Acute cholecystitis - zvinokonzera uye kurapa kwemishonga, kudya, nzira yekuvhiya

Nenguva isipi uye nokukurumidza kukura kuputika kwegorobladder kunonzi acute cholecystitis. Chirwere ichi, chakasimuka kwekutanga, chinoguma nekugadzirisa zvakakwana nekurapa zvakakwana. Kana kukanganisa kuchidzoka, chirwere chisingaperi chechirwere chinowanikwa. Nezera, hutano hwekuwana cholecystitis hunowedzera, mamwe majekiseni anokanganiswa nevakadzi kupfuura varume. Munzvimbo ine ngozi - vakadzi vane pamuviri, kutora mishonga yehomoni uye vanhu vakaoma.

Acute cholecystitis - zvinokonzera

Kurwiswa kwakanyanya kweguruvladder kunoratidzika nekusava nemafungiro mumutumbi we bile nokuda kwekudzivirirwa kwekubuda kwayo. Muzviitiko zvakawanda, kukura kwehutano kunosanganiswa nekuvapo kwematombo (kusvika kune zvinokwana 95% zvezvirwere), uye mu 60% yevarwere kune hutachiona hwehutachiona: E. coli, cocci, salmonella mu bile. Kusiyana kwakasiyana kunogona kukonzera cholecystitis, zvinokonzera chirwere zvinonzi zvinotevera:

• utachiona, bhakitiriya maruva mu bile;
• sclerosis yemadziro echando kana atrophy;
• kink yechiri uye inotevera kubuda kwebi;
• kuchinja masvingo echando nekuda kwezera;
• pancreatic juice mu bladder, kukanda enzyme dzepaccatic;
• kusagadzikana - mafuta, zvokudya zvinonaka uye zvokudya zvakanyanya;
• kuvhara kweka bile duct kana kukuvadza pamadziro nemaitiro akasimba.

Acidless cholecystitis

Zvichienderana nehupo hwematombo - bhaariary calculi - kuputika kwegorobladder yakakamurwa kuva kuverenga (nematombo) uye isiri kuverenga. Izvozvo zvekupedzisira chirwere hazviwanzovi. Sezvo mutemo, beskamenny cholecystitis ine chimiro chisingaperi, uye kana yakaoma, inosanganiswa nekupinda kwepathogen zvakananga mu gallbladder panguva yekuputira maitiro mumukumbo. Utano hunokonzerwa nezvinhu zvakadai sokuti:

• utachiona hwechirwere chemuviri;
• kuvapo kwebhakitiriya;
• chirwere chetachiona;
• E. coli ;
• staphylococcus, enterococcus;
• Proteus.

Calculous cholecystitis

Nemhaka yemakemikari kusaenzana mumuviri mune bhanhire uye mahara ayo, maitiro akasimba anoumbwa-matombo. Vanokuvadza bile ducts, zvichikonzera marwadzo, kusagadzikana, kuvhiringidzika uye kutyisa zvakaoma kuverenga cholecystitis. Zvinokonzera cholelithiasis, zvinotungamirira kuhutano hwechidzitiro:

• overweight;
• zvinetso kubva mukukurumidza kuora kurasikirwa;
• kugamuchirwa kwekudzivirira kubata pamuviri;
• chirwere cheshuga mellitus ;
• kukwegura;
• kushandiswa kwemishonga inoderedza huwandu hwehushutera muropa, nezvimwewo.

Acute cholecystitis - zviratidzo

Sezvo mutemo, zvakanyanya cholecystitis zvinoratidzika mushure mokutora zvokudya zvinokuvadza, kuchinetseka kana kutora doro. Izvo zvipenyu zvinopinda zvakasimba kune zvinhu zvisina kunaka. Kuderedza kudzvinyirirwa, kubata, kurutsira, kubhururuka uye zvimwe zviratidzo, anorondedzera kuti kuputika kweguruvladder kwave kwakatanga, zviratidzo zvaro zvakaoma kuisa hanya nazvo. Kuoma kwezviratidzo kunobva pachikamu chechirwere. Zviratidzo zvakajeka zveaicute cholecystitis, kuzvisiyanisa kubva kune dzimwe zvirwere nekubatsira kuti uongorore hutachiona:

1. Kana iwe ukanyanyisa panzvimbo iyo pakati pemakumbo emuviri we sternocleidomastoid, kurwadziwa kunowanikwa.
2. Nekudzika kwakadzika, murwere haakwanisi kuisa.
3. Munguva ye palpation ye right subcostal area, inhalation pain.
4. Ikoko kune dambudziko rekudzivirirwa remasumbu emimba.
5. Kusuruvara panguva yekukwira pamucheto wechindwe chechindwe chechikafu chinodhura chinobva kurudyi (nzvimbo yechando).

Zvinonyunyuta zvechirecystitis yakaoma

Kana chirwere chinenge chichiitika, murwere anonzwa asinganzwisisiki. Pakati pezvirwere zvisingafadzi zvakanyunyuta pamusoro: kutsamwa mumuromo, kushungurudza, kusuruvara nekugadzikana kwe bile, mushure mokunge pasina kuponeswa. Zvichida mvura zvigaro zvine acute cholecystitis, kuonekwa kwe jaundice uye kuwedzera kwekuwedzera kweguruvladder, kuwedzera kwekushisa kwemuviri (kusvika kusvika 40 degrees). Asi kunyunyuta kunonyanya kukosha uye zviratidzo zvikuru zvekushaya cholecystitis haisi kupfuura kurwadziwa.

Unhu uye nzvimbo yepamusoro yehutambu hwakanyanya mucholecystitis

Denda rinotanga nekurwisa kwakasimba. Marwadzo ane acute cholecystitis anoitika, sekutonga, mune zvakanaka hypochondrium region, inogona kuonekwa epigastrium. Kushushikana kusingafadzi kwenguva yakareba haipfuuri, irradiate kumusoro kumapapula uye nebandauko rorudyi, mutsipa, nzvimbo yepraclavicular, kumashure. Pain pumped with bouts:

• simuka usiku kana mangwanani;
• Iva nesimba, asi rega kupera kwechinguva (kubva pamaminitsi makumi matatu kusvika makumi matanhatu);
• kurwisana kwakaoma kumunhu, iye anomanikidzwa kutora nzvimbo isina kunetseka, kuvhomora makumbo ake mudumbu uye kuedza kupisa nzvimbo inopisa.

Ndeipi njodzi ye cholecystitis?

Kurwiswa kwechigunwe cholecystitis kunogara kwemazuva mazhinji, asi zvirwere uye sepsis zvinogona kukonzera matambudziko. Dzimwe nguva panguva yekuvandudzwa kwechirwere kuputika kwemadziro echando kunoitika. Somugumisiro, pane kuvhuvhuta kana kuti fistula inofadza inoumbwa. Kuongororwa kwepathology, yakaitwa panguva isina kunaka, kusarapwa kwekodzero kunowedzera mikana yokuti zvinetso zveaclecystitis acharamba ichikura. Zvinonyanya kuitika kwavari ndezvi:

• pancreatitis - kuvhiringidza kwepascreas ;
• Cholangitis - pathology ye bile bile duct;
• a abscess caulinian;
• empyema (kudyidzana), chirwere kana kukanganiswa kweguruvladder;
• biliary fistula;
• purulent diffuse peritonitis;
• jaundice.

Acute cholecystitis - kuongororwa

Varwere vanorapwa nokurwadza kwakanyanya kuna chiremba mushure mechiratidzo chakajeka che cholecystitis, sekutonga, vari muchipatara, vakaiswa muchipatara. Izvi zvinokonzerwa nekliniki kufanana kwezviratidzo ne appendicitis. Chipatara ichiita kusiyana kwakasiyana-siyana kwekutsvaga cholecystitis. Chigumisiro chinowanikwa mushure mekuongororwa kweongororo, iyo inosanganisira mabharatori uye nzira dzokushandisa. Kuongororwa hakusi kwakaoma uye kunosanganisira:

• kuongororwa kweropa (general), kuzarura kuvapo kwekuputika;
• biochemical blood test;
• Ultrasound yechipfuva chemimba, ichibvumira kuongorora nduru, yakawanda;
• urinalysis;
• Kuratidzwa kwemafirimu - nekufungira kwe peritonitis.

Acute cholecystitis - kurapa

Kana acute calculous cholecystitis inoratidzwa, kurapwa kunosanganisira kuparidzirwa kwechipatara nekukurumidza (mumaawa 24-48 okutanga) kubuda kwezvokudya zvechingwa. Nokuda kweizvi, a nasogastric tube inoshandiswa. Murwere anoratidzirwa zvakasimba zororo zororo. Kwemazuva anoverengeka iye anoramba kudya, mvura inoshandiswa inorohwa mumuviri mukati. Pamwe chete neizvi, mishonga inorayirwa. Pakupedzisira, murwere anoendeswa kunodya seimwe nzira huru yekurapa. Zvokudya zvakakodzera zvinowedzera kunaka kwakanaka kwebi.

Acute cholecystitis inomhanyira

Acute cholecystitis, zviratidzo uye kurapwa kwazvakatarirwa nekubatsira kwachiremba, inofanira kuonekwa muchipatara. Asi haasi munhu wose anoshanda mukurapa pachiratidzo chokutanga chekurwara, achida kugara kumba kwemazuva mashomanana ekutanga. Izvi zvakazara nezvinetso. Kutanga-kurapwa kwechirwere cholecystitis zvakakosha kugovera nekuchenjerera. Murwere haafaniri kupisa nzvimbo inopisa, kutora bhati inopisa, kunwa painkillers chete. Rubatsiro rwemhirizhonga runofanira kurongerwa kupa munhu rugare rwepfungwa vasati vasvika vanachiremba. Zvakakosha:

• kuti apiwe nechinzvimbo chisinganzwisisiki;
• kudzivirira kubva pakumanikidzwa (mupfungwa uye mumuviri);
• kuti kuderedze chiitiko chekunyunyutira, kupa chirevo chemuti;
• kuisa hutori muhotera hypochondrium, asi kwete kwenguva refu kupfuura maminetsi gumi nemashanu.

Acute cholecystitis - kliniki mazano

Acute cholecystitis chirwere chakakomba, asi kana ichionekwa munguva, chirongwa chekuchengetedza chinokwanisika. Apo kuvhuvhuta kweguruva kunowanikwa mune vana, kwete-kurapa mishonga kunowanzoshandiswa. Inosanganisira kudya, kunyanya muviri muviri, kugara mu sanatorium kudzorerwa kwemuviri. Especially useful stay in the resorts of mineral water. Mumatambudziko akaoma, kurapa kunosanganisira kutora mishonga, zvichida kupindira. Mishonga inoitwa panze yepamusoro.

Acute cholecystitis - zvinodhaka

Kushandiswa kwezvinodhaka mukurapa kwehutano kunoratidzwa mumamiriro ezvinhu akasiyana-apo chirwere chacho chiri pamatambo ekutanga, somuenzaniso, matombo aripo muchechi, asi haaiti kukanganisa kukuru, uye kana zvinetso zvikaitika. Kuwedzera kurapwa kunoenderana nekuoma kwekuvhiringidza uye mamiriro ezvinhu ose emuurwere. Nemubatsiro wemishonga, vanachiremba vanoedza kubvisa kuvhunika, kuisa muitiro wezvinyorwa zveB bile uye kuvimbisa kuti yakabuda. Kurapa zvinodhaka zvinoreva:

1. Spasmolytic zvinodhaka muzuva rokutanga rekurwisa kunobvisa kurwadziwa (Papaverin, No-Shpa, Dimedrol).
2. Mishonga inorwisa mabhakitiriya yeiclecystitis yakaoma (Ampicillin, Tetracycline, Cephzoline). Zvinogona kutorwa sulfanilamide kana yekutanga isingatenderwi nemurwere (Sulfazin, Ftalazol, Sulgin). Ivo vane antimicrobial effect.
3. Detoxification yemuviri nemishonga. Pakugara kwekutanga muchipatara, nzira yekuisa mukana inoshandiswa (plasma, Dextran, Ringer's solution, Reopoliglyukin).
4. Cholagogue, simiti uye inogadzirwa (Ursoliv, Ursosan, Febihol, nettle leaves, burdock midzi, kubvisa artichoke).
5. Kupirovanie zviratidzo zvechirwere. Zvinyorwa zvinogadziriswa painoona matombo mumucheka (kuapedza ivo).

Acute cholecystitis is opera

Maererano nezvimwe zviratidzo, kuputika kweguruvladder kunoitwa chirwere. Kubudirira kwezvinetso zvinoreva kushanda kwekukurumidza, uye kushanda kunoitwa apo chirongwa chinorongwa chisingaiti. Bvisa zvakakomberedzwa cholecystitis uye zvachose kukanganwa pamusoro pazvo zvinogona kungobvisa bongo. Basa racho rinoshandiswa nenzira yakasununguka uye yaparoscopic. Semitemo, kana acute phlegmonous cholecystitis inoratidzwa, imwe yemhando dzakasiyana-siyana dzehutano dzinotungamirira kuchirwere, murwere anobva aisa patafura kune chiremba.

Muchidimbu cholecystitis

Panguva yekurapwa uye mune ramangwana, murwere ane cholecystitis anofanira kutevera kudya kwakakosha. Zvokudya munyaya iyi hazvirevi chete kudzivirira kwekukura kwechirwere, asiwo nzira inobatsira yekurapa. Muzvirwere zvakakomba, kudya kunosuruvara kweguru rinenge kunoreva nzara yakakwana (mumazuva ekutanga mushure mokurwisa). Inobvumirwa kunwa chete juisi, muto wenzara, tei pasina shuga. Mushure meizvi, murwere anopfuurira kuzvokudya nhamba yechishanu - zvokudya zvinopesana nokuputika. Zvinorayirwa zvinotevera:

1. Carbohydrates inopera 200 g pazuva. Zvinoreva kutora makarubhaidharati chete: jams, shuga, uchi, jamu.
2. Kuwanda kwemapuroteni kwakaderedzwa kusvika ku 80 g. Fat yakafanana.
3. Zvinyorwa zveCororic zvemazuva ose zvinokwana 1600 kcal. Mvura inopera kusvika ku2,5 litita.
4. Nheyo yezvishoma zvekudya zvinoonekwa.
5. Zvokudya zvinofanira kugadzirirwa pasina munyu.
6. Zvinhu zvose zvinoshandiswa muchimiro chakaumbwa: nenzira ye purees, soups, soufflé.

Mutsamba yezvigadzirwa zvinorambidzwa:

• nyemba;
• kabbage;
• salted products;
• mushroom, kusanganisira broths;
• michero yakasviba nemabriji;
• sausages;
• chikafu;
• cottage cheese;
• cocoa

Chikonzero chekudya kunovaka muviri ndechekuti:

• nyama yakakondwa uye huku;
• hove yevakaroorana;
• vegetarian soups;
• crackers;
• yakabikwa mukaka michina;
• oatmeal, rice, gorosi peji;
• miriwo;
• kissels;
• michero yakaomeswa.

Kubva kunotapira zvinogoneka kushandisa:

• uchi;
• shuga;
• marshmallow;
• marmalade;
• onai zvinotapira kunwa.

Kuti usapfuudza kusagadzirisa chirwere cholecystitis, unofanirwa kuomerera pane zvinonaka uye pashure pokurapa. Muzviitiko zvakawanda, pamwe nekuchengetwa kwekudya uye kurapwa kwakachengeteka, zvinokwanisika kuzadzikisa kuregererwa. Kutora chero mishonga (painkillers, choleretic) nekuputika kweguruvladder inofanira kudzorwa nechiremba.