Koj puas tau muaj mob txawv txawv nyob rau sab xis saum toj ntawm koj lub plab, koj daim tawv nqaij thiab qhov muag daj, lossis tsis xav noj mov? Tej zaum koj yuav tau pom tias koj cov quav tau hloov daj. Cov no tsis yog tej yam uas tsis muaj tseeb xwb. Ib qho laj thawj kho mob uas ua rau qhov no yog vim cov kua tsib nqaim. Peb hu qhov no ua "(Biliary Stricture)". Tsis txhob txhawj, peb yuav tham txog txhua yam yooj yim xwb.
Hauv lus yooj yim, biliary stricture yog dab tsi?
Xav txog seb yog tias cov kav dej raug txhaws nrog av lossis yog tias cov kav dej raug zawm, cov dej ntws raug thaiv, puas yog? Qhov ntawd yog qhov tshwm sim ntawm no thiab. Cov kua tsib yog cov kua uas tseem ceeb rau cov txheej txheem zom zaub mov hauv peb lub cev. Cov kua tsib no yog tsim tawm hauv peb lub siab thiab mus rau txoj hnyuv me me los ntawm lub cev ntawm cov raj me me. Thaum cov raj uas cov kua tsib ntws los ua nqaim, nqaim, lossis raug thaiv rau qee qhov laj thawj, qhov no hu ua biliary stricture.
Thaum cov kua tsib raug thaiv li no, cov kua tsib pib sib sau ua ke hauv lub siab. Qhov no ua rau peb lub cev nyuaj rau zom cov zaub mov, tshwj xeeb tshaj yog cov zaub mov rog. Thiab ntau lwm yam tsos mob pib tshwm sim.
Dab tsi yog cov ua rau cov kua tsib nqaim?
Muaj ntau yam ua rau muaj tus mob no. Qee yam ua rau muaj mob qog noj ntshav, thaum lwm yam muaj feem cuam tshuam nrog lwm yam mob uas tsis yog mob qog noj ntshav. Kwv yees li ntawm 70% ntawm cov mob no yog vim mob qog noj ntshav, thiab 30% seem yog vim tsis yog mob qog noj ntshav.
Yuav kom yooj yim to taub, cia peb faib cov laj thawj no ua pawg.
| Hom laj thawj | Kev piav qhia thiab piv txwv |
|---|---|
| Cov Ua Rau Mob Cancer | Qhov no yog qhov ua rau feem ntau tshwm sim. Ib qho qog nqaij hlav tuaj yeem nias lossis loj hlob hauv cov kav dej kua tsib, ua rau nws nqaim.
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| Cov Ua Rau Tsis Yog Mob Cancer | Tus mob no kuj tseem tuaj yeem tshwm sim los ntawm lwm yam kab mob, kev phais mob, lossis kev raug mob. |
Tshwj xeeb, tom qab qee qhov kev phais, xws li kev hloov siab lossis Whipple txheej txheem, cov hlab ntsha tuaj yeem nqaim vim yog qhov caws pliav ntawm qhov anastomosis.
Cov tsos mob ntawm cov hlab ntsha hauv cov kua tsib yog dab tsi?
Thaum cov kav dej ntawm cov kua tsib raug thaiv, nws cuam tshuam rau peb lub cev ntau yam. Yog tias koj muaj ib lossis ntau yam ntawm cov tsos mob no, koj yuav tsum txhawj xeeb.
| Cov tsos mob | Ib qho lus piav qhia yooj yim |
|---|---|
| Tawv nqaij thiab qhov muag daj (Jaundice) | Qhov no yog qhov tsos mob tseem ceeb thiab pom tseeb tshaj plaws. Qhov no tshwm sim vim tias cov xim daj hu ua bilirubin hauv cov kua tsib tsis tuaj yeem tawm ntawm lub cev thiab sib sau ua ke hauv cov ntshav. |
| Khaus tawv nqaij/Pruritus | Cov ntsev ntawm cov kua tsib tuaj yeem sib sau ua ke hauv qab daim tawv nqaij, ua rau tag nrho lub cev khaus heev. |
| Cov quav daj ntseg los yog xim av nplaum | Feem ntau, xim av ntawm peb cov quav yog los ntawm cov kua tsib. Thaum cov kua tsib tsis mus txog cov hnyuv lawm, cov quav yuav poob nws cov xim thiab hloov mus ua xim dawb. |
| Mob nyob rau sab xis saum toj ntawm lub plab | Muaj ib qho mob txawv txawv, tsis tu ncua los ntawm thaj chaw uas lub siab thiab cov kav dej kua tsib nyob. |
| Kub taub hau thiab mob khaub thuas | Yog tias cov kua tsib sib sau ua ke thiab kis kab mob, yuav muaj kub taub hau thiab mob khaub thuas. |
| Lwm yam nta | Kuj tseem yuav pom xeev siab, ntuav, tsis xav noj mov, thiab poob phaus. |
Yuav kuaj mob li cas?
Thaum koj mus ntsib kws kho mob uas muaj cov tsos mob no, nws yuav kuaj koj thiab ua ntau qhov kev kuaj mob kom paub tseeb tias koj muaj mob. Feem ntau, tus kws kho mob plab hnyuv (tus kws kho mob uas tshwj xeeb hauv kev zom zaub mov) kho cov mob no.
Kev Ntsuas Ntshav
Ua ntej, qee qhov kev kuaj ntshav tau ua tiav.
- Kev kuaj Bilirubin: Qhov no ntsuas seb qib bilirubin hauv cov ntshav siab npaum li cas.
- Kev Kuaj Mob Siab: Cov kev kuaj no nrhiav seb cov enzyme hauv siab puas siab kom paub seb puas muaj kev puas tsuaj rau lub siab.
Kev luam theej duab thiab lwm yam kev kuaj duab
Tom qab kuaj ntshav tas, yuav muaj ntau qhov kev soj ntsuam los saib seb cov kav dej ntawm lub cev puas zoo.
- Kev Ntsuas Ultrasound: Qhov no yog qhov kev kuaj yooj yim tshaj plaws, tsis mob tshaj plaws uas ua tau ua ntej. Nws thaij duab ntawm cov kabmob hauv plab thiab tuaj yeem muab lub tswv yim zoo txog seb cov kua tsib puas o, muaj pob zeb, lossis raug thaiv.
- ERCP (Endoscopic Retrograde Cholangiopancreatography): Qhov no yog ib qho kev kuaj mob tseem ceeb heev uas siv rau kev kuaj mob thiab kev kho mob. Koj yuav tau txais tshuaj loog, thiab muab ib lub raj me me uas muaj lub koob yees duab txuas rau nws ntxig rau hauv koj lub qhov ncauj, hla koj lub plab, thiab rau hauv qhov qhib ntawm koj cov kav dej kua tsib. Tom qab ntawd yuav muab ib qho xim tshwj xeeb txhaj rau hauv cov kav dej thiab yuav thaij duab X-ray. Qhov no qhia tau qhov twg pom tseeb tias qhov txhaws. Yog tias tsim nyog, yuav muab ib daim ntaub so ntswg coj mus kuaj (biopsy) thiab kho qhov txhaws.
- MRCP (Magnetic Resonance Cholangiopancreatography): Qhov no yog kev ntsuas MRI. Tsis tas yuav ntxig cov raj rau hauv lub cev, lub zog sib nqus raug siv los ua kom tau cov duab peb-seem ntawm cov kav dej kua tsib, siab, gallbladder, thiab pancreas kom meej heev.
- PTC (Percutaneous Transhepatic Cholangiography): Qee zaum, yuav muab ib rab koob me me ntxig rau hauv daim tawv nqaij mus rau hauv lub siab, muab ib qho xim zas rau hauv cov kav dej ntawm cov kua tsib, thiab thaij duab X-ray.
Cov kev kho mob rau qhov no yog dab tsi?
Txoj kev kho mob nyob ntawm seb qhov ua rau cov ducts ntawm cov kua tsib nqaim.
Feem ntau, kev kho mob tuaj yeem ua tau tib lub sijhawm nrog kev kuaj ERCP. Qhov no yooj yim heev rau tus neeg mob vim tias nws tuaj yeem ua tiav yam tsis tas yuav phais loj.
Cov kev kho mob uas tuaj yeem ua tau thaum lub sijhawm ERCP suav nrog:
- Tshem tawm pob zeb: Yog tias cov pob zeb daig hauv lub zais zis, lawv raug rhuav lossis tshem tawm nrog cov cuab yeej tshwj xeeb.
- Kev Muab Stent Tso Rau Hauv: Cov hlab ntsha uas nqaim lawm yuav raug nthuav dav los ntawm kev ntxig thiab tshuab ib yam dab tsi zoo li lub npas. Tom qab ntawd, kom cov hlab ntsha qhib thiab tsis nqaim dua, yuav muab ib lub stent , ib lub raj me me zoo li lub mesh, tso rau hauv. Cov no tuaj yeem ua los ntawm yas lossis hlau.
- Kev tshem tawm cov qog nqaij hlav: Yog tias qhov kev thaiv yog los ntawm ib qho qog nqaij hlav me me, tej zaum yuav muaj peev xwm tshem nws tawm.
Kev Kho Mob Phais
Muaj tej lub sij hawm, tshwj xeeb yog tias nws yog mob qog nqaij hlav, tej zaum yuav tsum tau phais.
- Kev Phais Mob Los Ntawm Txoj Hnyuv: Qhov no cuam tshuam txog kev hla txoj hlab ntshav uas raug thaiv thiab tsim txoj hauv kev tshiab rau cov kua tsib ntws.
- Kev txiav tawm thiab Anastomosis: Qhov seem mob ntawm cov kav dej kua tsib raug txiav thiab tshem tawm , thiab ob seem noj qab haus huv seem raug txuas rov qab.
Puas muaj dab tsi uas peb ua tau los tiv thaiv qhov teeb meem no?
Peb tsis tuaj yeem tiv thaiv txhua yam ua rau cov kua tsib txhaws, xws li mob qog noj ntshav. Txawm li cas los xij, muaj qee yam kev pheej hmoo uas peb tuaj yeem tswj tau. Los ntawm kev saib xyuas lawv, peb tuaj yeem txo qhov kev pheej hmoo ntawm kev mob no.
- Noj zaub mov kom zoo: Txo cov khoom noj uas muaj roj thiab rog ntau, thiab ntxiv txiv hmab txiv ntoo thiab zaub ntau rau hauv koj cov zaub mov noj.
- Tswj koj cov roj cholesterol: Cov roj cholesterol siab tuaj yeem ua rau muaj pob zeb hauv lub zais zis, yog li nws tseem ceeb heev rau kev tswj koj cov roj cholesterol.
- Tswj qhov hnyav kom noj qab nyob zoo: Kev tswj qhov hnyav ntawm lub cev kuj tseem muaj txiaj ntsig zoo rau kev noj qab haus huv ntawm lub zais zis.
- Tsis txhob haus cawv ntau dhau: Kev haus cawv ntau dhau tuaj yeem ua rau lub siab puas tsuaj thiab ua rau mob pancreatitis. Ob qho mob no tuaj yeem ua rau cov hlab ntsha nqaim.
Thaum twg koj yuav tsum mus ntsib kws kho mob?
Yog koj muaj cov tsos mob hauv qab no, tsis txhob tsis quav ntsej lawv li cas los xij.Mus ntsib koj tus kws kho mob sai li sai tau thiab nrhiav kev pab tswv yim.
| Qhov tshwj xeeb uas yuav tsum tau them sai sai rau |
|---|
| Yog koj daim tawv nqaij lossis koj lub qhov muag dawb tig daj (jaundice). |
| Yog tias koj mob tas li lossis mob rov qab tshwm sim rau sab xis saum toj ntawm koj lub plab. |
| Yog koj poob phaus yam tsis muaj laj thawj. |
| Yog tias muaj kub taub hau thiab mob khaub thuas tas li. |
| Tom qab kho mob lawm, qhov chaw phais yuav pom cov cim qhia tias muaj kev kis kab mob, xws li liab, o, lossis kua paug. |
Cov Lus Qhia Txog Kev Coj Mus Tsev
- Cov cim qhia tseem ceeb ntawm kev txhaws ntawm cov kua tsib, daim tawv nqaij thiab qhov muag daj (jaundice), mob rau sab xis saum toj ntawm lub plab, thiab cov quav daj yog cov cim ceeb toom tseem ceeb ntawm kev txhaws ntawm cov kua tsib. Tsis txhob tsis quav ntsej txog cov no.
- Qhov no tuaj yeem tshwm sim los ntawm ntau yam, los ntawm cov mob yooj yim xws li pob zeb hauv lub zais zis mus rau cov mob hnyav dua xws li mob qog noj ntshav.
- Kev kuaj ntshav, kev ntsuas scans, thiab tshwj xeeb tshaj yog kev kuaj xws li ERCP yog qhov tseem ceeb heev rau kev kuaj mob kom raug.
- Feem ntau, cov hlab ntsha tuaj yeem qhib tau siv ERCP yam tsis tas phais.
- Koj txoj kev noj qab haus huv yav tom ntej nyob ntawm seb ua rau koj cov kua tsib txhaws, yog li nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev pab kho mob sai li sai tau.
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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