APPENDITSIT

APPENDITSIT (Appendicitis), iltihobi kirmruda, gazaki izofai kirmshakl (appendiks)-i kurruda. Dar rudai odam mikroorganizmhoi gunogun mavjud boshand ham, onho odatan bemoriovar nestand. Ammo dar baze mavridho khosiyati nomatlubi onho zuhur yofta, boisi gazaki ruda megardand. Mas., yake az sababhoi paydoishi A. az izofai kirmshakl ba kurruda bo dushvori guzashtani muhtavoi ruda ast. Qat (kaj) shudani izofai kirmshakl (kirmruda) yo bo pasafkandi sakht basta shudani ravzani on, inchunin az tasiri yagon angeza (mas., muyakkija yo mahsuli pusidai muhtavoi ruda) nogahon va sakht varam kardani luobparda ba kholi gashtani daruni kirmruda mone meshavand. Muttasil va az had ziyod bo safedai hayvonot (gusht, mohi) pur shudani medayu ruda agar az yak taraf boisi qabziyat gardad, az tarafi digar ravandi tosidani rudaro metezonad. Ba A. odamoni hamai sinnu sol giriftor meshavand.
A. shadid va muzmin meshavad. Gazaki shadidi izofai kirmshakl az pardai dokhili (luobi)-i on ogoz yofta, bad ba daruntar pahn megardad, boftaho, az on jumla, devorai kirmruda, purra oseb meyoband (A.-i flegmoni) va fasod ba daruni shikam meguzarad (A.-i shikofanda). Ikhtiloli gardishi khuni raghoe, ki kirmrudaro bo khun tamin mekunand, boisi mahvi on megardand (A.-okilavi). Dar natijai shikof shudan va pusidan (gangrena)-i kirmruda sifoq gazak megirad (peritonit). Hangomi A.-i shadid poyoni shikam (beshtar az tarafi rost) nogahon ba dard medaroyad. Aksar vaqt joyhoi gunoguni badan, az jumla sari dil va girdi nof dard karda, tanho bad az chand soat joe, ki kurruda voqe ast (tarafi rosti poyoni shikam), sakht dard mekunad. Dard tadrijan meafzoyad, dar vaqti sulfidan yo vazi badanro tagyir dodan, khususan hangomi ba pahlui chap khobidani bemor, dard purzur meshavad. Kudakon va odamoni solkhurda hangomi A. dardro kamtar his mekunand. Huruji A. beshtar dar behuzur shudani dil va qay zohir megardad, qabziyat yo ishol (asosan dar tobiston) ba vujud meoyad. Odamoni kalonsol qadre tab mekunand (37,50 – 38,50S), tabi kudakon boshad, nisbatan baland ast. Harorati badani odamoni solkhurda hatto hangomi shaklhoi vaznini A. niz mutadil meshavad.
Iltihob metavonad faqat bo gazaki pardai luobi mahdud gardad. Agar muhtavoi kirmruda ba kurruda rezad, khuruji A. qat khohad shud. Ammo ba chunin behbudi umed bastan noravost, chunki hatto dukhtur niz darajai vaznini va khususiyati gazaki kirmrudaro muayyan karda nametavonad va tagyiroti khatarnoki on (mas., okila) zud az khud darak medihad. Binobar in, dar har holat favran burida partoftani izofai kirmshakl zarur ast.
Dar kirmrudai bemore, ki bo yagon sabab jarrohi karda nashudaastu A.-i shadidro beozor az sar guzaronidaast, tagyirot boqi memonad (on metavonad boisi khuruji takrori va nisbatan vaznintar shavad). SHakhsone, ki ba A.-i takrori giriftor shudaand, doimo zeri khavfi sar zadani khuruji nav qaror dorand. Az in ru, onho boyad dar sayohati turisti va ekspiditsiyahoi ilmi dar mahallhoi kammaskun (dar joyhoe, ki yorii jarrohii tajili dushvor ast) shirkat navarzand.
Sababi asosii oqibathoi nokhushi A.-i shadid ba dukhtur der murojiat kardan ast, zero odamon dardi shikam, behuzur shudani dil va qayro (khususan agar in alomatho dar kudak ruy dihand) bisyor vaqt az «vayron shudani meda» medonand. Gayr az in, onho ba vositai doruhoi isholovar yo imola (huqna) rudaro toza kardani meshavand, ki bilkul noravost (zero gazak ba peritoniti farogiranda tabdil meyobad). Boyad donist, ki dardi shadidi shikam bisyor vaqt bo khuruji A. vobasta ast. Binobar in, hangomi dardi sakht hatman dukhturro davat kuned. To omadani u bemorro bistari karda ba rui shikamash zarfero bo yakh yo obi khunuk guzored (garmkunak guzoshtan mumkin nest). Istemoli doruhoi rafi dard noravost, chunki kam shudani dard boisi tashkhisu tabobati nodurusti bemori megardad.
Dar asnoi A.-i muzmin mariz az qabziyat, behuzur shudani dil, muttasil yo goh-goh dard kardani atrofi kurruda shikoyat mekunad. In alomathoi A.-i muzmin buda, metavonad har vaqt ba A.-i shadid guzarad (dar in holat amaliyoti jarrohi tavsiya karda meshavad).
Ad.: Kakharov A. N., Mukhamedov S. M., O znachenie rentgenologicheskogo issledovaniya v diagnostike khronicheskogo appendisita. Dar maj.: «Zdravokhronenie Tadjikistana», ; №5, 1966; Gostishev V.K., Obshaya khirurgiya, M., 2005; Petrov S.V., Obshaya khirurgiya, M., 2005; Hirurgicheskie bolezni, j. 1 – 2, M., 2005.
A. R. Dostiev.