Chithandizo cha matenda a gallbladder chimadalira mtundu wa matenda omwe alipo. Pankhani ya kuchiza zilonda zamtunduwu , kawirikawiri pali njira zitatu zokhazokha-njira ya "kudikirira ndi kuyembekezera" ngati palibe zizindikilo, opaleshoni kuchotsa ndulu ndi miyala, kapena mankhwala kuti aswe. Kuchiza mavuto ena a ndulu kapena bile, monga mwala umene umakhala nawo m'kati mwake, ungafunike njira yowonjezera yotchedwa ERCP.
"Yang'anani ndi Dikirani" Njira
Ambiri mawonekedwe a ndulu matenda ndi gallstones. Makungwa ambiri amachititsa kuti asakhale ndi zizindikiro.
Pamene amachititsa ululu, komabe opaleshoni nthawi zambiri amafunikira. Mankhwala samagwiritsidwa ntchito kawirikawiri kuti athetse zilonda zamkati, ngakhale kuti amagwiritsidwa ntchito pochiza ululu wa matenda a ndulu.
Mankhwala
Mukachiza matenda a ndulu, dokotala wanu akufuna kuchiza zizindikiro zanu zonse ndi matenda omwe akudwala.
Kuchitira Zizindikiro
Chizindikiro chofala kwambiri cha matenda a gallbladder ndi kupweteka, kawirikawiri kumtunda kumanja kwa mimba. Dokotala wanu akhoza kuthana ndi ululu wanu ndi mankhwala osakanikirana (nonsteroidal anti-inflammatory (NSAID) monga ibuprofen, kapena opioid ngati morphine.
Ndikofunika kuzindikira kuti ma opioids nthawi zambiri amachititsa anthu kugona ndipo kawirikawiri amachititsa kudzimbidwa, chifukwa chake dokotala angakulimbikitseni kutenga mankhwala ophera mankhwala ndi piritsi lanu lopweteka.
Kuchiza Gallbladder Yokakamiza Vuto
Pulogalamu yamchere ya acide monga Actigall (ursodiol) ingatengedwe kuti iwononge mitsempha ya cholesterol, yomwe imakhala yamwala kwambiri ku United States. Ngakhale kuti mapiritsiwa amavomerezedwa bwino, anthu ena amakhala ndi kutsegula m'mimba mofatsa, ngakhale kuti nthawi zambiri amatha nthawi.
Chotsutsana ndi kutenga pilisi ya asidi yambiri ndikuti zingatenge zaka zambiri kuti nyongolotsi zisungunuke; choncho lipiritsi ya asidi siyi njira yabwino kwa anthu okhala ndi ndondomeko ya gallstone.
Ngati munthu ali ndi kachilombo ka nthendayi kapena kachilombo ka biliary (mankhwalawa) amafunikira mankhwala opha tizilombo (operekedwa kuchipatala), pamodzi ndi madzi ndi kupweteka, kufikira chitsimikizo monga opaleshoni kapena ERCP ( onani m'munsimu) zachitika.
Ndondomeko Zapadera
Chithandizo choyamba cha matenda a ndulu ndi kuchotsa opaleshoni ya ndulu, yotchedwa cholecystectomy.
Komabe, pali zosankha zopanda opaleshoni, makamaka kwa anthu omwe ali pangozi yaikulu yochitidwa opaleshoni. Choponderezeka cha osagwiritsa ntchito opaleshoni ndi chakuti ndulu imakhalapobe, choncho nthendayi (makamaka magulu) imatha kubwerera.
Cholecystectomy
Cholecystectomy imagwira pansi pa anesthesia mu chipinda chogwiritsira ntchito ndipo ndi mankhwala othandiza kwambiri pa matenda a gallbladder.
Kwa anthu ambiri, opaleshoniyi yachita laparoscopically, yomwe imaphatikizapo dokotalayo kuyika chida chochepa, chosakanikirana (ndi kamera kanema pamapeto) kudzera pang'onopang'ono pamimba. Pogwiritsira ntchito zipangizo zautali, dokotalayo amapanga mabowo ang'onoang'ono amodzi pamimba, ndi kuchotsa ndulu.
Cholacystectomy ya laparoscopic imakhala yovuta kwambiri ndipo nthawi zambiri imakhala yosavuta kuchira kusiyana ndi chotsegula chotsegula m'mimba, chomwe chimadulidwa pamimba kuti chichotse mchere.
Kansa ya Gallbladder
Cholacystectomy ya laparoscopic siigwiritsidwe ntchito kawirikawiri pochiza khansara chifukwa zimakhala zovuta kuti khansara ina iwonongeke. Komanso, pali vuto la "kubzala" kapena kufalitsa khansara ku mbali zina za thupi. M'malo mwake, pofuna kuchiza khansara yamatenda, dokotala wa opaleshoni adzachita cholecystectomy yochuluka, yotchedwanso radial cholecystectomy.
Pakati pa cholecystectomy yochulukirapo, dokotala wochita opaleshoni amachotsa ndulu, zizindikiro zina za chiwindi pafupi ndi ndulu, ndi zitsulo zilizonse zapafupi. Nthawi zina, zimakhala zowonongeka (mwachitsanzo, mankhwala ambiri omwe amachititsa chiwindi, mapepala kapena chiwindi chachikulu), malingana ndi momwe khansara imafalikira.
Mankhwalawa ndi othandizira kuchiza khansa ya m'mimba.
Ngozi Zopangira Opaleshoni
Monga momwe mukuchitira opaleshoni iliyonse, pali zoopsa zomwe zimaphatikizapo:
- Kusuta
- Chitetezo cha sitepe
- Magazi amatha
- Chibayo
- Mavuto ochokera ku anesthesia
Dokotala wanu adzakuyang'anirani kuti muwonetsetse kuti zotsatirazi zafotokozedwa mwamsanga ndi moyenera.
Zotsatira za Opaleshoni
Ngakhale zili zotetezeka komanso zokhala popanda ndulu, anthu ena amapeza mpweya, kuphulika, ndi kutsekula m'mimba pambuyo pa kuchotsa ndulu. Ngakhale kuti izi ndizokhalitsa, zingapitirize zaka kwa anthu ena.
Pakhoza kukhala zotsatira zina zoopsa kuchokera ku kansalu yotchedwa cholecystectomy kwa khansa ya ndulu, monga kudya kapena kudya, kuphweteka m'mimba, kapena chiwindi chosalimba. Dziwani kuti dokotala wanu adzayang'anira ndi kuthetsa vutoli.
Kuchotsa mwachinyengo
Ngati munthu akufunika kuti chikhocho chichotsedwe koma ali ndi matenda ambiri, choncho amaonedwa kuti ali pangozi yaikulu ya opaleshoni, akhoza kuyendetsa njira zowonongeka pofuna kuchotsa mwala.
Ndi kuchotsa mwala mwachitsulo, chubu chochepa kwambiri chotchedwa catheter chimalowetsedwa kudzera pakhungu ndi kulowa mu ndulu kuti mulowetse madzi. The bile imadutsa mumtsuko wamadzi womwe umagwirizanitsa ndi mapeto a catheter. Kenaka, pamasabata angapo otsatira, dzenje limene catheter linayikidwa likukula pang'onopang'ono, kulola kuti mwalawo uchotsedwe.
Kusokonezeka Kwambiri Kwambiri
Chidutswa chodabwitsa cha mtundu wa wave (ESWL) ndi njira yopanda opaleshoni yomwe siigwiritsidwe ntchito mochiritsira kuchizira. Njirayi imagwiritsidwa ntchito pansi ndipo imagwiritsa ntchito mafunde osokoneza kuti aswetse mitsempha yazing'ono kukhala zidutswa zing'onozing'ono, zomwe zimatha kupasuka ndi kutulutsa ndulu.
Ngati agwiritsidwa ntchito, ESWL imasungidwa kwa anthu omwe sali olemera kwambiri, ali ndi zitsulo zosachepera zitatu, komanso omwe ali ndi ndulu yogwiritsira ntchito thanzi.
ERCP
Njira yomwe imatchedwa endoscopic retrograde cholangiopancreatography (ERCP) imalola dotolo kuganiza mozama kuti ntchentche zimakhala zosaoneka ngati bulu, ndulu, kapena chifuwa. Ngakhale chithandizo, ERCP imathandizanso, monga dokotala angathetsere vutoli panthawi yomweyi. Kwa mbali yaikulu, ERCP yathandiza opaleshoni kuti athetse vuto la mankhwala m'matenda.
An ERCP ndi ndondomeko yochitidwa pofuna kuthetseratu kutsekemera kwa mankhwala a bile, omwe amachokera ku mwala.
Zimene muyenera kuyembekezera
Panthawi ya ERCP , gastroenterologist idzatsogolera chubu lochepa, lomwe limakhala ndi kamera kakang'ono pamapeto pake (otchedwa endoscope) pansi pakamwa m'mimba ndi m'matumbo aang'ono. Dye wosiyana ndiye amaloledwa kudzera mu chubu kuti aganizire mozungulira ma-x-ray. Ngati chitetezo chikuwoneka, gastroenterologist ingagwiritse ntchito zipangizo zofunikira (zomwe zimayikidwa kudzera mu endoscope kuchotsa kapena kuchepetsa kutseka). Mwachitsanzo, dokotala akhoza kuchotsa mwala umene ukulepheretsa njira yowonjezera ya bile kapena kuika mpweya ngati njira yaying'ono.
Munthu amakhala pansi pa ERCP kuti athetse vuto lililonse ndikuonetsetsa kuti ali omasuka. Ngakhale kuti ERCP imakhala njira yabwino komanso yosamalidwa bwino, munthu amatha kupweteka kwambiri pakhosi kapena kupweteka pambuyo pake.
Mwachilendo, mavuto okhudzana ndi ERCP angakhalepo, kuphatikizapo:
- Pancreatitis, yomwe kawirikawiri imakhala yofatsa, koma imafuna kanthawi kochepa kuchipatala kwa madzi ndi ululu woyang'anira
- Phokoso m'matumbo (lotchedwa perforation), lomwe ndi losavuta komanso lalikulu, ndipo limafuna opaleshoni kukonza
- Kuchiza kwa mankhwala otchedwa bile (wotchedwa cholangitis), omwe amafuna kuti chipatala chikhale ndi mankhwala osokoneza bongo komanso madzi owonjezera
- Kupuma kwa chibayo, chifukwa chake nkofunika kuti musadye kapena kumwa kwa maola angapo musanayambe ndondomekoyi
Mankhwala Okwanira
Ngakhale matenda a ndulu ayenera kuchiritsidwa ndi dokotala, ndizomveka kuganizira mankhwala othandizira. Izi zanenedwa, ndikofunika kutengapo zitsamba, mavitamini, kapena zakudya zina zothandizira pothandizira dokotala wanu.
Zitsamba
Zitsamba zina monga silymarin ( Silybum marianum ), omwe amatchedwanso mkaka nthula , zimapereka chithandizo cha chifuwa ndi chiwindi. Kafukufuku wina akusonyeza kuti zitsamba zofanana ndi turmeric, Oregon mphesa, bupleurum, ndi udzu wa ndalama zimatha kuchepetsa kutupa kwa chifuwa ndi kuchepetsa chipsinjo cha chiwindi.
Zakudya Zachilengedwe
Kulandira zakudya zamagulu zokhala ndi zakudya zowonjezera kumathandiza kupewa matenda ena. Chakudya chokoma ndi ndondomeko ndi zipatso ndi ndiwo zamasamba, makamaka masamba a vitamini B ndi iron, monga sipinachi ndi kale, ndi zakudya zowonjezera zakuda monga blueberries, yamatcheri, tomato, sikwashi, ndi tsabola. Mapuloteni olemera kwambiri monga nyama zowonda, nsomba, tofu, kapena nyemba ndi zabwino zonse.
Kupangidwanso
Kuphunzira China pang'ono anapeza kuti kusintha kwapadera kunachepetsanso zizindikiro za ndulu yotupa (yotchedwa cholecystitis), ngati ululu wamsana ndi ululu wam'mimba. Ngakhale kutsegula m'mimba kungachepetse ululu wa matenda a ndulu, ndikofunika kuona dokotala kuchipatala (opaleshoni, makamaka) ya vutoli.
Kupewa
Kukhala ndi moyo wathanzi komanso thanzi labwino monga matenda a shuga, kunenepa kwambiri, ndi matenda a kagayidwe kake kamayambitsa matenda a ndulu, makamaka mapangidwe a gallstones.
Nkhani yabwino ndi yakuti munthu angachepetse chiopsezo chawo chokhala ndi mitsempha yambiri (komanso mavuto ena) mwa kukhala ndi chiwerengero cha thupi lachibadwa (BMI), kugwiritsa ntchito tsiku ndi tsiku, ndikuwona dokotala wawo wamkulu woyang'anira matenda awo a shuga kapena cholesterol (ngati panopa).
Monga pambali, ngati muli olemera kwambiri kapena olemera kwambiri ndipo mukuyamba kulemera kwa regimen, onetsetsani kuti mukuchita motsogoleredwa ndi dokotala wanu, ngati kuchepa kwa msanga kumawonjezetsa chiopsezo chanu chokhazikitsa miyala.
Pomaliza, posankha zakudya, kafukufuku wapeza kuti zakudya zabwino zomwe zimadya masamba, zipatso, mafuta a mkaka, mafuta onse, nyemba, ndi zonunkhira zimakhala ndi chiopsezo chochepa cha matenda a gallstone. N'zochititsa chidwi kuti kafukufuku amasonyezanso kuti kumwa mowa kumachepetsa chiopsezo cha munthu kuti apangire zinyontho.
> Zotsatira:
> American Cancer Society. (nd). Kuchiza Khansa ya Gallbladder.
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> Lee JY, Keane MG, Pereira S. Kuzindikira ndi chithandizo cha matenda a gallstone. Dokotala. 2015 Jun; 259 (1783): 15-9,2.
> Moga MM. Mankhwala othandiza a gallbladder matenda. Lingani Zolemba . 2003 Jan; 60 (1): 143-7.
> Stinton ML, Shaffer EA. Epidemiology ya Matenda a Gallbladder: Cholelithiasis ndi Cancer. Kutentha Chiwindi . 2010 Apr; 6 (2): 172-87.
> Tringali A, Loperfido S. (2018). Maphunziro oleza mtima: ERCP (endoscopic retrograde cholangiopancreatography) (Pambuyo pa Zowona). Howell DA (ed). Kupititsa patsogolo, Waltham, MA: UpToDate Inc.
> Wen FY, Li SC, Wang GM, Li LX, Nyimbo YQ. [Zotsatira za Jianjing (GB 21) kukhwimitsa pamtenda wa galasi ndi zizindikiro za cholecystitis odwala]. Zhen Ci Yan Jiu. 2012 Oct; 37 (5): 398-402.