Wakambovhiyiwa here kuti ubvise gallbladder yako? Uchiri kurwadziwa zvakanyanya here dzimwe nguva mudumbu rako? Zvakafanana nekurwadziwa kwaunowana kubva mumatombo egallbladder? Vanhu vazhinji vanofunga kuti mushure mekubviswa gallbladder yavo, kurwadziwa kwavo mudumbu kunenge kwapera zvachose. Asi dzimwe nguva chikonzero chekurwadziwa uku hachisi chatiri kufunga, asi chimwe chinhu. Ndizvo zvatichataura nezvazvo nhasi.
Zvichitaurwa zviri nyore, chii chinonzi Sphincter of Oddi?
Kuti tinzwisise izvi, ngatitangei tatarisa maitiro ekugaya chikafu mumuviri wedu. Chinhu chakaoma uye chinoshamisa. Nhengo dzakawanda, dzakadai sechiropa nepancreas, dzinoshanda pamwe chete kushandura chikafu chatinodya kuita simba.
- Chiropa: Apa ndipo panogadzirwa kemikari inonzi bile. Inochengetwa kwenguva pfupi munduru.
- Pancreas: Gland iri rinogadzira ma enzymes anobatsira kugaya chikafu.
Dumbu rinobva muchiropa nemaenzyme anobva mupancreas zvinofanira kuyerera pamwe chete muura hwedu hudiki. Tsandanyama diki inodzora rwendo irworwo, iyo inoshanda segedhi, inonzi Sphincter of Oddi .
Kana ichishanda zvakanaka, tsandanyama iyi, inonzi Sphincter of Oddi, inovhurika panguva yakakodzera, zvichiita kuti bile nema enzymes zvipfuure muura hudiki. Zvadaro inovhara zvakare.
Saka chii chinonzi Sphincter of Oddi Dysfunction (SOD)?
Zvichitaurwa zviri nyore, Sphincter of Oddi Dysfunction ndiyo nguva iyo gedhi ratakataura nezvayo, mhasuru inonzi Sphincter of Oddi, isingavhurike zvakanaka panguva yainofanira kuvhurwa. Chii chinoitika ipapo? Kuti bile nepancreatic enzymes hazvigone kupinda muura hudiki zvonamira muchubhu iyoyo. Kana yanamira seizvi, inokonzera kurwadziwa kwakanyanya mudumbu, zvakafanana nezvinoitika kana uine matombo emunduru.
Dambudziko iri rinowanzoonekwa muvanhu vakabviswa nduru yavo (cholecystectomy). Nekuda kweizvi, dzimwe nguva inonzi "post-cholecystectomy syndrome."
Ndeapi marudzi makuru uye mapoka echirwere ichi?
Dambudziko iri rinogona kukamurwa kuita mhando mbiri huru uye nhatu. Zvakakosha kuziva izvi, nekuti kurapwa kunoenderana nerudzi urwu.
| Rudzi / Chikamu | Zvakatsanangurwa zviri nyore |
|---|---|
| Mhando mbiri huru | |
| Kusagadzikana kweBiliary | Izvi zvinoitika kana nzira dzemudumbu dzichivharika, zvichiita kuti dumbu risapinde mudumbu diki. |
| Chipembenene | Muchiitiko ichi, kuvharika kunoitika mupancreas, zvichikonzera kuzvimba kwepancreas. |
| Zvikamu Zvitatu Zvikuru | |
| Mapoka I neII | Muzvikamu zviviri izvi, vanachiremba vanogona kuwana humbowo hwakajeka hwedambudziko iri kuburikidza nekuongororwa. Semuenzaniso, kuongororwa kweropa kusina kujairika kana kuongororwa ne ultrasound kunoratidza maburi e bile akakurisa kana maburi epancreatic. |
| Chikamu III | Rudzi urwu ndirwo rwakaoma kuona. Nekuti hapana humbowo hwakajeka hweizvi mumishumo yeropa, maskeni, nezvimwewo. Humbowo hwechirwere ichi chete kurwadziwa kwemudumbu kwemurwere. Saka, kurapa izvi kwakaomawo. |
Ndezvipi zviratidzo zvechirwere ichi?
Chiratidzo chikuru uye chinowanzoonekwa chechirwere ichi kurwadziwa kwakanyanya mudumbu, kwakafanana nekurwadziwa kunoitika kana matombo emunduru aumbwa.
- Kunobva kurwadziwa: Kurwadziwa kunopisa kunotanga kumusoro kurudyi kwedumbu.
- Kuparadzira marwadzo: Dzimwe nguva marwadzo aya anogona kunzwa sekunge ari kuenda pafudzi rekurudyi kana kumusana.
- Nguva yekurwadziwa: Marwadzo anowanzopera mushure memaminitsi angangoita makumi matatu kusvika paawa. Zvisinei, anogona kudzoka rimwe zuva.
Kuwedzera kune kurwadziwa uku kukuru, zvimwe zviratidzo zvakawanda zvinogona kuonekwa:
- Kusvotwa nekurutsa
- Kupindwa nechando
- Kutonhora
- Manyoka
Chinhu chakakosha ndechekuti zviratidzo izvi hazviwanzofanana. Mamwe mazuva zvinouya zvoenda, asi mamwe mazuva zvinogona kusashivirira.
Sei izvi zvichiitika? Ndezvipi zvinhu zvinokonzera njodzi?
Hapana chikonzero chimwe chete cheizvi. Dzimwe nguva mavanga kana kuzvimba kwemutsinga dzenyongo kunogona kuvharira kuyerera kwenyongo. Dzimwe nguva, pasina kuvharika, zvinogona kukonzerwa nedambudziko re sphincter yemhasuru yeOddi pachayo.
Asi kune mapoka akati wandei ari panjodzi huru yekubatwa nechirwere ichi.
- Chinonyanya kuwanikwa: Vakadzi vari pakati pemakore 20-50 vakabviswa nduru yavo nerubatsiro rwekuvhiyiwa.
- Zvimwe zvinhu zvinokonzera njodzi:
- Vanhu vakambovhiyiwa kuderedza uremu (Gastric bypass surgery).
- Vanhu vanodzoka vachirwara nepancreatitis.
- Vanhu vaiva nematombo emunduru.
- Vanhu vakamboisirwa chiropa.
- Vanhu vane chirwere chethyroid chisingashande zvakanaka (Hypothyroidism).
- Vanhu vane chirwere cheIrritable Bowel Syndrome (IBS).
- Vanhu vanonwa doro zvakanyanya.
- Vanhu vanoshandisa mimwe mishonga inoderedza marwadzo (kunyanya maopioid).
Zvingava nengozi here kana zvikasarapwa?
Ichi hachisi chirwere chinotyisidzira hupenyu, uye matambudziko makuru haawanzoitiki. Zvisinei, kurwadziwa kwakanyanya kwachinokonzera kunogona kukanganisa kugona kwako kushanda zvakanaka.
Asi kana zvikaramba zvakadaro pasina kurapwa, zvirwere zvinotevera zvingasawanzoitika:
- Chirwere chepancreatitis chisingaperi: Kukuvadzwa kusingadzoreki kwepancreas kunokonzerwa nekuzvimba kunoramba kuripo.
- Jaundice: Kutsvuka kweganda uye machena emaziso kunokonzerwa nekuunganidzwa kwebilirubin, chikamu chenyongo, mumuviri.
Chiremba anoongorora sei chirwere ichi?
Kana uine zviratidzo izvi, chinhu chekutanga chichaita chiremba wako ndechekuongorora zvimwe zvirwere zvinogona kukonzera kurwadziwa mudumbu mako, nekuti rudzi urwu rwekurwadziwa runogona kukonzerwa nezvimwe zvirwere zvakawanda.
Semuenzaniso, unofanira kuva nechokwadi chekuti hapana zvirwere zvakakomba zvakaita sechirwere chemaronda emudumbu, choledocholithiasis, kana kenza yepancreas kana bile duct. Zvinoshamisa kuti kurwadziwa kwemamwe matambudziko emwoyo (senge angina) kunogonawo kunzwa sekurwadziwa mudumbu.
Mushure mekunge chiremba wako aramba zvese izvi, anogona kukukumbira kuti uite bvunzo idzi:
- Kuongororwa kweropa: Tarisai kana paine mazinga akakwira eenzyme yechiropa nepancreas.
- Miedzo yemifananidzo:Tarisa kana paine zvisina kumira zvakanaka mu sphincter yemhasuru yeOddi kana ducts. Izvi zvinogona kusanganisira bvunzo dzakadai seAbdominal Ultrasound, CT scan, Endoscopic Ultrasound (EUS), Upper Endoscopy, uye Magnetic Resonance Cholangiopancreatography (MRCP).
Bvunzo yakakosha: ERCP neManometry
Dzimwe nguva, kana bvunzo dzese idzi dzisiri dzechokwadi, chiremba anogona kukutumira kune imwe bvunzo inonzi Endoscopic Retrograde Cholangiopancreatography (ERCP) ine manometry .
Izvi zvinosanganisira kuenda kuSphincter yeOddi nerubatsiro rwe endoscope, kuisa chubhu diki yepurasitiki, uye kuyera kumanikidzwa kuti uone kuti tsandanyama iyoyo inokwenya uye inokura sei.
Asi bvunzo iyi yeERCP ine njodzi diki. Vamwe vanhu, vanenge 15 kusvika 30 pa100, vanogona kurwara nepancreatitis mushure mekuongororwa uku. Saka, vanachiremba vanoita izvi chete mushure mekunyatsoongorora uye kana zvichidikanwa.
Ndezvipi zvinorapwa izvi?
Nzira yekurapa inoenderana nekuoma kwezviratidzo zvako uye kuti uri muboka ripi.
1. Kana kurwadziwa kusina kunyanya kuipa (kunyanya kune chikamu chechitatu):
Chiremba achakupa mishonga inonyaradza marwadzo (isiri opioid) uye inozorodza tsandanyama.
2. Kana kurwadziwa kwakanyanya (kwezvikamu zvekutanga nechipiri):
Kana zvakaoma kudzora nemishonga, chiremba anogona kukutumira kunorapwa kunonzi ERCP ne sphincterotomy . Izvi zvinoitwa pasi pe anesthesia kana pasi pe anesthesia. Chiremba anoshandisa endoscope kuenda kuSphincter yeOddi, ocheka tsandanyama shoma inenge yanamira, oisunungura. Panguva imwe chete, vanoongorora matombo ari mu ducts dze bile.
Njodzi dzekurapa sphincterotomy
Kurapa uku kunobatsira kuderedza marwadzo muvarwere vazhinji vane mhando yekutanga neyechipiri. Zvisinei, inzira yakaomawo ine njodzi.
- Vanenge 10% - 15% yevarwere vanogona kuva nematambudziko akadai sepancreatitis.
- Kunyangwe kuzvimba uku kuchiwanzova kudiki, dzimwe nguva kunogona kuva kwakanyanya uye kutyisidzira hupenyu.
- Muzviitiko zvakadaro, ungafanira kugara muchipatara kwenguva yakareba kuti urapwe.
Saka, vanachiremba vanoshandisa nzira iyi chete kana isingakwanise kudzorwa nedzimwe nzira dzekurapa.
Mharidzo Yekuenda Nayo Kumba
- Kana ukaramba uchirwadziwa mudumbu mushure mekubviswa nduru yako, usazviregeredza. Ehe ona chiremba.
- Marwadzo aya anogona kunge akakonzerwa neSphincter of Oddi Dysfunction (SOD), chirwere chinogona kuitika kunyangwe nduru isipo.
- Kune mhando dzakasiyana dzechirwere ichi. Dzimwe dzinoonekwa zviri nyore nekuongororwa, asi dzimwe (kunyanya rudzi rwechitatu) dzinonetsa kuona.
- Kune mishonga yakaita semapiritsi neERCP ne sphincterotomy, iyo inongoitwa chete kana zvichidikanwa. Zvisinei, yeuka kuti nzira idzi dzine njodziwo.
- Taura nachiremba wako nezvezviratidzo zvako, kuti zvinobuda sei, uye rudzi rwekurwadziwa kwako. Izvi zvichakubatsira kusarudza mushonga wakakodzera uye wakachengeteka kwauri.
💬 Comments (0)
Hapana zvakataurwa parizvino. Isa mhinduro yako pano kekutanga.
Wedzera zvaunofunga