Ascites yog ib qho kev pheej hmoo heev ntawm ntau cov kab mob ntawm cov hauv nruab nrog cev. Hauv qhov no, cov kua hauv cov kab noj plab muaj peev xwm ua tau transudative thiab exudative. Nyob rau hauv rooj plaub thawj, nws accumulates ntawm circulatory ntshawv siab thiab cov qog ntshav qis, nyob rau hauv ob - muaj coob tus leukocytes thiab protein compounds los ntawm txoj kev loj hlob ntawm cov mob inflammatory.
Ua rau muaj kua txig nyob hauv plab menyuam
Hais txog 80% ntawm tag nrho cov ascites yog qhov siab ntawm kev ua siab ntawm daim siab mob siab. Nyob rau hauv lig theem ntawm tus kab mob no muaj ib qho teeb meem loj ntawm ntshav khiav, stagnation ntawm biological kua.
Nyob rau hauv 10% ntawm cov neeg mob, kua hauv plab kab noj hniav yog kuaj tau rau hauv oncology. Raws li txoj cai, ascites accompanies cancer ntawm zes qe menyuam thiab pom tias yog ib qho kev mob tshwm sim heev. Sau qhov chaw nruab nrab ntawm cov plab hnyuv plab nrog lymph los yog effusion feem ntau qhia tias muaj mob hnyav thiab qhov sib thooj ntawm kev ua kom muaj kev tuag. Tsis tas li ntawd, qhov teeb meem yog ib qho qhia txog qog nqaij hlav:
- thawj mesothelioma;
- lymphoma;
- secondary carcinomatosis;
- metastases nyob rau hauv lub qhov rooj ntawm lub siab;
- leukemia;
- pseudomixoma;
- carcinomatosis.
Kwv yees li 5% ntawm cov ascites yog cov tsos mob ntawm cov kab mob plawv:
- decompensation ntawm ntshav kev;
- lub plawv tsis xws luag;
- constrictive pericarditis;
- cov kab mob ntev ntev.
Ib qho kev sib tw nrog cov kab mob no yog qhov muaj zog ntawm lub ntsej muag thiab lub plab.
Nrog rau seem 5% ntawm kev kuaj mob, cov kua haus dawb hauv cov kab noj plab yog tsim tom qab kev phais, tiv thaiv cov keeb kwm ntawm:
- pancreatitis;
- ntshav qab zib mellitus;
- lub raum tsis ua hauj lwm, kev mob lupus erythematosus;
- portal hypertension;
- lub Meigs Syndrome;
- kabmob voos-occlusive kab mob;
- peritonitis ntawm ntau lub hauv paus chiv keeb;
- Badda-Chiari kab mob;
- pistreatic hlwv ;
- Whipple's syndrome thiab lwm yam kev mob ntsws.
Kev txiav txim siab ntawm muaj cov kua hauv lub plab kab noj hniav los ntawm ultrasound
Nws tsis tuaj yeem paub txog ascites ntawm nws tus kheej, tshwj xeeb tshaj yog thaum pib ntawm cov dej haus. Muaj ntau ntau yam cwj pwm ntawm qhov teeb meem, piv txwv:
- hnyav heev hauv plab ;
- kev ua txhaum ntawm defecation;
- dull los yog daim duab mob hauv txoj hnyuv;
- cov kev hloov hauv qhov zaus tso zis thiab lub ntim ntawm cov khoom siv bioavailable;
- eructation;
- qee zaum - ua tsis taus pa;
- o ntawm qhov nqua, ntsej muag;
- "Qav" plab.
Tab sis cov tsos mob tshwm sim yog peculiar rau ntau yam kab mob, yog li ntawd nws yog qhov nyuaj rau txuas lawv nrog lub tsub zuj zus ntawm kua hauv qhov chaw hauv plab. Txoj kev txhim kho tsuas yog rau kev kuaj mob ascites yog ultrasound. Thaum lub sij hawm tus txheej txheem nws yog pom tseeb tsis tsuas yog muaj trans- or exudate, tab sis kuj nws ntim, uas nyob rau hauv qee qhov teeb meem muaj peev xwm ncav cuag 20 litres.
Txoj kev kho thiab siv cov kua dej los ntawm cov kab noj plab
Refractory, "loj" thiab "giant" ascites yuav tsum raug kho mob phais, vim tias ntau qhov dej ntawm lub cev tsis tuaj yeem raug rho tawm los ntawm kev sib luag.
Laparocentesis yog ib txoj kev rau tho lub plab nrog ib qho khoom noj, ib qho tshwj xeeb ntaus muaj cov koob thiab ib lub raj xa txuas rau nws. Qhov kev tshwm sim yog ua nyob rau hauv kev saib xyuas ntawm ultrasound thiab hauv zos anesthesia. Rau 1 kev sib ntsib, tsis tshaj li 6 litres ntawm cov kua tawm tau, thiab maj mam. Accelerated siv tawm ntawm kev tawm los yog transudate tuaj yeem ua rau ib tug ntse poob hauv cov ntshav siab thiab
Txhawm rau compensate rau cov protein ntau thiab cov ntxhia ntsev pob txha poob, tov albumin, polyglucin, aminostearyl, hemaccel, thiab lwm yam tshuaj zoo sib xws yog tib lub sijhawm.
Hauv kev phais niaj hnub, ib tus kws kho mob nyob ib puag ncig kuj yog ib yam tseem ceeb. Nrog nws cov kev pab, cov kua tshem tawm tsis tu ncua, tab sis qeeb heev.
Conservative kev kho mob ntawm ascites yog zoo nyob rau hauv lub teeb thiab medium ua sawv ntawm pathology. Nws raug xaiv los ntawm ib tug kws kho mob tshwj xeeb tom qab nrhiav tau qhov teeb meem ntawm qhov teeb meem.