Matenda a Gallbladder

Zamkati

• Kodi mitundu ya matenda a ndulu ndi iti?
• Miyala
• Cholecystitis
• Choledocholithiasis
• Matenda a ndulu acalculous
• Biliary dyskinesia
• Kukula kwa cholangitis
• Khansara ya gallbladder
• Tizilombo toyambitsa matenda
• Chiwombankhanga cha ndulu
• Kutupa kwa ndulu
• Kodi matenda a ndulu amapezeka bwanji?
• Mbiri yazachipatala
• Kuyesa kwakuthupi
• X-ray pachifuwa ndi m'mimba
• Ultrasound
• Kujambula kwa HIDA
• Mayesero ena
• Kodi matenda a ndulu amachiritsidwa bwanji?
• Zosintha m'moyo
• Chithandizo chamankhwala
• Opaleshoni
• Zovuta zakanthawi yayitali zamatenda a ndulu
• Kodi matenda a ndulu angapewe?

Chidule cha matenda a ndulu

Mawu akuti matenda a ndulu amagwiritsidwa ntchito pamitundu ingapo yazikhalidwe zomwe zingakhudze ndulu yanu.

Ndulu ndi kachikwama kakang'ono kooneka ngati peyala kamene kali pansi pa chiwindi chanu. Ntchito yanu yayikulu ya ndulu ndikutulutsa ndulu yopangidwa ndi chiwindi chanu ndikudutsa mumsewu womwe umalowerera m'matumbo ang'onoang'ono. Kuwola kumakuthandizani kukumba mafuta m'matumbo anu ang'onoang'ono.

Kutupa kumayambitsa matenda ambiri a ndulu chifukwa chakukwiya kwamakoma a ndulu, omwe amadziwika kuti cholecystitis. Kutupa uku kumachitika nthawi zambiri chifukwa cha ma ndulu otsekereza timabowo tomwe timatsogolera m'matumbo ang'onoang'ono ndikupangitsa kuti ndulu inyamuke. Zitha kubweretsa necrosis (kuwonongeka kwa minofu) kapena chilonda.

Kodi mitundu ya matenda a ndulu ndi iti?

Pali mitundu yambiri yamatenda a ndulu.

Miyala

Miyala imayamba pamene zinthu mu bile (monga cholesterol, bile salt, ndi calcium) kapena zinthu zochokera m'magazi (monga bilirubin) zimapanga tinthu tating'onoting'ono tomwe timatseka njira zopita ku ndulu ndi ma ducts.

Miyala yamiyala imapangidwanso pomwe ndulu siyituluka kwathunthu kapena nthawi zambiri. Amatha kukhala ochepa ngati mchenga kapena wokulirapo ngati mpira.

Pali zinthu zambiri zomwe zimakupatsani chiopsezo cha miyala yamtengo wapatali. Izi zikuphatikiza:

• kukhala wonenepa kwambiri kapena wonenepa kwambiri
• kukhala ndi matenda ashuga
• kukhala wazaka 60 kapena kupitirira
• kumwa mankhwala omwe ali ndi estrogen
• kukhala ndi mbiri yabanja yamiyala
• kukhala wamkazi
• kukhala ndi matenda a Crohn ndi zina zomwe zimakhudza momwe michere imathandizira
• kukhala ndi matenda enaake kapena matenda ena a chiwindi

Cholecystitis

Cholecystitis ndi mtundu wofala kwambiri wa ndulu. Zimadziwonetsera ngati zotupa kapena zopweteka za ndulu.

Pachimake cholecystitis

Cholecystitis pachimake chimayambitsidwa ndi ma gallstones. Zingakhalenso chifukwa cha zotupa kapena matenda ena osiyanasiyana.

Itha kukhala ndi ululu kumtunda chakumanja kapena kumtunda kwapakati pamimba. Kupweteka kumayamba kuchitika mukangomaliza kudya ndipo mumakhala ndi zowawa zakuthwa mpaka kupweteka kosalala komwe kumatha kumveka paphewa lanu lamanja. Cholecystitis pachimake ingayambitsenso:

• malungo
• nseru
• kusanza
• jaundice

Matenda cholecystitis

Pambuyo pakuwukira kangapo kwa cholecystitis pachimake, ndulu imatha kuchepa ndikutaya mphamvu yosunga ndi kumasula ya ndulu. Kupweteka m'mimba, nseru, ndi kusanza kumatha kuchitika. Kuchita opaleshoni nthawi zambiri kumafunikira kuchiza matenda a cholecystitis.

Choledocholithiasis

Miyala yamiyala imatha kukhala pakhosi la ndulu kapena m'mabowo am'mimba. Ndulu ikalumikizidwa motere, bile imatha kutuluka. Izi zitha kupangitsa kuti ndulu ipsere kapena isokonezeke.

Mipata yotulutsidwa ya bile ithandizanso kuteteza kuti bile isayende kuchokera chiwindi kupita m'matumbo. Choledocholithiasis ikhoza kuyambitsa:

• kupweteka kwambiri pakati pamimba yanu yakumtunda
• malungo
• kuzizira
• nseru
• kusanza
• jaundice
• mipando yotumbululuka kapena yofiira

Matenda a ndulu acalculous

Matenda a ndulu ndikutupa kwa ndulu komwe kumachitika popanda miyala yamtengo wapatali. Kukhala ndi matenda aakulu kapena kudwala kwadzawonetsedwa kuti kuyambitsa chochitika.

Zizindikiro zimafanana ndi pachimake cholecystitis ndi ndulu. Zina mwaziwopsezo za vutoli ndi izi:

• kuvulala kwakukulu kwakuthupi
• opaleshoni ya mtima
• opaleshoni m'mimba
• kutentha kwakukulu
• mikhalidwe yodziyimira payokha ngati lupus
• matenda amitsinje
• kulandira chakudya kudzera m'mitsempha (IV)
• matenda ofunika kwambiri a bakiteriya kapena ma virus

Biliary dyskinesia

Biliary dyskinesia amapezeka pamene ndulu imagwira ntchito yocheperako kuposa yachibadwa. Matendawa atha kukhala okhudzana ndi kutupa kwa ndulu.

Zizindikiro zimatha kuphatikizira kupweteka m'mimba mukatha kudya, nseru, kuphulika, ndi kudzimbidwa. Kudya chakudya chamafuta kumatha kuyambitsa zizindikilo. Nthawi zambiri palibe ma gallstones mu ndulu ndi biliary dyskinesia.

Dokotala wanu angafunike kugwiritsa ntchito mayeso otchedwa HIDA scan kuti athandizire kupeza vutoli. Kuyesaku kumayesa ntchito ya ndulu. Ngati ndulu imatha kumasula 35 mpaka 40% ya zomwe zili mkati kapena zochepa, ndiye kuti biliary dyskinesia amapezeka.

Kukula kwa cholangitis

Kutupa kosalekeza ndi kuwonongeka kwa dongosolo la bile zingayambitse mabala. Matendawa amatchedwa sclerosing cholangitis. Komabe, sizikudziwika chomwe chimayambitsa matendawa.

Pafupifupi theka la anthu omwe ali ndi vutoli alibe zizindikiro. Ngati zizindikiro zimachitika, zimatha kuphatikiza:

• malungo
• jaundice
• kuyabwa
• kusapeza bwino m'mimba.

Pafupifupi anthu omwe ali ndi vutoli amakhalanso ndi ulcerative colitis. Kukhala ndi vutoli kumawonjezeranso chiopsezo cha khansa ya chiwindi. Pakadali pano, chithandizo chokhacho chodziwika ndi kumuika chiwindi.

Mankhwala omwe amaletsa chitetezo cha mthupi komanso omwe amathandizira kuphulika kwa ndulu yolimba amatha kuthandiza kuthana ndi zizindikilo.

Khansara ya gallbladder

Khansa ya ndulu ndi matenda osowa kwambiri. Pali mitundu yosiyanasiyana ya khansa ya ndulu. Amatha kukhala ovuta kuwachiza chifukwa nthawi zambiri samapezeka mpaka kumapeto kwa matendawa. Miyala yamiyala ndiomwe imawopsa chifukwa cha khansa ya ndulu.

Khansara ya gallbladder imatha kufalikira kuchokera pamakoma amkati a ndulu kupita kumtunda kenako mpaka chiwindi, ma lymph node, ndi ziwalo zina. Zizindikiro za khansa ya ndulu imatha kukhala yofanana ndi ya cholecystitis yovuta, koma mwina sipangakhale zizindikilo konse.

Tizilombo toyambitsa matenda

Matenda a gallbladder ndi zotupa kapena zophuka zomwe zimachitika mkatikati mwa ndulu. Nthawi zambiri amakhala oopsa ndipo alibe zisonyezo. Komabe, nthawi zambiri amalimbikitsidwa kuti ndulu ichotsedwe ndi ma polyps opitilira 1 sentimita. Ali ndi mwayi waukulu wokhala ndi khansa.

Chiwombankhanga cha ndulu

Kuphulika kumatha kuchitika pomwe ndulu imayamba kutuluka magazi. Ichi ndi chimodzi mwamavuto akulu kwambiri a cholecystitis pachimake. Zinthu zomwe zimawonjezera chiopsezo cha vutoli ndi monga:

• kukhala wamwamuna komanso wazaka zopitilira 45
• kukhala ndi matenda ashuga

Zizindikiro za ndulu zingaphatikizepo:

• kupweteka pang'ono m'dera la ndulu
• malungo
• nseru kapena kusanza
• kusokonezeka
• kuthamanga kwa magazi

Kutupa kwa ndulu

Kutupa kwa ndulu kumachitika pamene ndulu imayamba kutentha ndi mafinya. Mafinya ndi kudzikundikira kwa maselo oyera amwazi, minofu yakufa, ndi mabakiteriya. Zizindikiro zimatha kuphatikizira kupweteka kumtunda kwakumanja pamimba limodzi ndi malungo komanso kuzizira.

Vutoli limatha kuchitika pachimake cholecystitis pomwe mwala wamtengo wapatali umatseketsa ndulu kwathunthu, ndikulola kuti ndulu izadza ndi mafinya. Ndizofala kwambiri kwa anthu omwe ali ndi matenda ashuga komanso matenda amtima.

Kodi matenda a ndulu amapezeka bwanji?

Kuti mupeze matenda am'mimba, dokotala wanu adzakufunsani za mbiri yanu yazachipatala ndikupemphani m'mimba. Izi ziphatikizanso kuyang'ana zowawa m'mimba. Njira imodzi kapena zingapo zotsatirazi zingagwiritsidwe ntchito:

Mbiri yazachipatala

Mndandanda wazizindikiro zomwe mukukumana nazo komanso mbiri yaumwini kapena yabanja yokhudzana ndi ndulu ndikofunikira. Kafukufuku wambiri atha kuchitidwanso kuti aone ngati pali zizindikilo za matenda a ndulu a nthawi yayitali.

Kuyesa kwakuthupi

Dokotala wanu akhoza kuyendetsa mwapadera panthawi yoyezetsa m'mimba kuti ayang'ane chomwe chimatchedwa "Chizindikiro cha Murphy."

Munthawi imeneyi, dokotala wanu adzaika pamimba panu ndulu. Kenako akufunsani kuti mupume kwinaku mukufufuza ndikumva malowo. Ngati mukumva kuwawa kwakukulu, zikusonyeza kuti mwina mungakhale ndi matenda a ndulu.

X-ray pachifuwa ndi m'mimba

Syndromeomatic cholecystitis nthawi zina imawonetsa miyala pamimba X-ray ngati miyala ili ndi calcium. X-ray ya pachifuwa imatha kuwonetsa pleurisy kapena chibayo.

Komabe, ma X-ray si mayeso abwino kwambiri odziwitsa matenda a ndulu. Nthawi zambiri amagwiritsidwa ntchito kuthana ndi zina zomwe zingayambitse zowawa zomwe sizigwirizana ndi ndulu, ndulu, kapena chiwindi.

Ultrasound

Ultrasound imagwiritsa ntchito mafunde akumveka kuti apange zithunzi m'thupi lanu. Mayesowa ndi njira imodzi yomwe dokotala amagwiritsa ntchito kuti adziwe matenda am'mimba. Ultrasound imatha kuyesa ndulu ngati kuli miyala yamtengo wapatali, makoma olimba, ma polyps, kapena misa. Ikhozanso kuzindikira mavuto aliwonse m'chiwindi chanu.

Kujambula kwa HIDA

Kujambula kwa HIDA kumayang'ana njira zomwe zili mkati mwa ndulu ndi chiwindi. Amagwiritsidwa ntchito nthawi zambiri munthu akakhala ndi zizindikiro za ndulu koma ma ultrasound sanawonetse chifukwa cha zizindikirazo. Kujambula kwa HIDA kungagwiritsidwenso ntchito kuwunikiranso bwino njira zamagetsi zamagetsi.

Chiyesochi chitha kuwunika momwe ndulu imagwirira ntchito pogwiritsa ntchito chinthu chopanda mphamvu chowulutsa ma radio. Katunduyu amalowetsedwa mumtsempha ndikuyang'anitsitsa pamene umadutsa ndulu. Mankhwala ena amathanso kubayidwa omwe amapangitsa kuti ndulu izitulutsa bile.

Kujambula kwa HIDA kumawonetsa momwe ndulu imasunthira bile kudzera mumadontho a bile. Ikhozanso kuyeza kuchuluka kwa bile yomwe imatuluka mu ndulu. Izi zimadziwika ngati gawo la ejection. Kachigawo kakang'ono kotulutsira ndulu kumawerengedwa pakati pa 35 mpaka 65 peresenti.

Mayesero ena

Mayeso ena ojambula, monga CT ndi MRI scan, amathanso kugwiritsidwa ntchito. Kuyezetsa magazi kumachitidwanso kuti aone kuchuluka kwa maselo oyera amwazi komanso chiwindi chachilendo.

Endoscopic retrograde cholangiopancreatography (ERCP) ndiyeso lowopsa koma lothandiza. Kamera yosinthasintha imalowetsedwa mkamwa ndikutsika m'mimba ndikudutsa m'matumbo ang'onoang'ono. Utoto wosiyanitsa umabayidwa kuti uwonetse dongosolo la ndulu ndi X-ray yapadera.

ERCP ndiyeso lofunika kwambiri ngati kutayika chifukwa cha ma gallstones kukukayika. Mwala uliwonse wam'mimba womwe umayambitsa kutsekeka umatha kuchotsedwa nthawi imeneyi.

Kodi matenda a ndulu amachiritsidwa bwanji?

Zosintha m'moyo

Popeza zikhalidwe zina zathanzi zimawonjezera chiopsezo cha kupangika kwa ndulu, kusintha kwa moyo kumatha kuthandizira kuthana ndi matenda am'mimba mwa anthu opanda zisonyezo. Kukhala wonenepa kwambiri komanso kukhala ndi matenda ashuga kumawonjezera mwayi wamatenda am'mimba. Kuchepetsa thupi komanso kuyang'anira bwino matenda ashuga kungathandize kuchepetsa ngozi yanu.

Komabe, kuchepa thupi kwakanthawi kochepa kumathandizanso kupangika kwa miyala. Lankhulani ndi dokotala wanu za njira zabwino zowonda.

Kuchulukitsa kwa masewera olimbitsa thupi kumawonekeranso kuchepa kwamapangidwe am'miyala pamodzi ndi kutsitsa ma triglycerides, mtundu wamafuta m'magazi. Nthawi zambiri amalimbikitsidwa kuti asiye kusuta komanso kuchepetsa kumwa mowa.

Chithandizo chamankhwala

Gawo loyamba la kutupa kwa ndulu nthawi zambiri limachiritsidwa ndi mankhwala opweteka. Chifukwa chowawa chimakhala chachikulu, mankhwala amafunikira. Dokotala wanu akhoza kukupatsani mankhwala ndi codeine kapena hydrocodone. Mankhwala a anti-inflammatories amatha kuperekedwa, kapena mankhwala opweteka kwambiri monga morphine.

Mankhwala owonjezera pa counter monga ibuprofen (Advil) ndi naproxen (Aleve) sangagwiritsidwe ntchito pafupipafupi chifukwa cha chiwopsezo chambiri cha mseru ndi kusanza. Ngati mwasowa madzi m'thupi, mankhwala opatsirana ndi kutupa amathanso kuyambitsa mavuto a impso.

Anthu ambiri amavutika kuthana ndi zowawa komanso zomwe zimatsatira kunyumba. Lankhulani ndi dokotala wanu kuti akambirane za chithandizo chabwino kwambiri kwa inu.

Kafukufuku wopitilira akuyang'ana kagwiritsidwe ntchito ka mankhwala ezetimibe ndi gawo lawo pochepetsa mapangidwe amiyala ya cholesterol. Mankhwalawa amasintha momwe thupi limayamwa cholesterol m'matumbo.

Opaleshoni

Kuchita opaleshoni ndikulimbikitsidwa kuti muchotse ndulu yanu ngati mwakumana ndi magawo angapo a kutupa. Opaleshoni ya gallbladder ikupitilizabe kukhala njira yothandiza kwambiri yochizira matenda a ndulu.

Kuchita opareshoni kumatha kuchitidwa mwina potsegula m'mimba mwanu ndi cheke, kapena laparoscopically. Izi zimaphatikizapo kupangira mabowo angapo pakhoma la m'mimba ndikuyika kamera. Opaleshoni ya laparoscopic imathandizira kuti achire mwachangu. Njirayi imakondedwa ndi anthu omwe alibe zovuta zamatenda owopsa a ndulu.

Pambuyo pa opaleshoni ya ndulu mwa njira iliyonse, si zachilendo kuti anthu azitha kutsegula m'mimba. Malinga ndi chipatala cha Mayo, anthu atatu mwa khumi atha kutsekula m'mimba atachitidwa opaleshoni ya ndulu.

Kwa anthu ambiri, kutsegula m'mimba kumangotenga milungu ingapo. Koma nthawi zina, zimatha zaka. Ngati kutsekula m'mimba kukupitirira pambuyo pa opaleshoni kwa milungu yopitilira iwiri, lankhulani ndi dokotala wanu. Kutengera ndi zizindikilo zina, mungafune kuyesa kutsata.

Zovuta zakanthawi yayitali zamatenda a ndulu

Nduluyo imatha kupanga njira yachilendo, kapena fistula, pakati pa ndulu ndi matumbo kuti zithandizire pokonza ndulu ya chiwindi. Izi nthawi zambiri zimakhala zovuta za kutupa kwakanthawi kokhudzana ndi ma gallstones.

Zovuta zina zingaphatikizepo:

• kutsekeka kwa matumbo
• kutupa ndi mabala
• Kuwonongeka (dzenje la ndulu)
• Kuwonongeka kwa bakiteriya pamimba, wotchedwa peritonitis
• Kusintha koyipa (masinthidwe amasintha kukhala chotupa cha khansa)

Kodi matenda a ndulu angapewe?

Zinthu zina zowopsa za matenda a ndulu, monga kugonana ndi zaka, sizingasinthidwe. Komabe, zakudya zanu zitha kuthandizira kupanga ma gallstones. Malinga ndi National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), zakudya zokhala ndi michere yambiri ndi mafuta athanzi zitha kuthandiza kupewa ndulu.

Mbewu zoyengedwa (zomwe zimapezeka m'matumbo a shuga ndi mpunga woyera, mkate, ndi pasitala) ndi maswiti otsekemera amakhala pachiwopsezo chachikulu cha matenda am'mimba. Mbewu zonse monga mpunga wofiirira ndi mkate wonse wa tirigu ndi mafuta ochokera ku nsomba ndi mafuta zimalimbikitsidwa.

Mavuto am'mimbamo am'mbuyomu amadziwika ndipo amachiritsidwa, zovuta zazikulu sizingachitike. Ndikofunika kuti mulankhule ndi dokotala ngati mukukumana ndi zizindikilo zilizonse za matenda a ndulu.