ʻO ka cirrhosis biliary mua

ʻO nā kī ʻoi nā kīʻaha e neʻe i ka pā mai ke ake a i ka ʻōpū liʻiliʻi. ʻO ka bile kahi mea kōkua i ka digestion. Kāhea ʻia nā āpau āpau i ka biliary tract.

Ke pehu a pehu paha nā aʻa o ka bile, pale kēia i ke kahe o ka bile. Hiki i kēia mau hoʻololi ke alakaʻi i ka scarring o ke ake i kapa ʻia he cirrhosis. Kapa ʻia kēia ʻo bilier cirrhosis. Hiki i ka cirrhosis holomua ke alakaʻi i ka ʻole o ke ake.

ʻAʻole ʻike ʻia ke kumu o nā dile bile i hoʻāla ʻia i ke ake. Eia nō naʻe, ʻo ka cirrhosis biliary mua kahi maʻi autoimmune. ʻO ke kumu o ka hōʻeha hewa ʻana o kou ʻōnaehana pale kino i nāʻiʻo olakino. Pili paha ka maʻi i nā maʻi autoimmune e like me:

• Maʻi Celiac
• Hanana Raynaud
• ʻO ka maʻi Sicca (nā maka maloʻo a waha paha)
• Maʻi thyroid

Hoʻopili pinepine ka maʻi i nā wahine waena.

Ma mua o hoʻokahi hapa o ka poʻe i loaʻa ʻole nā ​​ʻōuli i ka manawa o ke kuhi. Hoʻomaka hoʻomaka pinepine nā ʻōuli. Pākuʻi ʻia paha nā ʻōuli mua:

• ʻO ka ʻeha a me ka ʻeha o ka ʻōpū
• Ka luhi a me ka lilo o ka ikehu
• Waihona momona ma lalo o ka ʻili
• Nā noho momona
• Kāwili
• ʻO ka makemake maikaʻi ʻole a me ka pohō kaumaha

Ke holo a mānoanoa nei ke akepaʻa, komo pū paha nā ʻōuli:

• Fluid buildup i nā wāwae (edema) a i loko o ka ʻōpū (ascites)
• ʻO kaʻeleʻele melemele i ka ʻili, nā membrane mucous, a i ʻole nā ​​maka (jaundice)
• ʻO ka ʻulaʻula ma nā poho lima
• I nā kāne, impotence, shrinking of the testicle, a me ka puhū ʻana
• ʻO ka palu maʻalahi a me ke kahe ʻole o ke kahe, pinepine pinepine mai nā veins pehu i ka tract digestive
• Huikau a pilikia paha i ka noʻonoʻo ʻana
• Nā noho Pale a i ʻole nā ​​pālolo kele

E hana ka mea mālama ola i kahi hoʻokolohua kino.

Hiki i nā hoʻāʻo aʻe ke nānā inā e hana pono ana kou ake.

• Hōʻike koko Albumin
• ʻO nā hoʻokolohua hana ate (ʻo ka nui o ka alkaline phosphatase ka mea nui)
• Ka manawa Prothrombin (PT)
• ʻO Cholesterol a me nā ho'āʻo koko lipoprotein

Nā hoʻokolohua ʻē aʻe i hiki ke kōkua i ke ana ʻana i ke ʻano o ka maʻi akepau:

• Kiʻekiʻena immunoglobulin M pae i loko o ke koko
• ʻO ka biopsy ate
• Anti-mitochondrial antibodies (hopena maikaʻi ma kahi o 95% o nā hihia)
• Nā ʻano kūikawā o ka ultrasound a i ʻole ka MRI e ana i ka nui o nā kiko o ka ʻili (i kapa ʻia ʻo elastography)
• Mākēneki resonance cholangiopancreatography (MRCP)

ʻO ka pahuhopu o ka mālama ʻana e hoʻomāmā i nā ʻōuli a pale i nā pilikia.

Cholestyramine (a i ʻole colestipol) hiki ke hōʻemi i ka makaʻu. Hiki i ka Ursodeoxycholic acid ke hoʻomaikaʻi i ka hemo ʻana o ka bile mai ke kahe o ke koko. Hiki paha i kēia ke hoʻomaikaʻi i ke ola i kekahi poʻe. Loaʻa kekahi lāʻau hou aku i kapa ʻia ʻo obeticholic acid (Ocaliva).

Hoʻoiho ka lāʻau hoʻōla Vitamin i nā wikamina A, K, E a me D, i nalowale i nā pahu momona. Hoʻohui ʻia kahi waihona kalima a i ʻole nā ​​lāʻau lāʻau ʻē aʻe e pale a mālama ai i nā iwi palupalu a palupalu paha.

Pono ka mālama wā lōʻihi a me ka mālama ʻana i ka holo pono ʻole o ke ake.

Hiki ke kūleʻa ke ake ʻana o ke ake inā hana ʻia ma mua o ka hanana ʻole o ke ake.

Hiki ke hoʻololi i ka hopena. Inā mālama ʻole ʻia ke ʻano, make ka hapa nui o ka poʻe me ka ʻole o ke ake o ke ake. Ma kahi o ka hapahā o ka poʻe i loaʻa i ka maʻi no 10 mau makahiki e holo pono ʻole ke ake. Hiki i nā kauka ke hoʻohana i kahi hoʻohālikelike helu e wānana i ka manawa kūpono e hana ai i ke transplant. ʻO nā maʻi ʻē aʻe, e like me hypothyroidism a me anemia, hiki ke hoʻomohala pū kekahi.

Hiki i ka cirrhosis holomua ke hiki i ke kūleʻa o ke ake. Hiki i nā pilikia ke hoʻopili:

• Kahena
• Poino i ka lolo (encephalopathy)
• ʻO ke kaulike ʻole o ka wai a me ka electrolyte
• Hewa ʻole nā ​​hakuʻala
• Malabsorption
• Kaʻai pono ʻole
• Nā iwi palupalu a nāwaliwali paha (osteomalacia a i ʻole osteoporosis)
• Ascites (ka hoʻoliʻiliʻi wai i ka lua o ka ʻōpū)
• Hoʻonui i ka makaʻu o ka maʻi ʻaʻai ate

Kāhea i kāu mea hāʻawi inā loaʻa iā ʻoe:

• Huʻi ʻōpū
• Koko i nā noho
• Huikau
• ʻO Jaundice
• Ka ʻili o ka ʻili i hele ʻole a pili ʻole i nā kumu ʻē aʻe
• Koko luaʻi

Cholangitis biliary mua; PBC

• Cirrhosis - hoʻokuʻu

• ʻŌnaehana Digestive
• Ala hele bile

ʻO Eaton JE, Lindor KD. ʻO cholangitis biliary mua. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 91.

ʻO Fogel EL, Sherman S. Nā maʻi o ka gallbladder a me nā dile bile. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 146.

Kukui LW. ʻO ke akepaʻa: nā maʻi neoplastic ʻole. I: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. ʻO Rosai lāua ʻo Ackerman's Surgical Pathology. 11th hua. Piladelapia, PA: Elsevier; 2018: chap 19.

Smith A, Baumgartner K, Bositis C. Cirrhosis: ʻike a me ka hoʻokele. He Kauka Lapaʻau. 2019; 100 (12): 759-770. PMID: 31845776 pubmed.ncbi.nlm.nih.gov/31845776/.