Custom Search

Friday, February 10, 2012

Cholecystitis

Cholecystitis-About Cholecystitis:

Cholecystitis is infection, bile stimulation, pancreatic juice to the biliary reflux, as well as bilirubin Mino and the class of lipid metabolism disorders such as cholecystitis caused by the disease. Cholecystitis can be divided into acute cholecystitis and chronic gall bladder inflammation. Typical manifestations of acute cholecystitis, acute onset of right upper quadrant of persistent or paroxysmal colic, right angle radiation, gallbladder tenderness or rebound tenderness, muscle tension, fever, nausea, vomiting, jaundice and increased white blood cell; and chronic cholecystitis performance is recurrent and varying severity of abdominal distention, right upper quadrant and epigastric discomfort or pain, often radiating to the right shoulder back, accompanied by belching pantothenic acid indigestion symptoms, into the greasy food increased symptoms. Is a kind of infectious inflammation of the biliary system.

Cholecystitis - the difference between cholecystitis and cholelithiasis
Cholecystitis and cholelithiasis in the elderly is a common disease. Survey, the incidence rate of 28% over the age of 60. Often trigger cholecystitis and cholelithiasis, cholecystitis can be induced cholelithiasis, the two are closely related, and often concurrent.
Cholecystitis - etiology and pathogenesisCholecystitis more than caused by bacterial infection. Gallstone obstruction of the bile duct, cholestasis concentration, composition changes, stimulate the gall bladder mucosa, causing inflammation of change. Or pancreatic juice reflux into the biliary tract, activated by bile and pancreatic digestive enzymes erosion of the gall bladder wall, causing acute cholecystitis. A variety of bacteria (Escherichia coli) infection, the pathogen since the blood flow into the gallbladder or the roundworm carry intestinal bacteria penetrate into the biliary tract, can cause cholecystitis.Cholestasis, biliary tract infections, cholestasis of cholesterol metabolism disorders stones.Disease and the type of work and habits. Long-term office desk, very few of the activities of people, often oppressed bile duct, biliary excretion of poor retention, concentrated in the gallbladder, deposited into the stone.
Cholecystitis - symptomsAcute cholecystitis, the right upper abdominal support swelling pain, postural changes and breathing when the pain got worse, after the right shoulder or back radiating pain, fever, chills, and may have nausea, vomiting. Chronic cholecystitis, common indigestion, epigastric discomfort or dull pain, and may have nausea, bloating and belching after eating greasy food intensified.
Cholelithiasis performance, size and location of the gallstone. If the stone is embedded in and blocking the cystic duct, which can cause biliary colic, epigastric or right upper quadrant severe pain, restless, sweating, paleness, nausea, vomiting, and even develop jaundice and high fever. But there are also atypical symptoms, do not feel pain, saying "no pain gallstone.
Concurrent cholecystitis and cholelithiasis, impacted stones can be caused by perforation leading to peritonitis, the pain worsened or even toxic shock or failure. Cholecystitis and cholelithiasis can aggravate or cause coronary heart disease, caused by myocardial ischemic changes. Experts: gallstone is an important factor in inducing gallbladder. Cholecystitis and cholelithiasis can often lead to pancreatitis, acute pancreatitis caused by biliary tract disease account for about 50%. Trapped this cholecystitis in a timely manner modulating.

Cholecystitis - CategoryChronic cholecystitisCholecystitis chronic cholecystitis is the most common form of gallbladder disease, patients are generally at the same time with gallstones, but patients with chronic cholecystitis with stones are not uncommon in China. Chronic cholecystitis can sometimes be the sequelae of acute cholecystitis, but most patients not suffering from acute cholecystitis, chronic inflammation of gallbladder, gallbladder wall thickening of fiber, scar contraction, resulting in gallbladder contraction, the cavity can be completely closed gallbladder dysfunction, or loss of function.
Suffering from chronic cholecystitis, the patient will have the following two sets of symptoms:
(1) stones of the moment blocked gallbladder tube, causing episodes of biliary colic, pain in the upper abdomen or right upper quadrant, continued a few minutes to several hours, pain may involve the back or right shoulder blade and can be accompanied by nausea and vomiting.
(2) often abdominal distension, epigastric or right upper quadrant abdominal discomfort, heartburn, belching, Tunsuan and other symptoms of indigestion, eating fried or fatty foods tend to make these symptoms intensified.
Thus, some patients can no biliary colic attack, just felt epigastric discomfort, belching, Tunsuan and other symptoms of indigestion, often mistakenly believe that he is suffering from stomach. These patients' disease "in the" stomach disease "root" in the "guts", although long-term "stomach" symptomatic treatment ", but did not eliminate the disease." Root ", so the disease is prolonged unhealed.
Hepatobiliary scans of gallbladder imaging and B-mode ultrasound is a screening method for diagnosis of chronic cholecystitis valuable. Cholecystography can be found gallstones, narrow deformation of the gallbladder, as well as enrichment and contraction of a bad situation, and sometimes gallbladder nonvisualization.
B-ultrasound, you can still see signs of gallbladder wall becomes rough, and thickening of addition can probe the change of gallstones and gallbladder appearance. Patients with these symptoms should seek medical treatment through the above checks, generally confirm the diagnosis of chronic cholecystitis.
Cholecystitis acute cholecystitisThe symptoms of acute cholecystitis, right upper quadrant pain, nausea, vomiting and fever. Acute cholecystitis may cause right upper quadrant pain, is very similar to the beginning of the pain and biliary colic, acute cholecystitis caused by abdominal pain and its duration of often long for breathing and changes in position often make the pain worse, so patients like to the right side of repose, in order to reduce abdominal pain.
Some patients have nausea and vomiting, but vomiting is generally not severe. The majority of patients with fever, body temperature is usually between 38.0 ℃ ~ 38.5 ℃, high fever and chills are rare.
Minority of patients have mild whites of the eyes and skin yellow. When the doctor examined the patient's abdomen, right upper quadrant tenderness, and muscle tension, about 1/3 of patients can touch the enlargement of the gallbladder. Laboratory the patient's blood, white blood cell count and increase in neutrophils in the blood of most people. B-ultrasound can be found in the gallbladder enlargement and thickening of the wall and see the stones stuck in the neck of the gallbladder. According to the above symptoms, physical examination and a variety of auxiliary examination, doctors generally can make timely diagnosis of acute cholecystitis.
Cholecystitis - diagnosis of children with acute cholecystitis
Generally based on a history of upper abdominal pain and right upper quadrant tenderness and signs, the diagnosis is not difficult. Medical treatment of children with toxic shock down, should take into account the possibility of this disease. The combination of symptoms, signs and rapid progression, accompanied by the spirit of good, delirium, consciousness vague or coma and other symptoms, diagnosis can be made. Peritoneal exudate, do abdominal puncture, such as taking the green exudate can be diagnosed with biliary peritonitis.
The onset is often more abrupt, more than after the onset of days for treatment. The main symptoms of abdominal pain, fever plug war, occasionally jaundice. On the abdominal pain was continuous or intermittent dull pain or severe cramps. Often accompanied by nausea, vomiting. High fever can cause seizures, or the spirit of good, delirium, coma and other symptoms. Jaundice lesser time is short.
Physical examination showed acute tolerance, body temperature is sustainable in more than 38.5 ℃, the highest up to 41 ° C, right upper quadrant obvious tenderness and muscle tension, sometimes palpable enlargement of the gallbladder. Individual serious cases of toxic shock after treatment before onset of abdominal distension, peritonitis signs of abdominal tension and tenderness.
The peripheral blood white blood cell count, and may increase in neutrophil count, left shift and toxic particles.
Cholecystitis - principles of treatmentThe treatment of chronic cholecystitis factors and complications vary based on the onset of specific disease, the use of appropriate and flexible treatment principle.
Combination of non-surgical therapy for chronic acalculous cholecystitis in Western-based, clinical symptoms significantly with surgical therapy and gallbladder disease in patients with mild symptoms not relieved after surgery.
Calculous chronic cholecystitis, and Western medicine therapy in the trial.
Recurrent or associated with the larger stones, cholecystitis, the diagnosis has been determined cholecystectomy is a reasonable fundamental treatment, such as patients with heart, liver, lung, serious illness or physical condition is poor and can not tolerate surgery, internal medicine can be used treatment.
Acute exacerbation of chronic cholecystitis should be treated with antibiotics until the body temperature stable, local tenderness and white blood cell count to normal. Chronic cholecystitis the interval of the general treatment by Chinese medicine-based, to vote Shugan Qi, gallbladder pain, heat and dampness agent.
For patients with acute cholecystitis, the general non-surgical treatment, symptoms can be alleviated, and after elective surgery. The non-surgical treatments include bed rest, fasting, infusion, correct water and electrolyte imbalance, antibiotics and vitamins, if necessary decompression. Abdominal pain may be given antispasmodic agents and analgesics, such as atropine, meperidine, etc., should be closely observed changes in condition.
Of the following conditions shall be subject to short-term symptomatic treatment preparation, and emergency surgery:
1, the weight of clinical symptoms difficult to alleviate gallbladder enlargement, and the tension perforation may.Obvious, abdominal tenderness, abdominal rigidity, and peritoneal irritation, or in the process of observation and treatment, the abdominal signs increase.3, purulent cholecystitis chills, fever, white blood cells was significantly increased.4, the general symptoms of acute cholecystitis in non-surgical treatment fails to alleviate the condition worsening.Five elderly patients, prone to gallbladder gangrene and perforation, severe symptoms and surgery.
Cholecystitis - CategoryChronic cholecystitisCholecystitis chronic cholecystitis is the most common form of gallbladder disease, patients are generally at the same time with gallstones, but patients with chronic cholecystitis with stones are not uncommon in China. Chronic cholecystitis can sometimes be the sequelae of acute cholecystitis, but most patients not suffering from acute cholecystitis, chronic inflammation of gallbladder, gallbladder wall thickening of fiber, scar contraction, resulting in gallbladder contraction, the cavity can be completely closed gallbladder dysfunction, or loss of function.
Suffering from chronic cholecystitis, the patient will have the following two sets of symptoms:
(1) stones of the moment blocked gallbladder tube, causing episodes of biliary colic, pain in the upper abdomen or right upper quadrant, continued a few minutes to several hours, pain may involve the back or right shoulder blade and can be accompanied by nausea and vomiting.
(2) often abdominal distension, epigastric or right upper quadrant abdominal discomfort, heartburn, belching, Tunsuan and other symptoms of indigestion, eating fried or fatty foods tend to make these symptoms intensified.
Thus, some patients can no biliary colic attack, just felt epigastric discomfort, belching, Tunsuan and other symptoms of indigestion, often mistakenly believe that he is suffering from stomach. These patients' disease "in the" stomach disease "root" in the "guts", although long-term "stomach" symptomatic treatment ", but did not eliminate the disease." Root ", so the disease is prolonged unhealed.
Hepatobiliary scans of gallbladder imaging and B-mode ultrasound is a screening method for diagnosis of chronic cholecystitis valuable. Cholecystography can be found gallstones, narrow deformation of the gallbladder, as well as enrichment and contraction of a bad situation, and sometimes gallbladder nonvisualization.
B-ultrasound, you can still see signs of gallbladder wall becomes rough, and thickening of addition can probe the change of gallstones and gallbladder appearance. Patients with these symptoms should seek medical treatment through the above checks, generally confirm the diagnosis of chronic cholecystitis.
Cholecystitis acute cholecystitisThe symptoms of acute cholecystitis, right upper quadrant pain, nausea, vomiting and fever. Acute cholecystitis may cause right upper quadrant pain, is very similar to the beginning of the pain and biliary colic, acute cholecystitis caused by abdominal pain and its duration of often long for breathing and changes in position often make the pain worse, so patients like to the right side of repose, in order to reduce abdominal pain.
Some patients have nausea and vomiting, but vomiting is generally not severe. The majority of patients with fever, body temperature is usually between 38.0 ℃ ~ 38.5 ℃, high fever and chills are rare.
Minority of patients have mild whites of the eyes and skin yellow. When the doctor examined the patient's abdomen, right upper quadrant tenderness, and muscle tension, about 1/3 of patients can touch the enlargement of the gallbladder. Laboratory the patient's blood, white blood cell count and increase in neutrophils in the blood of most people. B-ultrasound can be found in the gallbladder enlargement and thickening of the wall and see the stones stuck in the neck of the gallbladder. According to the above symptoms, physical examination and a variety of auxiliary examination, doctors generally can make timely diagnosis of acute cholecystitis.
Cholecystitis - diagnosis of children with acute cholecystitis
Generally based on a history of upper abdominal pain and right upper quadrant tenderness and signs, the diagnosis is not difficult. Medical treatment of children with toxic shock down, should take into account the possibility of this disease. The combination of symptoms, signs and rapid progression, accompanied by the spirit of good, delirium, consciousness vague or coma and other symptoms, diagnosis can be made. Peritoneal exudate, do abdominal puncture, such as taking the green exudate can be diagnosed with biliary peritonitis.
The onset is often more abrupt, more than after the onset of days for treatment. The main symptoms of abdominal pain, fever plug war, occasionally jaundice. On the abdominal pain was continuous or intermittent dull pain or severe cramps. Often accompanied by nausea, vomiting. High fever can cause seizures, or the spirit of good, delirium, coma and other symptoms. Jaundice lesser time is short.
Physical examination showed acute tolerance, body temperature is sustainable in more than 38.5 ℃, the highest up to 41 ° C, right upper quadrant obvious tenderness and muscle tension, sometimes palpable enlargement of the gallbladder. Individual serious cases of toxic shock after treatment before onset of abdominal distension, peritonitis signs of abdominal tension and tenderness.
The peripheral blood white blood cell count, and may increase in neutrophil count, left shift and toxic particles.

Cholecystitis treatment
The treatment of chronic cholecystitis factors and complications vary based on the onset of specific disease, the use of appropriate and flexible treatment principle.

Combination of non-surgical therapy for chronic acalculous cholecystitis in Western-based, clinical symptoms significantly with surgical therapy and gallbladder disease in patients with mild symptoms not relieved after surgery.

Calculous chronic cholecystitis, and Western medicine therapy in the trial.

Recurrent or associated with the larger stones, cholecystitis, the diagnosis has been determined cholecystectomy is a reasonable fundamental treatment, such as patients with heart, liver, lung, serious illness or physical condition is poor and can not tolerate surgery, internal medicine can be used treatment.

Acute exacerbation of chronic cholecystitis should be treated with antibiotics until the body temperature stable, local tenderness and white blood cell count to normal. Chronic cholecystitis the interval of the general treatment by Chinese medicine-based, to vote Shugan Qi, gallbladder pain, heat and dampness agent.

For patients with acute cholecystitis, the general non-surgical treatment, symptoms can be alleviated, and after elective surgery. The non-surgical treatments include bed rest, fasting, infusion, correct water and electrolyte imbalance, antibiotics and vitamins, if necessary decompression. Abdominal pain may be given antispasmodic agents and analgesics, such as atropine, meperidine, etc., should be closely observed changes in condition.

Of the following conditions shall be subject to short-term symptomatic treatment preparation, and emergency surgery:

1, the weight of clinical symptoms difficult to alleviate gallbladder enlargement, and the tension perforation may.
Obvious, abdominal tenderness, abdominal rigidity, and peritoneal irritation, or in the process of observation and treatment, the abdominal signs increase.
3, purulent cholecystitis chills, fever, white blood cells was significantly increased.
4, the general symptoms of acute cholecystitis in non-surgical treatment fails to alleviate the condition worsening.
Five elderly patients, prone to gallbladder gangrene and perforation, severe symptoms and surgery.


Cholecystitis - General treatmentCholecystitis, acute and chronic cholecystitis, begin with the efficacy of removal of the gallbladder is the best.(A) non-surgical treatment include:
a. Bed rest, fasting, abdominal distension, gastric tube decompression;
and b. Rehydration, correcting water, electrolyte and acid-base balance;
(c) Antispasmodic and analgesic;
(d) Vein associated with effective antibiotics such as gentamicin, ampicillin, chloramphenicol, Vanguard ADM; effective in 80% -85% of early cases.(B) surgical therapies

A. Acute cholecystitis: the general idea by 12 to 24 hours of intensive medical treatment until the symptoms ease elective surgery.

Two. Chronic cholecystitis: with or without stones, gallbladder, loss of function, and removal of infected tissue, should be elective surgery.
(C) the nutritional treatment of cholecystitis and cholelithiasis in addition to use of drugs and surgical treatment, nutritional therapy has a supporting role, in particular, the recovery phase in the pain relief and post-operative health can not be ignored nutrition therapy and diet therapy principles are as follows:
(1) the head of the nutrition therapy is to control the fat intake, reduce or discharge of patients with pain and prevent stones. Patients with acute exacerbation of severe fasting, intravenous supply of various nutrients; can eat fast fat and spicy food, short-term edible with a high carbohydrate liquid diet. Gradually decreased with the progression of the disease may be given low-fat semi-liquid or low-fat low residue soft rice. Should be small meals daily, still need to limit meat and fatty food. Chronic cholecystitis should be given adequate calorie high protein, high carbohydrate and moderate restriction of fat diet, have a rich vitamin.
(2) sufficient thermal energy in order to ensure that the needs of patients. If the patient is overweight, should be given to low heat to diet, weight loss patients. Low heat to a diet containing fat mass also to restrict fat for gallbladder patients. Normal daily supply of calories 7531.2 to 8368 joules (1800 ~ 2000 kcal).
(3), in order to maintain good health, increase appetite, promote cholecystokinin conducive to the gallbladder emptying in patients with chronic cholecystitis, should maximize the proportion of protein in the diet. Daily protein supply per kg body weight l ~ 1.2 grams is appropriate, but avoid excessive intake of cholesterol with the protein.
(4) cause severe pain and should be strictly limited, so in the exacerbation of the fat can induce lesions of cholecystokinin. The daily fat supply should be less than 40 grams or fasting condition improved after moderate consumption.
(5) in the consumption of carbohydrate liquid diet, the main nutrients of sugar. Can give plenty of carbohydrates, the daily supply of 300 to 350 g, in particular, should be in the exacerbation of the venous supply.
(6) To supply a variety of vitamins, with particular attention to vitamin B,, K.
(7) avoid spicy food and alcohol.
What are the characteristics of the CT diagnosis of cholecystitis: patients with acute cholecystitis even need to do a CT scan. It can be found in the cystic duct or gallbladder stones, diagnosed according to:
The ① gallbladder expand;
② gallbladder wall thickening of universality, and enhanced scan shows gallbladder obviously enhanced.
The diagnosis was established, the two phenomena are indispensable. Gallbladder expand also be found in the biliary obstruction, or normal cholecystitis nodular thickening of the gallbladder wall, gives a gallbladder phenomenon. Therefore, the differential diagnosis requires a combination of clinical symptoms. Suppurative cholecystitis, bile CT values ​​greater than 20HU. Gallbladder inflammation around the gallbladder wall and liver parenchyma interface unclear or low-density ring around the gallbladder by the liver tissue due to secondary edema. Department of gallbladder perforation of the gallbladder fossa fluid level of the abscess. Emphysematous cholecystitis, gallbladder or intramural gas shadow. Chronic cholecystitis often coexist with gallstone. CT in addition to the gallbladder wall is generally thickened and enhanced scan shows wall strengthening, gallbladder expansion mostly bad or shrink. If the adhesions around the visible gallbladder folds deformation. It should be noted, such as the presence of non-gallstone, CT uncertain gallbladder narrowing is physiological or pathological contraction. The formation of the so-called "porcelain gallbladder bile calcification or gallbladder wall calcification, CT is easy to diagnose. Angiography showed a wall thickness of the undesirable expansion of gallbladder nonvisualization, bile duct, but a good developer can be sure of chronic cholecystitis, but CT is not commonly used in cholangiography.


Cholecystitis - Acupuncture treatmentCholecystitis acupuncture treatment of biliary tract disease, spasm pain, choleretic row of stone, Jiangni antiemetic effect can be used alone, can be used with other therapies.(1) Body Acupuncture① acupuncture(a) points: bile Yu, Zhong Wan, Zusanli, cure gall bladder hole, Yanglingquan. Colic and gu; fever plus the song pool; vomiting, add Neiguan.(b) needle: acupuncture points 2 to 4 above election, deep puncture, heavy spines, continuing to twist the needle 3 to 5 minutes, the needle for 30 minutes, 2 times a day.② EA(a) points: the right bile Yu (cathode), treatment of gall bladder hole sun, moon, Taichong (anode).(b) methods: needle, acupuncture, electrical connection acupuncture device, the use of adjustable wave strength from weak to strengthen, can be tolerated for the degree, every 30 minutes, 2 or 3 times a day.③ water needle(a) points: gall Yu, Zusanli Zhongwan, cure gall bladder hole.(b) Method: choose 1 or 2 points per hole injection angelica solution or safflower liquid 2ml; or 10% glucose solution 5ml, needle acupuncture after rapid bolus, 1 or 2 times a day.Wendeng Central Hospital of Yantai area using body acupuncture treatment of 219 cases of cholelithiasis, a row of stone of 185 cases, accounting for 84.5%. The group of 185 cases a row of stone row 151 1cm × 1cm × 1cm above the size of stones, of which a maximum of 4.5cm × 3.5cm, maximum diameter of 3.5cm. Some patients discharged from the discharge also roundworm residues and straw broom seedlings core stones. The acupoints right side of the sun and the moon on the door. Abdominal pain compared to the drama and gallbladder swell Juque through the abdominal sorrow, cure gall bladder hole. Needle followed by electro-acupuncture device, the power of 60 minutes, 1 day, the pain in severe cases, can also be 2 times a day. Oral administration of 33% magnesium sulfate 40ml.(2) Ear Acupuncture① points: liver, gall bladder, spleen, stomach, duodenum, the door of God, sympathetic.② stitch: the election of these reactions were 2 to 3 points, re-stimulation, the needle for 30 minutes, 2 times a day.In recent years, all over the country many Vaccaria seed, Mustard Seed or rapeseed sticking and pressing acupoints, with trotters and other high-fat diet treatment of cholelithiasis, a row of stone effect.
Cholecystitis - Qigong therapySuccessful acupunctureMm needle into the tributary, Yanglingquan. Long-contained, use the pull-rotation practices hair air, and right-hand guide air downstream.
Help practitioners① push threat "Hush" Qigong: stations or sitting, natural breathing, eliminate distractions, body relaxed. Knocking teeth 36 times a stir Tianjin pharynx into two threatened then-owned by the pubic region, put both hands palm in two Xiexia. Then inhale slowly, so that mouthful; breath when I read "Hush" pronunciation, his hands at the same time from the top down gently rub Mount two flanks, a total of eight interest.The ② push the chest lead gas: If the left rib pain, to put right palm on the left chest, push from the chest to the left of line, push the edge shift seven, and then rub the smell of mutton, on the door.③ the Shugan guide qigong:
a loose static standing, hands naturally hang down, palms down, fingers slightly at the micro-force, press, and imagine the air of the palm of the hand until the fingertips.
b, advantage of the opportunity with both hands raised to chest, palms forward push Zhijian, elbow, wrist, intended to save the palms.
c, with both hands around Stretch, such as birds Shu-wing, fingers upturned palm about flat push gas line to the palm. d palms advantage of the opportunity close to the chest relatively fingertips, palms up, and then turn over palm to push down to the pubic symphysis, cited in the gas line in the pubic region, then both hands on the sides of the body received the power.

Beginning of winter to sit reactiveThe Main the Yangming five gas should be 3 to 5:00 daily practice.
Tai chi the ① posture: sitting. Adjust respiratory ideas.② practice: open right hand, firmly hold down the right knee, left fist, bent elbow, pulled back five times. Using the same method, press the left knee to pull the right elbow five times, alternating left and right. And then restore in situ medicines, or knock out a tooth, rinse Tianjin pharyngeal fluid 7.(3) received power: relax, ease, received power.
Pai Shi Gong:The ① posture: sitting or standing, feet parallel, a distance of about three-legged long, two feet flat on the ground, spine vertical, waist slightly down taijiquan, the hips slight adduction, head and neck relaxation correct. Two light closed, smiling. Natural drooping shoulders along the side of the body, elbows slightly bent, thumbs deviates from the DPRK, the palms are gently placed on the groin, palm down, wrist relax virtual axillary, and slowly adjust interest rates gradually extended on the basis of natural breathing expiratory time.② If the water buffaloes graze like to tongue stirred up and down in the dentition of nine times.The ③ round strike waist: feet parallel standing shoulder width, meaning meditation clear, natural breathing. Force to the feet, I turn the waist, arms relaxed at the waist when you turn left to right fist (or forearm) hit the belly boxing left waist, waist to turn right, left fist (or forearm) hit the belly, right boxing waist. Zhuangruo children play "rattle", shoulders or arms slack cord.(4) Horse Riding shock split liver Yu or lumbar fossa: two hands to the back of the hand, knee bend, body like riding a kind of shaking up and down.⑤ elevated plus jump: over his head his arms on the elbow bend, wrist refers to relax, standing jump to the soles of the feet before landing, the heel off the ground, the use of counterforce.
Tapping acupuncture pointsLeft leg bow, right leg kicking, into a lunge standing. Light make a fist with both hands, natural breathing. Upper body bend forward, left fist percussion gall hole. Upper back, fist to fist back to hit Yu liver or kidney area, the left fist tapping the right shoulder. And so forth rhythmically tapping 9-18. From left to right
Cholecystitis - standing drugRoxithromycin in patients with cholecystitis and cholelithiasis, and often a sudden onset, especially when resistance is poor, or heart depressed, lack of energy, or binge eating binge or eat too much, often there will be chest tightness, indigestion, nausea, loss of appetite mild symptoms of cholecystitis, and sometimes go to hospital and is very inconvenient to how to do it? can be prepared in the family, some commonly used drugs, a symptom, can be self-serving, to relieve symptoms. Such as:Oral anti-inflammatory drugs:① Norfloxacin: three times a day, every 1 to 2 (ie, 0.1 ~ 0.2g) oral fasting.② erythromycin: 0.3 g, 4 times a day, after meals.(3) Chloramphenicol: 0.5g, 4 times a day, after meals.④ lincomycin: 4 times a day, each 1 to 2 (0.25 to 0.5g).⑤ Flagyl (metronidazole tablets) three times a day, each one (ie 0.2g), meal service, pregnant women, disabled.⑥ Pioneer IV capsule: 4 times a day, each 0.25 ~ 0.5g.Cholagogue: guts to pass, Danning, gallbladder benefits rather Danle, sodium cholate, facilitate bile acid, etc., should also be set aside.Onset in the above drugs, Select a drug taking. Should read the instructions before taking to avoid the wrong clothes. If the symptoms are getting heavier and heavier, it should go to the hospital.
Cholecystitis - prevention and control measuresA. Physical exerciseChinese physicians believed that around the "righteousness, evil can not be dry. Infirmity, blood flow, air-pass notes, liver catharsis degree, bile secretion and excretion of normal. It was found that body fat, do not love the activities, often desk workers susceptible to cholecystitis, so stick to the exercise, not allow obese, and in elderly patients in particular should be so. More specific methods, such as tai chi, qigong, and doing exercise such as walking. L one or two kinds of methods should be based on individual circumstances, continue to exercise, the course of time can be paid off.
Two. Maintain a smooth stoolOften constipation is one of the important reasons of induced cholecystitis. Therefore, to prevent and correct constipation, maintain a smooth stool is necessary. Peacetime should hyperactivity quiet, and to develop regular bowel habits, maintaining normal gastrointestinal function. The diet can eat the fresh fruits and vegetables rich in cellulose, such as bananas, apples, carrots, cabbage, mustard. To increase the intestinal capacity to stimulate bowel movements and prevent constipation, constipation timely treatment.
3. Maintaining a good moodChinese medicine believes that the situation fail to, liver qi stagnation, catharsis dereliction of duty, bile stasis is one of the main factors for the formation of inflammation and stones. Fierce this, pay attention to tone photo spirit, to feel comfortable, to avoid anger, anxiety, and depression is not conducive to healthy emotional changes. A happy and smooth the body's air-blood to reconcile, normal liver function of catharsis, bile normal secretion and excretion, to avoid the occurrence of cholecystitis.
4. Control of bacterial infectionPositive bacterial infection of the treatment of intestinal and other systems to prevent bacteria from invading the intestinal occurred cholecystitis. Aggressive treatment of biliary obstruction, in order to avoid cholestasis have conducive to bacterial growth Erzhi intestinal inflammation.
5 Prohibited alcoholAlcohol consumption can promote the generation of shrink choline enhance gallbladder contraction, intestinal sphincter of Oddi can not be timely relaxation of the outflow of bile may lead to acute exacerbation of chronic cholecystitis or gallstones. Therefore, cholecystitis and cholelithiasis patients are required to avoid alcohol.
6. Proper dietEat high-fat, high cholesterol foods such as egg yolk, roe, animal liver, brain intestine. Bile cholesterol, the easy formation of cholesterol gallstones. Vegetable oil can lower cholesterol, but also to promote cholesterol into bile acids to prevent gallstone formation, it should be mainly in vegetable oils. Deep-fried, the best do not eat fried food, so as not to cause biliary colic. Cooking as light as possible with less oil, home steamed, boiled, avoid fried, fried. Eat more foods rich in vitamin A such as carrots, tomatoes, red and yellow fruits and vegetables. Result of vitamin A can maintain the soundness of the gallbladder inner wall epithelium, may also reduce the formation of cholesterol gallstones. Carrots, fruit juices, shepherd's purse, hawthorn the choleretic the Shugan the role, and can eat. Increase the proportion of protein and carbohydrate in the food, to ensure that the caloric needs and conducive to the liver glycogen generation. Reduce the cellulose content and low residue diet can also reduce gastrointestinal irritation. Increase the number of meals to stimulate bile secretion, reducing the gallbladder bile stasis concentrated. For cholecystitis, gallstones formation mechanism of recent decades, it has been recognized to diet and cholecystitis, gallstones have a certain relationship between the cholesterol stones and people's over-nutrition, and pigment gallstone and food the lack of protein contact, the occurrence of pigment gallstone and biliary ascariasis have a close relationship. Based on these understandings, note the following aspects of the problem may have some role in the occurrence of the prevention of cholecystitis.
(1) a regular eating (three meals a day) is the best way to prevent stones. Because not eating, the gallbladder is full of bile, gallbladder mucosa to absorb water to make bile thicken, easy to form a large bubble of the cholesterol / lecithin, bile viscosity also increased, and finally the formation of biliary sludge. If you eat, the reactivity when food enters the duodenum to secrete cholecystokinin hormone, so that cholecystokinin, when a large number of thick and bile with biliary sludge is discharged to the intestines, thus preventing the formation of stones.
(2) proper nutrition and appropriate restriction of dietary fat and cholesterol. Cholesterol gallstone formation and bile contains higher amounts of cholesterol. Eating too much, especially foods have more fat and cholesterol, will be the increased concentration of cholesterol in the bile, will lead to the formation of cholesterol gallstones. In recent years, the life of our people have been greatly improved people's diet gradually to eat by the type of "food and clothing, eating fine change, fish, meat, poultry, eggs and other food consumption is increasing every year.Proper diet, however, with the improvement of living standards, bringing some to eat good, too much and cause "diseases of affluence", such as obesity, coronary heart disease and gallstones. To prevent these "diseases of affluence", we should pay attention to nutrition is moderate, with particular attention to not eat too much cholesterol and animal fat. Nutrition of the so-called moderate, is the quality and quantity of the diet of the people have to be certain restrictions and requirements of the quality of the diet to provide a variety of appropriate proportion of nutrients, the amount of food are able to maintain the body's normal life activities degrees. In accordance with the principles of proper nutrition, and with reference to the people of our country's eating habits and consumption levels, China's nutritionist the following per person per month is more reasonable food components: 14kg cereals, potatoes 3kg, beans, 1kg, meat 1.5 kg fish 0.5kg and fruit 1kg. Of course, the above criteria are applicable only to ordinary adults in the general activities. In addition, to participate in appropriate physical labor and physical exercise, excessive and will certainly help to prevent nutrition.
(3) to ensure intake of adequate amount of protein. Proteins maintain our physical health necessary nutrients. According to the research, the lack of long-term protein intake and the formation of pigment gallstone. Therefore, to ensure there is enough protein in the diet, will help to prevent the occurrence of pigment gallstone.
(4) pay attention to hygiene to prevent infection of intestinal roundworm. Develop good hygiene practices, wash hands before meals and after, raw fruits must be washed, environmental sanitation, etc., is an effective measure to prevent ascariasis, and thus is also helpful for the prevention of pigment gallstone.
(5) aggressive treatment of intestinal ascariasis and ascariasis. The discovery of intestinal ascariasis taking deworming drugs, roundworm so as not to drill into the biliary tract, in case had bile duct ascariasis, but should be actively treated to prevent pigment gallstone in the course of time.
(6) to maintain gallbladder contractile function, to prevent long-term stasis of bile. Patients with intravenous nutrition of long-term fasting, you should regularly use the cholecystokinin drugs, such as cholecystokinin
Cholecystitis - diagnosis measuresClinical suspicion of acute cholecystitis can be diagnosed by hepatobiliary scintigraphy and ultrasound. Intravenous injection of technetium 99m sub ammonia acetoacetate compounds can be quickly hepatic uptake and excretion, the application of isotope scanning technology can be displayed in turn the liver, extrahepatic bile duct, gallbladder and duodenum. Normal liver and bile duct imaging gallbladder undeveloped, tend to support the clinical diagnosis of acute cholecystitis, the sensitivity up to 97%, specificity of 90%. False positives can occur in total parenteral nutrition (TPN), pancreatitis, critical illness or fasting. Although the ultrasonic diagnosis of cholecystitis better method is not precise enough, but the diagnosis of acute cholecystitis confirmed under ultrasound Murphy sign, gallbladder wall thickening and pericholecystic fluid in the diagnosis.
When atypical clinical manifestations, the diagnosis of acute cholecystitis is more difficult, must identify with cholangitis, pancreatitis, appendicitis, peptic ulcer disease and pleurisy. These diseases has its own clinical characteristics, and hepatobiliary scans and ultrasound can provide reliable evidence for the diagnosis of acute cholecystitis.