Klatskin chotupa: Zizindikiro ndi Chithandizo

Klatskin chotupa - khansa ya proximal ya ndulu ritsa. The kutupa kwa mtundu uwu aumbike mwa kumtunda kwa thirakiti biliary, kumene iwo zidzasankhidwa pakati pa lobes chiwindi. Klatskin chotupa ungadzakhazikitsidwe ducts onse, kapena mmodzi wa iwo, komanso linanena bungwe kwa chiwindi. Ndi matenda chotupa ingafalire kwa mitsempha chiwindi.

General zokhudza matendawa

Ngakhale kuti mankhwala amakono chapeza kwambiri zipangizo zothandiza kudzera zimene mungathe kudziwa mwamsanga matenda, khansa ya chiwindi ndi kapamba akhala pang'ono kuphunzira. Makamaka zimenezi nkhawa gawo vnepechennogo a dongosolo m'mimba. Kwambiri atengeke chotupa Klatskin anthu okhudzidwa ena. Choyamba - ana osaposa zaka 5 zaka amene alibe amadwala kuvutika pa mundawo m'mimba. The chachiwiri - anthu amene analowa 60 chaka wosaiwalika, zikutivuta kwambiri biliary thirakiti uziyenda matenda.

Khansa akhoza otani pa zifukwa zosiyanasiyana, koma mankhwala amakono amasonyeza zotsatirazi: poizoni zinyalala anamasulidwa mu mlengalenga lalikulu zedi; maganizo ndi matenda ena wamanjenje; kuwonongeka kwa malo; zizolowezi zoipa. Komanso, chifukwa mapangidwe Klatskin zotupa angathe kutumikira ndi zakudya zosayenera:

• ntchito mankhwala zosinthidwa chibadwa chakudya;
• uchidakwa;
• wonyeketsa yambiri mchere; kutetezera ndi zina chakudya.

Matendawa amapezeka chifukwa cha mavuto zovuta kuti chimayambitsa matenda zachipatala. Iwo pamapeto pake kupanga zotupa zamitundu yosiyanasiyana. Ngati mulibe kulabadira zizindikiro ndi kuyamba matenda, izo amakula mwamsanga Nawalanditsa kusapeza kwambiri.

Gawo zotupa biliary

1. Chosaopsa: papillomas, lipomas, adenomas.
2. Zilonda: cholangiocellular khansa, ndulu khansa chikhodzodzo, khansa ya ndulu ducts.
3. Klatskin chotupa.

Gulu la munda wa kutanthauzira

• Zokhudza ya ndulu ducts ndi foloko kwa chiwindi.
• Akunde imodzi ducts lapansi.
• Kugonjetsedwa kwa ducts awiri.

madandaulo mtima

matenda anapezeka ndi madokotala kawirikawiri. Wopambana chithandizo kumatengera zifukwa zambiri, koma chofunika kwambiri - nthawi imeneyi, matenda a wodwalayo kwa dokotala. Ngati munthu anafunsa katswiri mu nthawi, mankhwala nthawi zambiri ndi bwino, ndipo ngati nthendayo akuthamanga, zakambidwa bwino ndi zambiri kuyembekezera. Childs, Klatskin chotupa matenda pa kuona chifukwa cha matenda ena pachimake kapena aakulu pa mundawo m'mimba.

Nthawi zina odwala kubwera kwa dokotala gastroenterologist thandizo ndi vutoli. Madandaulo ambiri odwala mu nkhani iyi:

• umalemera mu mbali yake;
• ambiri kufooka kwa thupi ndi kutopa;
• CHOSADZIWIKA zosasangalatsa kukoma ndi mouthfeel;
• malaise.

The Oncology omwewo akapezeka osiyanasiyana. chakuti Klatskin chotupa - matenda a chikasu ndiyo, monga iwo ukutchedwa - ali ndi zizindikiro zofanana ndi matenda osiyanasiyana, monga chiwindi parenchyma ndi kapepala biliary.

zizindikiro

Kumbali ya zizindikiro matenda ali mbali zotsatirazi:

• kuchepetsa kwambiri kulemera kwa nthawi yochepa;
• mkodzo kukuchita mdima wowalirako chopondapo;
• ndi yogwira matenda kupitilira limapezeka khungu kuyabwa, zotupa pa khungu;
• kukula chotupa amachititsa zomverera chowawa m'madera osiyanasiyana a pamimba, wosawoneka pamisinkhu ina ya matenda.

zinthu Etiological pa chitukuko cha chikhalidwe zilonda za maphunziro mu extrahepatic ducts ya ndulu pafupifupi osadziwika. Koma ngati zinanso kuti chitukuko cha matenda angachiritsidwe motere:

• Nthawi zambiri anthu okalamba 60 Klatskin chotupa ikutuluka molumikizana ndi cholelithiasis;
• Ndi zofunika kwambiri ndi kutengera za kumtundu, makamaka kwa anthu okhwima, koma osati ukalamba;
• mwa matenda kholo tinganene kuti chachikulu matenda cholangitis ;
• Osachepera wamba matenda chothandizira angathe kutumikira chiwindi mavairasi B ndi C.

Monga tawerenga pamaso pa matenda

njira zingapo angagwiritsidwe ntchito kuzindikira chotupa Klatskin:

1. Transcutaneous transhepatic cholangiography - ndi njirayi, madokotala amalandira zonse X-ray wa ya ndulu ritsa. Kwa ndondomeko, mtima ndikoletsedwa kwa maola 6 lisanayambe kudya ndi kumwa nthawi yomweyo iye anapatsidwa mankhwala. Kayendesedwe akuyamba ndi chiyambi cha m'dera lamanja la pamimba ya mankhwala ochititsa malo komanso kudzera pakhungu mu kapepala kakuti biliary ankanyamula singano woonda kudzera amene utoto jekeseni. Ndiye, X-ray, lomwe limasonyeza ngati pali monyanyira aliyense kapepala kakuti biliary. Ndondomeko lonse kuti afufuze ndi lolondola kumenya singano anachita ntchito ultrasound makina. Isanayambe kapena itatha percutaneous transhepatic odwala cholangiography Kwalamulidwa mankhwala pofuna kupewa kuthekera matenda.
2. Angiography. Izi mawonekedwe a matenda akapatsidwa ngati ritsa ndi ili pafupi ziwiya lalikulu magazi a chiwindi. Ndi angiography anatsimikiza ngati anakantha loyenda ziwiya chotupa. Iwo anaphedwa motere: mu mtsempha wamagazi groin anayambitsanso chubu woonda kudzera amene utoto umachitika zolinga yapadera, ndipo kenako akudutsa mu mitsempha ya.
3. Percutaneous transhepatic cholangiography amagwiritsidwanso ntchito pa mwambo wa khansara, ndi zothandiza kutsekeka chotupa. Iwo anachita molondola kwambiri kudziwa nthawi ya percolation njira pathological pambuyo percutaneous transhepatic cholangiography.
4. Maginito kumveka mankhwala - imodzi mwa njira zabwino za kufufuza chotupa cha. Timatha kudziwa malo enieni ndi visualizes kapangidwe ka zipangizo za chiwindi.
5. Biopsy - njira yabwino kwambiri. yekha limakupatsani molondola kudziwa kukhalapo kwa chotupa, matabwa ake ndi chikhalidwe cha minofu. Chifukwa cha zowonongeka gawo anatengedwa puncture ili, limene ankafufuza ndi kusanthula microbiological. Ndondomeko anachita molumikizana ndi percutaneous transhepatic cholangiography.

mankhwala a matenda

Monga tanenera kale, zovuta kuzindikira chotupa Klatskin. cholangitis mankhwala - ndi kukhazikitsa phukusi la miyeso kuchotsa matenda. Ngati nthawi sayamba chithandizo, wodwala, zivute zitani kufa pasanathe miyezi 4-6. Cancer - ndi ovuta kuchiza matenda amene ali ndi makhalidwe omwewo ndi chotupa Klatskin. Chithandizo cha matenda kumafuna kuchotsa kwa zimakhala anakhudzidwa. Pankhaniyi, izo ziyenera kukhala wangwiro, yemwe ndi minofu anakhudzidwa chikutha ndi nsalu yoyera. Izi zachitika kuti zinkakhala m'dera yatsala maselo zilonda, nthawi zina kuchotsedwa Lobe wina chiwindi. Ngati chotupa Klatskin, amene kwambiri angaletsedwe chitukuko cha Mapa sangathe kuchotsedwa chifukwa cha kugonjetsedwa kwa mitsempha ya magazi a thupi lonse ntchito cheza ndi mankhwala amphamvu, koma zambiri, ndi operewera.

Kodi kuyang'ana poomosch

Ngakhale kuti matenda funso kale kudziwika, ndipo pali njira kulimbana izo kupyolera kuchotsa minofu, pali palibe anthu ambiri nkhani ya mmene tiyenera kuchitira chotupa Klatskin. Chithandizo cha cholangitis suppurative bwinobwino kwambiri ikuchitika mu Israyeli zipatala apadera Oncology chithandizo. Pali kale zonse zofunika zinthu ndi chotupa cha ichi chiwindi chikhalidwe. Ndi palibe chinsinsi chimene Israel - malo a ndende ya akatswiri amphamvu a zachipatala, kotero n'zomveka chifukwa pali bwinobwino ankachitira ndi chotupa Klatskin. Reviews odwala azisonyeza apo, amasonyeza kuti utumiki mu zipatala Oncology Israeli ali pa mlingo wapamwamba.