I-Cirrhosis ebolile

-Delile

• Ziyini izimpawu zokuqina kwesibindi okubolile?
• Yini ebangela ukuqina kwesibindi?
• Itholakala kanjani i-cirrhosis ebolile?
• Yelashwa kanjani i-cirrhosis ebolile?
• Kukuthinta kanjani ukulindela isikhathi sokuphila?
• Okubalulekile

Iyini i-cirrhosis ebolile?

I-cirrhosis ebolile yigama elisetshenziswa odokotela ukuchaza izinkinga zesifo sesibindi esithuthukile. Abantu abane-cirrhosis ekhokhelwe kaningi abanazo izimpawu ngoba isibindi sabo sisasebenza kahle. Njengoba ukusebenza kwesibindi kuncipha, kungaba yi-cirrhosis ebolile.

Abantu abane-cirrhosis eboshiwe sebesondela ekugcineni ukwehluleka kwesibindi futhi bavamise ukubangabafakelwa isibindi.

Funda ukuze ufunde kabanzi nge-cirrhosis ebolile, kufaka phakathi izimpawu zayo nemiphumela esikhathini sokuphila.

Ziyini izimpawu zokuqina kwesibindi okubolile?

I-cirrhosis imvamisa ayibangeli zimpawu ezigabeni zayo zangaphambili. Kepha njengoba iqhubekela ekuqineni kwesibindi, ingadala:

• i-jaundice
• ukukhathala
• ukuncipha komzimba
• ukopha okulula nokulimala
• isisu esiqunjelwe ngenxa yokuqongelela uketshezi (ascites)
• imilenze evuvukele
• ukudideka, ukukhuluma okungaqondakali, noma ukozela (hepatic encephalopathy)
• isicanucanu nokuphelelwa isifiso sokudla
• imithambo yesicabucabu
• ububomvu ezintendeni zezandla
• ukuncipha kwamasende nokukhula kwamabele emadodeni
• ukulunywa okungaqondakali

Yini ebangela ukuqina kwesibindi?

I-cirrhosis ebolile yisigaba esithuthukile se-cirrhosis. I-Cirrhosis ibhekisa ekunqandeni kwesibindi. I-cirrhosis ebunjiwe yenzeka lapho lokhu kusikeka kuba nzima kangangokuba isibindi asikwazi ukusebenza kahle.

Noma yini elimaza isibindi ingaholela ekulimaleni, okungagcina kuphenduke isifo sokubola kwesibindi. Izimbangela ezivame kakhulu zesifo sokuqina kwesibindi yizi:

• isikhathi eside, ukusetshenziswa kotshwala obunzima
• i-hepatitis B engapheli noma i-hepatitis C
• amanoni amaningi esibindini

Ezinye izimbangela zesifo sokuqina kwesibindi zihlanganisa:

• insimbi eyakhiwe
• i-cystic fibrosis
• okwakhiwe ngethusi
• amapayipi e-bile angakhiwe kahle
• izifo ezizimele zesibindi
• ukulimala kwe-bile duct
• izifo zesibindi
• ukuthatha imithi ethile, njenge-methotrexate

Itholakala kanjani i-cirrhosis ebolile?

Ngokuvamile, odokotela bazokuxilonga nge-cirrhosis ebolile lapho uqala ukuba nezimpawu zokuqina kwesibindi, njenge-jaundice noma ukudideka kwengqondo. Ngokuvamile bazoqinisekisa ukuxilongwa ngokwenza izivivinyo zegazi ukuthola ukusebenza kwesibindi.

Bangase futhi bathathe isampula le-serum ukuza nemodeli yamaphuzu esigaba sokugcina sesifo sesibindi (MELD). Isilinganiso se-MELD yithuluzi lokuxilonga elisetshenziswa kakhulu lesifo sesibindi esithuthukile. Izikolo zisukela ku-6 kuye ku-40.

Odokotela futhi kwesinye isikhathi benza i-biopsy yesibindi, okubandakanya ukuthatha isampula elincane lezicubu zesibindi bese ulihlaziya. Lokhu kuzobasiza ukuthi baqonde kangcono ukuthi isibindi sakho sonakele kangakanani.

Bangase futhi basebenzise uchungechunge lwezivivinyo ze-imaging ukubheka usayizi nokuma kwesibindi sakho nobende, njenge:

• Ukuhlolwa kwe-MRI
• ama-ultrasound
• Ukuskena kwe-CT
• i-magnetic resonance elastography noma i-elastography yesikhashana, okuyizilingo zokucabanga ezithola ukuqina kwesibindi

Yelashwa kanjani i-cirrhosis ebolile?

Kunezinketho zokwelashwa ezinqunyelwe ze-cirrhosis ebolile. Kulesi sigaba sakamuva sesifo sesibindi, imvamisa akunakwenzeka ukuguqula isimo. Kodwa lokhu futhi kusho ukuthi abantu abane-cirrhosis ebolile bavame ukuba ngabaqokelwe okuhle ukufakelwa kwesibindi.

Uma okungenani unesifo esisodwa se-cirrhosis ebolile kanye nesilinganiso se-MELD se-15 noma ngaphezulu, ukufakelwa kwesibindi kunconywa kakhulu.

Ukufakelwa kwesibindi kwenziwa ngesibindi esinqunyiwe noma esiphelele esivela kumnikeli. Izicubu zesibindi zingakwazi ukuvuselelwa, ngakho-ke umuntu angathola ingxenye yesibindi kumnikeli obukhoma. Kokubili isibindi esitshalwe kabusha nesibindi somnikeli sizovuseleleka ezinyangeni ezimbalwa.

Ngenkathi ukufakelwa kwesibindi kuyindlela ethembisayo, inqubo enkulu enezici eziningi okufanele uzicabangele. Ezimweni eziningi, udokotela uzothumela lowo ozoba yisiguli esikhungweni sokufakelwa kabusha, lapho iqembu lochwepheshe bezokwelapha lizohlola ukuthi isiguli sizokwenza kanjani ngokufakelwa.

Bazobheka:

• isigaba sesifo sesibindi
• umlando wezokwelapha
• impilo engokwengqondo nengokomzwelo
• uhlelo lokusekela ekhaya
• ikhono nokuzimisela ukulandela imiyalo ye-posturgery
• amathuba okusinda ekuhlinzweni

Ukuhlola konke lokhu, odokotela basebenzisa izivivinyo nezinqubo ezahlukahlukene, ezinjengalezi:

• izivivinyo zomzimba
• ukuhlolwa kwegazi okuningi
• ukuhlolwa kwengqondo nezenhlalo
• izivivinyo zokuxilonga ukuhlola impilo yenhliziyo yakho, amaphaphu nezinye izitho zomzimba
• ukuhlolwa kwe-imaging
• ukuhlolwa kwezidakamizwa notshwala
• Ukuhlolwa kwe-HIV ne-hepatitis

Abantu abanezifo zesibindi ezihlobene notshwala noma izidakamizwa bazodinga ukukhombisa ukuzithiba kwabo. Kwezinye izimo, lokhu kungabandakanya ukukhombisa imibhalo evela esikhungweni sokwelapha umlutha.

Kungakhathalekile ukuthi ngabe umuntu uyakufanelekela yini ukufakelwa, udokotela futhi angancoma okulandelayo ukuthuthukisa ikhwalithi yempilo nokugwema ezinye izinkinga:

• ukulandela ukudla okunosawoti omncane
• ukungasebenzisi izidakamizwa zokuzijabulisa noma utshwala
• ukuthatha isisu
• uthatha imishanguzo yokulwa namagciwane ukuphatha isifo sokusha kwesibindi kohlobo B noma C okungamahlalakhona
• kunciphisa ukudla kwakho oketshezi
• ukuthatha ama-antibiotic ukwelapha noma yikuphi ukutheleleka okuyisisekelo noma ukuvimbela okusha
• ukuthatha imishanguzo yokusiza ukunqamuka kwegazi
• ukuthatha imishanguzo yokuthuthukisa ukugeleza kwegazi kuye esibindini
• kwenziwa inqubo yokukhipha uketshezi oluthe xaxa esiswini

Kukuthinta kanjani ukulindela isikhathi sokuphila?

Ukuqina kwesibindi kunganciphisa isikhathi sakho sokuphila. Ngokuvamile, ukuphakama kwesikolo sakho se-MELD, kwehla amathuba akho okusinda ezinye izinyanga ezintathu.

Isibonelo, uma unesilinganiso se-MELD esingu-15 noma ngaphansi, unethuba elingamaphesenti angama-95 lokusinda okungenani izinyanga ezintathu. Uma unesilinganiso se-MELD sama-30, isilinganiso sakho sezinyanga ezintathu sokusinda singamaphesenti angama-65. Kungakho abantu abanesilinganiso esiphezulu se-MELD benikezwa kuqala ohlwini lwabanikeli bezitho zomzimba.

Ukuthola ukufakelwa kwesibindi kukhulisa kakhulu isikhathi sokuphila. Ngenkathi icala ngalinye lihlukile, abantu abaningi babuyela emisebenzini yabo ejwayelekile ngemuva kokufakelwa kwesibindi. Izinga lokusinda leminyaka emihlanu lingamaphesenti angama-75.

Okubalulekile

I-cirrhosis ebolile iyindlela esezingeni eliphakeme ye-cirrhosis ehlotshaniswa nokwehluleka kwesibindi. Ngenkathi kungekho izinketho eziningi zokwelashwa zalo, ukufakelwa kwesibindi kungaba nomthelela omkhulu esikhathini sokuphila.

Uma utholwe une-cirrhosis ebolile, khuluma nodokotela wakho mayelana nokufaneleka kwakho ukufakelwa kabusha. Bangakukhomba naku-hepatologist, okuluhlobo lodokotela ogxile ekwelapheni izimo zesibindi.