Kia ako tātou i ētahi atu kōrero mō tō pūnaha biliary. He mea nui rawa tēnei!

I tēnei rā ka kōrero tātou mō tētahi pūnaha whakamiharo i roto i tō tātou tinana e āwhina ana i a tātou ki te nakunaku i te kai e kainga ana e tātou. Ko te Pūnaha Piriwai te ingoa . Kua rongo pea koe i tēnei ingoa i mua. He kupu ngāwari, he whatunga o ngā okana me ngā awa e hono tahi ana i roto i tō tātou tinana. He rite ki tētahi wheketere iti e āwhina ana i tō tātou tinana.

He aha te Pūnaha Piri? He aha tōna hiranga ki a tātou?

Āe, me titiro tuatahi tātou ki te pūnaha biliary. Koinei te pūnaha e hanga ana, e rongoa ana, e tuku ana hoki i te au ki roto i tō tātou pūnaha nakunaku ina hiahiatia. Tērā pea kei te whakaaro koe he aha te au. He wai kōwhai-kakariki te au e hangaia ana e tō tātou ate . Ko tana mahi matua he āwhina i te nakunaku i ngā kai e kainga ana e tātou, inā koa ngā kai momona.

Nō reira, he mahi nui anō tā tēnei pūnaha au. Arā, ka āwhina i te tango i ētahi o ngā para i roto i tō tātou tinana mā roto i tēnei au. Arā, ehara i te mea ka āwhina noa tēnei pūnaha i te nakunaku, engari ka āwhina anō hoki i te pupuri i te ma o tō tātou tinana. E mārama ana koe? Koia te take he mea tino nui tēnei ki a tātou.

Kei hea te pūnaha biliary? He aha ngā wāhanga matua o tēnei pūnaha?

Nā, kia tirohia tātou kei hea tēnei pūnaha biliary i roto i tō tātou tinana. Kei te wāhanga o runga o te kōhao puku. Hei whakamārama, ko te taha matau te wāhi kei reira te nuinga o ngā whekau.

He maha ngā wāhanga matua o tēnei pūnaha:

Ate: Te tohunga tunu kai o tō tātou tinana!

Ko te ate te kaitākaro matua o tēnei pūnaha. Ka hangaia e ia te au . Ehara i te mea koinā anake, engari i a ia e horoi ana i ō tātou toto, ka wehea hoki e ia ngā para pēnei i te cholesterol me te bilirubin tāpiri (e homai ana te tae kōwhai ki te au) ka tāpirihia ki te au. Ka hangaia hoki ngā waikawa au i roto i te au e te ate, e whakamahi ana hoki i te cholesterol. Ka āwhina ēnei waikawa au i tō tātou whekau iti ki te nakunaku kai. Ko te au, e kohia ana mā roto i ngā awa au tino kikokore i roto i te ate ('ngā awa intrahepatic'), ka tāpirihia ki ngā awa au nui e puta mai ana i te ate ('ngā awa extrahepatic').

Ngā awaawa au: ngā ara angiangi e kawe ana i te au

Koinei ngā awaawa e kohi ana i te au i hangaia i roto i te ate, ka haria ki te toenga o te pūnaha. Ka honoa ngā awaawa iti, ā, ka mutu, ka honoa hei awaawa nui e kiia nei ko te awaawa au noa . Ka hono tika tēnei awaawa au noa ki te wāhanga tuatahi o tō tātou whekau iti, te duodenum . Ka honoa hoki tēnei awaawa au noa ki te awaawa ate noa mai i te ate, te awaawa cystic mai i te pūhā, me te awaawa pancreatic mai i te pancreas. Whakaarohia he rite ki te whakawhitinga o ngā rori.

Pūngāwerewere: He rūma rokiroki iti

Tata ki te haurua o te au e puta mai ana i te ate ka haere tika ki te repe taiaki mā te awa au matua, engari ko te haurua ka haere ki te pūkahukahu . He okana iti tēnei, he rite ki te pēke, kei raro noa iho i te ate. Koinei te wāhi e rongoa ai, e whakawhāitihia ai te au. Ina whiwhi tō tātou whekau iti i te kai kei roto he ngako me te pūmua, me nui ake te au hei nakunaku. Kātahi ka tukuna e te whekau iti he tohu ki te pūkahukahu, e mea ana, "Āe, tukuna mai he au inaianei." I taua wā, ka whakawhāiti te pūkahukahu ka tukuna te au tāpiri mā te awa.

Pancreas: Tētahi atu kaiawhina nui

Kei muri i te puku tō tātou repe taiaki . Ka aro atu hoki te repe taiaki ki ngā tohu mai i te repe taiaki. Engari kāore e whakaputa i te au. Ka whakaputa i te ranunga o ngā whākōkī e āwhina ana ki te keri i ngā warowaihā, ngā pūmua, me ngā ngako. Ka haere ēnei whākōkī mā roto i te awaawa repe taiaki, ka kohia ki te wāhi e hono ai te awaawa repe taiaki matua ki te repe taiaki. I ētahi wā, ko tēnei kohinga, he puna iti e kohia ai te au me ngā whākōkī repe taiaki mō te wā poto, ka kiia ko te ampulla o Vater .

Te whekau iti – inā koa te duodenum: te hononga e honoa ai ngā mea katoa

Ko te wāhanga tuatahi o tō tātou whekau iti e kiia ana ko te duodenum . Koinei te wāhi e hono ai te pūnaha biliary me te toenga o tō tātou pūnaha nakunaku. Kia tae te au ki te whekau iti, ka wehea ngā waikawa au i roto. Ka tukuna ngā para e toe ana ki roto i te tūtae. Ka āwhina ngā waikawa au kua wehea ki te wawahi i ngā ngako i roto i te whekau. Kātahi ka mimitihia anō ngā waikawa au mā roto i ngā pakitara whekau ki roto i te toto ka whakahokia ki te ate. He rite tēnei ki te 'hangarua'.

He aha ngā mate noa ka pā ki te pūnaha biliary?

Nā te mea he tino hononga tata ngā okana me ngā awaawa katoa o tēnei pūnaha biliary, ki te puta he mate i tētahi wāhi, ka pā ngāwari ki ētahi atu wāhi. Ina koa, ka horapa ngā mate me te mumura ki ngā okana tata i te taha o ngā awaawa biliary. Waihoki, ki te aukati tetahi mea i te rere o te au, ka pā ki te pūnaha katoa.

Anei ētahi mate noa ka pā ki tēnei pūnaha:

• Ngā kōhatu pūkahukahu: He āhuatanga noa tēnei kua rongohia e te tini tāngata. Mēnā ka puta he kōhatu i roto i te pūkahukahu, ka noho ki roto i ngā awaawa pūkahukahu, inā koa te awaawa pūkahukahu noa, ka mamae kino te puku, ka mumura te pūkahukahu (cholecystitis), ā, i ētahi wā ka mumura te repe taiaki, ka kiia e tātou ko te pancreatitis pūkahukahu .
• Te mate kolestasis:I te kī poto, koinei te wā e puhoi ana te rere o te au, e ārai katoa ana rānei. Tērā pea nā te kore e hanga tika te au e te ate, nā te ārai rānei i ngā awa au i tētahi ara.
• Te whakawhāititanga o te awaawa o te kōpū: Mā te mumura roa o ngā awaawa o te kōpū ka puta he kiko whara, ka whaiti, ka ārai hoki i ngā awaawa. Ka puta pea tēnei i ngā mate tuku iho, i ngā mate pūnaha ārai mate rānei.
• Mate ate: Ka taea e te mate ate mō te wā roa te whakararu i te kiko o te ate, ka arahi ki te ngoikore haere o te ate. Ka kiia tēnei mate ko te cirrhosis . Kātahi ka kore e taea e te ate te whakaputa i te nui o te au.

Hei tāpiri atu ki tēnei, kei reira ētahi atu mate:

• Pankreatitis mau tonu
• Ngā pūkahukahu repeure
• Te dyskinesia biliary (te ngoikore o te mahi a te gallbladder)
• Ko te cholangitis sclerosing tuatahi
• Te mate pāwera biliary tuatahi
• Te atresia biliary (āhua whānau)
• Te ngoikore o te mimiti waikawa ale
• Matepukupuku awaawa (`Matepukupuku awaawa` / `Cholangiocarcinoma`)
• Matepukupuku ate
• Matepukupuku repeure
• Matepukupuku o te pūkahukahu
• Matepukupuku āmpulary

He aha ngā tohu o te mate pūnaha biliary? Kia tūpato ki ēnei!

Mena he raruraru kei roto i te pūnaha biliary, ka homai e tō tātou tinana ētahi tohu. He mea tino nui kia mōhio koe ki ēnei tohu.

• Te mate kiri māwhero: He āhua tēnei e kōwhai ai te mā o ngā kanohi me te kiri. Ka puta tēnei ina kore e taea e te au te rere tika, ka āraia i roto i te pūnaha, ā, ka kohia ki roto i te toto. Ka hoatu te tae kōwhai ki te au e te tae e kiia nei ko te bilirubin .
• Ko te kōroke o te puku: He momo mamae tino motuhake tēnei. I te nuinga o te wā ka puta i muri tata i te kai. Ka puta tēnei mamae ina kuiti te puku, ka tukuna te kōroke ki roto i te awa kōroke matua, ā, ka puta he ārai (pēnei i te kōhatu). Ka piki haere te mamae, ka eke ki tōna taumata teitei, kātahi ka heke haere.
• Whakapairuaki me te ruaki: He maha ngā wā ka haere tahi ēnei tohu e rua me te mamae o te puku. I ētahi wā, me te jaundice, ka puta te whakapairuaki me te ruaki tonu. Nā ngā paitini o te puku e kohia ana i roto i te toto tēnei.
• Steatorrhea: Ki te kore e tae tika ngā waikawa au, ngā waikawa au rānei ki te whekau iti mō tētahi take, kāore ngā ngako o te kai e kainga ana e tātou e nakunaku, e mimitihia rānei e te tinana. Kātahi ka tukuna ngā ngako me te tūtae. Tērā pea he hinuhinu te tūtae, ā, ka mānu i runga.

Hei tāpiri atu ki tēnei, tera pea ētahi atu tohu:

• Te mamae o te puku o runga.
• Te mimi pouri.
• Te pōhēhē, te ngoikore rānei o te hinengaro.

He mea nui: Ki te pāngia koe e tētahi, e ētahi rānei o ēnei tohu, me rapu tohutohu hauora. Ko te wawe o te tautuhi i te mate, ko te māmā ake o te rongoā.

He aha ngā whakamātautau ka āwhina i te whakatau i te hauora o taku pūnaha biliary?

Mena kei a koe ngā tohu kua whakahuatia i runga ake nei, ka tonoa pea e tō tākuta he maha ngā whakamātautau hei tirotiro i te hauora o tēnei pūnaha.

• Ngā whakamātautau toto: Mā ngā whakamātautau mahi ate (LFT) me ngā whakamātautau mahi repe taiaki ka kitea he nui ake ngā whākōkī ate me te repe taiaki. Mā te tatau toto katoa (CBC) ka kitea he nui ake ngā pūtau toto mā. Mā te nui ake o ngā pūtau toto mā ka tohu pea he mate pāwera, he mumura rānei.
• Ngā whakamātautau whakaahua: Mā ngā whakamātautau taketake pēnei i te ultrasound o te puku, te CT scan rānei ka āwhina i te whakatau mēnā he aukati, he pupuhi rānei kei hea i roto i te pūnaha biliary.
• Ngā whakamātautau whakaahua motuhake: He whakamātautau motuhake hei tirotiro hohonu ake i te pūnaha biliary. Ko ētahi tauira ko:
• Te orooro endoscopic (EUS)
• Te tirotiro ā-whatu o te ate (matawai HIDA)
• Te cholangiopancreatography aukume (MRCP)
• Ko te Endoscopic retrograde cholangiopancreatography (ERCP). Ka whakamahia tēnei hei whakamātautau, hei rongoā anō hoki mō ētahi maimoatanga.

He aha ngā rongoā mō ngā mate o te pūnaha biliary?

Ko te mea pai rawa atu, kei reira ngā rongoā whai hua mō ngā mate maha o te pūnaha biliary. Ka rerekē te tikanga rongoā i runga i te momo mate me tōna kaha.

• Te tango i te wai o te ate: He tikanga māmā noa iho tēnei. Ka mahia hei tango i te wai nui kua kohia i roto i ngā awaawa o te ate. Ka whakauruhia e te tākuta he ngongo angiangi (he katitere) mā roto i tō pakitara puku ki roto i tō pūnaha ate, ā, ka tangohia te wai o te ate mā roto.
• Maimoatanga endoscopic: I te wā o te tikanga ERCP , ka taea te whakahaere i ētahi maimoatanga mā te endoscope (he ngongo angiangi me te kāmera e piri ana). Hei tauira, mēnā he aukati, ka taea te tango, ka taea te tango i tētahi tauira kiko (he koiora), ka taea rānei te whakauru i tētahi ngongo iti ( he stent ) hei pupuri i te awaawa kia tuwhera tonu.

I ētahi wā, inā koa mō ngā āhuatanga pēnei i te kōhatu pūkahukahu, me pokanga pea hei tango i te pūkahukahu (cholecystectomy). Mō te mate pukupuku, me mahi pea ngā maimoatanga uaua ake pēnei i te pokanga, te radiotherapy, te chemotherapy rānei.

He aha tā tātou e taea ai te mahi hei pupuri i te hauora o tō tātou pūnaha ate?

"He pai ake te ārai i te rongoā." Arā, he pai ake te ārai i tētahi mate i mua i tōna putanga mai i te rongoā i muri i tōna putanga mai. Nō reira, he iti noa ngā mea ngāwari ka taea e tātou te mahi hei pupuri i te hauora o tō tātou pūnaha biliary.

• Kia mau ki te kai hauora: Kai i ngā kai māori kāore i tukatukahia (ngā kai katoa) kia rite ki te taea. Whakaitihia ngā kai he nui te huka me te ngako kukū. Mā tēnei ka ora ai tō ate, ka whakahaere hoki i ō taumata cholesterol. Kia maumahara, ko te nui o te cholesterol ka arahi ki ngā kohatu pūkahukahu me te mate ate momona.
• Whakaitihia te waipiro me te whakamahi koretake i ngā rongoā: Ko te nui rawa o te waipiro me ngā rongoā, pērā i ētahi rongoā whakamamae mamae, ngā tino take o ngā kohatu pūkahukahu me te mate ate. Mena he mate pūnaha biliary tōu, ka taea e ēnei mea te whakararu i te āhua.
• Tirohia te hauora i ia wā: Ka noho tonu ētahi mate o te pūnaha biliary i roto i te tinana mō te wā roa, kāore he tohu nui e puta. Nō reira, kaua e mahue ō tirotiro hauora ('tirotiro hauora'). Kātahi, ki te mea he mate, ka taea te kite i te wā tōmua. Kōrero hoki ki tō tākuta mō ngā rongoā e tangohia ana e koe, kia kitea ai mēnā he kino ki te ate.

Nā, ko te mea whakamutunga tino nui hei maumahara! (Karere hei tango ki te kāinga)

He wāhanga nui tō tātou pūnaha biliary o tō tātou pūnaha nakunaku me tō tātou pūnaha tohanga toto. Ki te kore e mahi tika, ka pā ki ngā mea katoa mai i tō tātou nakunaku ki tō tātou kai. Ka taea hoki e ia te tuku i ngā paitini kia kohia i roto i ō tātou tinana ka hoki ki roto i ō tātou toto.

He maha atu anō ngā mahi a ngā whekau o tēnei pūnaha, pērā i te ate me te repeure. Nō reira, ki te pāngia ēnei whekau e te mate, ehara i te mea ko te pūnaha toto anake ka pāngia, engari ko ētahi atu pūnaha e pā ana ki ēnei whekau. Nō reira, kaua e wareware he mea nui te pūnaha toto hauora mō te tinana hauora. Tiakina tō tinana, ā, ki te kite koe i tētahi mea rerekē, kaua e mangere ki te rapu tohutohu hauora.

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