Kia ako tātou i ētahi atu kōrero mō te mate ate! Kia kōrero tātou mō tēnei!

He tino nui te ate i roto i tō tinana. He rite tana mahi ki te tātari i roto i tō tātou tinana. Ka tātarihia, ka tangohia hoki ngā paitini mai i te toto. Engari, he rohe kei roto i ngā mea ka taea e tēnei tātari te whakahaere, tika? I ētahi wā, ka taea e tēnei mahi te kino i te ate . Nō reira, i tēnei rā, me kōrero tātou mō ngā mate ate .

He aha te mate ate?

Ina kī tātou ko te 'mate ate', ko te tikanga, ko ngā āhuatanga e kino haere ana te ate i roto i te wā, i te roanga o te wā, i te roanga rānei o te wā . Ka puta pea ēnei i ngā mate huaketo , i ngā paitini maha, i ētahi āhuatanga pākia rānei. Ko te mea whakamiharo, he kaha whakamiharo tō te ate ki te whakatika i a ia anō. Engari, ina whakamahia tonutia, ka heke haere taua kaha.

He aha ngā wāhanga o te mate ate mau tonu?

E whā ngā wāhanga matua o te mate ate kua roa e pāngia ana. Me titiro tātou ki ēnei wāhanga.

Wāhanga 1: Hepatitis

Ko te wāhanga tuatahi ko te hepatitis. He kupu ngāwari, koinei te pupuhi o te kiko ate. Pērā i te wā e whara ai tātou i tētahi wāhi, ka pupuhi, ina pakaru, ina paihana rānei te ate, ka puta tēnei pupuhi hei whakautu ki tēnā. Ka puta tēnei hei whakakore i te mate me te tīmata i te tukanga whakaora. Ka taea te whakatau i tēnei mā te pupuhi ohorere, rangitahi (hepatitis acute). Engari ki te mea kei te haere tonu te kino, te paihana rānei, ka haere tonu te pupuhi. Nā tēnei āhuatanga roa o te hepatitis (hepatitis mau tonu) , i te ngana o te ate ki te whakaora i a ia anō i roto i te wā, ka tīmata te hanga i ngā kiriuhi (fibrosis).

Wāhanga 2: Pūmua

Ko te wāhanga tuarua ko te fibrosis. Koinei te wā e tupu haere ana te kiko whara i roto i te ate, ka pakari, ka mārō. He rite ki te kakahu tawhito. Ka whakaitihia e tēnei kiko whara te rere o te toto ki te ate, ko te tikanga he iti ake te hāora me ngā matūkai e tukuna ana ki te ate. Koinei te huarahi ka tīmata te ate ki te ngaro haere i te mahi. He mea whakamiharo, ka taea te whakakore i ētahi o ēnei fibrosis. Arā, ki te whakaitihia te kino, ka taea e ngā pūtau ate te whakaora anō, ā, ka taea te whakaiti i te kiko whara.

Wāhanga 3: Te mate pūkahukahu

Ko te wāhanga tuatoru ko te cirrhosis, he whara kino, kore e taea te whakaora, he tuturu hoki o te ate.Koinei te wāhi e kore ai e taea te whakaora i te fibrosis. Ina ngaro te nui o ngā pūtau hauora o te ate hei mahi, kāore e taea e te kiko te whakaora anō. Heoi, ahakoa i tēnei wā, kei reira ngā huarahi hei aukati, hei whakaroa rānei i te kino. I te tīmatanga o te pānga o te cirrhosis ki te mahi ate, tērā pea kāore koe e kite i te rerekētanga nui i te tīmatanga, i te mea e ngana ana tō tinana ki te whakakapi i te ngaronga.

Wāhanga 4: Te ngoikore o te ate

Ko te wāhanga whakamutunga, tuawhā rānei, ko te ngoikore o te ate. Koinei te wā kāore e taea e te ate te mahi hei whakatutuki i ngā hiahia o te tinana. Ka kiia hoki tēnei ko te cirrhosis decompensated – arā, kāore e taea e te tinana te whakakapi i te ngaronga o te ate. I te pakaru haere o ngā mahi a te ate, ka tīmata koe ki te rongo i ngā pānga puta noa i tō tinana. He tukanga āta haere te ngoikore o te ate mau tonu, engari ki te kore he whakawhitinga ate, ka mate pea. Kia mahara, me whai ate tātou kia ora ai.

He pēhea te noa o ngā mate ate?

Ki te kōrero tātou mō te whānui o te horapa o tēnei mate ate, e rua miriona ngā mate e pāngia ana e ia i ia tau puta noa i te ao. Koia te 4% o ngā mate katoa. Ko te nuinga o ngā mate nā ngā raruraru o te cirrhosis. E rua pea te nui ake o te tūponotanga o ngā tāne ki te pāngia e tēnei mate i ngā wāhine.

He aha ngā tohu tuatahi o te mate ate?

I te nuinga o te wā, kāore ēnei mate ate mau tonu e whakaatu i ngā tohu nui i ngā wāhanga tōmua. Engari i ētahi wā, ka tīmata pea hei mate hepatitis ohorere, whakapeka. Hei tauira, ki te pāngia koe e te mate hepatitis huaketo, ka puta he wāhanga whakapeka i mua i te noho hei mate mau tonu. I taua wā, ka pāngia pea koe e te kirika, te mamae o te puku, me te whakapairuaki mō ētahi rā. Ki te kore e taea e te pūnaha ārai mate te whawhai ki te mate, ka huri hei mate mau tonu.

Ka taea hoki e ētahi atu take o te mate ate te whakaputa i ngā tohu ohorere pēnei i ēnei i te tīmatanga. Ko ngā tohu tōmua o te mate ate kāore i te tino kitea. Kei roto i ēnei ko:

• Te mamae o te puku o runga.
• Whakapairuaki,Kāore he reka o te kai .
• Te ngenge me te āhua kino (te ngenge me te kore hauora).

He aha ngā tohu o muri mai o te mate ate?

I te tīmatanga o te ngoikore o te mahi a tō ate, ka tīmata pea koe ki te kite i ētahi atu tohu. Koinei te wā e tino matatau ana te mate ate. Ko tētahi o ngā pānga tuatahi o te ngoikore o te ate ko te aukati i te rere o te au. Kāore e taea e te ate te hanga au tika, te pupuhi rānei ki roto i te whekau iti. Engari, ka tīmata te au ki te turuturu ki roto i te toto. Ka puta pea ētahi tohu motuhake:

• Te kōwhai o ngā kanohi me te kiri (te mā o ngā kanohi me te kiri).
• Te mimi pouri .
• Te tuku i te tūtae mārama te tae .
• He uaua ki te nakunaku i te kai, inā koa ngā kai momona.
• Te whakahekenga taumaha me te memeha o te uaua.
• Te manawa haunga haunga.
• He ngoikore ngawari o te mahi a te roro (hepatic encephalopathy).
• Mākūkū (he mākūkū noa iho, kāore he ponana i te kiri).

I te kaha haere o te mate ate, ka pāngia tō rere toto, ō homoni, me tō āhua kai. He maha ngā huarahi ka puta ai tēnei. Tērā pea ka kite koe i ēnei tohu i runga i tō kiri me ō whao:

• Ngā whao pūnu.
• Ngā maikuku o Terry (he mā ngā maikuku, ko ngā pito anake he māwhero).
• Ko te patu i ngā whao ko te pupuhi me te kōpiko o te turanga o ngā whao.
• Ngā angiomas pungawerewere ( ngā ira whero e rite ana ki te tukutuku pungawerewere).
• He ira whero iti kei runga i te kiri "(petechiae)".
• He putunga hinu kōwhai kei runga i te kiri, i ngā kamo rānei, ka puta hei puku iti.
• Ngāwari te pakaru me te toto .
• Te whero o ngā nikau.

Tērā pea ka kite koe i ngā tohu o te turuturu o te wai mai i ngā oko toto, me te kohikohi i roto i ngā wāhanga rerekē o te tinana:

• Te pupuhi o te puku (ascites).
• Te pupuhi o ngā pona, ngā waewae, ngā ringa, me te mata (edema).

Ngā āhuatanga motuhake mō te ira tangata

Tērā pea ka pāngia ngā wāhine e ēnei tohu e te mate ate:

• Ngā huringa paheketanga koretake.
• Te uaua ki te whānau tamariki (Te kore tamariki a te wahine).

Ka pāngia pea ngā tāne e ngā tohu pēnei i:

• Ngā porotiti kua mimiti.
• Te kiko o te ū o te tāne kua nui haere.

Ngā raruraru o te mate ate wāhanga whakamutunga

Ko te mate ate wāhanga whakamutunga he āhuatanga e kore ai e taea e te ate te whakatika i a ia anō, ā, ka haere mārire te mahi, e kiia ana ko te cirrhosis decompensated me te ngoikore o te ate. Ko ngā pānga kino e rua i tēnei wāhanga ko te toto toto tiketike me te mate pukupuku hepatocellular . Ko ngā raruraru o ēnei āhuatanga e rua te tino take o te whakaurunga hōhipera me te mate i roto i te hunga e pangia ana e te cirrhosis me te ngoikore o te ate.

Te toto toto tiketike o te tomokanga

Ko te toto toto tiketike o te tomokanga ka puta mai i te whara i roto i te ate, ka puta te pēhanga ki runga i te uaua tomokanga. Ina piki te pēhanga i roto i te uaua tomokanga, ka hurihia e te tinana te toto ki ētahi atu uaua e hono ana ki a ia. Kātahi ka nui haere, ka totoro, ka angiangi ngā uaua. Ka taea e ēnei uaua te turuturu, te pakū, te toto rānei. Ka taea e tēnei toto o roto te ohorere, te kino, me te morearea ki te ora.

Ahakoa he onge, tera pea ka puta mai ētahi atu raruraru:

• Te whakanui me te mahi nui o te whēkau (hypersplenism).
• Te ngoikore o te pūnaha manawa `(hepatopulmonary syndrome)`.
• Te ngoikore o te whatukuhu (te mate hepatorenal).

Matepukupuku ate

Ahakoa kāore e pāngia te hunga katoa e te mate ate roa e te mate pukupuku ate, he maha ngā tāngata e pāngia ana e te mate pukupuku ate he mate ate roa. Nā te huringa o te mumura, te whakaora, me te whara, ka nui ake te tūponotanga ka huri ngā pūtau ate, ka noho hei mate pukupuku. E whakaaro ana ngā tākuta ka pāngia hoki te DNA o ngā pūtau ate e ngā huaketo hepatitis mau tonu, ina koa, e te mate pukupuku.

He aha ngā pūtake o te mate ate?

Neke atu i te 100 ngā momo mate ate, engari ka taka ki roto i ētahi rōpū iti matua. Ko ngā take ko:

• Ngā mate urutā: Ka taea e ngā mate urutā roa pērā i te hepatitis B me te hepatitis C te whakaputa i te hepatitis mau tonu.
• He mate ate nā te waipiro: Ka taea e te inu nui i te waipiro te mate ate ate kino, mau tonu rānei. Mēnā ka haere tonu tēnei, ka arahi pea ki te mate ate cirrhosis me te ngoikore o te ate. He tino noa tēnei take i tō tātou whenua.
• He mate hepatitis paitini: Ka puta te mate hepatitis whakapeka, mau tonu rānei i te roa o te wā e pāngia ana e ngā matū paitini, pērā i ngā matū ahumahi, ngā rongoā rānei.
• Mate ate momona kāore e pā ana ki te waipiro (NAFLD): Ka taea e ngā āhuatanga pākia e pā ana ki te momona, te taumata huka toto tiketike, me te taumata ngako toto tiketike te whakanui ake i te ngako i roto i te ate. Ka taea e tēnei te arahi ki te mumura (steatohepatitis kāore e pā ana ki te waipiro – NASH). Ka kitea hoki tēnei āhuatanga i roto i te tini o te tangata i ēnei rā, inā koa nā ngā tikanga kai kino.
• Te korenga o te biliary duct: Ko ētahi āhuatanga whānau, pērā i te biliary atresia me te cystic fibrosis, ka taea te whakaemi i te au ka pakaru te ate mā te aukati, te aukati rānei i te rere o te au i roto i ngā awa au. Ko ngā take e puta mai ana i muri i te whānautanga ko te stricture biliary me ngā kohatu au.
• Ngā mate pūnaha ārai mate: Ko ngā mate pūnaha ārai mate pērā i te mate hepatitis pūnaha ārai mate, te cholangitis biliary tuatahi, me te cholangitis sclerosing tuatahi ka pupuhi, ka whara hoki te ate, ngā awa wai rānei mō te wā roa.
• Ngā mate pākia o te tinana: Ko ngā mate e kohikohi ai ngā paitini i roto i te toto, pērā i te mate rokiroki glycogen (GSD), te mate Wilson, te hemochromatosis, me te mate Gaucher, ka pā kino pea ki te ate mō te wā roa.
• Ngā mate ngākau: Ko ngā āhuatanga e pā ana ki te ate me te rere o te toto i roto i te ate, pērā i te mate Budd-Chiari, te ischemia, te mate uaua coronary, me te ngoikore o te ngākau taha matau, ka taea te whakararu i te ate mō te wā roa.

He aha ngā āhuatanga mōrearea mō te mate ate?

Tērā pea ka nui ake te tūponotanga ka pāngia koe e te mate ate mēnā:

• Ki te nui rawa te waipiro e inumia ana e koe.
• Ki te tango koe i ngā rongoā mā roto i te uaua, ka kiia tēnā he "rongoā ā-uaua".
• Mena ka whakamahia pinepinetia e koe ngā rongoā whakamamae mamae pēnei i te aspirin, te paracetamol rānei (ina koa i ngā horopeta nui me te kore tohutohu hauora).
• Mena kei a koe te mate pāwera (he huinga o te momona, te toto toto tiketike, te huka toto tiketike, me ngā taumata cholesterol kino).
• Mena ka pāngia pinepine koe e ngā matū paitini.
• Mena he maha tonu ngā wā ka pāngia koe e te toto, e ngā wai tinana rānei o ētahi atu (hei tauira, ngā kaimahi hauora, ngā kaitā moko).

Me pēhea te tautuhi i te mate ate?

Mā te tākuta e tirotiro ana mō te mate ate koe e tirotiro tinana tuatahi. Ka rapua e rātou ngā tohu me ngā āhuatanga, ā, ka pātai atu mō ō āhuatanga. Tērā pea ka pātai atu rātou mō tō kai, tō momo noho, me tō hītori hauora. Kātahi ka whakamahia e rātou ngā whakamātautau taiwhanga me ngā matawai whakaahua hei whakatau mēnā he mate ate tōu. Kei roto pea i ēnei:

• Ngā whakamātautau toto: Ka taea e te raupapa o ngā whakamātautau mahi ate te whakaatu i ngā tohu o te mate ate, te kaha o te mate, me ngā tohu o te ngoikore o te ate. Ka inehia e ēnei ngā mea pēnei i ngā whākōkī ate, te pūmua, me ngā taumata bilirubin. Ka taea hoki e ngā whakamātautau toto te whakaatu i ngā pānga taha pēnei i te pupuhi, ngā mate motuhake, te hekenga rānei o te toto toto.
• Ngā whakamātautau whakaahua: Mā te tirotiro oro-oro o te puku, te tirotiro CT (tirotiro tomografi rorohiko), te tirotiro MRI rānei (tirotiro irahiko aukume) ka taea te whakaatu i te rahi, te āhua, me te āhua o te ate. Ka āwhina tēnei ki te kite i te pupuhi, ngā pona, me te fibrosis.
• Elastography: He whakamātautau whakaahua motuhake tēnei e whakamahi ana i te hangarau ultrasound, MRI rānei hei ine i te pakari, te taumata rānei o te fibrosis, o te ate.
• Te tirotiro ā-roto:Ki te hiahia tō tākuta ki te tirotiro i roto i tō pūnaha awaawa, me whakamahi rātou i tētahi tikanga whakaahua e kiia nei ko te endoscopy. Ko te tikanga o tēnei ko te whakauru i tētahi kāmera iti (endoscope) mā roto i tō waha, ka tukuna ki raro i tō ara nakunaku. Kātahi ka taea te tirotiro i ngā awaawa mā te whakamahi i te EUS (endoscopic ultrasound) me te ERCP rānei (endoscopic retrograde cholangiopancreatography).
• Whakaahua rongoā karihi: Ko te werohanga i tētahi matū irahiko kore kino ki roto i te tinana, me te whakamahi i tētahi kāmera gamma hei kite i taua matū. I runga anō i te mimiti a tō ate i te matū, ka taea e ia te whakaatu i te wāhi kāore e mahi tika ana.
• Kohikohi ate: He tikanga iti tēnei. Ka tangohia he tauira iti o te kiko mai i te ate, ka whakamatautauria i roto i te taiwhanga. I te nuinga o te wā ka tangohia tēnei tauira mā te whakamahi i tētahi ngira tuwhera. Ka taea te mahi i tētahi kohikohi ate hei tirotiro mō te mate pukupuku, hei whakaū i te cirrhosis, hei kimi i te pūtake.

Me pēhea te rongoā i ngā mate ate?

He maimoatanga hauora motuhake kei ētahi momo mate ate. Hei tauira, ka hoatuhia ngā rongoā ārai huaketo mō te mate hepatitis huaketo, ā, ka hoatuhia ngā corticosteroids me ngā immunosuppressants mō ngā mate pūnaha ārai mate. Engari i te nuinga o te wā, ko ngā huringa āhua noho te maimoatanga matua mō te mate ate. He mea nui te whakaiti i te nui o ngā paitini e uru ana ki te ate mō ngā mate ate katoa. He mea nui rawa atu tēnei mō ngā mate ate i puta mai i te nui rawa o te ngako, te waipiro, ētahi atu paitini rānei.

Heoi, he mea nui te kitenga wawe kia pai ai te rongoā i te mate ate i mua i te pānga o te kino tuturu. Engari, kāore te katoa e kitea i te wā e taea ai te whakaora i te mate. Mena kua pāngia koe e te cirrhosis, te ngoikore rānei o te ate, me hiahia pea koe ki ētahi atu maimoatanga mō ngā raruraru pēnei i te toto toto tiketike, te mate pukupuku ate rānei. Tērā pea kāore e taea e tō ate te ora, ā, i te mutunga ka hiahia pea koe ki te whakawhitinga ate.

Me pēhea te whakaiti i te mōrearea o te mate ate?

Ka taea e koe te mahi i ēnei mea hei tiaki i a koe mai i te mate ate:

• Te werohanga: Kei reira ngā kano ārai mate hei tiaki i te mate hepatitis A me te B.
• Akuaku pai: Mā te horoi ringa i muri i te whakamahi i te wharepaku, te whakarite kai me te haumaru, me te whakamahi ngira me te haumaru ka āwhina i te aukati i te horapa o ngā mate.
• Whakaitihia te whakamahinga o te waipiro, me te tango i ngā rongoā e ai ki te whakahaunga: Mena he mate whakamahi matū tōu (hei tauira, 'Mate Whakamahi Matū – SUD'), mā te whiwhi maimoatanga ka āwhina i te ārai i te mate ate hepatitis i puta mai i ngā paitini.
• Te whakahaere i ngā āhuatanga pākia o te tinana pērā i te ngako me te huka toto: Ka taea e koe te tiki awhina mai i te tākuta mō tēnei.

Ka taea te whakaora i te mate ate?

Ka taea te whakakore i te mate ate i te wā tōmua mēnā ka kitea te pūtake, ā, ka mahi tahi koe me tō rōpū hauora ki te whakakore, ki te whakahaere rānei i taua mate. Kei runga i te pūtake me te pai o te rongoā tēnei. Mēnā he cirrhosis tōu, kāore e taea te whakakore i te kino kua pā mai. Engari ka taea e koe te ārai i ētahi atu kino, te whakaroa rānei i te tere o te mate. Kāore e taea te whakakore i te ngoikore o te ate mau tonu, engari ka roa pea ngā tau ka kino haere.

Ka taea te rongoā i te mate ate?

He maha ngā momo mate ate ka taea te whakaora. Ko te mate ate e puta mai ana i ngā paitini me te waipiro ka pai ake i te nuinga o te wā ina mutu te pānga ki aua paitini. Ko te mate ate momona kāore e pā ana ki te waipiro ka taea te whakaora mā te whakarerekē i te kai me te momo noho. Ko ētahi atu momo mate ate kāore e taea te whakaora, engari ka taea te whakahaere mā te rongoā. Ko ētahi mate tuku iho, ngā mate pūnaha ārai mate, me ngā mate huaketo ka hiahiatia he maimoatanga mō te wā katoa.

Me aha ahau ina noho tahi ahau me te mate ate?

Mena he mate ate tōu, me mahi ēnei mea hei tiaki i tō ate:

• Kia mau ki te kai hauora: Whakanuia ngā kai katoa, ngā hua me ngā huawhenua, me ngā pūmua kikokore.
• Te pupuri i te BMI (Body Mass Index) hauora: Me kōrero ki tō tākuta mō tēnei.
• Te karo i te waipiro, te tupeka, me ngā rongoā ka taea te hoko kore utu: Pātai atu ki tō tākuta kia āwhina koe ki te whakamutu.
• Tangohia ngā rongoā kia rite ki te whakahaunga: Kōrero ki tō tākuta mō ngā rongoā hou katoa e tangohia ana e koe.
• Te tiaki i a koe mai i ngā mate urutā: Āraihia te taumahatanga atu ki te ate mā te akuaku pai me ngā mahi moepuku haumaru.
• Kia mau ki ngā wā i whakaritea e tō tākuta: Me tirotiro i a koe anō i ia wā, me te tautuhi wawe i ngā raruraru.