Mawu oti "matenda a ndulu" amatchula vuto lililonse la thanzi lomwe limakhudza ndulu.
Ngakhale vuto lalikulu la nthendayi ndi gallstones (yotchedwa cholelithiasis), pali zifukwa zina, kuphatikizapo ndondomeko yotupa (yotchedwa cholecystitis), biliary dyskinesia, matenda ogwiritsira ntchito ndulu, matenda oyambirira a cholangitis, ndi khansa ya ndulu.
Zomwe Zimayambitsa
Mwala wamakono ndiwowonekera kwambiri kwa matenda a ndulu ndi mawonekedwe chifukwa cha cholesterol wochuluka kapena bilirubin (nkhumba yomwe imapangidwa m'chiwindi pamene maselo ofiira amagawanika).
Zitsulo zamakono ndi makina opangidwa mkati mwa ndulu, yomwe ili ndi mapepala opangidwa ndi peyala omwe ali pamwamba kumanja kwa mimba yanu pansi pa chiwindi. Cholinga chanu chachikulu cha ndulu ndicho kusunga madzi, otchedwa bile, omwe amapangidwa ndi chiwindi. Choyika ndi kofunika kuti mudye mafuta ndi mavitamini ena kuchokera ku zakudya zomwe mumadya.
Ndi mitsempha ya kolesteroloni , bile yanu "imadwala" ndi mafuta a kolesterol ndipo sungathe kuipasuka monga momwe imakhalira, choncho mawonekedwe a miyala. Ambiri omwe ali ndi gallstones ku United States ali ndi miyala ya cholesterol.
Nkhumba zamatumbo zingapangidwe ngati pali bilirubin yambiri. Matenda monga matenda a chiwindi (bilirubin yochuluka kwambiri imapangidwa ndi chiwindi) ndi matenda a sickle cell (kumene maselo ofiira amathyoledwa) amachititsa miyala ya pigment.
Potsirizira pake, mitsempha imatha kupanga ngati ndulu imazembetsa bile bwino (izi zimatchedwa bile stasis).
Zina mwazifukwa zomwe zimapangitsa kuti ziphuphu ziphuphuke ndi izi:
- Mayi wamwamuna
- Ali ndi zaka zoposa 40
- Mimba
- Kunenepa kwambiri
- Amadya kwambiri mu mitsempha ya cholesterol, mafuta okonzedwa bwino (mwachitsanzo, mkate woyera), ndi mafuta odzaza (monga tchizi, batala, ndi nyama yofiira)
- Kukhala moyo wosadzikonda
- Kutaya kolemera mwamsanga
- Matenda opatsirana (monga matenda a shuga, matenda a shuga, matenda a chiwindi, matenda a Crohn, cystic fibrosis, matenda a sickle cell, kapena kuvulala kwa msana)
- Mankhwala omwe ali ndi estrogen, monga mankhwala opatsirana pakamwa kapena mankhwala othandizira odwala
- Mankhwala ena monga Sandostatin (octreotide), Rocephin (ceftriaxone), ndi tizilombo ta thiizde monga Microzide (hydrochlorothiazide)
Zowonjezera Zifukwa
Zina mwazifukwa zina zimagwirizana ndi matenda a gallbladder.
Cholecystitis
Kutupa kwa ndulu (yotchedwa cholecystitis) ikhoza kukhala chifukwa cha gallstones (yotchedwa cholecystitis) kapena kawirikawiri, popanda gallstones (yotchedwa acalculous cholecystitis).
Cholecystitis yovuta imakhalapo pamene gallstone imakhala mkati mwa njira ya cystic, yomwe imawombera kutupa. Kuphatikiza pa ululu wambiri (biliary colic) wokhala ndi gallstone, munthu akhoza kukhala ndi malungo, kunyowa, kusanza, malaise, ndi / kapena kusowa kwa njala. Chiwerengero cha maselo oyera a m'magazi amakhalansopo.
Acalculous cholecystitis imachititsa zizindikiro zofanana ndi zizindikiro monga chowopsa cholecystitis, komabe, palibe gallstone alipo. M'malo mwake, akatswiri amakhulupirira kuti vutoli limachokera ku gallbladder stasis ndi ischemia (osauka magazi).
Matenda oterewa amapezeka makamaka odwala odwala kwambiri.
Zina mwa zinthu zomwe zimapangitsa munthu kukhala ndi mwayi wotenga acalculous gallbladder matenda ndi awa:
- Matenda aakulu (mwachitsanzo, mitsempha yoopsa ya khansa ya m'magazi, AID, matenda a mtima, mtima wa shuga, matenda a impso, ndi matenda a shuga)
- Kutentha
- Kubereka
- Kuletsa chitetezo cha mthupi
- Matenda aakulu kapena zoopsa
- Mankhwala ena (mwachitsanzo, opiates)
- Kuikidwa magazi ambiri
- Mitundu ya mpweya wabwino
- Kulandira zakudya kudzera mu mitsempha yanu (yotchedwa total parenteral nutrition)
Biliary Dyskinesia
Biliary dyskinesia imalongosola za matenda a biliary njira zothandizira zokhudzana ndi ntchito yosaoneka bwino ya sphincter ya Oddi-yomangira thupi lomwe limayandikana ndi malo omwe anthu ambiri amagwiritsira ntchito njira ya pancreatic pamene akulowa m'matumbo aang'ono.
Popeza sphincter ya Oddi sichigwira ntchito bwino mu matendawa, chitetezo cha biliyara chikhoza kuchitika. Zilonda zapakati pazigawo za biliary zimapangitsa ululu-ngati ululu-ululu wosasunthika, wopweteka nthawi zonse kumtunda kapena kumtunda pakati pa mimba.
Ngakhale kuti mimba yotchedwa abdominal ultrasound imatha kufotokoza njira yowonjezereka yowonjezereka, mayesero otchedwa sphincter a Oddi manometry angagwiritsidwe ntchito kuti atsimikizire bwinobwino kuti ali ndi dyskinesia. Ngati sphincter ya vuto la Oddi ili pamwamba (mayesero ali abwino), munthu akhoza kuchotsa sphincter (yotchedwa endoscopic sphincterotomy).
Sindidziwika bwino chomwe chimayambitsa biliary dyskinesia. Zikuwoneka kawirikawiri mwa anthu amene atulutsidwa ndi ndulu; ngakhale kuti anthu ambiri omwe atulutsidwa ndi nthendayi sakumana ndi biliary dyskinesia. Akatswiri ena adanena kuti matendawa amatha chifukwa cha kusokonezeka kapena kusokonezeka kwa mitsempha yamtundu wa sphincter.
Kugwiritsa Ntchito Gallbladder Disorder
Matenda ogwira ntchito amtunduwu amatanthauza anthu omwe amamva kupweteka kwa biliyasi (osamveka kumtunda kapena pakati pa mimba) popanda kutuluka kwa gallstones kapena sphincter ya Oddi yovuta.
Anthu omwe ali ndi matenda opatsirana pogwiritsa ntchito ndulu amakhala ndi mayeso oyenera a magazi, popanda umboni wa mavuto otupa kapena chiwindi. Iwo ali ndi chizoloŵezi cha ultrasound cha gallbladder popanda umboni wa gallstones.
Pambuyo polamulira zinthu zina zomwe zingafanane ndi ululu wa biliyoni (mwachitsanzo, matenda a mtima ischemic kapena matenda a zilonda zam'mimba), munthu akhoza kuyesedwa cholescintigraphy yotchedwa cholecystokinin (CCK) kuti atsimikizidwe kuti ali ndi matenda oopsa.
Chiyesochi chimawerengera gawo la ejection la gallbladder (kuchuluka kwake kumatulutsa ndulu). Ngati kachigawo kakang'ono ka ejection kakang'ono, ngati osachepera 40 peresenti, mayeso amathandizira kugwiritsidwa ntchito kwa matendawa. Chithandizo cha matendawa chimapangitsa kuchotsa ndulu (yotchedwa cholecystectomy).
Ngakhale kuti sichidziwike, n'zotheka kuti anthu omwe ali ndi vuto la m'mimba motility (mwachitsanzo, chotupa chachitsekemera cha m'mimba) akhoza kukhala pachiopsezo choyamba kugwira ntchito yamagulu.
Primary Sclerosing Cholangitis
Primary sclerosis cholangitis (PSC) ndi matenda a nthawi yaitali omwe amachititsa kuti thupi liziyenda kwambiri. Chifukwa cha kutupa kwanthawi yaitali, mankhwalawa amakhala osowa, amachititsa mitsempha, choncho bile sangathe kukhetsa. Zotsatira zake, bile imamanga m'chiwindi, kuwononga maselo a chiwindi ndi kuchititsa chiwindi. Ngati sichidwalitsidwe ndi chiwindi, PSC ikhoza kubweretsa khansa ya chiwindi ndi / kapena ndulu.
Choopsa chachikulu chokhazikitsa PSC chiri ndi ulcerative colitis. Ndipotu, anthu ambiri okhala ndi PSC ali ndi ulcerative colitis. Pa mbali yazing'ono, anthu ochepa okha omwe ali ndi zilonda zam'mimba amatha kukhala ndi PSC.
Kansa ya Gallbladder
Khansara ya gallbladder ndi yosavuta ndipo imachitika pamene maselo mu ndulu amakula mofulumira komanso mosasinthasintha.
Mitsempha yonse ndi primary sclerosis cholangitis imachulukitsa mwayi wa munthu kuti akhalitse khansa, ngakhale kuti ziphuphu zimakhala zofala kwambiri. Ndipotu, malinga ndi American Cancer Society, anthu atatu mwa anayi alionse amene ali ndi khansa ya ndulu amakhala ndi gallstones akapezeka.
Zina mwazifukwa zomwe zingayambitse matendawa ndi:
- Mayi wamwamuna
- Ukalamba
- Kunenepa kwambiri
- Mitundu (Mexican American kapena American American)
- Matenda omwe ali ndi mabakiteriya, Salmonella Typhi
- Mphepete mwa chida chofala chotchedwa bile
- Gallbladder polyps
- Zosawonongeka za ma ducts
> Zotsatira:
> Afdhal N. (2017). Acalculous cholecystitis. Mawonetseredwe am'chipatala, matenda, ndi kasamaliro. Ashley SW, Lindor KD (ed). Kupititsa patsogolo, Waltham, MA: UpToDate Inc.
> American Cancer Society. (2016). Kodi Ndizifukwa Zotani za Gallbladder Cancer?
> Catalano MF, Thosani NC. (2016). Zowonetseratu zachipatala ndi matenda a sphincter a Oddi matenda. Howell DA (ed). Kupititsa patsogolo, Waltham, MA: UpToDate Inc.
> Jessri M, Rashidkhan B. Zakudya komanso chiopsezo cha matenda a ndulu: Ophunzira achikulire omwe amapita kuchipatala. J Health Popul Nutriti. 2015 Mar; 33 (1): 39-49.
> Stinton ML, Shaffer EA. Epidemiology ya Matenda a Gallbladder: Cholelithiasis ndi Cancer. Kutentha Chiwindi . 2010 Apr; 6 (2): 172-87.