Abanye abantu abaneengxaki zesibindi banokuqala ngequbuliso ukuphuma kwegazi emlonyeni, okanye banokubona igazi kwindle yabo. Xa oku kusenzeka, awukwazi nokuyicinga into eyenzekayo. Esinye sezizathu eziphambili zale meko kukuba imithambo yegazi kwi -esophagus yakho, ityhubhu ehamba kuyo ukutya, iyadumba kwaye iqhume, ibangele ukopha . Kufana nemithambo evuvukileyo emilenzeni yakho, kodwa oku kwenzeka ngaphakathi emzimbeni wakho. Namhlanje siza kuthetha ngale meko, eyaziwa ngokwezonyango njenge-Esophageal Varices. Ungakhathazeki, masiyigcine ilula.
Zithini ezi (iiVarices ze-Esophageal)? Ngamafutshane…
Khawucinge nje, umphimbo wakho yityhubhu ethwala ukutya ukusuka emlonyeni wakho ukuya esiswini sakho. Ngaphakathi kweli thubhu kukho inethiwekhi yemithambo yegazi emincinci. Ukuba ngesizathu esithile, le mithambo yegazi iphantsi koxinzelelo olukhulu, iyadumba kancinci kancinci ize iqale ukwanda. Oku kubizwa ngokuba yi-esophageal varices.
Eyona nto iyingozi kakhulu ngale nto kukuba iindonga zale mithambo idumbileyo zibuthathaka kakhulu. Njengebhaluni evuthelweyo. Ngoko ke, zinokuqhuma kwaye zophe ngokulula . Oku kuphuma kwegazi emzimbeni kunokuba ngequbuliso, kube nzima, kwaye kunokuba yingozi ebomini.
Ingakanani ingxaki (ii-Esophageal Varices)?
Umngcipheko oyintloko nowona mkhulu wale meko kukopha . Nangona kungengabo bonke abantu abophayo, malunga nama-50% abantu abanale meko banokopha. Njengoko bekutshiwo ngaphambili, lo mngcipheko uyanda njengoko uxinzelelo kumthambo wegazi ophambili odlula esibindini, oko kukuthi, (i-Portal Hypertension), lusanda. Kwiimeko ezininzi, le meko (i-Portal Hypertension) ibangelwa sisifo esingapheliyo sesibindi. Ngoko ke, njengoko isifo sesibindi sisiya sisanda, le meko nayo iya isiba mandundu.
Abantu abanezibindi ezinesifo esinzima, oko kukuthi i-cirrhosis, banokuba nezinye iingxaki ngaphandle kwe-esophageal varices.Nangona kunjalo, esona sizathu sokuba abantu abane-cirrhosis bafakwe esibhedlele baze bafe kukuba le mithambo idumbileyo iyaqhuma ize yophe. Ukuba olu hlobo lokopha luyenzeka, umngcipheko wokufa umalunga nama-20%. Kwakhona, emva kokopha kanye, umngcipheko wokopha kwakhona uphezulu.
Zithini iimpawu ze (Esophageal Varices)?
Le mithambo idumbileyo ayibonakali ngathi ikwimilenze. Ifumaneka ngaphakathi esifubeni, rhoqo apho umqala udibana khona nesisu. Awuziva xa uginya. Azisoloko zibangela zimpawu de zophe.
Nangona kunjalo, ukuba ugqirha wakho ubona ezinye iimpawu ezibonisa uxinzelelo lwegazi oluphezulu okanye isifo sesibindi esingapheliyo, unokurhanela ukuba kukho ii-varies zomqala. Ezi mpawu ziquka:
- I-Jaundice : Ukutyheli kolusu namehlo.
- I-Ascites : Ukuqokelelana kolwelo esiswini.
- Ukudumba : Ukudumba kwemilenze namaqatha.
- Intlungu yesisu esingaphezulu : Intlungu inokubangelwa kukudumba kwesibindi okanye ipleyini .
- Ukurhawuzelela : Ukurhawuzelela ulusu ngaphandle kokwenzakalisa.
- Ukudideka (Hepatic Encephalopathy) : Ukungakwazi ukugxila, ukulahlekelwa yingqondo.
Iimpawu zokopha
Ukuba umthambo ovuvukileyo uqhuma ngequbuliso uze uqale ukopha, usenokungaziva ntlungu ngoko nangoko. Nangona kunjalo, kufuneka uqaphele ezi mpawu zilandelayo zokopha kwindlela yokugaya ukutya okanye emzimbeni :
| Iimpawu zokopha | Oku kwenzeka njani... |
|---|---|
| Ukuhlanza igazi emlonyeni | Xa uhlanza igazi, ungahlanza igazi eliqhekekileyo nelibonakala ngathi ligayiwe yikofu. Kodwa ukuba umthambo uqhuma ngequbuliso, ungahlanza igazi elitsha nelibomvu. |
| Igazi esitulweni | Xa igazi eliphuma emlonyeni ligaywa lize liphume nendle, lijika libe nombala otyheli okanye omnyama (melena). Nangona kunjalo, ukuba ukopha kukhawulezile kakhulu, igazi elitsha elibomvu linokuphuma nendle. |
| Ezinye iimpawu zomzimba | Xa kuphuma igazi elininzi emzimbeni, ubuso bunokuba mhlophe, kwaye ungaziva udiniwe kakhulu kwaye ungenabomi. Uxinzelelo lwegazi oluphantsi lunokubangela isiyezi. |
Kubalulekile: Iimpawu zeNgxamiseko (iHypovolemic Shock)
Ukuba ngequbuliso ufumanisa iimpawu zesimo esiyingozi esibizwa ngokuba yi-hypovolemic shock, yiya kwi-ETU ngoko nangoko! Ezi mpawu zezi:
- Ukubetha kwentliziyo
- Ukwanda kwesantya sokuphefumla
- Ndiziva ndibanda kwaye ndibila
- Ukungazinzi kunye nokudideka
- Ukulahlekelwa yingqondo
Zithini izizathu ze-esophageal varices?
Eyona nto ibangela le meko yimeko ebizwa ngokuba yiPortal Hypertension , ebangela uxinzelelo lwegazi oluphezulu kumthambo wegazi ophambili odlula esibindini (i-portal vein) nakwezinye imithambo ephuma kuso.
Imizimba yethu izama ukuziqhelanisa nolu xinzelelo luphezulu ngokuyalela igazi elongezelelweyo kwimithambo emincinci engakwaziyo ukuyinyamezela. Kuyo le, imithambo ethambileyo ekwimpundu yileyo idumba kakhulu.
Izizathu eziphambili ze-portal hypertension
Eyona nto ibangela oku yi-cirrhosis, ebangela ukuqina kwesibindi . Oku kubangelwa kukonakala kwesibindi ixesha elide. Iiseli zesibindi ziyalimala rhoqo ( i-hepatitis ), kwaye ekugqibeleni ziba zizicubu zesilonda. Olu silonda luthintela ukuhamba kwegazi esibindini. Oku akwenzeki ngaxeshanye, kodwa kwenzeka kwiminyaka emininzi.
Isifo sesibindi sisigaba sokugqibela saso nasiphi na isifo sesibindi esingapheliyo. Umzekelo:
- I-hepatitis ebangelwa butywala
- I-steatohepatitis engeyotywala (NASH)
- I-hepatitis yentsholongwane engapheliyo (efana ne-B, C)
- I-hepatitis ye-autoimmune
Kukho ezinye izizathu ezinokubangela i-Portal Hypertension:
- Iigranulomas esibindini : Ezi ziingqokelela zeeseli ezivuthayo ezenzeka kunye nezifo ezahlukeneyo kunye neemeko zokuvutha. Isizathu esiphambili soku sisifo esibangelwa yiparasite esibizwa ngokuba yiSchistosomiasis, esichaphazela abantu abamalunga nezigidi ezingama-230 kwihlabathi liphela.
- I-Thrombosis: Ukuba ihlwili legazi lenzeka kwinkqubo yemithambo yegazi edibene nesibindi, ukuhamba kwegazi kunokuthinteleka (umz. i-Budd-Chiari syndrome).
- Ukwandiswa kwepleen .
- Isifo sentliziyo : njengokusilela kwentliziyo kwicala lasekunene.
(IiVarices ze-Esophageal) Ukuxilongwa kunye noNyango
Awuyi kwazi ngale nto de ugqirha akuhlole. Ukuba sele ufunyenwe une-cirrhosis, ugqirha wakho uya kucebisa ukuba ujonge ukudumba kwemithambo yegazi. Uvavanyo oluphambili olusetyenziswa koku yi -upper endoscopy .
Yintoni (i-Upper Endoscopy)?
I-Upper Endoscopy , eyaziwa ngokuba luvavanyo lwe-EGD, luvavanyo lwendlela yakho yokugaya engaphezulu, equka umphimbo wakho, isisu, kunye nokuqala kwamathumbu akho amancinci (i-duodenum). Oku kwenziwa yingcali ye-gastroenterologist, ugqirha ogxile kwizifo zenkqubo yokugaya kunye neenkqubo ze-endoscopy. I-endoscope yityhubhu ende, encinci enekhamera encinci esiphelweni. Ityhubhu ifakwa ngomlomo wakho kwaye idluliselwe kwi-esophagus yakho ukujonga ngokuthe ngqo nakuphi na ukudumba. Ukuba kukho naziphi na iingxaki ezifunyenweyo, izixhobo ezincinci zingafakwa nge-endoscope ukuze zinyangwe.
Ziziphi iindlela zonyango (ii-Esophageal Varices)?
Iinjongo eziphambili zonyango kukulawula ukopha kwangoku, ukuthintela ukopha kwixesha elizayo, kwaye, ukuba kunokwenzeka, ukunciphisa uxinzelelo lwegazi oluphezulu lwegazi oluvela kwi-portal.
| Indlela yonyango | Kwenzeka ntoni kuyo? |
|---|---|
| Amayeza | Oogqirha banika amayeza e-intravenous afana ne-Octreotide ukunciphisa uxinzelelo lwegazi. Kukwakho namayeza afana ne-Beta-blockers onokuwasebenzisa ukuze uyeke ukopha. |
| Ukubotshwa kwebhendi yeVaricose | Kwakamsinya nje emva kokuba i-endoscope ifakiwe, kubekwa ibhande elincinci lerabha elijikeleze umthambo ophuma igazi, okanye umthambo orhanelwa ukuba wopha igazi, uze uqiniswe. Oku kuya kuyimisa loo nto. |
| Iinkqubo zokuthutha | Oku kunzima kancinci. Kukho iindlela ezimbini, i-TIPS kunye ne-DSRS. Oku kuquka ukudala indlela entsha yegazi yokudlula isibindi. Nokuba kungotyando okanye nge-X-ray, umthambo osesibindini uqhagamshelwe komnye umthambo ukuze kuncitshiswe uxinzelelo. |
| Ukunyanga unobangela oyintloko | Eyona nto ibalulekileyo kukunyangela unobangela oyintloko. Oko kuthetha ukuyeka ukusela utywala, ukunciphisa umzimba, okanye ukuthatha amayeza esifo esingaphantsi kwesibindi esifana nehepatitis C. |
Ukuphila nale meko
Imbono yakho ixhomekeke ekubeni unesifo sokopha emithanjeni yakho na nokuba isifo sakho sesibindi sibi kangakanani na. Izinga lokusinda konyaka omnye kubantu abane-cirrhosis nokopha limalunga nama-50%. Umngcipheko wokufa ngenxa yokopha kokuqala yi-20%, kwaye umngcipheko wokopha okwesibini, nokuba kunyango, ufikelela kuma-60%.
Ii-Esophageal varices zizinto ezinobungozi. Nangona kunjalo, ukuba isifo sesibindi sichongiwe kwangethuba, utshintsho kwindlela yokuphila lunokwenziwa ukuthintela ukuba esi sifo singabi mandundu, kwaye le mithambo inokuthintelwa ekudumbeni.
Umyalezo Wokuya Ekhaya
- Ii-varices ze-esophageal zihlala zibangelwa yi-portal hypertension, imeko ebangelwa yi-liver cirrhosis .
- Eyona ngozi iphambili yoku kukuba kungenzeka ukuba umthambo wegazi uqhume kwaye wophe . Oku kunokuba yingozi ebomini.
- Nokuba awubonisi zimpawu zibalulekileyo ekuqaleni, ukuba ufumana iimpawu ezifana nokopha emlonyeni, indle emnyama, ukutyheli kolusu, okanye isisu esidumbileyo, bonana nogqirha wakho ngoko nangoko .
- Oku kuchongwa ngokuchanekileyo kwaye ezinye iindlela zonyango zenziwa ngovavanyo olubizwa ngokuba yi-endoscopy.
- Kukho unyango, kodwa eyona nto ibalulekileyo kukuphepha izinto ezonakalisa isibindi (utywala, ukutya okuthile okungenampilo) nokulandela iingcebiso zonyango ngokuchanekileyo .
- Ukuba unesifo sesibindi, kubaluleke kakhulu ukuba uye kuvavanyo lwezonyango rhoqo ukuze kuhlolwe iingxaki ezifana nezi .
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