Lo lus "cholestatic jaundice" yog hais txog cov kab mob pathological uas cov zais cia ua los ntawm lub siab (kua siab) tsis nkag mus rau hauv duodenum, tab sis maj mam nce hauv cov ntshav. Yog tias thawj qhov kev ceeb toom tshwm sim, koj yuav tsum hu rau lub tsev kho mob sai li sai tau. Qhov no yog vim qhov tseeb tias cholestatic jaundice tuaj yeem qhia ob qho tib si ua txhaum me ntsis ntawm cov cellular metabolism, thiab kab mob ntawm lub siab thiab lub gallbladder, uas tuaj yeem ua rau tuag taus.
Pathogenesis
Lub tshuab ntawm txoj kev loj hlob ntawm tus kab mob yog raws li kev swb ntawm hepatocytes. Cov no yog cov kab mob siab uas nws lub luag haujlwm yog khi ncaj qha bilirubin thiab tso tawm mus rau hauv duodenum los ntawm cov kua tsib ducts. Raws li kev cuam tshuam ntawm ntau yam ua rau muaj kev cuam tshuam, cov txheej txheem no cuam tshuam.
Indirect bilirubin yog ib qho kev sib xyaw ua ke uas tsim nyob rau hauv reticuloendothelial system los ntawm hemoglobin tso tawm tom qab tawg ntawm cov qe ntshav liab. Cov txheej txheem ntawm nws cov synthesis yogtas li, nws tsis nres txawm tias ib pliag.
Raws li kev cuam tshuam ntawm ntau yam tsis zoo, kev ua haujlwm ntawm lub siab raug cuam tshuam, vim tias lub cev tsis tuaj yeem tiv thaiv kev tso tawm thiab kev ua haujlwm tsis ncaj ntawm bilirubin. Qhov tshwm sim ntawm qhov tshwm sim yog nws tsub zuj zuj hauv cov ntshav ntshav. Ntxiv mus, stagnation ntawm indirect bilirubin kuj pom nyob rau hauv daim siab nws tus kheej. Vim tias qhov sib xyaw ua ke nyob hauv cov ntaub so ntswg ntev, tus neeg mob daim tawv nqaij hloov daj lossis ntsuab. Qhov no yog ib qho cim tshwj xeeb ntawm cholestatic jaundice. Yog tias nws tshwm sim, koj yuav tsum hu rau lub chaw kho mob sai li sai tau.
Etiology
Raws li kev txheeb cais, feem ntau ntawm cov mob cholestatic jaundice yog txuam nrog kev siv tshuaj ntev ntev xws li androgens, broad-spectrum tshuaj tua kab mob, tshuaj tiv thaiv kab mob, sulfonamides, anabolic steroids. Tsis tas li ntawd, kev lom ntawm lub cev nrog qee cov pa roj, mercury thiab ntsev ntawm cov hlau hnyav tuaj yeem pib tsim cov txheej txheem pathological.
Cov hauv qab no yog cov npe ntawm cov kab mob uas tsis yog qhov ua rau mob cholestatic jaundice, tab sis ua lub luag haujlwm ntawm hom catalyst:
- kab mob siab mob siab.
- Qee hom kab mob Botkin.
- Cholestasis ntawm ib qho xwm txheej idiopathic.
- YPancreatitis.
- Cirrhosis ntawm daim siab.
- Nyob rau hauv lub cev.
- Malignant neoplasms hauv zos tsis yog hauv daim siab, gallbladder thiab nws cov ducts,tab sis kuj nyob rau hauv lub cev nyob ze. Qhov txaus ntshai tshaj plaws yog nthuav tawm los ntawm cov qog nyob rau theem ntawm metastasis.
- Cholestasis ntawm cev xeeb tub.
- Hepatosis (ob leeg rog thiab cawv).
- Cov kab mob ntawm cov kab mob sib kis (feem ntau cholestatic jaundice tsim tawm tsam keeb kwm yav dhau los ntawm toxoplasmosis, malaria thiab syphilis).
- Cholecystoatonia.
- Wilson's disease (feem ntau yog los ntawm caj ces).
Nws yog ib qho tseem ceeb kom nkag siab tias cholestatic jaundice yog ib qho mob uas ua rau muaj kev phom sij tsis yog rau kev noj qab haus huv xwb, tab sis kuj rau lub neej. Qhov no yog vim lub fact tias indirect bilirubin yog heev lom. Thaum nws cov concentration nce mus rau theem tseem ceeb, nws yog ib txwm ua los tham txog qhov xwm txheej tsis zoo. Hauv cov xwm txheej zoo li no, feem ntau muaj qhov tshwm sim tuag taus.
daim duab kho mob
Cov tsos mob ntawm cholestatic jaundice yog qhov tshwj xeeb, thiab yog li tus kws kho mob muaj peev xwm paub tau tus kab mob no thaum lub sijhawm kuaj lub cev thiab keeb kwm noj.
Kev kho mob tshwm sim ntawm tus kab mob:
- khaus ntawm daim tawv nqaij thoob plaws lub cev. Cov neeg mob hais tias qee zaum nws ua tsis taus.
- Hloov lub suab ntawm daim tawv nqaij, sclera ntawm lub qhov muag thiab mucous daim nyias nyias. Fabrics ua yellowish, ntsuab lossis reddish.
- Ntaus, nquag hloov ua ntuav.
- qaug zog heev.
- Nyob rau theem ntawm qaug zog.
- Kev cuam tshuam ntawm qab los noj mov mus txog qhov nws tsis ua tiav.
- poob ceeb thawj.
- Mob rhiab heev nyob rau sab xis ntawm thaj tsam ntawm tav. Thaum thawj theem ntawm kev loj hlob ntawm cholestatic jaundice, cov tsos mob yog mob me, tab sis dhau sij hawm, nws qhov kev siv zog nce ntxiv. Cov neeg mob hauv qhov xwm txheej no yws txog qhov mob paroxysmal.
Pathology yooj yim heev kom paub qhov txawv ntawm lwm hom jaundice. Thaum nws txoj kev loj hlob, tus neeg mob cov zis tsis tau txais qhov ntxoov ntxoo nplua nuj. Discoloration ntawm quav kuj tsis pom. Qhov no yog vim qhov tseeb hais tias nrog hom kab mob no nyob rau hauv cov ntshav cov ntshav, muaj ib txhij nce nyob rau hauv lub concentration ntawm ob leeg thiab dawb bilirubin. Yog li ntawd, cov txheej txheem ntawm kev tshem tawm cov tshuaj lom hauv lub cev yog cuam tshuam.
Txawm hais tias qhov mob hnyav ntawm cov tsos mob ntawm cholestatic jaundice, nws tsis tuaj yeem ncua kev kho mob ntawm pathology. Nws yog ib qho tseem ceeb kom nco ntsoov tias kev ncua yuav ua rau tus neeg mob ua rau lawv txoj sia.
Diagnosis
Thaum thawj cov cim ceeb toom tshwm sim, koj yuav tsum sab laj nrog kws kho mob. Cov kab mob pathology yog kho los ntawm tus kws kho mob gastroenterologist thiab kws kho mob hepatologist. Tus kws kho mob tshwj xeeb yuav kuaj xyuas lub cev, kuaj anamnesis thiab muab xa mus rau kev kuaj.
Kev kuaj mob cholestatic jaundice suav nrog cov kev tshawb fawb hauv qab no:
- kuaj ntshav dav dav. Raws li qhov tshwm sim, tus kws kho mob yuav txiav txim siab txog kev noj qab haus huv ntawm tus neeg mob tag nrho.
- kuaj ntshav biochemical. Nyob rau hauv lub xub ntiag ntawm cholestatic jaundice, ob qho tib si conjugated thiab dawb bilirubin tau nce.
- Ultrasound ntawm daim siab, gallbladder thiab nws cov ducts. NtawmYog tias tsim nyog, kuaj ultrasound ntawm cov kab ke uas nyob ib sab yog ua.
- CT scan ntawm daim siab thiab gallbladder nrog ducts. Tej zaum yuav raug txiav txim kom paub meej tias cov txiaj ntsig ultrasound.
- Endoscopic retrograde cholangiopancreatography. Txoj kev no tso cai rau koj txheeb xyuas qhov laj thawj ntawm kev txhim kho ntawm cholestatic jaundice.
- X-rays nrog qhov sib txawv.
Yog xav tias mob qog noj ntshav, koj tus kws kho mob yuav txiav txim siab kuaj lub siab.
Tsuas yog raws li cov txiaj ntsig ntawm kev kuaj mob dav dav, tus kws tshaj lij tuaj yeem muab cov ntaub ntawv hais txog yuav kho tus mob cholestatic jaundice.
Drug therapy
Ib feem ntawm kev siv cov dej num txhawm rau tshem tawm cov hauv paus hauv paus ntawm tus kab mob. Tsis tas li ntawd, kev kho mob ntawm cholestatic jaundice tau ua tiav.
Cov kev kho mob classic suav nrog kev noj lossis tswj cov tshuaj hauv qab no:
- tshuaj hormonal. Lawv raug sau tseg kom nres cov txheej txheem inflammatory thiab kom stabilize cell membranes.
- tshuaj cholagogue. Tso cai rau kom nrawm qhov tawm ntawm lub siab zais cia.
- Vitamins. Yuav tsum tau ua kom lub cev muaj zog.
- Hepatoprotectors. Cov khoom xyaw nquag ntawm kev npaj tiv thaiv hepatocytes thiab tiv thaiv cov txheej txheem ntawm lawv txoj kev tuag.
- YHemostatics. Tau teem caij los ntshav ntau ntxiv.
- Infusion daws. Pab tshem tawm lub cev ntawm cov tshuaj lom thiab normalize dej thiab electrolyte tshuav.
Kev kho mob cholestatic jaundice tsuas yog ua tiav yog tias txhua yam kev ntsuas tsim nyog tau raug coj los daws qhov laj thawj. Thaum mob hnyav, tus neeg mob tau mus pw hauv tsev kho mob.
kho mob phais
Thaum mob hnyav thiab thaum cov txheej txheem kev kho mob tsis zoo, kev cuam tshuam kev phais raug qhia. Muaj ntau ntau hom kev kawm uas siv tau los kho cholestatic jaundice:
- Kev tso dej ntawm lub gallbladder thiab nws cov ducts. Thaum lub sijhawm ua haujlwm, cov kua dej sib xyaw ua ke raug tshem tawm.
- Choledochotomy. Thaum muaj kev cuam tshuam, tus kws phais tau yuam kom qhib lub lumen ntawm cov kab mob sib kis.
- Papillosphiterotomy. Thaum lub sijhawm ua haujlwm, lub sphincter ntawm duodenum qhib.
- Hepatectomy. Nws txhais tau hais tias ib feem ntawm lub siab resection, uas yog, ntu cuam tshuam.
- Cholecystectomy. Thaum lub sijhawm ua haujlwm, lub gallbladder raug tshem tawm tag nrho.
Hauv cov xwm txheej sib cais, tom qab kev tswj hwm, daim duab kho mob txuas ntxiv mus lossis tseem hnyav dua li ua ntej. Hauv cov xwm txheej zoo li no, tus kws kho mob txiav txim siab txog qhov kev tawm tswv yim ntawm kev hloov pauv cov khoom nruab nrog cev.
Khoom noj khoom haus
Kev hloov ntawm kev noj haus yog qhov yuav tsum tau ua ua ntej, yog tias tsis ua raws li, kev kho mob tsis tuaj yeem ua tiav. Nrog cholestatic jaundice, cov kws kho mob tau sau cov zaub mov "Table No. 5", tsim los ntawm Dr. M. I. Pevzner. Cov kws kho mob xav tias nws yog qhov feem ntau.haum rau cov neeg uas raug kev txom nyem los ntawm lub siab, gallbladder thiab nws cov ducts.
Cov Txheej Txheem Kev Noj Qab Haus Huv:
- Koj yuav tsum noj 4-5 zaug ib hnub. Nyob rau tib lub sijhawm, qhov loj ntawm ib qho kev pabcuam yuav tsum tsis pub tshaj 200 g.
- tais yuav tsum tau npaj raws li hauv qab no: stewing, boiling, ci.
- Nws txwv tsis pub noj txias lossis kub dhau. Noj mov yuav tsum sov.
- Tus nqi ntsev yuav tsum txo qis.
- Nws yog ib qho tseem ceeb los saib xyuas kev haus dej haus cawv. Nws raug pom zoo kom haus 1.5-2 litres ntawm cov dej ntshiab uas tsis yog carbonated ib hnub.
- Cov ntsiab lus calorie ntawm cov khoom noj txhua hnub yuav tsum muaj txog 2800 kcal.
Pub khoom noj thiab dej haus:
- Weak dub tshuaj yej nrog txiv qaub.
- Compotes.
- Decoction based on wild rose.
- Kisely.
- Mousses, jelly nrog cov ntsiab lus qab zib tsawg.
- Nyob zoo ib tsoom niam txiv kwv tij neej tsas sawv daws los koom kev lom zem nrog rau cov phooj ywg sawv daws. Cov nqaij yuav tsum tau siav nyias thiab ntxiv rau lub tais tiav.
- Boscht.
- Mashed cereals.
- Pilaf.
- Oatmeal.
- Muasli.
- Bulgur.
- Lav qaib.
- Vaj.
- qaib.
- Turkey.
- Nyob.
- Mis sausages.
- ntses tsis rog.
- Oysters.
- Nqaj.
- Mussels.
- Squid.
- Bread (rye or bran).
- Cookies.
- Bread.
- Qub biscuit.
- Low-fat qaub cream.
- Natural yogurt.
- zaub qhwv.
- Seaweed.
- Avocado.
- Cucumbers.
- txiv lws suav (limited).
- Nyob zoo ib tsoom niam txiv kwv tij neej tsas sawv daws.
- txiv apples.
- Banaas (tsis pub tshaj 1 zaug ib hnub).
- Garnet.
- -watermelon.
- Prunes.
- Eggs.
- txiv roj roj.
- Nyob zoo Zucchini caviar.
- Sauerkraut.
- Berry.
- Marmalade.
x
Celery
Nws yog ib qho tseem ceeb kom tshem tawm ntawm kev noj haus:
- Cocoa.
- Coffee.
- dej qab zib.
- Cawv (nws tsis tsim nyog siv nws txawm tsis tshua muaj thiab tsawg kawg nkaus).
- Green tea.
- Whey.
- Chocolate.
- Karkade.
- Chicory.
- Packaged thiab freshly squeezed kua txiv.
- Okroshka.
- Lentils.
- Offal.
- Pob rog.
- Sushi, yob.
- khoom noj kaus poom.
- Nqaij thiab ntses rog.
- Red caviar.
- Crab sticks.
- khoom los ntawm cov khoom qab zib thiab puff pastry.
- Pancakes.
- khob cij tshiab.
- fried ncuav.
- S alted cheeses.
- Cov khoom noj mis nyuj uas muaj roj ntau.
- Mushrooms.
- pob kws.
- Spinach.
- Sorrel.
- dos ntsuab.
- Txiv lws suav.
- Raw white cabbage.
- Nuts.
- noob.
- Lemon.
- Ginger.
- Salo.
- Olives.
- Olives.
- Artichokes.
- Ketchup.
- Fuck.
- Mustard.
- Vinegar.
- Pepper.
- Ajika.
- Spices.
- Icecream.
- Halva.
- khoom pos.
- Popcorn.
- YCondensed milk.
- YHematogen.
- Kozinaki.
Mayonnaise
Thawj 5 hnub ntawm kev noj zaub mov yog lub sijhawm sim. Yog tias lub cev ib txwm hloov mus rau kev noj zaub mov tshiab, nws yuav tsum tau khaws cia li 5 lub lis piam. Ntau tus kws kho mob pom zoo kom noj zaub mov kom txog thaum rov ua tiav.
kev kho neeg zoo
Txhawm rau ua kom koj zoo dua, koj tuaj yeem siv txoj hauv kev tsis yog ib txwm ua. Txawm li cas los xij, nws yog ib qho tseem ceeb kom nkag siab tias lawv txoj kev siv tsis tshem tawm qhov xav tau nrhiav kev pab kho mob tsim nyog.
Qhov zoo tshaj plaws yog cov zaub mov hauv qab no:
- Noj 25 g ntawm pre-crushed immortelle. Ncuav raw cov ntaub ntawv nrog 1 liter dej. Muab lub thawv rau hluav taws. Boil rau ib nrab ib teev. Txias, lim. Noj 100 ml ua ntej noj mov kom txog thaum cov tsos mob ploj tag.
- Noj 50 g ntawm immortelle paj, 20 g ntawm coriander, 20 g ntawm peppermint, 40 g ntawm peb-nplooj saib. Sib tov tag nrho cov khoom xyaw thiab sib tov kom huv si. Noj 2 tbsp. l. raw cov ntaub ntawv thiab ncuav 400 ml ntawm boiling dej. Muab lub thawv rau hluav taws. Boil rau 20 feeb. Tom qab ntawd qhwv lub thawv nrog phuam thiab cia nws brew rau 1 teev. Lim. Noj peb zaugib hnub ua ntej noj mov 100 ml.
- Noj 20 g ntawm pre-ground wormwood. Muab cov khoom nyoos tso rau hauv lub khob iav nrog lub peev xwm ntawm 0.5 litres. Ncuav wormwood nrog vodka yam tsis muaj additives. Tshem tawm mus rau qhov chaw tsaus. Cia nws brew rau ib lub lim tiam. Nyob rau tib lub sijhawm, lub raj mis nrog cov ntsiab lus yuav tsum tau shaken. Noj cov txiaj ntsig tincture ob zaug hauv ib hnub 20 feeb ua ntej noj mov, 20 tee.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias txhua yam nroj tsuag tshuaj yog qhov muaj peev xwm ua xua. Yog tias cov tsos mob tshwm sim tshwm sim, kev kho mob nrog cov txheej txheem tsis zoo yuav tsum raug txiav.
Huab cua
Cholestatic jaundice yog ib yam kab mob, qhov tshwm sim ntawm qhov ncaj qha nyob ntawm kev mus ntsib kws kho mob raws sijhawm. Yog tias tus neeg mob ua raws li tag nrho cov lus qhia ntawm tus kws kho mob tshwj xeeb thiab nruj me ntsis raws li kev noj zaub mov, qhov kev ntsuas pom tau zoo. Ib qho kev zam yog cov xwm txheej thaum tus neeg raug coj mus rau qhov chaw kho mob hauv qhov mob hnyav. Qhov kev kwv yees nyob rau hauv qhov xwm txheej no tuaj yeem ua tau zoo lossis tsis zoo.
Tsis quav ntsej cov cim ceeb toom ua rau muaj kev loj hlob ntawm ob qho tib si kab mob thiab cholestatic jaundice. Hauv qhov no, qhov tshwm sim ntawm qhov tshwm sim tuag yog qhov siab heev.
Nyob hauv kaw
Cholestatic jaundice yog ib qho mob, txoj kev loj hlob mechanism ntawm kev puas tsuaj rau daim siab hlwb - hepatocytes. Raws li txoj cai, qhov no tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev siv cov tshuaj mus ntev. Yog thawj cov cim ceeb toom tshwm sim, koj yuav tsum hu rau tus kws kho mob gastroenterologist lossis kws kho mob hepatologist.
