Miyala

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Miyala imapanga pamene zinthu za mu bile zimawuma kukhala tizidutswa tating'ono ting'onoting'ono ta ndulu. Ma gallstones ambiri amapangidwa makamaka ndi cholesterol yolimba. Ngati bile yamadzi imakhala ndi cholesterol yochulukirapo, kapena ndulu siyimatulutsa kwathunthu kapena pafupipafupi, ma gallstones amatha kupanga.

Ndani ali pachiwopsezo?

Akazi ali ndi mwayi wowirikiza kawiri kuposa amuna kukhala ndi ndulu. Mahomoni aakazi a estrogen amakweza mafuta ambiri mu ndulu ndikuchepetsa kuyenda kwa ndulu. Zotsatira zake ndizokulirapo pakuyembekezera pamene kuchuluka kwa estrogen kukukwera. Izi zimathandiza kufotokoza chifukwa chomwe azimayi ambiri amadzimvera ndi ma gallstones ali ndi pakati kapena akabereka. Momwemonso, ngati mumamwa mapiritsi oletsa kubereka kapena mankhwala a mahomoni otha msinkhu, mumakhala ndi mwayi wopanga ndulu.

Mwinanso mumakhala ndi miyala yamtengo wapatali ngati:

• khalani ndi mbiriyakale yabanja yamiyala yamiyala
• onenepa kwambiri
• kudya zakudya zokhala ndi mafuta ambiri, cholesterol yambiri
• achepetsa kwambiri msanga
• ndi akulu kuposa 60
• ndi American Indian kapena Mexico American
• kumwa mankhwala ochepetsa cholesterol
• kukhala ndi matenda ashuga

Zizindikiro

Nthawi zina gallstones alibe zizindikiro ndipo safuna chithandizo. Koma ngati ndulu imalowa m'mitsempha yomwe imanyamula bile kuchokera ku ndulu kapena chiwindi kupita kumatumbo aang'ono, imatha kuyambitsa "kuukira" kwa ndulu. Kuukira kumabweretsa kupweteka kosalekeza kumtunda kumtunda kwa mimba, pansi pa phewa lakumanja, kapena pakati pa mapewa. Ngakhale kuukira kumachitika nthawi zambiri pamene ndulu ikupita patsogolo, nthawi zina mwala umatha kulowa munjira ya bile. Chingwe chotsekedwa chitha kuwononga kwambiri kapena matenda.

Zizindikiro zochenjeza za kutsekeka kwa ndulu

Ngati muli ndi zina mwazizindikiro za chotchinga bile, onani dokotala wanu nthawi yomweyo:

* ululu wopitilira maola 5

* nseru ndi kusanza

* malungo

* khungu lachikasu kapena maso

chopondapo cha utoto

Chithandizo

Ngati muli ndi ma gallstones opanda zizindikilo, simufunikira chithandizo. Ngati mukukumana ndi vuto la ndulu, dokotala wanu angakulimbikitseni kuti muchotse ndulu yanu - opaleshoni yotchedwa cholecystectomy.

Opaleshoni

Opaleshoni yochotsa ndulu-chinthu chosafunikira-ndiimodzi mwama opaleshoni omwe amachitidwa kwambiri kwa akulu ku United States.

Pafupifupi cholecystectomy onse amachitidwa ndi laparoscopy. Atakupatsa mankhwala oti akutonthozetseni, dokotalayo amabowola ting’onoting’ono ting’onoting’ono m’mimba n’kulowetsamo laparoscope ndi kamera kakang’ono kavidiyo. Kamera imatumiza chithunzi chokulitsa kuchokera mkati mwa thupi kuwonera kanema, ndikupatsa dokotalayo chithunzi choyandikira cha ziwalo ndi ziphuphu. Poyang'ana wowunikirayo, dokotalayo amagwiritsa ntchito zida kuti alekanitse bwino nduluyo pachiwindi, m'matope a bile, ndi zinthu zina. Kenako dokotalayo amadula chidebe chamadzimadzi ndikuchotsa nduluyo kudzera pachimodzi mwazing'ono.

Kuchira pambuyo pa opaleshoni ya laparoscopic nthawi zambiri kumangokhala usiku umodzi wokha kuchipatala, ndipo zochitika zabwinobwino zimatha kuyambanso patatha masiku ochepa kunyumba. Chifukwa chakuti minofu yam'mimba siyidulidwa panthawi yochita opaleshoni ya laparoscopic, odwala samva kupweteka pang'ono komanso amakhala ndi zovuta zochepa kuposa pambuyo pochitidwa opaleshoni "yotseguka", yomwe imafuna kudula pakati pa mainchesi 5 mpaka 8 pamimba.

Ngati mayeso awonetsa kuti ndulu ili ndi kutupa kwakukulu, matenda, kapena zipsera zochokera kuntchito zina, dokotalayo amatha kuchita opareshoni yotseguka kuti achotse nduluyo. Nthawi zina, opaleshoni yotseguka imakonzedwa; Komabe, nthawi zina mavutowa amapezeka panthawi ya laparoscopy ndipo dokotalayo ayenera kupanga chocheka chokulirapo. Kuchira kuchokera ku opareshoni yotseguka nthawi zambiri kumafuna masiku atatu kapena asanu kuchipatala komanso milungu ingapo kunyumba. Opaleshoni yotseguka ndiyofunikira pafupifupi 5% ya ndulu.

Vuto lofala kwambiri pochita opaleshoni ya ndulu ndi kuvulala kwamitsempha ya ndulu. Mchitidwe wovulaza wamba wa bile ukhoza kutuluka ndulu ndikupangitsa matenda opweteka komanso owopsa. Kuvulala pang'ono nthawi zina kumachiritsidwa mosavomerezeka. Kuvulala kwakukulu, komabe, ndikowopsa ndipo kumafuna kuchitidwa opaleshoni ina.

Ngati ma gallstones amapezeka mumadontho a bile, dotolo-nthawi zambiri gastroenterologist-amatha kugwiritsa ntchito ERCP kuti awapeze ndikuwachotsa musanachitike kapena mukamachita opaleshoni ya ndulu. Nthawi zina, munthu yemwe wakhala akudwala cholecystectomy amapezeka kuti ali ndi ndulu m'matope a bile, milungu, kapena zaka pambuyo pa opaleshoni. Ndondomeko ya ERCP nthawi zambiri imachita bwino kuchotsa mwala pamilandu iyi.

Thandizo lopanda opaleshoni

Njira zosagwiritsa ntchito opaleshoni zimagwiritsidwa ntchito pazochitika zapadera-monga ngati wodwala ali ndi vuto lalikulu lazachipatala lomwe limalepheretsa kuchitidwa opaleshoni - komanso miyala ya cholesterol yokha. Miyala imakonda kubwereranso mkati mwa zaka 5 mwa odwala omwe amathandizidwa mosavomerezeka.

• Mankhwala osamalidwa pakamwa. Mankhwala opangidwa kuchokera ku bile acid amagwiritsidwa ntchito kusungunula ndulu. Mankhwala a ursodiol (Actigall) ndi chenodiol (Chenix) amagwira ntchito bwino pamiyala yaying'ono ya kolesterolini. Miyezi kapena zaka za chithandizo zingakhale zofunikira miyala yonse isanayambe kusungunuka. Mankhwala onsewa angayambitse kutsekula m'mimba pang'ono, ndipo chenodiol imatha kukweza kwakanthawi kuchuluka kwa cholesterol m'magazi ndi enzyme ya chiwindi transaminase.
  
• Lumikizanani ndi dissolution therapy. Njira yoyeserayi imaphatikizapo kubaya mankhwala mwachindunji mu ndulu kuti asungunuke miyala ya kolesterolini. Mankhwala-methyl tert-butyl ether-akhoza kusungunula miyala ina m'masiku 1 mpaka 3, koma imayambitsa kupsa mtima komanso zovuta zina zanenedwa. Ndondomeko ikuyesedwa mwa odwala omwe ali ndi miyala yaying'ono.

Kupewa

Nazi zina zomwe mungachite kuti muteteze ma gallstones:

• Pitirizani kulemera bwino.
• Ngati mukufuna kuchepetsa thupi, chitani pang'onopang'ono-osapitirira ½ mpaka 2 mapaundi pa sabata.
• Idyani zakudya zopanda mafuta ambiri, zopanda mafuta m'thupi.

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