Bhiriary hypertension: tsanangudzo, zvinokonzera, zviratidzo uye kurapa

Maererano nehuwandu hwepa data, panguva ino nhamba yezvirwere zveB bile duct system yakawedzera. Izvi zvinotsanangurwa nemufambiro wemararamiro asina kunaka, kusagadzikana kwezvokudya, nekugara nhaka kwevanhu. Gore roga roga kune kuwedzera kwezvirwere pamwe chete nekuvandudzwa kwehutano hwehutachiona. Izvi zvakakomba zvirwere zvichakurukurwa munyaya yedu.

Zviratidzo zvechirwere

Bhiriary hypertension ndiyo chiratidzo chinowanzoonekwa chechirwere chinotyisa chinowanikwa muropa uye nduru chikafu. Kakawanda kacho chirwere ichi chinotungamirirwa nemichina ye jaundice. Chirwere chakaonekwa pamusoro wepakreas chinotanga kushandura pane bile ducts, uye mabwe kana mapepa anowanikwa ipapo anokurudzira kuonekwa kwekumanikidzwa, izvo zvisingabvumi kuti bile iende zvakanaka. Kuwedzera kwehutano kwakadaro kunobatwa kana iine hutano muzvisikwa, nekubatsirwa nekupindira kwekupora.

Zvinokonzera kukura

Bhiriary hypertension inokwanisa kukura pasi pemamiriro ezvinhu anotevera:

• Zvinorwarisa uye zvinouraya zvinokonzerwa mune imwe yemabhadhiary ducts, zvichiita kuti kutyorwa kwekubuda. Mukuwedzera, kubuda kwemararamiro akadaro kunotungamirira kukudzidzira kweimwe yemapundu akaumbwa muchechi iri pedyo neoplasm.
• Gallstone chirwere uye calculous cholecystitis. Zvirwere zvakadaro zvinoratidzwa nekuumbwa kwemabwe asina insoluble munzvimbo dzakasiyana-siyana dzehepatobiliary system uye kuitika kwe mechanical jaundice.
• Kuvapo mumatope emaronda - helminths.

Uyezve, chirwere ichi chinogona kukura nekuda kwekuberekwa kwekushaya hutano kweB bile ducts, iyo ine chimiro chakashandurwa uye kureba kwe lumen. Muchiitiko ichi, zviratidzo zvechirwere zvinoonekwa kare muhuduku.

Zviratidzo

Zviratidzo zvehutachiona hwehutachiona hazvizviratidzi ivo pachavo munzira yekutanga yekukura kwavo, ndicho chikonzero varwere vazhinji vanotanga chirwere ichi. Zvisinei, munhu anofanira kungwarira zviratidzo zvinotevera:

• Kushaya simba;
• Flatulence;
• Diarrhea;
• Pain mu right hypochondrium.

Chiratidzo chikuru, kuratidza zvakajeka chirwere chebhaariary hypertension, ndiko kuwedzerwa kwehuwandu hwepleen inobatanidza nekumanikidzwa mune portal system. Pane imwe nguva, anemia, thrombocytopenia, uye leukopenia inoitika.

Izvi zvinokonzera jaundice semugumisiro wekumanikidzwa kwemagetsi pamusoro peganda. Mumuviri wemimba yemvura (ascites) inogona kuunganidzirwa, iyo iyo inoshandiswa nayo yekudzivirira kurapa. Kuti ribvise, rinowanzotora nguva yakareba. Murwere anotanga kuwedzera kuwanda kwemuviri, kubhururuka kwemakumbo, pamadziro emimba, mutsara wekare unowedzera.

Kuratidzwa kwakanyanya kwazvo kwechirwere uku kuora kwemvura mukati mudumbu, rectum kana sophagus. Zvose izvi zvinoperekedzwa neropa kusuruvara. Uye kana kubuda ropa kunowanikwa mudumbu, ipapo mumucheka kuchava kusanganiswa kweropa.

Diagnostics

Nzira dzekushandisa dzekutsvakurudza dzinoitwa munyaya dzinotevera:

• Kusimbisa hupo hwehutano hwehutano;
• Kuti agadzirise chirwere chakakonzera kubuda kwehutano hwakadaro.

Nzira idzi dzinotevera dzinofungidzirwa kuti dzinodzidzisa.

Ultrasound

Chimwe chezvinhu zvinokosha pakusarudza hurongwa hwekurapa bhiariary hypertension ndeyezinga ye bile ducts. Muchiitiko ichi, nzira huru isiri iyo inoparadza ndiyo ultrasound kuongororwa kwemuviri mudumbu uye retroperitoneal nzvimbo. Pamusana pekuongororwa kwakadaro, kuwedzera kwe-extra-uye intrahepatic bile ducts kunoratidzwa, iyo chiratidzo chechirwere chakadaro.

Bhiriary hypertension ne-distal level yebhokisi inoratidzwa nekuwedzera kwehepaticocholedoch, uye mushure mechinguva inonzi intrahepatic ducts inowedzera, uye kuwedzerwa kwehukuru hweguruva kunoitika. Nzira inenge yakaita mamita 10 mm inoitika munyaya yekodhi. Nebhokisi rakakwirira, kuvapo kwehope yehope uye kuwedzera kwemajoni e-intrahepatic zvinoratidzwa. Dumbu racho rinowanikwa mu 51.3% yematambudziko.

Computed Tomography

CT yezviviri zvemuviri uye nzvimbo inonzi retroperitoneal inobatsira kufungidzira zviitiko zvechimiro chezvikamu zvakawanda. Kudzidza kwakadaro kunoita kuti zvive nyore kuwana zvikwaniro zvakakwana zvakakwana maererano nekuumbwa kwemasimba makuru uye kuongorora kuti kuwedzera kwavo kunowanikwa sei muzvivako zvakatarisana.

Radiocontrast yekudzidza nzira

Kana paine kusafungirwa kwehutano hwakafanana nehutachiona hwehutachiona, saka nyanzvi dzinowanzoita endoscopic retrocholangiopancreatography kana cholangiography. Nhanganyaya yezvinhu zvinokonzerwa neropaopa nenzira dzakadaro dzinoitwa nenzira dzakasiyana, asi ine chiitiko chakafanana. Kuonga chinhu chakadaro pamusoro pe X-ray, zvinokwanisika kuenzana nehuwandu hwehutano hwemarara.

Biopsy

Kudzidza kwakadaro kunofungidzirwa kuti inzira inopesana, uye inoshandiswa kwairi chete mumamiriro ezvinhu akaoma, kureva, apo chironda chakaipa chinenge chafungidzirwa. Kazhinji ivo vanoita zvinotarisirwa trepanobiopsy zvechiropa pasi pekutarisa kwe ultrasound. Tora zvishoma zviduku kubva pane zvakakosha zvehutano, izvo zvinowanikwa kuongororwa kwepanyama. Chigumisiro chakawanikwa chinoita kuti zvikwanise kutonga chimiro chemaoplasm.

Kuongorora mararamiro eparoscopy

Kana nzira idzi dzepamusoro dzisingagoni kugadzirisa chinokonzerwa nehutachiona hwehutachiona, ipapo kushanda kunoitwa. Inogona kuitwa laparoscopically kana laparotomically, uye inogona kuitika panguva imwechete kuita zvose zvirwere uye chirwere chokurapa. Nekubatsirwa kwekuongororwa, kuratidzira zvakananga uye intraoperative biopsy inoitwa. Kugadziriswa kushandiswa kunoitwa zvichienderana nehupenyu hwekuonekwa kwechirwere.

Kurapa

Kana biliary hypertension yakaonekwa, kurapwa kunoitwa nenzira yakachengetedza kana yekuvhiya.

Kuchengetedza chirwere chinowanzoitwa nehutano hwehutano, kubviswa kwacho kunoitwa nemishonga yakadai se "Atenolol", "Nitroglycerin", "Monopril", "Anaprilin", "Nitrosorbide", "Sulodexide", "Ednit."

Kurapa kwekuvhipwa kunoitwa kunze chete kana mishonga yakanyorwa isina kuunza chero mhinduro. Kuvhiya kunoitwa apo kukwira, kubuda mumimba, chironda uye kubuda kunowanikwa, uye pamwe nekuvandudzwa kwe hypersplenic syndrome. Nzira dzemazuva ano dzekupindira kwekuvhiya dzinosanganisira kushandisa laparoscopy, iyo inoshandiswa kugadzikana kusagadzikana nekushambadzira kuburikidza nehutano kuburikidza nekufungidzirwa zvishoma kwepombi dzakatetepa nekhamera, micromanipulator uye chiedza. Chifananidzo chinowanikwa pachitarisiko, kuisa pfungwa kune chiremba achibvisa chigadziro.

Mune mhaka yega unogona kuzvipa mishonga uye unotora mishonga, pamwe nemakemikari kuti ubvise tumarara, kuderedza dumbu remudumbu uye kubvisa matombo kunze kwekugadzwa kwachiremba. Mukuwedzera, kana bhiaryary hypertension yechiropa uye nduru yenyuchi ichionekwa, zvinotevera zviito zvekurapa zvinoitwa:

• Isa dhonsi kuti uchengetedze huwandu hwehutachiona uye electrolytes;
• Shandisa mishonga inovandudza ropa neropa rekushandisa kwemasero emuropa;
• Ita antibacterial therapy;
• Decompress the bile duct.

Mhedziso

Nokudaro, biliary hypertension inonzi inorwara zvikuru. Chaizvoizvo, zvirwere zvinotungamirira kuchirwere ichi zvinorapwa chirwere. Asi usatya izvi, nokuti kudanwa panguva yakakodzera kuna chiremba kunogona kubvisa chinokonzera kukanganisa kwakadai uye chirwere chairo.