Ukopha i-varices esophageal varices

I-esophagus (ipayipi lokudla) yishubhu elihlanganisa umphimbo wakho nesisu sakho. Ama-Varices yimithambo ekhulisiwe engatholwa ku-esophagus kubantu abane-cirrhosis yesibindi. Le mithambo ingahle iqhume futhi yophe.

Ukuqubuka (i-cirrhosis) kwesibindi kuyimbangela evame kakhulu yama-varices esophageal. Lesi sibazi sinciphisa igazi eligeleza phakathi kwesibindi. Ngenxa yalokho, igazi eliningi ligeleza emithanjeni yomphimbo.

Ukugeleza kwegazi okwengeziwe kubangela ukuthi imithambo esesigodini ibhaluni ngaphandle. Ukopha kakhulu kungenzeka uma imithambo idabuka.

Noma yiluphi uhlobo lwesifo sesibindi sesikhathi eside (esingapheli) singadala ama-esophageal varices.

Ama-Varices angenzeka futhi engxenyeni engenhla yesisu.

Abantu abanezifo ezingapheli zesibindi kanye ne-esophageal varices kungenzeka bangabi nazimpawu.

Uma kukhona ukopha okuncane kuphela, okuwukuphela kwesibonakaliso kungaba yimifudlana emnyama noma emnyama esitokisini.

Uma kwenzeka ukuphuma okukhulu kwegazi, izimpawu zingafaka:

• Okumnyama, izitulo zokubambezeleka
• Izitulo ezinegazi
• Ubumhlophe
• Ukudinwa
• Izimpawu zesifo esingapheli sesibindi
• Kuhlanza igazi

Umhlinzeki wakho wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba okungakhombisa:

• Indle enegazi noma emnyama (ekuhlolweni kwamakholomu)
• Umfutho wegazi ophansi
• Ukushaya kwenhliziyo okusheshayo
• Izimpawu zesifo esingapheli sesibindi noma i-cirrhosis

Ukuhlolwa kokuthola umthombo wokopha nokubheka ukuthi kukhona yini ukopha okusebenzayo kufaka:

• I-EGD noma i-endoscopy ephezulu, efaka ukusetshenziswa kwekhamera kushubhu eliguquguqukayo ukuhlola isopha nesisu.
• Ukufakwa kweshubhu ngamakhala ungene esiswini (nasogastric tube) ukubheka izimpawu zokopha.

Abanye abahlinzeki basikisela i-EGD kubantu abasanda kutholakala ukuthi bane-cirrhosis emnene kuya kokumaphakathi. Lesi sivivinyo sihlola ama-varices esophageal futhi sibaphathe ngaphambi kokuba kuphume igazi.

Inhloso yokwelashwa ukumisa ukopha okukhulu ngokushesha okukhulu ngangokunokwenzeka. Ukopha kufanele kulawulwe ngokushesha ukuvimbela ukushaqeka nokufa.

Uma kwenzeka ukuphuma kwegazi okukhulu, umuntu kungadingeka ukuthi afakwe kumshini wokuphefumula ukuze avikele indlela yakhe yomoya futhi avimbele igazi ekushoneleni emaphashini.

Ukumisa ukuphuma kwegazi, umhlinzeki angadlulisa i-endoscope (ithubhu elinelambu elincane ekugcineni) aye kulo umphimbo:

• Umuthi ojiyisayo ungafakwa kuma-varice.
• Kungabekwa ibhande lenjoloba elizungeze imithambo eyophayo (ebizwa ngokuthi yi-banding).

Ezinye izindlela zokwelapha zokunqanda ukuphuma kwegazi:

• Umuthi wokuqinisa imithambo yegazi unganikezwa ngomthambo. Izibonelo zifaka phakathi i-octreotide noma i-vasopressin.
• Akuvamile ukuthi kufakwe ipayipi esiswini bese lifuthwa ngumoya. Lokhu kuveza ingcindezi emithanjeni eyophayo (ibhaluni tamponade).

Lapho ukuphuma kwegazi sekumisiwe, amanye ama-varices angalashwa ngemithi nangezindlela zokwelashwa ukuvimbela ukopha esikhathini esizayo. Lokhu kufaka phakathi:

• Izidakamizwa ezibizwa nge-beta blockers, njengepropranolol ne-nadolol ezinciphisa ingozi yokopha.
• Ibhande lenjoloba lingabekwa lizungeze imithambo eyophayo ngesikhathi senqubo ye-EGD. Futhi, eminye imithi ingajovwa kuma-varices ngesikhathi se-EGD ukuze ibenze bajiye.
• I-Transjugular intrahepatic portosystemic shunt (AMACEBISO). Le yinqubo yokwakha ukuxhumana okusha phakathi kwemithambo yegazi emibili esibindi sakho. Lokhu kunganciphisa ingcindezi emithanjeni futhi kuvimbele iziqephu zokopha zingaphinde zenzeke.

Ezimweni ezingavamile, ukuhlinzwa okuphuthumayo kungasetshenziswa ukwelapha abantu uma olunye ukwelashwa kwehluleka. Ukuvalwa kwePortacaval noma ukuhlinzwa ukunciphisa ingcindezi kuma-esophageal varices kuyindlela yokwelashwa, kepha lezi zinqubo ziyingozi.

Abantu abane-varices yegazi esifo sesibindi bangadinga ukwelashwa okwengeziwe kwezifo zabo zesibindi, kufaka phakathi ukufakelwa kwesibindi.

Ukopha kuvame ukubuya noma ngaphandle kokwelashwa.

Ukopha kwe-varices esophageal varic kuyinkinga enkulu yesifo sesibindi futhi kunomphumela omubi.

Ukubekwa kwe-shunt kungaholela ekwehliseni ukunikezwa kwegazi ebuchosheni. Lokhu kungaholela ekushintsheni kwesimo sengqondo.

Izinkinga zesikhathi esizayo ezibangelwa ama-varices zingafaka:

• Ukuncipha noma ukuqina kwesimuncu ngenxa yesibazi ngemuva kwenqubo
• Ukubuyisa ukopha ngemuva kokwelashwa

Shayela umhlinzeki wakho noma uye egumbini lezimo eziphuthumayo uma uhlanza igazi noma unezihlalo ezimnyama zokubambezeleka.

Ukwelapha izimbangela zesifo sesibindi kungavimbela ukopha. Ukufakelwa kwesibindi kufanele kubhekwe kwabanye abantu.

Isibindi sokuqina kwesibindi - i-varices; Isifo sesibindi esingapheli se-Cryptogenic - ama-varices; Isifo sesibindi sokuphela - ama-varices; Isifo sesibindi esidakayo - ama-varices

• I-cirrhosis - ukukhipha

• Uhlelo lokugaya ukudla
• Ukunikezwa kwegazi lesibindi

IGarcia-Tsao G. Cirrhosis nokulandelana kwayo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 144.

Igcina iTJ, Jensen DM. Ukopha emathunjini. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. ISleisenger neFordtran's Gastrointestinal and Liver Disease: IPathophysiology / Diagnosis / Management. Umhlaka 10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 20.