Ascites mu cirrhosis ya chiwindi mwa akuluakulu
Ascites amadziwika kwambiri amatchedwa dropsy of abdomen. Dziwani kuti matendawa sangathe kutchedwa matenda odziimira okha, koma ndizovuta. Tidzakuuzani zomwe ascites ali mu chiwindi cha cirrhosis, zomwe zimayambitsa zochitika zake, momwe mungathanirane nazo. Kuchita ndi katswiri

Kodi ascites ndi chiyani

- Ascites wa m'mimba patsekeke - choncho pamene pathological kudzikundikira madzimadzi wapanga mu m'mimba patsekeke. Matendawa akufotokozera pang`onopang`ono, m`kupita kwa milungu ingapo, miyezi. Nthawi zambiri, odwala ambiri sadziwa n'komwe kuti amadwala ascites. Odwala amaganiza kuti angochira, choncho mimba imakula. Mu 75% ya milandu, ascites imagwirizanitsidwa ndi matenda a chiwindi, mu 25% yotsalayo ndi khansa, mavuto a mtima, akuti. gastroenterologist Olga Smirnova.

Dokotala ananena kuti lingaliro lakuti "cirrhosis imayambitsa kumwa mowa" ndi lolakwika, chifukwa matenda a chiwindi, kuwonongeka kwa chiwindi cha autoimmune ndi matenda a chiwindi amafuta kumayambitsa matenda a chiwindi.

Zomwe zimayambitsa ascites mu cirrhosis yachiwindi mwa akulu

Wodwala akafika kwa dokotala koyamba, ndipo amakayikira kuti ascites, chotsatira chikayikiridwa ndi matenda enaake a chiwindi. Koma dziwani kuti ngati muli ndi matenda enaake, izi sizikutanthauza kuti ascites zidzachitika 100%.

Pali zinthu zingapo zomwe zingapangitse mwayi wokhala ndi matendawa. Akatswiri amakhulupirira kuti pachiwopsezo ndi anthu omwe amakhala ndi moyo wopanda thanzi - kugwiritsa ntchito mankhwala osokoneza bongo ndi mowa. Izi zikuphatikizanso anthu omwe ali ndi matenda a chiwindi, odwala omwe ali ndi kunenepa kwambiri kwamitundu yonse, anthu omwe ali ndi cholesterol yayikulu, mtundu 1 ndi mtundu wa 2 shuga.

Zizindikiro za ascites mu matenda enaake a chiwindi akuluakulu

- Kumayambiriro kwa matendawa, wodwalayo sadziwa n'komwe kuti ali ndi ascites. Kuti wodwalayo azindikire msanga, m'pofunika kuti osachepera lita imodzi yamadzimadzi aunjike m'mimba. Ndipamene zizindikiro zina za ascites ndi cirrhosis m'chiwindi zidzayamba kuonekera, akutero adokotala.

Ena onse zizindikiro akhoza kale chifukwa cha ululu pachimake m`mimba, kudzikundikira mpweya (pamene mphepo yamkuntho kumachitika m`mimba), belching mosalekeza, kutentha pamtima pafupipafupi, munthu amayamba kupuma kwambiri, miyendo kutupa.

- Munthu akakhala ndi madzi ambiri mkati, mimba imayamba kukula, ndipo wodwalayo amayamba kuvutika pamene akugwada. Mimba imakhala ngati mpira, zizindikiro zotambasula zimawonekera, chifukwa khungu limatambasulidwa kwambiri. Komanso, mitsempha ina pamimba imakula, katswiriyo akupitiriza. - Pakachitika matenda oopsa kwambiri, wodwalayo amathanso kukhala ndi jaundice, munthuyo sakumva bwino, kusanza ndi nseru.

Chithandizo cha ascites mu matenda enaake a chiwindi akuluakulu

Pamene ascites ikukula motsutsana ndi maziko a cirrhosis, hepatoprotectors amagwiritsidwa ntchito pochiza. Pamodzi ndi izi, madokotala amapereka symptomatic mankhwala kwa odwala ascites.

Poyamba, wodwalayo ayenera kusiya mchere. Dokotala adzalamula zakudya zochepa mchere, zomwe ziyenera kuwonedwa mosamalitsa. Zikutanthauza kukana kwathunthu mchere kapena kugwiritsa ntchito 2 g patsiku.

Komanso, adotolo adzapereka mankhwala omwe amapanga chifukwa cha kuchepa kwa potaziyamu m'thupi, ndi mankhwala okodzetsa a edema. Dokotala adzayang'anira mphamvu ya chithandizo, komanso kulemera kwa wodwalayo.

Diagnostics

Monga tanena kale, ngati kuchuluka kwa madzi m'mimba ndi zosakwana 400 ml, ascites pafupifupi sizimaonekera. Koma zikhoza kudziwika mothandizidwa ndi maphunziro a zida. Choncho, n’kofunika kuti muziyezetsa thupi nthawi zonse, makamaka ngati muli ndi matenda a cirrhosis.

Jaundice mwa akuluakulu
Ngati khungu ndi mucous nembanemba zimasanduka zachikasu mwadzidzidzi, mavuto a chiwindi angakhale chifukwa. Komwe mungapite ndi mankhwala oti mutenge - muzinthu zathu
Dziwani zambiri
Zosangalatsa

Kuti muzindikire ma ascites, choyamba, muyenera kuwona dokotala yemwe adzayang'anire mawonedwe ndi palpation yamimba. Kukhazikitsa molondola matenda, m`pofunika kuchita ultrasound pamimba patsekeke ndipo nthawi zina pachifuwa. Kufufuza kwa ultrasound kudzawonetsa momwe chiwindi chikuyendera ndikulola dokotala kuti awone ma ascites okha ndi ma neoplasms omwe alipo kapena kusintha kwa chiwalo.

Dopplerography, yomwe idzawonetsa mkhalidwe wa mitsempha.

Kuti muzindikire molondola ascites, maginito a resonance imaging kapena computed tomography iyenera kuchitidwa. Maphunzirowa akuthandizani kuti muwone kupezeka kwamadzimadzi. Mwa kuyankhula kwina, kuwona zomwe sizikuwoneka panthawi ya ultrasound.

Nthawi zina, dokotala akhoza kupanga laparoscopy. Katswiriyo adzapanga puncture ya khoma la m'mimba, ndipo madzi ochuluka adzatengedwa kuti afufuze.

Kuphatikiza apo, amayesa magazi ambiri.

Mankhwala amakono

Njirazi ndi izi:

  • zakudya zopanda sodium (kukana kwathunthu mchere kapena kumwa 2 g patsiku);
  • kumwa ma diuretics.

Ngati njira zomwe zili pamwambazi zinali zopanda mphamvu ndipo sizinapereke zotsatira, wodwalayo anapitirizabe kuvutika, opaleshoni ingafunike. Dokotala yemwe ali ndi ascites amatha kuchotsa madzimadzi pang'onopang'ono. Pamenepa, dokotala wa opaleshoni amapanga choboola chaching'ono m'mimba ndikulowetsamo chubu.

Wodwala akhoza kukhala ndi ma catheters okhalamo komanso ma subcutaneous madoko. Madziwo adzachotsedwa akangolowa mwa iwo. Iyi ndi imodzi mwa njira zabwino zothandizira mankhwala - zimakulolani kuti muchepetse kuwonongeka kwa ziwalo zamkati ndi kutupa.

Kupewa ascites mu matenda enaake a chiwindi akuluakulu kunyumba

Zina mwa njira zopewera ascites ndi izi:

  • chithandizo chanthawi yake cha matenda opatsirana;
  • moyo wathanzi;
  • kusiya mowa, kusuta;
  • masewera olimbitsa thupi;
  • chakudya choyenera.

Wodwala matenda enaake ayenera nthawi zonse kufufuzidwa ndi akatswiri ndi kutsatira mosamala malangizo awo.

Mafunso ndi mayankho otchuka

Adayankha mafunso otchuka gastroenterologist Olga Smirnova:

Ndi zovuta ziti za ascites mu cirrhosis yachiwindi?
Ascites nthawi zonse amakulitsa njira ya matendawa. Nthawi zambiri, kukhala ndi ascites ndi cirrhosis ya chiwindi, zovuta zotsatirazi zimatha kuchitika:

wodwala amatha kupeza zovuta zamakina mwa kukanikiza ndi madzimadzi ascitic;

● madzi amatha kudziunjikira pakati pa mapepala a pleural - mu pleural cavity, mwa kuyankhula kwina, hydrothorax imayamba;

● ziwiya zikhoza kufinyidwa (otsika vena cava syndrome, kupanikizana kwa mitsempha ya aimpso);

● maonekedwe a hernias - nthawi zambiri umbilical;

● kusamutsidwa kwa ziwalo zamkati;

● kulowa kwa matenda - modzidzimutsa bakiteriya peritonitis;

● zovuta za kagayidwe kachakudya - kuphwanya kagayidwe ka electrolyte;

● hepatorenal syndrome ndi mkhutu aimpso ntchito.

Ndi liti kuitana dokotala kunyumba kwa ascites ndi matenda enaake a chiwindi?
Dokotala wakunyumba ayenera kuyitanidwa ngati:

● ascites inachitika modzidzimutsa, kapena mimba inayamba kukula mofulumira ndi maonekedwe a zizindikiro zosiyanasiyana;

● okwera kutentha thupi anaonekera pa maziko a ascites;

● kukodza kunachepa;

● panali kusokonezeka m'mlengalenga - wodwalayo sangathe kudziyang'ana komwe ali, tsiku, mwezi, ndi zina zotero.

Kodi ascites angakhale asymptomatic?
Inde, izi ndizotheka, koma ngati kuchuluka kwa madzi m'mimba ndi zosakwana 800 ml. Ndiye sipadzakhala psinjika makina a ziwalo za m'mimba, kutanthauza kuti ascites akhoza kukhala asymptomatic.
Kodi mungadye bwanji ndi ascites?
● kutsatira mosamalitsa zakudya zomwe mchere ukhoza kudyedwa pang'ono kwambiri (2 g patsiku), ndipo pazovuta kwambiri za ascites - zakudya zopanda mchere;

● kuchepetsa kudya kwamadzimadzi - osapitirira 500-1000 ml patsiku;

● kuchepetsa kudya kwamafuta kuti mupewe kuchulukirachulukira kwa kapamba.

Wodwala ascites ayenera kukhala ndi zakudya zoyenera. Zakudya ziyenera kukhala ndi masamba ndi zipatso zokwanira, mutha kudya zonse zatsopano ndi zokazinga, zamkaka - kefir ndi kanyumba tchizi. Mulimonsemo musati mwachangu chakudya, ndi bwino kuwiritsa kapena kuphika mu uvuni, njira yabwino yodyera chakudya chamadzulo kapena chamasana ndikutentha chakudya. Zakudya zamafuta, nyama zonenepa ndi nsomba, zakudya zosuta, zinthu zomwe zatha, mowa, zakudya zamzitini ndi zakudya zokazinga ndizoletsedwa.

Siyani Mumakonda