Txhua yam kab mob uas tsis kho lossis tsis ua raws li txhua tus kws kho mob cov lus pom zoo tuaj yeem ua rau muaj teeb meem loj. Tam sim no, ib feem pua ntawm cov pejxeem raug kev txom nyem los ntawm cov kab mob ntawm lub plab zom mov, ntawm lawv gastritis thiab ulcers nyob hauv ib qho ntawm thawj qhov chaw. Ib qho teeb meem ntawm cov pathologies yog perforated rwj ntawm lub plab thiab duodenum, cov tsos mob thiab kev kho mob ntawm cov pathologies yuav tau tham hauv qab no.
Dab tsi yog perforation?
Cov kab mob no yog tshwm sim los ntawm qhov teeb meem ntawm peptic ulcer, uas tuaj yeem tshwm sim rau ntau yam, tab sis tag nrho cov ntawm lawv tuaj yeem ua rau muaj kev tsim ntawm lub qhov hauv lub cev. Nws tuaj yeem yog lub plab lossis ib feem ntawm txoj hnyuv.
Raws li kev tsim ntawm perforation, tag nrho cov ntsiab lus ntawm lub plab lossis txoj hnyuv, ua ke nrog cov ntsiab lus thiab cov enzymes, nkag mus rau hauv plab kab noj hniav thiab pib corrode nws. Cov kab mob sib kis tsis nyob twj ywm, thiab teb rau cov xwm txheej zoo li no, cov txheej txheem inflammatory tshwm sim, uas yog hu ua peritonitis.
Qhov no yog qhov xwm txheej hnyav uas yuav tsum tau mus kho mob tam sim.kev cuam tshuam. Feem ntau, qhov teeb meem zoo li no tshwm sim hauv ib nrab ntawm tib neeg, thiab qhov kawg ntawm qhov tshwm sim tshwm sim thaum lub caij nplooj ntoos hlav thiab lub caij nplooj zeeg.
Ua rau lub plab perforation
Muaj ntau ntau yam uas tuaj yeem ua rau muaj qhov txhab perforated, ntawm lawv qhov chaw tseem ceeb yog nyob ntawm:
- Ntau cov txheej txheem mob plab hauv plab.
- Lub cev ua haujlwm uas ua rau muaj kev nce siab hauv plab.
- khoom noj ntau.
- Kev noj zaub mov tsis zoo.
- cov xwm txheej ntxhov siab.
- siv Aspirin lossis kho glucocorticoid.
Qhov muaj qhov mob ntawm daim tawv nqaij tuaj yeem ua rau muaj qhov txhab perforated, nws cov tsos mob tuaj yeem mus ntsib tus neeg mob. Nco ntsoov kuaj xyuas tas li thiab ua raws li tus kws kho mob cov lus pom zoo.
Ua rau duodenal ulcer
Feem ntau, qhov ua rau mob ntawm lub cev no yog teeb meem nrog lub plab. Yog tias koj tsis ua ib qho kev ntsuas los tshem tawm cov txheej txheem inflammatory hauv nws, ces qhov no yuav kis mus rau duodenum.
Qhov laj thawj kuj yog:
- Nyob zoo ib tsoom phooj ywg.
- Kab mob gallbladder, chronic appendicitis.
- Helicobacter pylori kab mob.
Nco ntsoov tias duodenal perforation ntau dua li mob plab.
Symptoms of a perforated ulcer
Thaum tus neeg mob tus kab mob hnyav zuj zus, nws ib txwm tshwm sim los ntawm qhov mobhnov, ntuav, tag nrho cov no feem ntau tshwm sim tom qab noj mov. Thaum lub sij hawm ntawm perforation tsim, lub perforated rwj muaj cov tsos mob nyob rau hauv daim ntawv ntawm ib tug ntse "dagger" mob uas yuav zam tsis tau. Tus neeg mob sim rub ob txhais ceg mus rau hauv siab kom txo qis.
Lub sijhawm no, kuj tseem muaj qhov tshwm sim ntawm kev qaug cawv ntawm lub cev vim tau txais txhua yam hauv plab mus rau hauv plab kab noj hniav. Cov tawv nqaij daj ntseg, hws txias tshwm, ntshav siab txo qis thiab lub plawv pib nrawm dua.
Nyob rau hauv txoj kev loj hlob ntawm no pathology, ob peb theem yog txawv:
- Txoj kev poob siab. Nws yog precisely tus yam ntxwv los ntawm unbearable ntse mob uas yuav tawg mus rau sab xis ntawm lub nraub qaum. Qhov no ua rau nws ua tsis taus pa thiab ua rau cov leeg tawv thiab nruj.
- Kev xav txog kev txhim kho. Nyob rau lub sijhawm no, thiab qhov no yog li ob peb teev tom qab pib ntawm txhua qhov mob, qhov xwm txheej zoo dua me ntsis, cov kab mob perforated txo nws cov tsos mob. Tsis muaj zog tshwm sim, lub siab tseem qis, cov leeg nqaij so me ntsis, thiab nws ua pa yooj yim dua. Lub cev kub feem ntau nce thaum lub sijhawm no, flatulence tshwm sim, cov neeg mob paub txog tus mob no yuav tsum tsis txhob cuam tshuam nrog kev lom lossis mob khaub thuas. Nws tsis tuaj yeem ua yam tsis muaj tsheb thauj neeg mob thaum lub sijhawm no.
- Tom qab 12 teev, cov tsos mob ntawm peritonitis twb tshwm sim: qhov ncauj qhuav, mob plab. Nws yuav tsum tau muab sau tseg tias cov tsos mob ntawm peritonitis yog ib txwm zoo ib yam, tsis hais txog ntawm qhov ua rau provoked nws. xav tiasqhov no tshwm sim tawm tsam keeb kwm yav dhau los ntawm lub plab perforated ntawm lub plab lossis cov hnyuv tsuas yog ua tau raws li qhov kev kuaj mob uas twb muaj lawm.
Peritonitis tuaj yeem tshwm sim los ntawm mob plab hnyuv, mob pancreatitis, tab sis txawm li cas los xij, yog tias xav tias muaj kab mob zoo li no, yuav tsum tau mus pw hauv tsev kho mob sai. Kev phom sij yog qhov xwm txheej thaum tus kab mob rwj tshwm sim tsis muaj cov cim qhia. Tus neeg mob tuaj yeem tsis quav ntsej cov tsos mob ntawm qhov tshwm sim perforation, tab sis tsuas yog sim txo qhov mob nrog cov tshuaj hauv tsev thiab cov tshuaj tua kab mob, thiab qhov no twb ua rau muaj kev phom sij rau lub neej.
Cov tsos mob ntawm plab hnyuv
Yog tias muaj qhov perforation ntawm duodenum 12, ces cov cim qhia yuav ua raws li hauv qab no:
- mob hnyav nyob rau sab laug hypochondrium, uas tuaj yeem tawm mus rau caj dab thiab caj dab.
- ntuav, feem ntau tsuas tshwm sim ib zaug xwb.
- Ua "disc plab".
- hws txias thiab xiav tinge ntawm mucous daim nyias nyias tshwm.
Ib yam li nrog lub plab perforation, ib qho perforated duodenal rwj, cov tsos mob uas peb tab tom xav txog, ua rau lub fact tias nyob rau theem ob ntawm kev loj hlob, cov tsos mob ntawm cov hnyuv nkag mus rau hauv lub plab kab noj hniav tam sim ntawd pib tshwm.. Tachycardia, kub taub hau, mob hnyav yog cov pov thawj tseeb rau kev loj hlob ntawm peritonitis. Hauv qhov xwm txheej no, xav tau kev pab ceev los ntawm cov kws phais mob.
Kev kuaj mob
Txij thaum lub plab perforated ntawm lub plab thiab duodenum, cov tsos mob tau tshaj tawm nyob rau thawj theem, thiab cov neeg mob, raws li txoj cai, tau mus rau kev kho mob.lub koom haum ntawm qhov thib ob, tom qab ntawd qhov kev kuaj mob kom raug yog nyob ntawm tus kab mob anamnesis. Tsis tas li ntawd, yuav tsum muaj kev tshawb fawb ntxiv:
- X-ray uas yuav qhia cov pa roj dawb yog tias muaj qhov perforation.
- Ultrasound kuaj pom qhov pib ntawm qhov mob hauv plab kab noj hniav thiab muaj cov kua dej.
- FGDS qee zaum siv los txheeb xyuas qhov tseeb ntawm qhov chaw ntawm pathology, tab sis muaj kev pheej hmoo ntawm cov pa nkag mus rau hauv lub plab kab noj hniav, yog li yuav tsum tau saib xyuas tshwj xeeb.
- Yog tias kis mob hnyav thiab cov tsos mob ntawm perforated duodenal rwj tsis meej, ces laparoscopy ua tiav.
- Kev kuaj ntshav kuj tseem yuav pom qhov nce ESR, siab stab leukocytes thiab qib hemoglobin qis.
Kev cuam tshuam kev phais yuav ua tau tsuas yog tom qab qhov perforation tau lees paub.
pab thawj rau perforated ulcer
Kev tsim cov perforation nyob rau hauv lub plab lossis cov hnyuv yog qhov txaus ntshai heev rau tib neeg lub neej, yog vim li cas thawj zaug xav tias muaj tus mob no, nws yog ib qho tsim nyog hu rau lub tsheb thauj neeg mob. Thaum lub caij tsheb thauj mus los, tus neeg mob uas mob hnyav tau muab tshuaj los tswj ntshav siab, nqus pa oxygen, thiab muab tshuaj tua kab mob.
Nws tsis raug nquahu kom siv tshuaj loog thaum lub sijhawm no, vim tias lawv cuam tshuam tus neeg mob lub siab tsis nco qab thiab lubricate qhov kev kho mob tshwm sim, uas ua rau nws nyuaj rau kev kuaj mob kom raug.
Kev kho mob ntawm perforatedulcers
Perforated ulcer ntawm txoj hnyuv muaj yuav luag tib yam tsos mob li perforation ntawm lub plab, lawv kuj koom siab los ntawm qhov tseeb hais tias tsuas yog cov kws phais xwb thiaj li tiv tau cov mob no. Kev phais yuav tsum tau ua kom sai li sai tau vim nws yuav tsis tsim nyog tom qab.
Yog tias qhov xwm txheej xav tau, tom qab ntawd txhua qhov kev tswj hwm tau ua tiav hauv chav saib xyuas hnyav. Ua ntej kev ua haujlwm, kev sojntsuam thiab lub catheter tau muab tso rau hauv lub zais zis, thiab kev ua haujlwm nws tus kheej yog ua raws li kev tshuaj loog.
Tus kws phais ua qhov phais thiab tshuaj xyuas lub plab lossis cov hnyuv, kuaj pom qhov perforation, thiab txiav txim siab yuav kho li cas. Muaj ntau ntau txoj kev xaiv rau qhov no:
- Koj tuaj yeem xaws ib lub qhov.
- Qee zaum, ib feem ntawm lub plab raug tshem tawm nrog rau qhov perforation.
- -qhov kev zam ntawm cov rwj thiab Vagotomy.
Feem ntau, cov kws phais neeg paub los ntawm lawv qhov kev paub tias kev suturing tsis yog 100% lav ntawm kev kho kom tiav, rov tshwm sim feem ntau tshwm sim. Yog li ntawd, txoj kev no ntawm kev soj ntsuam nrog perforation yog siv nyob rau hauv cov xwm txheej uas muaj mob peritonitis los yog nyob rau hauv lub xub ntiag ntawm pathology nyob rau hauv cov tub ntxhais hluas uas muaj kev nyuaj siab los ua tus mob no.
Nyob rau hauv feem ntau, kev tshem tawm ntawm lub plab los yog resection ntawm lub plab yog zoo dua.
Ob leeg ua ntej kev txiav tawm lossis suturing, thiab tom qab ua haujlwm, ua tiav kev huv ntawm cov kab noj hniav thiab ntau lub qhov dej tau teeb tsa.
Peb tau hais txog lub ntsiab lus: "Perforated ulcer tsos mob thiab kev kho mob." Kev pab thawj zaug hauv qhov xwm txheej no tseem ceeb heev,tab sis feem ntau nws lub ntsiab lus yog nyob rau hauv lub tsev kho mob ceev ceev ntawm tus neeg mob.
Teeb meem tom qab kev phais thiab kev soj ntsuam rau yav tom ntej
Ntawm tag nrho cov teeb meem ntawm cov txheej txheem tom qab, cov hauv qab no tuaj yeem hais tau:
- Kev txhim kho ntawm cov kab mob abscess hauv plab kab noj hniav.
- Pneumonia.
- Yog cov stitches phem, ces qhov no yog fraught nrog re-perforation thiab tsim peritonitis thiab sepsis.
- Tsis tshua muaj, tej zaum yuav muaj kev ua txhaum ntawm kev txav ntawm cov khoom noj los ntawm txoj hlab pas mus rau hauv lub plab vim qhov qis ntawm qhov nkag sphincter.
Yog tias pom qhov txhab perforated hauv lub sijhawm, cov tsos mob raug tshem tawm thiab tag nrho cov kev ntsuas tsim nyog raug coj los tshem tawm cov kab mob, ces qhov kev mob tshwm sim feem ntau yog qhov zoo. Yog tias koj ua raws li tag nrho cov lus pom zoo ntawm tus kws kho mob thiab kev noj haus, koj tuaj yeem ua lub neej ib txwm muaj.
Yog tias tus kab mob tau dhau mus dhau lawm thiab muaj qhov perforation tau tsim, ces cov kev kho ib txwm siv yuav tsis muaj txiaj ntsig ntxiv lawm. Tab sis tom qab kev phais, nrog rau cov txheej txheem ntawm kev kho mob, nws muaj peev xwm siv tau cov lus pom zoo ntawm cov kws kho mob ib txwm muaj.
Ntawm no yog qee cov zaub mov txawv los pab txo cov kua qaub hauv plab kom tsis txhob rov qab los:
- Sib tov kua txiv ntawm ob txiv qaub nrog 0.5 liv ntawm zib mu thiab tib lub ntim ntawm txiv roj roj. Npaj tshuaj siv 1 tbsp. l. ua ntej noj mov 3 zaug ib hnub rau ib hlis.
- 250 grams ntawm aloe nplooj grind nyob rau hauv ib tug nqaij grinder, ntxiv 250 grams ntawm zib mu thiab sov lub sib tov rau 50 degrees, ces ntxiv ib nrab ib liter ntawm liab cawu cub. Tag nrho cov no insist nyob rau hauv ib qho chaw tsaus rau 7 hnub, thiabces koj tuaj yeem noj ib tablespoon 3 zaug hauv ib hnub rau ib teev ua ntej noj mov. Lub sijhawm ntawm kev kho mob yog 3 lub lis piam.
Nws yuav tsum nco ntsoov tias cov tshuaj ib txwm muaj peev xwm ua tau zoo nyob rau hauv thawj theem ntawm kev loj hlob ntawm rwj, thiab thaum perforation tshwm sim, nws tsis muaj kev nkag siab ntxiv.
Yuav ua li cas tiv thaiv rov tshwm sim ntawm qhov perforation
Txhawm rau tiv thaiv qhov rov tshwm sim ntawm qhov txhab perforated, nws yuav tsum tau ua ntu zus los tiv thaiv kev rov qab los, uas suav nrog:
- Ua raws li kev noj haus. Raws li kev tiv thaiv kev tiv thaiv, cov neeg mob raug txhawb kom ua raws li kev noj haus No.
- Noj tshuaj tsim nyog. Tus kws kho mob uas tuaj koom yuav muab cov lus pom zoo rau qhov teeb meem no.
- Physiotherapy. Lawv muab cov txiaj ntsig zoo kawg nkaus thaum ua ke nrog kev noj zaub mov kom raug thiab tshuaj.
Kab mob plab hnyuv tuaj yeem ua rau muaj teeb meem rau tus tswv. Yog tias koj tsis ua raws li kev txwv tsis pub noj zaub mov nruj, ua phem rau tus cwj pwm phem, thiab ua rau muaj kev ntxhov siab ntau zaus, ces koj yuav tsum tsis txhob xav tsis thoob tias qhov txhab yuav rov tshaj tawm nws tus kheej nrog nws cov tsos mob tsis zoo. Saib xyuas koj tus kheej thiab koj txoj kev noj qab haus huv, nws yuav tsis muaj nyiaj.
