Acalculous mob cholecystitis: kev kho mob cov kauj ruam thiab

Acalculous mob cholecystitis - ib tus mob o ntawm lub zais zis tsib tsis muaj tus tsim ntawm gallstones. Qhov no daim ntawv ua rau mob nyob rau hauv txoj cai hypochondrium thiab dyspepsia.

Nyob rau hauv lub teb ntawm Gastroenterology ntawm ceg txheem ntseeg mob txhab nyiaj rau ntawm 5 mus rau 10% ntawm cov neeg. Nyob rau hauv cov poj niam, mob cholecystitis tsis muaj pob zeb no tshwm sim nyob rau hauv hais txog 4 lub sij hawm ntau. Cov uas yog cov statistics. Ib txhia soj ntsuam kaj mob cholecystitis tsis muaj pob zeb raws li ib tug hloov daim ntawv mus rau xws kab mob raws li cov roj uas txhaws kalkulez. Tab sis, raws li kev kho mob xyaum, cov neeg mob yuav tsis muaj lawm raug kev txom nyem los ntawm cholelithiasis.

Cov ua rau tus kab mob

Lub etiology ntawm cov kab mob no yog raws li nyob rau hauv ntau yam kab mob:

• E. coli;
• Enterococcus;
• aureus;
• Proteus;
• muaj ntawm mixed hom.

Lub allergic ntawm cov kab mob mus rau hauv lub gallbladder los ntawm cov plob tsis so tswj tshwm sim nyob rau hauv tej yam kev mob xws li:

• goiter;
• mob plab;
• enteritis;
• kab mob siab;
• pancreatitis.

Tsawg zaus, mob kis los ntawm cov qog los sis cov ntshav los ntawm cov kab foci nyob remotely.

Piv txwv li, tus kab mob kis nyob rau hauv cov kab mob xws li:

• ncig kab mob;
• nyob rau hauv mob tonsillitis;
• mob hnyuv tws;
• mob ntsws muaj dej;
• pyelitis;
• adnexitis.

Los ntawm provoking yam, uas qhib lub kab dab, xws li:

• cholestasis;
• biliary dyskinesia;
• ntxeem tau ntawm cab xws li Giardia, roundworm, amoebae;
• sphincter kawg;
• rog;
• dysmenorrhea;
• lub cev inactivity;
• malnutrition;
• burnout li al.

Acalculous mob cholecystitis yuav thickening thiab deformation ntawm lub gallbladder. Cov txheej membrane acquires ib tug Mesh qauv vim lub fact tias lwm atrophic cheeb tsam uas muaj polyps uas tsim tuab folds.

Thooj tshwm sim npag lub tsho tiv no. Nws zoo nkaus li caws pliav fibrous cov ntaub so ntswg. Thaum lub loj heev ntawm inflammatory txheej txheem yuav tsim pericholecystitis, tshwm sim adhesions nrog lub nruab nrog cev nyob rau hauv lub zej zog, ua paug, pseudodiverticulum.

kev faib ntawm cov kab mob

Swb yog ib lub teeb, medium thiab hnyav. Tus kab mob yuav muaj cov peb theem:

• aggravation;
• subsidence thiab aggravation;
• ruaj khov thiab tsis ruaj tsis khov so ib pliag.

Acalculous mob cholecystitis yuav npaj mus nrog rov. Tsis tas li ntawd, tus kab mob yog monotone thiab sib quas ntus.

Nyob ntawm seb raws li ntawm kev puas tsuaj rau paub qhov txawv ntawm qhov nyuab thiab uncomplicated daim ntawv ntawm mob cholecystitis nekalkuleznogo. Tsis tas li ntawd kom paub qhov txawv ntawm raug thiab atypical tsos. Cov yav tas daim ntawv no yuav muab faib mus rau hauv plab hnyuv, thiab kardialgichesky ezofagalgichesky hom.

Cov tsos mob ntawm tus kab mob cholecystitis acalculous manifest lawv tus kheej nyob rau hauv ntau txoj kev nyob ntawm cov neeg kawm ntawv ntawm lesion ntawm lub gallbladder.

Yuav ua li cas puas muaj tus kab mob nyob rau hauv me me?

Rau cholecystitis yog me me, yus muaj los ntawm luv luv ntev ntawm exacerbation, ntev 2-3 hnub. Lawv feem ntau provoked los ntawm malnutrition thiab yooj yim tshem tawm, kev kawm mus rau ib tug zoo cov khoom noj.

General cev mob qub lub cev kub yog ib txwm. Qhov kev xeem qhia tsis muaj kev haumxeeb teeb ntawm daim siab, gallbladder thiab txiav. Me me cov kev tshawb fawb ntawm cov kua tsib tsis qhia tej txawv txav.

Yuav ua li cas yog qhov nruab nrab zoo?

Nrog ib tug nruab nrab zoo xws li cov kab mob li mob cholecystitis acalculous, zam txim thiab aggravation hloov txhua lwm yam. Lub caij ntawm exacerbations yog 2-3 lub lim piam. Cov neeg mob feem ntau yog thab mob thiab qhia dyspeptic ntshawv siab. Feem ntau, cov kev tshwm sim los ntawm ib tug fatty noj mov los yog overeating. Nyob rau hauv tej rooj plaub, lub luag hauj lwm ntawm provocateur mob ua pa kab mob ua.

Raws li tshwm sim nyob rau hauv cov ntaub ntawv ntawm tus kab mob cholecystitis tsis muaj pob zeb? Cov tsos mob yog varied. Thaum lub sij hawm exacerbation ntawm cov neeg mob tsis muaj qab los noj mov, txo lub cev hnyav, intoxication zoo nkaus li qhia nyob rau hauv qaug zog thiab migraine. Nws kuj disturb tus mob tej pob txha.

Ib txhia neeg nyob rau hauv tas li ntawd mus mob nyob rau hauv txoj cai qaum quadrant yuav tsis txaus siab ntawm ib tug dull mob nyob rau hauv rau sab laug sab sauv quadrant thiab lub plab mog. Mob yog feem ntau thov rau ntawm lub plawv. Cov neeg mob kev txhawj xeeb txog xeev siab, cem quav los yog raws plab.

Nyob rau hauv ib tug kuaj txoj kev tshawb no, cov kua tsib cim nce nyob rau hauv tus nqi ntawm cov hnoos qeev, leucocytes, cholesterol, bilirubinate Ca, kua tsib ntsev nyob rau hauv ib co neeg mob microlites. Nws yog tseem tau mus ntes microorganisms.

Nyob rau hauv mob mob nyob rau hauv ib tug neeg mob mus ntes hloov nyob rau hauv daim siab muaj nuj nqi kev ntsuam xyuas. Feem ntau qhia ntsis hypoalbuminemia, ib tug me ntsis nce nyob rau hauv transaminase kev ua si, mas AJIT, ntsis nce thymol thiab kev ua si ntawm alkaline phosphatase.

Indexes ntawm laboratory kev soj ntsuam ntawm lub siab yog ib txwm nyob rau hauv txoj kev zam txim. Tus neeg mob tej zaum yuav cuam tshuam cov kev xav ntawm heaviness nyob rau hauv lub plab thiab tsam plab tom qab haus. Feem ntau, ib tug neeg txhawj txog cem quav los yog raws plab.

Dyspeptic cov tsos mob kom nrog fatty noj mov los yog ntxhib fiber. Tej zaub mov yuav ntxias ib tug aggravation ntawm tus kab mob.

Yuav ua li cas mob loj heev daim ntawv no tshwm sim?

Acalculous mob cholecystitis nyob rau hauv ib tug loj heev daim ntawv yus los ntawm ib tug khiav nrog rau qhov rov tsis muaj kev zam txim. Tus kab mob kis tau rau sab nraum lub gallbladder. Hla mus rau cov ntsiab kab mob txuam kab mob siab nyob rau hauv ib tug mob daim ntawv no, thiab pancreatitis.

Cov neeg mob tsis txaus siab ntawm tsis muaj qab los noj mov, mus tsis tu ncua xeev siab, heaviness nyob rau hauv lub plab. Tej zaum mob ncus yog shingles cim. Cov neeg mob pom zoo ib tug nruj kev noj haus, uas ua rau yus nqa tsis tau thiab qaug zog. Nyob rau hauv tej rooj plaub, muaj yog sepsis nyob rau hauv lub mob daim ntawv.

Cov functionality ntawm lub gallbladder ruaj zoo. Lub phab ntsa ntawm lub cev thickens. Yog hais tias qhov nruab nrab degree ntawm hepatic functionality yog cov tawg, thaum mob loj heev kab mob feem ntau nws nws tus kheej nyob rau hauv tus kab mob siab los yog cholangitis.

Nyob rau hauv cov ntaub ntawv no, cov nram qab dab muab qhov chaw:

• siab nce nyob rau hauv loj;
• ntaus cim txo nyob rau hauv cov ntshiab albumin;
• nce globulin feem thiab cov concentration ntawm tag nrho cov bilirubin.

Thaum peb qhia ultrasound ntawm lub plab mog qhia extension ciav ntawm cov tsib zais zis, qhia "teev" tsib lub zais zis, mob pancreatitis down functionality txiav.

Cov neeg mob feem ntau tsis txaus siab ntawm dyspepsia, xeev siab, poob phaus. Lawv cai nce quav ntim, steatorrhea, thiab kreatoreya amylorrhea.

Rau hauv loj heev kab mob cuam tshuam cov hlab ntsha thiab lub plawv, nws zoo nkaus li dystonia, coronary insufficiency nrog tsim nyog hloov rau ECG.

Raws li atypical daim ntawv ntawm tsev?

Nws yog yus muaj los ntawm ib tug atypical daim ntawv ntawm mob cholecystitis acalculous? Txhawj xeeb mob qhov kub siab, heaviness, mob qab lub breastbone, nraum dysphagia. Thaum lub plab hnyuv hom mus rau lub fore lub mob nyob rau hauv lub plab hnyuv cheeb tsam, tsam plab, cem quav.

Thaum cov tub ntxhais uas muaj hnub nyoog ntawm mob cholecystitis tsis muaj pob zeb zoo xws li cov rheumatism nyob rau hauv ib tug latent daim ntawv. Cov neeg mob tsis txaus siab ntawm asthenia, mob nyob rau hauv cov pob qij txha. Auscultation qhia tsis plawv suab.

Los ntawm atypical chav kawm ntawm tus kab mob no muaj xws li lumbar thiab piloroudenedalny hom mob cholecystitis. Thaum lumbar daim ntawv, cov neeg mob muaj kev mob nyob rau hauv lub txha nqaj. Nyob rau hauv xws li mob, nws qhia tau hais tias ib tug X-ray ntawm cov leeg nrob kem.

Symptomatology kardialgicheskoy daim ntawv

Qhov no daim ntawv ntawm tus kab mob yog xam qhovkev arrhythmias (extrasystoles) los yog mob hauv siab. Tsis tas li ntawd ECG hloov.

Nyob rau hauv nruab nrab thiab cov neeg laus uas muaj hnub nyoog zoo ib yam li ib daim ntawv ntawm mob angina los yog coronary insufficiency, ntws nyob rau hauv lub mob daim ntawv. Cov neeg mob tsis txaus siab ntawm qhov mob nyob rau hauv lub plawv, tachycardia.

gastroduodenal daim ntawv

Clinic mob cholecystitis nyob rau hauv cov ntaub ntawv no tsa ulcerative kab mob los yog gastroduodenitis nrog txhawb theem ntawm pais plab acid tsim. Cov neeg mob tsis txaus siab ntawm qhov mob nyob rau hauv lub plab thaum hmo ntuj.

txoj kev mob

Nyob rau palpation ntawm lub plab mog rau hauv lub cheeb tsam ntawm lub tsib lub zais zis muaj ce uas yog zuj zus thaum ua pa los yog effleurage cai costal koov.

Nyob rau hauv ib tug kuaj txoj kev tshawb no, nce tus nqi txiav txim:

• transaminases;
• alkaline phosphatase;
• γ-glutamyl.

Rau ib qho tseem ceeb heev diagnostic txoj kev muaj xws li:

• ultrasound;
• cholecystography;
• tseliakografiyu;
• holestsintigrafiyu;
• duodenal intubation.

Raws li qhov tseeb kev tshawb fawb, koj muaj peev xwm tham txog cov kev siv ntawm cov inflammatory txheej txheem.

Raug hloov tshwm sim nyob rau macroscopic theem nyob rau hauv cov kua tsib turbidity thiab muaj cov hnoos qeev thiab plaub ya ri.

Tsom qhia ib tug nce leukocyte count, bilirubin, protein, cov roj uas txhaws, thiab hais txog. D.

Bacteriological sowing cov kua tsib soj ntsuam nws cov microbial muaj.

Nrog kev pab los ntawm holetsistografii nyob rau hauv cov neeg mob kev txom nyem los ntawm tus kab mob cholecystitis acalculous kwv yees lub cev muaj zog thiab concentration functionality ntawm lub gallbladder, nws nkhaus thiab txoj hauj lwm.

Sonography no lub deformation ntawm lub gallbladder, atrophic dab nyob rau hauv nws cov phab ntsa, sis tsis ncaj nrog epithelium, muaj cov uas tsis yog-homogeneous cov ntsiab lus nrog rau cov inclusions ntawm cov kua tsib uas tsis yog niaj hnub zoo li taub hau.

Lub differential mob yog nqa tawm nrog biliary dyskinesia, mob cholangitis, ulcerative mob plab nonspecific, thiab Crohn tus kab mob.

txoj kev kho txoj kev

Nws eliminates mob cholecystitis tsis muaj pob zeb? Kev kho mob feem ntau yog ua conservative. Cov kws kho mob pom zoo kom noj cov zaub mov. Nws yog ib advisable mus cais los ntawm kev noj haus ntawm fatty thiab kib zaub mov, khoom noj khoom haus ntsim, mos mos thiab dej cawv haus.

Thaum mob plab pom zoo kom tsawg ntawm antispasmodics xws li "Platifillin" "Drotaverine" "Papaverine" thiab al.

Thaum lub sij hawm exacerbation ntawm tus kab mob los yog nws ua ke nrog cholangitis siv antibacterial kev kho mob "cefazolin" "amoxicillin", "erythromycins", "ampicillin" "furazolidone" thiab al.

Rau lub normalization ntawm tus mob huam yuav tsum tau mus coj cov "Festal", "Mezim-forte", "Pancreatin".

Yuav kom txhim kho secretion ntawm cov kua tsib feem ntau chaw uasi mus rau tau txais choleretic ( "Allohol" "Holenzim" "Oksafenamid").

Yuav kom tsim kho lub contraction ntawm tsib gallbladder thov magnesium sulfate thiab sorbitol.

Thaum lub sij hawm ib tug exacerbation los yog zam txim rau hu tuaj coj ib lub chav kawm ntawm kev kho nrog tshuaj ntsuab. Siv ib tug decoction ntawm chamomile, Calendula, rose, licorice, mint.

Nyob rau hauv txoj kev zam txim nqa tyubazh, haus dej haus ntawm ntxhia dej, qoj ib ce yog cov kev ua.

phais kev pab

Thaum phais yog muab rau tus account keeb kwm ntawm tus kab mob. Mob cholecystitis acalculous qhia nyob rau hauv deformation ntawm cov phab ntsa hauv lub gallbladder thiab intractable kho cholangitis thiab pancreatitis yuav tsum tau phais.

Nyob rau hauv cov ntaub ntawv no, nqa tawm los ntawm ib qho qhib cholecystectomy pab laparascopy los yog mini saib.

Kev siv cov pej xeem txoj kev

Yuav ua li cas lwm tus yog tshem tawm acalculous mob cholecystitis? Folk kev kho mob kuj muaj ib tug zoo ntxim.

Siv cov hauv paus hniav calamus, valerian, St. John lub wort Dried buds, Calendula, nettle, pob kws, flax noob. Nws tseem yog hu rau siv limes, peppermint, Leonurus, chamomile, fennel, horsetail, rosehip.

Thaum uas siv cov txoj kev nyob rau mob cov kab mob ntawm paj thiab immortelle elderberry phytotherapy ntxiv.

phytotherapy

Herbal tshuaj yuav siv ntawm ib tug dej cawv ntawm cov nram qab no tshuaj ntsuab:

• Pion - 20 ml;
• valerian - 20 ml;
• boyaryshnik- 20 ml;
• mint - 20 ml;
• belladonna - 10 ml;
• Motherwort - 20 ml;
• Calendula - 30 ml;
• wormwood - 20 ml.

Nyob rau hauv lub xub ntiag ntawm glaucoma belladonna ntxiv.

Haus dej cuab tam yuav tsum nyob rau 1-8 dauv peb lub sij hawm ib hnub twg rau tsib feeb ua ntej lub Txoj kev lis ntshav ntawm tshuaj ntsuab mus rau 1 tbsp. litres ntawm cov dej rau 4-6 lub lis piam. Cov sib tov tinctures calamus thiab inula coj nyob rau hauv sib npaug zos nyiaj. Tsis tas li ntawd haus rau 1-8 dauv peb lub sij hawm ib hnub twg rau ob tug nas this ua ntej tau txais infusions ntawm tshuaj ntsuab mus rau 1 tbsp. l. dej rau 4-6 lub lis piam.

Nws yuav tsum tau nco ntsoov tias sau los ntawm Phytotherapy yog kev cob cog rua ntawm ib koob tshuaj 0,00325, t. E. 14th dilution, thiab tsub kom txhua hnub los ntawm 1-2 qe mus cuag cov pom koob tshuaj.

Ib tug tsim tshuaj yog ib qho uas ua rau raws plab mob, thiab nyob rau lwm cov tes, thiaj li muaj cov degree ntawm uas twb muaj lawm cov tsos mob. Qhov no tshuaj noj thaum lub chav kawm, tab sis yog hais tias muaj yog tsis xis nyob, nws yog txo los ntawm 1-2 units.

outlook

Yuav ua li cas yog lub raug ntawm xws kab mob raws li tus kab mob cholecystitis tsis muaj pob zeb? Exacerbation ntawm me me tshwm sim xwb puav. Tus kab mob muaj ib tug dej siab kawg. Deterioration tshwm sim nyob rau hauv qhov twv ua ntej hais tias ib tug exacerbation tshwm sim nquag thaum lub nruab nrab tus kab mob heev.

kev tiv thaiv

Tiv thaiv kev ntsuas yog muab ntim rau hauv ib lub raws sij hawm kev kho mob ntawm tus kab mob, Readjustment ntawm foci ntawm tus kab mob, xa teeb nyob rau hauv lub paj hlwb, raws li zoo raws li restoration ntawm ib txwm metabolism. Koj yuav tsum tau soj ntsuam cov Noj cov zaub mov, mus tua hnyuv helminth kab mob thiab txhab.