Ake sifunde kabanzi ngesifo sesibindi! Ake sixoxe ngalokhu!

Isibindi siyisitho esibaluleke kakhulu emzimbeni wakho. Sisebenza njengesihlungi emzimbeni wethu. Sihlunga futhi sisuse ubuthi egazini. Kodwa, kunomkhawulo kulokho lesi sihlungi esingakuphatha, akunjalo? Ngezinye izikhathi, lo msebenzi ungalimaza isibindi . Ngakho-ke namuhla, ake sixoxe ngezifo zesibindi .

Kuyini Isifo Sesibindi?

Uma sithi 'isifo sesibindi', odokotela bavame ukukhuluma ngezimo ezilimaza isibindi kancane kancane, ngokuhamba kwesikhathi, noma ezingamahlalakhona . Lokhu kungabangelwa ukutheleleka ngamagciwane , ubuthi obuhlukahlukene, noma izimo ezithile ze-metabolic. Into emangalisayo ukuthi isibindi sinekhono elimangalisayo lokuzilungisa. Kodwa uma sisetshenziswa njalo, lelo khono liyancipha kancane kancane.

Yiziphi izigaba zesifo sesibindi esingamahlalakhona?

Ngokuvamile kunezigaba ezine eziyinhloko zesifo sesibindi eseziqhubeke isikhathi eside. Ake sibheke ukuthi ziyini.

Isigaba 1: I-Hepatitis

Isigaba sokuqala yi-hepatitis. Kalula nje, lokhu ukuvuvukala kwezicubu zesibindi. Njengoba nje lapho silimala endaweni ethile, siyavuvukala, lapho isibindi sonakele noma sinobuthi, lokhu kuvuvukala kwenzeka ngenxa yalokho. Lokhu kwenzeka ukuze kuqedwe ukutheleleka futhi kuqale inqubo yokuphulukiswa. Lokhu kungaxazululwa ngokuvuvukala okungazelelwe, kwesikhashana (i-hepatitis ebukhali). Kodwa uma kukhona umonakalo oqhubekayo noma ubuthi, ukuvuvukala kuyaqhubeka. Ngenxa yalesi simo sesikhathi eside se-hepatitis (i-hepatitis engapheli) , njengoba isibindi sizama ukuzelapha ngokuhamba kwesikhathi, ekugcineni kuqala ukwakheka izibazi (i-fibrosis).

Isigaba 2: I-Fibrosis

Isigaba sesibili yi-fibrosis. Lokhu yilapho izicubu zesibazi ziqoqana kancane kancane esibindini, okwenza siqine futhi siqine. Kufana nendwangu endala. Lezi zicubu zesibazi zinciphisa ukugeleza kwegazi esibindini, okusho ukuthi umoya-mpilo omncane kanye nezakhamzimba ezilethwa esibindini. Yile ndlela isibindi esiqala ngayo ukulahlekelwa ukusebenza kancane kancane. Ngokumangalisayo, ezinye zalezi zicubu zingaguqulwa. Okusho ukuthi, uma umonakalo uncishisiwe ngokwanele, amangqamuzana esibindi angaphinde avuseleleke futhi izicubu zesibazi zingancishiswa.

Isigaba 3: I-Cirrhosis

Isigaba sesithathu yi-cirrhosis, okuyizibazi ezinzima, ezingenakuguqulwa, ezihlala njalo esibindini.Yilapho i-fibrosis iba khona engalungiseki. Lapho isibindi silahlekelwa amaseli anele anempilo ukuze sisebenze, izicubu azikwazi ukuphinda zisebenze. Kodwa-ke, ngisho nakulesi sigaba, kunezindlela zokumisa noma zokunciphisa umonakalo. Njengoba i-cirrhosis iqala ukuthinta ukusebenza kwesibindi, ungase ungaboni umehluko omkhulu ekuqaleni, njengoba umzimba wakho uzama ukubuyisa ukulahlekelwa.

Isigaba 4: Ukwehluleka kwesibindi

Isigaba sokugcina, noma sesine, ukwehluleka kwesibindi. Lokhu yilapho isibindi singasakwazi ukusebenza ukuze sihlangabezane nezidingo zomzimba. Lokhu kubizwa nangokuthi i-decompensated cirrhosis – okusho ukuthi umzimba awusakwazi ukukhokha ukulahlekelwa kwesibindi. Njengoba imisebenzi yesibindi iwohloka kancane kancane, uqala ukuzwa imiphumela emzimbeni wakho wonke. Ukwehluleka kwesibindi okungapheli kuyinqubo eyenzeka kancane kancane, kodwa ngaphandle kokufakelwa isibindi, kungagcina kuholele ekufeni. Khumbula, sidinga isibindi ukuze sisinde.

Zivame kangakanani izifo zesibindi?

Uma sikhuluma ngendlela lesi sifo sesibindi esivame ngayo, sibangela ukufa kwabantu ababalelwa ezigidini ezimbili ngonyaka emhlabeni jikelele. Lokho cishe kungama-4% abo bonke abantu abafayo. Ukufa okuningi kubangelwa izinkinga ze-cirrhosis. Amadoda cishe aphindwe kabili amathuba okuthola lesi sifo kunabesifazane.

Yiziphi izimpawu zokuqala zesifo sesibindi?

Esikhathini esiningi, lezi zifo zesibindi ezingamahlalakhona azibonisi zimpawu ezinkulu ezigabeni zokuqala. Kodwa ngezinye izikhathi, zingaqala njenge-hepatitis ephuthumayo nengazelelwe. Isibonelo, uma unegciwane le-hepatitis elibangelwa yigciwane, kuba nesigaba esiphuthumayo ngaphambi kokuba libe elingamahlalakhona. Phakathi naleso sikhathi, ungase ube nomkhuhlane, ubuhlungu besisu, kanye nesicanucanu izinsuku ezimbalwa. Uma amasosha omzimba engakwazi ukulwa naleli gciwane, liba yigciwane elingamahlalakhona.

Ezinye izimbangela zesifo sesibindi nazo zingabangela izimpawu ezisheshayo ezifana nalezi ekuqaleni. Izimpawu zokuqala zesifo sesibindi ngokuvamile azibonakali kahle. Zingafaka:

• Ubuhlungu besisu esingaphezulu.
• Isicanucanu nomaUkudla akunambitheki .
• Ukukhathala kanye nokungaphatheki kahle (ukuzizwa ukhathele futhi ungaphilile kahle).

Yiziphi izimpawu zesifo sesibindi ezifika sekwephuzile?

Njengoba isibindi sakho siqala ukusebenza kancane, ungase uqale ukuqaphela izimpawu ezengeziwe. Lokhu kwenzeka lapho isifo sesibindi sesisesigabeni saso esiphambili kakhulu. Omunye wemiphumela emibi yokuqala yokwehluleka kwesibindi ukuthi ukugeleza kwenyongo kuyavaleka. Isibindi asisakwazi ukwenza inyongo kahle noma ukuyipompa emathunjini amancane. Esikhundleni salokho, inyongo iqala ukuvuza egazini. Lokhu kungabangela izimpawu eziningana ezithile:

• I-jaundice (ukuphuzi kwamhlophe kwamehlo nesikhumba).
• Umchamo omnyama .
• Ukudlula esitulweni esinombala okhanyayo .
• Ubunzima bokugaya ukudla, ikakhulukazi ukudla okunamafutha.
• Ukwehlisa isisindo kanye nokulahlekelwa yimisipha.
• Umoya onuka kabi.
• Ukukhubazeka okuncane kokusebenza kobuchopho (i-hepatic encephalopathy).
• Ukukhwehlela (ukuluma nje ngaphandle kokuqhuma esikhumbeni).

Njengoba isifo sesibindi siba sibi kakhulu, singathinta ukujikeleza kwegazi lakho, ama-hormone, kanye nesimo sokudla okunempilo. Lokhu kungabonakala ngezindlela ezahlukene. Ungase ubone izimpawu ezinjengalezi esikhumbeni sakho nasezinzipho:

• Izipikili ezifakwe isipuni.
• Izinzipho zikaTerry (izinzipho ziphaphathekile, zineziqongo ezipinki kuphela).
• Ukubopha izinzipho kuwukuvuvukala nokugoba kwesisekelo sezinzipho.
• I-spider angiomas.
• Amachashazi amancane abomvu esikhumbeni ``(petechiae)``.
• Amafutha aphuzi ahlala esikhumbeni noma emajwabu amehlo, abonakala njengamaqhubu amancane.
• Ukuphuka kalula nokopha .
• Ukubomvu kwezintende zezandla.

Ungase ubone nezimpawu zokuvuza koketshezi emithanjeni yegazi bese lunqwabelana ezingxenyeni ezahlukene zomzimba:

• Ukuvuvukala kwesisu (ama-ascites).
• Ukuvuvukala kwamaqakala, imilenze, izandla, nobuso (i-edema).

Izici eziqondene nobulili

Abesifazane bangase babe nezimpawu ezifana nalezi ngenxa yesifo sesibindi:

• Imijikelezo yokuya esikhathini engajwayelekile.
• Ubunzima bokuthola abantwana (Ukungazali kwabesifazane).

Amadoda angase abe nezimpawu ezifana nalezi:

• Amasende anciphile.
• Izicubu zesifuba sowesilisa ezikhulisiwe.

Izinkinga zesifo sesibindi sesigaba sokugcina

Isifo sesibindi sesigaba sokugcina yisimo lapho isibindi singakwazi ukuzilungisa futhi kancane kancane siba yisifo esingasebenzi kahle, esibizwa ngokuthi i-decompensated cirrhosis kanye nokwehluleka kwesibindi. Imiphumela emibi emibili emibi kakhulu kulesi sigaba yi -portal hypertension kanye ne-hepatocellular carcinoma . Izinkinga zalezi zimo ezimbili ziyimbangela ehamba phambili yokulaliswa esibhedlela kanye nokufa kubantu abane-cirrhosis kanye nokwehluleka kwesibindi.

Umfutho wegazi ophezulu we-portal

Umfutho wegazi ophezulu we-portal ubangelwa ukusha kwesibindi, okubangela ukucindezeleka emthanjeni we-portal. Lapho ukucindezeleka emthanjeni we-portal kukhuphuka, umzimba udlulisela igazi kweminye imithambo exhunywe kuwo. Imithambo ibe isikhula, inwebeke, futhi ibe mncane. Le mithambo ingavuza, iqhume, noma iphume igazi. Lokhu kuphuma kwegazi kwangaphakathi kungaba ngokuzumayo, kube kubi, futhi kusongela impilo.

Nakuba kungavamile, ezinye izinkinga zingase zibe khona:

• Ukwanda nokusebenza ngokweqile kwe-spleen (hypersplenism).
• Ukungasebenzi kahle kwesistimu yokuphefumula `(i-hepatopulmonary syndrome)`.
• Ukwehluleka kwezinso (i-hepatorenal syndrome).

Umdlavuza Wesibindi

Nakuba kungebona bonke abantu abanesifo sesibindi sesikhathi eside abazoba ne-hepatocellular carcinoma, abantu abaningi abathola umdlavuza wesibindi banesifo sesibindi sesikhathi eside. Umjikelezo wokuvuvukala, ukuphulukiswa, kanye nezibazi wenza kube lula ukuthi amangqamuzana esibindi ashintshe abe nomdlavuza. Odokotela bacabanga ukuthi amagciwane e-hepatitis angapheli, ikakhulukazi, angathinta ne-DNA yamangqamuzana esibindi.

Yiziphi izimbangela zesifo sesibindi?

Kunezinhlobo zezifo zesibindi ezingaphezu kwe-100, kodwa ziwela emaqenjini amancane amaningana amakhulu. Izimbangela zifaka:

• Ukutheleleka ngegciwane: Ukutheleleka ngegciwane kwesikhathi eside njenge-hepatitis B kanye ne-hepatitis C kungabangela i-hepatitis engamahlalakhona.
• I-hepatitis ebangelwa utshwala: Ukuphuza utshwala ngokweqile kungabangela i-hepatitis ebukhali noma engamahlalakhona. Uma lokhu kuqhubeka, kungaholela ekuqineni kwesibindi kanye nokwehluleka kwesibindi. Lena imbangela evamile ezweni lethu.
• I-hepatitis enobuthi: I-hepatitis ebukhali noma engamahlalakhona ingabangelwa ukuchayeka isikhathi eside ezintweni ezinobuthi, njengamakhemikhali ezimboni noma izidakamizwa.
• Isifo sesibindi esinamafutha angenalo utshwala (i-NAFLD): Izimo ze-metabolic ezihlobene nokukhuluphala, amazinga aphezulu kashukela egazini, kanye namazinga aphezulu e-lipid (amafutha) egazini kungabangela ukwakheka kwamafutha amaningi esibindini. Lokhu kungaholela ekuvuvukeni (i-steatohepatitis engahlobene notshwala - i-NASH). Lesi simo siyabonakala nakubantu abaningi kulezi zinsuku, ikakhulukazi ngenxa yemikhuba yokudla engafanele.
• Ukuma kwenyongo: Ezinye izimo zokuzalwa, njenge-biliary atresia kanye ne-cystic fibrosis, zingabangela ukuthi inyongo iqoqeke futhi yonakalise isibindi ngokuvimbela noma ukuvimba ukugeleza kwenyongo ngemibhobho yenyongo. Izimbangela ezenzeka ngemva kokuzalwa zifaka phakathi ukuqina kwenyongo kanye namatshe enyongo.
• Izifo ezihlasela umzimba: Izimo ezihlasela umzimba njenge-autoimmune hepatitis, i-primary biliary cholangitis, kanye ne-primary sclerosing cholangitis zingabangela ukuvuvukala isikhathi eside kanye nezibazi zesibindi noma i-bile ducts.
• Izinkinga ze-metabolic ezizuzwe njengefa: Izinkinga ezibangela ubuthi ukuba buqoqeke egazini, njengesifo sokugcina i-glycogen (GSD), isifo seWilson, i-hemochromatosis, kanye nesifo seGaucher, zingabangela umonakalo wesikhathi eside esibindini.
• Izifo zenhliziyo nemithambo yegazi: Izimo ezithinta isibindi nokugeleza kwegazi kuso, njenge-Budd-Chiari syndrome, i-ischemia, isifo semithambo yegazi yenhliziyo, kanye nokwehluleka kwenhliziyo ohlangothini lwesokudla, zingabangela umonakalo wesikhathi eside esibindini.

Yiziphi izici eziyingozi zesifo sesibindi?

Ungase ube namathuba amaningi okuthola isifo sesibindi uma:

• Uma uphuza utshwala obuningi kakhulu.
• Uma uphuza izidakamizwa ngomthambo, zibizwa ngokuthi "izidakamizwa ezifakwa emthanjeni".
• Uma usebenzisa njalo imithi yokubulala izinhlungu njenge-aspirin noma i-paracetamol (ikakhulukazi uma usebenzisa imithamo ephezulu ngaphandle kweseluleko sikadokotela).
• Uma une-metabolic syndrome (inhlanganisela yokukhuluphala ngokweqile, umfutho wegazi ophakeme, ushukela wegazi ophezulu, kanye namazinga e-cholesterol angenampilo).
• Uma uvame ukuchayeka kumakhemikhali anobuthi.
• Uma uvame ukuchayeka egazini noma emanzini omzimba abanye (isib. abasebenzi bezempilo, abadwebi bemidwebo).

Ungasithola kanjani isifo sesibindi?

Udokotela ohlola isifo sesibindi uzokuhlola ngokomzimba kuqala. Uzobheka izimpawu bese ebuza ngezimpawu zakho. Bangase futhi bakubuze ngokudla kwakho, indlela ophila ngayo, kanye nomlando wezempilo. Ngemuva kwalokho, bazosebenzisa izivivinyo zelebhu kanye nezikrini zezithombe ukuze bathole ukuthi unesifo sesibindi yini. Lokhu kungafaka:

• Ukuhlolwa kwegazi: Uchungechunge lokuhlolwa kokusebenza kwesibindi lungabonisa izimpawu zesifo sesibindi, ubukhali besifo, kanye nezimpawu zokwehluleka kwesibindi. Lokhu kulinganisa izinto ezifana nama-enzyme esibindi, amaprotheni, kanye namazinga e-bilirubin. Ukuhlolwa kwegazi kungabonisa nemiphumela emibi njengokuvuvukala, izifo ezithile, noma ukwehla kokujiya kwegazi.
• Ukuhlolwa kwezithombe: I-ultrasound yesisu, i-CT scan (i-computed tomography scan), noma i-MRI (i-magnetic resonance imaging) scan ingabonisa usayizi, ukuma, kanye nesimo sesibindi. Lokhu kungasiza ekutholeni ukuvuvukala, amaqhubu, kanye ne-fibrosis.
• I-Elastography: Lolu uhlobo lokuhlola olukhethekile olusebenzisa ubuchwepheshe be-ultrasound noma be-MRI ukukala ukuqina, noma izinga le-fibrosis, yesibindi.
• I-Endoscopy:Uma udokotela wakho efuna ukubheka ngaphakathi kwesistimu yakho ye-bile duct, kuzodingeka asebenzise inqubo yokuthwebula izithombe ebizwa ngokuthi i-endoscopy. Lokhu kuhilela ukufaka ikhamera encane (i-endoscope) ngomlomo wakho bese uyidlulisela emgudwini wakho wokugaya ukudla. Ama-bile ducts angabukwa kusetshenziswa i-EUS (endoscopic ultrasound) noma i-ERCP (endoscopic retrograde cholangiopancreatography).
• Ukuthwebula izithombe ngemithi yenuzi: Lokhu kuhilela ukufaka into eyingozi ekhipha imisebe emzimbeni nokusebenzisa ikhamera ye-gamma ukuze uyithole. Kuye ngokuthi isibindi sakho simunca kanjani into, singabonisa ukuthi ayisebenzi kahle kuphi.
• Ukuhlolwa kwesibindi: Lena inqubo encane. Isampula encane yezicubu ithathwa esibindini bese ihlolwa elabhorethri. Le sampula ivame ukuthathwa kusetshenziswa inaliti engenalutho. Ukuhlolwa kwesibindi kungenziwa ukuze kuhlolwe umdlavuza, kuqinisekiswe ukuqina kwesibindi, futhi kutholakale imbangela.

Izifo zesibindi zelashwa kanjani?

Ezinye izinhlobo zesifo sesibindi zinezindlela ezithile zokwelapha. Isibonelo, ama-antiviral anikezwa i-hepatitis ebangelwa yigciwane, kanti ama-corticosteroids kanye nama-immunosuppressants anikezwa izifo ezizimele. Kodwa ezimweni eziningi, izinguquko zendlela yokuphila yizona zindlela eziyinhloko zokwelapha isifo sesibindi. Ukunciphisa inani lobuthi obungena esibindini kubalulekile kunoma yisiphi isifo sesibindi. Lokhu kubaluleke kakhulu esifweni sesibindi esibangelwa amafutha amaningi, utshwala, noma obunye ubuthi.

Kodwa-ke, ukutholwa kusenesikhathi kubalulekile ukuze welaphe isifo sesibindi ngempumelelo ngaphambi kokuba kwenzeke umonakalo ohlala njalo. Ngeshwa, akuwona wonke umuntu otholakala ngesikhathi lapho lesi sifo sesiphinde sibuyele esimweni saso. Uma usuvele une-cirrhosis noma ukwehluleka kwesibindi, ungadinga ukwelashwa okwengeziwe kwezinkinga ezifana nomfutho wegazi ophakeme noma umdlavuza wesibindi. Isibindi sakho singase singakwazi ukuphulukiswa, futhi ekugcineni ungadinga ukufakelwa isibindi.

Unganciphisa kanjani ingozi yesifo sesibindi?

Ungenza lezi zinto ukuze uzivikele ezifweni zesibindi:

• Ukugonywa: Kunemithi yokugomela ukuvikela isifo sofuba i-hepatitis A kanye ne-B esibangelwa yigciwane.
• Ukuhlanzeka okuhle: Izinto ezifana nokugeza izandla ngemva kokusebenzisa indlu yangasese, ukulungisa ukudla ngokuphephile, nokusebenzisa izinaliti ngokuphephile kungasiza ekuvimbeleni ukusabalala kwezifo.
• Nciphisa ukusetshenziswa kotshwala bese uthatha imithi njengoba uyalelwe: Uma unenkinga yokusebenzisa izidakamizwa (isib. `Inkinga Yokusebenzisa Izidakamizwa - SUD`), ukuthola ukwelashwa kungasiza ekuvimbeleni i-hepatitis ebangelwa ubuthi.
• Ukulawula izici ze-metabolic ezifana nama-lipid egazini (amafutha) kanye noshukela egazini: Ungathola usizo kudokotela ngalokhu.

Ingabe isifo sesibindi singalungiseka?

Isifo sesibindi esiqalayo singaguqulwa uma imbangela itholakala futhi wena nethimba lakho lezokwelapha nisebenzisana ukuze nisiqede noma nisilawule. Lokhu kuncike ekutheni siyini imbangela nokuthi ingelashwa kahle kangakanani. Uma une-cirrhosis, awukwazi ukuguqula umonakalo osuvele wenziwe. Kodwa ungavimbela umonakalo owengeziwe noma wehlise ijubane. Ukwehluleka kwesibindi okungapheli akunakuguqulwa, kodwa kungathatha iminyaka ukuthi kube kubi kakhulu.

Ingabe isifo sesibindi singalapheka?

Izinhlobo eziningi zesifo sesibindi zingelapheka. Isifo sesibindi esibangelwa ubuthi notshwala sivame ukuthuthuka uma uyeka ukuchayeka kulezo zithiyo. Isifo sesibindi esinamafutha esingahlobene notshwala singelapheka ngokushintsha ukudla nendlela yokuphila. Ezinye izinhlobo zesifo sesibindi azinakwelashwa, kodwa zingaphathwa ngemithi. Ezinye izifo ezizuzwe njengefa, izifo ezizimele, kanye nokutheleleka ngamagciwane kungadinga ukwelashwa impilo yonke.

Yini okufanele ngiyenze uma ngiphila nesifo sesibindi?

Uma unesifo sesibindi, yenza lezi zinto ukuze unakekele isibindi sakho:

• Gcina ukudla okunempilo: Beka phambili ukudla okuphelele, izithelo nemifino, kanye namaprotheni angenamafutha.
• Ukugcina i-BMI enempilo (Body Mass Index): Xhumana nodokotela wakho ngalokhu.
• Ukugwema utshwala, ugwayi, kanye nemithi etholakala ngaphandle kwemithi kadokotela: Cela usizo kudokotela wakho ukuyeka ukubhema.
• Phuza imithi kuphela njengoba uyalelwe: Khuluma nodokotela wakho nganoma yimiphi imithi emisha oyithathayo.
• Ukuvikela izifo: Vimbela umthwalo owengeziwe esibindini ngokuhlanzeka okuhle kanye nemikhuba yocansi ephephile.
• Hlala unolwazi nge-aphoyintimenti kadokotela wakho: Thola ukuhlolwa njalo bese uthola izinkinga kusenesikhathi.