Aklã nye ŋutinu wɔnuku aɖe le míaƒe ŋutilã me. Ele abe dɔwɔƒe gã aɖe ene. Ewɔa dɔ vevi geɖewo abe aɖinuwo ɖeɖeɖa, kpekpeɖeŋunana nuɖuɖu be woaɖu, kple ŋusẽ dzadzraɖo ene. Ke hã, aklã xɔasi sia ate ŋu agblẽ le susu vovovowo ta. Ne aklãa le gbegblẽm atraɖii le ɣeyiɣi aɖe megbe la, abi ƒe lãkusi tea wɔwɔ ɖe lãmenugbagbevi siwo le lãmesẽ me teƒe. Emae nye nɔnɔme si míeyɔna be cirrhosis.
Nuka tututue nye ʋumenugbagbeviɣidɔ?
Bu eŋu kpɔ ne abi aɖe le wò ŋutigbalẽ ŋu si haya eye wògblẽ abi ɖi, alo? Nenemae wòdzɔna ɖe aklãa dzi. Ne dɔdzẽ le aklãa me ɣeyiɣi didi aɖe la, aklãa dzea agbagba be yeada gbe le eɖokui ŋu. Le esia wɔwɔ me la, abi ƒe lãkusi sesẽ siwo mewɔa dɔ nyuie o la dzɔna ɖe aklã ƒe lãkusi falɛfalɛ siwo le lãmesẽ me teƒe.
Kpuie ko la, aklãdɔléle si nɔa anyi didi ƒe akpa mamlɛtɔ. Le ɣeyiɣi sia me la, aklã ƒe akpa siwo le lãmesẽ me ƒe akpa gãtɔ va zu abi. Ne abi sia le dzidzim ɖe edzi la, aklãa megate ŋu wɔa eƒe dɔ si sɔ, si nye ʋua ŋu kɔklɔ kple nunyiamewo ŋudɔwɔwɔ o. Mlɔeba la, esia ate ŋu ana aklã nawɔ dɔ nyuie o .
Nu vevitɔe nye be womate ŋu atrɔ abi siwo cirrhosis hena vɛ, si fia be woada wo keŋkeŋ o. Gake mègatsi dzi o. Ne míewɔ atike nyuitɔ la, míate ŋu aɖu nɔnɔme sia ƒe gbegblẽ dzi alo aɖe edzi akpɔtɔ.
Ðe ʋumenugbagbeviɣidɔ ƒe afɔɖeɖe aɖewo lia?
Ẽ, ʋumenugbagbeviɣidɔ hã nu sẽna ɖe edzi vivivi. Mina míaƒo nu tso eŋu to emama ɖe akpa vevi eve me.
1. Compensated Cirrhosis: Esiae nye akpa gbãtɔ. Le ɣeyiɣi sia me la, togbɔ be aklãa gblẽ hã la, aklãa ƒe akpa si susɔ si le lãmesẽ me la te ŋu xea nusiwo gblẽ la teƒe, alo ‘xea fe’, eye wònana ŋutilãa nɔa dɔ wɔm. Esia tae ɖewohĩ dzesi aɖeke manɔ ŋuwò kura o. Ame geɖe menya gɔ̃ hã be dɔléle sia le yewo ŋu o.
2. Decompensated Cirrhosis: Le ɣeyiɣi aɖe megbe la, ne abi ƒe lãkusi siwo le aklãa me le dzidzim ɖe edzi la, aklãa megate ŋu dzraa nusiwo gblẽ la ɖo o. Esiae nye esime dzesiwo dzea egɔme dzena. Wokpɔa dzesiwo abe tsi si le ƒodo me kple ŋku kple ŋutigbalẽ ƒe ɣie le afɔɖeɖe sia me. Esiae nye dɔlélea ƒe akpa si nu sẽ wu.
Dzesi kawo ŋue wòle be míalé ŋku ɖo?
Cirrhosis ƒe dzesiwo medzena enumake o. Zi geɖe la, ne dɔlélea nu sẽ ɖe edzi ko hafi wodzena. Mina míade vovototo dzesi siwo dzena le gɔmedzedzea me kple esiwo dona megbe dome abe alesi gbɔna ene.
| Dzesi gbãtɔwo (Compensated Stage) . | Dzesi siwo nu sẽ emegbe (Decompensated Stage) . |
|---|---|
| - Ðeɖiteameŋu kple gbɔdzɔgbɔdzɔ ɣesiaɣi | - Ŋkuwo kple ŋutigbalẽ ƒe ɣie (Jaundice) . |
| - Nuɖuɖu ƒe dzodzro ƒe vɔvɔ | - Aɖuɖɔ doviviti kple aɖuɖɔ si me kɔ |
| - Xeɖeɖe | - Ŋutilã si le ʋuʋum (ne teƒeawo medzena tso gota o gɔ̃ hã) . |
| - Vevesese le ƒodo ƒe akpa si le etame | - Ƒodo, afɔ kple afɔkpodzi ƒe vuvu (le tsi ƒe ƒoƒo ta - Ascites ) . |
| - Asibidɛ ƒe dzodzro | - Kpekpeme dzi ɖeɖe kpɔtɔ kple lãmekawo ƒe gbegblẽ |
| - Ʋuka siwo le ŋutigbalẽa dzi ƒe dzedzeme abe akpɔkplɔ ene | - Ʋu ƒe dodo kple ʋu ƒe sisi megbe tso abi sue aɖe gɔ̃ hã me |
Nukatae ʋumenugbagbeviɣidɔ dzea ame dzi? Nukawo koŋ gbɔe wòtsona?
Dɔléle ɖesiaɖe si nɔa anyi didi si ana aklãa naxɔ abi ɣeyiɣi didi ate ŋu ana ame naxɔ aklãdɔ mlɔeba. Esiawo nye nusiwo gbɔ wòtsona wu le míaƒe dukɔa kple xexeame dometɔ aɖewo.
1. Ahanono fũu akpa (Ahanono ƒe Aklãdɔléle) .
Esiae nye susu si wonya nyuie wu eye wonya nyuie wu. Ahanono fũu akpa hena ɣeyiɣi didi gblẽa nu le aklãa ŋu vevie. Esia nana aklãa xɔa abi, si le ɣeyiɣi aɖe megbe la, ate ŋu ana ame naxɔ aklãdɔ.
2. Aklãdɔ si me ami le (MASH) .
Ŋkɔ bliboa si wotsɔ na esiae nye Metabolic dysfunction-associated steatohepatitis (MASH). Kpuie ko la, enye nɔnɔme sesẽ aɖe si ami si ƒoa ƒu ɖe aklã me le amesiwo menoa aha o ŋu hena vɛ. Ame siwo ŋu lãmenugbagbeviwo ƒe dɔwɔwɔ ƒe dɔwɔwɔwo abe suklidɔ, ʋumemi sɔ gbɔ ɖo, ʋusɔgbɔdɔ, kple lolo akpa ene le afɔku gã aɖe me.
3. Aklãdɔlékui B kple C dɔlékui siwo nɔa anyi didi
Aklãdɔe nye atikewɔwɔ me ŋkɔ si wotsɔ na aklã ƒe dɔdzẽ. Aklãdɔlékui C dɔlékui ƒe amedzidzedze ate ŋu ava zu dɔléle si nɔa anyi didi le ame geɖe ŋu. Togbɔ be atike nyuiwo li fifia na esia hã la, ame geɖe menya gɔ̃ hã be dɔlékuia le yewo ŋu o. Aklãdɔlékui B dɔlékui ate ŋu ava zu nusi nɔa anyi didi le ame aɖewo hã me. Dɔlékui eveawo siaa ate ŋu agblẽ nu le aklãa ŋu eye woana ʋumenugbagbeviɣidɔ nadze ame dzi ne wole afima ɣeyiɣi didi aɖe.
Nu bubu siwo gbɔ wòtsona mebɔ o
Tsɔ kpe ɖe susu siwo míeyɔ ɖe etame ŋu la, susu bubu geɖe hã li siwo mebɔ o:
- Dɔlélenutsiŋutete ƒe Dɔléle: Ɣeaɖewoɣi la, mía ŋutɔwo ƒe dɔlélenutsiŋutete dzea aklã me lãmenugbagbeviwo dzi vodadatɔe. Le kpɔɖeŋu me, nɔnɔmewo abe `(Autoimmune Hepatitis)` kple `(Primary Biliary Cholangitis)`.
- Domenyiŋusẽfianu ƒe Dɔlélewo: Domenyiŋusẽ ƒe dɔléle aɖewo ate ŋu ana aɖinuwo naƒo ƒu ɖe aklã me eye woagblẽ nu le ame ŋu. Dɔléle siawo ƒe kpɔɖeŋuwoe nye `(Wilson Dɔléle)` kple `(Cystic Fibrosis)`.
- Atike aɖewo kple aɖi aɖewo (Toxic Hepatitis): Vevesesenutsitike aɖewo (NSAIDs, Acetaminophen) zazã fũ akpa ɣeyiɣi didi alo atike aɖewo siwo me aɖi le zazã le nutoa me ate ŋu agblẽ nu le aklãa ŋu.
- Dzitodzito me Dɔléle: Dzi ƒe Dɔmawɔmawɔ nyuie (CHF) ate ŋu agblẽ nu le aklã ŋu le ʋu ƒe anyimanɔmanɔ alo ʋu ƒe agbɔsɔsɔ si ɖoa aklã me dzi ɖeɖe kpɔtɔ ta.
Aleke ɖɔktawo wɔna kpɔa esia?
Ne èsusu be ʋumenugbagbeviɣidɔ ƒe dzesiwo le ye ŋu la, ele be nàkpɔ ɖɔkta godoo. Ado wò kpɔ ahabia wò atikewɔwɔ ŋutinya, atike siwo nènona, kple agbenɔnɔ ŋuti nya. Emegbe, woate ŋu aɖe gbe be woawɔ dodokpɔ geɖe atsɔ aɖo kpe dɔlélea dzi.
1. Ʋudodokpɔ: Aklã ƒe Dɔwɔwɔ Dodokpɔ ate ŋu ana woakpɔe ɖa be aklãa gblẽ kple alesi gbegbe wòsẽe hã. Woléa ŋku ɖe ʋu ƒe sisi ƒe ŋutete si dzi ɖe kpɔtɔ hã ŋu.
2. Nɔnɔmetatawo Dodokpɔwo: Ultrasound scan ate ŋu akpɔ aklãa ƒe lolome, eƒe nɔnɔme, kple eƒe nɔnɔme. Scan tɔxɛ aɖe si woyɔna be elastography ate ŋu adzidze aklãa ƒe sesẽme, si nye abi ƒe lãkusi agbɔsɔsɔme si le eme.
3. Aklã ƒe akpa sue aɖe dodokpɔ (Liver Biopsy):Togbɔ be mehiã ɣesiaɣi o hã la, le go aɖewo me la, wotsɔa aŋe sue aɖe ɖea lãkusi sue aɖe ŋutɔ tso aklã me hedoa wo kpɔna le nusuekpɔmɔ̃ me be woaɖo kpe dɔlélea dzi godoo eye woake ɖe nusi gbɔ wòtso ŋu.
Nukawoe nye atikewɔmɔnuawo?
Togbɔ be womate ŋu atrɔ abi si ʋumenugbagbeviɣidɔ hena vɛ o hã la, taɖodzinu vevi eve le atikewɔwɔ me. Ðekae nye be woatɔ te nu bubu siwo gblẽa nu le aklãa ŋu. Eveliae nye be woakpɔ kuxi siwo dɔlélea hena vɛ gbɔ.
Nusi gbɔ wòtso la dada
- Atikewo: Fifia dɔlékuiwutikewo li siwo ate ŋu ada dɔlékuiwo abe aklãdɔléle C ene keŋkeŋ.Atikewo li siwo woatsɔ aɖu aklãdɔléle B. Wotsɔa atike siwo kpɔa dɔlélenutsiŋutete dzi daa dɔléle siwo dɔlélenutsiŋutete wɔna.
- Atikewɔwɔ na ahatsunono: Ne ahatsunono gbɔe ʋumenugbagbeviɣidɔ tsona la, atikewɔwɔ ɖeka kolia kple nyuitɔ kekeakee nye be nàdzudzɔ ahanono keŋkeŋ. Esia ate ŋu abia aɖaŋuɖoɖo kple atikewɔwɔ tɔxɛ aɖe.
- Lãmetsiŋusẽ ƒe dɔwɔwɔ dzi kpɔkpɔ: Ne aklã si me ami le gbɔe dɔlélea tso la, ele vevie ŋutɔ be woaɖu nusiwo le abe ʋumemi, suklidɔ, kple lolo dzi ɖeɖe kpɔtɔ ene dzi.
Nuɖuɖu kple agbenɔnɔ ƒe tɔtrɔ
Nuka kee ɖahe aklãdɔléle vɛ o, asaƒoƒo na ahanono kple atike siwo mehiã o le vevie be woakpɔ aklãa ta.
Ele vevie hã be nàɖu nuɖuɖu si naa lãmesẽ, akpɔ wò kpekpeme dzi, eye nàno nunyiametike siwo hiã abe alesi wò ɖɔkta gblɔe ene.
Kuxiwo dada
Ele be woada kuxi siwo doa mo ɖa ne dɔlélea nu sẽ hã.
- Ne tsi yɔ ƒodoa me (`(Ascites)`) la, wotsɔa atikekui (`(Paracentesis)`) ɖea tsia ɖa.
- Ne èle ʋu ƒom la, wotɔa ʋuka siwo le dodom la to endoscopy (Endoscopy) kple sclerotherapy (Sclerotherapy) dzi.
- Ðewohĩ ahiã be woaɖe ʋumenugbagbeviɣidɔ le nɔnɔmewo abe ayiku ƒe dɔmawɔmawɔ nyuie ene ta.
Aklã Dodo na Ame
Ne atikewɔwɔ bubuawo katã do kpo nu eye afɔku li be aklãa nawɔ dɔ keŋkeŋ la, tiatia mamlɛtɔ si ŋu woabue nye aklã dodo na ame. Esia bia be woaɖe aklã si ŋu dɔléle le la ɖa eye woatsɔ esi le lãmesẽ me aɖo eteƒe.
Ðe wòanya wɔ be mɔkpɔkpɔ nanɔ ame si be wòanɔ agbe kple dɔléle sia?
Esia nye nya si ŋu woate ŋu awɔ nuvevii ŋutɔ. Ame si ŋu ʋumenugbagbeviɣidɔ le ƒe agbenɔƒe nɔ te ɖe nu geɖe dzi. Esia lɔ alesi dɔlélea nu sẽe, kuxi siwo do mo ɖa, alesi wò ŋutilã wɔa nu ɖe atikewɔwɔ ŋui, kple wò lãmesẽ bliboa ɖe eme.
Ðɔktawo zãa dzesidede ɖoɖowo abe ``Child-Turcotte-Pugh (CTP)'' kple ``Model for End-Stage Liver Disease (MELD)'' tsɔ kpɔa dɔlélea ƒe sesẽme kple etsɔme ƒe nyagblɔɖi ƒe susu.
Nu vevitɔe nye be woakpɔ dɔlélea le eƒe gɔmedzedze (compensated stage) eye woada nusi gbɔ wòtso nyuie.Ne woda dɔ na wo eye wotrɔ woƒe agbenɔnɔ la, ame geɖe ate ŋu atɔ te dɔlélea ƒe gbegblẽ eye woanɔ agbe si sɔ ɣeyiɣi didi. Eyata mègana mɔkpɔkpɔ o. Ele vevie ŋutɔ be nàwɔ ɖe atikewɔlawo ƒe aɖaŋuɖoɖo nyuiwo dzi.
Gbedasi si Wotsɔ Yi Aƒeme
- Cirrhosis nye abi ƒe lãkusi ƒe wɔwɔme le aklã me le esi wògblẽ ɣeyiɣi didi ta.
- Ahanono fũu akpa, aklãdɔ si me ami le, kple aklãdɔlékui B kple C ye nye nusiwo koŋ gbɔ wòtsona.
- Esi wònye be dzesiawo mate ŋu adze le gɔmedzedzea me o ta la, ele vevie be woado wò kpɔ edziedzi le atikewɔƒe ne afɔku siwo le eme (suklidɔ, lolo akpa, ahanono) le ŋuwò.
- Togbɔ be womate ŋu ada abiawo keŋkeŋ o hã la, atikewɔwɔ ate ŋu atɔ te dɔlélea ƒe ŋgɔyiyi ɖe edzi alo aɖu edzi.
- Ne dzesi aɖewo le ŋuwò alo ɖikeke aɖe le ŋuwò la, yi wò ɖɔkta gbɔ enumake hena aɖaŋuɖoɖo.
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