Perforated urikanwi: Zviratidzo uye kurapwa

Chero chirwere wakasara untreated kana asingadi kutevedza mazano ose chiremba anogona kukonzera dzakakomba matambudziko. Pari, chikuru chikamu vemo anotambura zvirwere zvomudumbu turakiti, kusanganisira gastritis uye maronda Bhindaukai rimwe wokutanga akakwirira. Mumwe matambudziko anoitika pathologies izvi chinhu Perforated gastric urikanwi uye duodenal maronda, zviratidzo uye mabatiro pathologies izvi ichakurukurwa pashure.

Chii perforation?

chirwere ichi ndicho nemhaka yematambudziko ose peptic urikanwi chirwere, izvo zvinogona kuitika nokuda kwezvikonzero zvakasiyana-siyana, asi vanogona kutungamirira paumbwe kuburikidza mugomba muzvanza muviri. Izvi zvinogona mudumbu, uye chero ura.

Somugumisiro paumbwe zviri yose perforation mudumbu kana ura pamwe kugutsikana uye makemikari muwisira peritoneal mhango uye otanga kudya kure kwaari. Infectious yomuchipatara havarambi hanya, uye achipindura yakadaro chiitiko hwapedyo ane kushoma, unonzi peritonitis.

Iyi haisi ezvinhu kunoda pakarepo zvokurapa kupindira. Kakawanda kuomesa ichi rikaitika simba hafu vavanhu, uye panowanikwa nenhongonya mupfumvudza uye kwematsutso.

VaBennett perforation mudumbu

Pane zvikonzero zvinoverengeka zvinogona kutungamirira Perforated urikanwi, pakati pavo zvikuru zvinokosha:

• Kakawanda kuzvimba mudumbu.
• Kurovedza muviri, izvo zvinozoita kuti kuwedzera intraabdominal kumanikidzwa.
• rakawandisa Large zvokudya.
• Vakaregeredza nemafungiro kudya zvinenge zvataurwa.
• Zvinokangaidza.
• Kushandiswa asipurini kana glucocorticoid kurapa.

Kuvapo kuzvimba ari mucous Kamudzira kunogona kutungamirira pakuti Perforated urikanwi, zviratidzo zvayo anogona kushanyira murwere. Hako kuda firimu dzose uye kutevera chiremba audzwa.

VaBennett urikanwi 12 duodenal urikanwi

Kazhinji kacho muviri ichi maronda chinokonzera dzomuShoko nezvinetso mudumbu. Kana pasina zvinoitwa kubvisa kuzvimba ipapo zviri chokwadi kuparadzira kusvika duodenum.

The zvinokonzera angavawo:

• Chidhakwa.
• Gallbladder chirwere, chisingaperi appendicitis.
• HweHIV pamwe utachiona Helicobacter pylori.

Zvinofanira kurangarirwa kuti Perforated urikanwi 12 duodenal urikanwi zvinoitika zvikuru kakawanda kupfuura mudumbu.

Symptomatology Perforated urikanwi

Kana murwere ane rikwanise chirwere, nguva dzose kunoratidzwa marwadzo, kurutsa, izvi zvose kazhinji kunoitika pashure zvokudya. Panguva paumbwe perforation Perforated urikanwi zviratidzo chinhu unopinza "munondo" kurwadziwa kuti haagoni zvaitombova. Murwere anoedza kudhonza makumbo ake pachipfuva chake, kuderedza nayo.

Panguva ino, sezvo pane kuwedzera zviratidzo kudhaka nokuda kwechirwere zvose zviri mudumbu, ari kune abdominal mhango. The ganda inova rakachenuruka, rinowanika ziya chando, kunoderedza BP uye mwoyo kurova nokukurumidza.

Kukura chirwere ichi pane matanho anoverengeka:

1. Shock rwakazara. Sezvo nguva uye kunoratidzwa saregerereka kurwadziwa zvikuru kuti anogona mupe kurutivi rworudyi. Nokuda kwaizvozvi, zvakaoma kufema, tsandanyama kwakaoma uye kuoma.
2. Zvekufungidzira kuvandudzika. Panguva ino, zviri pamusoro maawa mashomanana pashure kutanga marwadzo, mamiriro akavandudzika zvishoma, Perforated urikanwi zviratidzo zvavo ipfupi. Pane utera, kumanikidza yakaderera, tsandanyama usanetseka zvishoma, uye zvinova nyore kufema. tembiricha muviri rinowanzova iyi rwuchiwanzwa, pane bloating, varwere vanoziva ichi, havachazotamburi kuvhiringidzwa naye muchetura kana chikosoro. Pasina chimbichimbi munguva iyi haigoni kupiwa.
3. Mushure 12 maawa kare kuzviratidza peritonitis zviratidzo kuoma iri nemumuromo mhango, ari abdominal marwadzo. Zvinofanira kucherechedzwa kuti zviratidzo peritonitis vanogara zvakafanana, pasinei chikonzero, kuti akaparirwa. Ndinofungidzira kuti ichi chakaitika pamusoro perforation pakati urikanwi mudumbu kana ura zvinogoneka chete pahwaro yacho iripo nechirwere.

Peritonitis zvinogona kukonzerwa appendicitis, pfungwa nomuviri zvemwana asati, asi chero kana vanofungidzirwa zvokurwara dzakadaro okukurumidzira muchipatara. Inokuvadza ndiwo mamiriro ezvinhu apo kukura urikanwi anenge asina zviratidzo. Zviratidzo yakaitika perforation murwere haagoni kufuratira, uye chete edza kuderedza marwadzo mhuri kugadzirwa zvinoreva uye inonyaradza marwadzo omusoro, uye upenyu pangozi.

Zviratidzo bowel maronda

Kana paine perforation pamusoro duodenum 12, zviratidzo zvingasanganisira:

• Kurwadziwa mukati hypochondrium kuruboshwe, iyo inogona kupiwa pamutsipa uye bondo.
• Kurutsa, kazhinji zvinoitika kamwe chete.
• It anova "dumbu pannukakku serin'i."
• Pane ziya kuchitonhora, uye rinokwanisa kucheneruka mucous membranes.

Sezvazvakanga zvakaita gastric perforation, Perforated urikanwi 12 duodenal urikanwi, zviratidzo izvo tiri kufunga, zvinotungamirira chokuti iri Danho rechipiri pakukura pakarepo kutanga kuratidza zviratidzo kuwana bowel zviri munzvimbo abdominal mhango. Tachycardia, fivha, kurwadziwa ndivo chapupu wakajeka kugadzira peritonitis. In mamiriro ichi, tinofanira kubatsirwa nokukurumidza vanovhiya.

diagnosing perforation

Sezvo Perforated gastric urikanwi uye duodenal urikanwi zviratidzo anotaurwa mu wokutanga pachikuva, uye varwere kazhinji kuuya kuchipatara yechipiri, ipapo hwaro zvakarurama nechirwere ndiyo nhoroondo zvokurapa. Uyewo, iva nechokwadi kuti zvokuwedzera:

• Radiography, iyo inoratidza kuvapo vakasununguka gasi, kana paine perforation.
• US rinoratidza kutanga kuzvimba muna peritoneal mhango uye kuvapo emura.
• dzimwe nguva EGD rinoshandiswa kuziva chaiyo nzvimbo zvokurwara, asi pane mukana gasi kupinda abdominal mhango, saka unofanira kungwarira chaizvo.
• Kana nyaya iri huru, uye zviratidzo Perforated urikanwi pamusoro duodenum iri lubricated, vanoita munhu laparoscopy.
• miedzo ropa uyewo vanoratidza zvakawedzera dziine ESR, mukuru uchibaya leukocytes uye Chizenga mumatunhu kudukupiswa.

Chete mushure nokusimbisa paine perforation zvekungofungira vachaitwa kuvhiyiwa.

rubatsiro First kuti Perforated urikanwi

perforation inotungamirwa mudumbu kana ura zviri ngozi chaizvo nokuti upenyu hwomunhu, ndicho chikonzero panguva nokufungirana ino wakare zvinokosha kudana amburenzi. In muitiro kutakura murwere ari chakakomba ezvinhu kugadzirira raitongwa kuramba arterial kumanikidzwa, inhalation reokisijeni kuita kupa inonyaradza marwadzo omusoro.

Akashandiswa iyi ndiyo kukodzera opioid analgesics, sezvo ivo kutyora murwere kuziva uye girisi zvekuchipatara kuratidzwa, izvo chinoita zvinetso nokuda yakarurama zvawanikwa.

Perforated urikanwi kurapwa

Perforated bowel urikanwi zviratidzo ndiye anenge kufanana perforation mudumbu, ivo kugovana zvakawanda uye kuti kurarama vagumirwe chete vanovhiya. Kushanda kupindira zvinokosha kuti tiite nekukurumidza, nekuti padanho pashure zvingava maturo.

Kana mamiriro ezvinhu anoda, manipulations zvose rwaiitwa ari yevanenge. Vasati vavhiyiwa, kuti vachiongorora zviri akaiswa uye anobudisa mushonga zvishoma nezvishoma kunyika dundira, uye pacharo kuvhiya rinoitwa pasi zvavo yokutindivadza.

The chiremba anoita incision uye anoongorora mhango mudumbu kana ura, kuona perforations, uye ipapo kugadzirisa dambudziko, sei kuhupedza. Kuti aite izvi, imi mune akawanda kuita:

1. Unogona kutora mugomba.
2. Mune zvimwe zviitiko, avabvisa chikamu dumbu pamwechete perforation.
3. Excision of urikanwi uye vakabata vagotomy.

Kakawanda, pane rangu, vanachiremba vanovhiya vanoziva kuti suturing haisi 100% runovimbisa pakupora zvakakwana, zvazvo zvinowanzoitika. Naizvozvo, nzira iyi kudzora perforation dzisina mumamiro zvakaoma. peritonitis, kana pamberi chirwere vechiduku vanenge vava chikonzero mamiriro ichi mupfungwa.

Kazhinji zvimwe zviitiko, rikurumidze excision kuti urikanwi kana gastric resection.

Sezvo vasati excision kana suturing, uye pashure akavhiyiwa anoteererwa kwakakwana nokubatanidzwazve mhango uye kumisa zvimwe drainages.

Takurukura waiti: ". Perforated urikanwi zviratidzo uye kurapwa" rubatsiro rwekutanga mukurapa izvi kuchikosha chaizvo, asi vakawanda zvainonyatsoreva nhema mukutanga muchipatara.

Matambudziko pashure pokuvhiyiwa uye for yeramangwana

Pakati postoperative matambudziko acho ndiwo zvinotevera:

• Kukura imwe mota iri abdominal mhango.
• Nemabayo.
• Kana vazvo anoitwa havaratidzi, izvozvo hwakazara paumbwe apiwa perforation uye peritonitis uye sepsis.
• Very kashoma zvinogoneka kutyora kukwidziridzwa zvokudya kuburikidza yegurokuro mudumbu somugumisiro wacho aienda pamusoro mazano ari sphincter.

Kana kuona munguva Perforated urikanwi, zviratidzo kugadziriswa uye akatora zvose matanho anodiwa kubvisa zvirwere, fungidziro iri kazhinji zvakanaka. In zvaidiwa vanorumbidza dzose chiremba uye kudya kunogona kurarama sezvinongoita.

kurapwa vanhu nemaronda

Kana hosha anyanyisa, uye vakaumba perforation, mishonga nemakwenzi asina maturo. Asi pashure pokuvhiyiwa, kuwedzera kune mwero yawapiwa, zvinokwanisika kushandisa kunenge tsika varapi.

Hedzino dzimwe Quick ichabatsira yokuderedza acidity pamusoro gastric muto, kudzivirira kuitazve:

1. Sanganisa muto Lemons maviri 0.5 litres uchi uye zvakafanana nemafuta omuorivhi. Ready kushandisa mushonga kuti 1 st. l. pamberi kudya 3 kanomwe pazuva kwemwedzi.
2. 250 magiramu ose Aloe mashizha vakadzvinyirirwa imwe nyama mukuyi, wedzera 250 magiramu uchi uye kudziyisa musanganiswa kusvika 50 madhigirii, zvino wedzera hafu ity waini tsvuku. Zvose izvi zviri yokusimbirira munzvimbo ine rima 7 days, uye ipapo unogona kutora rimwe spoon 3 kanomwe pazuva kweawa pamberi zvokudya. Ya kurapwa uyu 3 mavhiki.

Zvinofanira kurangarirwa kuti mushonga chinyakare anogona kubudirira kwokutanga nzendo kukura nemaronda uye perforations ari chiitiko hapasisina njere.

How kudzivisa dzokororo of perforation

Kuti adzivise dzokororo panowanikwa Perforated urikanwi, Anti kuitazve kurapa chinofanira kugara kunze, izvo zvinosanganisira:

1. Kudya abvume. Kuti tizvidzivirire varwere anoshanda № 1 zvokudya, kunyanya panguva yatinenge zvichibvira exacerbation.
2. Muchigamuchira mishonga inodiwa. The kupinda Chiremba kunodiwa kuti dzave panyaya iyi.
3. Physiotherapy. Vanopa nemigumisiro yakanaka pachiimbwa kudya zvinovaka muviri uye zvinodhaka kutarisira.
4. Periodic Spa kurapwa.

Zvirwere nemudumbu kunogona kukonzera dambudziko wayo. Kana musingadi vanoomerera pakuomerera zvokudya kurambidzwa, kushungurudzwa muropa, pasi kakawanda kushushikana, unogona kushamiswa kuti denda ndizivise zvakare pacharo nokuda kwayo hachifadzi zviratidzo. Zvichengetedze uye utano hwako, hazvigoni kutengwa chero mari.