Cholestasis ya mimba: Zizindikiro, mankhwala, chakudya

Ndi palibe chinsinsi kuti pa mimba m'thupi la mayi amakhala katundu lalikulu kwambiri. Komanso, zoterezi kusintha m'thupi zambiri kumayambitsa ena zosokonezeka. Zochita ano obstetric nthawi zina amapezeka matenda otchedwa cholestasis mimba. Popeza mankhwala yake zoterozo chikhalidwe zingakhale zowopsa mwana kukula ndi thupi la mayi.

Ndichifukwa chake ambiri oyembekezera amayi chidwi mafunso pa zimene kwenikweni matenda ndi chifukwa kumachitika. ndi zizindikiro zazikulu zimene? Kodi mankhwala kupereka mankhwala amakono? Kodi pali njira bwino kupewa? Mfundozi kudzakhala chidwi owerenga ambiri.

cholestasis ndi chiyani?

Cholestasis mimba - matenda amene anatsagana ndi zotupa dystrophic wa zimakhala chiwindi. Chotero zolakwikazo ndi amapezeka ndi maziko a kuwonjezera tilinazo hepatocytes kwa mahomoni kugonana, mlingo umene zimasiyanasiyana kwambiri, mutanyamula mwana. The chifukwa cha ndondomekoyi ndi kusokonezeka kwa njira yachibadwa ya mafuta kagayidwe ndi zidulo ya ndulu. Monga ulamuliro, akazi ndi matenda amenewa, kusintha ya ndulu, komanso disruptions mu otaya wabwinobwino wa ya ndulu, omwe chifukwa amakhudza lonse chamoyo.

Amayi ambiri oyembekezera akukumana ndi matenda amenewa. Koma nthawi yomweyo mantha, chifukwa nthawi zambiri ndi cholestatic hepatosis (amatchedwanso matenda) sangathe kulimbana ndi mwa mankhwala ndiwofatsa popanda mavuto alionse kwa thupi mkazi kapena mwana.

kuwanda

Mwakucimbidza Dziwani kuti kuphwanya uyu ndithu sizachilendo m'mayiko ena. Mwachitsanzo, malinga ndi maphunziro zowerengera ku Scandinavia, China, Bolivia ndi Chile ku matenda anavutika ndi amayi ambiri oyembekezera. Koma amayi apakati mu Sweden pa 10 000 mlandu popanda milandu zoposa 40 za matenda.

Pa gawo la Russia cholestasis pa mimba nawonso ankaona vuto n'chosoŵa - pafupipafupi ake si upambana 2%. The kuchotserapo yekha ndi kumpoto kwa dziko, komwe matenda amawapeza zambiri. Yachokera pa kafukufuku izi ofufuza amanena kuti magulu pangozi mtundu mkazi.

The chikuchititsa mavuto a matenda

Ndipotu, lero samadziwidwa mpaka kumapeto, chifukwa akufotokozera intrahepatic cholestasis mimba. Pali maganizo osiyanasiyana ndiponso kufufuza imene tingadziwire kusiyanitsa magulu atatu chachikulu cha zinthu:

• kuchuluka tilinazo hepatocytes gulu la timadzi kugonana, umene uli chifukwa makhalidwe majini;
• zolakwa chathu chofuna cha kaphatikizidwe michere wabwinobwino, yomwe zoyendera zigawo zikuluzikulu ya ndulu ku hepatocytes mu ducts ya ndulu;
• zolakwa chathu chofuna a yachibadwa ya ndulu asidi kaphatikizidwe kugwirizana ndi kuperewera kwa michere ena. Nayenso chisokonezo ndi kumabweretsa mapangidwe ya ndulu zidulo atypical.

Tikumbukenso kuti odwala ndi kutengera za kumtundu, kapena matenda obadwa nawo cholestasis zimawonedwa osati woyembekezera, komanso ndi kusintha mlingo wa mahomoni kugonana (mwachitsanzo, panthawi ya msambo, ntchito ya kulera m'kamwa).

The pathogenesis wa cholestasis. Kodi chimachitika n'chiyani pa matenda?

Cholestasis mimba limodzi ndi kuyan'anila atatu akulu:

• kulera mlingo wa zigawo zikuluzikulu ya ndulu m'mwazi;
• kuchepetsa katulutsidwe mu intestine ya;
• Zotsatira poizoni wa ya ndulu maselo a chiwindi ndi ducts biliary.

Kusokonezeka kwa kaphatikizidwe zachilendo ndipo outflow wa madzimadzi opangidwa ndi chiwindi, chifukwa kuwonjezeka lakuthwa mu mlingo wa progesterone ndi esitirojeni. Zimasintha m'thupi msanga kayendedwe chilengedwe cha ya ndulu, ngakhale mimba yachibadwa. Ndipo ngati pali chiopsezo vuto lobadwa, kusintha osachiritsika a sefa thupi kwambiri kuchuluka. Komanso, timadzi owonjezera bwanji pituitary England, kuchepetsa ntchito zake. Nayenso kusintha mu ntchito iyo ili amakhudza ndondomeko ya yopezera chiwindi a bilirubin ndi mafuta. Zimenezi zimabweretsa kusokonezeka kwa njira ya mapangidwe ndi katulutsidwe wa ya ndulu.

gulu la matenda

Pakali pano, pali machitidwe ambiri a gulu la matenda a. Mwachitsanzo, malinga ndi kukula kwa zizindikiro, secrete ofatsa, odziletsa ndi aakulu mitundu ya matenda.

Ndi chikhalidwe cha utuluke cholestasis akhoza kukhala mwina pachimake kapena aakulu (osauka exacerbation la matenda aakulu pa maziko a mimba). Malinga etiology ndi kusiyanitsa extrahepatic (anayamba mu mawonekedwe a kutsekeka kwa ducts ya ndulu) ndi intrahepatic cholestasis (mawonekedwe awa amapezeka amayi apakati).

Cholestasis ya mimba: Zizindikiro

kupatuka aliyense mwakale mu nthawi imeneyi amafuna yoyendera ndi malangizo a dokotala. Kotero izo zikuwoneka ngati cholestasis mimba?

Zizindikiro kawirikawiri kuyamba mavuto mwa trimester wachitatu (masabata 28-35.). Chiwonetsero chachikulu cha matenda ndi pruritus, ndipo mwina ndi osiyana a mwamphamvu. Odwala ena kulekerera kuphwanya ichi mosavuta, pamene ena amavutika zonse kupweteka nkhawa.

Kuyabwa amakhala kutchulidwa usiku, chifukwa mu sleeplessness ndipo motero, kutopa nthawi zonse, irritability, matenda a m'maganizo. Nthawi zambiri kumverera uku isanafalikire pa khungu la manja, mkono wonse wakumanja, miyendo, ndi zapambuyo m'mimba khoma. Cholestasis mimba (zithunzi za amene akupezeka akalozera zachipatala) zikubweretsa excoriation wa khungu, monga mkazi kuwapweteka iwo chifukwa kukanda zonse.

Pakuti zizindikiro zina za matendawa ndi monga matenda a chikasu ndiyo. Malinga ndi maphunziro zowerengera, chisokonezo zimawonedwa mu 10-20% ya akazi. Monga ulamuliro, ndi zizindikiro zonse za kutha paokha mwa masabata 1-2 atabadwa. Komabe, iwo akhoza adapitiriza pa maziko a wotsatira kulephera m'thupi (mwachitsanzo, pa mimba wachiwiri).

njira Basic matenda

Pamaso pa kuvutika aliyense ayenera yomweyo dokotala. Katswiri Choyamba kusonkhanitsa mbiri wathunthu zachipatala ndi mayeso thupi. Kwa akazi ena, mwina anatero matenda a chikasu ndiyo ang'ono ndi khalidwe kudetsa wa maso sclera. Kuwaona ku khungu kuzindikira redness, abrasions chifukwa cha kukanda khungu.

Zizindikiro zonsezi zikusonyeza kuti wodwalayo mwina cholestasis mimba. Ri ya ndende ya seramu ya ndulu zidulo otsimikiza kukayikitsa pamaso pa matenda mu chiwindi. Palinso maphunziro osiyanasiyana pa zili amuzolengedwa ndi ntchito ya michere chiwindi. Amasonyezanso ultrasound imene onani kuwonjezeka mu chikhodzodzo ndulu pamodzi ndi wamuyezo chiwindi ndi yunifolomu echogenicity.

matenda kungachititse kuti ena mavuto?

Zochita ano madokotala nthawi zambiri vuto otchedwa cholestasis mimba. N'koopsa okhumudwa? Inde. Ngakhale zidalira pa kuopsa kwa ndondomeko pathological, matenda nthawi anasankha mankhwala ndi T D..

Komabe, chiopsezo nthawi zonse. Kulakwila maphunziro ndi Kupha ya ndulu amakhudza njira kagayidwe kachakudya lapansi. Woterowo Mwina mkulu wa matenda a kubadwa msanga. Komanso, kuchuluka postpartum haemorrhage pakati pa akazi ndi matenda amenewa ndi apamwamba kwambiri, chifukwa kagayidwe wa vitamini K ndi mfundo zina coagulation.

Ngati malfunctions kwambiri chiwindi pali chiopsezo cha imfa yoopsa, kotero zina, madokotala amalangiza yobereka yomweyo.

mankhwala pa mimba

Chithandizo kumatengera zovuta matenda ndi makhalidwe mtima munthu. Kawirikawiri woyamba mankhwala azitsamba gepatoprotektory kuti kuteteza chiwindi zisaonongeke ndipo musati kuvutitsa thupi. Mwachitsanzo, "Hofitol" ndi cholestasis mimba amapereka zotsatira zabwino. Komanso, mankhwala "Gepabene" amagwiritsidwa ntchito mankhwala.

Kuwonjezera mankhwala masamba ntchito komanso hepatoprotectors kupanga makamaka "Ademethionine". Monga antioxidants mimba Kwalamulidwa tocopherol nthochi (vitamini E) ndi ascorbic asidi (vitamini C). Komanso, chofunika phwando ehnterosorbentov kumangidwa owonjezera ya ndulu zidulo mu intestine lapansi. Efficacy ndi chitetezo cha mankhwala imatengedwa "Polyphepan". mankhwala imakhala mankhwala kuti atsogolere otaya ya ndulu ndi kuchepetsa mlingo wa zidulo ya ndulu m'magazi. Makamaka ntchito mankhwala okhala ndi asidi ursodeoxycholic, mwachitsanzo "Ursosan".

Cholestasis ya mimba: mankhwalawa njira mankhwala ozunguza bongo

Kuwonjezera mankhwala, ntchito mankhwala ena achire. Makamaka amayi apakati nthawi zambiri zotchulidwa moyo plasmapheresis ndi hemosorption. njira zimenezi zakonzedwa kuti kuchotsa bilirubin kwa magazi ndi pruritogenov owonjezera kuti kuyambitsa kuyabwa. mpheto kumeneku kumapereka chifukwa zabwino kwenikweni. A kwathunthu mankhwala zambiri imakhala njira plasmapheresis anayi ndi hemosorption wina.

Yoyenera zakudya - mbali yofunika ya mankhwala

Kumene, pambuyo matenda, adokotala kusankha mankhwala kwambiri ndi zabwinobwino. Koma palibe mbali zochepa zofunika mankhwala ndi zakudya. Ngati cholestasis mimba choyamba tiyenera kusamalira zakudya, umene kuchepetsa katundu pa chiwindi.

Odwala amene analimbikitsa kuchepetsa nyama mafuta. Makamaka, ayenera kuchepetsa kumwa nyama mafuta, batala, mkaka. Muyeneranso amakana mayonesi, sauces ndi zakudya yokazinga. Popeza mafuta ofunikabe pa chitukuko wabwinobwino wa mwana wosabadwayo, akusowa zikhoza kupewedwa ndi kudya masamba kanthu (mafuta, ndi zina zotero. D.).

Amagwiritsidwanso contraindicated mu wobiriwira tiyi, khofi ndi zakumwa cholagogue. Akatswiri amalangiza kutenga tchuti mazira, maolivi, nyemba, mapeyala, mankhwala kuzifutsa radish, vwende, mtundu ndi Brussels zikumera.

The zakudya ayenera koma akhale zonse mavitamini ndi mchere, amene akhoza kuwapeza zipatso ndi masamba - iwo ayenera kukhala maziko zakudya. Anandilola kumwa phala, nsomba, Taphunzira nyama. Zothandiza ndi mankhwala okhala ndi mlingo waukulu wa vitamini C, mu malalanje makamaka sipinachi, parsley, msuzi kuchokera mchiuno ndipo T. D. Kudya ayenera kawirikawiri, koma chakudya chochepa. N'kofunikanso kuti tikhalebe olimba madzimadzi.

Kodi pali miyeso ogwira njira?

akazi ambiri amachita chidwi ndi mafunso ngati ife m'njira inayake kuteteza cholestasis mimba. Mwatsoka, palibe zipangizo kuti akhoza kuteteza motsutsana kuyan'anila amenewa. Choncho, odwala amene ali pa chiopsezo, izo tikulimbikitsidwa polojekiti kusamala mu mimba.

Ngakhale pamaso maonekedwe a zizindikiro woyamba wa akazi anatumizidwa kulandira zofewa kwa chiwindi amateteza, antioxidants ndi choleretic. M'pofunikanso kwambiri kudya zakudya bwino. Ndipo, ndithudi, mayi woyembekezera ayenera kukayezetsa mayeso zonse ndi mayesero pochitika, monga adzakhala kupereka mwayi kuti azindikire kuvutika pa siteji oyambirira.

Kodi kupirira zizindikiro? odwala pamawu

akazi ambiri akukumana ndi matenda a "cholestasis mimba." Reviews odwala akusonyeza kuti mankhwala Kodi kuthandiza kuthetsa kuyan'anila komanso kukhala ndi mwana wosabadwayo wathanzi. Komabe, nthawi zonse kuyabwa kwambiri impairs khalidwe la moyo.

Nkhondo kumverera pogwiritsa ntchito compresses wapadera. Mwachitsanzo, lotions ndi masks ku msuzi chamomile kapena oatmeal thandizo kuthetsa kusapeza, komanso ubwino maonekedwe a khungu, kutupa m'malo olumikizirana mafupa. Amathandizanso lotions wa madzi zosavuta ozizira, chifukwa kutentha otsika kubweza magazi, kuchepetsa kuyabwa. Odwala mankhwala akugona mu mpweya wokwanira, malo ozizira ndipo, ndithudi, amatsatira zakudya.