Ukunyangwa kwesifo se-gallbladder kuxhomekeke kuhlobo lwesifo esikhoyo. Xa kuziwa ekuphatheni i-gallstones , kukho izinto ezintathu ezikhethiweyo-indlela yokulinda nokulinda ukuba akukho zibonakaliso, utyando lokususa i-gallbladder kunye namatye, okanye amayeza ukuba aphule i-gallstones. Ukunyanga ezinye i-gallbladder okanye i-bile duct iingxaki, ezifana nelitye elifakwe kwi-buct ye-bony efanayo, lingadinga inkqubo ekhethekileyo ebizwa ngokuba yi-ERCP.
"Jonga kwaye ulinde" Indlela
Ubonakaliso obuqhelekileyo besifo se gallbladder yi-gallstones. Uninzi lwama-gallstones, nangona kunjalo, alubangangazi iimpawu kwaye ngoko awuvumeli unyango.
Xa bebangela intlungu, nangona kunjalo, utyando luvakala ngokufanelekileyo. Amayeza aqhelekanga asetyenziswe ukuphatha ama-gallstones, nangona asetyenziswa ukuphatha intlungu yesifo se-gallbladder.
Mayeza
Xa unyanga isifo se-gallbladder, ugqirha wakho uya kufuna ukunyanga zombini iimpawu zakho kunye nokuxilongwa.
UkuPhatha iZimpawu
Uphawu oluqhelekileyo lwesifo se-gallbladder intlungu, ngokuqhelekileyo kwicala elingasentla lesisu. Udokotela wakho angaphatha intlungu yakho nge-nonsteroidal anti-inflammatory (NSAID) njenge-ibuprofen, okanye i-opioid efana ne-morphine.
Kubalulekile ukuba uqaphele ukuba ii-opioids zivame ukubenza abantu balele kwaye ngokuqhelekileyo babangele ukudliwa, yingakho ugqirha wakho angancoma ukuba athathe i-laxative kunye nepilisi yakho yentlungu.
Ukunyangwa kweengxaki zeGallbladder Inkinga
Iipilisi ze-acid acid ezifana ne-Actigall (ursodiol) zingathathwa ukuze ziphule i-cholesterol gallstones, eyona ndlela eqhelekileyo ye-gallstone e-United States. Nangona le pilisi ivunyelwa kakuhle, abanye abantu bahlakulela isifo sohudo, nangona kudla ngokuhamba nexesha.
I-downside yokuthatha ipilisi ye-acid ye-bile yinto enokuthatha iminyaka emininzi ukuze i-gallstones ichithwe ngokupheleleyo; ngoko ipilisi ye-acidi ye-bile ayilona khetho olufanelekileyo kubantu abanokuhlaselwa kwama-gallstone okuphindaphindiweyo.
Ukuba umntu unobungqina bentsholongwane ye-gallbladder okanye i-biliary tract (i-complication of gallstones) uya kufuna i-antibiotiki (inikwe esibhedlele), kunye ne-fluids kunye nokulawula ubuhlungu, kude kube yonyango oluchanekileyo njengophando okanye i-ERCP ( sibona ngezantsi) kwenziwa.
Iinkqubo zeengcali
Unyango oluphambili lwesininzi sezifo ze-gallbladder ukukhishwa kwe-gallbladder, ebizwa ngokuba yi-cholecystectomy.
Nangona kunjalo, kukho iindlela ezingenanto zokupakisha, ikakhulu kubantu abanomngcipheko ophezulu kakhulu wokuhlinzwa. I-downside ye-non-surgical options kukuba i-gallbladder isaphila, ngoko isifo se-gallbladder (ikakhulukazi i-gallstones) sinokubuyela kwakhona.
Cholecystectomy
I-cholecystectomy yenziwa phantsi kwe-anesthesia jikelele kwigumbi lokusebenza kwaye yonyango olululo ngakumbi lwe-gallbladder.
Kubuninzi babantu, lo msebenzi uqhutyelwa i-laparoscopically, okubandakanya ugqirha onokufaka isixhobo esincinci, esitshintshileyo (kunye nekhamera yevidiyo ekupheleni) ngokusikwa esincinane kwisisu. Ukusebenzisa izixhobo ezide, ugqirha uya kwenza izibonda ezincinane ezinqamle kwisisu, kwaye ususe i-gallbladder.
I-laparoscopic cholecystectomy ayinakuncipha kwaye ilula ngokulula ukuyifumana kunokuba i-cholecystectomy evulekileyo, apho kunqunywe khona isisu esikhulu sokususa i-gallbladder.
Gallbladder Cancer
I-laparoscopic cholecystectomy ayisoloko isetyenziselwa ukunyanga umdlavuza we-gallbladder kuba kukho umngcipheko wokuthi omnye umhlaza uya kulahlwa. Ngaphezu koko, kukho inkxalabo yokuba "ukuhluma" okanye ukusasaza umhlaza kwezinye iindawo zomzimba. Endaweni yoko, ukunyanga umdlavuza we-gallbladder, ugqirha uya kuqhuba i-cholecystectomy ende, ebizwa ngokuba yi-cholecystectomy.
Ngethuba le-cholecystectomy ende, ugqirha uya kususa i-gallbladder, enye yeethambo zesibindi kufuphi ne-gallbladder, kunye nayiphi na i-lymph node. Ngamanye amaxesha, amanxeba amaninzi ayasuswa (umzekelo, i-buct ye-bison ejwayelekile, i-pancreas, okanye inxalenye enkulu yesibindi), kuxhomekeke ekubeni umhlaza usasazeka kangakanani.
I-radiation kunye ne-chemotherapy ingasetyenziselwa ukuphatha umhlaza we-gallbladder.
Mngcipheko
Njengoko naluphina utyando, kukho izingozi ezibandakanyekayo, ezibandakanya:
- Ukuhlamba
- Utsholongwane lwesiza sokungena
- Amacwecwe egazi
- Pneumonia
- Iingxaki ezivela kwi-anesthesia
Ugqirha wakho uya kukubeka iliso ukuqinisekisa ukuba ezi ziphumo ziqwalaselwa ngokukhawuleza kwaye ngokufanelekileyo.
Iziphumo zoPhando
Nangona ikhuselekile kwaye ilungele ukuhlala ngaphandle kwe-gallbladder, abanye abantu bafumana i-gas, bloating, kunye ne-diarrhea emva kokususwa kwe-gallbladder. Ngoxa le nto ihlala yesikhashana, ingaqhubeka iminyaka ethile kwabanye abantu.
Kungaba nemiphumo embi kakhulu kwi-cholecystectomy ye-cancer ye-gallbladder, efana nokugaya okanye ukutya iingxaki, i-bile ichitheka kwisisu, okanye ukuhluleka kwesibindi. Qiniseka ukuba ugqirha uya kubeka iliso kwaye alungise le mingcipheko.
Ukususwa Kwangaphandle
Ukuba umntu ufuna ukuba i-gallbladder isuswe kodwa ineemeko ezininzi zezokwelapha, ngoko kubonwa njengengozi enkulu yokuhlinzwa, unokufumana inqwanqwa yenkqubo yokucoca amanzi.
Ngokukhishwa kwamatye ngamathambo, ityhubhu encinci kakhulu ebizwa ngokuthi i-catheter ingeniswa ngesikhumba kwaye ibe ne-gallbladder ukuvumela i-bile drainage. I-bile ibhalela nge-bulb ye-drain edibeneyo ekupheleni kwenkathatha. Emva koko, phezu kweeveki ezimbalwa ezizayo, umgobo owawubekwa kuwo umkhotha wancinci wancinci, uvumele ukuba itye (s) isuswe.
Ukutshatyalaliswa kweNgcaciso ye-Wave Lithotripsy
Ukutshatyalaliswa kokutshatyalaliswa kwe-wave-thotripsy (ESWL) yinkqubo engeyiyo yokucoca engavumelekanga ukusebenzisa ii-gallstones. Le nqubo iyenziwa phantsi kobude kwaye iquka ukusetyenziswa kwamagagasi ukuphazamisa ama-gallstones zibe ziincinci ezincinci, ezinokuthi zidibanise kwaye zikhuphe kwi-gallbladder.
Ukuba isetyenziswe, i-ESWL igcinelwe abantu abangapheliyo, banamaqela angaphantsi kweethathu, kwaye banobomi obuphilileyo bokusebenza.
ERCP
Inkqubo ebizwa ngokuthi i-endoscopic retrograde ye-cholangiopancreatographyography (ERCP) ivumela ugqirha ukuba acinge ngesosibi se-bile ngenxa yezinto ezingaqhelekanga ezinjengegolstone, i-cyst okanye i-tumor. Ngelixa uxilongo, i-ERCP nayo yonyango, njengoko ugqirha angayiphatha imeko ngexesha elinye. Ngona-nxalenye, i-ERCP ithathe indawo yokutyunjelwa kwonyango lweengxaki ze-bile ducts kwizigulane.
I-ERCP yinkqubo eyenziweyo ekunciphiseni ukuphazamiseka kwe-buct ye-bile, ngokuqhelekileyo ukusuka kwitye.
Yintoni ongayilindela
Ngexesha le- ERCP , i-gastroenterologist iya kukhokela ityhubhu encinci, eguquguqukayo enekhamera encinane ekupheleni kwayo (ebizwa ngokuba yi-endoscope) phantsi komlomo kwisisu nangomathumbu amancinci. Idayi eyahlukileyo ijojowe kwi-tube ukujonga ngeso lengqondo i-bile ducts kwi-x-ray. Ukuba kukho ukuphazamiseka, i-gastroenterologist ingasebenzisa izixhobo ezikhethekileyo (efakwe kwi-endoscope ukususa okanye ukunciphisa ukuvalwa). Ngokomzekelo, ugqirha unokususa ilitye elivimbela i-buct ye-bony efana okanye ifake i-stent ukuba i-duct isancinci.
Umntu uhlaliswa ngexesha le-ERCP ukukhusela nayiphi na ingxaki kwaye ukuqinisekisa ukuba ikhululekile. Nangona i-ERCP ngokuqhelekileyo yinkqubo ekhuselekileyo kwaye ibekezeleleke, umntu unokufumana umqala wesifo somqala okanye ukuqhawula emva kwenkqubo.
Ngokungaqhelekanga, iingxaki ezinxulumene ne-ERCP zingenzeka, kubandakanya:
- I-Pancreatitis, edla ngokuba ngumnene, kodwa iya kufuna ukuhlala esibhedlele esifutshane kunye nokulawulwa kwentlungu
- Umgodi emathunjini (obizwa ngokuba yi-perforation), engabonakaliyo kwaye inzulu, kwaye idinga ukuhlinzwa ukulungisa
- Usulelo lwe-bile ducts (olubizwa ngokuthi yi-cholangitis), olufuna ukuhlala kwisibhedlele kwii-antibiotics kunye ne-drainage ye-fluid excess
- I-pneumonia yokuphefumula, kungenxa yoko kubalulekile ukuba ungadli okanye ungaphuze kwiiyure eziliqela ngaphambi kwenkqubo
LweMithi yoNyango
Nangona isifo se-gallbladder kufuneka siphathwe ngugqirha, kuqiqweni ukuqwalasela iziqulatho ezongezelelweyo. Oku kuthetha, kubalulekile ukuthatha nayiphi na imifuno, iivithamini okanye izongezelelo zokutya phantsi kolawulo lugqirha wakho.
IIrbs
Eminye imifuno efana ne-silymarin ( Silybum marianum ), ebizwa ngokuba yi- milk thistle , inokunika inkxaso ye-gallbladder kunye nesibindi. Olunye uphando lubonisa ukuba imifuno efana ne-turmeric, i-Oregon yamagilebhisi, i-bupleurum, kunye nengca yemali inganciphisa i-gallbladder ukuvuvukala kwaye inciphise ukudibanisa kwesibindi.
Ukutya kweNdalo
Ukufumana ukutya okunokubambisana kunokunceda ukunqanda ukuhlaselwa kwe-gallbladder. Ukutya okunomdla okunobungqingili kunobuncwane kwiziqhamo kunye nemifuno, ingakumbi imifuno ephezulu kwi vithamini B kunye neyinyithi, njengepinashi kunye ne-kale, kunye nokutya okucebile-antioxidant njenge-blueberries, i-cherries, i-tomato, i-squash, ne-bell pepper. Iiprotheni ezinomzimba ezinjengezilwanyana ezinomdla, intlanzi, i-tofu, okanye iiimbotyi kunye neentlobo ezipheleleyo zikhethwayo.
Ukwenza i-Acupuncture
Isifundo esisodwa seTshayina yafumanisa ukuba ukuguqulwa kwamanzi kwanciphisa impawu ye-gallbladder inflammation (ebizwa ngokuba yi-cholecystitis), njengentlungu yokubuyisela intlungu kunye ne-stomachache. Nangona i-acupuncture iyakunciphisa intlungu yesifo se-gallbladder, kubalulekile ukubona ugqirha unyango (uphando, ubuninzi) kwimeko engundoqo.
Thintelo
Ukuphila kwimeko yokuphila kunye neemeko zempilo ezinjengesifo sikashukela, ukukhuluphala, kunye nesifo se-metabolic zihambisana nesifo se gallbladder, ngokukodwa ukubunjwa kwama-gallstones.
Iindaba ezilungileyo kukuba umntu unokunciphisa umngcipheko wokuphuhlisa i-gallstones (kunye neengxaki ezinxulumene nazo) ngokugcina isiqulatho somzimba esiqhelekileyo (BMI), ukusebenzisa imihla ngemihla, nokubona ugqirha wabo wokunyamekela ngokuqhelekileyo kwi-diabetes okanye i-cholesterol ephezulu (ukuba zikhoyo).
Njengengcambu, ukuba ungaphezu komzimba okanye ukhuluphele kwaye uqala uhlaziyo lwexabiso lokulahleka, qi niseka ukuba wenze phantsi kolawulo lugqirha wakho, njengoko ukulahleka kwesisindo ngokukhawuleza kwandisa umngcipheko we-gallstone formation.
Ekugqibeleni, xa ukhetha ukutya, uphando lufumene ukuba umzekelo wokutya okunempilo okubandakanya ukutya okuphezulu kwemifuno, iziqhamo, iimveliso zobisi ezincinci, i-grains, i-legumes, kunye neziqholo zidibene nomngcipheko ophantsi we-gallstone. Kuyathakazelisa, uphando lubonisa ukuba ukusetyenziswa kotywala kunokunciphisa umngcipheko womntu wokuphuhlisa i-gallstones.
> Imithombo:
> I-American Cancer Society. (nd). Ukunyanga iGallbladder Cancer.
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> Lee JY, uKeane MG, uPerira S. Ukuchongwa kunye nokunyangwa kwesifo se gallstone. U msebenzi. 2015 Juni; 259 (1783): 15-9,2.
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> Tringali A, uLoperfido S. (2018). Imfundo yesineke: ERCP (endoscopic retrograde cholangiopancreatographyography) (Ngaphandle kwezinto ezisisiseko). UHowell DA (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Wen FY, Li SC, Wang GM, Li LX, Ingoma YQ. [Iimpembelelo zokwenza i-Jianjing (GB 21) kwi-gallbladder volume kunye neempawu zezigulane ze-cholecystitis]. Zhen Ci Yan Jiu. 2012 Oct; 37 (5): 398-402.