Kufotokozera obstructive matenda a chikasu ndiyo: Zoyambitsa, zizindikiro ndi mbali chithandizo

Kodi obstructive matenda a chikasu ndiyo? Zimayambitsa ndi mankhwala kwa matenda adzakhala pansipa. Mudzaphunziranso zimene zizindikiro za khalidwe la matenda ndi mmene matenda.

mfundo zofunika

Pakuti obstructive matenda a chikasu ndiyo khalidwe zili mkulu zimakhala ndi zinthu monga bilirubin. mchitidwe Izi zimamupatsa khungu ndipo zimagwira ntchito zosiyanasiyana mucous chikasu.

Ya ndulu pigment bilirubin foni. Malinga ndi akatswiri, iwo ali magulu awiri: mzere wolunjika, kuti, chikugwirizana ndi mosadziwika, ndiko kukhala mfulu.

Choncho, obstructive matenda a chikasu ndiyo khalidwe kudzikundikira chosefukira cha mchitidwe anati, kumene kumachitika chifukwa cha kulowererana wathunthu kapena tsankho lumen thirakiti biliary. dzina lina la matenda ndi matenda a chikasu ndiyo.

The chikuchititsa mavuto a matenda

Masiyanidwe matenda a zimayambitsa matenda a chikasu ndiyo obstructive ayenera kuchitika kokha m'chipatala. Pa zimene kafukufuku njira pa ntchito yomweyo, ife tinena pansipa.

M'chigawo wabwinobwino wa ya ndulu mtima kupangidwa mu chiwindi, ayenera kuwonetsedwa fupipafupi mu duodenum, kuti kutenga nawo mbali mu ndondomeko ya chimbudzi. Komabe, izi sizichitika zina. Chopinga otere ndondomeko zingaphatikizepo zifukwa zotsatirazi:

• Stenosis, kapena kuchepetsa otchedwa ritsa, ndi mucosal edema pamaso pa cicatricial postinflammatory stricture (mwachitsanzo, anamuona cholangitis kapena cholecystitis) kapena psinjika chotupa ndi;
• mawotchi kutsekeka kapena otchedwa alipo gawo bumped biliary calculi (miyala) pamaso pa cholelithiasis.

zopambana izi zonse zimalambira pathological ya ndulu stasis (i.e. mapangidwe cholestasis) chifukwa mu hypoxia kumachitika, zomwe opweteka hepatocytes.

Tiyenera kuona kuti chifukwa cha matenda a chikasu ndiyo obstructive akhoza kukhala ndi abscess, chotupa cha ndulu kapena kapamba, komanso majeremusi monga zozungulira kapena echinococcus.

zizindikiro

Monga tikuonera obstructive matenda a chikasu ndiyo? Zizindikiro za matenda osaoneka kovuta. Monga ulamuliro, matenda amenewa akufotokozera bwinobwino.

Malinga ndi akatswiri, matenda a chikasu ndiyo anaonetsa mbali monga:

• nseru, malungo, kusanza;
• woopsa koopsa ululu ufulu nusu chapamwamba, chimene chimamanga m'mafunde ndi yochokera kwa phewa kumanja kapena phewa;
• discoloration wa ndowe, kuyambira bilirubin salinso akulowa intestine;
• kusankha bilirubin mu mkodzo, zomwe zimalimbikitsa coloration ake mu woderapo mtundu;
• kuyabwa amphamvu chifukwa kudzikundikira mu thupi la ya ndulu zidulo poizoni.

Zizindikiro zina za matendawa

Kodi tingawazindikire chitukuko cha matenda a chikasu ndiyo obstructive? aakulu chikhalidwe ya ndulu otaya Violation kumachitika chimodzimodzi monga momwe tafotokozazi. Komabe, choopsa zizindikiro chotero achuluke malingana ndi nthawi ya cholestasis. Komanso, nthawi zina, odwala kuona steatorrhea (ie wapezeka undigested mafuta m'manyi), khungu hyperpigmentation, kuwonda ndi xanthoma (ie zamadzimadzi mafunsidwe mu khungu).

Tiyenera kuona kuti yake masiyanidwe matenda a matenda a chikasu ndiyo obstructive chingalepheretse chitukuko cha matenda monga matenda enaake. Matendawa yodziwika ndi mapangidwe fibrous zigawo connective minofu chiwindi, amene angabuke poyankha hepatocyte necrosis chifukwa matenda kagayidwe kachakudya ndi akusowa oxygen.

Ndi chitukuko cha matenda a chikasu ndiyo mu thupi limasintha kagayidwe wa mavitamini mafuta-sungunuka. Komanso, losowa vitamini D kumabweretsa kufooka kwa mafupa (ie, kuchuluka fupa fragility), ndi chifukwa kuti wodwala akumva kusapeza mu msana (lumbar kapena thoracic) ndipo akuvutika fractures lachibadwa.

Tiyeneranso kuti matenda a chikasu ndiyo nthawi zambiri amakwiya chitukuko cha matenda hemorrhagic, womwenso nosebleeds, maonekedwe a mtima "asterisks" ndi mikwingwirima pa khungu. zochitika amenewa chotsatira cha akusowa vitamini K.

Ndi kusowa kwa vitamini A m'thupi la wodwalayo amachepetsa ku madzulo masomphenya. Komanso, nthawi yaitali cholestasis kwambiri kumawonjezera Mwina wa mapangidwe gallstones.

Komanso pa maziko a chitukuko cha matenda a chikasu ndiyo kumaonjezera ngozi ya matenda ndi cholangitis bakiteriya, kapena otchedwa kutupa kwa ducts ya ndulu. Izi kawiri kawiri anaonetsa malungo ndi ululu pamimba chapamwamba bwino.

Njira matenda a matenda a chikasu ndiyo obstructive

Tsopano, inu mukudziwa, ndilo lililonse kwa okhutira mkulu wa obstructive matenda a chikasu ndiyo bilirubin m'magazi. Komabe, kusanthula amuzolengedwa magazi pa matenda ngati sapereka wathunthu matenda chithunzi. Choncho, akatswiri ambiri kuchita mayesero ena choyezera, komanso kugwiritsa ntchito njira zosiyanasiyana malangizo.

Choncho, kwa matenda a matenda a chikasu ndiyo obstructive ayenera:

• kupanga wathunthu magazi;
• kukumana endoscopic retrograde ndi maginito kumveka cholangiopancreatography;
• linakhala CT jambulani ndi ultrasound wa pamimba;
• kupanga laparoscopy ndi biopsy.

Kuchotsedwa kafukufuku imathandiza madokotala amachitsimikizira kukhalapo kapena kusapezeka kwa matenda a chikasu ndiyo.

Obstructive matenda a chikasu ndiyo: zochizira matenda

Monga ulamuliro, odwala onse anapezeka ndi 'obstructive matenda a chikasu ndiyo "yomweyo m'chipatala kuchipatala opaleshoni. Pambuyo kafukufukuyu akatswiri chitani mankhwala msanga a matenda. Childs, matenda akuthamanga mankhwala ndiwofatsa. Ndi cholinga chake ndi kuthetsa wa matenda a chikasu ndiyo ndipo cholestasis, komanso olimba a alili. Pamene mankhwala ikuchitika ndi kulandira nthumwi m'thupi ndipo pogwiritsa ntchito njira endoscopic.

Ndipo kuthetsa matenda a chikasu ndiyo nthawi zambiri amachita masitepe opaleshoni.

alowererepo ntchito ikuchitika kuti decompression (i.e. kuchepetsa kuthamanga), kapepala kakuti biliary ndi ya ndulu otaya kuyambiranso, kupewa kulephera chiwindi ndi matenda enaake. Pamene ntchito osati opaleshoni lotseguka, koma laparoscopic amene akupereka pansi ultrasound kapena CT jambulani. Zodabwitsa ndizakuti, wachiwiri wapatsidwa zokonda wapadera chifukwa cha Mwina otsika matendawo ndi ang'ambe thupilo yaing'ono.

mankhwala ena

Kuwonjezera opaleshoni, chiwembu zovuta mankhwala a matenda a chikasu ndiyo obstructive ndi zikuphatikizapo zinthu monga:

• gepatoprotektsiya (mavitamini a gulu B, ntchito yokonza "Essentiale"), kuwongolera a kagayidwe (polandira ascorbic acid ndi "pentoxy"), ntchito asidi ursodeoxycholic;
• detoxification mankhwala yotithandiza diuresis, utsogoleli wa njira shuga, saline, sodium mankhwala enaake, gemodeza;
• ziwiya kusintha microcirculation mu chiwindi;
• chithandizo antibacterial zinachitikira kujowina matenda;
• timadzi mankhwala amene lowonjezera ndi njira kupewa zilonda thirakiti m'mimba.

opaleshoni zotsatira

Iwo ayenera kukumbukira kuti alowererepo ntchito ku matenda a chikasu ndiyo aakulu angakhale ndi zotsatira chowawa. Choncho, monga mankhwala Kwalamulidwa yekha chifukwa cha matenda.

Ngati alili chololera, m'pofunika kudikirira mavuto cholestasis syndrome, ndiyeno kachiwiri mankhwala.