Acalculous cholecystitis okungamahlalakhona: isinyathelo ukwelashwa kanye

Acalculous cholecystitis okungamahlalakhona - yisishiso esinyeni nenyongo ngaphandle kumiswa amatshe atholakala enyongweni. Leli fomu kubangela ubuhlungu hypochondrium kwesokudla futhi dyspepsia.

Emkhakheni wezingalo Gastroenterology kusengozini akhawunti izilonda ezingamahlalakhona ngoba phakathi 5 kuya ku-10% amacala. Ngo abesifazane, cholecystitis okungamahlalakhona ngaphandle amatshe kwenzeka cishe ngo-4 izikhathi kaningi. Yilezo izibalo. Abanye abacwaningi nibhekane cholecystitis okungamahlalakhona ngaphandle amatshe njengoba ifomu zesikhashana ukuba isifo esinjengo cholesterol kalkulez. Kodwa, njengoba kwezokwelapha, iziguli ngeke zisaba uhlushwa cholelithiasis.

Izimbangela zesifo

Etiology lesi sifo kusekelwe izifo eziningi:

• E. coli;
• enterococcus;
• aureus;
• Proteus;
• izitshalo uhlobo exubile.

Ukungena-bacterium singene gallbladder ngokusebenzisa wamathumbu kwenzeka ezimweni ezifana:

• goiter;
• nesifo;
• enteritis;
• ukusha kwesibindi kohlobo;
• pancreatitis.

Ngaphansi ngokuvamile, isifo zaduma kulo lonke i-lymph noma igazi foci ezithathelwanayo elise ukude.

Ngokwesibonelo, ukutheleleka kwanda izifo ezifana:

• isifo periodontal;
• e namathansela ezingamahlalakhona;
• appendicitis;
• i-pneumonia,
• pyelitis;
• adnexitis.

Ngu ingqondo izici, okuyinto kusebenze izinqubo ezithathelwanayo, zihlanganisa:

• cholestasis;
• dyskinesia biliary;
• ayehlasela izimuncagazi ezifana Giardia, izikelemu, amoebae;
• sphincter ukungasebenzi;
• ukukhuluphala;
• dysmenorrhea;
• ukungawuvivinyi umzimba;
• ukungondleki;
• nokutubeka et al.

Acalculous cholecystitis okungamahlalakhona kuhilela ukuqina futhi ukusonteka we gallbladder. Ulwelwesi lwamafinyila ozuza isakhiwo anezikhala ngenxa yokuthi elinye izindawo atrophic nge-polyp akha emphethweni obukhulu.

Ukuba ugqinsi kwenzeka elingenamikhono kwemisipha. Kubonakala isibanda izicubu fibrous. Lapho ukwanda kwezingodo ukuvuvukala ingaqala pericholecystitis, avele ukuvuvukala ne izitho etholakala endaweni, abscesses, pseudodiverticulum.

Ukwahlukaniswa izifo

Ukunqotshwa kuyinto ukukhanya, aphakathi nendawo kanye ezisindayo. Lesi sifo kuhilela khona izigaba ezintathu:

• okubi kakhulu;
• subsidence futhi okubi kakhulu;
• ukuthethelelwa ozinzile futhi engazinzile.

Acalculous cholecystitis okungamahlalakhona kungakwenza ukuqhubeka ngangibuye ngihluleke. Futhi, lesi sifo ngephimbo elifanayo futhi ngakanye.

Kuye kube sezingeni ukulimala ukuhlukanisa phakathi ifomu kuyinkimbinkimbi futhi kube lula ka ezingamahlalakhona cholecystitis nekalkuleznogo. Futhi ukuhlukanisa phakathi ukubukeka ejwayelekile futhi atypical. Ifomu yokugcina sehlukaniswe emathunjini, futhi kardialgichesky ezofagalgichesky hlobo.

Izimpawu ezingamahlalakhona cholecystitis acalculous azibonakali ngezindlela ezahlukene kuye ngokuthi degree of lesion we gallbladder.

Kanjani nalesi sifo omnene?

Ukuze cholecystitis umnene libhekene sikhashana esifushane exacerbation, kuze kube nini nanini izinsuku 2-3. Basuke ikakhulukazi cuphuluza ukungondleki futhi ukuqedwa kalula, kuncike ukudla okufanele.

lokushisa isimo umzimba Jikelele umzimba Jwayelekile kuyinto evamile. Ukuhlolwa kwembula kungekho thuthuva obusebenzayo isibindi, gallbladder kanye amanyikwe. izifundo ezincane we Bile Akukona babonise kwezinso.

Kangakanani ukuma isilinganiso?

Nge i ijamo isilinganiso izifo ezifana ezingamahlalakhona cholecystitis acalculous, ukuthethelelwa futhi okubi kakhulu esikhundleni nomunye. Isikhathi exacerbations singemaviki lange 2-3. Iziguli ngokuvamile uhlupho ubuhlungu futhi wabonisa iziyaluyalu dyspeptic. Ngokuvamile, isimo esinjalo kubangelwa ukudla okunamafutha noma ukudla kakhulu. Kwezinye izimo, indima provocateur sibi zokuphefumula ukutheleleka izenzo.

Njengoba kwenzeka endabeni cholecystitis okungamahlalakhona ngaphandle amatshe? Izimpawu zihlukene. Phakathi exacerbation iziguli kungekho esesuthi, encishisiwe isisindo somzimba, ukudakwa ibonakala obonakaliswe ukukhathala kanye migraine. Kungase futhi ziphazamisa ubuhlungu bamalunga.

Ezinye iziguli ngaphezu ubuhlungu ilungelo quadrant engenhla ingase ikhononde we ubuhlungu buthuntu kwesokunxele quadrant engenhla nesisu engenhla. Ubuhlungu ngokuvamile isetshenziswa inhliziyo. Iziguli ngokuthi isicanucanu, ukuqunjelwa noma isifo sohudo.

Ocwaningweni i-laboratory, Bile ezinophawu ukwanda ngenani isikhwehlela, leucocytes, cholesterol, bilirubinate Ca, Bile nosawoti kwezinye izimo microlites. Kungenzeka futhi ukubona nezilwanyana ezincane.

Ngo isimo sibi e isiguli ukuthola ushintsho oluthile ekusebenzeni ukuhlolwa isibindi. Ngokuvamile wabonisa hypoalbuminemia ngokulinganisela, ukukhuphuka kancane emsebenzini transaminase, ikakhulukazi Ajit othobile ukwanda thymol futhi umsebenzi phosphatase ane-alikhali.

Izinkomba-Laboratory luhlolo kwesibindi ijwayelekile e ukuthethelelwa. Isiguli ungase uphazamise umuzwa ukusinda esiswini engenhla futhi ukuvuvukala ngemva ukungenisa. Ngokuvamile, umuntu ngokuthi ukuqunjelwa noma isifo sohudo.

izimpawu Dyspeptic ukwandisa nge okunamafutha ukudla noma fibre indawo. ukudla okunjalo kungaba kuvuse okubi kakhulu lesi sifo.

Inzima kangakanani ifomu kwenzeka?

Acalculous cholecystitis okungamahlalakhona ifomu ezinzima elinesimo zigeleze uyahluleka uma elwa nokuphuza njalo ngaphandle ukuthethelelwa. Lesi sifo basakaza ngaphandle gallbladder. Yeqela main isifo ezihambisana isifo sokusha kwesibindi ngo ifomu okungamahlalakhona, pancreatitis.

Iziguli esekhala yokuntuleka esesuthi, isicanucanu okuqhubekayo, ukusinda esiswini engenhla. Ngezinye izikhathi emizweni ubuhlungu kukhona ezimise okwama-tile uhlamvu. Iziguli Kunconywa ukudla okuqinile, okuholela isisindo ukulahlekelwa futhi babekhathele kakhulu. Kwezinye izimo, kukhona sepsis efomini ezingamahlalakhona.

Ukusebenza kwe-gallbladder kakhulu kahle. Udonga umzimba sikhula. Uma ngezinga isilinganiso ukusebenza hepatic kancane siphukile, lapho isifo esinzima ngokuvamile kubonakala ukusha kwesibindi kohlobo esingamahlalakhona noma cholangitis.

Kulokhu, izinqubo ezilandelayo zenzeke:

• inyuka isibindi ngobukhulu;
• ukwehla olukhulu endleleni albumin serum;
• anda globulin ingxenyenamba futhi lokuhlushwa bilirubin Imininingwane.

Lapho uqhuba ultrasound esiswini wabonisa isandiso imbobo kwesinye inyongo wasembulela "amile" nenyongo sesinye, pancreatitis ezingamahlalakhona phansi ukusebenza amanyikwe.

Iziguli ngokuvamile esekhala dyspepsia, isicanucanu, kwesisindo. Babebona anda ivolumu fecal, steatorrhea, futhi kreatoreya amylorrhea.

Ezitsheni nesifo esinzima iphazamiseke futhi inhliziyo, kubonakala dystonia, esingamahlalakhona senhliziyo nezinguquko ezifanele ku ECG.

Njengoba ifomu atypical of notshwala?

It libhekene ifomu atypical of ezingamahlalakhona cholecystitis acalculous? Ngokuthi ogulayo isilungulela njalo, ukusinda, ubuhlungu ngemuva breastbone, dysphagia lezivakashi. Lapho uhlobo emathunjini ukuthi ukubhujiswa kwamaJuda ubuhlungu emathunjini endaweni, ukuvuvukala, ukuqunjelwa.

Lapho eneminyaka engu ezisencane cholecystitis okungamahlalakhona ngaphandle amatshe afana rheumatism ifomu esicashile. Iziguli esekhala asthenia, ubuhlungu emalungeni. Auscultation wembula kwehle inhliziyo umsindo.

Ngenkambo atypical lesi sifo zihlanganisa lumbar futhi piloroudenedalny uhlobo cholecystitis okungamahlalakhona. Lapho ifomu lumbar, iziguli ubuhlungu yomgogodla. Ezimweni ezinjalo, sikhombisa i-X-ray of the ikholomu umgogodla.

ifomu Symptomatology kardialgicheskoy

Le ndlela sifo arrhythmias esingokwemvelo (extrasystoles) noma ubuhlungu besifuba. Futhi ECG izinguquko.

Ngo yobudala emaphakathi futhi ubudala kufana uhlobo angina inhliziyo noma esingamahlalakhona senhliziyo, ogeleza ifomu ezingamahlalakhona. Iziguli esekhala ubuhlungu enhliziyweni, tachycardia.

ifomu gastroduodenal

Umtholampilo cholecystitis okungamahlalakhona kulesi simo sifana nesifo esidalwa yizilonda emathunjini sibe noma gastroduodenitis ngamazinga aphakeme esiswini acid ukwakheka. Iziguli esekhala ubuhlungu esiswini ebusuku.

izindlela ukuxilongwa

On palpation esiswini endaweni kwesinye nenyongo kukhona soreness ukuthi kunomonakalo omubi nakakhulu lapho ukuphefumula noma effleurage kwesokudla lwaleli costal.

Ocwaningweni i-laboratory, likhuphuke kunqunywa:

• transaminases;
• phosphatase ane-alikhali;
• γ-glutamyl.

Ukuze uthole izindlela kubaluleke kakhulu zokuxilonga zihlanganisa:

• ultrasound;
• cholecystography;
• tseliakografiyu;
• holestsintigrafiyu;
• intubation duodenal.

Ngokusekelwe ucwaningo lwamuva, ungakwazi ukukhuluma ukushuba ukuvuvukala.

izinguquko ejwayelekile manifest ezingeni macroscopic e Bile turbidity futhi khona isikhwehlela kanye ishq.

luhlolo ezincane ukhombise okhushuliwe leukocyte ukubala, bilirubin, amaprotheni, i-cholesterol, nokunye. D.

Bacteriological ukuhlwanyelwa Bile uphenyo flora zayo amagciwane abe nenkani.

Ngosizo holetsistografii e iziguli esingelapheki cholecystitis acalculous kulinganiselwa motor kanye okuhlushwa ukusebenza gallbladder, wabuka yayo futhi isikhundla.

Sonography kuthola ukusonteka we gallbladder, izinqubo atrophic e nezindonga zayo, engalingani epithelium yangaphakathi, khona okuqukethwe okungekona eyohlobo ne inclusions of Bile ukungaguquguquki-non-iyunifomu.

Imiphumela yaloku kuhlola okungenhla umehluko Kwenziwa dyskinesia biliary, cholangitis okungamahlalakhona, izilonda emathunjini nesifo imvelo nonspecific, futhi isifo Crohn.

izindlela yokwelapha

It iqeda cholecystitis okungamahlalakhona ngaphandle amatshe? Ukwelashwa ngokuvamile kwenziwa olandelanayo. Odokotela batusa ukudla. Kungcono ukuwakhipha kusuka ekudleni okunamafutha kanye nokudla okuthosiwe, ukudla okubabayo, soft futhi iziphuzo ezidakayo.

Lapho ubuhlungu besisu Kunconywa engayitholi antispasmodics ezifana "Platifillin" "Drotaverine" "Papaverine" et al.

Phakathi exacerbation lesi sifo noma inhlanganisela yayo nge cholangitis esebenzayo elwa namagciwane ukwelashwa "cefazolin" "amoxicillin", "erythromycins", "ampicillin" "furazolidone" et al.

Ukuze ukuzinza yokusetshenziswa pheshana emathunjini belulekwa ukuba athathe "zemikhosi" "mezim-Forte", "Pancreatin".

Ukuze uthuthukise uketshezi of Bile ngokuvamile ziphendukela ukuthola choleretic ( "Allohol" "Holenzim" "Oksafenamid").

Ukuze sikhuthaze ukusikwa enyongo gallbladder isicelo magnesium sulfate kanye sorbitol.

Ngesikhathi exacerbation noma ukuthethelelwa uyelulekwa ukuqhuba inkambo yokwelapha ngamakhambi. Thatha decoction of chamomile, calendula, rose, licorice, Mint.

Ngo ukuthethelelwa eyenziwa tyubazh, isiphuzo lamanzi esiphethu, ukwelashwa umsebenzi wenziwa.

kokungenela kuhlinzwa

Lapho ukuhlinzwa uyiswa ekamu nomlando we-akhawunti lesi sifo. Okungalapheki cholecystitis acalculous obonakaliswe ukusonteka of izindonga gallbladder futhi Ezingalapheki ukulungiswa cholangitis futhi pancreatitis kudinga ukuhlinzwa.

Kulokhu, kwenziwe ngokusebenzisa evulekile cholecystectomy kokungenela laparascopy noma ukufinyelela mini.

Ukusetshenziswa izindlela abantu

Ikhona yini enye indlela siqedwa acalculous ezingamahlalakhona cholecystitis? amakhambi Folk Ukwelashwa futhi kuye kwaba nomphumela omuhle.

izimpande ezisetshenzisiwe imbewu calamus, valerian, St John sika wort omisiwe efihlekile, calendula, sembabazane, ummbila, yefilakisi. Kuyinto uyelulekwa ukusebenzisa limes, peppermint, Leonurus, chamomile, fennel, horsetail, rosehip.

Uma usebenzisa izindlela ethandwa e izifo izimbali kanye immortelle elderberry Phytotherapy wanezela.

Phytotherapy

Umuthi herbal kuhilela ukusetshenziswa cocktail we amakhambi ezilandelayo:

• Pion - 20 ml;
• valerian - 20 ml;
• boyaryshnik- 20 ml;
• Mint - 20 ml;
• Belladonna - 10 ml;
• motherwort - 20 ml;
• Calendula - 30 ml;
• umhlonyane - 20 ml.

Ephambi kwezinduna glaucoma Belladonna sengezwe.

ithuluzi Phuza kufanele kube ku 1-8 sehla kathathu ngosuku imizuzu emihlanu ngaphambi ukumnika yamakhambi ukuba 1 tbsp. amalitha amanzi amasonto 4-6. Ingxube isithako nomuthi nokalamusi futhi inula ezithathwe amanani alinganayo. Futhi bayiphuze 1-8 sehla kathathu ngosuku imizuzu emibili ngaphambi kokuthola infusions amakhambi ukuze 1 tbsp. l. amanzi amasonto 4-6.

Kufanele kukhunjulwe ukuthi ukuqoqwa Phytotherapy ixhunyiwe at umthamo 0,00325, t. E. dilution 14, futhi kwandisa nsuku 1-2 zizalela ukufeza umthamo elilungile.

A umthamo ofanele nalelo elibanga ukugula sohudo, futhi ngakolunye uhlangothi, kunciphisa degree of izimpawu ekhona. Lokhu umthamo esithathwayo ngesikhathi Yiqiniso, kodwa uma kukhona ukungakhululeki, kuyehla by 1-2 amayunithi.

ukuba nombono ongafani ngeke

Kwenzekani kumuntu onalesi sifo izifo ezifana cholecystitis okungamahlalakhona ngaphandle amatshe? Exacerbation ka omnene kwenzeka ngezikhathi ezithile kuphela. Lesi sifo has a Yiqiniso evumayo. Ukuwohloka kwenzeka isibikezelo uma i exacerbation ivela kaningi lapho ngokwesilinganiso isifo zaba namandla kakhulu.

zokuvimbela

izinyathelo zokuvikela kuthiwa ebiyelwe ukwelashwa esifike isifo, yokulungiswa foci ukutheleleka, ekuqedeni yokuphazamiseka isimiso sezinzwa, kanye nokubuyiselwa umzimba evamile. Kufanele uqaphele le yokudla elungile, ukulwa emathunjini helminth izifo kanye izilonda.