Ngaba wakha waziva ngathi isisu sakho sidumbile, sinzima kakhulu, kwaye iimpahla ozinxibayo zivakala ziqinile ngequbuliso? Mhlawumbi ubunzima bomzimba wakho bunyuke ngekhilogram enye okanye ezimbini kwiintsuku ezimbalwa. Oku akukokunyuka okuqhelekileyo, oku kusenokuba kungenxa yemeko ebizwa ngokuba yi-'ascites', imeko apho isisu sigcwala ngamanzi. Oku kuhlala kubonakala njengophawu lwesinye isifo esinzima emzimbeni wethu. Ngoko masithethe ngale nto namhlanje.
Yintoni kanye kanye i-Ascites?
Ngamafutshane, i-ascites kukuqokelelana kolwelo olugqithisileyo kwisisu sakho, okanye esiswini. Oku kungenzeka kancinci kancinci, okanye kunokwenzeka ngaxeshanye.
Khawucinge nje, kukho ulwelo oluncinci olujikeleze amalungu angaphakathi esiswini sethu, njengesisu, amathumbu, isibindi, kunye nezintso. Oku sikubiza ngokuba yi-peritoneum. Ineengqimba ezimbini. Ngokwesiqhelo, kukho ulwelo oluncinci kakhulu phakathi kwezi ngqimba zimbini, ukuze amalungu akwazi ukuhamba ngokulula ngaphandle kokungqubana. Kodwa kwimeko ye-ascites, ulwelo olungaqhelekanga luqokelelana phakathi kwezi ngqimba zimbini. Kulapho isisu siba sikhulu khona size sivakale ngathi kukho ibhola yamanzi ngaphakathi esiswini.
Jonga ukuba unazo na ezi mpawu.
Iimpawu eziphambili ze-ascites kukunyuka ngesiquphe kobukhulu besisu kunye nokunyuka ngesiquphe kobunzima bomzimba kwiintsuku ezimbini ukuya kwezintathu. Abanye abantu banokufumana ukudumba kwemilenze (i-edema).
| Uphawu | Inkcazo |
|---|---|
| Ubunzima bokuphefumla | Njengoko amanzi esiswini sakho esanda, acinezela imiphunga yakho, nto leyo eyenza kube nzima ukuphefumla. |
| Ubunzima bokuhambahamba nokuhlala phantsi | Umzimba awukhululeki njengoko isisu sikhula. Kuba nzima ukwenza izinto ezifana nokuhlala, ukuhamba, nokugoba. |
| Iingxaki zokugaya ukutya | Ukudumba, iintlungu zesisu, ukungabi namdla wokutya, kunye nokuqhina kwesisu kusenokubakho. |
| Umqolo obuhlungu | Ubunzima obunyukileyo esiswini bunokubangela uxinzelelo olongezelelekileyo emqolo kwaye bubangele iintlungu emqolo. |
| Ndiziva ndidiniwe | Usenokuziva udiniwe ngamaxesha onke ngenxa yokungonwabi emzimbeni kunye nokugula. |
Kutheni isisu sam sivakala sigcwele amanzi kangaka? Zithini izizathu eziphambili?
Eyona nto iphambili neyona ixhaphakileyo ye-ascites yi -cirrhosis yesibindi . Oku kuthetha ukuba iiseli zesibindi ziyatshatyalaliswa kwaye zithatyathelwe indawo yi-fibrous tissue (amanxeba) athintela isibindi ukuba singasebenzi kakuhle. Kodwa le ayisiyo yodwa imbangela.
Kunokubakho ezinye izizathu:
- Ukungaphumeleli kwentliziyo okubangelwa kukunganyamezelani
- Ukungasebenzi kakuhle kwezintso
- Umhlaza wesisu kunye nezitho ze-pelvic
- Isifo sephepha
- Kunqabile kakhulu ukuba isifo sezintso esibizwa ngokuba yi-nephrotic syndrome naso sibe ngunobangela.
I-ascites ikhula njani ngenxa ye-cirrhosis yesibindi?
Oku kufuna ingcaciso encinci. Khawucinge ukuba kukho umthambo oyintloko othwala igazi esibindini sethu, obizwa ngokuba yi-portal vein. Xa isibindi siba ne-cirrhosis, oko kukuthi, xa isibindi siba namanxeba, le mithambo yegazi iyavaleka. Emva koko uxinzelelo lwegazi olungaphakathi kulo mthambo luyanda kakhulu. Kwizonyango, oku kubizwa ngokuba yi-portal hypertension .
Xa olu xinzelelo lusanda, izintso zethu zifumana uphawu olungalunganga lokugcina ityuwa (i-sodium) kunye namanzi emzimbeni. Ekuhambeni kwexesha, ityuwa kunye namanzi agcinwa ngale ndlela, ngenxa yolo xinzelelo luphezulu, aqala ukuvuza emithanjeni yegazi aze aqokeleleke kwisisu. Le yindlela isisu esizaliswa ngayo ngamanzi.
Ngubani osengozini enkulu yokufumana i-ascites?
Nabani na onomonakalo wesibindi onokubangela isifo sesibindi usengozini enkulu yokuba ne-ascites. Ezi meko ziquka:
- Izifo ezinxulumene nesibindi esinamafutha (i-steatohepatitis enxulumene nokungasebenzi kakuhle kwe-metabolic - MASH)
- Ingxaki yokusebenzisa utywala
- Usulelo lweHepatitis B kunye neHepatitis C kwiintsholongwane
- Izifo apho amajoni omzimba ahlasela isibindi (i-Autoimmune hepatitis)
- Izifo zesibindi ezibangelwa yimfuza ezifana ne-hemochromatosis kunye nesifo sikaWilson
Ziziphi iingxaki ezinokubakho ze-ascites?
I-Ascites ayikokudumba kwesisu kuphela, kodwa inokubangela ezinye iingxaki zempilo ezinzulu.
I-Ascites luphawu olubalulekileyo lokuba isibindi asisebenzi kakuhle, ngoko ungaze uyityeshele.
| Imiphumela | Inkcazo |
|---|---|
| Ukungakhululeki kwesisu rhoqo | Intlungu, ukungonwabi, kunye nobunzima bokuphefumla obubangelwa lulwelo esiswini kunokwenza kube nzima ukwenza imisebenzi yemihla ngemihla efana nokutya nokuhamba. |
| Iintsholongwane | Ulwelo oluqokelelana esiswini lunokosulelwa ziintsholongwane. Oku kubizwa ngokuba yi-peritonitis. Oku kunokubangela umkhuhlane kunye nentlungu eqatha esiswini. Oku kunokufuna ii-antibiotics ezine-IV. |
| Ulwelo olujikeleze imiphunga (iHepatic hydrothorax) | Amanzi esiswini anokuvuza esifubeni aze aqokeleleke emiphungeni. Oku kunokubangela ubunzima bokuphefumla, ukukhohlela, kunye namanqanaba aphantsi eoksijini egazini (i-hypoxemia). |
| I-Hernia | Ngenxa yoxinzelelo oluphezulu esiswini, izinto ezifana namathumbu zinokuphuma kwiindawo ezibuthathaka esiswini. Oku kubizwa ngokuba yi-hernia. |
| Ukungasebenzi kakuhle kwezintso | Xa isifo sesibindi siba sibi kakhulu, sinokuchaphazela nokusebenza kwezintso kwaye sibangele ukungasebenzi kakuhle kwezintso. |
Ugqirha uyifumana njani le nto?
Xa usiya kugqirha, uza kuqala akubuze ngeempawu zakho aze ahlole isisu sakho. Ungafumana umbono ongeyonyani wokuba kukho ulwelo esiswini ngokulucofa ngomnwe wakho.
Emva koko, ukuqinisekisa imeko echanekileyo, kunokwenziwa ezi mvavanyo zilandelayo:
- I-Ultrasound okanye i-CT scan: Olu hlobo lweskeni lunokubona ngokucacileyo izinto ezifana nobungakanani bamanzi esiswini kunye nemeko yesibindi.
- I-Paracentesis: Oku kuquka ukufaka inaliti encinci kakhulu esiswini kunye nokuthatha ulwelo oluncinci esiswini. Olu lwelo lungavavanywa ukuze kubonwe ukuba luneeseli zomhlaza okanye iibhaktheriya. Olu vavanyo lubaluleke kakhulu ukuze kuchongwe unobangela ochanekileyo we-ascites.
Ziziphi iindlela zonyango lwe-ascites?
Eyona njongo iphambili xa kunyangwa i-ascites kukunciphisa ulwelo oluqokelelana esiswini kwaye luthintele ukuba lungaphinde luqokeleleke.
Iindlela zonyango ezisisiseko
- Ukulawula ityuwa (i-sodium): Oogqirha bacebisa kuqala ukunciphisa ityuwa oyityayo. Ungathi kufuneka utye ngaphantsi kwe-2000 milligrams yetyuwa ngosuku. Oku kuthetha ukuba kufuneka unciphise ityuwa oyityayo ekutyeni kwakho kwaye uphephe ngokupheleleyo ukutya okunetyuwa efihliweyo, njengeziqhamo ezomisiweyo, ii-pickles, iisosi, iisoseji, ukutya okuthengiweyo evenkileni, kunye nokutya okupakishwe kwiipakethe.
- I-Diuretics (iipilisi zamanzi): La mayeza abangela ukuba izintso zikhuphe amanzi angaphezulu kunye netyuwa emzimbeni ngomchamo.
- Ukunyanga isifo esisisiseko: Ukuba unobangela we-ascites ngumhlaza, ukunyanga kuya kunciphisa nobuninzi bolwelo esiswini.
Ngamanye amaxesha olu nyango lusenokunganeli...
Abanye abantu bakufumanisa kunzima ukulawula i-asidi yesisu sabo nasemva kokulawula ukutya ityuwa kunye nokusela iipilisi zamanzi. Kwimeko ezinjalo, kufuneka basebenzise ezinye iindlela zonyango.
- I-Paracentesis: Olu luvavanyo kunye nonyango. Le nkqubo isusa ulwelo oluninzi esiswini kusetyenziswa inaliti. Nangona oku kunika isiqabu ngokukhawuleza, kunokufuneka luphindwe njengoko ulwelo lunokuqokelelana kwakhona.
- Inkqubo ye-TIPS (Transjugular intrahepatic portosystemic shunt): Le yinkqubo enzima ngakumbi. Ibandakanya ukudala i-bypass encinci (shunt) phakathi komthambo we-portal, ophantsi koxinzelelo olongezelelekileyo, kunye nomnye umthambo othwala igazi kwisibindi. Oku kuvumela igazi ukuba lithathe indlela entsha esibindini, lidlule ukuxinana, okunciphisa uxinzelelo kwaye kunciphisa ubungakanani bolwelo esiswini.
- Ukufakelwa kwesibindi: Kubantu abane-cirrhosis enzima kakhulu yesibindi, ukufakelwa kwesibindi kunokufuneka njengenyathelo lokugqibela.
Ufanele uye nini kugqirha?
Ukuba unemeko efana ne-cirrhosis yesibindi, bona ugqirha wakho ngoko nangoko ukuba ufumana ezi mpawu zilandelayo:
- Ukuba ubunzima bomzimba wakho buyanda ngequbuliso.
- Ukuba uziva ngathi isisu sakho siyakhula.
- Ukuba unengxaki yokuphefumla.
Ukuba kuvela ezi mpawu zilandelayo, yiya kwiYunithi yoNyango oluNgxamisekileyo (ETU) yesibhedlele ngokukhawuleza ngaphandle kokulibazisa:
- Ifiva
- Intlungu yesisu enzima kakhulu
Umyalezo Wokuya Ekhaya
- I-Ascites kukuqokelelana kolwelo esiswini. Le yimeko embi kakhulu edla ngokubangelwa yi-cirrhosis, isifo sesibindi.
- Iimpawu eziphambili kukuvuvukala kwesisu, ukunyuka kobunzima, ubunzima bokuphefumla, kunye nokudumba kwemilenze.
- Ukulawula ityuwa kunye nokuthatha amayeza okukhupha isisu (iipilisi zamanzi) zezona ndlela ziphambili zonyango.
- Zilinganisele yonke imihla. Ukuba wongeza ngaphezu kwekhilogram enye ngosuku kangangeentsuku ezintathu ezilandelelanayo, yazisa ugqirha wakho.
- Kuphephe ukusela utywala ngokupheleleyo. Oku kuya konakalisa isibindi ngakumbi.
- Kuphephe ukusebenzisa amayeza okudambisa iintlungu e-NSAID (umz. i-ibuprofen, i-aspirin) ngaphandle kwengcebiso kagqirha. La mayeza andisa ukugcinwa kwamanzi netyuwa emzimbeni.
- Ukuba uqalisa ukuba nomkhuhlane kunye nentlungu eqatha esiswini, oko kungaba luphawu losulelo. Yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) esibhedlele ngoko nangoko.
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