I-cirrhosis yamabanga aphantsi

Imibhobho yenyongo yimibhobho ehambisa inyongo ukusuka kwisibindi ukuya kumathumbu amancinci. Ibile yinto enceda ekucoleni ukutya. Zonke iipayipi ze-bile zihlangene zibizwa ngokuba yi-biliary tract.

Xa imibhobho yenyongo idumbile okanye idume, oku kuthintela ukuhamba kwenyongo. Olu tshintsho lunokukhokelela ekunqandeni isibindi esibizwa ngokuba yi-cirrhosis. Oku kubizwa ngokuba yi-biliary cirrhosis. Ukuqina kwesibindi kungakhokelela ekusileleni kwesibindi.

Unobangela wokudumba kwenyongo yesibindi awaziwa. Nangona kunjalo, i-cirrhosis yokuqala ye-biliary sisifo sokuzimela. Oko kuthetha ukuba amajoni akho omzimba ahlasela ngempazamo izicwili ezisempilweni. Esi sifo sinokuqhagamshelwa kukuphazamiseka okuzenzekelayo okunje:

• Isifo seCeliac
• Into kaRaynaud
• I-Sicca syndrome (amehlo owomileyo okanye umlomo)
• Isifo se-thyroid

Esi sifo sihlala sichaphazela abafazi abaphakathi.

Ngaphezu kwesiqingatha sabantu abanazimpawu ngexesha lokuchongwa. Iimpawu zihlala ziqala kancinci. Iimpawu zokuqala zinokubandakanya:

• Isicaphucaphu kunye nentlungu esiswini
• Ukudinwa kunye nokuphelelwa ngamandla
• Amafutha afakwa phantsi kolusu
• Izitulo ezinamafutha
• Ukurhawuzelela
• Ukutya okungalunganga kunye nokwehla kobunzima

Njengoko umsebenzi wesibindi ukhula, iimpawu zingabandakanya:

• Ulwakhiwo lwamanzi emilenzeni (edema) nakwisisu (ascites)
• Umbala otyheli kulusu, inwebu yangaphakathi, okanye amehlo (i-jaundice)
• Ububomvu ezintendeni zezandla
• Emadodeni, ukungabi namandla, ukuncipha kwamasende kunye nokudumba kwamabele
• Ukutyumza ngokulula kunye nokuphuma gazi ngokungaqhelekanga, amaxesha amaninzi kuvela kwimithambo edumbileyo kwindlela yokugaya
• Ukudideka okanye iingxaki zokucinga
• Ipeyinti okanye izitulo ezinombala wodongwe

Umboneleli wezempilo uya kwenza uvavanyo lomzimba.

Ezi mvavanyo zilandelayo zinokujonga ukuba isibindi sakho sisebenza ngokufanelekileyo na:

• Uvavanyo lwegazi lweAlbumin
• Uvavanyo lomsebenzi wesibindi (i-serum alkaline phosphatase ibaluleke kakhulu)
• Ixesha leprothrombin (PT)
• Uvavanyo lwegazi lwekholesterol nepiprotein

Olunye uvavanyo olunokunceda ukulinganisa ukuba isifo sesibindi sinokuba sikhona njani:

• Umgangatho ophakamileyo we-immunoglobulin M egazini
• Isibindi se-biopsy
• Ama-anti-mitochondrial antibodies (iziphumo ziqinisekile malunga nama-95% amatyala)
• Iindidi ezizodwa ze-ultrasound okanye i-MRI eyenza umlinganiso wesixa sezicwili ezibomvu
• Imagnetic resonance cholangiopancreatography (MRCP)

Injongo yonyango kukunciphisa iimpawu kunye nokukhusela iingxaki.

I-Cholestyramine (okanye i-colestipol) inokunciphisa ukurhawuzelela. I-Ursodeoxycholic acid inokuphucula ukususwa kwenyongo kwigazi. Oku kunokuphucula ukusinda kwabanye abantu. Iyeza elitsha elibizwa ngokuba yi-obeticholic acid (Ocaliva) liyafumaneka.

Unyango lweVitamin lokulungisa lubuyisela iivithamini A, K, E kunye no-D, ezilahlekileyo kwizitulo ezinamafutha. Isongezelelo se calcium okanye amanye amayeza ethambo angongezwa ukuthintela okanye ukunyanga amathambo abuthathaka okanye athambileyo.

Ukujonga ixesha elide kunye nokunyanga ukusilela kwesibindi kuyafuneka.

Ukufakelwa kwesibindi kunokuphumelela ukuba kwenziwa ngaphambi kokuba isibindi siphume.

Iziphumo zinokwahluka. Ukuba le meko ayinyangwa, uninzi lwabantu luya kufa ngaphandle kokufakelwa kwesibindi. Phantse kwikota enye yabantu abanesi sifo iminyaka eli-10 baya kuba nokusilela kwesibindi. Oogqirha banokusebenzisa imodeli yeenkcukacha manani ukuqikelela elona xesha lilungileyo lokufakelwa. Ezinye izifo ezinje nge-hypothyroidism kunye ne-anemia nazo zinokuphuhla.

Ukuqhubeka kwesibindi kungakhokelela ekusileleni kwesibindi. Iingxaki zinokubandakanya:

• Ukopha
• Umonakalo kwingqondo (encephalopathy)
• Ukungalingani kwe-Fluid kunye ne-electrolyte
• Ukungaphumeleli kwezintso
• Malabsorption
• Ukungondleki
• Amathambo athambileyo okanye abuthathaka (i-osteomalacia okanye i-osteoporosis)
• I-Ascites (i-fluid buildup kwisisu esiswini)
• Umngcipheko owandisiweyo womhlaza wesibindi

Fowunela umnikezeli wakho ukuba unayo:

• Ukudumba kwesisu
• Igazi kwizitulo
• Ukudideka
• I-jaundice
• Ukurhawuzelela ulusu olungahambiyo kwaye aluhambelani nezinye izizathu
• Ukuphalaza igazi

I-cholangitis yamabanga aphantsi; I-PBC

• Isibindi - ukubhobhoza

• Inkqubo yokwetyisa
• Indlela yendlela

I-Eaton JE, uLindor KD. I-cholangitis yamabanga aphantsi. Ku: UFeldman M, uFriedman LS, uBrandt LJ, ii-eds. Sleisenger kunye neFordtran's Gastrointestinal and Liver Disease. Ngomhla we-11. IPhiladelphia, PA: Elsevier; 2021: isahl. 91.

UFogel EL, uSherman S. Izifo ze-gallbladder kunye ne-bile ducts. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 146.

Izibane LW. Isibindi: izifo ezingenayo i-neoplastic. Ku: Goldblum JR, Izibane LW, McKenney JK, Myers JL, eds. Rosai kunye neAckerman's Pathology. Ngomhla we-11. IPhiladelphia, PA: Elsevier; I-2018: isahluko 19.

USmith A, uBaumgartner K, uBositis C. Cirrhosis: ukuxilongwa kunye nolawulo. NdinguGqirha weNdawo. 2019; 100 (12): 759-770. IINKCUKACHA: 31845776 pubmed.ncbi.nlm.nih.gov/31845776/.