Sei kenza ascites

Akadana ascites effusion mvura chinoumba ropa kana node kupinda ari abdominal mhango. Izvi zvinogona kuitika mune zvirwere zvakasiyana-siyana uye pathologies, asi zviri kwese kuti zvirwere chiropa. Uyewo chaizvo nevakawanda ascites mu kenza, kunyanya chyloperitoneum (hwava mhingaidzo pakati nhumbi nhengo dzinobudisa hurongwa).

Makumi mashanu muzana kenza ascites kukura somugumisiro carcinomatosis parietal uye visceral peritoneum mashizha. pakupedzisira Izvi zvinotungamirira occlusion (mhingaidzo) node midziyo.

The kakawanda rokupedzisira pakati malignancies zvose anoda kubva gumi namashanu makumi mashanu kubva muzana. The ungangotarisa pokumuka ascites pamwe ovarian namamota, endometrial, gastric, chipfuva, Árbol sepombi uye dzimwe nhengo uye munyama.

More gumi muzana lesion kuumbwa panguva bundu chiropa parenchyma. Compression muviri womunhu venous hurongwa raizotungamirira kukurumidza paumbwe exudate ari abdominal mhango, mukuwedzera, Varwere kwakadaro hakuna kuumbwa raidaidzwa hepatomegaly.

Pathogenesis uye zviratidzo kenza ascites

Ascites zviratidzo zvakafanana kwaari - rakapinza kuwedzera mudumbu, uyewo murwere rwevanhu uremu. The yakawedzera kuomesa ari abdominal mhango kunotungamirira yakakwirira azvipire amire diaphragm, izvo zvinozoita kunokonzera zviratidzo gastro-oesophageal reflux (regurgitation, uye chirungurira, kuda kurutsa uye kurutsa), orthopnea uye dyspnea, compressed dumbu syndrome (nokukurumidza saturation zvokudya uye svoto).

Kuongorora Physical shoma ascites (200 milliliters) kwakaoma zvisingaiti kuziva. Effusion vhoriyamu kubva mashanu zana chiuru milliliters dzakaonekwa nemaziso somugumisiro bulging munharaunda kurutivi pachiuno ari mudumbu, chiratidzo kusiyana-siyana - akanaka. Pane hunhu ascites "kunoita" upenzi pachiuno nokuchinja nzvimbo muviri panguva percussion.

kenza Ascites anokonzerwa occlusion of venous wemuTesitamende chiropa rinowanika kuwedzera zvomene mutsinga ari abdominal rusvingo. In akazotevera nzendo paumbwe mamirire "musoro muramba" (bulging Anterior rusvingo abdominal mu ascites pamwe dilated mutsinga uye akaratidza mairi).

Wanikidza uyewo extraperitoneal zviratidzo yakaoma: mvura iri pasi pleural mhango, kuti zvaizopedza chakaderedzwa mutengo urove mwoyo, uyewo kuzvimba tila migove repasi (zvimwe yayo uye dumbu).

Kana chinouraya nzendo kenza ascites mwero hakuiti achiipa murwere mamiriro uye asingauyi kuumba njodzi kuupenyu, saka kurapa chete zvinodhaka diuretic, izvo kuwedzera excretion kuti zvinwiwa kubva mumuviri uye nokudaro kuderedza intra effusion.

Kana nechirwere pamusoro ascites, kurapwa rinoitwa veroshpironom (spironolactone) iro kuzivikanwa so "mureza wezvokurapa" pakurapa ezvinhu akadaro. Chinangwa zvinodhaka ichi akabatana furosemide (loop diuretic), ambotirega zvakare excrete kusvika 1000 milliliters pamusoro Urume pazuva.

Kana raidudzwa marwadzo uye kuvapo ascites uye tachypnea, akaita abdominal paracentesis (kuponjesa abdominal rusvingo nechinangwa abudise mhango). Zvikasabudiswa rinoitwa kwemaawa vanenge vatanhatu uye kusvikira panguva dzakadai ascites Urume haasisina iyerere ichipinda mugaba. The zvichiguma mvura rwunotumirwa Kuongororwa nokuongorora pamusoro zvachose mapuroteni kugutsikana, pamusoro fractional Zvinoumba LDH uye quantification pamusoro leukocytes. Uyezve, seeding rinoitwa pasi mvura svikiro.

Rinopa raidudzwa kunobatsirawo zvazvinoita etiological chinhu (zvakananga bundu pachayo). Nokudaro, nokudzinga nhengo panobviswa uye pathogenesis kenza ascites dzakachengeteka.