Ama-varicose Veins ase-Base of the Esophagus
I-varopose varicose veichageal varices. Lezi zinyopho, njenganoma yimiphi imivimbo ye-varicose, ingaqhekeka futhi iphule kalula. Ukusuka kwe-varophage ye-variceal yisimo esingesongela impilo okufanele sihlonishwe futhi siphathwe ngokushesha.
Izimbangela ze-Esophageal Varices
Imivimbo ye-Varicose yizivunguvungu eziye zahlanganiswa futhi izindonga zanwebeka kancane.
Zivame ukutholakala emilenzeni futhi zingakhula ngobudala ngoba, kahle, amandla adonsela phansi. Imifino ibuyisela igazi enhliziyweni futhi ayikho insimbi efanayo, izindonga ze-muscular njenge-arteries. Uma sikwazi ukuma futhi sihambe (eminyakeni, lokho) ingcindezi eyengeziwe imilenze yethu yomlenze ibekiwe.
Esikhathini sokuqala, imivimbo ye-varicose ikhula hhayi ngenxa yobudala nodonsela phansi, kodwa ngenxa ye-hepatic portal hypertension. Isistimu ye-venous ye-portal iqoqo lezinyosi ezihambisa igazi esibindi, lapho kusetshenzwa khona futhi kukhishwa khona. Ngemuva kokuthi igazi lishiya isibindi, konke kuhlanzekile futhi kutholakale khona, kuyaqhubeka enhliziyweni lapho kuthunyelwa khona emaphashini okugeza okuphefumula okwenziwe umoya we-oxygen. Kufana nosuku lwe-spa.
Esibindi ngesifo se-cirrhosis-eshiya ukulimala noma ukugula okuphazamisa ukugeleza kwegazi kwesibindi kuvinjelwe futhi igazi libuyela emuva ohlelweni lokungena, okwenza ukuba ingcindezi emithanjeni ikhule.
Le ngcindezi ingathinta ukugeleza kwegazi kulo lonke isifunda, ikakhulukazi kusukela ohlelweni lwesisu esisondelene nesisu nesisekelo sendawo.
Imifino esiswini (ebizwa ngokuthi i-gastric varices) futhi i-oophagus ifakwe njengeziluhlaza okwesibhakabhaka, okwesibhakabhaka emilenzeni. Izindonga zemithanjeni nazo ziba mncane futhi zibucayi kakhulu.
Ngengcindezi encane, ingaqhuma futhi ukuphuma kwegazi kungase kube nzima.
Ukuqothuka kwe-Esophageal Variceal
Ukusuka kwe-varophageal-variceal kuyingozi kakhulu. Azikho izimpawu zokulondeka kwegazi kuze kuqale ukuphuma kwegazi. Uma ukuphuma kwegazi kuqala, kunjalo, kunezibonakaliso nezimpawu . Iziguli ezinezinyosi eziphezulu ezingokwemathunjini (i-GI) -ukuphuma kwamanzi ezivela esiteshini nasesisu, kunokuba emathunjini-zingabheka lezi zimpawu nezimpawu ezilandelayo:
- Ukushaya igazi elibomvu elikhanyayo noma i-emesis ikhofi-emhlabathini (okumnyama kakhulu kanye ne-granular, igazi elincintisiwe)
- Izitembu ezimnyama, ezilindile noma ezinamathele
- Ukuvimbela
- Ukushayela okusheshayo
- Ukwehlisa umfutho wegazi
Ngokushesha, ukuphuma kwe-variceal okuyi-esophageal kungase kuholele ekushuseni futhi kunciphise amazinga okuqonda.
Ukwelashwa Okuphuthumayo
Uma kwenzeka ukuphuma kwe-varophage ye-esophageal variceal, ukwelashwa okuphuthumayo ngokushesha kuyadingeka. Uma uphethwe ngokushesha, ukuphuma kwe-varophage ye-esophageal kungaphathwa ngokusebenzisa izinqubo ezihlukahlukene. I-Endoscopy (ikhamera efakwe ngaphakathi kwesikhala ngomlomo) ingasetshenziselwa ukuthola nokuqondile ukuphuma kwegazi. Ngaphezu kwalokho, izidakamizwa eziphuthumayo (izidakamizwa ezithinta ukucindezelwa kwegazi ezigulini eziyingozi) zingasetshenziswa ukubhekana nokucindezelwa kwegazi ezigulini eziphuma ngegazi.
Iziguli ezisesimweni esiphuthumayo cishe zizophinde zithole amanzi okugcoba kanye nama-antibiotic.
Nini ukubiza 911
Iziguli ezinokuqala ngokuphazamiseka kwegazi nokuhlanza igazi elibomvu elingenalutho noma ukuhlanza okukhulu kwekhofi kufanele zifike esibhedlela ngokushesha. Shayela u-911 kunoma yisiphi isiguli esine-lethargic, ididekile, ifinyelelekile, idizzy, iluphukile, ipholile, futhi i-sweating (i-diaphoretic). Lezi ziguli zibonisa izimpawu zokushaqeka, okusho ukuthi ukuphuma kwegazi kunzima futhi kunengozi enkulu yokufa.
I-paramamedics izophatha ukwelashwa kwe-variceal yokuqeda amandla nge-IV fluids, ukubeka kahle, nezidakamizwa ze-vasoactive.
Ukuthutha okusheshayo ukuya esibhedlela kungukuthi ukwelashwa okucacile kwesiguli esinophephela igazi elincane.
Ukwelashwa Kwesikhathi Eside
Njengoba kushiwo ngenhla, azikho izimpawu zokuqeda izifo ngaphandle kokuba ziphule bese ziqala ukuphuma kwegazi. Isiguli kufanele nje sazi ukuthi une-cirrhosis noma enye indlela ye-hypertension ye-portal nodokotela kufanele babheke ama-varice esivumelwaneni nge-endoscope ukuze baxilongwe. Uma kutholakala, i-doc ingaphatha ama-varice prophylactically ngokuhlanganisa ngokubambisana nebhola le-raber elizungezile, elibizwa nge-band ligation.
Ngaphandle kokulungisa ngqo izinkinga zokungalingani ngokusebenzisa izinqubo ze-endoscopic, i-portal hypertension ingasetshenziswa ngemithi. Abavimba be-Beta bavame ukusetshenziswa kakhulu. Ezigulini eziningi, inhlanganisela ethile ye-band ligation kanye nemithi izosetshenziswa ekuphatheni izinga lokungalingani.
Umsebenzi We-Cirrhosis
I-cirrhosis inezimbangela eziningana. Okuvame kakhulu ukuthi i-hepatitis C engapheli, ukutheleleka kwesandulela ngculaza okungabangela ukuvuvukala nokulimala kwesibindi. Ukusetshenziswa kotshwala obunzima okungapheli nakho kuhlotshaniswa nezifo zesibindi futhi kungaholela ekutheni i-cirrhosis isakhiwe amafutha esibindi. Isifo sesibindi se-nonalcoholic fatty singenza umonakalo kanye ne-cirrhosis. Kungenzeka ngeziguli ezikhulu kakhulu nalabo abanezinkinga zemithi noma isifo sikashukela. I-hepatitis B engapheli yimbangela engaba imbangela ye-cirrhosis, kodwa manje engavamile ngenxa yokutholakala komgomo.
Ukuqaphela ukuthuthukiswa kwe-cirrhosis kungukuzivikela okungcono kunazo zonke zokungaboni kahle. Izimbangela ze-cirrhosis yizinkomba ezinkulu: izifo zesibindi, izidakamizwa, ukukhuluphala, nesifo sikashukela . Abantu abaningi abane-cirrhosis zakuqala ngeke babone izimpawu ekuqaleni. Njengoba iqhubeka, iziguli zingase zihlakulele ezinye noma zonke ezilandelayo: ukukhathala, ubuthakathaka, ukulahlekelwa isifiso sokudla, ukucheka, noma ukuncibilikisa.
I-cirrhosis ingabangela amazinga wegazi elimhlophe elilwa nokutheleleka noma amaplatelets asebenza ekwenzeni ama-blood clots, kanti ukwehla okuhambisanayo ekusebenzeni kwesibindi kungabangela amazinga aphezulu e-toxin egazini. I-toxin ingabangela ukudideka noma ukukhathazeka. Njengoba izinhlayiya ziqoqa egazini, iziguli zingahlakulela i-jaundice, okuyi-yellowing ye-sclera (abamhlophe bamehlo) nesikhumba.
Umsebenzi We-Hypertension Portal
Ekugcineni, zonke iziguli ezine-cirrhosis zizothuthukisa i-hepatic portal hypertension. Njengoba ingcindezi ikhiqiza ohlelweni lokungena, i-veins encane ithuthuka. Lezi zinyopho zinikeza indlela yegazi ukuhamba ngokuzungezile uhlelo lwama-portal olugcwele futhi libizwa ngokuthi ukuhamba kwemigodi. Ukusakazwa kwezimpahla kuhlinzeka indlela igazi elidlula isibindi ngokuphelele futhi lingalokothi lihlanzwe.
Ngaphandle kwama-varic esophageal, i-portal hypertension ingase ibangele ama-ascites, okuyi-fluid eyakhiwe esiswini. Njengoba amakhemikhali namanye amaminerali asusiwe kahle, ezinye izinkinga zivela ekuvelweni kwezinto nezinto ezivela ezinkampeni ezicindezelayo, njengokushintsha kwe-plasma kusuka egazini kuya ezihlotsheni ezizungezile. Ngokufanayo, uketshezi kungaphindela emilenzeni nasemagqumeni, okwenza ukuvuvukala kwaziwa ngokuthi i-edema. I-hypertension ye-portal itholakala ngokubheka enye yalezi zinkinga.
I-Cirrhosis ne-Esophageal Varices
I-cirrhosis ayisoze iholele ekutheni i-varopolisal varices, kodwa ayikho ubufakazi obucacile ukuthi zingaki iziguli ezine-cirrhosis ezihlakulela ukuphelelwa yisisu noma isisu esiswini. Kwezinye izifundo, ukuhlolwa kwamagciwane okuyi-esophageal ezigulini ezine-cirrhosis zahluka kusuka kumaphesenti angu-8 kuya kuma-83 amaphesenti. Lokho kuluhlu olukhulu.
Ama-varic esophageal kufanele atholakale ane-endoscopy, kodwa uma atholakele, ngokuvamile athola isikhathi esikhulu nakakhulu ngaphezu kwesikhathi. iziguli ezine-varopha ezixilongwa nge-esophageal varices zinezithuba ezingamaphesenti angu-30 okuthiwa yi-esophageal variceal bleeding.
Ngokuya ngesibindi se-cirrhosis, ukukwazi ukuphuma kwe-varical bleeding variceal kungancishiswa ngemithi ehlukahlukene yokwelapha. Imithi yokuvimbela imithi iphumelele ekulibaleni ukuphuma kwegazi ezigulini ezine-hepatitis B ezingapheli kanye ne-beta blockers yizidakamizwa ezikhethwe ukulawula i-hepatic portal hypertension.
> Imithombo:
> Hilzenrat, N., & Sherker, AH (2012). Ama-Esophageal Varices: I-Pathophysiology, Indlela, Nemithi Yomtholampilo. I-International Journal of Hepatology , 2012 , 795063. http://doi.org/10.1155/2012/795063
> Lahbabi, M., Elyousfi, M., Aqodad, N., Elabkari, M., Mellouki, I., Ibrahimi, SA, noBenajah, DA (2013). I-esophagusal variceal ligation ye-hemostasis ye-acute variceal yegazi: ukusebenza kahle nokuphepha. I-Pan African Medical Journal , 14 , 95. http://doi.org/10.11604/pamj.2013.14.95.1847
> Li, C.-Z., Cheng, L.-F., Li, Q.-S., Wang, Z.-Q., & Yan, J.-H. (2013). Ukwelashwa kwe-antiviral ukulibaziseka kwe-varical bleeding in-circulhos ehlobene ne-hepatitis B. I-World Journal of Gastroenterology: WJG , 19 (40), 6849-6856. http://doi.org/10.3748/wjg.v19.i40.6849
> I- cirrhosis | I-NIDDK . (2018). I-National Institute of Diabetes kanye ne-Digestive and Kidney Diseases . Itholakala kusuka ku-https: //www.niddk.nih.gov/health-information/liver-disease/cirrhosis
> ROMANO, G., AGRUSA, A., AMATO, G., DE VITA, G., FRAZZETTA, G., CHIANETTA, D., ... GULOTTA, G. (2014). I-endoscopic sclerotherapy ye-hemostasis yokuphuma kwe-acute egazini ye-variceal. Il Giornale Di Chirurgia , 35 (3-4), 61-64.
> Triantos, C., & Kalafateli, M. (2014). Ukwelashwa okungapheliyo kwe-varophageal varices kwiziguli ezine-cirrhosis yesibindi. I-World Journal of Gastroenterology: WJG , 20 (36), 13015-13026. http://doi.org/10.3748/wjg.v20.i36.13015