Kulephera Kwa Biliary

Zamkati

• Mitundu yamadontho a ndulu
• Nchiyani chimayambitsa kutsekeka kwa biliary?
• Kodi chiopsezo ndi chiyani?
• Kodi zizindikiro za kutsekeka kwa biliary ndi ziti?
• Kodi kulepheretsa biliary kumapezeka bwanji?
• Kuyezetsa magazi
• Zojambulajambula
• Sakani bion radionuclide (HIDA scan)
• Cholangiography
• Kujambula kwa MRI
• Magnetic resonance cholangiopancreatography (MRCP)
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Kodi chithandizo cha kutsekeka kwa biliary ndi chiani?
• Zovuta zakulephera kwa biliary duct
• Kodi kutsekedwa kwa biliary kungapewedwe?

Kodi kutsekeka kwa biliary ndi chiyani?

Kuletsa kwa biliary ndikutsekeka kwaminyewa ya bile. Mitsempha ya ndulu imanyamula bile kuchokera m'chiwindi ndi ndulu kudzera m'mapapo kupita ku duodenum, yomwe ndi gawo lamatumbo ang'onoang'ono. Kuphulika ndimadzimadzi obiriwira kapena obiriwira achikasu obisika ndi chiwindi kupukusa mafuta. Mukatha kudya, ndulu imatulutsa ndulu kuti izithandiza pakudya ndi kuyamwa mafuta. Kuwotcha kumathandizanso kuchotsa chiwindi m'zinthu zotayidwa.

Kutsekedwa kwa iliyonse mwanjira zamtunduwu kumatchedwa kutsekeka kwa biliary. Zambiri mwazokhudzana ndi zotchinga za biliary zitha kuchiritsidwa bwino. Komabe, ngati kutsekeka sikukuthandizidwa kwa nthawi yayitali, kumatha kubweretsa matenda owopsa a chiwindi.

Mitundu yamadontho a ndulu

Muli ndi mitundu ingapo yaminyewa ya bile. Mitundu iwiri yamadontho a ndulu m'chiwindi ndimadontho a intrahepatic ndi extrahepatic.

• Mitsinje ya Intrahepatic: Mitsempha ya intrahepatic ndimayendedwe ang'onoang'ono mkati mwa chiwindi omwe amatenga ndikunyamula bile kupita kumayendedwe a extrahepatic.
• Makina owonjezera: Miphika ya extrahepatic imayamba ngati magawo awiri, gawo lina kumanja kwa chiwindi pomwe lina kumanzere. Akamatsika pachiwindi, amalumikizana ndikupanga njira yodziwika bwino yodziwika. Izi zimayenda molunjika kumatumbo ang'onoang'ono.

Njira ya biliary, kapena njira yochokera mu ndulu, imatseguliranso munjira yodziwika bwino yodziwika bwino. Mchitidwe wa bile kuyambira pano kumadziwika kuti bile bile kapena choledochus. Asanatsanulire m'matumbo ang'onoang'ono, njira yokhayo ya ndulu imadutsa kapamba.

Nchiyani chimayambitsa kutsekeka kwa biliary?

Kulepheretsa biliary kungayambitsidwe ndi zinthu zingapo zokhudza:

• minyewa ya ndulu
• chiwindi
• ndulu
• kapamba
• matumbo aang'ono

Izi ndi zina mwazomwe zimayambitsa kusokonekera kwa biliary:

• ndulu, zomwe ndizofala kwambiri
• Kutupa kwa minyewa ya ndulu
• kupwetekedwa mtima
• kukhazikika kwa biliary, komwe kumachepetsa modutsira bwino
• zotupa
• ma lymph node owonjezera
• kapamba
• kuvulala kokhudzana ndi ndulu kapena opaleshoni ya chiwindi
• zotupa zomwe zafika pachiwindi, ndulu, kapamba, kapena timitsempha ta ndulu
• matenda, kuphatikizapo matenda a chiwindi
• tiziromboti
• cirrhosis, kapena mabala a chiwindi
• kuwonongeka kwakukulu kwa chiwindi
• choledochal cyst (alipo makanda akabadwa)

Kodi chiopsezo ndi chiyani?

Zowopsa zomwe zingalepheretse biliary nthawi zambiri zimadalira chifukwa chakulepheretsa. Milandu yambiri imachitika chifukwa cha ma gallstones. Izi zimapangitsa azimayi kukhala pachiwopsezo chotenga biliary. Zina mwaziwopsezo ndizo:

• mbiri ya miyala yamtengo wapatali
• matenda kapamba
• khansa ya kapamba
• kuvulaza gawo lamanja lamimba
• kunenepa kwambiri
• kuwonda msanga
• mikhalidwe yokhudzana ndi kuwonongeka kwa maselo ofiira amwazi, monga sickle cell anemia

Kodi zizindikiro za kutsekeka kwa biliary ndi ziti?

Zizindikiro za kutsekeka kwa biliary zimadalira chifukwa cha cholepheretsacho. Anthu omwe ali ndi zotchinga za biliary nthawi zambiri amakhala ndi:

• mipando yoyera
• mkodzo wakuda
• jaundice (maso achikasu kapena khungu)
• kuyabwa
• kupweteka kumtunda chakumanja kwa pamimba
• nseru
• kusanza
• kuonda
• malungo

Kodi kulepheretsa biliary kumapezeka bwanji?

Mayeso osiyanasiyana amapezeka kwa anthu omwe atsekeka ndi biliary. Kutengera chifukwa chakulepheretsani, dokotala wanu angakulimbikitseni chimodzi kapena zingapo za mayeso otsatirawa.

Kuyezetsa magazi

Kuyezetsa magazi kumaphatikizapo kuwerengera kwathunthu kwa magazi (CBC) ndi kuyesa kwa chiwindi. Kuyezetsa magazi nthawi zambiri kumatha kuthana ndi zochitika zina, monga:

• cholecystitis, komwe ndikutupa kwa ndulu
• cholangitis, komwe ndikutupa kwa njira yodziwika ya bile
• kuchuluka kwa bilirubin yolumikizidwa, yomwe ndi zotayira m'chiwindi
• kuchuluka kwa michere ya chiwindi
• kuchuluka kwa zamchere phosphatase

Zonsezi zitha kuwonetsa kutayika kwa bile.

Zojambulajambula

Ultrasonography nthawi zambiri ndimayeso oyamba omwe amapezeka kwa aliyense amene akumuganizira kuti watsekeka ndi biliary. Amalola dokotala wanu kuti awone ma gallstones mosavuta.

Sakani bion radionuclide (HIDA scan)

Kusanthula kwa hepatobiliary iminodiacetic acid, kapena sikani ya HIDA, kumatchedwanso kuti biliary radionuclide scan. Imagwiritsa ntchito zida zowulutsa ma radio kuti ipereke chidziwitso chofunikira chokhudza ndulu ndi zoletsa zilizonse.

Cholangiography

Cholangiography ndi X-ray yammbali ya bile.

Kujambula kwa MRI

Kujambula kwa MRI kumapereka zithunzi zambiri za chiwindi, ndulu, kapamba, ndi ma ducts.

Magnetic resonance cholangiopancreatography (MRCP)

Magnetic resonance cholangiopancreatography (MRCP) imagwiritsidwa ntchito pozindikira kutsekeka kwa biliary ndi matenda am'mimba.

Endoscopic retrograde cholangiopancreatography (ERCP)

Endoscopic retrograde cholangiopancreatography (ERCP) imaphatikizapo kugwiritsa ntchito endoscope ndi X-ray. Zonsezi ndi chida chodziwitsa komanso chothandizira. Amalola dokotala wanu kuwona timitsempha ta ndulu ndipo amagwiritsidwanso ntchito pochiza. Chida ichi ndi chothandiza makamaka chifukwa dokotala akhoza kuchigwiritsa ntchito kuchotsa miyala ndikutenga zitsanzo za biopsy ngati kuli kofunikira.

Kodi chithandizo cha kutsekeka kwa biliary ndi chiani?

Chithandizochi cholinga chake ndi kukonza zomwe zimayambitsa. Cholinga chachikulu cha chithandizo chamankhwala kapena opaleshoni ndikuchepetsa kutsekeka. Zina mwazomwe mungasankhe ndi monga cholecystectomy ndi ERCP.

Cholecystectomy ndikuchotsa ndulu ngati pali miyala yamtengo wapatali. ERCP ikhoza kukhala yokwanira kuchotsa miyala yaying'ono pamchira wamba wa bile kapena kuyika stent mkati mwanjira kuti mubwezeretse kutuluka kwa ndulu. Izi zimagwiritsidwa ntchito nthawi zambiri ngati cholepheretsa chimayamba chifukwa cha chotupa.

Zovuta zakulephera kwa biliary duct

Popanda chithandizo, zotchinga za biliary zitha kupha moyo. Zovuta zomwe zingachitike popanda chithandizo ndi izi:

• kuwopsa kwa bilirubin
• matenda
• sepsis
• matenda aakulu a chiwindi
• biliary matenda enaake

Lumikizanani ndi dokotala mukayamba jaundice kapena mukawona kusintha kwa mtundu wa chopondapo kapena mkodzo wanu.

Kodi kutsekedwa kwa biliary kungapewedwe?

Nazi kusintha pang'ono komwe mungapange kuti muchepetse mwayi wanu wokhala ndi vuto la biliary:

• Wonjezerani kuchuluka kwa ma fiber mu zakudya zanu.
• Chepetsani kuchuluka kwa shuga ndi mafuta okhutira pazakudya zanu. Izi zonse zimatha kuyambitsa ma gallstones.
• Ngati mukulemera kwambiri, pang'onopang'ono muzitha kulemera kuti mukhale ogonana, azaka zambiri, komanso kutalika.