Besisu ithumba: Oonobangela kunye neziphumo

serosa Thin - peritoneum - leyo ngeendlela okanye omnye ukwakweli iindawo eziphezulu amalungu, iye iipropati ezithile zokhuselo. Ngokomzekelo, xa nangokurhala, xi nga delimit kummandla ochaphazelekayo, ukwakha ithumba esiswini. Xa slang medical ibizwa ngokuba "ngelotha", oko kukuthi, ukuyilwa azikhuli phakathi kwamalungu ezikufutshane ukuze ufumane indawo evaliweyo.

definition

ithumba besisu - a ubovu ukudumba iqumrhu okanye inxalenye yawo, ngakumbi inyama yokunyibilikisa kunye philisi ukuyilwa kwisisu ngeenxa zonke. Kokuba ziphelile nangayiphi "umgangatho" ye kwisisu ekhatshwa iimpawu ukunxila, icesina kunye nokudumba.

Ukongeza, isigulana siya koyisa intlungu, waphawula yoKhuselo izihlunu esiswini, isicaphucaphu kunokwenzeka kunye nokugabha. Ngamanye amaxesha, kwiimeko kakhulu, azikhuli kubangela emathunjini.

lwezifo

ithumba besisu, ngokungamangalisiyo phofu, yavelisa ezilandelayo iinkqubo zotyando kwaye evakalayo njenge kwingxaki elolu hlobo lonyango. Ngenxa yokukhula kwenani imisebenzi eyenziwa qho ngonyaka, inani iingxaki ezinjalo kwandisa ngokuqhubekayo. A indima enkulu kule kukuhla sifo yaye abantu abaninzi nokusebenzisa imithi e Cya ezenza uzinzo kwaye iyakuqhwalelisa yokuthintela iingxaki postoperative.

Ngokutsho iziphetho Windows RT, elinye ekhulwini izigulane zotyando asakhasayo ithumba postoperative. Eli nani liphezulu xa ungenelelo belingqongqo kunye nexesha kwamalungiselelo ipreoperative wayengekho.

ubungozi

Umngcipheko factor ephambili, ngenxa apho kubekho ithumba le kwisisu - Kakade ke, utyando cavernous. Kukho ezininzi eziqhele kwenzeka emva kokuba unyango lwezifo pancreatic, inyongo isinyi, kwesisu loop nemithungo.

Imbonakalo ukudumba ngenxa yokuba sesichengeni imixholo isisu kwi peritoneum, kunye nongcoliseko yayo kwigumbi yokusebenza. Isenokuba kunokubangelwa trauma luhlaza esiswini. Endaweni ucinezelo eveliswa ukudumba aseptic, leyo kamva wajoyina flora eziziisekondari.

Ngaphezu kwesiqingatha ithumba kungaba Parietal (Parietal) iqhekeza le peritoneum, okanye phakathi Parietal yayo kunye sheets visceral.

izizathu

amathumba esiswini (ICD10 - K65) ingaba kuba sisiphumo nongcungcutheko esiswini, umzekelo, compressions elide okanye ukothuka, izifo ezosulelayo le wamathumbu (iersiteoz, salmonellosis, yicesina), uphuhliso lweenkqubo ukudumba kwizigqeba okanye isifo, ngokunjalo emva perforation nezilonda esiswini okanye emathunjini.

Kukho izizathu ezithathu eziphambili:

1. Ubukho peritonitis lesibini ngenxa komsipha ye isihlomelo, anastomoses atshone okanye emathunjini emva imisebenzi esiswini, necrosis intloko pancreatic, ukuphatheka esiswini.
2. Ubovu ukudumba amalungu zangasese, ezifana salpingitis, parameters piosalpinks, Tubo-ovarian ithumba kunye nabanye.
3. ukukrala Acute zepancreas nenyongo isinyi, ukudumba okwenziwa sisilonda sikabhobhosi.

Ukongeza koku kungasentla, ngamanye amaxesha unobangela ithumba ibe ukudumba izihlunu perinephric, osteomyelitis, empontshwa yomqolo, spondylitis tuberculous. Ngokufuthi komtshiso yodaka staphylococci, streptococci, clostridia kunye isherihy, okt nezihluma, leyo ngokwesiqhelo kungenzeka emathunjini.

Pathogenesis

esiswini ithumba postoperative ubonakala ngenxa indlela ngokugqithisileyo umxokomezelo wokugonyeka ukuba angenelele kwimeko bume lwangaphakathi okanye yokuzala ezincinane. I-arhente zinokungena kungena kwisisu peritoneal kunye egazini okanye nkovu, ngokunjalo osalayo eludongeni emathunjini. Ukongeza, kukho kusoloko kukho ingozi yosulelo kunye ugqirha ukuba abeke izandla zakhe, izixhobo okanye izinto ngexesha lokusebenza. Enye into ezivelileyo imizimba yokunxibelelana yemeko ezisingqongileyo, ezifana tubes okanye emathunjini.

Asinako ngaphandle imbonakalo lingene ukudumba emva angena izilonda esiswini, nangezilonda, sutures perforations divergence emva kotyando.

Peritoneum uyiphendula imbonakalo oluvuselela factor (ukudumba) stereotypically, oko kukuthi, kungenisa fibrin kumphezulu wayo eya ubuhlobo kunye iinxalenye isifo kwaye ikhetha eziko ukusuka ephilile. Ukuba le khuselo kutshatyalaliswa ngenxa ubomvu, lo detritus yokukrala lungena ngokukhululekileyo kucebisa kwisithuba esisu kunye kweeshelfu. Ngophuhliso enjalo nokudumba Imeko kwegama.

iimpawu

Kwenzeka ntoni ukuba umntu xa wabumba ithumba esiswini? Iimpawu ziyafana nasiphi na isifo arhabaxa:

1. High, a ukuqala ngesiquphe umkhuhlane kunye Ukugodola kunye nokubila lweenkcukacha.
2. Umzobo iintlungu esiswini, leyo ziyanyuswa ukuya ngaphandle kwebala okanye uxinzelelo.
3. Ukuchama rhoqo, njengoko peritoneum bulukwe kwaye ndiyacaphuka i baroreceptors lwesinye.
4. Izitenxo njengesihlalo ngohlobo kwesisu.
5. Isicaphucaphu kunye nokugabha kwi ukuphakama umkhuhlane.

Ukongeza, isigulana sibe iyangongoza. Oku kwenzeka ngenxa yezizathu ezibini: ngumkhuhlane kunye ukunxila. Kwaye uphawu pathognomonic yi izihlunu nengxabano cofa. Esi reflex yokhuselo, nto leyo ethintela ukulimaza ngakumbi indawo ebushushwini babo.

Ukuba ithumba ibekwe ngqo ngezantsi uvalo, ukongeza iimpawu eziqhelekileyo abo bathi kweli phawu. Umahluko lokuqala ukuba intlungu yenzelwe le hypochondrium, ukwanda ngexesha eyinkuthazo obubonakala kummandla scapular. Umahluko yesibini - ukutshintsha iqinelwa. Umntu uqalisa engathandi ukuthatha unonophelo abagulayo yaye isondela kuye, ukunciphisa uxinzelelo kwezihlunu.

ukungaphili

amathumba esiswini (ICD-10 - K65) ukuze zihlale akubonakali ukuba ekuphuhliseni kwisiqalo kwezinye iimeko kakhulu, okanye isigulane ukuba afune uncedo. Kodwa simele sikhumbule ukuba ngenxa yehambo kwenkathalo basenokuba iimeko ezisongela ubomi, ezifana nokudumba kwaye kuyenye peritonitis.

amathumba Subdiaphragmatic nga kunyibilika kwaye emngxunyeni ukuze singene kwisisu pleural, ukwakha azikhuli apho. Loo meko Usenokude ezikhokelela ekonzakaleni semiphunga. Ngoko ke, ukuba emva utyando okanye ukwenzakala, unomkhuhlane okanye nayiphi na intlungu, musa ukulindela ukuba zonke ziya kudlula ngokwayo. Kulo mbandela yokutshekisha extra ayikwazi buhlungu.

ekuxilongweni

ithumba ngenzolo Postoperative esibhedlele ibhaqe lula ngokufanelekileyo. Iindlela ezininzi ulwazi na x-reyi, ultrasound, CT kunye MRI of the esifubeni kunye namaziko esiswini. Ukongeza, kuyenzeka ukuba abafazi ukwenza okuhlatywa igumbi langasese ukukhangela ukuba ngaba kukho wachuba iindawo ubovu kwiindawo izidanga.

Kwakhona, musa ukulibala malunga uxilongo elebhu. Ngokubanzi, uhlalutyo igazi liya kuba waphawula ukwanda elibukhali kwi Izinga erythrocyte neentlenge (ESR), wbc kuya kuba shift kakhulu ukuya ngasekhohlo, kusenokwenzeka ukuba iifom abaselula kunye nenani olungagungqiyo iiseli ziya kwanda ngenxa neutrophils.

Umgangatho lokufunyaniswa ithumba na ultrasound esiswini. Kukho iimpawu ezicacileyo ukuba zibonisa ubukho infiltrate arhabaxa:

• ukubunjwa uye lichaza ecacileyo kunye capsule ashinyeneyo;
• ngaphakathi yinto kolwelo;
• isiqulatho isakhiwo inhomogeneous kwaye yahlulwe layers;
• Kuyinto ngaphezu irhasi engamanzi.

Treatment amathumba esiswini

Indlela engundoqo unyango mathumba, Kakade ke, uqhaqho. Kuyimfuneko ukuba nemali yokuhlawula lweHo- ithumba kunye Ukuhlamba kubola kunye nesisombululo isibulala-zintsholongwane. unyango Conservative ayiniki isiqinisekiso sokuba umtshiso kudambe, kwaye ulwelo ngaphakathi ithumba ngokwakho bakhutshwe.

Kakade ke, emva kokuba kujoliswe isusiwe, isigulane kufuneka ukuba ukumisela unyango elwa ukuba zintsholongwane olubanzi. Ngokuqhelekileyo, ugqirha imisela ngexesha elifanayo amachiza amabini kunye neendlela ezahlukeneyo amanyathelo nangempumelelo kutshabalalisa abameli ezahlukeneyo izilwanyana eziphilayo.

Wawungenakuzisola ukuba alumkise isigulana imiphumo kunokwenzeka konyango, ezifana ukugabha, ukungabi namdla, ukudumba umaleko papillary kolwimi, intloko ebuhlungu, kwaye rhoqo ukuchama. Yaye ugqirha kufuneka bakhumbule yaye ukubongeza umfanekiso kwezonyango sifo.

Ipredikshini kunye nokuthintela

amathumba esiswini (ikhowudi ICD-10 - K65) - kakhulu kwingxaki kakhulu, ngoko izigulane kunye amagqirha kufuneka baye ekuthinteleni le meko. Kuyimfuneko ukuba ngokwaneleyo ngokupheleleyo ukunyanga izifo yokukrala nayiphi na kwisisu, qiniseka ukuba aqhube ukulungiselela yesigulana phambi nasemva-operative, kwakunye nezixhobo ngokunjalo-zintsholongwane kunye kwezandla ngoogqirha.

Kuba appendicitis okusolwayo okanye kwimeko ukunyuka ngesiquphe kwamaqondo obushushu akuyomfuneko ukulinda umqondiso ovela phezulu, kwaye kufuneka ngoko nangoko udibane nogqirha icebiso. Isenokuba usindise ubomi bakho kunye nempilo.

Lokusweleka ngenxa ithumba esiswini ifikelela amane ekhulwini. Konke kuxhomekeke kwande ngayo inkqubo, apho sibekwe khona nendlela kwabangela sifo. Kodwa unyango ngexesha esibhedlele amathuba isiphumo esibi lifinyele.