Sclerosing cholangitis: yintoni, iimpawu kunye nonyango

Umxholo

• Iimpawu zesclerosing cholangitis
• Izizathu eziphambili
• Uxilongo lwenziwa njani
• Unyango lwe-sclerosing cholangitis

I-Sclerosing cholangitis sisifo esinqabileyo esixhaphake kakhulu emadodeni abonakaliswa kukuzibandakanya kwesibindi ngenxa yokuvuvukala kunye nefibrosis ebangelwa kukucuthwa kwemijelo apho kudlula i-bile, esisisixhobo esisisiseko senkqubo yokwetyisa, enokuthi ikhokelele, kwezinye iimeko, ukubonakala kweempawu ezithile, ezinje ngokudinwa okugqithisileyo, ulusu olutyheli namehlo kunye nobuthathaka bemisipha.

Izizathu ze-cholangitis azikacaci ncam, nangona kunjalo kukholelwa ukuba inokuba inxulumene nezinto ezizimeleyo ezinokuthi zikhokelele ekuvukeleni okuqhubekayo kwemibhobho yenyongo. Ngokwemvelaphi, i-sclerosing cholangitis inokuhlelwa kwiindidi ezimbini eziphambili:

• Isiseko se-sclerosing cholangitis, apho utshintsho lwaqala kwimibhobho yenyongo;
• Ischooling sclerosing cholangitis, apho utshintsho lisisiphumo solunye utshintsho, njengethumba okanye ukwenzakala kwisiza, umzekelo.

Kubalulekile ukuba kuchongwe imvelaphi ye-cholangitis ukuze kuboniswe olona nyango lufanelekileyo kwaye ke, kuyacetyiswa ukuba ubonane nogqirha okanye i-hepatologist ukuze ubonise uvavanyo kunye nokuvavanywa kwelabhoratri okuvumela ukuba kugqitywe ukuxilongwa.

Iimpawu zesclerosing cholangitis

Uninzi lweziganeko ze-cholangitis azikhokeleli ekubonakaleni kweempawu okanye iimpawu, kwaye olu tshintsho lufunyanwa kuphela ngexesha lovavanyo lokucinga. Nangona kunjalo, abanye abantu banokuba neempawu, ngakumbi xa kufikwa kwisifo se-cholangitis, apho kukho ulwakhiwo rhoqo lwenyongo esibindini. Ke, ezona mpawu ziphambili zibonisa ukuba yi-cholangitis zezi:

• Ukudinwa kakhulu;
• Ukurhawuzelela umzimba;
• Isikhumba esimthubi namehlo;
• Kunokubakho ukugodola komzimba kunye nentlungu esiswini;
• Buthathaka kwezihlunu;
• Ukuhla ukusinda;
• Ukwandiswa kwesibindi;
• Ipeni eyandisiweyo;
• Ukuvela xanthomas, leyo izilonda eluswini ezenziwe amafutha;
• Ukurhawuzelela.

Ngamanye amaxesha, kunokubakho urhudo, iintlungu zesisu kunye nobukho begazi okanye i-mucus esitulweni. Kubukho bezi mpawu, ngakumbi ukuba ziphindaphindeka okanye zihlala zikhona, kubalulekile ukuba ubonane nogqirha okanye ugqirha wezonyango ukuze uvavanyo luqhutywe kwaye kuqalwe unyango olufanelekileyo.

Izizathu eziphambili

Oonobangela be-sclerosing cholangitis abakaqiniswa kakuhle, nangona kunjalo kukholelwa ukuba kunokuba ngenxa yotshintsho oluzenzekelayo okanye unxulumene nezinto zemfuza okanye usulelo lweentsholongwane okanye ibhaktheriya.

Ukongeza, kukholelwa ukuba i-sclerosing cholangitis inxulumene ne-ulcerative colitis, apho abantu abanolu hlobo lwezifo zamathumbu ezivuthayo babesemngciphekweni omkhulu wokuphuhlisa i-cholangitis.

Uxilongo lwenziwa njani

Ukuxilongwa kwe-sclerosing cholangitis kwenziwa ngugqirha oqhelekileyo okanye i-hepatologist ngovavanyo lwelebhu kunye nemifanekiso. Ngokuqhelekileyo, ukuxilongwa kokuqala kwenziwa ngeziphumo zovavanyo ezivavanya ukusebenza kwesibindi, kunye neenguqu kwixabiso le-enzyme zesibindi, ezifana ne-TGO kunye ne-TGP, ngaphezu kokunyuka kwe-alkaline phosphatase kunye ne-gamma-GT. Ngamanye amaxesha, ugqirha unokucela kwakhona ukusebenza kweprotein electrophoresis, apho amanqanaba anyukayo e-gamma globulins, ngakumbi i-IgG, anokubonwa khona.

Ukuqinisekisa ukuxilongwa, ugqirha unokucela i-biopsy yesibindi kunye ne-cholangiografi, eluvavanyo lokuchonga olujolise ekuvavanyeni imijelo yenyongo kunye nokujonga indlela ukusuka kwinyongo ukusuka kwisibindi ukuya kwi-duodenum, kunokwenzeka ukuba ujonge naluphi na utshintsho. Qonda ukuba yenziwa njani i-cholangiography.

Unyango lwe-sclerosing cholangitis

Unyango lwe-sclerosing cholangitis lwenziwa ngokobunzima be-cholangitis kwaye ijolise ekukhuthazeni ukukhululeka kweempawu kunye nokuthintela iingxaki. Kubalulekile ukuba unyango luqaliswe kwakamsinya emva kokuxilongwa ukuthintela ukuqhubela phambili kwesifo kwaye kubangele iingxaki ezinje ngokuqina kwesibindi, uxinzelelo lwegazi kunye nokusilela kwesibindi.

Ke, ukusetyenziswa kweyeza eliqukethe i-ursodeoxycholic acid, eyaziwayo njenge-Ursacol, inokubonakaliswa ngugqirha, ukongeza kunyango lwe-endoscopic ukunciphisa inqanaba lokuthintelwa kunye nokuthanda ukuhamba kwenyongo. Kwiimeko ezinzima kakhulu ze-cholangitis, apho kungekho phuculo kwiimpawu kunye nokusetyenziswa kweziyobisi, okanye xa iimpawu ziphindaphindiweyo, ugqirha unokucebisa ukwenza ukufakelwa kwesibindi.