Appendicitis: ukuxilongwa, unyango. Ukuxilongwa ngokwahlukileyo kwe-appendicitis

Ukuvuvukala kwesihlomelo kuyisifo esingabaziyo abaninzi kuphela ngeengxolo. Phakathi kweempawu zonke ezivakalayo - iintlungu ezinzima esiswini. Nangona kunjalo, uphawu olulodwa lwesifo aluphelelanga omnye. Kwimeko apho i-appendicitis ivela kumntu osekhulile, akukho nto ibuhlungu. Kubalulekile ukunyamekela ngethuba leminye impawu ye-appendicitis kuwe okanye othandekayo kwaye ngoko nangoko uqhagamshelane nodokotela kwaye unike inkxaso ngoncedo olufike ngexesha. I-Appendicitis, efunyenwe ngezifundo ezininzi, inokukhokelela kwi-peritonitis, leyo leyo, eyona nto ingabangela ukufa.

Iimbangela ze-appendicitis

Oogqirha abanako ukunika impendulo echanekileyo, kutheni abanye abantu banezihlomelo. Nangona kunjalo, kukho uluvo lokuba ukuphuhliswa kwesi sifo kubangelwa ziingxaki zamathumbu, amatye esitye, ukuhlasela kwe-helminthic, ukuzithemba, ukukhulelwa kunye nokungaqhelekanga kwenkqubo. Ukungondleki kungakhokelela ekuvukisweni kwesihlomelo se- cecum. Akumangalisi ukuba ebuntwaneni saxelelwa ukuba imbewu engcolileyo ingakhokelela ekusebenzeni ukususa i-appendicitis.

Kwimeko nayiphi na into, akunakwenzeka ukuzikhusela kwisihlomelo. Ngenxa yokuxilongwa okubi, isibhedlele sifakwa esibhedlele, njengabantwana abasandul 'ukuzalwa, bobabini abasemhlala-phantsi kunye nabasempilo abaselula. I-Appendicitis, ukuxilongwa kwezinto ezibandakanya ukuhlula isifo kwiinkalo zezinye iingxaki zempilo, kufuna ukungenelela kwangangoko.

Amanyathelo okuphuhliswa kwe-appendicitis

Ukuvuvukala kwesithasiselo kunokuqala nokugqiba. I-appendicitis efanelekileyo, ukuxilongwa kwayo okubandakanya inani leendlela zokuchonga ingxaki kunye nokwahlukana kwesi sifo, kudlula amanqanaba amaninzi, nganye ehamba ngokugqithiseleyo ukuya kwesilandelayo. Ezi zi:

• I-Appendicitis iyingozi. Kule nqanaba, inkqubo yokuvuvukala iyathintela kuphela isihlomelo severmicular.
• Isigaba esingenangqondo sichazwe ngokuvuvukala okuqhubekayo kunye nomonakalo oyinhloko kumbrane we-mucous. Ngeli xesha, i-leucocytes negazi zifumaneka kwi-lumen ye-appendage.
• Kwinqanaba le-phlegmonous, isihlomelo esiphezulu sivuthayo, kubandakanywa igobolondo yangaphandle ye-appendage.
• Isigaba se-phlegmonous-ulcerative sibonakala ngokubonakala kwezilonda kwi-mucosa yesihlomelo.
• Isigaba sokugqibela siqhwaba, esichazwa yi-necrosis yesindululo sesongezo kunye nokuqukunjelwa kokuphakathi kwayo kwi-peritoneum.

Njengoko ukusukela ekuqalekeni kwesigxina se-peritonitis kwenzeka kuphela kwiintsuku ezimbini ukuya kwezine, kubalulekile ukubona ugqirha oza kusebenzisa zonke iindlela zokufumanisa i-appendicitis ukuba iimpawu zokuqala zesifo ziyafumaneka.

Iimpawu eziqhelekileyo ze-appendicitis ephezulu kubantu abadala

Njengawuphi na esinye isifo, ukuvuvukala kwesihlomelo se-cecum kunezibonakaliso zayo. Iimpawu eziqhelekileyo ze-appendicitis exhomekeke kwisigaba sokuvuvukala, indawo yenkqubo kunye nokuba ngumdala wesigulane. Kwinqanaba lokuqala lophuhliso oluphezulu lwe-appendicitis kukho isicupunu, ukuhlanza okukodwa okanye okuninzi, okungafani nokutyhelwa kokutya, akuyi kuzisa nayiphi na inkululeko. Umntu uqala ukukhalaza ngobuthakathaka obuthakathaka kunye nesimo sengqondo sokulahlekelwa yintlungu, ukulahleka kwesidlo kunye nezinye iingxaki zokuchasana. Ukuxilongwa kwe-appendicitis kubantu abadala kule nqanaba akunakwenzeka, kuba ukuphazamiseka okunjalo kufana nesifo esiluncedo kunye nesifo esingapheliyo.

Isigaba esilandelayo lulimi olululwe ngolwimi, lokuqala lumanzi, lube lumile. Ukushisa kwesigulane kuphakama ukuya kuma-degrees ama-38, kwaye i-rectal ngaphezu kweqondo lokushisa lomzimba ayikho ngo-1, kodwa ngamadididi athile. Indawo yefelvic yenkqubo ikhokelela ekubonakaleni kwesigxina esivulekile; Isihlomelo, esisondele kufuphi ne-vestile, sibangela ukuphazamiseka kwamanzi. Ukulahlekelwa kwesidlo, kubandakanya i-anorexia, kuphawulwe kwi-90% yeziganeko zokuvuvukala kwesihlomelo se-cecum. Ukuba isigulane siyaqhubeka sisidla ngokuqhelekileyo, ngoko ke, mhlawumbi, ukuxilongwa ngokungafaniyo kwe-appendicitis efunekayo, okuya kuvumela ukufumana esinye isifo esinempawu ezifanayo.

Iimpawu zeNgingqi

Njengoko iimpawu eziqhelekileyo ziphawu lwesinye sezifo, kunzima kakhulu ukwenza uvavanyo oluchanekileyo kwiiyure zokuqala. Nangona kunjalo, emva kweeyure ezingama-4, iimpawu zendawo zibandakanya iimpawu eziqhelekileyo, ezivumela ukuhlukana kwesikhalazo sesilomelo kunye nokubonelela unyango oluyimfuneko kwisigulane. Ezi zi:

• Ukubangela ubuhlungu obuhlungu. Kwaye intlungu iyabaleka phambi kokuphuhliswa kweempawu zendalo jikelele. Ingingqi okanye indawo yonke kwisisu, okanye kwimimandla ye-periac. Kwimeko ye-pelvic ye-appendage, intlungu ibakho phezu kwesifuba, kwaye kwi-prehepatic - kwi-hypochondrium. Kodwa ngokugqithiseleyo oogqirha babhekana nesimo esibizwa ngokuba yi- Kocher, xa ubuhlungu obuvelayo kwiiyure ezimbalwa ukusuka kwingingqi ye-epigastric kuya kwindawo efanelekileyo ye-aliac.
• Kancinci intlungu iqhubela phambili kwaye isuka kuguga iba nzima, ngamanye amaxesha iphinda ibuyisele kwisini somzimba, umva ongaphantsi okanye umlenze wesokudla. Ngokugqithiseleyo izigulane zivakalelwa xa zihamba okanye zikhwehlela. Ngokuqhelekileyo, oogqirha bacela isigulane ukuba siphumelele ukucacisa ngokuthe ngqo uhlobo kunye nendawo yentlungu.
• Ingaba intlungu ibuyele ngokukhawuleza? Le nenye yeempawu zesifo, esibonisa i-necrosis yamaseli enyantya kwinkqubo. Kwaye impawu ziyamangalisa, zandulela ukunyuka kwesimo somguli kunye ne-peritonitis.
• I-peritonitis iphinda iboniswe ukuxhatshazwa kweemisipha zodonga lwesisu (kwimeko ye-retrocecal indawo yenkqubo, izihlunu zengqungquthela zihlanjululwe). Xa uthinta isisu, inkontileka yemisipha iyakubonakalisa, ukubonisa ukuba ukuvutha kufikelele kwi-peritoneum ye-visceral.
• Kukho uxinzelelo lwesikhumba kwindawo efanelekileyo ye-aliac.
• Imisipha yecala lasekunene lesisu isenokubonakala lilele emva kokuphefumla, okubonisa ukuxhatshazwa kwemisipha.
• Kwizigulane ezincinci, inamba yancinci idluliselwa kwicala lasekunene.
• Ukuxilongwa kwe-appendicitis ekhaya kukubandakanya i-palpation. Kwanele ukuba ucinezele kwingingqi ye-aliac kwaye uphuke ngokugqithiseleyo i-brush-intlungu iya kwanda kwangoko.
• Uviwo oluqhelekileyo kunye ne-appendicitis lubonisa ukukhathazeka kwe-rectum. Ngokuchanekileyo, udonga lwaso langaphambili.

Iinkqubo zokuxilonga ezongezelelweyo ekhaya

Ukuchonga iingcamango zesifo kunye nokwahlula kwesi sifo, ezo ndlela zisetyenziswa:

• Isimpawu seDubois sivakalelwa gqitha xa sicinezela kwiimpawu ze-occipital ze-vagus nererve.
• Isibonakaliso saseMoscow ngumfundi ofanelekileyo.
• Kwakhona, kukho iingongoma kwisisu, ucinezela oko kubangela ukuhlaselwa kwentlungu kwi-appendicitis. Kodwa indawo yabo ngqo iyaziwa kuphela ngugqirha, ngoko kuyafaneleka ukulinda ukufika kweqela le-ambulensi.

I-Appendicitis kubantwana

Ubunzima bokufumanisa i-appendicitis kubantwana kukuba abanako ukuthetha ngeemvakalelo zabo ngenxa yobudala babo. Kule meko, umntwana omncinane, ngokukhawuleza eso sifo siyaqhubeka. Phantse zonke iimpawu ze-appendicitis yabantwana ziqhelekileyo, kungenxa yokuba kukho nawuphi na kubo kubalulekile ukuba uqhagamshelane neengcali. Ekuqaleni umntwana utshintsha indlela yakhe yokuziphatha, uyeka ukuhamba ngokunyanisekileyo, kuba ngumntu ongenanto kwaye enganandaba. Kamva, kukho ezinye iimpawu, ezenza kube lula ukuhlula isifo.

Iintsana ezisandul 'ukuzalwa zilahla ibhotile okanye ibhotile, i-fontanel iyacima, ulwimi luba lumile. Kufuneka kube noxinzelelo olunamandla kwingingqi ye-aliac. Ukuxilongwa kwe-appendicitis ebonakalayo kubantwana kukwabeka iliso kwimeko yomntwana. Ngokuqhelekileyo iintsana zilele ngasekunene ngamadolo aguqe. Abantwana abakhulileyo bangahlala, bancike phambili.

Xa isalathiso ngugqirha wesiganeko sokunene sase-aliac, umntwana utyhola umlenze wokunene kwisisu kwaye ugxotha isandla sogqirha kude naye. Ukuxilongwa kwe-appendicitis ezikolweni zasesikolweni nabantwana besikolo rhoqo kubandakanya umbuzo othi "yintoni ephosakeleyo?". Ngokwesiko, umntwana ubonisa indawo yomnatha. Ngexesha le sifo, intlungu iyakwazi ukufudukela kwindawo yokuvutha. I-Lethargy, i-nausea, ukuhlanza, ukuqothulwa ngaphambi kokuqala kweentlungu, i-tachycardia kunye nomkhuhlane nazo zibonakalisa ukuvutha kwesihlomelo.

I-appendicitis enobuchule kumama olindayo

Abafazi abakhulelweyo abazikhuseli kwisifo esinjalo esingathandekiyo njenge-appendicitis. Ukuxilongwa kuyinkimbinkimbi yinto yokuba iimpawu eziqhelekileyo, ezinjengeentlungu zesisu, isicupunu kunye nokuhlanza, ziphawu lwesifo se-toxicosis kwizigaba zokuqala zokukhulelwa. Ngokukhula kwesibeleko, ukuphuhliswa kweempawu zesifo kuya kuba nzima. Ezinye iindlela zokufumanisa i-appendicitis enamandla kwi-trimestri yesibini neyesithathu ayikwazi ukunika iziphumo. Ngokomzekelo, iimpawu zomsindo we-peritoneum azinqunywanga, iintlungu azihlali kwindawo yangasese, kodwa ngaphezulu, i-palpation ayiphumeli ngenxa yesibindi sokuvuthwa kwesibeletho esakhulayo. Ngenxa yolu buhlungu buhlungu, buhlungu okanye buhlungu buya kuphazamiseka ngenxa yeempawu zokulahleka kwesisu.

Ngenxa yobunzima bokufumanisa i-appendicitis kwabasetyhini abakhulelweyo, kuyimfuneko ukuba bahambe ngokukhawuleza kuviwo lwe-patient kunye nokugqithisa zonke iimvavanyo ezifunekayo ukuchonga ngokuchanekileyo uhlobo lwengxaki, ngaphandle kokulimaza unina, okanye umntwana wakhe. Ukumiswa kwe-appendicitis? Ukuxilongwa ngokucacileyo kuya kunceda ukuqinisekisa ukuba ukuxilongwa kukuchanekileyo okanye ukuphikisa. Iyeza langoku likuvumela ukususa isihlomelo ngexesha lokukhulelwa ngaphandle kokulimala kwimpilo. Iimeko eziphambili zeempumelelo zixilongwa ngexesha kunye nokuthintela iingxaki ezifana ne-peritonitis. Ngelishwa, kwimeko ye- appendicitis , i- appendicitis , i-caesarean section iyadingeka. Kuphela emva koko kunokwenzeka ukususa isihlomelo, uhlambulule isisu esiswini kwaye ulondoloze loo ntokazi.

I-appendicitis ubudala

I-appendicitis, eyenzeka kubantu asebekhulile, iyingozi kakhulu. Oku kungenxa yokuphulukana phantse zonke iimpawu zesifo. I-syndrome yeentlungu ibonakaliswe kakuhle, akukho nto ikhona yimiba ye-dysuric kunye ne-diarrheal, ubushushu buhlala buqhelekileyo. Musa ukuqaphela abantu abadala kunye nesimo sokuhlaselwa kwe-appendicitis tachycardia, ukwanda kwe-ESR kunye neukocytosis. Ngenxa yobudala bomda wodonga lwesisu, akukho mpendulo ekukhuseleni kwiimisipha zesisu. Kungenxa yoko izigulane ezinde zifanele ziphendule ngokukhawuleza kunokwenzeka naziphi na utshintsho kwiimeko zabo. Ngethuba elincinci lokuvuvukala kwesihlomelo, kuyimfuneko ukubiza udokotela oya kukwazi ukuqhuba uviwo olupheleleyo lwesigulane.

Iingxaki ze-appendicitis

Ifomu elibi le sifo lingakhokelela ekubhujisweni kwesihlomelo okanye ukukhishwa kwayo. Kule meko, izihlwele zihamba ngaphaya kweenkqubo, ezikhokelela ekuvukeleni kwendawo okanye kwi-peritoneum. Ngeflux reflux, kunokwenzeka ukuba kuphuhliswe i-empyema, isilululent lesion echitha i-peritoneum, i-rectum kunye nezicubu ezikufutshane. Yenza i-folic foci, ifikelele kwiithambo ezinamafutha.

Akukho miphumo embi kakhulu ye-thrombophlebitis yesihlomelo, ebangela ukuba uphuhliso lwe-septic thrombophlebitis ye- portal vein kunye namasebe. Oku kukhokelela ekukhuselweni kweemvini zesibindi kunye nokuphuhliswa kwezibilini ezithile. Ngenxa yokuxhamla okunjalo, i-appendicitis kufuneka iphathwe ngokukhawuleza, ngaphandle kokulibazisa "ngomso" kwaye ingathembeli ukuba "mhlawumbi iya kudlula."

I-Appendicitis engapheliyo

Kukho into enjalo njenge-appendicitis engapheliyo kwaye engekho. Iklinikhi, ukuxilongwa kunye nokunyangwa kwesi sifo kuyahluke nomfanekiso wokuvuvukala kolu hlomelo. Njengoko umbandela ongenasiphelo ngumphumo wokutshintshwa okanye ukuthwala ukuvutha komzimba. Esi sihlomelo sihamba ngeenkqubo ezinobungqina obunobunzima, ezihamba kunye nokutshatyalaliswa kwezicubu. Ukuvuvukala kwenzeka kwaye kuyaphilisa, kwakha imibala kunye nokunamathela, mhlawumbi ukubonakala kwezilonda kunye nokungena. Kwezinye iimeko, i-appendicitis engapheliyo ibangela ukuba inkqubo iguqulwa ibe yi-cyst, ukuqhutyelwa kwayo akuyona ingozi kunokuba kufikelelwe kwisihlomelo. Kubalulekile ukuba uqaphele ukuba ifomu elingapheliyo-into eqaqambileyo, ibone kuphela kwiimeko ezili-1 ze-100. Ngaba ukrokrela i-appendicitis engapheliyo? Ukuxilongwa, unyango kunye nenkxaso yonyango esilandelayo kwenzeka esibhedlele.

Diagnostics

Ukuxilongwa kwe-appendicitis ekhaya kufuneka kube ngokuchanileyo kunokwenzeka, kuba impazamo kunye nemithi elandelelweyo, ngokomzekelo, ukusuka kwisifo sotyhefu, kunokukhokelela kwimiphumo emibi. Oku akuyi kuba nzima nje ukuxilongwa, kodwa kuphazamisa imeko yesigulane. I-Appendicitis, ukuxilongwa kwakhe ngokwahlukileyo kwimeko ethile ekhoyo ekhaya, ayinyamezeli unyango. Ngaphambi kokufika koogqirha, akufanele uthathe nayiphi na imishanguzo okanye usetyenzise ukufudumala kwiindawo ezibuhlungu, uzama ukunciphisa ukuvakalelwa okungathandekiyo. "Ukhathalelo" olunjalo ngesigulane kunokukhokelela kwi-peritonitis ngaphambi kokuqala kunye nezinye iingxaki.

Ngaba uthathe esibhedlela ngesifo sokuqala sokuxilongwa kwe-appendicitis? I-US-diagnostics ye-appendicitis iya kuvumela ukuhlula isifo kwaye kuthathe amanyathelo afikelelekileyo ekugqibeleni ingxaki. Kwakhona, ekuxilongweni, i-radiography yesigxina esiswini, i-tomography ekhompyutheni, i- irrigoscopy isetyenziswa. Emva kokungenelela kokutyathwayo, uhlobo lwesimo sengqondo sesi sifo luchazwe kwaye uviwo lwakhe luya kwenziwa .

Unyango lwe-appendicitis

Ngokwesiko, i-appendi ye-cecum iyaxhaswa ngongenelelo olunyango. Indlela eqhelekileyo esetyenziswayo yi-appendectomy ye-laparotomic, apho inkqubo evuliwe isuswe kwisayithi edibeneyo yodonga lwesisu. Ngalo msebenzi, ngenxa yemibhobho emincinci, akukho zixhobo ezihamba emva kokusebenza, kwaye ukusetyenziswa kwebhusesi ye-telescopic kuvumela ukuba ukungenelela kokungenelelo kube ngokuchanekileyo kunokwenzeka. Ubungakanani bexesha lokuthunyelwa kwexesha emva kokunciphisa, ukunyanzeliswa kunye nokuphuhliswa kwesimo esingapheliyo sesifo kuncitshiswa.

Ulwaphulo lwe-antibiotics emva kokuhlinzwa lubekwe ukuba kukho ukuchithwa okuvuthayo kwi-pelvis. Kwi-catarrhal ifomu ye-antibiotics ayifuni. Isalathiso esisodwa emva kokusebenza sikwenza ukuba kube lula ukugqiba ukuba isilathisi sisusiwe, xa singena esibhedlele esinempawu ezifanayo kwixesha elizayo elibonakalayo. Ngenxa yoko, ngezinye iinkqubo kwi-ileum, i-appendicitis isuswe ngaso sonke isikhathi, nangona ingafaki, ukuze ingayonakalisi enye ingcali. I-appendicitis, ekufuneka ifunyanwe kwaye iphathwe ngokukhawuleza, kunokwenzeka ukuba isifo "esisodwa". Yingakho ukuba kukho iimpawu eziphindaphindiweyo kubalulekile ukubonisana neengcali eziza kukwazi ukufumana isifo esinempawu ezifanayo.