Cholecystopancreatitis: Zizindikiro ndi mankhwala

Cholecystopancreatitis - Uku ndi kuphatikizika kwa ndulu ndi kapamba. Imadziwoneka ngati ululu mu epigastrium, kumanja ndi kumanzere kwa hypochondria, kusanza mobwerezabwereza, zizindikiro zina za dyspeptic, kusintha kwa chikhalidwe cha chimbudzi, ndi jaundice. Amapezeka pogwiritsa ntchito kusanthula kwamwazi ndi mkodzo, pulogalamu yotsatsira, ultrasound yam'mimba, MRPHG, RCHP. Mankhwala, analgesics, myotropic, anticholinergic, antisecretory, antiemetic ndi antibacterial agents amagwiritsidwa ntchito. Njira zopangira opaleshoni ndi njira zosiyanasiyana za cholecystectomy, kunja ndi mkati mwa stomatology wamba bile duct, kugawa kwa Vater papilla.

Zambiri

Kupezeka kwa cholecystopancreatitis kumachitika chifukwa cha kuyandikira kwakumaso ndi magwiridwe antchito a kapamba (kapamba) ndi chikhodzodzo cha ndulu. Kulephera kwa kudziwongolera kwawokha kwa sphincter system ya nipple ya Vater pakadwala matenda amodzi a ziwalo posachedwa kumayambitsa kusintha kwatsiku lina. Malinga ndi kafukufuku yemwe amapezeka mu matenda a gastroenterology, mu 69-70% ya odwala omwe ali ndi vuto lotchedwa cholecystitis, kupweteka kwa chithokomiro kumasinthika, ndipo cholecystitis yotsika ikufika mpaka 85-88%. Mu 38-39% ya anthu omwe ali ndi vuto la pancreatitis pachimake, matenda a cholecystitis amadziwika, ali ndi kutupa kwa kapamba, ndulu imakhudzidwa mu 62-63% ya milandu.

Amayambitsa Cholecystopancreatitis

The zimachitika kuphatikiza kutupa kwa kapamba, ndulu ya ndulu limalumikizidwa ndi chachikulu chotupa chimodzi mwa ziwalo. 85% ya odwala, cholecystitis yolumikizidwa ndi cholelithiasis imakhala cholumikizira choyambirira cha matendawa. Mu 15% ya milandu, kutupa kumayamba ndi kapamba ndipo kumapangidwa ndi yachiwiri ya enzymatic cholecystitis. Kutsogolera kwa cholelithiasis mu chitukuko cha cholecystopancreatitis ndi chifukwa cha zinthu monga:

• Makina zoletsa za Vater papilla. Ndi kutsekeka kwa njira za magawidwe a pancreatic madzi, bile, biliary stasis imachitika, yomwe imakwiyitsa kudzikundikira kwamaluwa ofunikira mkati mwa ndulu, ndi kutupa kwa chiwalo. Kuwonjezeka kwa munthawi yomweyo kumapanikizika kwa ma pancreatic gland kumayambitsa kulowetsa kwa ma enzymes ake m'ziwalo zam'mimba komanso kuyambitsa kusintha kwakumaso ndi kowononga.
• Sphincter Oddi Kukanika. Kukwiya kosalekeza ndi calculi yaying'ono kumayambitsa dyskinesia ya minofu yosalala ya Vater papilla. The biliary-pancreatic and pancreatic-biliary Refluxes amathandizira kulowa kwa bile, kuphatikizapo kachilombo, mu kapamba, ndi michere ya pancreatic - mu ma ducts a bile. Chowonjezera chake ndi kuphatikizika kwa matenda oopsa motsutsana ndi maziko a kupindika kwa Oddi.

Limagwirira a chitukuko cha cholecystopancreatitis zachokera kuphwanya kwa thupi gawo la bile ndi pancreatic madzi mu duodenum. Nthawi zina, ma sphincters omwe amapezeka pancreatic komanso ma ducts wamba a bile amalepheretsa kutulutsa kwamkati. Ndi intraductal matenda oopsa oopsa omwe amapangidwa chifukwa cha kupangira kwa Vater papilla kapena dyskinesia ya sphincter ya Oddi, zimatha kuti bile ikalowe pancreatic duct.

Izi zimabweretsa kutsegula kwa phospholipase, michere ina ya kapamba, mapangidwe oopsa kwambiri omwe amawononga chiwalo kuchokera ku zigawo za bile. Pafupipafupi, poyerekeza ndi pomwe pancreatitis ilipo, ma enzyme amaponyedwa mu bile duct, omwe amakhumudwitsa kukula kwa cholecystitis. Chowonjezerapo ndi kufalikira kwa ma Reflux, hemato native and lympho native of pathogenic flora. Mu pachimake mitundu cholecystopancreatitis, kutupa ndi catarrhal kapena purcin-necrotic;

Gulu

Mukapangira mitundu ya cholecystopancreatitis, momwe masinthidwe am'mbuyomu komanso mawonekedwe amomwe matendawa amatengera. Kutengera ndi kutsogola kwa matenda amisala, kupatsirana, kuwononga, kuwononga komanso kuwononga matendawa mosiyanasiyana, pomwe mtundu wa kutukusira kwa ndulu ndi chidetso cha pancreatic ukhoza kukhala wosiyana. Ndi chikhalidwe chamakono, amasiyanitsa:

• Pachimake cholecystopancreatitis. Monga lamulo, zimachitika mwadzidzidzi pamaso pa makina otchinga kapena zolakwika zazikulu pazakudya. Amadziwika ndi kupweteka kwambiri komanso syndromes. Popanda chithandizo chokwanira, kufa ndi 31,5-55,5%.
• Matenda a cholecystopancreatitis. Matendawa amakula pang'onopang'ono ndipo nthawi zambiri amaphatikizidwa ndi cholelithiasis. Zizindikiro za Dyspeptic, kusapeza bwino mu epigastric ndi hypochondrium, kusokonezeka kwapang'onopang'ono kwa njira zogaya chakudya chifukwa cha pancreatic degeneration predominate.
• Matenda pafupipafupi cholecystopancreatitis. Nthawi zambiri zimakhala zotsatira za matenda owopsa, omwe samadziwika kwambiri m'mbuyomu. Kubwezeretsanso nthawi zambiri kumayamba chifukwa cha zovuta zopatsa thanzi. Chiwopsezo cha kufa pa exacerbations chikufika 3.5-7%.

Zizindikiro za cholecystopancreatitis

Chithunzi chachipatala cha matendawa ndizosiyanasiyana ndipo chimaphatikizaponso zizindikiro za kutukusira kwa ndulu ndi chamba cha pancreatic. Dandaulo lalikulu la odwala omwe ali ndi cholecystopancreatitis ndi ululu wam'mimba, womwe umatha kutulutsidwa m'dera la hypochondria kapena epigastric. Kuwonjezeka kwa zowawa mutatha kudya zakudya zamafuta ambiri ndikumwa mowa ndi khalidwe. Kusanza kangapo ndi zosafunika za bile ndikotheka, komwe sikubweretsa mpumulo kwa wodwala.

Matenda a dyspeptic mu mawonekedwe a mseru, kupindika, ndi kulemera pamimba amawonedwa pafupipafupi, ngakhale panthawi yopatsirana. Cholecystopancreatitis amadziwika ndi chopondapo matenda: odwala onani discoloration wa ndowe, kukhalapo kwa inclusions chakudya chosasinthika, kuchuluka matumbo kusuntha mpaka 4-6 pa tsiku. Chikaso cha sclera, mucous nembanemba ndi khungu zimatha kuphatikizika ndi mtundu wakuda wa mkodzo. Munthawi ya kukokomeza, kutentha kwa thupi kapena kufoka kwa thupi, kufooka kwathunthu komanso kuchepa kwa magazi kumawonedwa.

Mavuto

Ndi cholecystopancreatitis, kutchulidwa kokwanira kuperewera kwa thupi kumapangidwa, komwe kumayenderana ndi kuphwanya chinsinsi cha bile, kusowa kwa ma enzymes ofunikira. Odwala amakhala ndi steatorrhea ndi linterea, kuwonda kwakukulu kumawonedwa. Chifukwa chophatikizidwa ndi ma islets a Langerhans mu pathological process, pancreatogenicabetes mellitus akhoza kuyamba. Kulowa kwa magawo oyandikira kwa m'matumbo aang'ono kumayambitsa kupezeka kwa duodenitis ndi eunitis.

Vuto lalikulu la cholecystopancreatitis ndi pancreatic necrosis, yomwe imadziwika pamene michere imayatsidwa mkati mwa ma pancreatic ducts. Odwala nthawi zambiri amawonetsa kuwonongeka kwa gallbladder mwanjira ya pericholecystitis ndi empyema. Popanda chithandizo, mafuta a chiwalo ndi kutulutsa kwa kachilomboka komwe kali ndi kachilombo ka m'matumbo kumachitika. Pali chiopsezo cha biliary peritonitis. Ndikachulukirachulukira, kulephera kwamthupi kambiri kumatha kupanga, komwe nthawi zina kumabweretsa imfa.

Zizindikiro

Cholecystopancreatitis imatha kukayikiridwa pamaso pa madandaulo wamba ndi mawonekedwe akuthupi (Kera, Murphy, Mayo-Robson, Mussse-Georgiaievsky). Kuti muwonetsetse matendawa, kuwunika kokwanira pogwiritsa ntchito maphunziro a labotale ndikofunikira. Zothandiza kwambiri mu njira yodziwira matenda ndi njira monga:

• Mapazi amwazi. Zizindikiro zamatendawa ndizowonjezereka kwa alkaline phosphatase ndi bilirubin mwachindunji, ndi pancreatic necrosis, kuchuluka kwa AST ndi ALT kumawonjezeka. Hypoalbuminemia ndi dysproteinemia amapezekanso, zomwe zimalumikizidwa ndi kuperewera kwa chakudya m'mimba.
• Kuwunika kwa ndulu. Pankhani ya cholecystopancreatitis, zotsalira za chakudya chopanda, kuchuluka kwa minofu yosakhazikika ndi michere yotsika imatsimikiziridwa mu pulogalamu. Kuphatikiza apo, ELISA ya ndowe za alpha-amylase imachitidwa - kuwonjezeka kwa kuchuluka kwa enzyme mwa nthawi 3-4 kumakupatsani mwayi wotsimikizira kuti mwazindikira.
• Mimba ultrasound. Ma Ultrasound a ndulu, kapamba amawonetsa zizindikiro za kuwonongeka kwa ziwalo. Woonda makoma ndi kutupa kwa ndulu, kupezeka kwa calculi m'mphepete mwake ndi mapindikidwe am'mimba, heterogeneity ya pancreatic parenchyma, kuwonongeka kwa mapangidwe ake ndi chikhalidwe.
• Mbiri. Magnetic resonance pancreatocholangiography imagwiritsidwa ntchito posowa chidziwitso cha njira zina ndipo imathandizira kuwerenga mwatsatanetsatane kapangidwe ka kapamba ndi dongosolo la biliary. Njira ndiyofunikira kuti mupeze cysts ndi madera a necrosis, kuzindikira pathologies a chiwindi ndi mutu wa kapamba.
• RCP. Retrograde cholangiopancreatography imagwiritsidwa ntchito kuwona mkhalidwe wamtundu wamtundu wa biliary ndi ma dancts a pancreatic. Njira imakuthandizani kuti mupeze calculi yoyipa ya X-ray, muyeso wam'mphepete mwa bile ducts, komanso momwe sphincter ya Oddi ilili. Malinga ndi zikuwonetsa, papillosphincterotomy ikhoza kuchitidwa.

Pakuwunika kwa magazi kochulukitsa kwa cholecystopancreatitis, leukocytosis pang'ono ndi kuchuluka kwa ESR zimadziwika. Pakuwunika kwamikodzo mumkodzo, bilirubin ndi urobilin zitha kupezeka. Ngati mukukayikira helminthiasis, pulayimale yolumikizidwa ndi enzyme imagwiridwa. Pofuna kupatula ma pathologies a ziwalo zina zam'matumbo, ma radiographs a piramidi ndi kafukufuku wa x-ray wokhala ndi mawu osiyanitsa pakamwa amapangidwa.

Choyamba, cholecystopancreatitis pachimake kapena yowonjezereka imasiyanitsidwa ndi pachimake appendicitis. Njira zazikulu zodziwitsira ndikudziwitsa kupweteka kwa epigastrium kapena hypochondrium yamanzere, zizindikiro za ma pancreatic ndi biliary thirakiti, Zizindikiro zabwino za Mayo-Robson ndi Kera. Yang'anani pa anamnesis ndi kutalika kwa nthawi ya matendawa - kuwonjezeka kwazizindikiro motsutsana ndi maziko azomwe zikuchitika pakubala bwino m'malo mothandizidwa ndi opaleshoni yayikulu. Dokotala wazachipatala, katswiri wa matenda a m'matumbo ndi dokotala wothandizira amathandizira pakuwunika wodwalayo.

Chithandizo cha cholecystopancreatitis

Mukamasankha njira yochizira, mphamvu zakukula kwa matenda, zomwe zimasinthidwa pamalingaliro, ziwalo, kupezeka kwamatenda amakumbukiridwa. Odwala omwe ali ndi vuto lalikulu amagonekedwa kuchipatala chopangira opaleshoni, kupereka njira yothandizira kugaya chakudya (kufa ndi njala, kuwonongeka kwamatumbo, ndipo, ngati kuli kotheka, kudyetsa kwa abereki kapena enteral chubu). Mu mtundu wa cholecystopancreatitis, amachepetsa kudya kwamafuta, kuchepetsa kuchuluka kwa chakudya. Mwa mankhwala omwe agwiritsidwa ntchito:

• Ma analgesics osakhala a narcotic komanso a narcotic. Maziko a analgesia osokoneza bongo ndi ululu wopitilira. Muzovuta kwambiri, ndikotheka kupatsa antipsychotic ndikupanga mankhwala opweteka kwambiri.
• Myotropic antispasmodics. Kuchotsa kuphipha kwa minofu yosalala kumachepetsa matenda oopsa, amathandizira kutulutsidwa kwa madzi a pancreatic ndi bile. Ngati ndi kotheka, mankhwalawa a cholecystopancreatitis amathandizidwa ndi anticholinergics.
• Mankhwala a antiemetic. Pamaso pa regurgitation syndrome, mankhwala oyambira ndi ma dopamine ndi ma serotonin blockers. Odwala omwe akupitiliza kusanza amawonetsedwa osankha a 5HT-3-serotonin receptors.
• Maantibayotiki. Pofuna kupewa matenda opatsirana ndikuchotsa pathogenic zomera, semisynthetic penicillin, macrolides, cephalosporins ndi aminoglycosides amagwiritsidwa ntchito. Mukamasankha mankhwala, chidwi cha pathogen chimawerengedwa.
• Mankhwala osokoneza bongo. Pofuna kulepheretsa katemera wa pancreatic, ma pulon pump blockers ndi histamine receptor inhibitors amalembedwa. Ndi cholecystopancreatitis ndi chiwonongeko chachikulu, ma octapeptides ndi proteinase inhibitors ndi othandiza.

Poganizira kuopsa kwa zizindikiro, kulowetsedwa kumachitika pothandizidwa ndi mayankho a electrolyte, analeptics ndi mtima glycosides kukhalabe ndi mtima wamtima. Kupanda phindu kwa njira yokhazikika ya cholecystopancreatitis ndi chidziwitso cha opaleshoni. Nthawi zambiri, kusintha kumachitika pambuyo pa cholecysticomy yotseguka, laparoscopic kapena SILS cholecystectomy. Mu pachimake kutsekeka kwa biliary thirakiti, choledochostomy, choledochoduodenostomy kapena choledochoenterostomy amachitidwa. Odwala omwe ali ndi zotupa za Vater's nipple akuwonetsedwa papillosphincterotomy.

Zotsogola ndi kupewa

Kukula kwake kumatengera nthawi yamatendawa komanso kuchuluka kwa zosokoneza. Zotsatirazo zimakhala zabwino pakakhala vuto loyambira la cholecystopancreatitis komanso chithandizo chanthawi yake. Ndi zovuta zovuta za matendawa, matendawa amakayikira. Kuti mupewe, ndikofunikira kutsatira zakudya (kupewa kugwiritsa ntchito zakudya zopanda mafuta ndi zakudya, kuchepetsa kudya), kuchita zolimbitsa thupi mwamphamvu, komanso kuchitira matenda ena am'matumbo.

Zomwe zimayambitsa matendawa

Zomwe zimayambitsa matendawa ndi monga:

• kuchuluka kwa duodenum ndi chiwindi pakhungu,
• pafupi kwambiri ndi ziwalo zamkati za hepatopancreatic, chifukwa cha momwe bile limaponyedwa mu duodenum,

Palinso machitidwe amtundu wa pathogenetic, momwe cholecystopancreatitis imatha kukhazikika, monga:

Khansa yapakansa

Chithunzicho chikuwonetsa Vater Nipple

Chithunzi Sketchy Sphincter wa Oddi

Zokhudza chithandizo cha matenda

Nthawi zambiri, matendawa amathandizidwa. Chithandizo cha Syndrome chimayikidwa kwa nthawi yayitali. Mankhwala amagwiritsidwa ntchito kukonza chimbudzi. Othandizira oterewa ndi ma enymes am'mimba ndipo amafuna kuti athetse chimbudzi, amatulutsa chimbudzi ndi kuteteza kupangika kwa ndulu.

Njira yonse yochizira ndiyotengera izi:

• Kukhazikika kwa kapamba,
• kukonza moyo wabwino wodwala,
• kulowererapo kwa zovuta zotheka,
• Kuchotsa zotupa njira.

Intoxication imachotsedwa poika madzi am'migodi okhala ndi chloride ndi bicarbonates (galasi limodzi kasanu patsiku).

Kusanthula kwamadzi ochepa

Chakudya chapadera cha zakudya chinapangidwanso (tikulankhula za chakudya No. 5P), chomwe sichimapatula zakudya zamafuta, zonunkhira komanso wowawasa, zakumwa za kaboni

Pansipa pali mankhwala omwe amalembedwa pochiza cholecystopancreatitis.

Njira za anthu

Monga taonera kumayambiriro kwa nkhani ino, chithandizo chitha kuphatikizidwa ndi mankhwala ena wowerengeka. Zambiri mwa izi ndi infusions. Zothandiza kwambiri zalembedwa pansipa.

Gome. Zitsamba infusions zochizira cholecystitis

Malangizo Othandizira Zizindikiro

Nawa maupangiri ochepa othandiza pothana ndi matendawa.

Muyenera kumwa madzi ambiri momwe mungathere - osachepera malita awiri tsiku lililonse.

Cholesterol mu zakudya

Njira zopewera

Mfundo yayikulu yoletsa cholecystopancreatitis ndiko kukana mowa ndi kusuta.

Kusiya kusuta fodya, kugwiritsa ntchito mankhwala osokoneza bongo komanso mowa

Kuphatikiza apo, kuukira kwa matendawa kumayendera limodzi ndi kupweteka kwambiri pamimba pamtunda uliwonse pambuyo pa chakudya, kotero zakudya ziyenera kupangidwa mwanjira yoti kuchuluka kwa zakudya zomwe zimayambitsa matenda ochepa. Muyenera kudya pang'ono (osapitirira 60 g pa nthawi imodzi), ndikubwereza pafupipafupi, kuchuluka kwa mafuta kuyenera kukhala kochepa, ndipo mavitamini, m'malo mwake, adachulukanso.

Kodi cholecystopancreatitis ndi chiyani?

Cholecystopancreatitis ndi kuphwanya munthawi yomweyo kugwira ntchito kwa ndulu ndi kapamba, limodzi ndi chotupa.

Mchitidwewu umakhala wolumikizana, umawonongeka ndi ziwalo zapafupi za dongosolo la hepatobiliary. Ichi ndi kapamba ndi cholecystitis, womwe unayamba kupanga nthawi imodzi pazifukwa zosiyanasiyana kapena zingapo.

Poika matenda padziko lonse lapansi, cholecystopancreatitis amapatsidwa malo kalasi 11 (matenda am'mimba). Matendawa ali mgulu la K80-K87 - Matenda a ndulu, mapepala am'mimba komanso kapamba.

ICD ili ndi kachidindo kake K87.0 "Zilonda za ndulu, njira yothandizira ndi kapamba m'matenda omwe adayikidwa kwina."

Mankhwala

Chithandizo cha akuluakulu zimaphatikizapo kugwiritsa ntchito ma pinkiller, ma antacid, othandizira ndi mavitamini.

Zizindikiro za cholecystopancreatitis sizingayende bwino ngati zakudya zoyenera sizinyalanyazidwa limodzi ndi mankhwala.

Chithandizo cha matenda aakulu komanso pachimake cholecystopancreatitis chikuchitika ntchito zotsatirazi mankhwala:

• painkiller - zotchulidwa kupumula kwa ululu. Gulu ili ndi la Papaverine, No-spa, Ketorolac, Motilium.
• kukonzekera kwa enzyme - kuthandizira kugaya chakudya. Mwachitsanzo Festal, Mezim, Pancreatin ndi Creon.
• Maantacid - mankhwala abwino kwambiri ochizira pachimake cholecystopancreatitis ndi Almagel. Mankhwala ndikofunikira kuti achepetse acidity ndikuthandizira kugaya chakudya.

Zotsatira zamankhwala zimawonekera pokhapokha mutatsatira malangizo a dokotala.

Opaleshoni

Ndi kutupa kambiri, opaleshoni ndiyofunika. Izi zikutanthauza kuti opaleshoni ya gallbladder iyenera kuchitidwa mkati mwa maola 24 atagonekedwa m'chipatala.

Kutupa kwa gallbladder kuthekera kungathenso kuchiritsidwa popanda kuchitidwa opareshoni. Komabe, pambuyo pochiritsa mosamala, zovuta zambiri zimatha. Mu 30% ya milandu ya matenda a cholecystopancreatitis, dokotala amamulembera opaleshoni.

Pambuyo kuchotsa chiwalo, m'mimba mumimba mumatsukidwa kuti muchotse ndulu yonse yomwe ikudontha.

Okalamba kapena chiwopsezo chowonjezereka cha opaleshoni chifukwa cha matenda ophatikizika, opaleshoni amatha kuimitsidwa mpaka tsiku lina.

Zakudya zochizira cholecystopancreatitis

Akuluakulu ayenera kudya zakudya zoyenera. Ndi matenda, matenda a cholecystopancreatitis odwala ndi njira ya moyo.

Mwanjira yayikulu ya matendawa, madokotala nthawi zina amaloledwa kuchoka pamalamulo omwe amakhazikitsa pokhudzana ndi zakudya, koma izi siziyenera kuchitiridwa nkhanza.

Kodi kudya kumatanthauza chiyani? Choyamba, izi ndizopatula pazinthu zovulaza. Kuti mupeze zakudya, funsani dokotala. Ndikofunika kuganizira nthawi yamatendawa, kupezeka kwa zovuta zofananira, zotsatira zoyesedwa ndi mawonekedwe a kukoma kwa wodwalayo.

Kudya ndi gawo lofunikira la mankhwala. Komabe, njirayi singagwire ntchito ngati monotherapy. Kudya kamodzi sikothandiza kuchiritsa cholecystopancreatitis.

Ndondomeko ya chakudya iyenera kuwerengedwa nthawi yomweyo. Kudya kumalimbikitsidwa maola aliwonse awiri ndi atatu ndi atatu. Mwachitsanzo, kadzutsa uyenera kukhala 30% ya chakudya cha tsiku ndi tsiku, nkhomaliro - 10%, nkhomaliro - 30%, tiyi wamadzulo - 15%, chakudya chamadzulo - 10%.

Kutsatira zakudya kumathandiza kuti musamadye kwambiri, idyani bwino, osavutitsa m'mimba ndikuletsa kuyamwa.

Zakudya za mtundu:

Lolemba:

• Azungu atatu azira, oatmeal pamadzi, tiyi wopanda mphamvu, obalaza kapena masikono,
• kapu ya kefir kapena tchizi chamafuta pang'ono,
• msuzi wamasamba, kagawo ka nyama ya kalulu kapena nyama ina yoponda, semolina,
• kapu ya kefir yokhala ndi biscuit,
• compote ya zipatso zouma, osati zotsekemera.

Lachiwiri:

• oatmeal, obalaza ndi kulowetsedwa kwa chamomile,
• pastille ndi tiyi wam mbewa,
• kaloti wosenda, nyama yodulira ng'ombe, kulowetsedwa kwa rosehip,
• Beri wopanda wowawasa wokhala ndi mkate ndi tiyi wa dzulo,
• kapu ya yogurt yopanda mafuta, makeke ophika mabisiketi.

Lachitatu:

• mbatata omelette, chidutswa chofewa, dzira lowiritsa, tiyi,
• msuzi wa rosehip ndi caramel,
• msuzi waball, nyama yophika mu msuzi wa mandimu, tiyi wobiriwira,
• Chakudya chamasana - maapulo ophika,
• 200 ml ya kefir wopanda mafuta kapena mkaka.

Lachinayi:

• Dzira lowiritsa, tchizi ndi tchizi, tiyi wokhala ndi mkaka,
• tiyi wa chamomile wokhala ndi masikono owuma,
• maapozi ophika, msuzi wamasamba, mkaka,
• kanyumba tchizi,
• masamba saladi wa phwetekere ndi nkhaka, tiyi ndi mandimu.

Lachisanu:

• nthunzi yauwisi ndi saladi wamasamba, phala la buckwheat ndi mkaka, kapu ya tiyi wofunda ndi mandimu,
• makeke amphika ndi mkaka wonenepa kwambiri,
• odzola kapena oyambitsa ndi kefir, mbatata zosenda ndi batala, yogati,
• mutu wa curd, kissel,
• kapu ya kefir.

Loweruka:

• semolina phala, tiyi wobiriwira, tchizi mu msuzi wa uchi,
• chipatso
• msuzi wa udzu winawake, nsomba zansomba, phala la buckwheat ndi saladi wamasamba,
• tiyi wa mandimu ndi mafuta omira,
• yogati ndi mkate wowotcha.

Lamlungu:

• gawo la oatmeal, kanyumba tchizi ndi wowaza, kissel,
• masamba saladi, meringue,
• dzungu msuzi puree, compote, meringue,
• maapulo ophika ndi tchizi tchizi,
• tchizi chamafuta ochepa, tiyi wokhala ndi mandimu.

Kuti mupeze zakudya kwa sabata, muyenera kudziwa zakudya zomwe ndi zoletsedwa kugwiritsa ntchito ndipo mumaphika zakudya.

Odwala omwe ali ndi cholecystopancreatitis tikulimbikitsidwa kuti azidya zakudya zotsukira. Nthambi, kuphika, kuphika. Msuzi wa nyama siabwino.

Simungathe kumawerengera zokometsera, nyama zosuta, zipatso, zinthu zomwe zidapangidwa kale (sopo mu briquette, mbewu zosaphika). Sizoletsedwa kudya mkate watsopano, nyama yamafuta, zonona, nyemba, khofi ndi mowa.

Zakudya zoletsedwa ndizophatikiza zakudya zowuma, mafuta a nyama, ma muffin ndi bowa.

Zomwe zimayambitsa matendawa

Cholecystopancreatitis imayamba m'njira ziwiri: matenda opatsirana komanso osachiritsika, pomwe zizindikiro zawo ndizosiyana. Koma pali Zizindikiro Zodziwika Za Kukula Kwa Matendawa,

• matenda opatsirana
• matenda ashuga
• kagayidwe kachakudya matenda, chapamimba chilonda, kuchuluka acidity:
• matenda osiyanasiyana omwe amasokoneza kugwira ntchito kwa sphincter ya Oddi,
• zam'mimbazi khansa.

Zimayambitsa kutupa kwa ndulu:

1. Kuphwanya zolondola kayendedwe ka bile kudzera ma ducts, kusayenda kwake.
2. Zakudya zopanda pake.
3. Kulowerera kwa thupi ndi tiziromboti

Matenda a cholecystopancreatitis amayamba chifukwa cha kuperewera kwa zakudya m'thupi, kumwa mowa mwauchidakwa komanso kugwiritsa ntchito mankhwala osokoneza bongo popanda kuyang'aniridwa ndi dokotala, ndimatayidwe ochepa a mapuloteni, magazi osafunikira m'mitsempha, komanso mitundu yambiri ya ziwalo.

Zizindikiro komanso chithandizo cha matendawa

Pamene cholecystopancreatitis ili pachimake pachimake, zizindikilo zimachitika:

1. Kumva nseru ndi kusanza, kutulutsa, makamaka mukatha kudya.
2. Ululu mu hypochondrium yoyenera.
3. Matenda a Dyspeptic.
4. Zotupa pakhungu.
5. Kupezeka kwa mafuta mu ndowe.
6. Malo obiriwira m'manda, m'mimba.
7. Kupanda chilimbikitso.

Ngati cholecystopancreatitis ndi pachimake, ndiye kuti zizindikiritso zam'mimba, kusanza, kutulutsa, ndi ena, zimawonekera mutatha kudya yokazinga kapena zakudya zonunkhira. Komanso kupanga kutsekula m'mimba, kudzimbidwa, komanso motsutsana ndi kutaya kwa zonsezi, kusowa tulo.

Zizindikiro zomwe zili pamwambapa zimawonetsedwa nthawi yamatenda amtunduwu, pomwe ndizotheka kukulitsa chiwindi, kupweteka kwa ndulu. Chithandizo cha cholecystopancreatitis chazovuta chimaphatikizapo: kumwa mankhwala, physiotherapy, njira zina, komanso zakudya zoyenera.

Fomu yothandiza

Ngati cholecystopancreatitis yatenga mawonekedwe awa, ndiye kuti iyenera kuthandizidwa mwachangu. Izi ndichifukwa choti mkati mwa maphunzirowa pamakhala chotupa cha ma pancreatic ducts, zomwe zimabweretsa zosokoneza pakugwira ntchito kwa ziwalo zogaya, komanso kufinya kosiyanasiyana kwa kapamba ndi ziwalo zina zam'mimba.

Cholecystitis mu mawonekedwe awa ali ndi izi:

• kuteteza khungu
• kuwonongeka kwa mafupa ang'onoang'ono,
• kupezeka kwa ma cysts abodza.

Ngati chithandizo sichinayambike panthawi, zovuta monga mawonekedwe a magazi m'mitsempha, matenda a endocrine system, ndi peritonitis amatha.

Mankhwala

Matenda a cholecystitis ndi kapamba, mankhwala amalembedwa: maantibayotiki, ma pinkiller, othandizira a metabolic ndi enzymatic:

1. Kuti muchepetse kupweteka komanso kukonza ntchito ya ndulu, antispasmodics ndi mankhwala. Uku ndi Papaverine, Analgin.
2. Kusintha chimbudzi ndikupanga michere yokwanira - Creon, Pancreatin.
3. Kuchepetsa katulutsidwe wa gland - Omeprazole.
4. Mankhwala a antibacterial - metronidazole.
5. Kubwezeretsa matumbo microflora - Hilak.

Ndalama zonsezi sizingagwiritsidwe ntchito pazokha, ziyenera kuvomerezedwa pasadakhale ndi adokotala.

Panthawi ya matenda a cholecystopancreatitis, wodwalayo amapatsidwa njira zingapo za physiotherapy: laser mankhwala, UHF, diadynamic mankhwala, cryotherapy, omwe amachepetsa ululu. Kuchepetsa ma spasms, magnetotherapy, electrophoresis ndi ntchito ya parafini amagwiritsidwa ntchito. Chithandizo choterechi chimagwiritsidwa ntchito pokhapokha ngati dokotala wakuwuzani.

Njira Zodziwitsira

Cholinga chodziwitsa ndi kudziwa zomwe zimayambitsa matendawa. Njira zotsatirazi zimagwiritsidwa ntchito kuti mudziwe za matendawa:

• Zizindikiro ndi zodandaula za wodwala (mbiri ya zamankhwala),
• Kuyesedwa ndi dokotala
• Khungu pamimba,
• Kusanthula magazi, mkodzo, ndowe,
• Kuyesa kwa Ultrasound,
• Kumveka pamimba
• Magnetic resonance imaging (MRI) ya m'mimba.

Kutengera zotsatira zakuwunika kwathunthu, kudziwikitsa moyenera matendawa akuti.

Cholecystopancreatitis imafuna njira yolumikizira chithandizo. Maphunzirowa amakhala ndi kumwa mankhwala, kutsatira kadyedwe koyenera, ndi physiotherapy. Kutengera ndi kuopsa kwa matendawa, mtundu wa chithandizo cha munthu amasankhidwa. Lemberani mankhwala: Maantibayotiki (Cefazolin, Ampiok, Gentamicin), choleretic (Cholagol, Liobil), painkillers (No-shpa, Papaverin), ma enzymes (Omeprazole, Creon, Mezim, Pancreatin), kubwezeretsa thirakiti la m'mimba, antispasmodics, Drota ), antibacterial (Cycvalone, Oxafenamide), maantacid (Almagel), mankhwala osokoneza bongo. Kutalika kwa maphunziro, mankhwalawa kuti athane ndi cholecystopancreatitis amasankhidwa ndi adokotala. Ndi zoletsedwa kugwiritsa ntchito mankhwala omwe mumagwiritsa ntchito nokha, mutha kuyambitsa zovuta zina matendawa!

Physiotherapy imalembedwa kwa wodwala ngati matendawo akukhululuka. Chifukwa cha electrophoresis, kufalikira kwa magazi kumayenda bwino, kupanga kwa bile kumachulukitsa, ndipo njira zotupa zimachepa. Ngati pachimake cholecystopancreatitis (kapamba cholecystitis) kapena kuchuluka kwa matendawa, njira zimatsutsana. Kuphatikiza pamodzi kwa matendawa kumapereka zotsatira zabwino.

Zakudya za cholecystopancreatitis

Zakudya zopatsa thanzi ndi gawo lofunika la chithandizo. Chakudya chimatha kusokoneza chimbudzi, kupangitsanso nkhawa pa chikhodzodzo, chiwindi, impso. Tsatirani kwambiri malamulo a kadyedwe ndi malingaliro a dokotala.

• Idyani pomwe,
• Idyani zakudya zazing'ono
• Chakudyacho chimawonedwa kwa nthawi yayitali, osati kokha pakufalikira kwa matendawa,
• Idyani zakudya zovomerezeka zokha,
• Osasokoneza chakudyacho (mwachitsanzo, zakudya zochepa zomwe zimasuta zimatha kuyambiranso).

Zakudya zamagulu azakudya zimapangidwa limodzi ndi adokotala. Odwala okhala ndi cholecystopancreatitis ndiwo mankhwala No. 5. Chakudyacho chimakhala ndi zakudya zopatsa thanzi: nyama yophika nyama, nsomba zowotcha, msuzi wamasamba, zakudya zamafuta ochepa mkaka wowawasa, chimanga, tiyi wofooka, compote, zakumwa zamalonda, ndi zina zambiri.

• Zakudya zamafuta, zonunkhira, zonunkhira,
• Zakudya zakusuta
• Kuphika: mkate woyera, buns,
• Zowawa, zotsekemera,
• Zinthu zomwe zimakhala ndi cocoa (chokoleti),
• Garlic, anyezi, radish,
• Tiyi yapamwamba kwambiri
• Mowa
• Madzi owala
• Marinade okhala ndi viniga.

Zithandizo za anthu

Zithandizo za anthu zimatha kukhala ndi phindu pazimbudzi. Kulandila limodzi ndi mankhwala ndi njira zina kungabweretse zotsatira zabwino mwachangu. Zitsamba zamankhwala ndi mbewu zochizira matenda am'mimba:

• Wouma rosehip decoction. 500 gr. m'chiuno cha rose chimathiridwa ndimadzi, kunena maminitsi 30, kuyika moto pang'onopang'ono, wiritsani kwa mphindi 5. Tengani katatu patsiku, 200 ml mutatha kudya. Sungani msuzi mufiriji. Gwiritsani ntchito kapamba.
• Masamba a Golide Wamapewa. Pukutani masamba atatu a chomera, kutsanulira 500 ml ya madzi otentha, wiritsani pa kutentha kwapakatikati kwa mphindi 10-15. Kuumirira maola 8. Ndikulimbikitsidwa kumwa tincture wofunda katatu pa tsiku musanadye, 50 ml. Maphunzirowa ndi masiku 30. Chithandizo choterechi chimathandiza kuthetsa kutupa kwam'mimba, umagwiritsidwa ntchito pa matenda a ndulu.

• Kutolere zitsamba: burdock, chingwe, chowawa, maluwa a chamomile, calendula officinalis, sage. Sakanizani zitsamba zofanana, kutsanulira supuni ziwiri za 400 ml ya madzi otentha a 100, kusiya kwa ola limodzi. Tengani katatu patsiku, musanadye, 100 ml. Njira ya mankhwala ndi milungu itatu. Msonkhanowu uthandizira kuchiza matenda angapo am'mimba.
• Zomera zamtchire. Mizu ya sitiroberi zamtchire (1 tbsp.spoon) kuthira madzi otentha (250 ml). Lolani kuti aleke kwa ola limodzi. Imwani 100 ml m'mawa ndi madzulo. Wogwiritsidwa ntchito ndi cholecystitis, gastritis, ku kapamba.
• Katsabola. Madzi a katsabola amagwiritsidwa ntchito pamavuto ndi m'mimba. Mbeu zonkha kuthira madzi otentha, mulole zipere. Imwani katatu patsiku kwa 100 ml. Madzi okumba pansi okonzeka agulidwa ku pharmacy.
• Wort wa St. John, mamawort, maluwa a chamomile, rose rose, nettle. Tengani mitundu yofanana ya udzu, kusakaniza. Steam supuni ya chopereka ndi madzi otentha (250 ml). Lolani kuti aleke kwa maola 6. Idyani musanadye, 100 ml katatu patsiku.
• Phulusa lofiirira. Kusiyanitsa pakati phulusa lofiirira m'mapiri ogwira ntchito pothandiza pakamwa. Amagwiritsidwa ntchito ngati choleretic wothandizila; popewa kuchepa kwa vitamini, zipatso zouma zouma zitha kuwonjezeredwa tiyi ndi mbale. Mutha kuphika decoction wamapiri. Pogaya supuni ya zipatso, kutsanulira 200 ml ya madzi otentha, mulole brew kwa maola 5. Imwani 100 ml m'mawa ndi madzulo.
• Horseradish. Amagwiritsidwa ntchito ngati anti-yotupa, antibacterial, diuretic, choleretic, analgesic. Tincture imayenda bwino m'mimba. Pogaya muzu wa horseradish, supuni 1, kutsanulira 100 ml wa mkaka, simmer kwa mphindi 10 pa moto wochepa. Zozizira, zosefera. Tengani masana.

Njira ina iyenera kugwiritsidwa ntchito pochiza zovuta ndi mankhwala, mwachilolezo chachipatala.

Kupewa matenda

Kupewa matendawa ndikosavuta kuposa kuchiritsa, kumwa mapiritsi ndi kuthana ndi zovuta zina zomwe zimadza pambuyo pake. Njira zopewera:

• Moyo wathanzi
• Zakudya zoyenera, kudya,
• Kuzindikira kwakanthawi
• Njira zoyenera kulandira chithandizo,
• Kusiya zizolowezi zoipa,
• Yang'anani kulemera, kupewa kudya kwambiri,
• Pewani zochitika zovuta.

Cholecystopancreatitis ndi matenda oopsa, koma mwaukadaulo wodziwa bwino za mankhwalawa, mutha kuchotsa zizindikiro zosasangalatsa. Khalani athanzi!