Jaundice mgbochi

Ihe mgbochi jaundice bụ ọrịa na - esite na mpụga mmachi nke ịba ọcha n'anya site na mịrị amị ahụ n'ime duodenum n'ihi mgbochi ọrụ.

Mmechi nke oria ahụ: mgbochi obubu agha juputara, subhepatic jaundice, acholic jaundice, resorption jaundice, extrahepatic cholestasis.

Ihe na - ebute nsogbu site na ihe mmerụ ahụ na - apụta dị ka ihe mgbagwoju anya nke nnukwu ọrịa nke akwara na biliary system (usoro nke bile ducts na sphincters nke na - achịkwa usoro ọnya mmiri) yana ihe mgbaàmà ndị dị ka mmachi nke akpụkpọ ahụ, mucous membranes na sclera, mmamịrị gbara ọchịchịrị, ịkpụcha ọnya, anụ ahụ itching, mgbu afọ.

Nsonaazụ nke jaundice na-aga n’ihu nwere ike ịbụ ọdịda akwara, ọdịda akụrụ, purulent cholangitis, sepsis, biliary cirrhosis ma ọ bụ ọnya cholangitis nke imeju, na nnukwu ikpe na enweghị nlekọta nlekọta ahụike - ọnwụ.

Otu n'ime ihe ndị na-akpatakarị jaundice mgbochi, ọrịa gallstone (29% nke ọrịa) na oke ịba uru (67% nke ikpe) bụ iche. Mgbe afọ 30 dị, ọrịa gallstone kacha, n’ọgbọ dị n’agbata afọ 30-40, oria na ọrịa gallstone dị ka ihe na-akpata jaundice bụkwa ihe a na-ahụkarị. N'ime ndị ọrịa karịrị ogo iri anọ, tumọ neoplasms na-adịkarị elu.

Na mkpokọta, a na-achọpụtakarị ọrịa jaundice n'ime ụmụ nwanyị (82%). Agbanyeghị, mgbochi ụsọ nke biliary tract bụ ihe karịrị ụmụ nwoke (54%).

Ihe na-akpata jaundice mgbochi

Ruo taa, a na-amụ ihe ndị na-akpata igbochi egbochi ijikọ biliary ahụ anya nke ọma.

Dabere na ihe etiological, e kewara ha n’otu n’otu:

Ọkpụkpụ akụrụngwa nke usoro biliary: hypoplasia na atresia nke biliary tract,

Benign gbanwere na usoro biliary na pancreas n'ihi cholelithiasis: calculi (nkume) na bile ducts, diverticulum (protrusion of the wall) nke duodenum na stenosis nke nnukwu paodenal papilla (BDS) dị n'ime akụkụ na-agbadata nke duodenum, rub ọrịa akwara na-adịghị ala ala, sclerosing cholangitis,

Ihe mgbochi nke otu ihe na - akpata ihe mmerụ ahụ (gụnyere n'ihi mmerụ ahụ na - emebi ihe ma ọ bụ nke ọma),

Oria mbu na ogbaaghara (panastog-hepatobiliary cancer) nke panreato-hepatobiliary: oria ara, oria akwara na oria BDS, tinyere onodu nke otite di iche-iche n’ime imeju (oria n’azu nke afo, lymphogranulomatosis),

Mbibi nke imeju na ọnya biliary na nje ndị ọzọ (alveococcosis, hydatid cyst, wdg).

Ihe na - ebutekarị ọrịa jaundice bụ mgbochi neoplasms tumor (imeju, ọnya biliary, pancreatic head) na ọrịa gallstone. Ọkpụkpụ akụrụngwa nke usoro biliary na ọrịa nje na-adịkarị obere. N’oge agadi, a na-ahụkarị ihe na-egbu egbu (n’ihi ihe mgbu) na mgbochi mgbochi isi, n’oge ị dị n’agbata afọ iri anọ, ihe na-akpatakarị cholelithiasis.

Ọrịa Duodenal na ọnya nkwonkwo (n'ọnọdụ nke ebe a na - etinye ihe na mpaghara oghere ọnya) dịkarịsịrị nta na - akpata ọrịa a.

Cholestasis (mbelata nke mmiri nke bile na duodenum) na - aputa ihe na - ebupukarị n'ihi mbupụ akwara dị n'ime gallbladder. A na-ahụta nguzosi nke ogwe osisi n’ime akwara ndị na-adịkarị ala. Ha na-abanye gallbladder n'ime ebe ihe aru na aru abuo (bile dule na-eme) n'oge a na - ebuso helicatic colic agha. Oge mkpọda na - eme mgbe nnukwu okwute enweghị ike isi na ya gafee. Oge ụfọdụ, n'ihi ogologo oge nke sphincter nke Oddi (olu dị nro dị na BDS), ọbụlagodi obere okwute na-arapara n'akụkụ ọnụ nke ihe na-agakọ.

A na-achọpụta ọnụnọ nke nkume n'ime dupe ahụ n'ihe dị ka 20% nke ndị ọrịa nwere ọrịa gallstone. Jaundice nwere cholestasis n'ihi cholelithiasis na 65% nke ikpe bụ adịghị adịte aka. Ihe mgbaàmà ya na-ebelata mgbe ọ gafesịrị okwute n'ime eriri afọ. Oge nzụlite stenosis (warara) nke BDS bụ 25%.

Ahịrị nke mpaghara pensụl-hepatobiliary na-akpata jaundice na 37% nke ikpe. Ke akpa ebe ugboro ugboro bụ kansa nke anụre na BDS, na nke abụọ - mbufụt nke isi bile na eriri afọ. Arụji imeju na nsị ya adịkarịghị ụkọ.

Ihe mgbaàmà nke jaundice mgbochi

Ihe ịrịba ama ndị a na-ahụkarị gụnyere:

Ihe mgbu dọrọ njọ na mpaghara akụkụ nakwa n'okpuru ọgịrịga n'aka nri, nke na-abawanye nwayọ,

Ọchichiri gbara ọchịchịrị ma tọgbọrọ chakoo,

Yellowness nke anụ ahụ, akpụkpọ ahụ mucous na ọnya nke anya, icteric coloration nke akpụkpọ ahụ ji nwayọọ nwayọọ buru ọ eụ.

Agụụ agụụ, ibu belata

Ahụ Ikpo Ọkụ

N'ọnọdụ ụfọdụ, cholesterol na-acha odo odo na-acha odo odo anya n'ụdị nke akọwapụtara nke ọma na ọnya akpịrị,

Site na mgbochi ụyọkọ akwara mkpụrụ osisi, ihe mgbu ahụ bụ spasmodic, nkọ, enwere ike inye ya obi, aka nri aka na nku ya. Ihe ịrịba ama nke mpụga nke jaundice pụtara ụbọchị 1-2 mgbe ike gwụchara ọrịa ịba ọcha n'anya. Site na imeju imeju na-egbu mgbu. Afọ ọbara ezighi ezi. Na ịpị mpaghara n'akụkụ aka nri n'okpuru ọgịrịga na-eme ka njide ume ume. Ọgbụgbọ na ọgbụgbọ pụrụ kwere omume.

Site na etuto ahụ, pancreas, BDS, traktị biliary, ihe mgbu ahụ gwụrụ, mpaghara mpaghara epigastric, na-enye azụ. Na palpation, a na - ahụ eriri afọ ogologo, na --agide nke na - enweghi mgbu. Imeju na-abawanye, na-enwe etolite ma ọ bụ okirikiri, yana usoro ọjọọ nwere nhazi ihe oke. Ọ na - adịkarịghị nwetụ ahụ. Ihe nrịba ama nke Jaundice na-ebute tupu mbelata agụụ, itching akpụkpọ ahụ.

Imeju abawanye bụ ihe mgbaaka a na-ahụkarị maka mgbochi ụdọ. Imeju na-abawanye ụba n'ihi njupụta ya na mbibi ọnya biliary.

Mmụba nke gallbladder bụ njirimara nke etuto ahụ nke BDS, isi nke pancreas na akụkụ akụkụ nke otu ihe na-agakọ. Mmụba nke imeju na - apụta na 75% nke ndị ọrịa, mmụba nke ọnya afọ 65%, mana enwere ọrịa laparoscopy na - achọpụta ihe fọrọ nke nta ka ọ bụrụ 100% nke ndị ọrịa.

Akpụkpọ ahụ akpịrị na-amalitekarị ịma jijiji tupu ọdịdị nke ihe ịrịba ama nke jaundice, karịsịa na usoro mmalite nke ọrịa ahụ. Ọ dị ike, na-agwụ ike, ọ nweghị ike iwepụ ya site n'aka ndị ọrụ ọgwụgwọ. Scratches na-apụta na anụ ahụ, obere hematomas. A na-ahụkarị ihe dị arọ ibu na jaundice n'ihi akpụ cancer.

Mmụba nke okpomọkụ bụ tumadi metụtara ọrịa nke biliary tract, na-adịkarị ụkọ, yana mbibi nke akpụ ahụ. Mmụba nke na-agbatị agbatị ruo ogologo oge bụ ihe ịrịba ama dị iche nke na-egosipụta ọdịiche subhepatic jaundice site na ịba ọcha n'anya, na, n'oge oge nke ihe atụ nke jaundice, ọnọdụ okpomọkụ na-agbadata na njedebe nkịtị.

Ọrịa nke jaundice mgbochi

Nchọpụta nke mbido a esighị ike n'ihu akpụ akpụ, nke a na-apị ngwa ngwa. Ma na ngosipụta mbụ nke cholestasis, nchọpụta ahụ na-akpata ụfọdụ ihe isi ike, ebe ọ bụ na mkpesa onye ọrịa na mgbaàmà ụlọ ọgwụ n'ozuzu nwere ike ịbụ ihe ịrịba ama nke ọtụtụ ọrịa. Zọ ụlọ nyocha adịghị ọtụtụ uru maka nchọpụta mbụ nke ọrịa jaundice. Mmụba na cholesterol, bilirubin, alkaline phosphatase bụ ihe e ji mara ma intrahepatic cholestasis na ọrịa ịba ọcha n'anya.

Ya mere, mkpebi dị mkpa bụ maka usoro nyocha ngwa ọrụ, nke a na-etinye ihe ndị a:

Nchọpụta ọrịa ultrasound. Ọ na-ekpughe mgbasawanye nke dule dule, ọnụnọ nke akwara dị na ha na mmebi imeju. Site na ntughari nke okwute n’ime otite, ihe puru ime nchọpụta ha bu 90%, ebe ntughari ya bu akuku uzo nke bile - 25-30%. Njehie dị obere gụnyere ịkọwa akpụ akpụ dị ka mkpo nke calculi.

Ntụrụndụ duodenography. Iszọ ahụ bụ x-ray nke duodenum na ọnọdụ nke hypotension ya. Ejiri ya choputa oria Frostberg (mmebi nke elu ala nke akụkụ nke duodenum, n'ihi nsonaazụ ya yiri leta "E") na duodenal diverticulum. Ihe nrịba ama nke Frostberg bu ihe iriba ama nke oria a na - eme oria ma obu oria a na - eme ya na aru ya na ala aru.

Endoscopic retrograde cholangiopancreatography (RCP). A na - eji ya ma ọ bụrụ na ezughị ezu nke ultrasound, mgbe a na - enyo enyo na BDS na - enyo enyo. Site na usoro a, ihe dị iche na-abanye na eriri ahụ site na iji cannula (ọkpọkọ pụrụ iche), emesia ewere usoro ụzarị ọkụ. RCHP na-enye gị ohere ịchọpụta obere akpụ, na-eduzi nyocha cytological na akụkọ ihe mere eme nke epithelium na ọdịnaya nke duct. Nke a bụ usoro mmụta dị oke mkpa, mana ebe ọ bụ ihe na-akpali akpali, enwere ike ibute nnukwu nsogbu.

Percutaneous transhepatic cholangiography. E gosiputara ya maka mgbochi nke biliary tract n'ọnụ ụzọ nke imeju. N'okwu a, n'okpuru ọgwụ mgbochi n’akụkụ mpaghara n’okpuru ultrasound, agịga agịga dị warara na nke dị iche na-abanye n’ime otu oghere ịba ọcha n’ahụ na anụ ahụ. Ọnụ ọgụgụ nsogbu na usoro a karịrị nke RCHP (ọbara ọgbụgba n'ime, mwepu nke bile, peritonitis).

Radioisotope nyocha nke imeju. A na-eji ya wee gwọọ etuto ahụ yana ọrịa ọnya (alveococcosis), mgbe o siri ike ịchọpụta ihe mgbochi sistemụ na ọnya biliary n'ụzọ ọzọ.

Laparoscopy Nke a bụ usoro kachasị emetụta, a na-ejikwa ya mgbe ụzọ ndị ọzọ anaghị adabaghị n’ihe banyere nchọpụta ezi. Ojiji nke laparoscopy bụ ihe amamihe dị na ịkọwapụta metastases, iji chọpụta ogo mmebi imeju na alveococcosis, wdg.

Usoro ọgwụgwọ

Gụnyere nri nri nwere ilekwasị anya na akwụkwọ nri, mkpụrụ osisi, ngwaahịa mmiri ara ehi. Nri kwesiri idi okpukpu, efere - sie ma mashed. A na-atụ aro ị drinkụ mmiri dị ka o kwere mee (mmiri ọ juụ ,ụ, mmiri).

Nlekọta intravenous nke glucose, vitamin B, Essentiale, methionine ma ọ bụ lipocaine (iji mee ka ọbara na-ekesa ọbara), Vikasol (iji gbochie ọbara ọgbụgba), Trental, glutamic acid ka a na-ebu. Ọ bụrụ na ọ dị mkpa, ọgwụ mgbochi, plasmapheresis (ịsacha ọbara), enterosorption (usoro idobe).

Ihe na-akpata jaundice mgbochi

Ihe na - ebute ihe mgbochi n'okirikiri bụ mgbochi (mgbochi) nke ọnya biliary. Ọ nwere ike bụrụ ele mmadụ anya n'ihu ma ọ bụ zuru oke, nke na-ekpebi ịdị njọ nke ngosipụta nke ọrịa ahụ.

Nnukwu jaundice nwere ike ibute ọrịa ndị a:

• cholecystitis
• cholangitis
• cysts nke biliary tract
• ọrịa gallstone
• ma ọ bụ nruchi nke pale na-ebute,
• ịba ọcha n'anya, imeju nke imeju,
• ọria aru
• etuto ahụ bụ akwara, duodenum, afọ, ma ọ bụ akwara
• nje ndi ozo,
• Ọrịa Mirizzy
• tobawanye oghere lymph dị na mpaghara ọnụ ụzọ ámá mmeju,
• ịwa ahụ na ọnya biliary.

Usoro ogwu maka mmepe nke jaundice mgbochi. Ọ bụ n'ọtụtụ oge dabere na usoro mkpali na-emetụta dule dule. Na-emegide nzụlite mbufụt, edema na ndim nke akpụkpọ ahụ mucous nke ducts na-eme, na-eduga n'ịbelata lumen ha. Na onwe ya, usoro a na-emegide uzo nke bile. Ọ bụrụ na n'oge a, obere klulus batara n'osimiri ahụ, isi mmalite ya nwere ike kwụsị kpamkpam. N’ịkakọba ma na-agagharị n’ime eriri bile, bile na-enye aka na mgbasawanye ha, mbibi nke hepatocytes, yana bilirubin na acid bile na-abanye na mgbasa usoro. Bilirubin, nke na-abanye n'ime ọbara site na akwara ihe aru, akaghị maka protein - nke a na - akọwa oke mmerụ ahụ ya na sel na anụ ahụ.

A na-atụ aro onye ọrịa ka ọ atụọ ma ọ dịkarịa ala lita abụọ nke mmiri kwa ụbọchị, nke a na-enye aka na mwepụ nke bilirubin ngwa ngwa, si otú ahụ belata mmetụta ọjọọ ya na sistemụ akwara na akwara, akụrụ, akpa ume.

Thekwụsị mmụba nke bile acid n'ime eriri afọ na-emebi mmụba nke abụba na vitamin-abụba (K, D, A, E). N'ihi ya, usoro ịmịnye ọbara ọbara na-emebi emebi, hypoprothrombinemia na-etolite.

Ogologo oge nke bile na intrahepatic ducts na-atụnye ụbi mbibi dị ukwuu nke hepatocytes, jiri nwayọọ nwayọọ na-eduga guzobe ọdịda nke imeju.

Ihe ndị na-abawanye n'ihe ize ndụ nke ibute jaundice mgbochi bụ:

• ibu na mberede ma ọ bụ, na ibe, oke ibu,
• ofufe ọrịa nke imeju na pancreas,
• ogwugwo ogwu na akwara na biliary,
• mmerụ ahụ nke akụkụ dị elu nke afọ nke afọ.

Ọgwụgwọ ọrịa jaundice

Mainzọ kachasị mma iji gwọọ ọrịa jaundice bụ mgbochi, ebumnuche nke ya bụ iweghachi mmiri na-abanye na duodenum. Iji mee ka ọnọdụ onye ọrịa dị ka mma, a na-eme ọgwụ mgbochi, infusion na ọgwụ nje. Ejiri usoro ndị a iji melite mmebi nke bile nwa oge:

• choledochostomy - okike nke igbapu site na itinye fistula nke mpụga na pele dule,
• cholecystostomy - nguzobe fistula nke nkpuru azu,
• ọgbụgba na-akụ afọ mgbu
• igbapu nasobiliary (ntinye nke catheter na traktị biliary n'oge retrograde cholangiopancreatography).

Ọ bụrụ na, n'agbanyeghị ọgwụgwọ ejiri jaundice egbochi, ọnọdụ onye ọrịa ahụ anaghị aka mma, egosiri na ọgbụgba ahụ na - adịghị mma.

Mgbe emesighachi ọnọdụ onye ọrịa ahụ, a na-edozi ajụjụ maka usoro ọgwụgwọ ọzọ maka ọgwụgwọ jaundice. A na-ahọrọ usoro endoscopy n'ihi na ha anaghị enwe nsogbu. N'ihe banyere njiri akpụ akpụ na cicatricial stenosis, a na-arụ ọrụ biliary tract bougienage, nke na-esote ntinye nke stent na lumen ha, ya bụ, endoscopic stenting nke bile duct. Mgbe i jiri okwute gbochie sphincter ahụ, Oddi bidoro mebelata balloon.

N'ọnọdụ ebe usoro endoscopic na-ewepụ wepụ ihe mgbochi na ntiwapụ, na-amalite ịwa ahụ na-emepe emepe ọdịnala. Iji gbochie mmiri ịbanye n'ime oghere dị n'ime oghere site n'ọge ahụ, a na-arụpụta mmiri mpụga nke bile ahụ dịka Halstead (ntinye nke klọọkụ polyvinyl chloride na cystic duct stomped) ma ọ bụ mmiri mpụga nke bile ahụ dị ka Keru (ntinye nke ọkpọkọ pụrụ iche nke dị na T).

Ọ bụrụ na onye ọrịa enwetaghị nlekọta ahụike, mgbe ahụ megide mmalite nke oke ogbugbu hepatocytes, ọrụ imeju na-arụ ọrụ, mmebi imeju na-amalitekwa.

Nri maka jaundice mgbochi

Na usoro ọgwụgwọ siri ike nke jaundice mgbochi, nri ịgwọ ọrịa adịghị obere mkpa.N'oge ihe dị mkpa, nri kwesịrị iwelata ibu n'ụba sel imeju, ma ọ bụrụ na ịwa ahụ, ọ kwesịrị itinye aka na ahụ ngwa ngwa.

A na-atụ aro onye ọrịa ka ọ atụọ ma ọ dịkarịa ala lita abụọ nke mmiri kwa ụbọchị, nke a na-enye aka na mwepụ nke bilirubin ngwa ngwa, si otú ahụ belata mmetụta ọjọọ ya na sistemụ akwara na akwara, akụrụ, akpa ume.

Ihe menu nke ndi oria n’oge ogha kwesiri ị drinksua ihe ọ -ụ carbohydụ nke carbohydrate (ihe glucose, compote, tea tii na-adighi ike). Nke a ga - enyere gị aka igbo mkpa nke anụ ahụ ma n’otu oge anaghị ebute oke imeju, na - enyere aka melite usoro metabolic.

Mgbe emechara usoro ịwa ahụ ma melite ọnọdụ onye ọrịa, a na-eji nwayọọ nwayọọ mụbaa nri ahụ, jiri nwayọọ nwayọọ ewebata ihe ọ fruitụ fruitụ mkpụrụ osisi, mmiri ara ehi, ofe ofe n'ime nri. Ekwesịrị iwere nri n'ụdị ọfụma, ma nwee ụlọ okpomọkụ. Site na nnabata nri nkịtị, a na-etinye azụ ma ọ bụ nri anụ (steamed ma ọ bụ sie ya) na nri ahụ.

Abụba na abụba n'ihe oriri ka amachaghị. Site na ezigbo nnabata, enwere ike inye onye ọrịa obere mmanụ bọta na mmanụ oriri. Anụmanụ na-egbu anụmanụ.

Mgbe ejiri nwayọ nwayọ sie ike, achịcha ọcha ụnyaahụ ma ọ bụ nke a mịrị amị na ngwaahịa mmiri ara ehi nwere obere nri ka etinye ya na nri.

Mgbochi

Mgbochi mgbochi jaundice gụnyere mpaghara ndị a:

• nchọpụta oge na ọgwụgwọ arụmọrụ nke ọrịa gallstone, ọrịa na-adịghị ala ala nke sistemụ hepatobiliary,
• nri dị mma (mmachi nke eghe, kegriiz na ọgaranya nke ihe oriri nri, nnabata nri)
• ị ofụbiga mmanya ókè,
• ndu ndu
• normalisation nke ahu.

Ihe ịrịba ama ndị ọzọ nke jaundice mgbochi bụ mmachi mmamịrị nke mmụba, ikpochapụ ọnya, itching nke anụ ahụ.

Nsogbu enwere ike

Site na mmalite oge ọgwụgwọ, prognosis dị mma. Ọ na-akawanye njọ ma ọ bụrụ na mkpakọ nke ihe na -akpata ihe na-emetụta ya. Ọ bụrụ na e nwetaghị ọgwụgwọ ịwa ahụ n'oge, nsogbu ndị siri ike na-ebute:

• cirrhosis nke imeju
• bilirubin encephalopathy,
• sepsis
• nnukwu (ya na mgbochi zuru oke nke bile) ma ọ bụ nke na - adịghị ala ala (ya bụ na ọ nwere obere ihe mgbochi) imeju imeju.

Gịnị bụ ihe a

Mgbaàmà na-egosi na ndị nwere nsogbu na mmụpụ nke bile.

Ihe mgbochi jaundice bụ ọrịa pathologies ọnya. Site na ya, ọpụpụ nke bile na-agbagha, akpụkpọ ahụ na akpụkpọ anụ mucous na-acha odo odo. Nke a bụ n'ihi eziokwu ahụ bụ na ebe ihe na-acha ọbara ọbara na-abanye n'ọbara. Ọrịa nwere ọdịdị tumor n'ọtụtụ oge.

A na-ahụkarị akwara dị nro na ndị ọrịa karịa benit. N'ọnọdụ ụfọdụ, jaundice a abụghị ihe egwu na okike.

Ihe onyonyo a na - adakarị ọrịa ahụ na - amalitekarị nke nta nke nta. A na-ahụta mmalite mmalite ahụ obere oge, ọ na-ebutekarị ọrịa jaundice bụ nsonazụ nke mbufụt nke akụkụ biliary.

Ihe na-eme

Ihe na-ebutekarị bụ etuto ahụ bụ ọrịa ọjọọ. A na-achọpụta ọrịa Tumor neoplasms na ndị ọrịa karịrị afọ 40. Ọ na-abụkarị ụmụ nwanyị ka a na - egbochi ihe ike mgbochi.

N'otu oge, ihe mgbochi akpụ nke biliary tract bụ ihe kachasị agwa ụmụ nwoke.

Enwere ike kee ihe na - akpata ya

• Ezi mgbanwe na biliary system na pancreas nke merela n'ihi ọrịa gallstone, dịka ọmụmaatụ, na ọnụnọ nke nkume n'ime akwara ndị dị na bebi,
• a na-ahọta ọrịa agbụrụ nke usoro biliary,
• etuto ahụ nke usoro pensụl-hepatobiliary dịka ọmụmaatụ, kansa kansa gallbladder,
• mmebi nke imeju na ọnya biliary na nje ndị ọzọ,
• njikwa nke bile duct mgbe ịwa ahụ,
• ọnya duodenal na appendicitis,
• mbelata nke mmiri nke bile n'ime duodenum - cholestasis.

Ọrịa

• ọcha, akwa na akwa gbara ọchịchịrị,
• ọgbụgbọ, ọgbụgba na-adịghị ahụkebe,
• ihe mgbu na mpaghara akụkụ ụbụrụ na n'okpuru ọgịrịga n'aka nri,
• akpụkpọ anụ?
• icteric coloration nke anụ ahụ, akpụkpọ ahụ mucous na ọnya nke anya,
• imeju imeju
• ifelata na agụụ,
• ahu ọkụ.

Abali abụọ mgbe ọrịa ịba ọcha n'anya gasịrị, ihe ịrịba ama nke jaundice pụtara. Ogbugbu na ọgbụgbọ nwere ike ịmalite. Ihe mgbu nwere mpaghara dị n'ime akụkụ yana -eme ka azụ nwee ihe ọrịre na akwara afọ. Ihe nrịba ama a na-ahụ maka jaundice mgbochi ogologo oge bụ ọrịa imeju na-abawanye ụba n'ihi mbufụt nke akụkụ biliary na oke mmiri ya.

Foto a na-egosi sistemu biliary. N'ihe banyere odida na ọrụ ya, jaundice sistem nwere ike ịpụta.

Ọkpụkpụ akpụkpọ ahụ siri ike na-amalite inye ndị ọrịa nsogbu tupu ọdịdị nke ihe ịrịba ama nke jaundice, nke a na-ekwupụta karịsịa na ihe kpatara ọrịa ahụ. Enweghị ike ịdọrọ ya site na ndị na-ahụ maka ọgwụgwọ. N'ihi ya, combs na ọnya apụta na anụahụ. A na-ahụta ọrịa jaundice nke etuto ahụ na-eme, a na-ahụta ibu na-agaghị egbu egbu. Ọrịa ọnya afọ ma ọ bụ ire ere na-ebute fever.

Zọ nyocha

Na ọnụnọ nke akpụ na-agba ọsọ nke a na-apị apị, ọ dị mfe ime nchọpụta nke mbụ. Nchọpụta ọrịa na-akpata ụfọdụ ihe isi ike na ngosipụta mbụ nke cholestasis. Mkpesa ndị ọrịa na mgbaàmà izugbe nke ọrịa nwere ike igosi ọtụtụ ọrịa ndị ọzọ. N'oge a, ụzọ nyocha ụlọ anaghị enye nsonaazụ achọrọ.

Ndị bụ isi bụ ụzọ nyocha ngwa-ngwa:

• ntụrụndụ nke ezumike ma ọ bụ x-ray nke duodenum,
• nyocha nke ultrasound nwere ike ịchọpụta mmebi imeju, mgbatị nke bile na ọnụnọ nke calculi n'ime ha.
• A na-eme transhepatic cholangiography percutaneous na mgbochi nke biliary tract. Ma usoro a nwere ọtụtụ nsogbu, dịka ọmụmaatụ, nsipu nke bile, peritonitis ma ọ bụ ọbara ọgbụgba n'ime,
• A na-eji endoscopic retrograde cholangiopancreatography maka echere na egbochi BDS. Thiszọ a na - ezi ozi ọma nyere gị ohere ịchọpụta obere akpụ na nyochaa ihe dị na bile duct na epithelium, mana ọ nwere ike ibute nnukwu nsogbu.
• invzọ kachasị emetụta ahụ bụ laparoscopy. A na-eji ya na enweghị nsonaazụ sitere na usoro nyocha ndị ọzọ. Ọ dị mkpa iji chọpụta ogo nke mmebi imeju na alveococcosis ma chọpụta metastases,
• A na-eji nyocha imeju nke imeju na ime nchọpụta nke imeju na-eme nyocha nke imeju.

A na-edozi jaundice mgbochi na ọkwa abụọ. Na ogbo nke mbụ, a na - eji ụzọ dị iche iche nke obere mpe mpe mpekere mee ihe iji kpochapụ agaghari nke bile, ya bụ, cholestasis. A na-atụ arokwa ọgwụgwọ nchekwa.

Ọgwụ Conservative gụnyere ọgwụ vitamin na ọgwụ iji melite ọrụ imeju: Cirepar, Essentiale, Cocarboxylase. Na mgbakwunye, dọkịta ahụ nwere ike ịkọ Prednisolone, ihe mkpali nke metabolism nke Pentoxyl na amino acids n'ụdị nke methionine. Edere onye ọrịa ọrịa glucose ọbara, Glutamic acid, Vikasol, vitamin B, Trental. Ọgwụ nje, nsị na nhicha ọbara - a na - eji plasmapheresis ma ọ bụrụ na ọ dị mkpa.

Ọgwụ ịwa ahụ

Ekwuputara ọgwụgwọ ịwa ahụ kpọmkwem na enweghị mmetụta ziri ezi nke ụzọ ndị abaghị uru dị ala. Ha gụnyere:

• ntụgharị
• duudu mmiri
• ọgbụgba na - akpụ akpụ
• laparoscopic igbapu,
• na-egbochi ọnya ọgbụgba na biliary tract na mbelata anastomoses Bilio-intestinal,
• laparotomy nwere mwepu gallbladder.

Na ọkwa nke abụọ Aga-eji ọgwụ infusion siri ike na mmanye diuresis mee ihe maka ọgwụgwọ. Ọzọkwa, a na-enye onye ọrịa ahụ hemodesis mmiri ọgwụ, ihe nnọchi ọbara, ihe glucose na insulin, mmiri nnu.

Naanị ọkachamara nwere ike ịchọpụta ma depụta ọgwụgwọ. Gbalia ka ị gafee ule niile dị mkpa ka dọkịta nwee ike ịghọta nkọwa zuru ezu banyere ọnọdụ ahụike gị.

Ọgwụ ọgwụgwọ na ọgwụ ndiife

N'ihe banyere jaundice nke anụahụ ma ọ bụ ọrịa na-efe efe, ị kwesịrị ịkpọtụrụ ọkachamara ọkachamara. Ojiji nke ọgwụ ọdịnala yana yana ọgwụ ọdịnala ga-emepụta ọnọdụ maka mgbake ngwa ngwa. Osisi na-agwọ ọrịa na-enyere aka ịgbalite usoro ahụ ji alụso ọrịa ọgụ ma weghachi ike.

Ma usoro ọgwụgwọ herbal kwesịrị ịbụ naanị nkwado maka ọgwụ ọdịnala, ndị dibịa bekee ga-anabatakwa usoro ọgwụgwọ nke ndị mmadụ.

Omenala nke ọdịnala maka mgbochi jaundice:

• efere anwụghị anwụ
• ochicho mma nke nkpuru osisi, ifuru na anwu, ogiri ato, nkpuru nkpuru
• tinmwood tincture,
• tincture nke hazel leaf in wine ọcha,
• usion ga - eme ka okpukpo na - akpata ọrịa ma ọ bụ ọgwụ, ma ị ga - ewere ọgwụgwọ maka ndị ọrịa nwere ọrịa gastritis, enterocolitis na nephritis,
• ihe ọ juiceụ sauụ sauerkraut,
• infusion nke sage epupụta,
• infusion nke iwuli elu cones,
• infusion nke ọka stigmas.

Akwụkwọ nri, mkpụrụ osisi, ngwaahịa mmiri ara ehi kwesịrị imeri n'ihe oriri. Nri kwesiri iju. Ọ ka mma ịkpụ ma ọ bụ hichaa efere. Ọ dị mkpa ị drinkụ mmiri mmiri dị ka o kwere mee.

Kedu ọnọdụ na ọrịa na-akpata ọrịa jaundice n'ime ndị okenye

Maka ezi nghọta nke usoro mmepe nke jaundice, ọ dị mkpa iji hiwe nnabata ndabere nke ụdị ọnọdụ a.

Suprahepatic jaundice bụ nsonazụ nke usoro mmebi na ire ure nke sel ọbara. Ọ na - ebute mmụba nke ọdịnaya bilirubin n'ime ọbara, yana "itinye n'ọrụ" nke imeju na - enweghị ike ịchịkwa nke ọma.

Attentionaa ntị: bilirubin nwere ụdị isi abụọ. Nke mbu bu rụrụ (n'ụzọ na-adịghị mma, insoluble, na-enweghị conjugated) ogige ihe mejupụtara ya na protein na-emetụta ọbara ma na-ekesa n'ime ọbara. Nke abuo - n’efu (dịzi, soluble, conjugated), nke etolite na njikọta na akwara akwara nke ụdị nke mbu ya na glucuronic acid. Ọ bụghị ihe na-egbu egbu, a na-abanyekwa ya na eriri afọ dịka akụkụ nke bile.

Site na ụdị nke jaundice suprahepatic, uto nke ngụkọta bilirubin bụ n'ihi mmụba na bilirubin n'efu, ebe mkpụrụ ndụ akwara enweghị ike ịnagide njide ya. Ihe na-egbu egbu a na-eduga ná nsị nke anụ ahụ.

Maindị ụdị ọrịa na-akpata ọrịa jaundice suprahepatic bụ ọrịa haemolytic (yana mbibi nke mkpụrụ ndụ ọbara): familial hemolytic jaundice, thalassemia, sickle cell anaemia, wdg.

Ọrịa ịba na-eduga n'ịba haemolysis, ụfọdụ usoro akpaaka.

Hepatic A na-ebute jaundice site na mmebi (mgbanwe) nke sel akwara (hepatocytes), intrahepatic bile capillaries. Usoro mbibi nke hepatocytes na-esokwa mmụba nke ọdịnaya bilirubin na ọbara niile, megide ndabere nke mmụba na bilirubin n'efu.

Mmepe nke ịba ọcha n'anya bụ nke kpatara:

• ọrịa nje ịba ọcha n'anya (nnukwu na ala ala),
• ịba ọcha n'anya nke etiologies dị iche iche,
• mgbanwe ntụgharị nke imeju na-emegide nzụlite mmanya na-egbu egbu, nsí ndị ọzọ na ọnya ọgwụ.
• nje mononucleosis,
• Ọrịa Gilbert
• leptospirosis,
• kansa (hepatocellular) nke imeju,
• ọrịa autoimmune na-emebi anụ ahụ.

Subhepatic jaundice na ebuputa na imebi ihe mmirichukwu site na intra- na extrahepatic bile ducts. Imebi a na-akpalite ihe mgbochi sistemụ n'ụzọ nke nje nzuzo (mgbachi, mgbochi).

Enwere ike igbochi ọpụpụ nke bile ya site na:

• gallstones (calculi)
• ụdị eji achọ ihe
• pancreatitis (mbufụt nke pancreas),
• etuto ahụ nke akwara, imeju, eriri afọ, 12 - duodenum,
• nnoo nke nje ndi ozo,
• lymphogranulomatosis,
• nsogbu site na ịwa ahụ na akwara, dule, pancreas,
• Usoro atrophic na akụkụ biliary,
• spasm na warara (stenosis) nke sphincter nke Oddi (akwara okirikiri nke na-ahazi mmpụta nke ihe sitere na bele na - ejide choledoch n'ime eriri afọ).

Ihe mgbochi jaundice na-enye mgbanwe dị iche iche na nyocha nke biochemical. Ọkwa Bilirubin na-ebili tumadi n'ihi akụkụ dị na ya. Rectdị na-edoghị anya nwere ike ịdị n’usoro etu o kwesiri, ma ọ bụ nwekwuo ubé. A na-ahụkwa Bilirubin na mmamịrị.

Nchoputa nke oria na ebute oria

Ndị ọrịa, mgbe ha na-ekpebi ihe kpatara ọrịa jaundice, na-aga nyocha, nke na-amalite na nyocha na ajụjụ site na dọkịta.

Ọzọkwa ahọpụtara:

• Nnyocha ọbara biochemical (ọkachasị, ọmụmụ nke ọkwa bilirubin). Dị ka ọ na-adịkarị, ngụkọta nke bilirubin nke oke ala anaghị agafe 20 μmol / L, na-anọghị nso - 17 μmol / L, ma na - eduzi - adịghị elu karịa 2.5 μmol / L,
• fibrogastroduodenoscopy (FGDS),
• Ultrasound nke imeju, akwara ozi, eriri afọ, pancreas,
• Nyochaa imeju na akwara
• MRI
• nnwale immunologi iji chọpụta ọnụnọ immunoglobulins njiri mara ọrịa ịba ọcha n'anya.

Njirimara nke oria

Ọnọdụ a na-atụle, a na-akpọkwa resorption (acholytic, mgbochi, subhepatic) jaundice, ma ọ bụ extrahepatic cholestasis, na-etolite n'ihi ọdịdị nke ihe mgbochi igwe na-egbochi ụzọ nke bile n'ime lumen nke duodenum. N'otu oge, plasma ọdịnaya nke bilirubin, ogige ntụpọ na-acha ọbara ọbara na-acha ọbara ọbara nke etolite n'oge mgbagha nke mkpụrụ ndụ ọbara uhie wee wepu eriri afọ nke akụkụ biliary, pụta. Hyperbilirubinemia na-etolite, na-enye ngosipụta nke icteric mpụga.

Mgbaàmà nke ọrịa jaundice na ndị okenye na-egosi ogo ọrịa ahụ. Ma nye ọtụtụ ụmụ amụrụ ọhụrụ, nke a bụ ihe ọhụrụ maara physiological na-etolite na 60% nke ikpe. Ọ dị mma n'ahụ ma ọ chọghị ọgwụgwọ maka ọgwụ. Ihe mgbochi n’azu umuaka di obere ma o bu ihe ana ebughi oke bu oria. N'ebe a, ọgwụgwọ ezubere iche dị mkpa, enwere ike ịchọrọ ọgwụ ịwa ahụ.

Ọgwụ ịwa ahụ

Ọ dabere na isi ọrịa nke kpatara jundice mgbochi. Dabere na nke a nwere ike rụrụ:

Mwepu nke mmiri nke bile ahụ - iweghachi nke mpụga nke bile n'oge mgbochi usoro biliary. Nke a bụ usoro pere mpe nke nwere ike itinye n'ọrụ dịka emebere atụmatụ.

Endoscopic cholecystectomy - mwepu nke ọnya afọ site na oghere endoscopic na mgbidi nke eriri afọ.

Papillosphincterotomy Endoscopic - iwepu okwute na gallbladder.

Choledocholithotomy - a na - eme ya na mwepu nke gallbladder ma mejuputara iwepu okwute site na uzo ozo nke emeghere mgbidi ya.

Ọkpụkpụ nke ịba ọcha n'anya - mwepu nke akụkụ anụ ahụ na - emetụta usoro.

Mmụta: Enwetara diplọma na ọpụrụiche "General Medicine" na Mahadum Ahụike Russia. N.I. Pirogova (2005). Mmụta Postgraduate na ọpụrụiche "Gastroenterology" - ngalaba mmụta mmụta sayensị na sayensị.

Eziokwu niile gbasara abụba na afọ - 8 eziokwu!

5 nri, irè nke na-enen site na sayensị ndị ọgbara ọhụrụ

Jaundice bu otutu oria gosiputara dika akpachapuru anya nke akpukpọ aru, akpukpo aru na mucous nke edo edo, bu ihe jikọtara ya na oke aru nke bilirubin n’ahụ. Dị ka ọ na-adịkarị, a na-ewepụta ihe a n’oge ọgbụgba sel sel ọbara na - aputa n’ime oghere.

A na-egosipụta jaundice na akpụkpọ anụ arụ, akpụkpọ ahụ mucous na anya n'ihi mgbochi nke akwara ọnya ahụ na arụ ọrụ na ọnya afọ. Jaundice na - eme mgbe mmiri nke bile na duodenum na - egbu oge, ọ na - abanye n'ọbara. Agafeela usoro ọdịnala.

Nnukwu oria mebiri imeju - Ọrịa Botkin. Ugbu a, a kọwara ọrịa ahụ dị ka ịba ọcha n'anya A. Isi ihe ịrịba ama nke ọrịa ahụ: adịghị ike, ahụ ọkụ, akpata oyi, nchapu ịba ụba, ncha nke anụ ahụ na akpụkpọ ahụ na-ahụ anya, mmamịrị na agba nke ọchịchịrị biya, feces enweghị agba.

Otu ọrụ dị ezigbo mkpa nke imeju bụ mmachi ọbara bilirubin na mgbochi ya. Site na nke a, a na-echebe anụ ahụ, nke bụ ụbụrụ, pụọ na nsonaazụ ya. Enwere ike inyocha ikike nke imeju site na nnwale ọbara biochemical iji chọpụta ọkwa nke bilirubin, yana, ọ bụrụ na ọ dị mkpa, nkebi nke ọ bụla.

Ọrịa Jaundice

Otu njiri mara nke ọrịa ahụ bụ mgbanwe na akpụkpọ akpụkpọ ahụ, n'ihi nke ndị meghere emechi ahụ ka ana - akpọ yellowness. Ọkpụkpụ nke anya na uhere mucous na-acha odo odo. Site na cholestasis ruo ogologo oge, akpụkpọ ahụ na-aghọ odo odo. A na-enye ụda ụcha site na ụcha bilirubin, nke ukwuu n'ọtụtụ jaundice na-agbakọ n'ime gallbladder, ebe ọ na-abanyekwa n'ọkwa ọbara ọzọ, na-ejikọ ya na albumin.

E nwere ihe ngosi ndi ozo nke oria:

• ihe mgbu na epigastrium na / ma ọ bụ hypochondrium ziri ezi, nke nwere ike ịba ụba ka oge na-aga,
• gbara ọchịchịrị
• na-egbu egbu nke stool, nnụnụ nri,
• ọgbụgbọ, ọgbụgba ga-ekwe omume,
• agụụ, nke nwere ike ibute nri nri afọ,
• ahụ ọkụ, akpata oyi,
• ike ọgwụgwụ, ike ọgwụgwụ,
• ntụgharị a na-apụghị ịgbagha agbagha, nke na-eduga n'ọdịnahụ na obere ọnya,
• imeju imeju na nha.

Xanthelasms na-egosi mgbe ụfọdụ na nku anya - bulges bulges, nke bụ nkwanye cholesterol. Okpukpo ha na nmekorita nke cholesterol excretion, otutu ya na anupu isi ya.

Udiri ihe mgbu ahu nwere ike di iche. Yabụ na, iji ihe mgbago dị na ya pụta n'ihi ihe dị iche iche dị n'okirikiri, ihe mgbu na-apụta nke nwere ike ịgbanye n'akụkụ akụkụ aka nri banye mpaghara sternum, axillary na mpaghara scapular. Ihe mgbu na-eme n'oge palpation nke imeju. Site na ọnya ọnya nke akwara puru iche nke akwara puru iche, ihe mgbu ahuru ure. Ha na-elekwasị anya n'okpuru olulu, mana na-enyekarị azụ. Palp nke mpaghara imeju anaghị egbu mgbu.

Enweghi ike iwepu ihe itching ahụ site na iji aru oru ma obu uzo ndi puru iche. Akpụkpọ ahụ na-amalite ito ọbụna tupu ọdịdị nke ụkpa. Ihe njiri mara oke isi na ịta ahụ oke bụ ihe e ji mara tumo. Y’oburu na agu agwula ogologo oge tupu ekpughe ihe iriba ama ndi ozo, nka bu ihe akaebe na tumo nwere ike ibu oke oria.

Na jaundice, mmụba nke imeju na-ejikọta ya na ịba ụba nke eriri afo yana ọgwụ na-esite na cholecystitis / cholangitis. N'iji ọdịdị nke neoplasms, a na-enwe mmanụ otiti nke ọma ma na-egbu mgbu mgbe a na-agbanye ya.

Ọnụnọ nke ọnya na-egosipụtakarị mmepe nke ọrịa. Ahụ ọkụ na-adịgide adịgide bụ ihe ịrịba ama nke jaundice mgbochi. A na-elebara ya anya na nchọpụta ọdịiche iji wepu ọrịa ịba ọcha n'anya, ebe oke mmiri wee daa mgbe ụbọchị ole na ole gasịrị.

Ntuziaka maka ọgwụgwọ nke ọrịa jaundice na ndị okenye

Nhọrọ nke ọgwụgwọ ọgwụgwọ dabere na ọrịa na-akpata ọrịa na-akpasu jaundice, yana ogo nke ọnọdụ onye ọrịa ahụ. Na nke a, a na-ekpebi mkpa ọgwụgwọ dị mma (na ngalaba ahụike ma ọ bụ nke ịwa ahụ) ma ọ bụ na ọ ga-ekwe omume ọgwụgwọ ọrịa.

Enyere ndị ọrịa:

• Ọgwụ ọgbụgba - Ọ bụ kenyere nnukwu ọrịa nke ọrịa, Bilie oké mmenaanya. A na-ekpebi oge na ogo nke ọgwụ infusion ọgwụgwọ n’otu n’otu, dabere na data ọnọdụ onye ọrịa na nchọpụta nyocha ụlọ (ọkachasị maka ọrịa ịba ọcha n’anya, nnukwu ị andụ mmanya na-egbu egbu, mmebi imeju ọgwụ, ọrịa ọgwụ).
• Ọgwụ nje - gosipụtara n'ihe nke ọrịa na nje kpatara ihe na-akpata jaundice. Jide n'aka na ịme mkpebi gara aga nke uche nke microbial flora ka ndị na-ahụ maka ọgwụ antimicrobial. Nrube isi na usoro ọgwụgwọ, usoro onunu ogwu di elu na oria antifungal di nkpa.
• N'ime ọrịa ndị na-ebute jaundice na ndabere nke mmebi hepatocyte, a na-enye nsonaazụ dị mma hepatoprotector ichebe ma weghachite akwara imeju.
• Ọrịa anaemia n'ọtụtụ oge chọrọ hematotherapy (ọbara nkịtị na nkwadebe ya, yana mmịnye ọbara nke plasma na nnọchi ọbara).
• Oncologist na-ahọrọ usoro ọgwụgwọ nke usoro neoplasm (ọgwụgwọ ịwa ahụ, kemoteram, radiotherapy).
• Ọgwụ ịwa ahụ - nke egosiputara n’ihu nnukwu okwute buru ibu n’olulu, ducts. A na-arụ ọrụ ịwa ahụ na plastik maka nhụjuanya nke biliary tract na mgbe ọ nwesịrị nsogbu megide ndabere nke ịwa ahụ mbụ. Mgbe ụfọdụ, a na-eji ntụgharị imeju eme ihe.
• Immunotherapy.
• N'okwu ndị siri ike - ọgwụ ọgwụ homonụ.

Mkpakọ nke ọrịa na-enye ndị ọrịa jaundice

A pụkwara ịkọpụta ihe ngosi nke jaundice na ọrịa dị iche iche. Nsonaazụ nke a pụrụ ibilite megide ndabere nke jaundice dị adị nwere ike ịdị iche.

Ọtụtụ mgbe, ọrịa na-eme na jaundice na-edugakarị na:

• anaemia
• adịghị ala ala nke isi usoro,
• mmepe nke usoro oru ngo ndi ojoo.
• nnukwu ọrịa imeju na-adịghị ala ala,
• ujo, ime ka ihe mgbu bia,
• encephalopathy ịba ọcha n'anya,
• egbu ke ikpe siri ike.

Nri maka jaundice na igbochi ọdịdị ya

N'ime ụlọ ọgwụ, ndị ọrịa na-arịa ọrịa na ngosipụta nke icteric na-enweta ihe oriri na-edozi ahụ Nke 5 dị ka Pevzner.

Nri na-agụnye:

• mmụba nke ihe ọ --ụ --ụ - ihe ọ drinksụ andụ na ihe ọ fruitụ fruitụ mkpụrụ osisi sitere na mkpụrụ osisi na-anọpụ iche na nke dị ụtọ, mmiri ịnweta na-enweghị gas, ihe ọ sweetụ sweetụ dị ụtọ,
• viscous na ọka dị nro, jelii, poteto azọkọtara ọnụ.
• achịcha a mịrị amị, anụ a mịrị amị n'ụdị sie ya, ma ọ bụ steamed (meatballs, meatballs), obere abụba sie ya na anụ a na-eme achịcha,
• chiiz na obere anụ ụlọ nwere obere abụba, casseroles, pudding,
• marmalade na marshmallows mkpụrụ,
• tere mmanụ
• Mkpụrụ osisi ọhụrụ, ọ ,ụ.

N'oge ọrịa, ị kwesịrị ịjụ:

• ụdị nchekwa niile
• nri mara abụba (anụ na mmiri ara ehi, azụ),
• e ghere eghe, nke eji eji jaundice emechi emechi nke oma.
• chokoleko, koko, kọfị, achịcha, achịcha, achara,
• ụdị mmanya ọ bụla.

Amụma na mgbochi nke ọrịa jaundice n'ime ndị okenye

Nsonaazụ nke ọrịa a, yana jaundice, dabere na ihe kpatara, usoro na ịdị njọ nke usoro ahụ. Site na usoro ọgwụgwọ a haziri nke ọma, n'ọtụtụ oge ọ ga - ekwe omume ịnweta ọgwụgwọ maka onye ọrịa ma ọ bụ nwee ọganihu dị ukwuu n'ọnọdụ ya.

Maka ebumnuche mgbochi, iji zere mmepe nke jaundice, ọ dị mkpa ịgakwuru ọkachamara na oge. Na ọrịa na-adịghị ala ala - soro usoro na usoro nri.

Lotin Alexander, onye na-ahụ maka ahụike

12,241 mkpokọta echiche, 3 elele taa

Jaundice mgbochi - gịnị ka ọ bụ

N'ihi mgbochi nke dule dule, enwere ike ibute ọnọdụ nke mmụba bilirubin (hyperbilirubinemia). Ọrịa juputara n’agha bụ ọrịa na-efe efe mgbe akpịrị, mucous membranes, na sclera na-acha odo odo na-acha ọbara ọbara site na bilirubin. Jaundice teknụzụ n'ime ndị okenye abụghị ihe na-efe efe; ọ nwere koodu ICD nke 10 K83.1. Enwere ụdị ọrịa dị iche iche: mkpakọ, mkpọchi, subhepatic, jaundice mgbochi. Ekwesịrị ịmalite ọgwụgwọ n'oge ọ bụla o kwere omume, ma ọ bụrụ na ịkọwa ihe na-akụda mmụọ ga-ekwe omume.

Jaundice mgbochi - na-akpata

N'ihi ihe mgbochi na akụkụ akwara biliary, mgbochi ọrịa jaundice syndrome na-etolite na ndị okenye. Ntughari, okwute dule na-egbochi nnabata nke bile. A kọwara nke ọma ihe mmalite nke ọrịa a. Mgbe inges, ihe na-acha uhie uhie na-emerụ anụ ahụ, akpụkpọ ahụ mucous. Ihe na-akpata jaundice mgbochi:

1. Nsi ndi ozo di na traili na biliary, imeju (echinococcal cyst, alveococcosis).
2. Nchikota akwara isi akwara na -agbachasị mmerụ ahụ (mmụpụta na-adịghị mma, mmerụ ahụ na-ebugharị na akwara ndị ahụ).
3. Ọmụmụ nke akụrụngwa nke mmepe nke sistemụ biliary (atresia nke bile ducts, hypoplasia).
4. Ọrịa malignant: etuto ahụ na-eme na sistemụ pancreato-hepatobiliary (cancer cancer isi, nnukwu paodenal papilla, yana ọnya ọnya ọnya, ọnya ọnya) na metastases nke ọnọdụ dị iche iche (lymphogranulomatosis, cancer cancer).
5. Ihe omumu, oria cholelithiasis kpatara: warara (cicatricial solid of the bile ducts), ahuhu, ihe anakpo odi nkpa, aru nke BDS, sclerosing cholangitis, inductive pancreatitis, acre panreatitis na edema nke pancreatic gland.

Jaundice mgbochi - mgbaàmà

A na-ekpebi ihe osise na-adakarị site na ihe kpatara ya. Emegharia mgbanwe nke akuko, oria di iche iche bu ihe ndi n’adighi n’ihu. N'ihe banyere okwute okwute na-egbochi lumet nke duct ahụ, ọrịa ahụ na-agbanwe: ọ nwere ike ịpụ apụ, gosipụta ọzọ. Ihe ịrịba ama bụ isi na-acha odo odo nke anya na akpụkpọ ahụ. Ka oge na-aga, ịkpa ọchị na-agbanwe gaa ihu ọjọọ. Ọtụtụ ihe mgbaàmà ndị ọzọ nke juputara n’agha n’ime ndị okenye na ụmụ amụrụ ọhụrụ:

• iribia ibu ibu, oke ibu, oria,
• dull, nwayọọ nwayọọ na-eto ihe mgbu n'aka nri n'okpuru ọgịrịga, na mpaghara epigastric,
• imeju imeju
• tọgbọ chakoo, akpọnwụ akpọnwụ, ọnya gbara ọchịchịrị,
• akpụkpọ anụ?
• Ahụ ọkụ mụbara
• ọgbụgbọ
• n’ọnọdụ ndị dị ụkọ, vomiting, cholesterol edo edo na-acha odo odo.

Jaundice mgbochi - ọgwụgwọ

Usoro nchekwa nke jaundice mgbochi - nri, ọgwụ. Ọgwụ ịwa ahụ n’ịwa ahụ na-adabere na ọrịa butere ọrịa ahụ. Denye stent na igbapu site na endoscopic ma obu uzo transdermal. Nke ikpeazụ gụnyere: percutaneous transhepatic cholangiostomy (ChCHS) ma ọ bụ transcutaneous transhepatic cholecystostomy n'okpuru nlekọta nke ultrasound, CT. N'etiti ụdị ọgbụgba endoscopic, papillosphincterotomy (EPST), duodeno-biliary drainage bụ ihe dị iche.

Mgbapu Gallbladder nwere oke jaundice

Ọkpụkpụ mmiri na - adịghị ala ala (BHP) na - enye aka na ntopute. Mpụga mmiri nke dị na mpụga na-eduga na mmiri nke ihe na-edunye ya site na catheter n'ime usoro nri ka ọghọm ahụ ghara ibuga oke ọgbụgba. Mwepu nke agba agba nwere oke jaundice (nke dị n'ime) chọrọ ntinye nke catheter site n'èzí. Mgbe edema na mpaghara warara belatara, a na-ebugharị ya na duodenum, a na-ezigara bile na ogwe nri. Percutaneous endoprosthetics: ndị dọkịta na-etinye pipụ rọba na-anọchi akụkụ nke mgbidi ahụ.