Ukuvuvukala Kwesibindi 

Esinye sezitho zethu ezibalulekile, isibindi, siyadingeka ukuze siphile. Ngaphezu kokuhlunga ubuthi egazini kanye ukulawula i-cholesterol yegazi, lenza imisebenzi eminingi ebalulekile yezinto eziphilayo. Ikhiqiza i-bile, uketshezi olusiza ekugayeni amafutha okudla. Ngaphezu kwalokho, igcina i-glucose, uhlobo lukashukela olunikeza amandla asheshayo lapho kudingeka.

Ukwanda kwesibindi kubizwa ngokuthi i-hepatomegaly, okuwuphawu lwenkinga engase ibe yingozi. Ezimweni eziningi, kubangelwa izifo zesibindi okuholela ekuvuvukeni nasekuvuvukeni. Nokho, ngezinye izikhathi kungase kuhlotshaniswe nesifo senhliziyo noma igazi. Isimo esiwumsuka kufanele sihlolwe ngokushesha futhi silashwe.

Ingabe isibindi esikhulisiwe siyingozi?

Ukwandiswa kwesibindi kuyinkinga engathi sína. Ngokuya ngesizathu sokwanda kwesibindi, singaba yingozi noma sibe nempilo. Ingasebenza njengophawu oluyisixwayiso noma ibonise isimo esiphuthumayo. Isibindi singase sikhule ngezikhathi ezithile ngenxa yesifo esiyingozi (yesikhashana) ngaphambi kokuba sibuyele kusayizi waso ojwayelekile. Ngaphandle kwalokho, ingase ihlaselwe ukugula okungamahlalakhona okuwohloza kancane kancane ukusebenza kwayo. Kubalulekile ukukhomba ukuvuvukala kwesibindi ngenxa yesifo ngokushesha ngangokunokwenzeka. Ukuhluleka kwenhliziyo futhi umdlavuza yizimbangela ezimbili eziphuthumayo ze-hepatomegaly, futhi lolu hlobo lokuvuvukala kwesibindi lungaba yingozi.

Izimpawu zokwanda kwesibindi 

Akunakwenzeka ukuthi umuntu azi ngesibindi esikhulisiwe eyedwa. Ezimweni ezimbi kakhulu, izimpawu zokuvuvukala kwesibindi ezifana ukuqhakaza esiswini noma ukugcwala, kanye nobuhlungu engxenyeni engenhla kwesokudla sesisu (lapho isibindi sikhona), kungase kutholakale. Nokho, maningi amathuba okuthi izimpawu zokuvuvukala kwesibindi zibonakale lapho kuhlolwa udokotela. Izimpawu ezilandelayo zokuvuvukala kwesibindi zingase zenzeke uma kunezimo ezibucayi ezibangela ukuthi isibindi sivuvuke futhi sibe sikhulu kunalokho okudingekayo:

• Ukukhathala nokucanuzela kwenhliziyo
• Ukungabi nesifiso
• Ukulahlekelwa isisindo ngokweqile
• jaundice
• Ukuluma kwesikhumba
• Indle enombala okhanyayo nomchamo omnyama
• Ubende obukhulisiwe
• Ukuvuvukala kwemilenze ngenxa yezinkinga zesibindi ezibangelwa ukugcwala koketshezi

Izimbangela zokwanda kwesibindi

Izimbangela ezivame kakhulu zokuvuvukala kwesibindi zihlanganisa:

• Isifo sesibindi sotshwala: Isimo esiholela ekulimaleni, ukuvuvukala, noma izibazi zesibindi ngenxa yokuphuza kakhulu utshwala.
• I-hepatitis enobuthi: Ngokuvamile okubangelwa ukweqisa izidakamizwa, okuholela ukuvuvukala kwesibindi.
• Umdlavuza wesibindi: Umdlavuza osuka kwesinye isitho noma ingxenye yomzimba kodwa udlulele esibindini.
• Isifo sesibindi esinamafutha esihambisana nokudakwa noma i-metabolic syndrome.
• Amagciwane e-Hepatitis (A, B, no-C), kanye nezinye izifo zesibindi ezibangelwa amagciwane
• I-cirrhosis yesibindi noma isifo sesibindi esikhulu esibangelwa ubuthi obunjengotshwala.

Izimbangela ezingavamile zokuvuvukala kwesibindi zihlanganisa:

• Izifo Zofuzo ezifana neHemochromatosis, isifo sikaWilson, isifo sikaGaucher (sibangela ukunqwabelana kwamafutha esibindini), isifo sokugcina iGlycogen (sibangela ukwakheka kwe-glycogen esibindini), nesifo seSickle cell (sibangela ukunqwabelana kwensimbi esibindini).
• Izilonda zesibindi njengama-cysts esibindi, ama-Benign esibindini, kanye nomdlavuza wesibindi 
• Izimbangela zenhliziyo nemithambo yegazi njenge-Congestive heart failure kanye ne-Budd-Chiari syndrome
• Ukuphazamiseka kwemigudu ye-bile kanye nokuqina njenge-Primary biliary cholangitis kanye ne-Primary sclerosing cholangitis.

Selashwa kanjani isibindi esikhulisiwe?

Udokotela uzozama ukukhomba imbangela yokwanda kwesibindi, njengoba izonquma izinketho zokwelashwa ezitholakalayo zokuvuvukala kwesibindi. Ngokusekelwe emiphumeleni yokuhlolwa, bangase baphakamise imithi yokuvuvukala kwesibindi noma ukwelashwa okungenzeka kokuvuvukala komlenze okuhlobene ne-cirrhosis.

Udokotela angase atuse lezi zindlela zokwelapha ezilandelayo zokukhulisa isibindi, phakathi kokunye:

• Imithi nokwelashwa kwe-hepatitis C noma ezinye izifo ezihlobene nesibindi.
• Imisebe, ukuhlinzwa, noma imiphumela emibi yokwelashwa ngamakhemikhali umdlavuza wesibindi.
• Ukubhekana nezimbangela eziyisisekelo zomdlavuza we-metastatic.
• Ukuhlinzwa esikhundleni sesibindi ngenxa yokulimala okukhulu kwesibindi.
• Izinketho zokwelashwa kwe-lymphoma noma i-leukemia, kuye ngokuthi hlobo luni, izinga lokusakazeka kwesifo, nesimo sesiguli esivamile.
• Ukuyeka ukusetshenziswa kwezidakamizwa notshwala.

Uma ukuvuvukala kwesibindi sekuqinisekisiwe, udokotela uzovame ukweluleka ukwenza ukuguqulwa kwendlela yokuphila ukuze kuncishiswe ubuhlungu bokuvuvukala kwesibindi futhi kukhuthaze ukwelashwa kokukhulisa isibindi. Lezi zinguquko zendlela yokuphila zingabandakanya:

• Ukugwema ukuphuza utshwala.
• Ukuzivocavoca njalo.
• Ukulahlekelwa isisindo esiningi ezigulini ezikhuluphele noma ezikhuluphele.
• Ukulandela a Ukudla okunazo zonke nokuqonda ukuthi yini okufanele uyidle ngenxa yokuvuvukala kwesibindi.

Ukuxilongwa kokwandiswa kwesibindi

Isibindi siyisitho esitholakala ngaphansi kwezimbambo ezingakwesokudla, ngaphansi kwe-diaphragm. Uma udokotela ekwazi ukuzwa ngesikhathi sokuhlolwa ngokomzimba, kungase kubonise isibindi esandisiwe. Ngokuvamile, isibindi asikwazi ukuzwakala ngezandla zodwa. Njengoba sikhula ngokwemvelo, isibindi sethu siyakhula futhi sisinde.

Ukuze anqume imbangela yesifo sesibindi nokuvuvukala komlenze, udokotela angase acele ukuhlolwa okuningana kokuvuvukala kwesibindi, okuhlanganisa:

• Isibalo segazi esiphelele ukuze uhlole isibalo samangqamuzana egazi ukuze uthole izinto ezingavamile.
• Ukuhlolwa kwe-enzyme yesibindi ukuhlola impilo yesibindi.
• I-Ultrasonography, esebenzisa amaza omsindo ukuhlola isibindi nezinye izitho zesisu.
• I-X-ray yesisu iwukuhlolwa kwezithombe okungavamisile ukuhlola izitho zesisu.
• I-CT scan yesisu enesinqumo esiphezulu ukuze uthole izithombe ezinemininingwane yezitho ezithile zesisu.
• I-MRI ukuze uthole izithombe ezinemininingwane yezitho ezithile zesisu.

Uma udokotela esola inkinga enzima kakhulu, isibindi i-biopsy angalulekwa. Le nqubo yokuhlinzwa ihilela ukukhipha ingxenye encane yesibindi ukuze kuhlaziywe nge-microscopic.

Izimpawu zokuvuvukala kwesibindi

Ukuvuvukala kwesibindi, okwaziwa nangokuthi i-hepatomegaly, kungaba uphawu lwezimo ezahlukahlukene ezithinta isibindi. Isibindi siyisitho esibalulekile esibhekele imisebenzi eminingi, okuhlanganisa ukukhipha ubuthi, i-metabolism, nokukhiqizwa kwamaprotheni. Nazi izimpawu zokuvuvukala kwesibindi:

• Ubuhlungu besisu: Ubuhlungu noma ukungakhululeki ohlangothini olungaphezulu kwesokudla kwesisu kungase kubonise ukuvuvukala kwesibindi.
• Umuzwa Wokugcwala: Umuzwa wokugcwala noma ukuqunjelwa endaweni yesisu kungenzeka lapho isibindi sikhula futhi sicindezela izitho ezizungezile.
• Isibindi Esikhulisiwe: Kwezinye izimo, uchwepheshe wezempilo angase abone isibindi esikhulisiwe ngesikhathi sokuhlolwa komzimba.
• I-Jaundice: Ukuphuzi kwesikhumba namehlo (i-jaundice) kungase kwenzeke uma ukuvuvukala kwesibindi kungenxa yezimo ezithinta ukugeleza kwe-bile, njenge-jaundice evimbelayo.
• Ukukhathala: Ukukhathala okujwayelekile kanye nokuba buthakathaka kungabangelwa ukungasebenzi kahle kwesibindi.
• Ukuncipha Kwesisindo Okungachazeki: Ukuvuvukala kwesibindi okuhambisana nezimo ezithile kungase kuholele ekuncipheni kwesisindo esingaqondakali.
• Ukugcinwa Koketshezi: Ukuvuvukala emilenzeni nasesiswini (i-edema) kungenzeka uma ukungasebenzi kahle kwesibindi kuholela ekugcinweni koketshezi.
• I-Portal Hypertension: Isifo sesibindi esithuthukisiwe singaholela ekwenyukeni kwengcindezi ku-portal vein, okubangela izinkinga ezinjengama-ascites (ukuqoqwa koketshezi esiswini) kanye nama-varices (imithambo yegazi ekhulisiwe ku-esophagus noma esiswini).

Izinkinga zokuvuvukala kwesibindi

Ukuvuvukala kwesibindi, noma i-hepatomegaly, kungahlotshaniswa nezimo ezihlukahlukene ezingaphansi kokuthi, uma zishiywe zingalashwa, zingase zibangele izinkinga. Nazi ezinye zezinkinga ezingaba khona zokuvuvukala kwesibindi:

• I-Cirrhosis: Ukuvuvukala kwesibindi okungapheli kanye nokulimala kungadlulela ku-cirrhosis, lapho izicubu zesibindi ezinempilo zithathelwa indawo yizicubu ezibomvu. I-Cirrhosis iphazamisa ukusebenza kwesibindi futhi ingaholela ezinkingeni ezinzima.
• I-Portal Hypertension: Ukuvuvukala kwesibindi kungadala ingcindezi eyengeziwe ku-portal vein, okuholela ku-portal hypertension. Lokhu kungaholela ezinkingeni ezifana nama-varice (imithambo yegazi ekhulisiwe) kanye nengozi eyengeziwe yokopha.
• Ama-Ascites: I-Portal hypertension ingabangela uketshezi ukuthi lunqwabelane emgodini wesisu, okuholela ku-ascites. Ama-ascites angabangela ukuvuvukala kwesisu nokungakhululeki futhi andise ingozi yokutheleleka.
• I-Hepatic Encephalopathy: Isifo sesibindi esithuthukisiwe singaholela ekuqoqweni kobuthi egazini, kuthinte ukusebenza kobuchopho futhi kubangele i-hepatic encephalopathy. Lokhu kungabonakala njengokudideka, ukukhohlwa, nokushintsha ukwazi.
• Umdlavuza Wesibindi (Hepatocellular Carcinoma): Ukuvuvukala okungapheli kanye nokulimala kwesibindi kwandisa ingozi yokuba nomdlavuza wesibindi, ikakhulukazi i-hepatocellular carcinoma. Umdlavuza wesibindi uyinkinga enkulu ehambisana nesifo sesibindi.
• I-Coagulopathy: Isibindi sikhiqiza izici zokujiyisa, futhi ukungasebenzi kahle kwesibindi kungaholela ku-coagulopathy, ikhono elingasebenzi kahle legazi lokujiyisa. Lokhu kwandisa ingozi yokopha kanye nemihuzuko.
• Izinkinga ze-Gallbladder: Ukuvuvukala kwesibindi nokungasebenzi kahle kungaba nomthelela ekukhiqizweni nasekugelezeni kwe-bile, okungase kuholele ezinkingeni ze-gallbladder njengokwakheka kwamatshe enyongo.
• Amagciwane: Ukusebenza okusengozini kwesibindi esivuvukele noma esilimele kungandisa amathuba okuba sengozini yokuthola izifo. Ukutheleleka kwamagciwane, ikakhulukazi emgodini wesisu, kungaba inkinga enkulu.
• Izimpawu Zesistimu: Ukuvuvukala kwesibindi kungaba nomthelela ezimpawu zesistimu njengokukhathala, ubuthakathaka, nokuncipha kwesisindo okungahlosiwe. Lezi zimpawu zingathinta ikhwalithi yempilo iyonke.
• Izinkinga zenhliziyo nemithambo yegazi: Esifweni esithuthukisiwe sesibindi, izinkinga zenhliziyo nemithambo yegazi zingase ziphakame, okuhlanganisa izinguquko ekusebenzeni kwenhliziyo kanye nengozi eyengeziwe yezenzakalo zenhliziyo.
• Ukungasebenzi kahle kwezinso: Isifo sesibindi singathinta ukusebenza kwezinso, okuholela ezinkingeni ezifana ne-hepatorenal syndrome.
• Ukuphazamiseka kwe-Endocrine kanye neMetabolic: Ukungasebenzi kahle kwesibindi kungaba nomthelela ekulawuleni amahomoni kanye nezinqubo ze-metabolic, okuholela ezinkingeni ezinjengokumelana ne-insulin kanye nezinguquko ku-glucose metabolism.

Izingozi zokwanda kwesibindi

Ukuvuvukala kwesibindi kungenzeka kakhulu kubantu abathile ngenxa yofuzo. Uma noma yiziphi izici ezilandelayo zisebenza kumuntu othile noma emndenini wabo, kungase kube khona ingozi eyengeziwe yokwanda kwesibindi:

• Ukukhuluphala
• Izimo ze-Autoimmune, ikakhulukazi lezo ezithinta isibindi
• Izifo zohudo ezinokuvuvukala
• Isifo sesibindi esiqhubekayo
• Isifo se-sickle cell
• Umdlavuza wesibindi

Ingozi yokuvuvuka kwesibindi nayo ingathonywa indlela umuntu aphila ngayo. Phakathi kwalezi zici zendlela yokuphila kukhona:

• Ukusetshenziswa kotshwala obunzima
• Izinkontileka HIV kanye nesifo sokusha kwesibindi kohlobo B no-C ngokuzidweba umzimba, ukumpontshelwa igazi, nobulili obungavikelekile.
• Ingozi ye-malaria lapho uvakashela amazwe angaphandle.
• Ukusetshenziswa kwamakhambi afana ne-comfrey ne-mistletoe.

Ukuvimbela Ukuvuvuka Kwesibindi 

I-Hepatomegaly ingabangelwa izici ezihlukahlukene zokuphila. Umuntu anganciphisa ingozi yokuthuthukisa isibindi esandisiwe ngokulawula lezi zinguquko.

• Gcina indlela yokuphila enempilo futhi ulawule isisindo ngempumelelo.
• Uma kutholakala ukuthi une sikashukela, lawula amazinga kashukela egazini.
• Nciphisa ukuphuza utshwala. Ukusetshenziswa ngokweqile kungabonwa udokotela.
• Bonana nodokotela ngaphambi kokuthatha izithasiselo zamavithamini, njengoba zingase ziphazamise ukusebenza kwesibindi.
• Funa iseluleko sezokwelapha ngaphambi kokusebenzisa noma yiziphi izithasiselo zemithi. Amakhambi amaningi athengiswa njengamakhambi okulwa nokukhathazeka, ukushisa amafutha, noma ukwakha imisipha, kanye namaphilisi okuvuvukala kwesibindi, angase alimaze isibindi.

Ngesikhathi sokubona udokotela

Qiniseka ukuthi uyahlolwa isibindi sakho uma uqunjelwa noma ubuhlungu nganoma yisiphi isizathu. Ukwengeza, funa usizo lwezokwelapha uma unezimpawu ezingajwayelekile noma ezibucayi, njenge:

• Umkhuhlane ongapheli.
• Ukudideka noma ukudideka.
• Imizwa yobuthakathaka nesiyezi.
• Ukuphuzi kwamehlo noma isikhumba, okwaziwa nge-jaundice.

Isiphetho

Ukukhuliswa kwesibindi kuwuphawu, akusona isifo ngokwaso. Nokho, kungase kube uphawu lwezifo ezihlukahlukene ezicashile. Nakuba kungezona zonke lezi zimo ezingase zibe izimo eziphuthumayo, zidinga ukwelashwa kokuvuvukala kwesibindi. Ukufuna ikhambi elisheshayo lokuvuvukala kwesibindi kungaholela ekwelashweni okuphumelelayo kwabathile ukuphazamiseka kwesibindi. Ngakho-ke, noma ubani okhathazekile ngesibindi sakhe kufanele afune ukuxilongwa kwezokwelapha.

Imibuzo Evame Ukubuzwa

1. Kwenzekani uma isibindi sikhulisiwe? 

Isibindi esikhulisiwe sibonisa inkinga eyisisekelo njengesifo sesibindi, ukwehluleka kwenhliziyo eqinile, noma umdlavuza. Imbangela yalesi simo kufanele ihlonzwe futhi ilawulwe ngesikhathi sokwelashwa.

2. Kungakanani ukukhula kwesibindi okuvamile? 

Isilinganiso sosayizi wesibindi, esikalwa ngokushaywa, singu-10.5 cm kwabesilisa no-7 cm kwabesifazane. Kubhekwa njengokungavamile uma ubude besibindi bungu-2 kuya ku-3 cm mkhulu noma ngaphansi kwalezi zilinganiso.

3. Isibindi sikhuliswa kusiphi isigaba? 

Ukuvuvukala kwesibindi noma ukuvuvukala kuyisigaba sokuqala. Isibindi sanda njengempendulo yokungalingani okunobuthi lapho isibindi singakwazi ukucubungula kahle ubuthi noma ukubuqeda emzimbeni.

4. Ingabe isibindi esinamafutha sibangela ukwanda kwesibindi? 

Isibindi esinamafutha ngokuvamile siyakhuliswa uma siqhathaniswa nesibindi esivamile, esinempilo. Lesi simo siba nezigaba ezintathu: ukuvuvukala kwesibindi nokuvuvukala okuyisigaba sokuqala, kulandele isigaba sesibili, ukulimala kwezicubu zesitho somzimba ngokuhamba kwesikhathi (izibazi), nesigaba sesithathu, ukushintshwa kwesibazi kufakwe izicubu zesibindi ezinempilo okuholela ekuqineni kwesibindi. 

CARE Medical Team

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