Kubuda ropa esophageal varices

Iyo esophagus (chikafu chepombi) ndiyo chubhu inobatanidza huro yako nedumbu rako. Varices ndiwo akakurisa mutsinga anogona kuwanikwa mukati medu mukati mevanhu vane cirrhosis yechiropa. Tsinga idzi dzinogona kutsemuka nekubuda ropa.

Kupararira (cirrhosis) kwechiropa ndicho chinonyanya kukonzera esophageal varices. Uku kucheka kunocheka pasi paropa rinoyerera kuburikidza nechiropa. Nekuda kweizvozvo, ropa rakawanda rinoyerera kuburikidza nematsinga egurokuro.

Kuwedzera kweropa kuyerera kunokonzera tsinga dziri mudumbu kubharuni kunze. Kubuda ropa kwakanyanya kunogona kuitika kana tsinga dzichibvaruka.

Chero chero rudzi rwerefu-kwenguva refu (chisingaperi) chirwere chechiropa chinogona kukonzera esophageal varices.

Varices inogona zvakare kuitika muchikamu chepamusoro chedumbu.

Vanhu vane chirwere chisingaperi chechiropa uye esophageal varices vanogona kunge vasina zviratidzo.

Kana paine chete shoma shoma yekubuda ropa, iyo chete chiratidzo inogona kunge iri yerima kana nhema mitsara muzvituru.

Kana huwandu hwekubuda ropa hukaitika, zviratidzo zvinogona kusanganisira:

• Nhema, tarisa zvituru
• Ropa zvigaro
• Musoro wakareruka
• Ruvara
• Zviratidzo zvechirwere chechiropa chisingaperi
• Kusvipa ropa

Mutapi wako wezvehutano achaita bvunzo dzepanyama dzinogona kuratidza:

• Ropa kana dema chigaro (mune rectal bvunzo)
• Kuderera kweropa
• Kukurumidza kurova kwemoyo
• Zviratidzo zvechirwere chechiropa chisingaperi kana cirrhosis

Kuyedza kutsvaga iko kunobuda ropa uye kutarisa kana paine kubuda ropa kunosanganisira:

• EGD kana yepamusoro endoscopy, iyo inosanganisira kushandiswa kwekamera pane inochinjika chubhu kuongorora esophagus uye mudumbu.
• Kuisirwa chubhu kuburikidza nemumhino mudumbu (nasogastric tube) kutsvaga zviratidzo zvekubuda ropa.

Vamwe vanopa mazano vanopa EGD kune vanhu vachangobva kuongororwa kuti vane cirrhosis iri pakati nepakati. Iyi bvunzo inoongorora esophageal varices uye inovabata vasati vabuda ropa.

Chinangwa chekurapa ndechekumisa kubuda kweropa kwakanyanya nekukurumidza sezvazvinogona. Kubuda ropa kunofanirwa kudzorwa nekukurumidza kudzivirira kushamisika uye kufa.

Kana kubuda ropa kukuru kukaitika, munhu angangoda kuiswa pamushini wekudzivirira mweya wavo uye kudzivirira ropa kuti risapinda mumapapu.

Kumisa kubuda kweropa, mupi anogona kupfuudza endoscope (chubhu ine mwenje mudiki kumagumo) kupinda mudumbu.

• Mushonga unodzigisa unogona kuiswa jekiseni muzvirisa.
• Bhandi rerabha rinogona kuiswa rakatenderedza tsinga dzinobuda ropa (inonzi banding).

Dzimwe nzira dzekurapa kumisa kubuda kweropa:

• Mushonga wekusimbisa tsinga dzeropa unogona kupihwa kuburikidza netsinga. Mienzaniso inosanganisira octreotide kana vasopressin.
• Kazhinji, chubhu inogona kuiswa mukati memhino mudumbu uye kuzadzwa nemhepo. Izvi zvinoburitsa kumanikidza kunobuda ropa mutsinga (chibharuma tamponade).

Kana ropa rango miswa, mamwe ma varice anogona kurapwa nemishonga uye nzira dzekurapa kudzivirira kubuda kweropa mune ramangwana. Izvi zvinosanganisira:

• Zvinodhaka zvinonzi beta blockers, senge propranolol uye nadolol izvo zvinoderedza njodzi yekubuda ropa.
• Bhandi rerabha rinogona kuiswa rakatenderedza tsinga dzinobuda ropa panguva yeEGD maitiro. Zvakare, mimwe mishonga inogona kuiswa mukati meiyo varices panguva yeEGD kuita kuti ivhare.
• Transjugular intrahepatic portosystemic shunt (MAZANO). Iyi ndiyo nzira yekugadzira hukama hutsva pakati pemidziyo miviri yeropa muchiropa chako. Izvi zvinogona kudzikisa kumanikidza mutsinga uye kudzivirira kubuda kwezvikamu zvekubuda ropa kuti zvirege kuitika zvakare.

Muzviitiko zvisingawanzoitika, kuvhiyiwa kwechimbichimbi kunogona kushandiswa kurapa vanhu kana kumwe kurapwa kukatadza. Portacaval inovhara kana kuvhiya kudzikisa kumanikidza mune esophageal varices ndiwo marapirwo, asi maitiro aya ane njodzi.

Vanhu vane varices yekubuda ropa kubva kuchiropa chirwere vangangoda kurapwa kwakawanda kwechiropa chavo, kusanganisira chiropa chekuisa.

Kubuda ropa kazhinji kunodzoka uine kana pasina kurapwa.

Kubuda ropa esophageal varices chinetso chakakomba chechiropa uye chine mhedzisiro yakaipa.

Kuiswa kwe shunt kunogona kutungamira pakuderedzwa kweropa kuuropi. Izvi zvinogona kutungamira kuchimiro chepfungwa.

Zvinetso zvemunguva yemberi zvinokonzerwa nema varices zvinogona kusanganisira:

• Kuderedza kana kuomesa kwesopu nekuda kwekukanganisa mushure mekuita
• Kudzoka kwekubuda ropa mushure mekurapwa

Fonera mupiki wako kana enda kuimba yekukurumidzira kana ukarutsa ropa kana uine zvitema zvekugara.

Kurapa zvinokonzera chirwere chechiropa kunogona kudzivirira kubuda ropa. Kuisa chiropa kunofanirwa kutarisirwa kune vamwe vanhu.

Chiropa cirrhosis - varices; Cryptogenic chisingaperi chiropa chirwere - varices; End-nhanho chirwere chechiropa - varices; Chinodhakwa chiropa chirwere - varices

• Cirrhosis - kubuda

• Kugaya chirongwa
• Chiropa cheropa

Garcia-Tsao G. Cirrhosis uye sequelae yayo. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 144.

Inochengetedza TJ, Jensen DM. Kubuda ropa mudumbu. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chirwere: Pathophysiology / Diagnosis / Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016: chitsiko 20.