Mukati
Cholecystitis inzira yekuzvimba mu gallbladder, kazhinji inotsamwiswa nehutachiona hwenhengo ine intestinal microflora kuseri kwekutyora kwekubuda kwebile kuburikidza neyakavharwa cystic duct. Cholecystitis inowanzova complication ye cholelithiasis. Iyo gallbladder iri pedyo nechiropa uye inoshingaira mubasa rekudya. Bile inobuda nemudumbu mudiki, asi dzimwe nguva kune matambudziko nekubuda uye bile inounganidza mu gallbladder, zvichikonzera kurwadziwa kwakanyanya uye njodzi yakawedzera yehutachiona.
Sezvo mutemo, chirwere chinoitika pamwe chete necholangitis - kuzvimba kwe bile ducts. Cholecystitis inowanzoita chirwere chekuvhiya, kunyanya pakati pevakadzi vezera repakati nepamusoro - vanorwara katatu kusvika kasere kakawanda kupfuura vezera revarume.
Zvikonzero zvikuru zvekufarirwa kwevakadzi kune cholecystitis:
Kugara kudzvinyirira gallbladder panguva yekuzvitakura kunomutsa mhedzisiro yenguva refu - kusaenzana kwecholesterol uye bile acids, uye, semhedzisiro, kudzika kwe bile;
Zvimiro zvehomoni metabolism yevakadzi - zvakaratidzwa kuti progesterone, iyo inobudiswa muhuwandu panguva yekuzvitakura uye kupera, uye mamwe mahomoni echikadzi echikadzi anokanganisa kushanda kwe gallbladder;
Vakadzi vanowanzofarira kudya, uye zvirambidzo zvakakomba zvekudya zvinokanganisa kufamba (contractility) kwegallbladder.
Boka renjodzi, zvisinei nekuti murume kana murume nezera, rinosanganisira vanhu vakambove:
Intestinal uye / kana zvirwere zvechiropa;
Zvirwere zveparasitic (helminthic uye protozoal invasions, nzvimbo yakamira kana pane imwe yematanho ekukura muura uye / kana chiropa);
Chirwere cheGallstone (GSD) nekuvhara (kuvhara) kwemuromo wechibereko uye / kana kukuvadza kune mucous membranes ye gallbladder;
Zvirwere zvinokanganisa kugoverwa kweropa kumadziro e gallbladder.
A reflex connection pakati pepathologies ye gallbladder uye anatomically isina hukama nhengo dzemimba dzakaratidzwa - idzi ndidzo dzinonzi viscero-visceral reflexes. Zvose zviri pamusoro apa zvinokonzera cholecystitis imhaka yekukanganisa patency (kudzivisa) gallbladder, kana kukanganisa kwekufamba kwayo (dyskinesia).
Zvinoenderana neiyo etiological hwaro, mapoka maviri makuru enosological echolecystitis anosiyaniswa:
Calculous (lat. Calculus - dombo);
Noncalculous (isina dombo).
Zviratidzo zve cholecystitis
Zviratidzo zvekutanga zvecholecystitis zvinowanzo marwadzo anopinza murutivi rworudyi pasi pembabvuzvinoonekwa zvisingatarisirwi. Chikonzero cheizvi ibwe rinovhara cystic duct. Somugumisiro, kutsamwa uye kuzvimba kwe gallbladder kunokura.
Marwadzo anoenda mushure meimwe nguva ari oga kana mushure mekutora marwadzo, asi mune ramangwana inowedzera zvishoma nezvishoma, uye inova nguva dzose. Pane kukura kwechirwere, icho chinoperekedzwa nefivha yakakura, kurutsa uye kurutsa. Mamiriro emurwere anoramba achiipa.
Inomisa kuyerera kwe bile mumatumbo, chiratidzo cheiyo icteric coloration yeganda uye eye sclera. Zvinodiwa zvejaundice ndiko kuvepo kwematombo anovhara bile ducts. Kuoma kwepathogenesis kunoratidzwa nekuputika kwemurwere: kazhinji kurova kwemoyo kunobva pamakumi masere kusvika kune zana nemakumi maviri - zana nemakumi matatu ekurova paminiti (kana kunyange yakakwirira), inova chiratidzo chakakomba, zvinoreva kuti shanduko ine ngozi yakaitika. mumuviri.
Kana iri chimiro chisingaperi checholecystitis, zviratidzo zvingasanyanya kuoneka, mune ramangwana chirwere chinogona kuita kuti chinzwe mune imwe fomu yepamusoro kana kutora fomu yakaoma. Muchiitiko ichi, kurapwa chete mune imwe nzvimbo yezvokurapa inokosha kunodzivirira kuparara kwemamiriro acho ezvinhu.
Nausea pamwe cholecystitis - chiratidzo chinowanzoitika. Nausea mamiriro ezvinhu anowanzo kutangira gag reflex. Mune zvimwe zviitiko, kusvotwa uye kurutsa ndiko kudzivirira kwemuviri kune kudhakwa. Necholecystitis, kushungurudza uye kurutsa nguva dzose chikamu chechirwere chechirwere.
Nausea mu cholecystitis inofanira kusiyaniswa nezviratidzo zvakafanana mune zvimwe zvirwere uye pathologies:
Diarrhea (manyoka) ane cholecystitis kucherechedzwa kazhinji. Diarrhea, kuvimbiswa, kuputika zviratidzo zvisingachinji zvezvirwere zvegumbo remudumbu, kusanganisira cholecystitis. Kungoerekana kuoneka kwechirwere chechigaro panguva yekurapa cholecystitis kunoratidza nzira yakaoma yechirwere.
Zvikonzero zve cholecystitis
Zvikonzero zvechirwere zvinogona kunge zvakasiyana, asi kazhinji cholecystitis inoitika nekuda kwekuunganidzwa kwematombo mu cystic duct, muviri uye mutsipa we gallbladder, izvo zvinoita kuti zviome kuti bile kubuda. Chikonzero chacho chinogonawo kuva rudzi rwekukuvara kana utachiona, pamwe nekuvapo kwezvirwere zvakakomba zvakadai sechirwere cheshuga mellitus, zvisinei, pano cholecystitis ichazviratidza sechinetso chechirwere chiripo, uye kwete sechirwere chakazvimirira.
Mhedzisiro yezvese zviri pamusoro inogona kuve yakaomesesa fomu yecholecystitis ine gallbladder yakazvimba. Chimiro chechirwere chechirwere chinowanzoonekwa mumamiriro ezvinhu apo kutsamwa hakuregi kwenguva refu uye kunotora nguva refu, semugumisiro wekuti masvingo enhengo anova denser.
Kurwiswa kwecholecystitis
Kurwiswa kunofananidzira zvese zvekutanga cholecystitis uye kuwedzera kwechimiro chisingaperi chechirwere. Harbingers yekubatwa kusagadzikana mudumbu mushure mekutora mafuta, spicy chikafu kana doro.
Zviratidzo zveacute kurwisa cholecystitis:
Kurwadza kunorwadza mu hypochondrium yakarurama, epigastrium kana guvhu;
Nausea uye kurutsa, gasi belching, kuvava kuravira mumuromo;
Subfebrile kana febrile tembiricha yemuviri (37-38 0 C kana 38-39 0 KUBVA).
Nzira yekubvisa sei kurwiswa kwecholecystitis?
Kuti umise kurwisa cholecystitis, unofanira:
Dana amburenzi;
Rara pamubhedha wozora chando mudumbu;
Tora antispasmodic (no-shpa) uye analgesic;
Kuti uderedze kusvotwa, inwa mint tii kana isina-carbonated mineral water pane tembiricha yekamuri;
Muhupo hwekurutsa, iva nechokwadi chekuunganidza marutsi kuti aongorore.
Matambudziko nemhedzisiro
Iyo acute fomu yecholecystitis isina kukwana kurapa inova isingaperi nenguva dzekuwedzera uye kuregererwa. Uye zvirwere zvisingaperi zvakaoma kurapa, sezvo dzimwe nhengo dzinobatanidzwa mune pathogenesis. Iyo yepamusoro fomu ye cholecystitis inowanikwa mu15% yevarwere. Inogona kukonzera gangrene, biliary fistulas inobatanidza ura, itsvo uye dumbu ne gallbladder, obstructive jaundice, abscess, acute pancreatitis, uye dzimwe nguva sepsis.
Migumisiro (prognosis) yecalculous uye isiri-calculous cholecystitis:
Kufungidzira kweasina kuomesesa calculous cholecystitis yakanaka. Mushure mekurapa kwakanyanya, mufananidzo wekliniki unogona kusaoneka kwenguva yakareba. Mhosva dzekupora zvachose dzinozivikanwa. Mune maitiro akaoma ecalculous cholecystitis, kufungidzira kunonyanya kuchenjerera;
Kufungidzira kwe-non-calculous cholecystitis hakuna chokwadi. Nechirwere chakadaro, munhu anofanira kungwarira maitiro epurulent uye anoparadza ekuputika.
Kurapa uye kudya
Kurapa kweacute cholecystitis uye chirwere chisingaperi muchikamu chepamusoro chinoitwa muchipatara chekuvhiya. Nzira dzekurapa dzinosarudzwa mumwe nomumwe maererano nezviratidzo.
Conservative kurapa cholecystitis:
Mishonga inorwisa mabhakitiriya, kusarudzwa kunoenderana nekubudirira kwemushonga;
Antispasmodics kudzikamisa basa rekufamba kwebile mudumbu diki;
Cholagogue ne hypotension ye gallbladder uye yakajairika patency ye bile duct;
Hepatoprotectors kuchengetedza chiropa kushanda.
Kuvhiya kurapwa kwecholecystitis:
Cholecystectomy - kubviswa kwakakwana kwe gallbladder, kunoitwa pakarepo nezviratidzo zvekupararira peritonitis uye acute bile obstruction, mune dzimwe nguva - nenzira yakarongwa.
Kudya kwecholecystitis
Munguva yekurwisa kwakanyanya, murwere anopiwa chete chinwiwa chinodziya muzvikamu zviduku. Huwandu hwemvura hunosvika rita imwe nehafu pazuva.
Mushure mokubvisa kurwadziwa kwakanyanya, kudya kunosanganisira zviyo, kissels, steam cutlets kubva kune nyama yakaonda kana hove, zai rehuku muchimiro che omelet, uye chingwa chichena.
Zvokudya zve cholecystitis:
Iwe unoda kudya muzvikamu zviduku (5-6 kanomwe pazuva) kuchengetedza rhythm yekugadzirwa kwe bile;
Kudya kwemanheru kunokurudzirwa pasati papera maawa 4-6 vasati varara usiku.
Zvokudya zvevarwere vane cholecystitis zvinofanira kusanganisira:
Zvigadzirwa zvemhuka zvine huwandu hushoma hwemafuta, akachekwa uye akabikwa;
Zvigadzirwa zvemuriwo zvisina coarse fiber, yakapfuma muvhitamini uye inoteedzera zvinhu.
Ne cholecystitis, zvinorambidzwa kudya zvinotevera zvigadzirwa:
Mumagaba, pickled, kuputa, munyu, pickled, mafuta, astringent;
Kukurudzira kusadya uye kugadzira gasi (mukaka, nyemba, zvinwiwa zvecarbonated);
Kuchinja pH yezvakatipoteredza yemudumbu (doro, sorrel, sipinashi, michero yecitrus).