Ib qho ntawm cov kab mob pathological uas feem ntau kuaj tau los ntawm kws kho mob plab thiab xav tau kev kho mob hnyav yog cov kua tsib stasis. Cov tsos mob ntawm tus kab mob no qhia txog teeb meem hauv daim siab, uas tsim cov tshuaj no, thiab lub gallbladder, uas yog ib tug reservoir rau sau cov kua tsib.
Physiology
Ua ntej piav qhia cov tsos mob ntawm cov kua tsib stasis thiab kev kho mob ntawm cov kab mob no, peb yuav tsum pib nrog luv luv anatomical digression.
Nws paub tias tom qab noj cov rog uas nkag mus rau hauv peb lub cev tau tawg, tab sis kom tag nrho cov lipids tau emulsified thiab tag nrho cov vitamins kom nqus tau, ntxiv rau cov kua txiv hmab txiv ntoo thiab cov enzymes tsim los ntawm cov txiav, cov kua qaub. thiab ntsev yuav tsum tau - lub ntsiab Cheebtsam kua tsib. Lawv nkag mus rau hauv duodenum los ntawm lub gallbladder, qhov twg cov txheej txheem digestive thiab rog hydrolysis txuas ntxiv.
Kev phom sij yog dab tsi
Yog cov kua tsib stagnates thiab tsis nkag mus rau hauv plab hnyuv raws sijhawm, ces:
- txo qis kev ua haujlwm enzyme, uas tiv thaivua kom tiav cov rog. Cov lipids ntau dhau nkag mus rau hauv cov hlab ntsha, tiv thaiv kev hloov pauv ntawm cov piam thaj mus rau glycogen, uas, dhau los, yog fraught nrog kev loj hlob ntawm ntshav qab zib.
- Nrog cov tsos mob ntawm stagnation ntawm cov kua tsib nyob rau hauv lub gallbladder, muaj kev txaus ntshai ntawm tsub zuj zuj ntawm cov roj cholesterol ntau, uas muaj nyob rau hauv cov kua tsib nws tus kheej. Qhov tshwm sim ntawm qhov ua txhaum cai no yog hypercholesterolemia thiab kev loj hlob ntawm atherosclerosis.
- Yog tsis muaj kev kho kom raug, cov kua tsib stasis, cov tsos mob uas tau piav qhia hauv ntu tom ntej, ua rau mob cholecystitis lossis kab mob gallstone.
Ntau zaus, hauv cov neeg mob uas muaj cov kua tsib stasis, mob plab hnyuv tau kuaj pom, vim tias lub plab zom mov tsis tu ncua raug cuam tshuam los ntawm cov kua qaub uas nkag mus rau hauv txoj hlab pas rov qab los ntawm duodenum. Feem ntau qhov no tshwm sim nrog mob duodenogastric reflux, uas tshwm sim thaum lub plawv sphincter tsis muaj zog. Cov tsos mob ntawm cov kua tsib stasis tuaj yeem qhia tau tias cov kab mob duct fibrosis, uas cov kws kho mob hu ua sclerosing cholangitis.
Thaum muaj kev ua haujlwm tsis zoo hauv kev ua haujlwm ntawm cov kua tsib acids, tsis tsuas yog nqus cov rog zuj zus, tab sis kuj tseem muaj cov vitamins, uas los ntawm lawv qhov xwm txheej yog cov rog-soluble tshuaj:
- retinol (vitamin A);
- Yergocalciferol (vitamin D);
- tocopherol (vitamin E);
- Yphylloquinone (vitamin K)
vitamin deficiency tuaj yeem ua rau muaj teeb meem kev noj qab haus huv ntau. Piv txwv li, nrog tsis muaj retinolTwilight tsis pom kev phem, me me ntawm vitamin K hem kom txo cov ntshav txhaws, thiab qhov tsis txaus ntawm cov vitamin D nkag mus rau hauv lub cev ua rau osteomalacia - txo qis hauv mineralization thiab softening ntawm pob txha cov ntaub so ntswg. Tsis tas li ntawd, hypovitaminosis cuam tshuam nrog kev nqus ntawm calcium, uas ua rau nws xoob thiab yog ib qho mob zoo rau kev txhim kho pob txha.
Lwm qhov kev hem thawj uas tau tshaj tawm los ntawm cov tsos mob ntawm cov kua tsib stasis yog qhov nce hauv plab hnyuv acidity. Hauv cov neeg noj qab haus huv, cov kua tsib, uas muaj cov calcium cations, txo cov acidity ntawm lub plab, tab sis nrog cholestasis, acid-base imbalance ntawm lub plab zom mov tshwm sim, raws li qhov tshwm sim ntawm ascites yuav tsim.
Thaum thawj theem ntawm kev txhim kho cholestasis, txhua qhov kev kho mob tshwm sim tsawg heev. Qhov kev tshwm sim ntawm cov tsos mob ntawm tus kab mob thiab lawv qhov hnyav feem ntau nyob ntawm qhov ua rau thiab cov yam ntxwv ntawm cov kab mob hepatobiliary ntawm lub cev nyob rau hauv ib rooj plaub.
yam ntxwv tshwm sim
Cov tsos mob ntawm cov kua tsib nyob rau hauv lub gallbladder rau cov neeg mob feem ntau yog khaus thiab ua paug ntawm cov quav. Nws ntseeg tau tias cov epidermis khaus nrog cholestasis vim qhov nce ntawm cov kua tsib acids hauv cov ntshav. Lawv nkag mus rau hauv cov ntshav plasma vim kev puas tsuaj rau hepatocytes los ntawm chenodeoxycholic acid. Cov quav hauv cov kab mob no tau txais cov yam ntxwv tsis zoo vim yog qhov tsis txaus ntawm bilirubin, cov kua tsib xim, uas nyob rau hauv tus neeg noj qab haus huv yog oxidized rau stercobilin thiab stains quav tsaus thiab zis daj. Nrog stagnation ntawm cov kua tsibkuj hloov ntxoov ntxoo, ua tsaus, raws li tus nqi ntawm urobilin nyob rau hauv nws muaj pes tsawg leeg nce.
Cov tsos mob ntawm cov kua tsib nyob rau hauv daim siab yog cov kab mob dyspeptic. raws plab, cem quav, xeev siab tas li yog qhov tshwm sim ntawm tus mob no. Txij li cov kua tsib acids tsis muaj qhov tseem ceeb me me rau txoj hnyuv, lawv qhov tsis muaj ua rau cem quav. Qhov ua rau mob raws plab, ntawm qhov tod tes, yog ib qho ntxiv ntawm cov lipids uas tsis tau noj hauv cov quav lossis cov kab mob tsis sib xws hauv cov hnyuv lumen.
Ntawm cov tsos mob ntawm cov kua tsib stasis, nws yog ib qho tsim nyog yuav tsum nco ntsoov qhov mob nyob rau hauv txoj cai hypochondrium, sab sauv quadrant ntawm lub plab. Qhov mob yog npub paroxysmal nyob rau hauv qhov xwm txheej, tuaj yeem tawg mus rau sab nraub qaum ntawm lub cev, muab rau pob txha caj dab, xub pwg lossis lub xub pwg hniav.
Ntxiv rau, nrog cholestasis, cov neeg mob muaj kiv taub hau, tsis muaj zog. Vim lub stagnation ntawm cov kua tsib, lub siab loj tuaj, lub siab nyob rau hauv lub portal leeg nce. Nyob rau theem siab ntawm tus kab mob, nrog rau cholestasis, cov plaub hau poob (alopecia) tuaj yeem tshwm sim los ntawm triglyceride deficiency.
Cov tsos mob tsis tshua muaj tshwm sim ntawm cov kua tsib stasis
Tshuaj rau kev kho tus kab mob no raug xaiv nyob ntawm tus yam ntxwv ntawm nws cov chav kawm. Tseeb tiag, ntxiv rau qhov kev tshwm sim tseem ceeb hauv kev kho mob, cov neeg mob yuav ntsib lwm yam kev hloov pauv. Piv txwv li, nrog cholestasis, jaundice tuaj yeem tshwm sim. Txawm tias muaj tseeb hais tias cov tsos mob no tau pom ntau tsawg dua li cov saum toj noCov cim qhia ntawm cholestasis, nws tsim nyog saib xyuas tshwj xeeb. Tawm tsam keeb kwm yav dhau los ntawm cov ntsiab lus siab ntawm bilirubin hauv cov ntshav, cov epidermis, sclera ntawm lub qhov muag thiab cov mucous daim nyias nyias ua daj.
Ntxiv rau, qee zaum cov neeg mob muaj pob khaus ntawm daim tawv muag - xanthelasma. Hauv cov menyuam yaus, qhov tshwm sim ntawm stagnation ntawm cov kua tsib kuj suav nrog kev tsim ntawm xanthoma - focal daim tawv nqaij tsim, uas yog me me ntawm cov cholesterol. Feem ntau, xanthomas tshwm nyob ib ncig ntawm lub qhov muag, hauv qab lub mis, ntawm lub caj dab ntawm cov me nyuam mos. Qee cov tsos mob ntawm cov kua tsib stasis hauv menyuam yaus tuaj yeem tshwm sim los ntawm qhov tsis muaj cov tshuaj polyunsaturated tseem ceeb, suav nrog linoleic, linolenic, arachidonic. Tshwj xeeb, qhov tsis txaus ntawm cov tshuaj no ua rau dermatitis, kev loj hlob qeeb, kev txhim kho tsis zoo ntawm lub paj hlwb peripheral.
Yog tias tus neeg mob, ntxiv rau cholestasis, muaj keeb kwm ntawm lwm yam kab mob ntawm lub plab zom mov thiab plab hnyuv, muaj peev xwm kub hnyiab tau. Stagnation ntawm cov kua tsib yog tus cwj pwm los ntawm qhov kev xav tsis tu ncua ntawm lub qhov ncauj thiab dryness, feem ntau muaj ib qho tsis kaj siab tsw vim qhov deterioration ntawm kev zom thiab nqus cov protein. Txij li thaum cov kua tsib yog tsim los rhuav tshem cov proteins thiab nitrogenous hauv paus uas muaj nyob rau hauv cov khoom tuaj, nws tshaj provokes cov tsos ntawm ib tug tsis kaj siab tsw. iab eructation feem ntau ntxiv rau cov tsos mob ntawm cov kua tsib stasis tom qab phais ntawm lub gallbladder.
Yog tias kub taub hau nrog cholestasis, feem ntau yuav, peb tab tom tham txog kev sib ntxiv ntawm cov kab mob. Sepsis, phlegmonous los yoggangrenous cholecystitis feem ntau tshwm sim tom qab kuaj mob endoscopic.
Dab tsi ua rau cov kua tsib stasis
Qhov laj thawj tseem ceeb ntawm cholestasis gastroenterologists txiav txim siab qhov kev puas tsuaj ntawm hepatocytes los ntawm daim siab cirrhosis (thawj biliary lossis cawv). Xws li stagnation yog hu ua hepatocellular. Lwm pab pawg muaj xws li kev puas tsuaj rau daim siab los ntawm kev kis kab mob lossis kab mob cab, suav nrog:
- kab mob siab kab mob siab;
- daim ntawv mob siab ntawm tuberculosis;
- opisthorchiasis;
- amebiasis;
- giardiasis.
Qhov ua rau cov tsos mob ntawm cov kua tsib stasis tuaj yeem ua rau lub siab ua rau lub siab. Cov tib neeg cov tshuaj, suav nrog sulfonamides, tshuaj tua kab mob ntawm pab pawg penicillin, tshuaj tua kab mob, tshuaj hormones, tuaj yeem muaj kev cuam tshuam rau lub caj pas.
Kev loj hlob ntawm cholestasis tshwm sim nyob rau hauv lub xub ntiag ntawm benign los yog malignant qog, metastases. Ntawm cov laj thawj vim li cas stagnation ntawm cov kua tsib kuj muaj xws li:
- dyskinesia thiab inflection ntawm lub gallbladder;
- kab mob gallstone;
- txheej txheem mob hauv lub caj dab ntawm lub gallbladder;
- cystic formations ntawm cov ducts los yog lawv compression los ntawm cov qog nyob rau hauv lub txiav;
- ua haujlwm tsis zoo hauv kev ua haujlwm ntawm sphincters ntawm Oddi, Lutkens, Mirizzi, Geister;
- ua txhaum ntawm endocrine thiab paracrine mechanisms ntawm gastroduodenal theem ntawm kev zom.
Leej twg nyob hauv pab pawgrisk
Nws ntseeg tau tias kab mob tshwm sim feem ntau tshwm sim hauv cov neeg laus. Cov tsos mob thiab kev kho mob ntawm cov kua tsib stasis muaj feem cuam tshuam nrog lub cev tsis ua haujlwm: tus neeg mob txav tsawg dua, cov txheej txheem metabolic hauv nws lub cev tsis muaj zog thiab, yog li ntawd, qhov kev pheej hmoo ntawm kev tsim kab mob gallstone thiab biliary duct dyskinesia.
Tom qab cholecystectomy, cov kua tsib stasis raug hu los ntawm ntau tus kws tshaj lij ua qhov tshwm sim tom qab ua haujlwm. Xws li qhov tshwm sim ntawm kev cuam tshuam kev phais tshwm sim vim muaj caws pliav ntawm cov ntaub so ntswg uas ua rau lub qhov khoob ntawm cov kwj dej biliary.
Cholestasis tuaj yeem tshwm sim hauv cov neeg mob uas tsim txom cov khoom qab zib, pastries, thiab zaub mov muaj roj. Kev pheej hmoo ntawm cov kua tsib stasis yog cov neeg uas muaj kev haus dej cawv ntev ntev thiab rog rog, uas tau txais cov noob caj noob ces rau cov kab mob metabolic.
Kev kho mob cholestasis nrog tshuaj
Kev kho mob ntawm tus mob no yog ua raws li ib qho ntawm cov hauv paus ntsiab lus:
- yog qhov ua rau cholestasis paub thiab tshem tawm tau, kev kho etiological tau ua, suav nrog kev kho phais;
- Cov tsos mob ntawm cov kua tsib stasis hauv cov neeg laus uas tsis paub qhov laj thawj yog qhov qhia rau kev kho mob.
Yog tias congestion nyob rau hauv daim siab tsis ua rau o ntawm lub biliary ducts, tus neeg mob tau muab tshuaj raws li ursodeoxycholic acid. Cov tshuaj no yog ib feem ntawm cov kua tsib, muaj hepatoprotective, choleretic thiab choleretic zog. Ntawm cov kev npaj tshuaj ntawm pab pawg no, feem ntau tau sau tseg:
- Ursofalk.
- Cholacid.
- Livodex.
- Ukrliv.
- Ursosan.
- Ursodez.
- Ursochol.
- Choludexan.
Cov tshuaj no tau muab coj los ua tshuaj ntsiav thiab qhov ncauj tshem tawm. Lawv pab txo qis cov roj cholesterol, tiv thaiv nws txoj kev nqus hauv cov hnyuv me thiab, vim li ntawd, txo qis qhov tshwm sim ntawm kev tsim cov pob zeb roj cholesterol. Lub sijhawm ntawm kev kho mob thiab kev noj tshuaj txhua hnub, raws li tus neeg mob lub cev hnyav, suav nrog tus kws kho mob tuaj koom. Cov tshuaj no muaj ntau yam contraindications, tshwj xeeb tshaj yog, lawv tsis pom zoo rau cirrhosis ntawm daim siab, mob cholangitis thiab cholecystitis, cholelithiasis, nrog rau daim siab los yog raum tsis ua hauj lwm.
Rau cov tsos mob ntawm cov kua tsib nyob rau hauv lub gallbladder, kev kho mob suav nrog kev siv tshuaj choleretic:
- Holiver.
- Allohol.
- "Hofitol".
- Cynarix.
- Odeston.
- Heptor.
- Articol.
Feem ntau ntawm lawv ua rau muaj cov kua tsib ntau ntxiv, yog li ntawd, nyob rau hauv cov ntaub ntawv mob hnyav ntawm kab mob siab, mob siab ua haujlwm thiab jaundice, cov tshuaj no tsis siv. Lawv raug sau tseg kom ceev faj rau cov menyuam yaus, vim tias cov tshuaj choleretic tuaj yeem ua rau khaus, cuam tshuam ntawm cov ducts.
Ntxiv rau cov tshuaj, cov tshuaj tshuaj ntsuab tau siv rau hauv kev kho mob cholestasis. Piv txwv li, choleretic collection No. 2 suav nrog cov nroj tsuag tshuaj xws li immortelle, yarrow, peppermint,coriander noob. Cov menyuam yaus feem ntau tau sau npe sau npe 3, suav nrog calendula paj, tansy, chamomile thiab mint nplooj. Haus decoction yog npaj los ntawm phytocollection: qhov nruab nrab, 1 tbsp yog xav tau rau 1 khob dej npau. l. tshuaj raw khoom. Cov sib tov yog muab tso rau ntawm hluav taws thiab boil rau txog 10 feeb, tom qab uas nws yog insisted rau 30 feeb, lim thiab qaug cawv ua ntej noj mov thaum sawv ntxov thiab yav tsaus ntuj, 100 ml txhua.
Rose hips muaj cov khoom zoo sib xws: koj tuaj yeem npaj cov dej haus los ntawm cov txiv hmab txiv ntoo qhuav ntawm cov roses hauv tsev, thiab rau cov neeg uas tsis xav thab plaub, koj tuaj yeem yuav nws ntawm Holosas lub tsev muag tshuaj. Cov neeg laus yuav tsum tau noj cov tshuaj ntawm lub plab khoob, ib diav khoom qab zib ib hnub ib zaug, thiab cov menyuam yaus - ntawm tib zaus, tab sis ib nrab li ntau.
Kev phais rau cov kua tsib stasis
Yog tias kev kho tshuaj tsis tuaj yeem tshwm sim, tus neeg mob yuav raug txiav txim. Raws li qhov ua rau cholestasis thiab qhov chaw ntawm cov kua tsib stasis, cov neeg mob tau ua haujlwm hauv qab no:
- tshem tawm cov pob zeb thiab cov lej ntawm cov ducts cov kua tsib siv lub laparoscope (endoscopic lithoextraction);
- tshem tawm ntawm cystic lossis mob qog noj ntshav uas tiv thaiv kev tawm ntawm cov kua tsib;
- stenting ntawm biliary tract;
- dilatation (expansion nrog balloons) ntawm lub lumen ntawm cov ducts;
- kev txhim kho cov kua dej hauv cov kav dej ntau;
- kho qhov ua haujlwm ntawm cov sphincters ntawm lub gallbladder;
- cholecystectomy.
Cov tsos mob ntawm cov kua tsib tom qab tshem tawm ntawm lub gallbladder feem ntau rov qab los, yog licholecystectomy yog txoj kev kho mob tshaj plaws, uas yog siv rau hauv cov neeg mob siab heev. Tus me nyuam mos uas muaj cov kua tsib stasis vim yog biliary atresia yuav tsum tau hloov daim siab.
kev kho neeg zoo
Lwm txoj kev kho mob rau cholestasis muaj ntau yam sib txawv. Ntxiv nrog rau kev noj tshuaj, ntau tus kws kho mob pom zoo kom ua tib zoo kho nrog cov tshuaj pej xeem. Feem ntau ntawm cov zaub mov txawv tau tiv nrog cov tsos mob ntawm cov kua tsib stasis yam tsis muaj teeb meem ntau:
- kua txiv tshiab. Hauv tsev, rau 1-2 lub hlis, koj yuav tsum haus 100-150 ml ntawm cov kua txiv hmab txiv ntoo sib xyaw ua ke ntawm cov txiv apples, beets, carrots. Cov kua txiv yuav tsum tau noj ib teev tom qab noj mov.
- Kua cider vinegar. Ib tablespoon ntawm cov khoom no yog ntxiv rau ib khob dej. Lawv haus cov dej uas tsis muaj suab thaj, thiab yog tias koj xav kom qab zib, koj tuaj yeem muab ib teaspoon ntawm zib mu.
- Niam. Rau 10-14 hnub, nws yog ib qhov tsim nyog los haus cov ntsiav tshuaj mummy yaj hauv dej. Rau ib nrab ib liter dej, 0.2 g ntawm mummy yog siv. Cov tshuaj yog qaug cawv ua ntej noj mov hauv ob peb koob tshuaj txhua hnub. Cov chav kawm dav dav ntawm kev kho lub siab rau cov tsos mob ntawm cov kua tsib stasis yog tsawg kawg peb lub hlis. Hauv qhov no, tom qab ob lub lis piam ntawm kev siv, nws yog ib qho tsim nyog yuav tsum tau so 5-7 hnub. Ua ntej siv cov tshuaj no, koj yuav tsum tham nrog kws kho mob, vim tias shilajit nrog cov khoom noj no tuaj yeem ua rau raws plab thiab nce ntshav siab.
Nrog cholestasis, cov neeg mob feem ntau qhia kom noj persimmons - cov txiv hmab txiv ntoo no muaj vitamin C, beta-carotene thiabmanganese, uas yog superoxide dismutase cofactor thiab koom nrog hauv gluconeogenesis ntawm amino acids thiab roj cholesterol. Tsis tas li ntawd, persimmon muaj ntau cov enzymes antioxidant uas ua rau muaj kev tiv thaiv ntawm mucous daim nyias nyias. Tsis muaj tsawg zaus, nrog stagnation ntawm cov kua tsib, nws pom zoo kom siv pomegranate. Tab sis tib lub sijhawm, peb yuav tsum tsis txhob hnov qab tias, nrog rau cov khoom siv choleretic, nws muaj cov nyhuv nrawm thiab pab txhawb kev loj hlob ntawm cem quav.
Rau cov neeg mob uas muaj cholestasis, tshuaj ntsuab hauv tsev decoctions, uas tau siv ntev los kho cov kab mob hepatobiliary, yuav pab tau. Cov no suav nrog cov nroj tsuag hauv qab no:
- smoke;
- sandy immortelle;
- peb nplooj saib;
- pob kws silk;
- knotweed;
- grynnik liab qab;
- alpine arnica.
Basic of noj haus
Thaum cov kua tsib stasis, kev noj haus yog qhov yuav tsum tau ntsuas kev kho mob. Yog tias tsis muaj kev txwv kev noj haus, uas tau piav qhia meej hauv "Table No. 5" kev noj zaub mov, cov tshuaj thiab cov tshuaj pej xeem yuav tsis muab qhov kev xav tau ntawm kev kho mob. Nws yog ib qho tsim nyog yuav tau hloov kho cov khoom noj txhua hnub tam sim tom qab kev kuaj mob tau tsim. Lub hauv paus ntsiab lus ntawm kev noj haus rau cholestasis yog qhov xav tau:
- Tsis txhob noj cov zaub mov muaj roj, tshwj xeeb tshaj yog cov khoom tsiaj, suav nrog nqaij npuas, yaj, butter, tag nrho nyuj cov mis nyuj, qaub cream, nplua nuj broths.
- Tsis kam noj cov kaus poom thiab cov khoom noj qab zib (cov hnyuv ntxwm, cov nqaij haus luam yeeb, pickles,Cov khoom ua tiav, khoom noj txom ncauj, thiab lwm yam).
- Txo kev noj cov hmoov nplej thiab khoom qab zib.
Kev noj zaub mov ntawm tus neeg mob uas muaj cov kua tsib stasis yuav tsum muaj cov zaub tshiab thiab txiv hmab txiv ntoo (kev kho cua sov yog tso cai rau cov kab mob hauv plab), nqaij ntshiv, ntses, nqaij nruab deg, legumes. Txhawm rau ntxiv cov rog, nws yog qhov tsim nyog siv walnuts, almonds, flaxseed, taub dag noob. Rau ib sab phaj, tus neeg muaj cholestasis yog qhov zoo dua los noj mov xim av, buckwheat, oatmeal lossis barley porridge.
