【2017年整理】胆囊相关知识.ppt

胆胀（胆囊炎、胆石症） 中医护理方案 普外科--- 熊金梅 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 目录 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 一 胆囊的解剖位置 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 急性胆囊炎、胆石症是指湿热之邪阻滞肝胆，导致的肝胆气机紊乱，疏泄失常。 多与饮食不节、蛔虫上扰或情志刺激等因素有关。 二 概念及病因 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 三 临床表现及辅助检查 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 三 临床表现及辅助检查 （二）体征 右上腹可有不同程度压痛或叩痛，炎症波及浆膜时可出现反跳痛和肌紧张。 （三）检查　　 1、血常规检查可见白细胞计数及中性粒细胞比例升高，部分病人可有血清胆红素、转氨酶或淀粉酶升高。 2、B超可见胆囊增大，胆囊壁增厚，并可探及胆囊内结石影。CT、MRI均可协助诊断。 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 四 一般治疗治疗 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 四 一般治疗 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 四 一般治疗 腹腔镜胆囊切除术：　 腹腔镜胆囊切除术现已成为一种成熟的外科技术，并以创伤小、病人痛苦少、恢复快为特点，为广大病人所接受 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 四 一般治疗 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 五 常见证候要点 症状 舌苔 肝胆郁滞证 右胁胀满疼痛，痛引右肩，遇怒加重，胸闷脘胀，善太息，嗳气频作，吞酸嗳腐。 苔白腻 肝胆湿热证 右胁胀满疼痛，胸闷纳呆，恶心呕吐，口苦心烦，大便粘滞，或见黄疸。 舌红苔黄腻 气滞血瘀证 右胁刺痛较剧，痛有定处而拒按，面色晦暗，口干口苦 舌质紫暗或舌边有瘀斑 肝郁脾虚证 右胁胀痛，倦怠乏力，情绪抑郁或烦躁易怒，腹胀，嗳气叹息，口苦，恶心呕吐，食少纳呆，大便稀溏或便秘 舌淡或暗，苔白 胆腑郁热证 右胁灼热疼痛，或绞痛或胀痛或钝痛或剧痛。疼痛放射至右肩胛，脘腹不舒，恶心呕吐，大便不畅或见黄疸或伴发热 舌质红，苔黄 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 六 常见症状/证候施护 Eva