1. Chiratidzo che hepatojugular reflux
Kana kutadza kwemoyo kurudyi kuchikonzera kuzara kwechiropa nekuzvimba, chiropa chinogona kudzvinyirirwa nemaoko kuti tsinga dzemutsipa dziwedzere kuvhurika. Zvikonzero zvinowanzoonekwa kushaya simba kwe ventricular yekurudyi uye kuzara kwehepatitis.
2. Chiratidzo chaCullen
Ichizivikanwawo sechiratidzo chaCoulomb, kubuda ropa rakaita sepepuru-bhuruu paganda rakatenderedza umbilicus kana madziro epazasi pedumbu chiratidzo chekubuda ropa kwakanyanya mukati medumbu, izvo zvinonyanya kuitika mukubuda ropa kwepamuviri, chirwere chepancreatitis chinoputika, aneurysm yedumbu remusana, nezvimwewo.
3. Chiratidzo cheGrey-Turner
Kana murwere akabatwa nechirwere chepancreatitis, muto wepancreas unoyerera uchipinda muchikamu chemuviri wechiuno nechekumativi, mafuta ari pasi peganda achinyungudika, uye capillaries dzinobvaruka nekubuda ropa, zvichikonzera kubuda kweruvara rwebhuruu-pepuru paganda munzvimbo idzi, izvo zvinonzi chiratidzo cheGrey-Turner.
4. Chiratidzo cheCourvoisier
Kana kenza yemusoro wepancreas ikadzvanya duct yenyongo, kana kenza yepakati nepazasi peduct yenyongo ikakonzera kuvharika, jaundice inoonekwa inoitika. Dundira renyongo rakazvimba iro risinganyorove, rine pamusoro wakatsetseka uye rinogona kufambiswa rinonzwika, iro rinonzi Courvoisier's sign, rinozivikanwawo seprogressive obstruction yeduct yenyongo.
5. Chiratidzo chekutsamwiswa kwemudumbu
Kuvapo kwekunzwa kurwadza, kurwadza kwekudzokera shure uye kushushikana kwemhasuru dzemudumbu panguva imwe chete kunonzi chiratidzo chekunzwa kurwadza kwemudumbu, chinozivikanwawo sekuti peritonitis triad. Ichi chiratidzo cheperitonitis, kunyanya nzvimbo yekukuvara kwekutanga. Kubatana kwemhasuru dzemudumbu kunoenderana nechikonzero uye mamiriro emurwere. Mamiriro ezvinhu anosiyana, uye kuwedzera kwekuvharika kwemudumbu chiratidzo chakakosha chemamiriro ezvinhu akaipisisa.
6. Chiratidzo chaMurphy
Chiratidzo cheMurphy chakanaka ndechimwe chezviratidzo zvakakosha pakuongororwa kwechirwere cheacute cholecystitis. Pakubata dumbu renyongo pasi pemucheto wekurudyi, dumbu rakazvimba rakabatwa uye murwere akakumbirwa kufema zvakadzika. Dumbu rakazvimba uye rakazvimba rakadzika pasi. Murwere akanzwa kurwadziwa kwacho kuchiwedzera uye akangoerekana abata mweya wake.
7. Chiratidzo chaMcburney
Kupfava uye kupfava kunodzoka pamucheto waMcBurney mudumbu rezasi rerudyi (panobatana umbilicus nechikamu chimwe chete kubva muzvitatu chepakati nekunze chemusana werudyi wepamusoro weiac) zvinowanzoitika muacute appendicitis.
8. Utatu hwaCharcot
Chirwere cheAcute obstructive suppurative cholangitis chinowanzo ratidza kurwadziwa mudumbu, dzihwa, fivha yakanyanya, uye jaundice, inozivikanwawo seChaco's triad.
1) Marwadzo emudumbu: Anoitika pasi pe xiphoid process uye kurudyi kumusoro, kazhinji colic, nekurwiswa kwe paroxysmal kana kurwadziwa kunoramba kuripo pamwe nekuwedzera kwe paroxysms, iyo inogona kupenya kuenda kufudzi rekurudyi nekumusana, ichiperekedzwa nekurutsa nekurutsa. Inowanzo konzerwa mushure mekudya chikafu chine mafuta.
2) Kutonhora nefivha: Mushure mekuvharika kwemugero wenyongo, kumanikidzwa kuri mukati memugero wenyongo kunowedzera, zvichikonzera hutachiona hwechipiri. Mabhakitiriya nehupfu zvinogona kuyerera zvichidzokera muropa kuburikidza nemugero wenyongo wecapillary uye hepatic sinusoids, zvichikonzera nyongo yechiropa, sepsis, septic shock, DIC, nezvimwewo, zvinowanzoonekwa sefivha yakapararira, nekupisa kwemuviri kusvika 39 kusvika 40°C.
3) Jaundice: Kana matombo avhara duct yenyongo, varwere vanogona kuita weti yero yakasviba uye mavara eyero paganda ne sclera, uye vamwe varwere vanogona kuva neganda rinokwenya.
9. Reynolds (Renault) zviratidzo zvishanu
Kuvharirwa mujeri nematombo hakurerutsi, kuzvimba kunowedzera, uye murwere anotanga kurwara kwepfungwa uye kuvhunduka zvichibva paCharcot's triad, iyo inonzi Raynaud's pentalogy.
10. Chiratidzo chaKehr
Ropa riri mudumbu rinomutsa diaphragm yekuruboshwe, zvichikonzera kurwadziwa kwefudzi rekuruboshwe, izvo zvinowanzoitika mukuputika kwesplenic.
11. Obturator chiratidzo (obturator internus muscle test)
Murwere akanga akarara pasi, chidya chekurudyi nechidya zvakachinjika uye zvakazotenderedzwa mukati, zvichikonzera kurwadziwa kwemudumbu rezasi rerudyi, uko kunoonekwa mu appendicitis (appendix iri pedyo nemhasuru ye obturator internus).
12. Chiratidzo chaRovsing (bvunzo yekuwedzera kwemvura mukoloni)
Murwere anenge akarara pasi, ruoko rwake rwerudyi ruchidzvanya dumbu rekuruboshwe uye ruoko rwake rweruboshwe ruchidzvanya ura hwepazasi, zvichikonzera kurwadziwa mudumbu rerudyi, izvo zvinoonekwa mu appendicitis.
13. Chiratidzo chekutsamwisa cheX-ray barium
Barium inoratidza zviratidzo zvekusvotwa muchikamu chemudumbu chine chirwere, nekubuda kwemvura nekukurumidza uye kuzadza kusina kunaka, nepo kuzadza kwakanaka muzvikamu zvemudumbu zvepamusoro nepazasi. Izvi zvinonzi X-ray barium irritation sign, iyo inowanzoonekwa muvarwere vane ulcerative intestinal tuberculosis.
14. Chiratidzo chedenderedzwa rechiedza kaviri/chiratidzo chechinangwa
Muchikamu chechirwere cheCrohn, CT enterography (CTE) yakagadziridzwa inoratidza kuti madziro emudumbu akasimba zvakanyanya, mucosa yemudumbu yakawedzera zvakanyanya, chikamu chemadziro emudumbu chakapatsanurwa, uye ring yemukati memucous nering yekunze yeserosa zvakawedzerwa zvakanyanya, zvichiratidza chiratidzo che halo mbiri.
15. Chiratidzo chemuzinga wehuni
Muchikamu chechirwere cheCrohn, CT enterography (CTE) inoratidza kuwedzera kwetsinga dzeropa dzinoyerera, zvichiratidzawo kuwedzera kwemafuta anoyerera uye kusaoneka kwemasero, uye kuwedzera kwemasero anoyerera, zvichiratidza "chiratidzo chehuni".
16. Enterogenic azotemia
Mushure mekubuda ropa rakawanda mudumbu repamusoro, mapuroteni eropa anogayiwa mudumbu, uye huwandu hweurea nitrogen muropa hunogona kuwedzera kwenguva pfupi, iyo inonzi enterogenic azotemia.
17. Chirwere cheMallory-Weiss
Kuratidzwa kukuru kwechirwere ichi kunowedzera kamwe kamwe mudumbu nekuda kwekusvotwa zvakanyanya, kurutsa nezvimwe zvikonzero, izvo zvinokonzera kubvaruka kwenguva refu kwemucosa ne submucosa ye distal cardiac cardiac ne esophagus, zvichikonzera kubuda ropa mudumbu rekumusoro. Zviratidzo zvikuru ndezve sudden Acute hematemesis, inotungamirwa nekudzongonyedzwa kana kurutsa kakawanda, inonziwo esophageal and cardia mucosal tear syndrome.
18. Zollinger-Ellison syndrome (gastrinoma, Zollinger-66Ellison syndrome)
Imhando yegomarara remudumbu rinoita sepancreatic neuroendocrine bundu rinoratidzwa nemaronda akawanda, nzvimbo dzisingawanzoitiki, mukana wekuwana matambudziko emaronda, uye kusapindura zvakanaka pamishonga yekudzivirira maronda nguva dzose. Manyoka, kubudiswa kweasidhi yakawanda mudumbu, uye huwandu hwakakwira hwegastrin muropa hunogona kuitika.
Matumbu emudumbu anowanzova madiki, uye anenge 80% ari mukati me "gastrinoma" triangle (kureva, nzvimbo inoungana gallbladder ne common bile duct, chikamu chechipiri nechechitatu che duodenum, uye mutsipa nemuviri wepancreas). Mukati me triangle inoumbwa nepanosangana), anopfuura 50% ematumbu emudumbu ane kenza, uye vamwe varwere vakapararira kana vawanikwa.
19. Chirwere chekurasa marara
Mushure mekuvhiyiwa kwegastrectomy, nekuda kwekurasikirwa nebasa rekudzora re pylorus, zviri mudumbu zvinodururwa nekukurumidza, zvichikonzera zviratidzo zvakawanda zvinonzi dumping syndrome, iyo inonyanya kuitika muPII anastomosis. Zvichienderana nenguva iyo zviratidzo zvinoonekwa mushure mekudya, zvakakamurwa kuita mhando mbiri: kutanga nekunonoka.
●Early dumping syndrome: Zviratidzo zvekushaya simba kwenguva pfupi zvakaita sekushaya simba kwemoyo, kudikitira nechando, kuneta, uye ganda rakachenuruka zvinoonekwa hafu yeawa mushure mekudya. Zvinoperekedzwa nekurutsa nekurutsa, kurwadziwa mudumbu, uye manyoka.
●Dambudziko rekunonoka kudya: rinoitika maawa maviri kusvika mana mushure mekudya. Zviratidzo zvikuru idzungu, ganda rakachenuruka, ziya rinotonhora, kuneta, uye kurova kwemoyo nekukurumidza. Maitiro acho ndeekuti mushure mekunge chikafu chapinda mudumbu, chinomutsa huwandu hwakawanda hweinsulin, izvo zvinozokonzera hypoglycemia inokonzeresa. Inonziwo hypoglycemia syndrome.
20. Absorptive dystrophy syndrome
Idambudziko rezvirwere apo zvinovaka muviri zvinoshomeka nekuda kwekusashanda zvakanaka kweura hudiki mukugaya nekupinza zvinovaka muviri, zvichiita kuti zvinovaka muviri zvisakwanise kunyudzwa zvakanaka uye kuburitswa mutsvina. Mukurapa, zvinowanzoonekwa semanyoka, kutetepa, kurema, mafuta nezvimwe zviratidzo zvekunwa mafuta, saka zvinonziwo steatorrhea.
21. chirwere chePJ (chirwere chepigmented polyposis, PJS)
Ichirwere che autosomal dominant tumor chisingawanzoonekwi chinoratidzwa neruvara rweganda ne mucosal, multiple hamartomatous polyps mudumbu, uye mukana wekukura negomarara.
PJS inoitika kubva paudiki. Sezvo varwere vachikura, mapolyps emudumbu anowedzera zvishoma nezvishoma uye achikura, zvichikonzera matambudziko akasiyana-siyana, akadai sekupinda mudumbu, kuvharika kwemudumbu, kubuda ropa mudumbu, kenza, kushaya chikafu chakakwana, uye kunonoka kukura kwevana.
22. Chirwere chemudumbu
Kumanikidzwa kwemukati medumbu kwemunhu akajairwa kuri pedyo nekumanikidzwa kwemhepo, 5 kusvika 7 mmHg.
Kumanikidzwa kwemukati medumbu ≥12 mmHg iBP iri mukati medumbu, uye kumanikidzwa kwemukati medumbu ≥20 mmHg kunoperekedzwa nekukundikana kwenhengo dzemuviri dzine chekuita neBP iri mukati medumbu idambudziko re abdominal compartment syndrome (ACS).
Zviratidzo zvekiriniki: Murwere ane chipfuva chakamanikana, kufema zvishoma, kufema zvakaoma, uye kurova kwemoyo nekukurumidza. Kuvhurika kwedumbu uye kushushikana kwakanyanya kunogona kuperekedzwa nekurwadziwa kwemudumbu, ruzha rwemudumbu rusina simba kana kunyangarika, nezvimwewo. Hypercapnia (PaCO?>50 mmHg) uye oliguria (kubuda kweweti paawa <0.5 mL/kg) zvinogona kuitika pakutanga kweACS. Anuria, azotemia, kutadza kufema uye low cardiac output syndrome zvinoitika padanho rekupedzisira.
23. Superior mesenteric artery syndrome
Inozivikanwawo se benign duodenal stasis uye duodenal stasis, zviratidzo zvakawanda zvinokonzerwa nenzvimbo isina kujairika ye superior mesenteric artery inodzvanya chikamu chakatarwa che duodenum, zvichikonzera kuvharika kwe duodenum zvishoma kana zvakakwana.
Zvinowanzoitika kuvakadzi vakuru vane asthenic. Kunzwa kuda kurutsa, kuda kurutsa, uye kurutsa zvinowanzoonekwa. Chinhu chinonyanya kukosha pachirwere ichi ndechekuti zviratidzo zvine chekuita nenzvimbo yemuviri. Kana munhu akarara, zviratidzo zvekumanikidzwa zvinowedzera, nepo kana munhu akarara, akarara pachipfuva, kana kuruboshwe, zviratidzo zvinogona kuderedzwa.
24. Chirwere chebofu chinotenderera
Chirwere chemanyoka, kupererwa neropa, kusanyorova muviri uye kudzikira kwehuremu kunokonzerwa nekumira kwezviri mudumbu diki uye kukura kwemabhakitiriya mudumbu. Chinonyanya kuonekwa mukuumbwa kwezvipenga zvemapofu kana mabhegi emapofu (kureva zvipenga zvemadumbu) mushure mekuvhiyiwa kwegastrointestinal anastomosis. Uye chinokonzerwa nekumira kwemasero eropa.
25. Chirwere chemudumbu mupfupi
Zvinoreva kuti mushure mekubviswa kweura hudiki zvakanyanya kana kubviswa nekuda kwezvikonzero zvakasiyana-siyana, nzvimbo inoshanda yekunyudzwa kweura inodzikira zvakanyanya, uye ura hwasara hunoshanda hahugone kuchengetedza kudya kwemurwere kana zvinodiwa nemwana pakukura, uye zviratidzo zvakaita semanyoka, acid-base/water/electrolyte disorders, uye zvirwere zvinotongwa nezvirwere zvekunyudzwa uye kushandiswa kwezvinovaka muviri zvakasiyana-siyana.
26. Chirwere cheHepatorenal
Zviratidzo zvikuru zvekiriniki ndeye oliguria, anuria uye azotemia.
Itsvo dzemurwere dzakanga dzisina maronda akanyanya. Nekuda kweBP yakanyanya uye kutenderera kweropa kwakanyanya, kufamba kweropa mumuviri kwakadzikira zvakanyanya, uye zvinhu zvakasiyana-siyana zvinoderedza ropa zvakaita seprostaglandins, nitric oxide, glucagon, atrial natriuretic peptide, endotoxin, uye Calcium gene-related peptides hazvigone kushaiswa simba nechiropa, zvichiita kuti tsinga dzemuviri dziwedzere; huwandu hwakawanda hwemvura yemudumbu hunogona kukonzera kuwedzera kwakanyanya kwepressure yemukati medumbu, izvo zvinogona kuderedza kufamba kweropa muitsvo, kunyanya renal cortex hypoperfusion, zvichikonzera kutadza kushanda kweitsvo.
80% yevarwere vane chirwere chinokurumidza kukura vanofa mukati memavhiki maviri. Rudzi urwu runowedzera zvishoma nezvishoma rwakajairika mukurapa, kazhinji rwunoratidza kubuda kwemvura mudumbu uye itsvo dzichitadza kushanda zvakanaka.
27. Chirwere cheHepatopulmonary
Zvichienderana nechirwere chechiropa, mushure mekusabvisa zvirwere zvemwoyo nemapapu, kushaya simba uye zviratidzo zvekushaya hope zvakaita se cyanosis uye clubbing yeminwe (zvigunwe) zvinoonekwa, izvo zvine chekuita nekuwanda kweropa mumapapu uye kusashanda zvakanaka kweoxygen muropa, uye fungidziro yacho haina kunaka.
28. Chirwere cheMirizzi
Kubatwa kwematombo mumutsipa wenyongo kana mutsinga dzemudumbu, kana pamwe chete nekuzvimba kwenyongo, kumanikidzwa
Izvi zvinoitika nekumanikidza kana kukanganisa nzira yeropa iri muropa, zvichikonzera kuwanda kwenyama dzakapoteredza, kuzvimba kana stenosis yenzira yeropa iri muropa, uye zvinoonekwa sezvirwere zvakasiyana-siyana zvinoonekwa ne obstructive jaundice, biliary colic kana cholangitis.
Hwaro hwekugadzirwa kwayo ndehwekuti cystic duct ne common hepatic duct zvakareba zvakanyanya pamwe chete kana kuti nzvimbo yekubatana kwe cystic duct ne common hepatic duct yakaderera zvakanyanya.
29. Chirwere cheBudd-Chiari
Budd-Chiari syndrome, inozivikanwawo seBudd-Chiari syndrome, iboka rechirwere cheportal hypertension kana portal uye inferior vena cava hypertension inokonzerwa nekuvharika kwetsinga yeropa kana inferior vena cava iri pamusoro peburi rayo.
30. Chirwere cheCaroli
Kukura kwemudumbu wemudumbu unobva muchiropa. Maitiro acho haana kujeka. Zvingangofanana necholedochal cyst. Kuwanda kwecholangiocarcinoma kwakakura kupfuura kwevanhuwo zvavo. Zviratidzo zvekutanga zvekiriniki marwadzo ehepatomegaly nedumbu, kunyanya se biliary colic, inoomeswa nechirwere che bacterial bile duct. Fivha uye jaundice inoitika panguva yekuzvimba, uye huwandu hwejaundice hunowanzova hushoma.
31. Chirwere chepuborectal
Chirwere chetsvina chinokonzerwa nekuvharika kwenzira yekubuda nayo muchiuno nekuda kwekukwenya kana kuwedzera kwetsandanyama dzepuborectalis.
32. Chirwere chepasi pechiuno
Inoreva boka rezvirwere zvinokonzerwa nekusagadzikana kwetsinga dzemudumbu muzvikamu zvepasi pechiuno zvinosanganisira rectum, levator ani muscle, uye external anal sphincter. Zviratidzo zvikuru zvekiriniki kuoma kwekubvisa tsvina kana kusazvidzora, pamwe nekumanikidzwa nekurwadziwa kwepasi pechiuno. Kusashanda zvakanaka uku dzimwe nguva kunosanganisira kuoma kubvisa tsvina, uye dzimwe nguva kusazvidzora tsvina. Muzviitiko zvakakomba, zvinorwadza zvikuru.
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Nguva yekutumira: Gunyana-06-2024