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饮食养生:胆道阻塞的症状

由于肠道内缺乏胆汁或胆汁量减少,使维生素k吸收不足,影响了人体中凝血因子的形成,这样就会发生出血倾向。

Due to the lack of bile in the intestine or the reduction of bile volume, vitamin K is not absorbed enough, which affects the formation of coagulation factors in the human body, which will lead to bleeding tendency.

胆道系统阻塞后,胆汁的排泄受到阻碍而使胆红素返流到血液引起的黄疸,称为阻塞性黄疸。

After obstruction of biliary system, bile excretion is obstructed and bilirubin flows back to blood, which is called obstructive jaundice.

梗阻部位可在肝内或肝外,有完全性梗阻和不完全性梗阻。

The location of obstruction may be inside or outside the liver, with complete obstruction and incomplete obstruction.

2、胆道阻塞的病因胆道梗阻是外科急腹症中死亡率较高的一种疾病,多数继发于胆管结石和胆道蛔虫症。

2. Causes of biliary obstruction biliary obstruction is a disease with high mortality in surgical acute abdomen, most of which are secondary to bile duct stones and biliary ascariasis.

但胆管狭窄和胆管肿瘤等病变有时亦可继发此症。

However, bile duct stricture and bile duct tumor can sometimes be secondary to this disease.

上述疾病造成胆管阻塞,胆汁郁积,以及继发细菌感染。

These diseases cause bile duct obstruction, cholestasis and secondary bacterial infection.

致病菌几乎都来自肠道,经乏特壶腹或经胆肠吻合口的通道逆行进入胆道。

Almost all of the pathogenic bacteria come from the intestine, and retrograde into the biliary tract through the ampulla of Vater or through the channel of choledochojejunostomy.

细菌亦可通过血行或淋巴通道进入胆道。

Bacteria can also enter the bile duct or blood passage.

致病菌主要为大肠杆菌,克雷白菌,粪链球菌和某些厌氧菌。

The main pathogenic bacteria were Escherichia coli, Klebsiella, Streptococcus faecalis and some anaerobic bacteria.

3、胆道阻塞的鉴别诊断引起梗阻性黄疸的疾病大体分两类即良性疾病和恶性疾病。

3. The differential diagnosis of obstructive jaundice can be divided into two categories: benign disease and malignant disease.

良性疾病以胆道结石为最常见,其次还有胆道炎症性狭窄(如十二指肠乳头狭窄,急慢性胆管炎等),胆道良性肿瘤(如胆总管囊肿等)。

Bile duct stones are the most common benign diseases, followed by inflammatory stricture of biliary tract (such as duodenal papillary stenosis, acute and chronic cholangitis, etc.), and benign tumor of biliary tract (such as choledochal cyst).

这些良性病变黄疸的出现,其突出的伴随症状为上腹隐痛,发冷发热,腹痛性质一般为胀痛绞疼为主,有时绞疼为显着症状,既往有反复发作的病史,一般都呈急性和亚急性的症状出现。

The prominent accompanying symptoms of jaundice in these benign lesions are dull upper abdominal pain, chills and fever. The nature of abdominal pain is generally distending pain, strangling pain is the main symptom, sometimes strangling pain is a significant symptom. There has been a history of recurrent attacks in the past, which generally presents acute and subacute symptoms.

恶性疾病包括各种发生于胆总管部位的原发和转移癌,常见的有胆管癌、胰头癌、十二指肠乳头癌等。

Malignant diseases include various primary and metastatic cancers occurring in the common bile duct, including cholangiocarcinoma, pancreatic head cancer, duodenal papillary carcinoma, etc.

恶性肿瘤的病变一般都呈慢性过程,为无痛性黄疸,不引起患者重视,往往就医很晚,大都在1~2个月左右,伴随症状一般不典型,胰头癌往往以右上腹痛为突出的症状。

Malignant tumor lesions are generally chronic process, for painless jaundice, do not cause the attention of patients, often see a doctor very late, mostly in 1 ~ 2 months or so, accompanying symptoms are generally not typical, pancreatic head cancer often with right upper abdominal pain as the prominent symptom.

胆道阻塞如何预防注意肝脏功能变化:afc往往引起肝脏功能的严重损害,目前监测方法尚不能及早发现肝功能衰竭,多在出现精神症状、肝性脑病后作出诊断,因此必须高度重视各种临床性状,准确地记录每天胆汁量以及颜色、浓度等的变化。

How to prevent biliary obstruction and pay attention to the changes of liver function: AFC often causes serious damage to liver function. At present, monitoring methods can not detect liver failure early. Diagnosis is usually made after mental symptoms and hepatic encephalopathy. Therefore, we must attach great importance to various clinical characteristics and accurately record the changes of bile volume, color and concentration every day.

afc时,由于肝细胞、毛细胆管受损害,胆汁分泌与重吸收都受影响,有时胆汁量多,每天可多达4000~7000ml,颜色淡,可引起大量水与电解质丢失,进一步加重肝脏负担。

In AFC, the secretion and reabsorption of bile are affected due to the damage of hepatocytes and bile capillaries. Sometimes the amount of bile is large, up to 4000-7000ml per day. The color is light, which can cause a lot of water and electrolyte loss and further aggravate the liver burden.

使用生长抑素可明显减少胆汁分泌量。

The use of somatostatin can significantly reduce the amount of bile secretion.

胆管外引流后,肠道内胆盐明显减少,不能有效地抑制细菌繁殖和内毒素,而大量内毒素经门静脉至肝内,可进一步加重肝脏的损害,口服胆盐可明显减少肠道内细菌及内毒素。

After bile duct drainage, bile salt in the intestinal tract decreased significantly, which could not effectively inhibit bacterial reproduction and endotoxin. However, a large amount of endotoxin into the liver via portal vein could further aggravate liver damage. Oral bile salt could significantly reduce intestinal bacteria and endotoxin.

加强肠道灭菌和清洁也十分重要,卡那霉素可抑制肠道细菌,使肝内的内毒素量明显减少。

It is also very important to strengthen intestinal sterilization and cleaning. Kanamycin can inhibit intestinal bacteria and significantly reduce the amount of endotoxin in liver.

胆道阻塞中医疗法扶正养阴、回阳救逆:适用于休克期。

TCM treatment of biliary obstruction: it is suitable for shock stage.

常与西医的各种抗休克措施配合应用,可选用生脉散、复方丹参注射液、参附汤。

Shengmai Powder, compound Danshen injection and Shenfu Decoction can be used in combination with various anti shock measures of Western medicine.

清热解毒、凉血散血:在于抗感染和减轻各种毒血症状和出血倾向,常与西医的抗菌药物和激素等配合应用;通里攻下、利胆排石:主要采用泻药和利胆的中药,可选用清胆汤、胆道排石汤。

Clearing heat and detoxification, cooling blood and dispersing blood: it is used to resist infection and reduce various toxic blood symptoms and bleeding tendency, and it is often used in combination with antibiotics and hormones of Western medicine; Tongli attack, cholagogue expelling stone: mainly using cathartic and cholagogue Chinese medicine, Qingdan Decoction and bile duct Paishi Decoction can be selected.

根据中医辨证原则,扶正祛邪,清热解毒,舒肝利胆,活血化瘀,健胃健脾等,调理和改善机体脏器功能,提高抗病能力,增强免疫和清除内毒素,防治并发症,提高治愈率。

According to the principle of syndrome differentiation of traditional Chinese medicine, it is necessary to strengthen the body's vital energy and eliminate pathogenic factors, clear away heat and toxin, relieve liver and gallbladder, activate blood circulation and remove blood stasis, strengthen stomach and spleen, regulate and improve organ function, enhance immunity and remove endotoxin, prevent and treat complications and improve cure rate.

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