Zizindikiro za cholestasis
Zizindikiro za matenda a cholestasis zimayendetsedwa ndi a jaundice (mtundu wachikasu wa khungu ndi zotupa) zogwirizana ndi mitsempha yamdima, chotupa chamitundumitundu Ndi chimodzi pruritus (kuyabwa).
Kukachitika extrahepatic cholestasis, hepatomegaly (kuchuluka kwa chiwindi kuzindikirika pa palpation pamimba), ndulu yaikulu ndi malungo akhoza kuwonedwa ndi dokotala pakuwunika thupi.
Kutengera chomwe chimayambitsa cholestasis, zizindikiro zina zosadziwika bwino zitha kupezeka (mwachitsanzo, kuchepa thupi mu khansa).
Kuyesa kwa ma laboratory amagazi kumawonetsa:
-a kuchuluka kwa alkaline phosphatase ndiye chinthu chofunikira kwambiri pakuzindikira cholestasis.
-kuwonjezeka kwa gamma-glutamyl transpeptidase (gGT). Kuwonjezeka kumeneku sikunali kwachindunji kwa cholestasis ndipo kumatha kuwonedwa m'chiwindi ndi matenda a biliary (mwachitsanzo, kuledzera)
- kuwonjezeka kwa conjugated bilirubin, udindo wa jaundice
- zizindikiro za kusowa kwa vitamini A, D, E, K
-kuchepa kwa mlingo wa prothrombin (PT) wokhudzana ndi kuchepa kwa factor V (protein coagulation) mu hepatocellular insufficiency
Kuti mudziwe chomwe chimayambitsa cholestasis, onaniMimba ya ultrasound Kuwunika koyamba komwe kumawonetsa kufalikira kwa ma ducts a bile muzochitika za extrahepatic cholestasis. Pankhani ya intrahepatic cholestasis, ma ultrasound a m'mimba samapeza kutukuka kwa ma ducts a bile.
Monga cholinga chachiwiri, dokotala angafunikire kupereka mayeso ena a radiological:
- cholangiopancreatography (x-ray ya ma ducts a bile mutatha kugwiritsa ntchito chosiyana);
- scanner yam'mimba
- MRI (Nuclear Magnetic Resonance Imaging) ya ma ducts a bile
- ndi endoscopy
Ngati palibe vuto la ndulu yowonetsedwa ndi ultrasound, mayeso ena amachitidwa kuti awonetse chomwe chimayambitsa cholestasis:
-kuyezetsa magazi mwapadera (kufufuza ma anti-mitochondrial antibodies ndi antinuclear antibodies) kungakhale chizindikiro cha matenda a biliary cirrhosis.
- kufufuza kwa ma virus omwe amayambitsa matenda a chiwindi atha kuchitidwa
Ngati kuyezetsa kosiyanasiyana kumeneku sikunavumbulutse chomwe chimayambitsa, kuwunika kwachiwindi kungakhale kofunikira.
Mlandu wapadera: cholestasis ya mimba. - Zimapezeka nthawi zambiri m'kati mwa trimester yachitatu ya mimba ndipo ndi ngozi kwa mwana wosabadwayo. - The limagwirira chikugwirizana ndi kudzikundikira ya ndulu zidulo mu magazi amayi; ma bile acid owonjezerawa amatha kuwoloka nkhokwe ndikusonkhanitsa m'magazi a mwana wosabadwayo. - Osakwana 1% a mimba amakhudzidwa ndi cholestasis wa mimba [1] - Chiwopsezo cha cholestasis cha mimba chikuwonjezeka ngati mapasa ali ndi pakati, mbiri yaumwini kapena yabanja ya cholestasis ya mimba. -Kumaonekera ndi pruritus (kuyabwa kwambiri) makamaka m'manja ndi m'miyendo, koma thupi lonse likhoza kukhudzidwa. Ngati palibe chithandizo chamankhwala, jaundice imatha kuwoneka - Matendawa amatsimikiziridwa ndi kuyezetsa magazi kwachilengedwe komwe kukuwonetsa kuchuluka kwa bile acid -Kuopsa kwake, kochepa kwa mayi, kumatha kukhala koopsa kwa mwana wosabadwayo: kuvutika kwa mwana wosabadwayo komanso kubadwa msanga - Chithandizo cha ursodeoxycholic acid chimachepetsa kuchuluka kwa bile acid ndi pruritus -Atabereka, pruritus pang`onopang`ono kutha ndipo chiwindi ntchito kubwerera mwakale - Kuyang'anira ndikofunikira panthawi yomwe mayi ali ndi pakati. |