Pfungwa nomuviri zvemwana asati pseudotumor: zvinokonzera, zviratidzo uye kurapwa mamiriro

Pfungwa nomuviri zvemwana asati pseudotumor - mufananidzo-refu yaivapo chisingapere pfungwa nomuviri zvemwana asati pamusoro. The chirwere chinobata vanhu kakawanda kupfuura vakadzi. zvokurwara The zita rinobva mushoko rechiGiriki "rwatata" - rwatata, "itis" - kuzvimba uye "bundu" - bundu. Izvozvo chaizvoizvo rakashandurwa zvinogona kudaro - kuzvimba rwatata kuti mimics ari neoplastic muitiro.

Pseudotumor pfungwa nomuviri zvemwana asati: Kunokonzerwa, Zviratidzo

Sembura zvinhu kukura chirwere ichi chiri zvokurwara hepato-biliary hurongwa (semuenzaniso, CL) uye kushandisa doro kuripo. Ndoda - mishonga nezvimwe zvirwere dzokurapa. Kazhinji, pfungwa nomuviri zvemwana asati pseudotumor ndiyo migumisiro ine chirwere kushoma munyika rwatata uye nyama ndoda (vanenge 10% chiitiko) nayo padzakacherechedza pashure rikwanise kuzvimba.

Pokumuka zviratidzo pamusoro yaitwa cholelithiasis kazhinji hwakanyorwa vakadzi. Zvisinei, kwete chete zvingava precipitating chinhu zvikuru pano uye vane malformations ari biliary ezvinhu, zvirwere bile mutsinga dzinofamba nemukaka kana papilla kuti Vater. Muzviitiko izvi, chokutsva kukura somugumisiro kuramba kukanda bile kupinda pancreatic mutsinga dzinofamba nemukaka.

Imwe nzira kukura pseudotumor pfungwa nomuviri zvemwana asati kunogona lymphogenous kukundwa rwatata rinenge (kazhinji shwanu musoro nharaunda), apo kuzvimba anoparadzira kubva gallbladder kuburikidza nhengo dzinobudisa nodes uye nemidziyo.

In zvakawanda zvisingawanzoitiki Muzviitiko, pseudotumor chimiro chisingaperi pfungwa nomuviri zvemwana asati kunogona kuitika pamusoro yaitwa kushandisa estrogen, acetaminophen uye zvimwe zvinodhaka kwenguva refu kana takura nhaka. Uye kana nhaka etiology, chirwere mberi vachishingaira, izvozvo kunowedzera mukana wokuti malignancy (malignancy), uye simbi kushaikwa iri kukura nokukurumidza.

zvekuchipatara kuratidzwa

The symptomatology nzira iyi pfungwa nomuviri zvemwana asati chokuita compression pamusoro biliary turakiti, kwemakemikari anobudiswa kutadza uye kushaya pancreatic makemikari kuti vanobatanidzwa munyaya kugaya. Uyezve, namamota varipo zviratidzo uye kurwadziwa pakati yokuora kuratidzwa. Initial Danho Pseudotumor siyana zvingava asymptomatic.

Asi varwere vakawanda kupa zviratidzo chirwere zvinotevera:

• jaundice;
• nebhanhire marwadzo kuti kunoitika pashure ingestion kana rikwanise mafuta zvokudya, chero doro kana nokudyisa;

• undigested zvokudya pachituru ;
• kuda kurutsa, zvichiteverwa kurutsa, kunozorodza;
• "Bold" mutsvina yadzo (steatorrhea);
• manyoka rakatumbuka pamwe kupatirwa;
• kuderera mune shuga shiviriro;
• causeless uremu;
• palpation - musoro gasket rwatata;
• kuwedzera kenza.

Zvigadziriswe chitarisiko huru zviratidzo

Ari zvinorondedzerwa chirwere chiri kuwedzera rwatata, izvo chokuita panowanikwa cysts (pseudotumor chisingaperi pfungwa nomuviri zvemwana asati, pancreatic chikofu), lipomatosis kukura uye autoimmune maronda.

kazhinji kuzvimba kunokanganisa rwatata musoro - nzvimbo mbudo huru pancreatic mutsinga dzinofamba nemukaka. Somugumisiro, yokupedzisira ari kujekesa, uye pancreatic muto stagnates mumuviri. Somugumisiro, mashoko mutsinga dzinofamba nemukaka izere, uye kumanikidzwa mairi ari kukura. Makemikari zviri muto, vanotanga kugaya kuti pancreatic zvinyama, iyo inosvitsa panowanikwa irwadziwe chirwere, iro kunowanzoguma zvakakwana pseudotumor muchimiro pfungwa nomuviri zvemwana asati.

obstructive jaundice

Mune mashandiro kuti chiratidzo ichi chinoita hukuru basa kenza chakawedzerwa musoro, kudzvinya choledoch (bile mutsinga dzinofamba nemukaka). Somugumisiro bile ari chiropa haagoni ichiyerera kupinda duodenum, nokuda izvo nevamwe kupa kunowedzera uye bile zvishoma nezvishoma anopinda ropa rukova.

Huru akanyunyuta obstructive jaundice vari rakabuda ruvara mutsvina yadzo, zvikuru kuvaviwa, rima weti, uye yellowing ganda uye sclera.

How kuwana pseudotumor pfungwa nomuviri zvemwana asati kana kenza murwere

Akatsanangura chirwere zvinoreva kuti vakatorwa nhoroondo yose zvichemo zvekuchipatara zvinoratidza chirwere uye kuti asava zvimwe zvirwere, kwete chete rwatata (semuenzaniso, kenza), asiwo pedyo zvomukati, zvakafanana zviratidzo. Nokuti chinangwa ichi zviri fanira:

• gastroenterologist kubvunza.
• Nhoroondo Medical zvichemo (asati pfungwa nomuviri zvemwana asati, cholelithiasis, mishonga, kunyunyuta kurwadziwa zvakarurama yepamusoro quadrant uye epigastric nharaunda, uye vamwe).
• Kuongorora murwere nomufambiro palpation (zvichibvira chisimbiso uye unyoro munzvimbo rwatata).
• miedzo ropa. Nokuti akapiwa muchimiro pfungwa nomuviri zvemwana asati ane maitiro kuwedzera kwevari trypsin, amylase uye lipase, havachanyatsogoni shuga kushivirira.
• Kutsunga bundu zvezvinangwa uye pancreatic polypeptide (kubvisa kenza). By kuwedzera uwandu carcinoembryonic antigen, CA 125, CA 19-9, pancreatic polypeptide, bundu chirwere akatsinhira, uye kana kuderedza-pamusoro apa zvinhu kugumisa pamusoro pamberi kuzvimba, iyo inosimbisa chirwere "pfungwa nomuviri zvemwana asati pseudotumor".
• US rwatata (pamberi hypertrophy, uye kuchinja chimiro ducts shwanu zvinyama, kusavapo / kuvapo calcifications).
• CT kana MRI (kuti asava nyanyisa neoplasms).
• ERCP. kuri chidobi kuchinja pancreatic mutsinga dzinofamba nemukaka.
• Kusarudza tseliakografiya (kutsunga ezvinhu pancreatic midziyo).

kurapa

Pseudotumor pfungwa nomuviri zvemwana asati, izvo kurapwa mune rikwanise nguva iri rakaitirwa gastoenterologii, dzinoratidzwa undulating kosi (kureva alternation pamusoro remissions uye exacerbations).

Kurapa chirwere ichi inosanganisira kugadzwa kuva neusimbe kudya (tafura №5). Achirega kakawanda kudya (mashanu katanhatu pazuva), asi zvikamu zviduku. Cooking nzira: Kubika uye kubika, kashoma - richipedza. Wairambidza nuna zvakakangwa zvokudya, mazai zvakakangwa, tii simba, kofi, zvakasimba unongoshanda uwandu nyama (kunyanya nyama yenguruve) uye mukaka.

Chikuru muupenyu yokurapa iri etiotropic kurapwa, kureva kubviswa precipitating zvinhu (doro, zvinodhaka) uye zvikonzero kwakaparira izvi. Somuenzaniso, kana matombo omunduru - cholecystectomy, uye zvichingodaro.

Drug kurapwa zvinofanira zvainanga anoruramisa intra- uye exocrine shwanu insufficiency. Kuti aite izvi, kushandisa mishonga, makemikari, "Pancreatin" pachiimbwa "Solizimom" kana "lipase". Kuderedza steatorrhea akashandisa antacids uye calcium yakawanda zvokuwedzera.

Kuitira kuderedza dyskinesia raitongwa anticholinergics. Nokuti ruyamuro chakakomba marwadzo chirwere akashandisa antispasmodics kana "Atropine". Sezvo inobudirira nzira spasmolytic sphincter pamusoro oddi vanoshandisa "Mebeverin" kana "Gimekromon". Izwi exacerbation kurapwa zvinosanganisira tupukanana. Kana zvinodhaka kurapa hazvideredzi mumatenhere prostate, uye hypersecretion, ipapo kugadza yomunharaunda hyperthermia (local) kana munhu remunharaunda nemwaranzi chokupfeka.

Kunze kurapwa izvi, kazhinji yakakwana Pseudotumor pfungwa nomuviri zvemwana asati kuitisa endoscopic kuvhiyiwa (semuenzaniso, papillosphincterotomy) zvakagadzirirwa decompress yacho ductal hurongwa. chipingaidzo kwakadaro abudirire kana strictures prepalillyarnogo kadhi, papillostenoze, Zvakawanikwa rwatata musoro, achiperekedzwa obstructive jaundice uye compression zvakafanana bile mutsinga dzinofamba nemukaka.

dziviriro

Matanho ari nechirwere kuti "pfungwa nomuviri zvemwana asati pseudotumor" kuderedza, kunyanya, kuti kusiyiwa wokushandiswa doro. Zvinokoshawo kuti zvakakwana uye nenguva kurapwa zvirwere kuti kungamutsawo zvokurwara ichi. Zvinobatsira kudzivirira chirwere uye ndigadzirise, kudzora mazvikokota negashiro zvinodhaka nengozi.

mataridzikiro

Maberere panguva panowanikwa pfungwa nomuviri zvemwana asati akatsanangura fomu nekaupenyu zvakanaka. chirwere ichi hakuwanzowaniki pamwe exacerbations uye kufambira mberi zvishoma nezvishoma, uye kwemakemikari anobudiswa insufficiency kashoma rinobatanidza pave renal kukuvara uye angiopathy. Kufambira mberi chirwere chinogona akambopedza kugadzwa nenguva kurapwa uye Implementation pakati kunenge ari kupinda chiremba panguva yatinenge kanganwiro. Stay utano!