Wokondedwa wanu wa Oddi (SO) ndi chinthu chomwe simungaganizire kokha - pokhapokha ngati chitachitika. NTHAWI YANU ndi mitsempha yamtundu yomwe imayendetsa chitetezo kuchokera mu ndulu yanu ndi makina anu mumatumbo anu aang'ono. Pamene valve iyi ikugwira ntchito moyenera, sphincter ya Oddi matenda (SOD) amapezeka.
SOD ndi matenda osowa kwambiri.
Mu SOD, mitsempha yotchedwa sphincter, yomwe imapangitsa kuti ikhale yotsekedwa. Izi zingachititse kusungunula kwa bile ndi mapulaneti a pancreatic kumalo awo. Izi zingapangitse kutupa kwa chiwindi ndi / kapena zopangira.
SOD imagawidwa m'magulu ang'onoang'ono:
- Lembani I SOD: Kukhalapo kwa ululu, mankhwala owonjezera a bile, ndi chiwindi chokwanira komanso / kapena mapiritsi a puloteni.
- Mtundu Wachiwiri Wachiwiri: Kukhalapo kwa ululu, pogwiritsa ntchito njira yowonjezera kapena ma enzyme okwera, koma osati onse awiri.
- Mtundu Wachizindikiro Wachitatu: Kukhalapo kwa ululu, koma palibe zosawonongeka zimawoneka kudzera kuntchito ya ultrasound kapena magazi.
Mtundu Wachitatu SOD ukhoza kutchulidwa ngati SOD yothandiza. Izi zikhoza kupasulidwa kuti zikhale zokhudzana ndi biliary SOD komanso ntchito yogwiritsira ntchito pancreatic SOD.
Zinthu Zowopsa kwa SOD
Matenda ambiri a SOD amachitika pambuyo pochotsa nyongolotsi kapena chapamimba kupyolera opaleshoni yolemetsa yolemera . Pa milandu yomwe imapezeka pakapita khungu, SOD yowonjezereka mwa amayi kuposa amuna, koma nkofunika kuzindikira kuti SOD imakhudza kagawo kakang'ono ka anthu.
Zizindikiro za SOD
Chizindikiro chachikulu cha SOD ndi ululu wamkati pakatikati mpaka kumtunda. Ululu ukhoza kufalikira pamapewa kapena kudutsa pachifuwa. Zowawa zapweteka zingakhale zachidule kapena zotsiriza maola angapo. Maulendo amsinkhu amasiyana ndi zochitika ndi zochitika, ndipo zimakhala zochepa mpaka zolephera.
Zizindikiro zofanana zikuphatikizapo kusowa kwa njala, kunyowa, ndi kulemera. Chiwopsezo, kusanza ndi jaundice zikhoza kuchitika. (Kumbukirani, zizindikiro zazikulu monga izi zimafunikira kuchipatala mwamsanga.)
Kuzindikira kwa SOD
Pali mayesero osiyanasiyana a SOD. Cholinga cha kuyezetsa kuyezetsa magazi ndikupeza chodziŵika bwino chomwe chingayambitse matenda a m'mimba. Nazi njira zina zothandizira:
Ntchito ya Magazi: Izi ndizoyeso yoyamba yomwe imachitika. Dokotala wanu adzayang'ana michere yochuluka ya chiwindi kapena kapangidwe.
Kujambula: Dokotala wanu angayesere kupeza chithunzi cha zomwe zikuchitika mkati mwanu, makamaka bate lanu, chiwindi ndi kapangidwe. Izi zikhoza kupyolera mu X-ray, ultrasound, CT scan kapena MRI.
MRCP: Magnetic resonance cholangio-pancreatography amagwiritsa ntchito utoto ndi maginito kuti apeze chithunzi cha bile ndi pancreatic ducts.
ERCP: Endoscopic retrograde cholangio-pancreatography imagwiritsa ntchito endoscope, dye ndi X-ray kuyesa bile ndi pancreatic ducts. ERCP imakhala yovuta kwambiri ndipo imalimbikitsa odwala a mtundu wa I kapena II. Manometry ingathe kuchitidwa pa ERCP kuyesa kupanikizika kwa minofu ya sphincter ndipo imalingaliridwa kuti ikupereka chitsimikizo chotsimikizika cha SOD.
Kuchiza kwa SOD
Chithandizo cha SOD chimadalira kukula kwa zizindikiro. Pa zovuta zochepa, dokotala wanu angapereke mankhwala otupa, antispasmodics ndi / kapena mitundu ina ya kupweteka kwa ululu.
Pa vuto lalikulu, SO imadulidwa pa ERCP, njira yotchedwa sphincterotomy. Izi zimachitidwa kuti amachotse miyala iliyonse yomwe ingakhale ikukwera m'mphepete kapena kuyendetsa luso la ducts kukhetsa. Ndondomekoyi imachitika kokha ngati SO manometry imasonyeza kukhalapo kwa mphamvu yapamwamba mkati mwa SO ndipo akuganiza kuti amabweretsa mpumulo waukulu kwa odwala pafupifupi 50%. Komabe, pali ngozi zazikuluzikulu pa njirayi.
Choopsa kwambiri ndi chiopsezo cha kukula kwa chifuwa chachikulu. Vuto lina lomwe lingatheke ndilokuti njirayi ingayambitse kupweteka kotero kuti kubwerera kwa zizindikiro.
Zotsatira:
Behar, J., na.al. "Gallbladder yothandiza ndi Sphincter ya Oddi Disorders" Gastroenterology 2006 130: 1498-1509.
"Sphincter Oddi Dysfunction" University of Maryland Health Center Yapezeka pa July 22, 2105.
"Sphincter Oddi Dysfunction" Yunivesite ya Rochester Health Encyclopedia Inapezeka pa July 22, 2015.