Isisu se-stomach syndrome: izimpawu, izimbangela kanye nokwelashwa

Ubuhlungu esiswini buletha izinkinga eziningi kokubili abadala kanye nezingane. I-Gastritis, i-gastric ulcer, i-gastroduodenitis, i-reflux esophagitis, umdlavuza wesisu ingenye yezifo ezivame kakhulu zesigubhu sezinsi, okuvame ukuya esiteji esingapheliyo. Ingozi ekhethekile yisifo se-stomach syndrome. Ukunakekelwa okuphuthumayo kuyimpoqo. Lesi sifo asigcini nje ngokubangela ubuhlungu, kodwa futhi sisongela ngokuqondile ukuphila komuntu. Kubaluleke kakhulu ukwenza izingcingo ezifike ngesikhathi zokunakekelwa kokuhlinzwa.

Lesi sifo safika kanjani?

Leli gama lisetshenziselwa imithi ukubhekisela ezinhlungwini ezibuhlungu ezivela emgodini wesisu futhi zidinga ukunakekelwa okusheshayo kokuhlinzeka. I-syndrome yesisu esiswini singabangelwa ukuvinjelwa kwezitho zangasese zesisu noma isifo se-GI. Le syndrome imelela ingozi yangempela empilweni yesiguli.

Incazelo ye-syndrome "isisu esiswini" savela emthini wezokwelapha ngemuva kokushicilelwa kwencwadi kaHenry Mondor ethi "Ukuzizwa Okuphuthumayo. UBelly, eyanyatheliswa ngo-1940. Encwadini udokotela ohlinzayo wachaza igama elifanayo - "inhlekelele yesisu". Kungemva kwalolu shicilelo lo mkhuba wezokwelapha waqala ukuxoxa ngokuxilongwa nokuphathwa kwesifo esinjalo njengesifo esiswini esiswini. Izimpawu nezimbangela zaqala ukufunda kabanzi.

UHenry Mondor akayena kuphela ohlinzayo owachaza lesi sifo. Udokotela ohlinzayo waseRussia uN. Samarin wafunda lesi simo, futhi ezincwadini zakhe uthi isiguli esinalo lesi sifo kufanele sithathwe esibhedlela ngokushesha. Ezincwadini zakhe, ezashicilelwa izikhathi eziningana, uthi ngemuva kokubonakala kwezimpawu zokuqala, isiguli sinamahora ayisithupha kuphela.

Izimpawu

Ukuze uqonde isithombe somtholampilo saso sonke isifo, udinga ukwazi izimpawu. Uma ukhuluma ngesifo sesisu esiswini, izimpawu zilandelayo:

• Ubuhlungu obukhulu esiswini.
• Ukushisa okuphezulu.
• Ukushaya kwenhliziyo okusheshayo.
• Ukuvota.
• Ukuphuza.
• Shock.

Kodwa ukukhononda okukhulu kwesiguli kugcina ubuhlungu. Ngokusekelwe ezimpawu ezingenhla, odokotela bangenza amaphutha futhi babanikele kwezinye izifo. Isibonelo, ubuhlungu bungabonisa i-peritonitis ejwayelekile, ukuhlanza - bonisa ukudla kokudla. Umphumela wendlela yokwelapha ngokuqondile kuxhomeke ekutheni kusheshe kutholakale kanjani ukuxilongwa okulungile.

Isisu se-stomach syndrome: izimbangela

Izimbangela ezilandelayo zingabangela ukuqala kwesifo:

• I-Pancreatitis, i-cholecystitis, i-appendicitis, i-peritonitis, umdlavuza we-colon, i-embolism, i-thrombosis yamathambo, ama-abscesses.
• Amaphutha noma i- perforation yesisu, amathumbu.
• Ukuvuthwa kwe-pancreas, uhlangothi lwesibindi, isibindi, isibeletho, ama-appendages, okungahambisane nokuphuma kwegazi emgodini wesisu.
• Ukuvimbela emathunjini.
• Izifo zezingxenye ezitholakala ngaphandle kwesikhumba esiswini.

Ngokusekelwe kulokhu okungenhla, kunokuhlukaniswa kwezimbangela zalesi sifo:

• Izifo ezivuthayo ezidinga ukwelashwa okuphuthumayo.
• Ukuphuma kwamanzi emathanjeni emathunjini (i-Mallory-Weiss syndrome, ukuphuma kwesilonda, ukuphuma kwegazi, isisu esiswini, isifo sofuba esiswini ).
• Ukulimala kwesisu noma isilonda esangena ngaphakathi, lapho isibindi, isitha, amathumbu noma ama-pancrea ewonakele.
• Izifo zezingxenye zomuthi wamathumbu, ezingadingi ukunakekelwa okuphuthumayo (isibindi, i-peritoneal carcinomatosis, i-gastroenteritis, iersiniosis, i-liver porphyria, i-colic hepatic, i-cholecystitis ephawulekayo, i-enterocolitis epseudomembranous).
• Izifo ezithathelwanayo (i-dysmenorrhea, i-syndrome ebuhlungu phakathi nomjikelezo wokuya esikhathini, i-salpingitis).
• Izifo ze-Renal (i-pyelonephritis, i-kidney infarction, i-renal colic, i-paranephritis, i-hydronephrosis esiteji esibucayi).
• Izifo zenhliziyo (i-aortic aneurysm, i-infarction ye-myocardial, i-pericarditis).
• Izifo ze-neurological (i-hernia ye-disc intervertebral, umlando wakhe we-Schmorl).
• I-Pleuropulmonary (i-embolism ye-artery yamapayipi, i-pleurisy, i-pneumonia).
• Izifo ze-urogenital (ukuvuvukala kwama-ovari, ukugcinwa kwe-urinary elula).
• Ukulimala komgogodla (ukuhlukunyezwa, i-myelitis), izimbambo eziphukile, ama-vertebrae.
• Ezinye izifo (ukudakwa komzimba nge-arsenic poisoning, ukuhola, i-coma ekhululekile, inkinga ye-leukemic, i-coma yesifo sikashukela, inkinga ye-hemolytic, isifo se-Verlhof).

Indlela yokuthola lesi sifo

Kungakhathaliseki isimo sesiguli, odokotela baqhuba ukuhlonza, okunesizathu esiqondile. Ukuxilongwa kwe-syndrome "isisu esiswini" kanje:

1. Ukuqoqa anamnesis.
2. Ucwaningo lwesimo somzimba wesiguli.

Umlando uhlanganisa ngokuyinhloko izimo ezinjalo: isilonda se-duodenal noma isisu, i-hepatic, i-colic ye-renal, ukuhlinzwa okuhlinzekwayo, ukuvuthwa noma ukuphazamiseka kwesibindi, ukuphazamiseka kwegazi. Udokotela kuqala kokunakekelwa ngesikhathi sokuqala kobuhlungu nokutholakala kwendawo, i-dyspepsia, izinga lokushisa, izifo ezithathelwanayo ekuguleni komzimba, ukuphazamiseka kwemijikelezo yokuya esikhathini. Lokhu kubalulekile, ngoba i-syndrome yesisu esisemqoka ingavela ngenxa ye-apoplexy ye-ovary noma ectopic pregnancy. Ukuqoqwa kwazo zonke lezi zici kungathatha isikhathi eside, kodwa kuyadingeka ukuze uthole ukuxilongwa okulungile.

Ukuhlolwa kwezitho kuqukethe ukuhlolwa, i-palpation, i-percussion, isifundo esenziwe nge-vagin, rectum. Udokotela kuqala ulalela ukunakekelwa kwe-adynamia, ubuhlungu besikhumba, ukuphuma, ukuphuma kwamanzi. Ngemuva kokuhlolwa, udokotela ubeka izivivinyo ezilandelayo ze-laboratory:

• Ukuhlaziywa okujwayelekile komchamo.
• Ukunqunywa kohlobo lwegazi ne-Rh factor.
• Izinga le-hemoglobin, i-hematocrit.
• I-ESR.
• Ukuhlolwa kwegazi jikelele ngefomula ye-leukocyte eyandisiwe.
• Ama-enzyme we-pancreas nesibindi.

Ucwaningo lwe-laboratory aluyona into yokugcina, ngakho udokotela ubeka ukuhlolwa kwe-ultrasound kwezitho zangasese zomzimba, isikhala esiphezulu se-retroperitoneal. I-Ultrasound iyadingeka ukuthola i-pathologies engase ingabi nesithombe esicacile somtholampilo. Futhi, udokotela ubeka isisu esiswini ukuze kubonakale ukukhula kwamathumbu emathunjini omzimba noma isifo samathumbu emathunjini. Ngaphandle kwe-ultrasound, udokotela ubeka uhlolo lwe-rectal kanye nobulili kubantu besifazane. Lokhu kubalulekile, ngoba lezi zivivinyo zingabonakalisa ubuhlungu esifubeni esincane esingasakazwa ngaphansi kwesisu esiswini. Okubalulekile amaqhinga okuhlolwa kwe-radiation ku-syndrome yesisu esiswini.

Ukulinganisa lapho kutholakala lesi sifo

Le ndlela yokuxilongwa kufanele yenziwe ngokucophelela. Ukuzizwa kuyadingeka isandla esivuthayo esibekwe phansi kuyo yonke isisu. Okokuqala udokotela uhlola izindawo ezingenabuhlungu, avuselele isiguli ukuzwa okungathandeki. Khona-ke udokotela ubamba izindawo ezibuhlungu zesisu. Udokotela akufanele abe nomuzwa wesisu ngengalo yakhe engakwesokudla. Le ndlela yokuxilongwa ingathola ukuhlukunyezwa kwamasipha, ubuhlungu obukhulu, ukungenelela, ukubunjwa kwe-tumor nokufaka ukungena.

Ukuhlolwa kwe-Instrumental yesifo

Lapho isiguli singena egumbini lokulinda, unikezwa izifundo ezilandelayo:

• I-X-ray yesisu nesifuba, okudingekayo ukuhlonza isimo se-diaphragm (ukuhamba kwayo, ukuqoqwa kwegesi, izinga lokushisa emathunjini).
• Ukuhlolwa kwe-Radiopaque kwesisu.
• I-irrigoscopy (enezingqinamba ezithintekayo zekholoni).
• I-Laparoscopy (ezimweni ezinzima zokuxilongwa).

Indlela yokusiza isiguli

Usizo lokuqala lwe-stomach syndrome oluyisifo esibhedlela ngokushesha. Lapho esibhedlela kufanele isiguli sifakwe ngokushesha emnyangweni wokuhlinza.

Imiphumela yezidakamizwa esimweni sesiguli

Usizo nge-syndrome "isisu esiswini" asifaki ama-painkillers. Lokhu kusebenza kokubili ama-analgesics e-narcotic non-narcotic, okungagcini nje ukuyeka isithombe somtholampilo, kodwa futhi kwenza kube nzima ukuxilonga isiguli. Ngaphezu kwalokho, izidakamizwa zingalimaza isimo sesiguli, zihlehlise isikhathi sokuhlinzwa, zingabangela ukungena kwe-sphincter ka-Oddi. Futhi, akuvumelekile ukusebenzisa i-nootropic, i-psychotropic, izidakamizwa ze-laxative, ama-antibiotic futhi ubeke ukuhlanza ukuhlanza.

Ukwelapha

Uma konke kubonisa isifo sesisu esiswini, ukwelashwa kuqukethe izenzo ezilandelayo. Udokotela angasebenzisa i-antispasmodics - isisombululo se-2 ml ye- "No-Shpy" noma i-1 ml ye-"Atropine" engakapheli noma nge-intravenously. Ukwelashwa kwalesi sifo kungukungenelela kokuhlinzwa, okungenzeka kuphela ngemva kokuqiniswa kwezinkomba ezinkulu zomzimba. Kuye ngesimo sesiguli, ukulungiselela ukuhlinzwa kungathatha isikhathi esithile. Isiguli esiphathwe ngegazi, ukuvinjelwa kwamathumbu emathunjini, esimweni sokuthuthumela, kufanele silungiselelwe ukuhlinzeka kuphela ngemva kokuqeda ukukhathazeka komzimba. Izinkinga zemetaboliki (ukunciphisa kwe-bcc, ukuphulwa kwamanzi, usawoti, ukungasebenzi kahle kwezitho ezibalulekile, ukwephulwa kombuso we-acid-base) kwenzeka ngeziguli ezingena esimweni esibi kakhulu.

Isikhathi sokulungiselela ukusebenza sixhomeke esimweni sesiguli. Ekamelweni lokungenisa iziguli, iziguli kufanele zifake isifubeni esiswini ukuze zifise iziqu. Bese ugeza isisu ngaphambi kwe-gastroscopy bese uqapha ukuphuma uma isiguli senza kanjalo. I-catheter ifakwa kwisilonda ukuze ihlolwe ukulimala okungenzeka, futhi okubaluleke kakhulu - ukulawula i-diuresis yehora ngesikhathi kusetshenziswa ukwelashwa.

Uma kudingekile ukuphatha izidakamizwa ngokungahambisani, i-plasma noma i-erythrocyte mass, udinga ukufaka umcengezi emgodini we-subclavia ukugcwalisa ngokushesha ukulahleka kwegazi, ukuvuselela isimo se-asidi-base, amanzi-electrolyte ukucindezeleka futhi unqume ukucindezeleka phakathi kwenhliziyo.

Kulesi sifo, ukwelashwa kokukhipha ukukhonjiswa kuboniswa:

• Ukuphathwa kwesisombululo se-glucose.
• Ukwethulwa kwesisombululo se-electrolytes.
• Isingeniso sesisombululo sokushintsha i-plasma.
• Ukwethulwa kwesisombululo se "albinini".
• Ukwethulwa kwegazi, uma kunesidingo.
• Isingeniso se-plasma.
• Isingeniso sama-antibiotics ngenxa yokuvinjelwa kwamathumbu emathunjini noma ukuphazamiseka kwezitho.

Ukwelashwa kwasekuqaleni kwaqala, kube ngcono kakhulu umphumela wokungenelela. Ukulungiselela ukuhlinzwa kwenzeka ngesikhathi esifanayo nokuhlinzwa okusheshayo.

Isifo sesisu esisemathunjini kanye nezingane

I-syndrome yezinhlungu ezinganeni ingaba uphawu lwezifo ezihlukahlukene. Ngokuvamile lokhu kungaba ukucasuka kwe-mucosa, i-peritoneum, hhayi isifo sesisu esiswini ezinganeni. Izimpawu zalesi sifo ezinganeni zifana nabantu abadala. Umthombo angeke ube yilungu kuphela elisemgodini wesisu.

Izimbangela zobuhlungu besisu ezinganeni:

• Dysbacteriosis.
• Ukuvuvukala kwesifo.
• I-Colitis.
• Ukungena.
• I-enterocolitis.
• Gastroduodenitis.
• I-Duodenitis.
• I-Gastritis.
• Isisu sesisu.
• Reflux esophagitis.
• I-ulcerative colitis.
• Ukuqokwa.
• Pancreatitis.
• Cholecystitis.
• I-hepatitis.
• I-Worms, i-lamblia, i-ascarids.
• I-Dyskinesia ye-bile ducts.
• Ukutheleleka emathunjini.
• I-ARVI.
• Izisulu.
• I-Chickenpox.
• I-Cystitis.
• I-Pyelonephritis.
• Urolithiasis.

Kunoma yikuphi, uma kune-syndrome - ubuhlungu obukhulu esiswini, njengalesi sibonakaliso sezinye izifo ezingenhla, yilo "insimbi" yokuqala yokufuna usizo. Kukholelwa ukuthi uma umuntu efundele ngokwanele futhi enesiko, khona-ke uyakwazi ukunquma izimpawu zokugula okugcizelele esigabeni sakhe esibucayi. Ngokuvamile lokhu akunjalo. Ngokusho kwezibalo, imbangela yokucindezeleka okunzima kokufakelwa kwesisindo esigabeni esiyinkimbinkimbi yisiguli sokungahambisani nokubonakaliswa kokuqala kwesifo. Ukungabikho okungalindelekile kwe-syndrome ebuhlungu akuyona isizathu sokujabula, ngoba kungabonisa ukuphuluka kodonga lwesilonda esibuhlungu. Ezimweni eziningi, lapho isiguli sinikezwa isikhathi esifushane, umphumela wokungenela okuhlinzekwa ngokuxhomeka kuncike ekufundeni udokotela kanye nokwelashwa okulandela.

Isifo esiswini esiswini yisifo esesabekayo, ikakhulukazi kubazali. Ngakho-ke, kufanele kuqaphele ukuthi, ngaphambi kokusola okubi kakhulu, udinga ukwazi ukuthi imbangela evame kakhulu yobunzima ezinganeni kuwuhlelo lokufaka isisindo noma inqubo yokuvuvukala yenqubo yesithasiselo ye-cecum. Kubalulekile ukwazi ukuthi nge-appendicitis enhle ezinganeni ezincane, ubuhlungu be-syndrome bubukeka buthakathaka. Kodwa ingane ingenalutho, ilele kabi, futhi ingenangqondo. Ngokushesha kukhona isitoreji esivulekile lapho kutholakala khona isikhala. Ngenxa yalesi sibonakaliso, i-appendicitis ididekile ngokutheleleka kwesifo sobuthakathaka noma ukutheleleka emathunjini.

Indlela yokuhlukanisa i-appendicitis kusuka ekufakeni ubuthi noma ukutheleleka emathunjini? Ubuhlungu obuhambisana ne-appendicitis buyenzeka engxenyeni engenhla noma eduze nesifunda sombono, kodwa hhayi esifundeni esifanele se-aliac (indawo lapho isithasiselo sitholakala khona). Kukhona amacala lapho izingane ezincane isithasiselo sitholakala endaweni ye-rectum, eduze kwesinye. Kulolu cala, udokotela ohlinzayo kuphela ongakwazi ukubona ukufakwa komzimba okuvamile. Ezinye izibonakaliso ze-comorbid (ukuhlanza, isicanuche kanye nomkhuhlane) angeke zikhule kwezinye izimo. Uma kwenzeka i-appendicitis enobudlova obukhulu, ama-leukocyte angeke akhuliswe, futhi ukuhlukumeza komzimba wesisu kungasekho.

Kubalulekile ukwazi ukuthi ukuzithokozisa kwezingane akumukeleki. Akuyona nje kuphela isifo sobuhlungu akunakwenzeka ukuhleka usulu nokungazicabangeli ukunikeza amalungiselelo okwelapha izingane, kodwa futhi namahlaya alula abandayo ayingozi. I-Enemas, ukugcoba esiswini, ukungenisa izidakamizwa noma ezinye izidakamizwa ezingahle zibekwe uketshezi lokudla, ukuphuza ngokweqile noma ukuvimbela emathunjini, kungenza kube lula ukufaka i-appendicitis noma i-syndrome ye-abdominal acute. Kuyadingeka ngokushesha ukubiza i-ambulensi, ngaphambi kokuba ufike ungagcini isithombe bese ungalethi odokotela "ithrekhi yamanga". Ingane akufanele inikezwe amanzi noma ukudla. Uma ngabe i-ambulensi iphuzile futhi ingane iba yimbi kakhulu, ungabiza udokotela ukuze akwazi ukuxoxa ngezenzo ezengeziwe. Futhi, uma kukhona ukuthutha ekhaya, ungathatha ingane emnyangweni wokungena esibhedlela.