Te Mārama ki te "Pupurutanga o te Awa Au" arā, te Cholestasis - Nirogi Lanka

Kua rongo koe i ngā kupu pēnei i te "aukati au" me te "kōhatu au"? Tērā pea kua kite koe i ngā tāngata he kōwhai ō rātou kanohi, he kōwhai rānei ō rātou kiri. Kua whakaaro koe he aha ēnei mate, he aha rānei te take e puta ai? I tēnei rā, ka kōrero tātou mō tētahi mate e mōhiotia ana i roto i te rongoā ko te Cholestasis . Kaua e manukanuka, ka whakamāramahia e mātou māu i Nirogi Lanka.

He aha te Kolestasis?

I te whakarapopototanga, ka puta te cholestasis ina puhoi, ina mutu rānei te rere o te au mai i tō ate. Whakaarohia tō ate he wheketere pukumahi i roto i tō tinana e whakaputa ana i te au . He mea nui tēnei wai mō tō tukanga nakunaku, inā koa mō te wawahi i ngā ngako.

Ka tukuna e te ate te au ki tō pūnaha nakunaku mā roto i tētahi whatunga o ngā ngongo iti e kiia nei ko ngā awa au ( ngā awa au ). Kei roto i te ate ētahi o ēnei awa (intrahepatic), ko ētahi kei waho (extrahepatic). Ka hono tēnei whatunga i tō ate, te repeure , me te whekau iti hei hanga i te pūnaha au .

Inaianei, whakaarohia te mea ka puta mēnā he aukati kei roto i tēnei whatunga. Pērā i te paipa wai kua aukatia, kāore e taea e te au te rere tika. Ka tīmata te hoki whakamuri ki roto i ngā awaawa me ngā whekau e karapoti ana, tae atu ki tō ate. Ka taea e tēnei puranga te kino i te kiko me te whakararuraru i ngā mahi nui. Hei tāpiri, ka taea e te au e kore e rere ki roto i tō toto, he mea paitini ki tō tinana. Ka taea e tēnei te arahi ki ngā tohu mamae, ā, i roto i te wā, ngā momo raruraru hauora. Ka taea e te cholestasis te noho hei āwangawanga wā poto, hei mate mau tonu, e haere whakamua ana rānei.

He aha te pānga o tēnei ki tō tinana?

He maha ngā pānga o te cholestasis ki tō tinana:

Ngā pānga mō te wā poto:

Ko te pānga tonu kei runga i ngā whekau o roto i tō pūnaha biliary. Ka taea e te kohikohinga o te au te pupuhi me te mumura o tō ate, tō puku au, tō repe taiaki, ō awa au rānei ( mumura ). He maha ngā wā ka puta he mamae puku me te whakapairuaki i tēnei. Hei tāpiri, tera pea ka nui ake tō tūponotanga ki te pangia e te mate.

Nā te kore e nui te au o te whekau iti e whiwhi ana i te au, kāore e taea e tō tinana te nakunaku tika i ngā ngako. Ka arahi pea tēnei ki te pupuhi, te koretake o te kai, me te mate korere.

Ngā pānga mō te wā roa:

Mena ka mau tonu te mate, ka ara ake pea ngā raruraru kino ake:

• Ko te kohikohinga o te au i roto i te toto ka arahi pea ki te jaundice , e tohuhia ana e te kōwhai o te kiri me ngā kanohi, me te mimi pouri.
• Ka pāngia ētahi tūroro e te mākūkū nui (pruritus) , e hua mai ana i ngā tote au e whakapataritari ana i ngā io o te kiri.
• Ka taea e te mumura mau tonu o te ate te arahi ki te whara tuturu, he mate e mōhiotia ana ko te cirrhosis .
• Tērā pea he uaua ki te mimiti i ngā huaora wairewa-ngako, arā, ngā huaora A , D, E, me K. Ka arahi pea tēnei ki te kore kai pai, ka ārai pea i te tipu o ngā tamariki.

He Tuhipoka Hira:

Mena ka pāngia koe e te cholestasis i te wā e hapu ana (Obstetric Cholestasis), he nui ngā tūponotanga mō te whaea me te pēpi, tae atu ki te preeclampsia, te whānautanga wawe, me te whānautanga mate. Mena kei te hapu koe, ā, ka kite koe i ēnei tohu, rapua he awhina hauora ohorere, haere rānei ki tō hōhipera tata tonu.

He aha ngā tino take?

He maha ngā take o te cholestasis. I te nuinga o te wā, ka taea te whakarōpū kia rua ngā momo matua:

He aha ngā tohu o te cholestasis?

Ko ngā tohu tino kitea pea e koe ko:

• Te kiri mākūkū: Ko te kōwhai o tō kiri me te mā o ō kanohi te tohu tuatahi kāore tō ate e mahi tika ana. Ka puta tēnei nā te nui o te bilirubin, he tae kei roto i te au, i roto i ō toto. Tērā pea ka kite koe i tō mimi e huri ana hei kōwhai pouri, hei parauri rānei i a ia e ngana ana ki te tuku i te bilirubin nui rawa.
• Tūtae Mārama: Nā te mea kāore e taea e te au te tae ki ō whekau, ka rerekē pea te āhua o tō tūtae. Nā te mea e hiahiatia ana te au hei nakunaku i ngā ngako, ka tukuna pea te ngako i roto i te tūtae, ka āhua mā, ka āhua uku, ka mā rānei. Ki te kore he bilirubin hei hoatu i tōna tae parauri noa, ka āhua māmā te tūtae, ā, ka mānu pea, ka puta rānei he kakara kino, he kaha rawa.
• Mākūkū (Makukū): He tohu tino noa o te cholestasis. Ko te mākūkū nui nei nā te kohikohinga o ngā tote au i roto i ō toto, ā, ka whakaoho i tō pūnaha io taha. He mea nui, ka puta tēnei mākūkū me te kore he ponana e kitea ana. He rerekē te aro o te tangata ki te tangata; ka kitea pea i ō ringaringa me ō kapu waewae, ka rongo rānei koe i tō tinana katoa.

Haunga ngā tohu matua, tera pea ka pāngia koe e ētahi atu tohu i runga i te pūtake o te cholestasis:

• Mamae puku
• Whakapairuaki me te ruaki
• Ngenge

Me pēhea te tautuhi i tōna mate?

Mena kei te pāngia koe e ngā tohu o te cholestasis, ka tīmata pea tō tākuta mā te whakamātautau i tētahi tauira o tō toto.

• Ngā whakamātautau toto: Ka tirohia e ēnei ngā taumata teitei o te bilirubin me ngā tote au. Ka inehia hoki e tō tākuta ngā whākōkī ate, tae atu ki te alkaline phosphatase (ALP), te gamma-glutamyl transferase (GGT), me ngā taumata cholesterol, hei āwhina i te whakatau i te take matua.
• Ngā whakamātautau whakaahua: Mena ka kitea he raruraru i roto i te toto, ka whakamahia e tō tākuta te whakaahua hei aromatawai i tō pūnaha biliary. Ko ngā whakamātautau māmā, kore-whakaekenga pērā i te ultrasound o te puku, te CT scan rānei, te taahiraa tuatahi ki te rapu i ngā aukati tinana i roto i ngā awa biliary, i te pupuhi rānei o ngā okana.
• Ngā whakamātautau tūhura: Hei tautuhi i te tino take me te whakatau i te maimoatanga pai rawa atu, me whai rangahau taipitopito atu pea. Kei roto pea i tēnei ko te koiora ate, te tango i tētahi tauira kiko iti hei tātaritanga taiwhanga, he ERCP rānei (Endoscopic Retrograde Cholangiopancreatography) , e āhei ai ngā tākuta ki te tiro, te tātaritanga, me te rongoā i ngā raruraru i roto i ō awaawa au i te wā kotahi.

Me pēhea te rongoā?

Ko te maimoatanga mō te cholestasis e whakawhirinaki ana ki te pūtake o te take.

• Ngā take ohorere: He māmā noa iho te whakahaere i ētahi āhuatanga. Hei tauira, ka whakakapi pea tō tākuta i ngā rongoā e puta ai te raruraru, ka tohua pea he paturopi, he rongoā ārai huaketo rānei mō ngā mate, ka whakamahia rānei he tikanga endoscopic pēnei i te ERCP hei whakakore i ngā aukati o te awaawa ate.
• Ngā take mau tonu: Ka uaua ake ngā āhuatanga e pā ana ki te mate ate mō te wā roa. Ahakoa kāore e taea te whakaora, te whakakore rānei i ētahi āhuatanga ate mau tonu (pēnei i te cirrhosis), ka taea e koe te whakaroa i te haere whakamua o te mate mā te kai hauora, te whakakori tinana auau, me te karo katoa i te waipiro. Ka arotahi tō rōpū hauora ki te whakahaere i ō tohu me te ārai i ngā raruraru atu.

Kei roto pea i ngā mahere maimoatanga:

• Kai Totika: Ngā whakarerekētanga kai me ngā tāpiringa kai hei whakatika i te kore kai pai, te kore rānei o ngā huaora.
• Waikawa Ursodeoxycholic: Ahakoa e whakamahia ana hei whakarewa i ngā kōhatu o te pūkahukahu, ka taea hoki e tēnei rongoā te āwhina mā te whakanui ake i te hanga au me te whakaiti i te pānga o ngā tote au i roto i ō toto.
• Naltrexone: Ka tohua tēnei rongoā opioid hei whakahaere i te mākūkū nui mā te aukati i ngā ara io e whakaohokia ana e ngā waikawa ate.
• Cholestyramine: Ka mahi tēnei rongoā mā te herea ki ngā tote waikura i roto i te whekau, ka āwhina ki te whakakore i a rātou i roto i tō tūtae.