Chiwindi cha Chiwindi ndi Cirrhosis: Zofanana ndi Kusiyana

by Naheed Ali, MD

Kodi Kusiyana Kwa Chilombo cha Chiwindi ndi Cirrhosis N'chiyani?

Kodi kusiyana kwa chiwindi ndi chiwindi ndi chiyani? Kodi zizindikiro za matenda awiri, zomwe zimayambitsa, ndi zochizira zimasiyana bwanji ndi momwe zilili zofanana?

Zofanana ndi Kusiyanitsa Pakati pa Chiwindi cha Chiwindi ndi Cirrhosis

Matenda a chiwindi ndi matenda a chiwindi ndi matenda omwe amakhudza chiwindi. Pali kusiyana kwakukulu, koma kawirikawiri, matenda a chiwindi amatha kapena osasinthika (kuchiritsidwa) pamene cirrhosis imatulutsa chipsinjo chosatha cha chiwindi, nthawi zambiri ngati chimatha chifukwa cha matenda a chiwindi.

Monga matenda a chiwindi ndi kutsekula m'mimba ali m'njira zambiri pa kupitirira kwa matenda, zizindikiro zikhoza kukhala zofanana. Ngakhale kuti mitundu ina ya chiwindi cha hepatitis imabwera mofulumira kwambiri, matenda a chiwindi amayamba kukula pang'onopang'ono.

Tiyeni tione zizindikiro zomwe zingachitike ndi matenda onsewa, kufotokozera zofunikira za matenda, ndikufotokozerani zofanana ndi zosiyana.

Zizindikiro Zambiri za Matenda a Chiwindi

Zizindikiro za matenda a chiwindi zingakhalepo ndi matenda a chiwindi, chiwindi, kapena zina zilizonse zomwe zimachititsa kuti chiwindi chiwonongeke kapena chiwonongeke. Izi ziphatikizapo:

Jaundice - Jaundice , kapena kutuluka kwa chikasu kwa khungu ndi oyera a maso (sclera) ndi chizindikiro chofala cha matenda a chiwindi, koma amakhala ndi zifukwa zambiri. Jaundice imachitika chifukwa cha kumanga bilirubin , chikasu chikasu, m'magazi (hyperbilirubinemia.) (Jaundice imapezeranso makanda koma izi ndizomwe zimayendera mthupi.) Jaundice ikhoza kukula mofulumira komanso mochititsa chidwi (monga chiwindi cha hepatitis kapena bile conduit cholepheretsa) kapena mmalo mwake kukhala patsogolo pang'onopang'ono.

Matenda owonjezeka pa odwala amuna - Matenda ofutukulidwa, omwe amatchedwa gynecomastia amapezeka ndi matenda a chiwindi chifukwa cha kuwonjezeka kwa estrogen chifukwa cha chiwindi chosagwira ntchito.
Kuwotcha khungu lanu - Kuwopsya ( pruritis ) kumakhala kofala ndi matenda a chiwindi, ndipo ndi chifukwa cha salt salts yomwe imamanga pakhungu. Kuyabwa uku kumawoneka popanda kuthamanga.

Kuthamanga kwa magazi - Kuwombera magazi kungagwirizane ndi matenda a chiwindi m'njira zingapo. Chimodzi mwa zoopsa kwambiri ndizopopera. Magulu a Esophageal ndiwo makamaka mitsempha ya varicose m'mimba. Mitsempha ya mitsempha ya miyendo imayamba chifukwa cha magazi osauka m'milingo yomwe imayambitsa magazi kuti asamangidwe komanso kuthamanga, kuthamanga kwa magazi kumatha kuchepa chifukwa cha chiwindi chimene chimachititsa kuti pakhale chifuwa chachikulu, komanso kuwonjezeka kwa magazi mu chiwindi. Matenda opatsirana kwambiri amadziwika kwambiri ndi matenda a chiwindi kusiyana ndi matenda a chiwindi, monga zoopsa monga "kink mu hose" kwa mitsempha ya magazi yomwe imadutsa pachiwindi.
Kutsekemera kofuula.
Chiwindi chachikulu - Ndi chiwindi cha chiwindi nthawi zambiri chimakhala chachikondi ndipo chimakula ndipo chimatha kumveka pansi pa nthiti zomwe zili pamwamba pa quadrant pamimba. Ndi matenda a chiwindi, chiwindi nthawi zambiri chimakhala chochepa komanso chokhazikika, ndipo chimakhala ngati thanthwe pamene chimamveka pamimba.
Edema kapena kutupa kwa miyendo yanu.
Mabakiteriya peritonitis - Peritonitis amatanthauza matenda m'mimba.
Ascites kapena amadziwika kuti ndi madzi m'mimba - Ascites angayambitse kupuma ndi kupweteka kwa mimba, ndipo pamene kuli kovuta, kungachititse kuti mpweya ukhale wochepa chifukwa cha kupweteka kwa mimba kukankhira pamwamba pa chifuwa.

Kusintha tulo ndi mavuto ena ogona.
Kutaya chidziwitso.
Kusokonezeka maganizo kapena kuiwala - Chimodzi mwa ntchito zoyambirira za chiwindi ndicho "kuchotsa" magazi, ndiko kuti, kuchotsa poizoni ndi zinthu zina m'magazi. Pamene ntchito ya chiwindi isokonezeka, mankhwalawa akhoza kumangika m'magazi. Kuchulukanso kwachilendo ndi matenda omwe amachititsa kuti munthu asamangokhalira kusokonezeka, kusokonezeka, kusokonezeka kwa thupi, amnesia, komanso nthawi zambiri kusintha kwa umunthu. Nthaŵi zina timalakwitsa ngati matenda a Alzheimer, koma nthawi zina zimakhala zochepa zowonongeka.
Kutopa - Kutopetsa kosalekeza, kutopa kumene sikungayankhe usiku wonse wa kupumula, kumakhala kofala kwambiri ndi matenda a chiwindi ndi matenda a chiwindi.

Mndandandanda waukulu wa zizindikiro za chiwindi cha chiwindi cha matenda a hepatitis ukukambirana zambiri zotheka zizindikiro za chiwindi cha chiwindi.

Hepatitis vs Cirrhosis

Pofuna kumvetsetsa zofanana ndi kusiyana pakati pa matenda a chiwindi ndi matenda a chiwindi, ndizothandiza poyamba kufotokozera ndi kufotokoza izi. Pali kusiyana pakati pa zinthu ziwirizi, zomwe zidzatchulidwa pansipa.

Chiwindi cha chiwindi

Chiwindi cha chiwindi ndi kutupa kwa chiwindi ndipo sichikhoza kungokhala ndi mavairasi odziwika monga hepatitis B, koma zinthu zambiri. Mafupa a chiwindi ndi awa:

Matenda a chiwindi opatsirana - Pali zifukwa zingapo zomwe zimayambitsa matenda a hepatitis. Izi zikuphatikizapo chiwindi cha A, B, C, D, ndi E, komanso matenda opatsirana monga tizilombo toyambitsa matenda (epstein-Barr) ndi cytomegalovirus.

Mankhwala opatsirana pogwiritsa ntchito mankhwala osokoneza bongo - Pali mankhwala ambiri omwe angayambitse chiwindi.

Mowa wotsekemera wa mowa - Mowa ungakhudze chiwindi m'njira zambiri monga chiwindi cha hepatitis, mafuta a chiwindi, ndi chiwindi.

Kunenepa kwambiri - Matenda omwe si oledzeretsa a chiwindi ndi matenda omwe akuwonjezeka ku United States omwe angathe kupita ku matenda otchedwa NASH kapena osakhala stewahepatitis. Mofanana ndi mitundu yambiri ya matenda a chiwindi, NASH ikhoza kupita ku chiwindi cha chiwindi.

Matenda a chiwindi a m'mimba - Matenda osadziwika ndi omwe thupi lathu limapanga ma antibodies motsutsana ndi matupi athu.

Kuopsa kwa poizoni / mankhwala - Pali mankhwala ambiri omwe ali poizoni kwa chiwindi kuchokera ku tizilombo toyambitsa matenda kupita ku mankhwala omwe amapezeka m'nyumba zoyenera kutsuka.

Cirrhosis ya Chiwindi

Cirrhosis ndi chilonda cha chiwindi. Chiwindi ndi chosiyana kwambiri ndi mphamvu zake zobwezeretsanso pambuyo povulala, koma mobwerezabwereza kuvulala kapena matenda aakulu monga chiwindi cha chiwindi, izi zimasokonezeka. Potsirizira pake, chiwindi chimakhala chosatheka kugwira ntchito moyenera komanso kupweteka kumayamba kukula.

Zomwe zimayambitsa matenda a chiwindi ndizo zomwe zimayambitsa chiwindi, koma zimatha kuthetsa chiwindi kuti zidzichiritse, monga pamene chiwerewere chibwereza kapena ngati ndi matenda aakulu. Zowopsa kwambiri ku United States zikuphatikizapo matenda a chiwindi ndi chiwindi cha chiwindi cha C.

Kuzungulira cirrhosis kungayambitsenso chifukwa cha zinthu zina osati chiwindi cha hepatitis chosasunthira hemochromatosis (matenda olemetsa a chitsulo chochuluka,) alpha-1-antitrypsin kusowa, kutuluka kwa dothi, komanso kutseka mazira, monga congenital biliary atresia palibe.)

Pamene chiwindi chimadwala, ntchito ya chiwindi imatayika ndipo, panthawi yomweyo, limba limakhala laling'ono ndipo limakhazikika. Ngati muli ndi chiwindi chosachiritsika, madzi amadziwika m'milingo ndi m'mimba. Mchere wambiri ukhoza kumangirika pakhungu zomwe zingayambitse kupweteketsa ndi kuyabwa. Kupuma kwa mitsempha yayikulu mu thirakiti lanu la GI ndi momwe mungathenso kuchitika. Mankhwala amatha kupangidwanso m'magazi omwe angabweretse chisokonezo ndi kuchepetsa maganizo. Kwa anthu omwe ali ndi chibwibwi cholimba, chokhacho chowona, chenicheni, chithandizo cha matendawa ndi kuika chiwindi . Mwamwayi, pali zovuta zambiri za matenda a chiwindi, kuphatikizapo chiwindi kulephera ndi khansa ya chiwindi.

Cirrhosis imakhalanso ndi chikhalidwe chomwe chimakhala ndi thanzi labwino la chiwindi chimalowetsedwa ndi minofu yopanda ntchito. Matendawa nthawi zambiri amapezeka mwa anthu omwe sagonjetsa kumwa mowa. Malinga ndi kafukufuku, palibe mankhwala ochiritsira matenda a chiwindi. Komabe, mankhwala oyenera amachepetsa kuopsa kwake kwa zizindikiro ndi kuchepetsa kukula kwa matendawa. Gawo loyamba limene muyenera kuganizira limachepetsa zizindikiro za matenda a chipsinjo ndi kusiya kumwa mowa. Ngati mupitiriza kumwa mowa, zingachititse kuti chiwonongeko cha chiwindi ndi imfa isanakwane. Kafukufuku watsopano akuyang'ana njira zina zothandizira kuti matenda a chiwindi asapitirire ku matenda a chiwindi komanso kuwonjezereka kwa chiwindi. Mwachitsanzo, zilembo zingachepetse chiopsezo kwa anthu omwe ali ndi matenda a chiwindi. Ngati muli ndi matenda a chiwindi kapena mukudwala matenda a chiwindi, nkofunika kupeza katswiri wodziwa bwino maphunzirowa.

Kufanana pakati pa Chiwindi cha Chiwindi ndi Cirrhosis

Matenda a chiwindi ndi chiwindi ndi zinthu zomwe zimayambitsa chiwindi zomwe zingayambitse matenda oyambitsa matenda a chiwindi ndi zizindikiro za chiwindi.
Matenda a chiwindi ndi chiwindi amatha kuchititsa khansa ya chiwindi, kudwala chiwindi, kapena kufunika kokhala ndi chiwindi.

Kusiyanasiyana Pakati pa Chiwindi cha Chiwindi ndi Cirrhosis

Pali kusiyana kwakukulu pakati pa kutentha kwa chiwindi ndi chiwindi, ngakhale kuti zingayambidwe ndi chinthu chomwecho.

Kuwomboledwa - Mwachidziwitso (scaring) cirrhosis sizingatheke, pamene chiwindi cha hepatitis chikhoza kusinthidwa kwathunthu malingana ndi chifukwa.
Mayeso a magazi - Mavitamini a chiwindi (monga AST ndi ALT) nthawi zambiri amakhala ndi chiwindi cha hepatitis, makamaka chiwindi cha hepatitis. Koma ndi matenda a chibwibwi, poyamba, magawo oyambirira a chiwindi angakhale ochepa chabe.
Zinthu zina osati matenda a hepatitis zingapangitse ku matenda a chiwindi - Mwachitsanzo, hemochromatosis , alpha-1-antitrypsin yosowa, ndipo zambiri zingayambitse matenda a chiwindi.
Kuchiza - Ndi matenda a hepatitis, cholinga chake ndi kuchepetsa matendawa, mwachitsanzo, kuchiza matenda, kuchotsa mankhwala omwe amachititsa mankhwalawa, kapena kuchepetsa kulemera kwa thupi ndi kuwonjeza kagayidwe kake ka NASH. Ndi matenda a chibwibwi, kudandaula ndi kosatha ndipo sikungachiritsidwe. Choncho, cholinga chake ndi kuchiza zizindikiro zokhudzana ndi matenda a chiwindi komanso kupewa kuvulala kwa chiwindi.
Zizindikiro - Kutsekula kwapachipatala (onani pamwambapa) kumayambitsa mikodzo yowonjezereka, nthenda yotambasula, chiwerengero chochepa cha platelet, ndi mapuloteni otsika m'magazi (zomwe zimayambitsa mavuto ena) zimakhala zofala kwambiri ndi matenda a chiwindi kusiyana ndi matenda a chiwindi.

Mfundo Yofunika Kwambiri pa Kusiyana kwa Chiwindi cha Chiwindi ndi Cirrhosis

Mu njira zambiri, matenda a chiwindi ndi kutuluka kwa chiwindi ndi ofanana ndondomeko koma kupitiriza. Mwamwayi, zifukwa zambiri za kutupa kwa chiwindi zomwe zimayambitsa matenda a cirrhosis zimasinthidwa kumayambiriro oyambirira ndi chithandizo chamankhwala chabwino. Mwachitsanzo, kusiya kumwa mowa kumapangitsa kusiyana kwakukulu kwa matenda ozunguza mowa ndi kuchiza matenda a chiwindi cha matenda a chiwindi omwe amatha kuteteza matenda a chiwindi ndi mavuto ambiri a chiwindi. Zapezeka kuti mankhwala a chiwindi cha matenda a hepatitis C angathe kuthetsa vuto la matenda opitirira 90 peresenti, komabe anthu ambiri sadziwa kuti ali ndi matendawa mpaka atayamba kudwala matenda a chiwindi. Tsopano tikulimbikitsidwa kuti osati anthu okha omwe ali ndi chiopsezo cha matenda a chiwindi omwe amayesedwa, komabe aliyense amene anabadwa pakati pa 1945 ndi 1965 ayenera kuyesedwa ndi matenda a hepatitis C.

> Zotsatira:

> Faria, R., Woods, B., Griffin, S., Palmer, S., Sculpher, M., ndi S. Ryder. Kupewa Kukula kwa Cirrhosis mu Chiwindi cha Chiwindi ndi Fibrosis: Kugwira Ntchito ndi Kugwiritsa Ntchito Mtengo Wopambana wa Njira Zophatikizapo ndi New Direct-Acting Anti-Virals. Pharmacology and Medical Therapeutics . 2016. 44 (8): 866-76.

Kasper, Dennis L .., Anthony S. Fauci, ndi Stephen L .. Hauser. Mfundo za Harrison za Mankhwala a M'kati. New York: maphunziro a Mc Graw Hill, 2015. Print.

> Li, J., Chaung, K., Nguyen, P., Le, A., Hoang, J., ndi M. Nguyen. Kukula kwapamwamba kwa chiwindi cha matenda a shuga ku matenda opatsirana pogonana (CHB) Odwala omwe alibe zakumwa zoledzeretsa zakumwa (FL). Gastroenterology . 2017. 152 (5): Suppl 1: S1081-1082.