Ciroza \u00ebsht\u00eb nj\u00eb s\u00ebmundje e r\u00ebnd\u00eb e m\u00ebl\u00e7is\u00eb, me evolucion t\u00eb ngadalt\u00eb, zakonisht, pasoj\u00eb e nj\u00eb patologjie t\u00eb m\u00ebl\u00e7is\u00eb. Megjithat\u00eb, shkaku i saj kryesor mbetet konsumimi i tepruar i alkoolit, bile edhe para hepatiteve virale kronike. At\u00ebhere, cilat jan\u00eb shenjat paralajm\u00ebruese dhe cilat, trajtimet e mundshme? Lexoni p\u00ebrgjigjet e mjekut hepatolog.<\/p>\n
– S\u00eb pari, \u00e7far\u00eb \u00ebsht\u00eb ciroza?
\n– Termi \u201cciroza e m\u00ebl\u00e7is\u00eb\u201d vjen nga greqishtja e lasht\u00eb dhe do t\u00eb thot\u00eb zverdhje. Ciroza \u00ebsht\u00eb nj\u00eb s\u00ebmundje kronike e m\u00ebl\u00e7is\u00eb q\u00eb vjen si pasoj\u00eb e nj\u00eb s\u00ebmundjeje tjet\u00ebr hepatike dhe q\u00eb mund t\u00eb nd\u00ebrlikohet, duke u kthyer n\u00eb kancer t\u00eb m\u00ebl\u00e7is\u00eb. Ciroza shkakton degjenerimin e indeve t\u00eb m\u00ebl\u00e7is\u00eb. Hepatocitet, qelizat e m\u00ebl\u00e7is\u00eb, shkat\u00ebrrohen progresivisht dhe z\u00ebvend\u00ebsohen nga fibroza. M\u00ebl\u00e7ia b\u00ebhet e fort\u00eb, zmadhohet dhe, mbi t\u00eb gjitha, nuk e luan m\u00eb si\u00e7 duhet rolin e saj. Nj\u00eb m\u00ebl\u00e7i e sh\u00ebndetshme ka p\u00ebr funksion t\u00eb rikuperoj\u00eb ushqimet e thithura nga zorr\u00ebt, p\u00ebr t\u2019i transformuar n\u00eb energji t\u00eb nevojshme p\u00ebr t\u00eb gjitha qelizat e trupit. Ajo gjithashtu prodhon l\u00ebngun biliar, q\u00eb \u00ebsht\u00eb i nevojsh\u00ebm p\u00ebr tretjen e yndyrnave. Ciroza e m\u00ebl\u00e7is\u00eb, pra, prek qelizat e saj, duke i kthyer n\u00eb fibroz\u00eb. P\u00ebr pasoj\u00eb, kemi pamjaftueshm\u00ebrin\u00eb hepatike. N\u00eb m\u00ebl\u00e7i, gjithashtu, mund t\u00eb formohen nodulet e rigjenerimit. K\u00ebto nodule (grup i \u00e7rregullt qelizash) shfaqen kur qelizat e m\u00ebl\u00e7is\u00eb p\u00ebrpiqen t\u00eb vazhdojn\u00eb funksionimin, por nuk ia dalin dot si\u00e7 duhet dhe rigjenerimi i tyre \u00ebsht\u00eb anarkik, pa lidhje me en\u00ebt e gjakut. K\u00ebshtu, \u00e7rregullohet qarkullimi i gjakut, pra, gjith\u00eb mikro-qarkullimi. N\u00eb nj\u00eb m\u00ebl\u00e7i normale, gjaku vjen me an\u00eb t\u00eb ven\u00ebs sjell\u00ebse deri n\u00eb qelizat hepatike, para se t\u00eb niset n\u00eb venat e zemr\u00ebs. N\u00eb rastin e ciroz\u00ebs s\u00eb m\u00ebl\u00e7is\u00eb, ky qarkullim pengohet nga fibroza, q\u00eb krijon nj\u00eb hipertension t\u00eb ven\u00ebs dhe shkakton daljen e vari\u00e7eve, kryesisht, t\u00eb vari\u00e7eve t\u00eb ezofagut, tipike t\u00eb ciroz\u00ebs.
\n– Cilat jan\u00eb shkaqet e ciroz\u00ebs?
\n– a. Shkaku i par\u00eb \u00ebsht\u00eb alkooli. Konsumimi i rregullt i alkoolit p\u00ebr 10-15 vjet \u00ebsht\u00eb shkaku i par\u00eb i shfaqjes s\u00eb ciroz\u00ebs. Shfaqjen e s\u00ebmundjes e p\u00ebrcakton raporti mes sasis\u00eb s\u00eb alkoolit t\u00eb marr\u00eb dhe koh\u00ebzgjatjes s\u00eb helmimit me alkooli. Megjithat\u00eb, pragu i toleranc\u00ebs nuk \u00ebsht\u00eb i nj\u00ebjt\u00eb p\u00ebr t\u00eb gjith\u00eb, pasi secili reagon n\u00eb m\u00ebnyr\u00eb t\u00eb ndryshme.
\nb. Hepatitet virale, sidomos hepatitet B dhe C n\u00eb form\u00ebn e tyre kronike. Ciroza, n\u00eb k\u00ebt\u00eb rast, \u00ebsht\u00eb pasoj\u00eb e nj\u00eb nd\u00ebrlikimi t\u00eb vonsh\u00ebm t\u00eb hepatiteve kronike.
\nc. M\u00eb rrall\u00eb jan\u00eb s\u00ebmundjet metabolike, si hemokromatoza (mbingarkes\u00eb e hekurit), ose e s\u00ebmundjes s\u00eb Uilsonit (mbingarkes\u00eb me bak\u00ebr), t\u00eb cilat mund t\u00eb shkaktojn\u00eb ciroz\u00ebn. N\u00eb raste shum\u00eb t\u00eb rralla, ciroza mund t\u00eb jet\u00eb nj\u00eb s\u00ebmundje autoimunitare. \u00cbsht\u00eb vet\u00eb organizmi q\u00eb e shkat\u00ebrron m\u00ebl\u00e7in\u00eb, duke e par\u00eb si trup t\u00eb huaj.
\n– Cilat jan\u00eb shenjat klinike?
\n– Shenjat klinike t\u00eb ciroz\u00ebs jan\u00eb t\u00eb shumta, si p\u00ebr shembull lodhja, humbja e oreksit, dob\u00ebsimi dhe shenja t\u00eb tjera m\u00eb t\u00eb dukshme. Le t\u2019i marrim me radh\u00eb:
\na. V\u00ebllimi i m\u00ebl\u00e7is\u00eb shtohet. N\u00eb gjuh\u00ebn mjek\u00ebsore, kjo quhet hepatomegali. Mjeku mund ta v\u00ebr\u00eb re gjat\u00eb prekjes s\u00eb m\u00ebl\u00e7is\u00eb, pasi ajo \u00ebsht\u00eb e fort\u00eb, me nj\u00eb an\u00eb t\u00eb \u201cmpreht\u00eb\u201d.
\nb. Ngjyra e l\u00ebkur\u00ebs dhe e mukozave mund t\u00eb b\u00ebhet e verdh\u00eb, me nj\u00eb ikter (verdh\u00ebz).
\nc. Mbi l\u00ebkur\u00eb mund t\u00eb shfaqen angiomat stelare, mini-vari\u00e7e n\u00eb form\u00ebn e nj\u00eb ylli.
\nd. Mund t\u00eb shfaqet nj\u00eb eritem\u00eb palmare: P\u00ebll\u00ebmb\u00ebt e duarve dhe shputat e k\u00ebmb\u00ebve b\u00ebhen m\u00eb t\u00eb kuqe.
\ne. Hipokratizma dixhitale: Deformimi i gishtave dhe thonjve n\u00eb form\u00ebn e shkopave t\u00eb daulles. Thonjt\u00eb b\u00ebhen t\u00eb rrumbullakosur dhe t\u00eb p\u00ebrthyer n\u00eb maj\u00eb.
\nf. N\u00eb bark, mund t\u00eb shfaqen vari\u00e7e.
\ng. N\u00eb stadin e p\u00ebrparuar, barku mbushet me l\u00ebng dhe grumbullohet l\u00ebng intra-abdominal, sidomos n\u00eb kavitetin peritoneal.
\nh. Mund t\u00eb ndryshoj\u00eb gjith\u00eb morfologjia e trupit. N\u00eb stadin e p\u00ebrparuar, personi q\u00eb vuan nga ciroza, nuk njihet: Barku fryhet shum\u00eb, nd\u00ebrsa k\u00ebmb\u00ebt hollohen.
\n– Cilat jan\u00eb shenjat biologjike?
\n– Gjat\u00eb analiz\u00ebs s\u00eb gjakut, shfaqet:
\na. Nj\u00eb pak\u00ebsim i qelizave t\u00eb kuqe t\u00eb gjakut (anemi).
\nb. D\u00ebmtohet funksioni i koagulimit t\u00eb gjakut, me nj\u00eb r\u00ebnie t\u00eb faktor\u00ebve t\u00eb koagulimit, nivelit t\u00eb protrombin\u00ebs dhe faktorit V.
\nc. Kemi nj\u00eb ulje t\u00eb albumin\u00ebs, pra, hipo-albuminemi.
\nGjat\u00eb analizave mikrobiologjike, mund t\u00eb tregohet prania e virusit t\u00eb hepatitit B dhe C, n\u00eb rastin e nj\u00eb ciroze t\u00eb lidhur me nj\u00eb hepatit viral. Pasi sheh q\u00eb bilanci hepatik nuk \u00ebsht\u00eb n\u00eb rregull, mjeku do t\u00eb k\u00ebrkoj\u00eb t\u00eb b\u00ebhen edhe analiza shtes\u00eb.
\nd. Nj\u00eb ekografi e barkut tregon rritjen e volumit t\u00eb m\u00ebl\u00e7is\u00eb dhe ndryshimeve t\u00eb saj n\u00eb form\u00eb e struktur\u00eb.
\ne. Nj\u00eb endoskopi ose fibroskopi gastrike. Me an\u00eb t\u00eb saj, mjeku k\u00ebrkon pranin\u00eb e vari\u00e7eve n\u00eb nivelin e ezofagut. K\u00ebto vari\u00e7e, n\u00ebse \u00e7ahen, mund t\u00eb shkaktojn\u00eb hemorragji t\u00eb r\u00ebnda. Ato duhen trajtuar, q\u00eb t\u00eb evitohet \u00e7arja.
\nf. P\u00ebr nj\u00eb diagnostikim t\u00eb sigurt\u00eb, nevojitet nj\u00eb biopsi e m\u00ebl\u00e7is\u00eb. Merret nj\u00eb most\u00ebr indesh m\u00ebl\u00e7ie dhe analizohet, gj\u00eb q\u00eb b\u00ebn t\u00eb mundur t\u00eb dallohet fibroza dhe nodulet e rigjenerimit.
\n– Nuk ka ndonj\u00eb m\u00ebnyr\u00eb tjet\u00ebr p\u00ebrve\u00e7 biopsis\u00eb, p\u00ebr t\u2019u siguruar p\u00ebr pranin\u00eb e ciroz\u00ebs?
\n– Koh\u00ebt e fundit po p\u00ebrdoret nj\u00eb metod\u00eb moderne p\u00ebr z\u00ebvend\u00ebsimin e biopsis\u00eb. Ajo quhet fibroskan. Sa m\u00eb e fort\u00eb t\u00eb jet\u00eb m\u00ebl\u00e7ia, aq m\u00eb shum\u00eb fibroza ka dhe aq m\u00eb shum\u00eb \u00ebsht\u00eb e p\u00ebrparuar ciroza. Deri tani, vet\u00ebm biopsia tregonte pranin\u00eb e fibroz\u00ebs dhe noduleve. Fibroskani b\u00ebn t\u00eb mundur t\u00eb verifikohet elasticiteti i m\u00ebl\u00e7is\u00eb. Fibroskani p\u00ebrdor nj\u00eb teknologji t\u00eb re q\u00eb quhet elastometria me impulse. B\u00ebhet fjal\u00eb p\u00ebr nj\u00eb lloj vibracioni (ultratinguj), d\u00ebrguar nga aparati, q\u00eb p\u00ebrhapet n\u00eb sip\u00ebrfaqe t\u00eb l\u00ebkur\u00ebs dhe shkon deri te m\u00ebl\u00e7ia. Sa m\u00eb i shpejt\u00eb t\u00eb jet\u00eb shoku, aq m\u00eb e fort\u00eb \u00ebsht\u00eb m\u00ebl\u00e7ia. Matja \u00ebsht\u00eb e shpejt\u00eb, pa dhimbje dhe jo invazive (dometh\u00ebn\u00eb, jo si biopsia). Matja b\u00ebhet p\u00ebr pes\u00eb minuta. Me nj\u00eb fjal\u00eb shpikja e fibroskanit b\u00ebn t\u00eb mundur t\u00eb ndjek\u00ebsh evolucionin e ciroz\u00ebs, pra, edhe efikasitetin e trajtimeve t\u00eb p\u00ebrdorura. I vetmi problem: N\u00eb rast obeziteti, ose fryrjeje shum\u00eb t\u00eb madhe t\u00eb barkut, matja nuk \u00ebsht\u00eb e sakt\u00eb, bile \u00ebsht\u00eb e pamundur.
\n– Cilat jan\u00eb nd\u00ebrlikimet e ciroz\u00ebs?
\n– Pasi \u00ebsht\u00eb diagnostikuar ciroza, i s\u00ebmuri duhet t\u00eb ndiqet rregullisht nga mjeku, sepse megjith\u00ebse evolucioni i saj \u00ebsht\u00eb i ngadalt\u00eb, nd\u00ebrlikimet mund t\u00eb jen\u00eb fatale. Tre nd\u00ebrlikime jan\u00eb t\u00eb mundshme, nd\u00ebr t\u00eb cilat, m\u00eb e r\u00ebnd\u00ebsishmja \u00ebsht\u00eb:
\na. Ashiti. B\u00ebhet fjal\u00eb p\u00ebr nj\u00eb grumbullim t\u00eb l\u00ebngut n\u00eb bark dhe, m\u00eb sakt\u00ebsisht, n\u00eb kavitetin peritoneal, nj\u00eb zon\u00eb q\u00eb normalisht, \u00ebsht\u00eb bosh. Megjith\u00ebse ashiti nuk shkakton dhimbje, ai karakterizohet nga nj\u00eb shtim i madh i v\u00ebllimit t\u00eb barkut. L\u00ebngu mund t\u00eb shkoh\u00eb deri n\u00eb pleur\u00eb (cipa q\u00eb vesh mushk\u00ebrit\u00eb), duke shkaktuar nj\u00eb pleurit.
\nb. Encefalopatia hepatike. B\u00ebhet fjal\u00eb p\u00ebr probleme neuropsikiatrike. Llogaritet q\u00eb 20% e t\u00eb s\u00ebmur\u00ebve me ciroz\u00eb zhvillojn\u00eb nj\u00eb encefalopati hepatike. Ajo mund t\u00eb shkaktoj\u00eb probleme me sjelljen, ve\u00e7an\u00ebrisht me konfuzion, \u00e7orientim dhe inkoherenc\u00eb, somnolenc\u00eb (kur do t\u00eb flesh gjith\u00eb koh\u00ebn) e gjithashtu, me dridhje. N\u00eb rastet m\u00eb t\u00eb r\u00ebnda, mund t\u00eb biesh n\u00eb koma.
\nc. Kanceri i m\u00ebl\u00e7is\u00eb. Mund t\u00eb mos kesh asnj\u00eb simptom\u00eb p\u00ebr shum\u00eb vjet me radh\u00eb, derisa shfaqen shenjat e para. \u00cbsht\u00eb pra e r\u00ebnd\u00ebsishme t\u00eb ndiqet nga af\u00ebr evolucioni i ciroz\u00ebs, p\u00ebr ta diagnostikuar sa m\u00eb her\u00ebt nj\u00eb kancer t\u00eb mundsh\u00ebm m\u00ebl\u00e7ie dhe p\u00ebr ta trajtuar para se t\u00eb shfaq\u00eb metastazat. Duhet patur parasysh se secila nga k\u00ebto nd\u00ebrlikime q\u00eb tham\u00eb m\u00eb lart, mund t\u00eb nd\u00ebrlikohet edhe m\u00eb tej\u2026
\n– Cilat jan\u00eb trajtimet mjek\u00ebsore t\u00eb ciroz\u00ebs?
\n– Nuk ekzistojn\u00eb deri m\u00eb sot trajtime q\u00eb b\u00ebjn\u00eb t\u00eb mundur sh\u00ebrimin e ciroz\u00ebs s\u00eb m\u00ebl\u00e7is\u00eb, pasi d\u00ebmtimet e saj jan\u00eb t\u00eb pakthyeshme. Megjithat\u00eb, \u00ebsht\u00eb e mundur t\u00eb ngadal\u00ebsohet, bile edhe t\u00eb nd\u00ebrpritet evolucioni i s\u00ebmundjes. Kur ciroza diagnostikohet mjaft her\u00ebt, indet hepatike nuk jan\u00eb kthyer ende n\u00eb fibroz\u00eb dhe mund t\u00eb rigjenerohen. D\u00ebmtimet at\u00ebhere mund t\u00eb stabilizohen.
\na. Gj\u00ebja e par\u00eb q\u00eb duhet b\u00ebr\u00eb, \u00ebsht\u00eb ndalimi i menj\u00ebhersh\u00ebm dhe krejt\u00ebsisht i alkoolit. Kur nd\u00ebrlikimet jan\u00eb shfaqur, duhet b\u00ebr\u00eb s\u00eb pari trajtimi i tyre, p\u00ebr shembull me ila\u00e7e diuretike p\u00ebr t\u00eb trajtuar ashitin, me ila\u00e7e betabllokues p\u00ebr t\u00eb kufizuar rrezikun e hemorragjin\u00eb n\u00eb rastin e vari\u00e7eve t\u00eb ezofagut, ose trajtimeve antivirale, n\u00eb rastin e hepatiteve, etj.
\nb. Kur d\u00ebmtimet jan\u00eb shum\u00eb t\u00eb m\u00ebdha dhe m\u00ebl\u00e7ia nuk funksionon fare, duhet b\u00ebr\u00eb transplantimi i m\u00ebl\u00e7is\u00eb.
\nDuhet ditur se m\u00ebl\u00e7ia \u00ebsht\u00eb i vetmi organ i trupit q\u00eb mund t\u00eb rigjenerohet. \u00cbsht\u00eb pra e mundur t\u00eb b\u00ebhet nj\u00eb transplant m\u00ebl\u00e7ie, duke marr\u00eb nj\u00eb pjes\u00eb m\u00ebl\u00e7ie nga nj\u00eb dhurues i gjall\u00eb dhe kompatib\u00ebl. Megjithat\u00eb, n\u00eb shumic\u00ebn e rasteve, transplanti b\u00ebhet me m\u00ebl\u00e7in\u00eb e nj\u00eb dhuruesi q\u00eb \u00ebsht\u00eb n\u00eb gjendje kome (vdekje cerebrale). B\u00ebhen dy nd\u00ebrhyrje nj\u00ebkoh\u00ebsisht: Marrja nga dhuruesi dhe heqja e m\u00ebl\u00e7is\u00eb s\u00eb s\u00ebmur\u00eb te prit\u00ebsi. At\u00ebhere b\u00ebhet transplanti i m\u00ebl\u00e7is\u00eb.
\n– Si mund t\u00eb parandalohet ciroza?
\n– Parandalimi i ciroz\u00ebs ka lidhje me parandalimin e shkaqeve t\u00eb saj. Nd\u00ebrprerja e konsumimit t\u00eb alkoolit \u00ebsht\u00eb i domosdosh\u00ebm n\u00eb rastin e diagnostikimit me ciroz\u00eb. Mendohet se konsumimi i p\u00ebrditsh\u00ebm i 2-3 gotave me pije alkoolike te grat\u00eb dhe 3-4 gotave te burrave p\u00ebr 10 vjet, \u00ebsht\u00eb i mjaftuesh\u00ebm p\u00ebr t\u00eb provokuar nj\u00eb ciroz\u00eb. Parandalimi b\u00ebhet gjithashtu me p\u00ebrdorimin e ila\u00e7eve antivirale n\u00eb rastin e hepatitit B ose C. Hepatiti B i patrajtuar, \u00e7on patjet\u00ebr n\u00eb ciroz\u00eb. Parandalimi i mir\u00eb b\u00ebhet edhe duke aplikuar t\u00eb gjitha masat e parandalimit t\u00eb hepatiteve: Vaksinimet, marrjen e masave t\u00eb higjien\u00ebs p\u00ebr shembull te dentisti, kur b\u00ebn nj\u00eb tatuazh apo pirsing, si dhe mbrojtjen gjat\u00eb marr\u00ebdh\u00ebnieve seksuale.
\nN\u00eb fund, p\u00ebr t\u00eb mbrojtur m\u00ebl\u00e7in\u00eb, n\u00eb rastin e ciroz\u00ebs, duhet t\u00eb mbroheni nga produktet kimike helmuese, duke filluar q\u00eb nga ila\u00e7et helmuese p\u00ebr m\u00ebl\u00e7in\u00eb, si paracetamoli\u2026 K\u00ebto duhet t\u2019i diskutoni me mjekun hepatolog, i cili duhet t\u2019ju evitoj\u00eb ila\u00e7et q\u00eb d\u00ebmtojn\u00eb m\u00ebl\u00e7in\u00eb.<\/p>\n","protected":false},"excerpt":{"rendered":"
Ciroza \u00ebsht\u00eb nj\u00eb s\u00ebmundje e r\u00ebnd\u00eb e m\u00ebl\u00e7is\u00eb, me evolucion t\u00eb ngadalt\u00eb, zakonisht, pasoj\u00eb e nj\u00eb patologjie t\u00eb m\u00ebl\u00e7is\u00eb. Megjithat\u00eb, shkaku i saj kryesor mbetet konsumimi i tepruar i alkoolit, bile edhe para hepatiteve virale kronike. At\u00ebhere, cilat jan\u00eb shenjat paralajm\u00ebruese dhe cilat, trajtimet e mundshme? Lexoni p\u00ebrgjigjet e mjekut hepatolog. – S\u00eb pari, \u00e7far\u00eb […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[49],"tags":[],"class_list":["post-4825","post","type-post","status-publish","format-standard","hentry","category-shendet"],"_links":{"self":[{"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/posts\/4825","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/comments?post=4825"}],"version-history":[{"count":0,"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/posts\/4825\/revisions"}],"wp:attachment":[{"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/media?parent=4825"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/categories?post=4825"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/intervista.al\/web\/wp-json\/wp\/v2\/tags?post=4825"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}