Masifunde ngakumbi ngesifo sesibindi! Masithethe ngale nto!

Isibindi sisitho esibaluleke kakhulu emzimbeni wakho. Sisebenza njengesihluzo emzimbeni wethu. Sihluza kwaye sisuse ubuthi egazini. Kodwa, kukho umda kwinto esi sihluzo esinokuyiphatha, akunjalo? Ngamanye amaxesha, lo msebenzi unokonakalisa isibindi . Ngoko ke namhlanje, masithethe ngezifo zesibindi .

Yintoni isifo sesibindi?

Xa sithi 'isifo sesibindi', oogqirha badla ngokuthetha ngeemeko ezonakalisa isibindi kancinci kancinci, ngokuhamba kwexesha, okanye ezingapheliyo . Ezi zinokubangelwa zizifo ezibangelwa ziintsholongwane , iityhefu ezahlukeneyo, okanye iimeko ezithile zemetabolism. Into emangalisayo kukuba isibindi sinamandla amangalisayo okuzilungisa. Kodwa xa sisetyenziswa rhoqo, loo mandla ayancipha kancinci kancinci.

Zithini izigaba zesifo sesibindi esingapheliyo?

Kukho izigaba ezine eziphambili zesifo sesibindi ebeziqhubeka ixesha elide. Makhe sijonge ukuba zeziphi.

Inqanaba 1: I-Hepatitis

Inqanaba lokuqala yi-hepatitis. Ngamafutshane, oku kukudumba kwezicubu zesibindi. Njengokuba xa senzakala ndaweni ithile, siyadumba, xa isibindi sonakele okanye sityhefwe, oku kudumba kwenzeka ngenxa yoko. Oku kwenzeka ukuze kupheliswe usulelo kwaye kuqalise inkqubo yokuphiliswa. Oku kungasonjululwa ngokudumba okukhawulezileyo, okwethutyana (i-hepatitis ebukhali). Kodwa ukuba kukho umonakalo oqhubekayo okanye ityhefu, ukudumba kuyaqhubeka. Ngenxa yesi simo sexesha elide se-hepatitis (i-hepatitis engapheliyo) , njengoko isibindi sizama ukuzinyanga ngokuhamba kwexesha, ekugqibeleni kuvela amanxeba (i-fibrosis).

Inqanaba lesi-2: I-Fibrosis

Inqanaba lesibini yi-fibrosis. Oku kulapho izicubu zesilonda ziqokelelana kancinci kancinci esibindini, zisenza siqine kwaye siqine. Kufana nelaphu elidala. Le zicubu zesilonda zinciphisa ukuhamba kwegazi esibindini, nto leyo ethetha ukuba ioksijini encinci kunye nezondlo ezithunyelwa esibindini. Le yindlela isibindi esiqala ngayo ukulahlekelwa kukusebenza kancinci kancinci. Okumangalisayo kukuba, ezinye zezi fibrosis zinokuguqulwa. Oko kukuthi, ukuba umonakalo unciphile ngokwaneleyo, iiseli zesibindi zinokuphinda zikhule kwaye izicubu zesilonda zinokuncitshiswa.

Inqanaba lesi-3: Isifo sokuqina kwesibindi

Inqanaba lesithathu yi-cirrhosis, ebangela ukuba isibindi sibe namanxeba angapheliyo, angenakulungiseka.Kulapho i-fibrosis iba yinto engaphinde iguqulwe. Xa isibindi silahlekelwa ziiseli eziphilileyo ezaneleyo zokusebenza, izicubu azikwazi ukuphinda zivelise. Nangona kunjalo, kwanakweli nqanaba, kukho iindlela zokuyeka okanye zokunciphisa umonakalo. Njengoko i-cirrhosis iqala ukuchaphazela ukusebenza kwesibindi, usenokungawuboni umahluko omkhulu ekuqaleni, njengoko umzimba wakho uzama ukubuyisela ilahleko.

Inqanaba lesi-4: Ukungasebenzi kakuhle kwesibindi

Isigaba sokugqibela, okanye sesine, kukusilela kwesibindi. Oku kulapho isibindi singasakwazi ukusebenza ukwanelisa iimfuno zomzimba. Oku kukwabizwa ngokuba yi-decompensated cirrhosis – oko kuthetha ukuba umzimba awusakwazi ukuhlawula ukulahleka kwesibindi. Njengoko imisebenzi yesibindi iphela kancinci kancinci, uqala ukuziva iziphumo emzimbeni wakho wonke. Ukusilela kwesibindi okungapheliyo yinkqubo eyenzeka kancinci kancinci, kodwa ngaphandle kokufakelwa isibindi, ekugqibeleni kunokukhokelela ekufeni. Khumbula, sidinga isibindi ukuze siphile.

Zixhaphake kangakanani izifo zesibindi?

Ukuba sithetha ngendlela esi sifo sesibindi esixhaphake ngayo, sibangela ukufa kwabantu abamalunga nezigidi ezi-2 ngonyaka kwihlabathi liphela. Oko kumalunga ne-4% yabo bonke abantu abafayo. Uninzi lwabantu abafayo lubangelwa ziingxaki ze-cirrhosis. Amadoda anamathuba aphindwe kabini okufumana esi sifo kunabafazi.

Ziziphi iimpawu zokuqala zesifo sesibindi?

Uninzi lwexesha, ezi zifo zesibindi ezingapheliyo azibonisi zimpawu ziphambili kwizigaba zokuqala. Kodwa ngamanye amaxesha, zinokuqala njenge-hepatitis ekhawulezileyo nekhawulezileyo. Umzekelo, ukuba une-hepatitis ebangelwa yintsholongwane, kukho isigaba esikhawulezileyo ngaphambi kokuba ibe sisifo esingapheliyo. Ngeli xesha, unokuba nomkhuhlane, isisu esibuhlungu, kunye nesicaphucaphu kangangeentsuku ezimbalwa. Ukuba inkqubo yomzimba yokuzikhusela ayikwazi ukulwa nosulelo, iba sisifo esingapheliyo.

Ezinye izizathu zesifo sesibindi nazo zinokubangela iimpawu ezikhawulezileyo ezifana nezi ekuqaleni. Iimpawu zokuqala zesifo sesibindi zihlala zingacacanga. Zingabandakanya:

• Intlungu yesisu esingaphezulu.
• Isicaphucaphu okanyeUkutya akunancasa .
• Ukudinwa kunye nokungakhululeki (ukuziva udiniwe kwaye ungaphilanga).

Zithini iimpawu zesifo sesibindi ezifika emva kwexesha?

Njengoko isibindi sakho siqala ukusebenza kancinci, unokuqala ukuqaphela iimpawu ezingakumbi. Kulapho isifo sesibindi sikwinqanaba eliphezulu khona. Esinye seziphumo zokuqala zokungasebenzi kakuhle kwesibindi kukuba ukuhamba kwenyongo kuyavalwa. Isibindi asisakwazi ukwenza inyongo ngokufanelekileyo okanye ukuyipompa emathunjini amancinci. Endaweni yoko, inyongo iqala ukuvuza egazini. Oku kunokubangela iimpawu ezithile:

• I-Jaundice (ukutyheli kwamhlophe emehlweni naselusu).
• Umchamo omnyama .
• Ukugqitha isitulo esinombala okhanyayo .
• Ubunzima bokwetyisa ukutya, ingakumbi ukutya okunamafutha.
• Ukunciphisa umzimba kunye nokulahlekelwa yimisipha.
• Umoya onuka umphunga.
• Ukuphazamiseka okuncinci kokusebenza kwengqondo (i-hepatic encephalopathy).
• Ukurhawuzelela (ukurhawuzelela nje ngaphandle kokwaphuka eluswini).

Njengoko isifo sesibindi sisiya sisiba mandundu, sinokuchaphazela ukujikeleza kwegazi lakho, iihomoni, kunye nemeko yesondlo. Oku kunokubonakala ngeendlela ezahlukeneyo. Ungabona iimpawu ezifana nezi kulusu lwakho kunye neenzipho:

• Izipikili zespuni.
• Iinzipho zikaTerry (iinzipho zimhlophe, zipinki kuphela).
• Ukugquma iinzipho kukudumba nokugoba kwesiseko sezinzipho.
• Ii-spider angiomas.
• Amachaphaza amancinci abomvu eluswini ``(petechiae)``.
• Ioyile etyheli ifakwa eluswini okanye kwiinkophe, ibonakala ngathi ngamaqhuma amancinci.
• Ukudumba okulula nokopha .
• Ububomvu bezandla.

Ungabona neempawu zokuvuza kolwelo oluphuma kwimithambo yegazi luze luqokelele kwiindawo ezahlukeneyo zomzimba:

• Ukudumba kwesisu (i-ascites).
• Ukudumba kwamaqatha, imilenze, izandla, nobuso (i-edema).

Iimpawu ezithile zesini

Abafazi banokufumana iimpawu ezifana nezi ngenxa yesifo sesibindi:

• Ukungaqheleki kwemijikelo yokuya exesheni.
• Ubunzima bokufumana abantwana (Ukungazali kwabasetyhini).

Amadoda anokufumana iimpawu ezifana nezi:

• Amasende anciphileyo.
• Izicubu zesifuba sendoda ezikhulisiweyo.

Iingxaki zesifo sesibindi esikwinqanaba lokugqibela

Isifo sesibindi esikwinqanaba lokugqibela sisifo apho isibindi singakwaziyo ukuzilungisa size kancinci kancinci sibe singasebenzi kakuhle, esibizwa ngokuba yi-decompensated cirrhosis kunye nokusilela kwesibindi. Iziphumo ezimbini ezimbi kakhulu kweli nqanaba yi -portal hypertension kunye ne-hepatocellular carcinoma . Iingxaki zezi meko zimbini zezona ziphambili ezibangela ukulaliswa esibhedlele kunye nokufa kubantu abane-cirrhosis kunye nokusilela kwesibindi.

Uxinzelelo lwegazi oluphezulu lwePortal

I-portal hypertension ibangelwa kukuqhekeka kwesibindi, okubangela uxinzelelo kwi-portal vein. Xa uxinzelelo kwi-portal vein lusanda, umzimba uhambisa igazi uye kwezinye imithambo edibene nayo. Emva koko imithambo iyakhula, yoluleke, kwaye ibe ncinci. Le mithambo inokuvuza, iqhume, okanye yophe. Oku kuphuma kwegazi ngaphakathi kunokuba ngequbuliso, kube nzima, kwaye kube yingozi ebomini.

Nangona kunqabile, ezinye iingxaki zinokwenzeka:

• Ukwanda kunye nokusebenza ngokugqithisileyo kwespleen (hypersplenism).
• Ukungasebenzi kakuhle kwenkqubo yokuphefumla `(i-hepatopulmonary syndrome)`.
• Ukungaphumeleli kwezintso (i-hepatorenal syndrome).

Umhlaza wesibindi

Nangona kungengabo bonke abantu abanesifo sesibindi esihlala ixesha elide abaya kuba ne-hepatocellular carcinoma, abantu abaninzi abafumana umhlaza wesibindi banesifo sesibindi esihlala ixesha elide. Umjikelo wokudumba, ukuphiliswa, kunye nokuqhekeka kwenza kube lula ukuba iiseli zesibindi zitshintshe zibe ngumhlaza. Oogqirha bacinga ukuba iintsholongwane ze-hepatitis ezingapheliyo, ngakumbi, zinokuchaphazela i-DNA yeeseli zesibindi.

Zithini izizathu zesifo sesibindi?

Kukho iintlobo zezifo zesibindi ezingaphezu kwe-100, kodwa zahlulwe zangamaqela aliqela aphambili. Izizathu ziquka:

• Usulelo lwentsholongwane: Usulelo lwentsholongwane oluhlala ixesha elide olufana nehepatitis B kunye nehepatitis C lunokubangela ihepatitis engapheliyo.
• I-hepatitis ebangelwa butywala: Ukusela utywala kakhulu kunokubangela i-hepatitis ebukhali okanye engapheliyo. Ukuba oku kuyaqhubeka, kunokukhokelela kwi-cirrhosis kunye nokungasebenzi kakuhle kwesibindi. Le yimbangela eqhelekileyo kwilizwe lethu.
• I-hepatitis enobuthi: I-hepatitis ebukhali okanye engapheliyo inokubangelwa kukufumana ixesha elide izinto ezinobuthi, ezifana neekhemikhali okanye iziyobisi kwimizi-mveliso.
• Isifo sesibindi esinamafutha esingabangelwa butywala (NAFLD): Iimeko zemetabolism ezinxulumene nokutyeba kakhulu, amanqanaba aphezulu eswekile egazini, kunye namanqanaba aphezulu e-lipid (amafutha) egazini zinokubangela ukuba amafutha amaninzi aqokeleleke esibindini. Oku kunokukhokelela ekuvuvukeni (i-steatohepatitis engabangelwa butywala - i-NASH). Le meko ikwabonwa nakubantu abaninzi kule mihla, ingakumbi ngenxa yokutya kakubi.
• Ukungahlali kakuhle kwenyongo: Ezinye iimeko zokuzalwa, ezifana ne-biliary atresia kunye ne-cystic fibrosis, zinokubangela ukuba inyongo iqokeleleke kwaye yonakalise isibindi ngokuvala okanye ukuthintela ukuhamba kwenyongo kwimibhobho yenyongo. Izizathu ezenzeka emva kokuzalwa ziquka ukuqina kwenyongo kunye namatye enyongo.
• Izifo ezihlasela umzimba ngokwawo: Iimeko ezihlasela umzimba ngokwawo ezifana ne-autoimmune hepatitis, i-primary biliary cholangitis, kunye ne-primary sclerosing cholangitis zinokubangela ukudumba kunye nokuqhekeka kwesibindi okanye imibhobho yenyongo ixesha elide.
• Iingxaki zemetabolism ezizuzwe njengelifa: Iingxaki ezibangela ukuba iityhefu ziqokelele egazini, ezifana nesifo sokugcina i-glycogen (GSD), isifo sikaWilson, i-hemochromatosis, kunye nesifo sikaGaucher, zinokubangela umonakalo wesibindi ixesha elide.
• Izifo zentliziyo: Iimeko ezichaphazela isibindi kunye nokuhamba kwegazi kuso, ezifana ne-Budd-Chiari syndrome, i-ischemia, isifo semithambo yegazi yentliziyo, kunye nokusilela kwentliziyo kwicala lasekunene, zinokubangela umonakalo wesibindi ixesha elide.

Ziziphi izinto ezibangela umngcipheko wesifo sesibindi?

Usenokuba namathuba amaninzi okufumana isifo sesibindi ukuba:

• Ukuba usela utywala obuninzi.
• Ukuba usela amayeza ngemithambo yegazi, abizwa ngokuba "yi-intravenous drugs".
• Ukuba usebenzisa rhoqo amayeza okudambisa iintlungu afana ne-aspirin okanye i-paracetamol (ingakumbi xa usebenzisa iidosi eziphezulu ngaphandle kwengcebiso kagqirha).
• Ukuba une-metabolic syndrome (indibaniselwano yokutyeba kakhulu, uxinzelelo lwegazi oluphezulu, iswekile ephezulu yegazi, kunye namanqanaba e-cholesterol angaphili kakuhle).
• Ukuba uhlala ujongene neekhemikhali ezinobungozi.
• Ukuba uhlala ujongene negazi okanye ulwelo lomzimba lwabanye abantu (umz. abasebenzi bezempilo, abaculi beetattoo).

Indlela yokuxilonga isifo sesibindi?

Ugqirha ohlola isifo sesibindi uza kuqala akuhlole ngokwasemzimbeni. Baza kukhangela iimpawu baze bakubuze ngeempawu zakho. Banokubuza nangokutya kwakho, indlela ophila ngayo, kunye nembali yempilo yakho. Emva koko, baza kusebenzisa iimvavanyo zelebhu kunye neeskeni zomfanekiso ukuze babone ukuba unesifo sesibindi na. Ezi zinokubandakanya:

• Uvavanyo lwegazi: Uthotho lovavanyo lokusebenza kwesibindi lunokubonisa iimpawu zesifo sesibindi, ubukhali besifo, kunye neempawu zokungasebenzi kakuhle kwesibindi. Ezi zilinganisa izinto ezifana nee-enzymes zesibindi, iiproteni, kunye namanqanaba e-bilirubin. Uvavanyo lwegazi lunokubonisa neziphumo ebezingalindelekanga ezifana nokudumba, izifo ezithile, okanye ukuncipha kokujiya kwegazi.
• Uvavanyo lwemifanekiso: I-ultrasound yesisu, i-CT scan (i-computed tomography scan), okanye i-MRI (i-magnetic resonance imaging) inokubonisa ubungakanani, imilo, kunye nemeko yesibindi. Oku kunokunceda ekufumaneni ukudumba, amaqhuqhuva, kunye ne-fibrosis.
• I-Elastography: Olu luvavanyo olukhethekileyo lokujonga olusebenzisa iteknoloji ye-ultrasound okanye ye-MRI ukulinganisa ukuqina, okanye inqanaba le-fibrosis, yesibindi.
• I-Endoscopy:Ukuba ugqirha wakho ufuna ukujonga ngaphakathi kwenkqubo yakho ye-bile duct, kuya kufuneka asebenzise inkqubo yokuthatha imifanekiso ebizwa ngokuba yi-endoscopy. Oku kubandakanya ukufaka ikhamera encinci (i-endoscope) ngomlomo wakho uze uyidlulisele kwindlela yakho yokugaya ukutya. Emva koko i-bile ducts ingajongwa kusetyenziswa i-EUS (endoscopic ultrasound) okanye i-ERCP (endoscopic retrograde cholangiopancreatography).
• Ukufota ngamayeza enyukliya: Oku kuquka ukufaka into engenabungozi emzimbeni kunye nokusebenzisa ikhamera ye-gamma ukuyifumanisa. Ngokuxhomekeke kwindlela isibindi sakho esiyifunxa ngayo le nto, inokubonisa apho ingasebenzi kakuhle khona.
• Uvavanyo lwesibindi: Le yinkqubo encinci. Isampuli encinci yezicubu ithathwa esibindini ize ivavanywe kwilebhu. Le sampuli idla ngokuthathwa kusetyenziswa inaliti engenanto. Uvavanyo lwesibindi lunokwenziwa ukujonga umhlaza, ukuqinisekisa isifo sesibindi, kunye nokufumanisa unobangela.

Zinyangwa njani izifo zesibindi?

Ezinye iintlobo zesifo sesibindi zineendlela ezithile zonyango. Umzekelo, amayeza okulwa nentsholongwane anikwa i-hepatitis ebangelwa yintsholongwane, kwaye ii-corticosteroids kunye ne-immunosuppressants zinikwa izifo ezihlasela umzimba. Kodwa kwiimeko ezininzi, utshintsho kwindlela yokuphila lolona nyango luphambili lwesifo sesibindi. Ukunciphisa inani leetyhefu ezingena esibindini kubalulekile nakwesiphi na isifo sesibindi. Oku kubaluleke kakhulu kwisifo sesibindi esibangelwa kukutyeba kakhulu, utywala, okanye ezinye iityhefu.

Nangona kunjalo, ukufunyanwa kwangoko kubalulekile ukuze kunyangwe isifo sesibindi ngempumelelo ngaphambi kokuba kubekho umonakalo osisigxina. Ngelishwa, ayinguye wonke umntu ofunyaniswa ukuba unesifo ngexesha apho isifo siphinde sibuyele esiqhelweni. Ukuba sele une-cirrhosis okanye ukungasebenzi kakuhle kwesibindi, unokufuna unyango olongezelelweyo kwiingxaki ezifana noxinzelelo lwegazi oluphezulu okanye umhlaza wesibindi. Isibindi sakho sisenokungakwazi ukuphiliswa, kwaye ekugqibeleni unokufuna ukufakelwa isibindi.

Ungayinciphisa njani ingozi yesifo sesibindi?

Ungenza ezi zinto ukuze uzikhusele kwisifo sesibindi:

• Ukugonywa: Kukho amayeza okugonya okukhusela kwi-hepatitis A kunye ne-B ebangelwa yintsholongwane.
• Ucoceko olufanelekileyo: Izinto ezinje ngokuhlamba izandla emva kokusebenzisa indlu yangasese, ukulungisa ukutya ngokukhuselekileyo, kunye nokusebenzisa iinaliti ngokukhuselekileyo zinokunceda ekuthinteleni ukusasazeka kwezifo.
• Nciphisa ukusetyenziswa kotywala kwaye uthabathe amayeza njengoko kuyalelwe: Ukuba unengxaki yokusebenzisa iziyobisi (umz., `Ingxaki Yokusebenzisa iziyobisi – SUD`), ukufumana unyango kunokunceda ukuthintela i-hepatitis ebangelwa ziityhefu.
• Ukulawula izinto ezibangela imetabolism ezifana nee-lipids egazini (amafutha) kunye neswekile egazini: Ungafumana uncedo kugqirha ngale nto.

Ngaba isifo sesibindi sinokubuyiselwa kwimeko yaso yamva nje?

Isifo sesibindi esiqalayo sinokuguqulwa ukuba unobangela ufunyenwe kwaye wena neqela lakho lezonyango nisebenzisana ekusisuseni okanye ekulawuleni. Oku kuxhomekeke ekubeni yintoni unobangela kwaye sinokunyangwa kakuhle kangakanani. Ukuba une-cirrhosis, awunakuyitshintsha umonakalo osele wenziwe. Kodwa unokuthintela umonakalo ongakumbi okanye uwunciphise. Ukungasebenzi kakuhle kwesibindi okungapheliyo akunakuguqulwa, kodwa kungathatha iminyaka ukuba kube kubi ngakumbi.

Ngaba isifo sesibindi sinokunyangeka?

Iintlobo ezininzi zezifo zesibindi zinokunyangwa. Isifo sesibindi esibangelwa ziityhefu notywala sidla ngokuba ngcono xa uyeka ukudibana nezo tyhefu. Isifo sesibindi esinamafutha esinganxulunyaniswa notywala sinokunyangwa ngokutshintsha indlela yokutya nendlela yokuphila. Ezinye iintlobo zezifo zesibindi azinakunyangeka, kodwa zinokulawulwa ngamayeza. Ezinye izifo ezizuzwe njengelifa, izifo ezizikhuselayo emzimbeni, kunye nosulelo lweentsholongwane zinokufuna unyango lobomi bonke.

Ndingenza ntoni xa ndinesifo sesibindi?

Ukuba unesifo sesibindi, yenza ezi zinto ukuze unyamekele isibindi sakho:

• Gcina ukutya okunempilo: Beka phambili ukutya okupheleleyo, iziqhamo nemifuno, kunye neeproteni ezingenamafutha.
• Ukugcina i-BMI esempilweni (Body Mass Index): Nxibelelana nogqirha wakho ngale nto.
• Ukuphepha utywala, icuba, kunye namayeza athengiswa ngaphandle kwemvume kagqirha: Cela ugqirha wakho akuncede uyeke.
• Sela amayeza kuphela njengoko kuyalelwe: Thetha nogqirha wakho malunga namayeza amatsha owasebenzisayo.
• Ukuzikhusela kwiintsholongwane: Thintela umthwalo ongakumbi kwisibindi ngococeko olufanelekileyo kunye neendlela zesondo ezikhuselekileyo.
• Hlala unolwazi ngeziganeko zikagqirha wakho: Fumana uhlolo rhoqo kwaye uchonge iingxaki kwangethuba.