Matombo ako emunduru akabatwawo here mu common bile duct? (Choldocholithiasis) Ngatidzidzei nezvazvo!

Dzimwe nguva unonzwa kurwadziwa kwakanyanya mudumbu rako rekumusoro kurudyi mushure mekudya here? Unonzwa kuda kurutsa here kana kuti kuda kurutsa here? Dzimwe nguva unonzwa kuti maziso ako neganda zviri kuchinja kuita yero here? Izvi hazvisi zviratidzo zvakanaka zvekungofuratira. Izvi zvinogona kuratidza kuti dombo rakanamira mu 'Common Bile Duct' yako. Nhasi, tichataura nezvechirwere ichi chinonzi 'Choledocholithiasis'.

Zvichitaurwa zviri nyore, chii ichi (choledocholithiasis)?

Choledocholithiasis chirwere apo dombo rimwe kana akawanda anonamirwa mumugero wenyongo . "Choldocho" izita rechiLatin remugero wenyongo. "Lithiasis" zvinoreva dombo. Matombo enyongo zvidimbu zvakaoma, zvakaita sedombo. Matombo aya anogona kuumbwa chero kupi zvako mumuviri wedu uko nyongo inoyerera.

Zvino ungave uchishamisika kuti nyongo iyi chii uye kuti nyongo iyi chii. Zviri nyore kwazvo. Chiropa chedu chinoburitsa nyongo iyi. Nyongo iyi inotibatsira kugaya chikafu chatinodya, kunyanya mafuta. Nyongo iyi inoungana munduru. Kubva ipapo, inofamba nemuchubhu diki ichienda kumuchubhu wenyongo, iyo inobva yabatana neura hudiki. Saka, kana dombo rikaumbwa pane imwe nzvimbo parwendo urwu, dambudziko nderekuti.

Saka (Choldocholithiasis) ne (Cholelithiasis) zvinhu zviviri zvakasiyana here?

Ehe, pane musiyano mudiki. Ungave wakambonzwa izwi rekuti 'cholelithiasis'. Zvinoreva kuva nematombo munduru . Matombo enduru anogona kuumbwa munduru pachayo, mumigero yenduru, kana mune zvese zviri zviviri. Kunyangwe dombo rinoumbwa munduru rinogona kuzopinda mumigero yenduru yakajairika.

Zvichitaurwa zviri nyore, 'Cholelithiasis' zvinoreva matombo emunduru. 'Choldocholithiasis' zvinoreva matombo (rimwe kana kupfuura) akabuda munduru obva anamatira mudundira renyongo. Wanzwisisa here?

Chii chakasiyana pakati peCholedocholithiasis neBiliary Colic?

Kana uine choledocholithiasis, zvinoreva kuti une dombo rimwe chete mu common bile duct yako. Kana dombo racho riri diki kwazvo , ungasava nematambudziko. Rinogona kutopfuura nemudumbu mako robuda mumuviri wako. Asi kana dombo racho rikawedzera kukura rovhara common bile duct, unogona kurwadziwa mudumbu zvakanyanya uye jaundice.

Biliary colic chirwere chinoitika kana dombo rapinda mu nyongo. Chinowanzoitika kuvanhu vane matombo emunduru. Zvisinei, kana dombo riri mu common bile duct rikapinda mu duct, munhu ane choledocholithiasis anogonawo kusangana ne nyongo colic. Funga nezvazvo sedombo rakanamirwa mupombi yemvura, dzimwe nguva mvura inoyerera, dzimwe nguva haibude.

Izvi zvinongoitika emergency here? Ndinoda kurapwa nekukasika here?

Kuva nedombo kana matombo mu common bile duct hakusi nguva dzose kuri dambudziko. Zvisinei, pane njodzi . Sezvambotaurwa, matombo madiki anogona kubuda mumuviri. Zvisinei, njodzi ndeyekuti matombo anogona kunamira ipapo, kukura nekufamba kwenguva, uye kuvhara duct zvachose.

Nekuda kwengozi iyi, vanachiremba vanowanzo rapa matombo emutsinga wenyongo anowanikwa nekukurumidza. Vanowanzo kurudzira kushandisa endoscopy kuongorora nekubvisa matombo acho. Izvi zvinoreva kuti chiremba wezvekudya anoshandisa chubhu diki (catheter) inoiswa pasi pehuro kuti isvike mutsinga dzenyongo uye ibvise matombo acho. Usazvidya moyo, izvi zvinoitwa pasi peanesthesia, saka hauzonzwi kusagadzikana zvakanyanya.

Chii chinoitika kana chirwere ichi (choledocholithiasis) chikanyanya kuipa?

Kana dombo rikabatwa mumugero wenyongori wobva wamisa kuyerera kwenyongori, zvinokanganisa sisitimu yese yenyongori. Kureva, dzimwe nhengo dzese nemigwagwa inoyerera nyongori. Izvi zvinogona kukonzera kuzvimba, hutachiona , uye kunyange matambudziko anotyisidzira hupenyu.

Chinhu chinonyanya kukosha ndechekutsvaga rubatsiro rwechiremba nekukasika kana uine zviratidzo zvakaita seizvi, usingazviregeredze.

Dambudziko iri rakajairika zvakadii?

Paavhareji, vanhu vanenge gumi pavanhu zana vane matombo emunduru. Zvisinei, matombo mazhinji acho anoumbwa munduru. Vanhu vanenge 15% vane matombo emunduru vanowana matombo mumigero yemunduru. Vanhu vazhinji havambofi vakasangana nematambudziko nematombo aya. Vanhu vanenge 20% chete vane matombo emunduru ndivo vanowana matambudziko anoda kurapwa.

Ndezvipi zviratidzo zveCholedocholithiasis?

Ungasava nezviratidzo. Kana nduru yako isina kuvharwa nematombo emunduru, ungasatomboziva kuti unawo. Zvisinei, kana uine zviratidzo, zvinoreva kuti duct yako yemunduru yakavharwa nedombo. Zviratidzo zvekutanga zvinoitika kana duct yavharwa zvinonzi biliary colic. Izvi zvinosanganisira:

• Kurwadziwa kwemudumbu: Kurwadziwa uku kunoitika mushure mekudya. Kunogona kutora nguva kubva paawa imwe kusvika kune akati wandei. Kurwadziwa kwacho kwakanyanya kwemaminitsi makumi maviri ekutanga, kwozopera zvishoma nezvishoma. Vanhu vazhinji vanonzwa mudumbu rekumusoro kurudyi. Asi dzimwe nguva kurwadziwa kunogona kupararira kurudyi kana pafudzi.
• Kusvotwa nekurutsa: Zvakajairika kusangana nekurutsa nekurutsa pamwe ne biliary colic. Zvisinei, uchaona kuti, kusiyana nemamwe migraines, kurwadziwa hakuperi mushure mekurutsa. Kana biliary colic isiri yakanyanya, unogona kungonzwa kurasikirwa nechido.
• Jaundice:Kana nyongo isingayerere zvakanaka yodzokera muropa, ganda rako nemachena emaziso ako zvinogona kuita yero. Weti yako inogonawo kuita rima. Jaundice, se biliary colic, inouya yoenda. Asi inogona kuuya yoenda kusvika gomba riri mu duct rabviswa.
• Fivha: Kana uine kuzvimba kwakanyanya mu nyongo, unogona kutanga fivha. Fivha inogonawo kuva chiratidzo chehutachiona. Kana nzira dze bile dzakavharwa, mabhakitiriya haagone kubuda mumuviri zvakanaka, zvichiita kuti zvive nyore kuti utachiona hutange.

Ndezvipi zvimwe zvinetso zvinogona kukonzera izvi?

Dombo rinovhara duct yenyongo rinoita kuti nyongo idzokere kumashure. Izvi zvinogona kukanganisa mamwe ducts akabatana nayo, pamwe chete nenhengo dzakadai segallbladder, pancreas, nechiropa. Izvi zvinogona kukonzera kuzvimba, hutachiona, uye kukuvara kwenyama kwenguva refu. Matambudziko anogona kuitika anosanganisira:

• Utachiona: Mugero wenyongo wakavharika inzvimbo iri nyore kuti utachiona hupinde. Utachiona huri muhurongwa hwenyongo hune njodzi huru . Hunogona kupararira kuchiropa neropa. Kana hutachiona hukapararira muropa (septicemia), hunogona kukonzera chirwere chakakomba, chinouraya (sepsis).
• Cholangitis: Chikonzero chikuru chekuzvimba nehutachiona hwemugero wenyongori i'Choledocholithiasis'. Mugero wenyongori unozvimba nekuda kwekuungana kwenyongori kumashure, uye kuyerera kwenyongori kunowedzera kunonoka. Kuzvimba uku nehutachiona zvinogona kupararira kubva mumugero wenyongori kuenda kune mamwe matavi, kureva, kumapazi anopinda nemuchiropa. Izvi zvinogonawo kukonzera kuzvimba kwechiropa.
• Cholecystitis: Uku kuzvimba kwenyongo. Kana nyongo ikadzokera munyongo, inozvimba. Izvi zvinorwadza. Zvinogonawo kukanganisa mashandiro enyongo uye, nekufamba kwenguva, zvinoikuvadza. Ichi ndicho chikonzero chikuru chechirwere chenyongo.
• Gallstone Pancreatitis: Mugero wenyongo nepancreas zvinovhurika muura hudiki (ura hudiki). Kana nzira iyi ikajairika ikavharirwa nematombo emudumbu, zvinobuda mudumbu zvinogona kumira kufamba. Zvinobuda mudumbu izvi zvine ma enzymes akasimba, anogona kudzokera mudumbu, zvichikonzera kuzvimba kwakanyanya uye kukuvara kwenhengo. Izvi zvinonzi pancreatitis. Matombo emudumbu ndiwo anonyanya kukonzera pancreatitis isina doro.

Sei izvi (choledocholithiasis) zvichiitika?

Chiropa chedu chinogadzira bile kubva muzvinhu zvachinosefa kubva muropa redu. Zvinhu izvi zvinosanganisira cholesterol, bilirubin, bile salts, uye lecithin. Matombo emunduru anoumbwa kana chimwe chezvinhu izvi - kazhinji cholesterol, dzimwe nguva bilirubin - chikawandisa. Zvadaro, zvinhu izvi zvakawandisa zvinoungana setsvina.

Chinhu ichi chakaita setsvina chinoungana pasi penduru kana mugwara renyongori uye chinooma zvishoma nezvishoma. Sezvo tsvina yakawanda ichiyerera pamusoro payo, matombo aya anokura zvishoma nezvishoma. Izvi zvinogona kutora makore. Matombo mazhinji enyongori anoumbwa munduru. Zvadaro anofamba pasi pegwara renyongori opedzisira ava mugwara renyongori.

Ndezvipi zvinhu zvinokonzera njodzi zvinokanganisa izvi?

Unogona kunge uine mukana wekuva nematombo emudumbu nekuda kwezvikonzero zvinotevera:

• Kuva nechirwere checholangitis chisingaperi: Chirwere checholedocholithiasis ndicho chinokonzera chirwere checholangitis. Asi chinogonawo kuitika neimwe nzira. Kana ducts dze bile dzako dzikazvimba nekuda kwechimwe chikonzero, kuyerera kwe bile kunogona kunonoka, zvichiita kuti matombo aumbe muducts dze bile.
• Matombo emunduru akambovapo: Vanhu vazhinji vane matombo emunduru havazove nematambudziko. Zvisinei, vanhu vakambova nematombo emunduru kare vane mukana wekuti adzoke zvakare. Kunyangwe kana nduru yako ikabviswa senzira yekurapa matombo emunduru, mune dzimwe nguva, matombo matsva anogona kuumbwa mumigero yemunduru.

Zvimwe zvinhu zvinokonzera njodzi zvinowanzo kukonzera kuumbwa kwematombo emunduru zvinosanganisira:

• Mazinga ECholesterol Akakwira: Matombo mazhinji (anosvika 75%) emudumbu anoumbwa kubva mucholesterol yakawandisa muropa. Zvimwe zvikamu zve bile (munyu webile nelecithin) zvinofanirwa kunyungudutsa cholesterol iyi. Asi kana paine kusawirirana pakati peizvi, hazvishande zvakanaka.
• Mahormone echikadzi: Estrogen inowedzera cholesterol. Progesterone inoderedza kuzvimba kwenyongo uye inowedzera kubuda kwenyongo. Mahormone ese aya dzimwe nguva anokwira panguva yekubereka kwevakadzi. Kurapa kwekutsiva mahormone kunogonawo kuwedzera huwandu hwecholesterol.

Chirwere ichi (choledocholithiasis) chinoonekwa sei?

Matombo emutsinga wenyongo anowanzoonekwa mushure mekunge zviratidzo zvatanga. Kana uchitsvaga rubatsiro rwechiremba kuti uwane zviratidzo zvakaita se biliary colic kana jaundice, chiremba wako achaita bvunzo dzeropa uye bvunzo dzemifananidzo . Kuongororwa kweropa kunogona kuratidza kuti bile rakawanda sei. Kuongororwa kwemifananidzo kunogona kubatsira kuona kuti rakavharika kupi.

Ndedzipi bvunzo dziri kuitwa pakuita izvi?

Kuongororwa kweropa:

• Kuverengwa kweropa rose (CBC)
• Kuedzwa kweBilirubin
• Miedzo yekushanda kwepancreas
• Kuongororwa kwebasa rechiropa

Semiedzo yemifananidzo:

• Ultrasound yedumbu:Iyi bvunzo iri nyore, isingarwadzi. Inogona kukupa pfungwa yekutanga yemamiriro ako ezvinhu. Inogona kuratidza kana paine matombo munduru yako. Kunyangwe isingaratidze zvakajeka duct yenyongori, inogona kuratidza kana duct yacho yakakurisa. Izvi zvinoratidza kuti pane kuvharika. Kuvharika kwacho kunogona kutaridzika semumvuri.
• Ultrasound yeEndoscopic: Bvunzo iyi inosanganisa tekinoroji yeultrasound ne upper endoscopy kuti ibudise mifananidzo yakajeka ye bile ducts. Izvi zvinosanganisira kuisa chubhu diki ine kamera (endoscope) pasi pehuro pako uye mudumbu mako nemudumbu diki. Chishandiso cheultrasound chiri kumagumo eendoscope chinoshandisa mafungu eruzha kugadzira mifananidzo ye biliary system.
• MRCP (Magnetic Resonance Cholangiopancreatography): Iyi imhando yeMRI (Magnetic Resonance Imaging). Inonyatsotora mifananidzo yemigero yenyongo. Hazvikuvadzi muviri. Inogona kutora mifananidzo yakajeka yehurongwa hwese hwenyongo, kusanganisira duct yenyongo. Chiremba anogona kutanga aita bvunzo iyi kana achifungidzira kuti pane dombo mumigero yenyongo. Zvisinei, kana paine mukana mukuru wekuti pane dombo, anogona kuenda zvakananga kuna ERCP.
• ERCP (Endoscopic Retrograde Cholangiopancreatography): Bvunzo iyi inonyanya kupindira kupfuura dzimwe. Asi inobatsira zvikuru pakutsvaga matombo emunduru. Inogonawo kubvisa matombo. Inoshandisa maX-rays ne endoscopy. Kana endoscope yasvika muura hudiki, nyanzvi inoisa imwe chubhu diki kuburikidza nayo yoitungamirira mumigero ye bile. Zvadaro, mvura yakakosha (dhayi) inopinzwa kuburikidza nechubhu, uye mavhidhiyo eX-rays (fluoroscopy) anotorwa sezvo dhayi ichifamba nemumigero. Kana matombo akawanikwa, anogona kurapwa.

Vanachiremba vanobvisa sei matombo ari mu common bile duct?

Matombo aya anowanzo bviswa panguva yekuvhiyiwa kweERCP. Vanachiremba vanogona kushandisa zvishandiso zvakakosha zvakasungirirwa kumagumo e endoscope kupwanya nekubvisa matombo kana awanikwa. Dzimwe nguva, kucheka kudiki kunoitirwa mutsandanyama yemugero (sphincterotomy) kuti mugwagwa uwedzere uye dombo rikwanise kupfuura nepakati.

Kuvhiyiwa kunodiwa here pakurapa Choledocholithiasis?

Kuvhiyiwa kweEndoscopic retrograde cholangiopancreatography (ERCP) hakudi kubviswa kwedumbu kuti usvike mumigero yenyongo. Zvisinei, mushure mekubvisa matombo kubva mumigero yenyongo, vanachiremba vanowanzokurudzira kuvhiyiwa kwenyongo . Chikonzero cheizvi ndechekudzivirira matombo kuti asabude zvakare munyongo uye zvichikonzera choledocholithiasis.

Ndichada mamwe marapirwo here?

Zvichienderana nemamiriro ako ezvinhu, ungangoda mamwe marapirwo usati wabviswa matombo emunduru. Semuenzaniso:

• Kana paine hutachiona , mushonga unorwisa mabhakitiriya unorayirwa.
• Nzira dzekubvisa bile dzakaungana.

Ndezvipi zvinetso zvinogona kuitika mushure mekurapwa?

Matambudziko anotevera anogona kuitika munguva pfupi mushure mekubviswa kwematombo e endoscopic:

• Kubuda ropa
• Utachiona
• Chipembenene

Zvinotevera zvinogona kuitika kwenguva refu mushure mekurapwa:

• Kudzoka kwematombo munyongo: Kunyangwe matombo ese ari mumigero yenyongo akabviswa, matombo matsva anogona kuumbwa gare gare. Vanhu vakambova nematombo kare vane mukana wekuti adzoke zvakare.
• Bile duct fibrosis: Mavanga anogona kuumbwa kana bile duct yachekwa. Dzimwe nguva mavanga aya anogona kukonzera kuti duct itete (biliary stricture). Izvi zvinogona kukonzera rudzi rwakasiyana rwekuvharika kwe common bile duct. Zvingada kurapwa kwakasiyana.

Kukura kwecholedocholithiasis kunogona kudzivirirwa here?

Matombo mazhinji emunduru anokonzerwa necholesterol, uye unogona kuderedza huwandu hwecholesterol muropa rako nekuchinja kudya kwako nemararamiro ako. Izvi zvinogona kubatsira kuderedza njodzi yako. Vanachiremba vanoti dzivisa kudya "yo-yo", uko kuri kuderedza uremu panguva imwe chete wozohuwanazve. Kana ukadzikira uremu, zviite zvishoma nezvishoma . Kudzikira uremu hwakawanda panguva imwe chete kunowedzera njodzi yako yekubatwa nematombo emunduru.

Mamiriro ezvinhu akaita sei mushure mekurapwa?

Kune vanhu vazhinji, kurapwa kuri nyore uye kunobudirira. Kana munhu akasangana nematambudziko mushure mekurapwa, matambudziko iwayo anogona kurapwa. Mukati memakore gumi kusvika makumi maviri, vanhu vari pakati pe5 ne25 pavanhu zana vanotanga kubuda matombo matsva mumigero yenyongo. Njodzi iyi ishoma kana gallbladder ikabviswa.

Kurwiswa nematombo emunduru kunogona kuva chiitiko chinorwadza uye chinotyisa, kunyanya kana usina kuziva kuti une matombo kare. Kana ukangowana kurapwa nekukurumidza, unokurumidza kunzwa zviri nani. Biliary colic, kunyangwe ikauya yoenda, uye isina kunyanya kuipa, haifanirwe kuregeredzwa. Ichangowedzera kuipa kusvika kuvharika kwemugero wenyongo kwabviswa.

Zvinhu zvakakosha zvekurangarira (Mharidzo Yekuenda Kumba)

Zvakanaka, saka ndinovimba wava kunzwisisa zviri nani 'choledocholithiasis' yatataura nezvayo nhasi.

Chinhu chinonyanya kukosha ndechekuti kana uine zviratidzo zvakaita sekurwadziwa kwakanyanya mudumbu, kuda kurutsa, kurutsa, uye maziso kuita yero, usangozvifuratira wobva waona chiremba nekukasika.

Kune mishonga yakanaka yechirwere ichi. Kana chikaonekwa nekukurumidza, chinogona kurapwa matambudziko akakomba asati amuka. Usatya, tevera zano rachiremba wako. Uyewo chengetedza kudya kwako uye mararamiro ako. Ipapo unogona kuzvidzivirira zvakanyanya kubva kumatambudziko akadaro.

Matombo emunduru , duct yenyongo, choledocholithiasis, jaundice, kurwadziwa mudumbu, endoscopy, ERCP