1. Hepatojugular reflux kos npe
Thaum txoj cai plawv tsis ua hauj lwm ua rau mob siab thiab o, lub siab tuaj yeem raug compressed nrog ob txhais tes kom cov leeg jugular ntau dua. Feem ntau ua rau yog txoj cai ventricular insufficiency thiab congestion kab mob siab.
2.Cullen's kos npe
Kuj hu ua Coulomb's kos npe, ntshav-xiav ecchymosis ntawm daim tawv nqaij nyob ib ncig ntawm lub kaus mom lossis phab ntsa plab plab yog ib qho cim ntawm cov ntshav hauv plab loj heev, uas muaj ntau dua hauv cov ntshav retroperitoneal hemorrhage, mob hemorrhagic necrotizing pancreatitis, ruptured abdominal thiab lwm yam.
3.Grey-Turner kos npe
Thaum tus neeg mob muaj tus mob pancreatitis, kua txiv pancreatic ntws mus rau hauv cov ntaub so ntswg subcutaneous ntawm lub duav thiab flank, soluble subcutaneous rog, thiab capillaries rupture thiab los ntshav, uas ua rau bluish-ntsuab ecchymosis ntawm daim tawv nqaij nyob rau hauv cov cheeb tsam no, uas yog hu ua Grey-Turner's. kos npe.
4.Courvoisier kos npe
Thaum mob qog noj ntshav ntawm lub taub hau ntawm tus txiav ua rau cov kab mob sib kis, lossis mob qog noj ntshav ntawm nruab nrab thiab qis ntawm cov kua tsib ua rau muaj kev cuam tshuam, pom tseeb jaundice tshwm sim. Lub zais zis o uas yog cystic, tsis muaj kev sib tw, muaj lub ntsej muag du thiab tuaj yeem txav tau yog palpable, uas yog hu ua Courvoisier's kos npe, tseem hu ua kev cuam tshuam ntawm cov kab mob sib kis. levy.
5. Peritoneal irritation kos npe
Lub xub ntiag ntawm kev sib tw, rov qab rhiab thiab mob plab hauv plab yog hu ua peritoneal irritation kos npe, tseem hu ua peritonitis triad. Nws yog ib qho cim qhia ntawm peritonitis, tshwj xeeb tshaj yog qhov chaw ntawm thawj qhov txhab. Cov chav kawm ntawm cov leeg mob plab yog nyob ntawm qhov ua rau thiab tus neeg mob tus mob. Cov mob dav dav sib txawv, thiab mob plab ntxiv yog ib qho tseem ceeb ntawm kev mob hnyav zuj zus.
6.Murphy's kos npe
Qhov zoo Murphy kos npe yog ib qho ntawm cov cim tseem ceeb hauv kev kuaj mob ntawm tus mob cholecystitis. Thaum palpating lub gallbladder cheeb tsam nyob rau hauv txoj cai costal margin, lub o ntawm lub gallbladder tau kov thiab tus neeg mob tau hais kom nqus tau pa tob. Lub o thiab mob gallbladder txav mus rau hauv qab. Tus neeg mob hnov qhov mob hnyav thiab tam sim ntawd tuav nws ua pa.
7.Mcburney kos npe
Tenderness thiab rebound rhiab heev ntawm McBurney lub ntsiab lus nyob rau hauv txoj cai sab plab plab (qhov sib tshuam ntawm lub umbilicus thiab nruab nrab thiab sab nrauv 1/3 ntawm sab xis anterior superior iliac qaum) yog muaj nyob rau hauv mob appendicitis.
8. Charcot's triad
Mob obstructive suppurative cholangitis feem ntau tshwm sim nrog mob plab, ua daus no, kub taub hau, thiab jaundice, tseem hu ua Chaco's triad.
1) Mob plab: tshwm sim nyob rau hauv cov txheej txheem xiphoid thiab nyob rau hauv txoj cai sab sauv quadrant, feem ntau colic, nrog paroxysmal tawm tsam los yog mob tsis tu ncua nrog exacerbation ntawm paroxysms, uas yuav tawg mus rau sab xis lub xub pwg nyom thiab nraub qaum, nrog xeev siab thiab ntuav. Nws feem ntau tshwm sim tom qab noj cov zaub mov muaj roj.
2) Ua npaws thiab ua npaws: Tom qab cov kab mob hauv cov hlab ntsha txhaws, lub siab nyob rau hauv cov ducts nce, feem ntau ua rau cov kab mob thib ob. Cov kab mob thiab cov co toxins tuaj yeem rov qab mus rau hauv cov ntshav los ntawm cov hlab ntsha hauv cov hlab ntsha thiab cov kab mob siab hauv lub siab, ua rau lub siab ua paug, sepsis, septic shock, DIC, thiab lwm yam, feem ntau tshwm sim ua npaws, nrog lub cev kub txog li 39 txog 40 °. C.
3) Jaundice: Tom qab pob zeb thaiv cov kua tsib, cov neeg mob tuaj yeem tsim cov zis daj daj thiab xim daj ntawm daim tawv nqaij thiab sclera, thiab qee cov neeg mob yuav khaus tawv nqaij.
9.Reynolds (Renault) tsib lub cim
Lub pob zeb raug kaw tsis tau txo qis, qhov mob hnyav ntxiv, thiab tus neeg mob tsim kev puas siab puas ntsws thiab poob siab raws li Charcot's triad, uas yog hu ua Raynaud's pentalogy.
10. Kehr's sign
Cov ntshav nyob rau hauv lub plab kab noj hniav nkoos sab laug diaphragm, ua rau sab laug xub pwg mob, uas yog ib qho tshwm sim nyob rau hauv splenic rupture.
11. Obturator kos npe (obturator internus leeg kuaj)
Tus neeg mob nyob rau hauv lub supine txoj hauj lwm, nrog rau txoj cai lub duav thiab ncej puab flexed thiab ces passively tig sab hauv, ua rau txoj cai qis plab mob, uas yog pom nyob rau hauv appendicitis (lub appendix yog ze rau obturator internus leeg).
12. Rovsing's sign (colon inflation test)
Tus neeg mob yog nyob rau hauv lub supine txoj hauj lwm, nrog nws sab tes xis compressing sab laug sab plab plab thiab nws sab laug tes tuav lub proximal nyuv, ua rau mob nyob rau hauv lub sab xis sab plab mog, uas yog pom nyob rau hauv appendicitis.
13.X-ray barium irritation kos npe
Barium qhia pom cov tsos mob ntawm kev khaus khaus nyob rau hauv cov kab mob plab hnyuv, nrog ceev ceev thiab tsis zoo filling, thaum sau yog zoo nyob rau hauv lub sab sauv thiab sab plab hnyuv ntu. Qhov no yog hu ua X-ray barium irritation kos npe, uas yog tshwm sim nyob rau hauv cov neeg mob uas muaj mob plab hnyuv tuberculosis. .
14. Ob chav halo kos npe / lub hom phiaj kos npe
Nyob rau hauv lub active theem ntawm Crohn tus kab mob, kev txhim kho CT enterography (CTE) qhia tau hais tias lub plab hnyuv phab ntsa yog ho thickened, lub plab hnyuv mucosa yog ho txhim khu kev qha, ib feem ntawm lub plab hnyuv phab ntsa yog stratified, thiab lub puab mucosal nplhaib thiab lub nplhaib serosa sab nraud yog ho. txhim khu kev qha, qhia ib ob halo. kos npe los yog lub hom phiaj kos npe.
15. Ntoo comb kos npe
Nyob rau hauv lub active theem ntawm Crohn tus kab mob, CT enterography (CTE) qhia tau hais tias ib tug nce nyob rau hauv cov hlab ntsha mesenteric, correspondingly nce mesenteric rog ceev thiab qhov muag plooj, thiab mesenteric lymph node o, uas qhia cov "ntoo zuag kos npe rau".
16. Enterogenic azotemia
Tom qab los ntshav loj heev nyob rau hauv lub plab hnyuv sab sauv, cov khoom digestives ntawm cov ntshav proteins yog absorbed nyob rau hauv cov hnyuv, thiab cov concentration ntawm urea nitrogen nyob rau hauv cov ntshav yuav nce ib ntus, uas yog hu ua enterogenic azotemia.
17.Mallory-Weiss syndrome
Lub ntsiab kev kho mob tshwm sim ntawm tus mob no yog sai li sai tau nce nyob rau hauv lub plab mog vim mob heev xeev siab, ntuav thiab lwm yam yog vim li cas, uas ua rau longitudinal tearing ntawm lub mucosa thiab submucosa ntawm lub distal plawv cardia thiab txoj hlab pas, yog li ua rau lub plab hnyuv siab raum los ntshav. Qhov tshwm sim tseem ceeb yog qhov mob hematemesis tam sim ntawd, ua ntej los ntawm kev rov ua dua lossis ntuav, tseem hu ua esophageal thiab cardia mucosal tear syndrome.
18. Zollinger-Ellison syndrome (gastrinoma, Zollinger-66Ellison syndrome)
Nws yog ib hom kab mob gastroenteropancreatic neuroendocrine qog uas tshwm sim los ntawm ntau qhov mob, qhov chaw atypical, cuam tshuam rau cov kab mob rwj, thiab cov lus teb tsis zoo rau cov tshuaj tiv thaiv kab mob tsis tu ncua. Mob raws plab, gastric acid secretion, thiab nce ntshav gastrin yuav tshwm sim. siab dua.
Gastrinomas feem ntau yog me me, thiab kwv yees li 80% nyob rau hauv daim duab peb sab "gastrinoma" (piv txwv li, qhov sib xyaw ntawm lub gallbladder thiab cov kab mob sib xyaw ua ke, qhov thib ob thiab thib peb ntawm duodenum, thiab lub caj dab thiab lub cev ntawm tus txiav). Nyob rau hauv daim duab peb sab tsim los ntawm kev sib tshuam), ntau tshaj 50% ntawm gastrinomas yog malignant, thiab qee cov neeg mob tau metastasized thaum pom.
19. Khawv koob tiv thaiv kab mob
Tom qab subtotal gastrectomy, vim qhov poob ntawm kev tswj kev ua haujlwm ntawm pylorus, cov ntsiab lus ntawm plab hnyuv tau nqus sai heev, ua rau muaj cov tsos mob tshwm sim hu ua dumping syndrome, uas muaj ntau dua hauv PII anastomosis. Raws li lub sij hawm thaum cov tsos mob tshwm sim tom qab noj mov, nws muab faib ua ob hom: ntxov thiab lig.
●Early dumping syndrome: Cov tsos mob ntawm ib ntus hypovolemia xws li palpitations, hws txias, qaug zog, thiab daj ntseg tshwm sim ib nrab teev tom qab noj mov. Nws yog nrog xeev siab thiab ntuav, mob plab, thiab raws plab.
● Late dumping syndrome: tshwm sim 2 mus rau 4 teev tom qab noj mov. Cov tsos mob tseem ceeb yog kiv taub hau, daj ntseg daj, hws txias, qaug zog, thiab mem tes ceev. Cov txheej txheem yog tias tom qab cov zaub mov nkag mus rau hauv txoj hnyuv, nws txhawb nqa ntau cov tshuaj insulin secretion, uas ua rau muaj kev cuam tshuam rau cov ntshav qab zib. Nws tseem hu ua hypoglycemia syndrome.
20. Absorptive dystrophy syndrome
Nws yog ib qho kev kho mob uas cov as-ham tsis txaus vim qhov tsis ua haujlwm ntawm txoj hnyuv me hauv kev zom thiab nqus cov as-ham, ua rau cov as-ham tsis tuaj yeem nqus tau ib txwm thiab tawm hauv cov quav. Clinically, nws feem ntau manifests raws li raws plab, nyias, hnyav, greasy thiab lwm cov tsos mob ntawm cov rog, yog li nws tseem hu ua steatorrhea.
21.PJ Syndrome (Pigmented Polyposis Syndrome, PJS)
Nws yog ib qho tsis tshua muaj autosomal dominant qog syndrome tshwm sim los ntawm daim tawv nqaij thiab mucosal pigmentation, ntau yam hamartomatous polyps nyob rau hauv plab hnyuv ib ntsuj av, thiab qog susceptibility.
PJS tshwm sim txij thaum yau. Raws li cov neeg mob hnub nyoog, plab hnyuv polyps maj mam nce thiab loj, ua rau muaj ntau yam teeb meem, xws li intussusception, plab hnyuv, plab hnyuv los ntshav, mob qog noj ntshav, malnutrition, thiab kev loj hlob retardation nyob rau hauv cov me nyuam.
22. Abdominal compartment syndrome
Qhov siab ntawm lub plab hauv plab ntawm ib tus neeg ib txwm nyob ze rau atmospheric siab, 5 mus rau 7 mmHg.
Intra-abdominal siab ≥12 mmHg yog intra-abdominal hypertension, thiab intra-abdominal siab ≥20 mmHg nrog rau lub cev tsis ua hauj lwm muaj feem xyuam rau intra-abdominal hypertension yog abdominal compartment syndrome (ACS).
Clinical manifestations: Tus neeg mob muaj lub hauv siab nruj, ua tsis taus pa luv, ua tsis taus pa nyuaj, thiab ceev lub plawv dhia. Kev mob plab thiab mob siab tuaj yeem ua rau mob plab, lub plab zom mov tsis muaj zog lossis ploj, thiab lwm yam. Hypercapnia (PaCO?> 50 mmHg) thiab oliguria ( zis tso zis ib teev <0.5 mL / kg) tuaj yeem tshwm sim thaum ntxov ntawm ACS. Anuria, azotemia, ua pa tsis ua haujlwm thiab lub plawv tsis ua haujlwm tshwm sim nyob rau theem tom ntej.
23. Superior mesenteric artery syndrome
Kuj tseem hu ua benign duodenal stasis thiab duodenal stasis, cov tsos mob tshwm sim los ntawm qhov txawv txav ntawm cov hlab ntsha mesenteric uas ua rau cov kab rov tav ntawm duodenum, uas ua rau ib nrab lossis ua tiav kev cuam tshuam ntawm duodenum.
Nws muaj ntau dua hauv cov poj niam laus asthenic. Hiccups, xeev siab, thiab ntuav yog tshwm sim. Lub ntsiab feature ntawm tus kab mob no yog hais tias cov tsos mob muaj feem xyuam rau lub cev txoj hauj lwm. Thaum siv txoj hauj lwm supine, cov tsos mob compression hnyav dua, thaum lub sij hawm nws txoj hauj lwm, lub hauv caug-lub hauv siab txoj hauj lwm, los yog sab laug txoj hauj lwm, cov tsos mob yuav txo tau. .
24. Qhov muag tsis pom kev
Ib tug syndrome ntawm raws plab, anemia, malabsorption thiab poob ceeb thawj tshwm sim los ntawm stagnation ntawm cov hnyuv me thiab cov kab mob overgrowth nyob rau hauv txoj hnyuv lumen. Nws yog tsuas yog pom nyob rau hauv tsim ntawm dig muag loops los yog dig muag hnab (xws li plab hnyuv loops) tom qab gastrectomy thiab gastrointestinal anastomosis. Thiab tshwm sim los ntawm stasis.
25. Short plob tsis so tswj
Nws txhais tau hais tias tom qab kev phais me me los yog kev cais tawm vim muaj ntau yam, qhov chaw nqus tau zoo ntawm txoj hnyuv tau txo qis, thiab cov hnyuv ua haujlwm tseem tsis tuaj yeem tswj cov khoom noj ntawm tus neeg mob lossis kev loj hlob ntawm tus menyuam, thiab cov tsos mob xws li raws plab, acid-base/dej/electrolyte disorders, thiab syndromes dominated los ntawm kev tsis haum ntawm kev nqus thiab metabolism ntawm ntau yam as-ham.
26. Hepatorenal syndrome
Cov tsos mob tseem ceeb yog oliguria, anuria thiab azotemia.
Tus neeg mob lub raum tsis muaj qhov mob loj heev. Vim qhov mob hnyav portal hypertension thiab splanchnic hyperdynamic ncig, cov hlab ntsha hauv lub cev tau txo qis, thiab ntau yam vasodilator tshuaj xws li prostaglandins, nitric oxide, glucagon, atrial natriuretic peptide, endotoxin, thiab Calcium gene-related peptides tsis tuaj yeem ua haujlwm tsis tau. daim siab, ua rau lub cev vascular txaj kom dilate; Cov kua dej ntau hauv peritoneal tuaj yeem ua rau muaj kev nce siab hauv lub plab hauv plab, uas tuaj yeem txo cov ntshav hauv lub raum, tshwj xeeb tshaj yog rau lub raum cortex hypoperfusion, ua rau lub raum tsis ua haujlwm.
80% ntawm cov neeg mob uas muaj tus kab mob sai sai tuag hauv li 2 lub lis piam. Hom kev mob qeeb qeeb yog ntau dua hauv kev kho mob, feem ntau nthuav tawm nrog lub plab refractory thiab ua rau lub raum tsis ua haujlwm qeeb.
27. Hepatopulmonary syndrome
Raws li daim siab cirrhosis, tom qab tsis suav nrog thawj cov kab mob cardiopulmonary, dyspnea thiab cov tsos mob ntawm hypoxia xws li cyanosis thiab clubbing ntawm cov ntiv tes (toes) tshwm sim, uas muaj feem xyuam rau inrapulmonary vasodilation thiab arterial ntshav oxygenation tsis ua hauj lwm, thiab cov tsos mob tsis zoo.
28.Mirizzi syndrome
Lub gallbladder caj dab los yog cystic duct pob zeb impaction, los yog ua ke nrog gallbladder o, siab
Nws tshwm sim los ntawm kev quab yuam lossis cuam tshuam rau cov kab mob siab, ua rau cov ntaub so ntswg loj hlob, o los yog stenosis ntawm cov kab mob siab, thiab kev kho mob tshwm sim raws li cov kev kho mob ntawm cov kab mob uas tshwm sim los ntawm obstructive jaundice, biliary colic lossis cholangitis.
Lub hauv paus anatomical rau nws tsim yog tias cov cystic duct thiab cov kab mob siab ua ke ntev dhau los ua ke los yog qhov chaw sib txuam ntawm cov cystic duct thiab cov kab mob siab heev.
29.Budd-Chiari Syndrome
Budd-Chiari syndrome, tseem hu ua Budd-Chiari syndrome, yog hais txog ib pawg ntawm portal hypertension los yog portal thiab inferior vena cava hypertension tshwm sim los ntawm kev cuam tshuam ntawm cov hlab ntsha hauv siab los yog inferior vena cava saum nws qhib. kab mob.
30. Caroli Syndrome
Congenital cystic dilation ntawm intrahepatic bile ducts. Lub mechanism tsis meej. Nws yuav zoo ib yam li choledocha cyst. Qhov tshwm sim ntawm cholangiocarcinoma yog ntau dua li ntawm cov pejxeem. Cov tsos mob thaum ntxov yog hepatomegaly thiab mob plab, feem ntau zoo li biliary colic, nyuaj los ntawm cov kab mob ntawm cov kab mob hauv lub cev. Ua npaws thiab jaundice tshwm sim thaum lub sij hawm o, thiab qhov degree ntawm jaundice feem ntau me me.
31. Puborectal syndrome
Nws yog ib tug defecation disorder tshwm sim los ntawm obstructive pelvic pem teb qhov hluav taws xob vim spasm los yog hypertrophy ntawm cov leeg puborectalis.
32. Pelvic floor syndrome
Nws yog hais txog ib pawg ntawm cov tsos mob tshwm sim los ntawm neuromuscular abnormalities nyob rau hauv lub pelvic pem teb qauv nrog rau lub qhov quav, levator ani leeg, thiab sab nraud qhov quav sphincter. Cov tsos mob tseem ceeb hauv kev kho mob yog nyuaj rau kev tso quav los yog tsis muaj zog, nrog rau lub plab hauv plab thiab mob. Cov kev ua haujlwm tsis zoo no qee zaum suav nrog kev quav dej quav cawv, thiab qee zaum fecal incontinence. Thaum mob hnyav, lawv mob heev.
Peb, Jiangxi Zhuoruihua Medical Instrument Co., Ltd., yog cov chaw tsim khoom hauv Suav teb tshwj xeeb hauv cov khoom siv endoscopic, xws libiopsy forceps, hemoclip, polyp nuv,koob sclerotherapy, tshuaj tsuag catheter, cytology txhuam, phau ntawv qhia,pob zeb retrieval pob tawb, qhov ntswg biliary kua catheteretc. uas yog dav siv nyob rau hauvEMR,ESD, ERCP. Peb cov khoom muaj ntawv pov thawj CE, thiab peb cov nroj tsuag tau ntawv pov thawj ISO. Peb cov khoom tau raug xa tawm mus rau Tebchaws Europe, North America, Middle East thiab ib feem ntawm Asia, thiab tau txais cov neeg siv khoom ntawm kev lees paub thiab qhuas!
Post lub sij hawm: Sep-06-2024