Pulayimale biliary matenda enaake
Mitsempha ya bile ndi timachubu tomwe timasuntha bile kuchokera m'chiwindi kupita m'matumbo ang'onoang'ono. Kuphulika ndi chinthu chomwe chimathandiza kugaya chakudya. Mipata yonse ya bile pamodzi imatchedwa thirakiti ya biliary.
Mitsempha ya ndulu ikatupa kapena kutupa, izi zimatseka kutuluka kwa bile. Kusintha kumeneku kumatha kubweretsa zipsera m'chiwindi chotchedwa cirrhosis. Izi zimatchedwa biliary cirrhosis. Matenda owopsa amatha kuyambitsa chiwindi.
Chifukwa cha zotupa za bile zotupa m'chiwindi sichidziwika. Komabe, makamaka biliary cirrhosis ndimatenda amthupi okha. Izi zikutanthauza kuti chitetezo cha mthupi lanu molakwika chimagunda minofu yathanzi. Matendawa amatha kulumikizidwa ndi zovuta zama auto monga:
- Matenda a Celiac
- Chodabwitsa cha Raynaud
- Matenda a Sicca (maso owuma kapena pakamwa)
- Matenda a chithokomiro
Matendawa nthawi zambiri amakhudza azimayi azaka zapakati.
Oposa theka la anthu alibe zizindikiro panthawi yomwe amapezeka. Zizindikiro nthawi zambiri zimayamba pang'onopang'ono. Zizindikiro zoyambirira zimatha kuphatikiza:
- Nsautso ndi kupweteka m'mimba
- Kutopa ndi kutaya mphamvu
- Mafuta amaika pansi pa khungu
- Malo okhala ndi mafuta
- Kuyabwa
- Kulakalaka kudya komanso kuwonda
Pamene chiwindi chikukula, zizindikilo zingaphatikizepo:
- Kutsekemera kwamadzimadzi m'miyendo (edema) ndi m'mimba (ascites)
- Mtundu wachikaso pakhungu, mamina, kapena maso (jaundice)
- Kufiira pazanja zamanja
- Mwa amuna, kusowa mphamvu, kuchepa kwa machende, ndi kutupa kwa m'mawere
- Kuvulaza kosavuta komanso magazi osazolowereka, nthawi zambiri amachokera m'mitsempha yotupa m'mimba
- Kusokonezeka kapena mavuto kuganiza
- Zojambula zofiirira kapena zadongo
Wothandizira zaumoyo adzayesa.
Mayesero otsatirawa angawone ngati chiwindi chanu chikugwira bwino ntchito:
- Kuyesa magazi kwa Albumin
- Kuyesa kwa chiwindi (serum alkaline phosphatase ndikofunikira kwambiri)
- Nthawi ya Prothrombin (PT)
- Cholesterol ndi lipoprotein kuyezetsa magazi
Mayeso ena omwe angathandize kudziwa momwe matenda amchiwindi angakhalire ndi awa:
- Kutalika kwa immunoglobulin M mulingo wamagazi
- Chiwindi
- Ma anti-mitochondrial antibodies (zotsatira zake ndizabwino pafupifupi 95% yamilandu)
- Mitundu yapadera ya ultrasound kapena MRI yomwe imayesa kuchuluka kwa minofu yotupa (itha kutchedwa elastography)
- Magnetic resonance cholangiopancreatography (MRCP)
Cholinga cha chithandizo ndikuchepetsa zizindikiro ndikupewa zovuta.
Cholestyramine (kapena colestipol) imachepetsa kuyabwa. Ursodeoxycholic acid itha kusintha kuchotsedwa kwa bile m'magazi. Izi zitha kupititsa patsogolo kupulumuka kwa anthu ena. Mankhwala atsopano otchedwa obeticholic acid (Ocaliva) amapezekanso.
Mankhwala othandizira mavitamini amabwezeretsanso mavitamini A, K, E ndi D, omwe amatayika m'matumba amafuta. Mankhwala owonjezera a calcium kapena mankhwala ena amfupa atha kuwonjezedwa kuti ateteze kapena kuchiza mafupa ofooka kapena ofewa.
Kuwunika kwakanthawi komanso kuchiza chiwindi kumafunika.
Kuika chiwindi kumatha kukhala bwino ngati zichitike chiwindi chisanachitike.
Zotsatira zimatha kusiyanasiyana. Ngati vutoli silichiritsidwa, anthu ambiri amafa popanda kumuika chiwindi. Pafupifupi kotala limodzi la anthu omwe akhala akudwala zaka 10 adzakhala ndi vuto la chiwindi. Madokotala tsopano atha kugwiritsa ntchito chiwerengerochi kuti athe kuneneratu nthawi yabwino yoika munthu uja. Matenda ena, monga hypothyroidism ndi kuchepa kwa magazi, amathanso kukula.
Kupita patsogolo kwa chiwindi kumatha kuyambitsa chiwindi kulephera. Zovuta zitha kukhala:
- Magazi
- Kuwonongeka kwa ubongo (encephalopathy)
- Kusamvana kwamadzimadzi ndi ma electrolyte
- Impso kulephera
- Kusokoneza malabsorption
- Kusowa zakudya m'thupi
- Mafupa ofewa kapena ofooka (osteomalacia kapena kufooka kwa mafupa)
- Ascites (madzi amadzimadzi m'mimba)
- Kuchuluka kwa chiwopsezo cha khansa ya chiwindi
Itanani omwe akukuthandizani ngati muli ndi:
- Kutupa m'mimba
- Magazi pamalopo
- Kusokonezeka
- Jaundice
- Kuyabwa pakhungu lomwe silikutha ndipo sikugwirizana ndi zifukwa zina
- Kusanza magazi
Pulayimale biliary cholangitis; PBC
- Matenda enaake - kumaliseche
- Dongosolo m'mimba
- Njira yopanda madzi
Eaton JE, Lindor KD. Pulayimale biliary cholangitis. Mu: Feldman M, Friedman LS, Brandt LJ, olemba. Sleisenger ndi Matenda a Mimba ndi a Fordtran Amatenda a Chiwindi. 11th ed. Philadelphia, PA: Elsevier; 2021: mutu 91.
Fogel EL, Sherman S. Matenda a ndulu ndi ma ducts. Mu: Goldman L, Schafer AI, olemba. Mankhwala a Goldman-Cecil. 26 wa. Philadelphia, PA: Elsevier; 2020: chap 146.
Nyali LW. Chiwindi: matenda osaphulika. Mu: Goldblum JR, Nyali LW, McKenney JK, Myers JL, olemba. Rosai ndi Ackerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018: mutu 19.
Smith A, Baumgartner K, Bositis C. Cirrhosis: kuzindikira ndi kuwongolera. Ndi Sing'anga wa Fam. 2019; 100 (12): 759-770 (Pamasamba) PMID: 31845776 pubed.ncbi.nlm.nih.gov/31845776/.