Hepatic adenoma: ndi chiyani, matenda ndi chithandizo

Zamkati

• Zizindikiro zazikulu
• Momwe matendawa amapangidwira
• Momwe mankhwalawa amachitikira
• Zovuta zotheka

Hepatic adenoma, yomwe imadziwikanso kuti hepatocellular adenoma, ndi mtundu wosowa wambiri wa chotupa cha chiwindi chomwe chimapangidwa ndimankhwala osinthika am'magazi motero chimakonda kupezeka mwa azimayi azaka zapakati pa 20 ndi 50, atakhala ndi pakati kapena chifukwa cha kugwiritsa ntchito kwa nthawi yayitali njira zakulera zakumwa.

Kawirikawiri, chiwindi cha adenoma sichimatulutsa zizindikiro, choncho nthawi zambiri chimapezeka mwangozi pa CT scan kapena ultrasound kuti ayese kupeza vuto lina.

Popeza sichowopsa ndipo chimawoneka ngati chotupa chosaopsa, adenoma nthawi zambiri safuna mtundu wina uliwonse wamankhwala, tikulimbikitsidwa kuti tikhale tcheru ndi mayeso anthawi zonse, popeza, ngakhale ndi ochepa kwambiri, pali chiopsezo chokhala ndi zilonda kapena chotupa, kuchititsa magazi kutuluka mkati.

Zizindikiro zazikulu

Nthawi zambiri, hepatic adenoma siyimayambitsa zizindikiro zilizonse, komabe, anthu ena amatha kunena zakomwe kuli kupweteka pang'ono komanso kosalekeza kumtunda kwakumimba.

Ngakhale ndizosowa, adenoma imatha kuphulika ndikutuluka m'mimba. Zikatero, zimakhala zachilendo kumva kuwawa kwam'mimba mwamphamvu komanso mwadzidzidzi, komwe sikusintha komanso komwe kumatsagana ndi zizindikilo zina za kukha mwazi monga kuchuluka kwa kugunda kwa mtima, kumva kukomoka kapena kutuluka thukuta kwambiri. Ngati adenoma akukayikira kuti yaphulika, ndibwino kuti mupite kuchipatala msanga kuti magazi asiye kutuluka.

Dziwani zizindikilo zina zomwe zitha kuwonetsa kukha magazi.

Momwe matendawa amapangidwira

Matenda a hepatocellular adenoma amadziwika nthawi zonse poyesa kuti apeze vuto lina, chifukwa chake, ngati izi zichitika, tikulimbikitsidwa kuti tifunse katswiri wazachipatala kuti achite mayeso enaake ndikutsimikizira kukhalapo kwa adenoma. Mayeso omwe amagwiritsidwa ntchito kwambiri akuphatikizapo ultrasound, magnetic resonance kapena computed tomography.

Pakati pa mayeso awa, dotolo amatha kuzindikira mtundu wa chiwindi adenoma kuti awongolere bwino chithandizo:

• Kutupa: ndichofala kwambiri ndipo chimakhala chotsika kwambiri;
• Kusintha kwa HNF1α: ndi mtundu wachiwiri wofala kwambiri, wokhala ndi adenoma yopitilira umodzi yomwe imawonekera m'chiwindi;
• Ss-catenin kusintha: sizachilendo ndipo zimawoneka makamaka mwa amuna omwe amagwiritsa ntchito anabolic steroids;
• Osasankhidwal: ndi mtundu wa chotupa chomwe sichingathe kuphatikizidwa ndi mtundu wina uliwonse.

Kawirikawiri dokotala amalangiza kuti aziona kukula kwa chotupacho, komabe, ngati pali zotupa, mwachitsanzo, ngati zili zopitilira 5 cm, adotolo angasankhe kuti achite opareshoni kuti amuchotseretu.

Momwe mankhwalawa amachitikira

Popeza kuti chiwindi cha adenoma chimakhala chosaopsa nthawi zonse, njira yayikulu yothandizira ndikuwunika kukula kwake, pogwiritsa ntchito mayeso monga computed tomography, imaginization imaging kapena ultrasound chabe. Komabe, ngati adenoma ibwera mwa mayi yemwe akugwiritsa ntchito njira zolera, adokotala amalangiza kuti asiye kugwiritsa ntchito ndikusankha njira ina yolerera, popeza kugwiritsa ntchito piritsi kumatha kuthandizira kukulira chotupacho. N'chimodzimodzinso ndi anthu omwe akugwiritsa ntchito mtundu wina wa anabolic, mwachitsanzo.

Ngati chotupacho chimakula pakapita nthawi kapena chapitilira 5 cm, pamakhala chiopsezo chachikulu chotha kuphulika kapena kukhala ndi khansa ndipo, chifukwa chake, sizachilendo kwa dokotala kuti alangize opareshoni kuti achotse chotupacho komanso kuti chisachitike zovuta. Kuchita opaleshoniyi nthawi zambiri kumakhala kosavuta ndipo kumakhala ndi chiopsezo chochepa, kuchitidwa pansi pa oesthesia pachipatala. Opaleshoni itha kulangizidwanso kwa azimayi omwe akuganiza zokhala ndi pakati, popeza pali chiopsezo chachikulu cha adenoma yoyambitsa mavuto nthawi yapakati.

Ngati adenoma yaphulika, mankhwala omwe amagwiritsidwanso ntchito ndi opareshoni, kuyimitsa magazi ndikuchotsa chotupacho. Zikatero, mankhwala akuyenera kuyambitsidwa mwachangu kuti apewe kutaya magazi kwambiri, komwe kumatha kupha moyo.

Zovuta zotheka

Pali zovuta zazikulu ziwiri za hepatic adenoma:

• Kusokoneza: zimachitika makoma am'mimba atang'ambika chifukwa chakukula mopitilira muyeso kapena kupsinjika kwa chiwindi, mwachitsanzo. Izi zikachitika, chotupacho chimatuluka m'mimbamo yam'mimba, zomwe zimapangitsa magazi kutuluka mkati, ndikuyika moyo pachiswe. Zikatero, zimakhala zachilendo kumva kuwawa kwambiri m'mimba. Izi zikachitika, ndikofunikira kwambiri kupita kuchipatala mwachangu kukayamba chithandizo.
• Kukula kwa khansa: ndi vuto losowa kwambiri, koma zimatha kuchitika chotupacho chikamakula, ndikutha kusintha chotupa chotupa, chotchedwa hepatocellular carcinoma. Pakadali pano, ndikofunikira kuti muzindikire msanga kuti muwonjezere mwayi wakuchira. Dziwani zambiri za chotupachi komanso momwe amachiritsidwira.

Zovutazi ndizofala kwambiri m'matumba akulu kuposa 5 cm ndipo, chifukwa chake, chithandizo chimachitika nthawi zonse ndi opaleshoni kuchotsa chotupacho, komabe, chitha kuchitikanso m'matumba ang'onoang'ono, chifukwa chake ndikofunikira kuti muzilonda nthawi zonse kwa hepatologist ..