Thrombosis ya matumbo: zimayambitsa, zizindikiro, mankhwala

Anthu okalamba nthawi zambiri amayenera kuthana ndi matenda ngati matumbo a m'mimba. Kuonjezera chikhalidwe chawo molunjika kumadalira momwe iwo amafikira msanga kuchipatala ndipo adokotala adzapereka chithandizo cha munthu aliyense. Kuti musaphonye nthawi yamtengo wapatali, aliyense ayenera kudziwa za zizindikiro za matendawa ndiyeno atenge zofunikira zonse.

Ndiyenera kudziwa chiyani za matendawa?

Magazi, monga momwe amadziwira, ali ndi udindo wogwirizanitsa. Mu mankhwala, njira iyi imatchedwa coagulation. Ichi ndi ntchito yofunika kwambiri, popanda yomwe munthu aliyense atataya mabala akhoza kutaya magazi onse ndipo, motero, amafa. Kumbali inayi, kugwirana kumawathandiza pa nthawi yopanga mapepala, omwe amatchulidwa kuti thrombi. Malingana ndi akatswiri, iwo akhoza kupangidwa kwathunthu mu gawo lirilonse la thupi. Mwachitsanzo, kulowa m'kati mwa matumbo, thrombi nthawi zonse amavala kuwala kwake, motero amalepheretsa kudyetsa kudera linalake. Chifukwa chake, necrosis ya matenda m'matumbo amawonedwa. Matendawa amatchedwa thrombosis (mesenteric) a m'matumbo. Pazochitika zazikulu kwambiri, zikhoza kupha imfa.

Thandizo la mesenteric la m'matumbo ndi matenda omwe amapezeka chifukwa cha kusowa koyipa kwa mkulu, laliac kapena wochepa wamasiteria. Matendawa nthawi zambiri amachititsa kusintha kwa magazi m'ziwalo za m'mimba. Malingana ndi akatswiri, matendawa ndi ofanana kwambiri pakati pa amayi ndi abambo, koma ndi ofala kwambiri pakati pa okalamba.

Etiology

Tsoka ilo, lero palibe aliyense amene alibe matendawa. Komabe, madokotala amatchula zinthu zingapo zomwe zimayambitsa matenda, zomwe zimapangitsa kuti thupi likhale ndi matenda monga m'mimba. Zifukwa zikhoza kukhala motere:

• Matenda a atherosclerosis (matenda a mitsempha, omwe amadziwika ndi mapangidwe opangidwa motsatizana, ndi mapepala omwe amapezeka).
• Myocardial infarction.
• Kuthamanga kwa magazi (kuthamanga kwa magazi).
• Thrombophlebitis (kutukusira, kumapezeka m'mitsempha pamapazi ndikuyenda ndi magazi).
• Endocarditis (kutupa kwa chipolopolo chamkati cha mtima, kumapangitsa kuti maonekedwe a magazi asamaoneke).
• Sepsis (matenda a magazi).
• Rheumatism (matenda okhudzana ndi minofu yothandizira, yomwe imayambitsa kukula kwa matenda a mtima).
• Postpartum thrombosis.

Mwachitsanzo, kawirikawiri, kupweteka kwa m'mimba kumatuluka mwamsanga pambuyo pochita opaleshoni pa ziwalo zina. Komabe, pakadali pano, wodwalayo ali ndi mwayi wopulumuka, chifukwa patapita kanthawi atachita opaleshoni akuyang'anitsitsa ndi madokotala. Zikakhala choncho, katswiri amalingalira mwamsanga mankhwala. Anticoagulant kapena mankhwala ena omwe amachititsa thrombus imayidwa.

Zizindikiro zazikulu zachipatala

Akatswiri amanena kuti pamayambiriro a chitukuko zimakhala zovuta kupeza matenda opatsirana m'mimba. Zizindikiro zomwe zili m'munsimu, nthawi zonse mukhale ngati alamu ndipo muyenera kuzindikira aliyense.

• Kumva kupweteka pamimba, komwe kumachitika mwamsanga kamodzi kokha kudya.
• Kuyera kwa khungu, khungu louma, thukuta.
• Mphuno ndi kusanza, chotupa (kudzimbidwa kapena kutsekula m'mimba).
• Flatulence.
• Kutsika kwakukulu.
• Kukhalapo kwa malowa m'zimbudzi.

Ngati mutakumana ndi zizindikiro zili pamwambazi, ndikulimbikitsidwa kuti mupite kuchipatala mwamsanga. Mukangoyamba kumene chithandizo, zimakhala bwino kuti mutha kuchira bwino. Apo ayi, mwayi wa mavuto ndi wapamwamba kwambiri. Pambuyo pa mitsempha ya m'mimba, lumen m'matumbo, pali kuphwanya magazi m'madera awa. Chotsatira chake, pali chiphuphu cha m'matumbo (mankhwala osokoneza bongo ). Zotsatira zake, peritonitis ikukula kapena yayikulu kutuluka magazi mkati mwa peritoneum. Popanda chisamaliro choyenera panthaŵi yake, mwayi woti munthu atha kuwonongeka ndi wapamwamba kwambiri.

Miyeso yayikulu ya matendawa

Akatswiri amagawaniza thrombosis ya m'mimba m'magulu atatu a chitukuko:

1. Ischemia wa m'matumbo. Pakati pa matendawa, liwaloli likhoza kubwezeretsedwa. Odwala nthawi zonse amapitilira kupweteka kosalekeza m'mimba m'mimba ndi kusanza ndi zosafunika za bile. Mpando umakhala madzi.
2. Chikondi cha m'mimba. Matendawa samayima pang'onopang'ono. Zotsatira zake, kusintha kochuluka kumachitika m'thupi lomwe lakhudzidwa, zomwe zimabweretsa kuledzera kwa thupi lonse. Chombocho chimalowetsedwa ndi kudzimbidwa, tsopano m'magulu amtundu wambiri amatha kuzindikira kuwonongeka kwa magazi. Kupweteka m'mimba kumakhala kosalekeza, khungu limatembenuka, ndipo atakhala ndi mthunzi wa bluish.
3. Peritonitis. Panthawiyi, poizoni wa thupi ndi poizoni imatchulidwa, pali kuphwanya mu ntchito yoyendetsa. Ululu ukhoza kuima kwa kanthaŵi, koma m'malo mwa kusanza kwamphamvu, mpando umakhala wosadziŵika. Kutupa kumawonjezeka ndi nthawi. Posakhalitsa, pali kufooka, komwe kumabweretsa kuchedwa muchitetezo. Pali hypotension ndi kuwonjezeka pang'ono kwa kutentha kwa thupi.

Kulemba

Malingana ndi momwe kuli kobwezeretsa kwa kayendedwe ka magazi patatha kutsekedwa kwake, madokotala amagawaniza njira yowonjezera ya matendayo kukhala mitundu itatu:

• Kulipira (magazi m'matumbo pang'onopang'ono amapezeka mwachibadwa).
• Amapereka malipiro (chiwerengero chokhalira kuchira chikuchitika).
• Kusokonezedwa (sikutheka kuimika kuyendetsa kwa magazi, motero, pali chifuwa cha m'matumbo).

Kodi ndingapeze motani vuto langa lopweteka m'mimba?

Ndikofunika kwambiri kuyang'anitsitsa mkhalidwe wa thupi lanu nthawi zonse. Ngati pali kupweteka m'mimba ndi zakumwa zozizwitsa zomwe zimakhala ndi zoipitsa magazi, muyenera nthawi yomweyo kufunafuna thandizo kwa dokotala, chifukwa pali kuthekera kwa matenda monga kupweteka kwa m'mimba. Zizindikiro m'thupi la munthu aliyense zimasiyana. Choncho, anthu ena amavala khungu, kutentha kumafika madigiri 38, pamakhala kuthamanga kwa magazi, kenaka pali lakuthwa kwa magazi. Zizindikiro zonsezi ziyenera kuchenjezedwa. Muzochitika izi ndi bwino kuyitana ambulansi. Ndikofunika kukumbukira kuti kuchedwa kulikonse kungawononge moyo wanu. Ngati munthu sapita kuchipatala ali ndi zizindikirozi, akhoza kutsimikizika kuti matendawa adzatulutsa zotsatira.

Njira zazikuluzikulu zozindikiritsira kuchipatala

Akavomerezedwa ku chipatala ndi matenda opatsirana amtumbo, wodwalayo amakhala ndi kafukufuku wodalirika. Ikutanthauza njira zotsatirazi:

• Anamnesis ndi kuyesedwa koonera.
• Kuyezetsa magazi kwa msinkhu wa ESR ndi chiwerengero cha leukocyte (poyerekeza ndi thrombosis, zizindikirozi ndizowona kwambiri).
• Mafilimu.
• Mapulogalamu a pakompyuta (amalola kuti afufuze momwe ziwalo za thupi zilili momwe zingathere).
• Kuzindikira kwa laparoscopy (dokotala amapanga khungu pa khungu, ndiye chubu yomwe ili ndi kamera pamapeto idzalowetsedwa kenako, chithunzi chake chikuwonetsedwa mwachindunji pamakompyuta.)
• Kufufuza kwa laparotomy (kumachitidwa pamene palibe kuthekera kwa laparoscopy).
• Mng'oma wa zombo zogwiritsira ntchito zosiyana-siyana (mayesowa angayang'ane kuchuluka kwa mitsempha ya magazi).
• Colonoscopy.
• Endoscopy.

Thandizo lodziletsa

Pamene wodwala alowa kuchipatala, dokotala amayamba kuyesa pa siteji ya chitukuko komwe kumakhala kupweteka m'mimba. Chithandizo chogwiritsa ntchito njira zoyenera, monga lamulo, chimagwiritsidwa ntchito panthawi yomwe matendawa sanayambe kukula. Nazi ntchito:

• Njira yapamakono ya kayendedwe ka anticoagulants, cholinga chachikulu chomwe chiri kuwonetsera magazi. Nthawi zambiri amagwiritsira ntchito mankhwala "Heparin" ndi zina zake zofanana.
• Zilonda za thrombolytics ndi zosiyana (mankhwala Trental, Reopoliglyukin, Gemodez).

Ngakhale kuti anthu ambiri amamwalira chifukwa cha matendawa, pakakhala chithandizo cham'tsogolo nthawi zambiri amatha kuchira bwinobwino.

Ntchito yothandizira

Ngati mthende ya mesenteric ya m'mimba ikupita, kapena mankhwala sanathe kuthana ndi matendawa, dokotala akulamula ntchitoyo, ndipo mankhwalawa amachititsa ngati mankhwala ena.

Pankhani ya matumbo a ischemia, matendawa sakhala akudutsa okha, komabe ngati njira yothandizira, maantibayotiki akulimbikitsidwa kuchotsa poizoni kuchokera mthupi.

Ntchitoyi imaphatikizapo kuchotseratu zigawo zomwe zowonongeka za chiwalocho komanso kuchotsa zida zogonana. Nthawi zina, kufunika kwina kofunika. Panthawiyi, katswiri amapanga "detour" pafupi ndi chotengera chojambulidwa kuti magazi akhoze kutsogolo.

Ngati thrombosis ya zotengera za m'matumbo zimakhala zovuta, opaleshoni imathandizanso. Dokotala yekha amadziŵa zomwe zimayenera kuchitidwa (kuchotsa thrombus, kupanga angioplasty, shunting, etc.). Njirazi zimathandiza kuletsa chitukukochi, kenako minofu ya necrosis sizimawonekera.

Kukonzanso

Pambuyo pa opaleshoni yonse, wodwalayo, monga lamulo, amathera nthawi kuchipatala. Pa masabata awiri otsatira, akutsutsana ndi zochitika zilizonse. Apo ayi, n'zotheka kukwiyitsa maonekedwe a nthenda.

Madokotala panthawi ya kukonzanso amalangiza kuti azigonjetsa bedi, ngati kuli koyenera, kuchita mimba minofu nokha, mwakumangirira pang'ono.

Ndikofunika kutsatira malangizo onse ochokera kwa madokotala. Ndi njira yokha imene mungaiwale za vuto ngati matumbo a m'mimba.

Pambuyo pa opaleshoniyi, ndizofunikira kwambiri kumamatira ku zakudya za mkaka ndi masamba. Zakudyazi ziyenera kukhala ndi phala la mpunga, zipatso, nyama yophika / nsomba yophika, mankhwala opangira mkaka. Zakudya zonse zamzitini ndi zosuta, zakumwa zoledzeretsa, adyo ndi anyezi siziletsedwa. Sikoyenera kuti muzimwa mkaka wonse m'mwezi woyamba pambuyo pa opaleshoniyo, kuti musayambe kudwalitsa matenda.

Pomalizira, tiyenera kukumbukira kuti kuchiza matendawa kwa nthawi yake kumatha nthawi zonse. Musazengereze kukachezera dokotala ndi chithandizo chotsatira.