Iimpawu, ukuxilongwa kunye nokunyangwa kwe-PSC, izifo zesifo ezinxulumene ne-IBD
I-primary sclerosing cholangitis (PSC) isifo sesibindi esibangela ukuvuvukala kunye nokunciphisa i-bile ducts ngaphakathi nangaphandle kwesibindi. Akuqinisekanga oko kubangela i-PSC, nangona kucatshangelwa ukuba yimeko ehamba ngokuzenzekelayo . I-PSC ayicingelwa ukuba izuzwe ngokuthe ngqo, kodwa kucatshangelwa ukuba inomzimba wezofuzo.
Ibhokhwe iyimfuneko yokugutywa kwamafutha kunye nokukhutshwa kwesibindi.
I-PSC ibangela i-bile ducts ukunciphisa ukutshatyalaliswa nokuqhaqhazela, kwaye i-bile iqala ukuqokelela esibindi, eyonakalisa. Lo monakalo ekugqibeleni ukhokelela ekubunjeni kwinqabunga kunye ne- cirrhosis , okuvimbela isibindi ukuba senze imisebenzi yaso ebalulekileyo. Iminyaka emininzi ye-PSC ingakhokelela kwisisu somhlaza we-bile ducts esibizwa ngokuba yi-cholangiocarcinoma, eyenzeka kwi-10 ukuya ku-15% yezigulane.
I-PSC ihamba ngokuthe ngcembe kwiimeko ezininzi, kodwa ingenakuqikelela kwaye ingozi yokuphila. Abantu abane-PSC banokufumana unyango ekunciphiseni iimpawu kwaye bancedise ubomi bokusebenza.
I-Risk Demographic
Ngokuqhelekileyo, abantu abachaphazelekayo yi-PSC baphakathi kweminyaka engama-30 no-60, abaneminyaka yobudala yokuxilongwa kuba ngama-40. I-PSC ihlala ixhaphakile kumadoda; Abantu abangama-60 ukuya ku-75% abaxilongwa ngaba ngamadoda. Kuphela, i-PSC isifo esingavamile.
Iimpawu
Abanye abantu abanalo iimpawu zokuxilongwa okanye mhlawumbi iminyaka emininzi emva koko.
Iimpawu ziquka:
- Isifo sohudo (esibangelwa kwi-malabsorption yeenqatha)
- Ukukhathala
- I-Fever / chills (ukususela kwiintsholongwane ze-bile)
- Ukutshiza okudla ngokuchaphazela umzimba wonke
- I-jaundice (ukuphuka kwesikhumba kunye namehlo)
Izifo eziManyeneyo
Abantu abane-PSC banakho amathuba okuba nesifo sesibindi (IBD) okanye i-osteoporosis.
I-PSC inxulumene ngokuqinileyo ne-ulcerative colitis kwi-70 pesenti yezigulane, kodwa ingadibana nesifo sika-Crohn esibilini esikhulu, ngezinye izihlandlo esibizwa ngokuba yi- Crohn's colitis . Isizathu sokubambisana ne-IBD asiyazi, kodwa kucatshangelwa ukuba sisiphumo sempendulo yomzimba.
Ukuxilongwa
I-PSC ihlolwe ngokugqitywa ngenkqubo ebizwa nge- ERCP (endoscopic retrograde cholangiopancreatography) . Ngethuba le-ERCP, ugqirha uza kufaka i-endoscope emlonyeni aze ahambe ngayo nge-esophagus nesisu ukuya kumadada emithini ye-biliary. Idayi ifakwa kwiidolo ukuze zibonise xa kuthathwa i-ray-ray. I-ray-ray iyahlaziywa ukuze ichonge ukuba kukho na iingxaki nge-bile ducts.
Ukuxilongwa kwe-PSC kunokwenziwe ngokuqinisekileyo ngophando lwegazi olubizwa ngokuba yi-ALK (alkaline phosphatase), nangona umphumo omuhle ungabhekisela kwezinye iimeko ngaphandle kwe-PSC.
I-biopsy yesibindi iyakunceda ukuqinisekisa ukuxilongwa kwe-PSC, kunye nokubeka esweni inkqubela yesi sifo emva kokuxilongwa. I-biopsy yesibindi yenziwa kwisibhedlele esibhedlele kwisithuba sengqondo esinezilwanyana kunye ne- anesthetics yasekhaya . Ugqirha owenza uvavanyo uya kusebenzisa inaliti ukuba athathe isampula encinane yesibindi sesibindi sokuvavanywa ngumgulane.
Unyango
Akukho nonyango eye yaboniswa ukuba iyasebenza ekuphatheni i-PSC. Uphando lokufumana unyango olusebenzayo lwenziwa ngoku. Izicwangciso zonyango zijolise ekunciphiseni iimpawu, ukuphazamisa ukuqhubela phambili kwesifo, kunye nokubeka esweni iingxaki.
Iimpawu ze-PSC zinokunyangwa ukuze izigulane zibe zikhululekile. Ukutshiza kungaphathwa ngeQuestran (cholestyramine) okanye iBenadryl (diphenhydramine). Ukutheleleka ngezihlandlo eziqhelekileyo ezinokuthi zenzeke kunye ne-PSC, i-antibiotics ingafuneka. Ngenxa yokuba i-PSC iphazamisa ukuxutywa kwamanqatha, kunokuncedisa ukunyanzelisa i-vitamin A, D, E ne-K.
Ukuba iiblockages zenzeka kwiidrophu ze-bile, kufuneka kwenziwe inkqubo yokucoca okanye ivule. Izibonda, ezigcina iidumba zivulekile, zingafakwa kwiidolo ngexesha le nkqubo.
Ukuba ukuqhubela phambili kwe-PSC kubangela ukuhluleka kwesibindi okanye ukusuleleka kwintsholongwane yebhiliyali, ukufakelwa kwesibindi kunokufuneka. Ukufakelwa kwesibindi kunika umgangatho omhle wobomi kubamkeli, kunye nezinga lokusinda malunga neepesenti ezingama-75.
Ngexesha lokuya kubiza ugqirha
Ukuba kukho enye yeempawu ezilandelayo zenzeke nge-PSC, biza ugqirha wakho:
- Intlungu zesisu
- Izigxoko ezimnyama okanye ezimnyama kakhulu
- Jaundice
- Ukushisa ngaphezu kwe-100.4
- Ukuvutha ngegazi
Imithombo :
Johns Hopkins Medicine. "I-Primary Sclerosing Cholangitis." University of Johns Hopkins 2013.
Karlsen TH, Hampe J, Wiencke K, Schrumpf E, Thorsby E, Lie BA, Broomé U, Schreiber S, Boberg KM. "I-Genetic Polymorphisms Ehlobene Nezifo Ezibangelwa Ziqhwaba Musa Ukukhetha Ingozi Kwi-Primary Sclerosing Cholangitis." I-J Gastroenterol Jan 2007.
Manual Merck. "I-Primary Sclerosing Cholangitis (PSC)." Merck & Co, Inc Sept 2007.
I-Van Steenbergen W, iDe Goede E, iP MP, iReinders J, uTilanus M, u-Fevery J. "I-Cholangitis yesiBanga esiPrayimari kwiBazalwana ababini: Ingxelo yentsapho enegxininiso ekhethekileyo kwi-molecular HLA ne-MICA Genotyping." Eur J Gastroenterol Hepatol Jul 2005.