Chololithiasis ndi matenda omwe amapezeka kawirikawiri, makamaka kwa anthu oposa zaka 40. Matenda a miyala yamwala amakhudza makamaka amai, mwa amuna amapezeka kawiri kawiri kawiri. Ngati matendawa amapezeka nthawi, mungathe kuchotseratu zokhazokha ndi njira zoyenera. Zakale kwambiri, mankhwala okha opaleshoni amathandiza.
Miyala mu ndulu - zimayambitsa
Chikhalidwe cha mapangidwe a mapepala sichinafotokozedwe, ndizimene zimapangitsa kuti ziwoneke zowonongeka zimadziwika. Zinapezeka kuti cholelithiasis ndi yosavomerezeka kwambiri kwa ana, chiwerengero chake chikuwonjezeka kufika pakukula msinkhu komanso ukalamba. Chololithiasis nthawi zambiri amatha kupita patsogolo kwa amayi, makamaka atatha kubadwa 2-3 kapena kuposa.
Zina zowononga zomwe zimayambitsa nyongolotsi:
- chiwonongeko;
- kudya zakudya zokhala ndi mapuloteni a nyama ndi mafuta;
- obadwa ndi abambo omwe ali ndi vuto lomwe limasokoneza excretion ya bile;
- kudwala, kuphatikizapo kuwonongeka kwa maselo ofiira a magazi;
- moyo wokhala pansi;
- Matenda opatsirana a chiwindi ndi ndulu;
- kusowa chakudya;
- zochitika;
- kusamvana kwa hormonal;
- ntchito pa tsamba la m'mimba;
- high cholesterol mu thupi ndi ena.
Mitundu yamwala mu ndulu
Pamaso pa maonekedwe olimba, biliary sludge imapangidwira. Ndi wandiweyani, monga putty, bile. Mu boma, ndi madzi, ali ndi madzi okwana 95%. Mwa biliary sludge pang'onopang'ono anapanga ndulu chikhodzodzo. Iwo ali ndi mawonekedwe osiyana, mawonekedwe ndi kukula (kuchokera ku mchenga kupita ku nkhuku ya nkhuku), malingana ndi mankhwala awo. Mitundu yamwala mu bile:
- cholesterol;
- chiwonongeko;
- mtundu;
- zosakaniza.
Zotsatira mwa dongosolo:
- firimu;
- crystalline;
- amorphous;
- wodwala.
Kusiyanitsa kwa ndondomeko zamakono:
- mbali (multifaceted);
- choyimira;
- choyimira mbiya;
- helical;
- ovoid ndi ena.
Cholesterol miyala
Mtundu woterewu ndi wochuluka kuposa ena, pafupifupi 80%. Miyala yotereyi imakhala ndi kolesterolini. Kuwonjezera apo, ma pigments ndi calcium salt (osapitirira 10-15%) akhoza kuphatikizidwa mu maonekedwe awo. Cholesterol sichitha m'madzi ndi zina zamadzimadzi, kotero zimayendera limodzi ndi colloidal particles - micelles. Pamene njira zamagetsi zimasokonezeka, izi zimapangidwira zomwe zimapezeka mu ndulu. Poyamba amakhala ochepa, ngati mchenga, koma amakula pang'onopang'ono, amakhala ogwirizana.
Mwala wa calcareous
Mtundu uwu wa concrete wapangidwa motsutsana ndi maziko a zotupa. Mwala wa calcareous mu ndulu - zotsatira za kusungidwa kwa mchere wa calcium kuzungulira kusungunuka kwa mabakiteriya, maselo ang'onoang'ono a kolesterolini kapena maselo a epithelial. Omwe amachititsa kuti chifuwa chachikulu ndi kutupa ndi E. coli. Nthawi zina miyala ya laimu mu ndulu imapangidwa chifukwa cha hypercalcemia, ndi kukula kwa hyperparathyroidism. Ichi ndi mtundu wosawerengeka wa concrete.
Miyala yokhala ndi miyala
Chifukwa chomwe maonekedwe amenewa alili ndi mitundu yosiyanasiyana ya kuchepa magazi kwa magazi. Matendawa amachititsa kuphwanya kwa bilirubin, zomwe zimapanga maonekedwe a miyala mu ndulu. Kawirikawiri amapezeka kachiwiri, kuphatikizapo mitundu ina yamakono (cholesterol kapena calcareous). Zikatero, miyala mu gallbladder amapangidwa chifukwa matenda opaleshoni. Kutupa kungayambitse cholelithiasis wokha, mabakiteriya kapena tizilombo toyambitsa matenda.
Miyala Yosakaniza
Mtundu wa concrements wofotokozedwa uli wowala ndi waukulu mu kukula kwake. Mitengo yambiri yosakaniza mu ndulu ndi chifukwa cha mchere wa calcium mu cholesterol ndi bilirubin. Kukhalapo kwa machitidwe amenewa kumasonyeza nthawi yaitali ya matenda. Thandizo lodziŵika bwino la miyala yosakaniza ndilosachita bwino. Kawirikawiri mankhwalawa amatenga kuchotsa chiwalo chokhudzidwa pamodzi ndi calculi.
Miyala mu ndulu - zizindikiro
Pafupifupi 60-80% odwala omwe ali ndi cholelithiasis samamva zizindikiro za matenda m'zaka 5-15 zoyambirira. Pachifukwa ichi, kumayambiriro koyamba ndizosatheka kupeza miyala mu bile - zizindikiro mwina siziripo kapena zimachitika kawirikawiri ndipo zimapita mofulumira. Chodabwitsa ichi chimachokera ku stasis ya miyalayi, zovuta zomwe zimapweteketsa pokhapokha pokhapokha mutayendayenda.
Nthawi zina miyala mu ndulu imadzimva yokha ndi mawonetseredwe otsatirawa:
- kulawa kowawa pakamwa;
- chisokonezo;
- kukondwa ;
- kusanza ndi bile ;
- kuphwanya malamulo;
- icterus wa khungu ndi maso;
- kumangirira ndi mpweya;
- mala;
- kuwonjezeka pang'ono pa kutentha kwa thupi;
- zojambulazo;
- Kuwombera kapena kupweteka m'madera a chiwindi;
- kuchepa kwa njala.
Zotsatira za cholelithiasis
Kuwopsa kwa zizindikiro izi kumadalira nthawi ya kukula kwa matenda ndi kuuma kwake. Miyendo ya cholelithiasis:
- Mwala wisanayambe. The bile imawonjezera, biliary sludge amapangidwa. Zikhoza kukhala ndi mankhwala osakaniza a calcium ndi bilirubin, cholesterol precipitate.
- Asymptomatic. Miyala yoyamba imapangidwira mu ma ducts ndi chikhodzodzo. Ziri zochepa ndipo ndizochepa, kotero palibe zizindikiro za matenda.
- Kupita patsogolo. Mitengo ndi yaikulu komanso yambiri, nthawi zambiri munthu amavutika ndi vutoli. Panthawi imeneyi, mutha kuchotsa miyalayi mu bile popanda opaleshoni, mankhwalawa akuchitidwa m'njira zosamala.
- Zovuta. Chololithiasis ya chitukuko chopita patsogolo, njira yokha yopaleshoni yokhayo imayenera kutero. Mitengo imadzaza pafupifupi malo onse a m'kati.
Gallstone matenda - matenda
Njira yaikulu yodziwira matendawa ndi kupanga ultrasound. Ngati izo zikuchitidwa ndi dokotala wodziwa bwino, palibe chosowa chochita zina zowonjezera. Nthaŵi zina, njira zothandizira zimaperekedwa, zomwe zimapangitsa kuti muzindikire zowonjezera mu ndulu:
- chiwerengero;
- kubwezeretsa pancreatocholangiorentgenography;
- nyukiliya magnetic resonance.
Miyala mu ndulu - choti muchite chiyani?
Pali njira ziwiri zokha zothandizira mankhwala a cholelithiasis. Kusankha njirayo kumadalira momwe chiwerengero, chiwerengero ndi kukula kwa miyala, yomwe ili ndi miyala mu ndulu - zizindikiro, chithandizo chimagwirizana ndi siteji ya matenda. Zisanachitike zizindikiro za matendawa, zikhoza kuthetsedwa. Pakupezeka mavuto, opaleshoni yoperekedwa opaleshoni imayankhidwa nthawi yomweyo.
Mwala mu ndulu - mankhwala popanda opaleshoni
Ngati palibe chithunzithunzi chachipatala, mankhwala osungirako mankhwala amasankhidwa payekha. Zimathandiza kuti matendawa asamayende bwino komanso kuti zisawonongeke.
- kudya zakudya;
- chakudya cholondola;
- kulemera;
- zochitika zathupi.
Mwa kufanana, munthu ayenera kumwa mankhwala omwe amasungunula miyala mu ndulu:
- Ursosan ;
- Henofalk;
- Ursofalk;
- Genohol;
- Mzinda;
- Chithunzi;
- Ursofalk ndi zofanana.
Panthawi ya kugwidwa (colic), mankhwala oyenera a regimen amalamulidwa:
- Njala, mpaka kusanza kwatha.
- Kugwiritsa ntchito ayezi kapena ozizira compress ku hypochondrium yolondola.
- Kupwetekedwa mtima ndi spasmolytics (No-Shpa, Platifillin, Papaverin) ndi analgesics (Maxigan, Ibuprofen, Nimesil).
- Kulandila kwa maantibayotiki. Amasankhidwa ndi dokotala okha ngati pali matenda.
- Kutulutsidwa - Enterosgel, Atoxil.
- Kufulumira kwa kuchotsedwa kwa madzi m'thupi mothandizidwa ndi diuretics (Ureit, Lasix ndi ena).
Pamene kukula kwa miyala mu gallbladder sikudutsa 2 masentimita awiri, ndipo zowonjezera ndizochepa, zozizwitsa zowonjezereka zimalimbikitsidwa. Imeneyi ndi njira yothetsera nyumba zolimba kuchokera kunja, imagwiritsidwa ntchito pokhapokha ngati palibe njira yotupa. Pofuna kugwiritsira ntchito mankhwala ozunguza bongo, mgwirizano wodwalawo uyenera kukhala mkati mwawo, pafupifupi 75%.
Miyala mu ndulu - opaleshoni
Njira yothandizira opaleshoni imatchedwa cholecystectomy. Amagwiritsidwa ntchito ndi njira ya laparoscopic yomwe imakhala yovuta kwambiri komanso nthawi yayitali yokonzanso (mpaka masiku atatu). Uku sikutulutsidwa kwa miyala kuchokera mu bile, koma kusakaniza kwa chikhodzodzo kuchokera pachibelekero pamodzi ndi zolembazo. Kupambana kwa opaleshoni imeneyi kumafikira 99%, njirayi imakhala yogwira ngakhale poyambira matenda a cholelithiasis.
Cholecystolithotomy kapena kuchotsedwa kwa miyala kuchokera mu ndulu yosiyana, ndi kusungidwa kwa limba, silovomerezeka. Kuyesera kugwiritsa ntchito njirayi yothandizira opaleshoni inatha m'ma 60. Ntchito zoterozo ndizoopsa komanso zoopsa, ndi zotsatira zake. Pambuyo pake, kubwereranso kumachitika, ndipo munthu adayenera kupanga cholecystectomy.
Kudya ndi miyala mu gallbladder
Pa nthawi iliyonse ya cholelithiasis, chinthu chofunika kwambiri cha mankhwala ndi zakudya. Ngati palibe colic ndipo miyala yaying'ono yokha mu ndulu imapezeka, mankhwalawa akutsatira kutsata kwa Pevzner Chakudya # 5. Tengani zakudya 4-6 pa tsiku, pafupipafupi. Pamimba yopanda kanthu imalimbikitsidwa kumwa madzi ozizira ozizira. M'nthaŵi ya colic, kusala kwa nthawi yochepa kumaperekedwa ndi kusintha kwa pang'onopang'ono ku chakudya No. 5a. Zakudya zomwezo zimapangidwa pamene chowerengeka cholecystitis chimakula ndi kutupa. Chakudya choyenera chiyenera kukhala moyo wonse, popanda chisokonezo.