Y Diverticulum ntawm lub plab yog ib qho pathology ntawm txoj hnyuv, uas diverticula tshwm rau ntawm nws cov phab ntsa - hernial formations mus txog 2 cm loj. ntawm tus me nyuam.
Qee cov txheeb cais
Muaj kev xav tias diverticula yog ib yam kab mob ntawm ib tus neeg, tab sis qhov no tshwm sim tsis tshua muaj. Hnub nyoog qis dua 30 xyoo, pathology raug kuaj pom tsawg heev.
Qhov tshwm sim siab tshaj plaws tshwm sim thaum muaj hnub nyoog 80 xyoo, thaum muaj hnub nyoog no cov kab mob tau kuaj pom hauv 8 ntawm 10 tus neeg mob. 60% ntawm cov tib neeg pom tus kab mob no ntawm cov hnub nyoog ntawm 60 thiab 80, thiab tsuas yog 30% ntawm cov pejxeem - nruab nrab ntawm cov hnub nyoog ntawm 30 thiab 60.
Tab sis tus kab mob no tsis yog ua rau muaj hnub nyoog xwb. Pathology yuav luag tsis tau kuaj pom hauv cov teb chaws uas lub hauv paus ntawm kev noj haus fiber ntau, qhov twg kev lag luam yog nyob rau theem ntawm kev loj hlob. Hauv tebchaws Africa thiab Asia, yuav luag tsis muaj leej twg kuaj pom tus kabmob. Nyob rau hauv cov teb chaws Europe thiab lwm lub teb chaws tsim, gastric diverticulum yog kuaj tau heevfeem ntau. Qhov no yog vim cov pej xeem ntawm cov xeev no yog cov neeg quav yeeb quav tshuaj, noj ntau yam khoom qab zib, nqaij.
Russia tsis muaj kev zam. Tus naj npawb ntawm cov neeg mob hauv lub tebchaws nrog qhov kev kuaj mob zoo li no yuav luag sib npaug rau tus lej hauv cov tebchaws nyob sab Europe. Nyob rau tib lub sijhawm, cov kws kho mob nco ntsoov tias tus kab mob no tau "muab me me", ntau thiab ntau dua nws pom hauv cov neeg muaj hnub nyoog 20 xyoo.
Vim li cas qhov no tshwm sim?
Cov kws tshawb fawb hauv thaj chaw tshuaj tau hais tias lub diverticulum ntawm lub plab hauv tib neeg tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev nce siab ntawm cov quav rau ntawm phab ntsa ntawm txoj hnyuv. Ib tug neeg sau ib tug loj npaum li cas ntawm gases, uas kuj tso siab rau ntawm phab ntsa ntawm txoj hnyuv. Thiab yog vim li cas rau txhua yam yog kev noj zaub mov tsis zoo, ib qho me me ntawm fiber ntau hauv kev noj haus. Cov neeg uas muaj cov kab mob no noj ntau cov zaub mov, uas ua rau kev tsim cov zaub mov me me pob, uas tso lub siab rau cov hnyuv. Yog li ntawd, diverticula tshwm nyob rau hauv "tsis muaj zog" qhov chaw uas cov hlab ntsha nyob ze rau saum npoo.
Ntawm yog muaj cov neeg muaj caj ces muaj kab mob, tab sis qhov no yog ib qho tshwm sim tsis tshua muaj tshwm sim, kom tus kab mob pib zuj zus, tus neeg yuav tsum noj zaub mov tsis zoo.
Risk Factor
ua rau muaj kev cuam tshuam muaj xws li cov kab mob ntev ntawm lub plab zom mov: peptic ulcer ntawm duodenum thiab plab. Qhov tseem ceeb sib npaug yog cov khoom noj uas ib tug neeg noj, yog tias nws dhau, ces nws yuav muaj kev pheej hmoo. Pervisceritis, flatulence thiab ntuav ntuav tuaj yeem ua rau txoj kev loj hlobpais plab diverticulum.
Symptoms
Gastric diverticulum feem ntau tsis muaj cov tsos mob pom tseeb, ua rau nws nyuaj rau kev kuaj mob.
Yog tias muaj ntau lub diverticula, cov tsos mob hauv qab no yuav tshwm sim:
- tsis muaj quav ntau tshaj ib hnub;
- hnyav, thiab qee zaum mob hauv plab nrog qhov chaw nyob hauv sab laug;
- nce roj tsim thiab flatulence;
- ntshav tawm ntawm qhov quav yam tsis muaj mob.
Txawm li cas los xij, tsawg tus neeg mob siab rau tag nrho cov tsos mob no, lawv cuam tshuam nrog lwm yam kab mob.
Daim ntawv mob hnyav tuaj yeem nrog mob hnyav thiab ua txhaum cov quav.
theem kab mob
Muaj ntau hom kab mob plab hnyuv uas tshwm sim tawm tsam keeb kwm ntawm cov tsos mob sib txawv:
- daim ntawv tsis txaus ntseeg. Cov tsos mob tshwm sim los ntawm qhov yuav luag tsis muaj cov tsos mob.
- Daim ntawv pseudo-ulcerative hauv nws cov tsos mob zoo ib yam li thawj theem ntawm peptic ulcer. Tus neeg mob feem ntau muaj belching, xeev siab, mob heev tom qab noj mov, thiab lub caij nyoog yuav raug soj ntsuam. Yog tias daim ntawv diverticula hauv thaj av epigastric, qhov mob tshwm tom qab lub sternum thiab hauv thaj tsam ntawm sab laug hypochondrium nrog irradiation mus rau scapula.
- Pseudocarcinomatous daim ntawv yog tus cwj pwm los ntawm emaciation, asthenia, mob ntawm qhov tsis paub tseeb etiology. Qee cov neeg mob muaj qhov kub thiab txias subfebrile.
- daim ntawv sib xyawqhia tias gastric fundus diverticula tshwm sim tawm tsam keeb kwm ntawm cholecystitis, mob plab, lossis lwm yam pathologies ntawm txoj hnyuv.
Kuj paub qhov txawv dyspeptic lossis kab mob plab.
Muaj Teeb Meem
Ib qho teeb meem txaus ntshai tshaj plaws yog los ntshav, uas tuaj yeem ua rau tuag taus. Ua ntej pib los ntshav, raws li txoj cai, muaj qhov mob hauv thaj tsam epigastric, uas tau muab rau lub xub pwg nyom thiab lub xub pwg hniav. Nyob rau hauv ib qho chaw zaum, qhov mob yuav nce ntxiv. Yog tias muaj ntshav ntau dhau lawm, ces ntuav nrog cov hlab ntshav tuaj yeem tshwm sim. Yog tias ntshav poob me me, tab sis ntev, ces muaj lub rooj zaum nrog cov quav tso quav, tsis muaj zog thiab mob maj mam nce.
Perforation los yog atrophy ntawm txoj kev loj hlob sheath tej zaum yuav tshwm sim nrog rupture ntxiv. Qee cov neeg mob muaj qhov torsion ntawm diverticulum pedicle nrog strangulation ntawm mesentery ntawm txoj hnyuv loj. Tawm tsam keeb kwm yav dhau los ntawm diverticulum, gastritis theem nrab, sarcoma, polyps thiab txawm tias mob qog noj ntshav yuav tshwm sim.
Diagnosis
Gastric diverticulum - nws yog dab tsi thiab nws kuaj tau li cas? Qhov "tus qauv kub" rau kev kuaj mob no yog fibrogastroduodenoscopy. Thaum lub sijhawm kawm, cov khoom siv biopsy kuj raug coj mus.
X-ray sib piv kev kuaj, ultrasound, xam tomography tuaj yeem ua tau.
Yog tias tus kab mob kis mus yam tsis muaj teeb meem, ces tsis tas yuav kuaj kuaj. Yog xav tias muaj kab mob peptic, yuav tau ntshav.
Kev kho mob
Tsis muaj hnub noib qho kev sib koom ua ke rau kev tshem tawm cov tsos mob thiab kho diverticulum ntawm lub plab. Kev noj zaub mov noj muaj lub luag haujlwm tseem ceeb hauv kev ua kom tus neeg mob lub cev tsis muaj zog. Antispasmodics thiab prokinetics yog siv thaum lub sij hawm exacerbation thiab tsuas yog tom qab kuaj xyuas tag nrho cov kab mob.
Nyob hauv hnub nyoog laus, kev saib xyuas kev kho mob yuav tsum tau ua kom tiv thaiv kev phais.
Yog tus neeg mob cem quav, tej zaum yuav muab tshuaj laxative, tab sis tsis pom zoo xaiv tus kheej ntawm cov tshuaj no.
kho mob phais
Yog tias tsis muaj teeb meem, tab sis qhov mob tshwm sim tau qhia meej, ces qhov kev npaj ua haujlwm tuaj yeem ua tiav. Kev ua haujlwm kub ntxhov tau ua yog tias muaj kev hem thawj rau lub neej, los ntshav, mob qog noj ntshav lossis perforation tau pib.
hom kev ua haujlwm:
- resection ntawm diverticulum nrog rau qhov sib npaug ob-kab stitching ntawm qhov tsis xws luag hauv phab ntsa plab;
- tuaj yeem invaginated hauv lumen ntawm lub plab nrog ib txhij suturing ntawm lub qhov ncauj ntawm qhov kev loj hlob;
- pastric resection yog ua yog tias lub diverticulum tau tsim nyob rau hauv thaj chaw pyloric.
Txawm li cas los xij, nrog rau lub sijhawm nkag mus rau lub tsev kho mob thiab ua raws li cov cai pom zoo rau kev kho mob plab hnyuv, qhov kev pheej hmoo ntawm kev phais yog tsawg heev.
khoom noj khoom haus
Kho cov khoom noj yog tsom rau normalizing lub ntim thiab sib xws ntawm cov quav, tshem tawm qhov mob thiab spasms. Feem ntau, yuav tsum tau kho txoj kev ua neej, uas yog, kev ua kom lub cev nce ntxiv.
Nyob rau hauv plab hnyuv, kev noj zaub mov yog raws li kev siv cov khoom noj khoom haus fiber ntau, fiber ntau thiab cov khoom noj uas muaj kev txhawb zog rau kev ua haujlwm ntawm lub plab zom mov.
Cov zaub mov pom zoo rau kev noj txhua hnub:
- Txhua yam bran. Thaum nruab hnub, koj yuav tsum haus 2-3 tablespoons.
- Brown los yog "tsiaj" mov, uas yog, ntau yam tsis tau muab tshem tawm.
- Los ntawm cov khoom noj muaj roj, koj tuaj yeem siv paj noob hlis thiab txiv roj roj, butter.
- Ib hnub koj yuav tsum noj li ib nrab ib kilogram zaub thiab txiv hmab txiv ntoo. Lawv zoo tshaj plaws nrog cheese. Zaub yuav tsum tau steamed, mashed los yog mashed. Txiv hmab txiv ntoo yog noj zoo tshaj plaws nyob rau hauv daim ntawv ntawm compotes, txiv hmab txiv ntoo qhuav, kissels thiab jelly.
- YKoj tuaj yeem siv qab zib, marshmallow thiab zib ntab.
- Cov khoom siv hmoov nplej tsuas yog ua los ntawm cov hmoov nplej tag nrho.
- Cov khoom noj mis nyuj tau tso cai: kefir, tsev cheese, me ntsis cheese, cream, curdled mis nyuj, qaub cream.
- Cov nplej thiab cereals yuav tsum yog los ntawm cov nplej zom lossis cov nplej tag nrho. Ntxim qab kawg li os lawv yog cov steamed los yog mis nyuj, dej.
Nws yog qhov yuav tsum tsis kam lees txhua yam khoom uas yog tsiaj keeb kwm, tsis suav nrog cov khoom qab zib. Nqaij thiab ntses raug tso cai, tab sis nyob rau hauv qhov txwv - tsis pub ntau tshaj 150 grams tauj ib hnub. Qhov zoo tshaj plaws, koj yuav tsum noj 1 feem nqaij los yog ntses thiab 4 qhov chaw fiber ntau. Nqaij yog qhov zoo tshaj plaws steamed thiabgrind on ib grater los yog nyob rau hauv ib tug blender. Koj tsis tuaj yeem noj ntau dua ob lub qe hauv ib hnub. Lawv yuav tsum tau muag muag los yog siav hauv daim ntawv ntawm omelette, scrambled qe.
Noj mov yuav tsum tsis tu ncua thiab txawm, 5-6 zaug ib hnub.
Txwv tsis pub muaj:
- ntsev thiab haus cov tais diav;
- muffin;
- khoom ib nrab tiav;
- sweets: halva, chocolate;
- khoom noj kaus poom;
- noob.
Koj tsis tuaj yeem siv cov kua zaub ntawm "hnyav" broths ntawm nqaij qaib, lwm yam nqaij, ntses, nceb. Nws tsis raug tso cai noj qaub cabbage kua zaub thiab okroshka. Koj yuav tsum tso cov dej qab zib, kas fes, kvass, haus cawv.
Huab cua thiab tiv thaiv
Feem ntau, qhov kev cia siab rau kev rov zoo yog qhov zoo. Txawm li cas los xij, yog tias los ntshav tshwm sim, muaj kev pheej hmoo siab rov tshwm sim hauv ob peb lub hlis lossis ntau xyoo. Nws muaj peev xwm tsim cov ntshav liab. Kuj tseem muaj kev pheej hmoo ntawm kev tsim cov kab mob peritonitis, nkag mus rau hauv cov khoom nruab nrog cev. Yog tias kuaj pom tus kab mob pathology, tus neeg mob tau sau npe nrog lub chaw muag tshuaj.
Hnub no tsis muaj kev tiv thaiv tshwj xeeb. Txawm li cas los xij, tseem muaj peev xwm txo tau qhov yuav tshwm sim ntawm tus kab mob. Ua ntej tshaj plaws, koj yuav tsum noj kom raug, tshem tawm cov txheej txheem inflammatory hauv plab hnyuv, tiv thaiv cov tsos mob ntawm lub plab thiab duodenum.
Qhov tseem ceeb ntawm kev tiv thaiv qhov tshwm sim ntawm diverticulum hauv tus menyuam yog tus cwj pwm ntawm leej niam rau kev noj haus thiab kev ua neej thaum cev xeeb tub. Yog leej niam xav taukom nws tus menyuam noj qab nyob zoo, nws yuav tsum ua raws li txhua tus kws kho mob cov lus pom zoo.
