Ascites

Ascites ndiko kuvakwa kwemvura munzvimbo iripakati pemucheto wedumbu nenhengo dzemudumbu.

Ascites inoguma kubva mukumanikidza kwakanyanya mumidziyo yeropa yechiropa (portal hypertension) uye mashoma mapuroteni anonzi albumin.

Zvirwere zvinogona kukonzera kukuvadza kwechiropa zvakanyanya zvinogona kutungamira kune ascites. Izvi zvinosanganisira:

• Chirwere cheshuga C kana B hutachiona
• Kunwa doro zvisina kufanira kwemakore mazhinji
• Fatty chiropa chirwere (isiri-doro steatohepatitis kana NASH)
• Cirrhosis inokonzerwa nezvirwere zvemaranzi

Vanhu vane mamwe kanzira mudumbu vanogona kukura ascites. Izvi zvinosanganisira kenza yeapendikisi, colon, ovaries, chibereko, rwatata, uye chiropa.

Mimwe mamiriro ezvinhu anogona kukonzera dambudziko iri anosanganisira:

• Kuvhara mutsinga dzechiropa (portal vein thrombosis)
• Kuunganidzwa kwemoyo kukundikana
• Pancreatitis
• Kuomarara uye kupora kwechisak-chakafukidza moyo (pericarditis)

Itsvo dialysis inogona zvakare kuve yakabatana ne ascites.

Zviratidzo zvinogona kukura zvishoma nezvishoma kana kamwe kamwe zvichienderana nechinokonzera ascites. Unogona kusava nezviratidzo kana paine chete hushoma hwemvura mudumbu.

Sezvo kuwanda kwemvura kunounganidza, unogona kunge uine kurwadziwa kwepamuviri uye kuzvimba. Huwandu hwakawanda hwemvura hunogona kukonzeresa kufema, Izvi zvinoitika nekuti mvura yacho inosundira padhiramu, iro rinozomanikidza mapapu ezasi.

Zvimwe zvakawanda zviratidzo zvechiropa kutadza zvinogona kuve zviripo.

Chiremba wako achaita bvunzo dzepanyama kuti aone kana iko kuzvimba kungangoitika nekuda kwemvura inovaka mudumbu rako.

Iwe unogona zvakare kuve nemiedzo inotevera yekuongorora chiropa chako neitsvo:

• 24-awa weti kuunganidzwa
• Electrolyte mazinga
• Itsvo basa rekuyedza
• Chiropa basa bvunzo
• Kuyedza kuyera njodzi yekubuda ropa uye mapuroteni muropa
• Kuongorora urinal
• Abdominal ultrasound
• CT scan yemudumbu

Chiremba wako anogona zvakare kushandisa tsono yakatetepa kubvisa ascites fluid kubva mudumbu rako. Mvura yacho inoedzwa kuti itarise chinokonzera ascites uye kutarisa kuti mvura yacho ine hutachiona here.

Mamiriro ezvinhu anokonzera ascites acharapwa, kana zvichibvira.

Mishonga yekurapa kwekuvaka inogona kusanganisira shanduko yemararamiro:

• Kudzivisa doro
• Kuderedza munyu mukudya kwako (hapana anopfuura 1,500 mg / zuva re sodium)
• Kudzivisa kudya kwemvura

Iwe unogona zvakare kuwana mishonga kubva kuna chiremba wako, kusanganisira:

• "Mapiritsi emvura" (diuretics) kubvisa imwe mvura
• Mishonga inorwisa mabhakitiriya yezvirwere

Zvimwe zvinhu zvaunogona kuita kuti ubatsire kutarisira chirwere chako chechiropa ndeichi:

• Wana jekiseni rezvirwere zvakadai sefuruwenza, hepatitis A uye hepatitis B, uye pneumococcal pneumonia
• Taura nachiremba wako nezve mishonga yese yaunotora, kusanganisira mishonga uye zvinowedzera uye nemishonga inopfuura pakaunda

Maitiro aungave uine ndeaya:

• Kuisa tsono mudumbu kubvisa huwandu hwakawanda hwemvura (inonzi paracentesis)
• Kuisa yakakosha chubhu kana shunt mukati mechiropa chako (MAZANO) kugadzirisa ropa kuyerera kuchiropa

Vanhu vane magumo-chikamu chechiropa chirwere vangangoda chiropa chekuisa.

Kana iwe uine cirrhosis, dzivisa kutora nonsteroidal anti-anogumbura mishonga, senge ibuprofen (Advil, Motrin) uye naproxen (Aleve, Naprosyn). Acetaminophen inofanira kutorwa mune yakaderedzwa doses.

Zvinetso zvinogona kusanganisira:

• Zviripo zvebhakitiriya peritonitis (hutachiona hunotyisidzira hupenyu hweiyo ascitic fluid)
• Hepatorenal syndrome (itsvo kutadza)
• Kuonda uye mapuroteni kushaya zvinovaka muviri
• Kuvhiringidzika kwepfungwa, shanduko padanho rekusvinura, kana coma (hepatic encephalopathy)
• Kubuda ropa kubva kumusoro kana kwakadzika matumbu
• Kuvaka-kumusoro kwemvura mune iyo nzvimbo pakati pemapapu ako uye chipfuva cavity (pleural effusion)
• Mamwe matambudziko echiropa cirrhosis

Kana iwe uine ascites, fonera wako mutano wezvehutano ipapo ipapo kana iwe uine:

• Fivha iri pamusoro pe100.5 ° F (38.05 ° C), kana fivhiri isingaendi
• Belly kurwadziwa
• Ropa muzvigaro zvako kana nhema, zvigarire zvigaro
• Ropa mumarutsi ako
• Kupopota kana kubuda ropa kunoitika nyore
• Kuvaka-kumusoro kwemvura mudumbu rako
• Makumbo akazvimba kana makumbo
• Matambudziko ekufema
• Kuvhiringidzika kana matambudziko kugara wakamuka
• Ruvara rweyero muganda rako uye nevachena vemaziso ako (jaundice)

Portal neBP - ascites; Kurwisa - ascites; Chiropa kutadza - ascites; Doro kushandisa - ascites; End-danho chirwere chechiropa - ascites; ESLD - ascites; Pancreatitis ascites

• Ascites nekenza yemazai - CT scan
• Digestive system nhengo

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

National Institute of Chirwere cheshuga uye Digestive uye Kidney Zvirwere webhusaiti. Cirrhosis. www.niddk.nih.gov/health-information/liver-disease/cirrhosis/all-content. Yakagadziridzwa Kurume 2018. Yakasvika munaNovember 11, 2020.

Sola E, Gines SP. Ascites uye otomatiki bhakitiriya peritonitis. Muna: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger uye Fordtran's Gastrointestinal uye Chirwere Chiropa. 11th ed. Philadelphia, PA: Elsevier; 2021: chitsiko 93.