Kwegazi Biliary: Incazelo, Izimbangela, Izimpawu kanye Ukwelashwa

Ngokusho idatha etholakala emphakathini, manje isibalo sezikhungo izifo kohlelo biliary. Lokhu kungenxa ngokuziphatha yokuphila okungenamsoco, ukudla okungenamsoco, kanye nezici ezithile sitholwa njengefa. Minyaka yonke kukhona nokwanda kwezifo ephelezelwa ukuthuthukiswa nomfutho wegazi ophezulu biliary. Lesi sifo sina futhi kuzoxoxwa ngakho esihlokweni sethu.

Izici lesi sifo

nomfutho wegazi ophezulu Biliary iyona nokubonakaliswa ezivamile izimila nithela umdlavuza ephakama sesibindi gallbladder. Isikhathi esining impela, lokhu zokugula kuhambisana jaundice obstructive. Uvele ngasekhanda yesimila amanyikwe iqala ukuba siqhubeke Amapayipi Bile, futhi kukhona amatshe noma polyp ukukhuthaza okuvela ingcindezi okuyinto akukuniki evamile Bile ukugeleza. Kwegazi iphathwa ngakho uma kuyinto kungavamile ukuba ingozi, ngosizo Endoscopy kuhlinzwa.

izimbangela

Biliary kwegazi iyakwazi ukuthuthukisa izimo zokucabanga okubangelwa isifo ezilandelayo:

• izimila Benign nesibulalayo zingaveli omunye ipheshana biliary, okuholela ukuphazamiseka outflow. Ngaphezu kwalokho, ukuvela kwalesi zokugula okuholela kokucindezelwa ka omunye Amapayipi zibe isitho neoplasm eseduze.
• Cholelithiasis kanye cholecystitis calculous. Izifo ezihlala zinezikhathi kumiswa amatshe zingaxazululeki ezingxenyeni ezihlukahlukene uhlelo hepatobiliary futhi ukubukeka jaundice.
• Ukuba khona izinambuzane Amapayipi - helminths.

Futhi, lesi sifo ongase aphathwe yisifo ngenxa kombungu esizalweni ipheshana biliary, ezithinta ukuma ezishintshwe futhi ububanzi we Isikhala sayo esingaphakathi. Kulokhu, lo izimpawu zesifo azibonakali ebuntwaneni.

izimpawu

Izimpawu nomfutho wegazi ophezulu biliary lapho besanda kuqala ngendlela, ukungafuni nhlobo indlela ungabonisi ngokwabo, yingakho iziguli eziningi ezibanga izifo. Nokho, kufanele kuqashelwe nge zimpawu ezilandelayo:

• ngenxa yobuthakathaka;
• ukubuyisa;
• isifo sohudo,
• ubuhlungu ngakwesokudla quadrant engenhla.

Uphawu oyinhloko kusobala eyabonisa biliary nomfutho wegazi ophezulu syndrome, nokwanda ivolumu ubende elihlobene ne ingcindezi ohlelweni portal. Ngesikhathi esizayo kwenzeka kwegazi, thrombocytopenia, leukopenia.

Ngakho lapho i-jaundice ngenxa ingcindezi mechanical phezu gallbladder. uketshezi kungenzeka buthelela ngaphakathi komgodi ongaphakathi kwamathumbu (ascites), okuyinto sici ukumelana layo yokwelapha eqhubekayo. Ukuze balahle ngokuvamile kuthatha isikhathi eside. Isiguli uqala ukwandisa umthamo esiswini, izinyawo zingavuvukalanga, ukunwebeka lwenzeka phambi ngemithambo odongeni kwamathumbu.

Ukubonakaliswa okukhulu kakhulu lesi sifo singumbulali ukopha esiswini, ikholoni noma emphinjeni. Konke lokhu kuhambisana ngiphalaza igazi. Uma ukopha kwenzeka emphinjeni, kwesihlalo kuyoba igazi.

ukuhlola

izindlela Instrumental zocwaningo Kwenziwa kulezi zimo ezilandelayo:

• ukuqinisekisa ubukhona nomfutho wegazi ophezulu biliary;
• ukusungula isifo, okwabangela okuvela zokugula ezinjalo.

I ulwazi amaningi abhekwa njengokudla babe ngaphansi izindlela ezibalwe.

ultrasound

Elinye lamaphuzu ebalulekile ngokukhetha ukwelashwa uhlelo biliary nomfutho wegazi ophezulu iwukuba kutholakale izinga ukuvimba Amapayipi Bile. Kulokhu, lo main indlela non-koda kubhekwa ultrasound ukuhlola ngaphakathi komgodi ongaphakathi kwamathumbu nesikhala retroperitoneal. Ngenxa uphethwe lenjalo iveta ukunwetshwa extra- futhi intrahepatic Bile Amapayipi, okuyinto uphawu egunjini lokuhlolwa kwezifo.

Biliary nomfutho wegazi ophezulu distal block ezingeni libhekene ukunwetshwa hepaticocholedochus, kodwa ngemva kwesikhathi satholana ekwandiseni Amapayipi intrahepatic, futhi kukhona ukwanda ubukhulu gallbladder. I ububanzi imbobo ingaphezu 10 mm uma neoplasms. Ngokuba njengamazulu ephakeme ukutholakala iyunithi ukubona elele gallbladder nokwanda intrahepatic mapayipi. Ithumba is ebonwe 51,3% of amacala.

computed tomography

CT isikhala esiswini retroperitoneal kuyasiza ngeso lengqondo izici nokwakheka kwezitho eziningi. Lolu cwaningo kunikeza ithuba uthole imiphumela olunembile ngokumelene zokwakheka esikhulu ukuhlola kangakanani ukuhluma yabo ezenzeka esikhathini isakhiwo eduze.

izindlela zocwaningo radiopaque

Uma kukhona izinsolo zokugula ezifana nomfutho wegazi ophezulu biliary, izazi bavame ukuchitha retroholangiopankreatografiyu noma cholangiography endoscopic. Ukwethulwa izinto radiopaque ngoba izindlela ezinjalo eyenziwa ngezindlela ezihlukahlukene, kodwa kunomphumela ofanayo. Ngenxa into enjalo kule radiograph Bangalinganisa degree of patency kohlelo imbobo.

biopsy

Ucwaningo olufana nalolu ubhekwa koda resort kuze kuphela endabeni eziyinkimbinkimbi, okuyilezi ezimweni okusolakala isimila esibulalayo. Ngokuvamile enza kuhloswe isibindi trepanobiopsy ngaphansi ultrasound isiqondiso. Inani elincane izicubu ethathwe umthombo zokugula, okuyinto ngaphansi luhlolo histopathological. Lo mphumela wenza sikwazi ukuba wahlulele uhlobo neoplasm.

laparoscopy zokuxilonga

Uma izindlela ezingenhla zokuxilonga ayikwazanga ukubona imbangela nomfutho wegazi ophezulu biliary, ufeza msebenzi. Kungaba kwenziwe laparoscopy noma laparotomy, ithuba ngesikhathi ukuchitha njengoba izindlela zokuxilonga nokwelapha kuhlinzwa. Ukusebenzisa ukuhlola okwenziwa ngqo imaging intraoperative futhi biopsy. Izinqubo zokuhlinza zenziwa ngokuvumelana ubunjalo zokugula ihlangabezane.

ukwelashwa

Uma kutholakala ukuthi umfutho wegazi ophakeme biliary, impatho siyindlela olandelanayo noma kuhlinzwa.

ukwelashwa okulondoloza ngokuvamile kwenziwe iziyaluyalu ukusebenza, nokuqedwa okuyinto kuveza izidakamizwa ezifana "Atenolol" "nitroglycerin", "Monopril," "Inderal", "Nitrosorbide" "Sulodexide", "ednit".

ukwelashwa Steel Kwenziwa kuphela uma izidakamizwa ohlwini ziye zaletha hhayi noma yimuphi umphumela. Ukusebenza Kwenziwa ukuthola ascites, ukopha emathunjini, isisu emphinjeni, kanye nokuthuthukiswa gipersplenicheskogo syndrome. izindlela zesimanje ezihilela ukusetshenziswa laparoscopy kuhlinzwa, okuyinto kancane ukuhlinzwa koda nge isingeniso mnene ngokusebenzisa sebeziqhumbuza ezincane tube mncane ngekhamera kanye ukukhanyisa micromanipulators. On the qapha, kukhona ukucinga indikimba yendaba, ukugxila udokotela kwenza ukususwa izithiyo.

Akunakusetshenziswa ukuzisebenzela medicate futhi ngidle izidakamizwa namakhemikhali ukususa isimila, ukunciphisa ivolumu esiswini, asuse amatshe ngaphandle kadokotela. Ngaphezu kwalokho, uma bekubona biliary nomfutho wegazi ophezulu, isibindi nenyongo sesinye, kwenziwe lokhu okulandelayo izinyathelo ukwelashwa:

• Bona ukunikeza weThrojani ukulondoloza amazinga uketshezi elilungile kanye electrolyte;
• usebenzisa imithi ngcono ukugeleza kwegazi futhi amaseli umsoco isibindi;
• kwenziwe yokwelapha elwa namagciwane;
• ukuchitha biliary decompression endleleni.

isiphetho

Ngakho, umfutho ophakeme wegazi biliary ubhekwa isifo esiyingozi kakhulu. Ngokuyinhloko izifo eziholela nalesi sifo ziphathwa surgically. Kodwa ungesabi, ngoba ukwelashwa esifike ngesikhathi kudokotela angayiqeda imbangela impande yalesi nomfutho wegazi ophezulu kanye zokugula uqobo.