Dynamic ileus: rarrabuwa, haddasawa, cututtuka da kuma magani

Ileus - Cuta, wanda integrates wani hadadden na cututtuka da cewa an halin mai cikakkar ko m asarar hanji tawaya, duka biyu lokacin farin ciki da bakin ciki. Domin shi ne muhimmi rashin motsi da wani irin abinci, ciki har da m da ruwa taro, kuma ma gaban m kumburi a peritoneal kogo. Hanji toshewa ne tsauri da kuma inji.

siffofin da cutar

Dynamic ileus - mai raba irin ce cutar da ta auku a cikin 10% na marasa lafiya da hanji mai shãmakacẽwa. Don wannan ganewar asali da likitoci sau da yawa Firaministan bukatar kawar inji toshewa, wanda shi ne a cikin gaggawa bukatar for tiyata.

A wahala a diagnosing wannan cuta kunshi a gaskiya cewa pathogenesis na tsauri ileus ba halin gaban motsi cikas unambiguous juices da abinci, niƙaƙƙun gaɓãɓuwa fili. A wannan yanayin, kawai a takaice muhimmi akan rage jiki matakai.

Duk da haka, da hatsarin da cutar ta'allaka ne da cewa shi zai iya sa neurohormonal tabarbarewa a cikin haƙuri, kazalika da shafi da ayyuka na kananan da manyan hanji. Ka yi la'akari da abubuwan da tasiri da ya faru na wannan cuta a matsayin tsauri hanji mai shãmakacẽwa.

A Sanadin cutar

Ko da yake a kimiyyar zamani ne alama ta babban isa yabo da kuma nasarori a magani, amma ita ta ba a gudanar a warware takamaiman sunadaran cewa fararwa bayyanar cuta a cikin tambaya. Ana zargin irin matsaloli kamar yadda tsauri hanji toshewa iya lalacewa ta hanyar da wadannan dalilai:

• peritonitis wanda zai iya sa appendicitis ko pancreatitis.
• m mesenteric infarction.
• mai guba megacolon (Crohn ta cuta, Hirschsprung ta, ulcerative colitis).
• reflex yanayi (postoperative yanayin, colic, zubar da jini, na ciki rauni, da laka samu karaya a matsayin worsening inji ileus).
• cututtuka na neurogenic yanayi.
• canje-canje a hormonal matakan (msl, ciki).
• rayuwa cututtuka (hypokalemia, ketoacidosis, uremia, abin mãye).

Nau'in tsauri ileus

A magani, da ganewar asali daga kowane na da code, sunan da kullum yarda ma'aunansa na kiwon lafiya. Shi ne ba togiya da kuma irin cututtuka kamar tsauri hanji mai shãmakacẽwa. ICD-10 (International Nau'in Cututtuka) classifies da cuta a cikin tambaya kamar haka:

• Class XI "Cututtuka na narkewa kamar tsarin" (K00-K93).
• Dubi "Sauran hanji cuta" (K55-K63).
• ganewar asali code - K56.6.
• sunan - "The Other da unspecified hanji mai shãmakacẽwa."

A likita yi, na rarrabe tsakanin biyu na asali iri tsauri hanji toshewa:

• spastic.
• shanyayye.

Spastic hanji toshewa

A asibiti yi ne ɗai ɗai, shi ne yawanci hadu a cikin wani biyu tare da wani cuta. Sau da yawa cikin hanyar da cuta ne kamuwa da cuta na jiki tare da tsutsotsi ko pilorospazm, kamar yadda wani sakamako na haihuwa rauni. Har ila yau daga cikin sauran Sanadin irin wannan cuta sun hada da: cututtuka na juyayi tsarin, neuroses, dyskinesia.

Rabu da wannan matsala na iya zama kawai ta wajen ra'ayin mazan jiya hanyoyin, kamar yadda ya koma ga m baki a wannan yanayin bai sa hankali.

Spastic hanji toshewa: ãyõyi

A manya, cutar auku fiye da akai-akai, fiye da yara, amma da cututtuka su ne guda a kowane zamani. Wannan cutar halin kwatsam farko. A haƙuri tanã kai ƙãra na short-rayu hare-hare na ciki zafi, wanda ba su da wani takamaiman sarrafawa.

Marasa lafiya tare da wannan ganewar asali aka lura a cikin wadannan cututtuka:

• skhvatkopodobnye ciki zafi.
• m kumburi da kuma ji na cikar;
• tashin zuciya, amai yiwu, maƙarƙashiya.

A palpation na ciki da aka ji da lafiya kashi na kananan hanji, da ciki ne sosai taushi. Disturbances daga sauran tsarin ba ya lura. A general yanayin haƙuri ba m.

Pseudoileus

Niyya palsy hanji suna da hanji, tare da wani kwatsam komawa da baya aikin vivacity neuromuscular Tsarin. Rarrabe reflex da postoperative shanyayyen ileus.

Lokacin da cutar ya auku a matsayin reflex ruri daga m reshe na autonomic juyayi tsarin. Postoperative ileus ne mafi hadaddun da more kowa Farawa bayan daban-daban ayyukan a kan na ciki gabobin.

Tsokane da samuwar da kuma ci gaban da cutar da wadannan dalilai:

• kumburi tafiyar matakai a ciki yankin.
• kurma (ƙurji) retroperitoneal yanki.
• overall hoto aka lura bayan wani aiki kamar laparotomy.
• sakamakon na pathological cuta kamar pleurisy, ciwon huhu, tsokar zuciya infarction.
• mesenteric jijiyoyin bugun gini thrombosis.
• cututtuka, ciki har da mai guba paresis.

Akwai da dama, saukarwa da cutar:

Na Stage. "Cika warwarewarsu" - yake daidai da hankula postoperative hanji paresis. Duration na bayyanar cututtuka yana for kwanaki 2-3.

Mataki na II. "Subcompensated warwarewarsu" - ne halin da cewa akwai wani gagarumin kumburi, akwai alamun abin mãye da pseudoperitonitis jiki. Ba saurari noises hanginsu. A iri-iri na bayyanar cututtuka lura a radiographs.

Mataki III. "Decompensated cuta" - jiki ne a Jihar babba maye. Za ka iya duba da hanji wani rauni, amai, na hanji abinda ke ciki. Akwai cututtuka da peritoneal hangula, ciki ƙãruwa da yawa. X-ray bincike ya nuna a jam'i na kwance matakan da ruwa a cikin madaukai na hanjinsu (ƙanana da manyan a lokaci guda).

Mataki IV. "A inna na gastrointestinal fili" - a wannan mataki akwai wani take hakkin dukkan muhimman gabobin ga mutum rayuwa tsarin. Korau tsarin ji rashin lafiya ci gaba.

Tun zamani magani ba ya wanzu tukuna-ci gaba bambanci bincike siffofin na daban-daban pathologies da faruwa a cikin postoperative lokaci, don haka farkon ganewar asali da cuta ne kusan ba zai yiwu

Shanyayyen ileus: Alamun

A manya, cutar a kan bango na janar yanayin za kawai samun muni. Ya ji m zafi cewa ya zube a yanayi. Duk da haka, shi ne, ba kamar yadda tsanani kamar yadda a mechanically hanji mai shãmakacẽwa. AMAI kore kazamta. A haƙuri lura da karuwa exsicosis bayyanar cututtuka na yawan guba da kuma zuciya da jijiyoyin jini ciki.

Lokacin da ciwon inna ileus ta kumbura ciki na haƙuri, ta hanyar da gaban bango za a iya gani da karuwa a cikin juz'i na madauki neperistaltiruyuschih hanjinsu. Idan peritoneal ãyõyi ne ba ya nan, sa'an nan ciki ne m ga tabawa.

Saboda wannan cuta ne mataki tsari, tare da karuwa a cikin lokaci da cutar jihar na haƙuri tabarbarewa.Idan. A baya, saukarwa shi yiwuwa a lura tachycardia da nakasa daga 'ya'yan numfashi, bloating, languid peristaltic noises cewa suna da wuya su fita ba. Amai da muni.

A karshen saukarwa, mai kaifi Yaduwar morphological canje-canje a cikin neuromuscular na'ura. A haƙuri tanã kai ƙãra na gas da kuma stool da bata lokaci yana wanda ba safai ba ne urination.

Dynamic hanji toshewa a yara

Yara ne fiye da na kowa tsauri m hanji toshewa, wanda aka fi gani a shanyayyen form. Wadannan dalilai za a iya gano, sa da ci gaba da cuta a cikin shimfiɗar jariri, da:

• obstructive ko strangulation toshewa.
• iyaka ko yaxuwa peritonitis.
• ciki rauni.
• ciwon huhu.
• empyema.
• cuta na hanji aiki.

Popular sau da yawa, tsauri ileus m yara a cikin postoperative zamani. Har ila yau, sa shanyayyen maturation siffofin da cutar na iya zama hypokalemia.

Hadarin na cuta a cikin shimfiɗar jariri, da ne yiwu asarar mai yawa m da kuma gishiri saboda m amai, asarar ci, sallama potassium koda hypoproteinemia. Tsanani daga cikin yanayin iya dada tabarbare rinjayar m mai guba da kuma kwayan yanayi.

Dynamic ileus a jarirai za a iya jawo da da dama daga cikin wadannan dalilai:

• prematurity.
• Tsakani take hakkin.
• da amfani da kwayoyi (ciki har da haihuwa a lokacin daukar ciki).
• gipermagniemiya.
• amfani da tabar heroin bãyar haihuwa;
• ta amfani da hexamethonium.
• sepsis.
• enteritis.
• CNS cuta.
• necrotizing enterocolitis.
• endocrine cuta.

Dynamic hanji toshewa a yara sau da yawa yakan faru, amma an sauƙi kamu da kuma damar jiyya da wuri. A cikin hali na tuhuma a gaban irin wannan obstructions muhimmanci - ba a kawota da jaraba na kai-magani, da kuma tsananin bi da umarnin bayar da dacewa gwani. Mutuwa sakamako - shi ne quite yiwu aukuwa da irin wannan matsala a matsayin tsauri hanji mai shãmakacẽwa.

ganewar asali da cuta

Alamun cutar takamaiman-da m, cewa ba hana aiwatar da ganewar asali. Aiwatar da wadannan bincike hanyoyin:

• likita tarihi.
• jarrabawa na haƙuri.
• X-ray jarrabawa na gabobin a ciki area (kirga gaban gas sama da ruwa matakin a cikin hanji).
• Duban (ba dole ba ne a yi karatu domin shi ne ba isasshe m nuna alama).
• cikakken jini count.

Dynamic hanji toshewa: magani

Kullum, magani ne da nufin kawar da cutar na farko dalilai da cewa tsokana ta ci gaba (dauke da kwayar cutar yanayin da cuta, ciwon huhu, peritonitis da sauransu.). A hali da cutar ne a sakamakon guba ko reflex hali dace ra'ayin mazan jiya magani, wadda ta ƙunshi a miyagun ƙwayoyi far na korau mamaki da kai ga tsayawa da misali hanji hanginsu. Irin wannan far iya yinsu ta hanyar gabatar a cikin jikin mutum da kwayoyi kamar sodium chloride, tare da glucose. Sa'an nan kuma ka son wanke hanji da wani enema, idan ya cancanta - yin gabatarwar da ciki tube. A high zafi majiyai iya samun maganin ciwo.

A cikin akwati a lokacin da na awa shida magani haƙuri da yanayin ba ya inganta, tiyata da aka yi. Har ila yau gaggawa tiyata da aka yi a cikin nakasar hanji mai shãmakacẽwa.

Yawanci, da aiki kunshi wani m kau da Gut, wanda ba ya cika ta ayyuka. A tsanani aukuwa dora colostomy (wucin gadi dubura a ciki bango ta hanyar abin da matsawa da stool kuma suna da damar da za su shiga cikin wata na musamman jakar hitched).

Kada ka cire Gut kashi mai yiwuwa ne kawai idan akwai intussusception. A irin wannan yanayi yana yiwuwa don yada hanji da skipping Air hanji da kuma kara sarrafa overall hoto yin amfani da X-haskoki.

Postoperative magani kunshi mutum rage cin abinci, wanda ya dogara a kan ƙarar daga m baki. Kwana biyu na fari bayan tiyata, da mãsu haƙuri ya zama a cikin wani wuri Fowler, kuma bukatar yin numfashi bada. Har ila yau, a wannan mataki zai sha miyagun ƙwayoyi far, disintoxication far da ya hada da, daidaita electrolyte metabolism, da yin amfani da m-bakan maganin rigakafi, gastrointestinal stimulating jamiái idan ya nuna - hormonal magani.

Lokacin da rikitarwa a cikin postoperative zamani za a iya zurfafa raunuka, zubar da jini, peritonitis, m cuta daga cikin peritoneum.

Tare da tsauri ileus, kamar yadda tare da wani rashin lafiya, yana da muhimmanci ba sosai magani, kazalika da rigakafin wannan matsala. Rigakafin hanyoyin sun hada da:

• gyara na electrolyte balance.
• prokinetic magani.
• maganin rigakafi.
• dace rage cin abinci cewa shi ne low a kitse, kiwo da samfurori da kuma shuka abinci tare da babban abun ciki na gyara wanda ba narkewar da jikin mutum.