Ukopha kwe-varices esophageal varices

I-esophagus (umbhobho wokutya) yityhubhu edibanisa umqala wakho nesisu sakho. I-Varices yimithambo eyandisiweyo enokuthi ifumaneke kwi-esophagus kubantu abane-cirrhosis yesibindi. Le mithambo isenokugqabhuka ize yophe.

Ukuqhekeka (i-cirrhosis) yesibindi sesona sizathu siqhelekileyo se-varopha esophageal varices. Oku kunqunyulwa kunciphisa igazi elihamba ngesibindi. Ngenxa yoko, igazi elininzi liphuma emithanjeni yomqala.

Ukuhamba kwegazi okongezelelekileyo kubangela ukuba imithambo kwi-esophagus ibhaluni ngaphandle. Ukopha ngamandla kunokubakho ukuba imithambo iyakrazuka.

Naluphi na uhlobo lwesifo sesibindi sexesha elide (esingapheliyo) sinokubangela i-esophageal varices.

Ii-Varices zinokwenzeka nakwindawo ephezulu yesisu.

Abantu abanesifo esingapheliyo sesibindi kunye ne-esophageal varices abanako ukungabi nazimpawu.

Ukuba kukho kuphela ukopha okuncinci, uphawu kuphela olunokuba yimigca emnyama okanye emnyama esitulweni.

Ukuba kwenzeka ukopha okukhulu, iimpawu zinokubandakanya:

• Mnyama, ilindle
• Izitulo zegazi
• Ubumhlophe
• Ubumhlophe
• Iimpawu zesifo esinganyangekiyo sesibindi
• Ukuphalaza igazi

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba olunokubonisa:

• Isitulo segazi okanye esimnyama (kuvavanyo lwe-rectal)
• Uxinzelelo lwegazi oluphantsi
• Inqanaba lentliziyo elikhawulezayo
• Iimpawu zesifo esinganyangekiyo sesibindi okanye i-cirrhosis

Uvavanyo lokufumana umthombo wokopha kwaye ujonge ukuba kukho ukopha okusebenzayo kubandakanya:

• I-EGD okanye i-endoscopy ephezulu, ebandakanya ukusetyenziswa kwekhamera kwityhubhu eguqukayo yokujonga umqala kunye nesisu.
• Ukufakwa kwetyhubhu ngempumlo ungene esiswini (ityhubhu ye-nasogastric) ukukhangela iimpawu zokopha.

Abanye ababoneleli bacebisa i-EGD kubantu abasandula ukufumanisa ukuba bane-cirrhosis ethambileyo ukuya kuthi ga. Olu vavanyo luvavanywa kwii-varices esophageal varices kwaye zibaphathe ngaphambi kokopha.

Injongo yonyango kukuyeka ukopha ngokukhawuleza. Ukopha kufuneka kulawulwe ngokukhawuleza ukuthintela ukothuka kunye nokufa.

Ukuba ukopha ngamandla kwenzeka, umntu unokufuna ukufakwa kumatshini wokuphefumla ukuze akhusele indlela yomoya kunye nokukhusela igazi ekuhleni liye emiphungeni.

Ukuyekisa ukopha, umboneleli angadlulisa i-endoscope (ityhubhu enokukhanya okuncinci ekugqibeleni) kwisisu:

• Iyeza lokunqanda igazi linokujova kwii-varices.
• Ibhanti yerabha ingabekwa ijikeleze imithambo eyophayo (ebizwa ngokuba ngumtya-nkomo).

Olunye unyango lokumisa ukopha:

• Iyeza lokuqinisa imithambo yegazi linokunikezelwa ngomthambo. Imizekelo ibandakanya i-octreotide okanye i-vasopressin.
• Rhoqo, ityhubhu inokufakwa ngempumlo esiswini kwaye inyuswe ngumoya. Oku kuvelisa uxinzelelo ngokuchasene nemithambo eyophayo (ibhaluni tamponade).

Emva kokuba ukuphuma kwegazi kuyekiwe, ezinye i-varices zinokunyangwa ngamayeza kunye neenkqubo zonyango ukunqanda ukopha kwixesha elizayo. Oku kubandakanya:

• Iziyobisi ezibizwa ngokuba yi-beta blockers, ezinje ngepropranolol kunye nadolol ezinciphisa umngcipheko wokopha.
• Ibhendi yerabha inokufakwa kufutshane nemithambo eyophayo ngexesha lenkqubo ye-EGD. Kwakhona, amanye amayeza anokufakwa kwi-varices ngexesha le-EGD ukubenza bagqume.
• I-transjugular intrahepatic portosystemic shunt (IINKCUKACHA). Le yinkqubo yokwenza unxibelelwano olutsha phakathi kwemithambo yegazi emibini kwisibindi sakho. Oku kunokunciphisa uxinzelelo kwimithambo kwaye kuthintele iziqendu ezophayo zenzeke kwakhona.

Kwiimeko ezinqabileyo, utyando olungxamisekileyo lunokusetyenziselwa ukunyanga abantu ukuba olunye unyango aluphumeleli. I-Portacaval shunts okanye utyando ukunciphisa uxinzelelo kwii-varopha zokuqina kukukhetha unyango, kodwa ezi nkqubo ziyingozi.

Abantu abane-varices egazini besifo sesibindi banokufuna unyango olungaphezulu kwesifo sesibindi, kubandakanya ukufakelwa kwesibindi.

Ukopha kusoloko kubuya kunye okanye ngaphandle konyango.

Ukopha kwe-varices esophageal varices yingxaki enkulu yesifo sesibindi kwaye kunesiphumo esibi.

Ukubekwa kwe-shunt kunokukhokelela ekunciphiseni kokuhanjiswa kwegazi kwingqondo. Oku kunokukhokelela kutshintsho lobume bengqondo.

Iingxaki zexesha elizayo ezibangelwa zii-varices zingabandakanya:

• Ukunciphisa okanye ukuqina komqala ngenxa yokunqumka emva kwenkqubo
• Ukubuya kokopha emva konyango

Fowunela umnikezeli wakho okanye uye kwigumbi likaxakeka xa ugabha igazi okanye unezihlalo ezimnyama zokulinda.

Ukunyanga oonobangela besifo sesibindi kunokuthintela ukopha. Ukufakelwa kwesibindi kufuneka kuthathelwe ingqalelo kwabanye abantu.

Kwesibindi - varices; Isifo sesibindi esinganyangekiyo se-Cryptogenic - ii-varices; Isifo sesibindi sokugqibela - i-varices; Isifo sesibindi esinotywala - ii-varices

• Isibindi - ukubhobhoza

• Inkqubo yokwetyisa
• Ukuhanjiswa kwegazi lesibindi

UGarcia-Tsao G. Cirrhosis kunye nokulandelelana kwayo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 144.

Ugcina i-TJ, iJensen DM. Ukopha emathunjini. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Amathumbu kunye nezifo zesibindi: iPathophysiology / Diagnosis / Management. Ngomhla we-10. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 20.