Intestinal diverticulosis yog ib yam kab mob uas tib neeg ntsib tsis hais poj niam los txiv neej thiab hnub nyoog li cas (txawm tias cov me nyuam mos tej zaum kuj kuaj tau tus kab mob congenital). Tus kab mob yog nrog los ntawm kev tsim ntawm diverticula - protrusions ntawm txoj hnyuv phab ntsa. Yog tias tsis kho, cov kab mob tuaj yeem ua rau muaj ntau yam teeb meem, nrog rau cov hnyuv perforation, kev loj hlob ntawm peritonitis, cov tsos ntawm los ntshav loj.
Tau kawg, ntau tus neeg tab tom nrhiav kev paub ntxiv txog tus kabmob. Vim li cas plab hnyuv diverticulosis tshwm sim? Cov tsos mob thiab kev kho mob, muaj feem yuav tshwm sim thiab cov teeb meem tshwm sim yog qhov tseeb nthuav tsim nyog tshawb nrhiav.
Cov ntaub ntawv dav dav txog kab mob
Raws li twb tau hais lawm, plab hnyuv diverticulosis (ICD-10 muab tus kab mob code K57) yog ib yam kab mob uas tau nrog los ntawm kev tsim cov kab mob ntawm cov phab ntsa hauv plab. Txawm hais tias muaj tseeb tias tus kab mob tuaj yeem cuam tshuam rau ib feem ntawm txoj hnyuv, feem ntau, diverticula daim ntawv los ntawm cov ntaub so ntswg ntawm txoj hnyuv loj.(90% ntawm tag nrho cov diverticula yog nyob rau hauv txoj hnyuv).
Raws li kev txheeb cais, qhov yuav tshwm sim ntawm tus kab mob no nce ntxiv nrog lub hnub nyoog. Feem ntau, cov neeg muaj hnub nyoog tshaj 40 xyoo tau ntsib teeb meem zoo sib xws.
Vim li cas tus kab mob no tshwm sim?
Qhov tseeb, yog vim li cas rau txoj kev loj hlob ntawm tus kab mob no yuav txawv. Alas, lawv yeej tsis pom.
Yog tias peb tab tom tham txog kab mob congenital, ces nws yuav cuam tshuam nrog lub cev tsis muaj zog ntawm cov ntaub so ntswg. Hauv qhov no, diverticula tuaj yeem tshwm sim tsis tau tsuas yog hauv cov hnyuv, tab sis kuj nyob rau hauv lub zais zis, plab thiab lwm yam kabmob. Raws li txoj cai, thaum xub thawj phab ntsa ntawm lub protrusion muaj cov txheej txheem tib yam li cov phab ntsa hauv plab. Txawm li cas los xij, raws li tus kab mob no zuj zus, cov nqaij fibers maj mam atrophy.
Raws li cov ntaub ntawv kis tus kab mob, ntau yam tuaj yeem ua rau lawv txoj kev loj hlob. Piv txwv li, kev noj zaub mov tsis txaus yog qhov txaus ntshai. Yog hais tias ib tug neeg noj cov zaub mov uas yooj yim digestible, thaum tsis kam noj zaub mov nplua nuj nyob rau hauv fiber, ces qhov no nws thiaj li ua rau tsim cov quav tawv heev uas ua rau lub plab hnyuv phab ntsa. Tsis tas li ntawd, fiber ntau yog fraught nrog kev ua txhaum ntawm ntuj peristalsis. Ua ke, cov xwm txheej no ua rau cem quav ntev thiab thaum kawg diverticula.
Tseem muaj lwm yam kev pheej hmoo:
- rog dhau, rog;
- tsis muaj kev tawm dag zog;
- kev ua neej nyob;
- cuam tshuam ntawm kev txav ntawm txoj hnyuv(ob leeg congenital thiab uas yog txuam nrog kev loj hlob ntawm tej yam kab mob);
- vitamin deficiency;
- cem quav.
Kev tsim ntawm diverticulum ua rau cov ntshav tsis zoo nyob rau hauv cov hnyuv, thinning ntawm phab ntsa, maj mam atrophy ntawm cov leeg nqaij.
Forms of diverticulosis
Kev mob plab hnyuv diverticulosis tuaj yeem tshwm sim ntau txoj hauv kev. Yog vim li cas thiaj muaj ntau yam kev faib tawm. Diverticula tej zaum yuav yog:
- congenital (tsim thaum lub sij hawm fetal loj hlob);
- tau txais (tsim tom qab yug los ntawm kev cuam tshuam ntawm ntau yam).
Diverticula tuaj yeem yog ib leeg lossis ntau yam. Tsis tas li ntawd, cov txheej txheem pathological tuaj yeem ua rau thaj chaw sib txawv ntawm txoj hnyuv loj, piv txwv li, sigmoid, txoj hnyuv loj lossis qhov muag tsis pom (tsawg kawg) hnyuv. Diverticula nyob rau hauv cov phab ntsa ntawm cov hnyuv me muaj ntau tsawg (tsis ntau tshaj 10% ntawm cov neeg mob).
Tus kab mob no yuav tsis muaj tsos mob, tab sis feem ntau cuam tshuam nrog kev mob lossis muaj teeb meem. Diverticula tuaj yeem ua tau traction (tsim, piv txwv li, thaum lub sij hawm adhesions) los yog cuav (tsis muaj nqaij fibers nyob rau hauv lub phab ntsa ntawm lub protrusion).
Cov tsos mob tseem ceeb ntawm pathology
Nws tsim nyog sau cia tam sim ntawd tias qee zaum cov tsos mob ntawm diverticulosis ntawm txoj hnyuv loj tuaj yeem tsis tuaj. Yog tias muaj daim ntawv tsis sib xws ntawm tus kab mob, cov neeg mob tau ntau xyoo yuav tsis paub txoglub xub ntiag ntawm ib tug mob.
Txawm li cas los xij, raws li tus kab mob loj tuaj, qee qhov kev mob tshwm sim:
- Maj mam, txoj hnyuv motility yog cuam tshuam, thiab lub siab nyob rau hauv nws cov kab noj hniav nce, uas ua rau mob spastic. Kev tsis xis nyob yog paroxysmal - qhov kev xav tsis zoo yog nce lossis ploj. Qhov mob yog npub nyob rau hauv qhov xwm txheej thiab feem ntau nyob hauv lub plab plab, feem ntau ntawm sab laug.
- Qee zaum qhov mob thiab qhov tsis xis nyob tshwm los yog tshwm sim sai sai tom qab noj mov.
- Qee zaum, qhov mob dhau los ua qhov ntse thiab zoo li kev tawm tsam ntawm mob plab hnyuv. Tsis tas li ntawd, qhov tsis xis nyob tuaj yeem kis mus rau sab nraub qaum, sacrum, pob tw, qhov quav, puab tais thiab perineum.
- Tseem muaj teeb meem nrog lub rooj zaum. Constipation protracted feem ntau yog hloov los ntawm raws plab. Cov quav feem ntau muaj cov hnoos qeev ntau.
- Cov neeg mob raug kev txom nyem los ntawm kev mob plab thiab flatulence. Palpation yog nrog los ntawm kev mob ntxiv, tab sis tsis muaj qhov nro ntawm phab ntsa plab. Gases tawm ntawm txoj hnyuv muaj ntxhiab tsw heev.
- Qee tus neeg mob yws txog qhov kev thov cuav uas tsis tas yuav tshem tawm. Qee lub sij hawm tus neeg mob tau hnov lub plab zom mov tsis tiav.
Tus kab mob ua rau muaj teeb meem dab tsi?
Cov tsos mob ntawm plab hnyuv diverticulosis tuaj yeem ua rau mob hnyav dua yog tias muaj teeb meem. Thaum tsis muaj kev kho mob raws sij hawm thiab tsim nyog, tus kab mob tuaj yeem ua tauua rau muaj kev phom sij, qee zaum ua rau tuag taus. Lawv cov npe suav nrog:
- mob ntawm cov ntaub so ntswg ntawm lub diverticulum, uas yog nrog ua npaws, cov ntaub so ntswg puas, o thiab exacerbation ntawm qhov mob;
- plab hnyuv (ob qho tib si me thiab loj);
- perforation ntawm txoj hnyuv (perforation ntawm txoj hnyuv phab ntsa tshwm sim, uas yog nrog los ntawm kev tso tawm cov ntsiab lus ntawm cov hnyuv mus rau hauv lub plab kab noj hniav);
- tsim thiab sib sau ua ke ntawm purulent masses, tsim ntawm abscess thiab nws ntxiv rupture;
- sab nraud lossis sab hauv fistulas (qhia qee thaj chaw ntawm txoj hnyuv nrog cov kabmob nyob ze);
- adhesion formation;
- mob lossis mob ntev ntawm txoj hnyuv plab (muaj kev ua txhaum lossis ua tiav ntawm kev txav ntawm cov zaub mov thiab quav los ntawm txoj hnyuv).
ntsuas ntsuas
Hmoov tsis zoo, plab hnyuv diverticulosis yog nrog los ntawm cov tsos mob tsis tshwj xeeb uas yuav qhia tau ntau yam kab mob. Tias yog vim li cas qhov kev kuaj mob kom raug yog qhov tseem ceeb.
Ua ntej, koj xav tau kev kuaj dav dav, kev sab laj nrog tus kws kho mob dav dav thiab kws kho mob plab. Cov kws kho mob yuav tsum sau cov ntaub ntawv ntau npaum li ua tau kom ua tiav cov keeb kwm, nrog rau paub lawv tus kheej nrog tus neeg mob cov lus tsis txaus siab tseem ceeb.
Kev kuaj ntshav yog qhov yuav tsum tau ua. Kev nce hauv cov qe ntshav dawb qhia tau hais tias muaj cov txheej txheem inflammatory, thiab qhov txo qis ntawm cov qe ntshav liab qhia tias los ntshav sab hauv.
NtseegKev kuaj kab mob ntawm cov quav, coprogram, thiab tshuaj xyuas cov quav rau qhov muaj cov ntshav occult (dua, pab kom pom cov ntshav hauv cov hnyuv).
X-ray lub plab kuj xav tau.
Yog tias tsis pom qhov perforations thiab lwm yam teeb meem tshwm sim thaum lub sij hawm radiography, ces ib tug irrigography nrog ob qhov sib txawv yog ua. Hauv cov duab, tus kws kho mob yuav tuaj yeem pom qhov protrusion ntawm lub plab hnyuv phab ntsa, uas sib txuas nrog cov kab noj hniav ntawm txoj hnyuv.
Ultrasound ntawm lub plab hnyuv plab kuj ua tiav. Diverticula lawv tus kheej tsis tuaj yeem pom thaum lub sijhawm txheej txheem, tab sis qee qhov lwm yam kab mob tuaj yeem raug txiav tawm thiab qhov tsis muaj teeb meem tuaj yeem lees paub.
txoj kev kuaj endoscopic, tshwj xeeb, colonoscopy, kuj tseem ceeb. Nrog kev pab los ntawm cov cuab yeej tshwj xeeb, tus kws kho mob tuaj yeem ua tib zoo tshuaj xyuas cov hnyuv mucosa, txiav txim siab qhov muaj adhesions, protrusions thiab lwm yam deformities.
Thaum lub sijhawm endoscopy, qee zaum kev kuaj ntshav kuj tseem ua tau - cov qauv ntawm cov ntaub so ntswg puas raug coj mus nrog lawv cov kev kuaj mob ntxiv.
Computer thiab/lossis magnetic resonance imaging yog ntxiv.
Kev kho mob plab hnyuv diverticulosis ncaj qha nyob ntawm qhov ua rau nws txoj kev loj hlob thiab muaj cov teeb meem. Nws yog cov ntaub ntawv no uas koj yuav tsum paub thaum kuaj mob.
Tshuaj kho mob plab hnyuv diverticulosis
Cov tsos mob ntawm plab zom mov yog qhov laj thawj zoo rau kev teem sijhawm nrogkws kho mob. Cov tsos mob thiab kev kho mob ntawm plab hnyuv diverticulosis muaj feem xyuam. Cov txheej txheem ntawm kev kho mob yuav ncaj qha nyob ntawm seb cov tsos mob ntawm qee yam kab mob, nrog rau kev siv ntawm cov tsos mob.
Yog tias plab hnyuv diverticulosis tau tshawb pom los ntawm kev sib tsoo (tus kab mob yog nyob rau theem pib, tsis muaj tsos mob), ces cov neeg mob tau muab tshuaj noj tshwj xeeb hauv cov nroj tsuag fibers. Tsis tas li ntawd xwb, ib tug neeg yuav tsum tau mus kuaj xyuas tas li kom tus kws kho mob tuaj yeem soj ntsuam qhov kev loj hlob ntawm tus kab mob.
Qee zaum, ntxiv rau cov kev kho mob, kev npaj enzyme suav nrog (kom paub tseeb tias kev txhim kho ntawm cov txheej txheem digestive), nrog rau cov neeg ua haujlwm uas txo cov roj tsim hauv cov hnyuv. Probiotics kuj tseem yuav pab tau, uas ua kom lub plab zom mov nrog cov kab mob muaj txiaj ntsig.
Yog tias cov kab mob diverticulosis ntawm txoj hnyuv loj nrog cov txheej txheem inflammatory, ces nws raug nquahu kom noj tshuaj tua kab mob. Raws li txoj cai, cov kws kho mob tau sau cov tshuaj tua kab mob dav dav (koj tsis tuaj yeem coj lawv ntawm koj tus kheej).
Anspasmodic tshuaj ("Spazmalgon", "Spazmol", "Drotaverine", "No-shpa") pab txo qhov mob plab.
Cov tshuaj tiv thaiv kab mob hauv plab yog siv. Cov tshuaj xws li Motilac, Motilium, Domperidone raug suav hais tias yog siv tau.
Qee prebiotics yog siv los tiv thaiv cem quav, tshwj xeeb, Lactulose Poly, Normaze, Portalac, Duphalac.
Yog tias tsis muaj kev txhim kho hauv peb hnub tom qab pib kho tshuaj, tus neeg mob yuav tsum tau mus pw hauv tsev kho mob. Cov neeg mobntsev thiab piam thaj yog tswj hwm, uas pab tswj cov dej-ntsev sib npaug thiab cov metabolism hauv ntuj. Hauv qhov xwm txheej zoo li no, tus kws kho mob ua qhov kev kuaj mob ntxiv thiab txiav txim siab txog kev kho mob phais.
Kev noj zaub mov rau plab hnyuv diverticulosis
Koj twb paub cov tshuaj twg siv rau tus kab mob no. Txawm li cas los xij, kev noj zaub mov kom zoo hauv plab hnyuv diverticulosis tsis muaj qhov tseem ceeb dua li kev siv tshuaj.
txoj cai noj zaub mov yooj yim heev:
- Nplej bran yog qhov tseem ceeb, vim nws tuaj yeem txo qhov siab hauv cov hnyuv, nrog rau pab txhawb kev tsim thiab txhawb cov quav. Brewed bran tuaj yeem muab ntxiv rau cov kua zaub, cereals, zaub tais diav, sib xyaw nrog cov khoom noj fermented mis nyuj. Txij li thaum cov zaub fiber ntau tuaj yeem ua rau mob plab, nws raug nquahu kom pib nrog qhov tsawg kawg nkaus txhua hnub ntawm bran, maj mam nce nws.
- Cov zaub mov yuav tsum muaj xws li kefir, yogurt thiab lwm yam khoom noj mis nyuj fermented. Cov txiaj ntsig yuav yog cereals los ntawm buckwheat thiab hom qoob mog groats. Cov kws kho mob kuj pom zoo kom suav nrog zaub kua zaub (yuav ua tau siav hauv nqaij qaib), zaub casseroles.
- Nws tsim nyog muab mov thiab semolina, pasta, qhob cij thiab pastries ua los ntawm cov hmoov zoo. Koj kuj yuav tsum tsis suav nrog cocoa thiab chocolate, muaj zog brewed tshuaj yej, kas fes, jelly, liab cawu cub los ntawm kev noj haus. Cov zaub mov no ua rau lub plab zom mov qeeb thiab muaj zog astringent.
- Nws yog ib qho tseem ceeb kom tswj tau cov dej sib npaug - nws yog ib qho tsim nyog kom haus li 2 litres ib hnub twgdej ntshiab.
Thaum twg yuav tsum tau phais?
Cov tsos mob thiab kev kho mob ntawm cov kab mob colonic diverticulosis zoo sib xws. Thiab nrog cov tsos mob ntawm qee yam teeb meem, kev phais kev phais yog qhov tseem ceeb. Kev khiav hauj lwm yog ua nyob rau hauv lub xub ntiag ntawm cov nram qab no indications:
- tsim lossis qhib ntawm qhov uas twb muaj lawm;
- muaj fistulas;
- kev puas tsuaj rau lub diverticulum, tshwj xeeb tshaj yog tias cov txheej txheem cuam tshuam nrog kev loj hlob ntawm phlegmon lossis peritonitis;
- mob plab hnyuv;
- muaj plab hnyuv loj;
- nquag rov qab los ntawm tus kab mob, tsis muaj txiaj ntsig los ntawm kev kho tshuaj.
Kev kho mob ntawm diverticulosis ntawm txoj hnyuv loj yog tshem tawm thaj tsam cuam tshuam nrog ntxiv stitching. Raws li kev txheeb cais, cov txheej txheem tau txais txiaj ntsig zoo los ntawm cov neeg mob thiab muab cov nyhuv ntev. Txoj kev pheej hmoo rov tshwm sim dua (kev noj zaub mov kom raug thiab lwm yam kev ceev faj tau ua raws) yog li 2%.
kev kho neeg zoo
Tsev tshuaj tseem muaj cov tshuaj los pab tswj kev mob plab, cem quav, thiab lwm yam tsos mob ntawm plab hnyuv diverticulosis. Tau kawg, koj tuaj yeem siv cov nyiaj no tsuas yog tau tso cai los ntawm tus kws kho mob tshwj xeeb.
Herbal sau yuav pab daws cov plab zom mov. Ua ntej koj yuav tsum sib tov nyob rau hauv sib npaug zos qhov ntau tws rosehips, raws li zoo raws li qhuav chamomile paj, dill, nettle nplooj thiab motherwort. Ib tablespoon ntawm qhov sib tov yuav tsum tau nchuav nrog ib khob ntawm boiling dej thiabinsist (2-3 teev yuav txaus). Strained infusion yog noj ib nrab khob ob zaug ib hnub twg, nyiam dua nrog zaub mov. Cov tshuaj yog siv txhua hnub rau 6 lub lis piam.
Ntsuab txiv apples thiab germinated nplej nplej yuav tsum tau crushed nyob rau hauv ib tug blender (peb muab cov khoom sib npaug). Nws raug nquahu kom noj 200-300 g ib hnub twg, qhov no yuav pab kom lub cev saturate nrog cov nroj tsuag fibers thiab txhim kho plab hnyuv. Hoob kawm yuav kav ib hlis, tom qab ntawd koj yuav tsum tau so li 4 - 5 lub lis piam.
- ntsuas kev tiv thaiv
- Peb twb tau kawm txog cov tsos mob thiab kev kho mob plab hnyuv diverticulosis rau cov neeg laus. Raws li kev tshuaj xyuas ntawm cov kws kho mob thiab cov kev tshawb fawb soj ntsuam, tus kab mob feem ntau teb tau zoo rau kev kho mob.
- Hmoov tsis zoo, nws tsis tuaj yeem tiv thaiv kev loj hlob ntawm cov kab mob hauv lub cev. Raws li tau txais diverticulosis, koj tuaj yeem tiv thaiv nws qhov tshwm sim los ntawm kev ua raws li kev noj zaub mov zoo (koj yuav tsum muaj cov khoom noj uas muaj zaub fiber ntau hauv cov zaub mov). Tsis tas li ntawd, nws yog ib qho tseem ceeb kom tswj lub cev muaj zog, ntxiv dag zog rau cov leeg, txhim kho kev ua haujlwm ntawm lub cev. Txij li kev rog rog yog qhov muaj feem pheej hmoo, nws yog ib qho tseem ceeb los tswj lub cev qhov hnyav. Yog tias muaj cov cim ceeb toom, koj yuav tsum hu rau tus kws kho mob tam sim ntawd.
