Sclerosing cholangitis: kuyini, izimpawu nokwelashwa

-Delile

• Izimpawu zesclerosing cholangitis
• Izimbangela eziyinhloko
• Ukuxilongwa kwenziwa kanjani
• Ukwelashwa kwe-sclerosing cholangitis

I-Sclerosing cholangitis yisifo esingajwayelekile esivame kakhulu emadodeni esaziwa ngokubandakanyeka kwesibindi ngenxa yokuvuvukala ne-fibrosis ebangelwa ukuncipha kweziteshi lapho kudlula i-bile, okuyisisekelo esiyisisekelo senqubo yokugaya ukudla, engaholela, kwezinye izimo, ukuvela kwezinye izimpawu, njengokukhathala ngokweqile, isikhumba esiphuzi namehlo nobuthakathaka bemisipha.

Izimbangela ze-cholangitis azikacaci kahle, kepha kukholakala ukuthi ingahle ihlobane nezici ezizimele zomzimba ezingaholela ekuvukeleni okuqhubekayo kwemibhobho yenyongo. Ngokwomsuka, i-sclerosing cholangitis ingahlukaniswa ngezinhlobo ezimbili eziyinhloko:

• I-primary sclerosing cholangitis, lapho ukuguqulwa kwaqala khona emigodini ye-bile;
• I-Secondary sclerosing cholangitis, lapho ushintsho kungumphumela wolunye ushintsho, njengesimila noma ukuhlukumezeka kwesayithi, isibonelo.

Kubalulekile ukuthi kukhonjwe umsuka we-cholangitis ukuze kuboniswe ukwelashwa okufanele kakhulu ngakho-ke, kunconywa ukuthi uthintane nodokotela ojwayelekile noma i-hepatologist ukuze ukhombise ukuhlolwa kwe-imaging nelebhu okuvumela ukuthi ukuxilongwa kuphothulwe.

Izimpawu zesclerosing cholangitis

Izimo eziningi ze-cholangitis aziholeli ekubonakaleni kwezimpawu noma izimpawu, futhi lolu shintsho lutholakala kuphela ngesikhathi sokuhlolwa kwe-imaging. Kodwa-ke, abanye abantu bangathola izimpawu, ikakhulukazi uma kukhulunywa nge-sclerosing cholangitis, lapho kuhlala khona inyongo esibindini. Ngakho-ke, izimpawu eziyinhloko ezibonisa i-cholangitis yilezi:

• Ukukhathala ngokweqile;
• Ukulunywa komzimba;
• Isikhumba esiphuzi namehlo;
• Kungaba nemfiva ebandayo nobuhlungu besisu;
• Ubuthakathaka bemisipha;
• Ukwehla kwesisindo;
• Ukwandiswa kwesibindi;
• Ubende obukhulisiwe;
• Ukuqhamuka kwama-xanthomas, okuyizilonda esikhunjeni esenziwe ngamafutha;
• Ukulunywa.

Kwezinye izimo, kungahle kube nohudo, ubuhlungu besisu kanye nokuba khona kwegazi noma amafinyila esitobhini. Lapho kukhona lezi zimpawu, ikakhulukazi uma ziphindaphindeka noma zingaguquguquki, kubalulekile ukuthi uthintane nodokotela ojwayelekile noma i-hepatologist ukuze kwenziwe ukuhlolwa futhi kuqale ukwelashwa okufanele.

Izimbangela eziyinhloko

Izimbangela ze-sclerosing cholangitis azikakasungulwa kahle, kepha kukholakala ukuthi kungenzeka kungenxa yezinguquko ezenzeka emzimbeni noma zihlobane nezici zofuzo noma ukutheleleka ngamagciwane noma amagciwane.

Ngaphezu kwalokho, kukholelwa nokuthi i-sclerosing cholangitis ihlobene ne-ulcerative colitis, lapho abantu abanalesi sifo sesifuba esivuthayo besengozini enkulu yokuthola i-cholangitis.

Ukuxilongwa kwenziwa kanjani

Ukuxilongwa kwe-sclerosing cholangitis kwenziwa ngudokotela ojwayelekile noma i-hepatologist ngokusebenzisa izivivinyo zelebhu nezithombe. Ngokuvamile, ukuxilongwa kokuqala kwenziwa ngemiphumela yezivivinyo ezihlola ukusebenza kwesibindi, ngoshintsho enanini lama-enzyme wesibindi, njenge-TGO ne-TGP, ngaphezu kokunyuka kwe-alkaline phosphatase ne-gamma-GT. Kwezinye izimo, udokotela futhi angacela ukusebenza kwe-protein electrophoresis, lapho kungabonakala khona amazinga akhuphukayo ama-gamma globulins, ikakhulukazi i-IgG.

Ukuqinisekisa ukuxilongwa, udokotela angacela i-biopsy yesibindi ne-cholangiography, okuyisivivinyo sokuxilonga esihlose ukuhlola amapayipi enyongo futhi sihlole indlela esuka enyongweni esuka esibindini iye e-duodenum, sikwazi ukubuka noma yiziphi izinguquko. Qonda ukuthi kwenziwa kanjani i-cholangiography.

Ukwelashwa kwe-sclerosing cholangitis

Ukwelashwa kwe-sclerosing cholangitis kwenziwa ngokobukhulu be-cholangitis futhi kuhlose ukukhuthaza ukukhululeka kwezimpawu nokuvikela izinkinga. Kubalulekile ukuthi ukwelashwa kuqalwe ngemuva nje kokuxilongwa ukuvimbela ukuqhubeka kwezifo futhi kuholele ezinkingeni ezinjenge-cirrhosis yesibindi, umfutho wegazi ophakeme kanye nokwehluleka kwesibindi.

Ngakho-ke, ukusetshenziswa komuthi oqukethe i-ursodeoxycholic acid, owaziwa ngezebhizinisi njenge-Ursacol, kungakhonjiswa ngudokotela, ngokungezelela ekwelapheni i-endoscopic ukuze kuncishiswe izinga lokuvinjelwa futhi kuvunyelwe ukudlula kwenyongo. Ezimweni ezinzima kakhulu ze-cholangitis, lapho kungekho khona ukuthuthuka kwezimpawu ngokusetshenziswa kwezidakamizwa, noma lapho izimpawu ziphindaphindeka, udokotela angancoma ukwenza ukufakelwa kwesibindi.