbo kuchokera ku ziwiya zama mesentery kumasungidwa, ngakhale vasodilation imadziwika motsutsana ndi maziko a edema ya mesentery. Ma lymph mazu muzu wa mesentery akhoza kuchuluka. Mtsogolomo, chifukwa cha kutupa komwe kumachitika m'matumbo, mumakhala njira yomatira, pomwe matumbo angapo am'matumbo amatenga mbali ndikupanga matumbo ndi matumbo a matumbo.

Zachipatala maphunziro ndi matenda

Matendawa amayamba mwadzidzidzi ndi ululu wam'mimba, kutentha thupi kwa manambala. Ndi chitukuko cha matumbo phlegmon, ambiri mawonekedwe a wodwalayo amakhala ndi vuto lalikulu. Kuda nkhawa ndi kupweteka kwam'mimba (kutulutsa ululu kumatha kusiyanasiyana), kufooka, kutentha thupi mpaka 39-40 ° C, kutopa kwambiri, nseru, kusanza. Chithunzi chachipatala cha pamimba pamimba chikukula pang'onopang'ono. Lilime limakutidwa ndi zoyera kapena imvi. M'mimba simupuma mokwanira;

Ululu umatsimikizika malinga ndi kufalikira kwa phlegmon m'matumbo. Nthawi zina mumatha kumva kupyola m'mimba, kufewa, kusalala, kupweteka m'mimba. Ndi kukula kwa matendawa, zizindikiro za m'matumbo zimawonekera: lilime lakhala louma, lotsekemera, m'mimba limatupa, silitenga mbali popumira, limakhala lokhazikika, popanda kudziwitsidwa kwachidziwikire kupweteka, zizindikiro za kupsinjika kwakhungu kumawonekera. Pakhoza kuchepetsedwa chopondapo ndi mpweya, nthawi zina kutsegula m'mimba. Vutoli limakulirakulira kwambiri pamene kuledzera kwa purulent kumawonjezeka.

Mu pachimake matenda, leukocytosis, kuchuluka kwa ESR, kusintha kosangalatsa kwa leukocyte formula kumanzere.

Ndi chithunzi chotchulidwa cha purulent peritonitis popanda chifukwa komanso chizindikiritso chokwanira cha opaleshoni, phlegmon yamatumbo imatha kukhala chochita. M'matumbo am'mimba, kumatulutsa magazi kapena kumayambitsa magazi, matumbo omwe akhudzidwa ndi otupa, kukulitsidwa, khoma lake limakhala lakumaso, lolimba kapena lokhazikika. Pa serous nembanemba wamatumbo fibrinous wokulirapo.

Mu mawonekedwe a phlegmon yamatumbo, zochitika za kutupa sizinafotokozedwe bwino, zotupa zimasokonezeka pang'ono, kutentha sikuwonjezeka, koma zochitika zamatumbo stenosis komanso kukula kwa matenda omatira.

Pachimake matumbo phlegmon ayenera kusiyanitsidwa ndi pachimake yotupa matenda am'mimba: pachimake appendicitis, pachimake cholecystitis, pachimake kapamba, kuchuluka kwa peptic ulcer m'mimba ndi duodenum, pachimake kutupa kwa chiberekero.

Matumbo phlegmon ayenera kusiyanitsidwa ndi chotupa, chifuwa chachikulu, colitis, gastritis, kutukusira kwa chiberekero, chifuwa cham'mimba, actinomycosis, lymphogranulomatosis, appendicular kulowetsedwa. Matenda ochuluka chotere (omwe amakhala ndi matumbo osawoneka bwino), kusapezeka kwa matendawa kumathandizira kudziwa komwe kumapezeka. Kuzindikira koyenera kumakhazikitsidwa pokhapokha pakuchita opareshoni.

Njira zapadera zofufuzira, ultrasound, CT, kuthekera kwake komwe kumachepetsedwa ndi matumbo paresis, kuchuluka kwa mpweya, mwanjira zina zimapangitsa kuwonetsa kukula kwa khoma lamatumbo, nthawi zina kufika 2 cm, hypoechoicity, ndi kuchepa kwa peristalsis m'malo ena. Kusintha kwa CT pankhaniyi ndikokwera kuposa ultrasound.

Mu nthawi yayitali ya matendawa, kupenda matumbo a X-ray ndikotheka. Pankhaniyi, chilema chodzaza ndi mawonekedwe osalala, omveka amatsimikiziridwa, omwe amachepetsa lumen yam'mimba. Kudzaza zolakwika kumatha kupezeka m'malo angapo a matumbo. Kuzindikira kumathandizidwa ndi kuyesedwa kwa laparoscopic, komwe m'mimba mumakhala kupindika, gawo logundika lamatumbo lomwe limakhala ndi hyperemia, hemorrhages ndi kuwonekera kwa fibrinous.

Mwa zovuta za matumbo phlegmon, purulent peritonitis, mapangidwe amatumbo ndi fistulas, matumbo kutsekeka, matenda omatira amadziwika.

Mitundu ya mitundu ndi zomwe zimayambitsa kupezeka

Mitundu ya mitundu ndi zomwe zimayambitsa kupezeka
Zizindikiro ndi kuwonetsa matendawa
Chithandizo cha matenda

Ma purulent formations omwe amapezeka pamimba pamimba, gastroenterologists agawidwa mu intraperitoneal (intraperitoneal), retroperitoneal (retroperitoneal), visceral (intraorgan, intraorgan).

Kapangidwe ka magulu awiri oyamba amapezeka m'matumba amtundu ndi matumba pamimba zam'mimba komanso m'malo amtundu wa retroperitoneal fiber.

Mitsempha yamkati mwazinthu zam'mimba zimapezeka mkati mwa khoma la ziwalo zamkati. Mwachitsanzo, mu parenchyma ya kapamba, hepatic lobes.

Mphamvu ya pulasitiki ya khoma lam'mimba imathandizira kuchepetsa kutupa. Papugenic pologenic imapangidwa pang'onopang'ono, yomwe imalepheretsa kufalikira kwa mafinya.

Maphunziro ndi malo amagawidwa m'magulu atatu:

chidziwitso - zimaphatikizira, ma pentic, paracole, subphrenic ndi omwe ali kumanja kapena kumanzere kwamanzere,
retroperitoneal - perinephral, kapamba,
visceral - splenic, hepatic.

Chomwe chimayambira ndi:

zododometsa
postoperative
metastatic
mafuta.

Ma microorgan tizilombo otsatirawa amatenga nawo gawo limodzi pakupanga kutupa:

matumbo microflora,
aerobic gram-negative bacilli,
mayanjano ocheperako,
kuwukira kwa amoebic,
bowa
streptococci,
staphylococci.

Kutupa kwa m'mimba kumatha kupanga pambuyo pa opaleshoni, kuvulala kwam'mimba, matenda, komanso pambuyo popanga mafuta a makhoma a ziwalo ndi zotupa zomwe zimachitika mu rad.

Matenda angalowe m'matumbo am'mimba mutatuluka matumbo kapena chofufumitsa cham'mimba.

Kusunthira mbali zosiyanasiyana, mabakiteriya amapanga mawonekedwe a kutupa m'malo osiyanasiyana am'mimba. Mwachitsanzo, mtundu wa absphrenic.

Pambuyo owononga appendicitis, kufalikira kwa chilonda cham'mimba kapena m'mimba, mawonekedwe amimba.

Purulent peritonitis, yomwe wodwala akadadwalapo kale, imatsoganso ku ichi. Nthawi zambiri, mapangidwe ake amawoneka mwezi umodzi atadwala.

Zizindikiro za matendawa ndizosiyana, kutengera kukula kwa chikho ndi komwe ukupezeka. Kupweteka kumamveka pansipa kumbuyo, kugwedeza miyendo kumalimbitsa.

Chotupa chikhoza kupezeka pambuyo pa mankhwala otupa a ziwalo zoberekera za akazi (adnexitis, parametritis, salpingitis pachimake ndi ena).

Ma Enzymes omwe amagwiritsa ntchito ma fayilo ozungulira kapamba amapanga njira yotupa pamaso pa kapamba.

Pachimake cholecystitis nthawi zina zimapangitsa kuti pakhale chifuwa pamimba.

Mapangidwe awa nthawi zambiri amakhala ndi maluwa a polymicrobial pyogenic, omwe amaphatikiza onse aerobic ndi anaerobic mabungwe a michere.

Zizindikiro ndi kuwonetsa matendawa

Mitundu yonse ya abscess kumayambiriro kwa matendawa imakhala ndi zofananira:

kuledzera
kuzizira
kutentha kuwonjezeka
malungo
kugunda kwa mtima komanso kugunda kwa mtima
minofu yam'mimba yovuta
kusowa kwa chakudya
nseru
kudzimbidwa
ngati mapangidwewo ali pafupi ndi chikhodzodzo, ndiye kuti pamakhala kukakamiza pafupipafupi kukodza.

Palpation imatha kudziwa kutulutsa magazi pakubuka. Ma subphrenic abscesses amadziwika bwino, ndipo kuchuluka kwa minyewa yam'mimba kumawonetsa kupangika kwa minofu ya mesogastric.

Ululu pansi pa nthiti, mpaka kufikira phewa komanso scapular dera, umachitika ndi chimbudzi cha subphrenic.

Zizindikiro za kapisozi ya mafinya m'dera la m'chiuno chimaphatikizanso kukodza pafupipafupi, kupweteka kwam'mimba, komanso kupweteka m'matumbo. Retroperitoneal abscess imadziwika ndi kupweteka kumbuyo.

Ndi matenda omwe amapezeka m'malo a Douglas, odwala amamva kupanikizika komanso kulemera. Zitatha izi, colic imachitika m'mimba yotsika, malungo amayamba.

Mitundu yamatumbo amtundu wa abscess imadziwika ndi kupweteka kwapang'onopang'ono komwe kulibe kutengera kwina, kutengeka.

Pakufufuza koyambirira, wochiritsirayo ayenera kuyang'anitsitsa mawonekedwe omwe akukakamizidwa ndi wodwalayo kuti achepetse kupweteka: kugwada, kugona kumbuyo kwake, mbali yake ndi ena.

Dokotalayo amasanthula lilime ndi kutulutsa m'mimba. Izi zimamupangitsa kuti azindikire malo opweteka omwe angafanane ndi komwe kuli chikopacho (m'chiuno, pansi pa nthiti, ndi zina).

Kuyesereranso kwakunja kwa thupi ndikofunikanso, chifukwa chofukizira cham'mimba chokhazikika pachifuwa, kusuntha nthiti.

Kuti mudziwe matenda ake, wodwalayo ayenera kudutsa mayeso angapo:

magazi zamankhwala
kuyezetsa magazi konse
urinalysis
biomaterial pakufesa kwa bakiteriya.

Ngati deta yomwe yasungidwa sinakwanire, dokotala amatumiza wodwalayo kuti amupimenso.

Zotupa zotsalazo zikuthandizira kudziwa kuyang'ana kwam'mimba kwa m'mimba.

Kugwiritsa ntchito fistulography, irrigoscopy, X-ray ya m'mimba ndi njira yotsutsana ndi yomwe imatsimikiza kuchuluka kwa mayendedwe am'mimba ndi matumbo ndi kulowetsedwa. Kuyesera kopindulitsa kwambiri kwa ultrasound.

Kuyesedwa kwa odwala omwe ali ndi abscess kumachokera pa ntchito:

Kuyesa kwa X-ray,
Ultrasound
CT
kuwunika kwa wailesi.

Pamene chimbudzi chikupezeka pafupi ndi diaphragm, pleural effusion, kuchepa kuyenda komanso malo apamwamba amkati mwa minofu ya diaphragm ndi zizindikiro zina zitha kuchitika.

Zomwe zimayambitsa puranc pancreatitis

Poganizira milandu yonse ya odwala omwe ali ndi vuto lalikulu, 10-15% imayikidwa kuti ipangitse zovuta za purulent. Izi zikutanthauza kuti odwala 10 aliwonse amakhala ndi puranc pancreatitis. Kulowerera mkatikati mwa kapamba sikokwanira kungoipitsa zinthuzo kukhala ndi zotsatirapo zoyipa, kuphatikiza pazinthu zambiri ndikofunikira. Kuphwanya kapangidwe ka misempha, mitsempha yamagazi, kapamba ka mucosa kumayambitsa kutupa. Kukula kwa izi kumayendera limodzi ndi zifukwa zingapo:

kumwa kwambiri mowa (uchidakwa),
kuyamwa nthawi yayitali ndi zinthu zoopsa,
matenda oyamba ndi bakiteriya
miyala yamiyendo ndi chikhodzodzo,
zam'mimba ziwalo zam'mimba (zilonda zam'mimba, kutupa kwa membrane wa duodenal),
zotsatira zoyipa kuchokera pakumwa mankhwala omwe amasokoneza ntchito ya kapamba,
Zotsatira za opareshoni
zotsatira zavulala pancreatic,
appendicitis
cholowa.

Chiwalo chathanzi chimapanga ma enzymes osagwira, osuntha m'migawo yamagaya omwe adayambitsa. Ndi kapamba, ma enzyme amayamba kugwira ntchito kapamba, kuwononga makhoma ake. Mchitidwewo umakulitsidwa ndi zinthu zambiri zowonjezera ndipo njira yodontha yotupa imakhudzidwa ndi kuwonongeka kwa ma ducts, mitsempha yamagazi, mawonekedwe a pustular foci.

Kugwira ntchito koyenera kwa chiwalo sikumalephera, kutupa kumatha kupita ku ziwalo zam'mimba. Kutupa kwa purulent, kulowa m'magazi, m'mimba pachifuwa chiphe thupi, kusokoneza kugwira ntchito kwa ziwalo zofunika.

Chithandizo cha matenda

Chofunika pochizira matendawa ndi chipatala.

Wodwala yemwe wapezeka ndi puranc pitisreatitis ayenera kuyikidwa kuchipatala moyang'aniridwa ndi madokotala nthawi zonse. Gawo lamatenda la matenda limachitika pansi pa mawuwo - ozizira, anjala, odekha.

Pogona ponsepo chifukwa cha wodwalayo, chotupa cha m'mimba ndi madzi ozizira, ndi kugwiritsa ntchito ayezi pamimba kumayambitsa kuchepa kwa kutupa. Njala yathunthu imatheka chifukwa choletsa kupanga ma enzyme, chifukwa - kuchepetsa ululu. Kuti mulimbikitse izi, jakisoni wa anesthetics (papaverine, no-spa) ndi mankhwala omwe amachepetsa kupanga ma enzyme (almagel, trasilol), diuretics amachepetsa edema.

Mu pachimake nthawi matenda, limodzi ndi kukha magazi, kuwonjezera pa zikondamoyo, amafunika opaleshoni. Maluso osankhidwa moyenera amatha kuthetsa kuledzera, kupewa kuchepa kwa madzi m'thupi, komanso kulepheretsa chithokomiro chonse. Kuthandizira pakuchita opaleshoni sikungachitike ngati wodwalayo akudwala komanso kuti atulukemo.

Opaleshoni yomwe imakuthandizani kuti muchepetse kuwola kwa makoma a mucosa amatchedwa laparatomy. Kulowa m'matumbo, moyang'aniridwa ndi zida zonse, dokotala amawona malo omwe amatuluka ndikuwachotsa. Nthawi yomweyo, kuyesedwa kwa ndulu kumachitika, ndipo malinga ndi mkhalidwe wake, chisankho chimapangidwa (kuchotsa kapena kukhetsa).

Zotsatira zamatenda

Kukula kwa purulent-necrotic njira mu patsekeke lachiberekero motsutsana ndi matenda opatsirana kapena ma virus kumachitika chifukwa cholowerera kwa tizilombo toyambitsa matenda m'thupi lathu kudzera ma ducts a bile, omwe amachititsa kuti minyewa yake ikhale yotupa.

Kulowa kwa gland kumatha kuthandizira kukulitsa purulent foci, yomwe pakapita nthawi imakhala yokulirapo ndipo, pamapeto, imatha kuphulika. Izi zimapereka kufalikira kwakanthawi kwamphamvu kwa ziwalo zoberekera ndi ziwalo zina zapafupi, kuonetsetsa kuti zakumwa zoledzeretsa zipezeka mwachangu.

Zikatero, mwayi woti munthu akhoza kufa ndi wofanana ndi 100 peresenti.

Njira zovuta za purulent-necrotic mu chiwalo cha parenchymal zimatchedwa pancreatic phlegmon. Phlegmon imakulanso mothandizidwa ndi tizilombo toyambitsa matenda, motsutsana ndi maziko a njira za necrotic zomwe zimayambika ntchito ya pancreatic enzymes itayambika. Zonsezi zimatha kuyambitsa kusasinthika kwa magwiridwe antchito ndi ziwalo zina zamkati, zomwe popanda chithandizo choyenera zidzatsogolera kuimfa ya wodwalayo. Chifukwa chake, ndikofunikira kulabadira zonse zomwe zikuwonetsa kuwonongeka kwa chida cha parenchymal.

Chizindikiro chachikulu cha puranc pitisreatitis

Kukula kwa chikumba kumatha kuthandizira kuwonetsedwa kwa zizindikiro zambiri, monga:

kumverera kokhazikika kwa mseru
kusanza pafupipafupi komwe sikubweretsa mpumulo
kusowa kwa chakudya, mpaka kutha kwathunthu,
kutulutsa m'mimba.

Ndikofunika kudziwa kuti kukula kwa kufooka kwa ziwalozi m'matumbo a gland kumathandizira kuwonda kwambiri chifukwa cha zovuta zomwe zimagwira ntchito ndi ziwalo zina zam'mimba.

Komanso, zizindikiro za chifuwa cha pancreatic zitha kuonekera motere:

kuwoneka kwa zopweteka zowawa mdera la epigastric,
kuchuluka kwamtima,
kumverera kozizira motsutsana ndi kutentha kwa thupi kwakweza kwa wodwalayo,
kupuma kwambiri
kutsika kwa magazi,
chopondapo chopindika ndi kukula kwa kutsegula m'mimba kapena kudzimbidwa,
kukulira kwa thanzi la wodwalayo.

Ndi pancreatitis ya puritive mawonekedwe a maphunzirowo, wodwalayo amakhala wosasangalala, ngakhale munthawi yakusowa kwathunthu kwa ululu wa epigastric. Izi zamatsenga zimakoka mphamvu ndi mphamvu zonse za wodwala. Ndi kuyenda kwakanthawi kwamthupi, kapena kutsokomola, kumva kupweteka kwambiri.

Asayansi azachipatala, kutengera maphunziro, akuti kupangika kwa chithupsa, nthawi zambiri, kumayamba pakadutsa masabata awiri ndi atatu, pambuyo poti chiwopsezo cha matenda a chamba.

Ndipo chisonyezo choyambirira cha mawonekedwe amtundu wa purancreatic matenda amachitika ndikumva kupweteka kwapakati kwa dera la epigastric ndikubwerera kudera lodzaza kumbuyo. Chisoni chimatha kukhala ndikuwonetseratu kwakukulu kotero kuti odwala nthawi zambiri sangathe kupirira ndi kutaya chikumbumtima chotsutsana ndi maziko a mapangidwe a kupweteka.

Magawo olimbikira a chikondacho amadziwika ndi mawonekedwe a pakhungu lanu m'chigawo cha umbilical komanso pamimba pamalo amdima kapena burgundy. Nthawi zina, mawonetsedwe oterewa amatha kuchitika kumbali zam'mimba.

Njira Zodziwitsira

Kuzindikiritsa kukula kwa abscess ndikotheka pambuyo pazotsatira zingapo za njira zodziwira matenda. Gawo loyamba ndikupita kukayezetsa magazi kuchipatala mwatsatanetsatane komanso mwakuwunika mwatsatanetsatane, komanso urinalysis ndi njira ya X-ray ya ziwalo zonse zomwe zili m'mitsempha ya peritoneal.

Nthawi zina, njira zowonjezerapo zofufuzira zitha kufunikira kuti mutsimikizire kuti mwazindikira. Zikatero, wodwalayo amatumizidwa kuti akafufuze, ndipo pambuyo pake dokotalayo amatha kudziwa malo a zotupa za purative kapena kutulutsa kwa cystic.

Kuphatikiza apo, njira yoyeserera ya laparoscopic ingagwiritsidwe ntchito kuzindikira gawo la kukula, mtundu ndi kuuma kwa matenda, popanda kugwiritsa ntchito opaleshoni.

Pali nthawi zina pamene matenda a abscess amakhala ovuta kwambiri, chifukwa chamankhwala omwe wodwala amupeza kuti athandizidwe kuchipatala. Pa magawo oyambilira a chitukuko cha matenda a matenda, kupezeka kwathunthu kwathunthu kumatha kuchitika machitidwe wamba.

Muvuto lalikulu, kupezeka kwa purulent pancreatitis kumachitika mu gastroenterological kapena kwachipatala chosamalitsa, chomwe chimapulumutsa wodwalayo kuimfa.

Njira zochizira

Njira zothandizira zochizira pancreatitis ndi abscess zimachitika pokhapokha wodwala akagonekedwa m'chipatala, moyang'aniridwa ndi akatswiri odziwa bwino komanso oyenerera. Mfundo zachithandizo ndi kugwiritsa ntchito njala, kuzizira komanso kupumula. Zidazi zimatha kuchepetsa kutukusira ndikupangitsa matendawa kugwira ntchito.

Chithandizo cha kathumba kamakhala ndikuchita njira zoyeretsa zam'mimba pogwiritsa ntchito madzi ozizira, komanso kupuma kwathunthu.

Kuti tichotse zizindikiro zina zodziwika bwino za matenda ndi kuthetsa njira yotupa, odwala amalimbikitsidwa kuyika kuzizira kwa kapamba. Komanso, padera pali mowa wina wamchere womwe umatha kugwiritsidwa ntchito ngati mchere wopanda madzi, komanso zakudya zamafuta.

Aofatsa mawonekedwe a purulent matenda amathandizira poika ma dontho okhala ndi ma pinkiller ndi okodzetsa ofunikira kuti muchepetse kutupa. Zomwe zimathandizira kupweteka kwambiri ndi Heparin ndi Novocaine, ndipo mwa mankhwala omwe amachepetsa chinsinsi cha gland, Almagel, Trasilol ndi Rinisan ndi othandiza kwambiri.

Mitundu ikuluikulu ya chikopa, limodzi ndi zotupa ndi mapangidwe a chotupa chachikulu cha kapamba, imafunikira opaleshoni yofunikira. Kutsutsana ndi njira yamtunduwu ya mankhwala kumatha kukhala vuto lalikulu kwambiri la munthu komanso kuthekera kokufa asanathe opareshoni.

Njira imodzi yamakono yopangira opaleshoni ya pancreatic ndi kulowerera kwa laparatomic, komwe, ndikupanga kabowo kakang'ono pamimba, amakulolani kuti mufike pachilondacho ndikuchotsa popanda kudula m'mimba. Njira ya opaleshoni imeneyi imayendetsedwa pogwiritsa ntchito zida zapadera, zomwe nthawi imodzimodzi zimayendetsa bwino ntchito yonse yogwira ntchito.

Kukula kwa purulent pancreatitis ndi matenda oopsa kwambiri, chifukwa zovuta zake sizigwirizana ndi moyo wa munthu. Chifukwa chake, kupezeka kokha kwakanthawi kovomerezeka ndi chithandizo choyenera kungathandize kupewa zovuta komanso kupulumutsa wodwala.

Zomwe zilonda zam'mimba zimachitika ndi kutupa kwa kapamba

Zomwe zimapangitsa kuti mafinya odzaza mafinya apangidwe mu kapamba sizimamveka bwino. Akatswiri akukhulupirira kuti chachikulu pakukula kwa kathumba ikhoza kukhala:

Matenda akunja
Kuchotsera kopanda phindu kwa mutu wa pseudocyst,
Maonekedwe a fistula wopezeka pakati pa chotupa ndi matumbo,
Chithandizo cholakwika cha kapamba kapena kutha msanga kwambiri.

Malinga ndi ziwerengero, nthawi yayikulu ikamabzala mafinya ndi chimbudzi, mabakiteriya ndi coli omwe amayambitsa matenda am'mimba amapezeka. Ngati odwala ali ndi pancreatic necrosis, kuthekera kwakukulu kwachiwiri kumayambitsa kupweteka kwam'mimba. Ali pachiwopsezo ndipo amayesedwa mosamalitsa.

Ponena za kapangidwe ka khosalo, ndizomveka. Pambuyo povulazidwa kwambiri, minofu yam'mimba imayamba kuwonongeka pang'ono.

Ma enzyme osaphatikizika amakhudza mbali yakumaso ndi ziwalo zozungulira, akumawononga. Izi zimabweretsa kukula kwa ma pseudocysts kapena kukula kwa kapamba ka necosis, komwe ndiko maziko a kakulidwe ka m'mimba mwa purulent. Ngati matenda alowa mwa iwo, amathandizira kukulitsa kwakukulu f puroses, kapena kumakwiyitsa. Phlegmon malinga ndi dongosolo la masanjidwe a ICD amatchulira matenda oopsa kwambiri omwe ali ndi vuto labwino, komabe, ndiwofanana kwambiri ndi kathumba, kofotokozedwa kamodzi. Chifukwa chake, odwala omwe ali ndi abscesses, madokotala ayenera kupenda mosamala momwe angathere kupezeka kwa phlegmon mwa iwo.

Njira zopewera kupewa pancreatic abscesses

Popeza zomwe zimayambitsa zenizeni za kupezeka kwa ma pancreatic abscesses pambuyo povulaza kwambiri kapamba kapena chifukwa cha kukokoloka kwa pancreatic sikunafotokozedwe bwino, palibe mndandanda weniweni ndi kupewa kwawo. Madokotala amalimbikitsa kuti achitepo kanthu popewa kukula kwa matenda amenewa, chifukwa milomo ya purulent imangopanga maziko awo. Kuti muchite izi:

Siyani zizolowezi zoyipa,
Osamadya kwambiri, chifukwa kunenepa kwambiri kumachulukitsa matenda.
Onaninso pafupipafupi ngati pali anthu ena m'banjamo omwe ali ndi matenda a kapamba kapena matenda a ndulu.

Ngati munthu wadwala kale matendawa, ayenera kutsatira kwambiri zakudya, kuchotseratu mowa, shuga, shuga ndi mafuta onunkhira. Kutalika kwake kumatengera kutha kwa matendawa komanso kutalika kwa matendawa.Nthawi yomweyo, chakudyacho chikuyenera kukhala ndi zakudya zomwe zimakhala ndi mapuloteni ambiri, masamba ndi zipatso zambiri za carotene, Vitamini C. Simungadye nyama yokazinga, yosuta, zopangidwa ndi ufa wa tirigu wonse. Ndikofunikira kupewa mbale zokhala ndi fiber yambiri yazomera, chifukwa zimapangitsa kupanga mahomoni omwe amakhudza kapamba.

Ponena za kunenedweratu kwa matenda monga chomera, ndi osamveka - popanda kuchitapo kanthu opaleshoni, zotsatira zake zidzakhala zakupha. Ngati zidachitika munthawi yake komanso mwaukadaulo, chithandizo chotsatira chidachitika molondola komanso molimbika, mwayi wochira umawonjezeka kwambiri. Zitha kukhala zokwanira ngati simukunyalanyaza malingaliro a madokotala, yang'anirani thanzi lanu ndipo osayika thupi lanu mopitirira muyeso. Chachikulu cha machiritso athunthu ndikufunafuna thandizo posachedwa, osadikirira kuwonongeka.

Zambiri zokhudzana ndi kapamba zimaperekedwa mu kanema munkhaniyi.

Njira zopewera

Purulent pancreatitis amatanthauza matenda omwe ndi osavuta kupewa kuposa kuchiritsa. Kuwona njira zochepetsera zovuta, mutha kupewa mavuto ndi kapamba:

Health kuwunika, munthawi yake matenda a m'mimba thirakiti. Kukhazikika kwa zizindikiro zoyambirira kumafuna upangiri waluso.
Chithandizo cholondola, chothandiza cha matenda malinga ndi malangizo a akatswiri.
Mowa kwambiri, mowa, kusuta ndi mdani wa moyo wathanzi, abwenzi am'matumbo. Kutsatira zakudya, kudya zakudya zoyenera kumathandiza kupewa matenda kapena kupewa matenda obwera chifukwa cha matenda am'mimba.

Zowopsa za matendawa

Kuzindikira koyenera ndi moyo wopulumutsidwa wa munthu.

Zotsatira za matendawa ndi zazikulu. Kugudubuzika kwa makoma a kapamba kumapangitsa kuti magaziwo aziwonekera ndipo amapanga michere, yomwe imayambitsa poizoni m'thupi. Kulowa m'mimba komanso kupweteka kwambiri kumamuchititsa wodwalayo kukhumudwa. Poizoni wa m'thupi samadutsa popanda kutsatira. Zimapatsa kulephera kwa aimpso, jaundice, mapapu.

Zowonjezera michere yotulutsa imakhudza m'mimba. Zotsatira zake ndi zovuta za peritonitis. Ndikofunika, mukapezeka, kusiya zakumwa zoledzeretsa konse. Kumwa mowa woopsa ndi puranc pitisreatitis yowirikiza kawiri kumwalira. Poizoni owopsa wa thupi ndi poizoni kuphatikiza ndi zovuta za purulent umawonjezera ngozi yakufa. Kukula kwakanthawi kwa zovuta (sepsis, abscess, phlegmon) kumapangitsa kuti chiyembekezo chizichira.

Zakudya za puranc pitisreatitis

Munthawi ya chithandizo, onetsetsani kuti mwatsata zakudya.

Kuthana ndi zakudya zapadera zamankhwala othandizira othandizira odwala

Chofunika kwambiri ndikusapezeka kwa mowa uliwonse.
Kukana kwathunthu chakudya pakachulukitsa matenda.
Zakudya zochepa zama calorie, zakudya zoyenera panthawi yachikhululukiro. Chakudya chimatengedwa m'magawo ochepa 5-6 patsiku.
Onetsetsani kuti mumamwa zochuluka. Patsiku lomwe wodwalayo amamwa pafupifupi malita 1.5 amadzi (tiyi wobiriwira, mchere wopanda mchere, msuzi wa rosehip).
Zopanga zazikuluzikulu za wodwala ndi masamba. Yophika, yaiwisi, yophika, masamba otentha yomwe ili ndi mavitamini, ofunikira kufufuza ndikuwabwezeretsa kusokonekera kwa pancreatic.
Kuletsa kusuta, kukazinga, ufa, shuga.