He aha ka Liver Biopsy? Ke Kumu, ke Kaʻina Hana & Nā Hōʻike

ʻO ka liver biopsy he hana lapaʻau kahi e wehe ai kāu kauka i kahi laʻana liʻiliʻi o ka ʻiʻo ate e nānā ma lalo o ka microscope. Kōkua kēia hoʻokolohua maʻalahi i nā kauka e hoʻomaopopo i ka mea e hana nei i loko o kou ate ke hiki ʻole i nā hoʻokolohua koko a i ʻole nā kiʻi kiʻi ke hāʻawi i kahi kiʻi piha.

E noʻonoʻo e like me ka nānā ʻana i ke olakino o kou ate. Hiki i ka laʻana ʻiʻo, ʻoi aku ka liʻiliʻi ma mua o ka holoi penikala, ke hōʻike i ka ʻike nui e pili ana i ka maʻi ate, ka mumū, a i ʻole ka pōʻino i ʻike ʻole ʻia i nā hoʻokolohua ʻē aʻe.

He aha ka liver biopsy?

ʻO ka liver biopsy e pili ana i ka lawe ʻana i kahi ʻāpana liʻiliʻi o ka ʻiʻo ate me ka hoʻohana ʻana i kahi nila lahilahi a i ʻole i ka wā o ke ʻoki ʻana. Nānā kāu kauka i kēia laʻana ma lalo o ka microscope e hōʻoia i nā maʻi ate a hoʻolālā i kāu lapaʻau.

Hāʻawi ke kaʻina hana i kāu hui mālama ola i ka ʻike kikoʻī e pili ana i ke ʻano a me ka hana o kou ate. Hiki iā ia ke ʻike i nā maʻi kikoʻī, ana i ka nui o ka pōʻino o ka ate, a kōkua i ka hoʻoholo ʻana i ke ala lapaʻau maikaʻi loa no kou kūlana.

Hana ʻia ka hapa nui o nā biopsies ate ma ke ʻano he hana outpatient, ʻo ia hoʻi hiki iā ʻoe ke hele i ka home i ka lā like. Lawe wale ka hōʻiliʻili ʻana o ka ʻiʻo i kekahi mau kekona, ʻoiai ʻo ka manawa holoʻokoʻa e mau ana i kekahi mau hola me ka hoʻomākaukau a me ka manawa hoʻōla.

No ke aha e hana ʻia ai ka liver biopsy?

Hiki i kāu kauka ke ʻōlelo aku i ka liver biopsy ke pono lākou i ka ʻike kikoʻī e pili ana i ke olakino o kou ate ma mua o nā hoʻokolohua koko a i ʻole nā kiʻi kiʻi. ʻO ia ke ala pololei loa e hōʻoia ai i kekahi mau maʻi ate.

ʻO nā kumu maʻamau e pili ana i ka noiʻi ʻana i nā hoʻokolohua hana ate maʻamau, ka hoʻonui ʻana o ka ate i wehewehe ʻole ʻia, a i ʻole ka maʻi ate i manaʻo ʻia. Hiki i kāu kauka ke hoʻohana iā ia e nānā i ka maikaʻi o ka pane ʻana o kou ate i ka mālama ʻana i nā maʻi e like me ka hepatitis a i ʻole ka maʻi ate momona.

I kekahi manawa, kōkua ka biopsy i ka hoʻoholo ʻana i ke kahua o ka maʻi ate, kahi e alakaʻi ai i nā hoʻoholo lapaʻau. No ka laʻana, hiki iā ia ke hōʻike inā he maʻalahi a koʻikoʻi paha ka ʻeha ate (fibrosis), e kōkua ana i kāu kauka e hana i ka hoʻolālā lapaʻau maikaʻi loa.

Eia nā kūlana olakino nui kahi e ʻōlelo ai kāu kauka i kēia kaʻina hana:

• Hoʻonui ʻia nā enzyme ate i wehewehe ʻole ʻia e mau ana i ka manawa
• Nā maʻi ate autoimmune i manaʻo ʻia e like me ka primary biliary cholangitis
• Ka loiloi ʻana i ka paʻakikī o ka maʻi ate momona
• Ke nānā ʻana i ka hōʻole ʻana i ka transplant ate
• Ke noiʻi ʻana i ka hoʻonui ʻana a i ʻole nā ​​puʻupuʻu ate i wehewehe ʻole ʻia
• Ka ʻike ʻana i nā maʻi ate metabolic laha ʻole
• Ka loiloi ʻana i ka pōʻino ate mai nā lāʻau lapaʻau a i ʻole nā ​​toxins

E kaupaona mau kāu kauka i nā pōmaikaʻi e kūʻē i nā pilikia ma mua o ka ʻōlelo ʻana i kahi biopsy. E wehewehe lākou i ke kumu e koʻikoʻi ai kēia hoʻāʻo no kāu kūlana kikoʻī a me nā koho ʻē aʻe i loaʻa.

He aha ke kaʻina hana no ka biopsy ate?

ʻO ke ʻano maʻamau he percutaneous liver biopsy, kahi e hoʻokomo ai ke kauka i kahi nila ma kou ʻili e hiki ai i kou ate. E moe ʻoe ma kou kua a i ʻole ma kou ʻaoʻao hema i ka wā o ke kaʻina hana.

Ma mua o ka hoʻomaka ʻana, e hoʻomaʻemaʻe kāu kauka i ka wahi a e hoʻokomo i kahi anesthetic kūloko e hoʻopōʻino i kou ʻili. Hiki paha iā ʻoe ke ʻike i kahi manaʻo ʻeha pōkole, e like me ka loaʻa ʻana o ka lāʻau lapaʻau, akā pono e ʻeha ka wahi i loko o kekahi mau minuke.

Me ka hoʻohana ʻana i ke alakaʻi ultrasound, e ʻimi kāu kauka i kahi wahi maikaʻi loa e hoʻokomo i ka nila biopsy. Hana ʻia ka hōʻiliʻili ʻana o ka ʻiʻo maoli i ka wikiwiki - maʻamau i ka liʻiliʻi ma mua o kekona. Hiki paha iā ʻoe ke lohe i ke kani kaomi mai ka mea biopsy.

Eia ka mea e hana maʻamau i kāu kaʻina hana:

1. E hoʻololi ʻoe i ka ʻaʻahu haukapila a moe ma luna o ka papa hoʻokolokolo
2. E nānā ke kime lapaʻau i kou mau hōʻailona ola a hoʻomaka i kahi laina IV
3. E hoʻohana kāu kauka i ka ultrasound e ʻike i kahi biopsy maikaʻi loa
4. Hoʻokomo ʻia ka anesthetic kūloko e hoʻopōʻino loa i ka wahi
5. Hoʻokomo ʻia kahi nila lahilahi ma kou ʻili i loko o kou ake
6. Hōʻiliʻili ʻia ka laʻana ʻiʻo i loko o ka hapa o kekona
7. Hoʻopili ʻia ke kaomi i ka pūnaewele e pale ai i ke kahe ʻana o ke koko
8. E nānā ʻia ʻoe no kekahi mau hola ma mua o ka hele ʻana i ka home

Pono kekahi poʻe i ka biopsy ate transjugular, kahi e hiki ai ka nila i kou ate ma o ka vein ma kou ʻāʻī. Hoʻohana ʻia kēia ala ke loaʻa iā ʻoe nā maʻi kahe koko a i ʻole ka wai i loko o kou ʻōpū e hoʻopilikia ai ke ala maʻamau.

Pehea e hoʻomākaukau ai no kāu biopsy ate?

E hāʻawi kāu kauka iā ʻoe i nā ʻōlelo kikoʻī e pili ana i ka hoʻomākaukau ʻana no kāu biopsy, e hoʻomaka ana ma kahi o hoʻokahi pule ma mua o ke kaʻina hana. ʻO ka hahai ʻana i kēia mau alakaʻi me ka akahele e kōkua i ka hōʻoia ʻana i kou palekana a me ka holomua o ka hoʻāʻo.

Pono ʻoe e hooki i ka lawe ʻana i kekahi mau lāʻau lapaʻau e hiki ke hoʻonui i ka pilikia o ke kahe ʻana o ke koko, e like me ka aspirin, ibuprofen, a i ʻole nā mea lahilahi koko. E haʻi aku kāu kauka iā ʻoe i nā lāʻau lapaʻau e pale aku ai a no ka manawa lōʻihi ma mua o ke kaʻina hana.

Pono ka hapa nui o nā kānaka e hoʻokē ʻai no 8-12 mau hola ma mua o ka biopsy, ʻo ia hoʻi ʻaʻohe meaʻai a i ʻole ka inu ʻana koe wale nō nā sips liʻiliʻi o ka wai me nā lāʻau lapaʻau i ʻae ʻia. Kōkua kēia hana i ka pale ʻana i nā pilikia inā pono ʻoe i ke ʻokiʻoki ulia pōpilikia, ʻoiai he mea maʻamau loa kēia.

E komo paha kāu hoʻomākaukau ʻana i kēia mau ʻanuʻu nui:

• E hana i nā hoʻokolohua koko piha e nānā i kāu hana ʻana i ke koko a me ka helu koko
• E hoʻonohonoho i kekahi e hoʻokele iā ʻoe i ka home ma hope o ke kaʻina hana
• E hooki i ka ʻai a me ka inu ʻana e like me ka manawa i kauoha ʻia e kāu kauka
• E ʻauʻau i ka pō ma mua a i ʻole ke kakahiaka o kāu biopsy
• E ʻaʻahu i nā lole ʻoluʻolu a me nā lole ākea i kāu manawa
• E lawe mai i kahi papa inoa o kāu mau lāʻau lapaʻau a me nā mea hoʻohui
• E hoʻolālā e hoʻomaha ma ka home no ke koena o ka lā

E hōʻike i kāu kauka inā hāpai ʻoe, he maʻi āpau kāu, a i ʻole maʻi i ka lā o kāu kaʻina hana. Hiki i kēia mau mea ke hoʻopilikia i ka manawa a i ʻole ke ala o kāu biopsy.

Pehea e heluhelu ai i nā hopena o kāu biopsy ate?

E hoʻi mai nā hopena o kāu biopsy ate ma ke ʻano he hōʻike kikoʻī mai kahi pathologist, he kauka loea i ka nānā ʻana i nā laʻana ʻiʻo. Lawe maʻamau kēia hōʻike i nā lā 3-7 e hoʻopau ai, ʻoiai e hana wikiwiki ʻia nā hihia wikiwiki.

Nānā ka pathologist i kāu ʻiʻo ate ma lalo o ka microscope a wehewehe i kā lākou mea e ʻike ai e pili ana i ka mumū, ka ʻeha, nā waihona momona, a me nā cell abnormal. E hāʻawi pū lākou i nā helu a me nā pae i kekahi mau kūlana ke pili.

No nā kūlana e like me ka hepatitis, hiki i ka hōʻike ke komo i kahi helu mumū (pehea ka hana o ka maʻi) a me kahi pae fibrosis (ehia ka nui o ka ʻeha i hana ʻia). Kōkua kēia mau helu i kāu kauka e hoʻomaopopo i ke koʻikoʻi o kou maʻi a hoʻolālā i ka lāʻau lapaʻau.

E komo maʻamau kāu hōʻike biopsy i ka ʻike e pili ana i:

• ʻO ka hoʻolālā ate holoʻokoʻa a me ke ʻano o ke keena
• Ke kū ʻana a me ka nui o ka mumū
• Ka nui a me ke ʻano o ka ʻiʻo ʻeha (fibrosis)
• Nā waihona momona i loko o nā cell ate
• Nā waihona hao a keleawe paha inā pili
• ʻO nā cell abnormal a i ʻole cancerous
• Nā hōʻailona maʻi kikoʻī ke kūpono

E wehewehe ana kāu kauka i ke ʻano o kēia mau mea i kou olakino a e kūkākūkā i nā koho lapaʻau e pili ana i nā hopena. Mai hopohopo inā paʻakikī ka ʻōlelo lapaʻau - e unuhi kāu hui mālama ola i nā mea i loaʻa i ka ʻike kūpono e hiki ai iā ʻoe ke hoʻomaopopo.

He aha nā mea pilikia no ka pono o ka biopsy ate?

Hiki i kekahi mau maʻi olakino a me nā mea ola ke hoʻonui i kou hiki ke pono i ka biopsy ate. ʻO ka hoʻomaopopo ʻana i kēia mau mea pilikia hiki ke kōkua iā ʻoe e hana i nā hana e pale ai i kou olakino ate.

ʻO ka maʻi hepatitis viral maʻi, ʻo ia hoʻi ka hepatitis B a me C, pono pinepine i ka nānā ʻana i ka biopsy e loiloi i ka holomua o ka maʻi a me ka pane ʻana i ka lāʻau. Hiki i ka hoʻohana ʻana i ka waiʻona nui no nā makahiki he nui ke alakaʻi i ka pōʻino o ke ake e pono ai ka loiloi biopsy.

Hoʻokomo kekahi mau maʻi olakino i ke koʻikoʻi hou i kou ate a hiki ke koi i ka hoʻokolokolo ʻana i ka ʻiʻo. Hiki i nā maʻi autoimmune, nā maʻi metabolic, a me kekahi mau lāʻau lapaʻau ke hoʻopilikia i ka hana ate i ka manawa.

ʻO nā mea pilikia maʻamau e alakaʻi ai i ka biopsy ate e komo pū ana:

• Maʻi hepatitis B a i ʻole C
• Ka hoʻohana ʻana i ka waiʻona nui no nā makahiki he nui
• ʻO ka maʻi ate momona ʻole i ka waiʻona, ʻo ia hoʻi i ka poʻe me ka maʻi diabetes a i ʻole ka momona
• Nā maʻi ate autoimmune e like me ka cholangitis biliary mua
• Hoʻonui mau ʻole i nā enzyme ate
• ʻO ka mōʻaukala ʻohana o nā maʻi ate genetic
• Ka hoʻohana lōʻihi ʻana i kekahi mau lāʻau lapaʻau e hiki ke hoʻopilikia i ke ake
• Hōʻike ʻia i nā kemika ʻoihana a i ʻole nā ​​toxins

ʻO ka loaʻa ʻana o kēia mau mea pilikia ʻaʻole ia he manaʻo e pono maoli ʻoe i ka biopsy. Hiki ke nānā ʻia a mālama ʻia ka nui o nā poʻe me nā maʻi ate me ka ʻole e pono i kēia kaʻina hana, ʻoiai me nā hoʻokolohua koko holomua o kēia lā a me nā ʻenehana kiʻi.

He aha nā pilikia hiki ke loaʻa i ka biopsy ate?

ʻOiai he palekana ka biopsy ate, e like me nā hana lapaʻau ʻē aʻe, he mau pilikia kekahi. ʻO ka nūhou maikaʻi, he kakaikahi nā pilikia koʻikoʻi, e kū ana ma lalo o 1% o nā hana ke hana ʻia e nā kauka ʻike.

ʻO ka hopena maʻamau he ʻeha māmā ma kahi o ka biopsy, e like me ka ʻeha ma kou poʻohiwi ʻākau a i ʻole ka ʻōpū. He mau hola ka lōʻihi o kēia ʻoluʻolu ʻole a pane maikaʻi i nā mea hōʻoluʻolu ʻeha ma luna o ka counter.

ʻO ke kahe koko ka pilikia nui loa, ʻoiai he mea maʻamau ʻole. Mālama pono kāu hui lapaʻau iā ʻoe no kekahi mau hola ma hope o ke kaʻina hana e nānā i nā hōʻailona o ke kahe koko i loko.

Eia nā pilikia hiki ke loaʻa, i helu ʻia mai ka mea maʻamau a hiki i ka mea kakaikahi:

• ʻEha māmā a me ka ʻoluʻolu ma kahi o ka biopsy e mau ana no 1-2 mau lā
• ʻEha i hōʻike ʻia i ka poʻohiwi ʻākau
• Ke kahe koko liʻiliʻi e kū ana ma luna o kona iho
• Reaksiona Vasovagal (manaʻo nāwaliwali a i ʻole ka wili)
• Ke kahe koko nui e koi ana i ka lāʻau lapaʻau
• ʻO ka hou ʻana i nā ʻōkana kokoke e like me ka māmā a i ʻole ka gallbladder
• Maʻi ma kahi o ka biopsy
• Ke kahe koko nui e koi ana i ka hoʻoili koko a i ʻole ke ʻoki

E kūkākūkā kāu kauka i kēia mau pilikia me ʻoe ma mua o ke kaʻina hana a wehewehe pehea lākou e hōʻemi ai iā lākou ma o ka ʻenehana mālama a me ka nānā ʻana. Hoʻōla ka hapa nui o nā kānaka i loko o 24-48 mau hola me ka ʻole o nā hopena mau.

I ka manawa hea wau e ʻike ai i ke kauka ma hope o ka biopsy ate?

Pono ʻoe e hoʻokaʻaʻike koke i kāu kauka inā loaʻa iā ʻoe ka ʻeha nui o ka ʻōpū, ka wili, a i ʻole nā hōʻailona o ke kahe koko ma hope o kāu biopsy ate. ʻOiai he kakaikahi nā pilikia, he mea nui ka ʻike mua a me ka mālama ʻana inā loaʻa lākou.

Manaʻo ka hapa nui o nā kānaka i kekahi ʻoluʻolu ʻole no hoʻokahi a ʻelua paha lā ma hope o ke kaʻina hana, akā pono e hoʻomaikaʻi mālie kēia. Inā ʻoi aku ka ʻeha ma mua o ka maikaʻi, a i ʻole inā loaʻa iā ʻoe nā hōʻailona hou, he mea nui e ʻimi koke i ka lāʻau lapaʻau.

E kāhea koke i kāu kauka inā ʻike ʻoe i kekahi o kēia mau hōʻailona ʻōlelo aʻo:

• ʻEha nui a i ʻole e ʻino ana i ka ʻōpū ʻaʻole e hoʻomaikaʻi me ka hoʻomaha
• Pōniuniu, māmā ke poʻo, a i ʻole ka manaʻo e nāwaliwali paha
• Ka helu puʻuwai wikiwiki a i ʻole ka manaʻo nāwaliwali ʻole
• ʻO ka nausea a i ʻole ka luaʻi e pale ai iā ʻoe mai ka mālama ʻana i nā wai
• Ka wela ma luna o 101°F (38.3°C)
• Ke kahe ʻana o ke koko a i ʻole ka hoʻokuʻu ʻana mai ka pūnaewele biopsy
• Paʻakikī ka hanu ʻana a i ʻole ka ʻeha o ka umauma
• ʻO ka ʻili e lilo i keʻokeʻo, ʻoluʻolu, a i ʻole ke anu

No ka nānā ʻana i ka maʻamau, e hoʻonohonoho maʻamau kāu kauka i kahi manawa ma waena o 1-2 pule e kūkākūkā i nā hopena biopsy a hoʻolālā i kekahi lapaʻau e pono ai. Mai kānalua e kelepona me nā nīnau a i ʻole nā ​​hopohopo ma mua o kēia manawa.

Nā nīnau i nīnau pinepine ʻia e pili ana i ka biopsy ate

Q.1 He maikaʻi anei ka hoʻāʻo biopsy ate no ka ʻike ʻana i ka maʻi ate momona?

ʻAe, ua manaʻo ʻia ka biopsy ate ʻo ia ke kūlana gula no ka ʻike ʻana a me ka hoʻokumu ʻana i ka maʻi ate momona ʻole (NAFLD). ʻOiai hiki i nā hoʻāʻo koko a me ke kiʻi ke hōʻike i ka ate momona, hiki i ka biopsy ke hoʻokaʻawale ma waena o ka ate momona maʻalahi a me ke kūlana koʻikoʻi i kapa ʻia ʻo NASH (non-alcoholic steatohepatitis).

Hōʻike ka biopsy i ka nui o ka momona i loko o kāu mau cell ate a inā he mumū a i ʻole ka ʻili. Kōkua kēia ʻike i kāu kauka e hoʻoholo inā pono ʻoe i ka lāʻau a he aha ke ʻano e ʻoi aku ka maikaʻi no kāu kūlana kikoʻī.

Q.2 ʻEha anei ka biopsy ate i ka wā o ke kaʻina hana?

ʻO ka hapa nui o nā kānaka e ʻike wale i ka ʻoluʻolu liʻiliʻi i ka wā o ka biopsy maoli mahalo i ka anesthesia kūloko. Hiki iā ʻoe ke ʻike i ke kaomi a i ʻole kahi manaʻo ʻoi pōkole ke komo ka nila i kou ate, akā ʻoi aku kēia ma mua o kekona.

ʻO ka pahuʻi hoʻopāpā ma mua e hoʻoulu pinepine i ka ʻeha ma mua o ka biopsy iho. He nui nā kānaka e wehewehe ana i ka ʻike holoʻokoʻa he liʻiliʻi ka ʻeha ma mua o kā lākou i manaʻo ai, e like me ka lawe ʻana i ke koko a i ʻole ka loaʻa ʻana o ka lāʻau lapaʻau.

Q.3 Pehea ka lōʻihi o ka hoʻōla ʻana mai ka biopsy ate?

Hoʻōla piha ka hapa nui o nā kānaka i loko o 24-48 mau hola ma hope o kā lākou biopsy ate. Pono ʻoe e hoʻomaha no ke koena o ka lā ma hope o ke kaʻina hana, e pale ana i ka hāpai ʻana i nā mea kaumaha a i ʻole nā hana ikaika.

He nui nā kānaka e hoʻi i ka hana a me nā hana maʻamau i ka lā aʻe, akā pono ʻoe e pale i ka hāpai ʻana i nā mea kaumaha no hoʻokahi pule. E hāʻawi kāu kauka iā ʻoe i nā alakaʻi kikoʻī e pili ana i kāu hana a me ka pae hana.

Q.4 Hiki i ka biopsy ate ke ʻike i ka maʻi ʻaʻai ate?

ʻAe, hiki i ka biopsy ate ke ʻike i ka maʻi ʻaʻai ate a kōkua i ka hoʻoholo ʻana i ke ʻano. Hāʻawi ka laʻana ʻiʻo i nā pathologists e nānā i nā pūnaewele pākahi a ʻike i nā loli maʻi ʻaʻai i ʻike ʻole ʻia ma nā scans kiʻi.

Eia naʻe, ʻaʻole pono nā kauka i ka biopsy e ʻike i ka maʻi ʻaʻai ate. I kekahi manawa, hāʻawi ka hui pū ʻana o nā hoʻokolohua koko, nā kiʻi, a me kāu mōʻaukala olakino i ka ʻike lawa e hana ai i kahi ʻike a hoʻomaka i ka mālama ʻana.

Q.5 Aia kekahi mau koho ʻē aʻe i ka biopsy ate?

Hiki i kekahi mau hoʻokolohua non-invasive ke hāʻawi i ka ʻike e pili ana i ke olakino ate me ka ʻole e koi i kahi laʻana ʻiʻo. Aia kēia mau mea i nā hoʻokolohua koko kūikawā, elastography (e ana ana i ka paʻakikī o ka ate), a me nā ʻenehana kiʻi kiʻekiʻe.

ʻOiai he mea kōkua kēia mau koho ʻē aʻe no ka nānā ʻana i nā maʻi ate he nui, ʻaʻole hiki iā lākou ke hāʻawi i ka ʻike kikoʻī e hāʻawi ai ka biopsy. E kūkākūkā kāu kauka inā kūpono kēia mau koho ʻē aʻe no kāu kūlana.