Cholecystitis Calculous - ntoni na? Iimpawu, oonobangela, unyango lwe cholecystitis calculous

I-calcous cholecystitis yindlela yokuhlala engapheliyo apho amatye amaninzi (amatye) ekhona kwi-gallbladder. Inani kunye nobukhulu bazo ziyahluka. Ngamanye amaxesha eli lilitye elikhulu ngokwaneleyo, ububanzi balo buya kufinyelela ku-5-6 cm okanye ngaphezulu, kwaye mhlawumbi amaninzi amancinci anamanqanaba amade ayingqimba ye-millimeter, ngamanye amagama, isanti. I-Calculous cholecystitis - yintoni na? Oku kuya kuxutyushwa kule nqaku.

Ngokwezibalo, u-10% wabantu abadala abadala abanesifo se-CSF. I-cholecystitis engapheliyo ye-calleticstitis yabesifazane ibakhathaza ngokuphindwe kabini ngaphezu kwamadoda. Udidi lwegulane lwabadala luvela kwiminyaka engama-40 nangaphezulu. Abantwana kunye nabantu abatsha abangaphantsi kweminyaka engama-30 esi sifo sikhathazeka kakhulu.

Gallstones. Iyintoni ingozi?

Ubungakanani be-gallstones kwaye ibeka impawu, ubunzima bekhosi, ikliniki yesi sifo kunye neengxaki ezinokwenzeka ze- cholelithiasis (SCI). I-cholecystitis engapheliyo ye-calculation iyingozi ngenxa yeengxaki zayo.

Kwiimeko ezininzi (i-75%), izikhonkwane zikhona emzimbeni we-gallbladder, kodwa ngamanye amaxesha amatye amancinci angena kwi-buct ye-bile, ngokwenza kube nzima okanye ukuyivimbele ngokupheleleyo kwaye kubangele ukuhlaselwa kwe-bile colic.

Ukuba ama-concrements ukuya kwi-3 mm ngobukhulu angakwazi ukuphuma ngokuzimeleyo kwiidolo, amatye amathathu ukuya kwi-7 mm ubukhulu angaphuma kwi-gallbladder ukumboza i-bile duct, kwaye le nkcenkcesho iya kufuna ukunyango oluphuthumayo.

Ukubunjwa kwama-gallstones kuyahluka. Ba no:

• Amatye e-Cholesterol alo hlobo alubonakali kwi-radiography;
• Calcareous;
• Iigwegwe;
• Ezixubileyo.

Ngokuqhelekileyo kukho iindidi ezidibeneyo ze-gallstones, imilo yazo ihlukeneyo (ijikelezwe, i-polyhedral okanye i-branched).

Izizathu zeengxaki

I-calcous cholecystitis (SCI) ayilwanga ngokukhawuleza. Cinga ngezinto ezibangela ukubunjwa kwee-concrements kwi-gallbladder:

• I-Cholestasis, okanye i-stasis ye-bile, ngokomzekelo, inokuba neengxowa zomzimba we-gallbladder;
• Discholia, okanye ukuguqula i-bile yokwakheka, ukunyusa kwayo ngenxa yokwanda kwe-cholesterol okanye ukukhutshwa okungekho mthethweni;
• I-cholecystitis, okanye izinto ezivuzayo kwi-gallbladder.

Ukongezelela, kunokukhupha i-cholecystitis yokutya, ngokuchanekileyo, ukuphazamiseka kwenkqubo yesondlo (kakhulu eekhalori, ukutya okunotyebile kunye ne-cholesterol, ukungafumaneki kwamavithamini ekudleni). Ukutya okuchanekileyo kunye nokutya okukhawuleza kweekhalori, kunye nokusetyenziswa kwexesha elide lemithi ye-hormone ye-contraceptive, kungakhokelela kwi-SCI.

Phakathi kwezifo ezidla ngokubangela ukuba kwakhiwe ama-gallstones, kuyaziwa:

• Ukunyamezela kunye nokukhathazeka kokuxilongwa;
• Izifo ze-endocrine, umzekelo, isifo sikashukela sesifo;
• Isifo sesibindi, umzekelo, i-hepatitis kunye ne-cirrhosis;
• I-Dyskinesia ye-bile ducts;
• Pancreatitis;
• Duodenitis;
• Isifo sikaCrohn;
• Gastritis;
• I-Helminthiases.

I-Pathogenesis yama-gallstones okwakhiwa

Ukubunjwa kwe-bile kubandakanya i-acids, i-lipids, iingubo kunye namaminerali. Ngokuqhelekileyo, zonke ezi zixhobo ziseburhulumenteni (ehlakazekile). Ngezinto ezichazwe apha ngasentla, izinga le-cholesterol coefficient ye-bile liphulwa, okokuthi umlinganiselo wokuxinwa kwee-acids zayo kumxholo we-cholesterol. Oku kuncedisa ekuhambeni kwe-cholesterol kunye nekristalllization elandelayo. Ngaloo ndlela, ama-concrements e-gallbladder akhiwa.

Ukwahlula

I-Calculous cholecystitis - yintoni na? Inkambo yeklinikhi ye-CLD ingaba nzima okanye ingapheliyo. Kuxhomekeke kwiimpawu ze-symptomatology kukho uhlobo oluqhelekileyo, olungapheliyo, lwentliziyo, lwamazinyo kunye ne-atypical calculous cholecystitis. Iimpawu kwaye unyango luyahlukahluka ngokuxhomekeka kwimiba yesifo.

Kukho izigaba ezine ze-CSF ngokuhambelana nokuhlolwa kwe-ultrasound:

1. I-pre-stone, okanye okokuqala - izixhobo zayo ezibonakalayo bubuninzi be-bile, i-biliary stasis kunye nokwakhiwa kwe-microliths (isanti) kwi-gallbladder. Eli nqanaba lesifo, ngokukhetha ukhetho olufanelekileyo kunye nokumiselwa kwesondlo kwimeko ezininzi, kuya kuguqulwa.
2. Ukuqulunqwa kwee-concrements - ngokuhlolwa kwe-ultrasound enye okanye ngamatye amancinci atholakala.
3. Isifo esingapheliyo se-cholecystitis - esi sigaba sesifo sifaka ukubonakala kwezinto ezinobungakanani obuhlukahlukeneyo kwi-gallbladder. Le nto ingaba njengelitye elikhulu, kunye nokubunjwa kwesincinane okanye ubuncinci.
4. I-cholecystitis eyinkimbinkimbi yokubala - le nqanaba yesifo ibonakaliswe ukuphuhliswa kweengxaki ezahlukeneyo, umzekelo, ukugqitywa kwemibhobho ye-bile.

Diagnostics

I-ultrasound yindlela ephakamileyo yokuhlola uvavanyo lokuxilonga ukukhetha "i-cholecystitis". Yintoni na, imbono sele iqalile. Ukusebenzisa i-ultrasound, ingcali iza kugqiba inani kunye nobungakanani beekhonkco kwi-gallbladder, kunye nendawo yabo, kunye nemeko yeendonga zesibindi.

Ukusebenzisa iindlela zeemvavanyo ze-cholecystitis ziquka i-endoscopic retrograde ye-cholangiopancreatographyography (ERCPG). Le ndlela ikuvumela ukuba uhlolisise imeko yebhiliyari kwaye unqume umgangatho wokukhazamiseka, oya kunceda oyingcali ukuba akhethe iindlela ezifanelekileyo zokusebenza. Indlela iyancitshiswa ekuzaliseni i-radiocontrast ye-bile ducts ngexesha lokusetyenziswa kwe-GVD, emva koko kuhlolwa i-X-ray.

Ukongezelela kwezi ndlela zokusebenza zeemviwo, iimvavanyo zebhoratri zisetyenziswe, njengokuhlalutya ngokubanzi kunye nokuhlolwa kwegazi. Ngoncedo lokuqala lolo sifo, ungabona i-ESR eyongeziweyo phambi kwenkqubo yokuvuvukala kwi-gallbladder, kunye nokunyuka kwama-neutrophils kwindlela yokuhlalutya i-leukocyte.

Uvavanyo lwegazi lwangokwemvelo kweso sifo luyancitshiswa ekumiseni izinga:

• ALT kunye ne-AST;
• Bilirubin;
• Alkaline phosphatase;
• Iprotheni epheleleyo;
• CRP.

Ezi zikhombisi ziya kukonyuswa xa kuthengiswa i-bile (cholestasis). Uphuhliso olunjalo lwesifo luyakwenzeka ngokukhawulelana noluphi na uhlobo lwe-bile ducts.

Kukho ezinye iindlela ezongezelelweyo zokuxilonga isifo esifana ne-cholecystitis yokubala. Iimpawu kunye noyonyango kuya kuxhomekeka kwimeko yebhiliyari kunye nemeko jikelele yesibindi ngokubanzi. Ezi ndlela zokuxilonga ziquka:

• Ukuchithwa kweengxaki;
• I-oral cholecystography;
• Hepatobiliary scintigraphy.

Calculous cholecystitis. Iimpawu kunye neyeza. Ulwazi jikelele

Kwezinye iimeko, isigulane asinakutshitshi ukuba une-cholecystitis yokubala. Yintoni, ufunda emva kokuqala kwe-colic bilic. Ubonakalisa intlungu ebukhali kwi-hypochondrium ngakwesokudla, enokunika i-epigastrium, i-back back, ihlombe okanye intamo.

Ukuxakeka okunjalo kubakho emva kwemidlo nemikhosi, xa umntu ongenamdla wokugula kwakhe evumela ukuba athathe utywala aze atye ngokutya okunamafutha, okuvumba, ukutshaya okanye okutya. Ukuvuselela ukuhlaselwa okunjalo kunye nokusebenza ngokomzimba okanye iimvakalelo ezinamandla. Emva kokuba isigulane sithathwe kwiziko lempilo kwaye lihlolisise, ufunda malunga nokuxilongwa kwe "cholecystitis". Ukukhushulwa kunokuhamba kunye neentlanzi kunye nokuhlanza.

Ukusebenza okanye cha?

Ngokuxilongwa "kwe-cholecystitis", iimpawu kunye nenkango, kuxhomekeke kwisigaba sokuphuhliswa kwesi sifo kunye nesimo sebhiliyari, iyahluka. Ukuba iinkqubo eziguquguqukayo zisenokwenzeka kwi-pre-stone okanye iqalo lokuqala, ke kuzo zonke ezinye, xa ukubunjwa kwamatye sele kuqalile, isigqibo esona sichanekileyo siya kubakho kwi-"calculous cholecystitis". Kwaye kuqhutywe ukusebenza ngokukhawuleza, kungenakwenzeka ukuba kwenzeke iingxaki.

Ukulungelelaniswa kokusebenza kubandakanya ukuthatha i-antibiotics kunye nokuvuselela umzimba njengoko kufuneka. Ukulwa nokudambiswa kwamanzi kuya kwenzeka xa isigulane ngexesha lokuhlaselwa liye lahlanza ngokuphindaphindiweyo. Ezi nyathelo ziza kunceda ekunciphiseni kakhulu umngcipheko wokuphuhliswa kwe-sepsis.

Ngoxilongo "lwe-cholecystitis engapheliyo," utyando luvame ukuqhutyelwa nge-laparoscope. Le ndlela yanamhlanje inganciphisa intlungu ngexesha lokubuyiselwa nokunciphisa ixesha lokubuyiselwa, kunye nokunciphisa ingozi yokuxhatshazwa kwe-postoperative.

Ukususwa kobuhlungu

Ukuhlaselwa kwe-cholelithiasis kunokungafani kwintlungu kunye nobukhulu bayo. Kwiimeko ezinzima, isicupunu kunye nokuhlanza kunokwenzeka, kwaye xa ilitye livimba ngokupheleleyo i-bile buct, umbala we-stool usenokukhanya, Akuyi kubakho i-pigment ye-pigment. Ngohlaselo olunzima, kufuneka unyuke ngokukhawuleza kwiziko lempilo okanye ubize i-ambulensi.

Ukuba eso sifo sibonakalisa ukuhlaselwa okubuhlungu, ungazama ukususa intlungu. Ukwenza oku, thabatha iipilisi ezimbalwa zesilwanyana "Akukho-shpa" okanye "Papaverin" kwaye ubeke ubusika kwicala lasekunene le-hypochondrium. Isidlo kufuneka simiswe ubuncinane ubuncinane iiyure eziyi-12. Ukuba oku kungasebenzi, kufuneka ufune uncedo lwezokwelapha.

Calculous cholecystitis. Unyango ngaphandle kokuhlinzwa

Ngaphandle kokungenelela ngophengululo, lesi sifo sinokunyangwa, kodwa ngasinye salezi ndlela sinokuchasana kunye neengxaki, kwaye akuqinisekisi ukuba ukuphindaphinda kwesi sifo akuyi kwenzeka. Sisebenzisa ezi ndlela:

• Unyango kunye neziyobisi ezinama-asidi;
• Ukuqhathaniswa noqhagamshelwano lwe-gallbladder concretions;
• Ukutshitshiswa kwe-wavecorporeal wave thotripsy.

Ngoku ke makhe sithethe ngokuthe ngqo ngabanye.

Iilungiselelo ezine-Acid

Okwangoku, ngokuxilongwa kwe-cholecystitis engapheliyo, unyango luyenzeka ngaphandle kokuhlinzwa, kodwa le ndlela ibiza kakhulu kwaye akukho siqinisekiso sokuba akukho kubuyela kwakhona. Inkqubo yeyeza inokude - ubuncinane iinyanga ezingama-24. Kukho neemeko eziyimfuneko ezinxulumene nobungakanani bamatye, ukubunjwa kwawo, isimo se-gallbladder kunye namathanga alo:

1. Ubukhulu bamatye akufanele kube ngaphezu kwe-1.5 cm ububanzi.
2. Ukubunjwa kwamatye kubaluleke kakhulu kwi-cholesteric.
3. I-gallbladder kunye namadaka ayo kufuneka asebenze ngokuqhelekileyo kwaye abe semgangathweni.

Ngoxilongo lwe "cholecystitis", unyango ngaphandle kokuhlinzwa lwenziwa ngezilwanyana "Henofalk" kunye ne "Ursofalk" - yi-chenodeoxycholic kunye ne-urodeoxycholic acid, ngokulandelanayo.

Ingundoqo yonyango iyancitshiswa ukuba ezi zidakamizwa ezinama-asidi zihlangene kwi-bile kwaye zichithe ngokukhawuleza amatye e-cholesterol. Kodwa akukho siqinisekiso sokuba isifo asiyi kubuya. Ukubuyela kwakhona kunokwenzeka.

Ukuqhathaniswa kokuqhelaniswa kwama-gallstones

Le ndlela yonyango ayibandakanyi enye kodwa iinkqubo ezininzi. Ziqhutywa ngolu hlobo lulandelayo. Ngethuba le-ultrasound, ugqirha uhlaba udonga lwangaphakathi lomzimba ngesaliti ende kummandla we-gallbladder projection, kwaye i-catheter iyazifaka kwi-bladder ngokwayo, apho iilungiselelo ezizodwa zifunyenwe zingakwazi ukutshabalalisa i-gallstones. Ezi nkqubo zenziwa ngamaxesha amaninzi. Kufuneka ikhunjulwe ukuba ayifaneleka wonke umntu. Kukho ukulinganiselwa ezithile, okufanayo kwindlela echazwe ngasentla. Ukongezelela, kunokubakho iingxaki, umzekelo, ukuvuvukala kwe-mucosa yamathumbu.

Ukutshitshiswa kwe-wavecorporeal wave thotripsy

Kule nkqubo, i-sensor ifakwe kwisikhumba somguli kwindawo yokubaluleka kwe-gallbladder kwisalathisi sangasemva kwesisu, amaza okutshitshiswa aya kuvela kuwo aze enze kwi-gallstones. Ukwenza le nkqubo, le miqathango iyimfuneko:

• Kwi-gallbladder, akufuneki kubekho iinkqubo zokuvuvukala;
• Ubukhulu bamatye abukho ngaphezu kwe-3.5 cm;
• I-gallbladder kunye namadaka kufuneka asebenze kakuhle.

Le ndlela ayikhuseli ngokupheleleyo. Ezi ngxaki zilandelayo zinokwenzeka:

• Ukuvalwa kwamatye emidaka ye gallbladder;
• I-jaundice ekhuselekileyo;
• Uphuhliso lwe-pancreatitis okanye isifo sikashukela.

Kuze kube ngoku, i-cholecystectomy ihlale yindlela ekhuselekileyo yokuphatha i-cholecystitis ngokubaluleka ngokubhekiselele kwiinkathazo, oko kukuthi, i-cholecystectomy, oko kukuthi, i-cholecystectomy. Ukususwa kwe-gallbladder.

Iingxaki ezinokwenzeka

I-calcous cholecystitis kufuneka iphathwe, kuba kuyingozi kwiingxaki zayo. Sibala uluhlu oluqhelekileyo kubo:

1. I-pancreatitis enobuchule.
2. I-Empyema ye-gallbladder (ukuvuvukala ngokuzaliswa kwe-blister ngokuqulathekileyo).
3. Cholecystitis etshabalalisayo.
4. I-Cholangitis (inkqubo yokuvuvukala emidini ye-bile).
5. I-cirrhosis yesibini yebhilidi yesibindi.
6. Ukuqulunqwa kwe-fistula phakathi kwama-bucts kunye ne-bladder.
7. Isithintelo esiswini.
8. I-oncology ye gallbladder.
9. I-Choledocholithiasis (iimpumelelo kwiidle ze-bile).

Ukutya

Ngokufanelekileyo, kufuneka udle ngokufanelekileyo nangaphambi kokuba isigulane sifumane ukuba unomdlavuza ongapheliyo we-cholecystitis. Ukutya, okhethwe ngokufanelekileyo, kunokusebenza njengesithintelo sesi sifo esibuzwayo. Sichaza iinjongo zayo eziphambili:

1. Ukunciphisa umxholo we-lipid wegazi. Oku kusebenza kakhulu kwi-cholesterol kunye namaqhezu awo.
2. Qinisekisa ukusebenza ngokuqhelekileyo kwe-gallbladder kwaye uthintele iziganeko ezikhoyo.
3. Ngokukhawuleza uzama ukunciphisa ubunzima, ukuba kuyimfuneko. Ukulahlekelwa isisindo kufuneka kube lula, ngenyanga ulahlekelwa ngaphezu kwe-2-3 kg.
4. Phuza ezininzi zamanzi, ukuya kwi-2 ilitha ngosuku.
5. Ukutya iivithamini ezaneleyo kunye ne-microelements ngokutya, ukutya kufuneka kufumane imifuno, iziqhamo kunye nemifuno eninzi.
6. Ukuqinisekisa ukulungeleka kwamathumbu emathunjini, gcoba ukutya okunotye kwi-fibre, kunye nesonka sangqolowa esipheleleyo kunye nengqolowa yengqolowa.
7. Nika amafutha esilwanyana.
8. Amafutha afuno kufuneka abekhona ekudleni, kodwa angabi ngaphezu kwama-80 amagremu ngosuku.
9. Inyama, esetyenziselwa ukutya, imele ixhomekeke (ayihlambulukanga).
10. Ukunciphisa ukutya okunamanzi kunye nocoko, kunye nokutya okuthosiweyo. Izitya kufuneka zibiliswe okanye ziphekwe kwi-steak, kwakhona ukusetyenziswa kweemali ezivela kwimifuno eluhlaza kwamukelwa.
11. Yidla ukutya okuncinci amaxesha ama-5-6 ngosuku.

Imithetho efanayo iya kusebenza emva kokutya kwe-cholecystectomy (ukususwa kwe-gallbladder).

Utywala kufuneka kuthethwe ngokwahlukileyo. Nasiphi na isiselo esinxilisayo sithintela ngokuthe ngqo kule sifo. Njengoko kuboniswe ngembali engaphezulu kweyonyango, i-cholecystitis ephawulekayo idla ngokukhawuleza emva kokusetyenziswa kotywala. Ngokuqhelekileyo izigulane zizibhedlele ngokuthe ngqo ngenxa yeetafile.

Ukupheka kweMithi egqirha

Ngoxilongo lwe "cholecystitis", izilwanyana zamalungu nazo zingasetyenziselwa unyango. Faka isicelo semithi, i-infusions kunye ne-decoctions ene-choleretic effect, ukunciphisa uxinzelelo lwe-bile kunye nokunciphisa ukudibanisa kwi-gallbladder.

Effective abantu kuthathwa ukuba decoction zeentyatyambo of immortelle. Lokulungiselela yayo, 15 g eluhlaza owomileyo ugalele ml 80 yamanzi ashushu shushu kwi bath ngomphunga imizuzu engama-30. Unikwa uvumelekile ukuba ukupholisa ecociweyo, koko wenza ukuya ku-100 ml abandayo ebilisiweyo amanzi kunye nokuthatha 50 ml kabini ngemini phambi izidlo.

Kuba unyango lwe cholelithiasis ngokubanzi edume kusetyenziswa ukumnika cranberry lwegqabi. Kuba kulungiselelwa eluhlaza amayeza 3 itheyibhile icephe zizaliswe kulo thermos ze ugalele abilayo umthamo wamanzi welitha 1. Ukuba ezi zazo ntoni ngokuhlwa, kusasa leti unyango ulungele.

isiphelo

Kukholelwa ukuba unyango olungcono - nokuthintelwa esi sifo. Oku kusebenza ngokupheleleyo sisifo ezifana cholecystitis calculous. ukutya okufanelekileyo kunye nokubambelela ubomi obusempilweni kuya kukunceda ukuba uphephe oku kugula krakra. Kwaye ukuba yenzeka ukuze GSD nangoku ukusekwa, kuyimfuneko ukuba athathe amanyathelo akhawulezileyo ukucombulula kuyo. Khumbula ukuba isanda, xa esinyini inyongo kukho intlabathi endaweni amatye amakhulu, inkqubo zisenako kubuyela ebutsheni.