Iimbangela, iimpawu kunye noTyango
Isihlomelo sisakhiwo esincinci, esinjengothubhu esiqhotyoshelwe kwinxalenye yokuqala yesikhumba esikhulu (esibizwa ngokuba yi-colon). Ngoxa i-appendix ifumaneke kwicandelo elingaphantsi lesisu, alinalo umsebenzi owaziwayo kunye nokususwa kwalo kubonakala kungabikho utshintsho kumsebenzi wokugaya.
Sibanzi
I-appendicitis ukuvuvuka kwesihlomelo. Xa iqala, akukho lonyango oluchanekileyo lonyango, ngoko u-appendicitis uthathwa njengongxamiseko lwezonyango.
Xa unyangwa ngokukhawuleza, ezininzi izigulane zihamba ngaphandle kobunzima. Ukuba unyango lulibazisekile, isihlomelo singaphumela, sibangela ukusuleleka kunye nokufa.
Nangona nabani na abanako ukufumana i-appendicitis, kwenzeka ngokuqhelekileyo phakathi kweminyaka eyi-10 no-30.
Izizathu
Isizathu soluhlu lwe-appendicitis lubhekiselele ekukhuselweni ngaphakathi kwesihlomelo, esaziwa njenge-lumen. Ukukhutshwa kubangela uxinzelelo olunyukisayo, ukuhamba kwegazi okungaphelelekanga kunye nokuvutha. Ukuba ukukhutshwa kungagqithwanga, ukugqithwa kunye nokuphuka (ukuphula okanye ukukrazula) kwesihlomelo kungabangela.
Ngokuqhelekileyo, iifesi ibingenisa ngaphakathi kwesihlomelo. Kwakhona, iintsholongwane ze-bhakteria okanye iintsholongwane kwi-tract digestive zingakhokelela ekuvupheni kweempawu zesikhumba, ezifakela isihlomelo kunye nokubangela ukuphazamiseka. Ukulimala kabuhlungu kwisisu kusenokukhokelela kwisihlomelo, kwinani elincinci labantu.
Usenokumangaliswa xa ufumanisa ukuba i-genetics inokubangela ukuba ngubani ofumana i-appendicitis. Ngamanye amazwi, i-appendicitis ehamba kwiintsapho ingabangela ukuhlukahluka kofuzo okubangela ukuba umntu abe ngumqobo wokukhazamiseka kwe-lumen.
Iimpawu
Iimpawu ze-appendicitis zingabandakanya:
- Ubuhlungu kwisisu , kuqala ngqakraza isisu, uze uhambe endaweni ephantsi-oku kuthiwa ubuhlungu besisu esiswini
- Ukuphelelwa kwesidlo
- Isihlunu kunye nokuhlanza
- Ukutyunjwa okanye urhudo
- Ukungakwazi ukupasa igesi okanye ukudlula kwegesi rhoqo
- Umkhuhlane ophantsi oqala emva kwezinye iimpawu
- Ukukhupha kwamathumbu
- Ukunyanzelisa
Ngokweentlungu zesisu se-appendicitis (isibonakaliso esona siqhelekileyo kwaye esisoloko sisoloko sikhona), ubuhlungu bubuhlungu kwaye bubuhlungu xa buhamba, bethanda umoya, ukukhwehlela, okanye ukukrazula. Ummandla onobuhlungu uba lukhulu kunoma yiphina ingcinezelo.
Abantu banokuvakalelwa kwinto ebizwa ngokuthi "ukunyusa phantsi," eyaziwa nangokuthi "tenesmus," eyona nto inokuthi ukunyuswa kweembilini kuya kunciphisa ukungahambi kwabo. Oko kuthethwa, i-laxatives ayifanele ithathwe kule meko.
Kubalulekile ukuqonda ukuba akusiyo yonke into ene-appendicitis eneempawu ezi ngasentla. Yingakho kubalulekile ukubona ugqirha ngokukhawuleza ukuba unenkxalabo okanye nayiphina impawu engentla ngenesisu esiswini.
Kwakhona, abantu abaneemeko ezikhethekileyo abanakho ukuba babe neempawu zelapha ngasentla kwaye banokuziva baziva bengavumi. Iziguli ezinemiqathango ziquka:
- Abantu abasebenzisa i-immunosuppressive therapy njenge-steroids
- Abantu abaye bafumana ilungu lokutshintshwa
- Abantu abanentsholongwane kaGawulayo
- Abantu abanesifo sikashukela
- Abantu abanomdlavuza okanye abafumana i- chemotherapy
- Abantu abambene
Abafazi abakhulelweyo
Iintlungu zesisu, isicupunu, nokuhlanza ziqhelekileyo ngexesha lokukhulelwa kwaye mhlawumbi okanye zingabi ziimpawu ze-appendicitis.
Abasetyhini abaninzi abahlakulela i-appendicitis ngexesha lokukhulelwa abanakufumana iimpawu zeklasi, ngakumbi kwi-trimester yesithathu. Kubalulekile ukuba umfazi okhulelwe ova intlungu kwicala lokunene lokuqhagamshelana nesisu ngesigqirha.
Iintsana Nezingane
Iintsana kunye nabantwana abancinci kaninzi abakwaziyo okanye abakwaziyo ukuthetha ubuhlungu kubazali babo okanye oogqirha. Ngaphandle kwembali ecacileyo, oogqirha kufuneka bathembele ekuhloleni ngokomzimba kunye neempawu ezingaphantsi, ezifana nokuhlanza nokukhathala. Abantwana abane-appendicitis ngezinye iinkhathi banenkathazo yokutya kwaye babonakala belele ngokungaqhelekanga. Abantwana banokuba nokuzibamba, kodwa banokuba nezikhundla ezincinci eziqukethe i-mucus.
Ngamafutshane, iimpawu ziyahluka ngokubanzi phakathi kwabantwana kwaye azinjengeklasiki njengabantu abadala (ingakumbi kubantwana abancinci). Ngoko ukuba ucinga ukuba umntwana wakho une-appendicitis, qhagamshelana nodokotela ngokukhawuleza.
Abantu abadala
Izigulane ezindala zivame ukuba neengxaki ezininzi zonyango kunabantu abaselula. Abantu asebekhulile bahlala benomkhuhlane omncinci kunye nobuhlungu obungaphantsi kwesisu kunokuba ezinye izigulane zenze i-appendicitis. Abantu abadala asebekhulile abazi ukuba banenkinga enkulu kuze kube yilapho isihlomelo singasondeli. Umkhuhlane omncinane kunye nentlungu yesisu ngakwesokunene sinezizathu zokubiza udokotela ngokukhawuleza.
Enyanisweni, bonke abantu abaneengxaki zempilo ezikhethekileyo kunye neentsapho zabo kufuneka baqaphele ngokutshintsho kwintsebenzo eqhelekileyo kunye nezigulane kufuneka zibone oogqirha babo kungekudala, kungekudala, xa kukho utshintsho.
Ukuxilongwa
Imbali Yonyango
Ukubuza imibuzo ukuze ufunde imbali yeempawu kunye nokuhlolwa ngokucophelela kwimizimba ebalulekileyo ekuxilongweni kwe-appendicitis. Ugqirha uya kubuza imibuzo emininzi-njengengxelo-intloko-ezama ukuqonda ubunjani, ixesha, indawo, iphethini, kunye nobukhulu beentlungu neempawu. Naliphina iimeko zonyango zangaphambili kunye nophando, imbali yentsapho, amayeza kunye nokunyamezela kolwazi kubalulekile ulwazi kumgqirha. Ukusetyenziswa kotywala, ucuba kunye nezinye iziyobisi kufuneka zikhankanywe. Le ngcaciso ibonwa njengeyimfihlo kwaye ayikwazi ukwabelwana ngaphandle kwemvume yesigulane.
Uvavanyo lweMvelo
Ngaphambi kokuqala uvavanyo lomzimba, umongikazi okanye ugqirha uya kufaka iimpawu ezibalulekileyo: ukushisa, izinga lokupasa, ukuphefumula, kunye negazi. Ngokuqhelekileyo, uvavanyo lwangaphakathi luvela kwintloko ukuya kwizwane. Iimeko ezininzi ezinjenge-pneumonia okanye isifo senhliziyo zingabangela iintlungu zesisu. Izimpawu eziqhelekileyo ezinjengomkhuhlane, ukugqithisa, okanye ukuvuvukala kwama-lymph nodes kunokubhekisela kwizifo ezingenakufuna ukuhlinzwa.
Ukuhlolwa kwesisu kuya kunciphisa ukuxilongwa. Indawo yentlungu kunye nobubele kubalulekile-intlungu ibe yimboqo echazwe ngumntu kunye novelwano kuba impendulo ekuthintweni.
Imiqondiso emibini, ebizwa ngokuba yiimpawu ze-peritoneal, ibonisa ukuba ubhedu lwesisu buya kuvutha kwaye ukuhlinzwa kunokufuneka:
- zothando
- ukulinda
Ukunyamezela kwakhona xa ugqirha ugxininisa inxalenye yesisu kwaye loo mntu uvakalelwa ngakumbi xa uxinzelelo lukhutshwa ngaphandle kokuba lusetyenziswa.
Ukulinda kubhekisela kwizihlunu ezininzi ngokuphendula.
Ugqirha unakho ukuhambisa imilenze yesigulane ukuvavanya intlungu kwi-hip (ebizwa ngokuba ngumqondiso we-psoas), intlungu ngokujikeleza kwangaphakathi kwe-hip (ebizwa ngokuba ngumqondiso we-obturator), okanye intlungu ngakwesokudla xa ucinezela ngakwesobunxele (ukubiza Uphawu lweRovsing). Ezi zibonakaliso ezibalulekileyo zokuvuvukala kodwa akuzona zonke izigulane ezinabo.
Uvavanyo lweLebhu
Iimvavanyo zegazi zisetyenziselwa ukuhlolisisa iimpawu zentsholongwane, njenge-white white cell count count. I-chemistries yegazi iyakubonisa kwakhona ukungcola kwamanzi okanye ukuphazamiseka kwamanzi kunye ne-electrolyte. Urinalysis isetyenziselwa ukulawula ukusuleleka kwe-urinary tract tract. Oogqirha banokuyilungisa uvavanyo lokukhulelwa kwabasetyhini bexesha lokuzala okanye benze uvavanyo lwe-pelvic ukulawula izizathu zesifo sobuhlungu.
Uvavanyo lweemvavanyo
I-ray, i-ultrasound, kunye ne-computed tomography (CT) iifayile zingenza imifanekiso yesisu. I-Plain x imitha ingabonisa iimpawu zokukhazamiseka, ukuguqulwa (imingxuma), amaqumrhu angaphandle, kunye nakwiimeko ezinqabileyo, i-appendicolith, enesigxina kwi-appendix.
I-ultrasound ingabonisa ukuhluma kwesongezo kwaye iyakwazi ukuhlola isifo se-gallbladder nokukhulelwa.
Ngona luvavanyo oluqhelekileyo olusetyenziswa kakhulu, nangona kunjalo, yi-CT scan. Olu vavanyo lunikeza uluhlu lweemifanekiso zemizimba yomzimba kwaye luyakwazi ukubona ezininzi izimo zesisu kwaye ziququzelele ukuxilongwa xa ingcamango yeklinikhi ingathandabuzeki. Ngamanye amaxesha, i-imagery magontic resonance imaging (MRI) isetyenziselwa ukuncedisa ukuhlolwa kogqirha kwi-appendicitis kwabasetyhini abakhulelweyo (ekubeni imisebe yenziwa ngexesha le-CT kodwa ayiyi-MRI).
Kwiimeko ezikhethiweyo, ngokukodwa kubasetyhini xa isizathu seempawu singaba sisihlomelo okanye i-ovary okanye i-fallopian tube, i-laparoscopy ingafuneka. Le nkqubo inqanda imisebe kodwa ifuna i-anesthesia jikelele. I-laparoscope yincinci yincinci enekhamera efakwe kwi-body ngokusebenzisa i-cut cut, evumela oogqirha ukuba babone izitho zangaphakathi. Utyando luyakwazi ukuqhutyelwa i-laparoscopically ukuba imeko ekhoyo ifuna.
Unyango
Ukuhlinzwa
I-appendicitis eyiyo iphathwa ngokutyunjwa ukususa isihlomelo . Umsebenzi ungenziwa ngokuvulekayo kwizinga elincinci elisezantsi lesisu, okanye lingaqhutyelwa ngokusebenzisa i-laparoscope, efuna izinto ezintathu ukuya kwezine. Ukuba ezinye iimeko zikhankanywa ngokongeza kwi-appendicitis, zinokuchongwa ngokusebenzisa i-laparoscopy. Kwezinye izigulane, i-laparoscopy inokukhetha ukuvula ukuhlinzwa ngenxa yokuba isicatshulwa sisincinci, ixesha lokubuyisela likhawuleza, kwaye kufuneka imichiza engaphantsi. Isihlomelo sisoloko susiwe, nangona sifumaneka siqhelekile. Xa usususwe ngokupheleleyo, naziphi na iziganeko zentlungu aziyi kubakho kwi-appendicitis.
Ukubuyisela kwi-appendectomy kuthatha iiveki ezimbalwa. Oogqirha badla imithi yeentlungu kwaye babuze izigulane ukuba zinciphise umzimba. Ukubuyiselwa kwi-appparectomy ye-laparoscopic ngokuqhelekileyo ngokukhawuleza, kodwa ukukhawulelana nomsebenzi onzima kunokuba kuyimfuneko kwiintsuku ezi-3 ukuya kwezi-5 emva kokuhlinzwa kwe-laparoscopic kunye neentsuku ezili-10 ukuya kwe-14 emva kokuhlinzwa okuvulekileyo. Uninzi lwabantu baphathwa nge-appendicitis bafumana ngokugqithiseleyo kwaye banqabile ukuba benze nayiphi na utshintsho ekudleni kwabo, ekusebenzeni kwabo, okanye ngokuphila kwabo.
Unyango lwe-antibiotics
Ukuba ukuxilongwa akuqinisekanga, abantu bangabonwa kwaye ngamanye amaxesha baphathwe ngamayeza. Le ndlela ithathwa xa ugqirha egxeka ukuba iimpawu zesigulane sinokubangela ukuba kungabikho nonyango okanye unyango olwenziwe ngonyango. Ukuba imbangela yentlungu itheleleke, iimpawu zixazulula nge-antibiotics kunye ne-waterproof.
Ngokubanzi, ke, i-appendicitis ingaphathwa kuphela ngokuhlinzwa-kuphela kubantu abathile okanye kubantwana i-antibiotics yonyango kuphela ejongelwa unyango lwe-appendicitis.
Ngamanye amaxesha umzimba uyakwazi ukulawula ukulungiswa kwesongezelelo ngokwenza i-abscess. I-abscess iyenzeka xa usulelo luvaliwe kwindawo enye yomzimba. Ugqirha unokukhetha ukukrazula i-abscess kwaye ushiye i-abscess cavity kwiiveki ezimbalwa. I-appendectomy ingahle ihlelwe emva kokuba i-abscess ishiyiwe.
Iingxaki
Inkxalabo enzulu kakhulu ye-appendicitis iyaphuka. I-appendix bursts okanye iinyembezi ukuba i-appendicitis ayifumananga ngokukhawuleza kwaye ayihambelwanga. Iintsana, abantwana abancinci kunye nabantu abadala abadala basengozini enkulu. Isihlomelo esiphuliweyo singakhokelela kwi-peritonitis kunye nekhefu. I-Peritonitis yintsholongwane eyingozi eyenzekayo xa ibhaktheriya kunye nezinye iziqulatho ze-appendix eziqhekekileyo zivuza ngaphakathi esiswini. Kubantu abane-appendicitis, i-abscess idla ngohlobo lwe-mass mass. Kwizigulane ezimbalwa, iingxaki ze-appendicitis zingakhokelela ekuphumeleleni komzimba nasekufeni.
> Imithombo:
> Ikholeji yaseMerika yasezigqirha. (Uhlaziywe ngo-2014. I-Appendectomy: Ukususwa koPhulo lweSihlomelo.
> UMartin RF. (Novemba 2016). I-appendicitis enobuchule kubantu abadala: Imiboniso yeklinikhi kunye nokuxilongwa ngokuhlukileyo. Ku: U-UpToDate, Weiser M (ed), UpToDate, Waltham, MA.
> Isizwe seSizwe soSifo sikashukela kunye neeNtsholongwane zeNtsholongwane. Appendicitis.
> Wilms IM, de Hoog DE, de Visser DC, uJanzing HM. I-Appendectomy ngokubhekiselele kunyango lwe-antibiotic ye-appendicitis. I-Cochrane Database Syst Rev. 2011 Nov 9; (11): CD008359.