Bile tav txoj tav kev

Ciav tav rau ob leeg yog ib qho txhaws hauv cov hlab uas nqa kua tsib los ntawm lub siab mus rau lub lub plab thiab lub hnyuv.

Bile yog kua tawm los ntawm lub siab tawm. Nws muaj cov roj (cholesterol), kua tsib ntsev, thiab cov khoom pov tseg xws li bilirubin. Kua tsib ntsev pab koj lub cev zom (zom) yam rog. Bile hla tawm ntawm nplooj siab mus rau hauv cov kua tsib lub plab thiab khaws cia rau hauv lub zais plab. Tom qab noj mov, nws tawm hauv cov hnyuv me.

Thaum cov kua tsib ua paug, cov kua tsib ua rau lub siab, thiab daj ntseg (daj ntawm daim tawv nqaij) ua vim muaj ntau ntau ntawm bilirubin hauv cov ntshav.

Cov uas ua rau muaj cov kua tsib uas txhaws nrog:

• Cov hlwv ntawm cov kua tsib feem ntau
• Tshaj loj dua cov qog ntshav me me hauv porta hepatis
• Gallstones
• Kev mob ntawm cov bile ducts
• Qhov nqaim ntawm lub bile ducts los ntawm ntus
• Kev raug mob los ntawm kev phais mob gallbladder
• Cov qog ntawm cov kua tsib lub plab los yog quav tawv
• Cov qog uas tau kis mus rau txoj kev biliary
• Cov nplooj siab thiab cov kua tsib lub thoob (flukes)

Qhov pheej hmoo txaus ntshai muaj xws li:

• Keeb kwm mob kab mob gallstones, mob qaij leeg, lossis mob qog nqaij hlav hlav
• Kev raug mob rau thaj tsam mob plab
• Tsis ntev los no biliary phais
• Tsis ntev los no biliary mob cancer (xws li mob bile leeg mob cancer)

Qhov thaiv yuav tuaj yeem tshwm sim los ntawm kis kab mob. Qhov no feem ntau raug rau cov neeg tsis muaj zog tiv thaiv kab mob.

Cov tsos mob tuaj yeem suav nrog:

• Mob plab yog rau sab saud sab xis
• Tsaus zis
• Ua npaws
• Khaus
• Jaundice (daj tawv daj)
• Xeev siab thiab ntuav
• Tawv daj ua qhov quav

Koj tus kws kho mob yuav kuaj xyuas koj thiab hnov ​​koj lub plab.

Cov kev kuaj ntshav hauv qab no tuaj yeem yog vim muaj txhaws:

• Nce qib bilirubin
• Ua kom cov alkaline phosphatase ntau ntau
• Ua rau cov ntshav nce siab

Cov kev ntsuam xyuas txuas hauv qab no yuav raug siv los tshawb xyuas ib cov kua dej hauv cov roj:

• Mob plab hauv ultrasound
• Mob plab hauv TV
• Endoscopic retrograde cholangiopancreatography (ERCP)
• Kev Hloov Pauv Nruab Nrab cholangiogram (PTCA)
• Sib nqus resonance cholangiopancreatography (MRCP)
• Endoscopic ultrasound (EUS)

Cov nplais tawm ib qho uas thaiv tau kuj tuaj yeem hloov cov kev tshwm sim hauv qab no:

• Amylase kuaj ntshav
• Gallbladder radionuclide scan
• Kev kuaj ntshav lipase
• Lub sijhawm Prothrombin (PT)
• Zis bilirubin

Lub hom phiaj ntawm kev kho mob yog los daws txoj kev txhaws. Lub pob zeb yuav raug tshem tawm uas siv lub endoscope thaum lub ERCP.

Qee qhov xwm txheej, phais yuav tsum tau hla ntawm qhov thaiv. Lub plab zom yuav feem ntau yuav tsum tau muab tshem tawm pov tseg yog tias txhaws los ntawm tus mob gallstones. Koj tus kws khomob yuav sau ntawv muab tshuaj rau noj yog tias xav tias muaj tus kabmob.

Yog tias qhov blockage los ntawm mob qog noj ntshav, lub khob yuav tsum tau nthuav dav. Cov txheej txheem no hu ua endoscopic lossis percutaneous (los ntawm daim tawv nqaij ib sab ntawm daim siab) dilation. Lub raj yuav xav tau tso rau kom tso kua paug.

Yog hais tias qhov blockage tsis raug, nws tuaj yeem ua rau muaj kev phom sij txog rau lub neej thiab muaj kev pheej hmoo ntawm bilirubin.

Yog tias qhov txhaws ntev ntev, mob lub siab ua haujlwm tuaj yeem ua tau. Yuav luag txhua qhov kev thaiv nrog kev phais lossis phais. Cov lus qhia ua los ntawm mob cancer feem ntau muaj qhov tshwm sim tsis zoo.

Yog tsis kho, qhov mob tshwm sim tuaj yeem suav nrog mob voos, mob sepsis, thiab mob siab, xws li mob biliary.

Hu rau koj tus kws khomob yog koj:

• Pom qhov txawv txav ntawm koj cov zis thiab tso quav
• Tsim kev daj ntseg
• Raug mob plab uas tsis ploj mus los yog rov ua dua

Ceev faj txog cov kev pheej hmoo uas koj muaj, kom koj tuaj yeem nrhiav kev kho mob sai sai thiab kho yog tias tus kab mob bile duct sib cuam tshuam. Qhov blockage nws tus kheej yuav tsis tuaj yeem tiv thaiv.

Kev thaiv ob tog

• Lub plab zom mov
• Cov qog endocrine
• Bile taug txoj kev
• Kev thaiv ob tog - series

Cov Fogel EL, Sherman S. Cov kab mob ntawm lub gallbladder thiab kua tsib lub raj. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: cha 146.

Lidofsky SD. Qhov muag daj. Hauv: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger thiab Fordtran's Gastrointestinal thiab Kab Mob SiabCov. 11th ed. Philadelphia, PA: Elsevier; 2021: chap 21.