Ukwelashwa kwesifo se-gallbladder kuxhomeke kuhlobo lwesifo okwamanje. Uma kuziwa ekuphatheni ama-gallstones , ngokuvamile kunezinketho ezintathu-indlela "yokulinda nokulinda" uma kungekho zibonakaliso, ukuhlinzeka ukukhipha i-gallbladder namatshe, noma imithi yokwaphula ama-gallstones. Ukwelapha ezinye izinkinga ze-gallbladder noma ze-bile zokuhamba, njengetshe elifakwe ku-buct ejwayelekile, lingadinga inqubo ekhethekile ebizwa nge-ERCP.
"Ukubuka nokulinda" Indlela
Ukubonakaliswa okuvame kakhulu kwesifo se-gallbladder yi-gallstones. Kodwa-ke, ama-gallstones amaningi, angabangeli izimpawu futhi ngakho-ke awuvumeli ukwelashwa.
Uma bebangela ubuhlungu, noma kunjalo, ukuhlinzeka ngokuvamile kuvunyelwe. Imithi ayisetshenziswa kaningi ukuphatha ama-gallstones, nakuba asetshenziselwa ukuphatha ubuhlungu besifo se-gallbladder.
Imithi
Uma ukwelapha isifo se-gallbladder, udokotela wakho uzofuna ukwelapha kokubili izibonakaliso zakho kanye nokuxilongwa okuyisisekelo.
Ukwelapha Izimpawu
Uphawu oluvame kakhulu lwesifo se-gallbladder ubuhlungu, ngokuvamile ehlangothini olungenhla kwesisu. Udokotela wakho angaphatha ubuhlungu bakho nge-nonsteroidal anti-inflammatory (NSAID) njenge-ibuprofen, noma i-opioid efana ne-morphine.
Kubalulekile ukuqaphela ukuthi ama-opioids avame ukwenza abantu balele futhi ngokuvamile babangele ukuqothulwa, yingakho udokotela wakho angase ancoma ukuthatha i-laxative kanye nephilisi yakho yobuhlungu.
Ukwelapha Inkinga Ye-Gallbladder Engaphansi
Iphilisi ye-bile acid njenge-Actigall (i-ursodiol) ingathathwa ukuze ichithe ama-cholesterol gallstones, okuyinto ejwayelekile kunazo zonke ze-gallstone e-United States. Nakuba le pilisi ivame ukubekezelela kahle, abanye abantu bathuthukisa isifo sohudo, nakuba ngokuvamile kuhamba isikhathi.
Ukuphazamiseka kokuthatha iphilisi ye-bile iwukuthi kungathatha iminyaka eminingi ukuba ama-gallstones aqede ngokuphelele; ngakho iphilisi ye-bile acid akuyona into enhle kubantu abanokuhlaselwa kwe-gallstone okuphindaphindiwe.
Uma umuntu enobufakazi bokutheleleka kwe-gallbladder noma i-biliary tract (i-complication ye-gallstones) uzodinga ama-antibiotic (anikezwe esibhedlela), kanye nokuphefumula nokulawula ubuhlungu, kuze kufike ukwelashwa okuqondile njengokuhlinzwa noma i-ERCP ( bheka ngezansi) kuphelile.
Izinqubo ezikhethekile
Ukwelashwa okuyinhloko yeziningi zezifo ze-gallbladder ukususwa kokuhlinzwa kwe-gallbladder, okuthiwa i-cholecystectomy.
Noma kunjalo, kunezinketho ezingekho zokuhlinzwa, ikakhulukazi kubantu abengozi kakhulu ukuhlinzwa. Ukuphazamiseka kwezinketho ezingezona zokuhlinzwa ukuthi i-gallbladder isesekhona, ngakho-ke isifo se-gallbladder (ikakhulukazi i-gallstones) singase siphinde senzeke.
Cholecystectomy
I-cholecystectomy yenziwa ngaphansi kwe-anesthesia ejwayelekile ekamelweni lokusebenza futhi iyindlela yokwelashwa ephumelelayo kakhulu ye-gallbladder.
Kubantu abaningi, lokhu kuhlinzeka kwenziwa nge-laparoscopically, okubandakanya udokotela ohlinzayo efake ithuluzi elincane, eliguquguqukayo (enekhamera yevidiyo ekugcineni) ngokusebenzisa ukusika okuncane esiswini. Esebenzisa izinsimbi ezinde, udokotela ohlinzayo uyokwenza izimbobo ezincane ezinamathumbu emathunjini, bese ususa i-gallbladder.
I-cholecystectomy ye-laparoscopic ayinamandla kakhulu futhi ngokuvamile kulula ukululamela kunokuba i-cholecystectomy evulekile, lapho kunqunywe khona isisu esikhulu esiswini ukuze kususwe i-gallbladder.
I-Gallbladder Cancer
I-cholecystectomy ye-laparoscopic ayisetshenziselwa ukuphatha umdlavuza we-gallbladder ngoba kunengozi yokuthi omunye umdlavuza uzolahlekelwa. Ngaphezu kwalokho, kukhona ukukhathazeka ngokuthi "ukulima" noma ukusakaza umdlavuza kwezinye izingxenye zomzimba. Esikhundleni salokho, ukwelapha umdlavuza we-gallbladder, udokotela ohlinzayo uzokwenza i-cholecystectomy ende, ebizwa nangokuthi i-cholecystectomy ye-radial.
Phakathi ne-cholecystectomy ende, udokotela ohlinzayo uzosusa i-gallbladder, ezinye zezicubu zesibindi eduze kwe-gallbladder, nanoma yisiphi isisodwa se-lymph nodes. Ngezinye izikhathi, izicubu eziningi zisusiwe (isibonelo, i-biling buct evamile, ama-pancreas, noma ingxenye enkulu yesibindi), kuye ngokuthi umdlavuza usakaze kangakanani.
I-radiation kanye ne-chemotherapy ingasetshenziselwa ukwelapha umdlavuza we-gallbladder.
Izinhlekelele Zokuhlinzeka
Njenganoma yikuphi ukuhlinzwa, kunezingozi ezihilelekile, ezingabandakanya:
- Ukuphuza
- Ukutheleleka kwesitifiketi se-Incision
- Ama-clots egazi
- I-pneumonia
- Izinkinga ezivela ku-anesthesia
Udokotela wakho uzokuqapha ukuze uqinisekise ukuthi lezi zixazululo zibhekiswe ngokushesha nangokufanele.
Imiphumela Yomphumela Wokuhlinzwa
Ngisho noma kuphephile futhi kulungile ukuhlala ngaphandle kwe-gallbladder, abanye abantu bathola igesi, ukubhula, nokuhuda ngemva kokususwa kwe-gallbladder. Yize lokhu kujwayelekile okwesikhashana, kungase kuqhubekele iminyaka kwabanye abantu.
Kungase kube nemiphumela emibi kakhulu kusuka ku-cholecystectomy enwetshiwe yomdlavuza we-gallbladder, njengezinkinga zokugaya noma zokudla, i-bile yokusakazeka esiswini, noma ukwehluleka kwesibindi. Qinisekisa ukuthi udokotela wakho uzoqapha futhi alungise lezi zingozi.
Ukususwa Kwamaphutha
Uma umuntu edinga ukuba isisu sakhe sisuswe kodwa sinemibandela eminingi yezokwelapha, ngakho kubhekwa njengengozi enkulu yokuhlinzekwa, angase aqhubekele uchungechunge lwezinqubo zokuhambisa amanzi ukuze asuse amatshe noma izivimbela.
Ngokukhishwa kwamatshe ngamathambo, i-tube encane kakhulu ebizwa ngokuthi i-catheter ifakwa ngesikhumba futhi ingene enkanyeni ye-gallbladder ukuvumela amanzi embi. I-bile ibhidliza ngombhobho we-drainage ohlangene kuze kube sekupheleni kwe-catheter. Khona-ke, ngaphezu kwamasonto ambalwa alandelayo, umgodi owenziwe kuwo umcengezi ukhuliswa kancane kancane, uvumele ukuthi amatshe (s) asuswe.
I-Extracorporeal Shock Wave Lithotripsy
Ukwesatshiswa kwe-extracorporeal wave thotripsy (ESWL) yinkqubo engeyona yokuhlinzeka engavamile ukusetshenziswa kwamagciwane. Le nqubo yenziwa ngaphansi kwesilwane futhi ihlanganisa ukugagagagagagagubha ukudiliza ama-gallstones zibe yizicucu ezincane, ezingase zichithe futhi zikhishwe kwi-gallbladder.
Uma isetshenzisiwe, i-ESWL igcinelwe abantu abangaphelelanga, banama-gallstones angaphansi kwezingu-3, futhi abanamaphilisi asebenza ngendlela enempilo.
ERCP
Inqubo ebizwa ngokuthi i-endoscopic retrograde cholangiopancreatography (ERCP) ivumela udokotela ukuba acabange ngeso lengqondo ama-bile amadokhumenti nganoma yikuphi okungajwayelekile njengokungathi igolstone elivimbelayo, i-cyst noma i-tumor. Ngenkathi i-diagnostic, i-ERCP nayo iselashwa, njengoba udokotela angaphatha lesi simo ngesikhathi esifanayo. Ngokuyinhloko, i-ERCP ishintshe ukuhlinzwa ukuze kusetshenzwe izinkinga ze-bile ducts ezigulini.
I-ERCP yinkqubo eyenziwe ekuqedeni ukuvinjelwa kwe-bile duct, ngokuvamile ephuma etsheni.
Okufanele Ukulindele
Phakathi ne- ERCP , i-gastroenterologist izohola ithubhu encane, eguquguqukayo ephethe ikhamera encane ekupheleni kwayo (ebizwa ngokuthi i-endoscope) phansi komlomo esiswini nasezintwaneni ezincane. Umbala ohlukile ujova nge-tube ukuze ucabange ngeso lengqondo imibhoshongo ye-bile e-ray ray. Uma kubonakala ukuvimbela, i-gastroenterologist ingasebenzisa izinsimbi ezikhethekile (ezifakwe ku-endoscope ukususa noma ukunciphisa ukuvinjelwa). Ngokwesibonelo, udokotela angasusa itshe elivimbela ukuqhuma kwebhili elivamile noma ukubeka i-stent uma i-duct iyancipha.
Umuntu uhlezi ngesikhathi se-ERCP ukuvimbela noma yikuphi ukungakhululeki futhi ukuqinisekisa ukuthi ukhululekile. Ngenkathi i-ERCP ngokuvamile inqubo ephephile futhi ibekezeleleke kahle, umuntu angase abe nesifo somswakama omncane noma agweme emva kwenqubo.
Ngokungajwayelekile, izinkinga ezihlobene ne-ERCP zingase zenzeke, kufaka phakathi:
- I-Pancreatitis, ngokuvamile evamile, kodwa izodinga ukuhlala esibhedlela esifushane ukuze kusetshenziswe uketshezi nokuphathwa kobuhlungu
- Umgodi emathunjini (okuthiwa i-perforation), okuyinto engavamile futhi engathí sina, futhi idinga ukuhlinzekwa ukulungisa
- Ukwelashwa kwe-bile ducts (okuthiwa yi-cholangitis), okudinga ukuhlala esibhedlela imithi elwa namagciwane kanye nokugeleza kwamanzi amaningi
- I-pneumonia yokuphefumula, yingakho kubalulekile ukungadli noma ukuphuza amahora ambalwa ngaphambi kwenqubo
Imithi Ephelele
Ngenkathi isifo se-gallbladder kufanele siphathwe udokotela, kunengqondo ukucabangela ukwelashwa okuhambisanayo. Lokhu kusho, kubalulekile ukuthatha noma yikuphi amakhambi, amavithamini, noma izithako zokudla ngaphansi kokuqondiswa nodokotela wakho.
Amakhambi
Amakhemikhali athile afana ne-silymarin ( uSilybum marianum ), obizwa nangokuthi ubisi lwe-thistle , anganikeza kokubili ukwesekwa kwe-gallbladder nesibindi. Olunye ucwaningo lubonisa ukuthi amakhambi afana ne-turmeric, i-Oregon amagilebhisi, u-bupleurum, kanye nohlamvu lwemali angase avuse ukuvuvukala kwesibindi nokukhulula ukucinana kwesibindi.
Ukudla Kwemvelo
Ukwamukela ukudla okunomsoco we-gallbladder kungasiza ekuvimbeleni ukuhlaselwa okungaphezulu kwe-gallbladder. Ukudla okunomsoco okunomsoco kuyinto ecebile izithelo nemifino, ikakhulukazi imifino ephezulu ku-vitamin B neyensimbi, njenge-spinach ne-kale, nokudla okune-antioxidant-ocebile njenge-blueberries, cherry, utamatisi, u-squash, ne-pepper bell. Amaprotheni anempilo afana nezinyama ezinomzimba, izinhlanzi, i-tofu, noma ubhontshisi kanye nezinhlamvu zomzimba ezikhethiwe.
I-Acupuncture
Isifundo esisodwa se-Chinese esincane bathola ukuthi ukukhwabanisa kwanciphisa izimpawu ze-gallbladder inflammation (okuthiwa i-cholecystitis), njengobuhlungu be-shoulder back and stomachache. Nakuba ukugcoba umzimba kunganciphisa ubuhlungu besifo se-gallbladder, kubalulekile ukubona udokotela ukwelashwa (ukuhlinzwa, cishe) yenkinga engaphansi.
Ukuvimbela
Ukuphila ngokwemvelo kanye nezimo zezempilo ezifana nesifo sikashukela, ukukhuluphala ngokweqile nesifo se-metabolic zihlobene nesifo se-gallbladder, ikakhulukazi ukwakheka kwamagciwane.
Izindaba ezinhle ukuthi umuntu anganciphisa ingozi yokuthuthukisa izigulane (kanye nezinkinga ezihlobene) ngokugcina inkomba yemvelo yomzimba ejwayelekile, ukuhlola umzimba nsuku zonke, nokubona udokotela wabo wokunakekela ngokuyinhloko ukulawula isifo sikashukela noma i-cholesterol ephezulu (uma okwamanje).
Njengengxenye, uma ukhuluphele ngokweqile noma ukhuluphele futhi uqala isisindo sokulahlekelwa isisindo, qiniseka ukuthi ukwenze ngaphansi kokuqondiswa kukadokotela wakho, njengoba ukulahlekelwa kwesisindo ngokushesha kukhulisa ingozi yokubunjwa kwamatshe.
Okokugcina, lapho ukhetha ukudla, ucwaningo luye lwathola ukuthi iphethini enempilo yokudla ehlanganisa ukudla okunemifino yemifino, izithelo, imikhiqizo yobisi ephansi kakhulu, okusanhlamvu okugcwele, izithelo kanye nezinongo kuxhumene nengozi ephansi ye-gallstone. Ngokuthakazelisayo, ucwaningo lubonisa ukuthi ukuphuza utshwala kunganciphisa ingozi yomuntu yokuthuthukisa ama-gallstones.
> Imithombo:
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> Moga MM. Ukwelashwa okunye kwesifo se-gallbladder. Bonisa ama-hypothetical . 2003 Jan; 60 (1): 143-7.
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> Tringali A, uLoperfido S. (2018). Imfundo yesineke: ERCP (endoscopic retrograde cholangiopancreatography) (Ngaphandle Kwezingqalasizinda). I-Howell DA (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Wen FY, Li SC, Wang GM, Li LX, Song YQ. [Imiphumela ye-Acupuncture ye-Jianjing (GB 21) ngevolbladder volume kanye nezimpawu zeziguli ze-cholecystitis]. Zhen Ci Yan Jiu. 2012 Oct; 37 (5): 398-402.