Koj ob lub qhov muag thiab daim tawv nqaij puas zoo li daj? Los yog koj puas khaus thoob plaws koj lub cev? Tej zaum cov no yog cov tsos mob uas tshwm sim thaum cov kav dej uas nqa cov kua hu ua 'bile' los ntawm peb lub siab raug thaiv. Cov kua no hu ua 'bile' yog qhov tseem ceeb rau cov txheej txheem zom zaub mov hauv peb lub cev. Yog li ntawd, yog tias cov kav dej bile no raug thaiv, nws tuaj yeem rov qab mus rau hauv lub siab thiab ua rau muaj ntau yam teeb meem. Niaj hnub no, peb tab tom tham txog kev kho mob tshwj xeeb uas cov kws kho mob ua rau cov xwm txheej zoo li no. Nws hu ua Biliary Drainage.
Hais yooj yim xwb, qhov no yog dab tsi Biliary Drain?
Ib txoj hlab ntws ntawm cov kua tsib yog ib lub raj nyias nyias thiab yoog tau. Lub raj no yog siv los hla qhov thaiv hauv cov hlab ntws ntawm cov kua tsib uas txuas peb lub siab thiab txoj hnyuv me thiab tshem cov kua tsib tawm ntawm lub cev lossis xa nws rov qab mus rau txoj hnyuv me.
Xav txog ib daim khib nyiab daig hauv nruab nrab ntawm cov kav dej. Tom qab ntawd cov dej puv rau hauv ib qho chaw, qhov siab nce ntxiv, thiab cov kav dej tuaj yeem puas tsuaj, puas yog? Yog li ntawd cov kua tsib raug thaiv. Cov kua tsib sib sau ua ke hauv lub siab. Peb hu qhov mob no ua cholestasis hauv kev kho mob. Thaum qhov no tshwm sim, qhov mob ntawm jaundice, uas tig daj hauv qhov muag thiab daim tawv nqaij, tshwm sim, raws li tau hais ua ntej. Nrog rau qhov no, tuaj yeem muaj kev khaus hnyav thoob plaws lub cev.
Yog li, qhov uas cov kua tsib no ua yog hla qhov kev thaiv thiab tsim txoj hauv kev rau cov kua tsib ntws rov qab los. Qee zaum, cov kua tsib no raug sau rau hauv lub hnab sab nraum lub cev.
Cov txheej txheem ntxig raj no yog dab tsi? (Hom Kev Nqus Dej Biliary)
Muaj ob txoj kev kho mob tseem ceeb. Nyob ntawm koj tus mob, koj tus kws kho mob yuav txiav txim siab seb txoj kev twg zoo tshaj plaws rau koj.
1. Kev Siv Tshuaj Percutaneous Transhepatic Biliary Drainage (PTBD)
Qhov no suav nrog kev ntxig ib lub raj nyias nyias (catheter) los ntawm daim tawv nqaij ntawm sab xis ntawm koj lub plab, los ntawm koj lub siab, thiab rau hauv koj lub raj mis. Qhov no ua tiav los ntawm kev siv fluoroscopy, ib txoj kev siv X-ray tshwj xeeb. Lub raj raug ntxig tom qab nrhiav qhov chaw tseeb ntawm qhov txhaws. Tom qab ntawd, qhov kawg ntawm lub raj no txuas nrog lub hnab sab nraum lub cev. Tom qab ntawd cov kua qaub ncaug raug sau rau hauv lub hnab ntawd.
2. Kev Siv Tshuaj Endoscopic Biliary Drainage (EBD)
Qhov tshwm sim ntawm no yog tias ib lub raj nyias nyias uas muaj lub koob yees duab txuas nrog, hu ua endoscope , raug ntxig los ntawm koj lub qhov ncauj thiab nqes koj lub raj xa zaub mov mus rau qhov qhib ntawm cov kav dej kua tsib (qhov pib ntawm txoj hnyuv me). Tom qab ntawd, lwm lub raj nyias nyias raug ntxig los ntawm endoscope thiab ntxig rau hauv cov kav dej kua tsib uas raug txhaws kom ntws cov kua tsib.
Txoj kev no kuj ua tau ntau txoj kev sib txawv.
- Kev Siv Tshuaj Endoscopic Nasobiliary Drainage (ENBD):Ntawm no, cov quav mus los ntawm ib lub raj uas ntxig los ntawm lub qhov ntswg thiab sau rau hauv ib lub hnab sab nraum lub cev.
- Kev Tso Stent Sab Hauv: Qhov no suav nrog kev muab ib lub raj me me zoo li stent tso rau hauv thaj chaw uas raug thaiv thiab cia cov kua tsib ntws hla nws. Qhov no tso cai rau cov kua tsib ntws ncaj qha mus rau hauv txoj hnyuv me, es tsis txhob tawm hauv lub cev. Qhov no yog txoj kev siv ntau tshaj plaws.
Vim li cas ib tug neeg thiaj xav muab ib lub yeeb nkab zoo li no?
Muaj ntau yam ua rau cov hlab ntsha hauv lub cev raug thaiv lossis raug txhaws. Kev kho mob no yog qhov tsim nyog vim yog tus mob hu ua cholestasis uas tshwm sim thaum qhov no tshwm sim. Cia peb saib cov laj thawj tseem ceeb.
| Vim li cas thiaj thaiv | Ib qho lus piav qhia yooj yim |
|---|---|
| Cov pob zeb hauv lub zais zis los yog cov kua tsib (choledocholithiasis) | Cov pob zeb hauv lub zais zis uas tsim nyob rau hauv lub zais zis thiab thaiv cov kav dej ntawm cov kua tsib yog qhov ua rau feem ntau. |
| Mob Pancreatitis | Cov kav dej ntawm cov kua tsib tuaj yeem raug nias sab nraud vim yog qhov o ntawm lub txiav. |
| Cov mob qog noj ntshav | Cov hlab ntsha hauv lub pancreas, bile duct, gallbladder, lossis siab yuav raug thaiv los ntawm cov qog nqaij hlav. |
| Kev puas tsuaj rau cov ducts ntawm cov kua tsib | Cov kav dej ntawm cov kua tsib tuaj yeem raug puas tsuaj, tshwj xeeb tshaj yog thaum lub sijhawm phais xws li tshem cov kua tsib tawm. |
| Qee cov kab mob parasitic | Txawm hais tias tsis tshua muaj nyob hauv Sri Lanka, qee hom kab mob tuaj yeem ua rau cov kua tsib txhaws. |
| Kab mob Cholangitis thawj zaug | Qhov no yog ib qho mob ntev uas cov kav dej ntawm cov kua tsib raug mob thiab maj mam raug thaiv. |
Yuav tsum npaj li cas ua ntej kho mob?
Nws yog ib qho tseem ceeb heev uas koj yuav tsum ua raws li koj tus kws kho mob cov lus qhia ua ntej koj yuav kho qhov teeb meem no. Feem ntau, koj yuav tsum ceev faj txog tej yam no.
- Koj yuav tsum tsis txhob noj mov, haus dej, thiab haus luam yeeb tsawg kawg yog 6 teev ua ntej kev kho mob . Tej zaum koj yuav raug tso cai haus dej me ntsis, tab sis koj tus kws kho mob yuav qhia koj meej tias yuav ua li cas.
- Qhia rau koj tus kws kho mob txog txhua yam kev ua xua uas koj muaj ua ntej, tshwj xeeb tshaj yog rau cov tshuaj loog, cov xim sib piv uas siv rau hauv X-rays, yas, lossis hlau.
- Qhia rau koj tus kws kho mob txog txhua yam tshuaj thiab cov vitamins uas koj tab tom noj tam sim no .
- Yog tias koj noj tshuaj uas tiv thaiv cov ntshav txhaws (piv txwv li, cov tshuaj anticoagulants xws li aspirin thiab warfarin), nrog koj tus kws kho mob tham txog seb koj puas yuav tsum tsis txhob noj lawv ua ntej kho mob thiab yuav ua li cas.
- Yog tias koj cev xeeb tub los yog tej zaum yuav cev xeeb tub, nco ntsoov qhia rau peb paub.
- Vim tias koj yuav tsis tuaj yeem tsav tsheb tom qab kev kho mob vim yog tshuaj loog, nws yog ib qho tseem ceeb uas yuav tsum npaj kom muaj ib tus neeg tsav koj mus tsev ua ntej.
Muaj dab tsi tshwm sim thaum lub sijhawm kho mob?
Tej zaum yuav muaj qhov sib txawv me ntsis ntawm qhov uas yuav tshwm sim nyob ntawm seb koj yuav ua li cas, tab sis tus kws kho mob yuav piav qhia txhua yam rau koj ua ntej.
Yuav ua li cas thiaj ua tau txoj kev phais mob percutaneous (PTBD)
1. Ua ntej, tus kws kho mob yuav ntxuav daim tawv nqaij ntawm koj lub plab nrog cov tshuaj tua kab mob thiab ua kom thaj chaw ntawd loog.
2. Tom qab ntawd, muab ib rab koob nyias nyias ntxig rau hauv daim tawv nqaij mus rau hauv cov kav dej hauv lub siab.
3. Ib yam kua tshwj xeeb hu ua xim sib txawv raug txhaj rau hauv kom pom tseeb cov hlab ntsha hauv daim duab X-ray.
4. Tom qab nrhiav tau qhov chaw tseeb ntawm qhov txhaws, ib lub raj xa dej biliary raug ntxig rau hauv nws thiab cov kua tsib raug tso cai kom ntws tawm.
5. Lub qhov kawg sab nraud ntawm lub raj raug rub tawm ntawm daim tawv nqaij plab thiab txuas rau lub hnab. Cov quav yuav sib sau ua ke hauv lub hnab. Lub hnab no yuav tsum tau nchuav tawm ntau zaus hauv ib hnub.
Yuav ua li cas thiaj ua tau txoj kev kuaj mob endoscopic (EBD)
1. Koj yuav raug muab tshuaj loog tag nrho los yog muab koj pw tsaug zog tob.
2. Ua ntej muab lub endoscope ntxig rau hauv qhov ncauj, yuav muab tshuaj tsuag rau ntawm caj pas kom ua rau caj pas loog.
3. Tus kws kho mob mam li muab lub endoscope ntxig rau hauv qhov ncauj, muab nws tso rau ntawm cov yeeb nkab khoom noj, thiab nkag mus rau sab saud ntawm txoj hnyuv me.
4. Los ntawm qhov ntawd, lwm lub raj nyias nyias (catheter) raug ntxig los ntawm lub endoscope mus rau hauv cov hlab ntsha uas raug txhaws.
5. Tom qab ntawd, qhov txhaws raug tshem tawm thiab cov kua tsib raug tso cai kom ntws tawm. Yog tias muaj ib lub stent raug muab tso rau sab hauv, qhov no raug ua tiav lub sijhawm no. Yog tias muaj ib lub raj raug rho tawm, lub raj raug rho tawm ntawm lub qhov ntswg thiab txuas rau lub hnab.
Puas muaj tej yam txaus ntshai uas cuam tshuam nrog?
Ib yam li kev kho mob, muaj tej yam txaus ntshai thiab tej yam teeb meem uas yuav tshwm sim tau. Koj tus kws kho mob yuav qhia koj txog txhua yam no.
Nco ntsoov tias, qhov muaj feem yuav muaj cov teeb meem no tsawg heev. Thiab qhov muaj feem yuav muaj cov kua tsib txhaws ntau dua.
| Kev Pheej Hmoo/Teeb Meem | Kev piav qhia |
|---|---|
| Cov kev pheej hmoo sib xws | |
| Kev kis kab mob | Cov kab mob tuaj yeem nkag mus rau qhov chaw uas muab lub raj tso rau. Cov tshuaj tua kab mob raug muab los tiv thaiv qhov no. |
| Los ntshav | Nws yog ib qho tshwm sim tsawg heev, thiab tej zaum yuav xav tau kev pub ntshav. |
| Mob | Tej zaum yuav muaj qee qhov tsis xis nyob lossis mob qhov twg tau ntxig lub raj. |
| Lub raj xau los yog txhaws | Teeb meem tuaj yeem tshwm sim los ntawm kev rub lub raj tsis txhob txwm lossis los ntawm kev thaiv sab hauv. |
| Kev pheej hmoo ntsig txog cov txheej txheem tshwj xeeb | |
| Kev xau kua tsib (PTBD) | Cov kua dej tuaj yeem xau rau hauv lub cev los ntawm ib puag ncig lub raj. |
| Kab mob ntsws (PTBD) | Tsis tshua muaj, lub ntsws tuaj yeem raug puas tsuaj thiab cua tuaj yeem sib sau ua ke nyob ib puag ncig lawv. |
| Kab mob Pancreatitis (EBD) | Tom qab kev kho mob EBD, tej zaum yuav muaj o ntawm lub txiav pancreas ib ntus. |
Thaum koj mus txog tsev, koj yuav saib xyuas cov yeeb nkab li cas?
Yog koj muaj ib lub raj thiab ib lub hnab ntxig rau sab nraud koj lub cev, tus kws tu mob yuav muab cov lus qhia ntxaws ntxaws rau koj txog kev saib xyuas nws. Ua raws li cov lus qhia ntawd kom zoo.
- Haus cov dej haus electrolyte kom ntau npaum li cov kua tsib uas ntxiv rau hauv lub hnab. Koj tus kws kho mob yuav qhia koj tias yuav tsum haus dab tsi thiab yuav tsum haus ntau npaum li cas.
- Tom qab kho tas , so kom txaus . Zoo rau koj nrhiav ib tug neeg los pab koj hmo ntawd.
- Tsis txhob pw nrog koj qhov hnyav rau sab uas lub raj nyob . Ua li ntawd, yuav muaj tsawg dua qhov uas lub raj yuav ntswj.
- Feem ntau koj tuaj yeem rov ua koj cov dej num ib txwm tom qab 24 teev, tab sis tsis txhob tsa ib yam dab tsi hnyav dua 5 kg .
- Noj tag nrho cov tshuaj uas tus kws kho mob tau sau tseg raws li tau sau tseg .
- Koj tuaj yeem da dej tom qab 48 teev. Txawm li cas los xij, tsis txhob ua luam dej hauv pas dej, hiav txwv, lossis cov dej ntws kom txog thaum lub raj dej nyob hauv qhov chaw.
Thaum twg koj yuav tsum mus ntsib kws kho mob tam sim ntawd?
Yog tias koj muaj ib qho ntawm cov tsos mob hauv qab no, nws yuav yog ib qho cim qhia txog kev kis kab mob. Yog li hu rau koj tus kws kho mob tam sim ntawd lossis mus rau Chav Kho Mob Ceev (ETU) ntawm tsev kho mob ze tshaj plaws.
- Yog tias qhov mob, o, lossis liab ntawm qhov chaw ntxig raj nce ntxiv .
- Yog tias muaj kua qaub los yog lwm yam kua dej ntws los ntawm qhov chaw txhaj tshuaj.
- Yog koj kub taub hau .
Thov xyuam xim rau cov yam ntxwv no:
- Yog tias muaj qhov daj tshiab lossis qhov muag daj zuj zus tuaj .
- Yog tias xim lossis ntxhiab ntawm cov quav uas sau rau hauv lub hnab hloov pauv tam sim ntawd .
- Yog tias cov yeeb nkab zoo li xoob los ntawm qhov chaw uas nws tau muab tso rau.
- Yog koj mob plab tshiab los yog koj qhov mob uas twb muaj lawm zuj zus tuaj.
- Yog tias ntuav txuas ntxiv mus.
- Yog tias lub plab tsis khoob los yog cua tsis tawm los .
Nws yog ib qho ib txwm muaj uas yuav ntshai me ntsis thaum koj hnov txog hom kev kho mob no. Tab sis nco ntsoov, qhov no yog los pab koj lub cev tshem tawm qhov tsis xis nyob uas nws ua rau thiab ua kom nws rov qab zoo li qub. Tham nrog koj tus kws kho mob txog txhua lo lus nug lossis kev txhawj xeeb uas koj muaj. Nws yuav piav qhia txhua yam rau koj.
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Kev ntws kua tsib yog ib txoj kev kho mob tseem ceeb heev uas siv los pub cov kua tsib ntws los ntawm cov kav dej kua tsib uas raug txhaws.
- Qhov no tuaj yeem ua tiav los ntawm daim tawv nqaij (PTBD) lossis los ntawm endoscope (EBD).
- Nws yog ib qho tseem ceeb uas yuav tsum ua raws li cov lus qhia ntawm tus kws kho mob (kev yoo mov, cov ntaub ntawv txog tshuaj) ua ntej kho mob.
- Yog tias koj muaj ib lub raj tso rau sab nraum koj lub cev, kawm paub yuav ua li cas saib xyuas nws thiab ua raws li qhov ntawd.
- Yog koj muaj cov cim qhia tias koj muaj kab mob xws li kub taub hau, mob lossis o ntawm qhov chaw ntxig, lossis muaj kua qaub, nrhiav kev pab kho mob tam sim ntawd.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus