Cholelithiasis yog ib qho teeb meem uas cuam tshuam rau lub plab zom mov vim kev noj zaub mov tsis txaus thiab cov kab mob metabolic. Yuav ua li cas yaj pob zeb nyob rau hauv lub gallbladder, uas yuav thab ib tug neeg rau xyoo, peb yuav qhia nyob rau hauv peb cov khoom luv luv.
txhais thiab theem ntawm tus kab mob
kab mob gallstone yog dab tsi? Qhov no yog kab mob metabolic uas pob zeb tsim nyob rau hauv lub gallbladder thiab daim siab ducts. Cov pob zeb puas yaj? Nws tag nrho nyob ntawm theem thiab muaj pes tsawg leeg ntawm lawv.
Cov txheej txheem pathological mus dhau peb theem, uas tuaj yeem cuam tshuam ntau txoj hauv kev.
- Thawj theem tsis tshwm sim nws tus kheej hauv kev kho mob thiab yog tus cwj pwm los ntawm kev nce ntxiv ntawm cov roj cholesterol hauv cov kua tsib, mus txog rau cov roj cholesterol flakes thiab crystals. Tsis tas li ntawd, nws muaj tsawg dua phospholipids, bile acids thiab lecithin, uas yog cov khoom uas ua rau lub plab zom mov.
- theem ob txhais tau tiaspob zeb carrier, tsis manifest nws tus kheej nyob rau hauv txhua txoj kev thiab yog yus muaj los ntawm ib tug aggravation ntawm kev hloov nyob rau hauv cov khoom ntawm cov kua tsib. Flakes thiab crystals ntawm cov roj cholesterol tig mus rau hauv pob zeb uas maj mam sau lub gallbladder thiab nws cov ducts.
- theem peb yog raws nraim qhov calculous cholecystitis uas ua rau tus neeg mus ntsib kws kho mob. Txhawm rau kom yaj lub gallstones nyob rau theem no yam tsis muaj kev phais, nws yog ib qho tsim nyog yuav tsum ua raws li tag nrho cov tswv yim ntawm kev kho mob. Tsuas yog tus kws tshaj lij tuaj yeem muab rau lawv.
Cov tsos mob
Thawj ob theem ntawm tus kab mob gallstone yog asymptomatic. Cov tsos mob tshwm sim tshwm sim thaum:
- mob plab gallbladder thiab nws cov ducts.
- Clogging, congestion.
- Sau lub cev tag nrog pob zeb thiab ua txhaum nws txoj haujlwm ntawm kev tso nyiaj.
Tus yam ntxwv ntawm tus kab mob feem ntau yog colic. Nws yog tus cwj pwm los ntawm qhov mob hnyav nyob rau hauv txoj cai hypochondrium lossis hauv nruab nrab hauv qab tav. Mob yuav kis mus rau sab laug hypochondrium, hauv plab plab, nraub qaum, sab xub pwg hniav, lossis thaj tsam ntawm lawv. Qhov mob tuaj yeem mus ntev ntev. Ntxiv nrog rau kev hnov mob, muaj ntau yam kev tawm tsam: tawm hws, liab lossis pallor ntawm daim tawv nqaij, nce ntshav siab thiab lub plawv dhia ceev. Kev xeev siab thiab ntuav yog qhov sib koom ua ke ntawm biliary colic. Tsis tas li ntawd, qhov qab los noj mov txo qis, tus neeg mob tsis xis nyob, qhov mob tsis tso cai rau pw tsaug zog.
Thaum lub cev kub nce, mob cholecystitis lossis cholangitis yog xav tias. Yellowness ntawm daim tawv nqaij, sclera, qhia tias pob zebobstructs lub outflow ntawm cov kua tsib.
kuaj mob
Txawm tias nws puas tuaj yeem ua kom yaj cov pob zeb hauv lub gallbladder los ntawm ntau txoj hauv kev nyob ntawm seb pob zeb tsim nyob rau hauv lub zais zis thiab ducts.
Pob zeb yog cov hauv qab no:
- Cov roj (cholesterol) muaj txog 75% cov roj cholesterol, nrog rau cov pigments, txiv qaub ntsev, proteins thiab mucins. Feem ntau ntsib (los ntawm 70 mus rau 90% ntawm tag nrho cov mob). Lawv pom muaj nyob rau hauv lub gallbladder thiab ntau tsawg dua nyob rau hauv lub ducts.
- Cov pob zeb xim av muaj txog li 30% cov roj cholesterol, nrog rau calcium bilirubinate. Pom nyob rau hauv cov kab mob sib kis tom qab phais, tsis tshua muaj nyob hauv lub zais zis nws tus kheej.
- Dub pigment muaj cov xim dub, mucin thiab cov proteins. Feem ntau tshwm sim nyob rau hauv lub gallbladder, tsis tshua muaj heev nyob rau hauv lub duct.
- Cov pob zeb sib xyaw muaj cov roj cholesterol tsawg, nrog rau cov ntsev ntsev, cov proteins, mucin thiab cov xim xim. Muaj li ntawm 20% ntawm cov neeg mob.
Txo cov pob zeb hauv lub gallstone yam tsis tau phais yog tias lawv yog cov roj cholesterol. Cov pob zeb no tsis pom ntawm x-rays. Txoj kev kuaj mob tseem ceeb yog ultrasound. Pob zeb thiab lawv cov duab ntxoov ntxoo pom, nrog rau cov phab ntsa tuab ntawm lub gallbladder.
Ntawm cov duab hluav taws xob ntawm lub plab kab noj hniav, pob zeb pom tsawg dua yog tias lawv muaj cov ntsev ntsev, xov tooj cua zoo.
Fibrogastroduodenoscopy yog ua los tshuaj xyuas qhov chaw tawm ntawm cov kua tsibduodenal duct kom pom pob zeb thaiv.
Hauv kev kuaj ntshav biochemical, cov roj cholesterol thiab lipid spectrum tau kawm, nrog rau kev ua haujlwm ntawm lub siab raws li bilirubin thiab enzymes.
Ua tiav cov ntshav kuaj pom muaj lossis tsis muaj cov txheej txheem inflammatory los ntawm tus lej ntawm leukocytes thiab erythrocyte sedimentation tus nqi.
Kev noj haus rau tus kab mob gallstone
Txhua theem, kev noj zaub mov kho mob yuav tsum yog txhawm rau txo qis cov roj cholesterol, nws cov hypersecretion hauv lub cev. Lub luag haujlwm tseem ceeb ntawm no yog ua los ntawm kev noj zaub mov kom zoo, tsom rau kev txo lub cev hnyav, kho cov txheej txheem metabolic. Feem ntau cov duab ntawm cov kua tsib yog txuam nrog endocrine pathology, uas yuav tsum tau noj tshwj xeeb.
Khoom noj khoom haus yuav tsum tau muab faib ua feem - los ntawm plaub mus rau rau lub sij hawm ib hnub twg, faib zaub mov sib npaug ntawm cov xuab moos kom tsis txhob muaj cov kua tsib nyob hauv lub zais zis. Cov feem yuav tsum yog me me, gluttony yog txwv tsis pub, vim nws yuav ua rau spasm ntawm cov kua tsib ducts thiab mob rhiab heev ntawm kev siv sib txawv.
Khoom noj khoom haus tsis suav nrog kev noj kib, rog, haus luam yeeb, ntsim thiab calorie ntau ntau (txog 2900 kcal). Cov zaub mov yuav tsum muaj protein ntau. Thaum xaiv cov khoom, lawv cov ntsiab lus rog yuav tsum raug coj mus rau hauv tus account. Qhov no siv rau cov khoom siv mis nyuj, uas yuav tsum tau yuav nrog cov feem pua ntawm cov roj tsawg. Cov nqaij yuav tsum muaj roj tsawg (nqaij qaib, qaib ntxhw, luav, nqaij nyuj). Ntses dej los yog cov rog tsawg (bream, perch, cod, pike perch, hake). Nqaij thiab ntses yuav tsum tau steamed los yogua noj.
Noj txog 100 grams zaub nyoos lossis txiv hmab txiv ntoo peb mus rau plaub zaug hauv ib hnub yog pab tau. Koj yuav tsum noj lawv ua ntej noj mov loj. Txiv apples thiab pears, nrog rau cov kua txiv hmab txiv ntoo los ntawm lawv, pab yaj lub gallstones zoo, uas tau txais kev hlub ntawm ntau tus kws noj zaub mov. Rau tib lub hom phiaj, carrots, sauerkraut, celery yuav siv. Cov khoom noj uas muaj fiber ntau yuav tsum muaj nyob rau ntawm lub rooj ntawm tus neeg mob tawm tsam nrog kev tsim pob zeb. Noj ib tablespoon ntawm nplej bran ob zaug ib hnub twg yog ib qho ntawm cov kev kho mob pej xeem. Bran brewed nrog boiling dej thiab ntxiv rau lub ntsiab tais yuav pab kom yaj gallstones thiab txhim kho plab hnyuv muaj nuj nqi.
Ib nrab cov rog yuav tsum yog cov nroj tsuag. Cov roj zaub (sunflower, linseed, txiv ntseej, pob kws thiab taum pauv) pab txo cov roj cholesterol, txhawb lub cev nrog tocopherol, dilute bile nrog kev pab ntawm prostaglandins hauv lawv cov muaj pes tsawg leeg.
Cov kua tsib nruab nrab thiab alkaline ua rau muaj kev sib cais ntawm cov cholesterol hauv nws, thiab ib puag ncig acidic, ntawm qhov tsis sib xws, ua rau crystallization thiab pob zeb tsim. Qhov no ua rau kev noj ntau ntawm cov hmoov nplej thiab cereals. Txhawm rau ua kom ib puag ncig ntau dua alkaline, koj yuav tsum ntxiv cov khoom qab zib, tsev cheese, cheese, zaub (tshwj tsis yog legumes), txiv hmab txiv ntoo thiab berries (tshwj tsis yog liab currants) rau kev noj haus.
Cov kua zaub yuav tsum tau siav ntshiv. Cov qe mos mos raug tso cai tsis pub ntau tshaj ib hnub. Los ntawm seasonings, koj tuaj yeem siv parsley thiab dill, txiv hmab txiv ntoo sauces. Tshuaj yej thiab kas fes tuaj yeem qaug qaug zog, nws yog qhov zoo rau haus kua txiv. Txwv tsis pub haus cawv thiab npias.
Kev qhia tshuaj rau kev tshem tawm pob zeb
Nws muaj peev xwm yaj pob zeb hauv lub gallbladder los ntawm pej xeem thiab kev kho mob raws li qee yam xwm txheej:
- Lub gallbladder tsuas muaj cov roj cholesterol xwb, uas pom ntawm ultrasound thiab tsis tuaj ntawm cov duab hluav taws xob.
- Size - tsis ntau tshaj ob centimeters hauv qhov loj.
- Lub gallbladder ua haujlwm kom raug thiab tag nrho, sib sau cov kua tsib.
- Pob zeb hauv lub cev tsis pub ntau tshaj ib nrab ntawm nws ntim.
- Cov kab uas tawm hauv lub gallbladder yuav tsum dhau mus.
- Tsis muaj pob zeb hauv cov kav dej.
- Lub sij hawm rau cov pob zeb zoo li tsawg dua peb xyoos, txij li tom qab lawv tau sau ntau cov ntxhia ntsev uas nyuaj rau yaj.
Contraindications rau tshuaj tua cov pob zeb
Paub cov xwm txheej uas txwv tsis pub siv tshuaj lysis thiab cov pob zeb twg tuaj yeem ua rau yaj nrog tshuaj.
Contraindications yog:
- Cov tshuaj tiv thaiv mob hnyav hauv lub zais zis phab ntsa thiab ducts.
- pob zeb loj tshaj ob centimeters hauv kab.
- Pathology ntawm daim siab ntawm txhua yam etiology.
- mob pancreatitis.
- YPeptic ulcer ntawm lub plab thiab duodenum.
- Exacerbation ntawm cov kab mob ntev ntawm txhua qhov ntawm txoj hnyuv.
- Calcium carbonate pob zeb pom ntawm x-rays.
- lub gallbladder uas tsis muaj kev ua haujlwm.
- Kev cev xeeb tub thiabpub niam mis.
Yuav ua li cas cov tshuaj yaj lub gallstones
Rau kev kho mob lysis, kev npaj ntawm cov kua tsib acids - chenodeoxycholic thiab ursodeoxycholic, yog siv, uas them rau qhov tsis muaj cov tshuaj no hauv cov neeg mob uas muaj pob zeb tsim. Thaum siv cov tshuaj no, qhov nqus ntawm cov cholesterol los ntawm cov zaub mov thiab nws cov synthesis hauv lub siab yog inhibited, uas ua rau nws txo qis hauv cov kua tsib. Yog tsis muaj cov cholesterol, uas yog lub hauv paus ntawm lub pob zeb, nws tsim yuav nyuaj. Tsis tas li ntawd, nrog cov pob zeb roj cholesterol thiab cov pob zeb uas twb muaj nyob hauv lub zais zis, fatty acids tsim cov kua sib txuas uas ua rau cov kua tsib ua ke.
Cov tshuaj ntawm chenodeoxycholic acid yog "Chenofalk", tsim nyob rau hauv tsiav tshuaj los ntawm German tuam txhab kws kho mob Falk Pharma GmbH. Cov tshuaj tau muab tshuaj ua ntej yuav mus pw txhua hmo, vim cov pob zeb roj cholesterol tsim thaum hmo ntuj nrog rau lub sijhawm ntev ntawm cov kua tsib (vim ib tug neeg tsis noj hmo).
koob tshuaj nyob ntawm qhov hnyav ntawm tus neeg ntawm tus nqi ntawm 15 mg rau ib kg. Cov neeg rog rog yuav tsum paub tias qhov koob tshuaj ntau tshaj yog 1500 mg ib hnub twg.
Yuav tsum noj tshuaj kom ntev. Rau lub hlis tom qab, kev soj ntsuam xyuas ultrasound tau ua tiav, uas ntsuas qhov txiaj ntsig ntawm kev kho. Thaum tsis muaj qhov ua tau zoo, cov tshuaj raug tso tseg. Lub sijhawm siab tshaj plaws rau kev noj "Chenofalk" yog suav tias yog peb xyoos. Muaj ib txoj kev ntawm kev noj cov tshuaj rau kev tiv thaiv ntawm cov pob zeb tom ntej hauv cov neegnquag mus rau qhov no pathology, muab hais tias yav dhau los pob zeb yog yaj tag. Kev txais tos yog nqa tawm hauv ib hlis nrog so ntawm 60 hnub.
Henofalk qhov siab ntev yog qhov zoo. Koj yuav tsum ntshai ntawm kev tsis haum tshuaj nyob rau hauv daim ntawv ntawm khaus thiab pob khaus. Nrog rau kev noj ntau lub hlis ntev, nws yog ib qho tsim nyog los saib xyuas daim siab tsis ua haujlwm (ALAT thiab ASAT), thiab yog tias lawv nce ntxiv, txo qhov ntau npaum li cas.
Mob plab tuaj yeem tshwm sim thaum txav pob zeb. Cov quav xoob tuaj yeem ua tau ntawm cov koob tshuaj ntau vim tias muaj roj ntau hauv cov quav.
Cov tshuaj "Ursofalk" raws li ursodeoxycholic acid yog siv ntawm qhov ntau npaum li 10 mg ib kilogram ntawm lub cev hnyav ib hnub twg thaum yav tsaus ntuj. Qhov siab tshaj plaws yog 1250 mg. Cov tshuaj yog suav hais tias zoo dua rau cov pob zeb yaj, thiab nws txoj kev ua siab ntev yog qhov zoo. Kev txais tos yog nqa tawm raws li kev tswj hwm ntawm ultrasound. Ncua tseg "Ursofalk" nyob rau hauv qhov tsis muaj zog nyob rau hauv ib xyoos thiab ib nrab.
Nws muaj cov txheej txheem rau kev sib txuas "Chenofalk" thiab "Ursofalk" nrog kev noj ib nrab noj thaum hmo ntuj. Qhov kev kho no zoo dua qub thiab ua rau cov pob zeb tawg hauv 70% ntawm cov neeg mob, piv rau monotherapy, qhov kev vam meej nrog tsuas yog ib nrab ntawm cov neeg mob.
Qhia meej tag nrho cov contraindications ua ntej dissolving gallstones nrog acid npaj. Tsis tas li ntawd, ib tug yuav tsum nco ntsoov tias lawv cov tshuaj tsis tuaj yeem ua tsis tau.
tshuaj ntsuab uas ua rau lub gallstones
Kev siv tshuaj ntsuab kom yaj pob zeb yuav tsum tau ua tom qabtso cai los ntawm tus kws kho mob. Yog li, cov tshuaj uas yaj cov pob zeb hauv lub gallstone muaj nyob hauv cov tshuaj nram qab no.
Y Siv mis thistle, peppermint, tansy, rosehips, beetroot decoction, lingonberry nplooj, lavender paj, roob thyme. Lawv siv nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, infusions, tshuaj yej. Nco ntsoov tias txhua qhov kev kho mob muaj nws cov npe ntawm contraindications.
Nws muaj peev xwm yaj cov pob zeb hauv lub gallbladder nrog cov tshuaj pej xeem, suav nrog tshuaj ntsuab, nrog lawv txoj kab uas hla me me thiab cov roj cholesterol. Kev siv tshuaj ntsuab thaum lub sij hawm mob o yog contraindicated.
kev kho tsis yog tshuaj
Yuav ua li cas koj thiaj li yaj pob zeb hauv lub gallbladder yam tsis muaj kev kho mob phais, koj yuav tsum paub tom qab sab laj nrog kws kho mob plab thiab kws phais.
Txoj kev ntawm kev poob siab yoj cholelithotripsy tso cai rau crushing pob zeb loj (txog 3 cm) rau hauv me me. Cov pob zeb yuav tsum yog cov cholesterol. Lub gallbladder yuav tsum ua nws txoj haujlwm. Txoj kev yuav ua tau zoo tshwj xeeb yog tias koj pib siv fatty acid npaj ob lub lis piam ua ntej nws. Pob zeb tawg tau ua tiav hauv 95% ntawm cov neeg mob.
Cov txheej txheem percutaneous transhepatic cholelitholysis yog ib qho kev ua kom tsis muaj zog uas tau ua nyob rau hauv zos lossis cov tshuaj loog. Nws muaj nyob rau hauv kev qhia ib tug nyias sojntsuam mus rau hauv lub gallbladder los ntawm daim tawv nqaij thiab daim siab cov ntaub so ntswg thiab infusing ib tug tov los ntawm no sojntsuam kom yaj pob zeb. Qhov no dissolves txog li 95% ntawm cov pob zeb.
Kev Tiv Thaiv
Kev tiv thaiv yog txhawm rau tiv thaivtsim cov pob zeb thawj thiab tshiab calculi tom qab kho nrog cov saum toj no txhais tau tias.
ntsuas kev tiv thaiv suav nrog:
- khoom noj kom raug raws li tag nrho cov haujlwm saum toj no.
- Siv cov dej ntxhia uas muaj sulfate ion ("Essentuki", "Borjomi", "Truskavets", "Narzan").
- Spa kho mob.
- Kev tsis lees paub tus cwj pwm phem.
- Kev ua lub cev tsis tu ncua, suav nrog kev tawm dag zog uas txhim kho cov leeg ntawm lub diaphragm thiab xovxwm.
- tswj lub cev hnyav.
- kev kho mob ntev.
Peb tau tham txog yuav ua li cas thiaj ua rau cov pob zeb tawg. Nrog kev kho kom zoo, cov txiaj ntsig tau zoo.
