Hepatobiliary tsamaiso. Mafu a ea tsamaiso hepatobiliary

tsamaiso e khopo Hepatobiliary ke rarahaneng selotlolo boemo ba mochine ho etsa e hlophisitsweng, tsa bohlokoa tse kang tshilo ya dijo le excretion (excretion ea lihlahisoa metaboliki). Le ka lebaka la lona ho ba maloetse a senyehile tshilong ya dijo, dithulaganyo detoxification le ka karabelo boitshireletso, le tshireletso loantsang likokoana.

Litopo tsa tsamaiso hepatobiliary

tsamaiso e khopo Hepatobiliary bopilwe ka senya nyooko, sebete le bile ducts. mosebetsi lona se seholo ke ho thehoe le lipalangoang tsa bile, e hlahisoang ke lisele tsa sebete. Ho re susumelletsa hore ka ducts ka nyooko senya, e leng pokello eketsehileng. Bile hore bokella ho eona, concentrated sebete ka makhetlo 5-10. Ka mor'a lijo o fumana ka duodenum ena. Human anatomy ea tsamaiso hepatobiliary ho phaella ho sebete 'me nyooko senya le akarelletsa intrahepatic bile difapho hore ba sebakeng ka ho toba ka sebete. Ba qala ka methapong bile, butle-butle ho fallela ka ducts bile kholoanyane hore fetela ka nģ'ane ho sebete. Extrahepatic biliary emeloang tloaelehile hore batho ba e amanang le sebete le cystic kakaretso, e kopana ho theha tloaelehileng bile difapho.

Bile, mosebetsi lona 'meleng

Mesebetsi ya bile, e neng e entsoe ka electrolyte qhalwa ho ya ka metsi a, tšepe e boima (koporo) le dintho manyolo (letsoai le acid bile, k'holeseterole e, bilirubin, 'me ba bang ba bangata), tse fapa-fapaneng haholo. Ke haholo-holo ka setotsoana ho emulsification ea mafura le ho kgothaletsa ka hydrolysis le absorption ea protheine le lik'habohaedreite. Bile ke sethothetsi mosebetsi oa enzyme mala, 'me manyeme, ka tsela eo e susumetsang tshebetso ya ho tshilo ya dijo le absorption ea mafura le ho divithamini A, D, E, K.

, Ho phaella ho mosebetsi secretory ba bile ka 'mele' me o phetha taolo ho feta karolo ea ho laola bile sebopeho le zhelchevyvedenie, amang enjene le secretory mosebetsi ya intestine nyenyane. O ile a ho akarelletsa le inactivation peptin le asiti hydrochloric, e leng karolo ea lero le gastric, ho di hlohleletsago ata (ho ruruha), le desquamation la mala lisele tse epithelial, e ama secretion ea mucus. Ho phaella moo, ho ke ke ka setotsoana neutralizing le lithethefatsi tse chefo le tse fapa-fapaneng.

sebete

Human anatomy ea tsamaiso hepatobiliary nahana feela sebete e le lekala bohareng ba bile, empa hape e le setho sa bohlokoa ka ho fetisisa ho motho. Ke mona moo sebopeho sa ho fetisisa ea matla a 'mele a, hobane 20% ea boima ba lisele tsa sebete, nka mitochondria synthesize ATP. The sebete ke tšoelesa kholo ka ho fetisisa ka 'mele oa motho, e leng e fana ka kamehla tikoloho ya ka hare. O ile a phetha karolo ea bohareng ka protheine, mafura le carbon metabolism le ka metabolism ea lithethefatsi. Sebete ke ea e mong oa litho tsa ka hare 'maloa hore ba lula ba pepesehetse meroalo e boima, empa ka nako e tšoanang ba khona ho hlaphoheloa ka lithahasello tsa bona ka nako e khutšoanyane. Ka 'mele, ho etsa mesebetsi e latelang:

• bile sebopeho le zhelchevyvedenie;
• Tshilong ya dijo - ntle le ha e le hantle hore ho na le tswakana ya dintho tse ngata (lihaha-'mele, k'holeseterole e, glycogen, urea) ho hlokahala hore tshebetso tloaelehileng ea pampitšana gastrointestinal, sebete o etsoang tsoa ka metsing phapanyetsano molao oa tsamaiso le metabolism ea-amino acid le lihaha-'mele, lik'habohaedreite, lipids le dintho biologically mafolofolo nakong;
• beha - ke ea mofuta ofe setoro sebete moo ipokellela lihaha-'mele, lik'habohaedreite, mafura, divithamini, li-hormone, matsoai;
• mokoallo - koalloa mona mojaki le nang le chefo e metsoako amoheloa lijo kapa thehoa mala;
• excretory - sebete o khona ho bontša amohela dintho tse chefo ho bile, e leng ka lebaka la ho sebopeho lona tlosa ba le 'mele;
• homeostatic - tswakana le hlaha ka sebete, bokella le ho petsoha dikarolo tsa lero la mali mali, ka immunoglobulins ho khetheha, metsoako ea tsamaiso coagulation.

Mabaka a hlōloa ea tsamaiso hepatobiliary

Ho se sebetse ea tsamaiso hepatobiliary, haholo-holo sebete, hangata e ba ka lebaka la metsoako e senyang. Tsena li akarelletsa ho pepesehela chefo, baktheria le ea vaerase diso tsa radicals free. Ha tsamaiso hepatobiliary ka 'na ba utloa bohloko ka lebaka la mafu a tse fapa-fapaneng li-hormone le tshilong ya dijo, phepo e nepahetseng le mofutsana, o sa laoleheng fumana meriana, sebelisa joala hampe. Khatello ea kelello e ka boela ba le bohlokwa haholo ka ketsahalo ea pathologies tse sa tšoaneng.

Types of diso ea tsamaiso hepatobiliary

moriana morao-rao e se e tsejoa mefuta e latelang ea diso tse bakang tlōlo ea tsamaiso hepatobiliary:

• Mitochondrial - diso tsena hlahisa ka phahameng ka ho lisele 'me li ka thibela likepe a leeme ya enzyme tsa ketane ho hema. Hangata ka ho fetisisa ba ka lebaka la ho sebelisoa ha lithibela-mafu (tetracyclines), mahlahana a di-antiretroviral, parenteral phepo e nepahetseng. Liponahatso tsa diso joalo fetoha fibrosis ka linako tse ling ho ka khonehang keketseho ea ducts bile.
• Proteinosis le hlaha ka lebaka la ho tlōla tswakana protheine. Boholo ba diso tsena ke phello ea ho pepesehela telele ho chefo (joala, lithethefatsi, timetso bongata ba kokwanahloko le baktheria, chefo).
• Fibrosis develops ka lebaka la ba hlola meriana. Hangata ka ho fetisisa ba bitsoa lithethefatsi cytotoxic. Ho bonahala eka ho hōla ya dinama tse nyenyane tse fibrous, e senya phallo ea mali e etsa hore ho eketseha ha khatello ea ka mothapo-portal le sitisa tsamiso ya ho ea ka tšebetso ea lisele sebete.
• Cholestasis - fokotsa palo ya bile kena duodenum, kapa ba sieo ha eona. Sena se ka 'na ba obstruction phetha molao (gallstones) kapa ho hloka taolo hlahang ka boemo ba lisele tse sebete le intrahepatic bile ducts.
• diso Vascular - ka 'na etsahala ka maemo a fapaneng tsa marangrang a lona vascular tloha methapong le ho ipolaea le ho hlōloa ha ea bohlokoa bethe oona tsamaisong vascular le le mothapo-portal.
• Thickening ba bile - bolwetse ena ea tsamaiso hepatobiliary hangata e develops e loketseng ho blockage ea bile difapho kapa bile lipolaka mucous. Hangata ka ho fetisisa e le hlaha ka masea le e amanang le khohlano RH lebaka.

le matšoao

Mafu a ea tsamaiso hepatobiliary, ba atisa ho ba le matšoao a itseng le ho batho bao e seng e itseng. Bakeng sa nonspecific kenyeletsa le matšoao a botahoa a bontša lethargy, mokhathala, ho fokola le ho phahama mocheso linakong tsa exacerbation. Di amanang le fokotseha sebete detoxification mesebetsi khoneha reabsorption ba bile kapa mafu a ka protheine, k'habohaedreite kapa vithamine fapanyetsana. matšoao a itseng ho kenyeletsa le matšoao a tseo tse etsahalang ha ameha tsamaiso e khopo ka ho toba hepatobiliary. Tsena li akarelletsa:

• mafu a tse fapa-fapaneng tshilong ya dijo (ho nyekoa ke pelo, Boima ka tokelo quadrant e ka holimo, ke ka seoelo ho hlatsa a bakoang ke lijo qholotsoa, letšollo);
• bohloko mpeng "mala" kapa localized ka ho le letona, 'me hangata li etsahala ka mor'a mafura lijo kapa a tsuba;
• liponahatso letlalo (sekho methapong, xanthomas, mafu pigmentation, nyooko);
• Ascites - bokella mokelikeli ka cavity ka mpeng;
• venous ntlafatswa paterone tse ka mpeng;
• boteng ba sebete phefumoloho.

Ho tlola ea tsamaiso hepatobiliary ka bana

tsamaiso e khopo Hepatobiliary ka bana ba le lintho tse ngata tlase tloaelehile hore batho ba fetang ka batho ba baholo o ile a pepesa ho ruruha le bakoang ke mabaka a tšoaetsanoang. Haholo hangata e bolwetse amanang le mafu a tshebetso. Ba ka fumanoa ka ho bana ba lilemo tsohle, empa ba ho fetisisa ka tloaelo ameha bana ba sekolo. Sena ke ka lebaka la ho eketseha ha kelellong, maikutlong le 'meleng ho imeloa kelellong, hammoho le ka phetoho ea ho ja. Bohlokoa ka ho etsa hore mafu a tshebetso e eketsehile kgolo le hormonal fetola 'meleng oa ngoana. Ka ho fetisisa ka tloaelo fumanoe ka nako ena, biliary dyskinesia, ka seoelo - holetsistoholangity le cholecystitis.

Ho etsa qeto ea ho abelwang karolo ya diso mathomo le se mahareng ea tsamaiso hepatobiliary. The lethopa mathomo ka amanang le e sa tloaelehang anatomic pampitšaneng ena biliary, 'me le khopo la sphincters eo laola motsamao oa bile, ka ho khetheha, e sphincter tsa Oddi. ho se sebetse se mahareng a ka etsahala pathologies latelang:

• gastroduodenal (peptic seso, duodenitis);
• bolwetse ea manyeme le;
• mafu a tshilong ya dijo;
• mafu parasitic.

tlhathoba

Ho sa tsotellehe seo a se finyeletseng bohlokoa ka hepatology ea kajeno, o ile a re kgolo ya diso tse sa tšoaneng tsa pampitšana biliary le tšekamelo ea bona ea ho sa foleng le ho nako e telele, bo tsoelang pele e le hantle, e le fumanoe ka potlako e ka sehloohong. Ho phaella ho ho lekoloe, anamnesis le laboratori ea lithuto, le boitsebiso bo rutang tseo boholo ba tsona li ka nkoa e le k'hemistri mali, fumana tshebetso boemo thuso latelang mekhoa ea phuputso ea tsamaiso hepatobiliary.

1. Ea computed tomography - hangata e etsoa ka ho hlokomela biopsy dinama tse nyenyane tse ea cavity ka mpeng, ka ho fetisisa boitsebiso bo rutang intravenous tsamaiso ea mecha ea litaba ha li bapisoa.
2. MRI - ka tsela e atlehileng ho khetholla diso tse sa tšoaneng tsa lisele sebete le cysts, lumella ho hlahloba le ho khona ho utloa liphetoho vascular ka dithulaganyo oncological.
3. Radionuclide anthivaerase - ho hlahloba excretion ea bile le liphetoho tse sa tšoaneng lisele sebete, ho hlwaya dithulaganyo neoplastic, diso a hlabang le ho hlahloba patency tsa ducts biliary.
4. Cholangiography senola majoe le lihlahala ka bile difapho, hammoho le ho ba teng ha ea pathologies tse ling fistulas le pampitšana biliary. Ho feta moo, e lumella tlhahlobo nka disampole ba bile le bile difapho epithelium le kena catheter le ho khanna drainage ba bile, bile ducts atolosa le kenye litokisetso dissolving calculi (gallstones).
5. Angiography ho hlahloba phallo ea mali ka-portal le methapong e amanang le sebete. Ho mahlonoko tseo ho leng ka differential phumano ya diso kankere ea sebete.
6. Ultrasonography ea tsamaiso hepatobiliary ke mokhoa e bonolo ka ho fetisisa, ka theko e tlaase le tse rutang tsa lipatlisiso. Ke ee ke sekise tsoa majoe ka gallbladder le bile ducts gola ka botlalo ho lemoha ascites.

Ultrasonography ea tsamaiso hepatobiliary

Koetliso ea ho, e leng e lokela ho etsa ho etsa lipatlisiso ena, bonolo, empa e ke ho hlokahala hore ho fumana setšoantšo se feletseng. finyelle pakane ea sona ho e fumantsa phokotsong ea chelete ea khase ka mala ho mantle a sekgoqetsane etsa joalo haufi tlhahlobo ea litho tsa hlahloba. Ho etsa sena, bosiung ba la phuputso e entsoeng ho hlokahale ho ea tsamaisa tlhoekiso enema kapa nka laxative. Ho e fumantsa sephetho sa Tsamaiso e ne e le, matsatsi a mararo pele ho ketsahalo eo u lokela ho latela lijo tse, fokotsa tshebetso ya ho gasification. E lokela ho ile a etsa ka mpeng se nang letho, le lekhetlo la ho qetela lijo e lokela ho ba bonyane lihora tse 8.

Lijo pele oa ultrasound

Nakong ea ultrasound maemong hlahloba tsamaiso fuoa koetliso hepatobiliary lokela kenyeletsa, ho phaella ho mekgwatshebetso ya ho ho hloekisa, ho ja lijo, fokotsa flatulence. Mona ke melao-motheo ea lona:

• Phepo e nepahetseng e lokela ho ba karoloana - bonyane ka makhetlo a mane ka letsatsi, 'me ho ja lijo tsa ho qetela e lokela ho ba bonyane lihora tse 2 pele ho a il'o robala.
• Moqolo oa ea mokelikeli tlameha ho fokotsoa hore e etsang dilitara mong le halofo.
• Tsa kgetholla ho tloha lihlahisoa tsa lijo, tse akarelletsang tomoso, nama mafura kapa tlhapi, linaoa, tsoekere, tee le matla kapa kofi, carbonated kapa lino tse tahang.

tsamaiso e khopo Hepatobiliary etsa mesebetsi tse ngata tsa bohlokoa ka 'mele oa motho,' me ho ba bonoa ka nako e loketseng ea ho tlōla ka mosebetsi oa eona e tla thusa ho qoba mathata a mangata nakong e tlang.