Matenda a Ledda: zizindikiro, chithandizo

Chikhalidwe chowawa chokhudzana ndi malo osadziwika a duodenum, akhungu ndi midgut amatchedwa matenda a Ledd. Ndi zizindikiro ziti zomwe zimatsimikizira kukhalapo mthupili ndi njira ziti zomwe zimatsogoleredwa ndi chithandizo chake - tidzakambirana ndi nkhaniyi m'nkhani yathu.

Ledda Syndrome

Kusowa kwa matumbo kutembenuka kumene kumapangidwa panthawi ya kukula kwa msana (kawirikawiri pa sabata la 10-12) ndipo ndizopangidwira za duodenum ndi caecum ndi kutembenuka kwa matumbo apakati, ali ndi dzina lomveka - Matenda a Ledd.

ICD-10 ndiyo njira yovomerezeka yovomerezeka ya mankhwala okhudzana ndi matenda okhudzidwa ndi WHO. Malinga ndi kafukufuku wapadziko lonse wa Matenda a ndondomeko ya 10, matenda a Ledd amatanthauza matenda opatsirana pogonana (kalasi XI). Matendawa samapezeka kawirikawiri kusiyana ndi kamodzi kokha kwa ana okwana 500, ndipo anyamata amapezeka kawiri kuti ali ndi vutoli ngati atsikana.

Monga lamulo, matendawa amayamba sabata yoyamba ya moyo wa wodwala wamng'ono, mocheperapo - mwezi woyamba wa moyo. Kuti apeze matenda oyenerera, dokotala wa ana amafunikira kukhala ndi chidziwitso chachikulu cha matenda. Pankhaniyi, matendawa sapezeka nthawi zonse. Chizindikiro chodziwikiratu cha matenda m'masiku oyambirira a moyo ndi kusanza ndi kusakaniza kwa bile.

Mwatsoka, kuuma kwa chikhalidwe cha wodwala ali ndi matenda ofanana ndiwo kungawonjezereke kwambiri ndi kukhumudwa kwa msinkhu wobereka, monga:

• Impso kapena mapapu hypoplasia;
• Matenda a mtima;
• Matenda a mitsempha, etc.

Matenda a Ladd akuluakulu ndi osowa kwambiri. Kutseka kwa m'mimba kungabwere chifukwa cha kuyenda kwa cecum, komanso ndondomeko yomatira pamimba. Nthaŵi zina mapangidwe a ziwalo amachititsa chidwi ndi mimba ya m'kati mwa khomo la m'mimba. Osati malo otsiriza pakati pa zifukwa zomwe zimakhudza mapangidwe a dziko la morbid, zilonda zabwino ndi zoopsa za madokotala osiyanasiyana m'matumbo.

Zizindikiro za matendawa

Matenda a Ledd akhanda angabweretse zizindikiro zosadziwika. Kuwonjezera pa kusanza ndi kubwezeretsanso kwa bile, makanda nthawi zina amamva ululu m'mimba. Nthawi zina, kubwereranso kumabweretsa mavuto aakulu a m'mimba ndi kuwonongeka, mpaka kudziko lachigwirizano cha mwanayo.

Zizindikiro Zambiri za matenda:

• Kupweteka kwaparoxysmal;
• Kusungidwa kosungirako, kusungunuka kwa mpweya;
• Kuthetsa;
• Kuphana kwa chigawo cha epigastric ;
• Mimba ya m'mimba pamimba;
• Kuphatikizana sikupereka chidziwitso chathunthu cha mkhalidwe wa wodwalayo.

Mafilimu a m'kati mwa mimba amasonyeza magawo awiri amadzimadzi m'mimba ndi duodenum, komanso gasi pang'ono m'matumbo. Ngati barium sulphate inagwiritsidwa ntchito panthawiyi , zotsatira zake zimasonyeza kusungunuka kwa sing'anga mosiyana mu mimba yotambasula ndi duodenum. Kusiyanitsa kumagawidwa mofanana pamatope a matumbo aang'ono.

Irrigography nthawi zambiri amavomereza kukonza kwa chiwindi pansi pa chiwindi. Ndipo apa mothandizidwa ndi makina a kompyuta, kupotoza kwa matumbo apakati kuzungulira mitsementi ya mesenteric kumatsimikiziridwa.

Chithunzi chachipatala

Matenda a Ledda ndi matenda omwe amafunika kuthandizira mwamsanga. Monga tanenera poyamba, zizindikiro za matendawa ndizowonongeka ndipo zikhoza kubwerezedwa panthawi zingapo, masabata, kapena zaka.

Nthawi zingapo, vuto lopweteketsa silimadzipangitsa kukhala lodziwika kwa zaka zambiri ndipo limakhala losavomerezeka. Ana nthawi yomweyo amadwala chifukwa cha kuchepa kwa chilakolako chochepa, akutha msinkhu.

Kuphatikiza pa matenda achikondi a Ledd, mitundu iwiri yowonjezera imadziwika:

1. Pachiyambi choyamba, palibe kutembenuka kwa matumbo pakati, koma malo osadziwika a caecum amawonedwa, omwe amachititsa kuti duodenum iyambe.
2. Pachiwiri chachiwiri, pamakhala matope omwe ali pakati.

Matenda a matendawa (Ledda matenda) akhoza kukhala ovuta komanso osagonjetsa (osachiritsika). Mwachizolowezi, palibe kutchulidwa kwa ululu m'mimba, monga matumbo a m'mimba, nthawi zina kusanza, kuyerekezera. Pali bowo losweka. Mkhalidwe wa mwanayo umakhala wokhutiritsa. Kuzungulira kwa matumbo sikuchititsa kuphwanya magazi ake. Mu mitsempha ya m'mimba yaing'ono, amagazi okhawo amapezeka m'magazi ndipo m'mimba amatha kusintha.

Kutembenuka kwakukulu kwa intestine ndi vuto lalikulu kwambiri, lomwe, ngati losasangalatsa, limatsogolera ku necrosis kapena chifuwa cha m'matumbo.

Kuchiza kwa matenda a Ledd

Kupititsa patsogolo chikhalidwe chonse cha wodwalayo ndi matenda omwe amatha nthawi zambiri amathandizidwa ndi kugwiritsa ntchito antispasmodics. Komabe, izi ndizochepa chabe. Njira yaikulu yothandizira kutsekula kwa m'mimba ndikutsegulira opaleshoni. Mankhwala opatsirana (matenda a Ledda) ali ndi magawo angapo:

1. Poyambirira, kusanza ndi kuletsa kumachotsedwa.
2. Kenaka katumbo kakang'ono kakakhala m'mimba yoyenera, wandiweyani - kumanzere.
3. Ngati pali chofunikira chokonza matumbo m'mimba mwa parietal peritoneum, chitani izi. Muyeso wofanana umafunika ngati wodwalayo ali ndi ubongo wambiri wamatumbo.
4. Appendectomy ikuchitidwa.

Posachedwapa, njira zamakono zogwiritsira ntchito matendawa zimakhala zowonjezereka m'maganizo. Mafakitale oterewa amathandiza kwambiri. Komabe, kuchita opaleshoni mwanjirayi kumakhudzana ndi mavuto ena chifukwa cha kuchepa kwa m'mimba, komanso kukula kwake kwa mimba m'mimba mwa miyezi yoyamba ya moyo. Nthawi zina kumayambiriro koyambirira kumakhala zovuta:

• Sepsis;
• Peritonitis;
• Kutuluka kwa m'mimba;
• Kutsekera m'mimba.

Mpata wochira kwathunthu udzadalira zotsatira za opaleshoniyo. Ngati madipatimenti onse a m'mimba amasungidwa, zizindikiro zapamwamba kwambiri za moyo ndi zabwino. Ngati pangakhale kutsekula kwakukulu kwa m'mimba komwe kunayambitsa matenda a "chifuwa chachifupi", wodwalayo ali ndi mavuto okhudzana ndi kudya ndi kuyerekezera. Ndi zotsatira zotere za chithandizo cha opaleshoni, zipatala zambiri zachipatala zimachitidwa kuti zikhale ndi zakudya zogonana. Nthawi zina odwala ayenera kubwereza ntchito. Ngati katemera wa m'mimba sagwiritsidwa ntchito motsutsana ndi cystic fibrosis, kufotokozera kuti kuchira sikunayende bwino.

Preoperative kukonzekera

Mwana wakhanda akapezeka kuti ali ndi vuto la m'mimba (Ledda syndrome), amamutumiza kuchipatala chochita opaleshoni, chojambulidwa ndi chubu yamkati ndipo amachititsa kuti m'mimba mwake mukhale mimba. Nthawi yomwe ili yofunikira pakuyendetsa njira zowonongolera, kumadalira molingana ndi kupsinjika kwa chiberekero cha m'mimba.

Ngati wodwalayo ali ndi kachilombo koyambitsa matumbo, zotsatirazi zikuchitika:

• Mayeso a magazi kwa gulu ndi Rh factor;
• Kuyezetsa magazi kwa hemoglobin ndi hematocrit;
• Kuwombera magazi.

Chithandizo cha opaleshoni chikuchitidwa mofulumira, kukonzekera kukonzekera kumatenga nthawi yochuluka. Mwanayo amapatsidwa mankhwala othandizira kulowetsedwa, amalemba mankhwala a hemostatics, mankhwala opweteka, komanso nthawi zina mpweya wabwino. Catheter imayikidwa mkati mwa mitsempha.

Pankhani ya chitetezo cha m'mimba chochepa, kukonzekera kukonzekera kumatha kutenga maola 24. Panthawiyi mwana wakhanda amafunsidwa kuti apitirize kudziwika kuti ali ndi HIV. Pa nthawi yomweyi, yang'anani m'mimba, ganizirani kuchuluka kwa misala, kutulutsa mankhwala, mankhwala osokoneza bongo komanso haemostatic. Kudyetsa mwana wakhanda sikuchotsedwa.

Ana ambiri pa nthawi yopuma amatha kupuma mpweya wabwino, womwe umatha masiku asanu. Mankhwala oletsa antibiotic amagwiritsa ntchito mankhwala omwe akugwira ntchito motsutsana ndi mabakiteriya a anaerobic. Chikhalidwe cha microecological chimayang'aniridwa kawiri pa sabata. Tsiku lotsatira, opangidwa ndi mankhwalawa amalembedwa kuti azitha kusintha mavitamini, komanso mankhwala.