Tohumate ru mare. Tikanga o te faaotiraa o te mumura i roto i te puku

faaite te whaturama ventral protrusion iho okana ā katoa te wahi ranei ona i roto i te kuwaha ki te rohe subcutaneous o te taiepa mua o te kātua pute i hanga ranei. I roto i te hawhe o nga whekau o te kōhao puku kei tukutahi ki te kōpako rau peritoneal uhi i te wāhi subcutaneous roto. He faaiteraa angamaheni o te whaturama ko te tohumate o te mare ru.

Ki te tautuhi i te hononga puta ru ki te mate, hoatu he ringa ki te wahi protrusion me tona whanonga ina maremare. Tikanga, Kei te ua i te pana, tohu e te kupu o te hanganga anomalous o te peritoneum, te ngaro o taua taunakitanga o whaturama strangulated. Protrusion o whēkau puta i roto i te mowhiti hernial. peritoneum kōpako ki wahi o nga paru, karere, tendons riro i roto i putanga tohu te pūwhera hernial.

Ko te mahi o te peritoneum

Whakatika anga mo te whekau faufaa tauturu i roto i te tukanga o te homeostasis, whakawhiti wai, tautoko te pēhanga puku:

• mahi te reira i mahi resorptive, ara ki te mimiti i te hua pākarukarutanga o pūmua, kiko necrosis, exudates, huakita;
• cover serous i roto i etahi wāhi kikokore me duodenum taea ki te tohatoha pūtōtepe me te wai;
• taupa, te taviniraa i te ahua o te arai ki te arotahi inflammatory o mate, whakarato wātea i te mate tiaki pūkaha o te natura pūtau me te humoral.

Whaturama puku me ona pōauautanga

Ki te i roto i te akoranga o te wawaotanga hāparapara he tahi pēkerapu, e kore e tino e haapa'o te manawanui ki whakahau a te tākuta, i reira te mea he whaturama recurrent, e te kaimahi rite te kuwaha mo te wahi angiangi o te nawe. E kore e ki te whakahaere he i nga pōauautanga e whai ake nei i te whaturama:

• ki te, kua takahia nga mana i roto i roto i te pūwhera hernial, ka āta haere mai ratou immobilization, e te ati o te mumura, a whakatuma mate;
• Ki te whai wāhi te protrusion o te piro ko, na te wahi o tini kai me te ihirangi uaua;
• arata'i ki takanga o peritonitis me mata jamming sidewall whēkau, e tika ana ki te necrosis o te wahi riro;
• whakawhanake tukanga purulent (whēwhē);
• faarahi whaturama raina ma ki te rahi nui, arata'i tenei ki te take i muri i te tango i whēkau i roto i roto i te putea, kahore e pai i roto i te kōhao puku.

Atamira o te peritonitis i runga i te roanga o te mate

I roto i ngā tukanga inflammatory whakapeka i roto i te rohe puku karanga tonu mo te waka tūroro, he mōrearea ki te ora te tangata e whakaroa. rerekē oti e pā etahi wāhi ranei Peritonitis. meinga mumura e ngā momo o te huakita takohe me te anaerobic, takoto roto te kōhao puku. Tikanga o te faaotiraa o te ariā L. S. Simonyana, i runga i nga huringa pathological me roanga o te mate rānei, titore peritonitis taahiraa:

• pumau wā tauhohenga i roto i te ra tuatahi, a whakakitea nga tohu mōrahi;
• Kei te whakamana te whakawhiti ki te taahiraa paitini mō te 24 ki te 72 haora, ahua o karere rerekē haurangi me te paihana kaiao;
• hohonu, i roto i nuinga o te wā, he puka tina heke whakawhanake i muri i nga ra e toru, te mate me faaiteraa ohorere o te mumura rohe.

Whakarōpū o mate i te āhua o te mate

He onge peritonitis Paraimere, whakaaro, hoki e pā ana ki te 1% o te ari inflammatory. puta Belgium i muri i te rongo o te papapūata peritoneum hematogenous ara i roto, tikanga lymphogenous ranei i nga whekau whakaputa uri wahine o korere kākano.

HWM whaturama ai peritonitis tuarua i muri i tafa ranei e tika ana ki fifi o whētuki kiko peritoneal. I roto i tenei take, i reira e nga take mate e whai ake nei:

• mate i te mumura;
• ara whaturama;
• tomo ki o papapūata tika ki whara;
• pōauautanga postoperative.

Momo peritonitis i runga i ētahi atu āhuatanga

ahu Wahanga o te atamira whakapeka, me te ma'i te i tohu haumanu me te mate. Tikanga mō te whakatau, kia rite ki te exudate heheu fibrinous, serous, purulent, fibropurulent, āhua inflammatory haemorrhagic.

momo wehenga Etiological o peritonitis meinga e te momo o momo o microflora me huakita, meinga mumura. Ko te papapūata pathogenic matua mohio tenei ra rite staphylococci, streptococci, anaerobes, Proteus, enterococci, E. coli. Hoki te ope o huakita ngā pneumococci, gonococci, hemolytic streptococcus me ētahi atu momo.

Ko te rōpū etiological motuhake taratahi mate nonbacterial take iroiti, ka faingataa te whaturama HWM tika ki kătahi o te kōhao peritoneal o mimi, toto, ate ranei wai pekitīlia. Ko tenei he tauira kino, a ka peritonitis i roto i te torutoru haora tahuri ki te hopuhopu, rite e permeable ki huakita te taiepa rawa hohoro i muri i te tīmatanga o te mumura.

Tūkinotanga o ngā tukanga pūkoro

i titiro rangirua o te ōwehenga wai-kawehiko i roto i te tinana, me te pūmua toenga te rite te tohu o nga maripi o nga waho whaturama puku. whakatere Opaniraa pūmua te tika ki te hypermetabolism, kawea mate o te rauemi nui whare e i roto i te mimi, ruaki, exudate. Whakahuatia gipoproteinomiya me te whakaiti i te nui o pūmua e whakaaturia i te peritonitis urupa nui.

Āpiti atu ki te pāhare pāporo fluids tinana tukua, haere reira i te wāhi intercellular, no te mea o tenei, tūroro i hypokalemia. I muri i te whanaketanga o te tauira tukanga inflammatory matemate e taea te huri, rite iti excretion tākihi o te wai, i reira he whakangaromanga o te maha rawaka o ngā pūtau. Ka rite ki te hua o te huringa whakawhanake hyperkalemia.

E rua-hautoru o tūroro i roto i te alkalosis toto whanake, i ētahi wā i roto i te kopa whakakitea te neke ki acidosis hua i nga whakaoho circulatory, tauwhatinga o ngā tukanga pūkoro tinana me te hypoxia, whakapōnānā ana tenei tukanga te tango o te whaturama.

Ko te taahiraa o te kāpeka wā ki oliguria whakawhanake pūnaha hematopoietic tīmata ki te mahi i runga i te hanga o waikawa hua pūkoro pērā i te konupora, hauota, pāhare pāporo me ūkuikui. He he he neke o ngā tawhā toto i roto i te acidosis romahā me te pūkoro tinana. Kei te huri tere whakamātautau mō te peritonitis whakapeka, na aroturuki tamau e tūtohu toto, mimi, me te tahi atu fluids tinana.

peritonitis tohutanga

He he maha o ngā āhuatanga paerewa e e matau ana tatou me pehea ki te whakatau i te whaturama me te mumura o te peritoneum:

• mamae fuu kaha i roto i te peritoneum;
• kirika;
• putapu kopu, riro pakeke;
• he ongo o te ngoikore i roto i te tinana katoa;
• retching me te whakapairuaki;
• takahi o te gastrointestinal api parau, kōroke, flatulence.

tautoko mare syndrome

whakakitea te reira i roto i mate whakapeka, me te ma'i o te kōhao puku. Tātaritanga mō Whārangi patua ana G. G. Karavanovym me whakaahuatia i roto i te taipitopito IM Siomashem. Kua whāngai maha haumanu pokanga tenei tohumate mo te faaotiraa tuatahi o tohu o te mumura o te puku.

Methods o te whakamahi

paku piko maihao ki te nikau me pongaponga iti pēhi i runga i te rohe ako. Etahi wa i muri i tenei mahi kihai i tangohia e te mamae i mariri pēhanga. I muri i taua, whakamatauria te manawanui kei hoki tohumate mare ru. tapaea e ia ki te tākaro i te mare, ki te i muri i te tukanga, i reira he mamae i roto i te rohe o te pēhanga, tohu te reira i mumura i roto i te peritoneum.

parau tumu o te mahi

Te whakaiti koi i roto i te maremare spasm taiepa peritoneal me te HWM whakawhiti te pana ki te mata kei raro te ate, i nga okana. Ki tonu, ka waiho i raro ki te mahi o nga paru, i whakawhiti nekehanga iho. Sensation o te mamae puta ina he tinana mate farerei te nekehanga e ranei he rohe aki ki tona ringa. Ki te whai wāhi te tukanga inflammatory te peritoneum, whakakitea te sensation o te mamae e wiri i te paparanga roto, ai ara ake te pēhanga kōtuitui-puku.

whakaahua ana kaituhi Ako A. Cheremskoy mare syndrome te mahi i roto i te faatura o te mate whēkau. tonu te, no te maremare manawanui i roto i te take o te mumura o te tāpiritanga ite mamae i roto i te rohe iliac. Ko paku rerekē i te mare, me te whaturama i roto i peritonitis tenei pānga.

Syndrome haaparare i peritonitis whakapeka, me te atamira ma'i o te mate meinga sensations rerekē ina maremare. pahono tāpiritanga ma'i hāhā o manawa, ka rite ki te mea kei te ngana te manawanui ki whakaroa te mamae. āhuatanga te atamira whakapeka e mamae whakatūahu. Tohumate mare ru i roto i ngā huarahi rerekē heheu te wā o te peritonitis.

I tua atu i peritonitis, whēkau me te whaturama, faaite tenei tohu ano i roto i mate whakapeka, me te ma'i o te tahi atu whekau puku. Mamae i te ngaohiko i te mare puta i roto i te take o te mumura o te gallbladder, tuwhenua pekitīlia me te arai intestinal. Ko te kupu, e rere ke mare ru tohumate i te tahi atu rangahau e heheu te maha nui o mate i roto i te wāhanga tuatahi.

Whaturama me ona rerekē

Ka taea te riro a congenital Protrusions i roto i te tangata. Ko te kōwhiringa tuarua ko te tamariki whanau hou. puta tenei ofatiraa no te mea o te peritoneum hangahapa i roto i te whanaketanga fetal. puta protrusion riro o whekau i roto i te ora o te manawanui, a kua wehea ki e toru ngā momo:

• i nga uaua whakawarea o te taiepa puku;
• e tika ana ki te hākinakina nui kawenga mahi ranei;
• posttraumatic puta tika ki ofatiraa o te tapatahi o te peritoneum, ki te mea i reira te mea he mahi o mua; taiaho he painga i runga tikanga mea hāparapara i roto i te take taua.

whaturama ā-kei roto i te kōhao rei te rohe puku ranei. tinana protrusion waho kei roto i te wāhi e whai ake nei:

• i roto i te kopu;
• i runga i te hip ki te taha ki roto waho ranei;
• sacrum lumbar;
• i roto i te wahi o te wāhi o te perineum me papatoiake;
• i te taha ki mua o te utumu (epigastrocele);
• i roto i tetahi rohe o te tinana i te nawe i te pokanga.

Human whaturama whakarōpūtia ki recurrent, uaua kore faingataa (ki te matau) ranei. Ko te momo tuatahi ngā te protrusion, tonu mai anō ko muri i te pokanga.

tohu herniation

puta ngawhatanga atamira tuatahi rite te āhua porohita e kua he rite ngawari, a takitahi e taea te manawanui whakaparaha reira ki te pēhanga marama. I muri i te whakaiti i roto i te mata peritoneal i tenei wāhi e palpated kuwaha urunga, uaki i te puka o i'ai porohita koha taiepa puku ranei.

Rahinga rerekē i taatiraa i te rua o toru mitamano ki te maha henimita tatini. Ki te riro i te pūwhera hernial wahi o te taiepa intestinal tona tinana, palpation āhuatanga koropupū paraparau ihirangi tangi irava ranei. Tohu o puhoi faaite iho whaturama ngā kōroke, whakapairuaki, tokopā, bloating, pouri, takahi o urination.

tūtohutia whaturama te i roto i te take o te hara o te diverticulum, āhuatanga nei i te te tohu e whai ake nei:

• i reira he maha he mamae koi ohorere i muri i tou aranga ki taimaha, mahi, defecation waimaerotanga varavara tupu mo e kore take;
• i etahi wāhi te manawanui e taea kore, pera i mua, hiri maeneene, riro te reira pakeke, me te mauiui;
• me i retching nga tohu o mua, inoino o te heamana.

Take o te whaturama

Kua wehea take katoa ki ara nona nei here, me te toitoi. Kei te rōpū tuatahi o ngā take:

• hē congenital ranei whanaketanga rerekē o te taiepa puku;
• mo etahi take, te roha o te taiao wāhi puku ngoikore (femoral me mowhiti inguinal, pito);
• whakaiti o te kaha kiko kurut tika ki toulekeleká huringa kēkeno o te tinana ranei;
• aroaro i roto i te wāhi ngoikore puku posttraumatic ranei, ki te reira ko te mahi, hua te taiaho te haumaru tino i roto i tenei vahi faatura.

E pā ana te rōpū i muri ki te tirohanga puhipuhinga ranei ko te take o te whakanui ake i te pēhanga i roto i te kōhao puku triggering āhuatanga:

• mahi ranei te mana hākinakina pakeke;
• kōroke auau;
• mare, āhua ma'i;
• tetere puku ā-e tika ana ki te mahi hē o te kaiao;
• flatulence.

Me pēhea te ki te whakatau i te whaturama

te take i te taote e herniation i muri i te whakamātautau o te manawanui, me te whakatau i te aroaro i roto i te ora o te manawanui whakatau i te āhuatanga i runga, me te ngaru. Ka mau ia ki pūkete te āhua noho, pokanga me te tinana injuries. I roto i te tikanga ki te kitea i roto i nei e roto whekau waha i roto i te pūwhera hernial, te tākuta whakahaere i te rangahau ki te awhina o mea me taputapu.

Ultrasound o te puku, me te o nga protrusions taea ki tatou whakaaro ihirangi me te whakahaere pārōnaki roto te tātaritanga me ētahi atu mate. Kei te whakamahia te tikanga X-ray mo nga whakapakoko rerekē o te putea me te whaturama kuwaha.

ngā tukanga Medical me te pokanga

Ko te tikanga matua o te maimoatanga he tirohia hāparapara. Mau i te awhi tautoko te tautapatia ki te hunga tūroro e whai contraindications nui ki te pokanga, pērā i ngā huringa e pā ana-tau upoo- toto rawakore ranei. Tango i te protrusion puritia e rite ki te mahere, ki te te te whakarite i te manawanui mo te mahi, ranei i roto i ngā take kino, kawea pokanga te i roto i wawe. strangulated He tauira o te taua hui hia te whaturama ki te mamae fuu ileus tinana ranei.

Kei roto i te mahi i roto i te iritiraa i te ihirangi whaturama pūwhera me te whakamātautau. Ki te kahore e pakaru nga whekau, whakaiti ratou he, sutured he putea me te kuwaha, he mea ki te rahi mokemoke. kuwaha Kirihou i mahi te whakamahi kikokiko i te manawanui te whakamahi i te whakatupuranga hou o ngā rauemi waihanga ranei. Ko te hanganga ture whakahauanga ki tohutohu pou-mahi o te tākuta ki te whakaiti i te tūponotanga o te herniation recurrent.

I roto i te mutunga, me mea te reira kia e i te tohu tuatahi o protrusion i roto i te pouaka puku ranei taiepa kia kōrero tonu i te tākuta. e kore he pokanga hoki te whaturama he mahi matatini, nui atu uaua ki te karo i te fifi o te rere protrusion me te mamae e pā ana ki reira.