Isibindi ukudabuka: Izimbangela, ukwelashwa, imiphumela futhi Izibikezelo

Ukulimala kwezitho besisu ungomunye kwezinhlobo kunzima kakhulu, njengoba ezimweni eziningi abakubonisayo usongo izimpilo izisulu. Izimbangela nomonakalo onjalo kungaba zomgwaqo, ashaye endaweni esiswini noma ukuwa kusukela ukuphakama umxhwele. The njalo kunazo zenzeka amakhefu isibindi ngenxa ezinkulu usayizi ngokwanele futhi Ukuklanywa komzimba. Uyini ikhefu isibindi nokuhlinzeka usizo kwizisulu nokuthi kuzothatha ukwelashwa endaweni isikhungo sokwelapha? Impendulo uzofunda ngokufunda kulesi sihloko.

Isakhiwo isibindi

Ngaphambi kokuqhubeka izimfanelo ukulimala kwesibindi, kubalulekile ukusho amazwi ambalwa mayelana Ukuklanywa komzimba. Uyini isibindi, lapho likhona nokuthi kubuhlungu umzimba? Isibindi Itholakala engxenyeni engenhla peritoneum, bangazihluphi ilungelo quadrant engenhla. womuntu isibindi mass omdala ifinyelela i isilinganiso amakhilogremu nenxenye. Isitho has evele ezimbili: phezulu ngokufanele ngqo ngezansi diaphragm, kanye ngezansi.

Isibindi inezingxenye ezimbili: kwesokunxele bese kwesokudla. Ingxenye ahlukaniswe ucwezana umsipha. Ngu isibindi gallbladder oba kokuba zabelwe Bile kwesigubhu umzimba.

kokusebenza kwesibindi

Isibindi wenza imisebenzi ezibalulekile eziningana. It uyazihlanza igazi, udlala ezihlukahlukene ezibalulekile zokusebenza ezivamile amaprotheni umzimba, ukhiqiza enzyme ehilelekile zonke izinhlobo umzimba. Phakathi kwe-fetus ukukhula komuntu isibindi wenza hematopoietic function. Nokho, abantu abaningi bazi okuncane kakhulu ngakho, ezifana isibindi lapho nendlela kubuhlungu umzimba. Ukwazi lezi abaluleke kakhulu: uma isikhathi usola khona yisiphi isifo, ukwelashwa kuyoba nemiphumela engcono kakhulu.

izinyembezi Kwenhlekelele

Isibindi has a ukungaguquguquki sasivumela obukhulu, kodwa isitho lilimele kaningi. Lokhu kungenxa yokuthi kwesibindi imbozwe udonga besisu kuphela (ngaphandle surface body ngemuva). peritoneum Izacile ungakuvumeli ukuba isivikelo emathonyeni angaphandle. Ziningi izici kungabangela isibindi ukudabuka: Izimbangela yalesi sifo zahlukahlukene kakhulu. Ngokwesibonelo, indwangu ungadabula ngempela kalula ukuhlukumezeka noma ukushaywa unhlangothi.

Isibindi kungalimala e ukuhlukumezeka esifubeni noma okhalweni. Ingabe njalo isibindi ikhefu bese kuba nengozi. Trauma kungaba avuse buhlungu esinamandla isibindi. Lokhu kungenxa ethize isitho indawo yokwakheka nesisindo yayo enhle. Kusukela isibindi kuyinto kuyaqina ezahlukene futhi iqinile phakathi izimbambo kanye nomgogodla lilimele ke ngokuvamile lokho kwanele.

Kwezinye izimo, ukuze ukudabuka kwesibindi kungaba umphumela engafanele ukwenziwa yokusiza umuntu ukuba aphefumule cardiopulmonary, kodwa lokhu kwenzeka kakhulu kuyaqabukela.

Kungenzeka yini ukuba ukudabuka okuzenzakalelayo isibindi?

ingozi Ephakeme isibindi ukudabuka uma kwenzeka ukuthi umzimba ehlaselwa isifo yimuphi. Ngo umalaleveva, ugcunsula, amyloidosis ukuphula ngisho hhayi amathonya eziqinile zangaphandle kungadala. umonakalo ezinjalo zingakwenza hhayi kuphela isibindi esingu, imisipha uhlobo kodwa futhi ucindezele, isibonelo, uma ukhwehlela. amakhefu isibindi okuzenzekelayo kungenzeka khona umdlavuza emzimbeni noma semithambo aneurysms.

isibindi ukudabuka engenzeka ngokumelene ngemuva kokukhulelwa. Lokhu zokugula wayechazwa izikhathi ezicishe zibe ngu-120 kusukela ngo-1844. Ngesikhathi esifanayo, abesifazane abaningi baye kwatholakala ukuthi une-nomfutho wegazi ophezulu.

Ukwahlukanisa amakhefu isibindi

Ngokusho kobukhulu lezi ukulimala zihlukaniswe 4 izigaba eziyinhloko:

• kokunikezwa kwe-ubuqotho capsule ne ukopha okuncane;
• parenchymal igebe lapho ukopha kuyanqamuka ngokushesha ngemva sutures udokotela ohlinzayo;
• Ngokuvamile abantu baphuka izinqulu ngokujulile lapho izisulu babone yokushaqeka nokulahlekelwa ukwazi;
• parenchymal ukudabuka, ephelezelwa ukuhlukumeza ubuqotho imikhumbi emikhulu - ilimele ezinjalo umuntu kusheshe ziyafa ngenxa ukopha.

Ivelele njengoba ezimbili isigaba noma imisiwe amakhefu isibindi. Lapho kwakhiwa podkapsualnaya noma hematoma intrahepatic kamuva uqalisa ngaphakathi komgodi ongaphakathi kwamathumbu umonakalo esinjalo.

Uma isibindi kuhambisana ukwephulwa igebe fibrous umzimba igobolondo ubuqotho, igazi ingena ngaphakathi komgodi ongaphakathi kwamathumbu. Esimweni lapho kukhona zilimele beso, igazi zitholiwe ingaphakathi pleural. Uma emgodleni fibrous alilinyaziwe, igazi kancane kancane aqoqana phakathi kwakhe kanye parenchyma.

Ukusongela isibindi ukudabuka?

amakhefu isibindi cishe njalo ukumela usongo isisulu uhlala. Kungaba noma eyodwa noma amaningi: kusukela kule isici kuncike inani ukopha. Kuyaphawuleka ukuthi parenchyma isibindi kakhulu futhi imithambo yegazi abakwazi ukwehlisa. Kubangela ukuthuthukiswa ukopha, okungakwazi ayeke angesabi. Futhi, ukulahlekelwa igazi banezelwa yokuthi isibindi butjhilweni ngomoya. Ngaphezu kwalokho, igazi exutshwe Bile, okuyinto nzima kakhulu ekunqandeni yayo. Ezimweni ezingandile, ukopha zingayeka ngaphandle kokungenela wezokwelapha. Ngokuvamile, lokhu kwenzeka ezimweni lapho kungekho imikhumbi emikhulu kwabhujiswa.

symptomatology

Phakathi izimpawu eyinhloko isibindi ukudabuka zihlanganisa:

• Ubuhlungu endaweni esiswini. Ubuhlungu kungaba lizwakale ngokulambisa, futhi abukhali. Ngokuvamile, lapho isisulu uthola ukulimala kwesibindi eyenga ehlezi isikhundla: uma uzama ukushintsha ukuma iba ubuhlungu obukhulu kakhulu ( "Roly-midi" syndrome).
• Ubuhlungu luqine uma kudlwengulwe ivuliwe kuze kufike ohlangothini lwesobunxele: kungenxa yokuthi igazi zanqwabelana ohlangothini lwesokunene esiswini, ushukumiseleka ukuba ohlangothini lwesobunxele.
• izindebe lohlaselwayo aphenduke okwesibhakabhaka.
• Ngemva ukulimala esiswini esishubile futhi lukhulu.
• Ukucanuzela kwenhliziyo nokuhlanza.
• Ukubonakala izithukuthuku ebandayo, ukupholisa nasemilenzeni.
• Isisulu bangase bazizwe ome kakhulu.
• Isikhumba esiphaphathekile.
• Nokulahlekelwa ukwazi, ubuhlungu ukushaqeka.

Uma ngesikhathi sekhefu isibindi hematoma encane, isimo lesiguli ngokuvamile egculisayo. Uma umonakalo omkhulu nakakhulu, iziguli basesimweni esibucayi. Lapho olimele ezinsukwini zokuqala ngemva kokuthola izimpawu lingekho. Ngokuvamile ubuhlungu yaphela ngemva kwezinsuku ezimbalwa, kodwa isibindi kuyinto lakhulisiwe kancane. Kungase kube ukunyuka kwezinga lokushisa, ngezinye izikhathi eba jaundice encane. Ngemva kwalokho, noma ngabe isiphi voltage okuncane singenzeka capsule ukudabuka, ngaleyo ndlela hematoma is batheleka ngaphakathi komgodi ongaphakathi kwamathumbu.

Ngokushesha ngemva ukulimala ekhiqizwa, ingcindezi luyanda, Nokho, iqala wehlise ngemva okhulisa ukopha. Kukholakala ukuthi iconsi ingcindezi luqala ngemva ukopha ifinyelela 800-1500 namamililitha.

sitholakale kanjani isibindi ukudabuka?

Ukuxilongwa isibindi igebe kungenzeka nobunzima ezithile ikakhulukazi uma isiguli wathola ezinye ukulimala. Uma isikhathi ayenzi ukuxilongwa "ukudabuka kwesibindi", imiphumela ingaba ezinzima. Ngenhlanhla, sibonga yezindlela zesimanje amaphutha zokuxilonga ziyancipha.

Muva nje, ngokokuqala sitholakele amakhefu isibindi isicelo wokubhoboza besisu lapho umuntu eba ipayipi ekhethekile. Nale ndlela kungenzeka ngokushesha ukukhomba imininingwane yalolu ukulimala, futhi sifeze kudingekile izinyathelo zokulungisa. Ezinye iziguli ze-okuyikona Kunconywa ukwenza ultrasound kwesibindi.

Anqume izinguquko umfutho obangelwe ukungamethembi umuntu igazi, kusiza ukuhlolwa igazi. Inombolo kwamangqamuzana egazi abomvu aqala ukunqabela emahoreni ambalwa ngemva ukudabuka iphutha, kamuva baba nesifo sokuntuleka kwegazi okukhulu. abomvu egazi isivinini count ukwehla ukunquma ukushuba ukopha zangaphakathi. Ukuhlolwa kwegazi kufanele kwenziwe njalo ngemva kwamahora ambalwa, okuyinto ikuvumela ukulandelela Dynamics isimo lesiguli.

Shiya uphethwe nzima subcapsular nokopha: Ezinsukwini zokuqala ezimbalwa, isimo iziguli is eyanelisayo, khona-ke liwohloka e izilonda ezinjalo.

Ingabe izinkinga uphethwe ukudakwa utshwala isiguli noma nokuquleka kubangelwa kuhlasimulise nokulimala engqondweni.

izinyathelo zokwelapha

Abaningi banesithakazelo, njengoba uswidi isibindi igebe ukuthi ukwelashwa ngoludala yalesi sifo kungenzeka. ukuphathwa ukwa kungenzeka kuphela surgically. Donsela noma kunjalo ayikwazi ukuba: uma ungazinaki ukudabuka kwesibindi, imiphumela kungaba yingozi. I yokuyelapha ukumisa ukopha, susa zanqwabelana ngaphakathi komgodi ongaphakathi kwamathumbu wegazi nezicubu necrotic. Ukusebenza kuyadingeka ngokushesha ngangokunokwenzeka: ihora ukubambezeleka ngamunye kwandisa amathuba ukufa. Ukunqatshwa kwesicelo ukusebenza ulungisiswa kuphela uma Isisulu uphuthunyiswe esibhedlela ngisesimweni esibucayi inoperable.

Onalesi sifo of ukudabuka hepatic

Uma isiguli sine-ukudabuka isibindi, onalesi sifo kuxhomeke ezicini eziningana:

• izinga lomonakalo isitho;
• uhlobo ukulimala;
• yobudala lesiguli: izingane nasebekhulile ahlupheke amakhefu isibindi kakhulu ngoyisiwula kusinda kunakho kwezinye izigaba iziguli;
• Ukwenza ukuhlinzwa.

Yini kungaba izinkinga?

Omunye eziyingozi kakhulu kungenzeka ukuthi umataniswe nge isibindi ukudabuka kuyinto hematobilia. Lapho hemobilia kusuka imithambo yegazi baphazamiseka ngenxa yokulimala iqala buthelela emhlabeni imbobo we gallbladder futhi Bile notshwala izindlela. Hemobilia kungenziwa kuphela ukulungiswa ususe ukuxhumana phakathi isitsha futhi esinyeni nenyongo. Kungenjalo, isiguli singase ife ngenxa olubanzi ukopha.

inkinga lingandile kuba biligemiya. Lesi simo eba lapho wamshaya kanyekanye futhi Bile Amapayipi, futhi imikhumbi emikhulu. Kulokhu, igazi ungakwazi iyangena Bile. Izimo ezinjalo ziphathwa kuphela ukuhlinzwa.

Ngokuvamile ngenxa engafanele olwenziwa ukuhlinzwa, ukopha nokunwetshiwe kwenzeka ngokusebenzisa abakhwabanisi noma ngqo ngaphakathi komgodi ongaphakathi kwamathumbu. Ngokuvamile lokhu ukopha itholwa ngemva kwezinsuku ezimbalwa ngemva kokuhlinzwa. Ngaphezu kwalokho, ezinye iziguli subdiaphragmatic abscesses kwakhiwa, izinhlumba isibindi noma fistula nasezinkingeni ezilandela ngemva kokuhlinzwa.

Ukufa kwesibindi abathintekayo ngesikhathi sekhefu ezimweni eziningi zibangelwa ephoqelela ivolumu wegazi elahlekile. Inani labantu ababulawa esikhathini perioperative imayelana 9%. Uma isiguli umonakalo kwezinye izitho, le bebeletha inyuka kakhulu (ku-24%).

isibindi ukudabuka, izimbangela zezinkumbulo okungaba ahlukahlukene ngempela, isimo esiyingozi edinga lwezokwelashwa olusheshayo. Kungenjalo, ingozi eliphezulu sokufa ngenxa ezinzima igazi ukulahleka obuhambisana lolu hlobo ukulimala.