Tiyeni tiphunzire zambiri zokhudza matenda a chiwindi! Tiyeni tikambirane za izi!

Chiwindi ndi chiwalo chofunikira kwambiri m'thupi lanu. Chimagwira ntchito ngati fyuluta m'thupi lathu. Chimasefa ndikuchotsa poizoni m'magazi. Koma, pali malire pa zomwe fyuluta iyi ingathe kuchita, sichoncho? Nthawi zina, ntchito imeneyi imatha kuwononga chiwindi . Kotero lero, tiyeni tikambirane za matenda a chiwindi .

Kodi Matenda a Chiwindi ndi Chiyani?

Tikamanena kuti 'matenda a chiwindi', madokotala nthawi zambiri amalankhula za matenda omwe amawononga chiwindi pang'onopang'ono, pakapita nthawi, kapena omwe ndi osatha . Izi zitha kuchitika chifukwa cha matenda opatsirana ndi mavairasi , poizoni wosiyanasiyana, kapena matenda ena a kagayidwe kachakudya. Chodabwitsa n'chakuti chiwindi chili ndi mphamvu yodabwitsa yodzikonza chokha. Koma chikagwiritsidwa ntchito nthawi zonse, mphamvu imeneyo imachepa pang'onopang'ono.

Kodi matenda aakulu a chiwindi amakhala ndi magawo otani?

Nthawi zambiri pamakhala magawo anayi akuluakulu a matenda a chiwindi omwe akhala akuchitika kwa nthawi yayitali. Tiyeni tiwone zomwe zili.

Gawo 1: Matenda a Chiwindi

Gawo loyamba ndi matenda a chiwindi. Mwachidule, uku ndi kutupa kwa minofu ya chiwindi. Monga momwe timavulalira kwinakwake, chimatupa, pamene chiwindi chawonongeka kapena chakupha, kutupa kumeneku kumachitika chifukwa cha zimenezo. Izi zimachitika kuti matenda athetsedwe ndikuyamba kuchira. Izi zitha kuthetsedwa ndi kutupa kwadzidzidzi kwakanthawi (hepatitis). Koma ngati pali kuwonongeka kapena poizoni wopitirira, kutupa kumapitirira. Chifukwa cha matenda a chiwindi a nthawi yayitali (hepatitis yosatha) , pamene chiwindi chikuyesera kudzichiritsa pakapita nthawi, zipsera (fibrosis) pamapeto pake zimayamba kupangika.

Gawo 2: Fibrosis

Gawo lachiwiri ndi fibrosis. Apa ndi pamene minofu ya zipsera imasonkhana pang'onopang'ono m'chiwindi, zomwe zimapangitsa kuti chikhale cholimba komanso cholimba. Zili ngati nsalu yakale. Minofu ya zipsera iyi imachepetsa kuyenda kwa magazi kupita ku chiwindi, zomwe zikutanthauza kuti mpweya wochepa ndi michere imaperekedwa ku chiwindi. Umu ndi momwe chiwindi chimayambira kulephera kugwira ntchito pang'onopang'ono. Chodabwitsa n'chakuti, zina mwa fibrosis iyi zimatha kubwezeretsedwanso. Izi zikutanthauza kuti, ngati kuwonongekako kwachepa mokwanira, maselo a chiwindi amatha kubwereranso ndipo minofu ya zipsera imatha kuchepetsedwa.

Gawo 3: Matenda a Cirrhosis

Gawo lachitatu ndi cirrhosis, yomwe ndi yoopsa, yosasinthika, komanso yokhalitsa pachiwindi.Apa ndi pomwe fibrosis imakhala yosasinthika. Chiwindi chikataya maselo athanzi okwanira kuti chigwire ntchito, minofuyo singathenso kubwereranso. Komabe, ngakhale pa siteji iyi, pali njira zoyimitsira kapena kuchepetsa kuwonongekako. Pamene cirrhosis ikuyamba kukhudza ntchito ya chiwindi, simungazindikire kusiyana kwakukulu poyamba, chifukwa thupi lanu limayesetsa kulipira kutayikako.

Gawo 4: Kulephera kwa chiwindi

Gawo lomaliza, kapena lachinayi, ndi kulephera kwa chiwindi. Apa ndi pamene chiwindi sichingathenso kugwira ntchito kuti chikwaniritse zosowa za thupi. Izi zimatchedwanso decompensated cirrhosis - zomwe zikutanthauza kuti thupi silingathenso kulipira kutayika kwa chiwindi. Pamene ntchito za chiwindi zikuchepa pang'onopang'ono, mumayamba kumva zotsatira zake m'thupi lanu lonse. Kulephera kwa chiwindi kosatha ndi njira yopitira pang'onopang'ono, koma popanda kuyika chiwindi, pamapeto pake kumatha kubweretsa imfa. Kumbukirani, timafunikira chiwindi kuti tipulumuke.

Kodi matenda a chiwindi ndi ofala bwanji?

Tikanena za momwe matenda a chiwindi awa alili ofala, amachititsa imfa pafupifupi 2 miliyoni pachaka padziko lonse lapansi. Izi ndi pafupifupi 4% ya imfa zonse. Imfa zambiri zimachitika chifukwa cha mavuto a cirrhosis. Amuna ali ndi mwayi wowirikiza kawiri matenda awa kuposa akazi.

Kodi zizindikiro zoyamba za matenda a chiwindi ndi ziti?

Nthawi zambiri, matenda osatha a chiwindi awa sasonyeza zizindikiro zazikulu kumayambiriro. Koma nthawi zina, amayamba mwadzidzidzi ngati matenda a chiwindi oopsa. Mwachitsanzo, ngati muli ndi matenda a chiwindi omwe amayambitsidwa ndi kachilombo, pamakhala nthawi yoopsa isanafike nthawi yokhalitsa. Panthawiyi, mungakhale ndi malungo, kupweteka m'mimba, komanso nseru kwa masiku angapo. Ngati chitetezo cha mthupi sichingathe kulimbana ndi matendawa, chimakhala matenda osatha.

Zina mwa zifukwa zomwe zimayambitsa matenda a chiwindi zingayambitsenso zizindikiro zadzidzidzi ngati izi poyamba. Zizindikiro zoyambirira za matenda a chiwindi nthawi zambiri sizimaonekera bwino. Zitha kuphatikizapo:

• Kupweteka kwa m'mimba chapamwamba.
• Kusanza kapenaChakudya chilibe kukoma .
• Kutopa ndi kufooka (kumva kutopa nthawi zambiri komanso kusasangalala).

Kodi zizindikiro zomaliza za matenda a chiwindi ndi ziti?

Pamene chiwindi chanu chikuyamba kugwira ntchito mochepa, mungayambe kuona zizindikiro zambiri. Apa ndi pamene matenda a chiwindi ali pamlingo wapamwamba kwambiri. Chimodzi mwa zotsatira zoyipa za kulephera kwa chiwindi ndichakuti kutuluka kwa ndulu kumatsekedwa. Chiwindi sichingathenso kupanga ndulu bwino kapena kuipompa m'matumbo ang'onoang'ono. M'malo mwake, ndulu imayamba kutuluka m'magazi. Izi zingayambitse zizindikiro zingapo:

• Jaundice (kuyera kwa maso ndi khungu).
• Mkodzo wakuda .
• Kudutsa chopondapo chowala .
• Kuvuta kugaya chakudya, makamaka zakudya zonenepa.
• Kuchepetsa thupi ndi kuwononga minofu.
• Mpweya wonunkha ngati chipale chofewa.
• Kulephera pang'ono kwa ntchito ya ubongo (hepatic encephalopathy).
• Kutupa (kungoyabwa popanda ziphuphu pakhungu).

Matenda a chiwindi akamakula, amatha kusokoneza kayendedwe ka magazi, mahomoni, komanso thanzi lanu. Izi zitha kuonekera m'njira zosiyanasiyana. Mutha kuzindikira zizindikiro monga izi pakhungu ndi msomali wanu:

• Supuni misomali.
• Misomali ya Terry (misomali ndi yotumbululuka, yokhala ndi nsonga za pinki zokha).
• Kupindika kwa misomali ndi kutupa ndi kupindika kwa maziko a misomali.
• Angioma ya kangaude .
• Madontho ofiira ang'onoang'ono pakhungu ``(petechiae)``.
• Mafuta achikasu amatuluka pakhungu kapena m'zikope, n'kuoneka ngati matuza ang'onoang'ono.
• Kutupa ndi kutuluka magazi mosavuta.
• Kufiira kwa manja.

Mukhozanso kuona zizindikiro za madzi akutuluka m'mitsempha yamagazi ndi kuwunjikana m'mbali zosiyanasiyana za thupi:

• Kutupa m'mimba (ascites).
• Kutupa kwa akakolo, miyendo, manja, ndi nkhope (edema).

Makhalidwe okhudzana ndi jenda

Azimayi angakumane ndi zizindikiro monga izi chifukwa cha matenda a chiwindi:

• Kusakhazikika kwa nthawi ya msambo.
• Kuvuta kukhala ndi ana (Kusabereka kwa akazi).

Amuna angakumane ndi zizindikiro monga:

• Ma testicles ofooka.
• Minofu ya bere la mwamuna yokulirapo.

Mavuto a matenda a chiwindi omwe afika pachimake

Matenda a chiwindi omwe amafika kumapeto kwa gawo ndi vuto lomwe chiwindi sichingathe kudzikonza chokha ndipo pang'onopang'ono chimakhala chosagwira ntchito bwino, chomwe chimatchedwa decompensated cirrhosis ndi kulephera kwa chiwindi. Zotsatirapo ziwiri zazikulu kwambiri pa gawoli ndi portal hypertension ndi hepatocellular carcinoma . Mavuto a matenda awiriwa ndi omwe amachititsa kuti anthu omwe ali ndi cirrhosis ndi kulephera kwa chiwindi agone m'chipatala komanso azifa.

Kuthamanga kwa magazi kwa portal

Matenda a magazi otchedwa portal hypertension amayamba chifukwa cha zipsera m'chiwindi, zomwe zimayambitsa kupanikizika kwa mtsempha wa portal. Pamene kupanikizika kwa mtsempha wa portal kukukwera, thupi limasuntha magazi kupita ku mitsempha ina yomwe imalumikizana nayo. Kenako mitsempha imakula, imatambasuka, komanso imachepa. Mitsempha iyi imatha kutuluka, kuphulika, kapena kutuluka magazi. Kutuluka magazi mkati mwa thupi kumeneku kungakhale mwadzidzidzi, koopsa, komanso koika moyo pachiswe.

Ngakhale kuti sizichitika kawirikawiri, mavuto ena angachitike:

• Kukulirakulira ndi kugwira ntchito mopitirira muyeso kwa ndulu (hypersplenism).
• Kulephera kwa dongosolo la kupuma `(hepatopulmonary syndrome)`.
• Kulephera kwa impso (hepatorenal syndrome).

Khansa ya Chiwindi

Ngakhale kuti si onse omwe ali ndi matenda a chiwindi kwa nthawi yayitali omwe adzadwala khansa ya chiwindi, anthu ambiri omwe amadwala khansa ya chiwindi amakhala ndi matenda a chiwindi kwa nthawi yayitali. Kutupa, kuchira, ndi zipsera kumapangitsa kuti maselo a chiwindi asinthe kwambiri ndikukhala khansa. Madokotala akuganiza kuti mavairasi osatha a chiwindi, makamaka, amathanso kukhudza DNA ya maselo a chiwindi.

Kodi zimayambitsa matenda a chiwindi ndi chiyani?

Pali mitundu yoposa 100 ya matenda a chiwindi, koma amagawidwa m'magulu akuluakulu angapo. Zomwe zimayambitsa matendawa ndi izi:

• Matenda opatsirana ndi mavairasi: Matenda opatsirana ndi mavairasi monga hepatitis B ndi hepatitis C angayambitse matenda a chiwindi osatha.
• Matenda a chiwindi oyambitsidwa ndi mowa: Kumwa mowa mopitirira muyeso kungayambitse matenda a chiwindi oopsa kapena osatha. Ngati izi zipitirira, zingayambitse matenda a chiwindi ndi kulephera kwa chiwindi. Ichi ndi chifukwa chofala kwambiri m'dziko lathu.
• Matenda a chiwindi oopsa: Matenda a chiwindi oopsa kapena osatha angayambitsidwe ndi kukhala ndi zinthu zoopsa kwa nthawi yayitali, monga mankhwala a m'mafakitale kapena mankhwala osokoneza bongo.
• Matenda a chiwindi amafuta osakhudzana ndi mowa (NAFLD): Matenda a kagayidwe kachakudya okhudzana ndi kunenepa kwambiri, kuchuluka kwa shuga m'magazi, komanso kuchuluka kwa mafuta m'magazi kungayambitse mafuta ochulukirapo kudziunjikira m'chiwindi. Izi zingayambitse kutupa (steatohepatitis yosakhudzana ndi mowa - NASH). Matendawa amapezekanso mwa anthu ambiri masiku ano, makamaka chifukwa cha kudya mosayenera.
• Kukhazikika kwa ndulu: Matenda ena obadwa nawo, monga ndulu atresia ndi cystic fibrosis, angayambitse ndulu kusonkhanitsa ndikuwononga chiwindi mwa kutseka kapena kuletsa kuyenda kwa ndulu kudzera m'mitsempha ya ndulu. Zomwe zimayambitsa kubadwa pambuyo pobereka ndi monga ndulu yotsekeka ndi miyala ya ndulu.
• Matenda a Autoimmune: Matenda a Autoimmune monga matenda a chiwindi a autoimmune, primary biliary cholangitis, ndi primary sclerosing cholangitis angayambitse kutupa ndi zipsera kwa nthawi yayitali m'chiwindi kapena m'mitsempha ya ndulu.
• Matenda a kagayidwe kachakudya omwe amabadwa nawo: Matenda omwe amachititsa kuti poizoni azisonkhana m'magazi, monga matenda osungira glycogen (GSD), matenda a Wilson, hemochromatosis, ndi matenda a Gaucher, angayambitse kuwonongeka kwa chiwindi kwa nthawi yayitali.
• Matenda a mtima: Matenda omwe amakhudza chiwindi ndi kuyenda kwa magazi kudzera m'chiwindi, monga matenda a Budd-Chiari, ischemia, matenda a mitsempha ya mtima, ndi kulephera kwa mtima kumbali yakumanja, angayambitse kuwonongeka kwa chiwindi kwa nthawi yayitali.

Kodi ndi zinthu ziti zomwe zimayambitsa matenda a chiwindi?

Mungakhale ndi mwayi waukulu wopeza matenda a chiwindi ngati:

• Ngati mumamwa mowa wambiri.
• Ngati mumwa mankhwala kudzera m'mitsempha, amatchedwa "mankhwala olowa m'mitsempha".
• Ngati mumagwiritsa ntchito mankhwala ochepetsa ululu monga aspirin kapena paracetamol pafupipafupi (makamaka ngati mugwiritsa ntchito mlingo waukulu popanda upangiri wa dokotala).
• Ngati muli ndi vuto la metabolic syndrome (kuphatikiza kunenepa kwambiri, kuthamanga kwa magazi, shuga wambiri m'magazi, ndi kuchuluka kwa cholesterol kosafunikira).
• Ngati nthawi zambiri mumakumana ndi mankhwala oopsa.
• Ngati nthawi zambiri mumakumana ndi magazi kapena madzi amthupi a ena (monga ogwira ntchito zachipatala, ojambula zojambulajambula).

Kodi mungazindikire bwanji matenda a chiwindi?

Dokotala amene akufufuza matenda a chiwindi adzakuyesani kaye mwakuthupi. Adzafufuza zizindikiro ndi zizindikiro ndikufunsa za zizindikiro zanu. Angafunsenso za zakudya zanu, moyo wanu, ndi mbiri yanu ya thanzi. Kenako, adzagwiritsa ntchito mayeso a labu ndi ma scan kuti adziwe ngati muli ndi matenda a chiwindi. Izi zingaphatikizepo:

• Mayeso a magazi: Mayeso angapo a ntchito ya chiwindi angasonyeze zizindikiro za matenda a chiwindi, kuopsa kwa matendawa, ndi zizindikiro za kulephera kwa chiwindi. Izi zimayesa zinthu monga ma enzymes a chiwindi, mapuloteni, ndi bilirubin. Mayeso a magazi angasonyezenso zotsatirapo zina monga kutupa, matenda enaake, kapena kuchepa kwa magazi kuundana.
• Mayeso ojambulira: Kujambula m'mimba pogwiritsa ntchito ultrasound, CT scan (computed tomography scan), kapena MRI (magnetic resonance imaging) kungawonetse kukula, mawonekedwe, ndi momwe chiwindi chilili. Izi zingathandize kuzindikira kutupa, ziphuphu, ndi fibrosis.
• Elastography: Iyi ndi njira yapadera yojambulira yomwe imagwiritsa ntchito ukadaulo wa ultrasound kapena MRI poyesa kuuma, kapena kuchuluka kwa fibrosis, ya chiwindi.
• Endoscopy:Ngati dokotala wanu akufuna kuyang'ana mkati mwa njira yanu yolumikizira ndulu, adzafunika kugwiritsa ntchito njira yojambulira zithunzi yotchedwa endoscopy. Izi zimaphatikizapo kuyika kamera kakang'ono (endoscope) kudzera pakamwa panu ndikuyiyika m'mimba mwanu. Kenako njira zolumikizira ndulu zimatha kuwonedwa pogwiritsa ntchito EUS (endoscopic ultrasound) kapena ERCP (endoscopic retrograde cholangiopancreatography).
• Kujambula mankhwala a nyukiliya: Izi zimaphatikizapo kubaya mankhwala oopsa a radioactive m'thupi ndikugwiritsa ntchito kamera ya gamma kuti azindikire. Kutengera momwe chiwindi chanu chimayamwira mankhwalawa, zimatha kuwonetsa komwe sikukugwira ntchito bwino.
• Kufufuza chiwindi: Iyi ndi njira yaying'ono. Chitsanzo chaching'ono cha minofu chimatengedwa kuchokera ku chiwindi ndikuyesedwa mu labotale. Chitsanzochi nthawi zambiri chimatengedwa pogwiritsa ntchito singano yopanda kanthu. Kufufuza chiwindi kungachitike kuti muwone ngati pali khansa, kutsimikizira kuti chiwindi chili ndi matenda a chiwindi, ndikupeza chomwe chikuyambitsa.

Kodi matenda a chiwindi amachiritsidwa bwanji?

Mitundu ina ya matenda a chiwindi imakhala ndi mankhwala enaake. Mwachitsanzo, mankhwala oletsa mavairasi amaperekedwa pa matenda a chiwindi otchedwa virus, ndipo corticosteroids ndi immunosuppressants amaperekedwa pa matenda odziteteza okha. Koma nthawi zambiri, kusintha kwa moyo ndiye chithandizo chachikulu cha matenda a chiwindi. Kuchepetsa kuchuluka kwa poizoni wolowa m'chiwindi ndikofunikira pa matenda aliwonse a chiwindi. Izi ndizofunikira makamaka pa matenda a chiwindi omwe amayamba chifukwa cha mafuta ochulukirapo, mowa, kapena poizoni wina.

Komabe, kuzindikira msanga ndikofunikira kuti munthu athe kuchiza matenda a chiwindi bwino asanawonongeke kwamuyaya. Tsoka ilo, si aliyense amene amapezeka ndi matendawa panthawi yomwe matendawa amatha kuchira. Ngati muli kale ndi matenda a chiwindi kapena kulephera kwa chiwindi, mungafunike chithandizo china cha mavuto monga kuthamanga kwa magazi kapena khansa ya chiwindi. Chiwindi chanu sichingathe kuchira, ndipo pamapeto pake mungafunike kuikidwa chiwindi.

Kodi mungachepetse bwanji chiopsezo cha matenda a chiwindi?

Mukhoza kuchita izi kuti mudziteteze ku matenda a chiwindi:

• Kulandira katemera: Pali katemera woteteza ku matenda a chiwindi a A ndi B.
• Ukhondo wabwino: Zinthu monga kusamba m'manja mutagwiritsa ntchito chimbudzi, kukonza chakudya mosamala, komanso kugwiritsa ntchito singano mosamala zingathandize kupewa kufalikira kwa matenda.
• Chepetsani kumwa mowa ndipo imwani mankhwala monga mwalangizidwira: Ngati muli ndi vuto la kugwiritsa ntchito mankhwala osokoneza bongo (monga 'Substance Use Disorder - SUD'), kulandira chithandizo kungathandize kupewa matenda a chiwindi omwe amayamba chifukwa cha poizoni.
• Kulamulira zinthu zomwe zimayambitsa kagayidwe kachakudya monga mafuta m'magazi (mafuta) ndi shuga m'magazi: Mutha kupeza thandizo kuchokera kwa dokotala pa izi.

Kodi matenda a chiwindi amatha kuchiritsidwa?

Matenda a chiwindi akayamba msanga akhoza kuthetsedwa ngati chifukwa chake chadziwika ndipo inu ndi gulu lanu lachipatala mumagwira ntchito limodzi kuti muchotse kapena kuwongolera. Izi zimadalira chomwe chimayambitsa komanso momwe chingachiritsidwire bwino. Ngati muli ndi matenda a chiwindi, simungathe kusintha kuwonongeka komwe kwachitika kale. Koma mutha kupewa kuwonongeka kwina kapena kuchepetsa. Kulephera kwa chiwindi kosatha sikungathetsedwe, koma kungatenge zaka zambiri kuti kuipireipire.

Kodi matenda a chiwindi angachiritsidwe?

Mitundu yambiri ya matenda a chiwindi imatha kuchiritsidwa. Matenda a chiwindi omwe amayamba chifukwa cha poizoni ndi mowa nthawi zambiri amatha mukasiya kukhudzidwa ndi poizoniyo. Matenda a chiwindi omwe alibe mafuta okhudzana ndi mowa amatha kuchiritsidwa ndi kusintha zakudya ndi moyo. Mitundu ina ya matenda a chiwindi singathe kuchiritsidwa, koma amatha kuchiritsidwa ndi mankhwala. Matenda ena obadwa nawo, matenda odziteteza ku matenda, ndi matenda opatsirana ndi mavairasi angafunike chithandizo cha moyo wonse.

Kodi ndiyenera kuchita chiyani ndikakhala ndi matenda a chiwindi?

Ngati muli ndi matenda a chiwindi, chitani izi kuti musamale chiwindi chanu:

• Khalani ndi zakudya zabwino: Ikani patsogolo zakudya zonse, zipatso ndi ndiwo zamasamba, ndi mapuloteni opanda mafuta ambiri.
• Kusunga BMI yathanzi (Body Mass Index): Funsani dokotala wanu za izi.
• Kupewa mowa, fodya, ndi mankhwala ogulitsidwa kunja kwa sitolo: Funsani dokotala wanu kuti akuthandizeni kusiya kusuta.
• Imwani mankhwala okha monga mwauzidwa: Lankhulani ndi dokotala wanu za mankhwala atsopano omwe mukumwa.
• Kuteteza ku matenda: Kuteteza chiwindi kuti chisavutike kwambiri ndi ukhondo wabwino komanso kugonana motetezeka.
• Pitirizani ndi nthawi yokumana ndi dokotala: Pita kukayezetsa nthawi zonse ndikupeza mavuto msanga.