Maselo akuluakulu a chiwindi, hepatocytes amachita zambiri zofunika kwambiri: kusefa magazi, kuchotsa poizoni, kusunga ndi kaphatikizidwe ka shuga, ndi zina zotero.

Chiwindi chambiri chimakhala ndi ma hepatocyte omwe amapangidwa mozungulira, pomwe amazungulira ma capillaries amagazi ndi mafunde otentha a biliary. Mafakitole enieni a biochemical, ma cellwa amatha kutenga poizoni omwe amayenda m'magazi ndikuchotsa zinyalalazi mu bile. Koma iyi si ntchito yawo yokha, chifukwa amasunganso ndikupanga zinthu zambiri zofunika m'thupi: shuga, triglycerin, albumin, mchere wa bile, etc.

Popanda ntchito hepatocytes, moyo wa thupi si upambana maola angapo. Maselo amenewa amaperekadi ntchito zambiri zofunika, kuphatikizapo:

• lkasamalidwe ka shuga : pakakhala hyperglycemia, kapamba amatulutsa insulini, yomwe imayambitsa kuyamwa ndi kusungidwa kwa shuga wamagazi ndi hepatocytes. Mosiyana ndi zimenezi, pakakhala hypoglycemia, imatulutsa glucagon, kulimbikitsa ma hepatocytes kuti amasule mphamvuyi m'magazi;
• kutulutsa magazi : hepatocytes kuchotsa magazi a poizoni (mowa, mankhwala, mankhwala, etc.), ndiye kuwachotsa ndi bile; 
• kutulutsa kwa bile zomwe, zosungidwa mu ndulu, zidzatulutsidwa m'matumbo panthawi ya chimbudzi. Izi zimakhala ndi zinyalala zomwe zimachotsedwa m'magazi ndi bile acids, zomwe zimatha kuphwanya lipids zomwe zimalowetsedwa ndi chakudya mu triglycerides, "mafuta" ena a thupi;
• kaphatikizidwe wa triglycerides kuchokera ku shuga ndi mowa. Awa ndi mafuta acids omwewo monga tafotokozera pamwambapa. Mofanana ndi iwo, amatengedwa ndi magazi kupita ku maselo omwe amawafuna (minofu, etc.) kapena kusungidwa mu minofu ya adipose;
• kupanga zinthu zomwe zimapangitsa kuti magazi aziundana, kutanthauza kuti mapuloteni amene amaundana magazi.

Hepatic steatosis

Ndiko kudzikundikira kwa triglycerides mu hepatocytes. Matendawa amatha chifukwa chomwa mowa mopitirira muyeso komanso - ndipo nthawi zambiri zimachitika - amakula mwa odwala omwe samamwa koma onenepa kwambiri kapena omwe ali ndi matenda a shuga amtundu wa 2. non-alcoholic mafuta a chiwindi matenda (NAFLD).

Hepatic steatosis imakhalabe yosadziwika kwa nthawi yayitali isanayambitse matenda a chiwindi. Ndi kuyankha kotupa kumeneku komwe nthawi zambiri kumabweretsa kupezeka kwa ma pathology.

chiwindi

Kutupa kwa chiwindi, matenda a chiwindi amatha chifukwa cha matenda a chiwindi chamafuta, komanso kachilombo kamene kamachulukira mu hepatocytes (ma virus a hepatitis A, B kapena C), kuledzera kwamankhwala, kukhudzana ndi mankhwala oopsa kapena, kawirikawiri, autoimmune matenda.

Zizindikiro zimasiyana mosiyanasiyana malinga ndi vuto: 

• malungo;
• kusowa chilakolako cha chakudya .
• kutsegula m'mimba;
• chisokonezo;
• kupweteka kwa m'mimba;
• jaundice;
• etc.

Atha kukhala ofatsa kapena okhwima, amachoka okha, kapena kulimbikira. Mwachitsanzo, matenda a chiwindi C amakhala aakulu mu 80% ya milandu, pamene matenda a chiwindi A amatha kutha mwadzidzidzi. Matendawa amathanso kukhala osazindikirika, ndipo amapezeka pokhapokha atakula mpaka ku cirrhosis kapena khansa.

Cirrhosis

Ngati kutupa kwawo kosalekeza sikusamalidwa, hepatocytes imatha kufa imodzi pambuyo pake. Chiwindi ndiye pang'onopang'ono kutaya ntchito zake.

Ndi mawonekedwe a vuto limodzi kapena zingapo zomwe nthawi zambiri zimabweretsa kupezeka kwa cirrhosis: kutuluka kwa magazi m'mimba, ascites (kutuluka m'mimba komwe kumalumikizidwa ndi kuchuluka kwamadzimadzi m'matumbo a peritoneal), jaundice (jaundice pakhungu ndi diso loyera), mkodzo wakuda), khansa, etc.

Khansa ya chiwindi

Hepatocarcinoma, kapena hepatocellular carcinoma, imayamba mu hepatocyte yomwe, itakhala yachilendo, imayamba kufalikira mwankhanza ndikupanga chotupa choopsa. Ndikosowa kwambiri kuti mtundu uwu wa kuvulala uchitike pachiwindi chomwe chinalibe steatosis, hepatitis kapena cirrhosis.

Kutaya thupi mosadziwika bwino, kusowa kwa njala, kupweteka kwa m'mimba, nseru ndi kusanza, kutopa kwakukulu, maonekedwe a chotupa m'chiwindi, makamaka ngati akugwirizana ndi jaundice , ayenera kukuchenjezani. Koma chenjerani: zizindikiro izi ndizofala kwa ma pathologies ena a chiwindi. Ndi dokotala yekha amene angadziwire matendawa.

Zowonjezera nodular hyperplasia

Focal nodular hyperplasia ndi kuchuluka kwa hepatocytes m'chiwindi, zomwe zimapangitsa kuti ziwonjezeke kukula. Mafupa amtundu wa 1 mpaka 10 cm amatha kuwoneka. Zotupazi, zosawerengeka komanso zosaopsa, zimayamikiridwa pomwa njira zakulera zapakamwa kapena mankhwala opangidwa ndi estrogen. Zovuta zawo ndizosowa. Ichi ndichifukwa chake ndizosowa kuwachotsa opaleshoni.

Pochiza mogwira mtima komanso mokhazikika zomwe zimayambitsa matenda a chiwindi (mankhwala oletsa tizilombo toyambitsa matenda, kusiya mowa, zakudya zochepetsera thupi, kuwongolera matenda a shuga, ndi zina), matenda a cirrhosis amatha kupewedwa kapena kuyimitsidwa. Ngati minofu yawonongeka kale, sichitha, koma chiwindi chotsalira sichidzakhalanso. Ngati matenda a cirrhosis apita patsogolo kwambiri, kungoyika kokha kungabwezeretse ntchito yachiwindi yoyipa, pokhapokha ngati pali kumezanitsa.

Pakakhala khansa, gulu lamankhwala limakhala lalikulu:

• kuchotsedwa pang'ono kwa chiwindi;
• kuchotsedwa kwathunthu kotsatiridwa ndi kumuika;
• kuwonongeka kwa chotupa ndi ma radiofrequencies kapena ma microwave;
• electroporation;
• mankhwala;
• etc. 

Njira yochiritsira imadalira zinthu zingapo, kuphatikizapo kuchuluka kwa zotupa, kukula kwake, siteji yawo ndi chikhalidwe cha chiwindi.

Poyang'anizana ndi zizindikiro za matenda a chiwindi, kuyezetsa magazi kumatsimikizira kukhudzidwa kwa chiwindi (hypoalbuminemia, etc.). Ngati palibe kachilombo kamene kamapezeka m'magazi, ultrasound idzaperekedwa, kuwonjezeredwa ngati kuli kofunikira ndi MRI, CT scan kapena Doppler ultrasound. Kuphatikiza apo, biopsy ikhoza kufunsidwa.