Uphawu ukhohlokhohlo kukothuka. Indlela nokuzimisela ukudumba kwi esiswini

Le Ithemba ventral kuziveza Buze ilungu lwangaphakathi yonke okanye inxalenye yayo ngendlela yesango ukuya kummandla ongama lodonga ngaphambili buti okanye epokothweni kwakhiwa. Xa kwesiqingatha amalungu kwisisu ibekwe ngaxeshanye kunye Parietal igqabi peritoneal ukuyigubungela isithuba ongama ngaphakathi. A kubonakaliswa eziphawuleka Ithemba yeyona iliphawu khohlo kukothuka.

Ukuchonga ubudlelwane evela ngokungxamisekileyo kunye sifo, wabeka isandla umkhondo Buze, nokuziphatha kwayo xa ukhohlela. Ngokuqhelekileyo, push ziviwa, ebonisa ukuba isigidimi ukuyilwa anomalous umntu peritoneum, ukungabikho kobungqina loo Ithemba strangulated. Buze amalungu kwenzeka ngokusebenzisa khonkcweni hernial. peritoneum Parietal nenxalenye amathumbu, luvo, imisipha athinjwe yemveliso imele sac hernial.

Imisebenzi peritoneum

Ukulungisa isakhelo ngokuba amalungu abalulekileyo inceda kwinkqubo ye homeostasis, exchange fluid, ixhasa uxinzelelo esiswini:

• Iqhuba umsebenzi resorptive, eyile ukuba ufunxe iimveliso yokuwa iiprotheni, izihlunu necrosis, exudates, iintsholongwane;
• serous cover kwiindawo ezithile ukubhitya kunye duodenum nako ukwabela fibrin kunye wamanzi;
• kwesibindi, nakhonza uhlobo asisithintelo ugxininiso yokukrala usuleleko, okukwazi uyasikhusela ngomatshini endalo yeselula kunye humoral.

Ithemba esisu kanye nobunzima bayo

Ukuba ngethuba longenelelo ngoncedo ngotyando joint utshonile, isigulane asithotyelwa ngokupheleleyo imiyalelo kagqirha, kukho Ithemba nezolo, nto leyo isebenza esangweni for indawo obhityileyo kwesiva. Hayi yokuqhuba Ithemba na iingxaki zilandelayo:

• ukuba abasemagunyeni eziqulathwe kule sac hernial, ziye laphulwe, kofika ngokuthe ngcembe immobilization zabo, ukuba ingozi nangokurhala, wamsongela ezibulalayo;
• Ukuba Buze yethumbu libandakanyeka, ngoko ke indlela izihlwele ukutya kunye nomxholo nzima;
• kukhokelela isenzeko peritonitis udini jamming sidewall emathunjini, nto leyo ekhokelela necrosis lwenxalenye wathathwa;
• iphuhlise inkqubo ubovu (ithumba);
• Ithemba line emhlophe kwandisa ukuba ubukhulu, oku kukhokelela kwimeko emva ekususeni amalungu equlethwe engxoweni, musa ukungena kwi kwisisu.

Sigaba peritonitis kwi ngexesha sifo

Kwiinkqubo ukudumba etsolo kule ndawo esiswini nangoko ubize inqwelo yezigulana, ukubambezeleka kuyingozi kubomi babantu. Peritonitis kuyahlukahlukana epheleleyo okanye echaphazela kwindawo ethile. Ukudumba ibangwa iintlobo ezahlukeneyo iintsholongwane aerobic kunye anaerobic, ulale ngaphakathi esiswini. Indlela yokuqingqwa kwethiyori L. S. Simonyana, kuxhomekeka utshintsho zophendlo lwezifo kunye nexesha esi sifo, peritonitis umahluko inyathelo:

• ixesha reaction ihlala emini lokuqala kunye iimpawu ubuninzi babonakaliswa;
• lenguqu ukuya inyathelo ityhefu lwenziwa iiyure ezingama-24 ukuya ku-72, ukuvela abathunywa ezahlukeneyo ukunxila ubuthi eziphilayo;
• nzulu, kwiimeko ezininzi, ifom vuhlayiseki emva kweentsuku ezintathu, esi sifo kunye ekubonakalisweni ngokukhawuleza na ukudumba yasekuhlaleni.

Ukuhlelwa izifo uhlobo zokosuleleka

peritonitis Primary inqabile, ezenza malunga nesi-1% ye-nesenzeko arhabaxa. Usulelo kwenzeka emva kokuba sesichengeni amagciwane peritoneum yangaphakathi indlela hematogenous, indlela lymphogenous okanye amalungu ababhinqileyo emveliso tubes.

uvalo Ithemba ibangela peritonitis yesibini emva kotyando okanye ngenxa iingxaki peritoneal ijwabu trauma. Kulo mzekelo, kukho oonobangela usulelo ilandelayo:

• usulelo evela ukudumba;
• indlela indlebe;
• ukungena amagciwane ngenxa yokulimala;
• kwamaphaphu postoperative.

Iintlobo peritonitis kuxhomekeka kweminye imiba

Iziqephu ubungozi kwaye ezingapheliyo isigaba livela iimpawu zonyango kunye sifo. Indlela ukucacisa, ngokutsho exudate ityhila fibrinous, serous, ubovu, fibropurulent, indalo arhabaxa haemorrhagic.

Iifom division Etiological of peritonitis okubangwa ezahlukeneyo kweentlobo microflora neentsholongwane, ibangele ukudumba. Amagciwane ephambili ebangela isifo namhlanje zibalwa staphylococci, streptococci, anaerobes, Proteus, enterococci, E. coli. Kuba umkhosi iintsholongwane ziquka pneumococci, gonococci, hemolytic iStreptococcus kunye nezinye iintlobo.

Amaqela etiological ngokwahlukeneyo zodwa izifo nonbacterial imeko aseptic, xa Ithemba uvalo nzima ngenxa kwii-kwisisu peritoneal umchamo, igazi, inyongo okanye incindi esiswini. Lo ngumzekelo eyingozi, kwaye peritonitis ngeeyure ezimbalwa jikisa esosulelayo, njengoko iindonga akubonakali ukuba iintsholongwane ngokukhawuleza kakhulu emva kokuqala komtshiso oko.

Ukophulwa lweenkqubo metabolic

Ukuphazamiseka kwamanzi-electrolyte ratio emzimbeni kunye neprothini balance uthathwa njengophawu elizilolayo engaphandle Ithemba esiswini. iiproteni Isiphelo kwandiswa ngenxa hypermetabolism, ukulahleka kukho izinto ezibalulekileyo zokwakha lwenziwa kwi umchamo, emhlanzweni, exudate. Elibonakaliswe gipoproteinomiya nokunciphisa ubungakanani protein luboniswa peritonitis enkulu engcwabeni.

Kunye ne potassium neencindi zomzimba kwiwebhsayithi, wemka kwisithuba intercellular, ngenxa yoko, izigulane kufuneka hypokalemia. Emva kokuba uphuhliso ipateni inkqubo yokukrala nga inguqu, njengoko kuncitshiswa zinomgutyulo kwezintso bolwelo, kukho ukutshatyalaliswa inani elaneleyo iiseli. Ngenxa yeenguqu asakhasayo hyperkalemia.

-Ezimbini kwezintathu izigulane alkalosis igazi iphuhlisa, maxa wambi zomzimba lubonise ukutshintsha asidi evela ukuphazamiseka yokujikeleza, ukuphazamiseka iinkqubo pathways kunye hypoxia, le nkqubo iphazamisa ukususwa Ithemba.

Le Inyathelo kwesitishi ixesha kunye oliguria nokuphuhlisa inkqubo hematopoietic uqalisa ukusebenza ngomhla nokuveliswa kwemveliso pathways asidi ezifana magnesium, initrogen, potassium, iphosphate. Kukho utshintsho yemida igazi lactic bokuphefumla metabolic. Uvavanyo peritonitis etsolo iguquka ngokukhawuleza, ngoko esweni rhoqo kucetyiswa igazi, umchamo kunye nezinye neencindi zomzimba.

symptomatology peritonitis

Kukho iqela lemisebenzi esemqoka standard ngazo ukuba ukujonga indlela Ithemba kunye ukudumba peritoneum:

• ubuhlungu olungaphezu benamandla peritoneum;
• umkhuhlane;
• esiswini emthanda, uba nzima;
• imvakalelo ubuthathaka emzimbeni wonke;
• ubuqhophololo nentliziyo;
• ephula zesisu phecana, ukuqhina, flatulence.

inkxaso ukhohlokhohlo syndrome

Ebonakalisa ngayo izifo ezihlasela zosulele kwaye ezondeleyo ye kwisisu. Uxilongo for ekhohlela wanikela G. G. Karavanovym kwaye ichazwe ngokwenkcukacha IM Siomashem. Iikliniki ezininzi utyando baye bawamkela lo uphawu sokumiselwa kwincadi ezifumaneka kwicala lakwa iimpawu ukudumba esiswini.

Indlela yokusebenzisa

Iminwe waguqa kancinci ukuya entendeni kunye knuckles olova cinezela kwindawo isifundo. emva kwesi senzo akazange athathe buhlungu etsha ingcinezelo. Emva koko, isigulane avavanyelwe uphawu ukhohlokhohlo kukothuka. Uthe ukudlala ukukhohlela, ukuba emva kokuba inkqubo, kukho intlungu kwindawo yengcinezelo, libonisa ukudumba kwi peritoneum.

isimiso ukusebenza

Ukuncitshiswa elibukhali ukukhohlela spasm eludongeni peritoneal kunye uvalo sithumela push to kumphezulu ibekwe ngezantsi isibindi kunye namaziko. Bazaliswa ke inyanzeleke ukuba yintshukumo amathumbu, leyo adlulisele kuye phantsi motion. Sensation buhlungu lwenzeka xa isindululo okanye iqumrhu ogulayo sihlangana ummandla licinezelwe isandla sakhe. Ukuba inkqubo yokukrala ibandakanya peritoneum, kuyabuya intlungu kuboniswa ishukumisa umaleko engaphakathi, apho uxinzelelo intra-esiswini liphume.

Study umbhali A. Cheremskoy ukhohlokhohlo syndrome lichaza amanyathelo malunga nesifo appendicitis. Xa ukhohlela nomonde kwimeko ukudumba isihlomelo uhlala ubuhlungu apha kummandla iliac. Isiphumo sale nto eyahlukileyo kancinane ukusuka ukukhohlela kunye Ithemba in peritonitis.

Syndrome kuyenye peritonitis etsolo nebakala ezingapheliyo esi sifo kubangela njengokungathi ezahlukeneyo xa ukhohlela. appendix Chronic aphendula ukuphelelwa umoya, ngathi isigulane izama kuyilibazisa intlungu. Inqanaba etsolo luphawulwa ziintlungu ezinganyamezelekiyo. Uphawu ukhohlokhohlo kukothuka ngeendlela ezahlukeneyo ityhila ibakala peritonitis.

Ngaphandle peritonitis, appendicitis kunye Ithemba, le uphawu esizibonakalisa izifo ezihlasela zosulele kunye ezondeleyo zeminye imibutho esiswini. Intlungu evela ombane kwi ukhohlokhohlo libonakala kwimeko ukudumba senyongo, izilonda esiswini kunye emathunjini. Ngoko ke, ukhohlokhohlo shoka uphawu yohlukile kwezinye izifundo ebonisa inani elikhulu lwezifo isanda.

Ithemba ezahlukeneyo

Lunamaqoqo ku abantu neza bekhubazekile. Le ndlela yesibini iintsana kuzalwa. Le ukuhlukunyezwa kwenzeka ngenxa peritoneum URL ngexesha Palsy. Buze Acquired ngamalungu angaphakathi zivele ngexesha ebomini yesigulane, yaye zohlulwa ngokwendidi ezintathu:

• e izihlunu buthathaka yodonga esiswini;
• ngenxa yemidlalo okanye nomthwalo umsebenzi;
• posttraumatic ezivele ngenxa waphula ukuthembakala peritoneum, xa kukho umsebenzi wangaphambili; laser unalo ithuba elingcono izixhobo zotyando eqhelekileyo kwityala enjalo.

Ithemba lwangaphakathi ise em- thoracic okanye indawo esiswini. imizimba Buze Ngaphandle elime kule ndawo zilandelayo:

• ku ubudoda;
• ephangweni ngecala ngaphakathi okanye yangaphandle;
• sacrum empontshwa;
• kwindawo indawo perineum kunye isinqe;
• kwicala phambi umntla (epigastrocele);
• kuyo nayiphi na indawo apha emzimbeni kwi kukuqulungana utyando.

Human Ithemba ihlelwa nezolo, unzima okanye hayi nzima (kunye ekunene). Uhlobo lokuqala iquka Buze, rhoqo siphinde sibuye emva kotyando.

iimpawu herniation

Initial isigaba ukudumba kwenzeka imilo kwisetyhula has a guquki ethambileyo, kwaye sigulane asikwazi ngokuzimeleyo mcaba ngayo noxinzelelo ukukhanya. Emva ukucuthwa kumphezulu peritoneal kule ngongoma ukuba iviwe isango lokungena, nibonise ngohlobo kwiindawo zokubeka okanye setyhula esiswini udonga siphene.

Ubungakanani ziyahluka uphawu iperi milimitha ezintathu cm kweshumi eziliqela. Ukuba sac hernial wathimba inxalenye udonga wamathumbu okanye iqumrhu, Ngokucofa uphawu ophuphumayo oluvakalayo isiqulatho yakhe isandi sicatshulwa. Iimpawu njengembi nokubonisa ngokwawo Ithemba ziquka ukuqhina, isicaphucaphu, heartburn, ukuqumba, edandatheka, waphula umthetho ukuchama.

Ithemba kuyacetyiswa xa Ukophulwa a diverticulum, nto leyo luphawulwa mpawu zilandelayo:

• abantu basoloko iintlungu ngesiquphe elibukhali emva ubunzima wokuthwala, umthambo, defecation sokunciphisa azifane zenzeke ngaphandle kwesizathu;
• ngaxa ethile isigulane akakwazi, njengokuba ngaphambili, uphawu agudileyo, kuba nzima yaye ibuhlungu;
• kunye iimpawu yangaphambili ubuqhophololo, intlungu esitulweni.

Izinto ezibangela Ithemba

Zonke izinto zahlulwe ukunyuka enemiqathango bezindawo emane. Iqela lokuqala iqulathe yezizathu:

• bekhubazekile okanye uphuhliso okungaqhelekanga yodonga esiswini;
• ngenxa yesizathu esithile, ukwandiswa kwiindawo zendalo nesisu buthathaka (femoral kunye namakhonkco inguinal, inkaba);
• ukuncipha kwamandla inyama uqine ngenxa abalupheleyo utshintsho okanye ukuncipha komzimba;
• phambi kwiindawo ezibuthathaka nesisu posttraumatic okanye xa kukho umsebenzi, i-laser uvelisa kakhulu ekhuselekileyo kweli intlonipho ukusikwa.

Kwiqela elilandelayo ibhekisela baleka okanye kuvusa imibandela yintoni unobangela yokwandisa uxinzelelo ngaphakathi kwisisu:

• umsebenzi okanye igunya kwezemidlalo nzima;
• nokuqunjelwa rhoqo;
• isikhohlela, uhlobo ezingapheliyo;
• Ukudumba ngaphakathi esiswini ngenxa ukusebenza ngokungafanelekanga kumzimba;
• flatulence.

Indlela limisele Ithemba

Ugqirha ascertains ukuba herniation emva zoviwo kumguli isigqibo ubukho ebomini yomguli limisele miba ingentla kwakhula. Thathela ingqalelo yokuphila, utyando nasemzimbeni. Ukuze ufumanise ukuba yeyiphi amalungu ngomlomo ziqulethwe sac hernial, ugqirha siqhuba uvavanyo ngoncedo izixhobo kunye nezixhobo.

Ultrasound esiswini kunye lunamaqoqo kuvumela ukuba siqwalasele yangaphakathi umxholo kunye nokuziphatha kumahluko kwesifo kunye nezinye izifo. indlela X-ray isetyenziselwa abenza imifanekiso asengxoweni kunye Ithemba esangweni.

Iinkqubo zonyango notyando

Indlela ephambili unyango ukuthunyelwa yotyando. Linxibe isibiyeli inkxaso wabelwa kwabo izigulane kufuneka Izimo ezinzulu ukuba utyando, ezifana utshintsho enxulumene ubudala okanye igazi ekunqandeni kakuhle. Ukususa Buze ubanjwa ngokwesicwangciso, ukuba isigulane elungiselela umsebenzi, okanye kwiimeko kakhulu, utyando wenziwa ngokungxamisekileyo. Umzekelo sehlo icetywe ukuba strangulated Ithemba ziintlungu olungaphezu okanye ileus ngokwasemzimbeni.

Olu tyando iqulathe ekuvuleni umxholo Ithemba sac kunye neemviwo. Ukuba amalungu lwangaphakathi zonakele, ukuba anciphise, ibhegi kunye nesango sutured ukuba ubukhulu ivaleke. ngesango seplastiki eyenziwa usebenzisa zomzimba ukusuka umguli okanye usebenzisa isizukulwana esitsha zokwenziwa. Kuyinto ukuthotyelwa inyanzelekile imiyalelo post-operative logqirha ukunciphisa ingozi herniation nezolo.

Xa ndiqukumbela, kufuneka kunokuthiwa kwimiqondiso yokuqala Buze esifubeni okanye esiswini udonga kufuneka ngoko nangoko udibane nogqirha. Utyando ukuze Ithemba ayikho ngumsebenzi onzima, kunzima kakhulu ukuba siphephe iingxaki Buze bebaleka iintlungu ezinxulumene nayo.