Koj puas tau phais kom tshem koj lub zais zis? Koj puas tseem muaj mob hnyav qee zaum rau sab xis saum toj ntawm koj lub plab? Puas zoo li qhov mob uas koj tau los ntawm pob zeb hauv zais zis? Muaj ntau tus neeg xav tias tom qab tshem lawv lub zais zis tawm, lawv qhov mob plab ploj mus tag. Tab sis qee zaum qhov ua rau qhov mob no tsis yog qhov peb xav, tab sis lwm yam. Ntawd yog qhov peb yuav tham txog hnub no.
Hais yooj yim xwb, Sphincter of Oddi yog dab tsi?
Yuav kom nkag siab qhov no, cia peb xub saib cov txheej txheem zom zaub mov hauv peb lub cev. Nws yog ib qho nyuaj heev thiab zoo kawg nkaus. Ntau lub cev, xws li peb lub siab thiab lub txiav, ua haujlwm ua ke los hloov cov khoom noj uas peb noj mus ua lub zog.
- Siab: Qhov no yog qhov chaw uas cov tshuaj hu ua bile raug tsim tawm. Nws raug khaws cia ib ntus hauv lub gallbladder.
- Pancreas: Lub qog no tsim cov enzymes uas pab zom zaub mov.
Cov kua tsib los ntawm lub siab thiab cov enzymes los ntawm lub pancreas yuav tsum ntws ua ke mus rau hauv peb txoj hnyuv me. Cov leeg nqaij me uas tswj qhov kev mus ncig ntawd, uas ua haujlwm zoo li lub rooj vag, hu ua Sphincter of Oddi .
Thaum ua haujlwm kom raug, cov leeg no, hu ua Sphincter of Oddi, qhib rau lub sijhawm zoo, cia cov kua tsib thiab cov enzymes hla mus rau hauv txoj hnyuv me. Tom qab ntawd nws kaw dua.
Yog li ntawd, Sphincter of Oddi Dysfunction (SOD) yog dab tsi?
Hais yooj yim xwb, qhov teeb meem ntawm Sphincter of Oddi yog thaum lub rooj vag uas peb tham txog, cov leeg nqaij hu ua Sphincter of Oddi, tsis qhib kom raug thaum nws yuav tsum qhib. Tom qab ntawd yuav ua li cas? Cov kua tsib thiab cov enzymes pancreatic tsis tuaj yeem nkag mus rau hauv txoj hnyuv me thiab daig hauv lub raj ntawd. Thaum nws daig li no, nws ua rau mob plab heev, zoo ib yam li thaum koj muaj pob zeb hauv lub zais zis.
Feem ntau cov neeg uas tau phais tshem lawv lub zais zis (cholecystectomy). Vim li no, qee zaum hu ua "post-cholecystectomy syndrome."
Cov hom thiab pawg tseem ceeb ntawm tus mob no yog dab tsi?
Tus mob no muaj ob hom loj thiab peb pawg. Nws yog ib qho tseem ceeb kom paub qhov no, vim tias kev kho mob nyob ntawm hom no.
| Hom / Pawg | Piav qhia yooj yim xwb |
|---|---|
| Ob Hom Tseem Ceeb | |
| Kev ua haujlwm tsis zoo ntawm cov kua tsib | Qhov no tshwm sim thaum cov kav dej ntawm cov kua tsib raug thaiv, tiv thaiv cov kua tsib kom tsis txhob ntws mus rau hauv txoj hnyuv me. |
| Mob Pancreatitis | Hauv qhov no, qhov kev thaiv tshwm sim hauv lub txiav, ua rau mob ntawm lub txiav. |
| Peb Pawg Tseem Ceeb | |
| Pawg I thiab II | Hauv ob pawg no, cov kws kho mob tuaj yeem nrhiav tau pov thawj meej ntawm qhov teeb meem los ntawm kev kuaj mob. Piv txwv li, kev kuaj ntshav tsis zoo lossis kev ntsuas ultrasound uas qhia txog cov kav dej kua tsib lossis cov kav dej pancreatic. |
| Qeb III | Qhov no yog hom mob uas nyuaj tshaj plaws los nrhiav. Vim tias tsis muaj pov thawj tseeb txog qhov no hauv cov ntshav, kev ntsuas, thiab lwm yam. Tsuas muaj pov thawj ntawm tus kab mob no xwb yog tus neeg mob lub plab mob. Yog li ntawd, kev kho qhov no kuj nyuaj me ntsis. |
Cov tsos mob ntawm tus kab mob no yog dab tsi?
Cov tsos mob tseem ceeb thiab feem ntau ntawm tus mob no yog mob plab hnyav, zoo ib yam li qhov mob uas tshwm sim thaum muaj pob zeb hauv lub zais zis.
- Qhov mob los qhov twg: Mob kub hnyiab pib rau sab xis saum toj ntawm lub plab.
- Qhov mob kis mus rau lwm qhov: Qee zaum qhov mob no yuav zoo li nws mus rau sab xis ntawm lub xub pwg lossis nraub qaum.
- Lub Sijhawm Mob: Feem ntau qhov mob yuav ploj mus tom qab li 30 feeb txog ib teev. Txawm li cas los xij, nws tuaj yeem rov qab los ib hnub.
Ntxiv rau qhov mob tseem ceeb no, yuav muaj ntau lwm yam tsos mob ntxiv:
- Xeev siab thiab ntuav
- Ua npaws
- Mob khaub thuas
- Mob raws plab
Qhov tseem ceeb yog tias cov tsos mob no tsis zoo ib yam li qub. Muaj tej hnub lawv tuaj thiab mus, thaum lwm hnub lawv tuaj yeem ua rau tsis taus.
Vim li cas qhov no thiaj tshwm sim? Cov yam uas ua rau muaj kev pheej hmoo yog dab tsi?
Tsis muaj ib qho ua rau qhov no. Qee zaum qhov caws pliav lossis o ntawm cov kav dej kua tsib tuaj yeem thaiv cov kua tsib ntws. Lwm lub sijhawm, tsis muaj kev thaiv, nws tuaj yeem tshwm sim los ntawm teeb meem nrog cov leeg nqaij sphincter ntawm Oddi nws tus kheej.
Tiam sis muaj ntau pawg neeg uas muaj feem yuav mob no ntau dua.
- Feem ntau: Cov poj niam muaj hnub nyoog ntawm 20-50 xyoo uas tau phais lawv lub zais zis tawm.
- Lwm yam kev pheej hmoo:
- Cov neeg uas tau phais kom poob phaus (phais plab zom mov).
- Cov neeg uas muaj tus kab mob pancreatitis rov tshwm sim.
- Cov neeg uas muaj pob zeb hauv lub cev.
- Cov neeg uas tau hloov siab lawm.
- Cov neeg uas muaj cov thyroid tsis ua haujlwm zoo (Hypothyroidism).
- Cov neeg uas muaj mob plab hnyuv chim siab (IBS).
- Cov neeg haus dej cawv ntau dhau.
- Cov neeg uas siv qee yam tshuaj tua kab mob (tshwj xeeb yog cov tshuaj opiates).
Puas yuav muaj kev phom sij yog tias tsis kho?
Qhov no tsis yog ib qho mob uas yuav ua rau tuag taus, thiab tej yam teeb meem loj tsis tshua muaj. Txawm li cas los xij, qhov mob hnyav uas nws ua rau tuaj yeem ua rau koj tsis muaj peev xwm ua haujlwm tau zoo li qub.
Tiam sis yog tias nws tseem txuas ntxiv mus yam tsis tau kev kho mob, cov mob hauv qab no yuav tsis tshua muaj tshwm sim:
- Kab mob pancreatitis ntev: Kev puas tsuaj rau lub pancreas uas tsis rov qab kho tau los ntawm kev o.
- Jaundice: Kev daj ntawm daim tawv nqaij thiab lub qhov muag dawb uas tshwm sim los ntawm kev sib sau ua ke ntawm bilirubin, ib feem ntawm cov kua tsib, hauv lub cev.
Tus kws kho mob kuaj mob li cas?
Yog tias koj muaj cov tsos mob no, thawj qhov koj tus kws kho mob yuav ua yog kuaj xyuas seb puas muaj lwm yam mob uas yuav ua rau koj mob plab, vim tias hom mob no tuaj yeem tshwm sim los ntawm ntau lwm yam mob.
Piv txwv li, koj yuav tsum xyuas kom meej tias tsis muaj mob hnyav xws li mob peptic ulcer, choledocholithiasis, lossis mob qog nqaij hlav pancreatic lossis bile duct. Qhov xav tsis thoob yog, qhov mob ntawm qee yam mob plawv (xws li angina) kuj tuaj yeem zoo li mob plab.
Tom qab txiav txim siab tag nrho cov no, koj tus kws kho mob yuav hais kom koj ua cov kev kuaj no:
- Kev kuaj ntshav: Xyuas seb puas muaj cov enzyme hauv siab thiab pancreatic ntau dhau.
- Kev ntsuam xyuas duab:Tshawb xyuas seb puas muaj qhov tsis zoo ntawm cov leeg nqaij sphincter of Oddi lossis cov hlab ntsha. Qhov no yuav suav nrog kev kuaj xws li Abdominal Ultrasound, CT scan, Endoscopic Ultrasound (EUS), Upper Endoscopy, thiab Magnetic Resonance Cholangiopancreatography (MRCP).
Kev kuaj tshwj xeeb: ERCP nrog Manometry
Qee zaum, yog tias tag nrho cov kev kuaj no tsis muaj txiaj ntsig, tus kws kho mob yuav xa koj mus rau qhov kev kuaj tshwj xeeb hu ua Endoscopic Retrograde Cholangiopancreatography (ERCP) nrog manometry .
Qhov no suav nrog kev mus rau Sphincter of Oddi nrog kev pab los ntawm endoscope, ntxig ib lub raj yas me me, thiab ntsuas qhov siab kom pom tias cov leeg nqaij ntawd sib cog lus thiab nthuav dav npaum li cas.
Tiam sis qhov kev kuaj ERCP no muaj kev pheej hmoo me me. Ib txhia neeg, kwv yees li 15 txog 30 ntawm 100, tuaj yeem mob pancreatitis tom qab qhov kev kuaj no. Yog li ntawd, cov kws kho mob ua qhov no tsuas yog tom qab xav txog zoo thiab tsuas yog tias tsim nyog tiag tiag.
Cov kev kho mob rau qhov no yog dab tsi?
Txoj kev kho mob nyob ntawm seb koj cov tsos mob hnyav npaum li cas thiab koj nyob rau hauv pawg twg.
1. Yog tias qhov mob tsis hnyav dhau (tshwj xeeb tshaj yog rau pawg III):
Tus kws kho mob yuav sau ntawv rau koj kom koj noj tshuaj tua kab mob (tsis yog tshuaj opioid) thiab tshuaj ua kom cov leeg so.
2. Yog tias qhov mob hnyav heev (rau pawg I thiab II):
Yog tias nws nyuaj rau tswj nrog tshuaj, tus kws kho mob yuav xa koj mus rau kev kho mob hu ua ERCP nrog sphincterotomy . Qhov no ua tiav hauv qab tshuaj loog lossis hauv qab tshuaj loog. Tus kws phais siv lub endoscope mus rau Sphincter of Oddi, txiav me ntsis ntawm cov leeg uas daig, thiab ua kom nws xoob. Tib lub sijhawm, lawv kuaj xyuas seb puas muaj pob zeb hauv cov kav dej kua tsib.
Kev Pheej Hmoo ntawm kev kho mob sphincterotomy
Kev kho mob no pab txo qhov mob rau feem ntau cov neeg mob uas muaj pawg I thiab II. Txawm li cas los xij, nws kuj yog ib qho txheej txheem nyuaj nrog qee qhov kev pheej hmoo.
- Kwv yees li 10% - 15% ntawm cov neeg mob yuav muaj teeb meem xws li mob pancreatitis.
- Txawm hais tias qhov mob no feem ntau tsis mob heev, qee zaum nws tuaj yeem ua rau mob hnyav thiab txawm tias tuag taus.
- Hauv cov xwm txheej zoo li no, koj yuav tau nyob hauv tsev kho mob ntev heev rau kev kho mob.
Yog li ntawd, cov kws kho mob tsuas yog siv txoj kev kho mob no yog tias nws tsis tuaj yeem tswj tau nrog lwm yam kev kho mob.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Yog tias koj tseem mob plab tom qab koj rho koj lub zais zis tawm lawm, tsis txhob tsis quav ntsej. Mus ntsib kws kho mob kom sai.
- Qhov mob no tej zaum yuav yog los ntawm Sphincter of Oddi Dysfunction (SOD), ib qho mob uas tuaj yeem tshwm sim txawm tias tsis muaj lub gallbladder los xij.
- Muaj ntau hom kab mob no. Qee hom yooj yim nrhiav tau los ntawm kev kuaj mob, tab sis lwm hom (tshwj xeeb tshaj yog hom III) nyuaj nrhiav tau.
- Muaj kev kho mob xws li tshuaj ntsiav thiab ERCP nrog sphincterotomy, uas tsuas yog ua yog tias tsim nyog. Txawm li cas los xij, nco ntsoov tias cov txheej txheem no kuj muaj qee qhov kev pheej hmoo.
- Tham nrog koj tus kws kho mob txog koj cov tsos mob, lawv tshwm sim li cas, thiab qhov mob ntawm koj. Qhov no yuav pab koj xaiv txoj kev kho mob zoo tshaj plaws thiab muaj kev nyab xeeb tshaj plaws rau koj.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus