Tingamudziwe Dongosolo kusintha kuthamanga m'mimba mwa odwala matenda m'mimba

Chifukwa kuwonjezeka kwapakati pa-m'mimba kuthamanga (IAP) kungakhale zosiyanasiyana matenda ndi zinthu pathological mu M'mimbamo peritoneal ndi danga retroperitoneal. Pamene kuthamanga mu zonse m'mimba limatuluka kwa mlingo wa kumamusokoneza yachibadwa magazi kwa ziwalo, akufotokozera otchedwa kwapakati pa-m'mimba matenda oopsa matenda (SI-AH), chomwe chili kuwonjezeka zizindikiro kulephera limba.

Nkhani ya phunziroli anali magulu 6 odwala matenda osiyanasiyana pachimake opaleshoni ya zonse m'mimba. Gulu ulamuliro inkakhala odwala amene analibe pachimake kudwala opaleshoni. WBD mlingo ndi mphamvu ake imawunikidwa ndi kuyeza kuthamanga mu chikhodzodzo anthu.

Mu gulu ulamuliro wa kuzipenya (n = 15 amuna - 53%, akazi - 47%) pafupifupi WBD anapanga 2.4 ± 0.4 masentimita aq. Art.

Wapakati mtengo VBD odwala ndi pachimake cholecystitis (I gulu, N = 25, 17 - akhala opareshoni, 8 - ankachitira conservatively) pa chikuonetseratu anali 5,8 ± 0,6 masentimita aq. Art. Pa odwala sanali opareshoni kwa maola 7-8 mlingo wa IAP sanali osiyana ndi anthu mu gulu kulamulira. Mu odwala opareshoni kumayambiriro postoperative nthawi anatsimikiza ndi azimuth amphamvu kwa mitengo kuchuluka kwa WBD.

IAP milingo odwala ndi pachimake kapamba (II gulu N = 25) zosiyanasiyana malinga ndi kukula kwa matendawa. Choncho, odwala 11 ofatsa, ndipo 5 - ndi digiri pafupifupi yokoka mtengo WBD silinasinthe malire yachibadwa (6,8 ± 1,1 masentimita ndime aq ..). Y 3 odwala unoperated ndi aakulu pachimake kapamba Ndinaona digiri ya kwapakati pa-m'mimba matenda oopsa (IAH) (17,6 ± 0,5 masentimita aq. V.). Odwala 2, amene unathandizira pa peritonitis enzymatic, II la mlingo wa MSF wakhala mayina pamaso ntchito. Pambuyo ntchito WBD pang'onopang'ono utachepa. 4 odwala necrosis pancreatic anakhazikitsa, anali mphamvu zofanana WBD, ndi 1 ali ndi zizindikiro osiyana anali Siaha amene anachita pokhapokha ntchito.

Mlingo wa odwala IAP ndi ileus (III gulu N = 25) linasinthidwa motere: isanafike opaleshoni odwala 6 WBD zizindikiro anakhalabe mu osiyanasiyana wabwinobwino, 14 - anati digiri Ine, Y 5 - II digiri MSF. Pa nthawi yomweyo, odwala ndi milingo apamwamba WBD anali bwino X-ray chithunzi cha kutsekeka m'matumbo. Pambuyo pa opaleshoni, WBD akalozera anabwera mwakale.

Odwala 6 ndi chophukacho uschemlonnoy (IV gulu, N = 8), koma palibe m'matumbo necrosis mu zi- ndi postoperative nthawi, WBD anakhalabe mu osiyanasiyana yachibadwa. 1 mtima ndi m'matumbo necrosis kuzungulira preoperatively olembedwa Ine digiri MSF. 1 mtima WBD mitengo kuchuluka pambuyo mowiriza muyike pena wa hernias ventral.

V 9 odwala akakufunsani pachimake peritonitis Genesis zosiyanasiyana, limene ndi postoperatively WBD mlingo pafupi ndi mfundo yachibadwa (7,8 ± 1,5 masentimita aq. V.). 4 odwala opaleshoni kuti Ine digiri (15 ± 0,7 masentimita ndime aq ..), Mu 2 - II digiri MSF. Mu 1 mtima ndi zizindikiro kulimbikira postoperative wa peritonitis, MSF chawonjezeka ndi mlingo mlingo III, ndi zizindikiro zoonekeratu Siaha. Kamodzi anapanga relaparotomii WBD utachepa pang'ono, mouzirira ndi kulephera aimpso analimbikira.

VI gulu m'gulu odwala 2 ndi mitsempha thrombosis mesenteric.

Mmodzi wa iwo ine digiri MSF Zavumbulutsidwa, amene linathera pokhapokha ntchito. Wodwala chachiwiri pamaso opaleshoni anakhazikitsidwa kalasi II MSF, limene osati anakakamirabe nthawi postoperative, koma anali kukula ndi chitukuko cha woima matenda Siaha. WBD mlingo waponya pokhapokha relaparotomy ndi normalization wa ntchito za ziwalo ziwalo.

Choncho, matenda mwamsanga opaleshoni zikhoza kuwonjezera WBD, mpaka chitukuko cha Siaha. Izi zimafuna maso kusamala ndi ulamuliro wa chitukuko wachibale vuto ili, madokotala ndi madokotala pa ntchito.