Ukopha Ama-Varices Esophageal

-Delile

• Ziyini izinkomba zokopha kwe-esophageal varices?
• Yini ebangela ukopha kwe-varices esophageal varices?
• Yiziphi izinto ezinobungozi zokuphuma kwegazi lokugaya isisu?
• Ukuhlonza i-varices esophageal varices
• Ukwelapha i-varices esophageal varices
• Ukulawula i-portal hypertension
• Ngemuva kokopha sekuqalile
• Umbono wesikhathi eside wabantu abane-varices esophageal varices
• Kungavinjelwa kanjani ama-varices esophageal?

Yini ama-varices esophageal varices?

Ukopha kwe-varices esophageal varices kwenzeka lapho imithambo evuvukile (varices) ekuqhekekeni kwesisu sakho esezansi futhi wopha.

I-esophagus iyishubhu yemisipha exhuma umlomo wakho esiswini sakho. Imithambo esigaxeni sakho sangaphansi esiswini ingavuvukala lapho ukugeleza kwegazi kuye esibindini kuncishisiwe. Lokhu kungabangelwa izicubu ezibomvu noma i-clot yegazi ngaphakathi kwesibindi.

Lapho ukugeleza kwegazi lesibindi kuvinjelwe, igazi liyakhula kweminye imithambo yegazi eseduze, kufaka phakathi leyo esophophini yakho engezansi. Kodwa-ke, le mithambo incane kakhulu, futhi ayikwazi ukuthwala igazi eliningi. Ziyanwebeka futhi zivuvuke ngenxa yokwanda kwegazi.

Imithambo evuvukile yaziwa ngokuthi ama-esophageal varices.

Ama-esophageal varices angavuza igazi futhi ekugcineni aqhume. Lokhu kungaholela ekuphumeni kwegazi okunzima kanye nezinkinga ezisongela impilo, kufaka phakathi ukufa. Uma lokhu kwenzeka, kuyisimo esiphuthumayo sezokwelapha. Shayela u-911 noma uye egumbini lezimo eziphuthumayo eliseduze ngokushesha uma ukhombisa izimpawu zokopha kwe-esophageal varices.

Ziyini izinkomba zokopha kwe-esophageal varices?

Ama-varices esophageal mancane amathuba okuthi abangele izimpawu ngaphandle kokuthi aqhekekile. Uma lokhu kwenzeka, ungahlangabezana:

• i-hematemesis (igazi ebuhlanzweni bakho)
• ubuhlungu besisu
• ikhanda elikhanyayo noma ukulahlekelwa ukwazi
• melena (indle emnyama)
• indle enegazi (ezimweni ezinzima)
• ukushaqeka (umfutho wegazi ophansi ngokweqile ngenxa yokulahleka kwegazi okungaholela ekulimaleni komzimba okuningi)

Shayela ku-911 noma uye ekamelweni labezimo eziphuthumayo eliseduze ngokushesha uma uhlangabezana nalezi zimpawu ezingenhla.

Yini ebangela ukopha kwe-varices esophageal varices?

I-portal vein idlulisa igazi lisuka ezithweni eziningana ezisemgodini wamathumbu liye esibindini. Ama-varices esophageal angumphumela oqondile womfutho wegazi ophakeme emthanjeni we-portal. Lesi simo sibizwa ngokuthi yi-portal hypertension. Kubangela ukwakheka kwegazi emithanjeni yegazi eseduze, kufaka phakathi leyo esemzimbeni wakho. Imithambo iqala ukunwebeka futhi ivuvukale ngenxa yokwanda kwegazi.

I-Cirrhosis iyimbangela ejwayelekile kakhulu yomfutho wegazi ophezulu wengosi. I-Cirrhosis yisibazi esinzima sesibindi esivame ukukhula ngenxa yokuphuza ngokweqile noma ukutheleleka okunzima, njenge-hepatitis. Enye imbangela engaba khona yomfutho wegazi ophezulu wengosi yi-portal vein thrombosis, isimo esenzeka lapho amahlule egazi ngaphakathi kwe-portal vein.

Kwezinye izimo, imbangela ye-portal hypertension ayaziwa. Lokhu kubizwa ngokuthi yi-idiopathic portal hypertension.

Yiziphi izinto ezinobungozi zokuphuma kwegazi lokugaya isisu?

Ama-varices esophageal maningi amathuba okuthi opha uma une:

• ama-varices amakhulu we-esophageal
• amamaki abomvu kuma-varices esophageal njengoba kubonakala esikhungweni sesisu esikhanyayo (endoscopy)
• umfutho wegazi ophezulu wengosi
• ukuqina kwesibindi okukhulu
• ukutheleleka kwamagciwane
• ukusetshenziswa ngokweqile kotshwala
• ukuhlanza ngokweqile
• ukuqunjelwa
• izikhathi ezinzima zokukhwehlela

Khuluma nodokotela wakho ngengozi yakho yokuthuthukisa ama-esophageal varices, ikakhulukazi uma unomlando womndeni wesifo sesibindi.

Ukuhlonza i-varices esophageal varices

Ukuthola i-varices esophageal varices, udokotela wakho uzokwenza ukuhlolwa komzimba akubuze ngezimpawu zakho. Bangasebenzisa futhi ukuhlolwa okukodwa noma okuningi okulandelayo ukuqinisekisa ukuxilongwa:

• Ukuhlolwa kwegazi: Lokhu kusetshenziselwa ukuhlola ukubalwa kwamaseli egazi nokusebenza kwesibindi nezinso.
• I-Endoscopy: Ngesikhathi sale nqubo, ukufakwa kwekhamera elincane elikhanyayo kufakwa emlonyeni futhi kusetshenziselwe ukubheka phansi isisu, esiswini, nasekuqaleni kwethumbu elincane. Isetshenziselwa ukubhekisisa kakhulu imithambo nezitho ezivulekile. Ingasetshenziswa futhi ukuthatha amasampula wezicubu nokwelapha ukopha.
• Ukuhlola ukuhlolwa, okufana nokuhlolwa kwe-CT ne-MRI: Lokhu kusetshenziselwa ukuhlola izitho zesibindi nezesisu nokuhlola ukugeleza kwegazi ngaphakathi nangaphakathi kwalezi zitho.

Ukwelapha i-varices esophageal varices

Inhloso enkulu yokwelashwa ukuvimbela ama-esophageal varices kusuka ekuqhekekeni nasekuphumeni kwegazi.

Ukulawula i-portal hypertension

Ukulawula umfutho wegazi ophakeme imvamisa kuyisinyathelo sokuqala sokwehlisa ingozi yokopha. Lokhu kungafinyelelwa ngokusebenzisa le mithi elandelayo kanye nemithi:

• Ama-beta-blockers: Udokotela wakho angakunikeza imithi ye-beta-blocker, njengepropranolol, ukwehlisa umfutho wegazi.
• I-Endoscopic sclerotherapy: Usebenzisa i-endoscope, udokotela wakho uzofaka umuthi emithanjeni yakho evuvukile ezobanciphisa.
• I-endoscopic variceal ligation (i-banding): Udokotela wakho uzosebenzisa i-endoscope ukubopha imithambo evuvukile endaweni yakho ngebhande lokunwebeka ukuze bangakwazi ukopha. Bazosusa amabhendi ngemuva kwezinsuku ezimbalwa.

Ungadinga ukwelashwa okungeziwe uma ama-varices akho wokuqunjelwa esophageal esevele aqhumile.

Ngemuva kokopha sekuqalile

I-endoscopic variceal ligation kanye ne-endoscopic sclerotherapy ngokuvamile kuyindlela yokuvikela. Kodwa-ke, udokotela wakho angazisebenzisa futhi uma ama-varice esophageal varices wakho eseqalile ukuphuma igazi. Imithi ebizwa nge-octreotide nayo ingasetshenziswa. Lesi sidakamizwa sizokwehlisa ingcindezi emithanjeni evuvukile ngokuqinisa imithambo yegazi nokunciphisa ukuhamba kwegazi.

Inqubo yeTransjugular intrahepatic portosystemic shunt (TIPS) enye indlela yokwelashwa engahle yenzeke kuma-varices esophageal varices aphindayo. Le yinqubo esebenzisa i-X-ray ukuqondisa ukubekwa kwensimbi edala ukuxhumana okusha phakathi kwemithambo yegazi emibili esibindini sakho.

Kusetshenziswa ithubhu elincane ukuxhuma umthambo we-portal nomthambo we-hepatic. Umthambo we-hepatic udlulisa igazi lisuke esibindini liye enhliziyweni. Lokhu kuxhumana kudala ukuphambukiswa kokugeleza kwegazi.

Inqubo ye-distlen spnorenal shunt (i-DSRS) kungenye indlela yokwelashwa kepha iyahlasela kakhulu. Le yinqubo yokuhlinza exhuma umthambo omkhulu osuka ebeleni uye emthanjeni wezinso zangakwesokunxele. Lokhu kulawula ukuphuma kwegazi kuma-esophageal varices kumaphesenti angama-90 abantu.

Ezimweni ezingavamile, ukufakelwa kwesibindi kungadingeka.

Umbono wesikhathi eside wabantu abane-varices esophageal varices

Ukopha kuzoqhubeka ukwenzeka uma isimo singelashwa ngokushesha. Ngaphandle kokwelashwa, ukuphuma kwe-esophageal varices kungabulala.

Ngemuva kokuthola ukwelashwa kwe-varices esophageal varices, kufanele uye kuma-aphoyintimenti ajwayelekile wokulandelela nodokotela wakho ukuze uqiniseke ukuthi ukwelashwa kuphumelele.

Kungavinjelwa kanjani ama-varices esophageal?

Indlela engcono yokuvimbela i-esophageal varices ukulungisa imbangela eyisisekelo. Uma unesifo sesibindi, cabanga ngalezi zinyathelo ezilandelayo zokunciphisa ubungozi bokuba ne-varices esophageal varices:

• Yidla ukudla okunempilo okuqukethe kakhulu usawoti omncane, amaprotheni amancane, okusanhlamvu okuphelele, izithelo nemifino.
• Yeka ukuphuza utshwala.
• Gcina isisindo esinempilo.
• Yehlisa ubungozi be-hepatitis ngokwenza ucansi oluphephile. Ungabelani ngezinaliti noma izinsingo, futhi ugweme ukuxhumana negazi nolunye uketshezi lomzimba lomuntu onegciwane.

Kubaluleke kakhulu ukunamathela kuhlelo lwakho lokwelashwa futhi uye emihlanganweni njalo nodokotela wakho uma une-varices esophageal. Shayela ku-911 noma uye esibhedlela ngokushesha uma ukholelwa ukuthi imishanguzo yakho yokuqunjelwa kokuqhuma iqhume. Ukopha kwe-varices esophageal varices kusongela impilo futhi kungaholela ezinkingeni ezinkulu.