Kutuluka magazi kwamitsempha yamagazi

Mphuno (chitoliro cha chakudya) ndi chubu chomwe chimagwirizanitsa khosi lanu ndi mimba yanu. Mavitamini ndi mitsempha yowonjezera yomwe ingapezeke m'mimba mwa anthu omwe ali ndi matenda a chiwindi. Mitsempha imeneyi imatha kuphulika ndikutuluka magazi.

Kupunduka (cirrhosis) kwa chiwindi ndiye komwe kumayambitsa matenda opatsirana ambiri. Chipsera ichi chimachepetsa magazi omwe amayenda pachiwindi. Zotsatira zake, magazi ambiri amayenda mumitsempha ya kum'mero.

Magazi owonjezera amachititsa kuti mitsempha mu kholingo ibaluni panja. Kutaya magazi kwambiri kumatha kuchitika ngati mitsempha imang'ambika.

Mtundu uliwonse wa matenda a chiwindi wa nthawi yayitali amatha kuyambitsa matenda am'mimba.

Mavitamini amathanso kupezeka kumtunda kwa m'mimba.

Anthu omwe ali ndi matenda osachiritsika a chiwindi komanso ma esophageal varices sangakhale ndi zisonyezo.

Ngati pali magazi ochepa okha, chizindikiro chokhacho chimatha kukhala mdima wakuda kapena wakuda m'mipando.

Ngati magazi akutuluka kwambiri, zizindikilo zake zimaphatikizapo:

• Mdima wakuda, wodikira
• Zojambula zamagazi
• Mitu yopepuka
• Khungu
• Zizindikiro za matenda a chiwindi osatha
• Kusanza magazi

Wothandizira zaumoyo wanu ayesa mayeso omwe angawonetse:

• Chophika chamagazi kapena chakuda (poyesa mayere)
• Kuthamanga kwa magazi
• Kuthamanga kwa mtima mwachangu
• Zizindikiro za matenda a chiwindi osachiritsika kapena cirrhosis

Kuyesera kuti mupeze komwe kumachokera magazi ndikuwunika ngati pali kutuluka magazi ndi:

• EGD kapena endoscopy yapamwamba, yomwe imakhudza kugwiritsa ntchito kamera p chubu chosinthira kuti muwone kumimba ndi m'mimba.
• Kulowetsa chubu kudzera m'mphuno kulowa m'mimba (nasogastric chubu) kuti muone ngati pali magazi.

Omwe amapereka amapereka EGD kwa anthu omwe amapezeka kuti ali ndi matenda enaake ochepera pang'ono. Kuyesaku kumawunikira ma esophageal varices ndikuwathandiza asanatuluke magazi.

Cholinga cha chithandizo ndikuthetsa magazi pachimake posachedwa. Kutuluka magazi kuyenera kuyang'aniridwa mwachangu kuti musachite mantha kapena kufa.

Ngati magazi akutuluka kwambiri, munthu angafunike kumuyika mpweya wabwino kuti ateteze mayendedwe ake ndikutchingira magazi kuti asalowe m'mapapu.

Pofuna kuletsa kutuluka kwa magazi, woperekayo atha kupititsa endoscope (chubu chokhala ndi nyali yaying'ono kumapeto) kum'mero:

• Mankhwala otsekemera atha kubayidwa m'matumba.
• Gulu labala akhoza kuikidwa mozungulira mitsempha yotaya magazi (yotchedwa banding).

Mankhwala ena oletsa kutaya magazi:

• Mankhwala olimbitsa mitsempha ya magazi amatha kuperekedwa kudzera mumitsempha. Zitsanzo zimaphatikizapo octreotide kapena vasopressin.
• Nthawi zambiri, chubu chimalowetsedwa kudzera mphuno m'mimba ndikutulutsa mpweya. Izi zimapangitsa kupanikizika pamitsempha yotaya magazi (baluni tamponade).

Kutuluka magazi kukayimitsidwa, ma virus ena amatha kuchiritsidwa ndi mankhwala komanso njira zamankhwala zotetezera magazi mtsogolo. Izi zikuphatikiza:

• Mankhwala otchedwa beta blockers, monga propranolol ndi nadolol omwe amachepetsa chiopsezo chotaya magazi.
• Gulu labala limatha kuyikidwa mozungulira mitsempha yotuluka magazi munjira ya EGD. Komanso, mankhwala ena amatha kubayidwa mu ma varic nthawi ya EGD kuti awumitse.
• Transjugular intrahepatic portosystemic shunt (MALANGIZO). Iyi ndi njira yopangira kulumikizana kwatsopano pakati pamitsempha yamagazi iwiri m'chiwindi. Izi zitha kuchepetsa kupanikizika m'mitsempha ndikuletsa magawo omwe akutuluka magazi kuti asadzachitikenso.

Nthawi zambiri, opaleshoni yadzidzidzi itha kugwiritsidwa ntchito pochizira anthu ngati mankhwala ena atalephera. Portacaval amatseka kapena opaleshoni kuti muchepetse kupsinjika kwam'magazi am'mimba ndizosankha zamankhwala, koma njirazi ndizowopsa.

Anthu omwe ali ndi magazi omwe amatuluka m'magazi a chiwindi angafunikire chithandizo chochulukirapo matenda a chiwindi, kuphatikiza chiwindi.

Kuthira magazi kumabweranso ndi mankhwala kapena popanda mankhwala.

Magazi am'magazi am'magazi ndi vuto lalikulu la matenda a chiwindi ndipo amakhala ndi zotsatira zoyipa.

Kukhazikitsidwa kwa shunt kumatha kubweretsa kuchepa kwa magazi kuubongo. Izi zitha kubweretsa kusintha kwamaganizidwe.

Mavuto amtsogolo omwe amabwera chifukwa cha ma varices atha kukhala:

• Kuchepetsa kapena kukhwimitsa kwam'mero ​​chifukwa cha mabala atatha kuchitidwa
• Kubwerera kwa magazi mutalandira chithandizo

Itanani omwe akukuthandizani kapena pitani kuchipinda chadzidzidzi ngati musanza magazi kapena muli ndi malo okumbirako akuda.

Kuthana ndi zomwe zimayambitsa matenda a chiwindi kumatha kupewa magazi. Kuika chiwindi kumayenera kuganiziridwa ndi anthu ena.

Chiwindi matenda enaake - varices; Cryptogenic aakulu chiwindi matenda - varices; Mapeto siteji matenda chiwindi - varices; Mowa chiwindi matenda - varices

• Matenda enaake - kumaliseche

• Dongosolo m'mimba
• Magazi a chiwindi

Garcia-Tsao G. Cirrhosis ndi sequelae yake. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 144.

Amasunga TJ, Jensen DM. Kutuluka m'mimba. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Fordtran's Mimba ndi Matenda a Chiwindi: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 20.