Chiphalachi chili ndi zowonjezera zomwe zimapanga chitetezo. Zowonjezereka zimakhala ngati "famu" komanso kusungirako tizilombo toyambitsa matenda omwe amapanga microflora yothandiza. Kutupa kwa phokosoli ndi njira yowopsa kwambiri ya matenda opatsirana, zomwe zimafuna kuti athandizidwe mwamsanga.
Chizindikiro - zimayambitsa
Zenizeni zomwe zimayambitsa matendawa muzitsamba sizinakhazikitsidwe. Akatswiriwa amangoti chifukwa chake zimayambitsa matendawa - zifukwazi zimagawidwa m'magulu anayi malinga ndi zizindikiro zowonongeka:
- choyimitsa;
- matenda;
- mtima;
- endocrine.
Zimayambitsa zovuta kwambiri
Mfundo yaikulu ya chitukuko cha matenda omwe adatchulidwa ndikutsekedwa (kutsekedwa) kwazowonjezereka. Izi zimabweretsa kuwonjezeka kwa ntchentche ndi tizilombo toyambitsa matenda muzowonjezereka. Imawonjezera kukula, kuthamanga mkati kumakula ndi kutupa kumayamba. Mavitamini angapangidwe kumbuyo kwa kutsekedwa kwa zowonjezerapo nkhanambo (miyala yonyansa), kumeza matupi achilendo, helminths ndi chotupa (carcinoid).
Nthawi zina kupweteka kumapangitsa kuti chiyambi chake chizikhala chifukwa cha chifuwa cha chiwalo cha mtunduwu chifukwa cha zovuta zina m'mimba mwazi:
- kulowa ;
- colitis;
- adnexitis;
- cholecystitis;
- chiwonetsero;
- kupanga mapulogalamu.
Malingaliro ena otsala a maonekedwe a chiwindikiro, amayamba chifukwa cha zinthu izi:
- Matenda a chiwindi ndi ma tizilombo toyambitsa matenda;
- posachedwa;
- kuchulukitsa kwambiri maselo a serotonin.
Zowonjezera zowonjezera - zimayambitsa
Mtundu uwu wa matenda ndi kutupa pang'ono kwazowonjezereka, popanda zizindikiro zenizeni. Madokotala ambiri amatsutsa zowonjezereka zowonjezereka monga chodabwitsa. Madokotala ena amapanga chithandizo choterechi, kuchisankha icho kukhala mtundu wapamwamba ndi wachiwiri. Zomwe zimayambitsa ndondomeko yotupa yotere ndi:
- Matenda owopsa mu chiwalo chapansi;
- Kusintha kwa matenda osokoneza bongo pambuyo pa matenda oopsa kwambiri popanda kuchotsedwa kwazowonjezera.
Zizindikiro za kupatsirana
Kuchokera pakudziwika koyenera kwa matendawa, kupambana kwa chithandizo chake kumadalira. Munthu aliyense ayenera kukumbukira zomwe zizindikiro za kuwonjezereka zimapezeka poyamba. Izi zidzakuthandizani nthawi yomweyo kukayikira kutupa ndikufuna thandizo loyenerera. Apo ayi, padzakhalanso zovuta zowonjezereka - zizindikiro za mtundu woopsa wa matendawa zidzakula ndikuwatsogolera ku zotsatira zoopsa. Kupanda thandizo lachipatala m'mikhalidwe yotereyi kumadza ndi zovuta kwambiri, nthawi zina imfa imatha.
Zizindikiro zoyambirira za mgwirizano
Chithunzi chodziwika bwino cha matendawa chimayamba ndikumva bwino m'mimba, makamaka madzulo kapena usiku. Chizindikiro choyamba cha appendicitis ndi zowawa zowawa zofanana ndi gastritis. Chifukwa cha mphamvu yochepa ya mawonetseredwewa, munthu safulumira kupita kuchipatala. Palinso zizindikiro zina zogwirizana ndi appendicitis - zizindikiro zoyambirira:
- chisokonezo;
- kusanza (1-2 nthawi);
- kufooka;
- mala;
- Mlomo wouma.
Zizindikiro za zovuta zowonjezera
Pambuyo pa sitepe yoyamba, matendawa amakula, ndipo chithunzi chake cha chithandizo cha mankhwala chimaperekedwa mozama. Ululu wokhala ndi appendicitis umakhala wovuta, kuwombera kapena kupanikiza. Chisokonezocho chimamveka osati pakati, komanso m'mimba momwemo. Kuwonjezera apo, zizindikiro, zimakhala zoonekeratu m'maola ochepa otsatirawa:
- kuwonjezeka kutentha kwa thupi mkati madigiri 37-38;
- Kulephera kudya njala (anorexia);
- kusunthira kwakukulu kosalekeza;
- Mitambo ya mtima (tachycardia), mpaka pa 90 kugunda pamphindi;
- kukhetsa;
- chovala choyera pa lilime.
Zizindikiro za kupatsirana kosatha
Kuwonetsetsa kwapadera kwa mawonekedwe otha kupopera ndi osapitirira, kungakhale kosiyana ndi matenda ena osiyanasiyana a m'mimba. Zizindikiro za kuwonjezereka kosatha:
- Matenda a mitsempha, monga kuvomereza, ndi kutsekula m'mimba;
- kunyozetsa, makamaka pambuyo pochita mwakhama ndi zolakwika mu zakudya;
- chilakolako chofooka;
- kukwiya;
- kupweteka kwa m'mimba nthawi zonse.
Kodi mungadziwe bwanji momwe mungapangidwire?
Dokotala yekha woyenera angatsimikizire kukhalapo kwa kutupa kwazowonjezereka. Ngakhale kudziwa mbali ina ya zowonjezereka (m'munsi pamimba), ndi komwe mungapangire zitsanzo zakuthupi, sikungakuthandizeni kudziwa bwino lomwe matendawa. Kwa anthu ena, chiwalo chapansi chili pamalo amodzi, ndipo maonekedwe osayenera nthawi zambiri amachititsa kuwonongeka kapena kutha kwa makoma a zowonjezereka.
Pali njira zambiri zamaluso zodziwiritsira ntchito chiwindi:
- Chizindikiro cha Mendel. Pogwirana ndi chala cha m'mimba mwa m'mimba, kupweteka kumalo oyenera a ileali kumawonjezeka.
- Chizindikiro Sitkovsky. Kusokonezeka kumakhala kovuta ngati munthu atembenukira kumbali yakumanzere.
- Chizindikiro cha Pshevalsky. Zimandivuta kuti wodwalayo akweze dzanja lake lamanja.
- Chizindikiro cha Shchetkin-Blumberg. Kupweteka kochulukirapo ndi kuthamangitsidwa koopsa pambuyo pa kukakamizidwa.
- Chizindikiro cha kukwiya kwa peritoneum. Kupweteka kwakukulu panthawi ya kunjenjemera, kuseka, kutsokomola, kuyenda ndi kugunda.
Kuti chitsimikiziro chomaliza cha chithandizochi chidziwike, pali zinthu zingapo zomwe zikuchitika:
- kuyesa magazi (zamankhwala, zamagetsi), nyansi zamtundu, mkodzo;
- pulogalamu;
- kuyeza;
- mafilimu;
- Irrigoscopy;
- chiwerengero;
- electrocardiogram.
Thandizo loyamba ndi appendicitis
Ngati kutupa kwazowonjezereka kwa cecum kukudandaula, gulu lachipatala liyenera kutchedwa nthawi yomweyo. Pafoni ndikofunika kunena kuti wodwalayo akuyenera kukhala ndi chidziwitso - afotokoze zizindikirozo mwatsatanetsatane, kuti afotokoze chikhalidwe ndi ubwino wa munthu. Asanafike akatswiri, palibe zoyesayesa zokhazokha kuchipatala zomwe ziyenera kuchitika.
Thandizo lachidziwitso ndi appendicitis:
- Ikani womenyedwa pamtunda wosasunthika.
- Kupatsa wodwala mtendere wamaganizo.
- Musapereke madzi, chakudya, mankhwala.
- N'kosaloledwa kuika, kutentha m'mimba.
Kuwonjezera - ntchito
Njira yokhayo yothandizira matenda omwe akufotokozedwa ndi kuwotcha chiwalo choyaka. Kuchotsa opaleshoni kuchotsedwa kumagwiritsidwa ntchito pogwiritsa ntchito anesthesia ndipo kumafuna kukonzekera wodwalayo. Madzulo a opaleshoniyo, wodwalayo amamwa jekeseni wamthupi ndi mankhwala amphamvu kwambiri. Izi ndi zofunika kuchepetsa kukula kwa kutupa komanso kupewa matenda panthawi ndi opaleshoni. Kuonjezerapo, chapamimba chimatulutsa komanso m'mimba zimatsuka.
Njira yothetsera zowonjezereka ndi appendectomy ya laparotopic. Zimagwiritsidwa ntchito makamaka pa matenda a anesthesia ndipo zimapereka mwayi wolumikizana ndi gulu lochepa mwa kudula khoma la m'mimba mu gawo labwino. Chifukwa cha zochitika zamakono za zamankhwala, palinso njira ina, yopweteka kwambiri, njira yosakanirira yowonjezereka.
Kuchotsa zowonjezera ndi njira ya laparoscopic
Njira imeneyi imapereka magazi ocheperapo, imapanga mapangidwe akuluakulu ndi zomatira pamimba. Kutulutsidwa kwa laparoscopic kwazowonjezereka kumapangitsa kuti munthu asatengeke kwambiri ndi matenda ndi khungu, amachepetse nthawi yowonzanso. Malingana ndi kafukufuku wamakono, mtundu uwu wa ndondomeko sizimayambitsa mavuto.
Kuchita opaleshoni yotereyi ndi njira yowonjezera m'mimba ya carbon dioxide (pokonza malo okwanira ndi kupeza kwaufulu thupi) ndi zida zomangika ndi chipinda chaching'ono kudzera m'mabowo angapo ang'onoang'ono. Dokotala amawona zowonjezera kuchokera mkati mkati pakompyuta, ndipo amachotsa pang'onopang'ono ndondomeko yotenthedwa pogwiritsira ntchito osamala. Chiwalo chokongoletsera chimapezeka pamodzi mwa mabowo opangidwa.
Kukonzekera pambuyo pochotsedwera zakumapeto
Pakadutsa masiku 1-2 kuchokera nthawi yomwe opaleshoni imalimbikitsa mpumulo wogona, kugona pabedi kumaloledwa pa tsiku lachitatu. Nkofunikira kuti msoko pambuyo pa appendicitis usabalalitse. Masabata asanu ndi atatu otsatirawa, minofu idzaphwanyidwa, potsata kumene chiopsezo cha ma adhesi ndi hernias chikuwonjezeka. Pofuna kupewa zovuta, kuchita zolimbitsa thupi kumawonjezereka pang'onopang'ono, kukweza zolemera, masewera olimbitsa thupi komanso kugwira ntchito mwakhama sizichotsedwa. Kuthamanga kwa machiritso ndi kuteteza kusiyana kwa sutures kumathandizidwa povala bandage yapadera.
Kuphatikiza pa kuchepetsa thupi, wodwalayo amafunika:
- Nthawi zonse pitani kuchipatala ndi dokotala wa opaleshoni kuti mukayambe kafukufuku.
- Onetsetsani mabala a postoperative.
- Kukonzekera zigawo, kuti mupite zovala.
- Pambuyo powonongeka, mafuta odzola ndi mazira okonzekera.
Kudya pambuyo pa appendicitis
Kugwiritsa ntchito moyenera chakudya kumaloledwa kokha pa tsiku lachitatu la opaleshoni. Pa maola 72 otsatira, chakudya pambuyo pa kuchotsedwa kwazowonjezereka chimaphatikizapo zakudya zamadzi ndi mushy zokha. Amaloledwa kudya ndi zakumwa:
- masamba, osati msuzi wamphamvu nkhuku;
- mkaka;
- puree ku masamba;
- timadziti timadonthozedwa ndi madzi;
- nusu-madzi phala;
- msuzi wa dogrose;
- mchere, tiyi wakuda wakuda.
Kuyambira tsiku lachisanu ndi chimodzi menyu ikukula, mungagwiritse ntchito:
- rubbed soups;
- Zakudya za mkaka ndi mafuta ochepa;
- nyama zofiira kapena nsomba, zowonongeka kapena zophika, mu mawonekedwe osweka;
- phala pamadzi;
- masamba ndi zipatso zoyera;
- nthochi;
- mkate;
- odzola.
Pakatha miyezi 2-4 kuchokera kumapeto, ndikofunika kutsatira zolemetsazo ndikutsatira ndondomeko zowonjezerapo:
- Pali nthawi zambiri komanso pang'ono ndi pang'ono.
- Gwiritsani ntchito chakudya chokha, osati ozizira komanso osatentha.
- Pewani mankhwala omwe amachititsa kuti m'mimba mukhale otupa - nyemba, kabichi, marinades, pickles, mankhwala osuta.
- Sakanizani "chakudya cholemera" - mafuta, nsomba, zakudya zokazinga, supu zamphamvu ndi msuzi.
- Musamamwe mowa, soda.
Kubwereranso ku menyu yoyenera kwa munthuyo ayenera kukhala pang'onopang'ono ndi pang'onopang'ono. Akatswiri amalangiza kuti apitirize kutsatira ndondomeko za zakudya zoyenera, kuti akhale ndi chakudya chokwanira. Izi zidzakuthandizira kulimbikitsa chitetezo cha mthupi ndi kubwezeretsa kuchuluka kwa microflora m'matumbo, zomwe zinakhudzidwa ndi kutupa.
Kuwonjezera - zovuta
Zotsatira zopweteka zimachokera kumbuyo kwa matenda osanyalanyazidwa kapena kusowa chithandizo chamankhwala chokwanira. Mavuto amapezeka kawirikawiri ngati mankhwalawa amapezeka mofulumira - zizindikiro zimanyalanyazidwa pang'onopang'ono za kutupa kwapang'onopang'ono ndipo zimayambitsa kufalikira kwake. Zotsatira zake, ndondomeko ya matendawa imadutsa ku ziwalo zowonjezereka ndi matendawa, matenda opatsirana amatha kuchitika.
Pambuyo pa kuchotsedwa kwa zotsatirazi zotsatira zotsatirazi zoopsa zikhoza kukhala:
- peritonitis (kutupa kwa mimba yamimba);
- matenda othandizira ;
- magazi;
- kuperewera kwa pathupi pamimba (kuchepa kochepa mu kapsule wodzaza ndi pus);
- kusungunuka kwapakiteriya kwa mabakiteriya m'magazi;
- Kuchokera pazowonjezereka ndi kutuluka kwa zomwe zili mkati, kuphatikizapo nyansi zakutchire ndi zowonongeka, kulowa mu mimba;
- Kutupa kwa mitsempha ya chiwindi cha chiwindi, kungakhale purulent (pylephlebitis);
- thromboembolism - kutseka kwa mitsuko ya magazi ndi thrombus;
- phlegmon wa malo otchedwa retroperitoneal space;
- Periapendicular kulowa mkati (kusakaniza kwa zowonjezera ndi ziwalo zozungulira);
- thrombophlebitis wa mitsempha ya pelvis yaing'ono;
- kukhudzidwa kwa mabala opaleshoni;
- seam kusiyana;
- waulesi kapena wodwalayo.