Cholecystitis Calculous - kuyini? Izimpawu, izimbangela, ekwelapheni cholecystitis calculous

cholecystitis Calculous kuwuhlobo inqubo okungamahlalakhona, lapho calculi ehlukahlukene (amatshe) bukhona gallbladder. Inombolo yabo futhi usayizi ungahluka. Ngezinye izikhathi kungcono itshe kahle esikhulu, ububanzi ezingasetshenziswa afinyelela 5-6 cm noma ngaphezulu, futhi mhlawumbe eningi amatshe amancane kakhulu ngenhloso ububanzi kuyinto ingxenye milimitha, ngamanye amazwi, esihlabathini. cholecystitis Calculous - kuyini? Lokhu kuzoxoxwa ngakho kulesi sihloko.

Ngokwezibalo, 10% abantu abadala uhlushwa nenyongo amatshe. Okungalapheki calculous cholecystitis abesifazane bakhathazekile ngomphumela kahlanu kaningi kunabantu. Ubudala isigaba iziguli - kusukela eminyakeni engu-40 nangaphezulu. Izingane kanye nabantu abasha kuze kube iminyaka engu-30, lesi sifo akuvamile uhlupho.

Amatshe atholakala enyongweni. Iyini ingozi?

Kwakuwusuku ubukhulu amatshe atholakala enyongweni bese anqume izimpawu, kanzima isifo emitholampilo kanye nezinkinga kungenzeka yesifo gallstone (GSD). Okungalapheki cholecystitis calculous kuyingozi yezinkinga zayo.

Ezimweni eziningi (75%) ka concretions ise komzimba gallbladder, kodwa ngezinye izikhathi kungase kube amatshe amancane ku uvule imbobo Bile, futhi ngokwenza kanjalo walenza nzima noma ngokuphelele alisibekele futhi okubangela nokuquleka gallstone colic.

Uma concrements kuze 3 mm ingakwazi ukuphuma ngokusebenzisa Amapayipi, amatshe anobukhulu kusuka 3 kuya ku-7 mm kwayo kuleyo ndawo yokuhweba we gallbladder kungenziwa obturated (ukugqagqana) uvule imbobo Bile futhi lokhu inkinga edinga ukuhlinzwa esiphuthumayo.

Ukwakheka amatshe atholakala enyongweni iyahlukahluka. Zingaba:

• cholesteric - amatshe yalolu hlobo ingabonakali ku x-ray;
• lime;
• sombala;
• okuxubile.

Izinhlobo ezivamile okuxubile amatshe atholakala enyongweni, ifomu yabo wehlukile kakhulu (round, faceted noma branched).

Izimbangela inkinga

kwakhiwa cholecystitis Calculous (CL) ngokushesha. Cabanga okuyizici ezinomthelela kumiswa amatshe e-gallbladder:

• cholestasis, cholestasis noma, isibonelo, kungenzeka egoba gallbladder umzimba;
• diskholiya noma okushintshiwe Bile Ukwakheka, lokuhlushwa ngenxa yokuthi bafuna ukuya isigqugquzeli cholesterol uketshezi noma sokuphazamiseka kwengqondo;
• cholecystitis, noma ukuvuvukala kule gallbladder.

Ngaphezu kwalokho, inhlamvu uyakwazi calculous cholecystitis Ukudla, kunalokho, ukwephula ehlelekile ekudleni (kakhulu okunama-kilojoule amaningi, fat and ukudla ane-ocebile, ukuntuleka kwamavithamini ekudleni). yokulamba ehlelekile futhi okunama-kilojoule amancane indlela yokudla ehambisana nempilo, ngisho ukusetshenziswa eside izidakamizwa umuthi hormone singaholela cholelithiasis.

Ezinye zezifo ukuthi ngokuvamile umfutho ukuze kwakhiwe amatshe atholakala enyongweni, zaziwa:

• ukukhuluphala ngokweqile umzimba iziyaluyalu;
• izifo endocrine njengesifo sikashukela;
• izifo zesibindi, isib, kwesibindi sokuqina kwesibindi;
• dyskinesia biliary;
• pancreatitis;
• duodenitis;
• isifo Crohn;
• kolwelwesi ezingamahlalakhona;
• izifo helminth.

I pathogenesis kwetinhlavu amatshe atholakala enyongweni

Ukwakheka kuhlanganisa Bile acid, lipids, zombala futhi izinto amaminerali. Ngokuvamile, bonke laba izingxenye ku colloidal (abahlakazekile) isimo. Ngaphansi izici ezingezinhle engenhla, kwaphazamisa Bile cholesterol Coefficient, r. F. Lokuhlushwa ratio acid kwekuqukethe cholesterol. Lokhu kunomthelela ekulahlekelweni cholesterol inzika nge crystallization kwalo okwalandela. Ngakho concretions kwakhiwa esinyeni nenyongo.

ngezigaba

cholecystitis Calculous - kuyini? Inkambo zokwelapha GSD kungaba oyingozi noma ezingamahlalakhona. Kuye ngezimpawu ekuso, ezofagalgichesky, inhliziyo, emathunjini, futhi atypical cholecystitis calculous. Izimpawu kanye nokwelashwa zingahluka ngokuya izinhlobo inkambo isifo.

Kunezigaba ezine ngokuhambisana GSD luhlolo ultrasonic:

1. Predkamennaya noma kokuqala - izici zayo isici kukhona khona Bile obukhulu, nenyongo stasis kanye ukubunjwa microlites (isihlabathi) ku gallbladder. Lokhu nesigaba lesi sifo nge ilungelo ukwelashwa okukhethayo futhi ukuzinza kwamandla ezimweni eziningi emuva.
2. kumiswa calculi - by ultrasound Kutholwe eyodwa noma amatshe eziningana ezincane.
3. Okungalapheki cholecystitis calculous - lokhu nesigaba lesi sifo sidinga khona amatshe ezinobukhulu obuhlukahlukene ku gallbladder. Lokhu kungaba yitshe elikhulu elilodwa, kanye kumiswa ubukhulu elincane, noma kancane kancane.
4. Complicated cholecystitis calculary - lokhu nesigaba lesi sifo libhekene ukuthuthukiswa yezinkinga ezihlukahlukene ezifana isimiso biliary.

ukuhlola

Ultrasound indlela eyinhloko luhlolo inkinga uphethwe "cholecystitis calculous". Ukuthi kuyini, umbono zakhekile. Ukusebenzisa ultrasound Uchwepheshe ngeke ukucacisa inombolo kanye nosayizi concretions elise esinyeni inyongo indawo yabo, futhi isimo izindonga bubble.

Lapho senza izindlela wezinsimbi ka nokuhlolisiswa cholecystitis calculous futhi zihlanganisa endoscopic cholangiopancreatography retrograde (ERCP). Le ndlela yenza kube lula ukuhlola isimo ipheshana biliary futhi ukunquma degree of isimiso, ozokusiza ukukhetha ilungelo amacebo ukuhlinzwa onguchwepheshe. Indlela liqukethe ezigcwalisa radiopaque izidakamizwa biliary ipheshana ngesikhathi EGD, ngaphambi esimweni wenziwa.

Ngaphezu kwalezindlela zokudlulisela wezinsimbi of luhlolo esetshenziswa laboratory, ezifana ukuhlaziywa jikelele futhi igazi kwamakhemikhali. Nge kuqala lesi sifo kungabonwa esimweni khona ephakeme ESR ukuvuvukala kule gallbladder, kanye ukwanda neutrophil leucocyte count ukuhlaziywa.

ukuhlaziywa kwamakhemikhali igazi kule isifo kunciphisa ukuba ukuzimisela kumazinga alandelayo:

• ALT AST;
• bilirubin;
• phosphatase ane-alikhali;
• amaprotheni Imininingwane;
• CRP.

Lezi zinombolo izokwenyuka uma kwenzeka yokujama tsi of Bile (cholestasis). Lokhu ukuqhubeka kwesifo kunokwenzeka nge-calculus ukuvimbela yimiphi Amapayipi Bile.

Kukhona nezinye izindlela ezengeziwe ukuxilongwa izifo ezifana cholecystitis calculous. Izimpawu kanye nokwelashwa kuzoncika isimo ipheshana biliary futhi isimo jikelele isibindi iyonke. amasu anjalo zokuxilonga zihlanganisa:

• cholegraphy emthanjeni;
• cholecystography Oral;
• gepatobiliostsintigrafiya.

cholecystitis Calculous. Izimpawu kanye Ukwelashwa. ulwazi olujwayelekile

Kwezinye izimo, isiguli alazi ukuthi calculous cholecystitis. Kuyini, ifunda kuphela ngemva ekuhlaseleni colic biliary. It libhekene nobuhlungu obukhulu ilungelo quadrant engenhla, okungase ziyiswe epigastrium, ephansi emuva, ehlombe noma entanyeni.

ukuhlaselwa okunjalo ngokuvamile kwenzeka emva kwemaholide nezemikhosi, lapho ongaqaphile eziphathelene nokugula umuntu evumela yena ukuthatha iziphuzo ezidakayo nezinto zokuhlanza kokulunywa ukudla, okubabayo, ukudla ngibhema noma anosawoti kahle okunamafutha. Avuse ukuhlaselwa okunjalo kungase kusetshenziswe noma imizwelo enamandla. Uma isiguli silethwa esibhedlela futhi bahlole, nekezwa ukuxilongwa "cholecystitis calculous". Okubi kakhulu kungenziwa ephelezelwa isicanucanu nokuhlanza.

Usebenza noma cha?

Lapho sitholakele "cholecystitis calculous" izimpawu kanye nokwelashwa kuncike nesigaba lesi sifo futhi isimo ipheshana biliary zingahluka. Uma Kusengenzeka izinqubo esethola ke bonke abanye, lapho kumiswa amatshe usuvele uqalile, isinqumo engcono kungaba e sitholakele "cholecystitis calculous" ukusebenza e predkamennoy noma lapho besanda kuqala. Futhi ngokushesha kuyoba ukuhlinzwa, kancane amathuba ukuxakeka.

Ukulungiselela ukuhlinzwa useyayamukela antibiotic rehydration zomzimba uma kunesidingo. Ukulwisana amanzi emzimbeni ngempela eyenziwa uma isiguli ngesikhathi kuhlasela ukuhlanza okuphindaphindiwe. Lezi zinyathelo kuyosisiza ukuba kakhulu ukunciphisa ingozi sepsis.

Lapho sitholakele "ezingamahlalakhona cholecystitis calculous" msebenzi owawuvame ukwenziwa usebenzisa laparoscope. Le ndlela yesimanje wokunciphisa ubuhlungu esikhathini ukuvuselelwa kanye nokunciphisa isikhathi alulame futhi kuncishiswe ingozi yezinkinga nasezinkingeni ezilandela ngemva kokuhlinzwa.

Ukususa ubuhlungu kuhlasela

Ukuhlaselwa yesifo gallstone ingahluka ngokwemvelo futhi ukushuba ubuhlungu. Ezimweni ezimbi kakhulu, kungenzeka isicanucanu nokuhlanza, futhi uma itshe ivimbele ngokuphelele evamile Bile imbobo, umbala kwesitulo ingavuthi elikhanyayo ngoba akuyikubakho sombala Bile. Ngaphansi ukuhlaselwa ezinzima ezifana kubalulekile ukubhekana ngokushesha esibhedlela noma ushayele i-ambulense.

Uma lesi sifo kubonakala ukuhlaselwa kubuhlungu, ungazama lokunciphisa izinhlungu ngokwakho. Ukuze wenze lokhu, udinga ukuthatha ambalwa amaphilisi lomuthi "Cha-spa" noma "papaverine" wafaka amakhaza phezu hypochondrium kwesokudla. Ukudla ngesikhathi esifanayo ukuyeka lokungenani emahora lalingana langu-12. Uma lokhu kungasebenzi, kufanele ufune usizo lwabezokwelapha.

cholecystitis Calculous. Ukwelashwa ngaphandle kokuhlinzwa

Ngaphandle kokuhlinzwa, isifo zingelashwa, kodwa ngamunye yalezi zindlela has Izimo yayo kanye nezinkinga, kanye akuqinisekisi ukuthi lesi sifo ngeke ibuye ngamandla ngemva. Sibala yalezi zindlela:

• Ngemithi esidi;
• xhumana ukubhujiswa gallbladder amatshe;
• extracorporeal shock wave lithotripsy.

Manje ngqo ukhulume ngamunye wabo.

izidakamizwa esidi

Njengamanje, sitholakele ukwelashwa "ezingamahlalakhona cholecystitis calculous" kungenzeka ngaphandle ukuhlinzwa, kodwa le ndlela ibiza kakhulu futhi asikho isiqinisekiso sokuthi ngeke ibuye ngamandla ngemva. ukwelashwa eside - izinyanga okungenani 24. Kukhona izimo ezidingekayo ezihlobene ubukhulu amatshe, Ukwakheka yabo, isimo gallbladder futhi Amapayipi yayo:

1. usayizi itshe akufanele bube ngaphezu kuka-1.5 cm ububanzi.
2. Ukwakheka rocks - cholesterol kuphela.
3. Nenyongo sesinye futhi Amapayipi kumelwe asebenze kahle futhi ibe sesimweni esihle.

Lapho uphethwe "cholecystitis calculary" imisebenzi yokuzelapha eyenziwa ngaphandle izidakamizwa "Henofalk" futhi "Ursofalk" - kuyinto ursodeoxycholic futhi chenodeoxycholic acid, ngokulandelana.

Ingqikithi kwelashwa ukuqinisekisa ukuthi laba basebenzi esidi buthelela ukubunjwa Bile futhi kancane kancane chaza cholesterol calculi. Kodwa ukuqinisekisa ukuthi lesi sifo ngeke ubuye, akukho. uyahluleka uma elwa nokuphuza ezingenzeka.

Xhumana ukubhujiswa gallbladder amatshe

Le ndlela yokwelapha ihilela hhayi elilodwa eziningana nezinqubo. Basuke kwenziwe kanje. Phakathi ultrasound udokotela punctures le anterior udonga besisu inaliti eside e projection endaweni kwesinye inyongo bubble ngokwayo engena ipayipi lapho ukungena izidakamizwa okuqondile okungakusiza chaza amatshe atholakala enyongweni. Lezi zinqubo abazenzi izikhathi eziningana. Kumele kukhunjulwe ukuthi bengakwenzi zonke kufanelekile. Kunemikhawulo athile kuyafana indlela echazwe ngenhla. Ngaphezu kwalokho, kungaba khona yezinkinga ezifana ukuvuvukala mucosa emathunjini.

ukushaqeka Extracorporeal wave lithotripsy

Kulesi inqubo, esikhunjeni lesiguli endaweni projection we gallbladder phezu anterior udonga besisu we inzwa itholakala, amaza ngeke kuvela ke futhi uthathe isinyathelo amatshe atholakala enyongweni. Ukuze enze inqubo enjalo idinga kwale mibandela elandelayo:

• ku gallbladder akufanele ukuvuvukala;
• usayizi itshe - akukho kuka 3.5 cm;
• nenyongo sesinye futhi Amapayipi kufanele asebenze kahle.

Le ndlela lungavikelekile kakhulu. yezinkinga imbangela:

• ukuvala Amapayipi kwamatshe gallbladder;
• jaundice obstructive;
• ukuthuthukiswa pancreatitis acute noma isifo sikashukela.

Kuze kube manje, indlela ephephile kakhulu ekwelapheni cholecystitis calculous nge Ngokuphathelene nezinkinga uhlala holetsistoektomiya, okusho kokususwa gallbladder.

yezinkinga kungenzeka

cholecystitis Calculous iphathwa kudingeka t. Ukuze. Yena kuyingozi nge yezinkinga zayo. Sibala abathandekayo ezivamile:

1. pancreatitis olunamandla.
2. Empyema kwesinye nenyongo (ukuvuvukala balandela ngokugcwalisa okuqukethwe esinyeni ubovu).
3. cholecystitis Onakalisayo.
4. Cholangitis (ukuvuvukala Amapayipi Bile).
5. Secondary isifo sokusha biliary.
6. Fistulas phakathi imbobo Bile futhi avikele ulwelwesi lwesinye.
7. Ileus.
8. gallbladder Oncology.
9. Choledocholithiasis (concrements e uvule imbobo Bile).

ukudla

Kahle kahle, udinga ukudla ngendlela efanele kanye nangaphambi kokuba isiguli sekutholakele ukuthi sine- "ezingamahlalakhona cholecystitis calculous". Ukudla, akhethwe kahle, ungaba njengekhampasi zokuvimbela lesi sifo embuzweni. Lumelela izinhloso zayo eziyinhloko:

1. okuqukethwe Unciphise lipids egazini. Lokhu ikakhulukazi libhekisela cholesterol bese kukhishwa nezingxenyana yayo.
2. Ukuqinisekisa ukusebenza evamile gallbladder futhi kuvimbele yokujama tsi kuwo.
3. Kancane kancane silwele kwesisindo, uma kudingeka. Ukuncipha komzimba kufanele kube kancane kancane, inyanga ungalahlekelwa akukho kuka 2-3 kg.
4. Phuza amanzi amaningi, kuze 2 amalitha ngosuku.
5. Zigcwele ukudla amavithamini namaminerali azokusiza ukuthi ekudleni kufanele kube imifino samanje, izithelo kanye eziningi zasemazweni.
6. Ukuqinisekisa wamathumbu ukunyakaza ezinhle, udle ukudla okune-fibre futhi wonke-okusanhlamvu nesinkwa nokolweni bran.
7. Olulahliwe ezilwane.
8. Vegetable amafutha kufanele khona ekudleni, kodwa akukho amagremu angaphezu kwangu-80 ngosuku.
9. Inyama, Yidla, kufanele kube mafutha (lakanye amahwahwa enkomo).
10. Zikhiphe ohlwini kusukela ukudla okunosawoti futhi okubabayo, kanye ukudla okuthosiwe. Izidlo kufanele abiliswe noma steamed, nazo zamukelwa ukusetshenziswa isaladi ka nemifino eluhlaza.
11. Kuyadingeka ukuba udla njalo kancane izikhathi 5-6 ngosuku.

Imithetho efanayo iyasebenza ku ukudla ngemva holetsistoektomii (ekususweni gallbladder).

Mayelana utshwala kufanele ukhulume ngokwehlukile. Zonke izinhlobo zotshwala akuvunyelwe nakancane lesi sifo. Ibonisa ezingaphezu kweyodwa umlando lesi sifo, sibi cholecystitis calculous ngokuvamile kwenzeka ngemva nje ukuthatha utshwala. Isikhathi esining impela iziguli zilaliswe ngqo ngenxa etafuleni iholide.

Ungadliwa Omunye umuthi

Lapho sitholakele "calculous cholecystitis" amakhambi abantu angasetshenziswa ukwelapha. Osetshenziswayo Isikali amacala, infusions kanye Iziphungo banezimfanelo umphumela choleretic, ukunciphisa Bile okuhlushwa ukunciphisa yokujama tsi ku gallbladder.

Indlela ephumelelayo kubantu yi-decoction yezimbali ze-immortelle. Ukuze ulungiselele, u-15 g wezinto eziluhlaza okomile uthelelwa ku-80 ml wamanzi ashisayo futhi ubilisiwe emanzini okugeza ngamaminithi angu-30. Isiphuzo sivunyelwe ukupholisa futhi sihlungiwe, bese useza kufika ku-100 ml amanzi amanzi abilayo bese uthatha 50 ml kabili ngosuku ngaphambi kokudla.

Ukuze ukwelashwa kwe-CSF kubantu ekusetshenziselwa ukuxhaphazwa kwekhasi le- cowberry. Ukuze ulungise umuthi 3 wezipuni wezinto eziwusizo zihlanganiswe ku-thermos futhi zathelwe ngamanzi abilayo abilayo 1 litre. Uma lezi zenzo ziqhutshwa kusihlwa, khona-ke ekuseni itiye yokwelapha izobe ilungele.

Isiphetho

Kukholelwa ukuthi ukwelashwa okungcono kakhulu ukuvimbela izifo. Lokhu kusebenza ngokugcwele kwisifo esifana ne-cholecystitis yokubala. Ukudla okunempilo kanye nokuphila okunempilo kuzosiza ukugwema lesi sifo esingathandeki. Futhi uma kwenzeke ukuthi i-SCM isakhiwe, ngakho-ke kufanele kuthathwe izinyathelo eziphuthumayo ukuze ziqedwe. Khumbula ukuthi esiteji sokuqala, lapho i-gallbladder iqukethe isihlabathi, kunamatshe amakhulu, inqubo ingasuswa.