Cudurka cirrhosis-ka ee aasaasiga ah
Mindhicirka xiidmaha waa tuubooyin ka soo baxa xiidmaha beerka una gudba xiidmaha yar. Bile waa walax ka caawisa dheef-shiidka. Dhammaan marinnada xiidmaha oo wadajira waxaa loo yaqaannaa marin-biyoodka.
Marka marinnada xiidmuhu ay bararaan ama bararaan, tani waxay xannibaysaa socodka qulqulka. Isbeddeladani waxay horseedi karaan nabar ku dhaca beerka oo loo yaqaanno cirrhosis. Tan waxaa lagu magacaabaa biir cirrhosis. Cudurka 'cirrhosis' ee sareeya wuxuu u horseedi karaa beerka hawlgab
Sababta keenta dheecaanka xiidmaha beerka ee bararsan lama oga. Si kastaba ha noqotee, cirrhosis-ka 'biliary cirrhosis' waa cillad isdifaac ah. Taas macnaheedu waa habka difaaca jirkaaga inuu si qalad ah u weeraro unugyada caafimaadka qaba. Cudurka waxaa laga yaabaa inuu ku xirnaado cudurada isdifaaca jirka sida:
- Cudurka Celiac
- Raynaud ifafaale
- Sicca syndrome (indho qallalan ama afka)
- Cudurka qanjirka 'thyroid'
Cudurku wuxuu inta badan ku dhacaa dumarka da'da dhexe.
In ka badan kala bar dadka ayaan lahayn wax calaamado ah waqtiga cudurka. Astaamuhu badanaa waxay u bilowdaan si tartiib ah. Calaamadaha hore waxaa ka mid noqon kara:
- Lalabbo iyo calool xanuun
- Daal iyo tamar la’aan
- Kaydka dufanka ah ee maqaarka hoostiisa
- Saxaro dufan leh
- Cuncun
- Cunto xumo iyo miisaan lumis
Maaddaama shaqada beerku sii xumaanayso, astaamaha waxaa ka mid noqon kara:
- Kordhin dheecaan ah oo lugaha ah (edema) iyo caloosha (ascites)
- Midab jaalle ah maqaarka, xuubka xabka, ama indhaha (cagaarshow)
- Guduudasho calaacasha gacmaha
- Ragga, kacsi la'aan, xiniinyaha oo yaraada, iyo bararka naaska
- Nabarro fudud iyo dhiig bax aan caadi ahayn, badanaa badiyaa xididdada bararsan ee habka dheef-shiidka
- Jahwareer ama dhibaatooyin xagga fikirka ah
- Saxaro midabkeedu yahay cirro ama dhoobo
Bixiyaha xanaanada caafimaadka ayaa sameyn doona baaritaan jireed.
Tijaabooyinka soo socda ayaa hubin kara in beerkaagu si fiican u shaqeynayo:
- Baaritaanka dhiigga Albumin
- Tijaabooyinka shaqada beerka (serum alkaline phosphatase ayaa ugu muhiimsan)
- Waqtiga Prothrombin (PT)
- Baadhitaannada dhiigga ee Kalastarol iyo lipoprotein
Tijaabooyinka kale ee kaa caawin kara cabirka sida daran ee cudurka beerka u noqon karo waxaa ka mid ah:
- Heerka immunoglobulin M ee dhiigga ku jira
- Cad ka-qaadista beerka
- Unugyada anti-mitochondrial (natiijooyinka ayaa kufilan qiyaastii 95% kiisaska)
- Noocyada gaarka ah ee ultrasound ama MRI oo cabiraya qadarka unugyada nabarrada (waxaa loogu yeeri karaa elastography)
- Magnetic resonance cholangiopancreatography (MRCP)
Ujeedada daaweynta waa in la fududeeyo astaamaha lagana hortago dhibaatooyinka.
Cholestyramine (ama colestipol) ayaa yareyn kara cuncunka. Ursodeoxycholic acid waxay hagaajin kartaa ka saarida xiidmaha dhiigga. Tani waxay horumarin kartaa badbaadada dadka qaarkood. Daawada cusub ee loo yaqaan obeticholic acid (Ocaliva) sidoo kale waa la heli karaa.
Daaweynta beddelka fiitamiinku waxay soo celisaa fiitamiinnada A, K, E iyo D, kuwaas oo ku lumay saxarada dufanka leh. Kaalshiyamka ama daawooyinka kale ee lafaha ayaa lagu dari karaa si looga hortago ama loo daweeyo lafaha daciifka ah ama jilicsan.
Kormeer muddo dheer ah iyo daweynta cilladda beerka ayaa loo baahan yahay.
Beerka beerista ayaa laga yaabaa inuu guuleysto haddii la sameeyo ka hor intaan beerka shaqeyn.
Natiijadu way kala duwanaan kartaa. Haddii xaaladda aan wax laga qaban, dadka badankood waxay dhiman doonaan beer la'aan la'aan. Qiyaastii rubuc ka mid ah dadka uu cudurka ku dhacay muddo 10 sano ah ayaa beerka ku dhaca. Dhakhaatiirtu hadda waxay isticmaali karaan qaab tirakoob ah si ay u saadaaliyaan waqtiga ugu fiican ee lagu tallaalo xubinta taranka. Cudurro kale, sida hypothyroidism iyo dhiig-yaraan, sidoo kale way horumari karaan.
Cirrhosis-ka horusocodka ah wuxuu u horseedi karaa beerka hawlgab. Dhibaatooyinka waxaa ka mid noqon kara:
- Dhiigbax
- Dhaawaca maskaxda (encephalopathy)
- Isku dheelitir la'aanta dareeraha iyo korantada
- Kelyaha oo hawl gab
- Malabsorption
- Nafaqo darrada
- Lafaha jilicsan ama daciifka ah (osteomalacia ama osteoporosis)
- Ascites (dheecaan ku soo baxa caloosha)
- Khatarta sii kordheysa ee kansarka beerka
Wac adeeg bixiyahaaga haddii aad leedahay:
- Barar caloosha ah
- Dhiig saxarada ku jira
- Jahwareer
- Cagaarshow
- Cuncunka maqaarka oo aan tagin oo aan la xiriirin sababo kale
- Matag dhiig
Cholangitis aasaasiga ah; PBC
- Cirrhosis - dheecaan
- Nidaamka dheefshiidka
- Jidka Bile
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Fogel EL, Sherman S. Cudurada xameetida iyo dheecaanka xiidmaha. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: baab 146.
Nalalka LW. Beerka: cudurada non-neoplastic. Gudaha: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai iyo Ackerman's Pathology. 11aad. Philadelphia, PA: Elsevier; 2018: cutubka 19.
Smith A, Baumgartner K, Bositis C. Cirrhosis: ogaanshaha iyo maaraynta. Am Fam Dhakhtarka. 2019; 100 (12): 759-770. PMID: 31845776 pubmed.ncbi.nlm.nih.gov/31845776/.