Differential chirwere pamusoro abdominal marwadzo. Abdominal chirwere - chii?

Kana kuona abdominal marwadzo, vakawanda nhokwe kutora piritsi, "Asi-Spa" kana "ftalazol", muchitenda kuti vaiva nechinetso pamwe zvomudumbu maitiro. Zvisinei, mudumbu anogona kurwadziwa nokuda gumi nevaviri zvikonzero chokuita kana kuti dumbu kana ura. Fani iyi ndiyo kunyange wezvokurapa izwi - abdominal syndrome. Chii? The zita rinobva muchiLatin "dumbu", iro rinoshandurudza se "momuviri." Ndizvo zvose chokuita nzvimbo iyi womunhu wemuviri abdominal. Somuenzaniso, dumbu, ura, dundira, chirwatata, itsvo - iri abdominal nhengo, uye gastritis, pfungwa nomuviri zvemwana asati, cholecystitis, colitis uye nezvimwe zvinetso gastrointestinal - abdominal chirwere. By Fananidzo, abdominal chirwere - nayo dambudziko iri nomudumbu (zvakaoma kwazvo, marwadzo, tingling, cramping nemamwe manzwiro akaipa). Kana zvichemo zvakadaro murwere basa iri chiremba ari yakarurama Kusiyanisa zviratidzo, kwete kuti kururama pamwe nechirwere. Ngationei kuti izvi zvinoitwa tsika uye chii vari zvaidiwa marwadzo chokuita nechirwere chimwe nechimwe.

Human abdominal mhango

Kuti zvive nyore kubata mubvunzo: "? Abdominal chirwere - chii" uye kunzwisisa sei rakundwa, unofanira kunyatsonzwisisa zviri mukati dumbu yedu, iro rine nhengo sezvo ivo pamwe chete nomumwe. unogona kuona schematic chubhu yegurokuro pamusoro anatomical mifananidzo, zvakakura-kura dumbu, ura writhing nyoka, chaipo pasi mbabvu chiropa, chirwatata, akasiya, pazasi dundira kusvika ureter, Munotatamura kubva neitsvo. Ndicho, zvakafanana, ndizvozvo zvose. Kutaura zvazviri, redu abdominal mhango ane zvakawanda kunzwisisa chivakwa. Conventionally, rakakamurwa muzvikamu zvitatu. yokumusoro muganhu iri - paruoko rumwe - domed tsandanyama kushevedza diaphragm. Above ndiro thoracal mhango nemapapu. Mhiri rokumusoro chidimbu anosiiwa avhareji anonzi mesentery ari muura. Ichi kaviri rukoko nedanga, hwaishandiswa nhengo dzose zvomudumbu turakiti vari vasiyana kumashure yendege dumbu. Pamusoro chidimbu ane mapoka matatu - chiropa, rwatata uye shwanu. The pakati chidimbu kubva mesentery kunosvika pamberi kutanga chiuno. Zviri muchikamu ichi mudumbu ndiyo nzvimbo achiine rukuvhute. Pakupedzisira, rezasi chidimbu - imwe nzvimbo imwe wokushambidzira duku, iyo akawana nzvimbo urogenital nhengo uye dzokubereka nehurongwa.
Chero abnormalities (kuzvimba, utachiona, zvemaziso uye makemikari zvinokonzerwa, zvokurwara inotungamirwa uye kubudirira) mumuviri mumwe nomumwe pamusoro yakarongwa muzvikamu zvitatu kukonzera abdominal syndrome. Uyezve, muna peritoneum vari ropa uye nhengo dzinobudisa midziyo uye ganglia. Pakati pavo zvikuru nomukurumbira ndivo yeropa uye zuva nenyika dzinotenderera pariri plexus. The kuchangotanga dambudziko navo uyewo kutsamwisa kurwadziwa mudumbu.

To muchidimbu: abdominal urwere zvinogona kukonzerwa chero anozivikanwa kufambidzana, gastrointestinal chirwere uye urogenital ezvinhu, matambudziko nemidziyo ropa uye tsinga plexus pamusoro peritoneum, zvemakemikari dzokupisa (chepfu, mushonga), zvokuimba compression (Kudzvinya) zvose pedyo dzakabatana kuti dziri munzvimbo peritoneum.

marwadzo

Differential chirwere pakati abdominal marwadzo Kazhinji kunotanga kuziva nzvimbo uye hunhu kurwadziwa. Zvikuru upenyu pamutanhiko uye zvakaoma kuti muvanhu dzevanhu, Chokwadi, munhu unopinza kurwadziwa. It rikauya pakarepo, pakarepo, kazhinji pasina chinooneka makatsamwisa ayo zvinokonzera, akaratidza kurwisa, zvisingaperi kubva kwemaminitsi mashomanana kuti paawa.

Kurwadziwa angaperekedzwa kurutsa, manyoka, fivha, chills, kutonhora sweats, kurasikirwa chavanoziva. Kakawanda, vane chaiwo nzvimbo (kurudyi, kuruboshwe, pasi, kumusoro), izvo zvinobatsira kuumba munhu rokutanga kuongorora chirwere.

Zvirwere zvinokonzerwa abdominal chirwere kwakadaro - ndiko:

1. anogumbura pezvakaitwa ari peritoneum - chakasimba uye relapsing appendicitis, diverticulitis Meckel, peritonitis, rikwanise pfungwa nomuviri zvemwana asati kana cholecystitis.

2. mhingaidzo kana strangulated heniya.

3. perforation (perforation, buri) nhengo pamusoro peritoneum kuti kunoitika muna gastric uye / kana duodenal maronda uye diverticulitis. Paro zvingasanganisira discontinuities chiropa, yeropa, chirwatata, ovary anomera.

Muzviitiko perforation, uyewo appendicitis uye peritonitis murefu hwomunhu 100% novimba zvakarurama zvokuongorora uye kuita okukurumidzira kuvhiyiwa.

Zvimwe Zvidzidzo:

• bvunzo ropa (anobvumira kuti vaongorore basa kushoma, kuona boka ropa);
• Maekisirei (kunoratidza kuvapo kana kusavapo perforations, zvakavhara, heniya);
• Ultrasound;
• kana pane fungidziro kuti ropa iri zvomudumbu turakiti, zvichiita esophagogastroduodenoscopy.

marwadzo

Vanokura zvishoma nezvishoma uye pakupedzisira kwemwedzi yakawanda. Achinzwa panguva iyoyo kana kungopotsera, kudhonza, achirwadza, kazhinji "yakateurirwa" pamusoro yose arikunze ari peritoneum, pasina imwe localization. Marwadzo anogona kuserera uye kudzoka zvakare, somuenzaniso pashure zvokudya. In zvinenge zvose zviitiko, izvi zvinoratidza abdominal chirwere echirwere zvirwere abdominal mhango. Zvinogona kuva:

1) gastritis (kurwadziwa chokumusoro chidimbu, kuda kurutsa, rinorema dumbu, belching, chirungurira, pamwe defecation matambudziko);

2) gastric uye / kana duodenal nemaronda mukutanga mumatanho (kurwadziwa "mudumbu rake," usina chawadya, usiku kana pashure penguva pfupi nguva pashure kudya, chirungurira, iine acid regurgitation, bloating, flatulence, kuda kurutsa);

3) itsvo matombo (marwadzo murutivi yako kana dumbu, ropa uye / kana jecha weti, kunorwadza weti, kuda kurutsa, kurutsa);

4) chisingaperi cholecystitis (marwadzo zvakarurama repamusoro chidimbu, kurukutika, shungu muromo, tembiricha yakaderera, kwete kupfuura kuda kurutsa, kurutsa - dzimwe nguva bile, belching);

5) cholangitis chirwere (mu chiropa kurwadziwa, kurukutika, ganda yellowness, tembiricha yakaderera, mune kurwadziwa anogona kupiwa mwoyo uye nokuda chipande);

6) Oncology ura ari kutanga kwekupwanyiwa.

Idzokororo marwadzo muvana

Akadana idzokororo marwadzo, yokudzokorora. pashure kwenguva. Vanogona kuitika mune vana vemazera uye nedzevakuru.

Vachangoberekwa, chikonzero zvinowanzovapo kurwadziwa mudumbu kuva intestinal colic (inogona pakutsvaga unopinza mukuru-ndokudzika achichema, kupinduka pinduka, abdominal distention, kukundikana kudya, musana bhakoro, runobva kutsanya kufamba nayo-makumbo, regurgitation). Chinokosha intestinal colic ndechokuti ravo kubviswa mwana anova kudzikama, uchinyemwerera, anodya zvakanaka. Kutsungirira chirwere kunotibatsira kupisa, kwiza mudumbu, dhiri Vodicka. Pamwe mwana achikura, matambudziko aya ose vari havo.

A zvikuru chakakomba dambudziko ndiro abdominal chirwere pamwe somatic nezvirwere vana. "Soma" muchiGiriki rinoreva kuti "muviri". Ndizvo pfungwa "zvirwere somatic" rinoreva chimwe chirwere muviri nadzo uye vachiberekwa kana akawana ani kuremara. Kazhinji Neonates zvinochengetwa:

1) zvinotapukira gastrointestinal zvirwere (tembiricha kusvika dzinonetsa pamwero, kuramba zvokudya, lethargy, manyoka, regurgitation uye kurutsa tsime, vachidanidzira, mune zvimwe zviitiko, kushandura Ruvara ganda);

2) zvirwere zvomudumbu turakiti (heniya, chikofu, etc.).

Kuronga nechirwere ichi zvakafamba rakaoma nokuti mwana haasi kukwanisa kuratidza apo zvichirwadza, uye tsanangura manzwiro avo. Differential chirwere kuti abdominal kurwadziwa vacheche rinoitwa pachishandiswa mimwe miedzo, yakadai se:

• coprogram;
• Ultrasound;
• ropa ongororo;
• esophagogastroduodenoscopy;
• X-ray barium abdominal mhango;
• Esophageal ph zvichiongororwa.

Idzokororo marwadzo nedzevakuru

In vana vakura (kunyanya chikoro zera) uye vakuru zvinokonzera idzokororo abdominal marwadzo zvekuti vakakamurwa muzvikamu shanu:

• rwarisa;
• anogumbura (hapana chirwere);
• functionality;
• anatomical (chokuita imwe simba);
• microbiological (kukonzera tupukanana siyana, Vakazopinda muNyika zvomudumbu turakiti).

Chii rwarisa uye anogumbura kurwadziwa, zvakawanda kana zvishoma yakajeka. Uye kuti zvinoreva functionality? Kana vanopiwa chirwere, sei kunzwisisa kana shoko rokuti "abdominal chirwere kuvana"? Chii? Tsanangura pfungwa dzichipfekeka marwadzo anogona kuva saizvozvo: varwere ainetseka pamusoro abdominal kusanzwa pasina chikonzero uye hosha yacho peritoneum. Vamwe vakuru kunyange kudavira kuti mwana akarara pamusoro marwadzo ake, chero haana kuwana chinhu kutyorwa. Zvisinei, kutanga kwakadaro mushonga imomo, uye ikoko ndiko, sezvo mutemo, kuvana vakura kupfuura makore 8. Kukonzera dzichipfekeka marwadzo zvingasanganisira:

1) abdominal migraine (abdominal marwadzo anova nemusoro, ichiteverwa kurutsa, kuda kurutsa, vakadya kukundikana);

2) dzichipfekeka dyspepsia (kubva mwana zvachose utano, marwadzo chokumusoro mudumbu chidimbu uye inonyangarika shure bowel sangano);

3) intestinal bundu.

Chimwe gakava chirwere aiva "chakasimba kufema chaikonzerwa noutachiona ne abdominal chirwere" vana. Treatment iyi nyaya ine vamwe specificity, sezvo vacheche vane zviratidzo uye chikosoro uye intestinal zvirwere. Kazhinji, vanachiremba rokuongorora vana, vane napaduku zviratidzo chakasimba kufema kutapukirwa noutachiona (semuenzaniso, zvakajairika kuchitonhora), nokusimbisa zvirwere zvomudumbu turakiti haisi dzakaonekwa. Kakawanda nyaya dzakadaro, uyewo endemic zvirwere vakakodzerwa mberi nhau yacho.

Chenjera kufema urwere pamwe abdominal

zvokurwara Iri anonyanya kuenda kukireshi uye chikoro chepuraimari vana. In vakuru, ndizvo apo neapo. In mushonga, chenjera zvirwere kufema uye rikwanise kufema kutapukirwa noutachiona chokuita chete mhando zvirwere, sezvo RE (kufema chirwere) anowanzodanwa zvinokonzerwa nemavhairasi, uye vari yaibva kune muchikwata che RVI. zvikuru nyore "hove" zvavo mumapoka evana - zvikoro, kindergartens, nemaruva. Uyezve zvose anozivikanwa yokuSpain kufema, ngozi zvikuru vanonzi "dumbu dzihwa" kana rotavirus. Iyewo chirwere sezvo SARS pamwe abdominal syndrome. In vana, zviratidzo chirwere kuonekwa mazuva 1-5 mushure chirwere. The kunotoda mufananidzo uri sezvinotevera:

• kunyunyuta kurwadziwa mudumbu;
• kurutsa;
• svoto;
• tembiricha;
• manyoka;
• runny mhino;
• kukosora;
• huro dzvuku;
• rwadza kumedza;
• lethargy, utera.

Sezvinogona kuoneka kubva pamazita, uye zviratidzo pachena kuti chikosoro uye intestinal zvirwere. Mune zvisingawanzoitiki zviitiko, mwana anogona here kupa zvakafanana chando ndinoiitawo gastrointestinal chirwere kuti vanachiremba vanofanira kusiyanisa zvakajeka pakati. Chirwere pamusoro rotavirus chirwere zvikuru kunzwisisa. Unosanganisira immunosorbent munhu akaidza, Erekitironi microscopy, diffuse kwemvura, akatakura muzvizhinji wanda. Kazhinji pediatricians chirwere pasina Analyses yakaoma zvakadaro, chiremba kuratidzwa chete chirwere uye achishandisa anamnesis. Rotavirus, kunyange kune zviratidzo ushamwari, musava utachiwana repamusoro kufema mapazi uye nemudumbu, kazhinji muura. Panobva chirwere - murume airwara. Rotavirus kupinda mukati mumuviri muridzi itsva nezvokudya, maoko akasviba, zvinhu zvezuva nezuva (semuenzaniso matoyi), anoshandiswa murwere.

Mabatirwo SARS pamwe abdominal chirwere zvinofanira kuitwa maererano nechirwere. Saka, kana abdominal marwadzo ari mwana kunokonzerwa pathological zvibereko zvinokosha nezvebasa kufema nemavhairasi, mishonga chaicho chirwere, pamwe rehydration kuburikidza nokugamuchira sorbents. Kana yasimbiswa rotavirus chirwere hazvina musoro kugadza mwana nemishonga, sezvo vasina zvainoita nayo utachiona. Marapirwo kunoratidzwa negashiro kusashanda kabhoni sorbents, zvokudya, kunwa zhinji. Kana mwana aripo manyoka, probiotics vanogadzwa. Kudzivirira chirwere ndiko kubaya.

Paroxysmal marwadzo pasina bowel chirwere

Kuti zvive nyore kuziva chii akakonzera chirwere pamusoro abdominal marwadzo vanokamurwa muzvikamu maererano kunzvimbo mudumbu, apo vari vainzwa zvikuru zvakasimba.

Paroxysmal marwadzo asina zviratidzo dyspepsia kuitika pakati chidimbu (mesogaster) uchingodzikira (hypogastrium). Possible zvikonzero:

• infestation nehonye;
• Payra urwere;
• pyelonephritis;
• hydronephrosis;
• pamwe nhengo dzakavandika dambudziko;
• intestinal mhingaidzo (kukwana);
• stenosis (kudzvinya) ari celiac hunde;
• IBS.

Kana murwere abdominal chirwere chete kwakadaro, kurapwa iri ushandiswe pachishandiswa mimwe miedzo:

• yemhando bvunzo ropa;
• seeding mutsvina yadzo mazai nehonye uye intestinal zvirwere;
• urinalysis;
• Ultrassom of zvomudumbu turakiti;
• ergography (irrigoscopy barium danda nzira);
• Doppler Ultrasound of abdominal nhumbi.

Abdominal kurwadziwa pamwe bowel zvirwere

All Mapato mashanu idzokororo marwadzo zvingaitika munguva rezasi uye pakati zvikamu zviri peritoneum panguva nezvinetso muura. Zvikonzero nei paine kudaro abdominal urwere, zvikuru. Heano mamwe acho:

• helminthiasis;
• vari sema chero zvigadzirwa;
• nonspecific maronda colitis (manyoka mberi akaona, pachituru anogona kuva pus kana ropa, flatulence, kurasikirwa kudya, simba, dzungu, uremu);
• celiac chirwere (more nevakawanda vana vaduku panguva kutanga kwavo dzichifura mucheche bumbiro remitemo bota);
• zvirwere (salmonellosis, campylobacteriosis);
• pathologies ari muura Somuenzaniso, dolichosigma (sigmoid muura akareba), marwadzo ari akawedzera mazhinji kupatira;
• disaccharidase kushaikwa;
• Hemorrhagic vasculitis.

Zvapedzisira ezvinhu kunoitika apo zvomoto uye, somugumisiro, midziyo kuzvimba ropa iri ura, pakugwamba yavo kunoitika. Zvikonzero - kunetswa muropa riparadzirwe uye chaishanda hemostasis. Ichi chirwere inonziwo Hemorrhagic abdominal syndrome. Ari kusiyaniswa pamwero zvitatu basa:

I (nyoro) - zviratidzo ndivo munyoro, pakutsvaga mabasa ESR muropa.

II (makore uremu) - kune vanoziya kurwadziwa peritoneum, tembiricha inokwira, pane simba, uye kutemwa.

III (zvakakomba) - yakakwirira tembiricha, zvikuru nomusoro uye abdominal marwadzo, utera, kuda kurutsa, kurutsa ropa, weti uye mutsvina yadzo hwakakanyiwa ropa, anogona kukonzera ropa mudumbu uye ura, perforation.

Kana mukawana marwadzo pakati uye dzapasi peritoneum zvinhu zvakaipa pamusoro chero matambudziko bowel, Diagnostics zvinosanganisira:

• Rakatanga ropa kuongorora (nokukanganisika kwava);
• coprogram;
• fibrocolonoscopy;
• ergography;
• chetsoka tsika;
• kuongororwa ropa kuti antibodies;
• rehydrogen bvunzo;
• Endoscopy uye biopsy duku ura tishu;
• immunological miedzo;
• shuga munyonga.

Kurwadziwa repamusoro chidimbu pamusoro abdominal (epigastric)

Kazhinji, abdominal chirwere chokumusoro chidimbu kubva peritoneum ndiwo mugumisiro kwezvokudya yaunodya uye anogona kuoneka nenzira mbiri:

• dispepsionnom, iri kutyora mudumbu ( "nzara marwadzo" kutevera zvokudya);
• dyskinetic (anobuda marwadzo, kunzwa nokudyisa, zvisinei uwandu anwa zvokudya, belching, kurutsa, kuda kurutsa).

The zvinokonzera ezvinhu akadaro angava gastroduodenitis, gastric hypersecretion pamusoro hydrochloric acid, utachiona, intestinal makonye, pancreatic zvirwere uye / kana biliary turakiti, havachanyatsogoni gastroduodenal motility. Uyezve, epigastric marwadzo kungakonzera Dunbar syndrome (zvokurwara celiac kutsemuka hunde kana kusvinwa diaphragm). chirwere ichi ndicho vachiberekwa, nhaka (kazhinji) kana vawana munhu anouya neyrofibroznoy kukura tishu.

Celiac hunde (guru pfupi bazi abdominal yeropa) kana compression inotengwa wakarovererwa yeropa, kujekesa zvikuru mumuromo wayo. Izvi zvinokonzera abdominal ischemic urwere, chirwere rinoitwa uchishandisa musiyano X-ray (angiography). Celiac hunde pamwe nemamwe mudziyo ropa anopa ropa kune abdominal mhango ose gastrointestinal nhengo. Nepo kudzvinya kukurukura ropa, uye nokudaro nerubatsiro zvomukati zvakafanira zvinhu kuitika harizari, iyo inotungamirira okisijeni nezvaaishayiwa (hypoxia) uye ischemia. Zviratidzo zviri chirwere yakafanana neiya akaona gastritis, duodenitis, gastric urikanwi.

Kana ropa rakawanda kuperevedza ruzivo ura hwapedyo ischemic colitis, enteritis. Kana ropa havatorina kuti chiropa, hepatitis hwapedyo uye rwatata anopindura kukundikana muropa nerubatsiro pfungwa nomuviri zvemwana asati.

Chisingafaniri zvisirizvo pamwe nechirwere, yaifanira mberi kuongorora varwere vanofungidzirwa abdominal angina. Endovascular Diagnostics - ichi ndiyo nzira yakanakisisa inoumbwa pakuti midziyo ropa icho kupfurikidza inputting mairi anobudisa mushonga zvishoma nezvishoma kuva X-ray ehupfumi. Kureva nzira kuchaita kuona zvinetso tsinga pasina kuvhiyiwa. Endovascular chirwere rinoshandiswa hosha dzose abdominal nhumbi. Kana zvichiratidza, waya uye endovascular kuvhiyiwa. zvinogoneka Kupindura zvichemo murwere vakafunga abdominal angina:

• Kuramba kurwadziwa mudumbu, kunyanya pashure kudya, kana kuita chero basa remaoko kana mupfungwa;
• Manzwiro pakuzara nekuomarara chokumusoro chidimbu pamusoro peritoneum;
• belching;
• chirungurira;
• shungu mukati nemumuromo mhango;
• manyoka kana, Ukuwo, kupatira;
• kakawanda nomusoro;
• kupfupika mweya;
• pulsation mudumbu;
• uremu;
• vakawanda kuneta uye kushaya simba.

Kuongorora chete kwokunze murwere, uyewo mureza chirwere nzira (ropa, weti, Ultrasound) havasi kutsoropodza kuti vasabatwa chirwere.

Vertebral abdominal urwere

Izvi mhando zvokurwara chimwe chezvinhu zvakaoma kuona. It iri chokwadi kuti varwere vari zviratidzo zvakajeka nezvinetso nemudumbu (abdominal marwadzo, kurutsa, belching, chirungurira, manyoka kana kupatira), asi ivo zvinokonzerwa zvirwere musana kana zvimwe zvikamu zvetsandanyama nemapfupa hurongwa. Vanachiremba vasingawanzotauri nemazvo kuziva chikonzero pakarepo, saka kurapa rinoitwa, hakuiti nezvibereko. Saka, maererano nenhamba, vanenge 40% varwere osteochondrosis pamusoro thoracal, kurapwa vasiri aripo bowel chirwere dzavo, uye dumbu. Kunyange sadder mufananidzo pamwe musana zvirwere. Pain Pakadaro kazhinji vachirwadziwa, mikukutu, zvachose kwete chokuita nezvokudya yaunodya uye kana varwere vane kupatirwa kana manyoka, havana kubatwa kwakajairika nzira. Kukonzera zvinotevera zvirwere zvinogona vertebral abdominal urwere:

• spondylosis;
• scoliosis;
• Tiibhii of muzongoza;
• syndromes chokuita bundu kuchinja musana mbiru;
• visceral syndromes (Guttseyta).

Chinhu chinosiririsa ndechokuti varwere vachinyunyuta pamusoro abdominal marwadzo uye non-zvomudumbu turakiti pathologies, kazhinji vachinzwisisa sezvo malingerers. Kuti uzive mhaka hazvitaurwi abdominal kurwadziwa, zvakakodzera kushandisa mamwe nzira nechirwere, akadai spondylography, X-ray, MRI, rentgenotomografiya, ehospondilografiya uye nevamwe.