Ama-Ascites

I-Ascites ukwakhiwa koketshezi esikhaleni esiphakathi kolwelwesi lwesisu kanye nezitho zesisu.

Ama-Ascites abangelwa ukucindezela okukhulu emithanjeni yegazi yesibindi (i-portal hypertension) namazinga aphansi ephrotheni abizwa nge-albumin.

Izifo ezingadala ukulimala kwesibindi okukhulu zingaholela kuma-ascites. Lokhu kufaka phakathi:

• Ukutheleleka okungapheli kwe-hepatitis C noma i-B
• Ukuphuza ngokweqile iminyaka eminingi
• Isifo sesibindi esinamafutha (i-steatohepatitis noma i-NASH engeyona i-alcohol)
• I-cirrhosis ebangelwa izifo zofuzo

Abantu abanomdlavuza othile esiswini bangaba nama-ascites. Lokhu kufaka phakathi umdlavuza wesithasiselo, ikholoni, amaqanda, isibeletho, amanyikwe, nesibindi.

Ezinye izimo ezingadala le nkinga zifaka:

• Amahlule emithanjeni yesibindi (portal vein thrombosis)
• Ukwehluleka kwenhliziyo yokubopha
• I-Pancreatitis
• Ukuqina nokusikeka kwesembozo esifana nesenhliziyo (i-pericarditis)

I-dialysis yezinso nayo ingaxhunyaniswa nama-ascites.

Izimpawu zingakhula kancane noma ngokuzumayo ngokuya ngesizathu se-ascites. Ungahle ungabi nazimpawu uma kukhona inani elincanyana loketshezi esiswini.

Njengoba uketshezi oluningi luqoqa, ungaba nobuhlungu besisu nokuqunjelwa. Uketshezi oluningi kungadala ukuphefumula okuncane, Lokhu kwenzeka ngoba uketshezi ludlulela phezulu ku-diaphragm, yona ecindezela amaphaphu aphansi.

Ezinye izimpawu eziningi zokuhluleka kwesibindi nazo zingaba khona.

Udokotela wakho uzokwenza isivivinyo somzimba ukuthola ukuthi ukuvuvukala kungenzeka yini kungenxa yokwakhiwa koketshezi esiswini sakho.

Ungaba nokuhlolwa okulandelayo ukuhlola isibindi nezinso zakho:

• Ukuqoqwa komchamo wamahora angama-24
• Amazinga e-Electrolyte
• Ukuhlolwa kokusebenza kwezinso
• Ukuhlolwa kokusebenza kwesibindi
• Ukuhlolwa ukukala ubungozi bokuphuma kwegazi namazinga wamaprotheni egazini
• Ukuhlolwa komchamo
• I-ultrasound yesisu
• I-CT scan yesisu

Udokotela wakho angasebenzisa nenaliti encane ukukhipha uketshezi olusuka esiswini sakho. Uketshezi luyahlolwa ukubheka imbangela yama-ascites nokubheka ukuthi uketshezi luthelelekile yini.

Isimo esibangela ama-ascites sizokwelashwa, uma kungenzeka.

Ukwelashwa kokwakhiwa kuketshezi kungafaka izinguquko kwendlela yokuphila:

• Ukugwema utshwala
• Ukwehlisa usawoti ekudleni kwakho (kungadluli i-1,500 mg / usuku lwe-sodium)
• Ukunciphisa ukudla okuphuza uketshezi

Ungathola nemithi kudokotela wakho, kufaka phakathi:

• "Amaphilisi amanzi" (isisu) ukuqeda uketshezi olungeziwe
• Ama-antibiotic wezifo

Ezinye izinto ongazenza ukusiza ukunakekela isifo sakho sesibindi yilezi:

• Gomela izifo ezifana nomkhuhlane, i-hepatitis A ne-hepatitis B, ne-pneumococcal pneumonia
• Khuluma nodokotela wakho ngayo yonke imithi oyiphuzayo, kufaka phakathi amakhambi nezithako zokudla kanye nemithi ongayisebenzisi

Izinqubo ongazithola yilezi:

• Ukufaka inaliti esiswini ukuze ususe umthamo omkhulu woketshezi (obizwa ngeparacentesis)
• Ukubeka ithubhu ekhethekile noma i-shunt ngaphakathi kwesibindi sakho (AMACEBISO) ukulungisa ukugeleza kwegazi kuye esibindini

Abantu abanesifo sesibindi sokugcina bangadinga ukufakelwa kwesibindi.

Uma une-cirrhosis, gwema ukuthatha imishanguzo yokulwa nokuvuvukala, njenge-ibuprofen (Advil, Motrin) ne-naproxen (Aleve, Naprosyn). I-Acetaminophen kufanele ithathwe ngemithamo encishisiwe.

Izinkinga zingafaka:

• I-bacterial peritonitis ezenzakalelayo (isifo esongela impilo se-ascitic fluid)
• I-Hepatorenal syndrome (ukwehluleka kwezinso)
• Ukwehla kwesisindo namaprotheni
• Ukudideka kwengqondo, ushintsho ezingeni lokuqapha, noma i-coma (hepatic encephalopathy)
• Ukopha okuphuma phezulu noma ngaphansi kwamapheshana emathunjini
• Ukwakha uketshezi esikhaleni phakathi kwamaphaphu akho nesifuba (i-pleural effusion)
• Ezinye izinkinga zesibindi sokuqina kwesibindi

Uma une-ascites, shayela umhlinzeki wakho wezokunakekelwa kwezempilo ngokushesha uma une:

• Umkhuhlane ongaphezu kuka-100.5 ° F (38.05 ° C), noma umkhuhlane ongapheli
• Ubuhlungu besisu
• Igazi elisesitokisini sakho noma elimnyama, indle yokulinda
• Igazi emhlanzweni wakho
• Ukuqubuka noma ukopha okwenzeka kalula
• Yakha uketshezi esiswini sakho
• Imilenze evuvukile noma amaqakala
• Izinkinga zokuphefumula
• Ukudideka noma izinkinga zokuhlala uphapheme
• Umbala ophuzi esikhumbeni sakho kanye namhlophe wamehlo akho (i-jaundice)

Umfutho wegazi ophakeme portal - ascites; Ukuqina kwesibindi - ascites; Ukwehluleka kwesibindi - ascites; Ukusetshenziswa kotshwala - ascites; Isifo sesibindi sokugcina - i-ascites; ESLD - ascites; I-Pancreatitis ascites

• Ama-Ascites anomdlavuza we-ovari - i-CT scan
• Izitho zohlelo lokugaya ukudla

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.

I-National Institute of Diabetes kanye newebhusayithi yezifo zeDigestive and Kidney. Isifo sokuqina kwesibindi. www.niddk.nih.gov/health-information/liver-disease/cirrhosis/all-content. Kubuyekezwe uMashi 2018. Kufinyelelwe ngoNovemba 11, 2020.

USola E, iGines SP. Ama-Ascites kanye ne-peritonitis ebangelwa yi-bacterial peritonitis. Ku: Feldman M, Friedman LS, Brandt LJ, ama-eds. Sleisenger kanye neFordtran's Gastrointestinal and Liver Disease. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2021: isahluko 93.