胆结石 PPT课件.ppt

Gallstones胆结石,Understandingthegallbladderandbile了解胆囊和胆汁,Bileismadeintheliver.Itispassedintotinytubescalledbileducts.Thesejointogether(likethebranchesofatree)toformthemainbileduct.Bileconstantlydripsdownthebileducts,intothemainbileduct,andintothegut.胆汁产生在肝脏中。它被传递到小管被称为胆管。这些联合起来（如树枝），以形成主胆管。胆汁不断滴落下来的胆管，进入主胆管，进入肠道。,Thegallbladderliesundertheliverontherightsideoftheupperabdomen.Itislikeapouchwhichcomesoffthemainbileductandfillswithbile.Itisareservoirwhichstoresbile.Thegallbladdercontracts(squeezes)whenweeat.Thisemptiesthestoredbilebackintothemainbileduct.Thebilepassesalongtheremainderofthebileductintotheduodenum(thefirstpartofthegutafterthestomach).胆囊位于右侧的上腹部的肝脏下。它像一小袋，其脱落的主要胆管和充满胆汁。这是一个“蓄水池”，它存储胆汁。当我们吃食物时，胆囊挤压。此清空存储胆汁回主胆管。胆汁沿着胆管的剩余部分到十二指肠（肠胃后的第一部分）通过。胆汁帮助消化食物，特别是脂肪的食物。Bilehelpstodigestfood,particularlyfattyfoods.胆汁帮助消化食物，特别是脂肪的食物。,Whataregallstones?什么是胆结石？,Gallstonesoccurwhenbile,whichisnormallyfluid,formsstones.Theycommonlycontainlumpsofcholesterol-like(fatty)materialthathassolidifiedandhardened.Sometimesbilepigmentsorcalciumdepositsformgallstones.Sometimesjustafewsmallstonesareformed,sometimesagreatmany.Occasionally,justonelargestoneisformed.胆结石发生时胆汁，这通常是流体，形成结石。它们通常含有的胆固醇类（脂肪酸）的材料块体，且已固化和硬化。有时胆色素或钙盐沉积形成胆结石。有时只是一些小的结石形成，有时很多。偶尔，只是一个大石头就形成了。,About1in3women,and1in6men,formgallstonesatsomestageintheirlife.Theybecomemorecommonwithincreasingage.Theriskofforminggallstonesincreaseswithpregnancy,obesity,andifyoutakecertainmedicines.Beingvegetariananddrinkingamoderateamountofalcoholreducestheriskofforminggallstones.约1/3的女性，16名男子，形成胆结石在一生中的某个阶段。他们成为随着年龄的增加更为常见。形成胆结石的风险与怀孕，肥胖会增加，如果你把某些药物。作为素食主义者，饮酒适量减少形成胆结石的风险。,Whatproblemscangallstonescause?什么可以导致胆结石？,UsuallynoneMostpeoplewithgallstonesdonotknowtheyhavethem.Thestonesstayinthegallbladderandcausenosymptoms.(Becausegallstonesarecommon,theyareoftenfoundwhentheabdomenisscannedorx-rayed.Thesetestsmaybedonewhenlookingforthecauseofabdominalsymptoms.Ifgallstonesarefoundthisdoesnotalwaysmeanthattheyarethecauseofsymptoms.Theymaybe,buttheyaresometimesblamedforcausingsymptomswhichareduetoothercauses.)通常患有胆结石的人不知道他们有结石。结石停留在胆囊并引起任何症状。因为胆结石是常见的，他们往往发现腹部扫描或X光检查时，寻找腹部症状的原因时，这些检查可以。如果发现胆结石，这并不一定意味着他们的症状的原因它们可以是，但它们有时指责引起症状这是由于其他原因造成的。PossibleproblemsAbout3in10peoplewithgallstonesdevelopsymptomsorproblems.Theseinclude:在10人的胆结石可能有3人出现症状或问题。这些问题包括：,Biliarycolic.Thisisaseverepainintheupperabdomen.Thepainisusuallyworsttotheright-handside,justbelowtheribs.Itiscausedbyastonethatgetsstuckinthecysticduct.Thisisthesmalltubethattakesbilefromthegallbladdertothebileduct.Thegallbladderthensqueezeshardtodislodgethestone,andthiscausespain.Thepaineasesandgoesifthegallstoneispushedoutintothebileduct(whichthenusuallypassesoutintothegut),orifitfallsbackintothegallbladder.Paincanlastjustafewminutes,butmorecommonlylastsseveralhours.Aseverepainmayonlyhappenonceinyourlifetime,oritmayflareupfromtimetotime.Sometimeslessseverebutnigglypainsoccurnowandthen,particularlyafterafattymealwhenthegallbladdercontractsmost.疼痛。这是在上腹部剧烈疼痛。疼痛通常最坏的右手侧是，只是肋条下面。它是由卡在胆囊管的石头造成的。这是小管中的胆汁从胆囊到胆管。胆囊然后挤压很难再被动摇的石头，这会导致疼痛。疼痛减轻并进入如果胆石被推出到胆管（然后通常穿出进入肠道），或者如果它落回到胆囊。疼痛可以持续短短几分钟，但更常见的持续几个小时。剧烈疼痛可能只发生一次，在你的一生，也可能不时爆发时间。有时不那么严重，但会时不时的再出现，尤其是在脂肪餐后胆囊活动时最容易。,Inflammationofthegallbladder.Thisiscalledcholecystitis.Thiscanleadtoinfectioninthegallbladder.Symptomsusuallydevelopquicklyandincludeabdominalpain,fever,andbeinggenerallyunwell.Youwillnormallybeadmittedtohospitalandhaveyourgallbladderremovedsoonifyoudevelopthisproblem.胆囊发炎。这就是所谓的胆囊炎。这可能会导致感染的胆囊。症状通常发展迅速，包括腹痛，发热，且通常是不舒服。你通常会被送往医院接受治疗，让您的胆囊移除很快，如果你早期发现了这个问题。,JaundiceThisisanuncommoncomplicationofgallstones.Itoccursifagallstonecomesoutofthegallbladder,butgetsstuckinthebileduct.Bilethencannotpassintothegut,andsoseepsintothebloodstream.Thiscausesyoutogoyellow(jaundiced).Thestonemayeventuallybepassedintothegut.However,itiscommontoneedanoperationtoremoveagallstonewhichhasbecomestuckinthebileduct.(Note:therearemanyothercausesofjaundiceapartfromgallstones.)黄疸，这是胆结石的一种罕见的并发症。它发生，如果一个胆石出来胆囊，但卡在胆管。胆汁然后不能通过进入肠道，所以渗透到血液中。这会导致你去黄。这块石头可能最终被传递到肠道。然而，它是常见的需要手术以去除胆石这已成为卡在胆管。（注：有黄疸除了胆结石的许多其他原因。）,Pancreatitis.Thisisaninflammationofthepancreas.Thepancreasmakesafluidrichinenzymes(chemicalswhichdigestfood).Thepancreaticfluidtravelsdownthepancreaticduct.Thepancreaticductandbileductjointogetherjustbeforeopeningintotheduodenum.Ifagallstonebecomesstuckhereitcancausepancreatitiswhichisapainfulandseriouscondition.胰腺炎。这是胰腺的炎症。胰腺使得液体含有丰富的酶（化学物质消化食品）。胰腺液向下传播胰管。胰管和胆管一起加入刚刚开放进入十二指肠之前。如果胆结石成为困在这里它可以引起胰腺炎是一种痛苦，病情严重。Othercomplicationsoccasionallyoccursuchassevereinfectionofthebileduct(cholangitis),andotheruncommongutproblems.其他并发症偶有发生，如胆管（胆管炎）的严重感染，以及其他不常见的肠道问题。,Whatarethetreatmentsforgallstones?胆结石的治疗方法时什么？,NotreatmentisneededinmostcasesItisoftenbesttoleavegallstaonesaloneiftheycauselittleornosymptoms.有些治疗是不必要的，在大多数情况下往往不必处理，如果造成很少或根本没有症状。SurgeryAnoperationtoremovethegallbladderistheusualtreatmentifyouhavesymptomscausedbygallstones.Differenttechniquestoremovethegallbladdermayberecommendeddependingonitssite,size,andotherfactors.手术如果症状是由结石导致的，通常通过手术摘除，用什么方式的手术去摘除胆囊根据其大小及其他影响因素。,Key-holesurgeryisnowthemostcommonwaytoremoveagallbladder.(Thisiscalledlaparoscopiccholecystectomy.)Thisoperationonlyneedssmallcutsintheabdomenwithasmallscarremainingafterwards.Theoperationisdonewiththeaidofaspecialtelescopethatispushedintotheabdomentoseethegallbladder.Itisnotsuitableforallpeople.腹腔镜手术是现在最常用的方法，以消除胆囊。（这就是所谓的腹腔镜胆囊切除术）此操作仅需要在腹部小切口用小疤痕之后剩余。操作，是用一种特殊的望远镜被推入腹部看到胆囊的助剂。它并不适合所有的人。有些人胆结石需要传统的手术切除胆囊（胆囊切除术）。可能需要其他外科手术，如果一块石头卡在胆管。,Somepeoplewithgallstonesneedthetraditionaloperationtoremovethegallbladder(cholecystectomy).有些人胆结石需要传统的手术切除胆囊（胆囊切除术）。Othersurgicalproceduresmaybeneededifastonegetsstuckinthebileduct.如果一块石头卡在胆管，可能需要其他外科手术。,MedicationTakingamedicineissometimesanoption,butusuallyonlyforsmallstones.Theaimistodissolvethestones.Thismaytakeyearsoftreatment,andisnotalwayssuccessful.Itmaybetriedinpeoplewheresurgeryisnotsuitable.药物治疗药物治疗有时是一种选择，但通常只为小石头。其目的是“溶解”的石头。这可能需要数年的治疗，而且不总是成功的。这可能是试图在人们那里手术不适合经过胆囊删除。,Afteragallbladderisremoved胆囊摘除后,Youdonotneedagallbladdertodigestfood.Bilestillflowsfromthelivertothegutoncethegallbladderisremoved.However,thereisnolongeranystorageareaforbilebetweenmeals.Theflowofbileisthereforeconstan