Iyini i-Liver Biopsy? Injongo, Inqubo & Nemiphumela

I-liver biopsy iyinqubo yezokwelapha lapho udokotela wakho esusa khona isampula elincane lezicubu zesibindi ukuze alihlole ngaphansi kwe-microscope. Lolu vivinyo olulula lusiza odokotela ukuthi baqonde ukuthi kwenzakalani ngaphakathi esibindini sakho lapho izivivinyo zegazi noma izithombe zokuhlola zingakwazi ukunikeza isithombe esiphelele.

Cabanga ngakho njengokuthola ukubuka okuseduze ngempilo yesibindi sakho. Isampula lezicubu, ngokuvamile elincane kuneraba lepensela, lingadalula imininingwane ebalulekile mayelana nesifo sesibindi, ukuvuvukala, noma ukulimala okungenzeka kungaveli kwezinye izivivinyo.

Iyini i-liver biopsy?

I-liver biopsy ihlanganisa ukuthatha ucezu oluncane lwezicubu zesibindi kusetshenziswa inaliti encane noma ngesikhathi sokuhlinzwa. Udokotela wakho uhlola lesi sampula ngaphansi kwe-microscope ukuze athole izimo zesibindi futhi ahlele ukwelashwa kwakho.

Le nqubo inikeza ithimba lakho lezempilo imininingwane enemininingwane ngesakhiwo nomsebenzi wesibindi sakho. Ingakwazi ukuhlonza izifo ezithile, ilinganise izinga lokulimala kwesibindi, futhi isize ekunqumeni indlela engcono yokwelapha isimo sakho.

Ama-biopsies amaningi esibindi enziwa njengezinqubo zokugula ngaphandle, okusho ukuthi ungaqhubeka uye ekhaya ngosuku olufanayo. Ukuqoqwa kwezicubu zangempela kuthatha imizuzwana embalwa nje, nakuba ukuqokwa konke kuvame ukuthatha amahora ambalwa okuhlanganisa ukulungiselela nesikhathi sokululama.

Kungani kwenziwa i-liver biopsy?

Udokotela wakho angase ancome i-liver biopsy lapho edinga ulwazi oluningiliziwe ngempilo yesibindi sakho kunokuthi izivivinyo zegazi noma izithombe zokuhlola zinganikeza. Ngokuvamile yindlela enembile kakhulu yokuxilonga izimo ezithile zesibindi.

Izizathu ezivamile zihlanganisa ukuphenya izivivinyo ezingavamile zomsebenzi wesibindi, ukukhuliswa kwesibindi okungachazwanga, noma ukusolwa isifo sesibindi. Udokotela wakho angase futhi akusebenzise ukubheka ukuthi isibindi sakho siphendula kahle kangakanani ekwelashweni kwezimo ezinjenge-hepatitis noma isifo sesibindi esinamafutha.

Ngesinye isikhathi i-biopsy iyasiza ekutholeni isigaba sesifo sesibindi, esiqondisa izinqumo zokwelapha. Ngokwesibonelo, ingakhombisa ukuthi ukulimala kwesibindi (i-fibrosis) kulula noma kunzima, okusiza udokotela wakho ukuthi enze uhlelo lokwelapha olusebenzayo kakhulu.

Nawa amashwa ezokwelapha lapho udokotela wakho angase ancome le nqubo:

• Ukwenyuka okungachazeki kwama-enzyme esibindi okuqhubeka ngokuhamba kwesikhathi
• Kusolwa izifo zesibindi ze-autoimmune njenge-primary biliary cholangitis
• Ukuhlolwa kobunzima besifo sesibindi esinamafutha
• Ukuqapha ukwenqatshwa kokufakelwa kwesibindi
• Ukuphenya ukukhuliswa kwesibindi okungachazeki noma ama-mass
• Ukuxilongwa kwezifo zesibindi ezingavamile ze-metabolic
• Ukuhlola ukulimala kwesibindi okuvela emithini noma ubuthi

Udokotela wakho uzohlala elinganisa izinzuzo ezinobungozi ngaphambi kokuncoma i-biopsy. Bazochaza ukuthi kungani leli thikithi libalulekile esimweni sakho esithile nokuthi yiziphi ezinye izindlela ezingase zitholakale.

Yini inqubo ye-biopsy yesibindi?

Uhlobo oluvamile kakhulu yi-percutaneous liver biopsy, lapho udokotela efaka inaliti ngesikhumba sakho ukuze afinyelele esibindini sakho. Uzoqamba amanga ngomhlane wakho noma kancane ngohlangothi lwakho lwesobunxele ngesikhathi senqubo.

Ngaphambi kokuqala, udokotela wakho uzohlanza indawo futhi ajove i-anesthetic yendawo ukuze anumbise isikhumba sakho. Ungase uzwe umuzwa wokushaya ngokushesha, ofana nokuthola umgomo, kodwa indawo kufanele izizwe inganambitheki ngemizuzu.

Ngokusebenzisa isiqondiso se-ultrasound, udokotela wakho uzothola indawo engcono kakhulu yokufaka inaliti ye-biopsy. Ukuqoqwa kwesicubu kwangempela kwenzeka ngokushesha kakhulu - ngokuvamile ngaphansi komzuzwana owodwa. Ungase uzwe umsindo wokuchofoza ovela kudivayisi ye-biopsy.

Nakhu okwenzeka ngokujwayelekile ngesikhathi senqubo yakho:

1. Uzoshintsha ugqoke ingubo yesibhedlela bese ulala etafuleni lokuhlolwa
2. Ithimba lezokwelapha lizobheka izimpawu zakho ezibalulekile bese liqala umugqa we-IV
3. Udokotela wakho uzosebenzisa i-ultrasound ukukhomba indawo engcono kakhulu yokuthatha isampula
4. Umjovo wokubulala izinzwa wendawo ujeziswa ukuze uqede ngokuphelele indawo
5. Inaliti encane ifakwa ngesikhumba sakho ingene esibindini sakho
6. Isampula lezicubu liqoqwa ngesikhashana nje
7. Kufakwa ingcindezi endaweni ukuvimbela ukopha
8. Uzobhekwa amahora amaningana ngaphambi kokuba uhambe

Abanye abantu badinga i-transjugular liver biopsy, lapho inaliti ifinyelela esibindini sakho ngomthambo entanyeni yakho. Le ndlela isetshenziswa uma unezinkinga zokopha noma uketshezi esiswini sakho okwenza indlela ejwayelekile ibe yingozi.

Ungalungiselela kanjani i-liver biopsy yakho?

Udokotela wakho uzokunikeza imiyalelo ethile mayelana nokulungiselela i-biopsy yakho, ngokuvamile iqala cishe ngesonto ngaphambi kwenqubo. Ukulandela lezi ziqondiso ngokucophelela kusiza ukuqinisekisa ukuphepha kwakho nempumelelo yokuhlolwa.

Kuzodingeka uyeke ukuthatha imithi ethile engandisa ingozi yokopha, njenge-aspirin, i-ibuprofen, noma izinciphisi zegazi. Udokotela wakho uzokutshela ngqo ukuthi yimiphi imithi okufanele uyigweme nokuthi isikhathi esingakanani ngaphambi kwenqubo.

Abantu abaningi badinga ukuzila ukudla amahora angu-8-12 ngaphambi kwe-biopsy, okusho ukuthi akukho ukudla noma isiphuzo ngaphandle kokuthatha amanzi amancane ngemithi evunyelwe. Lokhu kuqapha kusiza ukuvimbela izinkinga uma udinga ukuhlinzwa okuphuthumayo, nakuba lokhu kungavamile kakhulu.

Ukulungiselela kwakho cishe kuzohlanganisa lezi zinyathelo ezibalulekile:

• Ukwenza izivivinyo eziphelele zegazi ukuhlola ukusebenza kwegazi lakho nokubala kwegazi
• Lungiselela othile ukuthi akuqhubele ekhaya ngemva kwale nqubo
• Yeka ukudla nokuphuza ngokwesikhathi esibekiwe ngudokotela wakho
• Geza ngeshawa ngobusuku obandulela noma ekuseni ngosuku lokuhlolwa kwakho
• Gqoka izingubo ezikhululekile, ezingaqinile eziya ekuqokweni kwakho
• Letha uhlu lwazo zonke imithi yakho nezithasiselo
• Hlela ukuphumula ekhaya ngosuku olusele

Yazisa udokotela wakho uma ukhulelwe, unezinto ozithandayo, noma uzizwa ugula ngosuku lwenqubo yakho. Lezi zinto zingase zithinte isikhathi noma indlela yokuhlolwa kwakho.

Ungawafunda kanjani imiphumela yokuhlolwa kwesibindi sakho?

Imiphumela yokuhlolwa kwesibindi sakho izobuya njengombiko onemininingwane evela kumguli, udokotela onguchwepheshe ekuhloleni amasampula ezicubu. Lo mbiko ngokuvamile uthatha izinsuku ezi-3-7 ukuqedwa, nakuba amacala aphuthumayo angase acutshungulwe ngokushesha.

Umtholampilo ubheka isicubu sesibindi sakho ngaphansi kwe-microscope futhi uchaze akubonayo mayelana nokuvuvukala, ukulimala, ukugcinwa kwamafutha, kanye nanoma yiziphi amaseli angajwayelekile. Bazophinda banikeze amabanga nezigaba ezimweni ezithile uma kusebenza.

Ezimweni ezinjenge-hepatitis, umbiko ungase uhlanganise izinga lokuvuvukala (ukuthi isifo sisebenza kangakanani) nesigaba se-fibrosis (ukuthi kungakanani ukulimala okwenzekile). Lezi zinombolo zisiza udokotela wakho ukuthi aqonde ubunzima besimo sakho futhi ahlele ukwelashwa ngokufanele.

Umbiko wakho wokuhlolwa ngokuvamile uzohlanganisa ulwazi mayelana:

• Isakhiwo sesibindi esiphelele nokubukeka kwamaseli
• Ukuba khona nobubanzi bokuvuvukala
• Inani kanye nephatheni lezicubu ezilimele (fibrosis)
• Ukugcinwa kwamafutha ngaphakathi kwamaseli esibindi
• Ukugcinwa kwensimbi noma ithusi uma kufanele
• Noma yimaphi amaseli angajwayelekile noma anomdlavuza
• Izimpawu zesifo esithile uma kufanele

Udktora wakho uzokuchazela ukuthi lokhu okutholakele kusho ukuthini empilweni yakho futhi axoxe ngezinketho zokwelapha ngokusekelwe emiphumeleni. Ungakhathazeki uma ulimi lwezokwelapha lubonakala luyinkimbinkimbi - ithimba lakho lezempilo lizohumusha okutholakele lwalulethe olwazini olungokoqobo ongaluqonda.

Ziyini izici eziyingozi zokudinga i-liver biopsy?

Izimo eziningana zempilo nezici zokuphila zingakhuphula amathuba okudinga i-liver biopsy. Ukuqonda lezi zici eziyingozi kungakusiza ukuthi uthathe izinyathelo zokuvikela impilo yesibindi sakho.

I-Chronic viral hepatitis, ikakhulukazi i-hepatitis B kanye ne-C, ngokuvamile idinga ukuqapha i-biopsy ukuze kuhlolwe ukuqhubeka kwesifo nokuphendula kokwelashwa. Ukuphuza utshwala obuningi iminyaka eminingi kungaholela ekulimaleni kwesibindi okudinga ukuhlolwa kwe-biopsy.

Ezinye izimo zezokwelapha zibeka ingcindezi eyengeziwe esibindini sakho futhi zingase zigcine zidinga ukuhlolwa kwezicubu. Izifo ze-Autoimmune, izifo ze-metabolic, nemithi ethile konke kungathinta ukusebenza kwesibindi ngokuhamba kwesikhathi.

Izici eziyingozi ezivamile ezingaholela ku-liver biopsy zihlanganisa:

• Ukutheleleka okungamahlalakhona nge-hepatitis B noma C
• Ukusetshenziswa kotshwala obuningi iminyaka eminingi
• Isifo sesibindi esinamafutha esingahlobene notshwala, ikakhulukazi kubantu abanesifo sikashukela noma ukukhuluphala
• Izifo zesibindi ze-Autoimmune njenge-primary biliary cholangitis
• Ukwenyuka okuqhubekayo okungachazeki kwama-enzyme esibindi
• Umlando womndeni wezifo zesibindi zemvelo
• Ukusetshenziswa kwesikhathi eside kwemithi ethile engathinta isibindi
• Ukuvezwa kumakhemikhali embonini noma ubuthi

Ukuba nalezi zici eziyingozi akusho ukuthi nakanjani uzodinga i-biopsy. Abantu abaningi abanezimo zesibindi bangaqashwa futhi baphatheke ngaphandle kokudinga le nqubo, ikakhulukazi ngamuhla ngemithombo yegazi ethuthukisiwe nezindlela zokuthwebula.

Ziyini izinkinga ezingenzeka ze-liver biopsy?

Nakuba ukuhlolwa kwesibindi ngokuvamile kuphephile, njenganoma iyiphi inqubo yezokwelapha, kuletha ezinye izingozi. Izindaba ezinhle ukuthi izinkinga ezinzima azivamile, zenzeka ngaphansi kuka-1% wezinqubo uma zenziwa odokotela abanolwazi.

Umphumela ovamile kakhulu ubuhlungu obuncane endaweni yokuhlolwa, okuvame ukuzwakala njengobuhlungu obuthuntu ehlombe lakho langakwesokudla noma esiswini. Lokhu kungakhululeki kuvamile ukuhlala amahora ambalwa futhi kuphendula kahle ezinhlungwini ezingaphezu kwe-counter.

Ukuphuma kwegazi yinkinga enkulu kakhulu engenzeka, nakuba kungavamile. Ithimba lakho lezokwelapha likuqapha ngokucophelela amahora amaningana ngemuva kwenqubo ukuze libheke noma yiziphi izimpawu zokuphuma kwegazi kwangaphakathi.

Nazi izinkinga ezingenzeka, ezisohlwini kusukela kokuvamile kuya kokungavamile:

• Ubuhlungu obuncane kuya obumaphakathi endaweni yokuhlolwa obuhlala izinsuku eziyi-1-2
• Ubuhlungu obudluliselwe besikhashana ehlombe langakwesokudla
• Ukuphuma kwegazi okuncane okuyeka ngokwako
• Ukuphendula kwe-Vasovagal (ukuzwa ukukhathala noma isiyezi)
• Ukuphuma kwegazi okukhulu okudinga ukunakekelwa kwezokwelapha
• Ukubhobozwa ngengozi kwezitho eziseduze njengamaphaphu noma i-gallbladder
• Ukutheleleka endaweni yokuhlolwa
• Ukuphuma kwegazi okukhulu okudinga ukumpontshelwa igazi noma ukuhlinzwa

Udokotela wakho uzoxoxa lezi zingozi nawe ngaphambi kwenqubo futhi achaze ukuthi bazinciphisa kanjani ngobuchwepheshe obucophelelayo nokuqapha. Abantu abaningi balulama ngokuphelele phakathi kwama-24-48 amahora ngaphandle kwemiphumela ehlala njalo.

Kufanele ngibone nini udokotela ngemuva kokuhlolwa kwesibindi?

Kufanele uthinte udokotela wakho ngokushesha uma uhlangabezana nobuhlungu obukhulu besisu, isiyezi, noma izimpawu zokuphuma kwegazi ngemuva kokuhlolwa kwesibindi sakho. Nakuba izinkinga zingavamile, ukubona kusenesikhathi nokwelashwa kubalulekile uma zenzeka.

Abantu abaningi bazwa ukungakhululeki okuthile usuku noma ezimbili ngemuva kwenqubo, kodwa lokhu kufanele kuthuthuke kancane kancane. Uma ubuhlungu bakho buba bubi kunokuba ngcono, noma uma uthola izimpawu ezintsha, kubalulekile ukufuna ukunakekelwa kwezokwelapha ngokushesha.

Xhumana nodokotela wakho ngokushesha uma ubona noma yiziphi lezi zimpawu zokuxwayisa:

• Ubuhlungu obukhulu noma obuqhubekayo besisu obungathuthuki ngokuphumula
• Isiyezi, ukukhathala, noma ukuzizwa sengathi ungaquleka
• Ukushaya kwenhliziyo okusheshayo noma ukuzizwa ubuthakathaka ngokungavamile
• Isicanucanu noma ukuhlanza okukuvimbela ukuthi ungagcini uketshezi phansi
• Umkhuhlane ongaphezu kuka-101°F (38.3°C)
• Ukuphuma igazi noma ukukhishwa okungavamile endaweni ye-biopsy
• Ukuphefumula kanzima noma ubuhlungu besifuba
• Isikhumba esiba mhlophe, esibandayo, noma esinamathelayo

Ukuze kulandelwe njalo, udokotela wakho ngokuvamile uzohlela i-aphoyintimenti phakathi kwamasonto angu-1-2 ukuze axoxe ngemiphumela yakho ye-biopsy futhi ahlele noma yikuphi ukwelashwa okudingekayo. Unganqikazi ukushaya ucingo ngemibuzo noma izinkathazo ngaphambi kwalesi sikhathi sokuqokwa.

Imibuzo evame ukubuzwa mayelana ne-biopsy yesibindi

Q.1 Ingabe ukuhlolwa kwe-biopsy yesibindi kulungile ekuxilongeni isifo sesibindi esinamafutha?

Yebo, i-biopsy yesibindi ithathwa njengezinga legolide lokuxilonga nokwenza isigaba sesifo sesibindi esingahlobene notshwala (NAFLD). Ngenkathi ukuhlolwa kwegazi nokucabanga kungase kusikisela isibindi esinamafutha, i-biopsy kuphela engahlukanisa ngokuqinisekile phakathi kwesibindi esinamafutha esilula kanye nesimo esibi kakhulu esibizwa nge-NASH (non-alcoholic steatohepatitis).

I-biopsy ibonisa ngqo ukuthi mangaki amafutha asezinhlayiyeni zesibindi sakho nokuthi ngabe kukhona ukuvuvukala noma ukulimala okuhambisanayo. Lolu lwazi lusiza udokotela wakho ukuthi anqume ukuthi ngabe udinga ukwelashwa nokuthi yiluphi uhlobo oluzosebenza kahle kakhulu esimweni sakho esithile.

Q.2 Ingabe i-biopsy yesibindi ilimaza ngesikhathi senqubo?

Abantu abaningi bazizwa bengakhululekile kancane ngesikhathi se-biopsy yangempela ngenxa ye-anesthesia yendawo. Ungase uzwe ingcindezi noma umuzwa omfushane obukhali lapho inaliti ingena esibindini sakho, kodwa lokhu kuthatha ngaphansi komzuzwana.

Umjovo wokuthulisa ngaphambi kokwenza ngokuvamile ubangela ukuphatheka kabi okukhulu kunokuthi i-biopsy ngokwayo. Abantu abaningi bachaza lonke ulwazi njengobuhlungu obuncane kunalokho ababelindele, okufana nokudonswa kwegazi noma ukuthola umgomo.

Q.3 Kuthatha isikhathi esingakanani ukululama ku-liver biopsy?

Abantu abaningi balulama ngokuphelele phakathi kwamahora angama-24-48 ngemuva kwe-liver biopsy yabo. Uzodinga ukuphumula ngosuku olusele ngemuva kwenqubo, ugweme ukuphakamisa izinto ezisindayo noma imisebenzi eqinile.

Abantu abaningi babuyela emsebenzini nasemisebenzini ejwayelekile ngosuku olulandelayo, yize kufanele ugweme ukuphakamisa izinto ezisindayo cishe isonto elilodwa. Udokotela wakho uzokunikeza imihlahlandlela ethile esekelwe emsebenzini wakho nasezingeni lomsebenzi.

Q.4 Ingabe i-liver biopsy ingathola umdlavuza wesibindi?

Yebo, i-liver biopsy ingathola umdlavuza wesibindi futhi isize ukunquma ukuthi hlobo luni. Isampula lezicubu livumela ochwepheshe bezifo ukuthi bahlole amaseli ngamanye futhi bathole izinguquko ezinomdlavuza ezingase zingabonakali ekuskeneni kwezithombe.

Kodwa-ke, odokotela abadingi njalo i-biopsy ukuze bathole umdlavuza wesibindi. Kwesinye isikhathi inhlanganisela yokuhlolwa kwegazi, izithombe, nomlando wakho wezokwelapha inikeza imininingwane eyanele yokwenza ukuxilongwa nokuqala ukwelashwa.

Q.5 Zikhona ezinye izindlela ze-liver biopsy?

Ukuhlolwa okuningi okungahlaseli kungahlinzeka ngolwazi mayelana nempilo yesibindi ngaphandle kokudinga isampula lezicubu. Lokhu kufaka phakathi ukuhlolwa kwegazi okukhethekile, i-elastography (elilinganisa ukuqina kwesibindi), kanye nezindlela zokuthwebula izithombe ezithuthukisiwe.

Ngenkathi lezi ezinye izindlela ziwusizo ekuqapheni izimo eziningi zesibindi, azikwazi ngaso sonke isikhathi ukuhlinzeka ngemininingwane enemininingwane enikezwa yi-biopsy. Udokotela wakho uzoxoxa ukuthi ngabe lezi ezinye izindlela zifanele yini isimo sakho esithile.