Kab mob appendicitis tuaj yeem ua rau txhua tus xav tsis thoob. Appendicitis syndromes (kev tshwm sim) zoo ib yam li ntau lwm yam kab mob. Los ntawm txoj kev, qhov no yog ib qho ntawm ob peb kab mob uas tseem raug kuaj pom tsuas yog los ntawm daim duab kho mob. Ib qho kev zam tsuas yog laparoscopy - ib qho kev kuaj mob me me, uas yog vim li cas thiaj xav tau. Yog li dab tsi yog cov tsos mob ntawm appendicitis? Yuav muaj teeb meem dab tsi?
Dab tsi yog appendicitis
Appendicitis yog ib qho mob ntawm daim ntawv mob plab ntawm caecum, uas tuaj yeem tshwm sim nrog qhov sib txawv. Inflammation yog ib yam kab mob ntawm lub plab kab noj hniav, uas yuav tsum tau muaj kev phais thaum muaj xwm ceev. Feem ntau, cov kab mob tau kuaj pom thaum muaj hnub nyoog 22 txog 25 xyoos, tab sis tuaj yeem tshwm sim rau txhua lub hnub nyoog.
Raws li kev txheeb cais, cov poj niam yuav kis tau mob plab hnyuv ntau dua li cov txiv neej. Mob plab mob plab, uas suav nrog yuav luag 90% ntawm cov neeg mob ntawm cov kab mob phais mob hnyav, yog ib qho ua raukev loj hlob ntawm peritonitis.
Ua rau mob
Ib txheej ntawm cov tsos mob lossis cov tsos mob ntawm tus mob appendicitis yog tsim los tsis paub vim li cas. Cov kws kho mob tseem tsis nkag siab tias yog vim li cas qee tus neeg mob plab hnyuv thiab lwm tus tsis ua. Tam sim no, tsuas yog kev xav ntawm txoj kev loj hlob ntawm pathology raug txiav txim siab.
Qhov kev xav ntau tshaj plaws yog kev kis kab mob. Nrog rau kab mob appendicitis, kab mob ntawm ntau yam kab mob feem ntau txiav txim siab nyob rau hauv tus neeg mob qhov kev ntsuam xyuas, piv txwv li, Staphylococcus aureus, E. coli, Streptococcus thiab ib tug xov tooj ntawm cov kab mob. Cov kab mob no yog ib txwm nyob rau hauv txoj hnyuv, tab sis nyob rau hauv cov xwm txheej zoo, lawv cov active reproduction pib, vim hais tias cov txheej txheem inflammatory tshwm sim.
Tsis tas li, qhov ua rau mob plab hnyuv plab tuaj yeem ua rau txhaws ntawm daim ntawv ntxiv. Qhov no yog yooj yim los ntawm congenital anomalies ntawm txoj kev loj hlob. Ntau yam neoplasms, fecal pob zeb thiab txawv teb chaws lub cev tuaj yeem txhaws lub lumen.
Txhawm rau stagnation ntawm cov ntshav thiab kev loj hlob ntawm necrosis ntawm lub appendix pab txhawb rau circulatory disorders. Kev ua txhaum ntawm kev ua haujlwm ntawm cov hlab ntsha me me cuam tshuam rau lub cev, provoking o. Kev tsim cov hnoos qeev ntau dhau thiab ua rau mob ntxiv ntawm daim ntawv ntxiv tuaj yeem tshwm sim thaum lub plab zom mov deteriorates vim cov tshuaj tiv thaiv neurogenic.
Kev xyaum kho mob qhia tau hais tias mob feem ntau raug kuaj pom hauv cov neeg mob uas muaj cem quav, qee yam kab mob sib kis thiab kab mob ntawm lub plawv thiab cov hlab ntsha.
Nyob rau hauv cov txiv neej, cov kab mob appendicitis tuaj yeem ua rau mob tawm tsam keeb kwm ntawm tus cwj pwm phem thiab cov kab mob latent hauv lub cev. Hauv cov poj niam, appendicitis syndrome yog provoked los ntawm cov kab mob gynecological. Nyob rau hauv thaum yau, congenital anomalies feem ntau ua rau pathology, piv txwv li, nqaim ntawm lub lumen ntawm caecum.
Thawj cov tsos mob ntawm tus mob appendicitis
Nws yog qhov nyuaj heev los txiav txim qhov mob plab ntawm koj tus kheej. Kev kuaj mob hauv qee kis yog nyuaj txawm rau cov kws tshaj lij. Appendicitis syndromes nyob rau hauv cov neeg laus yog zoo ib yam li cov tsos mob ntawm lom, tab sis tsis pom tseeb intoxication ntawm lub cev. Rov ntuav ntuav, qhov ncauj qhuav, qaug zog, thiab raws plab feem ntau tsis tshwm sim.
Mob plab mob plab tshwm sim hauv plab. Tom qab plaub mus rau rau teev, qhov tsis xis nyob hnyav zuj zus, txav mus rau thaj tsam ntawm sab xis ntawm lub dab teg. Qhov kub nce mus rau 37.2-37.4 ° C. Kev tsiv teb tsaws ntawm qhov mob tuaj yeem ua tau, uas yog, ib qho mob thaum tsis xis nyob hauv ntau qhov chaw ntawm lub plab.
daim duab kho mob
Tus yam ntxwv zoo tshaj plaws nyob rau hauv appendicitis yog mob hauv qab plab thiab hauv thaj tsam ntawm lub hnub ci plexus. Qee lub sij hawm tus neeg mob txhawj xeeb txog qhov tsis xis nyob yam tsis muaj qhov chaw tshwj xeeb. Qhov mob tuaj yeem yog qhov sib txawv. Tab sis maj mam nws localization ua kom pom tseeb - nws xav tias tsis xis nyob hauv thaj tsam ntawm daim ntawv ntxiv. Thaum tsiv, hloov lub cev txoj hauj lwm, txham thiab hnoos heev. Nyob rau hauv lub neej yav tom ntej, kev kho mob tsis tuaj yeem ua tau. Qhov no qhia txog kev txhim kho ntawm cov teeb meem (peritonitis).
Similar pain syndrome of appendicitis tsis yog qhov tshwj xeeb. Kev tsis xis nyob yog tshwm sim hauv ntaulwm yam kab mob hauv plab. Hauv cov menyuam yaus, piv txwv li, qhov mob tau sau tseg nrog kev kis kab mob. Txhawm rau pab txhawb kev kuaj mob ntawm tus kws kho mob, koj yuav tsum qhia txog cov kab mob yav dhau los. Qhov no yuav txuag sijhawm.
Cov kab mob dab tsi tseem tshwm sim nrog mob plab hnyuv? Kev mob qee zaum ua rau xeev siab thiab ntuav. Nrog lub plab khoob hauv ntuav, tsuas yog kua thiab hnoos qeev ntawm corpus luteum. ntuav feem ntau tshwm sim ib zaug. Tsis muaj cov kua tsib nyob rau hauv ntuav qhia tias cholecystitis, ib qho txhaws ntawm lub gallbladder. Ib qho xwm txheej yog qhov txaus ntshai thaum, tawm tsam keeb kwm yav dhau los ntawm cov tsos mob ntawm appendicitis (ib qho mob ntawm qhov mob thiab lwm yam cim), ntuav rov tshwm sim, uas tsis ua rau tus neeg mob tau zoo.
Feem ntau cov neeg mob txhawj xeeb txog qhov kub siab (kwv yees li 37-38 ° C). Nws yog qhov txaus ntshai kom nce mus rau 39-40 ° C thiab txo qis rau qhov tseem ceeb qis. Ib qho tshwm sim ntawm keeb kwm ntawm kab mob appendicitis yog ib qho mob hu ua dyspepsia. Qhov no yog kev ua txhaum ntawm kev ua haujlwm ntawm lub plab zom mov, uas tshwm sim nrog rau kev tso zis. Nyob rau tib lub sijhawm, cov zis tuaj yeem tau txais qhov ntxoov ntxoo khaus, tus neeg mob muaj lub zog eructation, tsim roj ntau dhau, kub hnyiab, blackening ntawm cov quav. Qhov tom kawg yog ib yam mob txaus ntshai heev uas qhia tau tias plab hnyuv lossis plab los ntshav.
Kab mob appendicitis tuaj yeem pib nrog cov tsos mob sib txawv thiab mob me me. Thaum noj cov tshuaj tua kab mob muaj zog, qhov mob ntawm cov kab mob appendicitis yuav qhia tau tias muaj kev hloov pauv hauv cov phab ntsa ntawm cov txheej txheem. Nrhiav kev kho mob tam sim.
Shchetkin-Blumberg syndrome yog ib qho mob rau mob plab hnyuv. Tom qab lub siab mos ntawm lub plab phab ntsa, koj yuav tsum tau txiav tawm koj cov ntiv tes. Nrog rau qhov mob, qhov mob yuav hnov ntau dua thaum txhais tes tawm, thiab tsis yog thaum lub siab raug siv rau hauv plab. Koj tuaj yeem txiav txim siab qhov mob los ntawm txiab syndrome. Nrog rau mob appendicitis, tachycardia hnyav tshwm sim tawm tsam keeb kwm ntawm lub cev kub.
Koj tuaj yeem kuaj pom Asaturian tus mob. Rau qhov no, lub nrig yog nias rau ntawm sab laug iliac cheeb tsam, thiab sab xis yog protrudes. Lub sijhawm no, caecum yog palpated nrog sab laug tes, thiab nyob rau hauv tus txheej txheem ib tug yuav pom ib tug mob taw tes uas sib xws rau appendicitis. Feem ntau, qhov mob ntawm palpation nce thaum tus neeg mob nyob ntawm sab laug. Feem ntau qhov mob tshwm sim nrog lub siab nyob nruab nrab ntawm lub plab.
Cov tsos mob hauv menyuam yaus
Hauv cov menyuam yaus, qhov kev pheej hmoo ntawm kev tsim kab mob peritonitis ntau dua li cov neeg laus, yog li cov niam txiv yuav tsum tau ua tib zoo saib xyuas cov kev hloov hauv kev noj qab haus huv ntawm tus neeg mob me.
Nyob rau hauv cov me nyuam mos, mob plab hnyuv ua rau mob tsis tshua muaj, qhov zaus ntawm kev kuaj mob nce ntxiv tom qab ob mus rau peb xyoos. Feem ntau, kev kuaj mob (yog tias peb tham txog mob plab hnyuv loj) yog tsim rau cov menyuam yaus hnub nyoog 9-12 xyoo, tab sis feem ntau qhov tshwm sim siab tshaj plaws tshwm sim thaum muaj hnub nyoog 15-19 xyoo.
Cov kab mob appendicitis hauv cov menyuam yaus txij thaum yug txog rau tsib xyoos feem ntau pom muaj raws li hauv qab no: kev tsis txaus siab, kev xav, xeev siab thiab ntuav, tsis muaj zog, tsaug zog, qhov ncauj qhuav, nqhis dej, ua npaws, ua daus no, pallor, plab zom mov (cov quav xoob lossis cem quav). Tab sisCov cim qhia saum toj no tuaj yeem qhia tau tias mob plab hnyuv thiab qhia lwm yam kab mob. Xav tau hu rau tus kws kho mob.
Tam sim no los ntawm lub hnub nyoog kawm ntawv, tib yam mob ntawm cov mob appendicitis tau pom nyob rau hauv cov menyuam yaus thiab cov neeg laus. Lub plab yuav mob, qhov kub thiab txias yuav nce, thaum nias sharply, tus neeg mob yuav hnov mob. Cov tsos mob tshwm sim tsuas yog 30% ntawm cov neeg mob, qhov seem 70% yog atypical. Qee lub sij hawm cov ntawv ntxiv yog nyob rau lwm qhov hauv lub peritoneum. Mob tuaj yeem ua rau hauv plab plab, thiab hauv plab, nraub qaum, qhov quav.
Cov cim hauv qab no qhia tias koj yuav tsum tau mus ntsib kws kho mob sai:
- nplaig qhuav;
- txo qab los noj mov;
- fever;
- ib zaug lossis rov ntuav;
- nausea.
Cov quav nyob ib txwm nyob rau hauv feem ntau, tej zaum yuav cem quav lossis raws plab (tej zaum tsis tshua muaj). Koj yuav tsum mus ntsib kws kho mob tsis pub dhau ob mus rau peb teev tom qab pib qhov kev tawm tsam. Yog hais tias ib tug hluas nkauj yws yws ntawm qhov mob, ua ntej tus kws kho mob tuaj txog, koj yuav tsum paub txog hnub kawg ntawm kev coj khaub ncaws. Mob uas zoo li mob plab hnyuv yuav tshwm sim ua ntej koj lub sijhawm.
Thaum muaj kev tawm tsam, koj tsis tuaj yeem siv lub tshuab cua sov rau lub plab thiab ua kom sov da dej, vim tias cua sov ua rau mob. Tsis txhob muab enemas, uas ua rau kom siab rau ntawm qhov chaw mob. Nws yog txwv tsis pub muab tshuaj rau tus menyuam noj lossis tshuaj laxatives, qhov no tuaj yeem ua rau muaj kev nyuaj siab thiab ua rau muaj kev puas tsuaj ntawm daim ntawv ntxiv. Koj noj tsis tau, koj tsuas muab dej qab zib xwb.
Mob plab mob plab tuaj yeem tsis meej pem nrog ntau lwm yam kab mob ntawm lub plab zom mov. Qhov no yog banal zaub mov lom, kab mob siab thiab lub raum colic, o ntawm lub tsev me nyuam, lymph nodes nyob rau hauv txoj hnyuv, mob cholecystitis. Txawm tias tus kws kho mob tsis tuaj yeem txiav txim siab nrog qhov tshwm sim tiag tiag uas tus neeg mob muaj kab mob appendicitis.
Muaj Teeb Meem
Yog tias koj tsis mus rau qhov chaw kho mob raws sijhawm thiab tshem tawm cov txheej txheem mob, qhov no yog qhov teeb meem loj heev. Twb tau tom qab 48 teev, appendicular infiltrate tsim, uas ua rau nyuaj heev rau kev kho mob phais. Yog tias qhov kev ua haujlwm raug ncua rau lub sijhawm ntev, cov txheej txheem inflammatory ntxiv yuav tshwm sim. Cov xwm txheej no yuav tsum tau ua haujlwm qhib. Tej zaum yuav muaj kev cuam tshuam ntxiv. Kev rov zoo yuav siv sijhawm li ob lub lis piam, thiab kev rov zoo yuav kav ntev li ib hlis. Nws yuav muaj peev xwm rov qab mus ua lub cev ib txwm ua tom qab ib xyoos.
Qhov teeb meem txaus ntshai tshaj plaws ntawm mob plab hnyuv yog peritonitis. Qhov xwm txheej no tuaj yeem ua rau tuag taus. Feem ntau, nyob rau hauv rooj plaub no, ob hnub tom qab cov tsos mob hnyav, lub sij hawm ntawm kev xav txog kev noj qab haus huv pib, uas yog, tus neeg mob zoo siab, nws txiav txim siab tsis nrhiav kev pab. Tab sis tsis ntev, qhov mob hnyav zuj zus nrog qhov tshwm sim loj tshaj plaws (kev puas tsuaj ntawm cov hnyuv, cov txheej txheem mob hnyav). Yog tias koj mus ntsib kws kho mob thaum pib mob, koj tuaj yeem txo qhov ntev ntawm kev nyob hauv tsev kho mob rau ib hnub thiab tau txais los ntawmkuj yooj yim ua hauj lwm. Yog tias muaj teeb meem, koj yuav tau nyob hauv tsev kho mob li ib lub lim tiam ntawm qhov zoo tshaj plaws.
ntsuas ntsuas
Kev kuaj mob yog nyob ntawm daim duab kho mob thiab tau lees paub los ntawm kev kuaj ntshav. Txoj kev ntseeg siab tshaj plaws yog laparoscopy. Kev nthuav qhia ntawm daim ntawv ntawm cov txheej txheem inflammatory yog ua tau thaum lub sij hawm kev phais, tom qab uas ib tug histological soj ntsuam ntawm cov ntaub so ntswg tshem tawm. Thaum kuaj pom los ntawm cov txheej txheem ntsuas, suav tomography, lub plab phab ntsa x-ray, kuaj ultrasound, irrigoscopy yog siv.
Txoj kev kuaj mob lig
Yog tias qhov mob tsis tau kuaj pom hauv lub sijhawm, qhov kev pheej hmoo ntawm cov teeb meem hauv lub sijhawm tom qab kev phais yuav nce ntxiv. Lub qhov txhab yog festering. Nws kuj tseem ua rau lub sijhawm ua haujlwm, lub sijhawm ntawm cov txheej txheem ntawm kev kho thiab rov ua haujlwm ntawm lub cev. Niaj hnub no txoj kev kho mob feem ntau tuaj yeem zam qhov tshwm sim txaus ntshai yog tias tus neeg mob tau soj ntsuam. Txawm li cas los xij, koj yuav tsum tsis txhob cia siab rau cov kws kho mob nkaus xwb, vim tias txhua tus yuav tsum muaj lub luag haujlwm rau lawv tus kheej noj qab haus huv.
txoj kev kho
Tam sim no, qhov mob ntawm mob plab hnyuv rau cov txiv neej, poj niam thiab menyuam yaus tsuas yog kho los ntawm kev phais. Yav dhau los, qhib lub plab phais tau ua tiav, tab sis qhov no yog ib qho kev sim nyuaj rau lub cev, kev kho mob nyuaj thiab ua rau muaj kev puas tsuaj loj hauv lub neej zoo nyob rau lub sijhawm postoperative. Feem ntau, kab mob appendicitisua haujlwm laparoscopically.
Nrog kev pab los ntawm cov cuab yeej tshwj xeeb, koj tuaj yeem kuaj xyuas thiab ua haujlwm ntawm lub cev. Ib tus kws kho mob uas paub txog nrog txoj kev no tuaj yeem ua haujlwm rau tsib hnub appendicitis, uas ua rau tus neeg mob lub neej zoo heev. Los ntawm txoj kev, laparoscopy kuj yog txoj kev kuaj mob zoo tshaj plaws. Dab tsi zoo li appendicitis, qhov tseeb, tej zaum yuav yog lwm yam kab mob uas yuav tshwm sim thaum lub sijhawm ua haujlwm. Yav tas los, cov kab mob appendicitis tsuas yog raug tshem tawm xwb, yog li nws tsis tuaj yeem siv txoj kev kuaj mob no.
Yog tias tsis muaj teeb meem, ces tus mob appendicitis hauv cov neeg laus tsis tas yuav siv tshuaj tua kab mob. Nyob rau hauv lub xub ntiag ntawm ib tug inflammatory txheej txheem nyob rau hauv lub pelvis, tshuaj tua kab mob yog muab. Kev sib xyaw ua ke ntawm ob peb pawg tshuaj tua kab mob feem ntau yog muab tshuaj. Cov kab mob appendicitis yuav tsum tau siv tshuaj tua kab mob.
cov lus qhia zoo los ntawm tus kws phais
Cov kws kho mob qhia kom tsis txhob kho tus kheej yog tias koj muaj cov tsos mob zoo ib yam li mob plab hnyuv. Koj yuav tsum tsis txhob noj cov tshuaj (tshwj xeeb tshaj yog cov tshuaj tiv thaiv kab mob, tshuaj tua kab mob, lossis tshuaj antispasmodics), vim tias qhov no tuaj yeem ua rau mob nyuaj. Kev nkag mus rau tus kws kho mob raws sij hawm yuav ua rau kom rov zoo thiab rov zoo tom qab kev phais. Nws yog ib qho tseem ceeb uas cov kab mob appendicitis tsis tuaj yeem kho nrog tshuaj, tsuas yog xav tau kev phais xwb. Los ntawm txoj kev, muaj ib tug loj ntxiv nyob rau hauv kev kho mob ntawm vermiform appendix - poob mob nrog nws ib zaug thiab kho, koj muaj peev xwm tsis nco qab txog appendicitis mus ib txhis.
mob plab hnyuv loj
Ntawmappendicitis yog ib daim ntawv sluggish ntawm o, uas feem ntau yog txuam nrog rau yav dhau los inflammatory txheej txheem. Daim duab kho mob yog tus cwj pwm los ntawm qhov mob, mob plab, raws plab lossis cem quav, flatulence. Kev kuaj mob yog ua raws li kev cais tawm ntawm lwm qhov laj thawj uas tuaj yeem ua rau muaj cov tsos mob zoo li no. Kev kho mob rau daim duab kho mob uas tsis tau hais tawm yog kev saib xyuas.
Kev Tiv Thaiv Kab Mob Kab Mob
Txhawm rau tiv thaiv tus kab mob, nws yog ib qho tsim nyog los kho ntau yam kab mob ntawm lub plab zom mov, cem quav, noj kom raug, thiab tsis txhob noj ntau dhau. Nrog kev ceeb toom cov tsos mob, koj yuav tsum sab laj nrog kws kho mob, vim tias txawm tias mob me ntsis tuaj yeem qhia tau tias muaj mob hnyav. Feem ntau, txoj kev noj qab haus huv tau pom zoo.
