Mukati
Chii chinonzi ascites
- Ascites yedumbu remudumbu - iyo kesi apo pathological kuunganidzwa kwemvura yakaumbwa mudumbu remudumbu. Chirwere chinokura zvishoma nezvishoma, chinopfuurira kwemavhiki akawanda, mwedzi. Kazhinji, varwere vakawanda havatombozivi kuti vanoita ascites. Varwere vanofunga kuti vakangoita zviri nani, saka dumbu rinokura. Muchikamu che75% chezviitiko, ascites inosanganiswa ne cirrhosis yechiropa, mune yasara 25% igomarara, matambudziko emoyo, anodaro. gastroenterologist Olga Smirnova.
Chiremba anotaura kuti pfungwa yokuti "cirrhosis inokonzera kunwa doro" haina kururama, nokuti kusingaperi hepatitis, autoimmune chiropa kukuvara uye mafuta ane chiropa chirwere zvinotungamirirawo ku cirrhosis yechiropa.
Zvinokonzera ascites mu cirrhosis yechiropa muvanhu vakuru
Apo murwere anotanga kuuya kuna chiremba, uye anofungidzira ascites, inotevera pasi pekufungidzirwa ndeye cirrhosis yechiropa. Asi cherechedza kuti kana uine cirrhosis, izvi hazvirevi kuti ascites ichaitika 100%.
Pane zvinhu zvakawanda zvinogona kuwedzera mikana yekuvandudza chirwere ichi. Nyanzvi dzinofunga kuti pangozi vanhu vanotungamirira mararamiro asina kunaka - kushandisa zvinodhaka uye doro. Izvi zvinosanganisirawo vanhu vakamboita hepatitis, avo varwere vakaonekwa kuti vane kufutisa kwemarudzi ese, vanhu vanorwara nehigh cholesterol, Type 1 uye Type 2 chirwere cheshuga.
Zviratidzo zve ascites mu cirrhosis yechiropa kune vanhu vakuru
- Pakutanga kwechirwere, murwere haatombozivi kuti ane ascites. Kuti murwere azvione nekukurumidza, zvinodikanwa kuti riite rita remvura riungane mudumbu. Ndiyo apo zvimwe zviratidzo zve ascites ne cirrhosis yechiropa zvichatanga kuonekwa, chiremba anodaro.
Zvimwe zviratidzo zvinogona kutonzi zvinokonzerwa nekurwadziwa kwakanyanya mudumbu, kuunganidza magasi (apo dutu remhepo rinoitika mudumbu), kuputika nguva dzose, kupisa kwemoyo nguva dzose, munhu anotanga kufema zvakanyanya, makumbo ake anozvimba.
- Kana munhu ane mvura yakawanda mukati, dumbu rinotanga kukura, uye murwere anotanga kutambura paanokotama. Dumbu rinoita sebhora, kutambanudza mavara kunooneka, nokuti ganda rinotambanudzwa zvikuru. Zvakare, mamwe matsinga ari mudumbu anowedzera, nyanzvi inoenderera mberi. - Muchiitiko chechirwere chakanyanya kuoma, murwere anogonawo kuita jaundice, munhu wacho achanzwa asina kunaka, kurutsa uye kushungurudza.
Kurapa kwe ascites mu cirrhosis yechiropa muvanhu vakuru
Apo ascites inokura inopesana nemashure e-cirrhosis, hepatoprotectors inoshandiswa mukurapa. Pamwe chete neizvi, vanachiremba vanorayira symptomatic therapy kune varwere vane ascites.
Kutanga, murwere anofanira kurega munyu. Chiremba acharayira kudya kwakaderera-munyu, iyo inofanira kunyatsocherechedzwa. Zvinoreva kurambwa kwakakwana kwemunyu kana kushandiswa kwe 2 g chete pazuva.
Zvakare, chiremba anonyora mishonga inoumba kushomeka kwe potassium mumuviri, uye diuretic mishonga ye edema. Chiremba achacherechedza maitiro ekurapa, pamwe nekurema kwemurwere.
Diagnostics
Sezvambotaurwa pamusoro apa, kana huwandu hwemvura mudumbu huri pasi pe400 ml, ascites inenge isingaoneki. Asi inogona kuzivikanwa nerubatsiro rwezvidzidzo zvekushandisa. Naizvozvo, zvakakosha kugara uchiongororwa muviri, kunyanya kana uine cirrhosis.
Kuti uongorore ascites, kutanga kune zvose, unoda kuona chiremba uyo achaita kuongorora kwekuona uye palpation yedumbu. Kuti ugadzirise kuongororwa kwakarurama, zvakakosha kuitisa ultrasound yedumbu remudumbu uye dzimwe nguva chifuva. Kuongororwa kwe ultrasound kucharatidza mamiriro echiropa uye kubvumira chiremba kuti aone zvose ascites pachayo uye neoplasms iripo kana kuchinja munhengo.
Dopplerography, iyo icharatidza mamiriro etsinga.
Kuti unyatsoongorora ascites, magnetic resonance imaging kana computed tomography inofanira kuitwa. Zvidzidzo izvi zvinokutendera kuti uone kuvepo kwemvura. Mune mamwe mazwi, kuona izvo zvisingaoneki panguva ye ultrasound.
Mune zvimwe zviitiko, chiremba wako anogona kuita laparoscopy. Nyanzvi ichaita puncture yemadziro emimba, uye mvura yakaunganidzwa ichatorwa kuti iongororwe.
Mukuwedzera, ivo vanoita general test test.
Mishonga yemazuva ano
Idzi dzinosanganisira:
- sodium-isina kudya (kuramba zvachose kwemunyu kana kushandiswa kwe2 g pazuva);
- kutora diuretics.
Kana nzira dziri pamusoro apa dzakanga dzisina simba uye dzisina kupa chero chigumisiro, murwere akaramba achitambura, kuvhiyiwa kunogona kudiwa. Chiremba ane ascites anogona kubvisa mvura inoyerera zvishoma nezvishoma. Muchiitiko ichi, chiremba anovhiya anoita chidimbu chiduku mudumbu uye anoisa chubhu yemvura mairi.
Murwere anogonawo kunge aine catheter yekugara uye subcutaneous ports yakaiswa. Mvura yacho inobviswa painongopinda mavari. Iyi ndiyo imwe yenzira dzakanakisisa dzekurapa - inokubvumira kuderedza dambudziko rekukuvadza kune nhengo dzomukati nekuputika.
Kudzivirira ascites mu cirrhosis yechiropa muvanhu vakuru kumba
Pakati pematanho ekudzivirira ascites ndeaya anotevera:
- kurapwa panguva yezvirwere zvinotapukira;
- mararamiro ane hutano;
- kurega doro, kusvuta;
- kurovedza muviri;
- kudya kwakakwana.
Murwere ane cirrhosis anofanira kugara achiongororwa nenyanzvi uye kunyatsotevera mirairo yavo.
Mibvunzo nemhinduro dzakakurumbira
Akapindura mibvunzo yakakurumbira gastroenterologist Olga Smirnova:
murwere anogona kuwana mechanical complications nekumanikidza neascitic fluid;
● mvura inogona kuunganidza pakati pemapepa epleural - mu pleural cavity, mune mamwe mazwi, hydrothorax inokura;
● midziyo inogona kudzvinyirirwa (inferior vena cava syndrome, kudzvinyirira kwerenal veins);
● kuonekwa kwehernias - kazhinji umbilical;
● kutamiswa kwemitezo intraperitoneally;
● kupinda kwehutachiona - kungoerekana kwaitika bhakitiriya peritonitis;
● matambudziko emagetsi - kukanganisa kwe electrolyte metabolism;
● hepatorenal syndrome ine kukanganisa renal basa.
● ascites yakaitika pakarepo, kana kuti dumbu rakatanga kukurumidza kuwedzera muhukuru nekuonekwa kwezviratidzo zvakasiyana-siyana;
● tembiricha yepamusoro yemuviri yakaonekwa kumashure kweascites;
● weti yakava shoma;
● pakanga pane kuvhiringidzika muchadenga - murwere haakwanisi kuzvitarisa paari, zuva ripi, mwedzi, nezvimwewo nhasi.
● kuderedza kunwa kwemvura - kwete kupfuura 500-1000 ml pazuva;
● kuderedza kudyiwa kwemafuta kuitira kudzivirira kuwedzera kwepancreatitis.
Murwere ane ascites anofanira kuva nekudya kwakakwana. Zvokudya zvinofanira kuva nehuwandu hwakakwana hwemiriwo nemichero, unogona kudya zvose zvitsva uye zvakabikwa, zvigadzirwa zvemukaka - kefir uye cottage cheese. Hazvina mhosva kuti usakanganise chikafu, zviri nani kubika kana kubika muchoto, nzira yakanaka yekuve nekudya kwakanaka kwemanheru kana masikati ndeyekudya. Zvikafu zvine mafuta, nyama ine mafuta nehove, chikafu chinopfungaira, zvigadzirwa zvakapedzwa, doro, chikafu chemumagaba uye chikafu chakabikwa zvinorambidzwa zvachose.