The aiki cire gallstones. Shiri for zaɓe na tiyata

Gallstone cuta yanzu ta zama daya daga cikin na kowa mamaki tsakanin ciki Pathology, da kuma tiyata don cire gallstones - da hanyar da muhimman hakkokin warware matsalar.

Gallstone cuta - abin da yake da shi?

Wannan cutar da ake dangantawa da samuwar a cikin bile ducts da kuma gall mafitsara duwatsu (calculi). An ɓullo da ga wadannan dalilai:

• stagnation ko canji a cikin abun da ke ciki na bile.
• kumburi tafiyar matakai.
• bilification take hakkin (dyskinesia).

A abun da ke ciki, akwai iri uku duwatsu. Mafi na kowa (80-90% na lokuta) akwai cholesterol duwatsu. Su samuwar taimaka wa wuce haddi cholesterol abun ciki a cikin bile. Lokacin da wannan ya auku samuwar lu'ulu'u saboda shaida na cholesterol a wuce haddi precipitate. Idan motility na gall mafitsara kakkarye, to, wadannan tsarin ba a nuna a cikin hanji yankin, da kuma zama a cikin ta, kuma za a fara girma.

Pigment duwatsu suna kafa saboda ya karu Lalacewar jini Kwayoyin - ja jini Kwayoyin. Mafi sau da yawa shi za a iya lura a hemolytic anemia. Akwai kuma gauraye ilimi. Su ne mai hade duka siffofin. Yana da aka hada da cholesterol, bilirubin da alli.

Ko aiki wajibi ne

Kowane mutum, wanda aka kamu da gallstones, jima ko daga baya tsayar da tambayar ko wa gudanar da sa baki ko zai zama isa ya mazan jiya magani. Yana da daraja ambata cewa duwatsu da kansu ba su filaye don cire gallbladder. Idan ba su nuna kansu, kuma ba su shafi al'ada aiki na sauran jikin, wani aiki ba zai iya tunani. Duk da haka, idan akwai sha raɗaɗin a cikin gallbladder, a take hakkin da janar yanayin, yellowness, da gaggawa bukatar tuntubar likita. Shi ne ya yi, bayan da binciken da za su yanke shawarar ko gudanar da sa baki wajibi ne, kuma abin da shi ne. Amma zama da sanin cewa cholecystitis gallbladder nufin riga ya fara da kumburi tsari. Idan wuce kima to fasa da yanke shawara, da chances zuwa cikakken mayar da kiwon lafiya bayan tiyata da cika fuska rage. Ko akwai wani guda hari, gallstones mafi cire.

Alamomi ga tiyata

Lokacin yankan shawara akan bukatar tiyata, masana yawanci la'akari da wadannan dalilai:

• gaban duwatsu (calculi) na daban-daban masu girma dabam, mamaya na uku daga cikin gall mafitsara.
• idan cutar ne m harin da zafi a cikin gallbladder (biliary colic), aiki ne da za'ayi la'akari da girma da concrements.
• Idan duwatsu aka shirya a cikin gall mafitsara da kuma a cikin ducts.
• yayin da rage ikon da gallbladder mu'ãmalar ko ta da cikakken cire.
• da ci gaban biliary pancreatitis.
• da breakage na gallbladder bango.
• tare da occlusion da na kowa hanta bututu.

Akwai duniya jagororin domin kayyade bukatar tiyata a cholelithiasis. Summing up da maki cewa an sanya wa daban-daban bincike Manuniya, likita zai ƙayyade ko tiyata ake bukata, kazalika da dangi da kuma cikakken alamomi ga shi.

-daban na yadda ake gudanar da

Yawanci, da aiwatar da samuwar gallstones - shi ne azumi ba. Hakika, idan kun kasance m, kuma motar asibiti zai kai ka zuwa wani m asibiti tare da wani m kai harin, wanda aka gane cholecystitis, gallbladder, da zabi ka yi shi ne kananan. Amma mafi yawan mutãne waɗanda suke sani game da matsalar a gaba tare da likita duk shawarwari da cikakken bayani, sanin da kwanan watan da aka shirya tiyata.

A zamani magani, akwai hanyoyi guda biyu na cire gallbladder (cholecystectomy)

• bude cholecystectomy - gargajiya Hanyar tanadar bude kogon ciki.
• laparoscopic cholecystectomy - wani zamani dabara cewa an fi son a yau.

bude cholecystectomy

Wannan aiki ya cire gallstones ne mai classic tiyata. Bayan wani sashe tare da midline na ciki da aka sanya dubawa na kogon ciki, da kuma gall mafitsara kau, idan ya cancanta, magudanun ruwa (shigarwa shambura, domin tabbatar da outflow na sakamakon exudate da sauran jiki ruwaye).

Duk da zargin wani zamani da kuma high-tech hanyoyin, bude cholecystectomy har yanzu dacewa. Wannan za a iya bayyana ta da cewa wasu dakunan shan magani da ba su da kayan aiki ko kwararru cancantar da suka wajaba don gudanar da wani laparoscopic hanyoyin. Bugu da kari ga wadannan, akwai wasu contraindications.

Laparoscopy gallbladder

Wannan shi ne wani nau'i na tiyata a gallstone cuta. Don kwanan wata, wannan hanya ne mafi zama na kowa saboda ingancinta, low-tasiri, akan rage dawo da sharuddan. The aiki aka yi amfani da laparoscope - musamman inji, wanda damar samun da lalace Gabar via mahara punctures na ciki bango ta hanyar abin da na manipulators an gabatar da, a zahiri, mai laparoscope. Wannan hanya ba ka damar ba kawai cire gallbladder ba barin scars, amma a wasu lokuta kawai cire duwatsu, da barin jiki a wurin. A irin wannan hanyar da ake amfani da su ne kawai domin lura da gallstone cuta, amma kuma ga kau da appendicitis, da magani daga inguinal hernias, wasu gynecological cututtuka, da kuma bincike yadda ake gudanar. Duk da hujjõji abũbuwan amfãni daga laparoscopic cholecystectomy, wannan hanya yana da nasa contraindications. Wadannan sun hada da:

• ƙurji, dake a cikin sashi na aiki;
• na karshe watanni uku na biyu a ciki.
• m cardiopulmonary cuta.

Har ila yau, ka tuna cewa lokacin laparoscopic tiyata, idan akwai wata 'yar alamar wahala a halin yanzu, likitoci wuce bude cholecystectomy. Kamar wancan ƙare game da 5% laparoscopic tiyata.

Shiri for tiyata

Kamar yadda da wani tiyata, tiyata don cire duwatsu a cikin gallbladder bukatar wasu horo. Bayan da misali binciken ciki har da wani isar da ƙididdiga (CBC da urinalysis, jini Biochemistry, coagulation - binciken da na jini clotting, hanta aiki gwaje-gwaje), wajibi ne a yi ciki ultrasonography, electrocardiography, kirji X-haskoki, bisa ga alamomi FGS da colonoscopy, da kuma samun da yin aiki ta rahoto. Bugu da ƙari, shiri domin zaɓe na tiyata hada da sokewa kwayoyi shafi coagulability na jini. Wadannan sun hada da wani iri-iri anticoagulants, bitamin E, ba-steroidal anti-kumburi kwayoyi. A 'yan kwanaki kafin aiki na bukatar kulawa ta musamman wajen rage cin abinci a cholelithiasis. A menu bai kamata ya ƙunshi nauyi abinci, da kuma fara daga tsakar dare na rana a lokacin da aiki da aka gudanar, shi wajibi ne don ware abinci da abin sha. A kan Hauwa'u na da ciniki rana for tsaftacewa da hanji , sãfe da maraice da suke tsarkakewa enemas ko shan magunguna na musamman. A safe dauki wani shawa tare da antibacterial sabulu.

A postoperative zamani

A yau shi ne wuya mamaki wani cholecystectomy. Wannan aiki ya cire gallstones ya dogon sa "a kan rafi", kuma shi ne game da yadda kowa a matsayin appendectomy. A haƙuri ya riga hudu sa'o'i bayan kammala aiki, a lokacin da ba shi yiwuwa a sha da kuma yin kaifi motsi da aka yarda su jũya a gado. Za ka iya sa'an nan za a fara sha ruwa ba tare da iskar gas a cikin kananan rabo (1-2 pharynx, amma ba fiye da 500 ml). Bayan awa shida bayan laparoscopic tiyata da haƙuri iya samun up. Shin, shi ne mafi alhẽri, idan akwai wani daga cikin likita ma'aikatan ko dangi, tun bayan jiki na dogon lokaci zauna a kwance matsayi da kuma a Jihar maganin sa barci, a lokacin da ka yi kokarin samun up akwai iya zama dizziness da kuma rufe da mãgãgi. The sosai Kashegari bayan da aiki da haƙuri iya matsar da yardar kaina a asibiti.

Bayan tiyata, da rage cin abinci ne da muhimmanci a cholelithiasis. Menu na rana na iya hada wani ruwa rage cin abinci - porridge a kan ruwa, abin da ake ci soups, kiwo kayayyakin. Bugu da ari, a rage cin abinci na iya hada Boiled naman sa, kaza nono, gasa apples ko ayaba. Yana dole ne a tuna da cewa a cikin makon farko bayan da aiki da aka haramta barasa, da karfi shayi ko kofi, sugar, soyayyen da kuma m abinci.

litholytic far

Idan m baki ne ba zai yiwu ba saboda tsananin somatic cututtuka ko cuta da jini clotting, kazalika da ƙi da mãsu haƙuri daga tiyata, da aka gudanar litholytic far. Wannan hanya, wanda amfani da formulations hada da bile acid, da nufin ta soke da kafa duwatsu. Tun da shi wajibi ne don la'akari da cewa, tsawon lokacin da magani iya bambanta daga shekara guda zuwa shekaru biyu, da kuma ko da shi ne zai yiwu ta soke da gallstones gaba daya, ba da tabbacin cewa ba za su bayyana a sake. Bugu da kari, a cikin shakka daga jiyya iya zama daban-daban da rikitarwa da gallstone cuta, ciki har da wadanda ke buƙatar m baki.

Sharudda litholytic Mafia

Wani da ya rage mata litholytic far ne wasu bukatun ga ka'idar da cutar:

1. Gallstones cholesteric ne ma, tare da girma ba wucewa 20 mm.
2. Aiki da gallbladder ceto da kuma duwatsu ba zauna fiye da rabin ta girma.
3. Cystic da kowa bile bututu kamata kula da patency.
4. Tun da samuwar duwatsu ba fiye da shekaru biyu.
5. A tarihin akwai dole ne uncomplicated hanya da cuta - m zafi, riqo na wuccin bouts na colic.

Jiyya ne da za'ayi a karkashin duban dan tayi kowane 3-6 watanni. Idan bayan watanni shida, babu wani ci gaba ba, to, shi ne zaton m, da kuma sake tada batun na tiyata. Idan litholytic far ya kasance nasara, domin dace gane da sabuwar kafa gallstones, US sa a kalla sau daya a cikin watanni uku.