Izimpawu ze-cholestasis
Izimpawu zomtholampilo ze-cholestasis zilawulwa yi-a jaundice (umbala ophuzi wesikhumba nezinsika) ezihlobene umchamo omnyama, indle eshintshe umbala Futhi eyodwa pruritus (ukunwaya).
Uma kwenzeka i-cholestasis ye-extrahepatic, i-hepatomegaly (ukwenyuka kwevolumu yesibindi etholakala e-palpation yesisu), i-gallbladder enkulu kanye nomkhuhlane kungase kubonwe udokotela ngesikhathi sokuhlolwa ngokomzimba.
Ngokuya ngembangela ye-cholestasis, ezinye izimpawu zomtholampilo ezingaqondile zingatholakala (isibonelo ukwehla kwesisindo kumdlavuza).
Ukuhlolwa kwegazi kwelabhorathri kubonisa:
-a ukwanda kwe-alkaline phosphatase okuyisici esiyinhloko ekuxilongweni kwe-cholestasis.
- ukwanda kwe-gamma-glutamyl transpeptidase (gGT). Lokhu kwanda akuqondile nge-cholestasis futhi kungabonwa kuzo zonke izifo zesibindi ne-biliary (utshwala njengesibonelo)
- ukwanda kwe-bilirubin ehlanganisiwe, ebangela i-jaundice
-izimpawu zokushoda kwamavithamini A, D, E, K
-ukwehla kwezinga le-prothrombin (PT) elixhunyaniswe nokuncipha kwe-factor V (i-coagulation protein) ekungaphumeleli kwe-hepatocellular
Ukuthola imbangela ye-cholestasis, theI-ultrasound yesisu ukuhlolwa komugqa wokuqala, okubonisa ukunwebeka kwemigudu yenyongo ezimeni ze-extrahepatic cholestasis. Esimeni se-intrahepatic cholestasis, i-ultrasound yesisu ayikutholi ukuvuleka kwamapayipi e-bile.
Njengenhloso yesibili, udokotela kungase kudingeke anikeze okunye ukuhlolwa kwe-radiological:
- i-cholangiopancreatography (i-x-ray ye-bile ducts ngemuva kokusebenzisa umkhiqizo ohlukile)
- isithwebuli sesisu
-I-MRI (i-Nuclear Magnetic Resonance Imaging) yemigudu yenyongo
- i-endoscopy
Uma kungekho ukungahambi kahle kwe-bile ducts okukhonjiswe yi-ultrasound, ezinye izivivinyo ziyenziwa ukuze kugqanyiswe imbangela ye-cholestasis:
-ukuhlolwa kwegazi okukhethekile (sesha amasosha omzimba alwa ne-mitochondrial kanye nama-anti-nuclear antibodies) kungase kube inkomba ye-primary biliary cirrhosis.
- ukusesha amagciwane abangela isifo sokusha kwesibindi kungenziwa
Uma lokhu kuhlola okuhlukahlukene kungazange kuveze imbangela ethile, kungase kudingeke i-biopsy yesibindi.
Icala elikhethekile: i-cholestasis yokukhulelwa. -Kuvela kaningi ku-trimester yesithathu yokukhulelwa futhi kuyi-a ingozi ku-fetus. -Umshini uxhumene nokunqwabelana kwe-bile acid egazini likamama; lawa ma-acid amaningi e-bile angawela i-placenta futhi aqoqeke egazini le-fetus. -Ngaphansi kwe-1% yokukhulelwa kuthinteka yi-cholestasis yokukhulelwa [1] -Ingozi ye-cholestasis yokukhulelwa iyanda uma kwenzeka ukukhulelwa kwamawele, umlando womuntu siqu noma womndeni we-cholestasis yokukhulelwa -Ibonakala ngokuluma (ukuluma kakhulu) ikakhulukazi ezintendeni zezandla nasematheni ezinyawo, kodwa umzimba wonke ungase ukhathazeke. Uma kungekho ukunakekelwa kwezokwelapha, i-jaundice ingase ibonakale -Ukuxilongwa kuqinisekiswa ukuhlolwa kwegazi lezinto eziphilayo okubonisa ukwanda kwe-bile acids -Ingozi, encane kumama, ingaba yingozi ku-fetus: ukuhlupheka kwe-fetus kanye nengozi yokubeletha ngaphambi kwesikhathi - Ukwelashwa nge-ursodeoxycholic acid kunciphisa ukwanda kwe-bile acid kanye ne-pruritus -Ngemva kokubeletha, i-pruritus iyanyamalala kancane kancane futhi ukusebenza kwesibindi kubuyela esimweni esijwayelekile – Ukuqapha kuyadingeka ngesikhathi sokukhulelwa okungenzeka okulandelayo. |