Zizindikiro za hepatomegaly ya kuphatikiza kusintha kwa chiwindi ndi kapamba

Chiwindi ndi kapamba (kapamba) zimagwira ntchito kwambiri pamizimba yam'mimba, yokhala ndi mndandanda wonse wa ntchito zamthupi.

Chifukwa cha kuchuluka kwake kwa magwiridwe antchito, zosunga zamtundu zimagwirizana ndi njira zosiyanasiyana zamatenda: kutupa, necrosis, autolysis, deformation. Mwa zina zomwe siziri zotupa, koma zofala kwambiri, hepatomegaly ndikuyambitsa kusintha kwa chiwindi ndi kapamba zimawonekera.

Kuzindikira kofananako kumamvedwa ndi odwala pambuyo pa kuyezetsa magazi ndi chiberekero cham'mimba, koma sizitanthauza kuti nthawi zonse timapeza matenda.

Zomwe zimayambitsa gulu lino la zamatsenga ndizambiri. Kuyambira pa kukanika kwa wamba bile duct ndikumaliza ndikuphwanya shuga.

Anatomy ndi physiology ya chiwindi ndi kapamba

Chiwindi ndi gawo lalikulu, lopanda dzanja, lochita masewera olimbitsa thupi lomwe limagwira ntchito zingapo. Ili pamimba yolondola. Ili moyandikana ndi khoma lakumunsi kwa diaphragm, 12th matumbo, kapamba, m'mimba ndi impso yakumanja.

Chiwalocho chili ndi ma loboti akumanja ndi kumanzere olumikizidwa ndi ligament. Chiwindi chimakhala ndi ma cell ambiri ochita masewera komanso magazi.

Amadziwika ndi zamankhwala, zofunikira za chiwalo ndi:

Wopusa. Mu hepatocytes (maselo olimba a chiwindi), bile amapangidwa, omwe amathandizira kugaya mafuta.
Mapuloteni. Ndi anthu ochepa omwe amadziwa, koma mitundu yonse ya mapuloteni amapangidwa m'chiwindi, popanda thupi la munthu sakanakhala ndi tsiku. Izi zimaphatikizapo albumin, ma globulin ndi mapuloteni omwe akukhudzidwa ndi kuphatikizika kwa magazi ndi dongosolo la anticoagulation.
Ntchito yosefera imagwira ntchito yoyeretsa magazi kuchokera kuzakumwa zonyansa zama cell a thupi.

Ndikusintha kwa pathological kapangidwe ka chiwindi, kuphwanya kwa ntchito izi kumachitika, komwe kumayambitsa mikhalidwe yayikulu ya thupi.

Mphepoyi ilinso chigawo chachikulu, chosatupa, cha parenchymal chomwe chili m'mimba.

Minofu yake imapangidwa ndi magawo omwe amagwira ntchito - ma pancreatocytes. Ambiri mwa kapamba amatenga malo okhalapo. Ndiye kuti, mahomoni omwe amayambitsa kuwonongeka kwa mapuloteni ndi zakudya zimapangidwa mkati mwake. Ndi gawo la procrine lomwe "pancreatic juice" limapangidwa.

Gawo lakumapeto kwa kapamba limayimiridwa ndi zisumbu za Langerhans. Amapanga mahomoni angapo omwe amayambitsa kagayidwe kazachilengedwe ka magazi. Choyamba, ndi insulin ndi glucagon, yomwe imayendetsa kagayidwe ka glucose.

Ndi kusintha kwa pathological mu chiwalo, kugaya chakudya ndi endocrine matenda kumachitika.

Etiology ya matenda

Popeza chiwindi ndi kapamba zimagwira ntchito zosiyanasiyana, zinthu zambiri zimakhala ngati zomwe zimayambitsa matenda.

Chiwindi chokulirapo ndi kapamba ndizodziwikiratu zomwe zimawonetsa kukhudzidwa kwa zinthu zakunja ndi zina zoyipa pakugwira ntchito kwa ziwalo.

Zomwe zimayambitsa matenda a pathological organ:

Mphamvu ya zakumwa zochokera kunja kapena zomwe zimapangidwa mkati, zinthu monga: zakumwa zoledzeretsa, kusuta, kubaya mankhwala osokoneza bongo, mankhwala osokoneza bongo omwe ali ndi hepatotoxic athari, chithandizo choyipa cha matenda osokoneza bongo komanso matenda ena a metabolic.
matenda opatsirana omwe gawo la parenchyma limakhudzidwa mwachindunji ndi chizindikiro cha hepatitis ya viral, kuphatikiza apo, hepatomegaly imatsogolera ku virusi mononucleosis yoyambitsidwa ndi kachilombo ka Epstein-Barr kapena cytomegalovirus, malungo, leptospirosis, pseudotuberculosis ndi ena,
Matenda a metabolic: systemic amyloidosis, matenda a Wilson-Konovalov, matenda a Gaucher, Cartagener syndrome,
mtima ndi mtima matenda - pachimake koronare, kuwonjezeka kupsinjika kwa m'mapapo, aneurysms, vasculitis, mitsempha ya varicose,
matenda a oncological ndi hematological - khansa ya pachimake komanso yovuta, lymphogranulomatosis, lymphomas, hepatocarcinoma, khansa ya kapamba, khansa ya impso,
Matenda ena - chiwindi lipomatosis, kunenepa kwambiri kwa chiwindi, amyloid dystrophy, malo enaake a metrase, metastases ya zotupa zina mu chiwindi, kapamba.

Kwa ma pathologies awa, hepatosplenomegaly ndiwodziwika kwambiri, ndiko kuti, kuwonjezera osati pachiwindi, komanso ndulu.

Zizindikiro zamatendawa

Chizindikiro cha hepatomegaly ndikuwonetsa kusintha ndichachulukanso.

Ndikosavuta kuchita ma diagnostics osiyanasiyana ngakhale kwa dokotala wodziwa zambiri.

Nthawi zambiri, odwala omwe amabwera kwa dokotala ndi matenda amtunduwu amapereka madandaulo osakhala achindunji.

Madandaulo awa ndi:

Kufalikira. Nthawi zambiri, chifukwa cha kukula kwa chiwindi, khoma lam'mimba limatuluka. Izi zimapereka chithunzithunzi chamimba yayikulu, yotupa. Koma adotolo, mothandizidwa ndi palpation ndi percussion, amatha kudziwa kukula kwachigawo china cha pamrenchymal cha kukula kwam'mimba.
Zovuta kapena kusasangalala kumanja, pansi pa nthiti. Zomverera zoterezi zimagwirizanitsidwa ndi kukulitsa kwa kaphatikizidwe kazinthu komwe kali ndi mathero amitsempha, kuwonjezera, zoterezi zimatha kuchitika chifukwa cha kukakamira kwa ndulu ya ndulu.
Ululu, kachiwiri, ndi chifukwa cha kutambasulira kwamphamvu kwa kapisozi kachulukidwe kam'mimba. Ululu ndi chinthu chosasinthika, chomwe chimawonetsa kunyalanyaza kwa njirayi.
Kuphwanya mobwerezabwereza ndi mawonekedwe aulesi ndi chiwonetsero cha dyspeptic syndrome, chomwe chimayamba chifukwa cha kuchepa kwa enzyme.
Mseru ndi kusanza zitha kukhala zapakati kapena zotumphukira. Mtundu wapakati ukhoza kukhala chiwonetsero cha zotsatira za michere ya chiwindi ndi pigment ku ubongo. Kusanza kwamtunduwu ndi mseru kumadziwika ndi liwiro lopanda malire. Kusiyanasiyana kwa zotumphukira kumalumikizidwa ndi matenda am'mimba, komwe nthawi zambiri kumakhala kutsutsana pang'ono ndi kusanza.
Kukhazikika pansi. Kusintha kwamatumbo kwa wodwala ndi hepatomegaly kumatha kukhala kosiyanasiyana. Kuphatikizapo kutsegula m'mimba, kudzimbidwa, kusinthasintha, kusasinthika.
Kupuma kwapadera kwa hepatic kumalumikizidwa ndi kuperewera kwa poyizoni.

Kuphatikiza apo, zomwe wodwalayo amakhala nazo zimasokonezeka. Odwala amakhudzidwa ndi kugona, kumangoganiza kugwira ntchito mopitirira muyeso, kukumbukira pang'ono komanso chidwi.

Ma syndromes apadera a hepatomegaly

Pali zizindikiro zomwe zimafotokoza kwambiri matenda a chiwindi.

Thupi loyimbira khungu ndi zotupa za mucous. Mwanjira ina, mthunzi wovuta kwambiri. Chizindikiro ichi chimalumikizidwa ndi piggubin yayikulu m'magazi. Aepuse icteric hue angatanthauze impephalopathy yomwe ikubwera.

Cholestasis syndrome, yomwe imawonetsedwa mwa kuwongolera kwambiri pakhungu popanda kuwoneka mwatsatanetsatane wa zotupa. Cider wa zakumwa zoledzeretsa pankhaniyi akufotokozedwa ndi malungo, kusintha kwa magawo a labotale, kuphwanya wamba.

Hemorrhagic syndrome imachitika pamene kusintha kwa kapangidwe ka mapuloteni amomwe amapezeka. Metabolic Disorder Syndrome. Cytolysis syndrome, yomwe imavuta kudziwa kuchipatala, koma imapezeka bwino pogwiritsa ntchito njira zofufuzira zasayansi. Mesenchymal kutupa syndrome kumakhalanso kovuta kukhazikitsa popanda kuyesa kwa labotale.

Ma syndromes onsewa ayenera kutsimikiziridwa labotale komanso yothandiza.

Njira zodziwitsa

Matendawa amatha kudwala mwa chaka chimodzi, koma ndikukaikira pang'ono, mndandanda wathunthu wamaphunziro uyenera kuchitika.

Pazidziwitso zoyenera, njira zingapo zoyeserera ndi zasayansi zimagwiritsidwa ntchito.

Mukangolandira zotsatira zonse za kafukufukuyu, mutha kudziwa bwinobwino.

Mayeso othandizira ndi a labotale ndizovomerezeka:

Ultrasound ndi njira yofufuzira yofufuzira, ndi thandizo lake mutha kuyang'ana kapangidwe, kukula kwa chiwalo, kuzindikira ma neoplasms, ndikuwunikanso kayendedwe ka magazi,
Kuyerekezera ndi maginito komanso kupatsirana kwa maginito kumathandizira kuzindikira koyenera komanso kutsimikizika kwa matendawa, kumakupatsani mwayi wodziwika wa metastase pang'ono panjira ya oncological,
ma radiograph am'mimba komanso chifuwa chamkati, mtundu uwu wazindikirika ndi muyezo chifukwa chidziwitso chake komanso kupezeka kwake,
kuyezetsa magazi konse kumakupatsani chidwi chokhudzana ndi kusintha kwamomwe magazi amapangidwira, makamaka, muyenera kuwerengera kuchuluka kwa maselo ambiri.
kusanthula kwa magazi a biochemical ndiko muyezo wa "golide" wofunsa matenda a chiwindi ndi kapamba, ndi iyo mutha kuyesa kuchuluka kwa bilirubin, alkaline phosphatase, mapuloteni athunthu, michere ya chiwindi (ALT, AST), urea, glucose gawo kuchokera kwina,
kuyesa kwachilengedwe kwa ma virus a hepatitis ndi ma virus ena a hepatotropic,
kuyesa kwa fibrosis ndi ntchito ya necrotic process,
coagulogram.

Kuphatikiza apo, zinthu zimatengedwera ngati chiwopsezo cha chiwindi - chothandiza kwambiri, koma njira zowonekera zodziwira matenda. Pansi pa kuwongolera kwa ultrasound, gawo la chiwalo chamoyo limatengedwa kuchokera kwa wodwala ndikutumizidwa ku labotale ya pathology kuti ikayesedwe.

Matenda a kapamba ndi Njira Zochizira

Popeza chiwindi ndi kapamba zimaphatikizidwa muntchito yawo, kupangika kwa gawo limodzi kungayambitse matenda a chiwalo chachiwiri.

Nthawi zambiri, kupweteka kwamphamvu kwa pancreatitis kumabweretsa hepatomegaly.

Izi zimachitika chifukwa cha ntchito yapamwamba kwambiri ya mtima kapena kukula kwa mitundu yayikulu ya matenda a shuga a mitundu yonse iwiri.

Njira zopatsirana.
Matenda a m'matumbo, kuphatikizapo cystic fibrosis.
Matenda osachiritsika

Kuphatikiza apo, minofu yamafuta imayamba. Kuwongolera kwa odwala omwe ali ndi hepatomegaly ndikusintha kwasintha ndi njira yovuta ndipo imafunikira chidziwitso chachipatala cholondola. Malangizo a algorithm zimatengera ukadaulo wa njirayi. Chithandizo chiyenera kuthandizidwa mwanjira inayake komanso mwamakhalidwe.

Choyamba, chakudya chimakhazikitsidwa hepatomegaly cha chiwindi ndi kapamba. Imaperekanso mtundu wapadera wa zakudya za odwala omwe sangathe kupangitsa kuti zinthu ziwonongeke kwambiri. Gome lazakudya limayikidwa ndi dokotala wopezekapo. Dotoloyo amaganizira mawonekedwe a wodwalayo, ndikuwona kuti ndi zinthu ziti zomwe zimapindulitsa chiwindi ndi kapamba makamaka.

Kutengera ukadaulo wa njirayi, zochitika zapadera zimalembedwa:

ndi viral pathology, antiviral therapy imayikidwa ndi mankhwala amakono,
pankhani ya lithiasis (miyala) ya ndulu, kuchiritsa mosasamala kapena kuchotsedwa kumayambiranso,
ngati genesis ya matendawa imalumikizana ndi matenda amtima wam'magazi, ntchito zake zimakonzedwa, ndiye kuti nkhani yothandizanso yathandizanso.

Ndiye kuti, nthawi zonse amapereka chidwi ku genesis ya matendawa. Ndikofunika kwambiri kuzindikira mu nthawi ndikuyamba chithandizo chamanthawi, izi zimawonjezera mwayi wopulumuka ndikuwonjezera mwayi wokhala ndi moyo wabwino.

Kodi kusintha kosiyanasiyana kwa kapamba amene akuwonetsedwa mu kanema pankhaniyi ndi chiyani.

Ndi matenda omwe angasonyeze

Ndi hepatomegaly amadziwika kuwonjezeka kwa chiwindi. Kusintha kovuta kumatchedwa chodabwitsa pamene zimakhala za chiwalo chonse zimakhudzidwa kwathunthu.

Kusintha kwa Hepatomegaly ndi kupukusa kwa chiwindi kumadziwika ndi matenda ndi mavuto otsatirawa:

Kudzikundikira kwa poizoni wa zinthu m'thupi la chiwindi ndi kapamba. Cholinga chake ndi kusuta fodya, kugwiritsa ntchito mankhwala osokoneza bongo kwa nthawi yayitali. Ngati matenda atapezeka koyambirira, zosinthazo zimasinthidwa ndipo ndizakanthawi.
Zomwe zimayambitsa matenda a chiwindi ndi njira yotupa yomwe imakhudza chiwalo chokha, matenda a kapamba ndi ndulu za bile. Izi zimaphatikizira cirrhosis, cholangitis, kapamba, cystic fibrosis, matenda a shuga, cholecystitis.
Nthawi zambiri kupezeka kwa majeremusi omwe amadzaza chiwalo parenchyma kumabweretsa hepatomegaly. Amalowa m'matumbo a chiwindi kuchokera m'matumbo kudzera m'magazi.
Kukula kwa chiwindi kumawonjezereka ngati pali matenda a mtima omwe amachititsa kuti mitsempha ya hepatic, pericarditis, khansa yamitsempha yam'mimba, hemangiomas.
Mavuto a autoimmune, monga lupus erythematosus.
Matenda opatsirana m'matumbo, kachilombo ka HIV.
Chotupa choopsa cha chiwalo chilichonse chomwe metastases imafalikira ku chiwindi, kapena khansa ya chiwindi.
Zosintha zokhudzana ndi zaka kwa odwala azaka zopitilira 50.
Kukula kwa mafuta a chiwindi ndi steatohepatosis.

Mwa ana aang'ono, hepatomegaly imachitika chifukwa cha zofunikira zathupi. Kukula kwa hepatatic kumalumikizidwa ndi hematopoiesis - imakulitsidwa pamene mwana akukula. Nthawi zambiri, pofika zaka 7, kukula kwa ziwalozo kumakhala kwabwinobwino.

Zizindikiro zokhala ndi nkhawa

Chizindikiro cha kusintha kwakulu mu chiwindi parenchyma chimatengedwa ngati zizindikilo zomwe sizifunikira kufufuza kwazinthu zam'mimba ndipo zapezeka kale pakuwunika koyamba kwa wodwalayo.

Odwala amadandaula ndi izi:

Kumverera kolemera m'dera la hypochondrium yoyenera, epigastrium.
Mukadina pamalopo, kupweteka kumawonekera, komwe kumakulira mukasintha mawonekedwe.
Beling, kuchulukira kwanyumba ndi kakhalidwe.
Khungu limakhala ngati kuwala kwa chikasu.
Pali mseru.

Munthu amatopa mosavuta, kusokonekera. Nthawi zina ndi hepatomegaly, kutopa kwam'maganizo komanso kwakuthupi kumawonedwa.

Matenda enieni, chifukwa cha hepatomegaly, amatha kuweruzidwa ndi zizindikiritso zina:

Kutupa kwa chiwindi minofu (hepatitis) nthawi zambiri kumayendetsedwa ndi kuyabwa, khalidwe la jaundice wolepheretsa.
Panthawi ya chiwindi, kupweteka kwa chiwindi kumawonjezeka ndi palpation.
Ndi cirrhosis, kupweteka kosalekeza mu hypochondrium yoyenera kumachitika mwa kusintha chiwindi parenchyma ndi minye yolumikizana. Zikatero, khungu limakhala lonyowa. Nthawi zambiri pamakhala magazi okhalitsa (pamphuno, m'mimba).
Ngati chifukwa cha hepatomegaly ndimatenda amitsempha, kukula kwa impso, ndulu ndi kapamba kumachulukana nthawi yomweyo ndi chiwindi.
Hemochromatosis (kuchuluka kwa chitsulo mthupi) kumayendera limodzi ndi hemoptysis.

Komabe, pakuwonetsa kotsiriza mawonetsedwe akunja sikokwanira. Kuti mumvetse bwino zomwe zimayambitsa hepatomegaly, kuyezetsa kumachitika pogwiritsa ntchito njira zamakono.

Zowonjezera diagnostics

Zizindikiro za hepatomegaly ndikusintha kwa chiwindi zimatsimikiziridwa ndi maphunziro awa:

Kuyesedwa kwa ziwalo zam'mimba pogwiritsa ntchito ultrasound. Ultrasound imawunika kapangidwe ka chiwalo. Njirayi ndiyofunikanso kudziwa kukula kwa ndulu. Ndi pathology, kufalikira kwa madera omwe akhudzidwa kumawonekera.
Kuyesa kwa mkodzo ndi magazi kuti muone mawonekedwe amomwe amachokera zamankhwala amadzimadzi.

Kuti muwonetsetse matenda, makompyuta kapena maginito a kutsitsa, tikulimbikitsidwa. Ngati oncology ikukayikiridwa, biopsy imachitika ndikuphunzira kwina kwa gawo mu labotale.

Mankhwala a hepatomegaly, njira yophatikizika imachitidwa.Pulogalamu yamachiritso ili ndi njira zomwe zimathandizira kuthetsa matenda omwe adadziwika, kubwezeretsa hepatocytes, kusintha chiwindi, ndikuchepetsa zovuta pa kapamba.

Hepatomegaly yolimbitsa thupi yomwe imasintha pakhungu limadutsa yokha, ngati mumasintha zakudya. Musachokere pamenyu:

zakudya zamafuta
chakudya chofulumira komanso zakudya zosavuta,
ma pickles, marinade ndi nyama zotsekemera,
zakumwa zoledzeretsa kapena zopatsa mphamvu,
skim mkaka ndi zotumphukira zake,
nyama yabwino kapena msuzi wa nsomba,
zotsekemera zonona, chokoleti, kuphika,
dzira
adyo, sorelo ndi anyezi,
tiyi wamphamvu ndi khofi wachilengedwe,
nyemba.

Kudya ndi hepatomegaly kumaphatikizapo kudya chakudya malinga ndi mfundo zaziphuphu 5-6 patsiku. Nthawi yomweyo, kukula kwa gawo hakuyenera kupitirira 200. Ngati zikondamoyo zimaphatikizidwa ndi zotupa, ndibwino kudya mbale zotentha.

Mankhwala

Kukula kwa chiwindi kumafunikira chithandizo cha mankhwala. Ndikosatheka kupereka mndandanda wa mankhwala ogwira ntchito osadziwa chomwe chimayambitsa matenda. Koma kukonza momwe chiwindi chilili, kuchuluka kwa ma enzymes okumba, omwe amapanga kuchepa kwa chilengedwe, komanso hepatoprotectors, akuwonetsedwa.

Essentiale, Galsten, Liv 52, Ornithine, Ursodeoxycholic acid amadziwika malinga ndi momwe wodwalayo alili komanso chifukwa cha hepatomegaly.

Zithandizo za anthu

Mankhwala ochizira hepatomegaly, maphikidwe a wowerengeka amagwiritsidwanso ntchito:

Sage ndi mamawort, dandelion, chicory, ndi mizu ya peony ndizosakanikirana zofanana. Pezani supuni zitatu, ndikuthira mumbale ndikuthira madzi 500 ml. Tenthetsani kwa chithupsa ndikuwotha kutentha pang'ono kwa mphindi 30. Imani kwa theka la ora ndikutenga magawo ang'onoang'ono tsiku lonse.
Tsiku lililonse amadya theka la kilogalamu ya dzungu losenda bwino. Ngati kukoma kwa masamba sikosangalatsa, sinthani ndi madzi atsopano.
M'mawa pamimba yopanda kanthu, sitiroberi kapena msuzi wa kiranberi ndizothandiza.
Tsiku lililonse amamwa chikho cha 2/2 kabichi brine ndi msuzi wachilengedwe kuchokera kwa tomato wamba.
Sungani 50 g uchi mu 500 ml ya madzi apulosi. Tengani kasanu patsiku 1 chikho chimodzi.

Ndi hepatomegaly, wowerengeka azitsamba amasankhidwa mothandizidwa ndi dokotala, poganizira zomwe zimayambitsa matendawa, komanso momwe munthu angachitire ndi zigawo zina zamankhwala kunyumba.

Mavuto ndi zotsatirapo zake

Kunyalanyaza zizindikiritso ndi kusapezeka kwa mankhwalawa kwa hepatomegaly kumabweretsa zochitika zingapo zowopsa:

Kulephera kwa chiwindi. Hepatocytes ndiowonongeka, zomwe zimapangitsa kuti ziwalozo zizigwira bwino ntchito. Kupita patsogolo kwa kulephera ndi chifukwa cha imfa.
Kupuma. Chifukwa cha kuchepa kwa chiwindi, kupanikizika kwa mitsempha ya portal kumachuluka, komwe kumayambitsa magazi mkati.
Kufalikira kwa matenda kumadera ena. Ngati matenda amakwiya chifukwa cha matenda opatsirana, pathogen yokhala ndi magazi ingalowe ziwalo zina.

Pofuna kupewa zovuta komanso kubweretsa kukula kwa chiwindi kukhala zabwinobwino, ndikofunikira kuchiza matenda omwe ali ndi vuto munthawi yake. Chifukwa chake, pazizindikiro zoyambirira za hepatomegaly, muyenera kukakumana ndi mayeso oyenera.

Zizindikiro Zabwino

Chizindikiro cha kuphatikiza chimasintha kwambiri zimatengera chomwe chimayambitsa chisokonezo.

Pa gawo loyambirira (ndi hepatomegaly), kuwonjezeka kwa ziwalo ndi asymptomatic. Ndi kukula kutchulidwa, wodwalayo amatha kumva.

Kuteteza khungu,
Ululu wamkati
Kumverera kosasangalatsa mbali yoyenera,
Kutupa
Kuchepetsa mseru
Kutentha kwa mtima

Kuzindikira kuwonetsa kwa kusintha kwa mayesedwe ndikofunikira kwambiri. Nthawi zambiri kusowa kwa matendawa kumayambitsa kuchepa kwa njira zachipatala komanso zovuta za matendawa.

Ndi matenda omwe angasonyeze

Malinga ndi machitidwe azachipatala m'chiwindi, kusintha kwakupezeka kumapezeka mu matenda angapo:

Kulephera kwa mtima kosatha:
Cirrhosis:
Kuledzera kwakukulu:
Hepatitis:
Glycogenosis:
Hemochromatosis.

Mu kapamba, kusintha kwakupezeka kumapezeka ndi matenda:

Lipomatosis:
Matenda apakhungu kapena pachimake:
Fibrosis
Matenda a shuga.

Chithandizo cha hepatomegaly ndichokhazikitsidwa pochiza matendawa, omwe anali omwe amayambitsa kusintha kwa kaphatikizidwe ndi kapamba ndi chiwindi.

Pochiza matenda a chiwindi, mankhwala otsatirawa amagwiritsidwa ntchito nthawi zambiri:

Hepatoprotectors - amatanthauza kuchepetsa kuthamanga kwamafuta ndikubwezeretsa hepatocytes owonongeka a chiwindi,
Ma diuretics - okodzetsa amene angathandize kuchepetsa madzi am'magazi ndi ziwalo zathupi:

Essentiale amakupatsani mwayi ntchito ya nembanemba, hepatocytes wa intracellular kupuma, kutulutsa. Imwani 2 kapisozi katatu pa tsiku ndi chakudya.

Heptral - imapangitsa detoxization, kusinthika kwa hepatocytes, ili ndi antioxidant katundu. Mlingo wake patsiku ndi 800 - 1600 mg.

Gepa Merz chimalola kugwiritsidwa ntchito bwino kwambiri. 1 phukusi la mankhwalawa limasungunuka mu kapu yamadzimadzi, imwani pakudya pakapita katatu patsiku.

Kuchepetsa katundu pa kapamba, zakudya zamagetsi zamagetsi zimaloledwa.

Nthawi zina, kutengera matenda oyamba - zomwe zimayambitsa masinthidwe osokoneza bongo, mankhwalawa amagwiritsidwa ntchito:

Antiemetic,
Mankhwala,
Ophera
Maantibayotiki.

Chithandizo cha opaleshoni chimalembedwa pokhapokha ngati mphamvu ya zochizira kapena milandu yayikulu kwambiri:

Matenda oopsa a portal,
Cysts
Tumors
Ma metastases

Ntchito zovuta kwambiri ndizophatikizira kupatsirana kwa chiwindi.

Hepatomegaly mwa ana

Kusintha kovuta mu chiwindi kapena kapamba mwa ana ndizosowa kwambiri.

Kusintha komwe kwadziwika ndikukulitsa chiwindi kumalumikizidwa ndikuti mu ana gululi limagwira ntchito ya hematopoiesis. Izi sizikusowa chithandizo ndipo zimatha ndi zaka, monga lamulo, ndi zaka 7.

Njira zosafunikira zimapezekanso nthawi zingapo:

Kodi hepatomegaly ndi chiyani, ndikuwonetsa kusintha kwa chiwindi ndi kapamba?

Mwa munthu wathanzi, ziwalo zamkati zimakhala ndi mtundu wopangika, ma cell osasinthika, mulibe zinthu zopweteka. Kukula ndi mawonekedwe ali mkati moyenera. Mothandizidwa ndi zinthu zowononga, kuphwanya malamulo kumachitika:

hepatomegaly - kuchuluka kwa chiwindi,
splenomegaly - kuchuluka kukula kwa ndulu,
hepatosplenomegaly - kuchulukana munthawi yomweyo kwa ndulu ndi chiwindi,
Amayambitsa matenda a kapamba ndi chiwindi - kuphwanya kapangidwe ka ziwalo parenchyma.

Hepatosplenomegaly imadziwika ndi maphunziro othandizira. Chimodzi mwazojambula ndi makina a ultrasound. Njira imawunika kukula, mawonekedwe ndi kapangidwe ka ziwalo.

Zomwe zimayambitsa kusintha kwamtunduwu

Zomwe zimapangitsa hepatosplenomegaly kusintha kwa kapamba ndi chiwindi:

kusiya mowa
Kugwiritsa ntchito mankhwala kwa nthawi yayitali popanda kupangika ndi katswiri (mankhwala olakwika, mlingo),
zolakwika za zakudya zomwe zimayambitsidwa ndi kuchepa kwa zakudya zofunika, mavitamini, kufufuza zinthu, mchere,
kudya kwambiri, kusala kudya,
kudya kwambiri, kunenepa kwambiri,
matenda a mtima dongosolo, momwe magazi amayenda mkati ndi ziwalo zamkati zimasokonekera (hypoxia imapangidwa - kufa ndi mpweya wa okosijeni),
mapangidwe a minofu ya adipose mkati mwa parenchyma, yomwe imachepetsa ntchito yake,
matenda otupa a chiwindi cha matenda opatsirana kapena kachilombo,
kuchepa kwa magazi mu parenchyma yoyambitsidwa ndi kupindika kwa chotengera chake, mapangidwe a magazi, kuphatikiza kwa matenda oopsa a portal,
Matenda obadwa nawo, chifukwa chomwe chotupa chamimba chiwonongeka.
kufalikira kwa metastases kuchokera ku ma neoplasms oyipa mu parenchyma.

Ngati ntchito, kapangidwe, kukula kwa kapamba kumalephera, adokotala akuwonetsa zifukwa zotsatirazi:

Kutalika kwa nthawi yayitali
kuchepa kwa ntchito ukalamba,
zovuta za matenda ashuga, zomwe zimayambitsa mafuta akusowa kwa kapamba,
kusokonezeka kwatsopano kwa ziwalo zomwe zimayambitsidwa chifukwa cha cholowa kapena matenda omwe amafala kuchokera kwa mayi kupita kwa mwana wosabadwayo.

Matenda owopsa amasokoneza kapangidwe ka ziwalo. Izi zimachepetsa ntchito, zovuta pang'onopang'ono zimayamba.

Kodi matendawa angadziwike bwanji?

Pambuyo polumikizana ndi akatswiri, kuzindikira kumayambira. Muli magawo angapo.

Mbiri kutenga.
Izi ndi zomwe zimapezeka m'mawu a wodwala kapena abale ake apamtima. Kutengera ndi zomwe zalandiridwa, kuyesedwa kumayesedwa.
Kuyendera
Wochiritsira amawunika mawonekedwe a khungu, mucous nembanemba. Zivumbulutsa kutanuka, mtundu. Dotolo amayang'ananso pamkamwa. Ndi matenda am'mimbamo, lilime lophimba limawoneka, lokanda pamano. Palpation (palpation) ndi percussion (kuomba).
Zoyeserera zasayansi.
Amasanthula magazi ndi mkodzo mwanjira zosiyanasiyana, zamankhwala am'mwazi, kapulogalamu. Kuwonjezeka kwa maselo oyera am'magazi ndipo ESR ikuwonetsa njira yotupa. Ndi matenda a chiwindi, bilirubin, michere ya hepatic imachulukirachulukira. Pulogalamuyo imavumbula ndowe ngati bilirubin metabolism imalephera. Kusanthula kukuchitika kwa olemba ziwindi.
Biopsy ndi histology.
Kanthu kakang'ono kamachotsedwa mu nsalu. Imawunikiridwa ndi ma microscope, momwe maselo amayesedwa.

Akalandira chidziwitsochi, dokotalayo amadzazindikira moyenera, amazindikira zomwe zimayambitsa hepatosplenomegaly. Pokhapo ndiye kuti chithandizo chimayamba.

Njira ya ultrasound imawunika kapangidwe kake ndi morphology yam'mimba. Dokotala amayeza iliyonse ya izo, kuwulula hepatosplenomegaly, kusintha kwa morphological kapangidwe kake.

Zosintha zovuta zimawoneka ngati ndizambiri. Zambiri mwatsatanetsatane wopanga maselo zimatsimikiziridwa ndi biopsy.

Pafupipafupi wa CT pamimba, ziwalo zimawoneka ndi chithunzi. Dokotala amatsimikiza za hepatosplenomegaly, kusokonezeka kwa minyewa yamanjenje, mitsempha yamagazi, mapangidwe a zilonda zoyipa ndi zotupa, kuchepa kwamafuta. Njira imalembedwa ngati mayeso a ultrasound ndi a labotale sanatsimikizire za matendawo.

Mu magawo oyambirira azachipatala zizindikiro za kupweteka kusintha kwa chiwindi, ndulu ndi kapamba sizingatero. Izi ndizowopsa kwa wodwalayo, chifukwa amapita kwa dokotala pambuyo pake zovuta zitabuka.

Ndi kuchulukitsa kwa matendawa, zizindikiro zamatenda azomwe zimayamba:

mavuto a dyspeptic (nseru, kusanza, kudzimbidwa, kutsegula m'mimba),
malaise (kufooka, ulesi, kutopa, kugona),
kupweteka kwam'mimba pansi pa nthiti zakumanja,
kukulitsa kwa ziwalo (hepatosplenomegaly) kuwonekera kwa wodwala,
chikasu cha khungu ndi sclera, zomwe zimayamba ndikuphwanya kwa kagayidwe kake ka bilirubin,
kuchuluka kwa kutentha kwa thupi,
kuwonda mpaka kutopa,
kukomoka
Ngati wodwala wayamba kutulutsa kapamba, kupweteka kwa m'chiuno kumawonekera,
kukhazikika kwa lilime, kuwoneka ngati mkamwa wowawa mkamwa,
Amuna, zilonda za mabere zimakulira, testicles zimachepa.
mwa akazi, msambo umasokera.

Zizindikiro za matenda opatsirana zikawoneka, hepatosplenomegaly amathandizidwa ndi dokotala. Ngati sanachiritsidwe, mavuto amakula, wodwalayo amwalira.

Chithandizo ndi kupewa

Mankhwalawa amatengera chomwe chinayambitsa matendawa.

Zakudya Zakudya zokometsera, zokazinga, zamchere, zosuta, zamafuta siziperekedwa muzakudya.
Kukana mowa.
Kuchotsa mankhwala omwe amachititsa hepatosplenomegaly.
Antiviral mankhwala a matenda a hepatitis.
Hepatoprotectors amateteza maselo a parenchyma kuti asawonongeke.
Kukonzekera kochokera ku Phospholipid. Amapinda mu kapangidwe ka hepatocytes, kubwezeretsa maselo.
Ma Multivitamini. Chotsani hypovitaminosis, kutopa. Ikani mawonekedwe amtundu wa mapiritsi kapena othandizira.
Mankhwala othana ndi kutupa omwe amachepetsa kutupa ndi kuyankha kwa chitetezo cha mthupi.
Mathandizo amachepetsa katundu pa kapamba.
Ophera Imwani osaposa masiku 7.

Popewa kukula kwa matenda osokoneza bongo am'mimbayo amatsatira malamulo awa:

kuyesedwa kwamaka ndi madotolo, mayeso a labotale,
Kuchepetsa kapena kusiya mowa kwathunthu,
kulera kuteteza kulowa kwa ma virus ndi matenda opatsirana pogonana,
zakudya zoyenera zomwe zimakhala ndi michere, mavitamini, mchere, michere,
mankhwalawa zokhudza zonse matenda.

Kusintha kovuta m'chiwindi, ndulu ndi kapamba ndizowopsa kwa wodwalayo. Ngati chizindikiro cha pathological chachitika, dziwa ndikuchiza chomwe chimayambitsa matenda.

ZOPHUNZITSA ZA KUSINTHA KWA ZINSINSI ZOSIYANA

Pankhani ya wodwala yemwe akusintha masinthidwe a chiwindi, madokotala amatha kusiyanitsa njira zowonongeka m'maselo a hepatocyte, omwe pambuyo pake amasinthidwa ndi minofu yolumikizana yosagwira ntchito. Minofu yolumikizana ngati imeneyi imayamba kukula.

Zomwe zimayambitsa matenda

Zomwe zimapangitsa kuti pakhale kusintha kwamphamvu kwa chiwindi ndi zinthu zachilengedwe zomwe zimakhudza thupi.

Zoopsa kapena poizoni m'chilengedwe
Zigawo zovulaza zamankhwala zomwe zimapezeka m'mankhwala ena
zinthu zoyipa zomwe zimalowa m'thupi la wodwalayo chifukwa cha kusuta fodya komanso kumwa kwambiri mowa.

Matenda omwe amayambitsa kusintha kwa chiwindi

Matenda omwe angayambitse kusintha kwakuchulukana kwa chiwindi ndi monga:

Matenda a chiwindi ngati matenda amatsenga, hepatitis, cholangitis ndi ena, limodzi ndi kutupa,
Matenda omwe amapezeka ndi kupezeka kwa thupi la wodwalayo majeremusi kapena mphutsi, monga giardiasis ndi opisthorchiasis.

Matenda a ziwalo zoyandikana zomwe zimatha kupangitsa kukulitsa kukulira kwa maselo a chiwindi ndi kapamba

Matenda a ziwalo zina zomwe kwezani Kupanga kusintha kwakaphatikiza ndi izi:

Matenda amkati ndi matenda ena opatsirana monga yersineosis, malungo, mononucleosis,
HIV
Matenda Ogwirizana ndi autoimmunengati lupus erythematosus,
Zilonda zam'mimba mu ziwalo zomwe zakhudzidwa zotupa, mwachitsanzo, hemangiomas ndi adenomas,
Khansa yothandizidwa ndi kupangika kwa zotupa ndi ma metastase mu ziwalo zomwe zakhudzidwa,
Kukhalapo kwa kulepheretsa kwa ma ducts a bile ndi hepatic mitsempha,
Matenda ngati khansa
Ndi kudzikundikira m'chiwindi cha kuchuluka kwambiri kwamapuloteni amatchedwa amyloidosis,
Kukula kwa kuchepa kwamafuta mwa wodwala.

Potere, anthu omwe ali ndi ma ecoes amaphatikizapo odwala am'mgulu la achikulire (opitilira zaka 50).

Zomwe zimayambitsa zosangalatsa zapancreatic

Akatswiri azindikira kuti tizilombo toyambitsa matenda titha kupangika chifukwa cha matenda okhudzana ndi matenda a endocrine, kutupa kapena metabolic zothandiza, omwe ndi:

Kusokonezeka chifukwa cha kapangidwe ka kapamba,
Zotsatira za matenda ashuga
mawonekedwe a cystic fibrosis.

Madokotala nthawi zambiri amati izi zimachitika chifukwa cha kuphwanya kwa ziwalo zawo (chiwindi, biliary thirakiti), pamaso pama stasis a magazi m'malo omwe akhudzidwa.

SYMPTOMATICS OBSERVEDULAPO PAKUKULUKA KWA HEPATOMEGALIA

Zizindikiro zophatikizana ndi hepatomegaly, zizindikiro za kupindika kusintha kwa chiwindi, zimatsimikiziridwa makamaka ndikutsika kwa causative wothandizila kukulitsa matendawa.

Mukamaphunzira gawo loyambirira la matendawa (kufalitsa kochulukirapo), zizindikiritso zimasintha mu chiwindi parenchyma zimatha kuzindikirika chifukwa cha kusowa kwa zomwe zikugwirizana muzochitika. Ngakhale, ndi chitukuko cha kuchuluka kwa ziwalo mu mawonekedwe otchulidwa, wodwalayo ali ndi zizindikiro zina.

Zizindikiro za chiwindi chachikulu kapena kapamba zimaphatikizapo:

mawonetseredwe a khungu la khungu, Kupweteka komwe kumachitika pakhungu la ziwalo zomwe zakhudzidwa,
kusapeza bwino mu chiwindi,
zotupa zingachitike
Odwala nthawi zambiri amadwala kutentha kwa mtima komanso / kapena nseru,

Monga matenda ena aliwonse ofunikira monga chiwindi ndi kapamba, kuchuluka kwawo ndikofunikira kuzindikira koyambirirakupereka mankhwala othandiza panthawi yake. Ngakhale ndizovuta kudziwa zizindikiro zam'mimba, chifukwa zomwe zimachitika pakukula kwake ndizosafunikira kwenikweni. Kuphatikiza apo, matenda atapezeka munthawi yake, mankhwalawa amathandiza kusintha kwa chiwindi kukhala othandiza komanso mwachangu kwambiri.

Zotsatira za kusintha kwa parenchyma

Madokotala amavomereza pang'onopang'ono kuti ngakhale kusintha pang'ono pamapangidwe a parenchyma kungasonyeze kukula kwa matenda owopsa a chiwindi:

Zotsatira za kulephera kwa mtima,
Magawo oyamba a matenda amitsempha,
Zotsatira za kuledzera kwambiri,
Kukula kwa chiwindi, glycogenosis, hemochromatosis.

Ngati tilingalira zakusintha kapangidwe ka pancreatic parenchyma, zovuta zotsatirazi zingaoneke:

Mawonekedwe a lipomatosis:
Kukula kwa chifuwa chachikulu kapena kapamba,
Mawonekedwe a fibrosis,
Matenda a shuga.

Kugwiritsa ntchito mankhwala kuchiza hepatomegaly

Mankhwala ochizira kusintha kwa kapangidwe ka minofu

Classical chithandizo mankhwalawa kusintha kwa chiwindi, kuphatikizapo ntchito mankhwala otsatirawa katswiri:

Mankhwala a Hepatoprotective, kudya komwe kumapangitsa kutsika kwa mafuta ndi kubwezeretsanso maselo a hepatocyte osinthika a ziwalo zomwe zakhudzidwa,
Njira za okodzetsa - zokhudzana ndi okodzetsa, kugwiritsa ntchito komwe kumapereka kuchepa kwamphamvu mu madzi am'magazi ndi ziwalo.
Kuphatikiza pa mankhwala omwe ali pamwambawa pochizira hepatomegaly, kuchiritsa akatswiri nthawi zambiri kumati ndi ma enzyme opakidwa chakudya, kudya komwe kumapangitsa kuchepetsa katundu pazinthu zomwe zakhudzidwa.

Mankhwala osokoneza bongo omwe cholinga chake ndi kuthetsa zizindikiro za matenda omwe adatsitsa hepatomegaly

Zambiri chithandizo chothandiza, madokotala amalimbikitsa kugwiritsa ntchito mankhwala omwe cholinga chake ndi kuthetseratu matenda omwe adayambitsa hepatomegaly. Mankhwalawa ndi awa:

Mankhwala a antiemetic
Mankhwala,
Ophera
Maantibayotiki.

Ndi chithandizo chochepa kwambiri chamankhwala pogwiritsa ntchito njira zochizira, dokotala yemwe akupezekapo angafotokozere njira zochitira opaleshoni: