Cholecystopancreatitis: cov tsos mob thiab kev kho mob

Tus mob cholecystopancreatitis - Qhov no yog kev sib txuam ua ke ntawm lub gallbladder thiab txiav. Nws nthuav tawm nws tus kheej li mob hauv lub epigastrium, txoj cai thiab sab laug hypochondria, rov ntuav ntuav, lwm cov tsos mob dyspeptic, qhov hloov pauv ntawm qhov quav, thiab tawv nqaij. Nws kuaj tau siv biochemical tsom xam cov ntshav thiab zis, coprogram, ultrasound ntawm lub plab zom plab, MRPHG, RCHP. Rau kev kho mob, ua kom loog, myotropic, anticholinergic, antisecretory, antiemetic thiab antibacterial tus neeg sawv cev yog siv. Pom zoo cov kev phais mob yog txoj kev sib txawv ntawm cholecystectomy, sab nraud thiab sab hauv stomatology ntawm cov kua tsib cov leeg, dissection ntawm Vater papilla.

Cov ntaub ntawv dav dav

Qhov tshwm sim ntawm tus mob cholecystopancreatitis yog vim qhov ua haujlwm ntawm lub cev thiab qhov sib cuam tshuam ntawm kev txiav mob ntawm tus txiav (txiav) thiab mob zais zis. Ua tsis tiav ntawm kev coj tus kheej ntawm txoj cai sphincter system ntawm Vater lub txiv mis thaum lub sij hawm muaj kab mob ntawm ib qho ntawm cov kabmob hloov ntxov lossis tom qab ntawd ua rau muaj kev hloov kho pathological hauv lwm. Raws li kev tshawb nrhiav hauv thaj chaw kho mob gastroenterology, hauv 69-70% ntawm cov neeg mob uas muaj tus mob cholecystitis, tus kab mob txha caj qaum yog mob pathologically kho, thiab nyob rau hauv ntev cholecystitis qhov taw qhia ncav 85-88%. Hauv 38-39% ntawm cov neeg mob los ntawm tus mob pancreatitis, tus mob cholecystitis yog kuaj mob, nrog mob txhaws ntev ntawm tus txiav, tus mob plab muaj cuam tshuam hauv 62-63% ntawm tus neeg mob.

Cov Ua rau ntawm Cholecystopancreatitis

Qhov tshwm sim ntawm kev sib xyaw ua ke ntawm cov txiav, lub zais zis txuas nrog thawj qhov mob ntawm ib ntawm cov plab hnyuv siab raum. Hauv 85% ntawm cov neeg mob, cholecystitis cuam tshuam nrog cholelithiasis ua tus pib txuas rau hauv tus kabmob. Hauv 15% ntawm tus neeg mob, cov txheej txheem mob tshwm sim hauv cov txiav ua kab mob thiab muaj teeb meem los ntawm cov kab mob cholecystitis uas muaj qib enzymatic. Lub luag haujlwm tseem ceeb ntawm cholelithiasis hauv kev txhim kho cholecystopancreatitis yog vim qhov haujlwm los ntawm yam tseem ceeb xws li:

• Txhua yam cuam tshuam ntawm cov Vater papillaCov. Nrog rau kev thaiv ntawm txoj hauv kev rau kev faib cov kua txiv quav yeeb, kua tsib, biliary stasis tshwm sim, uas provokes tsub zuj zuj ntawm cov teeb meem tseem ceeb ntawm plab hnyuv sab hauv lub zais plab, thiab mob rau lub plab. Ib lub sijhawm nce ntxiv ntawm qhov mob siab rau hauv lub qog ua rau lub caj pas ua rau txoj hlab ntsha ntawm nws tus kheej rau hauv cov nqaij mos thiab qhov pib ntawm qhov mob thiab ua rau muaj kev hloov pauv.
• Sphincter Oddi Qhov Tsis TxausCov. Kev voos tsis tu ncua nrog lub laij me me ua rau dyskinesia ntawm cov leeg du ntawm Vater papilla. Qhov tshwm sim ntawm biliary-pancreatic thiab pancreatic-biliary ua rau kev nkag los ntawm bile, suav nrog tus kabmob, nkag mus rau hauv lub nqus, thiab pancreatic enzymes - rau hauv cov kua tsib. Qhov ua rau tsis haum xeeb yog kev mob ntshav siab tiv thaiv keeb kwm ntawm hypertonicity ntawm tus kheej ntawm Oddi.

Cov txheej txheem ntawm kev txhim kho ntawm tus mob cholecystopancreatitis yog ua raws li kev ua txhaum ntawm kev mob tshwm sim ntawm lub cev ntawm cov kua tsib thiab kua txiv kom ua kua rau hauv duodenum. Nyob rau hauv ib txwm mob, tus kheej kheej ntawm cov txiav thiab txiav cov kua tsib cov leeg kom tiv thaiv kev rov qab ua haujlwm ntawm kev zais. Nrog rau kev mob ntshav siab tshwm sim los ntawm qhov teeb meem ntawm lub Vater papilla los yog dyskinesia ntawm tus mob sphincter ntawm Oddi, nws yuav ua tau rau cov kua tsib nkag mus rau qhov leeg txhaj leeg.

Qhov no ua rau kev ua haujlwm ntawm phospholipase, lwm cov kab mob pancreatic, tsim kom muaj cov tshuaj lom ntau uas ua rau cov khoom ua puas rau cov khoom hauv cov kua tsib. Tsawg tsawg dua, tawm tsam keeb kwm ntawm cov kab mob pancreatitis uas twb muaj lawm, cov enzymes tau muab pov rau hauv cov kua tsib, uas ua rau kev loj hlob ntawm cholecystitis. Ib qho laj thawj ntxiv yog qhov tsis kam rov qab, hematogenous thiab lymphogenous kis ntawm pathogenic flora. Hauv cov mob uas mob cholecystopancreatitis, mob yog catarrhal lossis purulent-necrotic, hauv cov mob ntev, cov txheej txheem fibro-degenerative predominate.

Kev faib tawm

Thaum systematizing cov ntaub ntawv ntawm cholecystopancreatitis, qhov xwm txheej ntawm keeb kwm kev hloov pauv thiab cov yam ntxwv ntawm chav kawm ntawm tus kab mob raug coj mus rau hauv tus account. Nyob ntawm cov coj ntawm morphological cuam tshuam, exudative, purulent, necrotic-cuam tshuam thiab atrophic sib txawv ntawm tus kab mob yog qhov txawv txav, thaum hom mob mob hauv lub qog plab thiab lub caj pas ua haujlwm tuaj yeem sib txawv. Los ntawm qhov tam sim no, lawv cais:

• Mob cholecystopancreatitisCov. Raws li txoj cai, nws tshwm sim dheev thaum muaj teeb meem ntawm cov tshuab lossis cov yuam kev tag nrho hauv cov khoom noj khoom haus. Nws yog tus cwj pwm los ntawm kev mob hnyav thiab cov mob sib nqus. Thaum tsis muaj kev kho kom txaus, kev tuag yog 31.5-55.5%.
• Tus mob cholecystopancreatitis mob ntevCov. Tus mob no loj hlob zuj zus tuaj thiab feem ntau cuam tshuam nrog cholelithiasis. Dyspeptic cov tsos mob, tsis xis nyob rau hauv lub epigastric thiab hypochondrium, muaj kev cuam tshuam loj heev ntawm cov txheej txheem zom zaub mov vim pancreatic degeneration predominate.
• Mob caj dab ntev cholecystopancreatitisCov. Ntau zaus nws yog qhov tshwm sim ntawm cov kev mob tshwm sim ntawm pathology, tsis tshua pom muaj nyob hauv cov kev kawm dhau los. Cov mob rov huam tuaj feem ntau yog tshwm sim los ntawm zaub mov tsis zoo. Lub neej kev tuag thaum lub sij hawm exacerbations ncav cuag 3.5-7%.

Cov tsos mob ntawm tus mob cholecystopancreatitis

Cov duab hauv chav soj ntsuam ntawm tus kab mob muaj ntau haiv neeg thiab suav nrog cov tsos mob ntawm ob lub gallbladder thiab lub qog nqaij hlav hauv lub caj pas. Cov kev yws tseem ceeb ntawm cov neeg mob cholecystopancreatitis yog mob plab, uas tuaj yeem muaj rau hauv thaj chaw hypochondria lossis epigastric. Ib qho kev mob siab ntxiv tom qab noj zaub ntau hauv cov rog thiab haus cawv muaj tus yam ntxwv. Ntau cov ntuav nrog impurities ntawm bile yog ua tau, uas tsis coj kev pab rau tus neeg mob.

Dyspeptic kev ntshawv siab nyob rau hauv daim ntawv ntawm xeev siab, ntuav, thiab hnyav dua hauv plab yog raug pom tas li, txawm tias nyob hauv lub sijhawm sib nrug. Cholecystopancreatitis yog cov tsos mob los ntawm kev tso quav: cov neeg mob nco qab cov quav, muaj cov cuam tshuam nrog cov zaub mov tsis muaj zaub mov, ua kom tso quav nce ntxiv 4-6 zaug hauv ib hnub. Qhov daj ntawm lub sclera, mucous daim nyias nyias thiab tawv nqaij yuav tshwm sim ua ke nrog tsaus xim ntawm cov zis. Nyob rau lub sijhawm exacerbation, subfebrile lossis febrile ua npaws, kev ua kom tsis muaj zog thiab txo ntshav siab yog pom.

Teeb meem

Nrog rau tus mob cholecystopancreatitis, qhov tshaj tawm txog kev zom zaub mov tsis txaus yog tsim, txuam nrog kev ua txhaum ntawm kev zais ntawm cov kua tsib, tsis muaj qhov tsim nyog ntawm pancreatic enzymes. Cov neeg mob tau coj tus mob steatorrhea thiab linterea, nws tau pom qhov kev hnyav hnyav. Vim muaj kev koom tes ntawm islets ntawm Langerhans hauv cov txheej txheem pathological, pancreatogenic diabetes mellitus tuaj yeem tsim kho. Kev kis tus kab mob nyob ib sab ntawm txoj hnyuv ua rau muaj qhov tshwm sim ntawm duodenitis thiab eunitis.

Cov teeb meem loj rau tus mob cholecystopancreatitis yog mob pancreatic necrosis, uas kuaj pom thaum cov enzymes qhib kom ua haujlwm sab hauv ntawm txoj hlab leeg. Cov neeg mob feem ntau qhia cov kab mob ua paug muaj kev puas tsuaj rau daim ntawv ntawm pericholecystitis thiab empyema. Yog tias tsis kho, kab mob ntawm lub cev thiab cov khoom tso tawm rau hauv lub plab pub dawb tuaj yeem tshwm sim. Hauv qhov no, muaj kev pheej hmoo ntawm biliary peritonitis. Nrog exacerbation, ntau yam kev ua haujlwm tsis tuaj yeem ua rau, uas qee zaum ua rau kev tuag.

Kev kuaj mob

Cholecystopancreatitis tuaj yeem xav tias tsam muaj kev tsis txaus siab thiab cov tsos mob lub cev (Kera, Murphy, Mayo-Robson, Mussse-Georgievsky). Txhawm rau paub tseeb tias kev kuaj mob, kev tshuaj xyuas dav dav uas siv kuaj thiab ntsuas cov txiaj ntsig yog qhov tsim nyog. Cov kev xav paub ntau tshaj plaws nyob rau hauv txoj kev kuaj mob yog siv cov hau kev no:

• Qhia txog ntshav ntshavCov. Cov cim ntawm tus yam ntxwv ntawm tus kabmob yog qhov nce siab hauv alkaline phosphatase thiab bilirubin ncaj qha, nrog pancreatic necrosis, qib ntawm AST thiab ALT nce ntxiv. Hypoalbuminemia thiab dysproteinemiasin kuj tau pom, uas cuam tshuam nrog kev ua haujlwm ntawm lub plab tsis txaus.
• Kev tsom xam cov quav ntawm cov quavCov. Cov ntaub ntawv ntawm cholecystopancreatitis, qhov seem ntawm cov zaub mov tsis muaj kev tiv thaiv, ntau ntawm cov leeg nqaij tsis ua haujlwm thiab cov hmoov txhuv nplej nplej tau txiav txim siab hauv coprogram. Tsis tas li ntawd, ELISA ntawm cov quav rau alpha-amylase tau ua - ua kom nce qib ntawm enzyme los ntawm 3-4 zaug tso cai rau koj kom paub meej tias kuaj mob.
• Mob plab hauv ultrasoundCov. Ultrasound ntawm lub zais khoom, txiav ua rau pom cov tsos mob hauv lub cev. Thickening ntawm phab ntsa thiab o ntawm lub qog, lub xub ntiag ntawm laij nyob rau hauv nws kab noj hniav thiab kua tsib ducts, heterogeneity ntawm pancreatic parenchyma, deformation ntawm nws contours yog yam ntxwv.
• TomographyCov. Magnetic resonance pancreatocholangiography yog siv rau qhov tsis muaj cov ntaub ntawv ntawm lwm txoj hau kev thiab pab tshawb fawb kom meej hauv cov qauv hauv kev ua haujlwm ntawm lub txiav thiab lub biliary. Cov txheej txheem yog qhov tsim nyog rau kev txheeb xyuas cov hlwv thiab thaj chaw ntawm tus mob necrosis, kuaj pom cov kab mob pathologies ntawm lub siab thiab lub taub hau ntawm lub txiav.
• RCPCov. Retrograde cholangiopancreatography yog siv los pom lub xeev ntawm biliary huam thiab pancreatic ducts. Cov txheej txheem tso cai rau koj txheeb xyuas lub teeb xoo hluav taws xob tsis zoo, ntsuas lub cheeb ntawm cov kua tsib, thiab cov mob ntawm sphincter ntawm Oddi. Raws li kev qhia, papillosphincterotomy tuaj yeem ua tau.

Hauv kev kuaj ntshav dav dav rau exacerbation ntawm cholecystopancreatitis, mob leukocytosis me ntsis thiab nce rau hauv ESR raug sau tseg. Hauv kev txheeb xyuas biochemical ntawm cov zis, bilirubin thiab urobilin yuav tuaj. Yog tias koj xav tias tsis muaj kab mob helminthiasis, kev tiv thaiv kab mob sib txuas ua ke ua kom tsis muaj zog. Txhawm rau tshem tawm pathologies ntawm lwm qhov kev mob ntawm txoj hnyuv plab hnyuv, kev thaij duab sab nraud thiab xoo hluav taws xob nrog kev ntsuas qhov ncauj nrog lub qhov ncauj sib txawv yog tsim tawm.

Ua ntej txhua yam mob, txhawm rau mob hnyav los yog txhaws tus mob cholecystopancreatitis yog yam mob sib txawv ntawm cov mob ntsig txog mob hnyuv tws. Cov ntsiab lus tseem ceeb rau kev kuaj mob hauv ib cheeb tsam yog qhov mob ntawm lub caij nyoog sab hauv epigastrium lossis sab laug hypochondrium, ultrasound cov tsos mob ntawm kev mob caj dab thiab biliary huam, mob zoo ntawm Mayo-Robson thiab Kera. Ua tib zoo saib xyuas qhov kub ntxhov siab thiab lub sijhawm ntawm tus kab mob - qhov nce sai ntawm cov tsos mob tiv thaiv keeb kwm ntawm cov neeg tom qab zoo-ua tim khawv pom zoo qhov kev txhawb nqa ntawm tus mob phais kab mob. Tus kws kho mob gastroenterologist, hepatologist thiab kws phais neeg yuav koom nrog kev tshuaj xyuas ntawm tus neeg mob.

Kev kho tus kab mob cholecystopancreatitis

Thaum xaiv cov txheej txheem kho kev tawm dag zog, kev hloov pauv ntawm kev txhim kho pathology, kev tsis sib xws ntawm morphological kev hloov hauv cov plab hnyuv siab raum, qhov muaj qhov tsis sib xws yog coj mus rau hauv tus lej. Cov neeg mob uas muaj cov txheej txheem mob hnyav yog raug pw hauv tsev kho mob, muab lub luag haujlwm ntawm lub plab zom mov (kev tshaib plab, mob plab hnyuv, thiab, yog tias tsim nyog, niam txiv lossis mob plab ua pa). Hauv kev ua ntu zus mus ntev ntawm tus mob cholecystopancreatitis, lawv txwv kev ua kom muaj cov rog cov zaub mov, txo cov carbohydrates. Ntawm cov tshuaj siv:

• Cov tshuaj tsis-narcotic thiab narcotic analgesicsCov. Lub hauv paus rau cov tshuaj analgesia yog mob tas li. Nyob rau hauv qhov xwm txheej loj tshaj plaws, nws yog qhov ua tau rau kev muab tshuaj tiv thaiv tshuaj tiv thaiv kab mob thiab ua rau tshuaj pleev ib ce.
• Myotropic antispasmodicsCov. Tshem tawm spasm ntawm cov nqaij ntshiv txo cov ntshav siab ntawm pob txha taub hau, pab txhawb kev tso kua txiv kab ntxwv thiab kua tsib. Yog tias tsim nyog, kev kho mob cholecystopancreatitis ntxiv nrog kev tiv thaiv anticholinergics.
• Cov tshuaj tiv thaivCov. Nyob rau ntawm qhov muaj cov mob regurgitation syndrome, thawj cov tshuaj yog dopamine thiab serotonin blockers. Cov neeg mob uas ntuav tsis tu ncua yog qhia xaiv cov blockers ntawm 5HT-3-serotonin receptors.
• Tshuaj tua kab mobCov. Rau kev tiv thaiv kev tiv thaiv cov teeb meem sib kis thiab kev tshem tawm cov kab mob pathogenic, semisynthetic penicillins, macrolides, cephalosporins thiab aminoglycosides yog siv. Thaum xaiv cov tshuaj, qhov rhiab ntawm cov kab mob coj los rau hauv kev txiav txim siab.
• Cov tshuaj AntisecretoryCov. Txhawm rau inhibit pancreatic secretion, proton twj tso kua mis blockers thiab histamine receptor inhibitors yog tshuaj. Nrog cholecystopancreatitis nrog kev puas tsuaj loj, octapeptides thiab protease inhibitors tau zoo.

Ua rau hauv kev txiav txim siab hnyav ntawm cov tsos mob, kev kho Txoj kev lis ntshav yog nqa nrog kev qhia txog kev daws teeb meem ntawm electrolytes, analeptics thiab mob plawv glycosides kom tswj tau cov kev ua si hauv plawv. Qhov tsis muaj txiaj ntsig ntawm qhov kev txuag kho nrog tus mob cholecystopancreatitis yog qhov qhia txog kev phais mob. Feem ntau, kev txhim kho tshwm sim tom qab qhib, laparoscopic lossis SILS cholecystectomy. Hauv kev muaj teeb meem ntawm txoj hlab ntshav biliary, choledochostomy, choledochoduodenostomy lossis choledochoenterostomy tau ua. Cov neeg mob uas muaj kev voos nyias muaj nyias ntawm Vater lub txiv mis yog qhia papillosphincterotomy.

Kev twv ua ntej thiab Kev Tiv Thaiv

Kev ntsuas pom yog nyob ntawm lub sijhawm ntawm cov chav kawm ntawm tus kab mob thiab qib ntawm cov yam ntxwv tsis zoo. Qhov tshwm sim yog qhov muaj txiaj ntsig zoo thaum muaj kev pom ntxov ntawm tus mob cholecystopancreatitis thiab nws tau kho nws kom ncav sijhawm. Nrog cov txheej txheem nyuaj ntawm tus kab mob, qhov kev pom ua haujlwm yog dub. Txog kev tiv thaiv, nws yuav tsum ua raws li kev noj zaub mov (tsis txhob ua phem rau cov zaub mov kib thiab roj, txwv kom haus dej haus cawv), koom nrog kev tawm dag zog lub cev, thiab kho lwm yam kab mob gastroenterological.

Qhov ua rau kev txhim kho ntawm tus kabmob

Cov laj thawj tseem ceeb ntawm tus kab mob no suav nrog:

• ntxiv zog rau duodenum thiab mob siab thaum tsam plab,
• ib qho chaw ze ntawm hepatopancreatic nrog rau cov nruab nrog cev, vim tias cov kua tsib yog muab pov rau hauv duodenum,

Nws kuj tseem muaj cov txheej txheem ntawm cov kab mob pathogenetic, uas tus kab mob cholecystopancreatitis tuaj yeem tsim kho, cov no suav nrog:

Pancreatic mob cancer

Daim duab piav qhia Vater Txiv Plig

Duab Sketchy Sphincter ntawm Oddi

Cov yam ntxwv ntawm kev kho mob ntawm tus kab mob

Feem ntau, qhov mob tau raug phais mob. Cov kev kho mob cov tsos mob tau kho kom ntev. Cov tshuaj siv yog siv los txhim kho kev zom zaub mov. Cov kab mob zoo li no yog cov khoom noj khoom haus sib xyaw ua ke ntawm cov zom zaws zom zaws thiab npaj siab los tshem tawm steatorrhea, ua kom lub plab zom mov zoo thiab tiv thaiv qhov tsim ntawm elastase hauv cov quav.

Tag nrho cov txheej txheem kev kho mob yog ua raws cov qauv hauv qab no:

• txiav caj dab stabilisation,
• txhim kho lub neej zoo ntawm tus neeg mob,
• neutralization ntawm tau muaj teeb meem,
• tshem tawm ntawm cov txheej txheem o.

Intoxication yog tshem tawm los ntawm kev teem caij muaj cov ntxhia dej muaj chlorides thiab bicarbonates (ib khob tsib zaug ib hnub).

Cov ntxhia dej ntxhia

Cov zaub mov tshwj xeeb kev noj haus tseem tau tsim kho (peb tab tom tham txog kev noj haus No. 5P), uas tsis suav nrog cov khoom noj muaj roj, ntsim thiab qaub, haus cov pa roj carbon monoxide.

Hauv qab no yog cov tshuaj uas tau sau tseg rau hauv kev kho mob cholecystopancreatitis.

Folk kev

Raws li tau sau tseg thaum pib ntawm tsab xov xwm, kev kho tuaj yeem muab ntxiv nrog qee cov kev kho mob hauv pej xeem. Feem ntau ntawm cov no yog infusions. Cov tau zoo tshaj yog cov muaj npe hauv qab no.

Cov lus. Herbal infusions rau kev kho mob ntawm tus mob cholecystitis

Cov Lus Qhia Txog Cov Kev Mob Siab

Nov yog qee qhov lus qhia tswv yim rau kev txo qis chav kawm ntawm tus kab mob.

Koj yuav tsum haus dej kom ntau li ntau tau - tsawg kawg 2 liv nyob rau ib hnub.

Cholesterol nyob rau hauv cov khoom noj

Kev tiv thaiv kev ntsuas

Lub hauv paus ntsiab lus tseem ceeb ntawm kev tiv thaiv tus mob cholecystopancreatitis yog qhov tsis lees txais haus cawv thiab haus luam yeeb.

Txiav kev haus luam yeeb, tshuaj thiab dej caw

Ib qho ntxiv, kev tawm tsam ntawm tus kabmob muaj nrog mob hnyav rau lub plab sab sauv tom qab txhua pluas noj, yog li kev noj haus yuav tsum tau tsim kom qhov nyiaj ntawm cov zaub mov tsis txaus nyob hauv nws yog qhov tsawg heev. Koj yuav tsum noj fractionally (tsis pub ntau tshaj 60 g nyob rau ib zaug), nrog kev rov ua dua, cov roj yuav tsum tau txwv, thiab cov vitamins, ntawm qhov tsis sib xws, nce ntxiv.

Dab tsi yog cholecystopancreatitis

Tus kab mob cholecystopancreatitis yog ib qho kev ua txhaum tib lub sijhawm los ua haujlwm ntawm lub zais plab thiab lub qhov quav, nrog rau kev tawm tsam.

Cov txheej txheem ua tau zoo sib xws, nrog kev puas tsuaj rau cov kab mob sib txuas ntawm cov kab mob hepatobiliary. Qhov no yog mob pancreatitis thiab cholecystitis, uas tau pib tsim ua ke rau ntau yam los yog ua rau muaj kev nyuaj siab.

Hauv kev faib tawm thoob ntiaj teb ntawm cov kab mob, tus mob cholecystopancreatitis tau muab rau ib qho chaw hauv chav kawm 11 (mob plab zom mov). Tus kab mob no yog nyob hauv pab pawg K80-K87 - Kab mob ntawm lub zais plab, lub plab thiab cov txiav ua pob.

ICD muaj nws tus lej K87.0 "Pom mob ntawm lub zais plab, lub plab thiab cov tawv nqaij hauv cov kab mob uas tau faib lwm qhov."

Tshuaj kho mob nkeeg

Kev kho rau cov laus yog siv cov tshuaj pleev xim, tshuaj tua kab mob, cov tshuaj enzyme thiab vitamins.

Cov tsos mob ntawm tus mob cholecystopancreatitis yuav tsis zoo yog tias kev tsis noj zaub mov zoo raug tsis saib xyuas nrog rau kev kho tshuaj.

Kev kho mob ntawm tus mob ntev thiab mob cholecystopancreatitis yog nqa tawm los siv cov tshuaj hauv qab no:

• tshuaj mob taub hau - kho rau daws qhov mob. Pawg no yog Papaverine, Tsis muaj-spa, Ketorolac, Motilium.
• enzyme kev npaj - pab rau txoj kev zom. Piv txwv Festal, Mezim, Pancreatin thiab Creon.
• antacids - qhov tshuaj tiv thaiv zoo tshaj plaws rau kev kho mob cholecystopancreatitis yog AlmagelCov. Cov tshuaj yog tsim nyog los txo acidity thiab txhim kho plab zom mov.

Tus txheej txheem kho yuav tshwm sim tsuas yog tias koj nruj me ntsis raws li tus kws kho mob cov lus pom zoo.

Kev phais mob

Nrog kev rov ua mob ntxiv, ib qho kev ua haujlwm yog kev pom zoo. Qhov no txhais tau tias kev phais mob gallbladder yuav tsum tau ua hauv 24 teev tom qab pw tsev kho mob.

Mob caj pas ua rau lub siab tseem tuaj yeem kho kom tsis muaj mob. Txawm li cas los xij, tom qab kev txuag txoj kev kho, ntau yam kev nyuaj tshwm sim tuaj. Hauv 30% ntawm cov kev kho mob ntawm tus mob cholecystopancreatitis, tus kws kho mob tau sau ntawv phais mob.

Tom qab tshem tawm ntawm cov khoom, lub plab kab mob yog ntxuav kom ntxuav tag nrho cov xau tso tawm.

Cov neeg laus los yog muaj feem yuav phais mob ntau dua vim yog cov kab mob sib kis, kev phais yuav raug ncua kom txog thaum tom qab.

Noj haus pab rau cholecystopancreatitis

Cov neeg laus yuav tsum noj zaub mov kom haum. Nrog pathology, mob caj dab ntev cholecystopancreatitis yog txoj hauv kev ntawm lub neej.

Hauv kev mob hnyav, tus kws kho mob qee zaum raug tso cai tawm ntawm cov cai lawv tau hais hauv kev noj haus, tab sis qhov no yuav tsum tsis txhob raug tsim txom.

Kev noj zaub mov zoo li cas? Ua ntej tshaj plaws, qhov no yog qhov kev tshem tawm ntawm cov khoom tsis zoo. Txhawm rau kos cov zaub mov noj, sab laj nrog koj tus kws kho mob. Nws yog ib qho tseem ceeb uas yuav tsum tau coj mus rau hauv qhov kev kawm ntawm tus kab mob, muaj cov kab mob concomitant, cov kev sim ntsuas thiab saj cov neeg mob.

Kev ua raws nraim nrog kev noj haus yog qhov theem tseem ceeb ntawm kev kho mob. Txawm li cas los xij, hom no tsis tuaj yeem ua raws li kev kho mob monotherapy. Ib qho kev noj haus tsis pab kho tus mob cholecystopancreatitis.

Cov caij noj mov yuav tsum tau muab xam tam sim. Noj haus yog pom zoo txhua 2.5-3 teev. Piv txwv li, noj tshais yuav tsum yog 30% ntawm qhov kev noj mov txhua hnub, noj su - 10%, noj su - 30%, tav su tshuaj yej - 15%, noj hmo - 10%.

Ua raws li kev noj haus pab ua kom tsis txhob noj ntau dhau, noj zaub mov zoo, tsis txhob ua kom lub plab thiab nres txoj kev ua kom mob.

Cov qauv qhia ua zaub mov noj:

Hnub Monday:

• 3 lub qe dawb, oatmeal ntawm dej, tshuaj yej tsis muaj zog, khoom tawg lossis khob cij,
• ib khob ntawm kefir lossis cov nqaij nyuj muaj roj tsawg,
• zaub kua zaub, ib qho hlais ntawm cov nqaij luav lossis lwm cov nqaij ntshiv, semolina,
• ib khob ntawm kefir nrog biscuit,
• compote ntawm txiv hmab txiv ntoo qhuav, tsis qab zib jam.

Tuesday:

• oatmeal, crackers thiab chamomile Txoj kev lis ntshav,
• pastille thiab mint tshuaj yej,
• mashed carrots, nqaij nyuj cutlet, rosehip Txoj kev lis ntshav,
• tsis muaj kua txiv qaub xyaw nrog nag hmo khob cij thiab tshuaj yej,
• ib khob ntawm qab rog tsawg yogurt, biscuit ncuav qab zib.

Hnub Wednesday:

• qos yaj ywm omelette, chav ua mov ci, khoom noj qe hau, tshuaj yej,
• rosehip broth nrog caramel,
• meatball kua zaub, ci ntses nyob rau hauv txiv qaub ntses, tshuaj yej ntsuab,
• txom ncauj yav tav su - ci txiv av paum,
• 200 ml ntawm cov rog uas tsis muaj rog kefir lossis mis.

Hnub Thursday:

• Cov qe muag muag, nplej zom nrog cheese, tshuaj yej nrog mis,
• chamomile tshuaj yej nrog qhuav biscuit,
• ci txiv apples, cov neeg tsis noj nqaij kua zaub, mis,
• tsev cheese casserole,
• zaub nyias ntawm lws suav thiab dib, tshuaj yej nrog txiv qaub.

Hnub Friday:

• ncu omelet nrog zaub xas lav, buckwheat porridge nrog mis nyuj, ib khob dej sov so nrog txiv qaub,
• biscuit ncuav qab zib thiab mis nyuj muaj roj tsawg,
• jelly los yog crackers nrog kefir, mashed qos yaj ywm nrog butter, yogurt,
• curd souffle, kissel,
• khob ntawm kefir.

Hnub Saturday:

• semolina porridge, ntsuab tshuaj yej, cheesecakes hauv cov ntses zib ntab,
• txiv ntoo
• celery kua zaub, steamed ntses, buckwheat porridge thiab zaub zaub,
• txiv qaub tshuaj yej thiab chav omelet,
• kua mis nyeem qaub thiab ci nqaij ua noj.

Hnub Sunday:

• ntu ntawm oatmeal, tsev cheese thiab cracker, kissel,
• zaub xam lav, meringue,
• taub dag kua zaub zom, compote, meringue,
• txiv apples ci nrog tsev cheese,
• muaj roj-tsawg tsev cheese, tshuaj yej nrog txiv qaub.

Txhawm rau kos cov zaub mov noj rau ib lub lim tiam, koj yuav tsum paub txog yam khoom noj uas txwv tsis pub siv thiab ua dab tsi lawv ua zaub mov noj.

Cov neeg mob uas mob cholecystopancreatitis raug nquahu kom noj zaub mov kom huv. Zog, ci, ua noj. Nqaij broths yog qhov tsis xav txog.

Koj yuav tsis tau cov tais diav, haus nqaij, de zaub mov, cov khoom lag luam npaj (ua kua zaub, mov ci nqaij). Nws yog txwv tsis pub noj qhob cij tshiab, cov nqaij rog, qab zib, legumes, haus kasfes thiab dej cawv.

Tsis tas li txwv cov zaub mov muaj xws li cov khoom noj siav, cov tsiaj cov roj, cov ncuav thiab cov nceb.

Ua rau muaj tus kabmob

Tus mob cholecystopancreatitis muaj ob txoj hauv kev: kis thiab tsis kis, thaum lawv cov tsos mob sib txawv. Tab sis muaj cov cim tshwm sim ntawm kev loj hlob ntawm tus kab mob,

• kis kab mob
• mob ntshav qab zib mellitus
• metabolic ntshawv siab, pais plab rwj, ntxiv acidity:
• ntau yam kabmob uas cuam tshuam nrog kev ua haujlwm ntawm tus kheej ntawm Oddi,
• lub plab zom mov qog nqaij hlav.

Ua rau muaj cov muaj kuab txhab:

1. Kev ua txhaum ntawm kev txav chaw ntawm bile los ntawm ducts, nws stagnation.
2. Kev noj haus tsis zoo.
3. Kev kis mob ntawm lub cev nrog cov cab

Ntev mob cholecystopancreatitis tshwm sim vim kev noj zaub mov tsis zoo, haus dej cawv thiab siv tshuaj yeeb yam tsis muaj kev saib xyuas ntawm tus kws kho mob, nrog cov protein tsawg, ua rau muaj ntshav tsis txaus hauv cov hlab ntsha, thiab ntau yam khoom hauv lub cev.

Cov tsos mob thiab kev kho mob ntawm tus kab mob

Thaum cholecystopancreatitis yog nyob rau theem mob, cov tsos mob tau pom:

1. Zoo li xeev siab nrog ntuav ntuav, tsam plab, tshwj xeeb yog tom qab noj mov.
2. Mob hauv qhov yog hypochondrium.
3. Dyspeptic mob.
4. Cov tawv nqaij ua pob.
5. Qhov muaj muaj roj nyob hauv cov quav.
6. Bluish me ntsis hauv qhov puab tais, ntawm plab.
7. Tsis qab los noj mov.

Yog hais tias cholecystopancreatitis yog mob, ces cov tsos mob: mob plab, ntuav, tsam plab, thiab lwm tus, tshwm sim tom qab noj khoom kib lossis ntsim. Raws li kev tsim kho mob raws plab, cem quav, thiab tawm tsam cov nyom ntawm txhua yam no, insomnia.

Cov tsos mob saum toj no ntawm kev ua kab mob yog pom thaum lub sij hawm exacerbation ntawm tus kab mob no, thaum nws muaj peev xwm nce siab mob siab, mob hauv lub plab. Kev kho mob ntawm tus mob cholecystopancreatitis muaj xws li: kev siv tshuaj kho mob, kho lub cev, lwm txoj hauv kev, nrog rau kev noj zaub mov kom zoo.

Obstructive daim ntawv

Yog tias tus mob cholecystopancreatitis siv daim foos no, nws yuav tsum tau kho tam sim ntawd. Qhov no yog vim hais tias thaum lub sij hawm nws muaj kev txhaws ntawm lub pancreatic ducts, uas ua rau muaj kev cuam tshuam hauv kev ua haujlwm ntawm lub plab zom mov, nrog rau ntau yam kua dej hauv cov txiav thiab lwm yam plab hnyuv siab hauv lub plab zom mov.

Cholecystitis nyob rau hauv daim ntawv no muaj cov tsos mob li nram no:

• yellowness ntawm daim tawv nqaij
• kev puas tsuaj rau cov pob qij txha me me,
• qhov tshwm sim ntawm cov hlwv cuav.

Yog hais tias kev kho mob tsis tau pib raws sijhawm, muaj teeb meem xws li cov tsos ntawm cov ntshav txhaws hauv cov leeg, kab mob ntawm cov kab mob endocrine, thiab mob peritonitis yog ua tau.

Tshuaj kho mob nkeeg

Hauv cov kab mob cholecystitis thiab mob pancreatitis, cov tshuaj noj yog muab tshuaj: tshuaj tua kab mob, tshuaj kho mob, cov kab mob hauv lub cev thiab cov enzymatic:

1. Txhawm rau txo qhov mob thiab txhim kho kev ua haujlwm ntawm lub zais zis, tshuaj antispasmodics yog tus kws kho mob. Qhov no yog Papaverine, Analgin.
2. Txhawm rau txhim kho kev zom zaub mov thiab tsim kom muaj txaus enzymes - Creon, Pancreatin.
3. Txhawm rau kom txo qis lub qog ntawm cov qog - Omeprazole.
4. Cov tshuaj tua kab mob - metronidazole.
5. Txhawm rau kom rov ua plab hnyuv microflora - Hilak.

Txhua cov nyiaj no tuaj yeem siv tsis tau rau lawv tus kheej, lawv yuav tsum pom zoo ua ntej nrog kws kho mob.

Thaum kho cov mob cholecystopancreatitis, tus neeg mob tau kho ntau txoj hauv kev ntawm kev siv tshuaj kho mob: kho laser, UHF, kho diadynamic, quaj kho, uas daws qhov mob. Txhawm rau txo cov spasms, kho cov tshuaj kho, electrophoresis thiab paraffin daim ntawv thov siv. Cov kev kho mob tsuas yog siv raws li tus kws kho mob qhia.

Kev kuaj mob

Lub hom phiaj ntawm kev txheeb xyuas yog txheeb xyuas qhov ua rau muaj tus kab mob. Cov hau kev nram no yog siv los txiav txim qhov mob:

• Cov tsos mob thiab kev tsis txaus siab ntawm tus neeg mob (keeb kwm kho mob),
• Kev kuaj qhov muag los ntawm tus kws kho mob
• Palpation ntawm lub plab,
• Txoj kev tsom xam cov ntshav, zis, quav,
• Ultrasound kev soj ntsuam,
• Suab nrov hauv plab
• Magnetic resonance imaging (MRI) ntawm lub plab zom plab.

Raws li cov txiaj ntsig ntawm kev soj ntsuam tag nrho, kev txheeb xyuas qhov tseeb ntawm tus kab mob tau hais.

Tus mob cholecystopancreatitis yuav tsum siv txoj hauv kev los kho tus mob. Chav kawm muaj kev noj tshuaj, ua raws li kev noj zaub mov zoo, thiab kev tawm dag zog lub cev. Nyob ntawm seb mob hnyav npaum li cas, tus kab mob kev kho mob ntawm tus kheej tau xaiv. Kws kho mob muab tshuaj: cov tshuaj tua kab mob (Cefazolin, Ampioks, Gentamicin), choleretic (Cholagol, Liobil), tshuaj kho mob (Tsis muaj-shpa, Papaverin), enzymes (Omeprazole, Creon, Mezim, Pancreatin), rov qab kho lub plab zom mov, tshuaj antispasmodics, Drota ), tshuaj tua kab mob (Cycvalone, Oxafenamide), antacids (Almagel), tshuaj tiv thaiv. Lub sijhawm tiv thaiv ntawm kev kho mob, tshuaj kho mob txhawm rau tiv thaiv cholecystopancreatitis raug xaiv los ntawm kws kho mob. Nws yog txwv tsis pub siv tshuaj rau tus kheej, koj tuaj yeem ua rau muaj kev cuam tshuam ntxiv ntawm tus kabmob!

Kev tawm dag zog lub cev yog kho rau tus neeg mob yog tias tus kab mob nyob hauv kev so dua. Ua tsaug rau electrophoresis, cov ntshav kev rov qab txhim kho, bile ntau lawm nce, thiab cov txheej txheem txo qis. Thaum muaj tus mob cholecystopancreatitis (pancreatic cholecystitis) lossis ua rau mob hnyav, tus txheej txheem yog contraindicated. Kev sib koom tes ntawm tus kabmob yuav muab cov txiaj ntsig sai.

Kev noj haus rau cholecystopancreatitis

Kev noj zaub mov zoo yog ib qho tseem ceeb ntawm kev kho mob. Cov zaub mov muaj peev xwm cuam tshuam txoj hnyuv zom zaub mov, tsim kev nyuaj siab ntxiv rau lub zais zis, lub siab, lub raum. Ua kom nruj thiab ua raws li cov kev cai noj haus thiab kws kho mob cov lus pom zoo.

• Noj cai,
• Noj zaub mov me me
• Cov khoom noj yog pom ntev, tsis tsuas yog thaum lub sij hawm exacerbations ntawm tus kab mob,
• Noj zaub mov uas tau txais kev pom zoo nkaus xwb,
• Tsis txhob rhuav tshem cov khoom noj (piv txwv li, cov zaub mov me me uas haus luam yeeb tuaj yeem ua rau rov huam dua).

Cov pluas noj zaub mov noj ua ke nrog tus kws kho mob koom nrog. Cov neeg mob uas mob cholecystopancreatitis tau sau tseg rau kev noj haus No. 5. Cov zaub mov muaj cov khoom noj muaj txiaj ntsig zoo: kev noj nqaij hau, nqaij ntses, zaub kua zaub, kua zaub muaj roj tsawg, khoom noj muaj roj, tshuaj yej tsis muaj zog, compote, kua txiv hmab txiv ntoo, thiab lwm yam.

• Cov rog, ntsim ntsim, ntsim ntsim,
• Cov nqaij haus luam yeeb
• Ci: khob cij dawb, buns,
• Qaub, cov kua txiv qab zib,
• Cov khoom muaj cocoa (chocolate),
• Qij, dos, radish,
• Muaj zog brewed
• Cawv
• Cov txim taws dej
• Marinades muaj vinegar.

Cov tshuaj kho neeg mob

Cov tshuaj hauv lub cev muaj cov txiaj ntsig zoo rau lub plab zom mov. Kev sib koom ua ke nrog kev siv tshuaj thiab lwm txoj hauv kev yuav coj tau cov txiaj ntsig sai, qhov zoo. Cov tshuaj ntsuab thiab cov nroj tsuag rau kev kho cov mob hauv plab:

• Qaug rosehip decoction. 500 gr. sawv duav yog nchuav nrog dej, hais kom 30 feeb, muab tso rau hluav taws qeeb, boil rau 5 feeb. Siv 3 zaug hauv ib hnub, 200 ml tom qab noj mov. Khaws cov nqaij rau hauv lub tub yees. Siv rau pancreatitis.
• Nplooj ntawm Golden Mustache. Zuaj 2-3 nplooj ntawm cov nroj tsuag, ncuav 500 ml ntawm dej npau, rhaub dua li hauv nruab nrab kub li 10-15 feeb. Txheeb 8 teev. Nws raug nquahu kom haus tincture sov 3 zaug ib hnub ua ntej noj mov, 50 ml. Hoob no yog 30 hnub. Cov kev kho mob zoo li no yuav pab txo qhov mob ntawm txoj hnyuv, yog siv rau cov kab mob ntawm lub zais zis.

• Kev sib sau ntawm cov tshuaj ntsuab: burdock, hlua, wormwood, chamomile paj, calendula officinalis, sage. Sib tov tshuaj ntsuab nyob rau hauv cov sib npaug zos, ncuav 2 dia ntawm 400 ml ntawm 100-degree dej npau, tawm rau ib teev. Siv 3 zaug ib hnub, ua ntej noj mov, 100 ml. Lub chav kawm ntawm kev kho mob yog 3 lub lis piam. Cov ntawv sau yuav pab kho ntau cov kab mob ntawm lub plab.
• Tsiaj qus txiv pos nphuab. Lub keeb kwm ntawm qus txiv pos nphuab (1 tbsp.spoon) ncuav dej npau npau (250 ml). Cia nws brew rau 1 teev. Haus 100 ml thaum sawv ntxov thiab yav tsaus ntuj. Siv nrog cholecystitis, gastritis, los ntawm pancreatitis.
• Dill. Dill dej yog siv rau cov teeb meem nrog lub plab zom mov. Dill noob ncuav dej npau npau, cia nws brew. Haus 3 zaug ib hnub rau 100 ml. Npaj dej dill tuaj yeem muas tau ntawm lub tsev muag tshuaj.
• John lub wort, motherwort, chamomile paj, sawv tsiaj, nettle. Noj hauv kev sib npaug sib luag ntawm cov nyom, sib tov. Ncuav ib tablespoon ntawm sau nrog dej npau (250 ml). Cia nws brew rau 6 teev. Haus ua ntej noj mov, 100 ml 3 zaug ib hnub.
• Liab lub roob tshauv. Qhov sib txawv ntawm liab lub roob tshauv hauv cov txiaj ntsig muaj txiaj ntsig zoo ntawm cov hnyuv. Nws yog siv los ua tus neeg sawv cev choleretic; hauv kev tiv thaiv cov vitamin tsis txaus, cov txiv hmab txiv ntoo qhuav txiv ntoo tuaj yeem ntxiv rau tshuaj yej thiab tais diav. Koj tuaj yeem noj cov roob tshauv decoction. Zom ib diav ntawm berries, ncuav 200 ml ntawm dej npau, cia nws brew rau 5 teev. Haus 100 ml thaum sawv ntxov thiab yav tsaus ntuj.
• Horseradish. Lawv raug siv los tiv thaiv, tshuaj tiv thaiv, tua kab mob, tshuaj tua kab mob, mob analgesic. Tincture kho txhim kho kev zom mov. Zuaj lub horseradish hauv paus, noj 1 tablespoon, ncuav 100 ml ntawm mis nyuj, simmer rau 10 feeb tshaj tsawg tshav kub. Txias, lim. Noj thaum nruab hnub.

Cov txheej txheem pej xeem yuav tsum tau siv rau hauv kev kho mob hauv txoj hauv kev nyuaj nrog cov tshuaj, nrog kev tso cai los ntawm tus kws kho mob tuaj koom.

Kev tiv thaiv kabmob

Kev tiv thaiv tus mob yog yooj yim dua li kho, noj tshuaj thiab daws tom qab cov teeb meem. Cov kev tiv thaiv:

• Kev noj qab nyob zoo ua neej
• Cov khoom noj kom zoo, kev noj haus,
• Kev kuaj mob raws sijhawm
• Ceev faj txog txoj kev kho,
• Tso kev phem tsis zoo,
• Taug qab ntawm qhov hnyav, tsis txhob hnyav dhau,
• Zam kev ntxhov siab.

Tus mob cholecystopancreatitis yog ib tus mob hnyav heev, tab sis nrog tus neeg paub coj los kho, koj tuaj yeem tshem tawm cov tsos mob tsis zoo. Noj qab nyob zoo!