Incazelo obstructive jaundice: Izimbangela, izimpawu kanye nezici ukwelashwa

Kuyini i-jaundice obstructive? Izimbangela kanye zokwelapha lesi sifo uzobe kuchazwe ngezansi. Uyofunda ukuthi izimpawu sici sifo nokuthi sitholakale.

ulwazi oluyisisekelo

Ukuze obstructive jaundice isici okuqukethwe okusezingeni eliphezulu ezicutshini into ezifana bilirubin. Lo msuka kunikeza isikhumba nolwelwesi lwamafinyila ophuzi umbala.

Bile sombala bilirubin ucingo. Ngokusho ochwepheshe, it has ezimbili imibango: iqonde umugqa, okungukuthi, axhunyiwe, futhi okuqondile, okungenxa yezimo okungukuthi khulula.

Ngakho, i-jaundice obstructive isici ekuqongeleleni ngokweqile element wathi, okuyinto eyenzeka ngenxa ezedlulayo okuphelele noma okuyingxenye inesikhala ipheshana biliary. Enye igama lesi sifo i-jaundice.

Ziyini izimbangela eziyinhloko zalokhu yesifo

ukuxilongwa umehluko izimbangela jaundice obstructive kufanele kwenziwe kuphela esibhedlela. On lokho ucwaningo izindlela ngesikhathi ukusetshenziswa efanayo, sizokutshela ngezansi.

Esimweni esejwayelekile we Bile nesineke kwakheka isibindi, kufanele akhonjiswe njalo ngezikhathi ezithile phakathi duodenum, ukuze iqhaza inqubo ukugaya. Nokho, lokhu akwenzeki kwezinye izimo. Isithiyo inqubo enjalo ingase ihlanganise yezizathu ezilandelayo:

• Stenosis, noma ukuvala imbobo okuthiwa, futhi mucosal edema ebukhoneni cicatricial postinflammatory stricture (isib obaphawuleka cholangitis noma cholecystitis) noma kokucindezelwa yesimila;
• mechanical ukuvimbela noma okuthiwa ukugqagqana ingxenye ibuyiswe biliary calculi (amatshe) ebukhoneni cholelithiasis.

Zonke lezi zenzakalo kuholele sokugembula Bile stasis (isb ukwakheka cholestasis) okuholela hypoxia kwenzeka, okuyinto elimaza hepatocytes.

Kufanele futhi wazi ukuthi imbangela obstructive jaundice bangaba ithumba, nginesimila we gallbladder noma amanyikwe, kanye izimuncagazi ezifana izikelemu noma echinococcus.

izimpawu

Njengoba kuboniswe jaundice obstructive? Izimpawu zesifo kungukuthi kubonakala kunzima ngempela. Njengomthetho, isifo enjalo ithuthukisa babazi.

Ngokusho kochwepheshe, jaundice owabonakaliswa izici ezifana:

• isicanucanu, imfiva, ukuhlanza;
• obuyisimanga ngokugwaza ubuhlungu phezulu ngakwesokudla quadrant, okuyinto yakha up in amagagasi futhi imbuthuma ngakwesokudla ehlombe noma ingqwababa;
• ichaza ukushintsha kombala endleni, kusukela bilirubin ayisekho ingena emathunjini;
• ukukhethwa bilirubin emchamweni, okuyinto enomthelela coloration yayo umbala konsundu;
• ezinzima ukulunywa kwesikhumba ngenxa ekuqongeleleni emzimbeni enobuthi Bile acid.

Okunye izimpawu zesifo

Singabonisa kanjani ukuqaphela ukuthuthukiswa jaundice obstructive? ezingamahlalakhona imvelo Bile ukugeleza Ukwephulwa kwenzeka ncamashi ngendlela efanayo njengoba kuchaziwe ngenhla. Nokho, kobukhulu izimpawu ezinjalo zingase zikhuphuke kuncike ubude cholestasis. Futhi, kwezinye izimo, iziguli ukuzwa steatorrhea (ie Kutholwe amafutha undigested e kwesihlalo), isikhumba hyperpigmentation, kwesisindo futhi xanthoma (ie lipid sebethule esikhumbeni).

Kufanele futhi wazi ukuthi ngesikhathi esifanele umehluko ukuxilongwa jaundice obstructive kungavimbela ukuthuthukiswa izifo ezifana isifo sokusha. Ukuze lesi sifo libhekene kumiswa fibrous zezinzwa izicubu izingxenye kwesibindi, kuphakama ekuphenduleni hepatocyte necrosis ngenxa umzimba iziyaluyalu futhi ukuntuleka komoya-mpilo.

With ukuthuthukiswa jaundice ngendlela umzimba womuntu izinguquko umzimba fat-encibilikayo amavithamini. Ngaphezu kwalokho, ukungabi vitamin D kuholela kwamathambo (ie, kakhudlwana ithambo fragility), futhi umphumela waba ukuthi isiguli uzizwa kabi yomgogodla (lumbar noma thoracic) nokuhlupheka kusukela nokuguqulwa waphuka.

Kufanele ukuthi jaundice ngokuvamile kuphakamisa ukuthuthukiswa oluhambisana syndrome, okuhlanganisa umongozima, ukubonakala "asterisk" semithambo nemihuzuko esikhumbeni. Okunjalo imihlola kuwumphumela ukuntula uvithamini K.

Nokushoda vitamin A emzimbeni wesiguli liyancipha nekhono twilight umbono. Ngaphezu kwalokho, cholestasis nokunwetshiwe kakhulu kukhulisa ematfuba kumiswa amatshe atholakala enyongweni.

Futhi ku ngemuva ukuthuthukiswa jaundice kwandisa ingozi yokutheleleka futhi cholangitis webhaktheriya, noma okuthiwa ukuvuvukala Amapayipi Bile. Lokhu okungukuthi ngokuvamile kubonakala nge imfiva kanye nobuhlungu elingenhla kwesokudla esiswini.

Izindlela ukuxilongwa jaundice obstructive

Manje, niyazi, okuyinto ejwayelekile wokuqukethwe lelisetulu obstructive jaundice bilirubin egazini. Nokho, kwamakhemikhali ukuhlaziywa kwegazi ezifana nesifo akukuniki ephelele zokuxilonga isithombe. Ngakho-ke, izazi eziningi enze nezinye ukuhlolwa laboratory, kanye ngokusebenzisa izindlela ezehlukene wezinsimbi.

Ngakho-ke, sitholakele obstructive jaundice kufanele:

• ukwenza ephelele segazi;
• ibhekane endoscopic resonance retrograde futhi kazibuthe cholangiopancreatography;
• ibhekane-CT scan kanye ultrasound esiswini;
• ukwenza laparoscopy nge biopsy.

Isiqalo nesigcino lolucwaningo ivumela odokotela ukuba cabangela khona noma ukungabi khona jaundice.

jaundice Obstructive: ekwelapheni lesi sifo

Njengomthetho, zonke iziguli ukuthi nginesifo 'jaundice obstructive "ngokushesha esibhedlela esibhedlela kuhlinzwa. Ngemva inhlolovo Ochwepheshe uqhubekele ngokushesha nokwelashwa kwezifo kungakephuzi. Ngokuvamile, isifo siphela yokwelapha olandelanayo. Uhlose at ukuqedwa jaundice kanye cholestasis, kanye kuqiniswa kwesimiso lesiguli. Lapho le ndlela yokwelapha yenziwa ngokuthola ejenti hormone nokusebenzisa amasu endoscopic.

Futhi ukuqeda jaundice ngokuvamile ziphendukela izinyathelo kuhlinzwa.

kokungenela Wasebenza Kwenziwa ukuba decompression (isb ingcindezi ukuncishiswa) esiqeshini biliary futhi Bile ukugeleza ukuze uqhube, zokuvimbela yokwehluleka kwesibindi ukusebenza futhi ziphathwe yisifo sokuqina. Uma le isetshenziswa ukuhlinzwa hhayi kuphela evulekile, kodwa laparoscopic abachitha ngaphansi ultrasound noma-CT scan. Phela, lo wesibili kunikezwa ekhethekile okuthandayo ngenxa ongaphakeme okungenzeka ngenxa yezinkinga encane imbobo.

Okunye ukwelashwa

Ngaphezu ukuhlinzwa, isikimu eziyinkimbinkimbi nokwelashwa jaundice obstructive futhi kufaka imisebenzi efana:

• gepatoprotektsiya (amavithamini iqembu B, ukulungiswa "Essentiale"), ukuthuthukisa lokugayeka kokudla (ngokuthola ascorbic acid futhi "pentoxy"), isicelo of ursodeoxycholic acid;
• ukwelashwa ngokukhishwa kobuthi egazini ukuze sikhuthaze diuresis, nokuphathwa isixazululo glucose, nosawoti, i-sodium chloride, gemodeza;
• izitsha ukulungiswa microcirculation esibindini;
• ukwelashwa elwa namagciwane esimweni ngokujoyina ukutheleleka;
• i-hormone yokwelapha, okuyinto is kwahambisana by okuyiwa nokuvimbela wokugaya ukudla ipheshana izilonda.

ukuhlinzwa umphumela

It Kumelwe kuphawulwe futhi ukuthi tekusebenta ukungenela ezinzima jaundice kungenzeka i enqabayo umphumela. Ngakho-ke, ezifana ukwelashwa okungukuthi enqunyiwe kuphela impilo izizathu.

Uma isimo lesiguli kuyivumela, kubalulekile ukulinda kube yisiphazamiso cholestasis syndrome, bese ukuphinda ukwelashwa.