Txheeb cais qhia tias hauv kev phais mob, mob plab hnyuv yog kab mob ntau tshaj plaws thiab suav txog 90% ntawm tag nrho cov haujlwm. Cov kab mob no tsis xaiv tib neeg raws hnub nyoog lossis poj niam txiv neej.
Kab mob appendicitis mus dhau ntau theem. Catarrhal appendicitis yog ib theem reversible. Muaj tshwm sim hauv 90% ntawm cov neeg mob thiab feem ntau hu ua appendicitis yooj yim.
Etiology
Cov kws kho mob tshwj xeeb ntawm cov tshuaj txheeb xyuas ntau qhov laj thawj uas ua rau muaj kev loj hlob ntawm pathology:
- muaj kab mob hauv lub cev;
- kab mob plab;
- ua haujlwm tsis raug ntawm daim ntawv ntxiv thaum lub sijhawm ua haujlwm cog lus;
- tau txais cov khoom, cov khoom noj tsis zoo thiab pob zeb;
- cov txheej txheem inflammatory hauv lwm lub cev, uas nws thiaj li txav mus rau hauv daim ntawv ntxiv.
Theoretical foundations of risk factors
Qhov tseeb, cov kws kho mob niaj hnub tsis tau tuaj yeem pom zoo tias yog vim li cas catarrhal appendicitis tshwm sim. Muaj ob peb txoj kev xavkeeb kwm ntawm tus kab mob, thiab txhua tus muaj txoj cai muaj nyob:
- Mechanical theory. Nws yog assumed tias tus kab mob no tshwm sim tawm tsam keeb kwm ntawm blockage ntawm cov txheej txheem nrog fecal pob zeb, qog thiab txawm worms. Cov txheej txheem inflammatory tuaj yeem pib tawm tsam keeb kwm yav dhau los ntawm cov txheej txheem kink lossis txhim kho nyob rau hauv lub xub ntiag ntawm adhesions hauv cheeb tsam plab.
- Txoj kev xav tsis haum. Nws ntseeg tau tias thaum hom 3-4 ntawm kev tsis haum tshuaj tshwm sim, kev tiv thaiv kev ua haujlwm ntawm cov txheej txheem phab ntsa tau txo qis, thiab cov kab mob thiab cov kab mob nkag mus rau qhov ntawd yam tsis muaj teeb meem, vim li ntawd, cov txheej txheem inflammatory pib.
- Kev mob txoj kev xav. Qhov kev xav no cuam tshuam nrog cov neeg kho tshuab. Nws ntseeg tau tias cov kab mob yuav tsum muaj nyob rau hauv lub cev rau qhov mob ntawm appendicitis.
- Raws li txoj kev xav vascular, nws tau xav tias catarrhal appendicitis tshwm tawm tsam keeb kwm ntawm kev txhim kho vasculitis ntawm cov phab ntsa ntawm cov hlab ntsha txheej txheem.
- Alimentary theory. Nws yog raws li kev lees paub tias kev loj hlob ntawm tus kab mob cuam tshuam nrog kev noj zaub mov tsis txaus. Cov kab mob tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev siv cov protein ntau thaum txo cov fiber ntau. Yog li ntawd, cov txheej txheem ntawm kev hla cov zaub mov los ntawm txoj hnyuv yuav nyuaj dua, thiab cov txheej txheem inflammatory pib.
Adherents ntawm sib txawv theories pom zoo rau lub hav zoov ntawm ob peb yam tseem ceeb txaus ntshai rau txoj kev loj hlob ntawm pathology. Cov no suav nrog:
- kab mob sib kis;
- tus cwj pwm phem;
- mob hauv plab hnyuv;
- malnutrition;
- dysbacteriosis.
Pathogenesis
Cov tsos mob ntawm catarrhal appendicitis muaj ntau yam zoo sib xws nrog cov tsos mob ntawm cov kab mob plab.
Yooj yim appendicitis yog superficial, thiab infiltration tsuas yog nyob rau ntawm daim tawv nqaij. Thaum pib ntawm cov txheej txheem inflammatory, qhov mob yog pom nyob rau hauv lub plab. Thaum lub sij hawm, nyob rau hauv feem ntau cov neeg mob, qhov mob pib tsiv teb tsaws, tshwm nyob rau sab xis, thiab tawg mus rau lub qhov quav. Thaum koj sim tig mus rau sab laug, qhov mob ntawm sab nce.
Qhov mob ntawm qhov mob feem ntau yog nyob ntawm qhov chaw ntawm daim ntawv ntxiv. Kev noj qab haus huv tag nrho ntawm tus neeg mob kuj muaj kev cuam tshuam loj rau cov tsos mob.
Ntxiv rau qhov mob, muaj qhov nce hauv lub cev kub. Mob raws plab los yog, conversely, cem quav yuav pib. Feem ntau muaj qhov ncauj qhuav, ntuav thiab tsis muaj zog thoob plaws hauv lub cev.
Thaum thawj qhov kev xav tias muaj kab mob catarrhal appendicitis, koj yuav tsum hu rau lub chaw kho mob tam sim ntawd. Nrog cov menyuam yaus, txhua yam nyuaj dua, lawv tsis tuaj yeem tham txog lawv txoj kev xav. Yog li ntawd, cov niam txiv yuav tsum xyuam xim rau tus cwj pwm ntawm tus me nyuam: nws dhau los ua lethargic, capricious, feem ntau muab nws txhais tes rau ntawm nws lub plab, pw tsis zoo, nws kub nce.
theem kab mob
Muaj plaub theem ntawm tus kabmob, nyob ntawm qhov tsis saib xyuas tus kabmob:
- Catarrhal daim ntawv mob plab hnyuv lossis thawj theem. Cov tsos mob tshwm sim thaum yav tsaus ntuj lossis hmo ntuj. Muaj mob lingering hauv plab, tom qab ntuav pib. Tus neeg mob yuav xav tias nws tau pibgastritis, lub plab yog mos, thiab qhov mob maj mam txav mus rau sab xis. Lub sijhawm siv sijhawm li 12 teev, thiab lub sijhawm no yog lub sijhawm zoo tshaj plaws rau kev ua haujlwm, tab sis nyob rau theem no, tsis tshua muaj neeg nrhiav kev pab.
- theem tom ntej yog catarrhal phlegmonous appendicitis. Cov theem no kav txog ib hnub. Qhov mob ua rau lub plawv dhia ceev, lub cev kub nce, tab sis tsis siab tshaj 38 degrees. Ntawm palpation, hardening yog pom ntawm sab xis ntawm lub plab mog.
- daim ntawv Gangrenous pib twb nyob rau hnub thib ob lossis thib peb tom qab thawj cov tsos mob tshwm sim. Cov txheej txheem ntawm kev tuag tawm ntawm cov hlab ntsha xaus ntawm lub cev tsim, yog li qhov mob txo qis. Lub cev kub poob mus rau 36 degrees. Kev mob ntxiv yog ib txwm tsuas yog rau cov txheej txheem palpation.
- Nyob rau theem kawg perforative, los ntawm qhov tshwm sim hauv lub cev. Qhov mob tsis tu ncua thiab hnyav. Muaj mob plab, tachycardia. Ib txheej xim av tsaus tshwm rau ntawm tus nplaig.
Kev mob nkeeg
Muaj ob hom kab mob tseem ceeb: mob hnyav thiab mob plab hnyuv thib ob.
Thawj daim ntawv muaj npe yog li vim tias thaum lub sijhawm nws cov txheej txheem inflammatory tshwm sim sai. Qhov no pathology tshwm sim feem ntau, tsis xaiv tus neeg mob raws hnub nyoog lossis poj niam txiv neej. Raws li txoj cai, cov txheej txheem raug thaiv los ntawm cov quav, helminths lossis txawv teb chaws lub cev.
Thiab hais txog daim ntawv thib ob, nws yuav tsum tau muab sau tseg tias qhov mob thib ob catarrhal appendicitis yog ib yam kab mob uas yog qhov tshwm sim ntawm kev hloov pauv ntawm cov txheej txheem inflammatory mus rau daim ntawv ntxiv nrog. Lwm yam kabmob: plab, gallbladder.
ntsuas ntsuas
Yog tias koj xav tias koj muaj kab mob appendicitis, koj yuav tsum hu rau lub chaw kho mob tam sim ntawd. Tus kws kho mob sau keeb kwm thiab ua qhov kev ntsuam xyuas. Muaj ntau txoj hauv kev uas tso cai rau koj los tsim kev kuaj mob thawj zaug.
Ua ntej tshaj plaws, tus neeg mob raug nug, thaum nws nyob hauv txoj kab rov tav, tig rau sab laug. Yog hais tias nyob rau tib lub sij hawm qhov mob hnyav, ces feem ntau yuav hais tias qhov kev kuaj mob yog tseeb, qhov kos npe no yog hu ua Sitkovsky tus tsos mob.
Rovsing cov tsos mob muaj nyob rau hauv qhov tseeb tias thaum lub plab sigmoid compressed, tus neeg mob pib mob hnyav. Raws li cov tsos mob ntawm Moscow nkag siab txog cov xwm txheej uas tus neeg mob cov menyuam kawm ntawv nyob rau hauv lub qhov muag sab xis me ntsis dilates.
Nco ntsoov nqa cov khoom mus kuaj ntshav thiab zis.
ntsuas ntsuas ntsuas kuj yuav tsum tau, tshwj xeeb:
- ultrasound;
- CT, MRI;
- radiography.
Instrumental cov tswv yim tso cai 100% kev kuaj pom tseeb.
Yog tias kuaj tau lig dhau los lossis tau txais kev kho mob tsis txaus, muaj kev pheej hmoo siab ntawm sepsis, los ntshav sab hauv, lossis adhesions.
Differential Diagnosis
Feem ntau, qhov kev kuaj mob sib txawv yuav tsum tau tsim kom muaj kev kuaj pom tseeb. Tseeb, nyob rau txhua theem ntawm catarrhal appendicitis, cov tsos mob yuav zoo ib yam li lwm yam kab mob:
- cholecystitis;
- pancreatitis;
- luag;
- mob plab thiab lwm yam.
Qhov ntawd yog, txhawm rau kom tsis txhob cuam tshuam cov kab mob appendicitis nrog rau lwm yam kab mob hauv plab kab noj hniav, kev kuaj mob sib txawv yog ua tiav.
Kev kho mob
Thaum nws xav tias tus neeg mob tuaj yeem muaj qhov mob ntawm qhov mob plab hnyuv, nws raug xa mus rau lub chaw phais mob tam sim ntawd. Tom qab ntawd, txhua qhov kev ntsuam xyuas tau ua sai sai kom paub meej qhov kev kuaj mob thiab muab kev pab.
Ntau tus neeg xav paub yog tias tus kab mob catarrhal appendicitis raug kuaj, seb puas yuav tsum tau ua haujlwm. Alas, kev cuam tshuam kev phais yog qhov tseem ceeb.
Hnub no, kev ua haujlwm tuaj yeem ua laparoscopically, transluminally lossis laparotomically.
thawj txheej txheem feem ntau yog siv, nws tsis yog mob heev rau tus neeg mob. Tus kws phais ua rau me me incisions los ntawm nws tshem tawm cov txheej txheem o. Txoj kev transluminal yuav tshem tawm cov hnyuv los ntawm lub plab lossis qhov chaw mos.
Kev phais Laparotomy feem ntau yog ua nyob rau hauv daim ntawv thib ob ntawm tus kab mob lossis yog tias muaj kev xav tias lwm yam kabmob cuam tshuam. Nyob rau hauv tas li ntawd, ib tug incision mus txog 10 centimeters ntev yog ua, thiab lub cev puas tsuaj raug tshem tawm. Nyob rau tib lub sijhawm, tus kws kho mob tuaj yeem pom meej tias puas muaj teeb meem nrog lwm cov kabmob sab hauv.
Yog tias tsis muaj teeb meem tshwm sim thaum lub sijhawm ua haujlwm, cov txheej txheem rov qab yuav kav tsis pub dhau 10 hnub. Thaum lub sij hawm rov qab los, tus neeg mob tau muab tshuajCov tshuaj tua kab mob, yog tias tsim nyog, tshuaj tua kab mob.
Rehab
Rau ntau lub hlis tom qab tshem tawm cov kab mob appendicitis, koj yuav tsum ua raws li kev noj haus. 12 teev tom qab ua haujlwm, tus neeg mob tuaj yeem haus cov kua mis, jelly lossis tshuaj yej. Thiab hnub thib ob nws raug xa mus rau ib feem ntawm 6 pluas noj ib hnub. Kev noj zaub mov kom ntxaws rau tus neeg mob yuav tsum tau ua los ntawm kws kho mob.
Nyob rau hauv cov txheej txheem ntawm kev kho kom rov zoo, nws raug tso cai siv zaub kua zaub, nrog dos, qos yaj ywm, carrots. Tsim nyog pasta, nceb, ci zaub, nqaij ntshiv thiab ntses, boiled thiab steamed. Koj tuaj yeem noj cov khoom noj muaj roj tsawg, txiv hmab txiv ntoo thiab tshuaj ntsuab tshuaj ntsuab.
Nws yog qhov yuav tsum tau zam kom tsis suav cov khoom haus luam yeeb, pickles, seasonings, khoom qab zib, borscht, fatty broths thiab nqaij.
Thaum lub sijhawm kho dua tshiab, nws raug nquahu kom taug kev txhua hnub, mus rau hauv pas dej lossis ua lwm yam kev ua kis las. Yog tias tus neeg mob hnyav dhau lawm, nws yuav tsum tau hnav daim ntaub qhwv ib ntus.
Kev Tiv Thaiv
Hnub no, tsis muaj laj thawj meej vim li cas catarrhal appendicitis tshwm. Vim li no, tsis muaj kev tiv thaiv zoo. Txawm li cas los xij, cov kws kho mob pom zoo kom tsis txhob haus cawv, tsis txhob koom nrog cov khoom noj "teeb meem", noj rationally, kom deb li deb tau, noj cov zaub mov uas muaj cov zaub mov thiab cov vitamins.
