Badda-Chiari Syndrome

Badda-Chiari syndrome tshwm sim los ntawm kev zuj zus obliteration (kaw los yog qis) ntawm lumen ntawm cov leeg ntws mus rau hauv daim siab. Chiari ntseeg hais tias lub ntsiab yog vim li cas - thawj tus mob ntawm cov kab mob hepatic. Tab sis nyob rau hauv cov nram qab no, thrombosis ntawm hepatic thiab inferior vena cava raug ntes tau qee zaum.

Cov ntaub ntawv qhia txog kwv yees li 200 tus raug mob rau obliterating endoflebita nyob rau hauv hepatic leeg (tus kab mob , Budd-Chiari syndrome).

Nrog rau kev txhim kho thrombophlebitis ntawm Aranzian ciav, uas ntws ncaj qha mus rau hauv cov leeg hepatic vein, thiab txoj hlab ntaws, qhov mob ntawm tus kabmob no tuaj yeem tsim menyuam yaus thaum ntxov. Lub puab plhaub ntawm lub hepatic leeg los yog ua tsis tau zoo vena Vienna (nyob ze ntawm lub txuas ntawm lub siab) yog loj hlob, tej zaum tuaj koom los ntawm cov ntshav txhaws. Tag nrho cov no ua rau kev kaw los yog qis ntawm lub lumen ntawm daim tawv nqaij, uas, tig, ua rau kev loj hlob ntawm stagnation thiab compression ntawm daim siab lub hlwb.

Budd-Chiari syndrome muaj kuj nyob rau hauv lub pathologies: phem neoplasms ntawm lub siab, txiav, raum, thiab lwm yam, vascular kab mob generalized xwm. Cirrhosis ntawm lub siab kuj tseem tuaj yeem ua rau kom txhuam cov kab mob hepatic. Ua rau Chiari Syndrome no nrog ib qhov chaw ntawm cov pos hniav, echinococcosis, actinomycosis, abscesses thiab lwm yam.

Clinically, tus Buddha-Chiari syndrome tau tshwm sim nws tus kheej los ntawm ib qho kev mob ntawm tus kab mob lwm yam, uas ua rau nws, ntxiv rau, qhov tshwm sim kuj yog nyob ntawm qhov ntev ntawm qhov blockage ntawm cov leeg. Ib qho ntse thiab maj mam pib ntawm qhov Syndrome no.

Kev txhaws nrawm ntawm cov kab mob hepatic leeg ua rau lub ntsej muag ntawm ntuav, qhov mob ntawm txoj kev hypochondrium los yog epigastrium vim qhov ua rau daim siab, thiab ntau tshaj li ntawm cov hlab ntsha lub plab, qhov mob ascites, pom me ntsis icterus.

Portal tawg muaj nyob rau tib lub sij hawm vim hais tias ntawm lub ceev ceev nce nyob rau hauv siab nyob rau hauv lub hepatic sinusoids thiab cov leeg.

Ascites hauv no pathology tsis tuaj yeem kho nrog diuretics, cov kua dej ceev nrawm nroos sai sai tom qab paracentesis, qee zaus kev haus dej hauv nws, tej zaum qhov kev loj hlob ntawm hydrothorax. Yog tias thrombosis muaj nyob rau hauv cov verior vena cava, o ntawm qhov qis qis, "jellyfish taub hau", thiab nrog me ntsis siab rau nws, ntshav txav.

Nrog rau kev txhim kho tag nrho ntawm cov leeg ntawm daim siab, thrombosis ntawm cov hlab ntsha hauv cov leeg, qhov mob thiab kev mob plab zuj zus tuaj, muaj teeb meem ntawm ib qho teeb meem ntawm lub paj hlwb ntawm kev puas tsuaj rau lub siab, uas ua rau tuag ob peb hnub.

Qee lub sij hawm Badd-Chiari syndrome, nrog rau ib nrab ntawm cov leeg, tuaj yeem tshwm sim tau ntev li ntev. Nrog rau qhov xwm txheej ntawm txoj kev khiav, qhov kev tiv thaiv ntawm sab nraud tshwm sim dhau lub sij hawm: cov kab mob ntawm cov tawv nqaij nthuav tawm, portal hypertension tshwm, thiab tom qab ntawd cov varicose leeg ntawm txoj hlab pas.

Ua kom paub tus mob, qhov muaj qhov txo lub sijhawm nyob hauv cov leeg ntawm daim siab thiab lub sij hawm nce hauv phoo vaj huam sib luag yog qhov tseem ceeb, raws li tau qhia los ntawm cov hom kab mob hepato- thiab splenomanometry. Retrograde X-ray-hepatopathography yog siv, thaum lub sijhawm sib txawv ntawm cov tshuaj raug muab tso rau hauv cov kab mob hepatic. UZ-diagnosis yog raws li cov cim qhia tseeb - pom tau ntawm cov ntshav khov hauv cov leeg.

Yog tias tsis muaj xim Doppler txoj kev tshawb nrhiav, ib tug yuav xav tias Budda-Chiari syndrome nrog:

• Muaj cov diffuse hloov nyob rau hauv lub siab, yam ntxwv mob fatty siab los yog fibrosis ntawm lub siab nqaij,

• Tsis muaj cov kab mob hepatic leeg nyob hauv daim duab, piv txwv li, vim tias lawv nyob ntawm lawv cov lumen ntawm cov pob zeb loj nyob hauv lumen,

• Ib qho qis dua vena cava,

• Cov cim qhia ntawm portal hypertension yog tias tus kab mob tseem nyob ntev.