Primary chinonzi sclerosing cholangitis: Zviratidzo, kuongorora chirwere neMarapirwo

Chinonzi sclerosing cholangitis - chirwere chiropa bile ducts umo avo masvingo chisingapere kuzvimba kunotanga. Mugumisiro kwayakatangira vari pezvakaitwa sclerosis, m. E. Replacement pamwe vanga tishu. zvokurwara ichi haana causal ukama nevamwe zvirwere chiropa, asi kazhinji kunotungamirira chimiro yematambudziko kubva mumuviri uyu. Mazuva ano nyaya tichasangana tsanangura sei kuva chinonzi sclerosing cholangitis. Zviratidzo uye pakurapa chirwere kuchaitawo kwaonekwa dzako.

anatomical bhuku

Bile kunokosha chezvinonhuwira ari zvomudumbu muitiro. Iye rinobatanidzwa yokuparara kwemafuta, anowedzera basa pancreatic makemikari uye zvinosimudzira peristalsis. Bile ndichifunda berekai chiropa masero - hepatocytes. Per zuva somugumisiro ravo ndichibvunza basa inotengwa anenge 1 fő emura. Pashure paizvozvo, vakuru bile anopinda dundira uye duodenum.

Water drainage secretion yakarongwa kuburikidza chaiwo ducts. Apo Vakasvika intrahepatic uye extrahepatic zvichienderana nzvimbo. Somugumisiro mira urongwa, kupinda kuti utachiona kana zvimwe zvikonzero, ivo ducts vangava zvomoto. Panguva iyoyowo yokutaura pamusoro pokumuka zvirwere zvakadai cholangitis. Pathological mutoo nguva dzose ane zvakasiyana etiology. Saka, zviri zvoga anotevera rudzi: chepfu, kwemabhakitiriya, helminthic, chinonzi sclerosing. Last zvikuru zvisingawanzoitiki, asi kunoratidzwa kwazvo.

Chinonzi sclerosing cholangitis rakakamurwa kaviri: nesekondari. Mumwe nomumwe wavo dzinoratidzwa chaicho yakatarwa zviratidzo uye kosi. Muchiitiko chokutanga kunoreva chirwere kuti pamwe kuzara kwakaita bile uye kwete purulent kuzvimba ducts, kuparadzwa kwavo uye pakutsiva kubudikidza connective tishu. Secondary chimiro zvokurwara hwapedyo pasi kuitwa zvine chepfu. Mune zvisingawanzoitiki Muzviitiko yakaitika zvayo kunokonzerwa kukwana ropa rive. Munyaya ino tichakurukura muudzame pamusoro chikuru musiyano wezvinyorwa chirwere.

Brief Description of chirwere

Primary chinonzi sclerosing cholangitis iri semhosva zvisingawanzoitiki pathologies ari biliary hurongwa. Maererano Statistical data, zvinonzi akaonekwa mune mumwe vanhu zvina paminiti 100 zviuru kwevanhu. Mashandiro okukura zvirwere akazoita kuonekwa kuzvimba iri duku hepatic ducts. Saka pane nokuomesa wavo. Zvishoma nezvishoma bindepinde uye akaremara mugero kuburikidza iyo bile runoyerera kupinda sefuro. Mira pezvakaitwa anoshanda kune intercellular nzvimbo chiropa, zvichiguma cirrhosis.

Kunyange pakupera rokupedzisira remakore zvaigoneka rokuongorora chirwere chete pashure oparesheni kana kuvhuya chitunha. Nemhaka kukura mushonga nhasi chirwere chinogona kuonekwa ipapa. Kusvika pamwero mukuru kubatwa nayo nevanhu makore 25 kusvika 40 makore. miganhu ava zvimiso zvikuru, nokuti chirwere chinogona asymptomatic kwenguva refu. Dzimwe zviratidzo kuzvimba kururama kuti autoimmune chirwere, maronda colitis uye cystic fibrosis.

The zvinokonzera cholangitis

Chaiyo zvinokonzera chirwere vasingazivikanwi. Doctors oga boka zvinoita kuti vawedzere mukana wokuti parinowanika. Pakati pavo vane:

• nemagene kubatwa;
• Virus basa mumuviri;
• propensity kune autoimmune zvirwere;
• kugarotamba zvine chepfu.

Pakati izvi zvinhu zviri pokutanga nemagene zvigadziriswe. Chaihwo hwokuti chokwadi ichi vari zvidzidzo chirwere mumhuri dzakawanda.

zvekuchipatara mufananidzo

On the chirwere kwemakore akawanda ave asymptomatic kana pamwe vanyoro zviratidzo. Varwere kazhinji havagoni kutaura chaizvo kana akazviratidza zvichiratidza chinonzi sclerosing cholangitis zviratidzo. Zvokurwara Kazhinji dzakaonekwa netsaona kuona chiremba pamusoro zvimwe zvinetso zvoutano. Panguva nechirwere akazivisa chiratidzo chirwere rokutanga - vakawedzera dziine hepatic makemikari.

Sezvo chirwere kupfuurira uye kunotoda mufananidzo kuchinja. Pakati yayo huru zviratidzo zvinotevera zvinofanira pachena:

• kuneta, kugara nehope;
• murombo havi;
• yellowing of mucous membranes uye ganda;
• kukwidza tembiricha kuti subfebrile tsika;
• vachirwadziwa marwadzo zvakarurama subcostal nharaunda, kuripa pamutsipa kana papfudzi;
• kuvaviwa;
• akawanda xanthomas;
• kusagadzikana mune kuruboshwe yokumusoro quadrant, zvichiguma kubva akawedzera chirwatata;
• akanatsiridzwa pigmentation ganda.

Dzimwe nguva, chinonzi sclerosing cholangitis pamwe anogumbura bowel chirwere. Izvi zvinosanganisira maronda colitis, Crohn chirwere.

nzira nechirwere

Kana uchifungidzira chirwere hwobva kutsvaka rubatsiro kubva chiremba. Kuongorora murwere kunotanga kudzidza nezvenhoroondo yaro, zvichemo chikuru zviratidzo. Pashure paizvozvo, endai kuongorora chaiko. Murwere kungava anokwenya paganda, yakanyanya jaundice. Palpation kakawanda kuwana kuwedzera chiropa uye chirwatata.

Kuti asimbise rokutanga zvokuongorora murwere akadana tichiongorora. Chinosanganisira zvinotevera mabasa:

• bvunzo ropa (zvinopfuura zviratidzi ose leukocytes uye ESR rinoratidza kuzvimba);
• Abdominal Ultrasound;
• elastography chiropa (anobvumira kufungidzira muviri elasticity);
• retrograde cholangiopancreatography (radiography uchishandisa musiyano);
• nemakemikari omuviri ropa (mu chinonzi sclerosing cholangitis vakachengeta kunyanya chiropa makemikari);
• MRI;
• Chiropa biopsy (nzira iyi tsvakurudzo kunobatsira kuziva nzvimbo fibrosis).

Nzira idzi kubvumira kuongorora kuzosimbisa chinonzi sclerosing cholangitis. Chirwere chirwere anotibatsira kuziva kukomba ari pathological muitiro. In zvachose pane zvina:

1. Portal. It kunoratidzwa chitarisiko puffiness uye hepatic fibrosis ducts.
2. Periportal. Zviratidzo wokutanga Danho vari kuzadzikiswa kunoitwa zvikuru raidudzwa fibrosis uye kuparadza kurongedza ducts.
3. Septal. Panguva iyi chirwere pane kutanga zviratidzo cirrhosis.
4. Cirrhotic. Dzinoratidzwa dzakazara kukura biliary cirrhosis.

Zvichienderana migumisiro kuongororwa kunzwisisa chiremba prescribes mushonga.

kurapwa Guidelines

Zvipatara zviri chirwere ichi nechinangwa kusunga kushoma, ari kuzoita bile kuyerera uye detoxification muviri. Kuti izvi zviitike, kuchinja uye kushanda nzira yokurapa inoshandiswa mukurapa ano. Muchiitiko chokutanga zvinoreva mishonga uye kuomerera kuti wakaoma kudya. Kuvhiya unoratidzwa Muzviitiko zvakaipisisa, kana kuchinja mabatiro rotsva. Selection imwe nzira yokurapa Zviri kwachiremba.

Kushandisa zvinodhaka

Zvichienderana kwokuomerwa chirwere, zvinogona kupiwa mubhedha zororo uye Kwabviswa chero muviri. Kana murwere kunetseka kurwadziwa, iye ushandiswe antispasmodics ( "No-Spa", "Spasmobru").

Kumisa kushoma kubatsira zvinotevera zvinodhaka:

1. Immunosuppressants ( "Azathioprine"). Ivo tunodzivisa basa zvirwere.
2. Antifibrogennye zvinoreva. Zvavakaita chikuru nechinangwa kuchaitwa fibrosis, uye kudzivirira dzavo pakuzadzisa.
3. Glucocorticosteroid kemikari ( "Prednisolone"). Vanobatsira kuderedza kuzvimba.

Kushandisa mishonga iyi inobvumira kuti kukunda kutanga kwekupwanyiwa Kugadzirwa chinonzi sclerosing cholangitis. Zviratidzo zviri chirwere kazhinji kudzivirira vatungamirire kuipa upenyu varwere. ganda Itchy, zvomudumbu turakiti matambudziko uye dyspepsia - kutyorwa izvi zvose vane inokanganisa utano hwavo. Naizvozvo anowedzera basa symptomatic kurapa. Kunosanganisira kugamuchira hepatic ( "Essentiale"), gastric makemikari ( "Creon") uye mishonga kuparadza kuvaviwa. Zvinodhaka nguva dzose aisarudza nomumwe, kufungisisa uchitikurudzira kunotoda mufananidzo uye murwere ezvinhu.

kudya Features

Varwere vakanga dzinounzwa kuna simba "tafura nhamba 5". Kana zvokudya zvinofanira kukutadzisa kudyiwa nuna zvakakangwa uye Spicy ndiro. Animal mafuta ari nani kutsiva chirimwa. Uyezve, zvinokosha kuti kubvisa zvachose zvokudya chikanywa uye zvihwitsi, yakashapa michero uye michero, chocolate, doro, nyama uye marinades.

Mvumo makapiwa kushandisa dzakaonda nyama / hove, dzimwe mhando chingwa, Porridge pamusoro mvura. Unogonawo kudya dheri zvigadzirwa, uchi, Pasta soups muriwo muto.

Apo chirwere kuti "chinonzi sclerosing cholangitis" kurapa nemishonga kudya kunopa yakanaka mugumisiro chete kutanga kwekupwanyiwa. Kana nguva iyi kurashikirwa, zvinoda kuvhiyiwa.

kuvhiya kupindira

Kuchinja kwomuchipatara akashandiswa nyore Zvekare zvimiro zvemhashu zvakaita pathological kwacho. Kunyange nenguva nezve chiremba hapasi kupa zvakanaka kunounza nomufambiro tevera mishonga. Kana kurapwa zvinodhaka haitungamiriri normalization ezvinhu kana anotadza kudzorera chakaipa kwazvino bile, unodzokera kuvhiya kupindira.

Nhasi vanachiremba vanosarudza endoscopic kushandiswa. Ivo vanoti kuita manipulations zvose kuburikidza cheka diki paganda. Zvisinei, nzira dzakadaro vari kakawanda kupa renguva pfupi uye hwakazara matambudziko. Uyewo kuitisa chibharuma dilatation uye stenting ducts. Munguva nzira, chiremba anowedzera hova dzinokosha sepombi uye anogadza pajira riya, zvomutadzisa kubva kuderedza. Kana paine zvinofanira raparurwa chinonzi sclerosing cholangitis, chiropa kurapwa zvinoreva.

zvinogoneka yematambudziko

The chirwere kunoratidzwa ne anononoka chokubuda. It anopindura havaratidzi mushonga, uye zvakawanda systemic zvinozonzi kunongoita muitiro. Pakati rakajairika matambudziko ayo zvinotevera:

1. Portal neBP. zvokurwara Izvi pamwe nokuwedzera nevezera muropa chekubuda hepatic. Kuratidzwa kwokuvimbika chikuru anonzi ascites.
2. Cholestasis syndrome. Muchirwisa colour wokuomeswa of bile ducts zvishoma nezvishoma taper kwavo muchinjikwa-vakadhakwa. Izvi anotsanangura chitarisiko jaundice uye pruritus. Sezvo kuchiita chirwere lumen nhete zvakanyanya. Steatorrhea kunoitika, icho pamwe osteoporosis.
3. Chirwere chinonzi sclerosing cholangitis chiropa.
4. Chisingaperi pfungwa nomuviri zvemwana asati.
5. Holangiokartsionoma (bundu bile ducts).
6. Cholelithiasis.

yematambudziko kwakadaro kuitika munyika 3-4 pavaipfuura pathological muitiro.

Kufembera uye kudzivirira matanho

Primary chinonzi sclerosing cholangitis iri semhosva zvishoma nezvishoma kufambira mberi chirwere. mugumisiro wake kakawanda zviri chisingapere chiropa kutadza. Sezvineiwo achiipa kubva fungidziro kukwegura murwere, kuvapo concomitant pathologies ari ura, panowanikwa yematambudziko. Kazhinji, pamwe kuonekwa kutanga zviratidzo chirwere pamberi mukunopera rinoenderera 7 kusvika 12 makore.

Zvinoita kudzivisa chinonzi sclerosing cholangitis? Reviews vanachiremba vanoti nokuda kukwana kudzidza dzakananga kudzivirira zvirwere haina dzakabudirira.