Koj puas tau hnov dua txog cov kua tsib nqaim lossis raug thaiv? Tej zaum koj tau hnov mob rau sab xis saum toj ntawm koj lub plab lossis pom tias koj daim tawv nqaij daj (hu ua jaundice )? Yog tias yog, koj yuav tsum tau ua tib zoo saib cov ntaub ntawv hauv qab no. Hnub no, peb tab tom tham txog Biliary Stricture . Thov tsis txhob ntshai; kev nkag siab txog qhov mob no yog thawj kauj ruam mus rau kev nrhiav kev daws teeb meem zoo. Nirogi Lanka nyob ntawm no los pab koj hla qhov no.
Biliary Stricture yog dab tsi? Cia peb piav qhia yooj yim!
Hais yooj yim xwb, qhov mob Biliary Stricture tshwm sim thaum koj cov kav dej kua tsib nqaim lossis raug thaiv vim muaj mob, caws pliav , lossis kev thaiv. Xav txog nws zoo li cov kav dej txhaws; thaum cov dej ntws raug txwv, cov kua dej tsis tuaj yeem hla dhau tau zoo. Thaum koj cov kav dej kua tsib nqaim, cov dej ntws ntawm koj lub siab mus rau koj txoj hnyuv me me raug txwv. Qhov no ua rau cov kua tsib rov qab mus rau hauv lub siab thiab tuaj yeem ua rau kev zom zaub mov nyuaj. Qhov mob no kuj tseem hu ua "bile duct stricture."
Yog li, cov ducts ntawm cov kua tsib yog dab tsi?
Xav txog koj cov kav dej ntawm cov kua tsib ua lub luag haujlwm rau koj lub cev zom zaub mov . Koj lub siab tsim cov kua tsib - cov kua dej zom zaub mov tseem ceeb rau kev zom zaub mov. Cov kav dej thauj cov kua tsib no mus rau koj txoj hnyuv me, qhov chaw uas cov kua qaub hauv cov kua tsib pab zom cov rog thiab cov protein. Koj cov kav dej ntawm cov kua tsib kuj txuas nrog cov kav pancreatic, uas nqa cov enzymes - ib hom protein uas pab ntxiv rau kev zom koj cov zaub mov.
Kab mob biliary stricture feem ntau tshwm sim li cas?
Txawm hais tias cov kws tshaj lij tsis muaj qhov tseeb tias muaj pes tsawg tus neeg raug kev txom nyem txhua xyoo, qhov mob no zoo li tshwm sim ntau dua. Ib qho tseem ceeb uas ua rau muaj kev phais mob qog ntshav ntau ntxiv, tshwj xeeb tshaj yog Laparoscopic Cholecystectomy . Thaum lub sijhawm ua cov txheej txheem no, cov kav dej ntawm cov kua tsib qee zaum yuav raug puas tsuaj lossis tsim cov nqaij caws pliav, ua rau nqaim. Zoo hmoo, qhov mob no tsis tshua muaj rau cov menyuam yaus.
Dab tsi yog cov laj thawj tseem ceeb uas ua rau cov kua tsib nqaim?
Muaj tej yam tsawg tsawg uas ib tug me nyuam yug los yuav muaj cov kua tsib nqaim, uas yog ib yam mob uas muaj txij thaum yug los . Txawm li cas los xij, feem ntau ntawm cov neeg mob—kwv yees li xya ntawm kaum tus—qhov ua rau muaj feem cuam tshuam nrog mob qog noj ntshav, xws li mob qog noj ntshav Pancreatic lossis Cholangiocarcinoma (mob qog noj ntshav ntawm cov kua tsib) .
Lwm yam mob qog noj ntshav uas yuav ua rau qhov no suav nrog:
- Mob qog nqaij hlav ntawm lub zais zis
- Mob qog nqaij hlav hauv siab (Hepatocellular carcinoma)
- Mob qog nqaij hlav
- Lymphoma
- Metastasis (mob qog nqaij hlav uas tau kis mus rau lwm qhov ntawm lub cev)
- Mob qog nqaij hlav me
Ua li cas txog cov teeb meem uas tsis yog mob qog noj ntshav (benign)?
Kwv yees li ntawm 30% ntawm cov neeg mob yog tshwm sim los ntawm cov mob tsis zoo lossis cov txheej txheem kho mob, suav nrog:
- Kev raug mob plab lossis kev raug mob
- Kab mob autoimmune pancreatitis thiab pancreatitis (mob ntawm lub txiav)
- Cov kab mob ntawm cov kua tsib vim yog cov pob zeb hauv lub gallstone
- Mirizzi syndrome (qhov twg pob zeb hauv lub zais zis ua rau cov hlab ntsha sab nraud raug nias)
- Kab mob biliary cholangitis thawj zaug
- Kab mob cholangitis thawj zaug
- Kev kho mob hluav taws xob
"Anastomotic Biliary Stricture" yog dab tsi?
Tom qab qee qhov kev phais mob nyuaj, xws li Whipple txheej txheem (feem ntau ua rau mob qog nqaij hlav pancreatic) lossis kev hloov siab, koj yuav tsim Anastomotic biliary strictureHauv cov kev phais no, tus kws phais yuav tsum txuas cov feem ntawm koj txoj hnyuv zom zaub mov rov qab, ib qho txheej txheem hu ua anastomosis . Qee zaum, thaj chaw uas cov nqaij no rov qab sib txuas tuaj yeem tsim cov nqaij caws pliav lossis kev puas tsuaj, ua rau nqaim. Qhov no yog hu ua anastomotic biliary stricture.
Cov tsos mob ntawm cov kua tsib nqaim yog dab tsi?
Yog koj muaj tus mob no, tej zaum koj yuav muaj cov tsos mob hauv qab no. Nco ntsoov tias, muaj ib lossis ob qho ntawm cov no tsis tau txhais hais tias koj muaj tus mob no, tab sis nws yog ib qho tseem ceeb uas yuav tsum sab laj nrog kws kho mob yog tias koj txhawj xeeb:
- Mob rau sab xis saum toj ntawm koj lub plab .
- Kub taub hau thiab mob khaub thuas .
- Kev hloov xim ntawm koj cov quav (zoo li daj ntseg, grey, lossis xim av nplaum).
- Khaus tawv nqaij tas li (Pruritus).
- Mob daj ntseg (daj ntawm daim tawv nqaij thiab cov dawb ntawm koj lub qhov muag).
- Tsis qab los noj mov .
- Xeev siab thiab ntuav .
Cov teeb meem mus sij hawm ntev yog dab tsi?
Yog tias cov kua tsib tseem nqaim lossis raug thaiv ntev ntev, cov kua tsib tuaj yeem rov qab mus rau hauv lub siab. Qhov no yuav ua rau muaj kev kis kab mob , kab mob siab ntev , lossis txawm tias cirrhosis ntawm lub siab (qhov txhab loj heev ntawm lub siab). Vim yog cov kev pheej hmoo no, nws yog ib qho tseem ceeb uas yuav tsum tau ua tib zoo saib xyuas koj cov tsos mob.
Koj yuav tsum mus ntsib leej twg kom kuaj mob thiab kho mob?
Yog koj muaj cov tsos mob no, koj yuav tsum sab laj nrog kws kho mob plab hnyuv . Lawv yog cov kws tshwj xeeb uas muaj peev xwm kuaj mob thiab tswj cov mob uas cuam tshuam rau koj lub cev zom zaub mov.
Cov kws kho mob kuaj mob li cas txog qhov mob ntawm cov biliary?
Koj tus kws kho mob tshwj xeeb yuav pom zoo kom kuaj ntau yam kom paub meej tias tus mob yog li cas:
- Kev kuaj ntshav:
- Kev kuaj Bilirubin: Thaum cov kua tsib nqaim, bilirubin (cov khoom pov tseg) yuav sib sau ua ke hauv lub cev. Kev kuaj no ntsuas cov qib ntawd.
- Kev kuaj mob siab: Siv los kuaj seb puas muaj cov enzymes hauv siab ntau, uas qhia tias lub siab ntxhov siab.
- Kev kuaj duab: Cov kev kuaj no tso cai rau koj tus kws kho mob pom qhov xwm txheej ntawm koj cov kua tsib los ntawm sab hauv.
- Kev Siv Ultrasound: Cov txheej txheem no siv cov suab nthwv dej los tsim cov duab uas qhia txog kev thaiv lossis nqaim hauv cov kav dej kua tsib. Nyob ntawm seb koj xav tau dab tsi, koj tuaj yeem ua Endoscopic ultrasound (kev siv ultrasound ua los ntawm lub raj tshwj xeeb nrog lub koob yees duab), kev siv ultrasound plab, lossis kev siv ultrasound siab.
- Kev kuaj mob Endoscopic retrograde cholangiopancreatography (ERCP): Qhov no ua ke nrog kev kuaj mob endoscopy sab saud nrog rau kev kuaj X-rays. Tom qab ua kom koj lub caj pas tsis hnov tsw, ib lub raj yas uas muaj lub koob yees duab (endoscope) raug xa mus los kuaj xyuas koj cov kab mob hauv plab thiab cov kav dej kua tsib. Thaum lub sijhawm ua qhov no, koj tus kws kho mob yuav sau cov biopsy (cov qauv nqaij) los kuaj xyuas seb puas muaj cov hlwb qog noj ntshav.
- Kev kuaj mob Magnetic resonance cholangiopancreatography (MRCP): Kev kuaj MRI tshwj xeeb, qhov no muab cov duab ntxaws ntxaws ntawm koj cov hlab ntsha hauv lub cev, daim siab, lub qog pancreas, thiab lub zais zis.
- Kev thaij duab Percutaneous transhepatic cholangiography (PTC): Ib txoj kev kuaj mob X-ray tshwj xeeb uas koj tus kws kho mob txhaj cov xim sib txawv los ntawm lub siab mus rau hauv cov kav dej ntawm cov kua tsib. Tom qab ntawd siv cov duab X-ray los taug qab cov xim ntws mus rau hauv koj txoj hnyuv me, qhia meej txog txhua qhov chaw uas raug thaiv.
Yuav kho qhov nqaim ntawm cov kua tsib li cas ?
Feem ntau, koj tus kws kho mob tuaj yeem daws qhov ua rau muaj kev thaiv thaum lub sijhawm ERCP lossis PTC.
Nyob ntawm seb qhov ua rau mob li cas, koj tus kws kho mob yuav ua cov hauv qab no:
- Tshem tawm cov pob zeb hauv lub zais zis yog tias lawv yog qhov ua rau muaj kev txhaws.
- Siv lub cuab yeej zoo li lub npuas dej los nthuav cov kav dej kua tsib uas nqaim thiab ntxig lub stent(ib lub raj me me uas ua los ntawm hlau los yog yas) kom lub raj qhib.
- Tshem tawm cov qog nqaij hlav lossis cov qog loj hlob.
Cov kev xaiv phais yog dab tsi?
Tsuas yog muaj ob peb tug neeg mob xwb uas yuav tsum tau phais rau qhov nqaim ntawm cov kav dej kua tsib, feem ntau yog thaum qhov nqaim ntawd yog los ntawm kev mob qog nqaij hlav lossis mob qog noj ntshav.
Cov kev xaiv phais muaj xws li:
- Kev phais hla txoj hlab zis: Hloov cov ntshav kom cov kua tsib thiaj li txav mus rau hauv koj txoj hnyuv me, hla txoj hlab zis uas raug thaiv.
- Kev txiav thiab Anastomosis: Kev phais tshem tawm qhov mob ntawm cov kav dej kua tsib thiab rov txuas cov kawg noj qab haus huv.
Tus mob no puas rov tshwm sim dua tom qab kho mob lawm?
Yog, nws muaj peev xwm ua rau cov kav dej kua tsib rov qab nqaim dua tom qab kho mob. Yog tias qhov no tshwm sim, koj tus kws kho mob yuav ua phais tshawb nrhiav cov kav dej kua tsib kom tshem tawm qhov chaw uas raug mob thiab txuas cov kav dej zoo rau koj txoj hnyuv me.
Puas muaj tej yam teeb meem tom qab kho mob lawm?
Cov teeb meem sib txawv nyob ntawm seb ua li cas. Ib txhia neeg yuav mob pancreatitis (mob o ntawm lub pancreas) tom qab ERCP. Nws yog ib qho tseem ceeb uas yuav tsum ua raws li koj tus kws kho mob cov lus qhia tom qab ua tiav.
Kuv puas tuaj yeem tiv thaiv kom cov kua tsib nqaim?
Koj tuaj yeem txo qhov kev pheej hmoo ntawm cov mob uas ua rau cov biliary strictures los ntawm kev coj ua cov cwj pwm noj qab haus huv, xws li:
- Noj zaub mov kom muaj txiaj ntsig zoo, muaj txiv hmab txiv ntoo thiab zaub tshiab.
- Tswj koj cov roj cholesterol kom tswj tau kev noj qab haus huv ntawm lub zais zis thiab tiv thaiv kom tsis txhob muaj pob zeb hauv lub zais zis.
- Tswj kom muaj qhov hnyav noj qab nyob zoo.
- Nrhiav kev txhawb nqa rau cov teeb meem ntsig txog cawv kom tiv thaiv kab mob pancreatitis thiab kev puas tsuaj rau daim siab.
Qhov tseem ceeb tshaj plaws yog kom koj muaj lub neej noj qab nyob zoo. Kev noj zaub mov kom zoo thiab kev tawm dag zog tsis tu ncua yog koj txoj kev tiv thaiv zoo tshaj plaws rau ntau yam mob.
Yuav ua li cas rau ib tus neeg uas muaj tus mob no?
Koj txoj kev kho mob yuav zoo li cas nyob ntawm seb ua rau qhov nqaim. Kev kho mob kom qhib cov kav dej ntawm cov kua tsib feem ntau ua tau zoo, txawm hais tias cov mob hauv qab xws li mob qog noj ntshav yuav xav tau kev kho mob nyuaj dua thiab txuas ntxiv mus.
Lub sijhawm rov zoo tom qab kev kho mob yog dab tsi?
Koj lub sijhawm rov zoo nyob ntawm seb koj ua li cas. Kev kho mob uas tsis tas phais ntau , xws li ERCP, feem ntau yuav rov zoo sai dua thiab mob tsawg dua piv rau kev phais qhib.
Ua raws li koj tus kws kho mob cov lus qhia kom zoo kom koj rov zoo tau zoo. Tej zaum yuav qhia koj kom noj cov khoom noj uas du los yog mos los yog hloov koj cov zaub mov kom muaj cov khoom noj uas yooj yim zom rau ib lub sijhawm.
Thaum twg kuv yuav tsum nrhiav kev kho mob?
Nrhiav kev kho mob tam sim ntawd yog tias koj muaj:
- Kub taub hau tas li.
- Mob plab sab saud tas li.
- Cov cim qhia txog kev kis kab mob tom qab ua ib qho kev kho mob (piv txwv li, kua qaub ntws tawm, liab).
- Poob phaus yam tsis paub vim li cas, xeev siab, lossis ntuav.
- Qhov muag los yog daim tawv nqaij daj (Jaundice).
Kuv yuav tsum nug kuv tus kws kho mob li cas?
Xav nug koj tus kws kho mob cov lus nug nram qab no:
- Ua cas kuv cov kua tsib thiaj nqaim?
- Kev kho mob twg zoo tshaj plaws rau kuv?
- Kuv yuav ua li cas thiaj li txo tau qhov kev pheej hmoo ntawm qhov no rov tshwm sim?
Cov tsos mob xws li mob plab, kub taub hau, mob khaub thuas, lossis mob daj ntseg—tshwj xeeb tshaj yog thaum lawv tshwm sim sai sai—yuav tsum tau saib xyuas kom zoo. Thov hu rau koj tus kws kho mob tam sim ntawd yog tias cov tsos mob no tshwm sim kom lawv thiaj li paub qhov ua rau thiab pom zoo kom kho mob ntawm Nirogi Lanka lossis koj lub tsev kho mob hauv zos.
Cov Lus Qhia Txog Kev Mus Tsev: Cov Ntsiab Lus Tseem Ceeb Uas Yuav Tsum Nco Ntsoov
Peb vam tias qhov kev piav qhia no yuav ua rau koj nkag siab meej dua txog Biliary Stricture .
- Nws hais txog qhov nqaim ntawm cov kav dej kua tsib, uas thaiv qhov ntws ntawm cov kua tsib.
- Muaj ntau yam ua rau, suav nrog kev phais mob, pob zeb hauv lub zais zis, lossis qog nqaij hlav.
- Ua tib zoo saib xyuas cov tsos mob xws li mob plab, mob daj ntseg, khaus tawv nqaij, lossis hloov xim quav.
- Yog tias koj muaj cov tsos mob no, nrog kws kho mob Gastroenterologist tham sai li sai tau.
- Muaj cov kev kho mob zoo, yog li sim tsis txhob txhawj. Kev kuaj pom thiab kho thaum ntxov ua rau muaj txiaj ntsig zoo tshaj plaws.
- Kev ua neej noj qab haus huv ua lub luag haujlwm tseem ceeb hauv kev tiv thaiv.
Yog koj muaj lus nug ntxiv, thov tsis txhob yig los tham nrog koj tus kws kho mob. Nyob kom noj qab nyob zoo!
