Mitsempha ya Varicose mu maziko a Esophagus
Mitsempha ya Esophageal ndi mitsempha ya varicose m'mimba. Mitsempha iyi, monga mitsempha yowopsya iliyonse, ikhoza kuphulika ndi kuuluka mosavuta. Kuthamanga kwapopugeal variceal ndi njira yomwe ingawopsyeze moyo yomwe iyenera kuzindikiridwa ndi kuchiritsidwa mwamsanga.
Zifukwa za Zovuta Zopangika
Mitsempha ya varicose ndi mitsempha yomwe yatsekedwa ndipo makomawo anatambasula.
Amapezeka mmiyendo ndipo akhoza kukula ndi msinkhu chifukwa, chabwino, mphamvu yokoka. Mitsempha imabweretsanso magazi m'mtima ndipo sakhala ndi mitsempha yofanana, mitsempha ngati mitsempha. Pamene tiyima ndi kuyenda (mu zaka, ndiko) kuwonjezereka kwa mitsempha ya m'mimba mwathu.
Pamimba, mitsempha ya varicose imayamba osati chifukwa cha msinkhu komanso mphamvu yokoka, koma chifukwa cha kutentha kwapachipatala. Ndondomeko yotsekemera ya pakhomo ndi mitsempha yomwe imayambitsa magazi mu chiwindi, kumene imasinthidwa ndi detoxified. Mwazi ukasiya chiwindi, watsopano ndi wochuluka, umapitirizabe kumtima komwe umatumizidwa m'mapapu kuti usambe mpweya wabwino komanso kutulutsa carbon dioxide. Ziri ngati tsiku la spa.
Mu chiwindi ndi matenda a cirrhosis omwe amatha kuvulazidwa kapena matenda okhudza chiwindi-magazi amaletsedwa ndipo magazi amapitanso kumalo osungirako ziwalo, zomwe zimachititsa kuti mitsempha iwonjezeke.
Kupanikizika kumeneku kungakhudze magazi m'madera onse, makamaka kuchokera m'mimba m'mimba momwemo m'mimba komanso m'mimba.
Mitsempha m'mimba (yotchedwa chapamimba varices) ndipo mitsempha imapangidwira ngati mitsempha yamtundu, yamphepete mwa miyendo. Makoma a mitsempha amakhalanso ofooka komanso osakhwima.
Ndi kupanikizika pang'ono, iwo amatha kupasuka komanso kutuluka magazi kumakhala kovuta.
Kuperekera kwazomera kwa Esophageal Variceal
Kuthamanga kwapopugeal variceal ndi koopsa kwambiri. Palibe zizindikiro zilizonse zowonongeka mpaka magazi atayamba. Pomwe magazi akuyamba, pali zizindikiro ndi zizindikiro . Odwala opatsirana m'mimba otuluka m'mimba ndi m'mimba, osati m'mimba-angayang'ane zizindikiro zotsatirazi:
- Kuwombera magazi ofiira owala kapena khofi emesis (mdima wambiri ndi granular, magazi osakanizidwa pang'ono)
- Mdima wakuda, wamala kapena otayika
- Kutseka
- Kuthamanga mwamsanga
- Kuchepetsa kuthamanga kwa magazi
Mwamsanga, kuthamanga kwa variceal magazi kungachititse mantha komanso kuchepa kwa chidziwitso.
Kuchiza Mwadzidzidzi
Pakadwala magazi othamanga, vuto lodzidzimutsa ndilofunika. Ngati atachiritsidwa mwamsanga, magazi amadzimadzi amatha kupyolera mwa njira zosiyanasiyana. Endoscopy (kamera imayikidwa m'kamwa kudzera pakamwa) ingagwiritsidwe ntchito kupeza ndi kulumikiza mwachindunji kutuluka kwa magazi. Kuphatikiza apo, mankhwala osokoneza bongo (mankhwala omwe amachititsa kuti magazi aziponderezedwa kwambiri) angagwiritsidwe ntchito kuthana ndi kuthamanga kwa magazi mwa odwala omwe amayamba magazi.
Odwala panthawi yosayembekezereka adzakhalanso ndi madzi amchere komanso mwina mankhwala opha tizilombo.
Nthawi yoitana 911
Odwala omwe ali ndi magazi ozunguza mwadzidzidzi omwe amawuluka mwadzidzidzi kapena kusanza magazi kapena mafinya ambiri a khofi ayenera kupita kuchipatala nthawi yomweyo. Itanani 911 kwa wodwala aliyense yemwe ali ndi lethargic, wosokonezeka, wofooka, wamzungu, wotumbululuka, wozizira, kapena wotuluka (diaphoretic). Odwalawa akuonetsa zizindikiro zowopsya, zomwe zimatanthawuza kuti magazi ndi owopsa ndipo pali ngozi yaikulu ya imfa.
Ma Paramedics adzatulutsa magazi ochepa omwe amadziwika ndi magazi a IV, malo abwino komanso mankhwala osokoneza bongo.
Kuthamanga msanga kupita kuchipatala ndi chitsimikiziro cha wodwala amene akudwala magazi ochepa.
Kuchiza Kwanthaŵi Yaitali
Monga tafotokozera pamwambapa, palibe zizindikilo zamagulu ochepa chabe pokhapokha ataphulika ndikuyamba kutuluka m'magazi. Wodwala amangozindikira kuti ali ndi matenda a chiwindi kapena mtundu wina wa chiwopsezo cha pakhomo komanso madokotala amayenera kuyang'ana mankhwala omwe ali pamtundu wa endoscope kuti awone. Ngati atapezeka, doc ikhoza kuchiza mankhwalawa poyambitsa mapulogalamu a mphira, omwe amatchedwa band ligation.
Kuphatikizapo kukonzekera mwachindunji mikwingwirima yowopsa pogwiritsa ntchito njira zogwiritsira ntchito mankhwala, kupatsirana kwapachipatala kungathe kuthandizidwa ndi mankhwala. Ophwanya Beta amagwiritsidwa ntchito kwambiri. Kwa odwala ambiri, kuphatikiza kwa band ligation ndi mankhwala zidzagwiritsidwa ntchito poyendetsa matenda osokoneza bongo.
Ntchito ya Cirrhosis
Cirrhosis ili ndi zifukwa zingapo. Chofala kwambiri ndi matenda a chiwindi a chiwindi, omwe amachititsa kutupa ndi kuwonongeka kwa chiwindi. Kugwiritsa ntchito mowa mopitirira muyeso kumayanjananso ndi matenda a chiwindi ndipo kungachititse kuti matenda a chiwindi asokonezeke ku chiwindi. Matenda a chiwindi a nthendocholic angayambitse matenda ndi chiwindi. N'zotheka kwa odwala kwambiri ndi odwala matenda a shuga kapena shuga. Matenda a hepatitis B omwe amachititsa kuti matendawa asokonezeke, koma tsopano siwodziwika chifukwa chopezeka ndi katemera.
Kuzindikira za kukula kwa chiwindi ndi njira yabwino yothetsera vutoli. Zomwe zimayambitsa matenda a chiwindi ndi zizindikiro zazikulu: matenda odziwika ndi chiwindi, uchidakwa, kunenepa kwambiri, ndi shuga . Anthu ambiri omwe ali ndi chibwibwi choyambirira sadzawona zizindikiro konse pachiyambi. Pamene ikukula, odwala akhoza kukhala ndi zina kapena zotsatirazi: kutopa, kufooka, kusowa kwa njala, kuyabwa, kapena kusuta.
Kuchulukanso kumayambitsa maselo oyera a magazi omwe amamenyana ndi matenda kapena mapulogalamu omwe amathandiza popanga magazi, ndipo kuchepa komwe kumagwiritsidwa ntchito ku chiwindi kumayambitsa mitsempha yapamwamba m'magazi. Ma poizoni angayambitse chisokonezo. Monga poizoni amasonkhanitsa m'magazi, odwala amatha kukhala ndi chifuwa, chomwe ndi chikasu cha misozi (azungu a maso) ndi khungu.
Udindo wa Kuthamanga Kwambiri kwa Portal
Potsirizira pake, odwala onse omwe ali ndi chiwindikiro adzakhala ndi vuto loopsa la pangondomu. Pamene chipsyinjo chimamangirira muzitseko zamakono, mitsempha yaying'ono imakula. Mitsempha imeneyi imapereka njira yoti magazi aziyendayenda pakhomo lachidziwitso ndipo amatchedwa kusungidwa kwadothi. Kufalitsa kwadongosolo kumapereka njira kuti magazi alowe chiwindi chonse ndipo asamatsukidwe konse.
Kuwonjezera pa zizindikiro zowonongeka, kutsekula kwa pakhomo kungayambitse ascites, yomwe imakhala yowonjezera m'mimba. Popeza kuti poizoni ndi mchere sizingachotsedwe bwino, mavuto ena amayamba kuchokera ku zinthu zowonjezereka komanso kuchokera ku kusintha kwa magetsi, monga kusintha kwa plasma kuchokera m'magazi kupita kumayendedwe ozungulira. Mofananamo, madzi amadzimadzi amatha kulowa m'milingo ndi mitsempha, zomwe zimapangitsa kuti kutupa kumatchedwa edema. Matenda opatsirana amadzimadzi amapezeka mwa kuyang'anitsitsa chimodzi mwa mavutowa.
Matenda a Cirrhosis ndi Esophageal
Kuzungulira cirrhosis sikuti nthawi zonse kumayambitsa matenda osokoneza bongo, koma palibe umboni woonekeratu wa angati odwala matenda a chiwindi amayamba kukhala ochepa kwambiri kapena am'mimba am'mimba. Muzofufuza zina, mchitidwe wong'onoting'ono wa oophageal kwa odwala omwe ali ndi matenda a cirrhosis amasiyana ndi 8 peresenti mpaka 83 peresenti. Ndiwo mtundu waukulu.
Magulu a Esophageal ayenera kupezeka ndi endoscopy, koma akapezeka, amayamba kukhala aakulu komanso osakhwimitsa pakapita nthawi. Odwala omwe ali ndi vuto lopweteka kwambiri ali ndi mwayi wokwana magazi 30%.
Malingana ndi chifukwa cha matenda a chiwindikiro, kuthekera kwa kutaya magazi kwa variceal kungachepe kupyolera mwa mankhwala osiyanasiyana ochiritsira. Mankhwala oletsa tizilombo toyambitsa matenda athandizira kuchepetsa kutuluka kwa magazi kwa odwala omwe ali ndi matenda aakulu a chiwindi ndi B beta ndi mankhwala osankhidwa kuti athetse vutoli.
> Zotsatira:
> Hilzenrat, N., & Sherker, AH (2012). Masewera a Esophageal: Mmene Tizilombo Tomwe Timapangidwira, Njira Yomwe Timagwirira Ntchito, ndi Zomwe Tizilombo Tomwe Timapanga. International Journal of Hepatology , 2012 , 795063. http://doi.org/10.1155/2012/795063
> Lahbabi, M., Elyousfi, M., Aqodad, N., Elabkari, M., Mellouki, I., Ibrahimi, SA, & Benajah, DA (2013). Esophageal variceal ligation for hemostasis ya acute variceal magazi: mphamvu ndi chitetezo. Pan African Medical Journal , 14 , 95. http://doi.org/10.11604/pamj.2013.14.95.1847
> Li, C.-Z., Cheng, L.-F., Li, Q.-S., Wang, Z.-Q., & Yan, J.-H. (2013). Mankhwala othandiza kuchepetsa matendawa amachedwa kuchepetsa magazi m'matumbo a hepatitis B okhudzana ndi kachilomboka. World Journal of Gastroenterology: WJG , 19 (40), 6849-6856. http://doi.org/10.3748/wjg.v19.i40.6849
> Kuchulukanso | NIDDK . (2018). National Institute of Diabetes ndi Matenda a Kumimba ndi Impso . Ipezeka kuchokera ku https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis
> ROMANO, G., AGRUSA, A., AMATO, G., DE VITA, G., FRAZZETTA, G., CHIANETTA, D., ... GULOTTA, G. (2014). Endoscopic sclerotherapy ya hemostasis ya magazi osokoneza bongo. Il Giornale Di Chirurgia , 35 (3-4), 61-64.
> Triantos, C., & Kalafateli, M. (2014). Kupititsa patsogolo mankhwala operewera kwa odwala matenda a chiwindi. World Journal of Gastroenterology: WJG , 20 (36), 13015-13026. http://doi.org/10.3748/wjg.v20.i36.13015