Ngaba isibindi sakho sisengozini? Yonke into malunga ne-cirrhosis yesibindi ngamazwi alula

Isibindi sisitho esibaluleke kakhulu emzimbeni wethu, akunjalo? Sifana nomzi-mveliso omncinci emzimbeni wethu. Kodwa esi sibindi sinokuba nezifo. Ngamanye amaxesha ukhe uve amabali anje ngokuthi "isibindi siqinile", "isibindi sonakele". Enye imeko enzima kangaka ibizwa ngokuba yi-cirrhosis yesibindi. Makhe sithethe ngale nto ngokweenkcukacha namhlanje, kuba kubaluleke kakhulu ukuyiqonda le nto.

Masiqale sijonge ukuba yintoni isifo sesibindi (cirrhosis)?

Ngamafutshane, isifo sesibindi yimeko apho isibindi sonakele ixesha elide kwaye iiseli zesibindi ezisempilweni zithathelwe indawo ziiseli zesilonda . Kanye njengokuba isilonda senzeka eluswini lwethu xa sinenxeba, ukuba kukho ukudumba okuqhubekayo esibindini, okanye oko sikubiza ngokuba yi-hepatitis , esi silonda senzeka njengoko isibindi sizama ukuzinyanga. Kodwa xa esi silonda siqokelelana, isibindi asikwazi ukusebenza kakuhle. Eli linqanaba lokugqibela lesibindi esisilela kancinci kancinci ( ukusilela kwesibindi okungapheliyo).

Ngaba kukho amanqanaba ahlukeneyo esifo sesibindi?

Ewe, isifo sesibindi asinto eyenzeka ngequbuliso. Sikhula kancinci kancinci, ngokuhamba kwexesha.

• Inqanaba lokuqala (i-Compensated Cirrhosis): Kweli nqanaba, ukusebenza kwesibindi sakho kuyancipha kancinci, kodwa umzimba wakho uyaqhelana nako, ngoko usenokungabi nazo naziphi na iimpawu ezinkulu. Usenokungazi nokuba kunjalo.
• Inqanaba elilandelayo (i-Decompensated Cirrhosis):Njengoko umonakalo wesibindi usanda, ukusebenza kwesibindi kuncipha ngakumbi. Kulapho uqala ukubona iimpawu ezicacileyo. Oku kunzulu ngakumbi.

Kwenzeka ntoni kwisibindi nomzimba ngenxa yesifo sesibindi?

Esi sicwili esisesibindini sithintela ukuhamba kwegazi kunye neoksijini esibindini. Kuza kwenzeka ntoni emva koko?

• Amandla esibindi okucoca igazi, ukucubungula izondlo, kunye nokucoca iityhefu ayancipha.
• Ukuveliswa kwenyongo kunye neeproteni ezibalulekileyo zegazi eziveliswa sisibindi kuyancipha.
• Esi sicwili sinokunciphisa imithambo yegazi engaphakathi kwesibindi. Ingakumbi xa imithambo ebalulekileyo, efana nenkqubo yemithambo yegazi engaphantsi komhlaba, icinezelwe, imeko ebizwa ngokuba yi-portal hypertension inokwenzeka. Oku kukwangumphumo onzima we-cirrhosis.

Ixhaphake kangakanani isifo sesibindi?

Isifo sofuba sisifo esixhaphakileyo. Sithathwa njengesona sizathu siphambili sokulaliswa esibhedlele nokufa, ingakumbi emva kweminyaka ephakathi. Oku kungenxa yokuba sikhula ngokukhawuleza. Umzekelo, eMelika, malunga ne-0.25% yabantu abadala kunye malunga ne-0.50% yabantu abadala abaneminyaka engama-45 ukuya kwengama-54 kuthiwa bane-cirrhosis. Le meko ayinakuthathelwa ingqalelo eSri Lanka. Isifo sofuba sisifo esixhaphakileyo kwihlabathi liphela.

Zithini iimpawu ze-cirrhosis yesibindi?

Iimpawu zesifo sesibindi zixhomekeke kubukhulu besifo. Kwinqanaba lokuqala, kusenokungabikho zimpawu konke konke. Okanye kunokubakho iimpawu ezimbalwa ezingacacanga ezifana nezinye izifo. Iimpawu zibonakala ngakumbi njengoko ukusebenza kwesibindi kuncipha. Umzekelo, kukho iimpawu ezibonakala xa inyongo ingahambi kakuhle kwaye iqokelelana kwezinye iindawo zomzimba.

Ziziphi iimpawu zokuqala ze-cirrhosis?

Kwizigaba zokuqala zesifo, ungabona iimpawu ezinjalo:

• Isicaphucaphu okanye ukungabi namdla wokutya .
• Ukudinwa , ukudinwa.
• I-Malaise yimvakalelo eqhelekileyo yokungaphili kakuhle.
• Intlungu esiswini esingaphezulu, ingakumbi kwicala lasekunene.
• I-spider angiomas yimithambo yegazi efana ne-spider webs eluswini.
• Ububomvu bezandla (i-palmar erythema).

Ziziphi iimpawu njengoko isifo siqhubeka?

Iimpawu ezibonakala njengoko isifo sesibindi siqhubeka zinokwahlulwa zibe ziindidi ezimbini: iimpawu ezibangelwa kukungasebenzi kakuhle kwesibindi kunye neempawu ezibangelwa luxinzelelo lwegazi oluphezulu lwe-portal.

Iimpawu ezibangelwa kukungasebenzi kakuhle kwesibindi:

• Ukutyheli kolusu namehlo kubizwa ngokuba yi-jaundice.
• Ulusu olurhawuzelelayo (iPruritus) (ngaphandle kwerhashalala ecacileyo).
• Umchamo omnyama kunye nendle ekhanyayo.
• Iingxaki zokugaya ukutya, ingakumbi xa kutyiwa ukutya okunamafutha.
• Ukubonakala kwamafutha amancinci atyheli eluswini okanye kwiinkophe.
• Ukwehla kobunzima obungachazekiyo kunye nokulahlekelwa yimisipha.
• Iziphumo ekusebenzeni kwengqondo (Hepatic Encephalopathy) – ezifana nokulahlekelwa yinkumbulo, ukudideka, kunye nokutshintsha kweemvakalelo.
• Ukungasebenzi kakuhle kwemisipha - ukuxhuzula, ukungcangcazela.
• Ukungalungelelani komjikelo wokuya exesheni kwabasetyhini.
• Ukwandiswa kwamabele kunye nokuncitshiswa kwamasende kumadoda.

Iimpawu ezibangelwa yi-Portal Hypertension:

• Ukudumba kwesisu, ukugcinwa kwamanzi (i-ascites).
• Ukudumba kwezandla, iinyawo, imilenze kunye/okanye ubuso (i-edema).
• Ukopha okulula kunye nokukrweleka (i-coagulopathy).
• Ukuhlanza igazi okanye ukuphuma kwegazi esitulweni.
• Ukuncipha kokuphuma komchamo (kusenokuba kungenxa yokungasebenzi kakuhle kwezintso ixesha elide).
• Ubunzima bokuphefumla (kusenokuba ngenxa yokungasebenzi kakuhle kokuphefumla okungapheliyo).

Zithini izizathu zesifo sesibindi?

I-Cirrhosis yimeko yokuqhekeka kancinci kancinci kwesibindi okubangelwa kukudumba okungapheliyo. Nasiphi na isifo esibangela ukudumba okungapheliyo kwesibindi (i-hepatitis engapheliyo) sinokukhokelela kwi-cirrhosis. Ezinye zezizathu eziphambili zezi:

• I-hepatitis ebangelwa butywala: Ukonakala kwesibindi okubangelwa kukusebenzisa utywala kakhulu ixesha elide. Nangona utywala bungunobangela oqhelekileyo we-cirrhosis, kukho izizathu ezininzi ezingezizo ezotywala.
• I-steatohepatitis engeyotywala (i-NASH): Umonakalo ongapheliyo obangelwa kukutyeba kakhulu esibindini. Ubangelwa zizinto ezibangela imetabolism ezifana namafutha aphezulu egazini, amanqanaba aphezulu eswekile egazini (njengeswekile), kunye noxinzelelo lwegazi oluphezulu.
• Usulelo lweHepatitis C olungapheliyo: IHepatitis C lusulelo olubangelwa yintsholongwane. Kubantu abaninzi, iba yimeko engapheliyo. Ngoku inokunyangwa ngamayeza okulwa neentsholongwane. Kodwa abantu abaninzi abazi ukuba banayo.
• Ukosuleleka yi-hepatitis B okungapheliyo: I-Hepatitis B ikwayintsholongwane. Kwinani elincinci labantu, inokuba yintsholongwane engapheliyo. Ukuba kunjalo, ihlala ubomi bonke. Kukho unyango, kodwa alunakuphiliswa ngokupheleleyo.

Kukho nezizathu zokuba kutheni ingaqhelekanga:

• Isifo senyongo esizikhusela ngokwazo emzimbeni: Ezinye izifo ezizikhusela ngokwazo emzimbeni zinokubangela ukudumba okungapheliyo kwesibindi. Imizekelo ibandakanya i-hepatitis ezizikhusela ngokwazo emzimbeni, i-cholangitis yenyongo eyintloko, kunye ne-primary sclerosing cholangitis.
• Izifo zemfuza: Ezinye izifo ezidluliselwa kwilifa zinokubangela umonakalo wesibindi ngokubangela ukuba iityhefu ziqokeleleke esibindini. Imizekelo ibandakanya isifo sokugcina i-glycogen, i-cystic fibrosis, kunye nesifo sikaWilson.
• I-hepatitis enobuthi: Ukuchanabeka ixesha elide kwiityhefu ezithile ezingqongileyo okanye ukusebenzisa amayeza athile rhoqo (nokuba ngamayeza okudambisa iintlungu athengiswa ngaphandle kwemvume kagqirha) kunokonakalisa isibindi.
• Isifo sentliziyo: Ukonakala kwesibindi kunokubangelwa zizifo ezibangela ukuba igazi lihlangane esibindini (ezifana nokusilela kwentliziyo) okanye izifo ezithintela igazi ukuba lingafiki esibindini (ezifana ne-ischemia engapheliyo).

Ngubani osengozini enkulu yokuba nale meko?

Usenokuba sengozini enkulu yokuba ne-cirrhosis yesibindi ukuba:

• Ukuba uneminyaka engaphezu kwama-50 ubudala.
• Ukuba unembali yokusela kakhulu.
• Ukuba unentsholongwane ye-hepatitis engapheliyo.
• Ukuba une -metabolic syndrome ( oko kukuthi, indibaniselwano yeemeko ezinje ngokutyeba kakhulu, uxinzelelo lwegazi oluphezulu, iswekile ephezulu yegazi, kunye ne-cholesterol ephezulu).

Zithini iingxaki zesifo sesibindi?

Kukho iziphumo ezininzi ezibangelwa yi-cirrhosis kunye ne-portal hypertension.

Iingxaki eziqhelekileyo:

• Ukuziva ugula, udiniwe, kwaye unenkungu engqondweni ngenxa yeetyhefu eziqokelelana emzimbeni.
• Ukuncipha komzimba, ukuphola kwenxeba okulibazisekileyo.
• Ukudumba okubangelwa kukuvuza kolwelo oluphuma kwimithambo yegazi.
• Ukungalingani kwamahomoni kunye nokusilela kwawo.
• Iingxaki zokugaya ukutya, ukungafunxwa kakuhle kwezondlo, kunye nokungondleki kakuhle.
• Ukuphazamiseka okuncinci ekusebenzeni kwengqondo kunye neengxaki zokulawula izihlunu.

Iingxaki ezinzima ezinokuba yingozi ebomini:

• Iintsholongwane zesisu kunye nokopha kwamathumbu.
• I-peritonitis yebhaktheriya eyenzeka ngesiquphe.
• Ukungaphumeleli kwezintso (i-Hepatorenal syndrome).
• Ukungaphumeleli kokuphefumla (i-Hepatopulmonary syndrome).
• Ukungasebenzi kakuhle kwesibindi okungapheliyo.
• Umhlaza wesibindi.

Ifunyanwa njani isifo sesibindi (cirrhosis)?

Ugqirha uza kuqala akuhlole ngokwasemzimbeni ukuze ajonge iimpawu zesifo sokuqina kwesibindi. Baza kukubuza imibuzo malunga nokuba iimpawu zakho ziqale nini kwaye nokuba zitshintshile na ngokuhamba kwexesha. Baza kukubuza nangembali yakho yezonyango, amayeza, iziqholo, kunye nezongezo ozithathayo, ukutya kwakho, kunye nendlela ophila ngayo. Baza kukhangela iimpawu zesifo sesibindi okanye umonakalo wesibindi.

Kulapho ke kuphela apho kuya kwenziwa khona uvavanyo lwezonyango ukuqinisekisa ukuba kukho isifo sesibindi. Ezi zingabandakanya:

• Uvavanyo lwegazi:Uvavanyo lokusebenza kwesibindi lunokubonisa iimpawu zesifo sesibindi kunye nokungasebenzi kakuhle kwesibindi. Olu vavanyo lulinganisa izinto ezifana nee-enzymes zesibindi, iiproteni, kunye namanqanaba e-bilirubin. Uvavanyo lwegazi lunokubonisa nezinto ezifana nokuncipha kokujiya kwegazi.
• Uvavanyo lokufota: Uvavanyo olufana ne-ultrasound yesisu, i-CT scan, okanye i-MRI lunokubonisa ubungakanani, imilo, kunye nemeko yesibindi. Uvavanyo olukhethekileyo lokufota olubizwa ngokuba yi-elastography lunokulinganisa ukuqina okanye i-fibrosis kwisibindi.
• Uvavanyo lwesibindi: Le yinkqubo encinci. Isampuli encinci yezicubu ithathwa esibindini ize ihlolwe kwilebhu. Le sampuli idla ngokuthathwa kusetyenziswa inaliti engenanto. Nangona kungasoloko kuyimfuneko, uvavanyo lwesibindi lunokunceda ukuqinisekisa isifo sesibindi kwaye mhlawumbi lufumane unobangela.

Ngaba isifo sesibindi singabuyiselwa okanye sinyangeke?

Nangona kunjalo, kunokwenzeka ukuyeka okanye ukulawula ukuqhubeka kwesifo sesibindi . Kuxhomekeke ekubeni yintoni ebangele esi sifo, ukuba sinokunyangwa kakuhle kangakanani, kwaye usabela kakuhle kangakanani kunyango.

Oogqirha banyanga njani isifo sesibindi?

Unyango lwe-cirrhosis luquka:

• Ukuba kunokwenzeka, lawula unobangela wesifo (nciphisa okanye umise umonakalo).
• Utshintsho olulula lokutya kunye nendlela yokuphila ukunciphisa uxinzelelo kwisibindi.
• Ukulawula okanye ukuhlola iingxaki zesifo sokuqina kwesibindi.
• Njengendlela yokugqibela, ukufakelwa isibindi .

Ukunyanga unobangela

Ezinye izifo zesibindi zinokunyangwa ngamayeza. Umzekelo, amayeza okulwa neentsholongwane anokunyanga i-hepatitis C engapheliyo, kodwa anokulawula kuphela (hayi ukunyanga) i-hepatitis B engapheliyo. Ii-corticosteroids kunye ne-immunosuppressants zinokunceda ukulawula ezinye izifo ezihlasela umzimba.

Ukuba isibindi sonakaliswe butywala okanye ezinye iityhefu, unyango olukuphela kwalo kukususa ezo tyhefu ebomini bakho. Abanye abantu banokufuna unyango lweengxaki zokusebenzisa iziyobisi. Ukuba isibindi sonakaliswe zizizathu ezingezizo ezotywala (ezifana ne-NASH), ukulawula izinto ezibangela imetabolism ezifana ne-cholesterol, iswekile yegazi, kunye nobunzima obugqithisileyo kunokunceda.

Ukutya kunye nendlela yokuphila

Nokuba isifo sakho sesibindi sibangelwa yenye into, ukuphepha utywala neziyobisi eziyingozi kwisibindi kunokunceda ukukhusela isibindi sakho ixesha elide. Kunjalo nangezinto ezibangela uxinezeleko lwe-metabolic. Oogqirha bacebisa ukuba nabani na onesifo sesibindi atye ukutya okunempilo aze azame ukugcina ubunzima obusempilweni. Abanye abantu banokufuna ukuthatha izongezo zokutya ukuze balungise ukungabikho kokutya okunempilo.

Unyango lweengxaki

Nje ukuba ugqirha wakho akufumanise ukuba une-cirrhosis, uza kujonga nemiphumo emibi eqhelekileyo. I-Portal hypertension yeyona miphumo ixhaphakileyo. Ikwanazo neengxaki zayo, nganye kuzo efuna unyango oluthile.

Usenokufuna izinto ezinje:

• Inkqubo encinci yokuvala umthambo owophayo.
• Utofelo-gazi ukubuyisela inani leeseli zegazi.
• Ukucoca izintso.
• Unyango lweoksijini.
• I-Paracentesis kunye nee-antibiotics zokususa ulwelo esiswini (i-ascites).
• Iilaxatives zinceda ekufunxeni nasekukhupheni iityhefu ekutyeni.

Umhlaza wesibindi

I-Hepatocellular carcinoma yenye ingxaki eyingozi ye-cirrhosis. Ayinguye wonke umntu one-cirrhosis oza kuba nomhlaza wesibindi, kodwa abantu abaninzi abafumana umhlaza wesibindi bane-cirrhosis. Ukuba umhlaza uvela ne-cirrhosis, unyango lomhlaza olufana ne-radiation okanye i-chemotherapy lunokunikwa. Okanye, ugqirha wakho unokugqiba kwelokuba ukufakelwa kwesibindi lolona khetho lufanelekileyo.

Ukufakelwa kwesibindi

Oogqirha bacebisa ukufakelwa isibindi xa becinga ukuba impilo yakho iya kuba mandundu ngaphandle kokufakelwa. Oku kunokwenzeka ukuba unesifo sesibindi esisebenzayo, unomhlaza wesibindi, kwaye/okanye awusabeli kunyango lwesifo sakho sesibindi. Ukuba ufanelekile ukufakelwa isibindi, uya kufakwa kuluhlu lokulinda lukazwelonke.

Ngaba isifo sesibindi singathintelwa?

Isifo sesibindi sinokuthintelwa ukuba singaqhubeki sibe yi-cirrhosis ngokungenelela kwangoko . Kuxhomekeke ekubeni uyazi na kwaye ngawaphi amanyathelo onokuwathatha ukuthintela. Ekubeni abantu abaninzi bengenazo iimpawu kwizigaba zokuqala, sinokubonwa ngexesha lokuhlolwa kwempilo rhoqo. Oku kukunika ithuba lokwenza utshintsho olubalulekileyo okanye ukuqala unyango.

Ngaba isibindi singaphila emva kwe-cirrhosis?

Xa sele une-cirrhosis, isibindi sakho asibi ngcono. Kodwa asibi mandundu kangako . Ukuba useneempawu (i-cirrhosis ehlawulelweyo), ungahlala unjalo okwethutyana. Ukuba unokuyeka okanye unciphise ukudumba okubangela i-cirrhosis, esi sifo sisenokungafikeleli kwinqanaba lokungahlawuli. Kodwa kuya kufuneka unyamekele isibindi sakho ubomi bakho bonke.

Ingakanani ixesha lokuphila xa uphila ne-cirrhosis?

Ulindelo lobomi xa uphila ne-cirrhosis luyahluka ngokuxhomekeke kwizinto ezininzi:

• Ubunzima besifo (esihlawulelwayo okanye esingenamali).
• Iingxaki onazo.
• Ukusinda kunye nempumelelo yonyango.
• Impilo yakho iyonke okanye nokuba unayo nayiphi na enye isifo.

Oogqirha basebenzisa iinkqubo zokuvavanya amanqaku ezifana nenkqubo yeChild-Turcotte-Pugh (CTP) kunye neModel for End-Stage Liver Disease (MELD) ukuvavanya imeko yakho kunye nokuchonga indawo yakho kuluhlu lokulinda lokufakelwa isibindi.

Kwinqanaba lokuqala le-"compensated cirrhosis", ixesha lokuphila linokuba ngaphezu kweminyaka eli-15. Xa i-portal hypertension ikhula, iyanciphisa ixesha lokuphila ngenxa yomngcipheko wokopha ngaphakathi. Umyinge wobomi be-"decompensated cirrhosis" umalunga neminyaka esixhenxe. Eli xesha linokuba lifutshane nangakumbi ngenxa yezifo ezinzima, ezinganyangekiyo kunye nezinye iingxaki. Kwabanye abantu, linokuba ngaphantsi kweminyaka emibini. Kodwa kubalulekile ukukhumbula ukuba ezi zibalo azifani kuye wonke umntu.

Ndingazinyamekela njani xa ndiphila ne-cirrhosis yesibindi?

Ezi zinto zinokunceda ukwandisa ubomi besibindi sakho:

• Yitya ukutya okunempilo, okupheleleyo kunye neeproteni ezingenamafutha .
• Ziphephe utywala, icuba, kunye namayeza athathwa ngaphandle kwengcebiso kagqirha kangangoko kunokwenzeka.
• Sela amayeza kuphela njengoko uyalelwe ngugqirha wakho. Thetha nogqirha wakho malunga nawo nawaphi na amayeza owasebenzisayo.
• Ungaphoswa luvavanyo lwezonyango olucwangcisiweyo kunye nokuhlolwa kweengxaki.