Malabsorption - ke eng see? Classification le bakang

Nyenyane intestine - e mong oa intestine le. Ho etsa mefuta e fapaneng ya mesebetsi, phetha karolo e khōlō ho tshilo ya dijo ea lijo le absorption ea limatlafatsi. Le tsoelo-pele ea itseng mafu a ferekanngoa lefapha ena - ho totobala malabsorption lefu, e leng e khutsufalitsoe e le CMA. ke eng lentsoe lena? syndrome, sena se bakoa ke mabaka afe?

bopa dikgopolo tsa Decoding

Ka lingoliloeng tsa bongaka, o ka fumana e leng lentsoe le kang "malabsorption". lentsoe lena le sebelisitsoe ho bua ka malabsorption mala mucosa ea likarolo lijo. Ho na le boetse ho na le nako e kang "maldigestion". Sena dithulaganyo tlōla sokoloha ha mafura, diprotheini le k'habohaedreite tshilo ya dijo lihlahisoa absorbable.

Litsebi kopana bobeli lentsoe ka holimo ( "malabsorption" le "maldigestion"), ha e mong o bua ka lefu malabsorption. O bua ka liponahatso rarahaneng ea tleleniki, hlahang tsoa ditlolo tsa cavity, leboteng, lera tshilo ya dijo le ho tsamaisa ka intestine nyenyane. Ka lebaka la liphetoho tse etsahalang 'meleng oa motho ka lebaka la ho ho hlaha ha lefu malabsorption, mafu tshilong ya dijo ka hlaha. Batho ba qala ho hlokofatsa matšoao a sa thabiseng.

Lisosa tsa sma kelas

malabsorption syndrome, o ile a re ka le mafu a mangata a lefa le congenital oo tšoenngoa absorption ea dintho, fokotswa mosebetsi potlakisang tsebetso ea lik'hemik'hale. E le mohlala, cystic fibrosis. Ka lefu lena, ho AGR develops ka lebaka la ho mosebetsi potlakisang tsebetso ea lik'hemik'hale le pancreatic mafu liphiri e tiileng e qamathelang theola.

Ho etsa hore malabsorption mafu lefu le bakoang ke tšoaetso ea le likokoana-hloko, e sa tloaelehang lymphatic le tsamaiso ea ho potoloha ha mali. CMA o boetse o hlokometse tabeng ea tšenyo e ya intestine nyenyane le fokotsa absorption sebakeng (bitsoa liphetoho 'meleng, ka fetoha sesosa sa meferefere e tebileng ea mefuta e mengata ea fapanyetsana ho,' meleng le stunting kelello).

Kahoo, malabsorption - sete ya matšoao a sa thabiseng hore ka etsa hore e ngata mabaka a fapaneng. Ba ka ho kopantswe e latelang:

1. Preenteralnaya sehlopha. Tsena li akarelletsa mafu a biliary pampitsana ena, sebete, mala, cystic fibrosis.
2. Postenteralnaya sehlopha. Ho akarelletsa ho ea lisele tsa mmele le ajoa mali mafu a ka intestine telele, eo e teng pakeng tsa mala le mala, exudative enteropathy, lymphosarcoma, lefu Hodgkin e.
3. Enteral sehlopha la mabaka. Tsena li akarelletsa galactose malabsorption, lefu celiac, disaccharidase hloleha, giardiasis, dermatitis herpetiformis.

Matšoao a itseng ho sma kelas

Ho sa tsotellehe 'nete ea hore malabsorption lefu tlholeho ka mafu a tse fapa-fapaneng, e ka ba hlaheletseng bontšang tšobotsi sa hae. Ha CMA ho nyekoa ke pelo, ho hlatsa. Ka bakuli ba fokotseha takatso ea lijo. le matšoao ana le 'ona a bone ka bloating, phetoho ka setuloana (letšollo hangata e hlaha ka). matšoao ana 'ohle ba bitsoa lefu dyspeptic. O le etellang pele ho liponahatso tsa tleleniki ea sma kelas.

tlhokomelo e khethehileng e lokela ho ba setulo. Lekola litšobotsi tsa mantle, litsebi li fumana litaba tsa bohlokoa tse ba lumeletse ho beha tepelletse maikutlong nepahetseng:

• le frothy mokelikeli setuloana ka monko asiti - letšoao hore e ka 'na sa tlholeho ka pathologies kang tsoekere-galactose malabsorption, disaccharidase khaello;
• greasy setuloana e pancreatitis foleng, cystic fibrosis, dermatitis herpetiformis, exudative enteropathy lefu Pearson, mala dysbacteriosis;
• litulo greasy haholo o ile a re ka cystic fibrosis, congenital lipase khaello;
• metsi letšollo - letšoao hore ka etsahala ha tšoaetso a kena 'mele, ho ntshetsa pele enterocolitis, malabsorption ya tsoekere le galactose.

Ha MCA ka linako tse ling ho na le bohloko ba. Hangata ka ho fetisisa, ba bakela mafu a tsoaetsanang mala le infestations. Bohloko lefu ka etsahala ka mor'a timetsang lihlahisoa tsa lebese. O ho kopantswe le foamy setulo le monko o bolila, flatulence bontša khaello lactase. bohloko mpeng nakong CMA felehetsa kulisoa lijo, mala tsela e sa tloaelehang, lefu Whipple e, ulcerative colitis, lefu Crohn e. Matšoao tse latelang di hlokometse le ha malabsorption lefu:

• letlalo lekhopho;
• mokhathala;
• ba le boikutlo bo bofokoli;
• bloating;
• ipolaisa tlala.

Malabsorption ka bana ba tsamaea le syndromes leqeme. Tšoenngoa ntshetsopeleng meleng. Ena e bontšoa ka phokotso ea boima ba 'mele, ho hōla ha khaello ea phepo, tswela pele ka botlalo ho hōla. Ka vithamine khaello e bontša boemo ba letlalo. Letlalo fetoha omeletseng le e qala ho Peel theoha. Ka ho hlaha matheba lefifi. Moriri thinning le qala ba khaotse ho. The manala ba molumo lerootho le exfoliate. Ha khaello k'halsiamo etsahala cramps, bohloko mesifa le masapo. Ho hloka ea tšepe, koporo le zinki isang ponahalo ea letlalo lekhopho, tšepe-khaello khaello ea mali, eketsa ka mocheso oa 'mele.

tlhophiso o teng

malabsorption syndrome, e akarelletsa tse fetang 70 mafu a fapaneng. Tabeng ena, litsebi li kopana mathata a mang ka tlhophiso ea ho lokisetsa ho. O atlehileng ka ho fetisisa ke ho makala a lefa le ho fumana syndromes malabsorption:

1. Pele ea bana ba e lemoha ho 10% ea linyeoe. Lefa sma kelas e fetisoa ho tloha ho batsoali ho ngoana. O ile a boela ka lebaka la liphetoho tse bang teng phatsa ea lefutso.
2. Fumanweng malabsorption lefu - ka lebaka la mafu a mala le extraintestinal (mohlala lihlahala, immunodeficiencies, sebete le manyeme).

Ho na le boetse ho na le tlhophiso e leng e thehiloe ho tiea tsa lefu malabsorption:

• Sehlopheng I (mofuta o bonolo) - bana hanyenyane fokotswa boima ba 'mele, matšoao a hlaha multivitamin hloleha hlokomela disharmonious ntshetsopeleng' meleng;
• II isa tekanyong (karolelano sebopeho) - mokuli o haelloa 'mele boima (kheloha ho tswa tloaelehileng le o moholo ho feta 10%) o ile a re mat du ka ntshetsopeleng meleng, bone bitsoa matšoao electrolyte khaello le insufficiency multivitamin;
• Sehlopheng III (haholo) - bana ba mmeleng underdeveloped, 'mele oa boima haelloa feta 20%, ka bang bakuli ba na le tieho ntshetsopeleng psychomotor.

mefuta malabsorption

Ka 1977 e neng e tšoaretsoe VIII World Congress ya Gastroenterology. Ho ditsebi li tsejoa mefuta e 'maloa ea malabsorption, ho itšetlehile ka bakang lona:

• intracavitary;
• posttsellyulyarnaya;
• enterotsellyulyarnaya.

Ho hloka bile secreted ke manyeme le dintho tseo e ama tshilo ya dijo recessed le etsa hore boemo boo, - malabsorption intracavitary mofuta. Toddlers ba hlaha ka lebaka la ho cystic fibrosis, congenital hypoplasia ea manyeme le. Ka bana ba baholoanyane le ponahalo ea intracavitary malabsorption lefu qholotsa mafu a kang ho thatafala ha sebete, pancreatitis foleng.

Mofuta oa bobeli oa sma kelas - posttsellyulyarnaya malabsorption. lefu lena, e tšoauoa ka ho lahleheloa ke lero la mali le protheine ka leboteng mala. O ile a re le anomalies tsa tsamaiso ea ho potoloha ha mali 'me lymphatic. E mong oa mafu a le - e idiopathic mala lymphangiectasia. O ile a ke sa tlholeho ka ho lahleheloa ke boima ba k'halsiamo, lipids le liprotheine ka pampitšana ea gastrointestinal.

Enterotsellyulyarny mofuta kopanya mabokosana tseo moo robehileng lera tshilo ya dijo kapa absorption ka lebaka la ho le sekoli ea litsamaiso potlakisang tsebetso ea lik'hemik'hale ea mala lisele tse epithelial. Joalo ka 'na etsahala ka bana ba banyenyane ka lebaka la mafu a lefa amanang le tlōlo ea:

• fire;
• lera tshilo ya dijo;
• tshilo ya dijo le absorption.

Bana ba baholo mofuta lilemo enterotsellyulyarny ea syndrome, malabsorption le hlaha ka lebaka la ho senya mala le seleng ea lefu ka lebaka la tšusumetso ea tšoaetso ea kapa likokoana-hloko, lefuba, lihlahala tsa intestine nyenyane, lefu Crohn e.

Mehlala intracavitary malabsorption

Le mofuta ona wa AGR haholo tšoenngoa tshilo ya dijo mafura. hydrolysis bona e etsoang ke lipase pancreatic, e leng e butswe ke bile. Le khaello ea thepa tsena bonahala letšoao kang steatorrhea. Sena kgetho le mantle feteletseng mafura. Sena se ka ho hlaka ho fetisisa o ile a bontša ka ho sa foleng pancreatitis steatorrhea. Tlase bonahaleng ena letšoao ka sebete 'me pampitšana biliary.

Har'a lisosa tsa malabsorption intracavitary, lokela ho nahana congenital hypoplasia ea manyeme (hypoplasia). Matšoao a hlaha ka matsatsi a pele kapa ka mor'a libeke tse ea bophelo. Ho na le ke ya diphalli morui, setulo potlako malodorous le greasy benya. Mafura a ka esita le a lula a Leak ka haha le.

Mehlala posttsellyulyarnoy malabsorption

Posttsellyulyarnaya mala malabsorption etsahala ha exudative enteropathy. Ena ke lefu leo ho lona lero la mali le protheine e lahlehileng ka mucosa le. Sesosa sa enteropathy exudative ka 'na ea ho ba teng ha congenital malformation likepe lymphatic mantle a. Hangata ka ho fetisisa bakang lefu lefu Whipple e, lefu Crohn e, lihlahala tse nyenyane mantle a, lijo allergy.

Exudative enteropathy ka linako tse ling le hlaha kantle liponahatso overt litleleniki tsa. Ka 'na ba le matšoao a kang letšollo le steatorrhea. Bakuli ba hlaha edema pheriferale, localized ka sefahleho, morao, perineum, maoto le matsoho.

Mehlala enterotsellyulyarnoy malabsorption

Enterotsellyulyarny mofuta AGR malabsorption ka 'na ba bakoa ke bolwetse e kang tsoekere-galactose malabsorption. Sena ke e futsitseng lefu moo robehile lipalangoang mafolofolo tsa tsoekere le galactose ka tse nyenyane intestine mucosa. Ho kula ka matsatsi a pele ea bophelo e bontšoa ke letšollo. Fecal abelwa ho tloha linakong tsa 10 ho isa ho 20 ka letsatsi. Ba metsi, tšoanang moroto. Ngwana hlahisa mocheso oa 'mele, ho hlatsa le hlaha. Haeba u hlakola phepelo lebese ke matšoao. Empa mafutsana mamello ea lipompong le lebese e ntse e bophelo bohle ba sona.

Mohlala o mong o enterotsellyulyarnogo CMA - fructose malabsorption. Ena ke ka seoelo liphatsa tsa lefutso malabsorption. Matšoao a etsahala ka mor'a tshebediso ya ea litholoana le tsa ditholwana, e nang le ka ho sebopehong lona e khōlō palo ya fructose. Sena ke liapole le dilamunu, 'me cherries le ciliegia. fructose, e sa ananelang 'mele, a etsa hore flatulence, letšollo metsi, bohloko colicky ka mpa wa. Maemong a mang, ho na le e ho hlatsa. The tiea matšoao itšetlehile ka ka tjhelete e ya fructose kena 'mele.

The atileng ka ho fetisisa lebaka enterotsellyulyarnoy malabsorption le phytoteratology lera tshilo ya dijo - e disaccharidase khaello. Haeba e sa ka ho feletseng arola disaccharides. Ba ha ba ikakhela ka setotsoana ha ba kena ka intestine distal le feta belisoa baktheria le ho iphetola ha lintho ea hydrogen. Ho na le linako tsa colic mala, bloating, letšollo, fokotseha takatso ea lijo, ho hlatsa, ho hlatsa.

Enterotsellyulyarnaya mala malabsorption malabsorption le tshilo ya dijo ka etsahala lefu celiac. Ho sa foleng lefa lefu leo ho lona senyehile villi ya intestine nyane ke lijo tse itseng. lefu Celiac e bontšoa ka ho bana ba likhoeli tse seng kae ka mor'a selelekeleng sa lihlahisoa phomosetsa glyutensoderzhaschih. Ha lefu lena le:

• defecation maqhubu e 2 ho 5 ka letsatsi;
• setuloana e mushy, ka linako tse ling frothy, ho ke ke tlhaho ka monko fetid, khanya;
• eketsa mpeng;
• ho na le lekaneng ho nona (ka mor'a nako e itseng ho batho ba bangata haelloa ke oona o kopanela khaello kgolo ya).

Ho phetha tlhathoba le lefu malabsorption

Tepelletse maikutlong malabsorption e sa atlehe. Litsebi tse khethollang sma kelas matšoao a laetsoeng ho bakuli ba tsona ba ho fetola ea liteko e khethehileng le Tlhahlobo ea ho netefatsa tsela e 'ngoe kapa bolwetse mong belaela halefisoa ke phytoteratology absorption kapa tshilo ya dijo.

Ha ho phetha tlhathoba, lingaka li tataisoa ke le ka tlaase-tharabololo ntshetswa pele ke Mokhatlo oa World Gastroenterology:

• pele o atlehe ka histori ka ho phethahetseng, bokella boitsebiso bo mabapi le ho noa meriana ikemiseditse sa tsoa ba tsamaea, tšebeliso ea lijo le lino-mapholi se akarelletsa lijo tloaelehileng;
• ithutile histori lelapa;
• ke ho hlahloba ka nameng lipontšo tsa malabsorption;
• ithutile setuloana, e kentse litšobotsi tse ba bona;
• liteko laboratori ea ba phethahatsoa bakeng sa boitsebiso bo eketsehileng.

Ho ekelletsa moo phumano ya lefu malabsorption akarelletsa ho diphuputso tiragatso ya lefu belaela celiac, boteng ba Giardia, libaktheria le likokoana-hloko 'meleng. Bohlokoa tekotshupo lesedi dumella ho fumana tsa ultrasound tsa litho tse ka hare tsa cavity mpeng. Ka ultrasound maemong khoneha ho hakanya boemo ba nodes sebete, manyeme, senya nyooko, lisele tsa mmele.

Ho qhelela ka thōko kapa ho tiisetsa gastritis autoimmune, lefu celiac, lefu Crohn e hlokahale esophagogastroduodenoscopy le biopsy ea mala le duodenum. Ho netefatsa ho hloka exocrine pancreatic mosebetsi tshwerweng setuloana lithuto tsa k'homphieutha le gomoso khoheli tomography, retrograde cholangiopancreatography ho bona eka ducts. Ho ithuta ka ho ba teng kapa ho ba sieo ha diso tsa ileum e, litsebi li e behiloeng ileokolonoskopiyu le biopsy tsa sebakeng seo ho ithuta le mala.

Kalafo ea lefu malabsorption

Mora diagnosing lisosa malabsorption lingaka etiotropic laela kalafo ikemiseditse ho bua le lefu lena le tsejoa. Mohlala:

• Haeba lefu celiac e lemoha, ho setsebi khothalletsa mokuli e ba manameng bophelo bohle gluten ntle ho ja;
• haeba lemoha malabsorption la lik'habohaedreite kapa mamellane lijo, joale e se ka abeloa ho ea lekanang e felisoa kapa lijo thata;
• dithulaganyo tšoaetsanoang bontša lithibela-mafu;
• ka tshilong ya dijo le endocrine mafu hloka lekaneng pathogenetic phekolo.

Ha a bontša hore letšollo syndrome, e bakang malabsorption, kalafo e ka ba etiologic, le pathogenetic bontshang matshwao. Patogenetichekaya etiological phekolo le ka ba le ho noa ea mokhoa oa ho latelang:

• lithibela-mafu bakeng sa letšollo baktheria;
• "Metronidazole" le amebiasis;
• lithethefatsi anthelmintic helminthiasis;
• glucocorticoids, cytostatics, "infliximab" ka lefu a hlabang mantle a;
• "Tetracycline", "Ceftriaxone", "Co-trimoxazole" lefu Whipple ya;
• "Octreotide" ka endocrine lihlahala tsa pampitšana eo gastrointestinal.

kalafo bontshang matshwao akarelletsa ho fumana probiotics, opiates, "Loperamide" monya moemeli (bismuth litokisetso "Diosmektita").

Ho intša ha khoneha ka ketsahalo ea matšoao a sma kelas. Ha ho fa litholoana tse molemo. Ho phaella moo, malabsorption - ke ponahatso ea mafu a ho tebileng 'me kotsi. Haeba u e-ba lipontšo tsa sma kelas e kgothaletswa ho buisana ngaka. Feela setsebi ka bitsoa sesosa 'nete ea syndrome, e le hore a khethe e phekolo e atlehang bakeng sa ho felisoa ha lefu le ka fumanoa.