Abanye abantu abanezinkinga zesibindi bangase baqale ngokuzumayo ukuphuma kwegazi emlonyeni, noma bangase babone igazi endle yabo. Uma lokhu kwenzeka, awukwazi ngempela ukucabanga ukuthi kwenzekani. Esinye sezizathu eziyinhloko zalesi simo ukuthi imithambo yegazi emhubheni wakho, ipayipi okuhamba ngalo ukudla, iyavuvukala futhi iqhume, okubangela ukopha . Kufana nemithambo evuvukalayo emilenzeni yakho, kodwa lokhu kwenzeka emzimbeni wakho. Namuhla sizokhuluma ngalesi simo, esaziwa ngokwezokwelapha ngokuthi ama-Esophageal Varices. Ungakhathazeki, masikwenze kube lula.
Ziyini lezi (ama-Esophageal Varices)? Kalula nje…
Cabanga nje, umphimbo wakho uyipayipi elithwala ukudla kusuka emlonyeni wakho liye esiswini sakho. Ngaphakathi kwaleli payipi kunenethiwekhi yemithambo yegazi emincane. Uma ngesizathu esithile, le mithambo yegazi ingaphansi kwengcindezi enkulu, iyavuvukala kancane kancane bese iqala ukukhula. Lokhu kubizwa ngokuthi ama-esophageal varices.
Into eyingozi kakhulu ngalokhu ukuthi izindonga zale mithambo evuvukele zibuthakathaka kakhulu. Njengebhaluni eligcwele kakhulu. Ngakho-ke, zingaqhuma kalula futhi zophe igazi . Lokhu kuphuma kwegazi emzimbeni kungaba ngokuzumayo, kube nzima, futhi kungaba yingozi empilweni.
Kuyingozi kangakanani (ama-Esophageal Varices)?
Ingozi enkulu nembi kakhulu yalesi simo ukopha . Nakuba kungebona bonke abantu abaphuma igazi, cishe abantu abangu-50% abanalesi simo bangopha igazi. Njengoba kushiwo ngaphambili, le ngozi iyanda njengoba ingcindezi emthanjeni wegazi oyinhloko odlula esibindini, okungukuthi, (i-Portal Hypertension), iyanda. Ezimweni eziningi, lesi simo (i-Portal Hypertension) sibangelwa yisifo esingamahlalakhona sesibindi. Ngakho-ke, njengoba isifo sesibindi siba sibi kakhulu, lesi simo naso siba sibi kakhulu.
Abantu abanezibindi ezigula kakhulu, okusho ukuthi i-cirrhosis, bangase babe nezinye izinkinga ngaphandle kwe-varices yomphimbo.Kodwa-ke, isizathu esiyinhloko sokuthi abantu abane-cirrhosis bangeniswe esibhedlela futhi bafe ukuthi le mithambo evuvukele iyaqhuma futhi yophe. Uma kwenzeka lolu hlobo lokopha, ingozi yokufa icishe ibe ngu-20%. Futhi, ngemva kokopha kanye, ingozi yokopha futhi iphakeme.
Ziyini izimpawu ze-(Esophageal Varices)?
Le mithambo evuvukile ayibonakali njengoba injalo emilenzeni. Itholakala ngaphakathi kwesifuba, ngokuvamile lapho umphimbo uxhumana khona nesisu. Awuzizwa uma ugwinya. Ngokuvamile azibangeli zimpawu kuze kube yilapho ziphuma igazi.
Kodwa-ke, uma udokotela wakho ebona ezinye izimpawu ezibonisa umfutho wegazi ophakeme we-portal noma isifo sesibindi esingamahlalakhona, angase asole nokuvaleka komphimbo. Izimpawu ezinjalo zifaka:
- I-Jaundice : Ukuphuzi kwesikhumba namehlo.
- Ama-Ascites : Ukuqongelela koketshezi esiswini.
- Ukuvuvukala : Ukuvuvukala kwemilenze namaqakala.
- Ubuhlungu besisu esingaphezulu : Ubuhlungu bungabangelwa ukuvuvukala kwesibindi noma i-spleen .
- Ukukhwehlela : Ukuluma kwesikhumba ngaphandle kokulimala.
- Ukudideka (i-Hepatic Encephalopathy) : Ukungakwazi ukugxilisa ingqondo, ukulahlekelwa ukwazi.
Izimpawu zokuphuma kwegazi
Uma umthambo ovuvukile uqhuma ngokuzumayo bese uqala ukopha, ungase ungazizwa ubuhlungu obusheshayo. Kodwa-ke, kufanele uqaphele lezi zimpawu ezilandelayo zokopha okuvela emgudwini wokugaya ukudla noma emzimbeni :
| Izimpawu zokuphuma kwegazi | Yile ndlela okwenzeka ngayo… |
|---|---|
| Ukuhlanza igazi emlonyeni | Uma uhlanza igazi, ungase uhlanze igazi eliqhekekile futhi elibukeka njengekhofi. Kodwa uma umthambo uqhuma ngokuzumayo, ungase uhlanze igazi elisha, elibomvu. |
| Igazi esitulweni | Uma igazi elivela emlonyeni ligaywa futhi liphuma nendle, liphenduka umbala ophuzi noma omnyama (melena). Kodwa-ke, uma ukuphuma kwegazi kushesha kakhulu, igazi elisha elibomvu lingaphuma nendle. |
| Ezinye izici zomzimba | Uma kulahleka igazi eliningi emzimbeni, ubuso bungase bube mhlophe, futhi ungase uzizwe ukhathele kakhulu futhi ungenampilo. Umfutho wegazi ophansi ungabangela nesiyezi. |
Okubalulekile: Izimpawu Zesimo Esiphuthumayo (Ukushaqeka Okubangelwa Yi-Hypovolemic)
Uma ngokuzumayo uba nezimpawu zesimo esiyingozi esibizwa ngokuthi i-hypovolemic shock, iya ku-ETU ngokushesha! Lezi zimpawu yilezi:
- Ukushaya kwenhliziyo
- Isilinganiso sokuphefumula esikhulayo
- Ukuzizwa ubanda futhi ujuluka
- Ukungaphumuli nokudideka
- Ukulahlekelwa ingqondo
Yiziphi izimbangela ze-varices yomphimbo?
Imbangela eyinhloko yalesi simo yisimo esibizwa ngokuthi i-Portal Hypertension , okuyingcindezi ephezulu yegazi emthanjeni wegazi oyinhloko odlula esibindini (i-portal vein) kanye neminye imithambo ehlukana nayo.
Imizimba yethu izama ukuzivumelanisa nalokhu kucindezela okwandayo ngokuqondisa igazi elengeziwe emithanjeni emincane engakwazi ukuyiphatha. Kulawa, imithambo ethambile endunu yileyo evuvukala kakhulu.
Izimbangela eziyinhloko zomfutho wegazi ophezulu we-portal
Imbangela eyinhloko yalokhu yi-cirrhosis, okuwukuqina kwesibindi . Lokhu kubangelwa ukulimala kwesibindi isikhathi eside. Amaseli esibindi ayalimala njalo ( i-hepatitis ), futhi ekugcineni aba yizicubu zesilonda. Lokhu kusilonda kuvimbela ukugeleza kwegazi esibindini. Lokhu akwenzeki konke ngesikhathi esisodwa, kodwa kwenzeka eminyakeni eminingi.
I-cirrhosis yisigaba sokugcina sanoma yisiphi isifo sesibindi esingamahlalakhona. Isibonelo:
- I-hepatitis ebangelwa utshwala
- I-steatohepatitis engeyona eyotshwala (i-NASH)
- I-hepatitis ebangelwa yigciwane engapheli (njenge-B, C)
- I-hepatitis yokuzivikela komzimba
Kunezinye izimbangela ezingaba khona ze-Portal Hypertension:
- Ama-granuloma esibindini : Lawa amaqoqo amangqamuzana okuvuvukala ayenzeka ngezifo ezahlukahlukene kanye nezimo zokuvuvukala. Imbangela eyinhloko yalokhu ukutheleleka okubangelwa yi-parasitic okubizwa ngokuthi i-Schistosomiasis, okuthinta abantu ababalelwa ezigidini ezingu-230 emhlabeni jikelele.
- I-Thrombosis: Uma kwenzeka ihlule legazi ohlelweni lwemithambo yegazi oluxhunywe esibindini, ukugeleza kwegazi kungavimbeka (isib. i-Budd-Chiari syndrome).
- Ukwandiswa kwe-spleen .
- Isifo senhliziyo : njengokuhluleka kwenhliziyo ohlangothini lwesokudla.
(I-Esophageal Varices) Ukuxilongwa Nokwelashwa
Ngeke wazi ngalokhu kuze kube yilapho udokotela ekuxilonga. Uma usuvele utholakale une-cirrhosis, udokotela wakho uvame ukuncoma ukuthi kuhlolwe lokhu kuvuvukala kwemithambo yegazi. Ukuhlolwa okuyinhloko okusetshenziselwa lokhu yi -endoscopy ephezulu .
Kuyini (i-Upper Endoscopy)?
I-Upper Endoscopy , eyaziwa nangokuthi ukuhlolwa kwe-EGD, ukuhlolwa kwendlela yakho yokugaya ukudla engaphezulu, okuhlanganisa umphimbo wakho, isisu, kanye nokuqala kwamathumbu akho amancane (i-duodenum). Lokhu kwenziwa udokotela wezifo zamathumbu, udokotela ogxile ezifweni zesimiso sokugaya ukudla kanye nezinqubo ze-endoscopy. I-endoscope iyipayipi elide, elincane elinekhamera encane ekugcineni. Ipayipi lifakwa ngomlomo wakho bese lidluliselwa emphinjeni wakho ukuze libheke ngqo noma yikuphi ukuvuvukala. Uma kutholakala izinkinga, amathuluzi amancane angafakwa nge-endoscope ukuze abelaphe.
Yiziphi izindlela zokwelapha (ama-Esophageal Varices)?
Imigomo eyinhloko yokwelashwa ukulawula ukopha kwamanje, ukuvimbela ukopha esikhathini esizayo, futhi, uma kungenzeka, ukunciphisa umfutho wegazi ophakeme we-portal.
| Indlela yokwelapha | Kwenzekani kuyo? |
|---|---|
| Imithi | Odokotela banikeza imithi efakwa emthanjeni efana ne-Octreotide ukuze kwehliswe umfutho wegazi. Kukhona nemithi efana ne-Beta-blockers ongayisebenzisa ukuze umise ukopha. |
| Ukubopha ibhande le -Varicose | Lapho nje i-endoscope ifakiwe, kufakwa ibhande elincane lerabha elizungeze umthambo ophuma igazi, noma umthambo okusolwa ukuthi uphuma igazi, bese liqiniswa. Lokhu kumisa ukuphuma kwegazi. |
| Izinqubo Zokushushumbisa | Lokhu kuyinkimbinkimbi kancane. Kunezindlela ezimbili, i-TIPS kanye ne-DSRS. Lokhu kuhilela ukudala umzila omusha wegazi ukuze lidlule isibindi. Kungaba ngokuhlinzwa noma nge-X-ray, umthambo osesibindini uxhunywe komunye umthambo ukuze kuncishiswe ingcindezi. |
| Ukwelapha imbangela eyisisekelo | Into ebaluleke kakhulu ukwelapha imbangela eyinhloko. Lokho kusho ukuyeka ukuphuza utshwala, ukwehlisa isisindo, noma ukuthatha imithi yesimo esingaphansi njenge-hepatitis C. |
Ukuphila nalesi simo
Umbono wakho uncike ekutheni unesifo sokopha emithanjeni yakho nokuthi isifo sakho sesibindi sibi kangakanani. Izinga lokusinda konyaka owodwa kubantu abane-cirrhosis nokopha licishe libe ngu-50%. Ingozi yokufa ngenxa yokopha kokuqala ingu-20%, kanti ingozi yokopha okwesibili, ngisho noma ukwelashwa kungenziwa, ifinyelela ku-60%.
Izifo ze-Esophageal Varices ziyisimo esibi kakhulu. Kodwa-ke, uma isifo sesibindi sitholakala kusenesikhathi, kungenziwa izinguquko endleleni yokuphila ukuze kuvinjelwe lesi sifo ukuthi singabi sibi kakhulu, futhi le mithambo ingavinjelwa ekuvuvukeni.
Umlayezo Wokuya Nawe Ekhaya
- Izifo ze-esophageal zivame ukuba umphumela womfutho wegazi ophakeme we-portal, isimo esibangelwa yi-liver cirrhosis .
- Ingozi enkulu yalokhu ukuthi kungenzeka ukuthi umthambo wegazi uqhume futhi wophe igazi . Lokhu kungaba yingozi empilweni.
- Ngisho noma ungakhombisi zimpawu ezinkulu ekuqaleni, uma uhlangabezana nezimpawu ezifana nokopha emlonyeni, indle emnyama, ukuphuzi kwesikhumba, noma isisu esivuvukile, bheka udokotela wakho ngokushesha .
- Lokhu kutholakala ngokunembile futhi ezinye izindlela zokwelapha zenziwa ngokuhlolwa okubizwa ngokuthi i-endoscopy.
- Kukhona ukwelashwa, kodwa into ebaluleke kakhulu ukugwema izinto ezilimaza isibindi (utshwala, ukudla okuthile okungenampilo) nokulandela iseluleko sezokwelapha ngqo .
- Uma unesifo sesibindi, kubaluleke kakhulu ukwenza izivivinyo zezokwelapha njalo ukuze kuhlolwe izinkinga ezinjengalezi .
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