Klatskin ƙari: halaye, cututtuka, magani, hangen nesa

Cholangiocarcinoma, a duniya kiwon lafiya al'umma zuwa statistics, game da 2% na dukkan sankara, kazalika har zuwa 10% na lokuta na hanta da kuma biliary fili ciwon daji. A daidai wannan ganewar asali na irin wannan ƙari ne sosai low: kawai 1.5-2%. Ƙari Klatskin mai suna bayan da sani akan cututtuka Gerald Klatskin, wani likita daga Amirka. A shekarar 1965, yayin da aiki a Jami'ar Yale, ya aka dogaro da 13 lokuta, ya bayyana duk siffofin da wannan cuta.

Cholangiocarcinoma, ko hanta ciwon daji, da kuma bile bututu

Klatskin ƙari - wani hatsari cutar. Domin wannan neoplasm halin da jinkirin girma da kuma daga baya ci gaban metastases. Saboda marigayi ganewar asali da kuma rashin iyawa ga hannu fita kau da aikin tiyata, ya high cuta mace-mace. A ganewar asali a mafi yawan lokuta yana sanya a kan karshen matakai na raya kasa na ilimi, wanda zame tiyata. A ci gaba da metastases aka kai tsaye fallasa da hanta, hanta ƙofofi, yankin Lymph nodes da ciki. Ƙari girma ya auku daga hanta epithelial Kwayoyin. Cũta da aka kafa, yafi bayan shekaru 50, amma a kowace shekara da shekaru na marasa lafiya da aka rage. Maza mãsu dan kadan ya fi saukin kamuwa da cutar fiye da mata.

A m hanyar da ƙari

Sanadin hanta cholangiocarcinoma ne ba a sani ba. Amma masana kimiyya sun sami sakamakon abin da kara hadarin siffofin maruran. Tare da wani tarihi na farko sklerotiziruyuschego cholangitis a 40 marasa lafiya daga 100 lokuta za a iya kafa Klatskin cuta. Ƙari kafa a 25 lokuta daga 100 kan gaji cututtuka, kamar Caroli cuta. Kumburi dauki saboda intrahepatic parasites iya haifar da ciwon daji.

Miyagun halaye da shafi kiwon lafiya na hanta: shan taba, barasa zagi, matalauta rage cin abinci, entailing kiba - indisputable dalilai domin cuta ci gaban. A gaban cholelithiasis qara damar siffofin maruran. A hadarin ne mutane da fallasa su shafe tsawon lamba tare da gubobi da abubuwa masu cutarwa. Kwayar cututtuka, da farko hepatitis, taimakawa ga ci gaban da cutar daji.

symptomatology cholangiocarcinoma

Tun da m ƙari a cikin hanta da wuya a gane asali, dole ne ka saurare jikinka ga farkon ganewa na cuta Klatskin. A ƙari iya halin da cututtuka kamar:

• babban alama da cutar - obstructive jaundice.
• m itching abin mamaki.
• wani nagging zafi a cikin sama dama na ciki.
• asarar ci kuma saboda haka m nauyi asara.
• gajiya, halayyar ƙari samuwar.
• a dagagge zafin jiki Klatskin marurai ma faruwa.
• canje-canje a cikin fitsari da kuma stool launi (duhu fitsari, stool da kuma m).

Alamun bayyana ba zato ba tsammani da kuma ci gaba. Jaundice samu a 90 lokuta daga 100, kuma yana daya daga cikin mafi m ãyõyin wata cuta kamar ciwon daji a Klatskin. Sharhi kan marasa lafiya, wani lokacin sãɓawa jũna. Wasu marasa lafiya ruwaito riko itching, zafi da kuma kwatsam nauyi asara. Wadannan manifestations ne saboda ci-gaba matakai na m siffofin maruran. Amma wasu ba su ji kusan babu sabawa a kiwon lafiya matsayi ko nasaba bayyanar cututtuka bayyana tare da sauran cututtuka.

Ƙari kanikancin Klatskin

Domin ganewar asali ne da za'ayi a yawan asibiti karatu cewa zai iya gaya tare da daidaito gaban Klatskin cuta. A ƙari ne a fili a bayyane a kan duban dan tayi a cikin nunawa na'ura. Wannan shi ne wani fairly tattali, abokantaka da kuma saukin m Hanyar. Da taimakon karkace CT sauki gane tafka magudi a cikin gall mafitsara, hanta lalacewa, da kuma ganin Lymph nodes. Amfani MRI (Magnetic rawa Hoto), gabatarwar bambanci ruwa zuwa hanta da high daidaituwa domin sanin halin da hanta da nama da kuma mataki na takaita na bile bututu a ganewar asali Klatskin ƙari. Photography nuna duk sassa na hanta da bile ducts.

Fluoroscopic da radiographic binciken ya nuna matsalolin da biliary hanyoyi. Kan aiwatar da ganewar asali yana gabatar da bambanci wakili, wanda damar ganin kwarara daga bile. Biochemical jini gwaje-gwaje don taimaka ƙayyade da matakin na enzymes kuma bilirubin. Su kuma za a iya sanya gwaje-gwaje don gane ciwon daji tel: CA 199, CA 125.

Popular sau da yawa, ƙari matakai isa hanta jijiya da kuma portal jannayẽnsa wadata jini da hanta. Kafin tiyata yana da muhimmanci sosai staging marurai, domin ya bayyana ko cutar ya yaɗu zuwa jini. A wasu lokuta, irin wannan ganewar asali ne wuya, sa'an nan tambaya ta sikelin da aka warware resection a lokacin tiyata.

Hanyar zalunta neoplasms

Untreated marasa lafiya a mafi yawan lokuta cikin tsawon rayuwar jama'a a watanni 6 bayan tabbatar da dalilin da wani cikakken ganewar asali. A farkon matakai da wuya bayyanãwa Klatskin cuta. A ƙari ne amenable ga karshen matakai na lura shi ne quite tasiri.

Surgery - daya daga cikin manyan hanyoyin da za a bi da ƙari. Duk da haka, a cikin aiki da shi yana da wani low dokin rayuwa (nufi 20%) saboda da marigayi ganewar asali. cikakken kau na lalace rabo daga bile bututu da ake amfani da su cimma wata kyau sakamako a cikin tarayya, tare da kau da daya lobe daga cikin hanta, domin kauce wa kamuwa da cuta daga jini.

Surgery ne zai yiwu a 'yan lokuta:

• ilimi ba zai shafi jijiyoyi na hanta. a wannan harka zai yiwu a cire duka rabo ko sulusi da murabba'i na lalace hanta.
• ilimi ba zai shafi bile bututu na daya ko biyu lobes na hanta.

Dauke unresectable cuta, a lokacin da ƙari ratsa cikin jini na hanta ko bile ducts na biyu da rabo.

Palliative magani

A inoperable lokuta ko matsayin adjunct far amfani da palliative kiwon lafiya.

Wadannan hanyoyin sun hada da:

• magudanun ruwa na biliary fili.
• jiyyar cutar sankara.
• radiation far.
• kewaye tiyata.
• photodynamic far.
• vysokosfokusirovannymi sakawa a iska mai guba na ultrasonic bim.

By hada da dama hanyoyin kwantar da hankali, guda biyu tare da farkon ganewar asali, rayuwa Hasashen za a iya karu daga 10 zuwa watanni 5 shekaru.

A hangen nesa bayan lura

Saboda gaskiya cewa samuwar marurai a cikin hanta ne m isa, da rayuwar jama'a ne daga rabi zuwa shekaru biyar. Complete kau na lalace yankunan iya ƙara rayuwa span ga m da kuma dace ganewar asali na cutar Klatskin. Marurai samu a cikin hanta, yana da ya fi karfinsu kintace. Wannan shi ne daya daga cikin mafi munin Manuniya aka lura a marasa lafiya tare da inoperable metastases samuwar. Irin wannan marasa lafiya za su iya kawai dogara da magudanun ruwa na biliary fili. Idan kamu a cikin hanta ciwon daji Klatskin, da rayuwar jama'a na rashin lafiya wani lokaci ba fiye da 'yan makonni.

Dalilin mutuwa, Oddly isa, ba metastasize, da kuma related rikitarwa. Wadannan sun hada da:

• cirrhosis lalacewa ta hanyar m bile outflow.
• kamuwa da cuta, da zai kai ga samuwar abscesses.
• total atrophy na jiki ta rigakafi da kuma rashin cin nasara.
• suppurative kumburi.

m matakan

Ga masu rigakafin neoplastic cututtuka na hanta da bile ducts wajibi ne a bi su dace abinci mai gina jiki, ba cũtar barasa da kuma hana parasitic kamuwa da cuta. Idan wani tarihi da cutar, wanda aka positioned a matsayin hadarin dalilai, shi ya kamata dace magani da kuma na din-din-din jarrabawa ga farkon ganewa na munanan a bile jikinsu. Shi ne kuma dole a kawar da sakamakon abubuwa masu cutarwa, kamar wurin aiki.

a ƙarshe

Modern bincike kayan aiki iya gane marurai a cikin hanta da bile ducts, kuma ma domin sanin mataki na m mawuyaci. Tallafi na sabon aiki da hanyoyin magance matsalar, dasawa da sauran warkewa matakan kaiwa zuwa inganta ingancin da tsawon rai ga marasa lafiya.