Ukuhlukumezeka kakhulu kwezilonda zesisu kanye nezidakamizwa yi-ulcer perforated ulcer noma i-perforation. Uma unganikeli ngokushesha usizo lokuphuthumayo, umuntu ubhekene ne-peritonitis ngisho nokufa. Ezimweni eziningi, lesi sifo singabantu, ngoba abesifazane bavikelekile nge-estrogen yomzimba, bevikela i-mucous.
Izimbangela ze-perforation yesilonda
Akunakwenzeka ukuthi i-perforation yesilonda esiswini isendaweni elinganayo, kunezikhathi ezithile ezikhona. Amathuba ayo aphezulu kulabo abahlukunyezwa yisifo sesilonda iminyaka eminingi engaphezu kweminyaka emithathu, ezigulini ezine-gastritis ezingavamile ukubonana nodokotela. Ukushayela i-perforation kungaba:
- umthwalo oqinile, obukhali;
- ukudla ngokweqile njalo;
- i-asidi ephezulu yesiphuzo esiswini;
- ukusebenzisa kabi izinongo;
- ukungahambisani nokulala nokuvuka, ukuhamba ebusuku emsebenzini, ukungabi nokulala;
- kokubili ukusetshenziswa kwesikhathi eside kanye nesikhathi esifushane kwezidakamizwa zemithi ethile;
- ukungahambisani nokudla, ukwenqaba kokudla okuketshezi, ukuhlukunyezwa kwemikhiqizo ethosiwe kanye nokubhema;
- ukusetshenziswa njalo kotshwala nokubhema:
- ukulungiswa kwesintu.
Isilonda esine-perforated yesisu - izimpawu
Noma yikuphi ubuhlungu obuqinile esifundeni se-epigastric kungase kuholele emcabangweni we-perforation yesilonda esiswini, izimpawu zazo eziyizici futhi ezizwakalayo. Isilonda esine-perforated noma i-perforation yesisu ihlukaniswe ngu:
- i-etiology;
- indawo (ngokwezifiso);
- indawo yokuphuma;
- izinkathi (izigaba zomtholampilo).
Izibonakaliso zokuqala zesilonda se-perforated
Ekuqaleni kwalesi sifo, esikhathini sokuqala, lapho i-perforation ye-ulcer ingakaze itholakale, izimpawu ziyisici futhi zicacile. Umazi, kukhona amathuba okungaqondi ngokugcwele imbangela yempilo embi. Kunezigaba ezintathu:
- I-peritonitis yamakhemikhali, ehlala amahora angu-3-6. Ngalesi sikhathi kukhona ubuhlungu obuningi ekwenzeni futhi ngakwesokudla kwesisu. Kuye ngendawo, isilonda se-perforated esiswini singabangela ubuhlungu obunama-atypical engxenyeni yesokunxele. Kancane kancane, ubuhlungu bubonakala buhlungu futhi buzwa ngaphakathi esiswini, ingcindezi iyancipha. Isikhumba siba mnyama futhi sinamathele, futhi isisu sigxuma ngenxa yokuqoqwa kwegesi. Lesi yisikhathi esihle kakhulu lapho isiguli kufanele sithathwe esibhedlela.
- I-peritonitis yebhaktheriya ayitholakali ngokushesha, kodwa emva kwamahora angu-6 kusukela lapho izibonakaliso zokuqala ze-ulcer isisu zibonakala. Kancane kancane, imvelo iba yiphuzo futhi isimo sesiguli siyadlula, nakuba engazi ukucindezeleka kwesimo. Lesi yisikhathi sokujabula, lapho izibonakaliso ze-perforation zesilonda ziba buthakathaka, ubuhlungu buyadlula futhi umuntu uzizwa kahle. Ngalesi sikhathi, ukucindezela kuphakama, njengokushisa komzimba, i-peristalsis iphukile, ulimi lumbozwe ngezingubo ezimpunga.
- Ukuphuza ngokweqile kwenzeka ngemuva kwamahora angu-12 kusukela ekuqaleni kwalesi sifo. Ukushisa kwehla, isikhumba soma, ukuhlanza nokuphelelwa amandla kwamanzi kuqala. Ukugcoba esiswini kuholela ekubeni isisu sinzima futhi siguquke ngenxa yegesi nemikhiqizo yokubola eboshelwe ku-peritoneum. Kukhona ukukhathazeka kwesiguli kulokho okwenzekayo, ukuphazamiseka, ukukhishwa kwamanzi okuhambayo kuyayeka. Kulesi sigaba i-perforated ulcer yesisu iba yingozi futhi cishe akunakwenzeka ukusindisa isiguli.
Isilonda esinesisindo - X-ray
Ukuqaphela izimpawu zokuqala zesilonda esiswini se-perforated, umuntu kufanele athunyelwe ngokushesha esibhedlela ukuze ahlolwe. Ngalesi sifo, noma yikuphi ukubambezeleka kuyingozi kakhulu. Ukuxilongwa kwenziwa ngezindlela eziningana:
- okwenza i-anamnesis yesiguli;
- Ukuhlolwa kwe-X-ray kanye ne-laboratory;
- ukuhlolwa kokugcina.
Emaphesenti angama-80%, i-X-ray ekuguleni kwesisu inikeza umphumela omuhle. Ukuziphatha kwalo kwembula igesi emgodini wesisu, okuwela ngesikhathi sokudabuka kwodonga lwesisu. Uma inani lalo lincane futhi ukuxilongwa akungabazeki, i-X-ray iphindaphindwa, ngemva kokuba isiguli sesine-carbonated liquid. Ngemva kwalokho, igesi ngokukhululeka ishiya i-peritoneum futhi ibonakala emidlalweni ye-X.
Ukuguqulwa kwesilonda - izinkinga
Njengezinye izifo eziyinkimbinkimbi, i-perforation yesilonda esiswini inezinkinga zayo:
- i-fistula yangaphakathi (emathunjini kanye ne-gallbladder);
- i-abscess;
- i-pneumothorax ne-abscess ephukile;
- i-peritonitis .
Indlela yokuphatha isilonda esiswini se-perforated?
Uma isilonda esiswini se-perforated sitholakala kumuntu, ukwelashwa kungenzeka ukuthi kuyashesha. Lena yindlela engcono kakhulu yokuphuma kweso simo lapho kungenzeka khona ukuthunga umgodi, futhi kwezinye izimo, ukufeza ukuthengiswa kwesisu. Kuphela ezimweni ezingavamile kungenziwa ukwelashwa okunomsoco uma isiguli senqaba ukuhlinzwa. Khona-ke, ukudonsa oketshezi ku-peritoneum nge-probe kusetshenziswa, ngandlela-thile ngezinsuku ezimbalwa isiguli sigqokwe, imithi yokwelapha okulwa nokuvuvukala imisiwe.
I-perforated esiswini isilonda - usizo oluphuthumayo
Ukunciphisa ingozi yomphumela obulalayo okungenani, ukunakekelwa okuphuthumayo kuyadingeka ekuqotheni izilonda zamathumbu ngesikhathi sokuqala kwesifo, okumele kunikezwe odokotela. Musa ukuzibiza ngemithi. Kuhunyushwa ngale ndlela elandelayo:
- Isiguli sigqoke ikhanda eliphakanyisiwe kancane namadolo aguqe kancane.
- Suck okuqukethwe okuqukethwe ngesisu.
- Ukususa ukushaqeka (uma kukhona), ukwethula izidakamizwa zenhliziyo;
- Ukumnika okwe-saline ne-glucose kwenziwa njengesiteji sokulungiselela ngaphambi kokusebenza.
Isilonda esine-perforated of stomach - operation
Emaphesenti angu-99%, isilonda esisodwa sezitho zomzimba sutured. Kuye ngokuthi indawo yesilonda nobunzima besimo sesiguli, ukungenelela okunjalo kulungele:
- i-suturing;
- ukuzitika kanye nokugeleza;
- ukuvuselelwa kwesisu ;
- ukuthengiswa kwezomnotho kanye ne-vagotomy (ukuhlukaniswa kwezinzwa ezithinta ukukhiqizwa kwe-hydrochloric acid ukugwema ukubuyela emuva);
- amanzi kanye ne-vagotomy.
I-perforated isisu sesilonda - isikhathi se-postoperative
Ukuguqulwa kwesilonda kusho ikhambi lokusebenza le nkinga. Isikhathi sokubuyiselwa akulula futhi eside. Kusukela ekuziphatheni okulungile ngalesi sikhathi kuncike empilweni yesikhathi esizayo yabasebenzi. Kunakekelwa kakhulu ekudleni nasekusebenzeni ngemoto. Ngemuva kokuhlinzwa kwezinsuku ezingu-3-4 isiguli sihlala embhedeni, emva kwalokho sivunyelwe ukuvuka. Yenza lokhu ngomsizi futhi kancane kancane, ngoba umzimba ubuthakathaka ngemuva kokuhlinzwa. Ukukhohlisa ngaphandle kokunyakaza akukhuthazwa futhi ngenxa yenqubo ephezulu yokubambelela.
Ukudla emva kokuhlinzwa kwesisu esiswini se-perforated
Ukuze unciphise izinkinga kusukela ekuhlinzekeni kuya ku-zero, uzodinga ukudla okuqinile ngemuva kwesilonda esiswini se-perforated. Izinsuku zokuqala ezingu-3-4 isiguli asondliwe, ngakho isisu sisetshenziselwa isimo esisha. Ukudla kuhanjiswa nge-dropper, usebenzisa isisombululo se-glucose. Ngosuku lwesihlanu isiguli singase siqale ukuphuza i-jelly encane kanye ne- decoction of dogrose , kodwa uketshezi oluningi luvinjelwe , njengosawoti. Ekupheleni kweviki ekudleni kuqaliswa isobho se-rice engasaphuntshiwe / iphalishi namaqanda abilisiwe. Isilinganiso sesikhathi esiseduze ngemuva kokuhlinzwa sihlanganisa:
- amaqanda abilisiwe;
- imfucuza ye-steam kanye nenyama ebilisiwe ye-turkey, unogwaja, inkukhu;
- izinhlanzi ezincibilikile zasolwandle ezilisiwe noma zinyiswe;
- imifino ehlanzekile;
- iberry jelly;
- ilayisi, i-oatmeal, i-buckwheat;
- ubhanana, amapheya;
- i-fat cottage shizi encane, ubisi, i-acidophilus kefir;
- abaphangi besinkwa sabo sezolo.
Ngeshwa, uhlu lwemikhiqizo evunyelwe lincane kakhulu, ngokungafani nohlu lwezinqatshelwe. Kuzodingeka balandele kuyo yonke impilo noma benze okungajwayelekile, eminyakeni engu-2-3 emva kokusebenza:
- imikhiqizo yokubhema;
- ama-sausages;
- iziphuzo ze-carbonated;
- ukhukhamba, utamatisi, iklabishi, amakhowe;
- anyanisi, i-garlic;
- ubhontshisi;
- i-soda, utshwala, ikhofi, i-kvass;
- ushokoledi, ama-dessert, i-ayisikhilimu, ama-buns.