ithumba lesibindi

Liyini ithumba esibindini

Ithumba lesibindi yisimila esigcwele ubomvu. Ithumba lesibindi lingenzeka kunoma ubani. Ngokwayo, akukona ukuphila engozini, njengoba ubomvu buhlanganiswe futhi buhlukaniswe kuzo zonke izicubu. Kodwa kungaba yingozi uma i-capsule ivuleka futhi okuqukethwe kuphuma. Kungenzeka kungazelelwe, ngakho kufanele uhlole njalo nodokotela wakho.

Uma ithumba lesibindi lisheshe latholakala, ngokuvamile liyelapheka. Ngaphandle kokwelashwa, kungaqhuma futhi kusabalalise ukutheleleka, okuholela ku-sepsis, ukutheleleka kwegazi lebhaktheriya elisongela ukuphila.

Izimbangela zethumba lesibindi kubantu abadala

Kunezizathu ezimbili eziyinhloko ezingavusa ithumba esibindini.

Okuthathelwanayo:

• ukutheleleka kwebhaktheriya emgudwini we-biliary;
• ukutheleleka kwebhaktheriya emgodini wesisu ohambisana ne-appendicitis, i-diverticulitis, noma ukubhoboza kwamathumbu;
• izifo zegazi;
• I-Entamoeba histolytica infection (into ephilayo ebuye ibangele i-amoebic dysentery - ingadluliselwa ngamanzi noma ukuthintana komuntu nomuntu).

Okuhlukumezekile:

• i-endoscopy ye-bile ducts nama-ducts;
• amagalelo, izingozi;
• ukuwa kwempilo.

Kukhona futhi izici ezandisa ubungozi bokukhula kwethumba esibindini:

• Isifo sikaCrohn;
• isifo sikashukela;
• ukuguga;
• utshwala;
• ukukhubazeka kwamasosha omzimba ngenxa yezimo ezifana nesandulela ngculazi noma ingculazi, kanye namanye ama-immunodeficiencies, ukusetshenziswa kwe-corticosteroid, ukufakelwa kwezitho zomzimba, noma ukwelashwa komdlavuza;
• ukungondleki kahle;
• ukuya ezindaweni lapho izifo ze-amoebic zivamile.

Izimpawu zethumba esibindini kubantu abadala

Ukubonakaliswa okuyinhloko kwe-abscess yesibindi kanye nezikhalazo ngakho kuyahlukahluka, kodwa ngokuvamile kufaka phakathi inhlanganisela yezimpawu:

• ubuhlungu besisu (ikakhulukazi kwesokudla phezulu kwesisu noma ngaphansi kwezimbambo);
• indle enombala wobumba noma empunga;
• umchamo omnyama;
• ukuphuzi kwesikhumba nokumhlophe kwamehlo (i-jaundice);
• isifo sohudo;
• imfiva noma amakhaza;
• ubuhlungu obuhlangene;
• isicanucanu ngokuhlanza noma ngaphandle kokuhlanza;
• ukulahlekelwa ukudla;
• ukuncipha kwesisindo okungaqondakali;
• i-malaise noma ukukhathala;
• ukujuluka.

Kwezinye izimo, ithumba lesibindi lingaba yingozi kakhulu empilweni. Shayela u-XNUMX ngokushesha uma isiguli sinalezi zimpawu:

• ukushintsha okungazelelwe kokuziphatha, njengokudideka, ukudangala, ukukhathala, ukubona izinto ezingekho, nokuba nekhanda elilula;
• izinga lokushisa eliphezulu (ngaphezu kuka-38 ° C);
• ukuyaluza noma ukukhathala;
• ukushaya kwenhliziyo okusheshayo (tachycardia);
• izinkinga zokuphefumula ezinjengokuphelelwa umoya, inkinga noma ukungakwazi ukuphefumula, ukuhefuzela noma ukuklinywa;
• ubuhlungu obunamandla;
• ukuhlanza.

Ukwelashwa kwethumba lesibindi kubantu abadala

Ukuxilongwa kuqinisekiswa uma kunezindawo ze-cystic noma ezinzima esibindi, lapho uketshezi lwe-purulent olunamasiko amahle lukhishwa lapho okuqukethwe kuthathwa. Kubalulekile ukuthola lezi zivivinyo ngokushesha futhi uqale ukwelashwa ngenxa yengozi enkulu yezinkinga.

Diagnostics

Ngemva kokuhlola nokuqoqa i-anamnesis mayelana nokuthi isiguli sagula kanjani, kufanele kwenziwe ukuhlolwa okuningi. Okokuqala, lokhu ukuhlolwa kwegazi okujwayelekile - ama-enzyme e-serum abonisa ukusebenza kwesibindi (i-alkaline phosphatase, i-ALT, i-AST), isiko legazi, isikhathi se-prothrombin kanye nesikhathi esicushiwe se-thromboplastin, ukuhlolwa kwe-serum yama-antibodies ku-Entamoeba histolytica,

Ngaphezu kwalokho, kuzothathwa ukuhlaziywa kwesihlalo se-Entamoeba histolytica antigen futhi kuzokwenziwa ukuhlolwa kwe-antigen noma i-polymerase chain reaction (PCR) yoketshezi lwe-abscess aspirated.

Benza futhi i-ultrasound yesibindi kanye ne-computed tomography.

Ukwelashwa kwesimanje

Ithumba lesibindi liphathwa ngazo zombili izidakamizwa nokuhlinzwa.

Ama-antibiotics. Ama-antibiotic ahlukahlukene asetshenziselwa ukwelapha ithumba lesibindi. Ukukhetha kwabo kuncike esimweni sokutheleleka. Izidakamizwa eziyinhloko:

• ama-aminoglycosides afana ne-amikacin (Amikin) noma i-gentamicin (i-Garamycin);
• clindamycin (Cleocin);
• inhlanganisela ye-piperacillin-tazobactam (Zosin);
• Metronidazole (Flagyl).

Uma kuyithumba le-amoebic, ngemva kokuba isifo seselaphekile, isiguli sizonikezwa omunye umuthi wokubulala i-amoeba emathunjini ukuvimbela ithumba ukuthi lingaphindeli.

izindlela zokuhlinza. Zihlukile, futhi ukukhetha kuncike ezingeni lokulimala kwesibindi kanye nobukhulu besimo sesiguli:

• i-aspiration - kulokhu, ubomvu bukhishwa ngenaliti emgodini wesisu, kwenzeka izikhathi eziningana (ngamathumba angaphansi kuka-5 cm ububanzi);
• i-drainage - idinga ukufakwa kwe-catheter ukukhipha ubomvu (ithumba elingaphezu kuka-5 cm ububanzi).

Zombili lezi zinqubo ziyi-laparoscopic, eyenziwa ngokusikwa okuncane. Kodwa ngezinye izikhathi ukuhlinzwa okuvulekile kuyadingeka ngenxa ye-peritonitis, amathumba anezindonga eziqinile, amathumba aphukile, amathumba amakhulu amaningi, kanye nezinqubo zokukhipha amanzi ezihlulekile ngaphambilini.

Ukuvimbela ithumba kwesibindi kubantu abadala ekhaya

Akwenzeki ngaso sonke isikhathi ukugwema ithumba esibindini. Kodwa-ke, ezimweni eziningi, unganciphisa ubungozi bokuthola izifo ngokugwema ukusetshenziswa kokudla noma amanzi angcolile, unciphise ukuya ezindaweni lapho izifo ze-amoebic zivame khona.

Imibuzo nezimpendulo ezidumile

Uphendule imibuzo yethu mayelana nethumba lesibindi i-gastroenterologist, i-hepatologist, isazi sokudla okunomsoco u-Natalya Zavarzina.