Calculous cholecystitis - ndichiyani? Zizindikiro, zimayambitsa, chithandizo cha cholecystitis calculous

Calculous cholecystitis ndi maonekedwe a ndondomeko aakulu, mmene calculi zosiyanasiyana (miyala) alipo mu ndulu ya. chiwerengero chawo ndi kukula zingasiyane. Nthawi zina ndi mwala mwachilungamo lalikulu, m'mimba mwake amene angafikire ku 5-6 masentimita kapena zambiri, ndipo mwinamwake kwambiri wa miyala ing'onoing'ono kwambiri ndi m'mimba mwake ndi nusu ya millimeter, mu mawu ena, mchenga. Calculous cholecystitis - ndichiyani? Izi m'nkhani ino.

Malinga ndi kafukufuku, 10% ya anthu akuluakulu amadwala miyala ndulu. Matenda calculous cholecystitis akazi nkhawa kasanu zambiri kuposa abambo. Age gulu la odwala - kuchokera zaka 40 ndi kuposerapo. Ana ndi achinyamata zaka 30, matenda kawirikawiri Musiyeni.

Gallstones. Kodi ngozi?

Zinali kukula kwa gallstones ndi kudziwa zizindikiro, mwamphamvu, matenda matenda ndi mavuto zotheka matenda gallstone (GSD). Matenda calculous cholecystitis ndi owopsa kwa mavuto ake.

Nthawi zambiri (75%) a concretions ankakhala mu thupi la ndulu, koma nthawi zina pangakhale miyala tating'ono ya ndulu ritsa, potero kupanga kovuta kapena kwathunthu kuphimba ndi kuchititsa khunyu gallstone colic.

Ngati concrements mpaka 3 mamilimita akhoza mosadalira kutuluka mwa ducts, miyala kuyambira kukula 3 7 mm pa kubwereketsa a ndulu akhoza obturated (alipo) ya ndulu ritsa ndi vuto ili opaleshoni mwamsanga.

Zikuchokera gallstones komanso zimasiyanasiyana. Iwo akhoza kukhala:

• cholesteric - miyala ya mtundu uwu sangathe kuona pa x-ray;
• laimu;
• pigment;
• losanganikirana.

Ambiri mitundu yambiri ankapita gallstones, maonekedwe awo ndi yosiyanasiyana (yozungulira faceted kapena nthambi).

Zimayambitsa vuto

Calculous cholecystitis (CL) aumbike yomweyo. Taganizirani zimene zimathandiza kuti mapangidwe miyala ndulu ndi:

• cholestasis, cholestasis kapena Mwachitsanzo, mwina pa anaŵerama ndulu thupi;
• diskholiya kapena kusinthidwa ya ndulu zikuchokera, ndende wake chifukwa okwera mafuta katulutsidwe kapena matenda;
• cholecystitis, kapena kutupa mu ndulu ya.

Komanso, choyambitsa amatha calculous cholecystitis zakudya, kani, kuyan'anila pulogalamu chakudya (kwambiri mkulu-kalori, mafuta ndi mafuta m'thupi kulemera zakudya, kupanda mavitamini mu chakudya). Mwadongosolo njala ndi otsika-kalori zakudya, ndipo ngakhale ntchito nthawi yaitali mankhwala m'thupi kulera zosiyanasiyanazi amathanso kukhala cholelithiasis.

Ena mwa matenda amene nthawi zambiri kutsogolera kwa mapangidwe gallstones, zimadziwika:

• kunenepa ndi kagayidwe kachakudya matenda;
• matenda endocrine monga matenda a shuga;
• matenda chiwindi, mwachitsanzo, matenda a chiwindi ndi matenda enaake;
• biliary dyskinesia;
• kapamba;
• duodenitis;
• matenda amene amatupitsa;
• aakulu gastritis;
• matenda helminth.

The pathogenesis la mapangidwe gallstones

The zikuchokera zikuphatikizapo ya ndulu zidulo, lipids, inki ndi mchere zinthu. Mwachibadwa, onse a zigawo zimenezi ziri colloidal (omwazika) boma. Mu zinthu akumane tatchulazi, akusokoneza ya ndulu mafuta mlingo koyefishienti, r Mukhoza. F. Yozunzirako chiŵerengero cha asidi wokhutira mafuta. Izi zimathandiza kuti imfa ya mafuta mu matope ndi crystallization wake wotsatira. Choncho concretions kupangidwa mu chikhodzodzo ndulu.

Gawo

Calculous cholecystitis - ndichiyani? Njira matenda GSD ingakhale yopweteka kwambiri kapena yokhalitsa. Malinga zizindikiro ndi lililonse ezofagalgichesky, mtima, m'mimba, ndi atypical calculous cholecystitis. Zizindikiro ndi mankhwala zosiyanasiyana malinga mitundu ya njira ya matenda.

Pali magawo anayi mogwirizana GSD akupanga Kupenda:

1. Predkamennaya kapena koyamba - zochititsa khalidwe ndi kukhalapo ya ndulu wandiweyani, ndulu stasis ndi mapangidwe microlites (mchenga) mu ndulu ya. Izi siteji ya matenda ndi ufulu chithandizo chisankho normalization mphamvu nthawi zambiri kusintha.
2. calculi mapangidwe - by ultrasound wapezeka imodzi kapena miyala angapo ang'onoang'ono.
3. Matenda calculous cholecystitis - ichi siteji ya matenda liyenela pamaso pa miyala zamitundu yosiyanasiyana mu ndulu ya. Zimenezi zingakhale limodzi miyala ikuluikulu, ndi mapangidwe awiri ang'onoang'ono, kapena angapo ang'onoang'ono.
4. Zovuta calculary cholecystitis - gawo ili la matenda amakhala ndi chitukuko cha mavuto osiyanasiyana monga kutsekeka biliary.

diagnostics

Ultrasound ndi njira yaikulu Kupenda matenda kwa matenda "cholecystitis calculous". Chimene icho chiri, lingaliro kale anapanga. Kugwiritsa ultrasound katswiri adzaona chiwerengero ndi kukula kwa concretions ili mu chikhodzodzo ndulu, ndipo malo awo, ndipo boma la mpanda kuwira.

Mwa njira malangizo a tione cholecystitis calculous mulinso endoscopic retrograde cholangiopancreatography (ERCP). Njira imeneyi zimathandiza kuti tione boma pa mundawo biliary ndi kudziwa mlingo wa kutsekeka, zimene zingakuthandizeni kusankha bwino machenjerero katswiri opaleshoni. njira tichipeza mu zimadzaza radiopaque mankhwala biliary thirakiti pa EGD, pamaso radiography imagwiridwa.

Kuwonjezera njira izi malangizo a zasayansi Kupenda ntchito, monga kusanthula ambiri ndi magazi amuzolengedwa. Ndi woyamba ku matenda Tingaone mu nkhani ya okwera ESR pamaso kutupa mu ndulu, komanso monga kuwonjezeka mu kusanthula neutrophil leucocyte kuwerengedwa.

Amuzolengedwa kusanthula magazi matenda kumachepetsa kuti mtima wa milingo zotsatirazi:

• Alt ndi Ast;
• bilirubin;
• zamchere phosphatase;
• okwana mapuloteni;
• CRP.

Chiwerengerochi udzakhala wautali mwa mwambo stagnation wa ya ndulu (cholestasis). kupitilira izi matenda ndi zotheka ndi kakyulasi kutsekeka kwa aliyense wa ducts ya ndulu.

Palinso njira zina za matenda a matenda monga cholecystitis calculous. Zizindikiro ndi chithandizo kumatengera ndi chikhalidwe cha thirakiti biliary ndi chikhalidwe ambiri a chiwindi wonse. maluso ameneŵa matenda monga:

• mtsempha cholegraphy;
• Oral cholecystography;
• gepatobiliostsintigrafiya.

Calculous cholecystitis. Zizindikiro ndi Chithandizo. zambiri

Nthawi zina, wodwalayo sadziwa kuti calculous cholecystitis. Kodi izo amaphunzira pokhapokha kuukira kwa colic biliary. Iwo amakhala ndi kupweteka kwambiri lamanja nusu chapamwamba, omwe angathandize epigastrium a m'munsi kumbuyo, phewa kapena khosi.

zoopsa zotere zambiri zimachitika pambuyo pa maholide ndi maphwando, pamene osazindikira za matendawo munthu akulola kutenga mowa ndi kuluma kudya bwino aliwonse, zokometsera, zakudya kusuta kapena mchere. Uyambe amenewa kumusonyeza kapena maganizo amphamvu. Kamodzi mtima laperekedwa kwa chipatala ndipo anafufuza, waphunzira za matenda "calculous cholecystitis". Aggravation akhoza limodzi ndi kunyansidwa ndi kusanza.

Ntchito kapena ayi?

Pamene matenda a "calculous cholecystitis" Zizindikiro ndi mankhwala malingana siteji ya matenda ndi chikhalidwe cha mundawo biliary zingasiyane. Ngati akadali zotheka njira kusintha, ndiye ena onse, pamene mapangidwe miyala wayamba kale, zochita zabwino adzakhala mu matenda a "calculous cholecystitis" ntchito mu predkamennoy kapena pa siteji koyamba. Ndipo liwiro adzakhala opaleshoni, chindichepere mosavuta zosokonezeka.

Kukonzekera opaleshoni akulandira mankhwala ndi zakumwa zobwezeretsa za thupi ngati n'koyenera. Kuthana ndi madzi m'thupi kwenikweni anachita ngati wodwalayo nthawi za zimene zinachitika linabwerezedwa kusanza. zonsezi ithandiza kuchepetsa chiopsezo sepsis.

Pamene matenda a "aakulu calculous cholecystitis" ntchito nthawi anachita ntchito laparoscope. Njira zamakono za kuchepetsa ululu mu nthawi konzanso ndi kuchepetsa kuchira nthawi ndi kuchepetsa chiopsezo cha matenda oyamba postoperative.

Kuchotsa ululu kuukira

Matenda matenda gallstone zingasiyane mu chikhalidwe ndi mphamvu ya ululu. Zikavuta, nkotheka kunyansidwa ndi kusanza, ndipo ngati mwala kwathunthu ndigwire wamba ya ndulu ritsa, mtundu wa mpando angakhale yowala chifukwa sipadzakhala pigment ya ndulu. Pansi zoopsa zotere aakulu m'pofunika kuthetsa mwamsanga kuchipatala kapena itanani ambulansi.

Ngati matenda kumaonekera kuukira Chowawa kwambiri, mungathe kuyesa kuthetsa ululu nokha. Kuti tichite zimenezi, muyenera angapo mankhwala a mankhwala "No-spa" kapena "papaverine" ndiponso kukuzizirira pa hypochondrium bwino. Kudya pa nthawi yomweyo kusiya kwa maola osachepera 12. Ngati izi sizikuthandiza, muyenera kuchipatala.

Calculous cholecystitis. Chithandizo popanda opaleshoni

Popanda opaleshoni, matenda angathe kuchizidwa, koma pakati pa izi njila ali contraindications ake ndi mavuto, komanso sizitanthauza kuti matenda sadzakhala ayambiranso. Tikungotchula njira izi:

• Ndi mankhwala acidic;
• funsani chiwonongeko cha miyala ndulu;
• extracorporeal mantha yoweyula lithotripsy.

Tsopano makamaka kulankhula za aliyense wa iwo.

mankhwala acidic

Pakali pano, matenda a "aakulu calculous cholecystitis" chithandizo ndi zotheka popanda opaleshoni, koma njira imeneyi ndi yokwera mtengo kwambiri ndipo palibe chitsimikizo kuti sadzakhala ayambiranso. mankhwala yaitali - miyezi 24. Pali zinthu zofunikira zokhudzana ndi kukula kwa miyala, zikuchokera awo, boma la ndulu ndi ducts ake:

1. mwala kukula sayenera oposa 1.5 masentimita awiri.
2. The zikuchokera miyala - yekha mafuta.
3. Ndulu ndi ducts liyenera kukhala labwinobwino ndiponso bwino.

Pamene matenda "calculary cholecystitis" ntchito mankhwala akutsatiridwa popanda mankhwala "Henofalk" ndi "Ursofalk" - ndi ursodeoxycholic ndi chenodeoxycholic asidi, motero.

Akamanena za mankhwala ndi kuonetsetsa kuti nthumwi izi acidic kudziunjikira mu zikuchokera ya ndulu ndi pang'onopang'ono kupasuka mafuta calculi. Koma akutsimikizira kuti matenda sadzabwereranso, palibe. N'zotheka musabise.

Lumikizanani ndi chiwonongeko cha miyala ndulu

Njira imeneyi mankhwala kumafuna imodzi koma angapo njira. Iwo anagwira motere. Pa ultrasound ndi dokotala punctures ndi zapambuyo m'mimba khoma la singano yaitali m'dera ziyerekezo kwa chikhodzodzo ndulu, ndi kuwira yokha akulowa catheter kudzera amene kulowa mankhwala enieni amene akhoza kuyimisa gallstones. njira akutsatiridwa kangapo. Ziyenera adzanyamula kukumbukira kuti si onse zoyenera. Pali sangachite ali chimodzimodzi monga mu njira tafotokozazi. Komanso, sipangakhale mavuto monga kutupa kwa mucosa matumbo.

Extracorporeal mantha yoweyula lithotripsy

Mu njirayi, pa khungu wodwalayo m'dera la ziyerekezo ya ndulu pa zapambuyo khoma m'mimba ya sensa ili, mafunde wodwalayo akuchokera kwa izo ndi kuchita gallstones. Kuchita ndondomeko umenewo kumafuna zinthu zotsatirazi:

• mu ndulu ya sayenera kutupa;
• mwala kukula - zosaposa 3.5 masentimita;
• ndulu ndi ducts bwino ntchito.

Njira imeneyi si otetezeka kwambiri. zosokonezeka zotheka:

• kutseka ducts miyala ndulu;
• obstructive matenda a chikasu ndiyo;
• chitukuko cha kapamba pachimake kapena matenda a shuga.

Mpaka pano, njira otetezedwa kwambiri ya chithandizo cha calculous cholecystitis ndi nkhani mavuto amakhalabe holetsistoektomiya, mwachitsanzo kuchotsa ndulu ya.

zosokonezeka zotheka

Calculous cholecystitis ankachitira kwenikweni muyenera T. Kwa. Iye yoopsa ndi mavuto ake. Tikungotchula anthu ambiri:

1. Pachimake kapamba.
2. Empyema wa chikhodzodzo ndulu (kutupa anatsatira polemba nkhani chikhodzodzo purulent).
3. Zowononga cholecystitis.
4. Cholangitis (kutupa kwa ducts ya ndulu).
5. Secondary biliary matenda enaake.
6. Fistulas pakati ya ndulu ritsa ndi chikhodzodzo.
7. Ileus.
8. Oncology ndulu.
9. Choledocholithiasis (concrements mu ya ndulu ritsa).

zakudya

Choncho, muyenera kudya bwino ndi pamaso pa mtima anapezeka ndi "aakulu calculous cholecystitis". Zakudya bwino osankhidwa, angathe kutumikira monga kupewa matenda funso. Potanthauza zolinga zake zikuluzikulu:

1. Yafupika zili lipids m'magazi. Izi makamaka amatanthauza mafuta ndi tuzigawo twa ake.
2. Onetsetsani uziyenda yachibadwa ya ndulu ndi kuteteza stagnation mu izo.
3. Pang'onopang'ono kuyesetsa kuwonda, ngati pakufunika kutero. kuwonda ayenera pang'onopang'ono, mu mwezi inu akhoza kutaya zosaposa 2-3 makilogalamu.
4. Kumamwa kowirikiza madzi, mpaka malita 2 pa tsiku.
5. Ankadya chakudya mavitamini mokwanira ndi mchere mu zakudya ayenera kupezeka masamba, zipatso ndi zambiri greenery.
6. Kuonetsetsa kayendedwe wabwino matumbo, kudya zakudya zokhala CHIKWANGWANI ndi wonse tirigu mkate ndi chinangwa tirigu.
7. Asachite nyama mafuta.
8. Masamba mafuta ayenera kupezeka mu chakudya, koma palibe magilamu 80 patsiku.
9. Nyama, Idyani, ayenera kukhala Taphunzira (palibe mafuta).
10. Kuletsa zakudya mchere ndi zokometsera, komanso zakudya yokazinga. Zakudya ayenera yophika kapena steamed, anakulandirani ntchito saladi zamasamba zosaphika.
11. M'pofunika chakudya yaing'ono nthawi 5-6 tsiku.

Malamulo imagwiranso ntchito kwa chakudya pambuyo holetsistoektomii (kuchotsa ndulu ya).

About mowa ayenera otchulidwa payokha. Aliyense mowa ndi koletsedwa kotheratu matenda. Izo zikusonyeza mbiri kuposa wina wa matenda, pachimake calculous cholecystitis zambiri amapezeka pambuyo kutenga mowa. Nthawi zambiri odwala anavomereza mwachindunji chifukwa tebulo tchuthi.

Maphikidwe Medicine Njira

Pamene matenda a "calculous cholecystitis" mankhwala wowerengeka Angagwiritsidwenso ntchito pofuna kuchiza. Ntchito mlingo milandu, infusions ndi decoctions okhala zotsatira choleretic, kuchepetsa ya ndulu ndende ndi kuchepetsa stagnation mu ndulu ya.

Mogwira anthu amati ndi decoction wa maluwa immortelle. Pakuti kukonzekera, 15 g yaiwisi youma kutsanulira 80 ml ya madzi otentha ndi mkangano pa kusamba nthunzi kwa mphindi 30. Chakumwa amaloledwa kuziziritsa ndi osasankhidwa, ndiye wapangidwa ndi 100 ml ya madzi ozizira yophika ndi kutenga 50 ml kawiri pa tsiku pamaso chakudya.

Zochizira cholelithiasis ambiri yotchuka ntchito kulowetsedwa wa kiranberi tsamba. Pakuti yokonza yaiwisi mankhwala 3 tebulo supuni anadzazidwa mu thermos ndi kutsanulira otentha madzi buku la 1 lita imodzi. Ngati mwai izi kuchita madzulo, ndi m'mawa ya tiyi achire ndi wokonzeka.

Pomaliza

Akukhulupirira kuti mankhwala abwino - kupewa matenda. Zimenezi zikugwira ntchito kwathunthu kwa matenda monga cholecystitis calculous. kudya zakudya zopatsa nthanzi ndi kutsatira moyo wathanzi chingatithandize kupewa matendawa zosasangalatsa. Ndipo ngati izo zimachitika kuti GSD akadali anapanga, m'pofunika kukhwimitsa mwamsanga kuthetsa nkhaniyo. Kumbukirani kuti pa siteji koyamba, pamene chikhodzodzo ndulu pali mchenga mmalo mwa miyala ikuluikulu, ndondomeko angathe anyamata.