txheem
Cholecystitis yog cov txheej txheem inflammatory nyob rau hauv lub gallbladder, feem ntau provoked los ntawm kev kis kab mob ntawm lub plab hnyuv microflora tiv thaiv keeb kwm yav dhau ntawm kev ua txhaum ntawm cov kua tsib los ntawm ib tug clogged cystic duct. Cholecystitis feem ntau yog ib qho teeb meem ntawm cholelithiasis. Lub gallbladder nyob ib sab ntawm daim siab thiab nquag koom nrog hauv cov txheej txheem ntawm kev zom zaub mov. Cov kua tsib tawm los ntawm txoj hnyuv me, tab sis qee zaum muaj teeb meem nrog kev khiav tawm thiab cov kua tsib nkag mus rau hauv lub gallbladder, ua rau mob hnyav thiab muaj kev pheej hmoo kis mob ntxiv.
Raws li txoj cai, tus kab mob tshwm sim ua ke nrog cholangitis - o ntawm cov kua tsib ducts. Cholecystitis yog ib qho kev phais mob, tshwj xeeb tshaj yog cov poj niam hnub nyoog nruab nrab thiab laus - lawv tau mob peb mus rau yim npaug ntau dua li cov txiv neej.
Cov laj thawj tseem ceeb ntawm poj niam txiv neej predisposition rau cholecystitis:
Kev mob ntev ntawm lub gallbladder thaum cev xeeb tub provokes qhov tshwm sim ntev - qhov tsis txaus ntawm cov cholesterol thiab cov kua tsib acids, thiab, vim li ntawd, stagnation ntawm cov kua tsib;
Cov yam ntxwv ntawm cov tshuaj hormonal metabolism ntawm cov poj niam - nws tau raug pov thawj tias progesterone, uas yog tsim nyob rau hauv loj npaum li cas thaum cev xeeb tub thiab menopause, thiab lwm yam poj niam txiv neej cov tshuaj hormones tsis zoo rau kev ua hauj lwm ntawm lub gallbladder;
Cov poj niam nyiam noj zaub mov, thiab kev txwv tsis pub noj zaub mov hnyav cuam tshuam rau kev txav mus los (kev cog lus) ntawm lub gallbladder.
Pawg pheej hmoo, tsis hais poj niam txiv neej thiab hnub nyoog, suav nrog cov neeg uas yav dhau los muaj:
Kab mob plab hnyuv thiab / lossis kab mob siab;
Kab mob kab mob (helminthic thiab protozoal invasions, nyob ruaj ruaj los yog nyob rau hauv ib tug ntawm cov theem ntawm kev loj hlob nyob rau hauv txoj hnyuv thiab / los yog daim siab);
Kab mob Gallstone (GSD) nrog kev thaiv (kev thaiv) ntawm lub ncauj tsev menyuam thiab / lossis kev puas tsuaj rau cov mucous ntawm lub gallbladder;
Cov kab mob uas cuam tshuam cov ntshav muab rau cov phab ntsa ntawm lub gallbladder.
Ib qho kev sib txuas ntawm cov kab mob ntawm lub gallbladder thiab anatomically unrelated plab hnyuv plab hnyuv siab raum tau raug pov thawj - cov no yog cov viscero-visceral reflexes. Tag nrho cov saum toj no ua rau cholecystitis yog vim yog ib tug ua txhaum ntawm patency (obstruction) ntawm lub gallbladder, los yog ua txhaum ntawm nws motility (dyskinesia).
Raws li lub hauv paus etiological, ob pawg nosological loj ntawm cholecystitis yog qhov txawv:
Calculous (lat. Calculus – pob zeb);
Noncalculous (stoneless).
Cov tsos mob ntawm cholecystitis
Thawj cov tsos mob ntawm cholecystitis feem ntau yog ntse mob nyob rau sab xis hauv qab cov tavuas tshwm sim poob nthav. Yog vim li cas rau qhov no yog lub pob zeb uas thaiv lub cystic duct. Yog li ntawd, khaus thiab o ntawm lub gallbladder tsim.
Qhov mob ploj mus tom qab qee lub sij hawm ntawm nws tus kheej lossis tom qab noj cov tshuaj tua kab mob, tab sis yav tom ntej nws maj mam nce, thiab tom qab ntawd nws ua tsis tu ncua. Muaj kev loj hlob ntawm tus kab mob, uas yog nrog los ntawm kub taub hau, ntuav thiab xeev siab. Tus neeg mob qhov mob tseem tsis zoo.
Nres qhov qub ntws ntawm cov kua tsib rau hauv cov hnyuv, Ib qho kev qhia uas yog icteric xim ntawm daim tawv nqaij thiab qhov muag sclera. Yam yuavtsum tau kawm uantej rau jaundice yog qhov muaj pob zeb uas thaiv cov ducts. Qhov hnyav ntawm tus kab mob yog tus cwj pwm los ntawm tus neeg mob lub plawv dhia: feem ntau lub plawv dhia yog los ntawm yim caum mus rau ib puas thiab nees nkaum - ib puas thiab peb caug ntaus ib feeb (los yog siab dua), uas yog ib qho teeb meem loj, txhais tau hais tias muaj kev hloov pauv txaus ntshai. hauv lub cev.
Raws li rau daim ntawv ntev ntawm cholecystitis, cov cim qhia yuav tsis tshwm sim tshwj xeeb, yav tom ntej tus kab mob yuav ua rau nws tus kheej nyob rau hauv daim ntawv siab dua lossis ua rau mob hnyav. Nyob rau hauv cov ntaub ntawv no, tsuas yog kev kho mob nyob rau hauv ib tug tshwj xeeb lub tsev kho mob yuav tsis txhob deterioration ntawm tus mob.
Ntshai nrog cholecystitis - ib qho kev mob tshwm sim. Nausea yog ib yam mob uas feem ntau ua ntej lub gag reflex. Qee zaum, xeev siab thiab ntuav yog ib qho kev tiv thaiv ntawm lub cev rau intoxication. Nrog cholecystitis, xeev siab thiab ntuav yog ib feem ntawm cov kab mob pathogenesis.
Kev xeev siab hauv cholecystitis yuav tsum tau sib txawv ntawm cov tsos mob zoo sib xws hauv lwm cov kab mob thiab pathologies:
Mob plab (mob plab) nrog cholecystitis pom ntau zaus. Mob raws plab, cem quav, tsam plab yog cov cim qhia ntawm cov kab mob ntawm txoj hnyuv, nrog rau cholecystitis. Qhov tshwm sim tam sim ntawd ntawm cov quav tsis haum thaum kho tus mob cholecystitis qhia tau hais tias muaj kab mob nyuaj.
Ua rau cholecystitis
Qhov ua rau ntawm tus kab mob tuaj yeem sib txawv heev, tab sis feem ntau cholecystitis tshwm sim vim muaj pob zeb nyob rau hauv cystic duct, lub cev thiab lub caj dab ntawm lub gallbladder, uas ua rau nws nyuaj rau cov kua tsib ntws tawm. Qhov ua rau tuaj yeem yog qee yam kev raug mob lossis kev kis kab mob, nrog rau muaj cov kab mob loj xws li ntshav qab zib mellitus, txawm li cas los xij, ntawm no cholecystitis yuav tshwm sim nws tus kheej raws li qhov teeb meem ntawm cov kab mob uas twb muaj lawm, thiab tsis yog kab mob ywj pheej.
Qhov tshwm sim ntawm tag nrho cov saum toj no tuaj yeem yog daim ntawv mob cholecystitis nrog rau lub gallbladder o. Daim ntawv mob ntev ntawm tus kab mob no feem ntau yog pom nyob rau hauv cov neeg mob uas khaus khaus tsis txo qis rau lub sij hawm ntev thiab protracted, vim hais tias ntawm cov phab ntsa ntawm lub cev ua denser.
Kev tawm tsam ntawm cholecystitis
Kev tawm tsam yog yam ntxwv ntawm ob qho tib si thawj cholecystitis thiab exacerbations ntawm daim ntawv mob ntev ntawm tus kab mob. Harbingers ntawm qaug dab peg yog qhov tsis xis nyob hauv plab tom qab noj rog, ntsim zaub mov lossis cawv.
Cov tsos mob ntawm qhov mob hnyav ntawm cholecystitis:
Nthuav cramping mob nyob rau hauv txoj cai hypochondrium, epigastrium los yog navel;
xeev siab thiab ntuav, gas belching, iab saj hauv qhov ncauj;
Subfebrile lossis febrile lub cev kub (37-38 0 C los yog 38-39 0 NTAWM).
Yuav ua li cas txo qhov kev tawm tsam ntawm cholecystitis?
Txhawm rau tiv thaiv tus mob cholecystitis, koj yuav tsum:
Hu rau tsheb thauj neeg mob;
Pw hauv txaj thiab siv txias rau lub plab;
Noj cov tshuaj antispasmodic (no-shpa) thiab analgesic;
Txhawm rau txo qhov xeev siab, haus mint tshuaj yej lossis dej ntxhia uas tsis yog carbonated nyob rau hauv chav sov;
Nyob rau hauv lub xub ntiag ntawm ntuav, xyuas kom meej sau cov ntuav rau kev soj ntsuam.
Cov teeb meem thiab qhov tshwm sim
Daim ntawv mob cholecystitis yam tsis muaj kev kho mob txaus yuav ua ntev nrog lub sij hawm exacerbation thiab tshem tawm. Thiab cov kab mob ntev yog qhov nyuaj rau kev kho, txij li lwm yam kabmob koom nrog hauv cov kab mob pathogenesis. Daim ntawv tshaj tawm ntawm cholecystitis yog kuaj pom hauv 15% ntawm cov neeg mob. Nws tuaj yeem ua rau gangrene, biliary fistulas uas txuas cov hnyuv, ob lub raum thiab lub plab nrog lub gallbladder, obstructive jaundice, abscess, mob pancreatitis, thiab qee zaum sepsis.
Cov txiaj ntsig (kev kwv yees) ntawm kev suav thiab tsis suav nrog cholecystitis:
Qhov kev kwv yees ntawm kev tsis sib haum xeeb suav nrog cholecystitis yog qhov zoo. Tom qab kev kho mob hnyav, daim duab kho mob yuav tsis tshwm sim rau lub sijhawm ntev. Cov xwm txheej ntawm kev rov ua kom tiav yog paub. Nyob rau hauv cov ntaub ntawv nyuaj ntawm calculous cholecystitis, qhov prognosis yog ceev faj dua;
Kev kwv yees ntawm cov tsis suav cholecystitis yog tsis paub tseeb. Nrog xws li ib tug kab mob, ib tug yuav tsum tau ceev faj ntawm purulent thiab puas cov ntaub ntawv ntawm o.
Kev kho mob thiab kev noj haus
Kev kho mob ntawm tus mob cholecystitis thiab mob ntev nyob rau theem mob yog nqa tawm hauv tsev kho mob phais. Cov kev kho mob raug xaiv ib tus zuj zus raws li cov lus qhia.
Conservative kev kho mob ntawm cholecystitis:
Cov tshuaj tua kab mob, kev xaiv nyob ntawm qhov ua tau zoo ntawm cov tshuaj;
Antispasmodics kom stabilize txoj haujlwm ntawm cov kua tsib mus rau hauv cov hnyuv;
Cholagogue nrog hypotension ntawm lub gallbladder thiab ib txwm patency ntawm cov kua tsib duct;
Hepatoprotectors los tswj lub siab ua haujlwm.
Kev kho mob ntawm cholecystitis:
Cholecystectomy - Kev tshem tawm tag nrho ntawm lub gallbladder, nqa tawm tam sim nrog cov tsos mob ntawm diffuse peritonitis thiab mob ob lub raum, nyob rau hauv lwm yam mob - raws li kev npaj.
Kev noj haus rau cholecystitis
Thaum muaj mob hnyav, tus neeg mob tsuas yog haus dej haus sov hauv qhov me me xwb. Qhov ntim ntawm cov kua yog txog li ib thiab ib nrab litres ib hnub twg.
Tom qab tshem tawm qhov mob hnyav, cov khoom noj muaj xws li cereals, kissels, steam cutlets los ntawm cov nqaij ntshiv los yog ntses, nqaij qaib qe hauv daim ntawv ntawm omelet, thiab qhob cij dawb.
Kev noj haus rau cholecystitis:
Koj yuav tsum tau noj me me (5-6 zaug hauv ib hnub) kom tswj tau cov kab mob ntawm cov kua tsib;
Noj hmo yog pom zoo tsis pub dhau 4-6 teev ua ntej ib hmos pw.
Kev noj haus ntawm cov neeg mob cholecystitis yuav tsum muaj xws li:
Tsiaj cov khoom uas muaj tsawg kawg nkaus ntawm cov rog, finely tws thiab steamed;
Cov zaub mov uas tsis muaj coarse fiber, nplua nuj nyob rau hauv cov vitamins thiab kab kawm.
Nrog cholecystitis, nws yog txwv tsis pub noj cov khoom hauv qab no:
Cov kaus poom, pickled, smoked, salted, pickled, fatty, astringent;
Provoking indigestion thiab gas tsim (mis nyuj, legumes, dej qab zib carbonated);
Hloov pH ntawm ib puag ncig ntawm lub plab (cawv, sorrel, spinach, citrus txiv hmab txiv ntoo).