Vim yog "pob looj tes ntiv tes" tig ntawm ib feem ntawm txoj hnyuv, intussusception yog taw qhia los ntawm mob plab heev. Nws yog ib qho ua rau muaj kev kho mob thiab kev phais mob xwm txheej ceev hauv cov menyuam yaus, vim nws tuaj yeem ua rau mob plab hnyuv. Hauv cov menyuam yaus thiab cov neeg laus, nws tuaj yeem ua rau mob ntev thiab qhia pom tias muaj polyp lossis qog nqaij hlav.

Lus txhais

Intussusception (los yog intussusception) tshwm sim thaum ib feem ntawm txoj hnyuv hloov zoo li hnab looj tes thiab koom nrog hauv cov hnyuv tam sim ntawd. Ua raws li qhov "telescoping", lub plab zom mov uas tsim cov phab ntsa ntawm lub plab zom mov cuam tshuam nrog ib leeg, ua rau lub ntsej muag yob muaj lub taub hau thiab caj dab.

Intussusception tuaj yeem cuam tshuam rau txhua theem ntawm txoj hnyuv. Txawm li cas los xij, cuaj zaug ntawm kaum, nws nyob ntawm txoj kev sib tshuam ntawm ileum (qhov kawg ntu ntawm txoj hnyuv me) thiab txoj hnyuv.

Daim ntawv tshaj plaws yog mob intussusception ntawm tus menyuam mos, uas tuaj yeem ua rau muaj kev cuam tshuam thiab cuam tshuam ntawm cov ntshav (ischemia), nrog rau kev pheej hmoo ntawm plab hnyuv necrosis lossis perforation.

Hauv cov menyuam yaus thiab cov neeg laus, muaj cov ntaub ntawv tsis tiav, mob ntev lossis ua tiav ntawm intussusception.

Ua rau

Mob idiopathic intussusception, yam tsis muaj kev txheeb xyuas, feem ntau tshwm sim hauv cov menyuam yaus noj qab haus huv, tab sis nyob rau hauv cov ntsiab lus ntawm tus kab mob los yog ENT kab mob nrog lub caij ntuj no recrudescence uas tau ua rau mob ntawm lub plab lymph nodes.

Secondary intussusception yog txuas nrog rau qhov muaj qhov txhab nyob rau hauv cov phab ntsa ntawm txoj hnyuv: ib tug loj polyp, ib tug malignant qog, ib tug inflamed Merckel's diverticulum, thiab lwm yam. Ntau yam pathologies kuj yuav koom nrog:

• rheumatoid purpura,
• lymphoma,
• hemolytic uremic syndrome,
• cystic fibrosis…

Postoperative intussusception yog ib qho teeb meem ntawm qee qhov kev phais plab.

diagnostic

Kev kuaj mob yog nyob ntawm kev kuaj mob. 

Lub plab ultrasound tam sim no yog qhov kev kuaj mob ntawm kev xaiv.

Lub barium enema, kev kuaj x-ray ntawm txoj hnyuv tau ua tom qab txhaj tshuaj qhov quav ntawm qhov sib piv nruab nrab (barium), yog ib zaug tus qauv kub. Hydrostatic enemas (los ntawm kev txhaj tshuaj barium los yog saline) los yog pneumatic (los ntawm huab cua insufflation) nyob rau hauv hluav taws xob tswj tam sim no siv los xyuas kom meej qhov kev kuaj mob. Cov kev ntsuam xyuas no muaj qhov zoo ntawm kev tso cai rau tib lub sij hawm ib qho kev kho mob ntxov ntawm intussusception los ntawm kev txhawb nqa kev hloov ntawm ntu invaginated nyob rau hauv lub siab ntawm lub enema.

Cov neeg txhawj xeeb

Mob intussusception feem ntau cuam tshuam rau cov menyuam yaus hnub nyoog qis dua 2 xyoos, nrog rau qhov siab tshaj plaws hauv cov menyuam mos hnub nyoog 4 txog 9 lub hlis. Cov tub yog ob zaug cuam tshuam li cov ntxhais. 

Intussusception hauv cov menyuam yaus hnub nyoog 3-4 xyoos thiab hauv cov neeg laus yog qhov tsawg dua.

Risk yam tseem ceeb

Congenital malformations ntawm lub plab zom mov yuav yog ib tug predisposition.

Ib qho kev nce me me ntawm kev pheej hmoo ntawm intussusception tom qab txhaj tshuaj tiv thaiv kab mob rotavirus (Rotarix) tau lees paub los ntawm ntau qhov kev tshawb fawb. Qhov kev pheej hmoo no feem ntau tshwm sim hauv 7 hnub tom qab tau txais thawj koob tshuaj tiv thaiv.

Hauv cov menyuam mos, mob plab heev, tshwm sim tam sim ntawd, tshwm sim los ntawm kev qaug dab peg ntev li ob peb feeb. daj ntseg heev, tus menyuam quaj, quaj, ntxhov siab… Sib cais thaum pib ntawm 15 mus rau 20 feeb, kev tawm tsam ntau dua. Nyob rau hauv lulls, tus me nyuam yuav tshwm sim serene los yog ntawm qhov tsis sib xws prostrate thiab ntxhov siab vim.

ntuav tshwm sai sai. Tus me nyuam tsis kam noj, thiab qee zaum cov ntshav muaj nyob hauv cov quav, uas zoo li "zoo li gooseberry jelly" (cov ntshav sib xyaw nrog cov hnyuv). Thaum kawg, kev tso tseg txoj hnyuv evokes plab hnyuv.

Hauv cov menyuam yaus thiab cov neeg laus, cov tsos mob feem ntau yog cov kab mob plab hnyuv, nrog mob plab thiab tso quav thiab roj.

Qee lub sij hawm cov kab mob ua rau mob ntev: intussusception, tsis tiav, yuav rov qab los ntawm nws tus kheej thiab qhov mob tshwm sim nws tus kheej hauv ntu.

Mob intussusception hauv cov me nyuam mos yog ib qho xwm txheej ceev rau menyuam yaus. Mob hnyav lossis tuag taus yog tias tsis kho vim muaj kev pheej hmoo ntawm plab hnyuv thiab necrosis, nws muaj qhov zoo tshaj plaws prognosis thaum tswj kom raug, nrog tsawg heev uas yuav rov tshwm sim dua.

Ntiaj teb txhawb

Kev mob me nyuam mos thiab kev pheej hmoo ntawm lub cev qhuav dej yuav tsum tau hais txog.

Kev kho mob enema

Cuaj zaug ntawm kaum, pneumatic thiab hydrostatic enemas (saib kev kuaj mob) yog txaus los muab cov ntu invaginated rov qab rau hauv qhov chaw. Kev rov qab los tsev thiab rov pib noj mov sai heev.

phais

Nyob rau hauv cov kev tshwm sim ntawm kev kuaj mob lig, tsis ua hauj lwm ntawm enema los yog contraindications (cov tsos mob ntawm irritation ntawm peritoneum, thiab lwm yam), kev phais yuav tsum tau.

Kev tuav txo qis ntawm intussusception yog qee zaum ua tau, los ntawm kev rov qab siab ntawm txoj hnyuv kom txog thaum cov hnyuv ntxwm ploj.

Kev phais phais ntawm qhov invaginated tuaj yeem ua tau los ntawm laparotomy (classic qhib plab ua haujlwm) lossis los ntawm laparoscopy (kev phais me me uas tau coj los ntawm kev siv tshuaj endoscopy).

Nyob rau hauv cov ntaub ntawv ntawm intussusception theem nrab mus rau ib tug qog, qhov no kuj yuav tsum tau muab tshem tawm. Txawm li cas los xij, nws tsis yog ib qho xwm txheej ceev.