Chiratidzo Kera uye Ortner cholecystitis. Kutanga zviratidzo uye nenzvimbo localization yavo

The zvinokonzera cholecystitis mune munhu anogona kuita zvakasiyana chirwere zvirwere, kana kuchinja mamiriro vamwe midziyo biliary turakiti. Rinogonawo kuva somugumisiro zvirwere mudumbu (chete vaya pamwe diskholiey). The huru panotaurwa mune tsanangudzo chirwere chiri chiratidzo Kera.

Common zviratidzo cholecystitis

Zvichienderana localization kuti kuzvimba kana vascular kuchinja mamiriro uye biliary turakiti, chinosiyanisa zviratidzo zvizhinji:

• patainzwa marwadzo zvakarurama hypochondrium, iyo kunosvika kumusoro - munzvimbo rworudyi scapula, clavicle uye nepfudzi; pamwe kukura chirwere marwadzo hunowedzera chakasimba uye kwakanyanya;
• kuda kurutsa uye kurutsa, uko chinokurwadzai marwadzo;
• shungu manakiro mumuromo;
• pamberi vomitus bile netsvina;
• rurimi zvemapuranga Dombo uye zvakare akaoma;
• pamwewo nefivhiri uye chills;
• kana hosha kunoita iri dzakaonekwa tachycardia, ikawanda BP;
• kana Clearance iri makavhara bile ducts (pamberi mabwe mairi), zvino munhu ane iziviswe jaundice;
• marwadzo ari palpation zvakarurama hypochondrium.

Kunze apa, chikuru chepfungwa chirwere chiri chiratidzo Kera. It runoratidzwa marwadzo ari palpation ari murwere muviri placement. marwadzo ari kukura uye kunosvika kanenge pamwe kukura vemunyika chirwere.

Dzinenge zviratidzo cholecystitis

By chaiwo zvinoratidza chirwere muri zviratidzo Kerala uye Ortner. Uyezve naPauro kunoitika pashure kusimbisa pamberi kuratidzwa izvi. Kuona chiratidzo chokutanga, zvakakwana rakadzika palpation rwerudyi yokumusoro quadrant, muchiitiko ichi, murwere yakanyanya kurwadziwa anooneka.

Chiratidzo Ortner dzakaonekwa kuburikidza tapping ari costal chematenga kurutivi rworudyi rwake. In kuvapo chirwere, manipulations zvose zvichabviswa pamwe anorwadza nezvekufadza kunosiyana madhigirii, zvichienderana sei kure chirwere vakava, uye chii zera uye utano hwakanaka wacho.

Mukuwedzera ivowo kusiyanisa:

• Obraztsova chiratidzo - kana munhu anofema panguva palpation uye marwadzo kunowandawo;
• Murphy chiratidzo - nekusagona ufuridzire pamusoro zvakadzika palpation zvakarurama hypochondrium;
• De Musset kuti chiratidzo-Georgievka - palpation sternocleidomastoid tsandanyama (mugumbo rake) murwere chinoratidza marwadzo.

In mumuedzo rabhoritari ropa rinogona kuwanikwa neutrophilia, lymphopenia uye leukocytosis.

Kana zviratidzo kuonekwa

Kushandisa chiratidzo Kera, unogona kuona pamberi acalculous cholecystitis. In pamberi matombo ari gallbladder kana biliary turakiti kusiyanisa dzimwe kuratidzwa symptomatic.

Kera chiratidzo nokuti rikwanise cholecystitis ndiye chidzoke kurwadziwa munduru dundira panguva yakadzika palpation pa nzvimbo murwere muviri nzvimbo.

chirwere Kusiyanisa

Chenjera cholecystitis anogona kusiyaniswa duodenal urikanwi kana dumbu, uyewo rikwanise pfungwa nomuviri zvemwana asati, appendicitis kana renal colic. Kuti varege kuvhiringidza zvirwere izvi, zvinokosha kukwanisa kusiyanisa pavo.

Pamusangano kurwadziwa nomudumbu urikanwi kunoitika hasha, uyezve, zviri zvikuru unopinza, apo cholecystitis vari chiropa marwadzo mikukutu uye pakupedzisira zvishoma kunowedzera. Uyewo pane tembiricha pedo 38 madhigirii uye kurutsa bile.

In chenjera pfungwa nomuviri zvemwana asati, marwadzo ari mupasi riri kuruboshwe yokumusoro quadrant, rinogonawo pamwe kuramba kurutsa.

Chenjera appendicitis haana zviratidzo zvayo marwadzo, zvichiratidza kuti papfudzi uye scapula, uye hariwaniki retching. Appendicitis mune murwere hakusi chiratidzo Kerala uye Musso.

In renal colic haina kuchengetwa kuwedzera kupisa uye pamberi ropa leukocytosis. The kurwadziwa vemunyika kunyanya lumbar munzvimbo uye kunosvika kuna muhudyu uye pelvic zvomukati.

cholecystitis kurapwa

cholecystitis kurapwa vanofanira kutanga pamberi muchipatara. Nomutsinga raitongwa mishonga kuti kuderedza marwadzo (anowanzodanwa kushandiswa jekiseni "shpy") uye kuderera kuita iri gallbladder bile water drainage nokuda kuvandudzika ura duku.

Chiratidzo Kera cholecystitis ane chikonzero pakarepo muchipatara, ichiteverwa zvomusejari kana kuchinja Kupindira pamusoro chikamu navanachiremba.

Nguva kuratidzwa hanya pamberi zvinorondedzerwa zviratidzo uye kukwanisa kusiyanisa kubva nezvirwere differential runogonesa mukana kuti kukurumidza kupora pasina kuvhiyiwa.