Zimayambitsa, Zizindikiro, ndi Chithandizo
Zowonjezereka ndizowonongeka kochepa kwambiri, zomwe zimaphatikizidwa ku gawo loyamba la matumbo akulu (omwe amatchedwanso colon). Pamene zowonjezereka zili mu gawo labwino la m'mimba, liribe ntchito yodziwika ndi kuchotsedwa kwa ilo likuwoneka kuti silikupangitsa kusintha mukumagwira ntchito.
Mwachidule
Kuwonjezera apo ndi kutupa kwazowonjezereka. Ukayamba, palibe mankhwala othandiza, choncho kuwonjezera pa matendawa kumatengedwa ngati mwachangu.
Akachitidwa mwamsanga, odwala ambiri amawombola popanda vuto. Ngati mankhwala akuchedwa, zowonjezereka zingathe kuphulika, kuchititsa matenda komanso imfa.
Ngakhale aliyense atha kuwonjezereka, amapezeka nthawi zambiri pakati pa zaka 10 ndi 30.
Zimayambitsa
Choyambitsa chiwindikiro chimagwirizana ndi kutseka mkati mkati mwa zowonjezereka, zotchedwa lumen. Kutsekeka kumabweretsa kuwonjezereka, kutaya magazi, ndi kutupa. Ngati kutsekedwa sikusamalidwa, kupwetekedwa ndi kupasuka (kuswa kapena kuvundula) kwazowonjezera kumatha.
Kawirikawiri, zimbudzi zimatsekera mkati mwazowonjezereka. Komanso mabakiteriya kapena mavairasi m'magazi angayambitse kupweteka kwa ma lymph node, zomwe zimaphatikizapo zowonjezereka ndikupangitsa kuti zisawonongeke. Kuvulala koopsa kwa mimba kungathenso kumabweretsa kuwonjezeka, mwa anthu ang'onoang'ono.
Mwina mungadabwe kumva kuti chibadwa chimayambitsa amene amapeza appendicitis. Mwa kuyankhula kwina, kupatsirana kwa matenda kumene kumayambira m'mabanja kungabwere chifukwa cha kusiyana kwa chibadwa chomwe chimapangitsa munthu kusokoneza chidziwitso cha lumen.
Zizindikiro
Zizindikiro zowonjezereka zingaphatikizepo:
- Ululu m'mimba , yoyamba kuzungulira mimba, ndikusunthira kumunsi kumanja-umatchedwa kupweteka kwa m'mimba
- Kutaya njala
- Nsowa ndi kusanza
- Kutsekula kapena kutsekula m'mimba
- Kulephera kupititsa gasi kapena kutuluka kwa mafuta
- Kutentha kwakukulu kumene kumayambira pambuyo pa zizindikiro zina
- Kutupa m'mimba
- Kudzikuza
Ponena za kupweteka kwa m'mimba kwa appendicitis (chizindikiro chofala komanso chopezekapo nthawi zonse), kupweteka kwapakatikukuwonjezereka ndipo kumapweteka pamene mukuyenda, kutaya mpweya, kutsokomola, kapena kunjenjemera. Dera lomwe liri lopweteka limakhala losavuta kukanikiza kulikonse.
Anthu angakhalenso ndi maganizo omwe amatchedwa "kulakalaka pansi," omwe amadziwikanso kuti "tenesmus," omwe ndikumverera kuti kayendedwe kowakometsera kumathandiza kuchepetsa mavuto awo. Izi zikunenedwa kuti, mankhwala osokoneza bongo sayenera kutengedwa mkhalidwe uno.
Ndikofunika kumvetsetsa kuti si onse omwe ali ndi chidziwitso ali ndi zizindikiro zonsezi. Ichi ndi chifukwa chake n'kofunika kuti muwone dokotala mwamsanga ngati muli ndi nkhawa kapena zizindikiro zili pamwambazi ndi ululu m'mimba.
Ndiponso, anthu omwe ali ndi mikhalidwe yapadera sangakhale ndi zizindikiro zapamwamba pamwamba ndipo angangokhala ndikumverera kwakukulu kosakhala bwino. Odwala omwe ali ndi izi ndi monga:
- Anthu omwe amagwiritsira ntchito mankhwala osokoneza bongo monga steroids
- Anthu omwe alandira chololedwa
- Anthu omwe ali ndi HIV
- Anthu omwe ali ndi shuga
- Anthu omwe ali ndi khansa kapena omwe akulandira mankhwala a chemotherapy
- Anthu ovuta
Azimayi Oyembekezera
Kupweteka kwa m'mimba, kunyozetsa, ndi kusanza ndizofala pa nthawi ya mimba ndipo mwina kapena sizikhala zizindikiro za kupatsirana.
Azimayi ambiri omwe amayamba kukhala ndi chithandizo pa nthawi yomwe ali ndi mimba samakhala ndi zizindikiro zakuda, makamaka m'miyezi itatu yachitatu. Ndikofunika kuti mayi woyembekezera yemwe amamva ululu kumbali yoyenera ya kukhudzana ndi mimba ndi dokotala.
Makanda ndi Ana
Ana ndi ana ang'onoang'ono sangathe kapena sangakwanitse kulankhulana ndi makolo awo kapena madokotala. Popanda mbiri yomveka bwino, madokotala ayenera kudalira kuwona thupi ndi zizindikiro zochepa, monga kusanza ndi kutopa. Ana omwe ali ndi appendicitis nthawi zina amavutika kudya ndipo amawoneka ogona modabwitsa. Ana angakhale ndi kudzimbidwa, koma akhoza kukhala ndi malo ochepa omwe ali ndi ntchentche.
Mwachidule, zizindikiro zimasiyanasiyana pakati pa ana ndipo sizili zofanana ndi za akuluakulu (makamaka ana aang'ono). Kotero ngati mukuganiza kuti mwana wanu ali ndi appendicitis, funsani dokotala mwamsanga.
Anthu Achikulire
Odwala okalamba amakhala ndi mavuto ambiri azachipatala kuposa achinyamata. Okalamba nthawi zambiri amamva kupweteka kwambiri komanso kupweteka kwambiri m'mimba kuposa momwe odwala ena amachitira ndi matendawa. Okalamba ambiri sakudziwa kuti ali ndi vuto lalikulu mpaka zowonjezereka zatsala pang'ono kutha. Chiwindi pang'ono ndi ululu m'mimba kumbali ya kumanja ndi zifukwa zokhalira dokotala nthawi yomweyo.
N'zoona kuti anthu onse omwe ali ndi nkhawa zaumoyo komanso mabanja awo ayenera kukhala osamala kwambiri kuti asinthe ntchito zawo komanso odwala ayenera kuwona madokotala awo posakhalitsa, pakakhala kusintha.
Kudziwa
Mbiri Za Zamankhwala
Kufunsa mafunso kuti mudziwe mbiri ya zizindikilo ndi kufufuza mwakachetechete ndizofunikira kwambiri kuti muzindikire kuti muli ndi vutoli. Dokotala adzafunsa mafunso ambiri-mofanana ndi mtolankhani-kuyesera kumvetsa chikhalidwe, nthawi, malo, chitsanzo, ndi kuuma kwa ululu ndi zizindikiro. Matenda aliwonse apitalo ndi opaleshoni, mbiri ya banja, mankhwala, ndi chifuwa ndizofunikira kwa dokotala. Kugwiritsa ntchito mowa, fodya, ndi mankhwala ena onse ayenera kutchulidwanso. Chidziwitso chimenechi chimaonedwa ngati chinsinsi ndipo sichikhoza kugawidwa popanda chilolezo cha wodwalayo.
Kusanthula thupi
Musanayambe kufufuza, namwino kapena dokotala nthawi zambiri amayeza zizindikiro zofunika: kutentha, kuthamanga, kuchuluka kwa kupuma, ndi kuthamanga kwa magazi. Kawirikawiri, kuyang'ana kwa thupi kumachokera mutu kumutu. Zinthu zambiri monga chibayo kapena matenda a mtima zingayambitse ululu m'mimba. Zizindikiro zowonjezereka monga fever, kuthamanga, kapena kutupa kwa maselo am'mimba amatha kuwonetsa matenda omwe sakanafuna opaleshoni.
Kufufuza mimba kumathandiza kuchepetsa matendawa. Malo a ululu ndi kukoma mtima n'kofunika-kupweteka pokhala chizindikiro chofotokozedwa ndi munthu ndi kukoma mtima kukhala yankho la kukhudzidwa.
Zizindikiro ziwiri, zotchedwa zizindikiro za peritoneal, zimasonyeza kuti kuyamwa kwa mimba kumatentha ndipo opaleshoni imafunika:
- chifundo chachikulu
- kuyang'anira
Chikondi chokhazikika ndi pamene dokotala akukakamiza mbali imodzi ya mimba ndipo munthuyo amamva chisoni kwambiri pamene kutulutsidwa kumatulutsidwa kusiyana ndi pamene akugwiritsidwa ntchito.
Kusamala kumatanthauzira minofu yambiri poyankha.
Dokotala angathenso kusuntha miyendo ya wodwalayo kuti ayese kupweteka kwa chiuno (chotchedwa chizindikiro cha psoas), kupweteka kwa kusintha kwa mkati kwa chiuno (chotchedwa chizindikiro cha obturator), kapena kupweteka kumbali yakumanja pamene akulimbikira kumanzere (kuyitana Chizindikiro cha Rovsing). Izi ndizizindikiro zamtengo wapatali za kutupa koma osati odwala onse ali nawo.
Mayesero a Laboratory
Mayeso a magazi amagwiritsidwa ntchito pofufuza zizindikiro za matenda, monga kuchuluka kwa maselo oyera a magazi. Magazi amadzimadzi angasonyezenso kutaya madzi kwa madzi kapena madzi osokoneza bongo. Kugwiritsira ntchito mankhwalawa kumagwiritsidwa ntchito pofuna kuthetsa matenda opangira mkodzo. Madokotala akhoza kuyitanitsa mayeso a mimba kwa azimayi otha msinkhu wobereka kapena kuchita kafukufuku wa pelvic kuti athetse zomwe zimayambitsa matendawa.
Mayesero Ojambula
X ray, ultrasound, ndi computed tomography (CT) mawonekedwe akhoza kupanga zithunzi pamimba. Mazira ochepa awonetsera zizindikiro zosokoneza, phokoso (dzenje), matupi achilendo, ndipo nthawi zambiri, appendicolith, yomwe imakhala yolimba muzowonjezereka.
Ultrasound ikhoza kusonyeza kupweteka kwa pulogalamu yowonjezera ndipo ingathe kupeza matenda a gallbladder ndi mimba.
Ndiyeso yofala kwambiri yomwe amagwiritsidwa ntchito, komabe, ndiyo njira ya CT. Chiyesochi chimapereka zithunzi zosiyana siyana za thupi ndipo zingathe kuzindikira zochitika zambiri za m'mimba ndikuwunikira kudziwa ngati chithandizo cha kuchipatala chiri kukaikira. Nthawi zina, kujambula kwa maginito (MRI) kumagwiritsidwa ntchito kuthandizira kafukufuku wa dokotala kuti apitirize kugwiritsidwa ntchito kwa amayi omwe ali ndi mimba (popeza kutentha kwapadera kumaperekedwa panthawi ya CT koma osati MRI).
Pazifukwa zosankhidwa, makamaka mwazimayi pamene chiwerengero cha zizindikiro zikhoza kukhala zowonjezereka kapena ovary kapena flalopian tube, laparoscopy ingakhale yofunikira. Njirayi imapewa kutentha kwa dzuwa koma imafuna kuti munthu awonongeke kwambiri. Laparoscope ndi kachidutswa kakang'ono kamene kamakonzedwa kamera kamene kamalowetsedwa m'thupi kudzera kudula kakang'ono, kulola madokotala kuona ziwalo za mkati. Kuchita opaleshoni kumachitidwa operewera pokhapokha ngati chikhalidwe chikufunikira.
Kuchiza
Opaleshoni
Kugwiritsa ntchito mankhwala opatsirana kumaphatikizidwa ndi opaleshoni kuchotsa zowonjezereka . Opaleshoniyi ikhoza kuchitidwa poyera kudzera muyezo waung'ono wamtundu wa m'mimba, kapena ingakhale ikugwiritsidwa ntchito pogwiritsa ntchito laparoscope, yomwe imafuna kuwona zochepa zing'onozing'ono zitatu kapena zinayi. Ngati zifukwa zina zikugwiritsidwa ntchito powonjezeretsa kuwonjezera, zingathe kudziwika pogwiritsa ntchito laparoscopy. Kwa odwala ena, laparoscopy ndi yabwino kuchitidwa opaleshoni chifukwa chakuti mankhwalawa ndi ochepa, nthawi yowonongeka imakhala yofulumira, ndipo mankhwala opweteka kwambiri amafunika. Zowonjezereka nthawi zonse zimachotsedwa, ngakhale zitapezeka kuti zili zachilendo. Ndi kuchotsedwa kwathunthu, zochitika zina zamtsogolo za ululu sizidzatchulidwa ndi kuwonjezera.
Kuchokera ku appendectomy kumatenga masabata angapo. Kawirikawiri madokotala amapereka mankhwala opweteka ndipo amafunsa odwala kuti asamachite zinthu zolimbitsa thupi. Kubwezeretsa kwa puloteni ya laparoscopic nthawi zambiri mofulumira, koma kuchepetsa ntchito yowopsya ikhoza kukhala yofunikira kwa masiku 3 mpaka 5 mutatha opaleshoni ya laparoscopic ndi masiku 10 mpaka 14 mutatha opaleshoni yotseguka. Anthu ambiri amachiritsidwa kuti apitirize kubwezeretsa bwino ndipo safunikira kusintha kaye kadyedwe kawo, kachitidwe kawo, kapenanso moyo wawo.
Thandizo la antibiotic
Ngati matendawa sakudziwika, anthu akhoza kuyang'anitsitsa ndipo nthawi zina amachizidwa ndi maantibayotiki. Njirayi imatengedwa pamene dokotala akuganiza kuti zizindikiro za wodwalayo zikhoza kukhala ndi vuto la mankhwala kapena mankhwala. Ngati chiwopsezo cha ululu chimawopsa, zizindikiro zimayambitsa mankhwala opha tizilombo towopsa.
Kawirikawiri, kupatsirana kwa mankhwala kungangoperekedwa ndi opaleshoni-kokha mwa anthu enieni kapena ana ndiwo mankhwala oletsa tizilombo tokha omwe amawoneka kuti akhoza kuthandizidwa kuti adziwe.
Nthaŵi zina thupi limatha kuyendetsa pulogalamu yowonjezereka popanga abscess. Chiphuphu chimachitika pamene matendawa atchingidwa mbali imodzi ya thupi. Dokotala angasankhe kuchotsa abscess ndikusiya kukhetsa pamphuno kwa milungu ingapo. Pulogalamu ya appendectomy ingakonzedwe pokhapokha atachotsedwa.
Mavuto
Chinthu chovuta kwambiri chogwiritsira ntchito pulogalamu yowonjezereka ndi kupasuka. Zowonjezereka zimapweteka kapena misonzi ngati mavitamini sakupezeka mofulumira ndipo samatengedwa. Ana, makanda, ndi akuluakulu ali pangozi yaikulu. Zowonjezera zakumapeto zingayambitse ku peritonitis ndi abscess. Peritonitis ndi kachilombo koopsa kamene kamapezeka pamene mabakiteriya ndi zina zomwe zili m'kati mwa zowonjezera zowonjezera zimalowa m'mimba. Anthu omwe ali ndi appendicitis, abscess nthawi zambiri amatenga mawonekedwe a kutupa misa wodzazidwa ndi madzi ndi mabakiteriya. Kwa ochepa odwala, mavuto a appendicitis angapangitse kufooka kwa thupi ndi imfa.
> Zotsatira:
> American College of Odwala Opaleshoni. (Yatsindika 2014. Appendectomy: Kuchotsa Opaleshoni ya Zakumapeto.
> Martin RF. (November 2016). Kuwoneka bwino kwa anthu akuluakulu: Kuwonetseredwa kwachipatala komanso kusiyana kwa matenda. Mu: UpToDate, Weiser M (ed), UpToDate, Waltham, MA.
> Chitukuko cha National Diabetes ndi Matenda a Kumimba ndi Impso. Appendicitis.
> Wilms IM, de Hoog DE, de Visser DC, Janzing HM. Mankhwala opatsirana pogwiritsa ntchito mankhwala ophera tizilombo. Database Cochrane Rev Rev 2011 Nov 9; (11): CD008359.