Isisu esisemthonjeni yokubeletha: izimpawu, izimbangela, ukwelashwa

I-clinical syndrome, ebangela ubuhlungu obukhulu kakhulu esifundeni sesisu, ukungezwani kwemisipha ehambisanayo kanye nesifo se-stool kubizwa ngokuthi yisisu esibukhali. Uma izimpawu ezinjalo zivela, udinga ukubiza i-ambulensi, ngoba isiguli singase sidinge ukuhlinzwa.

Izimpawu zezifo

Igama elithi "isisu esiswini" sihlanganisa izinqubo eziningana ze-pathological ezenzeka ezingxenyeni zesisu esiswini. Izimbangela zalenkinga kufanele ziphenywe odokotela, kodwa izimpawu ezihambisana nazo kufanele zaziwe kuwo wonke umuntu. Lokhu kuzosiza ukuqonda ukuthi yisikhathi sokubiza odokotela.

Umtholampilo wesisu esiswini somzimba wesifo somzimba, njengombuso, ufana nazo zonke iziguli. Ngokungazelelwe, ngesimo esijwayelekile sempilo, ubuhlungu buba khona. Ngokuvamile, abesifazane bangabiza ngisho nesikhathi esiqondile lapho evele khona. Ezimweni eziningi, iqala ngesisu esingaphansi. Ngokuhamba kwesikhathi, ubuhlungu buyasakazeka endaweni yonke yomzimba futhi luyaqina. Abanye abakwazi ukuma futhi bangalahlekelwa.

Ngaphezu kwalokho, kunezinye izibonakaliso lapho kungenzeka khona ukuxilonga isisu esisemthonjeni yokubeletha. Izimpawu zingaba: ukuhlanza, ukucabangela, ukucasuka kwe-peritoneum, ukuphulwa okuhlobene nokuphunyuka kwamagesi namanzi. Uma isithombe sekliniki esichazwe senziwa, kubalulekile ukubiza i-ambulensi. Ochwepheshe kuphela bangaqonda ukuthi kwenzekani, futhi bakhulise isiguli esibhedlela sephrofayli.

Ngesinye isikhathi iziguli nazo zikhononda ngobuthakathaka, isizungu nokucindezeleka ku-anus.

Izimbangela zezinkinga

Kukhona isimo esichazwe ngokuphuma kwegazi kwangaphakathi, izifo ezingenasifo se-digestive system, appendicitis, izinyembezi zesibindi, i- spleen. Ngokuvamile kukhona isisu esisimweni sokugaya izifo. Ubuhlungu bungabonisa ukukhulelwa kwe-ectopic, i-ovarian apoplexy, izifo ezivuthayo ezithombeni zobulili, uma i-peritoneum ihilelekile kule nqubo. Futhi, lezi zimpawu zingenzeka ezimweni zokuphazamiseka kwegazi ngaphakathi kobulili zangaphakathi. Lokhu kungahle kwenzeke, isibonelo, ekuphambeni kwemilenze yokubunjwa kwe-ovaries, ama-necrosis noma ukuphikisana kwama-node ama-myomatous.

Ngeke kwenzeke ukuxilongwa ekhaya. Ngakho-ke, izizathu zesisu esisemqoka (ngokuphathelene nokubeletha ikakhulukazi) kufanele zicaciswe kuphela ochwepheshe abaqeqeshiwe. Noma yiziphi izinkinga ezichazwe kudinga ukuxilongwa okusemandleni. Usizo kulokhu kumele lunikezwe ngokuphuthumayo.

Ukukhetha ukuxilongwa

Izifo ezivusa isifo sesisu esiswini ziyingozi kakhulu. Ngakho-ke, kubalulekile ukusungula ukuxilongwa okulungile ngokushesha ngangokunokwenzeka. Ukuxilongwa ngokwehlukana kwesisu esisemkhatsini wezinkinga zokubeletha kuvumela ukuba kungabikho ukutholakala kwamanye amagciwane (isib. Ukufakelwa kwesisu, ukuphazamiseka kwesifo somzimba, ukunyuka kwe-cholecystitis, ukuvimbela emathunjini ngendlela elula) nokusheshisa ukuhlonza izimbangela zabo.

Kule nkathi iminyaka yobuguli ibalulekile. Isibonelo, kwabesifazane ngesikhathi sokuya esikhathini, ukuphuma esikhathini sokuqala, emantombazaneni abancane nabesifazane abangeke baphile ngokocansi, ungakwazi ukukhipha ngokushesha amathuba okukhulelwa. Kanti futhi ngokuvamile abanaso izifo ezivuthayo. Iziguli ezinjalo azivami ukuya ku-gynecologist. Kungenzeka babe ne-appendicitis noma isifo sofuba.

Kodwa ukuphathwa kokwelapha ngokushesha kuqhubekela phambili umqondo wokuthi kungenzeka ukufakelwa kweqanda lomntwana emashubhu. Kungenzeka futhi uma owesifazane ngaphambili ekhulelwe i-ectopic pregnancy. Uma isiguli sinesifo sokuvuvukala ku-anamnesis yakhe, mhlawumbe lokhu kungenye yezinkathi zokucindezela.

Ukuthola ukuphuma kwegazi ngaphakathi

Kubalulekile odokotela hhayi nje ukuqhuba ucwaningo oluningiliziwe, kodwa nokuhlola isiguli. Lena yindlela ewukuphela kokuthola ukuthi "isisu esiswini" (ngesisu). Ukunakekelwa okuphuthumayo kuzonikezwa ngokushesha uma odokotela bengakwazi ukuqonda ngokushesha ukuthi yini eyabangela inkinga.

Isibonelo, mayelana nokusuka kwegazi ngaphakathi kwesisu kuwubufakazi bokungathembeki, amandla, ukucindezeleka kwengcindezi. Ubuso besiguli buzobe bubala, izindebe ze-cyanotic, i-pulse ivuselelwe futhi ithambile. Lokhu kungabonwa nge-ectopic pregnancy, i-ovarian apoplexy noma i-uterine perforation.

Esimweni sokuqala, le nkinga ihambisana nokulibaziseka esikhathini sokuya esikhathini, ukukhipha imfihlakalo emnyama ebusweni. Futhi, abesifazane bathola ukujuluka okunamathelayo, isisindo esivulekile, isicanuca kungenzeka. Ukushisa kuhlala kujwayelekile.

Njengoba i-ovary i-apoplexy, isisu esisimweni sokubeletha sitholakale, njengombuso, izinsuku ezimbalwa ngemva kokuphela kokuya esikhathini. Lokhu kwenzeka nxazonke ze-ovulation. Ukusola kwe-apoplexy kungenzeka uma isiguli sinomlando wama-cysts ovari.

E-perforation yesibeletho kungenxa yezimo lapho isisu somzimba esiswini senzeke ngemuva kokuchungechunge lwezinkinga zomzimba noma ukungenelela kokuhlinzwa. Ubuhlungu bungabonakala emva kokusungulwa noma ukususwa kwe-spiral, ukukhipha isisu noma ukukhishwa kwesifo. Izimpawu zingase zenzeke ngokushesha ngemva kwe-perforation noma emva kwezinsuku ezingu-1-2, lapho i-peritonitis iqala ukuthuthukisa.

Ukukhulelwa kwe-Ectopic

Kwezinye izimo kwenzeka ukuthi iqanda elikhuliswe lihlanganiswe bese liqala ukuthuthukisa ngaphandle kwezindonga zesisu. Lesi simo senziwa ngokwesilinganiso ngo-1.3% wukukhulelwa konke. Ngokuvamile, iqanda linamathele embumbeni we-fallopian - lokhu kwenzeka ngo-99% wazo zonke izimila ze-ectopic. Kodwa zikhona izimo lapho zitholakala kuma-ovari, umlomo wesibeletho noma ngisho nesisu somzimba. Ukuthuthukiswa kokukhulelwa kuyaqhubeka, ngokuvamile kuya emavikini angu-5-8. Emva kwalokhu, kukhona ukukhipha isisu. Yilokho okubizwa ngokuthi inqola yeqanda le-fetal elivela ezindongeni nokuxoshwa kwalo emgodini wesisu. Kulapho kubalwa futhi kuhlanganiswe. Kodwa ngezinye izikhathi umphumela ohlukile kungenzeka - ukuphula i-tube uterine.

Kulezo zimo lapho iqanda likhulelwa ngokushesha emva kokuvuthwa, lingakwazi ukunamathisela emgodini we-ovari noma wesisu. Esikhathini esilandelayo, sinamathele, njengombuso, ebusweni besibindi noma i-omentum.

Isisu esisemthonjeni yokubeletha singenzeka uma i-tube iphula noma iphazamisa ukukhulelwa kwesibhukela. Kwezinye izimo, kukhona esinye isithombe somtholampilo.

Izimbangela ze-ectopic pregnancy

Uma iqanda lokubeletha litholakala ngaphandle kwesibeletho, kubalulekile ukuqonda amanye amaqhinga okwelapha. Kodwa kuyadingeka ukuthola ukuthi yini eyaholela ekusungulweni okunjalo. Ngezinye izikhathi lokhu kwenzeka nge-infantilism yesisu. Le nkinga ixoxwa uma kwenzeka isiguli sigcine isikhathi eside futhi sine-tubolpio tubes nge-peristalsis encane.

Ezimweni eziningi, iqanda le-fetal lisetshenziselwa ukungena esibelethweni, ngenxa yokuthi inqubekela phambili yayo iyancipha. Lokhu kwenzeka ngezinqubo zokuvuvukala kulezi zingxenye zokusebenza, ngenxa yokubunjwa kokunamathela ngenxa yokusebenza okudlulisiwe emgodini wesisu noma kumatayipi. Esikhathini esilandelayo, zakha izicubu zomzimba, inkontileka ayikho kahle.

Futhi, lezi zici ezilandelayo zinomthelela omubi kwi-peristalsis yamapayipi:

- ukukhulelwa kwe-intrauterine;

- endometriosis yamatayipi;

- izinkinga nge-endocrine system (izifo ze-adrenal ne-thyroid gland);

- ukucindezeleka;

- ukuphathwa kwamalungiselelo e-progesterone.

Amathuba okufakwa kwe-ectopic yeqanda le-fetal ekhuphuka futhi enama-tumorous in the pelvis encane. Bangakwazi ukufakela amashubhu futhi bavimbele ukuhamba okuvamile kweqanda elikhulelwe.

Kungakhathaliseki ukuthi kungani iqanda le-fetal lihlanganiswe ne-tube, umphumela uzoba owodwa. Ukukhulelwa okunjalo kuzophazanyiswa. Ngaphezu kwalokho, uma kungenakutholakala futhi kuphazanyiswa ngokuhamba kwesikhathi, kuyoholela ekutheni owesifazane ufunda ngokuhlangenwe nakho kwakhe okudabukisayo ukuthi i-syndrome yesisu esisemthonjeni yokubeletha ibonakala kanjani.

I-ovarian apoplexy

Abesifazane beminyaka yobudala bangase bahlakulele izifo eziholela ekuguleni kwesisu esiswini. Lokhu kungase kube ukuphazamiseka (infarction, hematoma) ye-ovary. Lokhu ukwephulwa kobuqotho bayo ngokuqeda imfucuza kanye nokuqala kokuphuma kwegazi emgodini wesisu.

Lesi sifo siqala ngezinhlungu ezinzima ngokuzumayo, okuyinto, njengombuso, zikhona endaweni eyodwa. Izimpawu zokucasula i-peritoneum zingahle zivezwe kalula. Kubalulekile ukungadibanisi i-apoplexy ye-ovary ne-appendicitis, ngoba isithombe somtholampilo sezifo zezifo sifana.

Izicubu

Kubalulekile ukwazi zonke izimbangela zesisu esisemkhatsini wezinkinga zokubeletha. Phela, akulona njalo ngokumelene nesimiso se-intra-abdomrhage. Futhi, lesi sifo singase senzeke lapho idolo le-tumor liqhutshwa ku-ovary liphikisiwe, noma ukuhlushwa (nakwezinye izimo ze-necrosis) ye-node ye-myomatous. Ukuthuthukiswa kwesimo esinjalo kungenzeka uma ukubunjwa kungokwesayizi encane futhi kutholakala emlenzeni omude ohambayo.

Ukuqhuma kwesisu kuqala ngezinhlungu ezinzima, kuhambisane nokuhlanza noma ukucabangela nje. Ngokuvamile bahlotshaniswa nokunyakaza okungazelelwe noma ukuzikhandla ngokomzimba. Iziguli zinodonga oluncibilikisiwe lwe-peritoneum, ukugcinwa kwesitoreji kugcinwa. Isikhumba siphundukile, sigcwele ukujula okubandayo, iziguli zine-pulse njalo kanye nolimi olomile. Ukushisa komzimba kungaphakanyiswa.

Lapho i- myomatous knot iphikisiwe , izinhlungu ziyancipha, isithombe sokudakwa ngokweqile- kulimi olumile, isikhumba, izinga lokushisa 38-39 ⁰ C, isicashu, ukuhlanza kungenzeka. Egazini, inani lama-leukocyte lizokwandiswa. Ukuhlolwa kwe-gynecological kubonisa ukukhula okukhulu.

Izinqubo zokuvuvukala

Isibeletho esilula emithonjeni yezinkinga zokubeletha nesifo somzimba singase siphakamise isizinda sokukhushulwa kwezifo eziningana. Kungaba izinqubo zokuvuvukala kwezitho zangasese zangaphakathi. Ngenxa yalokhu, isiguli singathuthukisa i-pelvio-peritonitis (ngenqubo encane ye-pelvis) noma i-peritonitis (emgodini wesisu).

Izinkinga zingaqala lapho:

- ukukhiqizwa kokutheleleka kudlula ngemuva kwe-adnexitis noma i-metroendometritis;

- ukuhlukana kwe-sutures esetshenziselwa isigaba se-caesarean;

- ukuguqulwa kwesisu (emva kokukhishwa kwayo);

- Ukuguqulwa kwe-piovar noma i-pyosalpinx.

Kulezi zimo, ukubonakaliswa kwemitholampilo kungase kuhluke kuye ngokuthi yini eyabangela ngempela isifo sesisu esiswini.

Amacebo okuphathwa

Kungakhathaliseki ukuthi izizathu ezenza ukuthi ukutholakala "kwesisu esisemthonjeni yokubeletha" kusungulwe, ukwelashwa kufanele kwenziwe esibhedlela. Uma ukuphazamiseka okubuhlungu noma okubuhlungu, kubalulekile ukunikeza abanikazi bama-painkillers, ukwethula izidakamizwa ze-hemostatic, ukufaka esikhundleni segazi. Kubalulekile ukukhumbula ukuthi kunengozi yomphumela obulalayo, ngakho-ke ukuxilongwa kufanele kwenziwe ngaphandle kokulibala.

Uma ukukhulelwa kwe-ectopic kungatholakala ngaphambi kokuqala kobuhlungu, kuphazanyiswa ngendlela ehleliwe. Ngokusemthethweni, odokotela benza umsebenzi we-laparoscopic futhi iqanda elincane likhishwa ngokusebenzisa ukuqubuka okuncane. Kodwa ngokuvamile kuvame ukutholakala kwendawo yangakapheli lapho isiguli esise-ambulensi sithathwa esibhedlela ngokuxilongwa "kwesisu esiswini."

Ezinzini zokubeletha, isimo esiyingozi kunazo zonke lapho i-tube fallopian rupture. Kodwa kaningi ukukhulelwa kuphelela kulezo zingxenye zeqanda lomntwana ngegazi zixoshwa emgodini wesisu. Lokhu, njengomthetho, kuhambisane nokuphuma kwegazi ngaphakathi nangesisu futhi kubangele izimpawu ezichazwe.

I-pathology engeyona eyingozi kakhulu i-ovarian apoplexy noma i-uterine perforation. Kulezi zimo, i-intra-abdomrhage iqala futhi. Ngesinye isikhathi ngisho nokusungulwa okusheshayo kwezidakamizwa ezikhethekile esikhundleni segazi kuyadingeka.

Noma yiziphi izifo ezivuthayo zidinga ukwelashwa okufika ngesikhathi nokuqapha isimo sesiguli.