Afferent loop syndrome: isifo kwaye afumane unyango

Iinkqubo zotyando ziphantse lisoloko linxulunyaniswa emngciphekweni. Ukongezelela ukopha kunokwenzeka ngexesha utyando, kukho iingxaki ezininzi ixesha elide. Oku kuyinyaniso ngokukodwa zazo olukhulu apho nokususwa olwenziwa ilungu okanye inxenye yayo. Umzekelo ukusebenza Billroth-2. umongo wayo ekususweni uninzi esiswini kunye nokudala i anastomosis kunye emathunjini amancinci. afferent loop syndrome rhoqo emva kulo utyando. iingxaki ezinjalo kuvela nangoko emva kotyando, kwiinyanga ezimbalwa kamva. Kunye nophuhliso kule meko kurhanelwa, okanye kuyimfuneko ukuba omnye uqhaqho na.

Ingcamango afferent loop syndrome

Afferent syndrome loop emva resection esiswini kwenzeka malunga-13% amatyala. Eli nani ingahluka-1 ukuya kuma-50%, ngokutsho oogqirha. main uphawu yalo uyagabha inyongo, ezinxulumene ekudleni. Afferent loop syndrome - yimeko apho inxalenye emathunjini na, ngathi "icinyiwe 'ukusuka kwinkqubo ekugayeni. Ngenxa yoko, enyongweni oluhlala kwisebe kwaye phambi yeemeko ezinzima iphalale. Elinye igama le ingxaki - duodenobilliarny syndrome. Le meko ngumqondiso eyingozi, kwaye ngoko ke kufuna unyango ngotyando.

Ezibangela ukuba syndrome

Oyena nobangela afferent loop syndrome yi umsebenzi Billroth-2. It is a utyando omkhulu kwaye kuchaphazela umzimba wonke. Umsebenzi efanayo oluqhutywa umhlaza esiswini, ukuphuhliswa iingxaki isifo isilonda Peptic, nto leyo alunakupheliswa ngendlela kakuhle. Ngenxa yale nokuqhathwa yethumbu duodenum nabancinane engasekho athathe inxaxheba kwisenzo ukwetyisa. Ngenxa yale syndrome elandayo afferent loop.

Ekusetyenzwa phantsi kwazo zinefuthe isenzeko ingxaki, ezi kwephulwa zilandelayo:

1. isizathu Mechanical. Ngezantsi lenzelwe iingqimba ukutya nghena sayo "off" yeehenjisi. Kwakhona, kukho okongezeleke inyongo, nayo leyo nokulibazisa inkqubo ukwetyisa.
2. Ukulahleka kwezihlunu kwicandelo le "off". Esi sizathu kubangela syndrome okondeleyo afferent yomtya emva resection.
3. Spasm of anastomosis - kudibana kuthiwe isiphunzi esiswini kunye emathunjini amancinci. imisipha nawo sinciphile kwaye iplagi loop.
4. isiphako wenze ngexesha anastomosis. Oku kukhokelela yimbonakalo ngesizathu ngoomatshini afferent loop syndrome. Elo nxeba njenge ephambili (emva kokuba umsebenzi), yaye okwesibini.
5. Inflection loop afferent. Ngokuqhelekileyo oku iqale phantsi kwakhona.

Afferent loop syndrome: Pathogenesis esi sifo

Indlela of afferent loop syndrome iqulathe iiyunithi eziliqela. Okokuqala kukho ulwaphulo-mthetho umzimba ukudibana yokwakheka kwaye esebenza ngokwesiqhelo. Ngenxa ngokutsha 'ngumntu "ye wokugaya inkqubo inkqubo ukutya uyahluka ngobungxamo. Ukutya, zabekwa i "off" umtya isisu, ayinako le ndebe ukudlula kuzo. Ngoko ke kukho lilahle umva - reflux. Ukongeza, xa Pathogenesis le ukudumba inkqubo langoku. Oku kwenzeka ngenxa yokuba kokoma yenkitha esiswini hypotension KDP. Ngenxa yoko dysbiosis lesibini ethunjini. Yena kamva kukhokelela ukudumba wokugaya: cholecystitis, pancreatitis, esophagitis.

Lo mfanekiso kwezonyango afferent loop syndrome

Wabonakala iphambili yale ingxaki yintlungu kunye nokugabha. kuyaphela besisu kungenzeka ngokukhawuleza okanye emva ukusebenza ngokuhamba kwexesha. Kwimeko yokuqala kukho primary, afferent etsolo loop syndrome. Lubonakala ngokuthi cramping kunye neentlungu olwandisa indalo kwi hypochondrium okulungileyo epigastric. Xa syndrome ezingapheliyo ngenxa lwezonyango picture loop sicacisiwe hayi kangako. Iintlungu kwenzeka ubukhulu becala emva kokutya, kaninzi - kwi ulwamkelo ukutya okunamafutha. Kungakhathaliseki ixesha ingenzeka yeengxaki (ixesha oyingozi okanye engapheliyo) uyabonakala egabha. Oku kuza emva kokuba ukunyuka iintlungu esiswini, esidla isidlo. Ngenxa ukugabha rhoqo wayabela ukuya ml 500 ngosuku lwe inyongo. Isiphumo obuqhubekayo zokuncipha umzimba. Izigulane ngokukhawuleza ukunciphisa umzimba, uziva ubuthathaka jikelele.

Afferent loop syndrome: zokugula diagnostic

Lokufunyaniswa kwesifo iqala anamnesis (gastrectomy transferred) kunye noviwo malunga nesigulane eso. Okokuqala kufuneka wazi malunga nohlobo intlungu kunye nezihlandlo ukugabha, uqhagamshelo bakhe ubuchule ukutya. On uviwo, kufuneka sinikele ingqalelo asymmetry esiswini: iintonga isebe ekunene. Le uphawu uya kude emva nokugabha, njengoko imixholo ndzhendzheleko uyaphuma. Enye into ke senyongo le sclera kunye nesikhumba.

Ukongeza ukuvavanywa data zonyango, elebhu kunye uxilongo zomculo. Utshintsho abe pat (B-12 imibala anemia), smear igazi, coprogram (ukubonakala leukocytes, amafutha undigested). Xa X-ray ifezekiswe waphawula ukuba uphawu a niche yomtya afferent, zeDyskinesia gipermotornaya. I-arhente nshita izalisa yomtya ngenxa. Kwakhona kwenziwa iimviwo endoscopic. In ezingapheliyo afferent loop syndrome laziwa utshintsho ukudumba kwi senyongo kunye imibhobho. Kwezinye iimeko, pancreatitis kuphuhliswa. Xa oku ukudumba usekuhleni kwaye zepancreas. Xa ngokuhlwayela okuqulethwe flora emathunjini yintsholongwane emsebenzini, lo umlinganiselo enqanda pancreatic kakuhle. Ubuzaza sifo emiselwe ukugqitywa komzimba, ubungakanani yokuphulukana inyongo nomonde.

Yintoni na ingozi afferent loop syndrome: iingxaki

Kufuneka kukhunjulwe ukuba afferent loop syndrome yi kwingxaki kakhulu resection esiswini. Ilahleko esiqhubekayo inyongo zingenzeka ukugqitywa komzimba. Ukutya engena umzimba akakwazi kakuhle nokugaya (ngenxa yokuba "off" i KDP kunye inxalenye emathunjini amancinci), kunye izondlo kwelifunekayo. Ngenxa kuphuhliso dysbiosis wamathumbu amalungu emathunjini zibethwa iinkqubo arhabaxa. Ngophuhliso reflux esophagitis ukuya mpawu zidwelisiweyo zongezwa iintlungu esifubeni, yimvakalelo 'lump emqaleni. " Cholecystitis uhamba incasa ukrakra emlonyeni, isicaphucaphu. Ukuba ofike ukudumba zepancreas, iintlungu nga mkhulu ukuba herpes umlinganiswa. Xa ixesha le-pancreatitis ngoku linakho ukuphuhlisa seswekile. Iingxaki ahlekise afferent loop syndrome ziquka peritonitis, emathunjini. Ezi zifo zifuna unyango ngokukhawuleza yotyando.

Unyango lwe syndrome of afferent loop

Ukhetho unyango kuxhomekeke kwisigulana, iinkcukacha elebhu kunye neemviwo zomculo. Kubalulekile ukwazi ukuba ubungqongqo sifo iye afferent loop. Unyango kunokuba emithethweni futhi yotyando. kwenkcazo Mild ukutya okhethekileyo, ukudumba kunye neziyobisi antibacterial (imithi "Tsefriakson", "Tsiprolet"). Kwezinye iimeko zifuna phindwa lavage esiswini. Ngexesha unyango ngotyando eliphakathi kwaye kakhulu imfuneko. Kufuneka kujoliswe yokunqanda kokoma ukutya. Amaninzi kuvelisa ukuvuselelwa anastomosis. Xa uyagoba kubangele ephambuka eziqhotyoshelwe kwindawo echanekileyo sutured ukuya peritoneum. Isixa nohlobo unyango ngotyando kunokuba ezahlukeneyo kwaye kuxhomekeke unobangela iingxaki.

Uthintelo afferent loop syndrome

Okwangoku, utyando Billroth-2 uzama ukubuyisela ezinye iinkqubo zotyando. Oku kwenziwa ukuze kulondolozwe amalungu ka lokugaya. Ukuba Billroth-2 operation kodwa lwenziwe, kuyimfuneko ukwenza onke amanyathelo othintelo emiselwe ngugqirha. Ubukhulu becala oku kubandakanya ukutya. Emva resection akakwazi ukutya okunamafutha kunye ukutya okungekho mpilweni. Thatha ukutya kufuneka amaxesha 6-7 ngosuku ezincinane and semi-ulwelo karhulumente (umqa, isuphu).