Ngaba imithambo yegazi ekwi-esophagus yakho, ityhubhu ethwala ukutya emlonyeni wakho ukuya esiswini sakho, iyadumba kwaye ikhule? Usenokuba awuzange uve nokuva ngale nto. Kodwa le meko, ebizwa ngokuba yi-Esophageal Varices, inokuthi ingathethi kwaye ngequbuliso ibe yingozi. Ngoko ke namhlanje, masifunde yonke into ngayo ngokulula, ngokungathi sithetha nomhlobo.
Ngamafutshane, zithini ii-varices ze-esophageal?
Khawucinge nje, ngamanye amaxesha imilenze yethu inemithambo evuvukileyo nejijekileyo? Siyibiza ngokuba 'yimithambo ye-varicose'. Kwenzeka into efanayo ngaphakathi kwimiphunga yethu. Iindonga zale mithambo zibuthathaka kakhulu. Ngoko ke kukho ithuba elikhulu lokuba igazi liphume kuyo, okanye liqhume ngequbuliso lize liphume igazi. Oku kuphuma kwegazi emzimbeni kunokuba ngequbuliso, kube nzima, kwaye kube yingozi ebomini.
Le meko idla ngokubangelwa kukunyuka koxinzelelo kumthambo wegazi ophambili odlula kwisibindi kunye neminye imithambo edibene naso (iPortal Hypertension). Olu xinzelelo lungaqhelekanga lubangela ukuba imithambo emincinci esibindini idumbe kwaye ibe mikhulu. Le meko idla ngokubonwa kubantu abanesifo sesibindi.
Ibaluleke kangakanani le meko?
Eyona ngozi iyingozi ye-portal vein thrombosis kukopha . Asinguye wonke umntu opha igazi, kodwa malunga nama-50% abantu basengozini. Okukhona uxinzelelo lwegazi oluphezulu lwe-portal, kokukhona umngcipheko wokopha uphezulu. Olu xinzelelo luyanda xa umntu enesifo sesibindi, ingakumbi i-cirrhosis .
Abantu abane-cirrhosis enzima yesibindi banokuba nezinye iingxaki ukongeza kule mithambo idumbayo. Nangona kunjalo, esona sizathu sokulaliswa esibhedlele nokufa kukuqhekeka kwale mithambo kunye nokopha. Ukuba wopha kanye ngale ndlela, umngcipheko wokufa umalunga nama-20%. Kwakhona, ukopha kunokuphinda kubuye rhoqo.
Zithini iimpawu zale meko?
Ngenxa yokuba le mithambo ingaphakathi emzimbeni, ayibonakali njengomthambo osemlenzeni. Usenokungayiva nokuba uyiginye ukutya. Enyanisweni, isenokungabonakalisi zimpawu ide iqale ukopha .
Nangona kunjalo, ukuba ugqirha ubona ezinye iimpawu ezibonisa ukuba unesifo sesibindi okanye uxinzelelo lwegazi oluphezulu, banokukukrokrela oku.
| Uhlobo lwempawu | Ingcaciso |
|---|---|
| Iimpawu ezibonisa isifo sesibindi | |
| I-Jaundice | Ulusu lwakho namehlo akho ajika abe tyheli. |
| Ii-Ascites | Ukudumba kwesisu ngenxa yokuqokelelana kolwelo esiswini (esiswini). |
| Ukudumba | Ukudumba kwemilenze neenyawo. |
| Intlungu yesisu esingaphezulu | Intlungu ebangelwa kukudumba kwesibindi okanye ipleyini. |
| Ukuziva uphelelwe lithemba | I-Hepatic encephalopathy yimeko apho isibindi singasebenzi kakuhle, nto leyo echaphazela ingqondo. |
| Iimpawu zokopha emthanjeni | |
| Ukuhlanza igazi | Ukuba ukopha kuhamba kancinci, ukuhlanza kunokubonakala ngathi kukutya ikofu. Ukuba umthambo uqhuma ngequbuliso, igazi elitsha nelibomvu liya kuhlanzwa. |
| Igazi esitulweni | Ukuba igazi lihamba ngendlela yokugaya ukutya, linokubangela ukuba isitulo sibe mnyama mnyama, njengetar (melena). Kwimeko yokopha ngokukhawuleza, igazi elibomvu elitsha linokudluliselwa. |
| Ubumhlophe | Inkangeleko engwevu ngokungathi igazi liphume ebusweni. |
| Ukudinwa kunye nesiyezi | Ukuziva udiniwe, ubuthathaka, kwaye unesiyezi ngenxa yoxinzelelo lwegazi oluphantsi. |
Kubaluleke kakhulu: Ukuba ubonakalisa iimpawu zokothuka ngenxa yokopha kakhulu, yiya kwigumbi likaxakeka esibhedlele (ETU) ngokukhawuleza. Ezi mpawu ziquka: ukubetha kwentliziyo ngokukhawuleza, ukuphefumla ngokukhawuleza, ukubila okubandayo, kunye nokulahlekelwa zingqondo.
Kutheni le mithambo idumba? Yintoni unobangela?
Njengoko besitshilo ngaphambili, unobangela oyintloko yimeko ebizwa ngokuba yi-"Portal Hypertension." Masiyiqonde le nto ngokulula.
Cinga ngesibindi sethu njengesihluzo esikhulu. Igazi eliphuma ekutyeni okusesiswini lidlula esibindini, apho licocwa khona lize liye entliziyweni. Umthambo ophambili ozisa eli gazi esibindini ubizwa ngokuba yi-'Portal Vein'`.
Ngoku, ukuba isibindi sinezibazi kwaye siqinile ngenxa yesifo esifana ne-cirrhosis , elo gazi alinakudlula ngokulula esibindini. Kufana nokuba kukho ukuxinana okukhulu kwezithuthi endleleni. Oku kubangela ukuba uxinzelelo lwegazi ngaphakathi kwi-portal vein lunyuke kakhulu.
Umzimba uzama ukubuyisa olu xinzelelo lunyukileyo ngokujika igazi lidlule kwimithambo emincinci (imithambo emincinci). Imithambo ekwi-ureter yimimithambo emincinci kakhulu. Kodwa le mithambo mincinci ayinakukwazi ukumelana nobuninzi begazi noxinzelelo. Ngenxa yoko, iyadumba, ibe mikhulu, kwaye ingaqhuma nangaliphi na ixesha.
Ezona zinto zibangela isifo sesibindi esibizwa ngokuba yi-liver cirrhosis zezi:
- Ukusela utywala ngokugqithisileyo.
- Isibindi esinamafutha (i-Nonalcoholic Steatohepatitis).
- Usulelo lwe-hepatitis oluhlala ixesha elide.
- Inkqubo yomzimba yokuzikhusela ihlasela isibindi (i-Autoimmune Hepatitis).
- Ezinye izizathu ezifana nokuqhekeka kwegazi, usulelo olubangelwa zizinambuzane (iSchistosomiasis) njl.
Uyazi njani ukuba unale meko?
Ixesha elininzi, ufumanisa oku kuphela emva kokuba ugqirha ekuxilongile. Ukuba sele une-cirrhosis yesibindi, ugqirha wakho uya kucebisa ukuba uhlolwe olu hlobo lokudumba kwemithambo yegazi.
Uvavanyo oluphambili luvavanyo lwe-Upper Endoscopy okanye uvavanyo lwe-EGD .
Oku kuquka ukufaka ityhubhu encinci nethambileyo enekhamera enamathele emlonyeni wakho kwaye uhlolisise umphimbo wakho, isisu, kunye nokuqala kwamathumbu akho amancinci. Oku kuvumela ugqirha wakho ukuba abone ngokucacileyo ukuba imithambo yakho idumbile, inkulu kangakanani, kwaye ingaba isengozini yokopha.
Zithini iindlela zonyango zoku?
Ngethamsanqa, kukho iindlela ezahlukeneyo zonyango ezikhoyo zokulawula ukopha kunye nokuthintela ukopha kwakhona. Iinjongo eziphambili zonyango zezi:
- Lawula ukopha okusebenzayo ukuba kukho.
- Ukuthintela ukopha kwixesha elizayo.
- Ukuba kunokwenzeka, nciphisa imeko ye-`(Portal Hypertension)`.
1. Lawula ukopha (ungxamiseko)
Le yingxamiseko yezonyango. Esibhedlele, uza kunikwa ulwelo lwe-IV, utofelo-gazi ukuba kuyimfuneko, kunye ne-endoscopy emva kokuba imeko yakho izinzile. Apho:
- I-Varicose Band Ligation: Isixhobo esincinci sidluliselwa kwi-endoscope kwaye i-raber band encinci ibekwe ijikeleze i-varicose vein. Oku kuyayekisa ukuhamba kwegazi ukuya kwi-vein kwaye kulawula ukopha.
- Amayeza: Amayeza anciphisa uxinzelelo lwegazi kwaye anciphise imithambo yegazi (i-Octreotide, iVasopressin) anikwa ngomthambo.
2. Ukuthintela ukopha kwakhona
Nokuba kukho ukopha okanye akunjalo, ukuba kukho umngcipheko wokopha, ugqirha uza kuqala unyango lokuthintela.
- Ii-Beta-blockers: Olu hlobo lwamayeza, olunikwa uxinzelelo lwegazi oluphezulu, lunokunciphisa umngcipheko wokopha ngama-50%.
- I-Band Ligation: Le ndlela ikwasetyenziswa njengendlela yokuthintela abanye abantu.
3. Ukunyanga unobangela oyintloko
Ukuba unyango olungentla alunciphisi umngcipheko wokopha, ugqirha wakho unokucebisa ezinye iindlela zokunciphisa ngokuthe ngqo imeko ye-"Portal Hypertension."
- I-Transjugular Intrahepatic Portal-Systemic Shunt (IINGCEBISO): Le ayisiyonkqubo yotyando. Kule nkqubo, kufakwa ityhubhu encinci (i-stent) kumthambo ongaphakathi kwesibindi othwala igazi ukusuka kumthambo we-portal, okwenza unxibelelwano olutsha, okanye "indlela emfutshane." Oku kunciphisa kakhulu uxinzelelo.
- Utyando: Iinkqubo zotyando ezifana ne-"Distal Splenorenal Shunt (DSRS)" nazo zinciphisa uxinzelelo ngokujika ukuhamba kwegazi.
Ungalibali: Eyona nto ibalulekileyo kukunyangela unobangela wokonakala kwesibindi. Ukuyeka utywala, ukunciphisa umzimba, kunye nokunyanga izifo ezifana ne-hepatitis C kunokunceda ukunciphisa umonakalo wesibindi kunye nokuthintela isifo ukuba singabi mandundu.
Umyalezo Wokuya Ekhaya
- Ii-Esophageal varices yimeko enzulu edla ngokungabangeli zimpawu de kube kuphume ukopha.
- Eyona nto ibangela oku yi-portal hypertension ebangelwa sisifo sesibindi, ingakumbi i-cirrhosis.
- Ukuba unesifo sesibindi, kubaluleke kakhulu ukuthetha nogqirha wakho kwaye ufumane uvavanyo rhoqo.
- Ukuba ubona iimpawu ezinjengokuhlanza igazi okanye ukuphuma kwendle emnyama, yingxamiseko leyo. Yiya kwiSebe lezeMpilo eziNgxamisekileyo (ETU) lesibhedlele ngoko nangoko.
- Utshintsho kwindlela yokuphila, njengokuyeka utywala nokugcina indlela yokuphila esempilweni, lunegalelo elikhulu ekugcineni impilo yesibindi kunye nokuthintela le meko ukuba ingabi mandundu.
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