Kodi ascites khansa

Otchedwa ascites effusion madzi zikuluzikulu za magazi kapena lymph mu zonse m'mimba. Zimenezi angayambe matenda osiyanasiyana ndipo pathologies, koma ndi mmene matenda ambiri chiwindi. Ndi ascites zachilendo khansa, makamaka chyloperitoneum (akutulukira kutsekeka ziwiya za lymphatic dongosolo).

peresenti makumi asanu a khansa ascites akufotokozera chifukwa carcinomatosis parietal ndi masamba choipidwa peritoneum. Zimenezi n'kukumana ndi ziwiya occlusion (kutsekeka) lymph.

Pafupipafupi otsiriza mwa malignancies onse ranges ku khumi peresenti makumi asanu. The zambiri chitukuko cha ascites ndi zotupa yamchiberekero, endometrial, chapamimba, chifuwa, bronchial machubu ndi ziwalo zina ndi zimakhala.

peresenti khumi a chotupa inakhazikitsidwa m'zaka parenchyma chotupa chiwindi. Psinjika thupi la dongosolo venous zikubweretsa mapangidwe mofulumira exudate mu zonse m'mimba, kuwonjezera, odwala choterocho si analenga kutchulidwa hepatomegaly.

Pathogenesis ndi zizindikiro za khansa ascites

Zizindikiro Ascites mmene iye - kuwonjezeka lakuthwa m'mimba, komanso wodwalayo ambiri kulemera. Kuthamanga zochuluka zonse m'mimba kumayambitsa mkulu mlingo wa ataima zakulera, womwe amachititsa zizindikiro za gastro-oesophageal Reflux (regurgitation, ndi kutentha pa chifuwa, kunyansidwa ndi kusanza), orthopnea ndi dyspnea, wothinikizidwa m'mimba matenda (mofulumira machulukitsidwe chakudya ndiponso nseru).

Kupenda thupi ndi ping'ono ascites (200 Botolo) kuli kovuta kudziwa. Effusion buku kuchokera Botolo mazana asanu mpaka chikwi wapezeka zowoneka chifukwa cha oumbidwa dera la flanks mbali ya pamimba, chizindikiro fluctuation - positive. Pali khalidwe la ascites 'kumatilimbikitsa "kupusa kwa flanks ndi kusintha malo a thupi pa percussion lapansi.

khansa Ascites chifukwa cha occlusion a dongosolo venous mu chiwindi limapezeka kutambasuka kwa mitsempha zachiphamaso a linga m'mimba. Mu masiteji kutsogoloku mapangidwe khalidwe "mutu modabwitsa" (oumbidwa zapambuyo m'mimba khoma ascites ndi mitsempha dilated ndi zofotokozedwa mmenemo).

Kudziwa komanso zizindikiro extraperitoneal zovuta: madzimadzi mu M'mimbamo pleural, ndi kuchepetsa pamwamba kugunda kwa mtima, komanso kutupa tila mbali m'munsi (makamaka miyendo ndi mimba).

Pamene magawo osachiritsika a ascites khansa zolimbitsa si kuvutika alili ndipo alibe kulenga ngozi moyo, choncho mankhwala mankhwala diuretic yekha, omwe amaonjezera excretion wa madzi m'thupi ndipo motero kuchepetsa kwapakati effusion.

Ngati matenda a ascites, mankhwala ikuchitika veroshpironom (spironolactone) zomwe chimatengedwa ngati "muyezo zachipatala" mankhwalawa zinthu zimenezi. Cholinga cha mankhwala osakaniza furosemide (kuzungulira diuretic), amalola zina excrete mpaka 1000 Botolo la madzimadzi patsiku.

Pamene ululu kutchulidwa ndi kukhalapo kwa ascites ndi tachypnea, anachita paracentesis m'mimba (puncture khoma m'mimba ndi cholinga ngalande M'mimbamo). Kukhetsa ikuchitika kwa maola osachepera asanu ndi limodzi mpaka nthawi monga ascites madzimadzi salinso kuyenda mu chidebe. The madzi chifukwa imatumizidwa kusanthula ndi kufufuza izo zomwe zili okwana mapuloteni, pa zikuchokera fractional wa LDH ndi quantification wa leukocytes. Komanso, seeding amachitidwa pa sing'anga madzi.

Kamakupatsani kutchulidwa ubwino amadza etiological Chinthu (mwachindunji chotupa yokha). Choncho, membala galimoto likuchotsedwa ndipo mu pathogenesis wa obisika ascites khansa.