Kupenda chiwindi: mndandanda wa njira

Ngati inu munayamba kuzindikira soreness mu mbali lake lamanja, pakamwa pake anaonekera kulawa zowawa, kawirikawiri pa chifukwa amayamba kuona akudwala, zikuoneka kuti vuto ndi chiwindi. Koma musayambe kuwerenga masamba tiyi ndi kutenga mankhwala anthu afalitse. Ndi bwino kukaonana ndi katswiri ndi kuthera anayendera chiwindi. Nditaphunzira zotsatira za mayesero a ultrasound, CT, Kujambula, radioisotope jambulani kapena biopsy, mukhoza perekani mankhwalawa zolondola.

Complete magazi okwanira

Kawirikawiri sitepe yoyamba kuona chiwindi - kusanthula. Choyamba, madokotala nthawi zonse mankhwala wamba magazi mayeso. Izi ndi phunziro losavuta kuti ananena vuto linalake, koma zingakuthandizeni kudziwa kuti kuli kutupa thupi. Ndipo pamene chotero kuchepa kupatsidwa zinthu za m'mwazi wa kuwerenga, zikhoza kapadera chiwindi tizilombo chifukwa akusokoneza maselo chiwindi.

sayansi

Muyenera pobwezera magazi kuchokera mu mtsempha wa, imene chiwindi michere (aspartate aminotransferase ndi alanine aminotransferase) kudzayesedwa. zofufuza limapereka limasonyeza nembanemba kuonongeka khungu, amene akuloleza yeniyeni michere ma kuchokera chiwindi mu m'magazi. Norma michere imeneyi - zosakwana 41 U / L alt. Ngati kuposa, ili likhoza kukhala chizindikiro cha matenda a chiwindi wa zosiyanasiyana. kusanthula akutchedwa sayansi magazi. Chimathandiza kudziwa chiŵerengero cha alt, Ast, kudziwa zamchere phosphatase ndi bilirubin milingo kudziwa, amanena ndende ya Popanga madzi a gamma-glutamyl transferase (GGT). Malinga ndi kuwunika anatsimikiza ndi oposa 40 zizindikiro.

ultrasound

Yofunika gawo chiwindi Kupenda - ultrasound. Akupanga matenda zimathandiza kukhazikitsa kukula kwa chiwindi ndi ndulu. Njira limasonyeza kusintha akakufunsani monga hepatotoxicity, mitundu yonse ya kapamba, matenda enaake. Mwachitsanzo, pa gepatoze mu thupi kuonekera akagwidwa ndi zikanga maselo mafuta. Hepatocytes ndi mafuta ndi osalimba osiyana, kutanthauza kuti ultrasound chithunzi adzayang'ana gaudy. Ndipo ndi kukula kwa maselo matenda chiwindi adzakhala m'malo ndi minofu connective, ndi ultrasound zizindikiro za fibrosis.

Pankhani kusintha focal, chiwindi ndi ultrasound Kupenda amasonyeza mbali ndi osalimba kuchuluka, zimenezi hemangioma, adenoma, khansa metastatic, calcifications. njira imaperekanso molondola kudziwa utachepa m'madera echogenicity kuti zingasonyeze pamaso pa sarcoma, lymphoma, abscess kapena hematoma.

Atafufuza deta, dokotala sangathe kupanga matenda zolondola, koma imalongosola malangizo kwa kupenda chiwindi, kupatulapo njira anakana.

Wodwalayo, phunziro limeneli ndi sabweretsa chisoni kotheratu. Koma pamafunika maphunziro pang'ono, kuchotsa flatulence.

Computer scintigraphy ndi isotope chindodo

njira yamakono ya Kupenda chiwindi ndi monga radioisotope chindodo kapena matupi zogwirizana scintigraphy kompyuta chikukhudza chiwindi, ndulu ndi ducts. Yoyamba njira chimagwiritsidwa ntchito zochiritsira kuyambira 60s oyambirira ndi wataya ena zoyenerera. Yachiwiri njira zimakhalanso posachedwapa ndi kale zinatchuka mwa diagnosticians. Phunzirolo lili ndi muyeso wa kugwira ntchito kwa thupi, kudziwa kukula kwake, kudziwa zotupa ndi kukhazikitsa pamaso pa njira aakulu.

Scintigraphy imagwiridwa ntchito colloidal sulfure (kapena zina organic nkhani), zomwe zaikidwa ndi nyukiliya technetium 99. The isotope nyukiliya chikuyendetsedwera kuti wodwala m'nsinga kapena inhalation. Kenako, pogwiritsa ntchito makamera Popanga madzi a gamma kudziwa dzuwa, ndi mtima ndi kuwapereka kwa kompyuta. chithunzi abwera layering ndi mtundu. The kafukufuku amatenga kwa mphindi 30, kulola dokotala kuti aletse ntchito thupi ndi kupeza nkhani kudwala lapansi.

Isotopic chindodo ndi anagwiritsanso kwa mphindi 30-40, koma amafuna wodwalayo kumaliza kulephera kuyenda. Ooneka enieni chithunzi chimaonetsedwa pa pepala, osati pa zenera. Mtundu uwu shaded mizere.

njira onse a zofufuza zimagwiridwa pa chopanda kanthu m'mimba. maphunziro china chapadera chimene chikufunika.

CT ndi Kujambula

Pali awiri zambiri zamakono, koma yokwera mtengo njira ya mayeso chiwindi - kompyuta ndi kumveka maginito tomography. CT imagwiridwa ntchito X-ray. The chifukwa cha ndondomeko zakonzedwa zithunzi khumi (magawo yopingasa) kuti amalola kudziwa malo ndi kukula kwa zotupa. Kuwonjezera dokotala amatha kuonanso chikhalidwe cha vuto ndi kuona mmene anakhudzidwa zimakhala ozungulira. CT kutumikiridwa kwa amaganiziridwa obstructive matenda a chikasu ndiyo, cysts, zoopsa chiwindi, kukha magazi, hematomas, matenda enaake ndi zotupa.

Kujambula ndi mpake ankaona njira yolondola kwambiri a mosamala chiwindi ndi ziwalo zina. Maginito kumveka kulingalira detects zotupa molondola, ngakhale makulidwe ochepa. Pankhaniyi, pa ndondomeko, n'zotheka osati matenda a chotupa, komanso kukhazikitsa chikhalidwe, kudziwa metastases kuti aone patency ziwiya, kudziwa kusintha akakufunsani, kukhazikitsa digiri matenda enaake ndi zambiri. kafukufukuyu amachitika zida wapadera monga mphanga yotulukira ija. ndondomeko amatenga mphindi 30 kapena kuposa.

Matendawa akhoza anachita kapena popanda Mosiyana izo. Njira otetezedwa kwambiri odwala, koma amafuna ulamuliro wa zinthu zitsulo. Muyenera kuwombera zonse ndi zokongoletsa ndi zothandizira kumva, ndi kupeza mano otere. Kujambula pamaso pa mabala shrapnel, tatifupi chitsulo kapena zikhomo ndi pacemaker n'chotheka atakambirana ndi a dokotala.

biopsy

biopsy A amatipatsa kuthekera kudziŵa aetiology matendawa, mbali yake, ndi mlingo wa kuwonongeka limba. Yoganizira akutengedwa chidutswa cha minofu wamoyo, amene anatumiza histological (minofu), cytological (cell) kapena Kupenda bacteriological.

Pali zingapo mitundu ya biopsy chiwindi:

• puncture;
• chiyembekezo ndi ultrasound;
• transvenous;
• Laparoscopic.

Chiwindi chizolowezi kukonzekera biopsy ayamba mu masiku 7 lomaliza. Wodwala ayenera kusiya kumwa NSAIDs ndi kuteteza kuvomera anticoagulants. masiku 5 zakudya za amakonda zakudya kuonjezera flatulence. masiku 3 ayamba kulandira "Espumizan". Kayendesedwe anachita pa chopanda kanthu m'mimba.

Chinthu chachikulu ndicho kuti wodwalayo ayenera kumvetsetsa - likhoza ululu ndi zizindikiro zosasangalatsa kuzengereza kuitana kwa dokotala n'zosatheka. M'pofunika kuchita anayendera chiwindi. Kodi kuyamba ndi kusankha dokotala, monga iye adzafunika chithunzi chonse cha mkhalidwe wa limba. Kumbukirani, mavuto ambiri angathe kuchiritsidwa ndi mungachitepo yake.