Appendicitis: matenda ndi mankhwala. Masiyanidwe matenda a appendicitis pachimake

Kutupa zakumapeto - matenda ambiri a ife tikudziwa ndi zongomva. Mwa zizindikiro zimene Milomo aliyense - kupweteka kwambiri m'mimba. Komabe zomvetsera ululu symptomatology cha matenda si. Ndipo sizingakhale pa nthawi imene appendicitis amapezeka munthu wachikulire, ululu ndi. A nthawi zofunika kwambiri kumvetsera kwa zizindikiro zina appendicitis nokha kapena munthu wokondedwa ndipo pomwepo kuchipatala kupereka yake katswiri thandizo. Appendicitis matenda amene limapangidwa ndi maphunziro ambiri a, kungachititse kuti peritonitis, womwe mwina chifukwa cha imfa.

Zimayambitsa appendicitis

Madokotala sangapereke yankho lachindunji chifukwa chake anthu ena kuvutika zakumapeto. Komabe, akukhulupirira kuti kutsogolera kwa chitukuko cha matenda ndi mavuto ndi matumbo, miyala fecal, nyongolotsi infestation, kudzimbidwa, mimba ndi citukuko nthenda. Kusagwiritsa zakudya akhoza hule kutupa zakumapeto kwa cecum ndi. Osati kanthu pa ubwana wanga tinauzidwa kuti mbewu zauve kungayambitse opaleshoni kuti achotse zakumapeto.

Mulimonsemo sikutheka mungadzitetezere ku appendicitis. Ndi matenda oopsa mu kugwa kuchipatala monga makanda obadwa kumene, choncho akuluakulu ndi wathanzi achinyamata. Appendicitis matenda a ndiko kusiyanitsa matenda kuchokera angapo matenda ena amene amafuna yomweyo alowererepo pa opaleshoni.

Magawo chitukuko cha appendicitis

Kutupa kumapeto ali chiyambi chake ndi kwanzeru. Pachimake appendicitis matenda womwenso zambiri zomwe zinachitika kudziwa mavuto ndi matenda zosiyanasiyana, udzadutsa magawo angapo, aliyense wa wakupambana kuti wotsatira bwino. Ali:

• Catarrhal appendicitis. Pa nthawi imeneyi ya ndondomeko yotupa kumafuna yekha zakumapeto.
• siteji pamwamba amakhala ndi kutukusira kusintha kwa zinthu mucous nembanemba chotupa chachikulu. Nthawi imeneyi, mu lumen wa kumapeto anapeza maselo oyera ndi magazi.
• Pa sitepe phlegmonous chofuna zakumapeto lonse, kuphatikizapo ndondomeko kunja chipolopolo.
• siteji Abscess-chilonda amakhala ndi maonekedwe a zilonda pa mucosa wa kumapeto.
• Gawo lotsiriza - gangrenous, yodziwika ndi necrosis ndondomeko makoma ndi kuswa nkhani zake kuti patsekeke peritoneal.

Poganizira kuti kuyambira chiyambi cha kutupa kwa siteji ya zosayembekezereka wa peritonitis ndi monga masiku awiri kapena anayi, ndiye dokotala amene ntchito njira zonse za matenda a appendicitis, m'pofunika pamene kupeza zizindikiro woyamba wa matendawa.

zizindikiro zosonyeza pachimake appendicitis akuluakulu

Monga matenda ena aliwonse, kutukusira kwa zakumapeto kwa cecum ali zizindikiro zake. General zizindikiro pachimake appendicitis zimadalira siteji ya kutupa, Kamangidwe ndondomeko ngakhalenso zaka wodwalayo. Mu gawo loyamba la pachimake appendicitis nseru, osakwatira kapena mobwerezabwereza kusanza, amene, mosiyana ndi poyizoni chakudya, wosatenga thandizo lililonse. munthuyo amayamba kudandaula za kutopa kwambiri ndi malaise, kusafuna kudya, ndi mavuto ena ndi defecation. Kupeza Vuto appendicitis akuluakulu panthawi imeneyi kuli kovuta, monga matenda amenewa yodziwika zosiyanasiyana za matenda pachimake ndi aakulu.

Siteji yotsatira - aposa ndi kukhudza lilime, choyamba yonyowa, ziume ina. kutentha mtima limatuluka digiri 38, ndi kutentha thumbo thupi saposa 1, ndipo ndi madigiri ochepa. M'chiuno malo ndondomeko kumabweretsa chimbudzi madzi; kumapeto ili umakhala pafupi chikhodzodzo, kuchititsa matenda a njira ya mkodzo. Kusafuna kudya, kuphatikizapo anorexia, taonera 90% ya milandu kutupa zakumapeto kwa cecum ndi. Ngati wodwala akupitiriza kudya bwinobwino, mosakayika amafunika masiyanidwe matenda a appendicitis pachimake, zomwe ati awulule matenda ena ndi zizindikiro zofanana.

zizindikiro m'dera

Popeza kuti zizindikiro zofanana khalidwe kwa chiwerengero cha matenda ena, ndi matenda zolondola mu maola oyambirira zovuta. Komabe, pambuyo maola 4 zizindikiro zosonyeza kuti agwirizane m'deralo, kulola kusiyanitsa kutupa kumapeto, ndi kupereka chisamaliro zofunika mankhwala kwa wodwala. Ali:

• Akuvutika ululu wosasamala. Ndipo ululu amakhala palpable kutukula zizindikiro ambiri. Iwo isanafalikire kapena mu pamimba, kapena mu umbilical ndi ufulu iliac dera. Pamene malo m'chiuno cha kupweteka zakumapeto amapezeka pamwamba nyini, ndi predpechenochnom - mu nusu chapamwamba. Koma madokotala ambiri akukumana ndi otchedwa chizindikiro Kocher, pamene kupweteka kwa maola angapo a epigastric kusuntha mu iliac dera bwino.
• Pang'onopang'ono ululu m'kati ku kulongolola amakhala pachimake, nthawi zina zoperekera m'dera maliseche, m'munsi kumbuyo kapena ntchafu. odwala momveka bwino kumva kusapeza pa gulu kapena kukhosomola. Nthawi zambiri, madokotala kufunsa wodwala kutsokomola, molondola kudziwa chikhalidwe ndi malo ya kutanthauzira ululu.
• ululu ali anaphwa zikuchepa? Ndi chimodzi cha zizindikiro za matenda inanena necrosis maselo mitsempha ndondomekoyi. Yakudza chizindikiro alipo yoopsa yapitayi kuwonongeka mmene wodwalayo ndi peritonitis.
• O limasonyeza peritonitis ndi m'mimba khoma minofu nkhawa (mu nkhani ya kupsyinjika retrotsekalnogo ndondomeko dongosolo lumborum). Pamene inu musakhudze minofu m'mimba reflexively yafupika, kusonyeza kuti kutupa wafika pa peritoneum choipidwa.
• Oopsa amapezeka khungu mu iliac dera bwino.
• Minofu ya theka lamanja la pamimba ngati kwanthawi kupuma, kusonyeza kuti imakungika.
• Odwala Taphunzira Mchombo pang'ono ankatembenukira kwa kumanja.
• Kupeza Vuto appendicitis kunyumba zikuphatikizapo palpation. Ndi zokwanira kukakamiza dera iliac ndi mofulumira kukokera burashi ndi - ululu yomweyo kwambiri.
• Thumbo mupeza ululu wa appendicitis rectum. More ndendende, mpanda wake kutsogolo.

njira zina matenda kunyumba

Kudziwa pathological bongo ndi matenda zosiyanasiyana njira zimenezi ndipo amagwiritsa ntchito:

• Zizindikiro Dubois - zomverera chowawa ndi kukakamiza occipital mfundo vagus mitsempha.
• Zizindikiro Moscow - patsogolo mwana bwino.
• Komanso, pali mfundo pamimba, kukanikiza amene amayambitsa twinge a appendicitis. Koma iwo kudziwa malo enieni a dokotala, kotero muyenera kudikira kubwera ambulansi.

Appendicitis Ana

Vuto Kupeza Vuto appendicitis ana n'chakuti chifukwa cha msinkhu wawo sangathe kuyankhula maganizo awo. Pankhaniyi, wamng'ono ndi mwana, liwiro umayenda matenda. ana a pafupifupi onse zizindikiro wonse wa appendicitis, nchifukwa chake ngati aliyense wa iwo ayenera kupita kwa katswiri. Choyamba, mwana n'kusiya khalidwe lake kabwerebwere amathera kusuntha mwachangu, kumakhaladi lethargic ndi chidwi. Kenako pali zizindikiro zina zimene zingathe kusiyanitsa matenda.

makanda amakana chifuwa kapena botolo, limalephera fontanelle, lilime amakhala youma. Onetsetsani pali mavuto limbika iliac pane bwino. Matenda a pachimake appendicitis ana ndipo kuyan'anila vuto la mwanayo. Kawirikawiri, ana ali kumanja ndi mawondo wopindidwa. Ana okulirapo akhoza kukhala, atatsamira patsogolo.

Pa palpation dokotala bwino iliac mwana mwachibadwa othandiza pamimba bwino mwendo ndipo amakankhira dzanja dokotala achoke. Kupeza Vuto appendicitis ana a sukulu ndi sukulu zaka zonse muli funso lakuti "kumene zimawawa?". Pachikhalidwe, mwana anatchulapo m'michombo lapansi. Mu njira ya ululu matenda ikhoza kusunthidwa mu dera la zakumapeto chofuna. Ulesi, nseru, kusanza, kudzimbidwa, yapitayi isanayambike ululu, tachycardia, ndi malungo komanso ndi zizindikiro za ndondomeko kutupa chervovidnogo.

Pachimake appendicitis amayi oyembekezera

Amayi oyembekezera nawonso matenda zosasangalatsa ngati appendicitis. Matendawa ndi zovuta chifukwa chakuti zizindikiro ambiri monga m'mimba ululu, kunyansidwa ndi kusanza, ndi khalidwe la kawopsedwe mu magawo oyambirira mimba. Ndi kukula kwa chiberekero kudziwa kukula kwa zizindikiro za matenda Zimakhala zovuta kwambiri. Ena njira ya matenda a appendicitis pachimake mu trimesters wachiwiri ndi wachitatu sangapereke zotsatira. Mwachitsanzo, zizindikiro za kukhumudwa peritoneal sanalemberetu, ululu si isanafalikire mu iliac dera lamanja, ndi pamwamba, palpation osamveka chifukwa ndondomeko ya chophimba chiberekero kukula. Chifukwa cha ichi, kupweteka, wosasamala kapena cramping ululu kuonedwa ngati kuti ndi zizindikiro za kuyandikira padera.

Popeza n'zosatheka cha matenda a appendicitis mu amayi apakati, mwamsanga kupita kuona kuchipatala ndi kupereka mayesero zofunikira zonse molondola kudziwa chikhalidwe cha vutoli, popanda kuwononga ndiponso ngakhale amayi oyembekezera kapena mwana wake. Amaganiziridwa appendicitis? matenda masiyanidwe zidzatithandiza kuonetsetsa matenda zolondola kapena kutsutsa izo. mankhwala amakono limakupatsani kuchotsa zakumapeto pa mimba popanda vuto thanzi. The chikhalidwe chachikulu cha kupambana - yake matenda ndi kupewa mavuto monga peritonitis. Mwatsoka, nkhani ya abscess kapena gangrenous appendicitis kumafuna gawo la Kaisara. Only ndiye zingatheke kuchotsa zakumapeto, kuyeretsa zonse m'mimba ndi kupulumutsa mkazi.

Appendicitis okalamba

Appendicitis akupezeka anthu okalamba, zoopsa kwambiri. Izi ndi chifukwa avale pafupifupi onse zizindikiro za matenda. Ululu syndrome ndi bwino anasonyeza pafupifupi palibe dizuricheskie ndi matenda dyspeptic, kutentha akhala yachibadwa. Usanene anthu okalamba, ndipo zikusonyeza kuukira kwa pachimake appendicitis tachycardia, leukocytosis ndi kuchuluka ESR. Chifukwa zaka sagging khoma m'mimba sizimawoneka ndipo anachita kumbuyo ya minofu m'mimba. N'chifukwa chake odwala achikulire ayenera momveka bwino monga zotheka kuwathandiza aliyense chikhalidwe chawo. Pa kukayikitsa pang'ono kutupa kumapeto timasowa kuyitana dokotala amene adzatha kuchita kufufuza zonse zimene wodwalayo.

mavuto a appendicitis

Mawonekedwe pachimake cha matenda zikhoza chiwonongeko cha kumapeto, kapena amadulidwa chiwalo lachibadwa. Pankhaniyi, purulent misa upitirire ndondomeko yomwe imatsogolera kutupa m'deralo kapena zowombetsa mkota wa peritoneum lapansi. Pamene flegmoznoy mawonekedwe angathe empyema, purulent zotupa wakafika peritoneum, rectum ndi minofu ozungulira. Ndipamene purulent zotupa, kufika mafuta.

Palibe zotsatira zochepa kwambiri kuopseza thrombosis zakumapeto, amakwiya chitukuko cha septic thrombophlebitis ya m'mitsempha zipata ndi nthambi. Zimenezi zimabweretsa occlusion za mitsempha ya chiwindi ndi chitukuko cha purulent inflammations yeniyeni. Popeza mavuto awa, kuchitira appendicitis ayenera kuyamba pomwepo mwamsanga "mawa" ndi osayembekezera kuti "mwina zidzachitika."

appendicitis aakulu

Pali chinthu monga chosatha, osati pachimake appendicitis. Chipatala, matenda ndi mankhwala a matenda amasiyana chithunzi cha pachimake kutupa kumapeto. Ndipotu mawonekedwe aakulu - ndi zotsatira za kuvutika pachimake kutupa. Kumapeto zimachitika dystrophic ndi sclerotic njira limodzi ndi chiwonongeko minofu. Kutupa zimachitika ndi kuchiritsa, kupanga mabala ndi adhesions, zikhoza zilonda ndi infiltrates. Nthawi zina, aakulu appendicitis kumabweretsa chakuti ndondomeko ndi n'kukhala chotupa, amene yopuma ndi chimodzimodzi oopsa kuposa yojambula ya kumapeto. Dziwani kuti mtundu aakulu - chodabwitsa ndi osowa kwambiri, kokha mu 1 mwa milandu 100. Mukuganiza kuti muli appendicitis aakulu? Matenda, mankhwala ndi chithandizo kutsatira mankhwala kumachitika kuchipatala.

diagnostics

Kupeza Vuto appendicitis kunyumba ayenera kukhala molondola vuto ndi mlingo wotsatira wa mankhwala Mwachitsanzo, poizoni kungayambitse mavuto aakulu. Izi osati kusokoneza matenda, komanso kuvutika alili. Appendicitis masiyanidwe matenda amene kumlingo n'zotheka kunyumba, salola kudzikonda. Isanafike madokotala sangakhoze kutenga mankhwala kapena ntchito Kutentha PAD kwa zinkakhala m'dera, kuyesera kuti tichepetse nkhawa. Izi "chisamaliro" za mtima kungachititse kuti peritonitis msanga ndi mavuto ena zotheka.

Inu kuchipatala ndi matenda kuyambirira a appendicitis? Ultrasound matenda a appendicitis adzalola kusiyanitsa matenda ndi kuchitapo kanthu yake kuchotsa vuto. Ntchito matenda a radiography m'mimba yopangidwa tomography, irrigoscopy. Pambuyo pa opaleshoni woyengeka ndi morphological mawonekedwe a matenda ikuchitika Kupenda histological.

mankhwala a appendicitis

Pachikhalidwe, mafuta a cecum ndi kuwataya mothandizidwa ndi opaleshoni. Ambiri zambiri ntchito njira laparotomic appendectomy, kumene chofuna zakumapeto chikachita kuchotsedwa ndi m'mimba khoma gawo kuligaŵa. Pamene opareshoni ngati chifukwa mabowo ang'onoang'ono kumanzere mabala, ndi ntchito walola telescoping chubu kuti opaleshoni zolondola zotheka. Yafupika nthawi ya nyengo postoperative, kuchepetsa kuthekera adhesions ndi chitukuko cha mitundu aakulu a matenda.

Mankhwala mankhwala pambuyo opaleshoni akapatsidwa ngati m'chiuno yotupa exudate. Pamene catarrhal mtundu wa mankhwala si ntchito. mtundu A kwa chilonda pambuyo opaleshoni, zimathandiza kudziwa ndendende zimene zakumapeto kuchotsedwa, ngati kukhudzana ku chipatala ndi zizindikiro zofanana m'tsogolo. N'chifukwa chake pa ntchito zina mu iliac dera zakumapeto nthawi kuchotsedwa, ngakhale ngati si kuvutika, kuti akanyenge katswiri wina. Appendicitis matenda ndi mankhwala omwe iyenera kuchitikira posachedwapa - ndi "munthu wolemera" matenda. N'chifukwa chake pa nkhani ya zizindikiro mobwerezabwereza lankhulani akatswiri amene adzatha kuzindikira matenda ndi zizindikiro zofanana.