Kev kuaj mob ntawm "cholelithiasis" (GSD) yog ua rau tus neeg mob thaum kuaj pom muaj pob zeb hauv lub gallbladder. Tus naj npawb, muaj pes tsawg leeg thiab qhov loj me, lawv qhov chaw nyob yuav txawv. Raws li kev txheeb cais, nyob rau hauv cov teb chaws tsim kho, 20% ntawm cov poj niam cov pej xeem thiab 10% ntawm cov txiv neej cov pej xeem raug kev txom nyem los ntawm tus kab mob no. Nws yog ib qho tsim nyog yuav tsum paub txog cov tsos mob ntawm cholelithiasis thiab qhia meej qhov kev kuaj mob sai li sai tau kom tus neeg mob tuaj yeem ua raws li qee qhov kev cai noj zaub mov thiab tiv thaiv exacerbations. Nrog rau kev txhim kho tsis zoo ntawm tus kab mob, kev phais yog ua kom tshem tawm lub gallbladder nrog rau pob zeb.
Kev piav qhia tus kab mob thiab nws hom
GSD kab mob tshwm sim vim muaj kev cuam tshuam hauv kev tsim thiab kev ncig ntawm cov kua tsib hauv lub cev, ua txhaum ntawm cov metabolism ntawm cov roj cholesterol thiab bilirubin, ua rau tsim pob zeb.
Zoo nyob ntawm qhov chaw ntawm pob zeb, muaj 2 hom kab mob:
- Cholecystolithiasis, lossis kab mob gallstone.
- Cholecholithiasis - pob zeb hauv cov ducts.
Lub pob zeb yog los ntawm-rau sedimentation ntawm cov roj cholesterol, bile pigments, calcium ntsev, proteins, raws li zoo raws li kev kis kab mob thiab stagnation ntawm bile, lipid metabolism tsis zoo.
Cov tsos mob tseem ceeb ntawm cholelithiasis yog mob nyob rau hauv txoj cai hypochondrium, yellowing ntawm daim tawv nqaij (jaundice), biliary colic. Nrog rau kev txhim kho tsis zoo ntawm tus kab mob, cov teeb meem tshwm sim nyob rau hauv daim ntawv ntawm cholecystitis, peritonitis, fistulas yog tsim. Yog tias cov kev kho mob siv tsis muaj qhov xav tau, ces yuav tsum tau phais.
Cov yam tseem ceeb rau cholelithiasis hauv cov neeg mob:
- genetic predisposition los ntawm niam;
- kev noj zaub mov tsis zoo (kev tshaib plab, rog rog, roj cholesterol siab, thiab lwm yam);
- laus;
- noj cov tshuaj uas cuam tshuam rau cov metabolism hauv cov roj cholesterol lossis bilirubin (estrogen thaum cev xeeb tub, fibrates, ceftriaxone);
- ntau lub cev xeeb tub;
- kab mob cuam tshuam nrog cov kab mob metabolic (mob ntshav qab zib, metabolism, fermentopathy);
- kab mob plab hnyuv (GIT);
- xeev tom qab phais.
Ua rau tus kab mob gallstone
Cov khoom tsim tau tsim hauv tib neeg lub cev nrog kev ua txhaum ntawm cov nyiaj thiab cov khoom ntawm cov kua tsib, lawv maj mam sib koom ua ke thiab nce qhov loj, tsim cov pob zeb. Thawj cov tsos mob tsis zoo ntawm cholelithiasis tshwm sim, kev kho mob uas yuav tsum tau txheeb xyuas cov teeb meem hauv tus neeg mob lub cev thiab ua raws li tus kws kho mob cov lus pom zoo.
Qhov laj thawj tshaj plaws rau kev tsim cov pob zeb yog cov ntsiab lus siab ntawm cov cholesterol hauv cov kua tsib, uashu ua lithogenic.
Raws li cov kws tshawb fawb, muaj 3 qhov laj thawj tseem ceeb ntawm kev tsim pob zeb:
- Stagnation ntawm cov kua tsib vim muaj kev cuam tshuam rau cov txheej txheem ib txwm muaj ntawm nws cov dej ntws los yog thaum muaj kev ua haujlwm tsis zoo thiab kev tsis sib haum xeeb ntawm biliary (dyskinesia, thiab lwm yam);
- txheej txheem mob nyob rau hauv cov phab ntsa ntawm lub gallbladder vim yog kis kab mob, tsis haum tshuaj;
- Metabolic ntshawv siab, tsim kom muaj qhov tsis sib xws ntawm phospholipids, cholesterol thiab bile acids.
Xaiv lossis pob zeb tsim nyob rau hauv lub gallbladder tuaj yeem raug cais raws li lawv qhov muaj pes tsawg leeg:
- cov roj cholesterol, pom hauv 80% ntawm cov neeg mob vim yog cov ntsiab lus ntau dhau ntawm cov tshuaj no hauv lub cev, lawv muaj xim daj thiab kuj muaj qee qhov tsis huv;
- pigmented - muaj xim dub lossis xim av thiab tsim nrog ntau cov bilirubin hauv cov kua tsib;
- calcareous;
- mixed, i.e. muaj cov khoom ntawm bilirubin thiab cov cholesterol.
theem ntawm cholelithiasis: cov tsos mob thiab kev kho mob
Kev faib tawm niaj hnub ntawm tus kab mob no faib ua theem:
- pib (lub pob zeb ua ntej) - muaj kev hloov pauv hauv cov qauv ntawm cov kua tsib, uas tuaj yeem kuaj pom tsuas yog nrog nws cov tshuaj biochemical, tsis muaj cov tsos mob tshwm sim;
- tsim cov calculi (pob zeb) tshwm sim asymptomatically, latently, lawv tsuas pom tau nrog ultrasound kuaj;
- theem kho mob - tus yam ntxwv ntawm cov tsos mob ntawm tus mob hnyav lossis mob cholecystitis.
Qee tus kws tshaj lij kuj paub qhov txawv theem 4, uas tau tshwm sim los ntawm kev txhim kho cov teeb meem.
Kev kho mob tshwm sim ntawm tus kab mob gallstone
Cov tsos mob ntawm cholelithiasis nyob ntawm qhov loj thiab qhov chaw ntawm pob zeb, muaj cov txheej txheem inflammatory, ua raws li kev cai noj haus thiab lwm yam.
Cov cim tsis zoo hauv qab no tuaj yeem ua tau:
- iab hauv qhov ncauj tom qab noj zaub mov kib lossis rog;
- kos qhov mob ntawm sab xis, uas qee zaum tawg mus rau sab nraub qaum hauv thaj tsam ntawm scapula;
- flatulence, heartburn, qhia txog kev qaug zog;
Tus yam ntxwv thiab cov tsos mob ntawm tus mob cholelithiasis yog ib qho exacerbation nyob rau hauv daim ntawv ntawm biliary colic, uas yog tshwm sim los ntawm kev tawm tsam ntawm mob hnyav nyob rau hauv lub plab los yog nyob rau hauv txoj cai hypochondrium, uas yuav kav mus txog rau ob peb teev. Nyob rau tib lub sijhawm, tus neeg mob kuj tau ntuav ntuav, tom qab ntawd tsis muaj kev pab.
Cov laj thawj hauv qab no tuaj yeem ua rau mob plab biliary:
- noj zaub mov muaj roj, ntsim los yog kib, cawv;
- kev ntxhov siab, ua haujlwm dhau;
- ua haujlwm ntev ntev hauv txoj haujlwm inclined (thaum ntxhua khaub ncaws, thiab lwm yam);
- dhia, tsheb sib tsoo.
Zoo qaug dab peg yog vim li cas thiaj mus ntsib kws kho mob thiab kuaj ntxiv kom paub meej qhov kev kuaj mob.
Kev kuaj mob cholelithiasis
Txhawm rau kom paub meej qhov kev kuaj mob thaum cov tsos mob saum toj no ntawm tus kab mob gallstone tshwm sim, koj yuav tsum sab laj nrog kws kho mob gastroenterologist thiab kuaj cov hauv qab no:
- kuaj sab nraud, palpation ntawm phab ntsa plab thiabnpuas;
- kuaj ntshav rau qhov mob (nce leukocytes thiab ESR);
- ntshav biochemistry - yuav txiav txim siab qib roj cholesterol thiab bilirubin, kev ua haujlwm siab ntawm phosphatase;
- kuaj ultrasound hauv cheeb tsam plab, uas qhia pom muaj pob zeb, qhov xwm txheej ntawm phab ntsa ntawm lub gallbladder, cov cim qhia ntawm cholecystitis;
- MRI lossis CT ntawm lub plab hnyuv - kuj qhia txog qhov muaj tus mob cholelithiasis;
- kuaj ntshav thiab kuaj X-ray.
Muaj peev xwm exacerbations ntawm tus kab mob gallstone:
- mob cholecystitis - ib qho txheej txheem ntawm lub zais zis mucosa uas tshwm sim thaum lub duct raug thaiv los ntawm lub pob zeb - yog qhov txaus ntshai vim nws tuaj yeem hloov mus ua peritonitis;
- mob plab gallbladder;
- cholangitis - txuas cov txheej txheem inflammatory hauv cov ducts;
- choledocholithiasis - txav ntawm pob zeb mus rau hauv cov ducts;
- qhov khoob ntawm qhov khoob vim qhov caws pliav tom qab o;
- tshwm sim ntawm biliodigestive fistulas, qhov nruab nrab ntawm cov phab ntsa ntawm cov hlab ntsha thiab cov hnyuv;
- dropsy gallbladder thaum nws puv nrog mucus uas cuam tshuam rau cov kua tsib.
JSD nres: cov tsos mob, yuav ua li cas
Feem ntau, colic tshwm sim thaum yav tsaus ntuj lossis hmo ntuj, qhov mob zoo li txiav, stabbing, qee zaus nias lossis npub. Lawv tuaj yeem muab rau caj dab, xub pwg, qhov muag sab xis, hauv pliaj lossis lub puab tsaig. Qee lub sij hawm qhov mob tsiv mus rau hauv lub plawv, ua rau mob angina.
Cov tsos mob tseem ceeb ntawm biliary colic:
- mob ntev, tus neeg mob tig daj ntseg thiab qw nrov nrovmob, ua tau poob siab;
- xeev siab thiab ntuav nrog cov zaub mov seem thiab cov kua tsib;
- bloating, tawm hws ntau dhau;
- qee zaus, colic nrog rau qhov kub thiab txias hauv daim ntawv ntawm kev dhia ntse;
- nrog kev tawm tsam ntev, tawv nqaij daj (daj daj) tuaj yeem ua tau, uas feem ntau ploj hauv 3-4 hnub.
Yog vim li cas rau qhov mob hnyav no yog qhov mob hnyav ntawm cov leeg nqaij ntawm lub gallbladder, nrog rau nws cov ducts, uas tshwm sim los ntawm kev teb rau cov pob zeb hloov chaw thiab khaus ntawm phab ntsa. Nws tseem ua tau kom nws ncav cuag cov kua tsib ntau dhau.
pab xub thawj rau kev tawm tsam:
- puag saum txaj, ncab koj ob txhais ceg thiab so: yog tus neeg mob nyob ib leeg hauv chav tsev, thov hu rau cov phooj ywg lossis cov txheeb ze los pab;
- noj tshuaj antispasmodic los txo qhov mob thiab spasms ntawm lub gallbladder: "No-shpy", "Baralgina", Papaverine thiab lwm yam;
- nrog lub qhov ncauj qhuav yog qhov zoo dua haus dej ntshiab, tab sis tsis yog tshuaj yej lossis tshuaj ntsuab decoctions;
- tsis muaj dab tsi noj rau 12 teev, txawm tias tom qab kawg ntawm kev tawm tsam;
- nrog tus kab mob gallstone nws raug pom zoo kom muab cov cua sov tso rau hauv thaj tsam ntawm txoj cai hypochondrium;
- nrog rau qhov mob cholecystitis ntev, muab tso rau hauv qhov txias txias kom tsis txhob ua rau peritonitis.
Yog tsis tuaj yeem nres nws tus kheej hauv 20-30 feeb, tus neeg mob xav tau kev kho mob sai sai thiab mus pw hauv tsev kho mob.
YKev kho mob cholelithiasis
Yog tias tus neeg mob kuaj tau tus mob gallstonekab mob , tom qab ntawd tus kws kho mob pom zoo kom noj zaub mov thiab siv cov tshuaj expectant tactics. Yog tias muaj kev txhim kho tsis zoo ntawm tus kab mob, kev tawm tsam ntau zaus, kev phais raug pom zoo. Nrog cov tsos mob ntawm cholelithiasis, kev kho mob kuj tuaj yeem nqa tawm siv cov tswv yim tshem tawm pob zeb.:
- tawg ntawm pob zeb nyob rau hauv kev cuam tshuam ntawm kev npaj tshwj xeeb acid-muaj;
- Siv kev kho yoj yoj los tsoo pob zeb tsuas yog ua tau nrog ib qho kev tsim xwb, tab sis thaum tsis muaj qhov qhia tsis zoo.
Ob txoj kev no tsis ua rau muaj kev kho mob tiav, vim. kev tsim cov pob zeb tshiab tseem yuav txuas ntxiv mus.
Kev phais (lossis cholecystostomy) yog qhia rau tus neeg mob thaum muaj kev tawm tsam hnyav ntawm tus mob cholecystitis thiab ntau lub pob zeb. Thaum lub sijhawm ua haujlwm, lub gallbladder nws tus kheej raug tshem tawm nrog rau cov pob zeb. Nws tuaj yeem ua tau 2 txoj hauv kev:
- qhib kev phais hauv qab tshuaj loog;
- kev cuam tshuam laparoscopic, uas ua rau tus neeg mob lub cev zoo dua.
khoom noj kom raug rau tus kab mob gallstone
Nws yuav tsum tau ua nruj me ntsis txhawm rau txhawm rau tiv thaiv kom tsis txhob mob hnyav thiab pom cov tsos mob tsis zoo hauv kev kho mob gallstone, noj zaub mov. Nws yog tus uas suav hais tias yog qhov tseem ceeb tshaj plaws, lub hom phiaj yog:
- txhawb kev tso cov kua tsib ntawm lub zais zis;
- normalization ntawm daim siab thiab txiav txiav;
- pab txhawb kev ua haujlwm ntawm txhua yam kabmob ntawm lub plab zom mov;
- zam lub gallbladder spasms.
Cov ntsiab lus tseem ceeb rau kev npaj thiab noj zaub mov noj:
- noj me me 5-6 zaug ib hnub;
- tag nrho cov zaub mov yuav tsum tau boil, steamed, stewed los yog ci;
- qhov kub ntawm cov khoom noj yuav tsum yog +37-+40 ° C;
- tshem tawm cov khoom noj muaj roj cholesterol los ntawm kev noj zaub mov: rog, kib, ntsim, haus luam yeeb, thiab lwm yam.;
- haus tsawg kawg 1.5-2 litres dej ib hnub (tsis muaj roj);
- nyiam cereals uas muaj coarse fibers thiab zaub mov uas noj qab nyob zoo fatty acids.
Kev noj haus: ua thiab tsis ua?
Tso cai cov khoom lag luam txhawm rau tshem tawm cov tsos mob tsis zoo ntawm cov kab mob gallbladder gallstone thiab tswj tus neeg mob li qub:
- nqaij ntshiv (nqaij qaib los yog qaib ntxhw, luav, nqaij nyug);
- hiav txwv ntses (pollock, hake, halibut);
- protein omelets;
- zaub roj (txiv ntseej, flaxseed, sunflower), butter tsuas yog tso cai rau kev zam txim;
- cereals (oats, rice, buckwheat);
- zaub kua zaub lossis kua zaub tsis muaj zog;
- nplej croutons;
- ci txiv hmab txiv ntoo thiab zaub;
- zib mu - tsuas yog hauv me me;
- skimmed mis nyuj, kefir thiab yogurt, qes qes cheese casseroles;
- drinks: qaug tshuaj yej, chicory, txiv hmab txiv ntoo compotes thiab txiv hmab txiv ntoo dej qab zib diluted nrog dej, ntxhia dej tsuas warmed.
Cov zaub mov txwv tsis pub tuaj yeem ua rau lub gallbladder nrescolic lossis cov tsos mob tsis zoo hauv kev kho mob cholelithiasis (raws li cov neeg mob, qhov no tshwm sim thaum noj zaub mov raug cai):
- nqaij qaib thiab nqaij rog;
- kas fes thiab cawv;
- offal (siab, raum, thiab lwm yam);
- zaub ntsuab;
- -berries thiab txiv hmab txiv ntoo nrog qaub saj;
- sweet carbonated drinks;
- khoom thiab khaws cia hauv tsev;
- bread and durum pasta;
- seasonings, vinegar, spices thiab sauces muaj.
Kev kho tus kab mob gallstone los ntawm pej xeem txoj kev
Ntau tus neeg mob, ntxiv rau kev noj zaub mov, sim txhim kho lawv tus mob thiab tiv thaiv qaug dab peg los ntawm kev siv tshuaj ntsuab decoctions thiab infusions. Txhawm rau tshem tawm cov tsos mob tsis zoo thiab kho cov kab mob gallstone nrog cov tshuaj pej xeem, koj yuav tsum nrhiav kev qhia ntawm koj tus kws kho mob, leej twg tuaj yeem muab cov lus qhia muaj txiaj ntsig.
Cov tshuaj ntsuab zoo li no tso cai rau koj maj mam yaj cov pob zeb thiab tshem tawm ntawm tus neeg mob lub cev, tab sis lawv yuav tsum tau siv nrog ceev faj, raws li kev saib xyuas tas li ntawm tus kws kho mob plab.
Daim ntawv qhia rau kev kho tus kab mob gallstone:
- Infusion ntawm pob kws stigmas yog npaj los ntawm 100 g ntawm raw cov ntaub ntawv rau 1 tbsp. boiling dej, insist nyob rau hauv ib qhov chaw tsaus, tom qab txias, lim thiab haus txhua txhua 60 feeb. Nws yuav tsum raug sau tseg tias cov dej haus cuam tshuam qhov nce hauv cov ntshav txhaws, yog li nws yuav tsum tsis txhob siv los ntawm cov neeg muaj kev mob siab rau thiab tsim cov ntshav txhaws.
- Txhim kho cov noobdill yog npaj los ntawm 2 tbsp. l thiab 0.5 l ntawm boiling dej, tuav rau 15 feeb. hauv ib da dej. Haus ½ tbsp. hauv 2-3 lub lis piam 3-4 r. ib hnub.
- Kho nrog chaga nceb (birch): ncuav ib daim ntawm raw khoom nrog dej sov thiab muab tso rau 3-4 teev, tom qab softening, grate los yog grind, ncuav dej +50 ° C nyob rau hauv ib tug ratio ntawm 1: 5., tawm rau 2 hnub, lim. Haus 1 tbsp. mus txog peb zaug ib hnub.
- Decoction ntawm paj noob hlis hauv paus: txhawm rau npaj nws, koj yuav tsum khawb cov hauv paus ripe, ntxuav nrog rab riam (tsis txhob ntxuav), txiav tawm cov txheej txheem hauv daim ntawv xov. Tom qab ntawd txiav mus rau hauv torches thiab qhuav nyob rau hauv qhov ntxoov ntxoo. Cov khoom tuaj yeem khaws cia rau hauv lub hnab linen. Rau decoction noj 1 tbsp. qhuav keeb kwm, ntxiv 3 liv dej thiab boil rau 5 feeb. Thaum nruab hnub, haus 1 liter ntawm kev daws nyob rau hauv feem, khaws cia rau hauv lub tub yees. Tom qab 3 hnub, cov hauv paus hniav tseem tuaj yeem muab rhaub hauv 3 liv dej dua, tab sis nws yuav tsum tau boil rau 10 feeb, rau lub sijhawm thib 3 - 20 feeb. Lub sijhawm ntawm kev kho mob yog 2 lub hlis, uas yuav tsum tau 7 tbsp. qhuav cag.
- Decoctions of horsetail, shepherd's purse, herbal collection (yarrow, immortelle, rhubarb root) thiab lwm yam tshuaj ntsuab zoo sib xws.
Rau kev kho mob cholelithiasis, ntau tus kws kho mob pom zoo kom haus dej haus bicarbonate thiab sulfate-sodium ntxhia dej: "Essentuki" (No. 1 thiab 17), "Mirgorodskaya", uas ua rau muaj kev sib cais ntawm cov kua tsib. Koj tuaj yeem siv lawv tsuas yog hauv lub xeev sov thaum tswj kev noj zaub mov. Kev kho mob kav ntev li 4-6 lub lis piam, nws raug tso cai nqa tawm tsuas yog tias tsis muaj kab mob tshwm sim rau 2 lub hlis.
Tiv thaiv kev txhim kho ntawm cholelithiasis
Txhawm rau txo qhov yuav tshwm sim ntawm qhov tshwm sim ntawm tus kab mob, kom txo qis cov tsos mob tsis zoo hauv kev kho tus mob cholelithiasis, kev noj zaub mov thiab qee yam haujlwm yuav dhau los ua qhov tseem ceeb tiv thaiv, uas suav nrog:
- cov zaub mov feem ntau txhua 3-4 teev, uas pab kom tshem tawm cov kua tsib seem ntawm lub zais zis;
- ua raws li kev noj zaub mov tshwj xeeb, qhov hnyav normalization;
- nce lub cev ua si thiab ua si lub cev;
- tsis tshaib plab;
- haus dej tsawg kawg 1.5 litres ib hnub;
- zam kev ua haujlwm hauv txoj haujlwm inclined, uas tuaj yeem ua rau lub pob zeb txav;
- thaum cov tsos mob ntawm cov kab mob gallbladder tshwm sim hauv cov poj niam, nws raug nquahu kom txo qis cov tshuaj estrogen hauv lub cev, uas ua rau cov pob zeb loj hlob tuaj;
- noj 1-2 tsp txhua hnub. txiv roj roj, nws tuaj yeem siv rau kib thiab ntxiv rau kev noj haus;
- nce kev noj cov magnesium thiab zinc, uas txhawb cov hnyuv thiab tsim cov enzymes;
- tsis kam haus kas fes, uas cuam tshuam rau lub zais zis, qhov no cuam tshuam los thaiv cov kav dej thiab tsim kev tawm tsam.
Txawm hais tias cov tsos mob tsis zoo, kab mob gallstone tsis yog kab lus rau tus neeg mob, tab sis tsuas yog ib qho kev zam kom mob siab rau koj txoj kev noj qab haus huv. Ua raws li kev noj haus, kev saib xyuas tsis tu ncua ntawm lub zais zis thiab pob zeb yuav pab kom tsis txhob muaj teeb meem. Yog tias kws kho mob, rau kev noj qab haus huv, pom zoo rau kev npaj ua haujlwm, tom qab ntawd qhov no yuav pab tshem tawm cov pob zeb tag nrho.thiab muaj teeb meem tshwm sim.
