Payra syndrome: ua, cov tsos mob, kev kho mob

Muaj ob peb cov neeg uas yeej tsis tau muaj ib tug mob plab. Nyob rau hauv feem ntau tus neeg mob, tsis kaj lub siab tsos mob txuam nrog malnutrition los yog cov kab mob ntawm lub digestive kabmob xws li gastritis, pais plab rwj los yog cholecystitis. Yog hais tias mob plab ntse, ntxiv rau tus neeg mob muaj kev xeev siab thiab ntuav, feem ntau kev tshawb nrhiav hnyuv tws. Thiab qhov ua rau ntawm tag nrho cov teeb meem yuav ua tau Payra syndrome noj qab haus huv. Yuav ua li cas yog tus kab mob no thiab yuav ua li cas nws manifests nws tus kheej, tsis txawm paub txhua txhua tus kws kho mob, vim li cas, thiab muab cov tsis ncaj ncees lawm kev kho mob. Nyob rau hauv cov ntaub ntawv no, tus neeg mob tsis yog tsuas yog tsis muaj txoj kev txhim kho no tshwm sim, tab sis kuj exacerbated qhov teeb meem. Raws li ib tug tshwm sim, nws yog tsim nyog los daws tau xwb los phais. Yuav kom ncaj ncees hais tias clinically thiaj paub hais tias Payra syndrome raws li thiaj tau tuaj rau keeb kwm thiab palpation ntawm lub plab mog thiab nrog tsis muaj kev tsom xam ntawm cov kev tshwm sim, yeej nyuaj. Tab sis tus kab mob no muaj ib co nta uas paub qhov txawv nws los ntawm lwm yam gastrointestinal kab mob. Rau cov lus qhia yuav ua li cas kom paub txog qhov no txaus ntshai syndrome thiab seb nws puas yuav tau mus kho tus kab mob no tsis muaj kev phais - peb tsab xov xwm.

Payra syndrome - yog dab tsi?

Nco qab lub cev lub tsev kawm ntawv. Tag nrho cov zaub mov peb noj pib yuav tsum tau nqis nyob rau hauv lub plab, thiab ces mus rau hauv me me hnyuv qhov twg plab zom mov txheej txheem xaus. Muaj cov zaub mov nyob rau hauv cov ntshav los tag nrho uas yog koj, thiab nws yog sib tsis tau rau lub cev kis tau mus rau hauv txoj hnyuv loj. Ntawm no, los ntawm no loj ntawm dej absorbed, tawm hauv ib tug tuab taub hau pov tseg hais tias peb hu cov quav. Cov nyuv muaj ob peb seem, tus coos ntawm uas - cov nyuv. Simplistically nws yuav sawv cev nyob rau hauv daim ntawv ntawm ib tug hollow raj nrog ib lub cheeb ntawm txog 7 cm, zoo ib yam li lub ntug bordering cov hnyuv. Cov nyuv yog muab faib ua peb theem. Ascending ya yog nyob rau ntawm sab xis ntawm lub plab mog. Nws mus hauv lub siab, uas yog khoov duav ntawm lub kaum sab xis ze rau 90 ° thiab tau nyaij nyob rau hauv ib tug transverse ya. Qhov no yog ib feem ntawm cov nyuv nce mus txog rau thaj tsam ntawm tus po (lub cev dag nyob rau hauv rau sab laug sab sauv quadrant), yog bent dua, mus rau hauv cov descending ya tom qab nyob rau hauv lub sigmoid nyuv thiab qhov quav. Quav, pib tsim nyob rau tawm hauv cov hnyuv, yauv tag nrho cov no txoj kev uas ntev, maj mam nyeem tas. Raws li ib tug tshwm sim, cov zis peb tau tsim tuab txaus rau cal ceev. Payra syndrome los yog tus kab mob Payra cai thaum lub thib ob khoov ntawm cov nyuv (nyob rau hauv lub cheeb tsam ntawm tus po) yog ib tug loj npaum li cas tshaj nws yuav tsum tau physiologically. Thaum no tus taw tes, lub lub cheeb ntawm lub plab kab noj hniav ntau nqaim tias cov tshuaj no yog hu ua stenosis. Los ntawm lub vos qhib muaj nkoog cov quav tsis muaj lub sij hawm yuav tawm mus ceev ceev txaus kom qhov chaw rau lub khiav khiav. Cov no ib tug zoo ntawm mash los ntawm lub fact tias lub cev nws mus tso zis. Feem ntau ntxiv rau cov quav gases ua thaum lub sij hawm lub plab zom mov ntawm cov zaub mov.

Yuav ua li cas yog cov kev txaus ntshai Payra syndrome

Nyob rau hauv cov hnyuv mus rau hauv cov ntshav los ntawm cov khoom noj khoom haus dhau pab tau ib txoj lw ntsiab, vitamins thiab lwm yam tshuaj, thiab tag nrho cov ruaj thiab yuav tsim teeb meem yog txoj kev quav. Feem ntau peb muaj rau lawv txhua txhua hnub kom tshem lub cev, uas yog, yuav ua rau txoj cai ntawm defecation. Yog hais tias cov quav yog ncua uas muaj tshwm sim nrog cem quav, cov ntshav pib ntws tam sim no nyob rau hauv cov teeb meem tshuaj, nws pib ib gradual lom ntawm lub cev (intoxication). Qhov no yog lub ntsiab teeb meem, uas ua rau Payra syndrome. Qaug cawv muaj ntau phiv txim, yog ib tus uas muaj peev xwm yuav hu ua tiv thaiv. Qhov no nyob rau hauv lem ua rau lub fact tias txo kuj mus ntau hom ntawm cov kab mob. Nyob rau hauv tas li ntawd, cov khoom quav thab plaub lub plab hnyuv phab ntsa, uas ua nyob rau hauv lawv cov ulceration, thiab tib neeg npaj siab cem quav yuav ua rau cov tsos ntawm hemorrhoids. Lwm teeb meem loj tshwm sim los ntawm cov syndrome Payra - nws kolonoptoz uas txhais tau tias cov omission ntawm cov nyuv. Qhov no ua rau plab hnyuv rhuav txhua thiab tej zaum rau volvulus.

etiology

Payra syndrome twb piav los ntawm tus German kws phais neeg Irwin Pyro nyob rau hauv lub twb nyob deb 1905. Rau ntau tshaj 100 xyoo, cov loj heev ntawm tus kab mob no muaj ntau zog thiab mus txog kwv yees li 40% ntawm cov neeg laus cov pejxeem ntawm cov ntiaj chaw. nyuv inflection yog cai nyob rau hauv congenital plab hnyuv pathological qauv, xws li ib tug elongated ntoo khaub lig-ya ntawm cov nyuv. Vim tej no yog congenital anomalies, lawv ua pw nyob rau hauv tej tsis ua hauj lwm ntawm tsim ntawm lub hnyuv nyob rau theem ntawm lub embryo. Ntawm lawv yog cov lub unfavorable ib puag ncig, mob ntawm leej niam thaum lub sij hawm cev xeeb tub, tshuaj noj, tsis tau phem, lub paj hlwb kev nyuaj siab, haus dej cawv cev xeeb tub thiab lwm yam influencing yam nyob rau hauv txoj kev loj hlob ntawm lub fetus. Medical Statistics pom tias cov me nyuam, leej txiv thiab leej niam uas raug kev txom nyem los ntawm cov kab mob ntawm lub digestive ib ntsuj av tau, yog yug los es muaj lub syndrome Payra ntau dua cov me nyuam kiag li noj qab nyob zoo cov niam txiv.

pathogenesis

Payra syndrome cov tsos mob yog tus txheej txheem rau ntau lwm yam kab mob ntawm lub digestive ib ntsuj av tau, thiab yog li ntawd feem ntau incorrectly thiaj paub hais tias. Cov neeg mob tej zaum yuav muaj:

- cem quav;

- xeev siab;

- tsis qab los noj mov;

- mob nyob rau hauv lub plab mog;

- ntuav;

- o plab mog (vim lub fact tias cov gases yuav tsis tau kev khiav los ntawm txoj hnyuv loj);

- mob taub hau;

- txob taus.

Tsis tas li ntawd nws Payra syndrome tej zaum yuav qhia nws ces xws li:

- paroxysmal mob tsis paub hais tias localization (vim congestion at the point of inflection plob tsis so tswj roj thiab feces);

- mob heev nyob rau hauv lub siab lub ntsws ntawm qhov chaw ntawm lub cheeb tsam (tej zaum lawv muab nyob rau hauv lub xub pwg nyom los yog cov sab tes laug);

- yuav txo tau txoj kev mob, thaum tus neeg mob cov lus dag horizontally.

Stagnation ntawm cov quav ua o ntawm lub plab hnyuv phab ntsa thiab muab pov rau lawv mus rau hauv cov hnyuv uas tshwm sim nyob rau Payra syndrome feem ntau ua rau Reflux ileitis. Nyob rau hauv cov neeg mob, cov ntxiv cov tsos mob ntawm cov kab mob for free:

- hnoos qeev nyob rau hauv cov quav, tej zaum kuj nrog cov ntshav;

- ib qho kev nce nyob rau hauv kub.

dolichosigma

Ib kem ntawm cov nyuv yog lub sigmoid cov nyuv, yog li lub npe vim hais tias ntawm nws cov zoo lawm, dog dig li tsab ntawv «S». Nws yog nyob ncaj qha nyob rau hauv pem hauv ntej ntawm lub qhov quav, uas muaj nuj nqi yog nej yuav khiav tawm tas quav. Dolihosigmoy hu ua pathology, thaum ib tug neeg tau tsim ib tug sigmoid nyuv ntev tshaj li tsim nyog anatomically. Nyob rau tib lub sij hawm nws kuj tshwm sim yam tsis tau xav xwm ntawm stagnation ntawm cov quav, thiab cov tsos mob zoo li Payra syndrome. Dolichosigma yuav tsis tsuas innate, tab sis mas yuav kis tau. Nws yog ntseeg hais tias cov sigmoid nyuv yuav elongated nrog ntev-lub sij hawm (lub xyoo), txom nyem noj haus, nyob rau hauv lub siv ntau dhau tsiaj cov zaub mov thiab carbohydrates, nrog sedentary ua hauj lwm. Ib tug ntawm lub ntsiab tsos mob ntawm tus kab mob yog cem quav. Tsis tas li ntawd, cov neeg mob tsis txaus siab ntawm qhov mob nyob rau hauv rau sab laug subcostal thiab puj ntaws, nyob rau flatulence, zuag qhia tag nrho deterioration rau kev kho mob.

diagnostics

Payra syndrome rau cov neeg laus thiab cov me nyuam thiaj paub hais tias yog tsis yooj yim. Kev kho mob keeb kwm ntawm tus kab mob no yog heev uas zoo sib xws rau lwm yam teeb meem nrog rau cov hnyuv ib ntsuj av. Nws tshwm sim hais tias tus neeg mob nrog cov syndrome Payra txawm paub hais tias mob hnyuv tws thiab muaj kev phais. Thaum lub sij hawm no, muaj ib tug meej heev txoj kev mob ntawm no pathology - ergography. Qhov no yog qhov zoo tshaj plaws txoj kev los mus txiav txim nrog zoo raug tus neeg mob hauv lub xub ntiag ntawm inflection ntawm cov nyuv. Tus txheej txheem tau nqa tawm siv barium ncua kev kawm ntawv. Tus txheej txheem ntawm nws cov koom haum saib xyuas rau tus neeg mob yog tshuaj X-ray screen. Thaum sau cov nyuv daim duab ua nrog tus neeg mob pw, thiab thaum twg muab nchuav rau plob tsis so tswj - sawv.

Cov me nyuam ntawm cov muaj hnub nyoog 10-15 xyoo yog siv los kawm cov nyuv radioisotope txoj kev. Yog li tej kub colloidal tshuaj.

Thaum lub syndrome Payra nyob rau hauv daim duab koj yuav pom tias cov nyuv, zoo li ib tug garland, sagging nyob rau hauv lub pelvic cheeb tsam.

Nta Payra syndrome nyob rau hauv cov me nyuam

Tu siab Payra syndrome nyob rau hauv cov me nyuam tau raug me ntsis kawm, li ntawd, yog tsis muaj tseem pom zoo yuav ua li cas rau ntau meej kuaj nws muaj hnub nyoog tsim nyog cov tub ntxhais cov neeg mob, thiab yuav ua li cas zoo kho. Ua kev kho mob zaum txoj kev tshawb no pom tias cov ntxhais tus kab mob no tshwm sim ntau dua cov tub hluas.

Lub manifestation ntawm cov syndrome Payra pib nyob rau hauv thawj 12 lub hlis tom qab yug tus me nyuam, feem ntau ntawm ib lub sij hawm thaum tus me nyuam pib mus ntxias. Tshiab zaub mov yuav ua rau nws ntau tuab quav me nyuam uas yeej txhawb lawv cov tuav nyob rau hauv qhov chaw ntawm cov nyuv inflection.

Tus thawj cov tsos mob ntawm tus kab mob, cim tias seb thaum Payra syndrome yog: cov kev tom qab ntawm lub zuag qhia tag nrho noj qab haus huv ntawm tus me nyuam yuav tshwm sim cem quav thiab mob plab. Tom qab ntxiv intoxication cov tsos mob (xeev siab, ntuav) vim txuam nrog ntawm quav thiab ntev lawv nyob rau hauv lub plab. Yog tsis muaj kev kho mob, cov me nyuam 12-15 xyoo pom tau tib cov tsos mob Payra syndrome, raws li zoo raws li nyob rau hauv cov neeg laus. Thaum coj cov me nyuam uas poob siab tias nws Payra syndrome, tus kws kho mob yuav tsum nco ntsoov los xyuas seb yuav ua li cas cev xeeb tub proceeded, seb puas muaj yog ib tsev neeg tom ntej no ntawm kwvtij nrog hnyuv muaj teeb meem, yuav tsum tsis txhob inflammatory dab nyob rau hauv cov hnyuv ntawm ib tug ntshav lead xeem. Qhov kawg mob yuav tsum nyob rau hauv lub hauv paus ntawm barium xeem tau.

Payra syndrome: kev kho mob noj cov zaub mov

Thaum zoo li no muaj mob ib tug ntau ntawm cov xim, cov neeg mob yuav tsum tau muab rau khoom noj kom zoo. Khoom noj khoom haus yuav tsum tau high-calorie, tab sis nyob rau tib lub sij hawm ib qho yooj yim, tsis muaj ib tug ntau ntawm toxins. Cov ntawv qhia zaub mov yuav tsum yog tam sim no tsev cheese, butter, qaub cream, jelly. Yuav kom nce peristalsis hnyuv, cov neeg mob yuav tsum tau ua kom paub koj cov zaub mov whey, kefir, fermented ci mis nyuj, yogurt. Yuav tsum tsis raug tso tseg thiab khoom qab zib, uas kos kua rau hauv cov hnyuv, uas muaj txhawb rau thinning ntawm quav thiab defecation yooj yim txheej txheem. Cov neeg mob yuav tsum tau noj ib tug ntau ntawm txiv hmab txiv ntoo, zib ntab, noj txiv hmab txiv ntoo syrups.

Nyob rau hauv lub xub ntiag ntawm lub syndrome Payra li cem quav lwm yam etiology, nws tseem pab tau haus dej haus zaub broths thiab txiv hmab txiv ntoo dej qab zib raws li freshly ua kua txiv ntawm carrots thiab nyoos qos yaj ywm.

Dieting tsis tshem tawm tus kab mob no, tab sis nws yog ntau npaum li cas yooj yim rau nws.

conservative kev kho mob

Cov kws kho mob muaj peev xwm feem ntau pom ib tug teeb meem no lawv ntshai kev phais thiab xav ua ntej sim ib tug yeeb tshuaj kho, cov neeg mob uas pom Payra syndrome. Kev kho mob li cas tshuaj yuav tiv nrog tus kab mob no? Cov kws kho mob tej zaum yuav pom zoo kom tshuaj lactulose. Lawv yuav tsum tau muab rau cov me nyuam raws li thaum ntxov raws li kiag. Lactulose dog dig dilutes quav, tsub kom peristalsis thiab ib txhij inhabits cov plab ntawm pab microflora. Cov neeg laus thiab cov neeg uas muaj cem quav vim ntev-lub sij hawm o ntawm lub plab hnyuv phab ntsa pib, muab anti-inflammatory siv tshuaj. Rau qhov mob nyem yuav qhia antispasmodics "Drotaverinum" los yog "Platifillin" hoob muaj kuj pab tau prebiotics, probiotics, vitamins.

Payra syndrome kho nrog tshuaj tsuas yog nyob rau thawj zaug ua sawv ntawm tus kab mob, thiab cov kev tshwm sim yuav tsum short-lived. Nyob rau hauv thaum uas tig mus nrog tshuaj kws kho mob muab cov tshuaj physiotherapy (electrophoresis nrog novocaine tshuaj, paraffin daim ntaub ntawv rau lub plab mog, diathermy, UHF, obligatory nyob rau hauv lub plab zaws, thiab muab ce kom ntxiv dag zog rau nws cov phab ntsa.

phais kev pab

Qhov no yog qhov zoo tshaj plaws txoj kev ntawm kev kho mob, nyob rau hauv uas tag nrho cov tsos mob ploj kiag li, thiab mus ib txhis, thiab tsis nyob rau lub sij hawm, raws li nrog rau lwm cov kev kho mob. Operations yog nqa tawm los ntawm txawv txoj kev, nyob ntawm seb anatomical indications. Nyob rau ib tug ntawm lawv nqa ib tug nruab nrab laparotomy, resection ntawm lub transverse nyuv cov kev faib bypass nyob rau hauv nruab nrab ib feem, kom ncaj qha anastomosis. Ntxiv mus, transverse nyuv tsiv laterally nyob rau hauv lub puag-pais plab ligament thiab tsau los ntawm ib tug tshwj xeeb txoj kev, yog li ntawd lub khoov rau ob sab nyob rau hauv lub cheeb tsam ntawm lub siab thiab tus po raug npawv.

Raws li ib tug thib ob txoj kev resected ligament, securing txoj hnyuv loj (nyuv-splenic thiab cov nyuv-diaphragmatic) laparoscopy thuam cov splenic flexure nyob rau hauv thiaj li yuav khoov deb hnyuv. Lub lag luam yog ua nrog rau kev siv kev kho mob trocars thiab electrocautery.

Ua ke ua hauj lwm yog nqa tawm rau cov neeg uas paub hais tias "Payra syndrome dolichosigma". Xyuas ntawm cov neeg mob tom qab xws li kev kho mob yog heev paaj. Cov neeg yog tag mob, tsis txhob cem quav, thiab cov tsos mob intoxication ploj nrog lawv. Thaum lub sij hawm lub neej coj lub lag luam, nyob rau hauv tas li ntawd mus manipulation cov neeg mob uas cov nyuv thiab ib tug transverse feem splenic flexure khiav lag luam laparoscopy resection ntawm lub sigmoid nyuv.

outlook

Conservative kev kho mob ua tau nyob rau hauv thaum ntxov ua sawv ntawm tus kab mob, tab sis vim hais tias nws yog tshwm sim los ntawm anatomical pathology nyob rau hauv lub plab hnyuv qauv, tsuas yog tus phais yuav pab tau kiag li kov yeej tus kab mob no Payra. pej xeem kev kho mob yog tsuas yog siv raws li ib tug pab. Tsoos tshuaj muaj infusions thiab decoctions, thinning quav (cov tshuaj ntaus cev) thiab txhais tau tias ntawm mus pab tau txoj lub kom ntawm cov hnyuv. Nws kuj muaj cov cuab yeej uas ntxiv dag zog rau lub cev, pab txoj kev mob. Siv yuav tsum hau plantain, qos kua txiv, stewed prunes, qhuav txiv hmab txiv ntoo. Nws yog ib qho tseem ceeb kom paub hais tias nrog lub syndrome Payra enemas yog txhob.

Cov raug ntawm cov neeg mob uas tau cia li nqa tawm qhov tseeb kev kho mob, yog kiag li paaj. Yog hais tias Payr kab mob pib, tej zaum yuav muaj txoj sia teeb meem xws li hlav, ulceration ntawm cov phab ntsa, hemorrhoids, tawm los ntawm ib tug mus tas kev raug mob rau cov quav quav.