Cholecholithiasis yog lo lus rau kev muaj pob zeb hauv cov ducts. Raws li txoj cai, xws li kev cuam tshuam hauv lub gallbladder. Cov kav dej yog cov raj me me uas nqa cov kua tsib ntawm lub gallbladder mus rau cov hnyuv. Lub cev yog ib tug pear-puab tsim nyob rau hauv lub siab, nyob rau hauv lub sab xis ces kaum ntawm lub plab kab noj hniav. Feem ntau, pob zeb tseem nyob hauv lub zais zis lossis dhau los ntawm cov kab mob sib kis.
Txawm li cas los xij, raws li cov txiaj ntsig ntawm kev tshawb fawb txheeb cais, nws tau pom tias kwv yees li 15% ntawm cov neeg mob gallstones kuj muaj pob zeb hauv cov ducts.
Symptoms
Choledocholithiasis yog ib yam kab mob sluggish uas yuav tsis qhia nws tus kheej rau ntau lub hlis thiab ntau xyoo. Txawm li cas los xij, nyob rau hauv rooj plaub uas lub pob zeb tau daig hauv cov kav dej thiab dhau los ua kev cuam tshuam, cov cim hauv qab no ntawm kev ua txhaum cai tshwm sim:
- mob hauv plab kab noj hniav, thaj chaw nyob rau saum tojsab xis los yog nruab nrab;
- nce lub cev kub;
- jaundice (daj ntawm daim tawv nqaij thiab ob lub qhov muag);
- poob qab los;
- xeev siab thiab ntuav;
- av nplaum xim lub rooj zaum.
Ib pob zeb nyob rau hauv lub gallbladder duct tuaj yeem ua rau ob qho tib si tsis xwm yeem thiab mob tas li. Qee lub sij hawm, qhov mob zoo li ntsiag to, thiaj li yuav nce siab tom qab ib ntus. Cov mob mob hnyav tuaj yeem ua rau qhov xav tau kev kho mob sai. Qhov tshwm sim loj tshaj plaws ntawm qhov teeb meem feem ntau tsis meej pem nrog cov cim qhia ntawm cov kab mob plawv, xws li lub plawv nres.
Kev nyuaj siab
Ib pob zeb nyob rau hauv cov kua tsib (cov tsos mob uas tus neeg mob tsis quav ntsej rau lub sijhawm ntev) tuaj yeem ua rau muaj kab mob hauv lub plab. Cov kab mob uas kis tau sai heev hauv thaj tsam ntawm qhov txhab yuav txav mus rau hauv daim siab. Cov txiaj ntsig ntawm kev kis tus kab mob no ua rau muaj kev hem thawj rau tib neeg lub neej. Ntxiv nrog rau kev puas tsuaj ntawm cov kab mob, cov teeb meem xws li cholangiolytic cirrhosis lossis pancreatitis tuaj yeem tshwm sim.
Yog vim li cas
Ob hom pob zeb paub: cholesterol thiab pigment.
Cov roj (cholesterol) tsim muaj xim daj thiab muaj ntau tshaj plaws. Cov kws tshawb fawb ntseeg tias pob zeb ntawm hom no maj mam tsim los ntawm cov kua tsib, uas muaj:
- Cov cholesterol ntau dhau;
- ntau tshaj bilirubin;
- tsis txaus kua tsib ntsev.
Cov roj (cholesterol) tso tawm kuj tshwm sim nyob rau hauv rooj plaub ntawmua tsis tiav los yog tsawg dhau ntawm lub gallbladder.
Nws tseem tsis tau paub meej tias yog vim li cas pob zeb pigment tsim nyob rau hauv cov kua tsib. Raws li kws kho mob, lawv pom nyob rau hauv cov neeg mob uas muaj kev txom nyem los ntawm:
- cirrhosis ntawm daim siab;
- kab mob sib kis ntawm kab mob biliary;
- kab mob ntshav qab zib uas ua rau ntau dhau ntawm bilirubin los ntawm lub siab.
Risk factors
Cov pab pawg pheej hmoo feem ntau suav nrog cov neeg muaj keeb kwm ntawm kab mob gallstone thiab lwm yam kab mob cuam tshuam nrog kev ua haujlwm ntawm cov kua tsib lub cev thiab nws txoj hauv kev cuam tshuam. Tsis tas li ntawd, nws tsis yog qhov tsis yooj yim rau cov neeg mob no los tsim cov pob zeb hauv cov kua tsib tom qab lub zais zis. Lub gallstone qee zaum txaus ua rau tsis xis nyob thiab mob hnyav.
Cov yam hauv qab no ua rau muaj kev pheej hmoo ntawm kev tso cov roj cholesterol thiab cov xim pigment hauv cov excretory tract:
- obesity;
- - High-calorie, cov rog siab, muaj roj fiber ntau;
- xeeb tub;
- long post;
- poob phaus sai;
- tsis muaj kev tawm dag zog lub cev.
Qee yam ntawm cov xwm txheej no yooj yim los kho nrog kev hloov pauv ntawm kev ua neej zoo.
Cov xwm txheej uas hloov tsis tau suav nrog:
- hnub nyoog: pob zeb muaj ntau dua rau cov neeg laus;
- poj niam txiv neej: poj niam raug tus kab mob no ntau dua;
- haiv neeg: Neeg Esxias, Mev thiab Asmeskas Khab feem ntau yuav kuaj tau tus mob choledocholithiasis dua li lwm haiv neeg;
- tsev neeg keeb kwm: raws li qee cov kws tshawb fawb, cov yam ntxwv ntawm caj ces yuav ua lub luag haujlwm tseem ceeb hauv kev txhim kho cov kab mob choledocholithiasis.
Diagnosis
Yog tias muaj cov tsos mob tsim nyog, tus kws kho mob yuav tsum tau kuaj xyuas seb puas muaj pob zeb nyob hauv cov kav dej ntau. Rau kev kuaj mob, ib qho ntawm cov kev tshawb fawb hauv qab no tau ua:
- transabdominal ultrasound - tus txheej txheem uas siv lub suab nrov nthwv dej los tshuaj xyuas cov mob ntawm daim siab, gallbladder, spleen, ob lub raum thiab pancreas;
- abdominal xam tomography (cross X-ray);
- endoscopic ultrasound (ib qho kev sojntsuam ultrasound yog muab tso rau hauv ib lub raj uas hloov pauv tau thiab dhau los ntawm lub qhov ncauj mus rau hauv txoj hnyuv);
- endoscopic retrograde cholangiography - txheej txheem uas tso cai rau koj mus rau thaj chaw tsis yog pob zeb hauv cov ducts, tab sis kuj tseem muaj lwm yam tshwm sim (cov qog nqaij hlav, thaj chaw ntawm qhov nqaim);
- magnetic resonance cholangiopancreatography - MRI ntawm lub gallbladder thiab pancreatic duct;
- percutaneous transhepatic cholangiogram - X-ray ntawm cov kua tsib.
Koj tus kws kho mob kuj tuaj yeem xaj ib lossis ntau qhov kev kuaj ntshav kom paub tseeb tias koj muaj lossis tsis muaj tus kabmob thiab kuaj tib lub sijhawmstability ntawm kev ua haujlwm ntawm daim siab thiab pancreas. Cov kev xeem uas tau sau ntau tshaj plaws yog:
- suav ntshav tag;
- bilirubin test;
- tshuaj ntsuam ntawm pancreatic enzymes;
- ntsuas lub siab.
Kev kho mob
Pob zeb los ntawm cov kua tsib yuav tsum tau muab tshem tawm kom ntseeg tau tias ib txwm muaj patency thiab qhov mob ploj mus. Cov kws kho mob tuaj yeem pom zoo ib qho ntawm cov txheej txheem hauv qab no los daws qhov teeb meem:
- rho tawm pob zeb;
- rhuav tshem cov roj cholesterol thiab cov xim xim rau hauv cov khoom tawg (lithotripsy, crushing);
- phais kom tshem tawm lub gallbladder thiab cuam tshuam cov ducts (cholecystectomy);
- kev phais mob uas txiav cov kab mob sib kis kom tshem tawm lossis ua kom yooj yim rau cov pob zeb (sphincterotomy);
- biliary stenting.
txheej txheem
Endoscopic biliary sphincterotomy tseem yog kev kho mob tshaj plaws rau choledocholithiasis. Thaum lub sij hawm txoj kev no, ib tug tshwj xeeb ntaus ntawv nyob rau hauv daim ntawv ntawm ib tug balloon los yog pob tawb yog muab tso rau hauv lub clogged bile duct. Nrog nws cov kev pab, qhov kev thaiv ntawm txoj kev raug tshem tawm. Txoj kev no tau raug pov thawj zoo hauv 85% ntawm cov neeg mob.
Yog tias lub pob zeb tsis dhau ntawm nws tus kheej thiab tus kws kho mob xav tias qhov endoscopic biliary sphincterotomy yuav tsis txaus, lithotripsy tau sau tseg. Nyob rau hauv cov txheej txheem no, pob zeb yog crushed rau hauv me me fragments kom lawv yooj yim tshem tawm los yogsolo taug kev.
Ib pob zeb nyob rau hauv cov duct ntawm lub gallbladder tej zaum yuav nyob ib sab mus rau ib tug zoo sib xws tsim nyob rau hauv lub cev nws tus kheej. Hauv cov xwm txheej zoo li no, txoj kev kho mob zoo tshaj plaws yog kev tshem tawm ntawm lub gallbladder. Thaum lub sijhawm phais, tus kws kho mob yuav tshuaj xyuas cov hlab ntsha kom paub tseeb tias nws zoo li qub.
Yog pob zeb tsis tuaj yeem tshem tawm tag nrho los ntawm kev phais rau ib qho laj thawj (lossis yog tias koj muaj mob ntev los ntawm pob zeb hauv cov ducts tab sis tsis xav tshem koj lub gallbladder), koj tus kws kho mob yuav pom zoo kom ua rau biliary stenting. Cov txheej txheem muaj xws li ntxig cov hlab me me uas nthuav dav txoj hauv kev thiab yog li tshem tawm cov kev cuam tshuam thiab pob zeb hauv cov kua tsib. Kev ua haujlwm tsis zoo thiab muab kev tiv thaiv zoo ntawm cov neeg mob choledocholithiasis yav tom ntej. Tsis tas li ntawd, stents kuj tuaj yeem tiv thaiv kab mob sib kis.
Kev Tiv Thaiv
Yog tias koj twb tau ntsib qhov mob uas cuam tshuam nrog choledocholithiasis ib zaug, feem ntau qhov mob yuav tshwm sim - thiab ntau dua ib zaug. Txawm tias kev tshem tawm ntawm lub gallbladder tsis yog qhov kev kho mob zoo tshaj plaws: cov pob zeb hauv cov kav dej yuav tsum tau muab tshem tawm lub hom phiaj, txwv tsis pub cov kev pheej hmoo ntawm cov tsos mob ntawm cov kab mob tseem nyob.
Txawm li cas los xij, hauv ntau qhov xwm txheej choledocholithiasis tuaj yeem tiv thaiv tau. Txhua yam koj yuav tau ua yog hloov me me rau koj txoj kev ua neej. Qhov kev pheej hmoo ntawm tus kab mob no txo qis los ntawm kev tawm dag zog me ntsis thiab kev hloov pauv me ntsis hauv kev noj haus. Cov kws kho mob qhia kom taug kev ntau npaum li sai tau thiab xyuas kom koj cov zaub mov muaj cov nroj tsuag fiber ntau. Kev noj cov roj saturated yuav tsum txo.
Kev kwv yees ntev
Hauv xyoo 2008, ntau lub tsev kho mob paub zoo hauv Canada thiab Tebchaws Meskas tau ua txoj kev tshawb fawb raws li kwv yees li 14% ntawm cov neeg mob tau ntsib cov tsos mob ntawm cov pob zeb hauv cov kua tsib dua li ntawm kaum tsib xyoos tom qab thawj qhov tshwm sim ntawm qhov mob raug mob. syndrome thiab kev kho mob. Pom tseeb, kev tshem tawm cov pob zeb los ntawm cov kua tsib tsis yog ib txwm ua nrog kev saib xyuas txaus, vim tias muaj laj thawj ntseeg tias tus kab mob rov tshwm sim yog cuam tshuam nrog kev nce hauv cov roj cholesterol seem hauv qhov loj.
kev kho neeg zoo
Lwm cov tshuaj tsis suav hais tias muaj txiaj ntsig zoo hauv kev tawm tsam choledocholithiasis, txawm li cas los xij, raws li qee tus kws tshaj lij, cov tshuaj yooj yim uas tau npaj hauv tsev tuaj yeem ua rau kom cov kua tsib los yog tiv thaiv kev tsim tawm ntau dhau thiab khaws cov roj cholesterol.
Koj puas tau mob thiab xav tias nws yog los ntawm pob zeb hauv cov kua tsib? Yuav ua li cas yog koj tsis tuaj yeem mus ntsib kws kho mob? Sim ib txoj hauv kev hauv qab no.
Natural npaj
- Ncuav ib tablespoon ntawm txiv apple cider vinegar rau hauv ib khob kua txiv apple thiab do. Haus txhua zaus koj hnov mob hauv lub gallbladder thiab ducts. txhais tau tiasmuaj cov nyhuv analgesic tom qab 5-15 feeb.
- Ntxiv plaub tablespoons txiv qaub kua txiv rau ib khob dej. Haus qhov sib tov ntawm lub plab khoob txhua txhua sawv ntxov. Txoj kev kho txuas ntxiv mus rau ob peb lub lis piam - txog thaum lub pob zeb tshem tawm tag nrho ntawm lub cev.
- Boil ib khob dej, ntxiv ib teaspoon ntawm crushed qhuav peppermint nplooj, tshem tawm ntawm tshav kub, npog thiab ntxhab rau tsib feeb. Lim thiab ntxiv ib teaspoon ntawm zib mu. Haus mint tshuaj yej sov, ob zaug ib hnub rau 4-6 lub lis piam, nyiam dua ntawm pluas noj.
- Npaj cov zaub sib tov. Ua li no, nyem kua txiv los ntawm ib tug beetroot, ib dib thiab plaub medium-qhov loj qhov me carrots. Sib tov thiab haus ob zaug ib hnub. Ua raws li cov lus qhia no tau ob lub lis piam thiab koj yuav pom sai npaum li cas koj tus mob rov zoo li qub.
tshuaj ntsuab
- Muab ib teaspoon ntawm qhuav dandelion cag hmoov rau hauv ib khob. Ncuav dej kub tshaj, npog thiab cia zaum rau tsib feeb. Lim, ntxiv ib co zib mu los txhim kho saj. Haus cov tshuaj yej dandelion ob mus rau peb zaug hauv ib hnub rau 1-2 lub lis piam kom yaj cov pob zeb tom qab tshem lub gallbladder.
- Kho tshuaj yej tuaj yeem tsim los ntawm lwm cov nroj tsuag muaj txiaj ntsig. Ntxiv ob teaspoons ntawm marshmallow cag thiab ib teaspoon ntawm holly mahonia rau plaub khob dej. Boil qhov sib tov rau 15 feeb, ces tshem tawm los ntawm tshav kub. Ntxiv ob teaspoons ntawm qhuav dandelion nplooj thiab ib teaspoon ntawm qhuavpeppermint nplooj, ces infuse cov tshuaj yej rau 15 feeb. Lim thiab haus txhua hnub.
Kuj, cov nplooj ntsuab nplooj ntsuab tuaj yeem noj ncaj qha, xws li steamed lossis ntxiv tshiab rau zaub zaub xam lav.
Dandelion yog contraindicated rau cov neeg mob ntshav qab zib.
