Ukuvuvukala kwe-peritoneum noma i-peritonitis yesiguli esiswini somzimba kuyisifo esasongela ukuphila okudinga ukwelashwa ngokushesha nokuhlinzeka ngokuhlinzwa.
Ukulungiselela ukulungiselela kuqala
Ukuze silungiselele isiguli sokuhlinzwa, akuvumelekile ukuthi amahora angaphezu kwama-3 avunyelwe - ngalesi sikhathi odokotela benza ukwelashwa okunamandla okukhipha imithi ngesikhathi esisodwa ngemikhumbi engu-2 - 3 evulekile, ezama ukuvuselela imisebenzi ebalulekile yomzimba. Kulesi sigaba, kungenzeka ukuthuthukisa ibhalansi ye-electrolyte, ukubuyisela umthamo wokujikeleza kwegazi, ukwandisa izinga lokucindezeleka kwe-veous (CVP), nokunciphisa ukushaywa komzimba nokwandisa umthamo we-urine (diuresis). Kwenzeka ukuthi akunakwenzeka ukubuyisela umsebenzi wezinso emahoreni angu-3 - ukuhlinzwa akuhlehlisiwe kulokhu, kepha amathuba okuba nesifiso sokuhleleka kahle ayancipha.
Esikhathini sokulungiselela ukuhlinzeka, ukwenziwa kwe-catheterization ye-subclavian vein nayo yenziwa, okwenza kube lula ukuqapha i-CVP nokwandisa izinga lokungeniswa. Ngokuvamile, isisindo sinamakhemikhali: ngakho kungenzeka ukukala i-diuresis ngayinye.
Njengoba ukulungiswa kwepheshana lomathumbu, ukuphuma kwesisu kuyenziwa nge-probe, engasusiwe kuze kube yilapho kubuyiselwa khona kwe-motility ngemuva kokusebenza.
Izinyathelo zokusebenza
Ukwelashwa kwe-puritent peritonitis, udokotela ohlinzayo uhamba ngokulandelana okulandelayo:
- I-Laparotomy - i-incision yenza ngaphakathi kwesigxobo esiswini.
- Ukususwa kwe-exudate - uketshezi lwe-pathological okugcwalisa i-peritoneum, isuswe ngepompi kagesi, futhi umthombo we-peritonitis uchithelwa ngama-napkins napkins ehlanganiswe nesisombululo se-antiseptic.
- Ukuvinjwa kwezindawo ze-reflexogenic - i-novocaine ifakwe endaweni yesigxobo se-celiac, sigmoid nesisu esincane, i-mesentery eguquguqukayo, esusa i-spasm ye-vascular reflex futhi iphinde ikhuthaze ukutakula ngokushesha kwe-peristalsis.
- Ukuhlanzwa kwezingcola - isigaba esilandelayo sokwelashwa kwe-peritonitis yesigxobo esiswini sisho ukuhlanza kwayo nge-isotonic fluids ukunciphisa ukuhlushwa kwezinsizakalo ezincane ezingeni eliphansi.
- Ukuhlukaniswa komthombo we-peritonitis - kuye ngokuthi imbangela yokuvuvukala nesigaba sayo, i-hemicolectomy (ukususwa kwekoloni), ukuvuselelwa kwesisu (ukususa ingxenye yayo), ukususwa kwesithasiselo, isilonda senyongo, i-uterine tube - okungukuthi, isitho esaba ngumthombo we-peritonitis.
- Ukuncipha kwamathumbu ngesikhathi sokuvuselela kwenziwa ngokusebenzisa iziteshi ezivulekile zamathumbu, kungenjalo kusetshenziswe ama-probes amancane emathumbu. Inhloso yokucindezeleka ukuhlanza amathumbu avela ku-gesi nokuqukethwe oketshezi.
- Isigaba esilandelayo sokwelashwa kwesibindi sesisu sisho ukungcola nokucwiliswa okuphindaphindiwe ngamat. Khona-ke igcwele u-saline ngama-antibiotics, futhi ukugcoba kukhonyiwe.
Ukwelashwa kwe-peritonitis ngemuva kokuhlinzwa
Ngemuva kwamahora angu-6-8 ngemva kokuhlukumeza isilonda, i-exudate idonswa emanzini ngendlela engahambi kahle (ngenxa yohluko lokucindezela). Ngomugudu ophansi we-drainage, u-saline uphinde ugcwaliswe emgodini wesisu ngama-antibiotic, futhi ushiye amahora angu-6 kuya kwangu-8. Kungakapheli izinsuku ezimbili inqubo iphindwe izikhathi ezingu-2-3.
Ukwelapha okuqhubekayo kubonisa ukwelapha okulwa namagciwane kanye nokwehlisa umzimba, ukutakula kwe-asidi-base namanzi-electrolyte balance, bcc kanye nokuqukethwe kwamaprotheni egazini, nokubuyiselwa kwamathumbu emathumbu.
Ngokushesha ngemva kokusebenza, ukudla kuhlinzekwa ukuphathwa kwe-enteral kwezixazululo ezidlula indlela yokugaya. Kamuva ukudla okukhethekile kuboniswa - ukudla ne-peritonitis edluliselwe kuqhubeka okungenani izinyanga ezingu-6 futhi kungabandakanyi inyama ephuziwe, ama-pickle, ama-marinades, ushokoledi, utshwala.
Izithelo eziwusizo zemifino nezitshalo , isinkwa sezolo, izithelo ezinomsoco namajikijolo, amaqanda abilisiwe, izinhlanzi ezinomsoco nezitsha zenyama, uju, ubisi, ujamu.