Izimpawu, Ukuxilongwa Nokunakekelwa Kwe-PSC, Isifo Sezifo Esihambisana Ne-IBD
I-primary sclerosing cholangitis (i-PSC) yisifo sesibindi esibangela ukuvuvukala nokunciphisa ama-bile emaceleni ngaphakathi nangaphandle kwesibindi. Akuqiniseki ukuthi yini ebangela i-PSC, nakuba kucatshangwa ukuthi iyimvelo yokuzimela . I-PSC ayicatshangwa ukuthi izuzwe ngokuqondile, kodwa kucatshangwa ukuthi inesici sezakhi zofuzo.
Kudingeka ibhilidi lokugaya amafutha futhi uphumele esibindi.
I-PSC ibangela ukuthi ama-bile amathanga aqhekeke ekuqotheni nokuvuvukala, futhi i-bile iqala ukuqoqa esibindi, esiyingozi. Lo monakalo ekugcineni uholela ekwakhekeni kobunzima kanye ne- cirrhosis , okuvimbela isibindi ukuba senze imisebenzi yaso ebalulekile. Iminyaka eminingana ye-PSC ingaholela esithombeni somdlavuza we-bile ducts okuthiwa i-cholangiocarcinoma, eyenzeka ngeziguli ezingu-10 kuya ku-15%.
I-PSC iyaqhubeka kancane kancane ezimweni eziningi, kodwa ingase ingabi nakwazi futhi ingasongela ukuphila. Abantu abane-PSC bangathola ukwelashwa ukuze kunciphise izimpawu futhi babasize baphile impilo esebenzayo.
In-Risk Demographic
Ngokuvamile, abantu abathintekayo yi-PSC baphakathi kweminyaka engama-30 no-60, kanti isilinganiso seminyaka yokuxilongwa sibe ngu-40. I-PSC ivame ukuvame kakhulu kubantu; Abantu abangama-60 kuya ku-75% abathintekayo bangamadoda. Konke, i-PSC yisifo esingavamile.
Izimpawu
Abanye abantu abanalo izimpawu zokuxilongwa noma ngisho nangemva kweminyaka eminingana.
Izimpawu zihlanganisa:
- Isifo sohudo (esibangelwa ama-malabsorption of fat)
- Ukukhathala
- I-fever / chills (kusukela ekuthelelekeni emadayini we-bile)
- Ukucheka okuvame ukuthinta wonke umzimba
- I-jaundice (i-yellowing yesikhumba namehlo)
Izifo Ezihlangene
Abantu abane-PSC banamathuba amaningi okuba nezifo zesifo sofuba (IBD) noma i-osteoporosis.
I-PSC ihlotshaniswa kakhulu ne-ulcerative colitis ngamaphesenti angaba ngu-70 weziguli, kodwa ingase ihlotshwe nesifo sikaCrohn esibilini esikhulu, ngezinye izikhathi esibizwa nge- Crohn's colitis . Isizathu sokubambisana ne-IBD asiziwa, kodwa kucatshangwa ukuthi siwumphumela wokuphendula ngomzimba.
Ukuxilongwa
I-PSC ivame ukutholwa yinqubo ebizwa nge- ERCP (endoscopic retrograde cholangiopancreatography) . Ngesikhathi i-ERCP, udokotela uzofaka i-endoscope emlonyeni futhi azulazula phansi ngesisu nangesisu kuya emathangeni esihlahla sombhiliyali. Idayi ifakwa emidayini ukuze zibonise uma kuthathwa ama-x-ray. I-x-ray iyabuye yahlaziywa ukuze inqume ukuthi ikhona yini izinkinga nge-bile ducts.
Ukuxilongwa kwe-PSC kungabuye kuqinisekiswe ngokuhlolwa kwegazi okubizwa ngokuthi i-ALK (alkaline phosphatase) yokuhlola, nakuba imiphumela emihle ingabhekisela kwezinye izimo eziningi kune-PSC kuphela.
I-biopsy yesibindi iyasiza futhi ukuqinisekisa ukuxilongwa kwe-PSC, kanye nokuqapha ukuqhubeka kwesifo ngemva kokuxilongwa. I-biopsy yebindi yenziwa esibhedlela esibhedlela ngesifo sokugula esibhedlela . Udokotela owenza lesi sivivinyo uzosebenzisa inaliti ukuze athathe isampula encane yezicubu zesibindi ukuze ahlolwe yi-pathologist.
Ukwelapha
Ayikho ukwelashwa okuye kwafakazelwa ukuthi iyasebenza ekuphatheni i-PSC. Ucwaningo lokuthola ukwelashwa okuphumelelayo okwamanje luqhubeka. Izinhlelo zokulashwa zigxila ekunciphiseni izimpawu, ukuphazamisa ukuqhubeka kwesifo, nokuqapha izinkinga ezingenzeka.
Izimpawu ze-PSC zingaphathwa ukuze zenze iziguli zikhululeke. Ukunambitha kungaphathwa nge-Questran (cholestyramine) noma i-Benadryl (diphenhydramine). Ukutheleleka okuvamile okungenzeka kwenzeka nge-PSC, ama-antibiotic angadingeka. Ngenxa yokuthi i-PSC iphazamisa ukungena kwamanoni, kungase kudingeke ukondla ama -vithamini A, D, E no-K.
Uma i-blockages yenzeka emidayeni ye-bile, inqubo yokuhlinzwa ingadingeka ukwelula noma ukuyivula. Ama-stents, agcina ama-duc evulekile, angabekwa emidayeni phakathi nale nqubo.
Uma ukuqhubeka kwe-PSC kuholela ekuhlulekeni kwesibindi noma ukutheleleka kwe-biliary okuphikisanayo, ukufakelwa kwesibindi kungadingeka. Ukufakelwa kwesibindi kunikeza izinga elihle lokuphila kwabamukeli, kanye nesilinganiso sokusinda samaphesenti angaba ngu-75.
Nini Ukubiza Udokotela
Uma noma yiziphi izimpawu ezilandelayo zenzeka nge-PSC, shayela udokotela wakho:
- Ubuhlungu besisu
- Izitshalo ezimnyama noma ezimnyama kakhulu
- I-Jaundice
- Ukushisa kuka-100.4
- Ukushaya ngegazi
Imithombo :
Johns Hopkins Medicine. "Primary Sclerosing Cholangitis." I-Johns Hopkins University 2013.
Karlsen TH, Hampe J, Wiencke K, Schrumpf E, Thorsby E, Lie BA, Broomé U, Schreiber S, Boberg KM. "I-Polymorphisms Yofuzo Ehlanganiswa Nezifo Zezifo Ezivuthayo Azikho Ingozi Ye-Cholangitis Eyisisekelo Esibucayi." I-J Gastroenterol Jan 2007.
I-Merck Manual. "Primary Sclerosing Cholangitis (PSC)." Merck & Co, Inc Sept 2007.
Van Steenbergen W, De Goede E, MP MP, Reinders J, Tilanus M, J. J. Fevery "Primary Sclerosing Cholangitis Abazalwane Ababili: Umbiko Womndeni Ngokugxila Ngokukhethekile kwi-Molecular HLA ne-MICA Genotyping." Eur J Gastroenterol Hepatol Jul 2005.