Diverticulosis ntawm cov hnyuv sigmoid: cov tsos mob, ua rau thiab cov yam ntxwv ntawm kev kho mob

Cov txheej txheem:

Diverticulosis ntawm cov hnyuv sigmoid: cov tsos mob, ua rau thiab cov yam ntxwv ntawm kev kho mob
Diverticulosis ntawm cov hnyuv sigmoid: cov tsos mob, ua rau thiab cov yam ntxwv ntawm kev kho mob

Video: Diverticulosis ntawm cov hnyuv sigmoid: cov tsos mob, ua rau thiab cov yam ntxwv ntawm kev kho mob

Video: Diverticulosis ntawm cov hnyuv sigmoid: cov tsos mob, ua rau thiab cov yam ntxwv ntawm kev kho mob
Video: Niam tais Dawb tsis txwm pua Part2 4/29/2021 2024, Lub Xya hli ntuj
Anonim

Kab lus no yuav saib cov tsos mob thiab kev kho mob ntawm sigmoid diverticulosis.

Raws li kev txheeb cais, txhua tus neeg thib tsib hauv ntiaj teb tau kuaj pom tus kab mob no. Nws cov tsos mob yog tshwm sim, feem ntau, nyob rau hauv cov neeg laus, thiab muaj feem xyuam rau lub hnub nyoog ntawm cov teeb meem nyob rau hauv lub cev. Tom qab 80 xyoo, pom muaj tus kab mob zoo sib xws hauv ntau tshaj li ib nrab ntawm cov neeg mob.

diverticulosis ntawm lub plab sigmoid
diverticulosis ntawm lub plab sigmoid

Kev piav qhia

Diverticulosis ntawm lub plab sigmoid yog suav tias yog cov txheej txheem pathological, uas yog tus cwj pwm los ntawm kev tsim ntawm diverticula (saccular hernia zoo li protrusions ntawm phab ntsa ntawm txoj hnyuv). Raws li txoj cai, tus kab mob no tshwm sim ze rau lub hnub nyoog ntawm 50, txij li thaum nws yog nyob rau lub hnub nyoog no uas cov phab ntsa ntawm cov hnyuv sigmoid pib tsis muaj zog thiab nyem tawm sab nraud nrog kev nce siab hauv intracavitary.

Kev tsim ntawm diverticula feem ntau tsis yog kab mob hauv lub cev, tab sis tshwm sim nws tus kheej nyob rau hauv kev cuam tshuam ntawm qhov tsis zoo.yam, nrog rau kev tsis txaus noj haus. Thaum tsim ntawm ntau lub diverticula tau sau tseg hauv cov hnyuv sigmoid, xws li cov kab mob no yog tus yam ntxwv ntawm diverticulosis ntawm sigmoid nyuv (raws li ICD-10, txoj cai raug muab - K57), tab sis nws yuav tsum tau paub qhov txawv ntawm diverticulitis, qhov tseem ceeb tshaj plaws. nyob rau hauv qhov tshwm sim ntawm cov txheej txheem inflammatory.

Vim txoj kev loj hlob

Qhov tshwm sim ntawm kev txhim kho ntawm qhov tshwm sim pathological hauv cov tshuaj kho mob yog suav tias yog kev hloov pauv hnub nyoog uas ua rau degeneration ntawm cov leeg ntawm cov phab ntsa hauv cov hnyuv thiab ua rau muaj kev cuam tshuam dav dav hauv lub cev.

Lwm yam uas ua rau muaj kev loj hlob ntawm diverticulosis yog qhov tsis muaj zog thiab kev txhim kho tsis zoo ntawm cov ntaub so ntswg, uas tshwm sim los ntawm qhov tshwm sim los ntawm qhov tshwm sim los yog tsis ua tiav hauv kev sib txuas ntawm collagen fibers.

Tsis tas li ntawd, kev cuam tshuam hauv plab hnyuv yog suav tias yog ib qho ua rau tus kab mob no. Qhov no manifests nws tus kheej nyob rau hauv xws li ib tug txoj kev uas nrog ib tug nce nyob rau hauv lub plab hnyuv siab, lub fibers ntawm txoj hnyuv phab ntsa, raws li nws yog, stretch thiab tsim tshwj xeeb protrusions, uas yog hu ua diverticula. Lawv tuaj yeem tsim thaum lub sij hawm spasms ntawm txoj hnyuv, uas ua rau kom cov hlab ntsha hauv cov phab ntsa hauv cov hnyuv thiab ua rau cov ntshav tsis zoo hauv lawv. Raws li qhov tshwm sim, muaj qhov ncab thiab dystrophy ntawm qhov chaw nyob ib puag ncig cov hlab ntsha, uas thaum kawg ua rau muaj qhov sib xws.

Qhov ua rau ntawm kev tsim ntawm diverticulum tej zaum yuav yog ib yam kab mob, thiab qhov tshwm sim ntawm tus kab mob no nce ntau zaus yog tias tsev neeg tau sau tsegCov mob ntawm diverticulosis ntawm cov hnyuv sigmoid.

Kev noj zaub mov kuj tseem ua lub luag haujlwm tseem ceeb hauv kev txhim kho pathology. Ntau cov kev tshawb fawb tshawb fawb tau lees paub tias, piv txwv li, hauv Is Nrias teb thiab African lub teb chaws uas muaj cov khoom noj muaj txiaj ntsig zoo tshaj plaws hauv kev noj zaub mov, qhov xwm txheej ntawm tus kab mob no tsawg dua hauv Tebchaws Europe, qhov twg, raws li txoj cai, nyiam yog muab rau cov zaub mov ntawm tsiaj keeb kwm.

diverticulosis ntawm cov tsos mob ntawm txoj hnyuv sigmoid
diverticulosis ntawm cov tsos mob ntawm txoj hnyuv sigmoid

kab mob

Nyob ntawm thawj yam uas ua rau muaj kev loj hlob ntawm diverticulosis ntawm cov hnyuv sigmoid, cov kab mob yog cais raws li qhov tshwm sim los yog kis tau.

Muab qhov xwm txheej ntawm pathology, diverticulosis tuaj yeem yog:

  • asymptomatic;
  • nrog cov lus hais, yam ntxwv nta;
  • nyuaj.

False and true diverticulosis

Tsis tas li ntawd, tus kab mob tau muab faib ua qhov tsis tseeb thiab tseeb diverticulosis. Muaj tseeb hais txog, raws li txoj cai, mus rau congenital cov ntaub ntawv ntawm pathology, uas yog yus muaj los ntawm protrusion ntawm tag nrho cov txheej ntawm txoj hnyuv, nws mucous, muscular thiab submucosal daim nyias nyias. Daim ntawv cuav ntawm diverticulosis tau txais thiab txhim kho thoob plaws lub neej. Nws tuaj yeem tshwm sim nws tus kheej li ib qho kev tawm ntawm cov mucous ntawm cov nyuv sigmoid.

yam ntxwv tsos mob

Nws yog qhov zoo tshaj plaws los pib kho tus kab mob no thaum pib cov tsos mob tshwm sim, tab sis qee zaum nws yog qhov nyuaj rau kuaj pom diverticulosis ntawm sigmoid nyuv, txij li hauv cov neeg mob feem ntau cov txheej txheem pathological tuaj yeem tshwm sim yam tsis pom.cov paib thiab raug kuaj pom, feem ntau, los ntawm lub caij nyoog thaum lub sijhawm dhau los ntawm kev xeem.

Cov tsos mob ntawm tus kab mob no feem ntau yog mob hauv plab plab. Kev mob hauv qhov no tuaj yeem yog qhov sib txawv heev thiab tuaj yeem pom los ntawm tib neeg raws li kev tsis sib haum xeeb hauv lub plab zom mov, thiab hauv cov poj niam raws li kev tsis sib haum xeeb hauv kev xeeb tub. Cov neeg mob feem ntau koom nrog kev tsis xis nyob nrog kev noj zaub mov tsis raug thiab tsis nrhiav kev kho mob, vim qhov mob feem ntau ploj tom qab tso quav.

Ntau zaus cov tsos mob ntawm sigmoid diverticulosis tsim tawm tsam keeb kwm yav dhau ntawm lub plab zom mov. Thaum cov txheej txheem inflammatory tshwm sim, cov tsos mob ntawm tus kab mob pib nce zuj zus. Mob nyob rau hauv sab laug iliac ib feem ua tsis tu ncua thiab ntev, thiab nws siv tom qab ua defecation, raws li txoj cai, tsis txo.

Mob mob tuaj yeem nyob ntev li ob peb hnub thiab ua kom hnyav nrog palpation ntawm thaj chaw thiab txawm tias thaum txav mus los. Qhov tsis ruaj khov ntawm cov quav tuaj yeem nrog xeev siab, ntuav, mob plab thiab tsis xis nyob tas li.

Yog tias thawj theem ntawm qhov tshwm sim cov tsos mob ntawm diverticulosis ntawm cov hnyuv sigmoid yog qhov tsis tuaj, tom qab ntawd dhau sijhawm lawv ua rau lawv tus kheej hnov. Vim lub stagnation ntawm cov quav, kev loj hlob ntawm cov teeb meem ntawm tus kab mob no pib - o ntawm lub protrusions ntawm txoj hnyuv phab ntsa (diverticulitis). Nyob rau hauv cov ntaub ntawv no, qhov mob syndrome yuav ua tsis tu ncua thiab yog nrog los ntawm cov tsos mob ntawm intoxication nyob rau hauv lub cev thiab kub taub hau.

ThaumLub sijhawm ntev ntawm diverticulosis ntawm cov hnyuv sigmoid thiab tsim cov diverticula loj, cov tsos mob hauv qab no yuav tshwm sim:

  • kos qhov mob ntawm sab laug hauv plab los ntawm spasm ntawm lub plab sigmoid;
  • cem quav lossis quav quav ntev ntev;
  • blooj sab laug thiab flatulence;
  • Xav txog qhov hnyav thiab puv hauv plab, tshwj xeeb tshaj yog nyob rau sab laug, uas dhau tom qab quav.

Nws yog ib qho tseem ceeb kom paub yuav ua li cas kho sigmoid diverticulosis.

diverticulosis ntawm sigmoid nyuv mkb 10
diverticulosis ntawm sigmoid nyuv mkb 10

Muaj feem cuam tshuam

Thaum muaj teeb meem tshwm sim, tus neeg mob lub cev tsis zoo, uas yog nrog los ntawm kev qaug zog thiab kub taub hau. Yog tias tsis kho, cov kab mob hauv qab no tshwm sim:

  1. plab hnyuv los ntshav, uas tshwm sim nyob rau hauv feem ntau dheev thiab yog tshwm sim los ntawm vascular puas vim yog tsim ntawm erosions los yog rwj nyob rau hauv lub inflamed diverticulum. Tus neeg mob sau cov ntshav hauv cov quav, qhov ntau npaum li cas nyob ntawm qhov loj ntawm cov hlab ntsha cuam tshuam. Qee lub sij hawm los ntshav tuaj yeem tshwm sim heev, thiab yog tias cov tsos mob no dhau mus ntev, tus neeg mob pib mob ntshav qab zib, kiv taub hau, ua tsis taus pa, tsis muaj zog, thiab palpitations.
  2. Kev txhim kho ntawm diverticulitis. Qhov teeb meem no yog provoked los ntawm cov kab mob uas sib sau thiab ntau hauv cov quav. Cov txheej txheem pathological no tau tshwm sim los ntawm qhov mob hnyav, hyperthermia thiab cov tsos ntawm mucous ntsiab hauv cov quav.
  3. Txoj kevdiverticulum, thaum nws cov ntsiab lus tawm ntawm sigmoid nyuv mus rau hauv lub plab kab noj hniav thiab peritonitis pib, ib qho kev hem thawj rau lub neej. Yog hais tias nws nkag mus rau hauv lub retroperitoneal kab noj hniav, phlegmon (cov ntaub so ntswg suppuration) yog tsim.
  4. Abscess nyob rau hauv kab noj hniav ntawm pathological protrusion ntawm txoj hnyuv. Yog tias qhov kev tsim no tawg mus rau hauv txoj hnyuv, kev txhim kho ntawm tus neeg mob tau pom zoo. Nyob rau hauv cov kev tshwm sim ntawm ib tug tawg mus rau hauv ib tug ntawm cov nyob sib ze lub cev nqaij daim tawv, tsim ib tug internal fistula pib. Nrog rau qhov enterovaginal fistula, cov neeg mob muaj kev tso tawm ntau nrog cov ntxhiab tsw tsis zoo thiab sib xyaw ntawm cov quav los ntawm qhov chaw mos. Fistulas hauv plab hnyuv tau tshwm sim los ntawm ntuav ntuav, thiab plab hnyuv-hlwb provoke nquag cystitis, tus cwj pwm los ntawm kev tawm ntawm cov quav thiab cov kua paug hauv cov zis..
  5. Kev mob plab hnyuv, uas tshwm sim los ntawm lub sijhawm ntev diverticulitis thiab tsim cov adhesions hauv cov hnyuv.

Yuav ua li cas txhawm rau txheeb xyuas diverticulosis ntawm lub plab sigmoid (ICD-10 code - K57)?

ntsuas ntsuas

Txoj kev loj hlob ntawm tus kab mob no cuam tshuam nrog cov teeb meem tsis zoo thiab muaj teeb meem loj, yog li ntawd, kev kuaj mob kom raug thiab raws sijhawm yuav pab ntsuas ntsuas kom tsis txhob muaj kev phom sij rau lub neej.

Thaum kuaj tus neeg mob, tus kws kho mob tshwj xeeb yuav tsum tau saib xyuas ntau yam tshwj xeeb: hnub nyoog, yam ntxwv tsis txaus siab, kev ua neej nyob, nyiam ua rau cem quav, noj zaub mov. Tus kws kho mob kuj tshuaj xyuas tus neeg mob, txheeb xyuas qhov mob ntawm tus yam ntxwv ntawm cov txheej txheem pathological nrog kev pab ntawm palpation.

Kev txiav txim siab daim duab kho mob ntawm cov kab mob thiab txheeb xyuas cov kab mob diverticulosis kuj tseem yuav pab kom paub meej txog keeb kwm.

diverticulosis ntawm sigmoid colon cov tsos mob thiab kev kho mob
diverticulosis ntawm sigmoid colon cov tsos mob thiab kev kho mob

Txhawm rau kuaj mob, ib tus neeg kuj tau sau ntau yam khoom siv kho mob thiab kev sim kuaj. Lawv cov npe suav nrog:

  1. Colonoscopy, uas yog ib txoj kev tshawb fawb uas tso cai rau koj los soj ntsuam cov kab mob hauv plab hnyuv los ntawm sab hauv. Cov txheej txheem no yog ua los ntawm kev siv tshwj xeeb hloov tau yooj yim sojntsuam nruab nrog lub koob yees duab video thaum kawg. Kev sojntsuam yog muab tso rau hauv txoj hnyuv los ntawm qhov quav. Daim duab tso tawm rau ntawm lub monitor, thiab tus kws tshaj lij muaj lub sijhawm los ntsuas qhov pom ntawm txoj hnyuv, txiav txim siab txog qhov muaj diverticula thiab nqa cov ntaub so ntswg rau ib qho kev kawm tshwj xeeb.
  2. Irrigoscopy yog ib qho kev kuaj xyuas uas tau kuaj X-ray ntawm txoj hnyuv, ua ntej sau nrog tus neeg sawv cev sib txawv. Yog hais tias diverticula muaj nyob rau hauv lub sigmoid nyuv, xws li ib yam khoom nyob rau hauv lawv, thiab nyob rau hauv daim duab xws li saccular protrusions yog pom zoo heev.
  3. Laparoscopy, uas yog ib txoj hauv kev kuaj mob thiab kho tib lub sijhawm. Thaum lub sijhawm txheej txheem no, cov kws phais neeg ua peb punctures nyob rau hauv tus neeg mob lub plab phab ntsa, los ntawm qhov uas lawv ntxig ib lub koob yees duab me me uas tso cai rau koj los tshuaj xyuas qhov chaw ntawm lub cev thiab, nyob rau hauv kev nthuav dav, pom txawm tias qhov hloov me ntsis ntawm cov phab ntsa hauv plab. Yog tias tsim nyog, tus kws kho mob tuaj yeem tshem tawm cov diverticulum. Cov txheej txheem yog ua raws li kev siv tshuaj loog.
  4. Nyob rau qee qhov teeb meem, x-rays ntawm lub cev sab hauv raug sauLub plab kab noj hniav los yog cov tswv yim duab xws li MRI thiab xam tomography.
  5. Yuav ua li cas kho diverticulosis ntawm lub plab sigmoid
    Yuav ua li cas kho diverticulosis ntawm lub plab sigmoid

Kev kho mob ntawm sigmoid diverticulosis

Txoj kev kho cov kab mob yog nyob ntawm theem ntawm tus kab mob, kev loj hlob ntawm cov teeb meem, lub xeev ntawm kev noj qab haus huv thiab hnub nyoog ntawm tus neeg mob, kev noj haus thiab kev ua neej. Cov ntaub ntawv tsis sib xws ntawm diverticulosis raug kho kom zoo, thiab kev kho mob ntawm cov theem hnyav ntawm tus kab mob cuam tshuam nrog kev phais.

Txhim kho txoj kev kho mob ntawm sigmoid diverticulosis hais txog kev sib koom ua ke uas suav nrog kev noj zaub mov tshwj xeeb thiab kev siv tshuaj. Tus neeg mob raug tshuaj:

  1. Broad spectrum antibacterials (penicillins, cephalosporins).
  2. Anspasmodic thiab analgesic tshuaj uas tshem tawm spasms ntawm cov hnyuv ("Drotaverin", "Mebeverin", "No-shpa", thiab lwm yam).
  3. Motor-stimulating prokinetics.
  4. YEnzymes kom normalize digestion ("Festal", "Pancreatin").
  5. Laxatives uas muaj lactulose (Duphalac).
  6. Tshuaj uas kho cov hnyuv ("Bifidumbacterin").
  7. Tshuaj kho mob plab thiab raws plab ("Sulgin").

Hauv cov ntaub ntawv nyuaj ntawm tus kab mob, cov haujlwm hauv qab no tau ua:

  1. pab plab.
  2. Siphon enemas.
  3. Kev kho mob nrog cov tshuaj crystalloid.

Kev kho mob phais yog ua nyob rau hauv cov xwm txheej uas muaj teeb meem txaus ntshai,xws li los ntshav hnyav, plab hnyuv txhaws, peritonitis.

Kho sigmoid diverticulosis hauv tsev tuaj yeem ua tau zoo heev.

Kev noj haus rau diverticulosis

txhawm rau txhim kho tus neeg mob tus mob, noj zaub mov tshwj xeeb, uas muaj cov zaub fiber ntau ntau. Kev noj zaub mov yog tsim los ntawm cov txiv hmab txiv ntoo thiab zaub, cereals, nplej xim av thiab legumes. Txhawm rau kom tsis txhob mob plab hnyuv, nws raug nquahu kom ci, ncu lossis boil cov khoom. Dab tsi ntxiv yog kev noj haus rau diverticulosis ntawm cov hnyuv sigmoid txhais tau li cas?

Noj yuav tsum yog feem ntau, noj 5-6 zaug hauv ib hnub hauv me me. Nutritionists kuj qhia kom ua raws li kev noj zaub mov sib cais, uas ua rau kev nqus tau zoo ntawm lub cev.

Kev kho mob ntawm diverticulosis ntawm cov hnyuv sigmoid nrog cov tshuaj pej xeem
Kev kho mob ntawm diverticulosis ntawm cov hnyuv sigmoid nrog cov tshuaj pej xeem

Kev noj haus rau diverticulosis muaj xws li bran, whole grain cereals. Nws yog ib qho tsim nyog los txwv kev siv cov khoom qab zib, cov khoom ua tiav, cov chips, cov khoom siv hmoov.

Tag nrho cov mis nyuj, dej haus carbonated, qhob noom xim kasfes, kas fes thiab tshuaj yej muaj zog, cawv tsis suav nrog tag nrho cov khoom noj. Kev noj zaub mov hauv kev kho mob sigmoid diverticulosis tseem ceeb heev.

Ntxiv rau, nws yuav tsum muaj cov tshuaj laxatives hauv cov ntawv qhia zaub mov: qhuav apricots, prunes, tshuaj ntsuab infusions, fermented mis nyuj khoom. Nws kuj tau qhia kom haus qej, uas pab ntxuav cov hnyuv thiab neutralizes ntau cov kab mob pathogenic.

Pom zoo txhua hnub zaub xam lav ntawm cov zaub tshiab hauv cov roj zaub thiab lojtus nqi ntawm cov kua. Siv tau rau diverticulosis kuj yog cov zaub tshiab los yog kua txiv hmab txiv ntoo thiab kua tais diav. Cov fiber ntau muaj cov txiv ntoo, bran, cereals, zucchini, asparagus, zaub qhwv, carrots, spinach.

Xav txog kev kho mob diverticulosis ntawm cov hnyuv sigmoid nrog cov tshuaj pej xeem.

diverticulosis ntawm sigmoid txoj hnyuv nyob rau hauv tsev
diverticulosis ntawm sigmoid txoj hnyuv nyob rau hauv tsev

Kev kho mob nrog pej xeem tshuaj

Kev kho mob nrog cov tshuaj ib txwm siv tshuaj kho tau zoo heev rau tus neeg mob tus mob, tab sis lawv yuav tsum tau siv tom qab kev sab laj nrog koj tus kws kho mob. Cov tshuaj hauv qab no yog siv:

  1. Linen lossis txiv roj roj. Lawv pab txo cem quav thiab txo qhov mob. Nyob rau tib lub sijhawm, nws raug nquahu kom noj ib diav roj txhua hnub thaum nruab hnub thiab thaum sawv ntxov, thiab tseem siv rau hnav khaub ncaws zaub xam lav. Dab tsi lwm cov kev kho mob pej xeem rau diverticulosis ntawm cov hnyuv sigmoid yog siv?
  2. Herbal tshuaj yej. Rau nws cov kev npaj, qhuav nettle nplooj, chamomile paj, motherwort, dill noob thiab sawv hips yog tov nyob rau hauv sib npaug proportions. Ncuav ib tablespoon ntawm qhov sib tov no rau hauv ib lub thermos thiab ncuav 200 ml ntawm dej kub, tom qab ntawd nws raug tso cai rau brew rau ib teev. Tom qab ntawd cov infusion yuav tsum tau lim thiab haus 100 ml thaum sawv ntxov thiab yav tsaus ntuj.
  3. Decoction of elm bark. Ib diav ntawm crushed bark yog nchuav rau hauv 200 ml dej thiab boil rau 20 feeb, ces lub broth yuav tsum tau lim thiab noj txhua hnub rau 100 ml.

Peb tau saib cov tsos mob thiab kev kho mob ntawm sigmoid diverticulosis.

Pom zoo: