Perforated plab ulcer: phais, prognosis, txim

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Perforated plab ulcer: phais, prognosis, txim
Perforated plab ulcer: phais, prognosis, txim

Video: Perforated plab ulcer: phais, prognosis, txim

Video: Perforated plab ulcer: phais, prognosis, txim
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Nyob hauv tsab xov xwm, peb yuav xav txog kev ua haujlwm rau lub plab rwj.

Cov kab mob no tshwm sim vim muaj kev hloov pauv hauv cov mucous ntawm lub cev, uas yog nyob rau hauv kev sib cuag nrog cov zaub mov thiab yog lub ntsiab tiv thaiv kev tiv thaiv tiv thaiv ib puag ncig acidic ntau dhau ntawm cov ntsiab lus. Nyob rau hauv cov ntaub ntawv ntawm kev puas tsuaj ntawm cov mucous txheej, nws cov kev tiv thaiv zog txo, uas nws thiaj li ua rau ib tug nce thiab tob ntawm pathological foci, mus txog rau lub kiag li puas tsuaj ntawm phab ntsa ntawm lub plab. Uas yog, nyob rau hauv no txoj kev, ib tug los ntawm lub qhov tshwm sim, los yog nyob rau hauv lwm txoj kev no phenomenon kuj hu ua ib tug perforated plab rwj. Kev khiav hauj lwm sib txawv.

perforated plab ulcer ua haujlwm
perforated plab ulcer ua haujlwm

Kev kho mob ntawm pathology

Yog li, lawv puas ua phais mob plab?

Ib qhov txhab perforated yog kho tshwj xeeb los ntawm kev phais. Kev npaj rau kev phais yuav tshem tawm cov ntsiab lus hauv plab nrog rau kev kho ntshav siab. Lawv kuj ua kev tshawb fawb txog tus neeg mob lub cevxaiv cov kev ua ntxiv.

Kev xaiv phais rau plab hnyuv

Raws li tau sau tseg ua ntej, tib txoj kev kho mob rau lub plab perforated uas tau tsim nyob rau hauv lub plab, uas tuaj yeem cog lus tias yuav muaj txiaj ntsig zoo, yog kev phais. Nws yog tsim nyog hais tias cov kev ntsuas uas twb muaj lawm ntawm kev saib xyuas kev kho mob ua rau nws muaj peev xwm zam kev tuag tsuas yog nyob rau hauv cov xwm txheej cais.

Yuav ua li cas?

Lub ntsiab lus tseem ceeb ntawm kev phais mob yog ua kom huv ntawm cov kab noj hniav ntawm cov kab mob ntawm cov khoom, nws tseem yuav tsum tau ntxuav lub plab kab noj hniav thiab kaw lub lumen ntawm lub qhov perforated. Nyob rau hauv cov kev tshwm sim uas classic suturing ntawm lub perforation yog tsis tau, ces resection ntawm lub puas cheeb tsam ntawm lub plab phab ntsa yog ua. Nyob rau hauv cov ntaub ntawv no, ua ntej lub lag luam tshem tawm lub plab rwj, cov nram qab no tsis raug soj ntsuam:

  • Lub sijhawm dhau mus txij li pib muaj tus kabmob.
  • Qhov tshwm sim ntawm tus kab mob nrog rau qhov loj thiab qhov chaw ntawm qhov txhab.
  • Kev mob hnyav ntawm peritonitis thiab thaj tsam ntawm nws qhov kev faib tawm.
  • Hnub nyoog ntawm tus neeg mob.
  • Tus neeg mob muaj cov kab mob ntxiv.
  • Tsev yam ntxwv ntawm tsev kho mob nrog rau qib kev tshaj lij ntawm cov kws kho mob.
  • gastric ulcer phais
    gastric ulcer phais

Tam sim no, cov kws kho mob ua kev phais mob hauv lub cev (uas yog, kaw) thiab kev ua haujlwm radical (qhov no, peb tab tom tham txog kev phais, kev txiav tawm ntawm qhov txhab, thiab lwm yam).

Suturing a perforated qhov

Suturing ib lub qhov perforated yog sau nyob rau hauv lub xub ntiag ntawm ib tug ntau yam ntawm peritonitis thiab nyob rau hauv lub siab ua hauj lwm txaus ntshai cuam tshuam nrog rau lub xub ntiag ntawm concomitant kab mob los yog lub hnub nyoog ntawm tus neeg mob. Tsis tas li ntawd, kev ua haujlwm ntawm lub plab rwj tuaj yeem ua tau yog tias tsis muaj keeb kwm ntawm cov tub ntxhais hluas.

Cov txheej txheem ntawm kev ua haujlwm nyob rau hauv rooj plaub no muaj nyob rau hauv excising cov npoo ntawm lub rwj tsim thiab lawv tom qab stitching siv ob kab ntawm sutures. Nrog rau txoj haujlwm no, cov duab ntawm lub cev yog khaws cia nrog rau txoj kab uas hla ntawm nws lumen. Thaum ua tiav cov haujlwm, cov dej ntws ib ntus raug teeb tsa. Cov tshuaj tiv thaiv kab mob ntxiv kuj tau sau tseg.

Yuav ua li cas lwm qhov kev phais ua rau ntawm lub plab perforated?

Kev txiav txim siab

Kev phais plab yog ib qho kev ua haujlwm uas ua rau poob ntawm ib feem tseem ceeb ntawm lub cev. Tom qab nws siv, tus neeg mob tau txais kev tsis taus. Cov lus qhia rau kev ua haujlwm no yog muaj cov kab mob loj-ntev ntev hauv tus neeg mob thiab xav tias cov qog nqaij hlav malignant. Lwm qhov kev qhia yog lub hnub nyoog ntawm tus neeg mob tsawg dua rau caum-tsib xyoo, yog tias tsis muaj cov kab mob sib kis hauv lub sijhawm decompensation. Tsis tas li ntawd, qhov kev ua haujlwm no tuaj yeem ua tiav nrog kev txhim kho ntawm mob hnyav thiab tiv thaiv keeb kwm ntawm purulent peritonitis.

Thaum tsis muaj kab mob peritonitis, phab ntsa ntawm lub qhov perforated yog sutured ua ke nrog proximal vagotomy. Kev txiav tawm ntawm cov kab mob uas siv cov qia vagotomy thiab pyroplasty yog siv nyob rau hauv cov ntaub ntawv ntawm pathology nyob rau hauv lub pyloric ib feem ntawm lub plab, thiab.tiv thaiv keeb kwm ntawm los ntshav thiab stenosis.

phais mob plab ulcer
phais mob plab ulcer

Ib qho tseem ceeb kom nkag siab

Kev tsis muaj kev phais mob plab yuav ua rau muaj kev tuag nyob rau lub lim tiam tom ntej tom qab pib muaj tus kabmob. Tab sis kev ua haujlwm tsis tau lees tias muaj txoj sia nyob. Cov ntaub ntawv kho mob lub luag haujlwm rau kev tuag tom qab kev phais qhia tias tom qab 6 teev tsis pub ntau tshaj plaub feem pua ntawm cov neeg mob tawm mus, thiab tom qab ib hnub tsis pub ntau tshaj plaub caug.

Laser kho: nws ua li cas?

Qhov no yog li cas kev kho mob plab hnyuv rau perforated ulcers tam sim no ua:

  • Ib lub raj roj hmab tau muab tso rau ntawm tus neeg mob lub qhov ncauj, ib yam li ua tiav hauv kev kuaj mob fibrogastroscopy.
  • Tom ntej no, tus kws kho mob, los ntawm kev pom qhov muag, cauterizes lub plab nrog lub laser beam.

Yuav kom tau txais cov txiaj ntsig xav tau los ntawm kev phais mob plab plab laser, cov txheej txheem yuav tsum tau rov ua dua xya mus rau kaum zaug. Qhov no tsis kaj siab heev rau tus neeg mob. Tab sis qhov kev kho mob zoo li no tau zoo heev piv rau cov txheej txheem kev saib xyuas kev kho mob, txawm li cas los xij, nws yog qhov qis dua rau kev phais mob.

Kev noj zaub mov rau lub plab perforated yog qhov tseem ceeb. Xav paub ntau ntxiv hauv qab no.

Qhov tshwm sim thiab kev kwv yees

Qhov tsis muaj kev kho mob raws sijhawm ntawm perforated gastric ulcers, raws li txoj cai, ua rau cov neeg mob tuag nyob rau cuaj caum cuaj feem pua ntawm cov neeg mob hauv thawj xya hnub tom qab perforation. Kev phaistxoj kev ua rau nws muaj peev xwm txo tau daim duab no mus rau tsib mus rau yim feem pua. Nws yog tsim nyog hais tias tag nrho cov ciaj sia taus ntawm cov neeg mob nyob rau hauv thawj ob peb teev tom qab lub lag luam yog yuav luag ib puas feem pua, tab sis, hmoov tsis, daim duab no txo los ntawm ib tug thib peb hnub tom qab.

perforated plab ulcer noj tom qab phais
perforated plab ulcer noj tom qab phais

Txawm hais tias qhov kev ua tiav ntawm kev phais mob thiab qhov tsis tuaj yeem tshwm sim tom qab phais, tus neeg mob lub neej zoo yuav raug kev txom nyem los ntawm tus kab mob. Ua ntej tshaj plaws, koj yuav tsum ua raws li cov ntawv qhia nruj heev uas tus kws kho mob tau sau tseg, uas yuav ua raws li tus kheej tus yam ntxwv ntawm tus neeg mob.

Lub hauv paus ntawm kev noj zaub mov yuav ib txwm yog cov khoom noj yooj yim digestible nrog cov ntsiab lus ntawm cov zaub nyoos thiab tsis suav nrog cov kib, ntsim, qaub, qab ntsev thiab cawv thiab. Ntawm lwm yam, lub sij hawm exacerbations ntawm gastritis muaj feem yuav, ua rau xav tau kev kho tshuaj.

Cov ntsiab lus ntawm kev noj zaub mov tom qab phais

Cov zaub mov ntshiab yuav yog lub hauv paus ntawm kev noj zaub mov hauv thawj rau lub hlis tom qab kev phais mob plab. Lub sij hawm rov qab los ntawm tus neeg mob ncaj qha nyob ntawm kev ua raws li kev noj zaub mov nruj. Txhawm rau kom tsis txhob nthuav tawm cov plab hnyuv siab raum kom muaj kev ntxhov siab ntau dhau, kev noj zaub mov yuav tsum maj mam nthuav dav, hloov nws cov muaj pes tsawg leeg thiab cov txheej txheem ua noj. Kev noj zaub mov yog qhia hauv theem:

  • Lub sijhawm thawj xya hnub tom qab ua haujlwm, tus neeg mob tau txais cov ntxhia tshwj xeebdej nrog tsis muaj zog brewed tshuaj yej thiab lean broths. Lub sijhawm no, kev noj cov zaub mov, txawm tias pureed, tuaj yeem ua rau muaj teeb meem, vim tias cov microflora ntawm lub plab zom mov yuav luag puas. Yog li ntawd, cov zaub mov tseem yuav tsis zom.
  • Nyob rau lub lim tiam thib ob, cov tais diav uas tau muab tso rau hauv cov ntawv qhia txhua hnub hauv daim ntawv cereals boiled hauv dej nrog ib co mis nyuj. Kuj tseem muaj cov kua zaub pureed siav los ntawm cereals.
  • Nyob rau lub asthiv thib peb thiab plaub, tus neeg mob tau txais kev noj zaub mov zoo li qub. Ntxiv nrog rau cov nplej zom thiab cov kua zaub pureed, cov ntawv qhia zaub mov suav nrog cov zaub thiab nqaij feem ntau.
  • Tom qab rau lub hlis, cov ntawv qhia zaub mov tau ntxiv nrog cov tais diav uas tsis yog mashed, tab sis cov zaub mov yuav tsum tseem nruab nrab, uas yog, los ntawm kev pom tshuaj, tsis muaj cov txuj lom, qab zib thiab ntsev.

Kev noj zaub mov tom qab phais rau lub plab plab yuav tsum tau ua nruj me ntsis.

perforated plab ulcer kev ua haujlwm noj zaub mov
perforated plab ulcer kev ua haujlwm noj zaub mov

Txoj Cai Noj Mov

Tom qab ua haujlwm, tus neeg mob yuav tsum ua raws li cov cai hauv qab no:

  • Khoom noj khoom haus yuav tsum tau muab tshem tawm ntawm kev noj haus li ntawm ob lub hlis. Txawm tias ib qho me me tuaj yeem nkag mus rau hauv lub plab kab noj hniav, thiab lwm qhov kev ua haujlwm yuav tsim nyog tshem tawm, vim tias txawm tias ib qho kev sojntsuam yuav tsis pab rau qhov no.
  • Cov zaub mov zoo tshaj plaws yog ib qho uas tsis muaj cov carbohydrates ceev, cov roj cholesterol, cov txuj lom, cov khoom loj thiab cov carcinogens. Ntawd yog, cov khoom xyaw ntawm cov zaub mov thaum lub sij hawm zom zaub mov yuav tsum tsis txhob ua rau lub plab zom mov kom zais cov enzymes ntau dhau.
  • Qhov loj ntawm ib qho kev pabcuam yuav tsum yog qhov loj ntawm lub nrig. ATYog tias nws hloov mus ua ntau dua, lub plab tsuas yog tsis tuaj yeem tiv nrog txoj haujlwm, uas tuaj yeem ua rau rov qab los.
  • Cov zaub mov yuav tsum tau noj tib lub sijhawm. Ua tsaug rau qhov no, lub plab tau siv los tsim cov enzymes digestive ntawm lub sijhawm. Tsis tas li ntawd, nws yog ib qho tseem ceeb heev uas yuav tsum saib xyuas tib lub sijhawm ntawm cov pluas noj. Lub sijhawm siab tshaj plaws ntawm cov no yuav tsum yog peb teev. Yog tias nws tsawg dua, ces cov kabmob yuav tsis muaj sijhawm los tiv thaiv qhov qub. Yog hais tias nws hloov tawm mus rau ntau, ces nws tus kheej digestion yuav tshwm sim. Qhov tseeb yog tias tawm tsam keeb kwm yav dhau los ntawm kev tsis noj zaub mov ntev, lub plab tseem zais cov enzymes digestive uas ua rau nws cov mucosa.
  • Yuav tsum tsuas yog steamed thiab noj mov tuaj yeem ci hauv thawj ob lub hlis tom qab phais? Cov lus teb rau cov lus nug no yog undesirable. Txawm tias ci zaub mov thaum thawj lub hlis tom qab kev ua haujlwm tsis pom zoo. Cov txiv hmab txiv ntoo thiab zaub nyoos tseem yuav tau tso tseg tsawg kawg ib lossis ob lub hlis.

Tsis yog txhua tus paub noj dab tsi tom qab phais plab plab.

noj dab tsi tom qab phais plab plab
noj dab tsi tom qab phais plab plab

npe khoom

Cov zaub mov uas tau muab tshem tawm yog pom nyob rau thawj peb lub hlis, thiab yog tias muaj kev pheej hmoo rov qab los, nws yuav tsum tau ua raws li nws li rau lub hlis. Nws raug tso cai noj tsuas yog cov zaub mov boiled hauv dej, nrog rau cov nplej zom thiab cov kua zaub ntshiv. Tag nrho cov khoom xyaw yog av ua ntej noj nyob rau hauv ib tug blender los yog ua ib tug puree. Thaum lub sij hawm rov qab, nws yog ib qho tseem ceeb heev uas tus neeg mob cov ntawv qhia zaub mov yog dominated los ntawm protein cov tais diav, txij li cov nyob rau hauv xws liamino acids yog cov khoom siv hauv tsev rau tib neeg lub cev. Cov khoom tso cai yog:

  • Ntshiab zaub kua zaub tshwj tsis yog zaub qhwv kua zaub raws li nws siv sijhawm ntev los zom. Koj tuaj yeem ntxiv cov cereals hauv daim ntawv mov, buckwheat, millet, pearl barley thiab lwm yam rau cov kua zaub.
  • Nqe nqaij ntshiv nqaij qaib xws li qaib, qaib ntxhw, ntses, thiab lwm yam.
  • Noj cov nqaij ntshiv hauv daim ntawv ntawm patties, meatballs thiab mashed qos yaj ywm.
  • Haum rau pluas mov thiab cov qe mos nrog rau chav omelettes.
  • Siv cov mis tsis muaj kua qaub thiab muaj roj tsawg, qaub cream thiab qab zib, tab sis tom kawg tuaj yeem noj tsis ntau tshaj kaum grams tauj ib hnub. Non-acidic kefir kuj tseem yuav pab tau nrog rau cov fermented ci mis, me cheese thiab cov tsev cheese uas tsis yog acidic.
  • noj qab nyob zoo thiab qhuav qhaub cij ci los ntawm cov hmoov nplej.
  • Siv cov paj npleg, cheesecakes, tub nkeeg dumplings thiab casseroles, tab sis tsis yog qab zib, ntxiv zib mu rau cov khoom no.
  • Zaub mov boiled zaub nyob rau hauv daim ntawv ntawm cauliflower, carrots, zucchini, taub dag, eggplant thiab qos yaj ywm.
  • Zaub mov nrog cereals ntawm dej ntawm semolina, mov, oatmeal thiab buckwheat.
plab ulcer phais
plab ulcer phais

khoom qab zib

Los ntawm cov khoom qab zib, cov neeg mob no tau tso cai noj cov paj npleg thiab casseroles ua los ntawm cov nplej siav (tab sis lawv yuav tsum tau ntxiv zib mu es tsis txhob qab zib). Tsis tas li ntawd, ntau yam mousses, txiv hmab txiv ntoo jelly yog haum raws li khoom qab zib. Muaj tseeb, cov tais diav no tuaj yeem noj tsis pub dhau ob lub hlis tom qab ua haujlwm. Los ntawmhaus dej nyiam yuav tsum tau muab rau cov tshuaj yej tsis muaj zog. Nws yog ib qho tsim nyog yuav tsum tso tseg tag nrho ntsev thiab txhua yam txuj lom. Koj tseem yuav tau tsis kam pastry, pickles, offal thiab marinades. Haus luam yeeb, ntsim, kib thiab ntsim zaub mov nrog rau kev siv cov tshuaj tua kab mob nruj me ntsis.

Peb tau saib hom kev ua haujlwm thiab kev noj zaub mov rau plab rwj.

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