Ngokukhawuleza kwaye ngokukhawuleza ukuphuphuma kwe-gallbladder kuthiwa yi-acle cholecystitis. Esi sifo, esiye saqala okokuqala, siphela ngokubuyisela ngokupheleleyo kunye nokwanela unyango. Xa ukuphinda kugxininiswe kuphinda kulandeleke, isifo esingapheliyo sesifo sifumaneka. Xa uneminyaka yobudala, amathuba okufumana i-cholecystitis yanda, amaninzi amagciwane ayachaphazeleka ngabasetyhini kunamadoda. Endaweni yengozini - abafazi abakhulelweyo, ukuthatha izidakamizwa ze-hormone kunye nabantu abagqithiseleyo.
I-cholecystitis echukumisayo-izizathu
Ukugqabhuka ngokugqithiseleyo kwe-gallbladder kubonakaliswe ukunyakaza okungahambi kakuhle emzimbeni we-bile ngenxa yokukhutshwa kwe-outflow. Kwiimeko ezininzi, ukuphuhliswa kwezilwanyana kudibaniswa nobukho bamatye (kufika kwi-95% yezifo), kwaye kwi-60% yezigulane kukho ukusuleleka kwe-bacterial: E. coli, cocci, salmonella nge-bile. Izinto ezinokubangela izinto ezahlukeneyo zingabangela i-cholecystitis, izimbangela zesifo zibizwa ngokuba zilandelayo:
- isifo, isityalo se-bacteria nge-bile;
- i-sclerosis yeendonga zebladder okanye i-atrophy;
- ikink yelungu kunye nokuphuma kwe-bile;
- Ukutshintsha iindonga zesikhumba ngenxa yobudala;
- ijusi ye-pancreatic kwi-bladder, ukukhutshwa kwe-enzyme ye-pancreatic;
- ukungondleki - okunamanci, ukutya okunesonka kunye nokutya okuninzi;
- ukucinywa kwe-bile duct okanye umonakalo kwiindonga ngokuzimelela okuqinileyo.
Cholecystitis engenakho
Ngokuxhomekeke kubukho bamatye - i-calculi-inflammation ye-gallbladder ikwahlukana ngokubala (ngamatye) kwaye ayinakubalwa. Intsholongwane yokugqibela yinto engabonakaliyo. Njengomthetho, beskamenny cholecystitis inesimo esingapheliyo, kwaye ukuba siyinto eqhelekileyo, inxulumene nokungena kwe-pathogen ngqo kwi-gallbladder ngexesha lezinto ezivuthayo emathunjini. Ukukhubazeka kubangelwa zizinto ezifana:
- usulelo lwegciwane lomzimba;
- ubukho beebhaktheriya;
- yesifo sesifo;
- E. coli ;
- staphylococcus, i-enterococcus;
- Proteus.
Calculous cholecystitis
Ngenxa yokungalingani kwemikhemikhali emzimbeni kwintlambo kunye neendleko zalo, iifom ezomeleleyo zenziwe ngamatye. Bakhamaza i-bile ducts, kubangela intlungu, ukungahambi kakuhle, ukuvuvukala nokukhupha i-cholecystitis. Iimbangela ze-cholelithiasis, ezikhokelela ekuziphatheni kwe-bladder:
- u bunzima;
- iingxaki ezivela ekulahlekeni kwindleko ngokukhawuleza;
- ukufumana imithi yokukhulelwa komlomo;
- isifo sikashukela ;
- ubudala;
- Ukusetyenziswa kwezidakamizwa ezinciphisa izinga le-cholesterol egazini, njl.
I-cholecystitis ephawulekayo - iimpawu
Njengomthetho, i-cholecystitis ephawulekayo ibonakaliswa emva kokuthatha ukutya okunobungozi, ukufumana uxinzelelo okanye ukuthatha utywala. Umzimba uphendukela ngokukhawuleza kwizinto ezimbi. Uxinzelelo oluncitshisiweyo, ucolic, ukuhlanza, ukubetha kunye nezinye iimpawu, uxela ukuba ukuvutha kwe-gallbladder sele kuqalile, iimpawu zazo ezinzima ukuzijongela. Ubunzima beempawu kuxhomekeke kwisigaba sesifo. Iimpawu ezicacileyo ze-cholecystitis, ukuluhlula kwezinye izifo kunye nokunceda ukuxilonga i-pathology:
- Ukuba ucinezela kummandla phakathi kwemilenze yesisu se-sternocleidomastoid, intlungu ibonakala.
- Ngentlungu enzulu, isigulane asikwazi ukukhupha.
- Ngexesha lokubethelwa kwendawo efanelekileyo ye-subcostal, intlungu yokuphuza.
- Kukho ukukhupha okukhuselekileyo kwezidumbu zesisu.
- Ukuxhalaba ngexesha lokubetha umgca wesigqabi sesundu se-arch ebiza iindleko ukusuka kwicala lasekunene (indawo yesikhumba).
Izikhalazo ze-cholecystitis
Xa kwenzeka imeko yesifo, isigulane sivakalelwa. Phakathi kweempawu ezingenakukhathazeka zikhalazo: ukukrakra emlonyeni, isisongela, ukuhlanza kunye nokuxutywa kwe-bile, emva koko akukho ncedo. Izitofu ezinokusetyenziswa kwamanzi kunye ne-cholecystitis ephawulekayo, ukubonakala kwe-jaundice kunye nokwanda kwe-gallbladder, ukwanda kweqondo lokushisa komzimba (kufika kuma-40 degrees). Kodwa isikhalazo esibaluleke kakhulu kunye neempawu eziphambili ze-cholecystitis azidluli intlungu.
Umntu kunye nommandla weentlungu kwi-cholecystitis
Isifo siqala ngokuhlaselwa okubukhali. Iintlungu nge-cholecystitis ephawulekayo zenzeka, njengommiselo, kwindawo efanelekileyo ye-hypochondrium, ingavela kwi-epigastrium. Imvakalelo engathandekiyo ixesha elide lingadluli, irradiate phezulu kwi-scapula kunye nephepha elifanelekileyo, entanyeni, kwindawo engaphezulu, emva. Ubuhlungu buphefumlelwe ngamanzi:
- kuvuka ebusuku okanye kusasa;
- zomelele, kodwa ziyeke emva kwexesha (ukususela kumashumi amathathu ukuya kwimizuzu engama-60);
- ukuhlaselwa kunzima kumntu, unyanzelekile ukuba athathe indawo engakhululekiyo, athathe imilenze kwisisu sakhe kwaye uzame ukufudumala indawo evukelekileyo.
Iyintoni ingozi ye-cholecystitis?
Ukuhlaselwa kwe-acle cholecystitis ihlala ihlala iintsuku eziliqela, kodwa izifo kunye ne-sepsis zingabangela iingxaki. Ngamanye amaxesha ngethuba lokuphuhliswa kwesi sifo, ukugqithiswa kwodonga lwebladder kwenzeka. Ngenxa yoko, kukho ukuvuvukala okanye i-fistula enomdla. Ukuxilongwa kwe-pathology, kwenziwa ngexesha elingafanelekanga, ukungabi nonyango olufanelekileyo kwandisa amathuba okuba iingxaki ze-cholecystitis ziya kukhula. Ezizona ziqhelekileyo zazo zi:
- i-pancreatitis - ukuvuvukala kwe-pancreas;
- I-Cholangitis - i-pathology ye-bile duct;
- i-abscess caulinian;
- i-empyema (i-suppuration), i-gangrene okanye i-perforation ye gallbladder;
- i-fistula yebhiliyari;
- i-purulent diffuse peritonitis;
- jaundice.
I-cholecystitis echanekileyo - ukuxilongwa
Izigulane zonyango ngeentlungu ezinzima kumgqirha emva kweempawu eziqakathekileyo ze-cholecystitis, njengomthetho, zibhedlele, zifakwe esibhedlele. Oku kubangelwa ukufana kweklinikhi yempawu nge-appendicitis. Isibhedlele senza ukuxilongwa ngokuhlukileyo kwe-cholecystitis. Isiphumo sitholakala emva koluhlu lweengxelo zophando, olubandakanya iindlela zelabhoratri kunye nezixhobo. Ukuxilonga akunzima kwaye kubandakanya:
- ukuhlalutya kwegazi (ngokubanzi), ukutyhila ubukho bokuvuvukala;
- vavanyo lwegazi;
- I-ultrasound yesisu esiswini, evumela ukuhlola i-gallbladder, umthamo wayo;
- urinalysis;
- Uhlolojikelelo lwezobugcisa - ngokukrokrelwa kwe-peritonitis.
I-cholecystitis eyiyo-unyango
Ukuba i-cholecystitis ephawulekayo ifunyenwe, unyango lubandakanya ukulaliswa kwezibhedlele ngokukhawuleza kunye nangoko (kwiinyanga zokuqala ezingama-24 ukuya ku -8) ukuphuma kwintetho yesisu. Kule nto, ityhubhu yecasogastric isetyenziswa. Isigulane siboniswa ukuphumla kwebhedlele. Kwiintsuku eziliqela unqatshelwe ukutya, ama-fluid ayajongwa emzimbeni ngaphakathi. Ngaloo nto, amayeza anqunywe. Emva koko, isigulane sidluliselwa kwisondlo njengenye yezindlela eziphambili zonyango. I-regimen yokutya echanekileyo ikhuthaza ukuphuma kakuhle kwe-bile.
I-cholecystitis eyingozi iyingozi
I-cholecystitis eyiyo, iimpawu kunye nokunyangwa kwazo ezimiselwe ngoncedo logqirha, kufuneka zibonwe esibhedlele. Kodwa akusiyo wonke umntu osebenzayo ngoncedo lwezokwelapha kwisibonakaliso sokuqala se-pathology, ukhetha ukuhlala ekhaya iintsuku ezimbalwa zokuqala. Oku kubangele iingxaki. Ukunyangwa kwangaphambili kwezokwelapha kwi-cholecystitis kubalulekile ukubonelela. Isigulane akufanele sitshise indawo evuliwe, uthathe ibhedi eshushu, uphuze i-painkillers yedwa. Uncedo olungxamisekileyo kufuneka lujoliswe ekuboneleleni umntu uxolo kwengqondo ngaphambi kokufika kwamagqirha. Kubalulekile:
- ukumnika isikhundla esiphakamileyo;
- ukukhusela ekuxinekeni (ngokomzwelo nangokwenyama);
- ukunciphisa iziganeko zesicongconi, kunika i-decoction ye-mint;
- ukubeka ubanda kwi-hypochondrium efanelekileyo, kodwa engadluli kwemizuzu engama-15.
I-cholecystitis eyiyo-iingcebiso zeklinikhi
I-cholecystitis echanekileyo yingozi yokugula, kodwa xa ifunyanwa ngexesha, inyango ekhuselekileyo inokwenzeka. Xa ukuvuvukala kwe-gallbladder kufunyaniswa kubantwana, ukusetyenziswa kweziyobisi kungekhona ukusetyenziswa. Iquka ukutya, ukuzivocavoca umzimba okhethekileyo, uhlale kwindawo yokuhlengahlengisa ukubuyiswa komzimba. Ngokukhethekileyo luncedo ukuhlala kwiindawo zokuhlala zamanzi amaminerali. Kwiimeko ezinzima, unyango lubandakanya ukuthatha amayeza, kungenokwenzeka ukuba ungenelelo lotyando. Unyango luyenziwa kwinqanaba lokugula.
I-cholecystitis eyiyo-iziyobisi
Ukusetyenziswa kweziyobisi kunyango lwe-pathology kuboniswe kwiimeko ezahlukeneyo-xa isifo sisekuqaleni kwexesha, umzekelo, amatye akhoyo kwi-bladder, kodwa angabangeli ukuphazamiseka okukhulu, kwaye xa kukho iingxaki. Olunye unyango luxhomekeke kubunzima bokuvuvukala kunye nomqathango jikelele wesigulane. Ngoncedo lwamachiza, oogqirha bazama ukususa ukuvuvukala, ukucwangcisa ukubunjwa kwe-bile nokuqinisekisa ukuphuma kwayo. Ukusetyenziswa kweziyobisi kuthetha ukuba:
- Izidakamizwa ze-Spasmolytic ngosuku lokuqala lokuhlaselwa ukukhupha intlungu (Papaverin, No-Shpa, iDedrol).
- I-antibiotiki ye-cholecystitis (i-Ampicillin, iTetracycline, i-Cephzoline). Zingathatyathwa yi- sulfanilamide ukuba owokuqala awunakunyamezelwa ngumguli (uSulfazin, Ftalazol, Sulgin). Zinefuthe le-antimicrobial.
- Ukuxilongwa komzimba kunye neziyobisi. Ngethuba lokuqala lokuhlala esibhedlele, iindlela zokungeniswa ziqaliswa (i-plasma, i-Dextran, isisombululo seRinger, i-Reopoliglyukin).
- I-cholagogue, isityalo kunye nokwenziwa (i-Ursoliv, i-Ursosan, i-Febihol, amaqabunga ama-nettle, izimpande ze-burdock, i-artichoke extract).
- Kupirovanie iimpawu zentsholongwane. I-Lithotripsy xa ufumanisa amatye kwi-bladder (ukuchithwa kwabo).
I-cholecystitis eyiyo yintsebenzo
Ngokwezinye izibonakaliso, ukuvuvukala kwe-gallbladder kuqhutywe ngonyango. Ukuphuhliswa kweengxaki kubonisa ukungenelela ngongxamiseko, kwaye kwenziwa ukusebenza xa unyango olucetywayo lungasebenzi. Thintela i-cholecystitis enobucayi obuqatha kwaye uyalibala ngokupheleleyo malunga nayo ingasusa kuphela i-gallbladder. Ukusebenza kwenziwa ngeendlela zemveli ezivulekile kunye ne-laparoscopic. Njengomthetho, ukuba i-cholecystitis i-phlegmonous cholecystitis ifunyaniswa, enye yeentlobo zeentlupheko ezikhokelela kwisibhedlele, isigulane ngokukhawuleza sibeke phezu kwetafula kwigqirha.
Kwi-cholecystitis ekhangayo
Ngethuba lonyango kunye nakwixesha elizayo, isigulane esinama-cholecystitis kufuneka silandele ukutya okukhethekileyo. Ukutya kule meko akugcini nje ukuthintela ukuphuhliswa kwesi sifo, kodwa kunye nendlela ephumelelayo yonyango. Esi sifo esibi, ukutya kunye nokuvutha komsindo kwendoda yesilonda kubonisa indlala epheleleyo (kwiintsuku zokuqala emva kokuhlaselwa). Kuvunyelwe ukusela kuphela i-juice, umhluzi we-dogrose, itiye ngaphandle kweshukela. Emva koko, isigulane sidlula kwinombolo yesibini yokutya - ukutya okuchasayo. Iziphakamiso zilandelayo:
- Ii-carbohydrate zilinganiselwa kuma-200 g ngosuku. Kuthetha ukuthatha i-carbohydrate elula: iigam, ushukela, ujusi, i-jam.
- Isamba seprotheni sinciphisa sibe ngu-80 g. I-Fat ifanayo.
- Umxholo weCalor of ration day is about 1600 kcal. Ukusetyenziswa kwamanzi atyhutyhile ukuya kuma-2.5 ilitha.
- Umgaqo wesondlo esincinci uyabonwa.
- Ukutya kufuneka kulungiswe ngaphandle kwetyuwa.
- Zonke iimveliso zihanjiswe kwifom evuyiweyo: ngendlela ye-purees, isobho, i-soufflé.
Kuluhlu lwezithako ezingavumelekanga:
- imbotyi;
- iklabishi;
- iimveliso zetyuwa;
- amakhowe, kuquka amabhuthi;
- izithelo ezimuncu kunye namajikijolo;
- sausages;
- i-stew;
- i-cottage cheese;
- icocoa.
Isiseko sesondlo kukuba:
- inyama yenkomo nenkukhu;
- intlanzi i sibini;
- isobho;
- abaculi;
- iimveliso zobisi ezivuthayo;
- i-oatmeal, ilayisi, i-porridge yengxowa;
- imifuno;
- i-kisels;
- izithelo ezomileyo.
Ukususela kumnandi kunokwenzeka ukusebenzisa:
- ubusi;
- ushukela;
- i-marshmallow;
- i-marmalade;
- yongeza i-sweeteners yokusela.
Ukuze ungaqhubeki ukuphazamisa i-cholecystitis enzima, kufuneka uhambelane nokutya okunengqiqo kwaye emva kokunyanga. Kwiimeko ezininzi, kunye nokugcinwa kokutya kunye nokunyango lwonyango olulondolozayo, kunokwenzeka ukufezekisa ukuxolelwa. Ukuthatha nayiphi na imithi (i-painkillers, choleretic) kunye nokuvuvukala kwe-gallbladder kufuneka ilawulwe ngugqirha.