Ingaba isisu sakho siya sikhula ngokungathi sigcwele amanzi? Masithethe ngale nto yokudumba kwesisu (i-ascites)

Ngaba wakha waziva ngathi isisu sakho siba sikhulu ngequbuliso njengebhaluni yamanzi, uze uzive ngathi uyatyeba? Neempahla ozinxibileyo ziqala ukuziva zixinene... Oku akusiyo nje into eqhelekileyo yokudumba. Le meko inokuba yingozi. Ngokwezonyango, oku sikubiza ngokuba yi-ascites, okanye i-ascites. Namhlanje, siza kuthetha ngale nto ngokulula, ngendlela onokuyiqonda.

Yintoni le nto ibangela ulwelo esiswini (i-ascites)?

Ngamafutshane, i-ascites kukuqokelelana kolwelo olugqithisileyo, njengamanzi, ngaphakathi kwesisu sakho, oko kukuthi, ngaphakathi kwesisu sakho. Ngoku usenokuba uzibuza ukuba amanzi angena njani esiswini sakho.

Khawucinge nje, kukho inwebu encinci kakhulu ebizwa ngokuba yi-"peritoneum" ejikeleze amalungu abalulekileyo esiswini sethu njengesibindi, amathumbu, kunye nezintso. Ifana neshiti ye-polythene ejikelezwe kwimifuno. Ineengqimba ezimbini. Ngokwesiqhelo, kukho inani elincinci kakhulu lolwelo phakathi kwezi zingqimba zimbini ukuthintela amalungu ukuba angangqubani xa ehambahamba. Kodwa kwimeko ye-ascites, isithuba esiphakathi kwezi zingqimba zimbini sigcwala ngamanzi amaninzi. Emva koko isisu siyavuvukala kwaye sibonakale ngathi siginye ivatala okanye ibhola yomnyazi. Oku kwenza kube nzima kakhulu ukuhamba okanye ukuhlala.

Kutheni oku kusenzeka? Zithini izizathu eziphambili?

Eyona nto iphambili neyona ixhaphakileyo ebangela i-ascites emhlabeni yi -cirrhosis yesibindi . I-Cirrhosis yimeko apho isibindi sonakele kwaye sinamanxeba ngenxa yezizathu ezahlukeneyo, ingakumbi utywala, usulelo oluthile lwentsholongwane (iHepatitis B, C), kunye nesibindi esinamafutha. Isibindi siba nzima njengelitye kwaye asikwazi ukusebenza kakuhle.

Ngoku makhe sibone indlela isifo sesibindi esibangela ngayo ukugcinwa kwamanzi esiswini.

Kukho umthambo wegazi oyintloko othwala igazi elinezakhamzimba ukusuka emathunjini ukuya esibindini. Oku kubizwa ngokuba yiPortal Vein. Xa isibindi siba lukhuni ngenxa yesifo sesibindi, lo mthambo wegazi uyathintelwa ekuthwaleni igazi ngokufanelekileyo. Emva koko uxinzelelo lwegazi olungaphakathi kulo mthambo luyanda kakhulu. Silubiza ngokuba yiPortal Hypertension .

Olu xinzelelo luphezulu luthumela umyalezo ongalunganga kwizintso, ezicinga ukuba umzimba udinga ityuwa (i-sodium) namanzi, kwaye endaweni yokuzikhupha, ziqala ukuzigcina. Ekuhambeni kwexesha, ityuwa eyongezelelweyo namanzi aqokelelana ngale ndlela aqala ukuvuza kwimithambo yegazi aye kwisisu ngenxa yoxinzelelo oluphezulu. Le yindlela i-ascites ekhula ngayo.

Ngaphandle kwe-cirrhosis, kukho nezinye izizathu ze-ascites.

Zithini iimpawu ze-ascites? Uzibona njani?

Kukho iimpawu ezininzi umntu onesi sifo anokuziva aze azibone ngoko nangoko.

• Ukudumba kwesisu kunye nokutyeba ngokukhawuleza: Olu luphawu oluphambili. Ungafumana ukuya kuthi ga kwikhilogram enye okanye ezimbini ngexesha elifutshane, mhlawumbi iintsuku ezintathu.
• Ukudumba kwemilenze: Ukudumba, ingakumbi kwindawo yeqakala. Oku sikubiza ngokuba yi-Edema.
• Ubunzima bokuphefumla: Xa isisu sizele ngamanzi, sityhala isifuba. Oku kwenza kube nzima ukuba imiphunga ivuvuke kakuhle. Ungaziva uphefumla nzima kwaye ube nobunzima bokuphefumla nokuba uhamba okanye unyuka izinyuko.
• Iingxaki zenkqubo yokugaya ukutya: Ukudumba, iintlungu zesisu, ukuphelelwa ngumdla wokutya, kunye nokuqhina kwesisu kusenokwenzeka kuba isisu sizaliswa ngamanzi kwaye sibeka uxinzelelo kumathumbu.
• Intlungu yomqolo: Ubunzima obungaphezulu esiswini bunokubangela uxinzelelo emqolo kwaye bubangele iintlungu zomqolo.
• Ukudinwa: Usenokuziva udiniwe ngalo lonke ixesha ngenxa yokungonwabi emzimbeni kunye neemeko zempilo ezingabonakaliyo.

Ziziphi iingxaki ezinokubakho ngenxa yale meko?

I-Ascites ayisiyongxaki nje apho isisu siba sikhulu khona. Ukuba ayinyangwa kakuhle, inokukhokelela kwiingxaki ezinkulu.

• Iintsholongwane: Kukho ithuba elikhulu lokuba iintsholongwane zingangena kulwelo oluqokelelene esiswini zize zibangele usulelo. Oku sikubiza ngokuba yi-Spontaneous Bacterial Peritonitis. Emva koko unokufumana umkhuhlane kunye nentlungu eqatha esiswini. Le yimeko engxamisekileyo enokuba yingozi nakubomi.
• I-Hepatic Hydrothorax: Ngamanye amaxesha, ulwelo oluvela esiswini lunokuvuza esifubeni luze luqokeleleke emiphungeni, nto leyo eyenza kube nzima ukuphefumla.
• I-Hernias: Njengoko uxinzelelo ngaphakathi esiswini lusanda, amathumbu anokuphuma kwiindawo ezibuthathaka esiswini (umz., inkaba). Oku sikubiza ngokuba yi-hernia.
• Ukungasebenzi kakuhle kwezintso: Xa isifo sesibindi siba sibi kakhulu, sinokuchaphazela nokusebenza kwezintso kwaye sibangele nokungasebenzi kakuhle kwezintso.

Ugqirha uyifumana njani le nto?

Ukuba unale mpawu, xa ubona ugqirha, uya kuthatha amanyathelo aliqela ukuqinisekisa imeko.

1. Uvavanyo lomzimba: Okokuqala, ugqirha wakho uza kukuhlola. Baza kukuva isisu sakho baze bajonge ulwelo. Baza kujonga nokudumba kwesibindi sakho nemilenze.

2. Uvavanyo lwegazi: Kuza kwenziwa uvavanyo lwegazi oluninzi ukujonga indlela esebenza ngayo isibindi nezintso kunye nobungakanani betyuwa egazini.

3. Iiskeni: Iskeni ye-ultrasound okanye i-CT ingenziwa ukuze kubonwe ukuba angakanani na amanzi esiswini, imeko yesibindi injani, kwaye ingaba kukho naziphi na ezinye iingxaki.

4. I-Paracentesis: Olu luvavanyo olubaluleke kakhulu. Kulo, ulusu lwesisu luyaphelelwa ngamandla, kufakwa inaliti encinci esiswini, kwaye isampuli yolwelo oluqokelelweyo iyathathwa ize ithunyelwe kwilebhu. Oku kunokunceda ekuqinisekiseni ukuba unobangela ngumhlaza okanye usulelo.

Ziziphi iindlela zonyango lwe-ascites?

Kukho iinjongo ezimbini eziphambili zonyango: Enye kukunciphisa amanzi aqokelelene esiswini, enye kukunyangela isifo esibangela i-ascites.

Unyango lokuqala

Oogqirha bazama ezi ndlela kuqala.

• Ukulawula ityuwa (i-sodium): Olu lolona nyango lubalulekileyo noluphambili.Ityuwa yeyona nto ibangela ukuba umzimba ugcinwe amanzi. Kungoko ke, kuyacetyiswa ukuba unciphise umlinganiselo wetyuwa osetyenziswayo ngosuku uye ngaphantsi kwe-2000 milligrams. Oku kuthetha ukuba kufuneka unciphise umlinganiselo wetyuwa eyongezwa ekutyeni kwakho, kwaye kufuneka uyeke ngokupheleleyo ukutya ukutya okunetyuwa eninzi efihlakeleyo, njengentlanzi eyomileyo, ii-pickles, ii-sauces, ii-pickles, ii-sausages, kunye neesuphu ezithengwa evenkileni.
• I-Diuretics (okanye "iipilisi zamanzi"): Sidla ngokunika amayeza abizwa ngokuba yi-"diuretics" anceda umzimba ukuba ukhuphe amanzi agqithisileyo kunye netyuwa ngomchamo.

Iindlela zonyango eziphambili

Ngamanye amaxesha, nokulawula ukuthathwa kwetyuwa kunye nokusela iipilisi zamanzi kusenokunganciphisi ubuninzi bamanzi esiswini. Kwiimeko ezinjalo, kunokufuneka olunye unyango.

• I-Paracentesis: Olu luvavanyo kunye nonyango. Ulwelo oluninzi (ngamanye amaxesha lufikelela kwiilitha ezi-5-10) esiswini lunokususwa ngenaliti. Oku kunika isiqabu ngokukhawuleza. Oku kungenziwa ngokuphindaphindiweyo ukuba kuyimfuneko.
• I-Transjugular Intrahepatic Portosystemic Shunt (IINGCEBISO): Olu lunyango oluntsonkothileyo kancinci. Lubandakanya ukudala indlela entsha (i-shunt) yokuba igazi lihambe esibindini. Kufana nokudlula kwindlela yokudlula i-traffic jam. Oku kunciphisa uxinzelelo esibindini kwaye kulawula ukwakheka kolwelo. Kucetyiswa kubantu abangakwaziyo ukululawula ngezinye iindlela zonyango.
• Ukufakelwa kwesibindi: Kwabo bane-cirrhosis enzima kakhulu kunye nabo bangakhange basabele kwezinye iindlela zonyango, ukufakelwa kwesibindi kusenokuba sisisombululo kuphela.

Ndifanele ndimbone nini ugqirha?

Kufuneka ulumke kakhulu ngezi zinto.

Ndingenza ntoni ukuthintela nokulawula le meko?

Eyona ndlela ilungileyo yokuthintela i-ascites kukunyamekela isibindi sakho.

• Kuphephe utywala: Ukusela utywala kufuneka kuyekwe ngokupheleleyo. Utywala yeyona nto iphambili eyonakalisa isibindi.
• Kuphephe ukutya ityuwa eninzi: Njengoko besitshilo ngaphambili, ukuphepha ityuwa eninzi kubalulekile ekulawuleni i-ascites.
• Gcina ubunzima obusempilweni: Ukulawula ubunzima bomzimba kunokuthintela isibindi esinamafutha.
• Ukuzilolonga: Kubalulekile ukwenza umthambo imihla ngemihla.
• Zikhusele kwiHepatitis B kunye ne-C: Ezi ziintsholongwane ezonakalisa isibindi. Kukho iyeza lokugonya iHepatitis B. Ungazikhusela kwezi zinto ngokulandela amanyathelo okhuseleko.

Ukuba sele unayo i-ascites, ngokuqinisekileyo yenza ezi zinto.

• Zilinganisele yonke imihla: Zilinganisele rhoqo kusasa ngexesha elinye, unganxibanga mpahla okanye unxibe impahla efanayo, uze uyibhale phantsi encwadini. Ukuba wongeza ngaphezulu kwekhilogram enye ngosuku kangangeentsuku ezintathu zilandelelana, xelela ugqirha wakho.
• Lumka ngeentlungu: Kuphephe ukusebenzisa amayeza angengo-steroidal anti-inflammatory (NSAIDs), afana ne-ibuprofen, i-diclofenac, kunye ne-aspirin, kuba ezi zinto zinokunyusa ukugcinwa kwamanzi kunye netyuwa emzimbeni. Ukuba ufuna ukuthatha amayeza entlungu, buza ugqirha wakho ngayo.