biliary dyskinesia yog ib hom kab mob plab hnyuv. Raws li cov ntaub ntawv tsis raug cai, yuav luag txhua tus neeg thib peb raug tus kab mob no. Tsis muaj cov txheeb cais tseeb, vim tias tsis yog txhua tus neeg mob nrhiav kev pab kho mob: pathology ua rau muaj teeb meem ntau, tab sis tsis cuam tshuam rau lub neej. Txawm li cas los xij, qee zaum, tus kab mob tuaj yeem ua rau muaj teeb meem. Yog vim li cas nws thiaj tsim nyog paub yuav ua li cas kho biliary dyskinesia.
Kev piav qhia ntawm pathology
Dyskinesia ntawm lub gallbladder thiab biliary ib ntsuj av yog ib tug pathological yam ntxwv los ntawm uneven secretion ntawm cov kua tsib thiab impaired contraction ntawm tus du cov leeg ntawm lub excretory system thiab sphincters. Yuav kom nkag siab tias nws yog tus kab mob dab tsi, koj yuav tsum delve me ntsis rau hauv lub cev nqaij daim tawv, tau kawm txog kev ua haujlwm ntawm cov kua tsib thiab cov kab mob biliary.
Bile yog cov kua dej daj daj daj uas muaj cov dej ua haujlwmtshuaj thiab koom nrog hauv cov txheej txheem digestive. Nws yog tsim nyob rau hauv daim siab los yog kab mob siab, tom qab ntawd los ntawm cov ducts nws nkag mus rau hauv lub gallbladder, qhov twg nws tau txais qhov tsim nyog concentration thaum lub sij hawm tshem tawm cov dej ntau dhau. Los ntawm lub gallbladder, kua nkag mus rau hauv duodenum.
Lub luag haujlwm tseem ceeb ntawm cov kua roj ntsha no yog txhawm rau ua kom cov roj ntsha nyuaj, vim tias lawv tau hloov mus rau hauv cov roj ntsha fatty acids los ntawm kev ua ntawm enzymes. Cov tom kawg tuaj yeem nqus tau los ntawm lub cev yam tsis muaj teeb meem. Tsis tas li ntawd, cov kua tsib tau koom nrog hauv cov txheej txheem ntawm kev nqus tag nrho cov rog thiab carbohydrates.
Cov kua dej no txav mus los ntawm cov kab mob biliary nrog kev pab ntawm cov leeg du. Kev ceev ntawm kev thauj mus los yog tswj hwm los ntawm cov leeg pob txha (sphincters), uas yog "txiav" los ntawm cov tshuaj hormones uas tsim tawm hauv cov txiav thiab lub plab. Yog tias cov kua tsib txav nrawm dhau, ces nws nkag mus rau hauv lub plab hauv daim ntawv diluted; yog tias nws txav qeeb dhau, nws dhau los ua saturated. Ob leeg muaj kev cuam tshuam tsis zoo rau kev noj qab haus huv.
Kev faib tawm
Nyob ntawm seb cov kua tsib txav qeeb dhau lossis nrawm dhau, tus kab mob tau muab faib ua ob hom. Hyperkinetic hom biliary dyskinesia (JVP) yog kev thauj mus los sai heev ntawm cov kua tsib rau hauv duodenum, hypokinetic qeeb.
Ob hom kab mob tib yam no txawv tsis yog hauv cov tsos mob thiab cov hauv paus ntsiab lus ntawm kev kho mob, tab sis kuj nyob rau hauv pawg neeg uas muaj feem cuam tshuam rau lawv. Piv txwv li, daim ntawv hyperkineticdyskinesia ntawm biliary ib ntsuj av tau kuaj pom ntau dua nyob rau hauv cov neeg mob hluas, thiab hypokinetic raug kuaj pom hauv cov neeg muaj hnub nyoog plaub caug xyoo thiab cov neeg uas muaj lub siab tsis ruaj khov. Feem ntau, cov poj niam raug tus kab mob ntau dua li cov txiv neej. Biliary dyskinesia kuj tshwm sim hauv cov menyuam yaus, txawm hais tias tsis ntau npaum li cov neeg laus.
Cov kws kho mob ua raws li kev faib tawm txawv raws li qhov siab npaum li cas ntawm cov sphincters, uas "tswj" kev txav ntawm cov kua tsib, yog. Yog tias nws siab dua li qub, ces tus kab mob hu ua hypertensive biliary dyskinesia, yog tias qis dua - hypotonic. Qee qhov xwm txheej, tus kws kho mob tuaj yeem kuaj pom ib hom kab mob sib xyaw, uas yog, ob qho tib si hypokinetic thiab hyperkinetic mob.
ICD code rau biliary dyskinesia - K83.9. ICD-10 yog ib qho kev faib tawm thoob ntiaj teb ntawm cov kab mob, ib daim ntawv siv los ua cov ntaub ntawv tseem ceeb thiab tsim nyog hauv kev kho mob.
JVP Uas
Raws li qhov ua rau pathology, biliary dyskinesia tau muab faib ua thawj thiab theem nrab. Thawj qhov tshwm sim tsis tshua muaj tshwm sim, feem ntau yog vim muaj qee qhov tsis xws luag hauv kev loj hlob ntawm lub gallbladder los yog kua tsib ducts. Qhov no tej zaum yuav yog lub zais zis, qhov tsis muaj zog ntawm cov phab ntsa, muaj cov septum sab hauv, ob npaug ntawm cov ducts, qhov chaw txawv txav lossis txav ntawm lub gallbladder.
Nyob rau hauv daim ntawv thib ob, muaj lwm yam kab mob-ua rau. Provoke txoj kev loj hlob ntawm dyskinesia ntawm lub gallbladder thiab biliary ib ntsuj av tau kis kab mob siab, daim siab tsis ua hauj lwm thiab lwm yam kab mob, ntau yam.pathology ntawm lub plab zom mov (gastritis, rwj, duodenitis), cholelithiasis, appendicitis, kev tsis haum tshuaj, cholecystitis, pathologies ntawm poj niam cev xeeb tub, inflammatory dab tshwm sim nyob rau hauv lub plab kab noj hniav, menopause.
JP tuaj yeem tshwm sim nrog cov kab mob sib kis, suav nrog, piv txwv li, tonsillitis lossis caries. Tsis tas li, tus kab mob tuaj yeem tshwm sim vim giardiasis, lwm yam kab mob thiab helminthic invasions.
Qee zaum, qhov laj thawj tseem ceeb uas ua rau cov tsos mob ntawm biliary dyskinesia yog cov zaub mov tsis zoo thiab noj zaub mov tsis zoo. Kev siv ntau yam khoom qab zib, khoom noj ntsim, txuj lom thiab seasonings, khoom noj rog dhau, zaub roj, dej cawv, thiab khoom noj txom ncauj muaj qhov tsis zoo. Kev yoo mov ntev thiab noj zaub mov tsis tu ncua yog teeb meem.
Tsis ntev los no, qhov kev xav tau nthuav dav, raws li cov kab mob biliary dyskinesia tshwm sim los ntawm kev ua rau lub paj hlwb ntev, kev ntxhov siab thiab kev ntxhov siab, cov mob neurotic. Qhov no tsis yog ib nqe lus tshiab, vim hais tias tau ntev lawm ib tug stereotype tias tag nrho cov kab mob yog los ntawm paj hlwb. Rau tag nrho cov pathologies, qhov no yog, ntawm chav kawm, ib qho exaggeration, tab sis nyob rau hauv cov ntaub ntawv ntawm dyskinesia, cov nqe lus zoo plausible.
Txhim kho cov kua tsib yog tswj hwm los ntawm lub paj hlwb autonomic, uas qee txoj hauv kev nyob ntawm lub hauv paus paj hlwb thiab teb rau cov tshuaj hormones tsim. Yog li, txhua qhov kev paub dhau los tuaj yeem cuam tshuam rau kev ua haujlwm ntawm biliary ib ntsuj av. Tsis tas li ntawd, nyob rau hauv kev ntxhov siab hnyav, tib neeg tsis saib xyuaskev noj zaub mov tsis tu ncua thiab kev noj zaub mov zoo, uas cuam tshuam rau kev loj hlob ntawm tus kab mob.
Lwm yam uas tuaj yeem ua rau muaj kev txhawj xeeb uas yuav tsum tau kho rau biliary dyskinesia suav nrog:
- haujlwm sedentary, tsis muaj kev tawm dag zog;
- Hloov pauv hauv qib hormonal, kev tsis sib haum;
- rog lossis asthenic lub cev;
- tsis muaj cov vitamins thiab minerals hauv lub cev;
- dysbacteriosis thiab qee yam kab mob.
Cov tsos mob tseem ceeb
Rau cov ntaub ntawv hyperkinetic thiab hypokinetic ntawm biliary dyskinesia, cov tsos mob txawv me ntsis, tab sis muaj cov tsos mob tshwm sim - mob. Hauv thawj kis, nws yog qhov ntse, feem ntau tshwm sim thaum hmo ntuj lossis tom qab noj mov, muaj tus cwj pwm paroxysmal. Muaj qhov tsis xis nyob hauv txoj cai hypochondrium, nws tuaj yeem tawg mus rau lub xub pwg hniav lossis lub xub pwg nyom, nco txog qhov mob hauv osteochondrosis. Qhov kev tawm tsam feem ntau kav ntev li ib nrab teev. Tsis tas li ntawd, tus neeg mob tuaj yeem yws yws ntawm palpitations, loog ntawm cov ceg thiab qhov mob hnyav heev hauv qab tav.
Nyob rau hauv daim ntawv hypokinetic, qhov mob yog tas mus li, aching, localized nyob rau hauv lub tav. Kev tsis xis nyob feem ntau tuaj yeem hloov tau los ntawm kev xav hnyav thiab puv. Daim ntawv ntawm tus kab mob no yog tus yam ntxwv los ntawm tsam plab. Kev tawm tsam ntev dua, tuaj yeem ua haujlwm ntev. Qhov mob rov qab tom qab noj mov lossis tshuaj choleretic. Nrog rau stagnation ntawm cov kua tsib, kev hloov ntawm cov quav thiab cov zis yog cov yam ntxwv (feem ntau dhau los ua lub teeb, thiab cov zis darkens), yellowing ntawm sclera ntawm lub qhov muag thiab tawv nqaij,khaus khaus heev.
Cov tsos mob ntawm biliary dyskinesia hauv ob qho tib si tshwm sim tawm tsam keeb kwm ntawm kev noj zaub mov tsis txaus, kev ntxhov siab, qee zaum ua rau muaj kev tawm tsam tuaj yeem ua rau lub cev ua haujlwm. Belching, xeev siab, quav quav, txo qis lossis ua tiav tsis qab los noj mov, tso zis ntau dhau, iab hauv qhov ncauj, ua pa tsis zoo, cov cim qhia ntawm lub paj hlwb tsis muaj zog tuaj yeem tshwm sim hauv ob qho tib si hypokinetic thiab hyperkinetic JP: insomnia, mob taub hau, plawv palpitations, nce qaug zog. thiab tawm hws. Cov poj niam yuav muaj kev coj khaub ncaws tsis zoo, thiab cov txiv neej tuaj yeem txo qis zog.
Kev nyuaj siab
Cov tsos mob ntawm biliary dyskinesia feem ntau tsis quav ntsej kiag li los ntawm cov neeg mob thaum exacerbations. Tab sis yog tias koj kho tus kab mob tsis muaj kev saib xyuas zoo, nws tuaj yeem ua rau cholecystitis, kab mob siab. Tsis tas li ntawd txaus ntshai yog JP cholestasis - stagnation ntawm cov kua tsib, uas tuaj yeem ua rau mob colic thiab gallstone, uas yog, tsim cov pob zeb hauv lub gallbladder. Cov txheej txheem inflammatory uas pib hauv lub cev no tuaj yeem cuam tshuam rau tus txiav txiav, vim li ntawd, tus kws kho mob kuaj mob pancreatitis.
Tus neeg mob ua haujlwm
Koj yuav tsum mus ntsib kws kho mob plab yog tias koj ntsib cov tsos mob ntawm biliary dyskinesia. Tus kws kho mob yuav sau cov kev kho mob uas tsim nyog rau hom kab mob uas tus neeg mob kuaj tau. Kev kuaj tus kheej thiab kev kho tus kheej tsis tuaj yeem lees txais ntawm no, vim tias qhov twg yog qhov tsim nyog, piv txwv li, nrog daim ntawv hypokinetic tuaj yeemua tsis tau zoo lossis txawm tias muaj teeb meem thaum hyperkinetic. Tus kws kho mob tshwj xeeb yuav ua cov txheej txheem kuaj mob thiab qhia seb yuav kho tus kab mob li cas.
Diagnosis
Thaum thawj tus neeg mob mus ntsib kws kho mob plab, tus kws kho mob yuav palpate qhov mob. Tus kab mob yog tus cwj pwm los ntawm qhov mob ntse thaum nqus tau thiab nias rau ntawm lub gallbladder cheeb tsam. Tab sis txoj kev no tsis raug txiav txim siab dyskinesia, yog li nws tsis tuaj yeem txiav txim siab qhov nyuaj thiab daim ntawv ntawm tus kab mob. Yog vim li cas thiaj pom zoo kev tshawb fawb ntxiv.
Kev tshuaj xyuas fecal rau lipids, qib bilirubin, helminths, dysbacteriosis yuav raug sau tseg. Qhov tseem ceeb tshaj plaws yog ultrasound, uas yuav pab txiav txim seb qhov mob ntawm cov ducts thiab gallbladder. Feem ntau, lub suab duodenal tau ua, thaum tus kws kho mob tau txais lub sijhawm los txiav txim siab cov tshuaj muaj pes tsawg leeg ntawm cov kua tsib thiab cov enzymes, lub sijhawm tau txais cov kua tsib los ntawm ntau qhov chaw ntawm biliary system.
JP kev kho mob
biliary dyskinesia yog kho los ntawm ntau txoj hauv kev. Ua ntej, tus neeg mob tau pom zoo kom hloov cov khoom noj thiab kev noj haus, kev noj zaub mov kho mob tau raug sau tseg, qhov thib ob, cov tshuaj tau qhia, thiab thib peb, kev puas siab puas ntsws qhia tau zoo, tab sis txoj kev no tsis tas yuav siv. Yog tias tus kab mob no tshwm sim los ntawm lwm yam pathology, ces qhov ua rau raug tshem tawm ua ntej.
Kev noj haus
Kev noj zaub mov zoo rau biliary dyskinesia yog muab rau cov hom phiaj kho. Cov khoom noj khoom haus zoo li no pab ua kom tiav qhov khoob ntawm lub gallbladder, tab sis tsis ua rau mob. Tus neeg mob nrog dyskinesia yog qhia kom nojzaub mov los ntawm plaub mus rau rau lub sij hawm ib hnub twg nrog ib ncua ntawm peb teev. Koj tsis tas yuav overeat, koj yuav tsum noj cov tais diav hauv daim ntawv sov. Noj mov kawg yuav tsum yog ob mus rau peb teev ua ntej yuav mus pw, tab sis koj tsis tas yuav mus pw tshaib plab.
Muaj cov khoom noj uas yuav tsum tsis txhob noj tag nrho, cov uas zoo tshaj plaws thaum lub sij hawm exacerbation, thiab pom zoo. Cov npe tshwj xeeb hauv txhua kis yog nyob ntawm tus yam ntxwv ntawm cov kab mob thiab cov kab mob sib kis, yog li kev noj haus yuav tsum tau txiav txim siab los ntawm kws kho mob noj zaub mov lossis kws kho mob plab.
Feem ntau, peb tsuas tuaj yeem hais tias nws tsis xav noj kib, ntsim dhau lossis rog. Cov zaub mov yuav tsum tau dominated boiled, steamed los yog stewed lauj kaub tais diav. Thaum cua sov zaub mov, nws yog ib qho tsim nyog yuav tsum tso tseg cov zaub roj thiab margarine. Cov khoom noj mis nyuj yuav tsum tau noj txhua hnub.
Thaum hnyav dhau lawm, zaub mov yuav tsum tuaj hauv daim ntawv crushed los yog pureed. Nws yog ib qho tsim nyog yuav tsum tso cov rog, cov nqaij haus luam yeeb thiab cov marinades, txiv ntseej, cov kaus poom, khoom noj txom ncauj, millet porridge, nqaij rog, offal, nceb.
Nrog rau qhov qeeb ntawm cov kua tsib los ntawm cov ducts, qe thiab qhob cij dub, qab zib, qaub cream. Yog tias tus neeg mob ceev heev, nws raug nquahu kom txwv cov nplua nuj broths, fatty ntses, zaub roj, thaum nws yog ntshaw kom suav nrog cov tais diav hauv daim ntawv hypokinetic ntawm JP. Nyob rau hauv ob qho tib si, koj yuav tsum tsis txhob noj chocolate, ice cream, qhob cij dawb. Ib tug loj npaum li cas ntawm cov zaub tshiab thiab txiv hmab txiv ntoo, bran (raws liib tablespoon ua ntej noj mov).
Nws raug nquahu kom tso cov dej qab zib ntau, kas fes thiab tshuaj yej, cawv. Koj tuaj yeem haus cov tshuaj yej tsis muaj zog thiab dej ntxhia. Lub hom phiaj ntawm cov dej pom zoo yog qhov zoo tshaj plaws kuaj nrog tus kws kho mob gastroenterologist. Qhov kev xaiv tsis raug tuaj yeem ua rau lub fact tias cov dej ntxhia yuav tsis pab tiv nrog qhov tsis kaj siab tshwm sim ntawm dyskinesia, tab sis tsuas yog ua rau tus kab mob hnyav dua. Lub ntsiab lus ntawm no yog tias cov dej muaj qhov sib txawv thiab cov ntsiab lus ntxhia sib luag.
Tshuaj
Tshuaj rau biliary dyskinesia yog qhov sib txawv rau cov kab mob hypokinetic thiab hyperkinetic cov ntaub ntawv. Piv txwv li, nyob rau hauv thawj rooj plaub, tus kws kho mob yuav sau cov tshuaj uas ua rau kom cov kua tsib lub excretion, piv txwv li, Allohol, uas yuav ua rau aggravate tus mob nrog hyperkinetic dyskinesia. Hauv qhov no, "No-shpa", "Papaverin" lossis "Drotaverin" raug tshuaj. Tsis tas li ntawm cov tshuaj uas normalize kev thauj cov kua tsib los ntawm cov ducts yog Flamin, Oxaphenamide, Nicodin.
tshuaj ntsuab
Nyob rau hauv cov ntaub ntawv ntawm dyskinesia, cov tshuaj nom tswv yog qhov zoo rau cov uas tsis yog ib txwm siv. Biliary dyskinesia tom qab tshem tawm cov gallbladder thiab lwm yam tuaj yeem kho tau zoo (raws li kev kho mob, tau kawg) nrog tshuaj ntsuab decoctions. St. John's wort, coriander, immortelle, sage, mint, anise, pob kws stigmas pab tshem tawm ntau cov tsos mob tsis zoo. Cov txiaj ntsig zoo tau los ntawm kev haus cov kua txiv kab ntxwv ua ntej noj mov. Nrog hypotonicdaim ntawv ntawm tus kab mob qhia tau hais tias tinctures muaj ib tug tonic nyhuv, piv txwv li, ginseng, lemongrass los yog eleutherococcus. Motherwort thiab valerian tinctures muaj txiaj ntsig zoo rau lub paj hlwb autonomic.
Psychotherapy
Cov tsos mob ntawm biliary dyskinesia, yog tias lawv tshwm sim los ntawm kev tsis sib haum xeeb hauv kev ua haujlwm ntawm lub paj hlwb autonomic, raug tshem tawm nrog kev pab ntawm kev puas siab puas ntsws. Tab sis feem ntau cov neeg mob uas tig mus rau tus kws kho mob gastroenterologist feem ntau tsis npaj mus rau tus kws kho mob hlwb thiab categorically tsis lees txais txoj kev kho no. Yog li ntawd, ntawm no peb tuaj yeem txwv peb tus kheej kom tsuas yog cov lus pom zoo. Nws yog ib qho tsim nyog kom tsis txhob muaj kev ntxhov siab ntau li ntau tau, noj cov tshuaj sedatives, pw txaus sijhawm. Yog tias nws muaj peev xwm tsim tau qhov kev ntxhov siab tas li yog qhov ua rau muaj tus kab mob, ces tus kws kho mob yuav sau cov tshuaj muaj zog, xws li tranquilizers, neuroleptics lossis antidepressants.
Dyskinesia tuaj yeem tshwm sim los ntawm kev ua neej tsis muaj zog, yog li kev kho mob qoj ib ce thiab taug kev yog qhov pab tau. Cov txheej txheem physiotherapeutic thiab massages yog siv rau hauv cov txheej txheem kho mob, cov nyhuv ntawm ultrasound yog siv, muaj cov txheej txheem tshwj xeeb uas tso cai rau koj kom tso cov kua tsib los ntawm cov kua tsib ntau dhau. Feem ntau, kev kho rau ASD tseem muaj kev saib xyuas, thiab qee zaus (yog tias kev hloov pauv hauv kev ua neej thiab tshuaj tsis ua haujlwm), kev phais yuav raug txiav txim siab.
Huab cua
Dyskinesia tsis yog kab mob tuag taus, tab sis nws tuaj yeem ua rau mob hnyav dualub neej zoo. Raws li txoj cai, tus neeg mob raug yuam kom ua raws li kev noj zaub mov tshwj xeeb, thiab yog tias muaj exacerbations, ntxiv rau kev noj tshuaj. Kev saib xyuas tsis tu ncua thiab kev saib xyuas koj txoj kev noj qab haus huv yuav txo qhov zaus ntawm exacerbations thiab ua kom lub sijhawm tshem tawm ntau tshaj plaws.
JVP in me nyuam
Dyskinesia ntawm biliary ib ntsuj av nyob rau hauv cov me nyuam raug kuaj, raws li txoj cai, nyob rau hauv thawj xyoo ntawm lub neej thiab nyob rau hauv lub tsev kawm ntawv theem pib lossis theem nrab. Qhov no yog tshwm sim los ntawm immaturity ntawm cov kua tsib ducts thiab malnutrition. Kev so ntev ntawm cov pluas noj hauv tsev thiab tom tsev kawm ntawv, muaj teeb meem tsis sib haum xeeb, kev ntxhov siab, thiab kev siv cov khoom siv tsis zoo cuam tshuam.
Cov tsos mob hauv menyuam yaus zoo ib yam li cov neeg laus. Muaj: mob plab, xeev siab thiab mob hauv txoj cai hypochondrium. Kev kho mob yog ua raws li tib lub tswv yim. Yog li, qhov tseem ceeb tshaj plaws yog kev kho cov khoom noj thiab kev hloov pauv ntawm kev noj zaub mov, tshem tawm qhov tsis zoo ntawm lub cev ntawm kev ntxhov siab.
Kev Tiv Thaiv
Kev ntsuas tiv thaiv yog tib yam li cov lus pom zoo ntawm txoj kev ua neej tau muab thaum kuaj pom tseeb. Koj yuav tsum tsis txhob muaj kev ntxhov siab, koom nrog cov kis las uas ua tau lossis tsawg kawg taug kev ntau dua, tswj koj tus kheej txhua hnub, ua haujlwm so thiab ua haujlwm, ua kom noj zaub mov zoo thiab noj zaub mov zoo, thiab ua raws li kev noj zaub mov zoo. Qhov no yog qhov tseem ceeb tshwj xeeb rau cov neeg uas poob rau hauv pab pawg muaj kev pheej hmoo. Cov no yog cov neeg ua haujlwm ua haujlwm ua lub neej nyob tsis tu ncua, cov neeg uas nyob hauv kev ntxhov siab tas li, noj tsis raug (cov khoom lag luam ib nrab, ntawm kev mus), yogtus kiv cua ntawm kev noj haus thiab curative yoo mov. Kuj tseem muaj kev pheej hmoo yog cov menyuam yaus uas yuav tsis noj zaub mov hauv tsev kawm lossis hauv tsev thaum tsis muaj niam txiv.
In xaus
Cov tsos mob Dyskinesia yog qhov mob ntawm qhov sib txawv thiab lub sijhawm, nyob rau hauv txoj cai hypochondrium. Indigestion thiab xeev siab tuaj yeem tshwm sim. Feem ntau, cov neeg mob yws ntawm kev qaug zog. Txhawm rau kuaj tus kab mob thiab pib kho kom tsim nyog, koj yuav tsum hu rau tus kws kho mob tshwj xeeb. Kev kho mob muaj xws li kev noj zaub mov tshwj xeeb thiab tshuaj. Tsis tas li ntawd, nws yog ib qho tseem ceeb heev kom tsis txhob muaj qhov tsis zoo ntawm kev ntxhov siab, uas yuav siv tau cov tshuaj sedatives. Dyskinesia tsis yog kev hem thawj rau lub neej, tab sis tuaj yeem ua rau muaj kab mob txaus ntshai.
