Uyazazi yini izifo zesisu? Ake sixoxe ngalokhu!

Wake wezwa ngesimo esibizwa ngokuthi ama-gastric varices? Kungenzeka ukuthi uke wezwa leli gama lapho uya kudokotela ngenxa yobuhlungu besisu noma inkinga yokugaya ukudla. Kungaba yisimo esibi kakhulu, ngakho-ke kubalulekile ukwazi kahle ukuthi siyini. Ngakho-ke, namuhla sizokhuluma ngalesi simo esibizwa ngokuthi (ama-Gastric Varices) ngendlela elula, ukuze usiqonde.

Ayini ama-Gastric Varices? Masiqonde kalula!

Kalula nje, ama-Gastric Varices ayimithambo yegazi evuvukile futhi ekhulisiwe ongqimbeni lwesisu sakho. Angabukeka njengamabhaluni amancane. Lesi yisimo esibi ngoba uma le mithambo evuvukile iqhuma, ingabangela ukopha okusongela impilo esiswini sakho esingaphezulu.

Kungenzeka ukuthi uke wezwa nge-esophagus varices, okuyimithambo evuvukele emgudwini womchamo. I-gastric varices iyisimo esingavamile kakhulu. Kodwa-ke, uma i-gastric varices iphuma igazi, imvamisa iba yingozi kakhulu kune-esophagus varices.

Cabanga ngale ndlela. Isisu sakho sinenethiwekhi yemithambo yegazi emincane ethwala igazi. Ngokuvamile, igazi ligeleza ngale mithambo yegazi ngaphandle kwezinkinga. Kodwa-ke, ngezinye izikhathi ukuvaleka okukhulu kwenzeka emthanjeni wegazi oyinhloko othwala igazi liye esibindini. Lokhu kungabangelwa yisimo esibizwa ngokuthi i-cirrhosis, esibangela izibazi esibindini. Bese kuba khona "ukuxinana kwethrafikhi" okukhulu kulowo mthambo wegazi oyinhloko, okusho ukuthi ingcindezi ngaphakathi kwemithambo yegazi iyanda. Ngenxa yalokhu kucindezela okwandayo, igazi liqala ukufuna eminye imizila emincane, emifushane. Njengoba le mithambo emincane (ebizwa ngokuthi ama-varice) ezindongeni zesisu ingaklanyelwe ukuthwala inani elikhulu kangaka legazi, iyavuvukala, ikhukhumale, futhi iphume. Lesi simo sibizwa ngokuthi ama-varice esiswini. Uma lokhu kucindezela kungalawulwa, le mithambo evuvukile ingaqhuma.

Yiziphi izinhlobo eziyinhloko ze-varice yesisu?

Izifo zesisu zihlukaniswa kakhulu ngokusekelwe ekutheni zihlobene yini nomphimbo wakho noma cha.

Imithambo ye-Varicose ehlobene ne-esophagus

• Uhlobo 1 lwe-Gastroesophageal Varices (GOV1): Lolu hlobo lwe-varices luqala eduze komhubhe wakho. Bese lunwebeka "ohlangothini olungaphezulu" (ukugoba okuncane) kwesisu sakho. Cabanga ngalo njengomgwaqo oseceleni oqala lapho kuhlangana khona umhubhe bese wehla ohlangothini lwesobunxele lwesisu sakho. Lolu uhlobo oluvame kakhulu.
• Izinhlobo ze-Gastroesophageal Varices zohlobo lwesibili (GOV2): Lezi ziqala eduze komhubhe. Kodwa-ke, zinwebeka eduze "kokugoba okukhulu" kwesisu. Nakuba ziqala eduze komhubhe njengakuqala, lezi zindlela eziseceleni zihamba ohlangothini lwesokudla lwesisu.

Imithambo ye-Varicose engahlobene nomphimbo

• Uhlobo 1 Isolated Gastric Varix (IGV1):Lolu hlobo lwemithambo ye-varicose lukhawulelwe esiswini. Lutholakala engxenyeni ephezulu, eyindilinga yesisu (i-fundus).
• Uhlobo 2 Isolated Gastric Varix (IGV2): Lolu hlobo lungavuvukala noma kuphi odongeni lwesisu, hhayi nje kuphela e-fundus.

Ziyini izimpawu ze-varice yesisu?

Esikhathini esiningi, ama-varice esiswini awabangeli zimpawu. Kodwa-ke, inkinga iqala lapho eqhuma futhi eqala ukopha. Ngemuva kwalokho, izimpawu ezinzima zingavela ngokuzumayo. Ngezikhathi ezinjalo, ungase ubone izimpawu ezifana nalezi:

• Ukuhlanza igazi elibomvu elimnyama.
• Indle emnyama, ehlala isikhathi eside (lokhu kubangelwa ukuxubana kwegazi nama-asidi esiswini, okwenza indle ibe mnyama)
• Ngezinye izikhathi kuba negazi elibomvu elimnyama esitulweni.
• Ukuzizwa unesizungu.
• Ukushaya kwenhliziyo.
• Ungase ulahlekelwe ingqondo.
• Ukwehla okuzumayo komfutho wegazi.
• Isicanucanu nokuhlanza.
• Ukuqala ukushaqeka.
• Ukuzizwa ubuthakathaka kanye nokungabi nampilo.

Uma unezinye zalezi zimpawu, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha, ngoba lokhu kungaba yisimo esiphuthumayo.

Yiziphi izimbangela eziyinhloko ze-varice yesisu?

Imbangela eyinhloko ye-varice yesisu yisifo sesibindi esibizwa ngokuthi (Cirrhosis). Ku-cirrhosis, amangqamuzana esibindi ayalimala bese kufakwa izicubu zesibazi endaweni yaso. Lokhu kuvinjelwa kuvimbela ukugeleza kwegazi esibindini. Ngenxa yalokhu kuvinjelwa, ingcindezi ku-(Portal Vein) okuwumthambo oyinhloko oletha igazi esibindini, iyanda ngokweqile. Lesi simo sibizwa ngokuthi (Portal Hypertension) . Lapho ingcindezi ikhula kanje, igazi liyahlehla futhi lizame ukudlula kweminye imithambo emincane. Njengoba imithambo esodongeni lwesisu nayo iyimithambo emincane, ayikwazi ukumelana nalokhu kucindezeleka okwandayo futhi ivuvuke futhi ibe yimithambo evuvukalayo.

Ngaphezu kwe-cirrhosis, kunezinye izimbangela ezingabangela umfutho wegazi ophezulu we-portal futhi ziholele ekuguleni kwesisu:

• Ukuvaleka Kwegazi Emithanjeni Yesibeletho noma Emithanjeni Yesibeletho: Lokhu, njenge-cirrhosis, kuvimbela ukugeleza kwegazi.
• Ukutheleleka Kwama-Parasitic: Isibonelo ukutheleleka kwama-parasitic okubizwa ngokuthi i-Schistosomiasis. Lokhu kutholakala ezingxenyeni zase-Afrika, eNingizimu Melika, eCaribbean, eMpumalanga Ephakathi, naseMpumalanga Asia. Lokhu kutheleleka kungalimaza isibindi kanye ne-spleen futhi kubangele i-Portal Hypertension.
• Ezinye izimbangela ngaphandle kwe-cirrhosis: Ezimweni ezingavamile, umfutho wegazi ophakeme we-portal kanye ne-gastric varices kungenzeka ngaphandle kwe-cirrhosis. Isibonelo yisimo esibizwa ngokuthi i-Budd-Chiari syndrome, okuwukuvinjelwa kwemithambo yegazi ethwala igazi esibindini.

Yiziphi izinkinga ezingaba khona ngenxa ye-varice yesisu?

Inkinga eyingozi kakhulu yama-varice esiswini ukopha . Le mithambo yegazi evuvukele odongeni lwesisu ibucayi kakhulu. Uma ingcindezi ikhuphuka, ingaqhuma kalula. Uma lokhu kwenzeka, inani elikhulu legazi lingavuza ngokuzumayo emzimbeni, okungaba yingozi ngisho nokuphila. Ukopha okuvela kuma-varice esiswini kuyisimo esiphuthumayo sezokwelapha.

Akuvamile kakhulu ukuthi i-varicose yesisu engalashwanga ingabangela ezinye izinkinga, njenge:

• I-anemia yokuntuleka kwe-iron: Kancane kancane, ngokuhamba kwesikhathi, lapho ukulahleka kwegazi kuncipha, inani le-iron emzimbeni liyancipha, okuholela ezimpawini ezifana nokukhathala nokuphaphatheka.
• I-Hepatic encephalopathy: Lokhu kwenzeka lapho isibindi singasebenzi kahle, okubangela ukuba ubuthi buqongeleleke egazini futhi buthinte ubuchopho. Lokhu kungabangela izimo ezifana nokulahlekelwa yinkumbulo nokudideka.

Ungayithola kanjani i-varice yesisu?

I-Endoscopy kanye nezinye izivivinyo ze-imaging zisetshenziswa kakhulu ukuxilonga i-varice yesisu. Lezi zivivinyo zingafaka:

• I-Upper Endoscopy: Lena yindlela engcono kakhulu nebaluleke kakhulu yokuxilonga i-varice yesisu. Lokhu kuhilela ukufaka ipayipi elincane, eliguquguqukayo elinekhamera exhunywe emphinjeni wakho bese uhlola izindonga zangaphakathi zomhubhe wakho nesisu. Udokotela angabe esebona ukuthi kukhona yini i-varice, kanye nosayizi wayo, umbala, kanye nendawo.
• I-Abdominal CT scan: Lokhu kungakunikeza izithombe ezinemininingwane zesibindi sakho, udende, kanye nemithambo yegazi esiswini sakho. Nakuba kungenakubona ngqo imithambo evuvukele, kungakhomba izimpawu ezihlobene nesimo esithi "Portal Hypertension." Lokhu kusho ukuthi ungase ube sengozini enkulu yokuthola imithambo evuvukele.
• I-Doppler Ultrasound: Lokhu kuhlolwa kusebenzisa amaza omsindo ukuhlola iphethini yokugeleza kwegazi emthanjeni wakho we-portal kanye neminye imithambo yegazi esiswini sakho. Uma kukhona ukungahambi kahle kwephethini yokugeleza kwegazi, kungabonisa isimo esibizwa ngokuthi i-portal hypertension.

Iphathwa kanjani imithambo ye-varicose esiswini?

Ukwelashwa kwe-varice yesisu kuncike ekutheni i-varice iqhumile futhi yopha igazi, noma ayikaqhumi.

Ukwelashwa kwe-varies yesisu engakaqhekeki

Umgomo oyinhloko ukuvimbela ukuphuma kwegazi. Udokotela wakho angase akunike imithi ethile, njenge -beta-blockers engakhethi . Le mithi yehlisa umfutho wegazi emthanjeni we-portal, inciphise ingozi yokuqhuma kwemithambo yegazi ephukile.

Udokotela wakho angase futhi asikisele ezinye izinqubo ze-endoscopic, ezingavala ngqo imithambo ephukile noma zibangele ukuthi inciphe.

• I-Endoscopic Varicose Ligation (EVL): Kule nqubo, udokotela usebenzisa i-endoscope ukubeka amabhande amancane enjoloba azungeze imithambo evuvukele ye-varicose. Lokhu kuvimbela igazi ukuthi ligeleze liye emithanjeni evuvukile futhi kubangele ukuthi inciphe kancane kancane.
• Umjovo we-Endoscopic Cyanoacrylate: Kule nqubo, udokotela ufaka into ekhethekile efana neglue emthanjeni one-varicose vein. Lokhu kuvala umthambo ngaphakathi futhi kumise ukopha.

Ukwelashwa kwezifo zesisu eziphuma igazi

Lesi yisimo esiphuthumayo sezokwelapha. Ukopha kufanele kumiswe ngokushesha futhi noma yiziphi izinkinga ezingase zivele kumele zivinjelwe. Izinketho zokwelapha zifaka:

• Ukulaliswa Esibhedlela Nokumpontshelwa Igazi: Cishe uzogcinwa egunjini lokunakekelwa okujulile (ICU) futhi uqashwe ngokucophelela ngenkathi umpontshelwa igazi ukuze kubuyiselwe igazi elilahlekile.
• Ukwelashwa nge-Endoscopic: Ngaphezu kokusetshenziswa kwemithambo ye-varicose engakaqhekeki, ukwelashwa nge-endoscopic okufana ne-(EVL) noma (Cyanoacrylate Injection) nakho kuyasetshenziswa ukuvimba ukopha.
• Imithi: Imithi efana neVasopressin noma i-Octreotide ingasiza ekulawuleni ukopha ngokunciphisa ukugeleza kwegazi emithanjeni evalekile.
• Ezinye izindlela zokulawula ingcindezi:
• I-Balloon Tamponade: Kulokhu, kufakwa ibhaluni elikhethekile emhubheni wakho bese livuvukala, okubeka ingcindezi eqondile ezinhlungwini zokuphuma kwegazi. Lena indlela yesikhashana esetshenziswa ukulawula ukuphuma kwegazi.
• I-Transjugular Intrahepatic Portosystemic Shunt (AMACEBISO): Lena inqubo eyinkimbinkimbi kancane. Ihilela ukudala umzila omusha, omfushane wegazi ukuze ligeleze esibindini sakho. Lokhu kuvumela igazi ukuthi ligeleze ngqo lisuka emthanjeni we-portal liye emthanjeni oyinhloko esibindini sakho. Lokhu kuvumela igazi ukuthi lidlule ukuvaleka, kuncishiswe ingcindezi emthanjeni we-portal. Lokhu kunciphisa nengcindezi emithanjeni ye-varicose, okusiza ukulawula ukuphuma kwegazi.

Ingakanani iminyaka yokuphila komuntu onesifo sokuvaleka kwesisu?

Izinga lokusinda komuntu onesifo sokuvaleka kwesisu lincike ezintweni eziningana:

• Kungakhathaliseki ukuthi bayopha yini: Ukopha okuvela ezifweni zesisu kuyinkinga enkulu, okunciphisa kakhulu isikhathi sokuphila.
• Ubunzima besifo sesibindi esiyisisekelo: Isibikezelo ngokuvamile asisihle kulabo abanesifo sesibindi esibi kakhulu.
• Impumelelo yokwelashwa:Uma lesi sifo sitholakala kusenesikhathi futhi selashwa ngempumelelo, isikhathi sokuphila singanda kakhulu.

Uma unemibuzo noma ukungabaza mayelana ne-varic acid esiswini noma izici zayo eziyingozi, kungcono ukukhuluma nodokotela. Ngaleyo ndlela, ungathola isithombe esinembile ngesimo sakho.

Ingabe ukuvaleka kwesisu kungavinjelwa?

Kungaba nzima ukuvimbela ngokuphelele ukuvaleka kwesisu. Kodwa-ke, kunezinto ongazenza ukuze unciphise ingozi yakho, ikakhulukazi uma unesifo esibangela umfutho wegazi ophezulu we-portal. Nazi ezinye izinto ongazenza:

Lawula isimo sakho sezempilo esiyisisekelo.

Uma unesifo esifana ne-(Cirrhosis) noma (Schistosomiasis), kubalulekile ukulandela uhlelo lokwelashwa udokotela wakho akunikeza lona ngqo ukuze ulawule lesi sifo.

Imithi

Uma usuvele unemithambo ye-varicose, imithi efana ne -beta-blockers ingasiza ekunciphiseni ingozi yokopha okuvela kuyo. Kodwa-ke, le mithi ingase ingavimbeli ukwakheka kwemithambo ye-varicose emisha.

Izinguquko zendlela yokuphila

Ungenza lezi zinto ukuze unciphise ingozi yokuba nesifo sokuvaleka kwesisu:

• Gwema utshwala: Utshwala buyimbangela enkulu yokulimala kwesibindi. Bungaphinda bube bubi kakhulu umfutho wegazi ophakeme we-portal.
• Yidla ukudla okunempilo: Ukudla okunomsoco okucebile ngemifino, izithelo, ubhontshisi, kanye nokusanhlamvu okuphelele (isib. ukudla kwaseMedithera) kuhle kakhulu empilweni yesibindi sakho.
• Nciphisa usawoti: Ukudla usawoti omningi kungandisa ukugcinwa koketshezi emzimbeni futhi kubhebhethekise i-Portal Hypertension.
• Gcina isisindo esinempilo esikufanele: Isisindo esiningi sibeka ingcindezi eyengeziwe esibindini.
• Goma: Odokotela batusa ukuthi ugonyelwe i-Hepatitis A kanye ne-Hepatitis B. Lokhu kusiza ekuvikeleni isibindi.

Uma unezici eziyingozi zokuthuthukisa i-varice yesisu, kubalulekile ukukhuluma nodokotela wakho futhi uthole izivivinyo ezivamile, njenge-endoscopy, ezingabona i-varice kusenesikhathi. Ukutholwa kusenesikhathi kuvumela ukwelashwa kusenesikhathi futhi kungavimbela izinkinga ezinkulu, njengokuphuma kwegazi.

Kufanele ngimbone nini udokotela wami?

Uma usola ukuthi unesifo sokuvaleka kwesisu, ikakhulukazi uma unezimpawu ezingase zibonise ukopha, ungalibali ukubona udokotela. Funa iseluleko sezokwelapha ezimweni ezilandelayo:

• Uma utholakale unesifo esikhulisa ingozi yakho yokuba nomfutho wegazi ophakeme, njenge-cirrhosis noma i-schistosomiasis: Buza udokotela wakho ukuthi kufanele yini wenze i-endoscopy ukuze uthole imithambo ye-varicose kusenesikhathi.
• Uma unezimpawu zokuphuma kwegazi emgudwini wakho wokugaya ukudla ongaphezulu: ukuhlanza igazi, ukuphuma kwegazi esitulweni sakho, noma ukuphuma kwendle emnyama, ephuzile.
• Uma unezinhlungu zesisu noma ukuqunjelwa okungachazeki: Lokhu kungaba uphawu lwe-(Ascites) (ukunqwabelana koketshezi esiswini), okuhlotshaniswa ne-(Portal Hypertension).
• Uma unezimpawu ze-(Portal Hypertension Encephalopathy): Lokhu kusho ukudideka, ukozela, ubunzima bokugxilisa ingqondo, kanye nokuquleka.

Ukutholwa nokwelashwa kwe-varic acid kusenesikhathi kubalulekile ukuvimbela izinkinga ezinkulu, njengokuphuma kwegazi. Uma unemibuzo, ukukhathazeka, noma ukungabaza ngalokhu, ungangabazi ukukhuluma nodokotela. Uzohlola isimo sakho futhi ancome inkambo efanele kakhulu yokwenza.

Kufanele ngiye nini eMnyangweni Wezimo Eziphuthumayo (i-ETU) ?

Uma unezimpawu zokuthi ama-varice akho esisu aqhumile, iya ekamelweni lezimo eziphuthumayo eliseduze (i-ETU) ngokushesha. Ukopha okuvela kuma-varice esisu kubi kakhulu futhi kudinga ukunakekelwa kwezokwelapha okusheshayo.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Ungabuza udokotela wakho imibuzo efana nale:

• Yini engenza ngibe nesifo sokuvaleka kwesisu?
• Yiziphi izindlela zokwelapha izifo zami zesisu?
• Ziyini izingozi nemiphumela emibi yokwelashwa?
• Yini engingayenza ukuze ngivimbele imithambo yami evuvukele ukuthi ingaphumi?
• Yiziphi izinguquko zendlela yokuphila engingayenza ukuze ngithuthukise impilo yesibindi sami?
• Kukangaki ngidinga ukuqapha imithambo yami ye-varicose?
• Iyini inhloso yesikhathi eside kumuntu onesifo sokuvaleka kwesisu?

Ekugcineni, umyalezo okufanele uwuthathe uye nawo ekhaya

Ama-varice esisu angaba yinto eyesabekayo ukuyizwa. Kodwa-ke, ngokunakekelwa okufanele kwezokwelapha kanye nokutholwa kusenesikhathi, abantu abaningi abanalesi simo bangaphila impilo egcwele, esebenzayo. Into ebaluleke kakhulu ukuqaphela kusenesikhathi. Usuvele uthathe leso sinyathelo esibalulekile ngokufunda lesi sihloko. Kunezindlela zokwelapha ezisebenzayo zalesi simo, futhi udokotela wakho angasebenzisana nawe ukuthuthukisa uhlelo olungcono kakhulu lokuphatha ama-varice akho nokunciphisa ingozi yokopha.

Khumbula, awuwedwa kulolu hambo. Ngokunakekelwa kwezokwelapha okuqhubekayo, ungalawula lesi simo futhi uqiniseke ngempilo yakho. Ungesabi, thola ulwazi, futhi uthole ukwelashwa okufanele. Khona-ke nawe ungahlala uphilile!

Izifo zesisu , izifo zesisu, i-cirrhosis, isifo sesibindi, i-hematemesis, i-endoscopy, umfutho wegazi ophakeme we-portal