Acute uye chisingaperi cholecystitis: zvavari, zviratidzo uye kurapwa

Zvemukati

• Zviratidzo zvikuru
• 1. Acute cholecystitis
• 2. Chirwere cholecystitis
• Maitiro ekusimbisa kuongororwa
• Ndezvipi zvikonzero
• Kurapwa kunoitwa sei

Cholecystitis kuzvimba kwenduru, homwe diki iri inosangana nechiropa, uye iyo inochengeta bile, chinhu chakakosha kwazvo chekugaya kwemafuta. Uku kuzvimba kunogona kuve kwakanyanya, kunzi acute cholecystitis, ine yakanyanya uye inokurumidza kuwedzera zviratidzo, kana isingagumi, ine yakaoma zviratidzo zvinogara kwemavhiki kusvika kumwedzi.

Cholecystitis inokonzeresa zviratidzo nezviratidzo zvakadai sekurwadziwa mudumbu, kuda kurutsa, kurutsa, kupisa muviri uye hunyoro hwedumbu. Marwadzo kweanopfuura maawa matanhatu anobatsira kusiyanisa pakati peacute cholecystitis uye chisingaperi cholelithiasis kurwadziwa.

Kuzvimba kwakanyanya kweguruva kunogona kuitika nenzira mbiri:

• Lithiasic cholecystitis kana kuverenga: ndicho chikonzero chikuru che cholecystitis uye chinowanzoitika mumadzimai epakati nepakati. Zvinoitika kana dombo, rinodaidzwawo kuti dombo, rinokonzeresa kuvharika kwenzira inodurura iyo bile. Nekudaro, bile inoungana muguruva uye inoita kuti itenderedzwe uye ipiswe. Nzwisisa chinokonzera dombo renduru;

  
  
• Alithiasic cholecystitis: inonyanya kushomeka uye inokonzeresa kuzvimba kwenduru pasina kuvepo kwematombo. Zviratidzo zvakafanana neizvo zve lithiasic cholecystitis, asi kurapwa kwacho kwakanyanya kuoma uye nemukana wakaipisisa wekurapa, sezvazvinowanzoitika kune vanhu vanorwara zvakanyanya.

Chero zvazvingaitika, cholecystitis inofanira kurapwa nekukurumidza sezvinobvira, uye imwe haifanire kumirira kwenguva yakareba kupfuura maawa matanhatu mushure mekutanga kwezviratidzo, kudzivirira zvinetso zvakakomba sekuparuka kwegunduru kana hutachiona hwakazara.

Zviratidzo zvikuru

Chiratidzo chinonyanya kuzivikanwa che cholecystitis kurwadziwa nemudumbu, zvisinei, zvimwe zviratidzo zvinogona kusiyana kana chiri chirwere chakanyanya kana chisingaperi.

1. Acute cholecystitis

Muzviitiko zvakawanda, zviratidzo nezviratidzo zve cholecystitis zvinosanganisira:

• Colic kurwadziwa mune yekumusoro kurudyi chikamu chedumbu, inogara anopfuura maawa matanhatu. Uku kurwadziwa kunogona kutangawo pamusoro peguvhu ndokuzoenda kumusoro kwekurudyi;
• Kusuruvara kwepamuviri kunoyerera kubendekete rerudyi kana kumashure;
• Kunzwisisa mudumbu panguva palpation pakuongororwa kwechiremba;
• Kusvotwa uye kurutsa, nekushaya njere;
• Fivha, pazasi pe 39ºC;
• Kuonekwa kweakawanda malaise;
• Kukurumidza kurova kwemoyo;
• Yero ganda uye maziso, mune dzimwe nguva.

Pamusoro pezviratidzo izvi, chiremba anotarisawo chiratidzo cheMurphy, icho chinowanzoitika muchirwere checholecystitis uye chinosanganisira kukumbira munhu kuti afemeruke zvakadzama, achisundidzira dumbu nechekurudyi. Iyo chiratidzo inoonekwa seyakanaka uye, nekudaro, inoratidza cholecystitis, kana munhu akabata mweya wavo, achitadza kuenderera kufema.

Zviratidzo zvinoratidzwa zvinowanzoonekwa nezve 1 awa kana zvishoma zvishoma mushure mekudya chikafu chine mafuta, sezvo bile inoshandiswa nemuviri kubatsira kugaya mafuta uye kutora zvinovaka muviri.

Zvisinei, kune varwere vanopfuura makore makumi matanhatu kana kudarika vakaneta, zviratidzo zvinogona kunge zvakasiyana. Mumamiriro ezvinhu akadaro, zvakakosha kuti uzive zvimwe zviratidzo senge kuvhiringidzika kwepfungwa, kupisa uye kutonhora, bhuruu ganda. Mune zviitiko izvi, iwe unofanirwa kuenda kuchipatara nekukurumidza.

2. Chirwere cholecystitis

Chirwere cholecystitis inogara kwenguva refu, yakadhonzwa-kubuda kuzvimba. Izvo zvinokonzereswa nehurongwa hwakafanana neiyo yeacute cholecystitis, uye inogona kana isingasanganisike nekuvapo kwedombo.

Zviratidzo zvinowanzoonekwa mushure mekudya zvakakora-mafuta chikafu uye pakupera kwezuva, kuva zvakafanana neaya eacute cholecystitis, asi akasimba:

• Marwadzo mune chepamusoro kurudyi chikamu chedumbu, ichipenya kuenda kurudyi ruoko kana kumashure;
• Mamwe marwadzo akakomba anorwadza, ayo anovandudza mushure memaawa mashoma, biliary colic;
• Kunzwisisa mudumbu panguva palpation pakuongororwa kwechiremba;
• Kusvotwa, kurutsa, kurasikirwa nechido, kunzwa kubhururuka uye kuwedzera gasi;
• Kunzwa kusagadzikana;
• Yero ganda uye maziso, mune dzimwe nguva.

Chisingaperi cholecystitis inoita kunge inokonzereswa nezvidiki zvidimbu zvenduru yekudzivirira, inoitika kanoverengeka, nekufamba kwenguva. Semhedzisiro yematambudziko akadzokororwa, nduru inogona kuchinja, ichiita diki uye iine madziro akakora. Inogona zvakare kupedzisira yaita kunetsekana, sekukwiridzwa kwemadziro ayo, anonzi iyo porcelain vesicle, kuumbwa kwefistula, pancreatitis kana kunyangwe kukura kwegomarara.

Maitiro ekusimbisa kuongororwa

Kana zviratidzo zvinoratidzira zvecholecystitis zvikaonekwa, zvinokurudzirwa kuti ubvunze chiremba mukuru kana gastroenterologist kuti uongorore nyaya yacho uye uite bvunzo dzekuongorora, senge kuongororwa ropa, ultrasound kana cholecintilography.

Cholecintilography inowanzo shandiswa kana iyo ultrasound mhedzisiro isina kujeka zvakakwana kuti iongorore kana iyo nduru yakasimbiswa kana kuti yakapiswa, kana kana iine matambudziko ekuizadza.

Ndezvipi zvikonzero

Muzviitiko zvakawanda, cholecystitis inokonzereswa nenyuchi, izvo zvinoita kuti kuyerera kwe bile kutadziswe mugero inonzi cystic duct, iyo inobvumira bile kutiza kubva munduru. Kazhinji zviitiko zvinoitika zvakare zvine chekuita negallstone mamiriro, anogona kana angave asina zviratidzo, ane angangoita ¼ evanhu vane mabwe anogona kuve nekukura cholecystitis pane imwe nguva.

Mune zvimwe zviitiko, kuvharirwa hakukonzerwe nedombo, asi kune bundu, bundu, kuvapo kwezvipembenene kana kunyangwe mushure mekuvhiyiwa pane ducts.

Mune zviitiko zvealitiásic cholecystitis, kuzvimba kweguruva kunoitika nekuda kwezvikonzero izvo zvisati zvanyatsonzwisiswa, asi vanhu vakura, avo vari kurwara zvakanyanya, vakavhiyiwa zvakaoma kana vane chirwere cheshuga, semuenzaniso, vari panjodzi.

Kurapwa kunoitwa sei

Kurapa kwecholecystitis kunowanzo kutanga nekugamuchirwa kuchipatara kubatsira kudzora kuzvimba uye kubvisa marwadzo, uyezve kuvhiya nduru kubviswa kunoitwa. Izvo zvinowanzo kurudzirwa kuti iyo nduru ishandiswe mukati memazuva matatu ekutanga ekutanga kweacute kuzvimba.

Nekudaro, kurapwa kunogona kusanganisira:

• Kurumidza: sezvo gallbladder inoshandiswa kugaya, chiremba anogona kukurudzira kumisa kudya kwechikafu nemvura kwechinguva kuti ubvise kumanikidza kweguruva uye kugadzirisa zviratidzo;
• Fluid yakananga mukati mutsinga: nekuda kwekurambidzwa kudya kana kunwa, zvakakosha kuchengetedza hydration yemuviri neine saline yakanangana mutsinga;
• Mishonga inorwisa mabhakitiriya: mune inopfuura hafu yematambudziko, iyo nduru inotapukirwa mukati maawa makumi mana nemasere mushure mekutanga kwecholecystitis, sezvo kuremara kwayo kuchikonzera kuwanda kwebhakitiriya mukati;
• Marwadzo anoderedza: inogona kushandiswa kudzamara marwadzo asunungurwa uye kuzvimba kwenduru kwadzikira;
• Kuvhiya kubvisa nduru: laparoscopic cholecystectomy ndiyo nzira huru yekuvhiya kurapa cholecystitis. Iyi nzira inobvumira kukurumidza kupora, sezvo iri isinganetsi kune muviri. Nzwisisa kuti kuvhiyiwa kwenduru kunoitwa sei uye kupora.

Mumamiriro ezvinhu apo cholecystitis yakanyanyisa uye murwere asingakwanise kuvhiyiwa nekukasira, girobhu redhayera rinoitwa, iro rinobatsira kubvisa pus kubva mudunduru uye kudzikisa kuzvimba, nekudaro uchikwanisa kuvhura mugero wakadzivirirwa. Panguva imwecheteyo, mishonga inorwisa mabhakitiriya inopihwa kudzivirira iyo nduru kubva mukutapukirwa. Mushure mekunge mamiriro acho anyatsogadzikana, kuvhiya kubvisa nduru kunogona kutoitwa.