Ascites inongowanzosangana nezvirwere zvakasiyana-siyana zvemuviri. Muchiitiko ichi, mvura inenge iri mumimba yepamuviri inogona kuchinja uye inopisa. Muchiitiko chekutanga, inowedzera pamusana pekushungurudzika kwemhirizhonga uye lymph flow, muchipiri - ine nhamba yakawanda yeeukocyte uye mapuroteni emakemikari nekuda kwekuvandudzwa kwemaitiro anokonzera kupisa.
Zvinokonzerwa nehuwandu hwemvura inounganidza mudumbu remuviri
Inenge 80% yevose ascites ndiyo migumisiro yekufambira mberi kwechiropa chinonzi cirrhosis. Muchikamu chekupedzisira chechirwere ichi pane kushungurudzika kwakanyanya kweropa, kupera kwehupenyu hwehupenyu.
Muna 10% yezviitiko, mvura inowanikwa mumakumbo emimba inowanikwa mune inocology. Sezvo mutemo, ascites inofambidzana nekenza yevana uye inoonekwa sechirwere chinotyisa zvikuru. Kuzadza nzvimbo pakati pezvikamu zvekudya zvine lymph kana kupisa zvinowanzoratidza nzira yakaoma yechirwere uye kuswedera kwekuguma kwechigumisiro. Uyezve, dambudziko ndiro chiratidzo chemakumbo akadai:
- primary mesothelioma;
- lymphoma;
- secondary carcinomatosis;
- metastases mumasuwo echiropa;
- leukemia;
- pseudomixoma;
- carcinomatosis.
Inenge 5% ye ascites ndiyo zviratidzo zvehutano hwemwoyo:
- kuderedzwa kweropa kupararira;
- heart defects;
- constrictive pericarditis;
- kusingaperi zvirwere.
Chiratidzo chinogutsa chezvirwere izvi ndechekudzimba kwakasimba kwechiso nemakumbo.
Nezvasara 5% zvekuongororwa, rusununguko rusununguko mudumbu remuviri rinoumbwa mushure mekuvhiyiwa, maererano nechekubva kwe:
- pancreatitis;
- chirwere cheshuga mellitus;
- renal failure, systemic lupus erythematosus;
- portal hypertension;
- the Meigs syndrome;
- chirwere chemhepo-chekuita;
- peritonitis yakabva zvakasiyana;
- Chirwere cheBadda-Chiari;
- pancreatic cysts ;
- Whipple's syndrome uye zvimwe zvirwere zvepfungwa.
Kutsunga kwekuvapo kwemvura mumakumbo emimba ne ultrasound
Hazvibviri kuona kuti inokwira zvakasununguka, kunyanya pakutanga kwekuunganidza mvura. Pane humwe hunhu hunoratidza zvirwere, somuenzaniso:
- kusuruvara mumimba ;
- kukanganisa kwe defecation;
- kusviba kana kutora marwadzo mumutsi;
- kuchinja muhuwandu hwekudzora uye ivhu rekuwanikwa pasina;
- eructation;
- dzimwe nguva - kuoma kufema;
- kuzvikudza kwemakumbo, chiso;
- "Frog" mudumbu.
Asi zviratidzo zvakarongwa zvakasiyana nezvirwere zvakawanda, saka zvakaoma kuvabatanidza nazvo nekuunganidza kwemvura mumumimba. Nzira chete yekuvimbika yekuongororwa ascites ndiyo ultrasound. Panguva yekuita izvi zvinonyatsooneka kwete kungovepo kwekutengesa kana kubuda, asiwo ivhu rayo, iyo dzimwe nguva inokwanisa kusvika maita makumi maviri.
Therapy uye kupemha kwemvura kubva mumimba
Kuratidzira, "guru" uye "giant" ascites inofanirwa kurapwa chirwere, sezvo mvura yakawanda yemvura isingagoni kubviswa nemaitiro anochengetedza.
Laparocentesis inzira yekurova mudumbu ne trocar, chigadzirwa chakakosha chine nheyo uye ine bhuru rakasanganiswa naro. Chiitiko ichi chinoitwa pasi pekutarisa kwe-ultrasound uye yekunze anesthesia. Kwechikamu chechikamu, hapana anodarika 6 malita emvura yakabuda, uye zvishoma nezvishoma. Kukurumidza kupemha kunze kwe- kana kuti transudate kunogona kukonzera kudonha kwakakosha kweropa uye
Kubhadhara mapuroteni uye amaminerari emararamiro akarasika, sarudzo ye albumin, polyglucin, aminostearyl, hemaccel, nemimwe mishonga yakadaro inogadziriswa panguva imwe chete.
Mukuvhiya kwemazuva ano, imwe pirinoneal catheter inoshandiswawo. Nekubatsira kwayo, mvura yacho inobviswa nguva dzose, asi zvishoma nezvishoma.
Kuchengetedza kurapa kwe ascites kunobudirira muchiedza nepakati pepamusoro zvehutano. Inosarudzwa chete nenyanzvi mushure mokuziva zvikonzero zvechinetso.