Njira yayikulu komanso yothandiza kwambiri ya mankhwala a cholelithiasis lero ndi cholecystectomy - opaleshoni yochotsa ndulu. Koma njirayi sikuthetsa nthawi zonse zizindikiro za kupweteka kwa m'mimba, zomwe zimawonekera mu mawonekedwe a ululu ndi dyspeptic distemper. Awa ndi postcholecystectomy syndrome (PHC).
Zifukwa za postcholecystectomy syndrome
Zomwe zimayambitsa PCHP ndi izi:
- chotupa cha kapangidwe ka biliary extrahepatic;
- mpweya wa bile;
- miyala m'matope;
- matenda a chiwindi;
- kusamba kwa bile;
- kuchulukitsa kwa thupi kuti apangidwe miyala.
Pambuyo pa kuchotsedwa kwa ndulu, bile imalowa m'matumbo mwachangu, chifukwa cha chimbudzi cha chakudya chimasokonezeka ndipo chifukwa chake kuchepa kwa m'mimba kumatuluka. Choncho pali zowawa.
Kusanthula kwa postcholecystectomy syndrome
Zomwe zimaphunzitsidwa kwambiri zimachokera ku endoscopic retrograde cholangiopancreatography ndi manometry ya Oldy sphincter. Koma zipangizo zogwiritsira ntchito zoterezi zimangokhala malo ochepa ofufuzira.
Zovuta zowonjezera ma laboratory zomwe zimatsimikizira msinkhu:
- bilirubin;
- gamma glutamyl transfase;
- alangizi phosphatase;
- alanine ndi aspartic transaminases;
- amylase ;
- chithandizo;
- lipase.
Mayesero a ma laboratorywa akuyenera kuchitidwa nthawi, kapena mkati mwa maola asanu ndi limodzi pambuyo pa chiwonetsero chotsatira.
Zizindikiro za postcholecystectomy syndrome
Zizindikiro za PCHP:
- kupweteka kumbali yoyenera ndi dera la epigastric, lomwe lingaperekenso ku dera labwino la scapula ndi kumbuyo;
- Matenda osiyanasiyana am'mimba omwe amadziwonetsera okha ngati kunyozetsa, flatulence, kudzimbidwa, kutsekula m'mimba, kumva kukoma kwa mkamwa;
- komanso maonekedwe a jaundice.
Chikhalidwe cha postcholecystectomy syndrome
Palibe gulu limodzi la PCHP lero. Nthaŵi zambiri amagwiritsa ntchito njira yotere:
- Kuthetsa papillitis yodetsedwa.
- Biliary pancreatitis (cholepancreatitis).
- Ndondomeko yothandizira yowonjezera (yoperewera ya peritonitis) mu malo achigawo.
- Amatsitsiranso kupanga mapangidwe a miyala.
- Zilonda zam'mimba zam'mimba (biliary kapena hepatogenic).
Kuchiza kwa matenda a postcholecystectomy
Njira zothandizira PHC ziyenera kukhazikitsidwa kuthetsa mavutowa omwe amatha kugwira ntchito kapena m'magulu a m'mimba, chiwindi, ndondomeko yamadzi komanso zoperewera zomwe zimapweteka.
Imodzi mwa njira zochiritsira ndi chakudya chochepa (mpaka 6-7 pa nthawi). Panthaŵi imodzimodziyo ndi post-choledocystectomy syndrome, zakudya zimasonyezedwa - asidi, lakuthwa, yokazinga ndi zosuta zimachotsedwa.
Ngati pali kupweteka kwa pakhosi, n'zotheka kupereka mankhwala opweteka, monga:
- Mebeverin;
- Drotaverine.
Ngati chifukwa cha ululu ndi kusowa kwa puloteni, ndiye kuti kukonzekera kwa ma enzyme kumaperekedwa kuti zipangidwe bwino, monga:
- Panzinorm forte;
- Fesitanti;
- Creon .
Ngati atsimikiziridwa kuti atatha kugwira ntchito kuti achotse ndulu, matumbo a m'mimba amatha kusokonezeka, ndiye kuti mankhwalawa amalembedwa kuti abwezeretse m'mimba mwachindunji microflora. Pa nthawi yomweyo,
- Furazolidone;
- Intetriks;
- Doxycycline.
Ndalama zimenezi zimatengedwa masiku 5-7, kenako mankhwala osokoneza matumbo omwe ali ndi mabakiteriya othandiza:
- Linex;
- Bifidumbacterin ndi ena.
Patatha miyezi isanu ndi umodzi atachita opaleshoni, odwala ayenera kuyang'aniridwa ndi dokotala.