Klatskin bundu: unhu, zviratidzo, kurapwa, fungidziro

Cholangiocarcinoma, riri munyika yose utano vemunharaunda nokuongorora, anenge 2% kenza zvose, uyewo kumusoro kusvika 10% kubva Muzviitiko chiropa uye biliary kenza turakiti. Panguva zvokuongorora kwaiita bundu yakaderera chaizvo: 1.5-2 chete%. Bundu Klatskin mazita pathologist Gerald Klatskin, chiremba kubva America. Muna 1965, apo vaishanda Yale University, ari kuvimba 13 nyaya, akatsanangura zvose zvinoitwa chirwere ichi.

Cholangiocarcinoma, kana kenza chiropa, uye bile mutsinga dzinofamba nemukaka

Klatskin bundu - nechirwere ngozi. Nokuti neoplasm ichi dzinoratidzwa kunonoka kukura uye pashure kugadzira metastases. Nokuda mukupera zvokuongorora uye nekusagona tiite kubviswa nokuda vavhiyiwa, ane kumusoro vanourayiswa chirwere. The chirwere kakawanda anoiswa pamusoro yokupedzisira nzendo kukura dzidzo, iyo inosiya kuvhiyiwa. Pokumuka metastases iri pachena zvakananga chiropa, namasuwo chiropa, kwematunhu node nodes uye dumbu. Bundu kukura kunoitika kubva chiropa epithelial mumasero. Kutambudzika aumbwa ainyanya pashure pemakore 50, asi nerimwe gore makore varwere ipfupi. Vanhu zvishoma zvikuru kubatwa nechirwere ichi pane vakadzi.

The fungidzira chinokonzera bundu

VaBennett chiropa cholangiocarcinoma harizivikanwi. Asi masayendisiti akawana migumisiro izvo zvinowedzera mukana anomera. With nhoroondo chikuru sklerotiziruyuschego cholangitis muna 40 varwere kubva 100 zviitiko ingangoumbwa Klatskin chirwere. Bundu akaumba pa 25 nyaya kubva 100 nemhaka nhaka zvirwere, zvakadai Caroli chirwere. Anogumbura maitiro nokuda intrahepatic tupukanana kunogona kukonzera bundu.

Bad tsika chokuita utano chiropa: kusvuta, doro, murombo zvokudya, entailing kufutisa - zvazvisingarambiki zvinhu kuti chirwere kunoita. Kuvapo cholelithiasis kunowedzera mukana anomera. Pangozi ndivo vanhu pachena kuti kwenguva refu kuonana muchetura uye zvinokuvadza. Kutapukirwa noutachiona, kunyanya chiropa, inobatsira kuti pave kenza.

symptomatology cholangiocarcinoma

Sezvo akaipa bundu iri chiropa zvakaoma rokuongorora, unofanira kuteerera muviri wako nokuda mangwanani vasabatwa chirwere Klatskin. Bundu anogona dzinoratidzwa zviratidzo zvakadai:

• chikuru chepfungwa chirwere - obstructive jaundice;
• Kugara kuvaviwa chishamiso;
• mumwe nangananga marwadzo chokumusoro rworudyi chikamu mudumbu;
• kurasikirwa Nzara uye somugumisiro zvikuru uremu;
• mumuviri kuneta chinoratidza mota inotungamirwa;
• panguva tembiricha yakakwirira Klatskin mapundu kuitikawo;
• kuchinja weti uye chetsoka ruvara (rima weti, chetsoka kupenya).

Zviratidzo kungoerekana uye mberi. Jaundice inowanikwa 90 nyaya kubva 100, uye ari mumwe kupfuura kakawanda zviratidzo chirwere akadai bundu Klatskin. Reviews wevarwere dzimwe nguva dzinosiyana. Vamwe varwere yakashuma nemazvo kuvaviwa, marwadzo uye kungoerekana uremu. kuratidzwa izvi zvinokonzerwa yepamusoro zvokukura nyanyisa anomera. Asi vamwe havanzwi zvinenge hapana zvarakasiya utano mamiriro kana zvakabatana zviratidzo akazviratidza nezvimwe zvirwere.

Mota Diagnostics Klatskin

Nokuti chirwere rinoitwa nhamba yezvidzidzo zvekuchipatara angataura zvakarurama pamberi Klatskin chirwere. Bundu iri pachena zvinoonekwa pamusoro Ultrasound mu kuongorora midziyo. Uyu zvakanaka mari, ushamwari uye nyore nzira. Achibatsirwa zononoka CT nyore kuona hadzina kufambiswa zvakanaka munduru dundira, kukuvara chiropa, uye kuona node nodes. Uchishandisa MRI (Magnetic Resonance kuri), pakatanga kusiyana mvura kuti chiropa dzakakwirira zvakarurama kuona mamiriro chiropa rinenge uye ukuru aienda pamusoro bile mutsinga dzinofamba nemukaka panguva nechirwere Klatskin bundu. Photography anoratidza zvose zvikamu chiropa uye bile ducts.

Fluoroscopic uye radiographic kuongorora kunoratidza nezvinetso biliary nzira. Pfungwa nechirwere kutaurwa musiyano mumiriri, izvo anobvumira kuona chekubuda bile. miedzo ropa nokukanganisika kubatsira kuona pachiyero makemikari uye bilirubin. Vanogonawo kupiwa miedzo kuziva kenza Tel: CA 199, CA 125.

Kazhinji, bundu pezvakaitwa kusvika hepatic tsinga uye portal tsinga wedzerai ropa kuti chiropa. Asati avhiyiwa zvakakosha chaizvo inoshandiswa pakutsigira namamota, kuti kujekesa kana chirwere chapararira kune midziyo ropa. Mune zvimwe zviitiko, zvakadai chirwere chakaoma, uye ipapo mubvunzo kuti pakafunuka iri kugadziriswa resection pakuvhiya.

Nzira kurapa neoplasms

Varwere Untreated kakawanda avhareji youpenyu hunotarisira muna 6 mwedzi kutsunga kuongororwa zvakarurama. In tanga Kashoma zvinoratidza Klatskin chirwere. Bundu iri amenable kune yokupedzisira nzendo kurapwa iwayo inobudirira.

Surgery - imwe nzira huru kubata bundu. Zvisinei, ichishanda ine pasi pechikumbaridzo kurarama (kureva 20%) nokuda mukupera zvawanikwa. nokubviswa mugove dzaparadzwa pamusoro bile mutsinga dzinofamba nemukaka wakakwana rinoshandiswa kuzadzisa kunobatsirawo takabatana kubviswa rimwe akafukidza chiropa, kuitira kudzivisa chirwere midziyo ropa.

Kuvhiya zvinogoneka mune Kashoma:

• dzidzo haana kukanganisa kweropa hurongwa chiropa; iyi nyaya zvichibvira kubvisa mugove yose kana chikamu ukama chiropa;
• dzidzo haana kukanganisa bile mutsinga dzinofamba nemukaka mumwe kana vaviri lobes chiropa.

Vaiona unresectable chirwere, kana bundu chinopinda muropa nemidziyo chiropa kana Bile ducts zvose mugove wayo.

Palliative kurapwa

In inoperable Muzviitiko kana somunhu adjunct kurapa akashandisa palliative kurapwa.

Nzira idzi dzinosanganisira:

• abudise of biliary turakiti;
• mishonga;
• nemwaranzi kurapa;
• ndavhiyiwa;
• photodynamic kurapa;
• vysokosfokusirovannymi irradiation pamusoro ultrasonic matanda.

Nokuva Kurapa akawanda, pamwe mangwanani nechirwere, upenyu anotarisirwa zvinogona vakawedzera kubva 10 mwedzi 5 years.

The fungidziro pashure kurapwa

Nokuti kuti paumbwe anomera munzvimbo chiropa anononoka zvakakwana, upenyu anotarisirwa kubva nehafu makore mashanu. Complete nokubviswa munzvimbo dzaparadzwa anogona kuwedzera upenyu hupfupi kuti yakarurama uye nenguva chirwere chirwere Klatskin. Namamota zvinowanikwa chiropa, ane zvisingafadzi. Zvaifungidzirwa. Uyu ndiwo mumwe yakaipisisa zviratidzi vakanga kuchengetwa varwere inoperable metastases inotungamirwa. Vanaamai vakadaro vanogona chete kuvimba abudise ari biliary turakiti. Kana chirwere ari chiropa bundu Klatskin, ari hunotarisira vanorwara upenyu dzimwe hapana kupfuura shomanana.

Atongerwe rufu, oddly zvakakwana, usingatangi metastasize, uye anoenderana matambudziko. Idzi dzinosanganisira:

• cirrhosis anokonzerwa kukodzera bile water drainage;
• chirwere, zvichiita kuti paumbwe abscesses;
• zvachose atrophy muviri wacho kutapata uye kutadza;
• suppurative kuzvimba.

matanho

Nokuti kudzivirira neoplastic nezvirwere chiropa uye bile ducts zvakafanira kuomerera kudya zvinovaka muviri, kwete kushandisa doro uye kudzivirira parasitic chirwere. Kana nhoroondo chirwere, ayo papi sezvo zvinokonzera njodzi, chinofanira kuva nenguva kurapwa uye hurongwa kuongororwa kuti mangwanani kuziva miedzo abnormalities mu bile miviri. Zvinokoshawo kubvisa migumisiro zvinokuvadza, akadai kumabasa.

In mhedziso

Modern chirwere midziyo inogona kuona mapundu ari chiropa uye bile ducts, uyewo kuona mwero kuvhiya kunzwisisa. Kuitwa mutsva nzira operative kugadzirisa dambudziko, transplantation nezvimwe kuchirapa matanho kunotungamirira kuvandudza uye nguva upenyu varwere.