Kugadzikana kwakakomba kwegastric uye duodenal ulcers inonzi perforated stomach ulcer kana kupera. Kana iwe usingakurumidza kupa rubatsiro rwekukurumidzira, munhu anotarisana ne peritonitis uye kunyange rufu. Muzviitiko zvakawanda, chirwere chiri mumurume, nokuti vakadzi vanodzivirirwa nesrogen yemuviri, kudzivirira mucous.
Zvinokonzera kupera kwechirwere
Ikoko hakugoni kuve nekusvibiswa kwechironda chepamu pane imwechete yakaenzana, kune nguva dzose zvinyorwa zveizvi. Mikana yayo inowanikwa kune avo vanotambura nechirwere chechirwere chechirwere kwemakore anopfuura matatu, mune varwere vane gastritis vasingawanzoonana nechiremba. Kudana kunonoka kunogona:
- wakasimba, mutoro unopinza;
- kazhinji kudya;
- high acidity ye gastric juice;
- kushandisa zvisina kunaka zvinonhuwira;
- kusateererwa nehope nekumuka, usiku hunoenda kubasa, kusakwanisa kurara;
- kushandiswa kwenguva refu uye kwenguva pfupi yemishonga yemishonga yemamwe madhiragi;
- kusagamuchirwa nekudya, kuramba kwezvokudya zvinodhaka, kushandiswa kwezvakaomeswa uye kusvuta zvigadzirwa;
- kushandisa nguva dzose doro uye kusvuta:
- hereditary predisposition.
Perforated ulcer wepamu - zviratidzo
Chero humwe hutambu hwakasimba munharaunda ye epigastric hunogona kutungamirira kune pfungwa yekurohwa kwechironda cheponda, zviratidzo zvayo zvinoratidza uye zvinonzwisisika. Perforated ulcer kana kuputika kwemudumbu kunotsanangurwa ne:
- etiology;
- nzvimbo (nzvimbo);
- nzvimbo yekubuda;
- nguva (kuchipatara phases).
Zviratidzo zvekutanga zvechirwere che perforated
Pakutanga kwechirwere ichi, munguva yekutanga, apo kupera kwechirwere chisati chaonekwa, zviratidzo zvinoratidza uye zvinonzwisisika. Kuzviziva, kune mukana wekusanyatsonzwisisa chinokonzera utano husina kunaka. Pane zvikamu zvitatu:
- Kemikari peritonitis, iyo inotora maawa 3-6. Panguva ino kune marwadzo akaoma munharaunda uye kurutivi rworudyi rwemuviri. Zvichienderana nenzvimbo yacho, chironda chepurasi chinokonzera mimba chinogona kukonzera kurwadziwa kwepayimpiki muchikwata chekuruboshwe. Zvishoma nezvishoma, marwadzo anova akajeka uye akanzwa mukati rose mudumbu, kukanganiswa kunoderedzwa. Ganda rinova rakachenesa uye rinonamatira, uye mudumbu rinokurira nokuda kwekuunganidza magasi. Iyi ndiyo nguva yakanakisisa apo murwere anofanira kutorwa kuchipatara.
- Bhakteria peritonitis haina kuitika pakarepo, asi shure kwemaawa matanhatu kubva panguva apo zviratidzo zvokutanga zvekurwadziwa kwechironda chepamu zvakaonekwa. Zvishoma nezvishoma, mhuka inodhakwa uye mamiriro ezvinhu emuurwere anotowedzera, kunyange zvazvo asingazivi kukosha kwemamiriro acho ezvinhu. Iyi inguva yekupupurika, apo zviratidzo zvekunonoka kwechironda zvinowedzera kusimba, marwadzo anononoka uye munhu anonzwa zvakanaka. Nenguva ino, kuwedzera kunomuka, kufanana nekushisa kwemuviri, iyo peristalsis yakavhuniwa, rurimi rwakafukidzwa nemucheka mutsvuku.
- Kunwa doro kunowanzoitika mushure memaawa gumi nemaviri kubva pakutanga kwechirwere. Iyo inotonhora inodonha, ganda rinova rakaoma, kurutsa uye kupera simba kunotanga. Kuputika mumimba kunokonzera kuti dumbu rinova rakaoma uye rinoputika nekuda kwegezi uye kuparara kwemiti yakabatwa mu peritoneum. Ikoko kune kusava nehanya kwemurwere pane zviri kuitika, kuparara, urinary inogumira. Panguva ino chirwere chinoputika chemuviri chinouraya uye zvinenge zvisingakwanisi kuponesa murwere.
Perforated ulcer - X-ray
Kucherechedza zviratidzo zvekutanga zvemuviri wemaronda, munhu anofanira kutumirwa kuchipatara kuti aongororwe. Nehosha iyi, chero kunonoka kune ngozi. Kuongororwa kunoitwa nenzira dzinoverengeka:
- achiita anamnesis omurwere;
- X-ray uye laboratory exam;
- endoscopic kuongorora.
Muchikamu makumi mapfumbamwe nezana (80%), ma-X-ray pachinetso chemuviri chinopa chiitiko chakanaka. Kuita kwaro kunoratidzira gasi mumakumbo emimba, iyo inowira panguva yekuputsika kwekamuri rakaita. Kana huwandu hwacho hudiki uye hutachiona huri mubvunzo, X-ray inodzokororwa, mushure mekunge murwere ave nemvura yakawanda. Mushure mokunge, iyo gas inosununguka kubva pa peritoneum uye inowanikwa muma X-rays.
Kupera simba kwechirwere - zvinetso
Kufanana nezvimwe zvirwere zvakaoma, kuora kwemuviri wesumbu kune zvinetso zvaro:
- mukati fistura (intestinal uye gallbladder);
- an abscess;
- pneumothorax nekuputsika kusabatwa;
- peritonitis .
Nzira yekurapa chirwere chepurasi chinonzi perforated?
Apo chirwere chinoputika chiropa chinowanikwa mumunhu, kurapwa kunogona kuitika nokukurumidza. Iyi ndiyo nzira yakanakisisa yekubuda mumamiriro ezvinhu kana zvichikwanisika kuchera gomba, uye mune dzimwe nguva, kuita dumbu resection. Muzviitiko zvakasiyana-siyana zvinogona kurapwa zvinogadzirirwa zvinorayirwa kana murwere anoramba kuvhiyiwa. Zvadaro, kupomesa mvura iri kunze kwe peritoneum ine probe inoshandiswa, mune imwe nzira kwemazuva mashomanana murwere akaiswa pasi, mishonga yekurapa inopimha inorayirwa.
Perforated mudumbu ulcer - rubatsiro rwekukurumidza
Kuti kuderedza dambudziko remigumisiro inouraya kusvika zvishoma, kuchengetedzwa kwakanyanya kunodiwa mukugadzirisa kwezvironda zvepamuviri mumaawa ekutanga echirwere, icho chinofanirwa kupiwa navanachiremba. Usazviti-mishonga. Inoshandiswa nenzira inotevera:
- Murwere anoiswa nemusoro wakasimudzwa uye mabvi akadzikama.
- Svet zviri mukati mudumbu kuburikidza neprobe.
- Kuti abvise kushamiswa (kana pane), tumira mishonga yemwoyo;
- Kuiswa kwe saline uye glucose kunoitwa segadziriro yekugadzirira kusati kwaitwa.
Perforated ulcer wesisu - kushanda
Mumapfumbamwe makumi mapfumbamwe ematatu, chirwere chinoputika chemuviri chinogunun'una. Zvichienderana nechinzvimbo chechirwere uye kuoma kwemamiriro emurwere, kupindira kwakadaro kwakakodzera:
- suturing;
- kunyanya uye kunyura;
- resection of the stomach ;
- economical resection uye vagotomy (dissection yemitsipa inokonzerwa nekugadzirwa kwehydrochloric acid kuti isadzokezve);
- kunyura uye vagotomy.
Perforated tummy ulcer - postoperative period
Kushongedzwa kwechirwere kunoreva chirongwa chekushandisa chinetso. Nguva yekudzosa haisi nyore uye yakareba. Kubva pane mufambiro wakarurama panguva ino kunobva mune hutano huchaita huchashandiswa. Kunyanya kubhadharwa kune zvekudya uye motokari. Mushure mekuvhiyiwa kwemazuva 3-4 murwere anoramba ari pamubhedha, mushure mezvo anobvumidzwa kusimuka. Ita izvi nemubatsiri uye zvishoma nezvishoma, sezvo mutumbi unoshayiwa simba mushure mekuvhiyiwa. Kunyengera pasina kufamba hakubvumirwiwo nekuda kwehutano hwekutevedzera.
Kudya mushure mokunge chirwere chepuresi chinonzi perforated chirwere
Kuti uderedze zvinetso kubva pakuvhiyiwa kusvika kune zero, iwe unoda kudya kwakasimba mushure mekurwa kwechironda cheperesi. Mazuva ekutanga mazuva 3-4 murwere haafaniri kudya, kuitira kuti dumbu rinoshandiswa kune imwe nyika itsva. Zvokudya zvinowanikwa kuburikidza nehotera, uchishandisa glucose solution. Pazuva rechishanu murwere anogona kutanga kunwa zvishoma jelly uye decoction of dogrose , asi mvura yakawanda yakawanda inorambidzwa, semunyu. Pakupera kwevhiki mukati mekudya kunowanikwa unsalted rubbed rice soups / porridge uye mazai anonyorera. Chirongwa chemazuva anotevera mushure mekuvhiyiwa chinosanganisira:
- mazai akabikwa;
- steam cutlets uye nyama yakabikwa yehutu, sungura, huku;
- hove yehove yakabikwa yakabikwa kana yakanyanyiswa;
- mifuta purees;
- berry jelly;
- rice, oatmeal, buckwheat;
- bhanana, pears;
- low-fat cottage cheese, mukaka, acidophilus kefir;
- vanokanganisa zvokudya zvavo zvezuro.
Zvinosuruvarisa, urongwa hwezvinhu zvakabvumira zvigadzirwa zviduku zvikuru, zvakasiyana nekurongwa kwezvidziviswa. Vachafanira kutevedzera kuhupenyu hwose kana kuita zvisarudzo zvisingawanzoitiki, makore matatu mushure mekushanda:
- tsvina;
- sausages;
- carbonated drinks;
- makungu, tomato, kabichi, mushroom;
- anyanisi, garlic;
- nyemba;
- soda, doro, kofi, kvass;
- chokoti, dessert, ice cream, buns.