Anthu ena omwe ali ndi vuto la chiwindi angayambe kutuluka magazi mkamwa mwadzidzidzi, kapena angazindikire magazi m'chimbudzi chawo. Izi zikachitika, simungathe kuganiza zomwe zikuchitika. Chimodzi mwa zifukwa zazikulu za vutoli ndichakuti mitsempha yamagazi yomwe ili m'mero mwanu, chubu chomwe chakudya chimadutsamo, imatupa ndikuphulika, zomwe zimapangitsa kutuluka magazi . Zili ngati mitsempha yotupa m'miyendo yanu, koma izi zimachitika mkati mwa thupi lanu. Lero tikambirana za vutoli, lomwe limadziwika kuti Esophageal Varices. Musadandaule, tiyeni tisunge zinthu mosavuta.
Kodi izi (Esophageal Varices) ndi chiyani? Mwachidule…
Tangoganizirani, mmero wanu ndi chubu chomwe chimanyamula chakudya kuchokera pakamwa panu kupita m'mimba mwanu. Mkati mwa chubuchi muli netiweki ya mitsempha yamagazi yabwino. Ngati pazifukwa zina, mitsempha yamagazi iyi ili pansi pa kupanikizika kwambiri, pang'onopang'ono imatupa ndikuyamba kukula. Izi zimatchedwa esophageal varices.
Choopsa kwambiri pa izi ndichakuti makoma a mitsempha yotupayi ndi ofooka kwambiri. Monga baluni yodzaza kwambiri. Chifukwa chake, amatha kuphulika mosavuta ndikutuluka magazi . Kutuluka magazi kumeneku mkati mwa thupi kumatha kukhala mwadzidzidzi, koopsa, komanso koopsa moyo.
Kodi (Esophageal Varices) ndi yoopsa bwanji?
Chiwopsezo chachikulu komanso chachikulu cha vutoli ndi kutuluka magazi . Ngakhale kuti si aliyense amene amatuluka magazi, pafupifupi 50% ya anthu omwe ali ndi vutoli amatha kutuluka magazi. Monga tanenera kale, chiopsezochi chimawonjezeka pamene kuthamanga kwa magazi m'mitsempha yayikulu yamagazi yomwe imadutsa m'chiwindi, ndiko kuti, (Portal Hypertension), kumawonjezeka. Nthawi zambiri, vutoli (Portal Hypertension) limayamba chifukwa cha matenda osatha a chiwindi. Chifukwa chake, pamene matenda a chiwindi akukulirakulira, vutoli limakulirakuliranso.
Anthu omwe ali ndi chiwindi chodwala kwambiri, kutanthauza cirrhosis, angakhale ndi mavuto ena kupatula matenda a varices a m'mero.Komabe, chifukwa chachikulu chomwe anthu omwe ali ndi matenda a cirrhosis amagonekedwa m'chipatala ndikufa ndichakuti mitsempha yotupayi imaphulika ndikutuluka magazi. Ngati mtundu uwu wa magazi uchitika, chiopsezo cha imfa ndi pafupifupi 20%. Komanso, pambuyo pa kutuluka magazi kamodzi, chiopsezo cha kutuluka magazi kachiwiri chimakhala chachikulu.
Kodi zizindikiro za (Esophageal Varices) ndi ziti?
Mitsempha yotupa iyi siioneka ngati ili m'miyendo. Imapezeka mkati mwa chifuwa, nthawi zambiri pomwe m'mero umalumikizana ndi m'mimba. Simumaimva mukameza. Nthawi zambiri siimayambitsa zizindikiro zilizonse mpaka itatuluka magazi.
Komabe, ngati dokotala wanu akuwona zizindikiro zina zomwe zikusonyeza kuthamanga kwa magazi kwa portal kapena matenda osatha a chiwindi, angaganizenso kuti pali mitsempha ya m'mimba. Zizindikiro zimenezi ndi monga:
- Jaundice : Kuoneka kwachikasu pakhungu ndi m'maso.
- Ascites : Kuchulukana kwa madzi m'mimba.
- Kutupa : Kutupa kwa miyendo ndi akakolo.
- Kupweteka m'mimba : Kupweteka kungayambitsidwe ndi kutupa kwa chiwindi kapena ndulu .
- Kutupa : Kuyabwa pakhungu popanda kuvulaza.
- Kusokonezeka (Hepatic Encephalopathy) : Kulephera kuganizira bwino, kutaya chidziwitso.
Zizindikiro za kutuluka magazi
Ngati mtsempha wotupa waphulika mwadzidzidzi ndikuyamba kutuluka magazi, simungamve kupweteka kulikonse nthawi yomweyo. Komabe, muyenera kudziwa zizindikiro zotsatirazi za kutuluka magazi m'mimba kapena m'thupi :
| Zizindikiro za kutuluka magazi | Umu ndi momwe zimachitikira… |
|---|---|
| Kusanza magazi mkamwa | Mukasanza magazi, mutha kusanza magazi omwe aundana ndipo amaoneka ngati khofi. Koma ngati mtsempha waphulika mwadzidzidzi, mutha kusanza magazi atsopano ofiira. |
| Magazi mu chopondapo | Magazi ochokera mkamwa akagayidwa ndikutuluka ndi ndowe, amasanduka mtundu wachikasu kapena wakuda (melena). Komabe, ngati magazi atuluka mofulumira kwambiri, magazi ofiira atsopano angatulukenso ndi ndowe. |
| Zinthu zina za thupi | Magazi ambiri akatuluka m'thupi, nkhope imatha kuoneka yotumbululuka, ndipo mungamve kutopa kwambiri komanso kukhala opanda moyo. Kutsika kwa kuthamanga kwa magazi kungayambitsenso chizungulire. |
Zofunika: Zizindikiro za Zadzidzidzi (Hypovolemic Shock)
Ngati mwadzidzidzi muyamba zizindikiro za vuto loopsa lotchedwa hypovolemic shock, pitani ku ETU nthawi yomweyo! Zizindikiro izi ndi izi:
- Kugunda kwa mtima
- Kuchuluka kwa mpweya wopuma
- Kumva kuzizira komanso thukuta
- Kusakhazikika ndi chisokonezo
- Kutaya chidziwitso
Kodi zifukwa za mitsempha ya m'mimba ndi ziti?
Choyambitsa chachikulu cha vutoli ndi vuto lotchedwa Portal Hypertension , lomwe ndi kuthamanga kwa magazi m'mitsempha yayikulu yamagazi yomwe imadutsa m'chiwindi (mtsempha wa portal) ndi mitsempha ina yomwe imatuluka m'chiwindicho.
Matupi athu amayesa kusintha kuti agwirizane ndi kupanikizika kumeneku mwa kulowetsa magazi owonjezera m'mitsempha yaying'ono yomwe singathe kupirira. Mwa izi, mitsempha yofewa yomwe ili m'machubu ndi yomwe imatupa kwambiri.
Zifukwa zazikulu za kuthamanga kwa magazi kwa portal
Chifukwa chachikulu cha izi ndi matenda a chiwindi otchedwa cirrhosis, omwe ndi kuuma kwa chiwindi . Izi zimachitika chifukwa cha kuwonongeka kwa chiwindi kwa nthawi yayitali. Maselo a chiwindi amavulala nthawi zonse ( hepatitis ), ndipo pamapeto pake amakhala zipsera. Zipsera izi zimaletsa kuyenda kwa magazi m'chiwindi. Izi sizichitika nthawi imodzi, koma zimachitika kwa zaka zambiri.
Matenda a chiwindi otchedwa cirrhosis ndi gawo lomaliza la matenda aliwonse osatha a chiwindi. Mwachitsanzo:
- Matenda a chiwindi oyambitsidwa ndi mowa
- Matenda a chiwindi osagwiritsa ntchito mowa (NASH)
- Matenda a chiwindi a nthawi yayitali (monga B, C)
- Matenda a chiwindi odziteteza okha
Pali zifukwa zina zomwe zingayambitse matenda a magazi otchedwa Portal Hypertension:
- Ma granulomas m'chiwindi : Awa ndi magulu a maselo otupa omwe amapezeka ndi matenda osiyanasiyana komanso matenda otupa. Chifukwa chachikulu cha izi ndi matenda opatsirana otchedwa Schistosomiasis, omwe amakhudza anthu pafupifupi 230 miliyoni padziko lonse lapansi.
- Matenda a Thrombosis: Ngati magazi kuundana m'mitsempha yolumikizidwa ndi chiwindi, kuyenda kwa magazi kumatha kutsekedwa (monga matenda a Budd-Chiari).
- Kukula kwa ndulu .
- Matenda a mtima : monga kulephera kwa mtima kumbali yakumanja.
Kuzindikira ndi Kuchiza Matenda a Mitsempha ya M'mimba (Esophageal Varices)
Simudzadziwa izi mpaka dokotala atakuyezani. Ngati mwapezeka kale ndi matenda a cirrhosis, dokotala wanu nthawi zambiri amakulangizani kuti muwone ngati mitsempha yanu yatupa. Mayeso akuluakulu omwe amagwiritsidwa ntchito pa izi ndi upper endoscopy .
Kodi (Upper Endoscopy) ndi chiyani?
Upper Endoscopy , yomwe imadziwikanso kuti EGD test, ndi njira yowunikira kugaya chakudya cham'mwamba, komwe kumaphatikizapo mmero, m'mimba, ndi chiyambi cha matumbo ang'onoang'ono (duodenum). Izi zimachitika ndi dokotala wa gastroenterologist, dokotala yemwe ndi katswiri wa matenda a m'mimba komanso njira zofufuzira matenda. Endoscope ndi chubu chachitali, chopyapyala chokhala ndi kamera kakang'ono kumapeto. Chubucho chimayikidwa kudzera pakamwa panu ndikudutsa mu mmero wanu kuti chiwone mwachindunji kutupa kulikonse. Ngati pali vuto lililonse, zida zazing'ono zitha kuyikidwa kudzera mu endoscope kuti zichiritse.
Kodi mankhwala a (Esophageal Varices) ndi otani?
Zolinga zazikulu za chithandizo ndikuwongolera kutuluka kwa magazi komwe kukuchitika, kupewa kutuluka kwa magazi mtsogolo, komanso, ngati n'kotheka, kuchepetsa kuthamanga kwa magazi m'thupi.
| Njira yochizira | Kodi chimachitika ndi chiyani? |
|---|---|
| Mankhwala | Madokotala amapereka mankhwala ochepetsa kuthamanga kwa magazi monga Octreotide. Palinso mankhwala monga Beta-blockers omwe mungagwiritse ntchito kuti muchepetse kutuluka kwa magazi. |
| Kumangirira gulu la varicose | Kachipangizo ka endoscope kakangoyikidwa, kansalu kakang'ono ka mphira kamayikidwa mozungulira mtsempha wotuluka magazi, kapena mtsempha womwe ukuganiziridwa kuti ukutuluka magazi, ndipo kamangirizidwa. Izi zimaletsa kutuluka magazi. |
| Njira Zoyendetsera Shunt | Izi n'zovuta pang'ono. Pali njira ziwiri, TIPS ndi DSRS. Izi zikuphatikizapo kupanga njira yatsopano yoti magazi azidutsa chiwindi. Kaya kudzera mu opaleshoni kapena X-ray, mtsempha m'chiwindi umalumikizidwa ndi mtsempha wina kuti uchepetse kupanikizika. |
| Kuchiza chifukwa choyambitsa | Chofunika kwambiri ndi kuchiza chomwe chimayambitsa vutoli. Izi zikutanthauza kusiya kumwa mowa, kuchepetsa thupi, kapena kumwa mankhwala a matenda ena monga hepatitis C. |
Kukhala ndi vutoli
Malingaliro anu amadalira ngati muli ndi magazi m'mitsempha yanu komanso momwe matenda anu a chiwindi alili oopsa. Chiŵerengero cha moyo wa chaka chimodzi kwa anthu omwe ali ndi matenda a cirrhosis ndi magazi ndi pafupifupi 50%. Chiwopsezo cha imfa chifukwa cha kutuluka magazi koyamba ndi 20%, ndipo chiopsezo cha kutuluka magazi kachiwiri, ngakhale mutalandira chithandizo, ndi chokwera kufika pa 60%.
Matenda a m'mimba ndi vuto lalikulu. Komabe, ngati matenda a chiwindi apezeka msanga, kusintha kwa moyo kungachitike kuti matendawa asakule kwambiri, ndipo mitsempha imeneyi ingalepheretsedwenso kutupa.
Uthenga Wopita Nawo Kunyumba
- Matenda a m'mimba nthawi zambiri amayamba chifukwa cha kuthamanga kwa magazi m'thupi (portal hypertension), matenda omwe amayamba chifukwa cha chiwindi (liver cirrhosis ).
- Kuopsa kwakukulu kwa izi ndi kuthekera kwa mtsempha wamagazi kuphulika ndikutuluka magazi . Izi zitha kukhala zoopsa pamoyo.
- Ngakhale poyamba simukuwonetsa zizindikiro zazikulu, ngati mukuwona zizindikiro monga kutuluka magazi mkamwa, ndowe zakuda, khungu lachikasu, ndi mimba yotupa, pitani kwa dokotala nthawi yomweyo .
- Izi ndi zomwe zimazindikirika ndipo mankhwala ena amachitidwa kudzera mu kafukufuku wotchedwa endoscopy.
- Pali mankhwala, koma chofunika kwambiri ndi kupewa zinthu zomwe zingawononge chiwindi (mowa, zakudya zina zosapatsa thanzi) ndikutsatira malangizo a dokotala moyenera .
- Ngati muli ndi matenda a chiwindi, ndikofunikira kwambiri kuti muyezedwe nthawi zonse kuti muwone ngati pali zovuta ngati izi .
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