Nws yog dab tsi - plab hnyuv dolichosigma? Qhov no yog qhov txawv txav ntawm qhov ntev ntawm lub sigma, uas cov phab ntsa thickness tsis hloov, txoj kab uas hla ntawm txoj hnyuv tseem nyob li qub, thiab qhov ntev yuav nce. Sigma nyob rau tib lub sij hawm dhau los ua pathologically mobile thiab tsis tso cai rau cov quav tsim thiab txav mus ib txwm, motility thiab khoob khoob khoob. Vim nws qhov ntev ntev, nws tuaj yeem twist, quav rau hauv loops. Qhov ntev ntawm lub sigma yog 24-46 cm, nrog pre-chilosigma nws tshaj 46 cm thiab tsim ib qho ntxiv 2-3 loops.
Qhov tseem ceeb ntawm pathology
Dolichosigma hauv tus menyuam yuav tsis tshwm sim nws tus kheej hauv txhua txoj kev, thiab qee tus kws kho mob muab qhov no rau tus yam ntxwv ntawm lub cev. Yog hais tias xws li ib tug sigma ua rau cem quav thiab mob, tsim roj thiab intoxication ntawm lub cev, ces qhov no twb yog ib tug kab mob.
cem quav rau cov me nyuam yaus yog ib qho tshwm sim heev, nws yog ib qho teeb meem ntawm cov niam txiv thiab cov kws kho mob. Tab sis feem ntau qhov tshwm sim no yog txuam nrog kev noj haus, tshwj xeeb tshaj yog nyob rau hauv artificers. Yog hais tias cem quav yuav mus tas li, nws yogqhia tau hais tias mob plab hnyuv.
Dolichosigma raws li ICD-10
Dolichosigma hauv cov menyuam yaus raws li ICD-10 tsis muaj nws tus kheej txoj cai cais. Nws muaj ib txoj cai nrog cov pab pawg "Lwm yam congenital anomalies ntawm txoj hnyuv", nrog rau pathologies xws li caecum syndrome, plab hnyuv diverticula, dolichocolon, microcolon, megaloappendix, transposition ntawm lub appendix, megaloduodenum - Q 43.8.
YZoo mechanism
Yog li qhov no yog dab tsi - plab hnyuv dolichosigma? Nws yog kis tau thiab congenital. Rau cov menyuam yaus, qhov kev xaiv thib ob yog yam ntxwv, pathology tshwm sim txawm tias thaum lub sijhawm embryogenesis. Hauv qhov no, lub sigma muaj 2-3 lub voj voog ntxiv.
Kev kis tus kab mob tshwm sim hauv cov neeg laus dua 45 xyoos, feem ntau yog cov neeg uas coj txoj kev ua neej nyob tsis muaj zog thiab nyiam cov zaub mov muaj roj. Yog vim li cas dolichosigma tshwm sim nyob rau hauv ib tug me nyuam tseem tsis tau paub meej. Ib txhia hais txog kev phem kev qias. Lwm qhov tshwm sim ntawm dolichosigma hauv tus menyuam thaum lub sijhawm cev xeeb tub yog cuam tshuam nrog cov kab mob sib kis thaum cev xeeb tub lossis leej niam uas xav noj qee yam tshuaj. Tseem tsis tau muaj kev pom zoo los ntawm seb cov kab mob pathology yog qhov ua tsis zoo ntawm txoj hnyuv kawg.
Qee cov kws tshawb fawb xav txog cov kab mob pathological yog qhov sib txawv ntawm cov qauv, vim tias nws feem ntau tshwm sim thiab pom nyob rau hauv 25% ntawm cov menyuam yaus uas tsis muaj kev tsis txaus siab. Tab sis qhov sib txawv ntawm qhov kev xav no, muaj lwm yam - qhov cuam tshuam ntev ntawm lub sigma feem ntau nrog cov organic lossis kev ua haujlwm sib txawv hauv cov qauv ntawm ntu kawg ntawm sigma thiab lub qhov quav. NwsNws yog qhia nyob rau hauv mob o ntawm lub mucosa, plab hnyuv stasis, nce nyob rau hauv cov leeg nqaij fibers, thickening ntawm cov ntaub so ntswg mesenteric, puas intramural paj ganglia thiab ua txhaum ntawm cellular metabolism. Hauv lwm lo lus, dolichosigma ua rau cov kab mob degenerative ntawm txoj hnyuv thiab cuam tshuam nws txoj haujlwm.
Qhov laj thawj tseem ceeb ntawm qhov tshwm sim
Ua rau tsis paub, tab sis qhov xwm txheej tau txheeb pom:
- muaj teeb meem xeeb tub;
- kab mob thaum cev xeeb tub;
- hypovitaminosis thiab protein deficiency hauv leej niam txoj kev noj haus;
- kev ecology phem thaum leej niam cev xeeb tub - nce ntxiv tom qab hluav taws xob, roj paug, dej tsis zoo;
- tshuaj thaum cev xeeb tub.
Symptomatic manifestations
Hauv 70% ntawm cov neeg mob, cov tsos mob tshwm sim ua ntej xyoo. Hauv 30% ntawm cov neeg mob, cov quav tso zis tshwm sim thaum muaj hnub nyoog 3-6 xyoo. Thawj cov tsos mob ntawm dolichosigma hauv cov menyuam yaus feem ntau tshwm sim ntawm 6 lub hlis. Kev cem quav thiab stagnation ntawm cov quav tam sim ntawd tshwm sim nrog kev qhia txog thawj cov khoom noj ntxiv, nrog rau kev hloov mus rau kev pub mis nyuj.
cem quav yog qhov tsos mob tseem ceeb. Tus so ntawm lub tsev kho mob maj mam. Nws manifests nws tus kheej nyob rau hauv capriciousness, lethargy, quaj, tsis kam mus rau lub mis los yog zaub mov, pw tsaug zog tsis zoo thiab qw thaum nruab hnub. Cov tsos mob tsuas yog thaum tus me nyuam mus rau hauv chav dej xwb. Kev txo qis hauv kev tiv thaiv hauv zos yog tshwm sim los ntawm pustules me me ntawm daim tawv nqaij.
Tsis muaj quav rau 3-4 hnub, thiab plab zom mov ua teeb meem. Thaum xub thawj, lub plab zom mov tshwm sim txhua 3hnub, ib hlis ib zaug, thiab tom qab ib hlis.
Stagnation ntawm quav tshuaj lom lub cev, nws thickens, nce thiab kis tau ib tug fetid tsw ntawm lwj. Cov quav tawv, nrog rau lawv txoj kev ua haujlwm qeeb, ua rau lub qhov txhab ua paug, cov ntshav pib sib xyaw nrog lawv. Lub sigma yog stretched, thiab nws cov phab ntsa ua thinner. Qhov no yuav ua rau perforation. Yog tias enemas tau siv tas li, qhov voiding reflex txo qis.
Cov me nyuam laus muaj cov tsos mob raws li nram no:
- mob plab ib ncig ntawm lub dab teg lossis sab laug;
- cem quav;
- nausea;
- cov nails brittle;
- puab tsaig hauv kaum ntawm lub qhov ncauj;
- poob qis thiab tsis qab los noj mov (hypovitaminosis);
- ntsej muag daj;
- daim di ncauj xiav;
- flatulence;
- rumble;
- ua pa tsis zoo;
- nkag mus ntawm gastritis, mob pancreatitis, colitis, hemorrhoids.
Tus me nyuam zoo li nkees, feem ntau tsis kam noj, muaj lub plawv dhia ceev, tsis kam ua si. Vim cem quav thiab mob, tus me nyuam ntshai thov mus rau chav dej. Cov tsos mob tshwj xeeb yog hnyav dua tom qab noj mov lossis tawm dag zog.
Kawm kab mob
Dolichosigma tshwm sim nyob rau hauv peb theem lossis cov ntawv uas muaj qhov sib txawv ntawm qhov tshwm sim:
- Cov nyiaj them rau theem yog thawj zaug thiab yooj yim tshaj plaws. Kev cem quav tsis yog ib txwm cuam tshuam, lawv tshwm sim rau 3-4 hnub, lawv mus tom qab defecation, qhov mob tsis muaj zog. Cov xwm txheej tsis hloov pauv, tus me nyuam muaj zog heev. Cov theem tau yooj yim kho nrog kev noj haus thiab laxatives.
- Subcompensation stage - quav kuj tseem ploj lawm3 hnub, tab sis tam sim no mus tas li. Lub plab yog o, nws mob. Tus me nyuam noj tsis zoo, tsis hnyav thiab chim siab. Laxatives tsis txaus, koj yuav tsum siv enemas. Thawj cov cim qhia ntawm intoxication ntawm lub cev tshwm sim.
- Decompensation theem - tag nrho cov tsos mob yog ci, khiav. Constipation yog ntev, intoxication yog pronounced: mob taub hau, tsis qab los noj mov, daim tawv nqaij ua pob, xeev siab thiab ntuav, anemia thiab lethargy. Lub plab yog o tas li thiab mob txhua lub sijhawm. Npua ib lub lim tiam lossis ib hlis. Tej zaum yuav muaj cov tsos mob ntawm ib feem ntawm txoj hnyuv. Enemas yuav tsum tau siv tsuas yog siphon. Kev kho mob zoo tsuas yog phais xwb.
ntsuas ntsuas
Kev kuaj mob ntawm dolichosigma hauv cov menyuam yaus yog ua tom qab kuaj xyuas cov ntshav, quav, cov txheej txheem tshawb fawb. Ua ntej, kev kuaj pom pom pom qhov tsis muaj qhov hnyav thiab pallor ntawm tus menyuam, tev ntawm daim tawv nqaij ntawm tus ntiv tes vim yog beriberi.
Palpation xav tias lub plab puv hauv lub voj. Kev kuaj digital qhia tau tias lub qhov quav tsis muaj.
Irrigography yuav pab txheeb xyuas qhov degree thiab tus lej ntawm lub voj voos, qhov loj ntawm sigma. Cov loops ntxiv tuaj yeem ua "yim", "snail", "knot".
CT yog siv rau kev kuaj mob hauv cov menyuam yaus. Cov txheej txheem no tso cai rau koj los txiav txim siab volumetric formations. Kev kuaj CT tsis tuaj yeem ua tau rau cov menyuam yaus vim lawv txav mus los.
Ultrasound, X-ray, irrigoscopy, colonoscopy, general and biochemical blood tests, fecal analysis for worm egg and the available of occult bleeding is also prescribed. plab hnyuv ultrasoundpuv nrog cov quav tawv. Cov kev tshuaj xyuas hais li cas txog kev kuaj dolichosigma hauv tus menyuam? Ntau tus niam txiv txhawj xeeb tias qhov txheej txheem no ua rau tsis xis nyob thiab mob rau tus menyuam. Ntau leej niam categorically tsis mus rau qhov tseeb vim hais tias tus me nyuam tsuas yog tsis muaj peev xwm tiv tau tus txheej txheem thiab ntshai. Lwm tus ntseeg tias barium siv rau barium enema yuav ua rau muaj menyuam tsis taus rau tus ntxhais yav tom ntej. Qee tus xav tias barium yog qhov qias neeg, thiab txawm tias tus neeg laus tsis haus nws.
Txhua yam kev ntshai no tsis muaj tseeb. Ntau tus zam cov txheej txheem yooj yim. Ntxiv mus, thaum lub sij hawm colonoscopy, piv txwv li, cov menyuam yaus tau txais tshuaj loog luv luv.
Cov teeb meem ntawm dolichosigma
Thaum tsis muaj kev saib xyuas thiab kho, nws tau sau tseg:
- ncua kev loj hlob ntawm lub cev;
- ntshav qab zib;
- kab mob pustular;
- plab hnyuv vim pob zeb;
- mob plab.
Txoj Cai Kho Mob
Kev kho mob plab hnyuv dolichosigma hauv cov menyuam yaus yog ua los ntawm kws kho mob plab menyuam.
Lub hom phiaj ntawm kev kho:
- quav quav normalization.
- Txhim quav quav.
- Rov pib lub plab zom mov los ntawm kev ua kom lub plab zom mov.
- Kev tshem tawm cov mob hnyav.
Rau cov pob zeb crushing fecal, lub plab zaws thiab kev kho mob yog siv. Qhov no ua rau cov ntshav khiav mus rau cov hnyuv thiab ntxiv dag zog rau cov leeg nqaij. Txhawm rau txhim kho txoj haujlwm ntawm cov hnyuv, physiotherapy yog muab. Kev kho mob pib nrog kev noj haus thiab kev noj haus.
Special Diet
Yuav tsum tau muab dej thiab dej haus. Koj yuav tsum haus dej tsawg kawg 10 khob dej ib hnub. Khoom noj khoom haus yuav tsum yog feem ntau - 5-6 zaug ib hnub twg, nyob rau hauv me me, nruj nyob rau hauv lub sij hawm. Dej nrog txiv qaub pab kom loosen cov quav. Cov nqaij yog txwv tsis pub, ib khob ntawm 1% kefir yog xav tau.
Me nyuam cov zaub mov nrog dolichosigma: ntau cov khoom noj uas muaj fiber ntau (berries, tshuaj ntsuab, txiv hmab txiv ntoo). Lawv cov kev kho cua sov yog tsim nyog - boiling los yog steaming. Txhua yam uas tau them nrog lub qab qab zib, nrog rau kib, haus luam yeeb, ntsim, tsis suav nrog. Cov tais diav uas maj mam txav ntawm cov quav los ntawm txoj hnyuv kuj yog contraindicated - mov, semolina, millet, pasta, qhob cij dawb, muffins, ncuav qab zib thiab ncuav qab zib, kas fes, cocoa, tshuaj yej muaj zog. Tsiaj cov rog nce fermentation thiab tsis zoo digested. Hais txog chocolate: nws tuaj yeem muab tsis tshua muaj, tsis yog ib teev ua ntej noj mov thiab tom qab nws.
YKoj tuaj yeem muab rau koj tus menyuam ntses, tsev cheese, khoom noj siv mis, buckwheat porridge, zaub xam lav, zaub mov noj. Bran yog pom zoo, beets, prunes, carrots, figs, taub dag, ci apples, apricots, plums, qhuav apricots yog qhia los ntawm zaub thiab txiv hmab txiv ntoo. Los ntawm cov khoom qab zib koj tuaj yeem compotes, txwv zib mu, marmalade (muaj pectins).
Txiv tsawb, txiv hmab txiv ntoo thiab txiv ntoo tsis suav nrog. Vim muaj kev xaiv tsawg ntawm cov khoom, cov khoom noj rau dolichosigma hauv cov menyuam yaus tau ntxiv nrog cov vitamins C, A, E, pawg B, D. Lawv yuav txhawb kev tiv thaiv kab mob.
kev kho mob
Cov lus qhia kho mob rau dolichosigma hauv cov menyuam yaus suav nrog:
- tshuaj ntsuab enemas, laxatives (ntau quav quav), prokinetics, txhais tau tias txokala.
- "Motilium". Nws ua rau kom khiav tawm ntawm cov zaub mov bolus. Nws tau teem sijhawm rau 2 lub lis piam.
- Yog tias kev noj zaub mov tsis ua haujlwm, siv tshuaj laxatives, thiab pib nrog tsawg kawg nkaus.
- Mob plab thiab flatulence raug tshem tawm los ntawm "Dibazol" thiab "Prozerin" hauv kev txhaj tshuaj. "Proserin" kuj nce lub suab ntawm cov hnyuv phab ntsa. Cov nyhuv nce ntau zaus yog tias nws ua ke nrog hluav taws xob stimulation ntawm txoj hnyuv loj.
- Anspasmodics tsis muaj txiaj ntsig, vim qhov mob tsis yog tshwm sim los ntawm spasm, tab sis los ntawm txoj hnyuv atony.
- Ib kauj ruam tseem ceeb yog txhawm rau txhim kho plab hnyuv microflora, uas tau sau ua ntej thiab probiotics: Bifidumbacterin, Lactobacterin, Narine, Linex, thiab lwm yam.
- Thaum kev kho mob plab hnyuv dolichosigma hauv cov menyuam yaus, tus kws kho mob tau sau ntawv "Duphalac", "Psyllium", "Mukofalk" (cov tshuaj no yog los ntawm lub plhaub ntawm cov noob psyllium), "Duspatalin", "Festal" los txhim kho. nyob zoo. Lawv qhov kev txiav txim yog ntau yam: nce lub suab ntawm lub plab hnyuv, liquefaction ntawm quav, nce plab hnyuv motility.
Cov txiaj ntsig ntawm kev kho mob tuaj yeem txhim kho los ntawm cov tshuaj ntsuab decoctions thiab infusions, tab sis tsuas yog tom qab sab laj nrog kws kho mob. Cov tshuaj kuj siv los txo qhov mob plab, txo qhov tsis hnov tsw ntawm quav.
Txoj kev kho lub cev
Physiotherapy rau dolichosigma hauv cov menyuam yaus yog qhov tseem ceeb vim nws tuaj yeem ua rau lub plab zom mov zoo. Cov hauv qab no suav hais tias siv tau:
- hluav taws xob stimulation ntawm txoj hnyuv rau 2 lub lis piam nrog cem quav ntev;
- laser kho;
- kub;
- electrophoresis nrog cov tshuaj tonic.
Tus cwj pwm ntawm txoj hnyuv hydrotherapy yog qhov tsis zoo vim muaj ntau yam teeb meem.
Siv enemas
Ib qho tshuaj txhuam hniav yog ua tiav nrog dej huv lossis dej ntsev, chamomile decoction. Kev xav kom tsis muaj dab tsi tshwm sim raws li kev xav. Qhov ntim dej nyob ntawm lub hnub nyoog ntawm tus menyuam. Qhov kub ntawm cov tshuaj yuav tsum tsis txhob txawv ntawm qhov kub ntawm tus menyuam lub cev.
Tus menyuam tau muab tso rau ntawm sab xis, lub hau ntawm lub enema yuav tsum tau lubricated nrog roj vaseline. Tom qab qhia cov kua, lub pob tw yuav tsum tau nyem thiab tus me nyuam cem rau 10 feeb, tom qab ntawd tus me nyuam yuav tsum tau cog rau ntawm lub lauj kaub.
Enemas, txawm tias lawv ua tau zoo, yuav tsum tau siv tsawg li tsawg tau, nws yog qhov zoo dua los tsim cov reflex kom defecate kom mus rau chav dej txias.
Qhov txiaj ntsig ntawm massage yog dab tsi
Massage rau dolichosigma hauv tus menyuam yog qhov yuav tsum tau ua ntawm kev kho mob. Nws tsis yog ua tiav nrog cov ntshav hauv cov quav xwb. Cov me nyuam xav tau lub nraub qaum thiab plab zaws txhua hnub kom ntxiv dag zog rau lawv cov leeg.
Cov txheej txheem tau ua thaum muab tus menyuam tso rau ntawm lub plab. Nrog ob tus ntiv tes, maj mam ua kom muab kauv txav raws tus txha nraub qaum los ntawm sab nraub qaum thiab nqes mus rau coccyx. Lub plab yog massaged nyob rau hauv lub voj voog clockwise. Kev zaws yuav tsum zoo siab rau tus menyuam, txwv tsis pub nws yuav tsis muaj lwm yam tshwm sim dua li qw thiab quaj.
Qhov pib thiab xaus ntawm cov txheej txheem - nyob rau hauv daim ntawv ntawm stroking thiab rubbing. Massage txav yuav tsum qeeb,nias.
Tapping nrog ntiv tes phalanges hauv kev txiav txim rov qab. Tag nrho cov txheej txheem yuav siv sijhawm tsawg kawg 20 feeb. Nws yog qhov zoo dua los zaws thaum sawv ntxov, ua ntej pub mis.
Kev kho mob qoj ib ce yog qhia rau cov menyuam yaus. Nws yog qhov zoo dua yog tias cov no yog cov chav kawm pab pawg, qhov twg cov menyuam yaus saib ib leeg. Tom qab ntawd lawv rov ua qhov txav ntawm lawv cov neeg nyob ze thiab kawm sai dua. Txhawb kev ua haujlwm ntawm cov hnyuv kuj dhia rau hauv qhov chaw nrog hlua, khiav, tig lub hoop.
Surgery
Yog tias ntau txoj hauv kev ntawm kev saib xyuas kev kho mob tsis qhia cov txiaj ntsig zoo thiab tus kab mob txuas ntxiv mus ntxiv, muaj kev quav tshuaj rau enemas, kev haus luam yeeb tau tshaj tawm thiab nthuav dav ntxiv, mus rau txoj kev kho mob radical.
Kev ua haujlwm rau dolichosigma hauv tus menyuam tuaj yeem pom zoo los ntawm tus kws kho mob tsuas yog mob hnyav xwb.
Indications rau kev phais:
- tsis muaj qhov zoo ntawm qhov zoo los ntawm kev saib xyuas kev kho mob;
- pronounced qaug cawv;
- plab hnyuv;
- nias ib feem ntawm cov yeeb nkab mus rau lwm qhov - "pob ntim khoom";
- sigma twists, spikes thiab kinks;
- muaj pob zeb quav.
Kev ua haujlwm tsuas yog ua rau theem 3 ntawm tus kabmob. Contraindications rau kev phais: mob hnyav pathologies ntawm lub hauv paus paj hlwb thiab cov hlab plawv system.
Kev phais yog ua raws li kev siv tshuaj loog. Tsis tsim nyog loops ntawm sigmoid nyuv raug txiav tawm thiab qhov kawg yog sutured - sab sauv thiab qis.
Sigma resection phaishu ua proctosigmoidectomy. Yog tias xav tias plab hnyuv txhaws, tag nrho cov hnyuv raug tshuaj xyuas, vim hais tias qhov sib tw ntawm lub voj voog txav tau compresses thiab cuam tshuam cov khoom noj khoom haus ntawm cov hnyuv, ua rau cov nqaij mos necrosis. Tom qab ntawd ib feem ntawm qhov ntau dhau sigma thiab lwm ntu ntawm txoj hnyuv raug tshem tawm.
Lub sijhawm ua haujlwm 1.5 teev. Tshem tawm cov voj voog ntau dhau tso cai rau cov quav kom dhau los ntawm cov hnyuv ib txwm. Tom qab muaj kab mob, kev kho mob spa yog qhov muaj txiaj ntsig zoo rau kev rov zoo dua thiab sai dua.
Dab tsi yog qhov kev kwv yees
Kev noj haus, noj cov tshuaj kws kho mob yuav pab tau tus menyuam hauv thawj ob theem. Qhov no yuav ua rau cov quav tsis tu ncua.
Nyob rau theem 3, kev txiav txim siab yog tus kheej, nws txiav txim siab los ntawm ntau yam. Teeb meem tshwm sim thaum cov txheej txheem tsis quav ntsej lawm. Thaum kawg, fecal pawg tau tsim, uas tuaj yeem tsis tuaj yeem tawm ntawm lawv tus kheej. Nyob rau tib lub sijhawm, cov zaub mov pov tseg rots thiab lub cev raug lom. Qhov kev kwv yees nyob rau hauv cov xwm txheej zoo li no tsis zoo.
ntsuas kev tiv thaiv
Raws li kev tiv thaiv, kev noj zaub mov uas muaj fermented mis nyuj thiab cov zaub xam lav yog pom zoo. Koj yuav tsum haus dej kom ntau, ua haujlwm, taug kev ntau hauv huab cua ntshiab.
Tom qab noj mov, qhov zaws ntawm lub plab yog qhov xav tau, tshwj xeeb tshaj yog rau cov menyuam mos. Cov zaub mov yuav tsum yog feem ntau, tsis muaj overeating. Raws li ntau tus niam txiv, teeb meem nrog cov quav hauv lub caij ntuj sov hauv tus menyuam ploj los yog pom tau tias txo qis. Kev tshuaj xyuas zoo txog Microlax thiab Dufalac.
