Unoziva here nezveMatumbu eVaric? Ngatikurukurei nezvazvo!

Wakambonzwa nezvechirwere chinonzi gastric varices here? Ungave wakanzwa izwi iri pawakaenda kunoona chiremba nekuda kwekurwadziwa kwemudumbu kana dambudziko rekugaya chikafu. Chinogona kuva chirwere chakakomba, saka zvakakosha kuziva kuti chii chaizvo. Saka, nhasi tichataura nezvechirwere ichi chinonzi (Gastric Varices) nenzira iri nyore, kuitira kuti unzwisise.

Chii chinonzi Gastric Varices? Ngatizvinzwisise zviri nyore!

Zvichitaurwa zviri nyore, maGastric Varices itsinga dzeropa dzakazvimba uye dzakakura dziri mudumbu mako. Dzinogona kutaridzika semabharumu madiki. Ichi chirwere chakakomba nekuti kana tsinga idzi dzakazvimba dzikaputika, dzinogona kukonzera kubuda ropa mudumbu rako repamusoro.

Ungave wakambonzwa nezvemavhairasi emudumbu, ayo ari tsinga dzakazvimba mugumbo. Mavhairasi emudumbu chirwere chisingawanzoitiki. Zvisinei, kana mavhairasi emudumbu akabuda ropa, anowanzova akakomba kupfuura mavhairasi emudumbu.

Funga nezvazvo nenzira iyi. Dumbu rako rine network yetsinga diki dzeropa dzinotakura ropa. Kazhinji, ropa rinoyerera nepakati petsinga idzi pasina matambudziko. Zvisinei, dzimwe nguva kuvharika kukuru kunoitika mutsinga huru yeropa inotakura ropa kuenda kuchiropa. Izvi zvinogona kukonzerwa nechirwere chinonzi cirrhosis, chinokonzera mavanga pachiropa. Zvadaro, pane "traffic jam" huru patsinga huru iyoyo, zvichireva kuti kumanikidzwa mukati metsinga dzeropa kunowedzera. Nekuda kwekumanikidzwa uku kwakawedzera, ropa rinotanga kutsvaga dzimwe nzira diki, uye pfupi. Sezvo idzi tsinga diki (dzinonzi varices) dziri mumadziro edumbu dzisina kugadzirwa kutakura ropa rakawanda kudaro, dzinozvimba, dzinozvimba, uye dzinobuda. Dambudziko iri rinonzi gastric varices. Kana kumanikidzwa uku kukasadzorwa, idzi tsinga dzakazvimba dzinogona kuputika.

Ndedzipi mhando huru dzezvirwere zvemudumbu?

Zvirwere zvemudumbu zvinonyanya kupatsanurwa zvichienderana nekuti zvine chekuita negurokuro rako here kana kuti kwete.

Mitsipa yevaricose ine chekuita nesophagus

• Mhando yekutanga yeGastroesophageal Varices (GOV1): Mhando idzi dzevarices dzinotangira pedyo negurokuro rako. Dzinozobva dzatambanuka dzichitevedza "rutivi rwepamusoro" (kukombama kudiki) kwedumbu rako. Funga nezvadzo semugwagwa weparutivi unotangira panosangana gurokuro negurokuro wodzika kuruboshwe rwedumbu rako. Uyu ndiwo rudzi rwakajairika.
• Mhando yechipiri yeGastroesophageal Varices (GOV2): Idzi dzinotangirawo pedyo negurokuro. Zvisinei, dzinoenderera mberi ne "greater curvature" yedumbu. Kunyangwe dzichitanga pedyo negurokuro sepakutanga, nzira idzi dzepadivi dzinofamba nedivi rekurudyi redumbu.

Mitsipa yevaricose isina hukama negurokuro

• Rudzi rwekutanga rweIsolated Gastric Varix (IGV1):Rudzi urwu rwetsinga dzinoputika dzinongogumira mudumbu. Dziri muchikamu chepamusoro chedumbu (fundus), icho chakazvimba uye chakazvimba.
• Rudzi rwechipiri rweIsolated Gastric Varix (IGV2): Rudzi urwu runogona kuzvimba chero kupi zvako mudumbu, kwete mu fundus chete.

Ndezvipi zviratidzo zvezvirwere zvemudumbu?

Kazhinji, varices dzemudumbu hadzina zviratidzo. Zvisinei, dambudziko rinotanga kana dzikaputika dzotanga kubuda ropa. Zvadaro, zviratidzo zvakakomba zvinogona kuoneka kamwe kamwe. Panguva dzakadaro, unogona kuona zviratidzo zvakaita se:

• Kurutsa ropa dzvuku rakasviba.
• Nhema, tsvina yemazuva ano (izvi zvinokonzerwa nekusanganiswa kweropa neacid yemudumbu, zvichiita kuti tsvina ive nhema)
• Dzimwe nguva ropa dzvuku rakasviba rinobuda mutsvina.
• Kunzwa dzungu.
• Kurova kwemoyo.
• Unogona kurasikirwa nepfungwa.
• Kudonha kamwe kamwe kweBP.
• Kusvotwa nekurutsa.
• Kupinda mukushamisika.
• Kunzwa kushaya simba uye kushaya hupenyu.

Kana uine chimwe chezviratidzo izvi, zvakakosha kutsvaga rubatsiro rwechiremba nekukasika, sezvo izvi zvingava dambudziko rekukurumidzira.

Ndezvipi zvikonzero zvikuru zvezvirwere zvemudumbu?

Chikonzero chikuru chezvirwere zvemudumbu chirwere chechiropa chinonzi (Cirrhosis). Muchirwere chechiropa chinonzi cirrhosis, masero echiropa anokuvadzwa uye anotsiviwa nenyama yemavanga. Mavanga aya anovharira kufamba kweropa muchiropa. Nekuda kwekuvharika uku, kumanikidzwa mu(Portal Vein) inova ndiyo tsinga huru inounza ropa kuchiropa, kunowedzera zvakanyanya. Dambudziko iri rinonzi (Portal Hypertension) . Kana kumanikidzwa kwacho kukawedzera seizvi, ropa rinosundira kumashure uye rinoedza kupfuura nemumimwe tsinga diki. Sezvo tsinga dziri mudumbu dziriwo tsinga diki, hadzigoni kutsungirira kumanikidzwa uku kwakawedzera uye kuzvimba uye kuva nevaricose.

Kuwedzera kune cirrhosis, kune zvimwe zvikonzero zvinogona kukonzera BP yepamusoro uye kutungamira kuzvirwere zvemudumbu:

• Kuvharika kweropa muTsamba yePortal kana Splenic Vein: Izvi, kufanana necirrhosis, zvinotadzisa kufamba kweropa.
• Utachiona hweParasitic: Muenzaniso wehutachiona hweparasitic hunonzi Schistosomiasis. Hunowanikwa muzvikamu zveAfrica, South America, Caribbean, Middle East, neEast Asia. Utachiona uhwu hunogona kukuvadza chiropa nespleen uye kukonzera Portal Hypertension.
• Zvimwe zvinokonzera kunze kwechirwere cheitsvo: Muzviitiko zvisingawanzoitiki, chirwere cheitsvo cheportal uye gastric varices zvinogona kuitika pasina chirwere cheitsvo. Muenzaniso wechirwere ichi chinonzi Budd-Chiari syndrome, chinova kuvharika kwetsinga dzinotakura ropa kubva muchiropa.

Ndezvipi zvinetso zvinogona kuitika nekuda kwezvirwere zvemudumbu?

Dambudziko guru remavanga emudumbu kubuda ropa . Mitsipa iyi yeropa yakazvimba iri mudumbu inonyorova zvikuru. Kana kumanikidzwa kwacho kwawedzera, inogona kuputika zviri nyore. Kana izvi zvikaitika, ropa rakawanda rinogona kubuda kamwe kamwe mumuviri, izvo zvinogona kutokonzera njodzi kuhupenyu. Kubuda ropa kubva mumavanga emudumbu idambudziko rekurapa.

Kashoma, zvirwere zvemudumbu zvisina kurapwa zvinogona kukonzera mamwe matambudziko, akadai se:

• Kushaya iron mumuviri: Zvishoma nezvishoma, nekufamba kwenguva, kana ropa rikadonha, huwandu hweiron mumuviri hunoderera, zvichikonzera zviratidzo zvakaita sekuneta uye kucheneruka.
• Hepatic encephalopathy: Apa ndipo apo chiropa chinenge chisina kushanda zvakanaka, zvichiita kuti chepfu dziungane muropa uye dzikanganise uropi. Izvi zvinogona kukonzera matambudziko akadai sekukanganwa zvinhu uye kuvhiringidzika.

Nzira yekuongorora sei varices yemudumbu?

Endoscopy nedzimwe bvunzo dzekufungidzira zvinonyanya kushandiswa kuongorora varicella yemudumbu. Miedzo iyi inogona kusanganisira:

• Endoscopy Yepamusoro: Iyi ndiyo nzira yakanakisisa uye inonyanya kukosha yekuongorora varice yemudumbu. Izvi zvinosanganisira kuisa chubhu yakatetepa, inochinjika ine kamera yakasungirirwa pahuro pako woongorora madziro emukati meguropu nedumbu rako. Chiremba anogona kuona kana paine varice, uye saizi yavo, ruvara, uye nzvimbo.
• Kuongororwa kweCT mudumbu: Izvi zvinogona kupa mifananidzo yakadzama yechiropa chako, chirebvu, uye tsinga dzeropa mudumbu mako. Kunyangwe zvisingakwanise kuona zvakananga tsinga dzakakuvara, zvinogona kuona zviratidzo zvine chekuita nechirwere che "Portal Hypertension." Izvi zvinoreva kuti unogona kunge uri panjodzi yakakura yekuve netsinga dzakakuvara.
• Doppler Ultrasound: Kuongororwa uku kunoshandisa mafungu eruzha kuongorora maitiro eropa riri mutsinga yako yemudumbu pamwe nemimwe tsinga dzeropa dziri mudumbu mako. Kana paine zvinhu zvisina kumira zvakanaka pamaitiro eropa, zvinogona kuratidza chirwere chinonzi portal hypertension.

Mitsipa yemudumbu inorapwa sei?

Kurapa kwevarice yemudumbu kunoenderana nekuti varice yacho yabvaruka uye yabuda ropa here, kana kuti haisati yabvaruka.

Kurapa kwezvirwere zvemudumbu zvisina kuputika

Chinangwa chikuru ndechekudzivirira kubuda ropa. Chiremba wako anogona kukupa mimwe mishonga, yakadai se nonselective beta-blockers . Mishonga iyi inoderedza BP mu portal vein, zvichideredza njodzi yekuputika kwe varicose veins.

Chiremba wako anogonawo kukupa mamwe maitiro e endoscopic, ayo anogona kuvhara zvakananga mitsipa iri kukuvadzwa kana kuita kuti itetepe.

• Endoscopic Varicose Ligation (EVL): Mukuita uku, chiremba anoshandisa endoscope kuisa mabhandi madiki erabha kutenderedza tsinga dzakazvimba. Izvi zvinomisa ropa kuti risayerere kuenda kutsinga dzakazvimba uye zvinoita kuti dziderere zvishoma nezvishoma.
• Jekiseni reEndoscopic Cyanoacrylate: Mukuita uku, chiremba anobaya chinhu chakaita seglue mutsinga ine varicose. Izvi zvinovhara tsinga kubva mukati uye zvinomisa kubuda ropa.

Kurapa kwezvirwere zvemudumbu zvinobuda ropa

Iyi inyaya yekurapa. Kubuda ropa kunofanira kumira nekukasika uye chero matambudziko angamuka anofanira kudzivirirwa. Sarudzo dzekurapa dzinosanganisira:

• Kupinda muchipatara uye kuwedzerwa ropa: Ungangove wakachengetwa muchikamu chevarwere vanorwara zvakanyanya (ICU) uye uchitariswa zvakanyanya paunenge uchiwedzerwa ropa kuti ropa rakarasika ritsiviwe.
• Kurapa ne endoscopic: Pamusoro pekushandiswa kwetsinga dzisina kukuvara, kurapwa ne endoscopic senge (EVL) kana (Cyanoacrylate Injection) kunoshandiswawo kumisa kubuda ropa.
• Mishonga: Mishonga yakaita seVasopressin kana Octreotide inogona kubatsira kudzora kubuda kweropa nekuderedza kuyerera kweropa kuenda kutsinga dzine varicose.
• Dzimwe nzira dzekudzora kumanikidzwa:
• Bharuni Tamponade: Muizvi, bharuni rakakosha rinoiswa mugurokuro rako rofuridzirwa, zvichiisa kumanikidzwa kwakananga pavarice dzinobuda ropa. Iyi inzira yenguva pfupi inoshandiswa kudzora kubuda ropa.
• Kuvhiyiwa kweTransjugular Intrahepatic Portosystemic Shunt (MAZANO): Iyi inzira yakaoma zvishoma. Inosanganisira kugadzira nzira itsva, pfupi yekuti ropa riyerere nemuchiropa chako. Izvi zvinobvumira ropa kuti riyerere zvakananga kubva mutsinga yemusuwo kuenda kutsinga huru iri muchiropa chako. Izvi zvinobvumira ropa kuti ripfuure kuvharika, zvichideredza kumanikidzwa mutsinga yemusuwo. Izvi zvinoderedzawo kumanikidzwa patsinga dzine varicose, izvo zvinobatsira kudzora kubuda ropa.

Munhu ane chirwere chemudumbu anotarisirwa kurarama kwenguva yakareba sei?

Kurarama kwemunhu ane chirwere chemudumbu kunoenderana nezvinhu zvakati wandei:

• Kana vari kubuda ropa: Kubuda ropa kubva mumitsipa yemudumbu idambudziko guru, rinoderedza zvakanyanya makore ekurarama.
• Kuoma kwechirwere chechiropa: Kufanotaura chirwere ichi kazhinji hakuna kunaka kune avo vane chirwere chechiropa chakanyanya kuoma.
• Kubudirira kwekurapwa:Kana chirwere ichi chikaonekwa nekukurumidza uye chikarapwa zvinobudirira, makore ekurarama anogona kuwedzera zvakanyanya.

Kana uine zvinokunetsa kana kusava nechokwadi nezvezvirwere zvemudumbu kana zvinhu zvinokonzera njodzi, zvakanaka kutaura nachiremba. Nenzira iyi, unogona kuwana mufananidzo wakarurama wemamiriro ako ezvinhu.

Kukuvara kwemudumbu kunogona kudzivirirwa here?

Zvingave zvakaoma kudzivirira zvachose zvirwere zvemudumbu. Zvisinei, pane zvaunogona kuita kuti uderedze njodzi yako, kunyanya kana uine chirwere chinokonzera BP. Heano mamwe maitiro aunogona kuita:

Dzora mamiriro ako ehutano aripo.

Kana uine chirwere chakadai se (Cirrhosis) kana (Schistosomiasis), zvakakosha kutevedzera hurongwa hwekurapa hwaunopihwa nachiremba wako kuti udzivise chirwere ichi.

Mishonga

Kana uine mitsipa yakakuvara kare, mishonga yakaita se beta-blockers inogona kubatsira kuderedza njodzi yekubuda ropa kubva mairi. Zvisinei, mishonga iyi inogona kusadzivirira mitsipa mitsva yakakuvara kubva pakuumbwa.

Kuchinja kwemararamiro

Unogona kuita zvinhu izvi kuderedza njodzi yako yekurwara nezvirwere zvemudumbu:

• Dzivisa doro: Doro ndiro rinonyanya kukonzera kukuvara kwechiropa. Rinogonawo kuwedzera BP yemudumbu.
• Idya chikafu chine hutano: Kudya kwakaringana kwakapfuma mumiriwo, michero, nyemba, uye zviyo (semuenzaniso, kudya kweMediterranean) kwakanaka kwazvo pahutano hwechiropa chako.
• Deredza kudya munyu: Kudya munyu wakawandisa kunogona kuwedzera kuchengetwa kwemvura mumuviri uye kuwedzera BP.
• Ramba uine huremu hwakanaka hunokukodzera: Huremu hwakawandisa hunoisawo kumanikidzwa kwakanyanya pachiropa.
• Baiwa majekiseni: Vanachiremba vanokurudzira kubaiwa majekiseni eHepatitis A neHepatitis B. Izvi zvinobatsira kuchengetedza chiropa.

Kana uine zvinhu zvinokonzera kuti uve nechirwere chevarice mudumbu, zvakakosha kuti utaure nachiremba wako woongororwa nguva nenguva, zvakaita se endoscopy, iyo inogona kuona varice nekukurumidza. Kuonekwa nekukurumidza kunobvumira kurapwa nekukurumidza uye kunogona kudzivirira matambudziko akakomba, akadai sekubuda ropa.

Ndinofanira kuona chiremba wangu rini?

Kana uchifungidzira kuti une chirwere chemudumbu, kunyanya kana uine zviratidzo zvinogona kuratidza kubuda ropa, usanonoka kuenda kuna chiremba. Tsvaga rubatsiro rwechiremba mumamiriro ezvinhu anotevera:

• Kana wakawanikwa uine chirwere chinowedzera njodzi yako yekuwedzera kweropa, senge cirrhosis kana schistosomiasis: Bvunza chiremba wako kana uchifanira kuendoscopy kuti uone mitsipa iri kupararira nekukurumidza.
• Kana uine zviratidzo zvekubuda ropa kubva mudumbu rako repamusoro: kurutsa ropa, kubuda ropa mutsvina yako, kana kubuda tsvina nhema, yakasviba.
• Kana uine kurwadziwa mudumbu kana kuzvimba kusingatsananguriki: Izvi zvinogona kuva chiratidzo che (Ascites) (kuungana kwemvura mudumbu), izvo zvine chekuita ne (Portal Hypertension).
• Kana uine zviratidzo zve (Portal Hypertension Encephalopathy): Izvi zvinoreva kuvhiringidzika, hope, kuoma kuisa pfungwa dzako pane chimwe chinhu, uye pamwe nekoma.

Kuonekwa nekurapwa kwevarice yemudumbu nekukurumidza kwakakosha kudzivirira matambudziko akakomba, akadai sekubuda ropa. Kana uine mibvunzo, zvinokunetsa, kana kusava nechokwadi nezvazvo, usazeza kutaura nachiremba. Iye achaongorora mamiriro ako uye achakurudzira nzira yakakodzera yekuita.

Ndinofanira kuenda kuDhipatimendi reEmergency (ETU) riini?

Kana uine zviratidzo zvekuti mavanga emudumbu ako abvaruka, enda kuchipatara chiri pedyo (ETU) nekukasika. Kubuda ropa kubva muvanga remudumbu kwakanyanya uye kunoda kurapwa nekukurumidza.

Mibvunzo ipi yandinofanira kubvunza chiremba wangu?

Unogona kubvunza chiremba wako mibvunzo yakaita seiyi:

• Chii chinoita kuti ndive nezvirwere zvemudumbu?
• Ndezvipi zvingasarudzwa zvekurapa zvirwere zvemudumbu?
• Ndezvipi njodzi nemigumisiro yekurapwa?
• Ndingaitei kuti ndidzivise kubuda ropa mutsinga dzangu dzakakuvara?
• Ndezvipi zvandingashandura mararamiro angu kuti ndivandudze hutano hwechiropa changu?
• Kangani pandinofanira kutarisa mitsipa yangu ine varicose?
• Ndeipi tarisiro yenguva refu kune munhu ane chirwere chemudumbu?

Pakupedzisira, meseji yekudzokera nayo kumba

Zvirwere zvemudumbu zvinogona kutyisa kunzwa. Zvisinei, kana munhu aine chirwere ichi uye akachiwana nekukurumidza, vanhu vazhinji vane chirwere ichi vanogona kurarama hupenyu hwakazara uye hune simba. Chinhu chakakosha ndechekuzviziva nekukurumidza. Watotora danho iroro rakakosha nekuverenga chinyorwa chino. Kune mishonga inoshanda yechirwere ichi, uye chiremba wako anogona kushanda newe kugadzira hurongwa hwakanakisa hwekutarisira zvirwere zvemudumbu uye kuderedza njodzi yekubuda ropa.

Yeuka kuti hausi wega uri parwendo urwu. Nekurapwa nguva dzose, unogona kudzora dambudziko iri uye kuva nechivimbo muhutano hwako. Usatya, ziva, uye uwane kurapwa kwakakodzera. Ipapo iwewo unogona kuramba uine hutano hwakanaka!

Matumbu emudumbu , matumbu emudumbu, cirrhosis, chirwere chechiropa, hematemesis, endoscopy, portal BP