Ileus Dynamic: Ukuhlelwa, oonobangela, iimpawu kunye nonyango

Ileus - Disease, yona ethi inxulumanise a oluntsonkothileyo iimpawu luphawulwa ilahleko ngokupheleleyo okanye olungaphelelanga namathumbu yokukhubazeka, zombini nasebubini. Kuba ukunqongophala okusegazini intshukumo ye naluphi na uhlobo lokutya, ukuquka ubunzima eqinileyo elulwelo, kwaye kananjalo phambi ukudumba olunzulu em- peritoneal. emathunjini linamandla nobomatshini.

iimpawu zesifo

ileus Dynamic - uhlobo olwahlukileyo lwesifo uthe kwaye kwenzeka ngo-10% ezigulane kunye namathumbu kokuphazanyiswa. Kule une oogqirha utyhala imfuneko ukuphelisa isithintelo ngomatshini, leyo imfuneko engxamisekileyo uqhaqho.

Le ubunzima zokufumanis esi sifo sikuko into yokuba Pathogenesis of ileus enamandla zimpawu bubukho ihamba nemiqobo incindi nangokungenamathandabuzo iziqwenga ukutya phecana. Kulo mzekelo, unciphiso emfutshane azalwa kuphela kweenkqubo zomzimba.

Noko ke, ingozi sifo kuxhomekeke kwinto yokuba kunokubangela kwekhono neurohormonal kwi umguli, kwakunye kuchaphazela ukusebenza emathunjini amancinci kunye enkulu. Cinga ekusetyenzwa phantsi kwazo zinefuthe isenzeko sifo njenge isithintelo onamandla amathumbu.

Izinto ezibangela izifo

Nangona inzululwazi lwale mihla kuphawulwa ngumbandela kakhulu nempumelelo amayeza, kodwa yena uye wakwazi ukusombulula iindlela ezithile engabangela imbonakalo sifo umbuzo. Ukuvela iingxaki ezifana kwimiqobo enamandla namathumbu ukuba zibangelwa yi zinto zilandelayo:

• peritonitis esinokubangela appendicitis okanye pancreatitis;
• iqhosha mesenteric olunamandla;
• megacolon ityhefu (isifo Crohn likaThixo , sisilonda sikabhobhosi Hirschsprung yakhe);
• iimeko reflex (imeko postoperative, eliba, ukopha, iintlungu esiswini, yamophula spinal njengoko zisiba ileus mechanical);
• Izifo zemvelo neurogenic;
• utshintsho kumanqanaba hormone (umz, ukukhulelwa);
• Izifo pathways (hypokalemia, ketoacidosis, uremia, ukunxila).

Ukwahlukanisa ileus nezakhi

Xa amayeza, lokufunyaniswa nganye ikhowudi yayo, igama kunye nemigangatho eyamkelekileyo ngokubanzi unyango. Yiloo nto ngaphandle kunye nezifo ezifana olutshintshatshintshayo emathunjini. ICD-10 (International Classification of Diseases) ngokucalula nokwahlula sifo ekuthethwa ngolu hlobo lulandelayo:

• XI Class "Izifo kwinkqubo yokwetyisa" (K00-K93);
• Jonga "Ezinye isifo wamathumbu" (K55-K63);
• isifo ikhowudi - K56.6;
• Igama - "The Okunye kwaye elingachazwanga emathunjini."

Xa yezonyango, ukwahlula phakathi kweentlobo ezimbini ezisisiseko kwimiqobo enamandla emathunjini:

• yiSpasticity;
• ofe.

YiSpasticity wamathumbu kokuphazamiseka

Ekusebenzeni yinto ingaqhelekanga, oko kudla zikhawulelwa ukumatanisa nenye sifo. Ngokufuthi unobangela sifo sokosuleleka umzimba ziimpethu okanye pilorospazm, ngenxa yokuzalwa trauma. Kwakhona phakathi kwezinye izinto ezibangela olu hlobo sifo zibandakanya: zifo e-nervous system, nezifo, zeDyskinesia.

Lahla le ngxaki kuba kuphela ngokusebenzisa indlela 'endala, njengoko babhenele ukungenelela zoqhaqho kulo mzekelo akwenzi ngqiqo.

YiSpasticity wamathumbu kokuphazamiseka: Iimpawu

Xa abadala, esi sifo kwenzeka kakhulu qho ngaphezu ebantwaneni, kodwa iimpawu zayo ziyafana kuyo nayiphi na ubudala. Esi sifo luphawulwa ukuqala ngesiquphe. Isigulane ikhalazela zokuhlaselwa-obufutshane zeentlungu esiswini, ecingisisiweyo i eyendawo ethile.

Izigulane nalo unesifo babonakala kwezi mpawu zilandelayo:

• skhvatkopodobnye walunywa;
• ukufukuka engalinganiyo kunye nokuboniswa nenzaliseko;
• isicaphucaphu, ukugabha kunokwenzeka, ukuqhina kwesisu.

Kwi Ngokucofa esiswini ziviwa icandelo lokugula emathunjini amancinci, nesisu ithambe kakhulu. Ukuphazamiseka kwezinye iinkqubo akuxhaswanga ulandelwe. Imeko jikelele isigulana akuyonto ibalulekileyo.

Pseudoileus

Wazimisela emathunjini peristalsis palsy, sikhatshwe nokushiywa ngesiquphe vivacity esebenza izakhiwo neuromuscular. Ukwahlula reflex kunye ileus postoperative unedumbe.

Xa esi sifo njenge zovuselelo reflex lesebe onovelwano kwenkqubo yawo luvo. ileus Postoperative into ezinokuntsonkotha genesis eqhelekileyo ngakumbi emva imisebenzi eyahlukeneyo enyama esiswini.

Ukumqumbisa lokuqulunqa nokuphuhlisa kwesi sifo ngokuthi ezi zinto zilandelayo:

• iinkqubo ukudumba kwindawo esiswini;
• ilimaze (ithumba) indawo retroperitoneal;
• umfanekiso okupheleleyo saphawula emva utyando ezifana laparotomy;
• iziphumo izifo zophendlo lwezifo ezifana unepleurisy, inyumoniya, iposi engabalulekanga;
• mesenteric thrombosis yegazi;
• izifo ezosulelayo, kuquka paresis ityhefu.

Kukho zigaba ezininzi sifo:

I banga. "Ulwaphulo ingahlawulwa" - kulingana ngexabiso boqobo paresis postoperative emathunjini. Ubude iimpawu ihlala iintsuku 2-3.

Step II. "Ulwaphulo Subcompensated" - luphawulwa yi kukuba kukho ukufukuka ebalulekileyo, kukho iimpawu kunxilwe nomzimba pseudoperitonitis. Akuphulaphulanga ingxolo peristalsis. Iintlobo ngeentlobo iimpawu kwenziwa radiographs.

Step III. "Izifo Decompensated" - umzimba sikwimo kunxilwe omkhulu. Uyakwazi ukubukela ubuthathaka kwamathumbu, ukugabha, imixholo emathunjini. Kukho iimpawu aphazamiseke peritoneal, isisu mbile kakhulu. Uhlalutyo X-ray ubonisa ezininzi amanqanaba tyaba ulwelo kwi amarhintyela amathumbu (amancinane elikhulu ngaxeshanye).

Step IV. "Le ukushwabana iphecana zesisu" - ngeli nqanaba kukho kukwaphula onke amalungu ezibalulekileyo kwiinkqubo ubomi babantu. inkqubo okugwenxa waziva egula ngokuqhubekayo.

Ekubeni yesilungu ayisekho iimpawu diagnostic kodwa phambili kwezoqoqosho mahluko of ezimbi ezahlukeneyo ezenzeka kwixesha postoperative, isigulo kwangethuba kangaka esi sifo phantse akunakwenzeka

ileus kofe umzimba: Iimpawu

Xa abadala, esi sifo kwisiqalo imeko jikelele ingapheli. Uyaziva iintlungu rhoqo eye elichithwayo indalo. Noko ke, ayikho nje olunzulu njengoko bomatshini kwamathumbu kokuphazanyiswa. Linganihlanzi ukungcola eluhlaza. Isigulane sathi iimpawu ukwanda exsicosis yetyhefu nokudandatheka sentliziyo.

Xa ileus ofe kutyhobozela isisu umguli, ngenxa eludongeni yayo yangaphambili kunokubonwa ukwanda umthamo we amathumbu loop neperistaltiruyuschih. Ukuba iimpawu peritoneal abekho, ngoko ke esiswini ithambe ukuya ngaphandle kwebala.

Ngenxa yokuba esi sifo inkqubo eqongeni, kunye ukwanda ixesha karhulumente sifo yesigulana kuguga. Kumanqanaba kamva ukuze kuqatshelwe tachycardia kwakunye nokubamba-bamba umphefumlo, ukuqumba, iingxolo languid peristaltic ukuba yasentabeni enqabile. Ukugabha sibi.

Kumanqanaba yokugqibela, oko kukhokelele kwiqondo kabukhali utshintsho morphological kwi izixhobo neuromuscular. Isigulane ikhalazela zegesi kunye isitulo nokubambezeleka na ukuchama yimiyalezo.

emathunjini Dynamic ebantwaneni

Abantwana zixhaphake kakhulu olutshintshatshintshayo isithintelo etsolo namathumbu, oko kukuthi amaninzi kubonwa ngendlela unedumbe. Ezi zizathu zilandelayo kuchongwa, ukumqumbisa uphuhliso sifo ebuntwaneni:

• obstructive okanye strangulation kokuphazanyiswa;
• peritonitis limited okanye kwentamo;
• ukuphatheka esiswini;
• pneumonia;
• empyema;
• ukuphazamiseka komsebenzi emathunjini.

Lidla ileus onamandla ubuhlungu abantwana kwisithuba postoperative. Kwakhona ukuba iifom nokwanda onedumbe esi sifo kunokuba hypokalemia.

Umngcipheko sifo ubuntwana ukulahleka oluninzi ulwelo netyuwa ngenxa ukugabha rhoqo, ukungabi namdla, ngobhobhozo potassium kidney hypoproteinemia kunokwenzeka. Ebukhulwini imeko ukuze mandundu yi impembelelo kwezimo oyityhefu amagciwane.

ileus onamandla kuzalwa nga kuxhokonxwa eziliqela ezi zizathu zilandelayo:

• prematurity;
• Intervention amalungelo;
• ukusetyenziswa kweziyobisi (kubandakanywa lokuzala ngexa lokukhulelwa);
• gipermagniemiya;
• ukusetyenziswa heroin kuzalwe;
• usebenzisa hexamethonium;
• nokudumba;
• enteritis;
• isifo CNS;
• necrotizing enterocolitis;
• ukuphazamiseka yonyango.

emathunjini Dynamic abantwana badla kwenzeka, kodwa ngokulula ene kwaye ivumela unyango kwangoko. Kwimeko rhanelwa phambi kwizithinteli ezifana okubaluleke - musa kunikwa ukuhendwa self-amayeza, kwaye alandele ngqo ngokwemiyalelo enikwe yingcali echaphazelekayo. isiphumo esibi - kuba izinto kusenokwenzeka ingxaki efana isithintelo onamandla amathumbu.

isifo izifo

Iimpawu zesi sifo-ngqo necacileyo, loo nto kunokuthintela inkqubo loxilongo. Sebenzisa le ndlela ilandelayo diagnostic:

• imbali yezonyango;
• Ukuhlolisisa yesigulana;
• iimviwo X-ray ngokwamalungu kummandla esiswini (lwenza phambi yeegesi ngaphezu kwenqanaba ulwelo emathunjini);
• Ultrasound (akukho mfuneko isifundo kuba akukho Isalathisi ngokwaneleyo sokwaziswa);
• ngokupheleleyo wegazi.

Dynamic emathunjini: unyango

Ngokubanzi, unyango lujoliswe ekuyekisweni sifo izizathu zokuqala bandiqumbisayo uphuhliso yawo (uhlobo ezosulelayo zesi sifo, inyumoniya, peritonitis kunye nabanye.). Kwimeko esi sifo ngenxa yeemeko eziyityhefu okanye reflex unyango olufanelekileyo 'endala, esakhiwa ngo kunyango ngamachiza kwe iziganeko ezimbi ezikhokelela ukulisa i peristalsis standard emathunjini. unyango olunjalo kunokwenziwa ngokuqalisa emzimbeni womntu iziyobisi ezifana sodium chloride, kunye glucose. Ngoko ufuna ahlambe emathunjini kunye enema, ukuba kuyimfuneko - ukwenza ukuqaliswa tube esiswini. Xa intlungu eliphezulu iminqweno ukuba zifumana ntlungu.

Kwimeko xa unyango iiyure ezintandathu zonyango imeko yomguli akuthethi ngcono, utyando olwenziweyo. Kwakhona uqhaqho olungxamisekileyo lwenziwa iziphene kwamathumbu kokuphazanyiswa.

Ngokuqhelekileyo, umsebenzi siqulathe sokususa kwenxenye ethunjini, zingasayi uzalisekisa imisebenzi yawo. Xa neziqephu kakhulu kufuneka abeke indle (ilindle ngumntu eludongeni esiswini ngalo yisa isitulo kwaye babe nethuba lokuba aye engxoweni ekhethekileyo azibophela).

Musa ukususa ingxenye ethunjini kunokwenzeka kuphela xa intussusception. Kwiimeko ezinjalo ke kunokwenzeka ukuba asasaze emathunjini ngokuthi yokutsiba emathunjini Air kunye ukulawula epheleleyo usebenzisa-X-reyi.

unyango Postoperative ibandakanya yokutya ngamnye, nto leyo kuxhomekeka kumthamo yokungenelela yotyando. Iintsuku ezimbini zokuqala emva kotyando, isigulane kufuneka ibe kwindawo womthiyeli, nazo kufuneka ukwenza imithambo yokuphefumla. Kwakhona kweli nqanaba luya kufumana unyango iziyobisi, unyango disintoxication oluquka, kuqheleke electrolyte ukutya, ukusetyenziswa antibiotics ebanzi-spectrum, iiarhente oluvuselela zesisu ukuba kuboniswe - unyango hormone.

Xa iingxaki kwixesha postoperative inokuba nzulu amanxeba, ukopha, peritonitis, isifo enamathelayo le peritoneum.

Nge ileus onamandla, njengawuphi na isigulo, kubalulekile ukuba unyango kakhulu kwakunye nokuthintela le ngxaki. iindlela zokuthintela ziquka:

• Ukulungiswa balance electrolyte;
• amayeza prokinetic;
• antibiotics;
• Ukudla efanelekileyo esezantsi kukutyeba, iimveliso zobisi kunye nokutya kwezityalo ezinomthamo eliphezulu yeekhomponenti ezo ukudla yi emzimbeni womntu.