Биология ва тиббиёт муаммолари 2024 №5 (156)
Subject of the article
СИГМАСИМОН ИЧАК БУРАЛИШИНИНГ ДИАГНОСТИКАСИ ВА ДАВОЛАШДА ЗАМОНАВИЙ ЁНДАШУВЛАР (361-370)
Authors
Туляганов Даврон Бахтиярович, Абдулахатов Муроджон Хамидович, Элмурадов Ғолибжон Қаршиевич
Institution
1 - Республика шошилинч тиббий ёрдам илмий маркази, Ўзбекистон Республикаси, Тошкент ш.; 2 - Самарқанд давлат тиббиёт университети, Ўзбекистон Республикаси, Самарқанд ш.
Abstract
Сигмасимон ичак буралиши ичак тутилишлари таркибида нисбатан кам учрасада, лекин унинг асоратлари жуда оғир ҳисобланади ва бу ҳолат унинг диагностикаси аҳамиятини ўта кучайтиради. Беморларнинг 5-22%да техник сабабларга кўра эндоскопик деторсияни бажариш имкони бўлмайди ва улар хирургик амалиёга олинади. Яна бошқа 5-25% ҳолатларда эса ичак некрози ёки перфорацияси, перитонит, септик шок каби асоратлар бўлганлиги сабабли беморларга эндоскопик муолажалар ўтказилмасдан бевосита шошилинч хирургик амалиётлар бажарилинади. Колоректал хирургияда анастомоз етишмовчилигининг умумий миқдори 3,4%дан 6%гача ташкил қилсада, тўғри ичакка яқин сегментлар резекциясидан сўнги анастомоз етишмовчили 15%гача етиши мумкин. Сигмасимон ичакнинг илк бора буралиб қолишларини даволаш жараёнида ушбу асоратга олиб келган асосий омиллар (долихосигма, ичак тутқичининг узунлиги) бартараф қилинмасдан, беморга кўрсатилган муолажа ёки амалиётлар фақатгина ичак деторсияси билан чегараланган тақдирда, буралиш рецидиви хавфи юқорилигича сақланиб қолади ва 84%гача етиши мумкин. Сигмасимон ичак буралишининг рецидивининг олдини олишга йўналтирилган бир қанча операция турлари мавжуд бўлиб, улардан сўнги қайта буралиш миқдори 10-20%дан пастга тушмайди, бу эса касалликнинг қайталанишига қаратилган янада самарали ва етарли даражада хавфсиз усулларни излашни тақозо қилади.
Key words
сигмасимон ичак буралиши, долихосигма, эндоскопик деторсия, сегмопекция.
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