Biliary BP: Kufotokozera, Zoyambitsa, Zizindikiro ndi Chithandizo

Malinga ndi kafukufuku zilipo poyera, tsopano chinawonjezeka chiwerengero cha matenda a dongosolo biliary. Ichi ndi chifukwa khalidwe la moyo zilakolako zoipa, zakudya zamagulu ndi cholowa chimene chingawapangitse kukhala zidakwa. Chaka chilichonse pali ponso matenda limodzi ndi chitukuko cha matenda oopsa biliary. Izi matenda aakulu ndipo m'nkhani yathu.

Features matendawa

Biliary oopsa ndi mawonetseredwe ambiri zotupa kubala chotupa chija kuti ikutuluka chiwindi ndi ndulu. Nthawi zambiri, kudwala imeneyi limodzi ndi matenda a chikasu ndiyo obstructive. Anaonekera pa mutu wa kapamba chotupa wayamba tilimbikire pa ducts ya ndulu, ndipo pali miyala kapena tizilombo ting'onoting'ono kulimbikitsa yatsoka mwa mavuto amene sapereka yachibadwa ya ndulu otaya. Oopsa ankachita ngati ndi mtima wabwino, mothandizidwa ndi endoscopy opaleshoni.

zimayambitsa

Biliary BP akhoza kukhala otsatirawa zinthu pathological:

• Chosaopsa ndi zilonda zotupa akuwuka mu umodzi wa mundawo biliary, zikubweretsa kusokonezeka kwa outflow lapansi. Komanso, maonekedwe izi kudwala chifukwa psinjika mmodzi wa ducts kukhala mu pafupi limba neoplasm.
• Cholelithiasis ndi calculous cholecystitis. matenda yodziwika ndi mapangidwe miyala insoluble m'madera osiyanasiyana a dongosolo hepatobiliary ndi maonekedwe a matenda a chikasu ndiyo.
• Kupezeka kwa majeremusi mu ducts wa - helminths.

Komanso, matenda angathe chifukwa malformations kobadwa nako thirakiti biliary, zimene mawonekedwe asintha ndi awiri a lumen wa. Pankhaniyi, zizindikiro za matenda zimapezeka ana.

zizindikiro

Zizindikiro za matenda oopsa biliary pa siteji koyamba za chitukuko, mwamtheradi njira satchula okha, nchifukwa chake odwala ambiri hule matenda. Komabe, tiyenera asungika ndi zizindikiro zotsatirazi:

• kufooka;
• flatulence;
• m'mimba;
• ululu ufulu nusu chapamwamba.

The chizindikiro chachikulu ndi bwino zimasonyeza biliary matenda oopsa, ndi kuwonjezeka mu buku la ndulu chifukwa kuthamanga mu dongosolo zipata. Pa nthawi limapezeka magazi m'thupi, thrombocytopenia, leukopenia.

Motero matenda a chikasu ndiyo chifukwa cha kuthamanga makina pa ndulu ya. madzi akhoza kudziunjikira mu zonse m'mimba (ascites), lomwe mbali ndi kukana kwake kwa mankhwala mosalekeza. Kuti tichotse izo amatenga nthawi yaitali. Wodwala wayamba kuonjezera buku la mmimba, mapazi kutupa, kuwonjezeka udzachitika pa kutsogolo kwa mitsempha ya linga m'mimba.

Mawonetseredwe aakulu a matenda ndi magazi m'mimba, m'matumbo kapena kum'mero. Zonsezi limodzi ndi kusanza magazi. Ngati magazi kumachitika mu kholingo, ndi chopondapo adzakhala magazi.

diagnostics

njira malangizo a kafukufuku ikuchitika milandu zotsatirazi:

• kutsimikiza pamaso pa matenda oopsa biliary;
• kukhazikitsa matenda, chimene chinapangitsa pakutchulidwa wa kudwala zimenezi.

Zowaphunzitsa kwambiri amaonedwa kukhala pansipa njira imene ili.

ultrasound

Imodzi mwa mfundo zofunika posankha chithandizo dongosolo biliary oopsa ndi kudziwa mlingo wa ndigwire ya ndulu ducts. Pankhaniyi, waukulu si olanda njira imatengedwa ultrasound mosamala zonse m'mimba ndi danga retroperitoneal. Chifukwa matenda zimenezi umasonyeza kuwonjezeka extra- ndi intrahepatic ya ndulu ducts, lomwe ndi chizindikiro cha kudwala a.

Biliary oopsa wapotalikira chipika mlingo wofanana ndi kukula kwa hepaticocholedochus, ndipo patapita kanthawi yowonjezera ducts intrahepatic, ndipo pali kuwonjezeka mu kukula kwa ndulu ya. The ritsa awiri ndi oposa 10 mm ngati neoplasms. Mkulu kupezeka wagawo kudziwa akugona ndulu ndi kukula intrahepatic ducts. Chotupa zimawonedwa 51,3% ya milandu.

yopangidwa tomography

CT wa danga pamimba ndi retroperitoneal amathandiza kuti muzione mbali ya kapangidwe ka ziwalo zambiri. Phunziro lino amapereka mpata zotsatira zolondola ndi dongosolo lalikulu adziwe mmene kumera awo anachitika dongosolo pafupi.

njira kafukufuku Radiopaque

Ngati pali kukayikitsa kudwala matenda oopsa monga biliary, akatswiri zambiri amathera retroholangiopankreatografiyu kapena endoscopic cholangiography. Chiyambi zipangizo radiopaque kwa njira zimenezi ikuchitika m'njira zosiyanasiyana, koma ali ndi zotsatira zofanana. Chifukwa chinthu choterocho mu radiograph akhoza amanena mlingo wa patency a dongosolo ritsa.

biopsy

Kufufuza koteroko akuti ndi olanda, ndipo amachita zimenezi kokha ngati zovuta, ndicho mu milandu amaganiziridwa chotupa chotupa. Childs anachita aiming trepanobiopsy chiwindi pansi ultrasound malangizo. A pang'ono minofu anatengedwa kuchokera ku gwero la kudwala, amene pansi Kupenda histopathological. chifukwa Izi zimathandiza kuti uweruze chikhalidwe cha neoplasm a.

matenda laparoscopy

Ngati pamwamba njira yodziwira sanathe kupeza chifukwa cha matenda oopsa biliary, ndi wozengereza opareshoni. Izo zikhoza kuchitidwa ndi laparoscopy kapena laparotomy, ndi mwayi pa nthawi yocheza monga matenda ndiponso zochizira opaleshoni. Kugwiritsa diagnostics anachita mwachindunji intraoperative kulingalira ndi biopsy. Opaleshoni njira ankachiritsa malinga ndi chikhalidwe cha kudwala ndi anakumana.

chithandizo

Ngati inu anapezeka ndi matenda oopsa biliary, mankhwala ndiwofatsa kapena opaleshoni njira.

chithandizo ndiwofatsa nthawi zonse umachitikira matenda zinchito, kuwonongedwa kwa amene amapangidwa ndi mankhwala monga "Atenolol" "nitroglycerin", "Monopril," "Inderal", "Nitrosorbide" "Sulodexide", "ednit".

Opaleshoni mankhwala ikuchitika pokhapokha ngati mankhwala ali ndiribe zidapatsa chifukwa chilichonse. opaleshoni ikuchitika ndi kudziwika ascites, magazi matumbo, m'mimba ndi kum'mero, komanso chitukuko cha matenda gipersplenicheskogo. njira zamakono idzagwiritsa ntchito laparoscopy opaleshoni, amene ali asang'ambe opaleshoni ndi oyamba wofatsa kudzera amacheka yaing'ono woonda chubu ndi kamera ndi kuyatsa micromanipulators. Pa polojekiti, pali chithunzi poganizira dokotala amapanga kuchotsa zotchinga.

Palibe omva medicate ndi kutenga mankhwala ndi mankhwala kuchotsa chotupacho, kuchepetsa voliyumu ya pamimba ndi kuchotsa miyala popanda dotolo. Komanso, ngati wapezeka biliary oopsa, chiwindi ndi ndulu, anachita zotsatirazi mankhwala:

• Iwo kupereka dropper kukhalabe madzimadzi milingo mulingo woyenera ndi electrolyte;
• ntchito mankhwala kuti kusintha otaya magazi ndi maselo zakudya chiwindi;
• ikuchitika mankhwala antibacterial;
• amathera biliary decompression njira.

Pomaliza

Choncho, biliary oopsa akuti ndi matenda aakulu. Kwenikweni matenda amene kuyambitsa matenda lino ankachitira opaleshoni. Koma usaope, chifukwa chithandizo yake kwa dokotala angathe kuchotsa muzu wa matenda oopsa ichi ndi kudwala wokha.