Acalculous chronic cholecystitis yog ib qho mob ntawm lub gallbladder yam tsis muaj cov pob zeb tsim. Daim ntawv no ua rau mob nyob rau hauv txoj cai hypochondrium thiab dyspeptic mob.
Nyob rau hauv thaj tsam ntawm gastroenterology, cov kab mob ntev li ntawm 5 txog 10% ntawm cov neeg mob. Hauv cov poj niam, mob cholecystitis ntev tshwm sim li 4 zaug ntau zaus. Cov ntawd yog cov txheeb cais. Qee cov kws tshawb fawb tau txheeb xyuas cov kab mob cholecystitis ntev li ib qho kev hloov pauv ntawm cov kab mob xws li cov roj cholesterol calculosis. Tab sis, raws li kev kho mob tau qhia, cov neeg mob yuav tsis muaj kab mob gallstone yav tom ntej.
Ua rau kab mob
Tus etiology ntawm tus kab mob no yog ntau yam kab mob:
- E. coli;
- enterococcus;
- staph;
- proteus;
- mixed flora.
Kev nkag mus ntawm cov kab mob mus rau hauv lub gallbladder los ntawm txoj hnyuv tshwm sim nyob rau hauv tej yam kev mob xws li:
- dysbacteriosis;
- colitis;
- enteritis;
- kab mob siab;
- Ypancreatitis.
Tsis tshua muaj, kis tau los ntawm cov qog ntshav lossis ntshav los ntawm cov kab mob nyob deb foci.
Piv txwv li, tus kab mob kis tau los ntawm cov kab mob xws li:
- kab mob periodontal;
- mob tonsillitis;
- mob plab;
- pneumonia;
- pyelitis;
- adnexitis.
Cov laj thawj uas ua rau muaj cov txheej txheem sib kis muaj xws li:
- cholestasis;
- biliary dyskinesia;
- ntxiav los ntawm cov kab mob xws li giardia, roundworm, amoeba;
- sphincter tsis ua haujlwm;
- obesity;
- dysmenorrhea;
- lub cev tsis ua haujlwm;
- malnutrition;
- mob siab, thiab lwm yam.
Acalculous cholecystitis ntev cuam tshuam nrog thickening thiab deformity ntawm lub gallbladder. Lub mucous daim nyias nyias tau txais cov qauv mesh vim qhov tseeb tias thaj chaw atrophic alternate nrog polyps uas tsim tuab folds.
Muaj cov leeg nqaij tawv. Nws zoo nkaus li caws pliav fibers. Nrog rau qhov tshwm sim ntawm cov txheej txheem inflammatory, pericholecystitis tuaj yeem tsim, adhesions nrog cov kab mob nyob sib ze, abscesses, pseudodiverticula tuaj yeem tshwm sim.
Kev faib kab mob
Kev swb yog ib qho yooj yim, nruab nrab thiab nyuaj. Tus kab mob muaj peb theem:
- kev nyuaj siab;
- kev zam txim thiab tsis ruaj khov.
Acalculous cholecystitis ntev tuaj yeem tshwm sim nrog rov ua dua. Kujtus kab mob no monotonous thiab intermittent.
Nyob ntawm qhov kev puas tsuaj, nws yog ib txwm ua kom paub qhov txawv ntawm cov ntaub ntawv nyuaj thiab tsis sib xws ntawm cov kab mob cholecystitis ntev uas tsis suav nrog. Nws kuj yog ib txwm ua kom paub qhov txawv ntawm cov hom thiab atypical hom. Daim ntawv tom kawg yog muab faib ua cov hnyuv, cardialgic thiab esophagalgic hom.
Cov tsos mob ntawm tus mob cholecystitis ntev tshwm sim lawv tus kheej txawv nyob ntawm seb qhov kev puas tsuaj rau lub gallbladder.
Tus kab mob tshwm sim nws tus kheej li cas?
Rau tus mob cholecystitis me, luv exacerbations yog yam ntxwv, kav ntev li 2-3 hnub. Lawv feem ntau tshwm sim los ntawm kev noj zaub mov tsis zoo thiab tshem tawm tau yooj yim nrog kev noj zaub mov kom raug.
Txoj kev mob ntawm lub cev yog qhov qub, lub cev kub yog qhov qub. Kev kuaj xyuas tsis qhia txog kev ua haujlwm tsis zoo ntawm daim siab, gallbladder thiab pancreas. Cov kev tshawb fawb microscopic ntawm cov kua tsib tsis pom muaj qhov txawv txav.
Daim ntawv nruab nrab mus li cas?
Nrog rau qhov nruab nrab ntawm cov kab mob xws li mob cholecystitis, kev tso tawm thiab exacerbation ua raws ib leeg. Lub sij hawm ntawm exacerbations yog 2-3 lub lis piam. Feem ntau tus neeg mob txhawj xeeb txog qhov mob thiab mob hnyav dyspeptic. Raws li txoj cai, tus mob no yog tshwm sim los ntawm kev noj cov zaub mov rog lossis overeating. Qee qhov xwm txheej, kev kis tus kab mob ua pa ua rau ua rau muaj kev ua rau muaj kev mob hnyav.
mob acalculous cholecystitis ua li cas rau qhov no?Cov tsos mob muaj ntau yam. Thaum lub sij hawm exacerbation, cov neeg mob tsis qab los noj mov, lub cev qhov hnyav poob, intoxication tshwm sim, uas yog qhia nyob rau hauv asthenia thiab migraine. Kev mob pob qij txha kuj yuav thab.
Qee tus neeg mob, ntxiv rau qhov mob ntawm txoj cai hypochondrium, tuaj yeem yws ntawm qhov mob npub ntawm sab laug hypochondrium thiab lub plab mog. Mob feem ntau radiates rau lub plawv. Cov neeg mob mob xeev siab, cem quav lossis raws plab.
Hauv kev tshawb fawb txog cov kua tsib, qhov nce ntawm cov hnoos qeev, leukocytes, roj cholesterol, Ca bilirubinate, kua ntsev, thiab qee zaum microliths tau sau tseg. Nws tseem tuaj yeem kuaj xyuas microflora.
Nyob rau hauv ib qho mob hnyav, cov neeg mob pom qhov hloov pauv hauv kev kuaj mob siab. Feem ntau muaj mob me me hypoalbuminemia, nce me ntsis hauv kev ua haujlwm transaminase, feem ntau yog AJIT, nce nruab nrab ntawm thymol test thiab alkaline phosphatase kev ua haujlwm.
Cov txiaj ntsig hauv lub siab ua haujlwm zoo li qub thaum tso tawm. Tus neeg mob tuaj yeem cuam tshuam los ntawm kev hnov mob hnyav hauv plab plab thiab tsam plab tom qab noj mov. Feem ntau ib tug neeg raug cem quav lossis raws plab.
Dyspeptic manifestations yog aggravated los ntawm kev noj cov zaub mov muaj roj los yog coarse fiber. Cov zaub mov zoo li no tuaj yeem ua rau muaj tus kab mob hnyav dua.
daim ntawv loj zuj zus li cas?
Tus mob cholecystitis mob hnyav yog qhov tshwm sim los ntawm chav kawm nrog kev rov ua haujlwm tas li yam tsis muaj kev tso cai. Tus kab mob kis dhau ntawm lub gallbladder. Kab mob siab ntev thiab mob pancreatitis koom nrog tus kab mob tseem ceeb.
Cov neeg mob yws tias tsis qab los noj mov, xeev siab tsis tu ncua, hnyav hauv plab plab. Qee zaum qhov mob yog excruciating nyob rau hauv cov xwm. Cov neeg mob tau pom zoo noj cov zaub mov nruj, uas ua rau poob phaus thiab asthenia. Qee zaum, sepsis tshwm nyob rau hauv daim ntawv mob ntev.
Lub luag haujlwm ntawm lub zais zis yog qhov tsis zoo. Lub cev phab ntsa thickens. Yog tias, nrog rau theem nrab, kev ua haujlwm ntawm daim siab ua haujlwm tsis zoo, tom qab ntawd nrog cov kab mob hnyav, kab mob siab mob siab rau hauv daim ntawv ntev lossis cholangitis feem ntau tshwm sim nws tus kheej.
Cov txheej txheem hauv qab no tshwm sim:
- daim siab loj;
- txo cov ntshav albumin;
- globulin feem thiab qhov concentration ntawm tag nrho bilirubin nce.
Thaum kuaj ultrasound ntawm lub plab plab, muaj qhov nthuav dav ntawm lub gallbladder ducts, "stagnant" gallbladder, mob pancreatitis nrog kev ua haujlwm ntawm cov txiav txiav.
Cov neeg mob feem ntau yws ntawm cov kab mob dyspeptic, xeev siab, poob phaus. Lawv tau nce fecal ntim, steatorrhea, creatorrhea, thiab amylorrhea.
Nyob rau hauv daim ntawv mob hnyav, kev ua haujlwm ntawm cov hlab ntsha thiab lub plawv cuam tshuam, vegetovascular dystonia tshwm, coronary insufficiency nrog cov kev hloov pauv hauv ECG.
daim ntawv atypical ua li cas?
Daim ntawv atypical yog dab tsiChronic acalculous cholecystitis? Tus neeg mob txhawj xeeb txog qhov kub siab tas li, hnyav, mob hauv siab, ntuav dysphagia. Nrog rau hom plab hnyuv, mob hauv plab hnyuv, tsam plab, thiab cem quav tuaj ua ntej.
Thaum me nyuam yaus, mob cholecystitis ntev zoo ib yam li latent rheumatism. Cov neeg mob yws ntawm asthenia, mob hauv pob qij txha. Auscultation nthuav tawm lub suab qis lub plawv.
Cov kab mob atypical ntawm tus kab mob suav nrog lumbar thiab pyloric-densal hom cholecystitis ntev. Nyob rau hauv daim ntawv lumbar, cov neeg mob muaj mob nyob rau hauv tus txha nraub qaum. Nyob rau hauv tas li ntawd, ib tug x-ray ntawm tus txha caj qaum yog qhia.
Symptomatics of the cardialgic form
Daim ntawv ntawm tus kab mob no yog tus yam ntxwv ntawm arrhythmia (extrasystole) lossis mob hauv siab. ECG kuj hloov.
Hauv cov hnub nyoog nruab nrab thiab laus, daim ntawv plawv zoo ib yam li angina pectoris lossis coronary insufficiency, uas tshwm sim nyob rau hauv daim ntawv ntev. Cov neeg mob yws ntawm qhov mob hauv lub plawv, tachycardia.
Gastroduodenal form
Lub tsev kho mob cholecystitis nyob rau hauv cov ntaub ntawv no zoo ib yam li peptic rwj los yog gastroduodenitis nrog nce qib ntawm kev tsim ntawm gastric acid. Cov neeg mob yws tias mob plab thaum hmo ntuj.
Txoj kev kuaj mob
Ntawm palpation ntawm lub plab nyob rau hauv qhov chaw ntawm lub gallbladder, mob yog sau tseg, uas nce nrog inhalation los yog tapping ntawm txoj cai costal arch.
Nyob rau hauv kev kawm hauv chav kuaj, qhov ntsuas tau nce ntxiv yog txiav txim siab:
- transaminase;
- alkaline phosphatase;
- Yγ-glutamyl transpeptidases.
txoj kev kuaj mob tseem ceeb heev suav nrog:
- ultrasound;
- cholecystography;
- celiacography;
- cholescintigraphy;
- duodenal suab.
Raws li txoj kev tshawb fawb tshiab, peb tuaj yeem tham txog qhov kev siv ntawm cov txheej txheem inflammatory.
Cov kev hloov pauv ntawm qib macroscopic tau tshwm sim hauv cov kua tsib, nrog rau muaj cov flakes thiab mucus.
Kev tshuaj xyuas microscopic qhia tau tias muaj pes tsawg tus leukocytes, bilirubin, protein, cholesterol, thiab lwm yam.
Thaum bacteriological noob ntawm cov kua tsib, nws cov kab mob microbial raug tshuaj xyuas.
Nrog kev pab ntawm cholecystography hauv cov neeg mob uas muaj kev mob ntev ntawm acalculous cholecystitis, lub cev muaj zog thiab kev ua haujlwm siab ntawm lub gallbladder, nws cov contours thiab txoj hauj lwm raug soj ntsuam.
Echography qhia txog kev deformation ntawm lub gallbladder, cov txheej txheem atrophic hauv nws cov phab ntsa, qhov tsis sib xws ntawm sab hauv epithelium, muaj cov ntsiab lus inhomogeneous nrog kev suav nrog cov kua tsib ntawm qhov sib xws.
Kev kuaj mob sib txawv yog ua tiav nrog biliary dyskinesia, chronic cholangitis, ulcerative colitis ntawm qhov tsis tshwj xeeb, thiab Crohn tus kab mob.
Txoj Kev Kho Mob
mob acalculous cholecystitis kho li cas? Kev kho mob feem ntau yog kev saib xyuas. Cov kws kho mob pom zoo kom ua raws li kev noj haus. Nws raug nquahu kom tsis suav cov khoom noj rog thiab kib, ntsim tais diav, dej qab zib thiab dej cawv los ntawm kev noj haus.
rau mob plabNws raug pom zoo kom noj cov tshuaj antispasmodics xws li "Platifillin", "Drotaverin", "Papaverin" thiab lwm yam.
Yog tias muaj tus kab mob hnyav dua lossis ua ke nrog cholangitis, kev kho cov kab mob tua kab mob nrog Cefazolin, Amoxicillin, Erythromycin, Ampicillin, Furazolidone, thiab lwm yam.
Txhawm rau ua haujlwm ntawm lub plab zom mov, nws raug qhia kom noj "Festal", "Mezim-forte", "Pancreatin"
Txhawm rau kom tso cov kua tsib, lawv feem ntau siv cov tshuaj choleretics ("Allochol", "Holenzim", "Oxaphenamide").
Magnesium sulfate thiab sorbitol yog siv los txhawb lub gallbladder contraction.
Thaum lub sij hawm exacerbation los yog remission, nws yog advisable mus ua ib tug chav kawm ntawm tshuaj ntsuab kho mob. Decoctions ntawm chamomile, calendula, rosehip, licorice, mint tau txais.
Nyob lub sij hawm ntawm kev zam txim, tubage yog nqa tawm, dej ntxhia yog qaug dej qaug cawv, qoj ib ce kho mob.
Surgery
Thaum muaj kev cuam tshuam kev phais, cov keeb kwm kho mob tau muab rau hauv tus account. Chronic acalculous cholecystitis, uas yog qhia nyob rau hauv lub deformation ntawm cov phab ntsa ntawm lub gallbladder thiab uncorrected cholangitis thiab pancreatitis, yuav tsum tau phais.
Hauv qhov no, cholecystectomy yog ua los ntawm kev qhib kev cuam tshuam, laparoscopy lossis mini-access.
Siv cov txheej txheem pej xeem
Yuav ua li cas ntxivCov kab mob acalculous cholecystitis puas raug tshem tawm? Kev kho mob pej xeem kuj muaj txiaj ntsig zoo.
Cov hauv paus hniav ntawm calamus, valerian, qhuav inflorescences ntawm St. John's wort, calendula, nettle, pob kws, flax noob yog siv. Nws kuj tseem pom zoo kom siv linden, peppermint, motherwort, chamomile, dill, horsetail, qus sawv.
Thaum siv cov txheej txheem pej xeem hauv cov kab mob ntev, phytotherapy yog ntxiv rau cov paj ntawm immortelle thiab elderberry.
Phytotherapy
Phytotherapy suav nrog kev siv cov dej cawv ntawm cov tshuaj hauv qab no:
- peony - 20 ml;
- valerian - 20 ml;
- hawthorn - 20 ml;
- mint - 20 ml;
- Bella Beauty - 10 ml;
- Ymotherwort - 20 ml;
- calendula - 30 ml;
- wormwood - 20 ml.
Nyob rau hauv lub xub ntiag ntawm glaucoma, belladonna tsis ntxiv.
Haus cov tshuaj yuav tsum yog 1-8 tee peb zaug hauv ib hnub tsib feeb ua ntej noj tshuaj ntsuab rau 1 tbsp. l dej rau 4-6 lub lis piam. Kev sib xyaw ntawm calamus thiab elecampane tinctures yog noj hauv qhov sib npaug. Kuj tseem haus 1-8 tee peb zaug ib hnub ob feeb ua ntej noj cov tshuaj ntsuab rau 1 tbsp. l. dej rau 4-6 lub lis piam.
Nws yuav tsum nco ntsoov tias kev sau cov tshuaj phytotherapeutic txuas nrog ntawm koob tshuaj 0.00325, piv txwv li 14th dilution, thiab nce txhua hnub los ntawm 1-2 dilutions kom txog thaum cov koob tshuaj zoo tshaj plaws.
Ib koob tshuaj tsim nyog yog ib qho uas tsis ua rau mob dyspeptic, tab sis txo qis qhov kev tshwm sim tam sim no. Xws li koobnoj thaum lub sij hawm kawm, tab sis yog tias muaj kev tsis xis nyob, ces nws raug txo los ntawm 1-2 units.
Huab cua
Dab tsi yog qhov tshwm sim ntawm tus kab mob xws li mob acalculous cholecystitis? Ib qho exacerbation nyob rau hauv ib daim ntawv me yog tsawg. Tus kab mob no muaj kev kawm zoo. Ib qho kev mob tshwm sim tuaj yeem tshwm sim yog tias qhov tshwm sim tshwm sim ntau zaus nrog qhov mob hnyav ntawm tus kab mob.
Kev Tiv Thaiv
Kev tiv thaiv kev ntsuas tau xaus rau hauv kev kho mob raws sijhawm, kev kho mob ntawm foci ntawm tus kab mob, tshem tawm cov teeb meem hauv lub paj hlwb, nrog rau kev kho cov metabolism hauv ib txwm muaj. Koj yuav tsum ua raws li kev noj zaub mov kom raug, tiv thaiv kab mob plab hnyuv thiab kab mob helminthic.
