Acute cholecystitis - ua rau thiab kev kho mob ntawm cov tshuaj, noj cov zaub mov, txoj kev phais

Rapidly thiab sai sai mob o ntawm lub gallbladder yog hu ua mob cholessstitis. Tus kab mob, uas tau tshwm sim rau thawj lub sij hawm, xaus nrog tag nrho rov qab nrog kev kho mob txaus. Thaum qhov qaug dab peg rov qab, tus kab mob mus ntev yuav kuaj tau. Nrog rau lub hnub nyoog, qhov tseem tau txais cholecystitis nce, ntau cov kab mob ntawm cov pojniam ntau tshaj li cov txiv neej. Hauv thaj chaw uas muaj kab mob - cov poj niam cev xeeb tub, noj tshuaj hormonal thiab neeg rog.

Acute cholecystitis - ua rau

Mob o ntawm lub gallbladder yog tsiag ntawv los ntawm impaired txav nyob rau hauv lub cev ntawm bile vim hais tias ntawm blockade ntawm nws outflow. Feem ntau, txoj kev loj hlob ntawm pathology yog nrog lub xub ntiag ntawm cov pob zeb (txog li 95% ntawm cov kab mob), thiab hauv 60% ntawm cov neeg mob muaj kab mob tus kab mob: E. coli, cocci, salmonella in bile. Muaj ntau yam ua rau muaj mob cholecystitis, ua rau muaj tus mob hu ua cov hauv qab no:

• kab mob, kab mob hauv cov kab mob;
• sclerosis ntawm phab ntsa ntawm lub zais zis lossis atrophy;
• lub kink ntawm lub cev thiab lub tom ntej outflow ntawm bile;
• hloov cov phab ntsa ntawm lub zais zis vim lub hnub nyoog;
• pancreatic kua txiv nyob hauv lub zais zis, casting ntawm pancreatic enzymes;
• malnutrition - fatty, ntsim noj thiab zaub mov ntau;
• blockage ntawm lub bile ciav los yog kev puas tsuaj rau cov phab ntsa los ntawm solidations.

Acidless cholecystitis

Nyob ntawm lub xub ntiag ntawm lub pob zeb - biliary calculi - o ntawm lub gallbladder yog muab faib ua piv txwv (nrog pob zeb) thiab tsis muaj nyiaj. Lub tom kawg pathology yog tsawg dua. Raws li txoj cai, beskamenny cholecystitis muaj ib daim ntev ntev, thiab yog tias mob, nws yog txuam nrog cov nkag ntawm lub pathogen ncaj qha mus rau hauv lub gallbladder thaum lub sij hawm inflammatory nyob rau hauv txoj hnyuv. Tus kab mob pathology yog tshwm sim los ntawm tej yam xws li:

• kab mob parasitic tus kab mob hauv lub cev;
• muaj cov kab mob;
• kis kab mob;
• E. coli ;
• staphylococcus, enterococcus;
• Proteus.

Ntsuas cov cholecystitis

Vim tias cov tshuaj tsis txaus hauv lub cev hauv lub zais zis thiab cov yas ducts, cov formations tau tsim-pob zeb. Lawv raug mob rau cov kab mob hauv lub cev, ua rau mob, tsis xis nyob, mob thiab ua kom muaj kab mob khees-xis calculus cholecystitis. Qhov ua rau cholelithiasis, ua rau lub pathology ntawm lub zais zis:

• rog dhau;
• teeb meem los ntawm qhov hnyav sai sai;
• kev txais tos ntawm qhov ncauj tawm ntawm qhov ncauj;
• ntshav qab zib mellitus ;
• laus hnub nyoog;
• noj ntawm cov yeeb tshuaj uas txo qib ntawm cov cholesterol nyob rau hauv cov ntshav, thiab lwm yam.

Mob cholenessstitis - mob tshwm sim

Raws li txoj cai, mob cholecystitis ua rau nws tus kheej tom qab noj zaub mov muaj teeb meem, muaj kev nyuab siab lossis haus cawv. Tus kabmob no ua rau lub cev tsis zoo rau yam tsis zoo. Txo txo ​​hwj chim, colic, ntuav, tsam plab thiab lwm yam cim, nws ceeb toom tias mob ntawm lub gallbladder tau pib, cov tsos mob uas nyuaj nyuaj rau kev saib xyuas. Qhov hnyav ntawm cov tsos mob yuav nyob ntawm theem ntawm tus kab mob. Cov kev qhia tshwj xeeb ntawm mob cholecystitis, nws txawv los ntawm lwm cov kab mob thiab pab rau kev kuaj xyuas pathology:

1. Yog tias koj nias rau ntawm thaj tsam ntawm cov ceg ntawm cov leeg mob sternocleidomastoid, qhov mob tshwm.
2. Nrog sib sib zog nqus palpation, tus neeg mob tsis tuaj yeem nqus tau.
3. Thaum lub palpation ntawm txoj cai subcostal, txoj kev nqus tau pa.
4. Muaj kev nruj nruj ntawm cov nqaij ntshiv plab.
5. Mob hnyav thaum lub sij hawm ntawm tapping tus ntug ntawm lub xibtes ntawm lub koov ris ntawm sab xis (qhov chaw ntawm lub zais zis).

Kev tsis txaus siab rau mob cholenessstitis

Thaum ib tus kab mob pathological tshwm sim, tus neeg mob xav tsis zoo. Ntawm cov kev mob tshwm sim tsis txaus siab ntawm: lub qhov ncauj tawm hauv lub qhov ncauj, xeev siab, ntuav nrog kev pleev xim ntawm cov kua mis, tom qab uas tsis muaj kev pab. Tej zaum cov kua quav tau nrog cov cholessstitis, mob hnyav thiab qhov nce ntxiv hauv lub gallbladder, nce hauv lub cev kub (txog 40 degrees). Tab sis qhov tseem ceeb tshaj plaws kev tsis txaus siab thiab cov cim tseem ceeb ntawm mob cholenessstitis tsis kis mob.

Tus cwj pwm thiab thaj tsam ntawm qhov mob hauv mob cholenessstitis

Tus kab mob no pib nrog tus kab mob ntse. Cov mob nkeeg nrog mob cholenessstitis tshwm sim, raws li txoj cai, nyob rau thaj tsam ntawm txoj kev hypochondrium, tuaj yeem tshwm hauv cov kab mob epigastrium. Tsis kaj siab ntev ntev ntev tsis dhau, ntxeev siab nyob rau hauv lub scapula thiab txoj xub pwg, caj dab, supraclavicular cheeb tsam, rov qab. Mob pumped nrog bouts:

• sawv thaum tsaus ntuj los yog thaum sawv ntxov;
• los ua kom muaj zog, tab sis tsum tsis ntev tom qab ib ntus (ntawm 30 txog 60 nas this);
• qhov kev tawm tsam yog nyuaj rau ib tug neeg, nws yog yuam kom coj ib qho tsis xis nyob, rub nws ob txhais ceg rau nws lub plab thiab sim sov lub qhov chaw khoo.

Dab tsi yog qhov txaus ntshai ntawm cholecystitis?

Tus kab mob cholessstitis feem ntau yuav siv li ob peb hnub, tab sis kev kis mob thiab sepsis yuav ua rau muaj mob. Qee lub sij hawm thaum lub sij hawm kev loj hlob ntawm tus kab mob qhov perforation ntawm phab ntsa ntawm zais zis tshwm sim. Yog li ntawd, muaj qhov mob lossis ua ib qho fistula vesicourous. Ib txoj kev kuaj mob ntawm cov kab mob pathology, ua thaum lub sij hawm tsis ncaj ncees lawm, tsis muaj cov kev kho kom zoo yuav ua rau cov teeb meem ntawm mob cholenessstitis yuav tsim. Qhov feem ntau ntawm lawv yog:

• pancreatitis - o ntawm qhov ua pancreas;
• Cholangitis - pathology ntawm bile bile ciav;
• ib tug caulinian abscess;
• plhu (suppuration), gangrene los yog perforation ntawm lub gallbladder;
• biliary fistula;
• purulent diffuse peritonitis;
• jaundice

Mob cholessstitis - mob

Cov neeg mob kho mob mob hnyav rau tus kws kho mob tom qab cov kab mob cuav ntawm cholecystitis, raws li txoj cai, raug kho, muab tso rau hauv tsev kho mob. Qhov no yog vim qhov kev kuaj mob zoo sib xws ntawm cov tsos mob ntawm tus mob appendicitis. Lub tsev kho mob ua tus mob sib txawv ntawm mob cholenessstitis. Cov txiaj ntsig tau txais tom qab ib qho kev tshawb fawb, uas muaj cov kev sim thiab cov cuab yeej siv. Kev kuaj yog tsis nyuaj thiab muaj xws li:

• kev ntsuam xyuas ntshav (dav dav), pom qhov muaj cov mob o;
• biochemical ntshav kuaj;
• Ultrasound ntawm lub plab kab noj hniav, tso cai kuaj xyuas lub gallbladder, nws qhov ntim;
• urinalysis;
• Radiography overview - nrog lub sijhawm ntawm peritonitis.

Mob cholessstitis - kev kho mob

Yog tias kuaj tau mob cholecystitis sai, qhov kev kho mob yuav tsum muaj kev kho mob thaum muaj xwm ceev thiab sai li sai tau (hauv thawj 24-48 xuab moos) kev tsim tawm ntawm kev mob plab. Rau qhov no, ib lub raj siv nas. Tus neeg mob tau pom ib lub txaj pw nruj. Rau ob peb hnub nws tsis kam noj zaub mov, cov kua hauv lub cev tau txhaj rau hauv lub cev. Nrog rau qhov no, cov tshuaj tau sau tseg. Tom qab, tus neeg mob tau xa mus rau kev noj haus ua ib qho ntawm txoj kev kho mob loj. Qhov tseeb noj regimen txhawb nqa ib tug zoo outflow ntawm bile.

Acute cholecystitis yog ib qho xwm ceev

Mob cholessstitis, cov tsos mob thiab kev kho mob uas tau txiav txim siab nrog kev pab ntawm tus kws kho mob, yuav tsum tau pom hauv tsev kho mob. Tab sis tsis yog txhua tus neeg thov rau kev kho mob ntawm thawj lub cim npe ntawm pathology, preferring mus nyob hauv tsev rau thawj ob peb hnub. Qhov no yog fraught nrog teeb meem. Kev mob ua ntej rau kev mob cholecystitis yog ib qho tseem ceeb uas yuav tau ceev faj. Tus neeg mob yuav tsum tsis txhob kub lub qhov chaw kub, muab dej kub da dej, haus dej kom mob siab ib leeg. Cov kev pabcuam thaum muaj xwm txheej ceev yuav tsum yog los npaj kom muaj kev thajyeeb ntawm tus neeg ua ntej tuaj txog ntawm cov kws khomob. Nws yog qhov tsim nyog:

• muab nws nrog ib txoj hauj lwm tav toj;
• tiv thaiv kev ntxhov siab (kev xav thiab lub cev);
• kom txo tau cov xwm txheej ntawm xeev siab, muab ib lub decoction ntawm mint;
• muab cov khaub thuas tso rau hauv txoj cai hypochondrium, tab sis tsis ntev dua 15 feeb.

Mob cholenessstitis - kev soj ntsuam pom zoo

Kab mob cholecystitis yog ib txoj kev ua mob loj, tab sis yog tias nws kuaj tau rau lub sij hawm, kev kho kom zoo li qub tau. Thaum tus kab mob ntawm tus kab mob gallbladder tau kuaj pom hauv cov menyuam yaus, kev siv tshuaj yeeb-tshuaj feem ntau yog siv. Nws suav nrog kev noj haus, tshwj xeeb qoj ib ce, nyob hauv lub tsev kho mob kom rov qab kho lub cev. Kev pab tshwj xeeb tshaj yog nyob ntawm qhov chaw ntawm cov ntxhia dej. Hauv cov teeb meem nyuab, kev kho mob yuav siv tshuaj, kev kho phais nyaj. Kev kho mob yog ua tiav ntawm ib qho chaw kho mob.

Acute cholecystitis - tshuaj

Kev siv cov tshuaj hauv kev kho cov kab mob pathology nyob rau hauv ntau zaus - thaum tus kab mob yog thaum ntxov, piv txwv li, cov pob zeb muaj nyob hauv lub zais zis, tiam sis tsis ua rau tsis xis nyob, thiab thaum muaj teeb meem tshwm sim. Cov kev kho ntxiv yog nyob ntawm qhov mob loj ntawm qhov mob thiab qhov dav dav ntawm tus neeg mob. Nrog kev pab los ntawm cov tshuaj, cov kws kho mob sim tshem cov mob, normalize lub bile compound thiab xyuas kom meej nws cov outflow. Tshuaj kho mob siv tshuaj:

1. Cov tshuaj Spasmolytic nyob rau thawj hnub ntawm kev tua kom txo kev mob (Papaverin, Tsis-Shpa, Dimedrol).
2. Antibiotics rau mob cholenessstitis (Ampicillin, Tetracycline, Cephzoline). Lawv tuaj yeem hloov los ntawm sulfanilamide yog tias thawj zaug tsis kam rau tus neeg mob (Sulfazin, Ftalazol, Sulgin). Lawv muaj cov kab mob antimicrobial.
3. Detoxification ntawm lub cev nrog tshuaj. Thaum lub sijhawm thawj zaug nyob hauv tsev kho mob, txoj hlab infusion txhais tau hais tias yog plasma, Dextran, Ringer's solution, Reopoliglyukin).
4. Cholagogue, nroj tsuag thiab hluavtaws (Ursoliv, Ursosan, Febihol, nettle nplooj, burdock keeb kwm, artichoke Extract).
5. Kupirovanie cov tsos mob ntawm pathology. Lithotripsy thaum kuaj cov pob zeb hauv lub zais zis (dissolving lawv).

Acute cholecystitis yog ua haujlwm

Raws li qee qhov kev qhia, qhov o ntawm txoj hlab ntaws yog kho mob. Txoj kev loj hlob ntawm cov teeb meem txhais tau hais tias muaj kev cuam tshuam kev kub ntxhov, thiab kev khiav hauj lwm yog ua thaum txoj kev kho kom tsis muaj zog. Nres cov nyom cholecystitis nyuaj thiab tsis nco qab txog nws tsuas tshem tawm cov tshuaj tua kab mob. Lub lag luam yog ua los ntawm cov kev cai qhib thiab laparoscopic. Raws li txoj cai, yog tias muaj mob cholecystitis tsis meej, yog ib hom kab mob ua rau gangrene, tus neeg mob tau muab tso rau ntawm lub rooj mus rau tus kws phais.

Hauv mob cholecystitis

Thaum kho thiab yav tom ntej, tus neeg mob uas muaj cholecystitis yuav tsum ua raws li kev noj haus tshwj xeeb. Qhov kev noj haus nyob rau hauv rooj plaub no tsis yog tsuas yog kev tiv thaiv ntawm kev loj hlob ntawm tus kab mob, tab sis kuj yog ib txoj kev zoo ntawm kev kho. Nyob rau hauv mob loj heev, noj cov zaub mov uas muaj mob rau ntawm lub zais zis lwj tas ua tiav kev tshaib plab (nyob rau hauv thawj hnub tom qab qhov kev tawm tsam). Nws yog pub rau haus tsuas yog juices, broth ntawm ib tug dogrose, tshuaj yej tsis muaj suab thaj. Tom qab qhov no, tus neeg mob kis mus noj cov naj npawb 5 - khoom noj khoom haus. Cov lus pom zoo muaj raws li nram no:

1. Carbohydrates tsuas yog siv li 200 g ib hnub xwb. Nws txhais tau hais tias noj cov kab yooj yim carbohydrates: jams, qab zib, zib mu, jam.
2. Tus nqi ntawm cov protein yog txo kom txog li 80 g roj yog tib yam.
3. Cov ntsiab lus ntawm cov hnub ration yog txog 1600 kcal. Cov kua ua kom muaj li 2.5 liters.
4. Lub hauv paus ntawm kev noj zaub mov feem ntau yog pom.
5. Khoom noj khoom haus yuav tsum tau npaj kom tsis muaj ntsev.
6. Tag nrho cov khoom muaj nyob rau hauv daim ntawv grated: nyob rau hauv daim ntawv ntawm purees, soups, soufflé.

Nyob rau hauv daim ntawv teev cov khoom xyaw uas tsis raug cai:

• taum;
• cabbage;
• salted cov khoom;
• nceb, nrog rau cov ntxhuav;
• qaub txiv hmab txiv ntoo thiab txiv hmab txiv ntoo;
• sausages;
• stew;
• tsev cheese;
• cocoa.

Lub hauv paus ntawm kev noj haus yog:

• lean nqaij nyug thiab nqaij qaib;
• ntses rau ob peb leeg;
• neeg tsis noj nqaij soups;
• crackers;
• fermented mis nyuj khoom;
• oatmeal, mov, nplej porridge;
• zaub;
• kissels;
• qhuav txiv hmab txiv ntoo.

Los ntawm qab zib nws yog ua tau los siv:

• zib ntab;
• qab zib;
• marshmallow;
• marmalade;
• ntxiv cov sweeteners haus.

Ntxiv mus tsis cuam tshuam kev mob cholecystitis, koj yuav tsum ua raws li kev noj haus thiab tom qab kho. Feem ntau, nrog txoj kev saib xyuas kev noj haus thiab kev kho mob kom zoo, nws muaj peev xwm ua kom tau kev so ib leeg. Kev noj tshuaj (mob rau lub cev, mob cholera) nrog rau kev mob ntawm lub zais zis yuav tsum raug tswj los ntawm tus kws kho mob.