Matenda m'matope a bile akhoza kukhala ovuta koma ambiri amachira bwino
Cholangitis ndi matenda a ma ducts. Cholangitis yovuta imayambitsa zizindikiro za malungo, zilonda zam'mimba, ndi ululu m'mimba. Nthawi zina amatchedwa ascending cholangitis.
Cholangitis yoopsa ndi matenda aakulu omwe amafunikira chithandizo. Ndikofunika kuti anthu omwe ali ndi matendawa atuluke komanso athandizidwe mwamsanga kuti athe kupewa mavuto aakulu.
Zolemba za cholangitis zakula bwino m'zaka zaposachedwa ndipo anthu ambiri amachira.
Mitsempha Yotsitsa Blockages
Mtengo ndi chinthu chomwe chimathandiza kuchepetsa mafuta mu chakudya kuti chikhodwe. Chophika chimapangidwa m'chiwindi ndikuyenda kudzera mu njira yotchedwa bile ducts ku gallbladder , kumene amasungidwa mpaka pakufunika. Pambuyo pa chakudya, makamaka chomwe chimaphatikizapo mafuta, bile amamasulidwa kudzera mu kanjira komanso kumalo oyambirira a matumbo aang'ono (duodenum).
Nthawi zina ma ducts akhoza kutsekedwa kapena, kawirikawiri, amakhala ochepa kwambiri. Izi zikhoza kuchitika pamene nyongolotsi zimapanga kapena pamene pali chifukwa china chimene mazirawo amachepetsedwera, monga kukula kwa chotupa pafupi ndi kanjira kapenanso ndondomeko yotchedwa bile. Amwala amapezeka kwambiri mwa amayi, anthu omwe ali ndi matenda opatsirana (IBD, makamaka Crohn's disease), sclerosing cholangitis , ndi HIV / AIDS. Ziphuphu kapena ziboliboli monga chifukwa cha ntchentche za bile ndizochepa.
Pamene ndondomeko ya bile ili yotsekedwa ku gallstone kapena chifukwa china, pali mwayi wokhala ndi mabakiteriya. Matenda amatha kuchitika pambuyo pa opaleshoni kumene mbola imayikidwa mu ndondomeko ya bile. Mtundu uwu wa matenda a bakiteriya amatchedwa cholangitis.
Zowopsa
Kuopsa kokhala ndi cholangitis kudzadalira pazinthu zingapo koma pali zinthu zingapo zomwe zingayambitse matendawa.
Anthu omwe ali pachiopsezo chachikulu chotenga kachilombo koyambitsa matendawa amakhala ndi aliyense amene ali ndi:
- Mbiri yamakono
- Matenda a sclerosing cholangitis
- Posachedwapa tayenda kumadera kumene matenda a parasitic kapena bakiteriya amatha kuchitika
- Kachilombo ka posachedwapa kotchedwa "retosgraic retrograde cholangiopancreatography" (ERCP) ndi malo opatsirana (mu phunziro limodzi, chiopsezo chinali 13.2 peresenti)
Zizindikiro ndi Zizindikiro
Zizindikiro za cholangitis pachimake kawirikawiri zimakhala zofanana ndi zomwe zimakhala zonyansa ndipo zingaphatikizepo izi:
- Ululu wammbuyo
- Chills
- Zojambulazo
- Msuzi wamdima
- Fever
- Jaundice (khungu la khungu ndi maso)
- Nausea
- Ululu pansi pa mapewa
- Pamwamba kumanja kumeneku kapena kupweteka pakati pamimba komwe kuli kofiira, kosalala kapena kosalala
- Kuthamanga
Kudziwa
Kupanga matenda a cholangitis mwamsanga kuti muthe kuyamba mankhwala n'kofunika. Chinthu chimodzi kapena zingapo za mayesero osiyanasiyana omwe amawoneka ndi ndulu komanso bile.
Mayeso a magazi
Ngakhale kuyesera magazi sikungagwiritsidwe ntchito payekha kuti adziwe kuti ali ndi kachilombo koyambitsa matenda a bile, amagwiritsidwa ntchito kuthandizira kupeza chithunzi chonse cha zomwe zingayambitse zizindikiro. Mayeso a magazi omwe angachitidwe ndi awa:
- Bilirubin mlingo
- Matenda a enzyme ya chiwindi
- Mayendedwe a chiwindi
- Nambala yoyera ya magazi (WBC)
Mimba ya ultrasound
An ultrasound ndi mayeso omwe amagwiritsa ntchito mafunde kuti awone zochitika mkati mwa thupi. Zitha kuchitidwa pamimba pamene galasi kapena ndondomeko ya bongo imakayikira.
ERCP
Pakati pa mayesowa, chubu imadutsa pakamwa ndi kudutsa m'magazi kuti mufike pa dope. Izi zikhoza kuchitidwa osati kuti tiwone zomwe zikuchitika mudothi koma zingagwiritsidwe ntchito nthawi zina kuchotsa zitsulo. Panthawi imeneyi, mankhwala ena akhoza kuchotsedwa kuti ayese mabakiteriya. Bulu lidzakonzedwa mu labu kuti mudziwe zomwe mabakiteriya akuyambitsa matendawa.
Magnetic resonance cholangiopancreatography (MRCP)
Mayesowa ndi mayesero osakanikirana ndipo amagwiritsidwa ntchito kuti aganizirepo ziphuphu, ndulu, ndi mazira. Mitsempha iliyonse m'matope a bile akhoza kuwoneka pazithunzi zomwe zatengedwa.
Percutaneous transhepatic cholangiogram (PTCA)
PTCA ndi mtundu wa x-ray omwe amagwiritsidwa ntchito powona ma dope. Pamene wodwala atakhala pansi, singano imayikidwa kupyolera m'mimba ndi chiwindi kuti iwonetsere kusiyana kwa dera. Kenaka mndandanda wa x-ray umatengedwa kuti uwonetsere mazira ndi sing'anga wosiyana yemwe akuyenda nawo.
Chithandizo
Katemera atapangidwa, mankhwala ayenera kuyamba mwamsanga. Chifukwa cholangitis imayambitsidwa ndi matenda, chithandizo chidzaphatikiza mankhwala opha tizilombo kuti aphe mabakiteriya. Kachiwiri, chifukwa choyambira chiyenera kuchitiridwa. Pankhani ya ndondomeko, miyalayi ikhoza kuchitidwa powachotsa ndi ERCP, kuwasokoneza, kapena kuwaphwanya ndi mafunde oopsya. Nthawi zina, opaleshoni yakuchotsa ndulu ikhoza kuchitidwa.
Kwa zida zogwiritsira ntchito ndondomeko yotchedwa bile, njira zingathe kukhazikitsidwa kuti zikhale zotsekemera komanso kuti njirayo ikhale yotsegula. Pankhaniyi pali kuchepetsedwa kwa mankhwalawa chifukwa cha chotupa (chomwe si chachilendo), chomwe chikhoza kuchitidwa opaleshoni kapena mankhwala ena ngati akupezeka kuti ali oipitsa.
Mavuto
Sepsis ndi vuto limodzi lokha la cholangitis, ndipo ndi mkhalidwe woopsya. Sepsis imachitika pamene matenda sachiritsidwe ndipo amachititsa kuti thupi lilephereke, kuwonongeka kwa minofu, komanso mwinamwake imfa. Sepsis imachiritsidwa ndi mankhwala opha tizilombo ndipo nthawi zina ziyeso zina ndizofunika kuti zithandizire kuchotsa minofu yowonongeka. Sepsis ikhoza kukhala yonyozeka komanso yoopsya, chifukwa chake nkofunika kuwonetsa akatswiri azachipatala nthawi yomweyo ngati akuganiza kuti matendawa ayamba kukhala odwala.
Kupewa
Nthawi zina, kupewa cholangitis sikutheka. Komabe, monga nthawi zambiri zimayambitsidwa ndi zilonda zamkati zomwe zimatseketsa ntchentche za bile, kuteteza mitsempha kumathandiza. Kuteteza mitsempha kumatanthauzanso kudyetsa zakudya zabwino ndi zowonjezera zowonjezera komanso zosasungunuka komanso kuchita masewera olimbitsa thupi nthawi zonse. Kusiya kusuta kungathandizenso kuteteza chitukuko cha mitundu yambiri ya cholangitis. Kwa cholangitis yogwirizanitsidwa ndi ERCP ndi malo opatsirana, mankhwala opha tizilombo angaperekedwe panthawi ya ndondomekoyo kapena atatha kuteteza matenda.
Mawu Ochokera
Cholangitis chowopsa ndi vuto lalikulu chifukwa ndi matenda omwe angapangitse munthu kudwala kwambiri ndikumayambitsa mavuto. Kupeza mwachangu ndi kulandira chithandizo n'kofunika, choncho zizindikiro za ululu m'mimba, jaundice, ndi malungo zimayambitsa kuona dokotala nthawi yomweyo. Ngati matendawa athamangitsidwa ndipo amachiza mankhwala opha tizilombo amayamba, uthenga wabwino ndi wakuti anthu ambiri amachira kuchokera ku cholangitis.
> Zotsatira:
> Afdhal, NH. "Cholangitis yoopsa." Zaposachedwa. 18 Mar 2016.
> Zolinga za Kuletsa ndi Kuteteza Matenda. "Sepsis." CDC.gov. 23 Jan 2018.
> Tierney J, Bhutiani N, Stamp B, et al. "Zizindikiro zowonongeka zokhudzana ndi cholangitis pambuyo pa ERCP." Surgos Endosc. 2018: 32; 799. onetsani: 10.1007 / s00464-017-5746-z
> Yeom DH, Oh HJ, Mwana YW, Kim TH. "Kodi ndizifukwa zotani zomwe zimachititsa kuti cholangitis chikhale choopsa kwambiri choyambitsa matendawa?" Gut Liver . 2010; 4: 363. DOI: 10.5009 / gnl.2010.4.3.363