Kua rongo koe i tētahi wā e whaiti ana, e ārai ana rānei te awaawa o te ate? Kua pāngia pea koe e te mamae i te taha matau o runga o tō puku, kua kite rānei koe i te kōwhai o tō kiri (e mōhiotia ana ko te jaundice )? Mēnā koinā, me aro koe ki ngā kōrero e whai ake nei. I tēnei rā, kei te kōrero tātou mō te Biliary Stricture . Kaua e mataku; ko te mārama ki tēnei āhuatanga te taahiraa tuatahi ki te kimi i te otinga tika. Kei konei a Nirogi Lanka hei āwhina i a koe ki te whakatere i tēnei.
He aha te Biliary Stricture? Me whakamārama ngāwari tātou!
Ki te whakarāpopototanga, ka puta te Biliary Stricture ina whaiti, ka ārai rānei ō awaawa au nā te mate, te whara , te aukati rānei. Whakaarohia he rite ki te paipa kua āraia; ina herea te rere, kāore e taea e te wai te haere tika. Ina whaiti ō awaawa au, ka herea te rere o te au mai i tō ate ki tō whekau iti. Ka puta te au mai i te ate ki roto i te ate, ā, ka uaua te nakunaku. E kiia ana hoki tēnei āhuatanga i roto i te rongoā ko te "bile duct stricture".
Nā, he aha tonu ngā awaawa o te ate?
Whakaarohia ō awaawa aukume hei pūnaha wai mō tō pūnaha nakunaku . Ka whakaputahia e tō ate te aukume—he wai nakunaku e tika ana mō te wawahi i te kai. Ka haria e ngā awaawa tēnei aukume ki tō whekau iti, ki reira ka āwhina ngā waikawa o te aukume ki te wawahi i ngā ngako me ngā pūmua. Ka hono atu hoki tō awaawa aukume ki te awaawa repeure, e mau ana i ngā whākōkī—he momo pūmua e āwhina ana i te nakunaku o ō kai.
He pēhea te noa o te stricture biliary?
Ahakoa kāore anō kia tino tatauhia e ngā tohunga te tokomaha o ngā tāngata e pāngia ana i ia tau, te āhua nei kei te piki haere te maha o ngā tāngata e pāngia ana e tēnei mate. Ko tētahi o ngā take e whai wāhi ana ko te pikinga ake o te auau o te pokanga tango i te pūkahukahu , inā koa ko te Laparoscopic Cholecystectomy . I roto i ēnei tikanga, ka pakaru pea ngā awaawa pūkahukahu, ka puta rānei he kiko kiri, ka whaiti ai. He waimarie, he tino onge tēnei mate i roto i ngā tamariki.
He aha ngā tino take o te whaiti o te awaawa o te ate?
I ētahi wā tino onge, ka whānau mai pea he tamaiti me te whaiti o ngā awaawa au, he mate whānau mai anō tēnei. Heoi, i te nuinga o ngā wā—tata ki te whitu i roto i te tekau—e pā ana te take ki te mate pukupuku, pērā i te Mate Pukupuku Pancreas , te Cholangiocarcinoma rānei (te mate pukupuku awaawa au) .
Ko ētahi atu mate pukupuku ka arahi pea ki tēnei ko:
- Matepukupuku o te pūkahukahu
- Matepukupuku ate (matepukupuku ate)
- Matepukupuku ate
- Lymphoma
- Te mate pukupuku kua horapa mai i ētahi atu wāhanga o te tinana ( metastasis )
- Matepukupuku whekau iti
Ā, me pēhea ngā take kore-matepukupuku (ngā take pai)?
Tata ki te 30% o ngā take ka puta mai i ngā āhuatanga pai, i ngā tikanga hauora rānei, tae atu ki:
- Ngā whara o te puku, te whara rānei
- Te pancreatitis ā-aunoa me te pancreatitis (mumura o te pancreas)
- Te whara o te awaawa o te waikeri nā te mea he kohatu kei roto
- Te mate Mirizzi (te wāhi e pēhia ai ngā awaawa au e ngā kohatu o te pūkahukahu)
- Te mate pāwera biliary tuatahi
- Ko te cholangitis sclerosing tuatahi
- Te rongoā irahiko
He aha te "Anastomotic Biliary Stricture"?
Whai muri i ētahi pokanga uaua, pērā i te tikanga Whipple (e mahia ana mō te mate pukupuku repeure) me te whakawhitinga ate rānei, ka pāngia pea koe e te Anastomotic biliary stricture.I roto i ēnei pokanga, me hono anō e te taote pokanga ngā wāhanga o tō ara nakunaku, he tukanga e kiia nei ko te anastomosis . I ētahi wā, ka puta he kiko whara, he kino rānei i te wāhi e honoa anō ai ēnei kiko, ka hua ake he whaiti. Ka kiia tēnei he anastomotic biliary stricture.
He aha ngā tohu o te whaiti o te awaawa o te ate?
Mena kei a koe tēnei mate, tera pea ka pāngia koe e ēnei tohu e whai ake nei. Kia maumahara, ko te mea kei a koe tētahi, e rua rānei o ēnei tohu, ehara i te mea kei a koe tonu tēnei mate, engari he mea nui kia toro atu ki te tākuta mena kei te āwangawanga koe:
- Te mamae i te taha matau o runga o tō puku .
- Te kirika me te makariri .
- Ngā panonitanga o te tae o tō tūtae (he mā, he hina, he uku rānei te tae).
- Te mākūkū tonu o te kiri (Pruritus).
- Te kōwhai o te kiri me te mā o ngā kanohi ( jaundice ).
- Te ngaronga o te hiahia kai .
- Whakapairuaki me te ruaki .
He aha ngā raruraru mō te wā roa?
Mena ka noho whaiti, ka āraia rānei te awaawa au mō te wā roa, ka piki anō te au ki roto i te ate. Tērā pea ka arahi tēnei ki ngā mate pāwera , ki te mate ate mau tonu , ki te mate ate pūmau rānei (te mate kiriuhi nui o te ate). Nā ēnei mōrearea, he mea nui kia aro nui koe ki ō tohumate.
Ko wai me toro atu koe mō te tātaritanga me te maimoatanga?
Ki te puta ēnei tohu ki a koe, me toro atu koe ki tētahi Kaimātai Matepukupuku . Ko rātou ngā tohunga tino rite ki te tātaritanga me te whakahaere i ngā āhuatanga e pā ana ki tō pūnaha nakunaku.
Me pēhea te tautuhi a ngā tākuta i ngā uauatanga o te biliary?
Ka tūtohu pea tō tohunga i ētahi whakamātautau hei whakaū i te mate:
- Ngā whakamātautau toto:
- Whakamātautau bilirubin: Ina whaiti ngā awaawa o te ate, ka kohia te bilirubin (he para) i roto i te tinana. Ka inehia e tēnei whakamātautau aua taumata.
- Ngā whakamātautau mahi ate: Whakamahia hei tirotiro mō ngā whākōkī ate kua teitei ake, e tohu ana i te ahotea o te ate.
- Ngā whakamātautau whakaahua: Mā ēnei whakamātautau ka taea e tō tākuta te tiro i te āhua o ō awaawa au mai i roto.
- Ultrasound: Ka whakamahia e tēnei tikanga ngā ngaru oro hei hanga whakaahua e tautuhi ana i ngā aukati, i te whaiti rānei i roto i ngā awaawa au. I runga i ō hiahia, ka taea e koe te whai i tētahi Endoscopic ultrasound (he ultrasound e mahia ana mā roto i tētahi ngongo motuhake me te kāmera), he ultrasound puku, he ultrasound ate rānei.
- Endoscopic retrograde cholangiopancreatography (ERCP): Ka whakakotahihia te endoscopy o runga me ngā hihi-X. Whai muri i te whakangāwari i tō korokoro, ka tukuna he ngongo ngāwari me te kāmera (endoscope) hei tirotiro i ō whekau nakunaku me ngā awa waikura. I roto i tēnei tikanga, ka kohia pea e tō tākuta he koiora (he tauira kiko) hei tātaritanga hei tirotiro mō ngā pūtau matepukupuku pea.
- Ko te cholangiopancreatography aukume (MRCP): He matawai MRI motuhake, e whakarato ana i ngā whakaahua tino taipitopito o ō awa au, te ate, te repe taiaki, me te pūkahukahu.
- Kolangiography whakawhiti-hepatic percutaneous (PTC): He tikanga hihi-X motuhake e werohia ai e tō tākuta he tae rerekē mā roto i te ate ki roto i ngā awaawa au. Kātahi ka whakamahia ngā hihi-X hei aroturuki i te rere o te tae ki roto i tō whekau iti, kia mārama ai ngā wāhi kua āraia.
Me pēhea te rongoā mō te whaiti o te awaawa o te ate?
I ngā wā maha, ka taea e tō tākuta te aro ki te take o te aukati i te wā o te tikanga ERCP, PTC rānei.
I runga i te take matua, ka taea e tō tākuta te mahi i ngā mahi e whai ake nei:
- Te tango i ngā kohatu o te pūkahukahu mēnā koinei te take o te aukati.
- Te whakamahi i tētahi taputapu rite ki te poihau hei whakawhānui i te awaawa waikura kua whaiti me te whakauru i tētahi stent(he ngongo iti whakarewa, he ngongo kirihou rānei) hei pupuri i te paipa kia tuwhera tonu.
- Te tango i ngā pukupuku, i ngā tipu rānei.
He aha ngā kōwhiringa pokanga?
He tokoiti noa iho ngā tūroro e hiahia ana ki te pokanga mō te whakawhāititanga o ngā awaawa ate, i te nuinga o te wā ka puta te whakawhāititanga i te mate pukupuku, i te mate pukupuku rānei.
Ko ngā kōwhiringa pokanga ko:
- Pokanga karo: Te huri i te rere o te au o te ate kia taea ai e ia te neke tika ki roto i tō whekau iti, me te karo i te awaawa kua āraia.
- Te Tangohanga me te Anastomosis: Te tango pokanga i te wāhanga mate o te awaawa au, ka hono anō i ngā pito hauora.
Ka taea te hoki mai anō tēnei āhuatanga i muri i te maimoatanga?
Āe, tera pea ka whaiti anō te awaawa o te ate i muri i te maimoatanga. Mēnā ka tupu tēnei, ka whakahaerehia pea e tō tākuta he pokanga tirotiro awaawa hei tango i te wāhi e pāngia ana, hei hono anō i te awaawa hauora ki tō whekau iti.
He raruraru pea kei muri i te maimoatanga?
Ka rerekē ngā raruraru i runga i te tikanga i mahia. Tērā pea ka pāngia ētahi tāngata e te pancreatitis whakapeka (mumura o te repe taiaki) whai muri i te ERCP. He mea nui kia tino whai i ngā tohutohu a tō tākuta i muri i te tikanga.
Ka taea e au te aukati i te whaiti o te awaawa o te ate?
Ka taea e koe te whakaiti i te mōrearea o ngā āhuatanga e arahi ana ki ngā uauatanga o te biliary mā te tango i ngā tikanga hauora, pēnei i:
- Te kai i tētahi kai totika, taurite hoki, e nui ana i ngā hua me ngā huawhenua hou.
- Te whakahaere i ō taumata cholesterol hei pupuri i te hauora o te pūkahukahu me te ārai i ngā kohatu pūkahukahu.
- Te pupuri i te taumaha hauora.
- Te rapu tautoko mō ngā take e pā ana ki te waipiro hei ārai i te pancreatitis me te kino o te ate.
Ko te mea nui ko te pupuri i tētahi momo noho hauora. Ko te kai taurite me te whakakori tinana auau ngā parepare pai rawa atu mō ngā mate hauora maha.
He aha te tirohanga mō te tangata whai i tēnei āhuatanga?
Ko te āhua o tō whakaoranga ka whakawhirinaki ki te pūtake o te whaiti. Ko ngā maimoatanga hei whakatuwhera i ngā awaawa o te ate he angitu i te nuinga o te wā, ahakoa ko ngā mate pēnei i te mate pukupuku me whai tiaki uaua ake, tonu hoki.
Kia pēhea te roa o te wā whakaora i muri i te maimoatanga?
Ko te roa o tō whakaoranga ka whakawhirinaki ki te tikanga motuhake. Ko ngā maimoatanga iti rawa te whakaekenga , pērā i te ERCP, ka tere ake te whakaoranga me te iti ake o te mamae ki te whakatauritea ki ngā pokanga tuwhera.
Me whai i ngā tohutohu a tō tākuta kia ora ai koe. Tērā pea ka tohutohuhia koe kia kai i ngā kai mārama, ngā kai ngohengohe rānei , kia whakarerekē rānei i tō kai kia ngāwari te nakunaku mō tētahi wā.
Āhea ahau me rapu awhina hauora?
Rapua tonutia he awhina hauora mēnā ka pāngia koe e ēnei āhuatanga:
- Te kirika pumau.
- Te mamae tonu o te puku o runga.
- Ngā tohu o te mate i muri i te tikanga (hei tauira, te rerenga o te pūkahukahu, te whero).
- Te whakahekenga taumaha kāore i te whakamāramatia, te whakapairuaki, te ruaki rānei.
- Te kōwhai o ngā kanohi, o te kiri rānei (Jaundice).
He aha ngā pātai me pātai atu e au ki taku tākuta?
Pātai atu ki tō tākuta mō ēnei mea e whai ake nei:
- He aha te take o te whaiti o taku awaawa au?
- Ko tēhea maimoatanga te mea tino pai mōku?
- He aha ngā mahi ka taea e au te mahi hei whakaiti i te mōrearea o tēnei āhuatanga?
Me aro nui ki ngā tohu pēnei i te mamae o te puku, te kirika, te makariri, te kōwhai rānei—ina koa ka puta ohorere mai. Mēnā ka puta ēnei tohu, whakapā atu ki tō tākuta tonu kia taea ai e rātou te tautuhi i te take me te tūtohu i te tiaki tika ki Nirogi Lanka, ki tō hōhipera rānei o te rohe.
Karere hei kawe ki te kāinga: Ngā kōrero matua hei maumahara
Ko te tumanako ka āwhina tēnei tirohanga whānui i a koe kia mārama ake ki te Biliary Stricture .
- E pā ana tēnei ki te whaiti o te awaawa au, e aukati ana i te rere noa o te au.
- He maha ngā take, tae atu ki ngā kohao pokanga, ngā kohatu o te pūkahukahu, ngā pukupuku rānei.
- Kia tūpato ki ngā tohu pēnei i te mamae o te puku, te waikura, te mākūkū o te kiri, te panoni rānei o te tae o te tūtae.
- Mena ka puta mai ēnei tohu, me toro atu ki tētahi tohunga gastroenterologist i te wā tonu.
- He whai hua ngā maimoatanga, nō reira kaua e manukanuka. Mā te kitenga wawe me te maimoatanga ka puta ngā hua pai rawa atu.
- He mea nui te noho hauora hei ārai i te mate.
Mēnā he pātai anō āu, kaua e mangere ki te kōrero ki tō tākuta. Kia ora tonu koe!
