Ascites

Ascites ndikumanga kwamadzimadzi pakati pakatikati pamimba ndi ziwalo zam'mimba.

Ascites amadza chifukwa cha kuthamanga kwambiri m'mitsempha yamagazi ya chiwindi (portal hypertension) komanso kuchepa kwa mapuloteni otchedwa albumin.

Matenda omwe amatha kuwononga chiwindi kwambiri amatha kuyambitsa ascites. Izi zikuphatikiza:

• Matenda a hepatitis C kapena B
• Kumwa mowa mwauchidakwa kwazaka zambiri
• Matenda a chiwindi (osakhala mowa steatohepatitis kapena NASH)
• Cirrhosis yoyambitsidwa ndi matenda amtundu

Anthu omwe ali ndi khansa m'mimba amatha kukhala ndi ascites. Izi zimaphatikizapo khansa yazowonjezera, m'matumbo, m'mimba mwake, chiberekero, kapamba, ndi chiwindi.

Zina zomwe zingayambitse vutoli ndi monga:

• Makutu m'mitsempha ya chiwindi (portal vein thrombosis)
• Kulephera kwa mtima
• Pancreatitis
• Kulimba ndi zipsera za chophimba chophimba pamtima (pericarditis)

Impso dialysis ingagwirizanenso ndi ascites.

Zizindikiro zimatha kuyamba pang'onopang'ono kapena mwadzidzidzi kutengera chifukwa cha ascites. Simungakhale ndi zisonyezo ngati mumakhala madzi ochepa m'mimba.

Pamene madzi amadzimadzi amasonkhana, mutha kukhala ndi ululu m'mimba komanso kuphulika. Madzi ambiri amatha kupangitsa kuti mpweya ukhale wochepa, Izi zimachitika chifukwa madziwo amakankha chifundamtima, chomwe chimapanikiza mapapu apansi.

Zizindikiro zina zambiri za kulephera kwa chiwindi zitha kukhalaponso.

Dokotala wanu adzakuyesani kuti muwone ngati kutupa kumachitika chifukwa chakumangirira kwam'mimba kwanu.

Muthanso kukhala ndi mayeso otsatirawa kuti muwone chiwindi ndi impso zanu:

• Kutola mkodzo kwa maola 24
• Magulu a Electrolyte
• Ntchito ya impso
• Kuyesa kwa chiwindi
• Kuyesa kuyeza kuwopsa kwa magazi ndi mapuloteni m'magazi
• Kupenda kwamadzi
• M'mimba ultrasound
• CT scan pamimba

Dokotala wanu amathanso kugwiritsa ntchito singano yopyapyala kuti atulutse madzi am'mimba m'mimba mwanu. Madzimadzi amayesedwa kuti ayang'ane chifukwa cha ascites ndikuwunika ngati madzimadzi ali ndi kachilombo.

Chomwe chimayambitsa ascites chithandizidwa, ngati zingatheke.

Mankhwala ochiritsira madzi atha kuphatikizanso kusintha kwamachitidwe:

• Kupewa mowa
• Kutsitsa mchere mu zakudya zanu (zosaposa 1,500 mg / tsiku la sodium)
• Kuchepetsa kudya kwamadzimadzi

Muthanso kupeza mankhwala kuchokera kwa adotolo, kuphatikiza:

• "Mapiritsi amadzi" (okodzetsa) kuti athetse madzi owonjezera
• Maantibayotiki opatsirana

Zinthu zina zomwe mungachite kuti muthandize kusamalira matenda anu a chiwindi ndi:

• Pezani katemera wa matenda monga chimfine, hepatitis A ndi hepatitis B, ndi pneumococcal pneumonia
• Lankhulani ndi dokotala wanu za mankhwala onse omwe mumamwa, kuphatikizapo zitsamba ndi zowonjezera komanso mankhwala owonjezera

Njira zomwe mungakhale nazo ndi:

• Kuyika singano m'mimba kuchotsa madzimadzi ambiri (otchedwa paracentesis)
• Kuyika chubu chapadera kapena shunt mkati mwa chiwindi (MALANGIZO) kuti mukonze magazi mpaka chiwindi

Anthu omwe ali ndi matenda a chiwindi kumapeto kwake angafunike kumuika chiwindi.

Ngati muli ndi matenda enaake, pewani kumwa mankhwala osagwiritsa ntchito zotupa, monga ibuprofen (Advil, Motrin) ndi naproxen (Aleve, Naprosyn). Acetaminophen imayenera kumwa mankhwala ochepa.

Zovuta zingaphatikizepo:

• Bakiteriya peritonitis (matenda owopsa amoyo wamadzimadzi a ascitic)
• Hepatorenal syndrome (impso kulephera)
• Kuchepetsa thupi komanso kusowa zakudya m'thupi
• Kusokonezeka kwa malingaliro, kusintha kwa msinkhu, kapena kukomoka (hepatic encephalopathy)
• Kutuluka magazi kuchokera kumtunda wakumtunda kapena m'munsi
• Pangani madzimadzi pakati pa mapapu anu ndi chifuwa (pleural effusion)
• Zovuta zina za chiwindi cha chiwindi

Ngati muli ndi ascites, pitani kuchipatala nthawi yomweyo ngati muli ndi:

• Malungo pamwamba pa 100.5 ° F (38.05 ° C), kapena malungo omwe samachoka
• Kupweteka kwa m'mimba
• Magazi mu mpando wanu kapena wakuda, chembetsani malo
• Magazi m'masanzi anu
• Kuluma kapena kutuluka magazi komwe kumachitika mosavuta
• Kumanga kwamadzimadzi m'mimba mwanu
• Kutupa miyendo kapena akakolo
• Mavuto opumira
• Kusokonezeka kapena mavuto kukhala maso
• Mtundu wachikaso pakhungu lako ndi azungu amaso anu (jaundice)

Matenda oopsa - ascites; Matenda enaake - ascites; Kulephera kwa chiwindi - ascites; Kumwa mowa - ascites; Mapeto siteji matenda chiwindi - ascites; ESLD - ascites; Pancreatitis ascites

• Ascites ndi khansa yamchiberekero - CT scan
• Zakudya zam'mimba ziwalo

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.

National Institute of Diabetes ndi tsamba la Digestive and Impso Diseases. Matenda a chiwindi. www.niddk.nih.gov/health-information/liver-disease/cirrhosis/all-content. Idasinthidwa pa Marichi 2018. Idapezeka Novembala 11, 2020.

Sola E, Gines SP. Ascites ndi mowiriza bakiteriya peritonitis. 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 93.