Yuav ua li cas yog ascites cancer

Hu ascites effusion kua tivthaiv ntawm cov ntshav los yog cov qog rau hauv lub plab kab noj hniav. Qhov no txoj kev muaj peev xwm tshwm sim nyob rau hauv ntau yam kab mob thiab pathologies, tab sis nws yog raug rau feem ntau daim siab mob. Nws tseem yog heev ascites nyob rau hauv cancer, tshwj xeeb tshaj yog chyloperitoneum (qho rhuav txhua ntawm cov hlab ntsha ntawm lub lymphatic system).

Tsib caug feem pua ntawm cov ascites cancer npaj raws li ib tug tshwm sim carcinomatosis parietal thiab visceral peritoneum nplooj. Qhov no txoj kev nws thiaj li ua rau yus occlusion (rhuav txhua) qog cov hlab ntsha.

Tus zaus ntawm lub xeem ntawm tag nrho cov malignancies yog hom twg los ntawm kaum tsib rau tsib caug-tsib feem pua. Qhov tseem yuav loj hlob ntawm ascites nrog ntawm zes qe menyuam hlav, endometrial, pais plab, lub mis, bronchial hlab thiab lwm yam kabmob thiab ntaub so ntswg.

Ntxiv txog kaum tsib feem pua ntawm cov lesion tsim thaum lub sij hawm mob siab parenchyma. Compression ntawm lub cev ntawm lub venous system ua rau lub ceev ceev tsim ntawm exudate nyob rau hauv lub plab kab noj hniav, nyob rau hauv tas li ntawd, nyob rau hauv xws cov neeg mob yog tsis tsim cov lus hais hepatomegaly.

Pathogenesis thiab cov tsos mob ntawm ascites cancer

Ascites cov tsos mob raug rau nws - ib tug ntse nce nyob rau hauv lub plab mog, raws li zoo raws li tus neeg mob lub general ceeb thawj. Tus muaj zog siab nyob rau hauv lub plab kab noj hniav ua rau ib theem siab ntawm sawv diaphragm, uas nyob rau hauv lem ua rau cov tsos mob ntawm gastro-oesophageal reflux (regurgitation, thiab kub siab, xeev siab thiab ntuav), orthopnea thiab dyspnea, compressed plab syndrome (sai saturation ntawm cov zaub mov thiab xeev siab).

Lub cev kev xeem ib tug me me npaum li cas ntawm ascites (200 milliliters) yog yuav luag tsis yooj yim sua kom paub tias. Effusion volume los ntawm tsib puas rau ib txhiab milliliters kuaj visually raws li ib tug tshwm sim ntawm su cheeb tsam ntawm lub sab flanks ntawm lub plab mog, ib cov tsos mob fluctuation - zoo. Muaj yog ib tug yam ntxwv ntawm ascites "tsiv" lub stupidity ntawm lub flanks los hloov rau txoj hauj lwm ntawm lub cev thaum lub sij hawm percussion.

Ascites cancer tshwm sim los ntawm occlusion ntawm lub venous system nyob rau hauv lub siab zoo nkaus li extension ntawm lub ces dag leeg ntawm lub plab phab ntsa. Nyob rau hauv lub tom qab ua sawv ntawm txoj kev tsim tsa ntawm cov yam ntxwv "lub taub hau jellyfish" (su anterior mob plab phab ntsa nyob rau hauv ascites nrog dilated leeg thiab qhia nyob rau ntawd).

Ntes kuj extraperitoneal complex cov tsos mob: kua nyob rau hauv lub pleural kab noj hniav, cov offset apex dhia ntawm lub plawv, raws li zoo li o tila qis feem (dua li nqua thiab lub plab mog).

Thaum lub davhlau ya nyob twg theem ntawm cancer ascites ntsis tsis paug tus neeg mob tus mob thiab tsis tsim ib tug teeb meem mus rau lub neej, yog li txoj kev kho tsuas diuretic tshuaj, uas ua rau kom cov feem ntawm kua los ntawm lub cev thiab li txo intra effusion.

Yog hais tias qhov mob ntawm ascites, kev kho mob yog nqa tawm veroshpironom (spironolactone) uas yog pom zoo raws li "kev kho mob txheem" nyob rau hauv cov kev kho mob ntawm xws tej yam kev mob. Lub hom phiaj ntawm cov tshuaj no nyob rau hauv ua ke nrog nrog furosemide (voj diuretic), pub ntxiv raws mus txog 1000 milliliters kua ib hnub twg.

Thaum ib tug qhia tau mob thiab muaj cov ascites thiab tachypnea, ua mob plab paracentesis (hno lub plab phab ntsa rau lub hom phiaj ntawm kua kab noj hniav). Txhuav yog nqa tawm yam tsawg kawg yog rau lub sij hawm thiab kom txog thaum tej lub sij hawm raws li tus ascites kua yog tsis ntws mus rau hauv lub thawv. Cov uas ua kua yog xa mus rau tus tsom xam los ntawm tshuaj ntsuam nws rau tag nrho cov protein cov ntsiab lus, nyob rau hauv fractional muaj pes tsawg leeg ntawm LDH thiab quantification ntawm leukocytes. Nyob rau hauv tas li ntawd, yub yog ua rau cov kua nruab nrab.

Nws muab pronounced zoo ntxim rau tej yam etiological tau (ncaj qha mus rau lub qog nws tus kheej). Yog li, lub tsav tsheb neeg tshem tawm thiab nyob rau hauv lub pathogenesis ntawm ascites cancer retreats.