I-Varicose Veins kwi-Base ye-Esophagus
Ii-varopose veins ziyi-varopose veins. Ezi zithintelo, njenganoma yimaphi imivimbo ye-varicose, iyakwazi ukuphuka kunye negazi ngokulula. Ukuphuma kwamagciwane e-Esophageal variceal yimeko engasongela ubomi ekufuneka ihlonzwe kwaye iphathwe ngokukhawuleza.
Izizathu ze-Esophageal Varices
Iimvumba ze-Varicose ziyimvumba eye yafakwa kunye neendonga zolule.
Ngokuqhelekileyo zifunyenwe kwimilenze kwaye ziyakhula kunye nobudala ngenxa yokuba, kakuhle, amandla. Imifuno ibuyisela igazi entliziyweni kwaye ayinalo iindonga ezifanayo, iinduli ezinjengeemitha. Sekude sikhe size sihambe (kwiminyaka, oko kuku) uxinzelelo oluninzi lweemvini zethu zomlenze zithotyelwe.
Kwisisu, iimvumba ze-varicose ziphuhliswa kungekhona ngenxa yobudala kunye nobukhulu bamandla, kodwa ngenxa ye-hepatic portal yongcinezelo. Isistim sokunyusa i-portal iqoqo leemvini ezithintela igazi kwisibindi, apho zicutshungulwa kwaye zixutywe. Emva kokuba igazi lishiye isibindi, konke okutsha kunye ne-detoxed, kuyaqhubeka entliziyweni apho kuthiwa ithunyelwe kwimiphunga yokuhlamba i-oksijeni kunye nokukhupha i-carbon dioxide. Kufana nosuku lwamafutha.
Kwesibindi kunye ne-cirrhosis-obunobunzima obunobungozi okanye ukugula okuchaphazela ukuhamba kwegazi-mali kunqandekile kwaye igazi libuyela kwisitoreji se-portal, kubangela ukuba uxinzelelo kwiimvumba zanda.
Olu xinzelelo lunokuchaphazela ukuhamba kwegazi kulo lonke ummandla, ngokukodwa kwisistim sokusondeza esiswini kunye nesiseko se-esophagus.
Imifuno esiswini (ebizwa ngokuthi i-gastric varices) kwaye i-esophagus ifakwe njenge-blue, i-veiggly veins kwimilenze. Iindonga zeemvini nazo zincinci kwaye zincinci.
Ngengcinezelo encinci, iyakwazi ukugqithisa kwaye ukuphuma kwegazi kunokubakho bunzima.
Ukunyuka kwe-Esophageal Variceal
Ukuphuma kwe-varophageal variceal kuyingozi kakhulu. Akukho ziphi na iimpawu zokugonywa kwexesha elide kuze kube yilapho kuphuma ukuphuma kwegazi. Xa kuphuma igazi, kunjalo, kukho iimpawu kunye neempawu . Izigulane ezinomzimba wesisu (i-GI) ukuphuma kwamanzi-ukuphuma kwamanzi okuvela kwisisu nangesisu, kunokuba kusemathunjini-kunokukhangela izibonakaliso neempawu ezilandelayo:
- Ukutshatyalaliswa kwegazi elibomvu elikhanyayo okanye i-emesis yekhofi-yomhlaba (emnyama kakhulu kunye ne-granular, igazi elincinciweyo)
- Ubumnyama, i-tarry okanye i-stoy stakes
- Ukuqhawula
- Ukukhawuleza
- Ukunyuswa kwengcinezelo yegazi
Ngokukhawuleza, ukuphaphazeka kwamagciwane e-variceal kungabangela ukutshitshiswa nokuhla kwamanqanaba okuqonda.
Uphulo olukhawulezileyo
Xa kwenzeka ukuphuma kwamagciwane e-esophageal variceal, unyango olungxamisekileyo luyimfuneko. Ukuba uphathwe ngokukhawuleza, ukuphuma kwe-variceal esophageal kungaphathwa ngeenkqubo ezahlukeneyo. I-Endoscopy (ikhamera ifakwe kwisangqa ngomlomo) ingasetyenziselwa ukufumana nokujongana ngqo negazi. Ukongezelela, iziyobisi ezingenayo i-vasoactive (iziyobisi ezichaphazela uxinzelelo lwegazi kwizigulane ezinzima) zingasetyenziselwa ukujongana noxinzelelo lwegazi kwizigulana eziphuma ngegazi.
Izigulane kwiimeko eziphuculweyo ziyakuthi zifumane i-intravenous fluids kunye nemithi ekhoyo.
Ngexesha lokufowunela 911
Izigulane ngokuphuma ngokukhawuleza kwegazi elibomvu elihlanjululwayo kunye nokuhlanza igazi elibomvu okanye ubuninzi bemfucuza yomhlaba kufuneka ifike esibhedlele ngokukhawuleza. Ifowuni ye-911 nayiphi na isigulane esine-lethargic, ididekile, inobuthakathaka, i-dizzy, iluhlaza, ipholile kwi-touch, okanye i-sweating (diaphoretic). Ezi zi gulane zibonisa iimpawu zokutshatyalaliswa, oku kuthetha ukuba ukuphuma kwegazi kunzima kwaye kukho umngcipheko omkhulu wokufa.
Iiparamedics ziza kuphazamisa ukuphuma kwe-variceal ngegazi le-IV, ukubeka kakuhle, kunye neziyobisi ezikhoyo.
Ukuthutha ngokukhawuleza esibhedlele yinkqubo ecacileyo yesigulane esinokuphuma kwamagciwane e-variceal.
Inkqubo yexesha elide
Njengoko kuchazwe ngasentla, akukho zibonakaliso zengxowankulu yokuxilonga ngaphandle kokuba zihlukane kwaye ziqale ukuphuma. Isigulane nje kufuneka sazi ukuba une-cirrhosis okanye enye indlela yokuxinzeleleka kwengozi yonyango kunye noogqirha kufuneka bajonge ama-varices kwisigxina esine-endoscope ukuze baxilonge. Ukuba ifunyenwe, i-doc iyakwazi ukuphatha ama-varic prophylactically ngokubambisa iqela le-rubber elalijikelezileyo, elibizwa ngokuba yi-band ligation.
Ngaphandle kokulungiswa ngokuthe ngqo kwimiqathango ye-varophageal ngokusebenzisa iinkqubo ze-endoscopic, i-portal hypertension ingaqwalaselwa ngamachiza. B block blockers zisetyenziswa kakhulu. Kwizigulane ezininzi, ukuhlanganiswa kwe-band ligation kunye neyeza kuza kusetyenziswa ukulawula i-varophageal varices.
Indima ye-Cirrhosis
I-cirrhosis inobangela obuninzi. Eyona nto ixhaphakileyo yi-hepatitis C engapheliyo, intsholongwane ye-virus engakhokelela ekuvupheni nokulimala kwesibindi. Ukusetyenziswa kakubi kotywala okugqithisileyo kunxulumene nesifo sesibindi kwaye kunokukhokelela kwi-cirrhosis kwi-fatty buildup esibindi. Isifo sesibindi esingaqhenqwanga sino-nonalcoholic singenza umonakalo kunye ne-cirrhosis. Kunokwenzeka kwizigulane ezigqithisileyo kunye nalabo abaneengxaki zemethambo okanye isifo sikashukela. Isifo esiphezulu se-hepatitis B sisona sizathu esibangela ukuba sisifo se-cirrhosis, kodwa ngoku asiqhelekanga ngenxa yokufumaneka kwesigontsho.
Ukuqwashiswa ngokuphuhliswa kwe-cirrhosis kukukhusela okulungileyo kunokuba kunokwenzeka ukuba u-varophageal varices. Izizathu ze-cirrhosis zizona zibonakaliso ezinkulu: izifo zesibindi, utywala, ukunyanya, kunye nesifo sikashukela . Abantu abaninzi abane-cirrhosis yakuqala abayi kuba nempawu kuzo zonke ekuqaleni. Njengoko iqhubeka, izigulana zinokuphuhlisa ezinye okanye ezi zinto zilandelayo: ukukhathala, ubuthathaka, ukulahleka kwesidlo, ukunxila, okanye isicumiso.
I-cirrhosis inokubangela ukunciphisa amazinga egazi ezimhlophe alwa nosulelo okanye amaplatelet anceda ekwenzeni i-blood clots, kunye nokunciphisa ukuxhamla kwintsebenzo yesibindi kunokukhokelela kumanqanaba aphezulu eetyhefu egazini. Iibhoksi zingabangela ukudideka okanye ukuxhamla. Njengoko i-toxins iqokelela egazini, izigulana zinokuphuhlisa i-jaundice, okuyi-yellowing ye-sclera (abamhlophe kwamehlo) kunye nesikhumba.
Indima ye-Portal Hypertension
Ekugqibeleni, zonke izigulane ezine-cirrhosis ziya kuphuhlisa i-portal hypertension. Njengoko uxinzelelo lwakhiwa kwi-portal system, iimvumba ezincinci zikhula. Ezi zithintelo zinika indlela yokuba igazi lijikeleze i-portal evulekileyo kwaye ibizwa ngokuba yi-collateral circulation. Ukusabalalisa ngokubambisa kunika indlela yokuba igazi liwebe isibindi ngokupheleleyo kwaye lingalokothi lihlambuluke.
Ngaphandle kwezilwanyana ezixhasayo, i-portal hypertension inokubangela ukuba i-ascites, eyakhayo kwisisu. Ekubeni i-toxins kunye namanye amaminerali ayisuswanga ngokufanelekileyo, ezinye iingxaki zivela kwi-buildup yezinto kunye nokutshintshwa kwimizila yokuxinzelelo, njengokutshintshwa kwe-plasma ukusuka kwigazi ukuya kwiindawo ezizungezile. Ngokufanayo, i-fluid iyakwazi ukubuyela kwimilenze nasemagqatsheni, okwenza ukuvuvukala kwaziwa ngokuba yi-edema. I-hypertension ye-hypertension ifumaneka ngokuqwalasela enye yeengxaki.
I-Cirrhosis ne-Esophageal Varices
I-cirrhosis ayisoloko ikhokelela kwimigudu yokuxilonga, kodwa akukho ubungqina obucacileyo malunga nokuba ziphi izigulane ezine-cirrhosis zihlakulela i-varophageal okanye i-varic varice. Kweminye uphando, umzekelo wamagundane e-esophageal kwizigulane ezine-cirrhosis zahluka ukusuka kuma-8 ukuya kuma-83 ekhulwini. Lona luhlu olukhulu.
Ii-varophageal varices kufuneka zifumaneke zikhona nge-endoscopy, kodwa xa zifunyenwe, ziba zikhudlwana kwaye zincinci ngaphezu kwexesha. Izigulane ezinokuxilongwa kwe-varophageal varices zineepesenti ezingama-30 zengqondo yokuphuma kwamagciwane.
Ngokuxhomekeka kwisibalo se-cirrhosis, ukuphuma kwamagciwane okwe-esophageal variceal kungancishiswa ngeendlela ezahlukeneyo zokwelapha. I-Antitivirals iye yaphumelela ekulibazisekeni kokuphuma kwegazi kwizigulana ezine-hepatitis B ezingapheliyo kunye ne-beta blockers ziyizidakamizwa ezikhethiweyo zokulawula i-hepatic portal hypertension.
> Imithombo:
> Hilzenrat, N., & Sherker, AH (2012). I-Esophageal Varices: I-Pathophysiology, Indlela, kunye neeDilmemil Clinical. International Journal of Hepatology , 2012 , 795063. http://doi.org/10.1155/2012/795063
> Lahbabi, M., Elyousfi, M., Aqodad, N., Elabkari, M., Mellouki, I., Ibrahimi, SA, noBenaja, DA (2013). I-eophageal variceal ligation ye-hemostasis ye-acute variceal yegazi: ukusebenza nokukhuseleko. I-Pan African Medical Journal , 14 , 95. http://doi.org/10.11604/pamj.2013.14.95.1847
> Li, C.-Z., Cheng, L.-F., Li, Q.-S., Wang, Z.-Q., & Yan, J.-H. (2013). Ukuphuza ulwaphulo lwe-antiviral ukulibaziseka kwe-varical bleeding in cirrhosis ehlobene ne-hepatitis B. I-World Journal ye-Gastroenterology: i-WJG , 19 (40), 6849-6856. http://doi.org/10.3748/wjg.v19.i40.6849
> I- cirrhosis | NIDDK . (2018). Isizwe seSizwe soSifo sikashukela kunye neeNtsholongwane zeNtsholongwane . Ifumaneka kwi-https: //www.niddk.nih.gov/health-information/liver-disease/cirrhosis
> ROMANO, G., AGRUSA, A., AMATO, G., DE VITA, G., FRAZZETTA, G., CHIANETTA, D., ... GULOTTA, G. (2014). I-Endoscopic sclerotherapy ye-hemostasis ye-acophageal bleeding variceal. Il Giornale Di Chirurgia , 35 (3-4), 61-64.
> Triantos, C., & Kalafateli, M. (2014). I-Endoscopic unyango lwama-varopha e-esophageal kwizigulane ezine-cirrhosis yesibindi. I-World Journal ye-Gastroenterology: I-WJG , 20 (36), 13015-13026. http://doi.org/10.3748/wjg.v20.i36.13015