I-hepatic adenoma: yintoni, ukuxilongwa kunye nokunyangwa

Umxholo

• Iimpawu eziphambili
• Uxilongo lwenziwa njani
• Unyango lwenziwa njani
• Iingxaki ezinokwenzeka

I-hepatic adenoma, ekwabizwa ngokuba yi-hepatocellular adenoma, luhlobo olunqabileyo lwesisu esibi esiveliswa ngamanqanaba eehomoni atshintshiweyo kwaye ke kuxhaphake kakhulu ukubonakala kwabasetyhini abaphakathi kweminyaka engama-20 nengama-50, emva kokukhulelwa okanye ngenxa ukusetyenziswa ixesha elide kwezinto zokucwangcisa ngomlomo, umzekelo.

Ngokwesiqhelo, i-adenoma yesibindi ayivelisi mpawu, kungoko ihlala ichongiwe ngengozi ngexesha lokuvavanywa kwe-CT okanye i-ultrasound ukuzama ukufumanisa enye ingxaki.

Njengokuba ingekho nzulu kwaye ithathwa njenge-tumor, i-adenoma ngokubanzi ayifuni naluphi na uhlobo oluthile lonyango, kuyacetyiswa kuphela ukuba uhlale uphaphile kwiimviwo eziqhelekileyo, kuba, nangona iphantsi kakhulu, kukho umngcipheko wokuba mbi okanye ukugqabhuka, kubangele ukopha ngaphakathi.

Iimpawu eziphambili

Kwiimeko ezininzi, i-adenoma ye-hepatic ayibangeli zimpawu, nangona kunjalo, abanye abantu banokuthi buchaze ubukho beentlungu ezixineneyo nezihlala zihleli kwindawo ephezulu yesisu.

Nangona kunqabile, i-adenoma inokuqhekeka kwaye yophe kwisisu esiswini. Kwiimeko ezinjalo, kuqhelekile ukuva iintlungu ezomelele kakhulu kwaye ngesiquphe esiswini, ezingaphuculiyo kwaye ezihamba nezinye iimpawu zothuselo lokopha njengokunyuka kwentliziyo, ukuziva utyhafile okanye ukubila kakhulu. Ukuba kukrokrelwa ukuba i-adenoma idabukile, kuyacetyiswa ukuba uye esibhedlele kwangoko ukunqanda ukopha.

Yazi eminye imiqondiso enokubonisa ukothuka okophayo.

Uxilongo lwenziwa njani

I-hepatocellular adenoma iphantse ichongwe ngexesha lovavanyo lokuchonga enye ingxaki kwaye, ke, ukuba oku kuyenzeka, kuyacetyiswa ukuba ubonane nengcali yesifo sengqondo ukuba yenze uviwo oluthile ngakumbi kwaye uqinisekise ubukho be-adenoma. Ezona mviwo zisetyenzisiweyo zibandakanya i-ultrasound, i-magnetic resonance okanye i-computed tomography.

Ngethuba leemviwo, ugqirha uyakwazi ukuchonga uhlobo lwe-adenoma yesibindi ukukhokela kangcono unyango:

• Ukudumba: yeyona ixhaphakileyo kwaye inezinga eliphezulu lokophula;
• HNF1α utshintsho: luhlobo lwesibini oluqhelekileyo, kunye ne-adenoma engaphezu kweyodwa evela kwisibindi;
• Utshintsho lwe-SS-catenin: aziqhelekanga kwaye zibonakala ikakhulu kumadoda asebenzisa ii-anabolic steroids;
• Ayinokwahlulwal: luhlobo lwethumba elingenakufakwa nakoluphi na uhlobo.

Ngokwesiqhelo ugqirha ucebisa kuphela ngokujonga ubungakanani bethumba, nangona kunjalo, kwimeko yokuvuvukala, umzekelo, ukuba ingaphezulu kwe-5 cm, ugqirha unokukhetha ukwenza utyando ukuze ayisuse ngokupheleleyo.

Unyango lwenziwa njani

Kuba i-hepatic adenoma iphantse yahlala inobungozi, eyona ndlela iphambili kunyango kukusoloko ujonga ubungakanani bayo, kusetyenziswa iimvavanyo ezinje ngecomputer tomography, imaging resonance imaging okanye i-ultrasound nje. Nangona kunjalo, ukuba i-adenoma ivela kumfazi osebenzisa izinto zokuthintela ukukhulelwa, ugqirha unokucebisa ukuba ayeke ukusetyenziswa kwaye akhethe enye indlela yokuthintela ukukhulelwa, kuba ukusetyenziswa kwepilisi kunokuba negalelo kuphuhliso lwethumba. Kuyafana nakubantu abasebenzisa uhlobo oluthile lwe-anabolic, umzekelo.

Ukuba ithumba likhula ngokuhamba kwexesha okanye ukuba lingaphezulu kwe-5 cm, kukho umngcipheko omkhulu wokukwazi ukugqabhuka okanye ukuvelisa umhlaza kwaye, ke, kuqhelekile ukuba ugqirha acebise utyando ukususa isilonda kunye nokuthintela ukuba kungaveli iingxaki. Olu tyando luhlala lulula kwaye lunomngcipheko omncinci, wenziwa phantsi kweanesthesia jikelele esibhedlele. Ugqirha lunokucetyiswa kwabasetyhini abacinga ukukhulelwa, kuba kukho umngcipheko omkhulu we-adenoma ebangela iingxaki ngexesha lokukhulelwa.

Ukuba i-adenoma igqabhukile, unyango olusetyenzisiweyo kukwenziwa notyando, ukunqanda ukopha nokususa isilonda. Kule meko, unyango kufuneka luqaliswe ngokukhawuleza ukukhusela ukulahleka kwegazi okukhulu, okunokusongela ubomi.

Iingxaki ezinokwenzeka

Kukho iingxaki ezimbini eziphambili ze-hepatic adenoma:

• Ukuphazamiseka: Kwenzeka xa udonga lwethumba luqhekeka ngenxa yobungakanani obugqithisileyo okanye umothuko ngqo esibindini, umzekelo. Xa oku kusenzeka, ithumba liyopha kwisisu esisiswini, esikhokelela ekuphumeni kwangaphakathi, okubeka ubomi emngciphekweni. Kwezi meko, kuqhelekile ukuziva ubuhlungu obukhulu kunye nequbuliso esiswini. Ukuba oku kuyenzeka, kubaluleke kakhulu ukuba uye esibhedlele kwangoko ukuze uqale unyango.
• Uphuhliso lomhlaza: sisixakaxaka esinqabileyo, kodwa sinokwenzeka xa ithumba liqhubeka nokukhula, libe nakho ukwenza inguquko kwithumba elibi, elaziwa ngokuba yi-hepatocellular carcinoma. Kule meko, kubalulekile ukwenza uxilongo kwangoko ukwandisa amathuba onyango. Funda ngakumbi malunga nolu hlobo lwethumba kunye nendlela elinyangwa ngayo.

Ezi ngxaki zixhaphake kakhulu kumathumba amakhulu kune-5 cm kwaye, ke ngoko, unyango luhlala lusenziwa ngotyando ukususa isilonda, nangona kunjalo, zinokwenzeka nakwizicubu ezincinci, ke ngoko kubaluleke kakhulu ukugcina umlindo rhoqo kwi-hepatologist .