Le ha litho tsena e le likarolo tse arohaneng tsa tšilo ea lijo, ho na le kamano e haufi pakeng tsa tsona. Khafetsa, lits'ebetso tsa "pathological" ho e 'ngoe ea litho li lebisa ponahalong ea mafu ho a bobeli. Mohlala, lefu la gallstone hangata le lebisa ho nts'etsopele ea "pancreatitis" - ho ruruha ha lithane tsa pancreatic.
Mabapi le sena, ho na le tlhoko ea ho fumana hore na gallbladder le manyeme li hokae, li sebelisana joang le hore na li-pathologies tse tebileng li ka thibeloa joang.
Sebaka le ts'ebetso ea gallbladder
Mekholutsoane e karolong e ka ntle ea karoloana e ka letsohong le letona ea sebete. E tshwana le sebopeho sa peere kapa khoune. Boholo ba setho bo ka bapisoa le lehe le lenyenyane la khoho. E shebahala joalo ka mokotla o lutlang.
Sebopeho sa anatomical sa setho se arotsoe ka mokhoa o tlase (karolo e atolositsoeng), 'mele (karolo e bohareng) le molala (karolo e moqotetsane) ea mokokotlo. Hape ho na le li-ducts tsa hepatic le cystic, tse kopantsoeng ho ba duct e tloaelehileng ea bile bolelele ba cm 6. Molala o fihla ho 3.5 cm ka moleng oa cystic. Ho sebelisa boreleli ba mesifa e boreleli (Lutkens sphincter), bile le lero la pancreatic li romelloa ho duodenum 12.
Bile e sirelelitsoeng ke lisele tsa sebete e kena ka mpeng. Karolo ea bobeli e bokellana ka har'a botoneng. Ke mokelikeli o motala oa viscous. Kaha metsi a kenella 'meleng, khatello ea bile e eketseha makhetlo a' maloa. E na le bilirubin, cholesterol, pigment ea bile le asiti.
Ka letsatsi la 1, hoo e ka bang 1,500 ml ea bile e hlahisoa 'meleng oa motho. Ts'ebetso ea eona e ka sehloohong ke ho nka karolo ts'ebetsong ea tšilo ea lijo: bile ke sesosa sa ts'ebetso ea mefuta eohle ea li-enzyme, haholo-holo lipase. Ntle le moo, bile e etsa mesebetsi e joalo 'meleng:
- roba mafura ho limolek'hule tse nyane tse eketsang sebaka sa ho ikopanya le mafura ka li-enzyme;
- ntlafatsa motility, ho monya vithamine K le mafura;
- E na le phello ea bactericidal mme e thibela mekhoa ea ho bola.
Ha lijo li kena ka mpeng le duodenum, sebete se qala ho boloka bile e le ngata.
Letšoele la nyooko le bapala karolo e 'ngoe ea polokelo ea bile. Ha e khone ho boloka mokelikeli o mongata oa metsi - ke 60 ml feela. Leha ho le joalo, bile e kenang ka har'a setho sena e kenella haholo. Letšoao lena le feta makhetlo a 10 mahloriso a bile a sa tsoa hlahisoa ke sebete.
Kahoo, gallbladder e sebeletsang, eo ka ho eketsehileng e kenang ka mpeng, e etsa 1/3 ea bolo ea letsatsi le letsatsi ea bile e hlahisoang.
Sebaka le ts'ebetso ea manyeme
Makhopho ke karolo ea glandular e etsang mesebetsi ea endocrine le exocrine.
E sebakeng sa peritoneum ka morao ho mpa kahara sebaka sa epigastric pela spleen. Karolo ea eona e ka letsohong le letšehali e kena ho hypochondrium e ka letsohong le letšehali. Mokotla oa gland o arola mpa le manyeme. Setho sa kamorao se haufi le methapo le aorta.
Makhopho a makhopho a na le likarolo tse 'maloa - hlooho,' mele le mohatla. Karolo e bolotsana ea setho ke litlamorao tse tlotsitsoeng tse bulehelang khanya ea duodenum. Mona ke moo lero la pancreatic, le hlokahalang bakeng sa ts'ebetso ea tšilo ea lijo, le fumana. Karolo ea endocrine e na le lihlekehleke tsa manyeme, tseo ho thoeng ke lihlekehleke tsa Langerhans, tseo palo e kholo ea tsona e leng mohatleng oa manyeme.
Makhopho a etsa mesebetsi e mengata ea bohlokoa, a arotsoe ka karolo ea kantle (endocrine) le ea ka hare (exocrine).
Mosebetsi oa sephiri oa Intra - taolo ea boemo ba tsoekere le metabolism. Lihlekehleke tse ka bang limilione tse 3 tsa Langerhans li teng sehlopheng sena. Li na le mefuta e mene ea lisele tse kenyelletsang ho laola bongata ba tsoekere maling. Mofuta o mong le o mong o ikarabella bakeng sa tlhahiso ea li-hormone tse itseng:
- Lisele tsa alfa secrete glucagon, e eketsang tsoekere.
- Lisele tsa Beta li hlahisa insulin, e fokotsang tsoekere.
- Lisele tsa Delta li hlahisa somatostatin, e laolang mosebetsi oa lisele tsa alpha le beta.
- Lisele tsa PP li hlahisa pancreatic polypeptide (PPP), e hatellang secretion ea setho le e tsosetsang sephiri sa lero la gastric.
Ts'ebetso ea exocrine ke ts'ebetso ea tšilo ea lijo. Makhopho a pancreas ke mohloli oa li-enzyme tse khethehileng tse thusang ho theola lik'habohaedreite (hangata e le sesepa), liprotheine le lipids (mafura).
Mmele o hlahisa li-enzyme ka sebopeho se sa sebetseng se bitsoang proenzymes, kapa proenzymes. Ha ba kena duodenum 12, enteropeptidase e ba qobella, ba etsa amylase (bakeng sa ho phatloha ha lik'habohaedreite), proteinase (ea liprotheine) le lipase (bakeng sa mafura).
Li-enzyme tsena kaofela ke karolo ea lero la pancreatic, le amehang ho cheng lijo.
Lefu la Gallbladder
Li-pathologies tse atisang ho utluoa tsa gallbladder ke lefu la gallstone, cholecystitis, hammoho le polyps le dyskinesia ea setho.
Ka lefu la gallstone, majoe (majoe) a bopa ka metsong le ka har'a eona. Hajoale, batho ba linaha tse tsoetseng pele ba fetang 10% ba tšoeroe ke lefu lena.
| Lintho tse kotsi | Age, bong (basali ba kotsing ea ho feta), boima bo fetang tekano, hepatic choledoch stenosis le cysts, cirrhosis, hepatitis, parapapillary diverticulum ea duodenum 12, hemolytic anemia, tlhekefetso ea lijo tsa protheine. |
| Matšoao | Lefu lena le asymptomatic ka nako e telele (lilemo tse 5-10). Matšoao a sehlooho ke jaundice, colic ea biliary, bohloko ba sebopeho sa tlhaho, litlhaselo tsa angina. |
| Phekolo | Lijo tsa bohlano 5, tšohanyetso wave lithotripsy, cholecystectomy (ho tlosoa hoa setho), ho nka litokisetso tsa bile acid. |
Cholecystitis hangata hangata ke phello ea lefu la gallstone, moo microflora ea methapo e hlahisoang mme tlhahiso ea bile e ferekanngoa. Ka lebaka leo, ho ruruha gallbladder ho etsahala.
Lefu lena le ka hlaha ka tsela e sa foleng le e bohloko. Acute cholecystitis e arotsoe ka mefuta e mengata:
- catarrhal (e baka bohloko bo boholo ho epigastrium le hypochondrium);
- phlegm (bohloko bo bonoa esita le ka phetoho ea maemo, ho hema le ho khohlela, motho o na le bothata ba ho tachycardia le mocheso oa febrile);
- gangrenous (phokotseho e kholo ea boits'ireletso, setšoantšo se tsebahalang sa kliniki).
| Mabaka | Ho etsoa ha majoe ho bakang bile ho bonahala ka libaktheria tse kotsi. |
| Matšoao | Acute cholecystitis: bohloko bo bohale bo fuoang hypochondrium, epigastrium, mokokotlo o tlase, lehetla la mahetla, lehare le letsohong le letona, litlhaselo tsa ho nyekeloa le pelo le ho hlatsa, hyperthermia, tachycardia, bloating, lehlakore le letona la peritoneum nakong ea palpation ke mokhoa o ts'oanang. K'holera ea cholecystitis: ho nyekeloa ke pelo, bohloko bo bobebe ho hypochondrium e nepahetseng, lera le matla la ho opa ha bohloko hoseng haholo le bosiu, jaundice. |
| Phekolo | Kamohelo ea lithibela-mafu, phepo e khethehileng, antispasmodics, molumo oa duodenal, cholecystectomy. |
Ho bohlokoa ho hlokomela hore maemong a 99%, ho tlosoa ha gallbladder ho tlosa mathata afe kapa afe. Manolo a entsoeng ha a ame hantle tšilo ea lijo le mosebetsi oa bohlokoa oa motho ka kakaretso.
Pathology ea manyeme
Mafu a atileng ka ho fetisisa a pancreatic ke pancreatitis le lefu la tsoekere, pseudocysts, leoplasms e bohloko le cystic fibrosis ha e fumanoe hangata.
Pancreatitis ke mofuta o rarahaneng oa syndromes moo ho ruruha makhopho a tsoang teng.
Sena se bakoa ke ts'ebetso ea li-enzyme tšoelesa ka boeona. Ka lebaka leo, ha ba qetelle ka duodenum mme ba qala ho cheka gland ka boeona. Ho na le mefuta e 'maloa ea pancreatitis:
- purulent (ho ruruha ha phlegmous, sebopeho sa li-macro- le microabscesses);
- biliary (ho ruruha ha manyeme ka tšenyo ea sebete le pampitšana ea mala);
- hemorrhagic (timetso ea parenchyma le sebopeho sa methapo);
- joala bo bobebe (bo hlaha ka joala bo le bong kapa bo sa khaotseng).
| Mabaka | Ho itšetleha ka joala nako e telele, ho tsuba, ho nona khafetsa, ho hlekefetsoa ka lijo tsa protheine, lefu la gallstone, ho sebelisa meriana e itseng, biliary duct dyskinesia, cholecystitis, lesapo la duodenal, hepatitis B le C, tlhaselo ea helminthic, cytomegalovirus. |
| Matšoao | Pancreatitis e hlobaetsang: bohloko bo boholo ba epigastric (hangata ho pota-pota), ho hlatsa, bofokoli, hyperthermia, ho pepeseha hoa letlalo, botenya, ho qhekella kapa lets'ollo (dikarolo tsa lijo tse sa koaeloang ke letho li bonoa setulong). Pancreatitis e sa foleng: matšoao a bonolo, bofokoli bo phehellang, ho tsekela le ho nyekeloa ke pelo. |
| Phekolo | Li-enzymatic agents, li-enterosorbents, li-probiotic, antispasmodics, painkillers le antidiarrheals, li-mineral complex tsa vitamini-mineral. Ka ponts'o ea pancreatitis e matla ea matsatsi a 2, ho itšoaetsa lijo tsa kalafo ho laetsoe, joale - lijo No. 5. |
Lefu la tsoekere ke lefu le bonoang ke seoa sa lekholong la bo21 la lilemo. E tšoauoa ka karolo (mofuta II) kapa e felletseng (mofuta II) e emisang tlhahiso ea insulin. Ka lebaka leo, ho na le keketseho ea tsoekere ea mali.
| Lintho tse kotsi | Phello ea lefutso, ho nona ho feta tekano, boimana bo sa sebetseng, ho hlohlona ha pancreatic, tšoaetso ea vaerase. |
| Matšoao | Polyuria, lenyora le sa khaotseng, ho tenoa le ho tsitsipana ha lintho, e fokotse mahlo, ho fokola, ho teneha, ho tsekela, hlooho e bohloko, tsamaiso e sa sebetseng ea ho ikatisa (mathata a ho ilela khoeli le mathata a potency). |
| Phekolo | Phekolo ea insulin, lithethefatsi tsa hypoglycemic, lipapali. |
Thibelo ea mafu a tšilo ea lijo
Ho na le lintlha tse ngata tse amang mosebetsi oa gallbladder le manyeme.
Kaha mosebetsi oa gallbladder le manyeme o amana haholo, o hloka ho tseba ho sireletsa litho tsena litlamorao tsa lintho tse mpe tse kantle.
Lisosa tsohle tsa pherekano ts'ebetsong ea litho tsena li na le moelelo o fapaneng, mme bakeng sa ho felisoa ha tsona motho o lokela ho latela melao le litlhahiso tse itseng.
Mehato ea thibelo e kenyelletsa litlhahiso tse latelang tse tsebahalang:
- Thibelo ho ja lijo tse nang le mafura, tse letsoai, tse tsubeloang, tse khaotsoang le tse nang le lik'habohaedreite. Ho pheha ho lokela ho belisoa, ho apehoe kapa ho phehiloe.
- Taolo ea boima ba 'mele le bophelo bo mafolofolo. Motho ka mong o lokela ho tsamaea bonyane metsotso e 3040 ka letsatsi. Ka nako e ts'oanang, mosebetsi le phomolo li lokela ho fetoha.
- Ho qoba ho thothomela ho matla maikutlong. Joalo ka ha u tseba, khatello ea maikutlo ke sesosa sa maloetse a fapaneng a batho, haholo tšilo ea lijo.
- Itokisetse ho sebelisa mekhoa e meng ea ho etsa lipatlisiso e tla thusa ho tseba liphetoho tse tlang ka nako ea manyeme kapa mothong.
Ntho ea bohlokoa haholo ke phepo e nepahetseng ea phepo. Motheo o nkuoa linomoro tsa 5 tsa lijo ho latela Pevzner.
Ho thibela nts'etsopele e tsoelang pele ea pancreatitis kapa cholecystitis, ho hlokahala ho kenya lihlahisoa tse bonolo lijong. Tabeng ena, meroho e nkuoa hamolemo ka mokhoa o phehiloeng kapa oa grated.
Lijo li arotsoe ka makhetlo a 5-6, mme likarolo e lokela ho ba tse nyane. E lumelloa ho ja lijo tsa mocheso o mahareng, eseng tse chesang haholo kapa tse batang. Karolong ea lijo ea 5 le pancreatitis, o ka kenya lihlahisoa tse latelang:
- mefuta e fokolang ea nama le litlhapi tse tlaase;
- lebese la skim le lihlahisoa tsa lona;
- litholoana tse omisitsoeng, monokotsoai, liapole le libanana;
- leha e le efe lijo-thollo le sopho ea meroho;
- oli e meng ea meroho;
- litapole, tamati, likomkomere, li-beet;
- bohobe ba maobane, li-cookies tsa Maria;
- tee e tala, rosehip moro, kissel, uzvar.
Ho ke ho hlokomeloe hore maloetse a mokokotlo o fumanoe hangata haholo ka lebaka la bophelo bo sa sebetseng, khaello ea phepo e nepahetseng le boteng ba boima bo feteletseng ho batho ba bangata.
Ho hlohlona ha letlalo la pancreatic le nyooko ho lokela ho phekoloa ka meriana le ho buuoa. Ha ho meriana ea setso e ka folisang lefu lena.
Litšobotsi tsa anatomical tsa sebete, lesapo la mokokotlo le manyeme li tšohloa videong ena.
