txheem
- Dab tsi yog ascites
- Ua rau ascites nyob rau hauv cirrhosis ntawm daim siab nyob rau hauv cov neeg laus
- Cov tsos mob ntawm ascites nyob rau hauv cirrhosis ntawm daim siab nyob rau hauv cov neeg laus
- Kev kho mob ntawm ascites hauv cirrhosis ntawm daim siab hauv cov neeg laus
- Kev tiv thaiv ntawm ascites hauv cirrhosis ntawm daim siab hauv cov neeg laus hauv tsev
- Nrov lus nug thiab lus teb
Dab tsi yog ascites
- Ascites ntawm lub plab kab noj hniav - rooj plaub thaum ib tug pathological tsub zuj zuj ntawm kua tau tsim nyob rau hauv lub plab kab noj hniav. Tus kab mob no maj mam, zuj zus ntau lub lis piam, hli. Feem ntau, ntau tus neeg mob tsis txawm paub tias lawv tsim ascites. Cov neeg mob xav tias lawv nyuam qhuav tau zoo, ces lub plab loj tuaj. Hauv 75% ntawm cov neeg mob, ascites yog txuam nrog cirrhosis ntawm daim siab, nyob rau hauv seem 25% nws yog mob qog noj ntshav, mob plawv, hais tias. Gastroenterologist Olga Smirnova.
Tus kws kho mob sau tseg tias qhov kev xav "cirrhosis ua rau haus cawv" yog qhov yuam kev, vim hais tias mob siab kab mob siab, autoimmune daim siab puas thiab cov kab mob rog rog kuj ua rau lub siab mob siab.
Ua rau ascites nyob rau hauv cirrhosis ntawm daim siab nyob rau hauv cov neeg laus
Thaum tus neeg mob thawj zaug tuaj rau tus kws kho mob, thiab nws xav tias ascites, tom ntej hauv kev xav tias yog cirrhosis ntawm daim siab. Tab sis nco ntsoov tias yog tias koj muaj cirrhosis, qhov no tsis tau txhais hais tias ascites yuav tshwm sim 100%.
Muaj ntau yam uas tuaj yeem ua rau muaj feem kis tus kabmob. Cov kws tshaj lij ntseeg tias muaj kev pheej hmoo yog cov neeg uas coj txoj kev ua neej tsis zoo - siv tshuaj yeeb thiab cawv. Qhov no kuj suav nrog cov neeg uas muaj kab mob siab, cov neeg mob uas tau kuaj pom tias rog rog ntawm txhua hom, cov neeg muaj cov roj cholesterol siab, hom 1 thiab hom 2 mob ntshav qab zib.
Cov tsos mob ntawm ascites nyob rau hauv cirrhosis ntawm daim siab nyob rau hauv cov neeg laus
- Thaum pib ntawm tus kab mob, tus neeg mob tsis txawm paub tias nws muaj ascites. Yuav kom tus neeg mob pom nws ntxov, nws yog ib qho tsim nyog yuav tsum tsawg kawg ib liter ntawm cov kua hauv lub plab. Qhov ntawd yog thaum tus so ntawm cov tsos mob ntawm ascites nrog cirrhosis ntawm daim siab yuav pib tshwm, tus kws kho mob hais.
Tus so ntawm cov tsos mob tuaj yeem raug ntaus nqi rau qhov mob hauv plab, tsub zuj zuj ntawm cov pa roj (thaum muaj cua daj cua dub tshwm sim hauv plab), tsis tu ncua belching, nquag kub siab, ib tug neeg pib ua pa hnyav, nws ob txhais ceg o.
- Thaum tus neeg muaj kua dej ntau hauv lub plab, lub plab pib loj tuaj, thiab tus neeg mob pib mob thaum khoov. Lub plab yuav zoo li ib lub pob, stretch marks tshwm, vim hais tias ntawm daim tawv nqaij stretched heev. Tsis tas li ntawd, qee qhov ntawm cov hlab ntsha ntawm lub plab nthuav dav, tus kws tshaj lij txuas ntxiv mus. -Thaum muaj tus kab mob hnyav heev, tus neeg mob kuj tuaj yeem mob daj ntseg, tus neeg mob yuav hnov mob, ntuav thiab xeev siab.
Kev kho mob ntawm ascites hauv cirrhosis ntawm daim siab hauv cov neeg laus
Thaum ascites tsim tawm tsam keeb kwm ntawm cirrhosis, hepatoprotectors yog siv los kho. Nrog rau qhov no, cov kws kho mob tau sau cov tsos mob rau cov neeg mob ascites.
Pib nrog, tus neeg mob yuav tsum tso ntsev. Tus kws kho mob yuav sau cov zaub mov uas tsis muaj ntsev, uas yuav tsum tau ua nruj me ntsis. Nws txhais tau hais tias tag nrho tsis lees txais ntsev lossis siv tsuas yog 2 g ib hnub.
Tsis tas li, tus kws kho mob yuav sau cov tshuaj uas ua rau qhov tsis txaus ntawm cov poov tshuaj hauv lub cev, thiab cov tshuaj diuretic rau edema. Tus kws kho mob yuav saib xyuas cov kev kho mob zoo, nrog rau qhov hnyav ntawm tus neeg mob.
diagnostics
Raws li tau hais los saum toj no, yog tias cov kua dej hauv plab tsawg dua 400 ml, ascites yuav tsis pom. Tab sis nws tuaj yeem txheeb xyuas nrog kev pab ntawm kev tshawb fawb ntsuas. Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum tau kuaj lub cev tsis tu ncua, tshwj xeeb tshaj yog tias koj muaj cirrhosis.
Txhawm rau kuaj xyuas ascites, ua ntej ntawm tag nrho cov, koj yuav tsum mus ntsib kws kho mob uas yuav ua qhov kev kuaj pom thiab palpation ntawm lub plab. Txhawm rau tsim kom muaj kev kuaj mob kom raug, nws yog qhov yuav tsum tau ua ultrasound ntawm lub plab kab noj hniav thiab qee zaum hauv siab. Kev kuaj ultrasound yuav qhia txog lub siab ntawm lub siab thiab tso cai rau tus kws kho mob pom ob qho tib si ascites nws tus kheej thiab cov neoplasms uas twb muaj lawm lossis hloov pauv hauv lub cev.
Dopplerography, uas yuav qhia tau qhov mob ntawm cov leeg.
Txhawm rau kuaj xyuas ascites kom raug, kev kuaj xyuas magnetic resonance lossis xam tomography yuav tsum tau ua. Cov kev tshawb fawb no yuav tso cai rau koj pom qhov muaj kuab paug. Hauv lwm lo lus, kom pom dab tsi tsis pom thaum lub sijhawm ultrasound.
Qee zaum, koj tus kws kho mob tuaj yeem ua laparoscopy. Tus kws kho mob tshwj xeeb yuav ua rau lub plab zom mov, thiab cov kua dej ntau ntxiv yuav raug coj los tshuaj xyuas.
Tsis tas li ntawd, lawv kuaj ntshav dav dav.
Kev kho mob niaj hnub
Cov muaj xws li:
- noj zaub mov tsis muaj sodium (tsis kam ua tiav ntsev lossis noj 2 g ib hnub);
- noj diuretics.
Yog tias cov hau kev saum toj no tsis muaj zog thiab tsis ua rau muaj txiaj ntsig, tus neeg mob tseem raug kev txom nyem, yuav tsum tau phais. Tus kws kho mob nrog ascites tuaj yeem tshem tawm cov kua dej nrog maj mam ntws tawm. Nyob rau hauv cov ntaub ntawv no, tus kws phais ua ib tug me me puncture nyob rau hauv lub plab mog thiab ntxig ib tug kua raj rau hauv nws.
Tus neeg mob kuj tseem muaj cov catheters hauv tsev thiab cov chaw nres nkoj subcutaneous tso. Cov kua yuav raug tshem tawm sai li sai tau thaum nws nkag mus rau hauv lawv. Qhov no yog ib txoj hauv kev zoo tshaj plaws ntawm kev kho mob - nws tso cai rau koj kom txo tau qhov kev pheej hmoo ntawm kev puas tsuaj rau hauv nruab nrog cev thiab o.
Kev tiv thaiv ntawm ascites hauv cirrhosis ntawm daim siab hauv cov neeg laus hauv tsev
Ntawm cov kev ntsuas los tiv thaiv ascites yog cov hauv qab no:
- Kev kho mob raws sij hawm ntawm cov kab mob sib kis;
- noj qab nyob zoo rau kev ua neej;
- muab cawv, haus luam yeeb;
- kev tawm dag zog lub cev;
- kev noj haus kom zoo.
Tus neeg mob ntshav siab yuav tsum tau kuaj xyuas los ntawm cov kws kho mob tsis tu ncua thiab ua tib zoo ua raws li lawv cov lus qhia.
Nrov lus nug thiab lus teb
Teb cov lus nug nrov Gastroenterologist Olga Smirnova:
tus neeg mob tuaj yeem tau txais cov teeb meem kho tshuab los ntawm compression nrog ascitic kua;
● kua tuaj yeem sib sau ntawm cov nplooj pleural - hauv cov kab noj hniav pleural, hauv lwm lo lus, hydrothorax tsim;
● cov hlab ntsha tuaj yeem raug nyem (inferior vena cava syndrome, compression ntawm lub raum leeg);
● cov tsos mob ntawm hernia - feem ntau umbilical;
● tshem tawm cov kabmob hauv nruab nrog cev;
● nkag mus ntawm tus kab mob – spontaneous bacterial peritonitis;
● metabolic teeb meem - ua txhaum ntawm electrolyte metabolism;
● hepatorenal syndrome nrog raum tsis ua haujlwm.
● ascites tshwm sim tsis tu ncua, los yog lub plab pib loj hlob sai nrog cov tsos mob ntawm ntau yam tsos mob;
● nce lub cev kub tshwm sim ntawm keeb kwm ntawm ascites;
● tso zis tsawg zaus;
● muaj qhov tsis txaus ntseeg hauv qhov chaw - tus neeg mob tsis tuaj yeem taw qhia nws tus kheej qhov twg nws nyob, hnub twg, hli, thiab lwm yam yog hnub no.
● txwv kev haus dej - tsis pub ntau tshaj 500-1000 ml ib hnub;
● txwv tsis pub noj cov rog kom tsis txhob muaj kab mob pancreatitis.
Tus neeg mob ascites yuav tsum tau noj zaub mov kom zoo. Kev noj zaub mov yuav tsum muaj cov zaub thiab txiv hmab txiv ntoo txaus, koj tuaj yeem noj ob qho tib si tshiab thiab stewed, khoom noj siv mis - kefir thiab tsev cheese. Nyob rau hauv tsis muaj cov ntaub ntawv tsis txhob kib zaub mov, nws yog zoo dua rau boil los yog ua noj nyob rau hauv lub qhov cub, ib tug zoo txoj kev kom noj qab nyob zoo noj hmo los yog noj su yog chav ua noj. Cov zaub mov muaj roj, cov nqaij rog thiab ntses, cov khoom noj haus, cov khoom ua tiav, cawv, cov kaus poom thiab cov khoom noj qab zib yog txwv nruj.