txhais li cas - kua dej hauv plab kab noj hniav? Qhov no yog ib lo lus nug ntau. Cia wb mus saib kom ntxaws ntxiv.
Ascites yog ib qho mob thib ob uas exudate lossis transudate accumulates hauv plab kab noj hniav. Cov tsos mob ntawm tus kab mob yog tshwm sim nyob rau hauv daim ntawv ntawm ib tug nce nyob rau hauv qhov loj ntawm tus neeg mob lub plab mog, ua tsis taus pa luv, mob, ib tug xav tias hnyav thiab lwm yam cim.
Hauv cov tshuaj, cov kua dej ntau ntxiv hauv lub plab kab noj hniav tseem hu ua mob plab plab, uas tuaj yeem nrog ntau yam urological, oncological, gynecological, cardiological, gastroenterological, lymphological thiab lwm yam kab mob. Ascites tsis yog kab mob ywj pheej. Nws ua raws li qhov taw qhia ntawm ib qho kev tsis haum loj hauv tib neeg lub cev. Ascites ntawm peritoneal kab noj hniav tsis tshwm sim nyob rau hauv cov kab mob me, tab sis ib txwm nrog pathologies uas hem lub neej ntawm tus neeg mob.
Cov txheeb cais hais li cas?
Statisticalcov ntaub ntawv qhia tias cov kua dej hauv plab kab noj hniav yog tsim los ntawm cov kab mob siab (ntau dua 70% ntawm cov neeg mob). Cov qog nqaij hlav cuam tshuam rau hauv nruab nrog cev ua rau pathology hauv 10% ntawm cov xwm txheej, thiab qhov ua rau 5% yog lub plawv tsis ua haujlwm thiab lwm yam kab mob. Hauv cov neeg mob hluas, ascites feem ntau qhia txog kab mob raum.
Qhia tawm tias cov kua dej ntau tshaj plaws uas sau rau hauv tus neeg mob lub plab kab noj hniav tuaj yeem sib npaug li nees nkaum tsib litres.
Dab tsi ua rau ascites?
Kua hauv plab kab noj hniav tshwm sim vim ntau yam, uas nyob rau hauv txhua rooj plaub yog vim muaj kev ua txhaum loj hauv tib neeg lub cev. Lub plab kab noj hniav yog qhov chaw kaw uas cov kua dej ntau dhau yuav tsum tsis txhob tshwm sim. Qhov chaw no muaj nyob rau hauv qhov chaw ntawm cov kab mob hauv nruab nrog cev - qhov no yog qhov chaw ntawm daim siab, spleen, plab, ib feem ntawm txoj hnyuv, gallbladder thiab pancreas nyob.
Lub plab kab noj hniav yog kab nrog ob txheej: sab hauv, nyob ib puag ncig lub cev thiab nyob ib sab ntawm lawv, thiab sab nraud, txuas rau phab ntsa ntawm lub plab. Feem ntau, ib txwm muaj cov kua dej me me ntawm lawv, uas yog qhov tshwm sim ntawm kev ua haujlwm ntawm lymphatic thiab cov hlab ntsha uas nyob hauv cov kab noj hniav peritoneal. Txawm li cas los xij, cov kua dej no tsis sib sau, txij li yuav luag tam sim tom qab tso tawm nws tau nqus los ntawm lymphatic capillaries. Qhov tsis tseem ceeb uas tseem tshuav yog xav tau rau kev txav mus los ntawm txoj hnyuv thiab cov khoom nruab nrog cev hauv lub plab kab noj hniav kom lawvtsis sib tau.
Thaum lub resorptive, excretory thiab barrier functions ntawm lub exudate yog impaired, lub exudate yuav tsis tau absorbed ib txwm, nws accumulates nyob rau hauv lub plab mog, uas nws thiaj li ua rau ascites.
Ua kua dej hauv plab kab noj hniav hauv cov poj niam tau nthuav tawm hauv qab no.
Tej zaum feem ntau yog vim li cas rau qhov pom ntawm cov kua dej me me yog ovulation. Hauv cov poj niam uas muaj hnub nyoog me me, nws tshwm sim txhua hli. Thaum tawg, lub follicle nchuav tawm nws cov ntsiab lus mus rau hauv lub plab kab noj hniav. Cov dej no yaj nws tus kheej, tsis muaj kev hem thawj rau kev noj qab haus huv.
Ntxiv rau, qhov ua rau dej hauv plab hauv cov poj niam tuaj yeem ua cov txheej txheem pathological uas yuav tsum tau kho sai:
- Ntau zaus, kua dej hauv plab kab noj hniav nyob rau hauv cov poj niam yog tsim los ntawm o ntawm lub cev xeeb tub. Piv txwv li, o ntawm zes qe menyuam, txawm nws rupture. Tus mob no nrog rau qhov mob hnyav, nws tsis tuaj yeem tsis pom.
- Ectopic cev xeeb tub. Lub embryo yuav tsum txuas mus rau phab ntsa ntawm lub tsev menyuam, thiab txuas mus rau phab ntsa ntawm lub raj mis. Raws li nws loj hlob, cov yeeb nkab tsis ua haujlwm thiab tawg. Los ntshav sab hauv ua rau muaj kua dej.
- Lwm cov ntshav sab hauv, xws li vim kev raug mob, phais, ntu caesarean.
- Cov qog hauv plab ua rau muaj kev cuam tshuam - ascites - tsub zuj zuj ntawm cov dej ntau hauv plab.
- Endometriosis yog lwm qhov ua rau cov kua hauv plab hauv cov poj niam. Cov ntaub qhwv tshwj xeebuterine kab noj hniav los ntawm sab hauv, tuaj yeem loj hlob uncontrollably, mus dhau nws. Tus kab mob no tshwm sim rau cov poj niam uas muaj hnub nyoog me nyuam yaus, feem ntau tshwm sim tom qab kis kab mob ntawm lub cev xeeb tub.
Cov kab mob no tshwm sim los ntawm kev cuam tshuam ntawm ntau yam.
kab mob siab
Cov no feem ntau suav nrog cirrhosis, Budd-Chiari syndrome thiab mob qog noj ntshav. Cirrhosis tuaj yeem tshwm sim nws tus kheej tawm tsam keeb kwm yav dhau los ntawm kev siv tshuaj lom, nrog rau kab mob siab, cawv, steatosis thiab lwm yam cim, tab sis hepatocytes tsis tuag nyob rau hauv txhua rooj plaub. Raws li qhov tshwm sim, cov kab mob siab ib txwm raug hloov los ntawm cov caws pliav, qhov loj ntawm lub cev tshwm sim, cov hlab ntsha portal yog occluded, thiab ascites tshwm sim. Tsis tas li ntawd, kev tso tawm ntawm cov kua dej ntau dhau tuaj yeem ua tau vim qhov txo qis hauv oncotic siab, vim lub siab nws tus kheej tsis tuaj yeem tsim cov plasma protein thiab albumins ntxiv lawm. Cov txheej txheem pathological tseem exacerbates tag nrho cov npe ntawm cov tshuaj tiv thaiv reflex uas tshwm sim los ntawm tus neeg mob lub cev hauv kev teb rau lub siab tsis txaus. Dab tsi ntxiv ua rau cov kua dej ntau hauv plab?
mob plawv
Pathology xws li ascites tuaj yeem tshwm sim vim lub plawv tsis ua haujlwm, nrog rau vim muaj kab mob pericarditis. Qhov tsis txaus ntawm tib neeg lub cev tseem ceeb tuaj yeem yog qhov tshwm sim ntawm yuav luag txhua yam kab mob ntawm lub plawv. Cov txheej txheem ntawm qhov tshwm sim ntawm ascites nyob rau hauv cov ntaub ntawv no yuav yog vim lub fact tias cov nqaij hypertrophied ntawm lub plawv tsis tuaj yeem tso ntshav mus rau hauv.qhov yuav tsum tau ntim nyob rau hauv cov hlab ntsha, nrog rau cov inferior vena cava system. Vim yog qhov kub siab, qhov tshwm sim, cov kua dej yuav pib tawm ntawm lub txaj vascular, ua rau ascites. Cov txheej txheem ntawm nws txoj kev loj hlob hauv pericarditis yuav luag zoo ib yam, tsuas yog nyob rau hauv qhov xwm txheej no o ntawm lub plawv daim nyias nyias tshwm sim, thiab qhov no, nyob rau hauv lem, ua rau lub fact tias lub cev tsis tuaj yeem sau nrog cov ntshav ib txwm. Qhov no cuam tshuam rau kev ua haujlwm ntawm venous system yav tom ntej. Tsis tas li ntawd, muaj lwm yam laj thawj rau kev kuaj pom cov kua dej dawb hauv lub plab kab noj hniav ntawm ultrasound.
kab mob raum
Ascites tuaj yeem cuam tshuam los ntawm lub raum tsis ua haujlwm vim muaj ntau yam kab mob (urolithiasis, glomerulonephritis, pyelonephritis, thiab lwm yam). Cov kab mob raum ua rau muaj kev nce ntshav siab, nrog rau cov kua dej hauv lub cev, sodium yog khaws cia, thiab vim li ntawd, ascites tshwm sim. Kev txo qis hauv plasma oncotic siab kuj tuaj yeem pom hauv nephrotic syndrome.
Lwm yam yog vim li cas
Qhov tshwm sim ntawm ascites tuaj yeem cuam tshuam los ntawm kev ua txhaum ntawm kev ncaj ncees ntawm cov hlab ntsha lymphatic, uas tshwm sim los ntawm kev raug mob lossis muaj cov qog nyob hauv tus neeg mob lub cev uas metastasizes, thiab kuj vim yog kis kab mob. xws li filariae (lawv nteg qe rau hauv cov hlab ntsha loj).
- Ntau qhov mob plab tuaj yeem ua rau ascites, suav nrog fungal, tuberculous thiab diffuse peritonitis, mob qog noj ntshav, mob qog noj ntshav,endometrium, zes qe menyuam, plab, peritoneal carcinosis. Cov pab pawg no kuj suav nrog mesothelioma thiab pseudomyxoma ntawm lub plab kab noj hniav. Qhov ua rau cov kua dej hauv plab plab muaj ntau yam.
- Polyserositis yog ib yam kab mob uas ascites tshwm sim ib txhij nrog lwm cov cim, suav nrog pericarditis thiab pleurisy.
- Cov kab mob hauv lub cev tuaj yeem ua rau cov kua dej ntau ntxiv hauv lub peritoneum. Cov no muaj xws li lupus erythematosus, rheumatoid mob caj dab, rheumatism, thiab lwm yam.
- Nyob rau hauv cov menyuam mos yug tshiab, ascites kuj tshwm sim, feem ntau yog tshwm sim los ntawm cov kab mob hemolytic ntawm tus menyuam hauv plab, uas tshwm sim thaum muaj kev tiv thaiv kab mob hauv tsev menyuam, thaum cov ntshav ntawm niam thiab menyuam tsis sib xyaw rau qee qhov. antigens.
- Protein deficiency yog ib qho ntawm cov yam tseem ceeb uas ua rau cov ascites.
- Kab mob ntawm lub plab zom mov tuaj yeem ua rau cov kua dej ntau dhau hauv cov kab noj hniav. Nws tuaj yeem yog tus kab mob Crohn, pancreatitis, raws plab. Qhov no kuj suav nrog ntau yam txheej txheem uas tshwm sim hauv plab kab noj hniav thiab tsim teeb meem rau cov lymphatic outflow.
- Myxedema tuaj yeem ua rau ascites. Tus kab mob no yog tshwm sim los ntawm o ntawm cov mucous daim nyias nyias thiab cov nqaij mos, uas qhia tau hais tias tsis xws luag nyob rau hauv lub synthesis ntawm triiodothyronine thiab thyroxine, uas yog, thyroid hormones.
- qhov tsis zoo hauv kev noj zaub mov tseem tuaj yeem ua rau ascites hauv cov kab noj hniav. Hauv qhov no, kev noj zaub mov nruj thiab kev tshaib kev nqhis tshwj xeeb yog qhov txaus ntshai, uas ua rau cov khoom pov tseg ntawm cov protein hauv lub cev, kev poob qis hauv cov concentration.nws nyob rau hauv cov ntshav, uas ua rau ib tug pronounced txo nyob rau hauv oncotic siab. Cov kua ib feem ntawm cov ntshav nws thiaj li tawm hauv lub txaj vascular, thiab ascites tshwm sim.
- Ascites thaum muaj hnub nyoog ntxov nrog congenital nephrotic syndrome, malnutrition thiab exudative enteropathy.
Symptoms of disease
Kev tsim cov kua dej hauv plab kab noj hniav feem ntau txawv ntawm kev loj hlob zuj zus, ntau lub hlis, thiab yog li ntawd feem ntau ntawm cov neeg mob tsis txawm tsom rau nws ntev heev. Cov neeg feem ntau xav tias lawv tsuas yog nce qhov hnyav xwb. Nws yog ib qho nyuaj heev kom pom ascites thaum ntxov: nws yog ib qho tsim nyog yuav tsum tau sau tsawg kawg peb litres kua hauv lub plab kab noj hniav. Qhov no yog qhov yooj yim tshaj plaws pom ntawm ultrasound.
Tsuas yog tom qab ntawd ua cov cim qhia ntawm cov kab mob no tau nthuav tawm: flatulence, heartburn, mob plab, belching, o ntawm qis extremities, ua pa nyuaj. Raws li cov kua dej ntau ntxiv, lub plab kuj loj dua thiab loj dua, thiab tsis ntev nws yuav nyuaj rau tus neeg mob txawm khoov. Lub plab mog zoo li spherical, dilated veins thiab stretch marks yuav tshwm sim. Qee zaum, nrog ascites, cov kua dej tuaj yeem ua rau cov hlab ntsha hauv qab lub siab, thiab tus neeg mob yuav ua rau mob daj ntseg sai sai, nrog rau ntuav thiab xeev siab. Txawm li cas los xij, rau qhov kev qhia meej kawg ntawm daim duab, cov paib sab nraud tsis txaus - yuav tsum muaj kev sab laj tshwj xeeb.
Yuav ua li cas tshem tawm cov kua dej hauv plab?
Kev kho mobcov ntsiab lus
Yuav kom kho tau cov ascites, nws yog ib qho tsim nyog yuav tau pib kho cov kab mob tseem ceeb uas ua rau cov kua dej ntau ntxiv. Yog hais tias ascites yog tshwm sim los ntawm pathologies ntawm lub plawv, cov tshuaj uas dilates cov hlab ntsha, glycosides thiab diuretics yog muab. Kab mob raum yuav tsum tau txwv tsis pub haus dej thiab noj cov ntsev tsawg. Yog tias muaj kev ua txhaum ntawm cov metabolism hauv cov protein, kev noj zaub mov raug sau tseg uas cov protein muaj nyob rau hauv qhov zoo tshaj plaws, nrog rau kev hloov pauv albumin. Thaum cirrhosis, hepatoprotectors raug sau tseg. Lawv tau ntxiv los ntawm kev kho cov tsos mob: kev noj zaub mov tsawg hauv ntsev (tsis pub ntau tshaj ob grams ib hnub), qee zaum - noj zaub mov tsis muaj ntsev txhua. Nyob rau hauv lub xub ntiag ntawm cirrhosis, cov kua dej yuav tsum tau txwv, raws li zoo raws li cov tshuaj diuretic thiab poov tshuaj tshuaj. Thaum kho, tus kws kho mob tshwj xeeb saib xyuas txhua qhov kev hloov pauv hauv tus neeg mob lub cev, thiab tshwj xeeb tshaj yog nws lub cev hnyav. Yog tias txoj kev kho mob siv kev pab, ces qhov hnyav yuav tsum yog kwv yees li 500 grams tauj ib hnub.
Surgery
Thaum tsis muaj qhov xav tau ntawm cov txheej txheem kev saib xyuas, tus neeg mob xav tau kev cuam tshuam ntawm tus kws phais. Feem ntau, nrog ascites, kua dej los ntawm lub plab kab noj hniav raug tshem tawm los ntawm kev maj mam ntws tawm (thaum tus nqi tseem ceeb). Tus kws kho mob ua ib qho me me rau hauv cov kab noj hniav hauv peritoneal thiab ntxig ib lub laparocentesis (drainage tube) nyob rau ntawd. Lwm txoj hauv kev rau txoj kev mob hnyav thiab muaj kev pheej hmoo rau kev noj qab haus huv yog kev teeb tsa cov chaw nres nkoj mus tas li hauv qab daim tawv nqaij thiab catheters. Ascitic kua yog thaum kawg tshem tawm maj mam, raws li nws accumulates. Txoj hauv kev no ua rau lub neej yooj yim dua rau cov neeg mob los ntawm kev tshem tawm qhov xav tau ntawm cov punctures tshiab, yog li txo qis qhov tshwm sim ntawm qhov mob thiab lub cev puas tsuaj.
Qee zaum, intrahepatic shunting yog qhov tsim nyog, thaum tus kws kho mob tshwj xeeb tsim kev sib txuas ntawm cov hlab ntsha portal thiab cov hlab ntsha siab. Hauv qhov xwm txheej hnyav, yuav tsum tau hloov daim siab.
Tau kawg, nws nyob ntawm qhov ua rau lub plab ua kua hauv cov poj niam thiab txiv neej.
Khoom noj
Tus neeg mob noj zaub mov yuav tsum muaj calorie ntau ntau, uas yuav ua rau lub cev muab tag nrho nws cov kev xav tau rau cov kab mob tseem ceeb. Nws yog ib qho tseem ceeb heev kom txwv tsis pub siv ntsev thiab feem ntau tshem tawm ntawm koj cov zaub mov hauv nws daim ntawv ntshiab.
Cov kua dej uas koj haus kuj yuav tsum tau kho kom qis qis. Nws yog qhov tsis xav tau rau cov neeg mob haus ntau tshaj ib liter ib hnub (tsis suav cov kua zaub).
Nws yog ib qho tseem ceeb heev uas cov neeg mob noj cov zaub mov txhua hnub yuav tsum muaj cov khoom noj muaj protein ntau, tab sis lawv cov nyiaj yuav tsum tsis txhob ntau dhau. Txo koj cov rog kom tsawg, tshwj xeeb tshaj yog rau cov neeg uas muaj ascites los ntawm pancreatitis.
Yuav ua li cas rau cov kua hauv plab hauv cov txiv neej thiab poj niam yog dab tsi?
kho mob prognosis
Qhov kev kuaj mob ua ntej ntawm ascites tau tsim thiab pib kho cov kev kho mob, qhov muaj feem ntau dua rau kev daws teeb meem ntawm qhov xwm txheej. Nws yog qhov yooj yim dua los tshem tawm ascites nyob rau theem pib. Txawm li cas los xij, muajMuaj ntau yam uas cuam tshuam rau kev ua tau zoo ntawm kev kho mob - ntshav qab zib mellitus, hnub nyoog siab tshaj, oncological pathologies (tshwj xeeb tshaj yog mob qog noj ntshav), hypotension, peritonitis thiab txo qis ntawm albumin. Cov kab mob xws li ascites ua rau tib neeg tuag taus. Nyob rau hauv ib nrab ntawm tag nrho cov mob, nyob rau hauv tsis muaj kev ua tau zoo ntawm diuretics, ascites tau txais ib tug tragic tshwm sim. Tshwj xeeb tshaj yog txaus ntshai yog cov kua dawb nyob rau hauv lub plab kab noj hniav nyob rau hauv mob cancer, vim hais tias kev tuag yuav tshwm sim nyob rau hauv 60% ntawm tag nrho cov mob.
Xav tias muaj teeb meem thiab rov muaj dua tus nqi
Nws yuav tsum nco ntsoov tias ascites hauv txhua qhov xwm txheej cuam tshuam tsis zoo rau cov kab mob tseem ceeb, ua rau hernias, ua pa tsis ua haujlwm, plab hnyuv, hydrothorax thiab lwm yam teeb meem. Txawm hais tias cov ascites kho tau zoo, nws yog ib qho tsim nyog yuav tsum tau saib xyuas kev noj qab haus huv zoo, txij li qhov kev pheej hmoo ntawm kev rov qab los tseem nyob. Tias yog vim li cas koj yuav tsum ua raws li kev noj haus hauv kev noj haus tom qab ua tiav kev kho mob.
Peb saib cov kua dej hauv plab, txhais tau li cas tam sim no meej.
