Klatskin bundu: Zviratidzo neMarapirwo

Klatskin bundu - nekenza of proximal bile mutsinga dzinofamba nemukaka. Mumatenhere ichi mhando achiumbwa rokumusoro chikamu biliary turakiti, apo vari akakamurwa pakati chiropa lobes. Klatskin bundu ingangoumbwa vose ducts, kana mune umwe wavo, uyewo goho kubva chiropa. With chirwere bundu anogona kupararira midziyo chiropa ropa.

General ruzivo pamusoro chirwere

Pasinei chokwadi kuti mushonga ano awana zvizhinji kubatsira kuburikidza paunogona zvikavengwa nokukurumidza rokuongorora chirwere, kenza nerwatata zvave zvishoma kudzidza. Zvikurukuru, izvi chokuita chidimbu vnepechennogo pamusoro zvomudumbu hurongwa. Most kubatwa bundu Klatskin mapoka mamwe ngozi. First - vana pasi 5 makore vasingazivi vanotambura abnormalities ari nemudumbu. Wechipiri - vanhu vanenge vafamba chinhu-gore 60, tiri kusangana chinokosha biliary turakiti inoshanda nyonganyonga.

Nekenza angamuka nokuda kwezvikonzero zvakasiyana-siyana, asi mushonga ano inorondedzera zvinotevera: chepfu akabudiswa mugomba mumhepo yakawanda; Kunetseka uye dzimwe huta zvirwere; kushatiswa kwezvakatipoteredza; tsika dzakaipa. Mukuwedzera, chikonzero paumbwe Klatskin yamamota vanogona kushumira uye kudya kukodzera:

• kushandiswa zvinoberekeswa dzakachinjwa zvokudya zvinogadzirwa;
• doro;
• unoparadza yakawanda preservatives uye zvokudya yokuvirisa.

The chirwere anooneka somugumisiro zvinetso zvakaoma kuti kukonzera zvokurapa zvirwere. Ivo pakupedzisira kuumba mapundu akasiyana-siyana. Kana musingadi kuteerera zviratidzo uye kutanga chirwere, izvozvo mberi nokukurumidza uye anonunura chinokosha kusanzwa.

Kupatsanura biliary anomera

1. Benign: papillomas, lipomas, adenomas.
2. Nyanyisa: cholangiocellular kenza, nduru kenza dundira, kenza yacho bile ducts.
3. Klatskin bundu.

Kupatsanura chomunda localization

• Kukanganisa bile ducts pamwe hepatic neforogo.
• Mumaoko mumwe ducts.
• The kukundwa of ducts maviri.

tsungirirai kunyunyuta

chirwere ichi chirwere kuvarapi chaizvo kashoma. Kunobudirira kurapwa anoenderana zvinhu zvizhinji, asi rinonyatsooneka - nguva ino, mishonga murwere kwachiremba. Kana munhu akabvunza nyanzvi nguva, kurapwa kazhinji ndiyo kubudirira, uye kana hosha achimhanya, kubudirira zvaitika vangangoramba kuti kutarisirwa. Kazhinji, Klatskin bundu akaonekwa panguva kuongorora nokuti mamwe chakasimba kana chirwere nepfungwa yacho zvomudumbu turakiti.

Mune zvimwe zviitiko, varwere vanouya chiremba gastroenterologist rubatsiro pamwe dambudziko iri. Vakawanda kunyunyuta wevarwere munyaya iyi:

• kufundumwara parutivi rwake;
• mukuru novutera muviri uye nekuneta;
• Undefined kusingafadzi kunaka uye mouthfeel;
• zvakawanda zvive.

The chaizvo chete oncology kunokwanisa kuonekwa kwete nyore. Chokwadi chokuti Klatskin bundu - jaundice, sezvazvakanyorwa kunzi - ane zviratidzo zvakafanana zvirwere zvakasiyana-siyana, dzakadai chiropa parenchyma uye biliary turakiti.

zviratidzo

In Tichitevera zviratidzo, hosha ane anotevera zvinhu:

• chinokosha zvinoderedza uremu kwenguva pfupi nguva;
• weti rinokwidibira mumvuri raita chetsoka;
• nokuva chirwere kunoita sokuti itchy ganda, ganda mapundu;
• kukura bundu kunokonzera zvinorwadza nezvekufadza munzvimbo dzakasiyana-siyana mudumbu, izvo panguva kwapera zvokukura chirwere kuonekwe.

Etiological zvikonzero kuti kukura akaipa hunhu okudzidziswa extrahepatic bile ducts vari aisatombowanika. Asi sezvo predisposing kuti kukura chirwere chinogona kurapwa sezvinotevera:

• kazhinji vanhu vakuru 60 Klatskin bundu ichibudira pachiimbwa cholelithiasis;
• Zvinokosha zvikuru, uye kuvabereki kubatwa, kunyanya vanhu vakuru, asi haana kukwegura;
• pakati zvirwere wokutsauka anogona kunzi chinonzi sclerosing cholangitis ;
• Muduku zvakafanana chirwere tiwedzere anogona kushumira kuzvimba chiropa nemavhairasi B uye C.

Rinotaurwa kuvapo chirwere

nzira dzakawanda zvinogona kushandiswa kuziva mota Klatskin:

1. Transcutaneous transhepatic cholangiography - pamwe nzira iyi, vanachiremba Nyatsobatsirwa X-ray yacho bile mutsinga dzinofamba nemukaka. Nokuti nzira, murwere hakubvumidzwi kwemaawa 6 zvisati vakatanga kudya nokunwa pamwe chete nguva akapiwa sedatives. Procedure runotanga sumo kurudyi nzvimbo mudumbu ane munharaunda rufimbi, uye ipapo kuburikidza ganda mukati biliary turakiti vakatakura tsono nhete kuburikidza iyo dhayi iri jekiseni. Zvadaro, maekisirei, izvo zvinoratidza kuti pane chimwe hadzina kufambiswa zvakanaka mune biliary turakiti. The yose nzira kuongorora rakarurama tsono Hits vaiita kushandisa Ultrasound muchina. Usati uye pashure percutaneous transhepatic cholangiography varwere ushandiswe mishonga kuitira kudzivirira mukana wokutapukirwa.
2. Angiography. chimiro ichi nechirwere riri basa kana mutsinga dzinofamba nemukaka riri pedyo zvikuru ropa nhumbi chiropa. With angiography tsunga kana akarova inoyerera bundu midziyo. Zvinonzi akaurayiwa sezvinotevera: ari muhudyu tsinga inosuma nhete chubhu dhayi akasungwa unokudzwa, iyo zvino zvinoenda arteries kuburikidza nawo.
3. Percutaneous transhepatic cholangiography rinoshandiswawo zvinoitirwawo kenza, rinobatsirawo mu bundu mhingaidzo. It rinoitwa kuti zvakarurama kuona ya percolation pathological pezvakaitwa pashure percutaneous transhepatic cholangiography.
4. Magnetic resonance mushonga - imwe yenzira kuferefeta kuti bundu. Kunoitawo kuti kuona chaiyo nzvimbo uye visualizes nemamiriro midziyo chiropa.
5. Biopsy - nzira inonyatsobudirira. chete kunoita kuti zvakarurama kuona kuvapo bundu, ayo mamiriro uye yezvakaita tishu. For zvinangwa tagovera chikamu yatorwa ponji ichi, icho panguva kuongororwa nokuda microbiological kuongorora. nzira iyi rinoitwa pachiimbwa percutaneous transhepatic cholangiography.

pakurapa chirwere

Sezvambotaurwa, zvakaoma chaizvo kuziva bundu Klatskin. cholangitis treatment - ndiye Implementation ane pasuru zviyero kubvisa chirwere. Kana nguva hakutangi kurapwa, murwere kuti vafa mukati 4-6 mwedzi. Kenza - inonetsa kurapa chirwere ane zvakafanana zvatariswa uye bundu Klatskin. Kurapa chirwere ichi zvinowanzosanganisira kubviswa kwakakanganisa munyama. Muchiitiko ichi, inofanira kuva wakakwana, kuti, iye sei zvinyama yabviswa nomucheka wakachena. Izvi zvinoitwa kuitira kuti njodzi nzvimbo chakasara masero nyanyisa, dzimwe nguva kubviswa imwe akafukidza chiropa. Kana bundu Klatskin, izvo makadzivisa zvikuru kukura for hazvigoni kubviswa nokuda kukundwa kweropa ezvinhu muviri wose unoshandiswa nemwaranzi uye mishonga, asi kazhinji, zviri isashande.

kutsvaka poomosch apo

Pasinei nokuti chirwere muna mubvunzo yagara kuzivikanwa, uye pane nzira kurwisa nayo kuburikidza nokubviswa zvinyama, pachine ingaita yokusvika nenhau sei kurapa bundu Klatskin. Mabatirwo suppurative cholangitis kwazvo abudirira muIsraeri kushandiswa makiriniki kuti oncology kurapwa. Pane refu akanga zvose zvakafanira kurapa lesion iyi hunhu chiropa. Hazvina chakavanzika Israeri - nzvimbo wevasungwa akasimba nyanzvi mune zvokurapa, saka zvinonzwisisika sei pane zvinobudirira kurapwa uye bundu Klatskin. Reviews varwere kubatwa ikoko, anoratidza kuti basa Israeli oncology kiriniki iri kumusoro chechetere.