Biliary Tawg: hauj lwm, Ua, Cov tsos mob thiab kev kho mob

Raws li laj mej pej xeem muaj cov ntaub ntawv, tam sim no nce tus naj npawb ntawm cov kab mob ntawm lub biliary system. Qhov no yog vim tus cwj pwm ntawm ib tug tsis zoo txoj kev ua neej, tsis zoo noj cov zaub mov, thiab raws roj ntsha predisposition. Txhua xyoo muaj ib qho kev nce ntawm cov kab mob nrog txoj kev loj hlob ntawm biliary tawg. Qhov no kab mob loj thiab yuav tsum tau tham nyob rau hauv peb tsab xov xwm.

Nta ntawm tus kab mob no

Biliary tawg yog feem ntau manifestation ntawm hlav kev coj tus kheej malignancy uas tshwm sim nyob rau hauv daim siab thiab gallbladder. Heev feem ntau, qhov no pathology yog nrog los ntawm obstructive daj ntseg. Nyob ntawm lub taub hau ntawm lub pancreas mob pib mus nias rau cov kua tsib ducts, thiab muaj pob zeb los yog polyps txhawb tshwm sim ntawm siab uas tsis muab tej kua tsib txaus. Tawg kho ntawd yog hais tias yog benign, nrog rau cov kev pab los ntawm kev phais endoscopy.

ua rau

Biliary Tawg yog tau tsim hauv qab no pathological tej yam kev mob:

• Benign thiab phem hlav sawv nyob rau hauv ib tug ntawm cov biliary ib ntsuj av tau, ua rau muaj kev cuam tshuam ntawm cov outflow. Nyob rau hauv tas li ntawd, cov tsos ntawm no pathology ua compression ntawm ib qho ntawm lub ducts tsim mus rau hauv ib tug nyob ze hloov khoom nruab nrog neoplasm.
• Cholelithiasis thiab calculous cholecystitis. Tej kab mob yog tsiag ntawv los ntawm tsim ntawm insoluble pob zeb nyob rau hauv ntau qhov chaw ntawm lub hepatobiliary system thiab cov tsos ntawm daj ntseg.
• Muaj nyob rau hauv lub ducts ntawm lub cab - cua nab.

Tsis tas li ntawd, tus kab mob no tej zaum yuav tsim vim congenital malformations biliary ib ntsuj av tau, uas muaj ib tug kho zoo lawm thiab txoj kab uas hla ntawm lub lumen. Nyob rau hauv cov ntaub ntawv no, cov tsos mob ntawm tus kab mob manifest lawv tus kheej nyob rau hauv thaum yau.

cov tsos mob

Cov tsos mob ntawm biliary tawg ntawm thawj zaug rau theem ntawm nws txoj kev loj hlob, kiag li tsis muaj txoj kev tsis qhia lawv tus kheej, uas yog vim li cas muaj ntau yam neeg mob ua rau muaj mob tus kab mob no. Txawm li cas los, nws yuav tsum tau saib cov nram qab no cov tsos mob:

• tsis muaj zog;
• flatulence;
• raws plab;
• mob nyob rau hauv txoj cai qaum quadrant.

Lub ntsiab seb mob dab tsi yog kom meej meej indicative ntawm biliary tawg syndrome, yog ib qho kev nce rau hauv lub ntim ntawm tus po txuam nrog lub siab nyob rau hauv lub portal system. Thaum ib tug tom qab theem no tshwm sim anemia, thrombocytopenia, leukopenia.

Yog li muaj mob daj ntseg raws li ib tug tshwm sim ntawm cov neeg kho tshuab nyem rau lub gallbladder. kua tej zaum yuav noog nyob rau hauv lub plab kab noj hniav (ascites), uas feature yog nws kam mus rau lub tu ncua txoj kev kho. Yog xav tau tshem ntawm nws feem ntau yuav siv sij hawm ib tug ntev lub sij hawm. Tus neeg mob pib nce qhov ntim ntawm lub plab, o taw, lub expansion yuav siv sij hawm qhov chaw nyob rau pem hauv ntej ntawm cov leeg ntawm lub plab phab ntsa.

Qhov loj tshaj plaws uas paub txog tus kab mob no yog ib tug los ntshav nyob rau hauv lub plab, hnyuv los yog txoj hlab nqos mov. Tag nrho cov no yog nrog los ntawm ntuav ntshav. Yog hais tias los ntshav tshwm sim nyob rau hauv cov hlab pas, cov quav yuav ntshav.

diagnostics

Instrumental txoj kev ntawm kev tshawb fawb yog nqa tawm nyob rau hauv cov nram no mob:

• kom paub meej tias muaj cov biliary tawg;
• mus nrhiav kom tau tus kab mob, uas tshwm sim los qhov tshwm sim ntawm xws pathology.

Qhov tseem tuav pom tau hais tias yuav hauv qab no teev txoj kev.

ultrasound

Ib tug ntawm cov ntsiab lus tseem ceeb nyob rau hauv kev xaiv ib tug kho mob txoj kev npaj biliary tawg yog los mus txiav txim rau theem ntawm kev thaiv cov kua tsib ducts. Nyob rau hauv cov ntaub ntawv no, lub ntsiab uas tsis yog-tus qauv no yog xam tias yog ultrasound kev soj ntsuam ntawm lub plab kab noj hniav thiab retroperitoneal qhov chaw. Vim xws mob qhia expansion extra- thiab intrahepatic kua tsib ducts, uas yog cov tsos mob ntawm ib tug pathology.

Biliary tawg distal thaiv theem yog tsiag ntawv los ntawm expansion ntawm hepaticocholedochus, tab sis tom qab tej lub sij hawm expanding intrahepatic ducts, thiab muaj yog ib qho kev nce nyob rau hauv lub loj ntawm lub gallbladder. Cov ciav txoj kab uas hla yog ntau tshaj li 10 hli nyob rau hauv cov ntaub ntawv ntawm neoplasms. Rau siab muaj tsev ntes pw tsaug zog gallbladder thiab expansion intrahepatic ducts. Lub qog cai nyob rau hauv 51,3% ntawm cov neeg.

xoo tomography

CT ntawm lub plab mog thiab retroperitoneal qhov chaw yuav pab tau pom cov yam ntxwv ntawm cov qauv ntawm cov ntau yam hauv nrog cev. Txoj kev tshawb no muab ib lub sij hawm kom tau muaj tseeb tau tiv thaiv loj formations thiab ntsuam xyuas ntau npaum li cas lawv germination tshwm sim nyob rau hauv lub nyob ib sab qauv.

Radiopaque kev tshawb fawb txoj kev

Yog hais tias muaj yog lub sijhawm twg los ntawm pathology xws li biliary tawg, cov kws txawj feem ntau siv retroholangiopankreatografiyu los yog endoscopic cholangiography. Introduction ntawm radiopaque ntaub ntawv rau tej kev nqa tawm nyob rau hauv ntau txoj kev, tab sis muaj ib tug zoo li cov nyhuv. Vim li ib tug yeeb tshuaj nyob rau hauv lub radiograph yuav kwv yees cov degree ntawm patency ntawm lub duct system.

me

Tej kev tshawb fawb yog xav tau tus, thiab chaw uasi mus rau nws xwb nyob rau hauv lub complex cov ntaub ntawv, namely nyob rau hauv tus neeg mob uas xav tias kab mob qog hlav. Feem ntau ua aiming trepanobiopsy siab nyob rau hauv ultrasound kev taw qhia. Ib tug me me npaum li cas ntawm cov ntaub so ntswg coj ntawm qhov chaw pathology, uas yog raug rau histopathological xeem. Qhov no tshwm sim ua rau nws tau mus txiav txim rau qhov xwm ntawm ib tug neoplasm.

diagnostic laparoscopy

Yog hais tias saum toj no diagnostic txoj kev yuav tsis tau paub qhov ua rau ntawm biliary tawg, yog nqa tawm ib lub lag luam. Nws yuav ua tau los ntawm laparoscopy los yog laparotomy, nrog ib lub sij hawm rau ib lub sij hawm rau siv raws li ib tug diagnostic thiab kho phais cov txheej txheem. Siv diagnostics ua ncaj intraoperative imaging thiab me. Phais cov txheej txheem tau ua raws li qhov xwm ntawm tus pathology ces yuav tsum.

kev kho mob

Yog hais tias koj tau raug tshuaj mob nrog biliary tawg, kev kho mob yog conservative los yog phais txhais tau tias.

Conservative kev kho mob feem ntau yog nqa tawm nyob rau hauv haumxeeb mob, cov tshem tawm uas yog ua los ntawm xws li cov tshuaj raws li "Atenolol" "nitroglycerin", "Monopril," "Inderal", "Nitrosorbide" "Sulodexide", "ednit".

Phais kho mob yog nqa tawm tsuas yog hais tias tus uas muaj npe tshuaj tsis tau yielded tej tshwm sim. Lub lag luam yog nqa tawm los ntawm kev nrhiav kom tau ntawm ascites, plab hnyuv los ntshav, mob plab, thiab txoj hlab nqos mov, raws li tau zoo raws li cov kev loj hlob ntawm gipersplenicheskogo syndrome. Niaj hnub nimno txoj kev koom nrog txoj kev siv cov kev phais laparoscopy, uas yog tsawg kawg tus phais nrog maj taw qhia los ntawm me me incisions nyias raj nrog lub koob yees duab thiab teeb pom kev zoo micromanipulators. Nyob rau saib, yog ib daim duab, tsom rau tus kws kho mob ua qhov kev tshem tawm ntawm obstacles.

Nyob rau hauv tsis muaj cov ntaub ntawv yuav self-medicate thiab noj tshuaj thiab cov tshuaj kom tshem tawm cov qog, txo qhov ntim ntawm lub plab mog thiab tshem tawm cov pob zeb tsis muaj ib tug tshuaj. Tsis tas li ntawd, yog hais tias tus kuaj biliary tawg, daim siab thiab tsib lub zais zis, ua nram qab no kev kho mob cov kauj ruam:

• Lawv muab ib tug dropper kom muaj kev pom kev kua ntau ntau thiab ntsha;
• siv cov tshuaj uas txhim kho cov ntshav txaus thiab noj zaub mov mob hlwb;
• nqa antibacterial txoj kev kho;
• siv biliary decompression txoj kev.

xaus

Yog li, biliary tawg yog xav tau ib tug mob phem heev. Yeej kab mob uas ua rau tus mob no yog kho surgically. Tab sis tsis txhob ntshai, vim hais tias raws sij hawm kev kho mob rau cov kws kho mob yuav tshem tawm hauv paus ua kom muaj qhov tawg thiab pathology nws tus kheej.