Ngakhale ziwalozi ndizophatikiza pazakudya zamagetsi, pali mgwirizano wapakati pawo. Nthawi zambiri, njira za pathological mu chiwalo chimodzi zimatsogolera ku kuwoneka kwa matenda wachiwiri. Mwachitsanzo, matenda a gallstone nthawi zambiri amabweretsa kukula kwa kapamba - kutupa kwa minofu ya kapamba.
Pankhaniyi, pakufunika kudziwa komwe gallbladder ndi kapamba amapezeka, momwe amagwirira ntchito komanso momwe ma pathologies omwe angalepheretsedwe.
Malo ndi ntchito ya ndulu
Ndondomeko ya gallbladder ili mu gawo lakunja kwa gawo lamanjawo lamtali la chiwindi. Chimafanana ndi mawonekedwe a peyala kapena chulu. Kukula kwa limba titha kufananizira ndi dzira laling'ono la nkhuku. Chimawoneka ngati thumba loyambira.
Kapangidwe ka thupilo kamakhala gawo logawika pansi (gawo lokwakulitsidwa), thupi (pakati) ndi khosi (gawo lopendekera) la ndulu. Zina zomwe zilipo ndi zotumphukira za hepatic ndi cystic, zomwe zimaphatikizidwa mumtunda wamba wa 6-8 cm. Khosi limafika masentimita 3.5 mu cystic duct.Kugwiritsa ntchito minofu yosalala ya m'mimba (Lutkens sphincter), bile ndi pancreatic juice imatumizidwa ku duodenum 12.
Chomera chomwe chimasungidwa ndi ma cell a chiwindi chimalowa m'matumbo. Gawo lachiwiri limadziunjikira mu ndulu. Ndi madzi amadzimadzi obiriwira. Popeza madzi amalowetsedwa m'thupi, kuchuluka kwa ndulu kumachulukana kangapo. Muli bilirubin, cholesterol, bile pigment ndi ma acid.
Mu tsiku limodzi, pafupifupi 1,500 ml ya bile amapangidwa m'thupi la munthu. Ntchito yake yayikulu ndikutenga nawo gawo pazakudya: bile ndi chothandizira chomwe chimayambitsa mitundu yonse ya ma enzyme, makamaka lipase. Kuphatikiza apo, bile imagwira ntchito zotere mthupi:
- imaphwanya mafuta kumamolekyu ang'onoang'ono omwe amalimbikitsa malo okhudzana ndi mafuta ndi ma enzyme;
- timapitiriza matumbo motility, mayamwidwe a vitamini K ndi mafuta;
- Imakhala ndi bactericidal momwe ndipo imalepheretsa njira zowola.
Chakudya chikalowa m'mimba ndi duodenum, chiwindi chimayamba kupaka bile.
Chikhodzodzo ndima gawo lina la ndulu. Sitha kukhala ndi madzi ochuluka - 60 ml. Komabe, ndulu yolowa mu chiwalochi imakhazikika kwambiri. Chizindikirochi chimadutsa nthawi 10 za kuchuluka kwa bile komwe kumangopangidwa ndi chiwindi.
Chifukwa chake, gallbladder yomwe imagwira, yomwe imalowanso m'matumbo, imapanga 1/3 ya buku latsiku lililonse la bile.
Malo ndi ntchito za kapamba
Mpheteyi ndi chiwalo chamimba chomwe chimagwira ntchito za endocrine ndi exocrine.
Ili mu peritoneum kumbuyo kwa m'mimba m'chigawo cha epigastric pafupi ndi ndulu. Gawo lakumanzere limalowa mu hypochondrium yamanzere. Chikwama cha gland chimalekanitsa m'mimba ndi kapamba. Chiwalo chakumbuyo chapafupi ndi mitsempha ndi msempha.
Zikondamoyo zimakhala ndi magawo angapo - mutu, thupi ndi mchira. Gawo lokhala ndi chiwalochi ndi zimbudzi zobisika zomwe zimatseguka ndikuwala kwa duodenum. Apa ndipomwe madzi a pancreatic, ofunikira pakugaya, amapeza. Gawo la endocrine limakhala ndi zisumbu za kapamba, zomwe zimadziwika kuti zilumba za Langerhans, zomwe zimapezeka mchira wa kapamba.
Zikondazo zimagwira ntchito zambiri zofunika, zogawanika kukhala zakunja (endocrine) komanso mkati (exocrine).
Intra secretory function - kuwongolera shuga komanso kagayidwe kachakudya. Pafupifupi mamiliyoni atatu a zilumba za Langerhans alipo mgulu ili. Muli mitundu inayi ya maselo omwe amathandizira kuwongolera kuchuluka kwa shuga m'magazi. Mtundu uliwonse umakhala ndi udindo wopanga mahomoni enaake:
- Ma cell a Alpha secrete glucagon, omwe amathandizira shuga.
- Maselo a Beta amatulutsa insulin, yomwe imachepetsa shuga.
- Maselo a Delta amatulutsa somatostatin, yomwe imayang'anira ntchito ya alpha ndi beta cell.
- Maselo a PP amatulutsa pancreatic polypeptide (PPP), yomwe imachepetsa kubisala kwa chiwalo ndikuwonjezera kubisika kwa madzi a m'mimba.
Ntchito ya exocrine ndiyo njira yogaya chakudya. Mapaipi amapangira michere yapadera yomwe imathandizira kugwetsa chakudya (nthawi zambiri yovuta), mapuloteni ndi lipids (mafuta).
Thupi limapanga ma enzymes osagwira ntchito yotchedwa proenzymes, kapena proenzymes. Akalowa mu duodenum 12, enteropeptidase imayambitsa, ndikupanga amylase (pakuwonongeka kwa chakudya), proteinase (ya mapuloteni) ndi lipase (yamafuta).
Ma enzymes onsewa ndi gawo la madzi a pancreatic, omwe amathandizira kugaya chakudya.
Matenda a gallbladder
Kawirikawiri zomwe zimapezeka m'matumbo a gallbladder ndi matenda a ndulu, cholecystitis, komanso polyps ndi organ dyskinesia.
Mu nthenda ya ndulu, miyala (miyala) imapangika m'miyendo ndi ndulu. Pakadali pano, opitilira 10% a mayiko otukuka amadwala matendawa.
| Zowopsa | Age, jenda (azimayi atengeke kwambiri), onenepa kwambiri, hepatic choledoch stenosis ndi cysts, cirrhosis, hepatitis, parapapillary diverticulum wa duodenum 12, hemolytic anemia, ozunza mapuloteni. |
| Zizindikiro | Matendawa ndi asymptomatic kwa nthawi yayitali (zaka 5-10). Zizindikiro zazikulu ndi jaundice, colic biliary, kupweteka kwa chikhalidwe chodulira, angina akuwukira. |
| Chithandizo | Zakudya No. 5, kugwedeza kwamphamvu lithotripsy, cholecystectomy (kuchotsedwa kwa ziwalo), kukonzekera bile acid. |
Cholecystitis nthawi zambiri imayamba chifukwa cha matenda a gallstone, momwe microflora yam'magazi imapangidwa ndipo kutuluka kwa bile kumasokonezeka. Zotsatira zake, kutupa kwa ndulu kumachitika.
Matendawa amatha kuchitika nthawi zonse komanso mawonekedwe. Acute cholecystitis amagawika m'mitundu ingapo:
- catarrhal (kuchititsa kupweteka kwambiri mu epigastrium ndi hypochondrium);
- phlegm (kupweteka kumawonedwa ngakhale ndikusintha kwa malo, kupuma ndi kutsokomola, munthu ali ndi vuto la tachycardia ndi kutentha kwa thupi);
- gangrenous (kuchepa kwakukulu kwa chitetezo chokwanira, chithunzi chodziwika bwino chachipatala).
| Zifukwa | Kupangidwe kwa miyala yomwe imayambitsa kukondoweza kwa bile ndikuwoneka mabakiteriya owopsa. |
| Zizindikiro | Pachimake cholecystitis: ululu wakuthwa womwe umaperekedwa kwa hypochondrium, epigastrium, m'munsi kumbuyo, lamba lamapewa, phewa lakumanja ndi khosi, kuukira kwa mseru komanso kusanza, hyperthermia, tachycardia, kutulutsa, mbali yakumanja kwa peritoneum nthawi yamkamwa ndi kwakanthawi. Matenda a cholecystitis: nseru, ululu wosakhazikika mu hypochondrium, chiwindi colic, zovuta zam'mawa ndi usiku, jaundice. |
| Chithandizo | Kulandila kwa maantibayotiki, zakudya zapadera, antispasmodics, phokoso la duodenal, cholecystectomy. |
Ndikofunika kudziwa kuti mu 99% ya milandu, kuchotsedwa kwa ndulu kumathetsa mavuto aliwonse. Zomwe zimapangidwira sizimakhudza chimbudzi ndi ntchito yofunika ya munthu wonse.
Matenda a kapamba
Matenda ofala kwambiri a kapamba ndi kapamba komanso matenda a shuga.
Pancreatitis ndi zovuta pama syndromes pomwe kutupa kwa kapamba kumachitika.
Izi ndichifukwa cha kutsegula kwa ma enzymes mu gland yakeyo. Zotsatira zake, sizimakhala mu duodenum ndikuyamba kugaya gland palokha. Pali mitundu ingapo ya kapamba:
- purulent (kutupa kwa phlegmous, mapangidwe a macro- ndi microabscesses);
- biliary (kutupa kwa kapamba ndi kuwonongeka kwa chiwindi ndi m'mimba thirakiti);
- hemorrhagic (chiwonongeko cha parenchyma ndi mtima dongosolo);
- mowa pachimake (amapezeka ndi kumwa kamodzi kapena kosalekeza).
| Zifukwa | Kudalira kwa mowa kwa nthawi yayitali, kusuta fodya, kudya pafupipafupi, kugwiritsa ntchito mankhwala osokoneza bongo, matenda a gallstone, kumwa mankhwala ena, biliary duct dyskinesia, cholecystitis, zilonda zapakhosi za duodenal, hepatitis B ndi C, kukoka kwa helminthic, cytomegalovirus. |
| Zizindikiro | Pancreatitis pachimake: kupweteka kwambiri kwa epigastric (nthawi zambiri kuzunguliza), kusanza, kufooka, kuchepa kwa khungu, kutsekemera, kudzimbidwa kapena kutsekula m'mimba (chakudya chambiri komanso chosafunikira). Pancreatitis yayitali: Zizindikiro zofatsa, kufooka kosalekeza, chizungulire, ndi nseru. |
| Chithandizo | Othandizira enzymatic, enterosorbents, probiotic, antispasmodics, painkillers ndi antidiarrheals, vitamini-mineral complexes. Ndi chiwonetsero cha pachimake kapamba kwa masiku awiri, kusala kudya kwakhazikitsidwa, ndiye - zakudya No. 5. |
Matenda a shuga ndi matenda omwe amadziwika ndi mliri wa zaka za m'ma 2000 zino. Amadziwika ndi tsankho (mtundu II) kapena wathunthu (mtundu II) poletsa kupanga insulin. Zotsatira zake, pali kuwonjezeka kwa glucose wamagazi.
| Zowopsa | Matenda am'tsogolo, kunenepa kwambiri, kutenga pakati, kusowa kwa chimbudzi, matenda opatsirana ndi ma virus. |
| Zizindikiro | Polyuria, ludzu losalekeza, kumva kuwawa ndi kuzizira kwa malekezero, kuchepa kuwona kwakukalamba, kufooka, kusakwiya, chizungulire, kupweteka kwa mutu, kusokonekera kwa kubereka (kusamba kwa msambo komanso mavuto okhala ndi potency). |
| Chithandizo | Mankhwala a insulin, mankhwala a hypoglycemic, masewera. |
Kupewa matenda am'mimba
Pali zinthu zambiri zomwe zimakhudza ntchito ya ndulu ndi kapamba.
Popeza ntchito ya ndulu ndi kapamba ndizogwirizana kwambiri, muyenera kudziwa momwe mungatetezere ziwalozi kuchokera kuzinthu zoyipa zakunja.
Zomwe zimayambitsa chisokonezo pakugwira ntchito kwa ziwalozi zili ndi chiyambi chosiyana, ndipo pakuchotsa kwawo ayenera kutsatira malamulo ndi malingaliro.
Njira zodzitetezera zimaphatikizaponso malingaliro otsatirawa:
- Kuletsa zakudya zamafuta, mchere, utsi, zakudya ndi zakudya. Kuphika kuyenera kuwotchera, kuphika kapena kuwiritsa.
- Kuwongolera kunenepa kwambiri komanso kukhala ndi moyo wogwira ntchito. Munthu aliyense amayenera kuyenda osachepera mphindi 30 mpaka 40 tsiku lililonse. Nthawi yomweyo, ntchito ndi kupuma ziyenera kusinthana.
- Kupewa kugwedezeka mwamphamvu kwamalingaliro. Monga mukudziwa, kupsinjika ndi gawo la matenda osiyanasiyana amunthu, makamaka m'mimba.
- Konzekerani kudutsa njira zina zofufuzira zomwe zingakuthandizeni kuzindikira kusintha kwa matenda am'mapapo kapena chikhodzodzo.
Chofunika kwambiri ndizakudya zopatsa thanzi. Maziko amatengedwa zakudya nambala 5 malinga ndi Pevzner.
Popewa kupititsa patsogolo kwa kapamba kapena cholecystitis, ndikofunikira kuyambitsa zopatsa modekha muzakudya. Pankhaniyi, masamba amatengedwa bwino kwambiri mu mawonekedwe owiritsa kapena grated.
Chakudya chimagawidwa kukhala nthawi 5-6, ndipo magawo azikhala ochepa. Amaloledwa kudya chakudya chotentha wamba, osati chotentha kwambiri kapena chozizira. Pazakudya za 5 ndi kapamba, mutha kuyika zotsatirazi:
- mitundu yamafuta ochepa a nyama ndi nsomba;
- skim mkaka ndi zotumphukira zake;
- zipatso zouma, zipatso, maapulo ndi nthochi;
- mbewu zilizonse zamphesa ndi msuzi wamasamba;
- mafuta masamba;
- mbatata, phwetekere, nkhaka, beets;
- mkate wa dzulo, makeke a Maria;
- tiyi wobiriwira, msuzi wa rosehip, kissel, uzvar.
Tiyenera kudziwa kuti matenda am'mimba amadziwika kwambiri chifukwa cha moyo wopanda ntchito, kuperewera kwa zakudya m'thupi komanso kupezeka kwa kuchuluka kwa anthu ambiri.
Khunyu ya chikhodzodzo ndi ndulu imayenera kuthandizidwa ndimankhwala komanso opaleshoni. Palibe wowerengeka azitsamba omwe angachiritse matendawa.
Zinthu za chiwongola dzanja, chikhodzodzo ndi kapamba zimakambidwa kanema munkhaniyi.
