Matenda a chiwindi

Zamkati

• Momwe matenda a cirrhosis amakulira
• Zomwe zimayambitsa kufooka kwa matenda
• Zizindikiro za matenda enaake
• Momwe matenda a cirrhosis amapezeka
• Zovuta kuchokera ku cirrhosis
• Chithandizo cha matenda enaake
• Kupewa matenda a chiwindi

Chidule

Cirrhosis ndikutupa koopsa kwa chiwindi komanso kuwonongeka kwa chiwindi komwe kumawoneka kumapeto kwa matenda a chiwindi. Zilondazi nthawi zambiri zimayamba chifukwa chokhala ndi poizoni ngati mowa kapena matenda opatsirana. Chiwindi chili kumtunda chakumanja pamimba pansi pa nthiti. Ili ndi ntchito zambiri zofunika mthupi. Izi zikuphatikiza:

• kutulutsa bile, yomwe imathandizira thupi lanu kuyamwa mafuta azakudya, cholesterol, ndi mavitamini A, D, E, ndi K
• kusunga shuga ndi mavitamini kuti agwiritsidwe ntchito ndi thupi pambuyo pake
• kuyeretsa magazi pochotsa poizoni monga mowa ndi mabakiteriya m'dongosolo lanu
• kupanga mapuloteni otseka magazi

Malinga ndi National Institutes of Health (NIH), cirrhosis ndi nambala 12 yomwe imayambitsa kufa chifukwa cha matenda ku United States. Ndizotheka kuti zimakhudza amuna kuposa akazi.

Momwe matenda a cirrhosis amakulira

Chiwindi ndi chiwalo cholimba kwambiri ndipo nthawi zambiri chimatha kupanganso maselo owonongeka. Cirrhosis imayamba pomwe zinthu zomwe zimawononga chiwindi (monga mowa ndi matenda opatsirana a ma virus) zimakhalapo kwakanthawi. Izi zikachitika, chiwindi chimavulala komanso kuchita zipsera. Chiwindi chothedwa zipsera sichingagwire bwino ntchito, ndipo pamapeto pake izi zitha kuyambitsa matenda a chiwindi.

Cirrhosis imayambitsa chiwindi kufota ndikulimba. Izi zimapangitsa kuti zikhale zovuta kuti magazi omwe ali ndi michere yambiri alowe m'chiwindi kuchokera pamitsempha yama portal. Mitsempha yotsegula imanyamula magazi kuchokera kumimbazi mpaka m'chiwindi. Kupsyinjika kwa mitsempha yotseguka kumatuluka pamene magazi sangadutse m'chiwindi. Chotsatira chake ndi vuto lalikulu lotchedwa portal hypertension, momwe mtsempha umathamanga kuthamanga kwa magazi. Zotsatira zomvetsa chisoni za matenda oopsa a pakhomo ndikuti kuthamanga kwamphamvu kumeneku kumapangitsa kubweza, komwe kumabweretsa ma esophageal varices (monga mitsempha ya varicose), yomwe imatha kuphulika ndikutuluka magazi.

Zomwe zimayambitsa kufooka kwa matenda

Zomwe zimayambitsa matenda a chiwindi ku United States ndi matenda a hepatitis C omwe amatenga nthawi yayitali komanso kumwa mowa mopitirira muyeso. Kunenepa kwambiri kumayambitsanso matenda a chiwindi, ngakhale kuti sikofala monga uchidakwa kapena matenda a chiwindi a C. Kunenepa kwambiri kumatha kukhala chiopsezo chokha, kapena kuphatikiza uchidakwa ndi hepatitis C.

Malinga ndi NIH, matenda a chiwindi amatha kuyamba mwa amayi omwe amamwa mowa wopitilira awiri patsiku (kuphatikiza mowa ndi vinyo) kwa zaka zambiri. Kwa abambo, kumwa zakumwa zopitilira katatu patsiku kwazaka zambiri zitha kuwaika pachiwopsezo cha matenda enaake. Komabe, ndalamazo ndizosiyana ndi munthu aliyense, ndipo izi sizitanthauza kuti aliyense amene wamwapo zakumwa zochepa kuposa izi adzadwala matenda enaake. Matenda enaake obwera chifukwa cha mowa nthawi zambiri amakhala chifukwa chomwa mowa mopitirira muyeso kwa zaka 10 kapena 12.

Hepatitis C imatha kupatsirana pogonana kapena kukhudzana ndi magazi omwe ali ndi kachilombo kapena zinthu zamagazi. N'zotheka kudziwika ndi magazi omwe ali ndi kachilomboka kudzera mu singano zonyansa za gwero lililonse, kuphatikizapo kujambula zizindikiro, kuboola, kugwiritsa ntchito mankhwala osokoneza bongo, komanso kugawana singano. Hepatitis C imafalikiranso kawirikawiri mwa kuthiridwa magazi ku United States chifukwa chokhwima pamawonekedwe a banki yamagazi.

Zina mwazomwe zimayambitsa matenda a chiwindi ndi izi:

• Hepatitis B: Hepatitis B imatha kuyambitsa kutupa kwa chiwindi ndi kuwonongeka komwe kumatha kuyambitsa matenda am'mimba.
• Hepatitis D: Mtundu uwu wa hepatitis amathanso kuyambitsa matenda a chiwindi. Nthawi zambiri zimawoneka mwa anthu omwe ali ndi matenda a chiwindi a B.
• Kutupa komwe kumayambitsidwa ndimatenda amthupi: Matenda a chiwindi amadzipangitsa kukhala ndi vuto. Malingana ndi American Liver Foundation, pafupifupi 70 peresenti ya anthu omwe ali ndi chiwindi cha autoimmune ndi akazi.
• Kuwonongeka kwa mitsempha ya bile, yomwe imagwira ntchito kukhetsa bile: Chitsanzo chimodzi cha chikhalidwe choterechi ndi matenda a biliary cirrhosis.
• Zovuta zomwe zimakhudza kuthekera kwa thupi kunyamula chitsulo ndi mkuwa: Zitsanzo ziwiri ndi hemochromatosis ndi matenda a Wilson.
• Mankhwala: Mankhwala kuphatikiza kulembetsa ndi kugwiritsa ntchito mankhwala osokoneza bongo monga acetaminophen, maantibayotiki ena, ndi mankhwala ena opewetsa kupsinjika, amatha kudwala matenda a chiwindi.

Zizindikiro za matenda enaake

Zizindikiro za matenda a chiwindi zimachitika chifukwa chiwindi sichitha kuyeretsa magazi, kuwononga poizoni, kutulutsa mapuloteni oundana, komanso kuthandizira kuyamwa mafuta ndi mavitamini osungunuka ndi mafuta. Nthawi zambiri sipakhala zizindikiro mpaka matendawa atakula. Zina mwazizindikiro ndi izi:

• kuchepa kudya
• mphuno kutuluka magazi
• jaundice (kutuluka kwa chikaso)
• Mitsempha yaying'ono yooneka ngati kangaude pansi pa khungu
• kuonda
• matenda a anorexia
• khungu loyabwa
• kufooka

Zizindikiro zowopsa ndizo:

• chisokonezo ndi kuvutika kuganiza bwino
• kutupa m'mimba (ascites)
• kutupa kwa miyendo (edema)
• kusowa mphamvu
• gynecomastia (amuna akamayamba kukhala ndi minofu ya m'mawere)

Momwe matenda a cirrhosis amapezeka

Kuzindikira matenda a chiwindi kumayamba ndi mbiri yakale komanso mayeso athupi. Dokotala wanu atenga mbiri yonse yazachipatala. Mbiriyo imatha kuwonetsa zakumwa zoledzeretsa kwanthawi yayitali, chiwindi cha hepatitis C, mbiri yabanja yamatenda amthupi mokha, kapena zoopsa zina. Kuyezetsa thupi kumatha kuwonetsa zizindikilo monga:

• khungu lotumbululuka
• maso achikaso (jaundice)
• kanjedza zofiira
• kunjenjemera kwa manja
• chiwindi chokulitsa kapena ndulu
• machende ang'onoang'ono
• minofu yambiri yamawere (mwa amuna)
• kuchepa kukhala tcheru

Mayeso atha kuwulula momwe chiwindi chawonongeka. Mayeso ena omwe amagwiritsidwa ntchito poyesa matenda a cirrhosis ndi awa:

• kuwerengera magazi kwathunthu (kuwulula kuchepa kwa magazi)
• kuyezetsa magazi (kuwona momwe magazi amaundana msanga)
• albumin (kuyesa puloteni yomwe imapangidwa m'chiwindi)
• kuyesa kwa chiwindi
• alpha fetoprotein (kuyezetsa khansa ya chiwindi)

Mayeso owonjezera omwe amatha kuyesa chiwindi ndi awa:

• chapamwamba endoscopy (kuti muwone ngati pali ma esophageal varices)
• ultrasound kuwunika kwa chiwindi
• MRI ya pamimba
• CT scan pamimba
• chiwindi cha chiwindi (kuyesa kotsimikizika kwa matenda a chiwindi)

Zovuta kuchokera ku cirrhosis

Ngati magazi anu satha kudutsa pachiwindi, zimapangitsa kuti zisungidwe kudzera m'mitsempha ina monga ija. Kubwezeretsa uku kumatchedwa esophageal varices. Mitsempha imeneyi sinamangidwe kuti ithe kuthana ndi mavuto, ndipo imayamba kutuluka ndikutuluka kwamagazi.

Zovuta zina zochokera ku cirrhosis ndi izi:

• kuvulaza (chifukwa chokhala ndi mapuleti ochepa komanso / kapena kutsekeka bwino)
• Kutuluka magazi (chifukwa chakuchepa kwama protein)
• kutengeka ndi mankhwala (chiwindi chimapanga mankhwala m'thupi)
• impso kulephera
• khansa ya chiwindi
• insulin kukana ndi mtundu wa 2 shuga
• hepatic encephalopathy (chisokonezo chifukwa cha zotsatira za poizoni wamagazi muubongo)
• ndulu (kusokonekera kwa kutuluka kwa ndulu kumatha kuyambitsa ndulu kuti ilimbitse ndikupanga miyala)
• vutoli
• nthenda yowonjezera (splenomegaly)
• edema ndi ascites

Chithandizo cha matenda enaake

Chithandizo cha matenda enaake chimasiyana malinga ndi chomwe chidayambitsa matendawa komanso kutalika kwake. Mankhwala ena omwe dokotala angakupatseni ndi awa:

• beta blockers kapena nitrate (chifukwa cha portal hypertension)
• kusiya kumwa (ngati matenda enaake amayamba chifukwa cha mowa)
• njira zogwiritsira ntchito banding (zomwe zimagwiritsidwa ntchito poletsa kutuluka kwa magazi m'matumbo)
• mankhwala opha tizilombo (kuchiza peritonitis omwe angachitike ndi ascites)
• hemodialysis (kuyeretsa magazi a omwe ali ndi impso)
• lactulose komanso zakudya zochepa zomanga thupi (kuchiza matenda encephalopathy)

Kuika chiwindi ndichosankha chomaliza, pomwe mankhwala ena amalephera.

Odwala onse ayenera kusiya kumwa mowa. Mankhwala, ngakhale owerengetsa, sayenera kumwedwa popanda kufunsa dokotala.

Kupewa matenda a chiwindi

Kugonana mosatekeseka ndi makondomu kumachepetsa chiopsezo chotenga matenda a chiwindi a B kapena C. A US amalimbikitsa kuti makanda onse ndi achikulire omwe ali pachiwopsezo (monga othandizira zaumoyo ndi othandizira) apatsidwe katemera wa hepatitis B.

Kukhala osamwa, kudya zakudya zopatsa thanzi, ndi kuchita masewera olimbitsa thupi okwanira kumatha kupewa kapena kuchepa kwa chiwindi. Bungwe la World Health Organization linanena kuti anthu 20 mpaka 30 mwa anthu 100 alionse amene ali ndi matenda a chiwindi a B adzadwala matenda enaake kapena khansa ya chiwindi. National Institute of Health inanena kuti 5 mpaka 20 peresenti ya anthu omwe ali ndi matenda a chiwindi a C adzadwala matenda enaake pazaka 20 mpaka 30.

Werengani nkhaniyi m'Chisipanishi.