Gallstones

Zoo Siab

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Gallstones tsim thaum cov ntsiab lus hauv cov kua tsib harden rau hauv me me, zoo li pebbles hauv lub gallbladder. Feem ntau cov gallstones yog tsim los ntawm cov roj cholesterol. Yog tias cov kua tsib muaj cov roj (cholesterol) ntau dhau, lossis lub zais zis tsis khoob tag lossis feem ntau txaus, cov pob zeb tuaj yeem tsim tau.

Leej twg muaj kev pheej hmoo?

Cov poj niam muaj ob npaug ntau dua li cov txiv neej muaj lub gallstones. Cov poj niam cov tshuaj estrogen nce qib roj cholesterol hauv cov kua tsib thiab ua rau lub zais zis qeeb. Cov nyhuv tseem ntau dua thaum cev xeeb tub thaum cov tshuaj estrogen nce. Qhov no yuav pab piav qhia tias vim li cas ntau tus poj niam thiaj li mob gallstones thaum cev xeeb tub lossis tom qab yug menyuam. Ib yam li ntawd, yog tias koj noj cov tshuaj tiv thaiv kab mob los yog kev kho cov tshuaj hormones menopausal, koj muaj feem ntau dua los tsim cov pob zeb.

Koj kuj tseem yuav muaj pob zeb ntau ntxiv yog tias koj:

• muaj tsev neeg keeb kwm ntawm gallstones
• rog dhau lawm
• noj cov zaub mov uas muaj roj ntau, cov roj (cholesterol) siab
• tau poob ceeb thawj sai heev
• muaj hnub nyoog tshaj 60 xyoo
• yog neeg Amelikas Khab lossis Neeg Mev Meskas
• noj cov tshuaj uas txo cov roj cholesterol
• muaj ntshav qab zib

Cov tsos mob

Qee lub sij hawm gallstones tsis muaj tsos mob thiab tsis xav tau kev kho mob. Tab sis yog hais tias gallstones txav mus rau hauv cov ducts uas nqa cov kua tsib los ntawm lub gallbladder los yog daim siab mus rau cov hnyuv me, lawv tuaj yeem ua rau lub gallbladder "sib tsoo." Kev tawm tsam ua rau mob hnyav nyob rau sab xis ntawm lub plab, hauv qab lub xub pwg sab xis, lossis nruab nrab ntawm lub xub pwg hniav. Txawm hais tias kev tawm tsam feem ntau dhau mus thaum lub gallstones txav mus rau pem hauv ntej, qee zaum lub pob zeb tuaj yeem nkag mus rau hauv cov kua tsib. Ib txoj hlab ntsha uas thaiv tau tuaj yeem ua rau muaj kev puas tsuaj loj lossis kis kab mob.

Cov cim ceeb toom ntawm cov hlab ntaws raug kaw

Yog tias koj muaj ib qho ntawm cov tsos mob ntawm tus kab mob hauv lub cev, mus ntsib koj tus kws kho mob tam sim ntawd:

* mob ntev tshaj 5 teev

* xeev siab thiab ntuav

* ua npaws

* tawv nqaij daj lossis qhov muag

* quav quav quav quav

Kev kho mob

Yog tias koj muaj gallstones yam tsis muaj tsos mob, koj tsis tas yuav kho. Yog tias koj muaj ntau lub gallbladder tawm tsam, koj tus kws kho mob yuav xav kom koj tshem koj lub gallbladder - ib qho kev ua haujlwm hu ua cholecystectomy.

Kev phais

Kev phais kom tshem lub zais zis-lub cev tsis tseem ceeb-yog ib qho kev phais feem ntau tau ua rau cov neeg laus hauv Tebchaws Meskas.

Yuav luag tag nrho cov cholecystectomies yog ua nrog laparoscopy. Tom qab muab tshuaj rau koj kom ua rau koj tsaug zog, tus kws phais ua rau ntau qhov kev phais me me hauv plab thiab ntxig lub laparoscope thiab lub koob yees duab me me. Lub koob yees duab xa cov duab loj ntawm sab hauv lub cev mus rau ib qho video saib, muab tus kws phais neeg saib ze ze ntawm lub cev thiab cov ntaub so ntswg. Thaum saib lub monitor, tus kws phais siv cov cuab yeej ua tib zoo cais lub gallbladder los ntawm daim siab, ducts, thiab lwm yam qauv. Tom qab ntawd tus kws phais txiav lub cystic duct thiab tshem tawm lub gallbladder los ntawm ib qho ntawm cov me me incisions.

Kev rov zoo tom qab phais laparoscopic feem ntau tsuas yog siv ib hmo hauv tsev kho mob, thiab kev ua haujlwm ib txwm tuaj yeem rov pib dua tom qab ob peb hnub hauv tsev. Vim tias cov nqaij ntshiv plab tsis raug txiav thaum phais laparoscopic, cov neeg mob muaj qhov mob tsawg dua thiab muaj teeb meem tsawg dua tom qab "qhib" phais, uas yuav tsum tau muaj 5- txog 8-inch incision hla lub plab.

Yog tias kuaj pom tias lub zais zis muaj mob hnyav, kis kab mob, lossis ua caws pliav los ntawm lwm txoj haujlwm, tus kws phais yuav tuaj yeem qhib phais kom tshem lub zais zis. Qee zaum, qhib kev phais yog npaj; txawm li cas los xij, qee zaum cov teeb meem no tau tshawb pom thaum lub laparoscopy thiab tus kws phais yuav tsum ua qhov txhab loj dua. Kev rov qab los ntawm kev phais qhib feem ntau yuav tsum tau 3 mus rau 5 hnub hauv tsev kho mob thiab ob peb lub lis piam tom tsev. Qhib phais yog tsim nyog kwv yees li 5 feem pua ​​ntawm kev ua haujlwm ntawm lub zais zis.

Qhov teeb meem feem ntau hauv kev phais gallbladder yog raug mob rau cov kua tsib ducts. Ib qho kab mob uas raug mob los ntawm cov kua tsib tuaj yeem tso cov kua tsib thiab ua rau mob thiab ua rau muaj kev phom sij. Qee zaum kev raug mob me me tuaj yeem kho tsis tau phais. Kev raug mob loj, txawm li cas los xij, yog mob hnyav dua thiab yuav tsum tau phais ntxiv.

Yog tias muaj pob zeb nyob hauv cov ducts, tus kws kho mob-feem ntau yog tus kws kho mob gastroenterologist-tej zaum yuav siv ERCP los nrhiav thiab tshem tawm lawv ua ntej lossis thaum lub sij hawm phais gallbladder. Qee lub sij hawm, tus neeg uas muaj cholecystectomy tau kuaj pom tias muaj pob zeb hauv cov kua tsib lub lis piam, hli, lossis ntau xyoo tom qab kev phais. Cov txheej txheem ERCP feem ntau ua tiav kev tshem pob zeb hauv cov xwm txheej no.

Kev kho mob tsis phais

Cov kev phais tsis yog siv tsuas yog hauv cov xwm txheej tshwj xeeb-xws li thaum tus neeg mob muaj mob hnyav tiv thaiv kev phais-thiab tsuas yog rau cov pob zeb roj cholesterol. Pob zeb feem ntau rov tshwm sim hauv 5 xyoos hauv cov neeg mob kho tsis tau phais.

• Kev kho qhov ncauj tawm ntawm qhov ncauj. Cov tshuaj ua los ntawm cov kua qaub tau siv los yaj cov pob zeb. Cov tshuaj ursodiol (Actigall) thiab chenodiol (Chenix) ua haujlwm zoo tshaj plaws rau cov pob zeb me me. Lub hli lossis xyoo ntawm kev kho mob yuav tsim nyog ua ntej tag nrho cov pob zeb yaj. Ob qho tshuaj yuav ua rau mob raws plab me me, thiab chenodiol tuaj yeem nce qib cov roj cholesterol hauv ib ntus thiab lub siab enzyme transaminase.
  
• Hu rau kev tshem tawm kev kho mob. Cov txheej txheem kev sim no suav nrog kev txhaj tshuaj ncaj qha rau hauv lub gallbladder kom yaj cov roj cholesterol. Cov tshuaj-methyl tert-butyl ether- tuaj yeem yaj qee lub pob zeb hauv 1 mus rau 3 hnub, tab sis nws ua rau khaus thiab qee qhov teeb meem tau tshaj tawm. Cov txheej txheem yog raug kuaj nyob rau hauv cov neeg mob cov tsos mob nrog pob zeb me me.

Kev tiv thaiv

Nov yog qee cov kauj ruam koj tuaj yeem ua los pab tiv thaiv gallstones:

• Ua kom lub cev hnyav.
• Yog tias koj xav kom poob phaus, ua nws maj mam-tsis ntau tshaj ½ txog 2 phaus ib lub lim tiam.
• Noj cov zaub mov uas muaj roj tsawg, cov roj cholesterol tsawg.

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