Hepatobiliary usoro. Ọrịa nke hepatobiliary usoro

Hepatobiliary usoro bụ a mgbagwoju anya multi-larịị usoro ịrụ ndị dị mkpa dị Filiks dị ka mgbaze na excretion (excretion nke metabolic ngwaahịa). The N'ihi nke ya na-aghọ mebiri emebi metabolic ọrịa, detoxification Filiks na dịghịzi nzaghachi, na antimicrobial nchedo.

Ozu ndị hepatobiliary usoro

Hepatobiliary usoro mejupụtara ndị ńsí eriri afo, imeju na-na opi mgbailu. Ya isi ebumnobi bụ guzobere na iga nke bile, nke na-emepụta site na mkpụrụ ndụ nke imeju. Ọ na-akpali site na ducts na ńsí eriri afo, nke bụ ihe ọzọ na-esite. Bile na-anakọta na ya, lekwasị ke imeju site 5-10 ugboro. Mgbe nri ọ odụk duodenum. Anatomy nke hepatobiliary usoro na mgbakwunye na imeju na-na-elu ilu eriri afo agụnye intrahepatic bile duct na na-emi odude na na imeju. Ha na-amalite dị ka a bile capillaries, jiri nwayọọ nwayọọ na-akpụ akpụ n'ime ibu opi mgbailu na-agabigaghị imeju. Extrahepatic biliary anọchi anya nkịtị hepatic na cystic general, nke ikpokọta na-etolite nkịtị bile duct.

Bile, ọrụ ya na ahu

The ọrụ nke bile, nke na-agụnye electrolytes, etisasịwo na mmiri, arọ ọla (ọla kọpa) na organic bekee (bile salts na asịd, cholesterol, bilirubin, na ọtụtụ ndị ọzọ) bụ nnọọ iche iche. Ọ bụ idem ke emulsification nke abụba na enhances hydrolysis na absorption nke protein na carbohydrates. Bile bụ mkpali ọrụ nke enzymes nke eriri afọ na pancreas, si otú na-akpali akpali usoro mgbaze na absorption nke abụba na vitamin A, D, E na K.

Na mgbakwunye na secretory ọrụ nke bile na ahu na-arụ a ọzọ usoro iwu ọrụ ịchịkwa bile guzobere na zhelchevyvedenie, na-emetụta ndị moto na secretory ọrụ nke obere eriri afọ. Ọ na-agụnye ndị inactivation peptin na hydrochloric acid, bụ akụkụ nke gastric ihe ọṅụṅụ, ọ akpali proliferation (ọzịza), na desquamation nke nsia epithelial mkpụrụ ndụ, na-emetụta ndị secretion nke imi. Ke adianade do, ọ bụ idem ke iche iche ndị na-egbu egbu dị iche iche ọgwụ ọjọọ.

imeju

Anatomy nke hepatobiliary usoro weere bụghị nanị imeju dị ka Central ngwa nke bile, kamakwa dị ka ndị kasị mkpa ngwa nke mmadụ. Ọ bụ ebe a na e guzobere ọtụtụ ahụ ike, n'ihi na 20% nke uka nke mkpụrụ ndụ na-eme ka imeju, na-mitochondria synthesize ATP. Imeju bụ kasị gland na ahụ mmadụ, nke na-enye a mgbe nile esịtidem gburugburu ebe obibi. Ọ na-arụ a Central ọrụ protein, abụba na carbon metabolism na metabolism nke ọgwụ ọjọọ. Imeju bụ nke otu n'ime ole na ole akụkụ ahụ mgbe nile ịnabata ibu, ma n'otu oge na-enwe ike na-agbake na ha onwe ha n'ime a obere oge. Na ahụ, ọ rụrụ na-esonụ na ọrụ:

• bile guzobere na zhelchevyvedenie;
• Metabolic - e wezụga eziokwu na e nwere a njikọ nke ọtụtụ bekee (protein, cholesterol, glycogen, urea) dị mkpa maka nkịtị ọrụ nke eriri afọ tract, imeju na-rụrụ mmiri mgbanwe ụkpụrụ na metabolism nke amino asịd na-edozi, carbohydrates, lipids na biologically-arụ ọrụ bekee;
• Depositary - imeju bụ ụdị akwakọba, ebe ha pụrụ ịnọ na-edozi, carbohydrates, abụba, vitamin, homonụ, minerals;
• mgbochi - neutralized n'ime ebe a ọbịa na-egbu egbu ogige natara na ihe oriri ma ọ bụ kpụrụ ke eriri afọ;
• excretory - imeju bụ ike na-egosipụta natara ya nsi na bile, nke bụ ruru ya mejupụtara ewepu ha si ahụ;
• homeostatic - njikọ pụtara na imeju, ìgwè na kewara mmiri ọbara plasma, akpan akpan immunoglobulins, components nke coagulation usoro.

Ihe mere maka mmeri nke hepatobiliary usoro

Dysfunction nke hepatobiliary usoro, akpan akpan imeju, mgbe mgbe, na-aghọ n'ihi nke ike ike ogige. Ndị a gụnyere n'ebe toxins, nje na malitere ịrịa ọnya nke free radicals. Ka hepatobiliary usoro nwere ike na-ata ahụhụ n'ihi na nke dị iche iche mmiri ọgwụ na metabolic ọrịa, ogbenye oriri na-edozi, agụụ na-anata pharmaceuticals, ịṅụbiga mmanya ókè. Nchegbu nwekwara ike nwere bukwanu mkpa omume nke dị iche iche pathologies.

Types of ọnya nke hepatobiliary usoro

Nkà mmụta ọgwụ ọgbara achoputala na-esonụ ụdị nke ọnya na-eme ka a mebiri nke hepatobiliary usoro:

• Mitochondrial - ndị ọnya ịzụlite na cellular larịị ma na-na a ele mmadụ anya n'ihu mgbochi nke enzymes nke akụkụ okuku ume yinye. Ọtụtụ mgbe ha bụ n'ihi nke eji ọgwụ nje (tetracyclines), alụso nje virus ọgụ mmadụ, parenteral oriri na-edozi. Ngosipụta nke ndị dị otú ahụ ọnya aghọ fibrosis ekwe omume mgbe ụfọdụ proliferation nke opi mgbailu.
• Proteinosis emee ya ruru ka mebiri nke protein njikọ. Ọtụtụ n'ime ndị ọnya bụ n'ihi ogologo n'ebe na-egbu egbu (mmanya, ọgwụ ọjọọ, malitere ịrịa na nje mbibi, nsị).
• Fibrosis eto ka a n'ihi nke ọgwụ wee merie. Ọtụtụ mgbe ha na-akpọ cytotoxic ọgwụ ọjọọ. Ọ na-egosi uto nke fibrous anụ ahụ, nke a na-enye nsogbu ọbara na-akpata na-abawanye na mgbali na portal akwara na disrupts ịrụ ọrụ nke imeju mkpụrụ ndụ.
• Cholestasis - mbenata ego nke bile abanye na duodenum, ma ọ bụ enweghị ya. Ihe kpatara nke a nwere ike ịbụ a n'ibu mgbochi (gallstones) ma ọ bụ ọrịa ịda n'ogo nke mkpụrụ ndụ nke na imeju na-intrahepatic opi mgbailu.
• Vaskụla ọnya - nwere ike ime na ọkwa dị iche iche nke ya vaskụla netwọk si capillaries na-agwụcha na meriri nke ọbara bed vaskụla usoro na Portal akwara.
• Ndim nke bile - a daa ọrịa nke hepatobiliary usoro mgbe amalite ruru ka mkpọchi nke bile duct ma ọ bụ bile mucous plọg. Ọtụtụ mgbe ọ na-adị na ụmụ ọhụrụ na-ejikọta ya na esemokwu nke RH-akpata.

mgbaàmà

Ọrịa nke hepatobiliary usoro, agbasaghị nwere a kpọmkwem na-abụghị kpọmkwem ihe mgbaàmà. Iji na-agụnye ndị na-abụghị kpọmkwem ihe mgbaàmà nke igbu egbu, gosipụtara lethargy, ike ọgwụgwụ, n'adịghị ike na fever n'oge exacerbation. Ha na-metụtara ebelata imeju detoxification ọrụ na o kwere omume reabsorption nke bile ma ọ bụ ọrịa na a protein, carbohydrate ma ọ bụ vitamin mgbanwe. Specific mgbaàmà na-agụnye ndị mgbaàmà na-erukwa na mgbe otụk ozugbo hepatobiliary usoro. Ndị a gụnyere:

• dị iche iche na digestive ọrịa (ọgbụgbọ, arọ na nri elu quadrant, adịkarịghị vomiting mere site nri iwe, afọ ọsịsa);
• abdominal mgbu "afo" ma ọ bụ metụtara nanị akụkụ ụfọdụ na nri, na-emekarị na-ewere ọnọdụ mgbe a na abụba nri ma ọ bụ na-ese siga;
• akpụkpọ ngosipụta (ududo veins, xanthomas, pigmentation ọrịa, jaundice);
• Ascites - ìgwè ọmụmụ na abdominal uji eze;
• venous nkwalite ụkpụrụ na n'afọ;
• ọnụnọ nke imeju ume.

Imebi nke hepatobiliary usoro na ụmụ

Hepatobiliary usoro na ụmụ bụ ihe na-erughị nkịtị karịa okenye gụrụ mbufụt mere site na-efe efe ihe. Ọtụtụ ihe ndị ọzọ mgbe ọ daa ọrịa metụtara na ọtọ ọrịa. Ha nwere ike chọpụtara na ụmụaka nọ n'afọ ndụ nile, ma ọtụtụ mgbe, ha na-ata ahụhụ ụmụ akwụkwọ. Nke a bụ n'ihi na-abawanye na uche, mmetụta uche na nke anụ ahụ nchegbu, nakwa dị ka na a mgbanwe nke nri. Mkpa na-eme ọtọ ọrịa amụbawo ibu na mmiri ọgwụ na-agbanwe n'ahụ nke nwa. The akacha chọpụtara na oge a, biliary dyskinesia, adịkarịghị - holetsistoholangity na cholecystitis.

Ọ kpebiri igbunye isi na nke sekọndrị, ọnya nke hepatobiliary usoro. The isi lesion nwere ike na-metụtara ndị akpụpụta abnormalities nke biliary tract, na ihe ọjọ nke sphincters na mezie ije nke bile, akpan akpan, na sphincter nke Oddi. Secondary dysfunction nwere ike ime ndị na-esonụ pathologies:

• gastroduodenal (peptic ọnyá afọ, duodenitis);
• daa ọrịa nke pancreas;
• metabolic ọrịa;
• parasitic ọrịa.

nchọpụta nsogbu

N'agbanyeghị ịrịba rụzuru na oge a hepatology, kwuru, uto nke dị iche iche na ọnya nke biliary tract na ha ọchịchọ-adịghị ala ala na ogologo okwu, protracted N'ezie, mere nnọọ ihe ozugbo nchoputa bụ paramount. Na mgbakwunye na e mere na, anamnesis na laabu ọmụmụ, ndị kasị ihe ọmụma nke nwere ike na-ewere dị ka ọbara onwu, chọpụta ọtọ ala enyemaka na-esonụ ụzọ nke nchoputa nke hepatobiliary usoro.

1. Agbakọrọ tomography - ọtụtụ mgbe rụrụ nyochaa biopsy anụ ahụ nke abdominal uji eze, ndị kasị ọmụma igba ogwu n'akwara ochichi nke iche media.
2. MRI - rụọ ọrụ nke ọma iji mata dị iche iche ọnya nke imeju anụ ahụ na cysts, na-enye ohere inyocha na ịchọpụta vaskụla mgbanwe oncological Filiks.
3. Radionuclide ịgụ isiokwu - inwale na excretion nke bile dị iche iche mgbanwe imeju anụ ahụ, mata neoplastic Filiks, mkpali ọnya na-amata patency nke biliary ducts.
4. Cholangiography ekpughe nkume na etuto ahụ na bile duct, nakwa dị ka ọnụnọ nke ọzọ pathologies fistulas na biliary tract. Ọzọkwa, ọ na-enye ohere nnyocha iri samples of bile na bile duct epithelium na-abanye na catheter na-eduzi drainage nke bile, opi mgbailu ịgbatị na-abanye na preparations dissolving calculi (gallstones).
5. Angiography inwale ọbara na portal na hepatic veins. Ọ bụ oge dị oké egwu na esi nchoputa nke cancer ọnya nke imeju.
6. Ultrasonography nke hepatobiliary usoro bụ ihe kasị dị mfe, ọnụ na ihe ọmụma usoro nnyocha. Ọ na-ewetara ndị na nkume na gallbladder na opi mgbailu optimally ịchọpụta ascites.

Ultrasonography nke hepatobiliary usoro

Ọzụzụ, nke a chọrọ iji mezuo nke a nnyocha, dị nnọọ mfe, ma ọ dị mkpa iji nweta nkọwa zuru ezu. Ya ihe mgbaru ọsọ bụ jirichaa Mbelata nke ego nke gas na eriri afọ na bowel loop mere abụghị nso nyochaa nke na-enyocha akụkụ. Iji mee nke a, na Iv nke nnyocha e mere na mkpa na-akpa àgwà a ọcha enema ma ọ bụ iri a laxative. Jirichaa mmetụta nke usoro bụ, ụbọchị atọ tupu ihe omume dị mkpa ka ị na-eso a na nri, na-ebelata usoro nke gasification. Ọ ga-rụrụ na ihe efu afo, na nri ikpeazụ oge kwesịrị dịkarịa ala 8 awa.

Diet n'ihu ultrasound

N'oge ultrasound nnyocha nke hepatobiliary usoro ọzụzụ ga-agụnye, na mgbakwunye na ihicha usoro, nri, na mbenata flatulence. Ebe a na-na ụkpụrụ:

• Nutrition kwesịrị a nta - dịkarịa ala ugboro anọ a ụbọchị, na nri ikpeazụ kwesịrị dịkarịa ala awa 2 tupu alakpu ụra.
• Olu nke mmiri mmiri ga-ebelata ka otu na ọkara lita.
• Wezuga si nri na ngwaahịa, nke na-agụnye yist, abụba anụ ma ọ bụ azụ, agwa, sugar, ike tii na kọfị, carbonated ma ọ bụ na-aba n'anya.

Hepatobiliary usoro-eme ọtụtụ ihe dị mkpa na ọrụ na ahụ mmadụ, na-adọ nchọpụta nke imebi ya ọrụ ga-enyere aka igbochi ọtụtụ nsogbu n'ọdịnihu.