Lub ntsiab thiab zoo tshaj plaws txoj kev kho mob ntawm cholelithiasis hnub no yog cholecystectomy - ib lub lag luam kom tshem tawm cov gallbladder. Tab sis tus txheej txheem no tsis tas tua cov tsos mob ntawm qhov mob plab, uas ua rau nws tus kheej tshwm sim hauv daim ntawv ntawm qhov mob thiab qhov teeb meem ntawm dyspeptic. Qhov no yog qhov Postcholecystectomy Syndrome (PHC).
Ua rau postcholecystectomy syndrome
Feem ntau cov ua rau PCHP yog:
- lesion ntawm extrahepatic biliary ib ntsuj av;
- cyst ntawm lub bile ciav;
- lub pob zeb nyob hauv lub tsib lub pob tawb;
- daim siab mob;
- stagnation ntawm bile;
- lub propensity ntawm lub cev rau pob zeb tsim.
Tom qab tshem tawm ntawm lub gallbladder, bile nkag mus rau hauv intestine chaotically, raws li ib tug ntawm uas zom ntawm cov zaub mov yog cuam tshuam thiab raws li ib tug tsis txaus siab ntawm lub plab hnyuv microflora tshwm sim. Li no muaj mob heev.
Kev kuaj mob ntawm postcholecystectomy syndrome
Qhov feem ntau qhia yog nqa ntawm endoscopic retrograde cholangiopancreatography thiab manometry ntawm lub Oldy sphincter. Tab sis cov khoom siv rau kev kuaj mob xws li tsuas yog hauv ob peb qhov chaw tshawb xyuas.
Cov kev sim ntau tshaj cov kev kuaj mob uas txiav txim siab txog qib:
- bilirubin;
- gamma glutamyl hloov;
- alkaline phosphatase;
- alanine thiab aspartic transaminases;
- amylase ;
- elastase;
- lipase.
Cov kev ntsuam xyuas no yog tawm tswv yim kom siv tau thaum lub sij hawm, los yog tsis pub dhau 6 teev tom qab hnub tom qab.
Cov tsos mob ntawm postcholecystectomy syndrome
Cov cim qhia ntawm PCHP:
- mob rau sab xis thiab cheeb tsam epigastric, uas tseem tuaj yeem pub rau thaj av ntawm txoj cai scapula thiab rov qab;
- ntau yam kev mob digestive uas tshwm sim lawv tus kheej rau hauv xeev siab, kab ntsig, cem quav, raws plab, zoo nkaus li kev tu siab hauv lub qhov ncauj;
- kuj pom ntawm jaundice.
Kev faib tawm ntawm tus kab mob postcholecystectomy syndrome
Tsis muaj ib qho kev faib tawm ntawm PCHP rau hnub no. Feem ntau siv xws li kev siv lub cev:
- Stenosing duodenal papillitis.
- Kab mob pancreatitis (cholepancreatitis).
- Cov kab mob nquag ua ke (cov kab mob ntev ntev) nyob hauv subhepatic qhov chaw.
- Relapses nyob rau hauv lub tsim ntawm pob zeb nyob rau hauv lub bile ciav.
- Cov kab mob secondary gastroduodenal ulcers (biliary los yog hepatogenic).
Kev kho mob ntawm postcholecystectomy syndrome
Kev ntsuas rau kev kho mob ntawm PHC yuav tsum tau tswj kom tshem tawm cov kev ua haujlwm lossis cov kab mob hauv lub cev los ntawm txoj hlab plawv, daim siab, kab mob hauv lub cev thiab cov txiav ua rau mob.
Ib qho ntawm cov tshuaj ntsuas yog ib feem zaub mov (li 6-7 zaug hauv ib hnub). Tib lub sij hawm nrog tus mob choledocystectomy syndrome, yog noj zaub mov noj - cov kua qaub, cov kua qaub, cov khoom kib thiab cov khoom noj uas haus luam yeeb yuav raug tshem tawm.
Thaum muaj mob plab muaj qhov mob, nws tuaj yeem sau cov tshuaj mob, xws li:
- Mebeverin;
- Drotaverine.
Yog hais tias qhov ua rau mob yog qhov ua kom tsis muaj teebmeem enzymes, ces cov tshuaj enzyme yuav tsum tau kho kom txhim kho kev zom zaub mov, xws li:
- Panzinorm forte;
- Festal;
- Creon .
Yog hais tias nws yog tsim hais tias tom qab lub lag luam kom tshem tawm cov gallbladder, plab hnyuv biocenosis yog cuam tshuam, ces cov tshuaj muaj cov tshuaj los kho lub cev plab hnyuv microflora. Nyob rau tib lub sijhawm,
- Furazolidone;
- Kev sibtham;
- Doxycycline.
Cov nyiaj no yog siv 5-7 hnub, thiab tom qab ntawd ces cov tshuaj noj uas hnyuv tawm cov hnyuv nrog cov kabmob:
- Linex;
- Bifidumbacterin thiab lwm tus.
Rau lub hli tom qab ua haujlwm, cov neeg mob yuav tsum nyob hauv kev saib xyuas ntawm tus kws kho mob.