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},
"code": "C22",
"name": "Рак печени и внутрипеченочных желчных протоков",
"icd_name": "Рак печени и внутрипеченочных желчных протоков",
"gender": 0,
"age_min": 45,
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3,
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"slug": "c22_rak_pecheni_i_vnutripechenochnyh_zhelchnyh_protokov",
"lead": "наиболее распространённая первичная злокачественная опухоль печени. Результат малигнизации (злокачественной трасформации) гепатоцитов.",
"description": "Злокачественное новообразование, которое развивается из клеток паренхимы печени, называют гепатоцеллюлярной карциномой (ГЦК). Если опухоль образуется из эпителия желчных протоков, то ее называют холангиокарциномой. Опухоль может иметь вид одного или нескольких узлов разных размеров, или же поражать весь орган. В последнем случае принято говорить о диффузной форме рака печени. ",
"etiology": "<p>Риск развития рака печени повышается при: циррозе; алкогольном и лекарственном гепатите; сердечной недостаточности; паразитарных инфекциях (описторхоз, амебиаз и др.); желчнокаменной болезни; сифилисе; приеме анаболических стероидов; контакте с промышленными химикатами.<br /><br /><br /></p>",
"pathogenesis": "",
"diagnostics": "<p>Злокачественная опухоль печени может быть обнаружена путем сдачи анализа крови на биохимические показатели, которые указывают на функцию печени. При уменьшении альбуминов, росте активности трансаминаза, повышении фиброногена и мочевины, креатинина и остаточного азота может указывать на наличие ракового образования. При таком результате анализа врач назначает проведение печеночных проб и коагулограммы, а так же начальное лечение рака печени в Москве.</p>\r\n<p>Чтоб получить более точную картину состояния здоровья человека делается ультра-звуковое исследование, МРТ и КТ печени, ангиография. Для подтверждения или опровержения диагноза большинство врачей рекомендуют пункционную биопсию тканей опухоли и печени для детального и составного обследования.</p>\r\n<p>Если злокачественная опухоль печени начала метастазирование в другие органы тела, то важно установить места расположения метастазов и вовремя начать лечение рака печени. Для этого проводятся следующие манипуляции:</p>\r\n<ul>\r\n<li>ЭГДС;</li>\r\n<li>Рентгенография желудка;</li>\r\n<li>Ультра-звуковое исследование молочных желез;</li>\r\n<li>Маммография;</li>\r\n<li>Флюорография легких;</li>\r\n<li>Колоноскопия;</li>\r\n</ul>",
"treatment": "<p>Рак печени с трудом поддается лечению. При метастатическом раке прогноз обычно хуже, чем при первичном. Радикальным способом является удаление опухоли после предварительной химиотерапии. К хирургическому способу прибегают в тех случаях, когда опухоль локализована, не имеет внепеченочных метастазов, небольшого размера, не проросла кровеносные сосуды, а печеночная ткань не изменена циррозом. При этом можно удалить достаточно большую часть органа, так как печень обладает хорошей способностью к регенерации и уже через 6 месяцев способна полностью восстановить прежний объем. Но такие операции достаточно сложны технически и показаны не всем пациентам. После удаления части печени при раке выживаемость в течение 5 лет составляет не более 20%. Химиотерапию, как самостоятельный способ борьбы с раком печени, применяют лишь в неоперабельных случаях. Она облегчает самочувствие пациентов. Химиотерапия оказывается более действенной и легче переносится, если препараты вводить непосредственно в печеночную артерию. Лучевая терапия при раке печени не используется. Она малоэффективна, а печень очень чувствительна к радиации, и пациенты тяжело переносят данный вид лечения. Из альтернативных способов лечения рака печени в последнее время все активнее применяют радиочастотную аблацию и криоаблацию, таргетную терапию нексаваром, введение этанола в опухолевые узлы, протонную терапию. <br /><br /><br /></p>",
"prevention": "",
"clinical_picture": "<p>И первичный, и вторичный рак печени имеют одинаковые признаки. Они неспецифичны именно для онкологических заболеваний, поэтому их легко спутать с другими заболеваниями печени — обострением хронического гепатита, желчнокаменной болезнью и пр. </p>\r\n<p>Ранние симптомы рака: ощущение дискомфорта из-за вздутия живота; <a href=\"/symptom/toshnota/\" title=\"Перейти на страницу симптома Тошнота\">тошнота</a>, иногда <a href=\"/symptom/rvota/\" title=\"Перейти на страницу симптома Рвота\">рвота</a>; запоры и поносы; сниженный аппетит; постоянное <a href=\"/symptom/utomlyaemost/\" title=\"Перейти на страницу симптома Утомляемость\">недомогание</a> и <a href=\"/symptom/utomlyaemost/\" title=\"Перейти на страницу симптома Утомляемость\">усталость</a>; снижение веса; иногда — <a href=\"/symptom/oznob/\" title=\"Перейти на страницу симптома Озноб\">озноб</a> и <a href=\"/symptom/vysokaya_temperatura_38-42/\" title=\"Перейти на страницу симптома Высокая температура 38-42° \">повышение температуры</a>. Когда опухоль достигает достаточно больших размеров, она блокирует отток желчи из печени в кишечник. У пациента появляются признаки механической желтухи, это происходит из-за того, что желчь попадает из внутрипеченочных протоков прямо в кровь. Более поздними признаками опухолевого процесса в печени является механическая <a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">желтуха</a> — <a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\"><a href=\"/symptom/zheltuha/\" title=\"Перейти на страницу симптома Желтуха\">пожелтение</a> кожи</a>, слизистых и склер, <a href=\"/symptom/zud/\" title=\"Перейти на страницу симптома Зуд\">зуд</a> кожи, <a href=\"/symptom/temnaya_mocha/\" title=\"Перейти на страницу симптома Темная моча\">потемнение мочи</a> и осветление стула. Эти симптомы также неспецифичны и обнаруживаются при любых затруднениях оттока желчи. Кроме того, на этом этапе у больных появляются постоянные ноющие боли в правом подреберье. На поздних стадиях рак печени приводит к развитию анемии, кровотечений из разных органов, скоплению жидкости в брюшной полости, отравлению организма продуктами распада желчных кислот.<br /><br /><br /></p>",
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