Varicose Mitsetse muBase reEsophagus
Esophageal varices ndivo varicose vein in the hoophagus. Aya mitsetse, sevamwe vevicic varicose, inogona kuputika uye kubuda ropa nyore nyore. Esophageal variceal kubuda ropa ndiyo inogona kuisa upenyu hunotyisa iyo inofanira kuonekwa nekurapwa nokukurumidza.
Zvinokonzera Esophageal Varices
Varicose mitsipa ndiyo mitsetse yakave yakagadzirwa uye masvingo akatambanudzwa.
Zvinowanzowanikwa mumakumbo uye zvinogona kukura nezera nokuti, zvakanaka, simba. Mitsetse inodzorera ropa kumwoyo uye hauna imwe yakareba, masimba masvingo semagetsi. Kana tine nguva refu uye tichifamba (mumakore, ndiko) kunyanya kuomesa mitsipa yedu yemakumbo yakaiswa pasi.
Muchikamu, varicose mitsetse inobudirira kwete nekuda kwezera uye simba, asi nekuda kwehepatic portal hypertension. Nzvimbo yehutachiona yehutachiona ndiyo mutsara wezviputi zvinokonzera ropa muchiropa, uko inoshandiswa uye kuchinjwa. Mushure mekubuda ropa mukati mechiropa, zvose zvitsva uye zvinosvibiswa, zvinoramba zvichienda pamwoyo apo zvinotumirwa kumapapu ekushamba kweokisijeni uye kubudisa carbon dioxide. Zvakafanana nezuva re spa.
Muropa nechirwere che-cirrhosis-kupera kubva mukukuvadzwa kana kurwara kunokonzera chiropa-kuteerera ropa kunongororwa uye ropa rinodzokera kumasuwo, zvichiita kuti mumiro iwedzere.
Izvi zvinogona kukanganisa ropa rinoyerera munzvimbo yose, kunyanya kubva pamakumbo emitambo yakakomberedza mudumbu uye nheyo yepasi.
Mhemberero mumudumbu (inonzi gastric varices) uye sopu inoputika sezvakaita bhuruu, squiggly mitsetse pamakumbo. Masvingo emaketeni anovawo madonda uye akaoma.
Nokudzvinyirirwa kuduku, vanogona kuputika uye kubuda kunokonzera kunogona kuva kwakanyanya.
Esophageal Variceal Bleeding
Esophageal variceal kubuda ropa kune ngozi. Izvo hazvina zviratidzo zvesophageal varices kusvikira ropa rinotanga. Kana rimwe ropa rinotanga, zvakadaro, pane zviratidzo nezviratidzo . Varwere vane chirwere chepamusoro (GI) kubuda ropa-kubuda ropa kunotangira mudumbu uye mudumbu, pane mumatumbo-vanogona kutsvaga zviratidzo nezviratidzo zvinotevera:
- Kuvhara ropa rakatsvuka rakatsvuka kana kofi-pasi emesis (yakaita rima uye granular, ropa rinenge rakatsvaga)
- Rima, tarry kana mashizha
- Bloating
- Rapid pulse
- Kupera kweropa
Nokukurumidza, esophageal variceal kubuda ropa kunogona kukonzera kushamisika uye kuderera kwemazinga ekuziva.
Emergency Treatment
Muitiko reesophageal variceal kubuda ropa, nokukurumidza kurapwa kwakakurumidza kunokosha. Kana ikarapwa nokukurumidza, esophageal variceal kubuda ropa inogona kutarisirwa nenzira dzakasiyana-siyana. Endoscopy (ikamera inowanikwa mukati mehutu nemuromo) inogona kushandiswa kuwana nekutsinhira zvakananga kubuda ropa. Mukuwedzera, zvinodhaka zvevasoactive (zvinodhaka zvinokanganisa ropa mukati mevarwere vakanyanya) zvinogona kushandiswa kugadzirisa kukanganiswa kweropa muhutachiona kubuda ropa.
Varwere vari munharaunda yekukurumidzira vangangodaro vanogamuchira mvura inopisa uye pamwe nemishonga inorwisa mabhakitiriya.
Nguva Yekutumira 911
Varwere vane kamwe-kamwe kubuda ropa uye kurutsira ropa repepuru rakachena kana kuti mazana akawanda emakisi anokonzerwa nefivha anofanira kuenda kuchipatara pakarepo. Dana 911 kune chero munhu murefu anonzi lethargic, akavhiringidzika, asina simba, anozununguka, akajeka, anotonhorera kumubata, kana kutuka (diaphoretic). Ava varwere vari kuratidza zviratidzo zvekutyisidzira, izvo zvinoreva kubuda ropa kwakaoma uye kune ngozi yakawanda yekufa.
Paramedics inobata esophageal variceal kubuda ropa neIV fluids, nzvimbo yakakodzera, uye zvinodhaka zvinoshandiswa.
Kukurumidzira kutakura kuenda kuchipatara ndiko kunotsanangurwa kwechiremba ane esophageal variceal ropa.
Long-Term Treatment
Sezvakataurwa pamusoro apa, hapana zviratidzo zvesophageal varices kunze kwekuti vabuda uye vanotanga kubuda ropa. Murwere anongoda kuziva kuti ane cirrhosis kana imwe nzira yehutachiona hwehutachiona uye vanachiremba vanofanira kutarisa varice muhutano ne endoscope kuitira kuti vazviongorore. Kana akawanikwa, doc inogona kubata mavarice prophylactically nekusungiridza boka reRubber rakapoteredza, rinonzi band ligation.
Kunze kwekugadzirisa zvakananga esophageal varices kuburikidza ne endoscopic nzira, portal hypertension inogona kugadziriswa nemishonga. Beta blockers ndiyo inowanzoshandiswa. Mune varwere vazhinji, kumwe kusanganiswa kweboka rinoshandiswa uye mishonga inoshandiswa kugadzirisa zvirwere zvekudzivirira.
Basa reCirrhosis
Kurwisana kunokonzera zvinokonzera. Yakawanda ndeyekusingaperi kwechipatara C, chirwere chetachiona chinogona kutungamirira kukudzara nekukuvara kwechiropa. Doro rinodhaka rinodhaka rinoshandiswa rinosanganiswa nechirwere cheropa uye rinogona kutungamirira ku-cirrhosis kubva kumafuta anovaka muropa. Nonalcoholic fatty chiropa chirwere chinogona kukonzera kukanganisa uye kuparidzika. Zvinokwanisika mune varwere vakanyanya uye avo vane zvirwere zvemashuga kana chirwere cheshuga. Kurwara kwehupatachi B ndicho chinokonzera kukanganisa, asi ikozvino kusingawanzoitiki nekuda kwekuwanikwa kwechirwere.
Kuziva nezvekusimudzirwa kwechirrhosis ndiyo nzira yakanakisisa yekudzivirira pamusoro pekugona kwemaitiro emasikirwo. Zvinokonzerwa nekrrhosis ndiyo zviratidzo zvakakura: kuzivikanwa nechiropa chechiropa, kudhakwa, kuneta, uye chirwere cheshuga . Vanhu vazhinji vane chirwere chepachirwere chepakutanga havazooni zviratidzo zvachose pakutanga. Sezvo ichifambira mberi, varwere vanogona kukura zvimwe kana kuti zvose zvinotevera: kuneta, kushaya simba, kurasikirwa kwechido, kutema, kana kushungurudzika.
Chirwere chepiritsi chinogona kukonzera kuderera kwemasero machena eropa anorwisa utachiona kana maplatelet anobatsira mukugadzira ropa, uye kuwirirana kunobatanidzwa muropa chinoshanda kunogona kutungamirira kumazinga akakwirira ehupfu muropa. Iyo inokonzera inogona kukonzera kuvhiringidzika kana kuora mwoyo. Sezvo chepfu inounganidza muropa, varwere vanogona kukura jaundice, iyo inonzi yellowing ye sclera (vatsvene vemaziso) uye yeganda.
Basa rePortal Hypertension
Pakupedzisira, varwere vose vane cirrhosis vachakudziridza hepatic portal hypertension. Sezvinomanikidzwa zvinowedzera mumasipirini, zviduku zvidiki zvinokura. Aya mitsetse inopa nzira yekuti ropa rifambe-svetse rakasvibiswa pechipatara uye rinonzi kudonhedzwa kupararira. Kushambadzirana kwezvikamu kunopa nzira yekuti ropa ribvuruke chiropa zvachose uye risingambocheneswi.
Kunze kweedophageal varices, hofari yepamusoro yepamusoro inogona kukonzera ascites, iyo inowedzera mvura mumimba. Sezvo uturu uye zvimwe zvicherwa zvisati zvabviswa zvakanaka, zvimwe zvinetso zvinowanzobva pakuvakwa kwezvinhu uye kubva kuchinja mumagetsi ekudzvinyirira, zvakadai sekuchinja kwe plasma kubva muropa kusvika kune zvakapoteredza mishonga. Saizvozvowo, mvura inokonzera inogona kukwira kumakumbo nemakumbo, ichikonzera kuzvimba kunonzi edema. Pachirwere chepfungwa inowanikwa nekucherechedza chimwe chezvinetso izvi.
Cirrhosis uye Esophageal Varices
Chirwere chepiritsi hachiwanzoita kuti isophageal varices, asi hapana uchapupu hwakajeka hwekuti vangani varwere vane cirrhosis vanokura esophageal kana gastric varices. Mune zvimwe zvidzidzo, muenzaniso we esophageal varices muvarwere vane cirrhosis yakasiyana kubva pa8 kusvika ku 83 muzana. Ndiyo mhando huru.
Esophageal varices inofanira kuongororwa ne endoscopy, asi kana yawanikwa, inowanzova yakakura uye yakaoma kupfuura nguva. varwere vane hutachiona esophageal varices vane anenge 30% mukana we esophageal variceal ropa.
Zvichienderana nechinokonzera chirwere chetrhosis, simba rekushongedza variceal ropa rinogona kuderedzwa kuburikidza nemishonga yakasiyana-siyana yemishonga. Zvirwere zvekuvhara ropa zvakave nokubudirira mune kukanganisa kubuda kwekubuda ropa kune varwere vane chirwere chisingaperi chine hepatitis B uye beta blockers ndiyo mishonga yekusarudza yekurapa hepatic portal hypertension.
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> Li, C.-Z., Cheng, L.-F., Li, Q.S., Wang, Z.-Q., & Yan, J.-H. (2013). Antiviral therapy kunonoka esophageal variceal kubuda ropa muchipatara cheH hepatitis B. World Journal of Gastroenterology: WJG , 19 (40), 6849-6856. http://doi.org/10.3748/wjg.v19.i40.6849
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