Chotupa. Echinococcosis chiwindi: chithandizo zimayambitsa, zizindikiro, kupewa

Echinococcosis ndi helminthiasis kalasi ya cestodosis zinachititsa mu mapapo, impso, chiwindi ndi ziwalo zina kapena zimakhala amapezeka chotupa. chiwindi matenda hydatid amayamba ndi oyamba ndi kusasitsa mu tapeworms ake larval.

Zimayambitsa matenda

Kutithandiza kuona matenda a echinococcosis anthu zikuoneka kukhudzana ndi galu (majeremusi chonyamulira), amene angathe kutenga matenda ndi kudya zinyalala nyama. ponena wina angathe akhoza kukhala matenda a agalu kusaka zotsatira - ziwalo kuonongeka kapena zinyalala za nyama zakutchire.

Anthu, matenda makamaka m'manja mosasamba. Infection angayambe ku galu kudzera tsitsi lake, kapena lilime. nyama zina zikhoza kukhala zofanana mowiriza mazira transmitters ndipo tikhale iwo komanso asanakumane ndi agalu odwala.

Komanso pali kuthekera kuti munthu angathe kupeza matenda hydatid ndi kudya zipatso, masamba ndi zipatso, amene si mwasambitsidwa kapena ayi kuti analandira chithandizo koyamba. Madzi kuchokera nyanja zosiyanasiyana zachilengedwe komanso akutumikira monga gwero la matenda.

Chotupa akhoza zimachitika ndi anthu ntchito m'minda ya nkhosa. Iwo strigali nkhosa, abusa, abusa ndi anthu amene anakumana ndi anthu awa (achibale).

Zizindikiro za echinococcosis

Indicators matenda ndi ululu ufulu nusu chapamwamba, m'mimba chiwindi nseru. Kuyambira chiyambi cha matendawo ndi kudziwa zizindikiro woyamba zimatengera zaka zingapo, nthawi zina zambiri. Chiwonetsero cha echinococcosis amayamba ndi mayikidwe, voliyumu, chiwerengero cha kukula kwa chotupa ndi imakhudzira ziwalo ozungulira ndipo zimakhala.

Nthawi zina, matenda a adutse popanda zizindikiro zilizonse, ndipo nthawi zina amatha kudziwa ndi ultrasound kapena X-ray ntchito. Matendawa zambiri akuyamba ndi zizindikiro wamba - yaitali otsika kalasi malungo, kuwonda, kufooka, ndipo thupi lawo siligwirizana.

Pakuti ambiri a chotupa poyamba inali mu chiwindi. Factor akuimira katundu wa kufalitsidwa: phunzirani kutulutsa magazi intestine zipita m'mitsempha zipata a chiwindi kuyeretsa magazi. Kupeza njoka zam'mimba za matepi mu thupi otchedwa hydatid matenda a chiwindi.

echinococcosis kwa chiwindi ndi:

• kufupika kwa mpweya chifukwa cha kutanthauzira kwa zakulera sayenda;
• kupweteka kumanja;
• kunyansidwa ndi kusanza;
• mowiriza matenda a chikasu ndiyo (pamene cholizira ndime biliary);
• chiwindi kukulitsa.

Iwo kumatha chotupa chiwindi?

Chithandizo cha matenda paokha monga matenda hydatid a chiwindi, ndi sangathe. Ngakhale nthawi zina kwambiri pali ndi kudzikonda machiritso kugwirizana ndi lifotabe a mphutsi a. Ngati chotupa chipezeka, kubadwa kwa echinococcus, ndiye palibe mankhwala amene akanati atathetsa tiziromboti. chotupa chotupa analankhulanso za kufunika kwa opaleshoni mwamsanga.

Opaleshoni anachotsa chotupa lonse. Ngati izo ziri mu chiwindi minofu wosanjikiza, ndiye kuchotsa kwathunthu zosatheka chifukwa cha kuthekera kuwonongeka limba. Imeneyi, kuchotsa chotupa khoma chitin ndi kukokera nkhani zake. Ndiye pali kuchotsa chotupa wokha, popeza palibe imabwera chotupa ndi kulekana kwa tiziromboti lapansi. Pa kuyima bwino ndi chotupa dera ake kumanga kupopera mankhwala ndi sutured.

Opaleshoni ikuchitika chiwindi kuti kuchotsa kwathunthu ndi chotupa ku chipolopolo ake ndi wokhutira, kotero kuti palibe mu thupi, m'mimba ndi cavities thoracic. Ndi malo akuya kapena aakulu zotsalira kugonjetsedwa chipolopolo. Opaleshoni ndi mabuku a kuntchito chifukwa cha kukula kwa chotupa ndi mavuto kuti anabweretsa. Ngati wapezeka malire Kusinthaku chotupa, ndiye amachotsedwa pamodzi ndi kapisozi a. njirayi opaleshoni akhoza kugwiritsa ntchito laser kuchotsa hydatid chotupa.

mitundu ya ntchito

Ngati oimeetsya angapo hydatid chiwindi cysts lalikulu, ndiye resected. Pamene kupeza cysts yaikulu opangidwa ndi ntchito Spasokukotsky kapena Bobrov, imene ndi echinococcectomy mkati.

Pofuna kulimbana ndi matenda chotupa khungu si woyera, ndi M'mimbamo ake amaliona ndi mankhwala ndi majeremusi Mwachitsanzo, formalin, ayodini kapena mowa.

Ngati chotupa ndi ili pansi pa chifundamtima, ndi chifukwa cha opaleshoni pali M'mimbamo yaikulu, ndiye kumangitsa pogwiritsa ntchito njira Pulatova kapena Delbo kapena kuphimba M'mimbamo anapanga ndi chidutswa cha zakulera.

Ngati pali chotupa yojambula mu ducts ya ndulu, ntchito mwadzidzidzi imagwiridwa. Ndipo chotupa khoma inachotsedwa malo zinkakhala pa mundawo biliary. Imeneyi, biliary ngalande anatipatsira.

Ngati kusiyana kumachitika cysts mu zonse m'mimba, ndiye opareshoni mwadzidzidzi zichitike. Pa ndondomekoyi, anachotsa chotupa, ndi makapisozi, zomwe zinali bronchi, pleural ndi malo m'mimba. Iwo anachita theka-anatseka echinococcectomy. Zinthu zitafika povuta kwambiri ndi lotseguka Echinococcectomy.

Ndi misa echinococcus chiwindi n'kofunika kuti alowererepo opaleshoni pamaso vuto lina lilonse. opaleshoni angathe kuchitidwa pa chiwindi a Njira 2-3 spaced kwa masabata awiri kwa miyezi itatu.

Imfa mu Echinococcus ndi kuchokera 1 mpaka 5% ya anthu amene akudwalayo. Musabise zingachitikenso ngati chotupa cha chinang'ambika.

kupewa

Matenda a ziweto ndi anthu zachokera njira kuchitidwa ndi chithandizo ndi Chowona Zanyama. Muyenela nthawi zonse kuyendera kunyumba ndi utumiki agalu mphutsi, makamaka m'madera ovutika mankhwala awo, kumaliza nyama pokhala, komanso kukhazikitsa ulamuliro wa nyama zophera.

Kodi chofunika n'chiyani?

Kuchititsa ukhondo nthawi zonse anthu (galu obereketsa, obereketsa ziweto, alenje ndi mabanja awo), kusunga agalu ukhondo, zonse kusamba manja awo pambuyo nawo, komanso asanadye, Kuletsa ana zolankhulirana ndi nyama pokhala, mmene kusamba masamba, zipatso, madzi akumwa kupopera mankhwala madzi.

m'mapapo chotupa

Matendawa langoyamba ndi kuwonetsera pang'ono wapezeka ndi X-ray anayendera kuwala mu mawonekedwe a silhouette chowulungika mizere yeniyeni. The hemogram amasonyeza eosinophilia.

Mlingo wa cysts sanali akuchuluka anapanga anapitiriza ndi aakulu chifuwa, kufupika kwa mpweya, mpumulo kupuma pa malo a tiziromboti, zowawa lathu osiyana mu chifuwa, kayendedwe ka ziwalo mediastinal, akuwonetseredwa kuchepetsa percussion phokoso. Radiography limasonyeza m'mapapo mwanga yaikulu zozungulira mthunzi ndi contours enieni, omwe amasintha mawonekedwe a maulendo kupuma wa chifundamtima.

Mbali yachitatu ya m'mapapo echinococcosis ali ndi mawu aakulu ndi pathological chitukuko cha mavuto ndondomeko. Ndi zizindikiro za psinjika ziwiya kwambiri ndi ziwalo mediastinum ndi, amalembedwa mapindikidwe a chifuwa, dyspnea ndi hemoptysis. Pamene munthu amafa echinococcus cysts kutupa ndi zizindikiro zenizeni matenda a empyema pleural kapena m'mapapo.

cysts Autopsy limodzi ndimeyi bronchus kumaliseche lalikulu ndithu la precipitates yowala ndi bulanchi echinococci pomveka streaked ndi magazi. Ndi zamafinya zinangoti lotseguka burashi masamba hemorrhagic purulent sputum, komanso maonekedwe ananena poyizoni. Kuwulura cysts mu chipolopolo dzenje amakwiya maonekedwe a pleurisy exudative ndi anaphylactic mantha. X-ray Kupenda amasonyeza M'mimbamo ndi yopingasa madzi pamwamba si mwamphamvu akuwonetseredwa perifocal kusalola. kusalola otere wapezeka, ngati abscess chotupa.

chithandizo

Gwiritsani ntchito mankhwala ntchito (chotupa kuchotsedwa cuticular kapisozi kuchotsedwa m'mapapo). Mapa serzno zokwanira, ndi amgwirizano echinococcosis panopa ndi sekondale - wachisoni.

aimpso matenda hydatid

Hydatid chotupa a impso lero zachilendo, makamaka m'madera a kumidzi. Malaise ndi wosangalala helminth Taenia echinococcus. Amafalitsa tizilomboto ndi ziweto - agalu ndi amphaka. Monga ulamuliro, impso munthu anakhudzidwa, mu nthawi zina - awiri. chiwindi echinococcosis anthu kudwala wa gulu zaka pakati pa 20 ndi zaka 40, makamaka amayi.

helminth dzira akulowa impso lymphogenous kapena hematogenous njira, ambiri a makulidwe yokhudza kotekisi.

Kuchiza ndi madokotala ananena zawo

kwakukulukulu, chithandizocho yosalekerera ndi kugwira ntchito. Yodalirika ndipo imayenera ntchito - ndi eni wina gawo ehinokokkotomiya. Pontho nephrectomy.

Echinococcus chithandizo amafuna njira maphunziro thanzi kuti dziŵani anthu ndi matenda oopsa kwa ziweto, Kukwanilitsa kuyang'aniridwa mwaukhondo ndi Chowona Zanyama lakupha.

Pambuyo mankhwala ntchito ya osangalala.

ndulu matenda hydatid

cysts Parasitic a ndulu ndi zambiri kwaiye Echinococcus. Kutalika kwa matenda ukhoza zaka 15 kapena kuposa. Malinga ndi mlingo wa chitukuko cha tiziromboti imachitidwa kusuntha pambali ozungulira ziwalo m'mimba, ndulu minofu necrosis amapezeka.

matenda kuli kovuta kudziwa. Chotupa limodzi ndulu kulemera lamanzere nusu chapamwamba, matenda kapena kudzimbidwa, zazing'ono kuzimiririka ululu, nseru postprandial matupi awo sagwirizana zochita. Pa palpation a ndulu ndi kukhazikitsa yophunzitsa. thovu Large akhoza anayamba, nthawi zambiri kumabweretsa imfa ya m'munsili limba chophukacho.

Mu tiziromboti panopa zambiri lipoti zizindikiro za ziwengo - ming'oma, kuyabwa ndi ena. Pamene echinococcosis ndulu sequelae kumachitika cysts kusiyana suppuration kapena ake matenda mawu matenda.

The kusanthula ndowe, mwatsoka, silinena pamaso pa majeremusi. Matendawa zachokera X-ray kuona ndi ultrasound, imene Mipikisano chipinda mutsanulira kuwoneka.

chithandizo

Njira yabwino kwambiri chifukwa cha mankhwala cysts ndulu ankaona opaleshoni laparoscopic. Chotupa akhoza opareshoni mu njira zingapo:

• wathunthu kuchotsa ndulu ya;
• chotupa kutsegula ndi kuchotsa nkhani therefrom, kuyeretsedwa M'mimbamo;
• kudula mu zinkakhala m'dera la ndulu ya;
• kuchotsa ndulu kuchokera pampanda chotupa zili m'kati mwake;
• chosema chotupa zipolopolo.

Machitidwe a mtundu laparoscopic ndi mankhwala chotupa ndulu ndi m'njira ochiritsira, kuti athe kuchotsa kwathunthu gwero la matenda. Kuchotsa ndulu chotupa ikuchitika ntchito zida mkulu-yolinganizika ndi kulowa kamera wapadera. Kutalika kwa kanthu kugwira ntchito - maola 1.5-2. Ndiye nthawi zina kukhala zomverera chowawa, koma mu nthawi yochepa wodwalayo kwathunthu peza lapansi.