Ingabe isibindi sakho sisengozini? Konke mayelana nesifo sokuqina kwesibindi ngamagama alula

Isibindi siyisitho esibaluleke kakhulu emzimbeni wethu, akunjalo? Sifana nefektri encane emzimbeni wethu. Kodwa lesi sibindi singaba nezifo. Ngezinye izikhathi uke wezwa izindaba ezinjengokuthi "isibindi siqinile", "isibindi sonakele". Esinye isimo esibi kangaka sibizwa ngokuthi i-cirrhosis yesibindi. Ake sixoxe ngalokhu ngemininingwane ethe xaxa namuhla, ngoba kubaluleke kakhulu ukuqaphela lokhu.

Ake siqale sibheke ukuthi iyini i-cirrhosis yesibindi.

Kalula nje, i-cirrhosis yesibindi yisimo lapho isibindi sonakaliswe isikhathi eside futhi amangqamuzana esibindi aphilile ethathelwe indawo yizicubu zesibazi . Njengoba nje isibazi sakheka esikhumbeni sethu lapho sinenxeba, uma kukhona ukuvuvukala okuqhubekayo esibindini, noma lokho esikubiza ngokuthi i-hepatitis , lesi sibazi sakheka njengoba isibindi sizama ukuzelapha. Kodwa lapho lesi sibazi sikhula, isibindi asikwazi ukusebenza kahle. Lesi yisigaba sokugcina sesibindi esihluleka kancane kancane ( ukwehluleka kwesibindi okungapheli).

Ingabe kunezigaba ezahlukene ze-cirrhosis?

Yebo, i-cirrhosis akuyona into eyenzeka ngokuzumayo. Ikhula kancane kancane, ngokuhamba kwesikhathi.

• Isigaba sokuqala (i-Compensated Cirrhosis): Kulesi sigaba, ukusebenza kwesibindi sakho kwehla kancane, kodwa umzimba wakho uyajwayela, ngakho-ke ungase ungabi nazo izimpawu ezinkulu. Ungase ungaqapheli ngisho nokuqaphela.
• Isigaba esilandelayo (i-Decompensated Cirrhosis):Njengoba ukulimala kwesibindi kukhuphuka, ukusebenza kwesibindi kwehla kakhulu. Yilapho uqala ukubona izimpawu ezicacile. Lokhu kubi kakhulu.

Kwenzekani esibindini nasemzimbeni ngenxa yesifo sokuqina kwesibindi?

Lesi silonda esibindini sivimba ukugeleza kwegazi nomoya-mpilo esibindini. Kwenzekani-ke?

• Amandla esibindi okuhlanza igazi, ukucubungula izakhamzimba, kanye nokuhlunga ubuthi ayancipha.
• Ukukhiqizwa kwe-bile kanye namaprotheni egazi abalulekile akhiqizwa yisibindi kuyancipha.
• Lesi sicubu sesilonda singacindezela imithambo yegazi engaphakathi kwesibindi. Ikakhulukazi uma imithambo ebalulekile, njengohlelo lwemithambo ye-portal, icindezelwa, isimo esibizwa ngokuthi i-portal hypertension singavela. Lokhu futhi kungumphumela onzima we-cirrhosis.

Ivame kangakanani i-cirrhosis?

I-cirrhosis yisifo esivame kakhulu. Sibhekwa njengembangela ehamba phambili yokulaliswa esibhedlela nokufa, ikakhulukazi ngemva kweminyaka ephakathi. Lokhu kungenxa yokuthi sikhula ngokushesha. Isibonelo, e-United States, cishe u-0.25% wabantu abadala kanye no-0.50% wabantu abadala abaneminyaka ephakathi kuka-45 no-54 kuthiwa bane-cirrhosis. Lesi simo asinakubukelwa phansi eSri Lanka. I-cirrhosis iyinkinga enkulu yezempilo emhlabeni jikelele.

Ziyini izimpawu ze-cirrhosis yesibindi?

Izimpawu ze-cirrhosis zincike ebunzimeni besifo. Ezigabeni zokuqala, kungase kungabi nazimpawu nhlobo. Noma kungase kube nezimpawu ezimbalwa ezingacacile ezifana nezinye izifo. Izimpawu zibonakala kakhulu njengoba ukusebenza kwesibindi kwehla. Isibonelo, kunezimpawu ezibonakala lapho inyongo ingahambi kahle futhi iqoqana kwezinye izingxenye zomzimba.

Yiziphi izimpawu zokuqala ze-cirrhosis?

Ezigabeni zokuqala, ungabona izimpawu ezifana nalezi:

• Ukucanuzela kwenhliziyo noma ukuphelelwa yisifiso sokudla .
• Ukukhathala , ukukhathala.
• I-Malaise umuzwa ojwayelekile wokungaphatheki kahle.
• Ubuhlungu esiswini esingaphezulu, ikakhulukazi ohlangothini lwesokudla.
• Ama-spider angiomas yimithambo yegazi efana ne-spider webs esikhumbeni.
• Ukubomvu kwezandla (i-palmar erythema).

Ziyini izimpawu njengoba lesi sifo siqhubeka?

Izimpawu ezibonakala njengoba i-cirrhosis iqhubeka zingahlukaniswa ngezigaba ezimbili: izimpawu ezibangelwa ukungasebenzi kahle kwesibindi kanye nezimpawu ezibangelwa umfutho wegazi ophezulu we-portal.

Izimpawu ezibangelwa ukungasebenzi kahle kwesibindi:

• Ukuphuzi kwesikhumba namehlo kubizwa ngokuthi i-jaundice.
• Isikhumba esilumayo (i-Pruritus) (ngaphandle kokuqhuma okucacile).
• Umchamo omnyama kanye nendle encane.
• Izinkinga zokugaya ukudla, ikakhulukazi ngokudla okunamafutha.
• Ukuvela kwamafutha amancane aphuzi esikhumbeni noma emaqabungeni.
• Ukwehla kwesisindo okungachazeki kanye nokulahlekelwa yimisipha.
• Imiphumela ekusebenzeni kobuchopho (i-Hepatic Encephalopathy) – njengokulahlekelwa yinkumbulo, ukudideka, kanye nokushintsha kwemizwelo.
• Ukungasebenzi kahle kwemisipha - ukudikiza, ukuthuthumela.
• Ukungahambi kahle komjikelezo wokuya esikhathini kwabesifazane.
• Ukukhula kwamabele kanye nokuncipha kwamasende kwabesilisa.

Izimpawu ezibangelwa yi-Portal Hypertension:

• Ukuqunjelwa kwesisu, ukugcinwa kwamanzi (ama-ascites).
• Ukuvuvukala kwezandla, izinyawo, imilenze kanye/noma ubuso (i-edema).
• Ukopha okulula kanye nokuklwebheka (i-coagulopathy).
• Ukuhlanza igazi noma ukuphuma kwegazi esitulweni.
• Ukwehla kokukhishwa komchamo (kungaba ngenxa yokwehluleka kwezinso okungapheli).
• Ubunzima bokuphefumula (kungaba ngenxa yokwehluleka kokuphefumula okungapheli).

Yiziphi izimbangela ze-cirrhosis yesibindi?

I-cirrhosis yisimo sokuqhekeka kancane kancane kwesibindi okubangelwa ukuvuvukala okungapheli. Noma yisiphi isifo esibangela ukuvuvukala okungapheli kwesibindi (i-hepatitis engapheli) singaholela ekuqineni kwesibindi. Ezinye zezimbangela eziyinhloko yilezi:

• I-hepatitis ebangelwa utshwala: Ukulimala kwesibindi okubangelwa ukuphuza utshwala ngokweqile isikhathi eside. Nakuba utshwala buyimbangela evame kakhulu ye-cirrhosis, kunezimbangela eziningi ezingezona utshwala.
• I-steatohepatitis engeyona eyotshwala (i-NASH): Umonakalo ongapheli obangelwa amafutha amaningi esibindini. Ubangelwa izici ze-metabolic ezifana namafutha aphezulu egazini, amazinga aphezulu kashukela egazini (njengesifo sikashukela), kanye nomfutho wegazi ophakeme.
• Ukutheleleka kwe-hepatitis C okungapheli: I-Hepatitis C igciwane elibangelwa yigciwane. Kwabaningi, iba yisifo esingamahlalakhona. Manje ingelashwa ngemithi yokulwa namagciwane. Kodwa abantu abaningi abazi ukuthi banayo.
• Ukutheleleka kwe-hepatitis B okungapheli: I-Hepatitis B nayo iyigciwane elibangelwa yigciwane. Ebantwini abambalwa, ingaba yigciwane elingapheli. Uma kunjalo, ihlala impilo yonke. Kukhona ukwelashwa, kodwa ngeke kwelapheke ngokuphelele.

Kukhona nezizathu zokuthi kungani kungavamile:

• Isifo senyongo esizivikela ngokuzenzakalelayo: Ezinye izifo ezizivikela ngokuzenzakalelayo zingabangela ukuvuvukala okungapheli kwesibindi. Izibonelo zifaka phakathi i-hepatitis ezenzakalelayo, i-cholangitis eyinhloko yenyongo, kanye ne-primary sclerosing cholangitis.
• Izifo zofuzo: Ezinye izifo ezizuzwe njengefa zingabangela ukulimala kwesibindi ngokubangela ubuthi ukuthi buqongelelane esibindini. Izibonelo zifaka phakathi isifo sokugcina i-glycogen, i-cystic fibrosis, kanye nesifo sikaWilson.
• I-hepatitis enobuthi: Ukuchayeka isikhathi eside ezintweni ezithile ezinobuthi endaweni ezungezile noma ukuqhubeka nokusebenzisa imithi ethile (ngisho nemithi yobuhlungu ethengiswa ngaphandle kwemithi kadokotela) kungalimaza isibindi.
• Isifo senhliziyo: Ukulimala kwesibindi kungabangelwa nezifo ezibangela ukuthi igazi lihlangane esibindini (njengokwehluleka kwenhliziyo okuvalekile) noma izifo ezivimbela igazi ukuthi lifinyelele esibindini (njenge-ischemia engapheli).

Ubani osengozini enkulu yalesi simo?

Ungase ube sengozini enkulu yokuthola isifo sokuqina kwesibindi uma:

• Uma uneminyaka engaphezu kwengu-50 ubudala.
• Uma unomlando wokuphuza kakhulu.
• Uma unesifo se-hepatitis esingamahlalakhona.
• Uma une -metabolic syndrome ( okungukuthi, inhlanganisela yezimo ezifana nokukhuluphala ngokweqile, umfutho wegazi ophakeme, ushukela wegazi ophezulu, kanye ne-cholesterol ephezulu).

Yiziphi izinkinga ze-cirrhosis?

Kunemiphumela eminingi emibi ebangelwa yi-cirrhosis kanye nomfutho wegazi ophezulu we-portal.

Izinkinga ezivamile:

• Ukuzizwa ugula, ukhathele, futhi unenkungu engqondweni ngenxa yobuthi obunqwabelana emzimbeni.
• Ukwehla kwamasosha omzimba, ukuphola kwenxeba okulibazisekile.
• Ukuvuvukala okubangelwa uketshezi oluphuma emithanjeni yegazi.
• Ukungalingani kwama-hormone kanye nokuntuleka kwawo.
• Izinkinga zokugaya ukudla, ukungamuncwa kahle izakhamzimba, kanye nokungondleki kahle.
• Ukukhubazeka okuncane ekusebenzeni kobuchopho kanye nezinkinga zokulawula imisipha.

Izinkinga ezinkulu ezingasongela impilo:

• Izifo zesisu kanye nokopha kwamathumbu.
• I-peritonitis yamagciwane eyenzeka ngokuzenzakalelayo.
• Ukwehluleka kwezinso (i-Hepatorenal syndrome).
• Ukwehluleka kokuphefumula (i-Hepatopulmonary syndrome).
• Ukwehluleka kwesibindi okungapheli.
• Umdlavuza wesibindi.

Itholakala kanjani i-cirrhosis yesibindi?

Udokotela uzoqala akuhlole ngokomzimba ukuze ahlole izimpawu ze-cirrhosis. Bazokubuza imibuzo mayelana nokuthi izimpawu zakho zaqala nini nokuthi zishintshile yini ngokuhamba kwesikhathi. Bazokubuza nangomlando wakho wezokwelapha, imithi, amakhambi, kanye nezithasiselo ozithathayo, ukudla kwakho, kanye nendlela yakho yokuphila. Bazobheka izimpawu zesifo sesibindi noma ukulimala kwesibindi.

Kulapho-ke kuphela lapho kuzokwenziwa khona ukuhlolwa kwezokwelapha ukuqinisekisa ukuthi i-cirrhosis ikhona yini. Lokhu kungafaka:

• Ukuhlolwa kwegazi:Ukuhlolwa kokusebenza kwesibindi kungabonisa izimpawu zesifo sesibindi kanye nokwehluleka kwesibindi. Lokhu kulinganisa izinto ezifana nama-enzyme esibindi, amaprotheni, kanye namazinga e-bilirubin. Ukuhlolwa kwegazi kungabonisa nezinto ezifana nokwehla kokujiya kwegazi.
• Ukuhlolwa kwezithombe: Ukuhlolwa okufana ne-ultrasound yesisu, i-CT scan, noma i-MRI kungabonisa usayizi, ukuma, kanye nesimo sesibindi. Ukuhlolwa okukhethekile kwezithombe okubizwa ngokuthi i-elastography kungalinganisa ukuqina noma i-fibrosis esibindini.
• Ukuhlolwa kwesibindi: Lena inqubo encane. Isampula encane yezicubu ithathwa esibindini bese ihlolwa elabhorethri. Le sampula ivame ukuthathwa kusetshenziswa inaliti engenalutho. Nakuba kungadingeki ngaso sonke isikhathi, ukuhlolwa kwesibindi kungasiza ekuqinisekiseni ukuqina kwesibindi futhi mhlawumbe kutholakale imbangela.

Ingabe isifo sokuqina kwesibindi singabuyiselwa emuva noma selapheke?

Kodwa-ke, kungenzeka ukuvimba noma ukulawula ukuqhubeka kwesifo sokuqina kwesibindi . Kuya ngokuthi yini ebangele lesi sifo, ukuthi singelashwa kahle kangakanani, nokuthi usabela kahle kangakanani ekwelashweni.

Odokotela bamelapha kanjani isifo sokuqina kwesibindi?

Ukwelashwa kwe-cirrhosis kuhlanganisa:

• Uma kungenzeka, lawula imbangela yesifo (nciphisa noma umise umonakalo).
• Izinguquko ezilula zokudla kanye nendlela yokuphila ukuze kuncishiswe ukucindezeleka esibindini.
• Ukuphatha noma ukuhlola izinkinga ze-cirrhosis.
• Njengendlela yokugcina, ukufakelwa isibindi .

Ukwelapha imbangela

Ezinye izifo zesibindi zingelashwa ngemithi. Isibonelo, ama-antiviral angelapha i-hepatitis C engapheli, kodwa angalawula kuphela (hhayi ukwelapha) i-hepatitis B engapheli. Ama-Corticosteroids kanye nama-immunosuppressants angasiza ekulawuleni ezinye izifo ezizimele.

Uma isibindi sonakaliswa utshwala noma obunye ubuthi, okuwukuphela kokwelashwa ukususa lawo ma-toxin empilweni yakho. Abanye abantu bangadinga nokuthola ukwelashwa ngezinkinga zokusebenzisa izidakamizwa. Uma isibindi sonakaliswa yizimbangela ezingezona utshwala (njenge-NASH), ukulawula izici ze-metabolic ezifana ne-cholesterol, ushukela wegazi, kanye nesisindo esiningi kungasiza.

Ukudla nendlela yokuphila

Ngisho noma isifo sakho sesibindi sibangelwa okunye, ukugwema utshwala nezidakamizwa eziyingozi esibindini kungasiza ekuvikeleni isibindi sakho isikhathi eside. Kunjalo nangalabo abacindezela umzimba. Odokotela batusa ukuthi noma ubani onesifo sesibindi adle ukudla okunempilo futhi azame ukugcina isisindo esinempilo. Abanye abantu kungadingeka bathathe izithasiselo zokudla ukuze babhekane nokuntuleka kokudla okunempilo.

Ukwelashwa kwezinkinga

Uma udokotela wakho esekutholile ukuthi une-cirrhosis, uzohlola nemiphumela emibi evamile. Umfutho wegazi ophakeme we-portal uwumphumela ovame kakhulu. Futhi unezinkinga zawo, ngayinye edinga ukwelashwa okukhethekile.

Ungadinga izinto ezifana nalezi:

• Inqubo encane yokuvala umthambo ophuma igazi.
• Ukumpontshelwa igazi ukuze kubuyiselwe inani lamaseli egazi.
• Ukuhlanza izinso.
• Ukwelashwa nge-oxygen.
• I-Paracentesis kanye nama-antibiotic ukususa uketshezi esiswini (ama-ascites).
• Ama-laxative asiza ekumunceni nasekukhipheni ubuthi ekudleni.

Umdlavuza wesibindi

I-carcinoma ye-hepatocellular ingenye inkinga eyingozi ye-cirrhosis. Akuwona wonke umuntu one-cirrhosis ozoba nomdlavuza wesibindi, kodwa abantu abaningi abathola umdlavuza wesibindi bane-cirrhosis. Uma umdlavuza uvela ne-cirrhosis, ukwelashwa komdlavuza okufana ne-radiation noma i-chemotherapy kunganikezwa. Noma, udokotela wakho anganquma ukuthi ukufakelwa isibindi kuyindlela engcono kakhulu.

Ukufakelwa Kwesibindi

Odokotela batusa ukufakelwa isibindi uma becabanga ukuthi impilo yakho izoba yimbi ngaphandle kokufakelwa. Lokhu kungaba njalo uma unesifo sesibindi esisebenzayo, umdlavuza wesibindi, kanye/noma ungasabeli ekwelashweni kwesifo sakho sesibindi. Uma ufanelekile ukufakelwa isibindi, uzofakwa ohlwini lokulinda lukazwelonke.

Ingabe isifo sokuqina kwesibindi singavinjelwa?

Isifo sesibindi singavinjelwa ukuthi singaqhubekeli ekubeni yi-cirrhosis ngokungenelela kusenesikhathi . Kuncike ekutheni uyazi yini ngaso nokuthi yiziphi izinyathelo ongazithatha ukuze usivimbele. Njengoba abantu abaningi bengenazo izimpawu ezigabeni zokuqala, singatholakala ngesikhathi sokuhlolwa kwempilo okuvamile. Lokhu kukunika ithuba lokwenza izinguquko ezibalulekile noma ukuqala ukwelashwa.

Ingabe isibindi singalulama ngemva kwe-cirrhosis?

Uma usunesifo sokuqina kwesibindi, isibindi sakho asibi ngcono. Kodwa futhi asibi kakhulu . Uma usenezimpawu (isifo sokuqina kwesibindi esikhokhelwayo), ungahlala unjalo isikhashana. Uma ungakwazi ukuyeka noma ukunciphisa ukuvuvukala okubangela isifo sokuqina kwesibindi, lesi sifo singase singadluleli esigabeni sokungakhokhelwa. Kodwa kuzodingeka unakekele isibindi sakho impilo yakho yonke.

Iyini isikhathi sokuphila uma uphila ne-cirrhosis?

Isikhathi sokuphila uma uphila ne-cirrhosis siyahlukahluka kuye ngezici eziningi:

• Ubunzima besifo (esikhokhelwayo noma esincishisiwe).
• Izinkinga onazo.
• Ukusinda kanye nempumelelo yokwelashwa.
• Impilo yakho iyonke noma ngabe unezinye izifo.

Odokotela basebenzisa izinhlelo zokuthola amaphuzu njengohlelo lwe-Child-Turcotte-Pugh (CTP) kanye ne-Model for End-Stage Liver Disease (MELD) ukuhlola isimo sakho nokunquma indawo yakho ohlwini lokulinda lokufakelwa isibindi.

Ezigabeni zokuqala ze-"compensated cirrhosis", isikhathi sokuphila singaba ngaphezu kweminyaka eyi-15. Lapho kuvela umfutho wegazi ophakeme we-portal, kunciphisa isikhathi sokuphila ngenxa yengozi yokopha kwangaphakathi. Isikhathi sokuphila esimaphakathi se-"decompensated cirrhosis" cishe siyiminyaka eyisikhombisa. Lesi sikhathi singaba sifushane nakakhulu ngenxa yezifo ezinzima, ezingelapheki kanye nezinye izinkinga. Kwabanye abantu, singaba ngaphansi kweminyaka emibili. Kodwa kubalulekile ukukhumbula ukuthi lezi zibalo azifani kuwo wonke umuntu.

Ngingazinakekela kanjani ngenkathi ngiphila nesifo sokuqina kwesibindi?

Lezi zinto zingasiza ekwandiseni impilo yesibindi sakho:

• Yidla ukudla okunempilo, okuphelele kanye namaprotheni angenawo amafutha amaningi .
• Gwema utshwala, ugwayi, kanye nemithi ethathwa ngaphandle kweseluleko sezokwelapha ngangokunokwenzeka.
• Phuza imithi kuphela njengoba kuyalelwe udokotela wakho. Khuluma nodokotela wakho nganoma yimiphi imithi oyiphuzayo.
• Ungaphuthelwa ukuhlolwa kwezokwelapha okuhleliwe kanye nokuhlolwa kwezinkinga.