Abscesses isibindi: ukwelashwa, izimpawu, izimbangela, zokuvimbela

Isibindi abscesses kuyingozi ngoba kungaholela emiphumeleni engathí sina, ngezinye izikhathi kuze sepsis nokufa. By the way, lesi sifo kungaba samabanga aphansi noma. Ngokwezibalo, ithumba ibonakala zasemuva zezinye izifo zesibindi, hhayi ngaphezulu kuka 3-5% of amacala.

Noma kunjalo, abantu abaningi banesithakazelo imibuzo mayelana inkambo leso sifo, ngoba ukwephulwa ngokushesha iyoqashelwa, ngokushesha lo muntu uzothola ukwelashwa okufanele. Ngakho lapho kuba kwesibindi kubantu, futhi yiziphi izizathu esiyinhloko ukuhlulwa kwayo? Indlela yokubona izimpawu zokuqala ithumba? Yikuphi yezinkinga kungabangela isifo? Ingabe ngidinga yimuphi ukuhlinzwa noma ukugula zingelashwa esebenzisa imithi olandelanayo? Izimpendulo zale mibuzo abafundi abaningi.

Ithumba: Kuyini -ke?

Ngokwemvelo, abantu abaningi bafuna ukuqala ukubhekana eyisisekelo imigomo yokwakheka nezincazelo. Lapho umuntu isibindi kuyinto? Lena isitho esikhulu itholakala elingenhla kwesokudla esiswini square (kwesokudla quadrant engenhla).

Kuyaphawuleka ukuthi, ngenxa yokuntuleka zobuhlungu emzimbeni, noma ukuthi angalimaza isibindi futhi hhayi ephelezelwa ubuhlungu obungokomzimba noma ubuhlungu. Ngakho-ke kuyadingeka eduze nokuqapha umsebenzi wonke umzimba. Lesi sitho esibalulekile uyazihlanza igazi lomuntu ubuthi futhi izinto elimazayo ithatha ingxenye in the umzimba, idepho ka glycogen (reserves lisebenza) ukhiqiza futhi ulawula Bile acid ukugaya.

Ngeshwa, abanye abantu ibhekene ukuxilongwa ezinzima, njengoba ithumba. Kuyini lokhu? Lena ukuvuvukala ubovu ka kwezicubu, okuyinto kuhambisana ukuncibilika okuthiwa. Ngenxa inqubo enjalo ngaphakathi komgodi ithumba kubunjwa khona ubovu uquqaba uqale buthelela. Njengoba ukwanda degree ngobukhulu, futhi ngezinye izikhathi bangase siphukile, ukukhulula okuqukethwe ubovu.

Ngokocwaningo olwenziwa kwezibalo, abscesses isibindi, ngokuvamile umphumela ezinye izifo zomzimba. Abesilisa abahlushwa izifo ezifana kancane kaningi ngaphezu yabesifazane. Lesi sifo sivame uma kakhulu izifunda ezingeni eliphansi izimo sanitary namanzi angcolile. Leli qembu kuhlanganisa eChile, Brazil, Peru, India, Tibet, Nepal, Pakistan, Iraq, Iran, izwe eNingizimu Afrika.

isifo uhlelo ngezigaba

Namuhla, kunamabandla izikimu eziningi ngezigaba lokhu egunjini lokuhlolwa kwezifo. Ngokwesibonelo, abscesses isibindi kungaba isiqalo (inqubo ubovu ikhiqizwa isibindi parenchyma enempilo) nokwesibili (ngemuva livela kwamanye Izifo ukuvuvukala). Kuye uhlobo ukutheleleka, isifo sehlukaniswe yisinanakazana futhi amagciwane.

Uma sithatha ngokuthi yindlela yokuhlola indlela ukutheleleka, ukukhululwa:

• Ithumba hematogenous (ukutheleleka ingena egazini);
• holangiogennye uhlobo lesi sifo (lwegciwane ageje ipheshana biliary);
• ukuthintana (ukuvuvukala zibhebhetheka emazikweni engumakhelwane);
• ukucindezeleka kwangemva kwenhlekelele (kuba inkinga ngemva ukulimala noma ukuhlinzwa);
• cryptogenic (izimbangela pathologies bengayiqondi ngokugcwele).

Isibindi abscesses kungaba eyodwa noma amaningi, ukuba osayizi enkulu noma encane. Ukwabela ifomu kuyinkimbinkimbi futhi kube lula lesi sifo.

Isibindi ithumba: Izimbangela

Imbangela njalo iningi ubovu ukuvuvukala kuyinto Ukungena ukuthelelana nezicubu. Ngokuvamile, indima pathogen nezilwanyana ezincane webhaktheriya, kuhlanganise E. coli, Staphylococcus, streptococcus, kanye nabanye.

Ngaphezu kwalokho, kungenzeka umonakalo izicubu yisinanakazana. Ngokwesibonelo, eyaziwa emhlabeni wonke kuyinto amebic isibindi ithumba (ifomu ezishisayo isifo). Futhi ukuvuvukala ubovu ingaqala ku isizinda Ascaris KWAMAGUNDANE Echinococcus, alveococcus.

Ngakho, ithumba futhi, ngenxa-ke, isibindi ingaqala uma:

• Penetration kwamagciwane esibindini nge imbobo Bile. Okunjalo ebonwe izifo ezifana cholangitis, cholelithiasis, cholecystitis, izilonda anomdlavuza we imbobo Bile.
• Ukutheleleka akwazi ukungena kanye ukugeleza kwegazi ngokusebenzisa ingosi futhi emithanjeni hepatic. Ithumba kungaba inkinga e izilonda ukonakala kwenhliziyo, amathumbu, ubende, isisu kanye amanyikwe.
• Ngezinye izikhathi Amagciwane ukungena kwezicubu isibindi amaseli khona yisishiso ezithathelwanayo kwezitho eseduze. Ngakho-ke, izinto ezandisa le ngozi appendicitis, isifo diverticular (ukuvuvukala ezicutshini izindonga ezinkulu emathunjini), izilonda emathunjini, peritonitis, ubovu peritonitis.
• Ithumba bungase bubangelwe isibindi ukulimala okwenzeka, isibonelo, engena amanxeba ngaphakathi komgodi ongaphakathi kwamathumbu.
• Ukutheleleka izicubu ingabuye yenteke ngesikhatsi ukuhlinzwa ezithweni besisu.

Izimpawu zokuqala zalesi sifo

Yiziphi izimpawu isibindi ithumba? Izimpawu zingahlukaniswa ngamaqembu amabili. Esikhathini enkathini yokuqala isifo abangazazi izimpawu zokudakwa. Okokuqala, njengoba umthetho, kukhona imfiva, ubuthakathaka jikelele, Ukugodola, umzimba nobuhlungu bomzimba. Isiguli ekhononda ka ukutubeka futhi ukozela, isiyezi, tinnitus, nekhanda. Iphango wancipha.

Ngemva kwalokho, izimpawu ziba evelele. Ngokwesibonelo, Ukukhetha kungabonakala nasemkhakheni inqwaba umjuluko tacky. angaboni kahle ngangokunokwenzeka, ukuhhema, ukunakekela kahle futhi inkumbulo. Iziguli esekhala isicanucanu njalo. Ngezikhathi ezithile kukhona ukuhlanza, kanye nokuqukethwe wamathumbu.

Izimpawu ithumba elihlobene ne kahle isibindi umsebenzi

Njengoba isifo siqhubeka izimpawu adakwe ujoyine nezinye izifo. Njengomthetho Basikisela ukuthi kuwukwephula sina umsebenzi sesibindi isivele iyatholakala.

Iziguli esekhala ubuhlungu hypochondrium kwesokudla. Ekuqaleni kuphela ukungakhululeki ukuthi ngekukhula ithumba isiba evelele. Ubuhlungu syndrome zingase ziwohloka kuye ukudla, ukuvivinya umzimba, ukwelashwa ezinye izifo, nokunye. D.

Mayelana zokunciphisa esesuthi, isicanucanu nokuhlanza, ukwehla kancane kancane umzimba unamandla nesisindo somzimba. Phakathi ngihlolwa udokotela kungacacisa ukuthi khona hepatomegaly (isibindi ukwandisa ngobukhulu) kanye splenomegaly (kweNdikimba ubende).

Ngakolunye uhlangothi, ezinye iziguli kubika okusheshayo kwesisindo, okuyinto lihlotshaniswa ukuthuthukiswa ascites. uketshezi Mahhala uqala buthelela ngalo ingaphakathi lesisu, ukuze iziguli kwandisa, ngisho ezinkulu esiswini.

Izimpawu ithumba futhi ingase ihlanganise yellowing kwesikhumba, okuyinto lihlotshaniswa ukuthuthukiswa jaundice. Ngokuvamile ngemuva kwalesi zokugula siyenzeka ukuvela noma eziya ziba zimbi ka hemorrhoids. Uma ukuvuvukala izicubu isibindi kulandele ukwanda kwengcindezi imithambo yegazi hepatic, kungenzeka ukuba opha ngemithambo pheshana emathunjini. yezinkinga ababhekene nesimo esinje kungabaduduza eboniswe, isibonelo ukuhlanza, ukungaguquguquki okusikhumbuza ngezizathu ikhofi, noma yakha black hlala kuso.

izindlela zesimanje uphethwe

Uma izimpawu i esiphuthumayo kudingeka kudokotela. Ubovu ithumba Liyindawo yingozi. Ukushesha lokusiza nesineke afanelekayo zizonikezwa, le amathuba yokutakula yimpumelelo kangcono.

Ukuqala Specialist lizobuyekeza izikhalazo kwabantu kwenziwe ukuhlolwa jikelele. Inqubo uphethwe iphuzu elibaluleke kakhulu iyona ukuhlaziywa. Ngokwesibonelo, kungase kusho ukwehla kwamazinga hemoglobin, okuthathwe kwehle abomvu egazi nama-platelet ngesikhathi segazi. Njengoba sihambisana nale lizinga lelitfutfukile ESR, inani amangqamuzana amhlophe egazi, zona ngokwazo kubonisa khona ukuvuvukala ikhuphuke kakhulu.

Uma ithumba sivame ukuba ukuhwalala we umchamo. Phakathi ukuhlolwa laboratory kungabonwa inombolo okungavamile abomvu egazi ashaye kanye amangqamuzana amhlophe egazi. Futhi, umsebenzi ukuhlolwa isibindi abazenzi, phakathi kwesikhathi lapho ungathola ngaphambi kokukhulisa ezingeni of phosphatase ane-alikhali, bilirubin eqondile Imininingwane. Ngezinye izikhathi okwengeziwe kwenziwe coagulogram okuyinto lapho ithumba isibindi sikhombisa ukwehla igazi ekunqandeni. Ngenxa yalesi sifo libhekene ukushintsha kombala indle. Esikhathini ukuhlaziya sezinyawo angathola khona igazi.

Isinyathelo esibalulekile uphethwe futhi izifundo wezinsimbi. Ethandwa kakhulu futhi ezingabizi kuyinto x-ray esiswini, okungase ibonisa umgodi round nge imiphetho ebukhali, ubekwe parenchyma kwesibindi - lena ithumba. Ngosizo ultrasound ziqinisekisa Ihlahlubo ukunquma usayizi ubomvu kumiswa.

Izimo zethu zihluke kakhulu olunembile, kodwa kukhona izifundo ezibizayo ezifana CT nama-MRI. Lezi zinqubo zisiza ekwenzeni uphethwe, ukucacisa eqondile indawo, inombolo kanye nosayizi abscesses, futhi ngezinye izikhathi ngisho kutholakale imbangela yokushona ukuvuvukala. Ngezinye izikhathi iziguli anqunyiwe biopsy - phakathi naleyo nqubo eyenziwa kocingo okuqukethwe sangaphakathi neoplasm ukubizwa ukuhlaziywa okwalandela endaweni yokugeza.

Kakhulu kangakanani Kunenkolelo laparoscopy zokuxilonga, phakathi kwesikhathi lapho udokotela ehlola kwezitho zangaphakathi (isibindi kuleli cala) esebenzisa amakhamera akhethekile yethulwa kuleli ngokusebenzisa besisu odongeni wokubhoboza. Inqubo kuyingozi ngempela ngoba isengozini enkulu yokutheleleka umonakalo ithumba ukudabuka leso purulent uquqaba.

Yini yezinkinga zingenzeka?

Isibindi abscesses - nokwephula, okuyinto kunoma yiliphi icala akunakugwenywa. kumiswa kungelashwa, kungaba ukudabuka, ukukhulula okuqukethwe ngaphandle nibonakala ubovu. Umphumela walesi igebe kungenzeka kolwelwesi ubovu (okuqukethwe ubovu ifinyelela nezicubu ze-isisu), peritonitis (ngemva ukudabuka ubovu mass ukusakaza phezu komgodi ongaphakathi kwamathumbu), pleurisy (okuqukethwe ageje ithumba kule ingaphakathi pleural), pericarditis (ubomvu e ngalo ingaphakathi pericardial, okuyinto iyingozi kakhulu inhliziyo kwemisipha), enteritis (imfundo ukufohla senzeka emathunjini).

Zikhona nezinye, ukuxakeka kancane sina. Ngokwesibonelo, e discontinuity isizinda angagcina ithumba subdiaphragmatic, lapho inani elikhulu ubovu uquqaba zanqwabelana ngqo ngaphansi diaphragm. Imiphumela ingase ihlanganise ezinzima igazi ukulahlekelwa ngenxa ngopha isibindi. Ngezinye izikhathi iziguli ziba ascites, okuyinto kuhambisana ekuqongeleleni esiningi uketshezi ngaphakathi komgodi ongaphakathi kwamathumbu. Ngenxa yalokho, ukwanda nomfutho wegazi ophezulu ithumba etholakalayo portal - isimo esenza lihlotshaniswa anda wegazi vein portal, nakho kuhambisana opha vein of ipheshana wokugaya ukudla.

Njengoba singabona, nge isibindi - akusiwona okungasisiza okungafanele sithathwe kalula. noma yiziphi izinkomba ezisheshe Uma une kudingeka afune usizo lwezokwelapha.

imithi ye ithumba

Yini esinikezwa odokotela ezigulini uxilongwe "isibindi ithumba? izigaba kokuqala ukwelashwa kungase kube imithi, ikakhulukazi uma ukuvuvukala sanda kancane kancane, isimila kayikhuli, akukho ingozi ukudabuka yayo.

Yokwelapha yokuqala kuhloswe kokukhipha izimbangela ukuvuvukala, isb. E. Ngezinye ekuqedeni ukutheleleka. Ngesikhathi uphethwe yini odokotela kungaba ukuthola ukuthi kwaba ngaphansi kwethonya silwanyana uvele ithumba. Uma kuwukuthi uhlobo webhaktheriya lesi sifo, kunikezelwe nemithi. Indlela ephumelela kakhulu namuhla abhekwa oyisizukulwane sesithathu cephalosporins ( "Tsefoperazol" "Ceftriaxone") ukuthi avikelekile penicillins ( "Amoxiclav", "Augmentin"), fluoroquinolones isizukulwane lesithathu noma lesine ( "Ciprofloxacin", "Levofloxacin", "norfloxacin").

Uma ithumba lihlotshaniswa umsebenzi amagciwane, isiguli ekunike Yiqiniso yokwelapha antiprotozoal, ngokukhethekile, ukuthatha metronidazole noma analogue yayo. Ngokushesha kuyafaneleka ukuthi ukwelashwa wenziwa endaweni esibhedlela. Isimiso umthamo kanye nokuphathwa izidakamizwa kungenziwa kuphela kunqunywa udokotela ukuba khona.

Ngaphezu kwalokho, kuye ngezimo zesiguli, iqondiswa yokwelapha lingaze:

• kobuthi egazini ehlanganisa esasikhipha ukuba solution, Ringer sika noma 5% glucose;
• ebukhoneni ubuhlungu ebekiwe izidakamizwa ezinzima ezifana "Cha-spa" (kususa spasm) kanye "ibuprofen" (kususa ubuhlungu futhi imfiva, kuvimbela ukuthuthukiswa ukuvuvukala);
• futhi kudinga reception ehnterosorbentov isib "Smecta" phakathi ukudla;
• ne ukopha zangaphakathi iqondiswa sodium etamzilat okuyinto okuvimba ukulahlekelwa igazi;
• Uma isiguli uhlushwa ukuhlanza njalo bangakwazi ukunikeza antiemetics, isibonelo, "Metoklopromida" noma "Reglan".

ukuphathwa Steel uma sidingeka?

Kwezinye izimo, imithi ngeke ayiqede inkinga yokuntuleka isibindi ithumba. Ukusebenza ezimweni ezinjalo. Ngaphezu kwalokho, kokungenela kuhlinzwa liyadingeka eziphuthumayo (isib ukudabuka of ithumba).

Kuze kube manje, kukhona izindlela ezimbalwa yokwelashwa kuhlinzwa. Indlela elula kubhekwa amanzi ka ithumba. Ingqikithi yalo Inqubo kanje: ngokusebenzisa sebeziqhumbuza ezincane tube amabili akhethekile ufakwa ingaphakathi of ithumba. Ngemva omunye wabo njalo bephethe ikhambi elwa namagciwane, futhi ngaphandle nibonakala ngokusebenzisa ezinye okuqukethwe okukhipha ubovu kumiswa. Ngokuvamile, ukwelashwa okunjalo sihlala izinsuku ezingu-3-4.

Ngeshwa, le ndlela akuyona ukusebenza ukudabuka noma ithumba ebukhoneni izilonda amaningi. Ezimweni ezinjalo, i-laparotomy. Ukufinyelela udokotela ohlinzayo isibindi uthola ngokusebenzisa imbobo besisu. Ngesikhathi kokuhlinzwa, ithumba ngamunye ivulekile, bese, usebenzisa i aspirator, okuqukethwe ubovu isusiwe. Amaphilisi ezingenalutho agezwa ngesixazululo isinqandakuvunda ke isuswe, kanyekanye ushivaya izicubu isibindi enempilo. Njengoba ungacabanga, lokhu operation kuyingozi kakhulu (ingozi yokutheleleka), futhi isikhathi esiningi, futhi isikhathi nokuvuselelwa ihlala isikhathi eside. Noma kunjalo, kwezinye izimo, indlela kuphela ukuze asindise ukuphila kwesiguli.

By the way, kanye nokuhlinzwa ngokuvamile kwenziwa futhi ukwelashwa. Kufanele kuqashelwe ukuthi le self kule isifo akuvunyelwe nhlobo, njengoba nganoma iyiphi indlela uma kunganqandwa, kungakhathaliseki ngisho decoction herbal, kungenzeka senze isimo sishube. udokotela kuphela umuntfu unelilungelo akunikeze imithi.

Ukudla ithumba

Ngenxa kwesibindi - emzimbeni okuyinto kuhlobene ipheshana wokugaya ukudla bese uhlelo hematopoietic, amandla supply kubaluleke kakhulu ngoba iziguli izifo ezithile. Ukudla ngendlela efanele kuyokusiza ukusheshisa le nqubo yokwelapha, asize umzimba alulame emva kokuhlinzwa, ukuvimbela ukuvela ngangibuye ngihluleke.

Iziguli phakathi nangemva ukwelashwa ithumba Kunconywa ukushintshela uhlukanise ukudla - kumele kube khona njalo (izikhathi 6-7 ngosuku), kodwa izingxenye kufanele kube encane. Lokhu kuzokwenza lula inqubo ukugaya bese ukusiza ukuvimbela ukuthuthukiswa izinqubo elibi kanye ukuvutshelwa esiswini.

Kusukela Ukudla kuyadingeka ukuba ngakususi ifemu futhi roughage. Ochwepheshe batusa ukudla okusanhlamvu ezinye iphalishi, yemifino isobho, inyama ebomvu, futhi ezinye izinhlobo zezinhlanzi. Imifino nezithelo kufanele zibe khona ku ekudleni, kodwa noma kunjalo hhayi fresh - badinga ukupheka, ukubhaka, braise. Imenyu kungafaka imikhiqizo yobisi, kodwa amaphesenti eliphansi amafutha. Ncoma aphuza itiye, umhluzi okhalweni, izithelo iziphuzo kanye izithelo iziphuzo.

Kukhona imikhiqizo, lolo ngesikhathi sokuhlwanyelwa ngelashwa kufanele ngithi goodbye. Lezi zihlanganisa uhlu okunamafutha, okuthosiwe, ukudla ngibhema ezihlukahlukene ukhukhamba isagcine kanye marinades, nososo, amamaki namanoni inyama kanye nezinkukhu, izinongo. Iziguli kufanele enqabe amaswidi namakhekhe, amaqanda, ubisi lonke soda. Utshwala is ngokuphelele contraindicated.

Therapy ilungile futhi okubaluleke kakhulu, isikhathi esichithwa linikeza imiphumela emihle. Kaningi kungenzeka kuzuzwe alulame ngokugcwele.