Yog hais tias fetal kev loj hlob tsis mus lawm, lub fetus muaj anomalies nyob rau hauv tus qauv ntawm lub hauv nruab nrog cev. Ib qho ntawm cov kev hloov no yog Hirschsprung Syndrome (megacolon los yog aganglion). Tus kab mob no tshwm sim hauv ib ntawm 5000 tus me nyuam, feem ntau yog txiv neej.
Hirschsprung tus kab mob - yog dab tsi?
Lub plab hnyuv txhuam thiab lub sij hawm ntsim ntawm cov quav yog cov cai ntawm cov paj hlwb tshwj xeeb. Congenital megacolon yog cov uas tsis muaj los yog tsis muaj peev xwm, vim tias kev khiav tawm ntawm cov quav yog qhov hampered heev. Yog li ntawd, ib tug loj npaum li cas ntawm feces accumulates nyob rau hauv cov plab hnyuv loj. Qhov no ua rau kev txuas ntxiv thiab qhov hnyav ntawm lub cev.
Hirschsprung tus kab mob ntawm cov me nyuam - cov tsos mob
Cov duab kos pom zoo yog nyob ntawm qhov chaw nyob thiab kev ntsuas ntawm kev txuag ntawm txoj hnyuv. Hirschsprung tus kab mob hauv cov me nyuam mos tau tshwm sim hauv daim ntawv ntawm cov tsos mob nram qab no:
- tsis muaj thawj daim quav (meconium);
- cim gassing;
- flatulence ;
- ntuav, qee zaum tseem ceeb;
- ntev cem quav ;
- hloov nyob rau hauv cov duab ntawm lub plab;
- umbilicus rov qab los sis tsis muaj;
- tsawg zawv plab.
Tus kab mob Hirschsprung hauv cov me nyuam loj zog yog nrog cov tsos mob ntxiv:
- impossibility ntawm plob tsis so tswj tsis muaj lub qhov tsis dawb;
- mob plab;
- kev qaug ntawm lub cev;
- lag hauv kev loj hlob ntawm cev;
- ib nrab heterochromy;
- muaj cov quav tawv nqaij ("hnyuv pob zeb");
- anemia ;
- deformation ntawm lub hauv siab;
- hypotrophy;
- enterocolitis;
- nthuav ntawm txoj hnyuv loj;
- propensity los tsim cov hlab ntsws thiab mob ntsws o;
- ntuav thiab zawv plab tom qab cem quav ntev lawm.
Kab mob Hirschsprung rau cov me nyuam - mob
Kom paub tseeb tias qhov tseeb ntawm qhov kev ntsuam xyuas pathology, tus kws kho mob ua ntej ntsuas cov neeg mob me me. Hirschsprung tus kab mob nyob rau hauv cov me nyuam mos tau yav tas los tau tshwm sim txawm tias palpation, xav lub plab mog hauv cheeb tsam ntawm txoj hnyuv loj. Lub luag haujlwm tseem ceeb yog ua los ntawm niam txiv cov lus nug ntawm tus menyuam. Yog tias tsev neeg muaj mob ntawm qhov txawv txav, qhov tshwm sim ntawm qhov nws tshwm sim hauv tus me nyuam yog loj tuaj (qhov zoo tshaj plaws ntawm tus menyuam).
Lub qhov quav ntawm ib tus menyuam nrog Hirschsprung tus kabmob
Lub ntsiab kev tshuaj ntsuam xyuas tus kab mob no yog qhov muag thiab ntiv tes kuaj ntawm lub qhov quav (sigmoidoscopy). Hirschsprung tus kab mob yog nrog nws cov lus los ntawm lub suab nrov ntawm lub sphincter nrog rau qhov chaw npliag ntawm lub qhov ncauj qhib qhov ncauj, txawm tias qhov kev khoob tsis ua rau ob peb hnub. Yog xav paub ntxiv, kev tshawb fawb txog kev kho vajtse. Disease Hirschsprung - Kev mob:
- Irrigoscopy nrog cov kev qhia txog ntawm barium sib tov;
- kuaj txoj hnyuv;
- anorectal manometry;
- kuaj nrog cov keeb kwm yav dhau los.
Hirschsprung kab mob - X-ray
Ib hom kev kuaj mob uas yuav tsum tau ua hauv qhov kev ntsuam xyuas ntawm tus kab mob piav qhia yog qhov kev ntsuas ntawm daim ntawv ntsuam xyuas. Radiography pab nrhiav kom paub meej qhov twg qhov megacolon (Hirschsprung's disease) yog qhov chaw, kom paub tias qhov teeb meem loj ntawm kev mob ntsws. Yuav kom ntsuam xyuas qhov zoo ntawm txoj hnyuv kom khov, nws yog qhov pom zoo los ua kom paub zoo nruab nrab thiab ntxiv ultrasound.
Kev kho mob ntawm Hirschsprung tus kab mob hauv cov menyuam yaus
Qhov tsuas yog txoj hauv kev los kho cov tshuaj anomaly yog cov kev kho phais. Cov kev txuam nrog yuav tsum tau tsuas yog xav tau ntawm kev ua haujlwm xwb. Nws pab kom ua kom tsis zoo thiab txhawm rau Hirschsprung tus kab mob - kev kho mob yuav tshem tawm cov tsos mob ntawm tus kab mob pathology, normalizing lub excretion ntawm quav teeb meem thiab rov qab kho plab hnyuv. Tom qab phais kho nws tseem ceeb heev kom paub meej tias tus me nyuam txoj kev saib xyuas zoo thiab ua raws li kev ua raws li kev noj haus tshwj xeeb.
Hirschsprung tus kab mob nyob rau hauv cov me nyuam - kev soj ntsuam pom zoo
Thaum kuaj pom tseeb thiab tus kws kho mob tau tsa hnub ua hauj lwm, nws yuav tsum tau npaj rau txoj kev kho. Megacolon nyob rau hauv cov menyuam yaus yog cov kev kho mob nram qab no:
- Ntaus ntawm plab hnyuv. Txhuam cov tshuaj siphon enemas tas li nrog rau kev qhia txog kev sov so ntawm sodium chloride concentration ntawm 0.9%.
- Restoration ntawm plab hnyuv microflora. Cov me nyuam yuav tsum siv yeeb tshuaj uas ua rau lub txiaj ntsim tseem ceeb ntawm cov kab mob lig ( probiotics ).
- Txhawb nqa kev tiv thaiv. Tus me nyuam yog cov tshuaj vitamins - E, C, B6, B12.
- Txhim kho cov duab tso tawm. Rau normalize qhov nchuav ntawm cov hnyuv pab zaws lub plab thiab gymnastics.
- Kev tiv thaiv ntawm cem quav. Tiv thaiv kev ua pa ntawm cov quav nrog kev noj zaub mov nrog cov fiber ntau hauv kev siv nrog kev siv dej huv.
- Restoration ntawm cov txheej txheem metabolic. Nrog kev noj zaub mov mob loj, hnyuv ntxig cov kua hauv lub cev, cov kua qabzib thiab cov qhob noom protein.
Kev phais mob rau Hirschsprung kab mob
Muaj ob peb txoj kev xaiv rau kev phais mob rau kev tshem tawm tus kab mob nug. Tag nrho cov ntawm lawv muaj nyob rau hauv qhov excision ntawm qhov chaw puas ntawm ib txoj kab ncaj nraim thiab txoj hnyuv sigmoid thiab ua rau nruab nrab ntawm cov nqaij mos ntawm anastomosis. Hauv plab, Duhamel phais yog feem ntau hauv Hirschsprung tus kab mob, tab sis kuj muaj lwm hom kev nyab xeeb thiab nyab xeeb cov txheej txheem:
- Rectosigmoidectomy raws li Svenson-Hyatt-Isakov;
- qhov tob tob hauv qhov tsom iav anastomosis raws li Rebein;
- Cov lag luam Soave.
Cov kev qhia hauv qab no yog kwv yees zoo tib yam ntawm kev ua haujlwm zoo, yog li kev xaiv ntawm hom kev phais mob yog ua los ntawm ib tug kws kho mob tshwj xeeb. Muab ib txoj kev lag luam tshaj tawm, tus kws kho mob yog tus coj los ntawm lub hnub nyoog thiab tus neeg mob ntawm tus neeg mob me, ntsuas seb tus kab mob Hirschsprung sai npaum li cas. Nws yog ib qho tseem ceeb rau cov niam txiv kom nrhiav tau tus kws phais neeg ua hauj lwm, tag nrho cov kev khiav hauj lwm no yog cov yeeb yam ntawm txoj kev siv.
Disease Hirschsprung - noj haus
Yuav kom pom cov tsos mob ntawm cov kab mob uas tau piav qhia, ib qho kev noj haus zoo tshwj xeeb yog tsim nyog. Kev noj haus rau Hirschsprung tus kab mob yuav siv cov khoom uas muag cov quav thiab ua kom mob plab hnyuv txaus:
- ib tug decoction ntawm bran los yog dill (rau cov me nyuam mos liab);
- qaug qoob loo, qoob loo, tshwj xeeb tshaj yog compotes on lawv cov hauv paus;
- taub dag;
- buckwheat, oats, nplej porridge;
- ib hnub kefir;
- beets;
- cucumbers;
- yoghurt;
- neeg tsis noj nqaij soups;
- chav cutlets thiab soufflé los ntawm cov khoom noj uas muaj roj tsawg;
- zaub roj;
- fresh berries, txiv hmab txiv ntoo thiab zaub.
Los ntawm kev noj haus, peb yuav tsum tshem tawm txhua yam uas ua rau kom muaj zog thiab ua rau muaj kev ntxhov siab ntawm kev ua kom muaj zog hauv cov hnyuv:
- pears;
- mov, semolina porridge;
- tshiab dawb thiab rye qhob cij;
- cov khoom haus luam yeeb;
- bun thiab pastry;
- cocoa thiab chocolate;
- noob;
- cabbage;
- fatty meat;
- nqaij tawv thiab kua zaub;
- qos yaj ywm (nyob rau hauv qee yam);
- pasta;
- lws suav;
- khoom qab zib nrog roj cream;
- taum;
- mis nyuj haus.
Hirschsprung tus kab mob hauv cov menyuam yaus - lub txim
Yog tias tsis muaj kev kho kom haum thiab sij hawm kho, qhov txawv txav tsis pom zoo yuav xaus rau qhov phem, tshwj xeeb tshaj yog tias tau kuaj pom tus menyuam mos. Hauv 80% ntawm cov neeg mob, Harald Hirschsprung tus kab mob ua rau tus menyuam tuag. Thaum qhov phais tau ua tiav raws sij hawm thiab muaj txiaj ntsim, qhov kev twv ntxhias zoo tuaj, zoo li ntawm 90% ntawm cov neeg mob me tuaj yeem rov qab ua kom txaus.
Lwm yam teeb meem ntawm Hirschsprung tus mob:
- mob ua paug;
- anemia;
- plab hnyuv txhuam ;
- kev qaug loj heev;
- peritonitis;
- kub cev;
- plab hnyuv los ntshav;
- fistula;
- stenosis;
- fecal tsis kam tso tawm.