Obstructive jaundice yog dab tsi? Qhov ua rau ntawm txoj kev loj hlob thiab kev kho mob ntawm tus kab mob no yuav piav qhia hauv qab no. Koj tseem yuav kawm txog cov tsos mob ntawm tus kab mob no thiab seb nws kuaj tau li cas.
Cov ntaub ntawv tseem ceeb
Obstructive jaundice yog tus cwj pwm los ntawm cov ntsiab lus ntxiv hauv cov ntaub so ntswg ntawm cov khoom xws li bilirubin. Cov khoom no muab cov tawv nqaij thiab cov mucous daim nyias nyias xim daj.
Bilirubin yog cov kua tsib xim. Raws li cov kws tshaj lij, nws muaj ob feem: ncaj qha, uas yog, khi, thiab tsis ncaj, uas yog, pub dawb.
Yog li, obstructive jaundice yog tus cwj pwm los ntawm kev sib sau ntau dhau ntawm cov ntsiab lus hais, uas tshwm sim los ntawm kev ua tiav lossis ib feem ntawm cov lumen ntawm cov kua tsib. Lwm lub npe rau tus kab mob no yog obstructive jaundice.
Qhov laj thawj tseem ceeb ntawm kev txhim kho kab mob
Kev kuaj mob sib txawv ntawm qhov ua rau muaj qhov tsis zoo ntawm cov kab mob jaundice yuav tsum tau ua tsuas yog hauv tsev kho mob. Hais txog txoj kev tshawb fawb siv li cas, peb yuav qhia hauv qab no.
Nyob rau hauv lub xeev ib txwm ntawm tus neeg mob, cov kua tsib tsim nyob rau hauv daim siab yuav tsum, nrog rau ib tug tej zaus,tshem tawm nyob rau hauv lub duodenum nyob rau hauv thiaj li yuav coj ib feem nyob rau hauv lub digestive system. Txawm li cas los xij, qee zaum qhov no tsis tshwm sim. Cov laj thawj hauv qab no tuaj yeem ua rau muaj kev cuam tshuam rau cov txheej txheem zoo li no:
- stenosis, lossis qhov hu ua qhov nqaim ntawm cov ducts, nrog rau qhov o ntawm cov mucous membrane nyob rau hauv lub xub ntiag ntawm cicatricial post-inflammatory strictures (piv txwv li, pom nyob rau hauv cholangitis los yog cholecystitis) los yog qog compression;
- kev kho tshuab obturation, lossis qhov hu ua thaiv ntawm qee ntu ntawm cov kua tsib ducts los ntawm cov calculi hloov chaw (pob zeb) nyob rau hauv muaj kab mob gallstone.
Txhua yam ntawm cov xwm txheej tau teev tseg ua rau stagnation ntawm cov kua tsib (uas yog, mus rau tsim cov cholestasis), ua rau hypoxia, uas ua rau hepatocytes puas.
Nws kuj yuav tsum tau muab sau tseg tias muaj kab mob abscess, cyst ntawm lub gallbladder los yog pancreas, nrog rau cov kab mob xws li kab mob khaub thuas los yog echinococcus tuaj yeem ua rau muaj kab mob jaundice.
Symptoms of disease
Obstructive jaundice tshwm sim li cas? Cov tsos mob ntawm tus kab mob no nyuaj rau nco. Raws li txoj cai, tus kab mob no tshwm sim heev.
Raws li cov kws tshaj lij, jaundice tshwm sim los ntawm cov cim xws li:
- xeev siab, ua npaws, ntuav;
- mob stabbing mob nyob rau hauv txoj cai hypochondrium, uas loj hlob nyob rau hauv nthwv dej thiab tawg mus rau sab xis lub xub pwg hniav los yog caj dab;
- Dis xim ntawm cov quav raws li bilirubin tsis nkag musplab hnyuv;
- excretion ntawm bilirubin nrog rau cov zis, uas ua rau nws staining nyob rau hauv ib tug tsaus xim av xim;
- khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khaus khau khau khau khau khau khau khau khau khau khau khau
Lwm yam cim qhia ntawm tus kab mob
Koj tuaj yeem paub txog kev txhim kho ntawm cov kab mob jaundice li cas? Kev ua txhaum ntawm cov kua tsib ntawm cov kab mob ntev tshwm sim raws nraim tib yam li tau piav qhia saum toj no. Txawm li cas los xij, qhov hnyav ntawm cov tsos mob no tuaj yeem nce ntxiv nyob ntawm lub sijhawm ntawm cholestasis. Tsis tas li ntawd, qee zaum, cov neeg mob muaj steatorrhea (uas yog, cov roj undigested pom nyob rau hauv cov quav), tawv nqaij hyperpigmentation, poob phaus thiab xanthomas (uas yog, lipid deposits nyob rau hauv daim tawv nqaij).
Nws tseem yuav tsum tau muab sau tseg tias kev kuaj mob raws sij hawm ntawm obstructive jaundice tuaj yeem tiv thaiv kev loj hlob ntawm tus kab mob xws li cirrhosis. Tus kab mob no yog tus yam ntxwv los ntawm kev tsim ntawm cov ntaub so ntswg fibrous nodes nyob rau hauv daim siab, uas tshwm sim nyob rau hauv teb rau necrosis ntawm hepatocytes vim metabolic ntshawv siab thiab oxygen tshaib plab.
Nrog kev txhim kho ntawm jaundice nyob rau hauv tib neeg lub cev, cov metabolism hauv cov rog-soluble vitamins hloov. Tsis tas li ntawd, qhov tsis muaj vitamin D ua rau pob txha pob txha (uas yog, nce pob txha fragility), vim tias tus neeg mob hnov qhov tsis xis nyob hauv tus txha nraub qaum (hauv thaj tsam lumbar lossis thoracic), thiab kuj raug kev puas tsuaj los ntawm qhov tshwm sim.
Nws kuj yuav tsum tau hais tias kev mob jaundice feem ntau provokes txoj kev loj hlobhemorrhagic syndrome, uas muaj xws li lub qhov ntswg, qhov tsos ntawm vascular "asterisks" thiab bruises ntawm daim tawv nqaij. Cov xwm txheej zoo li no yog qhov tshwm sim ntawm qhov tsis muaj vitamin K.
Nrog tsis muaj vitamin A nyob rau hauv lub cev, tus neeg mob lub peev xwm rau twilight tsis pom kev. Tsis tas li ntawd, ntev cholestasis ua rau muaj qhov tshwm sim ntawm cov pob zeb tsim.
Tsis tas li, tawm tsam keeb kwm yav dhau los ntawm kev txhim kho jaundice, kev pheej hmoo ntawm kev kis kab mob thiab tshwm sim ntawm cov kab mob cholangitis, lossis qhov hu ua mob ntawm cov kua tsib, nce. Tus mob no feem ntau ua npaws thiab mob nyob rau sab xis sab xis ntawm lub plab.
Txoj kev kuaj mob jaundice
Tam sim no koj paub tias qhov mob jaundice tshwm sim los ntawm cov ntsiab lus ntawm bilirubin ntau ntxiv hauv cov ntshav. Txawm li cas los xij, kev kuaj ntshav biochemical rau cov kab mob zoo li no tsis muab daim duab kuaj pom tag. Yog li ntawd, ntau tus kws tshaj lij ua lwm yam kev kuaj sim, nrog rau siv ntau yam kev ntsuas.
Yog li, txhawm rau kuaj pom tus kab mob jaundice nws yog qhov tsim nyog:
- ua kom tiav ntshav suav;
- undergo endoscopic retrograde lossis magnetic resonance cholangiopancreatography;
- undergo xam tomography thiab ultrasound ntawm lub plab hnyuv plab;
- ua laparoscopy nrog lub hom phiaj biopsy.
Qhov tag nrho ntawm cov txiaj ntsig ntawm cov kev tshawb fawb no tso cai rau cov kws kho mob tuaj yeem xaus qhov muaj lossis tsis muaj tus kab mob jaundice.
Obstructive jaundice: kho tus kab mob
Raws li txoj cai, txhua tus neeg mob tau kuaj pom tias "obstructive jaundice" tam sim ntawd mus pw hauv tsev kho mob phais. Tom qab kev ntsuam xyuas, cov kws kho mob tshwj xeeb mus rau kev kho mob ncaj qha ntawm tus kab mob. Feem ntau cov kev kho mob ntawm tus kab mob no yog conservative. Nws yog tsom rau kev tshem tawm jaundice thiab cholestasis, nrog rau kev ruaj khov ntawm tus neeg mob. Hauv qhov no, kev kho mob yog ua los ntawm kev noj tshuaj hormonal thiab siv txoj hauv kev endoscopic.
Cov kauj ruam phais kuj feem ntau siv los tshem tawm jaundice.
Kev phais yog ua kom decompress (uas yog, kom txo qis) hauv cov kab mob biliary, nrog rau rov pib cov kua tsib, tiv thaiv daim siab tsis ua haujlwm thiab mob siab rau daim siab. Nyob rau hauv cov ntaub ntawv no, tsis tsuas yog qhib kev khiav hauj lwm, tab sis kuj laparoscopic sawv daws yuav, uas yog nqa tawm nyob rau hauv kev tswj ntawm ultrasound los yog CT. Los ntawm txoj kev, tom kawg yog muab tshwj xeeb nyiam vim qhov tsis tshua muaj tshwm sim ntawm cov teeb meem thiab kev phais me me.
Lwm yam kev kho mob
Ntxiv rau kev cuam tshuam kev phais, cov txheej txheem nyuaj rau kev kho mob jaundice muaj xws li cov dej num xws li:
- hepatoprotection (noj cov vitamins B, tshuaj "Essentiale"), txhim kho cov metabolism (los ntawm kev noj cov ascorbic acid thiab "Pentoxyl"), kev siv ursodeoxycholic acid;
- kev kho kom tshem tawm kom tshem tawm cov kab mob diuresis, kev tswj hwm cov kua qabzib, cov tshuaj ntsev, sodiumchloride, hemodez;
- kho microcirculation hauv cov hlab ntsha ntawm lub siab;
- tshuaj tua kab mob hauv cov ntaub ntawv txuas ntawm tus txheej txheem kis;
- kev kho tshuaj hormone, uas yog ntxiv nrog cov tshuaj tiv thaiv kab mob hauv plab.
Txoj kev phais
Nws tseem yuav tsum tau muab sau tseg tias kev phais mob hnyav hnyav tuaj yeem muaj qhov tshwm sim tsis zoo. Yog li, kev kho mob li no tsuas yog muab rau kev noj qab haus huv xwb.
Yog tus neeg mob tus mob tso cai, ces yuav tsum tau tos kom tus mob cholestasis txo qis, thiab rov kho dua.
