ostriy kishechnaya neproxodimost

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slayd 1 ostraya kishechnaya neproxodimost kishechnaya neproxo-dimost - zabolevanie, kotoroe xarakterizuetsya chastichnim ili polnim narusheniem prodvijeniya soderjimogo po jeludochno - kishechnomu traktu. naibolee chasto kishech-naya neproxodimost vstrechaetsya v vozraste 40-60 let. okn vozrastaet v letnie i osennie mesyatsi, chto svyazano s bolshey nagruzkoy na kishechnik rastitelnoy pishi, kotoraya soderjit bolshoe kolichestvo kletchatki. kishechnaya neproxodimost chastota okn okn - 3,8% ostrix zabolevaniy organov bryushnoy polosti ruz - 4-5 bolnix na 100 tisyach. muj. : jen.= 4:1 okn po urovnyu porajeniya prichini tonkokishechnoy neproxodimosti prichini tolstokishechnoy neproxodimosti klassifikatsiya a.g. solovev (1983) dinamicheskaya neproxodimost. mexanicheskaya neproxodimost smeshannaya neproxodimost o k n dinamicheskaya neproxodimost paraliticheskaya spasticheskaya parez kishechnika (peri- tonit, perenesennie operatsii, pankreatit, uremiya,ostroe rasshi renie kishechnika i dr.) spazm kishechnika (spasticheskiy kolit, psixicheskie sostoyaniya, svintsovaya kolika i dr) mexanicheskaya neproxodimost obturatsionnaya neproxodimost strangulyatsionnaya neproxodimost vnutrikishechnaya obturatsiya bez svyazi so stenkoy kishki vnutrikishechnaya obturatsiya, isxodyashaya iz stenki kishki vnekishechnaya obturatsiya: sdavlenie opuxolyami, kistami. obturatsiya …

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onit prichini spasticheskoy neproxodimosti pechenochnaya kolika askaridoz pochechnaya kolika stress prichini spasticheskoy neproxodimosti gipoprotei- nemiya uremiya avitaminozi atsidoz * rplm prichini mexanicheskoy neproxodimosti strangulyatsionnaya kishechnaya neproxodimost spaechnie protsessi uzloobrazovanie invaginatsiyu zavorot kishki mexanicheskaya neproxodimost obturatsionnaya kishechnaya neproxodimost inorodnie tela jelchnie kamni rubtsovie strikturi klubok askarid mexanicheskaya neproxodimost obturatsionnaya kishechnaya neproxodimost tuberkulez kishechnika sdavlenie kishki snaruji opuxoli drugix organov opuxol kishechnika obshaya simptomatologiya, diagnostika ostroy kishechnoy neproxodimosti. kvadrat simptomov toshnota i rvota vzdutie jivota zaderjka stula i gazov bol kvadrat simptomov toshnota i rvota vzdutie jivota bol ischeznovenie boli ili zaderjka stula i gazov kvadrat simptomov vzdutie jivota zaderjka stula i gazov bol toshnota i rvota zaderjka stula i gazov est net vremya bol zaderjka stula i gazov kvadrat simptomov toshnota i rvota vzdutie jivota rvota net est vremya diagnosticheskiy algoritm a. sbor anamneza b. ob'ektivniy osmotr bolnogo 1. obshiy osmotr 2. ob'ektivniy osmotr jivota a) ad oculus b) osmotr grijevix …

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i vislushivaetsya ”shum pleska” simptom kivulya – perkutorniy zvuk s yasnim metallicheskim ottenkom perkussiya auskultatsiya simptom grobovoy tishini ili molchashego jivota – stixanie i ischeznoveniya peristalticheskix shumov. simptom loteysena (beyli ) – vislushivanie serdechnix tonov i dixatelnix shumov. simptom spasokukotskogo – shum padayushey kapli. per rectum simptom girshprunga simptom obuxovskoy bolnitsi ili xogenega laboratornaya i instrumentalnaya diagnostika pri ostroy kishechnoy neproxodimosti ob'yom issledovaniya i. v obyazatelnom poryadke c i t o: - obshiy analiz krovi - obshiy analiz mochi - bioximiya krovi - gruppa krovi i rezus prinadlejnost - obzornaya rentgenoskopiya bryushnoy polosti ii. po pokazaniyam: - uzi bryushnoy polosti - rentgenografiya grudnoy kletki - passaj bariya jkt - irrigografiya - konsultatsiya terapevta i reanimatologa * rentgenologicheskoe issledovanie obyazatelno vsem patsientam s okn. vipolnyaetsya obzornaya r-skopiya ili r-grafiya pridaetsya polojenie «stoya» v pryamoy proektsii: pri nevozmojnosti proizvesti issledovanie v polojenii stoya pri tyajelom sostoyanii bolnogo, dopustimo lateropozitsiya (polojenie leja na …

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x zaporov, atonii, spasticheskogo kolita. osnovnimi simptomami koprostaza yavlyayutsya prodoljitelnaya zaderjka stula i gazov i bol v bryushnoy polsti. zakuporka kishok askaridami. otmechaetsya u detey i u vzroslix. chastota askaridnoy neproxodimosti zavisit ot zabolevaemosti glistnimi invaziyami i stepeni degelmintizatsii naseleniya. jelchnokamennaya kishechnaya neproxodimost jelchnokamennaya neproxodimost kishechnika, po dannom literaturi, vstrechaetsya ot 0,28 do 3,3% sluchaev mexanicheskoy neproxodimosti kishechnika . etot pokazatel znachitelno povishaetsya v starshix vozrastnix gruppax obturatsiya kishki kalovim kamnem formirovanie kalovix kamney v obodochnoy kishke. razmeri takix kamney dostigayut inogda znachitelnix razmerov, chto mojet privesti k obturatsionnoy kishechnoy neproxodimosti obturatsii kishki inorodnim telom inorodnie tela mogut bit proglocheni bolnimi v sostoyanii affekta ili alkogolnogo opyaneniya opisani sluchai obturatsii kishki marlevim tamponom, ostavlenennim v prosvete jeludka ili kishki vo vremya operatsii ili migrirovavshim v prosvet kishki v rezultate oporojneniya v nee abstsessa, soderjashego tampon. kliniko-instrumentalnaya diagnostika rentgenoskopiya ultrozvukovaya diagnostika rentgen – passaj bariya laparoskopiya, fibrokolonoskopiya kompyuternaya tomografiya strangulyatsionnaya kishechnaya …

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otnositsya k redkim formam okn (~2-5%). v 90% sluchaev v uzloobrazovanii prinimayut uchastie petli tonkoy i sigmovidnoy kishki. klinicheskie proyavleniya uzloobrazovaniya shok obezvojivanie organizma intoksikatsiya smeshannaya kishechnaya neproxodimost smeshannaya kishechnaya neproxodimost vklyuchaet v sebya kak elementi obturatsii, tak i elementi strangulyatsii prichini smeshannoy kishechnoy neproxodimosti spaechnaya neproxodimost ushemlennie griji jivota poroki razvitiya kishechnika invaginatsiya kishechnika okn pri porokax razvitiya kishechnika dublikatsiya jkt divertikul mekkelya malrotatsiya tonkogo i tolstogo kishechnika invaginatsiya kishechnika vnedrenie odnogo uchastka kishki v drugoy – vnachale protekaet po tipu obturatsionnoy, pri vovlechenii v protsess brijeyki po mere uvelicheniya vnedreniya prinimaet xarakter strangulyatsionnoy. klinika invaginatsii 1) nalichie vsex priznakov okn (sxvatkoobraznie boli, rvota, zaderjka stula i gazov) 2) «palpatsiya invaginata» (v vide kolbasovidnogo obrazovaniya, chashe v oblasti ileotsekalnogo ugla); 3) pri paltsevom rektalnom issledovanii obnarujivayut rasshirennuyu ampulu pryamoy kishki i sledi krovi, pri tolstokishechnoy invaginatsii golovku invaginata. spaechnaya kishechnaya neproxodimost eto patologicheskoe sostoyanie, kotoroe vizivaetsya spaechnoy boleznyu, s …

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slayd 1 ostraya kishechnaya neproxodimost kishechnaya neproxo-dimost - zabolevanie, kotoroe xarakterizuetsya chastichnim ili polnim narusheniem prodvijeniya soderjimogo po jeludochno - kishechnomu traktu. naibolee chasto kishech-naya neproxodimost vstrechaetsya v vozraste 40-60 let. okn vozrastaet v letnie i osennie mesyatsi, chto svyazano s bolshey nagruzkoy na kishechnik rastitelnoy pishi, kotoraya soderjit bolshoe kolichestvo kletchatki. kishechnaya neproxodimost chastota okn okn - 3,8% ostrix zabolevaniy organov bryushnoy polosti ruz - 4-5 bolnix na 100 tisyach. muj. : jen.= 4:1 okn po urovnyu porajeniya prichini tonkokishechnoy neproxodimosti prichini tolstokishechnoy neproxodimosti klassifikatsiya a.g. solovev (1983) dinamicheskaya neproxodimost. mexanicheskaya neproxodimost smeshann...

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