Ukunyuka kwama-ascites kwenziwe njani ngomhlaza

I-Ascites yinto yokuxutywa kwelungu legazi okanye i-lymph kwisigxina esiswini. Le nqubo inokuvela ngezifo ezahlukahlukeneyo kunye nezifo, kodwa yinto ebonakalayo yezifo zesibindi. Ukongezelela, i-ascites iyinto eqhelekileyo emdlalweni, kwaye ngokukodwa i-chysi ascites (eyenziwa ngokukhutshwa kweempahla ze-lymphatic system).

Kwimizuzu engama-50 yamatyala, i-ascites emdlalweni iyavela ngenxa ye-carcinomatosis yamaphepha e-parietal ne-visceral ye-peritoneum. Le nkqubo ekugqibeleni ikhokelela ekuthintekeni (umqobo) weenqanawa ze-lymphatic.

Ukuphindaphindiweyo kwezinto ezenzekayo kuzo zonke izidumbu ezinobungozi eziphakathi kweeshumi ezilishumi elinesihlanu ukuya kumahlanu. Inokwenzeka ukuba uphuhliso lwe-ascites kwi- tumors ye-ovaries, i- endometrium, isisu, izilonda ze-mammary, i-bronchi kunye nezinye izitho kunye nezicubu.

Phantse iipesenti ezilishumi elinesihlanu zenziwe nge-tumor lesion ye-parenchyma yesibindi. Ukunyanzeliswa kwenkqubo ye-venous yelo lungu kubangela ukubunjwa ngokukhawuleza kokuxhamla kwisisu esiswini, ngaphezu koko, kulezi zi gulane zenziwe zingabizwa ngokuthi yi-hepatomegaly.

I-Pathogenesis kunye neempawu ze-ascites emdlalweni

Ama-Ascites, iimpawu ziyimpawu kuye-ukwanda okweqile kwisisu, kunye nesisindo esipheleleyo sesigulane. Uxinzelelo olwandisiweyo kwisigxina esiswini lukhokelela kumgangatho ophezulu we-sulfurm emi, okwakubangela izibonakaliso ze-reflux ye-gastroesophageal (ukuhlaziywa kwe-acid kunye nokukhwaza, isicupunu kunye nokuhlanza), i-orthopnea kunye ne-dyspnea, i-compressed syndrome (ukutya okukhawulezileyo kwesisu kunye nesisulu).

Ekuhloliseni ngokomzimba, inani elincinci le-ascitic fluid (kufika kuma-milliliters angama-200) akunakwenzeka ukuba lifumane. Umthamo wokucutha ukusuka kumahlanu amawaka ukuya kwiwaka elingu-milliliters ubonakaliswe ngokubonakalayo ngenxa yesigxina sommandla wesigxina sesisu, uphawu lokutshintshwa kweemeko luhle. Ukuqwalasela ubunzima be-ascites "ukuhambisa" ukunyaniseka phezu kwamagqabi xa ushintsha isimo somzimba ngexesha lomdlalo.

Ama-Ascisse emdlalweni, obangelwa ukucinywa kweprogram yesibindi esibindiweyo, kubonakaliswe ukwandiswa kweemvini zangasese zodonga lwesisu. Izigaba ezisezantsi zibonakaliswe ngokubunjwa kwe "jellyfish head" (ukutshatyalaliswa kwodonga lwesisu esisenyakatho kwi-ascites kunye nemifuno ekhulisiweyo kunye neyaziwayo).

Zibonisa kwakhona ubunzima beempawu: uketshezi olusisigxina, ukufuduka kwe- apical impulse yentliziyo, kunye ne-edema yeengxenye ezantsi ze-tilla (ikakhulukazi iziphelo kunye nesisu esisezantsi).

Kwiimigangatho zokuphela komhlaza, ukunyuka kwamazinga aphezulu akukhathazi imeko yesigulane kwaye akukho nto ingasongela ubomi, ngoko ke, kusetyenziswe amayeza edayiretic kuphela, okwandisa ukuphuma kwamanzi emzimbeni kwaye ngaloo ndlela unciphise ukutshatyalaliswa kwangaphakathi kwesisu.

Ukuba i-ascites ifunyaniswa, unyango lwenziwe nge veroshpiron (spironolactone) ebizwa ngokuba yi "standard standard" kwonyango lemiqathango. Injongo yale nkunkuma ngokudibanisa ne-furosemide (i-loop diuretic), ikuvumela ukuba ususe kwi-body ukuya ku-1000 milliliters yomninzi ngosuku.

Nge-ascites ezithiwa kunye nobukho beentlungu kunye ne-tachypnea, i-paracenteis yesisu isenziwa (ukugqithwa kwodonga lwesisu ngenjongo yokucima umgca). Umjelo uqhutyelwa ubuncinane iiyure ezithandathu kwaye ude umlambo we-ascitic uphelela ukugeleza kwisitya. Umbane obangelwayo uthunyelwa ukuhlalutya, ukuwuhlola ngokumalunga nomxholo weeprotheni, ukwenzela ukubunjwa kwe-LDH kunye nenani elincinci lama-leukocytes. Ukongezelela, i-fluid ihlwayelwa kumgangatho wezondlo.

Isiphumo esiphumeleleyo sinika impembelelo kwi-etiologic factor (ngqo kwi-tumor ngokwayo). Ngaloo ndlela, ikhonkco ehamba phambili kwi-pathogenesis iyakususwa kwaye i-ascites isifo somhlaza.