Chiropa chimwe chezvikamu zvakakosha mumuviri wedu. Kufanana nefekitori hombe, chiropa chine nzira huru yetsinga dzeropa dzinobvisa tsvina muropa. Fungidzira, chii chinoitika kana imwe kana kupfuura yetsinga idzi dzeropa ikavharika kana kutetepa? Mukurapa, ichi chirwere chisingawanzoitiki asi chakakomba zvikuru chinokonzerwa nekuvharika kwetsinga dzinotakura ropa kubva muchiropa . Zvakakosha kuziva izvi. Ngatitaurei nezvazvo zviri nyore.
Zvichitaurwa zviri nyore, chii chinonzi Budd-Chiari Syndrome?
Nzira yakanakisisa yekunzwisisa izvi ndeyekufunga nezvezvinoitika kana dhiraini mumba medu rikavharika. Sekunge pombi yakavharika ichizara nemvura, kana tsinga dzechiropa dzikavharika, ropa rinotanga kuungana mukati mechiropa. Izvi zvinogona kunge zvichikonzerwa neropa rakagwamba, kuzvimba mukati metsinga, kana kumanikidzwa kubva kunze.
Kana ropa rikaungana nenzira iyi, chiropa chinozvimba uye chinokura. Kwete izvozvo chete, asi dumbu rinogonawo kukura nekuda kwekumanikidzwa uku. Kana chirwere ichi chikaramba chiripo, mimwe migumisiro yakakomba ingangoitika.
- Kumanikidzwa kweropa kwakanyanya mutsinga huru inotakura ropa kuenda kuchiropa ('mutsinga wepatsinga').
- Varices: Nekuda kwekumanikidzwa kwakanyanya uku, mitsipa yeropa munzvimbo dzakadai segurokuro nedumbu inokura uye inogona kuputika nekubuda ropa.
- Ascites: Chirwere chekuti mvura yakaita semvura inozadza dumbu, zvichiita kuti rizvimbe. Tinozvidaidza kuti "ascites."
- Cirrhosis: Kukuvadzwa kwechiropa kwenguva refu, zvichikonzera kufa kwemasero echiropa uye mavanga echiropa. Ichi chirwere chakakomba chisingadzoreki.
Kune mhando dzakasiyana dzechirwere ichi here?
Ehe, inogona kukamurwa kuita mhando huru dzakasiyana zvichienderana nekumhanya uye kuoma kwezviratidzo. Zvakare, kune mhando mbiri zvichienderana nechikonzero chaicho.
| Rudzi rwechirwere | Tsananguro iri nyore |
|---|---|
| Chirwere cheAcute Budd-Chiari | Zviratidzo zvinongoerekana zvaonekwa mukati memazuva mashoma kana mavhiki. Dzimwe nguva chiropa chinogona kungoerekana chakundikana kushanda. |
| Chirwere cheSubacute Budd-Chiari | Zviratidzo zvinoonekwa zvishoma nezvishoma kwemwedzi yakati wandei. Urwu ndirwo rudzi rwakajairika. |
| Chirwere Chisingaperi cheBudd-Chiari | Muchiitiko ichi, zviratidzo zvinoonekwa mushure mekunge chiropa chakuvara zvakanyanya uye chasvika padanho rekuti cirrhosis. Kusvika panguva iyoyo, zviratidzo zvinogona kunge zvisati zvaonekwa. |
Zvichienderana nechikonzero, kune mhando mbiri huru:
1. Primary Budd-Chiari Syndrome: Panyaya iyi, dambudziko riri mutsinga yeropa pachayo. Izvi zvinogona kukonzerwa neropa rakagwamba (thrombus) kana kuzvimba mukati metsinga.
2. Secondary Budd-Chiari Syndrome: Pano dambudziko rinobva kunze kwetsinga yeropa. Semuenzaniso, bundu rekenza kana risiri rekenza riri pedyo nechiropa rinogona kukonzera kuti tsinga yeropa ivharike.
Ndezvipi zviratidzo zveizvi?
Zviratidzo zvechirwere ichi zvinogona kusiyana kubva pamunhu kusvika pamunhu. Zvinosiyanawo zvichienderana nerudzi rwechirwere. Zvisinei, kune zviratidzo zvishoma zvinowanzoonekwa.
| Chiratidzo | Zvinorevei izvo? |
|---|---|
| Kurwadziwa kwedumbu | Kurwadziwa mudumbu repamusoro, kunyanya kurudyi. |
| Kuzvimba kwedumbu (Ascites) | Dumbu rinozara nemvura uye dumbu rinokura. |
| Jaundice | Kutsvuka kweganda, kuchena kwemaziso, nerurimi. |
| Kukura kwechiropa nespleen | Chiremba anogona kunzwisisa izvi paanoongorora dumbu. |
| Kuzvimba kwemakumbo (Edema) | Kuzvimba kwetsoka nemakumbo. |
| Kuneta | Kuneta zvakanyanya pasina chikonzero. |
| Kuvhiringidzika (Hepatic encephalopathy) | Chiropa hachishande zvakanaka, izvo zvinokanganisa uropi uye zvinokonzera kurasikirwa nendangariro. |
Yeuka kuti vamwe vanhu, kunyanya avo vane chirwere ichi chisingarapiki, vanogona kusaratidza zviratidzo zvachose. Saka kana uine zviratidzo izvi, zvakanaka kuti uone chiremba nekukasika .
Sei chirwere cheBudd-Chiari chichiitika? Ndezvipi zvikonzero?
Kazhinji, izvi zvinokonzerwa nechirwere chinowedzera mukana wemuviri wekuumba maronda eropa.
- Zvirwere zveropa (Myeloproliferative neoplasms - MPNs): Idzi mhando dzegomarara reropa dzisingawanzoitiki. Dzinokonzera kuti muviri ugadzire masero eropa akawandisa, zvichiwedzera njodzi yekugwamba kweropa.
- Matambudziko anogwamba ropa zvakanyanya: Matambudziko anokonzera kugwinha kweropa nekukurumidza nekuda kwezvikonzero zvemajini kana zvimwe zvirwere. Semuenzaniso, mamiriro ezvinhu akadai sekushomeka kwe'Protein C' kana 'S', 'Antiphospholipid antibody syndrome'.
- Matumbu echiropa kana eitsvo: Matumbu ane kenza kana asina njodzi anogona kukonzera kuti mitsipa yeropa iome kubva kunze.
- Kubata Pamuviri: Vakadzi vane mukana wekuti ropa riite maronda panguva yekuzvitakura.
- Mapiritsi ekudzivirira pamuviri: Kushandiswa kwemamwe marudzi emapiritsi ekudzivirira pamuviri kunogonawo kuwedzera njodzi yekugwamba kweropa.
- Zvimwe zvirwere: Zvirwere zvakaita se `Sickle cell disease` uye `Inflammatory bowel disease (IBD)` zvinogonawo kukonzera izvi.
Zvisinei, dzimwe nguva pane zviitiko apo pasina chikonzero chaicho chingawanikwe . Isu tinoti izvozvo 'idiopathic'.
Chiremba anowana sei izvi?
Kana ukaona chiremba, achanyatsoteerera zviratidzo zvako, okuongorora, uye obva araira kuti zviongororwe kakawanda kuti asimbise chirwere chako.
1. Kuongororwa kweropa: Izvi zvinobatsira kutarisa huwandu hwema enzymes echiropa uye kuona kana paine njodzi yekugwamba kweropa.
2. Miedzo yemifananidzo:
- Kuongororwa kweDoppler Ultrasound: Uku ndiko kuongorora kwekutanga, kuri nyore, uye kwakakosha. Kunoshandisa mafungu eruzha kutarisa kufamba kweropa mutsinga dzeropa dzechiropa. Izvi zvinogona kupa pfungwa yakanaka yekuti pane kuvharika here.
- CT Scan kana MRI Scan: Mhando idzi dzekuongorora dzinogona kutora mifananidzo yakajeka yechiropa nenhengo dzakapoteredza. Dzimwe nguva mvura yakakosha ('zvinhu zvakasiyana') inogona kuiswa mumuviri kuti tsinga dzeropa dzionekwe zviri nani.
- Venografiya (venogramu): Bvunzo iyi inoitwa kana mamwe maskeni asina kujekeswa. Mubvunzo iyi, mvura yakakosha inopinzwa mutsinga yeropa uye mifananidzo yeX-ray inotorwa kuti ione kuyerera kweropa.
3. Kuongororwa kwechiropa: Kuti zvionekwe kuti chiropa chakuvara zvakadii uye kana chirwere ichi chavepo, kachidimbu kadiki kechiropa kanotorwa uchishandisa tsono diki koongororwa nemaikorosikopu.
Ndezvipi zvinorapwa izvi?
Pane zvinangwa zvikuru zviviri zvekurapa: Chimwe ndechekuvhurazve tsinga yeropa yakavharika kana kugadzira imwe nzira yekufambisa ropa. Chimwe ndechekurapa chikonzero chacho.
Kurapa nemishonga
Pakutanga, mishonga yakaita semishonga inodzivisa ropa kuungana (inodzikisa ropa ) inopihwa kunyungudutsa magwamba eropa uye kudzivirira magwamba matsva kuti asaumbe. Semuenzaniso, mishonga yakaita seheparin kana warfarin.
Kurapa kwakakosha kusiri kwekuvhiya
Kana mishonga chete isingakwanise kudzora chirwere ichi, kune nzira dzakawanda dzekurapa dzinoitwa navanachiremba vane hunyanzvi.
- Kuvhiyiwa kweTransjugular Intrahepatic Portosystemic Shunt (MAZANO): Iyi inzira yakaoma zvishoma. Zvichitaurwa zviri nyore, inogadzira "bypass" mukati mechiropa. Chubhu diki (stent) inoiswa pakati petsinga yeportal ine pressure yakakwira netsinga yehepatic, iyo inoburitsa ropa kubva muchiropa. Izvi zvinogadzira nzira itsva yekuti ropa riyerere pasina kuvharika.
- Percutaneous Transluminal Angioplasty: Izvi zvinosanganisira kuputira tsinga yeropa yakavharika kana kutetepa nebharumu. Dzimwe nguva chubhu diki yakaita semesh ('stent') inoiswa kudzivirira tsinga kuti isatetepa zvakare.
Kuisirwa Chiropa
Kana mimwe mishonga yese ikatadza kushanda, kana chiropa chikatadza kushanda zvachose (chiropa chikatadza kushanda) kana kuti chave nechirwere checirrhosis, nzira yekupedzisira ndeyekuisirwa chiropa chine hutano.
Remangwana rechirwere ichi rakaita sei?
Kufanotaura chirwere kunoenderana nezvinhu zvakati wandei. Kuti chirwere ichi chinowanikwa nekukurumidza sei, kukura kwekukuvara kwacho, uye kuti chinopindura zvakanaka sei pakurapwa zvese zvakakosha.
Kana akasarapwa, murwere ane tsinga dzeropa dzakavharika zvachose anogona kufa nekuda kwekutadza kushanda kwechiropa mukati memakore angangoita matatu. Zvisinei, kana ukarapwa zvakanaka, kunyanya kuisirwa chiropa, unogona kurarama hupenyu hurefu. Saka, ruzivo rwakanakisisa nezveizvi runobva kuna chiremba wako. Iye achakutsanangurira zvinoenderana nemamiriro ako ezvinhu.
Mharidzo Yekuenda Nayo Kumba
- Budd-Chiari Syndrome chirwere chakakomba, asi chinorapika, chinokonzerwa nekuvharika kwetsinga dzeropa muchiropa.
- Kana uine zviratidzo zvakaita sekukuruma kwedumbu kamwe kamwe, kurwadziwa kurudyi kwedumbu, kuzvimba kwemakumbo, kana jaundice, usazviregeredza wobva waona chiremba nekukasika.
- Kuongororwa kwechirwere ichi nekukurumidza uye kutanga kurapwa kwacho kwakakosha zvikuru kuponesa hupenyu.
- Kune nzira dzakasiyana-siyana dzekurapa. Chiremba wako ndiye achasarudza nzira dzakasiyana-siyana dzekurapa, kubva pamishonga kusvika pakuisirwa chiropa, zvichienderana nemamiriro ako ezvinhu.
- Kunyangwe mushure mekurapwa, zvakakosha kuti munhu arambe achiongororwa uye aende kumakiriniki sezvakarairwa nachiremba.
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