BDS ndi chiyani? matenda Secondary BDS

Matenda a dongosolo m'mimba ziwalo - matenda zofala zimene zimachitika mu ambiri a anthu padzikoli. Komabe, sikuti aliyense amadziwa kuti matenda ambiri chifukwa cha m'mimba limati matenda aakulu mmatumbo papilla. Ku zipangizo za nkhani wowerenga amvela kuti BDS ndi, zimene yonse ya matenda odziwika mankhwala a dongosolo lino monga matenda zinthu pathological ndi mankhwala amene mu nkhani iyi ikuchitika.

Lingaliro BDS

Large mmatumbo papilla (BNS) akuimira dongosolo anatomical wa mawonekedwe hemispherical, amene oyenerera pa mucosa ukutsika mbali ya duodenum ndi. Mu mabuku a zamankhwala BDS angapezeke pansi maina osiyana - lalikulu mmatumbo papilla, ndi papilla wa Vater. Ndipo komabe, kodi BDS? Izi kukula 2 mm ndi 2 cm dongosolo limene anachita ntchito yofunika kwambiri - zikugwirizana wamba ya ndulu ritsa, waukulu pancreatic ritsa ndi duodenum. BDS nthawi otaya ya ndulu ndi madzi pancreatic mu matumbo ang'ono ndiponso kupewa zili matumbo mu ducts lapansi.

Mu dongosolo la OBD angayambe kusintha pathological mchikakamizo cha zinthu zosiyana -. Osiyanasiyana microflora tizilombo, kusinthasintha kuthamanga ndi kusintha mu muyezo asidi-m'munsi, stagnation mu M'mimbamo ndi, etc. Komanso, kapangidwe thupi akhoza akusokoneza Kusamuka kwa ya ndulu ritsa miyala kapena nyumba zina olimba.

kudwala BDS

Matenda a papilla lalikulu mmatumbo ndi yosiyanasiyana. Ndi chitukuko cha njira zamakono za diagnostics mfundo za matenda zinchito mu nyumba imeneyi nthawi zambiri wamba kuposa mmene ankaganizira poyamba. Komabe, chifukwa mwadzidzidzi ndipo m'malo zovuta kumapeto matenda zachipatala nthawi zambiri anakumana ndi nambala yaikulu zotsatira osauka mankhwala a odwala ndi cholelithiasis kapena kapamba imene inabuka pa maziko a kuyan'anila mu dongosolo BDS.

BDS wamba kudwala ankaona tumorous zophuka - tizilombo ting'onoting'ono hyperplastic mpaka 87% mwa neoplasms chosaopsa. Tizilombo ting'onoting'ono samasankha buluzi mu minofu zilonda. Adenoma - bole osowa matenda OBD khansa mpaka 25% a malignancies onse. BDS stenosis anapezeka mu 4-40% odwala. Monga ulamuliro, ndi BDS kudwala kumayambitsa matenda gallstone (GSD), lomwe limapezeka mu aliyense wokhala chakhumi.

Gulu la Matenda BDS

Matenda a papilla lalikulu mmatumbo zimagawidwa m'magulu awiri akuluakulu:

• chachikulu,
• sekondale.

The matenda oti matendawa zimene zimachitika ali isanafalikire mu dongosolo OBD - papillitis (yotupa matenda); chonsechi OBD stenosis, lomwe m'tsogolo lidzasanduke papilloskleroz; OBD zaka kusintha; kobadwa nako anomalies; chosaopsa ndi zilonda zotupa - lipoma, khansa, fibroma, adenoma, ndi tizilombo ting'onoting'ono, papillomas.

matenda Secondary BDS - stenosis amayamba ndi gallstones. Zizindikiro za matenda mwachindunji zokhudzana ndi zifukwa adali Kuitanidwa. Choncho, ngati ndondomeko pathological ndi zotsatira za matenda a dongosolo biliary, matenda ndi ofanana ndi maonekedwe a GSD - kudwala, yodziwika ndi mapangidwe miyala ndulu kapena ya ndulu ducts, limodzi ndi kumverera kwa kulemera mu chapamwamba nusu, flatulence, kutentha, mpando zosathandiza.

Pali mfundo ophatikizana stenosis - kuphwanya BNS ntchito kuti chikanachitika ndi maziko a chilonda cha duodenum ndi. Pankhaniyi, pali chosowa BNS.

kapamba

Ngati njira pathological mu dongosolo chifukwa cha kutupa OBD mawonetseredwe pancreatic matenda ofanana ndi zizindikiro za kapamba.

Kapamba - ndi yotupa ndondomeko mu kapamba. N'zochititsa chidwi kuti chithunzi cha matenda angakhale osiyana - kudwala angathe kukhala mofulumira, natenga mawonekedwe pachimake, kapena usati zimapezeka kwa nthawi yaitali, amene Ndi mmene kwa mawonekedwe aakulu a otaya lapansi.

The chizindikiro chachikulu cha kapamba pachimake ndi amphamvu kwambiri kudula ululu m'dera chapamwamba m'mimba - lamanja kapena lamanzere chapamwamba nusu. Ululu kunyamula nsungu ndipo sanaime ngakhale atakhala MANKHWALA OLETSA VUTOLI kapena analgesics. Ndicho chomwe BDS ndi zotsatira chifukwa kuphwanya ntchito zake.

Kuwonjezera pa ululu wa kapamba zimachitika gag reflex, kufooka kwa thupi, chizungulire. Zizindikiro zazikulu za kapamba ndi ultrasound ndi kusintha mawonekedwe ndi roughness wa m'mbali mwa kapamba. Mu matenda a cysts angathe kuonedwa mu thupi. Ine ndiyenera kunena kuti matenda ndi zovuta. Ndipo pa phukusi mwadzidzidzi kungachititse kuti imfa.

Chonsechi stenosis BDS

Stenosis OBD - chosaopsa kudwala kwa ndimeyi, amene amayamba chifukwa cha kutsekeka kwa ritsa pancreatic ndi ndulu chifukwa kusintha yotupa ndi cicatricial kaduka papillae. Kodi zimachitika? Ndime mwala ndi chilonda papilla ndi matenda mwakhama makutu kumabweretsa kukula kwa minofu fibrous ndi zigawo stenotic OBD ampoules.

Monga amadziwika, kapangidwe ka BDS likukhudza msinkhu wa munthu. Anthu okalamba mu cholelithiasis kuvutika sclerotic atrophic mawonekedwe papillita aakulu. The chimadalira, amene sizinawakhudze zaka makumi asanu kunja ungasinthe hyperplastic mu BDS (adenomatous, adenomiomatoznye).

M'zaka zaposachedwapa, chifukwa chakuti, mu matenda a matenda BDS endoscopes ntchito, n'zotheka bwino kusiyanitsa constrictive ndi catarrhal (nestenoziruyuschy) papillitis. Mawonekedwe woyamba wa kudwala kugwirizana ndi cholelithiasis. Ngati thupi si kupanga miyala chitukuko cha matenda ndi matenda aakulu omwe kufalikira kwa lymph panopa.

Mafomu stenosis BDS

Malinga ndi zilembo morphological mitundu itatu ya stenosis:

• yotupa-sclerotic stenosis - ndi kudwala kuti amakhala ndi amawasonyeza mosiyanasiyana wa fibrosis;
• fibrocystic stenosis - matenda imene mapangidwe fibrosis ndi cysts anapanga kakang'ono - chifukwanso zopangitsa kwambiri kumatheka kufinya ulusi minofu;
• adenomiomatozny Stenosis - kudwala, pa zimene adenomatous hyperplasia zopangitsa, komanso CHIKWANGWANI hypertrophy minofu yosalala ndi fibrous overgrowth ulusi, kuphwanya ndi zambiri amapezeka anthu achikulire.

Komanso, chilonda stenosis BDS wachinsinsi:

• chachikulu,
• sekondale.

stenosis chachikulu sayambitsa kusintha mu ducts ya ndulu. Kudwala chifukwa cha kusintha osachiritsika a papilla, amene kuonekera mu manja a wosanjikiza minofu. Nthawi zina stenosis chachikulu chilema kobadwa nako.

stenosis Secondary ndi zotsatira za kusintha alipo mu dongosolo chifukwa miyala kusamuka choipa papillae kapena opaleshoni.

Malinga mmene kufala kwa matenda stenosis BNS magawo:

• pa yekha,
• wamba.

diagnostics

Pakali pano, mankhwala ntchito njira angapo bwino matenda diagnostics OBD. Tiyeni tikambirane zina mwa izo. Endoscopic ultrasonography - njira imene kudzera chipangizo kuwala - pa endoscope - kafukufuku amene anachitika OBD dongosolo. Photography papilla anapanga ndi phunziro Mofananamo, tatchula pamwambapa.

Transabdominal ultrasonography - kuphimba njira Kupenda ntchito ultrasound, amene amalola kwambiri molondola kuzindikira kusintha structural mu ndulu, chiwindi, kapamba, ndi ducts. Komanso njira ndiyo homogeneity wa M'mimbamo ndi chikhodzodzo ndulu motility, pamaso / pakalibe inclusions intracavitary.

The njira wotsatira wa Kupeza Vuto pathologies BDS - akupanga cholecystography - mpheto, kudzera omwe ankayendera galimoto-achoke ntchito ya ndulu kwa maola awiri atatumidwa choleretic kadzutsa.

Mphamvu hepatobiliary scintigraphy - ndondomeko, ozikidwa - Kafukufuku absorptive-excretory ntchito ya chiwindi. Fractional chromatic mmatumbo akufufuza mpata kudziwa kamvekedwe wa chikhodzodzo ndulu; colloidal kukhazikika kwa chiwindi ya ndulu kachigawo ndi kapangidwe kake bacteriological. Pamene gastroduodenoscopy amaweruza boma la BDS, komanso zimene ananena chikhalidwe cha ya ndulu amakhala alipo. Kuwonjezera njira izi pali kompyuta tomography ndi diagnostics zasayansi.

BDS: chithandizo

Chifukwa cha matenda a stenosis wa BDS ndi ntchito yokonzanso otaya wabwinobwino wa ya ndulu ndi madzi pancreatic mu duodenum ndi. Mogwirizana ndi cholinga pali mfundo, kusunga zimene zingakuthandizeni Mokhumbira mankhwalawa:

• misala, chithandizo cha neuroses, ziziyenda milingo m'thupi, kuchepetsa nkhawa, kutakasuka, kudya bwino;
• Chithandizo cha pathologies wa zonse m'mimba,
• Kupha zinthu dyspeptic.

Pofuna kuthetsa matenda neurotic ntchito mankhwala infusions kapena decoctions zitsamba zosiyanasiyana. Komanso, odwala anasonyeza misala.

Mbali yofunika kwambiri ya chithandizo bwino zakudya:

• fractional chakudya;
• osadya mowa ndi enaake zakumwa, komanso zakudya kusuta ndi yokazinga;
• Kuchepetsa yolks chikuonetseratu dzira, kuphika, kirimu khofi amphamvu ndi tiyi;
• kudya kawirikawiri kabichi, tirigu chinangwa ndi buckwheat;
• kulandira MANKHWALA OLETSA VUTOLI, amene kuchotsa kuukira ululu.

BDS stenosis kawirikawiri kuchizidwa njira opaleshoni. Kusiyanitsa nekorrigiruyuschie ndi kukonza ntchito. Gulu loyamba zikuphatikizapo endoscopic PST, kusanthulasanthula BDS.

Mu nthawi ya chikhululukiro odwala kuwonjezera zakudya analimbikitsa yokonza mankhwala - ndi ubwino kuyenda tsiku, m'mawa olimbitsa kusambira.

Mwachidule, akhoza mwachidule kuti ambiri matenda m'mimba kumachitika ndi maziko a wonongeka dongosolo waung'ono. kuyan'anila zimachititsa kuti mavuto aakulu mu thupi ndi zambiri amenable kukonza yekha ndi opaleshoni. Ndicho chimene BDS.