Indlela eyinhloko futhi ephumelelayo yokwelapha i-cholelithiasis namuhla yi-cholecystectomy - umsebenzi wokukhipha i-gallbladder. Kodwa le nqubo ayiqedi ngaso sonke isikhathi izimpawu zesisu esiswini, esizibonakalisa ngesimo sobuhlungu kanye ne-dyspeptic distemper. Lena yi-postcholecystectomy syndrome (PHC).
Izimbangela ze-postcholecystectomy syndrome
Izimbangela ezivame kakhulu ze-PCHP yizi:
- i-lesion ye-tract bhearyary tract;
- i-cyst ye-bile duct;
- amatshe emidayeni ye-bile;
- isifo sesibindi;
- ukuqhuma kwe-bile;
- ukuphakama komzimba ekwakheni ngamatshe.
Ngemuva kokususwa kwe-gallbladder, i-bile ingena emathunjini, ngenxa yalokho ukugaya kokudla kuphazanyiswa futhi ngenxa yalokho ukungalingani kwe-microflora emathunjini kwenzeka. Ngakho-ke kukhona ukuzwa okubuhlungu.
Ukuxilongwa kwe-postcholecystectomy syndrome
Okufundiswa kakhulu kunokwenziwa kwe-endoscopic retrograde cholangiopancreatography kanye ne-manometry ye-Oldy sphincter. Kodwa imishini yokwenza lokho kuhlolisisa ingobuchwepheshe obuncane kuphela.
Izivivinyo ezivame kakhulu ze-laboratory ezinquma izinga:
- i-bilirubin;
- gamma glutamyl transferase;
- i-alkaline phosphatase;
- i-alanine ne-aspartic transaminases;
- amylase ;
- i-elastase;
- lipase.
Lezi zivivinyo ze-laboratory zeluleka ukuba zenziwe ngesikhathi, noma kungakapheli amahora ayisithupha emva kokuhlasela okulandelayo.
Izimpawu ze-postcholecystectomy syndrome
Izimpawu ze-PCHP:
- ubuhlungu ngakwesokudla kanye nesifunda se-epigastric, okungasinika isifunda se-scapula efanele futhi emuva;
- izifo ezihlukahlukene zokugaya ezizibonakalisa ngokwezindlela zokucasula, ukwehluleka, ukuqotshwa, isifo sohudo, umuzwa wokunambitheka okubabayo emlonyeni;
- futhi ukubonakala kwe-jaundice.
Ukuhlukaniswa kwe-postcholecystectomy syndrome
Ayikho isigaba esisodwa se-PCHP yanamuhla. Iningi livame ukusebenzisa uhlelo olunjalo:
- Ukuqeda i-papillitis ye-duodenal.
- I-pancreatitis ye-biliary (cholepancreatitis).
- Inqubo yokunamathela esebenzayo (i-peritonitis engavamile engalinganiselwe) esikhaleni esincane.
- Ubuyela emuva ekubunjweni kwamatshe ku-bile duct.
- Izilonda ze-gastroduodenal Secondary (i-biliary noma i-hepatogenic).
Ukwelashwa kwe-postcholecystectomy syndrome
Izinyathelo zokwelashwa kwe-PHC kumele zihloswe ekuqedeni lezo zinkinga ezisebenzayo noma ezakhiweni ezivela emhubheni wesisu, isibindi, i-bile ne-pancreas ebangela ubuhlungu.
Enye yezinyathelo zokwelapha ukudla okuyingxubevange (kuze kube izikhathi ezingu-6-7 ngosuku). Ngesikhathi esifanayo ne-post-choledocystectomy syndrome, ukudla kuboniswa - imikhiqizo ye-asidi, ebukhali, ethosiwe futhi ebhemisiwe ayinqatshelwe ngokuphelele.
Uma kukhona ubuhlungu be-paroxysmal, kungenzeka ukunikeza imithi yezihlungu, njenge:
- Mebeverin;
- I-Drotaverine.
Uma imbangela yobuhlungu iwukuntuleka kwe-enzyme, ama-enzyme amalungiselelo anqunyelwe ukuthuthukisa ukugaya, njengokuthi:
- I-forte ye-Panzinorm;
- I-Festal;
- Creon .
Uma kusungulwa ukuthi ngemuva kokusebenza ukukhipha i-gallbladder, i-biocenosis yamathumbu iphazamiseka, bese kuthi izidakamizwa zibekwe ukubuyisela i-microflora emathunjini evamile. Ngesikhathi esifanayo,
- Furazolidone;
- Intetriks;
- I-Doxycycline.
Lezi zimali zithathwa izinsuku ezingu-5-7, bese kuthi izidakamizwa ezikhipha amathumbu ngamabhaktheriya awusizo:
- I-Linex;
- Bifidumbacterin nabanye.
Ezinyangeni eziyisithupha emva kokuhlinzwa, iziguli kumele zibe ngaphansi kokuqondiswa udokotela.