Nkhumba ndi gawo lofunika kwambiri m'thupi. Amagwiritsa ntchito bile pofuna kudya chakudya, amateteza thupi ku zotsatira zowopsya za mankhwalawa ndikuwonetsa kuchuluka kwa mankhwalawa. Matenda ena a ndulu angayambitse kuswa kwa ntchito ya thupi ili, chifukwa cha chiwalocho chiyenera kuchotsedwa.
Ndi liti pamene kuchotsa ndulu?
Chiwonetsero chachindunji cha kuchotsa chikhodzodzo ndi ndondomeko ya miyala. Pamene cholecystectomy imayikidwa, zomwe zidzatchulidwe pansipa, izi zikutanthauza kuti chiwalo chakhala chitasokonezeka, chaleka kugwira ntchito zake. Kaya ntchito ndi yofunikira pamaso pa miyala, kuti athetse dokotala payekha, koma ndi matenda otero, madokotala opaleshoni amachotsa chiwalocho. Kuphwanya ndi kuyesa kuchotsa miyala sikuwatsogolera ku zotsatira zoyenera, chifukwa chikhodzodzo cha ndulu chimapanga zochitika zatsopano mu nthawi yochepa.
Kuchotsedwa ndi ntchito ya ndulu kumasonyezedwa m'mabuku otsatirawa:
- chigoba cha gallbladder;
- cholesterosis (cholesterol pamakoma a chikhodzodzo);
- kulowetsa mu khola la bile la mwala;
- kuika limba pamtunda wa cholecystitis;
- lalikulu polyps mu gallbladder ;
- ziphuphu mu chikhodzodzo;
- kutseka m'mimba chifukwa cha mwala umene unasunthira m'matumbo kuchokera ku ndulu kudzera mu fistula.
Njira zochotsera ndulu
Kuchotsa ndulu kumatanthawuza njira zowatengera opaleshoni. Pofotokoza zomwe zimachitika m'thupi, mitundu ndi zotsatira za opaleshoni, ochita opaleshoni amamvetsera wodwala kuti mphamvu yake imadalira luso la dokotalayo, thanzi la wodwalayo komanso khalidwe lake pa nthawi yopuma. Pali mitundu itatu ya cholecystectomy:
- Tsegulani chachikale - njira yakale kwambiri yochotsera ndulu;
- Kupititsa patsogolo kotsegulidwa - ntchito yoyamba idachitidwa pafupifupi zaka 45 zapitazo;
- Laparoscopy - inapezeka chifukwa cha kupita patsogolo kwa sayansi zamankhwala.
Cholecystectomy ya laparoscopic
Ngati nkofunika kuchotsa ndulu, laparoscopy ndi njira yabwino kwambiri. Laparoscopy, poyerekeza ndi mitundu ina ya cholecystectomy, ili ndi zosiyana zotsutsana, zofooketsa, zotsatira zochepa komanso nthawi ya kuchira. Laparoscopy siichitika pamaso pa kutupa, kumangiriza ndi zina za thupi.
Opaleshoni ya laparoscopic imagwiritsidwa ntchito pogwiritsira ntchito chipangizo chopangidwa ndi laserascopic. Zimakupatsani inu kusonyeza fano la ziwalo zamkati. Opaleshoniyi imayambira ndi zizindikiro zingapo za khomo la m'mimba, kumene opanga makina ndi kamera amaikidwa. Pomwe mutengapo mpweya wa carbon dioxide, muzitseni khoma la m'mimba ndikuthandizani kuti mukhale ndi chikhodzodzo cha ndulu. Chiwalocho chimachotsedwa ku chiwindi, kenako chimachotsedwa pamphuno.
Tsegulani cholecystectomy
Ntchitoyi kuchotsa bile imathandiza kupeza mwayi wopita kumimba chifukwa chochita zofunikira zomwe zimagwiritsidwa ntchito: kugwira ntchito pafupi ndi ziwalo zozungulira, kuyesa ma dicts, kuyesa ultrasound kapena cholangiography. Kwa ichi, kudula pamodzi ndi Kocher kumapangidwa pa khoma la m'mimba. Tsegulani cholecystectomy ili ndi zovuta zotere:
- ziwoneka zazikulu;
- nthawi yowonzanso;
- zovuta zambiri poyerekeza ndi laparoscopy.
Moyo pambuyo pa kuchotsedwa kwa ndulu
Pambuyo pa opaleshoni, zimatengera pafupifupi miyezi inayi kuti zithe kusintha kusintha kwa moyo. Mtolo waukulu m'nthaŵi ino ndi bile ducts ndi chiwindi, zomwe zimayenera kulipira kuti palibe limba. Panthawi imeneyi ndikofunikira kumamatira kudya, osati kudzipangira mankhwala. Kukonzekera kwachipatala komwe amavomerezedwa kuyenera kuikidwa ndi dokotala chifukwa cha kusowa kwa chola.
Pambuyo pa opaleshoni kuchotsa ndulu, kwa nthawi yaitali wodwala adzakumana ndi vuto ndi chopondapo, chomwe chidzachira pamene thupi limasintha. Pambuyo pa miyezi 4-6 munthu akhoza kukhala ndi moyo wodziwa bwino, koma panthawi imodzimodziyo ayenera kutsatira zozoloŵera zakudya mpaka kumapeto kwa masiku ake. Kusokonekera kwa zakudya kudzachititsa kuti zisamve bwino m'matumbo, zovuta ndi chinsalu, kupweteka m'dera la epigastric.
Kuchotsedwa kwa biliary - nthawi yopuma
Cholecystectomy yogwira ntchito ndi njira zophweka zopaleshoni. Pambuyo pa kuchotsedwa kwa ndulu, wodwalayo amasungidwa m'chipinda cholandira chithandizo kwa maola angapo pansi pa kuyang'aniridwa ndi adokotala. Pambuyo maola asanu, wodwala amaperekedwa kukwera mosamala, ndipo pambuyo pa maola 6-7 mukhoza kudya pang'ono. Tsiku lotsatira wodwalayo ayenera kuyamba kusuntha pang'ono. Pambuyo pa masiku angapo, wodwala wachotsedwa pamtsinje, ndipo, ngati palibe vuto, amamasulidwa tsiku lachitatu. Nthawi yonseyi ndi miyezi itatu yotsatira wodwalayo ali pa zakudya zodyera.
Kuchiza pambuyo pa kuchotsedwa kwa gallbladder
Mankhwala atachotsedwa kuchotsa ndulu ndi kuchepetsedwa. M'masiku oyambirira, madokotala angathe kupereka mankhwala opweteka ngati wodwalayo akuvutika kwambiri. Ndi spasm ya tsamba la biliary, spasmolytics ikhoza kulamulidwa kwa kanthawi. Pofuna kukonza malo a bile, mankhwala omwe amapezeka ndi ursodeoxycholic asidi amagwiritsidwa ntchito:
- Hepatosan;
- Ursosan ;
- Enterosan;
- Ursofalk.
Kudya pambuyo pa kuchotsedwa kwa gallbladder
Zakudya zabwino pakatha kuchotsedwa kwa ndulu zimakhudza nthawi ya kuchira ndipo zimapangitsa kuti wodwalayo akhale ndi moyo wabwino. Odwala omwe asiyidwa opanda ndulu amafunika kudziwa zomwe angadye atachotsa ndulu, ndipo amadya magawo 6 pa tsiku. Izi zidzathandiza kupanga mapangidwe a bile ndi kuteteza njira zowonjezera. Gawo la ola lisanayambe kudya, ndikofunika kumwa madzi, ndipo tsiku lonse ndibwino kumwa madzi okwanira 2 malita a madzi oyera.
Chakudyacho chiyenera kukhala chofunda, kuti asakwiyitse kagayidwe ka zakudya. Zakudya pambuyo pochotsa gallstone zambiri zimasonyeza kuti simungadye. Menyu pambuyo pa kuchotsedwa kwa gallbladder ayenera kukhala oyenerera ndipo ali ndi osachepera chiwerengero cha zinthu zoterezi:
- mafuta ndi zakudya zam'chitini;
- chakudya ndi mafuta a mafuta;
- maswiti ndi confectionery;
- mbatata;
- macaroni;
- zakumwa zoledzeretsa.
Mgonero wa tsiku ndi tsiku ukhoza kukhala ndi mbale:
- Chakudya cham'mawa: albumen omelet, mkaka pa mkaka, tiyi.
- Chakudya cham'mawa chachiwiri: gawo la kanyumba tchizi, msuzi wa mbumba.
- Chakudya: Chakudya cha kirimu ndi kuwonjezera kwa chimanga, chidutswa cha nkhuku yophika kapena chophimba, karoti puree, zakudya zopatsa zipatso.
- Zosakaniza: apulo wophika, ndi kanyumba tchizi ndi uchi.
- Chakudya chamadzulo: phala yamadzi, mbatata yosenda, nsomba yophika, tiyi.
- Chakudya chotsirizira: zakudya zopatsa zipatso, kefir.
Kuchotsa ndulu - zotsatira
Mulimonse mmene opaleshoni imachitikira, thupi limakhala ndi nkhawa komanso limakhala ndi nthawi yokonzanso kayendedwe ka thupi. Ngati wodwalayo atapangidwa cholecystectomy, vuto lidzatchulidwa mu nthawi yoyamba yopita patsogolo. Wodwala adzamva kupweteka komanso kupweteka, kupweteka kwa mtima, kupweteka m'mimba, adzakhala ndi mavuto ndi chitsime. Pang'onopang'ono, malingaliro ameneŵa adzachepa.
Kuchepetsa vutoli kumakhudzana ndi tsamba la m'mimba:
- kupweteka ;
- gastritis;
- chiwindi;
- kupweteka kwa sphincter wa Oddi;
- reflux.
Pa mavuto atatha opaleshoni kuchotsa ndulu ndi kufunikira kwa chithandizo chamankhwala mwamsanga zimasonyeza zizindikiro zotere:
- kutentha kwakukulu;
- zowawa;
- chikwangwani cha chikasu cha maso;
- icteric khungu.