Afferent voj syndrome: mob thiab kev kho mob

Phais cov txheej txheem yuav luag ib txwm txuam nrog uas yuav muaj. Nyob rau hauv tas li ntawd mus tau los ntshav thaum phais, muaj ntau ntau ntev-lub sij hawm teeb meem. Qhov no yog tshwj xeeb tshaj yog muaj tseeb uas nws kim heev manipulations nyob rau hauv uas tshem tawm yog ua hloov khoom nruab nrog los yog feem thereof. Ib qho piv txwv yog lub lag luam Billroth-2. Nws essence muaj nyob rau hauv qhov kev tshem tawm ntawm feem ntau ntawm lub plab thiab tsim ib tug anastomosis nrog cov hnyuv. afferent voj syndrome feem ntau muaj tom qab no phais. Tej teeb meem yuav tshwm sim sai li sai tau tom qab muab hlais tawm lawm, thiab ib tug ob peb lub hlis tom qab ntawd. Nrog rau txoj kev loj hlob ntawm tus mob no yog xav tias tsam, los yog nws yog tsim nyog hais tias ib lub phais.

Lub tswvyim ntawm afferent voj syndrome

Afferent voj syndrome tom qab pais plab resection tshwm sim nyob rau hauv hais txog 13% ntawm cov neeg. Qhov no xam tej zaum yuav txawv los ntawm 1 mus rau 50%, raws li cov kws kho mob. Nws lub ntsiab tsos mob yog ntuav cov kua tsib, muaj feem xyuam rau cov khoom noj kom tsawg. Afferent voj syndrome - ib tug mob nyob rau hauv uas yog ib feem ntawm txoj hnyuv yog, raws li nws twb "muab tua" los ntawm lub plab zom mov txheej txheem. Raws li ib tug tshwm sim, cov kua tsib accumulates nyob rau hauv lub tuam tsev thiab nyob rau hauv lub xub ntiag ntawm phiv yam nchuav tawm. Lwm lub npe rau qhov no yam tab kaum - duodenobilliarny syndrome. Lub xeev no yog ib tug txaus ntshai kos npe rau, thiab yog li ntawd yuav tsum tau phais kho mob.

Ua rau lub syndrome

Lub ntsiab ua afferent voj syndrome yog ib lub lag luam Billroth-2. Nws yog ib tug loj heev kev phais thiab muaj feem xyuam rau tag nrho lub cev. Ib tug zoo xws li cov lag luam yog nqa tawm nyob rau hauv pais plab mob cancer, txoj kev loj hlob ntawm cov teeb meem ntawm peptic rwj kab mob, uas muaj peev xwm tsis tsum tshem tawm ntau maj mam txoj kev. Raws li ib tug tshwm sim ntawm no manipulation ntawm lub duodenum thiab hnyuv yog tsis koom tes nyob rau hauv lub ua los ntawm kev digestion. Vim hais tias ntawm no loj hlob syndrome ntawm afferent voj.

Yam tseem ceeb uas cuam tshuam qhov tshwm sim ntawm no yam tab kaum, yog cov nram qab no ua txhaum cai:

1. Neeg kho tshuab ua. Hauv qab no nws yog meant zaub mov masses nkag mus rau lub lumen "off" hinges. Tsis tas li ntawd, muaj yog sau cov kua tsib, uas kuj ncua hauv tus txheej txheem ntawm kev zom.
2. Poob ntawm nqaij laus nyob rau hauv lub "off" section. Qhov no yog vim li cas feem ntau ua rau mob syndrome ntawm afferent voj tom qab resection.
3. Spasm ntawm anastomosis - lub hlws ris ntawm lub hauv paus ntoo ntawm lub plab thiab cov hnyuv. nqaij tseem yuav raug txo kom tsawg thiab nyob rau hauv lub voj qhov hluav taws xob.
4. Ulcerative kho raws lub sij hawm lub anastomosis. Nws ua rau yus mus rau lub tsos ntawm cov neeg kho tshuab yog vim li cas afferent voj syndrome. Nws yuav tsim raws li ib tug thawj (tom qab lub lag luam), thiab ib tug thib ob lub sij hawm.
5. Inflection afferent voj. Feem ntau nws muaj dua.

Afferent voj syndrome: pathogenesis ntawm tus kab mob

Lub mechanism ntawm afferent voj syndrome muaj ob peb chav nyob. Ua ntej ntawm tag nrho cov muaj yog ib qho cuam tshuam rau lub cev li ib txwm anatomical thiab haumxeeb kev sib tshuam. Raws li ib tug tshwm sim ntawm "dag" restructuring ntawm lub digestive system txheej txheem cov zaub mov txawv khiav tawm. Khoom noj khoom haus, ranked nyob rau hauv lub "off" plab hnyuv voj, yuav kis tsis tau rau. Yog li ntawd muaj yog muab pov nws rov qab - reflux. Nyob rau hauv tas li ntawd, nyob rau hauv lub pathogenesis ntawm lub inflammatory txheej txheem tam sim no. Nws tshwm sim vim cov stagnation ntawm cov masses thiab digestive hypotension KDP. Cov no ib tug thib ob plab hnyuv dysbiosis. Nws tom qab ua rau yus mob ntawm lub digestive ib ntsuj av tau: cholecystitis, pancreatitis, esophagitis.

Cov soj ntsuam daim duab nyob rau hauv afferent voj syndrome

Lub ntsiab ces ntawm no yam tab kaum yog mob thiab ntuav. Plab tsis xis nyob yuav tshwm sim tam sim ntawd los yog tom qab lub lag luam thaum lub sij hawm. Nyob rau hauv rooj plaub thawj muaj yog ib tug thawj, mob afferent voj syndrome. Nws yog yus muaj los ntawm ntswj thiab mob Expander qhov nyob rau hauv txoj cai hypochondrium thiab epigastric. Nyob rau hauv ntev syndrome uas ua kev soj ntsuam daim duab voj qhia tsis yog li ntawd ntau npaum li cas. Mob tshwm sim feem ntau tom qab noj mov, ntau zaus - nyob rau ntawm kev txais tos ntawm fatty khoom noj. Txawm li cas los ntawm lub sij hawm ntawm tshwm sim ntawm teeb meem (mob los yog mob lub sij hawm) muaj cai ntuav. Nws los txog tom qab tus sawv ntawm qhov mob nyob rau hauv lub plab mog, feem ntau yog tom qab ib tug noj mov. Vim heev ntuav tej zaum yuav faib mus rau 500 ml ib hnub twg ntawm bile. Cov no ib tug hnyav havzoov ntawm lub cev. Cov neeg mob sai sai poob phaus, xav tias kev tsis muaj zog.

Afferent voj syndrome: diagnostic pathology

Mob ntawm tus kab mob no pib nrog anamnesis (kis gastrectomy) thiab kev soj ntsuam ntawm tus neeg mob. Ua ntej ntawm tag nrho cov koj yuav tsum tau paub txog qhov xwm ntawm kev mob thiab lub zaus ntawm ntuav, nws twb kev txuas nrog cov zaub mov hom kev kawm. Nyob rau kev xeem, yuav tsum xyuam xim rau mob plab asymmetry: txoj cai department sticks. Qhov no cov tsos mob ploj tom qab ntuav, raws li tus txheem ntawm lub voj los. Lwm feature yog lub daj ntseg ntawm lub sclera thiab daim tawv nqaij.

Nyob rau hauv tas li ntawd mus rau lub kev luj xyuas ntawm kev soj ntsuam cov ntaub ntawv, kuaj thiab instrumental diagnostics. Cov kev hloov tej zaum yuav KLA (B-12 tsis muaj peev xwm anemia), ntshav smear, coprogram (tsos ntawm leukocytes, undigested roj). Thaum X-ray emission cai cov tsos mob ntawm ib tug me me nyob rau hauv lub afferent voj, gipermotornaya dyskinesia. Lub sib piv neeg sawv cev nyob rau hauv lub ua voj. Tsis tas li ntawd ua endoscopic xeem. Nyob rau hauv ntev afferent voj syndrome feem ntau cim inflammatory kev hloov nyob rau hauv lub gallbladder thiab ducts. Nyob rau hauv tej rooj plaub, pancreatitis tsim. Thaum zoo li no o yog raug thiab lub pancreas. Thaum sowing tus txheem ntawm lub plab hnyuv kab mob muaj yog cai, tus piv ntawm tsis hnov pancreatic enzymes. Cov heev ntawm tus kab mob yog txiav txim los ntawm havzoov ntawm lub cev, luaj li cas ntawm txoj kev poob ntawm cov kua tsib tus neeg mob.

Yuav ua li cas yog cov kev txaus ntshai ntawm afferent voj syndrome: mob

Nws yuav tsum tau nco ntsoov tias afferent voj syndrome yog ib tug loj mob pais plab resection. Cov nruam tsis cov kua tsib tej zaum yuav tshwm sim mob hnyav havzoov ntawm lub cev. Cov zaub mov nkag mus rau hauv lub cev yuav tsis zoo zom (vim "off" lub KDP thiab ib feem ntawm cov hnyuv), thiab cov as-ham tsis absorbed. Raws li ib tug tshwm sim ntawm txoj kev loj hlob ntawm plab hnyuv dysbiosis hnyuv cov kabmob uas yuav raug rau inflammatory dab. Nrog rau txoj kev loj hlob ntawm reflux esophagitis rau teev cov tsos mob no ntxiv rau lub hauv siab mob, ib tug kev xav ntawm "pob nyob rau hauv lub caj pas." Cholecystitis yog nrog los ntawm ib tug ntsim saj nyob rau hauv lub qhov ncauj, xeev siab. Yog hais tias koom o ntawm lub pancreas, qhov mob yuav amplified muaj herpes cim. Thaum lub caij ntawm qhov tam sim no pancreatitis yuav tsim ntshav qab zib. Teeb meem ntawm mob afferent voj syndrome xws li peritonitis, plab hnyuv dab tsi thaiv. Cov kab mob no yuav tsum tau tam sim ntawd phais kho mob.

Kev kho mob ntawm lub syndrome ntawm afferent voj

Cov kev xaiv ntawm kev kho mob nyob rau hauv tus neeg mob, kuaj cov ntaub ntawv thiab instrumental xeem. Nws yog ib qho tseem ceeb kom paub tias dab tsi lub heev ntawm lub syndrome muaj afferent voj. Kev Kho Mob yuav ua tau conservative thiab phais. Me me muab ib tug tshwj xeeb kev noj haus, inflammatory thiab antibacterial tshuaj (medicaments "Tsefriakson", "Tsiprolet"). Nyob rau hauv tej rooj plaub yuav tsum rov pais plab lavage. Thaum mob loj tsawv thiab mob xav tau kev phais kho mob. Nws yuav tsum tau tswj xa cov stagnation ntawm cov zaub mov. Feem ntau cov feem ntau tsim ib reconstruction ntawm lub anastomosis. Thaum nws bends ua nyob rau hauv loops uas txuas mus rau qhov tseeb txoj hauj lwm thiab sutured mus rau lub peritoneum. Tus nqi thiab hom phais kho mob muaj peev xwm yuav txawv thiab nyob ntawm qhov ua rau mob.

Kev tiv thaiv ntawm afferent voj syndrome

Tam sim no, kev phais kom Billroth-2 sim los hloov lwm yam phais cov txheej txheem. Qhov no yog ua nyob rau hauv thiaj li yuav khaws cia rau lub physiology ntawm lub digestive ib ntsuj av. Yog hais tias Billroth-2 lag luam tsis tau lawm, nws yog tsim nyog los nqa tawm tag nrho cov kev pab tiv thaiv kev ntsuas tshuaj los ntawm cov kws kho mob. Feem ntau qhov no muaj xws li cov khoom noj. Tom qab resection tsis tau noj fatty thiab junk zaub mov. Noj cov zaub mov koj yuav tsum tau 6-7 zaug ib hnub twg nyob rau hauv me me thiab semi-kua hauv lub xeev (porridges, kua zaub).