Ukusebenza ukususa amatshe atholakala enyongweni. Ukulungiselela ukuhlinzwa yokuqokwa

manje isifo Gallstone isibe omunye izenzakalo ezivamile phakathi zokugula besisu, futhi ukuhlinzwa ukhishwe amatshe atholakala enyongweni - indlela isixazululo siyinhloko inkinga.

isifo Gallstone - kuyini?

Lesi sifo lihlotshaniswa kumiswa ku Amapayipi Bile namatshe nenyongo sesinye (calculi). It is ithuthukiswe ngenxa yezizathu ezilandelayo:

• yokujama tsi noma ushintsho ukubunjwa Bile;
• izinqubo ukuvuvukala;
• bilification ukwephulwa (dyskinesia).

Ngo ukwakheka, kukhona izinhlobo ezintathu zamatshe. Okuvame kakhulu (80-90% of amacala) zikhona cholesterol amatshe. kumiswa babo bunomthelela ngokweqile okuqukethwe cholesterol Bile. Uma lokhu kwenzeka kumiswa zinhlayiya ngenxa sebethule cholesterol kwenze ngokweqile. Uma uphule motility esinyeni inyongo ke lezi zokwakheka ababoniswa endaweni emathunjini, futhi ahlale ngaphakathi ke bese eqala ukukhula.

Pigment amatshe akhiwa ngenxa nokwahlukana anda wamangqamuzana egazi - amangqamuzana abomvu egazi. Ngokuvamile-ke kungabonakala nasemkhakheni anaemia hemolytic. Kukhona futhi imfundo okuxubile. Ziyakwazi inhlanganisela yakho kokubili amafomu. It sakhiwa cholesterol, bilirubin ne-calcium.

Kungakhathaliseki ukusebenza kuyadingeka

Wonke umuntu oye kwatholakala ukuthi une-amatshe atholakala enyongweni, manje noma ngokuhamba kwesikhathi ebhekene umbuzo ukuthi kokungenela op noma kuyoba okwanele ekwelashweni olandelanayo. Kuhle kokusho ukuthi amatshe ngokwabo ngezizathu ukususa gallbladder. Uma bengakuqondi bazibonakalise, futhi musa kuthinte operation evamile nezinye izindikimba, ukuhlinzwa abakwazi ukucabanga. Nokho, uma kukhona ubuhlungu gallbladder, ukunikezwa kwe-isimo jikelele, yellowness, nesidingo esiphuthumayo uthintane udokotela ohlinzayo. Nguye, emva inhlolovo ozonquma ukuthi kokungenela op kuyadingeka futhi kuyini. Kodwa uqaphele ukuthi cholecystitis gallbladder kusho esiqaliwe ukuvuvukala. Uma ngokweqile ukuhlehlisa isinqumo, amathuba ukubuyisa ngokugcwele impilo emva kokuhlinzwa sanciphisa kangcono. Ngisho noma kwaba khona ukuhlaselwa olulodwa, amatshe atholakala enyongweni kangcono ukususa.

Izinkomba ukuhlinzwa

Lapho enza isinqumo ngokuphathelene isidingo ukuhlinzwa, ochwepheshe ngokuvamile cabangela la maqiniso alandelayo:

• khona amatshe (calculi) lobehlukene, bangazihluphi wesithathu esinyeni nenyongo;
• uma lesi sifo singumbulali ukuhlaselwa njalo ubuhlungu gallbladder (colic biliary), ukusebenza Kwenziwa kungakhathaliseki ubukhulu concrements;
• Uma amatshe ahlelwe esinyeni nenyongo nasesikhathini Amapayipi;
• kuyilapho ekwehliseni ikhono gallbladder ungenwa noma ukunqamuka wako;
• ukuthuthukiswa pancreatitis biliary;
• ngu zokugwema ukuphuka odongeni gallbladder;
• nge occlusion we ezivamile imbobo hepatic.

Kukhona izinkombandlela ngamazwe sokunquma isidingo zokuhlinza cholelithiasis. Efingqa amaphuzu ukuthi basebenza izinkomba ezahlukene zokuxilonga, udokotela eyonquma ukuthi ukuhlinzwa liyadingeka, kanye izinkomba isihlobo kanye ngokuphelele ngenxa yalo.

izinhlobo imisebenzi

Ngokuvamile, inqubo kumiswa amatshe atholakala enyongweni - akusiyo okusheshayo. Yiqiniso, uma amashwa, futhi ambulensi kuzokusa isibhedlela kuhlinzwa ngokuhlaselwa acute, okuyinto kwatholakala cholecystitis, gallbladder, ukukhetha une incane. Kodwa iningi labantu abazi ngenkinga kusengaphambili nodokotela wakho wonke ukuxoxisana imininingwane, ukunquma usuku nokuhlinzwa okuhleliwe.

Ngo inqubo yokwelapha yesimanje, kukhona izindlela ezimbili yokususa gallbladder (cholecystectomy)

• evulekile cholecystectomy - indlela evamile ehlinzekela kokuvula komgodi ongaphakathi kwamathumbu;
• cholecystectomy laparoscopic - inqubo sanamuhla ayethanda namuhla.

cholecystectomy evulekile

Lo msebenzi ukususa amatshe atholakala enyongweni kuyinto ukuhlinzwa zakudala. Ngemva kwesigaba kanye umugca lohlukanisa emkhatsini esiswini senziwa ukuhlolwa ingaphakathi lesisu, nokususwa nenyongo sesinye, uma kunesidingo, amanzi (ukufakwa amashubhu, ukuze kuqinisekiswe outflow we exudate okuholela futhi olunye uketshezi lomzimba).

Naphezu kwavela izindlela zanamuhla futhi zobuchwepheshe, cholecystectomy evulekile namanje efanele. Lokhu zingachazwa ngezinqubo yokuthi eminye imitholampilo akudingeki imishini noma ochwepheshe ezidingekayo iziqu ukuba afeze izinqubo laparoscopic. Ngaphezu kwalezi, kukhona Izimo ezithile.

gallbladder Laparoscopy

Lena enye indlela wezinqubo zokuhlinza isifo gallstone. Kuze kube manje, le ndlela Sekuvamile ngaphezulu ngenxa ukusebenza yayo, ongaphakeme-umthelela, ukuncishiswa imigomo yokutakula. Ukusebenza eyenziwa besebenzisa laparoscope - kungaphefumuli ekhethekile, okuvumela ukufinyelela isitho obonakele nge amaningi punctures odongeni kwamathumbu okuyothi ngalo ezandleni yethulwe futhi, empeleni, a laparoscope. Le ndlela ikuvumela ukuba ukususa hhayi kuphela gallbladder akuyona kokushiya izibazi, kodwa kwezinye izimo bakhiphe amatshe kuphela, ushiya umzimba endaweni. Indlela efanayo isetshenziswa hhayi kuphela ekwelapheni isifo gallstone, kodwa futhi ngoba ukususwa appendicitis, ukwelapha hernias inguinal, ezinye izifo gynecological, nemisebenzi yokuhlola. Naphezu kokuba ecacile cholecystectomy laparoscopic, le ndlela has Izimo yayo. Lezi zihlanganisa:

• ithumba, ise-zone wokusebenza;
• nezinyanga zokugcina ezintathu zokukhulelwa;
• nesifo esinzima cardiopulmonary.

Futhi, khumbula ukuthi lapho ehlinzwa laparoscopic, uma ubunzima kancane ku wamanje yayo, odokotela abahlinzayo ukudlula ukuvula cholecystectomy. Iphela kanjalo iminyaka mayelana 5% ukuhlinzwa laparoscopic.

Ukulungiselela ukuhlinzwa

Njenganoma iyiphi ukuhlinzwa, ukuhlinzwa ukuba bakhiphe amatshe e-gallbladder kudinga ukuqeqeshwa abanye. Ngaphandle inhlolovo ejwayelekile kuhlanganise cwaningo ukulethwa (CBC futhi urinalysis, igazi biochemistry, coagulation - ukuphenywa kokuphulwa igazi ekunqandeni, umsebenzi sesibindi ukuhlolwa), kubalulekile ukwenza ultrasonography besisu, electrocardiography, esifubeni X-ray, ngokuvumelana izinkomba FGS futhi colonoscopy, futhi uthole umbiko nongoti sika. Ngaphezu kwalokho, ukulungiselela ukuhlinzwa yokuqokwa kuhlanganisa yokukhansela izidakamizwa ezithinta coagulability kwegazi. Lezi zihlanganisa ezihlukahlukene anticoagulants, vitamin E, non-steroidal izidakamizwa eqeda ukuvuvukala. Ezinsukwini ezimbalwa ngaphambi kokuba ukusebenza kudinga ukubhekelwa ngokuthi yokudla cholelithiasis. Imenyu akufanele ibe ukudla esindayo, futhi kusukela phakathi kwamabili of suku uma ukusebenza uqhutshwa, kubalulekile ukubeka eceleni ukudla nokuphuza. Ngobusuku obandulela usuku Ukuhweba ukuhlanza wamathumbu ekuseni nakusihlwa ukwakheka enemas elihlanza noma ukusebenzisa izidakamizwa ezikhethekile. Ekuseni ushawa ngensipho elwa namagciwane.

Isikhathi nasezinkingeni ezilandela ngemva kokuhlinzwa

Namuhla kunzima kusimangaze umuntu cholecystectomy. Lo msebenzi ukususa amatshe atholakala enyongweni Sekuyisikhathi eside ukubeka "ekusakazeni", futhi imayelana ejwayelekile njengesinkwa i appendectomy. Lesi siguli kakade ngemva kwamahora amane okushaya beqeda ukusebenza, ngesikhathi lapho akunakwenzeka ukuba baphuze bese wenze ukunyakaza abukhali uvunyelwe ukuze ujike embhedeni. Bese usungaqala ukuphuza amanzi ngaphandle igesi in izingxenye ezincane (1-2 pharynx, kodwa hhayi ngaphezulu kuka-500 ml). Ngemva kwamahora ayisithupha emva kokuhlinzwa laparoscopic isiguli uvuke. Kwenze kangcono, uma kukhona umuntu kusukela abasebenzi bezokwelapha noma izihlobo, kusukela emuva kokutholakala kwesidumbu isikhathi eside wahlala esimweni evundla esimweni izinzwa, uma uzama ukuthola lapho kungenzeka isiyezi nokuquleka. Ngakusasa ngemuva kokuhlinzwa isiguli Ungahambisa ngokukhululekile esibhedlela.

Ngemva kokuhlinzwa, ekudleni kubalulekile cholelithiasis. Imenyu kosuku ingafaka ukudla okuwuketshezi - iphalishi phezu amanzi, amasobho wezokudla, imikhiqizo yobisi. Ngaphezu kwalokho ekudleni kungafaka yenkomo abilisiwe, inkukhu webele, apula wabhaka noma ubhanana. Kumele kukhunjulwe ukuthi ngesonto lokuqala emva kokuhlinzwa kungavunyelwe utshwala, itiye eqinile noma ikhofi, ushukela, okuthosiwe nokudla okunamafutha.

ukwelashwa litholytic

Uma kokungenela kuhlinzwa akunakwenzeka yizifo ezinzima ukuphathwa kwabathintwayo noma iziyaluyalu igazi ekunqandeni, kanye nokwenqaba isiguli kusukela ukuhlinzwa, aphethwe yokwelapha litholytic. Le ndlela, okuyinto esetshenziswa ukwakhiwa ehlanganisa Bile acid, okuhloswe ukuncibilikisa amatshe kwakhiwa. Njengoba kubalulekile ukucabangela ukuthi isikhathi sokwelashwa zingahluka kusuka onyakeni owodwa kuya eminyakeni emibili, bese ngisho noma kungenzeka ukuncibilikisa amatshe atholakala enyongweni ngokuphelele, akuqinisekisi ukuthi ngeke sivele futhi. Ngaphezu kwalokho, e-Inkambo yokwelashwa kungenzeka yezinkinga ezihlukahlukene zezifo gallstone, kuhlanganise nalezo ezingasebenzisi ezidinga ukuthi kungenelelwe kuhlinzwa.

Isimo sokunquma Ukwelashwa litholytic

Elinye ikhambi komkhawulo litholytic kukhona nezimfuneko ezithile ukuze nenqubo ye-isifo:

1. Amatshe atholakala enyongweni cholesteric kudingeka, nge Ubukhulu esingeqile 20 mm.
2. Umsebenzi we gallbladder ngazisile ngisindisile futhi amatshe musa hlala ezingaphezu kwesigamu umthamo yayo.
3. Cystic futhi ezivamile Bile imbobo kufanele silondoloze patency yayo.
4. Kusukela kwasungulwa amatshe bengekho ngaphezu kwama-iminyaka emibili.
5. Emlandweni kufanele kube Yiqiniso ayinzima zesifo - ubuhlungu omnene, izikhathi zokudakwa esikhethiwe colic.

Ukwelashwa wenziwa khona ngaphansi ultrasound njalo ezinyangeni 3-6. Uma ngemva kwezinyanga eziyisithupha akukho ngcono ke luwela ayizwakali, waphinda futhi waphakamisa impikiswano ukuhlinzwa. Uma yokwelapha litholytic uye waphumelela, ukuze ngesikhathi esifanele ukuthola amatshe atholakala enyongweni elalisanda kumiswa, US ukwenza okungenani kanye ezinyangeni ezintathu.