1. Chizindikiro cha hepatojugular reflux
Pamene kulephera kwa mtima kumayambitsa kusokonezeka kwa chiwindi ndi kutupa, chiwindi chikhoza kupanikizidwa ndi manja kuti mitsempha ya jugular iwonongeke kwambiri. Zomwe zimayambitsa kwambiri ndi kusakwanira kwa ventricular yolondola komanso kuchulukana kwa chiwindi cha chiwindi.
2.Chizindikiro cha Cullen
Chodziwikanso kuti chizindikiro cha Coulomb, ecchymosis wofiirira-buluu pakhungu mozungulira umbilicus kapena khoma la m'munsi mwamimba ndi chizindikiro cha kutuluka kwa magazi m'mimba, komwe kumakhala kofala kwambiri pakukha magazi kwa retroperitoneal, pachimake hemorrhagic necrotizing kapamba, kupasuka kwam'mimba kung'ambika, ndi zina zambiri.
3.Grey-Turner chizindikiro
Wodwala akayamba pancreatitis pachimake, madzi a kapamba amasefukira mu danga la subcutaneous minofu ya m'chiuno ndi m'mphepete, ndikusungunula mafuta osakanikirana, ndipo ma capillaries amang'ambika ndikutuluka magazi, zomwe zimapangitsa kuti pakhungu pakhale ecchymosis yofiirira, yomwe imatchedwa chizindikiro cha Grey-Turner.
4.Courvoisier sign
Khansara ya mutu wa kapamba ikakanikizira njira wamba ya bile, kapena khansa yapakati ndi m'munsi mwa njira ya bile imayambitsa kutsekeka, jaundice yodziwikiratu imachitika. Chotupa cha ndulu chomwe chili ndi cystic, chosakhala chofewa, chili ndi malo osalala ndipo chimatha kusunthidwa ndikumveka, chomwe chimatchedwa chizindikiro cha Courvoisier, chomwe chimatchedwanso kutsekeka kwa njira ya ndulu. msonkho.
5.Peritoneal irritation chizindikiro
Kukhalapo kwa nthawi yomweyo kwachifundo, kupwetekedwa mtima kwapang'onopang'ono ndi kugwedezeka kwa minofu m'mimba kumatchedwa chizindikiro cha peritoneal irritation, chomwe chimadziwikanso kuti peritonitis triad. Ndi chizindikiro cha peritonitis, makamaka malo a chotupa chachikulu. Njira ya kupsinjika kwa minofu ya m'mimba kumadalira chifukwa chake komanso momwe wodwalayo alili. Zomwe zimachitika kawirikawiri zimasiyanasiyana, ndipo kuwonjezeka kwa m'mimba ndi chizindikiro chofunikira cha kuipiraipira.
6. Chizindikiro cha Murphy
Chizindikiro chabwino cha Murphy ndi chimodzi mwazofunikira pakuzindikiritsa kwachipatala kwa pachimake cholecystitis. Akamakupatira ndulu pansi kumanja kwa mtengo wamtengo wapatali, ndulu yotupayo idakhudzidwa ndipo wodwalayo adafunsidwa kuti apume mpweya kwambiri. ndulu yotupa ndi yotupayo idasunthira pansi. Wodwalayo anamva ululuwo ukukulirakulira ndipo mwadzidzidzi anagwira mpweya wake.
7. Chizindikiro cha Mcburney
Kukoma mtima ndi kubwereza chifundo kwa McBurney kumunsi kumanja kwa mimba (mphambano ya umbilicus ndi pakati ndi 1/3 ya kunja kwa 1/3 ya kumanja kwa msana wapamwamba wa iliac) ndizofala mu appendicitis yovuta.
8.Charcot's triad
Acute obstructive suppurative cholangitis nthawi zambiri amakhala ndi ululu m'mimba, kuzizira, kutentha thupi kwambiri, ndi jaundice, yomwe imadziwikanso kuti Chaco's triad.
1) Kupweteka kwa m'mimba: Kumachitika pansi pa ndondomeko ya xiphoid ndi kumtunda wapamwamba wa quadrant, kawirikawiri colic, ndi kuukira kwa paroxysmal kapena kupweteka kosalekeza ndi kuwonjezereka kwa paroxysms, zomwe zimatha kutulutsa paphewa lakumanja ndi kumbuyo, limodzi ndi nseru ndi kusanza. Nthawi zambiri amayamba kudya zakudya zamafuta.
2) Kuzizira ndi kutentha thupi: Pambuyo pa kutsekeka kwa ndulu, kupanikizika mkati mwa njira ya bile kumawonjezeka, zomwe nthawi zambiri zimayambitsa matenda achiwiri. Mabakiteriya ndi poizoni amatha kubwereranso m'magazi kudzera mu capillary bile ducts ndi hepatic sinusoids, zomwe zimapangitsa kuti chiwindi chikhale ndi biliary abscess, sepsis, septic shock, DIC, ndi zina zotero, zomwe zimawonekera ngati kutentha kwa thupi, kutentha kwa thupi kufika pa 39 mpaka 40 ° C.
3) Jaundice: Miyala ikatseka njira ya ndulu, odwala amatha kukhala ndi mkodzo wachikasu wakuda ndi madontho achikasu pakhungu ndi sclera, ndipo odwala ena amatha kuyabwa pakhungu.
9.Reynolds (Renault) zizindikiro zisanu
Kutsekeredwa mwala sikumatsitsimutsidwa, kutupa kumakula kwambiri, ndipo wodwalayo amayamba kusokonezeka maganizo ndi kugwedezeka chifukwa cha triad ya Charcot, yomwe imatchedwa pentalogy ya Raynaud.
10. Chizindikiro cha Kehr
Magazi a m'mimba amayambitsa diaphragm ya kumanzere, yomwe imayambitsa kupweteka kwa phewa lakumanzere, komwe kumapezeka kawirikawiri kuphulika kwa splenic.
11. Chizindikiro cha obturator (kuyesa kwa minofu ya obturator internus)
Wodwalayo anali pampando, ndi ntchafu yakumanja ndi ntchafu zimasinthasintha ndipo kenaka zimazungulira mkati, zomwe zimayambitsa kupweteka kwa m'mimba kumanja, komwe kumawoneka mu appendicitis (zowonjezera zili pafupi ndi obturator internus muscle).
12. Chizindikiro cha Rovsing (kuyesa kwa inflation ya colon)
Wodwalayo ali pa mpando, ndi dzanja lake lamanja kukanikiza kumanzere m'munsi pamimba ndi dzanja lake lamanzere kufinya proximal m'matumbo, kuchititsa kupweteka kumanja m'munsi pamimba, amene amawoneka appendicitis.
13.X-ray chizindikiro chakwiyitsa barium
Barium amasonyeza zizindikiro za kukwiya mu gawo la matumbo omwe ali ndi matenda, ndikutulutsa mofulumira komanso kusadzaza bwino, pamene kudzaza kuli bwino m'magulu a m'mimba komanso m'munsi mwa matumbo. Izi zimatchedwa X-ray barium irritation sign, yomwe imapezeka mwa odwala omwe ali ndi chifuwa chachikulu cha zilonda zam'mimba. .
14. Chizindikiro cha halo iwiri/chizindikiro chomwe mukufuna
Mu gawo logwira ntchito la matenda a Crohn, kupititsa patsogolo kwa CT enterography (CTE) kukuwonetsa kuti khoma la m'mimba limakulitsidwa kwambiri, matumbo am'mimba amakulitsidwa kwambiri, gawo la khoma lamatumbo limapangidwa, ndipo mphete yamkati yamkati ndi mphete yakunja ya serosa imakulitsidwa kwambiri, ikuwonetsa halo iwiri. chizindikiro kapena chandamale.
15. Chizindikiro cha zisa zamatabwa
Mu gawo logwira ntchito la matenda a Crohn, CT enterography (CTE) imawonetsa kuchuluka kwa mitsempha yamagazi ya mesenteric, momwemonso kuchulukira kwamafuta a mesenteric ndi kusawoneka bwino, komanso kukulitsa ma lymph node, kuwonetsa "chizindikiro cha zisa".
16. Enterogenic azotemia
Pambuyo pa kukha mwazi kwakukulu m'matumbo a m'mimba, chimbudzi cha mapuloteni a magazi chimalowa m'matumbo, ndipo kuchuluka kwa urea nayitrogeni m'magazi kumatha kuwonjezeka kwakanthawi, komwe kumatchedwa enterogenic azotemia.
17.Mallory-Weiss syndrome
Waukulu matenda mawonetseredwe a syndrome izi mwadzidzidzi kuwonjezeka kwapakati-m`mimba kuthamanga chifukwa kwambiri nseru, kusanza ndi zifukwa zina, amene amachititsa kotenga nthawi kung`ambika mucosa ndi submucosa wa distal mtima cardia ndi kum`mero, potero kuchititsa chapamwamba magazi m`mimba. The mawonetseredwe waukulu mwadzidzidzi pachimake hematemesis, patsogolo ndi mobwerezabwereza retching kapena kusanza, amatchedwanso kummero ndi cardia mucosal misozi syndrome.
18. Matenda a Zollinger-Ellison (gastrinoma, matenda a Zollinger-66Ellison)
Ndi mtundu wa chotupa cha gastroenteropancreatic neuroendocrine chodziwika ndi zilonda zingapo, malo osawoneka bwino, kutengeka ndi zovuta za zilonda zam'mimba, komanso kusayankha bwino kwamankhwala oletsa zilonda nthawi zonse. Kutsekula m'mimba, kuchuluka kwa asidi m'mimba, komanso kuchuluka kwa gastrin m'magazi kumatha kuchitika. apamwamba.
Gastrinomas nthawi zambiri amakhala ang'onoang'ono, ndipo pafupifupi 80% amakhala mkati mwa makona atatu a "gastrinoma" (mwachitsanzo, kulumikizana kwa ndulu ndi njira yodziwika bwino ya ndulu, gawo lachiwiri ndi lachitatu la duodenum, khosi ndi kapamba). Mkati mwa makona atatu opangidwa ndi mphambano), oposa 50% a gastrinomas ndi owopsa, ndipo odwala ena adapezeka kuti ali ndi metastasized.
19. Kutaya matenda
Pambuyo pa subtotal gastrectomy, chifukwa cha kutayika kwa kayendetsedwe ka pylorus, zomwe zili m'mimba zimatulutsidwa mofulumira kwambiri, zomwe zimapangitsa kuti pakhale zizindikiro zachipatala zomwe zimatchedwa dumping syndrome, zomwe zimakhala zofala kwambiri mu PII anastomosis. Malinga ndi nthawi yomwe zizindikiro zimawonekera mutadya, zimagawidwa m'magulu awiri: oyambirira ndi mochedwa.
● Early dumping syndrome: Zizindikiro za hypovolemia kwa kanthaŵi monga kugunda kwa mtima, kutuluka thukuta lozizira, kutopa, ndi khungu lotumbululuka zimawonekera patatha theka la ola mutadya. Zimatsagana ndi nseru ndi kusanza, kutsekula m'mimba, ndi kutsegula m'mimba.
● Late dumping syndrome: amapezeka patatha maola awiri kapena anayi mutadya. Zizindikiro zazikulu ndi chizungulire, khungu lotumbululuka, thukuta lozizira, kutopa, komanso kugunda kwa mtima. Limagwirira ndikuti chakudya chikalowa m'matumbo, chimayambitsa kutulutsa kwa insulin yambiri, komwe kumayambitsa hypoglycemia. Imatchedwanso hypoglycemia syndrome.
20. Absorptive dystrophy syndrome
Ndi matenda a chipatala omwe zakudya zimakhala zoperewera chifukwa cha kusagwira ntchito kwa matumbo aang'ono pogaya ndi kuyamwa zakudya, zomwe zimapangitsa kuti zakudya zisawonongeke bwino ndikutuluka mu ndowe. Zachipatala, nthawi zambiri zimawonetsa kutsekula m'mimba, zowonda, zolemetsa, zonenepa ndi zina zomwe zimayamwa mafuta, motero zimatchedwanso steatorrhea.
21.PJ syndrome (pigmented polyposis syndrome, PJS)
Ndi osowa autosomal dominant chotupa syndrome yodziwika ndi khungu ndi mucosal pigmentation, angapo Hamatomatous polyps mu m`mimba thirakiti, ndi chotupa chiwopsezo.
PJS imachitika kuyambira ali mwana. Odwala akamakalamba, matupi a m'mimba amakula pang'onopang'ono ndikukulitsa, zomwe zimayambitsa zovuta zosiyanasiyana, monga intussusception, kutsekeka kwa m'mimba, kutuluka magazi m'mimba, khansa, kuperewera kwa zakudya m'thupi, ndi kuchepa kwa kukula kwa ana.
22. Matenda a m'mimba
Kuthamanga kwapakati pamimba kwa munthu wabwinobwino kumakhala pafupi ndi kuthamanga kwa mpweya, 5 mpaka 7 mmHg.
Kuthamanga kwapakati pamimba ≥12 mmHg ndi kuthamanga kwa magazi m'mimba, komanso kupanikizika kwapakati pamimba ≥20 mmHg komwe kumayendera limodzi ndi kulephera kwa chiwalo chokhudzana ndi matenda oopsa a m'mimba ndi matenda a m'mimba (ACS).
Zizindikiro zachipatala: Wodwala amakhala pachifuwa chothina, kupuma movutikira, kupuma movutikira, komanso kugunda kwa mtima mwachangu. Kuthamanga kwa m'mimba ndi kupsinjika kwakukulu kungakhale limodzi ndi kupweteka kwa m'mimba, kumveka kwa matumbo kufooka kapena kutha, etc. Hypercapnia (PaCO?> 50 mmHg) ndi oliguria (kutulutsa mkodzo pa ola <0.5 mL / kg) zikhoza kuchitika kumayambiriro kwa ACS. Anuria, azotemia, kupuma kulephera komanso kutsika kwamtima kwamtima kumachitika pambuyo pake.
23. Superior mesenteric artery syndrome
Imadziwikanso kuti benign duodenal stasis ndi duodenal stasis, mndandanda wazizindikiro zomwe zimayamba chifukwa cha kusakhazikika kwa mtsempha wapamwamba wa mesenteric kukakamiza gawo lopingasa la duodenum, zomwe zimapangitsa kutsekeka pang'ono kapena kwathunthu kwa duodenum.
Ndiwofala kwambiri mwa amayi akuluakulu a asthenic. Kukomoka, nseru, ndi kusanza ndizofala. Chodziwika bwino cha matendawa ndi chakuti zizindikiro zimagwirizana ndi malo a thupi. Pamene malo a supine amagwiritsidwa ntchito, zizindikiro zoponderezedwa zimakulirakulira, pamene malo okhazikika, malo a mawondo-pachifuwa, kapena kumanzere, zizindikiro zimatha kumasulidwa. .
24. Blind loop syndrome
Matenda otsekula m'mimba, kuchepa kwa magazi m'thupi, malabsorption ndi kuwonda chifukwa cha kusayenda kwa m'matumbo ang'onoang'ono komanso kuchuluka kwa bakiteriya m'matumbo a lumen. Imawonekera makamaka pakupanga malupu akhungu kapena matumba akhungu (mwachitsanzo, malupu am'mimba) pambuyo pa opaleshoni yamatumbo ndi m'mimba. Ndipo chifukwa cha stasis.
25. Matenda a matumbo amfupi
Zimatanthawuza kuti pambuyo pochotsa matumbo ang'onoang'ono kapena kuchotsedwa chifukwa cha zifukwa zosiyanasiyana, kuyamwa bwino kwa matumbo kumachepetsedwa kwambiri, ndipo matumbo otsalawo sangathe kusunga zakudya za wodwalayo kapena kukula kwa mwanayo, ndi zizindikiro monga kutsekula m'mimba, matenda a asidi-base / madzi / electrolyte, ndi syndromes zomwe zimagwidwa ndi matenda osiyanasiyana a absorption.
26. Matenda a hepatorenal
Zizindikiro zazikulu zachipatala ndi oliguria, anuria ndi azotemia.
Impso za wodwalayo zinalibe zotupa zazikulu. Chifukwa cha hypertension ya portal ndi splanchnic hyperdynamic circulation, kayendedwe ka magazi kamene kamakhala kochepa kwambiri, ndipo zinthu zosiyanasiyana za vasodilator monga prostaglandins, nitric oxide, glucagon, atrial natriuretic peptide, endotoxin, ndi Calcium gene-related peptides sangathe kutsekedwa ndi chiwindi; kuchuluka kwa peritoneal fluid kungayambitse kuwonjezereka kwakukulu kwa kuthamanga kwapakati pamimba, komwe kungachepetse magazi aimpso, makamaka aimpso cortex hypoperfusion, zomwe zimayambitsa kulephera kwaimpso.
80% ya odwala omwe ali ndi matenda omwe amapita patsogolo mwachangu amamwalira mkati mwa milungu iwiri. Mtundu wopita patsogolo pang'onopang'ono umakhala wofala kwambiri pachipatala, nthawi zambiri umakhala ndi kutuluka kwa m'mimba kosalekeza komanso kulephera kwaimpso pang'onopang'ono.
27. Matenda a hepatopulmonary
Pamaziko a chiwindi matenda enaake, pambuyo kupatula chachikulu matenda cardiopulmonary, dyspnea ndi zizindikiro za hypoxia monga cyanosis ndi clubbing zala zala (zala) okhudzana ndi intrapulmonary vasodilation ndi mtsempha wamagazi oxygenation kukanika, ndipo matenda ndi osauka.
28. Mirizzi syndrome
Gallbladder khosi kapena cystic duct mwala kugunda, kapena kuphatikiza ndi kutupa kwa ndulu, kuthamanga
Zimachitika mwa kukakamiza kapena kukhudza wamba kwa chiwindi ngalande, kuchititsa ozungulira minofu kuchulukana, kutupa kapena stenosis wa wamba kwa chiwindi ngalande, ndipo matenda kumaonekera ngati mndandanda wa matenda syndromes yodziwika ndi obstructive jaundice, biliary colic kapena cholangitis.
Maziko a mapangidwe ake ndikuti cystic duct ndi wamba hepatic duct ndi yayitali kwambiri limodzi kapena malo olumikizana a cystic duct ndi wamba hepatic duct ndizotsika kwambiri.
29. Budd-Chiari syndrome
Budd-Chiari syndrome, yomwe imadziwikanso kuti Budd-Chiari syndrome, imatanthawuza gulu la portal hypertension kapena portal and inferior vena cava hypertension chifukwa cha kutsekeka kwa mitsempha ya hepatic kapena inferior vena cava pamwamba pa kutsegula kwake. matenda.
30.Caroli syndrome
Congenital cystic dilation of intrahepatic bile ducts. Makinawa sakudziwika bwino. Zitha kukhala zofanana ndi choledochal chotupa. Chiwopsezo cha cholangiocarcinoma ndi chachikulu kuposa cha anthu wamba. Zizindikiro zoyambirira za matendawa ndi hepatomegaly ndi ululu wam'mimba, makamaka ngati biliary colic, wovutitsidwa ndi matenda a bakiteriya. Kutentha thupi ndi jaundice wapakatikati kumachitika panthawi yotupa, ndipo kuchuluka kwa jaundice nthawi zambiri kumakhala kochepa.
31. Puborectal syndrome
Ndi vuto lachimbudzi lomwe limayamba chifukwa cha kutsekeka kwa m'chiuno chifukwa cha kupindika kapena hypertrophy ya minofu ya puborectalis.
32. Matenda a m'chiuno
Zimatanthawuza gulu la ma syndromes omwe amayamba chifukwa cha zovuta za neuromuscular m'magulu apansi a pelvic kuphatikizapo rectum, levator ani muscle, ndi kunja kwa anal sphincter. Waukulu chipatala mawonetseredwe ndi kuvutika chimbudzi kapena kusadziletsa, komanso m`chiuno kuthamanga ndi ululu. Zowonongekazi nthawi zina zimaphatikizapo kuvutika kwa chimbudzi, ndipo nthawi zina kusadziletsa kwa chimbudzi. Pazovuta kwambiri, zimakhala zowawa kwambiri.
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Nthawi yotumiza: Sep-06-2024