Appendicitis: chirwere uye kurapwa. Differential chirwere kuti rikwanise appendicitis

Kuzvimba okuwedzera - chirwere iyo vazhinji vedu kuziva chete rwakaipa. Pakati zviratidzo zviri pamiromo wese - rakapinza kurwadziwa mudumbu. Zvisinei Audio marwadzo symptomatology chirwere haringorevi. Uye Haingambovi muzviitiko apo appendicitis kunoitika munguva munhu akwegura, munhu kurwadziwa. A nguva inokosha zvikuru kuteerera vamwe appendicitis nezviratidzo munyika pachako kana munhu akada munhu uye pakarepo kwachiremba uye kupa nenguva nenyanzvi rubatsiro. Appendicitis chirwere iyo unotora munhu nhamba yezvidzidzo, kungaita kuti peritonitis, izvo zvinozoita kungava chinokonzera rufu.

Zvinokonzera appendicitis

Vanachiremba havagoni kupa mhinduro nomazvo kuti nei vamwe vanhu rirwadze okuwedzera. Zvisinei, zvinonzi vaidavira kuti riwedzere nekuda kukura chirwere matambudziko pamwe paura, mabwe fecal, honye infestation, kupatira, pamuviri uye yakaoma kukura kwacho. Usava Kudya zvinogona kukonzera kuzvimba okuwedzera pamusoro cecum. Pasina ndichiri muduku takaudzwa kuti mbeu akasviba kungaita kuti kuvhiyiwa kubvisa okuwedzera.

Chero zvazvingava hazvibviri uzvidzivirire appendicitis. Pamwe anotyisa zvokuongorora muchipatara kuwa sezvo achangoberekwa vacheche, saka vakwegura uye utano vechidiki. Appendicitis, chirwere chiri kusiyanisa hosha kubva zvimwe zvinetso zvoutano kuti zvinoda nokukurumidza kuvhiya kupindira.

Zvokukura kukura appendicitis

Kuzvimba okuwedzera ine mavambo ayo uye musoro mhedziso. Chenjera appendicitis chirwere zvinosanganisira dzinoverengeka zviitiko kuziva matambudziko uye zvirwere Kusiyanisa, anoenda mumatanho akawanda, chimwe nechimwe inopfuura kuti tevera zvakanaka. Ivo:

• Catarrhal appendicitis. Panguva iyi kushoma hakungorevi mashoko okuwedzera.
• Pamusoro chikuva dzinoratidzwa mberi kuzvimba mucous Kamudzira chepuraimari lesion. Panguva iyi, muna lumen pamusoro okuwedzera akawana chena ropa masero uye ropa.
• At danho phlegmonous zvomoto okuwedzera yose, kusanganisira rokunze deko rikurumidze.
• Pute-urikanwi Danho kunoratidzwa chimiro nemaronda pamusoro mucosa ari okuwedzera.
• The wokupedzisira Danho - gangrenous, vaine necrosis kwacho masvingo uye kutyora zviri mariri peritoneal mhango.

Tichifunga kuti kubva pakutanga kuzvimba kusvikira padariro panowanikwa peritonitis inongova mazuva maviri kana mana, ipapo bvunza chiremba uyo achashandisa nzira dzose nechirwere ose appendicitis, zvakakodzera kana Detective zviratidzo chirwere wokutanga.

Common zviratidzo rikwanise appendicitis nedzevakuru

Kufanana chimwe chirwere, mumwe kuzvimba okuwedzera pamusoro cecum ine zviratidzo zvayo. General chenjera appendicitis zviratidzo zvinobva padariro kuzvimba, muitiro marongerwo uye kunyange murwere zera. In padariro wokutanga rikwanise appendicitis kuda kurutsa, kuroora kana akadzokorora kurutsa, izvo, kusiyana poizeni, haiunzi chero zororo. Murume anotanga chokunyunyuta chakakomba kuneta uye zvakawanda zvive, kurasikirwa kudya, uye zvimwe zvinetso pamwe defecation. Diagnosing appendicitis nedzevakuru Panguva iyi kwakaoma zvisingaiti, sezvo zvirwere izvi dzinoratidzwa kuti dzakasiyana-siyana chakasimba uye chisingaperi zvirwere.

Akatevera Danho - zvikamu chete kubatwa rurimi, kutanga kunyorova, nokuomesa paya. tembiricha murwere achisimuka 38 madhigirii, uye rectal muviri tembiricha haapfuuri 1, uye noruoko madhigirii shoma. Pelvic nzvimbo muitiro kunotungamirira mvura-mvura zvituru; mumashoko okuwedzera riri pedyo napedyo kuti dundira, zvichikonzera Urinary zvirwere. Kurasikirwa kudya, kusanganisira kudya munyaya 90% kuti zviitiko kuzvimba okuwedzera pamusoro cecum. Kana murwere kuramba kudya kuitiswa, ungangowana tinodawo differential zvokuongorora kuti rikwanise appendicitis, izvo zvicharatidza mumwe chirwere zvakafanana zviratidzo.

omunharaunda zviratidzo

Sezvo zvakafanana zviratidzo zviri mamirire kuti zvimwe zvirwere, kuongororwa zvakarurama mukutanga maawa zvakaoma chaizvo. Zvisinei, pashure 4 maawa vakaderera zviratidzo swatanudza omunharaunda, vachibvumira kusiyanisa kuzvimba okuwedzera, uye kupa zvinodiwa kurapwa kumurwere. Ivo:

• Nangananga mikukutu marwadzo. Uye kurwadziwa rinova palpable kukudziri- zvavo zviratidzo. Zvinonzi vemunyika kana yose mudumbu, kana ari achiine rukuvhute nezvakarurama iliac nharaunda. Kana pelvic nzvimbo yacho okuwedzera marwadzo kunoitika pamusoro nyinyo, uye predpechenochnom - iri repamusoro quadrant. Asi vanachiremba vakawanda nezvinoda anonzi chiratidzo Kocher, kana kurwadziwa, nokuti maawa mashomanana epigastric kufamba zvakarurama iliac nharaunda.
• Zvishoma nezvishoma marwadzo mberi kubva anokakavara anova chakasimba, dzimwe nguva kupa kuzasi, yakaderera shure kana chorudyi. Varwere kunyatsoyeuka kunzwa kusagadzikana panguva kufamba kana vangakosora. Kazhinji, vanachiremba kumbira murwere kukosora, kuti zvakarurama kuona hunhu uye nzvimbo yacho localization kurwadziwa.
• The marwadzo anenge yaserera nehasha? Zviri mumwe zviratidzo hosha, vanotsanangura necrosis masero etsinga kwacho. Chine chiratidzo aripo inotyisa yatangira kudzikira ezvinhu omurwere uye peritonitis.
• O inoratidza peritonitis uye abdominal rusvingo tsandanyama kunokonzerwa (mu nyaya kugozha retrotsekalnogo kwacho urongwa lumborum). Kana mukabata mudumbu tsandanyama reflexively akaderedzwa, achiratidza kuti chokutsva sezvarwakasvikira visceral peritoneum.
• NeBP rinowanikwa ganda zvakarurama iliac nharaunda.
• Tsandanyama rworudyi hafu mudumbu akaita lag kufema, zvichiratidza kuti tsandanyama makakatanwa.
• Varwere dzakaonda guvhu zvakachinja zvishoma kurutivi rworudyi.
• Diagnosing appendicitis mumba kunosanganisira palpation. Zvaringana kuti vomanikidza iliac nharaunda uye zvikuru kudhonza bhurasho - marwadzo pakarepo kuwedzera.
• Rectal Kuongorora kunoratidza kurwadza appendicitis mugaranhoko. More chaizvo, rusvingo rwaro kumberi.

Zvimwe nzira nechirwere kumba

Kuziva pathological hunenge uye zvirwere Kusiyanisa nzira uye anoshandisa akadai:

• Chiratidzo Dubois - zvinorwadza nezvekufadza kushushikana pamusoro occipital pfungwa vagus tsinga.
• Chiratidzo Moscow - waenda zvakanaka mudzidzi.
• Uyewo, pane pfungwa mudumbu, chinokutsimbirirai iro rinoita twinge kuti appendicitis. Asi vanoziva chaiwo nzvimbo chiremba, saka unofanira kumirira kusvika amburenzi.

Appendicitis Vana

Dzikatadza diagnosing appendicitis muvana ndechokuti vane nemhaka yezera ravo havagoni kutaura manzwiro avo. Panyaya iyi, muduku mwana, asi nokukurumidza runoyerera chirwere. Inenge zvose zvevana chikuru zviratidzo appendicitis, ndokusaka kana mumwe wavo vanofanira kuenda nyanzvi. Chokutanga, mwana anochinja vanongogara maitiro ake hunoguma kufamba vachishingairira, zvinova lethargic uye vasingakendengi. Gare gare, pane zvimwe zviratidzo kuti kubvumira kusiyanisa chirwere.

Vana vacheche kuramba mazamu kana bhodhoro, fontanelle rinosakara, rurimi kunova pakaoma. Iva nechokwadi pane makakatanwa yakasimba iliac zvakanaka the pane. Chirwere kuti chenjera appendicitis muvana uye ari vachiongorora mamiriro ezvinhu mwana. Kazhinji, vana vari kurudyi pamwe pamabvi hwakakungwa. Vana vakura vanogona kugara, akasendamira mberi.

On palpation chiremba zvakarurama iliac mwana anongozvarwa it mudumbu rokurudyi uye achisunda ruoko chiremba kure. Diagnosing appendicitis mune vana kuenda kukireshi uye chikoro zera nguva dzose inosanganisira mubvunzo "apo zvichirwadza?". Setsika, mwana panotaura guvhu. Nokufamba marwadzo chirwere chinogona vakatamira kudunhu zvomoto okuwedzera. Lethargy, kuda kurutsa, kurutsa, kupatira, anotangira kutanga marwadzo, tachycardia, uye fivha tiri zviratidzo kuzvimba chervovidnogo kwacho.

Chenjera appendicitis mu vanamai pamuviri

Vakadzi vane pamuviri vanosanganawo akadaro zvisingafadzi zvirwere akafanana appendicitis. Chirwere rakaoma nokuti mukuru zviratidzo zvakadai abdominal kurwadziwa, kuda kurutsa uye kurutsa, muri runozivisa toxicity ari tanga pamuviri. With kukura dumbu kuona kukura zviratidzo hosha zvinonyanya kuoma. Vamwe nzira nechirwere kuti rikwanise appendicitis ari trimesters wechipiri newechitatu havagoni kupa mugumisiro. Somuenzaniso, zviratidzo peritoneal kutsamwa haana kutsunga, kurwadziwa haana vemunyika zvakarurama iliac nharaunda, uye pamusoro, palpation sashanda wakakodzera muitiro kufukidza kukura dumbu. Nokuda kwaizvozvi, achirwadza, pakunzwa kana cramping marwadzo kungava kururama kuti zviratidzo pedyo kubva kwepamuviri.

Kupiwa kunzwisisa nechirwere ose appendicitis vakadzi vane pamuviri, hwobva kuenda kuchipatara kuongororwa uye ape zvose bvunzo anodiwa kuti zvakarurama kuona hunhu dambudziko, tisingazvikuvadzi uye kana amai vanepamuviri kana mwana wake. Vanofungidzirwa Appendicitis? Differential chirwere kuchabatsira nechokwadi yakarurama zvokuongorora kana kuvhara nayo. mushonga Modern unokubvumira kubvisa okuwedzera panguva yepamuviri pasina kukuvadza utano. The chikuru Mamiriro ubudirire - nenguva chirwere uye kudzivirira yematambudziko zvakadai peritonitis. Zvinosuruvarisa, mune nyaya pute kana gangrenous appendicitis kunoda Caesarean chikamu. Chete saka zvinoita kubvisa okuwedzera, kuchenesa abdominal mhango nokuponesa mukadzi.

Appendicitis vakwegura

Appendicitis kunoitika muna vanhu vakwegura, kupfuura nengozi. Izvi nokuda kusakara kusvika zvose zviratidzo chirwere. Marwadzo chirwere ari havaratidzi akaratidza anongoda hapana dizuricheskie uye dyspeptic zvinetso, tembiricha anoramba chakaipa. Musati vanhu vakwegura, uye anowanzoramba zveefa kurwisa rikwanise appendicitis tachycardia, leukocytosis ikawanda ESR. Nokuda makore sagging rusvingo abdominal hariwaniki uye kuzvidzivirira maitiro pamusoro chikamu abdominal netsandanyama. Ndokusaka varwere vakwegura vanofanira zvakajeka sezvinobvira kupindura chero kuchinja avo ezvinhu. Kuchangotanga nokufungirana pakati kuzvimba okuwedzera vanofanira kudana chiremba uyo achakwanisa kuitisa zvizere kuzviongorora murwere.

matambudziko anoitika appendicitis

The chenjera chimiro chirwere kungaita kuparadzwa okuwedzera, kana kwatangwa amputations. Muchiitiko chino, purulent makore kudarika muitiro inotungamirira omunharaunda kana generalized kuzvimba peritoneum. Kana flegmoznoy hunogona kuva empyema, purulent maronda vakapararira kune peritoneum, mugaranhoko uye yakapoteredza tishu. Anoumba munhu purulent maronda, richisvika mafuta.

No migumisiro zvishoma chakakomba kutyisidzira thrombosis okuwedzera, chinokurwadzai kuvandudzwa septic thrombophlebitis pamusoro portal tsinga uye mapazi. Izvi zvinotungamirira occlusion ari mutsinga chiropa uye kukura chaizvo purulent inflammations. Kupiwa matambudziko aya, kubata appendicitis vanofanira kutanga pakarepo, pasina kunonoka "mangwana" uye kwete kutarisira "pamwe ngakuitwe."

chisingaperi appendicitis

Pane here chinonzi chirwere, pane rikwanise appendicitis. The kiriniki, chirwere uye kurapwa zvirwere zvichisiyana mufananidzo rikwanise kuzvimba okuwedzera. Kutaura zvazviri chisingaperi fomu - iri migumisiro kutambura rikwanise kuzvimba. In okuwedzera kuitika dystrophic uye sclerotic pezvakaitwa achiperekedzwa tishu kuparadzwa. Kuzvimba kuitika aporese, zvichiumba mavanga uye adhesions, anogona kukonzera maronda infiltrates. Mune zvimwe zviitiko, chisingaperi appendicitis inoenda ndechokuti kwacho ari kutendeuka kuva chikofu, iro zororo hakuna kudzikira ngozi kupfuura budiriro yacho okuwedzera. Zvinokosha kucherechedza kuti chirwere chimiro - kuti chinhu chinoshamisa zvikuru zvisingawanzoitiki, akacherechedza chete muna 1 kubva 100 zviitiko. Munofunga kuti mune chirwere appendicitis? Chirwere, kurapwa uye kutevera-zvinodhaka rutsigiro anotora nzvimbo muchipatara.

Diagnostics

Diagnosing appendicitis mumba zvinofanira kuva yakarurama somunhu kukanganisa uye wakatevera dose kurapwa Somuenzaniso, kubva muchetura unogona kutungamirira kumigumisiro inosuruvarisa. Izvi zvichaita kwete chete omesa nechirwere, asi achiipa murwere ezvinhu. Appendicitis, differential chirwere iyo kusvika pamwero zvinogoneka kumba, haashiviriri kuzvidzora. Asati asvika vanachiremba haigoni mushonga kana kushandisa kudziyisa ikanyanya kune njodzi yacho, kuedza kuderedza kunetseka. Izvi "hanya" pamusoro murwere anogona kukonzera vakurumidze peritonitis uye zvimwe zvinogoneka matambudziko.

Muri kuchipatara ane rokutanga chirwere kuti appendicitis? Ultrassom chirwere kuti appendicitis kuchaita kusiyanisa chirwere uye kutora nenguva chiito kubvisa dambudziko. Also kushandiswa nechirwere pamusoro radiography abdominal computed tomography, irrigoscopy. Ndavhiyiwa riri ndarama uye morphological chimiro chirwere rinoitwa histological kuzviongorora.

Mabatirwo appendicitis

Setsika, nemanda iri cecum kuraswa tichibatsirwa pakuvhiya. Zvinowanzoshandiswa nzira laparotomic appendectomy, apo zvomoto okuwedzera akabvisa kuburikidza abdominal rusvingo chikamu dissected. Kana akadaro kuvhiyiwa nokuda makomba duku dzakasara mavanga, uye chikumbiro anobvumira telescoping chubhu kuti kuvhiyiwa yakarurama zvichibvira. Akaderedza nguva yose postoperative nguva, kurerutsa mukana adhesions uye kukura chisingaperi siyana chirwere.

Inorwisa mabhakitiriya kurapa pashure pokuvhiyiwa iri tanzi kana pelvic anogumbura exudate. Kana catarrhal chimiro inorwisa mabhakitiriya hadzina kushandiswa. A mhando vanga vasara pashure pokuvhiyiwa, anobvumira kuziva izvo okuwedzera abvisa, kana kunyorerana kuchipatara zvakafanana zviratidzo mune foreseeable ramangwana. Ndokusaka panguva mamwe mabasa ari iliac nharaunda okuwedzera hadzingadzurwi, kunyange kana isina uchazvimba, kuti arege kutsausa vamwe nyanzvi. Appendicitis, chirwere uye kurapwa izvo zvinofanira kuitwa nekukurumidza - a "mumwe-kure" chirwere. Ndokusaka nyaya akadzokorora Zviratidzo vanofanira kutaura penyanzvi achakwanisa kuziva chirwere zvakafanana zviratidzo.