Tērā pea ka tīmata te toto o te waha o ētahi tāngata he mate ate, ka kite rānei i te toto i roto i ā rātou tūtae. Ina tupu tēnei, kāore e taea e koe te whakaaro he aha te mea e tupu ana. Ko tētahi o ngā take matua mō tēnei mate ko te pupuhi me te pakaru o ngā oko toto i roto i tō korokoro , te ngongo e haere ai te kai, ka puta te toto . He rite ki ngā uaua varicose i roto i ō waewae, engari ka puta tēnei i roto i tō tinana. I tēnei rā ka kōrero tātou mō tēnei mate, e mōhiotia ana i roto i te rongoā ko te Esophageal Varices. Kaua e manukanuka, kia māmā noa iho.
He aha ēnei (Ngā Varices Esophageal)? He māmā noa iho…
Whakaarohia, ko tō korokoro he ngongo e kawe ana i te kai mai i tō waha ki tō puku. Kei roto i tēnei ngongo he whatunga o ngā uaua toto angiangi. Mēnā he nui rawa te pēhanga o ēnei uaua toto, ka pupuhi haere, ka tīmata te whakanui. Ka kiia tēnei ko te varices esophageal.
Ko te mea tino mōrearea mō tēnei ko te ngoikore o ngā pakitara o ēnei uaua pupuhi. Pērā i te poihau kua pupuhi rawa. Nō reira, ka tere te pahū me te toto . Ka ohorere, ka kino, ā, ka tūpono pea te ora o tēnei toto i roto i te tinana.
He pēhea te kino o te (Esophageal Varices)?
Ko te mōrearea matua me te tino kino o tēnei mate ko te toto . Ahakoa ehara i te katoa e toto ana, tata ki te 50% o te hunga whai mate nei ka toto. E ai ki te kōrero i mua ake nei, ka piki ake tēnei mōrearea i te pikinga ake o te pēhanga i roto i te uaua toto matua e tika ana mā te ate, arā, (Portal Hypertension). I te nuinga o te wā, ka puta tēnei mate (Portal Hypertension) i te mate mau tonu o te ate. Nō reira, i te kino haere o te mate ate, ka kino haere anō hoki tēnei mate.
Haunga ngā varicose esophageal, tera pea ētahi atu raruraru ka pā ki te hunga he tino mate te ate, arā, ko te cirrhosis.Heoi, ko te tino take e noho hōhipera ai te hunga whai mate ate, ā, e mate ai, ko te pakaru me te toto o ēnei uaua pupuhi. Mēnā ka puta tēnei momo toto, tata ki te 20% te mōrearea o te mate. Waihoki, i muri i te toto kotahi, he nui te mōrearea o te toto anō.
He aha ngā tohu o te (Esophageal Varices)?
Kāore ēnei uaua pupuhi e kitea ana, pērā i ngā waewae. Kei roto i te uma ēnei uaua, i te nuinga o te wā kei reira te hononga o te korokoro ki te puku. Kāore koe e rongo i a rātou ina horomia e koe. Kāore e puta he tohu tae noa ki te wā e toto ana.
Heoi, ki te kite tō tākuta i ētahi atu tohu e tohu ana i te toto toto tiketike, i te mate ate mau tonu rānei, ka whakapae pea ia he varices esophageal. Ko ēnei tohu ko:
- Te kiri mākūkū : Te kōwhai o te kiri me ngā kanohi.
- Ascites : Te kohikohinga o te wai i roto i te puku.
- Edema : Te pupuhi o ngā waewae me ngā pona.
- Mamae o te puku o runga : Tērā pea ka puta te mamae i te pupuhi o te ate, o te whēkau rānei.
- Mākūkū : Te mākūkū o te kiri, kāore he aha.
- Pōhēhē (Hepatic Encephalopathy) : Te kore e taea te arotahi, te ngaro o te māramatanga.
Ngā tohu o te toto
Ki te pakaru ohorere te uaua pupuhi, ā, ka tīmata te toto, kāore pea koe e rongo i te mamae tonu. Heoi, me mōhio koe ki ngā tohu e whai ake nei o te toto mai i te ara kai, mai i te tinana rānei :
| Ngā tohu o te toto | Koinei te āhua o te tupu… |
|---|---|
| Te ruaki toto mai i te mangai | Ina ruaki koe i te toto, tera pea ka ruaki koe i te toto kua pupū, ā, he rite ki te paura kawhe te āhua. Engari ki te pakaru ohorere te uaua, tera pea ka ruaki koe i te toto hou, whero. |
| Te toto i roto i te tūtae | Ina nakunaku te toto o te waha, ka puta tahi me te tūtae, ka huri hei kōwhai parauri, hei mangu rānei te tae (melena). Heoi, ki te tere rawa te toto, ka puta mai pea he toto whero hou me te tūtae. |
| Ētahi atu āhuatanga o te tinana | Ina ngaro te nui o te toto i te tinana, ka mā te mata, ā, ka tino ngenge koe, ka ngaro hoki te ora. Ka taea hoki e te toto toto iti te whakapouri. |
He mea nui: Ngā tohu o te ohorere (te ohorere hypovolemic)
Ki te puta ohorere mai ngā tohu o tētahi āhuatanga kino e kiia nei ko te hypovolemic shock, haere tonu ki te ETU! Ko ēnei tohu:
- Ngā tere o te ngakau
- Te tere o te manawa
- Te mātao me te werawera
- Te kore okiokinga me te pōhēhē
- Ngaronga o te māramatanga
He aha ngā take o te varices esophageal?
Ko te tino take o tēnei āhuatanga ko te mate e kiia nei ko te Portal Hypertension , arā, he toto toto tiketike i roto i te uaua toto matua e tika ana mā te ate (te uaua portal) me ētahi atu uaua e peka atu ana i reira.
Ka ngana ō tātou tinana ki te urutau ki tēnei pēhanga kua piki ake mā te tuku i te toto tāpiri ki roto i ngā uaua iti ake kāore e taea te tu atu. O ēnei, ko ngā uaua ngawari o te nono ngā mea e pupuhi nui ana.
Ngā take matua o te toto toto tiketike
Ko te tino take o tēnei ko te cirrhosis, arā, te whakapakeketanga o te ate . Nā te kino roa o te ate tēnei. Ka whara tonu ngā pūtau ate ( hepatitis ), ā, i te mutunga ka huri hei kiko koha. Ka āraihia e tēnei koha te rere o te toto i roto i te ate. Kāore tēnei e puta i te wā kotahi, engari ka puta i roto i ngā tau maha.
Ko te mate ate pūmau te wāhanga whakamutunga o tētahi mate ate mau tonu. Hei tauira:
- He mate hepatitis i puta mai i te waipiro
- Te mate huka kore-waipiro (NASH)
- He mate hepatitis viral mau tonu (pēnei i te B, C)
- He mate hepatitis ā-aunoa
Tērā atu anō ngā take pea o te toto toto tiketike o te whare:
- Ngā Granuloma i roto i te ate : He kohinga pūtau mumura ēnei e puta mai ana i roto i ngā momo mate me ngā āhuatanga mumura. Ko te tino take o tēnei he mate pirinoa e kiia nei ko te Schistosomiasis, e pāngia ana e te 230 miriona tāngata puta noa i te ao.
- Te toto totoka: Mena ka puta he toto totoka i roto i te pūnaha uaua e hono ana ki te ate, ka āraia pea te rere o te toto (hei tauira, te mate Budd-Chiari).
- Te whakanui ake i te whēkau .
- Ngā mate manawa : pērā i te ngoikore o te manawa i te taha matau.
(Ngā Varices Esophageal) Te Tātaritanga me te Maimoatanga
Kāore koe e mōhio ki tēnei mea kia tirohia rā anō koe e te tākuta. Mena kua kitea kētia tō mate cirrhosis, ka tūtohu tonu tō tākuta kia tirohia tēnei pupuhi o ngā uaua. Ko te whakamātautau matua e whakamahia ana mō tēnei ko te endoscopy o runga .
He aha te (Endoscopy o Runga)?
Ko te Endoscopy o Runga , e mōhiotia ana ko te whakamātautau EGD, he whakamātautau i tō ara nakunaku o runga, tae atu ki tō esophagus, tō puku, me te tīmatanga o tō whekau iti (duodenum). Ka mahia tēnei e te gastroenterologist, he tākuta e tohunga ana ki ngā mate o te pūnaha nakunaku me ngā tikanga endoscopy. He ngongo roa, angiangi te endoscope me te kāmera iti i te pito. Ka whakaurua te ngongo mā tō waha ka tukuna ki raro i tō esophagus hei tirotiro tika mō tetahi pupuhi. Mena ka kitea he raruraru, ka taea te whakauru i ngā taputapu iti mā te endoscope hei rongoā i aua raruraru.
He aha ngā maimoatanga mō (Esophageal Varices)?
Ko ngā whāinga matua o te maimoatanga he whakahaere i te toto e nāianei ana, he ārai i te toto ā muri ake nei, ā, ki te taea, he whakaiti i te toto toto tiketike.
| Tikanga maimoatanga | Ka ahatia? |
|---|---|
| Ngā rongoā | Ka hoatu e ngā tākuta ngā rongoā ā-uaua pērā i te Octreotide hei whakaheke i te toto toto. Tērā anō hoki ngā rongoā pērā i ngā Beta-blockers ka taea e koe te tango hei whakamutu i te toto. |
| Te herenga o te whitiki varicose | Kia whakaurua te endoscope, ka whakatakotoria he here rapa iti ki te taha o te uaua e toto ana, te uaua rānei e whakapaetia ana kei te toto, ā, ka whakakīia. Mā tēnei ka mutu te toto. |
| Ngā Tukanga Whakawhiti | He ahua uaua tēnei. E rua ngā tikanga, ko TIPS me DSRS. Ko te tikanga o tēnei ko te waihanga i tētahi ara hou mō te toto kia whiti atu i te ate. Mā te pokanga, mā te hihi-X rānei, ka honoa tētahi uaua o te ate ki tētahi atu uaua hei whakamama i te pēhanga. |
| Te rongoā i te take matua | Ko te mea nui ko te rongoā i te pūtake o te mate. Arā, me mutu te inu waipiro, te whakaiti i te taumaha, te tango rongoā rānei mō tētahi mate pēnei i te hepatitis C. |
Te noho me tēnei āhuatanga
Ko tō tirohanga kei runga i te toto kei roto i ō uaua me te kaha o tō mate ate. Ko te ōrau oranga mō te tau kotahi mō te hunga whai mate ate cirrhosis me te toto he tata ki te 50%. Ko te mōrearea o te mate mai i te toto tuatahi he 20%, ā, ko te mōrearea o te toto tuarua, ahakoa kua rongoatia, he teitei ake i te 60%.
He mate kino te varicose esophageal. Heoi, ki te kitea wawe te mate ate, ka taea te whakarerekē i te momo noho hei ārai i te kino haere o te mate, ā, ka taea hoki te ārai i te pupuhi o ēnei uaua.
Karere Tangohia ki te Kāinga
- He maha ngā wā ka puta ngā varicose esophageal i te portal hypertension, he mate e puta mai ana i te cirrhosis ate .
- Ko te tūponotanga nui o tēnei ko te pakaru me te toto o te uaua toto . Ka tūpono pea tēnei ki te ora.
- Ahakoa kāore koe e whakaatu i tētahi tohu nui i te tīmatanga, ki te pāngia koe e ngā tohu pēnei i te toto mai i te waha, te tūtae mangu, te kōwhai o te kiri, te puku pupuhi rānei, me toro atu ki tō tākuta tonu .
- Ka tino tautuhia tēnei mate, ā, ko ētahi maimoatanga ka mahia mā te whakamātautau e kiia nei ko te endoscopy.
- He maimoatanga kei reira, engari ko te mea nui ko te karo i ngā mea e kino ai te ate (te waipiro, ētahi kai kino) me te whai i ngā tohutohu hauora .
- Mena he mate ate tōu, he mea tino nui kia tirotirohia e koe ngā raruraru pēnei i ēnei .
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