Kanjani ama-ascites akhiwa ngomdlavuza

Ama-Ascite yi-absorusion ye-liquid component noma i-lymph emgodini wesisu. Le nqubo ingenzeka ngezifo ezihlukahlukene kanye ne-pathologies, kodwa yinto ejwayelekile kakhulu yezifo zesibindi. Ngaphezu kwalokho, i-ascites ivame kakhulu emdlalweni, futhi ikakhulukazi ama-ascites ama-chysi (okwakhiwa ukuvinjelwa kwezitsha ze-lymphatic system).

Ezimweni ezingamaphesenti amahlanu, ukunyuka komdlavuza kuvela ngenxa ye-carcinomatosis yamapayetali nama-visceral amashidi e-peritoneum. Le nqubo ekugcineni iholela ekuvimbeleni (izithiyo) ezenzweni ze-lymphatic.

Ukuphindaphindiwe kwezinto ezenzekayo kuzo zonke izidakamizwa ezibulalayo eziphakathi kwamaphesenti ayishumi nanhlanu kuya kwamashumi amahlanu nanhlanu. Ukuthuthukiswa okungenzeka kakhulu kwama-ascites emathunjini ama-ovari, i- endometrium, isisu, izilonda ezincelisayo, i-bronchi nezinye izitho nama-tissue.

Cishe amaphesenti ayishumi nesishiyagalolunye sakhiwe ngesifo se-tumor se-parenchyma yesibindi. Ukucindezelwa kwesimiso esibucayi salesi sitho kuholela ekwakheni okusheshayo kwe-effusion emgodini wesisu, ngaphezu kwalokho, kulezi ziguli kuhlanganiswa hhayi ngokuthi i-hepatomegaly.

I-Pathogenesis nezimpawu ze-ascites emdlavuza

Ama-Ascite, izimpawu ziyisici kuye - ukwanda okubuhlungu kwesisu, kanye nesisindo sonke sesiguli. Ukucindezela okwandayo emgodini wesisu kuholela ezingeni eliphakeme le-diaphragm elimi, eliphinde lidale izimpawu ze-reflux ye-gastroesophageal (i-acid yokuphindaphinda nokuphuza, isisindo sokuhlanza nokuhlanza), i-orthopnea ne-dyspnea, i-compress syndrome (i-static syndrome).

Ekuhloleni ngokomzimba, inani elincani le-ascitic fluid (kufika kuma-milliliters angu-200) cishe akunakwenzeka ukuthola. Ivolumu ye-effusion kusuka kumahlanu amahlanu kuya ku-milliliters eziyinkulungwane ibonakala ngokubonakalayo ngenxa yokuhamba kwesifunda sezingxenyeni zangasese zesisu, isibonakaliso sokushintshashintsha kahle. Ubuningi obubonakalayo obunobuthi obuhambayo bokuthi "ukuhamba" phezu kwamagqabha lapho kushintsha isikhundla somzimba ngesikhathi sokucubungula.

Ama-Ascite emdlalweni, obangelwa ukuvinjelwa kwesimiso sezinambuzane esiqindi, kubonakala ngokukhuliswa kwemithanjeni engaphandle yodonga lwesisu. Izitebhisi ezikude zibonakala ngokubunjwa kwekhanda elithi "jellyfish head" (ukukhishwa kwendonga yangasese yangasese emanzini ase-ascites ngezindebe ezikhulisiwe nokukhulunywa ngazo).

Zibonisa futhi izimpawu eziningi eziyinkimbinkimbi: i-fluid emgodini wesikhala, ukufuduka kwe- apical impulse yenhliziyo, ne-edema yezingxenye ezingezansi ze-thalax (ikakhulukazi emaphethelweni nasesithombeni esiphansi).

Ezigabeni ezibulalayo zomdlavuza, ama-ascites aphakathi nendawo awanandaba isimo sesiguli futhi angabi yingozi empilweni, ngakho-ke, kusetshenziselwa imithi yokwelapha kuphela, okwandisa ukuphuma kwamanzi okuphuma emzimbeni futhi ngaleyo ndlela kuncishiswe ukukhipha ngaphakathi kwesisu.

Uma i-ascites itholakale, ukwelashwa kwenziwa nge-veroshpiron (i-spironolactone) eyaziwa ngokuthi "indinganiso yezokwelapha" ekwelapheni kwezimo ezinjalo. Inhloso yalesi sidakamizwa kuhlanganiswe ne-furosemide (loop diuretic), ikuvumela ukuba ususe ngaphezu komzimba kuze kufike ku-1000 milliliters ketshezi ngosuku.

Njengoba i-ascites ebizwa ngokuthi i-ascites kanye nokuba khona kobuhlungu kanye ne-tachypnea, i-paracenteis yesisu isenziwa (ukukhishwa kwodonga lwamathumbu ngenhloso yokususa isikhala). Ukugeleza kwenziwa okungenani amahora ayisithupha kuze kufike uketshezi lwe-ascitic ukungena emkhunjini. Umkhiqizo okhishwayo uthunyelwa ukuhlaziywa, ukuwuhlola ngokuqukethwe kwamaprotheni amaningi, ngokubunjwa kwengqikithi ye-LDH nokuqukethwe okwanele kwama-leukocytes. Ngaphezu kwalokho, umthamo uhlwanyelwe kumaphakathi wezakhi.

Umphumela omuhle wanikeza umphumela kwisici se-etiologic (ngokuqondile ku-tumor ngokwayo). Ngakho-ke, isixhumanisi esiholela ekutheni i-pathogenesis isuswe futhi i-ascites emdlalweni we-cancer.