So mogya ntini a ɛwɔ wo esophagus, a ɛyɛ afiri a ɛde aduan fi w’anom kɔ wo yafunu mu no ahonhon na ayɛ kɛse? Ebia woante eyi ho asɛm mpo. Nanso tebea yi a wɔfrɛ no Esophageal Varices no betumi ayɛ komm na mpofirim ara abɛyɛ asiane. Enti ɛnnɛ, momma yensua ho biribiara a ɛnyɛ den koraa, te sɛ nea yɛne yɛn adamfo bi rekasa.
Sɛ yɛbɛka no tiawa a, dɛn ne esophageal varices?
Wo de susuw ho hwɛ, ɛtɔ mmere bi a yɛn nan ho ntini ahonhon na akyeakyea? Yɛfrɛ wɔn ‘varicose veins’. Saa ara na ɛkɔ so wɔ yɛn gullet no mu. Ntini yi afasu yɛ mmerɛw yiye. Enti hokwan kɛse wɔ hɔ sɛ mogya betu afi wɔn mu, anaasɛ wɔbɛpae mpofirim na mogya atu. Saa mogya a ɛba nipadua no mu yi betumi ayɛ nea ɛba mpofirim, emu yɛ den, na ɛde ne nkwa mpo to asiane mu.
Mpɛn pii no, nhyɛso a ɛkɔ soro wɔ mogya ntini titiriw a ɛfa mmerɛbo no ne ntini afoforo a ɛka ho no mu (Portal Hypertension) na ɛde saa tebea yi ba. Saa nhyɛso a ɛnteɛ yi ma ntini nketenkete a ɛwɔ mmerɛbo no mu no hohoro na ɛyɛ akɛse. Wɔtaa hu saa tebea yi wɔ nnipa a wɔwɔ mmerɛbo mu yare no mu.
Tebea yi yɛ aniberesɛm dɛn?
Asiane a ɛyɛ hu sen biara a ɛwɔ portal vein thrombosis mu ne mogya a ɛbɛtɔ . Ɛnyɛ obiara na mogya tu, nanso nnipa bɛyɛ 50% na wɔwɔ asiane mu. Dodow a portal hypertension no kɔ soro no, dodow no ara na asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no yɛ kɛse. Saa nhyɛso yi kɔ soro bere a mmerɛbo mu yare, titiriw mmerɛbo mu yare .
Ebia nnipa a wɔwɔ mmerɛbo mu yare a emu yɛ den no benya ɔhaw afoforo de aka ntini a ɛho ahonhon yi ho. Nanso, ade titiriw a ɛma wɔde wɔn kɔ ayaresabea na wowuwu ne ntini yi mu paapae na mogya tu no. Sɛ mogya tu wo pɛnkoro wɔ saa kwan yi so a, asiane a ɛwɔ hɔ sɛ wubewu no bɛyɛ 20%. Afei nso, mogya no betumi asan aba mpɛn pii.
Dɛn ne tebea yi ho sɛnkyerɛnne?
Esiane sɛ saa ntini yi wɔ nipadua no mu nti, wonhu te sɛ ntini a ɛwɔ nan mu. Ebia worente wɔn nka mpo bere a womene aduan no. Nokwarem no, ebia wɔrenna yare no ho sɛnkyerɛnne biara adi kosi sɛ wobefi ase atu mogya .
Nanso, sɛ oduruyɛfo bi hu sɛnkyerɛnne afoforo a ɛkyerɛ sɛ wowɔ mmerɛbo mu yare anaa portal hypertension a, ebia obesusuw sɛ eyi nso.
| Nsɛnkyerɛnne no su | Nkyerɛmu |
|---|---|
| Nsɛnkyerɛnne a ɛkyerɛ sɛ mmerɛbo mu yare | |
| Jaundice a ɛyɛ mmerɛw | Wo honam ani ne w’ani dan kɔla. |
| Ascites a ɛyɛ mmerɛw | Yafunu mu ahonhon esiane nsu a ɛboaboa ano wɔ yafunu (yafunu) mu nti. |
| Edema a ɛma obi ho yɛ hyew | Nan ne anan a ɛho ahonhon. |
| Yafunu atifi yaw | Ɛyaw a ɛnam mmerɛbo anaa akyi berɛmo a ɛho ahonhon so ba. |
| Abasamtu ho atenka | Hepatic encephalopathy yɛ tebea a mmerɛbo no ntumi nyɛ adwuma yiye, na ɛka amemene no. |
| Nsɛnkyerɛnne a ɛkyerɛ sɛ mogya tu fi ntini bi mu | |
| Mogya a wɔfe | Sɛ mogya no tu brɛoo a, ebia ɔfe no bɛyɛ te sɛ kɔfe a wɔayam. Sɛ ntini bi pae mpofirim a, mogya foforo a ɛyɛ kɔkɔɔ bɛfe. |
| Mogya a ɛwɔ nsu mu | Sɛ mogya fa aduan mu a, ebetumi ama nsu no ayɛ tuntum tuntum, te sɛ tar (melena). Sɛ mogya tu ntɛmntɛm a, wobetumi de mogya kɔkɔɔ foforo nso akɔ. |
| Paleness a ɛyɛ mmerɛw | Hwɛ a ɛyɛ bruu te sɛ nea mogya no afi anim. |
| Ɔbrɛ ne adwenemhaw | Ɔbrɛ, mmerɛwyɛ, ne adwenemhaw a wɔte nka esiane mogya mmoroso a ɛba fam nti. |
Nea ɛho hia yiye: Sɛ wunya hypovolemic shock ho sɛnkyerɛnne esiane mogya a ɛtɔ dodo nti a, kɔ ayaresabea dan a wɔhwɛ wɔn a wɔwɔ yare a egye ntɛmpɛ (ETU) ntɛm ara. Saa sɛnkyerɛnne ahorow yi bi ne: koma bɔ ntɛmntɛm, ɔhome ntɛmntɛm, fifiri a ɛyɛ nwini, ne adwene a ɛyera.
Dɛn nti na saa ntini yi hohoro? Dɛn na ɛde ba?
Sɛnea yɛadi kan aka ho asɛm no, nea ɛde ba titiriw ne tebea bi a wɔfrɛ no ``Portal Hypertension.`` Momma yɛnte eyi ase kakra.
Fa no sɛ yɛn mmerɛbo no yɛ ade kɛse a wɔde yiyi mu. Mogya a efi aduan a ɛwɔ yafunu mu ba no fa mmerɛbo no mu, na ɛhɔ na wɔhohoro na afei ɛkɔ koma no mu. Ntini titiriw a ɛde mogya yi ba mmerɛbo no mu no, wɔfrɛ no ``Portal Vein``.
Afei, sɛ mmerɛbo no mu akuru na ayɛ den esiane yare bi te sɛ cirrhosis , nti a, saa mogya no ntumi mfa mmerɛbo no mu ntɛmntɛm. Ɛte sɛ nea kar akɛse a ayɛ basaa wɔ ɔkwan bi so. Eyi ma mogya mmoroso a ɛwɔ portal vein no mu no kɔ soro kɛse.
Nipadua no bɔ mmɔden sɛ ebetua nhyɛso a ɛkɔ soro yi denam mogya a ɛdan fa ntini nketenkete (ntini nketewa) mu no so. Ntini a ɛwɔ ureter no mu no yɛ ntini nketenkete a ɛte saa ara. Nanso saa ntini nketenkete yi ntumi nni mogya ne nhyɛso pii no ho dwuma. Ne saa nti, wɔn hohoro, wɔyɛ akɛse, na wotumi pae bere biara.
Nneɛma atitiriw a ɛde mmerɛbo mu yare ba ne:
- Nsã a wɔnom boro so.
- Mmerɛbo a srade wom (Steatohepatitis a ɛnyɛ nsa).
- Hepatitis a ɔyare mmoawa de ba bere tenten.
- Nipadua no ankasa nipadua mu ahoɔden a ɛko tia nyarewa no tow hyɛ mmerɛbo no so (Autoimmune Hepatitis).
- Nneɛma afoforo a ɛde ba te sɛ mogya a ɛtɔ, mmoawa a wɔsɛe nnɔbae (Schistosomiasis) ne nea ɛkeka ho.
Wobɛyɛ dɛn ahu sɛ wowɔ saa tebea yi?
Mpɛn pii no, bere a oduruyɛfo bi ahwɛ wo akyi nkutoo na wuhu eyi. Sɛ wowɔ mmerɛbo mu yare dedaw a, wo duruyɛfo bɛtaa akamfo akyerɛ sɛ ɔnhwehwɛ ntini a ɛho ahonhon yi mu.
Sɔhwɛ titiriw ne Upper Endoscopy anaa EGD sɔhwɛ .
Nea ɛka eyi ho ne sɛ wode afiri a ɛyɛ tratraa a ɛyɛ mmerɛw a mfoninitwa afiri a wɔde fa w’ano abata ho bɛhyɛ mu na woahwɛ wo menewam, yafunu, ne wo dwensɔtwaa ketewa no mfiase. Eyi ma wo duruyɛfo hu pefee sɛ ebia wo ntini ahonhon, sɛnea ɛsõ, ne sɛ ebia mogya betumi atu no anaa.
Dɛn ne ayaresa ahorow a wɔde sa eyi?
Nea eye ne sɛ, ayaresa ahorow wɔ hɔ a wobetumi de asiw mogya a ɛretu no ano na wɔasiw mogya a ɛbɛsan atu no ano. Botae atitiriw a ɛwɔ ayaresa mu ne sɛ:
- Di mogya a ɛretu a ɛyɛ nnam so sɛ bi wɔ hɔ a.
- Mogya a ɛbɛtɔ daakye a wobesiw ano.
- Sɛ ɛbɛyɛ yiye a, tew tebea a ɛne `(Portal Hypertension)` no so.
1. Siw mogya a ɛtɔ (nea egye ntɛmpɛ) so .
Eyi yɛ aduruyɛ mu asɛm a egye ntɛmpɛ. Wɔ ayaresabea hɔ no, wɔbɛma wo nsu a wɔde fa IV mu, sɛ ɛho hia a, wɔbɛma wo mogya, na wɔayɛ endoscopy bere a wo tebea no ayɛ den awie no. Hɔ:
- Varicose Band Ligation: Wɔde adwinnade ketewaa bi fa endoscope no mu na wɔde rɔba ketewaa bi twa varicose vein no ho hyia. Eyi ma mogya a ɛkɔ ntini no mu no gyae na ɛhwɛ mogya a ɛretu no so.
- Nnuru: Wɔde nnuru a ɛma mogya mmoroso so tew na ɛtwetwe mogya ntini (Octreotide, Vasopressin) fa ntini bi mu ma.
2. Mogya a ɛbɛsan atu no a wobesiw ano
Sɛ mogya retu anaasɛ ɛnte saa no, sɛ asiane wɔ hɔ sɛ mogya bɛtu a, oduruyɛfo no befi ase ayɛ ayaresa de asiw ano.
- Beta-blockers: Saa aduru yi a wɔde ma mogya mmoroso no betumi atew asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so bɛyɛ 50%.
- Band Ligation: Wɔde saa kwan yi nso di dwuma sɛ ade a wɔde siw ano ma nnipa binom.
3. Nea ɛde ba no a wɔbɛsa
Sɛ atifi hɔ ayaresa ahorow no ntew asiane a ɛwɔ hɔ sɛ mogya bɛtɔ no so a, wo duruyɛfo betumi akyerɛ akwan foforo a wobɛfa so atew ``Portal Hypertension'' tebea no so tẽẽ.
- Transjugular Intrahepatic Portal-Systemic Shunt (TIPS): Eyi nyɛ oprehyɛn a wɔyɛ. Wɔ saa adeyɛ yi mu no, wɔde afiri ketewaa bi (stent) hyɛ ntini bi a ɛwɔ mmerɛbo no mu a ɛde mogya fi portal vein no mu, na ɛma nkitahodi foforo, anaa "kwan tiawa" ba. Eyi ma nhyɛso so tew kɛse.
- Oprehyɛn: Oprehyɛn te sɛ ``Distal Splenorenal Shunt (DSRS)`` nso tew nhyɛso so denam mogya a ɛkɔ baabi foforo a ɛdannan no so.
Mma wo werɛ mmfi: Ade a ɛho hia sen biara ne sɛ wobɛsa nea ɛde mmerɛbo no sɛe no. Sɛ wogyae nsa, wo mu duru so tew, na wosa tebea horow te sɛ hepatitis C a, ebetumi aboa ma mmerɛbo a ɛsɛe no so atew na asiw yare no ano.
Nkrasɛm a Wɔde Kɔ Fie
- Esophageal varices yɛ tebea a emu yɛ den a ɛtaa mfa sɛnkyerɛnne biara mma kosi sɛ mogya bɛtu.
- Nea ɛde eyi ba titiriw ne portal hypertension a mmerɛbo mu yare, titiriw cirrhosis de ba.
- Sɛ wowɔ mmerɛbo mu yare a, ɛho hia paa sɛ wo ne wo duruyɛfo kasa na woyɛ nhwehwɛmu daa.
- Sɛ wuhu sɛnkyerɛnne ahorow te sɛ mogya a wobɛfe anaasɛ nsu tuntum a wobɛfa mu a, ɛyɛ ntɛmpɛ. Kɔ ayaresabea bi Dwumadibea a Ɛhwɛ Nneɛma a Ɛho Hia Ntɛmntɛm (ETU) ntɛm ara.
- Nsakrae a ɛba asetra mu, te sɛ nsa a wogyae ne asetra a ɛfata a wobɛkɔ so akura mu no boa kɛse wɔ mmerɛbo akwahosan a ɛkɔ so tra hɔ na ɛmma tebea yi nsɛe no mu.
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