Izwi rokuti "gallbladder" rinotsanangura chero dambudziko rehutano rinokanganisa nduru.
Kunyange zvazvo chikonzero chinowanzokonzera chirwere chegurbladder chirwere chinonzi chirlelithiasis, pane zvimwe zvinokonzera, zvinosanganisira gallbladder inflammation (inonzi cholecystitis), biliary dyskinesia, inoshanda gallbladder chirwere, primary sclerosing cholangitis, uye chirwere chenduru.
Zvinowanzokonzera
Gallstones ndiyo inonyanya kuratidza zvirwere zve gallbladder uye chimiro sechikonzero chekuwanda kwecholesterol kana bilirubin (iyo pigment iyo inogadzirwa muropa kana masero matsvuku eropa akaparadzwa).
Gallstones ndiwo makristuru anogadzira mukati mejarbladder, iyo nhengo yakagadzirwa peiri iri kumusoro kwepamusoro kwebumbu rako pasi pechiropa chako. Chinangwa chako chikuru chenduru ndechekuchengetedza mvura inonzi fluid, inonzi bile, iyo inogadzirwa nechiropa. Bhiri inofanirwa kugadzira uye kudira mafuta uye mamwe mavitamini kubva pane zvokudya zvaunodya.
Necholesterol gorostones , yako bile "yakashungurudzika" necholesterol uye haikwanise kuiparadza sezvinowanzoita, saka mabwe akaita. Izhinji huzhinji hwevanhu vane mazamu ehurumende muUnited States vane majole echolesterol.
Nguruve mabhudzi anogona kuumba kana kune yakawanda kwazvo bilirubin. Zvirwere zvakadai se-cirrhosis (yakawanda kwazvo bilirubin inoumbwa nechiropa) uye sickle cell chirwere (apo masero matsvuku eropa akavhuniwa) anogona kukonzera marombo emagetsi.
Pakupedzisira, mabhuti anogona kuumba kana chirongo chisina kubvisa bile zvakanaka (inonzi bile stasis).
Zvimwe zvezvipingamupinyi zvinokonzera kukura kwemajenya zvinosanganisira:
- Mukadzi wechikadzi
- Zera rinopfuura 40
- Kuberekwa
- Kuwedzera muviri
- Zvokudya zvakanyanya mucholesterol, zvakanatswa nema carbohydrates (somuenzaniso, chingwa chakachena), nemafuta akazara (saizi, batare, uye nyama tsvuku)
- Sedentary lifestyle
- Kukurumidza kuora kurasikirwa
- Zvirwere zvirwere (somuenzaniso, chirwere cheshuga, chirwere chemagetsi, chirwere cheCrohn, chirwere chekristic, chirwere chengarava kana chirwere chepinini)
- Mishonga ine vesrogen, seminzwiro ekudzivirira pamuviri kana kuti hormone replacement therapy
- Mimwe mishonga yakadai seSandostatin (octreotide), Rocephin (ceftriaxone), uye thiazide diuretics seSyzizide (hydrochlorothiazide)
Zvinokonzera Zvinokonzera
Zvimwe zvinokonzera zvinokonzera chirwere chinonzi gallbladder.
Cholecystitis
Kuvhiringidza kwegorobladder (inonzi cholecystitis) inogona kukura semagumisiro emaronda (anonzi acute cholecystitis) kana zvisiri zvishoma, pasina mabhuni (anonzi acalculous cholecystitis).
Acute cholecystitis inowanikwa apo gorosi rinowanikwa mukati memharadzano ye cystic, inoita kuti guru rinoputika. Mukuwedzera kune zvinowanzoorwadza (biliary colic) yekuve negorosi, munhu angave ane fever, nenyuka, kurutsa, malaise, uye / kana kurasikirwa kwechido. Chimwe chetsvene chemasero eropa ropa chinowanzovapo.
Acalculous cholecystitis inokonzera zviratidzo zvakafanana uye zviratidzo sepute cholecystitis, zvisinei, hapana gorosi iripo. Pane kudaro, nyanzvi dzinofunga kuti izvi zvinokonzerwa ne gallbladder stasis uye ischemia (kusava neropa kutenderera).
Izvi zvinorwara zvirwere zvinowanzoitika kune vanorwara zvikuru.
Zvimwe zvinhu zvinowedzera mukana wemunhu wekuita acalculous gallbladder chirwere zvinosanganisira:
- Zvirwere zvakakomba (somuenzaniso, zvakanyanya myelogenous leukemia, AIDs, coronary heart disease, mwoyo kusagadzikana nechirwere cheshuga, chirwere chemagumo ekupedzisira, uye vasculitis)
- Burns
- Kubereka
- Yakadzingwa immune system
- Matambudziko makuru kana kushungurudzika
- Mamwe mishonga (somuenzaniso, opiates)
- Kuwedzera kuwedzerwa
- Mechanical ventilation
- Kuwana chikafu kuburikidza nemuviri wako (unonzi total parenteral nutrition)
Biliary Dyskinesia
Biliary dyskinesia inorondedzera chirwere chebiliary duct system kudzivirirwa kunoenderana nekushanda kusina kushandiswa kwe sphincter yeOdidi-chimiro chemasumbu chinopoteredza nzvimbo iyo yakazara bile duct inosangana ne pancreatic duct sezvavanopinda mudumbu duku.
Sezvo sphincter yeOdidi isingashandi zvakanaka muchirwere ichi, kudzivirira kwebhaariary kunogona kuitika. Izvi zvikamu zvepakati zvinokonzera mabhiriyari zvinokonzera maronda-sekurwadziwa-kunetseka, kunorwadza nguva dzose kumusoro kwepamusoro kana kuti kumusoro kwepamativi chikamu chemuviri.
Kunyange zvazvo dumbu re ultrasound rinogona kuratidza kufanana kwevanhu vakawanda, bvunzo inonzi sphincter yeOdidi manometry inogona kushandiswa kugadzirisa kuongorora bliyary dyskinesia. Kana sphincter yeOdidi yepamusoro yakakwirira (muedzo unofadza), munhu anogona kubviswa kwe sphincter (inonzi endoscopic sphincterotomy).
Hazvizivikanwi izvo zvinokonzera biliary dyskinesia. Zvinowanzoonekwa muvanhu vakave vakagumburwa vhudzi ravo; kunyange zvazvo huzhinji hwevanhu avo vakave vachibvisa vhudzi ravo vasingagoni kuwana biliary dyskinesia. Dzimwe nyanzvi dzakaratidza kuti chirwere ichi chinokonzerwa nekuputika kana kushungurudzika kwenzara kumutsipa we sphincter.
Functional Gallbladder Dambudziko
Basa rinoshandiswa nehutachiona hwehutano rinoreva vanhu vanoona kurwadziwa kwepabonde (kusanzwisisika mumusoro wepamusoro kana pakati penhengo yechimbuva) mukushaikwa kwegurustones kana kuti sphincter yeOdidi dysfunction.
Vanhu vane hutachiona hwehutachiona hwehutachiona vane chirwere chepachivi chepachena, pasina uchapupu hwekuputika kana dambudziko reropa. Ivewo ane chimiro chechidimbu chechirongo chisina uchapupu hwehutsinye.
Mushure mokutonga kunze kwemamwe mamiriro ezvinhu angafananidza marwadzo ejeri (somuenzaniso, chirwere chemwoyo chinonzi ischemic kana chirwere chepptic ulcer), munhu angapinda muedzo anonzi cholecystokinin (CCK) -stimulated cholescintigraphy kuti asimbise kuongororwa kweshoko gallbladder disorder.
Uyu muedzo unoyera chikamu cheejection ye gallbladder (yakawanda sei muchengeti anosiya ganda). Kana chikamu che ejection chiri pasi, seasingapfuuri makumi mana kubva muzana, muedzo unotsigira kuongororwa kwebasa rinonzi gallbladder disorder. Kurapa kwechirwere ichi kunosanganisira kubviswa kwegorobladder (inonzi cholecystectomy).
Kunyange zvazvo zvisingazivikanwi, zvinogona kuti vanhu vane chirwere chepamuviri chemuviri chemuviri (somuenzaniso, chisina kuchena gastric vacting) chinogona kuva pangozi yekuvandudza kushanda kwegorbladder disorder.
Primary Sclerosing Cholangitis
Primary sclerosis cholangitis (PSC) chirwere chenguva refu chinotungamirira ku bile duct kupisa. Nemhaka yekusagadzikana kusuruvara, bile inobhururuka inosvibiswa, zvichiita kuti zviputike, saka bile haikwanisi kubuda. Somugumisiro, iyo bile inovaka mukati mechiropa, ichikuvadza masero eropa uye ichikonzera cirrhosis. Kana isingatarisirwi nechiropa chokupemha, PSC inogona kutungamirira kuchiropa uye / kana chirwere chenduru.
Chinhu chinonyanya kuisa pangozi yekusimudzira PSC ndechekushaya ulcerative colitis. Ichokwadi, ruzhinji rwevanhu vane PSC vane ulcerative colitis. Pamusoro peflip, nechepakati pezana yevanhu vane ulcerative colitis pakupedzisira inokudza PSC.
Gallbladder Cancer
Gallbladder kenza haigoneki uye inoitika apo masero ari mu gallbladder anokura nokukurumidza uye asingadzori.
Zvose mapurisa nemaronda eplerosis cholangitis zvinowedzera mukana wemunhu wekukura kenza yeguruva, kunyange zvazvo mavara emvura ari mazhinji kwazvo. Muzvokwadi, maererano neAmerican Cancer Society, vanenge vatatu kune vane vana vane kenza yeguruvladder vane gonye kana vakaonekwa.
Zvimwe zvinokonzera njodzi dzekuvandudza chirwere chenduru zvinosanganisira:
- Mukadzi wechikadzi
- Age akwegura
- Kuwedzera muviri
- Ethnicity (Mexican American kana Native America)
- Utachiona hweHIV hune hutachiona, Salmonella Typhi
- Tsvina mukati mejena bile duct
- Gallbladder polyps
- Abnormalities ye bile bile ducts
> Sources:
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> America Cancer Society. (2016). Ndeapi Zviitiko Zvengozi zveGallbladder Cancer?
> Catalano MF, Thosani NC. (2016). Chipatara zviratidzo uye kuongororwa kwe sphincter ye Oddi dysfunction. Howell DA (ed). UpToDate, Waltham, MA: UpToDate Inc.
> Jessri M, Rashidkhan B. Zviratidzo zvemuviri uye njodzi yekurwara nehutachiona: Chipatara-based case-control in vakadzi vakadzi vakuru. J Health Popul Nutriti. 2015 Mar; 33 (1): 39-49.
> Stinton ML, Shaffer EA. Epidemiology yeGallbladder Disease: Cholelithiasis uye Cancer. Gut Liver . 2010 Apr; 6 (2): 172-87.