Qhov cecum muaj ib cov hnyuv loj uas ua rau lub cev muaj kev tiv thaiv. Cov ntawv cog lus ua raws li ib hom "ua liaj ua teb" thiab cia ntawm cov kab mob uas ua rau ib qho kev pab microflora. O ntawm no appendage yog qhov ntau hom pathology ntawm digestive system, kheej tam sim ntawd phais kev cuam tshuam.
Appendicitis - ua rau
Qhov tseem ceeb tshaj plaws uas ua rau muaj tus kab mob nyob rau hauv nqe lus nug tseem tsis tau tsim. Cov kws kho mob tsuas yog qhia tias yog vim li cas appendicitis tshwm sim - qhov ua rau raug muab cais ua 4 pawg raws li cov kab mob uas tshwm sim ntawm txoj kev mob nkeeg:
- mechanical;
- kis mob;
- plawv;
- endocrine.
Ua rau mob hnyuv tws
Lub tswv yim tseem ceeb ntawm txoj kev loj hlob ntawm tus kab mob piav qhia yog lub hlwb (obturation) ntawm daim ntawv qhia appendix. Qhov no ua rau cov khoom hnyuv tso tawm thiab kab mob hauv cov ntaub ntawv. Nws nce nyob rau hauv qhov loj, lub siab sab hauv thiab hlob tuaj. Mob hnyuv hnoos tau tshwm sim nyob rau ntawm keeb kwm ntawm cov hnyuv ntawm pob txha tom qab (pob zeb pob zeb), lub cev nqaij daim tawv, lub cev thiab cov nqaij hlav (carcinoid).
Qee lub sij hawm qhov txheej txheem inflammatory ua rau nws debut vim ntawm lub hauv paus inflexion los ntawm cicatricial fusion vim lwm pathologies nyob rau hauv lub plab kab noj hniav:
- enteritis ;
- mob plab;
- adnexitis;
- cholecystitis;
- peritiflita;
- tsim ntawm adhesions.
Raws li seem ntawm theories ntawm cov tsos mob ntawm tus mob appendicitis, nws tshwm sim los ntawm qee yam ntawm xws li:
- tus kab mob ntawm cov kua txiv hmab txiv ntoo nrog cov kab mob pathogenic;
- kev mob vasculitis;
- tso zis ntau dhau ntawm serotonin hormone.
Mob hlwb appendicitis - ua rau
Daim ntawv ntawm tus kab mob no yog ib qho mob qis ntawm cov hnyuv, tsis muaj cov tsos mob tshwm sim. Feem ntau cov kws kho mob tsis kam txais cov kab mob appendicitis. Qee cov kws kho mob tau tsim ib qho kev kuaj mob, muab faib rau hauv hom thawj thiab theem nrab. Qhov ua rau ntawm qhov ua kom mob ntsig yog:
- Hloov cov kab mob nyob hauv pawg me me;
- hloov qaub qis hloov tom qab mob nyhav dhau los uas tsis tau muab tshem tawm ntawm daim ntawv "appendix".
Cov tsos mob ntawm tus mob appendicitis
Los ntawm kev paub lub sij hawm ntawm qhov kev ntsuam xyuas pathology nyob rau hauv nqe lus nug, qhov kev vam meej ntawm nws cov kev kho mob nyob ntawm. Txhua tus neeg yuav tsum nco ntsoov tias cov tsos mob ntawm tus mob appendicitis tau pom ua ntej. Qhov no yuav pab kom sai li sai tau tsam tus mob thiab nrhiav kev pab tsim nyog. Txwv tsis pub, yuav muaj tus kab mob hnyav hnyav - cov tsos mob ntawm tus kab mob mob yuav muaj zog thiab ua rau muaj kev phom sij. Thaum tsis muaj kev cuam tshuam nrog kev kho mob rau hauv tej lub sijhawm no muaj kev nyuab siab heev, qee zaum kev tuag txawm yog qhov muaj tseeb.
Thawj cov cim mob hnyuv tws
Ib hom kab mob tshwm sim ntawm tus kab mob no pib nrog kev xav tsis zoo nyob rau cheeb tsam ntawm lub plab, feem ntau yog yav tsaus ntuj los yog hmo ntuj. Thawj tus kab mob ntawm tus mob appendic yog dull ntsis mob xws li gastritis. Vim yog qhov tsis siv ntawm qhov kev tshwm sim no, ib tug neeg tsis tuaj yeem mus tom tsev kho mob. Muaj lwm cov cim qhia nrog mob hnyuv tws - cov tsos mob thaum ntxov:
- xeev siab;
- ntuav (1-2 zaug);
- tsis muaj zog;
- tsis pom kev;
- qhov ncauj qhuav.
Cov tsos mob ntawm tus mob mob hnyuv
Tom qab theem pib, qhov pathology loj zuj zus, thiab nws cov duab saib mob yog qhov chaw tshaj tawm. Qhov mob nrog mob hnyuv yuav ua mob nyhav, phom sij los yog nias. Qhov tsis xis nyob yog xav tsis yog hauv qhov chaw xwb, tab sis kuj nyob hauv plab plab yog. Appendicitis, cov tsos mob, tshwm sim ntau dua li ob peb xuab moos tom ntej:
- nce hauv lub cev kub li ntawm 37-38 degrees;
- Tsis tshua muaj tsis qab los noj mov (anorexia);
- persistent siab xeev siab;
- plawv palpitations (tachycardia), mus txog 90 neeg ntaus ib feeb twg;
- tsam plab;
- dawb lo rau ntawm tus nplaig.
Cov tsos mob ntawm tus mob appendicitis
Clinical manifestations ntawm tus mob qeeb-burning ntawm tus mob yog nonspecific, lawv yuav muaj cov yam ntxwv ntawm ntau yam kab mob ntawm cov kab mob gastrointinal. Cov tsos mob ntawm tus mob appendicitis:
- quav muaj mob, xws li cem quav, thiab raws plab;
- xeev siab, tshwj xeeb tshaj yog tom qab lub cev nqaij tawv thiab kev tsis noj nqaij hauv kev noj haus;
- tsis qab los noj mov;
- txob taus;
- periodic mob plab mob.
Yuav ua li cas los txiav txim rau mob hnyuv tws?
Tsuas yog tus kws kho mob uas tsim nyog tuaj yeem paub tseeb tias muaj cov txheej txheem tiv thaiv kab mob hauv lub hnyuv. Txawm tias paub txog sab twg ntawm daim ntawv qhia appendix (sab plab hauv plab), thiab qhov twg mus nias rau kev kuaj lub cev, yuav tsis pab kuaj qhov tseeb. Hauv qee leej tib neeg, pawg neeg hauv qab no muaj nyob rau hauv qhov chaw hauv atypical, thiab palpation incorrectly ntau zaus cuam tshuam kev puas tsuaj los yog tawg ntawm phab ntsa ntawm daim ntawv qhia appendix.
Muaj ntau cov tswv yim cob qhia rau kev paub cov kab mob appendicitis:
- Mendel lub tsos mob. Thaum tapping nrog tus ntiv tes ntawm phab ntsa hauv sab nrauv, qhov mob nyob rau hauv txoj cai atal.
- Ntseeg Sitkovsky. Kev tsis xis nyob yog khaus ntau yog tias ib tug neeg twg tig mus rau sab laug.
- Cim ntawm Pshevalsky. Nws yog qhov nyuaj rau tus neeg mob nce nws txoj cai ceg.
- Cim ntawm Shchetkin-Blumberg. Mob ntxiv nrog rau cov tshuaj retraction tom qab lub siab.
- Yeeb yam ntawm kev tsim txom ntawm cov peritoneum. Tsis xis nyob thaum hnoos, luag, hnoos, taug kev thiab thab plaub.
Txog kev lees paub kawg ntawm kev tshawb nrhiav qhov tseeb, muaj ntau yam kev ua si:
- kuaj ntshav (soj ntsuam, biochemical), quav, zis;
- coprogramme;
- kuaj ultrasound;
- duab hluav taws xob;
- Irrigoscopy;
- computed tomography;
- electrocardiogram.
Thawj pab nrog kab mob hnyuv tws
Yog tias ib qho kev mob ntawm daim ntawv tom qab ntawm qhov cecum yog xav tias, yuav tsum tau hu rau pab pawg kho mob tam sim ntawd. Hauv xov tooj nws yog ib qho tseem ceeb uas yuav tsum tau qhia tias tus neeg mob yuav tsum tau muaj tus kab mob appendicitis - piav qhia cov tsos mob ntawm qhov tseem ceeb tshaj plaws, kom paub meej txog tus mob thiab kev noj qab haus huv ntawm tus neeg. Ua ntej tuaj txog ntawm cov kws tshwj xeeb, tsis muaj kev ywj pheej ntawm kev kho mob yuav tsum tau ua.
Kev pab thaum muaj xwm txheej kub hnyuv laus:
- Tso cov neeg ntawm ib sab ntug.
- Txhawm rau muab tus neeg mob kaj siab lug.
- Tsis txhob muab dej, khoom noj, tshuaj.
- Nws yog txwv tsis pub tso rau hauv enemas, muab tso rau hauv lub plab.
Appendicitis - ua haujlwm
Tib txoj kev los kho tus kab pathology no yog kom mob cov kab mob hauv lub cev. Kev tshem tawm ntawm txoj hnyuv tom qab cov hnyuv raug siv nrog kev siv tshuaj loog thiab yuav tsum tau ua ntej rau tus neeg mob. Ntawm lub tswv yim ntawm lub lag luam, tus neeg mob yog txhaj nrog physiological saline thiab hwj chim tshuaj tua kab mob. Qhov no yog qhov yuav tsum tau txo qhov kev siv ntawm qhov mob thiab tiv thaiv tus kab mob thaum thiab tom qab kev phais. Tsis tas li ntawd, gastric lavage thiab plab hnyuv ntxuav.
Tus txheej txheem ntawm kev tshem tawm ntawm daim ntawv qhia appendix yog laparotopic appendectomy. Nws yog ua los ntawm cov tshuaj loog thoob plaws thiab muab kev nkag ncaj qha mus rau hauv lub cev qis los ntawm kev txiav lub plab phab ntsa nyob rau sab xis. Ua tsaug rau cov kev kho mob niaj hnub nim no, muaj lwm txoj kev, tsis muaj kev ntshai, txoj kev ntawm kev txiav txim ntawm daim ntawv qhia appendix.
Tshem tawm ntawm txoj kab nruab nrab ntawm txoj kev siv laparoscopic
Txoj kev kho no ua rau cov ntshav qis dua, tiv thaiv kev tsim cov nti loj thiab cov kab mob hauv plab. Laparoscopic tshem tawm ntawm daim ntawv "appendix" ua kom muaj kev raug mob tsawg heev rau cov nqaij mos thiab tawv nqaij, ua rau lub sij hawm ncua sij hawm rov qab. Raws li cov kev tshawb fawb niaj hnub no, hom kev ua no tsis tshua muaj kev cuam tshuam.
Xws li kev phais mob yog qhov kev taw qhia rau cov kab mob ntawm cov pa roj carbon dioxide (rau lub koom haum ntawm qhov chaw txaus thiab kev nkag mus rau lub cev) thiab cov twj ywm uas muaj lub tshuab me me los ntawm ntau qhov me me. Tus kws kho mob pom cov ntawv loj ntawm sab hauv ntawm lub computer saib, thiab maj mam tshem tus txheej txheem ntawm kev siv cov twj siv. Lub cev ntim tshuaj yog tau los ntawm ib qho ntawm qhov ua.
Rehabilitation tom qab tshem tawm ntawm daim ntawv qhia appendix
Tsis pub dhau 1-2 hnub txij li lub sijhawm phais pom zoo kom txaj txaj, tawm ntawm txaj yog pub rau hnub 3 hnub. Nws yog qhov tsim nyog tias lub seam tom qab appendicitis tsis faib. Tom ntej 6 lub lim piam, cov leeg yuav fuse, tiv thaiv cov keeb kwm yav dhau ntawm qhov kev pheej hmoo ntawm kev sib txawv thiab hernias nce. Txhawm rau tiv thaiv kom tsis txhob muaj teeb meem, lub cev muaj zog tuaj yeem maj mam nce, hnyav hnyav, ncaws pob thiab ua haujlwm nyhav. Tsav kom kho kom zoo thiab tiv thaiv kom tsis txhob muaj kev sib tshuam ntawm cov khoom siv yog pab los ntawm hnav ib lub hnab tawv nqaij tshwj xeeb.
Ntxiv rau kev limiting lub cev lub cev, tus neeg mob xav tau:
- Nco ntsoov mus ntsib kws kho mob thiab kws phais mob rau kev kuaj mob txhua hnub.
- Saib xyuas lub xeev ntawm qhov txhab tom qab.
- Txhawm rau txoj kev xa cov seams, mus hnav khaub ncaws.
- Tom qab overgrowing kev puas tsuaj, grease scars nrog tshuaj pleev tshuaj pleev npaj.
Kev noj haus tom qab mob hnyuv tws
Kev noj zaub mov tsis tau sab nraud tsuas yog siv tau los ntawm hnub 3 hnub ntawm kev ua haujlwm. Tshaj li 72 teev tom ntej, qhov kev noj haus tom qab tshem tawm cov hnyuv tws muaj xws li cov kua roj ntsha thiab cov khoom noj sib txawv. Tso cai rau noj mov thiab dej qab zib:
- zaub, tsis muaj zog nqaij qaib broth;
- mis nyuj jelly;
- puree los ntawm cov zaub;
- juices diluted nrog dej;
- semi-kua porridge;
- broth ntawm dogrose;
- herbal, tsis muaj zog dub tshuaj yej.
Los ntawm Hnub 6 ntawm cov ntawv qhia zaub mov, koj tuaj yeem siv tau:
- rubbed soups;
- khoom noj khoom haus nrog cov roj tsawg;
- lean ntau yam nqaij los yog ntses, steamed los yog boiled, nyob rau hauv ib daim ntawv crushed;
- porridge ntawm dej;
- zaub thiab txiv hmab txiv ntoo ntshiab;
- bananas;
- mov ci;
- jelly.
Tsis pub dhau 2-4 lub hlis tom qab mob hnyuv tws, nws yog ib qho tseem ceeb kom ua raws li qhov hnyav thiab ua raws li cov lus pom zoo rau kev tsim:
- Muaj ntau zaus tsawg thiab me ntsis.
- Siv cov zaub mov sov xwb, tsis txias thiab tsis kub.
- Tsis kam siv cov khoom uas ua rau gassing nyob rau hauv cov hnyuv - legumes, cabbage, marinades, pickles, smoked khoom.
- Tsis txhob noj cov "hnyav" - cov rog rog, ntses, zaub mov kib, muaj zog cov kua zaub thiab kua zaub raws lawv.
- Txhob haus cawv, dej qab zib.
Rov qab mus rau cov ntawv qhia me ntsis rau tus neeg ntawd yuav tsum maj mam thiab qeeb. Cov kws kho mob qhia kom ua raws li cov qauv kev noj zaub mov kom zoo, kom muaj kev noj qab haus huv thiab kom haum. Qhov no yuav pab ntxiv dag zog rau lub cev thiab rov qab txhawm rau ntawm microflora nyob rau hauv cov hnyuv, uas tau cuam tshuam los ntawm cov txheej txheem inflammatory.
Appendicitis - teeb meem
Cov kev tsis zoo yuav tshwm sim rau ntawm tus mob tsis muaj tus kab mob los yog tsis muaj kev kho mob txaus. Cov teeb meem feem ntau pom tau tias yog tom qab tus kab mob appendicitis tau pom lig - cov tsos mob ignored thaum ntxov ntawm kev mob o thiab ua rau nws kis tau. Vim li ntawd, qhov kev ua rau cov kab mob kis tau mus rau cov kab mob nyob ze thiab cov nqaij, cov kab mob thoob plaws yuav tshwm sim.
Tom qab tshem tawm cov kab mob appendicitis nram qab no yuav ua rau muaj kev phom sij:
- peritonitis (mob ntawm qhov mob plab);
- mob kab ;
- sab hauv;
- periapendicular abscess ntawm lub plab kab noj hniav (tsuas muaj tus kab mob hauv lub khob tshuaj uas muaj paug);
- sepsis - nkag mus ntawm cov kab mob pathogenic mus rau hauv cov ntshav;
- rupture ntawm cov ntawv appendix nrog cov kev tawm ntawm nws cov khoom, nrog rau cov quav thiab tso tawm, rau hauv qhov chaw plab;
- o ntawm vag portal ntawm daim siab, tuaj yeem yuav purulent (pylephlebitis);
- tromboembolism - xoos ntawm ib txog hlab ntsha nrog ib qho thrombus;
- phlegmon of retroperitoneal qhov chaw;
- Periapendicular infiltrate (fusion ntawm cov appendix thiab lwm yam kabmob);
- thrombophlebitis ntawm cov leeg ntawm cov plab me me;
- kev xav ntawm kev phais mob;
- cais divergence;
- mob ntsws los sis mob hnyuv.