I-cirrhosis ye-biliary yaseprayimari: yintoni, iimpawu kunye nendlela yokunyanga

Umxholo

• Iimpawu eziphambili
• Indlela yokuqinisekisa ukuxilongwa
• Izizathu ezinokubangela
• Unyango lwenziwa njani

I-cirrhosis yokuqala ye-biliary sisifo esinganyangekiyo apho imibhobho yenyongo ekhoyo ngaphakathi kwesibindi itshabalaliswa ngokuthe ngcembe, ukuthintela ukuphuma kwenyongo, into eveliswa sisibindi kwaye igcinwe kwi-gallbladder kwaye inceda ekwetyisweni kwamafutha okutya. Ke, i-bile eqokelelwe ngaphakathi kwesibindi inokubangela ukudumba, ukutshabalalisa, ukuqaqamba kunye nokuphuhliswa kwesibindi.

Alukho unyango lwe-cirrhosis yokuqala ye-biliary, nangona kunjalo, nanjengoko esi sifo sinokubangela ukonakala kwesibindi, kukho ezinye iindlela zonyango ezibonakaliswe sisigulana esinezifo zesisu okanye i-hepatologist ejolise ekulibaziseni ukukhula kwesi sifo kunye nokuphelisa iimpawu ezinje ngeentlungu esiswini, ukudinwa kukudumba okugqithisileyo okanye ukudumba ezinyaweni okanye emaqatheni, umzekelo.

Xa isithintelo se-bile sithatha ixesha elide, kunokwenzeka ukuba kuya kubakho umonakalo omkhulu kwaye ukhawuleze esibindini, ubonakalisa i-cirrhosis yesibini, edla ngokunxulunyaniswa nobukho bamatye enyongo okanye amathumba.

Iimpawu eziphambili

Kwiimeko ezininzi, i-cirrhosis ye-biliary ichongwa ngaphambi kokuba kubonakale naziphi na iimpawu, ngakumbi kuvavanyo lwegazi olwenziwe ngesinye isizathu okanye njengesiqhelo. Nangona kunjalo, iimpawu zokuqala zinokubandakanya ukudinwa okungapheliyo, ulusu olurhawuzayo kunye namehlo owomileyo okanye umlomo.

Xa isifo sikwinqanaba eliphambili, iimpawu zinokuba:

• Ubuhlungu kummandla ongasentla kwesisu;
• Intlungu edibeneyo;
• Ubuhlungu bemisipha;
• Iinyawo ezidumbileyo namaqatha;
• Isisu esidumbileyo;
• Ukuqokelelwa kolwelo esiswini, ekuthiwa zii-ascites;
• Amafutha afakwa kulusu olujikeleze amehlo, iinkophe okanye iintende, iintende, iingqiniba okanye amadolo;
• Isikhumba esimthubi namehlo;
• Amathambo aethe-ethe ngakumbi, okwandisa umngcipheko wokuqhekeka;
• Cholesterol ephezulu;
• Urhudo ngezitulo ezinamafutha kakhulu;
• IHypothyroidism;
• Ukwehla kwesisindo ngaphandle kwesizathu.

Ezi mpawu zinokubonisa ezinye iingxaki zesibindi kwaye, ke ngoko, kuyacetyiswa ukuba uqhagamshelane ne-hepatologist okanye i-gastroenterologist ukufumanisa ngokuchanekileyo kunye nokulawula ezinye izifo ezineempawu ezifanayo.

Indlela yokuqinisekisa ukuxilongwa

Ukuxilongwa kwe-cirrhosis yokuqala ye-biliary yenziwa yi-hepatologist okanye i-gastroenterologist esekwe kwimbali yeklinikhi, iimpawu zomntu kunye novavanyo olubandakanya:

• Uvavanyo lwegazi ukujonga amanqanaba e-cholesterol, ii-enzymes zesibindi kunye ne-antibodies ukufumana isifo se-autoimmune;
• I-Ultrasound;
• Ukucatshulwa kwemifanekiso ngemagneti;
• Endoscopy.

Ukongeza, ugqirha unokuyalela i-biopsy yesibindi ukuqinisekisa isifo okanye ukumisela inqanaba le-cirrhosis yokuqala. Fumanisa ukuba kwenziwa njani i-biopsy yesibindi.

Izizathu ezinokubangela

Isizathu se-cirrhosis ye-biliary ephambili asaziwa, kodwa ihlala inxulunyaniswa nabantu abanezifo ezizimele kwaye, ke ngoko, kunokwenzeka ukuba umzimba ngokwawo uqalise inkqubo yokuvuvukala etshabalalisa iiseli zemibhobho yenyongo. Oku kudumba kunokudlulela kwezinye iiseli zesibindi kwaye kukhokelele ekubonakaleni komonakalo kunye nokuqhekeka okubeka esichengeni ukusebenza ngokuchanekileyo kwelungu.

Ezinye izinto ezinokuba negalelo ekubangeleni i-cirrhosis yokuqala ye-biliary sisifo esenziwa ziibhaktheriya ezinje Escherichia coli, IMycobacterium gordonae okanye uNovophingobium yeyiphi na, ukungunda okanye iintshulube ezifana I-Opisthorchis.

Ukongeza, abantu abatshayayo okanye abanelungu losapho abane-cirrhosis yaseprayimari abasemngciphekweni okhulayo wesifo.

Unyango lwenziwa njani

Akukho lonyango lwe-cirrhosis ye-biliary, nangona kunjalo, amanye amayeza anokusetyenziselwa ukulibazisa ukukhula kwesifo kunye nokunciphisa iimpawu, ezibandakanya:

• Ursodeoxycholic acid (Ursodiol okanye iUrsacol): sesinye seziyobisi sokuqala esisetyenzisiweyo kwezi meko, njengoko sinceda i-bile ukuba idlule kumajelo kwaye ishiye isibindi, ukunciphisa ukudumba nokukhusela ukonakala kwesibindi;
• Iasidi ye-Obeticolic (Ocaliva): Esi sixhobo sinceda ukusebenza kwesibindi, ukunciphisa iimpawu kunye nokuqhubela phambili kwesi sifo kwaye sinokusetyenziswa sodwa okanye kunye ne-ursodeoxycholic acid;
• I-Fenofibrate (i-Lipanon okanye i-Lipidil): Eli yeza linceda ukunciphisa i-cholesterol yegazi kunye ne-triglycerides kwaye, xa isetyenziswa kunye ne-ursodeoxycholic acid, inceda ukunciphisa ukudumba kwesibindi kunye nokunciphisa iimpawu ezinje ngesikhumba esikrwada.

Kwiimeko ezinzima kakhulu, apho ukusetyenziswa kwamachiza kubonakala ngathi kulibazisa ukukhula kwesi sifo okanye xa iimpawu zihlala zinamandla kakhulu, i-hepatologist inokucebisa ukufakelwa kwesibindi, ukuze kwandiswe ubomi bomntu.

Ngokwesiqhelo, amatyala okufakelwa ngokutsha ayaphumelela kwaye isifo siyanyamalala ngokupheleleyo, sibuyisa umgangatho wobomi bomntu, kodwa kunokuba yimfuneko ukuba kuluhlu lokulinda kwesibindi esifanelekileyo. Fumanisa ukuba kwenziwa njani ukufakelwa isibindi.

Ukongeza, kuqhelekile ukuba abantu abane-cirrhosis ye-biliary babe nobunzima ekufumaneni amafutha kunye neevithamini. Ngale ndlela, ugqirha unokucebisa ukuba kulandelwe kunye nesondlo ukuba aqale ukongeza iivithamini, ngakumbi iivithamini A, D kunye no-K kunye nokwenza ukutya okunesondlo kunye nokusetyenziswa kwetyuwa esezantsi.