Cov kab mob duct yog suav tias yog kev cuam tshuam thiab thaiv cov kab uas ua los ntawm daim siab mus rau lub gallbladder, thiab tom qab ntawd mus rau cov hnyuv. Qhov no yog ib yam ntawm cov neeg kho tshuab kev cuam tshuam uas tshwm sim vim yog lub pob zeb los yog los ntawm kev sib txuas sab nraud ntawm cov ducts. Pathology yog tus yam ntxwv los ntawm nws qhov ua rau, cov tsos mob thiab qhov tshwm sim, uas koj yuav tsum paub txog txhawm rau txheeb xyuas tus kab mob kom raug thiab ua tiav kev kho mob tag nrho.
Ua rau kev thaiv
Cia peb mus saib cov lus piav qhia ntawm qhov txhaws ntawm cov kua tsib.
kua tsib yog tsim nyob rau hauv daim siab, khaws cia rau hauv lub gallbladder, thiab ces siv nyob rau hauv cov hnyuv. Tom qab noj mov, ib feem me me ntawm cov kua tsib nkag ncaj qha rau hauv cov hnyuv los ntawm duodenum, qhov twg nws zom cov rog, tshwj xeeb tshaj yog tsiaj keeb kwm, thiab cov vitamins. Cov kua tsib feem ntau tseem nyob hauv lub gallbladder.
Nyob hauv tshuajib nrab los yog tag nrho obstruction ntawm lub biliary ib ntsuj av tau faib. Cov hauv qab no tej zaum yuav muaj feem cuam tshuam rau kev txhaws ntawm cov kab mob hauv lub cev:
- Cysts, pob zeb nyob rau hauv cov ducts uas tau daig nyob rau hauv lawv tag nrho los yog ib feem clog lub lumen.
- Nplaim nrog nruj hauv cov ducts.
- Ntau yam kab mob kab mob.
Kev cuam tshuam ntawm cov kab mob tuaj yeem ua rau muaj kab mob xws li cholangitis thiab cholecystitis nrog rau mob pancreatitis, mob qog nqaij hlav, kab mob ntawm daim siab thiab txoj hnyuv, kev ua haujlwm tsis ntev los no ntawm cov kabmob no thiab raug mob rau sab xis ntawm lub plab kab noj hniav. Kev hloov pauv hauv lub cev hnyav nrog rau kev rog lossis poob phaus sai heev tuaj yeem ua rau muaj qhov thaiv.
Dab tsi yog cov cim qhia ntawm kev txhaws ntawm cov ducts, xav txog hauv qab no.
Clogging pathogenesis
Bile, thaum hla cov ducts thaiv, tsis tuaj yeem txav ntawm qhov nrawm. Vim li no, nws accumulates nyob rau hauv qhov chaw uas muaj ib tug obstacles, thaum stretching phab ntsa ntawm lub elastic raj. Feem ntau, qhov mob sai sai tshwm sim hauv thaj chaw no, vim tias cov mucous membrane thickens zoo heev, uas ua rau muaj qhov txo qis hauv txoj kab uas hla ntawm cov ducts.
Tom qab ntawd cov kua tsib rov qab nqus thiab tso cov kua dej tawm. Cov kua no hu ua cov kua tsib dawb. Qhov tshwm sim no qhia tau tias muaj kev puas tsuaj loj rau daim siab cov ntaub so ntswg, vim yog qhov ua tsis tiav ntawm lub luag haujlwm ntawm lub cev nrog rau kev cuam tshuam ntawm carbohydrate thiab rog metabolism thiab pathological. Kev hloov pauv hauv lub cev, piv txwv li, hauv lub raum thiab lub siab.
Ua rau thiab cov tsos mob ntawm cov kab mob hauv cov hlab ntsha yog sib cuam tshuam.
Ncaj nraim rau hauv daim siab nws tus kheej, yog tias muaj kev cuam tshuam hauv nws, cov kua tsib ntau ntxiv cuam tshuam rau nws cov hlwb hauv txoj hauv kev muaj tshuaj lom, tawm tsam cov kua tsib acids thiab bilirubin ua rau lawv puas tsuaj. Lub sij hawm ntev stasis ua rau cov kab mob loj heev ntawm lub cev, mus txog rau kev loj hlob ntawm daim siab tsis ua haujlwm. Tsis tas li ntawd, cov kua tsib muaj peev xwm nkag mus rau hauv cov hlab ntsha, ua rau qaug cawv nrog rau cov hlab ntsha thiab lub cev puas tsuaj.
Symptomatics
Symptomatology ntawm blockage ntawm cov kua tsib ducts suav nrog ntau yam khoom. Piv txwv li, cov kev tshwm sim hauv qab no yuav raug pom:
- Tshuaj tawv nqaij khaus thiab pob khaus.
- Staining daim tawv nqaij thiab sclera daj.
- Ntawm qhov iab hauv qhov ncauj, thiab ntxiv rau, txheej ntawm tus nplaig.
- ua pa tsis zoo.
- Qhov tshwm sim ntawm qhov mob hauv txoj cai hypochondrium.
- Zoo mob taub hau.
- plab o thiab lub plawv dhia qeeb.
- Txhim kho cov txheej txheem ntawm cov ntshav txhaws.
- Ib lub teeb-xim thiab qias neeg heev.
- tso zis tsaus nti nrog bilirubin.
Yuav ua li cas rau theem siab?
Nyob rau hauv cov neeg mob siab heev, cov neeg mob yuav hnov mob nrog rau hws, thiab ntxiv rau, kev txawj ntse tsis zoo. Txij li cov tsos mob no tuaj yeem tshwm sim lwm yam kab mob ntawm lub plab zom movsystem, kev kuaj mob tsuas yog tsim tom qab cov txheej txheem kuaj mob tshwj xeeb tau ua tiav.
Kev kuaj kab mob
txhawm rau kuaj xyuas qhov txhaws ntawm lub gallbladder duct, cov neeg mob kuaj ntshav biochemical thiab, raws li cov txiaj ntsig, tsis suav nrog cholangitis nrog cholecystitis, tsim kom muaj tag nrho cov bilirubin, daim siab enzymes, thiab alkaline phosphatase. Ntawm cov txheej txheem kev tshawb fawb kho vajtse, ultrasound tau sau tseg, uas ua rau nws muaj peev xwm txiav txim siab seb puas muaj pob zeb thiab pneumobilia nyob rau hauv cov ducts, uas yog, muaj huab cua nyob rau hauv lawv, uas tuaj yeem tshwm sim raws li qhov teeb meem ntawm kab mob siab thiab biliary pathologies.
Kev kuaj mob endoscopic lossis laparoscopic
Cov tswv yim no tsim kom muaj cov hlwv lossis pob zeb hauv cov ducts. Cov kev tshawb fawb no tau sau tseg yog tias cov tsos mob ntawm tus kab mob me me thiab muaj kev xav tias pathology tseem nyob hauv nws daim ntawv me. Cov cuab yeej kuaj mob kuj suav nrog kev noj cov ntaub so ntswg yog tias xav tias mob qog noj ntshav.
Sib nqus resonance thiab suav tomography tso cai rau koj pom cov duab ntxaws ntxaws ntawm cov ducts ntawm daim siab thiab txiav txiav. Yog tias qhov kev kuaj mob ntawm "kev thaiv ntawm cov kua tsib ducts" tau lees paub, ces kev kho mob raug muab tshuaj raws li cov txiaj ntsig ntawm kev tshawb fawb.
Kev kho mob ntawm pathology
Kev kho mob ntawm cov kab mob ntawm cov ducts aims kom tag nrho los yog tsawg kawg ib nrab txo lawv ntawmthaiv. Ib qho ntawm cov kev xaiv uas twb muaj lawm rau kev tshem cov pob zeb los ntawm cov ducts yog siv lub endoscope ua ib feem ntawm endoscopic cholangiopancreatography lossis papillosphincterotomy. Cov kev ua haujlwm zoo li no tau muab rau cov neeg mob thaum qhov kev nqaim ntawm cov ducts ntawm cov kua tsib tsis tseem ceeb lossis lawv tau txhaws nrog pob zeb me me.
Tsis tas li ntawd, patency ntawm cov channel tau rov qab los nrog kev pab los ntawm stent, uas yog lub raj hollow uas tau nruab rau hauv cov ducts txhaws. Nws pab nthuav cov duct thaum nws nqaim yog tshwm sim los ntawm cov qog tsim. Tom qab qee lub sijhawm, yuav tsum tau ua haujlwm thib ob los hloov lub stent.
Nyob rau hauv cov xwm txheej uas cov kab mob ntawm cov kua tsib provoked los ntawm cov pob zeb nyob rau hauv lub gallbladder, ces nws raug tshem tawm, qhov no yog hu ua cholecystectomy. Ductal sphincterotomy yog siv thaum lub pob zeb muaj nyob rau hauv cov kua tsib thiab ducts tib lub sijhawm.
Tsis tas li ntawd, lawv siv rau kev kho mob thiab tshuaj ib txwm siv. Txhawm rau kom ruaj khov ntawm cov kua tsib, cov neeg mob tau qhia kom noj:
- Ib khob kua txiv apple nrog ib diav ntawm vinegar.
- Ib khob dej nrog plaub tablespoons txiv qaub kua txiv.
- Decoction ntawm mint dog dig.
- Kua txiv ua los ntawm ib lub dib thiab beets thiab plaub carrots.
Txhua yam tshuaj no yuav tsum tau noj txhua hnub tsawg kawg ob lub lis piam kom tau txais txiaj ntsig. Tab sis nws yuav tsum tau borne nyob rau hauv lub siab hais tias lwm txoj kev kho mob ntawm blockageCov ducts tsis tuaj yeem hloov pauv rau ib txwm muaj, tab sis tsuas yog ntxiv rau nws.
prophylaxis
Txhawm rau tiv thaiv kev txhaws, cov kab mob ntawm cov kab mob biliary thiab daim siab yuav tsum tau tiv thaiv. Ua ntej tshaj plaws, kev tiv thaiv kab mob gallstone yog yuav tsum tau. Rau cov hom phiaj no, koj yuav tsum ua cov hauv qab no:
- Siv tsuas yog noj zaub mov zoo xwb.
- Ua neej nyob noj qab nyob zoo. Xws li kev ntsuas yuav tiv thaiv ntau yam kab mob sib txawv uas ua rau pom cov teeb meem hauv txoj hauv kev ntawm cov kua tsib. Cov teeb meem no feem ntau yog qog nqaij hlav nrog rau nti, adhesions, nqaim thiab lwm yam.
Txhawm rau tiv thaiv koj tus kheej los ntawm qhov tshwm sim ntawm cov kab mob ntawm lub plab zom mov, uas tuaj yeem ua rau muaj kev cuam tshuam ntawm cov ducts, kev noj zaub mov yuav tsum tsis txhob ua dhau sijhawm, tab sis thoob plaws lub neej. Muaj cov canons tseem ceeb tshaj plaws:
- Nws yuav tsum noj raws sijhawm, tsis hais pluas tshais, noj hmo lossis noj su. Nws yog ib qho tseem ceeb heev los soj ntsuam cov proportions ntawm cov khoom noj. Ib tug yuav tsum tsis txhob noj zaub mov ntau thaum yav tsaus ntuj.
- Nws yog qhov yuav tsum muaj cov khoom noj kub, xws li kua zaub, hauv kev noj haus txhua hnub.
- Nws yog ib qho tseem ceeb kom tsis txhob noj zaub mov tsis zoo hauv daim ntawv kub dev, kib txoj kev pies, french fries, branded sodas.
- Nws yog ib qho tseem ceeb kom tshem tawm ntawm koj cov zaub mov noj uas ua rau muaj kev phom sij rau cov kab mob biliary. Qhov no feem ntau yog cov khoom noj muaj roj hauv cov nqaij, qaub cream, borscht thiab kib zaub mov. Nws yog txwv tsis pubtau nqa mus thiab ntsim zaub mov nrog ntau cov kua txob dub thiab liab kub thiab lwm yam seasonings. Cov khoom noj khoom haus, uas ua rau kom muaj kev zais ntawm digestive enzymes thiab cov kua tsib, kuj yuav tsum tau zam, yog li cov nplua nuj broths yuav tsum tsis txhob noj.
Yog tias muaj kab mob ntawm cov kab mob biliary thiab daim siab tshwm sim, lawv yuav tsum tau kuaj xyuas thiab kho kom raws sijhawm, vim tsis ntev los sis tom qab lawv tuaj yeem ua rau txhaws ntawm cov kua tsib.
kab mob prognosis
Kev soj ntsuam rau cov tsos mob ntawm cov kab mob hauv cov hlab ntsha feem ntau yog qhov zoo, yog tias tus neeg mob raug kuaj thiab kho raws sijhawm. Qhov kev kwv yees yuav nyuaj rau qee qhov xwm txheej hauv qab no:
- Tawm tsam keeb kwm ntawm kev mob qog noj ntshav ntawm cov kab mob sib kis. Qhov kev kuaj mob no ua rau cov kab mob tsis zoo thiab ua rau kev kho mob nyuaj.
- Kev nkag mus ntawm kev kis kab mob thiab tshwm sim ntawm cov txheej txheem purulent hauv cov ducts thiab gallbladder.
- Tawm tsam keeb kwm yav dhau los ntawm kev kho mob nrawm nrawm hauv qhov mob hnyav ntawm tus neeg mob yog tias kev kho mob tsis tau ua tiav.
- Nyob rau hauv kev kho tus kheej hauv tsev nrog kev koom tes ntawm pej xeem txoj kev.
Muaj Teeb Meem
Cov teeb meem ntawm cov kab mob ntawm cov kua tsib los ntawm lub pob zeb feem ntau tshwm sim yog tias tsis ua raws li kev kho mob raws sij hawm ntawm tus neeg mob. Kev thaiv feem ntau ua rau muaj teeb meem hauv qab no:
- Qhov tshwm sim ntawm sepsis, tawm tsam tag nrho lub cevkis kab mob.
- Cov tsos mob ntawm bilirubin encephalopathy. Tib lub sijhawm, bilirubin cuam tshuam rau cov ntaub so ntswg hlwb hauv cov neeg mob, vim tias cov khoom no hauv lub cev tau nce ntau.
- Zoo ua rau daim siab mob cirrhosis.
- Kev txhim kho lub siab tsis ua haujlwm. Qhov no tshwm sim tawm tsam keeb kwm yav dhau los ntawm kev thaiv tag nrho ntawm cov ducts.
- Qhov tshwm sim ntawm daim siab tsis ua haujlwm. Qhov no tshwm sim tawm tsam keeb kwm yav dhau los ntawm ib feem ntawm cov ducts.
Cov ntaub ntawv kawg
Yog li, qhov txhaws ntawm cov ducts yog qhov tsis zoo lossis ua tiav ntawm lawv cov patency tiv thaiv keeb kwm yav dhau los ntawm kev cuam tshuam rau cov kua tsib los ntawm lub siab mus rau lub gallbladder. Tus kab mob no suav hais tias yog qhov tsis txaus siab heev, thiab nyob rau hauv cov xwm txheej nyuaj nws kuj ua rau muaj kev phom sij ntawm ntau yam teeb meem, tawm tsam txhua yam kab mob ntawm lub plab zom mov tuaj yeem tshwm sim. Muab qhov hnyav ntawm cov kab mob no, tsis muaj qhov xwm txheej yuav tsum tsis quav ntsej nws, thiab yog tias qhov tsos mob me ntsis tshwm sim, koj yuav tsum hu rau koj tus kws kho mob.
Peb tau saib cov tsos mob thiab kev kho mob ntawm cov kab mob hauv lub cev.
