Clinical manifestations
Feem coob ntawm cov neeg mob uas muaj tus kab mob appendicitis (95%) cov tsos mob li nram qab no:
• qhov mob - ua ntej tshaj, ces laus;
• tsis qab los noj mov.
Txawm li ntawm, ib nrab ntawm cov neeg mob, "typical" signs of appendicitis tuaj yeem ua rau mob lwm yam kab mob ntawm cov kab mob plab. Hauv cov menyuam yau thiab cov neeg laus, feem ntau muaj ntau txoj kev mob ntsws tsis sib xws uas tshwm sim tom qab theem ntawm txoj kev mob ntsws, uas ua rau kom muaj teeb meem. Cov ntawv qhia appendix feem ntau nyob rau hauv txoj kab plaub sab plaub ntawm lub plab, uas pom tau tias qhov chaw nyob ntawm qhov mob hnyuv. Thaum cov pob txha nyob tom qab lub cecum los yog hauv cov kab noj hniav pelvic, qhov mob tsuas tuaj yeem tshwm sim thaum kuaj qhov quav. Ntawm qhov tsis sib haum xeeb, thaum lub cev xeeb tub, txoj kev xa tawm ntawm cov ntawv appendix ntawm kev siv los ntawm lub cev xeeb tub mus rau saum teb mus rau qhov chaw loj dua ntawm qhov mob.
Cov mob hnyav dua
• Hnov qhov mob ntawm lub plab lossis hauv plab, nrog rau xeev siab, ntuav thiab tsis qab los noj mov.
• Qee tsiv zuj zus ntawm kev mob rau qis qis plaub ntawm lub plab (mus rau ntawm McBurney), muaj zog ntau dua nrog lub siab ntawm lub qhov ncauj thiab lub zog zuj zus
siab (ib qho tsos mob ntawm Shchetkin-Blumberg).
• Hloov lub cev ntawm cov nqaij ntshiv ntawm tus neeg mob thaum tuav palpation los yog hnoos.
• Kub taub hau tsawg: Lub cev kub ntawm qhov ntau ntawm 37.7-38.3 ° C.
• Tsis paub meej ntxiv ntawm cov leukocytes hauv cov ntshav (leukocytosis).
Tus kab mob no feem ntau yog ua raws li keeb kwm thiab kev mob tshwm sim ntawm tus kab mob. Ib hom kab mob ntawm cov kab mob appendicitis mob sai sai, feem ntau yog ntev tshaj 24 teev. Cov tsos mob tshwm sim dhau ntau tshaj 48 teev, qhov mob ntawm kab mob appendicitis tsis zoo li. Kev ntsuam xyuas tshwj xeeb kom paub tseeb tias tsis muaj tus kab mob appendicitis, tsis muaj kev ntsuam xyuas dab tsi ntxiv rau kev ntseeg hauv kev kuaj mob.
Txoj kev tshawb nrhiav
• Cov kev kuaj mob kuaj ntshav thiab kuaj cov cuab yeej siv los tawm tsam lwm yam ua rau mob hnyav kom paub tseeb tias mob ntsws appendicitis.
• Laparoscopy - kev kuaj mob ntawm qhov kab mob plab siv cov cuab yeej siv tshuab raj yees duab.
• Ultrasonography feem ntau tseem ceeb nyob rau hauv kev sib txawv ntawm cov kab mob appendicitis thiab gynecological pathology (xws li, mob ntawm cov plab hnyuv pelvic).
Ib tus kws kho mob uas tau paub txog kev mob ntsws mob tau tuaj yeem kuaj xyuas mob hnyav rau ntawm qhov keeb kwm thiab chaw kho mob, tab sis thaum lub sij hawm 15% ntawm kev ua haujlwm rau mob hnyuv tws tau pom tias qhov ua rau "mob plab" yog lwm hom kab mob, los yog tsis muaj cov kab mob hauv av. Yog tsis muaj kev saib xyuas kom tsim nyog rau mob hnyuv tws hnyav yog muaj teeb meem loj heev, yog li ntawm cov neeg tsis paub tseeb, cov kws phais mob phais raug phais. Obstruction (blockage) ntawm daim ntawv "appendix lumen" ua rau muaj kev ntxhov siab ntxiv nyob rau hauv nws thiab kev puas tsuaj rau qhov mucous membrane. Raws li cov mob no, cov kab mob nyob rau hauv txoj hnyuv yooj yim nkag mus rau ntawm phab ntsa ntawm cov ntawv loj (appendix) thiab ua rau mob. Vim yog qhov txuam rau hauv lub lumen ntawm qhov hnyuv tws ntawm cov hnoos qeev hauv siab, qhov siab hauv nws nce nrog rau cov kev ntsuas qis ntawm cov hlab ntsha. Nrog rau kev loj hlob ntawm gangrene, ib lub pob zeb tawg ntawm lub phab ntsa tua tau.
Ntau yam ua rau
Nws ntseeg hais tias yog vim li cas hnyuv tws (appendicitis) yog qhov mob ntawm qhov mucosa, tej zaum yog vim tus kab mob Yersinia microbe. Kev rhuav tshem ntawm cov ntawv loj (appendix) yog feem ntau tshwm sim los ntawm kev tiv thaiv mob ntsws (muaj hnyuv tws ntawm cov fibers cog). Lwm cov laj thawj muaj xws li:
• cov hnyuv quav;
• Cov tum;
• Edema ntawm cov ntaub so ntsig lymphatic hauv cov kab mob plab hnyuv nyob hauv kis kab mob.
Cov kev mob tshwm sim hauv kab mob mob hnyuv tis sai sai heev. Thaum kuaj pom, txoj kev tuaj yeem tuaj yeem tawg ua ke ntawm phab ntsa ntawm txoj kev nrog qhov tawm ntawm nws cov kab mob hauv lub plab hauv plab (perforation).
Qhov yuav tshwm sim
• Nrog kev nrawm nrawm ntawm cov ntawv loj (appendix), daim duab ntawm txoj kev mob loj ntawm cov kab mob hauv plab (peritonitis), uas yuav muaj peev xwm tuag taus.
• Nrog rau txoj kev qeeb qeeb qeeb qeeb, nws muaj peev xwm los npog qhov chaw ntawm lub perforation nrog ib tug loj caj pas chaw nrog tsim ntawm ib tug abscess.
Morbidity
• Kab mob appendicitis yog hais txog cov kab mob phem tshaj plaws thaum yau thiab cov hluas; qhov tshwm sim ntawm cov txiv neej yog siab tshaj cov poj niam (piv 3: 2).
• Tsis tshua muaj tus mob appendicitis tshwm sim nyob rau hauv thaum yau thiab hnub nyoog laus, nrog rau kev pheej hmoo ntawm ntau yam kev nyuab.
• Tag nrho, qhov tshwm sim ntawm cov leeg mob hauv lub ntiaj teb yog qis dua. Qhov tsis zoo ntawm qhov no yog tsis paub, tab sis cov qib qis ntawm pathology nyob hauv lub teb chaws (tshwj xeeb tshaj yog nyob rau qee thaj tsam ntawm Asia) pom zoo rau txoj haujlwm ntawm cov khoom noj haus.
Qhov tsuas yog siv rau kev kho mob mob hnyuv txhaws (appendicitis) yog tshem tawm ntawm qhov hnyuv tws (anemectomy). Niaj hnub no, kev khiav haujlwm ntawm laparoscopic nkag tau tuaj yeem muaj ntau.
Ceev ceev rov qab
Tom qab kev phais, cov neeg mob feem ntau rov qab sai sai. Txoj kev pheej hmoo ntawm kev kis tus kab mob no yog txo los ntawm cov tshuaj tua kab mob hauv cov tshuaj tua kab mob. Yog hais tias muaj ib qho kev poob ntsej muag, nws yuav tsum tau muab pov tseg. Ib qho mob hnyav uas muaj cecum lossis hnyuv ntxeem me me yuav tsum tshem tawm ntawm tag nrho cov khoom ntawm abscess ua raws li cov kev siv cov tshuaj nrogostostomy (tshem tawm cov lumen ntawm txoj hnyuv thooj ntawm daim tawv nqaij).
Kev tiv thaiv kev ntsuas
Thaum lub sijhawm ua haujlwm, lub plab thiab kabmob plab yog ua tib zoo kuaj xyuas seb puas muaj kabmob kheesxaws. Piv txwv li, tus kws phais neeg tuaj yeem ntes ib qho kev txawv txav - Mackel diverticulum (ib qho tawm me me ntawm phab ntsa ntawm txoj hnyuv). Txawm tias thaum tsis muaj qhov tshwm sim ntawm qhov mob, nws yog ib qho tsim nyog los tshem nws tawm kom thiaj li tiv thaiv tau cov teeb meem.