Kev cuam tshuam hauv plab yog kab mob tshwm sim los ntawm kev ua haujlwm tsis zoo ntawm lub cev thiab ua rau lub cev tsis muaj zog, cov hnyuv hauv lub cev tsis tuaj yeem tshem tawm, ua rau lub plab zom zaub mov, tuag tes tuag taw, thiab tom qab ntawd cuam tshuam. Kev rhuav tshem txoj hnyuv hauv cov nyuj mis nyuj yog ib hom mob plab tsis ncaj uas tshwm sim los ntawm kev mob plab zom mov, uas ua rau muaj kev cuam tshuam ib nrab lossis ua tiav ntawm ib lossis ntau qhov hnyuv. Tus kab mob no yog ib yam kab mob sib kis tshaj plaws nyob hauv nyab nyuj sib nraus. Yog tias pub mis tsis zoo, zom tau yooj yim thiab noj zaub mov zoo rau lub sijhawm ntev, nws yooj yim ua rau lub plab ua haujlwm tsis muaj zog thiab ua rau lub plab zom mov, nws yuav tsum tiv thaiv thiab kho kom zoo. Cov hauv qab no yog nkag siab: ua rau muaj kev cuam tshuam hauv plab hnyuv hauv cov nyuj nyuj, cov tsos mob ntawm kev kuaj mob thiab kev tiv thaiv kab mob hauv plab hauv cov nyuj nyuj.
1. Kev txheeb xyuas Etiological
Clinically, nyuj nyuj muaj feem ntau ua rau lub plab tsis ua tiav, uas tsis yog tsuas yog cuam tshuam nrog kev tsis raug kev noj haus thiab kev tswj hwm, noj zaub mov tsis zoo, tsis muaj zaub mov zoo, tsis muaj dej haus thiab lwm yam tab sis kuj muaj tshwm sim thaum cev xeeb tub, tshwj xeeb yog thaum cev xeeb tub lig, vim kev loj hlob sai ntawm tus me nyuam hauv plab, lub plab hauv siab tau nce ntau, ua rau lub plab zom mov pom tseeb cov tshuab nrawm, uas ua rau lub zog peristaltic tsis muaj zog, ua rau qeeb rov qab thauj ntawm cov hnyuv, nqus cov dej noo uas muaj nyob hauv ntau cov ntsiab lus, ua kom lawv qhuav, thiab tsis nyob hauv thaj chaw no, yog li ua rau pib muaj tus kab mob.
2. Cov tsos mob
Nyob rau theem pib ntawm qhov pib, cov nyuj muaj mob tau qhia pom mob plab. Thaum sawv ntsug, lawv yuav ncaws thiab ncaws lawv ob txhais ceg tsis tu ncua, tsis so, thiab ncaws lawv ob txhais ceg tom qab pw hauv av. Nrog kev nce qib ntawm cov kab mob, feem ntau tom qab 4 hnub, cov tsos mob ntawm lub plab yuav maj mam yooj yim lossis ploj mus tas li, kev nyuaj siab, tsis kam taug kev, txawm tias lub siab xav tso quav tab sis tsis tuaj yeem tso tawm tau yooj yim, qee zaum peptone-zoo li cov hnoos qeev tuaj yeem raug tso tawm, yog tias ceg tshwm sim tsis tiav qhov thaiv yuav tsim cov xim daj-xim av.
Cov neeg yug tsiaj nyuj yuav tsum tso tseg kev noj zaub mov, qeeb lossis ua kom tiav ntawm rumen peristalsis, palpation ntawm rumen xav tias mos thiab muaj kev nkag siab ntawm qhov hloov pauv. Feem ntau, lub cev kub tsis nce siab, thawj lub plawv dhia zoo li qub tom qab tsib hnub yuav mus txog ntau dua 100 zaug hauv ib feeb, nrog rau pom lub cev qhuav dej, pom kev nyuaj siab. Thawb lub tsho tshaj sab xis nrog lub nrig yuav ua rau muaj suab nrov. Yog tias nws zoo li hauv qab kab tav, qhov ua rau duodenal feem ntau tshwm sim, lossis kev pyloric obstruction yuav tshwm sim. Yog tias nws tshwm sim nyob ib puag ncig ntawm qhov chaw thawb, caecum, txoj hnyuv lossis ileum ua rau muaj kev cuam tshuam.
3. Kev tiv thaiv thiab tswj kev ntsuas
Tshuaj
Kev kho tshuaj sab hnub poob feem ntau lees txais kev quav dej quav cawv thiab tswj kev sib xyaw ntawm 5000-8000 mL dej, 500-800 g mirabilite thiab 100 g rhubarb hmoov los ntawm pais plab cev. Tom qab 3-4 teev, 2-3 mg ntawm Formylcholine lossis 30-50 mg ntawm pilocarpine tuaj yeem txhaj tshuaj subcutaneously. Kev ua kom loog tuaj yeem muab los ntawm kev txhaj tshuaj txhaj tshuaj ntawm 30 mL Analgin, txhaj tshuaj ntawm 1000-2000 mL 5% cov piam thaj hauv ntshav, 50 mL 5% vitamin C txhaj tshuaj thiab txhaj tshuaj intramuscular ntawm 20 mL 20% Analgin Caffeine ib hnub ib zaug rau 2-3 hnub.
Knotting txoj kev kho
Kev soj ntsuam hauv plab ntawm cov nyuj muaj kab mob tuaj yeem tsoo lub ntsej muag loj thoob plaws hauv lub qhov quav yog tias pom tias muaj qhov cuam tshuam loj nyob rau sab nraub qaum ntawm ob lub raum sab laug lossis hauv qab lub plab phab ntsa ntawm txoj cai hnav tsoos tsho; yog tias muaj qhov cuam tshuam loj heev nyob rau sab ib sab ntawm duodenum thiab nws tau tsim los ntawm cov hauv paus hniav cog, nws tuaj yeem tsoo ncaj qha, tab sis yuam kev kneading yog txwv tsis pub txhawm rau tiv thaiv kev puas tsuaj rau phab ntsa hauv plab.
phais kho mob
Cov muaj mob mis nyuj ntog rau hauv av ntawm sab laug, rub thiab tsau lawv lub hauv pliaj rau pem hauv ntej nrog cov hlua, rub thiab kho lawv cov nqaj qaum rov qab, thiab rub lawv lub taub hau nrog lub hnab knitted kom tsis txhob tawv nqaij tawv. Tom qab ntawd cov neeg ua liaj ua teb mis nyuj yuav tsum xaiv txoj cai posterior tav koov nqaij fossa rau kev phais, txiav nws cov plaub hau, tom qab ntawv thov 5% iodine tincture rau kev tua kab mob, tom qab ntawd siv 75% cawv rau deionization, cim qhov ntev ntawm qhov chaw phais, feem ntau nrog kab tav kawg raws li qhov taw qhia tawm, 5 cm deb ntawm tus tav tom qab, 6-10 cm hauv qab txoj kev hloov pauv ntawm tus nqaj nqaj qaum ua qhov pib, ntsug lossis raws nws.
Hauv qhov kev taw qhia ntawm tus tav tav, 15 N18 cm cim tau kos nrog cov quab yuam hemostatic. Kev txhaj tshuaj ntawm 500 mL ntxiv rau 0.9% saline lossis 5% glucose nrog 30 mL hemostatic rhiab heev tau siv rau hemostasis. Txoj kev ua tshuaj loog ua ke nrog paralumbar hlab ntsha ua kom siv tshuaj loog thiab tshuaj loog tau siv, piv txwv li 10 mL 2% procaine hydrochloride tau txhaj rau hauv cov txheej txheem ntawm thawj, thib ob thiab plaub lub lumbar vertebrae feem, tom qab ntawd 100 mL O.5% procaine hydrochloride yog txhaj subcutaneously thiab leeg nqaij ntawm cov ntsiab lus sib txawv hauv thaj chaw ua haujlwm.
Tom qab 5-15 mln, cov nyuj muaj mob tuaj yeem ua tshuaj loog thiab tom qab ntawd ua kom loog. Txhim kho qhov txhab ntawm lub phuam kom zoo, thaum siv rab koob koob rab koob siv rau ntawm daim tawv nqaij ntawm lub chaw ua haujlwm, kev ua haujlwm tuaj yeem ua tau yam tsis muaj mob. Cov tshuaj loog dav tuaj yeem kav ntev li 1.5-2 teev. Tus kws phais neeg txiav lub plab ntawm phab ntsa hauv lub tsho tshaj sab, tshuaj xyuas txoj hnyuv thiab duodenum sab nraum lub qhov zis ntau dua los txiav txim seb puas muaj qhov thaiv, thiab tom qab ntawd mus ncig qhov qhov omentum ntau dua los tshawb xyuas qhov thaiv.
Yog tias muaj kab mob plab tshwm sim, nws tuaj yeem tsoo ncaj qha hauv lub plab kab noj hniav; yog tias duodenal obstruction yog tshwm sim los ntawm cov khoom noj, nws kuj tseem tuaj yeem tsoo ncaj qha; yog tias duodenal obstruction yog tshwm sim los ntawm cov nyom nyom nyom nyom, nws tsis tuaj yeem yuam kom zom, nws tuaj yeem txhaj nrog cov roj tsim nyog ntawm ntau lub ntsiab lus, yog li nws tuaj yeem tso tawm ntawm nws tus kheej; Kev thaiv ntawm lub cov hnyuv yog tshwm sim los ntawm cov hauv paus ntoo. Nws yog thawj zaug pinched rau hauv lub voj voog thiab thawb mus rau txoj hnyuv noj qab haus huv. Tom qab ntawd txoj hnyuv yog txiav thiab tshem tawm.
Yuav kom zam kab mob, 8 lab IU tshuaj penicillin sodium tuaj yeem raug txhaj rau hauv lub plab kab noj hniav txhawm rau txhawm rau txhawm rau txhawm rau lub plab, hauv plab, thiab cov leeg ua ke. Nws yuav tsum tau sau tseg tias txhua txheej yuav tsum tau ntxuav nrog cov ntsev ib txwm muaj, thiab cov tshuaj tua kab mob huv huv tau siv los nqus dej, thiab tom qab ntawd 4 lab IU penicillin sodium hmoov tau txau. Cov tawv nqaij txheej yog sutured los ntawm nodules, smeared nrog tsim nyog iodine glycerin, thiab tseem, cov tawv nqaij txheej yog sutured nrog iodine glycerin. Lub qhov txhab raug tsau nrog daim ntaub pov thaiv kom tsis txhob kis kab mob. Tom qab ua haujlwm, cov tsiaj muaj mob tau txhaj tshuaj nrog 500 mL O.9% saline thiab 1.6 lab IU gentamicin txhua hnub. Yim teev tom qab ua haujlwm, cov nyuj muaj mob tuaj yeem tso quav tau yooj yim, lub plab hauv plab me dua, thiab lawv tuaj yeem noj quav nyab me me. Tom qab 10 hnub, daim tawv nqaij tuaj yeem raug tshem tawm.