Habka ugu muhiimsan ee ugu haboon ee daaweynta ee cholelithiasis maanta waa cholecystectomy - qalliin looga hortago gallbladder. Laakiin nidaamkani mar walba ma baabi'iyo calaamadaha xanuunka caloosha, taas oo muujinaysa qaabka xanuunka iyo qoyaanka dyspeptic. Tani waa cilladda postcholecystectomy syndrome (PHC).
Sababaha loo yaqaan 'postkolinsstectomy syndrome'
Sababaha ugu badan ee PCHP waa:
- dhaawaca faafidda cududda qalafsan;
- cyst ee xuddun bile;
- dhagaxyada xiidmaha;
- cudurka beerka;
- joojinta xitaa;
- tayada jidhka ee dhismaha dhagax.
Ka dib marka la saaro qashinka, xitaa galaan xiidmaha, taas oo sabab u ah dheef-shiid kiimikaadka ah oo la gooyey iyo natiijada dheellitirka microflora mindhicirka ayaa dhacaya. Sidaa darteed waxaa jira dareen xanuun.
Ciladeynta cilladda postcholinsstectomy syndrome
Xogta ugu muhiimsan waxay ka socotaa endoscopeic retrograde cholangiopancreatography iyo manometry of Oldy sphincter. Laakiin qalabka loogu talagalay in lagu sameeyo baadhitaanka noocan oo kale ah kaliya ayaa ku yaal xarumaha cilmi-baarista.
Imtixaanada shaybaarka ugu badan ee go'aamiya heerka:
- bilirubin;
- gamma glutamyl transferase;
- fosfatase alkaline;
- daaweynta xiniinyaha iyo aspartic;
- amylase ;
- ciriiri;
- lipase.
Imtixaanada shaybaarkan waxaa lagula talinayaa in lagu fuliyo inta lagu jiro, ama 6 saac gudahood ka dib weerarka soo socda.
Astaamaha calaamadaha postcholinsstectomy syndrome
Calaamadaha PCHP:
- xanuunka dhinaca dhinaca midig iyo qaybta epigastric, taas oo sidoo kale siin karto gobolka ee scapula midig iyo dhabarka;
- cudurada dheefshiidka ee kala duwan oo muujiya lallabada, suuxdinta, caloosha, shubanka, dareenka dhadhanka qadhaadh ee afka;
- sidoo kale muuqaalka cagaarshow.
Qeybinta cilladda postcholinsstectomy syndrome
Ma jiraan hal qeexid oo ah PCHP maanta. Inta badan isticmaalaan nidaamkan sida:
- Dhicinta papillitis duodenal ah.
- Cadaadiska xayawaanka (Cholepancreatitis).
- Nidaamka adhaha oo firfircoon (peritonitis xaddidan) ee degaanka subhepatic ah.
- Dib u soo noqoshada dhismaha dhagxaanta xaydha xitaa.
- Boogaha gaduudan ee secondary-ka ah (biliary ama hepatogenic).
Daaweynta cilladda postcholinsstectomy syndrome
Cabbiraadyada daaweynta PHC waa in loola jeedaa in laga takhaluso cilladahan ama qaabdhismeedyada ka yimaada mareenka caloosha, xuubka, dheecaanka iyo xameetada oo keena xanuun.
Mid ka mid ah tallaabooyinka daaweyntu waa cunto jajab ah (ilaa 6-7 jeer maalintii). Isla mar ahaantaana leh cilladda post-choledocystectomy syndrome, cuntada ayaa la muujiyaa - googo, badeecado, qallajin, oo la cabo ayaa si buuxda looga reebay.
Marka ay jirto jirro maskaxeed, waxaa suurtagal ah in la qoro daawooyinka xanuunka, sida:
- Mebeverin;
- Drotaverine.
Haddii sababtu tahay xanuun aan fiicnayn, markaa daawooyinka enzyme waxaa loo qoraa si loo hagaajiyo dheefshiidka, sida:
- Panzinorm forte;
- Festal;
- Creon .
Haddii la dhiso ka dib markii qaliinka kadib laga saaro cirbadda, boogooshka mindhicirka waa la gooyey, kadibna daawooyinka ayaa loo qoraa si loo soo celiyo microflora caadiga ah ee mindhicirka. Isla mar ahaantaana,
- Furazolidone;
- Intetriks;
- Doxycycline.
Lacagahan waxaa la qaataa 5-7 maalmood, ka dibna daawooyinka xaddidaya mindhicirka leh bakteeriyada waxtarka leh:
- Linex;
- Bifidumbakterin iyo kuwo kale.
Lix bilood ka dib qaliinka, waa in bukaanadu hoos yimaadaan kormeerka dhakhtarka.