Kev mob ntawm txoj hnyuv me (enteritis) yog kab mob polyetiological ntev uas, yog tias tsis kho, tuaj yeem ua rau mucosal atrophy thiab lwm yam tsis zoo. Dab tsi ua rau nws? Dab tsi yog qhov yuav tsum tau ua ua ntej? Los ntawm cov tsos mob dab tsi koj tuaj yeem paub txog lawv qhov muaj nyob? Thiab, qhov tseem ceeb tshaj, yuav ua li cas kho nws? Qhov no thiab ntau lwm yam yuav tau tham tam sim no.
Txog tus kab mob hauv luv luv
Kev mob ntawm cov hnyuv me yog tshwm sim los ntawm kev txo qis hauv nws txoj haujlwm, nrog rau kev hloov pauv hauv cov kab mob hauv lub cev. Ntawm tag nrho cov pathologies cuam tshuam rau lub plab zom mov, nws yog qhov ntau tshaj plaws. Ntau tus neeg tau ntsib ib qho mob hnyav, thiab kwv yees li 25% ntawm cov neeg nyob hauv peb lub ntiaj teb raug kev txom nyem los ntawm cov kab mob, raws li kev txheeb cais.
Cov hnyuv me yog koom nrog ntau theem ntawm kev ua zaub mov. Yog hais tias nws yog mob, ces ntau ntawm nws cov dej num yog impaired. Qhov no cuam tshuam txog kev nqus cov as-ham thiab hydrolysis ntawm cov zaub mov complexcov khoom. Raws li qhov no, nws tuaj yeem nkag siab tias enteritis ua rau muaj kev phom sij loj tsis yog rau lub plab zom mov xwb, tab sis rau tib neeg lub cev tag nrho.
Yog vim li cas
Kab mob ntawm cov hnyuv mucosa tuaj yeem muaj qhov sib txawv ua ntej. Feem ntau, cov laj thawj tuaj yeem txheeb xyuas hauv cov npe hauv qab no:
- Txoj kev noj haus. Kev pheej hmoo yog cov neeg uas tsis tuaj yeem noj zaub mov ib txwm muaj, nrog rau cov neeg nyiam noj zaub mov kib, haus luam yeeb thiab rog. Kev noj zaub mov tsis zoo ua rau muaj kev ua haujlwm tsis zoo hauv tag nrho cov plab zom mov. Raws li kev txheeb cais, qhov no yog qhov tshwm sim ntau tshaj plaws. Nws tshwm sim hauv 75-80% ntawm tus neeg mob.
- Hlwb Helminthiasis. Vim Giardia thiab ascaris, qhov mob ntawm cov hnyuv me kuj feem ntau tshwm sim.
- Txoj kev swb. Yog hais tias ib tug neeg tau noj cov khoom uas tas sij hawm los yog tsis zoo, ces qhov yuav kis tau tus kab mob shigella los yog salmonella nce ntau.
- YDysbacteriosis. Yog hais tias twb muaj teeb meem nrog txoj hnyuv loj, ces muaj qhov zoo tshaj plaws ntawm kev kis mus rau tus me.
- Kab mob autoimmune. Enteritis, uas tshwm sim vim li no, tsis tshua muaj. Cov xwm txheej zoo li no nyuaj rau kho. Cov kab mob autoimmune feem ntau yog Crohn's disease. Nws tuaj yeem ua rau tsis tsuas yog mob plab hnyuv loj xwb - tag nrho cov plab hnyuv siab raum muaj kev pheej hmoo. Thiab qhov ua rau muaj kab mob autoimmune yog qee yam tsis ua haujlwm ntawm lub cev tiv thaiv kab mob.
- Kev tsis haum. Raws li txoj cai, rau qhov no, enteritis tshwm sim hauv cov menyuam yaus. Tab sis nws kuj tshwm sim hauv cov neeg laus, txawm tias tsawg dua.
- Txiv neej yam ntxwv. Muaj tseeb ntauNws yog paub tias qhov tshwj xeeb ntawm lub digestive system yog vim los ntawm heredity. Thiab yog li ntawd, yog hais tias ib tug los yog ntau tus niam txiv muaj ib tug enzymatic deficiency, ces tus me nyuam yuav tau txais tib yam nta thiab ib tug "pob paj" ntawm tej teeb meem. Ntawm lawv yog ib tug predisposition rau colitis, enteritis, thiab lwm yam.
- Kub intolerance. Nws yog ib qho tseem ceeb uas yuav tsum tau hais txog xws li "zaum lub caij ntuj sov". Tom qab lub npe no yog qhov ua rau lub plab hnyuv loj, uas ua rau nws tus kheej muaj kev kub ntxhov (tsis yog txhua tus neeg zam nws zoo).
Ntxiv rau qhov saum toj no, qhov ua rau mob plab hnyuv loj tuaj yeem ua haujlwm tsis ntev los no lossis raug mob.
Kev tshwm sim ntawm tus kab mob
Tam sim no peb yuav tsum tham txog cov tsos mob ntawm qhov mob ntawm txoj hnyuv me. Cov cim ceeb toom tuaj yeem raug txheeb xyuas hauv cov npe hauv qab no:
- Mob, uas yog nyob rau hauv lub dab teg thiab saum lub plab. Nws tuaj yeem muaj qhov mob, tawg, ua npub. Tsis tshua muaj tshwm sim yog mob dagger. Yog tias qhov mob kis tau lossis hloov nws txoj haujlwm, nws zoo li tus txheej txheem tau ntes lwm qhov chaw ntawm lub plab zom mov.
- Tsis xis nyob: rumbling, hnov txog lossis txav hauv plab.
- Zoo plab. Yog tias cais cov kab mob ntawm cov hnyuv me tau kuaj pom, cov tsos mob tsis tshwm sim. Ntxiv nrog rau raws plab, lwm yam kev hloov pauv hauv cov quav tuaj yeem taug qab - stickiness, fatty thiab mucous impurities. Thiab qhov zaus ntawm kev hu qee zaum nce mus txog 15-20 zaug hauv ib hnub.
- Ntxhais yaum kom tso quav. Lawv pom nyob rau hauv cov txheej txheem system.
- mob thiab qaug zog.
- Ua kom lub cev kub. Nws tuaj yeem sib txawv ntawm 37.5 ° C txog 40 ° C. Nrog rau cov cim qhia ntawm kev qaug cawv ntawm lub cev.
- kev tshaib plab.
- Bloating thiab flatulence.
- Rashes yog enteritis muaj ib qho kev tsis haum xeeb.
- ntuav, xeev siab, hnov qab puv hauv cheeb tsam epigastric.
Feem ntau, cov tsos mob yuav kav 7-10 hnub. Txawm hais tias lawv txhua tus sib tw, tsis txhob noj tshuaj rau tus kheej. Txwv tsis pub, enteritis tsuas yog mob ntev.
Tests
Zoo, saum toj no tau qhia luv luv txog cov yam ntxwv ntawm kev mob ntawm txoj hnyuv me. Kev kho mob yuav tau tham me ntsis tom qab, tab sis tam sim no peb yuav tsum tau xyuam xim rau qhov tshwj xeeb ntawm kev kuaj mob.
Ua ntej tshaj plaws, tus kws kho mob gastroenterologist sau cov neeg mob keeb kwm, ua qhov kev kuaj thawj zaug, thiab ua palpation ntawm lub plab. Yuav tsum tau kuaj. Thiab ntawm no yog cov:
- suav ntshav kom tiav. Pab kom pom cov tsos mob ntawm qhov mob. Lawv tau qhia los ntawm qib siab ntawm leukocytes thiab ESR.
- Fecal tsom xam. Nrog nws cov kev pab, qhov tsis txaus enzyme yog txiav txim siab, thiab qhov txiaj ntsig ntawm kev zom zaub mov kuj raug soj ntsuam. Nws kuj tseem tuaj yeem kuaj pom qhov mob kis tau. Feem ntau rog, hmoov txhuv nplej siab, nqaij fibers muaj nyob rau hauv biomaterial.
- Biochemistry ntawm ntshav. Tso cai rau koj txheeb xyuas cov cim qhia ntawm malabsorption syndrome.
Instrumental Study
Lawv kuj pab tshawb xyuas qhov mob hnyav lossis mob ntev ntawm txoj hnyuv me. Raws li txoj cai, xws liresearch:
- FGDS.
- Endoscopy with capsule.
- Colonoscopy.
- X-ray.
Nws nyuaj heev los ua qhov kev kuaj mob endoscopic. Cov cuab yeej tsuas tuaj yeem nkag mus rau hauv cov chaw ua haujlwm davhlau ya nyob twg. Cov txheej txheem nws tus kheej suav nrog kev noj tshuaj biopsy ntawm mucosa rau kev txheeb xyuas histological. Feem ntau nws tuaj yeem txheeb xyuas qhov tshwm sim atrophic thiab dystrophic los ntawm txoj hnyuv villi thiab epithelial hlwb.
X-ray kuaj, uas yog ua nrog kev qhia txog tus neeg sawv cev sib txawv, tso cai rau koj txheeb xyuas cov kev hloov pauv hauv cov qauv folded, txheeb xyuas cov kab mob segmental, ulcers, qog formations. Lub xeev ntawm plab hnyuv muaj nuj nqi kuj raug soj ntsuam.
Differential Diagnosis
Nws yog ua tau yog tias ib tug neeg xav tias mob ntev ntawm cov mucous daim nyias nyias ntawm cov hnyuv. Nws yog ib qho tseem ceeb heev uas yuav tsum paub qhov txawv ntawm tus kab mob no los ntawm cov kab mob uas tseem ceeb los ntawm emaciation thiab mob raws plab.
Cov tsos mob zoo sib xws hauv ntshav qab zib mellitus, thyrotoxicosis, Simmonds thiab Addison cov kab mob. Cov tsos mob zoo sib xws tau pom hauv amyloidosis, malignant neoplasms, ulcerative colitis. Crohn's disease thiab plab syndrome kuj yuav tsum tau txiav tawm.
Tseem muaj ntau zaus, cov teeb meem hauv plab hnyuv tau kuaj pom vim pathologies ntawm daim siab, plab, txiav txiav thiab cov qog tsim cov tshuaj hormones.
mob plab mesentery ntawm txoj hnyuv
Tus kab mob no tsim nyog saib xyuas tshwj xeeb. Lub mesentery yog ib hom ligament uas kho lub cev ntawm lub plab kab noj hniav. Nws tseem yog lub luag haujlwm rau kev xa cov paj hlwb los ntawm NS receptors, txhawb kev tiv thaiv kab mob thiab muab cov pa oxygen nrog cov as-ham.
Tsis tshua muaj, mesentery ua rau nws tus kheej. Qhov no feem ntau tshwm sim tawm tsam keeb kwm ntawm peritonitis. Nws yuav luag tsis yooj yim sua kom paub txog pathology, txij li daim duab kho mob muaj ntau yam. Cov tsos mob tshwm sim feem ntau yog mob hauv lub plab, uas tshwm sim nws tus kheej hauv ntau qhov sib txawv ntawm kev siv.
Ntawm cov tsos mob tsis pom tseeb, ib tus tuaj yeem pom qhov nce hauv cov qog nqaij hlav ntawm mesentery, hyperemia thiab o ntawm qhov chaw mob. Tom qab ntawd foci ntawm granulation cov ntaub so ntswg pib tsim, uas tom qab ntawd ua caws pliav.
kev kho mob hnyav
Tam sim no peb tuaj yeem tham txog kev ntsuas kho mob. Kev kho mob zoo li cas rau tus neeg mob tau txiav txim los ntawm tus kws kho mob. Vim hais tias cov tshuaj uas muaj peev xwm tshem tawm, piv txwv li, catarrh ntawm cov hnyuv me nrog rau cov tshuaj tsis haum, yuav tsis muaj zog kiag li hauv kev tawm tsam cov kab mob uas tshwm sim vim dysbacteriosis.
Nws tseem ceeb heev uas yuav tsum ua ncaj qha rau qhov laj thawj. Yuav ua li cas los xij, daim ntawv mob hnyav tau kho hauv tsev kho mob. Feem ntau cov neeg mob tau muab tso rau hauv lub chaw ua haujlwm gastroenterology, tab sis yog tias tus kab mob no yog kab mob, ces tus neeg raug xa mus rau tus kab mob sib kis.
Txhua tus neeg mob tau pw tsaug zog, haus dej ntau, noj zaub mov, kho kho mob thiab kho mob.
Yog tias mob dysbacteriosis loj zuj zus, ces cov kab mob hauv plab yuav raug kho. Thiab raws plab yog tshem tawm nrog astringents. Yog ibprotein metabolism raug cuam tshuam, ces cov tshuaj polypeptide yog tswj.
Feem ntau, kev kho mob tsis siv ntau tshaj ib lub lis piam. Thaum cov tsos mob tshwm sim, tus neeg raug tso tawm.
Kev Kho Mob
Nws tseem yuav tsum tau tham txog nws qhov tshwj xeeb hauv lub ntsiab lus ntawm cov ncauj lus hais txog cov tsos mob thiab kev kho mob ntawm cov hnyuv me. Hauv qhov no, ib tus neeg kuj tau mus rau hauv tsev kho mob kho.
Cov kws kho mob tau sau npe noj zaub mov 4, uas txhais tau hais tias tsis lees txais cov khoom noj ntxhib, qaub, ntsim, nrog rau txhua yam uas tuaj yeem ua mob rau cov mucous. Nws yog ib qho tseem ceeb uas cov zaub mov muaj ntau cov carbohydrates, proteins thiab rog. Tsis txhob noj mis nyuj thiab zaub mov muaj fiber ntau.
Thaum lub sijhawm tso tseg, kev noj zaub mov kom zoo yog qhia, uas muaj cov zaub mov txaus, vitamins thiab cov khoom muaj txiaj ntsig.
Tshuaj
Qhov tsis txaus ntawm digestive enzymes raug kho nrog cov tshuaj xws li Festal, Pancitrate thiab Pancreatin. Absorption yog stimulated los ntawm cov tshuaj nrog nitrates. Cov tshuaj tiv thaiv tau ua tiav rov ua haujlwm ntawm cov cell membranes.
Nyob rau hauv kev kho mob diphtheria o ntawm txoj hnyuv me (los yog lwm yam), "Loperamide" feem ntau yog tshuaj, uas suppresses ntau propulsive motility.
Cov neeg mob uas mob raws plab tau pom tias muaj tshuaj astringent, tshuaj tua kab mob, tshuaj nqus dej thiab ntim tshuaj. Phytotherapy feem ntau siv rau cov hom phiaj no (decoctions ntawm sage, chamomile, noog cherry, St. John's wort, alder cones, blueberries).
A rauKev kho dysbacteriosis yog cov tshuaj eubiotics thiab probiotics. Intravenous tswj ntawm amino acid daws tej zaum yuav qhia tau. Tab sis qhov no yog yog tias qhov nqus tau hais tawm, thiab nrog rau qhov tsis muaj protein ntau.
Qee zaus diverticula thiab polyps tsim tawm tsam keeb kwm ntawm enteritis. Yog tias cov neoplasms no ua rau lawv tus kheej paub, ces lawv txoj kev phais raug kho.
Huab cua
Yog enteritis muaj qhov mob me me lossis nruab nrab, tom qab ntawd nrog kev kho kom raug los ntawm kws kho mob, nws yuav ploj mus ob peb hnub.
Thaum tus kab mob no khiav, tej yam yuav nyuaj me ntsis. Daim ntawv hnyav feem ntau ua rau muaj teeb meem, suav nrog necrosis, los ntshav, lub cev qhuav dej hnyav, perforation.
Tus kab mob ntev, uas tshwm sim nrog kev hloov pauv thiab kev zam txim, maj mam nce ntxiv. Enteritis mob zuj zus, mob kis thoob plaws hauv plab hnyuv, cov cim qhia ntawm malabsorption nce. Yog tias tsis muab kev ntsuas kom raug, ces qhov tshwm sim tuag tau tshwm sim. Qhov ua rau yuav ua rau muaj kev ua txhaum loj hauv homeostasis, nrog rau kev qaug zog.
Kuj enteritis feem ntau ua rau muaj kev sib kis ntxiv.
Hauv cov ntawv me me thiab hnyav, muaj peev xwm ua haujlwm tau zoo. Tab sis, ntawm chav kawm, tus neeg muaj kev nyuaj siab. Nws tsis xis nyob nrog kev tawm dag zog lub cev thiab kev ntxhov siab.
Kev Tiv Thaiv
Txhawm rau tiv thaiv kev mob plab hnyuv, ua raws li cov lus pom zoo no:
- Nyob zoo, ua kom koj cov zaub mov muaj txiaj ntsig zoo.
- Ua tib zootxheej txheem zaub mov. Zam cov zaub mov muaj kuab lom.
- Saib cov lus pom zoo ntawm kev nyiam huv.
- Noj tshuaj ceev faj, thiab nco ntsoov tsuas yog raws li cov lus qhia.
Tab sis qhov tseem ceeb tshaj plaws yog kev tshawb nrhiav kom tau raws sijhawm thiab kev kho mob tom qab ntawm cov kab mob hauv plab, endocrine thiab metabolic ntshawv siab.
Thiab ntawm thawj cov tsos mob tsis txaus ntseeg, koj yuav tsum mus ntsib kws kho mob tam sim ntawd, tsis tas yuav noj tshuaj antispasmodics thiab tshuaj tua kab mob, vim lawv "lubricate" cov tsos mob, thiab qhov no ua rau mob hnyav heev.
