Kev mob plab hnyuv yog qhov txo qis hauv cov lumen ib txwm nyob hauv ib feem ntawm txoj hnyuv. Lub lumen tuaj yeem nqaim vim muaj ntau yam tsis zoo, nrog rau cov kab mob organic. Pathology tshwm sim hauv cov neeg laus thiab menyuam yaus. Menyuam yaus stenosis feem ntau tshwm sim los ntawm tus kab mob congenital.
Symptomatics
Tus kws kho mob uas paub txog yuav tsis yooj yim rau kev kuaj mob "kab mob plab". Cov tsos mob hauv cov neeg laus yog qhov tshwj xeeb, tab sis tus kab mob tsuas tuaj yeem lees paub tom qab kuaj ultrasound.
Yog li, cov cim qhia tias muaj cov kab mob no suav nrog:
- frequent bloating;
- mob plab sab sauv;
- ntuav kua tsib;
- daj ntseg ntawm daim tawv nqaij, qee zaum muaj qhov grey tint;
- poob phaus;
- nce roj tsim;
- tsis muaj peev xwm nce qhov hnyav;
- paj plab ua haujlwm tsis zoo;
- tso zis tsis zoo;
- tawv thiab flaky.
Raws li koj tuaj yeem pom, cov tsos mob ntawm cov kab mob no yog qhov tshwj xeeb thiab nws nyuaj heev kom tsis meej pem, tab sis qee zaum atresia kuj tshwm sim nws tus kheej, uas feem ntau yuam kev rau plab hnyuv stenosis. Cov tsos mob ntawm ob yam kab mob no zoo sib xws, tab sis nrog atresia muaj ib tug ua tiav overlap ntawm tib neeg txoj hnyuv. Txhawm rau txhawm rau tsim qhov kev kuaj mob kom raug, cov kws kho mob siv cov kev kuaj mob niaj hnub no.
Yog vim li cas thiaj pom
Kev loj hlob ntawm tus kab mob tuaj yeem tshwm sim ntawm txhua lub hnub nyoog. Hauv cov neeg laus, cov kab mob pathology, raws li txoj cai, tau txais, thiab hauv menyuam yaus, plab hnyuv stenosis feem ntau kis tau.
Feem ntau tus kab mob no tshwm sim rau cov laj thawj hauv qab no:
- cuam tshuam ntawm cov metabolism hauv ib txwm;
- nquag tus leeg nqaij spasms;
- plab hnyuv volvulus;
- mob hauv plab hnyuv;
- adhesions uas tshwm sim tom qab phais;
- qog zoo li cov txheej txheem hauv cov hnyuv;
- mob, thiab lwm yam.
Yog tus neeg mob tau kuaj pom tus mob zoo li no, nws tsim nyog npaj rau kev kho mob ntev thiab nyuaj, vim tias stenosis tsis yog ib qho yooj yim pathology.
Tsis tas li, tsis txhob kho tus kheej. Ntau tus neeg mob pib nrog kev kho tus kheej, ua rau muaj cov tsos mob lom lom. Sij hawm dhau mus, tus neeg mob qhov mob hnyav zuj zus, thiab nws nyuaj rau kho stenosis.
Kev kuaj mob uas twb muaj lawm
Kev kuaj mob pib nrog kev kuaj pom. Twb tau nyob rau theem pib, tus kws kho mob yuav xav tias stenosistxoj hnyuv. Cov tsos mob thiab kev kho mob ntawm pathology yog tus kheej.
Txoj kev tshaj plaws rau kev kuaj mob stenosis yog ultrasound. Thaum lub sij hawm tus txheej txheem, nws yog ntshaw kom siv ib tug contrast neeg sawv cev. Txawm li cas los xij, ultrasound tsis yog tib txoj kev. Rau qhov kev kuaj mob zaum kawg, nws tseem pom zoo kom kuaj x-ray thiab pub ntshav rau kev tshuaj ntsuam biochemical.
Nws tsim nyog nco ntsoov tias stenosis tuaj yeem cuam tshuam rau txhua qhov ntawm txoj hnyuv. Nws tuaj yeem yog cov hnyuv loj, cov hnyuv me, lossis duodenum. Thaum kuaj ultrasound, tus kws kho mob tuaj yeem txiav txim siab seb thaj chaw twg raug cuam tshuam, thiab qee zaum nkag siab qhov ua rau tus kab mob no.
Types of stenosis
Hauv tshuaj, muaj ntau hom kab mob no. Lawv muab faib nyob ntawm qhov chaw ntawm qhov txhab, nrog rau kev noj qab haus huv ntawm tus kab mob.
Muaj peb hom stenosis tag nrho:
- Pyloric. Nrog rau ntau yam no, qhov nqaim yog tam sim no nyob rau thaj tsam ntawm lub plab thiab cov hnyuv me.
- Duodenal. Qhov ntau yam no txhais tau tias muaj qhov nqaim hauv thaj tsam ntawm duodenum.
- Atresia. Qhov ntau yam no txhais tau tias yuav luag tag nrho sib tshooj ntawm lub lumen nyob rau hauv ib feem ntawm txoj hnyuv. Qhov kev tshem tawm tau txo qis heev uas cov zaub mov tsuas tuaj yeem txav tsis tau ib txwm hla thaj tsam cuam tshuam.
Kuj nyob rau hauv kev kho mob, qhov no pathology kuj tau muab faib raws li qhov chaw ntawm qhov txhab. Qhov no tej zaum yuav yog stenosis ntawm cov hnyuv loj, cov hnyuv me, los yog ib cheeb tsam ntawm lub duodenum.
Thaum lub sijhawm kuaj mob, nws yuav tsum yogqhia seb qhov twg ntawm lub plab zom mov tau nqaim. Yog tsis muaj qhov no, qhov kev kuaj mob tsis tuaj yeem suav tias yog qhov kawg.
Cov cim qhia tshwj xeeb ntawm tus kab mob
Txawm tias thaum pib ntawm tus kab mob, tus neeg tam sim ntawd hnov mob tsis zoo. Cov tsos mob no tshwm sim los ntawm lub cev qhuav dej, tsis muaj zog, thiab mob plab. Septic shock nrog plab hnyuv stenosis kuj tshwm sim vim kev loj hlob sai ntawm pathology.
Nws tsim nyog sau cia tias thawj teev ntawm kev txhim kho pathology, ib tus neeg yuav muaj cov quav ib txwm, nrog rau lub cev tsis muaj zog, tab sis tom qab stenosis yuav tshwm sim nws tus kheej raws nraim qhov opposite.
Ntxiv rau cov tsos mob dav dav, kuj tseem muaj ib qho tshwj xeeb uas yog tus yam ntxwv ntawm tus kab mob no:
- bloating ntawm ib nrab ntawm lub plab, thaum tus yam ntxwv kev nyuaj siab tshwm sim nyob rau lwm ib nrab;
- lub plab yog mos heev ntawm palpation, thiab nws sab laug yog mob heev thaum lub sij hawm manipulations;
- thaum tus neeg mob co phab ntsa plab, hnov tus yam ntxwv gurgle;
- vim qhov tseeb tias lub plab zom mov yog qee qhov tuag tes tuag taw, thaum kuaj xyuas, koj tuaj yeem hnov ntau lub suab nrov, xws li exhalations, inhalations thiab lub plawv dhia, qhov no yog vim muaj cov pa roj ntau ntau;
- yog tias tus kab mob twb tau tsim mus rau theem ntawm necrosis, tus neeg mob yuav yws yws ntawm cov ntshav tawm ntawm qhov quav.
Nyob rau hauv cov xwm txheej nyuaj tshaj plaws, cov ntaub so ntswg necrosis tuaj yeem tshwm sim vim muaj cov hlab ntsha. Necrosis yuav luag tsis tshwm sim hauv sigmoidplab. Cov ntaub so ntswg tuag ntau dua hauv cov hnyuv.
Knot formation
Qee zaum cov qauv nodular tuaj yeem pom ntawm ultrasound, uas kuj yog ib qho cim ntawm plab hnyuv stenosis. Cov tsos mob tshwj xeeb tshaj tawm, thiab qhov mob ua rau mob heev.
Stagnation ntawm gases, tib neeg cov khoom pov tseg, compression ntawm cov ntaub so ntswg ua rau muaj kev ntshai thiab kev ntxhov siab ntawm cov neeg mob. Cov neeg mob yws yws ntawm qhov tsis xis nyob hauv lub peritoneum, ntuav thiab tsis tuaj yeem ua txoj haujlwm zoo rau lawv tus kheej. ntuav ntuav thiab qaug zog heev tuaj yeem ua tau. Yog hais tias ib tug neeg tsis zam qhov mob, ces txawm tias lub sij hawm luv luv ntawm kev nco qab yog ua tau.
Nws yog ib qho tsim nyog sau cia tias nrog nodulation, cov tsos mob sab nraud tsis tau hais tawm zoo li nrog rau cov plab hnyuv stenosis. Piv txwv li, tus kws kho mob tsis tuaj yeem kuaj pom tsam plab loj, thiab qhov asymmetry kuj yog me me.
Invagination yog lwm yam mob hnyav ntawm txoj hnyuv stenosis. Hauv qhov no, kev kho mob yuav tsum tau pib tam sim ntawd, vim tias muaj qhov tshwm sim ntau ntawm kev tsim cov ntaub so ntswg necrosis thiab poob ntshav loj.
Invagination yog txheej txheej ntawm ib ntu ntawm txoj hnyuv rau lwm qhov. Raws li txoj cai, lub tuam tsev nyob qhov twg qhov nqaim tshwm sim yog nkag mus rau hauv chav haujlwm nrog ib txwm lumen. Feem ntau muaj ib qho invagination ntawm ob txheej, txawm li cas los xij, hauv cov xwm txheej hnyav, cov txheej txheem tuaj yeem ncav cuag li xya.
Nws tsim nyog sau cia tias qhov kev nkag siab tuaj yeem tshwm sim ntawm txhua lub hnub nyoog, tab sis feem ntau tus mob no yog tus yam ntxwvrau cov menyuam yaus hnub nyoog qis dua 5 xyoos.
Stenosis vim qog kev loj hlob
Yog tias tus neeg mob muaj neoplasm nyob rau hauv txoj hnyuv, ces plab hnyuv stenosis yog tsim nyob rau hauv lub department uas cov qog tsim. Nyob rau hauv cov ntaub ntawv no, feem ntau tus kab mob pib sluggishly rau lub sij hawm ntev thiab tsis manifest nws tus kheej nyob rau hauv txhua txoj kev. Cov tsos mob tsis tuaj los yog mob me heev.
Feem ntau, cov txheej txheem malignant pib xav tias tsis muaj cov tsos mob tshwj xeeb, suav nrog:
- Nyob ntev hauv qhov kub thiab txias mus rau theem me;
- ntshav qab zib;
- poob phaus.
Qhov txaus ntshai tshaj plaws yog cov qog, uas nyob rau hauv txoj cai ntawm txoj hnyuv. Nws raug kuaj pom tsis zoo, tab sis sai sai rau hauv lwm cov ntaub so ntswg. Cov qog nyob rau sab laug ua rau cov tsos mob hnyav thiab mob hnyav.
Stenosis tawm tsam keeb kwm ntawm qog nqaij hlav yog tus cwj pwm los ntawm:
- mob plab;
- mob hnyav tom qab noj mov;
- bloating vim roj tsuj roj;
- cem quav;
- mob raws plab vim khaus plob tsis so tswj, uas cuam tshuam los ntawm o.
YCoprostasis
Coprostasis yog ib qho ntawm cov tsos mob ntawm plab hnyuv stenosis, uas yog ib qho zoo rau cov neeg laus. Raws li txoj cai, nws tsim tawm tsam keeb kwm yav dhau los ntawm cem quav, senile atony, cov leeg tsis muaj zog ntawm thaj tsam plab, thiab lwm yam. Tsis tas li ntawd, coprostasis feem ntau pom hauv cov neeg mob uas tsim txom cov tshuaj laxatives.
Thaum coprostasis thiab stenosiscov hnyuv sib sau ua ke, ces tus neeg mob tsim cov tsos mob hauv qab no:
- ncua ntev hauv plab hnyuv;
- mob plab;
- mob plab;
- nquag plab thiab flatulence;
- quav hauv daim ntawv nyias nyias;
- kev tshem tawm tsuas yog ua tau nrog lub zog nruj.
Cov kws kho mob tshwj xeeb yog ceev faj txog qhov kev kuaj mob no, txawm li cas los xij, cov tshuaj niaj hnub thiab cov neeg ua haujlwm hauv tsev kho mob muaj peev xwm pab tau tus neeg mob kho tus mob coprostasis yam tsis muaj kev phais.
Npaj pob zeb thiab stenosis
Tshuaj plab stenosis tshwm sim los ntawm lub gallbladder pob zeb yog ib tug tsis tshua muaj pathology. Qhov tseeb yog tias tsuas yog pob zeb loj heev uas muaj txoj kab uas hla tsawg kawg 5 cm tuaj yeem thaiv txoj hnyuv lumen.
Yog qhov no tshwm sim, raws li txoj cai, stenosis tau sau tseg hauv cov hnyuv. Nws yog ib qho nyuaj rau nrhiav tau qhov no pathology. Nws raug muab tawm los ntawm kev tsim roj ntau hauv lub gallbladder thiab nws cov ducts.
Yog tias, txawm li cas los xij, cov kws kho mob kuaj mob stenosis tiv thaiv keeb kwm yav dhau ntawm kev txav ntawm pob zeb los ntawm lub gallbladder, ces nws yuav tsum pib kho sai li sai tau. Qhov tseeb yog hais tias ib tug txawv teb chaws lub cev heev heev injures lub nto ntawm txoj hnyuv. Raws li qhov tshwm sim, kev hloov pauv gangrenous tuaj yeem txhim kho, uas nyuaj rau kho.
Kev kho mob
Thaum ib tug neeg raug tus kab mob zoo sib xws, feem ntau nws txaus siab rau lo lus nug, puas yog phais tsim nyog rau txoj hnyuv stenosis? Hmoov tsis zoo, kev kho mob rau cov kab mob no, raws li txoj cai, tsis cojCov txiaj ntsig zoo.
Kev ua haujlwm nyob ntawm ntau yam:
- qhov chaw nyob qhov twg;
- yog vim li cas stenosis tsim;
- Puas muaj teeb meem tshwm sim tawm tsam keeb kwm ntawm stenosis.
Nws tsim nyog nco ntsoov tias kev teem sijhawm ntawm kev ua haujlwm tsuas yog ua tau tom qab kev kuaj xyuas tiav ntawm tus neeg mob. Yog hais tias stenosis tshwm sim tawm tsam keeb kwm yav dhau ntawm kev loj hlob ntawm cov qog malignant, tom qab ntawd ib qho kev phais ntawm txoj hnyuv tau muab. Tsis tas li ntawd, kev tshem tawm ib feem ntawm txoj hnyuv kuj tau qhia yog tias cov txheej txheem irreversible nyob rau hauv cov ntaub so ntswg twb pib, piv txwv li, lawv necrosis.
Hmoov tsis zoo, kev cuam tshuam kev phais muaj nws qhov tsis zoo. Piv txwv li, thaum lub sij hawm ua hauj lwm uas yog tsom rau kev kho mob stenosis, adhesions nyob rau hauv txoj hnyuv yuav tshwm sim thaum lub sij hawm rov qab los. Txhawm rau txo qhov txaus ntshai, cov kws kho mob nquag siv txoj kev kho mob endoscopic, tab sis nws tsis yog ib txwm siv tau. Kev kho mob endoscopic ntawm stenosis yuav tsum tsis txhob ua rau cov kab mob malignant lossis qhov txhab loj.
Raws li qhov tshwm sim, nws yuav tsum tau sau tseg tias nws tuaj yeem kho tus mob stenosis, tab sis qhov tshwm sim feem ntau yog nyob ntawm kev kuaj mob zoo, kev tsim nyog ntawm tus kws tshaj lij thiab tus kws phais. Nws tseem yog ib qho tseem ceeb kom ua raws li tag nrho cov lus pom zoo thaum lub sij hawm rov qab los, vim nws yog lub sijhawm no uas muaj ntau yam teeb meem tshwm sim.
