Cholestasis yokukhulelwa: izimpawu, ukwelashwa, ukudla

Kuyinto imfihlo ukuthi ngesikhathi sokukhulelwa yomzimba wowesifazane ehlelwa umthwalo omkhulu kakhulu. Ngaphezu kwalokho, okukhulu ukushintsha kwama-hormone ngokuvamile kuholela ezinye izinkinga. Ngo umkhuba yesimanje azoya ngezinye izikhathi kwenzeka disorder ngokuthi cholestasis yokukhulelwa. In the ukungabikho ukwelashwa esifike ezifana isimo kungaba yingozi ngoba ingane ekhulayo futhi umzimba kamama.

Yingakho omama abaningi abalindele abanesifiso imibuzo mayelana siyini ngempela lesi sifo futhi kungani kwenzeka. Ziyini izimpawu eziyinhloko? Yini ukwelashwa ukunikela kwezokwelapha zanamuhla? Zikhona izindlela eziphumelelayo lokuvikela? Lolu lwazi kuyoba abafundi abaningi.

Kuyini cholestasis?

Cholestasis okukhulelwa - isifo okuyinto kuhambisana izilonda dystrophic kwezicubu isibindi. kuwukwephula okunjalo kwenzeka ngokumelene isizinda okwandisa nozwela hepatocytes nama-hormone ocansini, ezingeni zazo siyahluka kakhulu uthwele ingane. Waba yini umphumela walesi nqubo ukuphazamiseka izinqubo evamile cholesterol umzimba Bile acid. Njengomthetho, abesifazane kanye kokutshelwa ngokukhubazeka kwengane, ushintsho Bile, kanye ukuphazamiseka e ukugeleza of Bile, okuyinto ngenxa yalokho kuthinta wonke umzimba.

Omama abaningi abalindele ibhekene kokutshelwa ngokukhubazeka kwengane. Kodwa musa ngokushesha bethukile, ngoba ezikhathini eziningi nge hepatosis cholestatic (owaziwa nangokuthi isifo) hhayi angabhekana ngayo esebenzisa imithi olandelanayo ngaphandle kokudala yimuphi ukulinyazwa emzimbeni womuntu wesifazane noma ingane.

nokudlanga

Ngokushesha kuyafaneleka ukuthi lokhu nokuphulwa ngempela evame kakhulu kwamanye amazwe. Ngokwesibonelo, ngokuvumelana izifundo imininingwane eScandinavia, China, Bolivia futhi Chile ezifweni ezifana wahlupheka omama abaningi okhulelwe. Kodwa-akhawunti e-Sweden ku 10 000 kubantu besifazane abakhulelwe ngoba awekho amacala angaphezu kuka-40 yalesi sifo.

Ensimini ka Russia cholestasis ngesikhathi sokukhulelwa ke Uphinde abhekwe kwetintfo ayeyivelakancane - imvamisa yayo ingeqi 2%. Okukhishwayo kuphela ezisenyakatho yezwe, lapho isifo sitholakale kaningi. Ngokusekelwe kulezi idatha, abacwaningi basikisela ukuthi amaqembu ingozi zihlanganisa uhlanga wesifazane.

Ziyini izimbangela eziyinhloko zalokhu yesifo

Empeleni, namuhla akwaziwa kuze kube sekupheleni, kungani eba cholestasis intrahepatic yokukhulelwa. Kukhona mbono eziningi nocwaningo, ngakho singakwazi ukuhlukanisa ngezigaba ezintathu eziyinhloko yezinto:

• anda nozwela hepatocytes eqenjini lama-hormone ocansini, okuyinto ngenxa izici zofuzo;
• amaphutha esizalwa nawo wokuhle zamagama enzyme evamile, okunikeza ukuthuthwa izingxenye Bile kusukela hepatocytes phakathi Amapayipi Bile;
• amaphutha esizalwa nawo wokuhle evamile Bile acid zamagama elihlobene ne nokuntuleka enzyme ethile. Ngakwelinye ihlangothi, ukuphazamiseka esinjalo siholela kumiswa atypical Bile acid.

Kufanele kuqashelwe ukuthi iziguli ezine-yofuzo, noma ukuphazamiseka kwempilo azalwa naso cholestasis siyenzeka hhayi kuphela phakathi nenkathi yokukhulelwa, kodwa futhi nanoma yimuphi ushintsho izinga lama-hormone ocansini (isibonelo, esesikhathini, ukusetshenziswa zokuvimbela inzalo temlomo).

I pathogenesis ka cholestasis. Kwenzekani lapho ugula?

Cholestasis yokukhulelwa kuhambisana ukwephulwa ezinkulu ezintathu:

• ukhulisa izinga izingxenye Bile egazini;
• nokwehlisa uketshezi emathunjini;
• imiphumela ezinobuthi of Bile kumaseli isibindi Amapayipi biliary.

Ukuphazamiseka synthesis evamile futhi outflow uketshezi ekhiqizwa isibindi, ngenxa waba ukwanda okukhulu kwezincwadi ezingeni of progesterone futhi estrogen. Izinguquko ezinjalo, ngakho-hormone kancane ukuhamba engokwemvelo Bile, ngisho ngokukhulelwa evamile. Futhi uma kukhona ingozi kwasekuzalweni, izinguquko esiwohlozayo umzimba esihlungini kakhulu anda. Ngaphezu kwalokho, ama-hormone ngokweqile kuthinte indlala pituitary ukunciphisa umsebenzi wayo. Ngakwelinye ihlangothi, izinguquko umsebenzi le ndlala kuthinta inqubo yokukhipha kwesibindi bilirubin cholesterol. Lokhu kuholela ukuphazamiseka izindlela kumiswa futhi uketshezi of Bile.

Ukwahlukaniswa izifo

Kuze kube manje, kukhona izinhlelo eziningi ngezigaba ngalesi sifo. Ngokwesibonelo, kuye ngokuthi kobukhulu izimpawu, secrete amafomu imnene, ngokulinganisela futhi ezinzima zalesi sifo.

Ngu uhlobo notshwala cholestasis kungaba oyingozi noma ezingamahlalakhona (ekuthuthukiseni exacerbation izifo esingamahlalakhona ku ngemuva yokukhulelwa). Kuye etiology ukuhlukanisa extrahepatic (ithuthukiswe ngendlela isimiso we Amapayipi Bile) kanye cholestasis intrahepatic (lezi ifomu kwenzeka kwabesifazane abakhulelwe).

Cholestasis yokukhulelwa: izimpawu zesifo

Noma yimuphi ukuphambuka kusuka kuyinsakavukela kule nkathi ekuphileni ezidinga ukuhlolwa kanye neseluleko udokotela. Ngakho kubonakala sengathi cholestasis yokukhulelwa?

Izimpawu ngokuvamile ziqale izinkinga yokuthathu yesithathu (amasonto 28-35.). Ukubonakaliswa eyinhloko lesi sifo pruritus, futhi angase abe ntshashintshe of kobukhulu. Ezinye iziguli ukubekezelela kuhlukumeza lula, kanti abanye baphathwa njalo, ukungakhululeki ezibuhlungu.

Ukulunywa iba evelele ebusuku, okuholela nokungalali, futhi ngokulandelana, ukutubeka, ukucasuka, iziyaluyalu ngokomzwelo. Ngokuvamile lokhu umuzwa itholakala ku isikhumba izandla, ngemilenze, imilenze anterior udonga besisu. Cholestasis yokukhulelwa (izithombe zazo ethulwa lwemibhalo wezokwelapha) okuholela excoriation kwesikhumba, njengoba owesifazane babalimaze ngenxa ukunwaya njalo.

Ukuze uthole ezinye izimpawu zesifo zihlanganisa i-jaundice. Ngokocwaningo olwenziwa kwezibalo, kuba nokuphazamiseka esinjalo ebonwe 10-20% abesifazane. Njengomthetho, zonke izimpawu zinyamalale bebodwa emasontweni 1-2 emva kokuzalwa. Noma kunjalo, zingase kuqaliswe isizinda okwalandela ukwehluleka hormone (isibonelo, phakathi nenkathi yokukhulelwa wesibili).

izindlela eziyisisekelo uphethwe

Ephambi kwezinduna iyiphi kwezinso kufanele ngokushesha kudokotela. Uchwepheshe Okokuqala ukuqoqa umlando ephelele wezokwelapha kanye ukuhlolwa ngokomzimba. Kwamanye abesifazane, kungase kusho jaundice amancane staining isici amehlo sclera. Uma kubhekwa ngasohlangothini isikhumba ungase uphawule ububomvu, imihuzuko kubangelwa ukunwaya isikhumba.

Zonke lezi zimpawu abonisa ukuthi isiguli kungenzeka cholestasis yokukhulelwa. Ihlaziya of the lokuhlushwa serum Bile acid ziqinisekisa izinsolo khona iziyaluyalu esibindini. Kukhona futhi izifundo ezihlukahlukene kokuqukethwe kwamakhemikhali kanye umsebenzi enzyme isibindi. eboniswe Futhi ultrasound phakathi nalapho wazi ukwanda esinyeni nenyongo kanye olingene isibindi echogenicity iyunifomu.

lesi sifo kungaholela kwezinye izinkinga?

Zokwelapha zanamuhla babhekana nale nkinga ngokuthi cholestasis yokukhulelwa. Ingabe kuyingozi esimweni esinjalo? Yiqiniso, yebo. Nakuba konke kuncike kobukhulu inqubo sokugembula, uphethwe esikhethiwe therapy ne t. D.

Noma kunjalo, ingozi sihlala sikhona. Ukwephula imfundo nokuqeda Bile kuthinta izinqubo umzimba. Nge okungenzeka enjalo ephakeme isifo wazalwa kungakabi isikhathi. Ngaphezu kwalokho, amaphesenti kwangemva kokubeletha haemorrhage phakathi kwabesifazane kanye kokutshelwa ngokukhubazeka kwengane futhi siphezulu, ngenxa umzimba vitamin K futhi ezinye zezici coagulation.

Uma eziyimbangela yezinkinga ezizuzwa sina kwesibindi kukhona ingozi yokufa kwengane, ngakho kwezinye izimo, odokotela batusa ilethwe ngokushesha.

ukwelashwa ngesikhathi sokukhulelwa

Ukwelashwa incike ngobucayi isifo futhi izici ngamunye nesineke. Ngokuvamile kuqala linqume gepatoprotektory herbal ukuthi ukuvikela isibindi ekulimaleni futhi akulimazi umzimba. Ngokwesibonelo, "Hofitol" nge cholestasis yokukhulelwa linikeza imiphumela emihle. Ngaphezu kwalokho, izidakamizwa "Gepabene" lisetshenziswa therapy.

Ukwengezwa izidakamizwa yemifino zisetshenziswa futhi hepatoprotectors zokwenziwa ngokukhethekile "Ademethionine". Njengoba Antioxidants ekukhulelweni ebekiwe tocopherol acetate (vitamin E) kanye ascorbic acid (uvithamini C). Ngaphezu kwalokho, kudingeka reception ehnterosorbentov ngoba ngibopha ngokweqile Bile acid emathunjini. Nephephe umuthi kubhekwa "Polyphepan". Therapy siqukethe izidakamizwa ezihambisa ukugeleza Bile futhi ukunciphisa izinga Bile acid egazini. Ikakhulukazi, sisebenzisa imithi aqukethe ursodeoxycholic acid, isb "Ursosan".

Cholestasis yokukhulelwa: ekwelapheni izindlela nezidakamizwa

Ngaphezu izidakamizwa, wasebenzisa ezinye izindlela zokwelapha zokwelapha. Ikakhulukazi, abesifazane abakhulelwe evame ukunikezwa inkambo plasmapheresis futhi hemosorption. Lezi zinqubo zenzelwe ukususa bilirubin egazini pruritogenov ngokweqile ezibangela ukulunywa. zokukhwabanisa enjalo inikeza yalokho okuhle ngempela. Inkambo egcwele ukuphathwa ngokuvamile uhlanganisa izinqubo ezine plasmapheresis nokukodwa hemosorption.

Ukudla ngokufanele - kuyingxenye ebalulekile yokwelapha

Yiqiniso, ngemva kokuvela kwaleso sifo, udokotela ayoyikhetha zokwelapha ngempumelelo kakhulu futhi ayinangozi. Kodwa akukho ingxenye engaphansi ebalulekile kwelashwa Ukudla. Uma cholestasis yokukhulelwa kumelwe kuqala banakekele Ukudla, okuyinto kuzonciphisa umthwalo isibindi.

Iziguli abatuswa ukuba inciphise ezilwane. Ikakhulukazi, wokuthi kudingeka anciphise ubudlelwane ukusetshenziswa nokunamanoni, ibhotela, nemikhiqizo yobisi. Kufanele bayakwenqaba imayonnaise, nososo ukudla okuthosiwe. Njengoba amafutha Kusadingeka sokuthuthukiswa evamile fetus, ukuntula kwabo kungagwenywa ngokudla yemifino ndaba (amafutha omnqumo, nokunye. D.).

Liphinde contraindicated oluhlaza itiye, ikhofi kanye iziphuzo cholagogue. Ochwepheshe batusa ukuba awushiye amaqanda, iminqumo, ubhontshisi, ukwatapheya, imikhiqizo zifakwe emanzini anosawoti, isithombo, ikhabe, umbala kanye Brussels amahlumela.

Ukudla kufanele nokho igcwale amavithamini namaminerali, okuyinto lungatholakala izithelo nemifino - kufanele ekudleni isisekelo. Ivunyelwe baphuze iphalishi, inhlanzi, mafutha inyama. Ngilusizo kukhona imikhiqizo equkethe ebulilini Vitamin C, amawolintshi ethile, isipinashi, i-parsley, umhluzi kusuka ezinqulwini t. D. Ukudla kudingeka ngokuvamile kodwa izingxenye ezincane. Kubalulekile futhi ukuba sihlale silinganisela uketshezi.

Zikhona izindlela eziphumelelayo ukuze uvikeleke?

Abesifazane abaningi banesithakazelo imibuzo ephathelene nokuthi sikwazi ngandlela-thile ukuvimbela cholestasis yokukhulelwa. Ngeshwa, azikho amathuluzi angakusiza ukuvikela komgomo ezinjalo. Ngakho-ke, iziguli abasengozini, kunconywa zokuqapha ngokucophelela phakathi nokukhulelwa.

Ngisho nangaphambi kokuba ukubonakala izimpawu zokuqala abesifazane babelwe ukuthola ezithambile zizivikele hepatic, Antioxidants choleretic. Kubalulekile futhi kakhulu ukulandela yokudla efanele. Futhi-ke, umama okhulelwe kufanele ibhekane izivivinyo njalo futhi ukuhlolwa ekupumeni kuyokunikeza ithuba ukubona kwezinso ngendlela efanele usaqala.

Kanjani ukuba ubhekane nezingcindezi izimpawu? iziguli izincomo

Abesifazane abaningi abazi ukuthi sibhekene ukuxilongwa "cholestasis kokukhulelwa." Izibuyekezo iziguli kusikisela ukuthi ukwelashwa uyasiza ukuqeda ukwephula futhi silondoloze umbungu enempilo. Noma kunjalo, ukulunywa njalo kakhulu ikhono izinga lempilo.

Fight lo muzwa usebenzisa ukulibopha ekhethekile. Ngokwesibonelo, lotions kanye buso kusuka umhluzi chamomile noma oatmeal usizo ukuqeda ukungakhululeki, kanye nomphumela omuhle ukubukeka kwesikhumba, ukunciphisa ukuvuvukala. Futhi ikusiza lotions amanzi abandayo lula, ngoba izinga lokushisa ongaphakeme siyehla ukugeleza kwegazi, ukunciphisa ukulunywa. Iziguli batuse belele ethoyilethi, endaweni epholile futhi, nakanjani, landela ngokucophelela ekudleni.