Kodi mukumvabe kupweteka m'mimba mukachotsa ndulu? Izi zitha kukhala chifukwa cha Sphincter of Oddi Dysfunction!

Kodi mwachitidwa opaleshoni yochotsa ndulu yanu? Kodi nthawi zina mumakhala ndi ululu waukulu kumtunda kwa kumanja kwa mimba yanu? Kodi ndi ululu womwe mumamva chifukwa cha miyala ya ndulu? Anthu ambiri amaganiza kuti akachotsedwa ndulu yawo, ululu wawo wa m'mimba umatha kwathunthu. Koma nthawi zina chifukwa cha ululuwu si zomwe timaganiza, koma china chake. Ndicho chimene tikambirana lero.

Mwachidule, kodi Sphincter wa Oddi ndi chiyani?

Kuti timvetse izi, choyamba tiyeni tiwone momwe kugaya chakudya kumagwirira ntchito m'thupi lathu. Ndi chinthu chovuta kwambiri komanso chodabwitsa. Ziwalo zambiri, monga chiwindi chathu ndi kapamba, zimagwirira ntchito limodzi kuti zisinthe chakudya chomwe timadya kukhala mphamvu.

• Chiwindi: Apa ndi pomwe mankhwala otchedwa ndulu amapangidwa. Amasungidwa kwakanthawi mu ndulu.
• Pancreas: Gland iyi imapanga ma enzyme omwe amathandiza kugaya chakudya.

Nthenda ya ndulu yochokera m'chiwindi ndi ma enzyme ochokera ku kapamba zonse ziyenera kuyenda pamodzi kulowa m'matumbo athu ang'onoang'ono. Minofu yaying'ono yomwe imalamulira ulendowo, yomwe imagwira ntchito ngati chipata, imatchedwa Sphincter of Oddi .

Ikagwira ntchito bwino, minofu iyi, yotchedwa Sphincter of Oddi, imatseguka panthawi yoyenera, zomwe zimathandiza kuti bile ndi ma enzyme alowe m'matumbo ang'onoang'ono. Kenako imatsekanso.

Ndiye kodi Sphincter of Oddi Dysfunction (SOD) ndi chiyani?

Mwachidule, Sphincter of Oddi Dysfunction ndi pamene chipata chomwe tidalankhula, minofu yotchedwa Sphincter of Oddi, sichimatseguka bwino nthawi yomwe iyenera kutsegulidwa. Ndiye chimachitika ndi chiyani? Kuti ma enzyme a bile ndi kapamba sangalowe m'matumbo ang'onoang'ono ndikukakamira mu chubu chimenecho. Chikakakamira chonchi, chimayambitsa kupweteka kwambiri m'mimba, mofanana ndi zomwe zimachitika mukakhala ndi miyala ya ndulu.

Vutoli limapezeka kwambiri mwa anthu omwe achotsedwa ndulu (cholecystectomy). Pachifukwa ichi, nthawi zina limatchedwa "post-cholecystectomy syndrome."

Kodi mitundu ndi magulu akuluakulu a vutoli ndi ati?

Vutoli lingagawidwe m'magulu awiri akuluakulu ndi magulu atatu. Ndikofunikira kudziwa izi, chifukwa chithandizo chimadalira mtundu uwu.

Kodi zizindikiro za matendawa ndi ziti?

Chizindikiro chachikulu komanso chodziwika bwino cha vutoli ndi kupweteka kwambiri m'mimba, kofanana ndi kupweteka komwe kumachitika miyala ya ndulu ikapangidwa.

• Kumene ululu umachokera: Kupweteka koyaka kuyambira kumtunda kwa mimba.
• Kufalitsa ululu: Nthawi zina ululuwu umamveka ngati ukupita ku phewa lamanja kapena kumbuyo.
• Kutalika kwa ululu: Ululu nthawi zambiri umatha patatha mphindi 30 mpaka ola limodzi. Komabe, ukhoza kubwereranso tsiku lina.

Kuwonjezera pa ululu waukulu uwu, zizindikiro zina zingapo zingawonekere:

• Kusanza ndi kusanza
• Malungo
• Kuzizira
• Kutsegula m'mimba

N’chifukwa chiyani izi zimachitika? Kodi zinthu zomwe zimayambitsa vutoli ndi ziti?

Palibe chifukwa chimodzi chokha cha izi. Nthawi zina zipsera kapena kutupa kwa ndulu kumatha kuletsa kuyenda kwa ndulu. Nthawi zina, popanda kutsekeka kulikonse, kungayambitsidwe ndi vuto la sphincter ya minofu ya Oddi yokha.

Koma pali magulu angapo omwe ali pachiwopsezo chachikulu cha vutoli.

• Chofala kwambiri: Azimayi azaka zapakati pa 20-50 omwe adachitidwa opaleshoni ya ndulu yawo.
• Zina mwa zinthu zoopsa:
• Anthu omwe adachitidwa opaleshoni yochepetsa thupi (Gastric bypass surgery).
• Anthu omwe amadwala matenda a pancreatitis omwe amabwereranso.
• Anthu omwe anali ndi miyala ya ndulu.
• Anthu omwe adaikidwapo chiwindi.
• Anthu omwe ali ndi vuto la chithokomiro chosagwira ntchito mokwanira (Hypothyroidism).
• Anthu omwe ali ndi vuto la m'mimba lotchedwa Irritable Bowel Syndrome (IBS).
• Anthu omwe amamwa mowa mopitirira muyeso.
• Anthu omwe amagwiritsa ntchito mankhwala enaake ochepetsa ululu (makamaka opiates).

Kodi zingakhale zoopsa ngati sizikuchiritsidwa?

Uwu si matenda oopsa, ndipo mavuto akuluakulu ndi osowa. Komabe, ululu waukulu womwe umayambitsa ukhoza kukhala chopinga chachikulu pakugwira ntchito bwino.

Koma ngati ipitirira popanda chithandizo, zinthu zotsatirazi sizingachitike kawirikawiri:

• Matenda a kapamba osatha: Kuwonongeka kosatha kwa kapamba komwe kumachitika chifukwa cha kutupa kosalekeza.
• Jaundice: Kutuluka kwachikasu pakhungu ndi maso chifukwa cha kuchulukana kwa bilirubin, yomwe ndi gawo la ndulu, m'thupi.

Kodi dokotala amazindikira bwanji matendawa?

Ngati muli ndi zizindikiro izi, chinthu choyamba chomwe dokotala wanu angachite ndikuwunika matenda ena omwe angayambitse kupweteka m'mimba mwanu, chifukwa mtundu uwu wa ululu ungayambitsidwe ndi matenda ena ambiri.

Mwachitsanzo, muyenera kuonetsetsa kuti palibe matenda aakulu monga matenda a zilonda zam'mimba, choledocholithiasis, kapena khansa ya kapamba kapena ndulu. Chodabwitsa n'chakuti, kupweteka kwa matenda ena a mtima (monga angina) kungamvekenso ngati kupweteka m'mimba.

Dokotala wanu atachotsa zonsezi, angakufunseni kuti muchite mayeso awa:

• Kuyezetsa magazi: Yang'anani kuchuluka kwa ma enzyme a chiwindi ndi kapamba.
• Mayeso ojambula zithunzi:Yang'anani ngati pali vuto lililonse mu sphincter ya minofu ya Oddi kapena ducts. Izi zitha kuphatikizapo mayeso monga Abdominal Ultrasound, CT scan, Endoscopic Ultrasound (EUS), Upper Endoscopy, ndi Magnetic Resonance Cholangiopancreatography (MRCP).

Mayeso apadera: ERCP ndi Manometry

Nthawi zina, ngati mayeso onsewa sakukwanira, dokotala angakutumizireni ku mayeso apadera otchedwa Endoscopic Retrograde Cholangiopancreatography (ERCP) pogwiritsa ntchito manometry .

Izi zimaphatikizapo kupita ku Sphincter ya Oddi pogwiritsa ntchito endoscope, kuyika chubu chaching'ono kwambiri cha pulasitiki, ndikuyesa kuthamanga kuti muwone momwe minofuyo imakokera ndikukulirakulira.

Kodi mankhwala ochizira izi ndi otani?

Njira yochiritsira imadalira kuopsa kwa zizindikiro zanu komanso gulu lomwe muli nalo.

1. Ngati ululu suli woopsa kwambiri (makamaka wa gulu lachitatu):

Dokotala adzakupatsani mankhwala ochepetsa ululu (osakhala opioid) ndi ochepetsa minofu.

2. Ngati ululu uli waukulu (wa magulu I ndi II):

Ngati n'kovuta kulamulira ndi mankhwala, dokotala angakutumizireni ku chithandizo chotchedwa ERCP chokhala ndi sphincterotomy . Izi zimachitika pansi pa anesthesia kapena pansi pa anesthesia. Dokotalayo amagwiritsa ntchito endoscope kuti apite ku Sphincter of Oddi, kudula minofu yochepa yomwe yamatirira, ndikuyimasula. Nthawi yomweyo, amafufuza miyala mu ndulu.

Zoopsa za chithandizo cha sphincterotomy

Chithandizochi chimathandiza kuchepetsa ululu mwa odwala ambiri omwe ali ndi magulu oyamba ndi achiwiri. Komabe, ndi njira yovuta komanso yowopsa.

• Pafupifupi 10% - 15% ya odwala amatha kukhala ndi mavuto monga kapamba.
• Ngakhale kutupa kumeneku nthawi zambiri kumakhala kofatsa, nthawi zina kumatha kukhala koopsa komanso koika moyo pachiswe.
• Zikatero, mungafunike kukhala m'chipatala kwa nthawi yayitali kuti mupeze chithandizo.

Chifukwa chake, madokotala amagwiritsa ntchito chithandizochi pokhapokha ngati sichingathe kulamulidwa ndi mankhwala ena.