Ascites

ʻO Ascites ka kūkulu ʻana o ka wai i ke ākea ma waena o ka uhi o ka ʻōpū a me nā ʻōpū o ka ʻōpū.

Nā hualoaʻa o Ascites mai ke kaomi kiʻekiʻe i nā kīʻaha koko o ke ake (portal hypertension) a me nā pae haʻahaʻa o kahi protein i kapa ʻia ʻo albumin.

ʻO nā maʻi e hiki ai ke hōʻeha i ka ate hiki ke alakaʻi i ka ascites. Pākuʻi ʻia kēia mau mea:

• ʻO ka maʻi hepatitis C a ʻo B paha
• ʻO ka hōʻino waiona i nā makahiki he nui
• ʻO ka maʻi maʻi ake momona (non-alkohol steatohepatitis a i ʻole NASH)
• Hoʻokumu ʻia ka Cirrhosis e nā maʻi maʻi

Hiki i nā kānaka me kekahi mau maʻi ʻaʻai i loko o ka ʻōpū ke hoʻomohala i ka ascites. Hoʻopili kēia i ka maʻi ʻaʻai o ka pākuʻi, kolona, ​​ovaries, uterus, pancreas, a me ke ake.

ʻO nā kūlana ʻē aʻe i hiki ke kumu i kēia pilikia e:

• Nā clots i nā aa o ke ake (portal vein thrombosis)
• Hoka puʻuwai Congestive
• ʻO Pancreatitis
• Mānoanoa a scarring o ka ʻeke e like me ka uhi ʻana o ka puʻuwai (pericarditis)

Hiki ke hoʻopili ʻia ka dialysis kidney i ka ascites.

E ulu lohi paha nā ʻōuli a kaukaʻi paha i ka hopena o ka ascites. ʻAʻohe ou mau ʻōuli inā aia ka liʻiliʻi o ka wai i loko o ka ʻōpū.

Ke hōʻiliʻili hou ʻia ka wai, loaʻa paha iā ʻoe ka ʻeha o ka ʻōpū a me ka momona. Hiki i ka nui o ka wai ke hoʻopōkole i ka hanu, Hana ʻia kēia no ka mea e pahu ka wai i ka diaphragm, a laila kaomi i nā māmā haʻahaʻa.

Nui ʻē aʻe nā ʻōuli ʻē aʻe o ke kūpaʻa ʻole o ke ake.

E hana ana kāu kauka i kahi hoʻokolohua kino e hoʻoholo ai inā paha ka pehu ma muli o ka hoʻoulu wai i loko o kou ʻōpū.

Loaʻa iā ʻoe i nā hōʻike aʻe e nānā ai i kou ake a me nā puʻupaʻa.

• Hōʻiliʻili mimi 24 hola
• Nā pae uila
• Nā hoʻāʻo hana hakuʻala
• Nā hoʻāʻo hana ate
• Nā hoʻāʻo e ana i ka makaʻu o ke kahe ʻana o ke koko a me nā protein i loko o ke koko
• Urinalysis
• ʻO ke ultrasound ʻōpū
• CT scan o ka ʻōpū

Hiki paha i kāu kauka ke hoʻohana i kahi nila kele e huki i ka wai ascites mai kou ʻōpū. Hōʻaʻo ʻia ka wai e nānā no ke kumu o ka ascites a e nānā inā loaʻa ka wai i ka maʻi.

E mālama ʻia ke ʻano i nā ascites, inā hiki.

Hiki i nā hana no ke kūkulu ʻana i ka wai ke komo pū me nā loli nohona:

• Hōʻalo i ka waiʻona
• Ke hoʻohaʻahaʻa nei i ka paʻakai i kāu papaʻai (ʻaʻole i ʻoi aku ma mua o 1,500 mg / lā o ka sodium)
• Ka palena ʻana i ka lawe ʻana o ka wai

Hiki iā ʻoe ke loaʻa nā lāʻau mai kāu kauka, me:

• "Pila wai" (diuretics) e kāpae i ke kinowai keu
• Nā Antibiotics no nā maʻi

ʻO nā mea ʻē aʻe hiki iā ʻoe ke hana e kōkua i ka mālama ʻana i kāu maʻi ate.

• E loaʻa i nā lāʻau āpau no nā maʻi e like me ka maʻi palū, hepatitis A a me ka maʻi hepitis B, a me ka pulumococcal pneumonia
• E kamaʻilio me kāu kauka e pili ana i nā lāʻau āpau āu e lawe ai, e like me nā mea kanu a me nā mea hoʻopihapiha a me nā lāʻau i kūʻai pono ʻole ʻia

Nā hana e loaʻa iā ʻoe:

• Hoʻokomo i kahi nila i loko o ka ʻōpū e hemo i nā nui o ka wai (i kapa ʻia he paracentesis)
• Ke kau nei i kahi paipu kūikawā a i ʻole shunt i loko o kou ake (TIPS) e hoʻoponopono i ke kahe o ke koko i ke ake

Pono paha ka poʻe me nā maʻi ate hope loa i kahi transplant ake.

Inā he cirrhosis ʻoe, e hōʻalo i ka lawe ʻana i nā lāʻau anti-inflammatory nonsteroidal, e like me ibuprofen (Advil, Motrin) a me naproxen (Aleve, Naprosyn). Pono e lawe i ka Acetaminophen i nā lāʻau hoʻemi.

Komo pū nā pilikia:

• Peritonitis koʻohune kūlohelohe (kahi maʻi hoʻoweliweli ola o ka ascitus wai)
• Hepatorenal maʻi pale (hakuʻala ole)
• Ka hōʻemi kaumaha a me ka malnutrine protein
• Huikau ka noʻonoʻo, hoʻololi i ka pae o ka makaʻala, a i ʻole koma (hepatic encephalopathy)
• Kahe mai ka mahele o luna a lalo o ka gastrointestinal
• Kūkulu-o ka loli i ka hakahaka ma waena o kou mau māmā a me ka lua o ka umauma (pleural effusion)
• Nā pilikia ʻē aʻe o ka cirrhosis ate

Inā he ascites kāu, e kāhea koke aku i kāu kauka lawelawe inā loaʻa iā ʻoe:

• Fever ma luna o 100.5 ° F (38.05 ° C), a i ʻole ke kuni e hele ʻole
• ʻEha ʻōpū
• ʻO ke koko i loko o kāu pahu a ʻeleʻele paha, noho aliʻi
• ʻO ke koko i kou luaʻi
• ʻO ka palapū a me ke kahe e maʻalahi
• ʻO ke kūkulu ʻana i ka wai i kou ʻōpū
• Nā wāwae pehu a me nā kuʻekuʻe wāwae
• Nā pilikia hanu
• Huikau a pilikia paha e makaʻala ana
• ʻO kaʻeleʻele melemele i kouʻili a me nā keʻokeʻo o kou mau maka (jaundice)

ʻO ke kiʻekiʻe hypertension - ascites; Cirrhosis - piʻi; Hoka kō ʻole - ascites; Hoʻohana waiʻona - ascites; Hopena maʻi ate - ascites; ESLD - ascites; Piʻi ka Pancreatitis

• ʻO Ascites me ka maʻi ʻaʻai ovarian - CT scan
• Nā ʻōnaehana ʻōnaehana Digestive

Garcia-Tsao G. Cirrhosis a me kona hopena. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 144.

Pūnaewele Institute of Diabetes a me Digestive a me nā maʻi maʻi puʻuwai. Cirrhosis. www.niddk.nih.gov/health-information/liver-disease/cirrhosis/all-content. Hoʻohou Malaki Malaki 2018. Loaʻa iā Nowemapa 11, 2020.

ʻO Sola E, ʻo Gines SP. Ascites a me ka peritonitis koʻohune spontaneous. I: Feldman M, Friedman LS, Brandt LJ, eds. ʻO Sleisenger a me Fordtran's Gastrointestinal a me ka maʻi ate. 11th hua. Piladelapia, PA: Elsevier; 2021: chap 93.