Cov tsos mob ntawm tus mob cholestasis
Cov tsos mob ntawm cholestasis yog dominated los ntawm a dajntoo (daj xim ntawm daim tawv nqaij thiab integuments) txuam nrog tsaus zis, quav quav thiab ib qho mob pob khaus ( khaus).
Nyob rau hauv cov xwm txheej ntawm extrahepatic cholestasis, hepatomegaly (nce nyob rau hauv lub ntim ntawm lub siab pom nyob rau hauv palpation ntawm lub plab), lub gallbladder loj thiab kub taub hau tuaj yeem pom los ntawm tus kws kho mob thaum kuaj lub cev.
Nyob ntawm seb qhov ua rau cholestasis, lwm cov tsos mob tsis tshwj xeeb tuaj yeem pom (piv txwv li poob phaus hauv qog noj ntshav).
Laboratory kuaj ntshav qhia:
-a nce alkaline phosphatase uas yog lub hauv paus tseem ceeb hauv kev kuaj mob cholestasis.
- nce hauv gamma-glutamyl transpeptidase (gGT). Qhov kev nce no tsis yog tshwj xeeb rau cholestasis thiab tuaj yeem pom hauv txhua daim siab thiab biliary ntshawv siab (piv txwv li cawv cawv)
- nce hauv conjugated bilirubin, lub luag haujlwm rau jaundice
- cov cim qhia ntawm vitamin A, D, E, K deficiency
- qhov txo qis hauv prothrombin (PT) qib txuas nrog qhov txo qis hauv qhov V (coagulation protein) hauv hepatocellular insufficiency
Txhawm rau kom paub qhov ua rau cholestasis,Abdominal ultrasound yog thawj-kab tshuaj ntsuam xyuas, qhia dilation ntawm cov kua tsib ducts nyob rau hauv cov ntaub ntawv ntawm extrahepatic cholestasis. Nyob rau hauv cov ntaub ntawv ntawm intrahepatic cholestasis, plab ultrasound tsis pom dilation ntawm cov kua tsib ducts.
Raws li lub hom phiaj thib ob, tus kws kho mob yuav tsum tau sau lwm yam kev kuaj hluav taws xob:
- cholangiopancreatography (x-ray ntawm cov kua tsib tom qab siv cov khoom sib txawv)
- un scanner plab
-MRI (Nuclear Magnetic Resonance Imaging) ntawm cov kua tsib
- ib qho endoscopy
Thaum tsis muaj qhov txawv txav ntawm cov ducts uas pom los ntawm ultrasound, lwm yam kev kuaj mob tau ua los qhia txog qhov ua rau cholestasis:
-Kev kuaj ntshav tshwj xeeb (nrhiav cov tshuaj tiv thaiv mitochondrial thiab antinuclear antibodies) tej zaum yuav qhia tau tias tus kab mob biliary cirrhosis.
- Kev tshawb nrhiav cov kab mob ua lub luag haujlwm rau kab mob siab tuaj yeem ua tiav
Yog tias ntau yam kev kuaj no tsis tau qhia txog qhov laj thawj tshwj xeeb, daim siab biopsy yuav tsim nyog.
Cov xwm txheej tshwj xeeb: cholestasis ntawm cev xeeb tub. -Nws tshwm sim feem ntau thaum lub sij hawm peb lub hlis twg ntawm cev xeeb tub thiab yog ib tug txaus ntshai rau fetus. -Cov txheej txheem yog txuas mus rau tsub zuj zuj ntawm bile acids nyob rau hauv niam cov ntshav; Cov kua tsib ntau dhau tuaj yeem hla cov placenta thiab sau rau hauv cov hlab ntsha ntawm tus menyuam hauv plab. - Tsawg dua 1% ntawm cev xeeb tub yog cuam tshuam los ntawm cholestasis ntawm cev xeeb tub [1] -Qhov kev pheej hmoo ntawm cholestasis ntawm cev xeeb tub yog nce ntxiv thaum muaj menyuam ntxaib, tus kheej lossis tsev neeg keeb kwm ntawm cholestasis ntawm cev xeeb tub -Nws manifests nws tus kheej los ntawm pruritus (khaus khaus hnyav) nyiam nyob rau hauv ob txhais tes thiab ob txhais taw, tab sis tag nrho lub cev yuav muaj kev txhawj xeeb. Thaum tsis muaj kev kho mob, jaundice tuaj yeem tshwm sim -Qhov kev kuaj mob tau lees paub los ntawm kev kuaj ntshav lom uas qhia txog kev nce hauv cov kua tsib -Qhov kev pheej hmoo, me me rau leej niam, tuaj yeem loj heev rau tus menyuam hauv plab: kev txom nyem hauv plab thiab kev pheej hmoo ntawm kev yug ntxov ntxov -Kev kho mob nrog ursodeoxycholic acid txo qhov nce hauv cov kua tsib acids thiab pruritus -Tom qab yug me nyuam, pruritus maj mam ploj mus thiab lub siab ua haujlwm rov zoo li qub - Kev saib xyuas yog tsim nyog thaum lub sij hawm cev xeeb tub tom ntej. |