Parenchymal jaundice: cov tsos mob, ua rau, mob

Niaj hnub no, muaj ntau yam kab mob uas tib neeg tsis niaj hnub raug. Txawm li cas los xij, koj tseem yuav tau paub txog lawv tsawg kawg me ntsis. Tom qab tag nrho, piv txwv li, koj tuaj yeem tiv thaiv tau qhov teeb meem no. Tias yog vim li cas kuv xav qhia rau koj hauv kev nthuav dav txog cov kab mob no, xws li parenchymal jaundice.

Terminology

Ua ntej koj kam nrog tus kab mob no, koj yuav tsum txiav txim siab txog cov ntsiab lus uas yuav siv tau rau hauv tsab ntawv no. Yog li, parenchymal jaundice yog ib tug kab mob, los yog, qhov teeb meem tshwj xeeb ntawm tus cwj pwm, uas yog xim ntawm cov xim pob txha ntawm cov xim tsis yog ntawm daim tawv nqaij xwb, tab sis kuj yog cov mucous membranes (sclera ntawm ob lub qhov muag). Qhov no yog vim lub fact tias bilirubin yog maj accumulating nyob rau hauv lub cev ntawm tus neeg mob (qhov no yog ib qho xim kas fes). Nws tseem ceeb heev uas yuav tsum nco ntsoov tias tus mob no qhia tias tus neeg mob muaj teeb meem nrog lub siab, uas yuav tsum tau daws kom sai li sai tau.

Nws yog nthuav hais tias nyob rau hauv cov tshuaj muaj kuj lub tswvyim ntawm cuav jundundice. Nyob rau hauv cov ntaub ntawv no, tsis paub bilirubin nyob rau hauv tib neeg lub cev, tab sis carotene, ib txwm yam khoom, vim yog lub dyeing ntawm daim tawv nqaij yuav siv qhov chaw. Yog li, qhov no tshwm sim yog tias ntau zaus thiab nyob rau hauv qhov loj loj kom haus carrots, taub dag, txiv kab ntxwv, zoo li beets. Qhov teeb meem no tej zaum yuav tshwm sim yog hais tias tus long-term noj picric acid, raws li zoo li ib co lwm yam tshuaj tshuaj.

Clinical duab

Tus kab mob no puas zoo li lub cev ntaj ntsug? Tus kab mob ntawm tus kab mob yog raws li nram no. Yog li, thawj zaug nws yuav tsum tau muab sau tseg tias nyob rau hauv qhov kev lag luam, bilirubin, tus kabmob kua mis, yog tawm ntawm lub cev lawm. Yog hais tias muaj qee qhov teeb meem nyob rau hauv kev ua haujlwm ntawm lub siab, nws pib maj mam nyob hauv lub cev, taw qhia qhov no los ntawm qhov muag daj, nrog rau cov nqaij mos. Saib ntawm cov ntaub ntawv hais txog dab tsi parenchymal jaundice, nws yog ib qho tseem ceeb hais tias qhov teeb meem no muaj 3 lub ntsiab theem ntawm txoj kev loj hlob.

1. Thawj theem. Nyob rau hauv cov ntaub ntawv no, ib tug yuav txo tau nyob rau hauv cov kev ua ntawm enzymes, membrane puas hepatocytes, direct bilirubin tsis nquag ua.
2. Nyob rau hauv lub thib ob theem ntawm tus kab mob nyob rau hauv cov neeg mob muaj ib qho teeb meem xws li giperfermentiya, hepatocyte membrane permeability qab. Mob hauv sab tshwm vim yog cia li muab cov hlab pas tawm.
3. Nyob rau hauv lub thib peb kauj ruam ntawm tus txheej txheem yog ib tug ntxaug glucuronidation ntawm bilirubin tshwm sim hepatic tsis ua hauj lwm. Tsis tas li ntawd, cov zis tuaj yeem ua kom pom tseeb, qhov mob ntawm sab yog qhov tseeb.

Nws yog tsim nyog sau cia tias nws yog ib qho tseem ceeb heev uas yuav tau pib sib ntaus sib tua parenchymal jaundice ntawm thawj theem ntawm qhov pib ntawm tus kab mob. Tom qab tag nrho, qhov no, koj tuaj yeem tiv nrog qhov teeb meem yooj yim dua thiab sai dua. Yog tias "ncua sij hawm" pib ntawm txoj kev rov zoo mus rau theem peb, ces nws yuav nyuaj heev kho qhov kab mob no.

Ua rau qhov teeb meem

Vim li cas thiaj yuav parenchymal jaundice tshwm sim, dab tsi yog qhov ua rau nws tshwm sim?

• Ua ntej tshaj plaws, nws yuav tsum tau sau tseg tias qhov teeb meem tseem ceeb tshaj plaws hauv qhov no yog cov neeg mob kis: Cov no yog cov kab mob, cov kab mob, cov tshuaj toxins. Feem ntau ntawm cov xwm txheej no peb tham txog cov kab mob xws li malaria, syphilis, toxoplasmosis, thiab lwm yam.
• Lub yeej ntawm hepatocides nrog poisons ob qho tib si organic thiab inorganic. Tshuaj lom ntawm lub cev tuaj yeem tshwm sim los ntawm kev siv cov taug nceb, tsis zoo haus cawv, tom qab noj arsenic los yog ib tug nab tom.
• Txhawm rau ua rau qhov teeb meem no tseem tuaj yeem txais tos ntawm qee cov tshuaj uas muaj cov nyhuv hepatotoxic. Hauv qhov no, feem ntau nws yog ib qho kev npaj xws li "Paracetamol" los yog tshuaj tua kab mob.

Heredity

Xav txog qhov ua rau parenchymal jaundice, nws kuj yuav tsum tau hais tias tus kab mob no kuj muaj qhov zoo tshaj plaws ntawm tus menyuam. Ntawd yog, nws kis tau los ntawm poj niam los ntawm ib tus neeg hauv tsev neeg mus rau lwm tus.

• Tej zaum yuav tsis muaj cov ntsiab lus ligandin, uas nyob rau ntawm daim nplooj siab.
• Qhov ua rau tuaj yeem yog ib qho tsis muaj peev xwm ntawm qhov tshwj xeeb enzyme, hu ua UDP-glucuronyltransferase.
• Nws yog raws roj ntsha, thiab Wilson tus kab mob, thaum muaj ib tug cia hnab khib nyob rau hauv lub hepatocytes ntawm tooj liab, vim hais tias ntawm no genetic defect yog cuam tshuam functionality ntawm lub cev.

Lub ntsiab symptomatology

Xav tias zoo li tus kab mob, xws li parenchymal jaundice, cov tsos mob - qhov no kuj yuav tsum tau hais kom zoo. Yog li, qhov tshwm sim li cas yog tus kab mob no?

1. Ua ntej tshaj plaws, qhov teeb meem no yog qhia los ntawm yellowing ntawm daim tawv nqaij, nrog rau cov mucous membranes, feem ntau yog sclera ntawm ob lub qhov muag.
2. Tsis tas li ntawd, tus neeg mob yuav muaj khaus me ntsis.
3. Muaj mob taub hau, kub cev, mob ntsws.
4. Feem ntau cov neeg tsis txaus siab ntawm kev tsis qab los noj mov, ua rau lub cev tsis hnyav.
5. Tseem muaj cov leeg mob thiab tsis muaj zog.

Cov kev ntsuas ntawm kev txheeb xyuas kuj tseem hloov.

• Cov quav ua lub teeb, me ntsis xim. Txhua yam tshwm sim vim yog kev tsis tau ntawm sterocilin, lwm cov kua mis.
• Zis kuj hloov xim. Yuav ua tau dhau lub teeb lossis tsaus heev.
• Nyob rau hauv cov ntshav ntawm cov neeg mob, cov ntsiab lus ntawm ncaj qha thiab indirect bilirubin nce.

Diagnostics

Yuav ua li cas koj thiaj to taub tias ib tug neeg muaj parenchymal jaundice? Kev kuaj - uas yog dab tsi yuav qhia rau koj txog lub neej ntawm tus kab mob no. Rau qhov koj xav tau:

1. Ua txhua yam kev soj ntsuam ntawm cov zis, quav, thiab ntshav.
2. Kev soj ntsuam ntawm txhua daim duab saib mob.
3. Biochemical ntsuam ntawm ntshav.
4. Qee cov kev tshawb fawb tau muab tso rau.

Soj ntsuam kev soj ntsuam

Yog hais tias tus neeg mob npaum li cas tsom xam ntawm cov quav thiab zis, nyob rau hauv cov ntaub ntawv no, thaum tus kab mob bilirubin thiab urobilin ntsuas nce ho, thaum lub xov tooj ntawm stercobilin ntog, uas ua rau tsis muaj zog coloring tib neeg quav.

Yuav tau kuaj ntshav ntxiv. Hauv qhov no, cov kab mob leukocytosis thiab anemia tuaj yeem raug cai. Yog hais tias tus neeg mob tau parenchymal jaundice, biochemistry ntawm cov ntshav yog dab tsi tseem ceeb. Ntawm no, cov txiaj ntsim ntawm khi thiab khib nyiab thiab cov tshuaj urobilin yuav nce.

Muaj qee zaum, yuav muab tus neeg mob thiab lwm cov kev tshawb fawb ntxiv. Nws tuaj yeem ua tau:

• Kev txiav txim siab txog theem ntawm folic acid thiab vitamin B12 nyob rau hauv cov ntshav.
• Kev txhais ntawm cov neeg ua haujlwm.
• Coprogram: Analysis rau cab thiab cua nab.

Kev tshawb fawb

Ib tus kws paub txog kev paub tshwj xeeb tau yooj yim qhov txawv ntawm qhov mob parenchymal jaundice los ntawm tus kab mob uas muaj kab mob. Txawm li cas los xij, qee zaum, txawm tias cov luminaries ntawm cov tshuaj feem ntau yuav tsum tau kawm ntxiv txog kev tshawb xyuas kab mob. Hauv qhov no, tus neeg mob yuav raug xaiv:

1. Radiography. Txheeb xyuas cov teeb meem nrog lub plab, mob plab tsev thiab hnyuv.
2. Cholecystography. Nws yog ib qho tsim nyog to taub yog tias muaj pob zeb hauv lub gallbladder.
3. Ultrasound yuav muab cov lus qhia txog lub xeev ntawm lub siab thiab lwm yam loj hauv nruab nrog cev.
4. CT los yog MRI.

Tsawg heev, cov neeg mob tau sau ib daim siab ntsws biopsy.

Kev Kho Mob

Nws yuav tsum tau sau tseg tias cov kab mob pathology no muaj ntau txoj hauv kev kom tshem tau nws. Txhua yam nyob ntawm qhov tsis nco qab txog cov kab mob lwm tus. Feem ntau, cov kws kho mob tau sau cov tshuaj uas tshem tawm cov tshuaj tshaj ntawm bilirubin los ntawm lub cev. Txawm li cas los, cov tshuaj tsis tas yuav pab. Hauv qhov no, cov kws kho mob tuaj yeem sau cov txheej txheem xws li phototherapy. Thiab tag nrho vim hais tias ultraviolet yog ua tau sai sai ua txhaum lub molecules ntawm bilirubin thiab pab lawv tshem tawm sai. Nrog rau tus kab mob no, nws tseem yog ib qho tseem ceeb rau noj ib lub complex ntawm cov vitamins, tshwj xeeb tshaj yog B thiab C, lipoic acid thiab cov amino acids.

Tiv Thaiv thiab Tiv Thaiv

Vim parenchymal jaundice yog ib yam kab mob uas tshwm sim rau cov keeb kwm ntawm lwm yam kab mob (kab mob siab B thiab C, pob zeb hauv lub zais zis, thiab lwm yam), nws tseem ceeb heev uas yuav tau pib tshem tawm cov kab mob hauv lub sijhawm no. Tom qab tag nrho, peb yuav tsum nco ntsoov tias yog tias koj tsis pab tus neeg mob rau lub sijhawm, nws tuaj yeem ua rau qee yam teeb meem. Uas yog: tus neeg mob tau irretrievably ua txhaum ntawm kev ua hauj lwm ntawm daim siab thiab gallbladder. Nyob rau tib lub sijhawm, qhov nce siab ntawm bilirubin ua rau qaug zog ntawm lub cev, uas cuam tshuam rau kev ua haujlwm ntawm txhua yam hauv nws lub cev thiab lub tshuab.