Iyo cecum ine chinyorwa chezvinyorwa zvinowedzera zvinoshanda. Mashoko ekuwedzera anoshanda se "firimu" uye kuchengetwa kwemakiromita anogadzira microflora inobatsira. Kuvhiringidzika kwechipembenene ichi ndicho chinonyanya kurwara chirwere chekudya, izvo zvinoda kupindira munguva pfupi.
Appendicitis - zvinokonzera
Icho chaiicho chinokonzera chirwere ichi mumubvunzo hachisati chagadzirwa. Nyanzvi dzinongorongedzera kuti sei appendicitis inomuka - zvinokonzera zvinongororwa mumapoka mana zvichienderana nematachiona anokonzerwa nekuputira:
- mechanical;
- infectious;
- mwoyo;
- endocrine.
Zvinokonzera zvakanyanya appendicitis
Nheyo huru yekusimudzirwa kwechirevo chinorondedzerwa chirwere ndeyekudzivirira (kuvharwa) kwechiwedzera. Izvi zvinokonzera kuunganidza huwandu hwemucus uye microorganisms muzvinyorwa. Inowedzera muhukuru, kupindira mukati kunowedzera uye kuputika kunotanga. Izvozvo zvinogona kuitika pamucheto wekuvharwa kwezvinyorwa zvekuwedzera (mabwe anokopa), kumedza dzimwe nyika, helminths uye tumarara (carcinoid).
Dzimwe nguva kubvumira kunokonzera kutanga kwayo nekuda kwechirwere chemuviri kuburikidza nehutachiona hwehutano huchibva kune dzimwe hutachiona mumakumbo emimba:
- enteritis ;
- colitis;
- adnexitis;
- cholecystitis;
- peritiflita;
- kuumbwa kwekunamatira.
Maererano nemasikirwo akasara ekuonekwa kwechikwata, inowedzera pasi pesimba rezvinhu zvakadaro:
- hutachiona hwemavermiform appendage ne micropacogic microbes;
- systemic vasculitis;
- kunyanya kuporesa kwehomoni serotonin.
Kusingaperi appendicitis - zvinokonzera
Ichi chimiro chechirwere ndechekurumidza kuputika kwezvinyorwa, pasina zviratidzo zvakananga. Vanachiremba vakawanda vanoramba kusagadzikana kwechidimbu sechiitiko. Vamwe vanachiremba vanotanga kufungidzira kwakadaro, vachiiisa kuti ive yekutanga uye yechipiri. Zvinokonzerwa ne latent kuvhiringidza nzira ndeizvi:
- Zvirwere zvisingaoneki muchikamu chemukati;
- kuchinja kwehutachiona mushure mekushaya zvirwere zvakanyanya pasina kubviswa kwezvinyorwa.
Zviratidzo zve appendicitis
Kubvira pakuona kwakakodzera kwehutano mubvunzo, kubudirira kwehutano hwahwo kunoenderana. Munhu mumwe nomumwe anofanira kuyeuka kuti zviratidzo zvependiendi ndezvipi zvinoonekwa pakutanga. Izvi zvichabatsira nokukurumidza kufungidzira kuputika uye kutsvaka rubatsiro rwakakodzera. Kana zvisina kudaro, pachava nechakaoma appendicitis - zviratidzo zvechimiro chakaoma chechirwere chichawedzera uye chinotungamirira kumigumisiro ine ngozi. Kushayikwa kwechiremba mune mamiriro ezvinhu akadaro kwakazara nemamiriro ezvinhu akaoma, dzimwe nguva kunyange kufa kunogona kuitika.
Zviratidzo zvekutanga zve appendicitis
Chimiro chechirwere chechirwere chetachiona chinotanga nekunzwa kusuruvara mukati memudumbu, kunyanya manheru kana usiku. Chiratidzo chokutanga che appendicitis isina kuora zvakanyanya kufanana negastritis. Nemhaka yekuderera kwakaderera kwekuratidzwa uku, munhu haakurumidzi kuenda kuchipatara. Kune zvimwe zviratidzo zvinosanganisira appendicitis - zviratidzo zvokutanga:
- nausea;
- kurutsa (1-2 nguva);
- kushaya simba;
- malaise;
- dry mouth.
Zviratidzo zvekuwedzera appendicitis
Mushure mechikamu chekutanga, hutachiona hunofambira mberi, uye chipatara chacho chinyorwa chinonyatsotsanangurwa. Pain ne appendicitis inova yakaoma, inopisa kana kupindira. Kuvhiringidzika kunonzwika kwete chete mukati, asiwo muzasi kumakumbo. Appendicitis, zviratidzo, inova pachena mumaawa mashomanana anotevera:
- kuwedzera mukupisa kwemuviri mukati ma37-38 degrees;
- Kunyanya kusava nenzara (anorexia);
- zvinoramba zvakanyanya kushungurudza;
- moyo palpitations (tachycardia), kusvika kune makumi mapfumbamwe nemapfumbamwe paminiti;
- bloating;
- chena kupfeka parurimi.
Zviratidzo zvekusingaperi appendicitis
Chirwere chemukati chekuratidzira kwekunonoka-kupisa kwomuviri wekuputika hakusi kwepecific, zvinogona kunge zvakasiyana nezvimwe zvirwere zvakasiyana-siyana zvemuviri wepamuviri. Zviratidzo zvekusingaperi appendicitis:
- stool disorders, sekudzivirira, uye kubuda;
- kushungurudzika, kunyanya pashure pokushingaira kwepanyama nekusaziva mukudya;
- weak appetite;
- kutsamwa;
- kurwadziwa kwepamuviri nguva nenguva.
Nzira yekuziva sei appendicitis?
Chiremba anokwanisa chete anokwanisa kusimbisa kuvepo kwekuvhiringidza kwekuita muzvinyorwa. Kunyangwe kuziva rutivi rwupi rwezvinyorwa (kurudyi pasi pemimba), uye kupi kunowedzera kune miviri yenyama, hazvingabatsiri kunyatsoziva chirwere chacho. Mune vamwe vanhu, nhengo iri pasi inowanikwa mune imwe nzvimbo inypical, uye kutadza kusina kunaka kunowanzokonzera kukanganisa kana kuparara kwemadziro ezvinyorwa.
Kune nzira dzakasiyana-siyana dzehutano hwekuziva appendicitis:
- Chiratidzo chaMendel. Kana uchinge uine munwe wechipinda chemukati chepamuviri, marwadzo ari munzvimbo yakarurama yealeal inowedzera.
- Chiratidzo Sitkovsky. Kunetseka kunowedzera zvakanyanya kana munhu akatendeukira kuruboshwe.
- Chiratidzo chePhevalsky. Zvakaoma kumurwere kusimudza gumbo rake rokurudyi.
- Chiratidzo cheSchchetkin-Blumberg. Kuwedzera kunorwadziwa nekukanganiswa kwakasimba mushure mokumanikidza.
- Chiratidzo chekutsamwa kwe peritoneum. Kunetseka kwakanyanya panguva yekucheka, kuseka, kukwezva, kufamba uye kugunun'una.
Nokuda kwekusimbiswa kwekupedzisira kwechikonzero chekufungidzirwa, mabasa akawanda anoitwa:
- kuongorora ropa (kliniki, biochemical), feces, urine;
- coprogramme;
- ultrasound exam;
- radiography;
- Irrigoscopy;
- computed tomography;
- electrocardiogram.
Kutanga kubatsira ne appendicitis
Kana kuputika kwechiwedzera chececum kuchifungidzirwa, boka rezvehutano rinofanira kunziidzwa pakarepo. Pamusoro pefoni zvakakosha kurondedzera kuti murwere anofanirwa kunge ane appendicitis - tsanangudzo zviratidzo zvakanyanya, kurondedzera mamiriro uye hupenyu hwevanhu. Pamberi pokusvika kwevanyanzvi, hapana kuedza kuzvimiririra pakurapa kunofanira kuitwa.
Emergency rubatsiro ne appendicitis:
- Ita akakwidzwa pane imwe nzvimbo yakanyanyisa.
- Kupa murwere rugare rwepfungwa.
- Usapa mvura, zvokudya, mushonga.
- Zvinorambidzwa kuisa dutu, kuisa kupisa pamudumbu.
Appendicitis - operation
Nzira chete yekurapa inorondedzerwa hutachiwana ndeyekugadzira chikamu chinopisa. Kugadziriswa kubviswa kwezvinyorwa kunowanikwa nekushandiswa kweanesthesia uye kunoda kutanga kugadzirira murwere. Mumazuva ekuvhiya, murwere anokonzerwa nehutano hwepanyama uye zvinorwisa mabhakitiriya. Izvi zvakakosha kuderedza kusimba kwekuvhiringidza uye kudzivirira utachiona panguva uye mushure mekuvhiyiwa. Uyezve, gastric washing and intestinal cleansing are performed.
Mhando yakazara yekubviswa kwezvinyorwa ndeye laparotopic appendectomy. Inowanikwa zvikuru pasi peaneshesia yakawanda uye inopa zvakananga kusvika kune chikamu chakanaka kuburikidza nekucheka rusvingo rwemimba mune chikamu chakanaka. Kuvonga kubudirira kwemazuva ano, pane imwe, inosuruvarisa, nzira yekusakoshera kwependiendi.
Kubviswa kwezvinyorwa ne laparoscopic nzira
Iyi nzira yekurapa inopa kurasikirwa kweropa kudarika, kunodzivirira kuumbwa kwezvitsvuku zvakakura uye kusungwa mumudumbu wepamuviri. Kubudiswa kwepapososcopic yezvinyorwa zvinogadzirisa kushungurudzika kunononoka mishonga uye ganda, kunopedza nguva yenguva yekudzorera. Maererano nezvidzidzo zvemazuva ano, rudzi urwu rwemitiro haruwanzokonzera matambudziko.
Kupindira kwakadaro ndiko kuiswa mukati mechidziro chemuviri chekhabhoni dioxide (nokuda kwekugadzirisa nzvimbo yakakwana uye kusununguka kwemuviri) uye zvigadziriswa zvinogadziriswa nekamuri huru-duku kuburikidza nemakomba maduku. Chiremba anoona zvinyorwa kubva mukati mukati mekombiyuta kuongorora, uye anobvisa zvinyoro zvinyorwa zvinoshandiswa kushandisa manipulators. Nhengo yakanyanyisa inowanikwa kuburikidza neimwe yemakomba yakaitwa.
Kuvandudzwa pashure pokubviswa kwezvinyorwa
Mukati me-1-2 mazuva kubvira panguva yekuvhiyiwa yakakurudzirwa zvakasimba mubhedha wekurara, kubva pamubhedha kunobvumirwa chete musi wechitatu. Zvakakosha kuti ganda mushure mekushandisa appendicitis hariparadzi. Mavhiki matanhatu anotevera, mishonga inenge ichinyatsoputika, nechepamusoro penzira iyo ngozi yekubatanidza neyamarini inowedzera. Kudzivirira zvinetso, basa rekuita rinowedzera zvishoma nezvishoma, kusimudza kusimba, mitambo inoshanda uye kushanda zvakaoma hazvibvumirwi. Kukurumidza kusimudzira kuporesa nekudzivirira kukanganisa kwe sutures kunobatsira nekupfeka bhanhire rinokosha.
Mukuwedzera pakugadzirisa kushanda mumuviri, murwere anoda:
- Nguva dzose shanyira kurapwa uye chiremba chiremba zvekuongorora zviitiko.
- Chengetedza mamiriro ezvinhu emashure anonzi postoperative.
- Kuita mapurisa, kuti uende kupfeka.
- Mushure mokunge uwedzere kukuvadza, mavara emafuta ane mavara ekugadzirira.
Kudya mushure mekushandisa appendicitis
Kuzvimiririra kushandiswa kwezvokudya kunobvumirwa chete kubva pazuva rechitatu rekushanda. Pamakore 72 anotevera, kudya mushure mokusunungurwa kwezvinyorwa zvinosanganisira chete mvura uye mushy foods. Kubvumira kudya uye kunwa:
- miti, kwete mutsara wakasimba;
- mukaka jelly;
- puree kubva mumiriwo;
- majisi anonatswa nemvura;
- semi-liquid porridge;
- muto wembwa;
- mishonga, isina simba nyeii chai.
Kubva pazuva rechitanhatu yemenyu inowedzera, unogona kushandisa:
- rubbed soups;
- Zvishandisi zvehuchi nemafuta zvakadzika;
- zvinyoro zvakasiyana zvenyama kana hove, zvakanyoroveswa kana kubika, mune fomu yakapwanyika;
- pariji pamvura;
- miti nemichero yakachena;
- bananas;
- chingwa;
- jelly.
Mumwedzi 2-4 mushure mekuwedzera, zvakakosha kutevera uremu uye kutevera mazano ekugadziriswa kwemaitiro:
- Kune dzimwe nguva uye zvishoma nezvishoma.
- Shandisa chete zvokudya zvinodziya, kwete kutonhora uye kwete kupisa.
- Rega chero mishonga inobatsira kuisa gumbo mumatumbo - maruva, kabichi, marinades, pickles, kusvuta zvigadzirwa.
- Usatora "nzara" kudya - mafuta nyama, hove, zvokudya zvakabikwa, masimba ane simba uye masuka anobva kwavari.
- Usanwa doro, soda.
Dzokera kumudziyo unozivikanwa kuti munhu wacho anofanira kuwedzera zvishoma nezvishoma uye anonoke. Nyanzvi dzinopa zano rokuramba richienderana nemitemo yekudya kwakakodzera, kuchengetedza kudya kwakakwana uye kwakakwana. Izvi zvichabatsira kusimbisa masimba ezvirwere uye kudzorera kukwana kwe microflora mumatumbo, iyo yakakanganiswa nekuputira.
Appendicitis - zvinetso
Migumisiro yakaipa inomuka pamusoro pemamiriro ekurwara asingakanganwi kana kusakwanisa kurapwa kwakakwana. Matambudziko anowanzoonekwa kana appendicitis ichionekwa munguva pfupi - zviratidzo zvisingateereri panguva yekutanga yekuputika kufambira mberi uye kumutsa kupararira kwayo. Somugumisiro, hutachiona hunopfuurira kune nhengo dziri pedyo nematumbu, utachiona hwehuwandu hunogona kuitika.
Mushure mokubviswa kwechikwata chekuwedzera kune zvinotevera zvinogona kuitika:
- peritonitis (kuputika kwemuviri wemimba);
- chibatanidza chirwere ;
- mukati kubuda ropa;
- periapendicular abscess yechipfuva chemuviri (kukurumidza kuputika mune capsule yakazara pus);
- sepsis - kupindira kwebhakitiriya yepathogenic muropa;
- kuputika kwezvinyorwa nezvinyorwa zvayo zviri mukati, zvinosanganisira feces uye exudate, kusvika mudumbu;
- kuputika kwechivako chechivako chechiropa, kunogona kuva purulent (pylephlebitis);
- thromboembolism - kuvhara ropa remudziyo ne thrombus;
- phlegmon ye retroperitoneal space;
- Periapendicular infiltrate (fusion ye appendix uye nhengo dzakapoteredza);
- thrombophlebitis yemaketani emakona maduku;
- kudyidzana kwemavanga ekuvhiya;
- seam divergence;
- ane usimbe kana asingagumi appendicitis.