Zizindikiro, Kuzindikira ndi Chithandizo cha PSC, Matenda a Chiwindi Ophatikiza ndi IBD
Pulasitiki sclerosing cholangitis (PSC) ndi matenda a chiwindi omwe amachititsa kutupa ndi kuchepa kwa dothi mkati ndi kunja kwa chiwindi. Sitikudziwa chomwe chimayambitsa PSC, ngakhale kuti imaganiza kuti ndiyomwe imayendera. PSC sichimaganiziridwa kukhala yobadwa mwachindunji, koma imaganiziridwa kuti ili ndi chigawo cha chibadwa.
Kutsekera ndikofunikira kuti chimbudzi cha mafuta chichoke ndikuchotsa chiwindi.
PSC imachititsa kuti ntchentche zikhale zochepa kuti zisakanike ndi kutupa, ndipo bile imayamba kuwonjezeka m'chiwindi, chomwe chimayipitsa. Kuwonongeka kumeneku kumadzetsa kuphulika kofiira ndi kupiringizika , zomwe zimateteza chiwindi kuti zisamachite ntchito zake zofunika. Zaka zingapo za PSC zingapangitse chotupa cha khansa cha mankhwala otchedwa cholangiocarcinoma, omwe amapezeka odwala 10 mpaka 15%.
PSC ikupita patsogolo pang'onopang'ono, koma ingakhalenso yosadziŵika bwino ndi kuopseza moyo. Anthu omwe ali ndi PSC angathe kulandira chithandizo kuti athetse zizindikiro komanso kuwathandiza kukhala ndi moyo wokhutira.
Chiŵerengero cha Demo
Nthawi zambiri, anthu omwe ali ndi vuto la PSC ali pakati pa zaka makumi atatu ndi makumi asanu ndi zisanu ndi zisanu ndi ziwiri (60) ndipo ali ndi zaka makumi asanu ndi anayi (40). 60 mpaka 75% ya anthu omwe amapezeka kuti ndi amuna. Padziko lonse, PSC ndi matenda osadziwika bwino.
Zizindikiro
Anthu ena alibe zizindikiro za matendawa kapena ngakhale patapita zaka zingapo.
Zizindikiro zikuphatikizapo:
- Kutsekula m'mimba (kochokera ku malabsorption of fat)
- Kutopa
- Chiwopsezo / chimfine (kuchokera ku matenda m'matope a bile)
- Kuyabwa komwe kumakhudza thupi lonse
- Jaundice (khungu la khungu ndi maso)
Matenda Ogwirizana
Anthu omwe ali ndi PSC amakhala odwala matenda opatsirana (IBD) kapena osteoporosis.
PSC imakhudzidwa kwambiri ndi ulcerative colitis kwa odwala 70 peresenti ya odwala, koma ikhozanso kugwirizanitsa ndi matenda a Crohn m'matumbo akulu, omwe nthawi zina amatchedwa Crohn's colitis . Chifukwa choyanjana ndi IBD sichikudziwika, koma akuganiza kuti ndicho chotsatira cha kuyankha kwa chitetezo cha mthupi.
Kudziwa
PSC imapezeka ndi njira yotchedwa ERCP (endoscopic retrograde cholangiopancreatography) . Panthawi ya ERCP, dokotala amalowetsamo kamvekedwe kameneka ndikuyendetsa pansi kupyola m'mimba ndi m'mimba kupita ku mitengo ya biliary. Dye imalowetsedwa m'matope kuti iwonetsedwe pamene x-ray imatengedwa. Ma x-rays amafufuzidwa kuti adziwe ngati pali mavuto aliwonse ndi bile.
Kutulukira kwa PSC kungakhale kotsimikiziridwa ndi mayeso a magazi omwe amadziwika kuti ALK (alkaline phosphatase), ngakhale kuti zotsatira zabwino zikhoza kuwonetsa zina zambiri kuposa PSC.
Chiwindi cha chiwindi chimathandizanso kutsimikiziranso kuti matenda a PSC ndi otani, komanso kuyang'anitsitsa kukula kwa matendawa atatha kupeza matenda. Chiopsezo cha chiwindi chimaperekedwa kuchipatala pamlingo wapachilombo chifukwa cha kuchepetsa thupi . Dokotala yemwe akuchita mayeso amagwiritsa ntchito singano kutenga kachidutswa kakang'ono ka chiwindi cha chiwindi kuti ayesedwe ndi wodwala matenda.
Kuchiza
Palibe mankhwala omwe atsimikiziridwa kukhala othandiza pochiza PSC. Kafukufuku wopezera chithandizo chamankhwala wothandiza tsopano akuchitika. Mapulani a chithandizo amalingalira kuthetsa zizindikiro, kusokoneza kukula kwa matenda, ndi kuyang'anira zovuta zomwe zingatheke.
Zizindikiro za PSC zikhoza kuperekedwa kuti odwala akhale omasuka. Kuyamwa kungapangidwe ndi Questran (cholestyramine) kapena Benadryl (diphenhydramine). Kwa matenda opatsirana omwe angathe kuchitika ndi PSC, ma antibiotic angakhale oyenera. Chifukwa chakuti PSC imasokoneza mafinya, mafuta owonjezera amatha kukhala oyenerera kuti athetse mavitamini A, D, E ndi K.
Ngati mitsempha imapezeka m'kati mwake, njira yopaleshoni ingakhale yofunikira kuwongolera kapena kuwatsegula. Nsonga, zomwe zimapangitsa kuti mipata ikhale yotseguka, ikhoza kuikidwa m'matope panthawiyi.
Ngati chiwerengero cha PSC chimachititsa chiwindi kulephera kapena matenda opatsirana a biliyali, kuika chiwindi kungakhale kofunikira. Kuwombera kwa chiwindi kumapereka moyo wabwino kwa obwera, komanso kupulumuka kwa pafupifupi 75 peresenti.
Nthawi yoyenera Dokotala
Ngati zizindikiro zotsatirazi zikuchitika ndi PSC, dinani dokotala wanu:
- Kupweteka m'mimba
- Zithunzi zakuda kapena zakuda
- Jaundice
- Kutentha kuposa 100.4
- Kuthamanga ndi magazi
Zotsatira :
Johns Hopkins Mankhwala. "Primary Sclerosing Cholangitis." University of Johns Hopkins 2013.
Karlsen TH, Hampe J, Wiencke K, Schrumpf E, Thorsby E, Lie BA, Broomé U, Schreiber S, Boberg KM. "Mafupa Omwe Amayambitsa Matenda Opatsirana Opaleshoni Musathenso Kuopseza Cholinga Chachikulu Cholangitis." M J Gastroenterol Jan 2007.
Merck Manual. "Primary Sclerosing Cholangitis (PSC)" Merck & Co, Inc Sept 2007.
Van Steenbergen W, De Goede E, Pulezidenti wa Emond, Reinders J, Tilanus M, Fevery J. "Primary Sclerosing Cholangitis mwa Abale Awiri: Lipoti la Banja Lolimbikitsa Kwambiri pa HLA ndi MICA Genotyping." Eur J Gastroenterol Hepatol Jul 2005.