Cov kab mob ua rau daim siab yog qhov txaus ntshai vim lawv tuaj yeem ua rau muaj qhov tshwm sim loj, qee zaum nce mus txog sepsis thiab tuag. Los ntawm txoj kev, tus kab mob no tuaj yeem yog thawj thiab theem nrab. Raws li kev txheeb cais, ib qho abscess tshwm sim tawm tsam keeb kwm ntawm lwm yam kab mob siab tsis ntau dua li ntawm 3-5% ntawm cov neeg mob.
Txawm li cas los xij, ntau tus neeg txaus siab rau cov lus nug txog kev kho mob zoo li no, vim tias pom kev ua txhaum sai sai, tus neeg yuav tau txais kev kho mob sai. Yog li ntawd, tib neeg lub siab nyob qhov twg thiab dab tsi yog qhov ua rau nws puas tsuaj? Yuav ua li cas txheeb xyuas thawj cov cim qhia ntawm tus kab mob abscess? Cov teeb meem dab tsi tuaj yeem ua rau tus kab mob? Puas tsim nyog kev phais lossis tus kab mob puas tuaj yeem kho nrog cov tshuaj tiv thaiv? Cov lus teb rau cov lus nug no txaus siab rau ntau tus nyeem.
Abscess: nws yog dab tsi?
Ib txwm, ntau tus neeg xav nkag siab cov ntsiab lus anatomical thiab cov lus piav qhia ua ntej. Tib neeg lub siab nyob qhov twg? Qhov no yog lub cev loj nyob rau sab xis sab xis ntawm lub plab (txoj cai hypochondrium).
Nws tsim nyog sau cia tias, vim tsis muaj qhov mob receptors hauv lub cev, qee lub siab puas tuaj yeem thiabtsis txhob nrog lub cev tsis xis nyob los yog mob. Yog li ntawd, nws tsim nyog ua tib zoo saib xyuas kev ua haujlwm ntawm tag nrho cov kab mob. Lub cev tseem ceeb no ntxuav tib neeg cov ntshav ntawm cov co toxins thiab cov khoom tsis zoo, koom nrog hauv cov metabolism, yog glycogen depot (lub zog reserves), tsim cov kua tsib acids thiab tswj kev zom zaub mov.
Hmoov tsis zoo, qee cov neeg tau ntsib nrog qhov kev kuaj mob nyuaj xws li abscess. Nws yog dab tsi? Qhov no yog purulent o ntawm cov ntaub so ntswg, uas yog nrog los ntawm lawv li-hu ua melting. Raws li qhov tshwm sim ntawm cov txheej txheem no, ib kab noj hniav yog tsim nyob rau hauv lub abscess, qhov twg purulent masses pib mus sau. Raws li nws tsim, tsim kom loj tuaj, thiab qee zaum nws tuaj yeem tawg, tso cov ntsiab lus purulent.
Raws li kev tshawb fawb txheeb cais, daim siab abscesses feem ntau yog tshwm sim los ntawm lwm yam kab mob ntawm lub cev. Cov txiv neej raug kev txom nyem los ntawm cov kab mob no me ntsis ntau dua li poj niam. Tus kab mob no feem ntau tshwm sim hauv cov cheeb tsam uas tsis huv thiab dej qias neeg. Cov pab pawg no suav nrog Chile, Brazil, Peru, Is Nrias teb, Tibet, Nepal, Pakistan, Iraq, Iran, South African lub tebchaws.
kab mob kev faib tawm
Hnub no, muaj ntau yam kev faib tawm rau cov kab mob no. Piv txwv li, daim siab abscesses tuaj yeem yog thawj (cov txheej txheem purulent hauv parenchyma ntawm lub siab noj qab haus huv) thiab theem nrab (tshem tawm tsam keeb kwm ntawm lwm yam kab mob). Nyob ntawm qhov xwm txheej ntawm tus kab mob,Cov kab mob muab faib ua kab mob thiab kab mob.
Yog tias peb coj txoj kev kis tus kabmob raws li kev ntsuas, ces lawv txawv:
- hematogenous abscesses (kev kis tau los ntawm cov hlab ntsha);
- cholangiogenic cov ntaub ntawv ntawm tus kab mob (cov kab mob los ntawm cov kab mob biliary);
- kev sib cuag (mob kis los ntawm cov kabmob nyob ze);
- kev puas tsuaj tom qab (peb tab tom tham txog qhov teeb meem tom qab raug mob lossis phais);
- cryptogenic (qhov ua rau cov ntaub ntawv ntawm pathology tsis nkag siab tag nrho).
daim siab ua paug tuaj yeem yog ib leeg lossis ntau yam, loj lossis me. Muaj cov ntaub ntawv nyuaj thiab tsis yooj yim ntawm tus kab mob.
Kev Mob Siab: Ua rau
Qhov feem ntau ua rau kev loj hlob ntawm cov txheej txheem purulent inflammatory yog nkag mus rau hauv cov ntaub so ntswg ntawm tus kab mob. Raws li txoj cai, lub luag haujlwm ntawm cov kab mob yog ua los ntawm cov kab mob kab mob, suav nrog E. coli, staphylococci, streptococci thiab lwm yam.
Tsis tas li ntawd, cov kab mob parasitic puas tuaj yeem ua tau. Piv txwv li, amoebic daim siab abscess (ib hom kab mob tropical ntawm tus kab mob) yog dav paub. Tsis tas li ntawd, purulent o tuaj yeem tsim tawm tsam keeb kwm ntawm kev cuam tshuam los ntawm roundworms, echinococci, alveococci.
Yog li, ib qho abscess thiab, vim li ntawd, daim siab ua haujlwm tsis zoo tuaj yeem txhim kho thaum:
- Kev nkag mus ntawm cov kab mob mus rau hauv daim siab los ntawm txoj hlab pas biliary. Qhov no tau pom nyob rau hauv cov kab mob xws li cholangitis, cholelithiasis, cholecystitis, mob qog noj ntshav ntawm cov duct.
- Kab mob tuaj yeem nkag mus nrog cov ntshav ntws los ntawm lub portal lossis kab mob siab. Cov kab mob abscess tuaj yeem ua rau muaj mob septic lesions ntawm lub plawv, plab hnyuv, spleen, plab, pancreas.
- Qee lub sij hawm cov kab mob nkag mus rau cov ntaub so ntswg thiab cov hlwb ntawm lub siab thaum muaj cov kab mob sib kis ntawm cov kab mob nyob ze. Yog li ntawd, muaj feem yuav muaj xws li appendicitis, diverticulosis (mob ntawm lub connective ntaub so ntswg partitions ntawm txoj hnyuv loj), ulcerative colitis, o ntawm lub peritoneum, purulent peritonitis.
- Kev ua paug tuaj yeem yog qhov tshwm sim ntawm kev raug mob rau lub siab, xws li kev raug mob ntawm lub plab.
- Cov kab mob kis tau tuaj yeem tshwm sim thaum phais plab.
Thawj cim kab mob
Daim siab ua paug ua rau nws tus kheej li cas? Cov tsos mob tuaj yeem muab faib ua ob pawg. Nyob rau hauv thaum ntxov lub sij hawm ntawm kev loj hlob ntawm tus kab mob, cov cim qhia ntawm intoxication ntawm lub cev yog mas manifested. Ua ntej, raws li txoj cai, muaj kub taub hau, tsis muaj zog, ua daus no, mob lub cev. Tus neeg mob yws yws ntawm qhov qaug zog tas li thiab tsaug zog, kiv taub hau, tinnitus, mob taub hau. Kev tshaib plab poob qis.
Tom qab ntawd cov tsos mob tau tshaj tawm. Piv txwv li, ib tug tuaj yeem soj ntsuam qhov tso tawm ntawm ntau cov hws nplaum. Tsis pom kev tsis pom kev, hnov lus tsis txaus ntseeg, thiab kev nco kuj tuaj yeem ua tau. Cov neeg mob yws ntawm xeev siab tas li. Qee lub sij hawm muaj ntuav, thiab cov ntsiab lus ntawm txoj hnyuv.
Cov tsos mob ntawm tus kab mob Abscess txuam nrogLub siab ua haujlwm tsis zoo
Raws li tus kab mob no tshwm sim, lwm yam kab mob koom nrog cov tsos mob ntawm intoxication. Raws li txoj cai, lawv qhia tias muaj kev ua txhaum loj ntawm daim siab ua haujlwm twb muaj lawm.
Cov neeg mob pib yws ntawm qhov mob ntawm txoj cai hypochondrium. Thaum xub thawj, qhov no tsuas yog tsis xis nyob, uas dhau los ua ntau thiab ntau tshaj tawm thaum lub abscess loj hlob. Kev mob yuav hnyav zuj zus nyob ntawm kev noj zaub mov, kev ua lub cev, kev kho tshuaj rau lwm yam kab mob, thiab lwm yam.
Vim poob qab los noj mov, xeev siab thiab ntuav, nws maj mam txo qis hauv lub cev. Thaum kuaj lub cev, koj tus kws kho mob tuaj yeem kuaj xyuas hepatomegaly (lub siab loj) thiab splenomegaly (qhov loj ntawm tus po).
Ntawm qhov tod tes, qee cov neeg mob qhia qhov hnyav nce sai, uas cuam tshuam nrog kev loj hlob ntawm ascites. Cov kua dej dawb pib nkag mus rau hauv lub plab kab noj hniav, yog li cov neeg mob muaj qhov nce ntxiv, txawm tias lub plab zom mov.
Cov tsos mob ntawm tus kab mob no suav nrog yellowness ntawm daim tawv nqaij, uas cuam tshuam nrog kev loj hlob ntawm jaundice. Feem ntau, tawm tsam keeb kwm ntawm cov kab mob no, qhov tshwm sim lossis exacerbation ntawm hemorrhoids tau pom. Yog hais tias o ntawm daim siab cov ntaub so ntswg yog nrog los ntawm ib tug nce nyob rau hauv lub siab nyob rau hauv cov hlab ntsha, ces los ntshav los ntawm cov hlab ntsha ntawm lub plab hnyuv ib ntsuj av tau. Cov teeb meem zoo li no tuaj yeem tshwm sim nws tus kheej, piv txwv li, los ntawm ntuav, uas zoo li lub hauv paus kas fes hauv qhov sib xws, lossis los ntawm kev tsim cov quav dub, tarry quav.
Cov txheej txheem kuaj mob niaj hnub
Yog tias koj muaj tsos mob, mus ntsib kws kho mob tam sim ntawd. Ib tug purulent abscess yog incredibly txaus ntshai. Qhov sai dua tus neeg mob tau txais kev pab tsim nyog, qhov muaj feem yuav rov qab tau zoo dua.
Pib nrog, tus kws tshaj lij yuav paub txog cov lus tsis txaus siab ntawm tus neeg, ua qhov kev ntsuam xyuas dav dav. Hauv cov txheej txheem ntawm kev kuaj mob, kev tshuaj ntsuam xyuas yog qhov tseem ceeb heev. Piv txwv li, thaum kuaj ntshav dav dav, qhov txo qis hauv hemoglobin qib, txo qis ntawm erythrocytes thiab platelets tuaj yeem raug sau tseg. Nrog rau qhov no, theem ntawm ESR nce, tus lej ntawm leukocytes nce ntau, uas nyob rau hauv nws tus kheej qhia tias muaj qhov mob.
Thaum muaj abscess feem ntau pom cov zis tsaus nti. Thaum kuaj hauv chav kuaj, koj tuaj yeem pom muaj cov qe ntshav liab thiab cov qe ntshav dawb txawv txav. Kev kuaj mob siab kuj tau ua tiav, thaum lub sijhawm nws muaj peev xwm ua ntej ntawm qhov nce qib ntawm alkaline phosphatase, ncaj qha thiab tag nrho bilirubin. Qee lub sij hawm ua ib qho coagulogram ntxiv, uas, nrog rau daim siab abscess, qhia txog qhov txo qis hauv cov ntshav txhaws. Tus kab mob no yog yus muaj los ntawm discoloration ntawm cov quav. Kev kuaj quav tuaj yeem kuaj pom muaj ntshav.
Kev tshawb fawb instrumental kuj yog ib theem tseem ceeb ntawm kev kuaj mob. Qhov nrov tshaj plaws thiab pheej yig tshaj plaws yog x-ray ntawm lub plab kab noj hniav, uas tuaj yeem pom muaj cov kab noj hniav sib npaug nrog cov npoo ntshiab nyob hauv daim siab parenchyma - qhov no yog ib qho abscess. Nrog kev pab los ntawm cov khoom siv ultrasound, nws muaj peev xwm ua kom paub tseeb tias qhov kev kuaj mob thiab txiav txim siab qhov loj ntawm qhov tsim purulent.
Zoo meej, tab sis kujKev kuaj mob xws li suav tomography thiab cov duab sib nqus resonance yog kim. Cov txheej txheem zoo li no pab txhawm rau txheeb xyuas qhov tseeb, txiav txim siab qhov chaw nyob, tus lej thiab qhov loj ntawm cov abscesses, thiab qee zaum txawm txiav txim siab qhov ua rau ntawm kev txhim kho ntawm cov txheej txheem inflammatory. Qee lub sij hawm cov neeg mob kuj tau muab tshuaj rau biopsy - thaum lub sijhawm ua haujlwm, cov ntsiab lus sab hauv ntawm cov neoplasm raug txheeb xyuas, ua raws li kev tshuaj xyuas hauv chav kuaj.
Ntau zaus tsawg dua, kuaj mob laparoscopy yog ua, thaum tus kws kho mob tshuaj xyuas cov kab mob hauv nruab nrog cev (qhov no, lub siab) siv cov koob yees duab tshwj xeeb tso rau hauv los ntawm kev sib tsoo ntawm phab ntsa plab. Cov txheej txheem yog qhov txaus ntshai heev, vim tias muaj kev pheej hmoo siab ntawm kev puas tsuaj rau cov abscess nrog ib qho instant outpouring ntawm purulent masses.
Yuav ua li cas nyuaj?
daim siab abscesses yog ib yam mob loj uas yuav tsum tsis txhob ignored. Yog tias tsis kho, qhov tsim yuav tawg, tso cov ntsiab lus purulent tawm sab nraud. Raws li qhov tshwm sim ntawm qhov kev puas tsuaj tuaj yeem yog purulent gastritis (cov ntsiab lus purulent nkag mus rau hauv cov ntaub so ntswg ntawm lub plab), peritonitis (tom qab rupture, purulent pawg kis thoob plaws hauv lub plab kab noj hniav), pleurisy (cov ntsiab lus ntawm abscess nkag mus rau hauv pleural kab noj hniav), pericarditis (kua paug nyob rau hauv lub pericardial kab noj hniav, uas yog heev txaus ntshai rau lub plawv). cov leeg), enteritis (tawg tsim tshwm sim nyob rau hauv cov hnyuv).
Muaj lwm yam teeb meem loj sib npaug. Piv txwv li, tiv thaiv keeb kwm yav dhau los ntawm kev tawg, ib qho subdiaphragmatic abscess tuaj yeem tsim, nyob rau hauv uas muaj ntau cov purulent masses sau ncaj qha rau hauv lub diaphragm. Qhov tshwm sim tuaj yeemnqa hnyav ntshav poob vim los ntshav los ntawm daim siab. Qee lub sij hawm cov neeg mob tsim ascites, uas yog nrog los ntawm kev sib sau ntawm cov kua dej ntau hauv lub plab kab noj hniav. Raws li qhov tshwm sim ntawm qhov tshwm sim ntawm qhov loj me, qhov kev kub siab portal tuaj yeem ua tau - ib qho mob uas cuam tshuam nrog kev nce ntshav siab hauv cov hlab ntsha portal, uas, dhau los, nrog los ntshav los ntawm cov hlab ntsha ntawm txoj hnyuv.
Raws li koj tau pom, kab mob siab tsis yog ib yam uas yuav tsum tau ua me ntsis. Yog tias koj muaj cov tsos mob me me, koj yuav tsum sab laj nrog kws kho mob.
kho mob ntawm abscess
Cov kws kho mob muab dab tsi rau cov neeg mob kuaj pom tias muaj kab mob siab? Kev kho mob ntawm cov theem pib tuaj yeem kho mob, tshwj xeeb tshaj yog tias cov txheej txheem inflammatory maj mam, cov neoplasm tsis loj hlob, tsis muaj kev pheej hmoo ntawm nws qhov tawg.
Ua ntej ntawm tag nrho, kev kho mob yog txhawm rau tshem tawm qhov ua rau mob, piv txwv li, tshem tawm cov kab mob. Thaum kuaj mob, cov kws kho mob tswj xyuas kom paub tias nyob rau hauv qhov cuam tshuam ntawm cov kab mob tshwj xeeb uas tshwm sim. Yog tias nws yog cov kab mob ntawm cov kab mob, ces cov tshuaj tua kab mob tau sau tseg. Cov txiaj ntsig zoo tshaj plaws niaj hnub no yog tiam thib peb cephalosporins (Cefoperazole, Ceftriaxone), tiv thaiv penicillins (Amoxiclav, Augmentin), thib peb- lossis plaub tiam fluoroquinolones (Ciprofloxacin, Levofloxacin, Norfloxacin).
Yog tias qhov abscess cuam tshuam nrog kev ua haujlwm ntawm cov kab mob cab, tom qab ntawd tus neeg mob tau txais kev kho mob antiprotozoal, tshwj xeeb, noj metronidazole lossis nws cov analogues. Ib zaugNws yuav tsum raug sau tseg tias kev kho mob yog nqa tawm hauv tsev kho mob. Kev noj tshuaj thiab koob tshuaj tsuas yog txiav txim los ntawm tus kws kho mob tuaj koom.
Ntxiv rau, nyob ntawm tus neeg mob tus mob, cov tshuaj kho mob tau sau tseg:
- kev tshem tawm muaj xws li kev tswj hwm ntawm Ringer cov tshuaj lossis 5% qabzib;
- nyob rau hauv lub xub ntiag ntawm qhov mob hnyav, tshuaj xws li No-shpa (relieves spasm) thiab Ibuprofen (relieves mob thiab kub taub hau, inhibits txoj kev loj hlob ntawm inflammatory txheej txheem) yog sau;
- nws tseem yuav tsum tau noj enterosorbents, piv txwv li, "Smecta" ntawm pluas noj;
- nyob rau hauv lub xub ntiag ntawm cov ntshav los, sodium etamsylate yog tshuaj, uas txwv tsis pub ntshav;
- Yog tus neeg mob mob ntuav ntuav, tuaj yeem muab tshuaj tiv thaiv emetics xws li Metoclopromide lossis Cerucal.
Kev phais: thaum twg nws xav tau?
Qee zaum, kev kho tshuaj tsis tuaj yeem tshem tawm daim siab ua paug. Kev ua haujlwm yog tsim nyog nyob rau hauv cov xwm txheej zoo li no. Tsis tas li ntawd, kev phais yog qhov yuav tsum tau ua rau thaum muaj xwm txheej ceev (xws li kev tawg ntawm qhov abscess).
Hnub no, muaj ntau txoj hauv kev kho mob phais. Qhov yooj yim tshaj yog cov kua dej ntawm abscess. Lub ntsiab ntawm cov txheej txheem yog raws li nram no: los ntawm me me incisions, ob lub raj tshwj xeeb yog muab tso rau hauv lub abscess kab noj hniav. Los ntawm ib tug ntawm lawv, ib tug tov nrog ib tug antibacterial tshuaj yog tas li muab, thiab los ntawm lwm yam, cov ntsiab lus ntawm purulent tsim yog muab tshem tawm mus rau sab nraud. Feem ntau,Txoj kev kho no kav li 3-4 hnub.
Hmoov tsis zoo, cov txheej txheem no tsis ua haujlwm thaum lub pob khaus tawg lossis muaj ntau qhov txhab. Hauv qhov no, laparotomy tau ua. Tus kws phais tau nkag mus rau daim siab los ntawm kev phais hauv lub plab kab noj hniav. Thaum lub sijhawm ua haujlwm, txhua qhov abscess qhib, tom qab ntawd, siv lub tshuab nqus dej, cov ntsiab lus purulent raug tshem tawm. Cov tshuaj ntsiav khoob yog ntxuav nrog tshuaj tua kab mob, thiab tom qab ntawd tshem tawm, thaum suturing daim siab noj qab haus huv. Lawm, xws li kev ua haujlwm yog qhov txaus ntshai dua (muaj kev pheej hmoo ntawm kev kis kab mob) thiab siv sijhawm ntev, thiab lub sijhawm kho kom rov zoo siv sijhawm ntev. Txawm li cas los xij, qee zaum, qhov no yog tib txoj hauv kev los cawm tus neeg mob txoj sia.
Los ntawm txoj kev, nrog rau kev phais, kev kho tshuaj feem ntau ua. Nws tseem tsim nyog sau cia tias kev noj tshuaj rau tus kheej rau tus kab mob no yog txwv tsis pub, txij li kev kho tsis tau tshuaj, txawm tias tshuaj ntsuab decoction, tuaj yeem ua rau qhov xwm txheej hnyav dua. Tsuas yog tus kws kho mob uas tuaj koom tau tso cai los sau tshuaj.
Kev noj haus rau abscess
Vim lub siab yog ib qho khoom nruab nrog uas txuas ncaj qha nrog lub plab zom mov thiab cov kab mob hematopoietic, khoom noj khoom haus tseem ceeb heev rau tus neeg mob uas muaj qee yam mob. Kev noj zaub mov kom raug yuav ua kom cov txheej txheem kho sai, pab lub cev rov qab los ntawm kev phais, thiab tiv thaiv kev rov qab los.
Cov neeg mob thaum lub sijhawm thiab tom qab kev kho mob abscess tau pom zoo kom hloov mus rau cov zaub mov feem ntau - koj yuav tsum noj ntau zaus (txog 6-7 zaug hauv ib hnub), tab sis feem yuav tsum me me. Qhov no yuav ua rau cov txheej txheem yooj yim duadigestion thiab pab tiv thaiv kev loj hlob ntawm putrefaction thiab fermentation nyob rau hauv cov hnyuv.
Los ntawm kev noj zaub mov koj yuav tsum tsis suav cov khoom noj khoom haus thiab ntxhib. Cov kws tshaj lij pom zoo kom noj cov zaub mov thiab qee cov cereals, zaub kua zaub, nqaij ntshiv thiab qee hom ntses. Zaub thiab txiv hmab txiv ntoo yuav tsum muaj nyob rau hauv cov zaub mov, tab sis los ntawm tsis muaj txhais tau tias tshiab - lawv yuav tsum tau boiled, ci, stewed. Koj tuaj yeem suav nrog cov khoom noj mis nyuj fermented hauv cov ntawv qhia zaub mov, tab sis muaj feem pua ntawm cov rog tsawg. Teas, rosehip broth, compotes thiab txiv hmab txiv ntoo haus yog pom zoo kom haus.
Muaj cov khoom lag luam uas koj yuav tsum tau hais ua ntej thaum kho thiab kho dua tshiab. Lawv cov npe suav nrog fatty, kib, smoked zaub mov, ntau yam pickles, kaus poom zaub mov thiab marinades, kua ntses, fatty nqaij qaib thiab nqaij, txuj lom. Tsis tas li ntawd, cov neeg mob yuav tsum tso cov khoom qab zib thiab pastries, qe, mis nyuj thiab dej qab zib. Cawv yog contraindicated nruj me ntsis.
Kho thiab, qhov tseem ceeb tshaj, kev kho raws sij hawm muab cov txiaj ntsig zoo. Feem ntau, kev rov ua kom tiav tiav.
