Matenda a Caroli: Zizindikiro ndi Chithandizo

Matenda a Caroli ndi matenda ovuta kwambiri a chiwindi, kupeza ndi kuchiza zomwe zimayambitsa madokotala aakulu.

Kodi matendawa ndi otani?

Matenda a Caroli ndi matenda omwe amabwera chifukwa cha chiwindi chifukwa cha kupweteka kwa dothi. Zimadziwika ndi kuti kayendetsedwe kake ka bile kamasokonezeka, stasis yake ndi chiyanjano cha ndondomeko yotenga matenda. Kawirikawiri matendawa amapezeka mwa amuna ndipo amayamba ndi ubwana kapena unyamata. Mchitidwe wa matendawa umadalira mwachindunji ndi kuchuluka kwa kuwonongeka kwa mazira mkati mwa chiwindi.

Mafomu a matendawa

Mpaka pano, palibe kusiyana kosiyana kwa matenda a Caroli mu mankhwala. Komabe, ngakhale izi, pali mitundu iwiri yosiyana ya matendawa. Fomu yoyamba imadziwika ndi kuphwanya maonekedwe a bile, kenako kumapanga miyala.

Fomu yachiŵiri imayanjanitsidwa ndi congenital chiwindi fibrosis. Pachifukwa ichi, kuwonjezeka kwakukulu kwa madengu kumaonetsedwa, ndipo kupanga miyala sikuchotsedwa, ngakhale kuti nthawi zina kumachitika pakapita nthawi pa matendawa.

Mitsempha yowonjezereka ikhonza kugwirizanitsidwa ndi zigawo za chiwindi za chiwindi ndipo panthawi imodzimodziyo, kukulitsa kwa septa ndi khoma kumawonetsedwa mu lumen.

Zimayambitsa

Matenda a Caroli amatanthauza matenda opatsirana omwe amayamba chifukwa chokhala ndi cholowa chodziwika bwino. Ngati pali achibale apamtima omwe ali ndi matenda ofanana ndi amenewa, ndiye kuti mwanayo atangoyamba kubereka, ayenera kuyesedwa bwino, popeza pali mwayi waukulu wopatsirana ndi matendawa.

Nthawi zina, matenda ena a chiwindi amathandizanso matendawa, omwe ndi ovuta kwambiri kuchipatala.

Zizindikiro zazikulu

Zizindikiro za matenda a Caroli zikhoza kudziwonetsera okha pa msinkhu uliwonse wa ana ndi achinyamata. Zizindikiro zazikulu za matendawa zikuphatikizapo:

• Kupweteka m'mimba;
• Fever;
• Pewani khungu la khungu;
• Kukulitsa chiwindi nthawi ya palpation.

Kuwonetsa mawonetseredwe a matenda a matendawa nthawi zambiri amagwirizanitsidwa ndi njira yotupa. Kawirikawiri, matenda a Caroli amapezeka mwa ana aamuna. Pamene kuwonjezereka pali kuwonjezeka kwakukulu mu msinkhu wa bilirubin ndi leukocyte m'magazi.

Kuchita zogonana

Ngakhale kuti zizindikiro za matendawa zimatchulidwa, komabe, zimakhalanso ndi zizindikiro zina zambiri za chiwindi. Ndondomeko kuti mudziwe ndikuzindikira kuti Caroli amatha kudwala ultrasound ndi khalidwe la CT. Masewera amtunduwu amadziwika kuti ndi imodzi mwa njira zophunzitsira zowonjezera, popeza n'zotheka kuwona zolakwa zonse zomwe zilipo kale. Kuphatikiza apo, chokhazikitsa cholangiography chingayesedwe kuti chidziwitse.

Mayeso ogwira ntchito a chiwindi kwa nthawi yaitali samasintha konse, komabe, ndi matenda omwe amatha kufalikira komanso kusakanikirana kwa nthawi yaitali mu kusanthula kwa magazi, zizindikiro zonse za cholestasis zimapezeka.

Popeza odwala ali pachiopsezo cha cholangiocarcinoma, kuwonetseredwa kwa serological kuyeneranso kuchitidwa pofuna kupezeka kwa khansa.

Mbali za mankhwala

Pamaso pa matenda a Caroli, malangizidwe azachipatala ayenera kuwonedwa mosalekeza, popeza matendawa ali ndi chikhalidwe chopita patsogolo. Kuchiza kumaphatikizapo kugwiritsa ntchito ma antibayotiki ochuluka, komanso kukhazikitsa ursodeoxycholic asidi pofuna kuteteza kupanga miyala.

Komanso, mankhwalawa akuphatikizapo:

• Kugwiritsa ntchito analgesics;
• Litholysis ya miyala;
• Kusambira kwa bile ducts.

Ndi kuwonjezera kwa cholangitis kapena mavuto ena a purulent chikhalidwe, mankhwala ndi osiyana ndi kuchiza bakiteriya cholangitis. Ndikofunika kuthetsa purulent zomwe zili mkati mwake ndipo pakadali pano mankhwalawa amayeretsedwa, ndipo mankhwala ophera antibacterial omwe amathandiza kuchotsa matendawa amagwiritsidwa ntchito.

Opaleshoniyi imagwiritsidwa ntchito pokhapokha ngati zovuta zowonjezereka zikuchitika kapena ngati kugwiritsa ntchito njira zowonongeka sizothandiza. Chiwerengero cha opaleshoni chitha kusintha mosiyanasiyana. Ndi miyala yokha kapena mazira omwe angathe kuchotsedwa.

Pankhani ya kukula kwakukulu kwa bile ndi kuchuluka kwa bile, dokotalayo amatha kuchotsa chiwindi chimodzi cha chiwindi. M'mayesero oopsa kwambiri, kuperewera kwa chiwindi, chiwindikiro cha chiwindi kuchokera kwa wachibale chingakhale cholimbikitsidwa.

Pofuna kupeza zotsatira zabwino, madokotala ena amalimbikitsa kuti chiwindikiro cha chiwindi chichitike ngakhale kuti palibe zizindikiro zoopsa m'zigawo zoyambirira za matendawa. Komabe, nthawi zambiri kupezeka kwa kachilombo ndiko kutsutsana kwa kusamba. Kuchuluka kwa odwala atatha kuikidwa ndi congenital fibrosis, amene kutupa kwa biliary kapepala kameneka kanatulukanso pakapita nthawi, ndi kochepa kokwanira.

Chizindikiro cha matendawa n'chosavomerezeka, chifukwa kubwezeretsa kumachitika zaka zingapo. Komabe, kawirikawiri zimayambitsa imfa ya wodwalayo.

Caroli Syndrome

Matenda a Caroli nthawi zambiri amakhala ndi matenda a chiwindi, omwe amachititsa matenda a Caroli. Zonsezi zimapangidwa chifukwa cha kuphwanya kofanana kwa mapangidwe a bile mu chiwindi cha chiwindi pamlingo wa kukula kwa embryonic. Matendawa amachokera kwa wachibale ndipo amawonetseredwa ndi ululu m'mimba, komanso amachotsa mitsempha yosakanikirana. Ana obadwa kumene angakhale ndi zizindikiro zazikulu za congenital chiwindi fibrosis, matenda a Caroli ndi matenda a impso a polycystic.

Matendawa ndi a congenital bile a ma ducts, koma ndi osowa kwambiri ndipo makamaka anthu osapitirira zaka 30. M'zaka zingapo zoyambirira, matendawa amayamba mosavuta, mpaka kufalikira kwa mankhwala a bile kumachititsa kuti phokoso la bile likhale lopweteka, lomwe lidzapangitse zinthu zonse kuti zikhale ndi miyala komanso matenda. Ngati jaundice ikuwonetsedwa pamodzi ndi zizindikiro zotsalira, ndiye izi zikusonyeza kukhalapo kwa cholangitis.

Pali makamaka zilonda zam'kati za chiwindi, koma nthawi zina zimakhala zogwirizana.

Nthawi zina, kuwonongeka kwa chiwindi ndi koopsa kwambiri moti kungakhudze ziwalo zina. Choncho chimodzi mwa mavutowa chikhoza kuganiziridwa ngati kutuluka kwa impso kulephera.