Kuvhiringidza kwe peritoneum kana peritonitis yemuviri wemimba ndiyo inotyisa zvikuru yehupenyu inoda kuparidzira nekupindira kwekuvhiya.
Preoperative kugadzirira
Kugadzirira murwere kuvhiyiwa, hapana maawa anopfuura matatu anobvumirwa - panguva ino vanachiremba vanoita chirwere chakakonzerwa nekodzero yekukanganiswa panguva imwe chete nemidziyo ine mirefu 2 -3, vachiedza kuisa basa rinokosha remuviri. Panguva iyi, zvinogona kuvandudza mvura-electrolyte balance, kudzorera kuwanda kwemazipa eropa, kuwedzera hutano hwehutano uye hukuru hwemhepo inokonzerwa nemavhu (CVP), kuderedza kupisa uye kuwedzerwa ivhu remvura (diuresis). Zvinowanzoitika kuti hazvibviri kudzorera maitiro epso mumaawa matatu - chirwere hachina kusimbiswa munyaya iyi, asi mukana wekufananidzira kwakanaka kwakanyanya kuderedzwa.
Panzvimbo yegadziriro yekuvhiyiwa, catheterization yevhisi ye subclavia inoitwawo, iyo inoita kuti zvikwanise kuongorora CVP uye kuwedzera kuwandisa kwezinga. Kakawanda, chirwere ichi chiri catheterized: saka zvinogoneka kuyera diuresis yeawa imwe neimwe.
Sezvo kugadziriswa kwemukati wemakumbo, gastric kubvisa kunoitwa nenzira yepurogiramu, isina kubviswa kusvikira kudzorerwa kwemaitiro mushure mekushanda.
Nhanho dzekushanda
Kurapa kwe purulent peritonitis, chiremba anovhiya anoita zvinotevera:
- Laparotomy - kusanganisa kunoitwa pakati nepamuviri pamimba.
- Kubuda kwekunyepedzera-chirwere chinokonzera chirwere chinokonzera peritoneum, chinobviswa neine pombi yegesi, uye iyo inobva peritonitis inosungirirwa nemaputikiti e gauze yakanyoroveswa nesariseptic solution.
- Kuvharwa kwezvirwere zvinonzi reflexogenic zones - novocaine inoshandiswa munzvimbo yechipamba cheecliac, sigmoid uye musikana muduku, mutsara unopera, unobvisa tsvina yevascular spasm uye unowedzera kukurumidza kugadziriswa kweperistalsis.
- Kunatswa kwetsvina - danho rinotevera rerapa ye peritonitis yemakumbo emimba zvinoreva kushambidza ne isotonic fluids kuderedza kusanganiswa kwei microorganisms muexudate kusvika pachidimbu.
- Kuve nechokuita kwechinhu chinonzi peritonitis - zvichienderana nechinokonzera kuvhiringidzika uye chikamu chacho, hemicolectomy (kubviswa kwekoloni), kugadziriswa kwemudumbu (kubviswa kwechikamu chacho), kubviswa kwezvinyorwa, gorova, uterine tube - kureva, nhengo iyo yakava iyo inotangira peritonitis.
- Kusagadzikana kwemukati panguva yekugadziriswa kunowanikwa kuburikidza nemigwagwa yakazaruka yemukumbo, zvisinei kana zviduku zvishoma zvemukati zvinoshandiswa. Chinangwa chokuderedzwa ndechekuchenesa matumbo kubva kune magasi uye mvura iri mukati.
- Chikamu chinotevera chekurapa kwechidziro chemuviri chinoreva kunatswa patsva uye kunyura nekusimbiswa nesilicone tubes. Zvadaro yakazadzwa nesaine nemishonga inorwisa mabhakitiriya, uye kusungurudzwa kwakaiswa pasi.
Kurapa kwe peritonitis mushure mekuvhiyiwa
Mushure memaawa 6-8 mushure mekugadzirisa vanga, iyo exudate inodonhedzwa mukati memvura inenge isingaiti (nemhaka yekusiyana kwezvinetso). Kuburikidza nechitsiko chemvura chepasi, saline yakazara zvakare mumudumbu wepamuviri nemishonga inorwisa mabhakitiriya, uye yakasara kwemaawa matanhatu kusvika ku8. Mumazuva maviri nzira yacho inodzokororwa 2-3 nguva.
Kuwedzera kumwe kurapa kunoreva antibacterial uye detoxification therapy, kupora asidi-base uye mvura-electrolyte balance, bcc uye mapuroteni anowanikwa muropa, uye kudzorerwa kwepachivi motility.
Pakarepo mushure mekushanda, chikafu chinowanikwa ne enteral administration yekugadzirisa kupfurikidza nekugadzira chirwere chekudya. Gare gare chikafu chakakonzerwa chinoratidzwa - kudya nekatenderedzwa peritonitis kunotora mwedzi inenge mitanhatu uye kusabatanidza kusvuta nyama, pickles, marinades, chocolate, doro.
Inobatsira yemiriwo nemafuta ezvekudya , chingwa chezuro, michero inotapira nemabriji, mazai anonyorova, mazai akaonda uye nyama ndiro, uchi, mukaka, jamu.