Perforated lub rwj: cov tsos mob thiab kev kho mob

Tej yam kab mob uas yog tsis kho los yog tsis ua raws li tag nrho cov tswv yim pom zoo ntawm tus kws kho mob yuav ua rau loj teeb meem. Tam sim no, ib tug loj feem pua ntawm cov pejxeem suffers los ntawm cov kab mob ntawm lub digestive ib ntsuj av tau, xws li gastritis thiab ulcers nyob ib tug ntawm cov thawj qhov chaw. Ib tug ntawm cov teeb meem ntawm cov pathologies yog ib tug perforated pais plab rwj thiab duodenal ulcers, cov tsos mob thiab kev kho mob ntawm cov pathologies yuav tau los sib tham tom qab.

Yuav ua li cas yog lub perforation?

Tus kab mob no yog cov kev tshwm sim ntawm teeb meem ntawm peptic rwj kab mob, uas muaj peev xwm tshwm sim rau ntau yam yog vim li cas, tab sis lawv muaj peev xwm ua rau hauv lub tsim ntawm los ntawm qhov nyob rau hauv lub hollow lub cev. Qhov no tej zaum yuav lub plab, thiab tej hnyuv.

Raws li ib tug tshwm sim ntawm lub tsim ntawm tag nrho cov txheem ntawm lub perforation ntawm lub plab los sis txoj hnyuv ua ke nrog cov ntsiab lus thiab enzymes ntog mus rau hauv lub peritoneal kab noj hniav thiab pib noj tam sim ntawd ntawm nws. Kis kab agents tsis nyob twj ywm indifferent, thiab nyob rau hauv cov lus teb rau tej kev tshwm sim muaj ib tug inflammatory txheej txheem, uas yog hu ua peritonitis.

Qhov no yog ib tug loj heev teeb meem uas yuav tsum tau tam sim ntawd kev kho mob kev pab. Feem ntau cov feem ntau qhov no yam tab kaum tshwm sim nyob rau hauv lub muaj zog ib nrab ntawm cov tib neeg, thiab qhov tshwm sim ntawm peaks nyob rau hauv caij nplooj ntoos hlav thiab lub caij nplooj zeeg.

Ua rau perforation nyob rau hauv lub plab

Muaj ntau ntau yam uas yuav ua tau kom ib tug perforated lub rwj, ntawm lawv lub tseem ceeb tshaj plaws yog:

• Nquag o ntawm lub plab.
• Cev ua ub ua, uas ua rau ib qho kev nce nyob rau hauv intraabdominal siab.
• Loj cov nqi ntawm cov khoom noj khoom haus.
• Tsis tau saib xyuas tus cwj pwm rau dieting.
• Stressful lub sijhawm.
• Kev siv cov tshuaj aspirin los yog glucocorticoid txoj kev kho.

Qhov muaj mob nyob rau hauv lub qog ua kua membrane yuav ua rau lub fact tias lub perforated lub rwj, nws cov tsos mob yuav mus xyuas tus neeg mob. Tas yuav tsum tau kuaj tsis tu ncua thiab ua raws li tus kws kho mob pom zoo.

Ua rau lub rwj 12 duodenal rwj

Ntau zaus tshaj tsis no lub cev tawm ua yog rooted nyob rau hauv cov teeb meem nrog rau lub plab. Yog hais tias tsis muaj kev txiav txim yog coj mus tshem tawm cov o nyob rau hauv nws, ces nws yog ntsoov kis mus rau lub duodenum.

Cov ua zaum kuj yuav:

• Alcoholism.
• Gallbladder tus kab mob, mob hnyuv tws.
• Kab mob nrog tus kab mob Helicobacter pylori.

Nws yuav tsum tau borne nyob rau hauv lub siab hais tias perforated lub rwj 12 duodenal rwj tshwm sim ntau npaum li cas heev tshaj lub plab.

Symptomatology perforated lub rwj

Thaum tus neeg mob muaj mob ceev, nws yog ib txwm manifested los ntawm kev mob, ntuav, tag nrho cov no feem ntau tshwm sim tom qab ib tug noj mov. Thaum lub sij hawm ntawm tsim ntawm lub perforation perforated lub rwj cov tsos mob yog ib tug ntse "dagger" ib tug mob uas yuav tsis zam lub txim rau. Tus neeg mob nws mus rub nws ob txhais ceg rau nws lub hauv siab, kom tsis txhob muaj nws.

Thaum lub sij hawm no, raws li muaj ib qho kev nce tej yam tshwm sim ntawm intoxication vim yog tej yam tag nrho cov uas yog nyob rau hauv lub plab, nyob rau hauv lub plab kab noj hniav. Cov tawv nqaij yuav daj ntseg, zoo nkaus li tus mob khaub thuas tawm hws, thiaj li ntshav siab thiab lub plawv pib tuav ceev.

Nyob rau hauv txoj kev loj hlob ntawm tus kab mob no muaj ob peb theem:

1. Shock theem. Raws li lub sij hawm thiab yog yus muaj los ntawm intolerable mob heev uas yuav muab rov qab mus rau sab xis. Vim li no, nws yog ib qhov nyuaj ua pa, cov nqaij ntshiv ua nyuaj heev thiab tense.
2. Xav txog tej yam kev txhim kho. Thaum lub sij hawm no, nws yog hais txog ib tug ob peb teev tom qab qhov pib ntawm kev mob, tus mob khees me ntsis lawm me ntsis, perforated lub rwj lawv cov tsos mob txo. Muaj yog ib tug tsis muaj zog, lub siab yog tsawg tsawg, cov nqaij ntshiv so ib me ntsis, thiab nws yuav yooj yim dua rau ua pa. Lub cev kub yog feem ntau nyob rau hauv no lub sij hawm yog muaj zog, muaj yog tsam plab, cov neeg mob uas muaj me ntsis mob no, tsis muaj lawm los yuav tsis meej pem nws nrog lom lossis cov mob khaub thuas. Tsis muaj xwm txheej ceev thaum lub sij hawm lub sij hawm no tsis tau dispensed.
3. Tom qab 12 teev twb tshwm sim peritonitis cov tsos mob dryness nyob rau hauv lub qhov ncauj kab noj hniav, cov mob plab. Nws yuav tsum tau muab sau tseg tias tej yam tshwm sim ntawm peritonitis yeej ib txwm zoo li qub, tsis hais txog ntawm qhov ua rau, hais tias nws txhais. Kuv xav tias hais tias qhov no tau tshwm sim los tiv thaiv cov perforation ntawm lub rwj ntawm lub plab los sis txoj hnyuv yog tau tsuas yog nyob rau lub hauv paus ntawm cov muaj mob.

Peritonitis yuav tshwm sim los mob hnyuv tws, pancreatitis, tab sis nyob rau hauv txhua rooj plaub uas xav tias pathology xws xav tau kev pab ceev pw tsev kho mob. Nyaum yog qhov teeb meem thaum loj hlob lub rwj yuav luag tsis muaj tej yam tshwm sim. Cov tsos mob tshwm sim perforation neeg mob yuav tsis quav ntsej, thiab cia li sim los daws qhov mob tsev neeg improvised txhais tau tias thiab painkillers, thiab nws yog ib lub neej txoj sia.

Cov tsos mob ntawm plob tsis so tswj ulcers

Yog hais tias muaj yog perforation ntawm lub duodenum 12, lub, tej zaum muaj xws li:

• Mob mob nyob rau hauv rau sab laug hypochondrium, uas yuav tsum tau muab nyob rau hauv lub caj dab thiab pob txha qais.
• Ntuav, feem ntau nws yuav tshwm sim ib zaug xwb.
• Nws ua ib tug "pancake-zoo li tus plab."
• Muaj yog ib tug txias hws, thiab xiavlus txheej week.

Ib yam li nyob rau hauv cov ntaub ntawv ntawm pais plab perforation, perforated lub rwj 12 duodenal rwj, cov tsos mob uas peb xav, ua rau lub fact tias nyob rau hauv lub thib ob theem ntawm txoj kev loj hlob ntawm ib zaug pib qhia tej yam tshwm sim ntawm tau txais plob tsis so tswj txheem mus rau hauv lub plab kab noj hniav. Tachycardia, kub taub hau, mob heev yog tiag tiag li tim khawv txoj kev loj hlob ntawm peritonitis. Nyob rau hauv lub xeev no, peb yuav tsum tau ceev pab cov neeg phais.

diagnosing perforation

Txij li thaum lub perforated pais plab rwj thiab duodenal rwj cov tsos mob yog cov lus hais nyob rau hauv thawj theem, thiab cov neeg mob feem ntau yog tuaj mus rau lub tsev kho mob rau ib tug thib ob, ces lub hauv paus ntawm muaj tseeb mob yog kev kho mob yav dhau los. Tsis tas li ntawd, nco ntsoov yuav tsum tau ntxiv cov kev tshawb fawb:

• Radiography, uas qhia tau tias muaj cov dawb roj, yog hais tias muaj yog ib tug perforation.
• US qhia txog cov pib ntawm o nyob rau hauv lub peritoneal kab noj hniav thiab muaj cov kua.
• EGD yog tej zaum kuj siv los txheeb xyuas cov chaw qhia kiag ntawm pathology, tab sis muaj ib tug uas yuav muaj roj rau hauv lub plab kab noj hniav, yog li ntawd koj yuav tsum tau ceev faj heev.
• Yog hais tias yog cov ntaub ntawv loj heev, thiab cov tsos mob ntawm perforated lub rwj ntawm lub duodenum yog lubricated, lawv ua ib laparoscopy.
• Kuaj ntshav kuj qhia ntau zog cov nqi ntawm ESR, siab nkaug leukocytes thiab hemoglobin theem txo.

Tsuas yog tom qab cov kabke ntawm lub xub ntiag ntawm ib tug perforation xav yuav ua phais.

Thawj pab rau ib tug perforated lub rwj

perforation tsim nyob rau hauv lub plab los yog cov hnyuv yog heev txaus ntshai rau tib neeg lub neej, yog vim li cas nyob rau thawj lub sijhawm twg los ntawm tus mob no yog tsim nyog los hu rau ib tug tsheb thauj neeg mob. Nyob rau hauv tus txheej txheem ntawm thauj ib tug neeg mob nyob rau hauv ib tug loj mob preparations los siv rau cov muaj arterial siab, nqus tau pa oxygen ua muab painkillers.

Siv nyob rau hauv lub sij hawm no yog tsis tsim nyog opioid analgesics, raws li lawv ua txhaum rau tus neeg mob pem thiab ntub cov kev soj ntsuam ces, uas ua rau muaj teeb meem rau qhov tseeb kuaj mob.

perforated lub rwj kev kho mob

Perforated plob tsis so tswj lub rwj cov tsos mob yog yuav luag tib yam li tus perforation ntawm lub plab, lawv muab ntau thiab hais tias mus rau tiv nrog xws li ib tug lub xeev tsuas yog cov neeg phais. Hauj lwm kev pab yog tsim nyog los nqa tawm sai li sai tau, vim hais tias thaum ib tug tom qab theem tej zaum nws yuav tsis muaj nuj nqis.

Yog hais tias qhov teeb meem no yuav kom muaj, tag nrho cov manipulations tau nqa tawm nyob rau hauv lub intensive kev saib xyuas unit. Ua ntej phais, cov kev sojntsuam no tso thiab lub catheter mus rau hauv lub zais zis, thiab nws tus kheej phais ua nyob rau hauv kev tshuaj loog.

Tus kws phais ua ib qho kev incision thiab tshuaj xyuas cov kab noj hniav ntawm lub plab los sis txoj hnyuv, ntes perforations, thiab ces daws tau qhov teeb meem, yuav ua li cas muab tshem tawm. Ua li no, koj muaj ob peb qho kev xaiv:

1. Koj muaj peev xwm coj nyob rau hauv lub qhov.
2. Nyob rau hauv tej rooj plaub, lub tshem tawm ib feem ntawm lub plab nrog rau cov perforation.
3. Excision ntawm lub rwj thiab tuav vagotomy.

Feem ntau cov feem ntau, los ntawm kuv txoj kev, cov neeg phais paub tias suturing tsis yog ib tug 100% guarantee ntawm ua tiav rov qab, rov feem ntau tshwm sim. Yog li ntawd, qhov no txoj kev tswj perforation resort nyob rau hauv lub sijhawm uas muaj teebmeem peritonitis, los yog nyob rau hauv lub xub ntiag ntawm tus kab mob nyob rau hauv cov tub ntxhais cov neeg uas tau ua yog vim li cas rau lub xeev no ntawm kev nyuaj siab.

Nyob rau hauv feem ntau lwm yam mob, ntau npaum excision ntawm lub rwj los yog pais plab resection.

Raws li ua ntej excision los yog suturing, thiab tom qab ua hauj lwm yog ua tiav reorganization kab noj hniav thiab tsim kom muaj ib co drainages.

Peb tau soj ntsuam lub npe: "perforated lub rwj cov tsos mob thiab kev kho mob." Thawj pab nyob rau hauv qhov teeb meem no yog ib qho tseem ceeb heev, tiam sis feem ntau ntawm nws cov ntsiab lus yog lus dag nyob rau hauv thaum ntxov pw tsev kho mob.

Teeb meem tom qab kev phais thiab kev twv rau lub neej yav tom ntej

Ntawm cov postoperative teeb meem ntawm tus txheej txheem yog cov nram qab no:

• Cov kev loj hlob ntawm ib tug rwj nyob rau hauv lub plab kab noj hniav.
• Mob Ntsws Txheem Dej.
• Yog hais tias lub nqaws yog ua tsis zoo, nws yog fraught nrog rau cov tsim ntawm re-perforation thiab peritonitis thiab sepsis.
• Heev tsis tshua tau ua txhaum ntawm lub nce qib ntawm cov zaub mov los ntawm cov hlab pas mus rau hauv lub plab raws li ib tug tshwm sim ntawm lub narrowing ntawm lub tswv yim ntawm cov sphincter.

Yog hais tias kev kuaj nyob rau hauv lub sij hawm perforated lub rwj, cov tsos mob lawm thiab tau noj tag nrho cov tsim nyog ntsuas kom tshem tawm tus kab mob no, cov raug yog feem ntau paaj. Nyob rau hauv kev ua raws cai nrog tag nrho cov tswv yim pom zoo ntawm tus kws kho mob thiab kev noj haus yuav ua tau ib lub neej zoo.

Cov neeg txoj kev kho mob ntawm ulcers

Yog hais tias tus kab mob tau ploj mus ib yam nkaus thiab deb deb, thiab tsim ib tug perforation, txoj kev kho kev cai muaj tsis ntxim. Tab sis tom qab kev phais, nyob rau hauv tas li ntawd mus rau ib tug standard chav kawm ntawm kev kho mob, nws yog tau mus thov cov tswv yim pom zoo ntawm tsoos healers.

Ntawm no yog ib co zaub mov txawv uas yuav pab tau los txo cov acidity ntawm pais plab kua txiv, los mus tiv thaiv relapse:

1. Tov kua txiv ntawm ob tug txiv qaub nrog 0.5 liv ntawm zib ntab thiab nrog tib tus nqi ntawm txiv roj roj. Npaj kom txhij los siv cov tshuaj rau 1 st. l. ua ntej noj mov 3 lub sij hawm ib hnub twg rau ib lub hlis.
2. 250 grams ntawm aloe nplooj crushed nyob rau hauv ib tug nqaij li, ntxiv 250 grams cov zib ntab thiab sov lub sib tov rau 50 degrees, ces ntxiv ib nrab ib liter ntawm liab cawu cub. Tag nrho cov no yog mus hais nyob rau hauv ib tug maub qhov chaw 7 hnub, thiab ces koj yuav muab rau ib diav 3 zaug ib hnub twg rau ib teev ua ntej ib tug noj mov. Lub caij ntawm qhov kev kho no yog 3 lub lis piam.

Nws yuav tsum tau nco ntsoov tias twb tsoos tshuaj yuav ua tau zoo nyob rau hauv thawj zaug rau theem ntawm txoj kev loj hlob ntawm ulcers thiab perforations nyob rau hauv cov kev tshwm sim muaj yog tsis muaj kev txiav txim.

Yuav ua li cas tiv thaiv kom txhob rov muaj dua ntawm lub perforation

Nyob rau hauv thiaj li yuav tiv thaiv kom txhob rov tshwm sim ntawm perforated lub rwj, anti-relapse txoj kev kho yuav tsum tsis tu ncua nqa tawm, uas muaj xws li:

1. noj cov zaub mov ua raws cai. Raws li ib tug yuam rau cov neeg mob ua hauj lwm pab № 1 noj cov zaub mov, tshwj xeeb tshaj yog thaum lub sij hawm lub sij hawm ntawm tau exacerbation.
2. Tau txais qhov tsim nyog tshuaj. Cov mus kawm tus kws kho mob yuav tsum tau ua cov tswv yim nyob rau hauv no hais txog.
3. Physiotherapy. Lawv muab tau zoo heev nyob rau hauv nrog cov khoom noj kom thiab tshuaj thawj coj.
4. Periodic spa kev kho mob.

Cov kab mob ntawm tus mob huam yuav ua rau ib tug ntau ntawm teeb meem rau nws tus tswv. Yog hais tias koj tsis ua raws li nruj zaub mov txwv, kev tsim txom muaj yees, raug heev kev nyuaj siab, koj yuav ua tsis tau ras tias tus kab mob plague dua tshaj tawm nws tus kheej rau nws cov unpleasant cov tsos mob. Saib xyuas ntawm koj tus kheej thiab koj kev kho mob, nws yuav tsis tau rau txhua yam nyiaj.